Christmas and New Year Holiday hours

Have a safe and happy holiday season! We’ll have special hours for Christmas and New Year’s Day. As always, one of our doctors will be available after hours by phone for emergencies. You can also use our portal to contact us for NON urgent issues.

Our offices will be open on Christmas Eve 12/24 and New Year’s Eve, 12/31, by appointment only, in the mornings. Please call for an appointment if your child needs to be seen. We cannot “squeeze in” walk-in patients during this busy time. We will be closed Christmas Day 12/25 and on New Year’s Day 1/1/2019.

Kids Time After Hours Pediatrics is the best choice for routine pediatric care when our offices are closed. They have locations in Alpharetta, East Cobb, and Sandy Springs. For more information including their holiday hours, visit their web site.

Children’s Healthcare Urgent Care Centers will be open on Christmas Day and New Year’s from 9 am to 7 pm, and of course the Children’s Emergency Departments at Scottish Rite and Egleston are always open, 24/7.

Visit this page for more information about the best resources for after-hours pediatric care in the Atlanta area, including examples of what kinds of problems are best handled at Kids Time, Urgent Care, or the Emergency Department.

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Welcome Dr. Reanne!

We’re excited to announce a new pediatrician joining our practice — Dr. Reanne Stephansson! She’ll start seeing patients at our Windward office in January.

Dr. Reanne was born in the Philippines, moved to the United States when she was five years old, and spent most of her childhood in Dalton, GA. She attended the University of Georgia, where she met her husband, Erik. She was a member of Phi Beta Kappa Honor Society and graduated Magna Cum Laude with high honors in Microbiology. Dr. Reanne conducted research on Salmonella at the CDC for two years prior to attending Mercer University School of Medicine. She completed her pediatric training at Emory University School of Medicine in 2011. She practiced pediatrics in Alpharetta for eight years prior to joining Pediatric Physicians, PC.  She is a Board Certified pediatrician and a Fellow of the American Academy of Pediatrics.  Dr. Reanne resides in Dunwoody with her husband, son, and daughter. Outside of pediatrics, she loves traveling, exercising, relaxing at home, and spending time with her family.

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A message from Dr. Lindsay

In January, I’ll be leaving Pediatric Physicians to pursue a new job as Medical Director Associate with Anthem. Though I’ll be taking a break from practicing pediatrics, I’ll be continuing to work in the medical field.
I am excited for this new career opportunity but will miss my patients and their families. It has truly been an honor to care for your kids and watch them grow. I know that everyone will continue to receive outstanding care at PPPC in the capable hands of excellent physicians.
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Thanksgiving holiday hours

Have a safe and happy holiday! We’ll have special hours this week. As always, our doctors are available after hours by phone for emergencies. You can also send us a portal message for NON URGENT questions.

All office hours are by appointment only.

Wednesday 11/21 Open morning only, Roswell and Windward.
Thursday 11/22 Closed
Friday 11/23 Open morning only, Roswell and Windward
Saturday 11/24 Usual hours (Roswell open Saturday mornings)

In addition, the Kids Time after hours clinics are open for walk-ins with no appointments necessary:

Thursday 11/22 Sandy Springs ONLY open 9-1 am
Friday 11/23 Alpharetta and East Cobb open 10 am-1 pm
Saturday 11/24 East Cobb and Alpharetta open 1-5 pm
Sunday 11/25 East Cobb and Alpharetta will be open regular weekend hours, 1-7 pm
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Acute Flaccid Myelitis – what parents need to know now

You’ve probably seen it on the news – a rare, polio-like illness is causing cases of paralysis in children. Here’s the latest info, based on our best current knowledge from the CDC.

AFM is a sudden illness that causes weakness in one or more extremities – one arm or (less likely) a leg, or any combination of arms and legs. The words in the name express the key features: it’s acute, beginning over hours or sometimes a few days; it’s flaccid, meaning the affected body parts are floppy and weak; and it’s a myelitis, meaning the disease occurs in the spinal cord. The muscles are fine, the brain is fine, but the area of the spinal cord that carries signals to the muscles becomes inflamed and stops working. You can see distinctive changes on an MRI scan of the spine to help confirm the diagnosis.

The first cases of what was later named AFM were reported in California in 2012. The CDC started closely tracking cases of AFM in 2014, when a surge of reports about the illness began to appear in the United States and overseas. Since then, we’ve seen a striking pattern, with most cases occurring in the late summer and early fall, August through October. In the US, we’ve also seen an unexplained pattern where most cases occur in spurts every other year – in 2014, 2016, and now again in 2018. 2015 and 2017 had far fewer cases.

Over 400 cases of AFM have been reported in the US over the last four years, including about 80 in 2018 so far. Most states have reported at least one case, including Georgia. There doesn’t seem to be geographic focus in any area. Overall, the rate is less than one in a million people – AFM is a very rare disease. Almost all cases of AFM have occurred in children, at an average age of 4-6 years.

Several different viral infections have been found in children with AFM, though it’s unclear that these viruses were the cause of the symptoms. The most-commonly associated viruses are from a family called “enteroviruses”, including one that has been implicated in groups of acute severe respiratory disease called enterovirus D68. Other viruses have been investigated including West Nile or Japanese Encephalitis viruses, herpes viruses, and adenoviruses. Most commonly, no specific viral infection is found. The cause of most cases of AFM is unknown.

Still, it seems most likely that a viral infection is the trigger, because of the seasonality of the disease and its propensity to strike children rather than adults. Similar symptoms were once seen with the polio virus, and multiple tests for polio have been performed in  children reported with AFM. But it’s never been found — polio itself is not the cause AFM in the United States or abroad. The CDC is continuing to investigate the possibility of one or more viral triggers, an inflammatory condition triggered after a viral infection, or a possible environmental trigger as causes of AFM.

Children with AFM typically have a preceding illness with fever, runny nose, cough, vomiting, or diarrhea 1-2 weeks prior to the beginning of AFM symptoms. Often these common viral symptoms have resolved by the time AFM begins, with its rapid onset of limb weakness. There may be near-complete paralysis (inability to move the limb), or varying degrees of weakness. Sometimes, symptoms including stuff neck, headache, or pain in the limbs accompanies the weakness. It’s also sometimes possible for AFM to affect the nerves in the upper neck and head, causing a face or eyelid droop, difficulty swallowing or speaking, or a hoarse or weak voice.

Children with AFM need to be hospitalized. Many tests need to be done to narrow down the diagnosis and rule out other causes of weakness (including blood tests, a lumbar puncture, and MRI scans.) Children with AFM can develop weakness of the muscles that help them breathe, and may need to be treated in an ICU. Neurologists, infectious disease specialists, and public health officials will all help guide care.

There isn’t solid evidence that any specific treatment is effective, since good clinical trials of therapy haven’t been performed yet. It’s been difficult to study AFM because it’s so rare, and the disease progresses quickly. In addition to supportive care, many people with AFM have been treated with intravenous immunoglobulin, steroids, and plasmapheresis. Though some children with AFM have recovered quickly, many continue to have lasting paralysis requiring long term care.

So what should parents do about this? First, there’s no need to panic. The press and Facebook like to stir up trouble with blaring headlines and clickbait titles – but remember that AFM is really rare, with about 100 or so cases a year occurring across the entire country. Polio caused about 15,000 cases of paralysis a year in the 1950’s before a vaccine was introduced. We’ve come a long way, and your children are, overall, far safer than children have ever been from infections, environmental illnesses, and trauma.

Some common-sense steps can probably help. Most cases of AFM seem to have a viral trigger, so avoiding infections is a good idea. Teach your children to practice good handwashing, and keep them out of group care when they’re ill. Though we don’t have a vaccine to prevent AFM, vaccines can prevent the neurologic complications of other infections like influenza, measles, and mumps – so be sure to keep your child fully vaccinated. And seek care immediately if your child becomes weak in one or more limbs.

And, please, support your public health community and the scientists who work to keep your children safe. There’s always another new health challenge out there (Ebola, Zika,  SARS, and MERS, to name a few.) We need to keep our public health infrastructure strong to help tackle AFM and whatever the next challenge turns out to be. Go science!


More info from the CDC’s AFM home page, the October 2018 CDC press briefing, and the November 2018 webinar for clinicians

Republished from Dr. Roy’s blog, The Pediatric Insider

© 2018 Roy Benaroch, MD


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