Archive for 2011

Seattle Mama Doc 101: When is a Child Ready for a Cellphone?

On May 16, 2011 Reader Jenny asked: ” What is the developmentally appropriate time to allow kids to have cell phones?”

Thank you Jenny for your suggestion. If you have a question or topic suggestion for the Seattle Mama Doc 101 video series please leave a comment here.

If It Were My Child: A Pediatric ER When Possible

A joint statement published in 2009 by the American Academy of Pediatrics Committee on Pediatric Emergency Medicine, American College of Emergency Physicians Pediatric Committee, and Emergency Nurses Association Pediatric Committee spelled out the need for reform in emergency care when it comes to caring for children.

The bottom line is this: if your child has an emergency and you have the luxury of time and choice of where to go, go to an ER at a Children’s Hospital or a pediatrician-staffed emergency room. Collect $200 and pass go. Learn from my mistakes.

Driving the joint statement was concern from both pediatricians and ER physicians about inconsistent care for children in Emergency Departments (EDs) that do not normally specialize in the care of children. The statement outlines strategies to prepare EDs around the country to care for children based on some sobering statistics… Read full post »

Forever My Baby

Being a parent is entirely overwhelming. Yes I know, we hold it together about 99.9% of the time, but there are these little windows where our fractures are evident. Or where our Mama/Papa-Achilles is wide open, taught and stretched. Or the beats of time where we get to let our knees buckle beneath the weight of our world. Where we give into the love we feel, the desperation of certain moments, the lack of control over things, and the slipping moments that occur each and every day as our children grow–where we feel we lose parts of them, and then simultaneously gain bits and pieces of who they become.

A pediatric partner of mine once told me that she felt the toddler and preschool years were the most intimate time of parenthood. I think about it all the time. It actually haunts me on some level, as if I’ll lose this proximity with my boys as time marches forward. That I won’t have this utter closeness. That the kisses at the cubby really will come to an end.

Last night, I buckled a little bit. I was also reminded that my pediatrician partner may be wrong.

Before bed, O (he’s 2 1/2 now) and I somehow migrated into his bedroom alone. Usually we read books together with his brother, but last night it was just the two of us while the husband read to F. He reached for a dreaded book and handed it to me. I wanted to shake my head. It was clear: he insisted. Of course I consented to read it but as I opened the cover, my stomach flipped. I knew I was in for a doozy. It had been a tiring day and I was weak in the knees with love for my boys. The book: Read full post »

5 Things We Shouldn’t Do

I really want you to trust your child’s doctor. I really want them to trust you, too. Partnership is key to any relationship. Recently an article was published in the Archives of Internal Medicine entitled The “Top 5″ Lists in Primary Care. It sounded more like a blog post than an article. In media summaries, reporters wrote about less being more. Not surprisingly, it was right up my alley. Like I’ve said many times before, in medicine, less is often more. Partnering with your child’s doctor is essential in assuring that when nothing needs to happen, nothing does.

This list is a reminder for us all.

The group authoring the article is part of the “The Good Stewardship Working Group” and represents 22,000 physicians for the National Physicians Alliance. Their intentions: to find 5 things “not-to-do” in primary care. For pediatrics, the committee used evidence (Cochrane reviews, AAP/AAFP Guidelines, The FDA, NAEPP), experience in the office, and field testers (pediatricians) to generate a list of what to avoid/what not to do, to avoid harm. The goal is to improve health, reduce burdens both financially and physically, and ultimately to empower patients, parents, and pediatricians to avoid unnecessary testing and intervention. I’m sharing them here because good care is partnered care. Being a strong, informed parent is likely the best asset your child will ever have in a health system. Parents need to know this list. If I could tattoo it on your arm, I would. You’re the strongest and most motivated person to advocate for your child. You’re also the most likely to help avoid unnecessary and dangerous intervention alongside the doctor or nurse caring for your child. The “don’t” list according to this group: Read full post »

Seattle Mama Doc 101: Teen Texting when Driving

Autism Screening At 1 Year Check Up?

A recently published study proposed and evaluated a new autism screening checklist for the 1-year well baby check-up. I had a hard time getting my hands on the study (crazy but true–even pediatricians sometimes are boxed out of research studies), but read lots about it first in the press. I was excited about the potential for early screening. The checklist, designed to be administered by a pediatrician, intends to improve early detection and diagnosis of autism. The goal: to enable early intervention and treatment for at-risk children. It’s clear that early intervention improves autistic children’s outcome with autism spectrum disorders but the media may have provided false information and false hope. So before you expect this checklist at your baby’s next 1-year check up, let me explain what the study found, my concerns about the results, and how the checklist may become useful.

I take care in using any screening tool–any intervention can cause unnecessary harm. My main concern resides around false positives (when a test suggests there is a problem when in reality there isn’t) and the numbers from this study… Read full post »

The Differences

While I was at my 15-year college reunion this weekend, I found myself repeatedly describing my boys to old friends and peers who had never met them. I told variant stories, but ultimately spent time on their differences. The contrast helps illuminate their truths. Eventually, it became clear that the easiest way was this:

The boys are entirely different but made of the same things.

Yet, F is really going to need O to drag him into the ocean to play in the waves.

And O is really going to need F to remind him that they could drown while in there.

Seattle Mama Doc 101: Baby Proofing Your House

I’m A Physician On Twitter: Patient Privacy

On Monday night, Dr Bryan Vartabedian, a pediatric gastroenterologist in Texas, wrote a blog post about physician behavior on Twitter. In the world of health and social media, it’s caused a near nuclear explosion of thought, an outpouring of opinion, and most importantly a much-needed discussion. Discourse is perfect for progress.

I think about this all the time.

In the post, Doctor V called out an anonymous physician blogger and tweeter, (@Mommy_Doctor), on her tweets about a patient suffering from an embarrassing and painful medical condition. Nearly 100 comments later and numerous other blog posts, physicians and patients are openly battling and exchanging perspectives.

I wonder, what do you think? I rarely write about patients directly. More, I write about what I learn from patients. I never want a patient or family member to stumble upon anything I write and wonder if I’m writing about them. When I have written about patients, I have asked permission and even then, waited for a period of time before writing about them to avoid the time-stamp the internet provides. Read full post »

2 Questions For School On Community Immunity?

My phone wasn’t working well today so I stood in line at the “genius” bar this afternoon to resolve the problem. To be clear, that was 2 1/2 hours ago and I’m home with the promise from a very nice genius that it would be activated by the time I reached my home. It didn’t happen and I’m phoneless (a new thing for me) so it’s quiet around here. In lieu of being able to communicate by phone, I’ll share something I learned while waiting for help. It turns out to have shaped my thoughts for the afternoon.

While at the store, I ran into a researcher who works at the interface of vaccine hesitancy and immunization rates. We got to talking about his work, my writing and work in clinic, and what will ultimately help families. I mentioned what I really want is for families to get good information from their pediatricians (online and off) so when they immunize their children, they rest easy knowing that their children are protected. He asked a question, well two questions, that I didn’t have the answer to in my own life. I wonder, do you? Read full post »