Diary of a Doc: Dr. JJ -- 1212 Days and Counting

Well, where have the last several weeks gone?? Real life has stepped in the way of late -- as plans for a week away took a hairpin turn back to Los Angeles! My father-in-law was admitted to the ICU at Cedars, and by last Sunday, we seriously thought we were going to lose him. That said, for Max it was an automatic decision to return home instead of trying to feign enjoyment in NYC while grandpa (or DOD, Dear Old Dad, as we call him) was fighting for every breath. So Max (and his friend Lorin) returned home Tuesday, immediately sailing into DOD's room, and actually finding him a bit improved (as he had made no progress for 9 days prior). As the other grandkids gathered 'round as well, I think DOD decided he couldn't throw in the towel, and started to fight all week -- inspired by the young who sat at his side daily. I think Max (and Bruce and I) heard more funny (and secret) stories from Grandpa this week than we had heard in the last 20 years. It was as if he had unlocked more of his legacy and made sure it was verbally given to the kids. What a great gift! Although an emotionally draining few weeks, Max and Lorin left yesterday knowing that DOD was being transferred to a regular room, and against all odds would make it home.
As the kids' adventure got derailed, we made sure (with the kindness and generosity of friends) that they returned to Michigan with a few memories -- innumerable rides on The Simpson's at Universal Studios (thanks Janice!), a Laker's game (thanks Rex & Val!), and a day on the firing range in Tujunga (where Lorin looked like Annie Oakley, and shot more like a pro than a novice). The kids helped Bruce and I refocus and settle down, as initially every phone ring made us both jump, thinking we were going to hear the worst.
The kids returned to a HUGE storm just in time, and today we return to a regular life -- with its completely unexpected twists and turns...
We are grateful to all those who have returned DOD to us, and thank our friends and family for all their support and love.

Diary of a Doc: Dr. JJ -- 1240 Days & Counting

Our intrepid Max, fully outfitted in khaki green Northface expedition parka and LL Bean subzero boots continues to love the freezing cold, ice storms, snow and subzero temperatures that define the heart of winter in Michigan. Spring break for the Wolverines comes the third week of February -- as the kids are likely to be in the depths of seasonal affective disorder, dreading short days and long nights, and tired of the daily slog through snow drifts to get to class, the prospect of a little fun for a week keeps them warm with hope.
Max's first inclination was to return home for some R&R. However, knowing that we would force him out on the trail of identifying employment for summer dashed his dreams of sleeping in, eating trays of food lovingly prepared by mom, and the prospect of doing nothing. Skip to Plan B -- a trip to Mount Rushmore, by bus, enduring 36 hours in a smelly seat with perfect strangers. Good enough? NO! Skip to Plan C -- a quick trip to New York to visit the United Nations, see a Broadway show, take in the Museums before they are impassable in the Spring, a return to Ellis Island to caress the inscribed names of his great grandparents -- you bet! With the kind offer of a friend to stay in her apartment while there, Max will trek to the bigger city to take inn a little culture, a lot of history, and while not really having a chance to defrost, enjoy the vibrancy that is Manhattan.
It will be a little late to see Conan, but no less thrilling.
So what does Mom do? Put away the trays (ready to be laden with home cooked food), forget about fluffing up the pillows, put herself back in the office to work, and mope a bit...all part of the necessary process of emancipation and detachment that both parent and young people experience at this stage of life! So much of the college experience comes from not what is conveyed in the classroom, but rather the coping, resourcefulness and creativity that comes from striking out on one's own, problem solving, living within a budget and surging forward steadily into real adulthood.
Yeah, I'm moping a bit, but inside, I am totally proud!

Health & Safety Tip: Are you keeping your New Year's Stay-Healthy Resolutions?

Well, we're 22 days in to the New Year and it's awe-inspiring to think how much change we've all been surrounded by of late! With all this excitement, it's sometimes easy to forget the promises we made to ourselves at the top of the year, so we thought we'd check in and see how your progress is going on your New Year's resolutions. We know how difficult it is to keep them, however well-intended they may be. So we're sharing our favorite stay-healthy resolutions that are actually easy to keep (and easy to pick up again any time of year)!

1. "I resolve to use sunsreen on my family every day."
   We know, we know..."But it's January! And we're not at the beach!" Believe it or not, harmful UV rays don't just make their appearance Memorial Day through Labor Day. Exposure to UV rays adds up all year round. The most effective way to prevent skin cancer (aside from staying out of the sun) is to use sunscreen 365 days a year. Our favorite (though we know we're biased) is the Babysafe Sunscreen Towelettes SPF 30+. These indispensable sunscreen wipes are so easy to pop in the pocket of your winter coat and have a perfect amount of sunscreen to cover any exposed areas like face, ears & back of the hands -- any time of year.
   
   
2. "I resolve to wash my hands...a lot!"
   In our pediatric practices we are constantly bombarded with nasty germs, yet we rarely get sick. Our most tried & trued stay-healthy secret is surprisingly simple: We wash our hands constantly! Hand washing is the most effective (and easiest) way to prevent the spread of germs that cause colds, the flu, and several gastrointestinal disorders. Help your kids get in the habit early by teaching by example. Make it fun and lather up to a rousing rendition of the ABCs! If you don't have soap and water handy, go ahead and use a great multipurpose alcohol-free wipe or all-natural hand sanitizer.
   
   
3. "I resolve to adhere to the 30-second rule."
   Did you know the most effective way to maintain your and your baby's precious moisture barrier is to smooth on a moisture balm within about 30 seconds of patting dry? We like to call it the "30-second rule", and it's one of our favorite techniques to recommend to parents of children with eczema and dryness. Especially as the temperature continues to drop and winter dryness threatens even normally supple skin, we suggest at least a once-daily dose of moisture balm. A note to parents of children with very dry skin or eczema: One key to successfully treating these conditions is REPEATED application throughout the day.
   
   
4. "I resolve to up the antioxidant ante."
   Antioxidants protect us (and our babies) on the inside and out, aiding in skin repair and strengthening blood vessels. Blueberries are our top "superfood" choice for little ones (they're packed with antioxidants, phytoflavinoids, Vitamin C and potassium!) and a recent British study even showed that an antioxidant-rich Mediterranean diet may even prevent allergic rhinitis and asthma symptoms in youngsters. When it comes to the outside, be sure to look for antioxidants like Vitamin E, Avocado Oil, Grapeseed Extract and Olive Squalane to protect baby's uniquely delicate skin from environment damage.

These resolutions we know we can keep... Now if only somebody would make it easier for us to stop eating chocolate and start jogging!

Diary of a Doc: Dr. JJ

A year and a half ago, I started to blog about my son in my practice newsletter - counting down the 400 days he had at home until his graduation from High School. Was he ready to go forth into the big world of college? Had we given him the right tools?
He successfully completed his journey and started as a freshman at the University of Michigan in September. Yet another countdown started, as I blog about his progress in college, our progress as empty nesters, and reflections of the life he faces currently. Enjoy as we pick up on this week's entry, and check back every Friday as we update our countdown...

1257 Days and Counting...

Brrrrr.....it's cold in Ann Arbor - freezing temps are hitting the entire Midwest and Northeast. From the comfort of our tropical climate, we shudder at the thought of even a 40 degree morning in LA - and yet thousands of our kids trudge bravely through several feet of snow, ice and slush to go to class, grab a hot chocolate, nourish in the dining hall, or just go to work! Max related that the other night, in the midst of an almost-blizzard, the fire alarms went off in his dorm, the kids trudged downward and outside, dreading the cold, and beleagured at the hour. What did they face at the front door - an army of energetic colleagues from the dorm across the way - and a pile of thousands of pre-made snowballs at the ready! The battle was on, the freezing temps didn't matter, as the proud warriors engaged in a contest that none of us could or would survive at our age. This is just one example of how our perspective changes with youth. Seriously, aside from a brief weather report from Max, I have not heard ONE complaint from him about the cold. His daily description is "It's so beautiful mom", and "thanks for the great coat and boots - 'cause I'm not cold."....and here I am this week, dreading a trip to NY, Boston and Providence next Friday - imagining that upon leaving the safe confines of a warm airport terminal, that I will IMMEDIATELY turn into a human popsicle and never recover! Of course the very mention of my anxiety arouses huge guffaws from my son, and a reminder from him that I have a little natural insulation to help me through such ordeals - oy!

The kids are gearing up for a celebration of hope on Tuesday as the inauguration and its' personal significance to Max and his friends is truly huge. I hope that we all stop and pause on Tuesday and realize the signficance of this very day. Think about the millions who will happily stand in the cold, ice, and snow to witness history, to revere freedom, and to support our country and its new president. Take the opportunity to share this event with your children, as it will generate such a variety of discussion points - both from the past and present. Whatever your politics, it is incumbent upon all of us to link together in mutual support in order to survive these tough economic and political times...

Have a great week - and enjoy this historic moment!

It’s that time of year, the holidays are upon us, and travel reaches a fever pitch at the end of November. Here are a few tried and true tips for safe and sane travel with your young ones:

Stay healthy on the go! Before you travel, make sure your children’s vaccinations are up to date, including flu vaccine (have your pediatrician guide you) – especially since nothing stops people from traveling to loved ones during the holidays – not even colds or flu!

Arrive early at the airport. If it is naptime, find a quiet corner for your child to nap while awaiting your flight. A rested child is a better traveler.

Always pack comfort items for your baby or tot . A lovey, pacifier or blanket are essential. For older children - a couple of favorite books, a favorite packable toy or a stuffed fuzzy friend are always a welcome companion.

Remember to also pack some light snacks for your tots or older children. Babies will do well with nursing or sucking on a bottle during take offs and landings as this will reduce discomfort associated with middle ear pressure changes.

Sample-size your routine! Current regulations permit a maximum size of 3oz bottles of creams, lotions, or gels as carry-on items. Baby Silk...To Go! is a perfect carry-on choice: 1oz tubes containing diaper rash cream and liquid powder, together with 2oz bottles containing hair &body wash and moisture balm are TSA-approved for carry-ons and make for an easy pass through at the security gate. (Don’t forget to also bring your Babysafe Sunscreen Towelettes!) We suggest you check www.tsa.gov the day prior to departure for the most updated security information, to avoid unnecessary delays at the security checkpoint.

Children like to be comfortable traveling, too! Their softest PJs are better choices than their most fussy outfit! Save that for your destination. If you’re also traveling with a toddler, be sure to keep their shoes on when walking around a plane – unexpected injuries can be prevented.

If you are changing time zones, keep your child on his “home” time schedule until you arrive at your destination. Once at your destination, expect that for every hour time change you experience, your child will need a day to adjust …on the return leg, the same occurs. Try your best to remember regular naps and a consistent place for your child to sleep. Ironically, keeping a baby up and missing naps usually results in very sleepless nights.

Whether you are traveling near or far, or not at all, we wish you a happy, healthy and loving time with family and friends this holiday season!

October is Breast Cancer Awareness Month

Philanthropy is an essential core value of ours, both in our personal and professional lives as pediatricians and through MD Moms. As physicians, women and mothers we are committed to raising awareness when it comes to both child and family health.
As you may or may not know, October is Breast Cancer Awareness Month. While we love that there is a month of the year dedicated to awareness, we hope it will just be a kickoff to what is an entire year, and lifetime, of action.

It is nearly impossible to encounter a family that has not been touched by this dreadful disease in some way. For some of us it is our mothers or fathers, our sisters, our aunts, our grandmothers. For others it is a best friend, a friend of a friend, an acquaintance.
Many of you reading this have bravely fought and gloriously triumphed over a most devastating diagnosis. Too many women (and men) have not.
One more mother, one more grandparent, one more individual dying from breast cancer is one treasured person too many.

During the month of October, we will be donating 15% of the web sales of Baby Silk on our site mdmoms.com to The Breast Cancer Research Foundation.
This global organization, founded by the extraordinary Evelyn Lauder fifteen years ago, is dedicated to finding a cure in our lifetime and we hope we can help make that goal a reality!

We hope you will be inspired by a person you know, or even one you don't, to join us, get involved, and take action to fight breast cancer.

Health Tip: How to Perform a Breast Self-Exam

Get the facts.
Breast self-exam, as part of a 3-part program (including self-exam, mammograms and clinical breast exams every 3 years starting at age 20) can be an important element in the early detection of breast cancer. But how many of us really know how?

Here, a step-by-step guide on 3 different ways to perform a breast self-exam:
IN THE SHOWER

• Put one hand behind your head, elbow facing upward
  

• With the pads of your three middle fingers, move your hand over the entire breast area
  

• Use right hand for left breast, left hand for right breast
  

• Use one of the three following patterns to examine your breasts: 1)Circle: in a series of circles around your nipple, middle of breast, and outside perimeter of breast; 2) Up & Down: up and down in a zig zag pattern from top to bottom over the entire breast; or 3) Wedge: in a series of "wedges", working from the nipple outward in 8 or so sections
  

For consistency, be sure to examine the same way each time, using the pattern and technique recommended by your healthcare professional at your clinical breast exam. (The American Cancer society recommends the up & down pattern.) Check for lumps, knots or thickenings.

LYING DOWN

• Place a pillow or towel under your right shoulder, with your right hand behind your head.
  

• Using your left hand, follow the same technique (using one of the above patterns) as in the shower. Then lower your right arm slightly and with your left hand, check your right underarm.
  

• Check for lumps, knots or thickenings.
  

• Repeat on the other side, using your right hand to check the left breast and underarm.
  

IN FRONT OF A MIRROR

• With your hands firmly pressing down on your hips, check for changes in shape, size or skin texture of your breasts. Then raise your arms overhead and check again. Be sure to note any swelling, redness or skin dimpling. Also be sure to check for any changes in your nipple or unusual discharge.
  

Be sure to perform a self-exam monthly (perhaps after your periods when your breasts are not full or tender) and report any changes or irregularities to your healthcare professional immediately.

An important note: This guide is not intended as a replacement for medical care. For a complete diagnosis and course of treatment, please see your doctor.

The Breast Cancer Research Foundation has a great resource in its Breast Cancer Basics Library. Be sure to check it out for video and articles about everything from more details on how to perform a self exam to understanding the stages of breast cancer.

The Magic Mommy Kiss, and the Baby Silk Babysafe Sunscreen Towelettes, Seen Round the World

We’re not going to lie and say that it’s not unbelievably exciting (a dream, really) to wake up to photos of an A-list celebrity toting our products along with her most precious cargo (who, P.S., is definitely one of the most adorable tots in town). When we saw the pics of Jennifer Garner planting a big ‘ol magic mommy kiss on her darling Violet, while holding our Babysafe Sunscreen Towelettes, our “awwwwwws” turned to “WOOHOO!”s.

As founders of a company, in a celebrity-obsessed society, we couldn’t dream of a better caught-on-film moment. But as pediatricians, what REALLY excited us was seeing a mom diligent about sun safety…in almost-October!

“What a FABULOUS opportunity” we exclaimed, “to remind everyone that the sun’s harmful UV rays don’t take a vacation just because you came back from yours!”

So, here are a few tips and reminders to help us keep our kids protected, 365 days a year.

• Just because it’s cool outside doesn’t mean UV rays aren’t present and harmful. The temperature may have dropped by a few degrees, but UV rays are still present! Sunscreen is just as much of a post-labor day must-have as it is in the Spring and Summer
• Pack a lunch, pack a sunscreen single. Typically, daycares and schools don’t provide sunscreen for their students, yet kids spend considerable time outdoors (even in the winter). Recess, playtime, lunchtime, or school sports are all opportunities for UV exposure and an important time for sunscreen application.
• Don’t forget about afterschool sports. Whether it’s big brother or sister on the field, or baby cheering them on from the stands, even that hour or two a couple times a week adds up to a significant amount of time exposed to UV rays. If you’ve applied sunscreen to your child before school, don’t forget to reapply prior to heading out to practice.
• Baby it's cold outside! UV rays can be reflected off snow and other surfaces, so don’t forget to protect exposed areas with a broad spectrum sunscreen during winter sports or while perfecting your snow angel skills.

Dr JJ's Diary of a Doc: Allowing yourself a much needed 'Mom's Time Out'

One of the great perks I enjoy, since I travel a lot as president of MD Moms, is taking advantage of the opportunity to meet great moms and Baby Silk customers in any city I wake up in. A few months ago I had the privilege (for the second year in a row) of being the “in house” pediatrician for Mommy and Baby week at the Greenhouse Spa in Dallas.

Certainly, a week at a high end spa is usually only the subject of dreams for most of us (including me), so seizing an opportunity like this (4 days of sublime treatments in the company of several moms and adorable babies) was a no-brainer…..

I met a great group of moms from all backgrounds and walks of life as well as a few speakers who brought their insights and expertise to this event. Two moms had 4 kids under kindergarten age (twins made the math “easy” for both of them – one was a stay at home mom, and the other was a fulltime attorney in Washington DC), one mom had a very young one month old, one was having a last hurrah before returning to her position as an aerospace engineer at NASA, another a single mom/prosecuting attorney who had lost her home in Hurricane Katrina, a store owner, a foundation head and 2 mompreneurs – one who manufactures organic baby food and the other, socially responsible dog products.

These are lucky women – auspiciously not because they could afford the week at the Greenhouse (although I’d be lying if I didn’t acknowledge that), but because they have taken the time, with the support of their families, to recognize that relaxation, revitalization, and recreation were important enough to stop real life for a few days, and treat themselves to some needed rest, some healthy food, a few naps made possible by the help of in-house helpers, and an opportunity to make some new friends.

How often do we, as mothers in particular, sacrifice things like a good haircut, a meal or coffee out with a friend, or worse yet, a needed doctor’s appointment or yearly mammogram, because we are just “too busy?”

How often do we say “no thank you” when a friend, relative or colleague offers to take our kids out, drive them to school or daycare, or just give us a break?

While martyrdom was popular in the dark ages, there should be no role for it in our lives. Allow yourselves to take the time to assign your partner to your child for an hour, light some candles, and soak in a bath. Say yes to your neighbor, let her watch your child, and go get your hair cut or nails polished.

Grab your young one, and curl up together for a nap, and defer a few errands or chores to just suspend yourself in rest for a few minutes. Despite the fact that most of us don’t have a big budget for a spa, we can easily create some “aaah” time as a priority. You will find, as I have this week, that the world does not stop and implode when you are gone for a few minutes or hours. These breaks are difficult to take, but allow us to refresh our bodies, minds, and spirits so that we become better mothers, better partners, and better people.

Dr. JJ's Diary of a Doc: 8/10/08

It seems as though age is catching up with me – between my daily work in my pediatric practice, getting my son ready for his departure to the University of Michigan next week (Go Blue!), new construction in my office, and of course, serving as President of MD Moms, one would expect a grey-tinged person such as myself to stifle a few yawns………Believe it or not, I get enough sleep to prevent that from happening……………..UNTIL THIS WEEK!

Every four years my husband and family surrender and hand me over to my television set to live, eat and breathe the Olympic spirit. My issue this year is that the major network televising this marvelous event is broadcasting to the West Coast on tape delay – and you lucky folks on the East Coast get to view the games live! Why does that matter to me? Well, my TIVO broke long ago, I don’t have the necessary cable to watch a live feed, and I struggle to stay awake past my midnite bedtime to see history unfold once again.

After lifting my jaw off the floor (and my box of tear stained tissues) after the mind-bending opening ceremonies, I trudged, half asleep to bed with the knowledge that I would miss the torch being lit. I prided myself on my ability to stay awake, but swore under my breath when my neck hurt this morning from the odd yoga position I found myself in as I drifted off to sleep on my sofa.

I resolved to stay awake last night to see the pride of the University of Michigan, Michael Phelps, win his first gold and look to the stands for his mom, his inspiration. There went another box of tissue! However, with the intricacy of the opening ceremonies setting a high benchmark, do you think that the National Anthem could have been played correctly, and not awkwardly cut off at the end? Perhaps you all respond like I do at these medal ceremonies, silently mouthing the words and welling up in tears feeling the magnitude of the moment………and then our collective joy is cut short as the last stanza just drops off! Come on!

More importantly, I wanted to witness a more significant piece of history unfold – the debut of Dara Torres . She is a symbol of courage, talent, determination (OMG that 12 pack)! She is also a friend of the MD Moms, and her young Tessa wears our Baby Silk Babysafe Sunscreen Towelettes daily, while mom works out in Coral Gables. It angers me that the press speculates that her grueling schedule of workouts, and the transformation of her “middle aged” body is the result of doping. She has gone so far as to have her blood stored and frozen for any future analyses, to prove to the world, that greatness can come just with hard work and talent. She has something to prove, and serves as an inspiration to many individuals who feel that age is an impediment to accomplishment – especially in the realm of physical competition.

I never got to see Dara take the podium to win her Silver Medal last night…sleep overtook me and this morning I hope to find a rerun somewhere to recreate that moment….I anticipate that I will be yawning daily at work, quaffing more than my usual 2 coffees daily, and aiming home as soon as patients are out the door, to catch these moments of triumph and persistence, joy and disappointment, pride and pain, as these young (and middle aged) ambassadors of the world make us feel, for just a few days, that the worlds’ people could get along under one roof…..

OK, so enough rambling……….grab a pen, write to NBC, appeal to them to give me some live feed on the West Coast so I can sleep! NOT!

Enjoy the Olympics! ...and GO DARA!

JJ Levenstein, MD, FAAP

President, MD Moms – makers of Baby Silk