Does my child have croup or a cold?

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You wake up in the middle of the night, to the sound of your child “barking” from across the room. Is it serious, or is it just a cold? Before fall is in full swing, find the facts on croup from OCH’s Nishua Bendt, DO.

  • What is croup? Croup is typically a viral illness that affects children, especially those under 3 years of age. Croup is an inflammation of the upper airway (from the mouth to throat and the wind pipe), along with the voice box (larynx). It tends to be seasonal, affecting children more often in the fall and spring months.
  • Symptoms of croup? This inflammation causes irritation, runny nose, congestion and the famous “barky cough.” Children may have a wide range of symptoms from mild with no fever, a little runny nose/cough to severe that can cause problems with breathing and swallowing. Children may also be clingy as well as hoarse.
  • How is croup spread? Croup is spread by droplets such as coughing, sneezing and via dirty hands. Croup is not 100% avoidable; however, if you kids wash their hands often, cough into sleeve/elbow/or tissues and avoid others who are sick, they can significantly reduce possible exposure.
  • How long does croup last? Croup can last several days (5-10) and may reoccur through the winter season. Consult a healthcare provider any time you have questions, or if you child develops a high fever, decreases drinking or has fewer wet diapers than normal, if symptoms change to one specific area of concern, or if your child is experiencing problems with breathing that a home treatment isn’t helping.
  • Treatment for croup? Viruses aren’t fixed with antibiotics. Treating the congestion, fever and sore throat keeps kids calm and relaxed so they stress their vocal cords less. Symptoms tend to be more severe at night and children may seem much sicker than they really are. Going from a steamy shower to cool night air may improve symptoms and using a cool mist vaporizer may help also.

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Nishua Bendt, DO is a board certified physician at the OCH Webster County Clinic in Rogersville, Mo. With more than 10 years’ experience in family medicine, Dr. Bendt can see patients of all ages from infants to adults. In addition to preventative care and well woman checks, Dr. Bendt can offer some procedures in office including examining skin conditions, freezing warts, suturing, and removing abscesses and ingrown toenails. To schedule an appointment with Dr. Bendt, contact the OCH Webster County Clinic at 417-753-9404.

Torti-What?! The facts about Torticollis.

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You or your pediatrician may have noticed your baby always looking one direction. You may have heard someone say your baby has a wry-neck. Find out more information on Torticollis from OCH Pediatric Physical Therapist, Lexi Sneed, before it becomes a major issue.

  •  What is Torticollis? Torticolis (Congential Muscular Torticollis) is a condition in which the infant keeps his or her head turned one direction and may also have a tilted head. Most often the child will be looking to the right and the head will be seen tilted to the left. The tilt is caused by a tightening and shortening of the sternocleidomastoid muscle, a thick muscle which runs from behind the ear down to between the collar bones.
  • How did my child get this? The cause of torticollis can be unknown, or it could be related to how the baby was positioned while in the uterus. For example the baby could have been in a breech position or “crowded” while developing. It could also be a result of the baby spending too much time on his or her back; whether in a crib, car seat, swing or on the floor. Tummy time is very important!
  • What is Plagiocephaly? Plagiocephaly (play-jee-oh-sef-uh-lee) is also called “flat head syndrome” and is often associated with torticollis. Because a baby’s skull is very soft an infant who wants to always look one direction causes increased pressure on the tissue and bones of that side of the head.

 

  • How can it be fixed? We can help!!! The Pediatric Physical Therapists here at OCH are available to assess your child’s needs. As Physical Therapists, we are trained to assist in stretching and moving your child’s body to correct the muscle differences. We can provide regular visits to help your child along with providing parents stretching exercises to do at home between therapy visits.

 

  • How can parents help? Seeking the help of an experienced Physical Therapist is without a doubt one of the best ways to help your child overcome torticollis. At OCH, we have experienced therapists who can treat this condition. A great way to help your child at home is to make sure they have plenty of tummy time.

 

Lexi Sneed is a pediatric physical therapist at the OCH Evergreen Clinic in Springfield, Mo. Lexi works with children and their families to assist each child in reaching their maximum potential to function independently. To schedule an appointment with Lexi or any of the physical therapists at the OCH Evergreen Clinic, call 417-823-2900, or the OCH Christian County Clinic at 417-724-3004.

Dealing with Fall Allergies!

Fall Allergy

Just when your nose finally adjusted to the sights and smells of summer, fall allergy season hits full force. Sure, the crisp autumn evenings offer a welcome relief from the summer heat; but for those suffering from allergies, fall is one of the worst times to be outside. Ozarks Community Hospital of Gravette nurse practitioner Anita Marie Kane shares a few tips on how to keep the sniffles, itching and irritation at bay.

Sneezing, itchy eyes, runny nose, throat drainage…yes it is that time of year again! We are blessed to live in a region with beautiful foliage and dramatic seasonal changes. However, one of the drawbacks to this seasonal beauty is an abundance of budding, blooming, seeding, and blowing allergens.

The CDC reports over 17.6 million people were diagnosed with “hay fever” in the last year. According to Dr. Moses of Family Practice Notebook, hay fever affects 35 million people yearly, with 3 million missed work days.

What can you do to avoid those missed days? Talk to your provider about your options. Generally, try to avoid allergens you react to, use an air purifier in the home if indicated, avoid tobacco smoke, and use a mask if needed when mowing or working in dust-filled areas. Medications may offer some relief also. These include antihistamines (such as Allegra, Benadryl, Claritin and Zyrtec), intranasal corticosteroids (such as Flonase and Nasonex) and saline nasal spray. Other options in severe cases may include systemic steroids or even allergy testing with hyposensitization.

Just remember, the season will change (and there will be new allergens!). Stay healthy, drink plenty of water, exercise regularly and get adequate rest, a healthy you is your best defense.

Anita Marie Kane, APN is a long time resident of Gravette, AR, who started out as a nurse’s aide at the Gravette hospital shortly after moving to town. She obtained her MSN as a Family Nurse Practitioner from Pittsburg State University in Kansas. Kane specializes in Family Practice and Urgent Care.

This Labor Day Weekend, Don’t Forget to pack your “Common Sense.”

Summer is nearly over and families are headed out for a final weekend of fun before fall hits! Before you throw “caution to the wind” and rush head on into the holiday weekend, don’t forget the basics. Check out pediatrician Dr. Spinelli’s list of simple (yet essential) safety reminders for you and your family: 

Labor Day is coming up and families will be outside more as kids and parents alike are off for the long weekend.  Here are a few simple safety tips to help ensure your weekend is enjoyable and not spent in the emergency room!

LABOR DAY SAFETY TIPS

TIP #1: Water safety.  Many families will choose to go to pools and/or lakes (or stay home to enjoy a pool in the back yard).  Vigilance is important, especially around small children who cannot swim. Always make sure that a competent adult is paying attention to those in the water. It  is very important that the supervising adult does not have his/her attention divided between too many things, as this affects their ability to truly watch the children.  It is also important, if your family is headed to a lake or river, to encourage children to wear a life jacket at all times (not just while in the water, but when they are anywhere near the water as there is sill a potential danger).  Even the most agile athlete (such as Michael Phelps) can benefit from wearing a life jacket if participating in a boating activity/sport; as a serious accident could render him unconscious (if you lose consciousness, you cannot swim!) Most boating accidents are accidents, but it never hurts to be prepared, as you may not be able to swim once in the water.

TIP #2: Burn precautions.  Often times, grilling or cooking occurs during holiday weekends.  Make sure small children (and even older children) are aware when there is a hot surface and are not ducking under or playing too close to hot surfaces.  Sunburns can also be a significant issue. Always make sure that you and your family are wearing sunscreen if you plan on being outside more than 20 minutes.

TIP #3: Food safety.  If you are sharing a large meal, try to be aware how long the food has been sitting out prior to consuming.  Food poisoning is a frequent companion of holiday gatherings.  If you’re not sure, just don’t eat it.  Monitor for choking hazards as some foods may cause issues for smaller children.

TIP #4: Bike safety.  If you are going on a family bike ride, don’t forget the helmets and water bottles! As always, stay safe and enjoy the holiday weekend!

*This post was updated Friday, August 29, 2014*

IMG_7261 resizeChristopher Spinelli DO, FAAP, is a pediatrician at the OCH Evergreen Clinic in Springfield, MO. Dr. Spinelli is also currently a Major in the United States Air Force Reserve. After completing an undergraduate degree from Truman State University, Dr. Spinelli graduated from Kirksville College of Osteopathic Medicine and completed his Pediatric residency at Keesler Medical Center in Biloxi, MS. To contact Dr. Spinelli, call 417-823-2900 or visit http://www.OCHonline.com. 

Back-to-school health isn’t just for kids

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The dog days of summer are at their tail’s end and fall is rapidly approaching; families are flocking to Wal-Mart to purchase back-to-school supplies and wardrobes, teachers rush to prepare for the influx of students, and fall health & flu prevention begins.

Each year, around 50,000 people in the United States die from vaccine-preventable diseases according to Centers for Medicaid and Medicare Services (CMS.gov). Influenza, pneumococcal pneumonia and hepatitis B, diseases with available vaccines, account for over 250,000 hospitalizations on an average year.

The good news? Medicare covers vaccinations for each of these diseases. Medicaid and CHIP covers the influenza vaccination along with other vaccinations needed for children.

But it’s not just for kids. Influenza claims an average of 36,000 lives a year. People 65 and older make up a large amount of that statistic. The same goes for invasive pneumococcal disease. Of all the deaths caused by the bacterial pneumonia, greater than half are 65 years of age or older.

This fall, schedule a “time-out” from watching fourth-string scrubs play football or visiting shopping rallies at the mall and take the first step. Contact your health care provider or a local clinic to find out more about vaccines and immunizations.

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For more information on vaccines and preventable diseases, visit: http://www.cdc.gov/vaccines/vpd-vac. For more information on what vaccinations are covered by Medicare and Medicaid, visit http://www.cms.gov/Medicare/Prevention/Immunizations/.

The Vaccination Debate: Q&A with the Authors

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OCH Pediatrician Christopher Spinelli, DO and Maryann Karinch, a human behavior specialist, recently published a book titled The Vaccination Debate: Making the right choice for you and your children with New Horizon Press. The book is described as:

Rational approach to discussing the science of vaccines in the context of everyday life. As Spinelli and Karinch examine the schedule of vaccines from birth through adolescence, the authors shed new light on this timely and controversial issue, writing with a tone that a pediatrician would use with curious, concerned parents. (Goodreads, 2015)

Prior to publication, the authors sat down and answered some frequently asked questions in the “vaccination debate.” Read their answers to the questions below:

  1. How safe are vaccines?

For people with healthy immune systems, they are generally completely safe. We say “generally” because in rare cases, a genetic abnormality makes a vaccine unsafe for the individual with that condition. Yet, despite the rigorous testing of vaccines to ensure their safety and effectiveness—often decades of research and testing—89 percent of the people who participated in the C.S. Mott Children’s National Poll on Children’s Health rated “vaccine safety” as the most important topic in children’s health research today. Anecdotal “evidence” about adverse reactions has a profound effect on public opinion, despite the overwhelming scientific evidence that vaccines are safe for almost everyone.

A slight fever in response to a vaccine is normal; it doesn’t mean the vaccine is unsafe. Nearly all vaccines can induce fever since they rev up the immune system and fever is a feature of the immune system.

  1. Why do we give vaccinations to kids for diseases that we rarely or never see anymore?

The short answer is: Because you don’t want to see them ever again. The vaccine for smallpox was removed from the schedule in 1980 when smallpox was considered eradicated globally. It would be great if we eradicated other diseases and no longer needed those vaccines, either. But the reality is that diphtheria, polio, measles, mumps, chickenpox, whooping cough and other diseases that many people have never seen still exist and are potentially fatal.

  1. What about “herd immunity”—doesn’t that protect us?

Herd immunity means that enough people have immunity to a contagious disease that the people who don’t have immunity are safe. If people didn’t travel outside of their communities, it would be fairly easy to achieve herd immunity for a lot of vaccine-preventable diseases like measles and mumps. But we do travel and people without immunity are vulnerable.

Herd immunity is generally defined in terms of 90-95 percent of a population being immune to a particular contagious disease. Think about how fast those numbers can tumble downward when just a few new unvaccinated kids enter your local elementary school, or one new family without immunity joins your church.

Herd immunity only works if we keep vaccinating against diseases we rarely see anymore—and then only stop when we never see them anymore.

  1. What’s wrong with alternative vaccination schedules, so that babies don’t get so many shots at once?

The success of vaccinations in controlling and eradicating disease involve both the science of antigens and the science of timing. The schedule reflects the science of timing, meaning that vaccines are given at times in a child’s life when preventing the disease is vitally important to help the child thrive. For example, if a child of one year old or under contracts measles, the chances that the disease leads to very series health issues or death are much greater than if an older child contracts measles. For that reason, the vaccine is scheduled when a baby hits the one-year mark. Also, studies show that children have more anxiety about vaccines (even infants) if they are subjected to multiple “shot visits” with fewer vaccines each time instead of multiple shots a fewer visits.

  1. Why not just let kids catch “childhood diseases” to build immunity—like people used to do?

Parents who believe it’s better for a child to get a disease that probably isn’t life threatening—and these typically include measles, mumps, chickenpox, flu, rotavirus and whooping cough—seem comfortable with ideas that don’t make sense to most doctors and nurses. Exposing a child to these diseases is not just a matter of mortality, but a matter of morbidity; the disease is accompanied by symptoms that can be awful for a child. Secondly, in treating the disease after the child gets it, medications are generally involved. These can include antibiotics, cough medicine, anti-diarrheal medication and more. In the case of chickenpox, there may be permanent scarring. The third consideration is the younger sibling, perhaps an infant, who is far more vulnerable to devastating effects of the disease than an older brother or sister.

Here’s a final thought: Most parents who push this theory that it’s better to let the child get the disease have never seen the bad outcomes; they have not experience them firsthand. Ask parents who have experienced the bad outcomes of vaccine preventable disease and see what they say about this question.

  1. How effective are alternatives to vaccines, like breastfeeding and homeopathic medicines?

Babies are continually getting extra antibodies from their mothers’ breast milk. (Formula-fed kids are lacking in this extra immunity.) But while the advantages provided by breastfeeding are long-lasting, they don’t last forever. Breastfeeding is a superb complement to vaccination.

The argument to avoid vaccines in favor of homeopathically prepared preventative solutions is deeply flawed—and we say that with all due respect to homeopathy as a source of remedies for problems that already exist. Leading spokespersons for homeopathy assert that the reason that solutions with undetectable amounts of active ingredient work is that, when the body has a need for a substance, that need creates hypersensitivity. When the body senses that what it needs is nearby, it takes advantage of it. Knowing this, how would a homeopathic formula work as a prophylactic since, at least in theory, it’s administered while the body is healthy and not in need of the substance?

  1. Why are things like aluminum and thimerosal in vaccines?

Vaccines contain more than the virus or bacterium that serves as the main ingredient because some are used as preservatives, some are suspending fluids, some serve as culture material to grow the bacteria or virus, and some are enhancers that help improve the vaccine’s effectiveness.

Aluminum is an enhancer, also known as an adjuvant. The intended role of adjuvants is to provide more antibodies and prolong the vaccine’s protection by boosting the immune system’s response to the virus or bacteria agent. The inactivated type of vaccine requires adjuvants to stimulate an immune response. This is partly why it’s possible to reduce the number of actual antigens from the viruses and bacteria needed to make the vaccine, but still get effective protection. In the 1960s, there were about 3,000 antigens in a pertussis (whooping cough) vaccination. Now there are five.

Thimerosal is a preservative. Preservatives and stabilizers enable vaccines to remain unchanged when they’re exposed to heat, light, acidity or humidity. Preservatives are not, by their nature, “good” or “good for you,” and research continues to try to determine the most benign preservatives for medical applications.

  1. What’s the link between vaccines and autism?

No cause-and-effect link has been proven based on a large body of studies, but that is not the same as saying with certainty there is no link between vaccination and the onset of autism symptoms. The bulk of evidence points to a pattern of autism spectrum disorders that runs in families—meaning the cause of autism appears to be genetic. But—and this is an important “but”—scientists are currently trying to determine the extent to which metabolic, bio-chemical, neurological, and environmental factors affect the emergence of autism.

In other words, evidence strongly suggests that autism is genetic in nature, so vaccines wouldn’t make a child autistic, but some scientists believe that vaccination might trigger a negative response.

  1. What’s the profile of people who choose not to vaccinate their children?

The profiles are so different that it’s shocking. Basically, it’s well-educated people who tend to be liberal politically and shop at places like Whole Foods as well as people with a libertarian orientation who feel that an individual parent’s right to determine what’s best for a child should supersede any government mandates. Caught in the middle are parents who have been exposed to disturbing anecdotal evidence about vaccines and are inclined to take a “modified schedule” approach to vaccinations.

In short, the profile tends to be people whose lifestyle choices, ideology, and fear override scientific evidence.

  1. What are the prospects for vaccines for diseases like cancer, HIV, and Alzheimer’s?

Very good. New ways of developing vaccines have been developed and those new methods open the door to an array of vaccines against diseases like cancer, HIV, and Alzheimer’s, as well as malaria, Ebola, and other diseases that have been a particular threat in Africa—where a child dies every minute from malaria according to the World Health Organization.

Some of these new methods of development have resulted in DNA vaccines, which rely on genetic material to prevent disease. Some of the diseases targeted by researchers developing DNA vaccines are cancer, HIV, malaria, and typhoid.

References

Goodreads. (2015). The vaccination debate. Retrieved from https://www.goodreads.com/book/show/24886662-the-vaccination-debate

Tummy Time & Your Baby’s Development

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Tummy time plays a large role in your baby’s overall health and development. But when should you start? And how long should your baby spend on his or her belly each day? Ozarks Community Hospital/Advantage Therapy physical therapist Jennifer Witt shares specifics below and offers tips to help make tummy time more enjoyable for baby and mom.

“Tummy time.” If you are the parent of an infant, you probably hear this phrase all the time and you probably have questions. Why? When do you start? How long? What if they cry/get mad? These are questions I deal with frequently and here are some of the answers I give parents.

Why Practice Tummy Time

There are too many babies that sit in car seats, cribs, and lay on their backs for too many hours of the day. Needless to say, there are numerous reasons to implement tummy time into your infant’s daily routine!

  • It helps babies achieve developmental milestones (i.e., holding head up, rolling, sitting).
  • It strengthens muscles of the neck and back when infants have to hold their heads up against gravity.
  • It prevents flat spots on the head and allows for proper head shape development.
  • It allows infants to explore their environment from a different perspective.

When You Should Start

Tummy time should be started as soon as possible; even as soon as you get home from the hospital. The earlier you implement it into their daily routine, the less likely they will be to fight against it.  Place your infant on their tummy for short periods of time initially, gradually building up the amount of time they are spending in that position.

Need for Tummy Time Increases with Age

Tummy time should be a daily activity for infants. Again, this routine should be started as soon as you bring your baby home from the hospital. Here is a guide for how long babies should be spending time on their tummies.

  • First couple of weeks: 5 minutes per day
  • 1 month old: 20 minutes per day
  • 2 months old: 30 minutes per day
  • 3 months old: 60 minutes per day
  • 4 months old: 81 minutes per day

Sometimes babies cry during tummy time. Usually, I tell parents not to pick the infants up, unless there is some harm to the little one. I recommend setting a timer for 5 minutes and then the baby can be picked up when the timer goes off.

Making Tummy Time Fun

Nothing makes my little ones cry more than placing them on their bellies! Some babies do great, others, not so much. Again, tummy time should be started as early as possible to get them used to being on their bellies. Here are some ideas for keeping it fun.

  • Get down on the floor with them! It encourages engagement and bonding between the two of you.
  • Place fun toys around them so that they have fun stuff to look at and eventually play with!
  • Use mirrors (baby-proof, of course)! Every baby knows they’re super cute, so they really enjoy looking at themselves in the mirror.
  • If your infant has reflux, try propping them up on a pillow or boppy to take pressure off their tummies.
  • Place the baby on your chest while you’re lying down. This way, they can “talk to you” and still get tummy time.

Jennifer works at OCH in Springfield, Missouri and at OCH Christian County Clinic in Nixa. She received both her Bachelor of Science in Psychology and Doctorate in Physical Therapy from Missouri State University. She has experience in inpatient, outpatient, home health and pediatric  settings. Her primary interest in physical therapy is pediatrics, specifically the 0-3 age group covering a variety of diagnoses.