Dental Health: Would you kiss a donkey if you had a toothache?

Dental Health Month

By Dena Pepple

Would you kiss a donkey if you had a toothache? Do you go to the barber when you tooth hurts? Do you chew on chili peppers for your tooth pain? Would you have your tooth pulled in the town square by a traveling salesman?

These are just a few of the “old time” treatments for tooth pain, and actually the milder and less grotesque ones that I’ve come across. Now, why am I asking? Well, it’s because February is National Dental Month. Luckily, we’ve come a long way since those old time remedies were used. That said, we have some work to do.

Tooth Decay

Tooth decay is the number one chronic illness among children in the United States of America. It’s the second most common disease in general, coming in right behind the common cold. 10% of two-year-olds already have one or more cavities, and almost 50% of children have tooth decay by the time they go to school.   Children endure pain, miss school days and more in relation to this poor dental health.

Tooth DecayThis early occurrence of disease in our children spills over into the adult population as it’s the number one risk factor for poor oral health into adulthood. Daily, we’re learning new information that links adult tooth decay to many illnesses, such as diabetes, heart health, cancer and more. It’s estimated that 90% of system diseases have oral health connections.

According to the CDC, our nation spends about 124 billion dollars a year on dental care. So, that’s the bad news.

The Good News

The good news is this disease, tooth decay, is preventable. As parents, there are many things you can do to slow/stop potential tooth decay in your children. Start early with good dental habits.

With the very first tooth, you should start brushing your baby’s teeth with a tiny (rice grain size) bit of fluoride toothpaste on a soft bristle brush at least twice a day. Did you know some of the earlier tooth brushes were made from hog, horse and badger hair?  Flossing can also be an important part of this early routine. The website Healthychildren.org has some great information on the specifics of this and how to progress as your baby grows.

Healthy eating is a big part of dental health.

Decrease the sugar in your kiddos diet. This of course includes cookies/candy/pop, but also, even the sticky nutritious fruit like raisins or prunes. Did you know the cotton candy machine was invented by a dentist? Talk about sticky food! If they do have these sweets, have them brush afterwards. We often suggest honey for cough treatment in our kids over one year old, and brushing is necessary after this as well. A baby bottle should only have milk/formula (or rarely per doctor water or juice) but NEVER pop, Kool-Aid, or other sweetened drinks, and NEVER before going to bed.

Fluoride is a huge part of tooth health.

Fluoride is added to the water supply of many cities in the United States. Check with your city, and if it doesn’t add fluoride, talk with your doctor/dentist for other sources.  I repeat: this is HUGE!

It’s very important that your child have a “Dental Home.” 

Healthy Habits for Dental CareJust as we are your medical home, (for general health, growth and development, illnesses, etc.) your child needs a dental home where it’s recommended that your baby see a dentist within 6 months of her first tooth, or around 1 year of age. The American Academy of Pediatrics recommends this early start so the dentist can then follow the baby and help guide further specifics of dental health.

We are here to help as well. Checking oral health is part of our well child care procedure.  We share our office monthly with Hope Dental, who serves our under-insured patients with accessible dental care. We follow the American Academy of Pediatrics guidelines for dental care, and keep up-to date information on local pediatric dentists. And we have display information at all of our offices about dental health this month!

I’ve seen first-hand that this process works.

I have two grandsons (age 2 and 4) who started very early with a dental care routine. They know where their toothbrushes are at my house and remind me when it’s time to use them. (Of course it could be the “Spiderman” electric toothbrush that reminds them!) They know what floss is for, and already see a dentist regularly.  And they’ve already beaten the stats… no cavities!

Working together, parents, kiddos, and dentists can definitely impact future health by helping us take care of our teeth. Let’s do it!

Juuling and Vaping: The nitty-gritty on E-cigarettes.

Sarah Dedrick, C-P.N.P.By Sarah Dedrick, PNP

It’s hard as a parent of an adolescent to know what the latest trend is and what all the kids are doing.

Being the mother of four children, two of those being teenagers, along with being a Pediatric Nurse Practitioner, I try to stay in tune with what is the newest and “coolest”’ thing to do as a teenager. The most recent hype the past few years has been with E-cigarettes.

E-cigarettes: Vape and Juul

There are many different types of E-cigarettes. I will be giving you some quick facts about the two most popular among teenagers: the ‘’Vape’’ (medium to large tank device) and the Juul.

Vape

The ‘’Vape’’, as my teenagers and others call it, can be either a medium or large tank metal device. It’s used by having a separate bottle of liquid that you pour into the holding tank on the device. The liquid is heated up as you smoke. This is where the ‘’vape’’ gets tricky. The liquid that is being put into the device may or may not contain nicotine. There are liquids that vary in nicotine concentrations from 0 mg/ml to as high as 36 mg/ml. A normal cigarette contains an average of 12mg per cigarette.

The only way you will know, as a parent, is by seeing the bottle containing the liquid and knowing this is for sure the liquid that was used. A big trend with these type of devices is doing ‘’tricks’’ with the smoke that is produced. They may not be smoking for the nicotine but using the device to make ‘’donuts’’, ‘’jellyfish’’, ‘’tornados’’, or a ‘’waterfall’’ to name a few with the smoke that’s exhaled. Even though they’re not inhaling nicotine, they’re still inhaling toxic chemicals and metals produced with the device when it heats up and the smoke is inhaled.

Juul

E-cigarettesThe Juul is the newest and, likely, most popular among the teenagers. It’s also one that most parents are not aware of. Many have no knowledge regarding this device.

The Juul is another form of an E-cigarette. It looks like a flash drive and is even charged using a USB port. It’s very discrete and does not resemble a typical cigarette or other larger vaping device (like the one mentioned above). It has very few parts and is uncomplicated (again unlike the one mentioned above). Due to this, it can be very easily hidden. It can be hidden in a hand while the adolescent is smoking it. Which makes it easy to smoke at school, in the classroom or bathroom, and at home. It operates by heating up a ‘’pod’’ that is filled with the nicotine containing liquid. You buy the pods and change them out when the liquid is done.

Besides charging it, this is as easy as it gets. The one small ‘’pod’’ contains as much nicotine as a pack of cigarettes, making it highly concentrated and addicting.

For all E-cigarettes, the fear in the medical community is increasing regarding the potential harm to the teenagers.

E-cigarettes are not only popular because of their discreetness, but also the appealing flavors that are possible: mango, crème, cucumber, mint, fruit, etc. The smoke has a sweet scent and doesn’t make the adolescent smell. Their clothes, car, room, breath, etc, don’t smell like a traditional cigarette.

The nicotine in these devices is a highly addictive drug.

E-cigaretteWhen the concentration of nicotine is even higher, teenagers are getting more of a ‘’high’’ from it. They get an energetic boost or a calming experience from smoking/vaping. Even if they’re smoking a vape device that has no nicotine… just developing the habit of smoking can lead to smoking traditional cigarettes or  engaging in other drug use.

Besides developing the habit and/or addiction, there’s worry of the damage to an adolescents developing brain.

The adolescent brain is not developed like the adult brain. When they’re exposed to nicotine, it affects the ‘’reward’’ system in the brain which leads to addiction. The nicotine can also affect the brain circuits that control attention and learning along with mood and impulse control. These, along with the obvious harms of smoking and inhaling foreign substances into your lungs, are becoming a real concern for parents and the medical community.

We recently visited a Cardiologist for my husband. The Cardiologist briefly mentioned nicotine, specifically with the Juul, stating how bad the nicotine is on the heart muscle. In the years to come, it will be interesting to see how many young people end up having heart issues related to nicotine use.

Parenting is hard.

There’s no right way or wrong way to parent. It’s easy to point fingers or say that a child is doing this because of their home life or the type of parents they have. I think I’m a decent parent =) And yet I’ve caught my teenage daughters Juuling.

Educating ourselves and being aware is what we can do as parents. This is not only with smoking/vaping but with all aspects of teenage life: drinking, texting and driving, speeding, drugs, sex, social media, etc. We need to know what the newest trends are so we can know what signs to watch for…  and how to, hopefully, dissuade them from taking chances with their health. They are teenagers, and we should expect mistakes and curiosity. Mistakes are part of their journey and how they learn. Even as adults, we’re still making mistakes and learning from them.

Loving your teenager, accepting their mistakes, educating them and encouraging them are the some of the most valuable aspects of parenting (in my opinion).

Happy New Year from LSPG! [Office Holiday Party Pics!]

Happy New Year! Can you believe it’s 2019?

To finish out 2018, we wanted to share some photos of our office holiday party with you. We played games, exchanged gifts and had a great time celebrating the holidays.

We hope your year is off to a good start! It’s a great time to consider some healthy resolutions!

Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year Happy New Year

Festive, Spooky and More – Darlene Makes it Happen

By Cindy Aldrige, F.N.P., Provider for Lee’s Summit Physicians Group

Ever wonder how the decorations get changed at LSPG?

DarleneThere’s someone that does a lot of work around LSPG, but never gets paid! Darlene Barnard, Dr. Barnard’s wife, was gracious enough to answer a few questions for me. She has been helping our office and the community for many years. She is one of the silent, necessary components that keep LSPG running smoothly. When questioning her about the things she does and enjoys, I learned a great deal!

“I enjoy meeting all of the staff at LSPG. I also like the office building and grounds to be welcoming to the clients & staff of LSPG. Pretty flowers and trees always make me smile, so I like to add some color around the office.

I try to maintain the flower pots at the entry doors festive and inviting. I enjoy the positive comments from kids and adults as they walk in the doors to LSPG.  I offer my input (usually only when asked) about the landscaping of the green areas around the office parking lots!”

Anyone that knows Darlene, knows she likes to garden. She brings her bounty in to share with staff when the season is good.

But holidays would not be the same here without her help!

“I decorate the front desk and waiting areas for Halloween, fall and Christmas. The receptionists and patients enjoy the decor. The decor is inviting and comments on the ghosts, pumpkins, snowmen and Santa are a nice diversion for the clients and families of LSPG. “

DarleneDarlene loves flowers and trees and doesn’t want LSPG to look “institutional” so she loves to add color around the office. She enjoys interacting and watching the children look at the decorations. Often, the decorations open communication with our staff like what they’re going to wear for Halloween, what presents they got for Christmas, and what they like about the holiday season.

And we couldn’t make this an article about her without mentioning her love to walk her two golden retrievers every day. She brought them to meet the staff when they were little and now they’re too big to come inside to say hello. But once in a while, you might see them outside in the car as happy as can be to get some attention!

Photography, loving on her grandkids and being outside (particularly on the BEACH) are some of her other favorite things!

Thank you Darlene for being such a great part of our daily life at LSPG!

Marijuana and CBD – Legal Status, Treatment and Risks

By Dr. Andrew Huss

Marijuana and CBDA drive down I-35 and I-70 just before the midterm elections in November 2018 showed me that change was coming. Billboards for two different CBD oil dispensaries and two separate medical marijuana bills greeted me during my morning commute. With the passage of Amendment 2 legalizing medical marijuana in Missouri and with the Hemp Farming Act of 2018 set to legalize CBD oil nationally, now is a good time to review both the legal status and medical risks and benefits of marijuana, CBD, and similar products.

What’s the difference between marijuana and hemp?

Marijuana and hemp are actually two different varieties of the same plant species called Cannabis sativa. Just like dachshunds and greyhounds are both from the Canis species but were bred for different leg lengths, marijuana and hemp were also bred to emphasize different properties. Marijuana plants are cultivated for their flowers and THC content, while hemp is typically grown for its fibers and oils (and more recently, for its CBD content).

But wait, what are THC and CBD?

  • THC (tetrahydrocannabinol) is the psychoactive compound found in cannabis plants that causes the ‘high’ that users associate with marijuana. For a plant or plant product to be defined as hemp (and not marijuana) the THC concentration has to be less than 0.3%.
  • CBD (cannabidiol) is another chemical found in cannabis plants that has found use as a treatment for certain seizure disorders in children and has been suggested as a treatment for chronic pain and several other chronic conditions.

So what is the legal status of CBD and medical marijuana in Missouri?

  • Medical MarijuanaSimply put, possession and use of marijuana for recreational purposes remains illegal.
  • CBD oil is currently in an a legal no-man’s-land in Missouri.
  • Hemp production is legal in several states, but law enforcement interference in the transport between states and sale was essentially restricted by Congress in 2016 (The pending 2018 farm bill is expected to formally legalize hemp production nationally.)
  • Amendment 2 legalized medical marijuana use in Missouri in several forms (such as capsules, oils, smoking, ointments, patches, or edible products) under supervision of a physician for a “qualifying medical condition.” That definition under the law is very broad.

 A “qualifying medical condition” includes:

  1. Cancer
  2. Epilepsy
  3. Glaucoma
  4. Intractible migraines
  5. A chronic medical condition causing persistent pain or muscle spasms (such as Multiple sclerosis, Parkinson’s)
  6. Debilitating psychiatric disorders including PTSD (needs diagnosis by psychiatrist)
  7. HIV/AIDS
  8. A chronic medical condition that is normally treated with a prescription medication that could lead to physical or psychological dependence, when a physician determines that medical use of marijuana could be effective in treating that condition and would serve as a safer alternative to the prescription medication
  9. Any terminal illness [aka end-stage or incurable disease]
  10. In the professional judgment of a physician, any other chronic, debilitating or other medical condition, including, but not limited to, hepatitis C, amyotrophic lateral sclerosis, inflammatory bowel disease, Crohn’s disease, Huntington’s disease, autism, neuropathies, sickle cell anemia, agitation of Alzheimer’s disease, cachexia, and wasting syndrome.

As you can see, that leaves a lot of leeway for interpretation by a physician. Some might feel comfortable prescribing it for pain or other chronic illnesses, but others might leave that prescribing up to the specialist managing their patient’s condition (such as a neurologist managing epilepsy or Parkinson’s or their cancer doctor managing their cancer pain). Furthermore, with the availability of a few prescription medications that mimic the effects of CBD or THC and allow controlled dosing, some physicians might be more comfortable using a product with standardized and consistent dosing and FDA approval.

So what is the evidence for treatment with CBD and marijuana and what prescription alternatives exist?

Headlines such as “Research Shows CBD Benefits 50+ Conditions” are difficult to ignore. However, a closer look at many of the medical conditions listed show only a few studies performed on rats or mice or cells on petri dishes – not enough evidence to make any conclusions on how CBD treatment will affect humans. Other studies don’t include a placebo group or have a very small amount of people in the study which limit how useful the results are. A few areas that actually have been studied in-depth are seizures, nausea and poor appetite in cancer patients, and chronic pain.

Seizures (specifically the rare conditions Dravet Syndrome and Lennox Gastaut Syndrome) are one area in which CBD has been shown to provide some benefit. In fact, it has shown enough benefit for the FDA to approve cannabidiol for the treatment of this and a prescription form of CBD (Epidolex) has been approved. However, experts still recommend further research to determine the long-term side effects of this treatment and Epidolex/CBD is not recommended as a first-line treatment.

Marijuana and synthetic THC have also been evaluated as a treatment for nausea associated with chemotherapy as well as with poor appetite and weight loss associated with cancer or chronic disease. Two synthetic forms of THC (nabilone and dronabinol) have FDA approval for use in certain patient populations. Although these medications have been shown to have benefit similar to other anti-nausea medications, there is an increased risk of adverse events when compared to traditional anti-nausea medications. While dronabinol has been shown to help with weight loss associated with AIDS, studies show that both synthetic THC medications are less effective than another appetite stimulant (Megace) or placebo in cancer patients.

Some weak evidence exists that smoked or ingested cannabis can help with chronic neuropathic pain, although studies have yet to show evidence that this helps with other types of chronic pain. The use of cannabinoids wasn’t shown to provide a significant benefit over placebo in treating disease progression in multiple sclerosis but did show a small benefit in muscle stiffness and very small benefits in treating spasticity and pain.

What risks are associated with marijuana or CBD treatment?

RiskAlthough there is evidence of benefit from marijuana or CBD in some conditions, any benefits need to be weighed against the risks of treatment.

  • Short-term side effects of smoked marijuana include dizziness, dry mouth, paranoia, hallucination, and sleepiness.
  • Long-term marijuana smoking is associated with cough, wheezing, and increased mucus production.
  • The most common side effect of CBD is drowsiness, with fever, decreased appetite, diarrhea, vomiting, and elevation of the liver markers AST and ALT also reported.
  • A potentially dangerous side-effect of CBD is how it interferes with the body’s enzymes that process certain medications, especially anti-seizure medications.
    • For example, some children on anti-seizure medications given CBD in a research trial were found to have higher levels of the seizure medicine in their blood (despite no change in their dose of medicine) and more side effects from their medicine.

It is important to let your doctor know if you are taking CBD as it could require adjustment of medication doses or closer monitoring.

What do we know about cannabis use in kids?

The effects of marijuana on children’s developing brains are also very important to consider when discussing treatment with marijuana or CBD products.

  • Regular cannabis use during the teenage years is associated with a lower IQ in adulthood.
  • Some studies show a link between increased risk of psychosis or depression in teenage marijuana users.
  • MRI scans of the brains of people who used marijuana regularly in the teen years show decreased brain volume in the parts of the brain responsible for memory, motivation, and emotional processing.

These findings show that the long-term risks of marijuana use in children need to be weighed against the possible benefits of that treatment (and also compared to risks and benefits of different treatments as well).

What does the passage of Missouri Amendment 2 mean for me?

Legalized medical marijuana is coming to Missouri, although the rollout will take several months to set up state-approved distributors and to finalize rules and regulations. This new law gives physicians much leeway in terms of which conditions they can recommend the use of medical marijuana for, but science is lagging behind the law.

There’s little to no quality scientific evidence of benefit for many of the conditions medical marijuana can be prescribed for. Similarly, there is little to no quality scientific evidence that CBD benefits many of the diseases that it is claimed to treat. Even in diseases in which CBD and marijuana have been more closely studied, often the studies don’t show much benefit compared to existing treatments, and medical marijuana and CBD are not recommended as first-line treatments.

It will be interesting to see what knowledge is gained in the coming years, but in the meantime, we must carefully consider the risks and benefits of CBD and marijuana and remain skeptical of many of the claimed benefits for certain diseases until more research is performed.

Additional Resources

Three LSPG Providers that Sing in their Church Choir

By Matthew Hornung, Director of Information Technology for Lee’s Summit Physicians Group

SingingLee’s Summit Physicians Group has three doctors whose backgrounds include singing in their church choir. They’ve been singing for many years, almost as long as they’ve practiced medicine! We recently interviewed them about their choir history.

  • When did you start singing?
  • What part do you sing in your choir?
  • Where do you sing?

Dr. Trites

Barbara S. Trites, M.D.I’ve been singing as long as I can remember… and I’m not telling how many years that is! I sing alto (and occasionally help with the tenor part) at Lutheran Church of the Resurrection. Our choir is typically just 10-12 people. We’re a small group, but have a great time.

I have also sung with my high school alma mater (Shawnee Mission South) on those occasions when someone organizes a reunion choir. The most exciting time was when we were able to perform at Carnegie Hall with our former director conducting us. That was in November of 2001, so it was the aftermath of the attacks on 9/11. It was a sobering, but also uplifting and unforgettable experience. It has been my great joy to watch all three of my children sing in choir for decades now. All three have had the opportunity to sing at Carnegie Hall; two have sung at the Vatican; one sang at the White House and met Michelle and Barak. We love the Ella Fitzgerald quote, “The only thing better than singing is more singing.”

Dr. Veenstra

Sallie L. Veenstra, M.D.I started singing in church choirs as a child and was fortunate enough to sing in High School Choir. I sing soprano.

Our high school was outside of Washington, D.C. and our choir got to sing at the National Cathedral in a Bach Festival. There’s nothing like classical music sung in a resounding space like a cathedral. After my schooling was finished, I sang in the Johnson County Community Chorus, and then in my church choir. We’ve had the opportunity to travel to Europe and sing in some incredible cathedrals there. Our church was just redesigned to improve the acoustics and we have a new magnificent pipe organ to sing with. I am fortunate to sing with the choir every Sunday and in concerts several times a year.

Dr. Lewandowski

Molly Lewandowski, M.D.I started singing in my church choir in 2009 when I became an empty nester. I sing soprano in my church choir in Leawood, Kansas, and each summer in the Lee’s Summit Summer Singers group directed by Dr William Baker.

November is Diabetes Awareness Month

By Rhonda Pfaffly, Referral Coordinator for Lee’s Summit Physicians Group

LSPG: November is Diabetes Awareness MonthNational Diabetes Month, a time when communities across the country team up to bring attention to diabetes and its impact on millions of Americans. An estimated 30.3 million people have diabetes, that’s 9.4% of the population! It was the 7th leading cause of death in the United States in 2015.

Today I’d like to give you some tips on how to manage living with this disease and also to bring a little bit of awareness. November is a perfect month to spotlight Diabetes, not only because it is Diabetes Awareness month, but we’ve also just ate our kids stash of Halloween candy! This will be followed by  Thanksgiving, which always includes Grandma’s pumpkin pie and Aunt Lois’s sweet potato casserole. Then we turn around and we have all the holiday parties, cookie exchanges at work or church(darn those cookies), Christmas dinner, oh my goodness, food overload! So as you can imagine these next few months are torture for people with diabetes with all these temptations.

Staying on Track During the Holidays

A registered dietician with Abbott states that a few simple planning strategies and nutrition swaps can help you enjoy the festivities and stay on track.

  • Plan Ahead – look at restaurants online menu’s ahead of time or ask the host what they are planning on serving and suggest bringing a side dish that is a healthy addition. Stay away from dips or sauces can have hidden sugars/calories.
  • Don’t skip meals – skipping meals can impact your blood glucose levels. Again, pre-planning is the key.
  • Stay hydrated – Drinking water no matter if you have diabetes or not is one of the most important overall. It flushes out toxins, helps you stay hydrated and researchers have found that drinking water helps with eating fewer calories by making you feel fuller, as well as less sugar intake and cholesterol.
  • Pay attention to portions – *One cup=a fist,*3 oz. = palm of your hand,*1 tablespoon= your thumb
  • Move – after that turkey dinner take the kids for a walk, not only will that burn some calories but it will wear out those little ones so you can enjoy the game!
  • Get back on track – if you had a little food slip up, it’s ok!  Don’t feel guilty just remember to be aware at your next meal.

Since you literally have the world at your finger tips these days with Google, all kinds of helpful websites and apps on your smart phone that  makes it easier for diabetics to help manage their disease. Listed below are a few websites and smartphone apps that are endorsed by our very own Cindy Aldrige, APRN, who offers special one on one Diabetic education in our office.

Helpful Websites:

Helpful Smartphone apps:

  • Diabetes Goal Tracker (free download)
  • My Fitness Pal (free download)
  • On Track Diabetes
  • Glucose Buddy

Diabetics should be proactive in making sure they’re getting the proper care. This includes regular office visits to your provider every three months or as your physician advises. Each year, a physical should be done with foot exam, diabetic eye exam, immunization review, and annual lab work. These recommendations are based on the American Diabetes Association guidelines.

Lee’s Summit Physicians Group prides ourselves in taking the extra measures that insure you’ll be given the best care when it comes to any of your healthcare needs.  If you would like to discuss diabetes, or have a family history and would like to be tested, please call our office at 816.554.1918 to make your appointment today!

Pediatric Walk-In Flu Shots Now Available

By Jennifer M. Sauer, M.D.

Walk-In Flu ShotsWe strongly believe in the importance of giving the flu vaccine to our patients. Therefore, we allow our patients to walk in for flu vaccines while we’re open with the hours listed on our website. Staffing has even been increased while kids are out of school to make it quick and convenient for our patients and families to get their flu shot at all three of offices.

Influenza Cases Reported in Missouri

Influenza is already in the area with the CDC report showing 147 lab confirmed cases in Missouri during the week of October 7th – October 13th. There’s also been the death of a child because of influenza this year in Florida. (Per the Florida Health Department where the CDC reports sporadic activity of influenza currently.)

Per the American Academy of Pediatrics in September 2018, excluding the 2009 pandemic, the 179 pediatric deaths reported through August 18th, 2018, during the 2017–2018 season (approximately half of which occurred in otherwise healthy children) are the highest reported since influenza-associated pediatric mortality became a nationally notifiable condition in 2004.

As of October 6, 2018, a total of 183 pediatric deaths had been reported to CDC during the 2017-2018 season. This number exceeds the previously highest number of flu-associated deaths in children reported during a regular flu season (171 during the 2012-2013 season). Approximately 80% of these deaths occurred in children who had not received a flu vaccination this season.

Source: CDC.gov

Some sources estimate the total death toll from influenza nationwide last year to be 80,000 people. But only flu deaths in children are directly reported to the CDC.

American Academy of Pediatrics (AAP) Recommendations

The American Academy of Pediatrics (AAP) recommends annual influenza vaccination for everyone 6 months and older, including children and adolescents, during the 2018–2019 influenza season.

Special effort should be made to vaccinate individuals in the following groups:

  • all children, including infants born preterm, 6 months and older (based on chronologic age) with chronic medical conditions that increase the risk of complications from influenza, such as pulmonary diseases (eg, asthma), metabolic diseases (eg, diabetes mellitus), hemoglobinopathies (eg, sickle cell disease), hemodynamically significant cardiac disease, immunosuppression, renal and hepatic disorders, or neurologic and neurodevelopmental disorders;
  • all household contacts and out-of-home care providers of children with high-risk conditions or younger than 5 years, especially infants younger than 6 months;
  • children and adolescents (6 months–18 years of age) receiving an aspirin- or salicylate-containing medication, which places them at risk for Reye syndrome after influenza virus infection;
  • children who are American Indians and/or Alaskan natives;
  • all health care personnel (HCP);
  • all child care providers and staff; and
  • all women who are pregnant, are considering pregnancy, are in the postpartum period, or are breastfeeding during the influenza season.

Also per the AAP, those patients with history of egg allergy can safely receive an influenza vaccine as long as there are no other contraindications to the vaccine.

Be sure to visit our contact page for office hours so you can plan a good time to get your flu vaccine.

Do I really have to get a mammogram?

MammogramBy Molly Lewindowski M.D.

Screening mammograms are the most important tool to diagnose early breast cancer. About 1 in 8 women will be diagnosed with breast cancer. While there’s no one answer why the rate has increased in the past 25 years, there are known risk factors. Some risk factors we don’t have any control over- getting older, family history, prior history of breast cancer. Another common issue is high breast density, which can complicate the reading of the mammogram. But others risks we can change: smoking, drinking alcohol, avoiding weight gain, lack of exercise, use of hormone replacement therapy.

There are several types of mammograms.  The screening starts for most women at age 40.

  • The digital  mammogram is the standard screening test. If you are told you have dense breasts, this is normal. About 50% of women have a larger proportion of fibrous and glandular tissue than fat. The only reason this is important to know is that it does make the images harder to interpret, and you may be called back for more testing.
    *Getting called back after the mammogram does not mean you have breast cancer.
  • The 3D mammogram is another type of x-ray that will allow the radiologist to look at the tissue in greater detail. Many times this type of mammogram gives the best detail in dense breast tissue. However, insurance frequently will not cover it 100%. Check with your insurance, as each one is different.
  • Breast ultrasound is usually ordered when trying to determine if an area is a cyst or a solid mass. It may be used during pregnancy as there is no x-ray exposure.
  • Breast MRI can provide other information when diagnosing and treating breast cancer.  This type is usually ordered in women who are at high risk for breast cancer, when there is a close family member diagnosed before age 50.

Two local sites for mammograms are the Breast Center at St Luke’s and The Diagnostic Imaging Center. You do not need an order, but we do ask that they send the report to us for your health record.

Even though mammograms and breast imaging have greatly advanced in recent years, it’s important to notify your primary care office of any breast lumps or skin changes. Checking your own breasts monthly is a healthy habit, and may save your life. We can provide instructions during your annual physical visit.

Best of luck to Nurse Angie and Nurse Tina!

By Jody C. Brown, Director for Lee’s Summit Physicians Group

When we hire new providers, we may take out an advertisement in the local paper. We may also have a poster sized picture put in our waiting room announcing their arrival. But when one of our own chooses to take a leap of faith and step out into the unknown to pursue a dream or an adventure, we just quietly send them on their way. Not today.

Today we are forced to say goodbye to two of our nearest and dearest nurses, and given all their years of service and sacrifice, we can’t let them go quietly! If your child has been a patient of ours any amount of time at all, you will likely know both of these ladies. Nurse Tina has been with LSPG for 15 years, and Nurse Angie has been with us for 11 years. While both are leaving us to pursue new adventures, some known, some unknown, I know that I speak for this entire staff when I say that these two ladies will be dearly missed.

LSPG: Nurse Angie

Nurse Angie

Nurse Angie

I will forever think of Nurse Angie when I hear someone doing an eye chart test on one of our patients. No higher praise has ever been given than when a patient performed well while standing on those stickered feet in the middle of the hallway, closing one eye with their hand and trying their hardest figure out what shape or letter was being pointed at!

Nurse Tina

Nurse Tina is our go to gal and she has the ability to calm the most frazzled of nerves with her soft voice and even keel. During her last couple of years with us, Nurse Tina has had the task of keeping the nurse’s station flowing, taking care of the many calls that come in on our non-urgent message line and not stopping until she has taken care of the needs of the person or person she is trying to help. Dedication is a word that will always be synonymous with her.

LSPG: Nurse Tina

Nurse Tina

If there is one thing you can count on if you have the pleasure of having either of these two ladies as one of your nurses during one of your visits to our office, is that you will be greeted with a smile and a very warm welcome. These nurses have a way of making you feel like you are the most important patient of the day. They are always a ray of sunshine in the nurse’s station, even on the most hectic of days. They strive to do their best to anticipate the needs of the doctor they are working for, which in turn makes the job of that doctor so much easier, and the experience of the patient and their parent the best that it can be.

We could go on and on about what we will miss, but by far it will be the smile that we are greeted with every single day. Tina and Angie, we wish you the best of luck in your new endeavors and we are so thankful for the years that you have invested in the lives of our patients and their parents. You are now and forever will be a part of our LSPG family!