Sparrow Pediatrics November update: Fall feelings and RSV

Sparrow Pediatrics November update: Fall feelings and RSV

November feels

Who is excited about fall in Texas? 

After enduring many winters in the Midwest, I often faced the season with a sense of unease, watching as the vibrant trees shed their leaves, the skies turned into a seemingly perpetual grey, and the comforting warmth of summer faded into a distant memory.

In Texas I find the fall brings a sweet relief. More time outside with my family, more fresh air and cool walks. Less sweating every time I walk out the door. Sweaters in the morning and sunshine in the afternoon. This particular November is extra special in that I am filled with overwhelming gratitude. I am humbled to have the privilege to walk alongside new families as they have entrusted me with the care of their children. I have met many amazing individuals in my journey towards direct primary care. People who truly care about the health of our children and community and aren't afraid to take a risk in order to do this well. Families who want better options for their child's healthcare and overall wellness. The Dripping Springs community has embraced me and for that I am grateful. 

Unfortunately, along with the season changes comes a new batch of respiratory viruses. I get asked multiple times per week "what types of illnesses are you seeing right now?" Read below for the latest information about what is in the community and what to do about it.

RSV is here...what to do?

According to the weekly surveillance reports, RSV is officially on the rise. 

What is RSV? It stands for respiratory syncytial virus and it can be a nasty little bug. When I was a hospitalist I had several patients each year who had severe cases of RSV requiring prolonged stays in the intensive care unit. The tricky thing about this virus is that for one baby it can barely produce a sniffle, and for another it may cause life threatening breathing problems and hypoxia (low oxygen levels). Here is what you need to know:

• The virus is mainly of concern in young infants with smaller airways. Big kids usually get a bad cold but no breathing problems.

• It causes inflammation in the lower airways (bronchioles, hence the term "bronchiolitis") which can cause sloughing of the epithelial cells

• This leads to copious amounts of drainage and mucous and can also cause wheezing and difficulty breathing in some babies

• The symptoms tend to peak in severity around day 5-6 of the illness

• Risk factors for severe symptoms include prematurity, underlying lung disease, and smoke exposure

• Breastfeeding is protective

• Treatments: suction, suction, suction! Babies need help clearing the mucous and it tends to build up again frequently so needs to be repeated multiple times per day

• Use steam showers, saline sprays and humidifiers

• In general, avoid cough medicines, albuterol, and steroid treatments as these have not shown to be helpful and can have harmful side effects in infants

• Red flags to seek care: poor feeding, excessive sleepiness, fast or labored breathing, persistent fever for more than 4-5 days

• Babies with RSV bronchiolitis sometimes need frequent reassessments as the illness progresses. This is where a DPC pediatrician can be helpful. Text check-ins, next day follow up appointments, and guidance for what to do if your child is not improving the way you were expecting.