Reminder to those patients who have been called and informed that their Flu vaccine or Menactra vaccine are here, to please call and schedule an appointment, if you have not already done so.

Family Counseling: We now have a counselor from Children’s Aid and Family Services working in our office once or twice a week to see our patients who request their services. We hope this will provide a familiar place for our patients and families to see a counselor who is available for issues which include behavior, negotiation, adolescence, divorce or other family concerns. If you have questions, please ask us about this service.

Ear piercing: We periodically get inquiries from patients asking if we do ear piercing here. Dr. Ungerleider does do this procedure for patients in our office. There are several advantages to having it done in our office. Most importantly, we use sterile prepackaged earrings and sterile procedures to protect against infection. The second is that we use hypoallergenic surgical steel earrings plated directly with pure 24-karat gold, with no intermediate layer of nickel (which some people are allergic to). We also use a local anesthetic cream, called EMLA, which is applied 1 hour prior to the procedure. We only recommend piercing the actual ear lobe, not the upper cartilaginous part of the ear. The cartilage doesn’t heal in the same way and is prone to infections.

Here are some costume and trick-or-treating guidelines from the American Academy of Pediatrics:

	Plan costumes that are bright and reflective. Make sure that shoes fit well and that costumes are short enough to prevent tripping, entanglement or contact with flame.
	Consider adding reflective tape or striping to costumes and Trick-or-Treat bags for greater visibility.
	Because masks can limit or block eyesight, consider non-toxic makeup and decorative hats as safer alternatives. Hats should fit properly to prevent them from sliding over eyes.
	When shopping for costumes, wigs and accessories, look for and purchase those with a label clearly indicating they are flame resistant.
	If a sword, cane, or stick is a part of your child's costume, make sure it is not sharp or too long. A child may be easily hurt by these accessories if he stumbles or trips.
	Obtain flashlights with fresh batteries for all children and their escorts.
	Teach children how to call 9-1-1 (or their local emergency number) if they have an emergency or become lost
	A parent or responsible adult should always accompany young children on their neighborhood rounds.
	If your older children are going alone, plan and review the route that is acceptable to you. Agree on a specific time when they should return home.

Remind Trick-or-Treaters:
· Stay in a group and communicate where they will be going.
· Carry a mobile phone for quick communication.
· Only go to homes with a porch light on.
· Remain on well-lit streets and always use the sidewalk.
· If no sidewalk is available, walk at the far edge of the roadway facing traffic.
· Never cut across yards or use alleys.
· Never enter a stranger's home or car for a treat.
· Only cross the street as a group in established crosswalks (as recognized by local custom).
· Don't assume the right of way. Motorists may have trouble seeing Trick-or-Treaters. Just because one car stops doesn't mean others will!

Also, consider these tips, for staying healthy on Halloween:

• A good meal prior to parties and trick-or-treating will discourage youngsters from filling up on Halloween treats.
• Consider purchasing non-food treats for those who visit your home, such as coloring books or pens and pencils.
• Wait until children are home to sort and check treats. Though tampering is rare, a responsible adult should closely examine all treats and throw away any spoiled, unwrapped or suspicious items.
• Try to ration treats for the days following Halloween.

• Help them get up during the night to urinate.

• Make it easy to get to the toilet (use nightlights)

• Have your child drink a lot during the morning and early afternoon, so that they can enlarge their bladder capacity.

• Restrict fluids for the 2 hours prior to bedtime. (This may or may not help much).

• Make sure your child urinates just prior to bed.

• Stop using diapers or pull-ups at night. (when they are older than 6); then they are more likely to feel the need to get up.

• Praise your child in the morning for dry nights.

• Do not punish or tease your child when they do wet.

If your child is older than 6, you can also:

• Wake your child up at night (when you go to bed).

• Have your child change his/her wet clothes at night and help change the wet bedding in the morning.

• Help your child learn to wake himself/herself up at night. Tell him/her to lie on the bed with eyes closed and pretend it’s the middle of the night. Pretend his bladder is full and trying to wake you up. Then have him run to the bathroom and urinate.

If your child is 8 years old or older, you may want to consider speaking to us about using an enuresis alarm or medication.

You should also call us if your child has any of the following:

• pain or burning on urination

• the stream of urine is dribbly or weak

• daytime wetting

• new wetting if he/she had been dry

• is over 12

• has tried the above and is not better.

Boys will sometimes suffer from testicular pain. We consider it a serious complaint which almost always merits an office visit.

Preadolescent males may sometimes have sudden onset of testicular pain without activity and may be quite severe. Regardless of the presence or absence of swelling, your child should be examined here or in the emergency room.

Pubertal or adolescent boys may have trauma, torsion or twisting of the testicle or a small appendix on the testicle, which is also painful. Infection of the testicle and testicular cancer can occur in young men as well. Any discoloration, swelling, or pain in the groin area merits immediate examination. After some examinations, an ultrasound examination at the hospital will be requested to prove the viability of the testicle.

Boys may be hesitant to request an examination, however, there is a limited time to save an injured or twisted testicle, and we would encourage contact with us or the emergency room when the complaint first occurs.

HOME     NEWSLETTER INDEX