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