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How to choose a pediatrician

Giving birth has evolved. Now people are taking charge of their birth story and making more informed decisions about their care. That includes choosing a pediatrician.

Back in the “old days,” you went into the hospital on a horse and carriage, were knocked out and woke up with a baby. You didn’t pick a pediatrician, you got whomever was on call that day and that was that. No research, just hope for the best.

Now, we know better, so we do better. Most people make careful choices about where they would like to deliver, what kind of birth they prefer (if baby cooperates) and who their pediatrician will be. Pediatrician’s offices have time built into their busy schedules for appointments for new parents to “interview” them. They hold meet and greet nights at the office and local hospitals, and they have Facebook pages where you can see what kind of office you are getting. They have different cultures per se, and you as a parent, get to choose what is best for your family. 

Questions to consider when choosing a pediatrician

Do you want a solo practice where the doctor calls you from a cell phone but is only open 9-5? Do you want the office that has 15 providers and you never see the same person twice, but is open at 7 AM and closes at 9 PM? Most people want the best of both worlds. How do you choose?

What do you want and need from your pediatrician? How will you know what you are getting? The first stop for most of us is a Google search. Where is the closest office, what are their hours and who works there. What does the website look like? Easy to navigate? What hours is this office open? How quick can I be seen? Do they take my insurance? Does anyone answer the phone? Can you book appointments online? Do they have a Facebook page? Where did providers get their training? Are they nice? 

It’s common to see posts in the local Facebook mom groups from parents looking for provider recommendations and which offices to avoid. It’s the age of the internet, and decisions are made right there on smartphones, instantly. However, making your own judgement about a practice is best, given that your particular goals may be very different than other people’s. 

Is there an on call provider or nurse that is available when the office is closed?

Besides the obvious is this person a good medical provider and know what they are doing, there is lots to think about. 

According to Healthy Children, one question you should have for your pediatrician’s office is “What is the doctor’s policy on taking and returning phone calls? Is there a nurse in the office who can answer routine questions?”

We nurses know that this is a very important question. You as a parent need to know that there are nurses available to chat with when you have questions about your child, whether it be a brand new baby, toddler or teenager. These little humans don’t come with an instruction manual! Nurses and health care providers are basically like walking, talking kid manuals. Make sure your office has these human manuals available 24/7. 

As a mom of three, one of my biggest concerns is “Can I get in touch with a real person right away.” I am not one who enjoys waiting for a call back. I don’t have time for phone tag. My peaceful moment to chat when I make the initial call can turn into a loud and chaotic cry fest at any moment, especially with a sick kiddo. I am a nurse, but also a mom, so I want to be able to get medical advice when I call or text the office. It’s that simple. 

I also want to get an appointment when I need one. If I have to wait until tomorrow to see someone, or 1 hour to talk to someone, and I’m worried, I will likely end up at urgent care. Like many parents these days, I’m impatient. 

That being said, not everyone is impatient (LOL OK OK we all prob are). It’s important to think about what matters most to you and your family. 

Location of your pediatrician’s office

How close is this office to your home or daycare? Are the hours convenient? If your new office is 1 mile from your house, but closes before you get home from work, then it is likely not the best choice for you. Your new office needs to be accessible. Do you drive? Can you get there by train? Can you walk there if you have no car? Is there parking? What things stress you out– let’s avoid those things! 

What hospital is your pediatrician’s office affiliated with

Another really important question is to know where your child’s new provider is affiliated. Will they send you to your preferred hospital if you need emergency care? If you don’t like the hospital they are affiliated with, or they can’t access records from your hospital of choice, then maybe you should pick a different office. It is important to know that you will get the best care, and emergency care is part of that care. Make sure you are comfortable with emergency care choices that your new pediatrician’s office will be recommending and potentially admitting your child to. If you have no preference on what hospital you would go to if there was an emergency, then move on to something more important to you.

Does your office have labs or imaging

Can your office draw necessary lab tests (aka drawing blood) or conduct imaging on site, such as x-rays, ultrasounds, or MRIs? This is good to know for when your child needs to get routine lab work or needs any special testing or imaging such as x-rays or ultrasounds. Will you have to drive 20 min with a screaming 3 year old who just got a flu shot and doesn’t want labs too? Or can you walk across the hall and get it done asap. 

Another thing to think about is how frequently patients in the practice are getting labs done on and how old those patients are. I have a hard time watching someone struggle poking my children for bloodwork, but if the person drawing labs is experienced then it makes the whole process that much easier. If you are lucky, you won’t need more than a few routine labs and this won’t be an issue!

Is your new office supportive?

Are the people in the office nice? By nice, I mean, how were you greeted? Do you feel supported when you call? What kind of triage is available? Will your provider call you if you want to talk to them? Will the nurses give you home care advice? Will you be brought in for every concern? Do the people in the office make you feel cared for? 

An important aspect of health care is trust. In order to build trust, you must have a relationship with the people that give you the information. Feeling that your needs and concerns are important is the first step in developing trust. As a patient or parent, it is important that your health care providers listen to you, and validate your concerns (or explain to you in a clear way why you are worrying unnecessarily 😂 ). 

Physician rating and review sites

Consult online medical review sites to see ratings and opinions from other parents who take their kids to this pediatrician office. There are a lot of these sites to choose from, so be sure to compare a few to help get a full picture of what reviewers have to say. This is an important part of any pediatrician selection process, but it is only one factor in your overall decision making process. 

You can do this! There are lots of really great providers. You will figure out which one is right for you and your child. 

And as always, if you have health questions, or you’re not sure whether an appointment is required, feel free to chat with one of our nurses!

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, tell me about eczema treatments and causes. How to check for head lice in kids, and how to use a lice comb. How to rehydrate an adult who has the stomach bug. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

 

Asthma

Did someone say asthma?

It’s that time of year.  The fall 🍂 and spring 🌷and winter ❄ can trigger asthma. So basically all year. What the heck is actually going on in the lungs though? Asthma is a chronic condition that is made up of two main problems happening behind the scenes:

  1. People with asthma are often allergic to something. Mold, dust, seasonal allergies, pet dander, air pollution if living in busy cities, and even roaches and mice (ewww, I know, but they are the worst!). Whatever it is they are allergic to gets into the lungs as they breath, and causes inflammation in the airways of the lungs without them even noticing! Over time, this can build up into thick mucus, or what I like to call “gunk.” Yup, it’s the technical term. 😂 This gunk can hang out in the lungs and create the perfect environment for bad asthma flares (aka “asthma attacks”). This is why steroid (aka “controller”) inhalers are so important. See more about this below.  These controller inhalers work only to keep the inflammation down over time. They DO NOT work acutely, as it takes time to remove the “gunk.”
  2. Now that the lungs have some “gunk” in them, all of a sudden a certain trigger will hit that causes the muscles in the lungs of the airways to spasm.  Yup, your lungs have muscles in them. Sounds bad right? Well, it kinda is. Now the lungs have some “gunk” in them, and the muscles are spasming/tightening/swelling. This causes the airways in the lungs to really have a hard time getting oxygen to the place we need it to go. Check out this great illustration from the National Institutes of Health. Here is where “rescue” inhalers, for example, Albuterol come in handy to help calm the muscles down. They DO NOT remove the “gunk” (see above). 

Asthma triggers can vary greatly, but most people get asthma attacks from upper respiratory infections, often just common colds. Other triggers include seasonal allergies, environmental allergies, abrupt cold weather, and even sports. Everyone is different and can have various triggers. Asthma causes shortness of breath, difficulty breathing, coughing, wheezing and chest tightness. 😷   Here is what you need to know.

Allergy induced asthma

One example of allergy-induced asthma is seasonal allergies. When fall and spring arrive, the pollen falls. If you have an allergy or sensitivity to pollen and ragweed, these particles in the air can cause more irritation in the lungs, triggering more “gunk” to build up, and eventually an attack. Asthmatics begin to cough and wheeze when things reach a certain threshold that the body can’t tolerate anymore. 

The idea is pretty similar for environmental allergies causing asthma. Instead of pollen, household mold, perfumes, air freshener sprays, pet dander, or even rodents can trigger the asthma attack. If you live in a big city where there are lots of cars and buses, your asthma may be worse during times of high automobile traffic. 

Asthma can be hard to control and is a serious medical condition. It’s important to identify your asthma triggers and control your asthma for optimal health. Have you talked to your primary provider about your asthma and your asthma triggers? Certain cities have programs in place to help people keep their homes clean and allergen free. Some even provide free HEPA filters for vacuums. Check out HUD’s website to learn more about steps you can take to decrease allergens in your home. Oh, and if you smoke (even just outside the home), it can be super irritating to lungs, especially those of little children! Need help quitting? It’s free!

Asthma medications

There are various medications for the treatment and control of asthma. Asthma is a chronic condition. There are many different medications to help keep asthma under control. Most are listed here on this great resource from the Mayo clinic.  You will usually be prescribed one rescue inhaler and one controller inhaler. 

Your provider should review these medications as well as your asthma action plan (“AAP”). Your AAP helps you to know when you should start your controller medications or take your rescue medication, which symptoms to look for and when to seek medical care. Each person is different, and you should have a plan that your provider makes specifically for you. Asthma can be overwhelming, but let’s see if we can make it easier to understand. 😊

Asthma controller medications

You may have heard the term asthma controller medicine.  Long term asthma CONTROLLER medications are key to keeping asthma under control (get it!?) and prevent asthma exacerbations (aka “attacks”). 😩 Controller medications usually contain a small dose of steroids that reduces the inflammation/swelling, mucus, and “gunk” in your lungs’ airways. 

Controller medications work best when taken every day. Why? Well, if you have mucus build up in your lungs due to allergens in your environment, then that means every day you are exposed to allergens that put you at risk for worsening asthma symptoms. So doesn’t it make sense to take the controller medication every day to help keep this inflammation down? Use the controller medication daily, and slowly but surely you will keep the mucus away. Stop using it, and the mucus will build up again. Sadly, this medication does not work right away. So if you haven’t taken it for a while and start feeling like an attack is coming on, the controller medication will not help you much the same day, or even the next day. This medication needs to be used daily to work! 

Daily use keeps asthma symptoms at a minimum and decreases the risk of severe asthma attacks and death. Examples of controller medications include inhaled corticosteroids such as Flovent, Adviar, Pulmicort, Qvar as well as a daily oral medication called Singular, to name a few. They work best when they are taken daily.  They are long acting and will not provide quick relief. They are extremely important in keeping daily symptoms at bay and lower the risk for asthma attacks. They won’t help much during an asthma attack so be sure to travel with your fast acting rescue inhalers, too. 

Fast acting rescue medications

Fast acting medications (aka “rescue inhalers”) are used for quick relief.  They open up the lungs and relax the airways within minutes. They can stop or reduce symptoms of an asthma attack. Fast acting medications work within minutes. These fast acting medications are not intended for daily use. That’s what controller medications are for.  

Fast acting medications should be used for quick action and rescue.  If you are using your rescue inhaler daily, or more than your provider recommends, you should have a follow up to discuss your uncontrolled asthma.  Uncontrolled asthma puts you at risk for a serious asthma attack, and you probably need the addition of a controller medication (see above). 

Common rescue inhalers include Proair, Albuterol, Xopenex and Atrovent. If you use your rescue inhaler and it doesn’t help with your difficulty breathing, call 911 or get to a hospital immediately.  🏥

Oral steroids

Oral steroids can sometimes be necessary when people have moderate to severe asthma symptoms that are not responding well to the asthma action plan. Long term use of these oral steroids 💊can come with side effects.  Having good control of your asthma by using your controller medications helps prevent your asthma from getting so bad that you need an oral steroid. 

It might sound like taking a controller medication every day is way too much medication. Hey, I get it, I don’t like taking medications either 🙄. BUT, it’s better to take a controller inhaler with steroids in it every day for a year than having your asthma flare up and needing to take a single course of oral steroids. How is that possible? 

Well, inhaled steroid medications are low dose and mostly just go straight to your lungs, while oral steroids go everywhere in your body in much higher doses even though the rest of your body doesn’t really need them. Take your inhaled controller medication as recommended by your provider and you will likely prevent asthma attacks and the need for oral steroids. If at any point you stop your inhaled controller medication without the consent of your provider, make sure to start it back up if you are having an increase of asthma symptoms. It never hurts to talk to your provider and check-in about your asthma, especially if you are having daily symptoms! Of course Nurse-1-1 is here to help answer your questions as well.

What are the symptoms of asthma

Everyone with asthma is different.  Some people have mild symptoms on occasion, while others have more severe symptoms that interfere with daily life.  Coughing and wheezing can occur daily, only with exercise, or with the onset of illness. Coughing and wheezing can increase at night, and interfere with sleep.  😴 Some people just have a chronic, pesky cough that will not go away! Yup, this could be an asthmatic cough and you don’t even know! 

Asthma symptoms in children– when to get checked

Asthma symptoms in children can be subtle. Sometimes, if children have severe wheezing, the only symptom they may have is labored breathing. Labored breathing in a baby 👶 or child is usually noticed when the parent thinks the breathing looks “off.”  Often the child’s belly is puffing in and out and they are taking short small breaths. Something called retractions happen in children when they are having difficulty breathing. 

Retractions occur when someone is working hard to breathe. These retractions can be seen around the neck and chest as skin gets pulled around the bones due to difficulty breathing. In babies you may notice that they are reaching their head back, and their nose may be flaring as they struggle to take in more air.  These symptoms need to be seen emergently.  

Babies and young children will eventually tire out from this kind of breathing and will need support such as oxygen that can be provided in the doctor’s office, urgent care, or emergency room. On the other hand, some children might have such mild symptoms that all you notice is they get “winded” faster than other players during sports (this could be sports-induced asthma). 

When to seek emergency treatment in adults

Severe asthma attacks can be life-threatening. Don’t hesitate to call 911 if you have difficulty breathing. An asthma action plan can help you when you aren’t sure what to do. Always feel free to chat with us if you are feeling well enough to text.🤳

Signs of an asthma emergency can include wheezing or shortness of breath that suddenly feels worse, increased use of your rescue inhaler (such as albuterol or proair) or no improvement after use of your inhaler.  If you feel shortness of breath while sitting around, or while asleep, it’s important to get checked out right away. 🏥

Want to learn more about asthma? Chat with us anytime!

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, tell me about eczema treatments and causes. How to check for head lice in kids, and how to use a lice comb. How to rehydrate an adult who has the stomach bug. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Eczema treatments and causes

What is eczema?

That one little word you may have heard over, and over, and over again. It’s a little word, but it causes you BIG problems. 🙄 Up late itching? Eczema. 🙄 Can’t focus at work? Eczema. 🙄 Covering up embarrassing dry skin? Eczema. 🙄 Let me guess, you must be exhausted by eczema! Let’s start off discussing what the heck eczema even is…

Eczema, or what we in healthcare call “atopic dermatitis” (atopic = allergic, dermatitis = skin inflammation), is a chronic condition characterized by itchy, inflammatory skin. Yes, sadly it is chronic (you have it for life) 😔, but symptoms can be well controlled by taking certain measures. It’s unclear exactly what causes the disease, but most believe it’s some combination of an overactive immune system that is going a little haywire and an abnormal skin barrier. Yes, many people with severe eczema are also sensitive to environmental and/or food allergens. But this is usually not the main cause of eczema, and instead a contributing factor. 

With eczema, the skin becomes dry, flaky and very itchy. Once the person starts to itch the skin, the affected area can become thick, open up and start to ooze. Broken skin is at risk of infection with bacteria, viruses, or fungus (yikes! 😳). Itchy skin can be very disruptive and painful. The more you itch, the more your eczema will disrupt your life. Before you get too itchy… read on, as there is lots you can do! 

Can stress increase eczema symptoms?

Stress can worsen eczema symptoms. The way that stress increases the response in your skin is poorly understood. What we do know is that stress causes an inflammatory response in the skin. This makes eczema worse which can make sleep worse and stress levels rise even more. Taking care of yourself becomes a priority during times of stress. Try to reduce stress in your life to help reduce triggers for your eczema. When you start to feel stressed, it’s common to start to itch. Some people experience flushing of the skin or a hive-like rash. Getting an itchy rash can make you feel even more stressed, exacerbating the eczema. Make a list of things that work for you to help decrease stress. Try and do something other than itch!

Eczema and allergens

Allergens can definitely worsen eczema symptoms, especially when your skin barrier (the epidermis) is not working as well as it should. Allergies to dust, dander, and certain foods (among others) can trigger symptoms of eczema. Other triggers include bathing too often without moisturizing your skin, living in dry environments, just having chronic dry skin, and overheating the skin. For long-term eczema management, it is helpful to figure out what triggers your eczema to worsen, and then avoid those triggers. . Basically, it’s not rocket science, whatever causes your itch, avoid it! 😜 

Dust mites, animal danders, molds, and pollens can make eczema worse. Have you noticed these allergens in your living space? What can you do to minimize your exposure to them? Thorough home cleaning can help. I know, I know, who has time for thorough home cleaning? 🙄 But it’s important! Using hypoallergenic sheets and pillow covers, and removing mold are also good places to start. Got pets? If they worsen your eczema then they better not be sleeping in your room, or even worse, in your bed 😆. Vacuum, a lot! Use hypoallergenic sheets and pillow covers. 

Some people have a sensitivity and/or an allergy to different foods that causes an inflammatory response and eczema symptoms as well. Following up with an allergist to determine if you or your child has an allergy will be helpful if you are suffering from eczema. Identifying your triggers, then avoiding or treating them, can help to alleviate your symptoms. 

Eczema in children

In children under 5 years of age with eczema, up to 30% also have a food allergy, according to The National Eczema Association. Causes of eczema can be complicated and it can be hard to treat. Eczema can be disruptive to sleep and daily life, and can cause infections and complications. It is important to really pay attention to your child’s skin and make an effort many times a day to help alleviate symptoms. Definitely have your pediatrician evaluate your child’s eczema and discuss a plan of action! 

What can I do for my eczema?

First, let’s start with what irritants you can remove before we jump to medication treatments. Eczema is usually worsened by an irritant. You must identify what the irritant is and remove it. Start by removing any fragranced products from your daily routine. Washes, shampoos, lotions, laundry detergents, and fabric softeners are often the culprits in causing irritation to the skin. It’s important to find products that are hypoallergenic and fragrance free. The National Eczema Association lists some of their recommendations to help decrease the irritants in your life. Start looking at labels to see what is in the products you are using. Try switching to hypoallergenic products for your home and skin. Many times, simply switching to a non-fragranced fabric softener will significantly improve eczema symptoms. 

Often times your eczema may not flair until the heat is blasting in your home, or you are out in the summer heat sweating. It all depends on how your skin reacts. If it helps, write down what bothers your skin so you can remember next year! For example, it may help to add a reminder to your calendar to start moisturizing in late September before the heat turns on at home.

Treatment for eczema

Treating eczema is hard work and takes dedication and action on multiple fronts. Annoying, I know. But, we promise, it will be worth the work! 😊 The main goals are to (1) remove possible external causes of eczema, and (2) keep the skin as moisturized💧as possible! If you’ve been trying a lot on your own without much improvement, working with a primary care provider or dermatologist can be super helpful! The following eczema treatments are worth trying:

  1. Eliminate fragranced products from your daily routine, including fragranced detergents, body washes, lotions… anything that touches your body.
  2. Use a cool mist humidifier in your home and room, especially when the heat is on or if you live in a very dry place.
  3. Take a warm oatmeal or baking soda bath (sometimes doctors even recommend bleach baths. You can ask your provider if this is right for you– don’t go dumping bleach anywhere without a plan!) 
  4. Use daily emollients (types of creams) such as Aquaphor, hydrolatum or Eucerin cream to keep skin moisture locked in. Use the creams directly out of the bath when the skin is still wet. This will help lock in the moisture. I often recommend applying a moisturizing cream onto damp skin, then covering that with vaseline/hydrolatum to lock in the moisture. Some people even recommend wearing damp clothing on top of that to help keep the skin moisturized for hours.
  5. Apply an over the counter hydrocortisone cream to reddened, irritated areas, once or twice a day. Limit use to 1 week and avoid the face and genital regions. Overuse of steroid creams can thin the skin and cause wrinkles (and that is no fun). If you use hydrocortisone for a week and the problem still persists, or if you need treatment on the face/genital areas, then please discuss with your primary provider, as they can monitor stronger steroid cream use.
  6. Moisturize, moisturize, moisturize!
  7. Don’t scratch! If you are having trouble holding back 😤 then consider trying an over the counter antihistamine cream or antihistamine oral medication such as cetirizine (aka Zyrtec) or diphenhydramine (aka Benadryl). Please use only as directed and discuss with your provider if using long term for severe itching. 
  8. If you have any skin breakdowns, or if the rash is starting to become red, consider speaking with your provider and applying antibiotic ointment such as bacitracin or mupirocin. 

When to be seen by a medical professional for eczema symptoms

There are many steps in improving eczema and it can take some effort, so be patient. Get checked out by a medical professional if you or your child has a rash that doesn’t improve or gets worse after a few days of really moisturizing and protecting your skin. It’s important to get checked out if the rash begins to have any oozing, pus, redness, swelling, or warmth at the site, or if develop a fever along with the rash then. 

For some, eczema can be severe and requires prescription medication to treat eczema flares. We can chat with you if you aren’t sure about your symptoms or want us to look at a photo of your rash.

– Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, does cold weather cause the flu Is the Hep A vaccine safe How to stop pertussis or whooping cough in babies. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Americans Trust Nurses Most to Improve the Healthcare System. Shouldn’t Your Organization?

Author: Nurse-1-1 Medical Team

Hey, have you heard? Americans trust Nurses to improve the U.S. healthcare system over every other healthcare group. By far. Why should it matter to your organization? Because trust may be the single most important factor that dictates your patients’ healthcare decisions. 

This past October (of 2019), The New York Times, the Commonwealth Fund, and the Harvard T.H. Chan School of Public Health conducted a survey of 2,005 adults titled “Americans’ Values and Beliefs About National Health Insurance Reform.” The survey specifically asked how much trust the public has in various healthcare stakeholders to improve the U.S. healthcare system. Over half of respondents (58%) trust nurses to undertake this goal. Only 30% of those same respondents trust doctors, and 18% trust hospitals to improve the system. The stats are even worse for health insurance companies, the government, and business leaders. Find the final report here

Americans trust nurses over doctors

Were we surprised to see nurses as the most trusted group to improve healthcare? With nearly double the trust rate compared to doctors? Nope! After all, we are called Nurse-1-1 for a reason. However, this knowledge does make me wonder if our healthcare system is doing enough to put nurses at the center, and creating opportunities for them to innovate and improve the system.

It’s not like the jury is still out on whether patients will respond positively to more interactions with nurses during their care journeys. Opinion polls in the U.S. have rated nurses as the most trusted profession for the past 17 years. Nurses exude ethics, honesty, and care. They were “mission-driven” way before this became the cool buzzword for startups. And most importantly, patients trust them. 

Patients trust nurse to care for their ill grandfathers. They trust them to explain the complicated jargon that just came out of the doctor’s mouth. They trust them to be honest. And, they trust them to make healthcare better than it is today. 

Trust leads to patient engagement

This one little factor, trust, can make or break a patient’s experience as they navigate the healthcare landscape and make decisions that greatly affect them. From step one, when illness strikes and patients’ journeys begin, patients are searching for a place they can trust to return them back to health. If you are a healthcare entity of any kind (payer, provider, employer, information source), how you engage with patients during this critical moment will greatly dictate the next steps of the patient’s journey. 

Please note the emphasis in the last sentence, it’s how YOU engage with your patients, not how patients engage with you. Fail to build the right level of trust at the outset and your patient is more likely to make poorer healthcare decisions, like postponing care or unnecessarily ending up in an ER. Postponed care can lead to increased healthcare costs and bad outcomes, both things we strive to avoid. Create solid trust from inception and patients will seek care as recommended, stay engaged, avoid the ER, and live healthier lives. 

Are you building high-levels of trust with your patients from step one? If you don’t have nurses involved at this crucial step, chances are the answer is no. 

When we decided to build a company that helps people during the very first step of their illness journey, we knew nurses must be the foundation. That’s why patients who use Nurse-1-1 are messaging with a nurse within 30 seconds. When it comes to our product, our motto is: “get the heck out of the way and let nurses work their trust-building magic.” 

Want to build more trust with your patients at this critical moment? Nurse-1-1 is here to help. Learn more by visiting the providers, payers, and employers sections of our website. Or contact us below and we’ll tell you more.

Head lice

The dreaded call– your child has head lice

What to do besides panic, when your school nurse calls home and tells you that your child has head lice? Now don’t go burning down the house just yet. You can do this, lice can be beat. 

Lice is no joke. Having creepy crawlies in your child’s and likely your head is serious business. So serious that people are opening lice clinics ALL over the place. They are charging $100-200 per head to get rid of head lice. The service is not guaranteed and often times the head lice come back. Now that you are itchy and there are lice bugs crawling all over you (not really but feels like it, Ya?), let’s talk about how we can help! Save your family the $800 and try to tackle this at home. The job will take grit and persistence. YOU can do this!

Checking for head lice in kids

Dr. Patricia Brown, a Dermatologist at the FDA explains how you can best check for head lice. Take a deep breath and whooossaaahhh. You can do this.

  1. Part the hair in several spots
  2. Use a magnifying glass and a bright light to help find the lice (fun fact– lice is the plural of louse. One louse, many lice.). The light might scare the lice, but mostly will help you to see things better. 
  3. Lice like warm areas, so check behind the ears and at the nape of the neck.
  4. Head lice can move fast (Eww) and it may be easier to spot the eggs. Lice eggs are otherwise known as nits. Nits don’t move and they usually are stuck to the hair shaft, almost like little white tiny grains of rice.
  5. Nits can look like dandruff, but you can identify them by picking up a strand of hair close to the scalp and pulling your fingernail across the area where you suspect one is hiding. Dandruff will come off easily, but nits will stay firmly attached to the hair. 

Lice treatment

There are many over the counter lice treatments on the market to help with lice problems. The medication will only kill the actual bug (louse) and not the (nit) egg. There is no medication that will completely penetrate and kill the lice eggs. It is important to read the directions on the box if you are using a lice treatment at home. It is especially important to read the age limits for the treatment, as some home treatments are not meant for children or babies. 

If you have called your provider and received a prescription, make sure to follow the instructions for use as well. The CDC outlines many of these lice treatments which can help you to determine which is best for you. 

The MOST important thing about treating lice after killing all the live bugs is to prevent the lice eggs from hatching. Live lice on your head feed on your body and then lay eggs on your hair follicle. Once these eggs hatch, you are back to square one and the life cycle starts all over.

A full grown bug will lay the eggs after about 1 week. These eggs take about another 1 week to hatch. The cycle continues until you stop these eggs from hatching on your head! You must get those eggs OUT OF THERE.

GET RID OF THE EGGS– How to use a lice comb

Lice eggs (nits) will be stuck to the hair shaft. You will need to comb the hair with a lice comb or pick them off. 

The nits need to be picked off to resolve the lice problem. Ever heard of the term Nit picking? Now you know where it comes from! Nit picking is tedious and awful work. But if you miss ONE egg, and it hatches, you may as well start crying now. The lice will be back. You must be nit picky! 

Every nit counts. Every last strand of hair must be combed. This must happen EVERY DAY for TWO WEEKS. No joke. You must do this daily. The best way to comb the nits is by lightly wetting the hair and parting it. Separate with a clip and use the lice comb to check every strand. After each swipe, wipe the comb on a paper towel. A nit will appear as a white/grey/yellowish teeny tiny grain of rice. And a bug, well…a bug looks like a bug. But they are TINY and may be dead or alive. Be prepared. 

Clean your house to help control the spread of head lice

Take a vacuum to your couches, change your sheets and take all the stuffed animals out of your kiddo’s rooms. Do a quick clean. The honest truth here is that people freak out about their homes and spend lots of time cleaning, and not enough time picking. I’m going to be nit picky here (see what I did?)— pick the nits, don’t waste all your time freaking out about your house. The lice like your nice warm head and can only live while hosting on your scalp. It is unlikely that your lice buddies will jump off your head and set up shop in your couch cushions. I mean they may fall off there but they won’t live long and they really just want a cozy scalp to live on. 

If you have questions about head lice, always feel free to chat with one of our nurses. We’re here to help!

Preventing head lice 

Sharing isn’t always caring! Don’t share brushes, headbands, hats or clothing. This will prevent you from catching head lice from infected friends. Be sure to remind your kiddos that they shouldn’t share headwear at school. Keep hats to themselves! Avoid sleepovers with infected friends. Laying on a couch or pillow that an infected person has been lounging on can get head lice on your head too. One little friend may fall off and cozy up to your head. 

Make it a habit to do a quick comb once a month or so during the school year, and more often when that dreaded letter comes home that someone in your child’s class has head lice. Head lice do not discriminate, anyone can get it! Now stop scratching your head and order that lice comb 🙂  And always feel free to reach out to our nurses with questions.

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, how to treat constipation in toddlers? Do I have a stomach bug or food poisoning? Does cold weather cause the flu?

Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Stomach bug

The stomach bug– so catchy you might just get it from reading this article.

The dreaded words… the stomach bug.🤢 Let’s talk about how we can avoid catching it and what it is.

The stomach bug is usually caused by a virus 🤒that causes vomiting and/or diarrhea 💩🤮. Viral gastroenteritis, stomach flu, stomach bug, puking, the runs all usually mean one thing. They don’t call it runs for just the obvious reasons… You will be running to the bathroom as well as having runny poo. How did you catch this, and is it really the stomach bug? 

Stomach bug transmission and symptoms

The stomach virus is spread by touching infected vomit, stool and saliva. 🤮 Good handwashing is a must.🚰 Don’t get caught eating a poop particle (yuck) 💩. Keep your hands away from your mouth! Try telling that to your thumb sucker or orally fixated school aged kiddo. 

Your symptoms usually occur about 24-48 hours after exposure to the virus. Besides suffering from vomiting and diarrhea, you will likely feel sick, have abdominal cramping, low grade fever, nausea and overall feel achy. 🤒 The stomach bug is hard to contain. If someone in your house has it, either clean the toilet each time they use it, or if you are lucky enough to have two bathrooms, only let them use one!

What causes the stomach bug

The most common viruses to cause the stomach bug 💩🤮 are the norovirus, rotavirus, and the adenovirus. Both the noro and rota viruses are SUPER contagious and can blow through schools, offices, and homes over a few days. Handwashing and good hygiene are KEY to preventing the spread. The most common time to get these viruses is October through April— Poop virus from Pumpkins to Petunias is a good way to remember it. But let’s face it, that’s more than half the year, so let’s just say it’s always around! Wash those hands! 🤒

What should I expect; how to rehydrate an adult who has the stomach bug

The stomach bug will usually only last 3-4 days, but it can last as long as 10 days! It’s important to give your gut a rest when the symptoms first start. If you are vomiting, give your belly a rest until the vomiting calms down by avoiding all food. Take small sips of Pedialyte or watered down Gatorade or broth. Small sips means small sips! If you chug the drink (which you may want to do, SO THIRSTY) you will likely vomit! Don’t do that! You are better off sipping and letting your body absorb small bits of fluid at a time than chugging a large amount and immediately vomiting it up, while absorbing nothing. 

Hydration is key with the stomach bug.🥛 You will feel awful, and that feeling will worsen if you become dehydrated. So take it easy, slow and steady wins the race. Once vomiting has stopped and you can tolerate drinking well, you can start eating small amounts of plain, bland, foods that are easy to digest. Don’t go eating a Big Mac or chicken wings. Stick to plain, non greasy, low fat foods. 

High protein foods like eggs 🥚, boiled chicken are okay🐔, as well as plain rice, broth and crackers. Avoid dairy for at least a week, especially in children. Milk and cheese🧀 are hard to digest and can prolong diarrhea symptoms. Switch to a non-dairy alternative such as coconut, nut or soy milk to hold them over as some kids love their milk! Plain yogurt with live cultures is also a great alternative as it provides some good bacteria for your gut. 

How to rehydrate your baby or young child who has the stomach bug

If your baby is less than 6 months old and has vomiting or vomiting or diarrhea 💩🤮, you should call your primary care provider. They may want you to come into the office for a visit. Babies over 6 months of age with stomach bug symptoms usually can be managed well at home with some effort. But not all! Make sure to call with any signs of dehydration or if your child is ill appearing.

First off, babies should have a wet diaper a minimum of every 6-8 hours. It’s important that their body is making urine (pee) regularly. If that’s not happening, that it a sign they are getting dehydrated and should be evaluated by your primary provider, an urgent care, or the ER depending on time of day. When in doubt, check with us or call your pediatrician. Don’t hesitate if things seem off, ask for some help and guidance, as young infants can get dehydrated much faster than older children. Remember, if they are not peeing, they should get checked! 

If your baby is actively vomiting, let their belly rest for an hour or two until the fast and furious vomiting improves. Once things calm down, offer your baby small amounts of Pedialyte at a time. Small sips are important. Keep track of what they are taking (put a sheet of paper on the fridge and track it all). If they chug the bottle, they are likely to vomit it all up. 🍼 Small sips means that they are absorbing small amounts frequently. Offer ½ oz-1 oz every 15 min and increase as they are able to keep it down. Some babies may even need you to syringe 5-10mL of fluid or give teaspoons every 2-3 minutes as they may refuse the bottle/breast.

Gelatin, tea, fruit juice, rice water, and other beverages are not recommended to rehydrate your child. Stick to premade oral rehydration such as Pedialyte, Infalyte, and ReVita or other generic Pedialyte version are great. Oral rehydration popsicles are a fan favorite and they are found non frozen next to the regular pedialyte bottles. 

Don’t give your baby formula or cow’s milk for 24 hours or until they are able to tolerate full feeds of Pedialyte. For babies on formula, you can reintroduce them slowing back to regular bottles by giving 50/50 Pedialyte/formula and then once tolerating that, back to 100% formula. 

Can I give breastmilk to an infant with stomach bug?

You CAN breastfeed your baby who has the stomach bug. Breastmilk is very well absorbed– your baby can easily digest your breastmilk. The same rule goes for chugging! Small sips, so either pull the baby off the breast or pump and offer small amounts at a time. 🤱Pedialyte frozen pops or breastmilk pops are also great ways to rehydrate without chugging.

Infants (0-6 months) can become dehydrated VERY quickly. If your baby isn’t taking any bottles, or is refusing to breastfeed, you should have a discussion with us or your provider about the plan for them as they will become dehydrated quickly. 

The stomach bug 💩🤮 can last up to 10 days in kiddos as well as adults. Once your child stops vomiting, diarrhea usually follows. Avoid letting your baby drink cow’s milk and dairy based formula until the diarrhea slows down to once a day or completely resolves. Lots of cows milk, cheese, greasy hard-to-digest foods can prolong diarrhea in kids and young babies. Who wants to deal with that!?

High protein foods like eggs, boiled chicken are ok, as well as plain rice, broth and crackers. Avoid dairy for at least a week, especially in children. Milk and cheese are hard to digest and can prolong diarrhea symptoms. Switch to a non-dairy alternative such as coconut, nut or soy milk to hold them over as some kids love their milk! Plain yogurt with live cultures is also a great alternative as it provides some good bacteria for your gut. 

If for any reason your child isn’t urinating for more than 8 hours, doesn’t make tears when they cry, has a very dry mouth, has sunken eyes, feels cool/clammy, seems listless/out of it/confused, or is complaining of a bad headache they should be evaluated by a provider right away. Remember, you know your child best, so if something seems up, don’t hesitate to get some help and have someone lay eyes on your kiddo! 

Food poisoning 

Food poisoning is similar to the stomach bug 💩🤮, but is caused by eating bad food that has a virus or parasite in it. Vomiting and diarrhea start fast and furious, about 2-6 hours after eating the bad food. Food poisoning usually doesn’t last as long as the “stomach bug.” Along with the vomiting and/or diarrhea, if you have food poisoning you will likely experience chills, sweating and lots of abdominal cramping. 

To help prevent food poisoning, avoid eating raw or undercooked meat, eggs, sprouts and other foods, and unpasteurized cheese and drinks. Also make sure to cook your food thoroughly. You can also help prevent food poisoning by washing your raw veggies and fruits well before eating. 

When to worry about dehydration in kids with stomach bug

The stomach bug usually resolves without complications. However, this is not always the case. If your child hasn’t urinated or had a wet diaper in 6-8 hours, they may be dehydrated. A sign of dehydration can be no tears when crying and a dry mouth. Kiddos are much smaller than adults and can become dehydrated MUCH faster than adults. Your child may appear to be like a wet noodle and can’t stand or lift their head. If you can’t get your kid to use their iPad and if your teen isn’t texting… well that is a clear sign you have a sick kid. If this is the case, you should have them seen right away in urgent care or the Emergency room as they may need intravenous (IV) hydration. 

Another reason to bring that kiddo to the office is if there is frequent diarrhea that lasts more than 3 days, poop with blood in it, or significant pain that is worsening or not resolving. Pain or vomiting and/or diarrhea with high fever >101.5 should also be seen right away. If you child can’t walk due to pain, or you have that uneasy feeling, always go with your gut and get them checked out.

When to be concerned about the stomach bug

Parents are always tired, but when should you worry about yourself or other adults? The stomach bug usually resolves without complications, especially in adults. However, this is not always the case. Often times you will have no energy and can’t get out of bed or may feel dizzy when standing. You may have the following symptoms: very dry mouth, no urination in 8 hours, feel like you have a fast heartbeat, have dark urine and the feeling of extreme thirst that doesn’t seem to improve with drinking. If this is the case, you should be seen right away in urgent care or the Emergency room as you may need intravenous (IV) hydration. Another reason to visit your provider is if you have fainting, there is frequent diarrhea that lasts more than 3 days, poop with blood in it, or significant pain that is worsening or not resolving. Pain or vomiting and/or diarrhea with high fever >101.5 should also be seen right away. 

We can chat with you to help you to determine if you are having severe symptoms of dehydration or this is something you can tackle at home. 

What will urgent care or the Emergency Room do for the stomach bug?

The nearby urgent care or the emergency room will do everything possible to get you or your child to drink orally before considering IV hydration (often times by starting with a dose of an orally absorbed anti-nausea medicine called ondansetron/zofran), so try your best to drink or get that kiddo to drink at home. Popsicles and a favorite drink offered frequently are helpful in getting stubborn kiddos to hydrate. Play a game with a drink or have a tea party with some Pedialyte or Gatorade to encourage your child to drink. Even offering small amounts with an oral syringe can help. Once you or your child start to absorb some fluids, you should feel significantly better. 

If you can’t seem to tolerate drinking and you are still vomiting and having diarrhea 💩🤮 and have signs of dehydration, and urgent care or the Emergency Room can help you to recover. They can place an IV in your arm and give you or your child proper fluids and electrolytes to help you recover from your illness. Dehydration can be very serious and can require medical treatment to reverse. In some cases medication is given to help with symptoms of nausea. Sometimes certain medication is needed to treat your diarrhea. The ER can do testing if necessary.🏥 

Chat with us if you aren’t sure on what to do! 

Prevent the spread of vomiting and diarrhea

Regardless of how you got your illness, it’s important to prevent transmission of the virus. Good handwashing is key to prevent the spread of illness. Always wash your hands before and after eating, when handling food and when using the bathroom. 🚰🤚🖐 Clean surfaces where raw meat is placed and never reuse an unwashed plate for raw food to serve cooked food. Always wipe surfaces down with Clorox or bleach products. 

According to the CDC, you can shed billions of virus particles in your vomit and poop 💩🤮. It only takes a few of these particles to make someone sick. Keep away from others while you are actively sick and for 2 days after. Don’t cook dinner or go to your job as a chef until your have been well for a few days. Keep your child home from school and daycare for an extra 2 days after they are vomiting and diarrhea free! And again, WASH YOUR HANDS! 🚰🤚🖐

– Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, does cold weather cause the flu?  Is the Hep A vaccine safe?  How to stop pertussis or whooping cough in babies. Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Does cold weather cause the flu?

Was Grandma right after all? Does cold weather cause the flu? 👵

What is the flu?

The flu, also known as the influenza virus, is spread by exposure to infected particles. These particles are transmitted through the air when people cough and sneeze. You can also be exposed by touching the particles and then touching your mouth or nose. The flu causes achiness, fever, cough, runny nose, sore throat and can make you feel yucky and gross in general. You will be a hot achy mess. Many people complain that every last part of their body hurts, eyeballs included. You DON’T want this virus. Of course, it might be just the common cold

Don’t forget your coat!

“Put a hat on or you will catch the flu!” “Zip your coat or you will catch the flu!” 🧥 Was Grandma right? Does the cold weather cause the flu? 

The answer is, well, no, the cold weather alone doesn’t CAUSE the flu. The influenza virus does. But Grandma did have a point. The cold weather seems to have something to do with the spread of the influenza virus, according to the National Institutes of Health. Let’s explore why, so we can help decrease flu transmission this winter! 

One of the obvious causes for the flu to spread more easily in cold weather is that you are likely indoors when the weather is cold and windows are likely to be closed. This traps the air in, and with it, the influenza virus that your visitors are coughing all over your living room. To help avoid this, open up those windows when the air is mild to circulate the air in your house. Also avoid sitting across from your coughing friends in closed quarters, and let’s just avoid sitting in a room of coughing people unless you can’t avoid it. AKA don’t go to the ER for 1 day of runny nose. Talk to us first! Ever see someone wear a mask at the airport? Prob some good advice from Grandma!

The flu spreads better in the cold

According to an article by Harvard University, the influenza virus has been found to survive significantly longer in dry, cold air. This means when the cold wind blows 🌨 and it’s dry in your house, the influenza virus will live much longer and is more likely to infect you. Hmm, looks like Grandmas ARE always right. 

This means once the heat is on, it’s time to get that air nice and moist (yucky word but not yuck in this case). So either sleep on your shower floor OR start up that cool mist humidifier and get that air nice and humid. Keep warm and don’t forget that stocking hat!

Humidified air– when should we use humidifiers

Humidified air can help decrease flu transmission. The first thought is that why don’t we just humidify ALL the air!? Hospitals which tend to be cold and dry might benefit from humidified air as well as those dry hot schools. Humidifiers in every classroom? 🏫 Seems like a cheap alternative to costly flu treatments and hospitalizations. CNN reports that taking action based on this study may help reduce flu transmission, but it’s still too early to justify humidifying the entire community.

Flu vaccines and hand washing are still the best way to prevent the flu. That being said, if humidified air decreases flu transmission, there may or may not be 5 humidifiers being delivered to my house tomorrow! You get a humidifier, you get a humidifier, everyone gets a humidifier!!!! 😜

Get that immune system strong

The Harvard article also states that when the winter comes, the sun goes away and your Vitamin D and melatonin levels drop. This drop makes your immune system weaker and your chance of catching the flu higher. So it looks like that tropical vacation is a perfect way to avoid the flu! Or if you are a regular old human who can’t jet off for the winter to a tropical island, you can just boost Vitamin D with some vitamin supplements or fortified foods and some sunshine on those mild days. Keep that body strong and rested and well nourished!

Protect yourself– get a flu shot

Get your flu shot. Besides avoiding winter, you can get your flu vaccine to decrease your chances of getting the flu. The flu vaccine is going to help prevent you from getting the influenza virus. It’s very important to protect yourself and others around you from getting the flu. If you are sick, have a fever and are coughing away, it might be a great idea to stay home and rest. If you are out in public, you are exposing all the people around you to the flu. 

Good hand washing is always a great idea too. Wash your hands as often as possible during flu season (and always), and stay clear of those hacking buddies! Wash or sanitize before and after eating, after touching that grocery cart and basically whenever you think of it. Your healthy body will thank you!

Grandma had some great points all these years. You may as well get that chicken soup cooking, your winter hat ready and zip up that coat!

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, how to stop pertussis, or whooping cough, in babies. Is the Hep A vaccine safe? How to prevent UTIs in men? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

Flu vaccine

Let’s talk flu vaccine. As a mom I understand the worries that you might have. Is this safe? Is this necessary? Am I doing the right thing? It’s not only OK to ask these questions, but necessary. Now, the key to asking the questions is… Who is answering them? 

Get medical professionals to answer flu vaccine questions

As a pediatric nurse practitioner 👩‍⚕️I must put my foot down. A medical professional or a trusted, reputable, science based resource MUST be the one answering your questions about the flu vaccine. Please do not ask on a mom group, a celebrity blog, or a random website🤦🏽‍♀️. Check your source. I don’t make money from vaccine companies when giving my advice, but celebrities do make money from talk shows and magazines. That’s a fact 🤷🏾‍♀️. Always consider the incentives your information source might have. 🤑

Here is an example of a great article about common flu myths from a trusted Children’s Hospital. 

I worry about the safety of my children and those around us. If my healthy son gets the flu will he be ok? 🤧 The fact is, since he is vaccinated, he likely will be just fine. 💉 Studies show that vaccinated children are less likely to die from the flu than those that are unvaccinated. You can find one of the studies supporting this here from the American Academy of Pediatrics. Just be aware it has lots of science speak🤣🤣🤣! Will Susie down the street be ok when she gets the flu? She just had a heart transplant and her immune system is subpar (what we in the healthcare world call “immunocompromised”). She might not be ok. 

Flu vaccine helps you and others

Think about Susie. Patients like Susie who have a suppressed immune system need to be vaccinated to be protected. 🤧 Sometimes, however, patients like Susie can’t get the flu vaccine due to their disease or severe allergies. So, instead, they rely on healthy people getting the vaccine and decreasing the chances that the flu virus is passed around. 👾 Healthy people should be vaccinated to protect themselves and so they don’t give the flu to those who are immunocompromised. 🤧 Not all people can get all vaccines due to allergies and medical issues. 

If you don’t get vaccinated, you are more likely to get the illness and spread it to others. Help protect those who can’t get the flu vaccine for medical reasons. What if Susie were your child. You would protect her right? It takes a village to raise kids. Be the village❤️. Vaccinate your child. 

Please, for the safety of your family and families around you, don’t listen to celebrities, mom groups, or untrusted sources that are NOT backed by science. Listen to the facts. The Centers for Disease Control and Prevention (CDC) reports that children are less likely to DIE from the flu if they are vaccinated. This is a very important statement. 

Is the flu vaccine safe?

The flu vaccine is found to be very safe. 💉 Sometimes the flu vaccine can cause pain at the site or localized redness around where you were given the shot. As your body develops antibodies, you may feel achy, have a headache or nausea 🤢, but the flu shot does NOT actually cause the flu! These milder symptoms should not last long. 😷

The flu vaccine helps protect those who are unable to be vaccinated. 🤧 Help a mama out. Protect Susie. Protect your family. We are all in this together. Read the facts. The flu vaccine is going to reduce YOUR child’s risk. Let’s vaccinate.

Don’t let non-medical professionals teach you about vaccines. If your child had the flu you wouldn’t take them to the mechanic, right? Then don’t take them to a Facebook group made up of people who are not medical professionals. 💊 Take them to your local pediatrician’s office and have a conversation. Shoot, have a few conversations!

Or chat with us at Nurse-1-1.com. We are medical professionals, and we can help you figure out what’s best. 👩‍⚕️👨‍⚕️

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, should I be concerned about giving my child the MMR vaccine to prevent measles? What are the best ways to prevent UTIsWhen to get that sports injury checked out by a medical provider? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

What is Hepatitis A? Is Hep A vaccine safe?

What is Hepatitis A?

Hepatitis A is a serious infection of the liver by the Hepatitis A virus (HAV). Hepatitis A is spread by fecal matter (tiny poop particles💩) that you accidentally eat (Eww😝), usually by means of contaminated food and water. Hep A can also spread by close contact with a person infected with the virus or their caretakers, shared needle use, and unprotected sexual contact. 

According to the CDC, signs of this infection include:

  • fever, fatigue, loss of appetite, nausea, vomiting, and/or joint pain
  • severe stomach pains and diarrhea (mainly in children), or
  • jaundice (yellow skin or eyes, dark urine, clay-colored bowel movements)

HAV can last up to 2-6 months and usually begins within a few weeks of exposure. Most people will be ok and have no long term effects from this virus. Once you get Hep A you can’t get it again (phew!). In some severe cases Hep A can cause death. 😳 Interestingly, children under the age of 6 may not have any symptoms at all. 

Hepatitis A Vaccine 

The Hepatitis A vaccine protects you against getting hepatitis A. 😎 It is routinely offered to children at 1 years of age and then again at least 6 months later at their 18 month or 2 year visit. Anyone can get the vaccine and it works best as 2 doses given 6 months apart. According to the CDC, the following high risk people should get the Hep A vaccine. People who:

  • are traveling to countries where hepatitis A is common
  • are a man who has sex with other men
  • use illegal drugs
  • have a chronic liver disease such as hepatitis B or hepatitis C
  • are being treated with clotting-factor concentrates
  • work with hepatitis A-infected animals or in a hepatitis A research laboratory 
  • expect to have close personal contact with an international adoptee from a country where hepatitis A is common

Is the Hep A vaccine safe?

Hepatitis A vaccine is found to be very safe with very minimal side effects or problems. Since the vaccine was developed in 1996, the occurrence of Hepatitis A in the community has significantly decreased. Minor side effects of the vaccine include pain at the injection site, achiness, fatigue and low grade fever. Most people tolerate the hepatitis A vaccine very well. The risks are low and the benefits are high! ❤️

What if I am exposed to Hep A?

If you know, or suspect, that you have been exposed to Hep A, you should be sure to get the Hep A vaccine or a special infusion called immune globulin within 2 weeks of exposure. You should call your Primary Care Provider right away to discuss the best plan for you.

Why are there Hepatitis A outbreaks?

You may have heard about Hepatitis A on the news. There have been many outbreaks in recent years. From 2013 to 2016, there were multi-state hepatitis A outbreaks because of contaminated frozen strawberries and pomegranate seeds and a localized outbreak from raw scallops. More recently there was an outbreak in Colorado and California related to drug use. 

This disease is often seen in areas of poor living conditions, in intravenous drug users, and in jails. Now, don’t think that because you aren’t an IV drug user that you can’t get Hep A. All it takes is someone with Hep A to go to the bathroom, not wash their hands and then make your food at a restaurant (gross, I know!). Water contaminated with Hepatitis A that is used to wash your produce can also cause transmission. This is how outbreaks happen and how hepatitis A is spread. 

You may not feel you’re at high risk for hepatitis A, but it is important to protect yourself and your family against hepatitis A, especially if you go out to dinner or have other people preparing your food in the grocery store or a restaurant. Which, let’s be honest, is all of us! So be sure to wash those hands.

hep-a-outbreaks-food-safety

Think you might have symptoms of Hepatitis A?

If you are worried that you might have Hepatitis A, make sure to do the following. Drink plenty of fluids to keep yourself hydrated, use good hand hygiene to avoid exposing others, and reach out right away to your primary care provider to get guidance. Usually, HAV infection is self-limited. This means your immune system will take care of it on its own without medication. However, really good self-care and rest is crucial. The Hep A illness may last months and it might take up to 6 months to fully get back to yourself. If at any point you are feeling worse, getting yellow 😷, unable to stay hydrated and having profuse diarrhea, or having any other concerning symptoms, please make sure to get checked out right away! 

You may have lots of questions about the vaccine or the illness. We would love to chat with you if you are concerned. Reach out to one of our nurses 24/7 and we can help. 

–Kim Liner, RN, MSN, CPNP

 

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like how to prevent tick bites in kids? Is there an HPV treatment? How common is pertussis in adults? Well we can help— we put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.

 

What is Human Papillomavirus (HPV)?

What is Human Papillomavirus (HPV)???

If you’ve ever had sex, oral sex, anal sex, or any contact with someone’s genital region… This article is for you. If you haven’t done any of this before, you should still read the sections lower down. You are one of the lucky people who can actually prevent yourself from ever getting HPV by the beauty of a simple vaccine! Thank you science! 😍😍😍 And, if you’re the parent of a young child or teenager, then this article is a must read! 

HPV, or human papilloma virus, is very common and very contagious. Most middle-aged men and women who have been sexually active probably have or have had HPV at some point (unfortunately, the vaccine did not exist when they were young). It often goes without symptoms for many years, but can also crop up as groups of warts. 

Types of HPV

HPV comes in two varieties: low-risk types and high-risk types. Most cases of HPV are low-risk types that can crop up as groups of warts, but that’s about it. The body’s immune system is usually good at fighting both low-risk and high-risk types and often can clear the HPV on its own within 2 years. 

However, there are some high-risk types of HPV (13 of these suckers according to the CDC). These can lead to cancer in a small minority of people after decades of being infected and the body not being able to clear the virus. Over recent years, its been found that HPV is more serious than once thought. HPV has been found to be the cause of different kinds of cancer, specifically of the cervix, vagina, vulva, penis, and back of the throat and other types of oral throat cancer. 😳 What was once thought to be just a wart is now just a wart that can cause cancer. It can be silent, and very serious. But there are ways to keep yourself safe, so read on! 😀😀

Skin Symptoms of HPV

You may find fleshy, flat, or mini cauliflower like skin clusters growing in the genital region or around the anus. These warts are itchy and spread easily. Thankfully, warts aren’t dangerous and they don’t lead to cancer. Instead they are just really annoying to whoever has them. The good part is that your healthcare provider or a nearby sexual health clinic like Planned Parenthood can diagnose them and then work on treating and removing them (usually by freezing the warts). Sometimes, even if you have HPV, you also may find NOTHING AT ALL on the skin. You may have HPV and not even know it. 

How to prevent HPV— HPV vaccine

The HPV vaccine 💉 is offered to children over age 9, and encouraged by at least age 11. Gasp, you say, 11 years old they’re not sexually active! Well the scary truth is that a lot of kids are sexually active at age 11 or are thinking about it. Some people also do not consider oral 👄sex as sex, but oral sex can still transmit HPV. ANY skin to skin contact can transmit HPV. Oral, anal or genital all count. Kids are trying out these new things on the bus 🚌, in school, when you’re not home, and maybe even when you are home! 

The age of onset of sexual activity keeps getting younger. Sex has been around since the beginning of time. It’s biological and it’s real. It’s important to teach the kids to protect themselves, and that these things can cause serious long-term effects on their bodies. The best thing you can do as a mom or dad is to consider the HPV vaccine for your child, and yourself. 

Getting the HPV vaccine isn’t a green light to sex. It’s a way to protect long before having sex. The CDC reports that “HPV infections are so common that nearly all men and women will get at least one type of HPV at some point in their lives. Nearly 80 million Americans are currently infected with some type of HPV. About 14 million Americans, including teens, become infected each year.” Be open, have conversations with your child about their bodies and about sex.

Really, as a parent, you should be thinking about the HPV vaccine 💉like you do the tetanus and meningitis vaccines. You should ask the same questions about all vaccines. Are they safe? Do we need them? The answer is YES! They are crucial to preventing serious deadly illnesses and keeping your children safe.

HPV vaccines do the same as the other routine sets of vaccines. The best part, for children ages 9-14, you only need a series of 2 vaccine shots over 6 months, while anyone ages 15 and over must get a series of 3 shots over 6 months. Do your kids a favor, get the vaccine when they are young and save yourself one extra trip to the doctor and one less reason for your kids to be whiny and upset! 🤣

Additional ways to prevent HPV

Besides getting the HPV vaccine to prevent some strains of the virus, there are other ways to protect yourself. Avoiding sex is one way to prevent HPV. Though most adults will have sex at some point in there life. Thus, using barrier protection is another. Most people who have HPV may not even know it, so your sexual partner may be spreading the HPV virus to you during genital contact without the slightest clue they are doing so.😳 Remember, safe sex is great sex and can decrease your chances of HPV and STIs. 

Using condoms 100% of the time can prevent the spread of HPV, as well as other sexually transmitted infections. You will need to protect yourself when having oral (i.e. dental dams), anal and genital sexual contact. ANY skin contact with an infected partner can spread the disease. Read more here about symptoms of STIs in men and STIs in women here. Don’t forget to talk to your children about the importance of protection and the reality of what sexual choices can mean. It’s 2019, time to talk to those kids! Need help? Check out this great resource for parents from Planned Parenthood. 

Side effects of HPV vaccine

One of the main side effects of the HPV vaccine is fainting. It is recommended to get the HPV vaccine while laying down. Teenagers are the most likely to faint. The truth is that teenagers are the most common group of kids under 18 to pass out with any kind of blood work or shots, so it’s hard to know if the cause is the age group or the actual vaccine. Other side effects include pain at the injection site, headache and mild fever. 

When I mention the HPV vaccine, it’s common for some parents to provide pushback. They think that this is a new vaccine and that it’s not safe. But this vaccine has been around since 2006 and has been studied for safety. The CDC reports on the safety of the HPV vaccine here.

Make sure to feed your teen a snack before getting any shot or bloodwork. Teens are more likely to faint in general. I cringe when I send kids for blood work when they haven’t had breakfast! I always offer juice before a vaccine for all teens, as they are the ones who always seem to faint! Babies and kids cry when they get vaccines so they are forced to breathe as they yell and scream. Teens tend to hold their breath and tend to pass out 🙄

Since the HPV vaccine came out in 2006, some young adults haven’t received the vaccine. When I say young adults, I mean people in their late 30s and early 40s! These people most likely have been exposed to HPV during their lifetime, so it’s especially important for them to be more vigilant about getting pap smears and checked at their dentist for oral cancers. If you haven’t gotten the vaccine, it’s never too late to protect yourself! Talk to your primary healthcare provider! 

Does the HPV vaccine prevent cancer?

The HPV vaccine does not prevent you from getting cancer 100%, but it significantly decreases your risk by protecting you from 9 different high-risk strains of HPV. Decreasing your risk is a big deal. It’s important that we always do better when we know better. 

How do I know if I have HPV?

You may have HPV and not even know it. Some people don’t find out that they have HPV until they find a wart, have an abnormal PAP smear or are diagnosed with cancer. For women, it’s important to get regular Pap smears at your gynecologist’s office. Some primary care offices will also provide this service. 

What is a pap smear? 

Providers perform pap smears to check the cervix for abnormal cells, inflammation and disease. The provider inserts a small brush into the vagina to scrape cells from the cervix and test them for anything abnormal. The pap smear is now recommended every 3 years for most people over the age of 21 years. Planned Parenthood has some really great information about females being tested for HPV. 

HPV treatment— can HPV be treated?

There is no actual treatment for HPV. There is however medication that can be taken to help suppress the warts if you have developed genital warts. If your pap smear is abnormal and precancerous cells are found, then there are treatments to help prevent the cells from developing into full blown cancer. Of course, if you are found to have cancer, there are treatments for that too. 

If you are worried about your health or have concerns about HPV, please reach out to one of our nurses. We would love to chat!

–Kim Liner, RN, MSN, CPNP

Nurse-1-1 Health Center is written by nurses in a straight to the point type of way to provide basic health information. We get a lot of people like you searching online for answers to health concerns or looking for a hotline to ask a nurse a few questions. Questions like, should I be concerned about giving my child the MMR vaccine to prevent measles? What are the best ways to prevent UTIs? When to get that sports injury checked out by a medical provider? Well we can help. We put some info here for you to find while searching through all that other dry, scary medical information online. Stop that. Read our posts, or chat with us. This is not medical advice or a replacement for medical care, but see what we have to say with our free health information, and hopefully it will stop you from scaring yourself any more than you already have. We can help.