January 2022 Newsletter
Bambini News
A mind-boggling 440 patients came through the doors here Monday December 27th! Dr. Miller reports that 126 were COVID positive!! But this wave is taking a toll on our staff, as four were out last week with the bug. In fact, eight of us have been affected in the last two months – some for the second time. Thankfully, we have not had a pediatric patient admitted during this surge with COVID-19. 
Sad to say, the surge is being seen well beyond Bambini. In January, the previous peak here in New York state was about 19,000 cases per day. On Sunday the 26th, 86,000 cases were reported. On Monday, 543,000 cases were reported here in the US😵 The previous record high was 302,000. Puerto Rico, which is one of the most highly vaccinated US territories, saw a 5,000% increase in cases over the previous two weeks.
To cope with this unprecedented situation, we have made a number of adjustments:
1.  Routine physicals for school-age children will be deferred for at least the next two weeks.
2.  Likewise, first dose of Pfizer COVID vaccine will also be deferred. We really like to have these on a practitioner schedule.
3.  Effective Tuesday Jan 3rd, we are moving adult COVID testing, which we have been doing as a community service, out to Hyde Park at the former Quest Diagnostics Lab in the Stop & Shop Plaza next to Liquorama. Phone number of testing is (845) 288-0252. 

Testing is by appointment only. Both PCR and antigen will be offered as supplies and staffing permit. For details, please see the testing page on our website. Parents of Bambini patients whose children are being seen will still be tested on request in our main office.

Finally, we have added a saliva-based antibody test for COVID-19 called CovAb-Screen. If your toddler had a bad cold or cough over the last few months and you wonder if it could have been coronavirus, this painless test might be helpful. For details, again see the testing page.
Vitamin D & Alopecia
Alopecia areata is a somewhat common non-scarring form of patchy hair loss -- as shown in the photo. The bald patches typically appear abruptly. It is considered an auto-immune disorder.

Telogen effluvium is another condition we see fairly often in which diffuse thinning occurs. It typically occurs a few weeks after a serious illness or traumatic event.

What do these two conditions have in common? Patients that develop these forms of hair loss often have low blood levels of vitamin D! Now that January is here, and we are dealing with the Omicron wave, most of us are taking supplemental vitamin D. Some of us are even getting our blood level checked to assure the dose is right. As a result, we hope to be seeing a drop in new alopecia patients.

Airline Travel with Newborn
A few weeks ago, a parent asked us about flying to Bogotá with their healthy two month-old. The concern was that the destination is at 8,600 feet elevation.

Most babies tolerate the cabin pressure of commercial airline travel well. This is set to about 8,000 feet. Travel plans for an infant with a history of premature birth, congenital heart disease, or a few other uncommon conditions might need to be postponed.

What about driving across Colorado? Vail Pass, for instance, is at 10,600. According to Barton Schmitt MD, "brief drives over higher mountain passes are safe." For additional info, click here.
Vitamin K2 & COVID-19
Although rarely mentioned by public health officials, by now most of us are well aware of the benefit of vitamin D in managing COVID-19. Indeed 57 studies involving more than 100,000 patients have substantiated the role it plays. 
But the value of other fat-soluble vitamins (A, E, & K) in COVID-19 is becoming increasingly clear. When we used to think about vitamin K, it may have been in the context of perhaps a grandparent on blood thinners. Vitamin K1 is also given as an injection to newborns to stave off bleeding. 
A century ago, a very sharp dentist named Weston Price discerned that something in grass-fed butter he called “X factor” contributed to healthier teeth and bones. In the last couple decades, we learned that this mystery agent was vitamin K2. K2 works synergistically with vitamin D to direct calcium to where it needs to go. 
Recent studies evaluating serum K2 levels in COVID-19 hospitalized patients found that patients with poor outcomes of COVID-19 had the lowest levels of vitamin K2. According to Dr. Rob Janssen, a researcher from the Netherlands, giving a COVID-19 patient vitamin D without vitamin K2 could actually make them worse. Yikes!