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Mansfield Expansion
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EXTREME MAKEOVER- MANSFIELD ADDITION
For those who haven't seen the big trucks on site, we are actively expanding the Mansfield office. We will have a new waiting area with new check in/check out, more exam rooms (hopefully less waiting!!), and a small consultation area. We will also have new floors and brighter walls and maybe even a fish tank if we can pull it off.
The external work has been going on throughout July. Starting August 1, we will move all operations to the WESTWOOD office for 5 weeks. We expect to reopen Mansfield Tuesday Sept 8.
ALL AUGUST APPOINTMENTS WILL BE IN THE WESTWOOD OFFICE.
We appreciate your patience and support and are very excited about showing you are beautiful updated space in September. We are planning an open house so stay tuned for more information...
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The Medical Home
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The American Academy of Pediatrics describes the medical home as a model of delivering primary care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective care.
To that end, we at Westwood-Mansfield Pediatrics have started to develop processes and systems to make our practice your medical home. We have formed the Medical Home Team in which parents, providers and staff come together to discuss what is important in the medical home and how to implement this in our day-to-day activities. We have hired Christine Purcell as our Medical Care Coordinator and Lisa Drenkahn as our Educational Care Coordinator. Both are here to help you navigate the sometimes complex systems involved in providing your children with the best care. Now that electronic medical records have been with us for a full year, we are developing and implementing programs to make sure all labs and studies are reported to you in a timely fashion, and that when we send you to a specialist, they have all the information needed to answer the question we are asking and that there recommendations get back to us as well. This had been happening regularly in the past, however EMR gives us the ability to monitor and improve what doesn't work. Over the next months and years, we expect to continue to make changes to our practice which will enhance both patient and family care.
We are excited about this initiative and will keep you updated on changes made in your medical home. |
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New Lead Initiative ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The U.S. Centers for Disease Control and Prevention and Massachusetts Department of Public Health define an elevated blood level as >+10. We routinely test for lead with a finger stick during wellness visits at ages 9 months, 2 years, and 3 years.
Some scientific studies suggest that by the time the lead level reaches 10 negative health effects may have already occurred and that children with a lead level over 5 should have more frequent lead tests to ensure their levels are not rising to the point where there may be negative health effects.
As part of our mission to always be "proactive in your child's care" the families of all our patients with a lead level 5 or greater will recieve a folder with information regarding potential lead exposure and what to do about it and will have more frequent rechecks until we are certain the lead level has stabilized. We may also ask you and your child to go to the lab to have a venous sample drawn to correlate with the fingerstick draw. |
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Keep Toddlers in Rear-Facing Car Seat until Two
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The American Academy of Pediatrics now endorses the practice of keeping toddlers in rear-facing car seats until the age of two ( American Academy of Pediatrics Car Seat Guide). This is because children are up to five times safer if they are rear-facing. Rear-facing car seats spread frontal crash forces over the whole area of a child's back, head, and neck. This position also prevents the head from snapping relative to the body in a frontal crash. Rear-facing car seats may not be quite as effective in a rear-end crash, but severe frontal crashes are far more frequent (72% of all severe crashes) and far more severe than severe rear-end crashes (4%). Rear-facing car seat are NOT a safety risk just because the child's legs are bent at the knees or because they can touch/kick the vehicle seat. A child may use a rear-facing convertible car seat to its weight and height limits, however a good rule of thumb is that the child's head should not be any higher then the top of the shell of the car seat. |
| August: The Dirty Month (at least that's what Dr. Hartman calls it!!)
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Staph aureus thrives in hot moist areas (inside shoes, gloves, helmets and protective padding) and it is especially prevalent in the hot summer months of July and August. Over the years, many of you have be hearing about Methicillin Resistant Staph Aureus (MRSA). These strains of Staph aureus are resistant to several antibiotics and therefore becoming harder to treat. Yet with proper treatment, most MRSA is no more dangerous than regular Staph infections. However, it is important to keep in mind that occasionally this bacteria can cause deep skin infections. We had 3 athletes hospitalized in 2007 for this reason.
To prevent such an occurrence with your child or teen:
1) SPRAY INSIDE ALL HELMETS, PADS, GLOVES, AND SHOES- SPRAY TWICE A WEEK WITH A MIX OF 1/2 TSP OF BLEACH IN 8OZ SPRAY BOTTLE OF WATER - IT SHOULD NOT EFFECT THE COLOR OF THE EQUIPMENT.
2) Give your child/teen a small first aid kit complete with Band-Aids, triple antibiotic ointment, moist wipes (if possible with Benzalkonium chloride) and bandages. Instruct them to clean every bleeding cut no matter how minor with the wipes - place ointment and then apply the Band-aid.
3) Have your child/teen shower as soon as they get home. |
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Calling All Fall Asthmatics!!!!!
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Up until a couple weeks ago it didn't really even feel like summer. However, it is the beginning of August and for our fall allergy and asthma kids, it is time to get prepared for the upcoming season. Most of you will want to start your preventative or "green zone" medications by August 15th or September 1st at the latest. Make sure you have refills of all your necessary meds and that you have your forms filled out for school. Make sure you have an up-to-date asthma plan on file and if you need to make your asthma recheck now. Prevention is key - we know if we can get you on the right plan your child won't miss any school and you won't miss any work, but it only works if you use it. |
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Update on Concussions - New Recommendations!
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Concussions in children and adolescents are a growing concern among the medical community. In June, the latest Consensus Statement on Concussion in Sport issued numerous guidelines for pediatric patients, most of them stating the pediatric patients require more time than adults to recover and that returning to sports too soon can put the athlete at increased risk of a severe concussion (resulting in prolonged neurologic changes, or even coma and death). It is never appropriate for an athlete under age 18 to return to play on the same day of a concussion. If your child suffers a concussion, please call our office to arrange an appointment.
The new guidelines recommend pre-participation neuropsychological assessment. IMPACT testing is a computerized program designed to measure the concentration, reaction time, and memory of individuals. The current standard of care is for all athletes in medium or high risk sports (soccer, football, hockey, lacrosse, basketball, snowboarding, competitive skiing) to obtain a pre-participation ("baseline") test. Then, should the athlete suffer a concussion, a repeat IMPACT test can be compared to this baseline exam to determine more scientifically (and safely) when an athlete may resume athletic activities.
Westwood-Mansfield Pediatric Associates recommends that all teenage athletes in medium or high risk sports obtain a baseline IMPACT test. Many local high schools (including those in Westwood, Norwood, Needham, Dedham, Sharon, Walpole, Medfield and Stoughton) are now routinely providing this service. Please contact your high school and ask if your child can receive a baseline IMPACT test. If your school does not yet offer it, IMPACT testing can be obtained at the following places (unfortunately, insurance companies most likely will not pay for pre-injury "baseline" testing - we realize that the economy is not great, but think this is money very-well spent):
1) Dr. Neal McGrath: located on Beacon Street in Brookline. Dr. McGrath is a neuropsychologist specializing in sports-related concussions who we have worked closely and successfully with in the past. He provides an interview with the student and family (to identify any background factors that might affect test performance), a concussion history, and an IMPACT test. His "baseline" visit (including IMPACT testing) costs $50 and he can be contacted through his website: Sports Concussion New England.
2) Childrens Hospital Concussion Clinic: located at Longwood (Boston) location only. Childrens Hospital offers a baseline IMPACT test without the interview or history. The charge for the test is $25 and can be arranged by calling 617-355-8597.
Be on the lookout for more information on concussions this fall!
Play safe.
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11-21 Year Olds: What you Need to know about the HPV vaccine
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Some parents come into our office with their teenage girls and are hesitant to have their daughters immunized with the HPV vaccine (Gardasil). There has been a lot of press about this vaccine both on the internet and TV, not all of which is based on sound analysis of the data available thus far. Below is some information about the HPV virus and what we know to date about the vaccine and its efficacy and safety.
HPV (human papillomavirus) is a virus that is common in the United States and around the world and can cause both cervical cancer and genital warts. HPV is spread through sexual contact. HPV is the major cause of cervical cancer in women and is also associated with several other types of cancer in both men and women. HPV is the most common sexually transmitted infection in the United States with at least 50 % of sexually active people getting some form of HPV at some time in their lives. It is most common in young women and men who are in their late teens and early 20's.
The Gardasil vaccine protects against four types of HPV felt to be responsible for 70 % of cervical cancer and 90 % of genital warts. It works best if given before the onset of sexual activity and exposure to HPV. It is a series of 3 shots given over a 6 month period and is recommended for all girls and women ages 11 through 26, however can be given as young as 9 years of age. There are trials underway looking at vaccination of boys and men as well as older women. In fact, in Australia the Gardasil has been approved for boys ages 9-15.
As with all vaccines, there are some common side effects with the Gardasil vaccine. Pain at the injection site is most common and there has been note of an increased incidence of fainting following the shot (felt mostly due to the fact that we are giving this to teenage girls and young women who seem to be slightly more likely to faint than other age groups). Few others will experience mild to moderate fever and itchiness at the injection site.
As with all vaccines, the CDC and FDA have been closely monitoring the safety of the HPV vaccine through a variety of mechanisms. The most well known of these in the VAERS or Vaccine Adverse Event Reporting System. As of May 1, 2009 over 24 million doses of HPV vaccine have been given. There have been just over 13 thousand reports of adverse events reported of which 7 % (~900) were considered serious. Please realize when an adverse event is noted to have followed a vaccination it is only linked in time and does not prove that the vaccine caused the event. When medical experts evaluated all of these serious adverse events, there was no common medical pattern to link any of these to the Gardasil vaccine.
The FDA, CDC, and Westwood-Mansfield Pediatrics believe that the Gardasil is a very safe vaccine that will significantly reduce a serious and deadly disease. Please feel free to discuss with us your concerns and questions about this vaccine.
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17 -21 Year Olds: College Safety
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One out of every five young women will be sexually assaulted on college campuses this year. 82% of female students who experience unwanted sexual intercourse were under the influence of either drugs or alcohol at the time. Encourage your college student or read the book SMASHED by Koren Zalickas - a story about one girl's challenges with alcohol in college. While date rape drugs are extremely dangerous- alcohol alone has by far created more cases of rape and unwanted sexual assaults.
College students must be very careful - two consenting drunk adults may not be two consenting sober adults the next day. If students choose to drink they should have condoms readily available even if they do not anticipate having sex. Female students may talk with their providers about birth control options including the "morning after" pill or Plan B which is now available without a prescription for women 17 and older.
These sometimes may be difficult subjects to broach with your teen or young adult - however, they are important and necessary. If you need advice, feel free to call us. |
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Reaching Beyond Ourselves ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In Haiti, the clinic is thriving and a second floor is being built for a dental clinic. The clinic now has a laboratory and soon will have a lab assistant. A water filtration program will be implemented in the next 6 months and vaccines will be administered hopefully sooner. Westwood-Mansfield Pediatrics recently sent a shipment of bandages and gauze with the last crew. Well over 300 mosquito nets have been distributed as to the villagers and surrounding towns. Future plans are to look at agricultural training options for the people as the best medicine is the proper food. | |
