Transcription of Dr. Lynne Tetreault for the show Kids’ Health #54
Dr. Lisa: This is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and Podcast number 54, Kids’ Health, hearing for the first time on WLOB and WPEI Radio Portland, Maine.
On Today’s show, we will be speaking with Dr. Lynne Tetreault of Maine Medical Partners Pediatrics in Saco and also the medical director of Vax Maine Kids; Dr. Amy Belisle, medical director of the child health quality improvement projects at the Maine Quality Counts Program; Dr. Lisa Letourneau, executive director of Maine Quality Counts; and three representatives from the Girls on the Run Maine Chapter, Jen Rohde the council director, Sandi Sinclair program coordinator and Staci Olsen, outreach and events coordinator.
I first moved to Maine in 1977 as a fairly small child and have lived here for many of the years since. My family has 10 and I’m the oldest, so I had a lot of experience with kids’ health from the very earliest years of my life. I myself have three children and when it came time to be a doctor and raise them, I thought, “You know, what better place to live than Maine.”
Kids’ health has always been very important to me through my 10 years as a medical director at Maine Health, I worked for the learning resource centers and the Maine Health, works on wellness program and also the Raising Readers Program.
I also wrote for 10 years for the Parent and Family Newspaper in the Southern Maine area, so I know kid’s health and it’s important to me. I thought we’d bring together some of the thought leaders in kids’ health. Thought leaders that not only are doing good work now, but have been doing good work for a long time.
In fact, you’ll find as you listen along that some of these individuals are ones that I have trained with. Some are ones that I have known all my life and some are ones that have had an important impact on my life in public health over the last 15 years.
Then we also bring in a new group of individuals who are also very enthusiastic about kids’ health and these are the women from Girls on the Run, a new program which is encouraging girls to get out there and feel good about their bodies and themselves through running.
There’s a lot you’re going to get from this program and one of the topics that I know some of you may find controversial is vaccinations. But I hope you’ll give it a listen, because what we strive to do in the Dr. Lisa Radio Hour is to represent different points of view. We think that everybody has a right to live their own life and have their own health their own way, but it’s important to have as much information as possible in making good decisions.
Thank you for being a part of the Dr. Lisa Radio Hour and Podcast and listening in and having an open mind and being inspired in going out in raising your own kids and helping other children to be as healthy as possible in this great State of Maine.
The Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England. As part of this sponsorship, we offer a segment we call, “UNE Wellness Innovations.” This week’s wellness innovation comes from the University of New England itself.
According to the National Institute of Mental Health, anxiety disorders affect about 25% of adolescents aged 13 to 18 with close to 6% seriously affected and close to 40 million suffering well into adulthood. With a $404,000 research grant it has just received from the National Institutes of Health, the University of New England plans to investigate some of the neurological basis of this debilitating anxiety disorders in adolescents.
Michael Burman, Ph.D., assistant professor in the University of New England’s Department of Psychology and principal investigator of the grant says, “Although the neural systems involved in adult fear and anxiety are well-studied, how these systems develop and contribute to the occurrence of life-long anxiety is not well-understood.”
For more information on this wellness innovation, visit doctorlisa.org. For more information on the University of New England, visit une.edu.
Speaker 1: This portion of the Dr. Lisa Radio Hour and Podcast has been brought to you by the University of New England, UNE, an innovative health sciences university grounded in the liberal arts. UNE is the number one educator of health professionals in Maine. Learn more about the University of New England at une.edu.
Dr. Lisa: On today’s Dr. Lisa Radio Hour and Podcast, I have the great pleasure of having in the studio with me, one of my former teachers and colleagues at the Main Medical Center. When I was a family practice resident, I was in training with this really wonderful pediatrician, now pediatrician, Dr. Lynne Tetreault who is with the Maine Medical Partners Pediatrics Practice in Saco.
I like to remember what it was that caused me to want to be a doctor and some of this was being in with people who also wanted to be doctors and teach. I know this is part of what you do in your regular practice every day is teach.
Dr. Lynne: I do. I teach residents and I teach students. In a way, you also teach the parents of your patients. I think being a teacher is a big part of my job, but I love doing it because I can share my enthusiasm for it with medical students and these young residents and they’re embarking on their profession and their career. So I can show them that isn’t a stressful or as cumbersome as sometimes it can appear.
A lot of docs who have been in this while get so discouraged by the people work and everything else that you have to encounter in a day. I really love what I do and it’s been such a privilege to see patients grow. I’ve been in practice 14 years.
There are teen girls that are now mothers, married and have their own children that come to see me. I feel like I’ve been around a little longer than some. I also seen these babies that I took care 14 years ago now be teenagers.
Dr. Lisa: Why did you go into pediatrics in the first place? What’s the decision making point? Because it shows about kids’ health, so you like kids apparently.
Dr. Lynne: I always love children. I come from a big French-Canadian family so I was always around children. I got a great sense of enjoyment and satisfaction from just seeing children grow and encouraging them to be active and healthy.
In my college years, in my summers, I used to work at the Parks and Rec Program and I used to run programs for toddlers and their moms up to teenagers and do arts and crafts and things like that. I’ve always enjoyed working with children and I’ve told people that if I didn’t end up being a pediatrician, I might work at Disney World doing some kind of rec management position. I knew someone that ended up doing that. It seems really like it.
Dr. Lisa: So instead of Disney World, you’re now on the other side of it. You’ll be tormenting kids just a little bit.
Dr. Lynne: Thankfully my nurses do the shots so I get to be a good lady in the office, but children do get apprehensive when they see me because it’s the women in my office that do the shots, so they do get a little nervous seeing me. Most of the time, I try not to torture them, but yes sometimes digging in the ears is not very fun for them, but you have to do what you have to do.
Dr. Lisa: Talk to me a little bit about that. I know that your other job is working for the Maine Health, Vax Maine Kids Program and that has to do with vaccinations and you’ve already alluded to the fact that vaccinations are painful for children. I think they’re also a lot of different ways we could go with this whole idea of vaccinations, but talk to me about what that program is.
Dr. Lynne: That program is raising awareness about the importance of vaccines and getting our kids vaccinated in the State of Maine. A lot of people are apprehensive about vaccines. That’s normal. There’s been a lot of stuff in the media. Unfortunately, some of the stuff that was initially put out in the media got debunked but that hasn’t really gone out there saying, the guy that said that autism was linked with shots. His data actually was made up and he was found to have been a fraud.
Unfortunately, that kind of message doesn’t get out there, but it’s so important to get our kids vaccinated. Recently, we’ve had outbreaks of pertussis in the area. Also, there was an outbreak of measles in the fall in the Boston area. These diseases that are so important to be protected against are still out there and a lot of parents don’t realize that they should get their children up to date.
Sometimes they might be missing a tetanus shot. After their five year shots, they may think they’re all set, but actually as teenagers they do need a booster for tetanus. The new tetanus has pertussis as part of it so they are able to get caught up and they should have that every 10 years. If a parent isn’t sure if their child is up to date, they should contact their doc and have their child’s record checked.
Dr. Lisa: Talk to me about some of these things that we vaccinate against. I have three children, I chose to have them all fully vaccinated even though I was aware of the mercury thimerosal, all of the controversy surrounding vaccinations. I did choose deliberately to get my children vaccinated and it was because the diseases we’re preventing can be life threatening.
Dr. Lynne: Absolutely. Pertussis in young babies can be fatal. There’s meningitis. About one or two children a year in the Portland area still get meningitis. So it’s very important to have your child immunized against these diseases. A lot of people don’t know that chickenpox can be fatal. A hundred kids a year were dying of chickenpox and 60 of them were normal in this country.
Now that the vaccine has been around for a few years, that number has gone down to almost zero which is great. So it is important to get your children vaccinated. And the benefits do outweigh the risk, but it is important to do your research, make sure you have all the information so that you feel comfortable with that decision. Ask your doctor questions, go check the American Academy of Pediatric’s website. They have a lot of good information about vaccines, so does the CDC.
Because there are things that are still out there, the meningitis, the measles, chickenpox. We also immunize against polio and a lot of people think polio has been eradicated. But actually some parts of the world it isn’t. hepatitis A can be prevalent in some parts of the country and that’s a liver disease. One of my partners had a patient that had to have a liver transplant after being exposed to hepatitis A.
All these vaccines are important. They may seem numerous, but there is a good logical reasoning behind recommending having them done.
Dr. Lisa: One of the things that I know a lot of parents have concerns about is the number of vaccines being given at one time and if your child has a reaction, then how were you supposed to know what they’re reacting to? What do you say to parents who ask that question?
Dr. Lynne: That is a tough question if you have a lot of the time. I try to limit it at three at a time. Most of the time, if there’s a reaction, we know which one it is. The whooping cough, tetanus one is the one that sometimes gives a low grade fever or sometimes a sore arm or little bump on the leg called a little sterile abscess. So we kind of do know which ones are the troublemakers for the vaccines, but they’re mild, self-limiting. Meaning that they’ll go away within a few days to a week. Tylenol and Ibuprofen can always help the discomfort of vaccines.
In terms of the immune response, some parents are apprehensive of giving so many shots at ones, but many studies have shown that if you are given three or four shots at the same time, it doesn’t inhibit the body’s response to build immunity. So you still will get immune to those disease.
Dr. Lisa: Are there actually significant and serious side effects that have been associated with some shots?
Dr. Lynne: There has been, but a lot of times it’s high fever or kids who are more predisposed to seizures. There’s an age around from 2 to 6 where they can get a seizure from having a high fever. Of course, if you get the vaccine and you have a high fever, you may get a seizure. That side effect is very rare but it is there. It’s usually in kids who are already predisposed to seizures.
In terms of the other reactions, there is a rare side effect called Guillain–Barré syndrome that can happen from a flu vaccine, but again, it’s usually there’s a family history or predisposition to developing these serious side effects. Usually, the families are aware of those risks before the vaccines actually happen.
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Dr. Lisa: What about some of the newer vaccines that have come on the market like Gardasil?
Dr. Lynne: Gardasil is definitely one of the ones that causes a lot of apprehension in the moms and dads of teenagers because it’s relatively new but it’s been around since probably early 2000s in their research phase. Then it became broad marketed in 2006.
The data I’ve seen that in 2006, there was 21 million doses and only 8,000 side effects which is like less than 1%. Of course if you are one of those 8,000, that’s significant. A lot of times though, the Gardasil just gives a sore arm. Some kids get a little dizzy after a shot, but that’s more just a reaction to the stress of the shot.
In terms of our practice as we really in the five practices I’m associated with, we don’t haven’t really seen much of a side effect to Gardasil that is more just nationwide.
Dr. Lisa: And what is Gardasil protecting against?
Dr. Lynne: It’s protecting in cervical cancer. It tries to prevent you from getting infected from four different human papilloma viruses that are known to cause cervical cancer.
Dr. Lisa: So when you vaccinate young, then you’re protecting against something that girls can be exposed to over the course of their lifetimes which could then lead to cancer.
Dr. Lynne: Exactly and the important thing of getting them vaccinated young is that you want them to be vaccinated before they become sexually active.
Dr. Lisa: You alluded to the meningitis vaccine. There are other vaccines that do take place in the teens and actually leaders, kids are getting ready for college, right?
Dr. Lynne: Right. There is a meningitis vaccine called Menactra and it’s very important to get them started. We do them at age of 11 and now there’s a booster after the age of 16 so that they are doubly protected. The immunity of it should last at least 10 years to get them through to college years.
The college kids are the most at risk for meningitis because they live in dorm settings and close quarters. Then high school kids are the next highest at risk and then junior high. That’s why we try to get them vaccinated when they’re 11.
Dr. Lisa: What if a parent comes in and says, “Dr. Lynne, I just don’t want my kid vaccinated.” What’s your response?
Dr. Lynne: I respect the parent. My role is being their medical adviser. Ultimately, you’re the parent, you make the decision on your child but I want you to be fully informed. We’ll talk about it. I’ll make sure that they’re aware of all the risks of not being vaccinated, but ultimately if they have made the decision and they have done their research, I respect that.
You really can’t force it and in the State of Maine, I believe children can go to school and the parents can sign a waiver if they’re philosophically opposed or if they have a health condition. Some kids don’t get immunized for measles, the MMR vaccine because they have an egg allergy. I do respect what the parents have to say but I try to make sure that they’re as fully informed as they can be before they make that decision.
Dr. Lisa: Let’s talk about what happens if you don’t vaccinate your child and you’re exposing your child to get sick and you’re exposed to things on an airplane or a foreign country. What’s the public health risk of not vaccinating a child?
Dr. Lynne: There is a public health risk. That’s why we have outbreaks of pertussis right now because not everyone is fully immunized. If you get at least 95% of the population immunized, then I believe the risk for herd immunity. The risk for infection goes way down because there’s this thing called herd immunity that if most of the populations immunized, it will protect the ones that are not.
As our rates go a little higher, again I’m not exactly sure of the exact percentage. There is that risk that if you’re not immunized, you will catch the disease and then you spread it to other people. Those that are immunized will have a milder form of it and they’ll be okay, but the ones who aren’t will be more at risk.
The bummer thing like for chickenpox is say your child is not immunized and there’s a case of chickenpox in the school, it takes sometimes 21 days for it to come out. Your child will miss 21 days of school and that can be very awful in terms of finding childcare and you missing work. Sometimes, you have to look at those risk as well to not immunizing your child.
In theory, if you have this thing called herd immunity and a lot of people get immunized, then it protects the small amount that are not, but again it has to be a very small amount. Thankfully, in my population, I actually don’t have a lot of kids who don’t get immunized.
Dr. Lisa: Is there anything that you would leave as a parting message to parents who might be listening today whether they’re thinking about vaccinations or their children’s health? What are some of the things that you routinely tell parents?
Dr. Lynne: I tell parents to definitely ask your doctor any questions that are on your mind. Sometimes what is worrying the parent the most actually can be easily reassured by giving them information and facts. So don’t be afraid to talk to your doctor and get that information about shots and get your kids vaccinated.
Dr. Lisa: It has truly been a pleasure to actually see you again after many years. I want the people who are listening today just to know Dr. Tetreault is an example of why people go into medicine in this great state because she always had this unbridled enthusiasm for teaching and children and you can just tell being with her. She is caring and compassionate and she’s so smart.
As the medical director for Vax Maine Kids working with Maine Health and also pediatrician with Maine Medical Partners Pediatrics in Saco, we’re so thrilled to have you here. Thanks for coming in.
Dr. Lynne: Thank you again for having me. It was a pleasure. It was great to see you too.