Getting Back-to-School Ready with Dr. Christine Lucas

It’s the middle of summer in Southern Illinois and that means it’s time to schedule back-to-school physicals, dental exams, and vaccinations. In this episode, of Your Rural Health Connection we’ll talk with Dr. Christine Lucas, family healthcare provider at Rural Health, Inc. about everything families need to know to make this process go smoothly. 

Transcript

SPEAKER_03 0:00

Welcome to Your Rural Health Connection, the podcast that links you to healthier living in southern Illinois. Whether you're tuning in from somewhere in southern Illinois or around the globe, thanks for taking a little time out of your day to join us. We're so glad you're here. This podcast, presented by Rural Health Incorporated, is all about you, your health, your community, and the resources that can help you live your best rural life. Our goal is to not just share what we do at Rural Health Incorporated, but to connect you with healthcare providers, services, programs, health events, and much more available to you in Southern Illinois. I'm your host, Shauna Ryan, Director of Public Relations at Rural Health Incorporated. I've spent over 30 years working in Rural Healthcare, and one thing I've seen time and time again is how easy it is to feel disconnected from the care and resources that are actually available to us. That's exactly why this podcast exists. To keep you informed, bridge those gaps, and make navigating your health care a whole lot easier. So let's get started. Because better health begins with connection. Well, it's the middle of summer in Southern Illinois, and that means we are on the downhill slide to another school year. And for those of us here at Rural Health Incorporated, that means scheduling back-to-school physicals, dental exams, and vaccinations for kiddos in our region. In this episode of Your Rural Health Connection, we'll be talking with Dr. Christine Lucas about everything you need to know to make this process go as smoothly as possible for you and your family. So stay with us. We'll be back in 60 seconds.

SPEAKER_00 1:45

Rural Health Incorporated is a not-for-profit organization serving Johnson, Massac, and Union Counties in Illinois, designated by the federal government as a federally qualified health center, or FQHC, whose mission is to provide quality services to all patients in need of health care while being committed to the overall health and well-being of the underserved.

SPEAKER_01 2:05

Hi, this is Cindy Flam, Chief Executive Officer of Rural Health Inc. For over 40 years, many across Southern Illinois have entrusted us with their health and well-being. Rural Health Inc. provides numerous exceptional services tailored to you and your family across five clinics in Union, Johnson, and Massac counties. We work with most insurance carriers, Medicare, Medicaid, and we even provide sliding fee discounts. Quality services for all and committed to the underserved. That's Royal Health Inc. We specialize in you. Give us a call at 618-833-4471.

SPEAKER_03 2:38

Welcome back, listener, to our podcast today. We are so glad that you are joining us here on your Rural Health Connection. Joining me is somebody that I've I've I actually had the thrill of interviewing you before. This is our second time together, uh this time in a real health capacity, so I'm really thrilled about that. But uh everybody, this is Dr. Lucas, and uh Dr. Lucas, I'm just gonna let you introduce yourself and tell you, tell everyone what you do here.

SPEAKER_02 3:08

I am a family doctor and I see uh patients of all ages. I've been here since 1999, and I really enjoy seeing the kids and babies, are my favorites, I would have to say. Um school-age people or younger. Um when I first started, we had two pediatricians here, and over the years we have not had that anymore, but I've had some really good uh training in pediatrics, and so yeah, so that's what I do.

SPEAKER_03 3:39

So you're you're working with the kiddos and getting them ready for back to school right now and and talking with their families about what all it's needed. So let's go ahead and talk about that. Let's let's go ahead and just dive right into our conversation uh about back to school shots, physicals, and what uh our patients can expect when they come in the door. So, first off, what should they know about those school physicals, including sports physicals? What are some things they should be asking and considering?

SPEAKER_02 4:09

So, sports physicals have changed a little bit over the years. Uh, it used to be a pretty short form, and the the purpose of it is to make sure that the kids are not with any without any conditions that would prevent them from being a successful athlete. So most of the school or the sports physical, I'm sorry, is really questions trying to find risk factors for more serious underlying conditions that may not have shown up along the way in any other checkup. So it's a long questionnaire for the parents. They really have to do more work than I do because that information is what um guides my process of clearing them for sports. Um so knowing the family history is really helpful. There's a few conditions, they're not very common, but when they are in the family history, you want to know about that so you can treat things a little differently. Mostly cardiac history. Okay.

SPEAKER_03 5:08

Yeah, you don't want to have a cardiac event on the basketball court or any other serious condition that might come into effect as they're playing sports and doing other activities. So that's very understandable. Now, Illinois does require school physicals, sports physicals, and vaccinations for students who are going into early childcare, such as Head Start, pre-K, kindergarten, sixth grade, ninth grade, and all new out-of-state and county transfers, regardless of grade level. Now, can you verify that? That's what we are finding from IDPH.

SPEAKER_02 5:45

That is correct for our school systems in this area. Um when the kids are caught up on vaccines, they don't require any going into high school. So that's something that a lot of times that age group is a little hesitant about and worried about. And there should not be any required vaccines for high school if they are caught up. What used to be done at ninth grade is now done in sixth grade.

SPEAKER_03 6:11

Okay, and for sports physicals, we want families to realize this is not the same physical as when they get a general school physical, correct? That is correct.

SPEAKER_02 6:21

They can often be combined because they're very similar, but they are uh separate forms and uh you're looking for uh some separate things. Um, you know, we love it when the kids want to do sports, obviously. Um it's good for the health and mental and physical. And it there are a lot of studies that show that student athletes you know have to be more organized. So it really doesn't take away from their academic um progress. It's it's really nice benefit. So it's pretty unusual for a child to not be eligible for sports. Um but it is important to get that check up to make sure that it all systems are go. Um other doctors may handle this differently, but I do not require um the kids to be naked basically to have a full body exam, such as a testicular exam or a hernia check. We talk about that. Um, and I'm happy to do it. It's not that I don't want to, but some I don't feel like someone needs to be embarrassed in order to do what they want to do, I guess. Um, you know, I always say, you know, if there's something going on there, if you want to see a male doctor, I can make that happen. You know, please don't ignore it. Let me know what's going on. We do talk about it and just try to normalize that as another body part, but also just being respectful of their privacy and their uh just you know, hesitation maybe to to put off something because they think that they be a part of it. I try to just put that out there right at the beginning that that's fine to do, but it's not a requirement on my part that we do that. And again, some other doctors may handle that differently, but I feel like if there is something going on down there, it is hard to ignore and hopefully it won't get uh missed just because I didn't do a full body exam if they're sports physical or school physical.

SPEAKER_03 8:08

Well, and that's where it's so important that when you've got that parent or guardian in the in the exam room with you, that you can ask them, is there anything in general that you're concerned about not be addressing specifically in this appointment? So you're opening that up. So because generally most times, you know, families, you know, parents, guardians, they'll know what's going on with their child in that respect. So, you know, having that one-on-one with the family helps a lot in making sure that you're not making that child feel uncomfortable and addressing something that doesn't need to be addressed. Right. Um, something new uh this year in the state of Illinois is um the state is requiring that children between the ages of one and seven go through a bloodless blood-led risk assessment. Explain that to us a little bit and why that's become so important in our state.

SPEAKER_02 9:00

So our entire area is considered a high-risk zip code. Um so we typically draw a blood-lead level at age one or their one-year uh well check as part of a check for anemia, also. So you do one blood draw from the arm, not a finger stick, and then you can tell um the status of their you know blood cell production, make sure there's no anemia going on, and also get the blood lead level at that same time. Um, in most cases, if a child of age one has a normal or you know, non-detectable lead level, it would be unusual that when they get older, uh, you know, say when they're two, that it would go up. You know, typically the age for lead exposure where they're really putting everything in their mouths that's on their hands and that is in their environment, you know, would have passed or would have already been picked up at the one year. Uh so typically we've just done that one time test at age one, but we do see enough uh mild elevations of lead levels that we try to get at least one level on everyone. Um, as the kids get older, it gets a little bit trickier sometimes to explain to a two-year-old why you need them to hold their arm still.

SPEAKER_03 10:11

Yeah.

SPEAKER_02 10:12

You know, in general, the blood draw is actually less painful than a finger stick, but it takes a little bit longer. Um so it can be can be tricky, but uh that's the reasoning behind that. Lead can really um cause some you know behavior problems, some effects on cognition and thinking, um, could certainly be a component of a learning disability or an ADHD kind of scenario. So it's just something that's treatable and preventable, basically. So we are on the lookout for it.

SPEAKER_03 10:43

Sure. And and we want people to realize, you know, that like you said, they generally do that test around the age one or two. And people may wonder, okay, well, why do you keep doing that? I mean, you may have a child that's moved into a different home. Um, there's you know, there's a lot of factors that go into that. And again, anyone under the age of seven, like you said, they're more apt to put things in their mouths and to to ingest. So for anyone who's listening to this, we just want them to realize this is just something new to make sure that those children are getting the the necessary treatment that they need and prevention screening that they need for lead poisoning. So, yeah, a lot goes into that for sure. Um, now I I know that that you're a physician with us, but if we can, let's talk a little bit about dental exams. We know that in the state of Illinois, a dental exam is required for any child entering kindergarten, second, and sixth grades. Um, do you have anything that you want to add to that as far as what we offer here at Rural Health?

SPEAKER_02 11:44

Um, I don't know that I have much to add to that, but I do think it's not just a box to check off. It's just so critical um to keep up with the dental issues because things can really get ahead of you quickly if if you just let it slide. So that's um, you know, the efforts to just at least ensure at a bare minimum that those um checkups are happening at those ages. And then hopefully that the kids are being more comfortable seeing the dentist that they realize that's just a routine thing to do and keep up with uh just becomes a part of their lifestyle if at all possible. Um, I know that a lot of the schools do a dental safari program where there's a mobile dental unit that goes to the schools. Um and sometimes they can, you know, pick up on things that need further attention, then we're happy to see those kids here uh to follow up on that. You know, any abnormalities that they are finding that are of concern beyond the scope of what they're able to do.

SPEAKER_03 12:39

Exactly. All right, we just want families to realize that they can get uh dental services with us here at Rural Health as well as getting those other checks done. So thank you so much for talking about that in particular. Um, so let's let's talk a little bit about some of the vaccines that are required for children in Illinois. We know that in the state of Illinois, I think at last count we had about 14 uh vaccinations that they had to be up to date on. Um, what can you you share with families who might be concerned about those vaccinations?

SPEAKER_02 13:10

I try to always keep the door open uh for talking about vaccines. It can be a really sensitive topic for um people. It's just gonna become that way over the last um five years or so, especially since COVID. Um but in general, vaccines are um something I believe in very strongly. I advocate for them. Uh, 14 sounds intimidating, but most of them are combinations, so it's not 14 different needle sticks going into their child. They're you know groups together, and that's been done for a very long time, and it's shown to be both safe and still effective when they're combined. Um sometimes parents want to space things out a little bit and they feel like giving them all at once is too much. Um, and I won't uh not do that, but really that uh ends up really making the kids despise coming here. Uh I I I don't support, I don't advocate for that. I mean, I will definitely do whatever schedule parents want as long as you know it's um within safety parameters. But they are designed to be given together. And really, if you're giving, you know, having one needle stick, I don't know that one, two, or three is really so much worse than none. So I do try to encourage just to kind of stay on a schedule. The other reason, the reasoning behind that is there's a set schedule for safety reasons. You get used to doing things a certain way and you rely on that to be reminders. And then when you make alterations to that, and we try to individualize the immunization schedule, it can get just a little extra complicated. But again, I'm I'm happy to do that. I would rather do that than not. Um, I've given all my kids all the vaccines that I give anyone else. I would never, you know, do something to another patient that I would not do to myself or my own family. Um, and I do try to uh thank them because really by vaccinating their children, they're protecting the entire community with the effect of what's called you know, herd immunity, where it protects you know, people in our community who have cancer, who are on oxygen, who are very vulnerable and just, you know, they're out in the stores, the parks, you know, hopefully they're getting out and about and they can feel safe knowing that our vaccine rates are fairly high. Um and I've also been in practice long enough that I remember being um in training and seeing infants um under the age of two before the Hib vaccine was actually developed, um, it was not unusual to have, you know, five or more kids in a pediatric hospital needing spinal taps because they had meningitis or, you know, a very dangerous infection that had spread because they didn't have any immunity to it. So that vaccine, even though it's been around a long time, I do remember when it wasn't. Uh, and I think once you stop seeing the illnesses that you're preventing, maybe the vaccines just don't seem as critical. And they just are, they are so important. Um, and by the time you realize that you wish you would have given them, there oftentimes is not treatment for things that get that far ahead of us. If an infection just takes over the brain and spinal cord, um, you know, or the meningitis issues, you know, we can't always um treat things that could have been prevented. So that's uh what we're all trying to do with the vaccines.

SPEAKER_03 16:23

Exactly. And and we realize that that families have questions about the vaccines, and you're available to answer any of those questions that they might have. Absolutely. Right. And and in keeping in mind, you know, we we are dealing with a lot of of young parents who are questioning the validity of vaccinating their children. Um, but keep in mind, as a young parent, chances are you're already vaccinated yourself and you're doing okay. Uh so you know it's important to ask those questions, make sure that you're getting accurate information and and ask and doing exactly what you need to do. Um now, when it comes to those vaccinations, how does a parent know if their child is current or not? Is that something you have access to here at Rural Health?

SPEAKER_02 17:11

So there's a state system that um lets us know which shots they've already had. In most cases, even if they've been given at another office or health department, um, the health department has a program where we can look that up and verify that for them. If they have vaccines in a different state, that's not always possible. But in most cases, we're able to confirm you know what they may still be due for or in need of, and then take care of that while they're here.

SPEAKER_03 17:37

Okay. So if you if you have a child that comes in from another state and you're not sure whether or not they've had their full series of, let's say, MMR, by giving them the a booster, does that impact anything? Does that affect them in any way? Other than, you know, it build that immunity back up.

SPEAKER_02 17:59

So I would take that on a case-by-case basis. I mean, in general, the vaccine's going to be just as safe as it was when it was given, or if it was given already, and there would not be any harm done. You can draw titers to see if it's absolutely necessary. So a lot of that would be dependent on the age of the child, how well I know the family, and just lots of other factors. I wouldn't just necessarily give another one just because I don't know, but I certainly will do that in certain situations if it seems appropriate.

SPEAKER_03 18:27

Yeah. I I know that I get asked that a lot when I'm out in the community, and and I explain to them about titers and how they can get a blood test to determine whether or not they've got that immunity built or not, and whether or not a booster is needed. So it's it's good to address that with, and I that's why I wanted to share that today. Uh, just to make sure that folks know that we're not just out there giving shots willy-nilly, that there is a system to it to make sure that if we don't have those records, then we have do have a way to kind of follow up and make sure that they're getting what they need.

SPEAKER_02 18:58

Right. I mean, if it's urgent, you know, then we do what we need to do. We can, you know, sign a records release, we can obtain records from other states. It just sometimes takes a little bit of time. Um, you know, and people have transportation issues and they don't know when they'll come back to the office. There's just a lot of factors that go into whether we should just give one just in case. Um, it can be done, it doesn't have to be done in very many situations. You know, we can wait a week or two and get more information. Um, but again, do the blood test if they really want to confirm. Some people will have declining immunity, and if they're really concerned about measles bumps, bella that because that is something that's coming back around, and we can just find out and then you know give them a booster if it's appropriate.

unknown 19:38

Sure.

SPEAKER_02 19:38

So we're happy to do that.

SPEAKER_03 19:40

Yeah, because if you're someone like me who who who I recently had in the a booster on on MMR, but if you think that you know you got those vaccines as a child, you can get the titers done and determine whether or not you need to get that booster. So we want, you know, we're talking to uh to adults in that respect just as much as we are to kids, making sure that they're up to date. So so thank you for letting us address that point a little bit there. I appreciate that. So when it comes to scheduling uh appointments, I know, listener, if if you're if you're listening to this right now, this uh podcast is gonna land sometime in the middle part of July. Um, school starts in August uh for a lot of the schools in our region. Uh Dr. Lucas, when should parents really be thinking about and making sure that they've got those appointments in place?

SPEAKER_02 20:29

I would call now. I mean, we in general could always work in a child for a well check or a school physical. Um, but it'll be more pleasant experience, you know, if there's the amount of time allowed to really just have a a little conversation. So you know, we don't panic. We can always, you know, make room for your child. But if you could call now and get them set up, we're you know, that usually works better for you and us. We can have more flexibility in the scheduling. But we have plenty of providers here. We're happy to see all the kids, you know, really anytime. But now would be the time to call and get it get it going. I am also in denial that school is starting in a month and I will support the kids and not being excited about that. But yeah, uh, we are excited to see them as soon as possible for the school physicals, just so they don't get uh um, you know any concerns about they've started school and they didn't realize they needed something, and then it's feels uh frantic for the parents.

unknown 21:29

Sure.

SPEAKER_02 21:29

Some of the kids don't need to come in for any other time, you know, especially like after kindergarten. If you're a healthy child, you may not have been to the doctor for a little bit. Um, so that's kind of a time to get to know the patient again, um, try to keep some rapport going, um, or at least some sense of connection where they feel comfortable here. So sometimes it might seem like not that much happens once they make the appointment and get in here, but just uh seeing a person in person, seeing how their family interactions, dynamics are, just getting a sense of things. Is really important. So that's another benefit of the school physical that may not be so apparent on a checklist form, but is happening kind of behind the scenes, at least on my end of things.

SPEAKER_03 22:13

Exactly. And you know, if you're a new parent uh when it comes to getting your child into school, or if you're transferring in from another state, you know, it can be very daunting. There's a lot to it in terms of paperwork and making sure that you have everything in place. So by going ahead and scheduling those appointments early each year, you know, you're avoiding delays in paperwork, making sure that the vaccines are available that you need. Um, and and just making sure that that first day of school just goes so smoothly. There's nothing worse for a parent on that first day of school to get there and realize I forgot this. And um, so yeah, by getting in there early, they can they can get that done. Now, do we have the paperwork here at Rural Health that the families need? If not, where can they get the paperwork necessary?

SPEAKER_02 23:05

A lot of times they are provided with it from the schools, but we also have the exact same forms here. So if they left it at home or forgot it or lost it along the way, it's not a problem whatsoever. We have all the forms that would be needed.

SPEAKER_03 23:17

Okay, good. So you've got them covered no matter what. They're all said and ready to go.

SPEAKER_02 23:22

We have all the physical forms. Each school has some little um forms of their own for certain issues, such as giving medications at school and those kinds of things. And we have some generic forms that are, you know, rural health labeled. But if a school has a specific form that they accept only that format, then you know we'll we'll take care of that for them, but we would not have that here.

unknown 23:43

Okay.

SPEAKER_03 23:44

So again, early planning and early scheduling is gonna make a big difference, just making sure you have exactly what you need when you come to that child's exam. So that's yeah, that's exactly what we're thinking about there. Um, are there any specific questions that you that you think of from parents that you know that you've had over the years when it comes to their physicals that that somebody else might find beneficial who's listening to this? Anything at all?

SPEAKER_02 24:17

Uh no specific um thing comes to mind other than again, sometimes that's a time when kids are usually healthy. Well, the parents will have a question about something they would not have made an appointment for that, but while they're here, kind of thing. They want to ask about, you know, is this normal? Is this okay? They mentioned this, you know, on and off. What do you think? So I would say more um things that might seem minor but can get attention in that way. I find that the school physicals are very helpful for that.

SPEAKER_03 24:53

Yeah. And that's generally how those appointments go. As a parent, you're so focused on so many things, but once you hit that door, you start going, I need to ask about this and this and this. That's just kind of how it works for sure. So yeah, that is where Yeah, you see the list come out sometimes. Yeah. And that's fine. That you know, that is what we're here for. So that's just fine. Exactly. Uh, anything else you want to share with families today?

SPEAKER_02 25:20

Um, just that I really love seeing their kids. Uh, I think it's exciting to talk about what's coming up next in their lives. So I really enjoy school physicals a lot, and I just look forward to seeing anybody who has the chance to come in.

SPEAKER_03 25:34

Okay. Well, great. I do appreciate your time today, Dr. Lucas. Thank you so much. Um, you're always wonderful to talk to when it when it comes to school physicals or anything that's going on here at Rural Health. I do appreciate your time and your help on that. Um, we do want to remind our listener that Real Health does accept Medicaid as well as other insurances. So uh if you're concerned about the insurance that is accepted here, you can give us a call. We can talk to you about that. But want to make sure that generally most cases everything is just fine. Um, we don't turn anyone away here at Rural Health because they're not able to pay. Uh, we do offer a sliding fee schedule, but then again, if you're not able to pay, we we do work that out. We want you to realize that we are here for you and your family and what's best for them. Um, and so in getting your child ready for school, we are 100% for that and making sure that you have all that you need. Um, once again, Dr. Lucas, any final thoughts?

SPEAKER_02 26:32

I don't think so. Just thank you for everything that you're doing and keep up the good work. Oh, well, thank you. I appreciate that.

SPEAKER_03 26:39

This is this is too much fun. I'm having blasts. All right, take care, Shauna. All right, thank you, you too. Okay, bye. Bye-bye. All right, we've been talking with Dr. Christine Lucas. She is a provider here at Rural Health Incorporated. Once again, want to remind everybody that if you you know are wanting to learn more about rural health, you can visit us online at ruralhealthinc.org. You can also check out our Facebook page and our YouTube channel. Uh, we do have other podcasts available from Rural Health. If you would like to listen to those, you can just uh go to wherever you get your podcast and just search in your rural health connection and it will pop right in there for you. And you can also listen to this uh interview or podcast or whatever you want to call it today. Uh you can also listen to that on our YouTube channel as well. So from all of us here at Rural Health Incorporated, go out and make it a great day. And thanks again for listening. We'll see you soon.