In October 2011, the Centers for Disease Control and Prevention reported a 60% increase in “emergency department visits for sports– and recreation–related traumatic brain injuries, including concussions, among children and adolescents” over the past decade. That’s good news: as the CDC’s press release said, they believe the increase was due in part to “growing awareness among parents and coaches, and the public as a whole, about the need for individuals with a suspected ...

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While in residency, I took care of a toddler who was hospitalized following an anaphylactic reaction.  During a diaper change at home the child suddenly developed lip swelling and severe difficulty breathing for no apparent reason. The child was urgently brought to the hospital by ambulance and initially treated in the emergency room. By the time I met her on the inpatient floor her breathing and swelling had significantly improved. ...

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William Osler famously said (among other things):  “Listen to the patient. He is telling you the diagnosis.” I was doing my obstetrical rotation as a first year family practice resident. I had done nearly 100 deliveries and was feeling more confident in  my skills and knowledge than was justified.  Although this rotation did not involve actual care for the recently delivered newborns, I loved pediatrics and frequently stopped by the nursery ...

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The little boy, who looked to be about two, darted away in a fit of giggles. His young mother, who seemed thoroughly worn out and exasperated, ran after him, grabbed him by the arm and said in a harsh whisper, "You must stand here!" We were on line waiting to board a Southwest Airlines flight. For those of you not familiar with the Southwest system, there are no assigned seats. Rather, ...

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All play is not equal.  With the power of marketing, play has become increasingly associated with toys, electronic gadgets, television, and video games.  Just think about the amount of ads for children’s toys over the holidays.   Just think about the things your child might have asked for and the latest trends that become the new must-have of the season. Without realizing it, we may be intervening in a child’s most natural form of ...

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Shortly after 3:00 I was listening to Chloe’s precise clinical description: her daughter, Mysti, had been fine and "in her usual state of rambunctious health" despite a runny nose and a low grade temperature of 99.8 to 100.6 that mom had not felt warranted treatment because she was eating and drinking and playing normally, and sleeping despite a very mild cough when she lay down. That morning she had noticed a ...

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The principle of autonomy is one of the four guiding principles of medical ethics, the others being beneficence, nonmaleficence, and justice. It means that patients have the right to decide what is done to their own bodies. For children under eighteen, the age of majority, this means their parents decide for them. What happens when parents refuse a treatment that their child’s doctors recommend? (The right of a minor child ...

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Conversation with my lovable eight year old boy with autism. Me: Do you have autism? David: Yeah. (Pause.) I want some milk. Me: What do you like to play with? David: Calvin Me: Calvin is coming over today. He comes to see your sister. (David never plays with Calvin but does say hi to him). Me: Do you like school? David: Yeah What do you do at school? No answer Me: Do you like to run marathons? David: Yeah (Pretty sure ...

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shutterstock_144663938 A recent issue of Pediatrics includes a new report detailing the need for doctors to improve patient teaching about fever and fever-reducing drugs. Many parents fear their child getting a fever or have "fever phobia." I certainly can understand why. Kids can do crazy things when they get fevers. They don’t sleep well, eat poorly, and behave strangely. Some children ...

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