Category: Seasonal Health

Asthma and the Flu Vaccine

Posted on by Allied

By Dr. Stephen Borchman

#1 asthma tip of the year- GET THE FLU VACCINE

Any parent with a child with significant asthma will naturally have an underlying fear that their child may have a catastrophic asthma episode. Their fears are well-founded, as every day in the United States between 3 to 5 individuals succumb to acute asthma. Approximately 1/3 of the victims are children. Acute asthma has a variety of triggers, and these triggers vary greatly from child to child. As I often tell parents, asthmatics are like snowflakes, no two are the same. They all have their own individual characteristics. One of the most common and potent triggers of acute asthma in children are respiratory tract infections. Fortunately, for the most dangerous of infections, we have vaccines. And of all dangerous infections, the one that is most common in our society is the influenza viruses. Influenza viruses change their characteristics every season, and there are at least a half a dozen strains that circulate the globe every year, with more evolving every year. The World Health Organization monitors the frequency and severity of influenza infections yearly and then will decide which strains to include in the annual vaccine. While not perfect, this is currently the best approach we have towards protecting people from the very potentially serious consequences of influenza infection.

Acute asthma occurs when the triggering agent, whether this is an infection, pollen, animal dander, or environmental pollutants causes a sudden inflammatory event in the child’s bronchial tubes. If this inflammation proceeds unchecked, it is often accompanied by airway spasms, resulting in respiratory distress. Any parent who has seen their child in respiratory distress knows exactly what this looks like. It is terrifying and any parent who’s been through a hospitalization with their child certainly never wants to experience that again. Influenza infection is a very potent trigger of airway inflammation. And although the vaccine may not stop every influenza strain from causing illness in your child, getting the vaccine will certainly improve your child’s chances of avoiding hospitalization. This was proven in a 2017 study. In that year, 171 children died of influenza infection in this country. Of those 171 children who died, only one had ever received an influenza vaccine, but not in the year that the fatal event occurred.

So please, on behalf of all the doctors at Allied Physicians group, please follow the recommendations of the American Lung Association, American Academy of Pediatrics, and every other medical organization, make sure your child receives influenza vaccination every year. In fact, everyone in the home should be vaccinated for influenza as well to increase the probability of keeping it out of your home. Every year your child receives the vaccine, his or her immune system acquires more information about influenza viruses and is better equipped to defend itself against these infections. Please also follow your doctor‘s recommendations as specified in your asthma control plan. Make sure you contact your practitioner if you feel your child’s asthma is unstable in any way. Lastly, please always keep your follow up appointment so your doctor can monitor and change your child’s medications as needed.

Click here to learn more about our Asthma Control Education (ACE) program.

Fall Allergy and Asthma Guide

Posted on by Allied

By: Dr. Raphael Strauss, Dr. Robyn Kreiner, and Dr. Khalid Ahmad (Strauss Allergy & Asthma, Commack & Woodbury, NY)

Fall is the peak season for asthma in the Northeast. If you or your child is prone to cough, wheeze, or have bronchitis or asthma exacerbations in the Fall and Winter months, now is the time for a tune –up.

  1. Use of preventative asthma medications during this time of year is very effective. These are called controllers and usually contain an inhaled form of low dose steroid. These medications have been used in children for 50 years and have been shown to be safe and effective in reducing asthma episodes.
  2. People spend more time indoors, turn on heat and close windows. Dust mite populations, mold and pet dander exposure increase resulting in more respiratory symptoms.
  3. Try to keep your bedroom an allergy-free zone. Reduce clutter, stuffed animals, enclose bedding in zip – tight dust mite proof enclosures
  4. If you smoke, now is the time to try a new method to quit. Second hand smoke/vaping exposure will increase asthma and allergy symptoms. Put on a nicotine patch today! Come in for a visit with our doctors to discuss smoking cessation.
  5. Visit your doctor to go over your treatment plan. Make sure you and your child are taking the right medicine. Know what to do when asthma symptoms flare so you can avoid an urgent care or emergency room visit.
    1. Have medication available.
    2. Have the Allied telehealth app available on your phone.
  6. Get your entire family vaccinated for the flu. Keep this disease out of your home.
  7. On Halloween, for food allergic kids, make sure they know not to eat any candy before it is screened and inspected- if it is not labelled for allergens, throw it out!
    1. Put out a Teal Pumpkin to show that you have some nonfood treats such as stickers, and small toys for trick or treaters with food allergies. Let’s all enjoy a safe and fun Fall!

Surviving Springtime Allergies

Posted on by Allied

By: Dr. Robyn Kreiner & Dr. Raphael Strauss, Strauss Allergy & Asthma (Westbury & Commack, New York)

Spring is here the trees have begun to pollinate.  While some may start to enjoy the warmer weather others may be dreading allergy symptoms.  It’s time to stock up on allergy meds and find the best allergy regimen that works for you. It is important to start medications before symptoms begin. Consider a Spring allergy tune-up.

Over the counter products- what to buy:

1) Nasal steroid sprays: Flonase, Nasacort, Rhinocort, Sensimist are most effective when used daily

2) Antihistamines: get the type that does not cause drowsiness: Allegra(fexofenadine), Claritin(loratadine), Xyzal and Zyrtec(cetirizine). The generic products are just as good and less expensive.

3) Eye drops: over the counter allergy eye drops contain the medication ketotifen (Zaditor, Alaway) and artificial tears are helpful. DON’T RUB YOUR EYES

Don’t buy:

Allergy medications that can cause drowsiness such as Benadryl.

Decongestants- tend to cause adverse effects such as insomnia, elevated blood pressure

Avoid topical decongestants such as Afrin, Naphcon and Visine. Long term use can cause increased congestion and red eyes.

Although it is nearly impossible to avoid all pollen, here are some tips to limit your exposure

  • First, keep the doors and windows in your home and cars shut to keep the pollen out.
  • Take a shower and wash your hair after outdoor activities so you don’t bring the pollen inside with you.
  • Use of the Netipot to flush the nose and sinuses out twice per day or PRN. (This gives your nose a shower on the inside and gets the allergens that the nose has filtered out of the air).  It comes with packets to mix with water. Be sure to use sterile water, not just tap or well water.
  • Wipe off pets when they come indoors and don’t let them sleep in your bed with you and transfer pollen.

If these do not make you comfortable, see your allergist to discuss other options. There is no need to be uncomfortable.

It’s Flu Season- AGAIN

Posted on by Allied

By: Fatema Meah, MD (Peconic Pediatrics, Riverhead & Southold, NY)

Back to school time is the right time to think about getting this year’s flu vaccine. In general, flu season runs from October until April, and most cases are seen in the winter months. The peak of influenza disease in the Northeast is typically in February but varies every season.  It is ideal to get your flu shot early in flu season.

Why should you get the flu vaccine? Influenza, or “the flu”, affects between 5 – 20% of our population. It is responsible for 200,000 hospital admissions and 36,000 deaths each year.  Last year was especially severe with over 180 pediatric deaths and over 700,000 hospitalizations for flu-related illnesses.  These are the highest numbers recorded since surveillance began. Influenza is the most common vaccine-preventable illness we see!

What is Influenza? Influenza is a respiratory illness caused by influenza viruses. There are two main types of virus: influenza A and influenza B. Each type includes many different strains, which tend to change each year. This is why flu shots must be given every year.

Influenza is extremely contagious and is easily transmitted through contact with droplets from the nose and throat of an infected person during coughing and sneezing. These viruses may also be spread when a person touches these droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

If you have ever had “the flu” you know it is no fun.  Symptoms may include high fever, body aches, headache, dry cough, sore throat, and extreme fatigue.  Stomach symptoms like nausea, vomiting, and diarrhea can occur and are much more common in children than in adults.

Although anyone can get the flu, there are some groups that are at high risk for complications.  The high-risk groups include:

  • Adults 50 and older, especially those 65 and older;
  • Children 6 months – 18 years;
  • People age 6 months and older with chronic medical conditions, including heart disease, pulmonary disorders (including asthma), diabetes, kidney disease, hemoglobinopathies, and compromised immune systems (HIV or immunosuppressive therapy);
  • People with certain conditions (such as neuromuscular disorders) that can cause breathing problems
  • Pregnant women
  • Residents of nursing homes and chronic-care facilities

Other individuals are at high risk of transmitting the flu.  These include:

  • Health care workers involved in direct patient care;
  • Out-of-home caregivers and household contacts of children aged < 6 months.

There are 2 vaccines available to prevent influenza.  The first is the “flu shot”— an inactivated vaccine containing a killed virus. The flu shot is approved for use in people older than 6 months, including healthy people, people with chronic medical conditions and pregnant women. The second is the nasal-spray flu vaccine— a vaccine made with live, weakened flu viruses.  It is approved for use in healthy people 2-49 years of age.

This year there is some controversy about which vaccine is best.  What is important is that you get one of them.  If your child absolutely hates needles and will cause chaos for you getting “the shot” then opt for the nasal spray.  What is most important overall is to be immunized and protected!

There are two common myths associated with the flu vaccine.  The first is that the vaccine will give you the flu. It is not possible to get the flu from the flu vaccine!  Side effects of the flu shot do include soreness, redness or swelling at the site of the injection, low-grade fever, and mild body aches.  This is not the flu but your body’s response to the vaccine.  Side effects of the nasal flu vaccine in children can include runny nose, cough, wheezing, headache, vomiting, muscle aches, and fever.   In adults, side effects can include runny nose, headache, sore throat, and cough.  The second myth is that the vaccine does not work.  In years when the vaccine and circulating influenza viruses are well matched, the flu vaccine can be expected to reduce laboratory-confirmed influenza by 70 – 90%.  In years when the viruses are not as well matched it will still lower incidence of disease as well as reduce severity in those who do get influenza.  We must remember that not all flu-like illnesses are influenza, and the flu shot can only protect us against influenza viruses.

So is it time for your flu vaccine?  Yes, the flu vaccine is now routinely recommended for everyone.  That means babies over six months of age, children, and all adults including pregnant women.  It takes about two weeks for your body to make a response to the vaccine.  Call your doctor’s office to make an appointment today!

Spring Allergy Tips: Brace yourself, pollen is coming!

Posted on by Allied

By: Dr. Raphael Strauss & Dr. Robyn Kreiner, Strauss Allergy & Asthma (Westbury & Commack, New York)

Remember to:

STAY INDOORS whenever possible during pollen season.

USE AIR CONDITIONING and keep the windows shut.

MEDICINES THAT WORK THE BEST:

  1. Nasal steroid sprays: Flonase, Nasacort, Rhinocort, Sensimist – most effective when used daily.
  2.  Antihistamines- get the type that doesn’t cause drowsiness: Allegra(fexofenadine), Claritin(loratadine), Xyzal and Zyrtec(cetirizine). The generic products are just as good and less expensive.
  3. Eye drops: over the counter allergy eye drops contain the medication ketotifen(Zaditor, Alaway) and artificial tears are helpful. DON’T RUB YOUR EYES

Don’t buy:

Allergy medications that can cause drowsiness such as Benadryl.

Decongestants- -These tend to cause adverse effects such as insomnia, elevated blood pressure.

Avoid topical decongestants such as Afrin, Naphcon, and Visine. Long-term use can cause increased congestion and red eyes.

 

IF these are not providing relief, see your doctor and consider consultation with an allergist.

Winter Fire Safety

Posted on by Allied

 

By: Megan Hays, MSN, CPNP. Peconic Pediatrics (Riverhead & Southold, NY)

December, January and February are the most common three months of the year for home fires. With this in mind, we have created a quick quiz to test your knowledge of important fire safety topics.  See below for answers and helpful resources to further deepen your fire-safety knowledge – and have a safe and happy 2018!

Quiz

1) What is the leading cause of all winter home fires?

  1. Candles
  2. Child’s play
  3. Christmas trees
  4. Cooking

2) Children starting fires is almost always due to worrisome mental illness.

  1. True
  2. False

3) What is the most common time of day for winter home fires?

  1. 12 a.m. to 5 a.m.
  2. 9 a.m. to 3 p.m.
  3. 5 p.m. to 8 p.m.

4) Practicing fire escape plans and testing smoke and carbon dioxide detectors should be done at least annually.

  1. True
  2. False

Answers

  1. The leading cause of all winter home fires is D) Cooking – specifically having a heat source too close to combustibles.

As for Christmas tree fires – while they are rare, they are more likely to occur in January when the tree is dry.  They are also more likely to be serious than other fires.  The National Fire Protection Association (NFPA) reminds us to never store an old Christmas tree in the garage or near the house, and recommends disposing of trees by utilizing a local tree recycling program if one is available.  The NFPA also has some helpful tips on how to put those holiday electrical decorations away safely:

  • Use the gripping area on the plug when unplugging electrical decorations. Never pull the cord to unplug any device from an electrical outlet, as this can harm the wire and insulation of the cord, increasing the risk for shock or electrical fire.
  • As you pack up light strings, inspect each line for damage, throwing out any sets that have loose connections, broken sockets or cracked or bare wires.
  • Wrap each set of lights and put them in individual plastic bags, or wrap them around a piece of cardboard.
  • Store electrical decorations in a dry place away from children and pets where they will not be damaged by water or dampness.

Candles play a part in about 3% of home fires and 3% of home fire deaths.   Having kids in the home can make candle safety both more difficult and more important, so consider using electronic flame-free candles in the home during your child’s early years.  If you do choose to use live-flame candles, never leave a child alone in a room with a burning candle, and be sure to keep all matches and lighters out of reach and locked away from curious kiddos.  Also keep in mind that more than half of candle home fires can be attributed to combustible items being too close to the flame, so it is important to keep candles at least one foot (12 inches) away from anything that can burn.  Additionally, one-third of candle fires occur in the bedroom, and are especially dangerous if the person attending the candle falls asleep.  Be sure to blow out all candles if you are sleepy, or before leaving the room.

2.  Children starting fires is almost always due to worrisome mental illness – this statement is For most kids, playing with fire is an exercise in curiosity, but that does not make this behavior safe or okay.  If you are concerned that your child is exhibiting fire-setting behavior, reach out to your local fire department or pediatrician for resources and support.  Mental health services can be helpful for children who seem to be especially focused on fire starting or who are demonstrating thrill-seeking or attention-seeking behaviors.  For all children, it is important for adults to set a good example for fire safety in the home.  Never play with fire in front of your children, and keep any matches, lighters or combustible material out of the child’s reach and locked.  Kids under 6 are most likely to start fires in the home than other age groups.  The NFPA provides a great 1-page PDF for preventing play-induced fires here (nfpa.org/education).

3. The most common time for winter home fires is from C) 5 p.m. to 8 p.m., although the most common time for fires started by child’s play is between 2 p.m. and 8 p.m. This is a busy time of day with kids home from school and dinner cooking, so be extra mindful of fire safety during these hours.

4. Practicing fire escape plans and testing smoke and carbon dioxide detectors should be done at least annually – this statement is The United States Fire Administration (USFA) recommends practicing fire escape plans and testing smoke and carbon dioxide detectors monthly.  Children should be involved in these activities, specifically in creating and practicing escape plans.  Have a designated meeting spot, such as the porch of a trusted neighbor, in case evacuation is needed.  Make sure that kids and all family members also practice closing doors behind them during these drills — closing doors limits the speed in which fire can spread.  Below are the USFA’s tips on fire escape planning:

  • Make and practice a fire escape plan.
  • Plan two ways to escape from each room.
  • Pick a place to meet after you escape to check that everyone got out.
  • Practice your escape plan every month.
  • Plan for everyone in your home – including babies and others who need help to escape.
  • Involve children in making and practicing your escape plan.
  • Teach children to never hide during a fire – they must get out and stay out.

Have a safe and warm winter!

 

Resources

Health safety checklist for the holidays

Posted on by Allied

By: Megan Hays, NP (Peconic Pediatrics, Riverhead & Southold, New York) 

Tis’ the season … to make a pediatric health safety checklist – and check it twice!

The holiday season provides families with the perfect opportunity to visit or host friends and family, to provide children with new toys, and to feast and celebrate together.

The American Academy of Pediatrics and Poison Control both remind us, however, that these festive opportunities also merit extra attention to safety when kids and babies are underfoot!  To keep you safe AND sane, we here at Allied have compiled some holiday-specific safety reminders to keep you and yours safe while celebrating this holiday season.

New toy checklist

The holidays are a season of giving!  While we are thankful to receive gifts from family and friends, be sure to also ask yourself the following questions:

  • Is it safe?
    • Say “no” to baby walkers! These cute toys help babies get around – and that’s not always a good thing.  They are associated with higher instances of falling, drowning, or reaching unsafe items.
    • Secure all batteries! Batteries and magnets are a very dangerous choking hazard.  Make sure children are not able to access batteries in toys.
    • Snip that pull string! Toys with a pull string greater than 12” are more likely to pose a strangulation hazard
    • Watch for detachable (or breakable) parts! Double check toys to ensure any removable parts that could cause a choking hazard have been removed and put away.
  • Is it age-appropriate?
    • Beware of choking hazards, particularly for children who are under 3 or developmentally delayed.
    • Toys that plug into an outlet are not appropriate for children under 10; battery-powered toys are better (and remember to secure those batteries!).
  • Are there other children in the house that could choke on the toy or its pieces?
    • Does the toy fit through a cardboard toilet paper tube? If so, it can be a choking hazard for children under 3.  Recruit big kids to check their toys and keep them cleaned up or away from your little one, or create a special area for these toys that the baby can’t access.

Holiday décor safety checklist

  • Mistletoe berries and holly berries both contain chemicals that can cause nausea, vomiting, diarrhea and abdominal pain. (Holly berries pose additional health threats to dogs.)
  • Poinsettias: While the flowers are harmless, the sap can cause irritation to the skin, eyes, or stomach lining. The sap can also cause a cross-reactive allergic reaction in 40% of patients with latex allergy.  The most common reaction is a skin irritation, so rinsing the skin often prevents further problems.
  • Antique bubble lights: Beyond the risk of broken glass, bubble lights contain a fluid (usually methylene chloride) that is dangerous when touched, eaten, or inhaled. Such contact can cause nausea, vomiting, headache, drowsiness, coma, seizures, heart attack, or, unfortunately, death. The amount of methylene chloride in a single bulb is unlikely to cause symptoms, but it is still best to keep these nostalgic lights out of the home if possible, or at least keep kids away from the lights.
  • Balloons pose an extra choke hazard for children under 8, and ribbons longer than 12” pose a strangulation risk. Do not leave young children unattended with these festive items.

 

Household toxin checklist

When traveling to another person’s home or having guests in yours, the child may be more likely to have access to dangerous toxins.  Here are some specific items to be mindful of, along with a reminder of how to contact poison control.

  • Medication and Vitamins: Studies show that most grandparents identify outlets as the #1 kids safety risk around the holidays, but medication ingestion is 36x more likely to send a kid to the ER. Furthermore, studies show that older adults are more likely to have unsecured medicines in their home.  Ask your hosts and houseguests to keep medicines and vitamins out of reach and in child-proof containers.
  • Cleaning supplies: Double check that they are kept out-of-reach or in a locked cabinet.
  • Alcohol: Ensure that there is a designated “child watcher” during parties to make sure no curious kids or toddlers have an opportunity to consume partygoers’ drinks. According to Poison Control, alcohol can cause a child’s blood sugar to drop, leading to seizures, coma and even death. During and after the party, be sure to provide elevated locations for guests to keep their drinks, and to clean up drinks right away.  While we’re at it – don’t forget to appoint a designated driver!
  • Tobacco: Smoke and things that smell like smoke can put a child at risk for ear and lung infections. Cigarette butts provide additional concern as a curious child may eat them.  Ask guests to refrain from smoking in the house – provide a place to smoke outside and a flameproof receptacle so they aren’t tempted to drop them in the yard where your children play.
  • Poison control: If you think a child may have swallowed something that will hurt him or her, call the poison control hotline at (800)222-1222. Save it in your phone to make sure it is always at hand.  The poison control website also has an online tool for further guidance.

Being mindful of these hazards will help to ensure a safer and happier holiday for everyone.  Certainly, an ounce of prevention is certainly worth a pound of cure.  May you and yours have a safe and happy holiday season!

 

(Megan Hays’ pretzel cabin gingerbread house)

Healthy Holiday Harvest: Enjoying the Turkey Day Splurge in the Healthiest Way!

Posted on by Allied

By: Erica Singer, PA. Nutrition & Wellness- Allied Physicians Group

One of the most difficult times of the year for those trying to stay healthy is the fall and winter holiday season. While the holidays are meant to be a time to get together with family and friends, every party and gathering seems to revolve around food. It’s easy to take a holiday from your healthy eating habits with so much food all around! Did you know a traditional Thanksgiving meal clocks in at about 2,800 calories! That’s more than most of us need in a whole day! A cookie here, a chocolate there, washed down with some egg nog or apple cider, and before you know it your pants are a bit snug! The good news is that with a little foresight, we can stay healthy while still enjoying ourselves. To start the season off on the right foot, here are our tips for getting through Thanksgiving!

  • TURKEY TROT: Thanksgiving morning give thanks by participating in a local Turkey Day Trot or start one of your own! Getting some exercise in earlier in the day will help burn extra calories in anticipation of the big feast!
  • BE A SMART CHEF DURING FOOD PREP: Lighten things up… no one will notice!
  • Baked Turkey – choose a plain bird over a self-basting bird to lower the sodium content. To ensure a moist bird, bake un-stuffed, leave the skin on while roasting and remove from the oven when internal temperature reaches 170 degrees in the breast. Eat without the skin. To decrease the fat content, choose white meat from the breast of the bird.
  • Gravy –refrigerate pan juices to harden the fat and then skim the fat off before making your gravy. This saves around 656 grams of fat per cup! If you are willing to do without the gravy all together, skip that drizzle, as it is mostly saturated fats we can do without!
  • Candied Yams – leave out the margarine and those marshmallows! Sweeten naturally with a little apple juice or diced pineapple and flavor with sprinkles of cinnamon. Or better yet, serve baked sweet potatoes or roasted mini red bliss potatoes instead!
  • Green Bean Casserole – cook fresh green beans instead of a dish incorporating a cream soup. Top with almonds instead of fried onion rings. You can also try other green veggies too! We love roasted Brussel sprouts or asparagus. Remember to avoid the addition of extra oil or cheese in the veg you choose!
  • Mashed Potatoes – use skim milk, roasted garlic, and a little parmesan cheese instead of whole milk and loads of cream or butter. You can even offer mashed cauliflower as a healthier option too!
  • Cranberry Sauce– canned cranberry sauce is typically loaded with unnecessary sugar, despite sounding healthy. Try serving fresh cranberries without these added sugars.
  • Bread – serve smaller pieces or omit it altogether. Did you know bread is a better choice than a slice of corn bread which has more sugar!
  • Not hosting?
    • Offer to bring vegetables if you know the host/hostess typically does not offer!
    • Bring a healthy dish on your own without forewarning to avoid “No, don’t worry about it!”
  • STARTERS: Start the feast on a healthy – and filling – note. Instead of starting with dips that are high in calories and fatty appetizers, have low-calorie pre-dinner munchies available during food preparation and pre-dinner socializing.
    • hummus or low-fat ranch for dipping
    • baby carrots, cucumbers, broccoli florets and/or sliced peppers for dipping
    • edamame pods or sugar snap peas
    • mini fruit kabobs using toothpicks
    • low-fat popcorn or serve Skinny Pop pre-popped popcorn
  • HEALTHY HALF: Place bowls of different-colored veggies without sauces on the table first, either at the start of the buffet or as the first dishes passed around the table. That will allow people to cover a good portion of their plates with healthier choices before serving higher calorie foods like stuffing and mashed potatoes. Remember, to keep a balanced plate, half the plate should be fruits or veggies!
  • Serve salad. Go heavy on greens, light on non-veggie add-ins like cheese.
  • Even try a broth based soup as a starter to fill your stomach up and avoid overeating!
  • Make the vegetable side dishes the star of the show – or at least the co-star. Try new, eye-appealing and interesting veggie recipes that pack plenty of flavor without extra calories.

 

  • OMIT ADD-ONS: Make gravy and dressings a choice, not the default. Instead, serve turkey without gravy and salad without dressing. For those who want the sauces, they should add it themselves.

 

  • PROPER PORTIONS: Be mindful of served portion sizes; someone can always ask for more. After filling half your plate with healthy vegetables or salad, the remaining portions should be filled with protein and a carbohydrate:

 

  • PROTEIN: turkey, ham, beans, chicken, fish à palm sized portion
  • CARB: potatoes, sweet potatoes, stuffing, cranberry sauce, bread à fist sized portion

 

  • FRUITFUL DESSERTS: Get up and moving between dinner and dessert. Always have plain fruit options along with traditional choices. If you fill half your dessert plate with fruit, you will be full and likely to eat less of the sugary stuff! Try hard to only choose one dessert.

 

  • DRINK UP: Have plenty of water on the table and readily available. Make non-caloric beverages the default option. Avoid soda or juice on Thanksgiving. The extra calories are not needed!

 

Any way you slice it, this time of year can be challenging, but with these tips and tricks you are guaranteed to make it your healthiest holiday season yet! After all, our health is what we should be most thankful for! Wishing you a happy and healthy Thanksgiving, from our Allied family to yours!

Halloween Safety Tips

Posted on by Allied

By: Dr. Eric Levene, Chester Pediatrics (White Plains, NY)

Halloween is almost here. We are spending time decorating our homes, schools, and offices. We are planning parties for our kids as well as for parents. We are putting the finishing touches on our homes and costumes for both adults and kids.

It’s time then to remind everyone of a few safety tips so we can all enjoy the day.  It is important whether we are with our kids trick or treating or biting our nails while they are out on their own, that we keep the following in mind.

You are decorating your home, and pumpkin carving is a fun family activity. Give your child markers to draw on their pumpkin, let the adults do the carving.  Consider an electric light instead of candle to light the jack-o-lantern. Check your steps for anything a child could trip on when coming to your door. Replace any burned-out bulbs, and sweep away any wet leaves.

Some costumes take planning and time, and some children may throw it together that morning. Decorate the costumes and bags with reflective material.  Instead of a mask, us face paint or make up. Do a test patch before Halloween to make sure your child does not have a reaction to it. Make sure your child can see in their costume and they are not tripping over excess material. Sneakers that fit well will avoid many issues. If you are buying the costume, make sure it is flame resistant. Use glow sticks or electric lights in clear treat bags to allow your child to be seen better at night.

While trick or treating put the electronic devices away and look ahead. Always walk on sidewalks or paths. If there are no sidewalks always walk facing traffic. While crossing the street, remember the left right left rule when crossing. Teach the kids to make eye contact with the drivers before crossing.  Remind the younger kids no racing out into the street. Remind your older kids to stay in groups, only go to homes with lights on and never enter anyone’s home. They should have a cellphone for emergencies.

Please remind your kids not to eat any candy they have collected until an adult has had a chance to look at it.

If you are driving on Halloween night, SLOW DOWN. Kids don’t always remember the rules. Take an extra look at intersections and driveways. Remind your teen drivers to put their phones down.

Have a safe and fun Halloween!

Time to assess for asthma

Posted on by Allied

By: Robyn Kreiner M.D. and Raphael Strauss, M.D., Strauss Allergy & Asthma (Commack & Westbury, NY)

Asthma is an inflammatory disease of the airways of the lung. Symptoms are cough, shortness of breath and/or wheezing.  Note that a chronic or recurrent cough can be a symptom of asthma.

Asthma can be a chronic or intermittent disease affecting about 9% of children and 5% of adults in the United States.

How do you tell if asthma is well-controlled?

If you or your child is missing work/school or activities due to asthma or it has interfered with sleep or caused you to alter activities, asthma may not be well controlled.

Asthma should be assessed by:

  1. Symptoms: Ask questions like those in the ACT test: http://www.allergyasthmanetwork.org/cms/wp-content/uploads/2014/06/Childhood_ACT.pdf

(Keep in mind that the answers may change at different times of the year) And

  1. Pulmonary function testing for those able to do this test(usually after age 6)

Understanding the triggers of asthma are very important to controlling the disease.

Viral respiratory infections are the major trigger in young children but exercise, cigarette smoke exposure, air pollution, changes in weather and allergens are often major factors as well.  Allergy testing by an allergist can be beneficial to rule out any potential allergens in your environment that may be triggers.

There are two categories of medicine for treating asthma:
1. Relievers which treat cough, wheeze and shortness of breath immediately. The most common medication in use for this is albuterol which is available in an inhaler or by nebulizer solution. These medications do not prevent or alter the disease process.

  1. Controllers prevent symptoms of asthma. These medications make it far less likely for asthma to disrupt your life. There are many of these medications but the most effective are inhaled corticosteroids (Flovent, Pulmicort, Asmanex, Qvar). The side effects of these medications are few and the benefits can be tremendous making them an excellent choice for many patients.
  2. Combination medications include both an inhaled corticosteroid and a long-acting bronchodilator (Advair, Breo, Dulera, Symbicort) and are great for controlling asthma symptoms and the underlying inflammatory process if needed.

For those with asthma follow up every 3 months is important in order to assess control. Adjustment of the patient’s medications should be considered at every visit.

See your doctor before the Fall season and get control of asthma!

Summer is here and it’s time to go swimming

Posted on by Dr. Lisa Visentin

Summer is here and it’s time to go swimming. Recently there have been multiple news reports of children dying days to weeks after swimming with seemingly no symptoms and their death is attributed to “dry drowning”. Unfortunately, most of these reports contain significant amounts of misinformation and have caused unnecessary concern and confusion. In order to clear the confusion, we must start with some definitions. 　

The medical definition of drowning is “the process of experiencing respiratory impairment from submersion/immersion in liquid.”　(Definition of Drowning: A Progress Report. Bierens J,　Drowning 2e. Berline: Springer, 2014.) Drowning does not imply death or impairment. Drowning has only three outcomes: fatal drowning, nonfatal drowning with injury or illness, or nonfatal drowning without injury or illness. The use of other terms such as near-drowning, dry drowning, wet drowning, or secondary drowning are not medically accepted conditions and create confusion. The World Health Organization, the American Red Cross, and the CDC all discourage the use of these terms.

So what are we as parents to do this summer to keep our children safe? Prevention is key. Drowning is a leading cause of preventable pediatric death. Always closely supervise your child in and near water. Children should always be within arm’s reach when they are in or near water. At a party always have a designated adult who is supervising swimmers. Never assume that if multiple adults are around someone will see your child. Unfortunately, many drownings occur when multiple adults are present and all assume someone else is watching them.

Remember drowning is defined as having respiratory impairment after submersion or immersion in water. A child who swallows some water and coughs but symptoms resolve completely in a few minutes does not need to be evaluated. If symptoms are similar to a drink going down the wrong pipe children can be safely monitored at home. Any child who has worse than expected or persistent symptoms including coughing, wheezing, gagging, chest or abdominal pain, or seems abnormally tired should be evaluated by a medical professional. A child whose symptoms completely resolve after a few minutes will not suddenly develop new symptoms days to weeks later.

We wish you and your family a safe and happy summer!

For additional information

https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Drowning.aspx

http://journals.lww.com/em-news/blog/BreakingNews//pages/post.aspx?PostID=377

Dr. Visentin works at Allied Physicians Group – Peconic Pediatrics

Ticks and Lyme: What you need to know for your kids

Posted on by Allied

Ticks and Lyme:  What you need to know for your kids

By: Jennifer Shaer, M.D., Eric Levene, M.D., Kerry Fierstein, M.D.

There has been a lot in the news recently about ticks and tick-borne infections, particularly Lyme disease.  The CDC has warned that this summer ticks will be at an all-time high.  So what can you do to protect your kids from Lyme and other tick-borne infections?

As with most things, the best treatment is prevention.  The first and most obvious step is to try to avoid tick bites at all.  That means avoiding high grass areas, keeping your body covered, and using insect repellants.  The American Academy of Pediatrics and Centers for Disease Control recommend the use of 10%-30% DEET for all children over two months of age.  There are different types of insect repellent.  The following link discusses the differences and positive and negatives of each.  It also discusses how to apply the insect repellent safely. https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Insect-Repellents.aspx

However, despite your best efforts, a tick or two is likely to find your kids this summer.  There are many different ticks out there but it is the deer tick that can carry the bacteria that causes Lyme.   Keep in mind that an infected tick needs to be attached for over 36 hours to transmit infection.  So your second line of defense is to check your kids for ticks daily.  Don’t forget behind the ears, in the armpits, groin, belly button, and in the hair.

If you find a tick on your child, don’t panic.  Remove it immediately with a tweezer.  Do not use a smoldering match, nail polish, petroleum jelly (eg, Vaseline), liquid soap, or kerosene because they may irritate the tick and cause it to behave like a syringe, injecting bodily fluids into the wound. Don’t worry if a small piece of the tick gets left behind.  Any small pieces left behind cannot transmit disease.  After removing the tick, wash the skin and hands thoroughly with soap and water.  Not all deer ticks carry the bacteria that cause Lyme and even if the tick is infected, not all tick bites will go on to cause disease in the bitten child.  Testing the deer tick does not help predict infection and is not recommended.

Your next line of defense is to recognize the signs and symptoms of Lyme because when children are diagnosed, Lyme gets better with antibiotics.  Even if you don’t remember a tick bite your child could still have Lyme disease.  Typically it is not the tick you find that causes an infection, it is the tick that attaches, feeds, and falls off before you’ve even noticed it.  Living or visiting a high-risk area puts your child at high risk for Lyme disease.

Early signs of Lyme include the classic circular rash that you should get familiar with and generalized, flu-like symptoms.  The rash can occur 3-30 days after a tick bite.  Later signs include multiple circular rashes, joint pain and swelling, and rarely neurologic problems like a facial droop also known as Bell’s palsy.

If your child has symptoms of Lyme, see his pediatrician for an evaluation.  Making a diagnosis of Lyme with blood work can be misleading and routine testing is not recommended.   Early in the course of disease the blood test can be negative.  In addition, after successful antibiotic treatment, the blood test can remain positive for many years or may never even turn positive if the disease was treated early on.  Unfortunately, having Lyme once does not protect you from getting it a second time.  Your child’s pediatrician will help make the diagnosis and treatment plan based on a combination of a detailed history, physical exam, and blood work when needed.

Finally, sometimes your pediatrician will consider a prophylactic dose of an antibiotic after a tick bite.  If a tick has been attached to your child for over twenty-four hours, go see your pediatrician to discuss the pros and cons of this approach.  A prophylactic dose needs to be given within seventy-two hours of a bite so don’t wait too long.  This is not typically recommended for children under 8 years of age.

Thankfully most cases of Lyme in children respond very well to antibiotics.  If your child has been treated for Lyme and still feels sick, something else could be causing his symptoms.  Schedule an appointment with his pediatrician for a complete exam.

Have a great summer, enjoy the outdoors but be on the lookout for ticks!