Thank you for entrusting us with the care of your children.   As nurses and physicians, we wish to assist you in maintaining the wellness of your family through regular check-ups and immunizations.

OFFICE HOURS

Monday to Friday         9:00 am to noon, 1:15 pm to 5:00 pm

Saturday                     9:30 am to noon  

Nurse phone triage starts at 8:15 am

Phone number 616-243-9515,  Fax 616-243-1815

Answering service evenings and weekends:  616-776-7401

However, illnesses and mishaps are inevitable.  You will readily manage most of these events in the home setting.  We have developed a  Parents' Handbook to help you with these problems.  When an event occurs, we ask that you refer to this booklet.  If you still have questions, we are more than happy to augment this information when you call the office.

SPORTS PHYSICALS

On Monday, Tuesday and Wednesday (August 3-5) we are scheduling sports physicals.  These are brief physicals so if you have problems that need to be addressed you will need to schedule a complete physical with your docter.  Please bring your sports form with you to the appointment with the first side filled out.  The cost is $62.00 with an additional charge for extras such as urine analysis, vaccines, etc.  These appointments will be scheduled for every 15 minutes so please arrive a few minutes prior to your scheduled time.  Please remember that not all insurance carriers pay for sports physicals.

On Monday, July 27 we will be doing a walk-in sports physical clinic from 4 to 6 PM.  This will be on a first come first serve basis and will be CASH ONLY.  The cost is $50.00 and we will not be billing insurance carriers.  If  you do not have payment at the time we will not be able to see you.  Please bring your sports form with you and make sure you have the front page completed prior to your arrival.

SWINE FLU

1.  The media coverage has created much anxiety regarding swine flu.  Every year 36,000 people in the U.S.A. die due to regular influenza.  Every illness is important, but we must not panic.  It is important to continue safe, healthy habits (handwashing); but we must also keep things in perspective.

2.  Swine Flu (better named H1N1 Influenza) is a variety of Influenza A.  If your child does not have Influenza A, they do not have Swine Flu.  An excellent information site is from the CDC. http://cdc.gov/h1n1flu/swineflu_you.htm

INFLUENZA

Influenza is a viral illness that is highly contagious and transmitted person to person via the airborn route and respiratory secretions. Aerosal transmission (sneezes, cough)

The symptoms start suddenly and include:

1.  Fever (102 - 105 F) and chills for 2-5 day

3.  Myalgia (muscle aches)

4.  Sore throat

5.  Runny nose

6.  Dizziness

7.  Irritated eyes

8.  Headaches

9.  Fatique ("washed out", feeling "awful all over".)

***Please note that infuenza generally does not include vomitting and diarrhea.  Vomitting/diarrhea "flu" is not influenza.

If your child has a high fever and some or all of the above symptoms you may contact our office to set up an appointment to have your child tested for Influenza. 

If no high temp we ask that you treat your child with:

1.  Bed rest (at least encourage quite play)

2.  Liquids:  especially clear liquids such as jello, juices, pop, broth

3.  Humidity:  vaporizer or shower "steaming" will help relieve congestion and soothe sore throats

4.  Do not give your child aspirin for fever.  Only acetaminophen should be used.

Complications:

1.  Ear infection

2.  Pneumonia:  symptoms include prolonged fever, poor fluid intake, and decreased appetite in addition to a persistent cough.

Call our office if:

1.  Fever lasts more than 4 days

2.  Your child complains of ear pain

4.  The symptoms seem to be getting much worse.

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NEW MORNING WALK-IN CLINIC HOURS AT ALGER PEDIATRICS

Starting Monday, December 3, 2007, Alger Pediatrics will open from 7:30am - 8:30am Monday thru Friday to see patients with urgent or emergent health concerns.  Parents may "drop in" during this time for their child to be seen on a first come, first served basis.  During walk-in clinic hours, we will only address acute medical problems, such as strep throat, ear infections, rashes, asthma flares, diarrhea and vomiting, etc.

If your child has a more complicated or chronic issue, please schedule a regular appointment so your doctor has time to adequately address the concern.  The walk-in clinic is not intended for complex problems, such as ongoing abdominal pain, headaches, chronic constipation, or behavioral concerns.

One doctor will staff the walk-in clinic each morning.  If too many patients arrive on a given morning, we will reschedule them later that day. 

An excellent resource on vaccines for families interested in more information regarding the diseases they prevent and issues related to side effects can be found at the Center for Disease Control's website http://www.cdc.gov/vaccines/

All children who have received one dose of Varivax (chicken pox vaccine) need a second booster dose. Supply had been an issue. Currently we are able to order adequate amounts. If your child needs a second booster dose, please contact our office.

Influenza vaccine is currently available at Alger Pediatrics. The Center for Disease Control (CDC) recommends that all children between 6 months and 18 years receive this vaccine. This new recommendation reflects the risk of complication that can occur in younger children and the significant impact on the general health of older children and adolescents. The first year a child receives the vaccine, two doses a month apart are required. Additionally all patients with special health concerns such as asthma, cystic fibrosis, diabetes, cardiologic and neurologic conditions should receive flu vaccine yearly. High risk patients may receive this vaccine as early as September. In October any person may receive the flu vaccine if they wish to be protected from this illness. Influenza is a severe respiratory infection typified by high fevers, chills, prostration, and muscle aches for three to five days. Complications include pnuemonia, myositis (inflammation of muscle), and Reye's Syndrome. Aspirin therapy should be avoided if any of these symptoms are present. Please contact our office for Influenza vaccine clinic times in the fall.

Hemophilus Influenza B Vaccine (HIB) has significant supply issues currently. There are two manufacturers of this vaccine. The U. S. company that we have used for several years has temporarily withdrawn its product due to issues related to potential for contamination in the production of the vaccine. We are making every effort to procure as much of the alternative product that is manufactured by a French company. Nationwide there are shortages. This product normally requires three priming doses and one booster at fifteen months. The CDC has asked us to skip the fifteen month dose. Due to very limited supply we are making efforts to get at least two priming doses to each infant. Hopefully by this fall shortages will be over.

Meningococcal (Menactra) vaccine is available currently for the prevention of meningococcal (bacterial) meningitis. Vaccine supply was initially quite limited. This shortage has been resolved, so that a single dose is being offerred to anyone 11 years of age and older. It is recommended especially for those living in dormitory or barracks settings. This vaccine is required only once and will be offered during health maintenance exams. If your son or daughter is this age, you should schedule one of these exams and request the vaccine. If they have had a recent exam, you may call to make arrangements for this vaccine. The Menactra is now covered under the Vaccine For Children Program up to eighteen years of age. Menactra has recently been approved for some children down to two years of age. Children who should receive this at a younger age are those who have significant immune deficiency issues or lack spleens (sickle cell patients and those who have had spleens removed or are born without a spleen).

AHA Propose Cardiac Testing Before Prescribing Stimulants to Children with ADHD

It is "reasonable" to undertake cardiac testing when considering stimulant drug therapy for children with attention deficit/hyperactivity disorder, according to a scientific statement from the American Heart Association.

The statement, published online in Circulation, cites concerns that stimulants (e.g. Ritalin, Adderall) may increase the risk for adverse events, including sudden cardiac death, in children with congenital heart disease. Accordingly, the AHA recommends that clinicians do the following before starting treatment:

* obtain a complete patient and family history, with careful attention to conditions such as cardiomyopathy and Marfan's syndrome;

* perform a physical exam to check for cardiovascular abnormalities including heart murmurs and hypertension;

* consider ordering an ECG

* arrange a consultation with a pediatric cardiologist if abnormalities are discovered during the above steps.

The AHA concludes that:

* all children prescribed stimulants should be routinely monitored for cardiac symptoms;

* stimulants remain a reasonable option for children with stable heart disease, or those currently under a pediatric cardiologist's care;

* for children already on stimulants, physicians may want to take a complete history, review the physical exam, and order an ECG

The American Academy of Pediatrics has recently suggested caution on implementation of EKG's for everyone taking stimulant medication. Targeting the high risk groups for selective EKG's based on a risk in family history or findings on physical exam should trigger further evaluation .