Springtime Agonies for “Allergy Kids”

My son HATES spring. It’s absolutely bottom of his favorite season list – despite the Mid-West’s frigid winter temperatures. But he has good reason: seasonal allergies (aka hay fever, nasal allergies, allergic rhinitis, etc); and though the term encompasses all seasons, spring is often one of the worst for allergy sufferers.

Given the terrible winter weather this year, I had begun to think spring would never arrive in our region. But in the past couple of weeks it’s definitely made its presence known: sneezing, runny nose, itchy eyes and dark under-eye circles (allergic shiners). If you’ve never had allergies you might think, “so what?” However, for people with serious allergies, these symptoms can become a major issue. The agonies started when our son was a toddler, originally with severe nose bleeds – so bad that the upstairs bathroom looked like a scene from an episode of CSI. It turned out the nosebleeds were triggered by allergies which caused inflammation in his nose. We’ve since had the prick test on his back and he is sensitive to many indoor and outdoor allergens, but spring’s flowering trees and bushes really bring on the agonies.

Unfortunately, the little guy didn’t have much of a chance for an allergy-free life. Both my husband and I have allergies, and since the condition has a genetic component his likelihood of also getting them was greater than 70% (if only one parent has allergies the chances of children also having them are about 1 in 3). And to make matters worse, we compounded his genetic disadvantage by moving into an allergy-prone environment.

All Hail Knoxville, TN

Local allergists told me that we live in a particularly bad area of the US for allergies. The spring flowers and grasses are beautiful but, as my son sees it, they also have an evil side. When I checked into this recently I found that my city actually rates #43 (out of 100) on the list of 2011 Spring Allergy Capitals (see the Asthma and Allergy Foundation of America) or about three-quarters of the severity of the #1 city, Knoxville TN. But given the symptoms we still have I’m not sure that gives me much comfort, especially since if I were to drive 115 miles east or south I would hit the #7 and the #2 cities (Dayton, OH and Louisville, KY respectively). I think just being on the list should give pause to any allergy-sufferers considering a move to one of these locations. At least don’t be surprised if your child didn’t have allergy symptoms before but develops them once you move into an area with high pollen levels.

Managing the Multiple Symptoms

Since his diagnosis we’ve been able to mostly stave off the nosebleeds through daily use of allergy medication during the most challenging seasons, along with occasional application of a nasal lubricating cream. But spring allergy symptoms continue to be an issue: frequent sneezing and runny nose; eyes so itchy and swollen he couldn’t see and had to come home from school.

We’ve tried all the major brands of allergy medicine: Claritin, then Zyrtec, and now Allegra. They all seem to work fairly well, though some doctors feel some are more potent than others. Since they didn’t completely manage his symptoms during the peak spring pollen season our pediatrician added Singulair last year, which works differently than the other medicines. I’ve been taking Singulair for my allergies for a few years with good success, so this seemed like a great idea for him. However, everyone responds differently to medications and, unfortunately, my son showed behavior and mood changes after going on this drug. Since these effects had previously been reported with Singulair we decided to take him off it and the changes subsided. As with any medication, just watch your child for any unusual or reported side effects after starting a new medicine. For his eye issues we’ve been using Pataday, which has been excellent. It’s quite expensive but we went with it anyway due to the severity of his symptoms. He was so miserable that he didn’t even resist having drops put in his eyes!

An Ounce of Prevention

Since there’s currently no cure for allergies, experts recommend that we work to limit exposure to problem allergens such as pollen, dust mites or pet dander. The following sites give comprehensive allergen prevention strategies: Asthma and Allergy Foundation of America and AskDrSears. The latter helpfully breaks the strategies down by both convenience and expense.

A number of strategies have worked for us, particularly during springtime:

• Keeping our 2 dogs confined to the lower floor using an indoor invisible fence pod (plugs into electrical outlet – you can buy from your invisible fence company)
• Using a portable HEPA air filter in the “dog zone” – and a filter on the central air system
• Keeping windows and doors closed during high pollen periods
• Cutting our son’s hair shorter during allergy season – and washing it before going to bed
• Changing his clothes after coming in from playing outside
• Having school keep him indoors during recess and after school when symptoms are very bad

The process continues to be a challenge and we probably have to visit the allergist again as he started breaking out in hives on occasion over the past few months, which apparently is often caused by reaction to foods or medication. On to a new chapter in our allergy saga!

What strategies have worked for you in managing your children’s allergies?

Caring for Baby Teeth Means Healthier “Grown-Up” Teeth

Baby teeth are referred to as many things such as; deciduous, milk teeth, temporary or primary teeth. These teeth are the first set of teeth that a child develops. They develop in the womb and become noticeable in the mouth during the infant years. Permanent teeth are those which replace the baby teeth when they fall out.

Deciduous dentition consists of central incisors, lateral incisors, canines, first and secondary molars. The lower, two front teeth are the first teeth to go, followed by the upper two front teeth, moving on to the teeth on either side of the front teeth. The primary teeth may continue to fall out until the age of 12-13. The ages are general guide lines. Different children, even in the same families, vary in age ranges

Many times we are asked how to tell the difference between a baby tooth and an adult tooth. Primary teeth start to exfoliate between the ages of 4-6 years. Primary teeth tend to be whiter and smaller then the permanent teeth. The permanent teeth are 1.5 times the size of the baby teeth.

Care of baby teeth is just as significant as caring for permanent teeth. While the truth of the matter is that baby teeth only spend a short period of time in a child’s mouth, they play a fundamental role for the permanent teeth that come later:

• They not only save space for their permanent tooth replacement but they also give the face a normal look.
• They assist in clear pronunciation of words, help manage good nutrition for the body and help protect the permanent teeth.
• When a primary tooth is decaying or infected, it can also damage the permanent teeth underneath the gum line.

Care for baby teeth starts before they breakthrough the gums. Start getting in the habit of wiping your baby’s guns with a soft, wet washcloth or gauze during bath time. Toothpaste is not necessary at this stage. You can wrap the cloth around your finger and gently wipe over the gums. This also helps your baby get used to having his or her teeth cleaned as part of their regular routine.

After your child’s teeth start to show around 6 months of age or so, purchase a baby toothbrush with small bristles. Don’t get worried if your child hasn’t cut any teeth by the end of their first year, for some kids this doesn’t happen until 18 months of age. If you are cleaning your baby’s teeth regularly at this stage, toothpaste is still not necessary just yet. Brush gently on both sides of the teeth twice a day. You can brush your baby’s tongue gently to remove bacteria.

It’s always important to replace any toothbrush when it looks worn or the bristles start to spread out. Remember to start forming good brushing habits with your kids at a young age. Call your dentist with questions or concerns you may have with your child’s teeth. There is never a silly question for your dentist; we understand the importance of your child’s health.

The Last Time I Checked My Child’s Allergy Supplies Was…. ???

As summer approaches and families begin making plans for long-postponed vacations, for our family, it means beginning a summer check up for our allergy needs. Especially since vacation time can also make us forget about other details, summer is a yearly reminder to clean out, update and refill.

Cleaning Out A few months ago, something prompted me to check my son’s asthma inhaler. Upon examination, I was horrified. At some point, the inhaler must have discharged while it was enclosed in the holder and had “grown new friends”- yuck! Worse yet, I realized that my son had used the inhaler recently (which means all of what was hanging out in his inhaler was also having a party inside of his lungs too). In times of being a normal mom who worries about her son’s asthma, I was fast forwarded into dry-heave mode quickly followed by recycling the old case and getting a brand new one altogether. I sent the stretchy outer case through the washing machine and let it completely air dry.

The food allergy mom in me sent an email to the wonderful people at the Allergy & Asthma Network. With a tinge of embarrassment for feeling like I was the world’s worst allergy mom, I sent a picture and asked if they had any words of wisdom for me as well as to others on how to prevent a dirty inhaler from entering our lives again. They quickly responded with some helpful information from their Understanding Asthma Guide: “Clean your inhaler following the manufacturer’s instructions, usually once per week. Clean the actuator — not the metal canister — with warm water and leave time for it to air dry before another dose is needed. Holding chambers also need to be washed, especially when the unit becomes cloudy or filmy inside. Replace disposable parts as recommended to avoid bacterial growth. Talk with your doctor if there’s any uncertainty about cleaning your inhaler or holding chamber.”

Updating During my frantic summer allergy cleaning binge, I also noticed my son’s emergency contact paperwork was faded and torn. This is something that I consider to be an extension of safety for him in the event that he is unable to speak for himself. It contains a copy of my son’s Allergy Action Plan. I also updated his picture because, gosh, don’t all children seem to change overnight?! This is also helpful when your child is with people they normally aren’t around (such as a substitute teacher) so that they have immediate confirmation that the person with the food allergy pack matches up with the listed allergens and contact information. Never assume, always overdue. Nobody ever died from too much information, only not enough.

I also checked expiration dates on his medications both inside his allergy pack and the extras that we keep on hand in the house and made sure our stock was full. It only took one bad asthma night with just a few counted doses available in his inhaler for me to realize that expiration dates on these life-saving medications are something that cannot be forgotten. Again, as a mom of an asthmatic child, the last thing that you want to tell your child who is gasping for breath is to not use their inhaler unless they have to because it might run out. I’m not proud of that moment but it happens to the best of us and teaches us new organization and safety techniques to avoid future repeats.

Refilling Because of the discount cards available the past few years, this is one area that is super easy and non-stressful. Both EpiPen and Auvi-Q have continued to provide copay assistance, which means one less expense. Nothing can beat refilling a prescription for twin packs of epinephrine and seeing a giant $0 on the receipt. Don’t get me wrong- my son’s safety is priceless and I would gladly pay to keep him that much safer at all times but not having to spend that money each year is a food allergy parents dream.

I do recommend discussing how to write out the prescription correctly with your child’s pediatrician or allergy specialist. This will ensure full benefit of the copay discounts, additional epinephrine to have on hand and for the next school year and ultimately, it will save you time going back and forth to the pharmacy for repeat refills. Also discuss correct dosages of medications for your child’s height, weight and age to prevent wasting a refilled prescription (ex: filling an Epipen Jr prescription and finding out after the fact that your child is now considered to be within the EpiPen adult dosage range…then what to do with the wasted medications?)

Allergies can be tricky but each year brings new techniques and better ways to come up with a strategy on what works best for your child and family. Just remember to be accepting of what might not work in the beginning, or even the year after and always give yourself more than enough time to be ready for school. The better prepared and calm that you seem, the less stressed your allergic child will begin another school year.

How Concerned Should Parents Be About Whisper?

Whisper is an anonymous app, launched almost 10 years ago, where people post things that they might not want to admit to in public. While maybe not as well known by parents as some others, it has over 900 million accounts, according to the Washington Post and many of them are teens.

According to the Whisper’s own terms and conditions, users must be at least 13, but anyone under the age of 18 may only use the app under the supervision of a parent or legal guardian who agrees to their terms of use. They indicate that anyone who does not agree with these terms should simply not access or use the service. How often do you expect that happens?

While the company calls what people post on the app, “User Content”, most people simply call them either “Whispers” or “Secrets.” I’ve used Whisper and found it to be one of the most interesting apps out there. Of course, I fully expect that most of the “user content” is fake.

Assuming that people actually use it for its intended purpose, to secretly tell things about themselves and that they probably wouldn’t tell people they know, it’s probably harmless. But that’s clearly not all that happens on the app. Below is a graph for a grading system that I devised to help parents understand the risks involved for their children using popular apps. In my most recent article on Instagram, I explain in detail what the values on the graph mean and how using an app might endanger a child, but here it is below in a nutshell:

What the Numbers Mean:

The numbers / ratings represent the likelihood that you will see the risky behavior occur within this app.

• Rating < 5 is minimal risk and is highly unlikely to occur on the platform, but that doesn’t mean that it can’t happen.
• A rating of 5-6 is average risk – it should concern parents, but not overly so.
• A rating of 7 or 8 is problematic and should concern parents quite a bit.
• A 9 or 10 rating is very troubling as that behavior is almost a certainty within this app, and involves issues that are likely of extreme concern to parents, such as sextortion and child pornography.

Catfishing (10 out of 10)

As an “anonymous” app, there is no attempt made to identify the users. The profiles, what little of it there is on the app, don’t even include the possibility of a picture be added. That makes it perfect for people who don’t wish to be identified. When posting a secret on the app, users have the ability to upload a picture for that individual post, which may be of themselves or it may be one that they took from some other source. Additionally, Whisper has a large library of images available by users and the app will suggest images based on words typed by the user that get superimposed in front of the image.

Cyberbullying (8 out of 10)

The potential for cyberbullying exists anywhere. I’ve seen it on posts/apps where I would least expect it. With Whisper, it can often come from pictures that the person posted which were meant to be silly or sexy. Body shaming is pretty common in cases like this on Whisper, assuming that the image in the post is really of the person who posted it.

As another example, in a recent posting, a woman announced that her boyfriend had revealed online that they were engaged before she wanted it publicly known. Within just a few hours, there were well over 300 replies, many saying that she should be happy that he was excited to be engaged. In fact, the overwhelming majority of the replies were critical of the original post and a few were not polite about it, to say the least.

Language (8 out of 10)

There is virtually no filter on what people say on social media platforms and Whisper is no exception. On social media apps that are popular with kids, they may choose to intentionally spell words incorrectly, but close enough that the reader understands the message. For example, they may use “$” instead of “S” or “!” instead of “I.” Most likely, they are trying to avoid filters that search for specific keywords but considering how often I’ve seen posts on Whisper that have foul/inappropriate words on them, it seems likely that they have little to be concerned about in this area.

Nudity (8 out of 10)

This is a little bit of a gray area. Overall, I have seen very little, if any actual nudity on Whisper, but many images certainly push the boundaries. I have observed images showing both boys and girls in images that their parents would probably object to them using/seeing. As Whisper does allow people to send private messages between users, there may be cases where nudity is involved there, but I can’t say that for sure.

Privacy (6 out of 10)

As an anonymous app, this app has the advantage of not giving others easy access to users’ personal information. Facebook, for example, provides lots of opportunities for people to publicly share where they work, who they’re married to and more. So long as users practice common sense, there’s not too much risk of privacy being lost here. The risk with Whisper is how much personal information people are willing to share within their posts and through private messages. Let’s just hope that common sense prevails.

Sexting (8 out of 10)

This is a huge issue on the app. From what I can see, the majority of posts seem to have at least some sexual connotation to them. The rating would be higher than this based simply on the sheer volume of sexual content (explicit and implicit) on the app, however it is tempered somewhat by the anonymous nature of the app. It clearly has the potential for a higher rating, especially for an app that hosts groups with names such as Sexual Confessions, Horny People, etc.

Sextortion (6 out of 10)

Any app/site that has the potential for sexting also has the potential for sextortion – the act of forcing others to perform acts of a sexual nature online. This typically requires sending images or videos, which the recipient can then use against them to force them to send even more images or do just about anything else they want to avoid the images being made public.

It gets worse if the target provides their profile names for other sites/apps, which is common on Whisper. Unfortunately, it is very common to see people post their Snapchat or Instagram name on the account, (assuming that they’re providing their own information and not intentionally setting someone else up for online harassment).

Stalking (8 out of 10)

I recommend minors not use Whisper and that anyone who does use it disable the ability for the app to know their location. I say that because the app has a feature that will automatically include the location of where the picture was posted from. Other users then have the ability to search for posts made close to their current location.

A little over three years ago, a story made the news about a young girl who met a man on Whisper. She was only 14 but claimed to be 15-17 (Whisper uses age brackets). At some point, the man suggested that they switch over to a different app. At that point, he requested that she send him naked pictures of herself and she acquiesced. Eventually, they met in person, where he provided her with marijuana and eventually, sexually assaulted the young girl, according to authorities.

This was all possible because the predator was able to search geographically on the app to find potential targets. Online predators are very skilled at finding and recruiting, as I’ve written here on Pediatric Safety.

Another feature on Whisper is to find posts that were made recently. This lets predators hopefully find people before they have signed off and can engage them in a conversation. In theory, a good idea, but it is too easy for predators to exploit.

Viruses (3 out of 10)

Sending viruses via Whisper is all but impossible, from what I’ve seen. When entered as part of a secret, the words are there, but it has been converted to an image, not an active link. However, anyone who wished to send a virus could easily do so by placing it into a direct message to someone.

If they, in turn, copy/paste it into a browser, the virus could take effect. The tease of seeing naked pictures might entice someone to do that and with URL shorteners, it wouldn’t even look like a potential risky site.

Bottom Line

Whisper is riskier than it might appear were we to average the nine potential areas of concern. That is, an average would treat each of the concerns equally, but as parents, we may be more concerned with the areas of cyberbullying and sextortion than the risk of a virus. When it comes to using Whisper as safely as possible, there are some basic principles that all users, but especially kids, should follow:

1. It may be cynical, however, assume that nobody is who they claim to be on Whisper. Trust, but verify doesn’t apply here because everyone is hiding behind a veil of anonymity.
2. Assume that whatever you post on the app will be seen by everyone, not just the people who have access to seeing your posts. When taking the geographic search feature into account, it is very possible that people within your own community can see what you post on Whisper.
3. Never, under any circumstances, post a picture of yourself, or anyone else for that matter, that you might regret later. It’s better to think of it not being a question of IF someone you know will see what you post, but WHEN will they see it. That includes parents, teachers, siblings, co-workers, etc.

Like most apps, Whisper can be fun to use, but it comes with risk and those risks need to be considered. As I mentioned earlier, I have already done a similar article here on Instagram and will be doing more apps in the future, so I recommend that you check back here for more articles on popular apps. You can also check out my other articles here on Pediatric Safety by visiting my profile and complete list of articles.