Mother Knows Best Magazine

by Beth Palmer, RN, MSN, CPNP

 Choosing a pediatrician will be one of many important decisions that you will make as a new parent. Your pediatrician is the person whom you will turn to in times of extreme stress, such as 3AM fevers, earaches, bedwetting, and croup. If all goes well, your pediatrician will be an integral part of your child’s life from teething to teens. You should consider this choice an important one and not leave it up to a chance assignment in the hospital delivery room. 

With this being said, I suggest that you start your search for a pediatrician at the beginning of your third trimester of pregnancy. This will allow you time to research your potential choices. A good starting point in your search is your health insurance policy.  In today’s world of managed healthcare, you must ensure that your pediatrician is on your preferred provider list if you want to avoid those dreaded out of-network expenses. 

Next, you can ask your prenatal care provider for recommendations. Oftentimes, he/she will have a working relationship with several pediatricians and can offer professional insights. Additionally, friends, relatives, and coworkers can offer advice on choosing a pediatrician. Keep in mind that you want to look for a provider that is conveniently located, preferably close to home or work.

Once you have narrowed your search, consider the type of practice that you are looking for. Are you more comfortable in a small office practice or a larger group practice? Is the pediatrician’s age or gender important to you? Does he/she share your health care philosophies?

Finally, consider a prenatal consultation. This is not necessary for everyone, but for those of you with lots of questions or concerns, this might be a good option. Realize that there might be a nominal fee for this visit and that it will probably not be covered by your insurance policy.

When you call to arrange a prenatal consultation, first ask if the pediatrician is accepting new patients.  Pay attention to the person on the other end of the phone. Is she kind and respectful? Ask about appointments, office hours, and payment policies while you have her on the phone.

Once you arrive at the office, notice things such as parking availability and office cleanliness.  Are there separate waiting rooms for sick and well children? Talk with other parents while you are waiting.  Are they happy with the doctor? The office? The staff? What problems have they faced?

During your interview with the pediatrician, consider the following questions. Remember to prioritize your questions as your time with the pediatrician will be limited, and you want to address the most important issues.

QUESTIONS FOR YOUR PEDIATRICIAN CONSULT:
• How many physicians are in your practice?
• Who will see my child when you are not available?
• Do you have Nurse Practitioners or Physician Assistants in your practice? If so, how are they utilized?
• At which hospitals do you have staff privileges and do you admit patients?
• Are laboratory facilities on site? If not, where would my child go for lab work?
• Is screening for hearing and vision done in the office?
• When is the first newborn exam in the hospital? Will you be doing it?

There are certainly more questions to ask, but these are some of the most important. You should also explore the doctor’s attitudes about things that are important to you. For example, if you prefer the use of alternative health practices or traditional health practices, ask the pediatrician about his/her knowledge and feelings on the subject. If you have important cultural, ethical, or religious beliefs related to your child’s health care, discuss this with your pediatrician and assess his/her response. Remember, your choice of a pediatrician is an important one and no question is irrelevant.

My hope is that through thoughtful research and a prenatal consultation, you will find a pediatrician that will suit the unique needs of your family. The partnership between you and your pediatrician should be a comfortable one that will grow with your child and promote health and wellness for many years to come.

Beth Palmer is a Pediatric Nurse Practitioner and the owner of Baby Basics with Beth, a company in which she provides in-home newborn education to expectant and new parents. She lives in Savannah with her husband, Dr. David Palmer, of Southeastern Orthopedic Center, and their three children, Allison, Jonathan, and Sarah. To contact Beth, please call 429-3601 or email her at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

By Dr. Alan E. Smith

While most women know about and understand the importance of annual mammograms, there continues to be much confusion and misinformation about what tests women should routinely have to screen for cancers, and for precancers. We currently have tests to screen the general population for breast cancer, and cervical and colorectal precancers/cancers. We do not have (and should not recommend) tests to the general population that screen for ovarian, thyroid, and other cancers. Some high­risk patients should be screened for these cancers, but not the general population.

THE FOLLOWING IS RECOMMENDED BY THE AMERICAN CANCER SOCIETY (CANCER.ORG):

1. Cancer­related checkup. This includes periodic exams for those over age 20 that includes health counseling, and possibly exams for thyroid, oral, skin, lymphatic, and ovarian cancer. This is an exam only, without any specialized testing.

2. Breast cancer. Annual mammograms beginning at age 40, and clinical breast exams annually at age 40, periodically before that. Women with a greater than 20% lifetime breast cancer risk should get annual mammograms and breast MRI (ask your healthcare provider to assess your risk).

3. Colon and rectal cancer. Average risk patients should have one of the following beginning at age 50: flexible sigmoidoscopy every five years, colonoscopy every 10 years, barium enema every five years, or “virtual colonoscopy” every 5 years. I strongly recommend colonoscopy over the other tests to my patients. High­risk patients may need these tests earlier or more frequently.

4. Cervical cancer. Pap smears should begin within 3 years of onset of sexual activity, or no later than age 21. The test should be done annually to every 3 years, depending on age and history. New guidelines may come soon, since testing for HPV (the virus that causes cervical cancer and pre­cancer) has become widely available.

One important distinction to keep in mind is that while mammograms are designed to detect early cancers, Pap smears and colonoscopies are one step better. They optimally detect abnormal precan­cerous cells before they turn into cancer. Treatment for these precancers is typically much less inva­sive and more effective than treatment for the cancers they turn into.

One final topic: ovarian cancer. Much incorrect information has circulated regarding the CA­125, a test that helps doctors to decide whether a pelvic mass is cancerous, and to follow treatment in ovarian cancer patients. This test is NOT accurate enough to be used to screen the general popula­tion for ovarian cancer, and should NOT be offered to average risk patients without other signs or symptoms of ovarian cancer. Researchers are trying to find the magic test that can be used to screen for this cancer, but the CA­125 is clearly not that test.

 ■ Alan E. Smith, MD, a board certified Ob/Gyn with Savannah Ob/Gyn, has practiced in Savannah for 13 years. His office is located on the Candler Hospital campus, and he may be reached at (912) 355­8136. 

by Jamilyn Fussell

“How do you raise a child?” - “ How do you teach them to appreciate the little things?” These are questions that, as a mother, absolutely plague me. Like all parents, I want what is best for my children. I want them to grow to be happy, filled with the hunger for knowledge, to experience the magic of wonder, and the satisfaction of discovery.

When I think back upon the best memories of my own childhood, they aren’t centered around material objects, but rather, novel experiences. In my adult life, I realize that those adventures and everyday discoveries molded me into who I am today. There is so much that we can teach our children through thinking like children ourselves. That being said, I tried to imagine what would stand out in my mind, from my eldest child’s point of view. Coult is nearly six years old, and a very adventurous child. Some of the following is fact, some mere speculation as to what his memoirs would look like…

I got to walk down to Blackberry Creek with Mommy today. She lifted me up on top of her shoulders. It was so much fun! I love seeing the world from way up high.

Mommy and Daddy drew shapes in the dirt with a stick for me. We had fun playing, “name the shape”. Then they let me draw my own shape.

I got to use my own little rake to rake leaves today. AND Mommy let me dig my very own hole in the garden. I don’t usually get to do that outside of the sand box.

We made biscuits tonight from scratch. I got a little piece of dough to play with. I love the way it feels between my fingers.

I learned that you can’t water the plants with milk. I don’t understand, Mommy uses a milk jug to water plants. Maybe she puts water in it.

Daddy took me for a ride down a dirt road today… boy, it is bumpy! And fun. It makes your voice silly if you say,” Ahhhhhhhhh” going over the big bumps.

We dug worms in the garden today. I had a big collection. I learned that worms don’t stretch. I cried when one broke. I was really sorry.

I can run faster than the wind in my new shoes.

Daddy read to me tonight until I fell asleep. I love his big warm arms. He’s so warm and fuzzy.

My little brother giggles like crazy when I drag him down the hall on top of a towel. I love his baby giggles. They make me laugh too!

I learned how to make my bed today. It looks nice and neat like Mommy and Daddy’s. I’m going to try to get in with it still made.

I got to sleep in my tent tonight, on top of my bed, in my sleeping bag. AND it’s a school night!

My note from Mommy in my lunchbox today said, “You are my Sunshine.” I love that song. I sang it for my friends. Then we all sang it together.

We played “airband” in the car this morning on the way to school. I always get to be on guitar. Mommy plays drums and sings. My little brother nods his head to the music. I wonder if my Mommy knows how silly she looks.

The Golden Rule is very important. Even more important than washing your hands.

Marbles do not flush down the toilet. I wonder if anyone will notice?

Fireflies in a jar on my bedside table are one of my favorite things in the world.

My friends and I got to play in a big mud pit today. Mommy said, “Have fun, we’ll clean you up later” I loved it! I wish we had a mud pit in our back yard. It took forever to get all of the mud out of my, “nooks and crannys”

I wonder how Jesus and Santa know each other? Who is older?

Can elves make ANYTHING? If so, I want a bicycle-powered orange juice squeezer for Christmas. Why did Mommy laugh when I told her?

I love that I can be anything I want to for Halloween.

Mommy showed me a neat and easy way to make the letter,”A”. I think I’ll use it from now on.

What is the difference between dreams and awake? Mommy said both are very important, dream what you want to do and make it happen when you are awake.

It really is the little things that make impressions on our children. Gratefulness is learned through example. Love playing in the dirt, treasure laughter, embrace the magical, and work to make dreams come true.

Jamilyn Fussell lives in Union Point, GA with her husband Matt and sons, Coult and Pierce.  They have 2 black labs and a new white cat named Juno.

by Heather Feld-Gore

 Here are some fun cost-effective ideas for children's parties that will encourage them to think about others during the holiday season.  Use your imagination (and the internet!) to find the perfect party activity within these structures.

1-2 year olds:

Host a play date at your home and ask each toddler guest to wrap and bring a gently used toy that he/she can pass along to a friend.  You may want to establish an original price when new or otherwise  assign a value to the item in order to maintain some consistency.  Once all of the gifts are together, number them and allow each child to choose a number out of a hat that corresponds to a "new to them" gift to take home.

 3-5 year olds:

 Instead of exchanging gifts for the holidays, offer to host a Thanksgiving party or December holiday party that each child brings a new wrapped gift to.  Enlist the support of the childrens' families to bring a snack or beverage or a fun activity for the kids to participate in at the party.  One idea is to draw Hand Turkeys and assist the children in writing five things they are thankful for - one on each finger before they decorate them.  At the end of the party, the gifts are then donated to a local toy drive that same day.  Asking people to bring a wrapped gift allows them to purchase something within their price range to donate.

Grade School:

 Host a party for your child and friends.  Again, enlist the help of friends' families to bring food and beverage items and other party supplies.  Choose an age appropriate craft within your budget.  Ideas include decorating picture frames with beads and stones, jewelry, tree ornaments, door hangers, painting ceramic figurines, etc.  Children will draw each other's names out of a hat and create for that person. . . without telling who they have!  When everyone is finished, each child will present their gift to their friend.

Heather Feld-Gore lives in Savannah with her husband, Jeff, and two boys, Parker and Addison.  Her family spends their time at the park with their dog, Chelsea, reading, exploring, laughing and just being together.