Friday, November 10, 2017

What happened with your flu shot supply?

     You may be asking yourself this question: what happened with Hilliard Pediatrics flu shot supply?
     I will answer that. But some background. We order the vaccine from a supplier. Most offices place their order in February to receive the vaccine in August to September. How do we determine how much we order? We look at previous years supply and use and make an educated guess. The year that FluMist went off the market, we dramatically increased our flu shot order to have enough vaccine for those who had received the flu shot and those who received the FluMist in the past.
     We have about 10,000 patients. If we gave each of the infants two doses and all the older children 1 dose a year, we would go through more than 10,000 doses a year. We do not use that many. We realize some families do not vaccinate their children with the flu vaccine routinely. Other patients receive the vaccine in other places.
     Last year, it was the second year without the FluMist. We felt like the demand in the office was steady but not high. By the end of January, we ran out of our supply and most of the families seeking the vaccine from our office received it here. Typically we run out of the vaccine between late November and early January.
     This past Winter, we placed our current order for the same number of flu shots as last year. Although we added a new doctor, our total number of patients has not changed much. We received the vaccine in August (earlier than some years) and then began vaccinating our patients. As usual, we were giving the vaccine in the office and check-ups and (were appropriate) sick visits. We also had our usual flu shot walk-in clinics. How busy each flu shot clinic is seems to vary over the years. This year, we were less busy than usual until the last few clinics where the numbers went up.
     The week before we ran out, we realized we would need more vaccine. When we called, we were initially told we could order as much as we needed. After discussing in the office, we called the next day to be told the previous days information was in fact not true -- they could not supply us with any further vaccine.
      We have been asked why we do not hold back vaccine for the youngest of patients who need a second dose. We do not do that. In fact, we could not as we believed up until the last minute that we could order more vaccine. And we fully intended to order more. There other logistical issues with holding back vaccine to give to someone else.
     So what about next year? Surely we will order more vaccine. But we have found that each year has its challenges. We appreciate that many of our patients are able to and do receive the vaccine in the office each year.

Monday, October 23, 2017

Children with Easy Bruising Who Take Fish Oil Supplements

     We are asked regularly about children who bruise easily. If children have impressive bruises that occur after minor injuries, we will likely ask about your child's history with other issues that make us worry about a bleeding disorder. These questions include:
     Does your child have easy bleeding with minor mouth injuries or teeth cleaning?
     Does your child have frequent or hard to stop nose bleeds?
     Has your child had excessive bleeding after minor procedures?
     Does your child pass blood with a bowel movement?
     Has your child had painful, swollen joints after minor injuries?
     What medications or supplements does your child take?

     A combination of history and physical exam can prompt us to do screening labs or a referral to the hematologist at Nationwide Children's Hospital. Other histories and physical exams are reassuring.

     On a personal note: I spoke with my eye doctor in the last year about my eyes being dry. I had already tried some other remedies, so my eye doctor recommended that I try taking fish oil supplements. I began taking Occuvite and noted only so much improvement. I then switched to a higher dosed supplement, this time Member's Mark Triple Strength Wild Alaskan Fresh Fish Oil Softgels with 900mg of Omega 3. At my annual check up last week, I mentioned my easy bruising this year and the first thing my doctor said was "It is those Omega 3 supplements you take!". So now I am weighing the "eyes less dry" with the "easy bruising" tendencies.

     So a good thing to know is that fish oil/omega 3 supplements can increase the tendency to easy bruising. If your child is regularly taking these supplements, let your doctor know this if they are going to have surgery or if they have been prone to easy bruising.

Friday, August 25, 2017

Safe Sleep for Newborns and Beyond

     My oldest son is now 22 years of age. Back in 1990's, the cribs had wide enough slates that it was possible to get an arm or leg stuck between the slats. This prompted it to become nearly universal to use bumper pads to keep the arms or legs getting stuck and to pad the area so an infant would not "get hurt".
     This was not the safest sleep environment. We know now that there were more cases of SIDS and injured arms and legs with that setup. Now the slats are close enough to prevent these issues and it is recommended to not use any bumper pads. The chairman of the Consumer Product Safety Commission, Elliot Kaye states "I reiterate my belief that the public should stop using padded crib bumpers. The overwhelming evidence show that they do nothing more than contribute to the deadly clutter in many of our nation's cribs. Based on the real risk they present, it is a mystery to me why they continue to be sold." I agree.
     The Ohio legislature recently passed a law, Sub Senate Bill 332. It includes a bumper ban. I believe it goes into effect at the end of 2017. The law prohibits the manufacture or sale of non-mesh crib bumpers. The law allows for the sale of mesh crib bumpers for the next 3 years. The law will then ban the mesh crib bumpers if the Consumer Product Safety Commission (CPSC) has not created safe standards for mesh crib bumpers.
     "Bumpers are unnecessary and pose a real risk to the safety of infants." - Dr. Sarah Denny, Nationwide Children's Hospital.
     For more information about safe sleep for infants: here on the Ohio AAP website.

2017 Flu Shot Walk-In Clinic Dates and Times

     It is the flu shot season! We have a good supply this year of the flu shot. We are announcing the dates for walk-in flu shots for Sept.-Nov. 2017. Depending on the supply, we will schedule further dates in the Fall. We have shifted the weekday clinic date to Wednesday from Thursday (to accommodate our exam room needs in the office).
     Wednesday clinics are from 2-5 p.m. Saturday clinics are from 9 a.m.-12 noon.
     Wednesday dates: September 13, September 27, October 11, October 25, and November 8.
     Saturday dates: September 23, October 7, October 21, November 4, and November 18.

     We occasionally have to cancel/reschedule dates due to our supply of the vaccine. We will announce on the Hilliard Pediatrics Facebook page (maintained by Dr. Tim) if that occurs.

Monday, August 21, 2017

Solar Eclipse Safety

     Here it comes! The solar eclipse! Exciting as it is a fairly rare event. Now let us experience it safely!
     I love the Healthy Children website. Here is their article about safely enjoying the solar eclipse. Here is an article about eye safety during a solar eclipse from the American Academy of Ophthalmology.
     Be safe out there!

Friday, August 18, 2017

Car seat and car safety website

     I became aware of a very nice, accurate website recently. It is maintained by the National Highway Traffic Safety Administration. It has lots of resources regarding proper car seat use, safety tips for teen driving, and other safety information regarding cars. The website can be found at the Safer Car website.

Tuesday, August 15, 2017

Nationwide Children's Dublin Urgent Care has reopened.

     Due to staffing issues, Nationwide Children's Hospital's Dublin urgent care was temporarily closed for some months. As of August 2nd, 2017, it has reopened.
     We recommend using Nationwide Children's Hospital facilities when your child needs an urgent care or emergency room.
      The hours for the Main Campus (downtown) and Lewis Center Emergency Departments are 24 hours a day, 7 days a week. The Hilliard and Dublin (the two closest to our office) Urgent Cares are open Mon.-Fri. 3-10 p.m. and Sat.-Sun. 12-8 p.m.
     Laboratory and x-ray services are available as walk-ins with a doctors orders at both the Hilliard and Dublin locations. Laboratory hours are Mon.-Fri. 8:30 a.m. - 10 p.m., Sat. 9 a.m. - 8 p.m., and Sun. 12-8 p.m. X-ray services are available at both locations Mon.-Fri. 8:30 a.m. - 10 p.m. and Sat.-Sun. 12-8 p.m. Of note: patients needing TB screenings (often for volunteering, work, or college) can be seen from 3-7 p.m. everyday with no appointment needed at either the Dublin or Hilliard Close to Home Centers.
     As always, further information is available at