The Caribbean island of Grenada, nestled on the ocean just off the coast of Venezuela, is roughly 2,600 miles away from Denton. Traveling that sort of distance could give anyone the culture shock of a lifetime. Years ago, Racheal Stewart, a native of Grenada, made that trip. Yet despite the differences and difficulties she’s experienced since moving to Texas, Racheal always feels at home whenever she visits Health Services of North Texas
“How often do you get your doctor to call you back?” Racheal says with a laugh. “Usually a nurse or a medical assistant does it, but Dr. Siegel calls. Edward Gelber calls. Joseph Hallock calls…for me, that’s personal. You’re not getting a voice message.”
When she first came to Texas, Racheal had no insurance. She had applied for Medicaid assistance, and it was granted for her three children, but not for herself. Once she discovered HSNT and the sliding-scale fee system that they offer, Racheal knew she had found a place where she could get the care she needed.
“[The sliding-scale] was, above all, the best. They accommodated me, they didn’t treat me like a subservient – a lot of people, if you have Medicaid or no insurance, they treat you badly…. Here, you come in, and they’re like ‘What can you afford? Are you employed? Let’s work with you.’ A lot of places don’t do that.”
Along with being a mother of three, Racheal is a survivor of domestic violence. She was able to escape that situation with her children, and despite experiencing such a hardship, Racheal draws upon it to help people and to better understand them.
“You can’t treat people poorly, because you don’t know what they’re going through. You know, I have rods in my shoulders and knees, and I went to work every day whether I felt like it or not, because I knew if my smile and my positive attitude can give one person help…you just never know.”
Racheal is now gainfully employed, having gathered a wealth of experience working in all kinds of medical fields. She no longer needs to utilize the sliding-scale fee. But still, she keeps coming back.
“Coming here is like coming to my family, knowing that I’m going to get the best care for myself and my children…. Why would you want to leave a place that gives you grace in your hardest time?”
Here are some of the most common conditions your child could experience their first few weeks after birth along with how to solve them.
Infants and newborns can experience a wide variety of skin problems, such as diaper rash and cradle cap.
A Diaper Rash is any rash on the skin covered by a diaper, and it can be caused by several things. Most commonly it is caused by being in constant contact with stool or urine. Frequent diaper changes can prevent diaper rash, but sometimes this isn’t enough.
Your child’s health care provider may recommend the following diaper rash solutions:
Rinse the skin with warm water instead of using baby wipes, only using soap after bowel movements. Baby wipes are not normally recommended and can leave a film of bacteria behind.
Expose the skin to air as much as possible. This can be done by keeping the diaper loose around your child.
Rub petroleum jelly on the diaper rash. Petroleum jelly is easily cleaned and can provide a barrier between the baby’s skin and bowel movements.
Contact your child’s health care provider if the rash is not better in 3 days or if it becomes worse.
Cradle Cap is a skin condition when oily, scaly, or crusty patches form on your child’s scalp and is not itchy. Do not scratch cradle cap since the scales are not easy to remove. The condition usually clears up on its own in a few weeks or months. A possible solution to help loosen and remove the scales includes washing your baby’s scalp with a mild shampoo. If cradle cap continues or worsens, contact your child’s health care provider.
Jaundice is a condition that can cause the skin, eyes, and mouth of an infant to turn a yellow color. The yellow color is caused by a buildup of bilirubin, a substance produced in the normal breakdown of old red blood cells and in the forming of new ones.
The liver normally removes bilirubin, but for some infants, the liver may not be working at its full power. This causes the level of bilirubin to rise in the infant’s blood, causing them to turn a yellowish color – this is known as jaundice.
This is a normal condition in infants, but if the levels of bilirubin get too high in the infant’s blood, it could cause brain injury. All infants should see their healthcare provider if they have jaundice.
Most infants tend to have jaundice right after being born. After a few days of birth, the infant’s liver should catch up and start to remove the bilirubin. To help remove bilirubin for some, health care providers may prescribe phototherapy, a treatment using a special lamp.
Spitting up / Vomiting
Spitting up and vomiting is common in infants and newborns and it not normally an indication of a more serious problem. To prevent spitting up or vomiting, keep the infant in an upright position, avoid overfeeding, and take time to burp your baby. Contact your child’s health care provider if your child:
Isn’t gaining any weight
Spits up forcefully
Spits up green or yellow fluid
Spits up blood or material that looks like coffee grounds
Regularly refuses feedings
Has blood in their stool
Has difficulty breathing or other illnesses
Has fewer wet diapers than usual
Some parents may worry about their child spitting up while sleeping on their backs, causing them to choke. This is not the case. Babies may clear fluids easier on their backs. With how the windpipe is situated in the body, it makes it to where it is unlikely for fluids to cause choking.
It is recommended by the NICHD’s Safe to Sleep® Campaign for babies to sleep on their backs to prevent Sudden Infant Death Syndrome (SIDS). Ever since this recommendation was made in 1992, there has not been an increase in choking deaths. Actually, the majority of choking deaths is from infants sleeping on their stomachs.
Unexplained or Excessive Crying
All infants and newborns cry, sometimes for no obvious reason. If you have made sure that your baby has a clean diaper, been feed, burped, and is warm, the best solution is to talk to your infant, hold them, and swaddle them in a blanket. Eventually, you will be able to recognize your child’s cries and what they mean. If their cry ever sounds out of the ordinary, like if they are in pain, contact your child’s health care provider.
It is normal for infants to become fussy in the evenings, but if their cries do not stop and get worse, their cries bay be from colic. Colic is defined as a lot of crying once or twice a day when your child is less than 3 months old. With colic, the baby is usually consolable and acts normal in between bouts of crying. There is not much that can be done about colic, but it can go away by 3 or 4 months of age.
Heat exhaustion can be a major problem as temperatures rise this summer. Here are a few tips to help avoid heat exhaustion and other heat-related illnesses. Follow these tips to keep family members and yourself safe this summer.
Drink plenty of water and drink water even if you are not thirsty.
Keep up to date with the latest forecasts and avoid midday heat whenever possible.
Stay in air-conditioned areas if possible and avoid direct sunlight. Stay in the shade if outdoor activity is unavoidable.
Limit outdoor activity, especially during the midday heat
Schedule activities earlier or later in the day if possible.
Pace yourself. Start activities slowly and pick up the pace gradually.
Drink two to four cups of water every hour.
If you must be outside, breaks are encouraged to cool off and drink water
Wear light, loose clothing.
Wear a hat and other protective gear. Always reapply sunscreen.
Never leave children unattended.
Check on at-risk family and friends at least twice a day. At-risk could be elderly relatives or those who are very active.
Making sure your child has the best possible care is the top priority for most parents. Finding the right pediatrician for your child can be difficult, but with the help of these tips, the search will be a little easier.
Ask Family Members, Friends, and Coworkers Who They Recommend and Why
This is the best place to start on your hunt for a pediatrician or to return to if you are stuck in a rut. This tip works especially well if your family members or friends already have kids. They have already gone through the search, and this is who they chose. Do they recommend who their kids are seeing? Maybe another pediatrician in the same practice? Ask what they like about their pediatrician? Have there ever been any situations where the doctor has gone out of their way for your friend’s child? The American Pregnancy Organization gives us some additional questions you could ask:
Do you feel rushed during your appointments?
Does the pediatrician address all your questions and concerns?
Do your children like your pediatrician?
Does your pediatrician include you in the decision-making process?
Does your pediatrician explain all side-effects and risks of various treatments?
Do they respect your opinion? How do they react when you do not agree with them?
Take Time to Call Offices and Ask Some Questions
You want to make sure your child receives the best care, or else you wouldn’t be reading this article. Take the time to think about what you care about in your child’s health. Don’t be afraid to call their office and ask where they went to school at, what kind of certifications they have, you could even set up and interview with the pediatrician to ask them these questions. NorthShore University Health System gives us some questions you could ask:
Is the doctor accepting new patients?
What are the office’s hours and location?
If you were to call the office at night, who would answer your call – a nurse or your doctor?
Is the doctor apart of a group practice? How often would they be able to have an appointment with their doctor?
Will the office accept my insurance?
How does the doctor feel about certain issues (for example breastfeeding, vaccinations, or antibiotics)? See how the pediatrician reacts and if you are comfortable with their reaction.
Check with Your Insurance Company to See Who Accepts Your Health Insurance
Many insurance companies have a list of providers within their network. For some, it is as simple as going to the insurance website. Other companies make it easy for you to compare and have their credentials, ratings, and reviews displayed. It is important to choose a provider within your insurance network, so you know you are covered when you have an appointment. Finding an in-network provider will save you money in the long run.
Look for Fellow of the American Academy of Pediatrics or “FAAP”
These four letters are extremely important when it comes to looking for a pediatrician. FAAP stands for “Fellow of the American Academy of Pediatrics,” and it signifies that the Pediatrician is board certified, stays up to date on the latest in child health, and is committed to learning the rest of their life. If you are ever short on names during your search for a pediatrician, check out their pediatrician referral site. The website allows you to search for pediatricians in your area and gives their name, phone, and you can view their profile and where their practice is at.
Don’t Be Afraid to Use a Pediatric Nurse Practitioner
Pediatric Nurse Practitioners are registered nurses or nurse practitioners specializing in the care of children. Their focus is on preventative care, primary care, growth and development, and managing illnesses. Pediatric Nurse Practitioners provide a holistic treatment style, meaning they consider the child beyond their symptoms and educate as they are being treated. Pediatric Nurse Practitioners can work independently from a Pediatrician in the state of Texas and can diagnose and treat patients as well as perform procedures. Not only that, but nurse practitioners can help lower the cost of health care. According to the American Association of Nurse Practitioners, patients who see their nurse practitioner as their primary care provider often have less emergency room visits, shorter hospital stays, and lower medication costs.
To Carla Underhill, it felt like she was just having a little trouble getting a full breath of air. She had been tired all day and was too weak to walk, so she decided to spend the rest of it in bed. She had been to Health Services of North Texas’ Denton office and seen Dr. Terrence Moore, now retired, earlier in the day. His diagnosis was urgent: “You need to go to the hospital.”
“I was feeling fine other than I can’t get a little bit of air,” says Carla, a 61-year-old Texan who has lived in Denton for nearly all her life. “I took my blood pressure and it was a little low, and it got a little lower all through the night. I got on the internet and looked it up…and this one answer came back from some hospital in another state and they said, ‘you need to call an ambulance.’”
Carla wondered if that was really necessary. She had no insurance, and she was afraid of taking the extra cost of calling an ambulance to take her to the emergency room. She put it off until she called a healthcare hotline, and they said the same thing: she needed to go to the hospital. Her husband was leaving to deliver a rug, so she decided to ride in with him just in case.
At this point, Carla’s heart rate was in the low 40s, and fluctuating wildly.
Eventually, Carla and her husband decided to drive to the nearest hospital and just sit in the parking lot, watching for any more changes. It wasn’t until Carla was at her most exhausted that they finally checked into the hospital. The moment Carla explained her symptoms, she was immediately told to sit down and not to move. The nurse was aghast when Carla said her heart rate was at 39. “You’re a walking dead person,” she said. “Why didn’t you come in sooner?”
“Because,” Carla replied, “I have no insurance.”
Her worries about finances had been going on long before she reached that point. Because of Carla’s multiple health issues – lupus, scleroderma, fibromyalgia, and spinal stenosis, the latter of which she’s received seven back surgeries for – her insurance had renewed with a $2000 premium and a $7000 deductible. With her husband’s developing dementia, which made it difficult for him to work, Carla was forced to drop her insurance company. Money had always been tight, but now with no insurance, it would be even tighter, and at a time when they needed quality healthcare more than ever.
According to the cardiologist that saw her, Carla had a complete heart block. If she hadn’t gone to the hospital when she did, she would not have lived through to the morning.
Carla now sees Dr. Siegel, the Medical Director for Health Services of North Texas. “He’s almost like a family member in that sort of way,” she says. “Dr. Siegel will sit there in that office as long as you need to…. One time he was in there for an hour and a half with me. I was having a little difficulty at the time, and he was trying to figure the problem, but he was not trying to push me out.”
Carla isn’t the only one in her family who gets their care from Health Services of North Texas, Carla’s daughter now sees Dr. Siegel, as well as Carla’s husband, who has dementia. When she was told that they couldn’t take any new patients, Carla says that Dr. Siegel went up to the front desk and said “I will take them. I will make room.”
Health Services of North Texas has been able to provide Carla with affordable care that she can access, even without insurance. Carla knows that for some of her illnesses, she needs to go specialists outside of our offices, but when it comes to everything else, she insists on seeing Dr. Siegel.
“I’ve had doctors where, by the time I thought of the question I wanted to ask them, they were already out the door. I don’t want doctors like that, I want doctors that care enough. Dr. Siegel is just a caring person who cares about what he’s doing.”