Monday update November 24th

Today broke the record for the largest pile of charts that ever awaited me on my Monday morning desk.
I sat there in awe not quite sure where to start.
I am grateful for all of my patients, most of you are all SO sensible, it makes it so much easier.
There were two big issues today...the tummy kids and the coughers.

The tummy bugs is out there again. There is a combo of vomiting and diarrhea.
Right before vomiting the kids look pretty yucky, but feel a bit better once they have thrown up.
Many of these kids have had really poor appetites going on 4 or 5 days now.
There is little we can do for this.
Make sure your child is getting pro biotics.
Make sure they are on a bland/ starchy /easy diet.
I would minimize dairy except for Breast milk.
Make sure they are hydrated.

If days and days go by with no change, do call and we will check them out (assuming we have appointments)

The coughing kids are also out there in large numbers. I think RSV is here with a vengeance.
Again, treat the symptoms.
If your feel like your child is having labored breathing, lets make sure they get seen.

We are in the office only 3 days this week.
Wednesday we have only two doctors working, so our triage bar is set fairly high. We are trying to see those folks who really need to get in.

The after hours clinic will be there every day while we are closed for Thanksgiving.

The good news is that we finally got our flu vaccine.
 We are planning on holding our Saturday morning Flu shot clinic from 9:30-noon on December 6th.
I will send out more details next Monday.

Happy Thanksgiving.
Judy

Weekly update November 18th

For those who wait for this blog with bated breath, I am sorry that I am a day late.

I was gone for a long weekend and came back to mayhem.

There is still a big of a tummy bug circulating.
There is still some Hand/Foot/Mouth
There are lots of kids with fevers

The Big deal of the day is the nasty respiratory stuff that is going around. We have loads of kids that have started with a croupy/hoarse cough that moves down into the lungs and causes wheezing.
the wheezing has only lasted for a few days, but the cough has lingered for weeks.

I also just had our first positive RSV test here in the office.
Check my most recent Nurse Judy blog post for up to date info on this.

I also think I might be starting to see some Slap Cheek  starting to make the rounds.

So, there is a lot going on out there.

We now have flu vaccine in the office to take care of our patients. We are still waiting for the main shipment.
If it gets here this week we WILL have a Flu shot clinic on Saturday morning November 22nd, but that will be confirmed here in a new blog post. It is still not a sure thing.

I am posting the info below on behalf of Nurse Jen

WHAT:

An invitation to join a city-wide book drive benefiting underserved San Francisco and Oakland schools. 

WHO:

Organized by NY-based Project Cicero, San Francisco public, parochial and independent schools will work together to collect books to donate to Teach for America teachers to use in their SF and Oakland classrooms.

WHEN:

In school collection is March 16-20

Teacher event is March 21

MORE INFO:

The books will be collected over one week in March (March 16-20) and then Teach for America teachers will be invited to select books for their classrooms during the one day event (March 21.) All of the details are taken care of by Project Cicero (info below.) The only thing the participating schools have to do is promote the one week drive. Project Cicero provides the collection boxes, picks up the books, sorts them and invites the teachers to the drive. Of course, you (and your students) are welcome to volunteer at the event as well if you'd like but it's not required.

If you are interested in having your school participate, please email Nurse Jen at jbmaeder@gmail.com.

Project Cicero is a partnership of independent, public, and parochial schools, private and public organizations and corporations whose primary goal is to create and supplement classroom and school libraries for children in under-resourced New York City public schools through an annual citywide book drive. Project Cicero also puts books into homeless shelters, juvenile detention facilities, community centers, pre and after school programs, and wherever else there is a need. This past year, its thirteenth year of operation, Project Cicero distributed more than 150,000 books. To date, Project Cicero has placed two million books into more than 11,000 classrooms and school libraries reaching over 500,000 children in under-resourced schools in New York City.

**Flu Shot Update**
We have received 100 doses of pediatric flu vaccine!  This is quadrivalent preservative free for kids under 3 years of age and at least 6 months old.  You can call the front desk to schedule a shot appnt. 
Tues thru Thurs 10:00am-11:30, and 2:00-4:00pm.
Call the morning of the day you want to come starting at 9:00am.

Weekly update November 10th

This week we are seeing a lot of the same stuff.
Many of the very sore throats have been testing positive for Strep throat.

We are seeing lots of coughs/ colds.
There are some kids with fairly mild croup and lots of kids are wheezy.

I am seeing kids with 2-3 days of fevers, followed by a rash

I am seeing some kids with tummy stuff, but significantly less than last week. There may have been a connection to Halloween candy there, hmmmmm

Hand Foot Mouth is Still hovering around...or at least a variation of some viral that is causing a spotty rash around the mouth, hands, feet and butt.
We are also seeing a tremendous number of rashes  that mostly look like bug bits, but we aren't quite sure.

We are now just about out of our baby flu doses. Please call before coming if you are already scheduled.
We are completely out of adult flu shots. We have plenty of mist.
I hope to have more of the multidose vials in later this week.

I am not quite ready to give a firm date for a Flu shot clinic, Hopefully by next Monday I will have more info.

Our office IS open on Tuesday/Veteran's Day.
Keep in mind that now that we are in the Winter Illness season we are not doing routine Check-ups on our big kids (over 4)
This is for multiple reasons.
*We need the appointment spots for sick kids
*You don't want to have a healthy kid in here any more than necessary
*Schools often require a form that is signed after March...if you have a winter check up, many schools will require another visit that may or may not be covered by insurance.

If you absolutely need to have a physical the front desk will have you speak to one of the nurses and we can talk to you about making an exception.

If you have any acute care issues, of course we will be happy to take care of them!!!

Stay well
~Nurse Judy

Weekly update November 3rd 2014/Illness class this week

Time changes are tough on pets and babies. I wish I knew how to adjust their internal clocks for you!!

This was a very busy Monday morning.
Our appointments were snatched up before I was settled at my desk.

There are all sorts of annoying illnesses making the rounds.

I am seeing a spike in tummy issues.
Could it be from all the junk kids eat after Halloween? Possibly, but it has more of a viral feel and some of my young candy free kids are equally affected.
The kids are either vomiting or having loose stools or both. Some have moderate fevers with this.


We are also seeing a bunch of kids that had 2or 3 days of random high fevers. The fevers are gone but now they are SUPER fussy and unhappy.
This sounds a bit like roseola, but there is no rash and these kids are fairly miserable.
These folks were all given appointments for tomorrow so perhaps the mystery will be solved.

There are lots of patients with sore throats. The Strep tests have been negative so far.

There are lots of respiratory ailments. I have seen some croup, some general wheeziness and lots of mild to moderate coughs that are lingering for more than 2 weeks.

We have a load of kids with spots.. I think they are bites, because the kids don't seem ill otherwise.

We do have Flu vaccine in stock and are seeing patients Tues/Wed/Thurs to give the vaccine.
Please call in the morning for a same day appointment if available.
We are hoping to do a Saturday morning Shot clinic.
If the bulk of our supply arrives in time it will be November 22nd and then another one in December.

This is NOT a firm date yet. I will send out a post as soon as it is set.
I heard from CPMC that there were some positive FLU patients, but I don't think that there is a lot of Influenza circulating yet. I still would prefer to get the protection sooner than later.
We are frustrated that we don't have our full allotment yet.



If you want to spend 90 minutes talking about all this stuff with me,
I have an illness class this week on Wednesday evening at 7:30 pm.
RSVP to nursejudynvp@gmail.com

Stay Well.
Judy