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Home > Portable Practical Pediatrics > Interesting Conversations w/ Parents -January 2016 (Pedcast)
Podcast: Portable Practical Pediatrics
Episode:

Interesting Conversations w/ Parents -January 2016 (Pedcast)
Category: Kids & family
Duration: 00:00:00
Publish Date: 2016-01-03 19:05:40
Description: Topic Introduction I must say, I have such a fascinating job! I get to talk to so many bright interesting parents and children--and they are full of questions, information, and observations. I have always found that people, and that includes me, love to learn new things and a medical visit provides a great opportunity for this to happen.  That's why I started this series of pedcasts that I call "Interesting Conversations".  The first such pedcast I did a few months ago turned out to be very popular so here I go again with interesting questions and topics my patients bring up in conversation. I hope you enjoy this edition of Portable Practical Pediatrics. Oh, I'm sorry. how rude of me. I didn't introduce myself.  I am Dr. Paul Smolen, a board certified pediatrician practicing in Charlotte NC. I invented this blog as a experimental way to better communicate with my patients and their families. So here goes with the next installment of Portable Practical Pediatrics. Musical Introduction   Conversation 1: Length of time a child with strep remains contagious after treatment? The other day a family asked me how long one is contagious with strep throat after treatment has begun? This is certainly a very relevant question for families ready to get back to life when their child contracts strep throat. Well the standard answer you will hear from pediatricians is 24 hours and I think this is a good rule of thumb, with a few caveats.  Consider the fact that bacteria can double their numbers every 15 minutes.  That's 96 doublings every day, certainly enough time for a small number of strep bacteria to become many, many, many, in your child's tonsils!. Well, that's true in the opposite direction as well--the billions of strep germs that are in your child's tonsils can become a very small number and disappear quite rapidly after treatment is begun.  A few doses of antibiotics and strep is history. There was even one study I came across that said if a child had a dose of antibiotic as late as 5pm in the day, they could attend school the next day without risk of infecting other children. But, and this is a very big but, strep can live in colonies called biofilms for at least a month on surfaces that an infected child has touched. So your child who has been treated may not be shedding strep germs anymore, but they likely left the strep germ on lots of surfaces at school and at home that might infect someone else. In fact, I used to moonlight for a pediatrician/microbiologist when I was a resident, who would collect his strep swabs all day long and not plate them for a many hours after the patient had gone home. He told me that strep lives on surfaces for a long long time, and he was right.  Strep is not a fragile germ, rather a touch street fighter type of microbe. The truth is that most children who get strep right after having been treated with antibiotics, are getting reinfected rather than the treatment being a failure. Conversation 2: Hearing impaired infant with amazing visual contact of examiner. Related? I recently saw a child whose mother brought her to my office because she was worried about whether she had normal hearing. The child, like all children in the US, had her hearing tested at birth with a device called an OtoAcoustic Emissions device or OAE testing. This device essentially puts a click into the ear and listens for the echo. If the inner ear apparatus is intact and functioning, there will be a solid echo sent back. If the child does not have a functioning inner ear, there will be an abnormal echo. Now this child had passed the OAE in the state in which they were born, Connecticut. But this family had many hearing impaired members, including this child's brother. This mom just thought something was wrong with her daughter's hearing.  Interestingly, I noticed that while we were talking about her daughter's hearing that this six month old child wouldn't take her eyes off me.
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