Premier Pediatrics - Newsletter February 7, 2012

We would like to thank our sponsors for their financial support: Good Shepherd Medical Center, Ken Martin Audiology, Target of Longview, Open Imaging, Dr. William Rotzler, Dr. Todd Holman and Premier Pediatrics.

We are always looking for book donations and volunteers to read in the waiting area. For more information about the program, check outwww.reachoutandread.org. We have distributed almost 4000 books since we initiated the program here April, 2011!

Osgood Schlatter Disease

Osgood Schlatter Disease is a condition that causes localized pain and swelling over the growth plate at the tibial tubercle (the hard bony bump below the knee cap on the shin bone). This area is where the quadriceps muscle attaches to the lower leg by way of the patellar tendon. The pain is caused by overuse of the knee and legs. The pain may be worse with contractioon of the quadriceps muscles.

The most common age for Osgood Schlatter is young boys (11-15 years) that are usually active in sports where the knees are used to run, jump, or squat. This could include basketball, track, football, or basketball. The pain and swelling appears in times of growth spurts. The pain could be precipitated with a traumatic event or occur without trauma to the knee or leg.

Osgood-Schlatter Disease is diagnosed based on a thorough history and physical exam, and on exclusion of more serious causes such as ligament or tendon tears. X-rays of the knees may be taken to rule out any fracture to the bones of the knee; however radiographs are nonconclusive in diagnosing Osgood Schlatter Disease.

Osgood Schlatter Disease is treated by resting the affected leg. This means decreasing the activity or sport for 2-3 months or until the child is asymptomatic. Using the RICE method of rest, ice, compression, & elevation after use of the leg will decrease the inflammation at the tibial tubercle and therefore decrease the pain. Ibuprofen or Acetaminophen can be used to treat the pain and inflammation. A neoprene knee brace may provide symptomatic relief when exercising or playing sports.

Disciplining with Time Out

Choosing a Location

Choose a place away from toys, people, TVs, radios, windows and anything else entertaining. There should be no breakable objects nearby. It is best to have children sit in an adult chair during time out. Never turn off the light, as you don't want to scare the child.

· Best Places Hallway

Parents Bedroom

Kitchen Corner

· Least Effective Child's Bedroom

· Unacceptable Places Bathroom

Closet

Dark Room

Time Out Steps

1. Issue a command.

2. If your child does not obey the command within 5 seconds, issue a warning: "If you do not _____, you will go to time out."

3. If your child does not obey the command within 5 seconds, state: "Because you did not ______, you must go to time out."

4. Remain calm and lead your child to time out without lecturing, scolding, or arguing.

5. Ignore shouting, protesting, and promises to obey. Do not speak to your child at this time.

6. Tell him/her to sit in the time out chair. If he gets up tell him the time out period will start over.

7. When he is sitting quietly, set the timer for the appropriate length of time (1 minute for each year of age).

8. When the time out is over, including being quiet for the last 30 seconds, return to the chair and tell him the time out is over. Do not nag or lecture the child as to the reason he went to time out.

9. Restate the original command. If the child obeys, praise him.

10. If the child does not comply, implement the time out again.

Time Out Problems and Solutions

It is recommended that parents use time out only in the home parents and their children learn the steps. When children consistently take time outs with little fussing, then start using it outside of the home. In places where chairs are not available, use a corner, a step, a specific tile, etc. Never leave your child unattended in a public place.

· Refusing to go to the chair - Carry him with legs facing away from your body.

· Refusing to sit in the chair - Do not start the time out until he is seated.

· Leaving or moving the chair - Stop the timer until he sits down. Place him in the chair, tell him to stay, and place your hand on his leg.

· Insulting you - Ignore the yelling and crying.

· Refusing to leave time-out - Start time out over.

· Sibling interacting with the - Put the sibling in time out in another location.

Traveling with Children

Traveling with children can be unsettling for all parents. It always seems that the entire house is needed. There are clothes, diapers, formula, soaps, safety devices, entertainment, extra batteries, pillows, blankets, snacks, electronics, and even medications to be considered in our absolute can't do without list.

To help with the packing, we recommend you make that list and store the items in one area at least 3-4 days prior to your departure. If your child needs medications ensure that you have a clearly written prescription label with the name of the medication and how it is give. We do not recommend medications to sedate children for traveling in airplanes. Instead ensure that you have a bag packed with games, snacks, books, pencils, and other items appropriate for the age of your child. The airlines will allow you to board early and will assist you to make the trip less stressful for all.

If you are traveling abroad make an appointment with your provider several weeks prior to your departure to receive vaccines, medication refills, and letters to the airline of any special dietary needs or accommodations for your child.

Due to Measles outbreak in other countries, it is currently recommended that children 6 months and older receive MMR vaccine prior to their travel.

Infants 6-11 months should receive 1 dose of MMR prior to departure.

Children 12 months and older should have 2 doses of MMR vaccine separated by at least 28 days.

It may be necessary to begin malaria prevention with oral medication several weeks prior to your departure, while in the other country, and after your return. We recommend you visit the following website: www.CDC.gov/travel to assist you with a safe and healthy trip.

If you are traveling by car, ensure that your child is in an appropriate car seat for his/her size and weight. The AAP recommends all children under the age of 2 are rear facing in a weight appropriate seat.

Infant seats are used for children weighing 22-35 pounds.

Convertible seats can be used rear or forward facing and support toddlers up to 40 pounds.

Booster seats are used for children up to age 12 who weigh more than 40 pounds and are less than 4 feet 9 inches tall.

Community Events

Each year Premier Pediatrics participates in Relay for Life to raise money for the American Cancer Society. We invite you to join us in the fight against cancer!

Relay for Life 2012 is set for April 27th from 5pm -5am. The theme this year is "How sweet it is to relay".

Thanks for helping us raise nearly $800 for ACS through our "Strike Out Cancer" bracelet fundraiser.

Follow Premier Pediatrics on Facebook - just like us on our page.

Thank you for allowing us to participate in the care of your children!

Sincerely,

Premier Pediatrics