What to do When Your Child is Sick
What is it?
It is pain in the testicle, usually of sudden onset and may present with redness, swelling and a fever. It may be caused by a viral infection or it may be due to a twist in the base (root) of the testicle (testicular torsion). This is an emergency and it needs to be seen right away by a doctor and corrected; otherwise, it may cause permanent harm to the testicle.
When to call
CALL RIGHT AWAY. This is an emergency and needs to be checked out within hours and may need surgery to correct the problem.
A word about antibiotics
We get many questions about prescribing antibiotics over the phone. With rare exceptions, it is against our office policy to do so. We consider prescribing antibiotics over the phone without examining your child poor medical practice. Many illnesses are caused by viruses, and antibiotics have no effect on such illnesses. Furthermore, your child may have an illness that is more serious than you suspect and giving an oral antibiotic may not be adequate treatment. Giving an antibiotic from a previous illness or from someone else’s prescription may mask serious symptoms and signs and can affect test results.
When you receive an antibiotic for your child, give it for the entire prescribed time. If you run out before the recommended time, call the office during the day for a refill. If your child develops a potential allergic reaction to an antibiotic, stop the medication and call. If severe diarrhea develops, stop the medicine and call the office during the day.
What is it?
A lice infestation is a scalp infection caused by tiny gray bugs called lice. Lice are 1/16th inch long and move quickly. They are extremely difficult to see when looking through someone's hair. They lay eggs that are firmly attached to hair shafts near the skin. The eggs are called nits and are easier to see than lice. They look like specks of dandruff or grains of sand, but they do not shake off easily. Itching of the scalp is the main symptom, but not all people actually itch from lice. A scalp rash, often noted at the nape of the neck, may also be present. The empty nits are white, the unhatched nits are dull and usually found closer to the scalp. Nits are best found on the back of the head.
What you can do
In the past we have recommended over-the-counter Permethrin products, such as NIX or RID, but recently in California, most lice have become resistant to these products.
Here are some other options:
Purchase Cetaphil Gentle Skin Cleanser. This is a soapless cleanser usually found in the soap department at most drug stores.
Apply an ample amount and work into scalp, making sure the cleanser covers the entire scalp and hair. After hair is soaked through, wait 2 minutes.
Comb out excess cleanser with a fine-toothed comb.
Blow-dry your child’s hair. It must be completely dry to the scalp to suffocate the lice. Note: hair will take a long time to dry.
Leave dried Cetaphil in hair for 8 hours.
Wash off with regular shampoo and comb out nits (see below section for comb information).
Repeat twice in 1 and 2 weeks.
Don't forget to simultaneously wash all bedding/towels/hats/worn clothing in hot water and dry on high heat for at least 20 minutes.
Use a comb such as NIt Free Terminator Lice Comb ©. The Nit Free © company also has several products, such as shampoo, conditioner, and spray that can help repel and prevent lice from attaching to hair. You will need to comb through your child's hair multiple times per day over at least 2-3 weeks.
Nit Picking Option
Aggressive picking of nits can eliminate the mites, but every single nit needs to be removed. There are nit picking shops in the community that perform this, as well. We have a list of community resources available should you need this. Call our office for more information.
Any items that have been in contact with your child’s head within 24-48 hours prior to treatment will need to be cleaned, such as bedding, jackets, hats and stuffed animals. Lice die within two days without a blood meal. Nits take 8-10 days to hatch and then it takes about nine or more days for the lice to become adults and lay eggs. Since it is possible for nits or lice to be on items used by the child prior to treatment, clothing and bedding should be washed in hot water and dried using a high heat cycle for at least 20 minutes. Items that are not washable should be dry-cleaned or put in a sealed plastic bag for two weeks to prevent hatched lice from getting a blood meal. Soak combs, brushes, hair bands, and barettes in soapy hot water for at minimum one hour (or boil for five minutes). Carpets and furniture can be vacuumed daily. THERE IS NO NEED TO APPLY PESTICIDES.
When to call
Call during office hours if your child:
- continues to have lice despite above measures.
- has redness, pus, soft scabs or open sores on the scalp.
- is less than 2 months old
- has scalp rash or itch lasting more than a week after treatment.
If you need a medication refilled, please call us during regular office hours. Please give us at least 24 hours notice for regular medication refills and at least 3 business days for triplicate medication refills. Please note that we do not refill prescriptions after office hours.
Please note that it is our office policy to not call in medication prescriptions over the phone after hours and on weekends. Please call during regular business hours to speak to a nurse and/or schedule an appointment.
See package directions for larger children.