HELPING ARIZONA PARENTS RAISE HEALTHY KIDS AND TEENS
me Aweso e! rc resou tric ER a i d e P A d Kit First Ai
A better p int of Pediatric ERs can view make a difference A ‘dad’s perspective…’
…on being a ‘frequent ER flyer’ Fall 2013
ways to improve your child’s school performance
Your ONE- OF-A- KIND deserves the same in return.
We’ve made it easy to f ind the perfect Pediatrician. At Banner Children’s we make it easy to find exactly who you’re looking for. No matter where you live in the Valley, you can find a pediatrician near you. Just call 602-230-CARE (2273). That way you’ll be sure you have access to 30-plus pediatric specialties and kid-focused hospitals that are part of Banner Children’s.
(602) 230-CARE (2273) • BannerChildrens.com •
Sticks ’n’ stones…
long time ago, in a galaxy far, far away. I was a hot-tempered 6-year-old with a bushel of older brothers, one of which loved to get under my ‘thin’ skin. One episode in particular, he made some silly comment—probably about Jim the length of my ear lobes or Williams that I was hatched from an ostrich egg—and it was go Editor time. I took a mighty swipe and father at him that he easily dodged, of three though I did connect with the window in my parent’s living room, which promptly shattered. A piece of broken glass gashed my forearm, requiring a trip to the emergency room and a dozen stitches. And so it began. Over the next 10 years, I was stitched up dozens of times; I sprained ankles and I broke bones. In me, my parents were saddled with a rough-and-tumble child who was just a little bit accident-prone. (OK, more than a little bit!) However, I know they assessed each injury with the proper concern. I only wish I had their confidence. I’m thankful that none of my children, at least to this point, are as bumbling as I was. But if my genetic predication for accidental mayhem should rear its ugly head, you can be sure I’ll refer to Banner Children’s for help. Fact is, with every cut, burn or bump on the head, parents struggle with what is ER-worthy. Our cover story on page 6 speaks to some of these concerns, as well why pediatric ERs are a better choice for childspecific emergencies. We’ve also given you an ER First Aid Kit to address some of the more common crises parents face, and how to handle each one. Be sure to check out these resources as well as many other great stories in this issue of Total Kid. Don’t forget to download the Total Kid iPad app; it’s free! For details, go to totalkid.azcentral.com. • TK
Publication of Republic Media Custom Publishing. Cover Photo: Dr. William Schneider, with 7-year-old William Kalcevich of Surprise, in the pediatric Emergency Department at Banner Thunderbird Medical Center.
Contents Volume: 4 Issue: 2 – Fall 2013
A head case
A better point of view
Pediatric ER First Aid Kit
As fall activities gear up, it’s important for kids to get a baseline concussion test.
Assessing your child’s risk for developing Type 2 diabetes.
Pediatric emergency rooms offer child-specific treatment.
Should you go to the ER? Here’s a quick guide to common emergencies.
A dad’s perspective
Frequent trips to the ER give one dad a greater appreciation for pediatric staff.
5 easy ways to improve a child’s school performance Banner Children’s’ pediatrician offers timely tips.
Fit Kid Corner
“What we wish parents knew”
Kids activity page
Ready to take the Fit Kid Campus Challenge? Check out how to get healthy and stay fit!
Banner doctors offer helpful advice.
Some fun suggestions for fall activities. Plus, a kid-friendly recipe.
CREATED BY REPUBLIC MEDIA CUSTOM PUBLISHING FOR BANNER THUNDERBIRD MEDICAL CENTER AND CARDON CHILDREN'S MEDICAL CENTER VOLUME 4 NUMBER 2 FALL 2013 General Manager: Cami Kaiserfirstname.lastname@example.org Manager Creative Development: Isaac Moyaemail@example.com Editor: Jim Williams/JLWilliams@republicmedia.com Managing Art Director: Tracey Phalenfirstname.lastname@example.org Art Director: Miles Abernethy Contributors: Rick D'Elia, Nick Kostenko, Gremlyn Bradley-Waddell Total Kid magazine is published as a service to our friends and neighbors by Republic Media Custom Publishing for Banner Thunderbird Medical Center, 5555 W. Thunderbird Road, Glendale, AZ 85306 and Cardon Children's Medical Center, 1400 S. Dobson Road, Mesa, AZ 85202. Material in Total Kid is obtained from a wide range of medical experts and health-care authorities. If you have any concerns about specific items that appear in Total Kid, consult your personal physician. To order a copy or to stop receiving Total Kid magazine, call Cami Kaiser at Republic Media Custom Publishing, 602-444-6899. A division of Republic Media, 200 E. Van Buren St., Phoenix, AZ 85004, 602-444-1000
We exist to make a difference in people's lives through excellent patient care. For information, call 602-230-CARE (2273) or visit BannerHealth.com/BannerChildrens
ot a kid in sports or other recreational activities? Then take a wise preventative step and make an appointment for a BrainStamp at the Banner Concussion Center.
The Phoenix facility, which opened earlier this year, also offers a variety of testing and treatments for patients with concussions or mild traumatic brain injuries. But baseline testing, also known as BrainStamp™, is a smart move for any athlete, young or old, who hasn’t suffered any head trauma because it documents their normal brain function. And should the athlete suffer a concussion or other injury later, that neurological starting point helps doctors evaluate and treat the patient. “A baseline concussion test is like a fingerprint, if you will, of what someone’s neurological condition is prior to an injury,” says the center’s medical director, Steven Erickson, M.D., an internal and sports medicine physician who has worked extensively with youth, collegiate and professional athletes. “A BrainStamp is important because, whenever possible, we want to compare athletes to themselves before they were injured.” Nearly four million concussions are reported each year due to sports- and recreational-related injuries. Doctors do not believe a single well-managed concussion will result in long-term symptoms, but they know that multiple mismanaged concussions potentially can. The tests, which assess neurocognitive function, vision and balance, are available for anyone (including adults whose jobs or sporting activities pose a risk of physical injury are also urged to be tested) from age 6 and up.
Fees for individuals run $25 for the neurocognitive test or $50 for the full battery of tests. Computerized neurocognitive testing is performed utilizing ImPACT (Immediate Post Concussion Assessment and Cognitive Testing), an online computerized test that can be completed in less than 30 minutes. Although there are other neurocognitive testing programs available in the marketplace, ImPACT© is utilized by professional sports organizations, including the National Football League, National Hockey League, Major League Baseball and most National Collegiate Athletic Association schools. The testing evaluates the following neurocognitive functions: brain processing speed, memory, cognitive reaction time, and visual motor skills. This testing is used as an objective measure to determine neurologic recovery following injury, but it is most effective when a BrainStamp is available for comparison when an athlete suffers a concussion. The Banner Concussion Center is willing to assist any interested school or organization in instituting a BrainStamp testing program for their athletes, and Dr. Erickson hopes that coaches and athletic trainers choose to take advantage of this opportunity to have their student athletes baseline tested. “My desire would be for every club sport and every high school athlete to get the same care I’ve been providing to college and professional athletes for the last 10 years,” he says. • TK
A head case
Want to make an appointment for your child or your team? Call 602-839-7285. Or, for more information, check out BannerHealth.com/ BannerConcussionCenter
rizona’s wide open spaces promise all kinds of recreational fun, but one unfortunate result is accidents involving all-terrain vehicles, or ATVs. Even though the American Academy of Pediatrics advises against allowing children younger than 16 to ride the vehicles, the fact is ATVing is popular among many families and that leaves lots of kids at risk, says Tracey Fejt, R.N., injury prevention coordinator and outreach manager for Banner Children’s at Cardon Children’s Medical Center in Mesa. In 2010 alone, ATV-related accidents killed eight people, according to the Arizona Department of Health Services, resulting in hospital stays for 500 others and emergency room visits for another 1,900. While those figures don’t indicate how many victims were children, Fejt says the message is the same for all ages: Take safety precautions, and take them seriously. “We know families ride ATVs,” she says. “We just want them to do it safely.” The Southwest Alliance for Recreational Safety, of which Fejt is a founding member, makes the following recommendations: • Require each family member to take a class about ATV safety (classes are offered by the Arizona Fish and Game) • Always have adults supervise children • Never allow children to ride a vehicle driven by another child • Keep ATVs off paved roads; the tires are designed for dirt • Always wear safety equipment, especially a helmet; other recommended gear includes riding boots, a chest protector, elbow pads, gloves and motorcycle pants with built-in padding • TK totalkid.azcentral.com
I've heard diabetes is on the rise in children. What can families do to prevent these diseases?
Maria Corazon Hizon, M.D.
Maria Corazon Hizon, M.D. Pediatric endocrinologist at Banner Thunderbird Medical Center and a Banner Children’s specialist
Research shows childhood obesity is leading to more cases of Type 2 diabetes mellitus, but the good news is that lifestyle modification can reverse this unfortunate trend. Diabetes can be caused by the body’s inability to produce enough insulin or the body’s inability to use insulin due to insulin resistance, which leads to hyperglycemia. Type 2 diabetes is associated with accelerated weight gain and inactivity, but a healthy diet and exercise can prevent this condition. I always discuss healthy lifestyle changes with my patients’ families, alerting them to the risk of eating high carbohydrate, fatty foods and the importance of protein and portion control. I emphasize this is about teamwork, I avoid the word "obesity” and I urge families to give kids support. Lifestyle changes are hard to do alone. As for Type 1 diabetes, which primarily affects children whose bodies do not produce insulin, researchers are studying prevention methods. Nevertheless, it's evident that exercise and healthy eating habits go a long way, a good reminder in light of Nov. 14 being World Diabetes Day. • TK
Should I be concerned about my child’s frequent cough?
Jacqueline May Carter, M.D.
Jacqueline May Carter, M.D., Banner Health Clinic
Coughing is the body’s natural way of clearing the airway of an irritant, and an isolated cough once in a while is normal. But a cough that lasts longer than six weeks is a chronic condition that a doctor should assess. The biggest help in pinpointing the cause of the cough is the child’s medical history: circumstances surrounding when the cough first began, the time of day it occurs, how long it’s lasted and other symptoms. Generally, chronic coughs result from these three conditions: • Allergic rhinitis, an allergic reaction to dust, pollution, pollen or other irritant that irritates the nose or upper sinuses. Symptoms include a runny nose, itchy eyes and “wet” cough; • Early asthma, a condition not always accompanied by wheezing. It may feature a “dry” cough and no other symptoms; and • Reflux disease, or heartburn, which is caused by stomach acid coming up the throat. Associated with obesity, reflux happens more at night and may cause hoarseness or coughing the next day." • TK
A better point of view Pediatric emergency rooms offer child-specific treatment
By Gremlyn Bradley-Waddell hat’s a reason to choose a pediatric emergency department instead of a general one?
For some folks, it’s a tiny bundle of joy nestled in a crib. For others, it’s a teenage athlete on the field or pint-sized ballerina at a recital. It all comes down to kids and doing what’s best for them. “We only treat children, and we have pediatric emergency department specialists, nursing staff and Child Life specialists available 24 hours a day, seven days a week,” says Banner Children's James Reingold, M.D., medical director of the ER at Cardon Children’s Medical Center in Mesa, which along with the pediatric ER at Banner Thunderbird Medical Center in Glendale, has earned the state’s highest level of emergency pediatric care accreditation.
“Our experience and expertise in working with children, in addition to having the latest technology available, means we don’t need to do as much testing as a general ER, and that means a safer visit and that you’ll probably spend less time here.” In fact, William Schneider, D.O., medical director of Banner’s other pediatric emergency department in the greater Phoenix area, Banner Children's at Banner Thunderbird Medical Center in Glendale, says that unless their child is unconscious—in which case, they should head for the nearest possible ER—parents should opt for a child-centered facility over one geared more to adults. Because the fact is that children are not miniature adults and the way they react to disease isn’t necessarily the same as adults. Plus, there are childhood medical conditions that general ER-trained providers can potentially overlook. While the differences between a pediatric ER and a general ER are numerous, the most obvious one surely is the welcoming décor in the kid-friendly, Fall 2013
“We only treat children, and we have pediatric emergency department specialists, nursing staff and Child Life specialists available 24 hours a day, seven days a week.” —James Reingold, M.D., medical director, Cardon Children’s Emergency Department
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Dr. William Schneider (right) helps patients like William Kalcevich, 7, Surprise, feel at ease in the pediatric ER at Banner Thunderbird Medical Center. The hospital's specialized pediatric ER also provides a less institutional more comfortable, kid-friendly environment.
pediatric treatment areas and exam rooms: walls and furniture bursting with color, playful artwork, activity centers, video games to commandeer and treasure chests stuffed with toys. And the children’s programs playing on an almost non-stop basis on the TVs means pediatric staffers know their stuff when it comes to Elmo and Lightning McQueen, and that’s comforting for the younger set. Also comforting for both kids and their parents is the presence of Child Life specialists, health care professionals trained to work with families and children in hospital settings, who are available at every stage of the ER visit. Reingold and Schneider say other important differences patients will find at their ERs include fewer needle sticks because, for example, an experienced children’s specialist often doesn’t need to do blood tests on a child with a fever, and fewer tests such as CT scans and X-rays because not only are they often unnecessary for a diagnosis, they subject children to harmful radiation. There are better alternatives, totalkid.azcentral.com
Reingold says; children with appendicitis, for instance, often may be tested with an ultrasound instead. In addition, the adjacent inpatient pediatric beds at both hospital campuses and constant access to pediatric specialists means there’s no delay in care if a child needs to be admitted to the hospital or requires the care of a pediatric specialist, such as a pediatric surgeon. That can mean a lot—not only in terms of medical care, but also anxiety and time—in an emergency. And then there are the little touches the facilities offer to make kids’ experiences in the ER less frightening, like “ouchless shots,” which administer a bit of soothing anesthetic before an injection, or laughing gas for relaxation before a minor procedure like laceration repair. It’s those extra steps that make a big difference to a kid, and they’re not offered at most emergency departments. “We try to make the ER experience as pain-free as possible,” says Schneider. • TK TOTALKID
Feature n an emergency, even the most prepared parents can become seriously frazzled, especially when their child is the patient. So William Schneider, D.O., medical director of the pediatric ER at Banner Children’s-Banner Thunderbird Medical
Laceration (cut, any size) > When to go to the ER? • If bleeding won’t stop, tissue is visible or wound is gaping • If cut is on the vermillion border (where the skin and lip meet)
What to do at home/on the way? • Apply gentle pressure to area • Apply a light wrapping if possible
When to go to the ER? • Call 911 if patient’s lip or tongue are swelling, or if patient is having trouble breathing What to do at home/on the way? • OK to give Benadryl
When to go to the ER? • Call Poison Control at 602-253-3334 immediately for instructions • Call 911 if sleepy What to do at home/on the way? • Do not induce vomiting
Center, and James Reingold, M.D., medical director of Cardon Children’s Emergency Center, have put together a quick and handy guide to address many common emergencies and how to handle the situation on the way to the emergency room.
When to go to the ER? • If patient has difficulty breathing/cannot catch breath What to do at home/on the way? • OK to give an albuterol breathing treatment at home first • Carry rescue inhaler in vehicle and use if necessary
When to go to the ER? • Call 911 if burn covers a large area of body What to do at home/on the way? • For a simple burn, apply cool water only (no butter, steak, mustard, etc.) • Remove any clothing covering the burn • OK to give children’s ibuprofen
< INSECT BITE
When to go to the ER? • If any area is swollen or trouble breathing What to do at home/on the way? • OK to give children’s Benadryl and ibuprofen (or acetaminophen) together • Can put ice pack on affected area
WATER ACCIDENT (NEAR DROWNING) When to go to the ER? • Call 911 if patient requires CPR or is having trouble breathing • If persistent cough afterward
HEAD TRAUMA/ CONCUSSION
What to do at home/on the way? • Put on dry clothing and prevent any further access to pool
When to go to the ER? • Any broken bones should be evaluated at an ER • If bone is obviously bent, might want to call 911 so affected area can be splinted
When to go to the ER? • All head trauma patients should go directly to an ER—do not take to an urgent care facility, pediatrician or family provider • Call 911 if patient is not acting in a normal manner • If patient has headache or is vomiting, but otherwise is acting normal, it’s OK to transport by car What to do at home/on the way? • If patient is tired but otherwise acting normally, it’s OK for him to fall asleep • OK to give children’s acetaminophen; avoid children’s ibuprofen and aspirin
When to go to the ER? • Any child under age 5 should be evaluated at an ER
What to do at home/on the way? • OK to give children’s ibuprofen or acetaminophen for pain
What to do at home/on the way? • A large book, stick, board, or sling can function as a temporary splint (wrapping is not necessary) • Keep affected area elevated above heart • Apply ice to affected area • OK to give children’s ibuprofen or acetaminophen • TK
A Dad’s perspective
illiam Kalcevich is no stranger to the emergency room, mostly due to early childhood health issues but also as a result of being an active 7-year-old boy. His parents, Kristin and Matt, say their son has been seen about a dozen times in emergency departments around the country. But a recent visit—brought on by a collision in P.E. class, during which his left eye was accidentally scratched by a classmate’s fingernail—was markedly different from the rest in several positive ways. Matt says that’s because they ended up at in the pediatric emergency department at Banner Thunderbird Medical Center in Glendale, which has a welcoming, kid-friendly waiting room and compassionate staff who specialize in helping children. After a brief visual assessment and further inspection, William was diagnosed with a scratched cornea, given some ointment and sent on his way home to Surprise. He’s since fully healed. “Within a span of 75 to 90 minutes, he was seen, assessed and treated and we were informed as to what the next step in the process would be,” Matt says. “As many times as William’s had to go to the emergency room, this visit clearly stands out as one of the best, as well as the most efficient and most successful.”
easy ways to improve a
child’s school performance Banner Children’s pediatrician offers some timely tips
D 1 2
id your teen reveal over the summer how many times she fell asleep during last year’s first-hour class? Or maybe you recall how awkward it was to be the only fourth-grade parent who didn’t know which book the class was reading. With the school year just underway, now’s a great time to learn new habits and polish old ones so the kids in your life can put their best foot forward and improve their performance at school. Banner Health Center pediatrician Mark Pyle, D.O., offers these tips:
By Gremlyn Bradley-Waddell
Get involved! Research indicates kids do better in school when their parents are involved, he says. Talk with your child about the school day, find out what’s going on in class, make sure your child is completing homework and other assignments and communicate with teachers. Be positive! It takes 10 positive comments to counteract one negative comment, he says. Just consider all the negative things children hear at school, potentially for things like their appearance, grades or even shoes. “Our kids are our biggest investment,” he notes, so be positive with your child whenever possible. Spending special time alone with your kid is also important. He takes each of his three girls on a “daddy/daughter date” once a week, and the events don’t have to be extravagant; try a walk, bike ride or a movie at home.
Move it! Homework and extracurricular activities may swallow up a lot of time, but try to get kids involved in at least one hour of aerobic activity five times a week. Sneak in more exercise by having them walk the dog or take stairs instead of an elevator. totalkid.azcentral.com
Eat right! Start the day with protein—eggs/ egg whites, bacon or sausage (opt for turkey over pork), or even his kids’ favorite, bananas topped with peanut butter—and ditch those sugary, carbohydrate-loaded cereals and toaster pastries. For lunch, pack a meal from home because “rarely do schools offer healthy eating habits and, if they do, very rarely will kids choose the healthy ones over others,” he says. Wouldn’t you choose pizza over salad, too? Also, cut down on juice. Everyone over 2 years of age should drink skim milk or water and not much else. “If you want juice, eat an orange or an apple.”
Sleep soundly! Most kids ages 2 to 18 need 10 hours per night. But thanks to today’s myriad electronic devices, that’s not easily accomplished. To clean up your kid’s “sleep hygiene,” banish the TV from the bedroom and establish a time before bed when all devices are turned off and put away in the child’s room or—better yet—put in the living room or parent’s room for the night. Provide alternatives for your child to enjoy as they ready for bedtime, like listening to soft music, reading a book or drinking a glass of milk (just make sure teeth get brushed afterward). • TK TOTALKID
Fit Kid Corner
Take the Fit Kid Campus Challenge!
ey, students and school staffers! Think your school has what it takes to take on the Banner Children’s Fit Kid Campus Challenge? Then sign up for this exciting contest and help Banner Children’s find the Valley’s healthiest school! Your school just might win an awesome prize! Designed to promote healthy lifestyles, the campus challenge not only provides health tips from medical experts, fitness suggestions and motivational ideas but is also an outstanding way to build school pride. Just ask the folks at James K. Zaharis Elementary School in Mesa. The 50-member running club entered the challenge last year and ended up winning a free garden for the entire school to enjoy! Information on how you and your school can sign-up will be available in October at bannerhealth.com/banner childrensfitkid.You (or your parent) can also visit facebook.com/bannerchildrens and “Like” the page to receive Fit Kid updates on Facebook. Or, send a text message that says FitKids to 411987 on your mobile phone to receive Fit Kid updates via text. Banner Children’s, in partnership with News-Talk 92.3 KTAR and 98.7 The Peak, sponsors the Fit Kid program to Valley families and schools each year. Banner Children’s brings together pediatric medical services offered by Banner Health. With Cardon Children’s Medical Center in Mesa and Banner Thunderbird Medical Center in Glendale, and pediatric specialists and pediatricians across the valley, Banner Children’s has pediatric care covered valley-wide. With more than 30 pediatric specialties, Banner Children’s provides a wide range of services ranging from pediatric emergency rooms to highacuity health issues.
Shape up at Chandler Day of Play Mark your calendars for what’s shaping up to be the best health and wellness expo in Arizona! Chandler’s Day of Play, presented by Banner Children’s and Shape Up Arizona, is a free and fun, fitness-focused event from 9 a.m. to 1 p.m. Saturday, Oct. 26 at Tumbleweed Park, 2250 S. McQueen Road, in Chandler. Who’s invited? Everyone, from kids and teens to parents, teachers, seniors and the entire community! Along with entertainment, games, prizes and free tastings, there’ll be: bike helmets, courtesy of Banner P Free Children’s, for the first 500 kids stage performances, inflatables P Live and fitness stations
Banner Children’s Fit Kid Health Zone P The with tips and information from Banner Health medical experts • TK
For more information or to register, visit chandleraz.gov/ special-events, or contact Jyl Steinback at Jyl@ShapeUpUS.org or 602-996-6300. Fall 2013
“What we wish parents knew…” A candid discussion with 2 Valley pediatricians
here are a couple reasons why children should not drink much juice. People think fruit is healthy, which is mostly true, but the things that make fruit healthy are the vitamins and fiber it contains. When you juice fruit, you take out the vitamins, which are mostly in the skin, and the fiber, the pulpy material. What gets squeezed out is mostly acid and sugar, which are terrible for teeth. That sugar-filled juice is also high in calories, which no one needs and are especially harmful considering today’s obesity rates. So, my rule is no juice unless you’re constipated; otherwise, it’s water. Getting kids to only drink water is a lot about training and starting when they’re very young. For variety, kids can add a small amount of Crystal Light drink mix to water or opt for seltzer water or decaffeinated, sugarless iced tea. Milk is another option, but only low-fat (1% or skim) version for anyone older than 2 and no more than 16-20 ounces daily. Michelle Allen, D.O. Banner Children's — Banner Health Clinic in Mesa on Higley Michelle Allen, D.O.
hen it comes to protecting your child from germs at school, I think the best advice is to have your child get an annual flu shot. Vaccines usually are given starting in September, and the protection the vaccine provides goes a long way toward keeping your child healthy. It’s also important to teach kids to wash their hands properly, using soap and water, to suds up the hands and wash both sides. Hand sanitizers are helpful and kids can use them liberally, and most classrooms are stocked with sanitizing wipes that can be used on, say, a desk that gets sneezed on. Other good tips are to cough into your elbow so you don’t spread germs, sneeze into a tissue when possible and although sharing is a good thing in most instances, tell kids not to share pencils, food or drinks.
Wendy Lorenzen, M.D., Banner Children's —Banner Health Clinic in Queen Creek Wendy Lorenzen, M.D.
info to keep handy More health info for kids and parents:
BannerChildrens.com Banner Poison Control: bannerhealth.com/poisoncenter 800-222-1222 Facebook: facebook.com/bannerchildrens Sign up for our e-newsletter: bannerhealth.com/econnect Banner Children’s Fit Kid (info on fitness and nutrition): bannerhealth.com/bannerchildrensfitkid
Healthy alternatives for kids on the run
School is back in session, sports seasons are underway and other things are ramping up: kids’ appetites! Before they snag the processed and salty snacks after a hard day of learning, make it easier for them to make smarter snack choices by providing healthy alternatives like washed-and-ready-to-go veggies and fruit. And be sure to get kids involved in snack and meal prep when possible; it teaches them about food, nutrition, time management and self-sufficiency, to name just a few things. Older kids may be able to help with shopping and chopping, while younger kids can lend a hand with meal planning, washing foods and setting the table. To get your burgeoning chefs off to a good start, have them try either or both of these two simple recipes; adult supervision is suggested for the second one because it requires the use of an oven. The wrap is a satisfying after-school snack or a light dinner for one, and the dessertlike pizza is a mouthwatering snack or after-dinner treat for a crowd.
• 1 large whole wheat wrap, 11”—12” or 2 smaller wraps 8” • 1 tablespoon lite mayonnaise • 1 lightly packed handful rinsed baby spinach leaves • 1 tablespoon dried cranberries • 2 medium carrots, ends cut off, peeled and coarsely shredded • 2 slices reduced fat American cheese, 2 oz. • 2 thin slices store bought roasted turkey breast, 2 oz. Step 1 Lay the wrap on a work surface and spread the lite mayonnaise all over. Step 2 Sprinkle the spinach leaves, cranberries, and carrots evenly on top. Arrange the reduced American cheese and turkey in even layers over the vegetable layer. Fold in the side edges and then roll up snugly from the bottom. Step 3 Cut crosswise into 4 even pieces and wrap tightly in plastic wrap to store briefly in refrigerator. Source of both recipes: bannerhealth.com *Source: bannerhealth.com (link: healthlibrary.bannerhealth.com/ YourFamily/Children/HealthyChild/ Exercise/1,2945
Fresh Fruit Pizza
• 1 pound pre-made pizza dough • 1 tablespoon melted butter • 1 tablespoons sugar • 1 (8-ounce) package low-fat cream cheese at room temperature • 1/4 cup honey • 1 teaspoon finely grated orange zest • 1/2 teaspoon vanilla extract • Assorted fruit (blueberries, banana slices, mandarin orange sections, seedless grapes, kiwi fruit slices, and strawberry halves or any other favorite fruit)
Step 1 Heat the oven to 400° Step 2 Spread the dough in an ungreased 12-inch pizza pan. Brush on the butter and sprinkle one tablespoon of sugar. Bake the crust until it is golden brown about 12 to 15 minutes. Cool the crust on a wire rack. Step 3 In a medium-size bowl, combine the frosting ingredients with a rubber spatula. Mix until smooth. Step 4 Spread the frosting over the cooled crust. Gently press in the fruit. Serves 12.
It’s getting cooler, so get outside and enjoy the great outdoors! If you need some inspiration, consider these ideas: • Participate in community fitness events, such as charity walks or fun-runs. • Use family walks or bike rides as a time to do more than just exercise together. Talk about school and family issues when you're taking a break. • Plan outings that involve physical activity, such as going to a skating rink, the zoo, or a miniature golf course. • Turn chores into games. Have a water fight while washing the car or pretend you're digging for treasure while gardening. • Invite neighborhood kids to play games that require more participants, such as riding bikes or kickball.*
The peanut butter cookie looked so yummy that I forgot I was allergic.
THEN I REMEMBERED.
24/7 Pediatric ER care. Ouch-less shots. Kid-safe X-rays. Everything we do is focused on making things better for kids. Our entire team is trained to specifically help kids in emergency situations—including practicing the latest methods in calming a child’s fears. And if there’s care needed beyond the emergency room, we have more than 30 pediatric specialties available to you whenever you need them. We make it so comfortable your child may even forget what hurts. Isn’t that sweet? BannerChildrens.com/ER •
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This interactive magazine includes videos, photo galleries, kids games and recipes to help parents raise healthy kids. In this issue you will find: • Why it makes better sense to take your child to a pediatric ER • 5 ways to improve your child’s school performance • The first-ever interactive Total Kid ER First Aid Kit
GET IT NOW! totalkid.azcentral.com