Tag Archives: mucous

The Biology of a Viral Illness (Pedcast)

Today I am going to take you back to biology class to learn about the type of infections that unfortunately your children are going to get a lot of…viral infections. We are going to review a little basic science so you can understand what is happening in your child’s body when they get sick with a “virus”.  Don’t you hate when you take your child to the pediatrician and they use the V word, virus! The reality is however, that most infections, especially in vaccinated children, are viral infections.  To doctors, we like viral infections. Viral infection to pediatricians usually means a relatively mild, self limited illness that needs no specific medicine other than symptomatic measures.  You know, grandma stuff.  Many parents however hate this diagnosis…they want a medicine to make things better now.  Let’s take a little closer look at how viral infections unfold and how your child’s body deals with them, shall we? Continue reading

Avoiding Ear Infections, Dr. Sheila Kilbane (Pedcast)

Doc Smo here, your pedcast host.  Thanks for joining me  today for another edition of DocSmo.com, the pediatric podcast dedicated to children and their parents.  I am very fortunate to have as my returning guest, Dr. Sheila Kilbane, an integrative pediatrician and expert about much of life, to talk to us about a very common pediatric health problem, otitis media.  Anyone with children is very familiar with how frequently children are affected by otitis media or middle ear infections.  These infections are complications of bad colds and we all know that children get a lot of colds. So lets see how an integrative pediatrician approaches a child with  recurrent ear infections.   Maybe Dr. Kilbane just might be able to help your children avoid that ear infection nastiness.


Welcome Dr. Kilbane.



Question 1:Why do children get ear infections?


Question 2: For children with CHRONIC EAR INFECTIONS of CHRONIC EAR CONGESTION, how does the Integrative approach different than traditional pediatrics?

(Decrease mucous/ enhance immune response/ decrease inflammation/avoid antibiotics)


Question 3: How do you do these things?

(Stop dairy, probiotics, vitamin D, immunocap, correct structural problems)


Question 4: Which children do you suspect have structural problems in their Eustachian tubes?


Question 5: How do you reduce inflammation in a child’s body?


Question 6: Which children is the integrative approach most appropriate for?


Let’s summarize the integrative approach

-Reduce mucous production from inhaled allergy and oral allergy to food, mostly milk

-Correct structural problems

-Enhance child’s immune system

-Reduce inflammation by changing diet





Well, Dr. Kilbane, as always, you bring a fresh approach and viewpoint to both parents and physicians and I really appreciate that. You and I are on the same page, we both want to inform parents and make things better for children. I can’t thank you enough for sharing your time and expertise with us today.


This is Dr. Paul Smolen, you know, Doc Smo, thanking you for joining us and hoping your little dears, always have nice clear ears.  Until next time.


Ear pain solved by Dr. Mom, (Pedcast)

Thank you, Thank you, thank you for joining me today to talk kids.  I hope you are having a good day… I am.   The weather is great in Charlotte and I am energized to bring you another pedcast… a short audio discussions of useful health information in mp3 format.  Read or listen to a cast directly from my website or download an episode and take a DocSmo pedcast for a walk or to the gym.  I’m good company and I guarantee I will teach you something.  I might even make you laugh once in a while. Today I am going to bring you some very practical information about ear pain that might not only help you, but also save you some visits to the doctor.  Save you some hard cash… so sit back and listen.

I was in the office the other day when a 10 year old came in complaining of ear pain.  He is a frequent flyer when it comes to ear infections so it was very reasonable for his mother to bring him in to get checked out. Anyway, this was this child’s third visit since fall for ear pain so the subject of how to do home diagnosis of ear infections came up.  If you have a child with allergies like this child, you may hear the complaint of ear pain frequently so I thought my blog audience might be interested in what I told them so here goes, Doc Smo’s practical advice when it comes to parental diagnosis of ear pain.

Let’s review how our nose and ears work before we get into the nitty gritty details of what I want to teach you today.  You know, a quick detour down to where Science drive intersects Useful Way. When everything is working well in your child’s nose, each nasal breath forces a slight amount of fresh air into their ears and sinuses, freshening everything up so to speak.  It’s like opening the windows to let a little fresh air in. The nose should be full of air as well as the sinuses and… your child’s middle ear. These nasal breaths equalize the pressure between the nose and middle ear and also keep the air fresh inside the middle ear.

So now your child has some condition that makes the inside of their nose swell like a cold, or allergies.  Uh oh, now the Eustachian tubes, the connection between the nose and the middle ear, stop working…  No fresh air is going up to the middle ear with each breath so pressure changes start happening..  A negative pressure, a vacuum starts to develop in the ear that can literally suck mucous into the middle ear along with bacteria from the nose.  If this condition goes on long enough, you know what’s coming next…a full blown crying, screaming, middle of the night ear infection.  Remember this sequence of events:  first cold or allergies, that causes the eustachian tubes to stop working and a vacuum to form in the ear.  If this goes on long enough, fluid gets sucked into the middle ear, and eventually, an ear infection develops.

Now that you understand these events when your child’s nose clogs, you can understand that your child can get pain at the vacuum stage…  or …  at the ear infection stage.  It doesn’t matter whether the eardrum is sucked inward or pushed outward, either hurts like crazy.  You child’s eardrum is as sensitive as their cornea.  Movement of any form is incredibly painful. We all know what getting poked in the eye feels like…bad. Ears feel exactly the same.

Now lets get to the practical advice I gave this family.  Since ear pain can be caused by either a vacuum pressure change only needing home care or a real ear infection, I showed them how to tell the difference at home… should your child have ear pain, have them pinch their nose and gently blow air against the closed, pinched nose.  Try this yourself. This maneuver is called a valsalva. If they hear a click or pop in the ear with gentle outward blowing pressure, most likely your child does not have an ear infection since air can be forced into the middle ear.  Additionally, a very quiet noise like fingers rubbing together 12”-16″ from the ear can usually be heard if there is no ear infection.  The combination of a click and normal hearing means you might want to cancel that visit to the doctor.  Time to decongest the nose with saline and a nasal or oral decongestant. Should the contrary events be present however, no click with decreased hearing in the affected ear, this usually means an ear infection.  Time to review your “wait and see” procedure for ear infections and maybe call your child’s doctor.

It’s that simple.  Once you understand what causes middle ear pain, it’s fairly easy to make the diagnosis yourself as long as your child is old enough to cooperate and tell you what they feel.  I hope that knowledge will help you avoid unnecessary visits to the pediatrician.  Lord knows, you are probably there enough!  We love to see you but we would rather your child spend his or her time out playing at the park.  But, if you have any health question about your child, please call their pediatrician and talk it over with them.  They know your child best.

Thank you for tuning in today.  This is Dr. Paul Smolen, bringing you practical, portable, pediatrics.  Your comments are welcome at www.docsmo.com.  If you like talking all things kid, subscribe at my blog, like us on Facebook, or subscribe on iTunes.  I will try my best to make you glad you did.

This is Doc Smo, hoping that after this pedcast you have no fears about your child’s ears.  Until next time.

What is the “Fever” in Hay Fever? Q and A with “Simon” (Laura Nelle Parnell) (Pedcast)

It’s finally spring time and the earth is exploding with life. With all of the flowers, lush vegetation, and beautiful weather, however, comes something unpleasant — hay fever. In this pedcast, Doc Smo tries to improve your understanding of the concept of hay fever and allergies. Joined by his guest Simon (aka Laura-Nelle Parnell), Doc Smo answers questions about allergies and how your children’s bodies interact with their environment.

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Understanding Your Child’s Ear Infections Step by Step (Pedcast)

Ear infections, or otitis media, are a painful part of childhood. Understanding the biology behind the development of ear infections can help parents see the warning signs and take preventative measures. Thus, in this pedcast, Doc Smo walks you through the stages of ear infections and provides listeners with ways to help prevent them.



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By some estimates, 40% of visits to pediatricians are for ear infections.

Most children have otitis before the age of 2 years.

I Thought today, we would talk about why children get them, should they be treated, and can they be prevented?

Parents have these questions all the time.

So lets get started with our discussion with a trip down, you know where, science lane.


There are loads of germs in our nose that can cause ear and sinus infections…all the time!  That’s right, sinus and ear infections are usually an overgrowth of germs we already carry.

So why don’t we have ear infections all the time?

To understand the answer to that question, need to know how our noses work.  That’s right, our noses.

Remember the structures that are attached to our noses, our sinuses in every direction around our nose, our ears through the Eustachian tubes, our eyes up through the lacrimal ducts, and our throat pulling up the rear.  

Normally every time we take a breath through our nose, we put fresh air into our sinuses and ears. If our noses are working properly, each breath opens the windows and lets in fresh air into our sinuses and ears and at the same time equalizing the pressure with the ambient pressure around us.

In addition, the cells that line our nose, sinuses and ears secrete a steady trickle of mucous that is kept moving by our cilia, little brooms that constantly sweep the mucous into our throats.  A gentle river of mucous flows through our noses, sinuses, ears and bronchioles all the time cleaning and moving away dirt and germs away from our healthy respiratory system.

The combination of moving mucous and fresh air keeps germs from ganging up on us.


Now think of a child, especially a baby.  A cold means a swollen nasal passage without air moving and loads of extra mucous. Babies don’t blow their noses, remember! This is the recipe for a sinus and ear infection.

Stagnant mucous in airless places.

Here is the sequence of events:

Virus attaches itself to the nasal membrane causing swelling lining cells.  The medical jargon for this is apoptosis or swelling of cells.  We can feel that at the beginning of a cold.

The children’s tiny sinus and ear Ostia become obstructed from airflow causing a VACUUM to form in the ears and sinuses.

Your body doesn’t like a vacuum and fills up these spaces with mucous (when your child’s doctor says, fluid in ear…this stage).

Remember that bacteria in the nose, now it has warm, sugary pockets of stagnant fluid to grow in and BAM, a hot ear infection.

Since bacteria grow so fast, it can be only a matter of hours between fluid in the ear and a raging infection.

The body’s natural defenses, moving mucous and fresh air are not there to keep the germs from taking over.

Children who carry the allergy gene have all the same events occur but the swelling inside their noses is from both dust and pollen allergy and viral infections.  These children are especially prone to ear infections.

So what’s the perfect storm for ear infections?

Under 2 years of age….Promotes…Small nose and no blowing.

Remember this Doc Smo pearl, “Rivers that don’t flow are nasty!”

Being in an environment where infection with respiratory viruses is frequent…..  Being around a lot of other young children.

Remember this Doc Smo pearl…. “Infectious diseases are contagious!”


Being a child with eczema, food allergy, or recurrent wheezing…  having the allergy gene which means lots of swelling in the nose and loaded with mucous.


If your child is prone to ear and sinus infections…practical tips that might help.


1. Avoid crowds of children to play with especially when they are very young and put things in their mouths.  Touch is the method of spread.

2. Be especially careful with group care if your child exhibits signs of allergy.

3. Play with other children outside whenever possible, even when it is cold.  Unlikely to transfer germs outside.

4.Unless your child has clear allergy, Avoid cold medicines with antihistamines, which can make nasal mucous thicker… poor flow means more infections.

5. If your young child has loads of otitis media, try a milk free diet for 2-4 weeks to see if it helps.

6. Hose those little noses with saline a lot… water is a natural cleaner.  Use it!

7. Try and avoid treating ear infections in children older than 2, after your child can talk.  More on this subject listen to “Bugs and Drugs”



That wraps up todays “Pedcast” Thank you for listening.  I hope your understanding of ear infections is better now.

If you enjoyed this talk, try some other DocSmo episodes which you can find at my website, DocSmo.com, at my face book page or on ITunes.

Comments are welcome.


This is Dr. Paul Smolen.

Recording in full digital sound from studio 1E in Charlotte, NC.

Wishing your children noses full of warm breezes and years without sneezes


Until next time
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