Health Connection - December 2022

Too Much of a Good Thing? Screening Your Child’s Screen Time

By Zachary Schwab, MD

Just like holiday treats full of sugar (and spice!), kids could get too much of a good thing when it comes to screen time during the school holiday break.

Between TV, phones, tablets, gaming consoles, TVs, and computers, U.S. children ages 8-12 spend an average of 4-6 hours a day on screens, with teens averaging up to 9 hours. Screens have their place, but it's important to take stock of what your kids are watching and how much of their day is devoted to devices.

Too much screen time takes away from activities that promote intellectual, social, and physical growth, like playing outdoors, interacting with family, and reading. Research also shows that excess screen time can affect children and teens physically, mentally, and emotionally.

Physically, children who spend too much time in front of a screen can have more weight problems due to lack of exercise and snacking. Excess screen time can also cause sleep issues.

Mentally and developmentally, too much screen time can result in less time with family and friends and lower grades in school.

Emotionally, these kids are at greater risk of mood problems, including depression. They may experience fear of missing out (FOMO), develop self-esteem issues, and tend to be more impulsive than children whose screen time is more limited. Social media use, in particular, may contribute to additional emotional issues, including anxiety, negative body image, and exposure to bullying or harassment.

Before you run through the house confiscating every device, know that a total ban on screen time can backfire. We live in the digital age and kids must be technologically savvy. They also need to learn to self-regulate and turn off their devices. So, what do you do? How do you determine how much screen time is too much? A lot depends on what your kids are watching, whether you’re watching with them, and your child’s age.

Children Under Two

Both the World Health Organization and the American Academy of Pediatrics agree: With the one exception of video chats with family, children younger than two should not be put in front of screens. At that age, research shows, children don’t understand that videos represent real life. They benefit much more from face-to-face learning, the kind that happens when their caregivers talk and read to them.

Children Between Two and Five

The recommendation for this age group is no more than one hour of non-educational screen time per weekday, and no more than 3 hours on weekend days. Studies show that toddlers begin to learn from a screen somewhere between the ages of two and three, but only when they are watching slow-paced content developed for their age group and are watching with a parent or caregiver. After age three, children can learn from age-appropriate educational content even when watching by themselves.

Children Six and Older

Most families adopt more of a negotiating strategy with older children, tweens, and teens and how much TV everyone watches becomes more of a family culture issue. Check out the American Academy of Pediatrics' Family Media Plan for guidance on setting limits for older children's screen usage.

TV and computer time can be positive, healthy experiences for children and families, provided parents remain aware and involved. These tips can help you establish the right parameters for your family.

Encourage Healthy Habits

• Turn off all screens during family meals and outings.
• Avoid using screens to pacify a fussy child or stop a temper tantrum.
• Turn off all screens 30-60 minutes before bed. Do not let your child have a TV in their bedroom. Take away phones and tablets before bed.

Check Out Content

• Make sure what your kids are watching is age-appropriate.
• Use parental controls on all devices.
• When possible, watch with your kids.

Talk About What They're Watching

• If characters in a show are modeling good behavior, point that out to your child. Create a personal connection between what they are seeing and real life. Make comments like, “That’s the city where Grandpa was born!”
• When your child is exposed to advertising, point out how the advertising is trying to influence them.

Encourage Other Activities

• Expose your child to music, art, acting, sports, and other activities that don’t involve screens.
• Do family craft projects or have a family game night.
• Get outside together. Take family walks, hikes, or bike rides.

Set a Positive Example

Control your own screen time and let your child see you engaging in hobbies that don’t involve scrolling on your phone or watching TV.

Think About Safety

• Discuss online bullying. Make sure your child is not being bullied or engaging in online harassment.
• Teach children about online privacy and safety. Explain to them that people they might “meet” online may not be who they seem.
• Consider your child’s activities and maturity level when deciding whether they are ready for a personal device.

If you’re concerned about your child’s screen time, work on scaling back and consider talking to your pediatrician.

Dr. Zachary Schwab is a MarinHealth physician specializing in child and adolescent psychiatry.

Don't Wait for the New Year to Jump-Start a Healthier You

From shopping and decorating to celebrating and traveling, most of us try to pack a lot into the already-busy holiday season. The hectic pace of the holidays can be stressful, and the added stress makes it easy to push healthy habits aside until after the New Year. But did you know that some health conditions are more common during the holidays? And overindulging in unhealthy food or drinks, skipping exercise, sacrificing sleep, or not taking time to relax can put you at increased risk for these problems. That’s why it’s so important to make your health a priority and to help avoid these medical conditions that could derail your holiday plans.

Heart Attacks

According to a study published In Circulation, the flagship journal of the American Heart Association, more cardiac deaths occur on December 25 than on any other day of the year; the second largest number of cardiac deaths occurs on December 26, and the third largest number occurs on January 1. People tend to delay seeking care during the holidays, and are more likely to mistake symptoms such as chest pain for heart burn or acid reflux. Heart disease progresses over time, but increased stress and poor dietary choices during the holidays can make the heart work harder and result in a cardiac event. If you have cardiovascular disease or are at risk, take time to meditate and relax no matter how busy you are, get a little exercise every day, and save your holiday indulgences for the occasional special treat. Above all, don’t ignore the warning signs of a heart attack. If you or a loved one experience any symptoms, call 911 immediately.

Gallstones

Gallstones can strike anybody at any time, but eating large, high-fat meals or enjoying too many sugary treats during the holidays can be a recipe for gallbladder disaster. Gallstones are present in 15-20% of adults, and often just stay in the gallbladder and don’t cause any harm. But when gallstones block the tubes that drain from the gallbladder and liver into the intestine, they can cause serious problems and may require surgery. Symptoms include sudden onset of pain in the upper abdomen, most often with nausea or vomiting. Reduce your risk of painful gallstones and a trip to the ER during the holidays by drinking lots of water, eating a colorful variety of fruits and vegetables, and limiting consumption of high-fat and sugary foods. Try to take a brisk 30-minute walk daily to keep your digestive system moving. If you do experience severe abdominal pain that lasts more than two hours, or if it is accompanied by nausea, vomiting, fever, or yellowing of your skin or the whites of your eyes, seek immediate medical attention.

Falls at Home

The Consumer Products Safety Commission reports that 12,000 – 15,000 people end up in the ER every year as a result of falls from holiday decorating alone. Falls from ladders are particularly dangerous and can result in broken bones and serious head injuries. Avoid falls by exercising with common sense and knowing your limits. Make sure your ladder is solid and steady, have someone hold the ladder for you, and leave the decorating to someone else if you have balance concerns or feel unsteady. Find additional resources for preventing falls here.

Alcohol-Related Injuries

Drunk driving is the cause of nearly half of all holiday accidents and fatalities on the road. While a glass of champagne with family and friends can add to the festivities, two or more drinks can easily impair your judgment and make you a danger to yourself and others if you get behind the wheel of a car. Set limits on how much you will drink before heading out to any celebration, and make arrangements for safe transportation ahead of time. And remember that alcohol-fueled accidents aren’t just limited to the roads. About a quarter of all accidents in the home are caused by alcohol, including burns, cuts, and falls, so limit alcohol consumption while cooking or using appliances with sharp or moving parts. Learn about Alcohol Use Disorder here.

Depression

Even if you normally enjoy the holidays, the added demands and anxiety that come with the season can leave you feeling a bit down. The “holiday blues” can strike when you are lonely or have no plans, but also if you have too many plans and are feeling overwhelmed. Financial stress, increased food and alcohol intake, and trying to keep up with expectations and deadlines can all exacerbate low mood. Often, these feelings stop as the holidays end – but if the sadness sticks around for weeks or months, or if your mood interferes with your daily activities, talk to your doctor. Some ways to avoid depression during the holidays include taking time for yourself to relax and recharge, saying “no” to invitations that feel more like obligations, and practicing gratitude for the positive people and experiences in your life. Learn about suicide prevention here.

Remember that it’s important to enjoy the holiday season with friends and family, and missing an occasional workout or enjoying a special meal or treat shouldn’t be a problem. Stick to your wellness routine most of the time, and make healthy choices whenever you can, then relax and enjoy the festivities. You’ve earned it, and the New Year is right around the corner.

It’s a Snap With an App: Managing Your Health on MarinHealth’s Patient Portal

Are you on MyChart yet? If not, we have just one question: What are you waiting for? More than 150 million people from coast to coast are taking control of their health using this incredibly practical and totally private online resource. MarinHealth and UCSF are proud to offer our patients this convenient Electronic Medical Record (EMR) platform.

Benefits of MyChart

Whether you use it on your phone, tablet, or laptop, MyChart is intuitive and easy to use, and gives you the ability to:

• View your medications, test results, upcoming appointments, medical bills, and more, all in one place.
• Safely and securely share your medical records with all your providers.
• Schedule appointments and fill out your pre-visit forms online.
• Connect with your MarinHealth doctors from anywhere. You can get an online diagnosis and a prescription or schedule a video conference.
• Stay on top of family healthcare appointments.
• Pay your medical bills.

Learn more about MyChart and sign-up for access today. It’s quick and easy!

Other Innovative Health and Wellness Apps

When COVID-19 hit in 2020 and the country went into quarantine, healthcare became a challenge for many. Hospitals were overwhelmed. Researchers were trying to understand this new disease. Before the vaccines came out, people were afraid to go see their doctor. Some postponed needed tests and procedures. Gyms and yoga centers shut their doors. Suddenly, healthcare apps were no longer a neat novelty: They became a necessity for many people. Of course, no app can replace a work out at the gym, much less a doctor visit. But you’ll be amazed at what some of the latest healthcare apps can do.

Chronic Conditions

Chronic conditions like high blood pressure, diabetes, or kidney ailments require regular medical attention and frequent checkups. There are several apps available that help you monitor your condition and give you 24/7 access to healthcare specialists.

Diet Planning

There are a multitude of diet planning apps, most of which let you input your wellness goals, diet specifications (vegan, kosher, gluten-free etc.), and workout habits to help you develop a personalized weight loss program.

Health Reminders

Get reminders to take your blood pressure, do your physical therapy exercises, take your medicine, check your blood sugar, and more.

Health Trackers

These apps allow you to monitor your heart rate, heartbeat pattern, oxygen levels, circulatory strain, sleep, calorie intake, activity, symptoms, and respiration. Some include pre-recorded exercise sessions and training tips.

Medical ID

Accessible from your home screen, these apps allow emergency staff to view your critical medical data at a glance, including medical contacts, blood type, and allergies. Several of these apps will also share your GPS location with your emergency contact. This is a good option for people with dangerous allergies or chronic conditions that could cause them to pass out.

Medication Side Effects

Got a new prescription? Look up the side effects, drug interactions, and dosing guidelines.

Mental Health

These apps allow users to consult with an expert when they are experiencing a crisis or other mental health issue.

Pharmacy Delivery

A boon for folks who are sick, frail, or housebound, these apps allow people to buy their prescriptions online and have them delivered to their home.

Prescription Price Shopping

Price shop for your prescriptions to find the best prices and availability, in real time.

Eight Ways to Enjoy Holiday Festivities Safely

While we are proud of the life-saving care MarinHealth Medical Center’s Level III Trauma Center provides, we don’t look forward to the usual holiday uptick in alcohol-fueled car and bike accidents. Every year, impaired or drunk driving sends thousands of accident victims to the Emergency Department. Unfortunately, many drivers responsible for these accidents believed they could safely drive because they “hadn’t had that much to drink” or they downed a cup of coffee to “sober up.” The truth is, drinking alcohol at that holiday party has lasting effects. The alcohol in your digestive system continues to enter your bloodstream, affecting both judgement and coordination long after you’ve had that last drink.

As your community healthcare provider, we’re honored to care for you when you need us. On behalf of the MarinHealth Medical Center Trauma team, we’d like to share a few pointers regarding holiday drinking to help you stay safe and sound – and out of our Emergency Department.

1. Know your “no.” Decide your limit in advance. If you are going to stop at two drinks, stick to that commitment.

2. Space yourself. Have a non-alcoholic “spacer” drink between every alcoholic drink. A glass of water between drinks slows you down and dilutes the alcohol. And – bonus! – it also helps prevent dehydration. When you are hosting the party, have nonalcoholic options available, such as soft drinks, hot cider, or sparkling water.

3. Don’t hang out with party animals. The drinkers at the party tend to encourage each other to “have another!” Spend time with friends who drink moderately, or not at all.

4. Watch out for the punch. Sugar can mask the taste of hard liquor. Just because it tastes like fruit juice doesn’t mean it won’t pack a punch.

5. Eat something! Unless your host or hostess will be serving food, make sure you eat before you go out. That way, you won’t be drinking on an empty stomach.

6. Keep track of how much you’re drinking. If you’ve lost track, you’ve already had too much.

7. Mind those mixed drinks. When you order a cocktail, you could be getting a lot more alcohol than you planned on. Many mixed drinks contain several different kinds of spirits, which means the drink adds up to more than one official serving of alcohol. One "standard" drink consists of roughly 14 grams of pure alcohol, as in:

• 12 ounces of regular beer, which is usually about 5% alcohol.
• 5 ounces of wine, which is typically about 12% alcohol.
• 1.5 ounces of distilled spirits, which is about 40% alcohol.

8. Designate a driver, or use a rideshare service or taxi. As the signs on the highway say, “Buzzed driving is drunk driving.” Buzzed, plowed, tipsy … The policeman writing your ticket won’t care what word you use. It all adds up to a ticket and a DUI. Simply said, do not drive when you are impaired by alcohol and/or drugs, and do not allow your family members or friends to drive while impaired. If you haven’t had too much to drink, then be a good Samaritan and offer to be someone else’s designated driver.

Good News: MarinHealth Medical Center’s Trauma Center Receives Level III Reverification

It’s official! We’re thrilled to announce that the MarinHealth Emergency Department has been reverified as a Level III Trauma Center by the American College of Surgeons (ACS)’ Committee on Trauma. The verification program confirms once again that our Trauma Center has demonstrated our commitment to providing the highest-quality trauma care.

“This achievement recognizes our Trauma Center’s dedication to providing optimal care for injured patients as MarinHealth continues to provide Marin residents with life-saving emergency care close to their homes,” said Andrew Apolinarski, RN, Chief Nursing Officer at MarinHealth Medical Center.

Designation as a Level III Trauma Center means community members have 24/7 access to a complete team that includes board-certified emergency and trauma physicians, other specialists, nurse practitioners, nursing staff, physician assistants, emergency technicians and support staff. In addition to the critical services provided by its Level III Trauma Center, the Emergency Department at MarinHealth Medical Center offers comprehensive services, including life-saving care for major injuries, emergency spine and brain surgery, award-winning care for heart attack and stroke, and an “Ouchless ED” that incorporates child-friendly protocols to help reduce the anxiety and pain for those children who visit the Emergency Department.