Early Diagnosis of Autism Improves Outcomes

Tuesday, 19 June, 2018

April is National Autism Awareness Month. The prevalence of autism had risen to 1 in every 68 births in the United States – nearly twice as great as the 2004 rate of 1 in 125 – and almost 1 in 54 boys. Autism is treatable. Children do not “outgrow” autism, but studies show that early diagnosis and intervention lead to significantly improved outcomes. Skills such as taking a first step, smiling for the first time, and waving "bye bye" are called developmental milestones. Children reach milestones in how they play, learn, speak, behave, and move (crawling, walking, etc.). If a child is 'missing' these milestones, parents need to consider evaluation by their pediatrician.

But how does one know if a child is, or is not, meeting developmental milestones? The following is a Developmental Milestones Quiz developed by the CDC to help. If, after taking this quiz, you have concerns about a child in your life, call our office and arrange a time to speak with our pediatrician. We are here to help!


Top Tips for Medicine Safety in Your Home

Tuesday, 19 June, 2018
medicine safety, children, pediatrics

Top Tips for Medicine Safety in Your Home

Moms, do you keep medicine in your purse? Parents, do you have diaper rash cream within arm’s reach of the changing table? Have you ever shared medicine with a friend, like painkillers? Or missed a dose of a medicine so you took two to make up for it?

It’s instances like these that result in 1.34 million calls to poison centers for children each year. Watch the following video and read the below tips to help keep you and your children from being a statistic:

Top Tips for Parents of Little Kids Ages 5 and Under

  • Put all medicine up and away and out of sight, including your own. Make sure that all medicine and vitamins are stored out of reach and out of sight of children. Consider places where kids get into medicine, like in purses, counters and nightstands.
  • Consider products you might not think about as medicine. Most parents store medicine up and away - or at least the products they consider to be medicine. You may not think about products such as diaper rash remedies, vitamins or eye drops as medicine, but they actually are and need to be stored safely.
  • Use the dosing device that comes with the medicine. Proper dosing is important. Kitchen spoons aren't all the same, and a teaspoon or tablespoon used for cooking won't measure the same amount as the dosing device.
  • Write clear instructions for caregivers about your child’s medicine. When other caregivers are giving your child medicine, write clear instructions about what medicine to give, when to give it and how much to give.

Top Tips for Parents of Big Kids Ages 6 to 10

  • Teach your child that medicine should always be given by an adult. It’s important for kids to know that they should not take medicine on their own. Parents and caregivers can help make sure they are taking it correctly.
  • Don’t refer to medicine as candy. While saying medicine is candy may make it easier to get your child to take medicine, it may encourage them to try it on their own.
  • Take the time to read the drug facts or prescription label with your child, even for over-the-counter (OTC) medicine. As your kids get older, it’s important to teach them how to read and understand the label before taking medicine.
  • Model responsible medication behavior. What kids see us doing is a much stronger message than what we tell them to do. Make sure to store medicine out of the reach of children, read drug facts and prescription labels before taking medicine and follow the recommended dose.

Top Tips for Parents of Pre-Teens and Teens 11 and Up

  • Educate pre-teens and teens on how to read an over-the-counter drug facts or prescription label. Take the time to teach your child about each section of a drug facts label and its purpose. For a great resource on this topic, visit:
  • Communicate to pre-teens and teens the importance of only taking medicine that is meant for them. Taking medicine that belongs to someone else or misusing medicines (even OTCs) can cause harm.
  • Teach pre-teens and teens that medicine labels are rules, not guidelines. Be sure they knows that taking more than the recommended dose will not help them get relief any faster, and it could hurt them.
  • Check in with then and talk about medicine they are taking regularly. Even pre-teens and teens who need to take medicine daily may make errors in dose or dosing frequency, so it is important to communicate with them regularly about taking medicine responsibly.

Top Tip for Everyone

  • Save the toll-free Poison Help line number in your home and cell phones: 1-800-222-1222. You can also put the number on your refrigerator or another place in your home where babysitters and caregivers can see it. And remember, the Poison Help line is not just for emergencies, you can call with questions about how to take or give medicine and concerns about other potential dangers, including reactions to plants and mushrooms, bites and stings, chemicals, carbon monoxide, pesticides, and more.


[Courtesy of Safe Kids Worldwide.]

Menopause and your health

Tuesday, 19 June, 2018

According to a recent study published in JAMA Internal Medicine, hot flashes, which afflict up to 80% of middle-aged women, can last much longer than just a few years. In fact, they can last as long as 14 years, with a median length of seven years. Learn more about this study by reading the following NY Times article. To learn more about Menopause and Your health, take a look at our infographic below.

What you should know about yearly pap smears and cervical cancer

Tuesday, 19 June, 2018

January is Cervical Cancer Awareness Month. This form of cancer can be a silent killer, showing few symptoms till the damage is done. Knowing some facts about cervical cancer, however, can help you keep you or a loved one safer.

What is Cervical Cancer?

The cervix is the lower part of a woman’s uterus. Cervical cancer happens when abnormal cells grow out of control on the cervix. These cells usually stem from the human papillomavirus, also known as HPV. Many woman have HPV for years without realizing it. It can take years to develop into cancer. This is why regular testing is so important.

What are the Symptoms of Cervical Cancer?

HPV has few symptoms. If it develops into cancer, however, you may notice some of these symptoms.

  • abnormal bleeding unrelated to your menstrual cycle.
  • abnormal or bloody discharge

If cervical cancer spreads to other organs such as the bladder, lungs, liver, or intestines, more symptoms can develop. Some of these symptoms include:

  • back pain
  • bone fractures
  • tiredness
  • achiness
  • leaking urine or feces
  • pelvic pain
  • weight loss
  • no appetite

How is Cervical Cancer Diagnosed?

With regular pap smears, your doctor may be able to diagnose cervical cancer before it even becomes cancerous. Pap smears will let you know if you have HPV. If you do, your doctor will look for cervical cancer or precancerous cells. If you’re showing symptoms of cervical cancer, your doctor may also request a biopsy.

How is Cervical Cancer Treated?

If you have HPV but don’t have cancerous cells, your doctor may simply keep an eye on it. HPV often clears up on its own. If it doesn’t, he or she will discuss treatment options with you. If you have cervical cancer, the treatment depends on a few factors: how advanced it is, what kind of cervical cancer it is, and how old you are or what your overall state of health is. Treatment can range from chemotherapy to radiation to surgery.

What Can You Do?

An early diagnosis can make all the difference when it comes to cervical cancer. Get regular pap smears and pelvic exams. HPV and cervical cancer generally develop through unsafe sexual intercourse. Practice common sense. And don’t forget to spread the word. Raise awareness among friends and family about the dangers of cervical cancer and what they can do to avoid it as well.

Dr. Melanie Mintzer Wins Best Doctor Award!

Tuesday, 19 June, 2018
Best Doctor Award

In her first-ever Maggy win, Dr. Melanie Mintzer knocked a longtime Best Doctor favorite to second place!

Mintzer is a second-generation family doc who opened her Generations Family Practice in Cary in 2005; it serves children, adults and seniors.

Prior to private practice, the Chicago native worked in public and women’s health care for 20 years, including a stint as medical director of the Orange County Health Department, and taught at the UNC-CH School of Medicine.

Mintzer believes this Maggy Award recognition speaks well of the entire Generations team.
“Getting patients in, making them feel comfortable, is the really important thing; we want people to feel better when they leave,” she said. Some of her patients are literally lifelong — she helped birth them, and now cares for them as adults.

“It’s an honor to take care of them, and to see my former students now in practice,” Mintzer said. “I love what I do and I love my patients. This doesn’t feel like work.”

Outside the office, Mintzer knits, sews, exercises at Rex Wellness, and takes online classes in Hebrew. She’s also the proud owner of three at-home looms, which she uses to weave cloth for items such as jackets and rugs.

[article in Cary Magazine, January 2015 Issue]

Change is in the Air - 2015 Health Insurance Change That Is

Tuesday, 19 June, 2018

Do you know how the new 2015 insurance changes will affect your healthcare and what steps you can take to be better prepared? Generations Family Practice has received numerous calls and question from our patients on this topic. So many in fact, that we decided it would be beneficial to put together the below graphic in an attempt to help. If you still find yourself with questions, please call us. We will do our very best to answer them or direct you to the right person to help.

After the toys come home, how do I keep my kids safe?

Tuesday, 19 June, 2018

After you've bought safe toys, it's also important to make sure kids know how to use them. The best way to do this is by supervising play. Playing with your kids teaches them how to play safely while having fun.

Parents should:

  • Teach kids to put toys away.
  • Throw away broken toys or repair them right away. Christine Macomber, MD, a pediatrician at Generations Family Practice says. "I recommend periodically checking your toys for wear and tear. Broken down plastic can make for sharp edges and small attachments can loosen creating choking hazards."
  • Check toys regularly to make sure that they aren't broken or unusable:
    • Wooden toys shouldn't have splinters.
    • Bikes and outdoor toys shouldn't have rust.
    • Stuffed toys shouldn't have broken seams or exposed removable parts.
  • Store outdoor toys when they're not in use so that they are not exposed to rain or snow.

And be sure to keep toys clean. Some plastic toys can be cleaned in the dishwasher, but read the manufacturer's directions first. Another option is to mix antibacterial soap or a mild dishwashing detergent with hot water in a spray bottle and use it to clean toys, rinsing them afterward.

Dangerous Objects
Many non-toys also can tempt kids. It's important to keep them away from:

  • fireworks
  • matches
  • sharp scissors
  • balloons (un-inflated or broken balloons can be choking hazards)

Reporting Unsafe Toys
Check the CPSC website for the latest information about toy recalls or call their hotline at (800) 638-CPSC to report a toy you think is unsafe. If you have any doubt about a toy's safety, err on the side of caution and do not allow your child to play with it.


Are the toys that your kids play with safe?

Tuesday, 19 June, 2018

Did you know that toys send more than 26,000 children to the emergency room every year? In fact, toy-related injuries involving American children has jumped about 40 percent according to an analysis by the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. That can be very scary information for parents - however, many of these injuries can be prevented. As parents, we must arm ourselves with information and awareness of the toys on the markets and what to look for in toy safety.

“Purchasing age appropriate toys is one easy first step to ensure that the toys are more safe for your child.” Says Dr. Christine Macomber, pediatrician at Generations Family Practice. “Also, keep in mind that siblings like to play with each other and their toys. In our home, the Legos would come out during our baby's naptime or after bed - that way, choking on a small toy was one less thing for me to worry about!”

Below is a graphic that we put together discussing other safety features to be aware of. We hope that you find it informative. Keeping your whole family safe and healthy is Generations Family Practice's top priority!

[Coming up -- Part Three: After the toys come home, how do I keep my kids safe?]

Evolution of Toy Safety

Tuesday, 19 June, 2018
Evolution of Toy Safety

As the excitement and festivities of the holidays fade away, many households will be left with a small avalanche of new toys bestowed upon its children. These new items of fascination and joy will be loved upon and played with by the ones we cherish most. But what do you know about these toys? Are they safe?

New toys are meant to bring enjoyment. But sometimes there are products that are released to consumers that could cause our children harm. This is the FIRST PART in a THREE PART SERIES regarding TOY SAFETY. It is intended to educate and better enable you to protect your kids. Because toys should not bring tears, only smiles!

Part One: Evolution of Toys and Toy Safety Standards

For centuries, children of all ages have sought out ways to entertain themselves. As civilizations grew more complex, so have the toys and games available. Below is a historical overview of the evolution of toys, as well as toy safety standards imposed due to harmful products.

  • 400 B.C.: A Babylonian board game is played that was probably an ancestor of chess and checkers.
  • 300 B.C.: The first game resembling backgammon is played in Ancient Samaria. Stone marbles are first used in Egypt.
  • Mid-18400’s: The first American doll maker is granted a patent and dolls begin to be mass-produced in America for the first time. Alphabet Blocks become favorites and help children learn their alphabet the old-fashioned way.
  • 1880’s: The first BB gun is created. The BB gun is a descendant of the cap gun, which was invented soon after the Civil War, when some shotgun manufacturers converted their factories to make toys.
  • Around 1900: Edwin Binney and C. Harold Smith produce the first box of Crayola crayons.
  • 1930’s: Alfred M. Butts, an unemployed architect from Poughkeepsie, N.Y., invents a word game called the “Criss Cross Game.” In 1948, Butts sells rights to the game to entrepreneur James Brunot, who trademarks the game under the name Scrabble.
  • 1940’s: Candy Land, Chutes and Ladders, the Slinky and Silly Putty are introduced.
  • 1950’s: Matchbox cars, Yahtzee and Play-doh are rolled out onto the market.
  • 1955: New York's director of safety advised the state's fire chiefs to seize fake Davy Crockett coonskin caps from stores. Made of shredded paper, the caps burst into flame "in seconds after the most casual exposure to a live cigarette or to any spark."
  • 1960’s: Kids now have Twister, the Easy Bake Oven and the Nerf ball as play options.
  • 1965: Toys”R”Us opens its doors.
  • 1966: Child Protection Act enlarges the scope of the Federal Hazardous Substances Labeling Act to ban hazardous toys and other articles so hazardous that adequate label warnings could not be written.
  • Late 1960’s: The Zulu toy gun was popular with kids. Like a peashooter, the Zulu gun was mouth powered, shooting little plastic darts. Before long, emergency rooms around the country began seeing a surge in accidental ingestions of plastic darts, as children inhaled hard before blowing out.
  • 1969: President Nixon signed into law the Toy Safety Act, the first national safety standard for playthings. The act authorized the Department of Health, Education and Welfare to test and ban hazardous toys. The Zulu was one of eight toys the National Commission on Product Safety in 1969 recommended be banned. Others included the Empire Little Lady Stove, which had oven racks that could heat to 600 degrees, and the Bird of Paradise slingshot with razor-sharp missiles.
  • 1970’s: The card game Uno and Dungeons & Dragons hit the market.
  • 1973: Consumer Product Safety Commission created by Congress; takes over programs pioneered by FDA under 1927 Caustic Poison Act, 1960 Federal Hazardous Substances Labeling Act, 1966 Child Protection Act, and PHS accident prevention activities for safety of toys, home appliances, etc.
  • 1983: The Cabbage Patch Kids doll comes into the toy world a huge hit and leaves frantic parents searching endlessly for the coveted Christmas gift.
  • 1983: Cute little stuffed critters, dubbed Beanie Babies, become all the rage.
  • 1988: A pointy metal stake that you throw into the area while a bunch of people stand around...What could possibly go wrong? More than 6,500 people reported lawn dart injuries before they were recalled and made illegal.
  • 2002: Mattel closes last U.S. factory and moves production to China.
  • 2007: Mattel recalls nearly one million toys in the U.S. because products are covered in lead paint. All toys were manufactured in China.
  • 2007: In early 2007, The Easy Bake Oven was found to cause children getting their fingers or hands caught in the oven’s opening. Hasbro offers a free retro-fit kit designed to eliminate the danger. However, injuries continued with another 250 reports received. Over 70 of those children received burns, many severe. One child required a partial finger amputation due to her injuries. Hasbro issues a full recall on all Easy Bake Ovens manufactured after 2006. Since then the design has been updated and is considered safe for children over the age of 8.
  • 2010: According to the Consumer Product Safety Commission, toy-related deaths to children younger than 15 increased to 17 fatalities reported in 2010, up from 15 reported in 2009. According to the U.S. Consumer Product Safety Commission (CPSC), more than 250,000 toy-related injuries were treated in U.S. hospital emergency rooms in 2010. Of those, about one third involved kids under 5.

As one can see, toys have come a long way over time. And, thankfully, their safety standards have evolved as well. “The advancement in toy safety allows us to be proactive in caring for the well being of our children-whether it be with their toys, car seats, cribs, etc.” states Dr. Christine Macomber, a pediatrician at Generations Family Practice. “When available, registering purchased items will allow the company to inform you of known hazards and take steps before injury occurs.”

[sources: ; ; ]

[Coming up -- Part Two: How do I know if my children’s toys are safe?]

How to Enjoy a Healthy Thanksgiving Holiday!

Tuesday, 19 June, 2018

It’s upon us once again, the holiday travel season. Crowds, rushing, stressing, shopping, eating, etc, it all takes it toll. But it doesn’t have to. This Thanksgiving holiday, check out my favorite healthy travel and general holiday coping tips to help you get through with flying autumnal colors!

Check out these tips to keep healthy and sane this holiday travel season:

  • Pack patience! Now that the TSA has added heightened security measures and airlines have tacked on more fees, flying can be a beast. Do your best to give yourself enough time to get through the lines and know that it’s all just part of the experience.
  • Pack good attitude! Nothing spoils a holiday trip or exacerbates any problems more then a sour disposition. Do your best to make the most of the situation and enjoy the season because it only comes once a year. You never know what great memories you will make if you’re willing to enjoy the holiday!
  • Eat before you leave the house. You should always leave with a full tummy or you will be tempted to nosh on whatever is convenient. And that means expensive junk food that’s bad for you and the trash cans!
  • Know before you go. Know which airports you will be flying in and out of, laying over at, etc. Most have websites that show what dining establishments can be found in each terminal. For instance, I know that the Delta terminal at LAX has a Starbucks (for my soy latte) and a CPK express where I can grab a salad or soup for the flight. Most international hubs have chain restaurants or familiar fast food counters where you can order up a healthy meal for your in flight pleasure. From a veggie salad or sandwich at Quiznos to a black Bean Burger at Chili’s To Go, there are ways to not give in to bags of pretzels and pounds of danishes to keep you from passing out on your flight. The World Travel Guide site will lead you to each city’s airport web site.
  • Stay Hydrated. Seeing as how we cannot bring our own beverages from home anymore, the first purchase to make upon entering your gate is a big bottle of water. Or better yet, pack your favorite glass or BPA-free bottle in your carry on bag and fill it at the airport. This way you save money and you aren’t drinking unhealthy water or contributing to landfill waste. Above all else, staying hydrated during air travel is key to cutting down on fatigue and fighting off the munchies!
  • Take your vitamins & eat your veggies. If you’re running around and not able to eat balanced meals on your travel day, be sure to pack water soluble vitamin packets. In addition, there are many powdered veggie drinks that you can down and get your recommended servings of veggies a day to keep your immune system top notch when sucking in recycled air. My favorite brand for both is To Go Brands Go Greens and Vitamin C packs.
  • Stay away from caffeine. Drinking caffeinated beverages on or before a flight will keep you from relaxing on the plane. In addition, it messes with your insulin levels and can cause you to overeat.
  • Don’t drink alcohol in flight. Alcoholic beverages have double the effect in the air as they do on the ground,  so you’re definitely gonna feel crappy when you get to your destination. If you need to relax, grab some all natural melatonin to help you sleep along with some soothing tunes.
  • Pack snacks. Stock up on healthy bars, nuts and even sandwiches. Pack your carry-on with your own goodies so you aren’t spending money at the terminal on expensive, crappy food to be sure and have something on hand when hunger strikes.
  • Sleep well the night before travel. That’s the toughest with the anticipation and stress that comes with flying during the holidays, but it can be done. And if not, invest in a flight pillow, eye mask, earplugs or noise reducing headphones and a blanket. Bring all the comforts of home with you to make your catching ZZZs in the air easier.
  • Plan ahead! Know where you’re going directly after you pick up your bags at your destination. Home, hotel, family’s house, wherever – map out what is close by in case you need to pick up a snack or a full blown meal so you don’t keel over and start your vacation on a bad foot.

As far as getting through the stressful holidays without any familial or friend tension, here are some good rule of thumb tips for holiday gatherings that will keep the peace during this festive season:

  • While conversation is a must, and can be very enjoyable, over the holiday dinner table, specific topics should not be discussed. While no one likes to dinner over awkward or superficial chatter, no one likes a meal to turn ugly. Obviously the biggies to stay away from are politics, religion and sex (unless of course your group enjoys those topics). For the most part, not everyone will agree on such topics and it’s best to leave them alone. In fact, this includes veganism. The holiday table is not a place to stand on your soapbox unless it has been asked of you. In addition, it is not a place for attack on someone who is different. If a topic comes up that you are uncomfortable with, politely let them know that you do not wish to discuss that particular topic at that time. Shut it down with a smile and offer up a new topic.
  • Never assume that a host will be able to provide everything you need.  Always be prepared. It is impossible to make everyone happy and sometimes folks are left out of certain things.  If you have special dietary needs, be sure to let your host know ahead of time and offer to bring a dish that you can eat and share with the group. Or to be extra safe, eat before you got to the dinner so that you aren’t left starving during the meal.  The holidays are about enjoying the company of others so do your best to focus on that instead of what you can and can’t eat.
  • If you are hosting a meal, be mindful of others. In fact, the best way to have a happy gathering is to share the experience. Potluck dinners are the best way to include everyone and the onus doesn’t fall on you to feed a bunch of folks who may or may not like your taste in food.
  • If you aren’t feeling well or are in a particularly foul mood, admit it. Do what you can to handle your emotions before heading to a gathering. It’s not healthy for you or the other guests if you aren’t up for it or worse, taking it out on them. If you can pull through and try to have a good time, great. Otherwise, we all have bad days so do what you need to do to sort it out because nothing ruins your holiday and others like a foul mood.
  • Nobody’s perfect – try to plan ahead. I know this sounds like common sense, but it’s really important to remember. If you want to have people over and you’re working, don’t go crazy trying to make everything – get some food at the deli or the gourmet shop. A lot of times, people don’t mind bringing a salad or dessert. The point is to get together and celebrate with people, rather than trying to make it perfect.
  • Traditions can be changed. This might be hard for people, but there are a lot of people who actually dread the holidays, and some of that may be due to the way they’re celebrated. Maybe you don’t have to always be at Great Aunt Sue’s house, even though she’s hosted the holiday for years. Think of these things as being fluid and when they’re outmoded or outdated, come up with some new ones.
  • Don’t let the details take over. It’s difficult to find the time to get everything done during the holidays, but it’s the people who are really important to you and those who take care of you, that you must remember. Try not to be so overwhelmed doing things like writing out Christmas cards that you can’t talk to your loved ones. Don’t brush people off because of the holiday madness.
  • Always thank people. Whether it’s in writing or in person, you must put gratitude at the top. There’s never an excuse for not thanking someone for an invite or gift.
  • Remember that the holidays are about connection with others, understanding and love. The best rule, year round, is to treat others how you like to be treated, and there is no exception to that rule, especially over the holidays!
  • Also, this Thanksgiving, do your best to practice the act of gratitude, regardless of who you are with or where you happen to be this holiday. While the feast seems to take center stage next to football, parades and crazy black Friday shopping, the true meaning of this holiday is to give thanks so make sure that you don’t forget to do so this year!

[Courtesy of Carolyn Scott-Hamilton,]