Ask a Doc: Do your kids need sunscreen if they’re in the shade?

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You should put sunscreen on your kids even if they’re playing outside in the shade. – Paul Bradbury, Getty Images

Mansi Sarihan, MD  |  Contributor
As originally published USAToday.com 9:20 p.m. June 18, 2018

Question: Do you need to wear sunscreen if you’re outside in the shade?

Answer: I receive this question often and every time I answer:

Definitely yes!

You may think you’ve got it made in the shade, but you can still be hit by harmful UV rays that bounce off the sand, sidewalk, pool or ocean. They can even bounce off grass!

Even under an umbrella or a shade structure, UV rays can slink through the fabric and cause skin damage.

Yes, shade is a blessing. But if you’re relying on it to protect your skin from sunburn, you may be very disappointed. That’s why you’ll want to apply sunscreen before you step outside, even if you’ll stay in the shade.

Here’s the best way to protect yourself and your loved ones from direct and indirect UV rays:

  1. Use sunscreen of at least SPF 50 or higher, with full UV spectrum. Find a brand that you like – you’ll be more likely to use it. Reapply sunscreen every two hours you’re outside.
  2. Wear wide-brimmed hats (at least 3 inches of brim all around the head) and UV protective clothing.
  3. Avoiding the sun during peak hours is essential. From around 10 a.m. to 2 p.m., try not to go outside. Or, stick to shaded areas such as swimming at times when the pool is out of the direct sun.
  4. Get in the habit of applying sunscreen. Daily application of sunscreen in the morning, regardless of your activities during the day (even just driving in the car), can yield healthier and happier skin.

Follow these rules and your skin will thank you.

Mansi Sarihan, MD, is chief of dermatology at Maricopa Integrated Health System and Clinical Assistant Professor, University of Arizona, College of Medicine-Phoenix.

As originally published USAToday.com 9:20 p.m. June 18, 2018

Engaging Children with Spina Bifida for Increased Mobility

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Wednesday, April 11, 2018 – Linda Thunn

CRS partners with SBAAZ to encourage best mobility in young patients

SCOOOT provides an early experience of independence for kids with mobility challenges. It frees them to explore their home, play, chase and race friends and siblings without any help. Expert clinicians, designers and engineers worked hard to create a device that will help kids discover new skills as well as new pals. The potential for physical and cognitive development was a key factor in every element of the design.

Spina Bifida Association of Arizona Inc. (SBAAZ), an organization committed to enhancing the lives of those affected by spina bifida in Arizona, was awarded a grant from the PayPal Gives Corporate Advised Fund at Silicon Valley Community Foundation. The grant was recommended by PayPal’s employee-volunteer led Chandler, AZ GIVE Team.

The SCOOOT program idea was presented to the SBAAZ by CRS’s Myelomeningocele Planning Clinic Lead Physician Pamela S. Murphy, MD, FAAP. The program was coordinated by Sharri Runnels, executive director of the SBAAZ, along with SBAAZ board member Linda Thunn, PT, DPT who is also the Myelomeningocele Planning Clinic physical therapist at CRS.

The CRS Myelomeningocele Planning Clinic occurs every Friday, and they see approximately seven patients for all day clinic, visiting up to 13 different providers, having blood work drawn, and if necessary they will get casted for their orthotics and/or have x-rays. SBAAZ provides lunch and signs people up for their medical alert bracelets. Free Arts of AZ is there for the kids to create projects at lunch time.

The SCOOOT program involves readiness assessments, equipment placement, activities and progress checks that will empower ‘toddlers’ to keep pace with their siblings and peers as they establish a sense of mastery over their world. The mobility device, resembling a toy more than a piece of medical equipment, allows children to reach items from the floor, ambulate, and enter/exit the seat safely at will.

“CRS is a great partnership for SBAAZ as we are able to share resources with clients and assess needs over lunch with families that are served by the fantastic care team brought together by District Medical Group,” stated Runnels, “SBAAZ is very grateful for the relationship with DMG and wanted to share the first SCOOOT placement with their staff as they pour so much into the kiddos!”

Spina bifida (Myelomeningocele) is a birth defect in which the spinal canal and the backbone don’t close before the baby is born. This type of birth defect is also called a neural tube defect.

The SCOOOT Earliest Mobility Program kicked off was on Friday, November 10, 2017 with placements being made at the CRS Myelomeningocele Planning Clinic.

Make-A-Wish Arizona and District Medical Group to increase wishes for kids

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Tuesday, April 10, 2018 – Hollie Costello & Toni Eberhardt

Make-A-Wish® Arizona, the local chapter of the international wish granting organization, and District Medical Group (DMG), a Phoenix-based non-profit medical group comprised of more than 650 providers across medical specialties, are piloting a unique referral process to increase life-changing wish opportunities for eligible children receiving care at Arizona’s Children’s Rehabilitative Services (CRS), Phoenix.

The “Medical Champions” program was created by DMG using their electronic medical records (EMR) system to better identify and track children with critical illnesses who would qualify for a wish experience. Ensuring patient privacy, the team contacts the parents of its patients and assists them through the referral process so their child might benefit from a wish experience. With more than 16 staff members on board for the pilot, DMG has referred more than 22 wish kids since June 2017. Before the program, the team had referred 40 kids total over three years.

”We believe healthcare is more than administering clinical care; it is helping patients attain the life experiences they wish for by using the resources we have available,” said Troy Nelson, MD, DMG Medical Director at CRS. “We are thrilled to partner with Make-A-Wish Arizona and expand the use of our EMR to help young patients start the wish process.”

This innovative approach to referring new children for wishes has built a stronger relationship with medical professionals for Make-A-Wish Arizona. The chapter is excited to see if the program can be templated for other physician offices, hospitals and clinics.

“Medical professionals are an important referral source for our wish kids because they understand the value a wish can have on a patient’s medical journey,” said Jennifer Fleming, Intake and Medical Outreach Manager. “With this new system in place, DMG medical professionals can reach out to Make- A-Wish when their patients are most in need of the happiness and strength a wish can create.”

For wish mom Maria Beteta, the wish experience created for her son, Marcos, went above and beyond what she ever considered possible. Marcos, 14, lives with critical idiopathic epilepsy. His wish was to “meet” his favorite Disney characters.

“Marcos’ wish was a great, unique experience not only for Marcos, but for my entire family,” said Beteta. “To see my children so excited, so surprised by many things. My greatest happiness was looking at my son, Marcos, so surprised. His eyes shined with such emotion. He loved all the services that they gave my family. We all did not want the day to end.”

About Make-A-Wish® Arizona

Make-A-Wish® Arizona is the founding chapter of Make-A-Wish®, the world’s largest wish granting organization which grants life-changing wishes for kids with critical illnesses. With the help of generous donors, Make-A-Wish Arizona has a goal to grant more than 400 wishes this year. For more information, visit Arizona.Wish.org.

About District Medical Group

District Medical Group is a nonprofit entity consisting of more than 650 providers representing all major medical and surgical specialties and subspecialties. DMG providers serve acute care and psychiatric hospitals, diagnostic centers, family health centers, an internationally-recognized burn center, and numerous outreach programs. DMG administers Arizona’s Children’s Rehabilitative Services (CRS) multi-specialty clinic in collaboration with United Health Care, a first-of-its-kind clinic in the Phoenix area. For more information visit, DMGAZ.org.

Media Contacts

Make-A-Wish Arizona
Hollie Costello
Vice President, Public Relations & Marketing
O: (602) 343-9474
Email Hollie

District Medical Group
Toni J. Eberhardt
President, Prescriptive Communications
C: (602) 418-7767
Email Toni

Children’s Rehabilitative Services (CRS) Physical Therapy Department Spotlight

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Thursday, April 5, 2018 – Linda Thunn

The Children’s Rehabilitative Services (CRS) Pediatric physical therapists provide support and services for children (birth to 21 years) with developmental disabilities, and their families. They aim to develop, restore and improve mobility to improve quality of life.

Pediatric physical therapy benefits children and their families/caregivers by promoting activity and participation in everyday routines, increasing functional independence, improving strength and endurance, facilitating motor development and mobility, and easing the challenges of daily caregiving. Because patient’s are allowed to ”opt in” for services past the age of 21, there are several physical therapists qualified to treat individuals over the age of 21 as well.

Besides treating children one-on-one in the rehab clinic our providers also work in CRS’s Multidisciplinary clinics such as:

• Amputee Clinic
• Cerebral Palsy Orthopedic Clinic
• Cystic Fibrosis Care Center
• Myelomeningocele Planning Clinic
• Spasticity Planning and Follow-up Clinic

Our providers also perform equipment evaluations. They trial each child to determine what works best for them. Those evaluations are done on:

• Adaptive Seating
• Adaptive Car Seats (onsite at NuMotion)
• Forearm Crutches
• Gait Trainers
• Standers
• Walkers
• Wheelchairs (onsite at NuMotion)

A Spotlight on DMG Pediatrics

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Wednesday, March 28, 2018 – Prabodh Hemmady, MD | Eileen Maddix | Jeanine Pittman

Pediatrics Overview

DMG Pediatrics is multifaceted, responsible for patient care in many locations. At Maricopa Integrated Health System (MIHS), there is a robust ambulatory clinic at the Comprehensive Health Center (CHC) where both general pediatric and subspecialty patients are seen.

In partnership with the Ambulatory Care division of DMG, Pediatrics staffs primary care physicians at some of the MIHS Family Health Centers (Maryvale, South Central and Mesa). With the implementation of Proposition 480 (“Care Reimagined”), we are hoping to grow pediatric ambulatory care at MIHS. The Pediatric Emergency Department (ED) and inpatient care units at Maricopa Medical Center are also great resources for Phoenix and the surrounding communities.

The Pediatric ED is open 24/7/365 and is staffed by Pediatric ED trained physicians. The inpatient units consist of a neonatal intensive care unit (NICU), pediatric intensive care unit (PICU) and acute care unit. We also care for non-ICU newborns who stay with their mothers on the post-partum unit until discharged home.

In addition, DMG Pediatrics supports the DMG Children’s Rehabilitative Services (CRS) clinic located near 3rd Ave and Thomas Road by providing genetics, neurology and gastroenterology subspecialty care on site.

Pediatric Subspecialties

Subspecialties at the MIHS CHC include the following fields:

Adolescent Medicine
Neurology
Endocrinology
Gastroenterology
Cardiology
Infectious Disease
Nephrology
Genetics
Pulmonology

Pediatric Residency Program and Medical School Affiliations

DMG Pediatrics is a strong partner with Phoenix Children’s Hospital (PCH) and MIHS in training resident physicians, and for many years it has been known as the PCH/MMC Pediatric Residency Program.

There are 32 categorical pediatric positions per year and well over 100 pediatric residents who rotate through MIHS when the medicine-pediatric residents and the pediatric/pediatric neurology residents are added. The pediatric residency program receives well over 1000 applications and interviews over 275 people for the 32 pediatric spots each year. The residents come from all over the country and bring with them a variety of backgrounds.

The department is also very active in educating medical students from the University of Arizona College of Medicine and Midwestern College of Osteopathic Medicine. We also teach medical students from the Mayo School of Medicine and are excited about the relationship developing with Creighton Medical School.

Learn More About DMG Pediatrics

Would you like to know more about DMG’s Department of Pediatrics? The website is available in Spanish as well as English to better serve our patient population, giving them full access to the great information about us!

In Pediatrics: DMG’s Children’s Rehabilitative Services Leads the Way

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Children with special needs require care from a wide range of specialties: Physical and Occupational Therapy, Orthopedics, Speech, Audiology, Plastic Surgery, Cardiology, Neurology and Psychology.

District Medical Group’s Childrens Rehabilitative Services Clinic houses these specialties and more under the same roof, as the largest multi-specialty, interdisciplinary clinic in the State of Arizona. We provide a full spectrum of pediatric specialty care from birth to the age of 21.

AHCCCS Behavioral Health Services for Children in Foster Care  

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Arizona Health Care Cost Containment System (AHCCCS) is committed to ensuring the availability of timely, quality health care for foster children, including behavioral health services through our three contracted regional behavioral health authorities (RBHAs) and the Children’s Rehabilitative Services (CRS) program.

If you experience any difficulty accessing needed behavioral health services or have any concerns regarding the quality of those services, we encourage you to contact the RBHA or CRS in your area.