Monday, September 14, 2009

Back To School

The 1st week of school is over—how did your children (and you) fare? Naturally it can be difficult getting back on track after a leisurely summer, but for some, specifically those with ADD or AD/HD, transitioning into the structured school routine can be especially challenging. If back to school week was a bit rough, try some of the suggestions below this week to help your child adjust to the demands of the new school year:

Get Enough Shut Eye –
A solid night’s sleep helps your child feel refreshed and alert. Inadequate sleep can make your child frustrated, irritable and may cause him to be unable to keep impulses in check. While each child’s needs differ, generally preschoolers require 11-13 hours of sleep per night; children 5-12 years old need 10-11 hours; preteens-teens 8.5-9.5 hours per night. Establishing a regular sleep schedule by going to bed the same time and waking the same time helps develop a better sleep cycle that will help your child stay attentive and sharp throughout the school day.

Fuel Your Brain and Your Body
Getting the kids off to school in the am can be very hectic and stressful, however it’s important to start them off with a healthy breakfast – fruit, whole grain cereal, oatmeal, and eggs are some good choices. A healthy diet helps neurotransmitters—our brain’s chemical messengers-- to work efficiently, affecting memory, learning, and behavior. Studies show that kids who eat a balanced breakfast perform better in school.

Keep The Snacks Healthy
It’s not easy to sell your kids on an apple or low-fat string cheese when they are bombarded daily by slick ads for sugar-laden snacks. TV junk food ads are designed for and directed at our kids. Even purported “healthy” nutrition bars often contain trans fats, high fructose corn syrup and a large percentage of sugar and saturated fat. Become a food detective. Always analyze the labels. Be on guard for the words “partially hydrogenated oils.” Even though the nutritional facts label panel reads “0 grams of trans fats” anything partially hydrogenated indicates that the product does contain trans fats; FDA guidelines permit products containing less that .5mg of trans fats per serving to list on the panel “0 grams of trans fats.” Remember, even small amounts add up. Trans fats raise the risk of heart disease and diabetes. Offer your kids fruit smoothies, nuts, trail mixes, or popcorn. Or, try making your own healthy snacks. Most kids of course will want the snacks that tantalize them at the supermarket or on TV, and an occasional treat is ok, but the more you incorporate these healthy foods and stress the importance of avoiding eating processed foods, the easier it will be over time to help them make the right choices on their own.

Brain Food Exercise
Exercise increases blood flow to the brain and delivers oxygen and nutrients, helping to improve brain function and performance. Children who exercise are less likely to be disruptive – elevated neurotransmitters following a workout help with focus, impulsivity and promote a sense of calm. After school, encourage the kids to get outside and play for a bit, let them burn up some of the pent up energy from sitting at their desks all day – you’ll find it may help improve focus for the day’s homework.

Avoid Electronic Over Stimulation
Kids are barraged with sensory overload from the TV, cell phones, text messaging, I-Pods, handheld electronic games, video game systems, etc. A heavy diet of electronics over stimulates the auditory and visual senses leaving many children unable to concentrate, follow directions and/or complete assignments or tasks at school or at home. Set limits—better yet, put the video games away for a rainy day or the weekend.

Organize Your Child (and Yourself)
Establish a work area and schedule that your child can stick to to finish homework in a timely manner. Parents, prepare lunches and snacks, sign off on papers, etc. the night prior; have your children select their clothes for the next school day; place backpacks, shoes, etc. in one easy access location. You’ll find just a few minutes spent in the evening will help reduce stress levels in the am and make the mad dash to the bus a little less hectic. You’ll rest easy knowing that nothing has been left behind and that your kids are off to school with a clear head, ready to face the challenges of the day.

I hope these tips help make this week and those to follow a bit smoother for your family and wish your child much success in this new school year!

-- Dr. Chiappino

Sunday, September 13, 2009

A simple procedure for Dizziness/Vertigo

About 20% of all dizziness and 50% of all dizziness in older people is due to Benign Paroxysmal Positional Vertigo (BPPV). The symptoms of BPPV include dizziness or vertigo (spinning), imbalance, nausea, or lightheadedness with movement of the head. Many patients will tell me that they simply rolled over in bed or leaned their heads back and began to experience dizziness. The symptoms can last for a long time or they can come and go in short durations. The most common cause is head trauma, but much of the time there is no known cause.

In BPPV, the dizziness is thought to be due to the collection of debris or calcium carbonate crystals which form a plug in the inner ear canals. The calcium plugs don’t allow for the normal movement of fluid in the inner ear and the result is the sensation of spinning. This can be terrifying to someone to say the least. Imagine spinning around several times and having that feeling 24 hours a day!

The solution for this particular type of vertigo can be very simple and effective. Basically a practitioner places an infrared camera over the patients’ eyes and leans them back with their head off the table. If the person has true BPPV, the eyes will jump back and forth (nystagmus). This test is called the Dix Hallpike test. The procedure to move the calcium out of the canal is called the Epely Maneuver and can be performed right then in the office. Basically, the practitioner brings the patient backwards with their head back and observes their eyes with the camera. The patient is then rolled to one side slowly while the practitioner watches the eyes. When the nystagmus is reduced, they are rolled further, finally to a seated position. The patient then has to be careful to not lean their head back farther than 45 degrees for about 48 hours. This is usually a small price to pay for the benefits of the canal repositioning. Research has shown that the Epley Maneuver/Canal Repositioning is effective in about 80% of people with BPPV (Herdman et al, 1993). Please check out this website that does a great job of explaining the cause and treatments for BPPV:

Also, the Vestibular Disorders Association has a list of practitioners around the country who perform canal repositioning maneuvers and is a great resource for those suffering from dizziness/vertigo.

~ Dr. Reynolds