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

New Case of Measles Reported

Measles has returned to Wisconsin. The Wisconsin Division of Public Health has confirmed a second case of measles in Wisconsin in 2014. This individual was a young adult who had recently traveled to California and Mexico.

After his return to Wisconsin he became ill and was eventually diagnosed with measles. But prior to that diagnosis, he walked around potentially spreading the virus.

You may be thinking , So What?

Measles is a very contagious virus that is spread via a cough or sneeze. Those who have measles are very ill and the chance of a serious complication like pneumonia or encephalitis is around 10%. It is most dangerous in those less than 5 years old.

The last time we had a large resurgence of Measles was in 1989-1991 and there were 123 deaths during this outbreak.

This new case is another reminder to keep up on our children’s vaccines. The MMR vaccine, which contains measles, should be given at 12-15 months and again at 4-6 years old. Make sure your kids are up to date on this vaccine and others AND spread the word to parents who currently don’t see the importance of vaccines.

Interested in learning more about the measles virus?  Click here to go to the CDC webpage for up-to-date information.

~ 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

Summer Swimming Safety

Drowning is the leading cause of unintentional death for children ages one to four years of age.   According to the U.S. Consumer Product Safety Commission, children younger than age 5 represent more than 75 percent of pool submersion deaths and 78 percent of pool submersion injuries in the U.S. involving children younger than 15 years of age.

On average, there are almost 10 accidental drowning deaths a day in the US during summer months.

For every child 14 years and younger who died from drowning, 5 more received emergency care for nonfatal submersion injuries.

It only takes 30 seconds in the water for a child to drown.

As we enter the summer swimming season, follow these general guidelines to ensure that your children remain safe while swimming:

Never leave your child alone in or near water including a bath tub, bucket of water, pool or lakes.  Most children who drown quietly slip into the water unnoticed by adults who are often nearby.

Talk to your child about the importance of only swimming when being supervised by an adult.

If you have a pool, install a fence around it and install doors with locks to keep children away from and out of the pool.  Install door latches at least 54 inches high so as to be out of the reach of children.

Place alarms on doors and windows that lead to the pool area.

Teach your children to swim at an early age to ensure they can protect themselves in the event they accidentally fall into water or swim unattended. Make sure to get professional lessons.

For older children, use the buddy system when swimming to keep them safe.

Keep both rescue equipment and a phone by the pool.

Keep toys away from the pool when not in use to prevent children from going in to retrieve them.

Never have a drop off pool party or allow your child to attend a drop off pool party if they are under the age of 8 years.

Never assume someone else is watching.  Appoint a designated adult as the observer for pool safety.  Many drowning occur while adults are present but not watching.

Empty all wading pools immediately after done using them.

Air filled swimming aids are not a safe substitute for life jackets and never rely solely on life jackets to ensure safety.

Follow these guidelines to have a safe and enjoyable summer of swimming.

 ~ Daniel Dorrington, MD, Forest View Pediatrics

Daniel Dorrington, MD



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


School and Sleep

With the hustle and bustle of the holiday season approaching, we can all seem to have our sleep habits change.  With family events and school, our children are likely getting up earlier and earlier.  This is great time to talk about sleep in our school age children.  A good night’s sleep is essential to a good day in school.  I am convinced that many children who are “distracted in school” are likely to be over tired.  The recommendations for sleep vary depending on age, but a typical amount of sleep for a child between the ages of 5-10 years would be around 10 hours of sleep and teenagers likely need 8-9 hours of sleep.  However, you know your child best, as to how many hours he or she needs.

It is very important to make sure that we get our school children to bed at a reasonable time.  Some very basic tips for helping with sleep are a consistent bedtime routine.  The most important thing is to turn off all electronics, at least 30 minutes before that scheduled bedtime.  Video games and televisions keep those brains stimulated and typically leave children too awake to fall asleep at a reasonable time.  So remember that outside of good nutrition, sleep is the most important aspect that will improve your child’s performance in school.

Happy Holidays!

~ Chris Zukowski, MD, Forest View Pediatrics

Chris Zukowski, MD


My Experience Raising Boys

My wife is currently pregnant with our fourth child and we recently found out it is going to be a boy.  Given we already are blessed with an 8 year old, 5 year old, and 3 year old boy, I thought I’d share some of what I’ve learned about raising boys.  Keep in mind this is simply my perspective from a father’s point of view.  Here is what I have learned:

Once they become mobile boys rarely stop.

Boys mature later than girls, but then again we dads often mature later too.

It is not a good idea to own anything “nice” as it will likely be ruined within a short time period.

Boys like to be outdoors as climbing, building and exploring are natural characteristics of boys.

Before becoming verbal, biting, hitting and kicking can be a means of communicating.

Bathing and underwear are considered optional.

Wrestling is a sign of affection.

Bikes and scooters are meant to go off of curbs and down big hills whenever possible.

Every day is an enjoyable journey and adventure.

It is not easy raising children in today’s society.  Popular media glorifies promiscuity, alcohol and drug use, violence and crude behavior.  How are we as parents able to overcome these obstacles?  I recently read a fantastic book called Boys Should be Boys. 7 Secrets to Raising Healthy Sons.”  It is written by Dr. Meg Meeker who is an adolescent medicine doctor.  The wisdom from this book has been very helpful for me as both a pediatrician and father.  While the contents of this book are helpful for fathers, it may not apply to all families, particularly single parent or same sex parent families.  I want to share with you some of that wisdom and I encourage fathers or mothers to consider reading it.  Here are some excerpts:

“Every boy wants to be loved, accepted and valued. The quickest way to get there is by seeing mom or dad happy with him.”

“We often try to make our children happier by buying them things.  The reality is kids don’t need more of anything except time from their parents.  The true way to make a child happy is to spend meaningful time with them.”

“Boys need healthy encouragement from their fathers more than they need it from anyone else.  In a boy’s eyes, his father’s words are sacred.  They hold enormous power. His words can crush a boy or piece him back together after a fall.”

“Encouragement from a father can change a boy’s life.  To a son, a dad’s words are the final truth.  If they are positive, a boy feels that he cannot be beaten; if they are negative, however, a son feels that he could never win.”

“Young boys and men need less time face-to-screen with electronic life and more time face-to-face with people.  Sons who have healthy relationships with parents fare much better in life.”

“Boys need and want boundaries.  A boy without rules becomes a man without direction.”

“Fathers need to be careful that they do not project their own shortcomings on their sons.  Our sons are not mini versions of ourselves.”

The wisdom goes on.  For more information visit www.megmeekermd.com.   Dr. Meeker has also written two other excellent books:  “Strong Fathers, Strong Daughters,” and “The Ten Habits of Happy Mothers.”


 ~ Daniel Dorrington, MD, Forest View Pediatrics

Daniel Dorrington, MD