It is with great happiness that I update an earlier blog posted several months ago with the news that patients with food allergies now have a law that helps them afford their treatment. On Friday March 28th, Governor Jay Inslee signed a law that makes Washington the most recent state in the country to set a mandate for medical coverage of elemental formulas in the treatment of Eosinophilic GI disorders (EGIDs). EGIDs are a severe form of gastrointestinal inflammation that results from food allergy.
We all know that as a nation, we are getting bigger and heavier. Worse still, our future - our children- are becoming obese and unhealthy at increasingly younger ages. For decades, the scourge of obesity was blamed on a high calorie, high fat diet. Turns out, we have probably been doing it wrong all these years and our bulging waistline attests to this colossal failure. Research and the medical community now have increasing evidence that the real villain of the story is a very sweet little molecule called fructose. Fructose is what gives us the sweetness in table sugar (sucrose)…also in brown sugar, honey, agave, and of course, high fructose corn syrup. Call it by any name, but sugars are dangerous to our health. Fructose is addictive, much in the same way as alcohol and illicit drugs are. In fact, sugar (fructose) metabolism closely replicates alcohol metabolism except for the acute effects on brain. Sugar has been likened to alcohol without the buzz!
You may already have heard about First Lady Michelle Obama’s work with the FDA which has led to newly proposed changes to nutrition labels on packaged foods. The amount of sugars, specifically, “added sugars” will be part of that new label. I am not implying that a zero added sugar diet will be the panacea for the pandemic of obesity and ill health. We still need to eat healthy and exercise right. There is no magic pill, no startling new advice. Remember what our grandmothers used to say:
As a pediatric urologist, I am frequently asked to consult with parents whose newborn son has hypospadias.
Hypospadias is usually diagnosed during the physical exam right after the baby is born. When parents see the abnormal penile anatomy they naturally want to learn about the diagnosis and understand what, if anything, needs to be done. Answering these questions, discussing options, and performing reconstructive surgery to help restore normal penis appearance and function are some of the most rewarding things I do as a pediatric urologist.
I would like parents who have a son born with hypospadias to be reassured that the anatomy can be reconstructed, the surgery is well tolerated, and a good outcome with a normal, or near normal, penis appearance and function can be achieved.
It is not urgent to treat newborns with hypospadias because they can usually pee (urinate) just fine through their existing urinary opening.
In fact, when hypospadias is the only condition noted in a newborn physical exam there is a low chance of additional developmental abnormalities. Additional tests and studies on the baby are usually not necessary.
It is important to note that if any unusual shape of the penis or urethral opening (where the pee comes out) is present then circumcision (if desired) should not be performed until after the child is examined by a pediatric urologist. This is because the pediatric urologist may need to use the foreskin tissue for the surgical repair.
Here are answers to some commonly asked questions:
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 ...
Here's what you should know about antibiotics in these situations:
- Ear infections ...
Listening to Stephanie Baily talk about her daughter, Piper, turning one year old, you can’t help but hear the pride and gratitude in her voice. Piper was born seven weeks early due to complications with Stephanie’s pregnancy and spent 25 days in the Swedish NICU before she could go home.
Because of the excellent care they received at Swedish, Stephanie and her husband Jonathan wanted to do something special to honor their daughter’s first birthday. They also wanted to give back to the place that helped Piper during those first and fragile weeks of life. So they asked family and friends, in lieu of gifts of toys and clothes, to make a donation to the Swedish NICU.to the Swedish Neonatal Intensive Care Unit.
“Swedish has such a special place in our hearts. We wanted to show our appreciation for those who helped us, and to help make things better for the next babies and parents,” said Stephanie. “It’s so important that parents know they can trust their child to the care of a nurse or doctor, especially here in the NICU. I had such a hard time leaving Piper and going home without her, but the little things the nurses did made me realize they were treating her as if she was part of their family. They let me call any time, 24/7, answered all our questions, and accepted all our emotions. They were always nice and reassuring, which is so important to a first-time parent.”
Stephanie explained that every morning she would come to the hospital and find Piper...