Tuesday, March 23, 2010

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, March 19, 2010

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

Wednesday, March 17, 2010

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
/

Saturday, March 13, 2010

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

Tuesday, March 9, 2010

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

Monday, March 1, 2010

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