2009-11-29

Advanced Pediatrics on CNN this Wednesday on H1N1

Advanced Pediatrics on CNN 
this Wednesday, December 2
on knowing when H1N1 infection
becomes serious


We are pleased to share the news that this Thanksgiving weekend the national health editor
for CNN, Dr. Elizabeth Cohen, flew with her producer and a film crew from CNN
headquarters in Atlanta to Cleveland to ask Advanced Pediatrics about how to know
if your child's viral illness becomes serious.

The segment, featuring Dr. Elizabeth Cohen of CNN, Dr. Arthur Lavin of Advanced
Pediatrics, and a family from the practice, will air on CNN in the 7PM hour this
Wednesday, December 2.

They called Advanced Pediatrics to seek our advice on specific signs parents could use to
know if a viral illness, such as H1N1 infection, moves from being a mild to a serious disease.

Readers of our web postings on H1N1 infection know that the distinction between mild and
serious illness has been the key concept to keep in mind when caring for your child with
any viral infection, including H1N1.

A family from the practice was gracious enough to open their home to the recording of the
segment, and we put together an approach built on six key signs of serious illness.

The Six Signs that a Viral Infection has Moved from Mild to Serious are:
  1. Struggling to breathe- a certain sense that it is now very hard for your child to get air in and/or out of his/her chest
  2. Stiff neck- this means you cannot move your neck, not that it is sore.  If you can move your chin to your chest your neck is not stiff.
  3. Severe pain in one area of the body- if one area of the body, such as a spot in the belly, or chest, or limb, develops severe and persisting pain, this is a sign for concern.
  4. Blue fingernail beds and lips- lips and fingernail areas should be pink, turning blue means something could be seriously wrong, unless they are simply chilled.
  5. Altered consciousness- this is happening if your child cannot wake up, has lost consciousness, or when awake seems quite odd- unaware of their name, or situation, or time.  This is not the tiredness and exhaustion of being sick.  When you are tired, you still wake up and act pretty much like you usually do when tired.  Altered consciousness always is alarming and not hard to notice.
  6. A sense that something is seriously wrong- Very importantly, even if no specific sign is present, if a parent feels that something is seriously wrong, we urge you to call.  We have almost never found that a parent felt like nothing was seriously wrong only to find out the situation was serious at that time.
Dr. Cohen at CNN will be broadcasting a segment discussing these six signs in an effort to help parents understand two key points:
  1. When to know if your child's illness is mild and not dangerous (none of these six items are present)
  2. When to know if your child's illness is now potentially serious (one or more of these six items are present).
A very strong thank you to all the families in the practice who were part of preparations for this broadcast.

Most importantly, I hope the broadcast on CNN helps further clarify just when to know your child is safe when ill, and when it is important to call us for help.

Again, the segment is airing sometime during the 7PM hour (Cleveland time) on Wednesday, December 2.

We really do hope you find it helpful.


Dr. Arthur 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.

2009-11-24

H1N1 is Here!

Our Second Shipment of H1N1 Vaccine
Has Arrived


Advanced Pediatrics is pleased to announce that just this morning,
November 24, 2009, we received our second shipment of H1N1 
vaccine.


At this time, therefore, we are opening up appointments during regular
office hours for all those interested in having their children protected from
infection from the H1N1 virus.


A few points:
  1. This shipment includes the nasal spray and injection formats.
  2. This means we can immunize from age 6months up
  3. And we can immunize those with asthma.
  4. At this time we will offer vaccine to all those who need their first dose.
On our recommendation to be immunized against H1N1 illnesses
The fall epidemic of H1N1 illness in the Cleveland area ceased about
two weeks ago.  However, H1N1 could very easily return.  Further, if it 
does return we have no idea if it may cause more dangerous.


And so, once again, Advanced Pediatrics recommends you immunize all
your children 6 months of age and older for H1N1 infections.  This is a 
reasonable if not urgent recommendation.


Bottom Line:
Advanced Pediatrics has H1N1 nasal spray and shot.
Appointments can now be made to have your child receive 
their first dose of H1N1 vaccine.
Call soon while supplies last, but we do expect more 
shipments over time, too.


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.

2009-11-23

Announcing Final Seasonal Flu Vaccine Availability


Announcing Final Seasonal 
Flu Vaccine Availability


Advanced Pediatrics has just been informed that 
the seasonal flu vaccine we have in the office
will be all that we will be receiving.

We have also just completed our last special flu vaccine
clinic for 2009 and are able, therefore, to make available
the final doses of seasonal flu vaccine for 2009.
These doses are all injection-format, we have no more
doses of nasal spray-format.

Why? As with all other medical providers, we are
limited by the number of doses the pharmaceutical
companies make each year.  

These manufacturers have informed us that they are
not going to be making any more doses of seasonal
flu vaccine, and therefore not shipping any more.

So, as of now, we have a limited number of seasonal flu
vaccine available on a first-come, first-served basis.
(We have reserved and administered a number of doses
for those with dangerously serious illness already)

Bottom Line:
1. Call now- seasonal flu shots are available, for
a very brief time.
2. We still expect many more doses of H1N1 flu vaccine,
both nasal spray and injection, to be delivered to us.
Stay tuned to these postings for announcements
of their arrival. At this moment, that shipment
has not yet arrived, so we do not have any H1N1 vaccine,
yet.
3. We apologize for all the worry, inconvenience, and
frustration this flu season's immunizations has caused.
There is no way any of us could avoid feeling worried and
frustrated when we experience the double-hit of a potentially
dangerous, widespread novel flu epidemic (H1N1) coupled with
very real shortages of manufacture of seasonal and H1N1 vaccine.

Finally, we all at Advanced Pediatrics remain very grateful for your
patience and trust as we all work together to protect your children,
to the very best of our ability.

Dr. Arthur 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.

2009-11-20

H1N1 and Seasonal Flu Vaccine- Juggling the Schedules


H1N1 and Seasonal Flu Vaccine- 
Juggling the Schedules

Some children have been immunized for H1N1 and some for
seasonal flu.  

Some have had one dose but need a booster,
some have had one dose but do not need a booster.

This is a very unusual flu immunization year, instead of getting
one immunization for influenza, now you need two series of immunizations!


We hope this guide will clear up many questions you have.

H1N1 v. Seasonal Flu
Seasonal flu is a set of usually 3 related viruses that cause illness
in the US every winter, typically appearing in full force in January,
and gone until the next winter by May. It causes colds, flus,
ear infections, sore throats, coughs, pneumonias and such.
Most years the severity is pretty much the same as the year before,
but every now and then a more severe set of viruses appears.
It always appears in the same season and goes away for the same seasons,
even though the actual strains of viruses vary a bit year to year.


H1N1 virus is a far less predictable virus. It can come and infect 
a large area anytime of the year. It has already hit Cleveland in April-
June and September-October. Who knows if it will return?
Who knows how severe it will be if it returns? It has caused serious
disease in our region, even some deaths, but our own experience
at Advanced Pediatrics is that we saw no severe or dangerous illnesses
from H1N1 this year.
This physically the same virus each time it reappears in each of its
two epidemics this year. It may be done, or it may return.

Nasal Spray v. Injection
Nasal Spray is a highly effective approach to flu immunization in children.
It can only be used if you between ages 2-50 years old, and do not have a
chronic illness like asthma.
This form can be used for seasonal flu and/or H1N1.
If you get any nasal spray flu vaccine, you cannot get the other
nasal spray flu vaccine for about one month afterwards.
For example, if you get the H1N1 nasal spray, you have to wait about a
month before you can get the seasonal flu nasal spray (and vice versa).

Injection is the old-fashioned flu shot. It can be used in anyone 6 months
of age and older, with any illness, but not if you are allergic to eggs.
You can get any injection, including the other flu shot, along with any
flu shot (i.e., H1N1 or seasonal).

Getting Flu Vaccine if you are Sick
You can get any flu vaccine if you are mildly ill. That includes H1N1 or
seasonal, nasal spray or injection flu vaccines.
Mildly ill means that you can breathe without too much struggle, your
fever is not making you very uncomfortable, you are well enough to not
need to go to the hospital, etc.
It turns out that flu vaccines will not make your mild illness worse,
and your illness will not block the vaccines from working.

When to Get the Next Flu Vaccine
If you got the H1N1 shot, when can you get the seasonal flu shot?  
Anytime

If you got the seasonal flu shot, when can you get the H1N1 shot?  
Anytime

If you got the H1N1 nasal spray, when can you get the seasonal flu shot?
Anytime



If you got the seasonal flu nasal spray, when can you get the H1N1 shot?
Anytime



If you got the H1N1 nasal spray, when can you get the seasonal flu nasal spray?
At least about a month apart.



If you got the seasonal flu nasal spray, when can you get the H1N1 nasal spray?
At least about a month apart.

The Booster Question
If you are 10 years or older, you do not need a booster for H1N1
or seasonal flu immunization.

If you have had a seasonal flu vaccine in the past, you do not need
a booster, for seasonal flu vaccine.

For those who needs a booster, keep in mind: the first dose
offers a lot of protection. The booster is a good idea, but you still
have some protection from serious illness with one dose.

In case of shortages, it is urgent and important that everyone who can
receive their first dose of flu vaccination, for H1N1 and seasonal
flu, before anyone gets a booster.

Boosters for H1N1 and seasonal flu vaccination should only be given
one month or more after the first dose.

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.

2009-11-19

Dr. Lavin in Jacksonville FL on Autism



Dr. Arthur Lavin presents a National Conference on the topic of Autism

Dr. Arthur Lavin was invited by the Infusion Nurses Society to present at their national fall meeting, the National Academy of Infusion Therapy.  Each year the Society selects topics of top interest to their 6000 members, and this year the issue of most interest was autism.

Dr. Lavin was invited to present an overview of this subject, and was brought to Jacksonville FL and invited to submit a manuscript to the Society's Journal.  His presentation on autism is now available on-line, as a PowerPoint file, at www.advancedped.com.

In his presentation, on November 15, 2009, Dr. Lavin reviews the basic elements of normal cognition with special attention to the key aspects of social cognition.  A working definition of autism and its relevant spectrum conditions is also presented.  Then a review of the controversy on whether a true epidemic is occurring, as well as the status of various treatments currently proposed.

Dr. Lavin's key points are that autism is on the rise, but we still have no understanding of its true causes.


*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.

2009-11-12

H1N1 Epidemic Slowing, Vaccine Still on the Way


H1N1 Epidemic Slowing, 
Vaccine Still on the Way

The evidence is striking, the H1N1 epidemic that
raged this fall in the Cleveland area, has dramatically
weakened.

At Advanced Pediatrics, the number of calls and visits for
flu have dropped to nearly none.
We have also been very fortunate that no one has yet
been admitted to a hospital for flus this year.

At the same time, we still expect a very large shipment
of H1N1 vaccine, in shot and nasal spray form, sometime
over the next few weeks.

The urgency of H1N1 infection has faded tremendously,
for now.

We recommend you keep checking this website, we will post
when the new doses are available.

And, that you get the H1N1 vaccine, it may yet return.

Dr. Arthur 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.

2009-11-11

H1N1 and Seasonal Flu Vaccine Now at Shaker Heights


H1N1 and Seasonal Flu Vaccine 
Now at Shaker Heights


The Shaker Heights Department of Health
http://www.shakeronline.com/services/safety/H1N1FluInformation.asp
is receiving regular shipments of both injection and
nasal spray forms of both H1N1 and seasonal flu
vaccine, every Tuesday.


Please check their website, any qualified person
can receive H1N1 vaccine or seasonal flu there,
regardless of where you live.


Dr. Arthur 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.