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KEEPING OUR CHILDREN ALIVE

June 5, 2014

On May 17th at a local high school in Prince Georges County Maryland, a symposium was hosted by me and my wife to educate teenagers, young adults and their parents about avoiding situations that could alter their life. In response to the killing of Trevon Martin and Jordan Davis, we felt such a proactive program was needed for our kids.

We were fortunate to have the HBO award winning writer and director of the film THE TOMBS come from New York to participate in a panel discussion and to show his 20 minute film. Jerry LaMothe has won many awards for his thought provoking films but this film was pertinent in that it emotionally showed the story of a man going through the police station after being arrested and being detained until arraignment. It showed our audience the pitfalls of our legal system especially when one is devoid of money and resources. The other panel members included a pastor, a defense attorney, a representative from The National Action Network, police officers from the District of Columbia and Prince Georges County as well as representatives from the States Attorney office and a delegate from the State of Maryland government.

Often when attending discussion panels the question that arises is “what are we going to DO about it?’ Talking is fine but it gets you nowhere if there is no action. The action that I had to take before the program could emerge was exhausting. I had to find a venue, design and print flyers, pull together a panel of volunteers who would commit, and advertise. I starting getting the program off the ground about 3 months prior. Hitting the pavement to barbershops, salons, car washes, store fronts and grocery stores throughout the northern part of the county was hard and time consuming work. Talking to school counselors and principals, visiting the post office many times to send out posters and flyers were part of the commitment. Then there was the financial cost. Ever wonder why a budget always gets out of whack? I figured the total cost would be about $1000. The rule of thumb is to take your projected cost and simply double it. The $2,000.00 came out of my pocket and this event was FREE to the public. There was never any plan on making money out of this venture- it was a service to the community. Doing a little suffering never hurt anyone. Do you believe that it is better to give than to receive? Producing such an event will test your belief in this statement. In fact I would suggest you try a test on your morality: Instead of putting one or five or even ten dollars in the plate at church, just once, write a check for double or triple the amount you usually put in or write a check to your kid’s school PTA for any amount you can afford or donate some time to any worthwhile venture and see how you feel. I can tell you that the reward is a private one between you and your maker. It gives your mortality meaning in the sense that before you pack your bags and leave this planet, you know you have tried to do something GOOD. I am going to tell you another secret (and this is really weird) once you try giving without the expectation of receiving, it becomes addictive. You’ll want to give more and more.

So what did we take home from this symposium? I learned that the teenagers and young adults today live in a digital world. To make an impact on them YOU have to enter that digital world. The movie was very intriguing to the kids but once our panel of esteemed professionals began our discussion, you could see the kids tuning out. On came the smart phones and away began the texting and video watching. As the older generations, we need to connect to the young folks through the visual media; auditory connection is dead.

It’s the same reason your teens don’t want to place an old fashion phone call anymore. They need to see the communication either by the visual words or pictures. Hence, wouldn’t it be great for the social activists, politicians and community leaders to hook up with the new generation of movie makers and present messages via the visual-digital world. This may not necessarily be 90 minute movies (although that’s all good too) but shorts can go viral on Vines and U-Tube and Facebook and the like. Kids love comedy; even though our messages are more serious than watching Kevin Hart, we have to inject some comedy in our presentations. The nice thing about the internet is that to produce an influential piece of entertainment you don’t have to go through an agent and spend gobs of money.

There are some practical things we “took home” from the adult discussion however:

  1. It is not against the law to record any encounter with a police officer (Maryland law) although most of the panel thought this may provoke the officer and advised against it.
  2. After putting on blinkers and slowing down, you have the right to drive to a well-lit place when pulled over by a police.
  3. It is best to turn the interior lights on in the car when pulled over by police at night.
  4. If you are associated with a group and one member of the group is charged with anything illegal (drug or handgun possession) you will likely be charged as well and will have to report to the police station until the details of the individual encounter is straightened out. It does not mean that you will have an arrest record if you are released.
  5. It is not conclusive that oral sex (alone) can spread HIV.
  6. IF you choose to smoke marijuana, it is better to be caught on campus as a student than out in the community. However, it is important for the parents and students to know in depth the consequences of this action at student orientation. Even if you are in a state that has legalized the drug remember that if you are under 21 it is still illegal.
  7. Although criticized as almost “bowing down” to a police officer, it was agreed that teens exemplify respectful behavior when interacting with a police officer. Often, but not always, this may avoid harassing situations like auto searches or pat downs.
  8. Further discussion groups like this should include teens on the panel to keep their attention.
  9. Further discussion groups like this should have teachers on the panel. So start you own panel discussion groups at your school. I think the principal and PTA groups would be amenable.

Time restraint kept us from getting to other pertinent questions. Overall, (especially with the movie) most thought the program to be valuable and worthwhile. Many parents said to me “we have to do this again.”

So start you own panel discussion groups at your school. I think the principal and PTA groups would be amenable.

Until next time…….see ya !!

Dr. “D”

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Marijuana and College Campuses

March 17, 2014

Many of my patients are now on college campuses throughout the country.  Certainly, as a freshman, they are almost always living in a dormitory; unless they attend a commuter college.

I have learned through feedback from college students that there is a subject that needs our attention as parents so we can better prepare our kids; smoking marijuana in the dorm.  Now, you noticed I said “in the dorm.”  Smoking, possessing, paraphernalia may pose different punishments if they are caught in the city off campus or even on campus outside the dorms.  Of course, this will vary from state to state and their respective laws;  but,  because most students are below 21 years of age, it would still be considered illegal.

Here, I’d like to focus on “the dorm” issue.  I know this will vary with the region of the country,  whether you are in a state school or private. Where I went to undergrad in a very small private New England college drug use and experimentation was a non issue; the college didn’t care as long as you didn’t burn down the building.  NO ONE was reprimanded or punished for such action. However, in large state supported schools there seems to be a no nonsense policy that if caught smoking in the dorm, them your right to reside in any of the dorms either that year or for the remaining time you are at the college is taken away. You are left with finding your own living space off the campus grounds. That may not pose a problem for the upperclassmen and women since they would probably welcome the idea and parents would relish in the cost savings.  It does pose a problem for freshmen who generally don’t have cars and can’t legally sign for rental cars and apartment leases. This is where the parents are brought in for the added costs and inconvenience of providing alternate living space falls on our shoulders.

I guess the philosophy is that if a student uses drugs in the dorm that such behavior may ”infect” or affect other students and possibly convert them into “druggies.” Generally college campuses don’t expose such behavior to the local police; they would rather handle the issue internally. Alcohol (equally illegal for those under 21) is handled differently. There usually is a “three strikes you’re out” policy for alcohol possession so it gives a little more allowance.  It would seem to me that drugs use should be handled in the same way since young students will make mistakes in their judgment. I would think since accepting the student in the first place that the school would have an investment in their students and give them warnings prior to being put in the “slammer.”

Here’s where the real problem lies: The issue of alcohol and drug use almost always is in any given school’s handbook regarding code of conduct. It is discussed (sometimes lightly) by Sophomore RA’s and not anyone of adult authority. Since the penalties can be grave, you would think that all students during freshman orientation be given a clear warning BY AN ADULT in charge of student housing.

So, what do you do? ……..   Kids on campus WILL take risk and use poor judgment with alcohol or drugs. It is unreal for a parent to tell their freshman son or daughter to “don’t do drugs or alcohol” and believe that will “stick.”  So my advice would be “If you must indulge, DON’T DO IT IN THE DORM!!”   “I can’t afford to pay for your dorm room AND an apartment.”

For any parent attending orientation for their child in college, I think it would be very important for you to clearly understand the school’s policy and have it in writing including the right for appeal process. It would be very valuable for you the parents and your child to talk to upperclassmen about this subject as well.

ENJOY THE SPRING !!

Dr. “D.”   

OBESITY & HIGH FRUCTOSE CORN SYRUP

October 5, 2013

In 2011, the CDC  (Center for Disease Control) conducted a study of obesity in the United states and found that since 1980 the rate of obesity and type 2 diabetes mellitus sky rocketed over 100% of what the rates were in the 1960’s and 70’s.  What went on since the 1980’s to have such a drastic effect on this rate? In the 1980’s small farmers were drastically losing control of their farm business because of the emergence of big corporate food industries like Monsanto and Sysco.  There used to be small hardware stores in most neighborhoods until Home Depot and Lowes took over.  It’s hard to find a corner hardware store anymore. The same thing happened with the food industry. Small farmers could no longer compete. Well, if you now have a large conglomerate, for profit, public company, the number one priority is developing large enough profit margins to satisfy stock holders and maintaining the financial health of the company.

The tip of the human tongue has receptors that detect sweetness.  This is a very powerful stimulus to the brain that habit formation is quick to develop.  Who doesn’t like sweets?  Prior to the 1980’s most of our drinks and foods that called for sweetness used cane sugar. In fact, many other foods that we normally don’t associate with sweetness will have a small amount of sugar to create a habit for that particular brand. Caffeine is a good analogy here because neurologists certainly are aware of the habituation we humans have toward the drug and hence food and drink manufacturers added this to their products (i.e. soft drinks) so that we would be sure to come back and get that product again. Sugar cane does not grow well in the USA; most of its production comes from Central American countries like Trinidad, Haiti and the Dominican Republic.  This is one reason why these countries were so valuable to the French and other European countries because this “new spice” was even better than those found in the East Indies and China.

So, to use sugar in your foods as a major company you had to import the stuff and that cost money.  It’s logical that a major company, in order to increase the profit margin, would adopt a policy of “spending low and selling high.”  In the 1980’s chemical scientists working for the food industries began working on a new sweetener.  After much experimentation, they found the answer. Take corn which grows readily in the USA and extract its starch.  Dry the starch and what you have now is corn starch. Corn starch contains two sweeteners called fructose and glucose.  You simply had to add an enzyme chemical to the corn starch and you get these two products. Glucose didn’t pass the test for a sweetener because it simply was not sweet enough. Fructose was somewhat sweet (it’s the stuff that makes fruits sweet) but not as good as cane sugar.

So what the researchers did was to concentrate the fructose making it taste like cane sugar.  Now you have what we call high fructose corn syrup (also called modified corn syrup, modified corn starch, corn syrup solids).  It passed the taste test!!  Since then food manufacturers have been using high fructose corn syrup in everything!  Check the ingredient labels of your food in the pantry and as you go grocery shopping and you will be surprised as to how many products contain high fructose corn syrup.

Now here is where gets is “kinda” technical.  When we consume cane sugar (also called sucrose) it has to be broken down in the intestines.  This takes time and SLOWLY the products of cane sugar enter the blood stream.  The pancreas is the organ that takes the sugar in the blood (glucose) and acts like a security clearance agent that allows the glucose to enter every cell of the body for energy.  The more glucose, the more the pancreas has to work; the less glucose the less the pancreas has to work.  Fructose does not have to be digested and it RAPIDLY goes into the blood stream right after consumption. Well, this is OK to some degree (such as eating fruits) but if we have highly concentrated fructose rapidly enter the blood stream it overworks the pancreas.  When the pancreas is overworked the level of insulin produced by the pancreas is high and this is a signal to the brain to increase fat stores and do everything possible to increase body fat.  Since the pancreas is overworked, it will eventually become exhausted and fail at its function. This is when diabetes steps in.  The more we consume concentrated fructose the worse things become.  Down the road, heart disease, kidney disease and certain forms of cancer develop.

It’s cheap for the food industry but it is a slow poison to us consumers. This is the reason we are seeing not only high frequencies of obesity in children but also the emergence of type II diabetes. Pediatricians never thought they would be treating adult type diabetes in 12 or 13 year olds. We never though some of our patients would become so obese that the scales to weigh them were inadequate.  We never thought that our blood pressure cuffs couldn’t fit around their arms because of such obesity.  The life expectancy of those with extreme obesity certainly will be cut short. I will never forget a 15 year adolescent who was over 400 pounds and died that year from sleep apnea and heart failure because of his weight.

Sooooo,  What are we to do?  For all of us, get out and do something physical!  The body will pay you back for it. The next thing is to try reducing your consumption of high fructose corn syrup.  Do your grocery store research; look at the ingredients.  If it has high fructose sweeteners,  PUT IT BACK!  Although more expensive, there are usually substitutes that taste just as good if not better.  The body takes its time adjusting to new lifestyles; so be patient. After 4 to 6 weeks you will notice and see changes that will make you smile; not simply because of the way you look but more importantly, how you FEEL.

….till next time,

Dr. “D”

CHILDHOOD SAFETY

February 19, 2013

This blog is geared mostly to parents who have toddlers and young children but not limited to that age group.  I am going to assume that you have certain safety practices in place such as a car safety seats, guard rails and even outlet plug covers. Over this Winter I had encountered several accidents described below that should serve as good reminders.

A two year old boy “eyes” a coffee mug belonging to the parent near the edge of the table.  The cup contains hot tea that the mother just brewed and took a sip from. Mom was quick at catching the child’s desire to grab the cup and moved the tea toward the center of the table. You would think that all is well but moments later, when Mom was “off guard” the toddler pulled a chair over to the table, proceeded to climb onto the table and grabbed the cup. Well, that hot tea poured over the forearm resulting in a second degree burn, a trip to the hospital, lots of pain and parental guilt.

A four month old infant was placed on the exam table by the mother prior to my arrival so that a fresh diaper could be applied. The mother was by herself. When turning to retrieve a new diaper, WHAMM! Down goes the baby onto the floor. The intense scream caught my attention and upon my arrival the mother was understandably frantic with tears streaming down her face. Fortunately, the baby was not harmed.

A two and one half year old boy was in his crib as usual and one morning finally was able to exert enough muscle power to “pole vault” the crib’s guard rail. All was doing well when the toddler was at the top of the rail but when trying to descend toward the floor for freedom the right foot got caught and the boy was suspended head hanging downward and screaming louder than the alarm system. When the parents came to the rescue, they noticed the right thigh was grossly swollen. The emergency room evaluation revealed a spiral fracture of the right femur bone requiring surgery. The battle with Child Protective Service did not make it any easier for the parents. The child did well after all was said and done.

We had a round glass coffee table in the living room that was about three quarters inch thick. There were no sharp edges and the top was heavy enough that it seemed to present no problems.  My son (why is it always the boys?) loved to run into that room and use the table as a brace to stop his momentum. This went on for months so it was considered safe.  Well, one day the usual impact resulted in the table top tipping over. The weight of the top certainly would have caused a fracture of the foot or toe but what was earth shattering was that the glass broke in half right in front of him. Thanking all angels in heaven, he was not cut or injured in any way. We, as parents, were mortified. The table was never replaced.

The case I will never forget involves a one year old girl who, while exploring the floor, found Mom’s recently lost diamond earring stud. When Mom saw the child with it, suddenly time slowed down as Mom saw the child place the earring into the mouth and swallow it despite Mom’s attempt to run over and abort the mission. After finally reaching the child’s mouth, yep, it was gone! “My child has eaten my precious anniversary given diamond ear ring stud!” That’s when I got a call. Syrup of ipecac was given (over the counter) by mouth and after drinking some water the child vomited and the ear ring was recovered.

Over the 2012 year I cared for about 12 children involved in fairly serious auto accidents many involving the total destruction of the vehicle. I am presently involved with driver training for my last child, and what I realized, is that when you are teaching a teenager to drive defensively, you realize how inconsiderate other drivers can be even when there is a “rookie driver” sticker on the car. Despite the wide use of money making photo cameras throughout the D. C. area, when the coast is clear you see the release of frustration by many drivers speeding and cutting in and out of lanes. Placing your child in an automobile is one if not the most dangerous things we do to our children and we do it almost daily. When strapping them in simply give thought that this may be the time you get into a bad accident.

Just a few more comments.  While raising children there is one thing I’d suggest you NEVER have; a deep fryer. Third degree burns give rise to lifelong scars that surely will influence the psyche of that person eternally. Every child will have accidents no matter how hard you try to avoid them. Don’t be so hard on yourself with blame; assuming that you are doing your best.

See ya!

Dr. “D”

ABOUT OUR TEENAGERS

June 1, 2012

I was in a McDonald’s restaurant one Saturday afternoon after doing yard work and noticed four teenage males sitting at a table and having fun with their rambunctious conversations. The volume was loud and became louder. The cursing was mild and then became volatile. The “MF’s” the “N” word were in every sentence. The hats were carefully placed upon manicured braids and dreads. The blue jeans were tightly wrapped around the thighs so the “proud” buttocks could be imagined under the dirty underwear.

I didn’t budge very much since this is commonplace in the Washington D.C. area as probably in all urban areas. I kept reading my book as I continued to refresh my thirst with my cold drink.  Two fellows got out of their seats and began to play “tag” running around the eating area like four and five year olds.  The other two proceeded to do the same.  After a while the eating area transformed into a circus; the four teens acting like fools and the audience very quiet but attentive to what was going on.  I looked at the members of the audience and there was fear in their minds.  “I’m not going to get involved” I could imagine them saying.

At this point, my mental kettle began to hiss. I wasn’t sure I was upset at the teenagers or whether I was mad at the “do nothing” patrons. After a few more seconds, my primitive brain took over;  I couldn’t take it anymore!  It was deplorable behavior and frankly embarrassing to me because these kids were of my own African American race.  I stood up, came over to one of the boys, injected a very serious look into his eyes and told him to “cool it right now!!’ “You guys are acting like you WANT to be arrested when a patron secretly calls the police. What could have resulted in a confrontation with me and the teenagers turned into them looking at me with fear and eyes so wide open and apologetic. “I’m sorry mister” he said to me. I later sat down with all of them and explained how Michelle Alexander’s book, The New Jim Crow, explains how their behavior is profit material in the new prison industrial complex. THEY ACTUALLY LISTENED like no one has ever explained this to them before. They were all quiet now, sitting and apologetic again.

I then left what could have turned into a bad scene.

The lesson here is about fear. “You shouldn’t get involved; they may have a gun” is what we adults all hear. “Let the police take care of it.”   The above may all be true.  Approaching a teenager in public requires a great deal of sensitivity, however.  Let them know you have concern for them;  after all,  you are protecting them from what could result in a lifetime of derailment and an emerging hostile adult.  Be firm but not accusatory.

You will be surprised and renewed about the power you have as an adult. It may help when you have to chastise your own teenager when they challenge you,  often to the point of confrontation

They may look threatening but they are just physically grown up kids still.  Remember that.

…….talk with you soon,

Dr. “D”

MUSIC TO MY HEART

February 24, 2012

I was entering the exam room the other day to perform a routine physical exam for an eleven year old child. Nothing was unusual. Smiling faces from child and mom lifted the spirits and pleasantries were exchanged. What immediately flashed in my eye was a brand new iPhone with bright pink and silver ear plugs attached to the child; nothing unusual.  Since I am a music lover way back to elementary school, I am always curious as to what the young folks are listening to. “Can I listen to what you are hearing, I said.” As the ear phones were placed into my ear, I immediately started tapping and bopping to the rhythm. It was a female rapper. I inquired as to who it was but that info is not pertinent to my main take home message. What was different with this song was that I could clearly hear the words she was saying. What was more surprising was WHAT she was saying!!

I realize sex and all of its subsidiaries are central to lots of rap lyrics. It’s also central to American capitalism.  So to hear about sexual content on a rap lyric is no big thing as long as there is some discretion. What I heard on this piece was absolutely appalling.  The artist began begging her partner to explore and manipulate EVERY orifice of her body with every conceivable part of his body. (This is a nice way of saying that if there was such a thing as audio only pornography, this was it.)  There were no metaphors (which I could have better tolerated) to captivate the art of suggestion. Clear cut wording was what I heard. And by the way, the foul mouth cursing seemed mild compared to the content of her words.

So what is up with this experience?  I continued to bop and tap to conceal my astonishment and slowly removed the ear plugs from my ears. What bothered me was this was an eleven year old girl listening to this in front of her mother. I did not make a big deal out of this then because I had to calm my emotion of shock in order to be balanced. Obviously it continues to bother me so this is why I write about it.

Mom’s and Dad’s, I know you like your music relevant to what you grew up with, but do your own “study” on what your kids are listening to. Ask them to inform you of the latest rappers and video artist. Listen to them TOGETHER with your kids (they may be embarrassed but that’s ok). It’s a good intro into having family discussion about sex anyway. Our culture is such that this kind of entertainment WILL be out there for them no matter what. It is your job to put all of this into context as to:

  1. Maintaining your own morality within a sea of immorality
  2. Understanding that immorality sells
  3. Look at the target audience and surmise what influence media moguls would like to mold you into.

By the time that eleven year old begins his or her introduction to sexuality, there is already a preconceived acceptability about sexual inappropriateness. Sex and sexuality is part of being human. It is a very wonderful and enjoyable entity. I tell this to teenagers. It is a process however and not an immediate act to be followed because famous celebrities (and their money suppliers) promote it. The process should be slowly started by Mother Nature and guided by adults. Only then will the result be a healthy sex life which is important for long term adult committed relationships.

Oh, and by the way, don’t think that I am not going to bring this subject up to the mother I mentioned. I am sure the mom bought the IPOD; she has a right to listen to everything on it!

….talk to you later this Spring….

Dr. “D”

The FLU Confusion

October 11, 2011

By now I am sure you have seen plenty of visual and radio advertisements about getting your flu shot. Every drug store seems to be in on it. We physicians are called, e-mailed and faxed weekly about stocking up on flu vaccines. I got a call in June from a pharmaceutical rep pushing the sale of flu vaccines and encouraging me to start giving the shots in the summer. Wow!

Influenza (also called the flu) is an illness that usually starts in the winter and can continue until next spring. The majority of times the illness last for 5-7 days and is characterized by fever, malaise, body aches, headache and the typical cold symptoms of nasal congestion and cough. The majority of times people recover without problems. People who are at risk for complications are the very young (under 2 years of age) and the elderly.

When pharmaceutical companies make the vaccine (which is done for every year) they are guessing what strain of virus is going to be present that year. Sometimes they are right; sometimes they are wrong. It is clear that the flu virus changes every year- this is called changing the strain- If one gets a flu shot and it is not the particular strain that arrives in the winter then the shot is of no value. Generally, the side effects of the vaccines are minimal. There will always be the potential for someone to get severe side effects such as damage to heart muscle, allergic reactions and neurologic problems such as Gullain-Barre and Reye’s syndrome but these are rare. This poses a dilemma for the individual if they realize the shot may not work and there are possible side effects. Focus has been on encouraging the young and old to get the vaccine but this is the age category that is at greater risk for further morbidity if a serious complication arises.

The vaccine is available in a nasal spray for those over 2 years of age. This type of vaccine is what I encourage because of ease of administration, better protection of the blood and mucous membranes and fewer side effects. The time to get the vaccine is obviously close to the time of the disease. It takes about two weeks for the body to develop antibodies to fight the disease so any shot or spray given two weeks prior to winter is fine.  In our area of Greater Washington D. C., our winter usually kicks in during late December or January. I generally don’t start giving flu vaccines until late October; getting a flu shot very early may weaken one’s antibody level to fight the disease.

Of practical concern are the measures one can do to prevent getting the flu.

These include:

  1. Focusing on good nutrition;
  2. Increasing sleep time an additional hour more than usual;
  3. Airing  out your home or office or daycare center weekly for 15 minutes by opening windows and allowing for fresh air if possible;
  4. Using  HEPA filters in daycare centers and the work place would be great;
  5. Practicing good hand hygiene with good hand washing and use of sanitizers.

Fortunately the cost of the vaccine is not too expensive. The average cost around the country is about $30.00

I’ll talk to you again in December!!     Happy Thanksgiving!!