How to prepare for my visit to the doctor

 Make a list of what you want to discuss. For example, do you have a new symptom you want to ask the doctor about? Do you want to get a flu shot? Are you concerned about how a treatment is affecting your daily life? If you have more than a few items to discuss, put them in order and ask about the most important ones first. Don’t put off the things that are really on your mind until the end of your appointment—bring them up right away! 

The Talking With Your Doctor worksheets can help.  Some doctors suggest you put all your prescription drugs, over-the-counter medicines, vitamins, and herbal remedies or supplements in a bag and bring them with you. Others recommend you bring a list of everything you take and the dose (If you have successfully added all medications and supplements to your portal account, you do not need to bring in a list of either). 

You should also take your insurance cards, names and phone numbers of other doctors you see, and your medical records if the doctor doesn’t already have them. (Again, this step can be done through the portal. The Request of Information Authorization form should state your prior providers where we can request records from). Although we do not charge insurance for our monthly subscription, the reason we ask for this is so you can still use your insurance for medications and labs. 

Your first meeting is a good time to talk with the doctor and the office staff about some communication basics. Ask how the office runs. Learn what days are busiest and what times are best to call. Ask what to do if there is an emergency, or if you need a doctor when the office is closed. Share your medical history. Tell the doctor about your illnesses, operations, medical conditions, and other doctors you see. If you have problems understanding how to fill out any of the forms, ask for help. If you need help using the computer, our staff is here to help. Just let us know and you can come in and use one of our computers and we will be close by to help.  Keep your doctor up to date. Let your doctor know what has happened in your life since your last visit. If you have been treated in the emergency room or by a specialist, tell the doctor right away. Mention any changes you have noticed in your appetite, weight, sleep, or energy level. Also tell the doctor about any recent changes in any medications you take or the effects they have had on you. It is best to meet with your provider twice per year, at a minimum. This is to ensure your provider is up to date with any changes. 

Norovirus infection can cause severe vomiting and diarrhea that start suddenly. Noroviruses are highly contagious. They commonly spread through food or water that is contaminated during preparation or through contaminated surfaces. Noroviruses can also spread through close contact with a person who has norovirus infection. Diarrhea, stomach pain and vomiting typically begin 12 to 48 hours after exposure. Norovirus infection symptoms usually last 1 to 3 days. Most people recover completely without treatment. However, for some people — especially young children, older adults and people with other medical conditions — vomiting and diarrhea can be severely dehydrating and require medical attention. 

Signs and symptoms of norovirus infection may start suddenly and include: Nausea Vomiting Stomach pain or cramps Watery or loose diarrhea Feeling ill Low-grade fever Muscle pain You can continue to shed virus in your stool for several weeks after recovery. This shedding can last weeks to months if you have another medical condition. Seek medical attention if you develop diarrhea that doesn't go away within several days. Also call your health care provider if you experience severe vomiting, bloody stools, stomach pain or dehydration. 

Warning signs of dehydration include:

•  Fatigue 
• Dry mouth and throat 
• Listlessness 
• Dizziness 
• Decreased urine output 

Children who are dehydrated might cry with few or no tears. They might be unusually sleepy or fussy. 

When to take someone to the ER: 

For infants and toddlers, persistently dry diapers are a sign of dehydration. If your baby is younger than 6 months and produces little to no urine in 4 to 6 hours, or if your toddler produces little to no urine in 6 to 8 hours, she may be dehydrated. Rapid breathing and a weak but rapid pulse can indicate severe dehydration. The child will also have less awareness of his surroundings or will not be alert. His lips and mouth will look very dry and the skin may be doughy and wrinkled. Call 911 immediately if you notice these signs. If the person becomes unresponsive If the vomiting and diarrhea lasts longer than 3 days. It could be sooner in small children and the elderly. No urine output x 12 hours for older children and the elderly 

To prevent norovirus infection: Wash your hands thoroughly with soap and water for at least 20 seconds, especially after using the toilet or changing a diaper and before you prepare food and eat or drink. Alcohol-based hand sanitizers aren't as effective against noroviruses as using soap and water. Avoid contaminated food and water, including food that could have been prepared by someone who was sick. Wash fruits and vegetables before eating. Cook seafood thoroughly. Disinfect surfaces that might have been contaminated. Wear gloves and use a chlorine bleach solution or a disinfectant that is effective against noroviruses. Use caution when traveling. If you're traveling to areas with a high risk of norovirus infection, consider eating only cooked foods, drinking only hot or carbonated beverages, and avoiding food sold by street vendors. To help prevent norovirus infection spread, during illness and for 2 to 3 days after your symptoms end: Avoid contact with others as much as possible. Wash your hands thoroughly with soap and water. 

Stay home from work. Children should stay home from school or child care. Avoid handling food and items to be used by other people. 

Disinfect contaminated surfaces with a disinfectant effective against noroviruses. Dispose of vomit and stool carefully. Wearing disposable gloves, soak up material with disposable towels. Disturb soiled material as little as possible to avoid spreading noroviruses by air. Place soiled items in plastic bags and place them in the trash. Remove and wash clothes and linens that may be contaminated. Avoid traveling until 2 to 3 days after your symptoms are gone. The best treatment is time and fluids. 

Children and the elderly can become dehydrated at a faster rate than adults. To prevent dehydration in children, offer popsicles, an electrolyte drink such as Pedialyte or Gatorade. If the child is still in diapers, ensure frequent changes to avoid diaper rash and to monitor urine output. During this time parents may be concerned that their child is not getting enough to eat. Food is not important during this time. Ease back into eating. Try to eat small amounts of food frequently if you experience nausea. Otherwise, gradually begin to eat bland, easy-to-digest foods, such as soda crackers, toast, gelatin, bananas, applesauce, rice and chicken. Stop eating if your nausea returns. Avoid milk and dairy products, caffeine, alcohol, nicotine, and fatty or highly seasoned foods for a few days. Fluids and rest are best!   

Ticks…FAQ

Summer weather means lots of time outdoors for kids. It can also mean a risk of bug bites. Biting insects like ticks are common in many places during the warm months, and it's not unusual for people of any age to find one on their skin.

If you find a tick on your child, you might be concerned about what it means to their health. Most of the time, you can remove a tick at home, and your child will be fine right afterward. There is a small risk of tick-borne disease after a bite, so it's important to know what to look for in the days after a tick bite. 

What Are Ticks?

Ticks are tiny arachnids that feed on blood from mammals. They attach themselves to a person or animal by biting them and burrowing into the skin to feed. Their bites are usually painless, and you may not notice a tick on your body unless you're looking for it. They can be as small as a poppy seed or closer to the size of a pencil eraser. If you don't remove a tick, it will feed on a host for 3 to 6 days before dropping off on its own.

There are hundreds of kinds of ticks, and they live all over the world. In North America, ticks are most active from May to October. However, it's possible to get a tick bite any time of year.

Removal and what to do after being bitten by a tick?

1. Grasp the tick as close as you can to your skin's surface.
2. Pull straight up and away from the skin, applying steady pressure.
3. Check the bite site to see if you left any of the tick's head or mouth parts in the bite.
4. Clean the bite site with soap and water.

When should I be concerned about a tick bite?

Make sure you see a doctor if you notice the following:

The bite area shows some signs of infection including swelling, pain, warmth, or oozing pus. Development of symptoms like headache, fever, stiff neck or back, tiredness, or muscle or joint aches. Part of the tick remains in the skin after removal.

Are Tick Bites Dangerous?

Most of the time, a tick won't cause serious problems. The bites don't hurt, and once you remove a tick, your child may have a painless red spot that goes away after a few days. 

People can be allergic to ticks in rare cases and may react to the bite. Call your doctor if your child shows any symptoms of an allergic reaction, including: 

• Fever
• Muscle or joint pain
• Headache
• Fatigue
• Muscle weakness
• Pain and swelling at the bite

Ticks can also carry diseases and pass them on to humans, including: 

• Lyme disease
• Rocky Mountain Spotted Fever
• Colorado Tick Fever
• Anaplasmosis
• Tularemia 

Lyme disease is the most common tick-borne disease in the United States. Most cases are reported in the Northeast, Pacific Coast, and Upper Midwest, where deer ticks carry Lyme. But even if a deer tick bites your child, the risk of Lyme disease is very low. A tick needs to be on a person for 36 to 48 hours to be able to transmit the bacteria that cause Lyme disease.

What Should I Look for After a Tick Bites My Child or myself?

Once you have removed the tick from your child, you should watch for signs of a reaction or possible disease from the bite. Call your doctor right away if you notice any of the following symptoms in your child:

• Widespread rash beginning 2 to 14 days after the bite
• Fever or headache beginning 2 to 14 days after the bite
• Increased redness or swelling over time
• Weak, droopy eyelids, droopy face, or a crooked smile

Be on the lookout for a red ring or bull's-eye rash appearing 3 to 30 days after the bite. This is a symptom of Lyme disease. The rash is harder to see on dark skin tones, so speak to your doctor about what it might look like on your child. 

Can I Prevent Tick Bites?

You can protect your child from ticks by using an insect repellent that you spray on their skin and clothes. Your doctor can recommend a good spray. You can also encourage your child to wear tight-fitting clothing, including socks and a hat to keep ticks away from their skin.

Check your child for ticks whenever they have been playing outside. Pay special attention to their scalp, elbows, and knees, as well as the skin behind their ears and under their arms.

Resources:

https://www.uptodate.com/contents/what-to-do-after-a-tick-bite-to-prevent-lyme-disease-beyond-the-basics

https://lymediseaseassociation.org/medical-gallery/tick-vectors/?gclid=Cj0KCQjwna2FBhDPARIsACAEc_UQVgdKZHxwEvAx86Q19HVKLSHKMt4NK2l0aXPYdA9YQRU_gLB_BP4aAstaEALw_wcB

https://www.healthline.com/health/tick-bites