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Novel Coronavirus Information

 

 

Pediatric Inflammatory Multi-system Syndrome (PIMS): Helpful information from the AAP

May 7:

Testing for those with symptoms: For kids and parents with symptoms of fever, dry cough, body aches, loss of sense of smell. We can start with a telehealth or in person visit and then arrange for a nasal swab test. Currently we are recommending drive up testing with Children's Hospital Colorado which requires a referral from us and has a 24 hour or less turn around time. 

Antibody testing: in most cases this is not for patients with active symptoms. This requires a blood sample and currenly we are referring kids (over 10 only) to National Jewish Hospital. We expect a reliable, rapid test for these antibodies to be available in our office in the coming months, but it is not available at this point.  Antibody testing (IgG and IgM serology) is to determine who has already been exposed to the SARS-2 virus (COVID-19) in the past. 

 

April 21: HIP is gradually expanding our capacity for well visits while maintaining all the precautions we have put in place. We look forward to connecting with many of you soon! Check out the new information below and our latest audio update here


Cultivating Wellness (new page)


Your HIP team is here to support you...

Know that your team at Highlands Integrative Pediatrics is adapting to these unprecedented times and continually reshaping the services we provide with key goals in mind

  • Keeping you and your family safe

  • Providing up-to-date corona virus recommendations, support and evaluations when needed

  • Addressing non-coronavirus illness and mental and bevavioral health concerns

  • Delivering the vital preventative and general health and wellness support that you have come to expect from us

  • Staying connected with you and your family to support wellness in these trying times

Here's how...

  • Only well children and well parent/gaurdians are being seen in our main exam rooms and come through the main entrance of the building

  • We are asking that one parent bring just the child who is due for a visit when possible

  • Well visits are taking place in the morning and early afternoon. In addition to our own ongoing assessment of the situation, we are following the current guidelines from the American Academy of Pediatrics, Children's Hospital Colorado and the State of Colorado

  • Families with illness concerns including fever, congestion, cough, body aches, sore throat etc who need in person visits are being seen in the later afternoon in our tent exam room (in the parking lot) or in our studio which has a separate entrance at the rear of the building.

  • Telemedicine: We now offer virtual visits for Highlands Integrative Pediatrics families! These visits are with one of the providers and are  covered by insurance in the same way that in office visits are. In some cases, copays may be waived by your insurance plan

                                   
    • lactation consultations, virtual sick visits (for some illness presentations), behavioral consults, COVID19 support

    • To schedule call or text (720) 583-4470 or send us a message in MyChart

 

Reliable Online Resources

 

If your child has a cough and fever:

  • Call our triage line or send a message on MyChart to speak with our nurses and physicians on call.
  • As long as there are no breathing problems or symptoms concerning for an ear infection (ear tugging, difficulty sleeping, increased fussiness), we may advise you to stay at home and start with a telemedicine appointment. The recommendations around testing are evolving. If you think your child may need to be tested, give us a call and we can give you the up-to-date recommendations.  If your child or any family member develops cough, congestion with or without fever, we recommend that you self-quarantine for 10 days from the start of your symptoms.
  • If you are unsure whether your child is having breathing concerns or other symptoms that require evaluation, please send a MyChart message or call our triage team.
  • If your child or a family member has a medical condition that may put them at more risk from a respiratory illness (asthma, cystic fibrosis, diabetes, heart conditions, immunocompromised) and your child has a fever and cough, contact our triage line for advise.

Office visits

  • Our staff will be wearing masks, in order to protect you and your family.
  • We are using your car as the waiting room. Call us when you arrive for your appointment
  • We suggest bringing as few family members as possible to the office
  • We are able to do strep swabs, flu tests and some exams from your car, to avoid unnecessary exposure in the office. If your child needs to be seen in the office, we will ta

 

How to keep your family, and our community, healthy:

  • Minimize any close contact with people outside of your household at this time. Social distancing is important to help prevent the rapid spread of COVID. 
  • Stay home when you can, and support those in your community who can’t 
  • This is a great time to get your family outside! Walk, hike, jog, bike ride, play in the park… just try to keep about 6 ft from you and other people if possible :)
  • The obvious things: Wash your hands frequently with soap and water. Avoid crowded spaces as much as possible. Wipe down common surfaces with regular household cleaning products (doorknobs, cell phone, counter tops, the steering wheel, etc).
  • Remember to breathe. Inhale deeply so your belly rises for 4 counts, hold for 7 counts, exhale slowly for 8 counts. Repeat. Teach this to everyone you know. 
  • Put gratitude front and center. Appreciate the small things. Stay in joy. Stay as relaxed as possible. 
  • Take care of your community. Support each other. Get creative in doing so. When able, help elderly neighbors and family members who are most at risk.  Support small business when able.
  • Be kind. To everyone. Especially those who are working in service industries including (but of course not limited to) grocery stores, pharmacies, and mail delivery. Let's support each other through this.  
  • Practice being more in control of your feelings. This website is a fun way for kids (and parents) to explore that concept:  http://imaginaction.stanford.edu


We are here if you need us. Lots of love from your HIP healthcare team.

Instagram: @hipediatrics

Facebook: Highlands Integrative Pediatrics

 

Update 3/22/20: Audio update for HIP families and Poetry Respite (link)
 

Update 3/19/20: Ibuprofen and Elderberry

  • Ibuprofen:
    • Experts were worried that ibuprofen might make COVID-19 illness worse, so they recommended avoiding it until further research was done.
    • There is very little research overall on COVID-19, since it's such a new virus, so this is all very confusing for everyone.
    • The experts did some research. As of 3/18/20, Ibuprofen seems ok with COVID-19, but just to be on the safe side (since everything is so new and evolving), start with Tylenol first to treat fever (unless you have liver disease).
    • If you are on Ibuprofen (or other  NSAIDs, Non-Steroidal Anti Inflammatories) for other medical reasons, it's ok to keep taking them.
  • Elderberry:
    • Probably best to avoid elderberry for now.
    • Elderberry (Sambucus nigra) can be effective in preventing Influenza, but may worsen the COVID-19 infection. If you are science minded, or want the mechanism of action, a full explanation is below.
      • Sambucus nigra (Elderberry): There is preclinical evidence that elderberry inhibits replication and viral attachment of Human coronavirus NL63 (HCoV-NL63), different than COVID-19, but a member of the coronavirus family.
      • Sambucus appears most effective in the prevention or early stage of corona virus infections. Of note, Sambucus significantly increases inflammatory cytokines, including IL-B1 so should be discontinued with symptoms of infection (or positive test). An evidence-based systematic review of elderberry conducted by the Natural Standard Research Collaboration concluded that there is level B evidence to support the use of elderberry for influenza which may or may not be applicable to COVID-19 prevention. Typical dosing of 2:1 elderberry extract is 10mL -60mL daily for adults and 5mL-30mL daily for children.
      • To Avoid: Given the integral role of inflammatory cytokines (namely IL-1B and IL-18) in the pathogenicity of COVID-19, as well as the impossibility of predicting which individuals are susceptible to the “cytokine storm”, technically called secondary hemophagocytic lymphohistiocytosis, or sHLH, it appears to be prudent to avoid high and regular use of immunostimulatory agents which increase these cytokines. Again, in the absence of human clinical data, caution is warranted with elderberry, an immune activating agent, due to preclinical evidence of increased IL-1B and/or IL-18 production in infected immune cells.

 

 

 

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Please do not submit any Protected Health Information (PHI) through this contact form. All health and immunization forms requests must be submitted through MyChart patient portal, faxed, or dropped off at the clinic. We will not open or download any attachments sent through email in order to protect your child's privacy.