Coronavirus Pandemic Notice
Posted 7/4/20

Our Practice Updates General Covid-19 Updates
We are open for physicals and sick visits with safeguards in place to maintain proper social distancing within the office. Telehealth visits are available also, and they are covered by the insurance companies. As usual, we are available for advice 24/7.

All persons 2 years and up who enter the office must wear a face mask that covers both the mouth AND the nose.

We are seeing patients by appointment only.

We continue to have Saturday hours but not evening hours. M-Friday hours are 8-4pm.

To limit traffic in the office we request that only one adult accompany the child/children for the appointment(s). (Please do not bring extra children who do not have appointments.)

To maintain proper social distancing we have our patients using their vehicle as their own private waiting room until called to be escorted inside, one family at a time.

Well/Advance Rechecks are scheduled in the mornings and early afternoons while sick visits that cannot be managed by telehealth visits are scheduled in the late afternoons.

All patients are screened for:

  • symptoms of Covid-19 within 2 wks
  • travel to a Covid-19 “Hot Spot” within 2 wks.
  • a close contact:
    • with symptoms of Covid-19 within 2 wks.
    • who traveled to a Hot Spot within 2 wks.
    • under investigation for or quarantined for Covid-19 within 2 wks.
Appointments for well visits or advance rechecks are rescheduled if the screening above is positive.

We are not handling/exchanging forms nor payments within the office space. Please mail, fax, or send forms/papers through the patient portal.

Your family will be escorted out of the office one family at a time.

Employees are screened similarly prior to entering the office.

Our goal is to keep minor illness out of the office and urgent care centers, so please call for a Telehealth Visit.

We are not doing in-office testing for Covid-19.

The Center for Disease Control and the American Academy of Pediatrics endorse continued well visits to ensure that children stay up to date on their immunizations.

Refer to the Erie County Dept. of Health website for a list of Covid testing locations.

If you get tested, isolate as if you are positive until the results are reported as normal.

If there is a test-proven, positive Covid-19 case in your household refer to the Erie County Health Commissioner mandate (Health Alert Priority #355) for the proper quarantine procedure via this link: www.erie.gov/covid19.

The practice is not recommending Covid-19 antibody blood tests until more data is available on their accuracy and clinical usefulness.

Continue social distancing and good hand hygiene.

Do not send your child to daycare, camp, nor school with any symptoms of Covid-19 nor if he has had close contact with someone who has or is under investigation for Covid-19.

If you think your child has the Covid-19 virus he may be treated supportively at home. Regarding suspected Covid-19 illness, call if there is fever of 100.4 or higher longer than 72 hours or if there is shortness of breath, trouble breathing, or an extensive rash.

Everyone eligible for Flu shots should be vaccinated this season.


Just because we all are getting tired of the Pandemic, it doesn’t mean it’s over!
Everyone must do their part for the greater good.
If that is not inspiring enough, do it for your Nana and Papa!
Stay safe.
Thank You from the Providers and Staff of Genesee-Transit Pediatrics.

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Appendicitis

What is Appendicitis?

Appendicitis is the most common cause of an acute surgical abdomen in children. It occurs when the appendix, a small tube which protrudes from the large intestine, becomes acutely inflamed.

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What Causes Appendicitis?

Appendicitis is usually caused by some sort of obstruction of the appendix or it's opening (appendiceal lumen) by feces, any foreign object or body, or, in a few cases, a tumor. It can also be caused by a twist of the appendix, which can result in ischemic necrosis, a disease in which blood vessels are blocked by this twist so blood supply to the organs decreases and many cells die.

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Who Gets Appendicitis?

Though appendicitis usually occurs in children over the age of two years and peaks during the teen and young adult years, it can occur in infants and toddlers. The disease is more commonly found in males than in females. The exact incidence of appendicitis is unknown. In terms of genetics, appendicitis has been found to show a familial tendency.

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What are the Symptoms of Appendicitis?

The typical first warning sign of appendicitis is dull pain around the navel. The pain continues and often becomes more localized at the site of the appendix, downward and to the right side of the navel. Usually, pressure applied to this area will cause tenderness and pain. It is important to note that there is variability in the location of the appendix and so the location of the pain may also vary. A loss of or reduction in appetite is always present. Other symptoms may include: nausea, vomiting, and a low-grade fever, however, the vomiting never precedes the pain.

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What are Some of the Other Possibilities?

The differential diagnosis for appendicitis is extensive. In the case of gastroenteritis (commonly called the stomach flu), vomiting and diarrhea usually occur before the onset of pain. Constipation can often be confused for appendicitis however this its pain pattern is not located in the lower right quadrant of the abdomen. A pneumonia in the right lower lobe of the lung can present with symptoms similar to appendicitis. Other conditions that may mimic appendicitis are: Urinary tract infection, inflammatory bowel disease, sickle cell crisis, diabetic ketoacidosis, ovarian torsion, ectopic pregnancy, dysmenorrhea, Mittelschmerz, intussusception, Meckel's diverticulitis or post-surgical adhesions in the abdomen.

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How is Appendicitis Diagnosed?

If symptoms are present, the health care provider may perform tests while the patient is lying on his or her back to determine the severity and proximity of the pain such as: extending the right leg or rotating a flexed leg. A rectal exam may show right-sided tenderness. He or she may also choose to perform an abdominal ultrasound, an abdominal CT scan, or an exploratory laparotomy, a procedure using a small camera and an incision. Your health care provider may also choose to perform a chest x-ray, a complete blood count (CBC) and/or a urinalysis and urine culture. A pelvic examination may be indicated in a female adolescent with abdominal pain.

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How is Appendicitis Treated?

Most commonly, appendicitis is treated by a surgery called an appendectomy whereby the appendix is removed (open surgery). More recently, surgeons have performed laparascopic surgery whereby smaller incisions are made to pass a camera and surgical instruments. A systematic review of 5 studies in 436 children aged 1 to 16 years found that laparoscopic surgery significantly reduced the number of wound infections and the length of hospital stay compared with open surgery. The review did not find any significant difference between laparoscopic surgery and open surgery for intra-abdominal abscesses, in postoperative pain, and in the time to mobilization.

Another systematic review of several studies found that prophylactic antibiotics reduce the number of wound infections in children with complicated appendicitis compared with no antibiotics. Further studies are under way to determine whether antibiotics in children with simple appendicitis are indicated.

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What are the Complications of Appendicitis?

Due to the variability in symptoms upon presentation and the subsequent progression of symptoms in young children appendicitis sometimes is not diagnosed in time, causing the intestines to perforate before surgery can be performed. Other complications of the disease include peritonitis (an infection in the intra-abdominal fluid and tissues, and/or decay of the intestines (gangrene).

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Can Appendicitis be Prevented?

Studies have been done in adults whereby antibiotics were given to try to avoid surgery, but the recurrence rate was too high to make this a viable option. At the present time, there is no evidence that dietary or lifestyle regimens will help to prevent appendicitis.

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References

Hoekelman RA, Blatman S, Friedman SB, Nelson NM, Seidel HM. Primary Pediatric Care 1987 C.V. Mosby

Suerland SR, Lefering R, Neugebauer EAM. Laparoscopic vs. open surgery for suspected appendicitis. The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley and Sons

Milewczyk M, Michalik M, Ciesielski M. A prospective, randomized, unicenter study comparing laparoscopic and open treatments of acute appendicitis. SURG Endosc 2003; 37: 1317-1320

Reviewed 9/5/2009

By Daniel Feiten M.D.

Greenwood Pediatrics

Copyright 2012 Daniel Feiten M.D., All Rights Reserved

 

Transit Office Hours

4899 Transit Road Depew, NY 14043

Monday thru Thursday: 8am-7pm
Fri: 8am-4pm
Sat: 8am-12pm

(716) 558-5437