Why am I hearing so much about RSV and what can I do to keep my child healthy this winter?

From a surge in RSV cases to COVID and the flu, the news headlines can feel overwhelming for parents. We sat down with Dr. Lorna Fitzpatrick to get answers to some of your most asked questions.

Lorna K. Fitzpatrick, MD

Dr. Lorna K. Fitzpatrick is the Vice President of Medical Affairs at Excellus BlueCross BlueShield. She is Board Certified in Pediatrics and Pediatric Hematology-Oncology, obtained her medical degree at Jacobs School of Medicine in Buffalo, and continued on to Residency in Pediatrics at St. Louis Children’s Hospital/Washington University St. Louis. She completed a Fellowship in Pediatric Hematology-Oncology at Johns Hopkins University.

Q: Dr. Fitzpatrick, we are hearing a lot in the news about respiratory syncytial virus – or RSV – and how cases are soaring. Can you tell us what RSV is and who should be worried about it?

The Centers For Disease Control (CDC) is seeing an increase in RSV cases and hospitalizations across the country. RSV is a respiratory virus that usually causes mild cold-like symptoms in otherwise healthy children and adults. Anyone can get RSV but it’s a more serious problem in babies or older adults when it turns into bronchiolitis – which is inflammation in your lungs – or pneumonia, which is an infection in your lungs. The most at risk are newborns and premature infants. As we approach holiday gatherings, remember that what is a slight cold in a healthy adult can be a serious illness for an infant or toddler. Keep babies close to you and avoid having friends and relatives, as well-meaning as they may be, kiss or hold your babies.

Q: What are the symptoms of RSV and how do you know when your child needs to be seen by a doctor?

Early symptoms of RSV include a runny nose, loss of appetite, a cough which may include wheezing, and sometimes a fever. You’ll want to see a doctor immediately if you see your baby or child struggling to breathe. Sometimes this looks like a child’s nostrils are flaring out, their ribs are pulling in, and/or they are using their belly muscles to breathe. Also, with a baby, call your pediatrician if they aren’t taking in enough fluids or having 6-8 wet diapers a day. If symptoms are getting worse instead of better, you should see your doctor. Your provider cares – call if ever in doubt.

Q: We are also hearing a lot about the flu already this year, and we know COVID is still around. What is the latest on those illnesses?

We are in “flu season” from now until at least February. The flu can be serious especially in older adults, young children, pregnant women, and nursing home residents. The CDC recommends the flu vaccine for everyone 6 months and older. This will help protect you as well as anyone who is particularly vulnerable. And while COVID cases are down, you should stay up to date on vaccines to help prevent a more serious infection if exposed. Talk to your doctor if you have questions about which vaccine is best for you or your child. Getting a flu vaccine or COVID booster is as simple as stopping by your local pharmacy. Visit vaccines.gov to find a vaccination site near you.

Q: How do parents know when to keep kids home from school or an event? What guidelines should they follow?

If your child tests positive for flu, RSV or COVID they should stay home for the period of time recommended by their pediatrician. If your child is sick and tests negative for these illnesses, they should still stay home until they are “fever free” and “symptom free” without the use of medication for 24 hours.

Q: What’s your best advice for everyone on staying healthy this winter?

Stay up to date on your vaccinations. Even if you do get sick, being vaccinated will likely keep your symptoms mild. Make sure you wash your hands often for 20 seconds with soap and warm water – and make sure your children know how to wash their hands properly, too. It’s a good idea to remind kids to wash or sanitize their hands in school during the day. We all should use the hand sanitizing stations at the grocery store – maybe carry a sanitizer in your purse or car, too. And avoid close contact with people who are sick.

“I don’t always want to be known as the kid with a heart transplant,” he said. “I want to be known as the kid who made a difference.”

Heart failure from a cold?

In the fall of 2018, Zachary Losee was in many ways a typical teenage boy. He lived in Monroe County with his family, a dog, a cat and two pet birds. He played volleyball and was on the school diving team.

One autumn day, Zachary came down with what seemed like a bad cold or the flu. He had a fever, body aches, coughing and a sore throat. A doctor told Zachary to rest and drink plenty of fluids.

The next night, Zachary’s health went from bad to worse. Zachary’s mom, Julie Prest, rushed him to the local emergency room. When he arrived, he could hardly breathe and started to collapse. From there, things started to move very quickly.

Suddenly, Zachary was being transported by ambulance to UR Medicine’s Golisano Children’s Hospital. At Strong, he was rushed to the pediatric cardiac care center. “It was a whirlwind when we got there,” Julie remembered.

Julie sat in the waiting room for several hours, not knowing what was happening to her son. Finally, a nurse came and told Julie that her son was experiencing heart failure with liver and kidney failure. Julie was floored, “From a cold?” she exclaimed. She didn’t understand how that could happen.

The lowest of the lows

Julie soon learned that Zachary did not have a simple cold, but had viral myocarditis. Viral myocarditis is a rare but serious condition. It occurs when a virus causes inflammation and damage to the heart muscle, making it difficult for the heart to pump properly. In Zachary’s case, the virus antibodies were detecting his heart as a foreign object and attacking his heart.

Zachary remained in the hospital as his body continued to fight the infection. Julie described Zachary’s time there as “a very emotional rollercoaster. It’s the lowest of the lows for any parent to go through.”

After several weeks at Golisano Children’s Hospital, Zachary continued to struggle, and his health declined. It was clear that Zachary was going to need further specialized care. On Thanksgiving Day, Zachary was transported by Mercy Flight to Morgan Stanley Children’s Hospital in New York City.

Two weeks later, on December 5, doctors told Julie and Zachary that he would need a new heart because his heart was failing. He was placed on the organ transplant waiting list. The next day, Zachary had surgery for a left ventricular assist device (LVAD), a device that would help his heart pump blood to the rest of the body as he waited for a new heart.

Total shock

According to the United Network of Organ Sharing, about 8,800 New Yorkers are currently waiting for an organ. Many have been on the waiting list for 5 or more years. Across the United States, about 17 Americans die every day waiting for an organ, according to the Health Resources and Services Administration.

Amazingly, Zachary’s wait time was much shorter. After only one day, a doctor told Zachary and Julie that a heart was available. “Mom and I were in total shock that something so big could happen so fast,” said Zachary. Less than 24 hours later, a new, healthy heart was beating inside Zachary’s chest.

Afterwards, Julie described how it felt to meet the doctor who had performed the surgery on Zachary. “It was an overwhelming feeling to shake this man’s hand. To know there was so much knowledge, skill and delicacy in his hands. It was something I’ll never forget.”

Two little words

Zachary and Julie don’t know much about the donor who gave Zachary a heart. They don’t know if it was a man or a woman, an adult or a child. “The only thing we know is that the heart came from within a 500-mile radius of the hospital,” said Zachary.

They planned to write a letter to the family of the donor. When asked what he thought he might say to the family, Zachary thought for a moment and then said “Two little words can mean so much…I would just say thank you. It means much more than people think.”

“We are really hopeful that we can meet this donor family that gave my son the greatest gift of all, which is to continue with life. He wouldn’t be here now if it wasn’t for that gift.” said Julie.

A second chance at life

Zachary said a heart transplant was “a second chance at life.” Since his surgery, Zach said he is feeling amazing and getting stronger every day. He’s looking forward to going back to school soon and getting back into volleyball and diving. After graduating, he plans to go on to college and study architectural design or cardiology.

He’s also working to spread the word about organ donation and the importance of joining the registry.

“You could save so much more than yourself,” said Zachary, about joining the registry.

“It’s such a selfless act that you can do,” added Julie, “and yet, it’s the greatest thing you can give anybody.”

The dire need for organ donors

While 90 percent of U.S. adults support organ donation, only 60 percent are registered organ donors, according to organdonor.gov.

You can help make a difference by joining the organ donation registry:

1. Sign up through the New York State Department of Motor Vehicles in-person or online at DMV.NY.gov
2. Sign up when you register to vote. Check the “New York State Organ and Tissue Donation” box on the voter registration form.
3. Enroll through New York state’s Health Plan Marketplace when applying for health insurance at NYStateofHealth.NY.gov
4. Complete a paper or online registration form at DonateLife.NY.gov
5. If you don’t reside in New York state, visit organdonor.gov to find out how to register as an organ donor in your home state.

For more information on the dire need for organs in New York state, click here.

*Since this interview with Zachary, he has returned to school and is enjoying spending time with his friends and classmates.  

Pollen and ragweed may not bother us at this time of year, but that doesn’t mean people who live with allergies can breathe easy.

Allergies are often worse in the cold weather months, because windows are shut, the furnace is cranked, and people and their pets spend a lot more quality time together indoors. Our homes are less ventilated in winter, and it’s common for people with allergies to feel the effects of coughing, sneezing, a runny or stuffy nose, postnasal drip, and itchy eyes, nose and throat.

“Many children and adults find that their allergies flare up in the winter months because they spend more time exposed to indoor allergens, including dust mites, mold spores and pet dander,” said Nicholas Massa, M.D., senior medical director for clinical services at Excellus BlueCross BlueShield. “Eliminating the source of the allergens is the most effective step in alleviating symptoms.”

Here are some tips to allergy-proof your home this winter.

Keep pets out of the bedroom

If you are allergic to animals, keep your pets out of your bedroom and away from carpeted areas. Bathe your pets often. If you are considering getting a pet, research short-haired or non-shedding varieties.

Control dust mites

These tiny bugs can be found in mattresses, pillows, cloth furniture and carpets. Battle dust mites by covering mattresses and pillows with allergy-proof covers. Wash sheets, pillowcases and blankets weekly in hot water. Vacuum often with a vacuum that has a HEPA (high-efficiency particulate) filter. Use blinds instead of curtains or drapes for window treatments. Cut down on the number of stuffed animals in the kids’ bedrooms (or at least wash them frequently). And, if possible, replace carpeting with hardwood floors.

Stop mold growth

Mold grows in damp and moist areas. Prevent mold from growing by using an exhaust fan while showering, repairing water leaks in basements, inside walls and under sinks, and fixing leaking roofs or pipes. Put a dehumidifier in a damp basement but remember to drain the water collection tank often.

Stop cockroaches from moving in

Cockroach droppings are among the most common winter allergy triggers, and a forced air heating system easily spreads them throughout the house. To help keep these annoying pests out of your home, store unrefrigerated food in closed containers, make sure your kitchen garbage is stored in a lidded can, and wipe down any area or plate where crumbs may gather. Don’t forget to keep pet food in sealed containers.

“Reactions to indoor allergens can linger for weeks or even months,” said Massa. “If allergy-proofing your home isn’t effective and symptoms persist, speak with your physician.”

Treatments for winter allergies include:

• Antihistamines, which reduce sneezing, sniffling, and itching
• Decongestants, which clear mucus to relieve congestion and swelling
• Immunotherapy (allergy shots or under-the-tongue tablets), which expose your body to gradually increased doses of the allergen. This approach can curb your symptoms for a longer period of time than allergy drugs.

We’re wired to focus on the negative or what is missing in our lives. By intentionally focusing daily on what is good and right in our lives, our habit of negativity weakens, and appreciation strengthens. If we can make gratitude a habit, it becomes a default setting. When life unravels, our grateful attitude can help us pull through. But it doesn’t just happen, it comes with practice. We need to consciously apply and repeat, deliberately and daily. As our practice grows, our level of contentment rises.

Benefits of practicing gratitude

Although there are still many unknowns about the impact of gratitude on health, there is agreement that it makes you feel good! Overall, practicing gratitude creates positive emotions which can reduce stress and improve wellbeing and life satisfaction. Other benefits may include:

• Feeling valued which increases our self-esteem
• Minimizing negative thoughts and feelings
• Preventing worry and frustration
• Feeling inspired which improves motivation
• Being hopeful for future
• Building stronger relationships
• Coping better with stress
• Being more alert, enthusiastic and productive
• Experiencing higher levels of love, happiness and optimism
• Having stronger immunity, lower blood pressure, and better quality and duration of sleep

Simple exercises can be used every day to practice gratitude

• Gratitude countdown– Take turns with a friend, spouse or child to count down from 10, listing 10 things you are grateful for. Be specific. For example, rather than saying “I’m grateful for my dog”, say “I’m grateful for my dog snuggling up to me tonight and making me feel loved.” This will help evoke an authentic feeling of gratitude. You can also do this solo.
• Gratitude journaling– Each day, write down 10 items you’re grateful for, including bigger things that are easier to notice and the day to day things that we tend to overlook. Putting pen to paper helps to organize thoughts and deepen their impact. Do this exercise at the same time everyday to establish habit. Don’t worry about grammar or writing a well written sentence. The idea is to let writing flow naturally without too much thought to channel gratefulness from heart to pen to page.
• Gratitude reminder– This is a simple cue to remind you to tap into gratitude during the day. It could be an audio (a squeaky door, an alarm) or visual (a bracelet, a pet) reminder to practice gratitude. When you hear or see that cue/reminder, pause, take a deep breath, and find gratitude in that moment.

Sources:

• Harvard Medical School – Giving thanks can make you happier
• Greater Good Magazine – Is gratitude good for your health?
• Mayo Clinic – To improve your health, practice gratitude

Holiday decorating may look a little different for you this year. It has taken an interesting turn – not for the better or the worse. It’s just, well, different.

Read some of these stories our Excellus BlueCross BlueShield team members have shared, and you’ll see what we mean.

 

A Tale of a $99 Branch

In my home this year, the Christmas trees, lights outside, and house filled with gnomes are all traditional.

What’s not? The enormous twig on a rope my husband decided to “gift” me after I attempted to convince him I was buying the notorious “Twig on a String” for $99 at Crate and Barrel that went viral on social media.

The best part of this décor is the fact that the original story is that I bought six of these twigs on a string and had my very calm, cool, collected husband so frazzled he believed me… and I got it on video! The video has made its way around to friends and family for their viewing enjoyment.

Well, the joke was on me when I was welcomed earlier this month with a surprise of my own. The very same twig on a rope – about 10 times the original size – was there hanging from my garage – he even included some festive ribbon!

 

A Tree of Faces

“Our tree is a collection of memories: ornaments the kids have made, we bought on vacation or from memorable moments in our lives,” said Crystal Gallagher, of Monroe County.

Every year when her family puts up their tree, they talk about all the different ornaments and what they mean.  Years ago, her now 17-year-old Dillon’s ornament he had made with his picture on it disappeared.  “We thought he had thrown it away and we were mad,” she said. “This year we moved, and I found it at the bottom of our coat closet!”

So, to change things up for 2020, Dillon’s 16-year-old brother, Ian, decided to make his photo ornament and Dillon’s the tree topper.

“We thought it was so funny we left it and packed our usual bow back up for next year!” Crystal said.

 

Decorating – or Not Decorating – Your Way

In 2016, Roxy Greninger from Monroe County wasn’t feeling well and the thought of putting up the Christmas tree was crippling. Instead of guilting herself, she got creative and decided she would cut herself some slack that year.

“I told my family that Santa was going to pour the presents down the chimney. My son, Riley, was a teenager so he didn’t mind, and my husband was supportive, though he enjoys the tree but wasn’t prepared to put it up himself,” she said. “We enjoyed our holiday in a fun new way and it got me through a rough patch.”

This year, as Roxy felt the depression creeping in, she turned the chore of putting up the Christmas tree into something she enjoyed doing – designing. She had a vision in mind, so she ran to the craft store and got to work – even decorating the banister!

“I hung the stockings but left the other Christmas décor in storage for 2020,” she said reminding us all that “Tree or not, both Christmases’ were and will be special. It’s about doing what’s best for you.”

 

Making Trees Out Of… Trees

Peter Kates, of Erie County, made a very unconventional tree this year. He made a Christmas tree out of dowels and a wooden closet rod. As he said, he made a tree out of a tree!

Peter’s daughter has many allergies, including to pine trees. And recently, she developed a chemical sensitivity to many man-made materials, so their artificial tree is now outside the kitchen on the back deck…fully strung with lights, and rusting. Peter’s homemade tree will be inside and loaded with all their favorite ornaments.

What does your 2020 holiday decorating look like? Share your decorating stories in the comments section below. 

We sat down (virtually) with Dr. Saba Abaci, medical director for Safety Net Behavioral Health Children Services at Excellus BlueCross BlueShield to learn some tips for how to best support a child’s mental health during the pandemic.

What are some signs parents want to look for to indicate their child may be struggling to cope with the pandemic?

(Dr. Abaci) I think it is important to look for any changes in regular daily activities, including some regressive or new behaviors, changes in appetite, motivation, energy, sleep issues, or mood shifts. Stress can cause changes in all these areas. A child’s age also plays an important role in how they can express their feelings. Sometimes engaging in some play time and activities like drawing can be very helpful tools to facilitate communication about thoughts and feelings.

What are some healthy ways for kids to cope with stress?

Depending on your child’s age, you could encourage your child to take breaks from watching, reading or listening to news stories, including those on social media. Hearing about the pandemic repeatedly can be upsetting. Instead, encourage your child to do other activities they enjoy, like spending time outdoors or playing a game. Connecting with friends and family can also help with feelings of stress. You can help your child to brainstorm ways to stay connected safely, such as through phone calls, video chats or mailing cards. Everyone is in an unusual situation right now, so it’s important for all of us to be intentional about caring for our mental health.

How can parents help their child build resilience during the pandemic?

There’s a lot that is outside of our control right now. But some things we can control are taking care of our health, including getting enough sleep, ensuring good nutrition, and being physically active. Keeping a consistent daily routine, when possible, can also help increase that sense of control. Helping children find ways to feel in control can improve resilience, which can improve mental health.

Any tips or approaches for dealing with kids who have mental barriers for doing certain types of schoolwork at home?

It can be frustrating and exhausting dealing with kids who have mental barriers for doing certain types of work. I think reassurance is very important for everyone. Children do well when there is a clear, consistent schedule. Making daily activity schedules ahead of time can be useful. Having some relaxing or fun activity before the child begins their assignments may put them at ease while still having the time set to begin the assignment. This also varies from child-to-child. I find it very helpful to work together on a list of the child’s wishes, goals and how they think they can achieve them.

How can families keep positive during a winter where we’ll likely be at home more than normal?

It will be important to plan ahead this year given our current environment and maintain good routines and social connections, which can be a mood booster during fall/winter months. Regular exercise, sleep, and good nutrition are all important for staying energized. It’s also important to be proactive about finding opportunities to connect with friends and loved ones, even if it’s in a virtual way. Get some natural light daily or keep the lights on during the evenings while engaging in hobbies can help when the nights feel so long.

How can parents find additional support to help their child?

If you have concerns about your child’s mental health, a conversation with your child’s primary care provider is a good place to start. If you need help finding a primary care provider, visit ExcellusBCBS.com/FindaDoctor. Excellus BCBS members also have access to a 24/7 Nurse Call Line, which can provide support and education through specially trained registered nurses.

Any tips for getting an appointment with a mental health specialist?

Your child’s primary care provider can help with making a referral to a mental health specialist, if needed. Most mental health providers now offer telehealth, making it easier for patients to get care from the privacy of home, where they feel comfortable and can call at their convenience. Many Excellus BCBS members are also able to receive mental health services through MDLIVE® with the same provider on an ongoing basis.

For more tips on getting a specialist appointment, watch the video below.

The 24/7 Nurse Call Line is a service provided to Excellus BlueCross BlueShield members to support their relationship with their health care providers. The information provided is intended to help educate members, not to replace the advice of a medical professional. If you are experiencing severe symptoms such as sharp pains, fever, loss of bodily function control, vomiting or any other immediate medical concern, dial 9-1-1 or contact a physician directly.