Warts

Verruca vulgaris is the fancy medical term for common warts.  And common they are, even in children, and usually found on the bottoms of feet or around the fingernail beds.  Sometimes parents find it difficult to distinguish a wart from a callus.  A wart is characterized by tiny dark specks on it, which are really thrombosed capillaries.  As with many things in medicine, warts are virally induced, and as it turns out, there is no great therapy for them.  A friend of mine showed me her daughter's warts the other day, and I told her she could try an over-the-counter preparation with salicylic acid.  If warts on the bottom of feet start to bother the child, I do recommend a visit to a podiatrist or dermatologist for liquid nitrogen or laser therapy.  But without any treatment, warts can disappear on their own, whether it be next week or next year.  In many cases, I end up telling parents just to wait the warts out; sometimes patience really is the best medicine.

Waxing On About Ear Wax

It's a good visit for me and the patient.  Flushing wax out of a child's ear is far from glamorous, but I find it satisfying when a big ball of wax emerges and suddenly the child says, "Oh, my gosh, I can hear again!"  The parent is usually a little disgusted to see how much wax can emerge from the child's ear; invariably she asks what she can do to prevent the wax buildup.  Relax, I say, God made ear wax for a reason; it helps to keep the pH of the ear canal balanced, and it helps to prevent infections of the ear canal.  If wax builds up such that a child is complaining he can't hear well, a parent can use an over-the-counter solution that softens the wax, which will work its way out of the ear.  If not, it takes about two minutes at the pediatrician's office to flush out the wax.  I do caution parents not to use Q-tips to go digging for wax.  Q-tips cause too many ear canal abrasions from forceful probing by parents.  In fact, Q-tips usually push the wax in further.

So ear wax is your friend, I always tell parents.  It's a good thing; don't do battle with it, and certainly not with Q-tips.  In the not-so-common instance when the buildup actually prevents a child from hearing well, a pediatrician will find it very gratifying to flush it out.

Childhood Vaccination - It's A Very Good Thing

I understand parental anxiety.  I'm a parent who worries about everything about my kids.  But there is one thing I have never worried about, and that is giving vaccines to my children.  I'm a big proponent of vaccines and the world of good they've done and continue to do in reducing mortality, morbidity and misery.  Imagine what it would be like to fear your child becoming crippled from polio.  Imagine your child contracting measles and developing encephalitis from the infection.  Imagine your son becoming sterile from a mumps infection.  Today's parents don't have to fear such diseases because of childhood vaccination.  Because these diseases now seem so antiquated and remote to parents of our generation, it has become easy for some moms and dads to be cavalier about vaccines.  Oh, my child isn't going to get polio or measles, they say.  I'll just count on everyone else getting vaccinated, and that will protect my child indirectly.  Selfish argument?  Absolutely. 

Then we have the group of parents who believes their child will become autistic if they get too many vaccines.  The group of researchers from Britain who started all this vaccine and autism talk in the 1990s recently retracted their statements.  Hallelujah, we pediatricians cried, when that announcement was made.  There is no good science to support any link between vaccines and autism.  Some parents also worry that the number of vaccines we give can overwhelm the immune system.  My partner, Dr. Michael Segarra, likes to tell moms that a child's pacifier introduces more antigens into the body than the vaccines we give at one visit!  He's absolutely right. 

I know that there are parents out there who will remain skeptical of vaccines no matter how much information we pediatricians give them, but I also like to tell these parents that if I didn't think vaccines were safe and necessary, I certainly wouldn't have given them to my kids.  I think that says a lot.