gretchencoadyblog

Allergies - How to not be so miserable every Spring!

Wed, 28 May 2025 02:43:48 GMT

How do I know if I have allergies?

Symptoms of allergies are sneezing, runny nose or congestion, itchy eyes, nose, or ears. These symptoms can come in “typical” allergy seasons such as spring, or you could have year-long allergies to things like cats or dust.

What should I take for it?

Flonase of Nasonex

Nasal steroid sprays work best for allergies. They decrease inflammation in your nose, which helps both nose and eye symptoms.

Antihistamine Nasal Spray

An antihistamine nasal spray like azelastine or olopatadine are a close second; they treat histamine release but also bring down inflammation in your nose. These medicines work more quickly than any other group (within about 10 minutes).

Antihistamine Pills

Claritin, Zyrtec, and Allegra are easy to take. They work well, but not as well as the nasal sprays and can have more side effects. Use them if allergies are mild and short-lived, but it’s best not to use these medicines for prolonged periods.

Does my kid have allergies?

Runny noses in kids are more likely to come from colds than allergies. If you see a pattern of a runny nose that lasts a few weeks and then improves, but then comes back again a week or two later, your kid is having back to back colds. On average, small kids have a cold every month, and the runny nose from colds can take up to 3 weeks to go away - so it can seem like kids ALWAYS have a runny nose!

Antihistamines don’t help this kind of runny nose and do have a lot of side effects. Instead, use nasal saline to flush out their noses and help the congestion.

When should I get allergy testing?

Allergy testing can be helpful if:

It would make you change your lifestyle - if you knew you were allergic to cats, you would get rid of your cat.
You would consider allergy shots to help your allergies (usually only for those with severe allergies or asthma).

If your allergy testing is negative, that doesn’t mean you don’t have allergies; it just means you don’t have allergies to common, widespread things that can be treated with shots.

First, try to treat your allergies with over the counter medicines like we listed above. If that’s not helping, then you should talk to your doctor about allergy testing.

What NOT to take for allergies

Decongestants like Afrin and Sudafed can work very well in the short term. But if you use them for longer than about 3 days in a row, they can actually make congestion come back worse. Save these medicines for short term use only.

Don’t take antihistamines (Allegra, Zyrtec, Claritin) continuously for allergies (for months at a time) - these can lead to increased risk of dementia.

We recommend against taking medicines like Benadryl for most allergies, because this medicine makes most people sleepy, and might bring an increased risk of dementia.

Don’t give kids antihistamines for colds.

Recommendations for healthcare screening

Fri, 23 May 2025 15:05:25 GMT

The United States Preventative Services task force (USPSTF) develops the recommendations for screening in the United States. Generally, insurance companies use these guidelines to decide which screening services they will pay for. Click the name of the screening you want to learn more about:

Mammogram

Pap Smear

AAA Screening

Colon Cancer Screening

Lab Tests

Lung Cancer Screening

Bone Density

Mammogram

Mammograms are officially recommended by the USPSTF every other year from ages 40-65. Despite this every other year recommendation, insurance companies will pay for yearly mammograms if you are older than 40. There is no upper limit of age for which insurance will pay for a mammogram, but insurance will likely not pay the whole cost if you are less than 40.

If you are at high risk for breast cancer and over 35, you can take a medicine like tamoxifen for 5 years to decrease your future breast cancer risk. This calculator can tell you your risk level: https://bcrisktool.cancer.gov/ and if your risk is more than 3% in 5 years, you should consider taking a medicine.

Pap smear

Pap smears recommendations have changed dramatically in the last 10 years because we now have testing for HPV, which is thought to be the cause of most cases of cervical cancer. If you are greater than 30 and your Pap and HPV test are both negative, you only need a pap smear every 5 years. Make sure you confirm at your appointment that your doctor is sending the HPV testing with the Pap smear (if they don’t send it, then you’ll have to come back at the 3 year mark). If you are 21-29 years old, you should get a Pap smear (with no HPV testing) every 3 years. Pap smears for women under 21 are no longer recommended, because their risk of cancer is very low.

Colon cancer screening

Colonoscopy is the most common test for colon cancer screening. The starting age for colonoscopy has gone down in the last few years. Now, colonoscopies start at age 45 and go through age 75. If your colonoscopy is normal, you will get a colonoscopy every 10 years. If it is abnormal, your repeat will be on an interval of every 1-7 years, depending on what they found during your colonoscopy.

If you have a family history (first degree relative - mom, dad, sister, brother, child) then you should start colonoscopies at 10 years younger than the age of diagnosis of your family member, and from then on you will get colonoscopies at least every 5 years.

Stool testing through Cologuard (every 3 years) and stool blood testing (every 1 year) are also available if you don’t want to get a colonoscopy. If these tests are positive, it doesn’t mean that you necessarily have cancer, but it does mean that you need to get a colonoscopy. Insurance companies generally pay for a regular colonoscopy better than a colonoscopy done because you have a problem (and a positive Cologuard is classified as a problem). Consider this before choosing whether to do a colonoscopy or a stool test.

Abdominal aortic aneurysm (AAA)

An AAA is a widening of the aorta in your lower abdomen. This usually has no symptoms, but if the aneurysm gets large enough it could burst. Older men who have smoked are at higher risk of this, so the USPSTF recommends that all men over 65 who have ever smoked (100 total cigarettes in your lifetime) be screened with an ultrasound of the stomach.

Lab tests

The USPSTF recommends some screening lab tests for every patient:

Hepatitis C testing once for everyone 18-80 years old

HIV screening - at least once for everyone 15-65 years old

Lung cancer screening

If you are between 50 and 80 years old and have smoked more than a pack a day for 20 years, they recommend a CT of the chest every year to look for lung cancer. If you quit smoking, you should continue getting this scan until you have been quit for 15 years.

Bone density screening

If you are above 65 and a woman, DEXA screening for osteoporosis is recommended every few years (insurance will not pay for this more often than every 2 years). If you are younger than 65 and postmenopausal, you might also qualify for bone density if you are high risk - talk to your doctor about your personal risk.

How to care for your newborn in the first two weeks!

Fri, 18 Mar 2022 09:32:19 GMT

Having a newborn can be overwhelming! Here are some things to expect in the first 2 weeks of life.

Feeding - Babies should feed on demand (that is, as often as they want to eat), and in the first 2 weeks should not go more than 4 hours between feeds. Babies will start out at very small amounts, about 10-15 mL per feed, but quickly go up to 2oz a feed after the first 2 days. Sometimes babies will be very hungry and will eat every hour; other times, they will go the full 4 hours between feeds. If it’s been more than 4 hours since your baby fed, wake them up and make them eat.

Sleeping for parents and for baby - babies can sleep up to 22 hours out of a day. They tend to be more awake and want to feed more at night, and want to sleep more during the day. We recommend always putting your baby on its back to sleep with nothing loose or fluffy in the crib - this prevents sudden infant death syndrome (SIDS).

Do not underestimate how tired you will be in these first few weeks! It is very easy to fall asleep while holding your baby, so make sure if you’re feeling sleepy you always put the baby down in their crib or basinet. Remember that your baby will be more awake at night, so it is VERY important that you take naps during the day when your baby is sleeping. If you plan to be awake most of the night, and make yourself sleep during the day, you will be much better off.

Babies need to be dressed in one layer more than what you are wearing to be comfortable, and need to have a hat on most of the time for the first week or so. They lose a lot of heat through their skin and especially through their scalp. Babies will usually be more comfortable if they are swaddled tightly - if you find your baby is getting out of their swaddle, it’s not that they don’t like it - you didn’t do it tightly enough.

Pooping - babies should poop at least once in the first 24hrs. At first, the poop will be black and thick. As they eat more, the poop will turn into a yellow or green poop that is mostly liquid and looks like it has small seeds in it. Babies poop on their own schedules - some babies poop 8 times a day, and rarely some babies will go up to 8 days without pooping. They will grunt and strain and turn red in the face as they are trying to poop. All this is normal. If the poop comes out in hard small balls, then they are constipated - talk to your doctor about it.

Peeing - babies should pee once on the first day of life, twice on the second, etc until they are peeing 6-8 times a day. If your baby ever goes more than 12 hours without peeing, they are probably dehydrated and you need to talk to your doctor.

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True projectile vomiting (throwing up everything they eat; the vomit literally goes across the room like in the Exorcist) is not normal. Any baby might do this once, but if they do it over and over they need to be seen. This is paragraph text. Click it or hit the Manage Text button to change the font, color, size, format, and more. To set up site-wide paragraph and title styles, go to Site Theme.

Cord care - the cord should be left alone and kept dry. Do not put your baby down in water until the cord falls off. It generally falls off somewhere in the first 2 weeks. Cords can rarely get infected - if you see pus coming from the cord or redness of the skin growing from the cord out, then see your doctor.

Bathing - babies do not like baths because it makes them cold. At first, you will do only a sponge bath until the cord falls off. After that, you can put them in water but do it quickly (a bath should take less than 5 minutes). Babies don’t need baths every day, and giving too many baths can dry out their skin. Give them a bath about once every 2-3 days at the most.

Fevers and illness - it can be hard to tell just from looking at a small baby if they are seriously sick or if they just have a cold. If your baby has a fever at any time in the first 6 weeks of life, they need to go to the ER. A fever is a temperature of 100.4 or more, measured rectally. You don’t need to check their temperature all the time, but if they feel too warm, they are acting sick (coughing, etc) or if they are acting strange (you can’t wake them up), you should check a temperature.

After your baby is 2 months old, you can trust how they look to tell you if they’re seriously sick. We won’t make you run to the ER just for a fever any more.

Because we don’t want you to have to go to the ER, try not to let your baby get sick in the first 6 weeks or life. For this reason we recommend limiting your baby’s exposure to other people. Going outside is fine, but limit your time in public spaces because people will want to touch your baby. Make everyone who comes to your house wash their hands and make them stay away if they are sick. If you are sick, make sure you wash your hands and don’t breathe directly on the baby or kiss them.

Skin care - most term babies will have peeling skin in the first few weeks. It’s fine to use plain lotion that is hypoallergenic, but most babies don’t need a lot of lotion. If you have a strong family history of eczema, we recommend you start using lotion every day right away even if their skin doesn’t seem dry.

Baby noises - hiccups, yawning, throat clearing, and sneezing are all normal baby noises. Because baby’s nose is so small, and because they only breathe through their nose, it can sound like your baby is very congested when they aren’t. Instead of listening for the congestion, look for trouble breathing. If a baby is pulling in their skin under their ribs or between their ribs every time they breathe, they are having trouble breathing. First, suction out their nose with some saline. If they are still having the pulling or retractions, they need to be seen right away.

Sometimes less is more - babies really just need your time and attention. Most babies don’t need any medicines; avoid giving them any kind of medicine unless you talk to your doctor about it. Even medicines that seem simple, like cough medicines, can have bad side effects for babies.

Avoid any screen time for babies. They need time to explore the world and learn, and screens stop them from doing that. Try not to allow your baby any tablet time, phone time, or TV time until they are 2 years old at least.

Car Seats - your baby needs to be in a rear-facing car seat until they are 2 years old. While the car seat is the safest place for your baby in the car, it’s not a safe place for them to sleep outside of the car because they can slump down and have trouble breathing. Any time you’re not in the car and your baby is sleeping, move them to their crib.

Colic - at least 20% of babies will get colic, which is crying for more than 3 hours a day for no particular reason. If your baby is crying, first try everything that you know to make them better - undress them and change their diaper, make sure they are warm enough when you redress them (for the first few weeks, a onesie with socks, covered by footy pajamas, a hat, and swaddled), feed them, rock them. If none of this works but you find you are getting frustrated, take a quick break. Hand off your baby to your family, or just set them in the basinet for a few minutes. Once you take some deep breaths and you feel calmer, try it all again. It can be very frustrating when your baby is crying, but if they feel your frustration it will be even hard to get them to settle - getting yourself calm and organized really helps.

Postpartum depression - babies are wonderful, but also exhausting! It’s normal to be very tired, to cry at times, and to wonder if you’re really up for this parenting job! If, however, you find that you are sad all the time, that you can’t enjoy being around your baby, or that you see no hope of this tiredness getting better, you could have postpartum depression. Please call your OB right away to talk to them about it.