Weekly update/ New years schedule

I am a day late on this, the phones were so nutty yesterday that I couldn't get to the blog.

We will be closed for New Years on Tuesday afternoon and Wednesday all day.
We will be back to our normal hours on Thursday January 2nd.

This week we are still seeing lots of tummy stuff.
Many of the patients and families have vomiting/ diarrhea and mild fever.
This is lasting only for several days.
If the diarrhea is lasting longer than that even with the simple diet, we might send the stool to the lab to be cultured.
Indeed this week one of our patients tested positive for Salmonella.
Most patients recover fully from that, but it is a nasty journey.
We are seeing lots of colds/ coughs and congestion as well as some Strep throat.

We have had patients traveling all over the place these past couple of weeks and alas, quite a few have gotten sick. Quite a few of our patients has tested positive for Influenza Type A while away.

There seem to be multiple strains of the flu out there.
The vaccine this year is clearly not a perfect fit, but it does protect against the H1N1/ swine flu strain that is making the news.
So far the folks who have gotten the flu have been very low energy, feverish,achy, congested and have had some stomach issues ( typical)


I wish everyone a Happy and Healthy new year.

~Nurse Judy

Monday update 12/23 and Holiday schedule

There are lots of sick kids this week. I know it is nasty timing with all the holiday festivities and traveling that is going on, but so it goes. (I swear I think I have spoken to patients in almost all 50 states today)

The biggest complaint this week is the tummy bug. There are loads of families (yup, the parents are getting hit with this as well) that have the vomiting and diarrhea.

There are tons of coughs and colds.
We are seeing high fevers and general viral yuck.
RSV is going around, but more of the tests this week have been negative.

We are seeing quite a bit of strep throat.

We had a positive flu test last week. (and likely quite a few that we haven't tested)
Alas the patient with the positive flu test did have the flu shot this season....
What does that mean???
It means that the flu shot this season is not a perfect match.
The shot protects against 4 different strains but there seems to be an A strain out there that isn't covered by the vaccination. That being said, the patient was only ill for 3 days or so, so it is possible that the flu shot kept him from getting a full scope of the illness.
The shot also may well protect from other strains that may circulate (We can only hope), so I am still feeling like it is better to have the flu shot than to skip it.

We are here in the office tomorrow for the morning only.
The after hours clinic opens the phone lines at noon and will start seeing patients as early as 1pm.
They are your best option for Christmas day as well.
We reopen on Thursday but have only one doctor working. My triage bar will be set fairly high and the visits will be limited to the sicker patients who really need same day appointments.
We have two docs working on Friday so that hopefully we can take care of any needs before the weekend.
Happy Holidays!
Judy

Monday update december 16th

The winter illnesses are here with a vengeance.
We are seeing a lot of RSV and actually have one baby in the hospital with it.
http://www.nursejudynvp.blogspot.com/2013/11/rsv.html

If your child is still able to drink and has normal color and okay energy, then they are probably managing to work through this nasty virus. When they are having too much trouble with the breathing to properly eat, it is time to get them looked at.
For the record...I HATE RSV.

The ER says that it is also getting some positive FLU tests. We have seen quite a few kids who looked like they may be FLU candidates. Now that we know it is here we will start testing. I don't have a good sense of what the classic symptoms are for this season's FLU yet. I will update here.
Every season is a bit different.

We are seeing strep throat. If you have a patient with a sore throat, fever, aches, stinky breath  it is worth doing a swab to see if it is strep.

There are lots of kids with tummy aches and diarrhea. Some of them are vomiting as well
http://www.nursejudynvp.blogspot.com/2013/03/tummy-bugs-101.html

Safe Travels to all of you who are going away for the holidays.
Nurse Judy

Monday Update December 1st

Very busy day at the office...so sorry for longer then expected wait times to talk with the nurses today. So many lingering cold and cough symptoms this week. Get your humidifiers going at night, warm baths before bed and lots of fluids to help with symptoms. It seems to be hanging on for most people for 2 weeks.
There has beem some lingering tummy bug issues, watch for dehydration and use the BRAT diet.  If combined with vomiting, start slowly with clear fluids.
It is going to be very cold this wk so bundle everyone up, and cover your plants!
Hope everyone had a lovely holiday and call us if you need us

Monday update November 25th

We have an odd virus going around.
I have almost a dozen kids with hives. They are itchy but don't seem to be super sick.
Hives are strange. They can be associated with severe allergic reactions so they make many parents nervous. However, many times they simply come along as part of a virus.
We are interested in whether or not your child is on a new medication and/ or has eaten something new and unusual, but if there is no trouble breathing and no obvious source, I am thinking that it is viral.

Most of these kids have had hives on and off for about 4 or 5 days and then they are better.
If they are old enough, we would be fine giving them benedryl as needed.
If they are under 6 months do check in with us.

We are also seeing lots of Strep throat.

There is still a bit of diarrhea going around.

There are tons of coughs and colds out there as well.

For all of you who are traveling for the holidays
Here is an oldie but a goodie from my blog with some travel wisdom.
http://www.nursejudynvp.blogspot.com/2013/08/hello-from-pittsburgh-pennsylvania-i-am.html

Our office will be closed for the holidays on Thursday and Friday. We will be back in business on Monday December 2nd.
If you need help as always call the after hours clinic 387-9293

Happy Holidays!
Judy

Monday update November 18th

We are still seeing lots of colds and coughs.
This cough hangs on for weeks!

I am also getting lots of folks with several days of fevers
Here is my updated fever post.
http://www.nursejudynvp.blogspot.com/2013/11/dealing-with-fevers.html

A few of these folks have ended the fever with a rash and a few fussy days. When that happens I am thinking Roseola or other viral syndrome.

We are having some sore throats.
Some of these have been positive for Strep.

There is a mild tummy bug out there. (If you or your child has it, you might question my choice of words...but most folks are shaking it after a day or so)

Aside from that early positive Flu test last month, I don't think we are seeing any active Flu circulating.
Stay well.
~Nurse Judy

Monday update November 12

The most common illnesses that I have seen in the office and have been getting calls about are the terrible coughs and colds.

We have also had several patients with very high fevers.
We haven't had any more positive flu tests in the office, but to be honest we haven't been testing too many patients.
We have had a couple positive strep throat tests.

I am seeing several folks with a mild tummy bug. Most of these folks have resolved within a few days.

Stay healthy!
~Nurse Judy

Baby Food Recall

http://plumorganics.com/Nov13Recall.pdf?579fdd

Dr Anne asked me to post this. This recall just came to her attention.
She actually had some of this food in her kitchen!

I get calls all the time about babies eating some foods that might be spoiled or simply putting strange and often disgusting items in their mouths.
If your baby has eaten something and is acting fine, we are generally NOT concerned.
If, on the other hand, your child has eaten something questionable and is acting fussier than usual or the poops are unusual, then do check in with us.

~Nurse Judy

Monday update November 4th/ flu shot clinic

We are absolutely swamped with sick kids this week.
Last week the winning phone calls belonged to the "tummy bug"
Today it is all about the respiratory illnesses.
There are loads of coughs/ colds/ wheeziness and fevers.

I do think that RSV is making the rounds
http://www.nursejudynvp.blogspot.com/2013/11/rsv.html

We are seeing lots of croupy kids as well. 

We also had our first positive Flu test!
It feels awfully early for that, but so it goes.
The patients symptoms presented with a few days of congestion that turned into wheezing.

If you haven't gotten your shot yet, we will be doing another Saturday flu shot clinic on November 9th.
9am until noon.
No appointment needed.
This is for the patients and families of Noe Valley pediatrics only.
We have both the flu mist and shots available.

Stay well!
Judy

Monday Update October 28th/ Costume photos/safety class

Towards the end of last week and continuing today we are seeing a lot of kids with upset stomachs, Most of these also have diarrhea.
They seem to be very crampy. ( a bit more cramp complaints than I usually see with this)
This passes after a few days.
http://www.nursejudynvp.blogspot.com/2013/03/tummy-bugs-101.html

I have heard from some of the parents that the day cares are seeing some Hand Foot Mouth.
I have NOT seen much of that in the office yet.

http://www.nursejudynvp.blogspot.com/2013/06/hand-foot-mouth-and-butt-virus.html

We are seeing lots of kids with coughs, colds and croup.

http://www.nursejudynvp.blogspot.com/2013/09/croup.html

http://www.nursejudynvp.blogspot.com/2013/08/dealing-with-those-pesky-colds-and.html


I do have space in my upcoming safety class Wednesday evening at 7:30.
We will review choking rescue, poisons, burns, general child proofing tips, head injuries, pet safety..
You name it....
Classes are $20/ person. sliding scale.
RSVP required
Nursejudynvp@gmail.com

Remember that we have our next Flu shot clinic on Saturday morning November 9th.
I am looking forward to seeing our little patients in costume.
I will be posting photos on the web site ( no names of course)
If you would like to have your little star as part of our gallery, come by and let us snap a picture or email us your best shot to nvpeds@gmail.com

Happy Halloween!!!

http://www.nursejudynvp.blogspot.com/2013/10/halloween-safety-tips.html

get rid of expired meds/ parenting class/ Halloween

This upcoming Saturday is a national expired medication give back.
It is important to routinely clear out your medicine cabinet and getting rid of old medications can be a challenge. You do NOT want to dump them down the drain.

http://nursejudynvp.blogspot.com/2013/09/stocking-your-medicine-cabinet-link-for.html
******

This coming Wednesday evening October 26th, I do have some space in my parenting workshop.
In this fun two hour workshop I talk about effective rewards, consequences, bed time and meal time challenges, tantrums, problem solving etc.
Full info at www.nursejudy.com
Wait until your child is over 2 for this class.
To RSVP email me at nursejudynvp@gmail.com
******

Is your child going to be in a costume this week? We are going to add a special Halloween gallery to the new website.
If you are in or near the office in costume and would let us post  a photo ( no names will be  used of course) come by and let us snap some shots( the kind that don't hurt!)

Monday October 21st

We are seeing a lot of mild/moderate illnesses.
There are lots of congested kids with colds and coughs. The coughs have been lasting and lasting.
Some of the patients are wheezy.

There are plenty of kids with a couple of days of moderate fevers.

If the high fevers come at the same time as a deep cough, your child should be seen.

I am getting some calls about kids with tummy aches...some of those have had some loose stools, and others have done some vomiting. There is no real pattern to this yet.

I am still seeing some mild slap cheek around.

If you haven't gotten your flu shot yet and the week day appointments are hard, we will be doing our next Flu shot clinic on Saturday November 9th from 9:00 am-noon....no appointment needed.
This is for Noe Valley Pediatric patients and families only.

Stay well

Nurse Judy

Monday update October 14th/ flu shot clinic

We will be doing another Saturday on Saturday November 9th from 9:00 am until noon.
If you miss the last one, you have another chance.
If this is the first year that your baby is getting the flu vaccine, they do need to get two doses.
The doses need to be at least 4 weeks apart.


We don't seem to have any actual flu around here yet. We have tested a few kids who presented looking fairly miserable, but the tests came back negative.
 I have heard that some strep throat is around, but we haven't seen much of it in here.

We are seeing tons of kids with a cough/ cold/ fever. The coughs are fairly harsh and seem to be lingering for a few weeks.

I also am still seeing some slap cheek.
http://www.nursejudynvp.blogspot.com/2013/10/slap-cheek.html

Stay well,
Nurse Judy

October 7th Monday update

We had 85 folks in taking advantage of the flu shot clinic on Saturday
We will try to schedule another one later in the season, I will update here when the date is chosen.
In the meantime, we are doing flu shots Tuesday, Wednesday and Thursdays. Call in the morning for a same day appointment. There is a limit to how many we can do in one day, so bear with us.

The phones are very busy today.
Most of the complaints are cold and cough related. The coughs are hanging on for a couple of weeks.
We are also seeing many kids who are wheezing.
Labored breathing is what makes me worried about a cough.
Ask your child to take a great big deep breath in and out. If that deep breath triggers a coughing attack, there could be some inflammation and wheezing going on.

I am also getting lots and lots of calls about kids with diarrhea and vomiting.
The vomiting is usually resolving after a day, but the loose stools are hanging on a bit longer.
Check out last weeks post for the link to the tummy bug blog post.

I think that we are starting to see slap cheek.
I spoke to quite a few families today who have suspicious symptoms.
This virus will have red chappy cheeks, a lacy rash up and down the body and sometime a high fever.
All of the symptoms can come and go.

There are a ton of kids with all sorts of odd rashes.
 Thanks to the warm weather the bugs were having a picnic on all of my sweet little patients.
Many of the kids with bites seem like they have gotten some hives that are hanging around for a day or so. They seem quite fine otherwise.

Stay well
Judy

Saturday Flu shot clinic/ Monday update/ illness class this week

Lots of illness out there.
There are quite a few kids with coughs.
Our wheezers are wheezing and those nebulizers have been humming in all of the exam rooms...so there is certainly something going around.
We are also seeing croup.
http://www.nursejudynvp.blogspot.com/2013/09/croup.html

There are kids with fevers. Most of them have been lasting about 3 days.
http://www.nursejudynvp.blogspot.com/2013/03/all-about-fevers.html
We have had some kids with sore throats. None of them have tested positive for strep yet this week.

There were a few patients in this week with vomiting and diarrhea.

http://www.nursejudynvp.blogspot.com/2013/03/tummy-bugs-101.html
We hadn't been seeing much of that around recently. I hope it is a quick one, if it seems like it is anything especially nasty I will post again later this week.

We are doing the first flu shot clinic of the season on Saturday morning  
October 5th from 9:00 am-noon.

No appointments are needed.
We will see any of our Noe Valley Pediatrics patients and parents.
Parent shots are cash only ( We can give you a bill to send to your insurance if you request it)
$40


All of vaccine that we purchased this season is the Quadrivalent form. It protects against 4 possible flu strains, rather than the 3 in the standard vaccines.

All of our vaccines are preservative free
So far this season the side effects have been quite mild.
I have had one or two young patients who had a mild fever after the shot, but for the most part folks are fine.
I barely even had a sore arm after mine.

If you are interested in getting the nurse judy posts automatically
e-mail me nursejudynvp@gmail.com and I will be happy to add you to the list

I do have an illness class coming up Thus Wednesday October 2nd at 7:30 pm
where we focus on knowing how to recognize when an illness needs attention and when you can play the wait and see game.
Email me if you are interested in a spot.

Stay Well,
Nurse Judy

Monday update September 23

Summer is officially over.
We have lots of kids with runny noses and harsh croupy coughs.

There are plenty of fevers out there as well. Some of the kids are breaking out in a rash once the fever is gone (usually the fever lasts 2 or 3 days). Many viral syndromes have that pattern and usually don't need to be seen.
If your child has a rash with a fever at the same time, I want you to call.

We also have seen  a 48 hour illness with mild fever, very cranky, low energy,  head ache, decreased appetite and some vomiting. Warning Warning, the parents are coming down with this one as well.


We are busy with flu shots.
See last weeks post for our flu shot hours.

Stay well
Nurse Judy

Hey Brown and Toland Patients

If you are a Brown and Toland patient and you receive one of the patient satisfaction surveys please do take the time to fill it out.
Your feedback is important to us and if there is something that we can to to improve our service we want to know.
(Alas we don't have a magic wand that eliminates any waiting..but we sure do wish we did)

If there is something that we are doing especially well of course we love to hear about that as well.

We appreciate your time!
Thanks
Nurse Judy and the Noe Valley pediatrics staff

We have the flu vaccine

We got the long awaited flu vaccine for babies today.
We are now well stocked with the Quadrivalent Flu vaccine for all patients over the age of 6 months.

If you have an appointment to see one of our doctors, we can always add a flu vaccine to the visit if the doctor feels your child is well enough to get one.

If you are coming in for the flu vaccine only we will be holding our standard flu shot clinic hours.
Tuesday Wednesday and Thursday from 10:00 am-11:30 am and again from 2:00pm-4:00 pm
Please call in the same morning to get on to one of the lists.
If your child is coming in for a shot only, please be aware that they won't be seen by one of the doctors.

We are still seeing our normal flow of patients, so it is a balance to get all the flu shots taken care of without massively stressing out our hard working medical assistants.

We will also be holding our first Saturday morning Flu shot clinic of the season on October 5th from 9:30 am until noon.
There is no appointment needed for the Saturday clinic and we will vaccinate Noe Valley Pediatric patients and family members.
(for parents, we do not bill your insurance but we will be happy to furnish you with a super bill that you can submit)
Fee for parents is $35 for the flu shot, $40 for the flu mist
( the mist is probably more effective for younger patients..we suggest the shot for the older adults)

I got my flu shot last week and had no side effects at all.

Here's to avoiding the flu this season!!!
Nurse Judy

Monday Update September 16th

We are seeing some kids with fevers and congestion.
 Some of the fevers have lasted for four days or so, but the kids don't seem too worrisome. If the fever continues into day 5, they need to be seen.
 If the fever does not respond to meds or the child is super fussy, I would want them seen sooner.

Below is the link to my blog post on fevers
http://www.nursejudynvp.blogspot.com/2013/03/all-about-fevers.html

There are also lots of coughs and colds.
Last week many of the kids seemed to have labored breathing with a croupy cough. Any time you have labored respirations your child should be evaluated.

I am hoping that the infant flu vaccine will come this week.
I will let you know.

Have a healthy week
Nurse Judy

September 9th Monday Update

This morning when I looked at my Monday pile of charts I knew that the slow season was over.

There were lots of  calls about fevers and coughs,
I had a few kids with vomiting and diarrhea.
There was one case of croup that ended up in the ER.
There is definitely some RSV around  (which will present as terrible congestion/ cough/fever)
I have some patients with hand foot mouth, and they report that their schools are sending out notices about it. I personally have not had tons of calls about this lately...but it is out there.

With the hot weather I also had the expected calls about heat rashes, bug bites and kids falling all over the place.

 Last week,we got in our first shipment of the "big kid" inject able flu vaccine.( I am getting my flu shot tomorrow!)
 We are still waiting for the infant doses that are for babies under the age of 3.
 Hopefully it will be here next week. I will post the information as soon as it arrives.


There is a recall out there for the Infant Motrin
http://www.motrin.com/infantnews?utm_source=google&utm_medium=cpc&utm_campaign=Additional+Infants+Motrin+Recall&utm_term=infants%20motrin%20recall%202013&utm_content=Recall%7Cmkwid%7Cs7RY4Uqjk_dt%7Cpcrid%7C28191135124


Nothing dangerous, but do check any that you have to make sure you don't have the lot numbers in question.


Be well,
Nurse Judy

Tuesday September 3rd update

We were flailing around in here today after the 3 day weekend, so thanks to everyone for  their patience if you encountered busy signals or long wait times.

Towards the end of last week, many of the calls were related to all sorts of rashes.
There are a few cases of hand foot mouth.

This week most of the issues were cough and cold related.
We had one positive test for RSV ( a nasty cold that usually shows up in the fall and winter, I will do a post on it for the nurse Judy blog one of these weeks)

We still do not have the injectable flu shots. I will let you know when it arrives.

We are also completely out of the PPD/ TB tests.
There is a nation wide shortage.
I am trying to get some answers from the health department for guidance about this.
 Currently the adult immunization clinic on Grove street has a limited supply that they will administer to patients over the age of 13. It is $40 from them.

Stay well,

Nurse Judy

Tahoe air quality

We have been getting a lot of calls from families who were planning on heading up to Tahoe area for the long weekend.
Nurse Jen did some calling around to get the scoop from a doctor friend of hers who lives up in Truckee

The air quality is fairly poor. If your plans are flexible it probably makes sense to go up there another time when you can fully enjoy it.
You certainly would not want to go up there and do any out door activities.
I would be especially cautious if anyone in the family has asthma.


We will be closed on Monday for Labor day.
If you need to be seen call PERC  387-9293

Enjoy your weekend

Judy

Monday update August 26th

Most of our kids are back to school and I have heard of some kids with fever, but the acute care calls are fairly mellow today.

I have a few patients with loose stools and vomiting and a few with coughs and colds.

In preparation for the winter/ flu season we do have flu mist in stock. ( for folks over 2)
I am told we will get the rest of our flu shots some time in September..I will update the supply status here.

Be Well,
~Nurse Judy

Monday update/ August 19th

Many of our patients are back in school today. It seems so early!
Most of our patients seem reasonably well this week ( I am knocking on wood)

This morning in my pile of Monday charts the big winner was.....diarrhea.
There were half a dozen or so babies with very frequent stools who seem to be otherwise well.

We had one patient in the office with Hand Foot Mouth ( there is rarely just one...stay tuned)
We are still very booked up with well child checkups

I just did a blog post on this season's Flu Vaccine ( check the nurse judy blog for that one) but for the rest of the season, this will be where you should check for your flu updates.
I will keep you in the loop with vaccine availability as well as any other relevant Flu info.

Currently we have the Flu mist in stock.
This is the live vaccine that is given into the nose.
It is indicated for anyone over the age of two.

As soon as we get our injectable vaccine I will let you know.
Be Well,
Judy

Monday update 8/5/2013

We are seeing a smattering of little ailments.
There are mild fevers, colds and coughs, rashes, and some ear infections.
That being said, although we are LOADED with check ups and newborns, the acute care calls and sick kid visits are very manageable. For the most part folks don't seem too worried or sick enough that they need to come in.
(That will change as soon as school begins, I am sure)

We will be getting the first batch of the FLU MIST soon.
I will put it here in the blog as soon as we actually receive it.

The injectable flu vaccine usually comes around the end of August.
I will do a post about the different options in a week or so.

Stay well, enjoy the last bits of summer.
Judy

Monday Update July 29th

I was all set to say that everyone was healthy as can be, but then all of a sudden the phone started to ring and I had about a dozen calls in a row about kids with fevers.

Some of the kids are on the 3rd day or so. Most of them are fussy. So far this seems viral.

There have been a few cases of strep around ( this tends to go through the day camps every summer).

There have been a few cases of kids with upset tummies.. nothing too major.

We of course have our share of mystery summertime rashes.

Stay healthy!

Nurse Judy

Free Dental screening this weekend!

Please pass along this information to anyone with children who lives in and near
the Mission:
http://www.ucsf.edu/news/2013/07/107701/ucsf-offers-dental-screenings-kids-sunday-streets


UCSF Offers Dental Screenings for Kids at "Sunday Streets"


When:       Sunday, July 28, 2013          11:30 a.m. to 3:30 p.m.
Where:      24th and Harrison Streets    San Francisco Mission District

UC San Francisco will offer free dental screenings and health education as
part of the City’s “Sunday Streets” in the Mission District this weekend,
in conjunction with the UCSF chapters of the Student Society of Pediatric
Dentistry and the Hispanic Student Dental Association. UCSF School of
Dentistry residents will perform the screenings and apply fluoride varnish
for children, with parental consent, to prevent cavities. They also will
provide dental education for children and their parents/guardians, as well
as referrals to the UCSF Pediatric Dentistry Clinic where appropriate. No
appointment is necessary for the screenings.

Early detection is key to diagnosing potential tooth decay, which remains
one of the most common diseases of childhood – five times as common as
asthma. By age 17, more than seven percent of children have lost a
permanent tooth to decay, according to the U.S. Department of Health and
Human Services.

UCSF also will have a booth at the street fair for its Science Health &
Education Partnership, which provides hands-on science lessons to nearly 90
percent of San Francisco public schools, their teachers and students

Monday update 7/22/13

This morning when I plowed through the stack of Monday morning calls, the most common theme was kids who were vomiting/ diarrhea/ tummy ache and a little fever.
Most of them were on the first or second day of this.
I will keep you updated if this looks like it is becoming a problem.
If your child has tummy symptoms take a look at the tummy bug blog post on the www.nursejudynvp.blogspot.com  That post is on the march menu.

We have also had a couple cases of strep throat.

Enjoy summer, those back to school commercials will be starting before we know it.
~Nurse Judy

Monday Update July 15th / Lucille packard weight control program

We have been very busy with out well child exams and lots of newborn visits. If you need a check up this summer PLEASE call in advance for an appointment.

Most of my acute care calls today have been about rashes. For some reason I have had quite a few children with blotchy faces ( cheeks and chins). The kids all seem reasonably well except for these rashes.

We were just given information about a weight control program down at Stanford
If you know someone who might benefit for this, the information is as follows:

Registration for the Packard Children’s Weight Control Program’s fall groups for 8-15 year olds is now in process.

(No physician’s referral needed, please ask interested families to call(650) 724-5611).

We will have two class options, 4:30-6:00pm, and 6:00-7:30 pm. Classes will run every Monday for six months.

Our program has been recognized both nationally and internationally for its success in helping kids reduce their overweight and ultimately reducing their chances of having related health concerns such as diabetes in the future.  Please forward the information below to any interested families. Thank you!

To be added to our enrollment list, please have families email us as soon as possible, or call us at 650-724-5611.

Spaces are limited and we are enrolling on a first come, first serve basis.

Have a healthy week

Judy

Monday Update July8th

There is nothing significant to report.
We are seeing dribs and drabs of little viral illnesses but not enough of any one thing to blog about.
More of my calls have been about little injuries than illnesses.

The winner of the most interesting call contest today was the child who got bitten by a dog....in Costa Rica. OY!

Enjoy the nice weather while we have it.

Judy

Monday update July 1st

How is it possibly July???

There are quite a few of my patients with fevers today.
They  are on day one or two right now. I don't know how long it lasts.
Some of the kids also have congestion and cough.

There is still a tummy bug making the rounds
There are still reports of the mild hand/foot/mouth illness going around

To me July 4th mean fireworks injuries..
( It also means fog...I don't care how hot the weather is, I have lived here for 27 years and there has only been one clear July 4th that I can recall.)
Please be safe.
With the warm weather it is in your power to make sure you and your kids stay hydrated and sunburn free. Do your best!!
Be wary of hot barbeques.
Be careful of the spray on sunscreens, there have been reports that some of those products are flammable.
Dr Anne returns from her maternity leave this week! We are delighted to have her back. Dr Beardsly will still be doing Wednesdays for us through August.

Do remember to schedule appointments for check ups. If you call at the last minute we will have a hard time accommodating your scheduling needs
Remember to bring your forms with you to avoid any form fees.

Stay well
Judy

Weekly update June 25th

This week the most calls were about a diarrhea virus that went through quite a few of our families.
There was not a lot of vomiting with this and luckily it seemed to be the 24 hour brand.

We are still talking to patients with HFM virus, Check out my newest blog post ( on the Nurse Judy blog) for how to deal with that.
Most of the kids this go round have had a fairly mild version and we have NOT needed to see them.

There are also lots of random rashes.
Some kids are ill with several days of fever.
We are seeing lots of conjunctivitis

I do have spots in my illness class tomorrow evening. Email nursejudynvp@gmail.com to sign up


Stay well
Judy

Monday update June 17th

We seem to be finally in the "summer season".
Kids are still getting sick here and there, but the acute care phone calls are way down.
We are keeping very busy with well child exams, but it is a nice change to have some of those winter ailments ease up.

My most common call today was all about gooey eyes. My most recent blog post addresses this for the youngest patients. For the older kids, gooey/ pink eyes can be viral, allergic or bacterial. If your child is in a daycare situation, they may want you to have your child evaluated to make sure they aren't contagious.

I am also getting some calls about hand/foot/mouth virus. So far none of the kids have anything more than a mild case, but it certainly seems that it is back in town.

Stay well,

Judy

Monday update June 10th

Things are a bit mellower as far as illnesses this week.
Most of my morning calls were about various rashes. I imagine that the hot weather this past weekend had something to do with it.

I have several kids with conjunctivitis.
A few calls have come in about loose stools

We are mostly busy with checkups.

Summer time is always our busiest check up season. Please call us at least 4 weeks in advance for the best selection of appointment slots.
Forms that are filled out at an exam have no form fee.

Dr Anne will be returning from her maternity leave next month.
She will be back Tuesdays and Fridays starting July 2nd.

Stay well.
~Nurse Judy

Monday update June 3rd/Costco Organic berry recall

Whenever you see a head-line about a public health concern you can be sure that my phones will be ringing like crazy.
If you haven't heard, the news today is that there is an outbreak of Hepatitis A associated with Townsend Farm Organic Antioxident Blend Frozen Berry Mix.
So far 30 cases have been reported in 5 states, including Calilfornia. ( none in San Francisco yet)

This product is popular in Cost-co, but also sold in other stores.

Early signs of Hepatitis A appear 2-6 weeks after the exposure. Symptoms commonly include mild fever, loss of appetite, nausea, vomiting, diarrhea, fatigue, right upper quadrant pain, dark urine and jaundice.

If you or your child has had even one of the 2 series Hepatitis A vaccine, they are not considered to be at risk.
Hepatits A vaccine can prevent the illness if given within 2 weeks of the exposure, so if your child has not been vaccinated please call to get that scheduled.

Children can get the vaccine once they have reached their first birthday.

Young children often don't seem to get as ill from the Hepatitis A as  the adults, but if  your child has been exposed to the tainted berries and shows any sign of illness, please call us ASAP.

If you have further questions, the public health department has a hotline number that you can call 701-2311


In terms of the normal illness flow....
We are seeing plenty of allergy symptoms and an assortment of odd rashes.

Stay well.
Judy

Tuesday May 29th/ looking for medical assistant

Sorry for the missed week, I was out of town and things in the office were hectic!

Do check out the new website
WWW.NOEVALLEYPEDIATRICS.COM
The old Brown and Toland site still shows up if you simply google us, the more people who go to the actual site the better, Maybe the Google Gods will start sending people in the right direction.

The new website is still a work in progress,  your comments have been helpful.
We are still happy to get the photos of our beautiful patients.
Email them to nvpeds@gmail.com

We have been very busy the past couple of weeks.
The allergies are driving folks nuts. The wheezers out there have been wheezing and the nebulizers have been humming along in many of the exam rooms.

We have seen all sorts of odd rashes. Some kids have had little lesions that have looked an awful lot like chicken pox, but these kids have been vaccinated and are acting well, so I don't think that is what is going on.

We have a few kids with very persistent loose stools.
We are starting to send little samples to the labs for clues.
Some patients are also vomiting

We have a bunch of kids with several days of fevers. At day# 3 we are starting to bring them in to take a look. So far it seems like there are just lots of little viruses floating around.

I have a couple of kids with gooey eyes.

On a different topic. Our excellent medical assistant Rosa will be moving along on her career path. We will be posting an ad for a new medical assistant this week, but I thought I would put it out there.
If anyone know anyone looking for that type of position, send me an email!!

My next blog post will be all about tick bites. ( will be up on Friday)
You can access the Nurse Judy Blog from the website.

Have a good week
Judy

Monday update/ May 13th

Thanks to all of you who send me those wonderful photos.
The new website is up and running. We are still working out some kinks and fine tuning the info so it will continue to evolve for a little while. Is there anything that should be on there that isn't? Your feedback is appreciated.
It is not too late for your photos.
High resolution, good quality photos are best. My goal is to have a little gallery on there.. We have so many adorable patients!

The tummy bug is still out there with a vengeance.
Many of the patients are suffering with diarrhea that is lasting for almost a week.
Once we get to day 4 or so, if the diet changes aren't helping you out, I am going to want them in here for a weight check.

I am also seeing the basic cough, could, mild fever illness.

There is a lot of conjunctivitis out there. I think that much of that is allergic, but it is worth checking if it is hanging on for more than a few days, or you have a fussy child.

There are a few kids that seem to have hand/ foot/ mouth. They have the mouth sores as well as a fever with this.

I am seeing all sorts of odd rashes.

We are also seeing lots of "summertime" injuries, kids are falling and getting all scraped up.

Stay well and safe

Judy

May 6th Monday update

By far, most of the calls I dealt with today are tummy related.

What I am mostly seeing is a virus that starts with some vomiting. Alas the diarrhea/ loose stools are lingering for 4-5 days.

In the office we have seen lots of kids with coughs and colds. Last week we had many positive strep tests.
I am getting lots of email photos of various strange rashes.
Some may be bites, others allergy or heat related.
Many rashes are simply coming along with a virus.
( see the nursejudynvp.blogspot.com  post on rashes for a guide of when to worry)

There is one of my patients with  possible hand foot mouth virus.
We had one possible case 2 weeks ago and this is only the second one I have seen. Hopefully this isn't the start of things.

We are SO busy these days.
If you have any physical exams that need to be scheduled or forms that need to be filled out, please call ASAP. If you call 2-3 months ahead of time, you should have no trouble finding a spot that works with your schedule seeing your primary doctor.There is no fee for forms that are filled out when you come in for an exam.

Dr Anne popped in with her lovely babies today. They are adorable. She is planning to ease back in to working a few days a week in July.

Thanks for the fabulous photos!!! It isn't too late.
 I will let you know when the new website is up and running

~Nurse Judy

update/ vomiting

I think I jinxed it yesterday by mentioning that the tummies out there were behaving.
I have been on the phone non-stop today with the parents of vomiting kids.
Many of them have not started with the diarrhea yet.

Do review the tummy bug blog post.

Good handwashing!!!!!

Judy

More monday Mayhem/ April 29th

Thanks to all of you who have sent photos.
They are quite wonderful.
 I will let you know when the new website is up and running.

We look like we are going to have another super busy week on our hands.
There are lots of kids with colds, coughs, ear infections, sore throats and allergies.

We have a few kids with high fevers.
There are lots of kids with sore throats. Some have been strep, more seem to be viral or allergy related.

I have a few kids still with vomiting and diarrhea. That is way less of a complaint today than it was last week.

With warm temperatures come the calls about the rashes. Try to keep your kiddos cool and hydrated.


Stay well,
 Judy

Monday update April 22nd/ and request for Photos of your kids!!!

My pile of charts this morning was so high that I could barely peer over it to look at the computer screen.
For all the lovely weather, there are still a ton of sick kids out there.
Last week we actually had a positive FLU test ( strain B...covered by the vaccine)
We had one positive strep throat test today.

The worst illness is the tummy bug. This one has teeth. I think it is likely the Norovirus.
One of my little sweeties was actually popped into the hospital for a day or so due to dehydration. Most folks have been managing at home. Time will fix this. Do your best with the hydration and of course call the office if you are worried. Parents be warned....adults are getting this too.

There are also loads of kids plagued with allergy symptoms. There are lots of runny noses, watery eyes and coughs.
If your child is over a year, go ahead and try treating with the claritin syrup. If you get some symptomatic improvement, you will know that it is likely allergies. If mucous is getting greener and greener, your baby is fussy and there is any fever then I would be looking for another cause.
There are lots of coughing kids. Some of the wheezers are starting to get mildly wheezy.

I have also had tons of odd rashes. Check the rash blog post on the www.nursejudynvp.blogspot.com to see if you need to be concerned.
When the weather is hot I always see an increase in cases of heat rashes and bug bites. ( make sure your windows have screens!!)

I also saw a poor little guy in today with what looked like a horrible case of Hand/ Foot/ Mouth..
 I hope I am wrong, because when that virus comes around it tends to spread pretty easily. If I start seeing more I will update.
There are several kids with very high fevers for a few days. These kids are pretty happy within 30 minutes of the fever meds. This might be roseola. Roseala shows up with several days of fever, kids don't look as ill and one might expect, on day 3 the fever goes away and a rash pops out.


PHOTO REQUEST...
 Our web site is going to get a long overdue facelift. I would love to add photos of your adorable kiddos. (We will probably have a brand new site soon, hopefully with the same address)
Do you have suggestions for things on the website that you would find useful? The current one is pretty awful.
If you want to have your little one on the site send me photos!!! Much appreciated.

Stay well
~Nurse Judy

Monday April 15th...a taxing day, to be sure!!!

We were packed in here today. We are very booked up with checkups and there are still quite a few sick kids out there who are taking up the rest of the spots with acute care appointments.
The nastiest thing out there right now is the tummy bug.
This round is a tough one. The kids have vomiting, diarrhea and fever. The diarrhea has been lasting for upwards of 4 days, even with folks avoiding dairy and doing probiotics. I suspect a strain of norovirus.

With most of these illnesses, time will fix things. Your job is to keep your child hydrated.
Check in with us if things aren't clearing after a few days.( check the tummy bug blog post)

I also have lots of kids with coughs, colds and a low grade fever.

Schedule those check ups!! If you plan at least 6 weeks in advance you can more easily pick and choose your appointment times. Last minute appointments are much harder to manage.

If you have friends who are expecting a baby and are interested in using us, have them call early.
We are currently doing 2 intake groups a month. Each group has 9-10 couples.
The groups for May are full.
We hate to turn people away, but seeing how busy we are now with our existing patient load, we can't accommodate any more patients than we allot from the intake groups and the siblings that are being born.

Stay well.
~Nurse Judy

Monday update April 8th

Most of my calls today have been folks plagued with the tummy bug. This is coming with all sorts of combinations of vomiting/ diarrhea/ gassy tummy aches and some fever.
I have a few patients who have been dealing with this for 3 or 4 days.
Refer to the earlier tummy bugs blog post for advice on treatment
The same post is also on my new blog nursejudynvp.blogspot.com where it might be easier to find

We have tons of kids with coughs and mild colds. Allergies are starting to flare up a bit with all the lovely things blooming out there.

We are also seeing quite a bit of conjunctivitis. If you have an older child, it might be worth seeing if the eyes clear up with an over the counter allergy eye drop. My favorite brand is Zaditor.

For younger kids with the goopey eyes, we often like to see them to make sure they don't have an ear infection. Those often go together.

We are getting lots of requests for forms to be filled out for summer camps and activities.
Our office does have a $10 form fee ( $20 if you need it immediately, so plan ahead)
If you have an exam scheduled and you bring the form with you, the fee will be waived.

Enjoy this lovely weather!
~Nurse Judy

baby photos

Here are Dr Anne's lovely twins!

Monday Update April 1st

There are lots of little illnesses that continue to float around.
We had 3 positive flu tests last week for strain B ( the type that is protected by the vaccine)
We have seen quite a bit of strep throat.
There is a croup virus going around that has a moderate fever associated with it. The worst of this is lasting for several days ( but the cough hangs on for a while longer)
I had quite a few calls this morning from families with a bit of a tummy bug (too much Easter candy perhaps?)

If you are interested, check out www.nursejudynvp.blogspot.com
This weeks entry was all about dealing with head lice.
Older posts include tylenol dosages charts, travel tips, teething charts etc
Hopefully you find the info useful and easy to look through.


Dr Anne stopped by today. Her little twins are doing great. She is still planning on returning to work in July.

I had a cancellation in this weeks Parenting workshop so there is one space left. Full class info is at www.nursejudy.com

Happy Easter and Passover to all of you who celebrate.

Stay well

~Nurse Judy

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 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

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

The Babies have arrived

Dr Anne is a proud mama of two beautiful babies.!!!  She has a boy and a girl. I will post the names when they become official.

Monday update February 25th

This week is very similar to last week.

Flu continues to be around but diminishing.  It is still worth while for babies to get their 2nd shot this season. Once they have one season where they have had two shots they are considered "primed" and they will only need one a year in the future.

We are still seeing some vomiting and diarrhea. I did have two little patients who were dehydrated and needed IV hydration from the ER.
If your child won't keep down even little sips and seems very lethargic, they need to be seen.

We are still seeing tons of kids with colds and coughs. Many of these folks have a few days of moderate fevers. I wish I could tell you how long the cough lasts, but it is still lingering and lingering. If your child seems wheezy please give us a call.
For all you nebulizer users out there, if you have been using the same tubing for more than 6 months it is time to get a new set.
I have given the Noe Valley Walgreens a standing order to refill tubing for my patients. If it is one of the regular pharmacy staff members you should have no trouble ( tell them Nurse Judy sent you)

We have also seem lots of kids with ear infections. Many of these kids have had one and off colds for several weeks and have finally succumbed.
If your child has been congested and all of a sudden you are seeing a new onset of fever, fussiness or trouble sleeping, it is worth having those ears looked at.

I am still seeing lots and lots of slap cheek ( also known as fifth disease) There is often an on and off fever, rashy kid and red cheek. It is rare for this illness to get me alarmed ( although some kids can seem pretty sick with it)

Dr Anne is STILL PREGNANT!!
I will certainly have a different report for you by next week.


Stay well
Judy

contagious?

When is someone contagious ?

( in other words, can my child go back to daycare?)

 Some of my most common questions revolve around when kids are contagious and when are they ready to go back to day care or school.

There is rarely a simple answer. On one hand, of course we want to be a responsible parents and not expose others to our sick child.   On the other hand we want to protect our own recovering child from going back too quickly where they may come down with something new. In order to logically best  make these decisions there are many issues that we need to consider.

Some parents have an easy time taking time off and others simply can’t afford to. It is naïve to think that these aren’t real factors.

One of the tricky thing is that many viral syndromes are contagious a day or two before the kids show clear signs that they are ill. Many kids may be a little fussier than usual. They might take a longer lap. Perhaps they don’t eat quite as much.

Are those reasons to stay home from day care??? Of course not!

The fact is, if you child comes home from school on Monday afternoon and is sick that evening, most likely everyone there has already been exposed and I am going to take that into consideration when we try to come up with the most sensible plan on when they can return.

If you are in a small share care situation, it is essential to have a talk with the nanny and the other families involved to make sure you are all on the same page.

I would suggest that you create a “sibling” relationship. This simply means that you all accept that the kids are most likely going to get each other’s mild illnesses.

If you plan on staying at home until your little toddler is free from a runny nose, you will be waiting a very long time before you leave the house.

Remember that some clear runny noses are not contagious. Teething as well as some allergies can be the cause.

As far as common colds go, the average for kids under 2 years of age is EIGHT colds a year.

While I would like to keep my youngest and most vulnerable patients free from viral syndromes and colds as long as possible, exposure to these common viruses is in fact developing the immune system. At some point they are going to have to deal with some mild illnesses. It is a rite of passage.

Typically if I have a child with a fever over 101, a  new case of diarrhea, or a brand new green mucousy cough or cold it is worth keeping them home for at least a day to see what  is coming next.

If your child has an infection that is being treated with antibiotics, we generally consider them no longer contagious after they have been on the medication for more than 24 hours.

There is never any assurance that can be given that your little one is “ not contagious”

Use your best common sense. When in doubt avoid contact with anyone who is vulnerable. This would include newborns, or someone with a compromised immune system.

Weekly update February 19th

We are seeing  a little bit of everything.
Most of the visits have been kids with the cough/cold/ fever.
We had a few new cases of flu last week but that is surely slowing down.

There seems to be more wheezing this week.
We are seeing lots of conjunctivitis and ear infections

There are some cases of tummy bugs. More kids seem to be vomiting with this. I haven't seen quite as much diarrhea.
Some of the vomiting kids had a one day high fever and then seem better.

There is some strep throat out there so if we have a fever that is lasting for more than a day, along with vomiting ( no diarrhea) I want to check them for strep.

BABY UPDATE:
Dr Anne is 37 weeks and counting. No babies yet. I will keep you in the loop.

NURSE JUDY CLASS UPDATE:

I have one spot left in my "managing your kids illnesses" class this Wednesday night.

My next "NEW BABY boot camp" is March 2nd ( Saturday morning)
I have room for 2 more couples.
That class is also great for folks on their second time around. It is easy to forget all that newborn stuff when you are used to a big kid who can tell you what's on their mind
For more info or to sign up for any classes email nursejudynvp@gmail.com

Stay well and warm!
Nurse Judy

Fever tidbits

To get on my email list and have these tidbits sent to you directly ( along with class schedules and updates) just pop me an email to : nursejudynvp@gmail.com  and I will be happy to add you


All about fevers.



Fevers turn on the body immune system. They are one of our protective mechanisms

Many fevers can actually help the body fight infection.

.

Fevers that are associated with most viral syndromes and infections do NOT cause brain damage. Our brain's thermostat will not allow a fever to go over 105 or 106.

Only body temperatures higher than 108°F (42.2°C) can cause brain damage. Fevers only go this high with high environmental temperatures (e.g., confined to a closed car.)



There are many methods out there for measuring a fever. I don't feel the need to invest in any expensive thermometers. I am quite happy with a digital underarm reading. The important thing is that however you take it, your thermometer seems accurate. Test it on other family members and take your child's temp when they are healthy to make sure you trust it.

One of my favorite brands is Becton Dickinson. These are reasonably inexpensive on Amazon and have been reliable in my experience.

If you have one of the new ear or temporal scanning gadgets, feel free to keep using that. Sometimes their "high" readings seem a little higher than I believe. Don't let this freak you out.


If your infant is under 8 weeks of age we want to be notified of any fevers, however there are a few common causes..


*over bundling....

Seriously, some times the babies come in with 10 blankets wrapped around them.

Please don't do that. The best rule of thumb is giving them one layer more than you are wearing.

If your baby was indeed over bundled, get some of those layers off and re take the temp in about 10 minutes to see if they have cooled down.


*dehydration....

Sometimes if moms milk isn't in yet, babies can be simply dehydrated and need to get some fluids. This is the time that you need to squirt some milk or formula directly into your baby's mouth. You can use a syringe or a dropper.

More often than not the elevated temperature will normalize fairly quickly.


If there is no obvious cause for an elevated temperature, and it doesn't resolve within 30 minutes your baby needs to be evaluated. Giving a fever reducing medication to a newborn should only be done under strict guidance from your pediatrician.




For any child older than 2 months, as long as your child is active and happy, I generally don't feel the need to "treat" a fever unless it is over 101.5 or so.



Parent's often ask me, "When do we need to worry about a fever?"

I am always much more interested in your child's overall mood and behavior than I am in any specific number on a thermometer.

I am way more concerned about the lethargic, whimpering child who has a 99 temperature than I am the singing child with 104.

But, here is the Nurse Judy's rule about fevers:


If the fever is over 102 ( It doesn't matter how you measure, just be consistent)


*Treat with proper dose of Acetaminophen or Ibuprofen

*Do a tepid bath or place cool compresses on the forehead, insides of elbows and neck

*Get them drinking. Really, any type of fluid will work.

Little sips at a time are fine. Breast milk is always a great choice if you have it.
Popsicles and ice-chips are good for older kids

*re check the temp in 45-60 minutes



If it is STILL over 102 and hasn't budged at all, that is a fever that I am concerned about.
It is time to get your child seen.

When children are in the process of spiking a fever, it is not uncommon for them to tremble and look shaky.

On the other hand, one of the more frightening aspects of a fever can be a febrile seizure. About 4% of children will have these.

Febrile seizures are scary to watch, but they usually stop within 5 minutes. They cause no permanent harm.

If your child is having a seizure they may have large jerky motions and their eyes may roll back.

Your job is to stay calm. Make sure their airway is open. It is perfectly reasonable to call 911


Once your child has had even one febrile seizure we tend to be more aggressive with fever control and will treat even a low grade fever. It is important to talk with your doctor about this so that you have a plan in place that you are comfortable with.

Most kids grow out of the seizures by the time they are 5 years old.


As I mentioned before, a fever by itself doesn't alarm me.

If the fever is accompanied by a very fussy child, I want them seen so that we can figure out what is going on.

Most of the time, if a fever lasts for more than 3 days, I consider it time to have a look so that we can make sure there isn't an infection source ( like ear infection, urinary tract infection, strep throat or pneumonia)

This month we are seeing lots of flu. Many or our patients have fevers that are lasting 5 days.

Because there is so much of this going around I am relaxing my "3 day rule" If the kids seems like they are 'managing' ( drinking, peeing, easy breathing, consolable, fever responds to meds) I am okay watching them for another couple of days



Temp° conversions

98.6° F =37.0° C

99.5° F=37.5° C

100.0° F=37.8° C

100.4° F=38.0° C

101.0° F=38.4° C

102.0° F=38.9° C

103.0° F=39.5° C

104.0° F=40.0° C

105.0° F=40.6° C