With summer sports starting, comes the return of sports injuries, including head injuries and concussions.  As parents, it is important to understand the signs and symptoms of a concussion as well as their long-term effects.

 

What is a concussion?

A concussion is a type or traumatic brain injury, or TBI, which is caused by an impact of the body with enough force to causes the head and brain to go back and forth.  This rapid movement can cause the brain to bounce around or twist, which can result in damage to brain cells inside the skull.

What are the signs of a concussion?

The signs of a concussion can be immediate or can take hours or even days to present.

Signs that can be observed include:

• Can’t recall events prior to or after a hit or fall.
• Appears dazed or stunned.
• Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
• Moves clumsily.
• Answers questions slowly.
• Loses consciousness (even briefly).
• Shows mood, behavior, or personality changes.As symptoms progress, the individual may report some of the following:

• Headache or “pressure” in head.
• Nausea or vomiting.
• Balance problems or dizziness, or double or blurry vision.
• Bothered by light or noise.
• Feeling sluggish, hazy, foggy, or groggy.
• Confusion, or concentration or memory problems.
• Just not “feeling right,” or “feeling down”.

There are several “danger” signs that need to be recognized and if present, these require immediate evaluation at the nearest emergency room. These include:

• One pupil larger than the other.
• Drowsiness or inability to wake up.
• A headache that gets worse and does not go away.
• Slurred speech, weakness, numbness, or decreased coordination.
• Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
• Unusual behavior, increased confusion, restlessness, or agitation.
• Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.

What is the recovery time from a concussion?

All head injuries should be evaluated by medical personnel.  Currently, there is a minimal time of 5 days before returning to any activities. Although most concussions take only a few days to resolve, some symptoms from a concussion can linger for weeks to months.  Rest is the most important factor in recovering from a head injury.  While resting, it is important to minimize any stimulation to the brain.  Physical activity or any activity that may require concentration, such as doing homework, watching TV, or playing video games, may cause the symptoms of a concussion to return and worsen.  In addition, any activities that cause the head or brain to be jostled, should also be avoided (playing sports, riding a bicycle, riding roller coasters).  Returning to activities too soon can put an individual at risk for greater injury.  If the athlete suffers another concussion before completely recovering from initial head injury, there is an increased incidence of prolonged recovery or even severe brain swelling (second impact syndrome) with devastating or even fatal consequences.

Returning to Sports

The athlete should only be allowed to return to sports once cleared by their health care provider. The Center for Disease Control (CDC) has recently adopted the HEADS UP policy regarding concussion management. These steps should take a few days to be completed.  An athlete should only move to the next step if they do not have any new symptoms at the current step. If an athlete’s symptoms come back or if he or she report new symptoms, this is a sign that the athlete is pushing too hard. The athlete should stop these activities and the athlete’s medical provider should be contacted. After more rest and no concussion symptoms, the athlete can start at the previous step.

HEADS UP STEPS:

Baseline: Back to School First
Athlete is back to their regular school activities, is no longer experiencing symptoms from the injury when doing normal activities, and has the green-light from their health care provider to begin the return to play process.

Step 1: Light aerobic activity
Begin with light aerobic exercise only to increase an athlete’s heart rate. This means about 5 to 10 minutes on an exercise bike, walking, or light jogging. No weight lifting at this point.

Step 2: Moderate activity
Continue with activities to increase an athlete’s heart rate with body or head movement. This includes moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weightlifting (less time and/or less weight from their typical routine).

Step 3: Heavy, non-contact activity 
Add heavy non-contact physical activity, such as sprinting/running, high-intensity stationary biking, regular weightlifting routine, non-contact sport-specific drills (in 3 planes of movement).

Step 4: Practice & full contact 
Young athlete may return to practice and full contact (if appropriate for the sport) in controlled practice.

Step 5: Competition
Young athlete may return to competition.

In summary, even though most concussions are mild, all concussions are potentially serious and can result in prolonged brain damage or even death if not recognized and managed properly.  Remember, you cannot see a concussion and most sports concussions occur without loss of consciousness.  If there is a suspected concussion or your child reports signs or symptoms of a concussion, seek medical attention as soon as possible.  All Illinois schools are now required to follow the IHSA policy which requires written clearance from a physician licensed to practice medicine or certified athletic trainer, working in conjunction with a physician.

Adapted from the CDC and the 3^rd International Conference on Concussion in Sport, in conjunction with the Illinois High School Association

March is Illinois Poison Prevention month!  More than a million American children younger than 6 years old suffer from poisoning every year.  Children are very curious and often explore the world with their mouths- it’s a normal part of their development.  The most common products that children ingest include household cleaners, personal care products, and over-the-counter medications.  Vitamin pills, especially containing iron, and Aspirin are typically safe for adults, but can cause serious reactions in a child’s body.

Keep detergents and other hazardous cleaning products out of reach of children or securely locked in a cabinet that your child cannot open.  Keep all products in their original containers to avoid confusion.  If ingested, these products can cause serious burns to your child’s mouth, feeding and breathing tubes.

If you suspect poisoning, some signs can include vomiting, an unexplained odor from their mouth or on their clothes, or a burn on their skin.  Before attempting any at home remedies, please call Poison Control right away.  If your child has any trouble breathing or has passed out call 911!

Grandparents tend to take more pills!  Make sure they keep all caps on bottles, and that the bottles are kept out of reach of children.  Child resistant caps do not always mean they are child-proof!  If they use a pill organizer, make sure this is kept in a secure place.  For any adult please avoid taking medications in front of a child, because they may try to imitate you later on.  Also, never call a medication “candy.”

Having a Party? Make sure to keep alcohol in a locked cabinet, and empty and rinse any containers immediately after gatherings to prevent alcohol ingestion by your child.

Please keep the Poison Help line handy in case you encounter one of the above situations.  Put the number in your cell phone or stop by the office to pick up a magnet for your fridge!  No question is too silly, they have probably heard it before (eating bugs, diaper cream, a plant, even poop to name a few!).  If you’re unsure, it’s better to be safe and call:

For more information:
http://illinoispoisoncenter.org/
http://ipcblog.org/
https://www.healthychildren.org/English/safety-prevention/all-around/Pages/Poison-Prevention.aspx

In the 1960’s after a long day of school and work families would come home unwind over dinner and talk about their day.  The kids would go outside to play weather permitting or play a game inside, listen to the radio or read before going to bed.

Fast forward to 2017 after a long day of school/daycare or work families are rushing to figure out what to feed the kids for dinner.  We turn on the TV or hand our children their tablet and let them distract themselves.  How about the car ride to school or the store? …. We give them distractions to keep them occupied.  What happened to talking, or listening to music, or just looking out the window in the car.  We constantly have the need to fill our time with something (adults included).  Children who aren’t allowed to experience boredom or are constantly entertained with electronics continue to feel that need as they get older and become adults. Like other addictions it becomes harder and harder to fill that need.   It’s important for children to learn to be comfortable with quiet.   It allows them time to think, be creative, use their hands, read, ect.   We all lead busy, hectic lives and I struggle as a parent trying to find ways to keep my children occupied while getting dinner on the table and raise well rounded kids in the age of the electronics.

There are great learning activities and fun apps for children to use but these things can’t replace talking with our children or one on one time interacting with them on the floor.  Research has shown that children learn best from in-person interactions where they can interpret facial expressions and body language. Children who have larger amounts of screen time (even TV on in the background) have higher rates of language delay, problems with attention, sleep, eating disorders, and obesity.  The American Academy of Pediatrics recommends no screen time for children under 2 and less than 2 hours a day for all children and teens

Teens and Social Media

Multiple studies have shown that adolescents who spend larger amounts of time on social media or who are more “emotionally invested” in social media have higher rates of anxiety and depression.  Look at your children’s’ news feed or your own for that matter.  We are bombarded with constant images of how great everyone else’s lives seem to be or conversely by the tragedy and violence in the news.  This can have long lasting impact on a developing brain.

People are less filtered on social media and are more likely to make negative comments about others. Cyberbullying occurs more often than we realize and continues after school hours.  This form of constant viscous bullying can have serious, even deadly consequences.

Our teens are comparing their lives to their peers and can develop the feeling that their own life is not quite good enough. Body image issues can arise from constantly seeing photo-shopped revealing pictures of men and women in the media.  We are also finding that children have more difficulty with social skills because they have gotten accustomed to texting friends and less in person or verbal interactions.  Teens also have less restful sleep from alerts on their phone which they often will respond to in the middle of the night The Internet also can be a gateway for risky behaviors. Monitor what your child is seeing and reading on the internet.

Technology keeps us connected in ways that weren’t possible before, but more disconnected in many ways.  There are many great things about the internet such as having access to unlimited information and the ability to connect with people across the world.  The internet and social media are a tool, but it can become an obsession or an addiction that has an impact on our mental health.

“It is the mini-moments of disconnection, when parents are too focused on their own devices and screens, that dilute the parent-child relationship,” Dr. Steiner-Adair warns. And when kids start turning to the Internet for help or to process whatever happened during the day, you might not like what happens. “Tech can give your children more information that you can, and it doesn’t have your values,” notes Dr. Steiner-Adair. “It won’t be sensitive to your child’s personality, and it won’t answer his question in a developmentally appropriate way.”

Our children need us to be present in their lives. They notice when you are distracted by your phone and not focusing on them and they begin to model that behavior themselves.  Create a “phone and screen free time” for your family.  Establish at least one hour where no one picks up the phone or turns on the screen.  Remove TVs and phones from the bedroom at night.   Turn of the background noise TV and allow there to be silence, or music, or talking especially at dinner time.

If you have any questions on this subject, always feel free to call us at the office at 847-398-0400.

If you can believe it, it’s October already, and that means Halloween is coming! Kids often spend months deciding what they’d like to dress up as, days getting ready, and hours out trick or treating (followed by days of enjoying their candy hauls). What steps should parents take to make sure kids stay safe and healthy this Halloween? Now’s a good time to review some basic tips to keep the festivities fun and safe.

Let’s start with the costumes. Halloween gives your children a chance to make their imagination come to life. Costumes seem pretty straightforward, just another outfit, but we want to be sure it’s a safe one. How do we do that?

• Look for fire resistant materials and nontoxic makeup and accessories
• Visibility is key, so try to stick to light/bright colors or add reflective materials if needed
• Make sure everything fits appropriately, and make alterations if needed (no tripping hazards!)
• If using a hat or a mask, make sure it won’t block your child’s vision
• Skip the costume shoes, especially if they fit poorly. You’ll be better off sticking to sneakers.

 Now that you’ve got your costumes ready, it’s time to head out for Halloween’s most beloved tradition: trick-or-treating.

• Make sure trick or treating is well supervised and takes place on a planned route
• Keep to sidewalks and well-lit areas (beware of cars and cyclists)
• Carry a flashlight
• Remind your children to never enter a stranger’s house
• Pay attention to the weather and dress appropriately even if it covers up the costume! Some years it’s frigid on Halloween, if so limit time outdoors.
• Finally, remember to stick to the official hours for trick or treating. For most local villages this is 3pm-7pm on 10/31, but be sure to check for your specific area.

So much sugar! Sure going around trick-or-treating is fun, but now you’re left with bags full of candy. What to do with it?

• Once you’re back home, inspect all of the candy and throw away anything unwrapped or spoiled
• Ration your candy. Try to avoid the stomachache that often comes after overdoing it on Halloween. You can limit your child to picking 1-2 pieces at a time or make it into a reward system for household chores, etc.
• Consider donating some of the excess sweets. There are various organizations that will accept wrapped Halloween candy, for example:
  • Operation Gratitude (https://opgrat.wordpress.com/2013/07/18/halloween-candy-for-the-troops/)
  • Operation Shoebox (http://www.operationshoebox.com/how-you-can-help/candy-donations/)
  • Halloween Candy Buyback (http://www.halloweencandybuyback.com/)
  • Local shelters and food pantries

Hopefully you’ll find some of these tips helpful for a safe holiday, we wish your family a very Happy Halloween!

If you have any questions, please do not hesitate to contact our office at 847-398-0400.

Here at APL, we want everyone to look their best!  Acne, or pimples, is a normal part of being a teenager, but your teen may be concerned about their acne or even embarrassed by it.  Acne is caused by a combination of increased oil production, dead skin cells, bacteria, and inflammation.  This leads to blackheads, whiteheads, and deeper pimples or nodules.  There are numerous over the counter and prescription medications for acne to treat all of the different causes.  We recommend starting the conversation about acne here at APL!

Some common myths are that foods such as chocolate or fatty foods cause zits.  These are not true!  We always want your child to eat healthy, but your child’s diet is not related to their acne.  Some people think that sunlight improves acne.  This is not true either!  It is especially important for your child to wear sunscreen to protect their skin from damage and skin cancer.  Another myth is that you are supposed to pop pimples…unfortunately this leads to more inflammation which can make the pimple worse, and can lead to scarring of the skin.  I know it is tempting, but don’t pop the zits!

Initial treatment of acne includes washing the face with soap and water and the use of a topical cream or gel.  If your child has acne on their chest and back, we may suggest a medicated body wash or even a pill to take for the pimples.  Females can have hormonal related pimples that flare during certain times of their cycle, and if the above treatments don’t help, then sometimes we try a daily hormone pill.  Some teens with severe scarring or severe acne may need stronger treatments, and in those cases we may refer your child to a dermatologist.

Unfortunately, acne treatments are not a quick fix.  It can take up to 6 weeks for a medication to start working and for the skin to look improved.  Actually, sometimes the acne can look worse at first before it gets better.  It is important to be patient and still apply the zit cream every day.

Again, lots of pimples can be embarrassing and can cause problems with your teen’s self-esteem and mood.  If your child is bothered by their acne, let’s talk about it at their upcoming physical, or feel free to schedule an appointment so we can create an individualized “Acne Action Plan” today!

References:

http://www.healthychildren.org/English/ages-stages/teen/Pages/Zits-are-the-Pits-How-Parents-Can–

Leung, Barankin, Hon.  “Adolescent Acne Vulgaris. An Overview of Therapeutic Options.”  Consultant for Pediatricians.  February 2015.