This blog informs the public about information key to pediatric specialists in the Houston and East Texas area. Dr. Rotenberg serves as the editor. Independent MD/PhD pediatric specialists are invited to participate. These physician specialists welcome patients who require attention. This blog will be relevant if you want to learn more about an illness affecting a child, teen or young adult.
Houston Area Pediatric Specialists
Monday, February 3, 2014
No technology helps kids get healthy sleep
Here's the scenario: A child is glued to his Xbox, or maybe his iPhone or iPad and won't go to bed. Frustrated, mom or dad gives up the fight and walks away, letting the kid play just a little longer -- even though it's a school night.
But an expert on children's sleep says parents need to buck-up.
Dr. Daniel Lewin, associate director of Pediatric Sleep Medicine at Children's Medical Center, says he too has a child who wants to be on the computer constantly.
"It's simply modeling and limit setting, which is critical," Lewin says.
It comes down to parents limiting their own exposure to electronics, especially while in front of children. This helps show the behavior they'd like their kids to mimic.
Lewin says in a culture with constant access to electronic media, there's a lot of pressure to perform.
But "those kids who are on media devices to do their homework and when that's done right before bedtime they're impacting their sleep," says Lewin.
When it comes to kids, Lewin recommends making sure the electronics are off at least an hour before bedtime. That's because the light actually shuts down the biological process that initiates sleep.
"Sleeping with a dim light in the bedroom is fine. But sleeping with electronics on in the bedroom is really not optimal," Lewin says.
For children who take ADHD medication, Lewin says it's extra important to make sure he or she is getting a good night's sleep.
"Getting enough sleep at night is critical for attention, for regulation of emotion," says Lewin. He says it's really important to be able to recognize the signs of sleep disorder and to recognize the signs of inadequate sleep.
"We have a lot of kids who are on ADHD medications. We could start by optimizing sleep before putting kids on medications. Some certainly need it," Lewin says.
There's also a relationship between sleep deprivation and mood, including suicidal thoughts. Chronic sleep deprivation can lead to high blood pressure, strokes and Type 2 diabetes.
Children around the ages of 12 and 13 should get 9.5 to 10 hours of sleep. Older children and adolescents should get about 9.5 hours of sleep.
And, Lewin adds, "The American Academy of Pediatrics has been very clear: no TVs in the bedroom and no electronics in the bedroom absolutely critical."
Read more here
Saturday, February 26, 2011
Babies and grandmas: Who will Texas' Medicaid cuts hurt? All of us - but the oldest and youngest most of all
Babies and grandmas: Who will Texas' Medicaid cuts hurt? All of us - but the oldest and youngest most of all
.....
It comes up in meeting after meeting, e-mail after e-mail, from group after group, from outfits representing senior citizens, the middle class, children, the court system, hospitals, doctors, universities, the mentally ill and public schools. The budget-slashed, rainy-day-fund-untouched Texas that our Legislature is contemplating wouldn't be just a mean, hard place for our families to live. It would be an inefficient one, too — and one whose problems this budget will only make worse.
The proposal to cut reimbursements paid to Medicaid providers by 10 percent is pure pound-foolishness. And its horrifying long-term costs will hit us all.
Copyright 2011 Houston Chronicle
Feb. 2, 2011, 11:37PM
To read the entire editorial
http://www.chron.com/disp/story.mpl/editorial/7410555.html
Tuesday, November 2, 2010
November is Epilepsy Awareness Month - Get the Seizure Facts
Get the facts about seizures and epilepsy!!Seizure First Aid Do you know what to do?
From Dr. Rotenberg, Child & Adolescent NeurologistBoard Certified Epileptologist
Member American Epilepsy Society
www.txmss.com - 714-464-4107
Find out How Seizure Smart You Are and Take the Quiz!
Thursday, October 14, 2010
Great Site for the Autism Industry Skeptic
What does this mean? Diagnostic tests are performed using validated and standardized techniques. As a result, you get similar results in different labs.
Would you build a bridge with non-standard techniques? Would you fly in plane fixed with non-standard techinique?
Why would you treat a child based on such methods?
Great Site for the Autism Skeptic - This is a great one stop shop for rational inquiry.
http://www.autism-watch.org/
CHILDHOOD SLEEP APNEA LINKED TO BRAIN DAMAGE, LOWER IQ
---“A Wake-Up Call” for Parents and Pediatricians--
In what is believed to be the first study showing neural changes in the brains of children with serious, untreated sleep apnea, Johns Hopkins researchers conclude that children with the disorder appear to suffer damage in two brain structures tied to learning ability.
Writing in the Aug. 22 issue of the global online journal Public Library of Science Medicine, the Hopkins investigators say they compared 19 children with severe obstructive sleep apnea (OSA) to 12 children without the disorder. Using a special type of MRI, researchers identified changes to the hippocampus and the right frontal cortex. Next, using IQ tests and other standardized performance tests that measure verbal performance, memory and executive function, researchers were able to link the changes in the two brain structures to deficits in neuropsychological performance.
The hippocampus, a structure in the temporal lobe, is vital to learning and memory storage, while the right frontal cortex governs higher-level thinking, such as accessing old memories and using them in new situations.
“This should be a wake-up call to both parents and doctors that undiagnosed or untreated sleep apnea might hurt children’s brains,” says lead author Ann Halbower, M.D., a lung specialist at the Johns Hopkins Children’s Center. “This is truly concerning because we saw changes that suggest brain injury in areas of the brain that house critical cognitive functions, such as attention, learning and working memory.”
Link to article http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0030301
Site - http://www.hopkinsmedicine.org/press_releases/2006/08_21_06.html
Friday, August 27, 2010
Symptoms of a seizure can be subtle...
A seizure is usually defined as a sudden alteration of behavior due to a temporary change in the electrical functioning of the brain, in particular the outside rim of the brain called the cortex. Below you will find some of the symptoms people with epilepsy may experience before, during and after a seizure. Seizures can take on many different forms and seizures affect different people in different ways. It is not implied that every person with seizures will experience every symptom described below.
Seizures have a beginning, middle, and end
When an individual is aware of the beginning, it may be thought of as a warning or aura. On the other hand, an individual may not be aware of the beginning and therefore have no warning.
Sometimes, the warning or aura is not followed by any other symptoms. It may be considered a simple partial seizure by the doctor.
The middle of the seizure may take several different forms. For people who have warnings, the aura may simply continue or it may turn into a complex partial seizure or a convulsion. For those who do not have a warning, the seizure may continue as a complex partial seizure or it may evolve into a convulsion.
The end to a seizure represents a transition from the seizure back to the individual’s normal state. This period is referred to as the “post-ictal period” (an ictus is a seizure) and signifies the recovery period for the brain. It may last from seconds to minutes to hours, depending on several factors including which part(s) of the brain were affected by the seizure and whether the individual was on anti-seizure medication. If a person has a complex partial seizure or a convulsion, their level of awareness gradually improves during the post-ictal period, much like a person waking up from anesthesia after an operation. There are other symptoms that occur during the post-ictal period and are detailed below.
Please note: Below is only a partial list, some people may experience other symptoms not listed below. These lists are meant to help patients communicate with their physicians.
Early seizure symptoms (warnings)
Sensory/Thought:
Deja vu
Jamais vu
Smell
Sound
Taste
Visual loss or blurring
Racing thoughts
Stomach feelings
Strange feelings
Tingling feeling
Emotional:
Fear/Panic
Pleasant feeling
Physical:
Dizziness
Headache
Lightheadedness
Nausea
Numbness
No warning: Sometimes seizures come with no warning
Seizure symptoms
Sensory/Thought:
Black out
Confusion
Deafness/Sounds
Electric Shock Feeling
Loss of consciousness
Smell
Spacing out
Out of body experience
Visual loss or blurring
Emotional:
Fear/Panic
Physical:
Chewing movements
Convulsion
Difficulty talking
Drooling
Eyelid fluttering
Eyes rolling up
Falling down
Foot stomping
Hand waving
Inability to move
Incontinence
Lip smacking
Making sounds
Shaking
Staring
Stiffening
Swallowing
Sweating
Teeth clenching/grinding
Tongue biting
Tremors
Twitching movements
Breathing difficulty
Heart racing
After-seizure symptoms (post-ictal)
Thought:
Memory loss
Writing difficulty
Emotional:
Confusion
Depression and sadness
Fear
Frustration
Shame/Embarrassment
Physical:
Bruising
Difficulty talking
Injuries
Sleeping
Exhaustion
Headache
Nausea
Pain
Thirst
Weakness
Urge to urinate/defecate
If you or someone you know has the symptoms listed above -- you are not alone.
Adapated from: Schachter SC, editor. Brainstorms: epilepsy in our words. New York: Raven Press; 1993; and Schachter SC, editor.The brainstorms companion: epilepsy in our view. New York: Raven Press; 1995..