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    How to Avoid Common Illnesses through the Holidays

    Last updated 6 months ago

    Winter is the time for holiday parties, family get-togethers, and joyful memories; unfortunately, winter is also the time for common illnesses such as the cold and flu. Make sure you and your family enjoy the holiday season with these tips on avoiding common illnesses:

    Wash Your Hands Frequently One of the best ways to keep cold and flu germs from entering your body is to wash your hands on a regular basis, especially before eating and before touching your face. The Centers for Disease Control and Prevention recommends that all children and adults wash their hands for 15 seconds at a time with warm water and soap. Individuals with sensitive or dry skin may consider using an antibacterial lotion to keep their hands soft while still killing bacteria.

    Follow a Healthy Diet Eating a well-balanced diet provides your body with the vitamins and nutrients it needs to fight off germs and viruses. Try to incorporate more fresh fruits, green leafy vegetables, lean proteins, whole wheat, and low-fat dairy products into your family’s diet while still taking portion size into consideration.

    Get Plenty of Sleep Getting a full night’s sleep boosts many of the body’s functions, including those of your immune system. In this way, getting plenty of rest can actually help your body ward off germs and destroy viruses before they lead to illness.

    Get a Flu Shot The influenza vaccine is available to all individuals six months of age and older. However, individuals who are allergic to eggs, are pregnant, or currently have an illness such as pneumonia should talk to their physicians before receiving a vaccination.

    Is your child showing symptoms of the common cold or the flu? Ensure that your children receive the care they need by contacting pediatrician Dr. Nanette Nuessle at (913) 948-3323. You can also check out our website for more information on our general pediatric services for families of Independence, KS.

    Pertussis's Effect On Your Children

    Last updated 6 months ago

    Are your children up to date on their pertussis immunization? How about you? Pertussis is a bacterium that causes whooping cough. It attacks the respiratory system and can be deadly to children 2 years old and under. This illness scares me. When I have a patient with this, I've been known to sit up all night at their bedside to make sure they keep breathing. I have toddlers in my practice that had whooping cough at 6-8 weeks of age, too young to be vaccinated. How does a child this young get exposed to pertussis, you ask? They get exposed through family members.

    Vaccines work. We know this. However, their effectiveness wains over time. Many people haven't had a pertussis vaccine since 5 years of age. There is a relatively new vaccine on the market for teens and adults. Teens should receive this at age 10-11. Adults need to get this ASAP, then repeat it every 10 years. If you have a new baby, then mother, father, grandparents and older children all need to be up to date on their pertussis immunization before that baby comes home from the hospital. It could be lifesaving. Routine immunization and booster shots are important. Without a primary care physician and routine well visits, these things can be easily missed. I don't think there is enough being done to educate the public about this.

    As doctors, we are taught that whooping cough is only a severe illness in small children. We are told that adults get a mild illness with a cough that lasts a month. Here is one family's experience with whooping cough. I would have trouble calling this a mild illness:

    "Hello!

    You asked for our family’s experience with pertussis last fall, so here goes. First, I should say we’re a family of four; our son Adrian is 30 and lives on his own, while our daughter Rachel, now 18, was living with us during her last year of high school here.

    While health care is free in Canada, our much-loved family doctor had left his practice five years before, and we hadn’t been able to find an adequate replacement. During our search for a new doctor, when we needed health care, we relied on local walk-in clinics. The care there is good, and it’s covered by our health insurance, but unlike a family practice, there’s a lack of continuity. And treatment tends to be on a “per visit” basis, which means that ongoing health issues like vaccination schedules can be overlooked. By last fall, neither of the adults in the household had had DTP vaccinations for well over 10 years; Rachel had had one when she was 11, but was due for another; and Adrian hadn’t had one since his teen years. We later discovered that this left us all wide open to pertussis.

    In September 2011, we attended an event at my father-in-law’s synagogue. Most of the guests were elderly, and we noticed that some had coughs or colds, but put that down to the season and their age. A week or two later, both Adrian and my husband Mitchell began coughing. Adrian’s cough was bad enough to keep him home from work, and he told us he’d been throwing up at the end of some coughing spasms. He’d cough for nearly a minute at a time, unable to catch his breath, and would eventually vomit or retch. We were quite concerned, and urged him to see a doctor. He did go to a clinic, where he was given a prescription cough suppressant. It did next to nothing, and eventually he asked Mitchell to accompany him to the ER at a local hospital, as he couldn’t control the cough and he was getting quite worried about it. In the ER, he was given a ventolin puffer and more cough suppressants, but no one mentioned pertussis.

    Meanwhile, Mitchell had also been coughing severely enough that he pulled a rib out of alignment. He was lucky, though—his cough seemed relatively mild by comparison with Adrian’s, and it cleared up within about three weeks.

    Next to fall was Rachel. As I mentioned, she’s had moderate to severe asthma since she was two years old, with multiple hospital admissions and visits to the ER. She’d been in the care of the respirology clinic at the local children’s hospital since she was about 12, and was doing pretty well on a combination of Alvesco, Advair, and ventolin. When she started coughing, it seemed like a mild cold at first, but as always, she upped her doses of preventive asthma drugs; but the coughing quickly escalated to the point where she was breathless and gasping, then vomiting at the end of each spasm. It was complicated, though, because she was also wheezing quite a bit. We took her to the ER twice in one week, and she was given large doses of ventolin, and sent home.

    About a week into Rachel’s illness, I got it as well. (I should add that on September 28 last year I had a tib-fib fracture followed by emergency surgery, and was still in my cast, in a fair bit of pain, and unable to move much. Broken ankle + pertussis? Not a lot of fun.) As with Mitchell, Adrian, and Rachel, I found that the coughing would start to worsen in the evening, and would keep me wide awake most of the night. By morning it would start to ease up a bit, enough that I could grab a bit of sleep. Mine went on for about three weeks, and then started to improve.

    At around the time that I started coughing, though, Adrian called me and said he was pretty sure we all had pertussis. I didn’t believe him at first—after all, isn’t that a rare disease that’s pretty much been eradicate? But he’d done his homework, and sent me to several online sources that seemed to confirm his suspicion. So after Rachel’s second hospital visit, when she kept getting worse, we took her back, and insisted that they do a swab for pertussis. The doctor on duty was very skeptical, and kept insisting that it was highly unlikely, and that the test was very uncomfortable, she wouldn’t like it, it wouldn’t tell them anything...but Mitchell politely insisted, and eventually they did the test. Two days later, the hospital called us back to confirm that Rachel had pertussis. And based on symptoms, so did the rest of our family.

    Rachel and Adrian both continued coughing, though not quite as violently, well into the new year—the Chinese aren’t kidding when they call it the 100 Day Cough! Adrian missed about a month of work, and Rachel lost a good five weeks of he

    r final year of high school. Fortunately, we’re all fine now, but it was a rough several months, and when I realized that it was basically because of our own ignorance, I was horrified. We strongly believe in vaccination, and would have had our shots if we’d known we were due for them; the main problem was just not knowing. Oh, and I should add that Mitchell, Rachel, and I have since found an excellent family physician that we all like; we’re hoping there will be room for Adrian in the practice in the next few months.

    I hope this gives you a good picture of our experience, but if you have any questions, I’ll be happy to answer them.

    Take care,

    Karen"

    Karen's experience highlights a number of issues:

    1. Pertussis is still with us and whooping cough is still a problem.

    2. Vaccines and immunization updates (booster shots) can fall through the cracks

    3. It is important to have a primary care physician who oversees your healthcare

    4. There is a huge need for vaccine education as a public health initiative.

    Please stay tuned, as I will be bringing more information on immunization to my website in the next few months. You can also read more at Karen’s website: http://afterthekidsleave.wordpress.com/

    ~Dr Nan N~

    Learn How To Help Your Kid Stay Healthy By Reading These Articles

    Last updated 6 months ago

    Children are bound to have at least a few illnesses and injuries as they grow up, which is why having a family pediatrician can prove extremely beneficial. A pediatric physician is trained to handle a wide range of health concerns that children often encounter. To learn more about the medical problems that a pediatrician can treat, please read the following articles.

    • Halloween is a holiday that commonly necessitates trips to the pediatrician. The Centers for Disease Control and Prevention offers an overview of Halloween safety tips.
    • ADHD, or attention deficit hyperactivity disorder, affects approximately five percent of all children in the United States. WebMD provides a guide to recognizing the symptoms of this condition and seeking treatment for children with ADHD.
    • Though education, medication, and pediatric care can greatly alleviate asthma symptoms, your child may suffer an asthma attack from time to time. KidsHealth.org discusses coping with childhood asthma.
    • Physical activity is a great way for your children to be active and healthy; however, it also makes them susceptible to certain sports injuries. The National Institute of Arthritis and Musculoskeletal and Skin Diseases breaks down the most common childhood sports injuries and how to prevent them.
    • A congenital heart defect does not have to inhibit your child’s quality of life. The Mayo Clinic describes treatment methods for congenital heart defects.

    Dr. Nan Nuessle offers Independence, Kansas families personalized pediatric care. To find out more about how we can help your child manage a range of conditions, including asthma and ADHD, or to schedule an appointment with Dr. Nan, please call (913) 948-3323.

    Earlier Puberty in Boys: A Pediatrician's Take

    Last updated 7 months ago

    Boys are starting puberty 6 months to 2 years earlier. The AAP broke this story last week, and it quickly became one of the hottest news stories in the nation. Parents and physicians were concerned about what this meant. Are our boys simply developing earlier, or is this precocious puberty, a medically significant deviation from normal puberty that requires treatment? My own children are well past puberty. If they weren't there are certain things I would want to know. Is this dangerous? What is causing it? What do I need to do as a parent? When should I be worried? This link attempts to address some of these issues.

    Girls in the US have been entering puberty earlier for several years. We know that this can be linked to obesity. However, this information on early puberty in boys is new. Perhaps this is because the onset of puberty is harder to track in boys. They don't have menstrual periods or breast development. What does the study mean by "earlier"? Well, we doctors have tables and charts that we use to track physical development. These are our guides as to what is 'normal.' They were developed decades ago. This is the first study in many years that has looked at when puberty begins in boys, and it is earlier than we were taught to expect.

    Precocious puberty refers to puberty that occurs earlier than normal. That's not a very useful definition in this case, so let me explain. We used to think that "early" was before age 9 in girls. Now we know that normal puberty in girls can begin as early as age 7. In boys, it refers to puberty before the age of 9. Signs of early puberty in boys include armpit or pubic hair, growth of the genitals, facial hair, muscle growth or deepening of the voice. If you see such changes in your son before age 9, have him see his physician. Your provider may be able to tell by physical examination whether this is normal. Or, he or she may want to run tests to see if these signs are due to changes in the brain, genetic problems, certain tumors that release hormones, or certain creams or ointments that contain hormones.

    This AAP study refers to normal puberty occurring earlier than we previously expected. It does not refer to precocious puberty. Furthermore, it refers to the onset, or beginning, of puberty. Boys are still finishing puberty at the usual time. (It is taking longer). There is no immediate danger from this, but we do not know the long term effects. We don't know what is causing it. At this time, we cannot blame obesity, BPA or the hormones in milk. As parents, we need to teach our children what to expect. This means we may need to move the puberty talk to a younger age. There is something else we can do as parents. We can help find out why early puberty is occurring. We can make ourselves available to answer surveys and questionnaires about our boys' health and habits.

    In summary, early puberty is occurring in boys as well as girls. There is no immediate danger from this. We do not yet know the cause. Contact your physician if you see signs of puberty in boys before the age of 9. As always, if you have questions or concerns either leave your comments below or contact your child's healthcare provider.

    ~Dr Nan N~

    Tips for Helping Your Child Manage Asthma Symptoms

    Last updated 7 months ago

    While a common childhood illness, asthma is also a highly treatable one. Knowing what induces an asthma attack and what can prevent it will take some time to determine. Moreover, each asthmatic child will respond differently to various triggers and medications. Yet with persistence, patience, and pediatric care, parents and their children can find great success in both reducing the frequency and severity of flare-ups.

    Eliminate asthma triggers.

    Virtually anything can constitute an asthma trigger. A trigger may be an allergen such as dust mites, pet dander, or pollen. Asthma can also be trigged by another illness such as the cold or flu. A trigger may even stem from weather changes. Additionally, no two asthma triggers will affect a child in the same way. However, by paying careful attention to the circumstances surrounding your child’s asthma attack, you can begin to identify triggers and remove them when possible.

    Anticipate asthma flare-ups.

    If your child has been diagnosed with asthma, consult your pediatrician about using a peak flow meter at home. A peak flow meter is a device that measures breathing ability. Even if your child shows no asthmatic symptoms and claims to feel fine, a peak flow meter can alert you to a future asthma attack. In some cases, this device can serve as a warning days before a flare-up occurs.

    Follow your pediatrician’s instructions.

    A crucial component of managing your child’s asthma is having an open line of communication with your pediatrician and closely following her medication recommendations for your child. While trigger elimination and flare-up prevention are important parts of coping with childhood asthma, they cannot take the place of professional general pediatric care.

    Does your child suffer from asthma? If so, Dr. Nan Nuessle can help. Dr. Nan is a pediatric physician who offers personalized care for patients in Independence, Kansas. No matter whether your child is newly diagnosed with asthma or has been suffering from it for years, Dr. Nan can help manage your child’s symptoms for a more comfortable and flare-free life. To schedule an appointment, please call (913) 948-3323.

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