We had a lice day

3 girls and a woman at a delousing boutique

Thanks to Elyse Kolender for helping us delouse.

The discovery

After a letter came home about a lice outbreak at the girls’ school, I immediately went to check them out. I stood in the elementary school office checking my girls’ hair, and sure enough, there were little crawling lice and eggs staring back at me. I embarrassingly and mortifyingly looked at the secretary and gave her “The Nod.”

As it turns out, it was a family affair; all six of us had lice! That includes my four daughters (even our 3 month old) and my 45-year-old physician husband. How could this happen to us?! I thought we were so clean! Of course as a pediatrician I knew it wasn’t because we weren’t clean, but as a mom I felt dirty and ashamed. As a mother, my battle with lice ensued, and it oddly, it was more empowering than I thought it would be. We faced it head on. (No pun intended!)

Oh no. We’re now a statistic.

Most people are ashamed of lice. But let’s face it, lice is highly contagious and it shouldn’t be taboo. Did you know that between six and 12 million American children between 3 and 11 years old get lice each year? My family just became part of that statistic. Eeeeew gross! But honestly, it can happen to anyone.

It’s critically important to be open, transparent and educated about all contagious diseases. With lice, it’s not a reflection of cleanliness but rather just how contagious lice is.

As a mom and a pediatrician, my public service announcement is: Please let your school, friends and contacts know if you have something contagious. It will help decrease the spread of the disease and save health, time and money!

Our response

The first step was knowing it was going around; it is fiercely going around in schools right now. The second step was accepting it, facing it, not being ashamed of it and treating it. The third step was very important: We had to tell everyone we had it — brave, I know — but extremely important. So off went the emails and texts advertising our family had head lice and anyone who had contact with us should get checked.

A little about lice

According to the Center for Disease Control (CDC), infestation with head lice is most common among preschool- and elementary school-age children, and their household members and caretakers. However, we are now seeing it in high schools and other places.

Head lice are mainly spread by direct contact with the hair of an infested person. The most common way to get lice is through head-to-head contact with a person who already has it. Some studies suggest that girls get head lice more often than boys, probably due to more frequent head-to-head contact. Common ways to get lice include:

  • playing with others at school or home.
  • activities where your child interacts with others (e.g., sports, playgrounds, camp, slumber parties, etc.).
  • wearing clothing (e.g., hats, scarves, coats, sports uniforms, hair ribbons, etc.) worn by an infested person.
  • using infested combs, brushes or towels.
  • lying on a bed, couch, pillow, carpet or stuffed animal that has recently been in contact with an infested person.

Head lice are not known to transmit disease; however, secondary bacterial infection of the skin resulting from scratching can occur with any lice infestation.

Preventing and controlling the problem

Here are some simple things you can do to help prevent and control the spread of head lice.

  • Avoid head-to-head (hair-to-hair) contact during play and other activities.
  • Do not share clothing (including hats, scarves, coats) or things worn in the hair.
  • Do not share combs, brushes or towels. Disinfect combs and brushes by soaking them in hot water (at least 130° F) for 5 to 10 minutes.
  • Do not lie on soft objects that have recently been in contact with an infested person.
  • Wash things that an infested person wore or used for the two days before treatment. Simply machine wash and dry them using the hot water (130° F) laundry cycle and the high heat drying cycle. Clothing and items that aren’t washable can be dry cleaned or sealed in a plastic bag and stored for two weeks.
  • Vacuum the floor and furniture, particularly where the infested person sat or lay. Spending a lot of time and money on housecleaning isn’t necessary to avoid reinfestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
  • Do not use fumigant sprays or fogs. They aren’t necessary to control head lice and can be toxic if inhaled or absorbed through the skin.
  • To help control a head lice outbreak in a community, school or camp, teach your children how to avoid activities that may spread head lice.


Lice is not difficult to identify and there are many options for treatments out there. Talk to your pediatrician about different options for diagnoses and treatment. My family went to a local delousing boutique that kindly got rid of our little friends for us.

After the delousing, we went out to dinner as the cleanest, lice-free family in town. It was only partially embarrassing and peculiar to be out with our shower caps, a night to remember for sure!

After the delousing, we went out to dinner. It was only partially embarrassing and peculiar to be out with our shower caps, a night to remember for sure!

Moving forward

We are officially the cleanest, most lice-free family in our community now. As for you, stop itching (I know reading about it can bring on the itchiness!) and go make sure you don’t have it, too.

Dr. Hannan Alsahlani is a Beaumont pediatrician and proud mother of four officially lice-free girls (Sophia 9, Summer 8, Serene 2, and Solei 4 months).

My IBD is embarrassing me!

Elementary-age boy crouched over, hiding his head

Unaltered image. Tjook, Flickr. CC License.

“Jack! Come quick I have a surprise for you!”

Jack ran down the stairs to see the surprise his mother had for him. His mom told him to get his jacket because they were going to the planetarium; he had begged his parents for weeks to go. Jack loved science and was learning lots of cool things in his 5th grade science class. However, instead of excitement and elation Jack looked a bit panicked and overwhelmed.

“Jack, what’s wrong? I thought you’d be happy about going to the planetarium.”

Jack told his mother that he was happy, but nervous too because he hadn’t mapped out where all the bathrooms were at the planetarium.

Jack has inflammatory bowel disease (IBD) and when he goes to new places, he likes to know where all restrooms and exits are ahead of time in case he has an urgent need to use the bathroom.

What is IBD?

IBD is a condition that effects the gastrointestinal (GI) tract. Crohn’s disease and ulcerative colitis (UC) are two types of IBD. IBD occurs when there is inflammation along the GI tract. UC affects the colon, whereas Crohn’s may affect the entire digestive system. Common symptoms of IBD include severe abdominal pain/cramping, frequent diarrhea, weight loss, fatigue, and even failure to grow in children with Crohn’s. Proper absorption of nutrients and minerals is a major concern.

Many children and teens with IBD can relate to Jack’s anxiety. Managing IBD can be difficult especially as a child or teenager. Below are some tips and suggestions for how to help your child manage some of those potentially embarrassing moments.

Besties with the bathroom

Having IBD may mean spending more time in the bathroom than you’d like. Kids and teens often think that others are judging them or monitoring their frequent use of the bathroom.

  • Remind yourself or child that the only people who are interested in his/her bathroom use are parents and your doctor. Most people are too busy to notice someone else’s bathroom frequency/habits.
  • In school, work with teachers and staff to come up with a code word or planned times when your child is able to use the restroom without bringing additional attention to himself. Most kids and teens will have a 504 plan that will allow them to manage their IBD within the school setting.
  • Bring an extra change of clothes, undergarments and wipes for easy cleanup if accidents occur.
  • Keep travel-size perfume/fragrance and hand sanitizer on hand.
  • Know what may trigger a flare-up and avoid triggers if possible when there’s an upcoming event or activity that your child wants to participate in.
  • Try not to rush your child when he/she is in the bathroom as this can cause more anxiety. Put your patience hat on.
  • Always have a plan and plan ahead when possible.

Peanut, Shrimp, Small Fry, Half-Pint

Sometimes nutrition can be a concern due to poor absorption, which can lead to short stature and even malnutrition. Kids can be cruel and tease others for being short. What can you do about it?

  • Get ahead of the joke. Tell the joke first before anyone has a chance to. Consider thinking of some “comebacks” to short jokes and practice delivering them in the mirror. Addressing the teasing in the beginning in a way that shows that the child/teen is confident can eliminate teasing immediately.
  • If teasing continues and becomes problematic, parents should address it with school staff and the parents of the other child/teen. Continue to address it and check in with your child until the bullying stops completely. Parents may want to consider talking to the other parent themselves if school is not helpful. Consider contacting NoBLE (Beaumont Health’s bullying program) at 248-898-9951.
  • Help your child focus on areas of strength. Get involved in activities where height isn’t a requirement. For example, instead of trying out for the basketball team, suggest golf or bowling. If your child isn’t athletic, consider hobbies such as photography, drama, band, chess or debate club.

How do I look?

Some of the side effects of the treatments for IBD, such as steroids, can alter your child’s appearance and mood. Be sure to discuss the side effects of all treatments with your doctor.

  • If you notice that your child/teen is more moody or angry than usual and they are taking steroids, discuss other treatment options with your doctor.
  • Consider meeting with a psychologist or mental health professional to learn coping skills to manage the moodiness.
  • For changes in physical appearance, consider meeting with the school and teachers of younger kids to discuss with the class why your child may look differently. This can help prevent bullying and make your child feel more comfortable going to school.
  • For middle and high school students, work with school staff to identify options for optimal academic success is important. Some options may include doing a presentation on IBD for extra credit or minimizing opportunities for teasing by allowing the student to leave class five minutes early to avoid crowded hallways and limited adult supervision.

– Carnigee Truesdale-Howard, PsyD, ABPP is a Pediatric Psychologist with Beaumont Children’s Hospital Divisions of Hematology/Oncology & Gastroenterology

No Debate: Vaccinating Children is Safe, Effective for Disease Prevention

Little boy holding up his sleeve for a shot

There’s a big debate raging among parents: to vaccinate or not to vaccinate. But if you ask pediatricians, infectious disease physicians and allergists, there’s no debate. Vaccinate.

“There isn’t a single vaccine on the market that hasn’t been cleared by the Food and Drug Administration,” says Bishara Freij, M.D., chief of Pediatric Infectious Diseases at Beaumont Hospital, Royal Oak. “The FDA even sends inspection teams to the manufacturers overseas who distribute vaccine in the United States. Having children vaccinated in the United States is a safe and effective way to prevent many communicable diseases that can be deadly.”

Those who argue against vaccinating children tend to fall back on the same misinformation:

  • There’s mercury, or thimerosal, in vaccines.
    There hasn’t been mercury or thimerosal, which is a preservative, in pediatric vaccines in more than 10 years. “The concern was always with the developing brain and the effects of mercury,” explains Dr. Freij. “Researchers measured mercury levels before and after vaccination, and found there was nothing to note.” Only multi-vial doses for adults contain some thimerosal.
  • Vaccines can cause autism.
    “This has been studied and researched endlessly in many countries because parents expressed concern,” says Dr. Freij. “There is no increased risk for autism and there’s no science to support a link. It’s just an unfortunate coincidence that children are at the height of their vaccination schedule around the same time that autism signals start showing.”
  • Why would I inject my child with poison?
    “I tell people that my son got every vaccine that was available and sometimes before it was recommended for his age,” shares Dr. Freij. “The idea of ‘poison’ is the price for success. Many of the diseases children are vaccinated against are under control now, but that leaves room for people to focus on the sideshow. The benefits of vaccination far outweigh any perceived risk of poisoning.”
  • The herd mentality
    There’s a difference between herd immunity and herd effect. “Herd immunity only happens with live vaccines,” explains Dr. Freij. “For example, I get the vaccine and it passes through my system and comes out as bodily waste. Other people inadvertently become vaccinated with direct contact and cross contamination.” The herd effect happens when unvaccinated people are the minority population. Those who are vaccinated won’t become ill, which reduces the transmission of the infection and reduces exposure for unvaccinated people. Unvaccinated people aren’t protected, they are just less exposed. “The ideal rates for vaccination are over 95 percent,” says Dr. Freij.
  • People die from being vaccinated
    Death from vaccinations is extraordinarily rare, according to Dr. Freij. “If a child dies from a vaccine, it’s usually because they were immune compromised and didn’t know it,” he says. “Or they developed anaphylactic shock which is an exceedingly rare event.”
  • My child is allergic to eggs.
    According to Devang Doshi, M.D., chief of Pediatric Allergy and Immunology at Beaumont, Royal Oak, eggs are only a concern with two vaccines in the United States: influenza and the MMR (measles, mumps and rubella). “The amount of egg protein in these vaccinations is so miniscule, the American Academy of Pediatrics and the American Academy of Allergy, Asthma and Immunology recommend giving them to children with egg allergies,” Dr. Doshi says. “The typical protocol is to give the vaccine and then have the patient stay in the doctor’s office for 30 minutes to be monitored as a precaution.” A normal reaction to the shot includes a low-grade fever, redness at the injection site and slight swelling. “Restricted airway, hives, swelling of the lips and eyelids are signs of an anaphylactic reaction, which is exceptionally rare, especially in view of an egg allergy. But the risk of not vaccinating due to an egg allergy is not worth the theoretical risk of a potential reaction and definitely not worth getting a life-threatening infection.”

If you have concerns about vaccinations, Dr. Freij recommends checking out the websites for the Centers for Disease Control and Prevention as well as the American Academy of Pediatrics. “All these concerns have been tested and debunked,” says Dr. Freij. “It’s a false sense of safety to believe medical information that’s not supported by science. You’re setting yourself up to be bamboozled.”

Sniffle … Sneeze … Cough …

Little girl blowing her nose.

Cropped image. Oddharmonic, Flickr. CC License.

It’s that time of year when there seems to be a subtle cacophony of sniffle, sneeze, and cough all around. And with that tune, we’ve entered cold and flu season. Before chiming in, here are a few tips regarding those pesky bugs, and how to stay comfortable or, even better, how to prevent being a part of the chorus to begin with.

The term “common cold” unfortunately gets its name due to its contagiousness and how often it occurs. Colds spread easily between children in close contact with one another and a few viruses seem to be responsible for most of the missed school and work days. It’s not unusual for a child to get an upper respiratory infection six to eight times per year. With that frequency, it may seem like your child is always sick, but fortunately most of these colds resolve on their own.


Some symptoms of the common cold are runny nose, cough, fever and sore throat. Initially the nasal drainage will be clear but will thicken and may develop a yellow-green color as the symptoms continue due to an immune response. Most colds last between seven and 10 days, but there may be a slight cough or nasal drainage for another week or so after. However if your child isn’t getting better after a week, it may mean she’s picked up another infection and it’s a good idea to check in with your child’s health care provider at this time.


Most colds can be managed at home with supportive care. However if your child is younger than three months, has any worrisome symptoms (like nasal flaring or difficulty breathing), or your child just isn’t acting like himself then you should notify your pediatrician right away.

For typical cold symptoms, extra rest and hydration can be helpful. Cool mist humidifiers, steam treatments, and nasal saline and suction can help loosen nasal mucous. While antibiotics are great for bacterial infections, they offer no relief from the viruses responsible for common colds. And, keep in mind, most over the counter cough medicines are not recommended for children under age six.


There are a few things that can be done to aid in preventing colds.

  • It’s best to isolate babies younger than three months from those who may be sick and to keep them away from public spaces during cold and flu season when there are a higher number of viruses circulating. Viruses seem to cause more serious illness in babies younger than three months and prevention is the best strategy to use in keeping them healthy.
  • Some vaccines can help prevent cold weather-prone illnesses like flu and whooping cough.
  • Good hand washing and keeping hands away from the face and eyes can help keep viruses away from their desired environments for replication.
  • If a child isn’t feeling well, it’s best to have her cough/sneeze into a disposable tissue instead of into her hands, which are likely to touch a surface that another person could also touch and pick up a virus left behind.

While we await the symphony of spring, with good preventative techniques hopefully your family can avoid most of winter’s illnesses.  And if your child does catch a cold, hopefully he or she is able to stay comfortable while recovering and while building a strong immune system.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of a toddler and volunteers with the Parenting Program.

Vaccine Awareness

Little boy playing in leaves

As we settle into fall and winter approaches, it’s inevitable that part of your little one’s exploration will include viral/bacterial contact. While it may only lead to a simple cold, it could be something more serious with vaccine-preventable illnesses such as pertussis (whooping cough), measles and influenza (flu) on the rise. The best way to combat illness is with prevention measures such as hand-washing and through immunizations.

The World Health Organization estimates that vaccines prevent 2–3 million deaths per year from vaccine-preventable illnesses. Immunizations protect people against communicable diseases that can be spread through contact or droplets in the air. Immunizations work by vaccinating using a dead or weakened virus/bacteria, which triggers an immune response that prompts the body to create an antibody that will attack and destroy that specific pathogen if a person is exposed again. Some vaccines will require boosters before a person is fully immunized.

Vaccines do more than protect individuals; they protect communities through a concept known as herd immunity. We rely on herd immunity to help protect those who don’t respond to a vaccine or who are unable to get the vaccine due to allergy or contraindications. Herd immunity relies on 95 percent of the population being vaccinated. Unfortunately due to a reduction in vaccination rates, vaccine-preventable illnesses such as pertussis, measles and influenza are on the rise in the United States and worldwide.

  • A decline in the vaccination rate of the population led to an increase in measles outbreaks where herd immunity had been compromised. In 2011 the measles vaccination rate in France dropped to 89 percent; following the decline in the vaccination rate, 14,000 people in France developed measles.
  • A spike in pertussis cases in 2012 led to 18 deaths in the United States, mostly in infants under 3 months of age. In 2013 the number of reported pertussis cases declined and was attributed to widespread immunization of adolescents and adults to pertussis. While pertussis cases still were quite high in 2013 even with the year-over-year reduction, hopefully with increasing knowledge a further reduction will occur annually.

While children receive the majority of vaccines in the first two years of life, children may not be fully protected until they’ve had all of their boosters. Infants are the most vulnerable to disease, which is why the immunization schedule specifies the majority of vaccines to be received by two years of age. In light of the natural vulnerability of infants, it’s important to make sure that the whole family is up–to-date on immunizations to protect those who haven’t been fully immunized or are too young to receive immunizations. Certain immunizations like the flu shot need to be given annually due to the ever-changing morphology of the influenza viruses.

Myths and misinformation may confuse parents who are trying to make sound decisions regarding vaccines. Certain allergies or disease conditions may make it so a person is not a candidate for a vaccine. Make sure to get the facts and speak with your child’s health care provider if you have concerns regarding the safety of vaccines.

While exploration is wonderful to a child’s development, it’s important to ensure they are safe while doing so. As influenza season begins in October, this is the perfect time of year to evaluate the entire family’s immunization status in preparation for a healthy winter.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of a toddler and volunteers with the Parenting Program.