Back to School in Pampa: A Practical Health Checklist for Your Family

Pampa ISD students go back Thursday, August 20. Every August the same list comes around: shoes, supplies, a bedtime that actually works. All of that matters. But there are a handful of things worth doing in the couple of weeks beforehand that pay off for the whole year, and most of them take one appointment.

Here's the version I'd give a friend.

Start the sleep shift now

Moving a bedtime two hours on the night of August 19 does not work. Start now: shift it back 15 to 20 minutes every couple of days, and pull the wake-up time earlier at the same pace. Two and a half weeks is enough runway to do this comfortably, which is a luxury you won't have if you wait until the weekend before.

School-age children need 9 to 12 hours. Teenagers need 8 to 10, and almost none of them get it. This is worth some effort, because insufficient sleep in a child looks remarkably like an attention problem. Every year I see children referred for evaluation whose real issue is that they are running on six hours.

Combine the physical with the well-child visit

If your child needs a UIL sports physical, don't do it in isolation. One visit can cover the form, growth and blood pressure, vision and hearing, and a look at the immunization record. For an older kid it can also buy a few minutes of confidential conversation without a parent in the room, which matters more than most parents expect.

Vision and hearing deserve particular mention. A child who can't see the board or hear the teacher from the third row is routinely described as distractible, behind, or disruptive. It's among the cheapest and highest-yield screens in medicine, and it gets skipped constantly.

If your child has asthma, do this before September

September is the worst month of the year for pediatric asthma. That isn't bad luck. It's rhinovirus, the common-cold virus, which surges within a week or two of schools reopening and which triggers wheezing and croup in children with reactive airways. With an August 20 start, that puts the first wave of classroom colds moving through Pampa right around Labor Day weekend.

Before the first bell:

• Check the expiration date on the rescue inhaler. Check it now, not in October.
• Make sure the school nurse has current orders and a copy of the action plan on file.
• If your child needed rescue medication more than twice a week last spring, the maintenance plan probably needs adjusting. Come in.

Watch for the anxiety that shows up as a stomachache

Between the new building, the new social landscape, and the academic pressure, August and September bring a real and measurable rise in anxiety in children and teenagers. In younger kids especially, it rarely announces itself as worry. It shows up as recurring stomachaches or headaches with no clear physical cause, trouble falling asleep, withdrawal from things they used to enjoy, or repeated requests to stay home.

If that pattern lasts more than a couple of weeks, it's worth a visit rather than a wait-and-see. Mental health is part of primary care here, not a separate referral you have to chase.

Use the meal programs

Pampa ISD's breakfast and lunch programs exist precisely so that no child in this district starts the day hungry, and a substantial share of local families qualify. Use them without hesitation and without any sense that it reflects on you. A child who has eaten learns better. That is the entire point.

What's likely to go around this fall

As of the end of July, respiratory illness activity nationally is very low. Flu is quiet, RSV is quiet. That makes right now the useful moment to get ahead of it, because the pattern each year is reliable:

• Rhinovirus first, within a week or two of school reopening, hardest on preschoolers and early elementary.
• RSV, influenza, and COVID following in October and November.
• Parainfluenza and adenovirus are already running elevated nationally.

Flu vaccine becomes available in late summer; taking it in September gives you protection that holds through the December-to-February peak.

Two illnesses worth knowing by sight

Texas has seen measles and whooping cough return over the past two years after a long absence. The state health department has issued pertussis alerts two years running, and most of those cases have been in children.

I want to be clear about why this section is here. It applies to every family reading this, whatever you have decided about vaccines. If anything, knowing how to recognize these early matters more if your child isn't immunized, not less. This is information you can use on your own terms.

Measles

The thing to know is that measles doesn't start with the rash. It starts with high fever, a hard cough, runny nose, and red, watery eyes: two to four days of what looks like a bad cold or flu. The rash comes after, starting on the face and moving down.

There's one earlier sign worth knowing, because it's specific to measles and almost nothing else causes it: tiny white spots inside the cheeks, roughly opposite the back molars, appearing a day or two before the rash. If you see those alongside a high fever and red eyes, call.

A person is contagious for roughly four days before the rash appears through four days after. That's why it spreads the way it does.

If you suspect measles, call us before you come in. 806-304-0353. This isn't a formality. The virus lingers in the air of a room after an infected person leaves, and a phone call lets us arrange testing in a way that doesn't put other families in the waiting room at risk, including infants too young to be protected. Seek emergency care for difficulty breathing, severe drowsiness, or seizures.

Whooping cough

Pertussis starts as an ordinary cold. One to two weeks in, the cough changes: fits of coughing that come in runs, often worst at night, sometimes ending in vomiting or a gasping "whoop." The cough can last weeks to months.

Two things parents don't usually know:

• Vaccinated children can get it, and often present without the classic whoop. Sometimes it presents as nothing more than a stubborn cough that won't quit. A history of immunization doesn't rule it out.
• In infants under a year, it may not look like coughing at all. They may gag, gasp, vomit, stop breathing, or turn blue. About a third of babies under twelve months who get pertussis end up hospitalized. Any of those signs in a young infant is an emergency.

Timing matters for treatment. Antibiotics are most useful when started within three weeks of the cough beginning, and within six weeks for infants and pregnant women. If a cough has gone past two weeks and is getting worse rather than better, come in.

Immunizations

School entry requirements haven't changed for 2026-27, and the district can tell you what's outstanding for your child's grade. If you want to be up to date and simply aren't sure where things stand, bring whatever records you have, or none at all. We can pull immunization histories and tell you exactly what's missing in a few minutes.

Two practical notes:

Cost is a solvable problem. The Texas Vaccines for Children program provides vaccines free or at low cost for eligible children, and the Adult Safety Net program does the same for qualifying adults. If cost is the obstacle, ask us and we'll walk you through eligibility.

If you're expecting, or there's a new baby in the house, this is worth a conversation regardless of how you feel about the childhood schedule generally. Infants are too young to be protected on their own and are the group that does worst with whooping cough. Tdap in pregnancy and for the adults who'll be holding the baby is aimed squarely at that gap.

And if you have questions or concerns about any of it, including if you've decided against some or all of it, I would rather have that conversation than not have it. Bring the questions. You won't get a lecture, and you won't be treated as a problem. That's a promise.

When to keep them home

The goal is keeping kids in school, not out of it. The practical version:

• Fever: home until fever-free for 24 hours without fever-reducing medicine.
• Vomiting or diarrhea: home until it's resolved. One specific note on norovirus: alcohol hand sanitizer does not kill it. Soap and water, twenty seconds, is the only thing that works.
• A cough lasting more than two weeks, especially in fits or with vomiting afterward: worth evaluating.
• Suspected measles: call first.

Most other things, like a mild runny nose or a lingering cough at the tail end of a cold, don't require staying home, and missed school has its own costs.

We're here for the whole family

At Lukner Medical Clinic we care for adults and children, and we look for root causes rather than treating symptoms one at a time. In practice that means a single visit can cover your child's sports physical, your teenager's anxiety, and your own blood pressure, without three separate appointments across three separate offices.

If you're not sure where to start, start with a phone call.

Lukner Medical Clinic, PLLC 2545 Perryton Parkway, Suite 31 (Pampa Mall), Pampa, TX 79065 Phone: 806-304-0353 Book online at luknermed.com

This article is for general educational purposes and is not a substitute for individualized medical advice. Please talk with your physician about your family's specific circumstances.

Sources: Texas Department of State Health Services (measles and pertussis health alerts, school immunization requirements, Texas Vaccines for Children program); Centers for Disease Control and Prevention (respiratory illness data channel, pertussis and measles clinical guidance, K-12 infection prevention guidance).