New Years coverage

We will have morning hours on Friday.
The after hours clinic will see patients Friday afternoon and through the weekend as usual.
If you have any concerns and think you want your child checked before the weekend, make sure you call early!!

Also, just letting you know...We just had our first official positive flu test on an unvaccinated child..
Influenza has arrived. If you haven't yet done so..please get your flu shot or flu mist!
Happy New Year
~Nurse Judy

December 27th update/RSV alert

I hope everyone had a nice holiday and that all the travelers out there have easy trips home.
There is a lot of coughing out there. We have some confirmed cases of RSV..a nasty bronchiolitic sounding cough.
Our littlest patients can have a hard time with this and may end up in the hospital for observaion. Older children simply deal with this aggravating cough and congestion.
If you have a very young baby please avoid crowds and exposure as much as you reasonably can.
We have had plenty of patients with sore throats today. About 25% of them have tested positive for strep throat.
There have been some calls with complaints about loose stools and vomiting.
I am still seeing folks with a moderate fever.. This has lasted about 3 days so far and I do not think it is the actual influenza.
Stay well
~Nurse Judy

fevers

We are seeing a lot of kids with high fevers, conjestion and coughs. So far every one of them has had the flu shot this season.
This means either it is NOT the flu, or the shot is not protecting against this strain. We have not seen any positive flu tests yet, so likely it is just a nasty virus/ not the flu, but I will keep you in the loop as I get more data.
We are in the office Friday morning only for acute care visits, so if you want and need to be seen before the weekend call EARLY.
Happy and Healthy holidays!
~Nurse Judy

Nebulizers!

If you have one of our rental/loaner nebulizers and your child is not actively needing it, please return it to the office this week.
We charge a nominal fee per night to borrow a machine, but please note that you can buy a new one at Walgreens ( with a prescription) for less than $75 and your insurance may cover it. If you child has had more than one episode of wheezing, I think it is worthwhile to buy one. It may save you an emegency room visit one day

December 20th/travel tips

We are seeing a lot of ear infections this week.
Many kids have some fever and there are a few cases of vomiting kids around.
Dr Kaplan wanted to pass along some info on a Soocer injury prevention clinic in Mission Bay on Januaury 5th 2011 5:30-7:00PM.
call 318-8138 for more info.
Many of our families are traveling this month.
It is always a wise idea to scope out the options for seeking local medical care before you go anywhere.
Travel with tylenol or Ibuprofen.
If you child has a history of wheezing, stop Murphy's law in its tracks by bringing your nebulizer and medications along with you.
Find out in advance...
*What kind of insurance do you have and what will be your best bet for reimbursement?
*Do you have friend's or family with a local pediatrician who is willing to see a traveling patient?
*Where is the closest travel clinic or ER?

If your child seems ill while you are traveling, We are always happy to advise you by phone and help you decide if your child needs to be seen or not.

Stay well and have healthy holidays..
Thanks to everyone for the lovely photos cards and treats that we have recieved this month!!
~Nurse Judy

December 14th

This week I have an several folks complaining of sharp and gassy stomach pains.
Any severe stomach ache that seems steady as opposed to more intermittent should be checked on.
We are also starting to see achy kids with fevers...Flu??? Perhaps it is starting.
We are seeing some hand foot mouth lingering.
We still have the never ending colds and coughs, but more children seemed a bit wheezy today.
Stay well
Judy

December 10th 2010

For mid December it is fairly quiet.
We have seen some cases of hand foot mouth going around.
There are plenty of colds and coughs and a smattering of strep throat.
I still don't think I have seen any actual cases of flu yet this season, but I do suggest getting the flu shot if you haven't yet. The actual flu is NO fun at all if you get it. It almost always comes along with high fevers, aches, chills and congestion. The H1N1 last year also had a tummy component.
On a completely different track.....If anyone is looking for babysitters from now until the end of the year, my college age daughter ( home on break)is a wonderful sitter and is available for occasional days or evenings. Leave a comment if you want more info
Enjoy the upcoming sunshine this weekend and stay well
Nurse Judy

tummy bug back

This morning my desk is full of charts of vomiting kids.
Some have diarrhea, some have fevers with this..
so it is going around.....again.
Good hand washing please!!
Nurse Judy

Where did November go??

I hope everyone had a healthy and pleasant Thanksgiving holiday.
There is not much new going around.
Or biggest complaint is absolutely the ongoing cough.
We are seeing a bit more croup as we did last week and more of our kids are getting wheezy.
When your kids have colds and coughs please check in with us if
*you are noticing that the mucous is getting thicker and greener and not clearing
* there is a fever that is lingering for more than 3 days
* your child is much fussier than usual
*sleep is consistantly miserable for more than a few nights
**** and the most important thing of all..are the respirations labored??
Without listening to the sounds, look are your child. Is the breathing more rapid than usual? is the tummy going in and out more than usual?
These are signs that the breathing isn't as easy as I would like it and it might be worth a visit. it is certainly worth a call.
Now you can start listening. Is the breathing very noisy..from the chest?? Sometimes colds can cause noisy nose breathing from the nose...we are not bothered by that. We are interested in noises that seem to be coming from down in the lungs.
To recap.
Noisy labored breathing and /or fussy kids need to be seen.
Congested, stuff kids who are sleeping, eating, content, clear mucous....we can play the wait and see game.
While you are waiting, you can do the following to keep your kids more comfortable.
*Elevate their heads
*use a humidifier at night and/ or go into s steamy bathroom several times a day
*put saline or breast milk in the nose and use an aspirator or nose frida to suck it back out
*keep your child drinking as much as you can. Good hydration will keep the musous thinner and help it clear more easily.
Call as needed!!
Judy

Happy Thanksgiving/ some croup around

We are here only 3 days this week.
Perc will be available for any of your after hours needs during the holiday break.
Today we have had some weekend reports of CROUP.
Croup usually presents in the middle of the night with a very barky cough. Some kids actually sound like seals.
If this happens, stay calm and go into a steamy bathroom for a few minutes. Most of the time the symtoms ease quite a bit from either steam or going outside into the night air.
If you feel like your child is really laboring, it is reasonable to head over to the emergency room.
In most cases of croup the symtoms have significantly lessened by the time you get there, but in some cases the kids need treatment including a shot of steroids to calm things down.
The croup virus is quite contagious and usually lasts around 3 days, with nights being worse than the days.
Running a humidifier at night and giving lots of oral fluids during the day should help out a lot.

We still have some cases of hand/ foot/ mouth around including some unfortunate moms who must not have had it when they were young.
Most of what we have been seeing are the very persistent coughs and colds.
Anything that has been lingering for more than 3 weeks probably deserves an evaluation.
A few stragglers still have the tummy bug, but that has tapered off for now.

Hope you all have a happy thanksgiving and easy travels if you are braving the airports or doing a road trip
~Nurse Judy

upcoming flu clinic

We will having another flu clinic here at the office on Saturday morning November 20th from 9:30 until 12:30.
If any patients or family members need to get their first or second shots (or mist) feel free to drop by. No appointment is necessary.
We haven't seen any official cases of flu yet, but we are certainly seeing a viral syndrome that causes fairly high fevers along with some congestion.
Coughs and colds abound!
Enjoy the nice weather this week.. I fear that we are in for a change soon!
Stay well
Judy

November 9th

We have a whole shopping list of stuff out there.
There is still a tummy bug around, some strep throat and some hand foot and mouth.
There are plenty of coughs and colds as well.
Today I also spoke to quite a few folks dealing with head lice.

With all of the winter ailments keeping our phones and schedules very busy, it becomes very important to schedule your child's routine exams way in advance.

If you haven't yet gotten a flu shot we will be holding another Saturday flu shot clinic at the office on Saturday morning November 20th from 9:30 until noon.

This week in Illness

The tummy bug is still out there! Clear Liquids, BRAT diet, avoid cows milk dairy. (remember breastmilk is a clear liquid).

Had a few kids with upper respiratory symptoms plus a fever this week.

A couple of positive strep screens. The sore throat with congestion virus seems to be receding.

I hope everyone has a great weekend!

Warmly,

Nurse Charity

Soccer Injury Clinic!

UCSF Orthopaedic Institute and Sports Medicine with
San Francisco Sport and Spine Physical Therapy
is proud to present a free
soccer injury screening clinic
-- Wednesday November 10, 2010 5:30PM-7:00PM
At the UCSF Human Performance Center in Mission Bay.

Call 415.318.8138 to schedule.
Bring yourself and your questions.

November 1st

Last week we had a fairly horrid tummy bug making the rounds.
It is still out there but not quite as bad.
Today we mostly saw lots of colds and coughs.
There were several sore throats that were NOT strep ( always worth testing though)
If the sore throat is accompanied by lots of congestion it is less likely to be strep.
There are quite a few folks out there with mild to moderate fevers that are lasting for about 3 days or so.

I hope everyone has a fun and safe Halloween!
Judy

tummy bug/ strep alert

Busy day on the phones.
There are tons of folks with a tummy bug.
Some have fevers, others not.
It mostly is starting with some vomiting and moving along to diarrhea.
Look back at earlier posts for tips on how to deal!!
We are also seeing plenty of strep throat, a couple cases of pneumonia and some miserable kids with mouth sores.
Poor babies!!!
For all of those with tummy bugs. I have been having marvelous results with a probiotic called Florajen.
you can check it out at florajen.com
The only Walgreens that carries it is at Diamond heights, but other locations are listed on the website.
Stay well....
Judy

MId October

There isn't one particular thing going around right now.
We have had some hand foot mouth,
a few kids have high fevers
there is a mild tummy bug
plenty of coughs and colds ( I have the cold...ugh)

Flu season hasn't hit yet, but now is a good time to get vaccinated if you haven't yet done so.
Children under 9 will need to get 2 flu shots ( at least 4 weeks apart) if they haven't had a previous year where they have gotten 2 seasonal flu shots in the same season.
Be well
~Nurse Judy

Whew!!

The volume of calls is very, very high, and I am struggling to keep up. Thanks for your patience. Helpful to the front desk is to keep any messages to a sentence or two.

This week we have-

---Hand Foot and mouth, a nifty little virus, usually with fever, but can come without, characterized by sores in the mouth and on the soles of the feet, palm of the hand. It spreads rapidly and every child usually gets it at least once. Your child is not contagious after the sores have crusted over and the child feels well.

Treatment usually includes ibuprofen or acetaminophen for fever, cool creamy foods usually are tolerated well.

It is already warmer than usual here in the Bay Area, so really offer those drinks! Especially if your little one has a fever.

----We continue to have a tummy bug as well with vomiting. Rest, clear liquids, when the clear liquids stay down, then you can move to the BRAT diet (Bananas, rice, (white or rice cereal) apples (really applesauce is best) and toast (white bread, no butter). This is a time to stock up on non-food items like jello (pick a light color as it is less likely to stain your couch). As long as we can keep kids well hydrated, they usually pull through without needed medical care (like anti-emetics and IV fluids). Remember that breastmilk is considered a clear liquid.

---I continue to see some vial rashy thing- fever (100-103), when the fever breaks the child gets a rash on the torso (it creeps a few other places too). If the fever breaks and then the rash comes, it is usually viral in nature, an is a sign that the virus is on its way out. Kids can return to school when they are fever free for 24 hours and _feel well_ even if they still have the rash on the trunk. Rashes that come _with_ a high fever need to be seen.

Love to all!!


Nurse Charity

September 27th

The phones were pretty insane today. With both Charity and I going full throttle, a lot of folks were waiting longer than usual for a call back today. We appreciate your patience.
I do want to remind you all though that if you are really concerned about something, please let them know at the desk when you call and we will strive to put you on the top of the pile when possible.

Most of my calls today were the basic colds and coughs.
Some folks are having some tummy issues, with vomiting and diarrhea.
We did have one Ruptured appendix last week.. It is a good reminder that vomiting and a stomach ache without diarrhea needs to be watched closely.
A few folks have fevers, but nothing that lasted long enough to cause concern.

Regarding the Similac recall, Happily none of our patients are the worse for wear from any bug parts that may have made it into their formula (yuck).. Seriously, last I checked there were only a handful of consumers out of hundreds of thousands, who may have been impacted.
Any formula that is back on the shelf of a major store is safe at this point.


We have another few hot days on the way, keep yourself and your children well hydrated!
~Nurse Judy

Mid September

This Saturday, Birth & Baby Events is teaming up with the CHP to provide FREE carseat installations and safety checks Saturday, September 25th from 8am-12pm at the San Francisco CHP office. If all those latches, buckles & straps are a mysterious tangled mess, let trained, certified technicians check or install your seat for you. Remember that you are REQUIRED to have a carseat installed to take your baby home. So even if your little one isn't here yet you can get you can still book an appointment to get your carseat installed. For more info contact info@birthandbabyfair.com

We do have plenty of flu vaccine in stock. We will start the flu clinics as soon as October comes around. If you feel like you are in a hurry to get it sooner we may be able to accomodate you. Give a call and schedule an appointment.

Pertussis is still a concern. The best we can do is to make sure that anyone who is having close contact with your children has been vaccinated with the TDaP vaccine. Certainly all nannies and parents should make sure they are protected.

So far today we have seen one case of Hand, foot mouth, lots of colds and coughs, a bunch of sore throats ( some strep some not) and a few rashes that look like mild staph infections. Rashes that are pimply are worth a look!

Stay well
Nurse Judy

Flu Shot clinic scheduled

I hope everyone enjoyed the 3 day weekend.
I was expecting to come back to work to find the typical mayhem after a long weekend, but things are relatively quiet.
I do want to alert you that we will be scheduling a Saturday Flu shot clnic on October 2nd from 9:30-12:30 here at the Noe Valley Pediatrics office.

This clinic will be open to all patients, patients families and patient's caregivers.

We have flu mist as well as the shot.
For pregnant women we will have the preservative free vaccine available.

Non patient fee is $35. We do not bill your insurance

If you are interested in getting the flu shots during regular business hours, we will be doing our weekly flu shot clinics on Wednesdays and Thursdays from 10-11:30 and 2-4.
Please call that morning to schedule

Rashes, and loose stools, and fever; Oh My!!

Whew. Busy phone day and 90% of the calls fell into three catagories-

A viral, non-itchy rash on the trunk with runny nose. The fever is either not present or low for this one 99-100. These kids look and act well.


Crabby kids with loose stools, 2-3 times per day. No fever.

And a High fever virus, no rashes as of yet, but I will keep you posted.

We have the Flu mist in, as well as regular flu. Our PF flu for kids under two is not yet in. Keep checking the blog for Flu updates!!

August 30th/ whooping cough vaccine

Soon most of the schools will be back in session and along with that come the expected coughs and colds.
Today we saw several cases of hand/foot/mouth.
It isn't going wild yet, but every season when I see these first couple of cases I always expect the dozens to come along soon.
We saw several cases of strep throat as well as many ear infections today.
Several parents called about their children with "Mystery rashes". The kids are not terribly bothered, and they don't have fevers, so we will do the wait and see approach.
Lots of parents are checking in about the whooping cough outbreak.
We start vaccinating the children against this as early as 6 weeks. The vaccine is the DTaP. D=diptheria T= tetanus P=Pertussis. Pertussis is another name for whooping cough.
To complicate things further, our DTaP is generally given as part of a combination vaccine called Pentacel.
If you are following the standard vaccination schedule your baby is protected.
They usually get the initial series at 2, 4 and 6 months. The first booster is given at 1 year. One more booster is given between 4-6 years.
We strongly suggest that all parents and caregivers get the adult version of the shot called the TDaP. This will give tetanus protection as well.

~Stay well
Nurse Judy

August 23rd

For the first time all summer I am delighted to tell everyone to put on that sunblock!!

It was fairly mellow in here today. We are still doing lots of summertime checkups.
The sick patients presented with coughs, ear infections and some mild fevers.
Last week I thought I was starting to see some Hand/Foot/Mouth, but haven't heard of any new cases showing up.

Stay well
~Nurse Judy

Back to school

Hard to believe that a good many of our kids started school already today.
Today the biggest complaint has been a moderate fever.
Many of the children started it by vomiting once.
So far the patients are on the first or second day of this, so no guesses yet as to how long it lasts.
Any fever that hangs on longer than 3 days is worth calling about.

We are also seeing lots of little coughs and colds.
Charity says she has gotten lots of calls about a mysterious rash on the trunk that doesn't seem to bother the kids too much.

I will check in if anything else interesting seems to be making the rounds

~Nurse Judy

August 9th update

We are seeing all sorts of rashes.
Most of them are the "lets wait and see" variety and end up fading away without much intervention.
We have seen all sorts of interesting bites.
Some spider bites will remain quite red and hard for more than a week. They need attention if the redness gets more intense or there are any red streaks coming from the area.

There is a fairly mild cold and cough making the rounds.

Hard to believe that school will be starting soon. I anticipate that we will see plenty more things going around once that happens. We will keep you up dated on what we are seeing here.
Stay well
~Judy

Calling all nebulizers!!

Wowza! We are missing quite few of our in house and loaner nebulizers. If you have one at home, please bring it back!!!

we are missing nebulizer numbers-

1, 2, 3, 5, 6, 8, 9, one sport nebulizer and TWO "office use only" nebulizers.


We need these for our wheezers. If you need long term neb therapy best to buy your own. Usually covered by insurance.


In other news-

We have croup going around, vomiting with fever, and roseola. If you go hiking please do a careful tick check.

Hope everyone is having a fab Summer :-)

Nurse Charity

August check in

I was gone last week,(to the land where there are fireflies and you can wear shorts outside in the evening) but Charity reports seeing
Croup
a virus with a rash
vomiting with fever


Our flu mist has arrived,
Hopefully we will protect everyone and not see much flu this year.
Stay well!
~Judy

July 26th

This morning I have had reports of a handful of kids with a short but violent tummy bug, that started with vomiting and moved into diarrhea.
The key to handling these is to focus on keeping your child hydrated with small sips of an electrolyte solution (like pedialyte), gatorade or of course breast milk if you are lucky enough to have some. When your child is retaining fluids you can advance the diet along to bland and starchy foods.
Probiotics are very useful for getting the tummy back to its normal state.

We have also seen several kids with mild body rashes.. At this point I am blaming it on food sensitivities, but we are watching to see if any other symptoms come along.

We have gotten several labs tests back where the patients are low in Vitamin D.
In this foggy city, it is probably wise for everyone to be making sure they are getting adequate Vitamin D. An over the counter supplement is an easy way to ensure this.

A couple of our patients have gotten ticks... Pet stores sell tick removing tweezers for pretty cheap. They are a good thing to keep around, because they easily remove the ticks with the head intact...the right tool for the job!
If your child gets a tick bite. Remove it and put it in a baggy. Then call us!!

We will be getting the flu mist in the first week in August.
If you are in the office and want to get it for yourself or your over 2 year old, just let the doctor know!

Have a healthy week
~Judy

July 19th

Towards the end of last week I started getting reports of a tummy bug starting to make the rounds. Lots of diarrhea..
This morning the Monday calls were reasonably light.
We have several kids with a high fever viral type syndrome and swollen glands.
We have several wheezy kids.
plenty of ear infections.
The prize for the most miserable of the bunch goes out to a little 2 year old with a mouth full of awful sores..
If you have school forms that need to be filled out, please don't wait until the last moment to get them over to us!
~Stay well
Nuurse Judy

July 13th

mostly quiet on the viral front this week.
There are a few coughs and colds out there but nothing too awful.
We do have a couple of kids with the chicken pox.

Believe it or not we are expecting our first shipment of the flu mist within a few weeks.
This season the H1N1 is combined with the seasonal flu.
Anyone over the age of 2 can get the mist and it should give protection throughout the entire flu season.
We have no idea what flu will be coming this year, last year was so strange, but we do think that the vaccine is safe and worthwhile. We will be offering it to anyone who wants it (including parents and babysitters for $35). I will let you know when we get it.

I needed to reschedule my safety class..I will likely do the next one some time in August.
Let me know if you would like an email when I pick the date
~stay well
nurse Judy

July update

Although the phones were certainly busy on this Tuesday morning...there was not a central theme.
We had kids who are old enough to know better swallowing lego pieces,
A baby bitten on the face by the family dog because she interfered with the food bowl
(pet owners....please take pains to make sure this doesn't happen to you),
Lots of little sprains and injuries,and plenty of bug bites.
In terms of illness I am getting reports of a croupy cough virus and some mild diarrhea. Nothing much else to report.
stay well
~Judy

safety class

I have my next safety class scheduled for July 21st ( Wednesday evening) at 7:30 pm
Some of the things that this class deals with includes basic first aid, head injuries, burns, choking rescue and tips for staying calm in an emergency.
The class runs about 90 minutes and costs $20/person (sliding scale available)

If you are interested in signing up
visit www.nursejudy.net to register..

Weekly update

Pertussis is still causing a buzz.
Our best method with coping with this outbreak is to make sure that we vaccinate our children as soon as they are old enough ( usually at the 2 month visit).
All parents and care givers should also have the Tdap.
Walgreen is now giving it for $65/shot.
We charge $50. We will not bill your insurance but we will give you something that you can submit yourselves.

We have a few patients in the practice who have been exposed to Pertussis at school. They all have mildly irritating coughs and have been treated with zithromax just in case.

We also have a young patient that just came down with a whopping case of chicken pox. Her mom is frankly puzzled about where she could have been exposed...but it is out there.
We generally vaccinate for it at the 15 month visit.
If you child has not had the protection, think long and hard before you subject them to suffering through a week of itchy lesions.

As far as other illnesses, I had several patients calling about fevers, some conjunctivitis and a bit of strep.

stay well
~Nurse judy

Summer has started

Things seem mellower today.
There are some stragglers with the 5 day virus ( fever/ diarrhea/ snotty nose).
Not a whole lot of excitement otherwise.

With hot weather approaching (for anyone who steps foot out of SF that is)
pay attention to sun protection and hydration!
stay well
~Nurse Judy

Tummy Bug alert

The calls about a tummy bug have taken a sharp spike today.. I spent the entire morning talking about poop!

The kids have generally started with some vomiting and moved along to soft funky stools. Some of the kids have had some moderate fevers with this as well.

To Review...our main issue is making sure your child stays hydrated.
A dehydrated child is very droopy with decreased urine. If you have a perky kid with wet diapers you are doing okay.

AS far as diet goes, breast milk or pedialyte are the perfect fluids...Give small frequent amounts ( If they vomit after an ounce..try 1/2 ounce..if they can't keep that down give a spoonful etc)
Once they are retaining fluids and they express interest in eating go ahead and start with Bland starchy stuff that is age appropriate..
Things like Bananas, applesauce, rice, pasta, and boiled chicken are usually easy to digest.
Avoid dairy except for yogurt for a few days or until the tummy is clearly back to normal.
If you go back on milk too quickly you often will see the diarrhea come right back

I hope you all manage to avoid this one!
~nurse Judy

Mid June Update

Good Morning,
We have a report from the upper Noe Valley playground that there has been a visiting cat in the sand box.
They are dealing with this and you can check out noevalleyreccenter.com/updates
We have had a few patients with spots that could be caused by flea bites...tis the season. Ever if you don't have pets in your house, your child can get bitten from being in a sandbox or sitting in the grass.

We also have a couple of cases of what appears to be our old friend the Hand foot mouth virus.
That nasty viral fever is still around, causing fussy kids with on and off fevers for about 4 or 5 days. Some kids are having mild tummy ailments with or without fevers.

Lots of fairly mild but persistent cold symptoms have rounded out the calls this morning.

Stay well
~Nurse Judy

June 8th

I am waiting for Summer to start and for all this illness to fade away.
The Viral syndrome with the high fever is still hanging around.
We are seeing lots of colds and coughs as well.
Strep throat and conjunctivitis round out the most frequent complaints.

I will check in next week or sooner if something exciting comes along
stay well
~Nurse Judy

Welcome to June

I hope everyone had a nice 3 day weekend.
We are still seeing the high fever virus that lingers for about 4 days.
We are also seeing plenty of strep throat, lots of rashes and a persistent cough.
I have seen a couple kids today with significantly red and swollen eyes, likely from a bug bite.
If your child seems well, no fever, vision not impacted..it is okay to do a trial of benedryl and a cool compress.
Any swollen eye associated with an illness of a fever needs to be seen that same day

Just to review...
*Since strep does seem to be around, if your child is over 2 and has a sore throat and fever without a lot of congestion, we should check them for strep

*Any fever that is moving into day 3 merits a call to the doctor to at least touch base and make a plan

*We need to pay prompt attention to any rash that is Purplish, comes with a fever, is oozy, or is painful or itchy
With other rashes it is okay to take a wait and see approach...if several days go by without any signs of fading then certainly we should take a look

*coughs can hang on for a long time.
If there is any possibility of a wheeze, or labored breathing we will want to take a listen.

~stay well
Nurse Judy

Thursday update

Lots of fevers,
lots of mild diarrhea
lots of rashes

We are closed on Monday for the Memorial day weekend.
If you have a concern that warrants a visit before the weekend, do not wait until 4:30 tomorrow afternoon to call....

If you have a child who is ill over the weekend or on Monday, give the after hours clinic a call at 387-9293

Stay well
~Nurse Judy

May 24th update

We are still seeing lots of kids with fevers.
Several patients also seem to have a tummy bug, some vomiting with mild diarrhea accompanied by low grade fevers
At the end of last week we were seeing lots of strep throat as well as strep butt..
Strep butt????? yes indeed.
Children under 2 rarely get strep throat but they can get a strep infection that presents as a super red pimply diaper rash. It is treated with antibiotics.

We have had several patients with pink eye today.
conjunctivitis can be viral, bacterial or allergic.
If eyes are very gooey and your child is fussy, we would like to see them rather than just giving drops. More than half of the time they also have an ear infection ( to the surprise of the parents)
Stay well
Nurse Judy
you can now access the blog from our website
www.noevalleypediatrics.com ( still a work in progress)

fevers

I saw lots of high fevers today. Many of the kids are on the third day of this nasty little virus. Most of them have clear runny noses as well. The fevers have gone up and down and mostly have responded well to fever reducers.
If your child has a high fever, go ahead and treat them with tylenol or motrin. ( make sure the stuff you have on hand is not on the recall list. There are plenty of alternate brands available)
Keep track of the correct dosages as your child grows.
Keep your child hydrated and also consider popping them into a tepid bath or sponging them down with a cool cloth.
I would like to see the temperature responding within an hour.
A fever that remains over 103 despite your best efforts to lower it needs to be evaluated.
It is worth checking in with us if the fever is still hanging on past the third day.
Often when a fever is spiking kids can get very shivery and chilled.

We have also been seeing quite a few coughs and ear infections.

The SF Public Health department has also issued an advisory that there has been a case of Rubella and a case of Measles reported.
There are also MANY cases of pertusis ( Whooping cough) making the rounds.
Most babies get the Pertusis protection from the DTaP vaccinations that they get starting at 2 months.
The Measles and Rubella protection are given at the 15 month visit in the MMR vaccine.

Parents should make sure that they are up with their vaccine protection as well. Check with your doctors to make sure you have had the MMR and the TDaP

stay well
Nurse Judy

fevers and sore throats

For mid May we are seeing a lot of illness.
We are seeing lots of kids with sore throats. Many of them are indeed turning out to be positive for Strep.
Strep throat often comes with sore throat, fevers, aches, nausea, dizziness and some times a sandpaperish rash. Some moms say that they can "smell" an odor on their children's breath when they have strep.

It is contagious, but statistics say that siblings and family members have a 50-50 chance of catching it. That seems to agree with my experience here.
It is very unusual for children under two to have strep throat.
We do want to treat it. Usually with Amoxicillin. You are no longer considered contagious after 24 hours of the antibiotics

We have also seen quite a few children with a nasty virus that comes with a high fever.

We are still seeing plenty of colds and coughs
We will update again soon if anything exciting rears its head.

stay well
~Nurse Judy

tylenol recall/ Monday report

As you may have heard, several Mcneil products including Childrens and Infant Tylenol, Motrin and Zytrec have been recalled.
They say that the products are not a health risk, but there are some quality control issues that they need to deal with. If your child has taken one of the products and seems to be just fine, Relax. We have NOT seen any adverse reactions.
However if you have the affected lots you should return the products and get reimbursed
For more information go to www.mcneilproductrecall.com
In the meanwhile, it is our understanding that the generic products are safe and available. As another option Acetaminophen suppositories are also available from the parmacist without a prescription.

Here is the Monday report on "what's going around"....

*Left over tummy virus, vomiting, diarrhea with a bit of a fever
*coughs and colds, with the cough lingering for several weeks
*several kids with aches and fevers lasting about 3 days
*some strep throat

here's to a healthy week
~Nurse Judy

April 30th

Thank you for your comments.
The website www.noevalleypediatrics.com is up and running, although it is still a work in progress
I am so glad that people find the blog useful. At some point the blog will be easily accessed through the website as well.
Regarding appointments online...that isn't going to happen anytime soon.
It is such a delicate balance here, making sure that people can get routine physical exams done in a timely manner, while leaving enough open spots for acute care needs. We also end up needing to fit in last minute newborns and emergencies. On very busy days, we need to really use our triage skills to make sure that the few existing appointments go to those who really need them.

We are still seeing a tummy bug making the rounds. It has been lasting only a day or two. It has started with low grade fever and some vomiting and then moves into some diarrhea.
We have seen a handful of truly miserable children with high fevers and low energy.
So far this is the second day that I am seeing this, so I don't know how long it will be hanging around.
We have lots of mild colds and coughs that are lingering for WEEKS.
For some odd reason I have also had several sore penis complaints this week as well!!
Enjoy the weekend!
~nurse Judy

web site

I am working on a website for Noe Valley pediatrics.
It is up and running in it's most basic format
www.Noevalleypediatrics.com

I would love some feedback from you.
What are you most looking for in a website?
comments and suggestions welcome!!
Thanks
~Nurse Judy

April 26th

coughs and colds are the order of the day.
I heard rumors of a fever/ flu syndrome making the rounds, but I have NOT seen much of that with our patients.
We are getting busy with summer check ups. If you have camp and school forms do NOT wait for the last minute to get an appointment.
We have tons of newborns in the practice who need to be fit in without much advance warning, We also need to save room for acute care appointments, so please plan in advance so that we can accommodate your needs.

If anyone is in need of a super nanny, please let me know.
We have a family that is moving to the East Coast that has nothing but wonderful things to say about the nanny they are leaving behind.
If you are interested, leave a comment here and I can get you in touch
~Nurse Judy

Nebulizer/asthma Folks take note-

Got Xopenex??

The Xopenex manufacturer is picking up your copay!!

https://secure.xopenex.com/xopenexPromos/eligibility-card.cfm

Go to the above website- fill out the information- get a card to print out good for 0 copay on Xopenex nebulizer treatments for 12 refills.

Hope this helps some of our families who need to Xopenex treatments this year....

This is an open coupon, so you can pass it on to families not in our practice.

Warmly,

Nurse Charity

spring colds/ weekly update

I am still getting some reports of hand foot mouth out there
there are many families with coughs and colds with some wheezing
The pollen count is very high and allergy symptoms are flaring up
Ear infections and conjunctivitis are a constant complaint
There is a mild tummy illness still making the rounds, people are typically over it within a few days.
Nothing exciting to report... that is a good thing I imagine.
~nurse Judy

what's going around

We are still seeing a tummy bug.
Allergies are pretty bad this week as well, some of our more allergic kids are doing some wheezing.
Plenty of little coughs and colds making the rounds.
Nothing too dramatic out there.
Enjoy the bit of sunshine that we are seeing
~Nurse Judy

FREE cardiac physicals for teens

Dr Kaplan discovered a great resource.
UCSF is offering free cardiac physicals for any high school athlete on May 22nd 2010.This includes a physical exam by a sports medicine physician as well as a cardiac exam byt a UCSF cardiologist.
For more info check out the website....playsafe.ucsf.edu
please pass this info along to anyone you think can make use of it.
~Nurse Judy

Roto virus information

A couple of calls today about the Rota virus vaccination. We only use the Merck- RotaTeq for our clients so _no need to worry_ about the vaccination recall on the Rotarix product- here is the statement from the FDA-

Rotarix Vaccine: Update to Clinicians and Public Health Professionals

[Posted 03/22/2010] FDA is recommending that healthcare professionals temporarily suspend the use of Rotarix, a vaccine used to prevent rotavirus disease. FDA’s recommendation is a precaution taken while the agency learns more about the situation.

FDA has learned that DNA from porcine circovirus type 1 (PCV1) is present in Rotarix. PCV1 is not known to cause disease in humans. There is no evidence at this time that this finding poses a safety risk. Because available evidence supports the safety of Rotarix, no medical follow-up is needed for patients who have been vaccinated with Rotarix.

There are two licensed vaccines for rotavirus in the United States: RotaTeq and Rotarix. For children who have received one dose of Rotarix, CDC advises that clinicians can complete the series with RotaTeq for the next two doses.



What is Rota-virus??
Bad, bad diarrhea/vomiting illness. Small babies dehydrate quickly, so we like for them to be protected in their first year.

Let me write again- we do not use Rotarix in our office.

Warmly,

Nurse Charity

Mellow April

Nothing much to report.
There is a mild tummy thing going around. Half of the patients do have some fever with this one. Everyone has cleared it within a few days.
We have the standard coughs and colds.
We also have some lingering slap cheek and hand foot mouth, much less than last week. check earlier blog posts for info on those annoying viral syndromes.
For all of you with children over 4 who need summer/ school/ camp checkups....call early for those appointments.
If your child is going to camp get a hold of the forms as soon as possible.
Enjoy this lovely weather.
~Nurse Judy

April

April fools day started off with a little girl swallowing her hair clip, but moved along to more normal issues.
We seem to be having a run of vomiting patients out there. So far the bowel movements are mostly normal and there is not much fever. I will keep you updated if I start seeing more of that.
I also heard a report that there is a surge of H1N1 in the South East.
Could that mean it is coming back this spring?? We shall see. It may be time for that booster of the H1N1 vaccine if your child has only had one. (or didn't get the shot at all)
stay well
~Nurse Judy

Rashes..when to worry

All this lovely weather makes me think....Nice sunshine... time for the heat rash calls!

I like to tell my parents out there that rashes fall into one of two categories.
1. Rashes I am concerned about or
2. Rashes I am curious about.

What Rashes make me worried....
If a rash is purplish.. doesn't get pale when pushed on and comes with a high fever, this could be a type of meningitis and would be considered an emergency. Get to the ER pronto!!

Rashes that are oozy and moist, or have pimples with pus filled centers, could be bacterial and need to be seen that day.

A rash that comes with a high fever could be strep related and should be seen the same day

A rash that is painful or very itchy should be seen sooner than later

All other rashes...

Many viral syndromes have rashes associated with them. Often the rash shows up after the fever is gone. Once the rash shows up generally the patients are no longer contagious

For our children who seem perfectly well but have a "mystery rash", we often need to be scientists.
are they on any new medications?
Have they eaten any new and unusual foods? special attention to nuts, fish, berries
Have they been eating a lot of citrus and acidic foods?
Have you changed to any new detergents? bubble baths? lotions?
Many times rashes will simply fade away without us actually figuring out the cause.
If a rash is persistent it is worth a visit at some point.
Enjoy the sun!
~Nurse Judy

Friday update

We are seeing a potpourri of illnesses.
*Today I have spoken to quite a few folks who seem to have a tummy bug. So far this has been 2 days of vomiting and some loose stools.

*Slap cheek is still going around. Many of the patients have had a very aggravating time with it this year. The fevers and the rashes have been coming and going for almost 3 weeks. There has been some complaints of achy joints with this package.

*Many of our patients have been wheezy and the high pollen count isn't helping anyone.

* there is a basic cough/ cold viral making the rounds. If you are dealing with clear mucous, no fever, unlabored respiration s, eating, sleeping, consolable... We are not concerned.
If any of those symptoms change or you feel the need to check in for mild but prolonged illness, call for an appointment.

Enjoy the weekend
`Nurse Judy

Happy St Patricks Day

Happily none of our patients are turning green today...
This week we have seen a few cases of pneumonia. We also have had lots of conjunctivitis and ear infections.
For our patients who will need school physicals this summer, please plan in advance. There is usually at least a several weeks wait for a complete physical. Of course we will always try to see any acute issues on the same day.

If there are any topics you would like to see covered in this blog please let me know!
stay well
~Nurse Judy
/

next class

My "illness class" is scheduled for march 27th Sat morning at 10:30.
for more info check out www.nursejudy.net
let me know if you are interested in attending.

This week we saw a few more fevers.. Is it the flu? I still don't know, but I am fascinated by the absence of the seasonal flu this year ( I am knocking on wood as I type)
We still have plenty of H1N1 vaccine available. If you haven't received it, it may be worth it. Last year H1N1 started to show up in the late spring.

By the way, Great news...Next season's flu vaccine ( which becomes available in late August if they have their acts together) will have seasonal and H1N1 protection combined in the same shot.
Have a good weekend and enjoy this stunning weather!
~nurse Judy

same old stuff

Nothing new and exciting.
That's a good thing.
Dr Schwanke reported one or two patients who may have had the FLU last week.
I will let you know if we start seeing more of that.
Currently slap cheek, hand foot mouth, croup,ear infections and conjunctivitis are keeping us fairly busy.
We have generally had plenty of appointments if you call us in the mornings, but if you are first calling us after lunch we may be booked for the day.
My favorites are the 4:30 pm Friday afternoon calls about a cough that has been lingering for several weeks.....Don't do that!!

Stay well..
I will check in next week or sooner if the mood strikes
~Nurse Judy

March already/ slap cheek

This week we continue to see "slap cheek" virus, This virus has several names including fifth disease ( if you are planning on goggling it)
Just like Hand Foot Mouth, this is a fairly contagious rite of passage.
Most people get it while they are still children.
The symptoms are quite variable. Some kids don't seem too impaired, while on the other more unfortunate end of the spectrum, others have high fevers on and off for several weeks.
Most of the kids will at some points have very red, chappy warm cheeks followed by a lacy mottled rash up and down the body. It tends to like the arms and legs more than the trunk.
Some kids will be very achy and fussy with this virus.
Very rarely kids can get quite ill with this... in 22 years here I have NOT seen that happen, so relax, but remember Nurse Judy's rule.....any fever that is lasting 4 or five days needs to be checked on.
The most important thing about slap cheek is that it can be dangerous to a fetus.
Most women had this as a child and are therefore not at risk. But since most people also don't really know if they had it or not, It is best to avoid contact with pregnant women as much as possible if your child has been diagnosed with this.

We have also been seeing quite a bit of conjunctivitis.
For very young children, goopey eyes can also signal an ear infection, so it may be worth an office visit.

Bronchiolitis continues out there as well.

Stay well
~Nurse Judy

quick update/slap cheek

I have spoken to many people out there today with what I think is slap cheek virus.
I will write more about it tomorrow, this is just the heads up that it is going around
~nurse Judy

different types of appointments

Since there isn't a hot illness topic today I thought I would review the different appointment types that we have.

ROUTINE CHECKUPS
are the most important appointments.
We like to see our babies when they are born ( maybe a few times until things are really sailing) then 1 month, 2 month, 4 month, 6 month 9 month 12 month, 15 month, 18 month, 2 year, 2 1/2 year ( some insurance companies will not pay for this one.. we do like to do it though, it feels like it is worth checking in with kids at that age)
3 year, 4 year, 5 year, 6 year and then every other year unless there is an issue.

We limit the number of check ups that we do in one day in order to keep spaces available for acute care needs. Therefor it is a good idea to make the appointments well in advance.
We suggest that you try to see your primary doctor for these exams.
We try not to do "big kid" checkups in the winter months for a multiple of reasons.
If your child is over 5 schedule any annual exams for the spring, summer or early fall.
Make sure your bring any forms with you to the appointment. There is no fee for forms filled out at that time.
There is a fee for all other form requests.
There is also a fee for "no showing" a physical, or a last minute cancellation.

ACUTE CARE exams
for these you can see any available doctor.
There is no charge for a last minute cancellation, but please give us as much advanced notice as possible.

SHOT appointments

These are with the nurse or the medical assistant. If you are scheduled for a shot only you will NOT be able to see one of the doctors unless they happen to have an opening.
if you have an "Oh by the way...." it is much better to be scheduled to be seen by the doctor.. we can always add a shot to an acute care visit, we can NOT add a doctor eval to a shot visit.
Hope this is helpful!
~nurse Judy

nothing exciting/ hand foot mouth review

This week the virus that the most folks have called about is our old friend "hand foot Mouth"
surprisingly several of our moms and dads have come down with it as well.
Most folks have had it as a child and should not get it again, unless this is some type of new strain.
Unfortunately any child hood illness that is visited on an adult is usually quite miserable.
Just to review.
*I like to call it Hand Foot Mouth and Butt because the little blisters tend to like the diaper area as well
*many of the cases are so mild that you barely know your child is ill.
typically the cases run for several days. They may or may not have fevers. The most miserable kids are the ones with the most mouth lesions
If your child has no fever and is happy, in our opinion it is okay for them to be at day care

For those miserable few with the sore mouths..keep the Motrin/ tylenol doses going.
Keep them hydrated.
Cool creamy foods are the ones that they will do best with.
feel free to call if you have any other concerns that you want to address

Stay dry...stay well!!
~Nurse Judy

Thursday Feb 18th/nebulizers

For mid February it seems like a comparatively mild winter so far.
We continue to have a lot of wheezy coughers. ( interesting..the spell check would like to change this to cougars)
Our loaner nebulizers are all out.
If you have one and your child no longer needs it, please get it back to the office.
On the other hand, if you have had one for over a week it may be wise to consider owning one.
We currently work with a company called care connections. We keep several of their machines here for purchase. If you take one of those machines, care connection will bill your insurance. Worst case scenario would be an out of pocket fee of $99.

Just because your child is wheezing does NOT mean they have asthma. Often little airways get inflammation from a viral syndrome. Hopefully they will grow out of that tendency.

Regardless, once they have shown that they can get wheezy, having your own nebulizer tucked in the back of a closet can save you from potential midnight visits to the ER.

Stay well
~Nurse Judy

Time is the great healer

We have lots of kids with colds/ coughs and fevers.
Much of the time these symptoms are caused by a virus and will at some point go away on their own.
We are limited in what we can offer in terms of treating a viral syndrome. Antibiotics will not help. We generally rely on supportive care..fluids, steam, elevating the head, suctioning the nose.
Some of our parents report getting relief from Chinese herbs from the Chinese Medicine works.

Sometimes what starts as a virus can turn into something treatable...all that fluid in the head is the perfect breeding ground for bacteria.

When we have a child who has congestion, be on the lookout for increased fussiness, a cough that is getting deeper or a fever that is lasting for more than 3 or 4 days.
these symptoms may be worth an office visit.

Fussy congested kids may have an ear infection. Dr Anne says she has seen tons of them this week!
No one here is eager to give antibiotics and some mild ear infections may in fact go away on their own, but knowledge is always a good thing. Decisions about whether or not to can be made thoughtfully.

On a completely different subject...there is a herd of goats happily munching on the bushes at the bottom of Clarendon avenue.. They will likely be there all week if you are looking for something free and fun to do with your kids
Stay well!
~Nurse Judy

is the flu here??

We have not bothered doing any flu testing this week, but I have seen quite a few kids with very high fevers. In some cases we were very suspicious about strep, but the cultures all came back negative.
So far we are dealing with the third and fourth day of this.
Other kids have very wet and rattly coughs with a low grade fever.
I am still getting reports of hand foot mouth out there
Some tummy stuff, but that seems to be waning
Stay healthy!! Call as needed
~Nurse Judy

cough cough cough

This week has been full of Wheezy coughers.
Many of our kids have had the ongoing congestion for well over a week.
Happy kids, who are eating well, sleeping well, have clear mucous, no fever, unlabored breathing do not need to be seen.

I do want to see anyone who is very fussy, has a fever lasting more that 3 days, has green or yellow mucous that doesn't clear after several days or has any labored breathing.
If your child's eye's get gooey it can often be associated with an ear infection. It is probably worth a call or a visit.

Wash your hands and stay warm and dry this weekend if you can!!
~Nurse Judy

Tuesday

This week we are seeing lots of wheezy coughs and we are still seeing a tummy bug.
Most of the kids are over these within a few days.
We have had some positive strep throat tests.. NOT a lot of flu ( strange for the first week of February)
We still have plenty of the H1N1 vaccine for anyone out there who has not gotten both doses ( children under 9 should have a second one)

Thank you for the class feedback.
I have scheduled the safety class for Wednesday February 10th at 7:30 pm
the Illness class with be February 20th Saturday morning at 10:30am the classes last about 90 minutes
If you are interested in signing up for either class you can do it via the website
www.nursejudy.net or give the office a call

Friday

We have continued to have lots of tummy issues along with colds and coughs.
Nothing exciting to report.
Have a healthy weekend!
~nurse judy

nurse judy classes

For those of you who don't know, I occasionally offer several classes to small parent groups.
My safety class deals with "lifes little emergencies such as Falls/ head bumps, burns, basic first aid, poisinings and choking...and don't forget the bean in the nose

My illness class reviews the more common illnesses, focusing on recognizing symptoms that require attention.
It includes fevers, rashes, coughs and colds, diarrhea etc

I usually hold them in the Noe Valley Pediatrics waiting room on either Saturday mornings or Wednesday evenings.

More info can be found on my website www.nursejudy.net

If you are interested in either of the classes and have a preference between evening or weekend, please let me know by commenting here or emailing vias the website.
I will pick a date soon and decide which class to hold first.

~Judy

We are seeing a bit of everything!

There is all sorts of stuff going around.
*There is a nasty high fever with a sore throat and cough that is lasting for several days.
Maybe it is the flu but we haven't tested folks.
Remember the Nurse Judy Rule....we want to at least be talking about any fever that lasts more than 3 or 4 days.
*There is a tummy bug still making the rounds. Many of our unfortunate parents are getting hit with this one as well....Our focus is hydration. Make sure you and your child are getting enough fluids. We aren't too worried about a few days of poor appetite for solids.
*we are seeing croup and RSV..and severe upper respiratory infections.
again fluids, steam, keeping the head elevated, saline to the nose. If there is any labored breathing your child needs to be evaluated
* hand foot mouth virus as well as Slap Cheek virus are also still making the rounds
*lots of kids with ear infections too!!

See!! I wasn't kidding about the "germ soup"

Call as needed!
~Nurse Judy

Calling all Nebulizers!

If you have a nebulizer and do not need it, please return it to the office. We have wheezy kids who need one and we are running out.

We have nebulizers for purchase if you seem to be borrowing them for an extended amount of time.

We are seeing a lot of viral echo rashes this week- Roseola and slap cheek as well as a continuation of croupy coughs.

As always- wash hands, keep sick kids at home.

Warmly,

Charity

Cough, cough! Plus OTC Medication recall

Croup is our biggest complaint today. Scroll on down for the low down from Nurse Judy on Barky Coughs.

Lots of medication recalls- here is the website so you can check what you have.

http://www.mcneilproductrecall.com/

What is wrong with them? They smell funky; read on-

Based on this investigation, McNeil Consumer Healthcare has determined that the reported uncharacteristic smell is caused by the presence of trace amounts of a chemical called 2,4,6-tribromoanisole (TBA). This can result from the breakdown of a chemical that is sometimes applied to wood that is used to build wood pallets that transport and store product packaging materials. The health effects of this chemical have not been well studied but no serious events have been documented in the medical literature. A small number of the product lots being recalled were associated with the complaints of an unusual moldy, musty, or mildew-like odor, and some of these lots were found to contain trace amounts of TBA. In December 2009, McNeil Consumer Healthcare also recalled all lots of TYLENOL® Arthritis Pain 100 count with EZ-OPEN CAP related to this issue. McNeil Consumer Healthcare has now applied broader criteria to identify and remove all product lots that it believes may have the potential to be affected, even if they have not been the subject of consumer complaints.

Warmly,

Nurse Charity

Friday update/hydration

We are closed on Monday for the MLK holiday.
The after hours clinic will be open to take care of any of your concerns.
Today I have been talking to lots of families with the vomiting/diarrhea misery.
This usually passes in a day or two. We are not worried if your child doesn't eat much for a few days, We do worry if they are not getting enough fluid.
A dehydrated child looks really droopy and has way less urine output.
A playful child with big juicy tears and plenty of wet diapers is NOT dehydrated.
Offer small amounts of clear fluids ( or breast milk if you are lucky enough to have that option). Once fluids are being kept down, you can advance the diet to small amounts bland, starchy foods. I personally suggest avoiding dairy except for yogurt until the stomach seems settled.
If you are worried that your child is dehydrated and not retaining fluids...a trip to the ER for IV fluids is likely the next step. The CPMC Children's ER on California is a good option.

We are also seeing strep throat.
Any fever/headache/ sore throat combo that does NOT have congestion involved should be checked for strep.

I will be on the East Coast next week. If there is anything interesting going on Charity will chime in
Have a healthy week
~Nurse Judy

Croup seems to be going around

We have been seeing Croup this week.
This is a common virus that is fairly contagious.
The kids have a hoarse, barky cough at night. Often they are much better during the day. Some have fevers, some may not.
Typically this lasts 3 nights.
The best thing to do is get your child into a nice steamy bathroom. A humidifier in the bedroom is also very helpful.
Extra fluids are useful as well.
If your child seems like they are laboring to breathe and it is NOT relieved by the steam or a few moments in the outside air they need to be seen.
In severe cases a shot of steroids will get everything calmed down.
I will post again on Friday unless something exciting pops up.
We still have plenty of the H1N1 vaccine (not the preservative free pediatric doses)

~Nurse Judy

what's going around?( hand foot mouth)

Happy Monday,
It was steady but not out of control in here today. After all the illness we saw this fall, so far the winter has been much milder.
We are seeing a bit of hand foot mouth virus.
This is a very common illness that most kids will get and get over very easily.
Some kids have such a mild version that you may not even get it diagnosed..a small spot on the hand that looks like a bite.
On the other extreme some kids have lots of little lesions on the hands, the feet, the butt and most unfortunately in the mouth.
Some get fevers...some don't.
The more sores in the mouth, the more miserable the child. In worst cases they won't eat or drink and end up in the ER for IV fluids. This is rare.
In most cases,with appropriate use of motrin and tylenol and sensible food choices, you can manage at home with just a day or two of misery.
Yes to smoothies and yogurts. Cool and creamy foods
No to orange juice or other acidic food, or sharp foods like tortilla chips.
If your child has no fever and is not fussy, it is our opinion that they can go to daycare.

Thank you

Thank you for the help with the name change!
As we move forward into the winter I will continue to update the blog with things such as the illnesses that we are seeing and anything else that strikes my fancy.

With cough and cold season in full swing, it is sometimes frustrating how limiting our resources are for helping get patients through a nasty virus.
Time is usually the main healer, but there are some things that may help you out along the way.
I really like the Neti Pot, for those of you unfamiliar with it, it is a saline irrigation system widely available at most drug stores.
If you have a congested head, this is a very natural and effective way to get relief.
I have some kids as young as 6 who do it willingly ( believe it or not)
For kids over the age of one I also find Honey Loquat syrup ( available at Whole Foods) very soothing for dry scratchy throats and mild coughs.


Wishing everyone a good weekend
~Nurse Judy

Thursday

Is there anyone out there who can show me how to change the name of this blog? Flu shot availability is becoming an obsolete name. ( I really don't know how)
I am getting feedback that people would like the blog to continue even after the H1N1 passes..Maybe NOE VALLEY PEDIATRICS CHAT?

We are seeing Lots of colds and coughs. They hang on and hang on. YOu are not alone out there.
I want to see your child if the cough causes any labored breathing or there is a fever that lingers longer than 3 days.
Feel free to call Charity or me during the day to talk about other symptoms that you are concerned about.
There is a new website that has come to my attention
www.healthychildren.org
check it out, it is full of good info.

Stay Well
~Nurse Judy

When it rains, it pours!

Yet another shipment of H1N1 came today!

We have H1N1 Mist
Regular H1N1 shots
0.5 dose Preservative free for our older kids.

Call for a same day slot Tuesday, Wednesday, Thursday.

Warmly,

Nurse Charity

swimming in vaccine

We just got more of the H1N1 mist.
We have plenty of the inject able as well. The only product that we don't have is the pediatric preservative free. We can give all of our youngest kids the .25 cc dose from the multiple dose vials

As I mentioned, Walgreen's now has the vaccine and will vaccinate anyone who wants it over the age of 9.
Safeway has SEASONAL flu vaccine and will vaccinate anyone over the age of 8.
You can find the closest flu clinic to you by checking out www.flu.gov
This website includes a flu vaccine locater. All you need to is plug in your zip code.

There are still plenty of coughs and colds going around. I don't think I have seen anything that makes me think the seasonal flu is here yet.

Stay well
~Nurse Judy

welcome to 2010

We have H1N1 in stock.
Walgreens now has it as well for anyone who wants it. I believe they only give it to people over 9 years of age.

This weekend the biggest complaints seemed to be pink eye, and various rashes.
There are also plenty of the expected winter coughs and colds.

In other Noe Valley Pediatrics News; With the new year, Dr Kaplan will now be in the office 4 days a week!

Wishing everyone a healthy week