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Doctor's In-box Archive
This page contains archived information from previous Doctor's In-box and home page stories.
Late Winter 2010 - New Things - New Spring
Dr. Julie: "
Well, I'm delighted to be writing about something besides influenza! Also delighted to report, before I leave the topic of influenza behind completely, that this season was not as bad as many experts predicted. Was this because of increased levels of immunization in the community? Increased vigilance with hand washing? More willingness to isolate children who were sick, and care for common colds with common sense? Perhaps. We may never know, but I think it speaks to the power of simple preventative efforts. We're not out of the woods yet, though: typically we see influenza well into April/May in the greater Boston area. And we have plenty of vaccine (both H1N1 and seasonal). If your child hasn't received the second dose of either vaccine, please consider coming in for it.
New Doctors, Hours at Lexington Pediatrics
I am very excited to let you all know of some upcoming changes at Lexington Pediatrics. In January, we welcomed our newest doctor to our team: Dr. Andrew Sinder (click for bio). Dr. Sinder and his family moved here from western Pennsylvania, and are looking forward to settling in the Lexington area. All of our newer doctors (Drs. Sinder, Garnett, and Gine-Nokes) are accepting new patients, and they are taking turns leading our monthly prenatal meetings for expectant parents. Click here to sign up for one of our upcoming dates.
With our newest doc on board, we are now able to offer evening hours FOUR nights per week! This is a tremendous boon for working parents looking to attend their children's checkups, late afternoon sick visits, and quieter, later office hours for consultations. Dr. Sinder will be taking over my long-standing Thursday evening clinic, and I will be running a Monday evening clinic instead. For those parents who appreciated my Thursday afternoon/evening hours (many kids have a half-day on Thursdays), I will still see patients on Thursday afternoon...thanks for the feedback!
Coming Soon - Electronic Medical Records
The launch of this website was the first major step in "electrifying" our office and moving towards a greener, more efficient model to communicate with patients and conduct office business. Soon we will be making another even more major step forward: in August of this year, Lexington Pediatrics will "go live" with our Electronic Medical Record (EMR). Once we are using an EMR, you won't see us writing in charts, writing prescriptions, or running around looking for your medical record...all of that information will be at our fingertips on our new tablet-style notebook computers.
We'll keep you updated on the progress as we prepare for this transition. At the moment, the most significant impact the EMR will have on our patients is the very limited availability for routine appointments in August and September (more on this below).
Summer Physicals - Come on In!
Our EMR transition will make it necessary for us to have very limited hours in August and September. We know that many of our families with school-age children want to schedule their yearly physicals without missing school, and many of our college students want to schedule physicals and gynecologic exams when they return home for the summer. In anticipation of this, we will be setting aside a substantial number of early morning, after-school, and evening hours for the months of April, May, and June. We will be contacting everyone who had a physical examination between mid-July and mid-September of 2009 (by phone and mail) to "front-load" as many of these appointments as possible. We do appreciate your cooperation and understanding as we make this transition, and we will try our best to make the change a smooth one. Please note that some insurance companies will not allow a routine yearly physical examination until a full 365 days has passed since the last exam; in this case, we will need to schedule the routine physical exam for October 2010 or later. Please check with your insurance company if you're not sure what your insurance will allow.
Have a wonderful spring, get outside to enjoy the few extra hours of sunshine and fresh air, and be well!
"
Fall 2009 - Swine H1N1 Flu Outbreak
Dr. Julie: "
FLU CLINIC UPDATES
Greetings,
I know that many of you are concerned about the current widespread H1N1 influenza virus. We are all working hard to see a greatly increased volume of patients, respond to a huge increase in sick visits, and of course, continue to provide well-child checks and all the routine care that your family requires. Unfortunately, because of this dramatic increase in our clinical activity, it has been a challenge to keep up with the volume of phone calls and website requests for influenza information.
In the following Inbox, I've tried to answer some of the most common questions we have gotten about the seasonal flu, H1N1 ("swine") flu, the vaccines, and our office policies. Please take the time to read through this information. I hope it is helpful to you.
First, I think it's important that you all know that all of us at Lexington Pediatrics believe that the H1N1 vaccine is extremely important in maintaining our community's good health through this winter. We know already that the H1N1 virus targets young healthy children and adults, and that people with underlying respiratory conditions are especially at risk. Therefore, we strongly recommend that all our patients plan on receiving the H1N1 vaccine as soon as they are eligible. {As a side note, I will also say that all of us with small children have had them immunized against both seasonal and H1N1 influenza.}
We are trying our best to immunize as many patients as possible against both H1N1 and seasonal influenza. If you have a routine appointment in the next few months, you MAY, depending on availability, get your flu shot as well as your H1N1 shot at the appointment. Due to the high volume of patients needing flu shots, we are not able to offer appointments for flu shots alone. Please click here for a link to out upcoming flu clinic dates.
If your child has an egg allergy, we will NOT be able to provide the flu vaccine during the flu clinic. You will need to make private arrangements with our office or your allergist's.
H1N1 (Swine Flu) UPDATE
The H1N1 vaccine is recommended for ALL children ages 6 months to 18 years and their caregivers. Children under the age of 10 will need two vaccines separated by one month. There is a shot as well as a nasal mist option. It is possible to get the "regular" flu vaccine and the H1N1 vaccine at the same time, as long as they are injected. The nasal mists for flu and H1N1 flu must be given separately.
As of December 13, we have plenty of H1N1 vaccine for all patients. Please click here for a list of upcoming flu clinics. Please note: at times, we have thimerosal-free vaccine for infants younger than 36 months. However, we cannot control which vaccine is shipped to us, and at times cannot offer thimerosal-free vaccine. There is a version of the vaccine which contains trace amounts of mercury as a preservative, and this has NEVER been shown to cause any harm. The doctors and nurse practitioners at Lexington Pediatrics feel that the benefits of the vaccine far outweigh any theoretical risk.
Due to the high volume of patients wanting the vaccine, and the fluctuating supply, there is a chance that we will run out of a particular vaccine before a flu clinic is over. If this happens, we will notify those waiting in line as soon as possible to minimize frustration and waiting in the cold. Thank you in advance for your patience; we are reviewing our flu clinic protocols constantly to keep up with this unprecedented demand.
Please click here to check which of the H1N1 vaccinations your child is eligible for. We adjust this eligibility information based on how much vaccine we have available.
We are offering the H1N1 nasal mist to children older than 2 years of age. In order to get the nasal mist, your child must also meet the following criteria:
- No history of asthma
- No wheezing in the past year
- No steroid use in the past 6 weeks
- No live vaccines (MMR, Varivax, seasonal flu mist) in the past 4 weeks
SEASONAL INFLUENZA UPDATE
As of 13 December, we have plenty of all three types of seasonal flu vaccine (preservative-free flu vaccine for children under 3 years of age, nasal "Flumist" for healthy children over 2, injections for children older than 36 months).
Thanks for your patience and for your understanding.
IMPORTANT: if you are coming to Lexington Pediatrics for a visit, please be aware that we are asking ALL patients with fever and cough, as well as their accompanying family members, to wear protective face masks while on the premises. We thank you in advance for your cooperation and understanding.
FLU READINESS "KITS"
Influenza can infect an entire family, and the symptoms can come on very suddenly. For this reason, we suggest you assemble an emergency "flu kit" at home. This should contain: Gatorade or other rehydration solutions (Pedialyte for babies); herbal tea bags and honey (for rehydration and soothing sore throats and coughs); ibuprofen and/or acetaminophen for treatment of fever and muscle aches; Purell or other hand sanitizing gel; tissues; saltine crackers; canned or frozen broth; freezer pops. [Families with college-age students might want to adapt this list for college kids and send along a care package. ]
Lexington Pediatrics is committed to keeping you and your family safe and healthy. We are receiving multiple updates weekly from the CDC, the Mass Department of Public Health, and from Children's Hospital Boston, and we will continue to update this site with information as we receive it.
"
Summer 2009 - Swine H1N1 Flu Update
Dr. Julie: "
You most likely have been following reports in the media about recent cases of H1N1, or “swine flu.” Swine flu is a new strain of influenza (flu) that has recently been identified in the United States and Mexico. It is called swine flu because it contains parts of flu viruses from pigs.
The symptoms are the same as those of regular influenza, including fever plus a respiratory illness (usually at least 1 of the following: cough, sore throat, or runny nose/nasal congestion).
As of June 12, it is becoming evident that this novel flu strain is quite widespread. However, we are pleased to report that most cases of H1N1 flu in this country are quite mild and self-limited, and require no more than the usual common-sense advice we give for all minor viral infections: get rest, drink plenty of fluids, take acetaminophen or ibuprofen to control fever and aches, and see the doctor if the symptoms worsen or last more than a few days.
"
Spring 2009 - Swine H1N1 Flu Reports
Dr. Julie: "
You most likely have read reports in the media about recent cases of “swine flu.” Swine flu is a new strain of influenza (flu) that has recently been identified in the United States and Mexico. It is called swine flu because it contains parts of flu viruses from pigs.
As of April 30th, confirmed cases have been identified in 10 US states including Massachusetts, and in several other countries. For a complete list of confirmed cases please check the Centers for Disease Control website
(www.cdc.gov/swineflu) or the World Health Organization (www.who.int).
The symptoms are the same as those of regular influenza, including fever plus a respiratory illness (usually at least 2 of the following: cough, sore throat, or runny nose/nasal congestion).
IMPORTANT: if you are coming to Lexington Pediatrics for a visit, please be aware that we are asking ALL patients with fever and cough, as well as their accompanying family members, to wear protective face masks while on the premises. We thank you in advance for your cooperation and understanding.
Known risk factors for exposure to swine flu are:
- travel to an area where there are confirmed cases of swine influenza A (H1N1) infection within the 7 days prior to onset of illness. As of April 27th, confirmed cases have been identified in 5 U.S. states (California, Kansas, New York (Queens), Ohio and Texas) as well as Mexico.
- contact with persons who had a fever along with a respiratory illness and were in one of the three U.S. counties or Mexico during the 7 days preceding their illness onset, or who had contact with a patient with a confirmed case of swine flu.
If your child is sick with flu-like illness, and if you have travelled to one of the areas known to have swine flu, your child may need to be evaluated. Please note that current recommendations are that ONLY people who have travelled to areas where there is swine flu need to be tested. If your child has a fever and upper respiratory symptoms, but no significant risk for swine flu, you may treat this illness as you would any other upper respiratory illness.
If you are concerned that your child may have been exposed to, or have symptoms of, swine flu, please call our office and we will assist you.
At the moment, the only recommendations for avoiding swine flu are as follows: avoid travel to areas known to have swine flu; use good hand-washing hygiene at all times, and cover your nose and mouth with a tissue when you cough or sneeze.
Lexington Pediatrics is committed to keeping you and your family safe and healthy. We are receiving muliple updates daily from the CDC, the Mass Department of Pulbic Health, and from Children's Hospital Boston, and we will continue to update this site with information as we receive it.
"
Winter 2009 - Winter In New England
In this issue of Doctor's In-box, Dr. Julie talks about staying active during the winter during the cold weather.
Dr. Julie: "I must confess--after 15 years living in New England, I still don't fully appreciate the lure of outdoor winter sports. It's beautiful outdoors, true, and I do love the quiet "crunch" of that first walk outdoors after a snowfall, and even the occasional cross country skiing or ice skating trip...but I will leave the appreciation of skiing and snowboarding to other, hardier souls. For the purpose of this newsletter, I'll remind everyone to make sure your kids dress in layers, and wear appropriate safety gear when going fast on any slippery surface. The Children's Safety Network has all the details:
http://www.childrenssafetynetwork.org/injury_news/shownews.asp?newsID=887
Part of my problem with winter sports is the huge amount of special equipment that seems to be required. On the other hand, it is important for kids to stay active, more of a challenge when it's cold and gets dark so soon after school lets out. If you're looking for ways to keep your kids active and enjoying the outdoors during this season, consider joining the Mass Audubon Society, which offers year-round nature programs at all of its sites, school vacation week programs, and low cost guided snowshoe hikes:
http://www.massaudubon.org/index.php
There are plenty of local opportunities to skate, ski, and snowboard; most places will rent equipment so you can try out the sport before committing to a lot of expensive gear. Be careful, though, when you rent shoes for your kids: my skating and skiing experts tell me that blisters are quite typical the first few times you "break in" a pair of skates or ski boots. If you're renting, wear two pairs of tight-fitting socks to alleviate the problem, and bring band-aids, moleskin, and some antibacterial ointment with you just in case.
For those of you looking for indoor activities until the weather heats up, you're in luck! Winter is a great time to start a book group, teach your kids how to cook (most kids will eat more of what you're serving if they've helped prepare it), or introduce your kids to board games and cards. Sure, video games encourage eye-hand coordination, but there is something perhaps more valuable to learn from board and card games. They encourage kids to learn strategy, fine motor skills, math and logic, as well as important social skills: playing fair, taking turns, and winning and losing gracefully. The following is a commercial, but good, site for finding board games both old and new:
http://www.areyougame.com/interact/default.asp
Or if you're crafty, you can help your kids make their own:
http://boardgames.lovetoknow.com/Board_Games_for_Kids_to_Make
Finally, if you need to get out of the house and want to keep warm, consider investigating some of the smaller museums in the area. It's a great way to keep warm, learn something, and broaden your kids' horizons!
Some suggestions: the New England Quilt Museum in Lowell (http://www.nequiltmuseum.org/), Harvard's Museum of Natural History (http://www.hmnh.harvard.edu/index.php), Museum of our National Heritage right here in Lexington (http://www.nationalheritagemuseum.org/), and--for older kids and parents who appreciate irony--the Museum of Bad Art, in two locations: Dedham and Somerville (http://www.museumofbadart.org/).
Enjoy the winter, and be well!
"
Fall 2008 - Fall Family Fun
In this issue of Doctor's In-box, Dr. Julie talks about Staying Centered and Healthy as the weather turns colder
Dr. Julie: "It's fall..crisp cool air, colorful trees, a new school year...the autumn season heralds many new and exciting changes for families, especially those with schoolage kids. Here are a few suggestions to keep your children healthy and happy as the days get shorter and cooler.
School stuff: for many families, the start of the school year means major adjustments in the family schedule. Suddenly there are music lessons, religious school, sports practices, and somehow, in between everything else, homework lessons to be completed (and dinner to be eaten).
Try and set aside time for the family to sit and eat dinner together each night. Sharing a meal is a wonderful way to connect with your kids at the end of the day. Also, studies have shown that children who share a family dinner each night are more likely to maintain healthy eating habits, less likely to use drugs, and less likely to develop eating disorders. It's a great way to connect with your growing child, and to teach him valuable social and communication skills, and to model healthy eating habits.
Speaking of food...we've had more and more parents asking about organic, sustainable food and its benefits. Eating fresh, locally grown food is a great choice for children and families. Locally grown food is available as soon as it's ripe, without a lot of delay or shipping costs. And buying local supports your local farmer. For a great list of local farmstands, farmer's markets, and dairy/meat sources, go to eatwellguide.org.
Organically grown food has the additional advantage of being free of pesticides, which are thought to be harmful to health. Buying organic can be pricey, though. If your budget is limited, you might want to try organic dairy products first, as well as some organic produce, to maximize the benefits. Check out foodnews.org for a list of fruits and vegetables with the highest exposure to toxins, and try buying organic instead of conventional produce that's high on their list. I think you'll find organic food to be notably more flavorful!
Fall is also the cold and flu season. This year, the AAP (American Academy of Pediatrics) is recommending that all children aged 6 months to 18 years receive the flu shot. We have walk-in clinics for our patients just about each week through December; clich [here] to see the flu clinic schedule.
Patients with asthma and allergies may find that the colder weather, and more time indoors, triggers their symptoms. If so, it may be time to renew your medications; just call our Nurse Triage line and leave a message requeseting refills. We also offer an "Asthma/ Reactive Airways" comprehensive office visit, provided by our nurse practitioners. Come in to see them and bring all of your current medications. They will take a careful history and make sure your child is on adequate and correct medication--and using it correctly-- as we enter the winter season.
Until next season, be well.
"
Summer 2008 - Sun Safety and Farmer's Market
In this issue of Doctor's In-box, Dr. Julie talks about Sun Safety with tips to keep your kids safe during the glorious sunny season.
Our Shameless Plug for Our Local Market -
One of the best things about summer in New England is the phenomenal fresh food available!
This year Lexington Pediatrics is proud to be one of the main sponsors of the Lexington Farmers’ Market, held on Tuesdays at the corner of Mass. Ave, Woburn St. and Fletcher Ave.
Come sample locally grown fruits and vegetables, and locally made baked goods and crafts. Check out the Farmers’ Market website.
Sun Safety is very important this time of year. Now that the cold winter, and rainy spring, is finally over, here are some tips to keep your kids safe during the glorious sunny season.
Dr. Julie: "All children should wear sunscreen when outdoors for any length of time, even if it's overcast. Apply a good-quality, name-brand lotion frequently; the SPF (sun protection factor) should be 15 or greater. More important than the SPF number is reapplying lotion every 3-4 hours, or after swimming, since lots of lotion rubs off with sweating. Most people don't apply nearly enough lotion to achieve the promised protection; each quarter-sized dollop of lotion should only cover an area as big as the palms of two hands.
The eyelids, lips, and cheeks need protection too, but regular sunscreen drips into the eyes and mouth; consider a "stick" sunscreen (like an oversized lip balm) for these vulnerable places. If your toddler resists lotion, consider purchasing SPF-protective clothing. Most are manufactured in Australia, where the high rate of skin cancers has led to a well-regulated and high-quality range of products ranging from sunscreens to bathing suits.
Don't forget hats and sunglasses! Children's eyes are especially vulnerable to the harmful effects of direct sun. Teach children never to look directly at the sun, encourage them to wear brimmed hats, and if they'll wear sunglasses, they don't have to be expensive, but they DO have to say "100% UV protection." Cheap sunglasses that simply darken the view will cause a child's pupils to expand, letting in more of the harmful rays.
Special note for infants: there is research which suggests that some of the chemicals used for children's sunscreen (the oxybenzones) may not be safe for infants and young toddlers. Kids under 2 should use a name-brand, fragrance-free lotion containing zinc oxide and titanium dioxide as the active ingredients, and ideally should not be exposed to sunlight when the sun's rays are most damaging, from 10 am to 2 pm.
Remember to bring water whenever you take the kids outdoors; even if it's not too hot, children become dehydrated very easily. Encourage them to drink before they become thirsty, as thirst is already a sign of mild dehydration. Water is the beverage of choice; sugary drinks such as fruit juice, soda, lemonade, or sports drinks are fine in moderation, but not necessary. A better choice would be fresh fruits, which provide nutrients and fiber in addition to hydration.
Most importantly, set a good example yourself and show your kids how you apply sunscreen, wear hats and glasses, get outdoors to exercise and enjoy the summer weather, and drink lots of fluids every day.
Be well and enjoy yourselves!
"
Spring 2008 - Travel Preparations
In this issue of Doctor's In-box, Dr. Julie talks about travel and how to plan a healthy, safe vacation.
Dr. Julie: "Travel is terrific for the whole family! It's a great way to escape the cold (or go somewhere even colder, if you like outdoor sports), and a wonderful way to reconnect with family away from the daily grind. With some advance planning, your trip can be safe, healthy, and fun for everyone. I assume you all know the common-sense planning that goes into a big trip--check the weather, pack comfortable layered clothing, don't forget sunscreen and insect repellent--but here are some thoughts on how to enjoy your vacation without last-minute medical problems:
1. Is your child taking any medications? Call our office well in advance if you think you might need refills to bring with you.
2. If your child has asthma, make sure that you have a nebulizer machine for travel, and that your hotel/destination will be able to accomodate the electrical plug.
3. Don't forget a mini-med kit for minor cuts, scrapes, and fevers. Acetaminophen (Tylenol), ibuprofen (Motrin), and diphenhydramine (Benadryl) are good to have, as well as topical antiseptic ointment and some bandages. Bring moleskin patches if you'll be doing a lot of walking, and of course sunscreen and insect repellent.
4. Traveling overseas? Schedule a "travel clinic" appointment with one of our nurse practitioners well in advance of your trip. We can review your child's immunizations and make sure they have all the recommended travel vaccines; advise on medication for malaria, typhoid, and other tropical diseases, and give additional advice on water, insect, and food safety abroad. Please call at least one month before travel so that we can ensure that your child receives all necessary vaccines in time for the trip."
Spring 2008 - About Allergies
Spring is in the air, and in addition to finding terrific "outdoors stuff" to share with your kids (daffodils poking up, baby birds hatching) some of us will be starting to suffer our annual allergy symptoms.
There are many effective medications for seasonal allergies; please call or set up an appointment with one of us so we can help figure out the best treatment options. In the meantime, we hope you can get outdoors and enjoy the lovely weather and longer evenings!
If your child experiences coughing, itchy eyes, sneezing, wheezing, disrupted sleep patterns, or seems to have a cold or cough that just won't go away, consider that he or she may have allergies.
If your child has allergies, and takes prescription medication, please check to make sure you have enough on hand. You can request a refill here.
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SPOTLIGHT
The information in these website links is not intended be a substitute for professional medical advice. It is provided for educational purposes only.
You assume full responsibility for how you choose to use this information.
Please call us or seek other qualified medical advice for your medical concerns.
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KNOW MORE |
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Knowlege and information about all aspects of your health are key components of living a healthy lifestyle for you and your family.
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