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How do we plan our life for the next few months?

Our family is having the same conversation that many of you are having right now. How do we decide who we can see, when we can travel, what should we do about school, what about grandparents….? 

Before diving into this overwhelming series of questions, I would invite you to find a moment to read this when the kids are finally asleep and you have a moment to quiet your strategic mind just a bit. While I will try to tackle some of the specific questions in what follows, at the end of the day, you will have to check in with something less strategic and more intuitive. Something less based on what your brain is telling you that you should do or have to do and more based on what your heart or your gut is telling you is the right thing to do. Something less related to short sighted wants and more related to a patient, longer term view of what is best for you and your family as well as your community. I sometimes find that when I really do let go of my to do list and all the plans I have, and actually listen to my heart’s intuition, it tells me something I didn’t want to hear but eventually am glad that I did. 

OK, I just felt the need to take a deep breath.

Some questions to start with.

In some ways, everything is falling apart for everyone right now. There is a global pandemic, economic uncertainty, civil and political unrest and societal reckoning with centuries of systemic racism. All this on top of the turmoil already present in the world before 2020 arrived. 

The first question must be, “How much is my own life in a state of crisis right now?”. 

If the answer is that you and your family are in a major personal crisis right now, your first priority must be basic survival. That crisis may be physical or mental health related, job loss, housing or food insecurity or any number of other obstacles. If you find yourself in this situation: 

  1. You may have no choice but to seek out childcare. If you can secure a daycare situation that you are comfortable with, that may be the best option. The state of Colorado has set guidelines for daycare providers that you can read through and ask your daycare about.

  2. If daycare is not an option, and a grandparent or other relative is able to provide childcare, this may be necessary. If you are considering the risk for a possible caretaker, the state issued a helpful decision tree to consider when weighing that choice. If that caretaker is high risk, you and that grandparent will have to sit with that and ultimately follow your hearts to make that decision

  3. School: Many school districts are moving toward an option for full-time in-person schooling. This may be the only viable option for you and your family. This may also be the best option for your child depending on their optimal learning style. The American Academy of Pediatrics supports the return to in-person learning with steps taken to decrease the spread of COVID-19 in the school setting and the need for school districts to adapt to changing local conditions.

  4. Know that you can always reach out to your provider at HIP and consider making a telemedicine or in person appointment. We may be able to offer some helpful suggestions or just provide a caring ear to walk with you as you make those decisions.

 

If the answer to, “How much is my own life in a state of crisis right now?”, is not really much of a crisis at all, you may have the ability to make some different decisions. 

 

  1. Consider the risk of your plans. Colorado has issued some guidelines to help evaluate common activities and travel plans.

  2. Be a part of the 65%: The Colorado Department of Public Health has put out projections based on the efficiency of our collective social distancing efforts. If we, as a community can reach the 60-65% efficiency, many lives could be saved by decreasing overall infection numbers and maintaining hospital and ICU capacity for new patients. Do you have the capacity to increase your social distancing efficiency as a family? How do you see your role in the community during this pandemic?

  3. Hanging out with friends: Having a small cohort of friends or a “quaranTEAM” can really decrease the spread of COVID-19 and can make tracing easier if someone tests positive. Having a group of a few friends whose families are on the same page and are otherwise practicing good social distancing is ideal. Having that team hang out outside and wear masks when possible (not for kids under 2) is helpful. Creating a rule where they don’t share food or drinks (preferably they don’t hang out with food or drinks, especially for younger kids).

  4. Summer camp: If you have the option for the camp to come to you, which some of them have offered that lowers the risk. Some camps are sending a counselor to a house with a group of a few kids. If you are considering a camp that hasn’t made major modifications to decrease the risk of spread, the better option may be to skip that camp this year. 

  5. Travel: The best option this summer is traveling by car somewhere that you can practice good social distancing (camping or renting a house where you can do the cooking). Airline travel with your family should really be carefully weighed, taking into consideration any higher risk immediate family members or those that you might be visiting. Here again, your heart will have to guide you in the end.

  6. Helping your kids find the beauty in the pause: This may be the summer and fall that you have almost nothing scheduled for your kids. How can you transform that sense of loss for all the things you had planned into an opportunity to find the beauty and wonder in the mundane of your home, your yard, your neighborhood park? Can this be an opportunity to awaken the imagination in yourself and your children?

  7. School: Many school districts are moving toward an option for full-time in-person schooling or learning from home. The right choice for your family really depends on your child’s learning style. If you feel your student thrived with an in-home learning setup and that is their preferred option, that may be the best option for them this fall. If you are in a position to support that learning environment at home, that may be a reasonable option for your student and help the community by decreasing the numbers of students at school. If your student and family are at low health risk and would benefit from in-person instruction, that is a reasonable choice. Again, the AAP guidelines provide some framework for this.

  8. Daycare: Is this confluence of moments an opportunity to reimagine how you have structured your family schedule? Is there a way to decrease your reliance on traditional daycare settings for your young child? With regulations around temperature checks and keeping sick children home, many families will be forced into a more flexible plan with their work. Would it be better for your family to proactively pull back from daycare for the near future? The answer for your family may be no, but it is worth asking the question with this new lens that the pandemic has created.

What about grandparents meeting their newborn grandchild. I’ll leave this one to this opinion piece written by a pediatrician. I think he gives sound advice on this question

These decisions are nuanced and individual. While it is important to gather data and opinions from people you trust, ultimately you will be forced to weigh options whose pros and cons are difficult to quantify. That is when your heart and intuition will have to come in as a parent and community member. The answer may be buried a bit beneath the layers of stress, but it is there, and I believe you will know it when you find it. 

Know that your HIP family is here to support you.

With gratitude for all you’re doing to support your kids and your community,

Bryan

May 30, 2017
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SEPTEMBER 2017 Newsletter

Falling into Fall

As we head into the fall and winter months, it is important to remember that washing your hands is one of the best ways to prevent getting sick. Normal soap and water are the best to use at home. Antibacterial soaps do not provide any additional benefit and have some downsides.

With that said, it's hard to keep your kiddo's hands clean at all times, and it's even harder telling your 6 month old to cover his or her mouth when coughing.  

Probiotics are always a great thing to use on a daily basis, regardless of the season.  If you ever have any questions about probiotics, feel free to call our triage line for more information.

For kids 12 months to 2 years of age, they can receive 1 tablet of 500mg of vitamin C for 5 days starting at the first sign of an illness.  For kids 2 years and up, you can do 1000mg of vitamin C for 5 days.  

Another supplement to help boost immune systems if Vitamin D.  Breastfeeding mothers can take around 6400 units per day to help pass along appropriate supplementation to their children.  Otherwise, you can give 800 units of vitamin D daily, for kids over a year,  to help boost up immunity heading into the winter. 

Elderberry is another immune booster that is appropriate for kids 1 year and up.   This is different from the Eldertussin/Elderberry cough remedy that we recommend, as it is just Elderberry extract for kids to use as daily immune support. Nature's Way makes a Kids Sambucus syrup or for kids 2 and up you can give one tablet per day of the Natures Way Elderberry extract.

Flu is another complication heading into the winter. Flu shots are available for kids 6 month and up.  If this is your child's first eligible flu season, he or she may need a booster flu shot one month after the first dose was given.  

Our flu vaccine clinics have begun, and we will run those clinics through Thanksgiving.  Flu clinics are Tuesdays and Thursdays as well as every other Saturday.  Please call our office to schedule a time to have your child get a flu shot!

Flu shots for parents are not available this early on in the season.  We will keep you posted on when and if we will have flu shots available for parents.  

Click here for more information on this year's Flu Shot recommendations,

Welcome Dr. Natalie Penn


Please join us in welcoming our new provider, Dr. Natalie Penn! We are very excited to have her join the HIP family. She has a strong interest in integrative medicine and will be taking newborn patients starting next week. Check back to see her bio on our website soon. 

We will be making some changes to our hours heading into the Fall and Winter months.  We will have some extended hours until 6pm with at least one doctor on each day of the week.  Furthermore, triage will be able to take calls until 5:30pm each day of the week.  

We are excited about these changes.  As with anything that is new, we hope this transition goes as smoothly as possible.  

Parking Help
As our practice begins to grow, we realize that at times we can run out of parking spaces.  To ensure that kids can be unloaded safely, we ask that only one car per family is parked in our lot.  Thank you for your understanding and patience!
MONTHLY DONATIONS 
In July, we donated to There With Care.  Whose mission is to provide a wide range of thoughtful and fundamental services to children and families during the critical phase of a medical crisis. We serve families referred by medical agencies, by building a network of services and people who ease the burden of life’s day-to-day obligations with compassion and care.


August's donation went to the MS Society.  They work to improve the quality of life for people affected by MS in and raise funds for critical MS research. Join the movement toward a world free of MS.
 
Coming Soon...Scheduling with MyChart
If you are not already signed up with MyChart, we will be adding another useful feature that may make it worthwhile. In the coming months we will be adding some scheduling options for Well Care visits through MyChart along with scheduling reminders when our schedules open up 3 months in advance.  

MyChart is the secure online patient portal that we use. By signing up you will have access to lab results and visit summaries. It also gives you the ability to upload forms for us to fill out and send email questions and pictures. 

For more information on activating MyChart, call our office and press option 1 to speak with our front desk team!

 

 

 

WEBSITE UPDATES

Our website now features a "Page your Doctor" button.  This button will allow you to page our on call doctor after hours when you and your family are in need of urgent advice.  The button appears at all times, but is only functional after hours.  

We hope that this medium will be a helpful tool for getting urgent advice from a nurse or provider after hours.  

As always, we are here to help with whatever we can whenever we can.  Please use this button for urgent questions regarding your child or children. 
 

SUNSCREEN RECOMMENDATIONS


As we enter into the summer months, sun protection is always recommended for you and your children.  When it comes to sunscreen, we recommend using mineral based sunscreens whose only active ingredients are zinc and titanium.  Brands we recommend include, but are not limited to:  Babyganics, Badger Balm, Alba California, and The Honest Company.  

One thing to keep in mind with mineral based sunscreen is that they are not as waterproof, and tend to wear off when in water or when a kid is active during the day.  Reapplication is recommended. For a great review on sunscreen ingredients check out this article from The Environmental Working Group

If you tend to prefer sunscreens that have better protection from sweat and water, make sure those sunscreens do not contain OxyBenzone as one of their listed ingredients.  

Furthermore, keeping kids protected from the sun goes beyond sunscreen.  Covered heads and light breathable clothing that provides good coverage to arms and legs is always recommended, especially for our young children.  

As always, please feel free to give us a call if you have any questions about sun protection.  

 

ACUPUNCTURE FOR KIDS with Brittany Lark, L.Ac., Dipl.Ac
Fridays                                  

Acupuncture is great for allergies, anxiety, asthma, ADHD, cough, tummy aches, constipation, diarrhea, ear infections, eczema, headaches, and body aches.
Treatments are tailored for each child’s needs. Many children start with non-needle techniques that involve gentle massage or tapping on the surface of the skin. Shonishin, a non-needle Japanese technique, is frequently used for children under 7 years old.
Call (303) 883-0878 or email Brittany to schedule an appointment.


 

FORMS 


As a reminder we do ask you give us at least 48 hours to complete any forms for school, daycare, camp or any other institution that may require you to submit General Health Appraisal Forms or Immunization Records.

We try and complete these forms in a timely manner, and appreciate your help.

We can submit these forms via fax, via MyChart, or having you pick them up at our front desk upon completion.

 

January 29, 2017
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Happy New Year and Thank You!


As we begin 2017, we want to express our gratitude to you, the families and community, for your continued support of HIP during the many changes we came across in 2016.  

As we grow and change, your patience and understanding has helped make the many transitions smoother for us at HIP.  We know that as we continue to expand, we have to make adjustments in order to provide the care you and your families are used to receiving from HIP.  It is a learning process for all of us, and we cannot express enough how thankful we are for your patience in dealing with these changes. 

Stacey, our wonderful PA-C, is so thankful to our families for their patience and consideration while she was out with injuries sustained from a bicycle accident.  She is back in our office, full time, and is more ready than ever to provide the care our families are used to receiving from her at HIP. 

We hope 2017 is a happy and healthy year for all of you, and we are eager to still be a valuable resource for you and your family.   

Happy 2017!

With gratitude, 
The HIP Team

FLU SEASON IS HERE


As we find ourselves in the middle of flu season, we wanted to provide you with a couple of reminders
  • If your child is in the midst of their first flu season, it is recommended that your child receives two flu shots to provide full coverage. The second dose is due 1 month after the first. It is OK if the interval is longer than one month but they will not have optimal protection until they receive both doses. 
Please feel free to review the CDC's recommendations for children and flu shots

Call the office to check availability and schedule an appointment

Staying Healthy During Flu Season

The best way to prevent the flu is for you and your family to receive the flu shot.  
Other ways to help prevent the spread of flu:
  • Washing your hands frequently throughout the day
  • Avoiding other people when feeling under the weather, or avoiding others when you are feeling under the weather. 
  • Avoid touching eyes, mouth or nose

IMMUNE SUPPORT
 
Prevention is the key to keeping your children healthy this cold and flu season. These are our recommendations: 
  • Well balanced diet with lots of fruits and veggies + water + good sleep
  • Vitamin D - 400 IU per day if under 12 months old; 800 IU per day over 12 months old
  • Probiotics 
    • Newborn to 2 months: Gerber Soothe, 5 drops per day
    • 2 - 6 months: Infant Jarrodophilus drops, 6 drops per day 
    • 6 months +: Baby Jarrodophilus (powder) or Garden of Life RAW probiotics for kids
  • Herbs for Kids Eldertussin (12 months +) - for immune support and cough. You can order it on Amazon or Scales Pharmacy on 1999 Pennsylvania in Denver has agreed to keep it in stock for our patients. Dose: 2-3 times per day during illness (up to 5 days)

 
Staying small

In order to maintain the quality of care that we deliver and our availability to our current patients, we will be limiting the number of new families that join HIP. More info on accepted insurance plans on our website.

We are so grateful for your referrals of friends and family to HIP and hope to fully open to more new families again soon. 

If you, or a friend, are expecting in the coming months and are already on our "expecting parents" list, we look forward to being your pediatric office when they arrive.

If you already have a child in our practice and are expecting another, we will, of course, happily welcome your your newborn to HIP. More info

AFTER HOURS

We pride ourselves on being available to you and your families as much as we can, even when our office is closed.  We appreciate you respecting the providers' time after hours. We will be adding an additional resource beginning February 1st with an answering service and optional nurse triage advice from Children's Hospital Colorado

After Hours phone calls should be made for urgent issues.  Our website has many useful tools to help determine the need for making these calls.  There is a symptom checker link, as well as a dosing chart readily available on our website.  

We cannot schedule appointments after hours, and prefer to only refill medications that are urgently needed (i.e. inhalers).  

Thank you again for your consideration of our providers' time when our office is closed!
Rx Life

Check out this great blog by integrative pediatrician, Dr. Larry Rosen

 

 

October 17, 2016
Category: Uncategorized
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Flu Shots

  • We have flu shots available for our patients, and are currently running Flu Clinics on Monday and Wednesday evenings from 5-6pm.  We also have Flu Clinics every other Saturday from 8-10 am.  If you'd like to schedule a time for your child to come in, please call our front desk for assistance.
  • We also have limited flu shot available for parents!  Flu shots for parents are $35.00 each.  If you'd like to schedule a flu shot for yourself, you can do so by calling our front desk for assistance.

 

Hyland's Baby Teething Tablets

  • Recently, the FDA released a statement that they are taking Hyland's Baby Teething Tablets off the market.  At this time, HIP does not recommend parents using these tablets for their children.  If you have any questions or concerns, please feel free to call us at any time.  

It is with mixed emotions that we have a few departures to announce. In each case we are sad to lose a valued H.I.P team member but excited for what the next chapter is bringing for them.
 
Lyndsey Buderus (Front Office Manager): Lyndsey is a beloved founding member of H.I.P and the smiling and warm soul that many of you have encountered as you enter our office. She is fulfilling a dream of hers and will be starting physical therapy school in September in California. We could not be more proud of her! Her last day will be Wednesday August 24th....stop by to wish her well if you can.  We take comfort in knowing that Denver will be getting an incredible physical therapist in a few years!!  We are thrilled to have Lyndsey's sidekick Anna Gadzina taking over as our front office manager.

Dr. Sarah Pilarowski: Dr. Sarah has been an integral part of HIP for the past 2 1/2 years. She has an opportunity to relocate closer to home at Sapphire Pediatrics. We are grateful for all her contributions to HIP and for the great care that she has provided for her patients. We wish her and her wonderful family well!! Her last day at HIP will be Thursday October 20th. For patients who have seen Dr. Sarah and would like to transfer to one of our other HIP providers, we will have added availability starting in November to accommodate you. We are in the process of finding an integrative pediatrician to take her place soon. 

Jessica Muniz, RN: Jessica finished up her time at HIP 2 weeks ago to take advantage of an opportunity to work from home and spend more time with her 2 year old son. She was a great asset to our practice, filling a variety of roles in the office. We wish her great success in her new venture!

We have some wonderful new additions to the practice to help fill the significant void left by these three. Thank you for your patience as we work through this transition.Coming soon.