Dr. David Bernstein, vice chair of the AAAAI committee on immunotherapy, warns that undergoing immunotherapy is a long-term commitment. “However, it is still the best treatment available to control and prevent symptoms or to reduce a need for daily medications. Read the rest of this entry »

Allergy and asthma victims, who just suffered through the first seasonal spike in pollens and other airborne allergens, can now brace themselves for the summer one, as weeds blossom in many parts of the United States. Right behind that will come autumn, bringing another, usually smaller and shorter allergy season. Read the rest of this entry »

Q: What causes hypertension in a 5-year-old?
A: Hypertension, or high blood pressure, is not common in infants or children and should always be carefully evaluated. The average blood pressure, or BP, for a 5-year-old boy or girl is about 95/55; blood pressure of 110/70 or higher would generally be considered too high.

The BP should be checked on two or more occasions when the child is well and not in pain (pain will elevate blood pressure), using the proper size cuff. (Your pediatrician will have a range of cuff sizes to fit different ages of children.) High BP can be caused, rarely, by medications such as dextroamphetamine and amphetamine-dextroamphetamine.

In adults, a specific cause for high BP is almost never found; adults with high blood pressure often improve when they go on a low-salt diet, exercise more, give up smoking and lose weight. For young children, however, high BP is often a sign of a heart or kidney problem.

Kidney disease or kidney malformation may be a factor in high BP for children around age 5. The kidneys may not have formed correctly, or they may be enlarged because of poor urine flow through the bladder or urethra. There may also be a problem with the blood supply to the kidney.

Your child should have a kidney (renal) ultrasound to determine whether the kidneys are normal in size and appearance. Urinalysis and blood tests should be done to determine whether the kidneys are functioning properly. If a problem is found, your child may be referred to a pediatric nephrologist (a kidney specialist) or pediatric urologist (a surgeon who specializes in the kidneys and urinary system) for further tests and treatment.

Another cause of high BP in young children is a narrowing of the aorta, the large artery that comes from the heart and carries the blood to smaller arteries throughout the body. Narrowing of the aorta, or coarctation, prevents the proper amount of blood from reaching the kidneys and results in high blood pressure.

Your child should have a chest X-ray and EKG (electrocardiogram) or echocardiogram (ultrasound of the heart and aorta) to make sure there is no coarctation. Coarctation can be corrected surgically.

Your child’s blood pressure may require treatment with anti-hypertensive medications, even if the cause is found and corrected. Your pediatrician, pediatric nephrologist or pediatric cardiologist will be an excellent resource for you as you go through this evaluation. I urge you to arrange for your child to have a thorough evaluation.

IBD affects nutrition in several ways, and people with the disease need to pay close attention to diet and to their nutritional needs. Children with IBD are at particular risk for nutritional problems. Read the rest of this entry »

During an episode of “managing-happily-ever-after disappointment” a quarter-century ago, The Enjoyment of Management by Frederick and John Dyer seemed like the right book for me to read. One chapter covered “the fight-the-report syndrome.” Everyone probably has had an experience with FTRS, but may not realize how extremely common it is. Read the rest of this entry »

And they lived happily ever after. What a comforting way to end a story. In the romance of fairy tales, things are resolved once and for all. The challenge is met, the yearning fulfilled, the scary thing defeated. Tuck the covers under the smiling chin, kiss the unfurrowed brow and turn out the lights. Now, re-enter the adult world. Read the rest of this entry »

An equally important step is to come up with an effective opener to these conversations. You will be calling people who are busy and you need to quickly give an overview of your background and your objective in calling them. Here’s an example:

“Hi, this is Matthew Thomas and I got your name from Sally Armenta who thought you might be willing to share your insights about the field of copywriting with me. I have been in public relations for seven years, working for a variety of financial institutions. I am interested in applying my writing skills in a new direction. Would you be willing to set up some time to meet? I’d love to ask you some questions.” Read the rest of this entry »

Last week we examined how to tell if it’s time to change jobs. We looked at ways to assess whether your interests, skills, values and personality style are a good fit for the kind of work you do. If you’ve now come to the realization that you may in fact need a career change, the next challenge is investigating all of the options and deciding among them. Read the rest of this entry »

If you have your own pool, a physical therapist can design an exercise program that is best for you. The Arthritis Foundation also offers a videotape called “Pool Exercise Program,” a 50-minute workout routine. Find the tape at the Foundation’s website. Read the rest of this entry »

Imagine going on a moonwalk. You’re nearly weightless, and when you take a step, you barely touch the surface of the moon. You’re basically floating along. Read the rest of this entry »