Blog Posts

By eMedical Urgent Care

Say so long to sweet summer and hello to the 2014-2015 school year. By now school supplies are purchased and the countdown until the kids go back to school is over. You’ve done all you can to prepare your child for a successful school year, but have you prepared them for a healthy one too? Here are back to school tips from the urgent care Middletown NJ and Berkeley Heights NJ doctors to help your child avoid sneezing ‘‘achoo” and keep cheering ”woo hoo” all year long.

Count Enough Sheep

Transitioning your child from summertime to a new bedtime can be a challenge, but one of the biggest health-related issues for elementary school-aged children is exhaustion; children need at least 10 to 11 hours of sleep each night. During the first few weeks of school, your child may come home tired and in need of a nap. Consider allowing your child to rest for 45 minutes, if he or she can’t sleep, try 45 minutes of quiet time to help rejuvenate your child before homework, dinner, bath time and bedtime. Plenty of rest at night will help to ensure a healthy start to the school day.

Morning Meal Time

In an ideal world, your child would sit down to breakfast each morning prior to heading to school. In reality, it is 8:15 a.m. the bus comes at 8:20 a.m. and your child’s shoe decided to play a game of hide-and-seek. The easiest thing to grab may be a sweet, sugary snack, but before you pick up the Pop Tart, consider whole grain cereal or an apple. While delicious, sweet, sugary snacks will give your child a jolt of energy which will come to a screeching halt within hours. Your child’s teacher also will appreciate him not coming to school on a sugar high.

Eyes and Ears

You can't expect a child to learn if he or she is having trouble seeing the board or hearing the teacher. So have your local Middletown NJ or Berkeley Heights NJ eMedical Urgent Care screen for vision and hearing problems during your child's back-to-school checkup. Remember: You can't assume your child has 20/20 vision just because he never complains about not being able to see; children with vision problems may not realize the world isn't blurry to everybody else. If your child often has headaches, tilts his head to one side to read schoolwork, or holds objects unusually close or far away to view them, it could be a sign that he has a vision problem.

Healthy Hand-Washing Habits

Start healthy habits while they’re young and teach your child the importance of frequent hand-washing. Hand-washing is essential before dinner or after they use the bathroom, blow their noses or touch pets and other animals. Teach your child these steps:

• Wet hands with clean, warm water.
• Soap up, rub hands together, making sure to get between the fingers.
• Continue rubbing for 20 seconds. Younger children can sing “Happy Birthday” twice to count the time.
• Rinse with warm, running water.
• Dry hands on clean towel.

If your child rockets out of the bathroom without stopping at the sink, consider sending her to school with a packet of antibacterial wipes. They're not as effective as soap and water, but they may have more appeal for young children. (You also can check how many wipes are left at the end of the day to see whether your child is really using them.)

Stay Active

From pool days to school days, your child has gone from running around the backyard to sitting at a desk. Children should get 20 to 30 minutes of regular, non-stop exercise a day. Physical education classes help get your child active but often time is spent standing around waiting for the ball. Bike riding, walks and a trip to the park will benefit the whole family. Going back to school is not only an adjustment for children but for parents too. Be sure to get plenty of rest, eat breakfast and stay active! And if you want to take an extra step to prevent illness this school year, bring the family to eMedical Urgent Care to get flu shots. We will be holding a Drive-Thru Flu Clinic at our Middletown NJ office on Sept. 20 from 8 a.m. to 2 p.m. If you need medical attention for a non-life-threatening illness or injury, both our eMedical Urgent Care Middletown NJ and eMedical Urgent Care Berkeley Heights NJ are open during the evening hours to treat walk-in patients. If you have questions about medical conditions, download iTriage from the iTunes or Android Marketplace, or check out iTriageHealth.com for your healthcare answers.

By eMedical Offices Your daughter came home from college and brought a stuffy nose. Your son came home from a play date and is complaining of a sore throat. Want to start placing bets when you’ll come down with a full blown cold? As colder weather approaches and more people stay indoors -- and in close proximity to each other -- our offices begin to see more patients with upper respiratory infections or colds. As doctors, we begin to see cases develop in October and peak during January and February, then begin to taper off in March. Getting the “flu” is different from the common cold because it’s caused by the influenza virus and can potentially be much more severe than the common cold. In the most susceptible patients, such as the elderly, or those with underlying medical conditions, severe flu illness can be potentially life threatening. Spreading the Virus The flu virus usually is contagious one day before symptoms develop and up to 5 to 7 days after symptoms develop. The virus is spread primarily by “droplet” contamination, meaning when an infected person talks, sneezes or coughs, droplets containing the virus can spread to others, up to 6 feet away. A bit gross to think about, but the droplets can land in the mouths and noses of others, and can be inhaled into the lungs.  This is why it’s important to cover your mouth and nose when coughing and sneezing and wash your hands afterwards. The next most common method of infection is from touching a surface that has the flu virus, such as a door knob, and then touching your mouth or nose. Washing your hands frequently with soap and water or using alcohol-based waterless hand cleansers are the best ways to prevent this transmission. Any items used by infected individuals, such as dishes, silverware, linens and towels, shouldn’t be shared and should be washed thoroughly before reusing. Prevention The most important piece of advice I give regarding preventing the flu is to get vaccinated. Vaccination not only helps prevent the vaccine recipient from illness but also helps prevent the spread of the flu throughout the community. The flu vaccine must be given annually. It contains the 3 most common strains of the influenza virus for the upcoming flu season based on sophisticated computer models that predict which virus will be most likely to be circulating in a particular year. The flu vaccine is recommended by the Centers for Disease Control and Prevention for everyone over the age of 6 months. Another option is the flu vaccine in a nasal spray form, which can be given to anyone who is healthy, not pregnant and between the ages of 2 to 49. Symptoms of the Flu Generally, the common cold and the flu can have similar respiratory infection symptoms.  The flu tends to be more severe and includes:

• High fever (although the flu can occur without a fever)
• Dry cough
• Sore throat
• Runny or congested nose
• Body aches
• Muscle aches
• Headache
• Chills
• Fatigue

Occasionally patients can develop nausea, vomiting and diarrhea. Your fever may last 3 to 5 days, and the cough and exhaustion can last up to 2 weeks. The symptoms generally start abruptly. But Do I Really Have the Flu? Your doctor will determine if you have the flu based on your symptoms and his clinical assessment of your physical condition. The most common testing used is the rapid flu test, when a swab is taken from the nose or throat and analyzed. This test can detect the flu usually within a few minutes. Unfortunately this test is not foolproof, meaning you can have a negative test and still have the flu. Generally if your doctor suspects the flu based on symptoms, patient risk factors and the pattern of flu infections in the community, he or she will begin treating the virus even if the rapid flu test is not performed. Treatment

• You can treat flu symptoms with and without medication
• Your doctor may prescribe antiviral medications to help alleviate your symptoms
• Antibiotics are necessary if your illness has developed into a bacterial infection

Last Words The virus that causes the flu and its symptoms are usually more severe than the common cold, and can be dangerous for high-risk patients with underlying medical problems. The flu virus is contagious, and proper precautions should be taken. Frequently washing your hands and covering your mouth when sneezing or coughing can help eliminate the potential of contamination. The most effective method of prevention for individuals and their communities is vaccination. If treated early, antivirals can reduce the severity and duration of flu symptoms. Call or stop by our office today if you think that you have the flu. If you need medical attention for a non-life-threatening illness or injury, eMedical Offices is open during the evening hours to treat walk-in patients. If you have questions about medical conditions, download iTriage from the iTunes or Android Marketplace, or check out iTriageHealth.com for your healthcare answers.

By eMedical Urgent Care You’ve tried to ignore it, but every swallow is a chore. You’ve got that big project at work, so there’s no time to be sick. How do you know when a sore throat requires medical attention – or just some hot tea and some R&R? Sore throat, also known as pharyngitis or tonsillitis, is a frequent complaint that brings patients to the urgent care center. I’m going to explain the causes and symptoms of sore throats. To treat them, urgent care centers are a convenient option to get the medical attention you need to get you back to feeling better. Causes of Sore Throats Up to 60 percent of sore throats are caused by viruses. The most common of these are adenoviruses, coxsackieviruses, Epstein-Barr virus, cytomegaloviruses and herpes simplex viruses. The second-most popular type is “strep” throat, which is caused by Streptococcus pyogenes or Group A beta-hemolytic streptococcus (GABHS). Only 5 to 15 percent of adults and 15 to 30 percent of children with sore throats actually have strep throat. Other less frequent causes of a sore throat are fungal infections (oral thrush or candidiasis), HIV-1 infection in the acute phase and gonorrhea. Non-infectious causes of sore throat include heartburn or gastro-esophageal reflux disease (GERD), allergies, post-nasal drip, chemical injuries and smoking. Symptoms of Strep Throat Strep throat most commonly occurs in children aged 5 to 15 years old in the fall and early spring. This usually happens after children come in contract with someone who is infected, like in a classroom or daycare facility, or a family gathering. Classic symptoms of strep throat include:

• Sudden onset
• White patches and pus on the throat and tonsils
• A fever greater than 101˚
• Difficulty swallowing
• Tender and swollen lymph nodes in neck
• Headache
• Chills and shakes alternating with cold sweats

In children, the above symptoms can be accompanied by nausea, vomiting or abdominal pain. Symptoms of a Virus Signs that the sore throat is caused by a virus include:

• Cough
• Runny nose
• Conjunctivitis (pink eye)
• Sneezing

Testing and Treatment of Sore Throats Doctors use several methods to determine if a sore throat is in fact strep throat. One of the most reliable methods is the rapid strep test. This test is quick and accurate, and allows treatment to start immediately following a positive result. The American Academy of Pediatrics recommends that doctors perform both a traditional throat culture and a rapid strep test on children. Although it takes 1 to 2 days to get results from a throat culture, because children are more likely to develop strep throat, this dual-testing method provides the most accurate diagnosis. While only a fraction of adults and children with sore throats nationwide actually have GABHS bacterial infections, more than 75 percent are prescribed antibiotics. This practice leads to resistant bacteria, meaning the infection doesn’t improve because it’s gotten used to antibiotics, as well as side effects from treatment, including allergic reactions, diarrhea and yeast infections. Our doctors use rapid strep testing and throat cultures, and follow guidelines for the diagnosis and treatment of GABHS set by the Infectious Disease Society of America. Strep throat responds well to penicillin. It can be given as a single dose injection or in pill form. Other prescription options include amoxicillin, cephalexin and azithromycin. To help relieve the pain and swelling of the throat, your doctor also may prescribe a single dose of dexamethasone, a steroid which is an anti-inflammatory, either by injection or by mouth. Strep Throat Shouldn’t Be Ignored GABHS pharyngitis will improve in a few days even if not treated with antibiotics, but we treat patients so that they feel better faster and are less contagious to others. If left untreated, strep throat can put you at risk for developing rheumatic fever, which can damage the heart valves. Another rare but serious complication is acute glomerulonephritis, an injury to the kidney, which can occur regardless of treatment. If you are on antibiotics and aren’t feeling better or if you’ve developed a rash, jaundice or abdominal pain, contact your doctor immediately, as this might indicate Epstein Barr virus or mononucleosis infection. In most cases, with proper evaluation and treatment, sore throats can be treated quickly and easily, often without antibiotics. If you need medical attention for a non-life-threatening illness or injury, eMedical Urgent Care is open during the evening hours to treat walk-in patients. If you have questions about medical conditions, download iTriage from the iTunes or Android Marketplace, or check out iTriageHealth.com for your healthcare answers.

It’s a brisk fall afternoon. You’re sitting in the bleachers, watching your son’s JV football game. In the scuffle during a play he hits his head on the turf. You see him get up a bit slowly, but he shakes it off and lines up for the next play. Should you be concerned? It is estimated there are 3 million head injuries each year related to contact sports, according to the Centers for Disease Control and Prevention. For teens and young adults aged 15 to 24 years, it is second only to motor vehicle accidents as the cause of traumatic brain injuries. Concussions can be caused by mild or more severe blows to the head. They may or may not involve loss of consciousness. Recently, more attention has been placed on recognizing and treating concussions earlier to decrease the risk of long-term neurological damage. The Signs of a Concussion Early signs of a concussion include:

• Headache
• Dizziness
• Nausea or vomiting
• Confusion
• Disorientation
• Vision changes
• Unequally sized pupils
• Lack of awareness of surroundings
• Slurred or incoherent speech
• Lack of coordination

If your child is injured and shows any of the above signs, he or she should stop participating in the sports activity immediately. The New Jersey State Interscholastic Athletic Association requires that any student athlete who sustains a possible concussion or any loss of consciousness be removed immediately from play. A medical evaluation is required to determine if a concussion was sustained. If it’s determined that your child did have a concussion, he or she must be symptom-free for one week before he or she can return to play. You should seek immediate medical attention if your child’s symptoms persist for more than 10 minutes. If the symptoms are mild, such as mild headache, dizziness, nausea without vomiting or loss of memory for a few minutes, watch to see if the symptoms worsen. The physicians at eMedical Urgent Care can help determine if further care is needed. When to Go to the Emergency Department You should bring your child to the nearest emergency department if the injury involves:

• Large cuts
• Prolonged loss of consciousness
• Severe headaches
• Drowsiness
• Inability to walk
• Slurred speech
• Seizures

What to Expect After a Concussion A few days to a few weeks after having a concussion your child might experience:

• A persistent, low-grade headache
• Light-headedness
• Poor attention and concentration
• Memory issues
• Fatigue
• Irritability
• Frustration
• Anxiety and/or a depressed mood
• Trouble sleeping

The recovery period for concussions can vary from patient to patient. Some may develop “post-concussion syndrome,” which can last weeks or months and includes chronic headaches, dizziness and nausea.  If your child sustains a more severe concussion, he or she should be seen by a neurologist in addition to your primary physician to manage ongoing care.