pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

Showing posts from: Illness

Children’s Bacterial Skin Infections

It’s incredible how popular the posts that I do with a “guess the answer” format have been. I usually try to make them about topics which train young parents in diagnostic or treatment skills that will help them keep their children healthy and safe.
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Cardiac Arrest: Commotio Cordis – Prevention, Return To Play

Astin, the 17-year-old who suffered cardiac arrest when he was hit in the chest by an elbow playing baseball, is back for his 2nd follow-up. Remember, last visit he was depressed with worry over all the junk he had read on the internet and you (well I) assigned him some homework.

For the third article in the series we’ll talk about what we can do to “prevent” Commotio Cordis (CC, his final diagnosis) and help him decide about going back to play baseball in competition.
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Cardiac Arrest: Commotio Cordis – Treatment and Prevention

Ok, it’s been over a week and your 17-year-old Commotio Cordis patient who suffered a cardiac arrest on the baseball field is back for his follow-up and an answer to his question: “When can I go back to playing baseball?”

You knew he was coming and you’ve had a week to prepare what to tell him… so, go ahead, I’d like to hear this too…

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Sudden Cardiac Death in Child Athletes

Sudden Cardiac Death is, by definition, both sudden and unexpected – especially in a child whose life is supposed to revolve around “play” and “fun.” Unfortunately, it is also increasing.

Just as unfortunate, children’s “play” is often “industrialized” into major competitions with adult methods, standards and expectations leading to unintended consequences.
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Otitis Externa: Swimmer’s Ear, More Than An Annoyance

That gunky, smelly, puss draining out of your son’s ear is an infection called ‘Otitis Externa‘ – or possibly Otitis Media that has ruptured and is draining.

With the history you gave I’m guessing it’s ‘externa’ – you can call it ‘Swimmer’s Ear‘ but I don’t, cause it’s certainly caused by a lot more things than merely swimming.
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Mosquito Illnesses – Zika, Dengue and Others

For the first time in a long time that I can remember, the dislike of mosquitos has taken on an entirely new life this summer. Most certainly due to all the medical news about the mosquito illnesses and Zika; but, there are other diseases mosquitos harbor too that we can’t just rely on “citrus smells” and “bug zappers” to defeat.
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Torn Anterior Cruciate Ligament (ACL) – Lachman Test

Lachman Test
Identifying an anterior cruciate ligament (ACL) tear

The Lachman test is pretty easy to explain to someone but difficult to understand without some kind of example.

graphic drawing of the structures of the knee for the lachman test
Graphic depiction of the structures in the knee

A plastic model of the knee helps in understanding but an actual patient is better. Unfortunately, there isn’t always one available during your “teaching moment.”

A great alternative is a good teacher and a cooperative patient on a video – like this one.

The anterior cruciate ligament (ACL) is hidden inside the knee joint and is diagnosed by performing the Lachman Test during a thorough physical exam – like this one by a pediatric orthopedist.

As you watch him explain the terms: “medial” means “inside or middle“; “lateral” means “outside“; “anterior” means “to the front” and “posterior” means “to the rear.

There are two “collateral” ligments – one on each of the medial and lateral sides of the knee which prevent right and left scissoring of the lower leg outward and inward.

And there are two “cruciate” ligments – the anterior and posterior, in the middle of the joint which prevent the lower leg from slipping forward or backward out of the joint.

There are other tests which diagnose tears in the remaining three knee ligaments that are not described here. An ACL tear is the most common injury of this type.

Allergy: Spring Hay Fever and Otherwise

However you spell it: Hay Fever or Hayfever, it’s miserable; and the name has become, like “Kleenex”, the “generic” moniker for any scratchy, itchy, watery red eyes with runny nose – even though the true disease occurs in the fall during the farmer’s haying season.
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Five Things You Should Know About Concussion and Contact Sports

Concussion and Contact Sports
Five important things to know

Did you pick out the Five Things About Concussions You Should Know?

First – don’t wait to “see if it goes away” before you seek accurate diagnosis. Often an accurate diagnosis depends on comparing measurements in an early visit with those in a later visit.

Second – Follow-up care is important not only to prevent further harm but sometimes to make an accurate diagnosis, especially about the brain and nervous system which can be very subtle.

Third – We now realize that there are long term effects of concussions, possibly up to 6 years! There may even be life-long consequences that must be overcome.

Fourth – Even multiple impacts without a diagnosed concussion often lead to long term effects. And,

Fifth, Helmets are designed to prevent skull fractures and NOT concussions.