H1N1 FluMist ONLY Now Available at Advanced Pediatrics

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H1N1 FluMist Only

Now Available

Advanced Pediatrics is pleased to announce 

that we now can make H1N1 flumist only

now.

We DO NOT have H1N1 injections yet.

Flumist is the nasal spray form of the vaccine.

H1N1 flumist can only be given to children who:

1. are 2 years or older
2. Do not have asthma, chronic illness.
3. Do not have compromised immune system.
4. Are not allergic to egg.

Advanced Pediatrics has decided to immunize

all the children in the practice first.  No parent 

will be offered this vaccine until all the children

are immunized.

Two Influenza Virus Epidemics

In the 2009-2010 influenza season, we are 

facing two epidemics:

• H1N1, which is NOW
• Seasonal influenza, which is due in January

Priority to H1N1

Given that H1N1 is our current epidemic, we are 

giving priority to this vaccination, especially now 

that we have it.

All Flu Vaccine Clinics will now be devoted

to H1N1 vaccination 

So, if you have an appointment for influenza 

immunization in October, our recommendation is that 

if you are over 2 years old, and have no chronic illnesses,

that you receive the H1N1 vaccine now, and the 

seasonal flu vaccine at a later time.

We will be setting up new times to accomodate

the two flu vaccine needs.

Anyone who gets Flumist for either flu must wait

3 weeks before getting the other.

That means if you got Flumist for seasonal flu, you

must wait 3 weeks before getting your H1N1 Flumist,

and vice versa.

BOTTOM LINE:

1. We have H1N1 Flumist
2. You have to be 2 years or older to get it
3. You cannot have it if you have:
1. asthma
2. active chronic illness
3. immunosuppression
4. For the next few weeks you should get H1N1 before you get seasonal flu vaccine
5. Seasonal flu virus does not appear until January, so we have time, and supplies, to do both.
6. Additional times for flu immunization are being set up now.
7. Shipments of H1N1 vaccine are coming in separate parts.
8. We will have a reserve of vaccine for ill children.
9. For healthy children, H1N1 vaccine will be scheduled on a first come, first serve basis, until all doses on hand are scheduled.
10. We will not make any appointments for any vaccine we do not have in stock.

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

The Epidemic is Here

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The Epidemic is Here


All indicators are that the Greater Cleveland area is now fully
blanketed with the H1N1 (swine) influenza virus.

The virus is causing, in nearly all cases, a mild cold illness.
Symptoms typically include: fever, headache, stomach ache,
body achiness, runny nose, sore throat, cough, and sometimes
diarrhea.

Infections from this virus are now very, very common, nearly
every family will see someone in the family, or someone they
know come down with it.


Guidance:
1. The key thing to be sure about is not whether you have H1N1
infection.
2. The key thing to be sure about is how sick you are.
3. Mild illness is safe to have whether you have H1N1 virus, or not.
a. If you have mild H1N1 infections, Tamiflu does not work work well,
so there is no need to test or to treat.
b. If you have mild H1N1 infections, treat them like you would any cold,
with comfort measures.
4. Serious illness is present if breathing into the chest becomes a struggle,
if you get a stiff neck, if you have altered consciousness, or if you look
very ill:
a. Whenever you get seriously ill, call us or 9-1-1 immediately.
b. If you are so ill you need hospitalization, then the very weak, mild
improvements seen with Tamiflu become helpful and we will
test for H1N1 and treat it.


BOTTOM LINE:

• H1N1 is here
• Mild illness looks like, and is an achy cold
• Mild illness requires no medical intervention
• More importantly, look for serious illness:
• Serious trouble getting air in your chest
• Stiff neck
• Change in level of consciousness
• A sense that the illness is very severe
• If you think you may have serious illness
• call us right away.

Dr. Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

SOME GOOD NEWS ON FLU

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SOME GOOD NEWS ON FLU


Everyone should know that in the midst of all the concerns about
influenza, flu, H1N1, swine flu, shots, flumists, nasal sprays, live
vaccine, inert vaccine, and boosters that there are some
very good items of news to share:


No Serious Illnesses so Far
As of October 16, 2009, Advanced Pediatrics has seen
NO serious cases of flu. NOT ONE child has been
admitted to the hospital for a case of flu so far this year.


Plenty of Vaccine so Far
We have ample supplies of seasonal influenza vaccine,
both shot and nasal spray form.


We will have H1N1 vaccine in the coming weeks.
We are a registered H1N1 vaccine site and should hear soon
when and how many doses we will receive.
Only once we have this information will we be able to set up
H1N1 immunization appointments.


BOTTOM LINE
We are actually weathering this influenza epidemic very well.
We have plenty of immunization material for seasonal and will have some
for H1N1 as well.


The only challenge we face today is that we need to be ready to
set up a schedule for offering H1N1 as soon as we receive the
material. This is the only reason we are holding on new appointments
for any flu vaccination: 
to avoid the need for unnecessary duplicate appointments and
re-scheduling.


Dr. Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

MILD versus SERIOUS ILLNESS

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MILD versus SERIOUS ILLNESS:
or, Knowing When to Worry
and Knowing What to Do


As our nation and community encounter and try to deal with the very
serious epidemic of H1N1 (swine) influenza virus, it makes sense
to take a moment to think about how do you know, when your
child gets sick, when to worry and what to do?


It turns out that the best guide to knowing when to worry and
to know what to do is not the name of the virus.

That is, finding out if the virus causing your child's illness is H1N1
or not, does not help you know how worried to be or what to do.

The key item you need to know is how sick your child is, not the name
of the virus.

So how do you know how sick your child is?

The answer is actually fairly easy, since there are only two possible
answers: mildly ill or seriously ill.

Symptoms of Mild Respiratory Illnesses:

• Fever (100.8-105.8)
• Runny nose
• Sneezing
• Congestion
• Cough
• Sore throat
• Achiness
• Feeling tired
• Trouble sleep
• Decreased appetite

Symptoms of Serious Illness:

• Struggling to get air in and out of your chest
• Alterations in consciousness
• Stiff neck
• A "sense" that something very terrible is happening

Use the above symptoms to tell you how worried to be.

Mild illnesses, even if caused by potentially dangerous germs,

are still mild illnesses.

If you child only has mild symptoms of illness, and no symptoms of

serious illnesses, you have little to worry about.

Of course, should symptoms of serious illnesses ever develop,

one has alot to worry about.

What to Do if You Have A Mild Viral Illness

It turns out that medical science has very little to offer that would

actually make a difference to someone with a mild viral illness.

Antibiotics do not work.

More to the point, antivirals do not work very well either for mild

influenza infections.  

So the use of Tamiflu is not recommended for use in mild viral
infections, it does little good, and could lead

to the drug not working if you really need it.

What you can do is to keep your child comfortable:

lots of fluids, lots of hugging, lots of distractions (videos),

perhaps ibuprofen or acetaminophen if fever or pain is

bothering them.

What to Do if you Have Symptoms of Serious Illness

Call us immediately.

If severe enough, call 9-1-1 first.

If severe enough, we will recommend immediate evaluation in an ER.

Once at the ER, if tests reveal influenza is present, Tamiflu will be used.

If influenza is not present, then the cause will be sought and treated.

BOTTOM LINE

H1N1 (swine) influenza virus is potentially dangerous, like almost all

germs.

The rules for knowing when to worry and what to do are the same for

H1N1 (swine) influenza virus and all other viruses.

If you have mild illness, you are in no danger, and should be treated with

comfort measures.

If you have serious illness, you should seek immediate medical care. It is

only serious infections with H1N1 (swine) influenza virus for which

Tamiflu is helpful.

Dr. Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Thank You From the Rose Garden

Thank You From The Rose Garden

Dear Families,

As some of you have heard, I was invited to represent the State of Ohio in the Rose Garden at The White House on October 5, 2009.

The event was an address by President Barack Obama, letting the country know the extent of physician support for reform and calling on all doctors to let everyone know the historic extent to which this support has reached. As of now, for example, the AMA has endorsed reform for the first time in its history, 525,000 out of

700,000 doctors belong to such organizations that have endorsed reform, and the New England Journal of Medicine has published data that show about 75% of US physicians when polled individually support reform.

It was a singular honor to represent Ohio doctors in the Rose Garden and a thrilling

moment in my life. After clearing White House security, we were greeted with the

beautiful music of the Marine Corps brass band, in full dress uniform.

Soon afterwards, we were escorted along the Southern entrance of The White

House, into the Rose Garden. I was able to sit in the second row, near the center

aisle, about 15 feet from the President.

As I watched President Obama come out of the Oval Office and then address us

directly, and via the cameras surrounding us, the nation, I was moved by his

evident awareness of the suffering our current health care system causes-

both physically and financially.

I also noted that a surprising proportion of the 50 doctors representing the

country were practicing physicians, from practices similar to Advanced

Pediatrics- privately owned, often small 2-3 doctor offices. They represented not

only pediatrics and family practice, but a wide array of specialties as well. None

were chosen for their titles or positions in an organization.

And that is why I write this posting as a thank you note. Not everyone agrees

with the current health care proposals, almost no one supports every provision

in them, but a very broad agreement has emerged that something needs to be done.

So my thank you, is for your trust in myself, Dr. Hertzer, and Kelley. We are daily

reminded of the critically valuable nature of that trust, and the importance of our

response to it. This is the center of what medical care is all about, and it was

physicians whose careers are centered on this trusting provision of care who were

chosen to represent their states. And so thank you, for it was your trust that led

to my opportunity to be there.

And of course, all the more importantly, thank you once again for your trust which

allows us to try to practice the type of medicine that will truly be responsive to

your very real concerns and needs, and will hopefully make a real difference in

your children's lives.

Thank you,

Dr. Arthur Lavin

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*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

Another Inconvenient Truth

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Another Inconvenient Truth: Booster Seats Should be Used

There are now two reasons for all people who weigh more than 40 pounds

AND are shorter than 4 foot nine inches to be in a booster seat in a car:

1. It really could save your life.
2. It is now the law in the state of Ohio.

Seats used in cars at any age are not "infant" or "baby" seats. They

have nothing to with being young.

These seats exist for only one purpose, to physically provide a framework

so that a seat and shoulder belt will work.

Nearly all cars are designed for adult-sized people, and so those less than

4 foot nine inches tall need a device to have a seat and shoulder belt work.

All people in a car need to have their pelvis held by a seat belt

and their shoulder held by a shoulder belt.

The reason is that if your pelvis and shoulder are held snugly, the chance

of serious injury during an accident is dramatically reduced.

And so various devices have been made for various sized people, all with

the one purpose of holding the pelvis and shoulder snug while in a car.

• For young infants, the device holds infants 3-20 pounds backwards.

• After one year of age AND being 20 pounds, the device should be
• designed to hold 20-40 or 20-60 pound children facing forward.

• And once you outgrow the 20-40 or 20-60 pound device, you should
• be in a booster seat until you are at least 4 foot 9 inches tall.

In the case of the booster seat, if you are over 40 pounds and shorter than

4 foot 9 inches, your chance of serious injury happening in a car accident

is reduced if you are in a booster seat by 59%!

That means proper use of a booster seat prevents over half of all serious injuries from

car accidents.

There was a time when seat belts, then shoulder belts, then infant car seats were

shunned as inconvenient. Now they are routine.

It is time for us to have all our children who weigh more than 40 pounds and are less

than 4 foot 9 inches tall be in a booster seat when riding in the car.

Dr. Lavin

*Disclaimer*
The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

H1N1 Influenza (swine flu) Immunization: Update for Sept 22

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H1N1 Influenza (swine flu) Immunization:

Update for Sept 22

We now have news to report on the H1N1 Influenza (swine flu)

immunization. Please note that this immunization program is

being designed by the US as an emergency program. We do

not order vaccine, the government distributes it. It will not be

available in the usual office appointment fashion, but more

as a special set of times once the facility that receives it has

it in hand. With all that in mind, here are the most recent facts:

• The immunization will come in nasal spray and shot form
• Children ages 10 and up need only one dose
• Children ages 6months through 9 years need 2 doses
• A regular flu shot and the H1N1 Influenza (swine flu) can be given on the same day
• Not so for regular flu nasal spray and H1N1 Influenza (swine flu) vaccine
• The H1N1 Influenza (swine flu) vaccine is made in the same way as the regular flu
• This means it should have the same, excellent safety profile

At this time, we still do not know if the H1N1 Influenza (swine flu) immunization

will be given via offices such as Advanced Pediatrics, or via schools.

We also should note that the H1N1 Influenza (swine flu) infection is now in

Cleveland. So far, it remains a very mild infection, of very little concern

medically, except for pregnant women and the very ill.

Please stay tuned for further updates. Within the next few weeks, the final

distribution of the H1N1 Influenza (swine flu) immunizations will be made and

we will know how many doses we will be given. No practice can purchase this

immunization, each will be assigned a fixed number.

Once that distribution is decided and we know how many doses Advanced

Pediatrics is to receive, we will know exactly how we will be offering

the H1N1 Influenza (swine flu) immunization, and will let you know as well.

Dr. Lavin

*Disclaimer*

The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.