Q: What is Dr. Paul Thomas' immunization schedule?
A: Dr. Thomas has posted both the AAP Immunization schedule and one in the book "The Vaccine Book" by Robert Sears. The AAP schedule is the official recommended schedule, however Dr. Thomas feels that this official schedule can be modified safely for your child’s circumstance and will take into consideration your preferences. Dr Thomas will have a full discussion of the risks and benefits of each vaccine, and help you determine what is right for your child.
Q: What are the most important things we can do to avoid toxins?
A: Eat organic, never microwave plastics and avoid plastics, eat little or no fish, drink filtered water and vaccinate selectively with focus on limiting the amount of mercury (still in some flu shots) and aluminum: Hep B - 250 micrograms, Hep A 250 micrograms, DTaP 170 - 625 micrograms depending on manufacturer, HIB (only the PedVaxHib has - 225 micrograms), Pc (prevnar) - 125 micrograms, HPV - 225 micrograms, Pentacel (DTaP, HIB and polio combo) - 330 micrograms, Pediarix (DTaP, Hep B and polio combo) - 850 micrograms. Note that the adult safe daily maximum has been listed as 50 micrograms a day for IV fluids and 5 micrograms per Kilogram of body weight a day for children per the FDA.
Q: Should I give my newborn the Hepatitis B vaccine?
A: If Mom is Hep B positive (has Hepatitis B) or if another family member in the household has Hepatitis B, or If parents have risk factors like multiple sexual partners or IV drug use then YES the newborn should get the Hep B Vaccine as soon as possible after birth. While the official recommendation is that all babies - regardless of risk factors - get the Hep B vaccine at birth it is a parent's choice to consider the following and make their own decision:
• Babies don't do the risk behaviors like being sexual active or IV drug use, so the only way a baby gets Hep B is if their mom has it. (there may be a few rare cases from household contacts out of millions).
• The Hep B vaccine has 250 micrograms of aluminum (the adult daily maximum for IV Aluminum is 50 micrograms)
• 10 year follow-up data indicates that almost half of the babies who got the Hep B series at birth, 1 month and 6 months are no longer immune at age 10, suggesting there may be good reason to wait on doing this series when the child is older and closer to the risk behaviors.
To see an example of the actual values of occurance of Hepatitis B in the United States vs predicted values from 1993, please see page 29 at the following link: www.cdc.gov/mmwr/PDF/wk/mm4253.pdf The estimated level of occurance for that year was 30,000 cases. The actual value for that year was 442 cases.
Q: If I don't do all the vaccines in the AAP recommended schedule, won't my child be excluded from day care or school?
A: In Oregon it is a parent's right to vaccinate as they feel best. The brochure from the state of Oregon "Claiming A Religious Exemption to School/ Child Care Immunization Requirements In Oregon What Parents Need to Know" states the following " DEFINITION OF RELIGION Oregon Administrative Rule 333-050-0010 defines "religion" for the purposes of immunization requirements to be "any system of beliefs, practices or ethical values". Parents who elect to vaccinate differently from the published schedule can check the box for religious exemption based on their beliefs - whatever they may be.
To Learn More About the Religious Exemption Requirements in Oregon, click here.
Get the Religious Exemption Form here.
Q: Can I get immunization or other health records over the Internet?
A: Integrative Pediatrics will soon have the system set up so you can use a secure-log in for each child and access their immunizations, medications, allergies and major problem list.
Q: What is Autism?
A: Autism is also sometimes called PDD (pervasive developmental disorder) when diagnosed after age 3, or Autism Spectrum Disorder when symptoms are not classic or are mild. The classic symptoms of autism involve poor language acquisition or loss of language, poor social interaction with others, and repetitive movements or mannerisms (sometimes called stiming). About 10% of children who end up with the diagnosis of autism never develop normally. Around 90% of autism cases these days involve normally developing children, who sometime between ages of 1-3 regress and lose language and eye contact and seem to go into a world of their own. Sometimes children with autism have bizarre or repetitive behavior patterns, or uncontrollable screaming or head banging and have great difficulty with transitions.
Q: What should I do if I think my child might have Autism?
A: Come and see Dr Thomas as soon as possible. The standard approach if your child has autism is to recommend behavioral therapies and speech therapy which is very helpful and the earlier the better. Dr Thomas has studied extensively in biomedical approaches that attempt to address the underlying causes of autism and in many cases recovery is possible.
Q: How common is Autism in Oregon?
A: Autism is now 1/100 children by the age of 5 in Oregon. Nation wide it is 1/150. This rise is real. In the 1970's it was 1-2 / 10,000.
Q: What causes Autism? Why are we seeing so much more autism these days?
A: While there are many theories and no one knows for certain. Dr Thomas believes that in genetically vulnerable individuals, toxins (heavy metals like mercury and aluminum, lead and arsenic), pesticides and plastics along with too many vaccines in the very young (possibly triggering an immune issue or perhaps just simply the toxic load of all the vaccines) triggers autism.
To Learn More About Autism,
Including Likely Causes, Rates of Occurance, and Prevalence, Click Here
Q: Is there a cure for Autism?
A: In some cases the answer is yes! Contrary to what you may have heard from other doctors, there are increasing numbers of children who have lost the diagnosis of autism by following biomedical interventions. There are, however, some cases that seem resistant to treatment. The DAN (Defeat Autism Now!) movement has been a huge force in moving forward the treatments for autism that address underlying body systems that are in distress (Immune, gastro-intestinal, nutritional deficiency, allergies and more).
Q: What treatments does Dr Thomas recommend for Autism?
A: Children should be treated based on their individual needs after a careful assessment. Treatments typically might include: improving the diet, trying the GFCF diet for at least 3-6 months, testing for allergies and avoiding foods that seem to trigger an allergic response, multivitamin and mineral support, essential fatty acids, probiotics, and in certain circumstances consideration for antifungal treatments, B-12 injections, digestive enzymes, and other more targeted treatments if indicated. (Note that this information is not intended to be a treatment recommendation and is for informational purposes only. You should consult with your child’s health care provider). It is generally wise to also only make one major change at a time so you are sure that changes you see in your child are due to that intervention.
Q: Why should I be concerned about my newborn if autism doesn't typically happen until after a year or two of age? How can I prevent autism?
A: If autism is triggered by the accumulation of toxins and/or by the deregulation of the immune system, then the most important time is the 9 months in the womb and the first months of life when the (BBB) blood brain barrier - a semi-permeable membrane that protects the fetus and infants brain -- is not yet formed. Toxins have much greater access to the developing brain up until 6 months of age when the BBB is thought to be fully formed. There may be a body burden of toxins such that a certain threshold is reached at different times for different children. It thus would be wise to minimize pesticide toxins by eating organic and minimize mercury by not eating fish while pregnant or serving it to an infant or young child, and to minimize the toxins we inject (like aluminum in vaccines), and to avoid giving too many vaccine's at once in the very young, in case there is an immune trigger mechanism to autism. The live virus vaccines (MMR and Varicella) present a very difficult challenge and require in-depth discussion with Dr Thomas or your health care provider.
Q: How do I know if my child may have ADD or ADHD or be on the spectrum (autism spectrum disorder)?
A: A careful evaluation is needed to figure out if what you are seeing is just normal or might represent something to be concerned about. Dr Thomas likes to have parents and teachers of school age children fill out the Vanderbilt forms and bring them to an initial 50-minute evaluation. Note that ADD (attention deficit disorder) or ADHD (attention deficit hyperactivity disorder) or ASD (autism spectrum disorder, or aspergers or autism for that mater, are all labels and diagnoses based on a constellation of symptoms. There is no blood test, and the treatments typically offered may not address the underlying issues of toxins or allergies or nutritional deficiencies. Dr Thomas will recommend treatments that integrate holistic and complementary medicine approaches and can also discuss the medications that might be helpful.
Q: Which Vanderbilt forms should we use for the evaluation of ADD or ADHD?
There is an initial form for parents and teachers and a follow-up form for parents and teachers. If this is your first evaluation, use the initial (longer) form. All subsequent visits - Dr Thomas likes to see children he is treating for ADD or ADHD or Autism etc. about every 6 months (sooner initially if making lots of adjustments to the treatment).
M-Chat – used to screen for Autisms at 18-24 months
Vanderbilts – used to screen for ADD and ADHD in school age children
Q: Will Integrative Pediatrics take the same insurance I had while at a previous clinic?
A: Integrative Pediatrics has contracts with many of the same carriers.
Q: Who will cover Dr Thomas if he is not in the office?
A: Dr Thomas (as friends you are invited to call him Dr Paul) will be in the office Monday - Friday and run a sick clinic on Saturdays (see hours). Dr. Thomas makes himself available most days and evenings at Integrative Pediatrics. When gone (2-3 weeks a year) and every other weekend - he will have Dr Squyres covering. Dr Paul and Dr Squyres share the same philosophy on most issues that are important to you.
Q: Will there be advice nurses available when the office is closed?
A: There will always be an advice nurse 24/7 365 days a year taking first call when the office is closed. The nurse will either be one hired by Dr Thomas (familiar to his patients) or part of the Emanuel Children's Hospital Pediatric Advice Line. Dr Thomas will always be available (their back up) for complex questions or health issues 24/7 365 days a year unless Dr Joel is covering for him. If you have a health question that can't wait for office hours or in any emergency that's not a 911 crisis, simply call our main office number: 503-643-2100 and if the office is closed the call will direct to the answering service who will direct the call to the appropriate on call nurse or Dr. Thomas.
Q: Can I email Dr. Thomas?
A: Dr. Thomas is available for email directly with him thorugh our portal. He is currently working on expanding to E-visits, that in certain situations, could take the place of an office visit. Until that time you can always get your questions answered by calling the main number 503-643-2100.
Q: Can I fill out paperwork in advance of my office visit?
A: The forms are located on our website. Fill out and fax to the office at 503-643-7300.
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