Maggie McKay (Host): Welcome to Total Health Talks, your Cook County Health podcast, where we empower your journey to better health. I'm your host, Maggie McKay. And today, we're going to talk with pediatrician Dr. Shipra Sharma about being ready for the bell, managing allergies, asthma, and school health. Thank you so much for being here today.

Shipra Sharma, DO: It's a pleasure to be here. Thank you for having me.

Host: It's such an important topic, especially at the beginning of the school year, it seems to me. As families get ready for a new school year, what are the most important health and well-being steps that parents should take before the first day of school?

Shipra Sharma, DO: Yeah, that's a great question. So, getting ready for the school year, I think there are several things to kind of keep in mind. One, it's important to know your particular school and your particular district, what the requirements are for entering students that year. And so, whether that actually means requiring a school physical or if it's just updated medical paperwork or an updated sports physical, kind of knowing what you need and getting those things completed ahead of time is really important.

For any children who may have chronic conditions, it's also important to think about, are their medicines refilled? Are they up to date on their visits? Are there times of the year, looking ahead, that they tend to get more sick or less sick or need the doctor more? And kind of think about those steps as the year is starting.

For kids who have medical conditions, I encourage parents to be in touch with the school nurse. School nurses are great resources. They are really on top of everything kids need at school, and are really tied into, you know, kind of the day-to-day pulse of what's happening at school with kids.

And then, lastly, you know, with all kids, it's a long year, so we want to anticipate, staying healthy throughout the year. So getting back on track, starting the school year strong. So, getting back on those sleeping routines, those kind of daytime routines, getting up early in the morning, getting ready for class, getting back to those schedules a couple weeks in advance of the school year starting.

Host: Dr. Sharma, what common health concerns do students face when they're returning to the classroom? And how can parents help reduce risks early on?

Shipra Sharma, DO: We kind of think about returning to the classroom is returning to that environment where you're exposed to all the other kids around you, right? So, whether that's whatever the infections are of the season, thinking about, you know, kind of cold viruses, respiratory viruses in the fall and winter. In the spring and the summer, we think about more of those other types of viruses, those stomach bugs, things like that. So, certainly keeping in mind that you're going to be exposed to so many more people and different germs, and what that presents. And then, also, you know, every year brings new challenges for kids and for students. And so, also thinking about, like, the adjustment to a new year and what those challenges might bring. So, if it's a new school, if it's, like, really challenging courses, if it's trying out for a new team. Kind of also supporting kids' emotional health through those transitions as well.

Host: For children with allergies or chronic health conditions, what information should parents communicate to teachers and the school nurse and caregivers before school starts?

Shipra Sharma, DO: It's important to let the school know what the specific allergies are and what the typical reaction entails whenever a child is exposed to something they may be allergic to. Most schools have actual paperwork that they want to have completed by a doctor and submitted. And that really details the specifics of a child's allergies.

So, it will delineate what they're allergic to, the symptoms that they experience, and the treatment for any reaction that might occur. You also want to be prepared to supply the school with any medications that might be necessary, in case an exposure to an allergen does occur.

Host: You mentioned allergies. Food allergies affect students more than ever, they say. What should schools and families do to create a safe environment while still allowing children to fully participate in school activities? Because you don't want them left out, but...

Shipra Sharma, DO: Of course. Yeah. And I actually think schools do a great job of this. They kind of know what the makeup of each classroom is as far as, you know, the foods that may be allowed or the foods that they may need to restrict. For parents, it's important to start teaching your child at, you know, whatever is the developmentally appropriate level for their age, teaching them about their allergy and what they need to do to keep themselves safe as well. So, those are the important things. I think with the school, it really entails like, open communication, and just kind of following the policies that they have in place.

Host: Right. A lot of parents hear terms like food allergy, food intolerance, and food sensitivity interchangeably. Can you explain the differences and why accurate diagnosis matters?

Shipra Sharma, DO: Yeah, this is a great question. When we think of a food allergy, we think of an adverse reaction to a food, that's mediated by the immune system. So, the specific cells that compromise your immune system. So, your antibodies and other cells of the immune system.

When we think of intolerances, that's a much broader category of reactions. So, it still is an adverse reaction. Sometimes the symptoms are quite similar to a food allergy, but it basically is happening through a completely different pathway in the body. And so, it might be something more related to how a food is digested or metabolized or absorbed by the body, as opposed to your body being sensitive to something and your immune system mounting a response to it.

And a sensitivity, sometimes that term is used interchangeably with allergy, because when we think of food allergies, the terminology that we use is that somebody's sensitized to a particular food, meaning they, may have a predisposition to react to a certain food.

Host: And what are the signs and symptoms of a severe allergic reaction? What should school staff and parents know about using epinephrine in an emergency?

Shipra Sharma, DO: So, allergic reactions can range from mild to severe. Severe reactions, you may have heard the term anaphylaxis, and that's the most severe type of allergic reaction, that occurs. And when that occurs, you're talking about involvement of multiple organ systems in the body.

And so, what that means is that, you know, in little kids, who are having an anaphylactic reaction, they may vomit, and they may develop hives after eating a food that they're allergic to. In milder forms, allergic reactions can take the form of a rash, hives as well, Sometimes a little bit of swelling in the face, like the lips or the eyes. But it's generally not as severe, and it doesn't generally involve multiple organs of the body, okay?

So, epinephrine is the best and most immediate treatment for anaphylaxis. And so, people who do have severe allergic reactions to foods or to medications or to, you know, insect bites, things of the sort. It's really important for them to have epinephrine, if that's appropriate.

And as far as what's important to know about using it, if there's concern for an anaphylactic reaction occurring, we always encourage using the epinephrine early. For kids who may be too young, you know, having an adult administer it is important. And then, seeking follow-up medical care, if epinephrine is administered is also important.

Host: So, the school environment can expose children to a lot of seasonal allergens, dust, mold, viruses, you name it. How can parents help strengthen their child's health and immune system during the school year?

Shipra Sharma, DO: Those things that our grandma told us about getting to bed early and eating our fruits and vegetables, and avoiding too much junk food, all those things are really still important for keeping us healthy. And so, encouraging lots of healthy habits. You know, the body, and the immune system are great at keeping us healthy and keeping us strong, whenever we are doing what we need to kind of support it, right? So, getting enough and adequate rest, and sleep is important. Certainly if your allergies warrant treatment, getting, you know, the medication you need and taking it as you're supposed to be taking it is also critical. Eating a healthy diet, so those fruits, those vegetables, eating a variety of things, more real foods and less junk foods, is always important. And then, you know, things like managing our stress and using common sense, you know, washing our hands, wearing a mask if you're going somewhere that people may be sick, things like that. Those are the important things for your immune system.

Host: I always tell my son, "Just pretend we're still in COVID and washing our hands for, you know, 20 seconds." Is that it?

Shipra Sharma, DO: Yes, absolutely. I mean, handwashing is the best way to prevent the transmission of germs. So you can't—

Host: Can't say it enough.

Shipra Sharma, DO: You can't say it enough. I absolutely agree.

Host: Asthma, as you've been mentioning, can be especially challenging during the school year. So, what are some common triggers in schools? And how can families help children keep their asthma under control?

Shipra Sharma, DO: Yeah. Common triggers for asthma are respiratory viruses, so getting colds, getting flus, getting sick. Those commonly will exacerbate asthma, so can exercise or physical activity. And then, changes in the seasons, weather changes, or if there's an extreme kind of weather day, like this summer how we had really high heat or the days where we had high smoke levels and high particulate matter in the air due to the wildfires. Those are all things that can certainly flare asthma.

Host: What roles do vaccinations and routine checkups and preventative care play when ensuring students are healthy, present, and ready to learn?

Shipra Sharma, DO: Yeah. Routine vaccinations are honestly a critical part of preventing infections and illnesses. You know, this is certainly a conversation that each individual should have with their doctor. But for people with underlying immune issues such as asthma, or allergies, you know, there may be certain recommendations that your doctor makes as far as vaccines go.

Then, of course, staying up to date with your checkups is also important, largely to make sure that, you know, if things are going well, that they actually are going well. We want to keep you doing well. We want to make sure that you're not running out of your medications. And certainly, if things maybe are not going well, if you're noticing that you're needing your medicine more or it's not working as well, then definitely it might be time to come in and get reassessed.

Host: Dr. Sharma, if you could give parents one piece of advice to help their children have a safe, healthy, and successful school year, what would it be?

Shipra Sharma, DO: One piece of advice. So, you know, parents are the experts on their kids. And every child is unique and has unique needs. That being said, I think parents, it's balancing the kinds of needs of your child. And so if you're noticing if you have the type of kid who wants to do everything, they're pushing themselves to do all the sports, do all the activities, get really good grades, to the point of, you know, tiring themselves out or getting sick frequently or getting hurt frequently, you know, it might be time to say, "Hey, you know, do we need to reel some of this in? Are we doing too much, because we're overextending ourself?" Right?

And then, the flip of it might be true, where some kids are really reluctant to do things. They haven't found their thing. They need a lot of encouragement to try different things. And so, for parents then also providing that kind of nudge and that encouragement, keeping kids engaged and active without overdoing it is really important. Balance is the key for all of us, and that's no different for kids.

Host: That's so true. Well, thank you so much for sharing your expertise today. This has been so helpful. We really appreciate it.

Shipra Sharma, DO: Thank you so much for having me and we look forward to talking with you soon.

Host: Absolutely. Again, that's Dr. Shipra Sharma. As we wrap up another insightful episode of Total Health Talks, make sure to visit cookcountyhealth.org/podcast and subscribe to our podcast, share and connect with us on social media. Stay tuned for more engaging discussions. This is Maggie McKay signing off from Total Health Talks. Stay well.