By Maryse Isma

 Special to CSMS MagazineMany parents will find themselves seeking answers to the same old questions about their children’s health…How can I find a good doctor for my child? While a pediatrician is the most obvious choice, family practitioners often make good doctors for children.             Carefully interview different types of doctors then pick one that meets your requirements…one with a peasant, caring attitude…a willingness to talk directly with your child as well as with you…clean, orderly office… and a good system for fielding after-hours phone calls. Make sure your child gets along with the doctor and accepts your insurance plan.             However, we need to be very careful. If the doctor belongs to a group practice, ask that you be allowed to make appointments specifically with him/her. Ask if the doctor can provide you educational materials regarding specific health issues. They’re big help when illness strikes –or during puberty.

Does my child need an X ray?

 In addition to being costly, X rays, CT scans, magnetic resonance imaging and other diagnostic tests are typically frightening to children. They are risky and unnecessary. They should be administered only if their findings will have a direct bearing on your child’s treatment. If your child has a cough, for example a chest X ray is generally unnecessary—unless the doctor has reason to suspect a serious lung ailment. Before agreement to any test, question the doctor thoroughly to make sure it is necessary. Below are the key question that you must ask:

• What’s the name of the test?
• Why is it necessary?
• What will it reveal that you don’t already know?
• What will happen if the test is not performed?
• What are the possible side effects?
• Is a less-invasive test available?
• Will the test results change your methods of treatment?

Are childhood immunizations safe?

 Most states require that all children be immunized against these following diseases—diphtheria, pertussis (whooping cough), tetanus, measles, mumps, rubella (German measles), poliomyelitis and Haemophilus influenza type B (bacterial meningitis). Experts are also now recommending varicella (chicken pox) and hepatitis B.            These vaccinations are typically administered between the ages of two months and sixteen years. They are generally quite safe. Half of all children who receive this five—dose vaccine develop fever, and in rare cases, children have developed mental retardation or another permanent disability. However, because pertussis is such a serious dangerous diseases, it is still prudent to have your child immunized.Minimizing the riskInsist that your child receive the acellular pertussis vaccine. It’s less likely to cause dangerous reactions than the old vaccine, which remains in use. The pertussis vaccine should never be given to any child who is over the age of six, who has a fever already had pertussis. Any child who experience fever, shock, persistent crying, convulsions or neurological problems after the first pertussis shot should not receive any of the additional pertussis boosters.            Here is an other pertinent question that needs to be addressed. My child has recurrent throat infections. Should his tonsils be removed? Tonsillectomy is neither necessary nor particularly effective at curing recurrent ear or throat infections, even though doctors often urge surgery. But When is it appropriate? If the tonsils become so swollen that they interfere with the child’s breathing, or if lab tests indicates the presence of absences behind the tonsils, then it is appropriate. In all other cases, it’s best to treat such infections with antibiotics.

What about chronic ear infections?

             Ear infections (otitis media) are common among children of smokers. If you smoke—stop. New mothers should avoid bottle-feeding their children. Research suggests that breast-feeding helps prevent earaches. Beyond this, there’s no real consensus on treatment.            The American Academy of Pediatrics recommends the use of oral antibiotics (usually amoxicillin), although some research casts doubt on their effectiveness. The surgical insertion of drainage tubes through the child’s eardrums (tympanostomy) can cause serious complications, including severe, infections and hearing loss.            Finally, there are some specific things to discuss with the doctor. At the first sign of pain, give your child acetaminophen (Tylenol) or another aspirin painkiller. Also helpful: A heating pad held against the ear. Choose a doctor’s office or a hospital that you feel comfortable with. The standard of care in children’s hospitals is no better than that in general hospitals with good pediatric sections. If your child requires important surgery, pick a hospital that performs that surgery on a routine basis.Also see A Link to Cancer and Unfaithful Husbands