Pediatric Physicians, PC

We know children don’t always get sick at convenient times, and sometimes you need your children to be seen when our office is closed. Though your “medical home” is with us, good after-hours care is sometimes essential. Fortunately, you have reliable choices for quality after-hours pediatric care in the Atlanta area.

Kids Time Pediatrics is an extension of our office, open weekdays in the evenings from 6-9 and on Saturday and Sunday from 1-7 (there are also special holiday hours, usually posted on our website.) At Kids Time, your child will always be seen by a board certified pediatrician—not by a “physician extender” who may not have pediatric experience. Waiting times tend to be less at Kids Time than at the other options, and with many insurance plans you’ll pay the same copay at Kids Time that you would pay at our office. Think of Kids Time as an ordinary pediatric office that happens to be open after hours, seeing the same kinds of things that we see in our office. Kids Time has multiple locations, including ones in Alpharetta and East Cobb—visit their web site for more information.

Children’s Healthcare of Atlanta (CHOA) Urgent Care Centers are in many neighborhoods. They can see any basic pediatric healthcare issue, and can also do x-rays and limited blood tests. Hours are usually 11 am-9 pm on weekdays, and 9 am – 9 pm on weekends (there are shorter hours on holidays.) Waits can sometimes be long, and many insurance plans have higher out-of-pocket expenses at urgent care centers than at our office. CHOA urgent care centers do NOT do sedation for procedures or IV fluids.

The Children’s Healthcare of Atlanta Emergency Departments at Scottish Rite and Egleston are open 24/7, 365 days a week, and are the best place for seriously ill children to be evaluated. They can handle anything, though waits can be long and visits to emergency departments can be very expensive for families.

There are many adult-oriented facilities that also offer to see children after hours, including clinics in drugs stores and adult urgent care centers. The providers working in these places are not pediatricians—they’re often not doctors at all—and may not have pediatric training or experience. We don’t think their care is up to the standards of a real pediatric facility, and we don’t encourage families to use them. Your children deserve better than a minute in a clinic.

In the table below are many common health conditions, and our initial suggestions for after-hours care. This list isn’t meant to be complete, and can’t account for every child’s individual circumstances. If you’d like more-specific guidance, please give us a call. One of our pediatricians is always available for emergency phone consultations for patients in our practice.

You can download a After hours care 2014 flyer of this document, including our care suggestions, here.

Prevention

Try to keep your local mosquito population under control by making it more difficult for the insects to breed. Empty any containers of standing water: tires, empty flowerpots,  birdbaths, gutters, and drainage pipes.

Biting mosquitoes are most active at dusk, so that’s the most important time to be vigilant with your prevention techniques. Light colored clothing is less attractive to mosquitoes.

Use a good mosquito repellent. The best-studied and most commonly available active ingredient is DEET. This chemical has been used for decades as an insect repellant and is very safe. Two other agents that are effective insect repellants are picaridin and oil of lemon eucalyptus. Other products, including a variety of botanical ingredients, work for only a very short duration, or not at all.

Consider yard sprays or traps to reduce the local mosquito population.

Treatment

After any mosquito bite, give an oral antihistamine like Zyrtec or Claritin. Typical doses are listed below. For kids who get bitten a lot, it is best to give an oral antihistamine daily, before the bites.

Apply a topical steroid, like OTC hydrocortisone 1%, twice a day. If bites are severe we may need to see your child, to consider prescribing a stronger topical steroid like triamcinolone or desonide. Do not use strong prescription steroids near the eyes.

Come see us if you are worried or there are signs of infection: pain or worsening swelling/redness/warmth that continues to get worse even 24 hours after the bite.

Antihistamine doses (these are dosed ONCE A DAY):

More about mosquito bite prevention and treatment, and why some kids get bitten more than others

There is nothing more important than the health and safety of your children. That’s why all of the physicians at Pediatric Physicians, PC have always been strong advocates of vaccinations. Making sure the children in our practice are fully vaccinated is the single most important thing we can do to keep your children and our communities safe.

This doesn’t just apply to the children who are patients in our practice—it’s just as true for the children of your doctors, and of our staff. Our doctors have 20 of their own children, and 2 grandchildren, all fully and completely vaccinated, on time and on schedule, using the same vaccines we have in our office. Our staff has a combined 52 children and 8 grandchildren, all fully vaccinated.

Unfortunately, not all children can be safely vaccinated. We see patients with immune problems, and cancer, and organ transplants—children who can’t be vaccinated. We also see special needs kids and premature babies at special risk for complications from infections. We need to do our absolute best to make sure that our office and waiting rooms are safe for all children, even those who can’t be protected with vaccines. That makes it especially important that every single child who can get their immunizations gets them. On time, to protect all of us.

What about delaying vaccines? That’s a very bad idea. It puts your child, and the other children you see in our office, at risk. And there is no evidence whatsoever that delaying vaccines makes them safer. We know that the person who came up with one delayed “alternative schedule” admitted he made it up, with no data and no science to support it. The schedule that we follow is the one backed by science. It’s safe and effective. Anything else is just making it up and hoping for the best.

At Pediatric Physicians, PC, we expect every single one of our patients to receive their recommended vaccines on time, following the established safe schedule. For children who for medical reasons cannot do this, we will of course accommodate whatever vaccines are recommended for your individual circumstance. If your child has fallen behind on immunizations, we will be happy to work with you to come up with a schedule to get your child caught up.

We encourage families to seek out reliable, honest, and science-based information on vaccines. We’ve listed some good resources below. We also encourage families to discuss questions about vaccine issues and other health matters with our doctors.

For families who’ve decided against vaccinations, we urge you to reconsider. Vaccine-preventable diseases are surging because of these unfounded fears, and you’re putting your children, your children’s friends, and the other children at our practice at risk. This is not a path we can agree on. We cannot accommodate you, and ask you to transfer your care to another pediatric practice.

Good resources about vaccinations:

Dr. Roy’s blog frequently features vaccine-related news and stories.

The Centers for Disease Control features comprehensive and authoritative vaccine information, including Q&As, information on schedules, and details about vaccine side effects and safety.

The Children’s Hospital of Philadelphia, a world-premier facility, hosts this comprehensive site, featuring Common Concerns About Vaccines, Are Vaccines Safe, and A Look at Each Vaccine.

A non-profit group, the Immunization Action Coalition, hosts this user-friendly site. Their board of directors includes the biggest names in vaccine research, and their material on vaccine-preventable diseases and sections about vaccine safety concerns are comprehensive and easy to read.

For those interested in the history and personalities behind vaccine controversies, this well-documented article reviews how one researcher’s flawed and misleading study led to the current MMR-autism scare.

Deadly Choices: How the Anti-vaccine movement threatens us all by Paul Offit. How did anyone come to view vaccines with distrust? The anti-vaccine propagandists have twisted science to scare generations away from one of the safest and most effective public health interventions in the history of mankind. You think their lies won’t affect you? Think again.

This is a “guest post” written by a mom in our practice, Marcy Parker. At her son’s recent checkup I learned that her husband has advanced throat cancer—a cancer that could have been prevented with a vaccine. This vaccine, Gardasil, is recommended for all children starting at age 11. If you’ve been “on the fence” deciding whether to get this vaccine, please read Ms. Parker’s account. Some cancers can be prevented. You owe it to your children to make sure they’re protected with this safe and effective vaccine.

 The HPV Vaccine – for Boys?

In February 2013, I sat around a table with three of my closest girlfriends, and we debated the HPV vaccine.  At the time, we all had 11-year-old boys.  While the vaccine has primarily been promoted to help prevent cervical cancer, the CDC had recently approved it for boys as well.  Which left us confused – why would we get our boys vaccinated for cervical cancer?

There were varying opinions at the table.  At the time, I was a firm no on the vaccine.  One of my girlfriends was a firm yes.  The other two were open-minded.

Exactly one year later, the four of us sat around that exact same table.  But this time, I came to the table after spending 5 hours that day with an oncologist and radiologist.  My husband had just been diagnosed with stage IV throat cancer.   The origin of his cancer?  HPV.

Since then, we’ve learned there has been a dramatic increase in the number of HPV throat cancer cases over the last decade.*  It typically hits people like my husband, otherwise healthy, mid-life people who have been in long term monogamous relationships.  My husband has never smoked.  He is an exercise fiend triathlete who eats a healthy diet.  Yet he could be the poster child for this disease.

The fact that we are living in a house with a cancer patient and a potential vaccination candidate at the same time hasn’t been lost on us.

The incidence of throat related HPV cancers is projected to overtake cervical cancer by 2020.*  By the time the CDC has enough data to promote the HPV vaccine as a preventative against throat cancer, it’s likely our kids are going to be outside the vaccination window.

During his treatment, my husband lost 34 pounds.  He spent 2 months being fed intravenously.  He has a stomach tube.  He was hospitalized for 12 days, so sick and drugged he has little to no recollection of his time there.  The treatment plan has been brutal.

After our experience, the decision to vaccinate our boys for HPV became a relatively easy one.  One of the blessings we’ve clung to throughout this process is that he has been the one fighting this disease, not our kids.  And if a three shot vaccine helps improve the odds they’ll never have to live through a similar diagnosis, it’s a shot we’re willing to take.

*SOURCE:  http://www.cancer.org/cancer/news/rise-in-rate-of-throat-cancer-linked-to-hpv. The CDC projects 26,900 cases of HPV-related cancers each year, and less than 40% of this is cervical cancer. Within a few years, it’s projected that the incidence of throat cancer will overtake that of cervical cancer. The HPV vaccine is not just for girls.

Our offices will be closed Friday July 4. As always, one of our physicians will be available for telephone consultations for emergencies. We’ll be open as usual on Saturday (Roswell- by appointment only.)

If your child needs to be seen Friday, the Kids Time Pediatrics locations have special holiday hours. The East Cobb location will be open from 1 to 4 in the afternoon, and Alpharetta from 1 to 7. On Saturday, regular weekend hours will resume.

Have a happy, healthy, and safe holiday!