Jan 17, 2014

Dr. Cindy Gellner: So how do you know when you should bring your child in to see the doctor? How do you know when it's okay to just call and get advice? How do you know if it's emergency room time? Or how do you know if you just need to just do some TLC and let your child get better? I'm Dr. Cindy Gellner, and that's what we're going to talk about today on The Scope.

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Dr. Cindy Gellner: So we are seeing a ton of viral illnesses right now. To give you an example, last week I saw over 100 children, and I could actually count that 10 of them were healthy. If your child just has a mild runny nose, a little bit of a cough, it's not croupy, it's not constant, they have a little bit of a sore throat but they're still able to eat breakfast, things like that, you probably can still go ahead and send them to school.
If your child is under three months old, no matter what other symptoms they have, if they have a fever of 100.4 or higher, then they need to be taken right away to the local children's hospital.
Let's say your 12-year-old has a fever of 100.4. That's okay. Kids normally can have fevers up to 104. That's their bodies' way of trying to fight off whatever infection is getting into their system. Don't worry so much about the number on the thermometer. Worry about how your child looks.
If your child has a temperature of 100.5 but they look miserable, then you need to be concerned. If your child has a fever of 102 and they're still playing with their Legos and they're happy as can be, then don't worry so much about the number. If your child has a fever of 100.4 or higher, again, no matter what age they are, they cannot go to school. The school will send them home.
If your child just has a mild runny nose, a sore throat, a little bit of a cough, you can still send them. But if your child has been sick for over two weeks and they start having discolored mucous, it's time to be seen.
Sore throat, hard to swallow, any concerns that strep is going around school, which we have been hearing reports of, bring them on in. If your child has a cough that is bothering them to the point where they can't focus in school, stay home. If you have a child who's asthmatic, who's coughing, who the Albuterol is not helping, bring them in.
For kids who just can't get to stop vomiting, then we need to see them to make sure they are hydrated. We usually don't give anti-nausea medicines and anti-vomiting medicines in kids. They're kind of risky depending on which medicine you're talking about.
Diarrhea. We are seeing the diarrhea that goes along with this stomach bug lasting for up to two weeks. Anti-diarrhea medications in kids, we try to avoid them. The best thing we usually recommend is probiotics. There are lots of different brands out there that you can get, and all of them help with replacing the good bacteria and helping put the balance back into the digestive system that is getting disrupted with the diarrhea.
Rashes are something that we're seeing a lot of, too, and that's kind of hard because it's really not easy to figure out what a rash is over the phone. Even when you bring them in, sometimes we're, like, "We're not really quite sure what that is. Let's get somebody else's opinion and have somebody else come in."
A lot of the rashes that we're seeing right now such as eczema, dry skin, the best thing you can do for that is lots of lotion that is fragrance-free, dye-free, sensitive skin lotion. Put it on a lot. If your child still has some rough patches there, a little bit of over-the-counter one percent hydrocortisone. A tiny little bit goes a long way. Don't put it around the eyes, don't put it in the arm pits, and don't put it in the private area. It gets absorbed too well into the body that way.
We're seeing roseola. If your child has a high fever of 103, 104 for 3 days and all of a sudden the fever goes away and a rash appears all over their body, red and blotchy and you're, like, "Well, okay. My child looks completely healthy except they're covered in spots," that's roseola. That's a normal childhood virus. Your child's going to be just fine.
If your child has a rash that looks really weird, if it looks like a bull's eye or is all over the place or just in one side of the place and is just really odd-looking, definitely come on in because we can't diagnose rashes over the phone.
So if your child has been really, really sick and you're really worried about them because they just don't look good to you or they can't stop vomiting, they can't stop coughing, or their fever won't go down, then, by all means, bring them in.
If they just seem pretty asymptomatic, just a little bit under the weather but not too bad, let them go ahead and go the school. You don't need to bring them in all the time. If you're just not sure, call us. Your pediatrician will never mind if you call for advice.

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