Dr. Homan's blog

child

As pediatricians, we often encounter cases of respiratory infections that are usually mild, but certain ones, like Mycoplasma pneumonia (often called “walking pneumonia”), can sometimes develop into something more serious. Mycoplasma pneumonia is a type of atypical pneumonia commonly seen in school-aged children and young adults, and it’s important for parents to know the basics about it. Here, we’ll cover the signs, symptoms, how it spreads, and when to seek treatment.

What is Mycoplasma Pneumonia?

Mycoplasma pneumonia is a bacterial infection that usually affects the respiratory system. Unlike traditional pneumonia, which can cause severe symptoms requiring immediate intervention, Mycoplasma pneumonia is often mild, resembling an upper respiratory infection (URI) more than a typical pneumonia. This mild nature is why it’s sometimes referred to as “walking pneumonia.” While most children with Mycoplasma experience minor symptoms, in certain cases, the infection can progress to a more severe form, making early recognition helpful.

Signs and Symptoms

In children, the signs and symptoms of Mycoplasma pneumonia can vary, but they often include:

• Persistent dry cough: This is one of the most common symptoms and may last for weeks.
• Sore throat: Children may experience a mild sore throat, similar to that of a common cold.
• Low-grade fever: Fever is usually mild but can occasionally spike.
• Fatigue and weakness: Children may feel tired or listless even if their symptoms appear mild.
• Headaches and body aches: These are more common in older children and adolescents.

Though symptoms often start mild, parents should be on alert if a persistent cough, shortness of breath, or fever that doesn’t improve develops, as these could indicate the infection is becoming more serious.

How is Mycoplasma Pneumonia Spread?

Mycoplasma pneumonia is spread through respiratory droplets, meaning it can be passed from one person to another through coughing, sneezing, or even talking in close quarters. This makes schools and daycare centers common places where the infection can spread quickly among children. It is also more common during colder months, as children are indoors and in closer contact with each other.

Treatment: Does It Always Require Antibiotics?

The good news for parents is that most cases of Mycoplasma pneumonia in children are mild and may not require antibiotics. Typically, symptoms resolve on their own with rest, hydration, and supportive care. However, in some cases where symptoms persist or worsen, your pediatrician may consider an antibiotic. While many bacterial infections require specific antibiotics, Mycoplasma pneumonia is unique in that it often responds well to a commonly prescribed antibiotic called azithromycin, or a “Z-Pack.” Azithromycin can quickly reduce symptoms and speed up recovery when necessary.

When to Seek Medical Advice

While Mycoplasma pneumonia often resembles a cold, if your child has symptoms that worsen or last beyond a week, it may be best to consult your pediatrician. Other red flags to watch for include:

• Persistent high fever
• Shortness of breath or difficulty breathing
• Severe cough that worsens over time
• Noticeable fatigue affecting your child’s daily activities

Prevention Tips

Because Mycoplasma pneumonia spreads easily in group settings, encourage children to practice good hygiene, especially during cold and flu season. Regular handwashing, covering coughs and sneezes, and avoiding close contact with those who are sick can all help reduce the risk of infection.

In summary, while Mycoplasma pneumonia is typically mild and often goes away on its own, it can sometimes lead to more severe respiratory issues. By recognizing the signs early and understanding when antibiotics like azithromycin may be helpful, parents can feel confident in managing their child’s health this cold season. For any questions or concerns, feel free to reach out to our office—our team is here to help you and your family stay healthy!

(General Health Maintenance and OTC and/or Prescription Medication)

Vaccinations are essential for keeping your child safe from serious illnesses, but it’s natural to worry about how they might feel afterward. While most vaccine side effects are mild and short-lived (though I have personally seen more severe reactions, such as seizures, seizure-like activity, and temporary loss of developmental milestones), there are steps you can take to help minimize inflammation and any discomfort and ensure your child feels their best. Here’s what you can do before and after your child’s vaccination to help reduce potential reactions.

1. Keep Your Child Hydrated

Making sure your child is well-hydrated before their vaccine can make a big difference. Encourage them to drink water throughout the day leading up to their appointment. Staying hydrated helps their body respond effectively to the vaccine and can also reduce the chance of feeling lightheaded afterward.

2. Offer a Nutritious Meal

Before heading to the doctor, give your child a healthy meal or snack that includes a balance of fruits, vegetables, proteins, and whole grains. This provides the energy their body needs to handle the vaccine, while keeping blood sugar stable helps prevent any lightheadedness or nausea after the shot. Avoid sugary snacks, which can lead to energy crashes.

3. Ensure They Get Plenty of Sleep

A good night’s sleep before vaccination day is crucial. When your child is well-rested, their immune system is better equipped to respond to the vaccine. Try to stick to their usual bedtime routine, aiming for at least 9-12 hours of sleep depending on their age. Kids who are rested often recover faster from any post-vaccine discomfort.

4. Soothe Their Anxiety

It’s common for kids to feel nervous about getting shots. Help them manage their anxiety by explaining what will happen in a calm, reassuring way. Depending on their age, using distraction techniques like bringing a favorite toy or allowing them to watch a video during the shot can reduce stress. Reducing anxiety may even help minimize the body’s stress response, which can contribute to side effects like soreness or fatigue.

5. Discuss OtC anti-inflammatory medication or Pain Relief Options with Your Pediatrician

If your child tends to experience significant pain, fever, malaise, or fussiness after vaccines, talk to your pediatrician about whether over-the-counter medications like acetaminophen (Tylenol) or ibuprofen (Advil) are appropriate. These medications can alter the immune response, which may be beneficial to your child. Your doctor can advise you on the best approach if your child experiences side effects after the shot. I recommend children be premedicated if they have a history of reactions or if the family has a history of vaccine reactions.

6. Discuss prescription anti-inflammatory medication or Pain Relief Options with Your Pediatrician

If your child or family has had severe reactions in the past (for example a seizure or seizure-like episode), then one option is premedicating with OTC medicines (ibuprofen, acetaminophen, and an anti-histamine) and considering adding a steroid, such as dexamethasone or prednisolone/prednisone.

7. Keep Your Child Active After the Shot

After the vaccine, encourage gentle arm movements and normal activity. Physical movement can help ease any soreness at the injection site. For younger children, simple activities like playing or using their arm in daily tasks can promote circulation and reduce stiffness. Applying a cool compress to the injection site can also relieve discomfort.

8. Plan for Extra Rest Time

While many children bounce back quickly after vaccines, some may feel tired or achy. It’s a good idea to plan a low-key day after their vaccination, giving them the chance to rest if needed. Mild symptoms like fatigue, a low-grade fever, or crankiness are common and generally short-lived, but ensuring your child has time to rest can speed recovery.

9. Monitor and Comfort

After the vaccine, keep an eye on how your child is feeling. If they develop a mild fever, make sure they continue to drink fluids and rest. Comfort them with extra cuddles or a favorite blanket, as physical reassurance can help them feel better. Most side effects, such as a slight fever or sore arm, go away within a day or two, but don’t hesitate to reach out to your pediatrician if you have concerns about your child’s reaction.

Final Thoughts

Vaccines are key to keeping your child healthy, and while mild reactions are common, these steps can help make the experience easier for both you and your little one. From staying hydrated to offering comfort and rest, preparing ahead of time can minimize any discomfort and help your child recover quickly. If you have any questions or worries about vaccines, don’t hesitate to discuss them with your pediatrician.

The aftermath of Hurricane Helene can be overwhelming for families, especially for children who may not fully understand what has happened. As a pediatric practice, Canopy Pediatrics is here to support you and your children during this challenging time. Here are some ways families can help their kids cope with the emotional and psychological impacts of the hurricane.

1. Create a Safe Space

Establish a calm environment at home where your children can feel secure. Encourage them to express their feelings about the hurricane, whether through words, art, or play. Listening to their concerns without judgment can help them process their emotions.

2. Maintain Routines

Children thrive on routine, so try to keep their daily schedule as normal as possible. The includes morning and bedtime routines. This can provide a sense of stability amid the chaos. Incorporate activities that your child enjoys to help distract them from stress.

3. Educate and Communicate

Talk to your children about the hurricane in an age-appropriate manner. Explain what happened and reassure them that they are safe now. Open communication can help alleviate fears and misconceptions.

4. Encourage Expression

Allow your children to express their feelings. This could be through drawing, writing, or talking. Validate their emotions by acknowledging that it’s okay to feel scared, sad, or confused.

5. Seek Professional Help

If your child is showing signs of prolonged distress, consider reaching out to a mental health professional. There are many psychologists in Tallahassee who can provide support. Here are a few resources you might find helpful:

• Tallahassee Psychology Group
• Dr. Alexandria (Alex) Meyer
• Dr. Jennifer Solomon
• Tallahassee Counseling Center
• FSU Anxiety and Behavior Clinic
• Dr. Marie Guilford
• Dr. Angela Henderson with North Florida Cares
• Elite DNA Behavioral Health

These professionals can offer coping strategies and additional support tailored to your child’s needs.

6. Access Medical Care if Needed

In case your child requires medical attention, whether for physical or emotional health, don’t hesitate to reach out for help. For adult medical care, Access Direct Primary Care can provide immediate care and support.

Conclusion

Hurricane Helene has left a significant impact, but with love, support, and the right resources, families can help their children navigate this challenging time. Remember that you are not alone—Canopy Pediatrics is here to support you and your family through every step of recovery.

For more information on how we can assist, visit our website at Canopy Pediatrics. Together, we can foster resilience in our children and help them thrive even after adversity.

Hopefully this wave will be shorter than previous waves, since Omicron spreads faster, but let’s also hope that we do not overwhelm our health system!

Dr. Russell Homan, MD

It’s that time of the year! Many of us are walking around like zombies: groggy, stuffy nose, headache, sore throat, and itchy eyes. There is a lot that can be done, and much with over-the-counter (OTC) medications. You don’t have to continue in a state of pollen zombiness. The following is what I recommend for my patients.

Most of people only know about sedating (ex. Benadryl) or non-sedating antihistamines (ex.’s Claritin, Zyrtec, or Allegra). “Sedating” means they cause sleepiness, and I think most people know that Benadryl can make you sleepy. But there are now many more options now, but we’ll start with the basics.

For Mild to Moderate Nasal Congestion, Sneezing, or Sore Throat:

• Non-Sedating Antihistamines: I recommend always starting with a non-sedating antihistamine. They rarely make people sleepy, they work quickly, and they usually last all day. Examples are loratadine (Claritin), cetirizine (Zyrtec), or fexofenadine (Allegra). Zyrtec is approved for children down to 6 months of age (but talk to your doctor first when giving it to a child less than 2 years of age).
• Non-Sedating Antihistamines plus Nasal Decongestants: Two nasal decongestants, psuedoephedrine (Sudafed) and phenylephrine, can be combined with allergy medications. Pseudoephedrine works well, but it must be purchased at the pharmacy desk, because it can be abused as a stimulant or used in the production of methamphetamines. I recommend only using decongestants for short periods, such as 1 to 2 weeks at a time, and avoiding their use in the afternoon or at night, because they can cause trouble sleeping. There are many medical conditions in which decongestants should not be used, so if you have a medical condition (besides allergies) speak to your doctor before using one.
• Sedating Antihistamines (i.e. Bendaryl): I would only recommend Benadryl (diphenhydramine) if you only have trouble with allergies at bedtime. Benadryl only lasts 6 hours and makes you sleepy.

If Antihistamines Do Not Work or for Moderate to Severe Nasal Congestion and Sore Throat

• Nasal Steroid Sprays: For the majority of people, nasal steroid sprays are sufficient to manage symptoms. Examples are Flonase (fluticasone), Rhinocort (budesonide), or Nasocort (Triamcinolone). I recommend fluticasone as it is a “2nd generation” spray, so less than 1% of the medication enters your body (as opposed to 10 to 50% of the older sprays, like triamcinolone or budesonide). Flonase “Sensimist” is approved for children down to 2 years-of-age.
• Cromolyn Nasal Sprays: Cromolyn nasal sprays are probably the safest allergy medicines available, it’s just that you need to use them 3 to 4 times per day. One brand is Nasalcrom. They don’t work as well as nasal steroid sprays, but they are so safe, I often suggest using them in infants (only try under the guidance of your pediatrician).

Prescription Options: If the oral antihistamines and/or Nasal Steroid Sprays do not work

• Singulair (Montelukast): Many kids (and some adults) do not like having something sprayed up their noses. In these cases, I usually prescribe my patient Singulair. It’s approved for children down to 6 months-of-age. Sometimes Zyrtec (or Claritin) + Singulair is the perfect solution. Singulair also prevents wheezing in people with asthma.
• Antihistamine Nasal Sprays: This is basically like spraying Benadryl right into your nose, and they work great for some people, especially people that have adverse effects from other medications.
• Combination Steroid/Antihistamine Nasal Spray (Dymista): Some people (or children) find relief using both a nasal steroid spray AND an antihistamine nasal spray. There is even one spray, Dymista, that combines the two.

Eye Symptoms: Dry, Itchy, Red, Watery Eyes

• Newer Antihistamine Drops: The drops work very and are safe, and all but one, “ketotifen” require a prescription. Ketotifen can be found under the brand name “Zaditor,” “Alaway,” or other names. Make sure you check for the active ingredient. It can burn a little when it goes it, but storing the bottle in the refrigerator can help.
• Oral antihistamines: The the sedating (Benadryl) and non-sedating (like Zyrtec) also help with eye allergy symptoms.
• Older Antihistamine + Anti-Red Eye Combinations: These don’t work as well as the newer antihistamine eye drops (like ketotifen), but are the most common drops that you will find in the store. These will be under the brand names Naphcon-A, Opcon-A, Visine-A. If you use these for more than 2 weeks, your eye will start to become red between doses.

Summary – For mild symptoms, start with Zyrtec (or similar). For moderate symptoms, start with a nasal steroid spray, like Flonase.

If you cannot get your allergies under control, I recommend contacting your doctor, because he or she can help you find the right mix of prescription and non-prescription medications to get you and your family outside enjoying the Tallahassee spring and summer.

I think we are all incredibly happy to get 2020 behind us, and I hope that 2021 is a much better year. As far as COVID goes, we finally have vaccines and doctors are better at keeping COVID patients out of the ICU. But still, COVID will give 2021 a challenging start for a few reasons:

Challenges:

1. COVID-19 ER visits and hospitalizations in Tallahassee have surpassed the previous July peak, forcing our hospitals to open new COVID-19 wards.
2. A 50% more contagious COVID-19 strain is now circulating in the United States.
3. Vaccine distribution is progressing more slowly than expected.
4. About 25% of adults infected by COVID-19 still have symptoms 6 to 8 weeks later, many for months.

Positives:

1. Two COVID-19 vaccines have been licensed and distributed and many more are on the way.
2. Death and the need for ICU beds from COVID-19 is still an issue, but it is decreased from early 2020.

The End is Near, but We Need to Buckle Down

Then end is near, but I believe things will get worse before getting better. People are getting tired of social distancing, and we are now seeing an increase in COVID-19 cases from families getting together over Thanksgiving, Christmas, and New Year’s. And there is a new, more contagious viral strain circulating. We are also continuing to learn more about COVID-19 “long-haulers” who experience symptoms of Post-COVID-19 Syndrome for weeks (sometimes even months) after their initial infection.

If we can continue to be diligent with social distancing and limit unnecessary exposure to other people and families, many less people will contract COVID-19. As a society, we will be much better off once more of us are vaccinated.

Many of Us Must Continue Living with a Significant Amount of COVID Exposure

Still, most of us must continue living with a significant amount of COVID-19 exposure. I must continue to treat patients. Many people must work in-person. Some kids cannot succeed with distance learning and need to be in school. Some parents must send their kids to school or daycare so that they can work to put food on the table. But, we can all continue to be disciplined, and limit unnecessary exposures.

If vaccines are released to the public by this summer (as expected), we could have a very normal fall! Hang in there another 6 months! This definitely encourages me to be extra careful for the coming months.

Some Practical Social Distancing Reminders:

1. Eating with people: I see this all the time. If you sit down to eat with people, especially inside, then you have just exposed yourself and your family to everyone these people have exposed themselves to. If you really need to eat with someone, try to find a table outside, which is much safer (but not perfectly safe).
2. Exposure time: The amount of time you spend exposed to COVID-19 really matters. Quickly checking-out at a cash register or passing people in an isle is much different than working next to someone for an hour or two.
3. Masks are not perfect: Masks are helpful as they block COVID-19 droplets from directly reaching people, but COVID-19 virus particles also sneak around the sides of the mask (or through the mask material), float in the air, and then get breathed in by nearby people.

And remember, it just takes one exposure! I have heard many stories about families that had been very careful, but then let down their guard just once and got COVID. They may have gone to a wedding (where people were not masked), ate with a friend (who was not as careful as them), or spent extended face-to-face time with someone.

YESSSSSSSSSS! I am so glad this day is here! For me, getting a COVID-19 vaccine is like getting into college or getting a new car, it’s such a gamechanger! I am so thankful for TMH getting me in on day 1 in Tallahassee, Florida. And thank you to private industry for finding a solution to the COVID-19 Pandemic.

If you have any doubts about the safety of COVID-19 please read my previous blog posts. As a general pediatrician, I did a lot of reading, and the more I read, the more I wanted a COVID-19 vaccine. Yes, I may get a little soreness or a fever, but THIS IS PART OF THE VACCINE DESIGN. If the vaccine didn’t elicit any inflammation, then the body would not make antibodies against the COVID-19 spike protein.

Hopefully the general public will be vaccinated soon! I did not expect the vaccine to arrive until 2021!!!!!!!!