Hema Nirmal
Hema Nirmal, M.D., FAAP

Hema Nirmal, M.D., FAAP

Hema Nirmal, M.D., FAAP
Specialty

Pediatric General Medicine, Primary Care

Clinical Interests / Special Procedures Performed

Adolescent Medicine, Attention Deficit Disorder, Newborn Care, Pediatric Care, Preventive Medicine, Primary Care

  • Accepting Children: Yes
  • Accepting New Patients: Yes
  • Accepting Medicare: Yes
  • Accepting Medicaid/DSHS: Yes
Insurance Accepted:

Contact this office for accepted insurance plans.

Personal Interests

Reading, cooking, gardening, spending time with her husband and two daughters.

Medical School

Bangalore Medical College, Bangalore University, India

Residency

New York Methodist Hospital, New York, NY

Board Certifications

Board Certified in pediatrics

Languages:

English, Malayalam, Hindi, Kannada, Tamil

Professional Associations:

Fellow of the American Academy of Pediatrics

Flu vaccine for children

A lot of parents have questions about the flu vaccine and many parents refuse the vaccine as they feel it does not very effective. Some parents are concerned about vaccines in general and refuse vaccinating their child as they don’t want to administer “another vaccine” to their child. The best way to prevent getting flu is by vaccination.

What is flu (Influenza)?

Flu (influenza) is not just a common cold or a stomach virus as most people think. Influenza usually occurs during the winter in our region although it can occur all year around in other parts of the world. It can be a serious respiratory illness that can lead to complications especially in children and older adults. Symptoms are generally similar to any other common cold infections and can vary from fever, runny nose, nose congestion, cough, body aches and headaches. The body aches and headaches are mostly reported by older children and adults. Children may not be able to explain their symptoms and may just be fussy.

Most children get over the flu without any complications. In some children and adults, however, it can lead to serious complications including pneumonia.

How to prevent the flu:

Influenza is ...

Summer, sun, and why you still need sunscreen in Seattle

Summer is almost here, so this is a good time to talk about sunscreens.

We all get excited when the sun comes out in our area, but it is always important to remember that everyone should avoid direct sun exposure when it is the harshest -between 10am and 4pm during the summer months,. Everyone should wear sunscreen, hats and covered clothing when exposed to the sun. Cloudy days do not offer too much protection as the UV rays can penetrate through the clouds and affect the skin the same way. Children and adolescents in particular should avoid tanning beds.

What you should know about different types of sunscreen:

Seasonal allergies

Everyone is talking about their allergies at this time of the year, so I thought it would be a good time to write about seasonal allergies.

Seasonal allergies occur only at certain times of the year and are usually caused by exposure to pollens from plants, trees and grass. They affect a large number of people of all ages and are seen mostly in urban areas. They are uncommon in children less than 2 years of age. Some patients may have similar symptoms year around and this is usually due to exposure to insects (cockroach), dust mites and animal dander (dogs and cats).

Most people do not react on exposure to these substances, but people with allergies hyperreact to these substances when exposed, and they subsequently develop these symptoms.

What are the symptoms of seasonal allergies?
Usual symptoms in children include runny nose, nasal congestion, itching of the eyes, nose and throat and occasionally cough. Sometimes these symptoms may interfere with sleep and thus cause fatigue, fussiness and tiredness during the day....

Organized sports activities: safety and benefits

A lot of children are now enrolled in organized sports activities, and more and more children are starting at a younger age. Children are enticed by successful professional sports players and strive to be like them. Many parents enroll their children in organized sports activities with the hope that their child would get an athletic scholarship for college and go on to become a professional player. However, parents must realize that only a few children end up becoming successful professional players.

It is important for children to be physically active, and organized sports can be a part of this healthy lifestyle. Studies have shown that children and adolescents who are physically active do well academically in school, have greater self-esteem, sleep well and have less behavioral/emotional problems. Children and adolescents who are active every day tend to develop less health problems like hypertension, obesity and hyperlipidemia , and grow to become healthy adults.

Here are some important ideas to keep in mind when your child is enrolled in organized sports activity:

Car seat safety

Thousands of Americans are injured in motor vehicle accidents every year. Motor vehicle crashes kill more people ages 5 to 34 than any other cause of death.

We, as parents and caregivers, can reduce the number of fatalities and injuries due to motor vehicle accidents by making sure children are restrained in their seats, car seats, or booster seats appropriately every time they ride in a motor vehicle.

Here are a few recommendations regarding appropriate use of restraints in different age groups:

Childhood obesity

Eating healthy and being physically active are important things to keep in mind during and especially after the holidays when an abundance of food is present.

Parents often have questions about their child’s weight such as: Is my child’s weight appropriate? Is there a difference between being overweight and being obese? When should we be worried about his or her weight? If I am overweight, what is the risk that my child may become overweight?

Physicians often use the term BMI (body mass index) to define the terms overweight and obese, and this provides physicians and parents with a guide to monitor weight in children. BMI can be calculated using the weight and height (weight in kilo divided by square of height in meters; this can also be calculated using the BMI calculator. A child is considered overweight if the BMI is greater than the 85th percentile and obese if greater than 95th percentile. Once a child is obese, they are at risk of developing complications like hypertension, high cholesterol levels, diabetes, etc.

Physical activity should be a significant part of everyday life of your child. Each child should aim to be active for a minimum of 30 minutes per day. They can be enrolled in an organized sports activity program like football, soccer, baseball, or swimming, or they can remain active by riding a bike, jogging and so on. Parents need to be aware if their child is playing video games for hours at a time and restrict the amount of screen time if necessary. Reduced television watching and computer use may reduce BMI and sedentary behavior.

Eating healthy plays an essential role in the well-being of every child. Studies have shown a lower prevalence of obesity in children who eat a healthy breakfast every day. Parents need to provide children with healthy food options at home so that they can develop a habit of eating healthy. It is important for children to try to eat all food groups, including grains, vegetables, fruits, dairy, and meat or fish. Fats, oils and sweets must be consumed in limited amounts. Lifestyle modification involving the whole family is a key factor in maintaining healthy weight in children.

What if my child is obese or overweight?

Whooping cough and the TdaP vaccine

There has been a recent outbreak of pertussis, a disease also commonly known as whooping cough, around the country. In the state of WA there have been 58 infants less than 1 year of age diagnosed with whooping cough; among these cases, 22 were hospitalized and 2 have died.

What is pertussis?

Pertussis is a highly contagious disease that is particularly severe in infants. . It is an infection of the airways caused by bacteria. More than half of infants younger than 1 year of age who get the disease must be hospitalized

In infants and children, the disease usually begins with runny nose, low grade fever, and mild cough that last for about 7-10 days. The cough usually worsens and infants may develop bursts of numerous rapid coughs. These bursts of cough are accompanied by sweating, facial flushing, and sometimes vomiting. With this disease, about 1 in 5 infants may develop pneumonia, about 1 in 100 will have seizures, and in rare cases whooping cough can lead to death.

Adults and adolescents also acquire this infection but do not have as a prolonged course as infants.
They usually have a prolonged, persistent cough that is often confused with acute bronchitis.

Whooping cough is most contagious before the coughing starts. Vaccinations are the best way to prevent the disease. 2 vaccines are available – the childhood vaccine is called DTaP vaccine and the booster vaccine for adolescent and adults is called the TdaP vaccine. Although both these vaccines protect against Pertussis, tetanus and diphtheria, the immune response can fade with time.

It is important as parents and caregivers that we are all immunized in order to prevent the spread of the disease to infants and children, who are most vulnerable. The vaccine recommendations are as follows:

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Offices

Swedish Snoqualmie Primary Care
37624 S.E. Fury St.
Snoqualmie, WA 98065
Phone: (206) 320-7293
Fax: (206) 320-5170

Monday-Friday, 8 a.m.-5 p.m.


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