It’s not often the pediatric community goes all a-twitter about personnel changes on daytime TV, but ABC just announced that Elisabeth Hasselbeck’s replacement on The View will be Jenny McCarthy, and doctors seem more worked up than Ann Curry fans at a Matt Lauer mall appearance. Apparently, some in the pediatric community fail to appreciate Ms. McCarthy’s groundbreaking work as 1994’s Playboy Playmate of the Year or her dramatic tour de force in Scream 3. No, many of my colleagues seem unable to overlook McCarthy’s antivaccine advocacy, blaming her in part for the estimated 1,170 deaths from vaccine-preventable diseases in the U.S. since she began her crusade in 2007.
Personally, I’m thrilled. For one thing, I love McCarthy’s “Green Our Vaccines,” campaign, agreeing that the common immunization colors of clear, white, and milky are passé and hard to accessorize. I also admire McCarthy for her unwavering loyalty to (former) Dr. Andrew Wakefield who, since being disgraced by evidence that he falsified the data in his discredited article linking autism to measles vaccine, needs a friend. And I am ready to defend McCarthy from those who say she wears glasses just to give the impression that she may be intelligent. Are these not are the same people who say she’s blind to the overwhelming evidence proving that vaccines do not cause autism? Make up your minds! I do still wish The View had given a little more consideration to another well-spoken, glasses-wearing celebrity, Dr. Paul Offit.
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I wish they'd find that Marco Polo. That yelling's hurting my ears.
Down the tubes
You might think that the most common surgery performed on children, accounting for nearly 670,000 pediatric procedures a year, would be governed by some sort of evidence-based guidelines. And you’d be right, provided you had that thought very, very recently. Because July 1st marked the release of the first-ever tympanostomy tube guidelines from the American Academy of Otolaryngology-Head and Neck Surgery. The good news: If doctors were to actually follow these guidelines, we could eliminate unnecessary ear surgeries, just as we’ve already done with the overuse of antibiotics!
Pinning down what tympanostomy tubes are good for has been harder than you’d think. The evidence for tubes improving speech delays is more ambiguous than Johnny Depp’s wardrobe choices. And the tubes themselves can cause complications that can reduce both patients’ hearing and their parents’ HSA balances.
Of the twelve recommendations, the most popular is bound to be the one allowing children with tubes to swim without using ear plugs. I anticipate at least a 30% reduction in kids screaming at our community pool; I’ll collect data this weekend. The most controversial recommendation is bound to be the one against placing tubes just because a child has had a lot of ear infections. Some people just prefer action to inaction -- it will take time to convince parents and some doctors that this is yet another of those situations where it’s better to make like Congress, and do nothing.
Brother, can you spare a rod?
In a world where it seems there are fewer and fewer things people can agree upon, I think it’s still safe to say most Americans have a generally unfavorable opinion of child abuse. But that consensus dissolves when we try to define the word “abuse.” Not only has the U.S. not joined the 33 other countries that have outlawed physical punishment of children, we still have school systems in my state that endorse paddling, giving some North Carolina children a better shot at winning foreign political asylum than Edward Snowden.
We already know that severe child abuse results in lifelong health consequences, including early mortality, chronic pain, and psychiatric disease, but a group of Canadian researchers wondered if the same outcomes would hold for children who were merely pushed, grabbed, shoved, or slapped on a regular basis. Sure, some people would say this is also child abuse, but where I live we call it “a visit to Walmart.”
Not surprisingly, adults who recalled these sorts of childhood punishments suffered more heart disease, arthritis, obesity, and other physical conditions. The authors admit that convincing parents to embrace less physical methods of discipline may pose special challenges, and I’d have to say my own experience in practice makes me pessimistic, but we can still hope for a day when “getting physical” means nothing more torturous than being made to listen to an Olivia Newton John song.
Finnish talking
In case you thought you were wasting your breath counseling families on healthy diet, researchers in Finland have good news for you: You’re wasting your breath on other stuff. Based on their new study in Diabetes Care, your words can indeed help improve adolescents’ diets and their insulin sensitivity, so long as you start the counseling during infancy and continue it for 20 years. Better yet, researchers suggest that you consider moving in with your patients’ families and cooking some of their meals, or at least dropping by unannounced and cleaning out their pantries from time to time.
This study just goes to show that the right kind of talk really can save lives, which brings me back to daytime TV. How does this strike you: “Live! With Kelly Ripa and Paul Offit!”? Now that’s a show I would view.