Health Update from Your Nurses
Drs. Gordon, Nussbaum, and Lappin  

October 24, 2011
It Creeps! It Crawls! It Bleeds!       
As, Halloween looms before us, it's a fun time to interject a certain seasonal creepiness factor into our newsletter right about now!

Let's talk about Pinworms! Nothing like a good parasite discussion to get one's skin crawling a bit, hmmmmm? And while we're at it, let's not forget about those nice juicy nosebleeds!

So, gently reader- come join us around the hearth as night falls, and we draw the curtains closed to begin our eerie Tale of the Dreaded Pinworm! These tiny, white, thread-like worms enter the body as swallowed microscopic eggs- so unfortunately you really don't see this one coming. Humans are the only known natural host, so pets and so forth are not risk factors. How does this "nightmare" happen?!

The swallowed eggs mature in the intestines of the human host. At some point, the adult female worm exits at the host's (your child's) rectum to lay eggs on the skin there, leading to the classic complaint of nightmare rectal itching. When you scratch there, the sticky eggs adhere to the fingers to then be transferred to whomever and whatever is touched, and the cycle continues onward. In girls, occasionally the worms can migrate to the vaginal area, also causing intense itching and discomfort there. 
Because young children play in close physical contact with each other, put their fingers and other objects in their mouths, and have to be reminded and helped to wash their hands and fingernails carefully- they are the age group most affected. How to diagnose? Rectal itching and scratching- one rarely actually sees the worms themselves though you may spot them in your child's bowel movement. If this scenario sounds familiar, give us a call to discuss it. Pinworms are treated with two small doses of a prescription mediation taken two weeks apart--pretty simple as cures go and usually very well tolerated!

How to avoid?

1)    HANDWASHING! And make a nail scrub a habit too!

2)    Frequent changes of underwear, pajamas, bedding, etc. washing in hot water and hot dryer

3)    Help children learn to avoid nailbiting.

And now, the ever-distressing sight of BLOOD caused by nosebleeds! These are quite common in childhood and typically harmless. The usual causes are physical trauma to the nose or a hot, dry weather condition, such as the Santa Ana winds we experience here in the southern California, or even lots of dry indoor air when homes are heated during the winter. Children can cause some trauma by fingers in the nose- even a heavy head cold with lots of nose blowing and wiping- anything that breaks down the fragile lining in our delicate nostrils! And there may be lots of BLOOD-this area is very richly supplied with blood vessels.

How to treat:

1)    Stay calm! Have your child sit upright tilted slightly forward. While it seems more logical to lean backward, it can cause your child to swallow blood, leading to nausea and vomiting.

2)    Pinch on the nose just above the nostrils, holding them together with steady pressure for at least 5 minutes- more may be needed (ten minutes is often the magic number).

3)    Do not stuff the nostrils with tissues- the bleeding may start again when you remove them.

4)    When the bleeding has stopped, avoid nose-blowing or bending over for a while

5)    Cool mist humidifiers are highly recommended! Also, over-the -counter saline nose drops.

NOTE: If the nosebleed is from an actual injury or lasts longer than 20 minutes- call us. If your child gets frequent, substantial nosebleeds, a visit to an ear/nose/throat specialist sometimes is advised to have a good peek in there.

And now, as we draw to a close our Tale of Creepy Things, one last reminder from your nurses: Enjoy the holiday and all its treats, but do try to help your child avoid a sugar overload--you'll be doing their immune systems a favor, especially important in this cold and flu season.

Also, a healthy dinner in your child's tummy before going out will help buffer any sweets coming their way. And some negotiating after an evening of collecting candy will make a special day of the year not become a special month. This site has science experiments you can do with your kids and their candy. Sometimes, with the little ones, out of sight really is out of mind and just having it disappear November 1 does the trick! Engage older children in chats about good healthy habits and special occasions.

And may Halloween be the only scary thing on your horizon! 

(P.S. Previous Health Updates are now archived on our very work-in-progress website).