Ages 5 years and up: 

• We will be holding a Covid vaccine clinic on Saturday, October 7th from 8:00-11:00 AM for those ages 5 and up. If you prefer weekdays, we are also doing them Monday 10/2 from 6:00-7:00 PM and Wednesday 10/4 from 5:45-7:00 PM.

• If you are interested, email info@heightspediatrics.com with your name(s) and preferred appointment dates and we will get back to you!

• If you recently received the bivalent Covid vaccine, you should wait at least 2 months to receive the updated version. 

Ages 6 months to 4 years: 

• If your child recently got their first dose of the bivalent vaccine, they should get their second dose (updated vaccine) at least 3 weeks after the first dose. 

• If your child recently received their second dose of the bivalent vaccine, they should get their third dose (updated vaccine) at least 8 weeks after the second dose. 

• Please call our office for these appointments.

We are scheduled to receive the updated Covid vaccines some time this week. As you may have heard, there is a significant change in the way that the vaccines are obtained. We are now responsible for purchasing the vaccines (each dose is between $150 - $170). At this point, the insurance companies we work with are not able to confirm if they will reimburse us, and if so, whether it will be the full cost or partial cost. 

As always, we will continue to submit your office visit to your insurance, but you may be responsible for the payment if your insurance does not reimburse us. If you are worried about the cost of the vaccine, please call your insurance before your visit to find out if they cover this vaccine. 

Please email the office to let us know if you are interested in receiving the vaccine so that we can order doses accordingly. As always, we will be offering the vaccine to parents as well. If you have any questions, please feel free to reach out to us through the portal. 

FLU SHOTS: Fall is flu season and so flu shots are now available as well. Please email us to request an appointment. And yes- you can get a flu shot and Covid shot at the same time!

RSV SHOTS: We have received a lot of questions on RSV shots. We promise that we are working on it and will have the shots ready as soon as it is possible. We will send another update once we have them available and will get a dose for everyone eligible. Please stay tuned!

As always, thank you for your support. 

Your team at Heights Pediatrics

To ensure the quality of our non-medical services that make Heights Pediatrics stand out, we find ourselves needing to charge our patients for the services that are not covered by insurance.

To do so, we have developed a Patient Service Plan (PSP) that will require an annual fee per child as follows:

• $100 per child for July-Dec of 2023
• $200 per child for Jan-Dec of 2024

When participating in our PSP, the following services will be included:

• Forms completion (outside of in-person well child office visits)
• Refill requests (outside of office visits)
• Miscellaneous non-medical services, such as meetings with schools and/or therapists or phone meetings with parents when they are not present during the visit
• Prior authorizations when needed
• Free Heights Pediatrics educational Zoom classes (view classes schedule)
• Discounts on CPR classes, New Mom’s Group, etc.

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Please also note that the PSP IS NOT MANDATORY. However, if you decline the plan, you will be charged for individual services as follows:

Individual Services:

• Form/letter completion (aside from complimentary DOE & 504 forms requested during well visits): $50 each
• Expedited form fee (same day service): $50 add-on
• Refill requests (same day or after hours): $50 each
• Heights Pediatrics educational Zoom classes: $30 each
• Miscellaneous non-medical services: $50 each
• Prior authorizations: $75 each
• Infant and toddler CPR Class: $100 per person (or $70 if opted for PSP)
• New Mom’s Group: $250 per person (or $200 if opted for PSP)

We reserve the right to implement price changes in the future.

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All families are required to Accept or Decline the Patient Service Plan. Families with Fidelis/Medicaid are excluded from both PSP and individual fees, but still need to submit a quick response.

MANDATORY RESPONSE FORM

SUBMIT RESPONSE FORM HERE

PAYMENT

If you Accepted the Patient Service Plan, please submit payment at your earliest convenience: PAYMENT LINK HERE

QUESTIONS

Prior to contacting us for questions, we encourage you to check our Patient Service Plan FAQ page. If your question is not answered there, email info@heightspediatrics.com with "#PSP2023" in the subject line.

As we promised, we are working on obtaining more vaccine doses as soon as possible. Heights Pediatrics has already been approved as a vaccination site and we are just waiting for shipment confirmation of the doses. After Dr. B’s hard work (she spent 3 hours last Friday at the Department of Health making sure that everything is OK-- and we thank her greatly!!), we are confident that the vaccine is coming either next week or shortly after that.

We will be vaccinating patients of our practice first and then we will open the vaccination to all interested families in the community outside of our practice. We will organize special hours for vaccinations- early mornings, late nights and weekends. In time, we are confident that we will have enough vaccines for everyone.

Please be sure that our patient community will be the first to know once we get more information. We understand that this is exciting news, but please try not to call our office at the moment as we do not have any more information outside of what we have included in this letter. This is still developing and we are actively working on setting everything up. We will send an update with more information as soon as we have the shipment information.

Thank you for your patience and we hope that you will all join us in fighting this pandemic.

Thank you,
Your team at Heights Pediatrics

We are very happy about Spring coming (pictured above are Dr. Silverblatt’s favorite Lilacs!), most kids going back to school, and New York City slowly reopening. The restrictions are slowly being relaxed- but we still need to remain careful and vigilant. Here is an interesting perspective on masks:

• The NY TImes - Mask On or Mask Off? Life Is Getting Back to Normal, and We're Rusty

Heights Pediatrics has some very exciting news as well.

THE COVID-19 VACCINE IS HERE

As of next week, we are getting our first shipment of the Moderna vaccine. We will be offering vaccines to everyone-- not just patients of Heights Pediatrics. This will require an appointment. Moderna is approved for people 18 years and older. We are actively working on getting the Pfizer vaccine as well (which is approved for children as young as 16 year of age). Please help us spread the word about vaccine appointments and get the whole city immunized! Individuals that are interested should just call our office for an appointment. We will be able to vaccinate people in their cars as well, so no need to come into our office.

We get a lot of questions about the availability of vaccines for children:

• CNBC - BioNTech Expects Covid Vaccine Data on Kids 5 to 11 as Early as End of Summer

We hope this will be true- rest assured that we will have the vaccines for children as soon as they become available.

For those interested here is an interesting link about how the vaccines are made:

• The NY Times - How Pfizer Makes Its Covid-19 Vaccine

And now for some very exciting news- Heights Pediatrics is expanding!

MEET DR. SARA BATOOL



We are very excited to welcome Dr. Batool to our practice. Dr. Batool grew up in New York City and completed her residency at the Upstate Golisano Children’s Hospital in Syracuse. Dr. Batool is very excited to meet all of our patients and become part of the Heights Pediatrics team. She will be starting on June 1st, and you can already schedule an appointment with her!

NEW OFFICE UPDATE

Lastly, I cannot forget to share the progress on our new location! Work is still ongoing and without any major issues, we should be moving during the month of June.

Stay safe,
Your team at Heights Pediatrics

First, I want to thank all our patients that contributed to our donation drive for a family that was struck by a sudden disaster. The amount of donations were overwhelming and within 20 minutes we actually had to stop the collection! The family was able to choose whatever they needed and the rest was donated to charity. We’re so thankful to have such a caring community that steps up to the plate to help when somebody is in need. Thank you again!!!

Here is another example of help that was very impressive to us and may bring a smile to your face:

• The Wall Street Journal - Stuyvesant Students Tutor New York City Children Amid COVID-19 Pandemic

Please share with your high schoolers- there is nothing better for our mental health than doing something good for others!

MENTAL HEALTH

Talking about mental health, here is an article that is very concerning and reflects what we have been seeing in our office.

• Time - Insurance Claim Data Show How Much Teen Mental Health Has Suffered During the U.S. COVID-19 Pandemic

Please do not delay getting help for kids that are showing signs of mental health issues. An ounce of prevention is worth a pound of treatment. You may always call our office for a list of resources.

Here is another insightful article:

• The Wall Street Journal - For Better Health During the Pandemic, Is Two Hours Outdoors the New 10,000 Steps?

SCHOOL REOPENINGS

We are happy to hear that schools are reopening and we hope that the majority of kids will be able to return to in person education. See the article below, classrooms are looking like a safe place to be.

• NBC New York - Study Finds Strong Evidence of Low COVID Transmission in NYC Schools • CDC - Operating Schools During COVID-19: CDC's Considerations

COVID-19 VACCINES

Lastly, we want to encourage everyone who is eligible to please get the vaccine as soon as possible. With the emergence of new variants the vaccine is the best thing that we have to bring coronavirus restrictions to an end. As always- vaccine education starts early. Here is a book about the history of vaccines that both you and your child may enjoy:

• The NY Times - A Kid-Friendly Graphic Novel History of Vaccines

OUR TEAM

As for Heights Pediatrics- we are going strong and doing all we can to make it another successful year! Remember that we are always available for appointments, potentially on the same day you call, and we continue to offer Covid testing and telemedicine visits, ADHD evaluations, and much more.

Thank you all for your continued support and we hope that you enjoy the beautiful spring weather!

Your team at Heights Pediatrics

The tragic loss of life as a result of COVID-19 is enormous and incomparable to anything else that we have seen in recent history. We will also have to consider that the coronavirus could very well be here to stay and may just change the way we live forever. Here’s an article that explores that idea:

• The Wall Street Journal - As Covid-19 Vaccines Raise Hope, Cold Reality Dawns That Illness Is Likely Here to Stay

THINKING OF TRAVELING? HERE IS A NEW IDEA:



PARENTS VS. SCHOOL CLOSURES

The toll that school closures are taking on our families is enormous. We encourage all our parents to reach out if they need to talk or if they feel like they need help. We are always available.

• The New York Times - Three American Mothers, On The Brink

VACCINES & ELIGIBLITY

But let’s take a moment to point out the recent achievements of modern science. The speed with which we were able to develop the vaccine, which will help us to come back to some semblance of normalcy, has never been seen before. Almost the entire staff at Heights Pediatrics has been successfully immunized. We want to encourage everyone that is eligible to get vaccinated as soon as possible. As of February 15th, the eligibility for the vaccine in NYS will expand significantly - it now includes people with select medical conditions. Please refer to the link below to see if you are eligible for the vaccine.

• NYS DOH - Check Covid-19 Vaccine Eligibility



NEW OFFICE

As for news from Heights Pediatrics- the construction of our new office has officially begun! We are very excited and are busy designing the new space. When the time comes, we will send out more updates.

Stay safe, continue to social distance, and we hope to see you soon!



Your team at Heights Pediatrics

After 4 weeks of vaccinations, no major side effects were widely reported. This is very encouraging going forward with the vaccination records. A note of the reports of the few allergic reactions: they may be concerning, but rest assured the reaction is short lived and fully treatable.

Both of our doctors have already received their first dose of the vaccine, and most of our staff already have appointments to get their vaccines. We strongly encourage everyone who is eligible to get their vaccine as soon as possible. The immunization rates across the city are low so far, but hopefully will increase soon. Here are some links that you may find helpful:

• CDC - Covid-19 Vaccines
• NYS Department of Health - Covid-19 Vaccine: Get the Facts
• The New York Times - Now That Grandma Has Been Vaccinated, May I Visit Her?

That being said, we want to alert everyone that we have seen more positive cases in our office this week than any other previous weeks. Many day cares in the area had to close due to positive cases among students or teachers. The most likely cause of this spike in cases is the holidays- people traveled to see friends and family. This is completely understandable but PLEASE be careful for a bit longer. Remember to take the appropriate precautions to prevent spreading the virus to others.

We continue to provide testing with an excellent return rate and encourage everyone to make an appointment if needed. If your children develop any symptoms, please do not hesitate to call us to discuss your next steps. Here’s a helpful link to get started:

CDC - What to Do If You Are Sick

Stay safe,
Your team at Heights Pediatrics

IMPORTANT INFO FOR ALL FAMILIES/INDIVIDUALS GETTING TESTED BY US

After scheduling your appointments, we will send the following information. This is a heads-up to all families, so that you are aware of what we need prior to your appointment.

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Lab Selection

When we send the samples there are different labs to choose from. The traditional ones such as Labcorp, Quest, LIJ/Northshore, etc. have a longer and very variable turnaround time due to the higher volume they receive (3 to 7 days). This is why we have found smaller labs with turnaround times that are shorter (about 3 to 4 days when samples are sent Monday to Thursday). The variability depends on the volume of samples the city produces in a given day.

In order to facilitate the testing and billing process, when you come Monday, Tuesday, Wednesday, Thursday we will be using the smaller labs such as BDL, unless you tell us otherwise. On Friday we will be sending specimens to LIJ/Northwell (You can consult with your insurance directly and verify in network coverage. As far as we have been informed, all COVID tests done under medical necessity are covered by all labs, but it is unclear what the coverage is when doing it as a choice).

Checking Your Results

For BDL (Bio Diagnostics Labs) Lab: Each family being tested will receive a link to BDL. With this link, you will be able to populate the information the lab will need to bill your insurance appropriately and they will also be able to send your results directly to you in real time (as soon as we receive them).

For LENCO, LIJ/Northshore, LabCorp, or Quest Labs: Our office will notify you via phone call (which will add about 24 hours to your waiting time) and if you desire you can go to the particular lab’s website and retrieve your results. Click here for the links: Laboratory Patient Portals. These labs will not automatically send your results.

As a policy of Heights Pediatrics, we will be happy to discuss positive results and next steps with each affected individual with a telemedicine visit.

What We Need From You

Please complete and send us the following items at least 48 hours before the appointment for each person receiving the test:
1. Covid-19 SWAB Testing Consent Form (will be attached in email sent to you after scheduling) - please complete ALL sections
2. Photos of the front & back of your insurance card(s) - we need these for documentation
3. If you choose BDL Lab, please register for each person in the link (that will be provided) in addition to completing #1 & 2.

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NEW PATIENT PORTAL

Regarding the new Patient Portal, please refer to our Portal FAQ page if you have any difficulty registering or navigating!


Thank you for the opportunity to help!
Your Team at Heights Pediatrics

In the next few days you should be receiving an email with a PIN number that you will be able to use to register for your new portal account. You will need to download an app - please use the following link that contains a QR code that will take you directly to the download page: Patient Portal App - QR Code to Download

Here is the link for instructions on how to proceed: Request A PIN and Complete Registration - Quick Reference Guide

Please remember that unless you re-register, you will not be able to access any of your information or questionnaires.

If you have any troubles with the transition or questions, please do not hesitate to contact our office by email: info@heightspediatrics.com. Thank you for being patient as you can imagine this will be somewhat of an overwhelming task for us.

REMINDER- FLU SHOTS ARE STILL AVAILABLE

We are now immunizing adults as we secured more flu shot doses! Call our office to schedule a visit.

Warmest Regards,
Your Team at Heights Pediatrics

We offer the Covid PCR test (the gold standard testing option for screening and asymptomatic patients) with a turn around time of 12-24h. Typically, you will receive the results the morning following the test. 

We offer the Rapid Antigen Covid Test (results in 15 min) for all actively symptomatic children. Remember: if you go to urgent care centers and take a rapid test while you are asymptomatic, it is inaccurate and you may receive a false negative.

We are still offering the Covid antibody test.

 

FAMILY OR POD/DAYCARE TESTING

We have developed a new program to help daycare centers and educational pods stay open and ensure student safety! This service can be utilized by individual families as well. 

We will come to your daycare, pod or home on a regular basis (weekly or every other week) and test whomever would like a test. We will report the results to you by the following day.

This way, you can get tested in your house or school without waiting in lines that often occur outside of busy testing centers. Please let us know if you are interested in hearing more about this service and how to sign up. Feel free to email us with any questions that you might have. 

GET TESTED BEFORE THANKSGIVING

We highly recommend that everybody should be tested before you go and see your families over Thanksgiving. Remember that large gatherings are discouraged due to the high risk of transmission, but testing is one of the best ways to protect the loved ones you will be visiting. We can test the whole family in the office before you travel!

In case you are curious to see how Covid tests work, here is a really helpful link: How do the tests for coronavirus work?

WHEN TO GET TESTED AFTER EXPOSURE

This seems to be a very common question these days. The answer is not always clear and depends on many different factors. 

Generally, you can become positive any day during 14 days after exposure. We know that the majority of people will become positive by day 5 after exposure. We feel that you do not need to run to City MD at night after you heard that you were exposed. Testing on day 5 is likely one of the safest ways to do it. 

If you have any questions about it please feel free to discuss it with the doctors.


Warmest Regards,
Your Team at Heights Pediatrics

Please note that New York’s travel quarantine rules have changed. Governor Cuomo just ended the quarantine requirement that has been in place and instead, people who are traveling into New York need to show proof of a negative test 3 days prior to entering the state and 3 days after arrival. Let’s briefly review the testing options that we currently offer:

TESTING FOR COVID

1. Rapid Covid antigen testing (~15 min) for any symptomatic child. Please note that this test is not accurate for asymptomatic individuals.
2. A PCR test for all asymptomatic patients (and parents). The turnaround time for this test is estimated to be 12 hrs (we have partnered with a new lab and we are testing their return time). Otherwise, the orders from the lab that we have been using since the spring have a return time of about 2-5 days. This is the test you need for any travel and also clearance for attending school.
3. Antibody testing. This test shows if you have had a Covid infection more than 4-6 weeks prior to testing. As far as we know, there is no proof of long lasting immunity from Covid.

We offer testing daily-- please call and schedule an appointment. There is no need to take your family to urgent care centers and then come to us afterwards- we are trying to decrease the exposure to Covid that our patients have.

SCHEDULE YOUR CHECK-UPS AND FLU SHOTS

Please make sure that you schedule your family’s check ups. It is important that everyone has all of their immunizations up to date.

Please keep in mind that our supply of flu shots is very low and will eventually run out-- please schedule your children’s flu shot as soon as you can before the window closes! Because we are low on supply, we are reserving the remaining flu vaccines for children only. We will no longer offer immunizations to parents, but we encourage them to receive this vaccination elsewhere.

NEW PORTAL

We are revamping our patient portal and will be switching over to a new portal. In order to keep improving your experience with the patient portal, all patients will unfortunately have to re-register. This process will be easy and it should be a smooth transition onto the new portal. Please keep an eye out for an email going out soon with directions on how to download the new portal app. After that, all parents will get a PIN number with instructions on how to re-register. The new portal will have a lot of new and very cool features to improve user experience, so please re-register once you receive the email so that we can hit the ground running!

Warmest Regards,

Your Team at Heights Pediatrics

 

COVID TESTING UPDATES

On the other hand, here at Heights Pediatrics we are getting ready for accommodating a larger number of sick children (which is likely to increase after schools open again). We are one of very few pediatric offices in the city that have acquired the rapid Covid test. Following the protocol put forth by the manufacturer, we will be reserving the rapid test for children that are actively sick with symptoms consistent with a covid infection. Please note that these tests will be reserved for patients of Heights Pediatrics only. For symptom-free children that will need to be cleared to go back to school, regular Covid swabs will be used. For patients and parents of patients, we are continuing to offer both antibody tests and elective Covid tests as before. 

OFFICE SAFETY

Our “your room is ready” notification system is up and functional (please be patient with it- we are still working out the kinks)- and we will continue to use it as we think it is the most effective way to eliminate use of our waiting room to promote social distancing for our patients.

We are devoted to safety now more than ever. We are continuing with the separation of sick and well patients- that may prove to be inconvenient for some but it will be very important going forward. The sick patients will be seen in the very beginning and the end of each day. The middle of the day will be reserved for whole office cleaning and then well patients.

FLU SHOT SEASON

The last and very important thing- as fall approaches so does FLU SHOT SEASON. Our flu shots have been promised to arrive next week. Like every year, we are organizing multiple flu shot clinics both on the weekend and weekdays. We are offering flu shots only (injectable), as the nasal preparations have historically had troubles with efficacy. Please call our office to schedule an appointment for the whole family.

Warmest Regards,

Your Team at Heights Pediatrics

 

As a result of the low infection rate in New York City, our governor has allowed schools to reopen. But, to go back to school or not to go back? Is it safe? This is probably the question that we get most frequently right now. We think that this is a very personal decision that depends on many factors. Families should assume that if they send their children to school that there is a realistic chance that children will be exposed to the virus. We then need to think about who our children will be interacting with-- are there grandparents or immunocompromised individuals in their lives? Are their parents healthy or do they have predisposed conditions that make them high risk? Did the kids do well with remote learning or did they struggle with it? Are they younger or older? How is their self motivation?

In other words, this is no simple decision. The good news is that there are indicators that multiple vaccine trials are progressing and there is a chance that the vaccine may be coming next year. If you have any concerns about returning to school, please feel free to give us a call.

No matter what your decision is, we still need to continue to stay safe- wear a mask and wash your hands. We hope that you can find these following articles helpful:

• https://www.cnn.com/2020/08/03/health/fda-hand-sanitizers-list-expands-trnd/index.html
• https://www.cnn.com/2020/08/08/us/duke-university-face-mask-test-trnd/index.html

As far as Heights Pediatrics goes- all is well! We are happy to be seeing many of our patients and we continue to make improvements. We will continue separating sick and well visits for the foreseeable future because we consider this to be the most important and effective safety measure. We also encourage all of you to consider our telemedicine services whenever appropriate. Not all services that we provide require a trip to the office. Telemedicine is convenient and lowers your risk of exposure while traveling to and from the office.

On a side note, Heights Pediatrics is preparing to announce some very exciting news but we cannot reveal it until all is final (which we hope is very soon)! Keep your eyes out for an announcement about this in the near future. In the meantime, thank you all for your continued support during this time and we hope to be seeing more of you soon! Stay happy, healthy, and well.

Warmest Regards,

Your Team at Heights Pediatrics

Also, please avoid large gatherings! We can all enjoy dining out “al fresco” but will have to wait for indoor dining. The more disciplined we are, the more likely it is that our children will be able to return to school in September- as we all know, that should be our collective goal.

We are enjoying seeing many of you in the office. The Telemedicine visits continue to be an excellent alternative for the families outside of New York City. We continue to offer all of our families both the antibody test and antigen test (you may need it before you travel). Our schedule has changed slightly and both doctors are now back to seeing well visits as well as sick visits. We are continuing with rigorous cleaning of the exam rooms and reception area and we are very successful with maintaining social distancing in the office. Please bear with us while we perfect our “room is ready “ notification system, it is new for us.

We would like to believe that school will reopen in September and with that, everyone will need an updated check up- please call the office and schedule your appointment as we will likely get quite overwhelmed at the end of August!

Enjoy your 4th of July weekend,
The staff at Heights Pediatrics  

We continue to offer testing for Covid-19 (both antibody and antigen) to anyone who may need it. You should consider getting tested after you may have been exposed, before travel and any other situation that may require it- even if you don't have any symptoms.

As for our practice, all is well with us and the staff. We are working on a lot of exciting new changes and we will let you know about them as soon as they will be finalized.

We would like to ask our patients to help us improve our workflow so that we can keep everybody safe. Please show up on time for your appointment- if you are late (or extremely early) it makes it difficult for us to assure social distancing in the office. We may need to ask you to reschedule if you are significantly late and the appointment after yours is already in the office. Also, please FILL OUT YOUR QUESTIONNAIRES before your appointment. These must be completed before your visit can begin. Doing so ahead of time will significantly decrease the amount of time you spend in the office.

Enjoy the beautiful weather, wear a mask and remember to practice social distancing!
Your team at HP

As far as our practice goes, we are very happy to be seeing a lot of patients in the office! We are all healthy and happy to be working. In our ongoing efforts to keep our patients and employees safe, we will be implementing some changes in our office to allow for better social distancing and decreased time spent in the office. We will be trying out a reservation confirmation system (just like in restaurants). We’ll text you when your exam room is ready so we completely eliminate waiting room time. We will ask for your cooperation and your feedback to create a system that works for everyone. Also, we’ll be asking for your credit card at the time of the appointment (to charge for copays) to eliminate face to face interactions at the reception desk.

The staff is going to be downloading school forms to your children’s portal automatically after their check up. It is our attempt to streamline the process and eliminate multiple calls. The forms should be on your portal in about 1 week after the check up.

Please let us know if you have any comments, questions, or suggestions.

Stay safe and we hope to see you soon,
Your team at Heights Pediatrics

As conversations about race with your children can be difficult, here is a resource that is helpful for having that important conversation: “Your Kids Aren’t Too Young to Talk About Race.”

Governor Cuomo has also allowed summer day camps to open. We get a lot of questions from parents about the safety of these day camps. The answer is not yet clear and may vary depending on how many coronavirus cases we see in the community. The short answer is- any group activity can put your children at risk of contracting coronavirus. On the other hand- the continuously lowering incidence rate of coronavirus lowers the risk and so if there are no high risk members within your family, it may be OK to send your child to day camps. It is a very individual (and difficult) decision from family to family.

Please let us know if you have any comments, questions, or suggestions. Stay safe and we hope to see you soon,
Your team at Heights Pediatrics

Heights Pediatrics is actively rethinking the functionality of our office for the future-- as a precaution, we are having our receptionists work from home for as long as possible. We are trying to keep our technology up to speed-- if you get the answering machine when you call, please leave a message! We will call you back.

The antibody testing is going strong. Please call our office and schedule an appointment if you are interested in knowing if you were exposed to the Coronavirus. Please remember that we are still not sure if the positive antibody test guarantees immunity to the disease. If your test results come back positive, please remember that it does not exempt you from CDC guidelines. All that the test can tell us is whether you have been exposed to the virus or not. We should all continue to practice social distancing and wear masks.

Let's make the best of it, let’s barbecue (without any guests) and enjoy the start of summer! Stay well.
Heights Pediatrics

With that - at Heights Pediatrics we will continue to offer telemedicine services and in office visits. Office visits operate with a reduced schedule that allows for social distancing in the office. Also, our staff will remain divided into 2 teams (well team and sick team) so that we minimize the chance of infection in the office via staff. We have opened our schedule through the end of August and we strongly encourage everyone to make their well visit appointments soon, as we expect to be very busy in August.

We are also following the news about a new condition primarily affecting young children that may be related to COVID-19. So far, it seems that the condition is quite rare and if caught early, is treatable. If your child has a very high fever (a fever is a temperature of more than 100.4ºF) for longer than 48 hrs, please contact our office and we will be happy to discuss what your next steps are.

We continue to be very optimistic and really appreciate your continued support. We are so incredibly grateful for all of our patients and their families. We are here for you!

With Love,
Your team at Heights Pediatrics

Our office remains open, as many of you know. You may have read the article in the New York Times that warns about a dangerous decrease in vaccination rates during recent times. This article completely expresses our sentiment and stands by our values. We recommend taking a look at it if you’d like to learn about changing trends in vaccination rates due to the pandemic.

We are open for well visits at different times than sick visits. We have a different set of staff members seeing sick patients vs. well patients so that we absolutely minimize a possibility of exposure. We strongly encourage all of our patients not to delay their check ups! For the many of you who have left the city, we do offer telemedicine visits. Home visits have recently become another option that we offer and truly enjoy.

Telemedicine is, as always, an option for any other issues like allergies, asthma follow ups and acute issues that may arise.

As of the week of May 11th, we will be running a serology clinic for all of you who are interested in knowing if you have had the virus or not. This is the antibody test that has recently been made available. We will be offering this test both to parents and children! Bloodwork is taken with results in 2-3 days. We all have to keep in mind that the information this test provides is limited and at this point still does not guarantee long term immunity.

Stay safe and thank you for your continuous support!
Your team at Heights Pediatrics

Heights Pediatrics is open daily for sick visits during the morning. These visits are for urgent appointments that cannot be handled via Telemedicine. We are also open for check-ups in the office. The well visits are conducted at different times from sick visits. We have divided our office into 2 teams- 1 team for sick visits and 1 team for well visits. The well team has been isolating and has not seen any sick patients for about a month. The well visits are also conducted at different times from sick visits.

We strongly recommend families that are around and due for a check-up to call the office and schedule as soon as possible. We expect to be overwhelmingly busy with check ups in the summer as many families will be getting back from extended stays outside of NYC.

We are also offering home visits if you do not wish to come to the office. These are for well visits only. Please call the office and the staff will help you schedule a visit that is appropriate for you. We now offer these visits even for children who are not clients of Heights Pediatrics.

If you have left the city for an extended period, you can schedule telemedicine check-ups - only parts of the visit can be done on line so you will need to come to the office upon return to New York for a quick exam and immunizations.

And please don’t forget - we are always available for any questions or concerns you may have via Telemedicine.

Stay positive and enjoy the spring,
Staff at Heights Pediatrics

To minimize exposure, we have separated our staff into two groups, with each group taking care of either well visits or sick visits. We will be seeing well visits at separate times from sick visits as well.

We will be contacting all patients that are due to be seen next week to try and accommodate and/or reschedule you. We will prioritize check ups at 2 months and 4 months, and will reschedule all other check ups based on availability. Also, home visits for well check ups are an option in Brownstone Brooklyn (or within 5 miles of the office). We are unable to travel further at this point.

We will continue sick visits both in the office and through Telemedicine - please call us and we will direct you to the appropriate service. Remember- no question is too small and the majority of visits are covered by your insurance!

As times are hard, we are also thinking of starting a support group (via Zoom) for both parents and children, working with psychologist Irena Kenny LCAT and one of our doctors. This group would be focused on easing anxiety towards the current situation, as well as offering a place to talk. If you would be interested, please let us know.

We will send another update on our practice next week. Please stay safe, follow social distancing orders, and have as much fun as possible!

- Dr. Maidana, Dr. Silverblatt, and staff at Heights Pediatrics

Until further notice, we will be opened for sick visits only Monday - Friday from 10am to 1pm. We will reschedule all check ups to Evisit check ups (which will follow an office visit for height, weight and shots when the situation calms down). All non essential visits will be done via Evisit from 10-4 daily. We will be available via phone for urgent matters 24 hour a day as always. During those times we may be able to do telemedicine visits at the discretion of a physician as well.

Please do not hesitate to contact us should you have any question or concern. 

We wish you all well!
Sincerely your staff at Heights Pediatrics

As of Tuesday 3/17 we will institute a system of separating the well visits and sick visits. We will be seeing the sick visits daily from 8-11 am and 4-7 pm. We will see well visits between 11am - 1pm and 2- 3:30 pm.

For patients who do not live within walking distance to the office we are offering check ups via telemedicine. These visits would have to be split in 2 parts- telemedicine check up during your regularly scheduled time (we will send you a link to your phone) and provide all the counseling needed, and then later when conditions settle you would have to come in for quick measurements, exam and shots if needed. We will start calling patients to reschedule their visits to fit them into this schedule as early as possible.

We will be diligently cleaning the office in between the sessions to prevent any contamination. To protect your fellow patients and our staff, we will ask all our patients with fever and upper respiratory symptoms to call us when they are in front of our office so they can be handed a mask. We also want to inform families that some visits can be done via our telemedicine service. It is really simple. After you call and schedule an appointment we can forward you a link and simply connect via facetime.

Currently we are not planning to close the office unless the Department of Health requires us otherwise. Up to date, we have not seen any positive cases of Coronavirus in our office. As far as testing goes - we have a very limited amount of tests that we reserve for our sickest and most vulnerable patients. That situation is likely to change very quickly and we will keep you informed of any changes.

Please follow us on our Facebook page where we will be posting our most recent updates. If you have any questions do not hesitate to call us.

Moreno & Silverblatt

Although we have absolutely no indication that this will be necessary, we would like to share our contingency plans with you in case of a mandatory physical closure of our facility. We will continue to schedule patients as usual. If you have a check-up on a day that we are not open, we will send you a link for an e-visit (this will be a text message at the time of your appointment). In such a case, we will do all of the counseling and education online, which takes up 80% of a normal check-up. Subsequently, we will schedule a follow-up in-person visit to do the full exam, metrics, and immunizations. If your appointment was for a sick visit, you will also receive the text message for an e-visit, and we will decide together what is the most appropriate next step.

You should always feel free to reach out to us with any doubts or questions by calling (718) 858-4924. Our thoughts are with you during these trying times.

Best regards,
Dr. B Maidana and Dr. K Silverblatt

Symptoms of Novel Coronavirus are fever, cough, shortness of breath, body aches, fatigue, sore throat, headaches, diarrhea. And, if these sound familiar it’s because this is just another viral infection. Please CALL US if anyone in your family has symptoms.    As with any other viral syndrome, you need to maintain all common-sense health and wellness practices, as well as take all regular precautions to prevent transmission of viruses.    As has always been our practice, we thoroughly clean and disinfect all surfaces before and after each patient is seen. Our staff wash their hands with soap and water throughout the day, before and after each patient encounter.    It is our policy that families must notify us if their child has any communicable disease, which we communicate to both staff and DOH accordingly. In the event of a case of COVID-19 within the community, protocol would go far beyond including a prior call for triage before determining that a visit to the office is the next best step.   Here are a few additional resources that may be helpful as this situation continues to develop:  

• The DOHMH just released this letter addressing the current status and relevance to New Yorkers, along with this FAQ sheet to guide you further.

 

• Though published several weeks ago, this article provides helpful points for talking with school-age children, particularly given the increased media attention they are likely aware of. While it is understandable that adults may be concerned, keep in mind the importance of modeling calm conversation regarding the situation with your children.

  

• Amid the latest developments related to this outbreak, we believe in the importance of refraining from xenophobic rhetoric. The National Association for the Education of Young Children recently published this article warning against possible fear and misinformation specifically targeting individuals of Asian descent.

 

• For parents of young children, we ask that you refrain from having conversations in front of your children that may cause unnecessary worry or concern.  

  Again, the health and safety of your children and all members of our community continues to be our top priority. As this situation progresses, we are committed to both monitoring new developments as they emerge and keeping you informed in a clear and timely manner.   We are deeply grateful for your partnership in keeping our community safe, and wishing only the best of health to you and your family.   How to protect your family:

• WASH YOUR HANDS regularly with soap and water for at least 20 secs
• Keep your kids away from others who are sick and keep them home if they are sick
• Teach the kids to cough and sneeze into their arm or elbow, not their hands
• Clean and disinfect household objects and surfaces in your home
• Avoid travel to China, Italy, South Korean, Iran.

Please refer to our facebook page for the most updated articles.   Follow us on Instagram at https://www.instagram.com/heightspediatrics/

  Flu viruses spread mainly by droplets made when people with the flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby, even people up to 6 feet away! Less often, a person might get the flu by touching something that has flu virus on it and then touching their own mouth, eyes or nose.   Symptoms of the flu can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, and chills. Some people with the flu will not have a fever, up to 2/3 of people with the flu can be asymptomatic and still be able to spread the flu virus. People with the flu may be able to infect others by shedding virus one day before even showing symptoms, and up to 5 to 7 days after symptoms have begun. Typically flu symptoms can last from 5-7 days, and sometimes up to 2 weeks.   The best way to prevent your child from getting the flu is to get the seasonal flu vaccine. It is also recommended that all family members and care takers of small children receive the vaccine. In addition to getting vaccinated, take and encourage your child to take everyday steps that can help prevent the spread of germs. This includes:

• Stay away from people who are sick.
• If your child is sick with flu-like illness, try to keep him or her in a separate room from others in the household, if possible.
• CDC recommends that your sick child stay home for at least 24 hours after his or her fever is gone except to get medical care or for other necessities. The fever should be gone without the use of a fever-reducing medicine.
• Cover coughs and sneezes with a tissue.
• Wash hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
• Avoid touching your eyes, nose and mouth. Germs spread this way.
• Keep surfaces like bedside tables, surfaces in the bathroom, kitchen counters and toys for children clean by wiping them down with a household disinfectant according to directions on the product label.

  If your child were to get flu-like symptoms there are a few steps you should take.

1. Keep your child comfortable by reducing pain or fever. The best medications for this are acetaminophen and/or ibuprofen. Conduct your child’s healthcare provider if you have any questions about the dosage or administration of either of these medications. You can also find a convenient dosing chart on our website heightspediatrics.com. Avoid giving products containing aspirin in children as this can potentially cause severe reactions in children, called Reye’s syndrome.
2. Keep your child hydrated with water or other clear fluids such as Pedialyte or Gatorade, which replace electrolytes.
3. If you child has any underlying health conditions, such as asthma, diabetes, other chronic issues, or is very young, see your health provider as soon as flu-like symptoms develop. These children should be tested for the flu and may be candidates for anti-viral treatment (discussed below).
4. Manage your child’s upper respiratory symptoms (cough and nasal discharge) using home remedies that are known to be effective in minimizing symptoms without causing harmful side effects. Most complications from the flu (pneumonia, and ear infections) occur from mucus in the body that isn’t cleared.

  Some of these remedies include:  

1. Have your child blow their nose often, or if they are younger you may need to suction their nose with a bulb or Nose Frida (sometimes with some saline drops or spray in the nose prior to suctioning) to clear their airways for them.
2. Use steam from warm showers to help loosen mucus and make it easier for the body to clear the congestion.
3. For children over 12 months of age, honey can be used as an effective cough medication that won’t have the side effects that the over-the-counter medications have. Over-the-counter cough medications are not recommended by the American Academy of Pediatrics for the treatment of cough due to potentially harmful side effects.
4. Elevate the head of the child’s bed by placing some pillows or rolled towels under the mattress to prop up the child when they are sleeping. This can help alleviate symptoms at night.

5. Protect yourself and others by keeping the sick child away from others, and taking standard precautions to protect others from infection like keeping surfaces clean, and washing hands often.

  When you should see your doctor:  

1. If your child has an underlying condition or is under 2 years old and presents with flu-like symptoms.
2. If your child seems very ill- exhibiting true lethargy or irritability.
3. If your child is not tolerating fluids and is showing signs of dehydration (lethargic, no urine production in more than 6 hours, or is lacking tears or has a dry mouth).
4. If your child is showing signs that they are having trouble breathing (rapid breathing, making noises when they breathe, or are using accessory muscles in their chest or stomach to breathe).
5. If your child has had symptoms for a few days but then seems to worsen. This can sometimes be a sign of a new illness, or potentially a complication from the initial illness.

      Treatment of the flu   The flu is a viral illness and in most cases does not require any treatment beyond the symptomatic care listed above, which you can do at home. In some cases, children may be candidates for anti-viral treatment of the flu. Anti-viral treatment is aimed at limiting the course and duration of the virus and therefore minimizing potential complications. Children who typically qualify for treatment are:

• The very young (<2yrs)
• Any child with a serious chronic illness
• Any child who is immune-compromised or lives with someone who is immune-compromised.

Anti-viral treatment is most effective when started within 48 hours of the onset of flu symptoms.   The most common medication used in Pediatrics to treat the flu is Tamiflu (Oseltamivir). You can find more information on Postmarket Drug Safety Information Page. There are both pill and liquid formulations of the medication and typical treatment lasts for 5 days. Most common side effects include nausea, vomiting, skin reactions, and in severe cases neuropsychiatric events such as hallucinations. Talk with your pediatrician if anti-viral treatment is necessary for the management of flu for your child.   Happy and healthy season from Heights Pediatrics!

The following is a quick and handy guide to the immunizations we currently provide. We schedule the following immunizations, as recommended by the AAP:

• DTaP (Three-in-one) http://www.immunize.org/vis/dtap.pdf
• Hib (Hemophilus influenzae type B) http://www.immunize.org/vis/hib.pdf
• Polio (IPV) http://www.immunize.org/vis/polio_ipv.pdf
• Rotateq (Rotavirus) http://www.immunize.org/vis/rotavirus.pdf
• Prevnar (Strep. Pneumococcus) http://www.immunize.org/vis/pcv.pdf
• Hepatitis B (Three-Dose Schedule) http://www.immunize.org/vis/hepatitis_b.pdf
• Hepatitis A (Two-Dose Schedule) http://www.immunize.org/vis/hepatitis_a.pdf
• MMR (Measles, Mumps, Rubella, Two-Dose Schedule ) http://www.immunize.org/vis/mmr.pdf
• Chicken pox (Varicella, Two-Dose Schedule) http://www.immunize.org/vis/varicella.pdf
• HPV (Genital Warts/Cervical Cancer) http://www.immunize.org/vis/hpv_gardasil.pdf
• Meningococcal Disease ( Menactra) http://www.immunize.org/vis/meningococcal_mcv_mpsv.pdf
• TdaP (Booster for Diphtheria Tetanus AND Pertussis or Whooping Cough) http://www.immunize.org/vis/tdap.pdf

 

• Influenza (Flu shot or Flu mist) http://www.immunize.org/vis/flu_inactive.pdf http://www.immunize.org/vis/flu_live.pdf

      Last year there were 2 developments in our vaccine schedule. First, the new version of  Guardasil vaccine came out . It is called Guardasil 9 and the main difference is that this vaccine is expanded to cover 9 serotypes of HPV virus rather then previous 4. That means that the vaccine is more protective then the previous one. It is approved for girls ages 9-26 y and boys 11-15. You can learnmore at : http://www.immunize.org/vis/hpv_gardasil_9.pdf.   Another development was a recommendation to immunize all kids at risk for Meningococcal meningitis type B. It is a standing recommendation to immunize all 11 and 16year old with Menactra, that covers meningococcus meningitis type A,C,W and Y. In recent years, we have seen increased incidence of type B in this country.  See more here http://www.nmaus.org/disease-prevention-information/serogroup-b-meningococcal-disease/. It is our opinion that all kids travelling to countries with high incidence of Meningococcal disease type B http://cid.oxfordjournals.org/content/50/Supplement_2/S37.full  as well as all kids that are going to college.   We also recommend that all patients 6 months and older receive a yearly influenza shot before the start of influenza season. For children 2 years and older without history of wheezing can get the nasal Immunization called flumist. Sometimes it is difficult to administer to our younger patients as it is preferable that children not cry during administration. If you have any questions about particular immunizations or your child’s immunization schedule, please don’t hesitate to call our office during business hours. If your child is not immunized or you have previously followed a different immunization schedule at a different practice and you would like your child to become our patient, you must discuss your child’s medical history and immunization schedule with one of our doctors before you can join our practice.

  Treatment of Vomiting and Diarrhea:   Mostly, vomiting will stop within 24 to 48 hours. Diarrhea will often continue for over a week, and it may be over 2-3 weeks before the stools return to normal. Unfortunately, Kaopectate and other over the counter mediacations are not helpful. Actually, all they do is stop the intestines from moving, allowing the virus to continue to do its damage. It is better to get the virus out of the body, even if it takes a few extra days. Antibiotics or other prescription medications are only used in the few cases that are caused by bacterial or parasitic infections. Majority of bacterial infection are not treated with antibiotics as they tend to get better on their own. The main goal of management of vomiting and diarrhea is to prevent dehydration. When hydrating the body, it usually is best to give Pedialyte or another  oral rehydrating electrolyte solution. During the vomiting phase, it is best to give small amounts like a sip or a dropper every 5-10 minutes. Increase the amounts slowly and if your child begins to vomit again, you probably went too quickly. We recommend then giving a stomach a rest  for 30 minutes before starting again with small sips. Once the vomiting has passed for at least 6-8 hours, your child can begin solid foods. Simple foods will be the best – Cheerios, crackers, rice, bananas, apple sauce or chicken noodle soup. You also want to add simple proteins like lean meats. Please avoid fatty foods and fruit juices. Sometimes after a bout of diarrhea children can have a temporary lactose deficiency and then all products with lactose should be stopped. Use of a probiotic is helpful in decreasing the amount and frequency of diarrhea when caused by a viral illness. This good bacteria now available in powder or capsules and helps to restore the balance in the digestive system. Currently our favorite probiotic is Bio-Gaia or Florastor, available at well stocked pharmacies and online.   Signs of dehydration  

• Few or no tears when crying
• Dry or sticky mouth
• Eyes that look sunken into the head
• Soft spot (fontanelle) on top of baby's head that looks sunken
• Lack of urine or wet diapers for 6 to 8 hours in an infant (or only a very small amount of dark yellow urine)
• Lack of urine for 12 hours in an older child (or only a very small amount of dark yellow urine)
• Dry, cool skin
• Lethargy or irritability

  Reasons to call us  

• Vomiting not improved after 24 hours.
• Greater than 10 episodes of vomiting and/or diarrhea in a 12 hour period.
• Fever greater than 103 degrees.
• Bloody or green vomiting or bloody stool
• Infant or child who is listless, difficult to awaken, disoriented, or irritable.
• Abdominal pain that becomes worse and is not relieved by the vomiting or diarrhea.
• Swollen or distended abdomen.
• Vomiting associated with a severe headache, stiff neck, or painful urination.
• Infant or child who cannot cry tears or has not urinated in greater than 8 to 10 hours.

We hope you will enjoy it- and hopefully learn something in the process. So our first contribution will be seasonally appropriate:

What is new with flu shots this year and why is there limited amount of nasal flu vaccine?

Every year in the fall we try to accommodate all our patient’s demands for immunizations against influenza. As per CDC all children over the age of 6 months should be vaccinated. For the second year flu immunization is obligatory for children attending day care and pre-K. We share the opinion that all children and adults should get immunized if possible. Many parents have easier time persuading their children to come into the office to get the nasal flu vaccine. The nasal spray flu vaccine – also called FluMist or LAIV (Live Attenuated Influenza Vaccine) – contains weakened live viruses. It's approved for use only in healthy people 2 to 49 years old who are not pregnant. The regular flu vaccine is an injection that delivers an inactivated (killed) form of the virus. Unfortunately, a production delay of the FluMist flu vaccine has U.K. pharmaceutical giant AstraZeneca scrambling to alleviate shortages at doctors offices this flu season. Only 5 million doses of the vaccine made by Gaithersburg-based MedImmune, the biologics research and development arm of AstraZeneca PLC (NYSE: AZN), has been delivered so far this season. AstraZeneca originally said it planned to distribute 15 million doses. We have encountered some unforeseen challenges with production of two of the four strains contained in our vaccine, which has impacted delivery timing," an AstraZeneca official said in a statement. "As a result, a substantial portion of FluMist Quadrivalent doses will be available later in the influenza season relative to prior seasons." As we are told, we should not expect our next shipment before December, which may be too late if we get our flu epidemic in early. So we encourage everybody to make the trip to our office and we promise to make it as great of an experience as possible (we have few tricks up our sleeves!). And while we are at it – all adults can get their flu shot as well and be a good role model for their kids! See you soon! Dr. Silverblatt and staff at Heights Pediatrics