As leaves fall down, doctor’s waiting rooms fill up—especially those in pediatric practices. There’s even a term for these illness-prone years, says Dr. Gary Winston.
“In preschool, kindergarten and first grade, those ages are called the ‘reservoir of infection’ because kids sneeze on each other and they’re all over each other and they’re not great at hygiene,” says the Benicia pediatrician. “Studies show that in first grade, on average, they get sick once a month.”
Parents start calling when colds linger or flu strikes, and the number of calls jumps after children return to class following school breaks. “School started on a Wednesday this year and we stared getting patients the following Monday,” he says.
Dr. Winston, a pediatrician since 1977, knows the pattern well. And while many aspects of pediatric care have changed in 34 years of practice, the treatment of colds remains basically the same.
“I’ve seen lots of fads come and go—vitamin C and Zinc among them. If there was a real cure, we’d use it,” he says.
Dr. Winston, 62, co-founded North Bay Pediatrics with Dr. Alan Sher in 1984. A Benicia resident for more than 30 years, he and his wife, Susie, made the move to Santa Cruz two years ago after raising four daughters here. He now works part-time in the Benicia practice and plans to continue at least 10 more years because he enjoys what he does. “When I go on vacation, I miss working.”
Off-duty hours find Dr. Winston surfing, swimming, doing a little yoga, and reading. “I read all the time—mostly nonfiction, evolutionary biology and evolutionary psychology. And I read medical studies all the time,” he says with a grin.
When your child has a cold, what symptoms signal that it’s time to call or visit a doctor?
Pain—I think pain should be respected and addressed. Vomiting, also. If you’ve vomited a couple of times, call your doctor. Fever, but that varies according to age. In very young infants, under 3 months, call anytime fever is above 100.4. Under age 1, call if fever goes above 101 degrees. Between 1 and 2, 102 degrees, and call at any age if fever is above 104.
Same advice if a youngster has the flu?
Now, flu is different. You’re sicker with flu. I think it’s really important to see those patients because of possible secondary infections. We see lots of pneumonia, and you can’t tell from just looking at a patient. Parents can’t tell, either. If symptoms are significant, call your doctor. If your child is very lethargic, has pain, is vomiting, or has a very high fever, call your doctor.
The best preventative is to get a flu shot. I think everyone should get one, especially people with children in the home who are under 3. If you have a baby under 6 months, they can’t be immunized, so everyone else in the house should be. Anyone with chronic diseases, or if there’s a child in preschool, kindergarten or first grade, should get a flu shot.
Anything parents should avoid if their child as a cold?
I was taught at Oakland Children’s Hospital that cough and cold medications don’t work, and I’ve always advised parents not to give them to their kids. And about three years ago, a study came out showing that cold medications are contra-indicated for young children.
How do you stay healthy when treating so many children with cold and flu?
Running water and soap is the best way to stay healthy. I sing the ABC song—the long version—while I wash my hands to know how long to wash. I wash my hands a lot. Certainly between every patient, but if a child coughs on me, I wash my hands and face.
Are hand sanitizers effective?
Those sanitizers are relatively useless, unless they are all alcohol. Studies have shown the all-alcohol ones to be effective, but the ones that say they are germicides are not effective. Washing your hands with soap is the best.
What changes have you seen in pediatric medicine over the years?
A lot of things we used to put in a large, nondefined area—things like asthma. Now we have more knowledge and we’re able to tease out more details, so we can identify them better.
Another change is that we have better antibiotics. And we have better ways to deliver medicine, like inhalers. We’re able to use less medicine and get it more effectively to where it needs to be.
We have much better medicines for things like diabetes, we have better lab tests, and we have a better understanding of the disease process. Look at SIDS. It used to happen much more frequently, and now we know that if you put your baby on his back, it cuts down dramatically on the risk, unless there’s a smoker in the house. Oh, we’ve learned how bad smoking is, how bad second-hand smoking is. …
The treatment and understanding of ADHD is also much better, and those changes have been real lifesavers for some kids.
Do you remember your own pediatrician?
Dr. Etra. I think he saved me. I was a first child, and I think he took my anxious parents and backed them off a bit.
I’ve always like pediatricians as a group. It’s easier to be a nice person when you’re working with kids. I think they help keep me healthy.
What do you wish you’d known when you decided to become a doctor?
I wish I’d known about the paradox between what society says about kids and the way they treat them. We say we love children, we value children, but we don’t put money into programs that make a real difference in children’s lives. Day care, education, college—these things are so important for kids and teens, and they aren’t funded.
Would you make the same recommendations for adults as for your pediatric patients?
I have no knowledge about adult medicine (laughing). I’ve made the worst misdiagnoses on myself. I’ve missed every one.