Monday, March 18, 2013

Monday update march 18th

Today was tremendously busy. Our own little March Madness.
We are seeing a little bit of everything.
We even had a positive flu test in here today ( strain B)
The patient was  NOT vaccinated. Strain B is protected in this seasons flu shot, so if you did not get one, we still do have in stock.

We had several cases of strep throat reported from the weekend clinic.

Today many of my phone calls were kids with colds and lingering coughs.
We also have some kids still with a tummy bug.
Most of these have been very short vomiting/ diarrhea deals, but I have some kids with much longer lasting diarrhea.

If your child has loose stools that are lasting longer than a week I do want to see them. We will want to see how their weight is doing and make a decision about sending stool samples on to the lab for some testing.

There seems to be quite a bit of conjunctivitis floating around.

I have a couple kids with complaints of mouth sores..I am watching that closely to see if our old friend Hand/ Foot/ Mouth virus is starting back around again.

I will be out of the office next week.
 If anything exciting needs to be reports, I will have Charity or Jen chime in.

Over the last several months I have been adding posts about various topics.
Those are now all archived and easily accessible on www.nursejudynvp.blogspot.com
I will continue to update this blog most Monday's with the illness updates

have a healthy week

Nurse Judy

Monday, March 11, 2013

Monday Update March 11th

Quick reminder! Changing  your clocks is the time to also check your smoke detector batteries.
( If we could only figure out how to adjust the internal clocks on the babies!!!)

This morning most of my calls were tummy related. The bug that is around seems to be causing a day or two of vomiting and diarrhea. If there looks to be more to it than that, I will update you later in the week.
I am seeing less kids with fevers.

There are still many kids with lingering coughs. For those of you who have had a hellish winter, there is a sense of spring, things may be easing a little bit. Hang in there.


I am seeing some kids with a virus that causes on and off rashes. I am still pointing my finger at slap cheek.

Now that it is March we are booking our well child check ups. Don't forget to schedule those in advance. Do you have summer camps that may need forms filled out? Call ahead to get copies and bring them to the exam. If you have a form with you at the time of the physical there is no "form fee".

Enjoy this nice weather!
Judy

Monday, March 4, 2013

General rash info

RASH RULES
 
 
I have been having a high call volume about rashes this week, so I figured that this is a good time for the review on rashes.
 
Lots of rashes come along as part of a virus. Time will fix these. 
This past couple of weeks we have seen a lot of "slap cheek" otherwise known as Fifth disease.  
With that particular illness we have kids with rashes that come and go.  
This time around some of my patients have had on and off hives.  
Many times the cheeks are very red.  
In a future email I will discuss more about the specific virus, but today I want to answer the general question, "When should I worry about a rash?
 
I divide rashes into one of two categories;
*Rashes that I am worried about
 
Someone should take a look sooner than later
-If a rash comes along with a high fever,(slap cheek can cause a high fever, but we may want to still check them out)  
 
-If the rash is oozy and crusty
 
-If the rash seems very painful or itchy
 
-strep throat might come along with a sand papery rash, do they have a sore throat? Does their breath smell stinky? 
 
-Your child has hives that come along with a puffy face and difficulty breathing ( this could signal an allergic reaction and needs immediate attention)   
 
-The rash looks purplish ( doesn't lighten when you press on it
 
(You need immediate attention if there is a purplish rash/ high fever/child who appears ill)
-
 
 
 
*Rashes that I am curious about
 
If you child seems okay but has a random rash, ask yourself the following questions
-Are there any new medication?
 
-Are there any new foods? ( pay attention to citrus and berries)
 
-Are there any new soaps, detergents, bubble baths?
 
-Have you used a new sunscreen or lotion of any sort?
 
-Has there been an exposure to a new animal?
 
-Has your child been in a hot tub?
 
-Is the weather very warm?
 
-Has your child been laying in the grass or sand?
 
-Check the blog, are there any viral syndromes going around that cause a rash?
( this week, on and off red cheeks are a good clue)
 
If it seems like it may be viral, the wait and see approach is perfectly fine for a few days. 
 
 
If your detective work has led you to a different answer, make the common sense adjustments.
 
For example,
Your child seems very rashy
Possible cause: They have been eating lots of the little seedless easy peel tangerines this week
Solution: stop the citrus for a couple of days and see if the rash calms down.
 
 
My first stab at clearing up many a rash is with two basic staples that are worth keeping on hand.
 
*cetaphil cleanser ( no water needed, apply and wipe off)
*aquaphor
 
For diaper rashes...Get that diaper off as much as possible!( I do have a great carper cleaning guy if you need him..lol)
 

 
 
If a rash is persistent and your best attempts at clearing it with a variety of OTC creams isn't helping, it is worth having someone take a look. Let's schedule a convenient appointment for some time within  the next week. If the rash clears up you can always cancel.
Folks occasionally do email us photos of rashes. Once in a while we can figure things on from the picture but often a visit is needed. ( please use the nvpeds@gmail for photos)  
If you come in and the docs are baffled, the next step may be the dermatologist.
 
 
 

 
 
 

March= Mayhem / Monday update

It is after 5 pm and our phones are now off. This was the first free second that I have had today. After last weeks general mellowness I was NOT expecting today to be quite so nuts.

There are tons of coughs and colds and lots of wheezing out there.
I have several folks with moderate fevers ~101.

There are many folks with conjunctivitis and ear infections.

There is a bit of vomiting/ diarrhea

I am still seeing lots of odd rashes ( many I am blaming on the slap cheek virus)

The general call volume was very high. Charity and I were both in here working full throttle to try to get back to folks in a timely manner. If you ended up waiting for a call we very much appreciate your patience.

We were booked solid by 9:40 this morning and I ended up squishing in a few more patients who really needed to be seen.

Thanks to all of you for understanding that on some days, the mildly or moderately ill kids need to wait a day or so to be seen so that we can get the sicker kids in here..


Dr Anne thanks you all for the well wishes.
She reports that her babies are very sweet. Their names are Sonam and Sathyan.

We will be starting to book the well child exams for all of our older patients ( for kids over 3 we try to do the well child physical exams from March-October) If you plan in advance you will be rewarded with a much better selection of convenient times.

Stay well,

Judy