Tuesday, August 13, 2013

Tuesday, August 6, 2013

No shots? No school.

In SA, many children can't start school or college without certain immunizations. Watch Dr. Ratner in this KSAT video for more info.

Friday, August 2, 2013

It's time for meningitis vaccinations!

freshman-dorm_lIt’s that time. Summer’s almost over, and the frosh are getting ready to enter college. Among shopping for new pillow cases and hoping your roomie isn’t too weird, don’t forget that all schools of higher education in Texas require a meningitis vaccine. It’s not just your school giving you more forms to confuse you; it’s actually the law here in Texas that you get and maintain your vaccination.
Don’t wait until the last minute, either. Vaccinations take 7-10 days to become effective, and most schools won’t let you register for classes before you have the vaccine, and it’s effective. That means you need to have it done at least ten days prior to registration, or you might get stuck registering too late and miss out on a lot of classes you want/need to take.
But why do the schools and the state care so much? What’s the big deal?
Meningitis is a disease that inflames the meninges, or the membranes that protect your central nervous system. It’s spread by the exchange of saliva (or throat secretions), and people who live in close quarters (hello quad dorm room!) are more likely to spread it. So say your not-too-weird roommate isn’t feeling great, and sneezes all over your toothbrush when he’s in the bathroom. There’s a perfect chance for transmission. Or you know how much you love washing dishes. Say you use a fork that’s not completely 100% home-dishwasher clean. Even sharing water bottles, food, or the best college pastime--kissing--can spread meningitis.
Symptoms of meningitis include:

  • Rash or purple patches on skin
  • Severe headache
  • Light sensitivity
  • Confusion and sleepiness
  • Lethargy
  • Vomiting
  • Stiff neck
  • Nausea
  • High fever
  • Seizures

Meningitis can be very nasty. You really don’t want to catch it. It could potentially cause hearing loss, blindness, coma, kidney failure, limb damage requiring amputation, convulsions, learning disabilities and even death.
But wait, we can fix everything with antibiotics, right?
Well, you can treat meningitis with antibiotics if it’s caught early. But that doesn’t guarantee a cure, while the vaccination is effective against 4 out of 5 of the most common bacterial types that cause meningitis. Vaccination is very safe, with little to no side effects in most patients. Even when caught early and treated with antibiotics, meningitis can still cause permanent disability or death.
It is possible to decline the vaccination if it will cause you medical problems or if your religion denies vaccinations. However, this can take a while. At Texas Tech, for example,  they require a notarized affidavit and warn that it can take “a significant amount of time. Begin well in advance of your intended registration date.”
Yes, we have the vaccine! Walk in any day 8-8 to get your shot, and head on out to your close-quarters-sharing-water-bottles adventure!
For more info:
Photo credit: thegeoffmeister / Foter / CC BY-NC-SA

Friday, July 26, 2013

But it's so itchy!!

If you’re anything like me, the mosquitoes love you! It’s always nice to be popular, but in this case, I’d rather be a wallflower. I made the mistake of stepping outside for about ten minutes a couple evenings ago and, well, here’s the result:
Screen Shot 2013-07-26 at 2.14.54 PM
Being that we’re a medical clinic, there are a lot of people here who tell me to stop scratching! So what in the world can you do when you’re covered in itchy mosquito bites and you can’t scratch?????
Please note that this is not meant as medical advice. If you’re not sure what to do, contact your doctor, or come see us.
First, the best defense is a good offense, right? So invest in a good insect repellant and apply according to the manufacturer's directions. Did you know some need to be applied more often than others? If you prefer to avoid the chemicals in many bug sprays, there are options like citronella, peppermint oil or even garlic oil. Consult with an expert, however, before you try applying essential oils to your skin. Some essential oils can be concentrated enough to burn or even blister your skin if used incorrectly.
If you’ve been bitten, here’s where your self control needs to kick in. Wash off the effected areas as soon as possible, using mild soap and cool water. Pat it dry with a towel rather than rubbing. The reason it itches is because the mosquito has injected you with an anticoagulant (to drink more of your delicious blood) and your body is fighting its and having a minor allergic reaction.
For minor bites like these, a paste made of a teaspoon of baking soda mixed with a few drops of water and apply it gently. Or another option is to apply some vinegar to the bite.   Scratching, though it may feel good for a little while, can actually make the bite worse and make it last longer.
Here in the US, the risk of catching a serious disease from a mosquito bite is low, but you should seek medical help if you’re having a severe allergic reaction, like a racing heartbeat, difficulty breathing and severe swelling. If you’ve scratched your bites and they have become infected, that’s when it’s a good idea to see your doctor.

Thursday, July 11, 2013

Group B Strep Awareness

It’s July, and that means summer fun, 100-degree+ heat and (if you’re lucky) water slides! It also means it’s International Group B Strep Awareness month, which is a very common but little-known (apart from mommies and doctors) bacteria that effects babies in utero, newborns and babies up to six months old.
Huh? What is that, and why have I never heard of it?
GBS (Group B Streptococcus), or Streptococcus agalactiae--not strep throat--is a type of bacteria that can potentially effect babies as they pass through the birth canal or when the mother’s water breaks. Though up to 25% of women have this naturally-occurring bacteria in their digestive tract and/or birth canal, few babies who are exposed become ill.
However, that illness can be severe, such as meningitis, pneumonia or a permanent handicap like blindness, deafness or cerebral palsy. In some cases, GBS has caused stillbirth or miscarriage.
It’s a good idea to get tested for GBS before your baby is born (even if you’ve been tested on a previous pregnancy, that doesn’t mean you don’t currently have GBS living in your system). There are little to no symptoms associated with GBS for the mother, with the most common being yeast-infection-like symptoms or even a bladder infection. If your doctor suspects GBS when you are pregnant and have a bladder infection, they will likely perform a urine culture apart from the routine urine tests performed on all pregnant women. In the US it’s now standard practice for GBS testing to be part of your routine prenatal testing. If you test positive for GBS, you may be placed on IV antibiotics when you go into labor. Just four hours of IV antibiotics given to the mother in labor can prevent up to 90% of newborn GBS infections. Taking these prior to the onset of labor won’t help much, as the bacteria can grow back very quickly.
Just a side note: testing positive for GBS does not mean you’ve done anything wrong during your pregnancy, or are unclean. GBS can live in just about anyone.
Now your beautiful baby has been born, and you want to provide them the absolute best in care. There are some strategies you can follow to avoid infecting your baby (not just with GBS; some of these are common-sense guidelines to protect against bacteria in general)
  • Everyone, yourself included, needs to wash their hands before handling your baby. Antiseptic wipes won’t cut it--get out the soap and water.
  • If you’re able to breastfeed, it’s a great choice to supply your little one with antibodies to help fight infection.
  • Make sure everyone who takes care of your baby knows the symptoms of GBS infection in babies and how to respond.
Most cases of GSB will start in the first few hours after birth. Symptoms may include:
  • High-pitched cry, shrill moaning, whimpering
  • Constant grunting as if constipated
  • Projectile vomiting
  • Sleeping too much, difficulty being aroused
  • High or low or unstable temperature; hands and feet may still feel cold even with a fever
  • Blotchy, red, or tender skin
  • Blue, gray, or pale skin due to lack of oxygen
  • Fast, slow, or difficult breathing
  • Body stiffening, uncontrollable jerking
  • Listless, floppy, or not moving an arm or leg
  • Tense or bulgy spot on top of head
  • Blank stare
  • Infection (pus/red skin) at base of umbilical cord or in puncture on head from internal fetal monitor
  • Problems with temperature regulation
  • Grunting sounds
  • Fever
  • Seizures
  • Breathing problems
  • Stiffness or extreme limpness
Of course, if you have questions about GSB it's a good idea to ask your doctor! If you'd like to read more, check out these useful sites. There's even a Facebook page:

Tuesday, July 9, 2013

Why is my child limping?

You’re wor­ried about your child. They’ve been wak­ing up com­plain­ing their knee hurts, or you notice their fin­gers seem swollen, but they can’t remem­ber hurt­ing them­selves. Maybe they’ve been limp­ing a lit­tle in the morn­ing, or they seem to have a mild flu with a  pink­ish rash that comes and goes. What could be happening?

All of these are symp­toms of Juve­nile Arthri­tis, which effects more than 250,000 chil­dren under the age of 18 in the US alone. If your child has swollen, ten­der joints that last for more than six weeks, he/she could be among their num­ber. Com­monly, the knees, hands and feet will be the most effected, though some­times chil­dren with JA can also have inflamed eyes.
Diag­no­sis comes at the end of exten­sive test­ing per­formed by a juve­nile rheuma­tol­o­gist, who will exclude other con­di­tions through imag­ing, lab work and phys­i­cals before diag­nos­ing your child with arthri­tis. Most forms of arthri­tis are known as autoim­mune dis­or­ders, where the body’s own immune sys­tem attacks its own healthy tis­sues, caus­ing swelling, sore­ness and stiff­ness in joints and the sur­round­ing mus­cles and sup­port­ing tendons/ligaments. The result­ing inflam­ma­tion can dam­age the joints.
Some­times the dam­age done to joints can effect a child’s growth, caus­ing one leg or arm to grow longer than the other, or even slow­ing the child’s over­all growth.
Unfor­tu­nately, there is no cure for Juve­nile Arthri­tis. It’s con­sid­ered a chronic con­di­tion that will require care and treat­ment with exer­cise, phys­i­cal ther­apy and pos­si­bly med­ica­tion. Since every child is dif­fer­ent, there is no one right treat­ment plan for every­one. Your child’s doc­tors will work with you to come up with an indi­vid­ual plan that works for your child. Some chil­dren will have one or two flare-ups of arthri­tis and never suf­fer again, while oth­ers may have to deal with it on a day-to-day basis.
Some doc­tors may pre­scribe med­ica­tion right away, while oth­ers will advise treat­ment dur­ing flare-ups like swim­ming, which allows the child to exer­cise and move their joints with­out putting pres­sure on them. It’s impor­tant to sup­port your child not only with their phys­i­cal but also their men­tal needs to sup­port them through JA.
Screen Shot 2013-07-09 at 1.30.42 PM
There are a lot of great resources avail­able to learn more about Juve­nile Arthri­tis online. We rec­om­mend the fol­low­ing sites for more detailed info:
Photo credit: danieljohn­sonjr / Foter / CC BY-NC-SA

Thursday, July 4, 2013

Have a safe and happy 4th!

We're working today 8-8 in case you need help. Walk in to either location or check in online and we'll txt you when it's your turn!