Do the Elephant When You Sneeze

Rather than getting caught up and frustrated about the availability (or lack) of the different flu vaccines, why not channel that energy into finding fun ways to teach your child how to stay healthy? Here is a cute song and video by the Jimmies called "Do the Elephant." If you have Satellite Radio, you may have heard it on Kids Place Live.

Click here for a handwashing Video for Children (13-minute musical) by the Handwasher's Brigade about handwashing.

Click here for a 1-minute rap video by DocRock that includes 5 tips on how not to get the H1N1 infection.

Have you or your child come across a video you'd like to share? Please add it to the comment section. Thanks!

Disclaimer of Conflict of Interest: The author has no conflict of interest to state.

Why is my pharmacist asking so many questions?

I remember not too long ago, a friend of mine was complaining that the pharmacist asked her too many questions when she was getting her prescription filled. "What were you asked?" I wondered aloud. It turns out she was prompted to provide information about her weight, whether she was pregnant or breastfeeding, what other medications had she taken in the past, and what other medications is she on now. I explained to her that these questions are meant to help complete her profile so that the pharmacist can identify potential drug therapy problems with her medications before any adverse effects occur. She accepted that and later felt appreciation rather than the initial resentment.

In Connecticut, "a pharmacist shall make a reasonable effort to obtain, record, and maintain...:

(1) name, address, telephone number, date of birth or age, and gender;

(2) individual history where significant, including disease states, known allergies, and drug reactions;

(3) a comprehensive list of drugs and relevant devices dispensed by the pharmacy within the last 180 days; and

(4) the pharmacist's comments relevant to the individual's drug therapy."

This information will be helpful to the pharmacist when a patient presents a new prescription to identify any potential problems with the overall drug therapy. Basically, the pharmacist is looking for any:

• duplication of therapy (e.g. is the patient taking multiple medicines that work the same way or multiple products that contain the same active ingredient?);
• contraindication between the medicine and a disease (e.g. does the patient have a condition that precludes him/her from taking the medicine?);
• drug interactions (e.g. will this medicine increase or decrease the effects of the other medicines the patient is currently taking or vice verse?);
• issues with the dose and length of therapy prescribed (e.g. if the patient stated that he has kidney problems, is the dose going to be too high? or does the patient need to be on 3 weeks of high-dose steroids by mouth for an acute asthma attack? or if the patient is pregnant, she should not be taking certain medicines for blood pressure or cholesterol control);
• interaction of a medicine and allergy (e.g. if the patient stated that she is allergic to soy, she should not be given Atrovent as an inhaler); and
• clinical abuse or misuse and any other significant clinical issues relating to the appropriate use of drugs (e.g. is the patient really still in pain 4 weeks after a root canal treatment?). One's weight can be used to determine the appropriateness of the dose.

It is our duty as pharmacists to ask these questions. Unfortunately, as a patient, I've only been asked about my allergies and nothing else when I have had my prescriptions filled. In fact, I had to ask about the effect of the medications on the breastfeeding baby. I also wish I was asked my children's weight when I present their prescriptions. Well, it's not relevant when it is for a topical cream, but it could be for an oral antibiotic. It really doesn't matter what state you live in, because all pharmacists have been well-trained in all aspects of medications and common disease states. So, if you're visiting a pharmacy for the first time, and your child has a chronic illness or is currently on multiple medicines from a different pharmacy, ask if there is any other information the pharmacist might need for your child's profile. To make it easier, fill out a medication list (The Pediatric Pharmacy Advocacy Group has a sample you can download) and have a copy available for the pharmacist to review. It could save you some hassle later on.

Cold vs. Flu Symptoms in Children

I have already received the e-mail below twice from two different moms, and it is undoubtedly being spread like a cold virus from mom to mom. The email was meant to be helpful, but the information is not accurate. It is not always easy to tell which is which. It is also unknown where the content is from. The American Academy of Pediatrics (AAP) has a good FAQ about cold vs. flu (and a good explanation about swine flu), the Centers for Disease and Control and Prevention (CDC) has thorough information about the flues, and WebMD does a decent job differentiating cold vs. flu symptoms. While one of the ways (not the only way) to stop the epidemic is to share information, the ultimate way is to protect yourself and others by washing your hands with soap and water (for 20 seconds or sing Happy Birthday to you twice) frequently and to cover your mouth and nose when you sneeze or cough (with your sleeve and not with your hands, please). If your child is sick, keep him/her home to rest and get better. Do call the pediatrician for advice if you suspect it is not just a common cold. Over-the-counter cold and flu medicines do not cure either the cold or the flu; just rest, plenty of fluids, and flu antiviral medicine (if recommended by the pediatrician). Pass it on...

My additions are in blue in the table. H1N1 flu is about to be upon us and we need to be on top of information regarding it. Here is a comparison to the normal cold symptoms . Know the Difference between a Cold and H1N1 Flu Symptoms Symptom Cold H1N1 Flu (seasonal flu, too) Fever Fever is rare with a cold. A slight fever is typical in children with a cold. Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100.4°F or higher for 3 to 4 days is associated with the H1N1 (or seasonal) flu. Coughing A hacking, productive (mucus- producing) cough is often present with a cold. A non-productive (non-mucus producing) cough is usually present with the H1N1 (or seasonal) flu (sometimes referred to as dry cough). Aches Slight body aches and pains can be part of a cold. Severe muscle aches and pains are common with the H1N1 (or seasonal) flu. Stuffy Nose Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week. Stuffy nose is not commonly present with the H1N1 flu. Actually, stuffy nose can sometimes occur with the flu. Runny nose is common with the flu, but antihistamines will not help. Chills Chills are uncommon with a cold. 60% of people who have the H1N1 (or seasonal) flu experience chills. Tiredness Tiredness is fairly mild with a cold. Your child should be able to keep up with usual activities. Tiredness is moderate to severe with the H1N1 (or seasonal) flu and can last 2-3 weeks. Sneezing Sneezing is commonly present with a cold. Sneezing is not common with the H1N1 flu. Actually, sneezing sometimes occurs with the flu. Sudden Symptoms Cold symptoms tend to develop over a few days. The H1N1 (or seasonal) flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains. Headache A headache is fairly uncommon with a cold. A headache is very common with the H1N1 (or seasonal) flu, present in 80% of flu cases. Sore Throat Sore throat is commonly present with a cold. It may also be a scratchy throat and/or hoarse voice. Sore throat is not commonly present with the H1N1 flu. This is false, children with the flu can have sore throat also. Chest Discomfort Chest discomfort is mild to moderate with a cold. Chest discomfort is often severe with the H1N1 (or seasonal) flu (more so in adults). Other symptoms of the flu may include nausea, vomiting, and belly ache. The only way to stop the spread of the epidemic is to spread the awareness. Colds and flues spread via contact with droplets from sneezes, coughs, and runny noses. Have your child wash his hands frequently with soap and water (use alcohol-based hand sanitizers if soap and water are not available) and cover his mouth when he sneezes or coughs. Throw away tissues and wash hands immediately.