FacebookTwitter

Goodnight, Soon?

By on Nov 7, 2018 in Uncategorized | 0 comments

Navigating bedtime and establishing healthy sleep habits for your children can be tricky. But if your child is not getting enough sleep, there can be negative outcomes. According to a report done by the Centers for Disease Control and Prevention (CDC), children and adolescents who do not get the recommended amount of sleep for their age are at increased risk for chronic conditions such as diabetes, obesity, and poor mental health, as well as injuries, attention and behavioral problems, and poor academic performance. Bedtime basics are key to ensuring your child gets the right amount and best sleep for their overall health. How much sleep does my child need? As children grow, their sleep patterns and sleep needs will probably change. Each child will have individual factors that determine the average time they sleep. By observing your child’s sleep patterns, you can better ensure they are getting the good quality sleep they need. Here are a few guidelines to consider*: Age Recommended sleep time 4 – 12 months 12 to 16 hours (including naps) 1-2 years 11 to 14 hours (including naps) 3-5 years 10 to 13 hours (including naps) 6-12 years 9 to 12 hours 13-18 years 8 to 10 hours *The American Academy of Pediatrics (AAP) has issued a State of Endorsement supporting these guidelines from the American Academy of Sleep Medicine (AASM). How do I know if my child is getting enough sleep? Healthy sleep is vital to your child’s growth and development. Without proper rest, children are more susceptible to physical, mental and emotional problems including: • Hyperactivity • Drowsiness during the day • Struggling in school • Night terrors/sleepwalking • Anxiety about being separated from you at night • Mood swings • Irritability and confusion As your child gets older, be aware that the signs and symptoms of lack of sleep may change. Talk to your child’s doctor if you suspect some of these changes may be linked to their lack of sleep. What can I do to help my child go to sleep and stay asleep? If your child is struggling with their sleep, some simple life adjustments can make a world of difference including: • Follow a consistent daily and bedtime routine. • Spend one-on-one time with your child before bed doing quiet activities to help calm and reassure them such as reading. • Monitor screen time throughout the day and limit/remove screens before bedtime. • Avoid giving foods and drinks with stimulants, such as caffeine or sugar, to your child. What are other reasons why my child can’t sleep? Sleep can be affected by emotional, mental or physical issues. Diagnosing and treating sleep problems in children can be a complex and long process. Conditions such as bedwetting, restless leg syndrome, night terrors and even sleep apnea can wreak havoc on your child’s sleep, so it is important to identify how to overcome them. If you find that your child is having trouble sleeping beyond practical solutions, discuss your child’s sleep problems and habits with their pediatrician. Most sleep problems are easily treated and can be improved with close monitoring. University Health System Children’s Health offers comprehensive pediatric services, from primary care to advanced specialized care. The Pediatric Sleep Lab provides a variety of services and treatment options to children suffering from sleep problems or...

TIME Magazine Names Morgan’s Inspiration Island to World’s Greatest Places List

By on Aug 31, 2018 in Uncategorized | 0 comments

Aug. 23, 2018 SAN ANTONIO – Morgan’s Inspiration Island, the world’s first ultra-accessible™ splash park, has been named to TIME Magazine’s first annual World’s Greatest Places list that’s now online at www.time.com/greatestplaces and also scheduled to appear in print on newsstands Aug. 24. “We’re truly gratified to receive this international recognition from such a well-known publication as TIME,” said Ron Morander, general manager of Morgan’s Inspiration Island and unique Morgan’s Wonderland theme park.  “It’s wonderful that TIME understands our emphasis on inclusion, bringing together those with and without special needs in a safe, colorful, barrier-free environment to have fun and, in so doing, to gain a better understand of each other.” To create the list, TIME solicited nominations across a variety of categories – including museums, parks, restaurants and hotels – from TIME editors and correspondents around the world, as well as dozens of industry experts.  TIME evaluated each one based on key factors such as quality, originality, innovation, sustainability and influence.  The result is a list spanning six continents and 48 countries. Morgan’s Inspiration Island and its revolutionary waterproof wheelchairs also won the 2017 Leading Edge Award from the World Waterpark Association.  Earlier this year, Morgan’s Inspiration Island and Morgan’s Wonderland jointly received the Paralyzed Veterans of America Barrier-Free America Award.  And, for the seventh consecutive year, Morgan’s Wonderland has earned a Certificate of Excellence from TripAdvisor, the world’s largest travel website, for “earning exceptional traveler ratings.” Morander noted that both non-profit Morgan’s Inspiration Island and Morgan’s Wonderland were designed with special-needs individuals in mind and built for everyone’s enjoyment, and every person with a physical or cognitive special need is admitted free of charge. Morgan’s Wonderland, offering more than 25 wheelchair-accessible rides, playscapes and other attractions, will be open primarily on Fridays, Saturdays and Sundays through the end of the year.  Meanwhile, Morgan’s Inspiration Island will operate on weekends through Sept. 16, then reopen next spring when warm weather returns.  For the latest information on operating schedules, admissions and special events, visit www.MorgansWonderland.com. Tropically-themed Morgan’s Inspiration Island offers five major splash pads, the River Boat Adventure ride and support facilities such as the Wheelchair Valet, where guests can transfer out of their personal wheelchairs into waterproof wheelchairs for maximum aquatic fun. Morgan’s Wonderland and Morgan’s Inspiration Island are located at 5223 David Edwards Drive in Northeast San Antonio a half-mile west of IH 35 at the intersection of Wurzbach Parkway and Thousand Oaks. For More Information: Bob McCullough, APR, (210) 637-3418 or...

Sharing in Decision-Making Exceptional Kids

By on Aug 7, 2018 in Uncategorized | 0 comments

Ruchi Kaushik, MD, MPH July 14, 2018   Have you gone to see your child’s doctor with one plan in your head and left with a completely different one–a care plan that was created without an opportunity for you to voice your ideas, concerns or goals?  Pediatricians believe they are scientists who are most knowledgeable in the care of a child (and, indeed, they are), and parents believe they are loving, nurturing caregivers who are most knowledgeable in the care of THEIR child (and, indeed, they are).  In my opinion, this is a win-win.  Working as a team, parents (and many older, more cognitively able children) and pediatricians can create an effective, realistic, and evidence-based care plan to benefit a child using a process known as shared decision-making.   According to the American Academy of Pediatrics (AAP) is a process in which: at least two parties are involved, information is exchanged in both directions, all parties are aware of treatment options and what they are, and all bring their knowledge and values-related priorities equally into the decision-making process.   The collaborated effort should fall somewhere between your pediatrician developing a plan on her own (“paternalism”) and your pediatrician giving in to your plan (“consumerism”).  Following are a few things you should look out for during your visit.   Time:  Decisions that involve caring for children with disabilities and complexity are challenging and should not be rushed.  You should feel that the discussion is being given the appropriate amount of time.   What is the issue and who is involved:  Someone (preferably your pediatrician) should point out the fact that you have come to a point where a decision needs to be made.  And all parties involved should feel they have the opportunity to share their views and concerns–parents/caregivers, adolescents who are capable, and your pediatrician and pediatric subspecialists;  however, this may ALSO include family members whose opinions the parents/caregivers value, private duty nurses and home health therapists who can contribute constructively to the converstion, and religious leaders.  Because of the long list of individuals, at times a care conference may need to be held to entertain all ideas in a single discussion.   Needs, Wants, and Goals:  Take advantage of open-ended questions such as, “Tell me more…” “What do you understand about…?”, and “Why would you prefer this option?”  These are not meant to question you, but, rather, for your pediatrician to understand what you value.  You may prefer to have therapists provide care in your home instead of in an outpatient setting because your work hours don’t allow the latter (needs); or you may prefer that most tube feeding calories are administered through the night so you can focus on (and enjoy) oral feeding during the day (wants); or you may want to find the sweet spot of seizure medication dosing so that your child isn’t seizing often and is also alert enough to participate in physical therapy aimed at weight-bearing and standing independently (goals).  Don’t hesitate to share these, because we truly need and want to know.   Options:  Once your needs, wants, and goals are heard, you should be given evidence-based options to move forward (occasionally, there may be only one realistic option).  The risks and benefits of each option should be shared with you, and your pediatrician should check in with you regularly throughout the collaboration to make sure you understand everything correctly.  This is when you have the opportunity to state why one option may not be realistic or may work with modification (negotiation).   Care Plan:  When everyone has had a chance to share, an effective, realistic, and evidence-based decision can be made.  The plan should be documented and given to you (either on paper or through your patient portal) and new orders should be sent to your home health (private duty nursing, therapy) agencies.  An open door policy should be in place, allowing you to return in follow-up and discuss the issue again as necessary.   For more information, visit healthychildren.org.  If you believe your child is eligible to see a complex care pediatrician and are looking for a medical home, please call 210-704-4966....

April 2nd – World Autism Day

By on Apr 2, 2018 in Uncategorized | 0 comments

The eleventh annual World Autism Awareness Day is April 2, 2018. Joined by the international community, hundreds of thousands of landmarks, buildings, homes and communities around the world, light blue in recognition of people living with autism. Autism-friendly events and educational activities take place all month to increase understanding and acceptance and foster worldwide support. A new government survey of parents suggests that 1 in 45 children, ages 3 through 17, have been diagnosed with autism spectrum disorder (ASD). This is notably higher than the official government estimate of 1 in 68 American children with autism, by the Centers for Disease Control and Prevention (CDC). However, the CDC has acknowledged that its estimate has significant limitations. It’s based on an analysis of the medical and school records of 8-year-old children at monitoring sites across the country. As such, it can miss children who are not receiving medical or special education services related to autism. “The 1 in 45 estimate is not surprising and is likely a more accurate representation of autism prevalence in the United States,” comments epidemiologist Michael Rosanoff, Autism Speaks director for public health research. “This means that 2 percent of children in the U.S. are living with autism. The earlier they have access to care, services and treatment, the more likely they are to progress.” There are many organizations and services who offer access to care, services and treatment, for those looking for services like The Autism Treatment Center  https://www.atcoftexas.org/, Bloom Behavioral & Education Solutions, https://www.bloom-aba.net/, Empower Behavioral Health http://www.empowerbh.com/, The Shape of Behavior,  http://www.shapeofbehavior.com/ and so many more organizations in our area. So wear your light blue and join many walks, organizations and events who will be celebrating Autism Awareness Month....

MEET JOSHUA

By on Mar 19, 2018 in Uncategorized | 0 comments

MEET JOSHUA As far as we knew, Joshua was a healthy, active child up until he was 8 and a half, when he suddenly had a respiratory failure, ended up in the hospital and on a ventilator.  It took months for doctors to diagnose his extremely rare condition now known as ROHHAD which stands for Rapid-onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation.  He was the 23rd person in the world known with this condition.  It meant, for some unknown reason, his brain stopped getting messages telling him he needed to breathe or produce hormones, regulate his body temperature or hydration – all things most of us do without giving them a single thought.  There is no known cure. So, 3 days before he turned 9, Joshua got a tracheostomy, and he came home from the hospital a few weeks later with a home ventilator and other medical equipment and supplies. We didn’t know how to get Medicaid for him and had no money to pay for nursing so I got quite an education taking care of him and researching his disorder. Oh, and Joshua was also featured in a Discovery Channel Documentary when he was 10 years old. Joshua has since been approved for a Medicaid Waiver program, had nurses help take care of him.   He had surgery to implant a breathing pacemaker when he was 12.  He uses his pacers to breathe while he is awake – as long as he is not too sick.  He also got swine flu and double pneumonia when he was 13.  He came home after that using an IPV machine to help him clear secretions.  It has worked well for the last 8 years. He is now 21 years old, graduated high school and  even has a part-time job. I went back to school and became a Registered Respiratory Therapist and worked for a while at University Hospital in San Antonio before learning of Apple Homecare Medical Supply, where I now work and get to be my son’s RT.  I am so glad we have such a great DME company providing for Joshua’s needs.   Thank you Vanessa for sharing your Joshua’s story. Mom-Vanessa is a Registered Respiratory Therapist with Apple Homecare Medical Supply, Inc 866-332-7753 / www.applehms.com      ...