We would like to announce two new office policies that will help improve the medical experience for our patients with Attention Deficit/Hyperactivity Disorder (ADHD). 

• Three Month Prescriptions – As you are aware, federal prescribing laws control the writing and dispensing of prescription medications.  The vast majority of prescription medications used in the treatment of ADHD-related symptoms have been designated as controlled, schedule II.  Included are such commonly used stimulant medications as Adderall, Concerta, Daytrana, Focalin, Metadate, and Vyvanse.  As such, the prescriptions have been limited to one month supplies without refills.  Because a physical prescription with a handwritten signature is required, these medications cannot be "called-in." 

However, recent changes in federal guidelines now allow physicians to write three separate, thirty day prescriptions of these medications for established patients on stable dosing regimens.  All three prescriptions must be dated for the day of service with instructions that state "Do not fill until (blank future date)" for the second and third month supplies.  Upon receipt of the prescriptions, your pharmacy is now permitted to dispense a ninety day supply of medicine – thirty days at a time – without additional physician authorization.

• Three Month Patient Assessments – In light of the new prescribing guidelines, patients being treated for ADHD will need to be seen by a CPA physician every three months to receive new prescriptions.  During these appointments, your doctor will review any changes in past medical, family and social history, assess your child's interval, behavioral, academic, social and developmental progress, and perform a physical examination.  During the quarterly evaluation after your child's birthday, a complete preventative medical evaluation (Well Child Check) will also be performed.   Appointment requests can now be made by clicking the Request Appointment link above.

Your doctors strive to provide the most current, compassionate medical care available to your children.   It is our hope that the changes in prescribing guidelines, and the consequent changes in CPA policy, will result in a more convenient medical encounter for you and a more comprehensive medical experience for your child.  Please feel free to contact any of your CPA pediatricians if you have any specific questions or concerns regarding our new policies.

It is with sadness that we report that Dr. Dana Crater will be moving to Florida this summer to be closer to her family.  June will be her last month with Coastal Pediatric Associates.  Dr. Crater has been a tremendous asset to our practice and will be missed by us all.  Dana has become a very real part of her patients' families and is already telling us how much she misses all of the children that she has come to love!  Our prayers and thoughts go with her family as they get ready for the big move.

 While Dr. Crater will not be easily replaceable, we, her colleagues, are looking forward to the opportunity to extend the same compassionate, comprehensive care with which you entrusted her.

 We will all miss you, Dana! (. . . and will keep trying to figure out how to move your family closer to Charleston!)

Coastal Pediatric Associates is excited to offer you two new ways to schedule appointments for your children.

Online Appointment Request Page -- Parents may now utilize our website to request appointments for their children.  By clicking the "Request Appointment" link on the green bar at the top of the webpage, parents will be directed to an online form.  Upon receipt of your request, our Medical Office Assistants will schedule an appointment with the time, date, location and physician of your choosing.  You will then receive an emailed reminder card confirming your appointment.

For those parents who prefer to interact with a telephone representative, we also offer the following:

After-Hours Appointment Scheduling Service -- Parents have been very pleased with our after-hours nurse triage service.  Our nurses now have the capacity to schedule an appointment for your child even after the office is closed.  After discussing your child's medical problem, our nurses will ask you if you would like to schedule an appointment.  You will be offered an appointment with the time, date, location and physician of your choosing. 

It is our hope that these new services will allow you to acquire appointments in a more efficient manner.  Give these new services a try!  We are looking forward to seeing your child and hearing your feedback.

In December of 2007, the FDA recommended that DDAVP nasal spray no longer be used for the treatment of Primary Nocturnal Enuresis (bedwetting).  Patients using the intranasal form of this medicine are more vulnerable to significant drops in blood sodium levels (hyponatremia) and potentially resultant seizures.  The FDA alert can be viewed by clicking the following link. (DDAVP alert)

The physicians of CPA are advising their patients to stop using the intranasal form of DDAVP for the treatment of bedwetting.  Although the DDAVP tablets continue to have this indication, the FDA recommends the following information to patients using this product:

1. Treatment for primary nocturnal enuresis should be interrupted during episodes of fluid and/or electrolyte imbalance, such as fever, recurrent vomiting or diarrhea, vigorous exercise, or other conditions associated with increased water consumption.
2. Fluid intake should be restricted from 1 hour before to 8 hours after administration of desmopressin tablets. 

There are multiple treatment options available for the management of bedwetting. Patients taking any bedwetting medication should be seen regularly by our pediatricians to screen for any drug-related complications.  If your child has been taking this medication, don't worry!  However, we recommend stopping the DDAVP nasal spray and scheduling an appointment with us to discuss treatment alternatives.

On December 13th, 2007, Merck & Co., Inc. announced a voluntary recall of certain lots of two Haemophilus influenza type b (Hib) conjugate vaccines, PedvaxHIB® (monovalent Hib vaccine) and COMVAX® (Hib/hepatitis B vaccine).  

These recalls do not immediately affect Coastal Pediatric Associates as we use a Hib vaccine made by Sanofi Pasteur.  The recall, however, may create national shortages resulting in an ammended schedule for Hib vaccine.  Our pediatricians will continue to partner with you in determining the correct vaccine series for your child.

For more information, click the following link to the Centers for Disease Control.  (CDC Hib recall announcement)

We are very pleased to welcome Dr. Lynn H. Beck to our practice!  Lynn attended college and medical school at Saint Louis University in Missouri.  After completing her residency training at the Medical University of South Carolina (MUSC), she and her husband moved to Kansas where she has since been practicing general pediatrics.  Dr. Beck is certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics.  Dr. Lynn Beck is accepting new patients and will be working with us at both our East Cooper and West Ashley locations starting December 1^st, 2007.