Wednesday, August 27, 2014

Flu vaccine update August 2014

     The current recommendation is that everyone 6 months and above receive an annual influenza (flu) vaccine each year unless they have a medical contraindication (such as immunodeficiency or anaphylaxis to eggs). We have ordered the flu vaccine for at least 24 years. We order the vaccine the Winter before it is needed. We typically receive the FluMist (nasal spray for 2 years and above in children who do not have asthma or other high-risk-for-complications-with-influenza-illness medical conditions) in mid-August. And the flu shot typically within a few weeks later. We generally then routinely give the vaccine at visits to the office and walk-in flu vaccine clinics until our supply is gone, usually late November or after.
     Although we have ordered the vaccine in our usual way and they did not change the vaccine from last year (same 4 strains of influenza virus in the vaccine), our supply has been significantly delayed. We do not have any control over the vaccine being sent to us. We have yet to receive the injection (flu shot) vaccine -- honestly, we are grumpy about this -- especially when the large pharmacies in town have the flu vaccine. However, we are happy to say we just had our FluMist vaccine arrive today (8-27-14).
     We will update the website and Facebook page as we get updates and receive the flu shot. We still expect that our patients will be able to receive the vaccine in an appropriate time this year through our office. However, if your child has the opportunity to receive the vaccine somewhere else and needs the flu shot  -- health department, Nationwide Children's Hospital specialty clinic, or pharmacy -- that is fine.
     We will await the flu shot being available in the office before scheduling our flu vaccine clinics. We anticipate starting them September or October. 

September is the "perfect storm" time for asthma problems.

     A surprising fact for many families who have a child with asthma is that the peak month for asthma visits to the doctor's office, urgent care, and emergency department is often September. Why? It does not seem that it should be September -- the weather is still nice and the school year just started (and can the germs be that bad?). But the combination of the weed pollen season (mid August through late October), exposure to lots of germs as kids are back in the classroom, and the weather changes make September the worst month for asthma most years.
     What can you do to prevent problems? The most important thing to do is to have your child regularly take their controller medication to prevent flare ups of the asthma symptoms. Many families let their guard down at this time of the year with asthma. Many children have gotten out of the habit of using their controller medication (steroid inhaler or Singulair, most commonly). As these medications need time to work in your system (weeks), many children are more vulnerable at a time when those factors mentioned above make this a bad time of the year for asthma.
     So what to do? If your child has asthma triggered by allergies or illness (these are the big causes for the vast majority of the kids we see) and you realize your child has not regularly used their preventative medication(s), start back right now. If you want to further discuss your child's asthma care, follow-up with your pediatrician, allergist, or pulmonologist. And if you need medication refills, for both albuterol when your child does wheeze or for controller medications to prevent the asthma, call your child's doctor's office.

Monday, August 4, 2014

Switching from Summer to School Sleep Schedule.

     When the calendar turns to August, there are many things to do to get ready for the new school year. One of the many things to do is to get your kids (and possibly yourself) back on the "school schedule". For most families, this means waking up earlier and going to bed earlier. This causes some stress around most households. I know part of it in our house is the "summer is over?!" feeling.
     How is the best way to do it? Part of the answer to that question is based on the fact that most folks take about a week or two to get settled in to a new schedule. Some families do not change their schedule at all until the first day of school. I think that guarantees that for the first days of school your child will be tired. And it will take a few days or more to get settled into the new schedule.
     A better way to do it is to take 10-14 days and gradually get up earlier and go to bed earlier. It will be not so jolting for your family if you do it in 15-20 minute increments. Also, sleep specialists will tell us that the most important part is to wake up a little bit earlier each day. If you plan "well, I will just go to bed a little earlier" but you do not get up any earlier, you will not be tired enough each night to fall asleep soon after going to bed.
     So if your 14 year old is sleeping until 11 a.m. but will need to get up at 6:30 a.m. (that is what is happening in my house), note that the difference is 4 1/2 hours between when they are getting up and when they need to get up for school. If you divide that into 20 minute segments, that comes out to about 14. So if 14 days before school starts, you get up 20 minutes sooner each day and go to bed each day 20 minutes earlier, you will end up on schedule when the school year starts. Note that this means maintaining this through the weekends.
     Getting your child back on to a good sleep schedule for school will help your child get off to good start for the school year. Good luck!