Thursday, February 25, 2010

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

Tuesday, February 23, 2010

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, February 18, 2010

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

Thursday, February 11, 2010

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

Tuesday, February 9, 2010

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

Thursday, February 4, 2010

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, February 2, 2010

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