23September 2015 Flu Vaccine

FLU VACCINE IS HERE!!!
Please contact one of our offices today to schedule your child's appointment. Can't get to the phone? If you are on our patient portal send us an electronic appointment request!!

Here are our upcoming clinic dates:
By appointment only

Saturday, 10/3/15 Sewickley office 9am-12pm
Sunday, 10/4/15 Sewickley office 11am-2pm
Saturday, 10/10/15 Rochester office 9am-12pm
Saturday, 10/17/15 Wexford office 9am-12pm
Sunday, 10/18/15 Rochester office 11am-2pm
Sunday, 10/25/15 Wexford office 12:30pm-3:30pm
other appointments available upon request

Last Updated on Wednesday, 23 September 2015 13:53
 
CDC: PA leads Country in Tick Population

See the following links:

http://www.wpxi.com/news/news/local/cdc-pa-leads-country-tick-population/nfhDd/

http://www.cdc.gov/ticks/index.html

Find and Remove Ticks from Your Body

  • Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs.
  • Tumble clothes in a dryer on high heat for an hour to kill remaining ticks. (Some research suggests that shorter drying times may also be effective, particularly if the clothing is not wet.) 

Dogs are very susceptible to tick bites and tickborne diseases. Vaccines are not available for all the tickborne diseases that dogs can get, and they don’t keep the dogs from bringing ticks into your home. For these reasons, it’s important to use a tick preventive product on your dog.

Tick bites on dogs may be hard to detect. Signs of tickborne disease may not appear for 7-21 days or longer after a tick bite, so watch your dog closely for changes in behavior or appetite if you suspect that your pet has been bitten by a tick.

To reduce the chances that a tick will transmit disease to you or your pets:

  • Check your pets for ticks daily, especially after they spend time outdoors.
  • If you find a tick on your dog, remove it right away.
  • Ask your veterinarian to conduct a tick check at each exam.
  • Talk to your veterinarian about tickborne diseases in your area.
  • Reduce tick habitat in your yard.
  • Talk with your veterinarian about using tick preventives on your pet. 

 

Note: Cats are extremely sensitive to a variety of chemicals. Do not apply any insect acaricides or repellents to your cats without first consulting your veterinarian!

Tick Removal

If you find a tick attached to your skin, there's no need to panic. There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick quite effectively.

How to remove a tick

  1. Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.
  2. Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
  3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
outline of tick

Avoid folklore remedies such as "painting" the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin. Your goal is to remove the tick as quickly as possible--not waiting for it to detach.

tweezers grasping a tick close to the skin's surface
tweezers pulling a tick away from the skin in an upward motion

Follow-up

 

If you develop a rash or fever within several weeks of removing a tick, see your doctor. Be sure to tell the doctor about your recent tick bite, when the bite occurred, and where you most likely acquired the tick.

Symptoms of Tickborne Illness

Many tickborne diseases can have similar signs and symptoms. If you have been bitten by a tick and develop the symptoms below within a few weeks, a health care provider should evaluate the following before deciding on a course of treatment:

  • Your symptoms
  • The geographic region in which you were bitten
  • Diagnostic tests, if indicated by the symptoms and the region where you were bitten

The most common symptoms of tick-related illnesses are:

  • Fever/chills: With all tickborne diseases, patients can experience fever at varying degrees and time of onset.
  • Aches and pains: Tickborne disease symptoms include headache, fatigue, and muscle aches. With Lyme disease you may also experience joint pain. The severity and time of onset of these symptoms can depend on the disease and the patient's personal tolerance level.
  • Rash: Lyme diseasesouthern tick-associated rash illness (STARI)Rocky Mountain spotted fever (RMSF)ehrlichiosis, and tularemia can result in distinctive rashes:
    • In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called erythema migrans or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite. It may be warm, but is not usually painful. Some patients develop additional EM lesions in other areas of the body several days later.
    • The rash of (STARI) is nearly identical to that of Lyme disease, with a red, expanding "bulls eye" lesion that develops around the site of a lone star tick bite. Unlike Lyme disease, STARI has not been linked to any arthritic or neurologic symptoms.
    • The rash seen with Rocky Mountain spotted fever (RMSF) varies greatly from person to person in appearance, location, and time of onset. About 10% of people with RMSF never develop a rash. Most often, the rash begins 2-5 days after the onset of fever as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles and spreads to the trunk. It sometimes involves the palms and soles. The red to purple, spotted (petechial) rash of RMSF is usually not seen until the sixth day or later after onset of symptoms and occurs in 35-60% of patients with the infection.
    • In the most common form of tularemia, a skin ulcer appears at the site where the organism entered the body. The ulcer is accompanied by swelling of regional lymph glands, usually in the armpit or groin.
    • In about 30% of patients (and up to 60% of children), ehrlichiosis can cause a rash. The appearance of the rash ranges from macular to maculopapular to petechial, and may appear after the onset of fever.

Tickborne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult for physicians to diagnose. However, early recognition and treatment of the infection decreases the risk of serious complications. So see your doctor immediately if you have been bitten by a tick and experience any of the symptoms described here.

Lesion with bulls-eye target shape on the back of a patient

"Target" lesion on patient with Lyme disease.

stomach of patient with STARI showing red, radial, expanding edge of rash close to the site of tick bite

Patient with STARI.

  1. Site of tick bite
  2. Red, radial, expanding edge of rash
  3. Central clearing

Photograph used with permission from the Journal of Infectious Diseases.

hand and forarm of patient with Rocky Mountain spotted fever with a red, spotted rash

Late (petechial) rash on hand and forearm in patient with Rocky Mountain spotted fever.

Ulcer on the thumb of a patient with tularemia

An ulcer caused by tularemia.

outline of tick

Tick paralysis is a rare disease thought to be caused by a toxin in tick saliva. The symptoms include acute, ascending, flaccid paralysis that is often confused with other neurologic disorders or diseases (e.g., Guillain-Barré syndrome or botulism). Within 24 hours of removing the tick, the paralysis typically subsides.

 

Last Updated on Friday, 25 April 2014 12:35
 
WPIAL Sports Physicals

Each year there are many questions and frustrations with the timing of sports physicals.

The PIAA has recently revised their requirements for sports physicals prior to athletic participation. Sewickley Valley Pediatrics adheres to these specific policies.

As taken directly from the PIAA website, "Only physicals performed on or after June 1 of each year will be valid for sports participation for the coming school year . Physicals shall be effective, regardless of when performed during the school year, until the next May 31st." So, a physical exam performed 6/2/12 for the school year 2012-13 will be valid until May 31, 2013.

The student's parent/guardian shall be required to complete and submit to the school, Section 7 of the PIAA form (CIPPE Form) prior to the student's subsequent participation in another sports season during the same school year.  ALL PAGES OF THE PHYSICAL FORM MUST BE SUBMITTED TO OUR OFFICE for review and form completion.  If you do not submit all pages, we will be unable to accept the form and will ask you to resubmit as required.

SVPAM Physicians may require a follow-up visit for your child prior to a subsequent sports season if your child has experienced an injury, has a chronic illness, and/or has had a recent illness. These follow-up appointments are in the best interest of your child to make sure they are healthy and it is safe for them to participate in an athletic program.

Please refer to the PIAA website http://www.piaa.org/resources/forms/default.aspx for specific information ~ Link  used should be  PIAA CIPPE Form Sections 1-9 (No shading).   PIAA form revised 4/4/14 and available on the PIAA website effective 4/4/14.  

Last Updated on Tuesday, 05 August 2014 15:45
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What to Expect

This section gives you a little overview of the stages of well-child visits and their importance.  For more specific questions that are not addressed here, please contact the office or feel free to discuss at your next visit.

FIRST YEAR

During the first year of life, your child will be seen for multiple check-ups before turning 12 months.  So much growth and development takes place during this time, it is very important to monitor your baby's health frequently.

During these visits, our clinical staff will take careful measurements of your baby's growth, including height, weight and head circumference.  Your physician or CRNP will ask you questions about developmental milestones related to speech/social development, motor development, etc, and make sure your baby is given the appropriate immunizations.  Sleeping and eating patterns will be discussed as well.

Many parents have questions about when to start feeding their baby solid foods.  We will discuss this individually at each visit also.

At the 9 month visit we will order blood work for anemia (low iron) and lead.  You will go to an outside lab for this test.  We will also discuss transitioning from baby food to table food at this visit.

TODDLER - AGES 1-6 years

Check-ups continue to be a very important part of your child's life in this stage.  Important lab tests and screenings are performed at various times.

At the 12 and 15 month visits, we continue to document feeding and sleeping habits.  Immunizations are also due at these visits.

At the 18 month visit, we will help you complete an MCHAT questionnaire which screens for autism.  The physician or CRNP will review the results with you at the visit.  Toilet training discussions will start.

Check-ups continue for age 2, 2 1/2, and then annually from age 3-6 with more lab work being ordered to check iron, urine, etc.

At age 3, we also starting screening for hearing and vision.

At ages 4 and 5, we are completing the immunization series that was begun at infancy.  Lab work may be ordered now as well.

At age 6, except for the flu vaccine which we recommend annually, there are usually no immunizations until your child turns 11 or 12.  If your child is behind or on an alternative schedule, immunizations may continue to be given at varying intervals.

PRE TEEN - AGES 7-12 YEARS

We recommend annual check-ups throughout the preteen years as suggested by the American Academy of Pediatrics (AAP).  

Immunizations will be given typically at age 11 which includes a tetanus/pertussis booster, the first meningococcal vaccine and first HPV vaccine.  

We continue to monitor hearing and vision, growth and development along with social development.  

Puberty is discussed during the later years of this stage or sooner based on individual growth/development.  

TEEN - 13-19 YEARS

Your child should continue to receive annual check-ups during this span.  Growth and development still needs to be monitored and health education is provided.  We encourage teens to have private time with the MD or CRNP if they desire. It is a time that the patient can discuss other concerns directly with their provider.

At 14 & 16 years, your teen will be asked to sign consents giving parents access to information related to sexual/reproduction health and mental health if they choose.  They also have the right, in the Commonwealth of Pennsylvania, to deny parental access to this information.  

A meningococcal booster vaccine is given prior to starting college. At age 18, as your child is now a legal adult, we treat them as such, and they are given a form to authorize the sharing of medical information with their parents if they so choose.  We generally see children through their college years.  We will discuss transitioning to an adult practice during this phase as well.  

 

Last Updated on Wednesday, 24 February 2016 15:57
 
HPV Vaccine Reminders

The HPV vaccine (Gardasil) is a three dose series and it is very important that our male and female patients who have started the series, complete it appropriately.

The 2nd dose should be received 2 months after the first.

The 3rd dose should be received 6 months after the first or 4 months after the 2nd.

Please talk with any member of our clinical staff or one of the providers if you have any questions.

 

Last Updated on Tuesday, 13 August 2013 15:33
 


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Mon. through Sat.
Patients are scheduled by appt.

 

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Rochester, PA 15074
724-774-7110
Fax: 724-774-7394

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Sewickley, PA 15143
412-741-8700
Fax: 412-741-3710

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Wexford, PA 15090
724-935-6644
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Wexford, PA 15090
724-935-2610
Fax: 724-935-0331
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