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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?

Advocating for Children with Severe Food Allergies

Eosinophilic Gastrointestinal Disorders (“EGIDs”) are a severe form of gastrointestinal inflammation that results from food allergy.  Children and adults in the U.S. are increasingly being diagnosed with this condition that unfortunately requires strict elimination diets, and many times, a life-long inability to eat foods that most of us take for granted each day, including dairy, wheat, soy, and eggs. 

For children requiring such restrictive diets, pediatric gastroenterologists like me work hard to find adequate alternate sources of nutrition.  For my patients with EGIDs, I often prescribe special “elemental formulas” as a treatment to both heal the intestinal inflammation and prevent further harm.  These formulas are completely allergen-free while meeting 100% of a child’s nutritional needs. 

However, in the state of Washington, most ....

Worrying about your child's growth

The above letters reflect many of our children’s feelings when they are first seen by Dr. Kletter. They and their families arrive to the Pediatric Endocrinology clinic with hope that something can be done.

Children are usually followed by their pediatrician or primary care provider. The following questions are guidelines for parents who are worried about their child’s growth. While any “yes” to the questions may not indicate a problem, it warrants a discussion with your child’s healthcare provider.

  • Is my child the shortest or tallest in the class?
  • Is my child unable to keep up with children of the same age in play?
  • Is my child growing less than 2 inches or more than 3 inches a year?
  • Is my child showing signs of early sexual development (before age 7 in girls and before age 9 in boys)?
  • Has my 13 year old girl or 15 year old boy failed to show signs of sexual development?

An experienced pediatric endocrinologist will evaluate the following possible causes of short stature and growth failure:

Three summer safety tips - sunscreen, heat exhaustion, water

Summer is in full force! With sunny weather, long days, and loads of activities it can be easy to forget the basics to keep you and your children safe this summer. Here are an additional 3 summer safety tips (see Dr. Lee’s blog for tips on helmets, open windows, and fires):

1. Sunscreen

All children of any age need sunscreen if they’re going outside in the summer, even if it’s for a short period of time on an overcast day. Sunscreen is the best way to prevent sunburns and future skin cancer. Babies under 6 months of age should be kept out of direct sunlight as their skin is thinner and more sensitive. Sunscreen should be greater than 30 SPF and applied 30 minutes prior to exposure. Be sure to read the label to ensure it protects against both UVA and UVB rays. Most products need to be reapplied at least every 3 hours or sooner if your child has been wet or in the water. A “waterproof” sunscreen should be reapplied every 30 minutes while your child is in the water.

2. Heat exhaustion

Heat reactions in children are caused by high temperatures and excess water loss. Here are a few things you should remember:

What to tell kids when a loved one is ill or in the hospital

When a loved one in the family is in the hospital or dealing with a chronic illness it can be hard to know what to say to the youngest family members.  It’s natural to want to “protect” them by not telling them or talking to them, but chances are the kids already know that something is going on.  An honest conversation can help to ease any misunderstanding they may have. 

Here are some important areas to cover when navigating a discussion about the illness or hospitalization of a loved one:

  • Honesty – Use words and descriptions that are appropriate for their age. If they are older they may ask specific details about the illness.  It’s good to call the diagnosis by name.  They may come back at a later date with other questions or even ask the same questions more than once. 
  • "Can I catch it?" – Children often have the fear that they can “catch” illnesses. They need to know, if in fact it isn’t a contagious disease, that they can not catch the illness from their loved one by being near them, hugging them and visiting with them.  This is particularly important if it is a brother or sister who is ill.
  • "Did I cause this?" – Many ....

What to expect when your child is in the Pediatric ICU (PICU)

Just the mere mention of the Pediatric ICU (PICU) can be frightening to both kids and parents.  But having a basic understanding of what people and equipment can be found in the PICU can help to lessen the anxiety.

What is the PICU?

The PICU at Swedish is a section of the hospital that provides the highest level of medical care for your child (0 to 18 years).  The PICU is different than just the regular pediatric floor because it allows for more intensive nursing care of your child and advanced continuous monitoring of their blood pressure, heart rate, breathing and more.  Patients in the PICU may also require more intensive therapies such as ventilators (a breathing machine) and certain medications that require close monitoring.

Who is hospitalized in the PICU?

Kids who are seriously ill whose medical needs cannot be met on the regular Pediatric unit will be in the PICU.  PICU patients may have breathing problems such as asthma or pneumonia, have had a lengthy surgery, have seizures or any other physical condition.  Time spent in the PICU depends on....

Wheezing in children

Wheezing is one of the most common symptoms in children and adults. Wheezing refers to the high pitched, "musical" sounds generated from the respiratory tract. It may originate in multiple areas, from the nose, to the throat, to the lungs. When physicians use the term "wheezing", they are usually indicating the sounds produced by tightness in the lower airways ("bronchial tubes").

Wheezing is especially important in pediatrics because children have frequent respiratory infections. These infections are generally caused by viral infections which cause much irritation in the airways. In addition, the airways of children are small and more "sensitive," predisposing them to wheezing. The location of the irritation may be in the upper or lower respiratory tract. This means that wheezing can occur with just a cold as well as bronchitis or pneumonia.

Wheezing in most children will respond to treatment with ...

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