Dr. Scott K. Sokol, MD

Great question and an important one. First and foremost, anytime the rapid heart beat occurs Acutely along with difficulty breathing, disturbing color changes And altered alertness, this is a true medical emergency and should be treated as such. assuming that this observation is non acute but is one that is still Recurrent it should be investigated. It is a relatively common occurrence in kids. some non cardiac conditions that may increase heart rate are things like fever, exercise, dehydration and maybe a benign condition called POTS which happens when the heart rate increases when the child goes from sitting or lying down to standing. in any case assuming that the rapid heart beat is not an emergency, the child should certainly be seen by his or her regular pediatrician have a relatively extensive physical exam and tests like an EKG, Maybe a chest X-ray, some laboratory tests like electrolytes and Thyroid levels. this kind of attention will most likely result in Deciding if the episodes of tachycardia range from benign Childhood sinus tachycardia to more serious diagnoses.

A tonsillectomy is very commonly done in kids With a history of recurrent episodes of tonsillitis especially if over time the tonsils are Enlarged causing discomfort because of the size and also setting the child up for more Frequent infections. The actual procedure is of Course not painful because of adequate anesthesia. there will certainly be some soreness and discomfort right after the procedure but with adequate doses of pain meds and ice chip or ice pops or iced liquids, the child will get over the discomfort rather Quickly.

Most sinus infections are usually and initially caused by viruses with other cold symptoms. It can be treated with rest and fluids, Motrin or Tylenol for fever or discomfort, a humidifier And saline nasal spray. However if the symptoms continue for let us say 7-10 days especially If the fever continues and the nature of the mucus changes it may then be a bacterial sinusitis. At that point you may need to have the child seen or your primary care doctor on the basis of The history might then prescribe an appropriate antibiotic.

Thanks for your question. As far as allergy medication is concerned it is widely used and very safe when used properly. The best medications are the long acting kids antihistamines like Claritin or Zyrtec. They are given once a day with very Little side effects. Also Benadryl is available for acute episodes like hives or poison ivy. All these OTC meds are readily available And list proper dosages. They are taken once a day as needed. Be aware that medicines like dimetapp have antihistamine combined With a decongestant. The decongestant part does not help allergies and is not needed. So a stand alone kids antihistamine is all That is needed. To help keep allergies under control in addition to the oral long acting antihistamines there are available pediatric Nasal sprays for allergies which are effective. You can ask your kids medical provider for the names of the meds that he or she Likes to use.

Treatment depends upon the type of infection and also any underlying respiratory problems. Most chest infections are usually Part of a viral illness that besides a bad cough, has nasal congestion, fever, and maybe some abdominal discomfort and vomiting With lots of mucus. Also these respiratory infections may last as long as sometimes up to a week or more. However sometimes It may be a presumed bacterial infection. These may be presumed for example if the child seems to be getting better than the Cough gets worse and a reappearance of the fever. Then antibiotics may be needed. As far as any lower respiratory illness Is concerned, the usual protocol of rest, fluids, and maybe meds like robitussin dm will help make the sick child feel better. If for example the child has an underlying condition like asthma, the lung infection may cause something like wheezing and That has to be treated as well as the virus that started the illness.=20

The diagnosis of bronchitis is a common condition in kids and is almost always non-threatening. The condition of Bronchitis is most commonly viral in origin and is usually a part of a typical respiratory illness. These viral illnesses Usually include upper respiratory symptoms like nasal congestion, perhaps low-grade fever and an uncomplicated sore throat. Also, a not unusual part of these illnesses is a bad cough and on physical exam manifests with findings of lung Congestion. Some of these viruses may also cause some mild wheezing which also can be heard on physical Exam. These illnesses are common and treated with appropriate medications and can last several days or more. The treatable kinds of bronchitis that are not viral are usually manifested after some time as the child is recovering from a viral illness there may be a recurrence of fever, worsening cough, and perhaps even some abdominal pain. When examined the lower respiratory exam indicates diffuse pockets of infection. These are often secondary bacterial Infections and can be treated with appropriate antibiotics. The only times that acute bronchitis may be concerning is If, for example, the child is a known asthmatic which may predispose to respiratory distress. Otherwise, the main Concern ongoing is watching the child as he or she recovers from any secondary infection.

Children can take cough medicine but the kind of medicine and the kids age are important. For OTC cough meds the child should be at least 4 years old. The most effective kind of Cough medicine without most side effects would be a med like Robitussin DM or any Generic medication that has a similar formula. It does not contain anything other than An expectorant/cough suppressant. Directions in terms of dose and age are on the package. Just remember that most kiddie colds come with some cough and stuffy nose and maybe a Low grade fever and are usually fussy and irritable. The best way to make them feel better Is of course rest and plenty of fluids and maybe some Tylenol or Motrin. Also breathing Might be easier with the use of a cool mist humidifier. And a really good way to help sleep Would be some saline nasal spray and a teaspoon of honey. Remember that almost all Kids colds are viral in origin and do not require any antibiotics.

Good morning. Now about coughs. They are the way the body reacts to usually increased mucus either in The upper respiratory tract or the lungs. This can be due to infection, allergies, or the reaction to things like Dust or smoke. However as to the need for antibiotics with a cough, there first must be an inciting agent. In most cases the initial signs and symptoms are the result of an acquired respiratory virus. The cough is=20

Good question. Most sore throats in kids are easily treated depending on the cause. During a typical mild viral infection with a cough and cold, there will usually be a sore Throat. That can be eased with liquids or even an ice pop and will also get better with Fever meds such as Tylenol or Advil. If a child has for example allergies and nasal Congestion they will often be mouth breathers and will have a dry slightly painful Sore throat. If it happens during the winter the sore throat may be more uncomfortable. The child may need extra fluids, some saline nasal spray and a cold mist humidifier. The one typical cause of a sore throat that will require additional treatment would be a Strep throat. A typical strep infection would be a sore throat, fever, maybe some swollen Glands, maybe a strep rash. Once diagnosed the sore throat would still be treated With Motrin or Advil and fluids in addition to the prescribed antibiotics. Once the antibiotics Are started the sore throat usually gets better pretty quick.

First things first. almost all fevers are not harmful. they are certainly a worry for parents but other than perhaps the child being irritable, fussy and poor appetite the fever is an indication of an illness usually an infection. the only fever that is harmful is a fever associated with heat stroke. also, it is the level of fever that may indicate what is causing the fever. it seems that for some reason the body knows to cap the fever up to 104.8 degrees and will fall to a lower level by losing body heat rapidly. a short sponge bath with warm water may help.
for some reason when there is a documented fever of 105.0 and higher you are probably dealing with a treatable illness usually due to a bacterial infection. so with the understanding that prolonged fever is not harmful to the child, it may lead to a more extensive evaluation. obviously, the list of possible causes involves consideration of illness from the most common to perhaps. the most esoteric. it may involve not only blood and urine tests but also x-rays, and multiple disease cultures. As always an initial and extensive history and physical is essential and may help determine the direction of the evaluation as to the cause of the fever. so please remember that the fever itself when in the range of 101 to 102 and even 103 to 104, is not really harmful but may require a thorough investigation. One other point must be made. all these discussions pertain to kids of certain ages. it is needed to be immediately proactive with infants that are newborns and usually up to 2-3 months old that require immediate observation and testing and usually as an inpatient.

It looks like it may be what is called a plantar wart. which is just a wart on the bottom of the foot. one or two approaches may help. you may be able to treat it with OTC wart medicine or see a local podiatrist who will confirm the problem and do the proper treatment. it looks very benign and bears some watching and ultimately proper topical treatment.

There are two kinds of so-called ear infections. the first is an actual infection in the middle ear and usually presents with pain, sometimes fever and usually requires oral antibiotics and some ear drops for pain can help. the other common type of ear infection is an infection of the ear canal usually referred to as swimmer ear. it is also painful and will often have a rather nasty discharge. the treatment is medicine for pain and antibiotic ear drops to clear the ear canal infection.

In general, the acute onset of blood in the urine called hematuria is usually related to urinary tract infections in kids. It may be a bacterial infection usually caused by the bacteria E. coli or may be viral in origin which is usually caused by Adenovirus type 11 or 21. If it is bacterial then oral antibiotics will take care of the infection. For a viral infection, The usual treatment is fluids and rest maybe pain meds if needed. Other less common causes may be trauma, especially to the lower back. Also, a stone in the kidney may cause Blood in the urine as it passes from the upper part of the urinary to the lower part. The initial approach should include a careful history as well as any meds that are taken. After an initial general exam with attention to the lower abdomen, bladder, and kidney areas As well as any other signs or sites of bleeding. Subsequent testing of the urine may help Determine the type of infection if that is the cause. Also available are common testing Aids like X-rays and/or ultrasounds to further help pin down the cause.

Coughing is actually an important bodily function. It helps keeping the respiratory Tract free of mucus. However when it interferes with sleep and eating and resting It can be a problem. Assuming the baby is under 4 years old, you would not use Some OTC products like robitussin. The best oral treatment is actually honey Given as needed about 1/2-1 teaspoon. This helps thin the mucus that is inducing The cough. Also make sure the baby is not lying flat and in addition you can use A cool mist humidifier and add perhaps some saline mist to keep the nose clear.

The answer to the question depends on several factors related to the diagnosis. I assume We are talking about an episode of acute sinusitis. If this is the case, then treatment depends

Complaints of constipation are one of the most common questions regarding kids. It is a common occurrence and the Evaluation of treatment very often involves the age of the child, is it a new complaint, are there associated symptoms And other factors. Constipation usually occurs as a normal change in regular bathroom habits. It can be from certain Changes in diet, perhaps an episode of mild dehydration, or even an episode of a painful bm followed by some stool Holding. In school age kids who are well trained, a sporadic bout of constipation is easily treated with OTC meds. Miralax OTC is readily available and can be used occasionally for almost all ages including infants. Sometimes the

As asked, when diabetes in a child is documented, then insulin daily is required to Replace the natural occurring insulin. After confirmation of the diagnosis of type 1 Diabetes, it would be advisable to be referred to a pediatric specialist like an Endocrinologist to advise on initial and ongoing treatment as well as maintaining Contact with a pediatric dietician since an ongoing regular diet will change after The diagnosis has been confirmed.

The treatment in terms of how long depends on the cause of the illness. In general when a child has Been diagnosed with bronchitis it usually is caused by a respiratory virus. The illness is treated for Any of the clinical effects of the virus. If there is fever it is treated with either Motrin or Tylenol. For cough and congestion one can use a cough medicine like robitussin either plain or with the Cough suppressant dextromethorphan. For nasal stuffiness you can use some saline nasal spray And with little kids maybe a humidifier. Please be aware that recent evidence shows that nasal Oral decongestants like Sudafed are not needed because they don=E2=80=99t work. The rest of treatment Is of course fluids and rest. However if the child is diagnosed with a bacterial bronchitis then Oral antibiotics will be prescribed and will be given for 7-10 days. In either case whether it is A viral or bacterial bronchitis, usually after there is no fever, respiratory difficulty, no intestinal Symptoms or fatigue then the child can go back to school or quiet play.

Most cases of sore throats are not bacterial like strep throat but are usually viral. They can be part of a typical viral illness with low grade fever, cold and cough, Some abdominal discomfort and even some diarrhea and occasional vomiting. The typical treatment is either Motrin or Tylenol, otc cold meds and light diet And clear liquids. A typical strep throat is manifested by much higher fever, Some swollen glands, and a developing rash with extensive red spots that May feel rough like sand paper which is where the name scarlet fever comes from. The best approach is after noting some of the characteristics of strep is to Be seen either by your regular pediatrician or in urgent care to have a strep Throat culture to rule out a strep infection.

About 25-30% of kids of all ages have some degree of insomnia. It is considered primary if not complicated by a medical condition such as Documented sleep disorder or adhd or anxiety or stress disorder then it is A secondary condition. Most primary insomnia conditions are evident by Behaviors that are commonly known by parents, especially those who have Kids that do not sleep well. These kids commonly for example seem to At times refuse to go to sleep, frequent awakenings, or simply cannot fall Asleep when in bed. Some of these kids cannot sleep well because of Daytime problems like fatigue, mood and impulse problems or symptomatic Adhd. As far as fixing the problem, once there is no complicating problems, then These kids should have regular bedtime routine. They can be calmed by Such things as bedtime stories. In addition to this regular routine, a good Daytime diet can help as well as moderate daytime physical activity. If the child wakes up after some limited time asleep, the caregiver should Go into the kids room, not let the child out of the bed but redo a calming stint.