Search for tag: "children"

Needle phobia. It's something that as a pediatrician I see every day, several times a day. At least two-thirds of children have a fear of needles. It's hard to tell who is worse with it though, little kids or teenagers.

Unfortunately, vaccines are still given as shots at this time, and kids get a lot of shots to help build their immune system. At the mere mention of being due for vaccines or blood work, some kids will just burst into tears.

So what can you as a parent do to help when your child is due for a vaccine or needs blood work done? I always will tell parents and kids at the well visit before they are due for vaccines that the next time they have a checkup, there are shots involved.

Mainly, I do this to avoid surprises. Often parents will say that they had no idea their child was due for shots. So when I tell the kids, they remember the next time and that actually seems to help them be better prepared. It's the surprise "you need a shot" announcement that catches kids off guard more and their anxiety goes through the roof.

Parents also feel better knowing that they can tell their child that, "We talked about this," and that they can prepare their child in advance, not spring it on them on the drive to the office or once they get here.

One thing we as pediatricians ask that you don't do is tell your kid that if they don't behave, they'll get a shot. I hear that all the time as a scare tactic and it really bothers me. I'm not going to give your child a shot if it's not needed.

If you tell your child in front of me that I will give your child a shot if they misbehave, I will tell your child that I don't give shots for behavior, but I do have time out spots in the clinic.

And for the teenagers, if they get out of hand, we do have security officers who can help with behavior outbursts. And yes, sometimes that has been needed when the teenagers become violent.

Kids often will ask me if the shots hurt. Well, they are shots. They're not fuzzy caterpillars. Same with the needles we use to draw blood. I tell kids that, "Yes, they hurt just a little, but it's over quickly," and, "We have to use the needles, but for a good reason," and it's to make sure that they are healthy.

I try to be upfront and honest with the kids. Even little kids understand when you tell them the truth in a calm manner and explain why we are doing what we are doing.

I had a vaccine one day and I saw a patient later who was afraid of getting a shot. I showed her my Band-Aid and she was so surprised. She was like, "But you're the doctor." And I said, "Yes, I am, and I sometimes have to get shots too." She then said if I was brave enough to get one, then so was she.

I also tell kids when they're old enough what vaccines they're getting and why they're getting them. I ask if they have any questions about the vaccines, and that seems to help them understand the importance of the vaccines.

Same with the blood work. I explain everything to them so that they know I'm not ordering labs just because I want to torture them. It's because I'm trying to figure out what is going on in their bodies and how to make them healthier.

I also have the advantage of telling kids and parents that my medical assistants are who I trust with my own family and who I trust to draw my blood and give me any immunizations. So they know that they're in good hands.

I let them know that I don't like getting needles poked in me either, so they know they're not alone and that I get it.

I talk directly to the kids so they know they're heard and we are doing what we can to make this as easy an experience as we can. And they know that they get a sticker when they're done for being so brave, no matter how old they are.

So while needle phobia is a real thing, there are ways as parents that you can help make immunizations and blood draws less scary, which goes a long way when the kids are here in the office.

It seems there has been a big increase in the number of children being diagnosed with sensory disorders. One reason may be that kids with sensory issues actually have other diagnoses, such as ADHD, anxiety, PTSD from abuse, and autism, just to name a few examples. Other times, some kids may just be sensitive to some things but not others and don't actually meet the full criteria. It has only recently been added to the psychiatry diagnosis textbook, the DSM-5.

Sensory processing disorders are basically where kids are sensitive to sounds, textures, or other stimuli to the point where it is beyond normal childhood behavior and causing a disruption in the child's life and also in the life of the family. Any of the five senses, taste, touch, smell, sight, and sound can be affected. Often children with sensory issues also have poor fine motor skills or have a hard time with social cues and interactions. They have a hard time regulating their emotions.

One study shows that sensory processing disorders affect 5% to 15% of school-aged children. Another study showed that there may be a biological cause with abnormalities in the white matter of a child's brain that could explain sensory issues.

Some children are hypersensitive to things and may think everything is too loud or too bright. They are the ones who are covering their ears often or have a low pain threshold or are super picky with eating certain textures. They have a hard time focusing and controlling their emotions, and they don't like to be touched. Other children are hyposensitive and they crave input, trying to get more sensory input. They're more likely to have a high pain threshold, put things in their mouths, hug too tightly, invade other people's personal space, or rock and sway.

One big issue is that there is still so much to be learned about sensory processing disorders. Your pediatrician can suspect your child has a sensory processing disorder but cannot actually make the diagnosis. Again, there are so many other brain issues that can present with similar symptoms so it takes a developmental or a behavioral specialist or even a neuropsychologist to get an official diagnosis. Your pediatrician will refer your child to someone who can help do a full and complete evaluation to get the correct diagnosis. The mainstay of treatment for sensory processing disorders is occupational therapy. Occupational therapists can help kids and parents learn ways to manage their sensory needs.

If you have concerns that your child may have a sensory issue, please talk to your child's pediatrician and ask them for a referral to a specialist who can get them the right diagnosis and treatment.

Interviewer: So what exactly are growing pains, and are they normal? I'm here with Dr. Julia Rawlings, a non-operative sports medicine physician at University of Utah Health. And I just want to start out by asking what exactly are growing pains? Is it the legs actually growing? Or what causes these pains in kids?

Dr. Rawlings: Yeah, so the name growing pains is a little bit misleading. Children are growing, but that is not causing pain. There's no evidence that growth itself causes pain. What we think is actually happening is that when a child is just very active during the day, the muscles get a little tired and achy. And we'll see that kids get this achy, throbbing muscle pain that usually happens later in the afternoon or evening, or it can even wake the child up at night.

Interviewer: Geez. So it doesn't have anything to do with bones getting longer, muscles getting stretched. It's just them being active kids?

Dr. Rawlings: That's what we believe, yes.

Interviewer: When do kids usually start experiencing growing pains, if they do?

Dr. Rawlings: So there are two peaks that we typically see growing pains. It's usually the preschool age group, and then the preteen, so kind of 11, 12, maybe early teen, 13.

Interviewer: And it's normal, right? There's nothing . . .

Dr. Rawlings: Completely normal. It doesn't affect growth.

Interviewer: It's just a little uncomfortable?

Dr. Rawlings: Or quite uncomfortable. It can be pretty painful, yeah.

Interviewer: And let's say a kid is experiencing some severe pain in their legs, it's maybe keeping them up at night, etc. What are some ways that maybe you could treat it at home to give them a little bit of relief?

Dr. Rawlings: Yeah, so I think starting with just some massage, rubbing their legs is helpful. You can try a heating pad, or if they prefer it, you can even try ice. Sometimes just a dose of ibuprofen or Tylenol can be very helpful. And if they have this pain that comes up pretty frequently, you might even see if they'll be willing to stretch a little bit during the day and see if that helps at night.

Interviewer: Just running stretches, yoga stuff?

Dr. Rawlings: Yeah, yoga for kids, that's perfect.

Interviewer: Oh, fantastic.

Dr. Rawlings: Yeah, just some hamstring stretches probably is a good place to start.

Interviewer: Sure. And say a parent is listening right now. When can we expect these growing pains to stop?

Dr. Rawlings: Yeah, hopefully they'll stop after they leave those peak periods, so after they've left the preschool years or they enter their teen years. They can continue throughout the teenage years, but usually not through adulthood, into adulthood.

Interviewer: And until then, you've got stretches, ibuprofen, anything to help.

There have been concerns by some parents that they don't want their kids wearing masks because they believe their child will be inhaling their own carbon dioxide with prolonged mask wearing and that will cause oxygen deprivation. Some say that children will inhale up to six times the safe limit of carbon dioxide.

Let me help clear the air on this one. It's not true. Here's the science behind the truth. Carbon dioxide poisoning or hypercapnia from re-breathing the air we normally breathe out doesn't happen because carbon dioxide molecules are extremely small, even smaller than the respiratory droplets, which is what we are protecting against when we wear the masks. They cannot be trapped by cloth or medical masks or any sort of breathable fabric. Those tiny molecules just pass right through the material.

Surgeons, nurses, respiratory therapists, all of us in the medical profession, in fact, wear our masks for hours and hours during the day. Studies done by having surgeons wear oxygen monitors during their entire time in the operating rooms show that masks have no effect on the amount of oxygen they have in their bodies.

If your child is wearing their mask properly, covering their mouth and their nose and fitting snugly over their face with the ear loops or ties, then your child will be protected from the respiratory droplets we don't want going through the breathable fabric, but still letting them breathe in oxygen and exhale carbon dioxide through their masks.

The bottom line is masks work. Last year during what is usually a very busy winter season, I hardly saw any sick kids. Now we are seeing RSV and rhinovirus and all sorts of other winter viruses because people have loosened up on mask wearing and viruses are taking advantage of that. Hospitals are full with kids who are having respiratory virus complications. I've had parents of children with asthma tell me that since their kids wore masks, the last school year, they didn't get sick and didn't have any asthma flare-ups. We can do this.

The kids I've spoken to have no problem wearing their masks. They like to coordinate their masks with their outfits and get cool ones with princesses and superheroes on them. I tell them they actually are little heroes. They tell me they have no problem wearing masks all day at school either. My own kids even say that they're so used to their masks, they don't even think about them anymore. And they're in junior high and high school. So mask up. And if you have any other concerns about COVID and COVID precautions, be sure to talk to your child's pediatrician.

A lot of parents of younger children are now asking themselves a big question. I'm vaccinated against COVID, but my kids are too young for the vaccine. Can I let them play with their friends again? Do they have to wear a mask?

Kids have usually seemed to fare better with COVID than adults. But we know this isn't always the case. There are those kids who get COVID and then are affected by MIS-C, the multi-inflammatory system complication that will land a child in the intensive care unit. That is seriously scary. And that's why so many of us pediatricians worry about kids around COVID.

Another big concern has been that younger children would bring the virus home to vulnerable adult family members, and those would be the ones who would become significantly ill. So now that many places are not requiring masks anymore and places are opening up, it puts many parents in a situation where they're not sure what to do with younger kids. These kids have missed a whole year or more of socialization with friends and are really wanting to get back to playing.

The current recommendations are that if a person is not vaccinated, they should continue to wear a mask. That said, if your child is playing outside with friends that you trust and who have also been following precautions, it may be okay to let the kids play outside without masks on. There is evidence that kids who play outdoors have a low risk of being infected. There are also a lot of summer camps now, where masks are still being required. But they offer a lot of fun activities for kids who are too young to be vaccinated.

Adolescents ages 12 and up can be vaccinated now. My kids are both fully vaccinated now, and it was their choice, especially knowing that next year there will be no masks in junior high or high school in our area. They asked a lot of good questions about the vaccine and understood the science behind the vaccine. They both said it was such a relief to know that they are now protected. Vaccine trials are now underway for kids older than six months old at the time I'm recording this. The current projections are that kids ages 5 to 11 may be able to be vaccinated as early as September. And kids ages six months to four years may be able to be vaccinated by next spring.

The more people around your child who are vaccinated, the safer they will be. The bottom line is this is a choice your family needs to make. Are others in your family at high risk? Do you know who your kids are playing with? Are they outside? Is anyone sick? Or has anyone been exposed to COVID within days of the playdate? There is hope in sight for the youngest population, and science is working as fast as possible to get everything back to normal as quickly as we can.

Donating your child's organs when the unthinkable happens is not normally something parents ever think of. If you've been following my recordings, you know that a dear friend lost her teenage daughter recently. We had been very close to her daughter since she was a baby. And it was amazing that even in this difficult time, my friend thought of others. Her daughter was an organ donor. She improved the lives of at least six other children by this selfless act.

Before I was a pediatrician, I worked in organ transplant as one of the original 12 organ placement specialists for UNOS, the United Network for Organ Sharing. My job was to take information on those who had been declared brain dead, enter it into the computer, and find matches. That means finding those people waiting on the transplant list, who were genetically similar enough to the persons whose organs were being offered and coordinate with the transplant teams on both sides to get lifesaving organs from one person to another.

People can declare if they want to be organ donors on their driver's licenses or in their wills. But what happens when a child passes? Parents have to make that decision under the most difficult of circumstances. The process starts when a child is admitted to the intensive care unit and the doctors there suspect that the child will not recover from their injuries. They will discuss if the parents are interested in donating their child's organs if their child is declared brain dead.

Brain death happens when the brain essentially stops being able to do what it normally does — think, feel, and tell the body what to do. It cannot be reversed. While the heart can continue to beat and machines can keep a patient breathing, the brain is no longer working. A child may appear to be sleeping, but they're not. They're kept alive by machines and medicines. When the machines are turned off, the rest of the body will die, just as the brain already has.

Specific exams are done by specialists to confirm brain death. Someone is never declared brain dead without all of those tests being done to confirm that the brain is no longer functioning. Once brain death has been declared, someone from the local transplant team, called the organ procurement organization, will come and meet with the family. They are usually medical personnel with special training in how to handle this most sensitive situation. They will be able to answer questions and help the family through the process.

Once parents give consent, the paperwork begins, and that is where what I did comes in. When donors and recipients are matched, organ placement specialists will help with transportation to get the organs to where they need to go. Once everything is coordinated, the donor is taken to the operating room where the organs that were placed are then removed from the body and the machines are turned off, and thus, the patient has now become cardiac dead. Their heart stopped beating and they are gone.

The donor patient can have a full open casket funeral if desired. The organ procurement team works closely with funeral homes to make sure this can happen. For privacy, the recipients of the patient's organs are not disclosed to the donor family. But the organ procurement team does let the family know how many organs were able to be transplanted into waiting recipients.

While nothing can make the pain of losing a child suddenly better, families often say that knowing that, during the tragedy of their loss, they were able to give the precious gift of life to another and that helps the healing process begin. Their child will live on through those they have helped.

Knowing their friend was an organ donor started the conversation with my boys. They both told me that they would like to be donors if anything happened to them. They know their father and I are both registered donors as well. If you would like to be an organ donor, you can sign up at UNOS, UNOS.org/register-to-be-an-organ-donor. I would like to dedicate this podcast to all who have made the choice to donate and save another life. Thank you.

Pandemic fatigue, we all have it. However, it is affecting children more than adults in many cases.

Pandemic fatigue by definition is the mental exhaustion caused by being in a state of heightened awareness and alertness in the face of COVID combined with the uncertainty of how the pandemic will develop. Parents are struggling to continue to juggle working from home and teaching their kids who are doing online school. Healthcare workers are getting burned out from the stress of working with COVID patients and seeing the numbers of infected patients continue to go up.

Kids are becoming more anxious and depressed, not just about isolation and not seeing their friends, but I'm having parents bringing their kids to me about anxiety over things they've never been anxious about before. This is especially true because just as COVID numbers started to increase locally, we also had a major earthquake. I have some patients who if they get a cold are asking me if they're going to die. I have others who are terrified of germs and think they will get COVID if someone touches their dog or they will change their clothes as soon as they get home from being out of the house, even if they just went to a store.

People are tired of wearing masks. People are tired of physically distancing, of not having normal life milestones being able to be celebrated in the way we have done for years. So since this is not showing any signs of slowing down anytime in the immediate future, how can you help your children do the best they can while dealing with COVID in the long haul?

First, continue to make mask wearing fun. I've said it before, and I'll repeat it again. If the mask is something fun, kids will want to wear them more. Have fun characters on their masks. Let the kids have enough variety in their masks that they can coordinate them with their outfits. That's exactly what my younger son does every day. His teachers comment all the time about his cool masks and how they match what he's wearing.

For hand sanitizers, have seasonal scents. If your child doesn't have eczema and they're not sensitive to different fragrances, let them choose what they want to smell on their hands all day long.

Empower kids. Let them know it's okay to tell family members and friends that if they just aren't masked or they're not social distancing, then your kid can't play with them. It's okay to remind others of the rules. Just make sure it doesn't turn into a daily battle and they don't turn into the germ police.

Let kids connect with friends online. I know we didn't use to be a video game family, but when the pandemic hit and schools went online, I caved. I bought an Xbox for my boys and I let them have a certain amount of time to play with friends every day. It helps them still feel connected to their friends, but in a safe way. It also lets them get a break from school and just play and be kids.

Finally, remember that it's okay for them to be bored and figure out new things to do. It's okay to let them cry, even if they can't tell you what they're sad about. It's okay to have breakdowns and just get angry and need you to hug them until they're screaming turns into crying and then I'm sorrys. As long as your child isn't disrespectful or violent, let them express their emotions. Then, if they want to talk about their feelings, if they don't want to, that's okay. Let them have their space. The bottom line is everyone is feeling pandemic fatigue in one way or another. If we all help each other, then we will get through this together.

Dr. Gellner: You are in need of finding a new pediatrician whether it's because you're expecting your first child, you moved to a different city, your insurance has changed, or your previous provider has left their practice. It can be a pretty stressful situation. But I'll let you know some tips to help make this a little easier.

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kids Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: Finding the person you like and trust to help you raise your child, take care of them in sickness and in health, it can be tricky. The first thing I would say to do is to ask people around you who have children. Who did they see? Do they like their pediatrician? Do they like the staff at their pediatrician's office? Is the location close to you? Are their hours convenient?

I can't tell you how many new patients I get that come in saying, "You see my neighbor's kids or my family member's kids." It's actually quite humbling and an honor as a pediatrician to know that so many parents speak highly of me.

Next, call your insurance company. Do the pediatricians whose names keep coming up amongst your friends take your insurance? Doctor bills can be expensive, so make sure you pick a pediatrician in your network.

I then look them up online. Most practices not only have a short biography about their provider outlining what their education is. They'll also say if they're board certified. Do they have a particular area in medicine that they really like to practice? For example, my biography points out that my areas of expertise are preventive care, childhood obesity, and allergy and asthma management.

The biography also should give you a little insight into their personal life, like what do they like to do when they're not working. You might find that someone has a particular hobby that you do as well, which makes for a great icebreaker when you go in for your first appointment. Many of my new patients lately have been from Texas. And when they see I did a lot of my education in Texas, it's an instant connection. When you look them up online, also look at their reviews. What do other parents say about that provider?

Finally, when you've done all your homework and you've found someone who you think would be a good fit for your family, schedule a visit to establish care when your child is ready for a well visit or if they're sick or if they have a chronic condition that needs long-term care. Use that visit to see how this provider interacts with your child. Do they talk to your child as well as you? Is your child comfortable? Does your child leave with a smile on their face even if shots are involved in the visit? If you have a positive experience and you feel like you and your child connect well with the new pediatrician, then you know you found your match.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there's a pretty good chance you'll find what you want to know. Check it out at thescoperadio.com.