Dealing with Change


“The only constant in life is change” has been attributed to Heraclitus, the Greek philosopher so many years ago. Amazing how this is still pertinent today, in such different times. Regardless of the age, change is difficult for all of us. We become comfortable in some things and it is hard to break out of that comfort zone. I have been thinking a lot about this given my recent move to Legacy Pediatrics. The move was something I had been thinking about for some time…then the timing was just right. As difficult a decision as it was for me, I could not be happier in my new home! No matter how daunting a change may seem, what is scarier is regret.

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Some Vaccine Updates with Dr. Pichichero

 Teenagers and Whooping Cough

When adolescents contract whooping cough, a.k.a. pertussis, they usually don’t whoop but they cough, sometimes for up to 3 months.  So the illness can be quite impactful for patients as well as others because without treatment, patients can be contagious to classmates and family members.  Fighting against pertussis has had its issues thru the years: there has been waning immunity problems after experiencing pertussis infection, the old DTwP vaccine had to be discontinued in the US years ago due to safety issues, and then the newer Tdap has been in the news recently because of the rapidity of waning immunity in teenagers.  In assessing the results of the news a few comments are needed. First the study population was from California and that is a State where pertussis has been circulating much more than in most other States.  Exact reasons for a higher prevalence of pertussis in California are not fully understood, but a high rate of vaccine refusals may be a significant factor.  Secondly, the study used a mathematical model that would provide an estimate of waning immunity.  Nevertheless, the observations alert health care providers and the community that pertussis can occur even in vaccinated teenagers, especially as time passes after vaccination. The solutions are few at this time.  Public health care officials are unlikely to recommend boosters more frequently than already advocated (although that is an option).  Alternative formulations of Tdap to include other or additional ingredients could be a path forward, but the vaccine industry is tackling so many new diseases with vaccine development programs that a push for a better DTaP or Tdap is unlikely in the near term.

Flu vaccine: intranasal or shot?

More and more parents are requesting the intranasal flu vaccine at Legacy Pediatrics and each year we purchase more to accommodate those requests. The kids don’t want the shot and the parents don’t want to deal with the crying or pouting of their kids. The intranasal flu vaccine is live while the shot is a killed virus. The intranasal flu cannot be given to children below age 2 years or to children with asthma. In the news recently, a report described how the intranasal flu vaccine was not as effective as the shot last year (not this year since we don’t know yet). It turns out that the manufacturing process for the intranasal flu vaccine had a problem such that one of the strains in the vaccine was ineffective. Legacy Pediatrics has conducted studies of the different flu vaccines in years past and in those studies, the 2 vaccines performed equally well. So we will stay tuned for further research on this subject and advise the parents of our patients accordingly. Legacy Pediatrics does not currently have any more intranasal flu vaccine for this year and we do not intend to have any more for this season. The manufacturer has been unable to ship anymore to any offices this season. We still have flu shots available and we highly recommend you have you and your child vaccinated – it’s not too late!! We have seen a BIG increase in flu cases in just these past 2-3 weeks. In fact, take a look at the updated NYS Department of Health Weekly Influenza Surveillance Report.

Week Ending March 12th, 2016





All for One, A Sport for All: The Olympic Sport of Fencing

Fencing for RIO

I was an awkward kid. By awkward, I mean, I never graduated to the next level in swimming; I was a disaster in gymnastics; and I certainly wasn’t dainty enough to be a dancer. So, in an effort to get a strong and solid little girl to stay active and not to drive two kids to different activities, my parents signed me and my sister up for fencing. It was truly love at first lunge. Why fencing?

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Welcome Dr. Alice Taylor

Dr. Alice Taylor in Rochester NYOur Legacy family is absolutely thrilled to announce the addition of Dr. Alice Taylor to our practice. She brings experience and compassion to our existing team at Legacy Pediatrics. She has been the Medical director of the special care nursery at Highland Hospital in Rochester, NY since 2010, and was the recipient of Highland Hospitals Distinguished Physician award in 2012. She has been a Pediatrician in private practice for 16 years.

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Are You and Your Family “Fed Up?”

With the New Year in full swing, many of you either are happily into your New Years resolutions or have woefully abandoned them. Or, you may be like me, and just never made one to begin with. Regardless, this time of year brings up a lot of talk about diet for those young and old.  And, as this is not physical season at Legacy Pediatrics when we tend to talk the most about proper nutrition and eating habits, it does tend to be the time of year when it is on people’s minds. So here are some of my thoughts and conversations that I end up having with parents and children when talking about nutrition.

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Keep Calm and Carry On

Busy Family Calendar

Photo by Elf Sternberg

The holidays are upon us. Thanksgiving and Hanukkah came and went. Christmas Day is right around the corner, as is New Year’s. Time flies. There is no doubt the holidays can be stressful with the hustle and bustle. It’s supposed to be a time of joy, reflection, and happiness, but the long lines, traffic, and just not enough hours in the day admittedly get in the way sometimes. As the new year rapidly approaches, I find myself thinking about New Year’s resolutions. I know I’ve had my share. Some of my prior resolutions were to exercise more, volunteer more, be more patient with my husband and children. This year I hope to be more organized with my family calendar. Staying organized despite a busy family calendar is a challenge for me regardless of the season.

Keeping the family calendar is no small feat. Between extracurricular activities, work schedules, school events, and family get-togethers, this can be a lot for any parent to keep track of. Pre-planning and scheduling activities ahead of time is the key. When you receive the school calendar, document all of the school holidays, conference days, and events. Sports practices and games are good to get on the calendar as soon as you receive the schedule. Family birthday parties and special occasions are also good to schedule in advance. When other, unexpected activities come up, you will be able to schedule without hesitation.

Don’t be afraid to set some scheduling limits. Sometimes you need some down time, and so do your kids. This helps get some rest, clear your mind, and allow your kids some unstructured play. Limit the number of activities your kids participate in. Most kids want to join every sport team or every club.   Help them select the activities they want to do the most. One or two activities per season is a reasonable scheduling goal. This will allow them to participate in structured activities, while also allowing room to attend sleepovers and birthday parties, while staying healthy and rested. This also models for kids how to manage their own time as they get older, by prioritizing their goals.

Look over your calendar on a regular basis. There is no way to remember everything and checking the calendar routinely will help you to remember what’s coming up in the next few days. I sometimes have to look at my calendar multiple times a day to stay on top of activities. This helps to prevent double-booking, missing an activity or event, and even helps to feel more in control of your time.

Share your calendar. A family calendar should be monitored by THE FAMILY. Not just mom or dad. High school kids are more than capable of keeping an eye on their activities and planning accordingly. Of course, they will still need prompting and supervision. Paper calendars or personal organizers are great for keeping track, but may not be as accessible to an entire family. Online shared calendars work well. It’s important to use a trusted site that will protect your private family information. The iPhone Cloud allows families to share calendars.   OurFamilyWizard website and app not only schedules a busy family calendar, it also schedules parent-time for families with more than one home. If the kids are going to mom’s house on Tuesday, Mom is able to see their planned events and vice versa when the kids are at their dad’s home. It helps to clarify drop off and pick up, as well as upcoming school events and extracurricular activities.

No matter how you choose to stay sane with a busy family calendar, I wish you a happy and healthy 2016!

Legacy Pediatrics Research goes to South Korea

Incheon Airport - South Korea

Incheon Airport – South Korea. Photo credit

As many of you know, Legacy Pediatrics does clinical research in the area of ear infections in young children. Legacy Pediatrics is the #1 ear infection research site in the United States thanks to our wonderful families who participate in our research, and to the tremendous efforts of the Legacy Pediatrics staff, PAs, nurses and research coordinator. Since 2009, Legacy Pediatrics has published 79 papers on many topics relating to ear infections. Dr. Pichichero and I recently went to an international meeting on ear infections, which is held every 2 years, and presented some of the research from Legacy Pediatrics.

This past week, Dr. Pichichero and I traveled to South Korea to attend an international vaccine conference. We were invited to present some of the findings from our Ear Immunity Study. I presented the research results on the bacteria causing ear infections with data that is current and up to the minute. No one else in the world has this data so the audience was keenly interested in the information. I proudly told the audience that we currently have over 800 children enrolled in the study and we have had over 15,000 visits! The audience couldn’t believe that we have been able to enroll and follow so many young children and I told them that what we do is only possible because of the wonderful families who agree to participate in Legacy Pediatrics research. The bacteria that cause ear infections change over time and it is very important to follow the changes. Legacy Pediatrics provides data to the world, which contributes to the development of guidelines and policies for the treatment of ear infections and other respiratory bacterial infections in children.

Dr. Pichichero presented data generated by Legacy Pediatrics research that no other research site in the world has. The data he presented is very important for the development of a new vaccine for ear infections in children. Dr. Pichichero told the audience that our study kids have their blood drawn in order to study the immune response they make to ear infection bacteria when they are healthy, and, when they have an ear infection. Dr. Pichichero discussed details about the immune responses and how this information is very important for the development of a new vaccine. Many audience members were astonished that we have this information because it is so hard to draw blood in very young children. One questioner asked how we were able to do this. Dr. Pichichero again complimented our amazing families and their willingness to help develop the science that will help other children.

Our trip half way around the world was very successful! We represented Legacy Pediatrics well. Legacy Pediatrics is very unique! We are able to contribute to the health of children not only at Legacy Pediatrics but also around the world. None of it would be possible without the help of many people, and the most important are the kids at Legacy Pediatrics and their families.

Meningitis B Vaccine – A New Vaccine For Teenagers


Photo by NIAID

Photo by NIAID

At Legacy Pediatrics we have started giving the new Meningitis B vaccine to teenagers beginning at age 16 years old. Three doses will be needed to complete the immunization series. The doses are to be given spread out with the second dose about 2 months after the first dose and a third dose at least 6 months after the first dose. This is the same schedule as the HPV vaccine for boys and girls that prevents cervical and vaginal cancer in girls, and anal cancer, some head/neck cancers, and genital warts in both boys and girls.

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Is This ADHD?

Busy Child

As we embark on a new school year (where did the summer go?), you may be experiencing excitement, anxiety, and for some of you, even a little bit of fear as kids move on to the next academic level. Consider yourselves fortunate if your child enjoys school, likes to learn, and does homework without a fight. Many others have a very different experience of school. Academic demands are heightening and, as early as pre-k, we are seeing a shift in the expectations of our kids. While this is true, this is often a time when parents and teachers alike are surveying for any barriers to learning, which may include concerns for ADHD. In fact, some of you may have already been encouraged by a teacher or counselor to explore this possibility.

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