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The common cold is all too common, and parents here at Growing Child Pediatrics often want to know how to best help their children get well. Even if you’re not currently fighting colds at your house, here are five things you should know before your children get their next cold.

1) There really is no cure yet

We have identified the viruses associated with the common cold, but we still do not have a way to cure it. This does mean that, to some extent, you will have to endure a cold until the end. Furthermore, colds are also still very common.

2) Modern allergy medications do not help with cold symptoms as well as some older medications

When a cold sets in and a child starts sniffling or coughing, the instinct for many parents is to give their children an allergy medication like Allegra, Zyrtec or Claritin. The thought is that these medications will help dry up their child and help them make it through the day. Unfortunately, however, these newer medications have not proven as effective as some older medications at minimizing cold symptoms. In the past, we would give children medicines like Dimetapp, Triaminic, or Benadryl, and those actually did more to help children’s symptoms, but would they make children drowsy. When everything is taken into consideration, the non-drowsy medicines are probably the best daytime options.

3) Some of your grandmother’s remedies actually work

If your child has a cough, take the advice your grandmother gave you. Drink lots of fluids. Stay hydrated. Drink something with lemon, honey, or some tea if you need help soothing the cough and relieving some of your child’s cold symptoms. When your child has a cold with no cure, anything to help minimize the suffering is a good idea.

4) Homemade chicken soup helps boost immune systems

If you thought that chicken soup was comforting when you were growing up, you were on to something. In very controlled studies, researchers have found that homemade chicken soup with extra garlic and onion is actually an effective immune system booster. Please note, however, that this is the case for homemade chicken soup. Not every can of chicken soup you purchase at the store will necessarily have the same immune system boosts for the common cold because the ingredients can vary significantly. If you have the time, go ahead and make your soup fresh.

5) Many doctors recommend stopping dairy

Dairy can produce and thicken mucus, and many doctors recommend that children hold off on dairy for at least a day when they have a cold. If you are trying to help your child dry up, dairy can be a hindrance. Note that milk is an especially important dairy item to stop for a short time.

While no one can avoid the common cold entirely, we hope that these five facts will help prepare your family to get well quickly next time someone comes home from school with a cough.

What do you do if you have allergies in raleigh-

Allergy season can be difficult on families. In our last post, we wrote about some of the lesser-known keys for families to keep in mind in allergy season. Today, we want to give you three steps to effectively treating your child’s allergies.

First, you can give an antihistamine as a step.

This can be an appropriate first step for someone who thinks they are having trouble with allergies. You can buy an effective antihistamine over the counter at your local pharmacy, and this could potentially help with many of your child’s symptoms.

However, do keep in mind that allergens can cause a reaction that produces more than 30 chemicals (more about allergies at our previous post), and histamine is just one of those chemicals. This means that an antihistamine can only help with some of your child’s allergies, and it is not necessarily a cure-all.

Second, if your child’s allergies are persisting, go see your pediatrician.

We cannot help you overcome your allergies without knowing what the allergies are. Some indoor environmental allergies can be removed lowering the reaction to outdoor allergens. That’s why Growing Child Pediatrics uses an appropriately sensitive allergy test. Allergy tests have advanced over the years, and the ones we use help us get a good understanding of what allergic reactions your child is having. After that, we can help develop a treatment plan.

Additionally, your healthcare provider will be able to explore whether there is anything other than allergies affecting them. It is possible that what we think are allergies are actually another issue.

Third, take and keep notes about your allergic reactions.

How do your child’s allergies compare to last year? Did they flare up at the same time? How were they feeling? Most of these questions are hard to remember after 12 months of life. That’s why we recommend writing down how their allergies affect them in the moment.

You can simply write these down on a notepad if you’d like, but we would recommend a digital note-taking application. Evernote™, for example, is a free option that allows you to easily make notes from any device. If you find yourself wondering in a year how their allergies were in the past, you can easily search through your digital notebooks to find what you wrote about their allergies. This will be helpful both for you and for the team at Growing Child Pediatrics.

Perhaps today you need to schedule an appointment with your Growing Child Pediatrics location. We hope to see you soon!

Allergies in Raleigh Durham

Each spring we at Growing Child Pediatrics get questions about allergies. This makes complete sense. After all, many children wrestle with allergies, but most of us have never studied the inner workings of allergic reactions. Try understanding these four keys about allergies to learn how to better serve your child this spring.

The Raleigh-Durham Triangle really is one of the worst regions of the entire country for allergies.

While the yellow clouds of pollen that bombard our region every spring may have given this away, we really are in a bad location for allergies.  There are a number of reasons for this, but the main point is that allergies may be impacting your family.

Your body produces more than 30 chemicals in response to allergens.

When different people come in contact with different allergens (mold, pet dander, dust mites, etc.), their bodies can produce more than 30 different chemicals. These chemicals each have different effects on people.

For example, most people know that if you have allergies, an antihistamine can help resolve some of your symptoms. This is because histamine is one of these more than 30 chemicals your body may produce. If you have a runny nose (which histamine can cause), and you take an antihistamine, you may find that your symptoms decrease significantly. The histamine in your system is being addressed by the medication. However, if you are experiencing congestion (which histamine does not cause), taking an antihistamine may not address all of your symptoms. You may need to look at other options with your pediatrician for treating your allergies at that point.

Indoor and Outdoor allergies are both seasonal.

Many patients don’t know this, but both indoors and outdoor allergens have seasons. During the spring you have probably guessed that many outdoor allergens are in season. Yet some allergens, like dust mites, are actually in season during the winter months. We close up the house and turn on the heat, and that means that dust mites can flare up.

Current allergy tests are more appropriately sensitive than some older allergy tests.

The modern blood tests that Growing Child Pediatrics uses in their various locations are fantastic. New technology developments in recent years mean that we now are able to test for allergies in a way that gives great results. Consider the following example:.

If you were to come in to get an allergy to grass tested in past years, your test would have likely tested for 4-6 kinds of grass.  However, the tests were so specific that only if you were allergic to that strain of grass would the test be positive. If you were allergic to a ‘cousin’ kind of grass it would be negative. But the current test that Growing Child Pediatrics uses would show allergy to some of the similar grasses that would have tested negative in the past. Here, less specific is better so that we can better serve your allergy needs.

So, how do we address your child’s allergies?

Next week, we’ll help you think through a good action plan for making progress in treating your family’s allergies. Until then, feel free to comment below: what other allergy questions do you have?

Growing Child Pediatrics

Dear Patients,

Please note the recall for the following EpiPen and EpiPen Jr. products prescribed from 12/17/2015 through 7/1/2016 (Product/Dosage, NDC Number, Lot Number, Expiration Date):

  • EpiPen Jr Auto-Injector, 0.15 mg 49502-501-02 5GN767 April 2017
  • EpiPen Jr Auto-Injector, 0.15 mg 49502-501-02 5GN773 April 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 5GM631 April 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 5GM640 May 2017
  • EpiPen Jr Auto-Injector, 0.15 mg 49502-501-02 6GN215 September 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM082 September 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM072 September 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM081 September 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM088 October 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM199 October 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM091 October 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM198 October 2017
  • EpiPen Auto-Injector, 0.3 mg 49502-500-02 6GM087 October 2017

For further assistance, EpiPen users can contact Mylan at 800-796-9526 or email customer service at customer.service@mylan.com.  EpiPens are made by Meridian Medical Technologies, a subsidiary of Pfizer.

More information about today’s announcement is available at the FDA website.

nurse practitioner North Carolina

Representative Cynthia Ball, District 49, accepted our invitation and visited Growing Child Pediatrics and FastBraiin, our professional ADHD treatment provider, to discuss House Bill 88. The Modernize Nursing Practice Act is an important legislative update and would provide full practice authority for Nurse Practitioners across North Carolina. Passage of the bill will eliminate costly and unnecessary physician supervision requirements and improve access to care.

Growing Child Pediatric and FastBraiin Centers pioneered the Nurse Practitioner role in primary care in the Raleigh area, and we currently employ 16 Board Certified, Nurse Practitioners at our six locations. Our Nurse Practitioners are exceptional clinicians providing high-quality, evidence-based, comprehensive, pediatric primary care. We support our Nurse Practitioners and request our legislative representatives vote YES on House Bill 88.

According to the National Institutes of Health (“NIH”), a Clinical Study is medical research that involves the use of human volunteers (called study “subjects” or “participants”). The research is intended to add to medical knowledge, improve therapies and lead to better medical outcomes.  There are two main types of clinical studies: clinical trials and observational studies.

Evidenced based medicine requires thorough documentation and review of existing and new or evolving therapies. But in order to prove new treatments are safe and effective, all medications, medical devices and medical procedures have to undergo medical research.  This is where and how the Clinical Studies program at Growing Child Pediatrics, PA gets involved.  The program is crucial to making advances in medicine and aiding the care of our patients.

In the United States, clinical trials are offered to adults, adolescents and children with a wide range of conditions and illnesses. These studies are regulated by the FDA and governed by an Institutional Review Board (“IRB”) comprised of doctors, researchers and members of the community.  The IRB’s role is to make sure that the study is ethical and that the rights and welfare of participants are protected.

But why do studies on kids? As I am sure any middle aged parent has realized…..children and adults differ in physiological capabilities and metabolisms as well as the severity and type of disease and the average healing time.  Moreover age, growth and development influence side effects and the dose of medications is often dependent on body size or weight.  These differences often overwhelm the ability of modern science and researchers to correctly predict the effect on young people solely by extrapolating of data from studies of the adult population.  Simply put, it would be unethical to treat large numbers of children using treatments, the effects of which were only studied in adults.

Participants (and the parent/guarding’s) understanding of the purpose, methods, risks and consent is the cornerstone of protection for human subjects, especially when the research participant is a child. Parents are expected to act in the best interest of their child and hence have been entrusted with the responsibility of providing permission/approval for enrolling their children in a research study.  This process is called Informed Consent and it is how every volunteer begins their study participation with the GCP team.

2015 Duke Quality Improvement Project on Sleep and Reducing ADHD Symptoms

Last year, we were fortunate to be the primary clinical site for a Duke University School of Nursing study into the benefit of a provider-instructed, sleep hygiene routine which addressed the impact of screen time (from TVs, computers and mobile devices) on sleep in children, ages 5-11 years, affected with ADHD. The quality improvement project utilized a pre-posttest design to evaluate the effects of the sleep hygiene routine on sleep duration, ADHD symptoms and family quality of life.  The detailed results of this study will be published later this year.

2016 Pearson Quotient iPad Study

Currently, GCP is working with NCS Pearson on the Quotient iPad Normative Database study. This study is being conducted to create a database for the new Quotient® System iPad Test. Using a representative cross-section of ages, genders and ethnicities of healthy subjects (called “community sampling”), the results of this study will be compiled to create a baseline dataset against which the results of future clinical Quotient tests may be compared.  Down the road, a patient’s performance can be determined by comparing their actual results relative to this baseline for a specified developmental age and gender.  It is believed that this will be an effective, objective diagnostic tool to help providers assess a number of mental diagnoses.

Those wishing to participate (after a short enrollment pre-screening), will provide written informed consent, answer a brief self-assessment questionnaire and then complete the 15 minute Quotient test. The study will be open to healthy individuals between the ages of 6 and 80 years of age.

If you or your child would like to participate in any of our academic or clinical studies, know that you will be under the care of Growing Child’s providers, specialty-trained nurses and other professional research staff. All studies are completely voluntary and you can discontinue participation at any time.

If you would like further details, please contact Molly Milani at 919-488-0015 x 1213 or send an inquiry to Study@GrowingChildPediatrics.com.

For additional links and information:
US Clinical Trials Database   www.ClincialTrials.gov
National Institutes of Health    www.nih.gov

Jeff T Goller, CPA –  Chief Financial Officer of Growing Child Pediatrics, PA

Along with spring time, come the bees. Imagine… It’s a beautiful, warm and sunny day. Your children are laughing and playing outside. All of a sudden you hear a scream! Someone has stepped on a bee and was stung. You are listening to your child crying in pain while trying to figure out what to do to help. As a nurse that has taken her share of triage calls about bees, I can give you some tips to help along the way.

First, if your child has a known bee allergy, please follow the advice your provider has given you for when your child has been stung. If your child has no known bee allergy, then priority one is to calm the situation. Tell them they have been stung by a bee. Give your child a big hug to assure everything is going to be ok, because you are going to help.

Second, it is useful to count the number of stings your child received. If there are more than 5, please call our office for advice.

Third, look for the stinger at the site. If it is still attached, remove it using a fingernail or credit card edge. You may apply a paste made by adding a small amount of water to either meat tenderizer or baking soda. If neither of these is handy, you can try an aluminum-based deodorant. Either way, apply and leave for 20 minutes. As a backup, a 10 minute cold compress of ice can also be helpful.

You may give Tylenol or Motrin if the sting continues to hurt. If the sting becomes itchy, you may give an antihistamine oral dose or you may apply hydrocortisone cream to the affected site. Please call the triage line for dosing amounts if dosing instructions are not available. Please note that the pain can last for 1-2 hours. Itching usually follows. You will normally see redness and swelling at the site that may increase for up to 24 hours after the sting. Redness may last for up to 3 days and swelling for up to 7 days.

Call the office if the sting looks infected. Infection symptoms include streaking, swelling and/or redness that increases or doesn’t start until 24-48 hours after the sting. The first 24 hours is due to venom.

Anaphylactic (allergic) reactions will always occur within 2 hour period of the sting. If you see any of these symptoms, call 911. Symptoms include difficulty breathing, cough, tightness in throat or chest, difficulty swallowing, speech or thought confused and fainting or too weak to stand. Also, hives may come before an anaphylactic reaction. If you see hives with no breathing issues, please call the triage line for advice.

At Growing Child Pediatrics, our triage nurses are always here for you. Don’t forget, if you have any questions about bee stings to vaccines to sun screen, please keep our Triage Line in Mind.

Tammy Seagroves, RN Clinical Director
Resource -Barton Schmitt- Pediatric Telephone Protocols: Office Version