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|Topic: Houston Medical staff wearing out-Flood of Kids|
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| Topic: Houston Medical staff wearing out-Flood of Kids
Posted: October 10 2009 at 7:49pm
By CINDY GEORGE Copyright 2009 Houston Chronicle
Oct. 10, 2009, 9:25PM
Sniffles, coughs and aches have plagued Houston children, leaving doctors overbooked and overworked as the flu season officially begins.
“I have been working with my associates to the point of exhaustion during this novel flu season,” said Dr. Brian Talbot, one of five physicians at Texas Children's Pediatric Associates in Pearland, which serves more than 10,000 patients.
Pediatricians are working overtime to juggle routine checkups with ailing children without appointments who are swamping their offices.
While this is the traditional start of flu season, children have been sick since April from H1N1, which causes swine flu. Cases have surged again since school resumed in August.
It's the busiest time clinical supervisor Theresa Rivera has experienced in her 13 years at the Pearland practice.
“It's been nonstop since school started,” she said.
It's become so busy that parents calling for appointments are asked not to bring mildly ill kids into the office — for the protection of healthy patients and tag-along siblings who aren't sick.
Public health authorities also advise calling the child's physician or Texas 211 for medical advice before taking pint-size patients to already-clogged emergency rooms.
Texas Children's in Pearland is managing patients in waves — reserving early mornings and early afternoons for “well care” and fitting in ill patients at other times.
The sick side of the waiting room has the most toys, since that's where kids of any health gravitate.
Four-year-old Kwame Dako, who had a bad reaction to Tamiflu, a persistent fever and new joint pain, visited Talbot for the second time in a week Thursday. Lily-Anne Dako, 34, said her son has been lethargic with a light appetite.
The doctor prescribed antibiotics for a secondary infection that he found in Kwame's left ear.
“It's not going to take care of the flu that he's had — that's probably trying to wind itself down,” said Talbot.
Urgent care swamped
The H1N1 virus has hit children particularly hard. Young children have the highest flu hospitalization rates in the United States, and Texas led the nation in pediatric deaths, seven in all, for the week ending Oct. 3.
Some patients with underlying conditions and severe respiratory problems have been admitted to Texas Children's Hospital.
UTMB's pediatric urgent care clinic in Galveston — open until 10 p.m. on weekdays and 8 p.m. on weekends — usually sees 20 to 30 kids in the evenings. But “it's been up in the 60s every night for the last 10 days,” said Dr. Christine Turley, vice chair for clinical services in the UTMB pediatrics department.
“The number of outpatient visits has been just steadily climbing,” she said.
According to the federal Centers for Disease Control and Prevention, most flu circulating now nationwide is H1N1. Many patients with classic symptoms don't have the flu, and those who do have tend to have mild illnesses.
Still, parents aren't taking any chances.
Dina White whisked her 2½-year-old to the doctor Thursday after the toddler woke up with a high fever.
“I didn't want something worse to happen,” said White, who was surprised about her daughter's flu diagnosis and that the doctor didn't write a prescription. “You just always think when they have symptoms like this, they're going to go ahead and give it to them.”
The Pearland mother alternated Motrin and Tylenol to break Olivia's fever, but by Friday, the child's temperature remained at 100 degrees.
“I might have to take her back,” said White, 37. “Her cough has become more severe, and I hear a little more congestion in her chest.”
The CDC's treatment guidelines continue to change, a source of confusion for parents, Turley said.
“The CDC originally was saying we should treat all kids under 5 if we felt like they had flu, but two or three weeks ago, they said ‘Let's make that under 2.' If they're a little bit older and they don't have asthma or a heart problem, they don't have to get Tamiflu,” the Galveston pediatrician said.
The demands on children's providers and emergency rooms are expected to endure until next May, the CDC predicts.
Phones continue to ring nonstop. The No. 1 inquiry is whether doctors have the H1N1 vaccine, said Lori Simmons, a medical assistant at Texas Children's in Pearland.
Providers don't have it yet, but believe shipments may start arriving this month.
“They think as soon as we get it, they're going to be able to walk in here and get the vaccine,” Simmons said.
UTMB is expecting its first H1N1 vaccine “any day.”
Priority will be given to 2-year-olds and high-exposure health workers, Turley said.
Physicians and office workers are taking extra precautions to avoid getting sick.
The Pearland practice had extra hand sanitizer dispensers installed to supplement frequent hand washing.
Surgical masks are also available to block germs.
And the irresistible toys and video games in the waiting room?
They're cleaned twice a day, Rivera said.
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