Treating Yourself to a Good Night’s Sleep by Dr. Xiao Kristin Liang, MD Family Medicine Resident, PGY2

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What better way to jumpstart your day than with a solid, restful night’s sleep? In today’s fast-paced, high-tech world, there is still no substitute for a good old-fashioned snooze, which comes with numerous health benefits. These include improved mood, alertness, work or school performance, and even heart health.

Here are some ways to get the most bang for your buck while you catch those z’s! Also known as “sleep hygiene:”

  • Avoid caffeinated beverages such as coffee and tea in the afternoon.
  • Have a regular sleep schedule and stick to it, e.g. bedtime at 10 pm and alarm clock set for 6 am.
  • Sleep in a cool, dark, and quiet room.
  • If you are unable to fall asleep after 20 minutes, get out of bed and do something relaxing (see activities below) so that your body does not associate the bed with wakefulness.
  • Do something relaxing before bed such as drinking a warm beverage, reading a book, or meditating.
  • Avoid screen time before sleeping, as the blue light from phones and computers stimulates wakefulness.
  • Avoid drinking too much alcohol as it can disrupt your body’s sleep cycle.
  • Regular exercise, ideally in the morning or early afternoon, also improves quality of sleep.

Are you doing all of these things but still having trouble with falling or staying asleep? If so, you may have a sleep disorder. Our doctors at NOAH are happy to work with you to achieve your best sleep, health and wellness. Feel free to call us for an appointment at 480-882-4545.

5 Winter Skin Care Tips

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That uncomfortable dryness to the skin of the face, hands and feet can be so distracting, not to mention, it can be downright painful. For some, the problem is worse than just a general tight dry feeling. Skin can get so dry that it results in flaking, cracking, burning and even eczema can occur which is when the skin becomes inflamed.
When it’s cold outside what do we do? We run indoors and crank up the heater. While our body defrosts, our skin dry’s out. Know the difference between dry and dehydrated skin and follow our tips to prevent any further damage.

Dry skin
• Smaller pore sizes
• Feels dry all over the face, scalp and body


Dehydrated skin
• Lacking water
• Affects any skin type
• May feel oil and dry at the same time


Both skin types
• Itchy
• Tight feeling
• Flaky
• Dull looking
• Feel sensitive
• Products may sting/burn
• Rough skin texture
• Fine lines may look accentuated


Now that we know what our symptoms are, let’s learn how to prevent further damage to our skin.


Moisture more – find an ointment moisturizer that is oil-based rather than water-based as the oil will create a layer on top of the skin to protect it and help retain more moisture than a cream or lotion.


Don’t forget your hands – the skin on your hands is thinner than most parts of the body and has fewer oil glands so be sure to keep your hands moist when it’s cold and dry outside to prevent itchiness and cracking of the skin. Wear gloves when outside and use an ointment on your hands throughout the day. I always moisturize at night by applying a thick layer of ointment on the tops of my hands before going to bed. If you can, buy a pair of cozy loose-fitting socks that you can place over your hands to keep the ointment from getting on your sheets.

Use your humidifier – while many of us use a humidifier when someone’s sick, during the winter months, I use it daily to add moisture back into the air. When you turn your central heating system on, your blasting hot dry air throughout your house/office. Using a humidifier will help disperse moisture back into the air to keep your skin from drying out.

Hydrate – Not only is water good for overall health, it helps your skin stay hydrated. Drink at least 8-12 glasses a day. If you drink caffeinated beverages, you need to increase your water level to replenish the dehydration you get when drinking caffeine.

Grease those feet – daily exfoliation of your feet along with a moisturizer is super important all year long for your feet. During winter, you want to keep up with your daily exfoliation but it’s important to set your moisturizer aside and use a petroleum-based lotion instead. Exfoliation removes the dead skin cells so your lotion will skin in faster to repair the skin deeper. At night, I usually use Aquaphor or petroleum jelly on the bottoms of my feet and wear a cozy pair of loose-fitting socks to keep the sheets clean.

If you find that these tips just aren’t doing the trick and your symptoms are worsening, call your provider at NOAH and schedule an appointment to talk about other options you can try to heal your skin.

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.

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.

Skin Care Tips for Teens by Dr. Debbie Bauer, Pediatrician

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“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. Debbie 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.

National MA Week 2019

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This week our NOAH Care Team celebrated all that our medical assistants do for our patients and their families. Check out these cool pics of our MA’s smiling with their team members and help us wish all #MedicalAssistants a happy #MARWeek! For an appt., call 480-882-4545.

Mental Health in Teenagers by Dr. Debbie Bauer, Pediatrician

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Adolescence is a very difficult time for everybody, kids and parents alike. Teenagers are going through all kinds of changes such as: physical, emotional, intellectual and social. It can be hard to keep up with the way their feeling and finding ways to communicate with them. It’s a big challenge to try and not feel overwhelmed during these transitions. It’s very normal for a teen to feel moody, sad, or anxious, but when these feelings take over their life and start to affect how they think and act, it can become a serious problem. Mental health issues are much more common than you may think, about 1 out of every 5 adolescents has had a serious mental health disorder at some point in their life.

What parents need to know:

  • A mental health issue isn’t anybody’s fault. Just like with any other health complication, this is not a choice, it’s an actual problem with how the brain functions. The reason these issues develop is incredibly complicated and involves both genetic and environmental factors.
  • Mental health problems are common and treatable. There are many people and resources that are available to help your teenager. From pediatricians, to school guidance counselors, to mental health professionals – we’re all here to help. The sooner a concern is raised, the more time we have to address the issue, and get your teen the assistance they need. If you have any doubts, reach out!
  • It’s important to stay involved. Try to build a trusting relationship between yourself and your teenager. They should feel comfortable sharing information with you without fear of always being punished for bad choices. It can be helpful to share decisions that you have made or lessons you have learned from the past. Remember, they are still learning.

Signs of mental illness to look out for:

  • Loss of interest in past favorite activities
  • Sudden personality shifts that seem out of character
  • A sudden and/or dramatic change in grades
  • Isolation from friends and family
  • Big changes in sleep habits (more or less sleep then usual)
  • Dramatic changes in eating habits
  • Anything else that you think is concerning about their behavior

If you have any concerns about your teen’s mental health, talk to them. From there, you can schedule an appointment with their pediatrician. At NOAH, we address all aspects of your child’s health including their initial medical assessment. Other services that are available to you and your child include counseling and nutrition.

For more information, please visit:

www.healthychildren.org

Why Get Your Child a Flu Shot by Dr. Amit Jain, Pediatrician

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It’s that time of year again! The fall and winter seasons are approaching. Along with exchanging presents during the holiday season, everyone, especially children, are passing around germs and illnesses between each other. We here at NOAH want to inform you about the flu and why it is important to protect your child against the flu with the flu vaccine.

The Flu is short for Influenza – a virus that most often causes an illness that affects our breathing and airways. There are many different viruses that can cause common cold symptoms, but influenza is different in that it is more contagious, and often causes worse symptoms, lasts longer (a week or more) and has more severe problems that it can cause compared to other common cold viruses including pneumonia (an infection of the lungs), and a bacterial infection.

The flu is highly contagious, and most often spread via droplets, meaning it is most often caught from being near when a person with flu coughs or sneezes. It can also be caught when a child touches something contaminated with the flu virus, then touches their eyes, nose, or mouth.

The symptoms of the flu include:

  • Sudden, often high fever
  • Chills
  • Body shakes
  • Muscle aches
  • Headache
  • Being more tired than usual
  • Runny or stuffy nose
  • Sore throat
  • Dry cough
  • Some children may even throw-up (vomit) and have diarrhea

Although the likelihood of getting the flu is high, the children who would suffer the greatest problems from getting the flu are:

  • Those with chronic medical conditions – especially respiratory conditions including Asthma and chronic lung disease
  • Heart problems
  • Diabetes
  • Sickle cell disease
  • Weakened immune system
  • Disorders of the brain or nervous system

How can you prevent or decrease the risk of your child getting this scary flu virus? The best way to protect against the flu is the influenza vaccine. All infants and children 6 months old and older can get the flu vaccine every year. Since babies younger than 6 months cannot get the influenza vaccine, the best way to protect them is that everyone around and taking care of the baby get the flu vaccine. Along with this, frequent, good hand washing with soap and water is especially important. If you cough or sneeze, be sure to do so into your elbow (like a vampire holding their cape!) or into a tissue, but not directly into your hands. Teach your children these good habits from a young age as well! Sanitize toys that your children play with frequently as well.

Along with this, it may be a good idea to keep your child home from daycare or school if they are having the following symptoms:

  • Fevers (usually a temperature greater than 101F)
  • Chills and shaking of the body
  • Headaches
  • Body aches
  • Tiredness / sleepiness
  • Sore throat
  • Runny nose / congestion
  • Dry cough

Do not hesitate to bring your child in to your NOAH clinic to evaluate your child and determine if any treatment would be helpful. 

The side effects from the flu vaccine are few, and generally much less severe than getting infected with the flu. These include:

  • A low-grade fever
  • Some redness and soreness around the site that the injection was given.
  • The flu vaccine is made using eggs. Those who have a severe allergy to egg (anaphylactic reaction) should have a discussion with their doctor before getting the flu vaccine.

At NOAH, we are here to help you and your child get through the cold and flu season safely and healthily. Please call today to make an appointment to get you and your child the flu vaccine!

For more information, please visit:

  1. https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/The-Flu.aspx
  2. https://www.healthychildren.org/English/safety-prevention/immunizations/Pages/Prepare-Your-Family-for-Flu-Season.aspx
  3. https://www.cdc.gov/flu/index.htm
  4. https://www.cdc.gov/flu/prevent/vaccinations.htm

Asthma – 5 Most Common Triggers to Avoid

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May is #AsthmaAwarenessMonth. Did you know 24 million Americans live with #asthma, including 6 million #children? Learn to control this #chronicdisease that affects your #lungs by taking the right medicine & avoiding triggers that may cause an #asthmaattack. Our Care Team at NOAH will work with you & your child to choose the best path for their overall #health & #wellness. To schedule an apt., please call 480-882-4545!

Happy Physician Assistants Week – 2018

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We wish all #PhysicianAssistants a happy #PAweek! Our Care Team at NOAH are here to help you create and manage your #healthy #lifestyle #habits. Need help setting or sticking to your goals? Call 480-882-4545 today! #FamilyPractice #GetHealthy #MentalHealth