[BEGIN_TRANSCRIPT]
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Welcome to this edition of AMC.

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Tell you how I got better. I'm glad to be

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here, but a mission

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to. Well, I think that we're, we're talking, we're gonna

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talk about everybody's Arkansas is

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the 2nd highest prescriber.

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Welcome to AFMCTV. I'm Robin Ledbetter.

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Thank you for joining us. And today I have with me

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Doctor Chad Rogers. He is the chief medical officer

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here at AFMC. Thanks so much for being here, Doctor

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Chad. So we're talking about back

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to school wellness, preparedness. Um,

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what is, what are the most important

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health checkups and screenings for children?

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They should have before returning to school. Right?

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There's a lot of things to make sure kids

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are healthy so that they're ready to learn when they go back to

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school. So, you know, kind of your typical

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well child visits, a lot of times you'll hear people

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call them sports physicals or

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just help supervision exams. There's all sort

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of similar, although the sports tends to be kind of a

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little bit more focused towards.

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Athletics, but they all sort of involve,

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you know, getting into the office, getting to see the doctor,

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doing some screens to make sure that your,

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you know, mental health is doing well, that

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you're growing well,

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um, that you're, you have, you know,

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the nutrition and the sleep and all the things

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that you need. to kind of have lined up to

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go back to school.

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Uh, and

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so it's a really important visit happens,

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it can happen really any time of the year, but a lot of people

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because of the return to school need

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paperwork, and so they

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that becomes sort of the school back to school rush.

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And how can healthcare providers better

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support families in preparing their children

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for a healthy school year? Yeah, so I think

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um any time of the year is a good time to kind of

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talk about school

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and what the school environment, making sure that

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kids have what they need when they're at

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school as far as medications and stuff like that.

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Um, you know, I think kind of encouraging people

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to kind of make that yearly visit so

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that um they're already kind of plugged in.

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Even when you have a healthy child,

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uh, there's a lot of times where they haven't got

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to the doctor, you know, in several months or

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sometimes years,

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uh, depending on how they're doing, but yet, you're not

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checking their growth every day and maybe you don't know that it's

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time to check blood work or there may be certain vaccinations

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that they need.

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And so, uh, it's, you know. It's sort of that kind

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of yearly visits kind of making that part of the routine,

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even if you have a healthy kid that sometimes we can identify

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things. I think one of the things too that we often

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see is sometimes

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kids are dealing with some anxiety and depression that they're

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really just not talking about or maybe it's just kind of low

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grade, but it kind of brings it to the

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forefront. So it's a really good opportunity to

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kind of get to talk about those things. And you mentioned

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vaccinations. Um, what are the

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recommended vaccinations for school-age children? And

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why is timely immunization so critical?

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Yeah, so I always say the big things are 4,

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11, and 16. Those are the ages to

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sort of remember for your school age kids.

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Uh, so there are,

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there's, you know, rounds of shots at the 4

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year old visit, at the 11 year old visit, and the

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16-year-old visit. And there's a lot of 16

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year olds, like I was saying that haven't been to the doctor

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in 2 or 3 years. And so sometimes that's a really

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good kind of point to kind of make sure we're all

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caught up.

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But uh those are when some routine immunizations

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are given,

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and you can't have them unless

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you mean you can't go back to school unless you

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have them. And so school nurses are usually

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pretty good about looking at people's immunization

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records and making sure that they're up to date. And

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if you show up

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and you haven't had those, they may not let you come back to

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school or they may give you a timeline to get back

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to school. The tough part is if you're

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3 years old,

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and 11 months and 30

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days

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and you come in one day early for those

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shots. Not that those shots won't work, but they're

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not going to count. And so they

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need to be at least 4 and

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had their 11th birthday and had their 16th birthday

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in order to get their shots in order for them to kind of quote

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unquote count. And the school nurse

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can look that up,

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the clinic that you go to can look that up. It's

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all within the state registry.

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Um, so the health department also has those, so

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those are also good places. If you have an older

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child and you're on the run and you're just needing to

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get some shots, um,

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sometimes like your 16 year olds especially, and

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if they're just needing some boosters, the pharmacy

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may be a good place to get some shots as well.

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And we can address or

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how can we address vaccine hesitancy

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in our communities and particularly around

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flu and COVID vaccines. Yeah, it's

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been a particularly, you know, more difficult

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to kind of,

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especially when it comes to flu and COVID. I think people

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kind of feel like COVID has sort of faded

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a little bit, although we're still seeing cases of COVID,

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people are still getting sick from COVID, people are still dying

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from COVID,

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but it was. It wasn't as bad as it was during the pandemic.

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Flu has always been just traditionally

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a very hard, you know, vaccine to

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address. Um, you know, a lot of people

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have had the experience that they got the flu shot and they

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felt kind of achy achy after maybe

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stay at work because they didn't feel good. But

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that's actually your immune system responding

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to the shot or sometimes you just happen

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to be unlucky and have gotten something else in the meantime.

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But that flu shot, you know, you may still

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get the flu, but you've got some protections

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or you got some immunity to keep you from getting

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really sick. But people don't always

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see that real directly. But people do get really sick

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every year, healthy people, and um

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can die from like pneumonias and stuff associated

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with the flu.

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So the the the vaccines are still very real

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important. The routine vaccinations, where there is

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some hesity, you don't see quite as much

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than you do around the flu and the COVID.

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Um, but you know, we know that

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making sure that all kids are sort of vaccinated

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is the best way to protect people, and especially

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people who aren't vaccinated or maybe people who

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don't have a good immune system because they're getting chemotherapy

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or something like that.

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So we really kind of talking to parents about what their

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concerns are, letting them know what shots they're getting,

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why they're important. I think having really open

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conversations,

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um, you know, parents sometimes are just, I mean, you

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know, you have children, so you kind of can really,

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like you've been charged with this life and you want to

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make sure that they grow up healthy and you don't want to do anything to

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harm them and then you hear, you hear clips

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of information out there that may

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May be good information, may be a bad

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information, but you don't really know. And

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then you need to kind of sort that all out. So

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it's not unusual to have questions. It's not

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unusual to have fears. But I think

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in the end, we sort of know the science, we

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know the data, we know that people do well

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with shots

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and how important they are to prevent disease.

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So I think those kind of healthy,

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respectful conversations.

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Um, and kind of trying to be a

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good, you know, having a good relationship with

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your primary care provider, your pediatrician, your

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nurse practitioner, your family doctor, that

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you can talk about those things.

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Um, and sometimes people are just

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were like, I've heard this, is this, you know,

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what, what can you tell me about this? And I think

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that's a great opportunity. Number one, it's also a great

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opportunity to learn more about vaccines, so.

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And you touched on this a little bit about mental health

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and behavioral health,

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some signs

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that a child may be struggling

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with anxiety or depression as the school

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year begins. What should a parent

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or even a pediatrician look for?

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Right. So you know, anytime there's big

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changes in life,

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um, sometimes, um, you're going to see a little

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flurry of anxiety and depression. I mean, it's

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not unhealthy or uncommon to

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worry and it's not uncommon or unhealthy

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to be sad, but, um, and

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so definitely when you have some unknown.

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Starting a new school, maybe changing

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towns altogether and going to a

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whole new place can be kind

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of worrisome for kids. So then it's kind of a

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question of how it's impacting

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their life. So if they're not willing to go to school,

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they're not sleeping well, they're not eating well, they don't

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want to go sports, they don't want to go hang out with their

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friends, then it may be a little bit

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uh

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a little bit more unusual.

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The other thing is sometimes teenagers just withdraw.

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I mean, they just like to be in the room and be left alone.

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And that's not an unhealthy or unusual teenage

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behavior, but if And they may not be telling

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their parents everything they need to know. So that's where

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when they come in for those checkups, those screening

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tools that we use, can kind of sort of pull

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pull that out and to have a little

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discussion to normalize that the concept

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that have worrying a little bit or being

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said is normal, but when it becomes

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unhealthy.

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Um, so it's just a really, um,

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and you know, those things

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sometimes. come and go as well. So

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I think if kids are doing a better job, schools

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are doing a better job of talking about mental health.

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And so kids know the language a little bit better

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as well. So, um,

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you know, it's hard if you're feeling something, it's hard to know

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how to describe it if you don't have the words. So another good

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opportunity to kind of talk about those things. And you

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mentioned schools, um,

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schools and pediatricians can often

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work in tandem to support students' needs.

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And and mental health early on in the school

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year. Yeah, well, you know, um,

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you know, kids are definitely with their parents a lot, but

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most of their waking hours are really, especially

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during the school year at the school.

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So they're really sometimes pretty aware

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with what's going on with the kids. Sometimes, you know, the parents,

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parents have a lot going on with work or

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they're coordinating childcare and they're handing kids off

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from grandparents to other parents to

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To aftercare services, they may not

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realize sometimes that their kid has been coughing all

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day or maybe they woke up and they were fine, but they

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develop fever in the day. So school is a really

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important place for, um,

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and school nurses are so important, like,

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um, especially,

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uh, a good school nurse, it's gonna,

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um, really kind of watch for those kids that are coming

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in

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asking for their. Albuterol a lot, um,

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you know, maybe they're coming to the the nurse with

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the headaches a lot, that they're not telling their parents

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after they get home from school because, you

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know, they're better.

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But, uh, that communication between the school

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nurse and the parents and sometimes with the physician,

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there are some laws, you know,

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with the exchange of information and protection,

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just like they are on the healthcare and that you don't just share

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information. But there are forms and

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there are ways to communicate, um,

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uh, to make sure that kids have what they

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need, whether they're at school and then also to get that

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information back to the doctor.

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And what role does nutrition

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play in classroom performance? It's

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a big thing. It's a huge thing. I mean, I think people

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are becoming more and more aware of

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the fact that if kids are hungry, they're not gonna be

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able to learn and that you can't meet them.

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And you can't even begin to teach. I mean, we've all

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experienced being hungry, you know, when you and

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it's hard to think, it's hard to make a decision.

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It's hard to just be in a place where you're ready to learn if

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you're, you're hungry. So if we're not meeting those basic

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needs of our kids,

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um,

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then they're not going to be ready, but school

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is such a good place again, it's where they spend a lot of

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their waking hours. It's like they're there for breakfast

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and for lunch.

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Uh, we know that some of the kids, that's

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the only two meals they get in the day because a lot of

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families, especially our kids are dealing with food

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insecurity.

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And you know, I think the state has done a

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lot of work to try to expand,

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um, those not just during the school year, but

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also during the summer and so

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there's been a lot of efforts just to make sure that kids

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have what they need to, to learn and

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grow. Let's talk about

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sleep schedules. So we here

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where we, we try to get our kids

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back on a sleep schedule like a month before they go

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back to school.

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Is that necessary?

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Is it important? Yeah, it's really important

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because you can't go from staying up until 2

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in the morning.

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to bed at 10 and then waking up at 6 in the morning.

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It's amazing to me how many kids I see, you know,

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after lunch in the clinic and the

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teenagers particularly, and you could tell that they just got

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out of bed, you know, and you know, that's what

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summer is for and summer is also a good time to

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be restorative and to catch up on sleep

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and to have some fun.

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Um, so, but and teens tend

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to stay up later, um, they just kind

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of naturally do that. But those couple

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of weeks before school, we really kind of kind of start

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to get back on our routine,

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trying to go to bed closer to 9 or 10 for

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particularly young children even earlier to

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make sure that they're getting adequate sleep so that they're

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able to get up.

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Um, sometimes the biggest thing that you see

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is, you know,

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kids will have trouble falling asleep or

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staying asleep.

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Uh, those are things to talk to your doctor about.

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Uh, if you're having some daytime sleepiness as

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well and like they're falling asleep in class, and

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those are sort of red likes that the kids are not

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getting enough rest and and routine

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routine routine is really important for all of us. It's

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not just the kids, it's all of us.

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That was actually my next question. What are

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some tips that families can

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can do to get into a routine,

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establish that routine before school? Yeah,

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I think, um, one thing that they can do is,

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it's like I said, if they're staying up till 2 and getting

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up at 2.

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Then we may need to step it back. You can't tell it, say,

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OK, this Saturday night we're all going to bed at 9 o'clock

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because you're gonna lay in bed staring at the ceiling for a few hours.

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So trying to step it back by 15 minutes,

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30 minutes each night before

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going back to school. So thinking kind of ahead

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and trying to get back on the schedules, trying

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to get up a little bit earlier, the couple

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of days beforehand.

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I think getting them to do some physical activity

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so that they just don't go right back to bed.

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But trying to get those routines back, it

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kind of helps us all. We all know that I say

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moms do more before 7 a.m. than then I'll do all day

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long just to get the kids out the door. If,

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if you, if you have the kids, you know, um,

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with enough rest and then they have their breakfast

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and then get them. And out the door, it's

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gonna make a big difference in the back to school rush

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and like the chaos that comes along

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and you know, the stress.

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It is stressful and you know, hygiene

\[00:12:31.399]
practices also

\[00:12:33.759]
fall into that, but they also prevent

\[00:12:35.759]
illness,

\[00:12:37.119]
especially in classrooms and shared. Basis, what are some of the

\[00:12:39.239]
things that

\[00:12:40.599]
that the healthcare providers

\[00:12:42.960]
should be telling their patients? Yeah,

\[00:12:45.279]
you know, and I know that a lot of times it's battles, especially

\[00:12:47.558]
with older children and making them aware and you

\[00:12:49.599]
know, kids, you know, if you're around yourself all

\[00:12:51.719]
day long, you don't smell yourself, but

\[00:12:53.960]
other people get to smell you.

\[00:12:55.599]
And so it is actually part of sort of the routine.

\[00:12:57.908]
I think I kind of take the perspective that you

\[00:12:59.908]
talked about that it's part of being healthy.

\[00:13:02.269]
Your skin has to be healthy. If your skin is not

\[00:13:04.428]
healthy, it's gonna break down. You're gonna get sores, you're going

\[00:13:06.428]
to get infections, things like that. It's

\[00:13:08.469]
also,

\[00:13:09.330]
you know, your skin is sort of a protective barrier

\[00:13:11.509]
from the outside world.

\[00:13:12.899]
So, um, you know,

\[00:13:14.750]
kind of talking, especially to to as

\[00:13:16.830]
kids are getting more independent about the importance.

\[00:13:19.221]
Of, of, you know, taking a bath.

\[00:13:21.461]
It can also become a part of part speaking of routines,

\[00:13:23.780]
it can become a great part of their day in the evening

\[00:13:25.881]
in order to calm down and relax, taking

\[00:13:27.980]
a warm shower, getting uh

\[00:13:30.621]
getting their shower done so they don't have to get up early. Some kids

\[00:13:32.701]
are gonna do better to get up early,

\[00:13:34.421]
you know, a little bit earlier in the morning, take their shower then

\[00:13:36.780]
to wake themselves up.

\[00:13:38.341]
So, you know, again, trying to schedule out what's

\[00:13:40.461]
going to be best for your Kid, whether

\[00:13:42.653]
that's in the evening

\[00:13:43.893]
or um or the morning, um,

\[00:13:46.254]
it's going to be part of that routine.

\[00:13:48.293]
How can healthcare systems ensure equitable

\[00:13:50.933]
access to back to school care for underserved

\[00:13:53.053]
populations? I mean, that's a, that's a hot topic. Yeah,

\[00:13:55.793]
so you know, one,

\[00:13:57.212]
you know, people in order to have healthcare have

\[00:13:59.212]
to have access and they have to have insurance or

\[00:14:01.332]
some way to pay for the healthcare. So

\[00:14:03.332]
I think you know we're to make sure that everybody um

\[00:14:06.285]
has healthcare for their kids, you know, whether

\[00:14:08.565]
that's through your work or whether that's

\[00:14:10.684]
through Medicaid or through our

\[00:14:12.764]
kids, uh, to make sure that those

\[00:14:14.764]
services, all those services should be covered, those

\[00:14:16.846]
preventive services and shots are covered by

\[00:14:19.166]
insurance.

\[00:14:20.195]
Uh, so, um, there's usually not much barrier. In

\[00:14:22.205]
fact, for most plans, in fact, I think

\[00:14:24.365]
for all plans, there's not a co-pay

\[00:14:26.445]
to go for a checkup or a wellness visit.

\[00:14:28.678]
Um, it does take a little bit more time. So that's kind

\[00:14:30.779]
of removes the barrier of that \$5 or \$10 or

\[00:14:32.840]
\$20 or \$30 that you may have to pay

\[00:14:34.859]
when they're sick or for some other visit.

\[00:14:37.149]
Uh, but while those visits are covered, shots are

\[00:14:39.168]
covered, screenings for the most part, um,

\[00:14:41.649]
are covered, not all, but, um,

\[00:14:43.769]
most are.

\[00:14:44.908]
Uh, so it's a,

\[00:14:46.009]
so, you know, making sure that we all

\[00:14:48.210]
kind of have equal access

\[00:14:50.009]
to those tools to make sure that we're healthy because when,

\[00:14:52.369]
when you're healthy, then I'm healthy, you know,

\[00:14:54.489]
it's kind of a community thing.

\[00:14:56.298]
Um, it's not health doesn't tend to be just

\[00:14:58.389]
a real individualistic thing. And in order

\[00:15:00.489]
for the whole family to be healthy, it's important for all

\[00:15:02.519]
members of the family to be healthy, so.

\[00:15:04.719]
And one key message that you

\[00:15:06.739]
want parents, educators, healthcare professionals

\[00:15:09.019]
to know, to keep in mind for this

\[00:15:11.080]
back to school as we

\[00:15:13.139]
dive into the fall semester, it

\[00:15:15.259]
gets very busy and it does create a lot

\[00:15:17.298]
of panic because then you're like, oh,

\[00:15:18.979]
they're not gonna be,

\[00:15:19.859]
you know, they often get told they can't go back to school until

\[00:15:21.889]
they've had this checkup. So I think, you

\[00:15:24.038]
you know, thinking early sometimes um

\[00:15:26.500]
we're kind of later into the summer now, but early in the

\[00:15:28.580]
summer as people go on vacation.

\[00:15:30.798]
Um, that's a good time to get in for the visits. It's

\[00:15:32.979]
not quite as busy.

\[00:15:34.519]
Um, maybe even making

\[00:15:36.529]
your annual visit around your birthday. A lot of providers

\[00:15:38.820]
will do your school physical during your

\[00:15:40.940]
checkup, during your annual physical around your birthday.

\[00:15:43.580]
And that way you're not waiting until unless you're in August

\[00:15:45.779]
15th birthday or something like that, you probably

\[00:15:47.940]
wouldn't think about other times of the year. But that

\[00:15:50.019]
way you're sort of done and

\[00:15:52.099]
sometimes there's just some paperwork or some shots

\[00:15:54.700]
record that needs to be updated and that can be done with

\[00:15:56.889]
the nursing, not a whole, not a whole visit.

\[00:15:59.489]
So kind of making that part of your annual

\[00:16:01.908]
routine of going to the doctor

\[00:16:04.710]
um and making the other thing is a

\[00:16:06.750]
good time when you're off, you know, in the

\[00:16:08.750]
summer for if you're kind of doing a little staycation to

\[00:16:10.989]
go ahead and get your dental visits and get your,

\[00:16:13.109]
you know, your checkups and those sort of things so that

\[00:16:15.149]
the kids have the checkups that they need to

\[00:16:17.229]
get back to school.

\[00:16:19.389]
Well, Doctor, thanks so much for talking about important

\[00:16:21.440]
information and getting everybody ready back to school.

\[00:16:24.048]
I'm not ready for summer to end. I'm not either.

\[00:16:26.649]
I, I want to sleep late.

\[00:16:28.969]
Me too, and maybe a little vacation.

\[00:16:32.769]
Well, thank you so much for being here. Yeah, glad to be

\[00:16:34.769]
here. And that's it for this episode of AFMCTV.

\[00:16:37.690]
Thanks for watching and have a great day.
\[END\_TRANSCRIPT]