OFFICE NOTES
A reminder about credit cards: As your children get older they sometimes 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.
Physicals: Now that we see patients to the age of 21, we remind our older patients that we do not do parent conferences after high school. While we are happy to greet parents who accompany their young adults to the visit, the private conferences we hold with parents of 12-18 year old students stop. "This continues the health ownership of the young adult and transitions care."
HIPPA: We also want to remind you that by the privacy laws we are bound by, we may not discuss any information about your child if they are 18 years of age or older without their permission.
INFLUENZA UPDATE
We know many of you are concerned about the influenza strain which has been causing illness lately. It is thought that novel influenza A (H1N1 or “swine flu”) spreads in the same way that regular seasonal influenza viruses spread, mainly through the coughs and sneezes of people who are ill with the virus.
Most of the cases in the United States have been mild. The symptoms of the H1N1 strain of the flu are: fever of 101 degrees F or higher (although usually the fever is over 102), cough and possibly sore throat. There also may be symptoms which we often see with viral illness: headache, muscle aches, fatigue, decreased appetite and occasionally vomiting and diarrhea. If your child is experiencing a fever and/or any of the other symptoms you should contact us. DO NOT TAKE YOUR CHILD TO THE EMERGENCY ROOM unless he or she is severely ill and/or you are directed to do so by us.
Once we see your child in the office, we may test in our office for influenza. This is a general test for influenza; it does not tell us the specific type. That kind of testing can only be done by the state and they have recommended that only those with flu-like illness who have been admitted to a hospital or people who are part of a group of illness called a cluster authorized by the NJ Department of Health and County Epidemiologist be tested. However, if our test is positive in the office, we may prescribe one of the anti-viral medications called Tamiflu or Relenza.
It is important to remember that the steps parents can take to help prevent the spread of illness are the same with or without a diagnosis of H1N1. They are:
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People who have flu-like symptoms (students, staff, parents, etc) should stay out of school or work for at least 24 hours after their symptoms have gone away and 24 hours after their fever has gone. Although the CDC has mentioned that people should wait for 7 days, some school districts will allow people to return sooner with a doctor’s clearance note. |
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The ill person should limit their contact with others in the family. If taking care of a child, designate only one provider, to limit the contact with the sick child. |
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If schools are closed, children should not congregate in large groups (i.e.: movies, the mall, other students’ houses) to limit person to person contact and disease transmission. |
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In order to help prevent the spread of infection, please encourage your children to: cover coughs and sneezes (use tissues and dispose of them immediately – or cough into elbow if a tissue is not available), avoid touching eyes, nose and mouth, wash hands frequently – especially after coughing and sneezing. |
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Keep children home from school if they are sick, especially if they are experiencing a fever. |
The schools are working very closely with the local public health officials to monitor the cases and to ensure the health and safety of the children
For more information on H1N1 (Swine) flu please visit the following websites:
CREATINE
Over the years we have been asked questions about nutrition supplements for young people playing sports. Muscle milk, Explode, and other GNC powder concoctions are for sale legally as foods to students who wish to boost their strength. Unfortunately many of these powders or drinks contain excessive amounts of caffeine or a substance known as creatine.
Creatine is a substance obtained in the diet from meat and fish. It is also produced in the liver. It acts as an energy source in muscle tissue but has not been shown to improve performance. It can also inhibit sweating which is an essential mechanism of the body to prevent heat stroke or exhaustion.
The American Academy of Pediatrics and the American College of Sports Medicine recommends against creatine supplementation in patients less than 18 years of age.
SPRING ALLERGIES
Spring brings with it flowers, blossoming trees and….allergies. Some children will have yearly problems with allergies; others are only bothered periodically. Although the symptoms vary from person to person, they often include some degree of itchy, red, watery eyes, nasal congestion, cough and sometimes wheezing.
There are several options for treatment of seasonal allergies. The most important part of the treatment is removing the pollen when your child comes indoors. You should wash off your child’s face with a clean washcloth with cool water. The hair and hands should also be washed and the clothing worn outside removed.
If your child has itchy, watery, red eyes, they may be helped by eye drops, some of which are over-the-counter (such as Visine-A, Bausch & Lomb Allergy Eye Drops, Occuhist, Naphcon A). These allergy eye drops work by constricting the blood vessels of the eyes. Some also contain an antihistamine to relieve the itching. There are also prescription eyedrops which are used both for treatment and prevention of allergic conjunctivitis.
For persistent eye symptoms and to treat the concurrent nasal symptoms, you may need an oral medication. Several medications are now over-the-counter. These are long-acting antihistamines, such as non-sedating Claritin or the other brands of loratidine or Zyrtec, which may cause some sedation. These can be given on a daily basis during allergy season or on an as needed basis.
If these treatments are not helping, you should call us for your child to be seen. We might prescribe an alternate prescription antihistamine or a nasal spray containing a local steroid. We do not recommend using over-the-counter nasal sprays or drops (other than plain saline drops); these may actually worsen the symptoms. If your child is wheezing and you have not treated them for wheezing in the past, you should call us.
If despite all our treatments, your child is having persistent symptoms, he or she may need to avoid being outdoors during windy days when the pollen count is high. We also may recommend an allergist to determine exactly what he or she is allergic to in order to avoid that particular exposure.
POISON IVY
The poison ivy plant causes a contact dermatitis in many people. The rash begins one to two days after exposure to the plant, which often occurs while playing in the woods or a field. Itchy red bumps and blisters appear, usually in patches. They develop first on exposed body surfaces, but may spread to other areas, by the body’s own reaction to the exposure.
The best treatment is prevention. Children should learn what the plants look like and try to avoid them. Poison oak and poison sumac also cause this dermatitis. If contact occurs, the exposed areas should be washed well with soap and water. Exposed clothing should also be washed.
Treatment of the rash is symptomatic. Cool soaks and 0.5-1 % hydrocortisone cream (over-the-counter) applied to the involved area three times a day for one week may give relief. The rash may last up to 10-14 days. The fluid in the blisters is not contagious; therefore a person with the rash cannot spread it to others or to other parts of his/her own body, once the area has been washed.
If the rash is not improving or involves the face, eyes or lips, please call our office. We may need to see your child and may need to prescribe a prescription strength cortisone cream or an oral steroid.