Mississippi Center for Advanced Medicine

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How Our Pediatric Weight Management Clinic Helps Children Thrive

Are you concerned about your child’s weight and overall health? We understand that managing your child’s weight can be a delicate but challenging issue. Let us introduce you to our pediatric weight management clinic. Our team of experienced healthcare professionals, including pediatricians and dietitians, work together to develop personalized plans for each child, focusing on nutrition, physical activity, and emotional well-being. We believe in a holistic approach that empowers both children and parents to make sustainable lifestyle changes, fostering a lifetime of healthy habits.

At the Mississippi Center for Advanced Medicine, we provide a supportive and nurturing environment that prioritizes your child’s growth and development. You’ll have access to a range of services that address the physical, social, and emotional aspects of weight management in young children. Our team of experts tailor a treatment plan to meet your child’s needs and preferences, inviting the entire family to support your child’s wellness journey.

Our pediatric weight management clinic offers the following services:

  • Weight loss medication: Our doctors can provide medication to assist with weight loss when appropriate. We only use medications designed with your child’s metabolism and needs in mind.
  • Diagnosis and treatment of co-morbidities: From high blood pressure to high cholesterol, there are many conditions triggered or aggravated by childhood obesity. Our team will provide all the necessary support to help your child achieve optimal health.
  • Food and nutrition counseling: Fresh fruits and veggies should be part of every child’s diet. Let us tailor a healthy meal plan your kids will love.
  • Emotional and clinical advice for supportive family members: Your entire family can support your child’s path to a healthy weight. Our staff will teach you how.

Accurate Diagnoses, Compassionate Care for Obesity in Kids

Our pediatric weight management clinic is specifically designed to address the unique needs of young children. By providing weight gain support, comprehensive diagnoses, and dietitian services, we address childhood weight control from every angle. Our pediatricians know that without full understanding, it’s difficult for children to commit to essential life changes. That’s why our team makes you and your child partners in the process, starting with your first appointment.

Here’s an overview of our pediatric weight control programs:

  • Weight Gain Support: Our holistic approach includes counseling to help your child better understand the reasons behind their weight gain.
  • Evaluation for Causes: Many factors contribute to childhood obesity and weight gain. Our medical professionals adopt personalized strategies that result in effective evaluation and weight management.
  • Dietitian Services: Registered dietitians specializing in pediatric nutrition and weight management provide support and guidance that includes meal plans, nutrition counseling, and portion control education.

Work with our team to find the right programs and services for your child.

Evaluation and Treatment of Related Health Issues

At our pediatric weight management clinic, we also address other issues such as prediabetes, hyperlipidemia, hypertension, and fatty liver disease, commonly related to weight gain that can negatively impact your child’s health.

  • Prediabetes: Screenings and assessments can identify high levels of blood sugar that signal the start of Type 2 diabetes. To avoid this debilitating, life-threatening condition, your child needs to master effective weight management.
  • Hypertension: High blood pressure causes your child’s heart to work harder than normal. Through dietary changes in physical activity, your child can get their hypertension under control.
  • Fatty Liver: Non-alcoholic fatty liver disease (NAFLD) describes the buildup of fat in the liver. This makes it difficult for the organ to function properly. With lifestyle changes, weight management strategies and proper exercise, your child can improve the health of their liver.
  • High cholesterol: High cholesterol in children can negatively impact cardiovascular health. Our weight management pediatricians can give your child the treatment needed to keep this condition in check.

Mississippi Center for Advanced Medicine offers comprehensive care for children with weight gain challenges. Contact us today to book an appointment at our pediatric weight management clinic.

The Importance of Pediatric Audiology

Have your child’s teachers or caregivers raised concerns over their hearing? Does your child have difficulty hearing your voice if the TV is on normal volume? These signs may indicate that your child requires an evaluation by a pediatric audiologist. For the most accurate diagnosis and treatment of childhood hearing loss, visit our experienced audiologists.

At Mississippi Center for Advanced Medicine, our pediatric audiologists detect hearing and balance anomalies, such as the following:

  • Hearing Loss: Does your child need a hearing aid? Bring them in for an evaluation to find out.
  • Hearing Aids/Assistive Technology: What assistive devices can improve your child’s hearing, allowing them to interact with friends and classmates more freely? Our pediatric audiology team will carefully fit and adjust hearing aids and assistive technology to meet your child’s needs.
  • Dizziness and Balance: Hearing and balance are intimately connected. Let us help your child hear better and maintain their equilibrium.
  • Hearing Screening and Testing: We conduct hearing tests to determine the type and extent of hearing loss.
  • Noise and Hearing Loss Prevention: Explain how to protect hearing by limiting noise.
  • Tinnitus: We can provide advice on how to cope with the constant (often unexplained) ringing in the ears associated with this condition.

What Happens in a Pediatric Audiology Appointment?

Pediatric audiologists use kid-friendly techniques to put your child at ease. Following a family-centered approach, our staff, services, and facilities provide optimal conditions to assess hearing ability.
Pediatricians often refer patients to us due to hearing concerns. Here are some of the symptoms that may indicate your child requires hearing loss treatment:

  • Speech and language delays
  • Failed newborn or primary care screening
  • Family history of hearing loss
  • Numerous ear infections

What Happens in a Pediatric Audiology Appointment?

Hearing evaluations for children often include the following tests:

  • Auditory Evoked Potential Testing: Measures the electrical activity of the auditory system.
  • Tympanometry Readings: Measures eardrum movement following changes in air pressure; tests middle ear function.
  • Otoacoustic Emissions Test (OAE): Measures sound waves created in the inner ear to test cochlear function.v
  • Acoustic Reflex and Decay Testing: Measures muscle contractions in the middle ear following loud sounds; tests hearing sensitivity.
  • Visual Reinforcement Audiometry (VRA): Using visual stimuli, this test helps confirm responses to sounds.
  • Conditioned Play Audiometry (CPA): Uses play-based activities to test hearing.
  • Standard Audiometry: Measures hearing sensitivity using pure-tone sounds.
  • Auditory Processing Disorder Screening: Tests hearing ability in noisy or complex environments.

Our pediatric audiology team invites parents to ask questions, and we do our best to educate you on the best way to help your child recover their hearing.

Mississippi Center for Advanced Medicine proudly employs some of the leading pediatric audiologists in our service area. Contact us online to make an appointment to test your child’s hearing loss type and severity. As part of our Comfort Promise, we do everything in our power to put your child at ease.

How to Prepare for Pediatric Plastic Surgery

Perhaps your child has a cleft palate or a deformity due to an accident. A pediatric plastic surgeon can assess your child’s condition to determine if plastic surgery can help. If so, you’ll meet with a dedicated, experienced pediatric plastic surgeon to discuss your next steps. At the Mississippi Center for Advanced Medicine, our plastic surgeon handles traumatic and congenital abnormalities. From burn reconstruction to trauma management, you’ll find consultation and treatment options here.

What Is a Pediatric Plastic Surgeon and What Do They Do?

Pediatric plastic surgery is a sub-specialty that focuses on improving aesthetics and functionality. Typically, patients require plastic surgery following congenital, traumatic, or acquired illnesses or injuries.

Our pediatric plastic surgeon underwent years of additional training to perfect the skills needed to reshape soft tissues and correct defects for patients under age 19.

Types of Conditions Treated by a Pediatric Plastic Surgeon

Skin conditions, head shape anomalies, and congenital facial differences often require plastic surgery to resolve.

Here are a few examples of conditions that typically result in plastic surgery:

  • Skin conditions: Keloids, moles, burn reconstruction, masses, and scars.
  • Problems with head shape: Anomalies like plagiocephaly (flat head syndrome) and craniosynostosis (baby’s head bones fuse together too quickly).
  • Facial differences: Includes acquired or congenital conditions like a cleft lip and palate, facial paralysis, and facial asymmetry.
  • Other types of pediatric surgeries include rhinoplasty and ear surgery. Our team of surgeons includes specialists for a variety of corrective surgeries.

How to Prepare for Pediatric Plastic Surgery

As a parent, it’s essential to ask the tough questions to prepare for surgery that may save your child’s life. We invite you to read our reviews and check out the credentials of our talented plastic surgeon.
Schedule a consultation so we can discuss your child’s needs and expectations. Our surgeon will ask that you bring relevant imaging scans and medical records pertaining to the condition. We also ask you to provide a detailed medical history so that the pediatric plastic surgeon is aware of medications, allergies, and conditions that can impact the success of the procedure.

The surgeon and our staff will offer advice on how to mentally prepare your child, so they feel confident and comfortable on the day of the surgery.

It’s important to understand any and all restrictions associated with your condition. That includes adhering to postoperative instructions pertaining to diet, exercises, and healing.

Mississippi Center for Advanced Medicine has one of the leading pediatric plastic surgeons available in our service areas. Contact us online to book an appointment to discuss your child’s plastic surgery needs.

Finding Family Support in Pediatric Acute Care

When your child becomes ill or gets hurt, it affects the whole family. It’s important to find immediate care that takes the whole family into consideration. Your little one is in good hands at Mississippi Center for Advanced Medicine, but we recognize your role in getting them through a difficult time. That’s why our pediatric acute care team supports families while delivering first-in-class care for children 19 and under.

Our pediatric acute care services include diagnosis and treatment for conditions such as the following:

  • Coughs, colds, and sore throats
  • Infections
  • Trauma and injuries
  • Broken bones
  • Sports injuries
  • Allergic reactions
  • Asthma
  • Vomiting and diarrhea
  • Dehydration
  • Headaches

For more complex pediatric medical needs, we offer services for cardiology, endocrinology, hematology, and pulmonology, among others. Our staff also accommodates the inevitable concerns and offers updates to worried family members while your child receives the care they need.

Supportive, Comfortable Pediatric Acute Care

Effective communication is key when it comes to your child’s health. Our healthcare providers clearly explain your child’s medical condition and treatment plans so you can make the right decisions for your kids. We make sure to answer your questions with clarity and a caring attitude. When you bring your child to the Mississippi Center for Advanced Medicine, your family will find that our pediatric acute care clinic:

  • Offers emotional support: A situation that calls for acute pediatric care can be stressful for you and your child. Our physicians and staff provide reassurance and listen to your concerns as a parent.
  • Provides resources: Parents often need resources and information when they leave the clinic. We can provide educational materials, online resources, and referrals to appropriate community groups.
  • Fosters a positive environment: We nurture a welcoming environment to put you and your child at ease. Our team has created a family-friendly environment that includes activities and resources for both children and parents.
  • Provides practical support: Parents may need practical support such as finding financial assistance to pay for acute care. Our staff often connects parents with relevant resources in the community.

Stay Involved in Your Child’s Care

It’s crucial that you remain involved in your child’s care. The caring staff at the Mississippi Center for Advanced Medicine will help you remain calm and informed about what our health care professionals discover. You have an important say in your child’s treatment. Therefore, it’s essential to understand their health concerns and treatment plan.

Your child will need emotional support as well as medical care. Our staff does everything possible to help you feel equipped to care for your child once you leave the clinic.

Mississippi Center for Advanced Medicine treats many health concerns, such as asthma, allergies, and fevers. Through effective pediatric acute care, your family can receive the support needed to care for your child. Contact us to day to learn more about our services.

What is a Pediatric Rheumatologist? A Quick Guide for Parents

If your child experiences frequent joint pain or stiffness, you may need to see a pediatric rheumatologist. As a parent, it’s important to understand what a rheumatologist does, when your child should see one, and what to expect during the first appointment. You can support your child’s care by keeping track of symptoms, attending appointments, following the treatment plan, and staying informed about your child’s condition. The Mississippi Center for Advanced Medicine provides comprehensive rheumatology care for children 19 and under.

What Does a Pediatric Rheumatologist Do?

A pediatric rheumatologist specializes in diagnosing and treating conditions that affect the joints, muscles, and bones in children. If your child has joint pain, stiffness, swelling, or limited mobility, our experts will determine the underlying cause and set a course of treatment.
Some of the underlying conditions may include the following:

  • Arthritis
  • Lupus
  • Other autoimmune disorders

When Should My Child See a Rheumatologist?

If your child is experiencing persistent joint pain, swelling, stiffness, or difficulty with mobility, a rheumatologist can help. Other signs that may indicate the need for immediate treatment include:

  • Worsening joint pain
  • Joint pain aggravated by activity
  • Fever
  • Rash
  • Joint pain that lasts longer than a few weeks

What to Expect During Your Child’s First Appointment

During your child’s first appointment, an experienced pediatric rheumatologist will perform a comprehensive exam. We’ll review your child’s medical history and symptoms. In addition, your child will undergo a thorough physical examination. If needed, our doctors may request X-rays or other imaging studies for an accurate diagnosis.

What Treatments Can a Rheumatologist for Kids Provide?

Rheumatologists treat numerous conditions that may be causing discomfort in your child’s joints, muscles, and bones. In some cases, the doctor will prescribe medication or physical therapy. In other cases, we may recommend joint injections to help your child manage the symptoms.

How Can You Support Your Child’s Rheumatologic Care?

You play a vital role in improving your child’s joint health. This may include keeping track of symptoms and following the treatment plan set by the pediatric rheumatologist. Your contribution to the process cannot be underestimated and we are here to answer any questions you may have.

Schedule an appointment at Mississippi Center for Advanced Medicine today to get the specialized care your child needs for persistent joint pain, swelling, or stiffness. Contact us today to learn more.

Mississippi Center for Advanced Medicine treats many health concerns, such as fevers, joint pain, inflammatory disorders, lupus and more. Through effective pediatric rheumatological care, your child can find the relief they deserve. Contact us to day to schedule an appointment.

When Should I Bring My Child to a Children’s Walk-In Clinic Jackson, MS?

It’s Friday night and your child has severe diarrhea or stomach pain. What can you do to help them find relief? Instead of waiting for hours and paying high emergency room fees, you wonder if you can go to your local pediatric walk-in clinic in Jackson, MS. In many cases, the answer is yes!

The Mississippi Center for Advanced Medicine is a great option if your child has any of the following, or similar symptoms (or when you feel uneasy about their condition and need answers fast):

  • Your child has a fever and cold symptoms that are getting worse.
  • Your child is pulling at their ears, potentially indicating an ear infection.
  • You notice your child has a painful sore throat.
  • You suspect pink eye due to red, swollen eyes and discharge.
  • Your child is throwing up and/or has diarrhea.

In many of the cases above and similar scenarios, we can provide the necessary care at our children’s walk-in clinic in Jackson, MS, for children ages 19 and under. However, if your child has been in a serious accident, is bleeding profusely, or has a life-threatening emergency, call 911 or go to the nearest emergency room.

What Conditions Are Treated at a Pediatric Walk-In Clinic in Jackson, MS?

Pediatric acute care delivers fast care for illnesses and ailments. Our board-certified pediatricians provide acute care for the following symptoms and issues:

  • Asthma attacks: We are equipped to alleviate the effects of asthma and help your child breathe a little easier.
  • Infections, including ear and throat infections causing significant distress.
  • Minor to moderate injuries from sports and falls
  • Unexplained pain of all types
  • Broken bones
  • A fever that doesn’t abate
  • Cuts and burns
  • Rashes, minor allergic reactions, poison ivy
  • UTIs

Why Choose Pediatric Walk-In Clinic Care?

It takes special training and knowledge to diagnose health concerns for infants and toddlers. Children and young adults undergo rapid body changes and aren’t always comfortable talking about their health. We have kind, knowledgeable, and patient pediatricians with plenty of experience putting children at ease and helping them communicate their needs. We work to stabilize the patient and treat the source of the pain and discomfort.

At Mississippi Center for Advanced Medicine, we offer extended hours to give you more options for care at our children’s walk-in clinic in Jackson, MS. Contact us today to learn more about our services.

Can Pediatric Rheumatology Help My Child

Does your child have inexplicable muscle and joint pain and fevers? They may have an autoimmune or a rheumatic condition, such as lupus or juvenile idiopathic arthritis. Pediatric rheumatology can provide a definitive diagnosis and explain potential treatment options aimed at alleviating the symptoms and underlying conditions.

Mississippi Center for Advanced Medicine is a pediatric specialty clinic serving children 19 and younger. Your child should not have to endure pain and suffering from performing everyday tasks. Our pediatric rheumatologists would be happy to meet with you and your child to achieve better health and pain-free living.

What Is Pediatric Rheumatology?

Pediatric rheumatologists specialize in diagnosing and treating rheumatic conditions in children. These conditions cause swelling and stiffness in muscles, bones, and joints and can become quite painful if unaddressed.

When to See a Pediatric Rheumatologist

We may refer you to a pediatric rheumatologist if your child experiences any of these symptoms:

  • Symptoms of juvenile arthritis
  • Prolonged fevers
  • Unexplained rashes or severe acne
  • Muscle weakness
  • Sudden weight loss
  • Red, sore eyes
  • Pericarditis and pleuritis (inflammation around the heart and lungs)
  • Anemia, low white blood cell count
  • Recurring mouth sores

To ease your mind, make an appointment for a consultation to discuss your child’s symptoms and what they might mean.

What Do We Diagnose and Treat?

We provide diagnosis and treatment for the following rheumatoid conditions:

  • Juvenile idiopathic arthritis: One or more joints (knees, elbows, etc.) become inflamed. The condition may last weeks or months and occurs in kids under age 16.
  • Systemic Lupus Erythematosus: The immune system attacks tissues in the body, causing inflammation and potentially damaging the joints, skin, brain, lungs, kidneys, or blood vessels.
  • Juvenile Dermatomyositis: Impacts the muscles and skin in children 5 to 14 years old.
  • Vasculitis: Blood vessel walls thicken, constricting blood flow and possibly leading to organ and tissue damage.
  • Raynaud’s phenomenon: Small blood vessels start to narrow when exposed to stress or cold temperatures. This causes your child’s toes and fingers to turn blue and may be very painful. It can also affect the lips, ears, and nose.
  • Growing pain: Growing pains typically occur between ages 3 and 12 years. Your child may complain that the pain in their left and right leg alternates. Massaging the leg after a busy day can help.
  • Joint hypermobility syndromes: Excessive joint flexibility and joint pain characterize this condition. However, some kids have extremely flexible joints without the pain.

Tests to Determine the Type and Severity of Inflammation

A blood test can be used to determine whether your child has a condition related to pediatric rheumatology, as follows:

  • Antinuclear antibody (ANA) test: Checks for excess antibodies.
  • Complete blood count (CBC): Tests for balanced levels of white blood cells, red blood cells, and platelets.
  • Creatinine: Checks for kidney disease.
  • Rheumatoid factor test: Tests for rheumatoid arthritis.
  • White blood cell count: High levels may indicate inflammation.
  • HLA tissue typing: Identifies genetic markers indicating ankylosing spondylitis.
  • Joint aspiration (arthrocentesis): Checking joint fluid for bacteria, crystals, or viruses.
  • Muscle biopsy: Helps determine if your child has any conditions related to rheumatoid arthritis in the muscles.
  • Skin biopsy: May help diagnose lupus or psoriatic arthritis.
  • Urine test: Checks for proteins and blood cell levels indicating an issue related to rheumatology.
  • X-rays or other imaging tests can also help us properly diagnose your child’s health condition.

Pediatric Rheumatology Treatment for Your Child

The Mississippi Center for advanced medicine specializes in pediatric conditions. We have a robust pediatric rheumatology department that focuses on alleviating your child’s discomfort and treating underlying conditions. We will work closely with your current medical professional to help your child manage pain and inflammation. With the right treatment, they can get back to school, sports, and other essential activities they enjoy.

Mississippi Center for Advanced Medicine treats the conditions listed in this post and more. We are dedicated to the health and welfare of the kids and families we serve. Contact us to schedule a pediatric rheumatology consultation.

FAQs on Pediatric Urgent Care

If your doctor’s office closes at 5 pm and you don’t want to wait hours in the emergency room, consider another alternative. When your child cuts a knee in a sudden fall or suffers an injury while playing their favorite sport, you may need pediatric urgent care for immediate attention.

Mississippi Center for Advanced Medicine (MCAM) operates a children’s urgent care clinic conveniently located in Jackson, MS. Your child can receive prompt care from experienced pediatricians in a calm, soothing setting designed for teenagers and young patients. No appointment is needed and all insurances are accepted.

As a parent, you may have many questions about pediatric urgent care and when is it better to come to us instead of going to the doctor’s office or ER. That’s why we’ve put together the following FAQs.

What Is Pediatric Urgent Care?

Many parents report that urgent care is much less expensive than going to the ER. If you have a child aged 19 or younger, pediatric urgent care can save you time and money. At the same time, your child receives caring assistance from doctors with years of training for this specialized role.

Should I Go to a Children’s Urgent Care Clinic or the ER?

It depends on the illness or injury. If your child has a life-threatening health condition, go to the emergency room, or consider calling 911 for an ambulance, as the situation warrants. Pediatric urgent care centers treat most acute, non-emergency conditions.

What Conditions Do Urgent Care Pediatricians Treat?

MCAM’s children’s urgent care clinic treat cuts, broken bones (x-rays available), fever, and numerous other conditions, as follows:

  • Coughs, colds, and flu
  • Earaches and sore throats
  • Pink eye
  • Stomach aches, vomiting, and diarrhea
  • Sports injuries including sprains and strains
  • Asthma attacks
  • Allergic reactions (minor)
  • Burns
  • Urinary tract infections
  • Rashes
  • Poison ivy

Where Can I Find Pediatric Urgent Care Near Me?

The Mississippi Center for Advanced Medicine Urgent Care Clinic is located in the Belhaven Building at 1200 N. State Street, Suite 180 in Jackson, MS. When your child is hurt or sick, every minute counts. Visit our walk-in clinic when you can’t wait for an appointment within your doctor’s office hours or after hours.

Can Urgent Care Pediatricians Prescribe Medication?

Yes, your child can get the medication they need with the help of our pediatricians. MCAM’s board-certified pediatricians evaluate your child’s symptoms prior to writing prescriptions.

Can Urgent Care Doctors Do Stitches?

Pediatric urgent care doctors can stitch up minor injuries. However, for severe injuries with profuse bleeding, you may need to go to the ER.

What Are MCAM’s Hours of Operation?

Your doctor’s office might close at 5 pm, but we don’t. Our children’s urgent care clinic is open late and every day of the week including most holidays. The hours of operation are:

Monday-Friday 8:00 AM – 8:00 PM
Saturday and Sunday 12:00 PM – 8:00 PM

Let your child benefit from the MCAM advantage!

Mississippi Center for Advanced Medicine provides pediatric urgent care to children ages 19 and under. Walk-ins are welcome, but you can also contact us online to book an appointment.

What Conditions Require a Pediatric Specialty Clinic

Pediatric subspecialty physicians undergo additional training to better understand and manage specific organ systems and disease states in children. We specialize in rare childhood diseases and diagnosing and managing chronic disorders in children. Visiting a pediatric specialty clinic can give you peace of mind and provide your child with experienced caregivers who focus on medical treatment for kids.

At the Mississippi Center for Advanced Medicine, our patient-centered team of pediatricians can help you navigate available tests, treatments, and services that will optimize care for your child. Learn more about some of our treatment programs.

A Wide Array of Care Options to Keep Kids Healthy

Here are just some of the specialty practice areas we provide:

  • Pediatric Allergy and Immunology: Nearly ouchless shots make it easier to treat kids with allergies.
  • Pediatric Audiology: Early intervention can put your child on the right path for strong language development. If your newborn or infant has failed a hearing screening, this could indicate a hearing problem.
  • Pediatric Cardiology: What happens when genetic or environmental factors increase the likelihood of cardiovascular disease? Our pediatric cardiologists will monitor and treat any issues that arise.
  • Pediatric Chronic Pain: While focusing on pain relief, our pediatricians also look for root causes to eliminate chronic pain for infants, toddlers, and teens.
  • Pediatric Dietary and Nutrition Needs: Adolescents and kids of all ages benefit from a detailed assessment and recommendations to improve their nutrition.
  • Pediatric Endocrinology: Diabetes, puberty disorders, polycystic ovarian syndrome, and growth hormone deficiency are just some of the conditions we help children battle daily.
  • Hematology: Anemia, iron deficiency, and sickle cell disease are all treatable conditions. Let us help your child develop healthier blood through medical and lifestyle intervention.
  • Pediatric Mental Health Therapy: Kids need to understand that there’s always someone to turn to for mental health treatment.
  • Pediatric Rheumatology: Rheumatic diseases involve muscle and joint inflammation and may affect the eyes, organs, and skin. Kids of all ages may complain of fever, joint pain, and rashes. We have the knowledge and equipment to trace the symptoms to underlying causes.

Put Your Kids in Good Hands at Our Pediatric Specialty Clinic

By offering care designed for kids, we give our patients a better chance of growing into healthy, beautiful adults. We welcome your questions regarding our services or our staff.

Mississippi Center for Advanced Medicine is a pediatric specialty clinic. The above conditions are just a few of the conditions we treat for short- and long-term recovery. Contact us to book an appointment.

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