It is Time for your Annual Flu Shot!

By Colleen McCabe, MSN, CRNP

Happy fall! Along with adding pumpkin to your coffee and cheering on the Eagles, it is also time for your child’s annual flu shot.  There are many reasons why it is important to have your child vaccinated against the flu, especially during the coronavirus pandemic.

  • The annual flu vaccine helps prevent your child from getting sick from the flu. In fact, each year the flu vaccine prevents over four million people from getting sick.  Having your child vaccinated will help keep themselves and others around them healthy.
  • If your child does become sick with the flu, the vaccine can reduce the need of your child being seen by a doctor, going to the emergency room, or worse, being admitted to the ICU. 
  • Since we are in the midst of the COVID-19 pandemic, protecting your child from the flu with the vaccine will help keep them and those around them healthy. Strong immune systems are important during this time. 
  • If your child has a chronic illness, such as asthma or an immunodeficiency, it is especially important you vaccinate them as soon as possible.  Children with chronic illnesses are more likely to end up in the emergency room due to complications from the flu.

Call our office today to schedule your child’s flu shot.  We are offering flu shots during the week as well as Saturdays and selective Sundays.

Acne: Common Concerns About a Common Skin Condition

By Timothy J. Flynn, M.D.

What does acne look like?

Acne can look different on different people, on different areas of the body, or at different times. Whiteheads, blackheads, red bumps, and pus-filled bumps are all acne.

When does acne happen?

Acne usually appears as children and teens enter puberty. Most children have at least some acne at some point in their development. Luckily, for most people, acne does not last forever.

Where does acne happen?

Acne is most frequently found on the face, chest, and back.

Are there any special considerations for females?

For girls, acne is sometimes related to menstrual cycles or can be a sign of a hormonal disorder.

Ok, what about males?

For boys, if there is acne on the face it can make shaving more difficult.

Does sports or sweating cause acne?

Sports and sweating don’t cause acne by themselves, but certain athletic equipment may trigger or worsen acne. Anything that traps heat and sweat against the skin can be problematic. For example, headgear, helmets, and chinstraps can trigger acne on the face.

What sunscreen/makeup/skin care products should a child or young adult with acne use?

Use a gentle soap to wash trouble areas. Skin care products and cosmetics labelled as “non comedogenic” will be less likely to cause acne.

What should we avoid?

Please avoid the temptation to pop pimples or scrub too vigorously! It can lead to permanent scarring!

When should I bring my child to see a doctor about acne?

Your child has a skin problem but you are not sure if it is acne or not.

Your child is very young and seems to have acne.

Acne is interfering with your child’s happiness or quality of life.

Acne is not getting better with anything that you have tried.

You are concerned that the acne is leading to permanent scarring.

You are concerned that acne is a sign of another medical problem.

Managing Stress at Home During the COVID-19 Pandemic

By Colleen McCabe, MSN, CRNP

Ask, Listen, and Reassure

  • Ask your child how they are feeling in regards to the current situation.  Children handle stress in many different ways. Allowing your child to express their feelings may give better insight on how to reassure and calm them down. Younger children will be affected in different ways compared to an older child, which makes it even more important to talk to your children individually. 
  • Children look to their parents for reassurance.  They will react similar to how you react.  Keeping adult conversations positive around the children is important to reduce panic.  If you panic, your child is likely to panic. 

News and Media

  • Limit the amount of COVID-19 news your child is watching as best you can during this time.  If a child is hearing news throughout the day related to the pandemic, they are more likely to become anxious.
  • Remind your older children to look for credible sources of information in regards to coronavirus updates. The CDC website has the most up to date and credible information.

Schedule and routines

  • Children of all ages like predictability and routine; it helps to reduce the stress of the unknown.  Making a schedule for your child to follow during the week is important.  Allow time for schoolwork, exercise, meals, creative time and play time.  Older children can make a schedule for themselves that best fits their day. 
  • Set aside time for your child to FaceTime their friends, write letters to their family members, or make art projects to drop off at grandparents’ houses.  Socialization is a major part of a child’s development. Continue to encourage your child to keep in touch with friends and family.

Activity suggestions

  • Include your children when it comes to meal preparation. Allow them to help in the kitchen and brainstorm meal ideas.
  • Create dinner themes such as meatless Monday or taco Tuesday in order to keep a predictable routine for your children. This may help your meal prep as well.
  • Your family may have fun dressing up for a “Formal Friday” dinner. 
  • Play a re-run of an old baseball game and cook hot dogs on the grill as a family.
  • Music is great therapy for children of all ages. Many music studios are offering free music on their websites or on Facebook. Check them out!
  • Make time on weekend nights for older kids to have a family game night where you can do board games, card games, or puzzles. Use prizes or incentives for the winner to encourage participation.

Concerns

  • Encourage stress reduction by doing yoga, meditation, and journaling with your child. Check out Calm or Headspace apps for guided meditation.
  • Remember, things will not look perfect at home all of the time during this pandemic.  You are doing the best you can with the resources you have at home. Take each day one at a time.
  • If you have serious concerns about your child’s mental health at any time during this pandemic, please reach out to our office at 215-728-7711 so we can discuss and direct you further.

Telehealth Tips

We are pleased to announce that Fox Chase Pediatrics is using a web-based platform called Doxy.me.

There is no need to install any new apps! We will send you an invitation for your telehealth visit via text message or email after you have called to set up an appointment.

Here are some tips to get the most out of your telehealth visit:

Video is good but photos are better: If there is something you want to show us (for example, a rash or lump or bump), take a couple of unzoomed still photos in good lighting BEFORE the call. We will help you share those images during the telehealth visit.

Your connection: Try to avoid doing the call in areas where your Wifi or data coverage is poor.

Find a quiet space: Eliminating distractions and background noise helps us hear each other better during the telehealth visit.

Lighting: We can see you and your child best in a well lit room. Try to avoid having your back to a window or lighting source.

Picking your device for the chat: Pick the device (phone, tablet, computer) that has the best video camera. This will help us see you and your child better to help with the assessment and diagnosis.

If you have any questions, please call the office at 215-728-7711.

Fox Chase Pediatrics is Here for You and Your Children

Dear Fox Chase Pediatrics Family,

We know you are likely facing many changes and disruptions in your personal and home life as we face the novel coronavirus (COVID-19). Here at Fox Chase Pediatrics, we want to help guide you as you navigate your child’s health during this time. We are taking steps to ensure safe and effective care to all of our patients.

  • In order to best continue to treat and examine our patients, we will be making several changes. We will be separately bundling sick visits and checkups. For an example, we may see all well patients during the morning hours and sick appointments in the afternoon based on staffing and availability. We are also minimizing the number of patients in the office at any one time.
  • It is still very important for our youngest patients to be seen for their well appointments, especially to follow their growth and development, keep to their immunization schedules, and address their other necessary health concerns. Immunizations are important to prevent many other life-threatening diseases. We strongly encourage you to continue to keep their vaccines on schedule. If you have any apprehensions about bringing your child in for their well visit during the next few weeks, please feel free to call, and we will be happy to talk with you.
  • For all visits, we have been very diligent about cleaning rooms between patients and practicing appropriate hand hygiene. We have been deep cleaning our rooms.
  • We now have a “telehealth” medicine program, which would allow us to video call you from the comfort of your own home. Appointments that may be done via telehealth would include behavioral health visits, certain rashes, allergies, stomachaches and cold-like symptoms. If we feel your child needs to be seen in the office after we consult with you on the phone, we will set up an in-office appointment. We hope this helps to keep our volume of sick patients in the office lower as well as allow you to feel more comfortable keeping your child home.
  • As for testing and diagnosing COVID-19, we are continuing to follow the CDC’s guidelines.
    • If your child has come into contact with a person who has tested positive for COVID-19and showing symptoms, we ask you to call our office and we will direct you further. The best thing you can do as you wait for testing is to keep your child at home and quarantined.

Fortunately, the vast majority of children thus far have shown to have mild symptoms of COVID-19; however, they can still spread the virus to neighbors, grandparents, and friends. As of right now, we do not have any test kits at our office, but we will continue to keep you updated.

Please know our doctors, nurse practitioners, and dedicated staff are here for you. We will happily answer any questions or concerns you have and encourage you to reach out at any time at 215-728-7711.

Winter Indoor Exercise Ideas

by Yuliya Bilan Yu, MSN, CRNP

As part of a balanced lifestyle, all kids and teenagers need at least 60 minutes of moderate to vigorous physical activity each day. Not only does it help to create a healthy habit for life, but daily exercise also boosts the immune system, improves mood, regulates energy, and can help with concentration and learning. The 60 minutes do not have to be all at once, feel free to break it up throughout the day and do more if desired. If the cold weather is keeping you from going outside, consider some of these fun ideas for the family to engage in at home instead:  

  • Set up activity stations: Label each area with a type of exercise you would like the kids to do, such as jumping jacks, crawling under a rope, jogging in place, hula hoop, etc. Set a timer, then rotate through all the stations. Invite friends for more fun!
  • Freeze dance: Play some music and stop it at random times. When the music stops, everyone “freezes” in place. Then, see who has “frozen” in the funniest or most creative dance move.
  • Yoga JENGA: Write down a yoga move on each of the JENGA blocks with a pencil. Every time a block is pulled out, each player has to do the written yoga move. If the tower falls, do the plank for 30 seconds.
  • Treasure hunt: Scatter some objects on the floor around the house, such as coins/tokens or another item that won’t be painful to step on. Play music while the players try to gather as many as they can within a set timeframe and bring them back to the “treasure chest.” To make the game more challenging, have the kids focus on collecting only one category of objects at each level of the game (such as only green tokens). If there are small children or babies around, make sure the items are larger so they are not a choking hazard.
  • Crab carry: Teach your kids how to walk like a crab by placing their palms and feet to the floor while raising their stomach up to face the sky. Staying in that pose, let them see how long they can balance something like a bean bag on their belly. Crab races are also another fun option.
  • Reading Workout: Pick a common word in a children’s book and every time that word is read aloud, have your child do a jumping jack.
  • Bowling in your hallway: Use masking tape to create a bowling lane and empty plastic bottles for pins. You don’t need a real bowling ball since a tennis ball or another light ball will do!
  • Follow the leader: Take turns being “the leader” who decides on a fun exercise, such as jumping, spinning in place, dancing, etc. while the other players follow the action.
  • Train to be a superhero: Sell your child on the idea that superheroes work out every day to build strong muscles. Then have him or her do a set of push-ups, sit-ups, squats, step-ups, balanced hops on each foot, jump roping, etc. Set goals and use a chart on the wall, with stickers if desired, to track progress. It is a good activity to incorporate into their morning routine, especially for kids who might still be feeling sleepy when waking up on winter mornings.

Ideally, you would also limit screen time while increasing physical activity. An exception would be an active video game that encourages movement or children’s workout videos to follow. It is also worth checking out if your local community center, such as the YMCA, offers activities for kids and teens.

Finally, as with any play or physical activity, keep safety in mind and have fun!

Product Safety Alert: Infant Sleepers

By Caren G. Kirschner, M.D.

In April of 2019, the US Consumer Product Safety Commission in conjunction with Fisher Price  recalled 4.7 million Rock ‘n Play infant sleepers following an investigation that revealed 32 infants had died in them since 2011.

And last week, the same commission recalled another four brands of similar sleepers because of their risk of causing suffocation. These specific products are listed in the above link.

The American Academy of Pediatrics recommends for all infants to be placed on their backs to sleep on a firm mattress. They should be put in a crib, bassinet, portable crib, or play yard that conforms to the CPSC safety standards. These standards include slat spacing less then 2-3/8 inches, snugly fitting and firm mattresses, and no drop sides.

We discuss safe sleeping habits a lot at our routine check-ups because of its vital importance.

It is our mission and duty to educate our families on the most current evidence-based safety practices.

Don’t Fear: Warts are Common in Childhood

By Timothy J. Flynn, M.D.

What causes warts?

Warts are caused by viruses.

How are warts diagnosed?

Most warts can be diagnosed by examining them. Rarely, a biopsy may be necessary to make an accurate diagnosis.

What are some risk factors for warts?

Anything that causes skin breakdown can predispose a person to developing warts. In particular, children with eczema sometimes develop warts in their trouble areas. This is especially true for children who scratch at those eczema patches. Additionally, some families notice that warts get “passed around” from one person to another.  But not to worry, the vast majority of children with eczema will not have issues with warts.

I have heard many warts will go away on their own. Is that true? How long does it take?

Yes, most warts will go away on their own. It is very unpredictable how long it will take. Sometimes it is as short as a few months. Other times it takes several years.

What are some reasons to treat warts rather than wait for then to go away?

Some warts (particularly on the bottoms of the feet) can be painful. Other times the appearance is bothersome to a child or draws unwanted attention. And some families simply prefer not to wait and would rather try medical treatment to hasten the resolution.

What treatment options are available?

Duct tape is a common home remedy that does not have great scientific evidence behind it but is safe and cheap and might be worth a try. There are also over the counter and prescription medications that can be used. Cryosurgery (“freezing”) is another treatment that can often be performed in your doctor’s office.

If you are concerned, we are happy to see your child to discuss a customized treatment plan for any warts.

Urgent Care vs. Office Visit

By Colleen McCabe, MSN, CRNP

What do I do when my child is sick and the office is closed?

Most likely, you will want to make your child feel better as quick as possible. This is when the idea of an urgent care can come to mind. Urgent care facilities are marketed as a health care facility that is capable of providing immediate, fast care. While an urgent care provider is able to provide quick diagnoses, they may not always provide the best care for your child. An urgent care provider has no access to your child’s health history including allergies, recent and chronic illnesses, surgical history, or growth history, all which are important in making diagnoses and treatment plans. Many urgent care facilities are staffed by providers who focus on adult care, which can lead to over prescribing and misdiagnosing in the pediatric population. According to the American Journal of Managed Care, over half of urgent care visits lead to unnecessary antibiotic prescriptions for upper respiratory illnesses in which an antibiotic is not recommended or proved to be effective. Treating a viral illness with an antibiotic is just one example of how an urgent care visit may lead to a misdiagnosis for your child. [1]

So what are you suppose to do when your child is sick after hours? 

There are several options. If you child is breathing comfortably, their fever is controlled with Tylenol/Motrin, they are staying hydrated, and they are not showing signs of extreme pain or distress, it is safe for you to keep your child comfortable at home and have them seen the next day or two by one of our healthcare providers. We see sick patients every day of the week at our office. If you are unsure whether your child needs to be seen in the emergency room or if they can wait to be seen in the office, we encourage you to call us after hours. We have a provider available to speak to you 24 hours a day, 7 days a week.

When are urgent cares a good idea? 

Urgent care can be useful for patients who are traveling and are in need of medical attention but not near our office. Urgent care can treat strep throat, ear infections, skin infections, asthma, or wrist/ankle sprains. If your child is in any respiratory distress, severely dehydrated, severe abdominal pain, or life threatening medical episode, your child should go to the emergency room, not an urgent care.

[1] Palms D, Hicks L, Bartoces M, et al. Comparison of antibiotic prescribing in retail clinics, urgent care centers, emergency departments, and traditional ambulatory care settings in the United States [published online July 16, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.1632.