Keep your child’s trip to school as safe as possible with these tips from www.safekids.org. 

Go Safely on Four Wheels 

• While waiting for the bus, stand back 5 giant steps from the street. 

• When the bus stops, line up in a single-file line. 

• Hold on to the handrails, and be careful that your clothes or other objects don’t get snagged. 

• When you get off, take 5 giant steps away from the bus. 

• If you drop something near the bus, do not pick it up. Tell an adult. 

• When crossing the road, walk 5 giant steps in front of the bus and look both ways before you cross. 

Go Safely on Two Wheels 

• Make sure your bike is in good working condition. Check that reflectors are secure, the brakes work properly, gears shift smoothly and tires are properly inflated. 

• Wear a helmet whenever you ride, and make sure the helmet fits properly. 

Review bike safety tips: 

• Ride with traffic, not against it, and ride as far to the right as possible. 

• Use appropriate hand signals when turning or stopping. 

• Stop at all stop signs and red lights. 

• Stop and look left, right, and left again before entering a street. 

• Look behind you and yield to oncoming traffic. 

Go Safely on Foot 

• Parents: Walk with your children to find the safest path and most direct route with the fewest street crossings. Then make sure they take the same route to school every day. 

Review pedestrian safety with your child: 

• Look left, right and left again before crossing the street. 

• Walk, don’t run. 

• Understand and obey traffic signals and signs. 

• Cross at corners, using traffic signals and crosswalks when available. 

• Stop at the curb (or at the edge of the road if there is no curb) before crossing the street. • Never run into a street without stopping and looking first. 

 • Walk facing traffic on sidewalks or paths. Walk as far to the left as possible if there are no sidewalks.

Over the last couple of years, WakeMed’s Families First publication has offered lots of great back-to-school tips for parents and kids.  In anticipation of back-to-school, we will share this timeless information with you from sleep training to vaccinations to packing your child’s lunch to how to know when your child really is too sick for school.

 Sleepytime: Are your kids getting enough ZZZZs?

Ever dragged into work after staying up late to finish a project? That’s how a kid feels, too, if he/she hasn’t gotten enough sleep. “Kids who don’t get enough sleep have problems with attention and short-term memory,” said Jerry Bernstein, MD, a pediatrician with Raleigh Pediatrics. “They can be inconsistent in their work and slow to respond, too. Helping your child get a good night’s sleep is one of the best things you can do for them to do well in school and in life.”

How much sleep do school-aged kids need? There is no magical number, but most need around 10 hours each night. “Parents can usually tell if their child is not getting enough,” said Dr. Bernstein. “If they are cranky, irritable, or even hyper, parents should strive toward helping their child get more sleep each night.”

To do this, Dr. Bernstein recommends that parents:

-Explain how sleep works and stress the importance of going to bed at the same time each night. Try to maintain regular sleep/wake times on the weekend, too, to ward off stressful Monday mornings.

-Establish a bedtime routine that helps kids relax and get ready for sleep. Television, a stimulant, should not be a part of the routine.

-Make sure they get plenty of exercise, but not before bed.

-Limit caffeinated beverages, especially after 4 p.m. If possible, eliminate them completely. (Not only is the caffeine bad, but the acid and sugar in soda causes tooth decay.)

-School-aged children need private time with their parents. Make a little time just before bedtime to talk about the day and anything that’s on their minds.

Fun Sleepytime Facts

On average, how many hours does a new baby sleep each day?

About 20

How many hours should a school-aged kid sleep?

About 10

If your body misses some sleep, does it catch up later?

Usually, yes

Can you store sleep and use it later?

No. it’s better to get a good night’s sleep every night.

Skin cancer can be very serious and it does not discriminate. Just last week former Pittsburg Steelers coach Bill Cowher lost his wife, Kaye, to skin cancer.  She was only 54 years old. 

One in five Americans will develop skin cancer, a disease which is most prevalent in people over age 30, regardless of race or skin tone.  The good news is that most skin cancers are highly treatable if identified early.  Knowing when a spot on your skin may be cancerous is key to early detection. 

Melanoma is the most deadly form of skin cancer because it often spreads to other tissues, and the incidence of melanoma has increased by over 600% in the last 50 years. Melanomas can  have some distinctive characteristics, and physicians generally use the ABCDE rule for identifying this dangerous form of skin cancer. 

• A = Is the spot ASYMMETRICAL?
• B = Does it have an irregular BORDER?
• C = Is it variable in COLOR?
• D = Is the DIAMETER greater than 6 mm (approximately the size of a pencil eraser)?
• E  = Has the spot EVOLVED or changed and does it have a raised ELEVATION?

The other two types of skin cancer, basal cell and squamous cell skin cancers, will not necessarily follow the ABCDE rule, but they may have some of the same characteristics.  And, these two types of skin cancer are the MOST COMMON CANCER IN WOMEN AGE 25-29!

Basal cell is the most common type of skin cancer. It tends to spread more locally, and is typically the most difficult to recognize as skin cancer because the changes are not as distinct as what you see in a melanoma.  Basal cell skin cancers identifying characteristics are pearly borders and little blood vessels within the region. They can bleed easily, and most are found on the head and neck.

Squamous cell skin cancer tends to evolve from precancerous moles.  Physicians easily identify precancerous moles and often recommend proactive mole removal or treatment.

The Best Defense is Offense

You should always take measures to protect yourself from the sun using sunscreen, shade or clothing because no amount of sun exposure is “safe” there are no “safe” rays as advertised by some tanning salons.   A tan is the skin’s way of protecting against further sunburn.

When it comes to sunscreen, more is better and most people do not use enough sunscreen.  Plan to use 1 Teaspoon for your face and 2 Tablespoons for the rest of the body. 

The same application pitfall applies to sunscreen sprays.  While they are effective, most people do not apply a thick enough coat of sunscreen using the spray, leaving their skin vulnerable. Also, note that sunscreens are only effective up to SPF 50 – any higher and you do not get any more benefit.

Overall, a good rule of thumb is to have a primary care physician or dermatologists look at your skin every year to note changes.  It is also a very good idea to see a physician if you notice anything abnormal with your skin between physician visits. See your physician if you have a sore that won’t heal.

Between you and your physician, you will generally be able to identify most problems early.

Michele Casey is a primary care physician will Falls Pointe Medical Group. She is currently working on a fellowship in advanced wilderness medicine.

ATVs, whether for recreation or an occupation, are part of daily life in North Carolina – Safe Kids Wake County recommends that children under the age of 16 should never ride on or operate ATVs of any size – including youth-sized ATVs.

Nationwide, approximately 130 children under the age of 16 die each year as a result of ATV-related injuries, and an estimated 40,000 children under the age of 16 are seriously injured each year in ATV-related incidents.

Over the past five years at WakeMed, we have treated 201 ATV-related trauma patients. Of these, 73 were under 18 years of age and 39 were wearing helmets. And, although helmets can reduce the risk of severe head injuries, there are no safety devices that adequately protect against other injuries commonly sustained while riding ATVs.

ATVs are inherently difficult to operate, and children do not have the cognitive and physical abilities to drive or ride these vehicles safely. If an individual is not mature enough to drive a car with safety belts and traffic control devices on a paved road, that individual is probably not capable enough to drive a powerful open-seat vehicle at speeds up to 70 miles per hour over rough terrain.

This may not be the advice a lot of parents want to hear, especially if ATVs are commonly used by friends and family, but it’s the conclusion drawn from extensive and ongoing review of the data. The opinion of safety experts is that there is simply no way to make ATV riding a safe activity for children.

Rollovers, collisions and ejections involving ATVs can cause instantly fatal head injuries as well as serious nonfatal injuries to the head, spinal cord and abdomen. A child riding an ATV is four times more likely to be seriously injured than a rider over the age of 16.

For more information about ATVs and outdoor recreation safety visit www.safekids.org.

Sylvia Scholl is WakeMed’s Trauma Program Director.

Did you know there is a significant link between smoking and bladder cancer?  Last night, WRAL-TV aired a story featuring Wake Specialty Physicians Urologist Sam Chawla discussing this link.

When we originally posted the What’s Living on That…? blog a couple of weeks ago, we knew that folks would find it interesting. We were thrilled with the positive response we received on this blog, Facebook, and via email. Over the next week, we will be swabbing the following nine items suggested by readers:

• Utensils at salad bars and buffets
• Vending machine buttons
• Hand sanitizer pumps in hallways
• Sink handles in a public restrooms
• Shopping cart handle at the grocery store
• Elevator buttons
• Ketchup bottles at restaurants
• Water fountain at a gym
• Department store door handle

It will likely take a week or more to report the results, but we promise to provide you with a detailed run-down of all of the bacteria, viruses, and germs residing in these areas. And, we’ll even work with a microbiologist in the WakeMed Pathology Lab to determine how harmful these germs are and what we can do to prevent illness.

On Wednesday, WRAL aired a story featuring WakeMed Emergency Department physician Eduardo Piqueras discussing the dangers of rabies.

Yesterday it was announced that former vice president Dick Cheney received a left ventricular assist device (LVAD).  A LVAD is designed to help patients with end-stage congestive heart failure (CHF). 

CHF occurs when the pumping capacity of the heart is diminished to the point where there is insufficient blood flow to the body.  CHF can result from a number of causes.  It most commonly occurs when blockages in the heart arteries cause damage to heart muscle.

After the onset of CHF, the condition is usually progressive. Up to a certain point, patients can be treated with oral medicines and life-style modification. However, after a certain point, oral medications cannot help the heart pump enough blood to the body. This is called end-stage congestive heart failure. At this point patients have three options:

1. Intravenous (IV) medications which temporarily help heart muscle function
2. Heart transplant
3. A left ventricular assist device.

IV medications are not effective long term, and can actually make heart failure worse in some cases.  A heart transplant is the ultimate treatment for end-stage heart failure. However, finding an appropriate donor takes time. Until a transplant is available, a LVAD can help the heart pump blood to the body. 

L VAD’s are not new, and have been around for more than a decade.  These devices were initially large and required constant monitoring, and patients with LVADs were prone to life-threatening complications. However, technology has steadily improved, and the quality of life for patients with LVADs has improved along with these technological advancements. 

Studies have shown that patients who have end-stage heart failure live longer and have a better quality of life with an LVAD than without.  In fact, LVAD’s are now often used not just as a bridge until a heart transplant, but as a long-term solution by themselves, known as destination therapy.

Mr. Cheney has ischemic cardiomyopathy (damage to heart muscle due to blockages in the arteries).  These blockages have caused five heart attacks, the first of which was when he was 37 years old.

To treat these blockages, he has undergone bypass surgery and stenting procedures. However, his heart is now damaged to the point where he has end-stage CHF. To treat this, he has received a LVAD. It remains possible that he may need a heart transplant in the future.

Dr. Ravish Sachar is a cardiologist with Wake Heart & Vascular Associates and perfoms many procedures in the WakeMed Heart Center.

Advocates for Health in Action is working with area farmers markets to help them determine what customers are looking for in their market – is price, convenience or organic produce most important to you? Take a few minutes to fill out this SURVEY, so Wake County farmers markets can better serve you.

Oh, and if you are curious about what is currently in season and available at the North Carolina Farmers Market, check out this availability chart.  Also, NC Farm Fresh is a great site to find a farmer’s market near you.  You can even search by type of produce.

Laura Aiken is a community health specialist with WakeMed and director of Advocates for Health in Action.

Have you ever wondered what kind of germs or bacteria are living on that elevator button, office microwave or restaurant table? 

Well, we have.  And we are pleased to announce that the WakeMed Pathology Department has agreed to grow and interpret samples taken from around our community.  But we want your help determining what to swab. 

Let us know that you are curious about germy doorknobs, toys at childcare centers, equipment at the gym etc.  (Please be generic.  We don’t want to call-out any specific businesses or organizations.)

Then, we’ll pick seven things/locations to swab, and will report the results back to you.