New Page 1

OFFICE NOTES

Office staff: Please welcome our two new office staff. Susan will be working at the front desk on Saturday mornings, replacing Vicky, who has left to spend more time with her children. Adrianna will be working on the nurse side, as Sue is moving to Pennsylvania.

Physicals: Remember that physical exams do not need to be in the spring or summer. Especially if your child’s birthday is in the fall or winter, you may be able to avoid the crunch for physical appointments in the spring or summer by scheduling them in the fall or winter.

FLU VACCINE

Flu vaccine: We have been informed by the manufacturer of the Fluzone vaccine (the shot), that we will not be receiving shipment of the vaccine until November 2006 for children over 3 years of age. We will have the vaccine for the younger children before that. We will call those patients on our list when we receive the vaccine to schedule appointments.

Flumist: We should be receiving our Flumist (the nasal vaccine) order in October. We will also call those patients who are on our list for that when it arrives. Anyone who is not on our list, but wishes to receive this vaccine may call to discuss their eligibility with the office. Unlike the Fluzone, we will probably be able to order more of this vaccine, if needed.

GARDASIL

Last month we provided information about Gardasil, the vaccine for Human Papilloma Virus, a virus which has been shown to cause cervical cancer. We have been vaccinating girls 11 and up in the office. If you would like your daughter to have the vaccine, please call to schedule it. For more information on the vaccine, see our Summer 2006 newsletter.

TREADMILL SAFETY

We have seen several injuries in the past month secondary to treadmills. They have been second and third degree burns as well as bruises. Young children should not be playing near or on a treadmill. Children under the age of 12 should not be using a treadmill. If you have a treadmill and you or your child is using it, you should make sure that it is a treadmill that has an automatic shut off or safety key. This is a plastic “key” that fits into a slot on the treadmill and is attached via a string to a clip that attaches to the user’s clothing. If the person on the treadmill slips, the key will pull out of the slot and the treadmill automatically shuts off, lessening the chance of injury.

Never leave the treadmill running, even if it's just for a brief moment while you answer the phone, turn up the music or grab some water. Accidents can happen in a matter of seconds. If possible, store the treadmill in a locked room when not in use. Try not to use your treadmill in the presence of young children. Before using your treadmill, always check for small toys, wrappers etc. that may have been pushed under the belt.

COUGH

During the fall season we receive many calls regarding coughs. Most coughs are caused by viral infections which affect the upper airways (a cold or upper respiratory infection) or the larger lower airway passages (tracheitis or bronchitis). Coughing is necessary for the body to clear the mucous in these areas of the airway and can help prevent pneumonia (an infection in the lungs).

Coughs can last anywhere from a few days to a few weeks. The home care is to drink a lot of fluids, rest and use humidified air. In general, we do not recommend using cough suppressants during the day. The cough reflex helps protect the lungs; therefore it is not helpful to suppress it. The reason to occasionally use cough suppressants is if the cough is interfering with sleep. The cough suppressant used for children is dextromethorphan (DM).

Coughing is one of the ways in which disease is spread. Therefore it is important to teach your children to cough into their sleeve as opposed to their hands. They are far less likely to touch another person or object with their sleeves and it is not always possible to wash their hands immediately after coughing.

A common misconception is that milk should be eliminated from a child’s diet when there is a cough or congestion. Unless your child is allergic to milk, this is not necessary and probably will not help.

If your child’s cough is persistent (longer than 2-3 weeks) or if there is wheezing, difficulty breathing or fever, you should call our office; we may need to examine him/her to check for asthma or pneumonia or bronchitis.

If your child has asthma, you should start his/her inhaler when the cough is beginning, as opposed to waiting till there is difficulty breathing or full blown wheezing.

SINUSITIS

Sinusitis is a bacterial infection in the sinuses draining into the nose. Upper respiratory infections and allergies can cause congestion of the sinuses by blocking the openings, preventing fluid from draining. This fluid is then a good place for bacteria to multiply.

In an older child, sinusitis can cause pain and pressure in the forehead, behind the eyes or over the cheekbone, depending on which sinus is infected. There also may be a yellow nasal discharge, sore throat, fever, postnasal drip, cough or bad breath. Younger children often do not show the classic symptoms, but just have a “cold that won’t go away.”

Sinus infections take 1-2 weeks to develop; therefore congestion that is present for only a few days to a week is not a sinus infection and is probably a simple upper respiratory infection (cold). Colds are caused by viruses and do not respond to antibiotic treatment; they must “run their course” of a few days to a few weeks.

Sinus infections are treated with antibiotics, often a longer course than is needed for a simple ear infection. If your child acts sicker or has redness or swelling on the cheek, eyelid or forehead while taking the antibiotic, call the office; we may need to reevaluate him/her. Acetaminophen or ibuprofen help relieve fever and pain, and we may recommend nasal washes (with saline) and occasional decongestant nose drops. Antihistamines may also be given if there are underlying allergies.

Sinusitis is not contagious; therefore a child may return to school once feeling better.

BACK TO SCHOOL TIPS

(from the American Academy of Pediatrics)

Backpack safety: Choose a backpack with wide, padded shoulder straps and a padded back. Pack light. Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back. The backpack should never weigh more than 10 to 20 percent of the student's body weight. Always use both shoulder straps. Slinging a backpack over one shoulder can strain muscles. Wearing a backpack on one shoulder may also increase curvature of the spine. Consider a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember, however, that rolling backpacks still must be carried up stairs, and they may be difficult to roll in snow.

School Bus Safety: Wait for the bus to stop before approaching it from the curb. Check to see that no other traffic is coming before crossing. Make sure to always remain in clear view of the bus driver. Do not move around on the bus. Make sure your children are wearing the seat belts which are on all New Jersey school buses.

Homework and Study Habits: Create an environment that is conducive to doing homework. Youngsters need a permanent work space in their bedroom or another part of the home that offers privacy. Set aside ample time for homework. Establish a household rule that the TV set stays off during homework time. Be available to answer questions and offer assistance, but never do a child's homework for him/her. To help alleviate eye fatigue, neck fatigue and brain fatigue while studying, it's recommended that youngsters close the books for 10 minutes every hour and go do something else. If your child is struggling with a particular subject, and you aren't able to help him/her yourself, a tutor can be a good solution. Talk it over with your child's teacher first.

We hope the above information is helpful. If anyone has any topics they would like covered in future PedNotes, let us know.