What is EV-D68?

Enteroviruses (EV) are a very common group of viruses. They are closely related to Rhinoviruses which cause the common cold. EV-D68 is part of the enterovirus family. EV-D68 may cause more serious respiratory illnesses.

EV-D68 can be found in saliva, nasal mucus or phlegm. It is likely spread from person to person when an infected person coughs, sneezes or touches surfaces with dirty hands.

The CDC recommends that testing be done only on patients who are very sick and in the hospital. Special testing is needed for EV-D68. Most hospitals cannot test for this specific virus.

What are the symptoms?

Symptoms will be much like those of a mild cold. The symptoms of EV-D68 can range from mild to severe. Kids with asthma or a history of wheezing seem to be at higher risk for severe illness. EV-D68 may cause respiratory symptoms such as:

  • Cough.
  • Nasal congestion.
  • Runny nose.
  • Wheezing.
  • Trouble breathing.

How is EV-D68 treated?

Many infections will act like a mild cold. The symptoms are normally not serious and will go away on their own without treatment.

  • There is not a medication to treat an EV-D68 infection.
  • If your child has asthma, use albuterol as needed if your child is wheezing or coughing.

How can the spread of EV-D68 be prevented?

Viruses are spread through close contact with infected people. It is common for illnesses to be on the rise when children are back at school. There is not a vaccine that can prevent an EV-D68 infection. It is important that parents, teachers and caregivers help prevent the spread of illnesses. They should:

  • Have children wash their hands often.
  • Teach children to cover their noses and mouths when they sneeze and cough.
  • Avoid sending kids to school when they are sick.
  • Make sure kids with asthma take their regular medicines.

Information from the Centers for Disease Control and Prevention (www.cdc.gov)

ALERT: Call your child’s doctor, nurse, or clinic if you have any concerns or if your child:

  • Has breathing or wheezing that gets worse, even after taking medicine and the medicine has had time to work (15 minutes if inhaling a bronchodilator).
  • Is dehydrated.
  • Is vomiting and cannot keep down medicine or fluids.
  • Has a hard time breathing such as:

–      Chest or neck pulling in with each breath.

–      Hunching over.

–      Feeling like breathing is hard to do.

–      Breathing faster and/or harder.

  • Has trouble walking, talking or crying.
  • Has no interest in eating, drinking, playing.
  • Is having trouble sleeping.
  • Has lips and/or fingernails that look dark (blue or grey).
  • Has special health care needs not covered by this information.

This teaching sheet is meant to help you care for your child. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment, and follow-up.

Jennifer Miller, MA, PAC

~ Jennifer Miller, MS PAC; Forest View Pediatrics

Summer Viruses

It looks like summer has finally arrived here in Southeast Wisconsin.  With that, comes the summer virus season.  Unlike the typical cold and flu season, which involves stuffy noses and terrible coughs- summer viruses often present with different symptoms.  These symptoms include fevers, sore throats, and rashes on the extremities.

We are currently seeing a large number of young patients affected with this group of viruses.  As with all viruses, however, symptomatic care is always recommended.  Tylenol and Ibuprofen can be beneficial for the fever and sore throat symptoms.  Cool baths and lightly dressing your child will also help reduce the fever.  If the fever would persist beyond 3 days or if you feel your child is more uncomfortable than you would expect, I highly recommend that you call our office to speak with one of the nurses and consider an appointment at 414-425-5660.


Have a fantastic summer!


~ Chris Zukowski, MD, Forest View Pediatrics

Chris Zukowski, MD

Nursing Phone Line Wait Times

Long waits on our call lines when you are trying to address the needs of your ill child is phonefrustrating.  Our goal is to meet the needs of your child as quickly as possible.  Here are some tips to help you get the information and help you need in the most efficient way.

  1. Our busiest call times are from 8:30am-10am each morning (especially Monday mornings).  All of our nurses pitch in to help take calls during these hours, but even so, there can be a wait time.  You may want to try to call our office after 10am if your child’s need is not urgent.
  2. If you call and hang up and try calling again, you will be placed at the back of the que.  If you are able to hold, please stay on the line to avoid increasing your wait time.
  3. If absolutely necessary, you may leave a message with our office staff for the nurse to call you back if you cannot wait on hold.  When the nurses have a free moment, they will get back with you later in the day.
  4. Consider checking our website www.forestviewpediatrics.com for information about taking care of common illnesses at home such as sore throat, fevers, colds, vomiting, diarrhea, and constipation.  There is information on all these illnesses in our “For Parents” section of our web site.  Many times these problems can be managed at home and do not need an appointment with a doctor.  If you still have questions after reviewing the information on the web site, give us a call.
  5. If you have medication refill requests, we recommend calling after 10 am.  Don’t forget to push option 2 for the refill request line.

We work to give all the children in our practice the best care possible and hope that when you do talk with our nurses or come in for an appointment, you feel that the care we give is top notch.

Julie Averbeck, RN, MS, CPNP

Julie Averbeck, RN, MS, CPNP


On June 1st (this Saturday!) we will be switching over to an electronic medical record (EMR).  The specific EMR that we chose is called Epic.  This is the same software Children’s Hospital of Wisconsin started to use system wide in November.  Our system and their system will be linked and will share information.

Please remember, anytime there is change, there are always some “growing pains” that come along with it.  I like to say, it’s a little like having a baby…. There’s a lot of anticipation, and then when the baby comes, no matter how ready you are, there is still a pretty steep learning curve.  Well, Epic is our baby right now and we’ve put a lot of time into getting ready for it, but there’s nothing like the real thing.  So we ask that you try to be as understanding as possible if we are going a little slower and your visit is taking a little longer.  It won’t be that way forever.  In fact, prior to coming to Forest View, I worked at a hospital that went from paper charts to Epic, so I can tell you that it does get faster and ultimately better.  Because that’s our real goal; to get better!  So even though there are going to be a few downsides, here are the upsides to you as a patient in the end.

1.) Shared notes withing the Children’s System means whether you are in the ER, a specialist office, or our office, we can pull up the exact note, the exact medication, or the exact x-ray you had done.  If you are outside of the system, we can print those things for you to take with you.

2.) There is an After Visit Summary (you may hear someone at the office mention an AVS) that will go out with you that will explain your diagnosis and medications.

3.) MyChart is a function that won’t be 100% when we start, as we are learning the rest of system, but down the road we see it as a great way to communicate with patients for scheduling, seeing labs, medication refills, and short notes to each other.

4.) Electronic prescribing means your prescription goes right to the pharmacy.  This does not quite mean it will be instantaneous, though.  Just like phoned in prescriptions, different pharmacies check their electronic prescriptions at different times.

5.) Other cool tools; like electronic growth charts, being able to see a graph of certain labs, immunizations linked directly to the Wisconsin Immunization Registry, and quick refills.

We’re excited to be taking this next leap forward in medicine along with the rest of Children’s system!  Thank you all in advance for being patient and understanding!


 ~Paul Veldhouse, MD; Forest View Pediatrics

Paul Veldhouse, MD


Our EPIC Transformation

We all know how much technology has impacted the way we live.  It’s hard to imagine not having our smartphones or Internet access.    We’re pleased to let our patients and families know that, effective June 1st, we will be switching to a new electronic health record (EHR.

The new system, Epic, is designed to give us, and all of the providers across Children’s Hospital, faster access to one medical record for your child.  We expect that the electronic health record will improve communication between providers, and increase safety.  One example of how Epic will improve care is when a patient is referred to a pediatric subspecialist in the Children’s Hospital network, that physician will have the child’s previous office visits, labs, and imaging studies.  Another example of a benefit with the new EHR is the ability to electronically send your prescription to your pharmacy before you even leave the office.

An exciting feature is the future availability of MyChart, which will allow parents secure access to  your child’s EHR. (This should be helpful for all those school forms asking for immunization dates.)

Already we have been updating patients’ medication and allergy information into the new system.  While the physicians have been using EPIC in the hospitals, this will be a new way of caring for patients in our office, so please be understanding that there will be a learning curve as all of us get used to the new system.  Our primary focus, of course, will continue to be providing the best patient care we can  to your children and your family. 

~ Robert Hartmann, MD, Forest View Pediatrics
Robert Hartmann, MD


Flu Season is Upon Us!

Some of you may have seen our E-blast letting everyone know that we are now seeing some of our first cases of influenza at Forest View.  According to flu reporting from the Center for Disease Control (CDC), this looks to be one of the earliest flu seasons in about a decade.  Last year was a very mild flu season, but this year looks to be significantly worse.

Quick review:  Influenza is NOT the stomach flu.  It is a respiratory illness that can cause very high and prolonged fevers, cough, and runny nose.  It is especially dangerous because it can make you more susceptible to secondary bacterial pneumonias that can require hospitalization, or in severe cases, even cause death.  This early into the flu season, there have already been 5 pediatric deaths, and during the H1N1 flu season a few years ago, there were 281 flu associated pediatric deaths.  It is one of the most deadly common viruses around, especially for those who are unvaccinated.  There are certain high risk groups (although it is recommended that everyone get vaccinated) which include anyone 6 months to 4 years old, anyone with asthma, diabetes, or another chronic medical condition, or anyone who spends frequent time around either of these groups and infants under 6 months.

Fortunately, in the samples the CDC has tested, the vaccine appears to be about a 90% match so far, which is a pretty good match.  The vaccine does not always match, as the vaccine components are a very well-educated guess every year as to what strains we will see in the US (over 100 labs reporting to the World Health Organization who makes the recommendation to our FDA annually).  The flu season tends to peak around January and February typically, however, the vaccine can take up to two weeks to produce antibodies, so now is the time to come get it.  About the only real group unable to get a vaccine, are those that have had a severe allergic reaction to the flu vaccine in the past.  Patients with egg allergy (unless particularly severe) can still get the flu vaccine, so please call if you have questions about how to get it done safely.

We have vaccine available at Forest View, so please call and make your appointment to get vaccinated.  If you have any questions, we’ll happily provide the answers.  Please click here to see our flu information page.

Thanks and cover your cough!


 ~Paul Veldhouse, MD; Forest View Pediatrics

Paul Veldhouse, MD

Forest View Pediatrics 1962-2012

This month Forest View is celebrating 50 years as a pediatric clinic. We are very proud of our long tradition of providing excellent pediatric care. For this milestone, I interviewed the founder of our clinic, Dr John Czajka. (Pictured below).

Pediatric care was quite different in the 1960’s, focusing primarily on treating acute illness. When well babies left the nursery, they were not seen in the office until one month of age. Very few patients were seen for behavioral or education concerns. Fewer well child visits were recommended and only 5 vaccines were available: smallpox, diphtheria, tetanus, pertussis, and polio. (We now vaccinate for 15 diseases and the smallpox vaccine was discontinued in 1971.) The only antibiotics available in the early 1960’s included …Continue reading →

Ibuprofen, Tylenol, or Both?

When my children have a fever, I usually head to the medicine cabinet to see what I can do. Fever itself isn’t dangerous. There is even some literature that shows it can help kids fight off infection. Unfortunately, fevers sure do make them cranky. Remember, at times, it is OK to not “treat” a fever. Even if you do give your child a fever reducer, occasionally the fever may not come back to “normal”- and that’s OK. Really, all you are trying to do is to keep your child as comfortable as possible until the illness goes away.

Once you’ve decided your child needs something to feel better, what should you choose? There are lots of formulations of acetaminophen (e.g. Tylenol) and ibuprofen (e.g. Advil) out …Continue reading →