Bambini April 2017 Newsletter 
Ming Chen MD
Dr. Ming Chen, a board-certified pediatrician, will be joining us in about one month. She is actually driving cross-country from southern California as you read this!

A graduate from the University of S ão Paulo Medical School in 1989, Dr. Chen had her residency training in Pediatrics at the University of Missouri-Columbia from 1991-94. From there she worked in variety of outpatient and inpatient practice settings.

During that time, after personal experience confirmed its efficacy, she developed a special interest in an integrative form of care called NAET. The technique (which combines kinesiology, acupuncture, chiropractic, and nutrition principles) has been applied with remarkable success to children with autistic spectrum disorder.

Her primary interests are non-invasive, non-pharmacological approaches to chronic disease reversal rather than disease management, including but not limited to alkaline and anti-inflammatory diets. 

Dr. Chen speaks not only her native Portuguese but also Spanish, Mandarin, & Taiwanese.  In her spare time, she enjoys classical Chinese dance, qigong exercises, and mountain biking. 
Help for Grass Pollen Allergy
ORALAIR is a sublingual tablet used for allergies to the five most common grass pollens in the United States. It is currently FDA approved down to age 10. The tablet is taken once daily.
Ideally, one would want to start this treatment up to four months before the start of grass pollen season, but protective effect is typically seen much sooner.
Is it necessary to have a blood test to confirm the presence of grass pollen allergy? No. It usually doesn't take a rocket scientist to diagnose the itchy eyes and sneezing that peak in late June!
What is important, though, is to get the first dose in the office (we have a limited number of starter kits on hand). Although extremely rare, strong allergic reactions could occur. In fact, it is recommended to keep an Epipen at hand when taking Oralair!
Prescriptions can be filled locally or sent to a special mail-order pharmacy. Maximum out-of-pocket cost to patients is $25 per month. That's about the cost of a bottle of Zyrtec.
Why not just go to the local health food store and buy a bag of bee pollen? Well, if you have an 8 year-old, that may be the way to go at this point. The advantage of Oralair would be that contents are consistent. With bee pollen, it is hit or miss in terms of how much grass versus tree versus weed pollen it will contain.  
Other Practice Items
We received a number of concerns from parents this flu season about how difficult it was to get through to the office.  We apologize for this.  After much deliberation, we have decided to have daytime calls routed through an auto-attendant.  We hope this adjustment (coming in next month) will help.

For the last year or so, parents have been able to schedule appointments online through our patient portal.  Not too many have taken advantage of this yet.  Think about it.  It's 9 PM.  Your child starts complaining about an earache.  You could either:
a.) log into the portal and schedule a visit first thing in the morning with your favorite clinician.
b.) call first thing in the morning; stay on hold for six minutes and settle for a late afternoon appointment.
Portal appointments are also good for future visits, especially if your preferred clinician tends to be booked up days or weeks in advance.

Another matter we occasionally receive concerns about is fees for letters, school forms, refills, and other services that insurance does not cover.  This is just no one's favorite subject!  Going forward, to reduce misunderstandings and improve efficiency, we are going to require either an office visit or prepayment for these services.

Finally, tune in to part-3 of the Bambini Parent Forum recorded earlier this year.  Dr. Malak delves into rising incidence of auto-immune disorders in kids and what parents can do about that.
Free Tick Testing?  Tick Tubes?
Recently, we heard about a free tick testing service offered by the Bay Area Lyme Foundation.  Their lab checks for not just Lyme but six major tick-borne pathogens.

The catch seems to be their turnaround time.  Their lab is in Arizona and they are currently reporting results 21 days after receiving the tick.  That's way too long to be clinically useful.  Tick Report would be a better choice.  Last year, parents were getting emailed results 5 to 7 days after sending ticks.

Parents often ask us about safe, effective ways to reduce the tick population in their yard.  Experts, based on acorn crop and other factors, have predicted a big year for Lyme.

One option to consider is Tick Tubes.  They look like toilet tissue tubes stuffed with cotton!  Mice take the cotton, which is coated with permethrin (an insecticide derived from chrysanthemums), to make nests.  They're safe around children & pets.  They reduce tick population by up to 97%.  To save a few dollars, one can make your own

Another option is Garlic Barrier.  We had to laugh when one customer said his yard smelled like an Italian restaurant! 
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