Flu questions and myths cleared up

It's been an unseasonably warm winter, and with January and February days in the 60's and 70's, flowers are blooming early and grass hasn't completely gone dormant. The warm winter has also kept flu season from hitting North Texas, but the experts assure us the virus is still sure to hit. It's not an issue of if the flu will hit, but when.

Dallas County Health & Human Services and Children's Medical Center's Infectious Diseases experts both report that there has been a very low incidence of the flu virus in the DFW region so far this winter. But the latest numbers from the County suggest that the virus is ramping up and ready to do its seasonal damage. So, are you protected? The easiest, and safest way to keep you and your family protected from the flu this season, even this late into the winter, is to get a flu shot. And it's not too late, says our Infectious Diseases expert, Dr. Jeffrey Kahn.

Dr. Kahn answered some questions we had in our office about the flu and clears up some of the myths about the flu, like if you can get the flu from a flu shot or not.

Q: What time of year is flu typically at its peak? And why?

Dr. Kahn: Influenza, or the “flu,” typically circulates in the late fall and winter months in the northern hemisphere. During most years, the flu season can last up to 3 months with peak activity lasting 1-2 weeks or more. There is some variability in the start of the flu season—some years it starts in November, while in others (like this one) it can start in February or later. The seasonality of the flu remains one of the great mysteries in infectious diseases. Several potential explanations have been proposed (air temperature, humidity, etc) but none have been proven.

Q: Does wet hair actually make you more likely to catch a cold/the flu?

Dr. Kahn: That’s what our mothers and grandmothers tell us and I am not going to argue with them. So dry your hair and wear a hat!

Q: Can you get the flu by being out in cold weather? And… why is there a flu season?

Dr. Kahn: The flu is typically spread from person to person (so temperature and weather may not have a direct impact) and as we learned with the swine (H1N1) flu, cold weather is not required. The peak of H1N1 activity in Dallas in 2009 was early September when the daily temperatures were in the 80’s and 90’s!

Q: Why do kids’ fevers tend to spike at night? Why do their stuffy noses and coughs seem to get worse at night?

Dr. Kahn: While these are common observations, there is no single answer to these questions. Increase in cough and congestion at night may be the result of position effecting nasal drainage (upright vs. lying down). As for fevers being worse at night, I am not sure that there is solid evidence for this but we know that body temperature varies with the circadian rhythm.

Q: How can you tell the difference between a cold, the flu or some other respiratory virus?

Dr. Kahn: Typically, the flu has a sudden onset with high fevers and body aches. However, it is difficult at times to tell the difference between infection with influenza and infection with other respiratory viruses. But, if it is in the middle of flu season and you suddenly get sick with high temperatures and feel like you’ve been hit by a bus, it’s most likely the flu.

Q: Does Tamiflu really work?

Dr. Kahn: Absolutely! For maximum effect, it should be taken within 48 hours of the onset of symptoms.

Q: Does getting a flu shot give you the flu virus? Will you get sick from the flu shot or flu mist?

Dr. Kahn: The injectable flu vaccine is inactivated (killed) virus so you can’t get the flu from the shot. Flumist is a weakened form of the virus that can only replicate in the nose and does not result in flu symptoms in the VAST majority of recipients. Bottom line: either flu vaccine is SAFE and EFFECTIVE.

Q: Is it too late to get a flu shot?

Dr. Kahn: Since we are just beginning to see flu activity in north Texas, there is still time to get vaccinated. So if you have not already done so, GET THE VACCINE! It’s the best way to protect yourself and your loved ones from getting the flu.

What being a marrow donor really means

Last week, a throng of Children's employees, including myself, got to watch an amazing meeting here at Children's. It was a long-awaited reunion of sorts between 6-year-old Laurel Good and Krista Katris, 23. Krista donated her bone marrow to Laurel over a year ago, a gift that saved Laurel's life.

Laurel, who was diagnosed at birth with TAR syndrome, a rare genetic disorder which can lead to bone marrow failure and is marked by low platelets and the absence of radius bones in the forearms, is now in perfect health thanks to Krista's willingness to join the Marrow Registry and donate once she was called.

Krista said she couldn't wait for the day when she could meet Laurel. Laurel and her dad Ken and sister Darby, 12, gave Krista many gifts, including a homemade beaded necklace Laurel made for Krista. Laurel's mom Terri and grandmother Jan were also apart of the meeting.


Krista had gifts of her own. She gave Laurel an Americal Girl Doll she had custom made to look like Laurel. The 6-year-old's eyes lit up when she saw Krista's dad Chris carry over the shopping bag with Laurel's doll and accessories it. "It's my very own," Laurel shouted while she showed off her new doll.We've asked you all month to get typed to be on the Bone Marrow Registry, telling you that you could save a life. But when you see a little girl meet the stranger who saved her life with a simple, generous donation, you understand why it's so important to join the Registry.

Through the end of February, Children's will pay for your online registration. For a free kit, visit and enter the coupon code "childrens."

And share your story with us. Why did you decide to get typed?

Bullying shouldn’t have to be a part of growing up

I, unfortunately like many others, was teased in middle school. My peers would ridicule me for being too shy and quiet. I remember staying up nights wondering if I was weird. I struggled with that insecurity so much that I felt like I might even deserve the bullying.

But that was a long time ago. Long enough for me to forget how bad it was, at least. But all of it came flooding back to me when I attended the premiere of The Secret Life of Girls at the Dallas Children’s Theater. The play, which is about the challenges middle school girls face every day, gave me déjà vu, making me relive my days as an awkward middle schooler.

I believe I can speak for most females in the audience when I say it was difficult to revisit that experience. And based on the play, it seems like the conditions for junior-high girls are worse today than they were when I was their age. The bullying does seem to stop once you leave school anymore. Technology like cell phones and social networks are now used for bullying 24/7.

While I was watching the play, I kept thinking to myself, “These poor girls. Why is nobody stepping up to stop this?” The choice to take action against bullying is one that teenagers face every day. Since most bullying seems to be done in front of an audience, it’s common for bystanders to watch and shake their heads but not to intervene.

After the premiere, a group of panelists including Children’s psychologist Dr. Andy McGarrahan all stressed the importance of being an “active bystander” during a Q & A session with the audience. They said that even though standing up for someone else isn’t easy, especially for a teenage girl, it makes a big difference

Even though parents can’t speak for their children, Dr. McGarrahan said he believes parents can help their children become active bystanders. He referenced tips from Dan Olweus, Ph.D., one of the leading researchers in bullying prevention, that can be found on Olweus.org:

• Encourage your child to verbally intervene if it is safe to do so, by saying such things as: “Cool it! This isn’t going to solve anything.”
• Tell your child not to cheer on or even quietly watch bullying. This only encourages a child who bullies – who wants to be the center of attention.
• Encourage your child to tell a trusted adult about the bullying. Talking to an adult is not “tattling” – it is an act of courage and safety. Suggest going to an adult with a friend, if that will make it easier.
• Praise and reward “quiet acts of courage” – where your child tried to do the right thing to stop bullying, even if he or she was not successful.
• Work with your child to practice specific ways he or she can help stop bullying. For example, role-play with him or her what he or she could say or do to help someone who is being bullied.

One way to open the discussion on bullying is to take your child to a showing of The Secret Life of Girls. The final opportunity to see it is this weekend at the Dallas Children’s Theater. Just think – this could be the perfect opportunity to be an active bystander.

The Secret Life of Girls brings bullying to light

One of the main issues brought up in the Dallas Children's Theater's production of The Secret Life of Girls, which is running now through Feb. 26, is bullying. As Kristen brought up in an earlier blog, growing up is hard enough and bullying has always been a rite of passage, but with the technology of today, it can be impossible for kids to escape their tormentors.

This Saturday, Feb. 18, one Children's experts, Dr. Gabby Reed, Ph.D., will join other experts and teens for a Q&A Talk Back session, as part of the day-long Teen Scene Summit. We invite you to come and take part.

We asked Dr. Reed and a couple of our other experts at Children's what parents can do if they suspect their child is being bullied or is a bully. And then, what can be done to prevent it? Our conversation is below:

Q: Are certain types of children or teens more susceptible to bullying?

Dr. Gabriela Reed, Ph.D., pediatric psychologist: There are usually two types of kids who get singled out to be bullied. There are the kids who come across as anxious, insecure and cautious, and then there are the kids who are easily emotionally aroused and perceived by their peers as aggressive, argumentative and annoying. Bullies are like sharks in that they "bump" their targets before deciding which to choose. Kids who have better social skills and who know how to assertively set limits with their peers are often not chosen to be bullied.

Dr. Jane LeVieux, Ph.D., licensed professional counselor and registered play therapist: Anybody could be bullied. For kids with a medical illness, it could be their overall appearance that makes them a target. There's also research that says kids with low self-esteem may be targets, and some kids may not have the social skills to say, "Leave me alone."
Dr. Crista Wetherington, Ph.D., pediatric psychologist: There's some literature to suggest that rejected children, such as children who are difficult to get along with or have poor social skills, are more likely to be bullied than the quieter, shy child.

Q: What makes some kids want to bully others?

Reed: It is a common bullying myth that bullies have low self esteem and are loners. In fact, most bullies have average to above-average self esteem and usually have little trouble making friends. It's important to remember that bullying is not a form of conflict, it is a form of victimization. Bullies often act out of a feeling of contempt toward their victim, whom they feel is somehow inferior.

LeVieux: There's a nonprofit group in Dallas called the Bully Suicide Project, and they've interviewed kids about this. They've found that a lot of kids who've been the bully said they didn't understand the person they were targeting, or they thought of their targets as different from them. Also, if children or teens are being bullied at home or by their peers, bullying others is a way to take it out on someone else.

Q: If a child is being bullied at school, what steps should parents take with school representatives?

Reed: Parents should contact their child's teacher or school counselor to ask for an in-person meeting, and emphasize that they want to work with the staff to find a solution. Set a follow-up appointment to talk about any progress that's been made. Make it clear that you expect the bullying to stop.

LeVieux: If the parents have already talked to the school and nothing's being done, then use other approaches, such as going to the school principal. If that doesn't work, then go one step above and talk to the school district.

Q: Jane, you meet with patients in the Emergency Room at Children's who come in when they're in emotional distress and may be having thoughts of suicide. How many children come to the ER in this situation?

LeVieux: We see about 20 kids a week who are in a moment of crisis, and I'm estimating about 35 to 40 percent bring up bullying.

Q: For those who have been bullied and have thought about suicide, what tools do you provide them with?

LeVieux: We help them write down the triggers that cause the emotional distress. That way, when they have these thoughts, they know some things they can do to alleviate the feelings. We teach children deep breathing techniques, or we find out what they can do physically to alleviate those feelings — like bouncing a basketball or kneading some clay or doing artwork.

Q: How can parents help their child who has been bullied?

Reed: It's important to try to empathize with your child. Don't blame your child for being bullied, and don't minimize your child's feelings. Kids who have been bullied need to know that the bullying is not their fault and that you intend to do everything in your power to make the bullying stop.

At the same time, parents can also help kids figure out what, if anything, it might be that makes them less socially successful. For example, if the child has trouble with interrupting people, it would be great for a parent to say something like, "I've noticed that sometimes when your friends are talking, you jump in and interrupt them. Do you think that maybe that bothers them? Would you like it if someone interrupted you when you were talking? What can we do together to help you to be better about not interrupting people?"

Parents can also role-play assertive ways for kids to communicate with bullies. When approached by a bully, parents might recommend walking away to a friend or safe person, laughing it off, directly telling bullies to "knock it off" or, if the bullying persists or becomes physical, telling a trusted adult that you and your child have identified ahead of time.
Assertiveness and strong social skills will help kids now and in the future.

Most importantly, make sure your child has a safe and loving home environment where he or she can take shelter physically and emotionally. Parents can help make this a reality by eliminating sibling bullying and by keeping lines of communication open with their kids.

Q: Is there a way to prevent bullying?

Wetherington: This really comes down to changing the culture of schools and other environments where children are to not tolerate bullying. It requires a strong commitment from school staff, school administration, and from parents.

A big thank you 191 new registrants!

The 21st annual Be The Match Bone Marrow Drive was quite the success yesterday, and we want to thank the 191 people that came out to our Dallas and Legacy hospitals and joined the Marrow Registry. That means potentially 191 children could receive a life-saving bone marrow or stem cell transplant.

For those of you who still want to get on the registry and be available to save a life, Children's will pay for your online registration through Feb. 29. To send away for a free kit, visit http://marrow.org/Join/Join_Now/Join_Now.aspx and enter the coupon code "childrens."

Many thanks again. We would love to hear from those of you that came out the drive yesterday and what made you want to join the registry.

The Secret Life of Girls

I can’t imagine being in middle school today. When I was in seventh grade the first online instant messenger was launched, the likes of Cindy Crawford graced magazines, and the only phone I had was connected to a wall. But today, girls in middle school now send hundreds of text messages each day, are connected to more friends than I can imagine online, and the pressures of being perfect seem to be much greater.

When did growing up get so hard?

This Friday Dallas Children’s Theater kicks off the production of The Secret Life of Girls - a play that looks into the world of a group of girls who struggle with issues of body image and the destructive effects of bullying. And, on Feb. 10 and 18 two of our experts from Children’s Medical Center will host a live Q&A to answer any questions you might have.

The Secret Life of Girls will run Feb. 10-26 with tickets starting at only $20. You can purchase your tickets online at the Dallas Children’s Theater Web site by visiting, www.dct.org.

If you plan to attend here are a few questions to think about. Do you have any questions of your own? How do you talk to your girls on topics such as these? Let us know.

• Think about the play’s title, “The Secret Life of Girls”. Why do you think the author chose this title? Do girls tend to lead “secret lives”?
• What qualities does a good friend possess? Is it possible to be a good friend to others if you’re not a friend to yourself?
• How does our society contribute to the lack of esteem in girls today? What issues do girls face that have arisen from our society’s projected image of “the perfect woman”? Consider the physical, intellectual, social, and emotional expectations of a “perfect woman”.
• What do you feel is the greatest source of pressure for teens today? Is it society’s expectations, the media’s perceptions, peer pressure, parental pressure? What can be done to alleviate some of the pressures you face as an adolescent in today’s world?

Sea World Visit Makes a Splash

A few dozen patients had the chance to shake their tail feathers with some exotic visitors yesterday. SeaWorld San Antonio was gracious enought to bring a few of their non-marine animals for a show and learn visit.

Keepers talked to patients and their families about the importance of protecting our costal marshlands so native Texans like Padre the Roseate Spoonbill, pictured below with keeper Clay, could continue to call Texas home.

Below, Luna the Virginia Opposum, another native Texan, was a hit with patients.

Although shy, Tafari the Red Ruffed Lemur shown below with keeper Clay, drew oohs and ahs.

But the visitors that really stirred up the patients and drew the most questions were Pete and Penny the Magellanic Penguins, which are native to South America. Magellanic Penguins are one of 17 species of penguins and are a temperate species, meaning they like warm weather, unlike their Arctic cousins, who have twice the number of feathers as Penny and Pete to keep them warm.

The number one question from patients about the animals was, "Can I touch it." But no need to fear, the animals kept their distance and posed no infectious risk.