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2017 Aug

Remember the Physical

Don’t you just love the end of summer—long relaxing days at the beach, cook-outs with friends, and that nagging feeling that it’s time to prepare for the return to school…what, already? The to-do list is long. There’s clothes shopping since your munchkin has grown out of last year’s outfits. Plus you’ll need to stock up on school supplies. But there’s one other thing you need to take care of: your child’s school physical and necessary vaccines.

All children need a yearly physical. In addition, there are a few important years when you cannot start school or sports without an up-to-date complete physical exam. Don’t worry—it’s not too late. Call your pediatric healthcare provider today and make that appointment.

Kindergarten is a special time for you and your child. The beginning of school is indeed a grand occasion, unless you forgot to get your child a kindergarten physical! Did you know that children cannot start school without a complete physical and up-to-date vaccine record? During the physical your child will be checked head to toe. The healthcare provider will go over dietary needs, rest, exercise, and address any concerns you may have. Your child’s vision and hearing will be assessed.

Necessary booster vaccines before kindergarten can be given between the ages of 4 to 5 years and include the Dtap (diphtheria, tetanus, and pertussis/whooping cough), IPV (polio), and the MMRV (measles, mumps, rubella and varicella). The flu vaccine is also strongly recommended. Vaccine side effects are usually quite minimal and may include redness and soreness at the injection site and possibly a mild but brief fever. A school physical form will be completed.

If your child plans to play a sport this year, then you will need a sports physical. A sports physical must be completed yearly. Your child will need to be weighed and measured to evaluate the Body Mass Index. This determines if your child is at an appropriate weight for his or her height. Blood pressure is checked as well. A special series of screening questions is completed tailored specifically for athletics. A complete physical examination is performed and needed vaccines can be updated.

Before beginning middle school, children aged 10 years or older are required to have a Tdap vaccine. This protects against tetanus, diphtheria and pertussis (whooping cough). A complete physical examination may be needed as well if it’s been over a year since the last physical.

Middle schoolers tend to fear the pain of vaccines more than any other age group. Why? I suspect it’s because they haven’t had a vaccination in a while and they feel afraid. You see, the vaccine has become much bigger and scarier in their memory than it really is. I tell them, “You are fearing a dinosaur bite, but it’s really more like a mosquito bite.” They often cry in anticipation of the vaccine, but afterwards say that it barely hurt and leave the office laughing.

Public schools require a copy of an up-to-date vaccine record to begin middle school. Children 11 years or older should receive the Menactra vaccine to protect against life-threatening meningitis. HPV, which protects against cancer from the human papilloma virus, is recommended. A Hepatitis A vaccine, which protects against food borne hepatitis, is also recommended. Flu vaccine is strongly recommended. Why miss a week of school (and work) due to influenza?

Before sending that sweet child, I mean young adult, away to college, he or she will need a college physical. These exams are specific to each university so it is essential that you print out and bring in a copy of the required physical form to the visit. Some universities require a complete physical exam, which is a good idea if your young adult has not had one in over a year.

Pediatric providers will see your child until age 21. This is a good time to address common concerns for the age. The provider usually asks the parent to step out in order to be able to answer any confidential concerns. Patients over age 18 may be seen without a parent present, although it is encouraged that parents attend the visit to guide and support the young adult with healthcare decisions.

Vaccines generally needed prior to college include both a Menactra and Meningitis B vaccine to protect against different strains of life-threatening meningitis. Flu protection is strongly recommended as a week of influenza can side track even the brightest college student. Any missing vaccines can be caught up as well. Some programs require a PPD to test for tuberculosis. College students are always welcome to return over holiday break if they have any healthcare concerns or need booster vaccines. The last thing I tell my pre-college patients is to get proper rest, eat vegetables, drink water, and study more than you play.

This is an exciting and important time of preparation in your child’s academic life. After getting that physical out of the way, you can relax at the beach knowing that your child is well protected against diseases. See you in the office!

Dr. Melanie J. Wilhelm DNP CPNP is a Doctor of Nursing Practice, and a Certified Pediatric Nurse Practitioner at Pediatric Specialists in Norfolk. Her first book, Raising Today’s Baby, is available on Amazon or at www.RaisingTodaysChild.com. You may email her at raisingtodayschild@gmail.com. Follow her on facebook and twitter @DrMelanie4kids.

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