So you're feeling it too???

If you have been hit with a major whack of the blah stick, take some comfort in the fact that pretty much everyone I know- not just my patients but EVERYONE has come down with a major attack of end-of-year-itis this year.

Your symptoms; Tired, over it, no matter how much sleep you get it isn’t enough to make you feel refreshed and you need a holiday so badly it’s hideous!

I think what happens is that you see that light at the end of the tunnel (new year, a few days off at least, end of various projects) and you’re limping towards it and vaguely, feintly allowing yourself to relax into holiday mode. Plus you think “I’ll sleep in the holidays, I’ll relax in the holidays” etc. Meanwhile you run yourself ragged until those precious few days break actually arrive. Lastly we have the Christmas parties, the chocolates you’re given by the neighbours, your boss or your clients, the Christmas cheer and your eating habits have gone from restraint to diabolical and you’re now paying the price.

Then there’s the stress of the upsoming Christmas season. For my patients it’s often a matter of who gets which portion of the day(s). With so many needing to see mum and dad separately, often for both partners, there are sometimes four must-attend events. If any of those don’t have at least one person you’re dreading seeing, count your blessings.

So to get over the hump here my TOP 3 tips;

1. Exercise. My one size fits all panacea. Whether your thing is a half hour walk or a proper spin or pump calss at the gym, as long as you’re exercising more than just the fat on your rump, you will feel healthier.
2. Have some teetotal days. And don’t go nuts on the other days with the alcohol either. Feeling hung over or seedy won’t help you feel more energetic. Stick to water and maybe one glass of champagne or a beer. You really don’t need more than that.
3. Give away your Christmas hamper delights. I was fortunate enough to receive the most generous amounts of chocolate you have ever seen for Christmas. My problem is that having that stuff in the house overpowers my sense of self control. SO we packaged up our collective chocolates into brown paper bags and tomorrow we will drive them down to a local homeless shelter- or specifically to the guys sleeping in the rain outside because the homeless shelter is often full. I get to save my backside and the kids and I get to feel good at the same time. Bargain!!The year is nearly over! Enjoy!!

It’s not the ridiculous workplace bureaucracy that’s going off in WA that had people going ferral via email and twitter it was my reference to the fact that there’s no evidence to support a ‘nut free zone’ in schools.

First let me say that yes I am actually a doctor and I actually do see patients. Lots of my patients have severe allergies and many have had anaphylaxis. Their parents are doing an amazing  job to kep their children safe and happy. As a parent, I too place my children’s health and safety first.

The theory about a nut free zone in schools is sound on the surface; little children have poor hygiene so are unlikely to wash hands after touching their own sandwiches and they make a mess, meaning food goes everywhere. Plus they tend to share food. In that environment little children with food allergies could so easily become sick, even very sick if they’re accidentally exposed to a food to which they react.

The trouble is there’s no evidence having a nut free zone actually helps kids. By evidence I mean a study.. a published study in a medical journal. There is some evidence that focusing on peanut or all nut exposure has some other negative effects. It is ineffective unless policed strictly and our overworked teachers don’t have time to do strict lunch box inspections each day. In fact one study recently found that in 20 percent of schools with a nut free policy there was a child who experienced an allergic attack on school grounds despite the policy. While we don’t have hard data, the thought is that the rate isn’t much higher than in schools without a nut-free policy.

The next issue is possible complacency. The best management of anaphylaxis is avoidance of the trigger for sure. But it is ESSENTIAL that teachers and carers know how to recognize a serious allergic attack and use adrenaline (Epi-pen) as soon as possible to thwart the attack. Having a nut free zone could potentially give some staff a false sense of security about whether they will need to know how to use an Epi-pen or even whether what they’re seeing is indeed anaphylaxis.

In addition, it’s not just nuts that kids are allergic to. Eggs, seafood, fish (including salmon and tuna), and soy allergies are all common. one of my little patients is allergic to beef and garlic, another to peach and mango. Nut free zones don’t protect those children.

Studies have shown that food allergens don’t make it to the air in concentrations large enough to cause an allergic reaction. Other studies have shown that simple cleaning products remove peanut allergens from hard surfaces and that either hand sanitizers or soap and water remove allergens from hands. But even if your child does touch a substance to which he is allergic, unless he sticks his fingers in his mouth, chances are he will develop a rash that will go away on its own. Potentially fatal anaphylaxis tends to occur with EATING the food to which you’re allergic only.

So these days most experts suggest we focus on the allergic child. They have to know about eating their own food ONLY, about good hand washing and making sure they are near a responsible adult when eating just in case. And teachers have to supervise meal times to ensure there is no food sharing and avoid giving foods at school either as a reward or as a cooking demonstration etc. Hand hygiene makes sense all round- before and after eating.

For the people that emailed me worried that their children could die if another child so much as opened a peanut butter sandwich in the same room as their allergic little one, please, please see your doctor. Somehow somewhere the communication has gone awry and I’m concerned you might be worrying far more than you have to.

For all, a merry Christmas. For the people who write personally rude and insulting letters, I wish you a greater level of peace, tranquility and happiness in the year ahead.

happy days!!!

If you’re sitting there dreading the upcoming festive season and wondering why your family is so uniquely insane, I have some good news and some bad news. The good news is that – take it from me- everyone’s family is just as insane as yours (trust me around this time of year I see a sudden rush of family aversion disorder that’s fairly ubiquitous!) the bad news is your family’s driving you nuts and that won’t change just because everyone else’s family is equally nuts.

While many people look to chardonnay, champagne and gin to blunt the angles of the sister-in-law’s barbs about your unruly kids, expanding rear or profligate spending, or your mother in law’s implication that she might get leprosy if she sits on your toilet, I do have some other suggestions to help you survive the day(s) with your liver vaguely in tact;

1. Team work. Christmas is a great opportunity for those who seek to divide and conquer. The ‘your family vs my family’ rift can become a gaping chasm around now unless you and your partner make a solid commitment to stay committed as an indelible team. Like a dog digging at the breach in the fence, toxic relatives will sniff a break in the wall of your relationship and start working it. Sure up your fence before you head into the lion’s den.
2. Be. Think about the person you are, the person you want to be and make sure your actions and words reflect that person- not the person who is overly sensitive or spoiling for a fight. If you think of yourself as ethical, dignified, generous and gracious, be that person on Christmas Day and let others behaviour be their problem- not yours. Snide comments and outright arguments don’t reflect well on them but they also won’t change the person you are if you stay true to yourself.
3. Count your blessings. Look around you at your partner, children, your home, your suburb and be thankful. I can’t tell you the number of patients I have that are spending Christmas alone. While having no psycho in laws might sound heavenly right now, just imagine your life with nobody close enough to you to have you over for lunch. Horrible, huh!

Merry Christmas, Happy New Year

May all of your wishes for 2012 come true!

Public Holiday Angels

Kochie’s Angels today- watch the segment by clicking HERE

By the way once he’s married do you think Warney will turn down the settings on his personal tandoori oven a bit?

We’re not talking dysfuntional hopeless parents. We’re talking about loving parents whose eyes are falling out of their heads with tiredness after back to back gastroenteritis, croup, ear infections and colds have meant they haven’t had a decent sleep for months.

Tiredness- not just feeling a bit blah but serious sleep deprivation tiredness is toxic to your body and your soul and flattened mums are in no position to parent effectively or be a good, stable and loving partner no matter how good their intentions. These people need our compassion not our judgment.

If you are a single mum, you have parents that live across the country, if your partner is so flat out with work he can’t help or if your children have been receiving viral hand grenades from the daycare infection mothership, you have my absolute compassion and best wishes. And if you want to give your little one some over the counter medicine for one or two nights every now and then so you can refuel your tank just enough to keep moving through this tough time, you have my support. We’re talking over the counter medications here, not heroin hits.

The one caveat is that unfortunately these things are not OK for under two year olds because their metabolism is still developing and there have been some severe reactions even at the correct doses.

watch this highly controversial Sunrise segment HERE

When you think about abuse of children and the dreadful consequences this could have on a child’s wellbeing, what do you think of? Sexual abuse? Physical abuse?

Well a couple of weeks ago, to my amazement and horror I found out that recent research shows that emotional neglect is in fact the most devastating form of abuse a little child can suffer from. The root cause is probably a result of an inability to ‘attach’ to the adult who is in charge of their wellbeing. In effect, without a go-to adult who guides, loves and supports them, they seem to develop a form of brain damage which erodes their ability to form relationships and have appropriate emotions throughout the rest of their lives. Neglected kids also see big impacts on their health, IQ and mental health.

Ironically, unlike the physically abused kid who is noticed by police when they’re called to a domestic violence episode, or who is covered in bruises, the signs, at least at first of emotional neglect are almost impossible to pick up. They start often years after the damage is done and can be quite subtle and non specific. For example they might be timid and shy (though most timid, shy children aren’t negelected) or they may not really respond to affection, be depressed, hurt themselves and not get on well with other children. They might have learning difficulties and have special needs in the classroom.

By the time they have serious complications like academic and learning problems, depression and cutting themselves, we’re picking up the pieces and trying to treat the effects of neglect and the problem itself has become nicidental. What’s more, the age group most at risk of emotional neglect is the under threes- the little ones with no voice to alert you to their distress.

Governments have tried to start early intervention programs to pick up these children and get their parents help or move them to foster carers early but the problem is too big for any Government body. They can only handle the hard core cases but negelect is not only the domain of the cliched down and out alcoholic single parents with a criminal record. The insidious effects of more subtle rejection and emotional neglect from the average suburban mum will be less catastrophic but they’re not irrelevant. And who are any of us to judge? Parenting can be hard yakka for all of us- and every one of us has days where we just don’t want to do it any more!! It’s all a question of degree.

If a parent you know is going thrugh a hard or stressful time, if they hint that they’re not coping with the kids, don’t turn your back. Lend a hand, ask what you can do; tell them they’re not alone in struggling; offer to mind the kids for an hour or so for them to go for a walk or do the shopping without their children or invite them over for a cup of tea. What we do know is that parents who feel supported through extended family members, friends and a network like their church do better and the children suffer far less. All of us can play a role to make these kids’ lives better.

No this angelic penguin look was not pre-coordinated.

The important issues debated on Kochie’s Angels- click HERE to watch the segment

Might not be everyone's pin up but they rock my world!

Brad Pitt and Angelina Jolie may not be your pin up parents but they just took yet another massive step up in my book yesterday when they told USA Today that they believe in complete honesty in their family. “There are no secrets at our house,” says Pitt, now starring in Cannes champ The Tree of Life. “We tell the kids, ‘Mom and Dad are going off to kiss.’ They go, ‘Eww, gross!’ But we demand it.”

I’m in the Brangelina camp because I want to raise kind, honest, good adults. I just don’t feel that I can demand honesty from my kids if I don’t lead by example. I want my kids to know that they can bet the farm that what I tell them is true (to the best of my knowledge) and that I will never lie to them. In return, I demand their honesty. Few things will make me come down like ten tons of bricks on their heads, but lying to me is one of them.

I think if you’re going to demand honesty from your children, you can’t paint them into a corner either. Let’s take the very contentious issue of teenage drinking. It’s dangerous, and not only for the body.  As we all know, the actions and facebook posts undertaken by a written off teenager can destroy their reputations, too. So please don’t think I’m a fan of the junior tipple- I am not.

But if I tell my kids that under no circumstances are they to touch alcohol … and that if I catch them they’ll be punished from here to Bullamacanka…. etc I am making it pretty inevitable that I’m going to cop a lie instead. Worse, if they really fear being caught disobeying me, they might find themselves in a situation where they are at risk of harm but too scared to call me to get help. Their safety comes first. So here’s how I handle the issue;

1. I explain my concerns about teenaged drinking. I explain why getting hammered is a terrible idea. I answer every question patiently and back up my position with facts.
2. I tell them that no matter what happens, they can always call me.
3. I do not allow other teenagers to drink in my home unless I’ve spoken to their parents and cleared it with them.
4. I will not buy/ supply alcohol to a minor
5. No lies- unbreakable rule

They will drink- not all the time, but in a way that I think will hopefully protect them from harm. You might have a different philosophy but that’s our stand.

The honesty message can be taken too far. I don’t think I need to volunteer to embelish every statement with sordid details and am happy to stick to the bare facts.

That’s the Dr Ginni philosophy and like so many areas in the parenting stream, all we have is expert opinion and close to nothing in objective scientific analysis. But (unlike so many aspects of parenting) I have never had any reason to look back and question that stance. Sam is now 18 and an incredibly responsible, honest and fun loving guy. Tick one for my theory!

What do you think?

Look mum! No hands!!

A new report has found that Australia has become a take-away Nation. New data shows Australia now has more than 1250 Subways, 845 Domino’s, 780 McDonald’s and 300 Hungry Jacks and 600 KFCs here and in New Zealand. And we’re getting fatter. A correlation? Perhaps!

Now anyone who knows me knows that not only am I a food Nazi- I’m one of those mums who insists my kids eat their veggies and fish and we keep junk food to special occasions only (and my defnition of junk is probably broader than yours!!)… but I’m also a bit of a wannabe Masterchef. I LOVE cooking- even for my crazily enormous and diverse family. But I work full time and there are an awful lot of us and sometimes when I’ve started my day at 4:45am to get to Chanedl 7 before a long day in the surgery getting home at 6:45pm I cannot be trucked maing a meal let alone buying the ingredietns for one.

So am I going to wag my finger at you and insist you go to a farmer’s market and hand fillet your organic lamb? Nope. Friends, if you need to take a night off the kitchen every night to preserve your sanity and your relationships, I’m in your corner fighting for you. Do it. But let’s do it right so you’re not turning into the Goodyear blimp and taking the rest of your family down the same pathh in the process;

1. Soup. It’s winter. Over a weekend, chucking veggies in a pan with some stock cubes (sorry Masterchef but this is the real world here) and water while you do a load of washing is not difficult. Said soup can be frozen in lots and reheated to SUPPLEMENT your take away so you don’t need quite as much of it.
2. On the same weekend grab a kilo of carrots and peel and chop into batons and whack them in water. Have some cucumbers washed and stored in yor fridge and some washed punnets of cherry tomatoes. I won’t tell you to do the same with capsicums unless you’re lucky enough to be on the BRW Rich 200 list! But you get my drift. Have a stack of ready to go veggies on tap and whacking a plate of the good stuff on the kitchen bench while you place the take away order is a five minute procedure tops.
3. Make veggies the mainstay of your meal. When ordering Asian takeaway you can order a beef, chicken, a lamb and some rice. Even when cooking, most of us make the meat or chicken the mainstay of the meal and the salad or veggies are the things we eat if there’s room afterwards. When getting take away make sure to order at least 50% veggie dishes. And then still supplement with the veggies you’ve ‘prepared earlier’!!
4. The following are take aways are going to have to be taken off the table.. Totally
   1. Hot chips. Any masterchef knows that good chips are twice fried in animal oil. Cheaper ones are usually doused in palm oil and well, don’t get me started but those things have no place in your life.
   2. Anything that comes in a big bucket. Pretty much for the same reasons above and for the love of those cute little Orangutans in Borneo. Fried chicken, especially when the closest thing to resemble a vegetable is some cabbage doused in so much mayo it’s a self contained calorie orgy … well it just doesn’t cut it as a meal.
   3. The following should be removed from the weekly menu and relagetd to birthday parties and special occasions
      1. Indian curries like butter chicken and other cream based dishes. They are loaded with saturated fats and coupled with carbs like naan bread and rice and you’re on fat boulevarde. Go for daal, chickpeas and fish.
      2. Thai or a Malaysian curries that are based on coconut milk. Coconut milk is so good and so loaded with saturated fats. Coupled with rice and you’re blimping up by the minute.
      3. Soft drinks. Why is it that pizza and burgers have to be consumed with Coke? Calorie packed, full of chemicals and lethal to teeth , these things are consumed if ever out of the house and at special occasions.

Hey how’s that? Now that I’ve given you permission to dodge the cooking bullet you’ve got more time for fun stuff like laundry and the kids homework. Oh shucks………. any time!!!!

We discussed this on Sunrise this morning- click HERE to watch the segment

There are a few topics that are certain to stir up passions and tension…. and misinformation. Immunizations, food allergies and ADHD. In Melbourne at the moment, an artist by the name of Sean O’Carroll has opened an exhibition called Ritalin depiciting boys in cages to signify the overuse of medications in a ‘disorder’ that is often an ill-gotten label for normal boy behaviour.

Now I didn’t speak personally to the artist and it is possible that he has a degree in neurochemistry that qualifies him to make that call. But I’m going to attempt to debunk it in the name of children who suffer terribly from the affliction and who benefit from an incredibly effective treatment braving the judgement of other parents in the process.

Stimulants including Ritalin and Strattera are good at treating ADHD. They have more scientific evidence to support them than many of the drugs more commonly prescribed today. That doesn’t leave them without flaws;

1. Diagnosing ADHD is not a simple yes-no scan or blood test. At the moment the best test we have is called the DSM IV. It’s a manual that describes a whole range of symptoms. The children need to have 6 out of 9 symptoms in three separate categories to earn the diagnosis; the symptoms need to be present in two separate settings (at home and at school for example) and need to have been there for more than six months. In addition the symptoms need to be wreaking havoc in their life- for example impacting on their ability to learn or make friends.There is a lot of subjectivity at play here- because the symptoms are reported by teachers and parents as well as observed by the doctor. So there is a lot of potential for bias and misdiagnosis. Having said that I can’t think of too many doctors who would confuse normal boy behaviour with a condition like ADHD.
2. Simply throwing a medicine at a child with ADHD without giving them support through occupational therapists, psychologists, behavioural therapists, training the teachers and the parents on how to manage the problem is often inadequate. Unfortunately with many schools poorly resourced (the funding is available to schools for extra therapists but you need a seriously committed principal who is prepared to put in 18 hour days to comeplete the necessary paperwork to make it happen!) and with parents working full time and struggling to put a meal on the table and keep up with the washing let alone sit and do strategies and extra therapies at night…. and the cost of face to face therapies being prohibitive to most families, few are getting the therapies they need. However that does not mean medication is ineffective- it just could be better with the appropriate supportiv therapies.
3. Many children with ADHD will ALSO have another disorder. The most common are learning difficulties, condact disorder, anxiety and mood disrders (like depression). If these problems aren’t picked up and effectively treated, then you won’t get an optimum result.

However rather than thinking that there’s too much Ritalin and Strattera around, I am convinced the opposite is true. Access to these drugs is through a specialist paediatrician or psychiatrist only, meaning access is limited, especially in disadvantaged communities where it’s needed most.

And given the hideous and frankly unscientific attack launched against parents who get their children treated and the kids themselves by artists and others whose intentions are good, I fear more kids who could really benefit from having their condition treated will miss out.

That’s a shame because untreated, their prognosis is poor with many having chronic academic failures, employment and social problems. Let’s stop judging and give these kids a break.