Effective March 31st, 2012, Nicole Tran, D.O. from our Ladera Ranch office will no longer be affiliated with Southern Orange County Pediatric Associates. We are saddened that Dr. Tran will not be a part of our SOCPA team, however we wish her and her husband-to-be only the very best in their newest adventure in life!  The following is a message from Dr. Tran:

Dear SOCPA parents, patients, and families,

It is with much excitement and joy that I announce the wonderful news of my upcoming wedding and move to San Francisco this April to begin this next chapter in my life. It has been a true blessing and honor to be part of the SOCPA family and to serve our community as a SOCPA pediatrician. Thank you for entrusting me with the care of your children and allowing me to watch them grow while tending to their illnesses.

Being a pediatrician is such an incredible privilege because you are given the responsibility of taking care of these precious little babies from the moment of birth, continuing the care with their siblings, and counseling their parents every step of the way. So in essence, you participate in the care of the entire family and in doing so, you are able to grow with the family throughout the years. In no other profession are you given such an intimate and amazing role in the lives of these dear little ones throughout their childhood! Thank you for giving me this precious gift of becoming part of your families during my years at SOCPA.

I am truly grateful to have worked with such an outstanding and compassionate group of providers, remarkable administrative team, and exceptional staff here at SOCPA! I know you all will remain in their excellent care.

As God has so graciously taught me throughout my life, sometimes good things must come to an end, so that greater things can begin. I will miss you all and keep you close in my prayers. There will be so many grand adventures to come in 2012! I wish you and your families the very best in all things and thank you again for all that you have given me and taught me during my time at SOCPA. May God bless and keep you close always!

Sincerely,
Dr. Nicole Tran

As former patients of Dr. Tran, your children are welcome to see any of our other great providers within our group. All of our SOCPA providers are knowledgeable, compassionate and proud to provide quality care to the patients of our community. To learn more about our doctors, please visit the “Doctors” page in the “About Us” section of this website for more information.

Please Note:  If you have an HMO plan, and you have selected Dr. Tran as your child’s primary care physician, please know that your primary care physician will be switched to another physician in our group unless you request otherwise.  This will help to ensure continuity of care to your child.  Please contact our office if you have any questions.  Thank you.

Attention Blue Shield HMO Members:

Please be advised that starting May 1, 2012, Blue Shield will no longer have an HMO contract with our local IPA carrier, Monarch Healthcare. This change in status is causing significant concerns to patients, parents, providers and brokers. These contract issues are completely out of our control. The quality of care to our patients is very important to us, as is the continuity of care. Please refer to the information listed below for answers to common questions, and what you can do to AVOID any delay in care to your child. As always, we are here to help you. If you still have questions, please contact our office directly, so we can be of further assistance in this time of transition from one plan to another. We are hopeful that you will be able to remain a member of our SOCPA family, and this event will not affect the care of your child.

How will this affect our SOCPA patients?
Unfortunately, this decision will no longer allow you to choose one of our SOCPA providers as an “in network” primary care physician for your child; which could include care to other network specialists. This will not affect patients that carry a Blue Shield PPO contract. This decision ONLY affects the Blue Shield HMO members. Our contract remains in effect for all other HMO plans contracted with Monarch Healthcare, and most major PPO carriers.

What are the options available to our Blue Shield HMO Members?
As far as we know, the Blue Shield HMO contract with Monarch Healthcare will remain in effect until April 30, 2012. Up until this date, we will continue seeing our Blue Shield HMO patients. We will do our best to notify all of our parents/patients of these changes, so each member can take corrective action to retain our physicians as the primary care physician for the care of the patient. Each patient will be asked to sign a waiver form at the time of check in, should any coverage issues present themselves in the future. After May 1, 2012, SOCPA would gladly continue to provide care for your child with coverage through other HMO carriers (Aetna, Blue Cross, Caloptima, Cigna, Health Net and United Healthcare) along with most major PPO plans. Blue Shield HMO members seen after May 1, 2012 will be considered a “cash patient.”

As a parent/patient, what can you do?
Continuity of care is of top concern to our practice. We would encourage you to seek other options for coverage that would allow you to stay with your child’s primary care physician. Contact your human resource department or broker and VOICE YOUR CONCERNS. Most importantly, don’t be afraid to contact Blue Shield directly. Monarch Healthcare is also proactively assisting members with other options. For more information on high-quality plans that will guarantee access to your providers of choice, please visit DontLoseYourDoc.com.

We are anxiously awaiting a contractual resolution between the two parties (Blue Shield and Monarch Healthcare) but, until then, we want you to be informed. We look forward to providing uninterrupted care to the patients of our community.

Please click here for a printable version of this insurance update.

A new child passenger safety law will go into effect on January 1, 2012, requiring that all children be properly secured in a car seat or booster seat that meets federal safety standards until the age of 8, and in the back seat. Previously, the law required that a child remain in a booster seat until the age of 6 or until they reached 60 pounds.

Thank you to SafetyBeltSafe U.S.A. and Buckle Up Orange County for providing us with the following information:

Effective January 1, 2012

• Children under age 8 must be properly buckled into a car seat or booster in the back seat.
• Children age 8 or older may use the vehicle seat belt if it fits properly with the lap belt low on the hips, touching the upper thighs, and the shoulder belt crossing the center of the chest. If children are not tall enough for proper belt fit, they must ride in a booster or car seat.
• Everyone in the car must be properly buckled up. For each child under 16 who is not properly secured, parents (if in the car) or drivers can be fined more than $475 and get a point on their driving records.

Most kids need to ride in a booster seat until age 10 to 12.

If your child isn’t using a booster, try the simple test below the next time you ride together in the car. You may find that your child is not yet ready to use a safety belt without a booster.

The 5-Step Test

1. Does the child sit all the way back against the auto seat?
2. Do the child’s knees bend comfortably at the edge of the auto seat?
3. Does the belt cross the shoulder between the neck and arm?
4. Is the lap belt as low as possible, touching the thighs?
5. Can the child stay seated like this for the whole trip?

If you answered “no” to any of these questions, your child needs a booster seat to make both the shoulder belt and the lap belt fit right for the best crash protection. Your child will be more  comfortable, too.

For best protection, all children should ride in the back seat. It’s twice as safe as the front!

For a list of programs with low-cost car seats, call your local health department at 714-834-3059. 
For other information: SafetyBeltSafe U.S.A. www.carseat.org 800-745-SAFE (English) 800-747-SANO (Spanish)
Funding for this program was provided by a grant from the California Office of Traffic Safety through the National Highway Traffic Safety Administration.

Click here for a printable version that includes the California Buckle-Up Laws for Parents-English Version
Click here for a printable version that includes the California Buckle-Up Laws for Parents-Spanish Version

SOCPA will be closed on Monday, December 26th and Monday, January 2nd in observance of the Christmas and New Year’s holidays. Should your child require care on one of these days, please refer to our holiday after hours schedule.

The providers and staff of Southern Orange County Pediatric Associates wish all of our families a happy and healthy holiday season!

It is with great pride that we announce that Southern Orange County Pediatric Associates has been voted a Top Workplace in Orange County for the third year in a row!  Ranking 5th in the Small Business category, this honor is based upon the feedback given by employees and is presented by the Orange County Register.

We proudly thank our hard-working team of employees and providers. With dedication and compassion to our patients, they offer great care to great kids and demonstrate that they truly love what they do!

To learn more about SOCPA and the Top Workplaces distinction, please visit the OC Register’s 2011 Work Places online.

by Rose Yson-Zaragoza, M.D.
December 2011

Your dates are set, and everyone’s good to go! But before you hop on the road, be sure to consider the following things:

6-7 Months Before Travel
Know what vaccinations/preventive medications you will all need to have before or during your travel. Some countries require that you have certain vaccines documented before you can enter their country. Check the CDC’s Travel’s Health Destination webpage for vaccine recommendations specific to all countries/regions. Some vaccines, such as Hepatitis A, require a 6-month period to completion. Vaccinations that are not part of the routine U.S. Childhood Immunization Schedule are available at local travel clinics. Travel clinics, rather than your pediatrician, are best equipped to provide you with complete and accurate information about any vaccines or preventive medications you will need before, during, and after your travel. Check http://www.ochealthinfo.com/iz/travel for Orange County’s Health Department travel clinic and a link to the CDC (Center for Disease Control) Traveler’s Health website.

4-5 Months Before Travel
Find out how your health insurance coverage may/may not work in your destination area. If necessary and possible, obtain specific health insurance coverage to protect you while you’re there. And know, beforehand, where the closest local pediatric urgent care/medical care facility will be in your destination area, as well as how you will get there when you need it.

1-3 Months Before Travel
If you are traveling during the school year, find out what schoolwork your child will need to make up. Better yet, have them get it done before you leave! (Hey, if you can do all this prepping for the trip, they can too!)

Days/Weeks Before Travel
Prepare a backpack for each child, filled with quiet toys/diversion, books, and snacks that can be brought on a plane, train, or automobile. Other things to bring in your carry-on: acetaminophen or ibuprofen, and any prescription medications that you may potentially need during your travel, such as inhalers/chambers and Epipens. Remember, on an airplane, all liquids that you carry with you must be less than 3 ounces, and must fit inside a one-quart zip lock bag. And no, don’t try to adjust anyone’s internal clock to your destination’s time zone, yet.

During Your Travel
Try to stick to your child’s usual eating and sleeping schedules. While you’re en route to your destination, be sure you plan to let your child eat and nap (if he/she still does) at his/her usual times. If you’re taking a plane, train, or ship, factor in boarding times and long lines through security. If you’re flying, consider bringing the stroller to the gate, to be checked at the last minute to allow for nap time if it occurs during your wait to board. Bring snacks, but drinks other than infant formula are not allowed as a carry-on. Make sure your child has something to drink/swallow to minimize the effect of air pressure changes on the ears as the plane ascends or descends. Ask the stewardess for a cup of water, and tell her why you need it. Use acetaminophen or ibuprofen in case of ear pain that cannot be alleviated by swallowing/drinking; this is more likely to happen if your child has a cold or sore throat.

And, if you’re fortunate enough to have a seat for your under-2-year old, bring their car seat on board; they’re more likely to relax in this familiar setting– perhaps even readily fall asleep if the timing is right! And don’t forget to schedule in some activity breaks– get everyone moving! Most kids and adults cannot sit in one position for more than an hour or two, unless they’re sleeping. Plus, extended sitting in some individuals can lead to deep venous thrombosis (DVT) or blood clots in the legs. These are dangerous in and of themselves, but can lead to an even more life-threatening situation such as pulmonary embolism or stroke. So get up out of your seat and walk around (e.g. go to the restroom), if you can. If not, then do some leg/arm stretches while in your seat, every hour or two.

When You’re There
Give yourself time to enjoy your surroundings for a little bit–but, especially with kids, be sure to keep the first day’s activities brief, if at all. Now would be the time to start adjusting to your new timezone. Give it a few days and be sure to let natural sunlight and darkness work on your natural diurnal rhythm. Hopefully, after that, it’s all smooth sailing…and lots of fun!

The contents of this web site are provided as an informational tool. This is not intended to replace medical advice or care administered by a healthcare professional. Common sense should always be used when referencing this site. If, at any time, you feel your child is experiencing a medical emergency, call 911 immediately.

All SOCPA offices will be closed on Thanksgiving, November 24th, 2011, with limited hours in our Ladera Ranch office on Friday, November 25th (Sick Visits Only–9am-1pm).  We will be back to our regular After Hours schedule on Saturday.   For more information regarding after hours/holiday care, please click here.

The providers and staff of Southern Orange County Pediatric Associates wish you all a happy Thanksgiving.  We are thankful for all of our patients and their families!

by Margaret van Blerk, M.D.
November 2011

With so many of our children playing sports, we are seeing an increase in the number of sports-related injuries. Some of the most common injuries that we see are concussions. We have heard a lot about concussions recently with an increased awareness of the serious nature of these injuries and the long term consequences. It is estimated that about 136,000 concussions occur in high school sports every year. This may be a low estimate as many concussions are not reported. The majority of concussions are seen in football but there is also a significant number in hockey, soccer, basketball and wrestling. Most are seen in high school athletes, however with younger children becoming more involved in sports, these injuries are now being seen more commonly in younger children ages 8-13. These injuries may be more serious in younger children due to their developing brains.

What is a Concussion?

A concussion is defined as a traumatic brain injury. It may be defined as a head injury with a temporary loss of brain function. It may have effects on someone’s cognitive ability, their emotions, and it may cause a number of physical complaints. Most people with a concussion have some symptoms for about 24 hours and about 15% are symptomatic for more than one week. Usually by three weeks all of the symptoms are gone. However, it may take weeks or months to recover completely. There is a potential for serious or catastrophic outcomes if an affected player returns to play too soon. There is also a potential for cumulative effects with repeated concussions.

Common Signs and Symptoms of Concussions

• Physical- May complain of headaches, dizziness, poor coordination or balance, sensitivity to light or sound, nausea or vomiting, changes in vision, numbness or tingling.
• Cognitive or mental signs- Confusion, disorientation, poor concentration or easily distracted, post traumatic amnesia, feels “foggy”, slow to respond, slurred or incoherent speech.
• Emotional- Inappropriate emotions, sadness, nervousness or anxiousness, restlessness, irritability or lethargy.
• Sleep Issues- Difficulty falling asleep, fatigue, sleeping more or less than normal.

Medical Assessment of Concussions

• It is important that anyone who is suspected of having a concussion be evaluated by a physician and given medical clearance before they are allowed to return to play.
• Diagnosis is based mainly on history and physical, duration of unconsciousness, post traumatic amnesia, and neuropsychological testing.
• Based on the history and physical exam, a CT or MRI may be indicated, but the results of CT or MRI are usually normal with a concussion.
• Neuropsychological testing may be useful in evaluating a patient with a concussion. Some schools are starting to do a baseline assessment of athletes before the season starts so that they can see if they have any changes after a head injury. This is just one tool in the assessment of a concussion. Serial testing may be useful in determining when the athlete is ready to return to play.

Treatment of a Concussion and Return to Play

There is no medication used to treat concussions. It is important that the athlete is allowed to rest and not return to play until they are asymptomatic both at play and at rest. They should avoid loud noises as this may exacerbate their symptoms. They should also avoid physical and cognitive exertion such as schoolwork, video games, using a computer or watching TV as these may worsen the symptoms. They should not return to play if they are having any symptoms or if they are having trouble focusing in school.

Retirement from a sport should be considered if an athlete has suffered from multiple concussions or if they have suffered post-concussive symptoms for more than three weeks.

Prevention

It is not likely that we will prevent all concussions but we can reduce the risk by following the rules of the game and wearing proper safety equipment. It is important that the athletes and coaches are educated about the dangers of concussions. They must be made aware that continuing to play after a concussion can have life-long repercussions which we are just beginning to study.

References:

Halstead ME, Walter,KD; Council on Sports Medicine and Fitness. Sports-Related Concussions in Children and Adolescents. Pediatrics.2010. Sep; 126(3):596-615.

The contents of this web site are provided as an informational tool. This is not intended to replace medical advice or care administered by a healthcare professional. Common sense should always be used when referencing this site. If, at any time, you feel your child is experiencing a medical emergency, call 911 immediately.

by John Mersch, MD
October 2011

The tradition of celebrating Halloween is a central feature of the fall season in the U.S. While infants and toddlers are often oblivious to the costume selected by their parents, older children find excitement in the “trick or treat experience.” The following suggestions should promote a safe and enjoyable October 31st.

1. Children less than 2 Years of Age: This age of childhood is just starting to discover the world of imagination. Differentiating reality from fantasy is often difficult if not impossible. Parents can provide an emotional safety net during the Halloween season by reminding their children what is “pretend” and what is not. Reinforcement of the concept of pretend by comparing previous experiences (e.g. playing dress-up) with the future ones to be experienced on October 31st (e.g. costumes for themselves and others) will be helpful.
   
   Physical safety is paramount, avoidance of masks (vision impairment), street safety (not crossing without an adult), using flashlights and removal of “treats,” which may pose a choking hazard will guarantee a pleasant experience for both child and parent.
2. 3 to 5 Years of Age: The capability of imagination in this age range of 3 to 5 years is extreme – reason is dominated by perception (i.e. “perception is reality”). Therefore it is best to avoid masks, as they may be both scary and dangerous by restricting vision. Similarly, it is best to stay away from extremely dark and noisy areas (e.g. “haunted houses”). Prior to Halloween night, let the child get used to their costume by wearing it; rehearse saying “trick or treat,” and reinforce that everyone who is dressed in costume is also playing a pretend game just as they are. Discuss and reinforce real vs. not real. Allow them to express their concerns and fears and provide reassurance that your job as their parent is to protect them. Do NOT tell them “don’t be afraid,” this will stifle their need to express anxiety and invalidates their concerns and fears. If you are going to take them out on Halloween, try to go early in the evening before dark, and before their older peers venture out.
3. 5 to 8 Years of Age: In this age range, a reduction in pure imaginary play and thought process makes way for the introduction of logical thinking. This more sophisticated insight system makes these children less sensitive to irrational fear (witches and ghosts) but more sensitive to rational ones (mutilated bodies, blood and gore, and physical deformity). While some children profess an enjoyment of being scared and are fascinated with such costumes, their tolerance of such fears is often tenuous. Avoid movies or TV shows which emphasize such content.
4. 8 to 11 Years of Age: This age range (and through adolescence) provides a further maturation of rational fear along with the development of what some psychologists call “social fear.” Anxiety about “fitting in” is manifested by concerns regarding social embarrassment (e.g. being kissed by a mother in public, being in the “right group,” etc.). Fundamentally these concerns generate a need for peer acceptance – and such vulnerable children may be drawn into situations counter to good sense or their family upbringing. Halloween provides an opportunity to wear outlandish or fear inducing costumes. The goal is to shock adults – however, the very young children these adults are accompanying during the early trick or treating hours may be affected as innocent victims. Counseling them regarding this unintended consequence is important. In addition, reminding them that destructive behavior (for example, destroying property, destroying pumpkins, “egging” cars, etc.) is illegal and will not be tolerated.

SOCPA providers and staff would like to wish you and your family a safe and happy fall season!

The contents of this web site are provided as an informational tool. This is not intended to replace medical advice or care administered by a healthcare professional. Common sense should always be used when referencing this site. If, at any time, you feel your child is experiencing a medical emergency, call 911 immediately.

In celebration of National Character Counts! week, this Saturday, September 24th, our Talega office doctors and staff will host our SOCPA prize wheel booth at the Character Counts! Jamboree in San Clemente.  This is an annual free family fair that will be held at Vista Del Mar Middle School from 11:00 am to 3:00 pm.  This year’s event sports a patriotic theme and will feature arts and crafts, games, displays, face-painting, food (for purchase), children’s performances and more!

Map to Vista Del Mar Middle School

Character Counts! is a nationwide program that promotes the basics of good character–trustworthiness, respect, responsibility, fairness, caring and citizenship. It is today the most widely implemented approach to character education, reaching millions of youth through thousands of affiliated schools, agencies and organizations.

We at  SOCPA are very excited about our first year at the Character Counts! Jamboree and are looking forward to seeing the San Clemente/Talega community at this worthwhile event!