August 2003

Hope you are all enjoying your summer. Please remember that New York State requires school physicals for grades K, 1, 3, 7 and 10. We do however recommend yearly physicals for all your children. Just make sure the date of your child's physical is o.k. with your insurance company. Some insurance companies allow one physical per calendar year while others allow one physical every 365 days or later, so if in doubt, call your insurance company in advance of your appointment. It is difficult for us to know all insurance company rules since we accept so many plans. Congratulations to Alexandria Daston who won our "How many lollipops are in the clock contest". Her guess of 121 lollipops was closest to the 120 lollipops that were in the clock. Alexandria wins a Blockbuster gift certificate.

Dr. Barenfeld

Swimmer's Ear------------------------------------------

Swimmer's ear or otitis externa is a bacterial infection of the ear canal. Prolonged underwater swimming causes the sensitive skin of the ear canal to break down, thus allowing bacteria to enter. Ear wax acts as a protective barrier against this infection, therefore excessive cleaning of the ears may actually increase one's chance of getting this infection. Those of you who have had swimmer's ear know how painful it can be. Antibiotic ear drops are the mainstay of treatment. Some of these drops also contain steroids which help decrease the swelling more rapidly thereby reducing the pain quicker. Sometimes the ear canal is so swollen that the eardrops cannot penetrate fully into the ear. In this case an ear wick is inserted into the ear to allow proper distribution of the medicine. Antibiotics by mouth are not helpful for this condition unless the infection extends deeper into the ear. There are a few things that can be done to help prevent swimmer's ear. How much cleaning of our ears should be done? As discussed earlier, wax in the ear is normal and protective. However, too much wax can trap water in the ear and cause the condition too. Frequent or aggressive use of Q-Tips can also injure the ear and is not recommended. Ear plugs, especially custom made plugs, help prevent water from getting into the ear. Lastly, a 50-50 mixture of white vinegar and rubbing alcohol can be used. Just put 4 or 5 drops in both ears after swimming to prevent the infection. So, everybody in, the water's great!

Mind Bender of the Month---------------------------------------------------------------------- In honor of Harry Potter and the Order of the Phoenix, try these puzzles. A perfect score will surely help you pass your O.W.L.'s. Good luck.
BAGMAN DURMSTRANG PORTKEY BEAUXBATON EGG RITASKEETER CEDRIC FLEUR TASKS CHAMPIONS MADEYE TOURNAMENT CROUCH MAZE VIKTOR DRAGON MERPEOPLE WINKY	BLACK (Sirius) FIREBOLT PRONGS BOGGARTS LUPIN RAT BUCKBEAK MAP SCABBERS CROOKSHANKS MOONY TIME TURNER DEMENTORS PADFOOT WEREWOLF DOG PATRONUS WORMTAIL

Parent Questions of the Month-------------------------------------

Q. Dr. Barenfeld, should I put suntan lotion on my infant?

A. We have all been enjoying this summer especially after the long snowy winter and rainy spring. Finally our children are out of the house and away from their video games. However, it is important to remember that even though the sun makes us feel and look better, its effects have led to a dramatic increase in skin cancer. In 1935 the lifetime risk of developing skin cancer was 1 in 1500. By 1991, it had risen to 1 in 105. Today skin cancer occurs in approximately 1 in 75 persons. Although it accounts for only 2% of all pediatric cancers, the incidence in older adolescents has doubled in the past 10 years. In the United States, melanoma is the sixth most common cancer in adolescents 15 to 19 years old. An estimated 80% of lifetime sun exposure occurs before the age of 21 years, and it is estimated that regular use of sunscreens in the first 18 years of life could reduce the lifetime incidence of all skin cancers by 78%. Sunscreen product recommendations include the use of products that offer both UVA and UVB protection and have an SPF of at least 15 to 30. Sunscreen should be applied 15 - 30 minutes before going outside. Always use an adequate amount (one ounce covers the average adult body). Reapply it every two hours, after swimming, and after vigorous activity. Waterproof products are recommended for swimming. Now to finally answer the initial question. Sun avoidance and the use of protective clothing, including a hat, are the most important measures for children younger than six months of age. It is, however, safe to apply PABA free sunblock to exposed areas of the skin, such as the arms and face - avoiding contact with the eyes. Above six months of age manufacturer's labels should be followed.