Category Archives: Sickness

How to tell your kids when a loved one has been diagnosed with cancer or other serious illness

It is hard enough for us adults to have to deal with bad news that affects ourselves or a closed loved one. But it can be even harder on the adults if they have kids they need to inform that mom or dad, or grandma or grandpa or uncle Joey are seriously ill. In this blog article I will describe the when, why and how to tell kids these things.

Should I tell my child that Uncle Joey has cancer?
Absolutely you should tell. There has been much research on this topic. If you are not honest with your child about this, how can they trust you when they have tougher questions later on? Kids are also very perceptive and smart. It is hard to hide things from them, and they will hear things you think they can’t. It is much better to tell them directly and be open about it. Dont’t make up words or try to soften the blow too much. Use the actual word for cancer, e.g. leukaemia, lymphoma, breast cancer, brain tumor etcetera
When should I tell my child that a family member has a serious condition?
The sooner, the better. As soon as you know, you should tell them. It might explain to them why mom or dad are sad or are away from home more. You may get more snuggles and kisses, which is a great cure when you are feeling sad.
How should I tell my child that grandpa has an aggressive form of lung cancer?
You should tell any kids of any age, but the details of what you tell them, differs per age. Under age 8 yrs, basic terms and a very brief summary are usually enough. Between 8-13 yrs they may want more details or maybe even see pictures. Teens might want to read articles or books about it.
There are some good references out there that can help you (see this link)
These are the things that I would include:
  • that grandpa has cancer and it is located in the lungs
  • a short summary what next steps are (e.g. surgery, chemo, radiation)
  • what this might mean for the kids themselves in the near future and longer term (e.g. being picked up by others, more play dates, understanding why mom and dad are more emotional etc)
  • remember that kids still believe in magical world. make sure they understand they did NOT cause the cancer to occur (e.g. say something like “Doctors tell us nobody understands how the cancer gets there, but we DO know it is NOT caused by someone else”)
  • you can NOT catch cancer; it is NOT contagious like a cold (please give grandpa lots of hugs, he could use them)
  • please reassure your child that they may ask you questions at any time
What do I say if my child asks me if mommy is gonna die from the breast cancer she has been diagnosed with?
This is probably one of the hardest questions to deal with. It is already hard and painful enough for the adult to think about death in relation to the illness, let alone having to deal with answering this question. As much as you may want to reassure and say that “everything will be alright”, you cannot say this as nobody knows the answer to the question. Probably the best way to try to answer it is by not saying “no”, but rather “the doctors are gonna do everything they can to get rid of the cancer; what can help mommy is giving lots of hugs and writing cards/drawing pictures”, etc.
  1. Be honest when it comes to telling your kids about the diagnosis
  2. Make sure to reiterate cancer is NOT contagious
  3. Ensure that your kids understand they did NOT cause the cancer to occur
  4. Answer questions honestly without being too blunt
  5. Invite the kids that they can ask you questions about this at any time

Scratch that itch: Head lice, a common and harmless occurrence

A few times each year I will receive phone calls from parents who are in a panic, because they either have a child with head lice or because someone in their child’s class has head lice. Sometimes I will receive calls asking if they should pull their child out of school, not because their child has head lice, but to prevent them from getting it.

Some schools demand that parents pick-up their children right away once diagnosed with lice, or state that kids should stay home for at least 2 days after treatment. So, why are there so many questions, concerns and/or misconceptions? Is your scalp getting itchy just reading about this topic?

I am hoping this blog article will provide parents, and schools with all the data that we have at our disposal to take away any myths or misconceptions. And I hope this in turn will prevent potential outbreaks of massive hysteria amongst parents, and school staff alike.

I will use several references throughout this article. If you wish to use this blog article to show your school or other parents what current recommendations regarding head lice are, I would urge you to print the information from the different references I provide, rather than the actual blog.

What are head lice?

Head lice are wingless, 2 mm to 4 mm long (adult louse), six-legged, blood-sucking insects that live on the scalp of humans. Infested children usually carry fewer than 20 mature head lice (more commonly, less than 10 head lice), each of which, if untreated, live for three to four weeks. Head lice stay close to the scalp for food, warmth, shelter and moisture. The head louse feeds every 3 h to 6 h by sucking blood and simultaneously injecting saliva. After mating, the adult female louse can produce five to six eggs per day for 30 days, each in a shell (a nit) that is ‘glued’ to the hair shaft near the scalp. The eggs hatch nine to 10 days later into nymphs that molt several times over the next nine to 15 days to become adult head lice. The hatched empty eggshells (nits) remain on the hair, but are not a source of reinfestation. Nymphs and adult head lice can survive for up to three days away from the human host. While eggs can survive away from the host for up to three days, they require the higher temperature found near the scalp to hatch.

The classic symptom is itchiness to the scalp area leading to subsequent scratching.

Headlice do NOT spread disease.

Unlike body lice, head lice are not a health hazard, a sign of poor hygiene or a vector for disease, but are more a societal issue.

How are head lice transferred?

Head lice are spread mainly through direct head-to-head (hair-to-hair) contact. Lice do not hop or fly, but can crawl at a rapid rate (23 cm/min under natural conditions). Pets are not vectors for human head lice.

How to treat head lice?

There are special “Headlice” shampoos available. There are topical insecticides that have  been most commonly used. Some contain permethrin 1% (eg “Nix” shampoo). If one is allergic to ragweeds or chrysanthemums one should not use this. There are other non-insecticide shampoos on the market in North-America that do not contain permethrin (one example is “Resultz”).

Apply the product on dry hair, using enough to wet the hair. Make sure to follow the directions on the bottle, and leave in for 10 min. Then wash hair out. Use the special lice comb to lockout any nits that are left. After 48 hours, check again for any live lice. If there are, use the special shampoo again.  Check again after 7-10 days and repeat treatment.

Bedding, clothes, hats, stuffed toys etc. should be washed in hot cycle and then put in dryer in the hottest cycle. Clothes that cannot go in the dryer, can be drycleaned or sealed in plastic bag for 2 weeks. Combs, hairbrushes etc should be soaked in hot water with soap for 1 hour. Kids with long hair could have their hair pulled back while in school in order to minimize hair-to-hair contact.

Information for schools

The American Academy of Pediatrics, Canadian Pediatric Society and Centre for Disease Control all agree on return to school policy as well as whether a child should be sent home. As the lice have likely been in the hair for past 3-4 weeks prior to noticing it, there is no reason to send the child home earlier than at end of the day. Schools should provide a letter to all parents explaining someone in school has been found to have headlice, and to make sure to check their own children for lice. If lice are found, treat them. A child can be sent back to school as soon as he/she is treated (so if treated the evening before can go to school next day). Finding nits in hair does not equal “live lice”. In the past some schools in the U.S. tried a “No nits policy”, however this policy had no scientific basis. For an example of information that a local/provincial health authority distributes in school, check this link for Alberta Health Services. Please check your local health authority for more information as they might use a variation of this information.

Again, everyone should bear in mind that although a nuisance when it comes to causing itchiness and having to wash bed sheets, pillow cases etc, head lice do NOT spread disease.

Bottomline, Dr Raffi’s tips on Headlice:

1. Headlice do NOT spread disease

2. Treat with special shampoos, recheck after 48 hrs and again after 7-10 days

3. Once treated, a child can return to school

4. Useful websites are: AAP, CPS, CDC

Most bugs don’t need drugs

I am borrowing this slogan from an advertising campaign in which we are trying to educate the public that most infections are caused by viruses and not bacteria. The distinction is important, since antibiotics only work against bacterial infections. Most infections however, are caused by bugs known as “viruses” and these are the diseases that we need to fight off ourselves. We can use medicines for support, but not to “cure” infections caused by viruses.

Examples of diseases caused by viruses are chicken pox, the flu, and most common colds. I am not advocating an anti-antibiotics position, but we have found over the years that bacteria can build-up resistance to certain antibiotics, so it helps us to reduce this risk if we try to only prescribe it when indicated (for a great read on this, please visit Caring for Kids).

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