Dr. June APRN

16/05/2022

Good advice!

June Bryant, DNP, APRN, CPNP-PC
Pediatric Nurse Practitioner
Doctor of Nursing Practice

Compassionate care. No waiting rooms. Pediatric care that comes to you.

🚐 Mobile pediatric visits
📍Florida & Colorado

02/03/2022

Contest time!! Click on the post below to enter!

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💲 Currently services are direct pay (self pay). We cannot bill insurance companies at this time.

16/09/2021

Beautiful sunrise this morning. Took the longer route to appreciate it.

21/03/2020

My hunny is amazing! Design templates will be up as soon as it is perfected. Cotton fabric, air filters, elastic, wire and a couple other items. Washable. Reusable. Filters can be pulled and replaced. Passes the sniff test. :)

No N95s? This is the best we got!!

15/03/2020

Did you know that we should treat COVID-19 exactly like we treat other viral illnesses such as the common cold? 😷

Now more than ever, it is important to STAY HOME as long as safely possible for viral infections. 🏡 Here are my TOP TEN at-home tips:

1. Cold, flu, and COVID-19 are all caused by viruses. Antibiotics will NOT help. 💊 In fact, using antibiotics for a virus can harm the recovery process and lead to bacterial resistance. Most viral illness can be safely handled from home.

2. FEVERS are natural and safe in babies 3 months and up. 🔥 Babies less than 3 months need to be evaluated by a doctor for fever (defined as 100.4°F and above). Beyond this age, a fever is the body's way of ramping up the immune system to fight off infection. You only need to treat a fever if it’s making your child uncomfortable. Do not use aspirin. Tylenol is the preferred medication. It's wise to get checked at your doctor's office for a true fever lasting longer than 4 days.

3. Otherwise, fever is not the enemy – dehydration and respiratory distress are the enemies! You know your child is staying hydrated if they are urinating at least every 8 hours. 🕞 Signs of respiratory distress include sucking in with each breath, panting, head-bobbing, grunting, turning blue, or flaring of the nostrils to breathe – all of these things would warrant medical attention ASAP.

4. Loss of appetite is common. It’s actually OK if your child refuses to eat SOLID food for several days, but they need to stay hydrated. 🍼 Give them whatever they are willing to drink as long as it is age-appropriate. Using sports drinks or Pedialyte for electrolyte replacement is a great idea. Again, the goal is to urinate at LEAST every 8 hours.

5. For nasal congestion in babies and toddlers, use nasal saline drops and suction: Place a few drops into each nostril followed by gentle suction with a bulb syringe or device such as NoseFrida – this is especially helpful before sleep and feeds. 😴 For nasal congestion in older children, have them gently blow their nose and stay hydrated. A bit of Vaseline along the outer nostrils may prevent the skin from getting chapped/sore.

6. At any age, a cool-mist humidifier or vaporizer can be used to moisten the air. This may help to decrease cough and congestion. ☁ Do not worry about the color or consistency of your child’s mucus – the idea that green mucus is bad is a myth.

7. A sore throat paired with the cough and runny nose is likely viral and does NOT warrant testing for strep throat! ✋ Offer plenty of fluids, rest, and Tylenol/Motrin as needed for discomfort. For older kids, try gargling salt water.

8. Coughing protects the lungs from mucus build-up. 😁 Cough and cold medicines are NOT recommended in children under 6 years of age. Try half a teaspoon of honey for children ages 2-5 years or 1 teaspoon for kids ages 6 and above. Do not give honey to children less than 1 year old. Cough drops/lozenges are okay starting at 4 years and up.

9. Cough and congestion often last up to TWO weeks. HANG IN THERE. ⏳ Prevent the spread of germs by washing your hands (or using alcohol-based hand sanitizer) as often as possible. Cover your nose and mouth with a tissue or sleeve whenever you cough or sneeze (not your bare hand). Disinfect hard surfaces. Avoid touching your eyes, nose, and mouth.

10. Seek rapid medical care for any of the following 🚩 RED FLAG signs: Bulging soft spot, inconsolable crying, confusion, disorientation, stiff neck, new seizures, difficult or rapid breathing, blue lips or nails, refusal to move an arm or leg, severe abdominal pain/swelling, dehydration, or simply looking very ill. If your intuition is overall telling you that your child is really sick, please bring them in.

I love keeping you home from the doctor's office/ER whenever safely possible, especially during this time. Please feel free to share! ❤

14/03/2020

Just to give you an idea... (theme parks are included in that "AVOID" column btw).

14/03/2020

Keeping your kids on a schedule during this national emergency is so important. Here is an awesome example.

We came across this creative sample schedule from Jessica McHale Photography that may help your family get through the next few weeks.

For more tips on adding structure and skill-building to home life during these uncertain times, check out this morning’s blog: https://nesca-newton.com/making-the-most-of-covid-19-school-closures/

12/03/2020

05/03/2020

💉I’ve waited all day for my post.

💉 ZDoggMD asked today, March 5, doctors, nurses, healthcare workers speak up about vaccines, and use the following hashtag , , , .

I wrote this on my personal page about a year ago. And every word of it still stands now. At this moment.

💉 I am at the end of a lengthy well child visit. I talk to the parents about their children and give gentle guidance about what is to come. We discuss the importance of sunscreen, strangers, seat belts and wearing helmets. We converse about the importance of handwashing and we talk about what the parents should do when their amazing little child gets sick and has a fever. Towards the end of our visit, I bring out the vaccine information sheet and discuss the vaccines that the Centers for Disease Control recommend.

💉In that moment, I see hesitation. “I don’t think we are going to vaccinate."

💉In that moment, they will not see that my heart broke a little bit. 💔
Actually, more than a little bit. 💔💔
It actually broke a lot. 💔💔💔💔

💉In that moment, I heard the parent infer they do not trust that the vaccines are worth the risk. The minute risk of an adverse reaction. The falsities of the heightened risk of autism or increased risk of guillain-barré syndrome (please research!).

💉In that moment, I heard the parent infer they do not trust my recommendation for their child. If you have ever trusted me with the care of your children, you know I love every single of my patients like they are my own children. Not having this trust (or losing it) is one of the worst feelings a pediatric provider can have.

💉 In that moment, images flash in my head of the photographs of children with polio in Iron lungs, in ICUs with encephalopathy from measles or varicella, infants with pertussis that can not overcome the whooping cough, children infected with Hepatitis A or B and need liver transplants at the age of 10, or… images of my very own brother, at the age of 11, who had meningitis and still has disabilities to this day. The image of his body shutting down before my eyes will never be forgotten.

💉In that moment, I remember how thankful I am that my brother is alive and now there are vaccines to prevent what he went through and what our family went through in those 3 months of his surgery and recovery.

💉In that moment, I pray for the parent to reconsider. I pray for the desire to research how far we have come with reducing the amount of our children that contract and die from vaccine preventable diseases. I pray… I sincerely pray, that it does not take another child losing to a disease that could have been prevented in the first place. I pray... it is not their child.

💉In that moment, I do not roll my eyes. I will ask why. I will tell them my “why”. I will let them know all of my kids are vaccinated, on time, with no reactions. I will listen. I will give factual resources and references. I will EDUCATE. I will let them know I am here for them when and if they reconsider. Hopefully before it is too late.

💉In that moment, I search for a glimmer of hope. A glimpse of trust. A look of possible reconsideration.
In that moment... There it was. The parent asked. I answered. The parent trusted. My heart danced. We saved a life.

💉AND in that moment, It is worth it. It is why we are here and why we do what we do. We, your healthcare providers, will keep advocating for your child’s safety.

💉We will educate. We will answer your questions.

💉We . We . We .

, , ,

09/02/2020

Periods 🩸. Pen*ses 🍆. PUBERTY. 👙🩳
Scrunchies. 💇🏻‍♀️Hydro Flasks 💧. Black and White checkered shoes 👟. Shell chokers📿 . VSCO. Attitudes😫 . What’s next? You know it. Puberty.
Me at a 9 year old well visit: “Pretty soon, it is going to be time to start talking about puberty”
Literally every parent: (See picture below). 🙄😲😨
So the basics. What is puberty?
Puberty is the time when boys and girls bodies grow and develop super fast. Great thing is, is that every person does go through it. May just be the only thing that every human being has in common. So yeah – it is pretty important to know about and be prepared for. Don’t worry – I am here to help.
Puberty in girls starts a tad bit earlier than boys. In girls, puberty can start as early at 8 or as late as 13. In boys, it can start around 9 to 15. Yes that’s a wide range. That is why we have 5th graders with a bra size DD 👙 and boys who have not even had a voice change going into high school. A good estimate for girls “puberty age” is maternal puberty age. When did Mom start her menstrual cycle? That is a pretty good guestimate. Now-a-days there are so many other factors than can play into puberty start date as well (for example, the amount of adipose tissue). Recent studies also show that high intake of sugary drinks could lead to earlier onset of me**es. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325672/)
Maybe you have started to notice a little bit of a change in your daughter which is what brought you to this post. Typically, the breasts will start to develop first (yes, sometimes at different speeds so there is a chance that one breast will be bigger than the other – don’t worry – they will usually even themselves out). Once the breasts develop – you can bet she will start her cycles about 2 years later. During this time, hair will start to grow in the p***c area and under the arms. Another thing to consider is that girls typically hit their peak height about 2 years after their cycle starts – which is why most of us Moms can still wear our shoes 👡👠👟 that we had back in middle/high school.
Boys pubertal development usually starts with enlargement of the te**es, followed by growth of p***c hair. Then the p***s enlarges. 🥒 You will typically see the growth spurt about a year or so after the ge****ls start to enlarge. Most boys are not going to be open with their parents about “things” getting bigger. Just know what once they start getting tall fast, it has begun.
Keep in mind that this time period is a very trying time for kids. They have so called “puberty brain” and they are figuring themselves and their feelings out. It may seem like they believe that everyone is trying to upset them on purpose. Anything you say will aggravate them. Not because of what you said, just because you are saying anything at all. This has nothing to do with their feelings towards you. What it has to do with most likely is that a friend at school said something to another friend and not to your child 👭. Or that girl or boy they have a crush on was talking with someone else 💔💔. Or maybe they didn’t finish a homework assignment as they should have and they got a lower score than they would have liked. Or maybe you blinked wrong 👀. Whatever it may be, this too shall pass. Remember this is a huge transition period in their (and your) life.
Key tips: Stay ahead of the game 🏐🎲🎮 and be prepared. Rather than having the “talk”, break it up and talk about it over something you both enjoy (more effective that way). Make sure your daughter has a “period pack” 📅 on hand in case she is to start at school or away from you (most schools have supplies in the clinic 👩🏻‍⚕️ for these surprise visits, but if you get a chance, donate some pads to your daughters school, they always run out by the end of the school year!). Make sure you child is comfortable talking with you (or someone they trust) about their feelings. Your child’s health care provider is a great person for them to talk to about what’s to come.
So, when should you come to me (or to your provider?)
1. If puberty starts before the age of 8, then I would like see them. In most cases, just for discussion and staging of puberty (we rank puberty in stages), but sometimes bloodwork 🩸, x-rays 🦴 or a visit to endocrinology is necessary.
2. If your daughter’s period is not regular after about a year. The transition of all of the hormones is tough on a body, so sometimes it can take her body to regulate her cycles up to year. If after that, it is absent, or not regular, then it’s worth a deeper look 👀.
3. If you daughter hasn’t started her period by age 15, or your son has not started development by the age of 16, I would like to see them. Not time to worry yet, but again, may need some additional bloodwork or referral to endocrine depending on the findings.
4. Horrible stinky bad attitudes 😡 are not a reason to visit. Intentionally defiant behavior is also not a reason to visit your primary care provider (unless you are in need of direction for discipline etc). But this behavior is some what expected. Jump back to that toddler stage of needing independence and pushing the limits, and tantrums. Thought that was over? Cue teenagers.
5. Bad attitudes may not be a reason, but thoughts of su***de, hurting themselves or hurting others IS a reason to visit. 😭😞😢 We can help. If we personally can not, we KNOW resources that can.

Here’s a link for some resources that might help, in addition to your little talks with her.
https://www.amightygirl.com/blog?p=11614&fbclid=IwAR3n4KsQ_Uk110t7yi8hlpzlRMflWSrlPg0BOHXobspz9OI82zcqshKweVc
Please feel free to share my post with any one this might help 😊
More to come,
Dr. June 💖