My Blog
By Blaine E. Tolby, MD
May 04, 2020
Category: Children's Health
Tags: ADHD  
ADHDParents want the best for their child, which is why check-ups and appointments with their pediatricians are so important. Yet your pediatrician isn’t just available for when your child is sick or has physical ailments. They can also help with mental and behavioral conditions, including the diagnosis and treatment of ADHD. If your child struggles with focus, impulsivity, attention, or hyperactivity, schedule them for an evaluation. It’s also important to note that children must be at least four years old for a diagnosis.
 
The Three Facets of ADHD
There are three parts to pediatric ADHD: impulsivity, inattention, and hyperactivity. Each of them is signs and are necessary for a diagnosis. Here is some information about each of them.
 
Inattention: your child spends a lot of time daydreaming or not paying attention, struggles to listen, is easily distracted, makes careless mistakes, rarely finishes tasks, and is disorganized to the point of losing or forgetting important things. 
 
It’s important to understand that children with ADHD can pay attention, it’s just harder with topics that don’t interest them. They can tune out when tasks get repetitive. Working with them to organize their schoolwork and tasks is essential. Try to provide them with a quiet and calm environment to work in.
 
Impulsivity: your child can’t wait or acts without thinking, interrupts others, and has problems taking turns.
 
Children with ADHD have trouble with self-control, which leads to the impulsive characteristics mentioned above. They have a harder time censoring themselves. This results in them invading people's personal space or asking overly personal questions. Impulsivity problems also lead to moodiness and overreactions. 
 
Hyperactivity: your child seems to constantly be moving, without being able to sit still without squirming. They also talk too much and loudly, often playing in areas that aren’t permitted. 
 
It’s normal for younger children to have high energy levels. It’s only when your child seems to be constantly moving that it could be an issue with hyperactivity. When they do sit still, they are still moving. They may tap their fingers, shake their legs, or move their feet. 
 
Diagnosing ADHD
A diagnosis won’t happen right away. There are many steps in the process before an accurate understanding is available. Your pediatrician will most likely want statements from not just you and your child, but other caregivers and teachers. 

At the appointment with your child’s pediatrician, they’ll want you and others to fill out a questionnaire about your child’s behavior. Symptoms need to be present in multiple settings, like at home and school and cause issues at both. 
 
The criteria change depending on your child’s age, so it isn’t one-size-fits-all. Your pediatrician will work with you to get an accurate picture of your child’s situation. 
By Blaine E. Tolby, MD
April 01, 2020
Category: Child Health Care
Tags: Warts  

Warts are common, benign bumps that develop on the skin as a result of a viral infection known as the human papillomavirus (HPV). Warts are pretty common in children and can develop just about anywhere on the body; however, they are most often found on the face, feet, and hands. Generally, warts usually don’t cause any problems and will go away on their own, but if you don’t want to wait a pediatrician can offer effective wart removal options.

Types of Warts

There are different kinds of warts that can develop. These warts include:

  • Common warts: these rough bumps are often found on the elbows, fingers, and hands and are usually gray in appearance. If you look closely at the bump you may also notice small black dots.
  • Flat warts: these smooth warts are often pink or light brown and most often develop on the face
  • Plantar warts: these warts develop on the soles of the feet, which can be very uncomfortable for your child, especially when walking
  • Palmar warts: just as plantar warts develop on feet, palmar warts develop on the hands

Treating Warts

While warts will go away without treatment it can take months or even years. If your child is embarrassed by the wart, if your child is dealing with multiple warts or if the wart is causing discomfort or pain then this warrants seeing a pediatrician. There are many ways in which a pediatrician can remove the wart.

Your child’s best treatment option will depend on the size, location, type, and number of warts. While there are certainly over-the-counter medications that you can try (these medications should not be used on certain areas of the body including the face), a pediatrician will be able to provide you with safe, effective treatment under proper medical supervision.

Common wart removal options include:

  • Cryotherapy: freezing the wart with liquid nitrogen (a very common wart removal technique)
  • Salicylic acid: a doctor can also provide a strong prescription solution that contains salicylic acid (this can be applied at home as per your pediatrician’s instructions)
  • Laser: sometimes laser therapy is used to target and destroy the wart

Usually the wart will fall off within a few days after treatment, but sometimes more than one treatment session is necessary to successful remove the growth.

If your child has plantar warts or warts in embarrassing places then they will most likely need to turn to their pediatrician to treat the problem. Call your children’s doctor today and let them know that you want to discuss wart removal options for your child or teen.

By Blaine E. Tolby, MD
February 28, 2020
Category: Child Health Care

Sneezing. Watery eyes. Stuffy nose. These could just be symptoms of a cold or these could be signs that your child has allergies. If you notice that your child’s symptoms flare-up during certain times of the year then this could definitely be a sign of seasonal allergies. Unfortunately, allergies can impact everything from performance in school to participating in outdoor activities such as school sports. If you suspect that your child may have allergies it’s important to talk with your pediatrician.

Childhood Allergy Symptoms

Allergy symptoms can also seem a lot like a cold or other upper respiratory problems. Common symptoms associated with allergies include:

  • Watery, red, and itchy eyes
  • Itchy nose
  • Dark circles under the eyes or puffy eyelids
  • Ear pain and chronic ear problems
  • Nasal congestion
  • Facial pain and pressure
  • Headaches
  • Sneezing
  • Persistent cough
  • Chest tightness

So, how can you tell that your child is dealing with allergies and not an infection? Some telltale signs include itchy eyes and nose, which are classic signs of allergies. If your child has a fever this is usually a sign of an infection and not allergies. Unlike a cold, allergy symptoms can last for weeks. You may also notice that your child’s symptoms come and go, appearing more often during the spring and fall months. Again, this is a trademark of childhood allergies.

Treating Childhood Allergy

There are many ways in which a pediatrician can help your child manage their allergy symptoms, and the treatments that are recommended will depend on the type and severity of your child’s symptoms. Most treatment plans include a variety of lifestyle changes and medication. Children with minor symptoms may find relief through over-the-counter antihistamines and decongestants, while other children may require a prescription-strength allergy medication to tackle more moderate to severe symptoms.

Lifestyle modifications may include using a dehumidifier in your child’s bedroom, wearing glasses instead of contacts during allergy seasons, bathing immediately after being outdoors, limiting outdoor activities during high pollen counts, and keeping pets out of bedrooms (if your child suffers from pet dander allergies).

For severe or unresponsive allergies, your pediatrician may recommend immunotherapy, or allergy shots. Allergy shots may be a good option for your child when other treatment options and medications have not been successful.

Are your child’s allergy symptoms impacting their daily routine? If so, our pediatricians can help them manage their symptoms so they can get back to enjoying days on the playground and time spent with family.

By Blaine E. Tolby, MD
January 31, 2020
Category: Pediatrics
Tags: Child Care   Diabetes  

With the rise of newly diagnosed cases of type 1 and type 2 diabetes in children in the US, it’s now more important than ever for both parents and children to understand ways to prevent diabetes, as well as being able to identify the symptoms of type 1 and type 2 diabetes. A pediatrician is an integral part of your child’s health, providing everything from screenings and vaccines to routine checkups and lifestyle recommendations to ensure that your child stays healthy.

What is diabetes?

Diabetes is a chronic condition that affects glucose levels in the body. When the cells in the pancreas responsible for making insulin do not produce enough insulin or are insulin resistant, this results in diabetes.

Type 1 diabetes is most often diagnosed during childhood and is not the result of a poor diet or being overweight. In those with Type 1 diabetes the cells in the pancreas are unable to produce enough insulin. Unfortunately, there is no way to prevent type 1 diabetes in children.

On the other hand, type 2 diabetes is also becoming increasingly common in children because of the high rates of obesity. Type 2 diabetes means that the body doesn’t use insulin properly. Ensuring that your child eats right, gets regular exercise and maintains a healthy weight can greatly reduce your child’s risk for type 2 diabetes.

What are the symptoms of childhood diabetes?

Symptoms of type 1 diabetes will appear suddenly, while type 2 symptoms will develop over time. Symptoms may include:

  • Excessive thirst
  • Increased hunger
  • Frequent urination
  • Extreme tiredness
  • Mood swings
  • Blurred vision
  • Sudden weight loss
  • Cuts or sores that don’t heal
  • Dark patches of skin

If you notice any of these symptoms in your child it’s best to see a pediatrician right away. The sooner a diagnosis is made the sooner your child can get the proper medication and treatment they need to manage their blood sugar levels. By managing your child’s diabetes right away our doctors can prevent potentially serious complications and hospitalizations.

How is diabetes treated?

There are a variety of lifestyle modifications and medications that will be recommended to help treat your child’s type 1 or type 2 diabetes. For both forms of diabetes, a healthy diet and active lifestyle are paramount. Talk with your doctor about what foods your child should avoid. You will also want to monitor your child’s glucose levels during the day to make sure that the insulin medication is working effectively.

All children should visit their pediatricians regularly for checkups, vaccines and care. Of course, if your child displays any symptoms of diabetes, call our office immediately.

By Blaine E. Tolby, MD
December 16, 2019
Category: Pediatrics
Tags: Ear Infection  

An ear infection is one of the most common infections that children have to deal with. In fact, most children will experience at least one ear infection by the time they are five years old. Of course, it’s important to understand the telltale signs of an ear infection, as well as know how to treat the infection and when you should turn to a pediatrician for care.

An ear infection isn’t contagious and usually isn’t a cause for concern; however, you will want to monitor your child’s symptoms to make sure problems aren’t getting worse or don’t warrant seeing a doctor. In many instances, a child may develop an ear infection after they’ve had a cold.

Signs and Symptoms of an Ear Infection

So, how will you know if your child has an ear infection? Children who are old enough to talk will certainly be able to let you know that they are experiencing an earache or pain; however, a baby or toddler won’t be able to tell you that they are experiencing an earache. Therefore, signs that your baby might have an ear infection include:

  • Increased fussiness
  • A fever
  • Pulling at the ears
  • Crying or tantrums, particularly when lying down
  • Having difficulty hearing noises or not responding to sounds
  • Fluid draining from the ears

So, when should you wait out an infection and when should you call a pediatrician? You should give your child’s doctor a call if they have an ear infection and they are also experiencing:

  • A rash
  • Vomiting
  • Difficulty hearing
  • Ear swelling

You should also turn to a doctor for care if your child:

  • Has an ear infection and they are under 6 months old
  • Is in significant pain or still experiences pain after two days of taking ibuprofen
  • Also has other serious health problems

How is an ear infection treated?

In most cases an ear infection will go away on its own. If your child isn’t in significant pain and they don’t have a high fever your pediatrician may tell you to wait a couple of days to see if symptoms improve. If symptoms remain or get worse then you should bring them back to the doctor’s office.

While antibiotics are not normally prescribed to treat an ear infection they may be used if your child has a very high fever, is in significant pain or if their ear infection hasn’t improved within 48 hours. It’s important not to give your child any over-the-counter medications without first talking with your pediatrician.





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