There are a lot of fevers going around.
We have seen many kids with ear infections so if your child is fussy with the fever It is worth taking a look in the ears.
Many ear infections will go away on their own, however once in a while an untreated ear infection can cause the eardrum to rupture ( you will see drainage from the ear if this happens) frequent ruptures can lead to hearing loss.
If we are suspicious about an ear infection it is always a good idea to look.
An ear infection that has a high fever and a miserable kid is usually worth treating.
We are still seeing cases of RSV and Flu.
I have some reports of mild vomiting and diarrhea.
I had to cancel my illness class last week and MIGHT reschedule for this week on Wednesday evening the 28th if there is enough interest with such short notice
If you are interested email nursejudynvp@yahoo.com
Stay well
Judy
Monday, March 26, 2012
Monday, March 19, 2012
Monday March 19th
Wow, what ISN'T going around?!
We are seeing a lot of kids with a very persistent colds and coughs. In some cases, this illness has been lingering for 2 weeks or more
With the sicker looking or very young patients we are testing kids and coming up with positive results for both RSV and FLU.
The flu has had fevers lasting for a week in some cases.
If you or your child has been diagnosed with the flu, it is somewhat reassuring to know that the week long fever isn't necessarily something to worry about.
If your child has not been evaluated five days of fever is the longest I would want to let you wait before being seen.
We are seeing some strep throat and some hand foot mouth
We have been seeing some fairly nasty cases of croup.
stay well
Judy
We are seeing a lot of kids with a very persistent colds and coughs. In some cases, this illness has been lingering for 2 weeks or more
With the sicker looking or very young patients we are testing kids and coming up with positive results for both RSV and FLU.
The flu has had fevers lasting for a week in some cases.
If you or your child has been diagnosed with the flu, it is somewhat reassuring to know that the week long fever isn't necessarily something to worry about.
If your child has not been evaluated five days of fever is the longest I would want to let you wait before being seen.
We are seeing some strep throat and some hand foot mouth
We have been seeing some fairly nasty cases of croup.
stay well
Judy
Tuesday, March 13, 2012
solid foods class correction
Someone kindly pointed out that I have an error in an earlier post.
My next solid foods class will be March 31st ( Saturday morning) at 10:30 am
The illness class is March 21st (Wednesday evening) at 7:45 pm
There is currently a bit of room left in both classes
email nursejudynvp@yahoo.com to reserve a spot or ask for more info
My next solid foods class will be March 31st ( Saturday morning) at 10:30 am
The illness class is March 21st (Wednesday evening) at 7:45 pm
There is currently a bit of room left in both classes
email nursejudynvp@yahoo.com to reserve a spot or ask for more info
Monday, March 12, 2012
March 12th update
Flu is here.
We have seen both type A and type B showing up in our flu tests.
Interestingly the kids with type B have been vaccinated, so this years strain didn't quite match.
These kids do have high fevers and are very low energy. The fevers have lasted for 5 days or so. There is some sore throat and congestion. Most of the concern has been about the fevers lasting so long, otherwise the kids haven't seen sick enough to cause too much concern.
We are still seeing RSV. RSV is everywhere. Most of the folks with it are presenting with just a really rotten cold and cough, Some of our patients ( of all ages) have been just slammed with it and have ended up in the hospital.
There is also the basic cold and cough out there which has presented with a lot of watery red rimmed eyes. This has gone away with nothing other than typical symptomatic treatment.
I still have some kids out there with diarrhea, but that is significantly decreased..
Dr Hurd worked the after hours clinic this weekend. She reports seeing a few cases of hand/foot/mouth and lots of sore throats.
stay well
Judy
We have seen both type A and type B showing up in our flu tests.
Interestingly the kids with type B have been vaccinated, so this years strain didn't quite match.
These kids do have high fevers and are very low energy. The fevers have lasted for 5 days or so. There is some sore throat and congestion. Most of the concern has been about the fevers lasting so long, otherwise the kids haven't seen sick enough to cause too much concern.
We are still seeing RSV. RSV is everywhere. Most of the folks with it are presenting with just a really rotten cold and cough, Some of our patients ( of all ages) have been just slammed with it and have ended up in the hospital.
There is also the basic cold and cough out there which has presented with a lot of watery red rimmed eyes. This has gone away with nothing other than typical symptomatic treatment.
I still have some kids out there with diarrhea, but that is significantly decreased..
Dr Hurd worked the after hours clinic this weekend. She reports seeing a few cases of hand/foot/mouth and lots of sore throats.
stay well
Judy
Friday, March 2, 2012
Friday update/ next classes
I will be out of the office next week, so I am going to do a Friday update and will post again on the 12th.
This week we have seen a lot of strep throat.
I have some cases of hand foot mouth.
There is a cough that lingers for weeks.
RSV remains prevalent and we have had several babies hospitalized with it. ( they are doing okay)
We are finally seeing a slow down of the diarrhea, although some of the patients are having a hard time shaking it.
Typically with the diarrhea, they may be done with the virus but have a very sensitive and irritated gut. Time will fix this, but for those of you plagued with this, stay on the gentle non dairy diet, probiotics are helpful. Benefiber is also useful.
My illness class has 2 spots left. It will be held on March 21st at 7:45 pm
I just scheduled my next solid foods class..that will be March 21st ( Sat morning) at 10:00 am..reservations are needed. nursejudynvp@yahoo.com
have a healthy week
Judy
This week we have seen a lot of strep throat.
I have some cases of hand foot mouth.
There is a cough that lingers for weeks.
RSV remains prevalent and we have had several babies hospitalized with it. ( they are doing okay)
We are finally seeing a slow down of the diarrhea, although some of the patients are having a hard time shaking it.
Typically with the diarrhea, they may be done with the virus but have a very sensitive and irritated gut. Time will fix this, but for those of you plagued with this, stay on the gentle non dairy diet, probiotics are helpful. Benefiber is also useful.
My illness class has 2 spots left. It will be held on March 21st at 7:45 pm
I just scheduled my next solid foods class..that will be March 21st ( Sat morning) at 10:00 am..reservations are needed. nursejudynvp@yahoo.com
have a healthy week
Judy
Monday, February 27, 2012
Monday update February 27th
Since we will actually be on KRON today at 5pm talking about current Norovirus epidemic, I will start today's update with diarrhea.
I think that the calls about the tummy bug are subsiding but there are still some cases out there.
Rotovirus is typically the most common cause of diarrhea in young patients. By the time we get to the age of 5 or so, we usually have some immunity to many of the strains. recent studies are showing a 25% decrease in rotovirus cases since the vaccine came out several years ago.
Norovirus hits the older kids and adults. It can survive on surfaces for several hours, which helps it spread easily. good hand-washing is key to prevention.
Most of the time it lasts about 3 days. It may last longer in the younger kids.
I suspect due to the large numbers of adults and older patients hit with this recent onslaught, that it is Norovirus that we are dealing with.
Most of these patients have some vomiting, several days of loose stools, tummy aches and some low grade to moderate fevers.
If you or your child has diarrhea that comes along with bloody stools or high fever, then a bacterial infection should be ruled out.
If we have ongoing gassy, STINKY stools then at some point we will want to rule out Giardia or other parasites
Aside from the tummy bug...
We are also still seeing quite a bit of RSV
We have had LOTS of conjunctivitis.
There is a fever/ cough virus out there
We have had 2 positive flu tests to date.
They both had Type B strains of the influenza.
Stay well
Nurse Judy
I think that the calls about the tummy bug are subsiding but there are still some cases out there.
Rotovirus is typically the most common cause of diarrhea in young patients. By the time we get to the age of 5 or so, we usually have some immunity to many of the strains. recent studies are showing a 25% decrease in rotovirus cases since the vaccine came out several years ago.
Norovirus hits the older kids and adults. It can survive on surfaces for several hours, which helps it spread easily. good hand-washing is key to prevention.
Most of the time it lasts about 3 days. It may last longer in the younger kids.
I suspect due to the large numbers of adults and older patients hit with this recent onslaught, that it is Norovirus that we are dealing with.
Most of these patients have some vomiting, several days of loose stools, tummy aches and some low grade to moderate fevers.
If you or your child has diarrhea that comes along with bloody stools or high fever, then a bacterial infection should be ruled out.
If we have ongoing gassy, STINKY stools then at some point we will want to rule out Giardia or other parasites
Aside from the tummy bug...
We are also still seeing quite a bit of RSV
We have had LOTS of conjunctivitis.
There is a fever/ cough virus out there
We have had 2 positive flu tests to date.
They both had Type B strains of the influenza.
Stay well
Nurse Judy
Friday, February 24, 2012
frequently asked questions about the arsenic issue
Thanks to one of our mom's out there for furnishing me with this info to share!
Q: Which types of baby formula should I be worried about?
A: Our researchers tested two toddler formulas on the market that use organic brown rice syrup. Please see http://abcnews.go.com/Health/Diet/arsenic-organics-rice/story?id=15642428#.T0LIEXlW18F, http://video.msnbc.msn.com/nightly-news/46420960/#null, and http://articles.boston.com/2012-02-17/health-wellness/31065888_1_arsenic-levels-rice-syrup-baby-formula. Both products contained amounts of total arsenic that are above **10 parts per billion (ppb), the legal standard set by the U.S. EPA for public drinking water, and amounts of inorganic arsenic that are equal to or greater than this regulatory limit. See, http://water.epa.gov/drink/contaminants/basicinformation/arsenic.cfm
Q: What are the risks from ingesting these products?
A: The risks to an infant or young child who drinks these products for a relatively short period of time are not well-studied. Chronic life-time exposure to arsenic (for example from drinking private well water containing arsenic levels at 10 ppb and above every day), does result in increased risk for bladder, skin, lung and liver cancers, heart and respiratory disease. Very little is known about exposure to low doses of arsenic for short periods of time, but scientists at Dartmouth and other universities are currently studying the health effects of dietary exposure in infants and children.
Q: What can we do?
A: To be cautious, switch to a product that does not contain brown rice syrup. Please consult your pediatrician before you make this change. ( we say please switch!!!!!)
Q: I gave this formula to my child for two years—what should I do?
A: Arsenic does not accumulate in the body so when your child is no longer exposed to arsenic it will leave his/her system in a day or two. Long-term health consequences are unknown because previous studies have not examined childhood exposure at doses equivalent to levels found in these formulas. Scientists at Dartmouth and other universities are studying the potential health effects of dietary exposure to arsenic in infants and children.
To ensure that your children are not exposed to arsenic from other sources, make sure to have your well water tested. If you have additional questions about potential health effects and sources of arsenic, consult your pediatrician and a registered dietician.
The UK Food Standards Agency states that “as a precaution, toddlers and young children between 1 and 4.5 years old should not have rice drinks as a replacement for cows’ milk, breast milk, or infant formula.” The Food Standards Agency represents the UK Government on food safety and standards issues in the European Union.
Q: Should I get my child tested for arsenic?
A: No. Arsenic does not accumulate in the body, and the body normally excretes arsenic in the urine within one to two days of exposure. This is why scientists at Dartmouth are most concerned with long-term exposure. If you have a private well, you should test your well for arsenic to minimize exposure.
Q: Should I be worried about Cereal/Energy Bars?
A: Some of these products contain rice or brown rice syrup, both of which may contain arsenic. We tested 29 bars (multiple brands) of the hundreds of cereal/energy bar products on the market. Of those 29 products, our results showed that the amount of inorganic arsenic in each bar depends on the size of the bar, the concentration of total arsenic, and the percentage of total arsenic that is in the inorganic form. Eating 2 - 3 of the larger bars (approximately 70 grams) per day could contribute 10 micrograms of inorganic arsenic to your diet. If you examine the ingredient list and consider the weight of the bar, frequency and quantity consumed per day, you can make an informed choice.
************************************************************************************************
**In 2001, the EPA set 10 ppb as the legal standard for public drinking water for adults, but it determined the public health goal should be 0 ppb. The EPA set the legal standard based on human adults; it does not account for the low body weight of infants and the corresponding increase in arsenic consumption per pound of body weight. This 10 ppb standard was set as close to the public health goal (0 ppb) as possible, considering cost, benefits and the ability of public water systems to detect and remove arsenic. According to the EPA and many scientific studies, people who drink water containing arsenic in excess of 10 ppb over many years could experience skin damage, problems with their circulatory system, and may be at an increased risk of getting cancer and heart and respiratory disease.
For more information about arsenic and health, please consult these reliable independent sources:
o The World Health Organization produced a 2010 report titled: “Exposure to Arsenic: A Major Public Health Concern.” http://www.who.int/ipcs/features/arsenic.pdf
o The latest U.S. CDC/ATSDR public health statement on arsenic, published in 2007, recognizes inorganic arsenic as a “human poison.” http://www.atsdr.cdc.gov/phs/phs.asp?id=18&tid=3
Q: Which types of baby formula should I be worried about?
A: Our researchers tested two toddler formulas on the market that use organic brown rice syrup. Please see http://abcnews.go.com/Health/Diet/arsenic-organics-rice/story?id=15642428#.T0LIEXlW18F, http://video.msnbc.msn.com/nightly-news/46420960/#null, and http://articles.boston.com/2012-02-17/health-wellness/31065888_1_arsenic-levels-rice-syrup-baby-formula. Both products contained amounts of total arsenic that are above **10 parts per billion (ppb), the legal standard set by the U.S. EPA for public drinking water, and amounts of inorganic arsenic that are equal to or greater than this regulatory limit. See, http://water.epa.gov/drink/contaminants/basicinformation/arsenic.cfm
Q: What are the risks from ingesting these products?
A: The risks to an infant or young child who drinks these products for a relatively short period of time are not well-studied. Chronic life-time exposure to arsenic (for example from drinking private well water containing arsenic levels at 10 ppb and above every day), does result in increased risk for bladder, skin, lung and liver cancers, heart and respiratory disease. Very little is known about exposure to low doses of arsenic for short periods of time, but scientists at Dartmouth and other universities are currently studying the health effects of dietary exposure in infants and children.
Q: What can we do?
A: To be cautious, switch to a product that does not contain brown rice syrup. Please consult your pediatrician before you make this change. ( we say please switch!!!!!)
Q: I gave this formula to my child for two years—what should I do?
A: Arsenic does not accumulate in the body so when your child is no longer exposed to arsenic it will leave his/her system in a day or two. Long-term health consequences are unknown because previous studies have not examined childhood exposure at doses equivalent to levels found in these formulas. Scientists at Dartmouth and other universities are studying the potential health effects of dietary exposure to arsenic in infants and children.
To ensure that your children are not exposed to arsenic from other sources, make sure to have your well water tested. If you have additional questions about potential health effects and sources of arsenic, consult your pediatrician and a registered dietician.
The UK Food Standards Agency states that “as a precaution, toddlers and young children between 1 and 4.5 years old should not have rice drinks as a replacement for cows’ milk, breast milk, or infant formula.” The Food Standards Agency represents the UK Government on food safety and standards issues in the European Union.
Q: Should I get my child tested for arsenic?
A: No. Arsenic does not accumulate in the body, and the body normally excretes arsenic in the urine within one to two days of exposure. This is why scientists at Dartmouth are most concerned with long-term exposure. If you have a private well, you should test your well for arsenic to minimize exposure.
Q: Should I be worried about Cereal/Energy Bars?
A: Some of these products contain rice or brown rice syrup, both of which may contain arsenic. We tested 29 bars (multiple brands) of the hundreds of cereal/energy bar products on the market. Of those 29 products, our results showed that the amount of inorganic arsenic in each bar depends on the size of the bar, the concentration of total arsenic, and the percentage of total arsenic that is in the inorganic form. Eating 2 - 3 of the larger bars (approximately 70 grams) per day could contribute 10 micrograms of inorganic arsenic to your diet. If you examine the ingredient list and consider the weight of the bar, frequency and quantity consumed per day, you can make an informed choice.
************************************************************************************************
**In 2001, the EPA set 10 ppb as the legal standard for public drinking water for adults, but it determined the public health goal should be 0 ppb. The EPA set the legal standard based on human adults; it does not account for the low body weight of infants and the corresponding increase in arsenic consumption per pound of body weight. This 10 ppb standard was set as close to the public health goal (0 ppb) as possible, considering cost, benefits and the ability of public water systems to detect and remove arsenic. According to the EPA and many scientific studies, people who drink water containing arsenic in excess of 10 ppb over many years could experience skin damage, problems with their circulatory system, and may be at an increased risk of getting cancer and heart and respiratory disease.
For more information about arsenic and health, please consult these reliable independent sources:
o The World Health Organization produced a 2010 report titled: “Exposure to Arsenic: A Major Public Health Concern.” http://www.who.int/ipcs/features/arsenic.pdf
o The latest U.S. CDC/ATSDR public health statement on arsenic, published in 2007, recognizes inorganic arsenic as a “human poison.” http://www.atsdr.cdc.gov/phs/phs.asp?id=18&tid=3
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