Conquering Those Growing Pains
You might also want to consider a helmet for your wannabe Sasha Cohen. In a report in the August issue of Pediatrics, Smith found that kids are more likely to injure their head and face ice skating than while in-line skating or roller skating.
STREP THROAT
Ask for proof positive before a pill
Your child says her throat really hurts. She's got a cough and a runny nose with a nasty green discharge. She's been home from school for three days. Strep throat, right? Wrong. Only 15 to 36 percent of children who have sore throats turn out to actually have strep, an infection caused by the streptococcus bacteria. The majority of kids' sore throats are caused by viral infections, and antibiotics have no effect.
Fever accompanying a sore throat is a surer indicator of strep than coldlike symptoms, although in children the signs vary widely. If your child has been sick for a few days, talk with your pediatrician; make sure he or she does a strep test before prescribing antibiotics. A rapid test is now available that can diagnose strep in just 20 minutes, but a 2005 report in the Journal of the American Medical Association found that over half of physicians prescribed antibiotics for children without performing a strep test first. Overprescribing antibiotics contributes to the rise of bacteria that are resistant to them, a major public-health concern.
Parents and doctors also make the mistake of believing that newer, broader spectrum antibiotics will deliver a stronger punch and flatten the strep bug better than old-fashioned penicillin, the best drug for the job. Bad call. "The bug that causes strep can be resistant to azithromycin and newer antibiotics," says Jeffrey Linder, a physician at Brigham and Women's Hospital in Boston and lead author of the study.
BROKEN BONES
Old methods are cast aside
Just a few years ago, a busted femur meant a kid would be stuck in bed for a month or more, leg elevated in a full-length cast and immobilized while the bone knit back together. These days, orthopedic surgeons often skip the cast and the traction and mend long-bone fractures in arms and legs by inserting a flexible titanium rod into the center of the bone to stabilize it. The child will have a half-inch long incision in the thigh, but no cast, and could be walking around with crutches the next day.
"We used to have an aversion to operating on children," says Michael Vitale, a pediatric orthopedic surgeon at the Morgan Stanley Children's Hospital of New York-Presbyterian. "Now we realize that there are minimally invasive ways of treating a fracture surgically that are absolutely appropriate for kids." Some hospitals are more likely than others to take the surgical approach, however. According to a 2004 study Vitale coauthored in the Journal of Pediatric Orthopaedics, children with broken femurs were significantly more likely to be treated with implanted rods at pediatric hospitals than they were at other hospitals.
Kids with wrist or ankle fractures that are stable-likely to remain in place as they heal-may be fitted with removable splints that slide on like a glove or a boot and fix in place with Velcro. And even when a cast is necessary, as in so-called monkey-bar injuries when a child falls on an outstretched arm and breaks an elbow, kids don't have to be sidelined. Instead of cotton padding, "waterproof Gore-Tex lining is the latest thing," says Daniel Hedequist, a pediatric orthopedic surgeon at Children's Hospital Boston. And a waterproof cast also means no excuses when it comes to one of kids' least favorite rituals: bath time.
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