blog twincity pediatrics

Have you met our nurse practitioners?

We are delighted to have two extraordinary nurse practitoners, Danielle Keever and Whitney Ewing, as part of our team at Twin City Pediatrics. These wonderful providers are beloved by our patients and deliver quality and compassionate care to each child they see. For those of you who are unfamiliar with what a nurse practitioner does, here is a brief explanation.

A nurse practitioner (NP) is an advanced practice registered nurse (APRN) who is qualified as a medical provider having completed a Master's degree in nursing (MSN) and an additional two years of required clinical education. NPs diagnose medical problems, order treatments, prescribe medications, and make referrals for a wide range of acute and chronic medical conditions within their scope of practice. NPs tend to concentrate on a holistic approach to patient care, and they emphasize health promotion, patient education/counseling, and disease prevention. Most NPs maintain close working relationships with doctors and consult them as needed.


February 19, 2014

FYI: Does your child need ear tubes?

Ear infections are very common in children.  For most children who have an occasional infection here or there, antibiotics may be all they need (and many mild infections may actually go away on their own without any antibiotics - for more details about this please see Dr. Brown's prior blog post on ear infections).  But other kids, who get one ear infection after another, may need ear tubes (also called tympanostomy tubes).  

So which kids need ear tubes?  New guidelines were published several months ago to help us determine if your child should see an ear specialist (an otolaryngologist) to discuss ear tubes. We look at a few factors.  First, we consider the frequency of ear infections:  more than 3 infections in 6 months or more than 4 infections in 12 months.  But the new guidelines highlight one additional factor aside from how many infections.  The experts only recommend tube placement for kids with frequent ear infections who have fluid that stays behind their ear drum for more than 3 months.

So...why does fluid matter? When fluid builds up behind the eardrum (as happens when someone is congested with a cold), it is supposed to drain into the back of the nose through one's Eustachian tube.  But in kids, their Eustachian tubes are narrower and more horizontal than adults so they don't drain well and easily get clogged.  When the fluid stays there, it often creates an infection (and pain!) and also decreases hearing (because it acts like glue and keeps the ear drum from vibrating like it supposed to in response to sound waves). 

The tube works by equalizing pressure behind the ear drum and allowing the fluid to drain out. No fluid = fewer infections and better hearing (which also means better speech).  See this video for a great visual demo of how these tubes work.

The tiny, hollow, plastic tubes (about 1/20 of an inch wide) are inserted via a small incision in the eardrum.  The procedure is typically very quick (usually less than 20 minutes) and kids go home that same day.  

If your child has frequent ear infections, talk to us about whether or not they may need ear tubes!