Interesting Conversations w/ Parents, March 2017 (Pedcast)

Voice Intro

Welcome to another edition of Portable Practical Pediatrics. I am your host, Dr. Paul Smolen, a board certified pediatrician. People call me Doc Smo. My patients bring up such interesting topics…so interesting that a few years ago, I started sharing some of them with my blog audience. I have to say that after 35 years of practicing pediatrics I have learned and lived this Doc Smo pearl, “The best doctors listen way more than they talk.” With that in mind, I am going to share with some of the interesting things my patients have told me recently. I think you will see that by listening intently, I learn a lot from my patients.   So let’s get into the next set of “Interesting Conversations” I’ve had recently with my patients and their families, shall we?

Music Intro

Conversation #1- An Antibiotic Substitute

Recently, I was doing a checkup of a young man whose parents were from India. The last time I saw this young man before the day of his checkup, he was suffering from a staph skin infection at multiple sites on his body. You know, the usual places, along underwear friction areas, and under his arms. Bacteriologically dirty and damp places. The places germs love. When I last saw him with a staph infection, I had given his mother an antibiotic for him to take and some topical antibiotic ointment that inhibits skin bacteria from growing. You know, typical western medicine stuff. I assumed that his mother had followed my directions and thus cleared his infection since the infection was now gone. I asked his mother, had she given him the antibiotic to him and she said surprisingly, “No”. She decided to try a common remedy that is used in her home country of India. The remedy was an inexpensive antiseptic, a form of pine oil that is used to wash the infection away.  Yes, the same pine oil that we clean floors and furniture with. It is called Dettol and she says it is used for everything in India. curing skin infections including those caused by staph aureus, disinfecting cuts and abrasions, as well as cleaning household surfaces such as floors and cabinets.  It even works on acne she told me!  It comes in a cream, a soap form, gels form, cleaning solutions, hand washes, wipes for disinfecting surfaces, and a plaster for putting on wounds. Sounds like we all need to stock up on Dettol in case civilization implodes and we need to fight the microbial world without modern antibiotics. Maybe Dettol could be a solution to the antibiotic resistance crisis that is so quickly neutralizing effectiveness of our current antibiotics. After listening to her, I know I’m going to get some Dettol!

Conversation #2-Eating Placentas

Ok, this next topic really took me by surprise. I have never had a mom tell me that she was consuming her baby‘s placenta before… until recently. I’ve heard this practice in the animal world, but I have never had a mother tell me she was doing this.  I guess I just wasn’t paying close enough attention or asking the right questions.  As I began to read about this practice, I discovered that it is becoming quite fashionable, especially among the rich and famous. Advocates of placenta eating claim it is very good for a new mother’s energy and mood as well as being nutritionally rich in many essential nutrients and hormones. I couldn’t find a lot of information to justify the practice but that doesn’t mean it isn’t useful. Many swear it works miracles for new moms. You may be wondering how the placentas are consumed. I know I was curious. Well, the answer to that question is… anyway you can imagine. I think the most common practice is to have the placenta dried and pulverized into capsules but direct consumption of raw or cooked placenta is also an option I understand. Beneficial?  Your guess is as good as mine. In the 21st century, I think if we can’t even all agree that vaccines are effective; we are going to have a hard time proving or disproving the benefits of eating placentas.  Let’s just move on, shall we.

Conversation #3-Cutting umbilical cords

You wouldn’t think in the era of targeted immune therapies for cancers, genetic engineering for congenital metabolic disorders, bone marrow transplants, that the cutting of baby’s umbilical cord would generate controversy and be the focus of high tech medical research. But it actually is. The subject came up recently when a dad told me that he and all of his Dad friends cut their baby’s umbilical cord at birth. This has become a right of passage for new Dad’s today. I’m old enough to remember when Dad’s were nowhere to be found during the birthing of babies but slowly, during my pediatric career, they have crept into the delivery room and now, they are actually helping with deliveries. I don’t attend many deliveries anymore, but my patient’s tell me that Dad’s cutting cords has become a ritual in today’s births, even in an operating room when the birth is by C-Section. Next, Dad’s will be repairing episiotomies and closing abdominal incisions after C-sections!

While we are talking about umbilical cords and placentas, let me remind my listeners about the whole controversy about when to clamp this little organ is in the news.  Recently, the American College of Obstetricians and Gynecologists, began advocating a delayed cord clamping, allowing most of the blood contained in the placenta to transfuse into the newborn before the cord is cut. While this practice does make newborn jaundice more likely to develop in the infant, the benefits of all this blood including stem cells may outweigh the increased risk of jaundice. Experts now recommend that a delay of 30-60 seconds elapse before Dad or whoever cuts the cord.

http://www.cnn.com/2015/05/29/health/cut-the-cord/index.html

Conversation #4- Personal bathroom hygiene in India

My final interesting conversation occurred while talking about the health of a young girl whose parents were originally from India. Just before their most recent visit to India, I had diagnosed their daughter with a fairly rare inflammatory disorder of her labia call lichen sclerosis. I had referred her to a dermatologist for treatment of the lichen sclerosis and at this follow-up visit.  I was asking her mother had they taken her to dermatologist since I had not received a note about this visit?  She said “No”, that she had not taken her and that she had decided instead, to use the “Indian method of personal hygiene” to see if this would clear this condition. She explained to me that in India, toilet paper is not used after pottying, and that they instead, poured water over their bottoms with a little cup to get clean. This child’s mom swears that by using this method of cleaning instead of toilet paper, she had cleared her bottom of lichen sclerosis. Well, maybe she did…who am I to say.  Anyway, I learned about personal hygiene in India and maybe a new treatment for lichen sclerosis.  Maybe in this young girl, lichen sclerosis was a reaction to something in toilet paper? Stranger things have been known to happen.

Outro

If you enjoy learning about pediatrics with pedcasts, make sure you take a moment to like and share any pedcast you wish with your family and friends.  My entire library of 450 posts is available at my website www.docsmo.com.  It’s free and yours to enjoy. You can also get my latest content by subscribing on iTunes. My passion is to empower parents with insight and information. I want my listeners to be the best-informed parents in the room.  Thanks for joining me today. This is Doc Smo, hoping that you won’t balk, the next time your pediatrician wants to talk. Until next time.

Smo Notes:

Dettol antiseptic useful for everything

  1. http://www.chm.bris.ac.uk/motm/dettol/dettolh.htm
  2. http://www.dettol.co.in/

Mom’s Eating Placentas

  1. http://www.webmd.com/baby/should-i-eat-my-placenta
  2. http://www.cnn.com/2015/06/04/health/eating-placenta/

Clamping of the umbilical cord

http://www.acog.org/About-ACOG/News-Room/News-Releases/2016/Delayed-Umbilical-Cord-Clamping-for-All-Healthy-Infants

http://www.cnn.com/2015/05/29/health/cut-the-cord/index.html

Bathroom Hygiene in India

http://www.wikihow.com/Use-an-Indian-Bathroom

http://www.uptodate.com/contents/lichen-sclerosus-beyond-the-basics

Interesting Conversations w/ Parents, March 2017 (Pedcast)
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