March 2021 Newsletter
Practice Updates
+ Dr. Francesca Farinacci joined our part-time staff in late February. A native of northern California, she attended the University of San Diego, graduated with a degree in biology in 2008, and was awarded Presidential Scholarship.

From there, she made her first trip to the east coast. She matriculated in the Masters of Public Health program at New York Medical College (where she met her husband) with concentration in Global Health through 2010.
You can read the rest of her bio, including her critical care fellowship, here. We should be seeing more of Dr. Farinacci, who currently resides in Larchmont, later in the spring. 

+ Some bittersweet news: Lauren Van Buren PA-C, our favorite physician assistant who has been with us for the last six years, will be heading to Baton Rouge; her last day with us is May 14th.

Her husband, who has worked at Indian Point, will be transferring. Lauren, who is expecting her first child in July, has written a letter to all her patients (click here). Please join us in wishing Lauren and her family the best!
+ The dramatic decline in COVID-19 seen both nationally and locally that occurred between early January and late February seems to have plateaued. One day last week, in fact, we had 15 patients test positive! Thus far, we have yet to have had a pediatric patient hospitalized with either COVID-19 or MIS-C.
Most local school districts are gearing up to get kids that have been on "hybrid" schedules back in the classroom 4 full days a week. New York will be ending travel quarantine at the end of the month.

And from Dr. Michael Miller, our infectious disease expert:
We are keeping our eyes on the UK variant and the NYC variant. It is estimated in NYC that 50% of cases are due to one of these 2 variants. They have the potential to increase the U.S. pandemic trajectory in the coming months. The variants are doubling as a share of all new U.S. cases approximately every 10 days, continuing a pattern first identified by researchers in early February.

Could spring break herald an uptick in cases akin to what we saw after Thanksgiving and Christmas? We sure hope not; but in light of these recent developments, reasonable precautions seem prudent.
Colloidal Silver: Safety & Efficacy
Parents occasionally ask us about colloidal silver, and also share their experience. Nevertheless, we wish we knew more.

From what we do hear, colloidal silver has the following positive attributes: despite having antibiotic properties, it never seems to cause diarrhea or yeast overgrowth. We have never seen an allergic reaction.

Besides being well-tolerated, it is affordable, tastes (and looks) like water; there are no artificial colors, flavors, or sweeteners (amoxicillin -- the "pink stuff" has all three!).

Big pharma and the FDA, CDC, AAP, etc do not seem to care for colloidal silver. According to the NIH National Center for Complementary and Integrative Health, colloidal silver has no known health benefits. Yet studies conducted in North Carolina, Alabama, and China show it is effective against respiratory viruses. Moreover, recent research from Japan suggests colloidal silver may be effective against coronavirus.

What is a parent to do with this sticky situation? A practical approach, one that we generally take, is to limit colloidal silver to situations for which there is no generally accepted effective option. These include primarily topical applications such as viral conjunctivitis (as an eye drop) and viral URIs (as a nasal or throat spray). It is an active ingredient in Silvadene, a burn cream that many of us have used.
Can Cholesterol Get Too Low?
While humans need cholesterol in their diet. Colostrum is rich in cholesterol; so is human breast milk.

Reps from the infant formula companies that visit our office do not like to hear this, as a baby formula that contains cholesterol has never been sold!

Low levels of cholesterol have been associated with aggressive behavior, anxiety, and depression. In our experience, this is one of the most common deficiencies in children raised on a plant-based diet

Children on the autism spectrum seem to have an especially high incidence of hypocholesterolemia – up to 20% of them in our experience. If total cholesterol levels drop below 125 or so, a change in diet or supplementation (e.g. Sonic cholesterol) may be appropriate.
Should Your Child Take Lithium?
When doctors recommend lithium, they typically refer to a prescription form called lithium carbonate. This form does not easily pass the blood-brain barrier and thus must be given in doses of around 1,000 mg per day.

At this dose, it can control bipolar mania effectively, but often takes a toll on the thyroid and even the kidneys.

But there are many other forms of lithium. Lithium orotate, popularized by German physician Hans Nieper MD, passes into to the central nervous system easily at doses of around 1-4 mg per day. There are no harmful effects at this dose.

Not only has this small amount been found to reduce the risk of suicidal behavior but, more recently, it has also been shown to stimulate stem cell production in the brain and thus may be beneficial in traumatic brain injury and ADHD, not to mention older adults with dementia.

Although some have advocated adding low dose lithium to municipal drinking water, that it not likely to happen soon. In the mean time, some parents may want to consider the potential health benefits of small amounts of this mineral.