Clark Avenue Connection

Dr. Lily Harris

Monday Notes

Written by Dr. Lily Harris

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Today is Monday, May 22, 2017

  • This morning we sign off from our answering service at 8:00 am to take calls directly from our office.
  • We will be in the office until we finish our On Call Evening Clinic (typically around 7:00 pm).

Walk-Ins

  • 8:00 – 8:30 am: Today if you arrive at the Duraleigh office during that time your child will be seen by our pediatrician(s) covering walk-in patients.
  • Walk-In appointments are for acute sick visits only (symptoms of a short duration).
  • As always, all other visits today are scheduled by appointment only.

Today’s Lineup

  • On Call PediatricianDr. Lily Harris will be rounding on our newborns at Rex Hospital and running our On Call Evening Clinic.
  • In our Duraleigh Office today:  Drs. Muff Carr, Jamila Fletcher (AM), Lily Harris, Jen Long and Tom Sena
  • In our Brier Creek Office today:  Drs. Jamila Fletcher (PM), Rick Gessner and Ben Meares

After Hours Care

  • Our On Call Pediatrician manages our after hours care.
  • Urgent calls outside regular hours: 919-781-7490
  • After hours backup number: 919-831-5526
  • Poison Control: 1-800-222-1222

Dr. Todd Harris

Weekend Notes

Written by Dr. Todd Harris

06sat

It’s the Weekend, May 20 and 21, 2017

No Walk-In Appointments on the Weekend

  • Patients are seen by appointment only on all holidays and weekends.
  • If you think your child may need to be seen this weekend, call 919-781-7490 in the morning after 9 am and speak to the nurse working with the On Call Pediatrician.
  • Saturday Clinic begins 10am and Sunday Clinic begins at 11am. Clinic ending time varies depending on how busy we are.
  • After clinic, we are available to speak by phone about any urgent concerns you may have.

The Weekend Lineup

After Hours Care

  • Our On Call Pediatrician manages our after hours care.
  • Urgent calls outside regular hours: 919-781-7490
  • After hours backup number: 919-831-5526
  • Poison Control: 1-800-222-1222

Dr. Todd Harris

It’s Sport-A-Shirt-Share-A-Night Day

Written by Dr. Todd Harris

2017 Shirt

May 5, 2017 – Today we celebrate our “Annual Relaxed Dress Code Day” – a.k.a. “Sport-a-Shirt-Share-a-Night Day” by wearing t-shirts in support of the Ronald McDonald House.

The Ronald McDonald House charity supports families who are going through their most difficult timesduring the illness of a loved one.

RCAM is proud to support this effort each year.


Dr. Todd Harris

Happy Administrative Professionals Day!

Written by Dr. Todd Harris

Admin Assist Lunch 2017 Relish

April 26, 2017 – Today we stopped to thank our Front Office workers and remind them how important they are to our very important missionthe health and well-being of children.

It is a very broad and difficult set of tasks that we charge our staff to perform 364 out of 365 days a year (they get to take a break on Christmas).

Lunch was a small token; nonetheless we hope all felt acknowledged for their important roles.

 


Dr. Todd Harris

“She Loved Being A Nurse”

Written by Dr. Todd Harris

Peggy RN

Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the smallest act of caring, all of which have the potential to turn a life around.

-Leo Buscaglia

April 21, 2017Peggy Wilkinson worked as a nurse at Raleigh Children & Adolescents Medicine from December 30th, 1985 through December 31st, 2011. Peggy passed away this past Saturday morning.

Her obituary was published in Tuesday’s News & Observer. It can also be found here online.

This jarring news has shaken those at RCAM who worked with her.

Peggy spent 26 years with us.

We knew Peggy as a wife and a proud mother. It was clear to her co-workers that she loved her son Sam and spending time with her family was very important to her.

Over 26 years, we knew her as a friend.

Office manager Debbie Maness remembered that Peggy was among the first to bring you a casserole when preparing your own meal was being overshadowed by illness, grief, or (in better times) a new baby.

Pediatrician Muff Carr remembered – among other things – Peggy’s cranberry salad at office potlucks. Peggy was also a fierce competitor when it came to our white elephant office holiday party..

But we knew Peggy best as a nurse.

Twenty-six years represents a lot of phone calls trying to help a weary parent on the other end of the phone line. It includes countless efforts to ease an anxious child through their visit to the doctor.

Measuring growth. Assessing hearing and vision. Collecting and performing labwork. Giving vaccines. Documentation. Peggy was said to be a “meticulous and tireless worker.”

She knew a nurse’s workday focused on doing what needed to be done to help our most valued – our children.

And she loved it.

The other morning as the news spread through our office, Debbie thought for awhile and then it came to her. She said, “Peggy loved being a nurse.”

That is one way we will definitely remember our dear friend Peggy..


Dr. Todd Harris

Easter Weekend Holiday Schedule

Written by Dr. Todd Harris

Easter Sched 2017

We will be closed for routine business on Good Friday, April 14th

  • Good Friday – Friday, April 14th – BOTH offices closed for routine business; typical holiday office coverage (limited clinic at Duraleigh Office location)
  • Saturday, April 15th – typical Saturday / weekend hours
  • Easter – Sunday, April 16th – typical Sunday / weekend hours
  • Monday, April 17th – typical Monday hours at both offices; normal schedule

Some notes from our office about holidays and weekends:

  • Just like every day, one of our pediatricians is on call 24-hours-a-day for urgent health concerns
  • There are no walk-in appointments on holidays and weekends: we will see children with urgent medical concerns in the morning by appointment only
  • To talk to our nurse working with our on call pediatrician about possibly being seen in our weekend / holiday clinic, it is best to call between 9am and 10am
  • We try to handle concerns as much as possible on regular office days, but – anytime – if you have urgent concerns about your child’s health – call our main number 919-781-7490 (backup number 919-831-5526)

Dr. Todd Harris

Banner Change: Spring Edition

Written by Dr. Todd Harris

2017 Spring

April 1, 2017 – So this is 12 days late – spring officially began on March the 20th – but can you blame someone for being a little confused about the change of season around here?

It is our tradition to change our website banner to match the season, and in that spirit we remove the sledders – that seems like a pretty foreign concept at this point – and introduce the family walking on the partially tree-shaded path (is it half-sunny or half-shaded? What kind of person are you?).

Dad appears pretty casual. Mom seems to have kept her options open for the day with her choice of clothing. All three seem to be fully participating in each other on this beautiful day (do those assumptions make me a half-sunny kind of person?).

You could imagine as they walk the parents might gently lift their son by his hands and swing him back and forth (WARNING: don’t fall for it – it’s a trap).

Let me take this opportunity as your pediatrician to provide this public service announcement: SWINGING OR PULLING A CHILD BY THEIR EXTENDED ARM IS NOT A GOOD IDEA.

Nursemaids Elbow

The possible resulting condition described above is Nursemaid’s Elbow. You can find more information at the link provided.

In short, it is a painful yet fortunately treatable (and preventable) condition – don’t let it mess up your half-sunny day.


Dr. Todd Harris

World Read Aloud Day 2017

Written by Dr. Todd Harris

litworldwrad17calendar copy

February 16, 2017 – “What can I do to help my child’s development?”

As pediatricians, we get asked this question about everyday.

Aside from the obvious – the things I categorize as “the stuff that comes naturally” – like providing appropriate shelter, nutrition and attention for your child – there is one thing that has shown to have a tremendous developmental upside. 

It is not ‘the latest thing’ – the answer does not involve anything electronic. It doesn’t need to be plugged in or charged. It requires no data plan.

The thing that can have a most profound affect is reading out loud to your child.

Technological advancement has not been able to duplicate the the incredibly positive impact of reading to your child.

It is never too early or too late to get started as long as you do it today.
Today is World Read Aloud Day – one of those few days without its own Hallmark card – a day that exists to promote awareness that giving our children all the advantages is within our grasp.

So long as that grasp is used to take hold of a book, open it, and read aloud.

For more details about World Read Aloud Day, check out the LitWorld website.

 

 


Dr. Todd Harris

From the AAP: Updated Safe Sleep Guidance

Written by Dr. Todd Harris

January 12, 2017 – Recently, the American Academy of Pediatrics (AAP) came out with some updated and expanded safe sleep recommendations.

They list 19 recommendations for a safe infant sleeping environment and it is definitely worth taking a look at the details.

The 19 recommendations for a safer infant sleep environment:

  • Small detail: The 19 recommendations are listed with their strength of recommendation at the bottom of this post
  • Some detail:  A listing that includes brief explanations is found here.
  • More detail: The official AAP policy statement is found here.
  • Lots of detail: The AAP technical report is found here.

What your pediatricians at RCAM think about these new safe sleep recommendations:

1. New recommendations reflect the best information available now

First of all, we don’t shy away from new recommendations. Not at all. That is one of the strengths of medicine.

We know that we don’t know everything, and there is a vast and constant pursuit of better information. When more complete, up-to-date knowledge about how to keep our children healthy comes available, we want to incorporate it into what we do.

That is why it is okay that we sometimes hear grandmothers say, “That’s not what I was told when you were a baby.

Medicine strives to recommend based on the best information available now.

2. Old habits are sometimes hard to kick

It has taken us a few months to comment as a practice because these 19 recommendations include some real game changers.

For example, consider #4 below: “Room-sharing with the infant on a separate sleep surface is recommended” (for the first 6-12 months).

As a practice, we have generally agreed that establishing a healthy, through-the-night sleep pattern is greatly aided by the move of your infant into a separate room. But, some studies have shown a 50% reduction in the incidence of Sudden Infant Death Syndrome (SIDS) in infants who room-shared (not bed-shared) for the first 6-12 months. That is what I mean by a game changer.

There are 19 recommendations. No one will be perfect and follow all of them 100% of the time for the first 12 months of life (if your child has ever fallen asleep in their car seat and you didn’t as quickly as possible move them to a firm, flat surface, then you haven’t followed all the recommendations all the time).

However, it is important that we assess what we do and change our habits to be as safe as we can with out most valued members of society – our children.

3. Some old habits do not need to change

Back to sleep for every sleep is still very important for a safe infant sleep environment.

Summary of Recommendations With Strength of Recommendation

The list below comes from the AAP (link). The linked article provides more information along with references with each recommendation. The recommendations are grouped based on the Strength-of-Recommendation Taxonomy (SORT) for the assignment of letter grades to each of its recommendations (A, B, or C).

A-level recommendations (Level A: There is good-quality patient-oriented evidence.)

  1. Back to sleep for every sleep
  2. Use a firm sleep surface
  3. Breastfeeding is recommended
  4. Room-sharing with the infant on a separate sleep surface is recommended
  5. Keep soft objects and loose bedding away from the infant’s sleep area
  6. Consider offering a pacifier at naptime and bedtime
  7. Avoid smoke exposure during pregnancy and after birth
  8. Avoid alcohol and illicit drug use during pregnancy and after birth
  9. Avoid overheating
  10. Pregnant women should seek and obtain regular prenatal care
  11. Infants should be immunized in accordance with AAP and CDC recommendations
  12. Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS
  13. Health care providers, staff in newborn nurseries and NICUs, and child care providers should endorse and model the SIDS risk-reduction recommendations from birth
  14. Media and manufacturers should follow safe sleep guidelines in their messaging and advertising
  15. Continue the “Safe to Sleep” campaign, focusing on ways to reduce the risk of all sleep-related infant deaths, including SIDS, suffocation, and other unintentional deaths. Pediatricians and other primary care providers should actively participate in this campaign

B-level recommendations (Level B: There is inconsistent or limited-quality patient-oriented evidence.)

  1. Avoid the use of commercial devices that are inconsistent with safe sleep recommendations
  2. Supervised, awake tummy time is recommended to facilitate development and to minimize development of positional plagiocephaly

C-level recommendations (Level C: The recommendation is based on consensus, disease-oriented evidence, usual practice, expert opinion, or case series for studies of diagnosis, treatment, prevention, or screening.)

  1. Continue research and surveillance on the risk factors, causes, and pathophysiologic mechanisms of SIDS and other sleep-related infant deaths, with the ultimate goal of eliminating these deaths entirely
  2. There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS

Note: “patient-oriented evidence” measures outcomes that matter to patients: morbidity, mortality, symptom improvement, cost reduction, and quality of life; “disease-oriented evidence” measures immediate, physiologic, or surrogate end points that may or may not reflect improvements in patient outcomes (eg, blood pressure, blood chemistry, physiologic function, pathologic findings). CDC, Centers for Disease Control and Prevention.


Dr. Todd Harris

UPDATE: Warmer Weather, Normal Schedule

Written by Dr. Todd Harris

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January 10, 2017 – Hopefully, our last weather-related announcement for awhile:

Both RCAM offices will be opening ON TIME tomorrow morning.

DON’T FORGET: We open an hour later typically on Wednesday so opening normally will mean Walk-In arrival time at our Duraleigh Office is 9:00 to 9:30am (as opposed to 8:00-8:30am on all other weekdays).