352 - Vaccines with Dr Jay Sutay

Justin and Dr. Jay talk about Teen Mom 2 Star's anti-vaccine stance, and Pediatric Thoughts.

Dr. Jay Sutay

StandUpPediatrician.com
@DrJaySutay on Twitter

@iPodcastJustin on Twitter to watch Justin at work at KFIAM640. 

 

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Episode Transcript

(00:11):
Listen to me, listen to mychase that Hello and welcome to the Dad

(00:37):
Podcast. I'm your host, JustinWorsham, back with us again as our
resident pediatrician slash stand up comedian,the One the Only Doctor j Sute.
Good morning, doctor Jay. Howare you doing out there, Justica?
I am fantastic. We're having weatherin Los Angeles which always freaks people out
and scares them. Rain weather,rain weather. Yes, it's and it's

(01:00):
and cold, it gets down toit's funny to watch people on Instagram out
here post frost on their grass andon their windows because it was thirty seven
degrees overnight and the dead of nightgot down below forty degrees and everybody had
to close my office yesterday afternoon becauseof a storm that threatened three to five
inches and ice during the rush houryesterday evening. You know what I did

(01:23):
when I closed my office at oneo'clock? What I got in my car
and I drove down to see mygirlfriend in Milford in an hour drive that
took two hours. But was Iafraid of the snow? No, I
was not. I was happy tohave the time off. So see,
it sounds like we both experienced weatherlike, yeah, we're both having it's
raining frost, so scary. Ialso had something fun to happen that is

(01:49):
going to kind of connect to someof the stuff we're going to talk about
today, is that. And Imay be misrepresenting my poor friends. So
if you are listening to this,I apologize. But I'm not saying this
as a judgment. I am notsaying this as a criticism either, in
case those are different things. I'msaying it just because I thought it was
interesting and I could be wrong,And it's only because doctor j is so

(02:13):
passionate about the subject to give fullcontext to it. Is this. My
story with the flu vaccine has beenthat my pediatrician was there with her medical
assistant and they were talking about thevaccinations my son was going to get,
and they said, well, doyou want to give him a flu shot?
And I said no, I thinkhe's fine, and then the doctor
goes, nah, you're gonna givehim a flu shot. It's like okay,

(02:38):
Like I didn't I didn't push back. I don't have a necessarily a
strong stance on it. But allof this was turned around when we were
there. And we've told this storybefore, but Heath his and I were
there in Connecticut, and we wereheaded from Connecticut to Alabama, where they
had a humongous flu outbreak, andneither one of us had a flu shot.
So doctor j right there at theHartford Moneybone in the in the showroom,

(03:00):
gave us each a flu shot beforewe left for Alabama, right there
and then exactly and uh and sincethen, you have been dropping mad amounts
of knowledge on me, son aboutthe vaccinations. I've done research when there
was a measles outbreak, I didresearch at Disneyland. I did research about

(03:21):
that and did it on the radio, and I have I've come full circle.
So I don't know that my friendshave gotten the flu shot, and
if they have, I apologize formisrepresenting you. But I got the unfortunate
call that I think happens to alot of parents where not the children.
The children had been sick but wererecovered. But the children were fine and
in bed. But my my buddy'swife was just she was no good,

(03:44):
no buino man. She she couldn'tkeep fluids down, and so he had
to get her to urgent care andhe needed somebody to tap her out.
Tap both of the mountains. Staythere with the kids because the kids were
already asleep, And unfortunately, mywife was at an event which we were
supposed to podcast as that night,and my wife was at an event,
so I couldn't go there, sobut I called him. I go,
I call my wife and said,let me see if she's going to be

(04:05):
there. So long story short,fifteen minutes later I was at his house.
I got there about nine twenty ishand then left about one o'clock in
the morning because they got they gotdeferred or whatever, re rerouted to the
er when they were headed to urgentcare, and it all comes back there.
They're kind of diagnosis of it was, and I'm curious to get your

(04:26):
take on this was that the doctorgave her too intense and antibiotic because he
thought that the issue was sinus related, but and it was, but then
it became stomach related. And thereason I bring this up is because it's
come up before on the show,is that the difference between like a stomach
bug and and a flu. Aflu is actually more respiratory than it is

(04:46):
gastro intestinal yes, yes, andmore lung lower respiratory track than nasal congestion
and upper respiratory track, so itjust fills your your lungs with fluid.
And that's why second dairy pneumonia's somewhatcommon with the flu if you don't recover
quickly. So yeah, and thereare no stomach flus. Influenza doesn't cause

(05:09):
vomiting and diarrhea. I mean,you could cough your brains out and it
can make you vomit, but it'snot a stomach bug per se. So
when people say I caught a flubug, we usually try to, you
know, correct them and tell themit's a it's a stomach bug or a
GI bug or a testinal virus,and try not to link it with the
flu because it's two completely different things. And I think that it's important to

(05:32):
say this before I go into it, is that you know everybody should you
know, air on the side ofcaution. I think that's what we would
always say. But for me,my experience has been I got food poisoning
in Kansas City when I was bymyself and I just couldn't keep anything down
and I was in a hotel roomby myself, away from home where nobody
would probably check on me. Wehad days off, so nobody would check

(05:53):
on me for multiple days. SoI just thought if I got too dehydrated
and passed out, nobody would comein there because you know, to check
out. Well, maybe that's agood point. I could have just removed
the do not disturb sign, butI was kind of delirious from all of
the diarrheeing and the vomiting. Butso I decided to just take a taxi
to the hospital to go get somefluids put in me. And what I

(06:15):
learned there when I was talking tothe nurses and the doctors was that when
you have some kind of a stomachblue flu or bug, I guess is
a better way of putting a stomach. I apologize, I miss I misspoke,
But the best thing for you isactually just to stop eating and drinking
and let your system kind of stabilizeand that you can go clear everything out.
Yeah, you could go two tothree days without any kind of fluids

(06:39):
at all, right, Yeah,I mean adults probably could, but kids
are a little different. So kidsmaybe a day or two. Yeah.
I used the barometer of they've gotto pee at least three times in twenty
four hours, So the kids gotto tell the parents the first three times
they go to pee and then theydon't have to count anymore. Once they
get three voids in twenty four hours, they're hydrated and enough, even though

(07:00):
they may not be as hydrated asusual. Oh that's interesting. And then
if I'm an adult, I mean, I know, we all use the
color of the urine, right,but if I in theory, if I'm
pan and then I'm hydrated, rightlike if pretty much? Yeah? Pretty
much? Yeah. And the otherthing too is, you know, most
of the stomach bugs we have circulatingare you know, ones that caused vomiting
for like a eat to twelve hours, and then once the vomiting is done,

(07:24):
you have diarrhea for a couple ofdays. And that's just the body
purging. You know, it getseverything out from above and then it washes
everything out from below. So,you know, trying to force fluids or
foods in that eat to twelve hoursof vomiting, it's an uphill battle.
Once the eight hour puking thing isgone and you're getting the diarrhea, then

(07:44):
you're able to hold things down andyou start with your clear liquids and things
like that. There's also the medicationZophran, which is anti nausea, anti
vomiting medication that you can get prescribedas a lingual pill and it eases the
vomiting. It doesn't have too manysignificant side effects, So there's a lot

(08:05):
of that being used, and thatkeeps a lot of people from going to
the er for fluids. But onecould argue that if you are like I
was, at the point where ifI even took a sip, like I
was trying to just swish water aroundin my mouth because my mouth felt so
dry, swish water around in mymouth and then spit it out. But
that even when I did that,within about five to ten minutes, I'd

(08:28):
be even dry heaving. And sowhat we learned, what I've kind of
gathered I want to run up byyou, is that if that's the case,
you're better off just waiting it outright. I tell parents to wait
at least two hours after the lastvomit before you even try a sip of
anything. So you've got to havenothing going on for two hours and then
you try to take something. Otherwise, like I said, you're it's an

(08:50):
uphill battle. Your body is goingto reject whatever you're putting in it.
And what are the chances that anantibiotic can help with a sinus infection,
help with a sinus affection, great, But there are some strong antibiotics that
can also have, you know,the side effect of stomach upset. For
instance, you know augmented I'd sayseven out of ten people who take it
get diarrhea from it. And thenyou have others that usually you don't use

(09:15):
for you know, sinus infections,but something like a rhythromycin or doxycycling that
they used to treat acne. Imean that has a direct effect on the
upper stomach and could cause heartburn andvomiting and GI upset. And is it
like what? I'm just curious,And again I feel bad because I don't
know that my friend listens, butI don't want it to sound I just

(09:37):
like to use these opportunities to kindof spread some knowledge when you're sitting here
talking to a doctor. Is thatrealistically? Like, if if I'm taking
an antibiotic and it's making my stomachupset and I've got a sinus infection,
am I going to be okay bynot taking that antibiotic. If it's making
my stomach upset, you should finishthe antibiotic and tough it out, or
call your doctor and let them knowthat you're having that side effect to see

(10:00):
if he would maybe switched to somethingelse. But one thing you can always
do with the stomach upset is totake some probiotics like culture L or one
of those things while you're on astronger antibiotic to you know, the reason
that you get the stomach upset andthe diarrhea is the antibiotic is killing the
good bacteria in your intestines as well, so the balance gets destroyed. But

(10:22):
if you're taking probiotics or you know, you can do a yogurt every day
with live cultures. I tell thekids a yogurt a day keeps the loose
poops away, and it's true,So you know, I think that those
things are different things. But Iwould never anytime you're prescribed to antibiotic,
just take it for the full course. And if not, if you can't

(10:43):
take it for the full course forwhatever reason, talk to the doctor and
find out if if he were shewants to switch to something else to complete
it. Because people who get tendays of antibiotics can take it for four
days, it increases resistant antibiotic andthen they've got six days worth of antibiotics
left over for the next time theyget a cold, when they may or

(11:05):
may not need the antibiotics, andthat worsens the resistance of the bacteria.
So you know, take medicine asyour doctor prescribes it. Interesting. Interesting,
And if you're not gonna, youreally ought to let the doctor make
the decision as to whether to stopit or whether to switch to something else,
depending on what side effects you're having. To save grace for my friend

(11:28):
if if in fact she has asinus infection, chances of her having a
flu virus are slipton on because that'sin the lower lung, you said,
and so usually, but you canget the flu, which causes fever,
body aches and pains, nasal congestion, chest coggestion, and then as a
result of that flu virus, youcan get a secondary sinus infection, certainly,

(11:50):
and you can get pneumonia as aconsequence. You can have the flu
first and have those things creep upon you if things aren't turning around quickly.
And do you want to talk sincewe're talk about flu, do you
want to give your Connecticut flu updatenow or do you want to wait till
the end when we go through theYeah, I would just give it to
you. Now. The total debtsand Connecticut of the flu are now twenty

(12:11):
two so far. Of the twentytwo fourteen, we're over sixty five seven,
we're between fifty and sixty four,and one person was between twenty five
and twenty nine. In terms ofwhether people were vaccinated or not. Let
me see here, eleven hundred fortyseven hospitalized patients who tested positive for the

(12:33):
flu. And let's see this timelast year where worthy I saw that earlier
today at this point there were onlysixty three debts last year, and this
year the flu is responsible for twentytwo so far this season in Connecticut.
Wow, yeah, so sixty itlooks like it was worse last year,

(12:56):
but so far from this from Augustto now, eleven forty seven people hospitalized
and everywhere the whole state. Soam I crazy that? I mean,
Connecticut is a small state, andI just feel like that's a lot.
And I mean I know that,you know, there are people all over
the world listening to this humble breck, but but I mean, if you

(13:18):
could, you could, I thinkit's fair to say that you could extrapolate
those numbers to a larger scale torepresent America and the world, right,
And so is that a lot?Am I? Or is that is that
okay? Is I mean obviously oneis too many a lot? Yeah?
Right, let me let me goto California. Let's see. Uh I
got it up on my uh mywebsite. Here in California arguably has more

(13:41):
population than Connecticut. So I thinkwe should brace ourselves for larger numbers in
that area alone. Yeah, I'mtrying to find I'm trying to find the
the state by state thing here thatI would imagine too that there's also that
these flu outbreaks and any kind ofoutbreak is going to be more at risk

(14:01):
in more like the more dense thepopulation, right, Like absolutely, if
you're if you're in a big metropolitanarea, then chance your chances of catching
something are much greater than if youlive in the woods and off the grid.
Absolutely, because it's all exposure,living people on top of people.
Yeah. Oh, here it isactivity state activity monitor. How effective while

(14:26):
you're still pulling that up, howeffective is it for me to wipe down
like door handles and stuff with thelysol wipes and all that stuff. Very
Oh yes, the better hand washingand the better hand washing you do,
the better disinfecting you do, theless spread you're than a half. So

(14:48):
during flu we've talked about that before, but during flu season, it would
be wise to try to adopt atleast handwashing routine of two to three times
a day. Yes, yes,yeah, and any time before you eat
anything, you know, I thinkI think that if you're going to be
putting food into your mouth. Sorryabout that phone ringing, but if you're
gonna be putting food in your mouth, you're gonna be putting things on your

(15:09):
hands onto the food that goes intoyour mouth. So, uh, you
know, wash your hands before youeat anything, before you put your contacts
in all that kind of stuff.Oh, well, while we're while we're
talking about the flu vacs. Ohyou've got California stats. That's what you
were doing. Yeah, I lostit again. Oh here I'm trying it

(15:31):
again. I clicked the wrong butoh, here we go by state California
deaths. So far, since Septemberthirtieth, California, there has been one
hundred and eighty one deaths due tothe flu. Wow, you guys had
twenty two, right, twenty two? Yeah, and that's in September,
So you guys are in a redzone, which which means that it's highly

(15:52):
it's it's very much out out there, it's in season. I would also
be curious, and we'll use thisto kind of get it to the other
topics, but I'd be curiou usedto see how much of that, like
politics, you know, comes intoplay. I would imagine that Connecticut is
also a pretty liberal state. ButI just feel like, you know,
we joke about gluten and everything herein California, and I wonder if there's

(16:12):
just a greater likelihood of people whoare anti vaccination and then that's why our
numbers are a little bit higher,or if it is directly correlated to just
more people period. I mean,does do they say red zone because of
just the sheer number or is thatbased on a percentage? Oh really?
Okay, so yeah, so standsthe reason. I mean, again,

(16:33):
this is all anecdotal, but thatone could extrapolate that the likelihood of that
increase could be connected to that there'sjust a more tendency to not vaccinate yourselves
or your kids in California because youthink it's the devil? Do they and
is it optional for elementary school forflu. In California, they still so

(16:53):
what they There was a legislation thatwas being pushed and I can't remember if
it passed because we we did bringit up on the show, but it
was a couple of years ago wherethe governor was trying to get rid of
you being able to choose not tovaccinate your kid if you were going to
put them in a public school.And I think the only exception to that
was religious purposes. I think okaywas the only exemption, but that everybody

(17:15):
else is like, Nope, yougotta get your kids vaccinated. You don't
have a choice anymore. Because inConnecticut they require it for any any year
of preschool, So anybody that's inpreschool, even if it's an after school
program for older kids, they gotto have it, and they require it
for kindergarten entry. But then afterthat it's not a requirement. But what
I see is with most of myparents, I mean, get their first

(17:37):
one in six months. It justbecomes routine to come in every fall through
the flu vaccine, whether they're youknow, six, seven, eight nine.
We tend to hold on to thepeople that have gotten it all along,
whereas people who are new and maybehave never gotten it in there six
or seven and don't have to getit. They may out not to,
but it's you know, it listened. It's not perfect. If we're lucky,

(18:00):
it's better than fifty percent protection againstthe flu. But every kid I've
seen, I've seen four or fivepatients of mine that have tested positive for
the flu, and all of themhad been vaccinated. So there's always going
to be breakthrough. But then youwonder if they're the reason they had the
flu and didn't end up in thehospital really sick is because they got the
vaccine. You know, didn't protectthem one hundred percent, but it gave

(18:23):
them some protection so they didn't getreally sick from it. Right. Well,
And it's funny because you sent thisgreat article, which I always like
it when doctor j gets almost PeopleMagazine on us. But I do think,
at least on the internet, shemay be the new Jenny McCarthy of
our era of vaccinations. And I'mtalking about Kaylin Lowry who was on a
Teen Mom too, and she talkedabout she has a podcast called Coffee Convos

(18:49):
and she was on there with herco host and was talking about how she
doesn't vaccinate her kids, and therewas an uproar. There should be.
Yeah, she got a lot ofback. There's some quotes in her from
her she said, I definitely thinkthis is a controversial topic, and I
don't want to lose listeners because ofmy opinions. But I did vaccinate Isaac
because to me, I didn't lovedit. Yeah, she said, I

(19:15):
didn't know any better and let themvaccinate him with whatever they basically said that
he needed. Now she's talking abouther oldest son, the son she had
when she was a teen and pregnant. Right, is that the kinky haired
one or the straight haired? That'sthe straight haired one. I believe.
I feel like I was ignorant anddidn't do research. This is very fascinating,
the word choice that she has anddidn't know any better, Lowry said

(19:37):
in a conversation with her co hostLindsey Chrisley with Lincoln, which is her
second son, I knew a littlebit more and I started to research more,
and that's when I think the conversationabout vaccination started to really go on
with me and my friends who becamemoms, And there were documentaries on Netflix
and all kinds of news that Iwould try to look into, try to

(20:00):
look in right, exactly. Yeah, I tried to look into medicine when
I went to medical school four years. I just gave it a gave it
a gave it a shot. Trydocumentaries on Netflix and news that I would
try to look into. Where thearticle does it say she had a conversation
with her pediatrician, right? Orwas she studying published medical journals? Right?

(20:22):
Lincoln did not get all of hisvaccines. In fact, you know,
real quick, before I go backto her quote, I just want
to point out I don't think thatI've ever seen any news that is reporting
on research saying that vaccinations are nobueno. The news is always reporting on
people's opinion of being anti vaccination,right, That's all that they ever report

(20:44):
on. They never have I've neverseen a news story that says, hey,
there's a published journal that says vaccinesare are bad. They bury that
in the back of the paper.Lincoln did not get all of his vaccines.
I definitely picked and chose which onesI felt like were necessary, and
he did not get them all atonce. He did one or two vaccines
at a time, and again thosewere the ones I felt that he needed

(21:07):
lu. Yeah, Lux is eighteenmonths and he is not vaccinated. He
hasn't really ever been sick. Andfor me, I think the more research
that I do and the more educatedI've become, such a great choice of
words, I'm thinking, just don'tvaccinate him. Well, all I can
say is good luck Isaac, Lincolnand Lux, because you are fucked with

(21:30):
this geed educated mother. Well,it's it's it's so interesting to me.
How does she have time to dothis thorough research with three boys running around
the house. Yeah, all alsoyoung too, and I just, uh,
I don't know. It's there's there'shonestly there's. So did she need

(21:52):
a picture on the article University ofMotherhood? Yes, all right. It's
the easiest job to ever get,being a mother. And you can even
be drunk for the interview. That'swhat I'm saying. He is having a
party for you when you're sixteen andpregnant. But if you graduate from high
school, maybe I get some envelopeswith cash. She went on to say,

(22:12):
you're a parent and you know what'sbest for your child. And I'm
not here to judge. I'm nothere to start a parenting argument about it.
But it is going to light theflame and walk away. And that's
the thing I just don't understand whylike this is to me personally. It
gets really great where people like Iread an article recently and I was talking

(22:33):
about this on the weekly segment Ido on Garry and Shannon where they were
talking about how helicopter parenting is actuallybetter for kids, and I was like,
wha. And what they're saying isthat parents They tried to spind the
terms, and they said that parentswere who were involved in their kids' lives,
were their kids were more likely tobe self confident and happy and successful

(22:56):
in relationships and in their careers.But then and I was like that,
but that's none of the research thatI've seen using helicopter parenting as an example,
And I was like, where dothey do? And I kept reading
and what I found out was thatthey were they were correlating. The study
that they were quoting was actually aboutauthoritative parenting, which in my opinion,
is very different from helicopter parenting.Helicopter parenting, just so we're all clear,

(23:22):
is that this idea of I'm alwayshere, I'm always there to help,
I'm always involved, I'm always investedright at drone parenting though, you
know what I mean, because they'resmall. It's it's it's sometimes you don't
you know, the kids don't evenrealize they're being monitored. You know.
It's helicopters, big, noisy,lots of propellers. They're like drones that
in every single aspect of the kidslives, they're involved, right, and

(23:47):
authoritative parenting is more about it's theconnection is there, and I agree that
they are very involved and very invested, but the connection is about a direction
or a purpose, and it's notalways about protection. It's about protection when
it is needed. It is aboutestablishing a boundary for the kid a certain
level of freedom, but also alwayshaving a clear expectation of rules and boundaries

(24:10):
like that to me, and that'swhat they're saying. They're trying to glom
onto helicopter parenting. But helicopter parentingis a maybe a diet version of what
is the new term of lawnmower parentingright where it's that you're also a hyper
involved, but you're also about clearinga path and mowing down adversity for your
kids. So the reason I gointo all of this is that I think

(24:32):
it's interesting to me that when yousay you get to say something like you
know what's best for your kid.I do agree with that, right.
I do agree that that there isthere is that statement on its own is
fine, But when you put itin the context of vaccinations, I don't
think that you are actually qualified toknow what's best for your kid. Now,

(24:53):
what you should be doing is youshould be not looking at Netflix documentaries,
not trying to look news. Youshould be actually talking to a pediatrician.
And if you feel that, yougo to the CDC website CDC dot
gov backslash NIP National Immunization Program.You can read every verified, peer reviewed

(25:15):
medical article that's been written about vaccines. That's where you go if you want
information on vaccines. Yeah, butdoctor J that's big brother. That's you
can't trust big brother, that's biggovernment. They're not here. And this
is where I always fought. Thisis where I get kind of political,
where it's like, you know,I do believe to a certain extent that
the government does want you at leastto live because they need people to pay
taxes. But I don't know,then you dis government, Yeah, come

(25:38):
on, really, all of usthey want to live? Maybe you're right,
maybe you're right, maybe you're rightor probably right. Oh listen,
I'm gonna go try and find somenews about this subject and see what I
can find out. But I loveI want to dip down here to some
of the Yeah, right, I'msure there's one or two, especially about
Trump. I feel like it's funny. I feel like he was in office
two weeks and you know how,like Mama, he had like two or

(26:00):
three documentaries, but it was likewell into a second term where they were
going back. Trump was in theretwo weeks and they're already talking about it's
a fan. The day he wasinaugurated, it was great. Uh.
Here's some other comments that she wasinterviewed and in Touch Weekly, and she
said, the only thing I couldreally say and continue to stand for is
the parent how it's best for yourchild and family. People don't love everything

(26:22):
I do, but I don't loveshove my beliefs down anyone's throats. I
know what's best for my kids,and other parents know what's best for theirs.
Which again, but I want tofind because there were comments on the
thing, Oh somebody said on apodcast post and reaction to her episode.
They said, I think it's irresponsiblefor you to have a podcast where you
share your uneducated views against vaccinations.You have a following of young women who

(26:45):
admire you, and you're just beingignorant, And I would I would argue,
as a guy who spouts off onhis podcast in an uneducated way,
I would argue that the bigger issueis that who are these young women that
are looking up to her like That'sI would be more concerned about. I'd
be lying to you justin if Ididn't tell you that my twenty five year

(27:06):
old has teen mom on our DVRrecord list. So so occasionally I've walked
into the room and it's been onmy television. It's so it's fucking up
my cue. I'm telling you it'san unfair kind of joke. I do
believe because it's Here's the thing.The reality of it is is that when
I at least watched that show wayback in the day, and I don't

(27:27):
think I saw I saw the sequel, but there was it wasn't about it
wasn't about a bootstrap story. Inmy opinion, what I was seeing was
a portrayal of you know what,very easily could be perceived as white trash
girl who gets pregnant and uh,and now she has to deal with the
stress of high school and having ababy and parents helping out. She has

(27:49):
no time to read about measles.Okay, that's what I'm saying. How
educated kids she be. And Ithink it's idiot you're doing the year two
thousand, the year two thousand.How many cases of measles happened in this
country year two thousand, nineteen yearsago, how many cases of measles?
I don't know. I'm sorry.Zero Measles was eradicated from this country in

(28:12):
the year two thousand. They declaredit eradicated. Okay, Now because of
anti vaxers and the lack of herimmunity, we're having measles outbreaks all over
the time, all over the place, the Northwest. Now we had Disney
World a couple of years ago inCalifornia. I mean, it's incredible how

(28:33):
dumb some people are. And that'swhat it is. If this woman wanted
to research vaccines, all she reallyhad to do was have a discussion with
the person who's involved in her lifethat knows the most about vaccines, and
that's her kids doctor. Okay,doctors will take the time to explain to
you why it's best that they getvaccinated. I have posters all over the

(28:56):
walls with horrible pictures of children toscare the kids. They'll ask what that
is. I said, well,that's what you're going to get if you
don't get the shot. See thatbig thing growing off the side of his
head, Well that's you. Ifyou don't get the vaccine, that's great.
Oh I wish I could fly mykids across the country and have them
get an examination by doctor Jay.I think they'd get a kick out of
it. One last quotelet's kid upsetby it, and I say, good,

(29:18):
good, Well that's my point togo back to what I was saying
about team Mom, and if theirparents say no, I point out the
ones that they're not getting. Yea, So this is possible. This is
possible, This is possible. Okay. And that's the other thing is that,
going back to what she said aboutshe picked at Choose, I wish
that she would have kind of goneinto specifics because I think you've already said
on this show that you're you're finewith an immunization schedule, right, Like,

(29:41):
if you kind of space them out, that really doesn't matter. I
work with people that way, aslong as their kids are up to date
when they enter you know, daycare, preschool, kindergarten. So if you've
got a kid who's going to goto daycare at six months, you know
you don't really have time to spreadthem out that But yeah, I mean
I'll go along with it. Butyou know the people that say I'm not

(30:04):
going to immunize them at all,well, hopefully they did their due diligence
before the baby was born and cameout and had a visit with me,
because I make it pretty clear thatthat's my policy. This other listener said,
so, I'd love to know whatyour reasons are for not vaccinating.
There are none, and considering you'rethe only college educated one on the show,
I would hope you would have moresense in your head, which you

(30:27):
are. Then I guess I haveto retract my geed educated woman. I
take that back. I think.I mean I didn't get a college degree,
but I think I could also claimto be college educated. I mean
I have an associate's degree. Beingsmart enough to listen to your doctor who
went to school and listen twenty fiveand a half years. God if they

(30:51):
if there's some kind of magical conspiracygroup forcing us to vaccinate kids. I'm
not aware of it because I've vaccinatedmy own kids, and my job is
to protect the health and well beingof all the kids I take care of.
So everything I've read in every classI've ever taken, and every continuing
medical education chorus I've ever gone to, every grand rounds I've ever gone to,

(31:14):
I am basing my recommendation on allof that information that it has been
accumulated over twenty five and a halfyears. I don't know what else to
say anymore. And I tell parents, if you're not going to trust me
about my recommendations about vaccines, Ican't expect you to trust me about anything.
Yeah, and you already brought itup. But this outbreak that they
had in the northwest of America,it quotes what you just said. It

(31:40):
says there have been at least twentytwo confirmed cases of measles in Clark County,
Washington, and three more suspected casessince January one. One adult has
been infected with highly contagious airborne disease, and most of the twenty one children
are aged ten or younger. Onehas been hospitalized nineteen of these people infected,

(32:00):
we're not immunized against the disease,so three at twenty two three of
them. Three of them were vaccinatedbut still got it, probably due to
some kind of either issue with them. I'm guessing a herd immunity, right,
And then it goes on to quotethat that this disease was eliminated from

(32:21):
the US in the year two thousand. Clark zero point zero YEP. Clark
County, which borders Portland, Oregon, has the lowest vaccination rate in Washington,
with seventy seven point four percent ofpublic school students having completed their vaccination.
The Oregonian reports the outbreak. Thisis where I think this is wildly

(32:42):
interesting to me. The outbreak hashit religious and private schools in Clark County,
especially hard schools in a church havebeen identified as possible infection spots,
and affected people also visited Portland InternationalAirport, stores and restaurants, and a
January eleven Portland Trail Lasers game atPortland's Moda Center. Uh No Orgonians have

(33:04):
yet been diagnosed with measles, Soit's it's interesting to me that you would
assume that the because you know,you when you do watch a Netflix documentary
about healthcare, usually they talk abouthow the poor people are the ones who
are the most affected. And againI'm not I'm not saying I'm not trying
to push this in either direction.I'm just saying it's interesting that the biggest

(33:27):
the schools that were hit are privateschools and religious schools, which one you
know, you know why poor peopleare vaccinated. It's because in order for
them to get whipped, you know, of assistance for their their kids for
food, uh and formula and such, they have to be up to date
on their immunizations. And when theycome in with their forums, you know,

(33:50):
I have to fill them out,I have to sign it in a
test that they're up to date ontheir immunizations. So if they want to
be able to get essessionally government assistantsfor food or formula for the baby,
um, they've got to be compliantwith with that recommendation. And I would
say, uh, probably close toone hundred percent of my lower income state

(34:10):
assistant patients are are are vaccinated.It's it's it's you know, the vaccines
are available. It's not like it'sa there's a shortage of of of any
of them, you know, andyou know, again, it may be
just because it's a requirement for theWIG program. But on the other hand,
they're not the ones that come inand question vaccines. It's you know,

(34:32):
pseudo educated people who have a lotof time on their hands. Yeah,
it's They go on to say thatthere's been a wise of children not
being vaccinated, raising concerns among publichealth officials. Before the vaccine became wildly
used widely used in the early nineteensixties, about four hundred to five hundred
people died every year and tens ofthousands more were hospitalized. You know.

(34:57):
One of the side effects of themeasles zorchiditis, you could lose your testie
balls. You get that news outthere. At least fifty percent of the
population's going to consent to have theirvoice vaccinated. In twenty eighteen, the
Center for Disease Control and Prevention saysthree hundred and forty nine people in twenty
six states were confirmed infected with measles. So that's all, that's three hundred

(35:22):
and forty nine infected. We wentfrom four hundred to five hundred deaths a
year in nineteen sixty to forty yearslater, forty years. Think about that
in my lifetime forty years we gotrid of it. That's a success.
No cases of measles. And thenthere's bullshit with anti vaxers who basically got
their start with the doctor Wakefield's article, which has been disputed hundreds of times.

(35:45):
A man lost his medical license,but that stays as one of the
number one things to come up whenyou search things, and people are against
it because they think they know better, and this should be proof positive that
we know better. Okay, researchhas been done. We got rid of
a virus, like like we gotrid of the smallpox. Was anybody saying

(36:07):
no to having their kids vaccinated againstsmallpox when it was still a chance.
We've had a whole life here whereI haven't even had to consider the diagnosis
of smallpox, or what about I'venever seen a case of measles? What
about polio? Polio we pretty mucheradicated to. The only cases that occur
now are in other countries. Wedon't have any polio. Yeah, yeah,

(36:30):
I mean there has been a lotof success and people live a lot
longer. You know, people whootherwise would not have made it out of
childhood with these infectious diseases you know, are allowed to live and grow up
and then refuse vaccination vaccinations for theirkids. It's crazy. I'd be curious
to hear what you the listener thinkof if you are anti vaccination, I'd

(36:52):
be curious just to get your thoughts, just to I don't know. I
honestly don't feel that passionately about iteither way, to be honest, I
mean, most of the reason whyI do it is because a it's required
by my like my doctor recommends it, which is exactly what doctor J is
screaming about. And again just myexperience from talking to doctor J. And

(37:14):
I've seen kids with hibmeningitis, newmccaqulmaningitis, me ninchacackelemaningitis, all of these
things. When I was a residentfrom ninety to ninety three, we didn't
vaccinate against it. I saw thoseillnesses. I saw kids lose arms and
legs because of Ninja coxemia. SoI know what the possibilities are with this.
So it's coming from not only asource of knowledge based on the studies

(37:37):
and everything, but the experience ofhaving seen children suffer because of these diseases
that we now can protect them against. So that's I mean, if you're
listening to this and you're like,you know, geez, doctor J take
a chill pill. I think it'sthat. I think, right, we
all we all have certain amounts ofperspective, and you know, we make
fun of that Kayla Chick or Kyliewhatever her name is, Kaylin sorry,

(37:57):
Kaylin Lowry. But I think thatyou know, yeah, you get it
right her from her she's she's bringingher perspective to the table. But her
perspective, ironically enough, has noperspective, right, she has not she
she is only like she has treatedthe Internet like a roar shack. She
seems to have found what she looked, what she was looking for, and

(38:20):
didn't really bother to do a lotof poking around to uh to find things
that would refute what she believes.Which I think that's maybe that's the best
way to say it is that sure, everybody knows what is best for their
kids, but I think it's importantthat you look at both sides of the
argument equally and try to maintain alevel of objective opinions and and and and
why not lean on a on adoctor and and then if you don't like

(38:44):
that doctor, get two or threeopinions. But you know, I just
I don't know. You gotta yougotta talk to experts about anything, and
and I this is gonna be ahorrible comparison. But since I speirst,
are you gonna say, well,my plumbing exactly? You know it's ironic.
Well, it's funny that you.I've told that joke multiple times since
you and I started doing these episodestogether. Is that. One of my

(39:06):
favorite moments on Love Line was whenAdam Crowla talked about he goes I was
put on academic probation at a juniorcollege. I barely graduated high school,
and I was swinging a hammer.And if I went into a guy's house
who made a quarter of a milliondollars a year and told him that he
needed to hang a door a certainway, whether it was right or wrong,
he would go okay, absolutely,But when doctor Drew tells him that

(39:28):
he needs to cut back on hiscarbs and exercise twenty minutes a day,
and I goes out, what doyou know? Like? He just goes
in one, hear out the other. And it's always been a fascinating comparison
to me. It is it is, you know, I don't. I
don't understand it. And you knowit's it's it's it's my my career,
this is my this is my chosenpath, you know. And I want

(39:50):
to give parents information so that notso much to argue with them. And
you'd be interested to know that it'snot confrontational when I talked about them.
The thing is, it's time yougot to sit there and educate them and
give them resources. I mean,I tell parents all the time, I'm
not going to twist your arm overthis. Here's what I want you to

(40:10):
do. I want you to goto this website. I want you to
read this article. I want youto think about it, and that's a
good representation of my side. Okay, And then if after you read that
you still feel the same way,I'll feel better that you're making a good
decision for yourself. But you dohave to look at the evidence. And

(40:30):
people are looking at the evidence.They're looking at Facebook and Netflix and you
know, googling something, and it'sjust you know, you don't have to
do the legwork. We're doing itfor you. Basically, nobody's looking to
dup anybody. Yeah, I thinkmaybe we need to start a movement where
we need a hashtag. That's howwe fight back with Facebook and stuff.

(40:53):
Is that So if you are ata school pickup and somebody talks about how
they didn't get their kids a fluvaccine, just tell them fuck you and
then at see how that goes,and then on social media just put hashtag
fuck you on everything. Maybe maybethe hashtag unvaccinated. Let's go into labeling

(41:15):
these kids, because you know,they're little germ factories of resistance stuff,
so you know they should be abutt again there. You know, if
the measles trend is any indication,they should all get wiped out in the
next ten fifteen years. Anyhow,you also gave a great list of things
and it's called seventeen Thoughts on PediatricPractices. And this is interesting because we've

(41:37):
done these kinds of lists before whereit's like things your pediatric siou believes or
says or suggest you know, thatkind of stuff, and they seem to
be kind of general. This one, I think is a mixture of both.
There's some really in depth stuff here, like like number one, heat
can affect newborn metabolic screening tests,especially galactosemia. Did I say that right?
Yes, you did. Nice work, which would go along with my

(41:59):
impression that fall positive tests are morecommon in the summer. So what is
that talking about it even at all? Yeah, we do. They do
the newborn screen, that's the littlefour blots of blood that they do in
the nursery and then those get saidin the mail to the skate screening labs.
And what they're saying here is thathe can affect the result of the
galact to seem a screen. Andhe's saying, I mean, I never

(42:22):
noticed this trend that there's a lotmore false positives in the in the summer,
But I guess that makes sense ifthat's the case. He's saying that
if your kid was born on Julytwentieth and uh and then has some kind
of marker that comes back with galactosemia, that you know, chances are you
could wait a few months when theweather cools off and try it again.
Well, we always repeated any anyeven if it's a false positive. We

(42:45):
don't know it's a false positive untilit's repeat it. So so there's secondary
lab work to do if if achild screens positive, and you know we
have a number of kids who screenpositive for you know, there's fifty two
things to get screened against. Nowwhen you do the follow up test,
it's normal. So this next oneis would head to head really be the

(43:07):
correct description of study? Comparing diapercreams is really what I understand? What
is it? Like? Yeah?Right, Like I don't. But is
that a thing where people like dotwo different diaper creams and like try to
see which one's more effective or somethingI've never heard of yet? Oh?
We it's it's interesting, and Ihope I'm not misrepresenting or maybe I'm maybe

(43:30):
I'm just a pushover. But it'sfunny that all we did was we our
doctor said, uh, he's gota little bit of a rash. Get
this stuff. This butt paste stuffis the best stuff. She goes.
If he gets really really red,you get hit him with the decettin.
But more often than no, hedoesn't need it. He just needs some
of this butt paste and it's justto keep it from getting more irritated.
Oh okay, and we just boughtwhatever she told us. She show us

(43:51):
to get aquafor. We got aquafor. That's what we did. It
works great, Yeah, but asfancy basilines, right exactly, that's what
she said. She it's vasoline.She goes, if you get the stuff
that's medicated, it's got a littlebit zinc which will help with the rash
a little bit. But she said, really what In the beginning, it's
about non irritating. But if itseems to get really red or inflamed,
then you can put this butt pasteon it and it'll medicate it and help

(44:13):
bring down the inflammation. Good stuffBoudrou's butt page. Yeah there is,
but of ointment or triple paste.Those are my three favorites. Parents often
do not distinguish between the flu andstomach flu. We already talked about this.
This is not just of academic interest. For example, parents often assume
that flu vaccines do not work becausetheir child later had an intestinal virus.

(44:35):
Please do not use the phrase stomachflu, and when you hear parents use
it, gently educate them about it. Use our hashtag fuck you. I
believe the first shot hurts the most, so from a pain point of view
alone point of view alone, itis better to get three shots in one
visit rather than spacing them out,which would mean three first shots instead of

(44:57):
one. So what they're saying isis that if like one day, my
son literally had to get five shots, and I think he was actually five
years old, and we just hithim with all of them at once,
and by the fifth one because Itold him, if they didn't make a
big deal out of this, thatwe could go to the store and they
could pick a toy. And bythe fifth one, no exaggeration, he
leaned into it like he pushed intothe knee. I'm not kidd I mean,

(45:20):
I know and I'm not lying aboutthis. Early in my practice,
when we gave those five shots atfive, this five year old girl got
a puppy out of the deal.So wow, man, this this inflation
and parental inflation is killing us.But yes, I would agree with that.
I don't know that that can bestatistically verified, but I do think
that kids hate the doctor a lotmore if they get three shots over three

(45:44):
weeks, then three shots at onevisit and then don't come back for two
months. Yeah, and I'm alwayscurious. I mean, this is an
example I think that you would agreewith, Doc is that this is an
example of where you know your kidthe best and you just do what you
think is best for your kid.Because my I was actually weirdly enough,
it came up when I was visitingmy therapist that I shouldn't tell my kids

(46:04):
that they were going to get shots, Like, he goes, you don't
tell them a couple of weeks out, because then they just are going to
spend all that time being anxious aboutit. And I was like, well,
yeah, but then that's how theyconfront their anxiety, Like that's how
they learned to process it. Andthen eventually it comes like I would much
rather learn teach them that life skillthan try to teach them that I'm going
to trick them into something. Andit's not to say I've never lied to

(46:25):
my kids. I do it allthe time. But the point is that's
my way of parenting. And sothey know, they know when they're getting
shots, and I would much ratherthey start to develop a mindset that it's
not a big deal than to tryto make it into an episode of some
kind. But anyway, it's funny. Well this is a more personal thing.
I'll go back to the list herein a second. But my oldest
son, he's only got two babyteeth left. Now he's got he lost

(46:49):
a moler eating a bean and cheeseburrito and he swallowed it. And yeah,
and my wife. It's funny.It's so funny, my wife,
for the toothpape right exactly goes,he goes. He was he was eating
his burrito. He just goes,where's my tooth? So he had lost
it in a donut one other time, and so but that one was recovered.

(47:12):
It just fell out of his mouthwhile I guess or he felt it
this time. It's just so funnyto me how he's literally eating a bean
and cheese burrito, which I guessthe point is that there's not a lot
of chewing involved because it's kind ofpre masticated food, but he was sucking
the beans out of it. Ithink when he slurped the beans, he
slurped his tooth out of the spotand just swallowed it. My wife is
very concerned doctor Jay that because it'ssharp, that it's just gonna cut up

(47:36):
his intestines and destroy him from theinside. We won't know that he's hemorrhaging
and his distended belly from all thefluid build up, and that he will
he will pass in his sleep.And I told her, I said,
this is not an issue. Thisis but that I do believe that the
reason why she's saying all This isbecause that was his only other tooth where
he'd had a cavity and had afilling, and she wanted to save it

(47:57):
for some crazy reason, because Ithink she thought it was cute. But
so I volunteered. I said,I will dig through the poop if that's
what you want. I've did itfor a rock I'll do it for this,
you know kind of a thing.And I did it for a popsicle
stip with the dog. Ah really, oh look at that seventy two hours.
Oh well, that's the other thingis that she thought it would come
out in two to three days.But what I learned from the Rocky eight

(48:19):
was that it literally was out inthe next poop. He said, if
it'll probably come out tonight, orif not tonight, then the next morning.
And sure enough, the next morninghe took a poop and I and
the doc said, he goes,Unfortunately, you got to find it because
it's so big. We want tomake sure it comes out. But I
don't got to worry about a tooth, right like he Chances are God,
no, no, we everybody swallowsa tooth. Yeah, that's what I
thought, all right, Back tothe list, if we were if I

(48:40):
were to try to compare unpleasant sensations, I would consider nausea much worse than
pain. That's interesting to me,It is interesting. I don't know how
I feel about that pain. Atleast you can take something for well.
Nausea you can take so for him. But but yeah, I mean,
I'm going to see a neurologist nextweek because I've had a couple of dizzy

(49:04):
spells where I've gotten so dizzy it'sit's made me get sick and vomit and
nausea not pleasant. I mean,I can work through a day if I'm
in pain. I can't walk workthrough a day if I'm dizzy and nauseous.
I think it's because I don't knowif this comparison works, but I
would imagine that what they're kind ofhinting at here is that the spectrum of

(49:25):
pain versus the spectrum of nausea isthe same as the number of words that
Eskimos have for snow versus what theSaxon, the Anglo Saxons do, right,
Like, it's they define so manydifferent tiers of snow because it's such
a big part of their life,right that there's a broader spectrum of description,
and I think that that's what itis. That you could have a

(49:47):
paper cut versus actually lopping off alimb. Those are two separate levels of
pain, and one could probably argue, depending on how severe the nerve damage
is to losing a limb, thata paper cut is more painful and annoying
because it's just the tiny, littleaggravated all the nerve endings are right there
right, Whereas if you lose ahand, chances are you're not really feeling

(50:07):
that. What you're feeling is theshock and craziness of the sensation of not
having your hand anymore, right exactly, Yeah, which makes me nauseous.
So full circle ill plane along thoselines. There have been, of course
many advances in outpatient pediatrics in myforty years. Of these, my favorite,
even more than vaccines and uh centrifactcent sef traas on. It's intramuscular

(50:31):
injectable antibiotic where you could just givethem a shot of it. The er
oh H is perhaps on Dennis Citron. Yeah, that's the brand name is
Zofran, which I mentioned the nausea, particularly for oral dissolving form. This
works so much better with fewer adverseeffects than the rectal phenothiazines we used to

(50:53):
use, So you'd have to takeas depository for anti, which is what
they gave me when I got foodpoisoning. By the way, it Kansas,
and I did not partake. Idid not have it in me,
So I just like, I'm justgonna not drink water for a few days
and I'll be fine. Just writeit out. It's like being on a
cruise physicians. Physicians do not alwaysunderstand how discount coupons work, for exament

(51:14):
to medical school, so listen ifyou have a coupon, to do whatever
the hell you want with it.For example, suppose you have to choose
between a generic epinephrin with a twentydollars copay that costs the insurance company five
hundred dollars, and one with acoupon with a manufacturer pays the fifty dollars
copay, but the insurer is chargedtwo thousand dollars. The parents save some

(51:34):
money with the coupon, but theinsurance company and ultimately all the subscribers pay
more. Remember this the next timeyou attempted to use a coupon for what
might otherwise not be your preferred medicine. So where do you come down on
the whole Is that really the Ithink that's the consumer side of medicine.
And I write out a prescription andwhat they do with it, with the

(51:54):
with the co insurance or they have. There's an app called good RX go
O O d r X UH andit's a free app. I'm you know,
the Apple and you can download itand what it does, it's actually
pretty pretty cool. It has ageolocator, so it knows what pharmacies are

(52:20):
in your area. You could lookup any medication, any dosage, so
many days and it'll give you acomparison prices of all the different pharmacies.
You know, the top ten pharmaciesin your local area, so that you
can you know, shop based onconsumer value. Uh. And they also
have coupons that will lower the pricethere too. Again, if generic EP

(52:45):
and Effort is going to work asgood as you know, the brand name
now is a VQ and one isfive hundred bucks and the other is two
thousand, I feel that that isnot really shouldn't be the decision of the
doctor, but of the parrot.Now they think they're getting fifty bucks off,

(53:06):
they're only paying fifty, but theypay a fifty code pay. I
don't know, they're gonna go withwhatever the lower code pay is, right,
you know, it doesn't matter what'shappening on the other end. And
all I'm doing is writing out aprescription for a medicine that the child needs.
And really, you know, Iknow I have to use generics,
and I'm always gonna you know,use the right antibiotic for depending. Some

(53:31):
are more expensive than others, butyou know, the cost does come into
it if there's a generic alternative.But at the same time, that's not
my part of the equation. Iget called back so many times, you
know, you know, people wantsomething for their kids acne and I write
for, you know, an acnemedication, and then they'll call back and

(53:51):
say, well, the medications threehundred dollars. And I said, all
I did was right out of prescription. You know, I didn't put the
I didn't make the price, Ididn't create the product. This is what
I saw, this is what Ithought the best medicine was for it.
And you know the fact that youhaven't met your deductible yet and it's three
hundred dollars out of pocket, Isaid, well, you know, then

(54:13):
use something over the counter if youif you know active medicines in particular,
the insurance companies don't give you toomuch of a breakout. So it sounds
like, if I can extrapolate,is that what you with your opinion?
No, you did not ramble atall, but I just want to make
sure that I understood it. Isthat your opinion the generic versus the brand

(54:34):
name medication in theory is there's nota difference there and its effectiveness. Yes,
yes, exactly, Okay, Butwhat they're saying is is that the
doctor does not know this, andit's not part of the doctor's equation to
do this math or even to beaware of it. But it would not
be a Just because you're buying thegeneric doesn't always mean that it's the better
deal. And what I think they'regetting at here is that it's always good

(54:57):
to be as an as educated consumeras possi because usually, as my mother
always said, nothing is free.So you think it's free, but in
actuality it could be affecting the overallcost of your insurance and everything, because
you know, insurance is insurance.They make a profit. It's not like
you're paying You think you're paying less, but in actuality, you're probably using

(55:17):
the the healthcare system less than say, somebody else, and you're just helping
to pay for them like they've gotall that worked out. So that's right.
And the other thing is know yourinsurance, I mean, know what's
covered. No, what's the rulesare? We have little hints. I
mean, when I write out aprescription for someone and I go to the
medication list, if the insurance companyis programmed into them, if they have

(55:44):
the insurance in put it, it'llgive me a green smiley face, where
the cost effective ones a yellow kindof straight face, and then a sad
red face if it's the highest cope. So I do consider that when I'm
writing out a prescription if I feltthat one with a brand name was better
than the other, I usually havethat discussion with the parents before they leave

(56:06):
the office, so nobody's surprised.But I do want to, just so
it does get lost here that theapp good RX is actually you know,
for consumer cost savings on the endof pharmaceuticals, which are sometimes tough to
negotiate. You know, it's niceand then it'll tell you what it costs
for the exact medicine the exact numberof pills and days at all your local

(56:30):
pharmacies. And you know there aresometimes significant, significant hundreds of dollars difference
between what you would pay at CBSas opposed to maybe a wall Greed or
a write aid or or you know, one of the discount stores like a
Sam's Club or something. I mean, it is worth shopping. If you're
paying for your medication out of pocket, does it does it go into what?
Also the insurance ends up paying forthat because because this is completely independent

(56:54):
outside the insurance. In fact,if you use the coupon to get your
medicine and you pay what ever,that lower fee is if you can pay
it, which your HSA, butit doesn't go to intradductible Interesting YEA for
many illnesses. I'm curious to seewhat you think of this very many illnesses.
Before I examine a child, afterthe history, I will tell the

(57:14):
parents I have whittled the diagnosis downto two choices, which I will then
narrow down to one before they leavethe office. I also indicate what the
treatment and expected course will be dependingon the outcome. For example, I
will tell parents that their child eitherhas strapped throat or they don't. Then
when the test is negative, theyalready have been informed that no antibiotic will
be needed. Yeah, I agreewith that. But by the time they

(57:37):
know whether the kid has scrapp ornot, I've already told the parents I'll
be back in if there is apositive testible right out in the antibiotic or
the nurse will be back to tellyou it's negative. And then i tell
them, you know, tail andall rests for los andes all that other
stuff, and I'm usually in thenext exam room when the scrap test comes
back. That's funny. Possible thrushwhich I don't know what this is,

(58:00):
which looks like thrush is that littlewhite coating that babies can get on their
tongue inside their mouth. When it'son the tongue, it's usually drop,
you know, breast milk or formulathat accumulates there. But thrush is kind
of a you know, a fluffyuh they call it powdered sugar, but
it's it's kind of a fluffy,cheesy looking white coating, uh that we

(58:22):
worry or retreat when it's on theinside of the lips or the meat of
the cheek, inside the cheek andgums the roof of the mouth, and
it's a fungus. It's candida,which is a fungus and skin fungus.
But babies get it, you know, from nursing or you know, it
colonizes the nipples of moms and bottlesand they can get this infection. The

(58:49):
problem is it hurts uh and itinvades the mucus membranes of the mouth.
So if you use a tongue topresser to scrape the tongue and it's coated
with milk and it comes off withoutthe bleeding or anything, well then it's
milk. But if you have tolike scrape it a little harder and you
can see that there's a little tinybit of bleeding there, you know,

(59:12):
it usually indicates that it's thrush.It's getting into the mucous membrane. So
it's treated with either die flucan ornice statin, you know, two antifungals,
and it goes away. But theproblem you sometimes run into is,
you know, the mom and babyare giving it back and forth to each
other, so sometimes you have totreat the baby then treat the mom with

(59:34):
an antifungal as well in order tostop the merry go round. But the
point he's making here is if it'sjust on the tongue, don't worry about
it. When it gets into theinside of the cheeks and along the inside
of the lips, that's when youneed to come to the doctor. And
if it's just that what you said, the milk, that doesn't hurt the
baby if it's just But if it'sscrub off or something like that, like

(59:55):
if you get your finger in thereon the tongue and it looks like it's
bleeding a little bit, or it'shard to the touch, maybe like that's
that's a reason to be concerned.Yeah, where it doesn't come off easily.
I mean, I use a tonguedepressor. If I scrape off and
there's white stuff on my tongue depressor I know it's milk. If I
have to go back in and scrapea little harder and I can't get anything

(01:00:15):
off, then it's it's in there. So in theory, could I also
give my baby a little bit ofwater and then that might rinse it off.
If I'm just as a tap,yeah, yeah, but sometimes it
needs a little friction too. Formost diarrheal diseases. One can rehydrate with
the child's preferred beverage and not amore expensive, less tasty electrolyte solution,
even apple juice, which I don'tagree with the apple juice thing because apple

(01:00:38):
juice juices makes you It makes youpoop more so, if you're having diarrhea
already, I wouldn't use apple juice. I tend to use grape juice,
white grape juice. I call itpoop poop neutral. It doesn't give you
constipation and it doesn't give you diarrhea. But that doesn't mean that a child
over the age of one can't do, you know, gatorade or cool aid,

(01:01:00):
anything with sugar and water and warmjello water. You don't have to
go out and buy a pedia light, which a kid is going to reject
anyhow because it tastes horrible. Isuggest any parent who buys the kid pedio
light should take a take a swingoff of that bottle and seeing what the
hell you're trying to give me yourkid does. Everybody with a non anaphylactic

(01:01:20):
food allergy you need to carry epinefferand around. It would be great if
there were a way to determine whodoes and does not require one. And
guess what, justin didn't we onthe last episode discuss a young fellow who
is founded a company that is goingto do just that. Yeah, yeah,
we did. We did that studylast time. The third difference between
a sensitivity and analogy. Yeah,that's right, so interesting and it says

(01:01:45):
this doctor says, it would begreat if there is a way to determine
who doesn't doesn't need it, andwell, that kid might be the answer
to that question. Kid at Stanfordworking on it. Could A good guideline
for parents about deciding to go tothe er is the following. If they
do not feel the need to callnine one one, they probably have time
to call their pediatrician first to helpdecide, which is very interesting. I

(01:02:07):
feel like this is more of anew trend. Like when my kids were
really young, I was very shockedthat my pediatrician gave me her cell phone
number, and it was only afterwe'd been with her for about a year.
And I think that my assumption wasthat she felt like she could trust
me with that information. That isthat not the way is that? Does
everybody have their pediatrician's cell phone number? Now nobody's got mine? Unless they

(01:02:30):
go to my comedy website. That'sa little overset on my part, but
whatever, No, I mean Ithink that people know to call it answering
service and they'll be able to getin touch with somebody. And again,
if it's advice, it's one thing. If it's a true emergency, I
mean most you know, you callyour doctor. Usually the first thing is

(01:02:50):
is the office is closed. Asif this is a true emergency, please
hang up and dial nine one one. Yeah, and that's just an ass
cover but whatever, you gotta doit. But my feeling is if it's
not called the ambulance, yeah,if it's after hours and you're concerned about
your kid, yeah, you shouldpick up the phone and call the doctor
by whatever means and help you makethe decision. I just, you know,

(01:03:14):
for from my side, that's whatwe signed up for. Yeah,
this one, I'm fascinated by havingrecently seen yet another child who was rushed
to the er for a fever ofone hundred and four, despite my having
educated the parents otherwise. I thinkfamilies would be better served by having a
thermometer that only went up to onehundred and two as the highest reading,
and one would need a medical licenseto use one for recording above this cut

(01:03:36):
off. I love that one.I absolutely love that one. That's great.
I wish I wish I had thoughtof it. So is so is
the real number to rush to ahospital closer to one hundred and five or
something? Or well, like Isaid two parents, I said, I,
you've identified a fever. Let's dowhat we know brings down fevers like
tyl and all or ibprofen and seewhat happens over the next forty five minutes

(01:03:59):
or so, because sometimes, especiallyin the summer, I mean, we
see viruses that will cause fevers ofone hundred and four. So I mean,
if it's the you know, there'sa difference to me if it's been
one hundred and four for four daysor if this is the first side you've
had of a fever. Let's yourbody is recognizing something it needs to fight,
and this is its reason for makingthe fever high. Let's see what

(01:04:21):
happens. So I would always recommendbefore rushing to the r especially is to
give a dose of adviller Thailand all. See what happens. Is it come
down from one hundred and four toone hundred and three and a half that's
not enough, you know, andthen I have them called me back with
you know, whatever the temperature ofwell, I give them guidelines. If

(01:04:43):
it goes under this, then continueit through the night and you should be
okay and just make sure they're drinkingand PN and if it doesn't come down,
or if you know, another symptomcrops up, they're having trouble breathing,
then yeah, you get. Butit's communication that you know, I
don't hang up the phone and forgetabout them. You know, Uh,

(01:05:06):
this is I don't know anything aboutthis. Concerted capsules do not dissolve.
They work on a piston like mechanism, squeezing the medicine through a hole in
the capsule. Parents will sometimes seethe capsule in the stool. This is
normal. Yes. Concert is aform of riddling used for add which there
is an extended release a capsule whereyou know, they get forty percent of

(01:05:29):
the medicine in the morning, sixtypercent of the medication in the afternoon.
So it kind of like it kindof like a plunger gets pushed out the
bottom of the time releases that way. Some other pills are coated in the
different layers breakdown at different times sothat it's time release. But this one
uses a plunger kind of mechanism,so yeah, the capsule sometimes pass out

(01:05:53):
undigested. Yeah, this one Ithink is more for doctors than for it
But it says, unless you're sorelypressed for space, let mothers us feed
their babies in the examining examining roomafter a visit. This will make for
a happier baby and thus mother andthe right on the ride home. Yeah.
I do that all the time.Of course, experts are vague about
how long to quarantine a child withhand, foot and mouth syndrome, but

(01:06:15):
a jump until they feel better anddon't have a fever for twenty four hours.
That's what a feederle means, right, That's what it says. A
fedril is a febri fedril. Okay, that's it means having a fever.
Yeah, a febrow would mean nothaving a fever. Okay. Often we
do nothing when we see a childin the expectation that a condition will resolve
on its own. This is morepalatable to a parent if we attach a

(01:06:38):
plan to it. For example,if a well looking child presents with a
five day fever, that I thinkis viral. Besides explaining that to the
family, I tell them to giveit three more days and if not improving,
they can call back and we willprobably order some lab work. Then
that's just good, good advice ifyou if you don't have any focus.
Part of my job is also notto overdo it. Don't want to send

(01:07:00):
little kids for blood work unless Ireally think there's something I'm going to learn
from that, And sometimes it's justthat I need it. We need to
see what this does. Over Wecertainly do in the first three days of
most febril illnesses. But you know, you get to five days. You
know, if it's one hundred andfour for five days, you got to
worry about other things. But ifyou think it's viral, it's not Kawasaki's

(01:07:24):
disease. There's no evidence that itcould be, you know, a urinary
tract infection and a little girl.Yeah, you can always give it two
more days if you're convinced to that. I would say five days of a
fever, I probably would want toat least check the urine on pretty much
anybody. But but yeah, Imean, if you think it's viral,

(01:07:44):
then time is going to take careof it. And some parents think their
kids have been sick for six weekswhen they've had three viral illnesses back to
back to back, and that thathappens every year. So it all depends
on who you're hanging out with.Sounds good takes is one snotty nosed,
green snot kid in a daycare atwo hundred people to recab it over your

(01:08:06):
entire community. Yeah, and weall think it's funny because I think with
the internet or non immunized measles carryingkid at your church, our private school.
We'll end on that. Send usan email. Show at the Dad
podcast dot com. If you havea question for doctor JA. If you
want to see Doctor J do somestanding up comedy, go to Stand Up

(01:08:29):
Pediatrition dot com. You can alsofollow them on Twitter at doctor j Sute.
All of those links are in thedescription of this episode. And if
you want to find a way tochat with other like minded parents, don't
forget to check out Staying Frosty withthe Dad Podcast on Facebook. It is
run by our very old butcher Drew. Alright, alright, alright, and
it's a great way to again chatwith like minded parents. Doctor J will

(01:08:51):
post on there as well as RachelWright, our resident sex and Family therapist.
And I think that's it, soI'd be half of the fantastic doctor
J Sute. This is justin worshipsaying hug your kids, hump your loved
one, and stay frosty. Byfriends