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'Pediatric General Surgery' Parentelligence posts

How to prepare your child for a stay at the hospital

We all know that Swedish provides top-notch pediatric services for the emergent needs of children and their families.  You may be surprised to find out that many children come to Swedish for a planned inpatient stay as well.  There can be various reasons why a child and their family might be anticipating a hospital stay.  Some examples may include having a surgical procedure that requires them to be monitored for a set period of time afterward, neurological video monitoring, or medical preparations for a procedure the following day.

Regardless of what service your child will be receiving at the hospital, there are ways in which you can better prepare them and yourself for what to expect during your stay.

At Swedish, Child Life Specialists help children and families cope with the hospital process.  Child Life Specialists are available to help educate and prepare children and families prior to surgery and/or an inpatient stay.  Some tips on how to prepare your child for an inpatient stay include .....

Helping kids heal with music and technology

A young girl is cowering in the corner - it is the first day her care-taker has left her side. She has backed herself into a corner as far from anyone as possible. She appears to be filled with anxiety. Staff members and nurses try calming her, but nothing seems to work.

With her back turned, the little girl doesn’t notice a young man entering the room. He is holding a tool, one of which the full power and potential is still unknown to most. Even though he has witnessed its abilities before, what happens next still takes even him by surprise.

Not knowing what to say, he says nothing at all. He lifts his instrument and strikes the first chord. The girl stops. He continues to play. The girl turns and slides to the floor. The young man sinks to his knees, the same level as the girl. Strumming his ukulele the young man begins to sing. The little girl begins to scoot herself across the floor, 20 feet to where the young man kneels, closer and closer until her knees touch his.

There are gasps coming from the doorway, as a handful of hospital staff and nurses witness to an amazing transformation. In a flip of a switch, the little girl went from utter anxiety to calm and happy, soothed by the sound of music. As the young man finishes his song, the little girl smiles, reaches out her hand to touch his, then falls back, smiling and laughing.


This is the story of Melodic Caring Project Founder, Levi Ware, on his most recent visit to provide live music to pediatric patients at Swedish First Hill.

“I've been playing music for a long time and I've seen a lot of amazing things happen when music is introduced into certain situations. What happened on the Pediatric Unit at Swedish was one of the most wonderful, beautiful and undeniably powerful music experiences I've had.  ...

Lymph nodes in children

One of the most common referrals to my pediatric surgery practice is (in the parents’ words) “to check out this lump and make sure it’s nothing to worry about.”  Lymph nodes are part of the less publicized part of the circulatory system: the lymphatics.  Lymphatics play a key role in our body’s immune system, and lymph nodes grow in response to an infection in the “neighborhood” to produce cells necessary to hopefully resolve the infection. 

About half of all children will develop enlarged lymph nodes (cervical lymphadenitis) in the neck for example, and the vast majority of these are in response to a minor infection in the area (sore throat, sinus infection, ear infection, etc.).  Often the infection is quite subtle and might not be identified.  These nodes typically go through a pattern of growing and then receding in size once the infection resolves.  This process can take several weeks to months.  The nodes may become tender, warm, and there may be some redness of the overlying skin.  Your child might complain of pain in the area, be fussier, have fever, and/or have decreased appetite.  If the node itself becomes infected, it can turn into an abscess and would require antibiotics and a drainage procedure.  Any possibly infected lymph node should be evaluated by your doctor.
 
Some enlarged lymph nodes ...

When do kids need antibiotics?

Winter can seem like one long continuous “sick day” for families - kids pick up frequent infections at school or daycare and pass them around to everyone at home.  Often it feels like by the time the illness has worked its way through the household, a new one has started!  Even for physicians, it can sometimes be difficult to distinguish between viral and bacterial infections.  Since antibiotics cannot treat viruses, they are often over-prescribed - which can lead to significant side effects in children and also contributes bacteria becoming resistant to existing medications.  In November 2013, the American Academy of Pediatrics released an updated guidance regarding antibiotic treatment, helping answer the frequently asked question about when kids need antibiotics.

Here's what you should know about antibiotics in these situations:

  • Ear infections ...

Beware: Magnets May Be Hazardous To Health!

Magnets, a common household object with which we are all familiar, can be surprisingly dangerous, especially to children.  If this statement is startling to you, here’s what you need to know. 

Beginning in the 1970s and 80s, scientists discovered a new type of magnet, the so-called “rare-earth magnet”.  Made from some of the “rare earth” metals of the periodic table such as “Neodymium”, these new magnets are not only the strongest, most powerful magnets known to man (magnetic forces up to ten times that of other magnets), they are also permanent and relatively inexpensive to manufacture.  These properties revolutionized the production of many household products, even toys.  Basically, magnets we find in everyday items today are no longer made using old-fashioned magnets from a generation ago!

As a pediatric gastroenterologist, I am writing this blog to warn you of the dangers, should these powerful magnets be accidentally swallowed.  If more than one magnet is swallowed, or if a magnet is ingested along with another metallic object, the formidable strength of these magnets can attract 2 pieces of bowel to stick together with such great strength, it results in serious injury, even death.

This video ...

Handling stress with kids in the hospital

As the back to school sales begin, we are reminded that soon our kids will be back on the bus and returning to school routines.  As adults we may look forward to the return of a consistent routine or dread the increased activity that comes with sports, homework and friends.  For our children school can be both exciting and anxiety producing as well.

Stress can be a contributor to many illnesses and is something that we all can use help managing. (Want to find out how much you know about stress and your kids? Take this 5 question quiz here.) The questions bring up some great ways to manage stress daily for our kids; but what about the stresses of chronic illness or hospitalization?  What can you do for your child to decrease their anxiety in the hospital?

When a belly ache or stomach pain might mean appendicitis

As a pediatric surgeon, I am often asked when to “worry” about abdominal pain. Children often report aches or pains near the belly button (umbilicus), and the question arises around when this might mean something significant such as appendicitis.

Appendicitis is a common occurrence affecting about 7% of people over their lifetime, and it begins with vague abdominal pain of the central abdomen. Once the appendix becomes obstructed and begins to suffer from lack of circulation (ischemia), the body can detect more accurately the exact source of the pain. After this localization occurs, children older than 6 or so can identify that the pain is most severe in the right lower part of the abdomen. The localization usually occurs within 24 hours of feeling unwell. The pain is typically worse with movement of the appendix during activities such as walking, coughing, and change in position. I often ask children to jump up and down (on their bed is something kids are excited to do!) and watch their face to see if they wince. Typically with appendicitis, a child will either refuse to jump or may try it once but will not continue due to the pain.

Distraction is also frequently used in children that seem to be particularly “focused” on their pain. In gently feeling the abdomen of a child with early appendicitis that is distracted, the abdomen is soft until palpating the area of the appendix. This right lower part of the abdomen is...

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