We will be having another flu clinic this Wednesday, November 18, 2009, from 5-7 P.M. on a first come basis. You may enter through the main office door since the weather has turned colder. This clinic is for the intranasal H1N1 only for children ages 2-5 years old who have not yet received the H1N1 vaccine. (See below for contraindications to the intranasal vaccine.) If your child has already received their first H1N1 intranasal vaccine, we will be offering the second dose in the future when supplies allow. We realize our last clinic did not go as smoothly as we would have liked. Our vaccine supply for this Wednesday should be sufficient. Many of you have made good suggestions which we are taking into consideration as we continue to work through the flu season. Please remember that children who are 5 years old and attending school can get the vaccine in the office only if their school is not offering it. We do not yet know when we will be getting more of the injectable H1N1 vaccine.

Contraindications to giving the intranasal vaccine (seasonal or H1N1) include:

• Children less than 2 years of age;
• Children with a medical condition that places them at higher risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease;  children with medical conditions such as diabetes or kidney failure; or children with illnesses that weaken the immune system, or who take medications that can weaken the immune system;
• Children younger than 5 years old with a history of recurrent wheezing;
• Children receiving aspirin therapy;
• Children who have had Guillain-Barré syndrome (GBS), a rare disorder of the nervous system, within 6 weeks of getting a prior flu vaccine,
• Children who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.

AS A REMINDER, PLEASE READ THE FOLLOWING:

With the onset of H1N1, our office (as well as other physician offices) has been inundated with calls and appointments.  We are seeing over 100 children a day in the office, approximately 1/3 of which are add-ons. Judy, our nurse, is answering in the range of 50-75 phone messages a day (and that is a conservative estimate). Our front office staff have been extremely busy in answering calls and with moving patients in and out. Our physicians are busy as well returning phone calls, seeing patients, and handling emergencies. This does not take into account that every family being seen in the office has additional questions about the flu, which lengthens each office visit. In order to provide timely care in the most efficient manner, we ask your cooperation in reading and complying with the following reminders and suggestions:

1. When leaving a phone message, leave one phone number that we can reach you at. We will make one attempt to call you back. It is helpful if you can be brief and to the point in your concerns and questions because of the volume of calls we are receiving.

2. Have your caller ID turned off. We use our back lines to return phone calls. We leave our other phone lines open for new patient phone calls. If your caller ID is on, it will greatly delay our ability to call you back as we reserve the right to keep our back-lines private.

3. Evening and weekend phone calls are for emergencies only. If you have questions about H1N1, please call Monday-Friday during the day.

4. Please do not call on nights and weekends for prescription refills. Our policy states that we also require a 2-3 day notification for refills in general.

5. Referrals are not able to be done on Mondays. Our policy states that we need a one week notification for referrals, so please plan accordingly.

6. If your child has recently become ill, use common sense in initiating treatment. If it is a common cold or even the start of the flu, we will only tell you to do the obvious: treat the fever, increase fluids, rest, etc. We ask that unless there is a compelling reason for your child to be seen, to give it a few days first and see how your child does. We are trying to conserve appointment slots for the children who are most sick and in need of being seen. We do have to triage phone calls at times to accomplish this, so we ask for your patience and cooperation.

7. As an office, Tamiflu is only prescribed for good reason. We do not give it to otherwise healthy children who have the flu with no other complications.

We will continue to update the website in a timely fashion as we get new information and vaccine supplies. We again thank you for your patience and cooperation.

LPA