A parent’s guide for medicine use by children

Medicines can help your children feel better and stay active. Sometimes they even save lives.
To work the way they should, medicines must be used properly. When we make mistakes in the way we give medicines, children don’t get well.
Some mistakes cause problems that can put your child’s health include:

• Stopping a medicine too soon or too suddenly.
• Not giving enough of a medicine (forgetting or skipping doses and giving them at the wrong times).
• Letting a child refuse to take a medicine (or deciding on your own not to follow the doctor’s advice).
• Giving too much of a medicine (giving larger doses or giving them more often than advised)

How can you be sure that you do what’s best for your child? The first step is to speak up. Talk to your health professionals, your children, and the others who take care of your children about every medicine they take.

Talk to your health professionals

• Discuss the decision to begin or continue use of any medicine. Find out about non-drug approaches that may be used along with medicines.
• Ask your doctor to explain the benefits and the potential risks of medicines he or she prescribes for your child.
• Tell your doctor or pharmacist about other medicines your child is taking, including over-the-counter medicines. This can help prevent drug interactions.
• Never stop, or adjust, the dosage of your child’s medicine without consulting the doctor.
• Monitor and report on your child’s response to the medicine. If you think it is causing side effects, let the doctor know. Don’t be afraid of “bothering” him or her. Doctors need feedback to give the best treatment.
• Call the doctor or pharmacist if you have other questions later on. Don’t “guess” when it comes to medicines

Talk to your child

• Teach your children that proper use of medicines, is a key to good health, just like eating right or brushing your teeth.
• Explain the difference between legitimate medicines and illegal drugs. Use only the word “medicines” to talk about prescriptions and over-the-counter medicines. Use the term “drugs” to refer to illegal substances.
• Encourage your children to ask questions of the doctor and pharmacist about the medicines they will be taking. Show them how by your example.
• Decide together which responsibilities you and your child will have in following the treatment. A younger child might help you remember each dose; a teenager might take the lead, with you monitoring and providing back up.
• Get your child’s help in solving problems that make it hard to follow treatment, such as remembering medicine in a busy schedule, taking medicines in school, and coping with side effects.

Talk to others who care for your children

The other parent

Both parents and step-parents should be involved in helping the child take medicine. Share information you get from the health professional. Explain instructions. Clarify the roles each of you will play.

Grandparents, day care helpers, babysitters

Explain the medicine schedule and treatment details to all those who give your child medicine in your absence. Follow up to be sure your instructions were carried out.

School and teachers

Tell school personnel if your child is taking a long-term medicine or if a dose is needed during school. Involve the teacher or school nurse in watching for side effects, problems in taking medicines, or other problems.

Wellness: General Health

Controlling your risk factors for a first heart attack.

There’s a lot that most people can do to help prevent first heart attacks. Scientific and population studies show that certain traits and lifestyle habits increase the risk of a heart attack.  These danger signs are called “risk factors”.   The truth is, you can avoid many causes of heart attacks if you want to.  It starts by knowing the facts.

The basic Cause of heart disease.

Atherosclerosis is a long-term disease process in which cholesterol and other substances build up in the inner lining of artery walls.   Eventually, the artery may become completely closed off.  When the blood supply cant reach a part of the heart muscle, that part begins to die.  This is called a heart attack.

How risk factors contribute to heart attacks.

The risk factors for heart attacks are conditions and habits that tend to speed the development of atherosclerosis.  It’s important to identify them, and eliminate or modify as many as you can.  This can slow the development of atherosclerosis and help prevent a heart attack.

What can put you at risk?

The following is a listing of some important risk factors that may affect you.  While not all risk factors for heart attacks can be changed, such as your age or family history, there are many that can be modified.

Age/Sex

The older you get, the more you risk of a heart attack increases.  Men over 45 and women over 55 are at much greater risk.   For women, the risk goes up after menopause because the protective effect of female hormones (particularly estrogen) disappears.  As you get older, it’s recommended you have regular check-ups.

Family history of heart attack

If your brothers, sisters, parents or grandparents have had early heart attacks, you may be at risk too.  Most people with a strong family history of heart disease have one or more risk factors.  Your family may have a genetic condition that raises blood cholesterol… high blood pressure may run in the family… or you may have picked up bad lifestyle habits.

High blood cholesterol

A high level of cholesterol in the blood accelerates the development of atherosclerosis.  Studies show that the risk of heart attack for a person with a blood cholesterol level of 240 mg/dL or more is twice that of a person whose cholesterol is 200 mg/dL. A diet high in saturated fat and cholesterol is a main cause of high blood cholesterol.   In some people, overweight can also raise the level.  Exercise, as well as low-saturated-fat, low-cholesterol dietary changes, will often help control cholesterol. Diet and exercise are important first steps.  But if you have other risk factors besides high cholesterol – and diet and exercise haven’t worked – your doctor may also prescribe medication.

Low HDL cholesterol (good cholesterol)

You may have heard the terms LDL and HDL in reference to cholesterol.  LDL is often called “bad cholesterol” because it’s most likely to contribute to the atherosclerosis process.  HDL has been called “good cholesterol” because doctors think it tends to carry excess cholesterol back to the liver where it’s removed from the body.  A low level of “good cholesterol” is also considered a risk factor.

High blood pressure

Blood pressure is the force of blood against artery walls.  A major risk factor for heart disease, blood pressure is recorded as two numbers.  The higher number – systolic pressure – should be less than 140 mmHg.   The lower number – diastolic pressure – should be under 90 mmHg.  If either number (or both) is higher for two or more blood pressure measurements, than you have high blood pressure. High blood pressure is often the result of age, race, obesity, alcohol and a diet high in salt.  It’s important to get you blood pressure checked regularly, especially as you get older.

Physical inactivity

An inactive lifestyle contributes to higher blood cholesterol levels and obesity.  The American Heart Association recommends 30 to 60 minutes of aerobic exercise most days of the week to decrease the risk of a heart attack.  Before beginning an exercise program, consult with your doctor.

Obesity

A person is obese when he or she is more than 30 percent overweight.  Being this heavy increases the risk of heart disease and, in some cases, has an extremely bad effect on other risk factors.  If you can’t lose weight on your own,  talk with your doctor, a registered dietitian or a nutritionist licensed or certified by the state.

Cigarette / tobacco smoke

Scientists believe smoking promotes heart disease in a variety of ways.  It speeds up the development of atherosclerosis, reduces the level of HDL cholesterol, and may also encourage platelets to clump together which can lodge in an artery.  If you smote…  QUIT.  As soon as you stop, your risk of heart disease begins to drop.

Diabetes

Diabetes is the inability of the body to produce or respond to insulin properly.  Insulin allows the body to use glucose (sugar). Diabetes can damage the cardiovascular system by producing abnormalities in lipoproteins that may speed up atherosclerosis.  It also affects cholesterol levels.  People with diabetes can help control it by working with their doctor to change eating habits, control weight and get regular exercise.

Stress

Many scientists have noted a relationship between heart attack and a person’s stress.  A person may overeat or smoke continually from nervous tension,  which can contribute to heart attack risk.   The exact effects of stress on the heart aren’t fully known, and more research is needed.

Alcohol

Alcohol, in moderation, has been cited as having a protective effect against heart attack.  But too much alcohol can raise blood pressure, promote weight gain and even produce heartbeat irregularity.  If you don’t drink, don’t start.  And if you do drink, do so in moderation.  (The beneficial effects of alcohol stop after about two 6-ounce glasses of wine or two beers for men;  less for some women.)  You should quit drinking if you notice even one negative effect.  When you talk to your doctor, you may want to discuss your alcohol intake.

Decades Of Research Have Shown That When People Alter Their Lifestyles To Reduce The Risk Of Heart Disease, They Stay Healthy Longer – And They Can Actually Help Prevent Heart Attacks. A Healthy Heart Is Up To You.  It Involves You And Your Doctor.  And The Time To Begin Taking Steps Is Right Now.

Wellness: General Health

Straight talk about depression for young adults

You may not know exactly what’s wrong with you.  But you do know that you just don’t feel like your usual self.  And you’re not enjoying the things that once gave you pleasure.

The problem could be depression. A medical disorder that affects millions of Americans each year, depression is not a character failure.  It is not a weakness or personal fault.  It’s not even just a case of “the blues”.

Much like high blood pressure or allergies, depression can be diagnosed.  And treatment may be possible.

Depression is not something that’s imagined, or “all in your head”.  It’s a very real medical disorder that affects about 15 million people in the United States each year.  Yet, as common as it is, depression is also misunderstood, and many times not recognized.

How could something so common go untreated so often?  The reasons are many.

Some people may not seek treatment for depression because they feel that, sooner or later, they’ll “snap out of it.”   Some may consider depression a weakness or personal failure that they should be able to handle on their own.  And some may not realize that there may be effective medical treatment available.

So people who may be depressed often don’t discuss their symptoms with their doctors, and their depressed often don’t discuss their symptoms with their doctors, and their depression remains hidden. The result is that people who might be successfully treated for depression continue to suffer because they don’t seek the help that is available to them.

The signs of depression

How can you tell if you may be suffering from depression?  How do you know if you should talk to your doctor?  Depression has specific symptoms with which your doctor will be familiar.  If you’ve experience five or more of the following symptoms for longer than two weeks, you should see the doctor:

• • I feel sad and/or irritable.
  • I don’t enjoy the things that once gave me pleasure (eg. job, hobbies, sports, friends).
  • My appetite and/or weight has changed
  • My sleep patterns have changed, and I now sleep too much, or not enough.
  • I am tired all the time and have no energy.
  • I feel guilty, hopeless, or worthless.
  • I can’t concentrate, remember things, or make decisions.
  • My friends have noticed that I am restless or that my activity has decreased.
  • I often think about death, or have even tried to commit suicide.

What’s it all about?

One of the factors that research has associated with the symptoms of depression is a chemical imbalance.  In order to help correct this imbalance, antidepressant medication is sometimes prescribed.  That’s because an antidepressant works to increase the brain’s own supply of a chemical messenger (or neurotransmitter).

It’s important to note that while the symptoms of depression are constant, not everyone will experience all of the symptoms or the same symptoms.  Also, some people suffer from depression only once in their lifetime.   Others may experience it again and again.

The length of time that depression can last varies.  Depression may go on for month, and even years.  Your family and friends, how you perform on the job, and every other aspect of your day-to-day life may be affected.

Without treatment, there’s a chance that you might suffer from repeated episodes of depression.

Who is likely to become depressed?

Anyone – no matter what their age, race, religion, or gender – can be affected by depression.  But it seems as though some people are more likely to become depressed than others. For example, like families with a history of heart decease or alcoholism, people who have a family history of depression might show symptoms of depression in their own lives. And although anyone can become depressed at any age, studies show that men and women in their 20s, 30s, and 40s are most often affected by this disorder.  Women in general seem to suffer depression more often than men. In fact, recent studies suggest that because of factors that include being victims of abuse, in poverty, or fulfilling multiple social roles (eg, homemaker, employee, spouse), women are twice as likely to have an episode of depression.

Talking to your doctor is the first step

The good news is that most people with depression will respond to treatment.  And doctors are learning more and more about the disease and how it can be treated. By consulting your doctor today, you’ll be giving yourself the chance to recover from depression.  And, you’ll get the help and support necessary to begin enjoying your life again.

Wellness: General Health

Sometimes heartburn is more than just heartburn… sometimes it’s GERD  (gastroesophageal reflux disease)

When heartburn is just heartburn…

Just about everyone has occasional mild “heartburn” or acid indigestion.  This may be caused by eating certain spicy foods, such as pepperoni pizza, very hot peppers, or chili.   These foods can irritate the esophagus (the tube that carries food from your mouth to your stomach).

This sort of discomfort or “burning” feeling in the chest and throat may not last long.  And antacids or acid reducers that you can buy without a prescription often bring quick relief.  Over time, some people learn what foods cause problems for them and take acid reducers before eating those foods to help prevent symptoms.

But what if you follow all of the dosage recommendations of such medications (including the length of time you should continue to take them), and they still don’t relieve your symptoms?  Or what if you start having “heartburn” more often, and your symptoms are worse than when you had acid indigestion only once in a while? Then the chances are very good that your heartburn is more than just heartburn!

When Heartburn Is GERD… (Gastroesophageal Reflux Disease)

Where the esophagus joins the stomach, there is a muscular ring called the lower esophageal sphincter (LES).   Normally, the LES acts like a door that opens to let food enter the stomach and then closes to keep stomach acids (which process the food in the stomach) from flowing backward into the esophagus.

When the LES muscle are weakened by such things as spicy foods, smoking, or pressure on the stomach, acid from the stomach may flow back or “reflux” into the esophagus.  This can cause the esophagus to become irritated and inflamed (a condition called “esophagitis”) and produce the burning pain and discomfort of GERD.

If left untreated, GERD can cause ulcers to form in the esophagus, swallowing difficulties and, rarely, even more serious complications.  So if you think you have GERD, consult your physician.

Symptoms:

Frequent heartburn; Regurgitation, Food or sour liquid come back up info your mouth; Frequent belching or burping; Difficult or painful swallowing; Chest pain/discomfort; Symptoms at night or when sleeping; More discomfort after you eat, bend over, or lie down.

If you think you have any of these symptoms  – consult your physician.

Wellness: General Health

What if a poisoning occurs?

Call Poison Control Center at 212-340-4494 or 212-764-7667 (212-POISONS)

Do you know what to do if a poisoning occurs?

1. First of all, remain calm.
2. Call the Poison Center or your physician.
3. Have the following information ready:
   • Age of patient
   • Your name and phone number
   • Name of product and ingredients
   • Amount Involved
   • Time poisoning occurred
   • Any symptoms

The Poison Center or your Physician will give you instructions on what to do next.

Do you have Syrup of Ipecac?

Vomiting may help to remove poisons from the stomach. If vomiting is necessary, the Poison Center may instruct you to give the patient syrup of ipecac.  DO NOT GIVE IT UNLESS SPECIFICALLY INSTRUCTED TO DO SO. If you don’t have syrup of ipecac, you can purchase a one ounce bottle at your pharmacy. If hospital treatment is needed, the Poison Center will direct you to the closest hospital that can handle your problem.  When taking someone to the hospital, one adult should drive while another keeps the victim comfortable. Take the container the poison was in and any vomited material.  If the victim requires and ambulance, the Poison Center will arrange for one for you.

How Can You Prevent Poisonings?

1. Store all drugs and chemicals in their original containers and out of reach of children, preferably in a locked cabinet.
2. Never put chemicals in food containers.
3. Following the use of any drug or chemical, put the cap on properly and store the product out of reach and out of sight of children.
4. Never call medicine candy.
5. Use products with safety caps.
6. Read and follow label directions on all products before using them.
7. Keep the phone number of the Poison Center attached to your telephone.  Don’t hesitate to call if you have a problem or a questions.

If a poisoning occurs call Poison Control Center at 212-340-4494 or 212-764-7667 (212-POISONS)

Wellness: General Health

Anonymous HIV Counseling and Testing Program

HIV is a virus that can cause AIDS.  The HIV antibody test can show you if you have been infected by this virus.

The Anonymous HIV Counseling and Testing Program provides counseling to discuss your concerns about HIV infection and AIDS.   Counselors can help you identify ways to reduce your risk.

Free anonymous HIV antibody testing with appropriate referrals is available.  All tests are initially anonymous.   However, if you are found to be HIV infected, you will have the Option of attaching your name to your test result.  This will allow you to receive medical care and other services more quickly without having to take another test.

For more information or to discuss testing opportunities, contact the HIV Program nearest you.

Albany
518-458-6727         1-800-962-5065

Buffalo
716-847-4520         1-800-962-5064

Nassau
516-565-4628         1-800-462-6785

New Rochelle
914-632-3443        1-800-828-0064

Queens
718-262-9100         1-800-462-6787

Rochester
716-423-8081         1-800-962-5063
TDD 716-423-8120

Suffolk
516-952-2083        1-800-462-6786

Syracuse
315-426-7760         1-800-562-9423

Statewide HIV Counseling Hotline
(Evenings & Weekends)    1-800-872-2777

New York City Department Of Health
212-447-8200

AIDS Programs In Your Community
(Free, Confidential Assistance And Referrals)

Albany
AIDS Council of Northeastern New York 518-445-2437

Buffalo
AIDS Community Services of Western NY 716-847-2437

Johnson City Southern Tier AIDS Program
607-723-6520

Long Island
Long Island Association for AIDS Care
516-385-2437

Rochester
AIDS Rochester
716-442-2200

Syracuse
Central New York AIDS Task Force
315-475-2437

Westchester
AIDS-Related Community Services
1-800-992-1442

New York City

AIDS Center Of Queens County
718-896-2500

Bronx AIDS Community Service
1-800-334-3477

Brooklyn AIDS Community Service
718-783-0883

Gay Men’s Health Crisis
212-807-6655

Staten Island AIDS Task Force
718-981-3366

Upper Manhattan Task Force On AIDS
212-870-3352

Lower Manhattan AIDS Task Force
212-645-0875

Wellness: General Health