The Dangers of Codeine in Children

In recent years, there have been more and more instances of codeine related issues in children. Recently, the FDA provided an official warning on the dangers of pediatric use. The basic problem is that 1-7% of people have an enzyme in the liver that converts codeine to morphine at an unusually fast rate. High levels of morphine can suppress the body's drive to breathe and serious injury or even death can occur. Because of these risks, and the unpredictable response to codeine, I do not prescribe this drug. Click here for the FDA cosumer warning and suggestions on how to monitor for this unusual, but dangerous occurence

New Tonsillectomy Guidelines

There are a new set of tonsillectomy guidelines put out by the American Academy of Otolaryngology/Head and Neck Surgery. For kids with sore throats or strep throat, the guidelines suggest 7 or more in a single year indicates the need for tonsillectomy. Here's a CNN article related to this.Hopefully, these will remain guidelines and not be misused as strict rules. I'd hate to see a kid who has had 6 infections causing 24 days of missed school not get treated until they've had one more. Unfortunately, sometimes these guidelines are used by insurance companies or government agencies to dictate a cookbook style of medicine. I still believe each patient presents a unique set of problems and circumstances that needs to be considered.Read More