By RX FOR READERS/JUDY SIEGEL-ITZKOVICHA boy at the beach in the summer (Illustrative)(photo credit: TNS)We are new immigrants from a northern state in the US who arrived last winter and have two children aged eight and four. Unused to the climate and conditions here, we were wondering if there are any special things, like dealing with the sun, various bugs and so on, that we have to pay attention to when our kids go to summer camps here and when we go on trips in nature together.- J.D., Ashdod Dr. Liat Ashkenazi-Hoffnung, an expert in pediatrics at Schneider Children’s Medical Center for Israel in Petah Tikva, answers:After coping with children’s winter illnesses, parents usually breathe a sigh of relief when the summer comes. Still, it is important to prepare and know that the summer also has a variety of typical illnesses in children.Diarrhea and dehydration: Various contaminants, viruses and bacteria that cause diarrhea are very common during the summer months. The heat causes an increase in the amount of bacteria found in food eaten away from home or at picnics in nature spots.As a result, many children suffer from diarrhea, vomiting and dehydration. Babies and young children are more susceptible to diarrhea, both in terms of susceptibility to infection and in terms of the risk of dehydration. The percentage of water in children’s bodies is particularly high – 70% of body weight, compared with 50% water in adults.To prevent such infections, be sure to wash your hands after a visit to the toilet before and after meals. Also, avoid eating foods that stand in the sun and heat and outside cooling for an extended period of time.The main treatment is to provide fluids to prevent dehydration. In cases of acute diarrhea, it is recommended that you continue with the child’s regular diet. Infants should continue to breastfeed or drink formula (without the need to dilute or change the formula). I recommend giving one of the oral rehydration solutions containing a saline solution, which have been shown to reduce the need for intravenous fluids.In the event of frequent diarrhea (more than eight times a day) or vomiting, infants under two months of age, children with significant background disease and those with suspected dysentery (high fever, bloody diarrhea) or suspected dehydration (sleepiness and lack of urination) should be taken for immediate attention by a pediatrician.Heat vulnerability: Children are more exposed than adults to heat injuries. Exposure to heat is particularly significant in the sunny summer of Israel, at the beach or in the pool and on outdoor walks. Heat injuries occur in cases of excess environmental heat, when the body’s temperature is higher than its self-cooling capacity.Heatstroke, the most severe degree of heat injury, is characterized initially by headache, weakness, nausea, vomiting and a slight increase in body temperature. Later, the body temperature may rise above 40º, and there will be other signs of sleepiness, rapid flat breathing and even seizures.To prevent heat injuries, it is recommended to keep plenty of water in the summer. Strenuous activity should be avoided, especially during hours when the heat load is significant. Wear a brimmed hat against the sun and long-sleeved but light clothing. Of course, children should not be left alone in a closed car, even for a moment.In each of the stages of heatstroke, call for medical help quickly and at the same time work to cool the body (take off clothes, move the child to a shady, air-conditioned place, pour cold water on the body). Be sure to give the child plenty to drink if he or she is alert and able to drink.Sun exposure: Beyond the possibility of being overheated, prolonged exposure to the sun is not good for children’s skin, because sunburn in childhood increases the risk of skin cancer later. So avoid allowing them to spend much time in the sun, especially during the peak hours. When they are exposed to sun, apply sunscreen with an SPF of 30 or more and make sure they wear a hat and sunglasses.Mosquito bites: Although a mosquito bite does not cause significant damage, it can cause discomfort or secondary bacterial infection. To prevent them, you can use window screens and apply mosquito repellent preparations containing active DEET or picardine (this should not be used on infants under two months of age).Cool the bite and apply a soothing substance such as aloe vera or antihistamine (such as phenyl) to reduce the discomfort and itching that can cause skin injury and secondary bacterial infection.Mediterranean spotted fever: This is a disease caused by a type of bacterium that is transmitted to a person with a tick bite. MSF occurs mainly during the summer months, when both ticks and humans are active in nature. The disease is characterized by fever, headache and rash, muscle aches, vomiting and diarrhea. Without treatment, this disease may be fatal, so one must go quickly for medical care.Jellyfish stings: During the summer vacation, children may encounter jellyfish in the sea. Their stings can cause a burning sensation accompanied by pain, itching, blisters and sometimes even numbness in the affected area.In case of a sting, rinse the area with sea water or vinegar (the lifeguard will probably have what you need, if you don’t bring vinegar with you) and not with fresh water. Pain can be relieved by ice and painkillers.Drowning hazard: To avoid drowning, do not swim in the sea or in a pool without the presence of a lifeguard. Care must be taken for close supervision of children up to the age of five years, and use flotation devices even at older ages, if the children are not skilled at swimming. It is very important to maintain an adult presence and maintain eye contact with the child at any age.External ear infection: In the summer we spend a lot of time in the pool. When water enters the outer ear canal, external ear infection may develop. This inflammation causes great sensitivity in the ear, especially by pressing the front part of the earlobe.The recommended treatment is ear drops, which usually contain antibiotics and steroids. If this problem returns, don’t enter the pool without using ear plugs.I am a 64-year-old man who is about 10 kilos overweight, but I walk a lot and try to use my elliptical machine at home when I have time. I have been suffering from osteoarthritis in the right knee for some time. The cartilage at the joint is pretty much destroyed. Most of the time it doesn’t bother me, but from time to time, I get jabs of pain.The orthopedist I went to after undergoing an X ray said I should exercise more, lose weight, take painkillers and, if the pain continues, undergo a series of “Ostenil” injections, which he said was material similar to that in the red “comb” on the top of a rooster’s head. He also said that surgery would not help very much and should be considered only if I can’t walk at all.What is Ostenil, and could it improve my condition?- L. M., Rishon Lezion Prof. Meir Liebergall, chairman of the orthopedic surgery complex at Hadassah-University Medical Center in Jerusalem, replies:Usually I prefer to see patients and discuss all such issues in person, but I can tell you that Ostenil is hyaloronic acid, which is found naturally in the body and is an important component of articular cartilage. There are other commercial similar solutions (such as Arthrese). Injections may be indicated in mild or moderate disease for relief, but it is certainly not a cure and much less effective for an advanced condition.I am an 83-year-old woman in not particularly good health (osteoarthritis, scoliosis of spine, sciatica). Of late, I have become incontinent during the night, but not during the day or even when I’m away from home. Are there exercises I could do for this? I don’t want to take medication.- R.C., Jerusalem Prof. Amnon Brzezinski, director of the Women’s Health Center at the gynecology and obstetrics department at Hadassah-University Medical Center in Jerusalem, comments:You have to be evaluated by a urogynecologist. He or she can recommend some exercises (with limited benefit) or medications that might improve your condition.
