March 2019
News From Cornerstone Pediatrics
Those First Few Seconds...
This month, we are continuing our staff development focus on the Patient Experience by focusing on First Impressions.
We want Cornerstone Pediatrics to be a warm, welcoming place from the very first moment a family walks through the door. Our goal is to greet each family who enters with a smile and BY NAME! We are also working to stand up to greet our families at eye level.
BUT, we also realize that the first impression extends to that first phone call. So we are practicing smiling at the phone!! Sounds silly right? But try it and listen you your voice when you smile rather than not. It makes a HUGE difference!
We hope you notice!!
Ten Things Parents Can Do to Prevent Suicide
Depression is common in teens. Unfortunately, so is suicide. Here are some things you as a parent can do:
1. Don't let your teen's depression or anxiety snowball.
Maybe your child is merely having a bad day, but maybe it's something more if this mood has been going on for a couple of weeks.
Let's not wait for children or youth to come to us with their problems or concerns. Knock on the door, park yourself on the bed, and say, "You seem sad. Would you like to talk about it? Maybe I can help."
2. Listen—even when your teen is not talking.
Not all, but most kids who are thinking about suicide tip off their troubled state of mind through troubled behaviors and actions.
If your instinct tells you that a teenager might be a danger to himself, heed your instincts and don't allow him to be left alone. In this situation, it is better to overreact than to underreact.
3. Never shrug off threats of suicide as typical teenage melodrama.
Any written or verbal statement of "I want to die" or "I don't care anymore" should be treated seriously. Often, children who attempt suicide had been telling their parents repeatedly that they intended to kill themselves.
Any of these other red flags warrants your immediate attention and action by seeking professional help right away:
  • "Nothing matters."
  • "I wonder how many people would come to my funeral?"
  • "Sometimes I wish I could just go to sleep and never wake up."
  • "Everyone would be better off without me."
  • "You won't have to worry about me much longer."

4. Seek professional help right away.
If your teenager's behavior has you concerned, don't wait to contact your pediatrician. Contact a local mental health provider who works with children to have your child or youth evaluated as soon as possible so that your son or daughter can start therapy or counseling if he or she is not in danger of self-harm. However, call your local mental health crisis support team or go to your local emergency room if you think your child is actively suicidal and in danger of self-harm.
5. Share your feelings.
Let your teen know he or she is not alone and that everyone feels sad or depressed or anxious now and then, including moms and dads. Without minimizing his anguish, be reassuring that these bad times won't last forever. Things truly will get better and you will help get your child through counseling and other treatment to help make things better for him or her..
6. Encourage your teen not isolate himself or herself from family and friends.
It's usually better to be around other people than to be alone. But don't push if he says no.
7. Recommend exercise.
Physical activity as simple as walking or as vigorous as pumping iron can put the brakes on mild to moderate depression.
8. Urge your teen not to demand too much of himself or herself.
Until therapy begins to take effect, this is probably not the time to assume responsibilities that could prove overwhelming. Suggest that he or she divide large tasks into smaller, more manageable ones whenever possible and participate in favorite, low-stress activities. The goal is to  rebuild confidence and self-esteem .
9. Remind your teen who is undergoing treatment not to expect immediate results.
Talk therapy and/or medication usually take time to improve mood. Your child shouldn't become discouraged if he or she doesn't feel better right away.
10. If you keep  guns at home , store them safely or move all firearms elsewhere until the crisis has passed.
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News Flash: Screens are Still BAD!
Whether it's television, tablets, or smartphones, kids are spending more time in front of a screen than ever.
Daily screen time among youths younger than age 2 rose from 1.32 hours in 1997 to 3.05 hours in 2014, with most screen time spent watching TV.
Remember this is kids UNDER 2 we are talking about! THREE HOURS per day. That's 25% of a child's waking hours.
And, it's really bad for their brains. Children ages 9 and 10 who spent at least seven hours on screens daily had early thinning of the cortex in MRI scans, and those with more than two hours of daily screen time had lower language and thinking test scores, compared with those with shorter daily screen times, according to an ongoing NIH study. 
That's brain damage!
Please, please, turn OFF the devices. Read with them. Play with them. Even letting them play alone in their rooms is better than plopping them in front of a screen. Help their brains grow up big and strong. Turn off the screen.
Juuling-It's Huge. And Dangerous.

E-cigarettes are exploding in popularity, and are being used by both adolescents and adults. They are not a safe alternative to cigarette smoking.
E-cigarettes, personal vaporizers, vape pens, e-cigars, pod systems, e-hookah, or vaping devices, are products that produce an aerosolized mixture containing flavored liquids and nicotine that is inhaled by the user. E-cigarettes can resemble traditional tobacco products like cigarettes, cigars, pipes, or common gadgets like flashlights, flash drives, or pens.
Here are facts and tips to help parents and caregivers address e-cigarette use and exposure.
Are They Safe?
The solution in e-cigarette devices and vapor contains harmful chemicals like antifreeze  (made from one of two chemicals: propylene glycol or ethylene glycol), diethylene glycol, and carcinogens like nitrosamines which can cause cancer.
The nicotine in e-cigarettes is addictive and can harm brain development.
E-cigarettes are not yet regulated nor approved for smoking cessation by the  US Food and Drug Administration (FDA) , and the long-term health effects to users and bystanders are still unknown. Due to the lack of regulation, the chemical compounds in an e-cigarette device can vary between brands.
The best way to protect your children is to never smoke or vape near them. Talk with your doctor about quitting all tobacco. Never smoke indoors, in your car, or in places that children spend time.
Dangers to Youth:
E-cigarettes are the most commonly-used tobacco product among teens. In 2018, over 20% of high school students reported having used e-cigarettes in the last 30 days.
E-cigarettes contain a liquid solution that is usually flavored. Flavors, which are appealing to children, often are things like peach schnapps, java jolt, piña colada, peppermint, bubble gum, or chocolate.
Youth who use e-cigarettes are more likely to smoke traditional cigarettes in the future.
Children are exposed to e-cigarette advertising in the media, and in magazines and billboards.
Although it is illegal for e-cigarettes to be sold to youth under age 18, they can be ordered online.
Risk of Poisoning
E-cigarette solutions can poison children and adults through swallowing or skin contact.
A child can be killed by very small amounts of nicotine: less than half a teaspoon.
As of 2016, liquid nicotine is required to be sold in childproof packaging.
Symptoms of nicotine poisoning include sweating, dizziness, vomiting, increased heart rate lethargy, seizures, and difficulty breathing.

These devices are being marketed to kids-your kids. Parents, you need to educate yourselves about this health risk and then start a conversation at home. Communication is the first step to prevention.