The Anwers to All Your Parenting Medical Questions with Burton H. Goldman, M.D.
WebMD Live Events Transcript
Do you know what to do when your child has a cold or flu; how to handle strains and sprains; upset stomachs and gas; when to see your doctor and when to go to the emergency room? These are questions answers that parents need to know. Dr Burton Goldman will be answering any and all medical questions that pertain to the stressful and rewarding job of parenting.
The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.
Event_Moderator Welcome to WebMD Live. Today we are discussing The Answers to All Your Parenting Medical Questions with Burton Goldman, M.D.
Burton H. Goldman, M.D., is an expert in the fields of heart disease, diabetes and arthritis. Goldman received his M.D. from the University of Texas in Galveston. He then did his internship at the Los Angeles County Hospital and his residency in internal medicine at the Los Angeles Veterans Hospital. His skilled bedside manner and unparalleled level of empathy have made him a highly requested physician. He has a distinct interest in the diagnosis, treatment and prevention of heart disease.
Dr. Goldman, welcome to WebMD Live.
Dr_Goldman_Speaker Thank you.
Event_Moderator What can a parent do to keep children from catching a flu or cold?
Dr_Goldman_Speaker That's difficult because flus and colds are respiratory infections. That means we get them through breathing germs in from the air. So, we can get those at any time. Basically, for a child, I would think a child should get a proper diet, proper rest and try to avoid contact with individuals who have colds, sore throats, flu, etc., but I think the basic concepts are still the same; proper diet, rest, exercise, and stay as healthy as possible.
Event_Moderator Is it feed a fever, starve a cold?
Dr_Goldman_Speaker You know, it depends on where you're coming from. Basically, if you have a cold, you may not feel like eating. It's wise to drink liquids. And I still think the old concepts of tea, chicken soup and a little vitamin C are still very, very important, because these colds and fevers from a cold are due to viruses. While we do have more medication nowadays for treating viruses, usually these infections are self-limited and will go away. But certainly, when you have a fever, the treatment for a fever is to take something like Tylenol, drink plenty of liquids and see your doctor.
Event_Moderator What is the difference between a cold and the flu?
Dr_Goldman_Speaker You know, excellent question!
I was just reviewing this the other day. They are so closely related that it's almost impossible to tell one from the other, with a few exceptions. They're both caused by viruses. In the case of a cold, you generally don't see any evidence of fever. You have a runny nose. You generally don't have a cough and it goes away after a few days.
Now, there are degrees of flu. You may have flu that doesn't exhibit any fever. Or, in a lot of cases, not only does it have a fever, but has generalized body aches. I know when I see people that come in to my office and they're concerned about whether they have cold, sore throat, the flu, whatever, one of the questions I ask is about the generalized ache. When you have the flu, generally speaking, you just ache all over and you feel miserable. That's not true with a common cold, but they're both caused by viruses.
And, incidentally, the question earlier about preventing your child from getting a cold and the flu, there is one thing I omitted and that was the flu vaccine. We now have a flu vaccine which is generally given to adults and senior citizens, but it can be given to youngsters who are susceptible to frequent respiratory infections, including asthma, pneumonia, decreased immune system, etc. We do have that available. We do not have that with regard to colds as yet, but they're working on it.
Event_Moderator Do you recommend everyone get a flu vaccine?
Dr_Goldman_Speaker Well, I think it's a good idea because there is a tremendous loss of work, a financial loss, but not everyone can get a flu shot because some people are allergic to eggs. I think they still use eggs with the production of the flu vaccine so they need to find another method for producing the flu vaccine. I think they're working on it now because they have some newer methods for protecting yourself against the flu, like inhaling a nasal spray. I'm not certain if they are using eggs to produce that or not. You have to be cautious about giving a flu vaccine to a person who is allergic to eggs.
That question is a very good question. I think if we started giving flu shots to everyone, especially those in school, and I think it's coming to that, you will see a decreased incidence of the flu.
Event_Moderator A lot of people are running out and getting antibiotics when they get sick, but if they have the flu, they're bug is viral. Should they be taking antibiotics? Will this do any good? Could it do any harm to children?
Dr_Goldman_Speaker Actually, it's very difficult at times to tell a virus infection from a bacterial infection. Antibiotics don't work on virus infections. They may work on bacterial infections depending upon the bacteria. A doctor must be very careful, as strange as it may seem, about not just giving antibiotics, period, to any person who comes in with a runny nose, fever, etc. Sometimes that's very difficult in dealing with infants and children since they can't give you a history and there may be a temptation to give an antibiotic. However, giving antibiotics to individuals with viral infections, you can produce an allergy and it won't work.
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Event_Moderator Will they weaken your immune system as well?
Dr_Goldman_Speaker For the longest period of time, physicians have been emphasizing, don't depend on antibiotics for a cold or flu. It's not indicated. I don't think it will weaken the immune system. It's just not going to work. It's like filling up your car with water instead of gasoline. It's just not going to work. Viruses do not respond to antibiotics. Bacterial infections, such as strep throat, etc., will respond to antibiotics and that's when you give antibiotics.
Event_Moderator Is aspirin dangerous for a child to take with a cold or flu? What alternatives are safe?
Dr_Goldman_Speaker That's really very interesting. For years aspirin was given to children with the cold or flu, etc., until they discovered there was an association of aspirin with Reyes Syndrome which was, in many cases, fatal to children. So, as a result of that, the physicians have backed off of recommending aspirin and have used another which is very good: Tylenol or acetaminophen. And, there has been no association of the Reyes Syndrome with Tylenol and Tylenol works very well in children to reduce fever.
Event_Moderator What do I do to prevent scarring if my child has a cut, and when do I need to take my child to the hospital for an injury?
Dr_Goldman_Speaker That's a difficult question to answer, but I can answer it this way. If your child is cut, don't play doctor. Have someone see your child and determine whether or not they need stitches. They may not, in which case you won't need stitches. However, if you decide not to take the child to an emergency room or a physician and the child really needs stitches, then you're asking for trouble such as scarring or infection. That is an open wound so don't play doctor. Take your child to the emergency room or to a physician and let a doctor evaluate the injury.
And, with regard to scarring, let me add one more item here. Cuts on the face usually may require the need of a plastic surgeon. That is one way to cut down on scarring, particularly on the face. If surgery is indicated, have a plastic surgeon do the surgery. But, take your child to a doctor or to an emergency room, period.
Event_Moderator Do you put hot or cold on a sprain?
Dr_Goldman_Speaker Well, initially you put cold on a sprain. What it does is it helps constrict blood vessels. When blood vessels are constricted, there is no pouring out of the blood into the subcutaneous tissue. It reduces swelling, reduces pain, and healing will take place a lot quicker as a result of that. But, you have to be sure that it's a sprain and not a fracture, and you should see your doctor or go to the emergency room if an injury of this nature occurs.
Event_Moderator How can the foods you choose affect bone strength and immunity? Which foods are best for strengthening the two?
Dr_Goldman_Speaker Well, those foods that contain calcium are very important. You find calcium in milk products like milk and cheese. Those are the two main food products that contain calcium. I'm sure there are others, but those are the two main derivatives of milk products. Calcium is very important, not only for a growing child, but for an adult, as well as women who are in menopause.
Event_Moderator What are the nutrients that parents should focus on for their children?
Dr_Goldman_Speaker All of them, A, B, C, D, E, etc. Right now there is evidence that a child needs vitamins to assist in growth. Usually you get this in foods. Even in junk foods you get a lot of vitamins. Not all of them, but you should have the main ingredients of protein, carbohydrate, fat and minerals.
Event_Moderator What are your food recommendations for colic?
Dr_Goldman_Speaker I'm not a pediatrician, so I'd like to defer an answer on that. But, I must tell you this. I have taken care of a lot of children and, while I've heard of colic before, I have seldom seen it. So, I'm not so sure there is such a thing as colic, to be quite honest with you. Now, the parent may have a child who has "colic" but I'd make sure that is what it is and not something else. And this is from a non-pediatrician. In fact, as an aside, I have three children, none of whom had colic. My children have had children, none of whom have had colic. So, I'm not sure exactly what colic is, if it's really a scientific, medical problem.
Years ago, men used to die from "indigestion". That was before we knew that coronary arteries were blocked and they were actually having heart attacks. So I think the terms are synonymous. Indigestion was a term given to a particular condition, but really turned out to be coronary artery disease, blocked arteries. Colic, I think, falls in the same category.
Event_Moderator Should all children be immunized?
Dr_Goldman_Speaker Yes, unless they have an allergy to the particular vaccine. Let me explain why they should be immunized.
Years ago people died from diphtheria, whooping cough, polio, measles, small pox; you name it, they died from these things. Nowadays, you don't see diphtheria, you don't see whooping cough or polio. Small pox has been wiped off the planet. There is no small pox at all in any of the countries in the world. That's fantastic. They used to have epidemics of small pox and people died from this. Now we don't even have cases of this. Same thing with polio and how it caused damage and death. Today you don't see polio. And that's due to vaccines. So yes, all children should be vaccinated against diphtheria, polio, measles, mumps, rubella, whooping cough, and small pox. Also, hepatitis A, hepatitis B, chicken pox, and I think eventually influenza. But, now all of those, except influenza, are required to get into school and that's a good idea. The only exception, as I said, is if they're allergic.
Event_Moderator Is there a recommended schedule for vaccination of children?
Dr_Goldman_Speaker Yes there is. And it starts out basically at two months of age or with some physicians sooner. You go 2 months, 4 months, 6 months, 1 year, 15 months, 2 years, 4 years. And if you follow that schedule, and you're going to have to anyway because the schools require it. That's a very good rule.
People used to die from measles and get complications from measles and polio, as I mentioned before. You don't see that anymore because they're vaccinated. It's a health precaution.
Event_Moderator Where can a parent who cannot afford immunization go to get their children immunized?
Dr_Goldman_Speaker Off-hand, I can't tell you. I know there are programs for this and, if I'm not mistaken, I could be wrong, but it's through the Medical program here in California. Your family physician may be able to inform you of this. But, generally speaking, if you're eligible for Medical, then your children are also covered under that program. And all of the vaccines are covered under Medical.
loving_mom_MSN I have a 14-year-old son that is having bad back pain (flank of the back on left side) he is also vomiting. I'm not sure if I should take him to the doctor or just wait it out and see if it is the flu?
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Dr_Goldman_Speaker You don't wait out anything. You take an action. You're having flank pain and vomiting...what are you waiting for? Take your child to the doctor or the emergency room. Off-hand it could be a kidney stone or kidney infection. But, vomiting? That's not normal. Flank pain? That's not normal. Take your child to a doctor or emergency room and get some tests done. We live in a period of time where we have all these wonderful tests. Avail yourself of it and do it soon because if you put it off you may be causing damage to your child.
christine31_MSN Can you tell me if it's still okay that my son still wets at night?
Dr_Goldman_Speaker Enuresis is very common. Use some simple measures first. Restrict fluids before sleep a couple of hours or so. That's the main thing. That sometimes works. In fact, it works a great deal of the time. Should it persist, you probably should consult a physician to see if there is any bladder or kidney infections or any infections, period. Sometimes there is a psychological reason, but you have to go through those other means first.
Event_Moderator What should a parent do if their child gets chicken pox? At what age is this most common?
Dr_Goldman_Speaker Chicken pox, generally speaking, is a mild disease, especially in children. In very, very rare cases it can cause complications. However, you can avoid all of this by getting a chicken pox vaccine which has been available. And, now, this year it is required to get into school. Chicken pox is self-limiting and goes away after a while. You treat the symptoms with calamine lotion if there is itching and Tylenol for the fever. If the condition persists, you should see a physician in case there are other infections. But, now in California, it is a requirement before the child can enter school to get the chicken pox vaccination.
When I think about the diseases for which we now have vaccines that used to cause complications and death, I think this is wonderful! My kids got chicken pox and they went to school. It's only considered a mild disease. In a very few instances it can be bad.
There is one more thing about chicken pox. If a child gets chicken pox, that child should not be exposed to a senior citizen or a patient who is immune compromised. That's like someone who has AIDS. For someone who has AIDS it could be devastating. So, stay away from an immune compromised individual and stay away from senior citizens because their immune systems may be compromised.
Event_Moderator What are some food recommendations for poor sleep?
Dr_Goldman_Speaker Well, don't eat so much. That's number one. Because I know when my companion and I go out for dinner, she doesn't want to eat too late because it interferes with her sleep. So, don't eat too much food. Number two, stay away from caffeine. Caffeine is present not only in soft drinks, but in coffee, tea and chocolate. So, stay away from caffeine.
DIGGER3_MSN Fever Motrin and Thylenol Every two hours for fever 10-year-old.
Dr_Goldman_Speaker These are called antipyretics.I didn't mention Motrin before and I should have with regard to the people who get body aches or the flu, etc. This occurs in children. If Tylenol doesn't work in a child, then they have Motrin for children which generally does work. And, actually, it's an excellent product. It cuts down on inflammation and swelling and reduces fever. So it is excellent. As to how often you should take it, you leave that up to the attending physician. You could take it three times a day, twice a day, four times a day. It's up to the attending physician. But, I think you use one or the other. You either use Motrin or you use Tylenol. And in cases when you're dealing with an adult, aspirin could be an excellent antipyretic. But it' snot used in children because of the previous findings, as discussed earlier, about Reyes.
christine31_MSN What do you recommend to help a child lower their cholesterol?
Dr_Goldman_Speaker Well, that's a debatable item. It depends upon how high the cholesterol is. Generally speaking, whether you have a child or an adult, most doctors will say diet. Restrict your fats. Restricts your carbohydrates.
The fats and carbohydrates are the two main components responsible for an elevated cholesterol. Even with that, the liver still produces cholesterol. So, you may not be successful with diet to lower your cholesterol.
If diet is not sufficient, and there is a family history of high cholesterol, heart attacks or strokes, you might use medication to calm the statens to lower the cholesterol and they do work very well. However, in a growing child, you have to be very careful about this because they need everything. They need their vitamins, minerals, calcium. And, would you believe it, They need their cholesterol too! It's going to depend on how high the cholesterol is and a family history of high cholesterol.
Event_Moderator My 5-year-old son often has stomach aches; could this be signaling a larger problem?
Dr_Goldman_Speaker Well, it depends upon how often he has stomach aches. Does he have them before or after he eats or both? Is it related to food? He's a 5-year-old. Is he lactose intolerant? If he drinks a lot of milk, that might be a factor. Conceivably he may have other medical problems. He has to be checked out by a physician. Yes, he may have a serious problem. See your physician.
christine31_MSN When do you know certain antibiotics lose their effectiveness?
Dr_Goldman_Speaker That's another very good question. My answer to this, and I could be incorrect on that, is most of the time these expiration dates, I think, are a result of an FDA requirement to indicate to a person to use the medicine before a certain date. It varies from medication to medication. It's hard for me to answer this question regarding antibiotics or any other medication. It's my experience that if they give you a date, I'm not sure on what basis they have made this particular date, so I don't know enough about it to answer that question. But, generally speaking, I think that while the potency may be reduced, I think the effectiveness may not be reduced by using medication that's expired. But, I don't recommend that you use expired medications.
Event_Moderator What are the warning signs of Attention Deficit Disorder?
Dr_Goldman_Speaker Attention Deficit Disorder, in my experience, is where you pick this up is in school. The teacher will tell the parent that Johnny isn't paying attention, that he's disrupting the class. It's usually associated with hyperactivity. It's a debatable subject, but it usually comes from the school. The treatment for this is also a debatable one too.
Event_Moderator My 7-year old daughter often complains of a sore neck. Can I take her to my chiropractor?
Dr_Goldman_Speaker Well, you can. Chiropractors are certainly licensed to practice in the state of California. That's up to you. I know that chiropractors are associated with back problems and so the public generally is geared to that. My feeling would be whether it's a chiropractor or an M.D., that's a choice a parent makes. The problem I see with regard to taking the child to a chiropractor is that it may not be a bone problem. It may be something else. And, if it is a medical problem, then hopefully if you take your child to a chiropractor he will recognize that and tell you it's not a bone problem and send you to your physician.
That's one of the problems about going to a chiropractor because I think there is an emphasis on the back and bones and it may not be that.
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We just had an early user who had the pain in the back, but was in the flank and that sounds more of a kidney infection than a back problem.
Event_Moderator What are the risks of immunization? I have heard that sometimes immunizations cause more damage than good?
Dr_Goldman_Speaker You have to understand that before immunization there were a lot of deaths; a large number of deaths and complications. Since immunization, there have been extremely small cases of deaths and few complications. You have to weigh it. Yes, it's a child. Is it worthwhile protecting your child against a disease that may cause complications like diphtheria or whooping cough? There are still cases of diphtheria and whooping cough around and it requires a lot of heroic treatment to clear these things up. So, why take a chance that your child may get one of these disease when the chances are almost 99 to 1 that the immunizations will protect them from getting the disease.
I was reading an article recently where 30 million doses have been given of this particular drugs and they have had 70 deaths. Now, you take 70 deaths from 30 million doses. The chances for a serious problem like death are miniscule...very, very, very small. There is a bigger chance in Southern California of getting hit by a car and killed then there is from getting an immunization.
Event_Moderator My child is afraid of needles. Are there alternatives to needles, like air guns, which I can request my doctor use on my child?
Dr_Goldman_Speaker I don't think there is much use. The only way you get an air gun is when you have a mass immunization, I think. I remember when we had Saban on Sunday. This is when the vaccine for polio came out from Dr. Saban and in order to immunize as many as possible, they used to have doctors and nurses go to different places, schools, etc. and people would line up and we'd immunize them. We had air guns and shots and what have you. But that's usually for mass immunization. For the run of the mill every day most doctors rely on needles. I used to be afraid of needles too so I understand what the child is going through. You just have to comfort them and in most cases they'll live through it.
Event_Moderator What do you think is the most important information that a parent should know about taking care of their child when they are sick?
Dr_Goldman_Speaker Doing the right thing. Depending upon what is the nature of the problem, take them to a physician. Use simple measures initially. If they're vomiting, definitely take them to a physician. If they have a fever, check with your physician with regard to either giving them Tylenol or Motrin. See that they eat properly and keep liquids in them, and basically following traditional methods. But, if the simple measures don't work, definitely take them into your physician.
I'd like to thank all of you for your questions. I'm not a pediatrician and I want you to know, but I've taken care of a lot of children. And, interestingly enough, the basic measures still apply. Good nutrition, rest, immunizations, etc.
Years ago we didn't have immunizations and that's when we had a lot of problems. Now we have immunizations and don't have those problems basically. Since most of the questions were regarding children. Please have your child immunized. You won't have any choice since the schools are requiring it. And that's for your protection, as well as for your child's and you won't see the complications we have in the past. And stay well! Especially during this season. Drink a lot of liquids.
And, if I may just add one more addition to the treatment of colds and flus, etc., especially with regard to this being a flu season and senior citizens being exposed. They do have medications you can give a patient that will protect you somewhat from getting the flu. That's been around for a long time and is available now. It doesn't always protect the individual depending upon the strain that is circulating in a season. But there is a medicine available for adults, as well as children.
And, those individuals who have asthma, which is very common, should be immunized against the flu because if they get the flu and they develop asthma, asthma has been causing a lot of complications lately. So, if a child has asthma, get him/her immunized; it's very important. As long as they're not allergic to eggs. That's very important.
Event_Moderator Dr. Goldman, thank you for joining us.
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