Flumist? What’s that?

Flumist is a live, inactivated attenuated flu vaccine.

There’s no needle!

It’s sprayed in the nose.

You can read about this option for vaccination against influenza here.

See how the small amount of liquid vaccine is sprayed in the nose here.

Posted in 101, Children, Flumist. nasal flu vaccine, Immunization, influenza, influenza vaccine, Wellness | Leave a comment

99072 is for PPE

We’d like to provide families with information about the personal protective equipment (PPE) billing code, 99072.

This code was developed by the Centers for Medical and Medicaid Services specifically for the pandemic. The code addresses the increased PPE required to provide medical care during the COVID19 pandemic. This includes gloves, gowns, N 95masks, face shields, cleaning and disinfectant materials, as well as the MERV13 filters for our air conditioning and heating units.

We follow all health and safety procedures regarding PPE with patients. The staff and physicians wear PPE, and we have increased cleaning and disinfecting to keep families and ourselves safe.

The American Academy of Pediatrics and other medical societies, advocating on behalf of patients and families believe the cost should be borne by the insurance companies alone. We have seen some insurances chose to process this toward the family’s deductible. That is not our intention or the intention of the medical community. We encourage you to share this information with your insurer and human resources provider.

We will continue to advocate with the AAP and the California Medical Association for safe and fair treatment for all during the pandemic.

Posted in COVID19 | 1 Comment

Thermometers

Now is a good time to make sure you have a basic thermometer that you know how to use. Read more from the American Academy of Pediatrics.

Everyone has a temperature. Not everyone has a fever.

Taking your child’s temperature helps you and the pediatrician make decisions about your child’s condition and recommended treatment.

A rectal temperature is recommended for children under 2 months of age.

There are many inexpensive digital thermometers to chose from. These are sold as oral and rectal.

Ear, forehead (temporal artery and infrared) thermometers are more appropriate for children over one year of age. Doctors don’t recommend temperature strips or pacifier thermometers.

For tips on taking your baby or toddler’s temperature, see my Baby Center video here.

For tips on taking your older child’s temperature, see my Baby Center Video here.

Posted in 101, Babies!, Children, COVID19, DIY, Health Care, Pediatric Bits, Wellness | Leave a comment

Teen Wellness Screening

The American Academy of Pediatrics, the National Committee for Quality Assurance, and the Centers for Disease Control and Prevention set the standards for wellness screening. These organizations and your health insurance plan recommend testing teen women and young adults for genital Chlamydia infection.

This screening is also required when oral contraceptives are prescribed even though the prescriptions may be for medical reasons such as acne and managing menstrual problems like heavy or frequent bleeding.

Chlamydia infection is a significant and serious health problem. The vast majority of infections are asymptomatic, unrecognized, and therefore untreated. Chlamydia is the leading cause of pelvic inflammatory disease, ectopic pregnancy, and the leading cause of preventable infertility. Adolescent females have the highest risk of infection. It is estimated that 5-10% are currently infected. Males may similarly report no symptoms.

Questioning and interviewing are the least reliable screening format to identify young people at risk for this disease. The most reliable screening is to test, at a minimum, all adolescent girls of high school and college age. Testing is performed on a routine urine specimen. Teenagers should be able to receive the results confidentially. For patients over 18 years of age, all medical results are confidential. Treatment recommendations will be provided, if necessary, and counseling to identify partners will be offered. Results can be provided by telephone, by mail or secure on-line communication.

This testing is part of well care, and your insurance should process it toward well care. While we submit this test to the lab as well care, the lab may not always process the code correctly. We have brought this to their attention countless times. If you receive a bill for this test, please contact the lab and ask them to process the test the way it was coded from our office. Please contact our office if there are additional issues.

Read more about Chlamydia here https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm.

Once teens reach 18 years of age, baseline testing for HIV, Hepatitis C, and Syphilis are recommended. Rates of sexually transmitted infections were rising nationally before the COVID19 pandemic began, and this testing is another part of wellness. Read more here https://www.cdc.gov/std/life-stages-populations/adolescents-youngadults.htm

Posted in Teens, Wellness | Leave a comment

15 Minute SARS-CoV-2 Nasal Screening Now Available

We now offer the BD Veritor antigen screening for COVID19. This test uses a nasal swab 1″ into the nose. Results are available in 15 minutes. Testing requires a telemedicine evaluation with the swab done at our outdoor satellite location. Please call the office to schedule.

Posted in 101, COVID19, Urgent Care | Leave a comment

Forbidden Binkies?

The Baby Friendly Initiative, meant to foster successful breastfeeding, has had some unintended consequences. Pacifiers are forbidden. Sending the baby to the nursery so the parent can sleep is also out. While promoting breastfeeding is a worthy endeavor, mothers and families are contending with more than ever right now. While we wish successful breastfeeding for all, families may have different goals.

Your baby may enjoy keeping busy with a pacifier when they aren’t hungry. It allows the baby to learn the gentle act of self-comforting while parents attend to the million other things. And the binky gives mom’s nipples a break.

Not all of us have the perfect breastfeeding experience we anticipated, and when my daughter asked me how long I’d breast fed her, the answer was six months. I went back to work when she was six weeks old, she refused to get on the breast by 3 months, and when my mother died when she was six months old, the winter infection season was over, and I was done pumping. I am pro-breastfeeding, pro-mom, pro-family. You know your baby, yourself, and your family best.

There’s more about families and Baby Friendly at https://www.romper.com/p/the-failure-of-baby-friendly-initiatives-19374870

Posted in 101, Babies!, Wellness | Tagged , , | Leave a comment

Flu Excellence Award

California’s Vaccines for Children program awarded us their Flu Excellence Award for protecting babies, kids, and young adults from influenza.

Schedule your flu shot now!

Posted in Babies!, Children, Flumist. nasal flu vaccine, Health Care, Immunization, influenza, influenza vaccine, Medicine, Wellness | Leave a comment

Should the Baby be Circumcised?

 
Resources from the American Academy of Pediatrics for parents are here.happy-baby
Their position is that the decision to circumcise is one best made by parents in consultation with their pediatrician, taking into account what is in the best interests of the child, including medical, religious, cultural, and ethnic traditions.
 
As a pediatrician with years of experience, I welcome the opportunity to discuss the benefits and risks of circumcision with parents and the forms of analgesia that are available.
Posted in Babies!, Wellness | Leave a comment

Night Nurse Triage

NightNurseLogo

We are delighted to announce that our office has teamed up with Night Nurse Triage Services.
Night Nurse provides specialized triage services staffed with RNs averaging 18 years clinical experience.
To reach the advice nurse after hours, call the office and listen to the prompts.
If you have saved the previous advice nurse number, please update your speed dial!
Posted in 101, Babies!, Children, Health Care, Medicine, Pediatric Bits, Urgent Care, Wellness | Leave a comment

COVID19 Testing Update July 23, 2020

COVID19ImageOur communities are re-opening and our lives are expanding. This is a good thing!

As social distancing relaxes, exposures are increasing and we are receiving phone calls from worried parents. Fortunately, the data still shows that the majority of children have asymptomatic or mild cases. Still, an exposure or infection in your household has major implications for your family. Prevent infection by good hand-washing, social-distancing and wearing a face-covering. Once exposed, quarantine and isolation within your home are the most important tools to contain the virus. Testing is not a replacement for quarantine, however, under the right circumstances, testing can give useful information.

If your child has an exposure, please arrange for a telemedicine visit. Each case is different and needs to be fully understood so we can create the best plan for your child and your family. In the next few weeks, Casa Verde Pediatrics will have in-office COVID-19 testing with same-day results. Results are most accurate when done after symptoms develop, or at least 5-7 days after exposure. We have had many families rush immediately after an exposure to an urgent care and “get a test.” In these cases, a negative test should not be reassuring, as the virus can be in your body but not yet detectable. If there is an exposure, a 14 day quarantine is vitally important to protect the rest of your loved ones, and society. Second-hand exposures (being near someone who was near someone with COVID-19) don’t usually count as true exposure, and during a telemedicine visit we can help you figure out true risk.

COVID-19 testing at Casa Verde Pediatrics is done at specific times to minimize exposure to our staff and to preserve PPE. Testing will be done in your car.  After the telemedicine visit, we will help you schedule any needed testing.

The federal government has commandeered factory inventory to send to nursing homes in high-risk states. This has delayed our in-office test supplies. Please be aware that COVID-19 tests are precious resources. While we have some send-out COVID-19 tests, it is our responsibility to use them judiciously. Tests sent to the labs are taking over a week for results because the labs are overwhelmed.

We continue to read and learn and monitor for new recommendations with the goal of giving you the best information possible. As new information becomes available, we will update our advice. Now, more than ever, we thank you for trusting us with the care of your family.

Posted in 101, Babies!, Children, Wellness | Leave a comment