Tis’ the Season – When is a Cold Not a Cold?

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By Dr. Patty Avila, Pediatrician

It is that time of year again!  The busy time of year when everyone is preparing for the holidays is also when children are getting more colds and other respiratory illnesses.  These are the most common type of illness that children will see their doctor for, and it is important to recognize when to worry or not.  Most of these will be simple colds and resolve on their own, but there are some that can be serious.

The Common Cold; also called an Upper Respiratory Infection.

The common cold is caused by several different viruses and is the most common of all the respiratory illnesses. In the 1st 2 years most children will have about 3 to 5 colds per year. Older school age children and children in daycare can get sick even more often, because they are exposed to others.  Fortunately, most of these are just colds and will go away on their own and not lead to anything worse. 

Symptoms of the Common Cold:

  • Low fevers (101-102 degrees F).
  • Runny nose, nasal congestion comma and sneezing.
  • Sore throat.
  • Cough.
  • Not eating well.
  • Fussiness.

Most children will be better after 7 to 10 days of illness, but some may take up to 10 to 14 days to get better.

When to worry with the common cold:

Most children will not need to see their doctor with a common cold or upper respiratory infection. Infants younger than 3 months should see their pediatrician because they are at higher risk of getting very sick. 

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue.
  • The symptoms are lasting longer than 10 to 14 days.
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Antibiotics do not treat the common cold since it is caused by a virus. 

Supportive care includes:

  • Increased fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of a humidifier may provide relief. 

The Flu; sometimes called Influenza.

The flu is also caused by respiratory viruses called influenza and can present very similar to the common cold.  Children with the flu feel much worse and are sicker than with the common cold.  The flu can have very serious complications including need for hospitalization and sometimes death.   

Symptoms of the Flu:

  • Rapid onset of high Fevers (above 101 degrees F), chills.
  • Headaches, body aches.
  • Runny nose, nasal congestion.
  • Chest pain and cough.
  • Sore throat.
  • Poor appetite.
  • Feeling tired and weak.

Most children will get better after 2 weeks. Fevers from the flu can last up to 5 to 7 days. 

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue. 
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Young children and infants as well as children with high-risk medical conditions should see their pediatrician as soon as possible. These high-risk medical conditions include:

  • Heart defects.
  • Chronic lung issues.
  • Asthma.
  • Low immune system.
  • Diabetes.
  • Cancers. 

Supportive care includes:

  • Increased fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of humidifier may provide relief. 

Outside of supportive care, there is an antiviral medication called Tamiflu which may be indicated and started if the flu is diagnosed within the first one to 2 days.

Bronchiolitis.

Bronchiolitis is another respiratory illness that can be commonly seen during the winter months.  There are several viruses that can cause this illness but RSV, also known as Respiratory Syncytial Virus, is the most common.  RSV is an infection that will affect almost all children at least once before they turn 2 years old.  It usually starts as a cold and is followed by lower respiratory symptoms around 3 to 5 days of the illness.  For some children the illness can be severe, especially younger infants, preemies, and those with heart or lung defects.   

Symptoms of Bronchiolitis:

  • Cold symptoms with fevers, runny nose, nasal congestion, and cough.
  • Fussiness.
  • Poor Feeding.
  • Wheezing.
  • Difficulty breathing.

See your doctor immediately if your child or infant is having:

  • Trouble breathing or fast breathing – using their muscles in between their ribs to breathe or the openings of the nose get larger with every breath.
  • Nails or lips turn blue. 
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.
  • Ear pain or any other concerns for child/infant not improving or getting worse.

Supportive care includes:

  • Increase fluids.
  • Use of pain/fever medication such as acetaminophen or ibuprofen.
  • Nasal saline with suctioning for congestion.
  • Honey for cough in a child OLDER than 1 year (NEVER given an infant <1 year of age honey).
  • Use of humidifier may provide relief. 

For infants who are high risk there is an injection that is given monthly during the winter months called Synagis that can decrease the risk of severe RSV infection. 

Croup.

Croup is a common respiratory illness during the Fall and Winter months and is usually seen in infants and young children – children younger than 5 year of age.  It is caused by several different viruses including the flu virus and some cold viruses.  The illness is characterized by swelling of the upper airways including the voice box (larynx) and the windpipe (trachea). Symptoms from Croup are usually worse at the beginning of the illness. 

Symptoms of Croup:

  • Fevers which can be low grade or high.
  • Cold symptoms with runny nose and nasal congestion.
  • Hoarseness of voice.
  • Barky or “seal like” cough.
  • Noisy breathing when breathing in – stridor.

The swelling of the airway can sometimes be severe and need immediate medical attention.

See your doctor immediately if your child or infant is having:

  • Trouble breathing – struggles to catch their breath.
  • Noisy breathing that is getting louder and child/infant appears to struggle to breathe.
  • Cannot talk because of difficulty breathing.
  • Lips/mouth or nails turn blue.
  • Drooling and not able to swallow saliva.
  • Dehydration or not drinking well and not urinating well.
  • Child/infant is too sleepy or very fussy and not consolable.

Steroids can decrease the swelling and can be given by mouth, injection, or in a breathing treatment.  If given early can help decrease the need for hospitalization and improve breathing.  There are breathing treatments with epinephrine that can be given as well in severe cases, but these will require careful observation in the Emergency Department or Hospital setting.

Use of cold moist air can help improve mild symptoms as well and can be used at home with a cool mist humidifier.

PREVENTION TIPS

  • For all respiratory infections, the best form of prevention is to avoid exposing infants/young children to people who are sick or crowded situations. 
  • Breastfeeding infants as long as possible (at least 6-12 months) is also an important way to help prevent and fight infections because breastmilk provides antibodies. 
  • Practicing and teaching children good hand hygiene is key.
  • Use soap and water and scrub for at least 20 seconds (singing the ABCs).  Another option is the use of an alcohol-based hand rub if hands are not visibly soiled. 
  • Teach children to cover their coughs and sneezes properly by using a tissue or coughing in their arm rather their hands. 
  • Keep children home from daycare or school when they are sick to avoid spreading the illness. 
  • Eating a healthy balanced diet high in fruits and vegetables can help boost the immune system and help decrease the chances of getting sick.   

At NOAH, we’re here for you. If you have any questions for your child’s pediatrician, give us a call at 480-882-4545. You can also send a message to your pediatrician via your child’s MyChart account.

Skin Care Tips for Teens

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By Dr. Deborah Bauer, MD

“Adolescence can be a tough time – especially on your teen’s skin! Almost 8 out of 10 teenagers will have acne at some point,” says Dr. Deborah Bauer, Pediatrician. This is because the changing hormones cause an increase in oil production and can lead to clogged pores. This can happen all over your child’s body, not just their face. And while acne isn’t dangerous for their health, it can cause scars and decrease their self-esteem.

Here are a few pointers for home care of your teen’s skin:

  • Keep it clean: They should wash their face with warm water and a gentle cleanser twice per day. CeraVe, Cetaphil and Dove make reasonably-priced and effective cleansers.
  • Be gentle: Harsh scrubbing or rough washcloths are not recommended. Your teen should be using just their hands to gently rub in the cleanser and rinse off.  Very hot water or very cold water should not be used.
  • Stick to the routine: Oily skin and acne can last for months or years, so it’s important to have a good skin routine to minimize the effects. Remind your teen to always remove make-up before sleeping.  And change sheets and pillowcases frequently.
  • Don’t pop pimples: Although it’s tempting, squeezing pimples will only make things worse. Not only will they introduce more oil onto their skin from their hands, but this will probably push the oil deeper into the skin and cause inflammation and swelling.
  • Keep moisturizing: Drying out their face can actually lead to more acne because their body will try to produce even more oils to keep their face from being so dry. Make sure the moisturizer bottle says “oil free” or “noncomedogenic” on it so it doesn’t clog their pores more.
  • Use sun block: This is important for every child, but especially for those with acne. The sun’s rays can irritate skin and make acne and scars much, much worse. Make sure the sunscreen is at least SPF 15.

Some kids even need prescription medication to help manage acne, and our NOAH Pediatricians are here to help with that too!

For more information about taking care of your skin, visit the American Academy of Dermatology: www.aad.org.

Tips to Treat Nosebleeds in Children by Dr. Debbie Bauer, Pediatrician

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“Nosebleeds are very common in children, especially during these winter months,” says Debbie Bauer, Pediatrician. The dry air from outside combined with the dry air from heaters inside can make the skin inside the nose more fragile and sensitive. This is one of the most common reasons children get nosebleeds. Some children also get nosebleeds from picking their nose, from sniffling too much from allergies/colds, or of course from being hit in the nose.

Learn what to do if your child has a nosebleed and when to get help from a doctor below. Also, check out our tips on how to prevent nosebleeds from coming back!

What should you do if your child has a nosebleed?

– First, don’t panic! Nosebleeds are rarely serious. Your child will have an easier time following your instructions if you remain calm.

– Have your child sit down and put their head slightly forward, NEVER have them tilt their head backwards.

– Put firm pressure on either side of their nose with your fingers and hold it there for 10 minutes.

– After 10 minutes, check to see if the bleeding stopped. If it hasn’t, hold firm pressure again for 10 more minutes.

– When bleeding has stopped, gently clean blood off their face with water but do not put anything in their nose or have them forcefully blow their nose.

When should you get help from a doctor?

– If your child has a nosebleed for more than 20 minutes without stopping.

– If your child looks very pale, weak or sweaty.

– If you see blood in your child’s urine or stool.

– If your child has strange, unexplained bruises.

– If frequent nosebleeds are concerning you.

How can you prevent nosebleeds?

– You can use a saline nasal spray to keep their nose from getting dry.

– You can use a humidifier in their room.

– You can apply a small amount of Vaseline inside their nose carefully with a Q-tip.

– If your child picks their nose, keep their fingernails trimmed short.

At NOAH, we’re here for you. If you have any questions for your child’s pediatrician, give us a call at 480-882-4545. You can also send a message to your pediatrician via your child’s MyChart account.

Take Care of Your Mental Health This Holiday Season

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The holiday season brings different emotions that are often joyous, but for some, it can be a somber time of year. It’s important to consider the impact the holidays may have on your mental health.

Many are still finding difficulties navigating the ups and downs of the season, all the while, they are planning, attending and engaging in activities such as work parties and family gatherings. This may be due to the loss of a loved one, inability to gather as a family, or financial difficulties among other things. However, taking time to focus on the things you can do may help shift your focus.

First Things First – This Is Hard

As we turn the calendar to another December, remember we have been living through a pandemic that caused changes to routines, physical distancing, isolation, loss, and uncertainties for a few years now. With the holiday season here, it may be the first major event with family in a few years, or it could be the first time without a loved one. Try to remember we are all experiencing emotions through this – some similar and some different – but you aren’t alone and that can help you cope.

The Highs and Lows of Holidays

People face a lot of emotions during the holidays. This can be from not having family, having lost loved ones, living far away, or feeling overwhelmed by all the expectations and demands of the season. We should expect these feelings in ourselves and others.

Don’t avoid these feelings, recognize them. We can also expect these feelings to come in waves. The first wave will probably be the biggest, emotionally, and then it can become more manageable from there.

The important thing is to know yourself and expect some ups and downs. But the second most important thing to remember is that it’s best to embrace the feelings and work through them rather than trying to stop these feelings altogether.

Take Action

Knowing yourself is key to the entire process of mental and emotional health during the holidays and throughout the year. Try to understand your triggers – something that can make you feel sad, angry, overwhelmed – and be prepared.

The next step is to have coping skills, or actions you take to deal with the highs and lows. These skills will be a big part of working through things as they happen, even more so to help with holidays and mental health. Some coping skills can include:

  • Talking to someone
  • Making a list
  • Doing deep breathing exercises
  • Going for a walk
  • Or writing in a journal

Another way to be proactive is to notice changes in other people and yourself. Some of the most common changes can be withdrawing from activities, isolating, not contacting people, sadness, and not enjoying hobbies. These can be red flags during the holidays and may spark mental health concerns.

It’s OK to Feel Lonely

It can be very uncomfortable to feel lonely, but it is okay to feel lonely. It is a very normal emotion, even more so when we have expectations of something different.

Dealing with this can happen in a few ways.

  1. Throw out the idea of “should”. For example, don’t continually think or say “I should be able to be with my family” or “I should be going on a trip”. It’s fine, and even good, to mourn a lost holiday or celebration with people you care about, but then take those options out. Think about what you can do and focus on that this year.
  2. Change your expectations. This is a good rule any time of year. We set high expectations of ourselves and of the holidays, which can lead to disappointment. Rethink or lower your expectations to something more realistic.
  3. Use this opportunity to help others who may also be facing loneliness like a neighbor, an elderly friend or family member who has been isolated, or one of your kid’s friends who has family that is working during the holidays. Find ways to show people you care, that they aren’t alone, and make new memories. You will be surprised how much good it does for that person, and for you!

Loneliness is a big factor on holidays and mental health of people everywhere. Efforts in this area can make a big difference.

Know When to Ask for Help

We believe in prevention in healthcare, whether it is physical health or mental health. If you have been struggling, make an appointment with one of NOAH’s counselors or psychiatrists now.

People who are at a higher risk, or who deal with chronic depression or anxiety, should be seeing someone on a somewhat regular basis, especially if holiday stress or loneliness would trigger more emotions. Another warning sign is isolation. If you notice yourself isolating more or see changes in a loved one with their moods or interactions, that is a good time to make or encourage an appointment. Everyone can benefit from counseling.

Find Ways to Enjoy the Season

Now that we are ready to adjust our expectations, embrace the emotions of the season, and know what to expect, we can find new ways to celebrate the season safely for our mental health.

Make your plans – If you want to do a video call with multiple family members, make those arrangements. Remember that some people may not have reliable WiFi or be comfortable using certain technologies so plan accordingly. Making phone calls to loved ones and sending cards are ways to share the season with people you care about.

Remember to also be thankful and show gratitude which is helpful to your mental and emotional health all year. Showing gratitude to your family, friends, coworkers, neighbors and even strangers can have a ripple effect. So, hold the door open, smile, give a compliment, or make small talk with the cashier, and you will brighten many people’s day in the process.

If you need a counselor, reach out to NOAH’s team of experts. Virtual visits are common and can fit in your schedule and lifestyle.

Social Anxiety: More Than Shyness

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By Daniel Davis, MD | Internal Medicine

It is normal to be anxious or feel some stress about a social event from time to time. Everyone has been anxious about a social occasion like a new job interview, going to a party, going on a first date, giving a speech, etc. But for people with social anxiety disorder this fear can be extreme and cause significant impairment. The good news is that it is very treatable and has many treatment options. 

Examples of automatic negative thoughts in people with social anxiety

What is Social Anxiety Disorder?

Social anxiety is an intense, persistent fear of being watched and judged by others. It can impact work, school, and other daily activities, and it can also make it hard for people to make friends and other lasting relationships. This disorder is extremely common with up to 5-10% of the U.S. population living with it. However, it is underdiagnosed likely because having social anxiety means individuals may not want to get help or talk about it.

Treatment Options

If you are concerned you may have social anxiety, fill out this form from the National Social Anxiety Center and bring the results to your primary care provider, counselor, or psychiatrist. It can be difficult to differentiate this disorder from other diagnoses such as normal shyness, PTSD, autism spectrum disorder, panic disorder, agoraphobia, depression and generalized anxiety. So it is important to discuss your concerns with a PCP, psychiatrist or counselor

Social anxiety is common, but it can be disabling. The silver lining is that this condition improves with treatment. Response to both counseling and medications can be make a big difference for people who suffer from this disorder and the many areas of their life it impacts.

At NOAH we truly want to be able to help our patients in whatever way possible. If you are interested in getting evaluated at NOAH for social anxiety or you can contact us and see either counselors, a primary care provider (internal medicine or family medicine), or one of our psychiatric PAs.   

Gingerbread – Delicious AND Healthy?

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There’s no denying that gingerbread is a classic holiday dessert. Flavored with ginger, cloves, allspice and some additional sweetening ingredients, this tasty treat offers some nutritional benefits that might just surprise you!

Benefits of Ginger

Originating in Southeast Asia, ginger is one of the healthiest spices on the planet. The unique fragrance and flavor of ginger comes from its natural oils, the most important of which is gingerol. Gingerol is the main bioactive compound in the spice, responsible for its anti-inflammatory and antioxidant effects. According to National Library of Medicine, gingerol could also explain ginger’s role in keeping blood sugar levels steady, which helps to control on of the long-term effects of type 2 diabetes. The health benefits of ginger are endless, such as reducing symptoms of nausea, helping with osteoarthritis, and treating uncomfortable indigestion.

Additional Spice Benefits

Depending on the recipe, the spices used with ginger are equally as healthy. With significant levels of copper and iron, allspice is ideal for increased circulation and blood flow. Eugenol, quercetin, and tannins are all chemical compounds that aid in the antioxidant properties within allspice, perfect for removing toxins from the body.

Known for their sweet and fragrant spice, cloves have also been used for their medicinal properties. In fact, one teaspoon of ground cloves contains 55% of the daily value of manganese, an essential mineral for healthy brain function and building strong bones. Studies have also shown that due to their antimicrobial properties that help to eliminate harmful bacteria, cloves may promote oral health in combination with regular brushing and proper oral hygiene.

It is important to note that despite their many health benefits, gingerbread cookies and cakes are often loaded with sugar and unhealthy fats, so too much of a good thing can be bad.

Check out some of our favorite recipes that feature ginger for more inspiration!

Ginger Roasted Salmon

This fish is loaded with nutrients, tasty, versatile, and widely available no matter where you live. A great source of protein, salmon is also rich in healthy omega-3 fatty acids.

Pumpkin and Lentil Salad

This salad is bursting with healthful goodness, packed with antioxidants, tons of fiber, and plenty of protein to keep you full longer.

Pumpkin Gingerbread

Did someone say pumpkin and gingerbread in the same sentence? That’s right folks, you’ve been asking for fall and this recipe gets you there faster than ever before.

Healthy Holiday Hosting Tips

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The holiday season is a time for joy, celebration, and gathering with loved ones. As you prepare to host friends and family, it’s essential to prioritize health and safety. By following some key tips on food hygiene, kitchen cleanliness, and overall sanitation, you can create a safe and enjoyable environment for everyone. Here are some healthy hosting tips to ensure a worry-free holiday celebration.

Preparing Your Kitchen

Ensure a clean and sanitized kitchen by using hot water and soap to clean various surfaces and utensils such as the sink, counters, cutting boards, pans, knives, and thermometers. For an extra layer of cleanliness, consider sanitizing countertops and cutting boards using a diluted bleach solution. If instructions are not available, leave the diluted bleach solution on the surface for at least 1 minute before removing or wiping.

Keep an ample supply of clean cloth towels or paper towels within reach for both meal preparation and clean-up. If you opt for cloth towels, wash them frequently using the hot cycle of your washing machine.

Food Hygiene

Maintain food hygiene by practicing proper separation of raw and cooked foods to prevent cross-contamination. When preparing various items, such as a roast and raw veggies for a dip platter, keep raw meat from coming into contact with ready-to-eat foods. Additionally, avoid consuming raw dough or batter containing flour or eggs, and cook foods thoroughly to reach safe minimum internal temperatures. Check out this food temperature chart for guidelines on how to properly cook raw meat, poultry, and other foods.

Place Hand Sanitizer at Key Locations

Encourage good hand hygiene by strategically placing hand sanitizer at key locations throughout your home. Consider positioning hand sanitizer stations near the entrance, in the kitchen, and near the dining area. This simple step can significantly reduce the risk of germs spreading.

Clean and Restock the Restroom

Maintaining a well-kept restroom is crucial for guest comfort and hygiene. Follow these steps to ensure a clean and welcoming restroom environment:

  • Regularly clean and disinfect all bathroom surfaces, including sinks, countertops, and doorknobs
  • Provide ample soap, disposable hand towels, or paper towels, for proper hand hygiene
  • Check and restock essential supplies before guests arrive

The Two-Hour Rule

Follow the two-hour rule for food safety. Chill leftovers within two hours of cooking, and toss out any items that have been on the table for longer than two hours. Avoid leaving perishable foods, such as meat, poultry, eggs, and casseroles, in the Danger Zone (between 40 and 140 °F) for over two hours, as this is where bacteria multiply rapidly. Ready-to-eat items like cookies, crackers, bread, and whole fruit are exceptions to the danger zone.

Post-Party Cleanup

Don’t feel pressured to complete all party cleanup in one night. Instead, gather and centralize items in one place for easier management. Perform spot checks on carpets and furniture for immediate stain attention. Once organized, allow yourself to rest and approach the remaining cleanup with a fresh perspective the next day.

Following these guidelines will not only ensure the well-being of your guests, but also add to a joyous and worry-free gathering. Make sure to schedule an appointment with your NOAH provider for COVID and flu vaccinations to safeguard your well-being during the holiday season.