Saturday, October 28, 2006


Keep children safe on streets

It's Halloween. "It is finally here," said my 7-year-old daughter, who has been waiting for this moment since the beginning of summer. She kept a calendar, counting down the days until trick-or-treating time.

Halloween can be a fun time for all. Parties galore, costumes and the treats -- what is there not to be excited about? It is one last dose of excitement before the gloomy winter months.

Amid the Halloween hoopla, people need to remember to exercise safety precautions. The American Academy of Pediatrics recently released the following series of safety tips:

All dressed up

Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.

Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.

Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives.
Hats should fit properly to prevent them from sliding over eyes.

When shopping for costumes, wigs and accessories look for and purchase those with a label clearly indicating they are flame resistant.

Pay attention to weather forecast.

Perhaps having an overcoat may be useful for a cold night.

If a sword, cane, or stick is a part of your child's costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.

Obtain flashlights with fresh batteries for all children and their escorts.

Teach children how to call 911 if they have an emergency or become lost.

Home, safe home

To keep homes safe for visiting trick-or-treaters, parents should remove from the porch and front yard anything a child could trip over such as garden hoses, toys, bikes and lawn decorations.

Parents should check outdoor lights and replace burned-out bulbs.

Wet leaves should be swept from sidewalks and steps.

Restrain pets so they do not inadvertently jump on or bite a trick-or-treater.
Carving a niche

Small children should never carve pumpkins. Children can draw a face with markers. Then parents can do the cutting.

Votive candles are safest for candle-lit pumpkins.

Lighted pumpkins should be placed on a sturdy table, away from curtains and other flammable objects, and should never be left unattended.
On the trail

A parent or responsible adult should always accompany young children on their neighborhood rounds. Choose neighborhoods you are familiar with.

If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.

Remind trick-or-treaters:

Healthy Halloween

A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.

Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.

Wait until children are home to sort and check treats.

Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.

Many of these tips are general knowledge. But some might be overlooked in our busy lifestyles.

Paying attention might help someone and keep the fun alive. Have a happy Halloween.

Ravi Prakash, MD, is Chief of Pediatrics at The William W. Backus Hospital with a private practice in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Prakash and all of the Healthy Living columnists at

Thursday, October 26, 2006


Pack a healthy punch in your child’s lunch

Does your child have the same thing for lunch every day? “Brown bagging it” does not have to be boring – it can be a great opportunity to introduce more variety in your child’s diet.
Lunches do need to be healthy. With the childhood obesity epidemic sweeping the nation, and the fact that lunch supplies one third of your child’s calories for the day, it’s very important that lunch has eye appeal, tastes great and isn’t loaded with the wrong things.
Here are some hints to make lunch time more fun for your kids, and supply the nutrients they need to get through the day:
Involve your children in the lunch-making process – take them to the grocery store with you and ask what healthy foods they would like to have for lunches that week. Make it a game in which they pick out a new fruit or vegetable to try, and come up with a recipe featuring that food. Have your children help in packing or preparing foods for their lunch.

Include a form of protein in each lunch menu. Lean roast turkey or beef; tuna fish; a hard-boiled egg; tofu; soy or reduced-fat cheese; beans, natural peanut butter; nuts; and seeds all supply some protein and can be served in different ways. Remember: lunch does not have to include a “sandwich.” Salads, soups, casseroles, dips, pizza, even beverages can all supply protein and other nutrients. Try chili made with ground turkey and reduced fat cheese; hummus with whole wheat pita chips; pizza with shredded cheese and veggies made on a whole wheat crust; vegetarian lasagna; chef salad; or a shake made with silken tofu or yogurt blended with fruit.

Entice kids into eating vegetables by cutting raw veggies into fun shapes with cookie cutters and serving them with a low fat dip, low fat salad dressing or salsa for dipping. Include leafy greens like baby spinach or romaine lettuce; shredded cabbage or carrots or sliced cucumbers in sandwiches. Try doubling the amount of veggies and halving the amount of meat in casseroles, adding shredded or finely diced veggies to meatloaf mixtures or soups.

Go for whole grains when choosing breads for sandwiches. Look for sandwich bread or rolls that have at least 2 grams of fiber per serving. Keep lunches from becoming boring by varying the types of breads in sandwiches. English muffins, bagels, tortillas and pita bread all come in whole grain varieties and taste great too.

Make snacks/desserts healthy: In lieu of chips or cookies; include low fat pudding/yogurt, dried, fresh or canned fruit in juice, low sodium pretzels, pita or baked potato chips. Have kids assist in making healthy cookies with nuts or raisins or their own trail mix with nuts, seeds and dried fruit.

Set an example: Eat healthy yourself and keep only healthy foods in your kitchen. Children learn best by example, and if they see their parents eating healthy, they are more likely to do the same.
Remember the lunch packing ABC’s:
A: Vitamin A: Good sources include: apricots, carrots, spinach, sweet potatoes.
B: Vitamin B: (thiamine, riboflavin, niacin, B6, B12, folate) sources include: Whole grain breads and cereals, meats, fish, poultry, eggs, nuts, leafy vegetables, orange juice, cantaloupe.
C: Vitamin C: sweet peppers, pineapple, citrus fruit, leafy vegetables, broccoli, tomatoes and mangoes and Calcium: milk, cheese, yogurt, sardines, oysters, salmon and green vegetables.
Catherine Schneider is a Registered Dietitian in the Food and Nutrition Department at The William W. Backus Hospital. This column, which runs in the Norwich Bulletin newspaper on Tuesdays, should not replace advice or instruction from your personal physician. E-mail Ms. Schneider and all of the Healthy Living columnists at


Living healthier can have far reaching effects

I found myself hurrying to an appointment recently and stuck in slow moving traffic on Route 32. I soon felt irritated with the driver in front of me who seemed to be going well below the speed limit and the car behind hugging my bumper. I know after years of challenging myself with overfilled schedules (which I take complete credit for creating), that when there is little room for the unanticipated moments of life, stress is the outcome. The best definition of stress I’ve heard is “being here and wanting to be there”. It’s easy to see how the everyday kind of stress I was experiencing leads to a less than compassionate response to people, situations, and those who are driving these slow moving cars, not to mention towards ourselves.

People in Italy do not seem to live like this. I had the good fortune of visiting Italy this summer and aside from the drivers, the people seemed to understand the great value of taking time to thoroughly enjoy the pleasure of eating, visiting with family and working at a leisurely pace, even closing the stores and banks for a few hours in the afternoon when it wasn’t particularly hot. None of the stores were open in the evening. What a contrast to our culture where you can go grocery shopping in the middle of the night or as a friend of mine does work out at the gym at 4 a.m. When I heard the story of a man who had a heart attack washing his car at 2 a.m. I realized how we can too easily loose perspective, not let anything go, say yes to too much. There is a book titled “If Only There Were Seven of Me”. In reality those of us who are challenged in this way would probably find a way to do eight times more.

The effect of this kind of stress-filled living has a deeper than personal impact.
Our world today seems filled with turmoil, violence and uncertainty. Our planet is changing, and with more knowledge about the rapid progression of global warming, may be heading towards an irreversible crisis. War and violence between nations and within nations is causing untold suffering to scores of innocent people. Most people are living at a frenetic pace and aggression and unhappiness are surfacing in all aspects of our culture.

Our children are unfortunately learning from our example; filling every waking moment with activity. We may wonder why children in America are in record numbers taking anti-depressants and being treated for attention deficit and hyperactivity.

Many scholars and spiritual teachers have explored the connection between our personal, interior life and the reflection it creates in the world around us. When we are in discord within ourselves it is reflected in disharmony in our families, workplaces, neighborhoods, cities, country, world and our planet. Thomas Merton, a Trappist monk and author said, "There is a pervasive form of contemporary violence and this is overdoing and overwork. The frenzy of overdoing neutralizes our work for peace and harmony”.

We have become restless and uncomfortable unless our bodies and minds are moving, and our health and wellbeing are suffering. It is believed that at least 80% of illness today is stress related. Interestingly, the Chinese symbol for busyness is translated as “heart killer”. We might consider this on a physical as well as emotional level.

How are we contributing to this personal and global crisis, and what small steps can we each take to begin transforming our usual way of being? If we each ask the question what can I do to contribute to a kinder and more compassionate way of living each day, we may personally and collectively begin to turn things around.

The changes we choose to incorporate into our life will be different for everyone.
The physical body might be the starting place. We may choose to become more aware and mindful of what and how much we are eating and drinking, and if we are giving our bodies enough rest and exercise. We may find that our mind, emotions or spiritual life need attention first. The beginning point is not especially important. One thing will lead to another and one change to another. Choosing to live more mindfully will soon affect how we treat others and the earth itself.

There are many wonderful programs and teachers available to help us to begin a course of transformation and change if needed. Meditation, yoga, tai chi, spiritual direction or counseling may be very useful. For some people doing less, saying no to adding more activities, spending more time in nature, gardening for the simple pleasure of it, reading or just sitting quietly and doing nothing at all may be helpful ways to reconnect with life. In the words of the poet Roethke, “I recover my tenderness by long looking. By midnight I love everything alive”.

Science has proven again and again the interconnectedness of life in our own bodies and in the world of which we are all a part. When we to begin to live more consciously we will affect our health and the well being of our world.

As with any deep wound, true healing begins from the inside out. To heal our world, we must heal ourselves.

Amy Dunion, a registered nurse and massage therapist, is Coordinator of The William W. Backus Hospital’s Center for Healthcare Integration.This column, which runs in the Norwich Bulletin newspaper on Tuesdays, should not replace advice or instruction from your personal physician. E-mail Ms. Dunion and all of the Healthy Living columnists at

Wednesday, October 25, 2006


A stubborn cough can be a sign of asthma

Now that fall is here, I see many cases of asthma in my office. Here is an example:

John, a 10-year-old, was practicing for the “mile run” and was unable to complete it because he ran out of breath and was coughing.

I see John in my office and discover that he has never wheezed before. However his “colds” last a long time. John’s mother said “his colds always last for weeks. Many of the times they go down to his chest.” I notice that John’s mother also coughs occasionally, and denies having asthma or allergies herself or anybody else in the family. I also learn that they have a cat and a dog in their house, and John’s parents smoked.

Asthma, or Reactive Airways Disease, is a common problem and remains one of the more under recognized conditions affecting children of all ages.

What is Asthma?
Asthma is a chronic or long-term disease of the airways. The small tubes that carry air to the deep parts of lungs generally become narrow and inflamed. There is excess mucus production which is very sticky and further narrows the airways. It is very hard to clear this thick sticky mucous, especially in children who do not have big muscles or large lung volume to generate the force needed to bring it out. Children tend to gag or throw up with an episode of continuous coughing. This type of symptom is very typical of asthma in young children – especially infants and toddlers.

Who gets Asthma?
Asthma is a common childhood condition. In the United States, 10-15 percent of children in school have or have had asthma, and it is a significant reason for absences. The number of children with asthma is increasing, and the reasons for these increases are not exactly clear.

Having parents that suffer from asthma and allergies, having pets such as cats and dogs and exposure to second hand cigarette smoke increases the risk of developing asthma. Another childhood viral infection that is common during winter months, known as respiratory syncytial virus (RSV), is also known to increase the risk. Children with asthma do not necessarily have to wheeze. Cough alone can be a common symptom of asthma as illustrated above. The lingering cough after a cold could be a mild form of asthma. Further, as happened with John, strenuous activity can bring on airway narrowing.

How is Asthma diagnosed?
Doctors usually are able to diagnose asthma from gathering all the pertinent information and by examination of the patient. Simple tests can be used to demonstrate the airway narrowing; and reversal of this narrowing with appropriate inhaled medications is a good tool. Chest X-rays are not necessary.

How is Asthma treated?
Treatment of asthma has come a long way from the early days. Typically doctors use an inhaled medication known as Albuterol, or something similar, which helps in relieving airway narrowing. In infants and toddlers, this can be achieved by the use of nebulizers that deliver the medicine in a mist form. For some, as in the case of John, use of an inhaler prior to the strenuous activity is advised.

If your child has asthma symptoms more than twice a week, there are other medications that can be utilized. These medications reduce the airway inflammation and hyper reactivity. Avoiding exposure to dust and cigarette smoke also helps.

If this seems familiar to you or you know someone that suffers from similar symptoms, talk to your doctor. Do not just assume you have a cold and are passing it around in family. It could be more than that.

Ravi Prakash, MD, is Chief of Pediatrics at Backus Hospital with a private pediatric office in Norwich. This column, which runs in the Norwich Bulletin newspaper on Tuesdays, should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at


Football season brings many concussions

I know football season has officially begun when there are more athletes in my waiting room complaining of headaches. These headaches are often the result of a concussion. Each year over 300,000 brain injuries occur in sports. Twenty per cent of all high school and collegiate athletes will experience at least one concussion during their sports careers.

Every year we recognize more concussions at college, high school and junior levels of competition. The increased numbers are not related to poor equipment or coaching techniques but rather an effort by the Centers for Disease Control and several medical organizations to educate coaches to recognize the early signs of concussion.

A concussion is a brain injury. It consists of an impairment of neurologic function secondary to mechanical forces, most commonly the result of impact between the brain and a solid object. This is typically caused by a collision or a sudden jerking motion of the neck (whiplash). Concussions vary from mild to severe. Typical symptoms include headache, nausea, dizziness, confusion and blurred vision. Brief loss of consciousness and amnesia at the time of injury is not uncommon.

Recently, I had the opportunity to examine a young man who had suffered a head injury during football practice. He immediately had a headache and dizziness, which improved after resting. He didn’t report the injury to his coaches and returned to practice where he was involved in a seemingly minor collision with another player. His headache returned, he became disoriented and began vomiting. His next stop was the Backus ER and eventually to my office. Unfortunately, his headaches have persisted and he is having difficulty concentrating days after the injury. While I believe this athlete will fully recover, his season and possibly his football career are over because he failed to admit having a concussion to the coach or athletic trainer.

Failure to recognize the symptoms of concussion may result in permanent neurologic injury or death. Several years ago, researchers identified the “second impact syndrome.” This is a situation where two or more concussions occur in a short period of time. The brain then begins to swell uncontrollably resulting in sudden death, often before the athlete can be removed from the field.

When asked to evaluate an athlete immediately after a concussion, I assess the level of alertness, eye movements, size of the pupils, limb strength and coordination. Before being allowed to return to the game, the athlete must be able to perform wind sprints and other exertional tasks without symptoms. More serious injuries require brain-imaging studies in the form of CT or MRI scans.

Early recognition of symptoms and proper use of helmets are the only ways to minimize neurologic damage from concussions. It is my hope that by educating coaches, parents and athletes, we can avoid catastrophic injuries.

For a CDC tool kit to help prevent sports-related concussions, and recognize symptoms, click here.

Healthy Living appears in the Norwich Bulletin on Tuesdays, written by rotating medical professionals at The William W. Backus Hospital in Norwich, Connecticut. Dr. Anthony G. Alessi is a neurologist on the Backus Hospital Medical Staff and in private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Dr. Alessi and all of the Healthy Living columnists at

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