Focus 580; Childrens Health

Good morning welcome to focus 580 our morning talk program my name is David Inge. Well they have you with us. Please step back here on the program Dr. Robert Boe check He's a pediatrician that has been with us monthly for a long time to answer questions about children's health and we're open to whatever's on your mind as long as it's the kind of thing that you talk about with a pediatrician. The number here in Champaign Urbana 3 3 3 9 4 5 5. And we also do have a toll free line so that if it would be a long distance call we'll pay for the call that's 800 to 2 2 9 4 5 5 at any point here you got questions you can call us. Thanks for being here. Good morning it's good to be back. I think I want to just for a second talk about flu because there has been some reporting we had a piece on this morning on NPR and people may have seen stories about after the big concern about shortage of vaccine. Now apparently there are some places around the country they actually have a surplus. They have vaccine that they haven't given out. And I was talking about this the other day with Dr. Jeff Dr. Jeff where engine or family practice guy from Karl and I said Well over at your shop you know have you given out all the vaccine that you've got. And he said they

did have some. He didn't he didn't make it sound like they had a lot but he said he did have some. They still did have some and they still are trying to make sure that. The people who are in the high risk groups are vaccinated. So for four people of your of your concern for the pediatric patients that's just one more time say OK who should who should be vaccinated. OK. Basically in pediatrics it's pretty much the same as adults. Anybody with a chronic disease like asthma heart disease diabetes and other chronic disease like that probably arthritis and those kinds of chronic diseases no but anybody with that with that with a cardiovascular pulmonary component of their disease probably out it would be at risk to get the vaccine and diabetes because fear is an illness is kind of does funny things to diabetes and tends to get people in trouble because it interferes with their food intake and their food intake and and they get a lot more problems

that way you know. The other thing I guess it doesn't surprise me that we have extra flu vaccine. Maybe this year it was compound it a little bit by the fact that a lot of people who weren't in the high risk list didn't get it. But in past years when we've had a plentiful supply of vaccine people even those who should have gotten it weren't getting it. So we still end up with a lot of throwing it away. We still end up throwing it away because this year's vaccine is probably not going to be adequate for next year's vaccine so hopefully we've yet we've seen the problems that can happen when one producer can't produce. So next year folks. Hopefully they'll be a good supply of vaccine. Follow the recommendations and especially those that rich should get it anyway who doesn't want to get the flu should get it. What what have you heard just about the champagne Urbana area. Or have you heard anything about how much there is that still

available. I haven't heard anything about Champaign Urbana area I think there is very. I think there's I don't think there's a big surplus in Champaign-Urbana. That's got of what I thought but people are still concerned they can all this of course contact their doctor they can contact the champagne Urbana public health district and if they have any questions yes. We have a couple of callers here let's talk with someone in Matewan to start on our line number four. Hello good morning. Hopefully you can address this I am a grandfather of two 20 year old fraternal twin girls. They were delivered about six weeks early and they are perfectly fine healthy happy and really almost as their mother says almost too smart for their own good. However they really aren't using words yet they babble they talk they vocalize with each other and they actually seem to understand each other. OK. And you know I don't it's nothing anybody is overly concerned but we're just

I'm just curious as to is this normal and the situation and you know is there a point where you should start becoming a little concerned. OK. Twins can do it. I've never I have inspirationally seen this but twins apparently can develop a private language between one another. That's what we've read. And so that doesn't particularly disturb me. But I guess the other question though as do they understand you. Oh yes. And will they follow directions in that. Yes they well so then you say OK. Their input is ok their hearing is probably normal or reasonably normal and they have language in that they understand spoken language and they talk to each other in their own language so you say you know I think yeah I think they're going to be fine. I think they just need some more time. OK well that's that's what we're all kind of figuring but you know you just you just keep kind of keep

waiting for the words and I mean you know they think these words say Mommy and Daddy and OK. And so there are some words that are there but we thought that you know they might be you know maybe like another child who was born about the same time. Full term it's got like a 30 word vocabulary. Yeah an 18 month old just to have single words maybe some more putting than actually usually most 18 month olds are 20 month old or just using some single words and put I think it's hard to hear. It always drove me a little bit crazy to have people say to counter the counter child's vocabulary you say gee don't you have anything better to teach. Yeah. All right well we weren't concerned yet but I just thought I'd call and see if there was a time when we should start looking at it. Yeah I think I just keep watching them. But I think the twinship is probably intervened in their in their American English language development. It sounds like they've Yeah these twins

have got their own way of communicating with each other that's private. We don't understand it. You know they think I mean one well will chatter away and then the other will you know answers will get attention and go for it. You can go off and do something and or get something and bring it back. Makes you wonder what they're saying about you don't you know. All right thank you very near Well thank you for the call. Let's go on here and next we'll talk with someone I believe here in urban one number one. Hello hello. The previous question about the flu vaccine in quantity it's my understanding that it is that we have over supplies anywhere now but there's underuse that people have decided it's so late in the season they weren't able to get the vaccine at the normal time and now it wouldn't be any point in using it. Am I right in that. Probably partially. And in your you're right and that's a right and that's

wrong thinking. If you haven't had the flu if you haven't had influenza it's not too late to get the vaccine. There hasn't been much flu yet. No there hasn't. And it yeah December is about as early as we see it but it's probably not the prime month probably January is the prime month. So to get full benefit you need about 6 weeks from the time a vaccine is injected until exposure. But you'd have a good deal of benefit even among for a few weeks after. Actually you probably need 10 days to two weeks. Also it's not nearly as bad as a no. If if if you're a child a young child who's probably never had influenza. I mean all yeah like we said this year's influenza next year's influenza will be a different type than this year's influenza but there's still some commonality. So the dose for next year will be sort of a booster dose. It'll have specific antibodies to

the strain that's into dissipated next year but but to a certain extent they're all related so so it is sort of a booster booster primary dose it's a funny thing it's a kind of a combination So yeah about 10 days you you probably have some immune response already. So that's still quite important even for healthy people to take it because. It reduces the prevalence of the infection and reduces the danger to people who actually are very susceptible. Yeah Personally I'm not on the high risk list but if I hear that there is a surplus that they're opening it for anybody who wants it I will try and be the first in line. Well I just want to make that clear because I have the understanding that many people didn't understand it would still benefit. Thank you all. You're welcome to go. You know the other thing I had there was an article published in Pediatrics a couple of months ago and they were looking at young children who were definitely at the at risk group and what they

found is probably only 20 to 30 percent were getting it were getting the vaccine when they were they had diabetes they had severe asthma they had congenital heart disease whatever they were on the list that should get only 25 to 30 percent were getting it. This article put the blame on pediatricians that the pediatricians weren't reminding people well yeah ok Petri deserve part of the blame but if the child comes in for their annual visit in May. I'm probably not likely to think about the flu vaccine in May. Specially since we don't get it till October anyway I'm just not likely to think about it so I think here again. Parents have to take pediatricians need to take responsibility. Parents and caregivers need to take responsibility too my child is at risk. I remember once when the pediatrician said they should get the flu vaccine. Gee he forgot to remind me that he or she forgot to remind me this year but it's flu vaccine time my child has a

chronic disease and I got to get him in line to get the vaccine. Other questions are welcome 3 3 3 9 4 5 5. Toll free 800 to 2 2 9 4 5 5 Our guest is Dr. Robert pediatrician. He's with us age month always on Thursday we talk about children's health think you have questions you can give us a call. I want to also ask you about this obviously something we talk about a lot before but let's talk again a little bit about a whooping cough. Just for sort of for two reasons one over all that earlier this fall the CDC was talking about the fact that they're seeing the highest number of cases in quite a few decades. And I do recall recently within the last week or something seeing and. It's article in our local newspaper about the fact that there had been an uptick in pertussis and will be cough locally. So maybe again it wouldn't be such a bad idea just sort of talk about well what else is it. There is a standard part of the

standard package of vaccinations that kids get for it. That's packaged up with a diphtheria tarea tetanus DPD. So let's talk a little bit about whooping cough. OK. Whooping cough is a it's a it's an illness caused by border tella pertussis must have changed the name which they do periodically change the name of bacteria it causes a prolonged cough. It's May we worry about it. It can be have a high mortality morbidity in the first year of life the immunization starts at six to eight weeks. That one may not do much of anything it may add Zorba the antibodies that the baby is carrying from the mother so that one may not do a thing the second one is given eight weeks later and that one probably starts the immunization ball rolling. After five years of age we no longer immunize against

pertussis because the sight of the fact of the vaccine is it gives you a good sore arm and fever and yeah the side effects are not pleasant and it will Asia for three days so we just don't immunize after age 5 or 6 to pertussis anymore. So we've got this big and the vaccine lasts for about 10 years or so it's protected for about seven to 10 years or something like that. So we've got a huge pool. We've got most of the population that is susceptible to whooping cough or pertussis. And I'm not sure what the statistics are. What the statistics mean that were that more is reported is that because more doctors are looking for it and doing the appropriate lab tests and diagnosing it because we know that it exists in say after age 12 or so it anybody can get it and it's probably always existed in the and yet what we really want and for the

older child adult it's kind of a it's a darn cold that lasts for a darn long time with the bad cough that lasts for a darn long time and the cough doesn't have the whoop associated with that. And that's how it got its name because the young children when they cough they cough they cough they cough until their lungs are compared. Mostly running out of air and then they take this big inspiration and it sounds like a whoop. It can be quite severe in adults it's it's a nuisance but it's mortality and morbidity are very very low. So we do need to make sure our young children are immunized because we need to protect them because that's where the danger lies. We can't do anything about the adults at this time we don't even know if the adults at this time so we're just going to have to live with that and I'm not sure that yet the increase in cases in the population after age 12 is is particularly newsworthy except to remind us that the disease is out there

and we do need to protect our infants and young children where the disease is much more serious. Well one of the things that I and some of the things that I've read about this sort of pointed out the fact that as you say first of all that we don't immunize after body age sex. Consider five or six and that the immunity from the vaccine lasts for about a decade and that what some of these recent studies have pointed out from CDC is that a good a pretty healthy percentage like something around 40 percent now of the people who are getting it are between 10 and 19. And so I guess some people are raising this question of well do do we want to think at all about re immunizing but it sounds it sounds what you're saying is well probably the answer is no and that we don't really need to worry about them is that because it's not life threatening. Yeah except that that may change because we now have the so called a cellular pertussis vaccine the old protests that scene they took the bacteria

they killed it they chopped it up and they just injected the whole bacteria. And we now have a cellular pretends that scene where they've taken what they think are significant and Egyptians or significant parts of the bacteria. That if we make antibodies too we will protect ourselves against whooping cough. And so the vaccine is so-called a cellular now. The side effects are much lower. It's a much better tolerated vaccine and they're looking at whether adults will tolerate this. And so it may be in the future everybody supposed to get a diphtheria tetanus booster every 10 years for the rest of your life. If you live to be 120 every 10 years just to get a diphtheria tetanus will that change in the near future to diphtheria tetanus a cellular pertussis vaccine. So again we can protect the older children adult population from getting pertussis and keep them from the nuisance of six weeks of a cough. And also that way further protect the young children who

for whatever reason didn't get immunized. We have somebody else to talk with. Let's do that. Champagne wine one asked Dr. voters. I have got my first my hat to Chris ever heart. How to get. Well I guess the question is is he is he at risk. Is he at high risk again does he have. Yeah he's probably over 65 I think. So he falls into that category but does he have any other risk factors does he have any chronic diseases heart disease lung disease diabetes or anything like that. And is he one of those that saying OK I meant the high risk pool because I'm over 65. But I have no other risk factors since there's a

shortage of vaccine. I will I will forego it this year to save that dose for somebody who's more risk than I am and I betcha that's what I'll bet you that's what his thinking is. And to a certain extent I salute him for his. Sacrifice and generosity and otherwise if the spouse can't convince who is going to be off. He's a big boy Jim and Jan of you can't even fathom who is going to write very good other questions are welcome 3 3 3 9 4 5 5. That's for champagne Urbana listeners toll free 800 to 2 2 9 4 5 5 that's the toll free and our guest is Dr. Robert boat. He's a pediatrician This is our monthly show on children's health and whatever might have to be on your mind. But as we try to keep it within pediatrics but a lot of different things that we could talk about health behavior development some we've gotten into a lot of parenting issues any of that that kind of thing.

You can certainly do. Let's see. Well we have some others to talk with and then the next will also be in Champaign. My number one. Hi I'm wondering if you could give a quick comparison to the medication for Tara Adderall and Ritalin for teen you for ADHD. Hyperactive OK. You know the strict terror of the latest one I've never used. I retired before that came out my understanding is I think that's a norepinephrine inhibitor an epinephrine inhibitor uptake inhibitor so. So in that regard it's a stimulant too. OK. And I think I'm not sure I think in my mind I'm not sure I think there's yes there are different medications some work better in some kids than others and I'm not sure there's an advantage or a risk of one over the other so I think you know if one doesn't work you might try the other one and you

know see which one. Yeah in my mind I'm not sure I think there's a significant yet they're all absolutely different medications but in my mind I'm not sure I still think there's a significant difference. They're all still stimulants. Yeah all this to Tara says it's not a stimulant but in my mind it's if you're interfering with epinephrine and you're keeping the epinephrine level up. Man you give somebody an injection of epinephrine or stimulated. Right right. OK great. Thanks very much. You're welcome. Line 2 this is Urbana. Hello. Yes. My son is going to be going off to college next year and I have heard a lot of stuff about meningitis or an infectious disease that in fact I mean and stuff and I don't understand it very well. OK I'll hang up and I'm OK. Meningitis has a variety of bacteria and viruses that can cause meningitis but basically what the colleges are worrying about is meningococcal meningitis and basically it's those kids who live in dormitory.

Well the military learned long ago that you kind of separate the bunks in a barracks and you sleep it had to foot it to kind of minimize this spread that way. And in crowded conditions it's more likely to spread. As I recall during the winter months about 10 percent of the people carried this bacteria in their nose and throat they will not be safe. And it's it it's I don't know what the number is it's 1 in 100 or 100000 or yeah at the risk of coming down with the disease is of is very small I think there's something like fifteen hundred cases reported in the United States every year. So it's kind of a rare infection. The problem with that is the mortality rate I think is about 30 percent as I recall so it's it's a thing that you're not it's a disease that you're not likely to get but if you do it it can be disastrous. The vaccine out now. It depends which

organization you read the recommendations from. I think it's a Monotype of vaccine and I think there's three as I recall there's three or four types of men. Meningococcal that cause the disease. The one we had the vaccine we have now is is I think only one or two types and it's not the most common type and I'm sorry I'm a little out of date here to have a look but that that's the that's the substance of it. So there's so there's some debate whether the vaccine really is recommended or night and what further complicates it is there is a new vaccine coming out. I just yeah I just saw this in the AP news there's a new vaccine. I think it's been licensed already. But the evidence was if you gave the a better vaccine to the people who had the old vaccines that increase in their protection you decrease their protection. So at this point I think my advice is with the current vaccine probably pass it up.

Except for yeah in the first case of going into Cock o meningitis that occurs on campus then be the first one in line to get it so you don't get it yet to decrease your wrists again. But it appears that a new vaccine is licensed a much better vaccine is coming out and hopefully in the next few months it will be widely distributed. And then I would get in line for this one. Dissent answer your question. I hope well the caller has as wrong I hope so and she certainly is welcome to call back if she would like to follow up I guess I can imagine some parents being you know listening to your advice and being a little bit worried about it. By the time you get word of an outbreak is actually too late to do anything about it in terms of going in and getting the shot. Or is it is it better to launch a preemptive strike you know and Devon even though you're not really sure that they're

going to be exposed. I think at this time with the new vaccine licensing coming out I would wait okay. I would wait but. But as one of the first callers said you get a vaccine and it takes about 30 days for your body to respond to it make protective antibodies to it. But yeah with yeah with the manager I deserve the meningococcal vaccine. I don't have a very good answer and it's debatable I don't think the world. Yeah the powers that be have a good answer yet there's there's some dispute about it and I think hopefully with the new vaccine coming out it will be a better vaccine and cover all the types and hopefully be more effective in the. Yeah. Then I get that one. OK. Questions other questions are welcome 3 3 3 9 4 5 5. Toll free 800 2 2 2 0 9 4 5 5 we are about at our midpoint this our focus with our guest Dr. Robert Boccia He's a pediatrician and

our monthly program on children's health. And if you have a question gives a call. I just got a DVD in the mail with my last issue of the AP news that was produced by the CDC and it's about obesity. And we've we've we've talked about it sort of. Tangentially in the past and this was kind of an interesting and there were a lot of statistics here in it that 16 percent of our children are plain overweight or obese. In the African-American Hispanic group it goes up to close to 25 percent. For some reason I just read an article in our local paper last night that yeah the Asians and those people who tend not to be overweight after they lived in this country for 15 years they've adopted American habits and they're overweight too. And what's the solution to this. Probably it's a multi factor it factor all solution and it is a

family problem the other thing that as a parent is if both parents are overweight the children have about an 80 percent chance of being overweight. If mother is overweight and again I've seen different articles here two of the mothers the most important factor for the mothers overweight the child again has a very good chance of being overweight. And I presume that's because moms controlling the kitchen and the diet and the nutrition and it is it's a nutritional problem. Eat smart. And I think the major thing there is let's get rid of soft drinks the sugared soft drinks. Also juice is sort of a sugared soft drink in a way it's a natural product it's got vitamin C in it and that's sort of a basically. And yeah a glass of orange juice in the morning is important but a quarter of orange juice spread out during the day is probably not a good idea. So encourage good nutritional habits

mainly that's eating together eating a good diet. Snacks are OK. Chronic grazing is not ok. Chronic snacking is not ok. Encouraging activities like I were a day of good activities and discouraging. And this was interesting in the DVH in this in this in this program we talked about screen time instead of TV time they talked about screen time which includes video yet TV video games and and. Internet limit that to less than two hours a day and that encourages then yeah and just kind of when the weather's nice kick em out. Yeah and I think encourage the schools to do it. I was I was at a luncheon at one of our local schools yesterday had lunch with six fourth graders which was which was a real pleasure. But in order to improve their increase their scholastic time they had 15 minutes of

recess after lunch so there is no physical activities they get P.E. three times a week so you know again we're helping helping them scholastically but we're not helping their health and overweight and children leads to significant problems in adulthood with heart disease and diabetes type 2 and and actually diabetes type 2 is increasing in in children as well that's there whether they're what we used to call adult talk about adult onset which or you didn't really start to see until people got older and it used to be that you didn't you didn't really see that in children or in adolescence but that's that's no big target of concern that suddenly that we're now seeing this more and more that thing that's not that's more related to it related to problems like being overweight rather than it just being you know something that you're kind of born with which is the case for the. What we ALL THE TYPE want to what we also used to call the childhood diabetes.

If you look at those two things obviously there's two things going on there with those of but the one component is how much physical activity you know are you. Are you burning off the calories that you're consuming and then there is the quality of the calories that you consume. Yes. How much fat are you taking in and how much sugar and the both those kind of things. Do you think that either one or the other of those things are more important that is quality of diet or physical exercise or you just have to say well no don't don't do that. Behold the those things are important. Yeah. I don't yeah. Again I don't think you can split them I think they're both important because we have information that especially in adults that even normal weight people have a instance of heart disease unless you improve their activities get them get them on the treadmill get them on the stair machine get them walking get them get them doing something get them raising a sweat regularly for a sustained period of time and yeah you can't divide them. The other thing is it is a family problem like I

said if the parents are overweight chances are the kid's going to be overweight and I spose the reverse that the Tisch statisticians will argue about this and I can see that there's this isn't what I'm going to next say isn't exactly true. If you have an overweight child in my clinical experience if you have an overweight child you've got overweight parents so it is a family affair. And. You know I know who does the grocery shopping in the family and the grocer think the grocery shopper is responsible for don't buy those cookie. You know you don't need cookies in the house all the time. Fruit makes an excellent snack vegetable sticks make an excellent snack and just don't have the soda pops in the house and or if you do you know there is nothing wrong with them but ration them it's not some other story some other article I saw said the average child is drinking three helpings of soft drink a day

and you say wow that's a lot of calories. One thing that I know concerns parents and I'm sure that we've talked with some people like this over the years is that there are some kids that right before they have their growth spurt they put on weight. So yes we've got we've got kids that are you know older kids or are pre-adolescence or you know kids or I don't know eight nine 10 11 12 you know somewhere in there we're kind of chubby and all that and maybe the parents aren't. And when the kids were younger they weren't but when they get in this period and and I'm sure that they worry they'd say Whoa. What does this mean for the rest of their life. Are they indeed going to if they really do shoot up is that just going to spread out so that it's not going to be so much a bomber. I mean how do you how do you detect what is a really serious problem from something that is just a phase and something that they are likely to grow out of. Now they're talking about body mass index I mean all along we've measured a child's weight height

and head circumference to make sure everything's going well. Now there's a formula to calculate the body mass index again it has to do with weight and height. And there are growth charts for this too at this age. This is the yeah where the BMI should be and that the BMI should take care of that early puberty Oh boy who is getting a little white and get a little worried about it. His BMI should still be in the normal range even though he looks a little chubby. And the same thing for girls although again girls aren't supposed to look chubby in that pre-pubertal time or that early puberty time as much as boys are. But still. Yeah height weight is important. And stuffing the height weight into the BMI formula and plotting that is important and maybe more important than our old height weight chart free. So there are still some general guidelines and it's something that is pretty simple

too. Well I say it's sort of simple to calculate because you've got to do some conversion with the numbers and then but there are a lot of little websites that will let you do that all you have to do is plug in your height and weight and it will give you the number and then that will tell you something so that's generally pretty reliable for adults and for kids. And they make a little slide rule type things that float. Yeah you put numbers in and out comes the BMI number. OK. So what sort of BMI would you be wanting to have in a child and what's again dramatic I don't know because it depends on age. Oh yeah oh yeah you have to factor you have to. Yeah yeah there's where there's all this I don't like ages is my age. Yes just height and weight Yeah. But with kids their age is yes it matters it matters. And then gender matters too. Because girls have a little bit. Yeah. The female body has greased fat quantity normally over the male body so yeah age and gender

make a difference. OK well other questions are welcome we about a little less than 20 minutes in this part focus 580 with Beatrice and Dr. Robert. Questions are certainly welcome if you'd like to call in the number in Champaign-Urbana 3 3 3 9 4 5 5. We do also have a toll free line good anywhere that you can hear us that he's 800 to 2 2 9 4 5 5. Just as we were talking a bit earlier about the pertussis and the the immunization for it. One of these that I wonder about is over the next of the next few years do you think that will be adding to the standard package of immunization that kids get. I think seems to me that during the time we've been talking for example one of the things that got added on was chicken pox. And there was a long period of time where there was sort of debate back and forth about well should it be required or or shouldn't it. How long is the immunity do we run the risk of immunizing these kids and then suddenly find out later we have adults who are getting

chicken pox which wouldn't be such a good thing. And you know we sort of said well do we even need to worry about chicken pox I mean nobody. Well I don't think anybody ever died from getting chicken pox it's relatively benign so some people might have argued well what's the big deal. You know let him get second box telling upfield for a couple days and then life will go on. But we have now it is now required. Actually some kids do die of chicken pox or those with leukemia I mean deficiencies so it can be it can be a fatal disease but you're right mostly it's kind of a benign disease you know the kids at home and out of school for a week and maybe mom or dad have to stay home from work for about a week or so. So yeah. You know again I few prioritize you say OK measles is a bad disease whom awful is influenza. The hip tide or vaccine that's a bad disease you know. Meningitis you don't want to be the tightest. And I think yeah now we're developing vaccines against

diseases that well the meningococcal vaccine that's coming out that's you know again I've said there's 15000 cases in the United States country of what 300 million people or so so you say are three million people or so you say you say you know it's a bit player in our in our mortality statistics but you say why do i want any mortality at all if I can safely safely eliminate it so I think there will probably be more vaccines coming out. Hopefully we can eliminate some vaccines. If like measles measles the only host is the human being if we can eradicate measles worldwide. We don't need to Maisons vaccine anymore. Polio again. That's the only host does a human host if we can eliminate polio worldwide the need for polio vaccine goes to zero it becomes something to talk about in history books in the museum so yeah hopefully we will eliminate some hopefully will develop some more in the road a virus vaccine I read recently there's a new road a

virus vaccine coming out that's probably safe as effective as the old one and doesn't cause the interests of ception and the intestinal problems and and so maybe that vaccine will come out OK. Call here champagne to talk with line one right back about. I have a daughter who is lactose intolerant. OK and I gave her the lactase enzyme supplements to go through any negative things I mean she takes a lot of time daily because she likes to have hot lunch and you know in the field I'm usually. Should I give be given her that much or so I just you know make sure I discover milk for her milk along. No I said I know of no you know again lactase is an enzyme that most of us make some of us don't. Actually most of us don't you know most of us don't because we get to be adults or her nose goes down but it's in a way I say it's a natural product and I know of no ill effects from lactase. OK well thank you.

You're welcome. OK I get another questions you'd like to talk with our guest Dr. Robert Boe Checky is a pediatrician he's here once a month always on Thursday to talk about children's health. The number 3 3 3 9 4 5 5 toll free 800 2 2 2 9 4 5 5. We're back again to the to the question of demonisation I was thinking about I will wondering whether you think that what we will see at some point vaccines for sexually transmitted disease and that's something that perhaps we're just going to say you know adolescence maybe because we figure to figure out some time every minute everybody's going to become sexually active you know for example there has been I think a more and more research on the human papilloma virus and its role possibly in causing some cervical cancer and so actually I think they're working on a vaccine from it in India. So you know also that maybe indeed some day that that's we're going to say well if we could get rid of that we would get rid of all cervical cancer but we could put a big dent in it so maybe that would be a good thing. And you know who knows there might be some some other sorts of

things that would you know maybe we would develop a kind of a packaged package of vaccines that we would give to you know people when they were 17 years old or 16 years old or something like that to deal with some of these things that we think are more adult kind of illnesses because like rubella in this country we immunize all children against rebel It's part of the MMR at about 0 0. 12 15 months something like that. Europe I understand many countries in Europe say OK you know the reason we're immune I rebel is just a minor disease unless you get it when you're pregnant then it's still minor for the pregnant woman. But but it can have severe effects on the developing fetus. And my understanding is a lot of European countries say OK you're a guy you don't get rubella vaccine. You're a gal you're 12 years old you're approaching the age of sexual maturity we're going to give you the vaccine. So I think there's we do it one way in this country. Other countries

do it different ways. Who's right who's wrong. I don't think there is a right and wrong there are just other methods of doing it. Two Well I think where it would soon I think we're going to be another caller here lined up on we have color line number one. Hello. OK hold on second there where I think we have a caller we're not sure we're going to get him on the air. We do have about 10 minutes left in this part of the show again so the people who are listening have questions we'd like to talk with our guest Dr. Robert Boettcher 3 3 3 9 4 5 5 that's the number for Champaign-Urbana and toll free 800 to 2 2 9 4 5 5 and now we're going to go to our line number one called Hello hello. Yes. I've got a daughter who's been one of the local high schools through the second year at the school and went to the middle school you know she's got the odd cold here and there and you know she'd be sick for a couple of days maybe and that would be it.

But just at the high school you know she gets a virus. She's sick. She gets better. And about two three weeks later she's sick with something else and she began to miss some more school from time. She gets better and two or three weeks later she gets something else. This goes on the entire school year. And you know she washes their hands probably. She generally doesn't share drinks with people I mean she's she sort of knows what she shouldn't. OK. And you know I'm sort of beside myself because you know she misses you know high school part of the school. Sometimes it gets so bad it goes out of her chest and even Taylor's you know this kind of thing. You got any suggestions. No I wish I did. And I'm with you I'm a little bit disturbed because this is usually at that age you say OK you're entitled to your two colds a year and that's it but you shouldn't. Yeah if you're a kindergartner you should be. Yeah. If you haven't gone

to preschool you should be sick continuously during the winter. Not exactly but yeah you should have a lot more and I don't know what are these all similar. Are these all respiratory illnesses. Yeah they are. And she does get an inhaler with them. Well to have some of them the only time she gets you know as my condition to some time not always with certain really bad respiratory infection like right now she's using it. Now are we talking about a cough or a cold or a stuffy nose to along with the cough. All right now she's got a she's got a cough that really got bad and the only thing that would take care of it was to you know use preventable and Taylor and now she's using full vent which will basically take care of things for a while. Yeah I guess that's that's what I'm wondering is this a problem with infections or is this a problem that she's just got asthma.

Well but sometimes well before that she had a sinus infection. OK four weeks ago. Sometimes it's a sore throat. You know one time it was strep. You know OK you know it's like she recovers and it's about two three weeks and bam she's got something else. OK and this was last year same thing when this is last year too. Yep another right really before I mean maybe she get sick once or twice in the school year when she was OK. Yeah. And she's otherwise healthy and growing and doing well and in school and that sort of thing. Well when you miss school for being sick it's hard to keep up. But yeah yeah. Do you think school OK you've documented an illness with the thermometer or something like that. Is it is school avoidance a problem here. Well you know I've thought of that. But you know it's hard for a kid the sake of being pale.

OK. And have you know sort of you know the sort of you know how sometimes your eyes just look sort of you can tell by the eyes that it is for. You but Brad like symptoms. I like symptoms much better that you can measure how many Kleenex is there used today or how many how many degrees of. OK yeah you know if she's using a box of Kleenex a day OK then I'll say this is an illness this is not a yeah this is not a psychosocial school avoidance problem. You know because I forced her to go OK unless she's really that. I guess I would say this is a bad year. But trouble is this is two bad years in a row. It's Am I talking about coincidence or you know something about this. No I think you're probably talking about coincidence because you haven't mentioned any severe illnesses that are very solid in hospitalization or anything like that now. You've mentioned illnesses where she misses school sometimes and other times she can go to school with it because.

Yeah because they're not that severe. She is she can manage to track herself in. That's right that's right. So I think this is probably coincidence coincidence rather than anything that's gone wrong with her immune system or her lungs and that unfortunately she has she does have reactive airway disease. The only thing I'm wondering is is is her reactive airway disease more serious than we thought her asthma more serious than we thought and certainly respiratory illnesses colds and that sort of thing are the number one probably the number one cause of of asthma aggravated asthma. But it'd be interesting to see what the flow then does and maybe she stays on that a little bit longer. The colds that she gets won't cause quite a severe cough she won't miss quite as much school. Well you know what we've been told was that after she has no more coffee is a full event for another

week and then stop. Should we keep using the phone all winter. You know I think yes maybe. I'd be curious to see what would happen if you did use it longer. Because again flow vent is. It does have a steroid in it. An anti-inflammatory but that's the drug of choice that's the way you treat you treat asthma now and again it seems to be very safe. Doesn't seem to have any significant side effects it doesn't. It doesn't interfere with growth or anything else and it might be in might be interesting to just keep around slow them longer and you know it's certainly not going to prove it's certainly not going to prevent colds. But see if the colds behave themselves better if they're much milder and she will be able to go on to school without without as much severe cough and that sort of thing. And better sleeping at night so that it might be interesting to keep her in a flow vent longer and see what it does.

OK well I'll give that a try. I don't know what else to do. But yeah you know usually at least twice you know and the season she ends up on it. So this is the earliest that's happened so far. Yeah it might be interesting to keep running till gosh what are we talking. I don't know what we're talking about April or May. Certainly by May usually we're usually a pretty healthy maze definitely healthy but it might be interesting to keep around it through January. It's also going well February and just keep going that way and see if see if that will you know again it won't prevent these illness but see if it will modify the symptoms and and allow her to have less cough so she sleeps better at night and can tend school more regularly. OK I'll give that a try ok. Thank you. You're welcome thank you for the call. Well coming down the point here we have maybe about a minute or so left it anything in particular that you like to leave with folks. Yes. I wish you all a very happy holiday season and remember Christmas if you're Christian was all about the birth of a very special child.

And I would like to suggest that all children are special and enjoy them. Keep them keep them in the circle. Don't exclude them. Enjoy them and they're part of your family enjoy. Very good and well and I was in for my bit I'd say you know I see what you can do to reduce stress. I think that's a good thing I think you know man there was so there was so much pressure put on this particular time of years say as you say not everybody celebrates But you know a lot of people no matter whether they're very religious or not it is time for families to get together and it can be difficult particularly. That's it if you don't see these people very often. You know there's there's a lot of pressure on let's just make the most of this time around or you know let's fight as much as we can because we because we want to see each other for another six or 12 months get a hug and a warm smile maybe one of the most precious gifts we can give a very good thought. All right well I think probably we're going to have to finish

my apologies we have one last call here we just don't have time for but our guest Dr. Robert boat Jack will be back again next month and we'll do it again we do this on the third. It's the third isn't third. Third I should know that on the third Thursday of the month at 10:00 o'clock Eastern we talk about children's health. He is a pediatrician clinical assistant professor at the University of Illinois.