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Posts from the ‘Health and Safety’ Category

Brain Tumor Awareness Month

More than 3,000 children across the country are diagnosed each year with central nervous system tumors.  When brain cells grow abnormally or out of control, a tumor can form. If the tumor puts pressure on certain areas of the brain, it can affect how the body functions. 

Although there are many different types of brain tumors, doctors don’t know what causes them. Researchers believe that genetics and the environment may play a role. Doctors categorize a tumor based on its location, the type of cells involved and how quickly it grows. Some are cancerous while others are not.

The Pediatric Neuro-Oncology Program at Children’s of Alabama is the only program of its kind in the state and treats more than 300 children diagnosed with brain tumors. It is one of the largest programs in the Southeast.

When discovered early enough, brain tumors are usually treatable. Dr. Elizabeth Alva, assistant professor of pediatrics, said that there are different types of options depending on the kind of tumor.

Treatment requires a multidisciplinary approach and the appropriate treatment varies by the type of brain tumor,” she said. “Through our multidisciplinary team, we are able to provide the best care available to patients with brain tumors.”

Many slow-growing tumors are cured with surgery alone. Faster-growing tumors might need additional treatment with radiation therapy, chemotherapy or both.

One of the most exciting treatments currently happening at Children’s is the oncolytic virotherapy trial using herpes simplex virus. This approach is only available at Children’s and is evidence of Children’s commitment to providing more treatment opportunities for patients with difficult to treat recurrent or progressive brain tumors.

Signs and Symptoms

A brain tumor can cause symptoms by directly pressing on the surrounding parts of the brain that control certain body functions or by causing a buildup of spinal fluid and pressure throughout the brain. Signs or symptoms vary depending on a child’s age and the location of the tumor. They include:

  • vomiting
  • seizures
  • weakness of the face, trunk, arms or legs
  • slurred speech
  • difficulty standing or walking
  • poor coordination
  • headache
  • in babies and young toddlers, a rapidly enlarging head

 

Because symptoms might develop gradually and can be like those of other common childhood illnesses, brain tumors can be difficult to diagnose. If there are ever concerns about symptoms a child is having, a physician should be contacted right away.

For more information, visit childrensal.org/neuro-oncology.

Children’s of Alabama is a member of the Children’s Oncology Group (COG) that provides patients the opportunity to participate in the latest clinical trials and advanced care for pediatric brain tumors.  In addition, they are one of only 21 COG sites designated as a Phase 1 institution, which offers patients with brain tumors and other cancers with the newest therapies not available at other institutions and help further advance the knowledge of new treatments. Children’s clinical trials are open through the National Experimental Therapeutics (NEXT) Consortium, including the newest Head Start 4 protocol, which aims to improve the cure rates and quality of survival with young patients diagnosed with medulloblastoma and primitive neuro-ectodermal tumors.  

Scoliosis

Scoliosis is an abnormal side to side curvature of the spine. Instead of a straight line, it may form more of an “S” shape or “C” shape.  Scoliosis usually occurs during the growth spurt just before puberty.

Angela Doctor is a registered nurse and the Scoliosis Screening Coordinator for Children’s of Alabama.  In 1984, the state of Alabama mandated that all public school students between the ages of 11 and 14 be screened for scoliosis. “The importance of scoliosis screening is early detection,” Doctor says. “Children are doing a lot of growing during the adolescent period, so our goal is to halt the progression of scoliosis.”

Types of Scoliosis

Doctor says there are three types of scoliosis. The most common is adolescent idiopathic, in which case the cause is unknown.  But scoliosis can congenital, caused by a defect at birth, or due to a neuromuscular disease like cerebral palsy.

Treatment

For most children, scoliosis is not a problem. Some may require ongoing monitoring.  But a curve that gets worse can be bad for a child’s health. If an orthopedic specialist determines treatment is necessary, the options include a back brace to halt the deformity, or spinal surgery.

Possible Signs

Parents may wonder if their child has scoliosis. Doctor says signs to look for include:

-Uneven shoulders

-Uneven scapulas

-Uneven waist and hips

-One side of the back higher than the other when bending forward

If a parent suspects their child may have scoliosis, they should see their pediatrician.  He or she may refer the child to an orthopedic specialist to confirm a diagnosis and decide whether treatment is necessary.

It’s crucial to identify scoliosis early while the spine is still growing. When treatment is over, people with scoliosis are able to live full and active lives.

Protecting Children from Sexual Abuse

It’s estimated that 1 million children are abused every year. Many abuse victims suffer from sexual abuse. Deb Schneider is the executive director of the Children’s Hospital Intervention and Prevention Services (CHIPS) Center at Children’s of Alabama. She says even though it’s a difficult subject, it’s important parents teach children that their bodies are “private property.”

“Parents should be having an ongoing conversation with their kids. This is not a one-time thing,” Schneider says. “It’s good to look for teachable moments, like when you see a private property sign, or during bath time, or when you see an Amber Alert.”
Schneider says often when people try to entice children, they trick them with what she calls bait. “They use things like toys, candy or money,” she says. “They also will try to keep them from telling about the abuse. They may threaten to harm them or someone they love if they tell.”

She advises parents to educate children to understand what “bait” may look like and how to seek help if they find themselves in an uncomfortable situation.
Children should understand the “I Can Plan.”
Teach Children the “I Can Plan:”
  • Try to say NO
  • Try to Get Away
  • Tell Someone
  • It’s Not Your Fault
If a child reports a suspected incident of sexual abuse, Schneider advises parents to stay calm, thank the child for telling, assure the child you will get help and contact the authorities, whether it’s the local police or Department of Human Resources.
Schneider says hard as it may seem to stay calm, it’s very important to not frighten the child and not ask too many questions so the child will continue to share when asked by authorities. Authorities are trained to conduct interviews with children to help prosecute an abuser.
The CHIPS Center has abuse prevention resources available. For more information, 205- 638-2751 or go to childrensal.org/CHIPS.

Seasonal Flu

This flu season has caused a major influx of patients at medical facilities across the state of Alabama. Birmingham-area hospitals are reaching or already over capacity in response to the recent outbreak of the illness.

Jefferson County Health Department Officer Dr. Mark Wilson addressed the increase in local flu cases during a press conference on Jan. 10.  Wilson said that while the outbreak is not severe enough to be considered a pandemic, it is a significant “seasonal flu situation.”

Delphene Hobby-Noland,  Manager of Infection Prevention and Control at Children’s of Alabama, said that the answer to avoiding the flu is as simple as taking basic precautionary steps.

“The two biggest preventative measures you can take are to get your annual flu immunization and to wash your hands,” Hobby-Noland said. “Our hands are the primary way that we transmit germs.”

Hobby-Noland said that those most susceptible to the flu are children and the elderly because their immune systems tend to be weaker. Children under the age of  5, especially those younger than  2 years old, are particularly more likely to suffer from flu-related complications. These complications include pneumonia, dehydration, worsening of long-term medical problems like heart disease or asthma, swelling in the brain, sinus problems and ear infections. Children younger than  6 months cannot receive the flu shot, meaning that it is important for everyone who is of age to be immunized, especially caregivers and parents of young children. There is still time to get the flu shot. While the shot does not cover all strains of the flu, it can shorten or cause the case to be less severe even if someone does get the illness.

Other preventative measures involve disinfecting commonly used surfaces, as well as encouraging children to cover their mouths with a tissue when coughing or sneezing and to avoid touching their faces.

The Jefferson County Health Department encourages people experiencing milder flu-like symptoms to stay at home or call their personal doctor instead of going to the hospital. This helps to prevent further overcrowding, risking exposure to more serious illnesses and spreading the flu.

Common symptoms of the flu include:

  • Fever or feeling feverish with chills, though not all people with the flu will have a fever
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Vomiting and diarrhea, which are more common in children

For more information, visit https://www.childrensal.org/.

Severe Weather Preparedness

In Alabama, we are no stranger to severe weather, so it is a good idea to have a plan for your family to stay safe. Severe weather can happen any time in any part of the country, so it’s a good idea to be prepared ahead of time. Once a storm is approaching, it’s often too late to work on a preparedness plan.

Debbie Coshatt is the Nurse Educator in the Patient Health and Safety Information Department at Children’s of Alabama. She recommends families discuss their severe weather plan in advance, including where they will go for safety. “You want to make sure to go to an area without windows. If the house has a basement that would be ideal. Go to the lowest level of the home, an interior room without windows. A bathroom or a closet are good options,” she says. She also suggests that families practice going to their “safe place” to become more comfortable with the process.

Safe Place

  • Without windows
  • Lowest level of the home
  • Interior room

Coshatt recommends that families prepare a severe weather bag for each member of the family. The bags should always be stored in their “safe place.” This bag should contain essentials such as:

Severe Weather Bag

  • Helmet
  • Flashlight
  • Shoes
  • Name Band (filled out by parents)

She also recommends keeping a weather radio with an extra set of batteries in the safe place.

Other Safe Place Essentials

  • Weather radio
  • Extra batteries

The Patient Health and Safety Information Department at Children’s of Alabama has more information about this and other health and safety related topics. The department also has Storm Bags available for purchase for $5. They are located off the Russell Lobby in the Benjamin Russell Building at Children’s of Alabama.

Poison Look-a-Likes

Parents who take great care to child-proof their home may be overlooking every day household items that pose a risk of poisoning. Ann Slattery is the director of the Regional Poison Control Center at Children’s of Alabama. She says parents need to watch out for what she calls “look-a-like” products.

For instance, a child may think a bottle of pine cleaner looks like a bottle of apple juice or a bottle of all-purpose cleaner looks like a sports drink. There has also been an increase in poisonings due to detergent pods. The bright colors can cause a child to mistake it for a piece of candy. Experts say it’s best to use traditional detergent if you have a child under 6 years old in the home.

Slattery says the Regional Poison Control Center at Children’s of Alabama received more than 42,000 calls in 2016. Many of those calls were associated with household look-a-like items. She encourages parents to look around their home for items that may be mistaken for food or drink. And remember, just because an item has child-resistant packaging doesn’t always mean its child-proof.

Slattery says the risk doesn’t only apply to children. “Adults may unintentionally get into these products, not realizing what they are,” she says. “In some cases, it could be dark and they reach for the wrong bottle.” Accidental poisoning may also occur when an individual suffers from dementia. “All household cleaning products should be kept out of sight and out of reach. Ideally, these products should be in a cabinet with a child-resistant closure,” Slattery advises.

The Regional Poison Control Center at Children’s of Alabama is available 24/7/365 for poison advice for all ages. The number is 1-800-222-1222. Slattery recommends parents store the number in their cell phones for easy access.

Teen Driving

Automobile crashes are the number one killer of teenagers and the number one cause of disabling injuries for teens.  Sadly many of these accidents are preventable.

Leslie Brown is the coordinator of Alabama Safe Kids at Children’s of Alabama.

She says parents play an important role in encouraging their children to be safe as a driver and a passenger.

“Parents can start by talking to their child when in elementary school about being a safe passenger,” she says.  “Things like modeling safe behavior, wearing a seatbelt every time and putting the cell phone down. They’re going to do what we do,” she says.

In Alabama, the Graduated Driver License Law is a mandatory restriction in place for inexperienced drivers. One of the requirements is that a new driver may not have more than one non-family passenger in the vehicle with them other than the parent, guardian or a supervising licensed driver at least 21 years of age.

Brown says parents should become familiar with the Graduated Driver License Law and download a Teen Driving Agreement for their new driver to sign. This helps to establish important ground rules to keep the new driver safe.  And Brown says, if the teen violates any of these rules there should be consequences. “Take away their keys when they don’t follow the rules,” she says. “You can also offer rewards when they do make good choices.”

Brown says it’s important that teens and adults do these three things:

-Obey the law

-Wear a seatbelt

-Put down the cell phone

Brown has teenagers of her own so talking about safe driving isn’t just part of her job description, it’s personal.

“I always say to my teenagers, ‘Are you a great friend or a good friend?’” she says. I tell them, ‘Encourage your friends to wear their seatbelts.  Ask, ‘Can I send that text for you?’  instead of allowing them to text and drive.”

Getting a new driver’s license is an exciting time for a teenager.  By helping them to know the law and apply safe driving practices, parents can play an important role in keeping their teens alive.

Children’s of Alabama offers links to the Graduated Driver License Law, the Teen Driving Agreement, and more resources for parents and teens. Visit childrensal.org/Safe-Teen-Driving-Toolkit to download these resources.

Medication Safety

Parents play an important role in protecting their children from various illnesses and injuries, including poisoning. Dr. Megan Brennard is a physician in the emergency department at Children’s of Alabama. She says poisoning and ingestions are common reasons why children visit the emergency department. “The most common poisoning we see in a child is medication poisoning,”she says.

It’s important for parents to keep all medicines up high and out of reach of children. But sometimes the danger may be brought in by someone else. “Sometimes the most dangerous medicine in your house was brought in by a grandparent,” Brennard says. “They may keep their purse on the floor and not even realize it’s a risk for the child.”

Often adults store medicine in pill boxes or organizers, but parents need to remember these are not child-proof. And to a child, medicine may look like candy. It’s important to talk with guests of your home to ensure any medicine they have is kept out of reach of children.

Along the lines of “candy,” Brennard recommends parents never call medicine “candy.” “Sometimes parents do that to encourage their child to take medicine, but it’s never a good idea to confuse the two,” she says.

All teaspoons and tablespoons are not equal

It’s also important that all medicine be given with the appropriate measuring device as provided by the pharmacist, whether it’s a syringe or measuring cup. Brennard says eating utensils come in various sizes. One teaspoon could range from a half teaspoon to one-and-a-half teaspoons when measured. She also adds that bottle tops for medicine are “child resistant” not “child-proof.” Some children are still able to open them. “It’s a good idea to get a lockbox to store medicine, anything with a code to get in. This adds another layer of protection,” Brennard says.

The Regional Poison Control Center at Children’s of Alabama is always available to answer questions or concerns. The number is 1-800-222-1222. Brennard recommends that parents store this number in their cell phone for easy access. Of course, always call 911 in the event of an emergency.

E-Cigarettes and Vaping

E-cigarettes or electronic cigarettes are being marketed as a safe alternative to smoking, but health officials say they are not safe. Dr. Susan Walley is a pediatrician at Children’s of Alabama. She’s concerned about the increase in the use of e-cigarettes and vaping. “As a pediatrician there are two major issues with electronic cigarettes or vaping devices. One is that these are not safe products and the second is that they contain nicotine which is a tobacco product.” She believes many youth and adults don’t realize e-cigarettes contain nicotine, an addictive drug that affects the brain, nervous system and heart.


The use of e-cigarettes is on the rise. Starting in 2014, statistics show more youth use e-cigarettes than any other tobacco product. Five percent of middle school students are current users, while 16 percent of high school students consider themselves to be current users. That’s more than 3 million students.

Dr. Walley says it’s a disturbing trend, as she believes e-cigarette manufacturers are targeting children. “E-cigarette companies are using some of the same techniques that tobacco companies did decades ago by making these liquids appealing to children with candy flavors and dessert flavors,” she says. Some examples include “Skittles flavor” and “Death by Chocolate.”

Another concern, because e-cigarettes aren’t fully regulated yet by the FDA, is that the long term effects are still not fully known.

Parents who use e-cigarettes should know the liquid can be very dangerous for children. Between 2012 and 2015 the number of calls to poison control related to e-cigarettes went up by 1,492 percent. “It’s very scary,” Dr. Walley says. “These are completely preventable. There has even been a death from a child who ingested the mother’s e-cigarette liquid. The child had a seizure and couldn’t be resuscitated.”

Dr. Walley says it’s very important for parents, pediatricians and youth to be educated about the dangers of e-cigarettes and vaping. Because nicotine is so addictive, the best way to avoid the risks is to never start smoking or vaping. If a parent or child is a current user, they should talk to a doctor about ways to quit.

Croup

Croup can be a scary situation for a child and their parents. The symptoms usually occur at night. A child may awaken with a funny sounding cough and labored breathing. Peily Soong, M.D., a pediatrician at Pediatrics East, said croup is quite common in children. “It’s a very common illness,” Soong said. “It’s an illness that’s caused by a virus, the most common virus is one that’s called parainfluenza, but other viruses can cause it like the common cold or flu.”


The symptoms of croup are relatively unmistakable. They include a distinct cough that is described as sounding like a seal’s bark. It’s often worse at nighttime. Other symptoms that may accompany croup include cold-like symptoms such as a fever and runny nose, as well as a raspy voice.
“One thing about this illness,” Soong said, “It affects the throat area. It can cause swelling in the throat, which can cause something called stridor, a real wheezy sound that they can have while breathing. And that’s something to worry about,” Soong said.


Symptoms of Croup

  • Cough that sounds like a “seal bark”
  • Raspy voice
  • Common cold symptoms
  • Wheezy breathing sound

Parents should act quickly when their child demonstrates the symptoms of croup and particularly stridor, but oftentimes the symptoms can be handled at home. The key is helping the child to breathe in moist air. Soong offers these tips for treating croup:


Treating Croup at Home

  • Turn on hot shower, allow child to breathe in the steam
  • If it’s cold outside, take the child outside to breathe in cool air
  • If it’s warm, open freezer door and have them breathe the cold air from the freezer

In many cases, these actions can help alleviate the immediate symptoms of croup, however, it’s still a good idea to visit the pediatrician the next morning. He or she can prescribe a steroid to reduce swelling in the throat.
There are times when croup becomes an emergency situation. Get immediate care if:

  • Child has trouble breathing with no relief
  • Has stridor that is getting worse
  • Difficulty swallowing
  • Drooling
  • Shows signs of a “hot mouth”
  • Is pale or bluish around the mouth

The good news is in most cases children can recover quickly from croup with no lasting problems. With proper attention and recommended treatment, parents and child can rest easier.