Pediatrics

Don’t neglect the power of clinical examinations in modern medicine

Physician
February 17, 2023

I intended to write an essay endorsing the clinical examination (CE), but recent personal events have made me reconsider. I had outpatient sinus surgery and developed chest pain the next day, leading me to my local rural hospital’s emergency department (ED). The ED physician diagnosed atrial fibrillation, and a CT scan revealed a small pulmonary embolus. I was then transferred to a city hospital and eventually cardioverted to sinus rhythm.

Despite …

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Finding the right balance: Fleishman is in Trouble takes on parenting in the 21st century

Physician
February 13, 2023

For those who haven’t yet seen Hulu’s dramatic series Fleishman Is in Trouble, it’s really about the different forms of existential crises people face in middle age. The show contemplates the challenges of maintaining a marriage, parenting in the digital age, job dissatisfaction, and suburban listlessness, and how a responsible adult might reconcile these dilemmas and chart a new course forward.  It manages to explore these weighty themes with earnestness …

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A look into the safety of children products following baby formula recalls

Conditions
February 12, 2023

We previously reported about the national baby formula shortage that began in February 2022 and lasted for several months, affecting countless infants, parents, and caregivers and intensifying distress amid the ongoing COVID-19 pandemic. In fact, these supply chain disruptions were largely exacerbated by the novel coronavirus for numerous industries, including the food and infant care sectors, thereby further compounding the already precarious situation. As a result, these industry-wide shortages …

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Surviving and thriving: the new reality for chronically ill children

Conditions
February 11, 2023

My daughter was born with cystic fibrosis (CF). CF has been a catastrophic disease, historically fatal in childhood. CF is not pretty; it affects nearly every organ system, slowly and systematically damaging them. People with CF have thick, sticky mucous, which clogs their airways, pancreatic ducts, sinuses, and intestines. This mucous causes numerous health issues.

CF has been around for a long time. In the Middle Ages, a poem warns parents, …

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Say “no” to APNO and say “yes” to breastfeeding medicine

Conditions
February 7, 2023

It is common to get some nipple discomfort at the start of breastfeeding. Babies and moms are learning how to do this new skill, and sometimes they just don’t get it right, and nipple damage can occur. If caught and adjusted early, this can clear up quickly, but in the meantime, women can have cracks, bleeding, and extreme sensitivity to their nipples.

All-purpose nipple ointment – otherwise known as APNO – …

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How an eye for detail can save lives [PODCAST]

Podcast
February 6, 2023
YouTube video

Subscribe to The Podcast by KevinMD. Catch up on old episodes!

In this episode, we talk to Claire Unis. She reflects on her experiences as a pediatrician and how small moments of contentment and satisfaction, like seeing a healthy baby or a budding tree, led her to realize …

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It’s time to stop focusing on family weight

Physician
February 3, 2023

My eyes fell upon a horrible newspaper headline from 2008: “Fat kids die earlier.” That is the first article that I remember talking about obesity in childhood, but there were plenty more in the early 2000s. At the time, I clipped it because it reinforced my approach at the time: identify issues, educate, act, and avoid.

Over the past two decades, there has been an increase in the prevalence of children …

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Pediatric mental health is a growing epidemic. Here’s how Illinois is leading the way to solve that. 

Policy
January 27, 2023

One of my friends in middle school was known for her uncanny ability to brighten up any space she walked into. But when we hit high school, she had become more withdrawn and dejected, and her self-esteem plummeted. She was clearly struggling, but at the time, I didn’t know what the signs of depression were and was at a loss for how to support her. She and I had no …

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Where have all the pediatric beds gone? The consequence of strict admission criteria.

Physician
January 21, 2023

In the tale of the Pied Piper of Hamelin, the piper tunefully leads the children astray and to their doom.

Well, the piper has returned. Actually, he has been back for several years, but few noticed. This time he is not making off with the children but rather the beds they lie in, specifically pediatric hospital beds. This was not really obvious except to pediatricians until the recent calamitous “triple epidemic” …

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The power of a sticker: reflections on my journey as a pediatric resident

Physician
January 8, 2023

In my third week of residency, I gave out my first sticker.

My medical assistant opened the drawer and revealed the rolls of stickers, asking me to choose for my patient, who waited behind the door I just closed, their smile joining all the other little smiles that filled this room before and would continue to fill after.

The mind took me years back to little feet in pink and white flowery …

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Clinicians serving under-resourced populations should seize opportunity for free lifestyle medicine education

Conditions
January 5, 2023

As a pediatrician serving under-resourced families in Washington, D.C., I was glad to see health leaders converge for the White House Conference on Hunger, Nutrition, and Health. Solutions to food insecurity and diet-related diseases are urgently needed to address the crisis of chronic disease, which afflicts six in 10 Americans.

One of the important issues discussed at the conference is the critical need for more education and training in nutrition …

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Are pediatricians too nice?

Physician
January 1, 2023

One summer a few years ago, I went to pick my son up from camp. He was attending a week-long specialty day camp where the kids spent a week with an expert in some area of interest. The camp offered everything from basketball, soccer, and tennis to acting, magic, and chess. It was the first time I was going to pick him up, and I wasn’t exactly sure where to …

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Is there a third pathway of resilience?

Physician
December 30, 2022

My social media feed has increasingly included stories of friends “quiet quitting.” A term popularized through TikTok, quiet quitting is a reaction to the exploitation of employee labor without providing additional compensation. Simultaneously, my IRL conversations have been filled with stories of the Great Resignation, in which employees have voluntarily resigned, often without other employment secured. A recent report by the U.S. Surgeon General recognized the problem of workplace …

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Measles: a preventable disease that is making a comeback

Conditions
December 30, 2022

I see there has been yet another measles outbreak; at the time of writing, the count is 59 in central Ohio. All are either unvaccinated or not fully vaccinated. No doubt local pediatricians are being flooded with worried parents proffering their offspring for viewing with the statement, “Could this rash be measles, doctor?”

This certainly happened to me in 2019 when doing some primary care practice. That year experienced a massive …

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With RSV, it’s time for primary care to step up to the plate

Conditions
December 7, 2022

Every pediatrician is familiar with this endemic seasonal virus, expecting to see several cases in their office during the winter months and maybe even admit the occasional one for inpatient care. Even amongst the latter, most do well and recover without incident, though the stay can be prolonged.

However, the respiratory syncytial virus — when it causes pneumonia and bronchiolitis (inflammation of the small airways — can result in serious illness …

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Aesthetics and the physician’s eye

Physician
December 5, 2022

The fall sunlight calls my eye to notice little things: the veins on a yellowing maple leaf. The askew feather on a chicken’s wing. The faintest breeze tricking the pond into patterned sin waves around a lone white duck.

What do we owe this world but our ability to parse and observe, to interpret, to be filled enough by moments of abject beauty to return to the ugliness and try to …

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Protecting children from bad medical care

Conditions
November 24, 2022

Unfortunately, at least from where I sit, suboptimal medical care seems to abound. And every encounter of my family members with the health care behemoth is an opportunity for them to become a recipient of it.

When it comes to shielding them, I have had some failures in the past — it took a minor stroke in my father, who lived in England, for me to realize that he had never …

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Digital philosophy: a critical tool for the mental health of children

Physician
November 18, 2022

The precipitous decline in the mental health of U.S. children and adolescents has been meticulously cataloged in newspaper articles, books, and documentaries. In our own pediatrics clinic, the numbers have skyrocketed — a baseball player unable to get out of his car for practice, a teenager with aggressive behavior masking underlying depression and anxiety, and another 9-year-old unable to attend school due to daily panic attacks. Every day now, we …

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I saved a baby’s life

Physician
November 18, 2022

I saved a baby’s life today.

I say that not to impress anyone or to make myself out to be some kind of deity but because it is simply true.

A three-week-old baby arrived at my office, gray and limp, with agonal respirations and oxygen saturation of 67 percent. My team of dedicated office staff worked with me rapidly and seamlessly, providing oxygen, bag-mask ventilation, and emergency medical services (EMS) activation. Together, …

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