Welcome to our monthly parenting chat with Dr. Kathleen Berchelmann, who is an ER pediatrician with St. Louis Children's Hospital. Oh, she's also a mom to five beautiful children. We have a ton of questions, so let's get started.
The tattoo risk people don't talk about is regret. There is big industry in tattoo removal. Removal itself has medical risks including scarring and infection. I think it is important to put this risk out there are the most significant.
Hi Megan, I completely understand your feelings on this. I would similarly try to STRONGLY dissuade a teenager from getting one. But, I know body art is far more common than it has ever been before, and peer pressure at this age can be intense. Many in this peer group, and even older, see it as no big deal and a form of expression much like coloring one's hair. That said, I think the prevalence of tattoos does not lower the potential risks involved. That's the point you want to stress, and I think it's a smart way to go.
Medically, the most common risks of tattooing include infection and scarring. There is a small but real risk of blood borne infection such as hepatitis C if your tattoo artist is not using sterile instruments.
Regret is a very real risk and may not even kick in until years later, when skin might not be as taut and when ink has started to fade. Just like an 18 year old's clothes may not look great on a 50 year old woman, she may feel the same way about a tattoo she loves as a teenager.
It is true that tattoos can cause complications with MRIs, specifically burning at the site of the tattoo. Occasionally a tattoo can interfere with MRI image quality.
According to the Mayo Clinic, here are the most common risks: Allergic reactions. Tattoo dyes — especially red, green, yellow and blue dyes — can cause allergic skin reactions, such as an itchy rash at the tattoo site. This can occur even years after you get the tattoo.
Skin infections. A skin infection is possible after tattooing.
Other skin problems. Sometimes bumps called granulomas form around tattoo ink. Tattooing also can lead to keloids — raised areas caused by an overgrowth of scar tissue.
Bloodborne diseases. If the equipment used to create your tattoo is contaminated with infected blood, you can contract various bloodborne diseases — including tetanus, hepatitis B and hepatitis C.
MRI complications. Rarely, tattoos or permanent makeup might cause swelling or burning in the affected areas during magnetic resonance imaging (MRI) exams. In some cases, tattoo pigments can interfere with the quality of the image.
And while there is little research on how lower-back tattoos effect epidurals during child birth, the doctor may have some concerns depending on the size and location.
Lower back tattoos in females do pose a small risk for epidural during labor or any type of epidural anesthesia. There is a small risk that some dye can get caught in the needle used for the epidural. The doctor might nick the tattoo first with a scalpel and then insert the needle through the nick. This reduces the risk of getting pigment in the needle. This can, however, result in scarring.
Trust me, I would freak out if my daughter wanted a tattoo. But, to be honest, I don't have to think back that far to remember a time when I toyed with the idea myself. If you can encourage your daughter to just think about it for six months before committing to it, the desire may just pass. (hopefully)
Hi Mike! Croup and asthma are very different diseases from a medical standpoint, but both very scary to parents up in the night with babies struggling to breath. From a medical perspective, though, croup is inflammation of the larynx or voice box, plus additional inflammation of any other part of the the airway. It is the inflammation of the voice box that causes that characteristic barking cough, which some people say sounds like a seal. The medical term for this sound is "stridor." Asthma, on the other hand, is a disease that causes the lower airways to constrict in response to some irritant, such as pollen, cold air, animal dander, or a viral infection. Asthma causes wheezing, which is a sound that usually can only be heard with a stethoscope unless it is really bad. Wheezing is a different sound from stridor.
Mike, I'll let Dr. B address the medical specifics of your question, but as a parent who also has a child suffered from allergies, chest infections and subsequent asthma, I think it's smart to be proactive about this risk. Even though allergies and asthma may not sound so serious, they can be a serious medical condition that has to be managed with medicine, diet and lifestyle changes. Our pediatric allergist had our child do a 'breathing test' in her office, which basically involved blowing into a device that measured how well his lungs were working, when we went to see her. It revealed that he needed a stronger dose of medicine than what he was currently taking. Our pediatrician recommended the specialist when my child started needing breathing treatments every spring and fall for allergy-induced asthmatic cough.
There is no lower age limit to diagnose asthma. To be diagnosed with asthma a child has to wheeze on two separate occasions and other causes for wheezing have to be ruled out. Your doctor may want to run additional tests to confirm the diagnosis of asthma.
See your physician and aggressively treat acne. Acne is one of the most overlooked illnesses. It can cause permanent scarring and enormous emotional issues. Acne can have a huge impact on self-esteem and can affect a young person's feelings about who and if they are able to date and enter romantic relationships.
The good news is that acne is very treatable, but you have to find a doctor who will treat it seriously. Most acne patient go through several medications before they find something that really works for them.
The same thing goes for BO. Try various deodorants, and talk to your pediatrician about prescription deodorants.
Ask your doctor for a referral to a dermatologist. Those appointments usually have a long wait, up to a few months.
Accutane is a strong acne medication that can and should be used for acne that is not responding to other medications. Don't settle for sub-optimal acne treatment. If it's not working, try something else. You do have to be patient-- it can take six weeks or more to see result from an acne medication, so you have to use it regularly for six weeks before you give up and try something else.
Thirteen-year-olds often need help from their parents to use acne medications regularly and complete their personal hygiene regularly. Consider setting an alarm on his phone twice a day to remind him to shower and/or complete his hygiene routine.
here are the links Dr. B promised during the chat:
Thank you so much for sharing your questions and concerns with us. If we couldn't get to your question this month, it will be first in the queue next month!
Welcome to our monthly parenting chat with Dr. Kathleen Berchelmann, who is an ER pediatrician with St. Louis Children's Hospital. Oh, she's also a mom to five beautiful children. We have a ton of questions, so let's get started.
Hello Aisha and Dr. B, How soon can/would a Pediatrician diagnose asthma in a child? Our three year old at least twice has suffered from croup and just in general seems to breath heavier after running(more so than her older sister did at the same age). Not a huge worry now but should I wait until her next "well" check up to discuss with her doctor? Thanks!
