The PediaMag Summer 2021

YOUR HOME FOR QUALITY PEDIATRIC CARE • SUMMER 2021

Fun in the Sun:

WATER SAFETY

Welcome to The PediaMag.............. 2 SUMMER FUN Summer Camp Revamped............... 4 Fun in the Sun: WATER SAFETY....... 5 SUMMER SNACKS Taming the Snack Habit................... 6 Smart Summer Snacking................ 7

SCOLIOSIS SCREENING Scoliosis Screening Explained......... 8 OUTDOOR AWARENESS Tick bites........................................ 10 SUMMER ACTIVITIES Summer Fun Awaits........................ 11 SPORTS MEDICINE Pre-participation physical examinations..................... 14 AHN School Sports Medicine Program........................... 15

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Welcome

Welcome to The PediaMag Summer 2021 is upon us, and COVID-19 restrictions are beginning to ease. We are all looking forward to a return to summer fun – swimming, picnics, playgrounds… and vacations!

Fun in the sun is a great way to spend the summer, but we must remember to enjoy the outdoors safely. In this issue you will find expert advice on how to stay safe in the pool or at the beach. Dr. Ashley Loboda from AHN Pediatrics St. Clair, who spent her teenage years as a lifeguard, shares her experience and expertise on water safety. Dr. Brian W. Donnelly from our Northland offices tells us how to enjoy our time in nature while remaining safe from tick bites.

And Karen Richards, LAT, ATC from AHN Sports Medicine advises us on the importance of pre-participation physicals for our children who play sports. In addition, you will find information about Scoliosis from Dr. Ryan Sauber at the Pediatric Orthopedics Institute and much much more.

So pull up a lawn chair in the shade of a tree or beach umbrella, grab a cold water or lemonade, and dive into the Summer 2021 issue of the PediaMag.

About Us: Pediatric Alliance was formed in 1996 when eight individual practices joined together to provide quality health care throughout Southwestern Pennsylvania. Over the years, Pediatric Alliance grew to be the largest physician-owned group pediatric practice in the area. In 2019, Pediatric Alliance joined with Allegheny Health Network to allow expansion of resources in order to stay abreast of the latest technology and advances in health care. Our board-certified pediatricians offer primary care to children and adolescents in 18 offices in the Pittsburgh and Erie areas including 14 primary care offices and 4 specialty offices - Allergy, Endocrinology, Developmental Pediatrics, and Dermatology.

We are proud to offer personalized, patient-centered care to patients from birth to 21 years of age. We strive to meet your family’s pediatric needs, provide convenient access to care, and build strong relationships with families to maximize your child’s health.

To learn more about AHN PediatricsPediatric Alliance, visit our website at www.ahnpediatrics.org.

AHN Pediatrics-Pediatric Alliance 1100 Washington Ave., Suite 219 Carnegie, PA 15106 www.ahnpediatrics.org

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The PediaMag is published quarterly, copyright 2020. All rights reserved.

Publisher AHN PediatricsPediatric Alliance

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

Editor Rebecca Scalise

Art Director Brent Cashman

New & Expectant Parent Classes Increase your knowledge and confidence as you prepare for the birth of your baby. Receive helpful tips to calm a baby, ease fussiness, and much more!

Advanced registration is required for these complimentary classes. Make sure to register early to reserve your space. www.AHNPediatrics.org

All classes are free and conducted online via Zoom. Login information is provided up on confirmation of registration. Visit www.AHNPediatrics.org for class schedules and registration.

BABY BASICS

BREASTFEEDING 101

Expectant parents can meet with a physician and receive basic information about the care of their newborn and what to expect while they are in the hospital.

Expectant moms and their partners can meet with a BoardCertified Lactation Consultant and gain knowledge on how to successfully initiate breastfeeding from day one.

JOURNEY TO TABLE FOOD

BREASTFEEDING: REWARDS AND REALITIES

Starting solids can be scary! There is so much information about what to feed baby, when to feed baby, and how to feed baby, that it can be overwhelming. This fun and informative discussion will help you understand the role of complimentary foods in your baby’s first year of life and navigate the best feeding choices for your baby and family.

Learn all about the how-to’s and benefits of breastfeeding, both short-term and long-term, for Mom, Dad, and baby.

Be aware of some challenges you may experience breastfeeding to be prepared for your journey and make decisions about your baby’s feeding.

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

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Summer Fun

Summer Camp Revamped

By Michael Petrosky, MD – AHN Pediatrics Arcadia

Temperatures are climbing and the school year is ending. This means it is time for summer camp season. With the pandemic consuming almost all of 2020 and the skyrocketing numbers of mental health, social, behavioral, and developmental issues, summer camp can be a much needed respite. Even with COVID cases declining and vaccine administering climbing, going to camp does have additional risks.

To go or not to go is a personal decision and everyone in the family should have some comfort with the choice. Is the experience and socialization worth the possibility of being exposed or contracting COVID? Unfortunately, there isn’t a universal answer to this question.

It should be decided on a case by case basis with decision being centered on both the camper and the camp itself. Hopefully some of the information you find below will help guide you to the decision that is best.

Camp this summer should look different than before the pandemic. If it doesn’t,

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that should be a red flag signifying that it may not be the best option at this time. I encourage parents/guardians to ask the camp questions or get information on a number of topics.

Are vaccines required for campers/ staff? This depends a lot on the age of the campers as right now children under the age of 12 are not eligible for the vaccine. If not required, what percentage of the staff is vaccinated? We know the higher this number is, the safer camp should be.

What is the camp’s masking policy?

Science has showed that masking is effective in preventing the spread and contraction of COVID-19. It still remains one of the best tools we have for those that who have not received a vaccine. See if there is any difference in masking for those vaccinated vs. unvaccinated. I also recommend knowing what happens if a camper doesn’t follow the rule. Safer camps have strict guidelines in this regard.

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

Despite all the safeguards and restrictions that camps may put in to place, no one can guarantee that an individual won’t get sick or acquire COVID. For this reason, the camp must have a policy in place to handle the situation if/when it arises.

Where will the camper get tested to see if it is COVID or not? Will the camper be sent home right away or be isolated first? How will the camp staff determine exposure, and what happens to exposed campers?

There should be a difference in individuals who have received the vaccine as those with immunity don’t need to isolate/quarantine while asymptomatic.

Camp can be a great time to learn, grow, develop friendships, and have fun.

These are all vital things in a child’s life.

However, safety is also paramount. I encourage you all to consider and really think about summer camp this year. Once you understand how camp will run this year, make the best decision for you and your family.

Fun in the Sun: WATER SAFETY

By Ashley Loboda, MD – AHN Pediatrics St. Clair

Drowning is the leading cause of accidental death in children ages 1-4 and is one of the top 3 causes of accidental death for rest of childhood1. Drowning is preventable! As a former lifeguard, swim coach, and pool manager, I have witnessed how quickly and silently drowning can occur. As a pediatrician, taking care of a child after a drowning or near-drowning event can be devastating. As a mother of four young children, I also know just how easy it is to be distracted at the pool, beach, and boating. It is important to teach all children water safety from a young age and to teach them to swim.

Tips for keeping your kids safe by the water this summer2: 1. Constant Supervision - many times it is not a lack of supervision but a lapse in supervision that results in a drowning accident; designate one adult to be the “water watcher” in 15 minute shifts; children who cannot swim should always be within arm’s reach of an adult when in the water.

2. Back Floating - children should be taught to roll onto their back and float face up; find a swimming program that teaches this skill; floating is a crucial life saving technique.

3. Keep Water Areas Secure - pool fences should have self-closing and self-latching gates; install high locks and alarms on all doors and windows that give access to the water area; remove the temptation of water toys or any object in the water when not in use.

4. Learn CPR - American Heart Association www.heart.org 5. Check the Water First - if your child is missing, always check the pool or nearby water areas first.

6. Beach Safety - check out water conditions before entering the water; swim in an area with a lifeguard; teach your child how to survive if caught in a rip current; dress your child in bright colors.

7. Boating Safety - all children should wear a Coast Guard approved life jacket; check to see that the life jacket will float your child face up; make sure that there is one life jacket for every person on board a watercraft.

Outdoor water fun is a favorite way to beat the summer heat. Let’s make it one of the safest ways as well.

CDC: Injury Prevention & Control ParentsPreventingChildhoodDrowning.com

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AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

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Summer Snacks

Taming the Snack Habit

By Jennifer Yoon, RDN, LDN, IBCLC – AHN Pediatrics St. Clair

Helping kids to listen to their body for real hunger and satiety is an important skill in establishing healthy eating and snack habits. Real hunger comes from the stomach and not the head. Real hunger is not related to being bored, tired, stressed, thirsty, or otherwise wanting to eat. Satiety is the absence of hunger. Satiety is not fullness.

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AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

The hunger and satiety scale is a tool for helping children learn to eat when hungry (and only when hungry) and stop when satisfied.

Before eating and throughout the meal or snack, children should check in on their hunger and satiety number. Hunger numbers of zero though 4 indicate varying degrees of hunger. A hunger number of 5 is neutral. A satiety number of 6 is satisfied. 7 or greater indicates degrees of fullness. Ideally, we start eating when we are a 3 or 4- hungry but not starving. Starting to eat at a 0-2, we are too hungry to make good food choices, we eat too fast, and often do not realize we are overly full until it is too late. If we are starting to eat in the absence of hunger, we are eating for reasons other than hunger. If the hunger number is 5 or 6, the reason for wanting to eat – boredom, fatigue, stress, thirst- should be managed with activity, rest, hydration, stress relievers.

In order to properly listen to the body’s hunger and satiety cues, encourage children to eat slowly and drink water throughout the meal. Try only eating while eating! Remove distractions during meals and snacks. Avoid snacking while watching TV or playing video games as this encourages mindless eating. Just enjoy the food and check in with your body.

Ideally we stop eating when we are around a 6- no longer hungry, but not full.

Healthy choices such as whole grains, fruits, vegetables, and lean proteins increase the satiety factor and can keep hunger from returning too soon. Though true hunger cues should be honored, a balanced meal or snack should keep hunger away for 2-3 hours.

Training kids to manage emotions without food, eat when hungry, and stop when satisfied, will contribute to a lifetime of healthy eating habits.

Smart Summer Snacking

By Jennifer Yoon RDN, LDN, IBCLC – AHN Pediatrics St. Clair

Summer fun is often accompanied by summer snacking. Time at the pool, outdoor play, sports, parks, and play dates usually include snacks. Not to mention time at home and the inevitable boredom resulting in cries of “I’m hungry!” Help kids make healthy choices and learn some healthy habits this summer using these healthy snacking tips and tricks: 1. Grains such as chips, crackers, and granola bars often top the list of snack choices. Choose products with whole grain listed as one of the first 3 ingredients and less than 10% of the daily value of fat. Portion the snack using the recommended portion size.

2. Have veggies on hand for a healthy snack. Cut cucumber, sweet peppers, celery, and summer squash to have on hand for snacking. Grape and cherry tomatoes are a fun and easy snack.

3. C ut fresh fruit for easy grab and go snacks. Fruits such as grapes and berries are also delicious frozen!

4. P air lean proteins with snacks to increase the nutritional value and balance. Proteins also are more satisfying and keep hunger at bay.

Turkey, chicken, or lean ham sliced thick from the deli can be cut into cubes.

One tablespoon of peanut butter can be added to crackers or used for dipping.

Hummus is great with cut veggies.

5. D airy is also a great way to increase the balance, nutrition, and satiety factor. Dip or mix fruit with yogurt or freeze for a low fat frozen treat. Let kids help create yummy summer treats using the fruit parfait or yogurt ice pop recipes below. Include a few small pieces of cut up cheese with crackers, fruit, or veggies.

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

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Scoliosis Screening

Scoliosis Screening Explained

By Ryan Sauber, MD – AHN Pediatric Orthopedic Institute

A little information can be a dangerous thing. An observant school nurse or a thorough Pediatrician during an annual wellness visit says there is something wrong with a child’s spine and it needs to be checked out. Few referrals bring about more confusion, concern, and sometimes outright terror than a referral to a spine surgeon for scoliosis. Visions of stiff braces, years of doctor appointments, and long surgical scars immediately come to mind.

Parent and child alike flock to the internet for their research. Facebook groups, YouTube channels, and various other social media outlets provide hours upon hours of information, but how much of it is reliable or even relevant? Luckily, a national campaign seeks to change all of this.

Scoliosis Awareness Month is celebrated by patients and their families each June to help improve the world’s understanding about the disease, to recognize its symptoms, encourage early detection and effective treatment. Despite affecting up to 5% of

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the adolescent population and perhaps more than 25% of the adult population, scoliosis remains a bit of a mystery to most Americans. Multiple medical societies including the Scoliosis Research Society (SRS) are pushing to bring the disease to light and

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

encourage people to seek treatment. Part of this educational campaign is to raise awareness regarding the benefits of early detection and treatment to prevent the need for surgical intervention.

Surprisingly, the idea of screening for scoliosis is actually controversial. In 2004 the United States Preventative Services Task Force (USPSTF), recommended against routine screening for scoliosis in adolescents without symptoms of the disease. Their decision was based on lack of evidence that screening led to early detection of the disease, and some evidence to suggest that screening could lead to harm based on overtreatment. Multiple professional societies came out against this ruling by the USPSTF. The SRS, American Academy of Orthopaedic Surgeons (AAOS), Pediatric Orthopaedic Society of North America (POSNA) and the American Academy of Pediatrics (AAP) came out against this recommendation. While there are some potential downsides of over-diagnosis, the benefits of early detection and treatment can be substantial. These societies put together a joint statement recommending the screening of adolescent females twice, at 10 and 12 years of age, during an annual wellness visit, and in males once at 13 or 14. They specified that the screening should be done by a well-qualified individual and should consist of forward bend testing, with the use of a special instrument called a scoliometer, and a thorough history and physical exam.

Widespread screening certainly can lead to over-treatment including excessive specialist referrals and unnecessary radiation. Fortunately, not all patients who are referred to a pediatric spine specialist need surgery or even x-rays. If x-rays are

required, new technology has been developed, like the EOS system, which allows for evaluation of the entire spine with a fraction of the radiation. Using this technology, 3D models of the entire spine can also be created to help with patient education, treatment decision making, and surgical planning. This has significantly reduced the amount of radiation patients with scoliosis are exposed to during their treatment.

Once the diagnosis of scoliosis is confirmed, early treatment can be instituted to decrease the likelihood that surgical intervention will be necessary. A specialized type of exercise with the help of a physical

therapist may be recommended for a child with scoliosis. In addition, for spinal curvatures which represent a higher risk, a custom made, 3D modeled brace may be prescribed.

The newest generation of braces for scoliosis provide strong curve correction while allowing for greater comfort to the wearer. Newer braces can also be worn below loose-fitting clothes making the child feel at ease while at home or in social situations.

It has never been safer to be screened or treated for scoliosis. While over-treatment is always a concern, pediatric spine care providers are hard at work coming up with new ways to decrease the risk of

scoliosis care. The spinal deformity team at the Pediatric Orthopaedic Institute in Wexford provides multidisciplinary care in a single location focused on aggressive nonsurgical treatment. With the state of the art EOS imaging system, on site physical therapy and bracing specialists, and multiple experienced providers who provide same day appointments, AHN is seeking to provide world class scoliosis care in a comfortable setting. We are committed to educating the community about scoliosis throughout the month of June and hope that you will also take some time to spread the word.

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

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Outdoor Awareness

Tick bites

By Brian W. Donnelly, MD – AHN Pediatrics Northland

It’s summer time, and the beautiful summer weather provides us the opportunity to get out of our houses and enjoy nature. As we picnic and play in the grass and hike in the woods, we often pay little attention to the little hitchhikers that can ride home on us and our pets. Let’s talk about ticks.

Ticks are arachnids. Arachnids are joint-legged invertebrates (arthropods) that have four pairs of legs, and two body regions, a cephalothorax and an abdomen.

Spiders, scorpions, and mites are also arachnids. Ticks have a 4 cycle life stage: Egg, 6 legged larva, eight legged nymph, and adult. The cycle lasts about 2 years.

After hatching, each stage requires a blood meal. Most ticks actually die because they aren’t successful in finding a host.

Ticks come to our attention because they try to attach themselves to our bodies or to the bodies of our pets. When ticks attach to a body, they are looking for a

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blood meal. Their strategy, once they have attached to an unsuspecting host, is to find a suitable place on that host to feed. They tend to seek the warmest places, which, for us, are often hidden areas, like the nape of the neck, the scalp, the groin or the armpit.

They secrete an anesthetic in their saliva, so the entry through the skin and into the blood vessel is undetected. They can then suck the host’s blood for several days. Once finished, they detach and move on to their next life stage. Tics are most active during the warmer months, generally from April to August, but have been spotted during the cooler months too.

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

We are concerned about tick bites for a few reasons. To start with, most of us are not that generous about sharing our precious blood with arthropods (which includes insects), even if we are impressed with how deftly they can perform surgery on us. But the bigger reason we care is the chance that they happen to inject us with bacteria that can cause other diseases. Most tick bites are harmless, but some can cause humans a lot of misery.

Ixodes scapularis, which is commonly called the blacklegged tick (or deer tick), is known to spread Borrelia burgdorferi, the Lyme disease bacteria. Deer ticks are very common in this area. In other parts of the country, different ticks can transmit the Lyme disease bacteria. For example, Ixodes pacificus, or the western blacklegged tick, spreads B. burgdorferi on the Pacific coast.

Ixodes scapularis are infamous for being quite small. The adult tick is approximately the size of a sesame seed, while the nymph is roughly the size of a poppy seed.

The tick that harbors dangerous bacteria can transmit them at any life stage, but nymphs and larvae are so small that the concern for them eluding our detection is greatly magnified. The only good news here is that the deer ticks must be attached for at least 36 hours to transmit the bacteria to us, so there is a window of opportunity to find and remove them.

If you find a deer tick, the best approach is to remove it with tweezers. Grasp the tick as close to the skin as possible, then pull it out with a slow, upward motion. Avoid twisting or squeezing the tick. Do not apply petroleum jelly, fingernail polish, or a hot match to the tick. If possible, save the tick

in a plastic bag, then store it in the freezer. If there is a question about the tick bite later, this could be useful.

Wood ticks, known scientifically as Dermacentor variabilis, are also very common in these parts. These are significantly larger than deer ticks, so are likely better noticed by us. These ticks will not spread Lyme disease, but they can harbor the causative agents of Rocky Mountain Spotted Fever (and other similar rickettsioses), tularemia, anaplasmosis, and ehrlichosis. Wood ticks can also induce a condition known as tick paralysis, where the attached tick produces a neurotoxin that can induce a rapidly

progressive flaccid quadraparesis (limp muscles that lack firmness). This terrifying condition can be cured by simply detaching the hungry arachnid.

Preventing tick bites can involve a few strategies. Keeping the grass cut short around the house can decrease the amount of mice in your yard. Mice are favored hosts of the deer tick. Some animals are proficient at eating ticks, among them chipmunks, squirrels and opossum. Ladybugs, ants, and spiders can feast on ticks. Birds that live on the ground – chickens, ducks, guinea fowl, wild turkey and peacocks – are known to gobble them up too.

Tick repellent chemicals can be applied to the skin before a possible exposure (like a walk in the woods … or the backyard). DEET, picaridin, lemon eucalyptus oil, and IR3535 (a plant based chemical) have all been shown to be effective. Permethrin (derived from the chrysanthemum) can be applied to clothes.

Checking your body (or your child’s body) for ticks is crucial, either after being outside or before going to bed. Finding the tick and removing it before it can transmit any bacteria is the preferred approach. If you have any questions about when to see your pediatrician about a tick bit, please don’t hesitate to call our offices.

Summer Activites

Summer Fun Awaits

By Ned Ketyer, MD – Editor, www.ThePediaBlog.com

Two weeks after its previous update, the Centers for Disease Control and Prevention issued new guidelines for people who are fully vaccinated against COVID-19.

The new rules are clear: > If you are fully vaccinated, you can resume activities that you did before the pandemic. > Fully vaccinated people can resume activities without wearing a mask or physically distancing, except where required by federal, state, local, tribal, or territorial laws, rules, and regulations, including local business and workplace guidance. > If you haven’t been vaccinated yet, find a vaccine.

The recommendations reflect the reality that all three COVID-19 vaccines approved for emergency use and distributed in the U.S. for the last six months are extraordinarily effective in preventing serious disease from SARS-CoV-2. The evidence is also stronger that fully vaccinated people are unlikely to have asymptomatic infection or transmit the virus to others. While it’s still not known just how long protection from the vaccine will last, or how much the vaccines prevent emerging variants of the virus, it is clear that vaccine efficacy doesn’t fade quickly.

People are considered fully vaccinated two weeks after the second dose of the Pfizer and Moderna vaccines, or two weeks after the single-dose Johnson & Johnson vaccine.

Fully vaccinated people can be reassured

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

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Summer Activites

that it’s safe to resume all outdoor and indoor activities without observing precautions: > Indoor and outdoor activities pose minimal risk to fully vaccinated people. > Fully vaccinated people have a reduced risk of transmitting SARS-CoV-2 to unvaccinated people. > Fully vaccinated people should still get tested if experiencing COVID-19 symptoms > Fully vaccinated people should not visit private or public settings if they have tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms. > Fully vaccinated people should continue to follow any applicable federal, state, local, tribal, or territorial laws, rules, and regulations.

It’s important to stop here and say that these new guidelines are meant for vaccinated people only. Nothing has changed for people who are not fully vaccinated yet, or those who choose to remain unvaccinated.

Instead, they must proceed with caution; prevention measures (wearing face masks in public, social distancing six feet apart, hand washing) are required for most outdoor and all indoor activities. For example, unvaccinated people can “walk, run, wheelchair roll, or bike outdoors with members of your household” without wearing a face mask.

Attending “a small, outdoor gathering with fully vaccinated family and friends” without a face mask is also permitted. For everything else, the risk of transmitting the virus or getting sick from it remains high and masks must be worn.

In situations where unvaccinated and vaccinated people gather together indoors and outdoors, the prudent policy during a global pandemic is to follow commonsense layers of protection and have everyone mask up and keep their distance from one another. Unless venues like stores, restaurants, and theaters can effectively separate those who are vaccinated from those who aren’t, it would be wise for everyone to wear a mask and stay socially distant in public indoor spaces. Having to show proof of vaccination isn’t a practical solution.

Nor is trusting those who choose to remain unvaccinated to do the right thing and protect others by wearing a face mask or just staying home.

Pediatrician Jaime Friedman reminds her patients that things aren’t back to normal… yet: Curious about the new CDC mask guidelines? Many of us are. On the one hand it will be nice to feel “back to normal”. On the other hand, you don’t know who is vaccinated and who isn’t and the vaccine doesn’t prevent 100% of infections, just severe illness and death. Furthermore, children under 12 can’t be vaccinated and 12-15 year olds are just staring to get their shots.

So, I will still wear my mask in the office and in public (indoors or if closely gathered outdoors). I will also recommend that unvaccinated children over the age of 2 continue to wear masks and all children continue to avoid gathering close with other children or unvaccinated adults.

We are almost there you guys!

Don’t give up yet!

The best solution for a rapid return to normalcy is for every American 12 and older to get the vaccine as expeditiously as possible.

Don’t delay! Summer fun is waiting!

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AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

Choosing Safer Activities Accessible link: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/participate-in-activities.html

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

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Sports Medicine

Pre-participation physical examinations As a parent, you want to keep your children safe on and off the field. There are many steps we take to prepare our children for the season, but the first step is to make sure they are physically ready and able to participate. Many youth leagues do not require a physical exam for participation, but most strongly recommend them to keep your child safe and playing to the best of their potential.

According to the American College of Sports Medicine, the purpose of a physical examination is to provide the schools and organizations that your child plays for with all information pertaining to your child’s health and wellbeing. The goal of the exam is to identify any medical or orthopedic problems as well as any correctable problems which may impair performance, and assess your child’s fitness level pertaining to their sports.

If any problems are identified, then your child can be referred to the correct specialist to resolve these issues before their season begins.

The Pennsylvania Interscholastic Athletic Association (PIAA) requires that, starting with middle school sports, student athletes who would like to participate in PIAA sanctioned sports must have a completed Comprehensive Initial Pre-participation Physical Examination (CIPPE) before the official start date of their sport. This examination must be done by an authorized medical examiner and be completed no earlier than June 1 of the academic year. The exam will remain valid through May 31 of the following year.

The CIPPE form may seem like a very long and tedious process, but taking the time to read and fill out each section with your child is an important step in ensuring their safety and well-being when it comes time to play. These forms will cover every-

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thing from general demographic information to past and present medical history. It is important to read each section carefully in order to answer to the best of your ability.

The exam consists of both a medical and orthopedic section. The medical section will assess your child’s vitals as well as a review of their internal systems, including cardiovascular. The physician will check your child’s heart to identify if they may be at a higher risk for cardiac issues. A large part of

the medical exam is dedicated to reviewing your child’s medical history. Adequate time and consideration should be taken when filling in the medical history section (Section 6) of the PIAA CIPPE, as this is one of the most important pieces of information for the exam.

This will cover not only your child’s medical history, but also your immediate family history, which is very important and relevant in regards to your child’s health. Presence of an illness within your child’s immediate family may predispose your child to the same condition. When filling in this section, make sure to provide an explanation for the questions to which you answer yes. It is also

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

important that your child understands what is on this form, especially if you are not going to be with them for the examination.

The orthopedic section of the exam will allow the physician to examine the musculoskeletal system in regards to your child’s ability to perform in their sport. Any previous injuries, or if you child is currently being treated for injury, should be disclosed on the history section of the exam. Muscular range of motion and strength, as well as the neurological system, will be assessed. This exam may result in your child needing to follow up with an orthopedic specialist to identify and / or correct any musculoskeletal deficits.

The other sections of the CIPPE include signatures of both the parents and students acknowledging the responsibilities and risks of athletics. New sections have been included over the past few to years to explain the importance of concussion awareness, cardiovascular health in athletics with the addition of Peyton’s Law in Pennsylvania, and CoVid 19 awareness and information.

There is also a section dedicated to athletes who wrestle and guidelines in regards to minimum weight classes.

As a parent or guardian of a young athlete, take the time to use the Comprehensive Pre- Participation Physical Examination as an opportunity to help your athlete excel on the field. The goal is not to disqualify your child from participation, but to protect them when they are out there on the field of play and allow them to succeed to the best of their ability.

Karen Richards, LAT, ATC Senior Athletic Trainer Allegheny Health Network North Catholic High School

AHN School Sports Medicine program > Athletic training

> Team physicians

> Therapy and rehab

> Sports performance

> Concussion care

> Sports medicine app

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org

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MyChart

Now that Pediatric Alliance is part of Allegheny Health Network, we’re moving from Patient Portal to MyChart.

MyChart is a secure online platform that gives you a quick and easy way to connect with our office: • Book appointments • View test results • Communicate with our care team • Request prescription refills • Review your child’s health history • Pay bills and view statements

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Follow these steps to register for MyChart now: 1. Visit mychart.ahn.org and click “Sign Up Now.” 2. O n the next screen, under “No activation code?” click “Sign Up Online” and follow the onscreen prompts.

3. Once you’re logged in, click “Profile” in the top right and then “My Family Access.”

4. Based on your child’s age, follow the instructions to get proxy access.

AHN Pediatrics • Summer 2021 • www.ahnpediatrics.org