Understanding your insurance policy is vital to coordinating your child’s health care. Your insurance policy is a contract between you and the insurance company. Our payment for services provided is also based on a contract between Erika Beard-Irvine MD LLC and your insurance company. We are obligated to report all services provided and to bill for them in accordance with our fee schedules. Much as it would be a contract violation for you to refuse to pay your insurance premium, it is also a contract violation not to charge or to undercharge for services we provide.
We’ve been hearing a lot about measles in Oregon in the past couple of weeks. There has been a lot of discussion online (and a lot of misinformation). What is it? Is it really that bad? Why is it spreading all of the sudden?
The American Academy of Pediatrics just released a new policy statement recommending against corporal punishment (define as “noninjurious, open-handed hitting with the intention of modifying child behavior”) and nonphysical forms of punishment “that are cruel and degrading and thus incompatible with the convention include, for example, punishment which belittles, humiliates, denigrates, scapegoats, threatens, scares, or ridicules the child.” The statement also includes things like forcing children to hold uncomfortable positions and forced ingestions (like washing a child’s mouth out with soap). What does this mean for parents?
Parents and schools tend to have a strong reaction to finding out a child has head lice. I hear “burn down the house” often given as a recommendation for dealing with lice. Head lice aren’t a health hazard or a sign of dirtiness or poor hygiene. They are, though, one of the most common causes of school absenteeism. Despite not causing any actual medical problems, those little bugs cause a great deal of anxiety among parents and schools. Grab a drink, y’all, because there is a lot to talk about.
Ear infections happen when infected fluid builds up in the space behind the ear drum (or tympanic membrane), called the middle ear. Fluid in the middle ear usually drains out the eustachian tubes, which connect the middle ear to the back of the nose. These tubes are soft tubes (like a sock with the toes cut off) rather than a hard tube (like a straw). Eustachian tubes open and let fluid drain from the middle ear when you move your jaw around talking or chewing, when you yawn, or when you hold your nose blow to “pop” your ears. If there is swelling or mucus around the opening of the eustachian tubes, like from allergies or a cold, the fluid can’t drain and will build up in the inner ear. If you have ever had a cold and felt like your ears were “stuffy” or your hearing was muffled, this is probably what was going on. Kids tend to get more fluid behind their ears than adults, because kids’ eustachian tubes are more horizontal. As people get older, their eustachian tubes get more vertical, which makes it easier for the fluid to drain.
A study was recently published in the Journal of the American Medical Association (JAMA) looking at unnecessary antibiotic prescription practices in different medical settings: doctors’ offices, emergency rooms, urgent care centers, and retail based clinics (clinics inside of stores like Walmart or CVS). Antibiotics are used to treat bacterial infections. The study found that nearly half (46%) of people seeking treatment in urgent care centers for viral illnesses like colds, flu, bronchitis/bronhiolitis, ear infections without pus behind the ear drum, and viral pneumonia and for things like asthma and allergies were prescribed antibiotics. That is nearly 3 times the rate of inappropriate prescription in medical offices (17%) and twice as high as emergency departments. Retail clinics actually had the lowest rate of inappropriate antibiotic prescriptions at 14%.
Have you seen headlines recently about a study showing that feeding babies at 3 months helps them sleep better at night? I have. The nonmedical press is not very good at reporting on medical studies and tends to put out sensational headlines with very little data. I was curious about this study, because this directly contradicts the recommendation to exclusively breastfeed for the first six months with no other foods introduced. I took a look at the original study, and here’s what I found.
It's that time of year again. School is out, so you have time to get your kids in for their check-ups and sports physicals. You have probably seen ads for sports physicals at urgent care clinics or group physicals run by local doctors offices. They seem convenient (and cheap!), but are they really the best thing for your kid?
Vitamin D regulates the amount of calcium and phosphorus in the blood and bones and is important for bone health. It’s also important in immune function and the regulation of inflammation. While it is found naturally in a few foods (like fatty fish), added to some foods (like milk), and available as a supplement, it is also made in the body through a process that’s triggered when sunlight strikes the skin. Because of the shallow angle of the sun in northern latitudes, we receive less sunlight here in Oregon to be able to make as much vitamin D naturally, especially in the months between November and April. Clothing and sunscreen use also decrease how much sunlight reaches the skin.
It’s summer again, so it’s a good time to talk about sunscreen. Kids and adults should be wearing sunscreen whenever they are outside. Choose a sunscreen that is at least SPF 30, is water resistant, and is labeled “broad spectrum” so it covers UVA rays (cause tanning, skin aging, and wrinkles) and UVB rays (cause sunburns and skin cancer). It takes about 15 minutes for sunscreen to absorb into the skin, so you should apply it before going outside to make sure the skin is protected as soon as it is exposed to the sun. I see lots of kids with sunscreen ON their skin but not rubbed INTO their skin. The sunscreen needs to be absorbed by the skin in order to do its job. Make sure you use enough! Most adults need about as much sunscreen as you can hold in the palm of your hand to cover their bodies. Decrease the amount accordingly for kids. Make sure you cover all exposed areas, including ears, the back of the neck, the hands, and the tops of the feet (I’ve had that sunburn before…ouch!). Lips can be protected by lip balm with at least SPF 15. Remember to reapply sunscreen every 2 hours when out in the sun, after swimming, and after sweating. Sunscreen can be used on babies as young as 6 months (don’t forget that bald, little head!). Younger babies should be protected from the sun with clothing and shade. Eyes can be protected with a hat or sunglasses.