Posts made in December, 2012

Whether his patients need reassurance or a life-saving treatment, surgeon Randolph Wong, M.D., takes each concern to heart. “I want every patient to feel that whatever problem they have – big or small – it is serious to me,” he says in this video, which is part of a series highlighting the diverse voices of PAMF physicians.

Dr. Wong lives and works in San Mateo County and often sees his patients at the grocery store, the farmer’s market or his children’s schools. “You realize how close-knit the community really is, and how important it is to treat each patient like a member of your family. I feel like the community I live in is part of my family.”

Studies show that approximately 80 percent of our New Year’s resolutions are destined to fail.  Basically, we take all of our bad behavior that has accumulated throughout the preceding year, compile a long list, and then systematically make resolutions meant to counteract each of these items. Unfortunately, since we’re not computers, eliminating bad habits is not like deleting junk mail from your inbox.  Many of us set lofty or abstract goals, such as “I’m going to lose weight” or “I’m going to manage my stress better” without having any realistic plan towards achieving those goals.

BJ Fogg, a researcher who runs Stanford’s Persuasive Technology Lab, recommends that instead of goals, try to set “tiny habits.”  He gives the example of flossing your teeth.  If that has been a challenge, instead of trying to floss your teeth every day, try flossing just one tooth.  Fortunately, this new habit is already attached to the ingrained habit of brushing your teeth, so eventually it should stick.  At that point you can add on more teeth until you are regularly flossing all of your teeth daily.

One of the reasons resolutions are difficult to stick to is because the brain area for willpower, known as the prefrontal cortex (pfc), is already overwhelmed with our daily tasks of organization, focus, problem-solving, and multiple other higher-level functions. When you tack on additional resolutions to an overworked pfc, it can’t handle it. Think of what happens when you come home after a long, tiring day at work, where your pfc has been under constant stimulation.  How easy is it to resist repeated visits to the pantry or the fridge for multiple handfuls and bites of unhealthy foods? A tired pfc just can’t fulfill the additional task of meeting your resolutions. Here are some good examples of how you can take a “tiny habit” and attach it to an ingrained habit so you can gradually transform it into a lasting behavior change: Read More about 2013: Year of the New Year’s Habit, Not Resolution

Many changes await you as you enter your late teen years. One of these changes is your transition from a pediatrician to an adult primary care doctor. Once you turn 18, you will no longer be seeing a pediatrician, so it’s a good idea to start looking for a primary care doctor before then. Here are some tips to help make that transition easier.

Tell Your Doctor If You’re Moving

If you are going away to college or moving to another city, tell your doctor. If you’re going away to college, give your doctor your school’s health care information. Ask your parents to help you make an information sheet that includes the contact information for your doctor, orthodontist and dentist. Also include on this sheet:

• Insurance company, policy number and phone number
• Date of last tetanus shot
• Name and dosage of daily medications
• Any allergies to medications
• When you need your teeth cleaned again (usually every six months)
• Date of last physical exam
• Emergency contact information for family and/or friends

Get Help Transitioning

Ask your doctor or another health care professional to help with your transition. Medical centers often offer such appointments.

Outline the different transitional steps, and then assign dates to these steps. (For example, plan on learning how to call in to make an appointment yourself by a specific date, or have your doctor quiz you on your health care insurance on a specified date.) If you overshoot these dates, don’t worry. It’s a learning process.

After The Transition

• Set an alarm reminding you when to take daily medicines
• Carry a copy or list of your medications and your doctor’s business card in your wallet with emergency contact information
• Keep an up-to-date calendar with all appointments
• Enter your clinic’s number into your cell phone

More detailed information on transitioning from a pediatrician to adult primary care provider is available on PAMF’s Teen Site.

Fruits and vegetables are an important part of a healthy diet, but getting our children to eat the right things can feel like pulling teeth. What should you do when your son gags at the sight of broccoli, or your daughter reaches for soda and candy instead of fruit?

Or, at the opposite end of the spectrum, what should you do if your child visits a local farm and vows never to eat a cow, pig or chicken again? Is it possible for a child to be healthy on a vegetarian diet?

Pediatrician Swati Pandya, M.D., answers parents’ questions about the importance of fruits and vegetables in children’s diets, how to encourage kids to eat more of these health boosters and meeting the dietary needs of young vegetarians.

How many fruits and vegetables should my child eat?

According to U.S. Department of Agriculture (USDA) guidelines, half of our daily diet should consist of fruits and vegetables, combined with smaller portions of grains, protein and dairy.

However, according to the U.S. Centers for Disease Control and Prevention, the majority of Americans do not eat nearly enough fruits and vegetables. As our kids get older, the problem worsens. A 2009 CDC report states that only 32 percent of high school students eat at least two servings of fruit daily and a mere 13 percent eat at least three servings of vegetables every day.

Why are fruits and vegetables so important, and are some better than others?

Fruits and veggies are important for many reasons. First, they contain nutrients that are difficult to find in other food sources, including folate; magnesium; potassium; dietary fiber; and vitamins A, C and K. Second, they reduce the risk of many chronic diseases. Third, they are naturally low in calories when prepared without adding fats or sugars – which helps maintain a healthy weight.

The most nutrient-rich vegetables are dark green, such as broccoli, spinach, collards, and turnip greens. Bright red and orange vegetables, such as tomatoes, pumpkins, sweet potatoes, and red peppers, also tend to have a lot of nutrients. It’s best to eat whole fruits or fresh canned, frozen and dried fruits as opposed to juice, which often contains fewer nutrients and more sugar and other additives.

How can I get my child to eat more fruits and veggies?

There are several ways you can serve up more fruits and veggies. Here are a few tips you can try:

• Serve them when your child is hungry. When your child gets home from school and is ravenous, put out a plate of veggies, such as carrots, bell peppers and cucumbers – along with hummus or another healthy dip.

• Encourage your child to try new fruits and veggies. If your child is resistant to trying new foods, implement the “try it first, then you can say no” rule. Even if your child rejects the new food after the first one or two tries, he or she may grow to like it over time.

• Market the health benefits of fruits and veggies using fun kid language. For example, tell your child carrots will give her “superhero vision” or spinach will make him “strong like Popeye.”

• Engage your kids in shopping and cooking. Many children enjoy making their own food choices and helping to prepare meals – and they are often more likely to eat what they select and cook.

• Make fruits and vegetables easy to access. Keep a bowl of fruit on the kitchen counter and stock your fridge with chopped-up, easy-to-grab veggies so that when your child goes hunting for a snack, healthy options are readily available.

• Find ways to add more fruits and veggies to your child’s favorite meals. For example, add pureed veggies to quesadillas and add chopped bananas to hot or cold cereals.

• Be a positive role model. Your child is watching everything you do, so be sure to eat a variety of fruits and vegetables as part of your daily diet.

My child wants to be a vegetarian, but I’ve heard many definitions and am not sure what it means. What are the different types of vegetarianism?

Your child may be exploring a vegetarian diet for many reasons, including concern for animals, the environment or his or her own health. People use the term vegetarian to describe a number of diets, but here are a few of the most common types:

• Vegans eat only food from plant sources.
• Ovo-vegetarians eat eggs, but no meat.
• Lacto-ovo vegetarians eat dairy and egg products, but no meat.
• Lacto-vegetarians eat dairy products, but no eggs or meat.
• Semi-vegetarians eat poultry or fish, but no red meat.

Is it possible for my child to be healthy as a vegetarian?

The simple answer is yes. In reality, the answer is a bit more complicated. Children can get all the nutrients they need from a vegetarian diet – but only if the diet is well planned and balanced. This is especially important if the diet doesn’t include dairy and egg products. And you’ll need to adjust the diet to meet the changing nutritional requirements of your child as he or she grows.

If your child or teen is going to become a vegetarian and you are unfamiliar with this diet, talk to your child’s doctor or a registered dietitian who can help you plan a healthy vegetarian diet. It’s important for the diet to include enough calories and nutrients for each stage of your child’s growth and development.

A properly planned vegetarian diet is high in fiber and low in fat. This offers many health benefits, including better cardiovascular health, lower blood cholesterol and reduced risk of obesity.

What foods should I encourage my child to eat as part of a healthy vegetarian diet?

To reap the health benefits of a vegetarian diet, your child should consume adequate calories and the following nutrients in the proper amounts for his or her stage of development:

• Protein, found in dairy products, eggs, soy products, beans and nuts
• Calcium, found in dairy products; broccoli; dark green leafy vegetables; dried beans; and calcium-fortified products such as orange juice, soy and rice drinks, and cereals
• Vitamin B12, found in dairy products; eggs; and vitamin-fortified products such as cereals, breads, and soy and rice drinks
• Vitamin D, found in milk and vitamin D-fortified products such as orange juice
• Iron, found in eggs, whole grains, leafy green vegetables, dried beans, dried fruits, and iron-fortified cereals and bread
• Zinc, found in wheat germ, nuts, dried beans, and fortified cereal

No matter how you dice it, eating lots of fruits and vegetables is important to your child’s health. So start buying, chopping, and serving up those fruits and veggies as much as possible to help your child enjoy a longer, healthier life.

Swati Pandya, M.D.

Swati Pandya, M.D., is a board-certified pediatrician at the Palo Alto Medical Foundation’s West Valley Center.