So, is it really the Flu?

This years Influenza season is upon us in full force. Typically, flu season can be from late fall to early spring with most cases in February and March. This year, we are seeing widespread flu cases in more than 40 U.S. states already. The Center for Disease Control (CDC) keeps a map of active flu cases, take a look, this is pretty impressive!! Click here for CDC Flu Map.

Influenza is a highly contagious respiratory virus that attacks the lungs, throat, and nasal passages.

Symptoms of the flu are:

• body aches
• fever
• dry cough
• headache
• fatigue
• sore throat
• runny/stuffy nose
• and sometimes nausea, vomiting and diarrhea

The flu most commonly starts with severe acute symptoms. One day you are fine, the next you are down for the count. It can last from a few days to a couple weeks. Influenza is most dangerous for babies <2 years old, adults >65 years old, asthmatics, those with blood disorders, those with chronic health conditions involving the lungs, heart, kidneys, nervous system, endocrine system, those with a compromised immune system, as well as other chronic health disorders.

BTW- Many people will have vomiting and diarrhea, and call it the flu. This is actually called gastroenteritis, most people will call it “the stomach flu.” It’s a virus, not an influenza at all. For more information about gastroenteritis, please check out my post, Yuck, the throw-ups…

How do you get the flu?? The flu is contracted through respiratory droplets of the infected person 24 hours before the symptoms are present, and throughout the course of the illness. These particles are spread through coughing and sneezing, hence the ever so important “cover your cough (sneeze)” etiquette. People are contagious before they actually come down with the symptoms, awhich is why the virus is so easily and rapidly spread.

So, why is the flu so dangerous?? The flu can cause other complications, such as dehydration, ear inflections, sinus infections, asthma flare ups, and the most dangerous is pneumonia. According to the CDC, “approximately 5% to 20% of U.S. residents get the flu, and more than 200,000 are hospitalized for flu-related complications each year. Over a period of 30 years, between 1976 and 2006, estimates of flu-associated deaths in the United States range from a low of about 3,000 to a high of about 49,000 people.” (http://www.cdc.gov/flu/about/qa/disease.htm)

Can you get the flu if you had the flu shot/mist? There are many different strains of the flu, the vaccine currently protects against 3 different strains. The companies that develop the flu vaccine for the U.S. study the trends of influenza in other parts of the world prior to determining which strains to put in the current years vaccine. Do they always get it right? No. Even if the current flu is a different strain, just having the antibodies from the vaccine should decrease the severity of symptoms and duration of illness for those vaccinated individuals. Children under 6 months of age cannot get the vaccine. I am a strong believer that household contacts of those most at risk for complications should be vaccinated to decrease the risk of transmission. For example, if you have a baby less than 6 months of age in the house, all of the family members should be vaccinated. Think about how easy it is for that 5 year old brother in kindergarten to get the flu in school and bring it home… And, if you haven’t had your flu vaccine yet, it’s not too late!

Can you do anything about the flu once you have symptoms? I always recommend increasing hydration and Vitamin C. Vitamin C helps boost the immune system, helping your body fight off infection faster. Some physicians will prescribe an antiviral medication, such as Tamiflu. Tamiflu should not be prescribed for everyone. Healthy people can usually fight the virus without antiviral medication. Antiviral meds should be reserved for the most compromised patients, such as the elderly, those with chronic lung disease, etc. I’m not a true believer in the efficacy of Tamiflu. I have a pharmacist friend that says the same thing. Has Tamiflu worked for some people? Yes. The guidelines for Tamiflu say that it must be started within the first couple days of symptoms to be effective, and may reduce symptoms and duration of illness.

So far in my office, we are seeing both Influenza A and Influenza B… Not good! All but one of our positive flu tests have been unvaccinated individuals. Has the flu shot helped? You tell me… It is looking like a bad flu year. Hopefully, it will come and go quickly, but it could be here for a while, and threaten to get worse and more widespread before we see it disappear.

How can you avoid the flu??

• It’s not too late to get vaccinated.
• Hand wash, hand wash, hand wash!!!!!
• If it’s possible to avoid crowded situations, do so.
• You just don’t know who touched that grocery cart before you, so, wipe it down.
• Keep little children and babies home.
• And, if you are sick, stay home!
• If your friends or co-workers are sick, tell them to stay home!

The flu is miserable, it is dangerous, and for some it is life threatening. It can take you out of school or work for a week or more. It can take another few weeks to completely recover. You don’t just bounce right back from the flu. You have to build yourself and your energy back up, and that takes time.

If you are worried someone in your family has the flu, you can get tested by your local provide. The flu test is a quick swab up the nose, and about a 10 minute wait.

Here’s to hoping your family stays well during this flu season, so that you and yours can continue to Enjoy the Journey!!

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Don’t eat that egg…You’re allergic to Ragweed…Huh??

Why in the world would I be telling you not to eat eggs if your allergic to Ragweed?? Concomitant Food Allergies.

Did you know there are certain foods that can make your environmental allergies worse? There are also foods that can worsen food allergies and food intolerance. These are called Concomitant or Synergistic Allergies. When certain environmental allergens are blooming (like ragweed for instance), eating these foods (such as eggs or milk) can make the allergy symptoms worse. Avoiding these foods during the blooming season is very helpful.

I wrote a post last week with basic allergy information, symptoms and treatment options, Springtime & Sneezes…You might have allergies if…. This post will help you recognize and treat your allergy symptoms.

You may not know what you are allergic to, and that is why allergy testing can be helpful!! Treating allergies isn’t easy, and knowing which allergens affect you can make developing a treatment plan easier. I remember calling my friend Kathy, RN/Allergy Specialist and asking her about Joshua’s allergies. She is my saving grace when it comes to Joshua and his allergies. (If you haven’t picked up on it yet, Joshua is definitely one of those kids that needs the entire village!) I have mentioned that Joshua has allergies, but has a negative RAST test. RAST testing is done via blood draw with lab testing to identify specific allergens.

There are many different panels that can be ordered depending on what part of the country you live in. Joshua was unable to do skin testing because he reacted to the control test that contained only saline. How his RAST test was negative alludes me… But, I say kids don’t read and follow the books. Also, we can’t test for every substance under the sun, it’s just not possible. Every April since this boy was 2 months old he has had a clear runny nose, that, my friends, is allergies!! No doubt about it. Some doctors will tell you that infants can’t have allergies. I beg to differ, I live with that clear runny nose, morning cough and sneezing each April, and have for 10 years now. Joshua eats a lot of apples, this high fiber food is actually necessary to help Joshua with another of his problems, but we can talk about why kids need fiber another day. So in April, when all the trees are blooming, Joshua avoids apples.

Keep in mind that allergy symptoms can be cough, congestion, clearing your throat, sniffles, runny nose, sore/scratchy throat, itchy/watery eyes, headache, skin rash, dry skin, eczema and asthma.

So, I wanted to share a list of specific foods that compound allergy symptoms. The following charts are provided by Online Allergy Center, and list what foods make specific allergies worse.

As you or your children sneeze and cough your way though this allergy season, I hope this information helps you Enjoy the Journey and beauty of Spring a little bit more!

Proven Concomitant Foods:

Rhus Allergy (poison ivy, oak, sumac)…	Pork, Black pepper
Ragweed…	Egg, Milk, Mint
Iva ciliata…	Wheat
Sage…	Potato, Tomato, Tobacco (chewing or snuff)
Pigweed…	Pork, Black pepper
Grass…	Legumes: Beans, Peas, Soybean, Cottonseed (cooking fats)
Cedar…	Beef, Yeasts (baker’s, brewer’s or malt)
Elm…	Milk, Mint
Cottonwood…	Lettuce
Oak…	Egg, Apple
Pecan…	Corn, Banana
Mesquite…	Cane sugar, Orange
Dust…	Oysters (seafood)
Molds…	Monilia, T.O.E., Cheese, Mushrooms, Truffles
Cystic breast disease…	Caffeine foods (thoephylline): Coffee, Tea, Cokes, Chocolate

Questionable Concomitant Foods (to be proven):

Dust…	Nuts
Influenza Vaccine…	Onion
Iva ciliata…	Tea
Chenopods…	Egg

Proven Synergistic Foods:

Corn…	Banana
Beef…	Baker’s yeast, Brewer’s yeast
Cane Sugar…	Orange
Milk…	Mint
Egg…	Apple
Pork…	Black Pepper

Questionable Synergistic Foods (to be proven):

Wheat…	Tea
Pork…	Chicken
Milk…	Chocolate

Springtime & Sneezes…You might have allergies if…

AAAACCHHOOOO! Excuse me! We’re having a little problem with allergies already this spring, how about you?!? It’s Springtime and allergies are in full flare! I love Spring, it is my favorite season! The grass is so green, the flowers are so pretty and brilliant, the birdies are singing, the air is warming up, what’s not to like? Well, ok, yes, the pollen and allergens that travel up our nose as we begin to venture back outside.

Can you recognize the symptoms??? Some patients tell me they don’t have allergies,  they just have a cough.

•  Well, if that cough is nagging you mostly at night and when you wake in the morning, you might have allergies.
• If you wake up and have to clear your throat or blow your nose, you might have allergies.
• If your child is coughing when they first wake up, it sounds a little wet, or a little hoarse, but then goes away in 30-45 minutes or so, they might have allergies.
• If you sneeze, you might have allergies.  
• If you have a sore, scratchy throat, but no fever, you might have allergies. (It is always a good idea to have a sore throat check out with your doctor or NP, if it’s strep, it has to be treated.)
• If you have a clear runny nose that doesn’t get worse and doesn’t go away, you might have allergies.
• If you have itchy, watery eyes, you might have allergies. 
• If your child has asthma and is wheezing, it may be worsened by allergies.

 There are many people that don’t think they have allergies, but they might…. . Keep in mind that if you notice these symptoms year round, your allergies may be indoor and outdoor. The best way to determine if you have allergies is to see you primary care provide or an allergist. My allergy doc and his RN/Allergy Specialist wife, are a great resource for me! They are two of the most knowledgeable people I know. They are the best!! If you are local, email me and I will give you their contact info. They would be happy to help!

There are millions of particles floating around in our environment.  Most people will have a little trouble in the Spring, even if they don’t suffer from bad allergies. I find that even if you aren’t allergic to pollen, it can still be very irritating to your sinuses.  We have all seen the yellow cars that are so hard to keep clean in the Springtime. Imagine breathing in that yellow dust every time you are outside, the pollen can sit in your nasal passages and sinuses just like it sits on the cars.

So, what can you do about your allergies so that you can enjoy the great outdoors???

• If you don’t typically suffer from allergy problems, a netty pot can be a great way to help clean out those sinuses. I have friends that swear by their nasal rinses! You will want to microwave or boil the water before using the netti pot…of course, you should allow it to cool to room temperature before doing the rinse. (Thanks, Kathy!)
• Taking an antihistamine such as Claritin or Zyrtec can be helpful, if you find that this does not resolve your symptoms, I recommend seeing your medical provider for an alternative.  
• Nasal sprays such as Flonase or Nasonex can be quite helpful. They help to reduce the swelling and secretions caused by allergens.
• Eye drops such as Zatidor or Pataday can be helpful as well. Check with your health care provider to be sure this is the appropriate treatment for your family.
• Wash your hair every night!! As we go though the day, all kinds of allergens sit on our hair. If we don’t wash them off, they are on the pillow. Laying on a pillow full of allergens all night is just as bad or even worse than being outside.
• Keep your windows closed! The first thing I want to do when the weather warms up is open the windows. My husband runs behind me closing them all up again because he and Joshua have bad allergies. Keeping the windows closed keeps the allergens out!
• Get rid of carpet and heavy drapes that hold dust and allergens. Hard floors and blinds are much easier to keep clean.
• Buy hypoallergenic pillow and mattress covers. I am not even going to mention all the allergens (dust mites,etc) that can be trapped in pillows. Speaking of which, I think I need some new ones. :-/
• When you are cleaning the house, wet dust and wet mop. Sweeping and dry dusting just moves the dust around. Investing in a vacuum with a good HEPA filter to trap the allergens can be helpful also. Many vacuums just blow the dust right back out.
• Immunotherapy: Allergy shots provide small exposure to specific allergens to help the immune system build up antibodies against the allergen. Immunotherapy works!
• Don’t forget that Hydration can be helpful! If you learn nothing else from me, you will learn the importance of hydration (see The Importance of Hydration for more info on adequate hydration)
• Treating allergies can be tricky, don’t try to do it all by yourself.

If your allergies are troublesome enough that a daily Claritin or Zyrtec isn’t helpful, I strongly recommend seeing an allergist. Most people don’t like shots, but those who get and need allergy shots will tell you it is very worth it. They definitely work! Please keep in mind that untreated allergies can cause increased problems for those with asthma and eczema. I see so many kids with eczema problems that are not on allergy medication, allergy medication may be key in controlling the eczema symptoms. The secretions that come from inflamed nasal and sinus tissue can cause ear infections, sinus infections, and headaches. I have found that most people that suffer from allergies are allergic to grass and dust mites. So inside and outside, there is always exposure. These people should be on allergy medication year round.

There are a many different foods that cause allergies as well, a couple of the most common are peanut and shellfish. Most peanut and shellfish allergies are quite dangerous and can cause severe breathing problems. Drew Elizabeth has a friend in her class, Sophie, with a peanut allergy. All the students and all the parents were made aware immediately for Sophie’s safety. A bad peanut allergy can cause hospitalization and death,it is nothing to play with! Drew came home from school the first week telling us all about peanut allergies and how dangerous they can be. I’m glad they designate a “no nut” table during lunch, all schools should, and many do.  Drew loves peanut butter tastykakes and has taken them for lunch all through preschool. She will tell us to be sure not to put any peanut butter tastykakes in her lunch, because she wants to be able to sit with Sophie at lunch, what a sweet friend! I love that girl!

Many people suffer from food sensitivities vs. food allergies. I suffer from occasional stomach pains, and was convinced it was from some food sensitivity. Food sensitives can present as stomach pain. I went to my friends at the ENT/Allergiest and had my friend Dania, RN test me. After the testing, I found out that I was allergic to dust, grass, cats (I’ve had cats for over 20 years now), dogs (explains alot about my asthma as a kid growing up with dogs), and a couple other plants of some sort. NO food allergies! Dania looked at me laughing and said, “Well, you know you could get allergy shots, you reacted to 6 different allergens.” She knew that wasn’t the information I was looking for, I wanted to know what foods I should be avoiding. We sat there laughing….Watch what you go searching for, you might find completely different information that you aren’t prepared to deal with.  Allergy testing, diagnosis, and treatment can be tricky.  We tested Joshua, who exhibits every allergy symptom I’ve mentioned (minus the asthma and eczema), and he has a negative allergy panel…Go Figure! I’ve talked to Kathy, RN my best allergy source at the office and we both agree that an negative allergy panel is not conclusive; there is no way to test for the millions of substances that are floating around in this world. As I’ve told you before, Joshua is a special case and hard to figure out, he doesn’t usually follow the books… :-/

Well, I hope I’ve given you enough info to help you through the Spring. I talk more about food allergies and concomitant allergies in another post, Don’t eat that egg…You’re allergic to Ragweed.  Concomitant allergies are foods that will make allergies worse. One example is avoiding apples during the season when oak trees are blooming. Another is avoiding milk, egg, and mint if you have a ragweed allergy. So, as you can see, allergy testing can be quite helpful!

I think it’s time end this post and go wash my face and hands… My cat came and sat down next to me about 10 minutes ago, which usually doesn’t bother me, but I was rubbing on him for a few minutes, and apparently touched my face, and now my eyes are all itchy and watering…. Still love my Jersey cat though! He’s a big, beautiful, black tom cat that will be 17 next month. He’s a sweety! Glad I didn’t know I had a cat allergy before I got him. Although, I had a sneaky suspicion when I got my Persian back in college and needed my inhaler every couple hours to breathe comfortably the first few days.  After I got used to her, things got better, I should have known then. I guess I did, but I love cats, and denial is a powerful defense mechanism!

Please let me know if you have more questions about allergies, and I will do my best to help you along your parenting journey!

It’s just a “cold”…so now what??

We have all suffered with colds throughout our lifetime.  A cold or URI/upper respiratory infection can be miserable. URI symptoms are cough, congestion, runny nose (clear or yellowish), low-grade fevers (<102F), sore throat, decreased appetite, disturbed sleep and overall just miserable feeling.  If fevers accompany the cough and congestion, a day off to rest isn’t a bad idea no matter what your age. If there is no fever with the cold symptoms,  most people just continue on through their daily routine.

I know what you are thinking… Yes, children do get colds more frequently than adults!  Fortunately and unfortunately, childhood is a time of building  immunity; good in the long run, but growing pains along the way.  It is true that the more organisms you are exposed to, the stronger your immune system gets.

So, what can you do to make life a little less miserable for your child with a cold??

There are a few simple rules….

Rule #1 – HYDRATION, HYDRATION, HYDRATION!!!  Drink plenty of fluids.  Adding Pedialyte or Gatorade can help, this helps to replace any loss of electrolytes, salts, sugars, etc. from the cold and fever.  If you learn nothing else from my post, you will learn about how important it is to be hydrated!

Rule #2 – Blow your nose.  This is hard for young children, but can be accomplished with continued practice and effort. For babies, use saline drops and a bulb syringe to help with the nasal drainage.

Rule #3 – Increase your Vitamin C intake.  I recommend 500-1000mg to my young patients, 1000-1500mg to the adolescents.  Vitamin C is great for boosting the immune system into gear, helping it fight off the cold.  We like the chewable Vitamin C in my house, they taste like sweet-tarts, just a little more tart.  Josh ate 8 of them one day (500mg each x 8 = 4000mg), and then told me how good they were!  I told him that he really shouldn’t have that many, although Vitamin C is not toxic.  Crazy kid! (You will start seeing a pattern with this kid, he keeps us on our toes around here.)

Rule #4 – Use a cool-mist humidifier in your child’s room while they are sleeping.  Don’t forget to pull the door closed, leaving a few inches for ventilation. Keeping the child’s head elevated is helpful too. Infants should have their mattress elevated on an angle, a pillow should never be used under an infant to elevate his head.

Rule #5 – Get plenty of REST! Children and adults need to take time to rest and let their body fight off the cold.  Our bodies heal during sleep, sleep is so important to maintaining good health.  (I will address sleep soon.)

All of the above can help your child be more comfortable.  There are some other helpful hints that may or may not be useful for you.  Keep in mind, all children are different, and have similar but different needs.  Some children will be more clingy and want to be with you 24/7.

Some children just need you to hold and love them because they don’t feel good.  It makes them fell better to have your hugs and kisses.  There is nothing like the love of a parent to make you feel better!

Other helpful hints:

• Take Motrin (Ibuprofen) for comfort.  It can also be helpful with the swelling and inflammation in the upper respiratory tract.  Nasal congestion is not just a runny nose.  Most of the little noses I see are so swollen inside,  some of them hardly have any room to breath, and many are breathing through their mouth.   I’m sure this sounds familiar, most children will breath through their mouth when they have a cold, and this is exactly why!
• The latest research shows that giving a spoonful of honey is more helpful than a spoonful of cough medicine!  I advise my patients to use Honey for that daytime cough.  Honey tastes good, isn’t full of chemicals, and you cannot overdose on it!  I think it is great that we are getting back to natural vs. chemical!!
• Taking an antihistamine or decongestant is helpful for some people.  I frequently recommend Benadryl (Diphenhydramine) at bedtime. I think this helps the child get some sleep and also helps to dry up some of the congestion. I think Benadryl is too sedating to give more than 1-2x a day, and don’t recommend daytime dosing unless the child is home and can nap. For Drew Elizabeth I use Claritin (Loratadine) instead of Benadryl. I do this because she has mild allergies and takes Claritin on a daily basis anyway. Also, I can give her the Claritin in the morning and it doesn’t make her sleepy. Although, I did forget this morning; Sorry, sweetheart! :-/ DO NOT use 2 allergy medications at the same time! Some decongestants such as Dimetapp and Robitussin can be helpful, but usually do little more than treat the cough for a few hours. DO NOT give Dimetapp Cold and Allergy with another allergy medication.  Dimetapp makes a Cold and Cough and a Cold and Allergy. Please read labels carefully!!
• I think cough drops can be helpful too. I personally like Ricola.  No, I don’t get paid by Ricola. Do you hear the horn in the background, Riiicooolaaaa ! The natural herbs just seem to be helpful for the sore throat and cough that accompany most colds.  Please keep in mind any hard object like cough drops can be a choking hazard for young children.
• Another helpful tip that a friend reminded me of after I wrote the cough post, was sinus rinses.  Thanks, Ami Jo! If you have never tried it, don’t knock it.  Most people will say yuck, until they have tried it.  A sinus rinse is a great way to help with a cold or allergies. I have parents that report back to me and swear by them.  Sinus rinses can be really helpful for allergy sufferers.

Please visit your child’s pediatric provider if they have a high fever, are uncomfortable when laying down (can be a sign of an ear infection because the pressure increases when they lay down), aren’t drinking and eating, or exhibit any signs of breathing problems.  Colds should get worse for a few days (3-5), then start to gradually get better.

Well, that is enough information for now, this was supposed to be a short post! Oops.  Too many helpful tips, I guess.

Keep in mind, all children are different!!  Some need more intervention then others while they suffer through yet another cold along this journey we call Life. Hope this information is helpful for all of you Moms and Dads out there! (Yes, this one’s for you, Ryan!) Thanks for reading.

I hope you are taking time to enjoy the journey!

What’s that cough all about??

Hi all! I hope you are doing well, ’cause there are lots of sick kiddos out there.  I have been so busy in the office, I haven’t had time for a post, so this one is going to be full of info for you.

So many kids are coughing!  I’m sure you are nodding your head in agreement right now.  What I’m noticing is a common goal: Most parents just want the cough to go away!  Well, of course they do, so I…. it’s the same in my house.  Drew Elizabeth has been coughing on and off for months; but, that’s life in Kindergarten.   Joshua coughs and sneezes and clears his throat every morning, which has got to be disturbing to him, it is to the rest of us.

With all of this coughing going on the real question is WHY IS MY CHILD COUGHING?? 

A cough is the body’s way to protect itself.  The real goal for parents and pediatric providers is to determine what is causing the cough? Is it post nasal drip, congestion from a cold, asthma, croup, pneumonia??   Figuring out what is causing the cough is the first step in figuring out how to treat the cough.  Treating a cough with a cough suppressant is not a good idea, the cough is there for a reason.

If your child has a cold (upper respiratory infection or URI), the congestion may be causing the cough.  URI symptoms are cough, congestion, runny nose (clear or yellowish), low-grade fevers (<102F), decreased appetite, disturbed sleep and overall they feel kind of miserable. The congestion from a cold usually runs down the throat, causing the body to cough.  Coughing is the body’s defense mechanism to keep the congestion from travelling down to the lungs.  Colds are caused by viruses, rhinovirus, adenovirus, etc.

Some viruses cause Croup.  Croup is caused by inflammation of the airway and vocal cords during a URI.  This causes a “barky” sound that is SCARY the first time you hear it. I freaked out the first time Josh had croup, at 2am my first thought was asthma attack because he looked like he couldn’t breath and his eyes were as big as eggs! He looked terrified, which terrified me!  If this happens to you in the middle of the night, do the tried and true steamy shower trick. As soon as you can, take a trip to the doctor for a dose of steroids and that cough won’t sound so scary.

Antibiotics will not get rid of a virus, antibiotics kill bacteria, not viruses.  Viruses typically last 7-10 days, with symptoms worsening over the first 3-5 days.   The best way to treat the cough is by trying to dry up the congestion.  I usually recommend an antihistamine or decongestant to help.  Check with your medical provider to see if this is proper treatment advice for your child.

Specific treatment options should be discussed with your primary care provider (PCP).  Children that do not start improving within a week should be evaluated for ear infections, pneumonia or other complications.  Children with symptoms that get bad quickly should have their child evaluated sooner.   Infants with lots of congestion and runny nose should also be evaluated sooner.  Babies are at higher risk for complications from viruses that older children and adults can easily fight off.

Pneumonia, a lower respiratory infection, can be a serious complication from ongoing cough and congestion. Children that have pneumonia will often present with symptoms other than cough, but not always.   These children will typically have little energy, and tire more easily when playing. Children with pneumonia will often have difficulty taking a deep breath, or doing so may be painful and will cause lots of coughing. These children are often compensating by doing lots of shallow breathing, and their breathing may be faster than usual.  Keep in mind fevers can also cause fast breathing and rapid heart rate. Children with pneumonia will often run a fever, but not always.  Another red flag with pneumonia is a cough that went away, or you thought it went away… The cough that is wet, thick and sounds bad, and then just disappears, may be a sign that there is fluid in the lungs that is inhibiting the child’s cough.  These children often look sick and have little energy, but again, not always.  If your child has a cough for more than a week that doesn’t get any better, but continues to linger, please have your child evaluated.  Children of all ages get pneumonia. I’ve treated just as many teens with pneumonia as younger children this winter.

Vaccinate against Pneumonia: You can help protect your children under the age of 5 years old with a vaccine.  Please check with your doctor to be sure that your child has had all of their pneumonia vaccines; this vaccine protects against 13 different organisms that cause pneumonia.  Children over the age of 2 years old with asthma or other chronic health conditions should consult with their doctor to see if they should have an additional pneumonia vaccine that is for people of all ages; this vaccine protects against 23 different causes.

Coughing can be a symptom of asthma.    Children with asthma will cough because of inflammation and secretions in the airway.  Children with asthma may not look like they are having difficulties breathing because they will breath more shallow to compensate.    Frequently, parents and children do not even realize this is happening.  I treated a little girl (8 yrs old) yesterday for asthma that was flaring because she has a cold.  The child’s symptoms were cough and congestion.  When I evaluated her, I discovered she was moving very little air in her lungs, but didn’t look bad at all.  Mom had not realize she needed her asthma treatments because her symptoms were so mild.  After giving her a nebulizer treatment in the office, she was able to move air in and out of her lungs more easily.   URI’s frequently cause children with asthma to have increased breathing problems.  Even if the child has not needed daily treatment in the past, they may while they have a URI.  Without a proper physical assessment, it is not possible to determine if a child is coughing because of asthma.  Please consult your provider to create an Asthma Care Plan for your child.  This plan should include treatment for mild, moderate, and severe asthma symptoms.  Asthma symptoms are often exacerbated by allergies, this should be addressed by your provider. Children cannot be diagnosed with asthma with one visit or one incidence of breathing difficulties.  Asthma is a diagnosis of chronic/ongoing incidence. 

If a child has allergies, they usually have a nighttime cough, but this cough goes away during the day.  These children will often cough, sneeze, and clear their throat for a while in the mornings.  Yes, this does sound like Joshua.  Zyrtec is often helpful for him, but at almost 10 years old, I let him chose if he is going to take it.  Recently, he has chosen no; so, the morning sneezing continues.  As April approaches  his allergy symptoms will get worse, and I will strongly encourage him to take his Zyrtec every night.  Joshua’s allergies are tricky to say the least, but that’s for another day.  If you think your child has allergies, check with your doctor to see if your child displays other silent allergy symptoms.  Allergy medication can be helpful, but you should always consult with your pediatric provider before starting a chronic medication.  I’ll talk about allergies in a future post, the season is not too far off.

I enjoy sharing my advice, and encourage you to consult with your pediatric care provider about all of your child’s healthcare needs and concerns.  Think of your Doc, PA, or NP as your partner in parenting and caring for your child. That is what I hope I am for all the families that I work with.  The journey is a challenging one, the more we stick together, the better parents we can be!

I hope you enjoy the journey, even with the coughs and runny noses!