New Page 1

FLU VACCINE

As most of you know, the flu vaccine is in. You should have received a postcard if you had reserved a vaccine for your child/children. If you remember ordering a vaccine but have not received a postcard or have not come in for the vaccine, please call for an appointment.

We are also trying a new system of ordering for next year. When you come in with your child for their flu vaccine, we will have you fill out an order form for next year. This will help us keep track of our ordering and limit the phone calls Val will have to make.

As a reminder, there are two different types of influenza vaccine, the injectable form (Fluzone) and the nasal spray (Flumist). If you have not previously ordered a vaccine for your child for this year, and you want the Flumist vaccine, we may be able to order one. We can not, however, get more of the injectable vaccine for the children age 3 and up. If you have any questions, please call our office.

EDUCATION.COM

Dr. Yankus was selected to be one of two medical experts for a national website called Education.com. The website is located in the San Francisco Bay Area and its vision is to become the largest provider of educational information and services to parents. The goal is to write, organize and consolidate accurate, authoritative information to parents on “whole child” education and wellbeing. The expert panel consists of 10 people who are Ph.D.s or MDs from across the country who have been distinguished in their profession. They meet yearly at Stanford University in Palo Alto, California.

Dr. Yankus is a frequent contributor to the website’s discussion board and will be authoring a special edition on Attention Deficit Disorder later this year.

Check it out for its school finder and tutoring services as well as its interesting age related articles and activities.

CROUP

Croup is a viral illness that occurs in children, usually under the age of 6, in the fall and spring. The medical name for it is laryngotracheitis. It is caused by a virus called parainfluenza. It can be “spasmodic,” which means it can begin suddenly in the middle of the night in a child who was well during the day. It can also occur in a child who has had symptoms of an upper respiratoy infection. It usually lasts one to two nights, with improvement by the day time.

The classic symptom of croup is a barking cough, sounding like a seal. They may also have a squeaking sound when they breathe in, which is called stridor. This comes from inflammation and swelling of the upper airways, which is different from wheezing, which comes from the lower airway passages. Without a stethoscope, it is sometimes difficult to tell the difference. So, if you are unsure, we should examine your child. Because it is caused by a virus, a fever may also be present. Laryngitis is another symptom.

Treatment is most commonly done at home. We usually recommend taking your child into the steam from a shower or bundling them up and taking them outside into the cold night air. This treatment may need to be repeated several times during the night.

If your child does not improve, they may need to go to the emergency room. If the symptoms are continuing during the day time, you should call the office for an appointment. Antibiotics are not prescribed for this illness, since it is caused by a virus, but we sometimes will prescribe an oral steroid to help with the inflammation.

Croup is contagious, so another child could potentially contract croup from exposure to it. An adult or older child may contract the virus, but will generally only get upper respiratory infection symptoms and/or laryngitis.

CANKER SORES

(APHTHOUS ULCERS)

Canker sores are painful sores (ulcers) that occur inside the mouth. They can be on the inner cheeks, roof of the mouth, gums and tongue. They are usually not accompanied by a fever unless there is a concurrent viral illness. They usually last 1 to 2 weeks.

The exact cause is unknown, but there are some theories proposing a viral etiology. They can also be caused by minor mouth trauma (from toothbrushes, rough foods, hot foods or biting one’s own tongue or inner lip). Some people seem to be predisposed to recurrent aphthous ulcers. They sometimes seem to be more common in certain families. They also may be hormonally mediated, as some girls/women have recurrences during menstruation. Certain medications, such as immunosuppressive drugs (i.e. methotrexate) may also cause an outbreak. It is also possible that certain foods, such as citrus, tomatoes or other spices may cause the ulcers, so you should keep a food log if the ulcers are recurrent.

They are different from “cold sores,” which are caused by the Herpes virus and occur on the outer lip, not inside the mouth.

There is no treatment to cure the ulcers, but there are some remedies which can soothe the pain. Your child can take ibuprofen (Motrin or Advil) or acetaminophen (Tylenol) for the pain. There are also some topical treatments:

· Your child can swish 1 teaspoon of an antacid, such as Mylanta, around in his/her mouth and then spit it out. If your child is not old enough to do that you can put the antacid directly on the sores.

· There is an over-the-counter product called Orabase Soothe-N-Seal made by Colgate. This is applied with a special swab (provided in the box) directly onto the sore and lasts longer than many of the older remedies.

If neither of these work, you can call the office and we may be able to prescribe another medicated treatment.

PREVIOUS TOPICS TO REVIEW

You may want to review some of our relevant Fall Topics from previous newsletters such as:

Halloween Safety Tips

Cough

Sinusitis

….and check the Index link from our home page for all of our previous topics.

http://www.yankusandungerleider.com

OFFICE NOTES

A reminder about credit cards: As your children get older sometimes they come for their visits alone. Since we now take credit cards, you have the option of leaving your credit card information on file with us, so that you can easily pay for these visits and not have to worry about paying the bill later. If you are interested in doing this, please talk to Chris or Dara.