How to explain Santa Fe High School shooting to kids

Another school shooting. How do we explain this to our kids? Sometimes it can feel like: “What can you say that you haven’t said multiple times this school year?”

In October, Jane Ripperger-Suhler, a child psychiatrist at Seton’s Texas Child Study Center, had this advice for parents about how much we should say about a shooting such as the one in Las Vegas that had happened at the time. It’s good advice for what has happened today.

Multiple fatalities have been confirmed at a shooting at Santa Fe High School in Santa Fe, Texas. KTRK-TV ABC13 via AP

We need to be careful about who is watching with TV with us and how we explain it.

“It really depends on the developmental level of the kids,” she says. Consider how you think your child will take what they see on TV, she says. “I wouldn’t watch a lot with preschooler.”

For kids already in school, you can watch some with them, but be prepared to talk about it and answer their questions. You can ask things like: “What do you think about this?” “What questions do you have?” Gage if they want to talk about it, but, she says, “I wouldn’t force them to talk about this.”

Dr. Jane Ripperger-Suhler is a child and adolescent psychiatrist at Texas Child Study Center.

Explain things in the simplest yet factual way you can. You could say “A kid walked into a school and shot students.”

You can focus on how you are feeling, that you’re upset and that you also don’t understand why this happened, but be careful about how you are reacting. “If a parent swoons or becomes frantic, a child is going to do likewise.”

Most importantly, remind kids that they are safe; that you will keep them safe, and when they are at school, their teachers will keep them safe.

If your child seems to be fixated on what happened in these shootings, you could encourage them to draw, build something or act something out, if they don’t want to talk about it.

If they don’t seem to be able to move on after a few days, are afraid to go to school, are too scared to go to bed, are having physical symptoms of stress or behavior problems, get them help sooner rather than later, Ripperger-Suhler says.

Be especially aware if a child has experience a trauma before. Watching this scene on TV will not cause post-traumatic stress disorder, she says, but it can be more traumatic and disturbing to some kids.

Ripperger-Suhler says it’s important to go about normal life. And that normal life means going to school.

If your child expresses some fear about it, reassure them that you will keep them safe.

“Parenting is hard, and it’s really hard when all this stuff is happening,” says Julia Hoke, director of psychological services at Austin Child Guidance Center. “We have to reassure them we are safe. It’s the thing you have to do.”

You also want to be authentic and genuine, she says, but you have to put up a wall and not show them the true depths of our fear and anxiety. “They are going to take the cue from us.”

Hoke has this advice for parents whenever there is an act of violence or terror — such as shootings in public places and schools or the bombings in Austin in March — “it really depends on the age of your kid.” Very young kids might not need you to say much of anything, she says.

For older kids, give them a simplified version of what is happening. Prepare yourself for what you are going to say and check your emotions before you talk to them.

“You’re going to check your own anxiety level,” Hoke says. “Our inhibition isn’t as good when we’re feeling stressed out ourselves.”

Many kids already will know what is happening because schools will be talking about it, their friends will be talking about it, and they have access to social media. They are looking to their parents and teachers to reassure them. “Your goal in talking to your child is making sure they are feeling safe,” she says.

Don’t go into graphic or gory details. “Even with older kids, you don’t want to overshare,” she says.

That also might mean you limit their access to TV news and social media right now. You might not want to have the news running in the background at all times. You’re trying to avoid exposing kids (and really yourself, too) to a secondary trauma.

“Generally when stuff like this happens, it’s important to maintain your normal routine as much as possible,” Hoke says. That doesn’t mean you ignore what’s going on.

Give them updates, but remind them that adults and law enforcement are going to do everything they can to keep them safe, but remind them that if they see something weird with one of their friends or classmates or are concerned about one of their classmates, they should tell an adult immediately.

RELATED: Five years after Sandy Hook, what has changed and what has not

 

Dell Children’s to open new mental health unit on Monday as it expands levels of care

On Monday, the first patients will be admitted into the new Grace Grego Maxwell Mental Health Unit at Dell Children’s Medical Center of Central Texas.

The center, which was made possible by a $3 million donation and matching grant from Nyle and Nancy Maxwell and their family in January 2017, is named after Nyle Maxell’s mother, a longtime volunteer at the hospital.

“As with most families who are challenged with raising children in this complicated environment we have today, mental health is a challenge,” said Maxwell, former Round Rock Mayor and owner of the Nyle Maxwell Family of Dealerships, when his family announced their donation. “My family is not immune to this.”

Dr. Sonia Krishna, a child and adolscent psychiatrist, shows an examination room at the Grace Grego Maxwell Mental Health Unit at the Dell Children’ss Medical Center of Central Texas. JAY JANNER / AMERICAN-STATESMAN

The opening of the 24-bed mental health hospital unit means that children with mental health diseases can be treated at the same facility as children with physical diseases.

“The biggest thing is we are really destigmatizing mental illness,” says Dr. Sonia Krishna, a child and adolescent psychiatrist at Dell Children’s. “It’s on the same plane as children getting treatment for physical illness. It’s another pediatric problem.”

Previously, children needing hospitalization for mental health diseases would come to the emergency room at Dell Children’s and then be transferred to the pediatric and adolescent unit at Seton Shoal Creek Hospital or another hospital. That unit at Shoal Creek accepted its last pediatric or adolescent patient on Thursday morning. Those remaining in that hospital over the weekend will be moved to the new unit at Dell Children’s on Monday. In the meantime, patients are being referred to other mental health hospitals throughout the area.

Seton Shoal Creek will become an adult-only facility on Monday. Seton has not determined what the now-empty unit at Shoal Creek will become. The long-range plan is for a new adult hospital.

The Grace Grego Maxwell Mental Health Unit at the Dell Children’s Medical Center of Central Texas will open on Monday. JAY JANNER / AMERICAN-STATESMAN

The new unit at Dell Children’s was both an addition and a remodel of existing space. The unit has a separate entrance and waiting room that will be staffed 24-hours a day. Physicians can now directly admit patients to the unit rather than patients having to go through the emergency room.

“The emergency room is not necessarily the best environment for kids in crisis,” says Angela Nguyen, the clinical manager of behavioral health and therapeutic services at Dell Children’s. It can be a scary place, she says, and it also can expose them needlessly to germs.

Patients also previously had to transition to another space for care, which was an added expense to families as well as added time before children got the right type of care they needed.

Now, families will be able to be go to that separate entrance, be assessed in one of four consultation rooms and be either admitted for inpatient care or accepted into the new intensive outpatient program or partial hospitalization program that will be on-site or accepted into a less-intensive outpatient program such as the Texas Child Study Center, which is connected to Seton and the University of Texas.

The Texas Child Study Center is expected to move to a location either on the hospital property or nearby by the end of the year, Nguyen says. Other Seton-affliated mental health physicians and psychologists will continue to deliver outpatient care at centers throughout the community, so that families don’t have to necessarily drive to Dell Children’s for that care.

In the new mental health unit, the assessment and referral should happen within two hours of arriving at the hospital, Nguyen says. Instead of just being given a set of numbers to call if a child doesn’t need to be admitted, families will be given “a here’s where you’re going to be going,” Nguyen says.

Patients who need physical medical attention because of self-harm or who are in imminent physical danger will be admitted to the hospital until that need has subsided.

If children do need to be admitted to the mental health unit for what is typically a four- to five-day stay, they will receive a continuity of care as they step down levels of care. They will see the same group of physicians who are sharing the same records, rather than having to go somewhere else.

“We’re focusing on integrated care,” Nguyen says. “The right place at the right time.”

The unit is not expected to reach capacity during the summer, which is the slowest time of the year for mental health intake cases as well as hospital intake cases in general, Krishna says. Fall and spring tend to be the busiest times of the year for cases, she says, and when it does reach capacity, doctors will do what they currently do and find patients placement at other area hospitals, or if they know a bed is about to become available, have them stay in another part of the hospital temporarily.

The inpatient unit will be divided by age — 6-12 and 13-17. It was built with the ability to separate areas and change how many of the rooms are for each age group based on need. The unit has spaces for group therapy as well as quiet and not-so-quiet activities. All the rooms have psych-safe furniture that is bolted down, but the unit was designed to be light and airy and not feel like a bad place to be, Nguyen says.

Rooster Teeth donated the unit’s healing garden, which will have a shaded basketball court, space for noisy activities and more quieter activities as well as the potential for raised gardens for kids to plant.

The intensive outpatient and partial hospitalization side has room for two to four groups of eight to 10 kids in each group at one time.

The new center will allow Dell Children’s to also expand care in specialized areas such as substance abuse treatment and eating disorders. The needs and where to put the focus is still being assessed, Krishna says.

“It’s going to be a really great experience,” Nguyen says. “We’re all going to be here under one roof. Everyone is excited to make sure kids have a great experience.”

Get inspired by the royal wedding with these fun kids activities this weekend in Austin, May 18-20

While you watch the royal wedding on TV , your kids can be enjoying a story time all about a “Wedding of the Century.” And while proud parents will be celebrating graduation at the University of Texas, you can give your kids a love of education at the Summer Reading Splash!

These are just some of the events happening this weekend. Look for a great weekend with highs in the low 90s, and only some rain on Sunday morning.

“Fancy Nancy and the Wedding of the Century” will be read at Barnes & Noble.

The 2018 Summer Reading Splash! Authors including Newbery winner Kate DiCamillo and Bluebonnet winner Max Brallier will be in attendance. 10 a.m.-3 p.m. Saturday. Free. Austin Independent School District Performing Arts Center, 1500 Barbara Jordan Blvd. 5bookdive.org

BookPeople events: Cat Berry: “Penguin & Tiny Shrimp Don’t Do Bedtime!” 2 p.m. Sunday. BookPeople, 603 N. Lamar Blvd. bookpeople.com

Tweens Night Out at Color Me Mine! Play games, paint and have pizza. $35. 6 p.m. to 9 p.m. Friday. Color Me Mine! 13500 Galleria Circle, U-110, Bee Cave. beecave.colormemine.com.

Parkapalooza. Live music, kids activities. Free. 11 a.m. to 3 p.m. Saturday. Easton Park, 7000 Cardinal Bloom Loop. parkapalooza2018.splashthat.com

Thinkery. Baby Bloomers: Away We Go. Learn about things that take flight. 9 a.m. Saturday. For birth to age 3. $5. Thinkery, 1830 Simond Ave. thinkeryaustin.org

Thinkery. Soap Making. Ages 4 and older. 10:30 a.m., noon, 2 p.m. or 3:30 p.m. Saturday and Sunday. $8. Thinkery, 1830 Simond Ave. thinkeryaustin.org

Zach Theatre presents “Goodnight Moon.” The classic children’s book comes to the stage. 11 a.m. and 2 p.m. Saturdays and 2 p.m. Sundays through May 27. $18-$24. Kleberg Stage, 1421 Riverside Drive. zachtheatre.org

Pollyanna Theatre. “The Secret of Soap & Spin.” 10-year-old Vic finds magic in the laundromat as his mother goes missing. For grades second through fifth. 2 p.m. Saturday and Sunday. $10.50-$12. Long Center, 701 Riverside Drive. pollytheatre.org

Barnes & Noble 11 a.m. Saturdays, story times at all locations: “Fancy Nancy and the Wedding of the Century.”

Kids Create: Make Art Like Alma Thomas. 2:30 p.m. Friday, Yarborough Branch.

Summer Camp Resource Fair. 1 p.m. Saturday, Carver Branch.

El día de los niños/El día de los libros Celebration. 11 a.m. Saturday, Pleasant Hill Branch.

Teen Harry Potter Club. 2 p.m. Sunday, Central Library.

“Harry Potter and the Sorcerer’s Stone” began the book and movie series.

 

Dell Medical School, Seton lessen amount of opioids given to women after childbirth

Doctors at Dell Medical School at the University of Texas and at all Seton Healthcare Family hospitals are rethinking they way they treat mothers for pain after a Cesarean section or a vaginal delivery.

The new protocol has decreased the use of opioids by more than 40 percent while new moms are in the hospital. “We changed the way we want to manage pain,” says Dr. Amy Young, chair of the Department of Women’s Health at Dell Medical School and head of Women’s Health at Seton.

Dr. Amy Young is chair of the Department of Women’s Health at Dell Medical School at the University of Texas.

Beginning in February 2017, Seton and Dell Medical School changed the questions doctors and nurses asked about pain level, the way they measured that pain level and the way they gave out pain medication.

The hope was that they could lessen the amount of opioid medications given after birth to then lessen the possibility of addiction later.

The opioid epidemic continues to affect thousands. (Dreamstime)

In 2012-2015 in Texas, drug overdose was the No. 1 cause of accidental death in women within a year of giving birth, according to state Department of Health Services. That same study found that more than half of those overdoses involved an opioid.

Now instead of asking moms to rate their pain on a scale of 1 to 10 or to look at a series of smiley and not-so-smiley faces, doctors and nurses are asking moms how they are doing with functional activities such as the ability to get up and go to the bathroom and the ability to sleep comfortably.

The previous pain scales were subjective, Young says. “I’m a big gigantic ninny when it comes to pain,” she says. “I’m terrible at it. My 1 might be your 10.”

Using the number scale might mean that a mom might say she was a 3 and be given one pain regimen, but really her pain was the same as another mom’s 7, who got a different pain regimen.

Now doctors and nurses are automatically giving moms a combination of acetaminophen (Tylenol) and ibuprofen (Advil) every six hours, unless they are allergic or don’t want it. Those two drugs work differently when it comes to how they control pain. Nurses also aren’t waiting for a woman to be in pain before giving her those medications.

What doctors and nurses found was that for many women, that was enough. They didn’t need the narcotics. For other women, who still reported pain when trying to do functional things, they were first given oral hydrocodone. If that still didn’t do it, they are given an intravenous pain medication like morphine.

Women who had had C-sections were more likely to need more than the acetaminophen/ibuprofen combination than those who had a vaginal birth.

RELATED: Dell Medical School is expanding a program to treat disorder that 40 percent of women experience

They also watched how patients rated their pain management in surveys. The hospital and school actually found those numbers either stayed the same as before they changed the protocol or improved slightly.

“This was a culture change,” Young says, “that took pretty embedded prescribing practices and changed them.” The fear was that patients would be in pain or that the acetaminophen/ibuprofen combination wouldn’t be enough, she says.

The change means that more moms aren’t leaving the hospital with the side effects of opioids such as constipation, feeling sedated and not being able to care for their babies because of that, or having withdrawal symptoms, she says.

“Any reduction that you can make (in opioid use in the hospital) should translate into a reduction in outpatient utilization,” Young says. “It’s a reduction of the number of narcotics floating around. It’s my little tiny place in the fight.”

A future study will look at opioid use after birth to compare what doctors are prescribing patients as they leave the hospital and what they actually fill and use.

Other hospital systems are looking at what Seton has done and some have even adopted Seton’s protocol, Young says. She plans to publish a paper on what they found in changing the pain protocol.

RELATED Study: Number of kids treated for opioids in hospital intensive care units doubled

RELATED: American Academy of Pediatrics reports: Kids are addicted to opioids, too

Parents, put off tackle football as long as possible, study suggests

Parents of kids who play football or who are thinking about playing football this fall, you might want to pay attention to a new study published in the “Annals of Neurology.”

The study from researchers at Boston University looked at donated brains from 246 football players. 211 of them had signs of CTE — chronic traumatic encephalopathy. That’s the disease that causes mood swings and dementia and causes former football players to either take their own lives or die from the symptoms.

The researchers looked at their brains to diagnose them for CTE, but they also asked people who knew the players at what age they started playing tackle football.

The players who started playing tackle football before age 12 reported functional impairment at a younger age than those who started playing tackle football later in their teen years. The age the players first played tackle football did not predict the severity of the disease, though.

“The data is reliable and should be looked at and considered very seriously,” says Dr. Michael Reardon of Child Neurology Consultants of Austin.

This study, he says, is another reason to be more concerned about all kids playing a sport like football, not just the ones that show up in his office with a concussion.

“Isolated episodes in which we are able to diagnose a concussion might not be as significant or important as the repetitive blows to the head over time even if they are not reaching the threshold of concussion,” he says. “The more often there are blows to the head and the harder they are, the more likely the brain might be affect by that.”

Many kids play football starting from a young age, but new research points to brain injury symptoms showing up earlier in people who played tackle football before age 12. American-Statesman 1997

Even players that have never been diagnosed with a concussion have had signs of a slowing of cognitive function, he says.

Why aren’t we seeing the same level of impairment with other sports like basketball or cheerleading or volleyball, which both have a high rate of concussion? Reardon says that while basketball players sometimes run into one another head first by accident, they aren’t doing it at every single play. “It’s more of a rare event,” he says. “They can go weeks or months between episodes.”

RELATED: Girls in sports have high rate of concussions, longer recoveries

That doesn’t happen with tackle football.

Reardon also worries about kids playing tackle football in the late elementary school and middle school ages because of the size differences among players. Some are bigger and more like high school players; some haven’t developed yet and are more like early elementary school players. Also, the head, neck and shoulders have not fully developed yet, creating more danger with each accelerated hit.

For kids who think that they are safe because they are wearing a helmet, Reardon says that a helmet does nothing to absorb the blow of a hit. Instead, it protects against a skull fracture but not a concussion or CTE. There are shock-absorbing materials being developed, but not for today’s helmets yet.

Jim Hudson, a former Longhorn and safety for the Jets, died in 2013. A postmortem study of his brain recently found that Hudson had chronic traumatic encephalopathy. RICARDO B. BRAZZIELL / AMERICAN- STATESMAN 2014

A helmet and face mask also can add to the risk of concussion or CTE, he says, because players feel invincible inside their helmet and face mask and might hit harder than if they weren’t wearing them.

“All evidence that’s mounting points to the idea that having a career in football is hazardous to your health,” Reardon says. “It’s bad for the brain.”

What is a parent of a child who loves playing football supposed to do?

  • Try to put off and encourage coaches to put off tackle football for as long as possible — at least until middle school, Reardon says.
  • Ask coaches to put off the amount of direct contact between players during drills at practice.
  • Find a team that doesn’t require players to play both offense and defense. You want to give the brain breaks between plays.
  • Remind kids that they need to sit out if they feel like they “got their bell rung” or are dizzy between plays or have blurry vision.
  • Find coaches that are actively looking for signs of concussion or other signs of trauma to the brain.
  • Find a sport like cross country or track for middle-schoolers that is a non-contact, no-collision sport.

RELATED: 20 percent of teens said they have had a concussion

RELATED: Are kids who only play one sport risking an injury?

RELATED: Austin company Brains Worldwide develops iPad concussion screening

Dell Medical School study helping prevent future strokes by combining drugs

Good news out of the University of Texas Dell Medical School:

A new treatment of combining two drugs after having a mini stroke or transient ischemic stroke has been shown to lower the risk of having a major stroke, heart attack or death by 25 percent in the next 90 days. The international study of 4,881 adults in 10 countries was published in The New England Journal of Medicine.  Dr. Clay Johnston, dean and professor of neurology at Dell Medical School was the lead author.

The study combined clopidogrel also known as Plavix and aspirin. The study compared using the combination drug and using just aspirin.

RAPID CT perfusion scan allows doctors to see what area of the brain and how much it is being affected by a stroke.

In a press release Johnson said, “The study gives us solid evidence that we can use this drug combination to prevent strokes in the highest-risk people, but not without some risk of bleeding.”

The study did show that for every 1,000 patients, there were five extra major bleeds but 15 fewer strokes or other “major ischemic events” within that 90 day period. Because the bleeding events are generally reversible, the overall benefit outweighs the risk for most patients, Johnston said in that press release. More than half of the 33 major hemorrhages that occurred were in the gastrointestinal track. No one died because of the bleeding, and the bleeds were thought to be preventable and treatable, and worth the risk.

Having a minor stroke or a TIA means that a person has a 3 percent to 15 percent chance of having a more severe stroke in the next three months, typically. The American Stroke Association estimates that more than a third of U.S. adults have had TIA symptoms.

“It’s likely we will see more patients who have had a TIA or a minor stroke receiving the combination of clopidogrel and aspirin in the future,” Johnston said in a press release. “If you’ve suffered from a minor stroke or TIA, it’s important to see a physician immediately, even in the emergency room, to ensure you’re taking steps to avoid a potentially debilitating stroke later on,” he said. “There are several tests that need to be done right away to determine the cause of the event and to make sure the best treatments are started as soon as possible.”

RELATED: Technology allows doctors to treat, reverse stroke damage within six hours

RELATED: Austin Speech Labs helping stroke patients speak again

What’s the best sunscreen? We put more than 20 to the test

Last year, I put 16 mosquito repellents to the test, and found some definite winners — and some losers.

This year, I grabbed 21 sunscreens of various types and tested them. I have very fair skin (ghostlike, my family says) and burn easily. I tried the sunscreens while gardening, while going for a long hike in the middle of Austin in the heat of the day (don’t try this at home) and while swimming at the pool.

Know which sunscreens work best and what to look for in a sunscreen. AMANDA VOISARD / AMERICAN-STATESMAN photos

I also rotated which area of the body each one covered to make sure that each sunscreen got an opportunity to be on both the upper body and lower body, except the ones that were made especially for the face. I tried ones that sprayed on, foamed on, slathered on and apply like deodorant. Some were all natural, some had chemicals by the dozen; some were sunblock rather than sunscreen. They had SPF (sun protection factor) of 21 to 100. Was there a difference?

The good news: All of them were better than nothing at all. The patches of skin left bare definitely reddened.

[cmg_anvato video=”4394829″ autoplay=”true”]

See how we rated them:

Baby

Badger Baby Chamomile & Calendula

Type: Very thick cream

Price: $11.48 with $2 off coupon

SPF: Broad spectrum SPF 30

Ingredients: Zinc oxide, plus sunflower seed oil, beeswax, chamomile, calendula extract, seabuckthorn fruit extract. The tube says it is non-GMO, biodegradable, 98 percent organic, 100 percent certified natural.

Water-resistant: Yes, up to 40 minutes

Scent: Light floral scent

Does it work? Yes. Badger baby was one of the best-performing. It was definitely water-resistant and sweat-proof. It was one of the few spots where there was no coloration of the skin, except the white residue left by the cream. The cream was a bit hard to spread because of its thickness. We could definitely tell where we put it. The scent was OK, but with all those floral ingredients, we expected it to smell better.

Would we use it again? Yes, especially on someone who is fair-skinned or a baby.

Banana Boat Simply Protect Baby

Type: Mineral-based lotion

Price: $7.92

SPF: Broad spectrum SPF 50+

Ingredients: Titanium dioxide, zinc oxide. The tube says there are no oxybenzone or parabens, no added oils or fragrances, but there are plenty of glycerides and other chemicals listed in the inactive ingredients.

Water resistant: Yes, up to 80 minutes

Scent: Light sunscreen scent.

Does it work? Yes. It was definitely sweat-proof and water-resistant, but it does not rub in or remove easily with soap and water. Days later, my back is still white from where this sunscreen is lingering. It also was not as thick as some sunscreens so it got everywhere, including my car seat.

Would we use it again? Maybe. The great thing is it really works, but with it getting everywhere and being hard to get out, we’re a bit hesitant.

Coppertone Water Babies Pure & Simple Whipped

Type: Mousse-like whipped sunscreen

Price: $9.97

SPF: Broad spectrum SPF 50

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus various alcohols, acids and other chemicals. The bottle also says it is free of fragrances, parabens, oils, dyes and PABA.

Water-resistant: Yes, up to 80 minutes

Scent: Very light sunscreen smell

Does it work? It definitely let some reddening of the skin happen. It also was not sweat-proof at all, and we didn’t experience any water-resistance qualities.

Would we use it again? Probably not. We loved the concept of the whipped sunscreen, but it was incredibly hard to unlock the cap and press down on the top to squirt out the mousse. It also got all over clothes, but it did rub in better than some of the other baby lotion.

 

Kids

H-E-B Solutions Kids

Type: Lotion spray that sprays white for no missed spots

Price: $6.75

SPF: Broad spectrum SPF 50

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus a lot of other chemicals as inactive ingredients. The bottle says it is hypoallergenic and dermatologist tested.

Water-resistant: Yes, up to 80 minutes

Scent: Light sunscreen scent

Does it work? Not well. This spray was goopy and gross, which made it hard to spray on hard-to-reach areas. It got everywhere. It also did not protect from pigment changes. In fact, each time, the area where we used this spray was one of the most burned areas. It was definitely sweat-proof, but not as effective on water-resistance after a trip to the pool.

Would we use it again? A big no.

Alba Botanica Kids Sunscreen tropical fruit

Type: Cream

Price: $5.99 with $2 off coupon

SPF: Broad Spectrum SPF 45

Ingredients: Avobenzone, homosalate, octocrylene, octyl salicylate, plus natural oils and extracts, as well as oils. The tube also says it is tear-free, gluten-free, biodegradable, with no oxybenzone, octinoxate or animal testing, and with natural fragrances.

Water-resistant: Yes, up to 80 minutes

Scent: Very light scent, not fruity.

Does it work? There was definitely some color change, but not as bad as with others. It was easy to apply, rubbed in nicely and didn’t leave that white residue. It did fine with handling sweat. It wasn’t particularly water-resistent, but it also didn’t come off in the pool, either.

Would we use it again? Yes, because it was so easy to apply, but it’s not the most effective one we tried.

Sport

Banana Boat Sport sunscreen stick

Type: Sunscreen stick with Powerstay Technology

Price: $7.92

SPF: Broad spectrum SPF 50+

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, plus some other chemicals and cocoa butter.

Water-resistant: Water and sweat up to 80 minutes

Scent: Very light.

Does it work? We did have some skin color change, but not a lot. It was some of the most water-resistant and sweat-resistant of the group. It was easy to use and didn’t feel tacky at all. In fact, you could hardly tell you had it on.

Would we use it again? For ease of use, yes, but we would go over the area a couple of times. Also, it’s unclear how much of the body you could cover before you would run out.

Neutrogena CoolDry Sport sunscreen stick

Type: Sunscreen Stick with Micromesh

Price: $9.97

SPF: Broad spectrum SPF 50+

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, also some beeswax, plus parafin and chemicals.

Water-resistant: Water and sweat-resistance up to 80 minutes

Scent: Strong scent that’s nice, but might be overpowering on the whole body

Does it work? No. This area had some of the most color change. It did have some excellent water-resistance, but wasn’t particularly sweat-proof. It also was tacky to the touch and hard to see where it went on.

Would we use it again? No. We love the idea of a sunscreen stick for ease of use, but it didn’t work as well as the Banana Boat version.

No-Ad Suncare 30 Sport

Type: Sunscreen

Price: $6.97 with a $2 coupon

SPF: Broad spectrum SPF 30

Ingredients: Avobenzone, homosalate, octisalate, oxybenzone, plus some alcohol, glycerin and a lot less other inactive ingredients than most. It says it is paraben-free, fragrance-free and oil-free.

Water-resistant: Water and sweat-resistance up to 80 minutes.

Scent: It has a heavy sunscreen scent.

Does it work? Yes. We did not notice a color change any time we used it. It stayed on with sweat and water, though it wasn’t noticeably water-resistant.

Would we use it again? Maybe. It worked, but was cold when it went on and slightly greasy. The smell was like wearing a walking billboard for sunscreen.

Neutrogena CoolDry Sport sunscreen spray

Type: Spray

Price: $10.97

SPF: Broad spectrum SPF 70

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus some other chemicals.

Water-resistant: Yes, up to 80 minutes, plus it says it “stays on through sweat”

Scent: It smells like a French perfume in a good way.

Does it work? We saw some color change. It was the easiest spray to use, though. When you do use it, get ready to jump. It’s really, really cold when it touches the skin. It also was a little greasy. We didn’t notice any particularly great water-resistance or sweat-resistance.

Would we use it again? Probably not. We wanted it to work better as a sunscreen. It was the easiest to use spray, though.

Goddess Garden Organics Sport

Type: Cream

Price: $12.98

SPF: Broad spectrum SPF 30

Ingredients: Titanium dioxide and zinc oxide, with some shea butter, coconut oil, safflower seed oil and sunflower oil. It calls itself a “natural sunscreen” with organic ingrediants, and says it has no chemical sunscreen.

Water-resistant: Yes, for 80 minutes.

Scent: I thought it was smelly; my husband thought it smelled good.

Does it work? Yes, there definitely was no skin color change with this sunscreen. It definitely had water-proofing and sweat-proofing abilities.

Would we use it again?Probably not. It was definitely one of the best sunscreens as far as efficacy, but it left a white residue and was smelly. It also never fully rubbed into the skin and left its mark on the seat of the car.

Hawaiian Tropic Island Sport Ultra Light

Type: Cream lotion

Price: $7.92

SPF: Broad spectrum SPF 30

Ingredients: Avobenzone, octocrylene, oxybenzone, plus fruit and flower extracts, shea butter, mango seed butter, paraffin, alcohol and chemicals. It says it is oil-free and breathable, non-greasy and won’t clog pours.

Water-resistant: Water- and sweat-resistant for 80 minutes.

Scent: Smells nice, though sunscreeny.

Does it work? Somewhat. There was definitely a color change, but it wasn’t particularly bad. It definitely had water-resistance properties.

Would we use it again? Maybe. It was some of the nicest feeling of the creams and rubbed in well. It left the skin with a cool feeling and wasn’t sticky. It’s performance was a bit disappointing.

Regular adult sunscreen

H-E-B Solutions Sunscreen Ultra Protection

Type: Clear spray

Price: $8

SPF: Broad spectrum SPF 100

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus some oils, flower extracts, and some chemicals.

Water-resistant: Yes, up to 80 minutes

Scent: Stinky sunscreen smell.

Does it work? No. Despite it being SPF 100, when we used it, the area had some of definite color change. This was also the only area where the burn actually hurt. It wasn’t particularly sweat-proof or water-resistant.

Would we use it again? No. It didn’t work, plus it was very oily and runny and hard to put on. It left the skin oily.

Neutrogena Beach Defense Water + Sun Protection

Type: Cream lotion

Price: $8.97

SPF: Broad spectrum SPF 70

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus water, alcohol, and more chemicals. It says it is oil-free and PABA-free.

Water-resistant: Yes, up to 80 minutes

Scent: Nice, light scent.

Does it work? It worked better than some of the others, but there was still some color change. It wasn’t particularly water-resistant or sweat-proof. It felt good, but made the skin look oily.

Would we use it again? Yes, but there are better sunscreens out there.

SunBum premium moisturizing sunscreen spray

Type: Light-mist spray

Price: $15.99

SPF: Broad spectrum SPF 50

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, plus a few other inactive ingredients including vitamin E-enriched. It says it is paraben-free, oil-free, PBA-free, hypoallergenic, vegan, cruelty-free, gluten-free, oxybenzone-free, non-comedogenic and retinyl palmitate-free.

Water-resistant: Yes, to 80 minutes.

Scent: Smells like sunscreen.

Does it work? Yes, it provided some of the least amount of skin color change. It didn’t have particularly noticeable water-resistance, and it wasn’t sweat-proof. The mist made it difficult to see if it was covering, but the sticky residue left behind helped us figure that out.

Would we use it again? Yes, but the price was a bit prohibitive. Also we could have done without the stickiness.

Hawaiian Tropic Anti-oxidant sunscreen lotion

Type: Moisturizing lotion

Price: $7.92

SPF: Broad spectrum SPF 30

Ingredients: Avobenzone, homosalate, octisalate, octocrylene and some alcohol and oils, flower and fruit extracts, plus green tea extract. It promises to help prevent skin damage and skin aging from the sun.

Water-resistant: Yes, up to 80 minutes

Scent: Nice fruity, floral, coconut scent.

Does it work? Yes, we didn’t see much color change. It out-performed some of higher SPF sunscreens.

Would we use it again? Yes, it rubbed in well, wasn’t greasy, smelled great, and left a nice cool feeling.

SunBum premium moisturizing sunscreen lotion

Type: Moisturizing lotion

Price: $14.99

SPF: Broad spectrum SPF 30

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, plus a few other inactive ingredients including vitamin E-enriched. It says it is paraben-free, oil-free, PBA-free, hypoallergenic, vegan, cruelty-free, gluten-free, oxybenzone-free, non-comedogenic and retinyl palmitate-free.

Water-resistant: Yes, up to 80 minutes

Scent: Nice light coconut scent

Does it work? There was a noticeable color change. It wasn’t particularly water-resistant or sweat-proof.

Would we use it again? No. It was very watery, yet it didn’t rub in very well and went everywhere. It left a glistening residue.

Neutrogena Hydro Boost water gel lotion sunscreen

Type: Water gel lotion

Price: $10.97

SPF: Broad spectrum SPF 50

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus water, glycerin, alcohol, and more.

Water-resistant: Yes, up to 80 minutes

Scent: Light, delightful floral scent.

Does it work? Yes, there was some color change, but not a lot. It had definite water-resistance.

Would we use it again? Yes, but note that it is blue in color, which is a bit odd, and it says it’s not greasy, but we found it to be a bit greasy. It was easy to spread and rub in.

Aveeno Active Naturals Protect + Hydrate lotion sunscreen

Type: Lotion

Price: $9.97

SPF: Broad spectrum SPF 70

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus water, glycerin, alcohol, beeswax, oat kernel flour and extract and oat protein.

Water-resistant: Sweat- and water-resistant up to 80 minutes

Scent: Nice floral scent.

Does it work? Not really. For SPF 70, we would have expected less color change. It also wasn’t particularly water-resistant or sweat-resistant.

Would we use it again? No. It was hard to spread around and didn’t rub in.

Bullfrog Mosquito Coast Sunscreen + Insect Repellent

Type: Spray with insect repellent for up to eight hours without bites

Price: $6.48 with $2 coupon

SPF: SPF 30, the only one that didn’t say “broad spectrum”

Ingredients: Octinoxate, octisalate, octocrylene, oxybenzone for sunscreen; butyl, acetylamino propionic acid ethyl ester for repellent; plus aloe and vitamin E.

Water-resistant: Yes, up to 80 minutes.

Scent: Very chemically smelling.

Does it work? No, each time we used it, we saw noticeable skin color change.

Would we use it again? No, not only did it not work, but it was smelly, oily and left the the skin at first tingly and then itchy. It also was not sweat-proof at all.

Face

Neutrogena Clear Face Break-out free liquid lotion sunscreen

Type: Liquid lotion for the face

Price: $8.97

SPF: Broad spectrum SPF 30

Ingredients: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, plus water, silica, bark extract and more.

Water-resistant: Yes, up to 80 minutes.

Scent: Neutral smell.

Does it work? Not really. This area of the face was the most burned area of the body. It also was very liquidy and left the skin feeling really tight.

Would we use it again? Nope. It didn’t do the job, plus pimples followed.

CoverGirl CG Smoothers BB Cream

Type: Tinted moisturizer and sunscreen

Price: $7.09

SPF: Broad spectrum SPF 21

Ingredients: Octinoxate and zinc oxide

Water-resistant: No

Scent: None.

Does it work? Not really. We still had reddening of the skin. We also sweated right through it.

Would we use it again? Yes, as a foundation; no as the only sunscreen.

Take aways

  • You can’t judge a sunscreen by the SPF number. One of the worst was SPF 100. Some of the best was SPF 30.
  • The sprays were less effective then the creams that you spread on or the sticks that you press on.
  • It’s true that those with titanium dioxide and zinc oxide, which are considered sunblocks rather than sunscreens, worked the best. You just have to be willing to put up with white tinting of the skin and that it doesn’t always rub in.
  • Just because it says water-resistant and sweat-resistant doesn’t mean that’s true.
  • Even the most “natural” sunscreens have some unpronounceable ingredients on the back.
  • There are really only about seven different sunscreen active ingredients. It’s about how they are stabilized and how they are delivered to your body.
  • Any sunscreen is better than no sunscreen.

Sunscreen tips

  • Sun damage is cumulative, and it matters how many burns you had as a child and young adult when it comes to skin cancer later in life.
  • A tan is sun damage.
  • You need sunscreen every day, especially on your face, neck and upper chest, which are regularly exposed.
  • Try to avoid going out in the heat of the day from 10 a.m. to 2 p.m.
  • Even if it’s a cloudy day, you can get burned. The clouds only block about 20 percent of the sun’s UV rays.
  • Apply sunscreen on 30 minutes before you go outside.
  • Most sunscreen should not be applied to wet skin unless the label says it can be.
  • Reapply sunscreen every two hours.
  • If you’re in water, reapply sunscreen every 40 minutes to an hour even if it says “water-resistant.”
  • Most people don’t use enough sunscreen. You need an ounce of sunscreen each time or about a shot-glass full.
  • Spread sunscreen in a thick layer. If you are using a spray, you need to rub it in. You might need to spray an area three times and rub it in three times to get it thick enough.
  • Choose a sunscreen that says “broad spectrum,” which indicates that it will protect against both UVA and UVB rays.
  • SPF stands for sun protection factor. SPF measures the protection against UVB rays. It does not measure protection against UVA rays.
  • Choose the right SPF. An SPF of 30 means its 30 times more sun protection factor than nothing. You want an SPF of 30 or above.
  • New research actually indicates that the higher the SPF the better, which means there’s now a case for an SPF of 70 or 100. Previously, scientist thought there wasn’t much of a difference after SPF 50.
  • The fairer your skin, the more SPF you want to choose.
  • Sunscreen in makeup is not enough SPF, plus you don’t re-apply it every two hours to adequately protect.
  • A layer of sun-protective clothing will be better than sunscreen for protection. You can buy clothing with SPF factor built into the fabric or you can actually wash it in the washing machine with RIT Dye SunGuard to give it an SPF factor of 30.
  • There’s a difference between sunblock and sunscreen. Sunblock will have zinc oxide or titanium dioxide in it. It prevents the UV rays from penetrating into the skin. Sunscreen doesn’t block the UV rays, but it changes them once they hit the skin to make the rays not as harmful.
  • Children younger than 6 months can use a sunblock made for babies, but check with your pediatrician first. Keeping babies that young out of the sun and covered will be a better option than the sunblock.
  • There are slight differences in the formulas of regular sunscreen and sunscreen for children. In general, the one for children is made for delicate skin. The formula for babies should be a sunblock, but not always, so read the ingredients label first.
  • If you see a change in your skin or a mole or birthmark, see a doctor.
  • One in 5 people will be diagnosed with skin cancer by age 70.
  • More people are diagnosed with skin cancer each year than all other cancers combined.

RELATED: More sunscreen tips

Sources: Dermatologists Dr. Ted Lain, Sanova Dermatology; Dr. Samantha Hill, formerly of Specially for Children and Dell Children’s Medical Center; and Dr. Lakshmi Atkuri, Scott & White Clinic — Round Rock; and Patricia Agin, formerly Coppertone’s scientific affairs leader at its Solar Research Center, and skincancer.org.

 

Use an EpiPen? Drug shortage might have you scrambling

Last week, the Food and Drug Administration reported a shortage of Epinephrine Injection, Auto-Injector from Impax Laboratories because of a manufacturing delay. 

What does that mean to you? It means that your pharmacy might be having trouble getting you an EpiPen, EpiPen Jr. and generic versions of those and of Adrenaclick.

Two EpiPen Jr autoinjectors are seen in 2016. Epinephrine autoinjectors, used to treat severe allergic reactions, are in short supply and were added to the Food and Drug Administration’s drug shortage list. (Chris Walker / Chicago Tribune/TNS)

What you can use as a substitute is Auvi-Q auto-injectors. Your doctor also can call your pharmacy and see which ones it has on hand.

The EpiPen manufacture Pfizer had this to say on the news of the shortage: “Pfizer takes very seriously the importance of EpiPen to everyone who needs it, and we are working tirelessly to increase production as rapidly as possible. We are currently shipping
EpiPen, with production increasing over the last few months and anticipated to continue to increase and stabilize over the coming months.”

Think it’s hard to find drug treatment in Texas? You would be right

Here’s a number where Texas doesn’t want to be No. 1:

No. 1 in the fewest substance abuse treatment centers per 100,000 drug users.

Keep prescriptions and other medications away from children. Liz O. Baylen/Los Angeles Times file

The new study from Wallet Hub has Texas as No. 37 for the worst drug abuse problem by state, but that number of substance abuse treatment centers figure really stands out.

In part, some of it could be that we also were 48th in the country for the percentage of adult drug users.

Where was the worst state for drug use? The District of Columbia. The best was Minnesota.

See the study here.

 

 

Harry Connick Jr. coming to Austin to talk about colon cancer

Singer, actor, TV personality Harry Connick Jr. and his wife Jill Goodacre Connick will be in Austin Tuesday, but this time it won’t be for a movie premiere (he’s shot two here) and it won’t be to perform.

Instead, he’s talking about turning 50 and the importance of getting screened for colon cancer.

Harry Connick Jr. will be back in Austin on Tuesday. In 2013, he was on the red carpet at the Paramount Theatre for the opening of “When Angels Sing” with Willie Nelson during the SXSW Film Festival. American-Statesman 2013

“Cancer’s been unfortunately a part of my life for as long as I can remember,” he says. His mom died of ovarian cancer when he was 13; his wife had breast cancer. “I’m just sick of cancer.”

Colon cancer is the second leading cause of cancer death in the United States, but it’s also one of the most preventable if caught early.

In Texas, we’re not great about getting our screenings. Texas ranks 41st in the country for colon cancer screenings, says Dr. Jacqueline Champlain, a family practice physician at Austin Regional Clinic.

The Connicks have been touring the country talking about screenings as part of Cologuard, a noninvasive colon cancer screening test, and its New 50 campaign. Age 50 is when most people should first be screened for colon cancer, unless they have genetic risk factors such as a parent with early onset cancer; symptoms such as changes in the stool or weight loss; or an underlying disease such as Crohn’s or colitis or irritable bowel syndrome.

On Tuesday, Connick will be at the Bullock Museum and talk about getting screened himself, using Cologuard. It was simple, he says, and took about a minute. Yet, he knows it’s not something people want to talk about. We’re trying to demystify the process of screening, he says.

RELATED: University of Texas tests app for colon cancer

“Fortunately, my results are negative,” he says, but he knows what it was like when his wife was first diagnosed with breast cancer. “It was a nightmare,” he says. “It’s terrifying. ”

Her cancer was caught by a routine screening, in her case a sonogram, instead of a mammogram.

A colonoscopy is considered the gold standard of colon cancer screening, Champlain says. A colonoscopy is like what a dermatologist does for a skin check, Champlain says, except it’s inside the colon. Think of it as a doctor looking for a suspicious mole, but in this case a polyp inside the colon. During a colonoscopy, the doctor can then do a biopsy of a polyp and even remove it.

Colonoscopy often it isn’t convenient to patients, Champlain says. Many people don’t have the time to do the prep work associated with a colonoscopy, she says. Often prep includes a day of drinking some medicine that will have you needing to be near a toilet to clean out the colon. Then it’s a day for the colonoscopy. Sometimes you have to have an appointment with the specialists who will be doing the colonoscopy after getting the referral from your doctor, though she tries to have her nurses smooth out that process.

Also, there’s the cost. Cologuard costs about $200 out-of-pocket if insurance won’t cover it, but Champlain says she has seen really good results in getting insurance to cover it. A colonoscopy can be thousands of dollars if you have a high-deductible insurance plan.

The Cologuard kit gets ordered by the doctor, then a patient takes it home. The kit comes with easy-to-read instructions, a bowl that you put into the toilet to capture your stool, a swab to collect a sample of the stool and then a package to mail in the sample.

With Cologuard, it’s looking for signals of cancer that the colon is giving off, Champlain says. She thinks of it like the colon sending out a wireless signal that Cologuard picks up like your cellphone picks up the wireless transmissions.

If Cologuard comes back positive, then a follow-up colonoscopy is done to see what is going on. She has not had anyone come back with a false positive, she says, and has patients right now that are being treated for colon cancer because of Cologuard.

“We need folks to get this done,” she says, because in addition to colon cancer being the second-deadliest cancer, the majority of people have no symptoms.

Yet, like skin cancer, if caught early, it is easily treatable by removing the cancer. If caught later, like skin cancer, it is not.

Cologuard screenings need to be done every three to five years, Champlain says. Colonoscopies need to be done every five to 10 years until age 75, but it also depends on what the initial colonoscopy finds and family history.

The Connicks will be issuing a #ScreenWithMe challenge on Tuesday. People 50 years old or older can pledge to get screened, then invite three of their friends to get screened. For every pledge, Exact Sciences, which makes Cologuard, will donate $1 to cancer research and advocacy. You can learn about the challenge at New50.com/Austin.

Connick says since turning 50 in September, “I physically never felt better,” he says. “I feel strong. Fifty is different than it used to be.”

It’s definitely different than what he thought 50 would feel like when he was young, he says.

He’s recently workshopped a new musical based on the movie “The Sting,” will be going on tour this summer and thinks a studio album won’t be far off.

Champlain also reminds that in addition to a screening for colon cancer, women need mammograms beginning at age 40 and pap smears beginning at age 21; men need prostate cancer screenings at 50. Beginning at age 25, your doctor should also do a blood panel to look for things like cholesterol and diabetes. Everyone should be getting their blood pressure and weight checked at each visit. Champlain says she screens for depression and domestic violence at each well visit as well.

Champlain thinks of these screenings as “low hanging fruits” with high rewards, minimal risks. “It’s like getting in our car and putting on your seat belt. Why wouldn’t you do that?”

Related: Moms, don’t skip your well-checks

 

The New 50: An Evening with Harry Connick Jr. and Jill Connick

When: 6-8 p.m. Tuesday

Where: Texas Spirit Theatre at the Bob Bullock Musuem, 1800 Congress Ave.

Cost: Free, but you must register at New50.com/Austin

Information: New50.com/Austin