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

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Mahmut Gazi Yaşargil: Micro-Surgery, Neurologic Pioneer

We’re at number 35 in our countdown of the top 50 most influential doctors in history and have come to a physician born in a cave, at gunpoint, in Eastern Turkey where his parents were being held by revolutionary/outlaws determined to challenge the new Turkish government in Ankara.

Born “baby” Yaşargil on July 6, 1925 he went on to become Neurosurgery’s Man of the Century (1950–1999) for his revolutionary achievements and advancements in micro-surgery; but… we get ahead of ourselves.
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Refresh: 15 Back To School Diseases

I’ve written about back to school diseases and problems before but it seems that questions and issues just keep the topic alive and asking for an update.

This will be just a quick update of 15 back to school diseases your child may encounter now that school bells are ringing again.
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Medical Marijuana – What, If Anything, Is it Good For?

We’ve explained that it’s the politicians and their meddling which has so far prevented medical research from delineating the truth about medical uses of marijuana, when it was clearly used hundreds of years ago for “medical purposes”—so-called: medical marijuana.

Misguided and incompetent laws have even prevented and delayed the finding of ways to remove the “drug’s” psychotropic side effects and make it safe for use!
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Medical Marijuana

Perhaps most, if not all, of you think of gangsters, terrorists, drug dealers and low-life “users” when you think of the word marijuana. And, with all the idiocy going on by politicians over “legalization” you might also think of societal breakdown, corruption, destruction of families… loss of moral values.

Or, after being beaten into a frazzle by the constant bombardment of so-called “do-gooders” on the media, you may be starting to feel guilty for living the life you’ve always lived trying to do right, knowing what you know about human nature and thinking what you think about the good and evil you’ve seen all around you during your life.
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George Papanicolaou: Cytopathology, Cancer

If Dr. George Papanicolaou isn’t considered with our list of the top 50 influential physicians of all time; then, who is?

I must confess that I must have said the words “Pap test” thousands of times in my training without once thinking about the man whose name those words were associated with.
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Marijuana: Test What You Know

Yea, I know there have been some reports about possible “benefits” of smoking Marijuana but you have to realize that I’m from THE generation where Leary convinced millions of gullibles to indiscriminately use drugs of all kinds with the sweeping generality: “look man, it don’t hurt nobody if I do it!”

That was looooong before the goofball that told me that had absolutely ANY proof of what he was saying… one way or the other. NOW we do!
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Prenatal Marijuana (Cannabis) and Brains

To my way of thinking the very thought that medical researchers are forced to stop what they are doing on important issues beyond our control and do research to prove that marijuana is bad for you and shouldn’t be used as a “toy” is unconscionable to the extreme.

We just can’t let the scammers and dealers destroy unborn babies like they did pushing tobacco however; so, that’s just what researchers had to do.
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Children’s Fitness: The Bleep Test

Assessing Children’s Health and Fitness
The “bleep” test, the “beep” test, the “Multistage Fitness Test” (MSFT)

The test had its beginnings in Britain to quantify the fitness level of children and sports team participants. Its popularity has grown world-wide and it is now used by major league teams as a requirement of participation, not to mention military units, the FBI, schools and other venues where fitness is a job requirement. Many other “clones” of the test have been developed (such as the yo-yo test) but all of them are pretty much the same measurement of the body’s ability to utilize oxygen and get it to its cells.

For those of you who wish to have a copy of the test to use in your family, an MP3 file is downloadable below.

Setup of the bleep test

The “game” or “exercise” is easy to set up and just as easy to perform (except for the running part) but it does need some explanation to those you want to administer it to. The tape uses “beeps” to time the exercise. You start the tape and don’t stop it until the last person taking the test has dropped out. Ostensibly to the highest level it takes just over 20 minutes; but no one has been verified as completing it even though several have claimed to do so. Most fit individuals reach their maximum around 10 minutes, only professional level athletes make it above level 12 or so (there are 21).

Give the instructions, start the tape, wait for the first set of three beeps and runners begin at a pace “just fast enough” to arrive at the cone where they wait until the next beep sounds and they start back. They run back and forth at the same pace waiting at the end for the next beep until another series of three beeps indicate the “next level” and the pace picks up. So, it’s back and forth to the time of single beeps until three beeps announces the next level of faster pace.

The “players” continue until maximal effort is reached with encouragement from the onlookers. The idea is to keep going until they have been “late for the beep” two times in a row and their score becomes the last level that they reached on time. Everyone in the family will be different and playing the game will improve both the score and fitness. Here is a video of a college professor teaching students how to administer the test.


So, what to expect at the various ages for “fitness?” Barring preclusive physical impairments here are the charts for boys and girls 9 through 17. Children younger than nine can run to the beeps but really shouldn’t do so under pressure. Developing a love for how their bodies feel when they’re fit and active should be the FIRST agenda. Nine is early enough to begin the challenge of competing with one’s self for improvement as the SECOND agenda. Physical competition against others should be left for sometime AFTER 12 as the THIRD agenda.



Percentile < 5 5-20 20-40 40-60 60-80 80-95 >95
Age very poor poor fair average good very good excellent
9 < 2/2 2/2-3/4 3/5-4/4 4/5-5/4 5/5-6/4 6/5-7/7 > 7/7
10 < 2/2 2/2-3/5 3/6-4/5 4/6-5/5 5/6-6/6 6/7-8/1 > 8/1
11 < 2/2 2/2-3/6 3/7-4/7 4/8-5/8 5/9-6/10 7/1-8/6 > 8/6
12 < 2/2 2/2-3/8 4/1-5/1 5/2-6/4 6/5-7/6 7/7-9/3 > 9/3
13 < 2/4 2/4-4/2 4/3-5/6 5/7-6/9 6/10-8/3 8/4-10/1 > 10/1
14 < 2/6 2/6-4/5 4/6-6/1 6/2-7/4 7/5-8/9 8/10-10/9 > 10/9
15 < 2/7 2/7-4/7 4/8-6/3 6/4-7/7 7/8-9/2 9/3-11/3 > 11/3
16 < 2/8 2/8-4/9 5/1-6/6 6/7-7/10 8/1-9/6 9/7-11/8 > 11/8
17 < 3/1 3/1-5/2 5/3-6/8 6/9-8/3 8/4-9/9 9/10-12/1 > 12/1


Percentile < 5 5-20 20-40 40-60 60-80 80-95 >95
Age very poor poor fair average good very good excellent
9 < 2/2 2/2-3/1 3/2-3/8 4/1-4/6 4/7-5/4 5/5- 6/6 > 6/6
10 < 1/7 1/7-3/1 3/2- 3/8 4/1-4/7 4/8-5/6 5/7- 6/8 > 6/8
11 < 1/6 1/6-2/8 3/1- 3/8 4/1-4/8 4/9-5/8 5/9-7/1 > 7/1
12 < 1/5 1/5-2/8 3/1-4/1 4/2-4/9 5/1-5/9 6/1-7/3 > 7/3
13 < 1/5 1/5-3/1 3/2-4/1 4/2-5/1 5/2-6/1 6/2- 7/5 > 7/5
14 < 1/5 1/5-3/1 3/2-4/1 4/2-5/1 5/2-6/2 6/3- 7/6 > 7/6
15 < 1/5 1/5-3/12 3/2-4/2 4/3-5/2 5/3-6/3 6/4-7/7 > 7/7
16 < 1/5 1/5-3/1 3/2- 4/2 4/3-5/2 5/3-6/3 6/4-7/8 > 7/8
17 < 1/5 1/5-3/1 3/2-4/2 4/3-5/3 5/4-6/4 6/5- 7/9 > 7/9

Finally, if you’re still with me, here is a summary chart of the entire test levels and shuttles on each level. It shows the relative speed the child is running (km/h) at each level as well as times and distances.


Bleep test summary information


Children’s Health: Less Healthy Than 50 Years Ago

Your grandparents and great-grandparents are always the shortest ones in all your family photos, right? It’s the same with all of us.

Your kids are taller, better fed and wealthier than your grandparents; so, why are today’s children LESS healthy than 50 years ago? Children’s health has actually gotten worse!
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James Parkinson: Social Activist and Advocate, Parkinson’s Disease and Palentology

Dr. James Parkinson was born on World Parkinson’s Disease Day, April 11th 1755, in London, England. Of course he didn’t know it at the time. Come to think of it, neither did his parents; nor the fact that he would become one of the 50 most influential doctors of all time.

Affecting an estimated 1% of people over 60 years of age, what has come to be known as “Parkinson’s Disease” is one of the most common neurologic disorders known today.
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Doctor’s Talking About Puberty and Sex

It seems that talking about puberty and sex is one of most every doctor’s LEAST favorite tasks. I know that because some research projects have studied the subject in patients of all ages with diseases of all types and by doctors of all specialties.

Well, it shouldn’t really surprise any of you because it’s your least favorite talk with your kids too (assuming you’re a parent)—and they’re YOUR kids.
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John Snow: Water Pumps, Cholera and Epidemiology

I live in no fear that telling you Dr. John Snow is one of history’s top 50 influential doctors will give even the slightest concern.

If it does, it means you really have no clue that he was the one who basically took Cholera off the front page of every newspaper and gave the world toilets, sewer systems and public works departments—world-wide.
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