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Helping your child cope with medical experiences

The hospital or any medical experience can be a stressful and frightening place for anyone, especially a child. They may encounter new faces, scary equipment and overwhelming feelings of loss of control.

Did you know that there are professionals who aim to reduce negative effects of medical experiences that may affect the development, health and well-being of children and families? These professionals are called certified Child Life specialists and are available at most hospitals who serve children to help you and your child cope with these experiences.

Swedish has four full-time Child Life specialists who cover First Hill and Issaquah campuses from surgery to radiology to inpatient stays. At Swedish, our Child Life team strives to reach every pediatric patient who walks through our doors in an attempt to make their stay a little easier.

Here are some tips for parents on how to help your child cope with medical encounters:

Do you have chronic diarrhea?

Many people suffer from chronic diarrhea, not realizing that many times the cause can be found and corrected. Chronic diarrhea is defined as loose stools that last for at least 4 weeks. It usually means more than 3 or 4 loose bowel movements per day. Chronic diarrhea can have a substantial negative impact on quality of life and overall health. Many people with this problem have to stay near a toilet and are afraid to even leave the house because of fear that they will not be able to control their bowel action. It is particularly troubling if there is associated incontinence.

Chronic diarrhea can be caused by intestinal infections, endocrine disorders, inflammatory bowel disease, food sensitivity or allergy and a side effect of medications. These problems can often be diagnosed with a careful history and appropriate diagnostic testing.

There is one particular ..

My experience with female urinary incontinence and pelvic prolapse

I am an OB/GYN who has been in practice now for 20 years in Seattle. My early training had a strong emphasis on vaginal reconstructive surgery, but I was always frustrated with our poor success rate in repair of pelvic prolapsed and urinary incontinence. As my practice has evolved I have continued to focus on urinary incontinence and new techniques for treating pelvic prolapse. In the recent years there have been some very exciting new changes.

Urinary incontinence in women

Many women are bothered by urinary incontinence. Recent studies have shown that this is worse if you have had a vaginal delivery, but some of women have either wide pelvic openings or poor tissue elasticity that can lead to this without ever having had a vaginal delivery. This is an embarrassing problem and can be very inconvenient, with many women carrying a change of clothes or wearing daily pads. In the elderly this can lead to slips or falls and even broken hips. For women who have had children, this may keep them from exercising or playing with their children for fear of leakage. Many women suffer in silence because this is too embarrassing to share even with their doctors.

Today we have several ways ....

Activity after open or laparoscopic abdominal surgery

Every patient who visits my office with a surgical condition has several decisions to make and has a lot of information to absorb and understand.

I typically spend much of our time together describing the condition itself, why I recommend surgery, how I will perform the surgery and any risks involved in the procedure. While this is all critical to anyone’s understanding of their treatment plan, once the decision has been made to proceed with surgery, many patients’ concerns quickly turn to their recovery and what to expect after surgery. Most patients want to know when they can get back to walking, lifting, exercising, and their normal daily routine. While every patient and procedure is different, some generalizations can be made to help you know what to expect.

General abdominal surgery can broadly be separated into two categories: 1) open surgery where a large incision is made through the abdominal wall and 2) laparoscopic (or robotic) surgery where the procedure is preformed through multiple small incisions. Both types of surgery are used for a wide array of surgical problems.

The recovery from these two types can be different. Every patient should ask their surgeon wound care questions, dietary restrictions or signs of possible complications specifically related to their recommended procedure. There will be activity restrictions in the early postoperative period for all surgical procedures.

Many people wonder why we limit activity after ..

Why you should take sports concussions seriously

Concussions are serious injuries that should be treated by healthcare providers who are experienced with their management. Sports Medicine physicians diagnose and treat concussions with the goal of promoting a healthy recovery and returning athletes to sports and kids to school. Additionally, we work with parents, athletes, coaches, and other providers to identify the signs and symptoms of a concussion and help to proactively manage the effects.

What is a concussion?

A concussion, also referred to as a mild traumatic brain injury, is an injury to the brain caused by a blow to the head or from a whiplash effect due to a hit to the body. Concussions change the way the brain works and how a person thinks, acts, and feels. Most people do not lose consciousness. Even a "ding" or "bell ringer" can be serious.

What are the symptoms of a concussion?

Symptoms fall into four categories: physical, cognitive or thinking abilities, mood and behavior, and sleep. A person may have many symptoms or only a couple of symptoms. If a person reports one or more symptoms of concussion or if another person notices the symptoms, keep the person out of play and seek medical attention.

The symptoms of a concussion that fall into each category include:

Increasing Your Child’s Comfort with Nitrous Oxide

You may be familiar with “laughing gas” as something you find at the dentist’s office but did you know it can also be used when your child is a patient at Swedish? Laughing gas is a mix of nitrous oxide and oxygen, but you might hear your pediatric nurses just call it “nitrous.” In pediatrics, we use it to help a patient relax and feel more comfortable during certain procedures such as IV placement or urinary catheterization.

Once your doctor or nurse has determined that your child is a good candidate for nitrous (without any contraindications such as conditions where air may be trapped in the body, pregnancy, or impaired level of consciousness), your nurses and certified child life specialist (CCLS) will explain the process: Your child will choose a flavor for the inside of their mask used to administer the gas. They will be on a stretcher or bed and have a saturation probe attached to a finger to monitor their oxygenation. One nurse will administer oxygen, then the nitrous, gradually increasing the amount until your child is suitably relaxed for the procedure, while remaining responsive to directions. Another clinician will perform the procedure, e.g., place the IV. A doctor is also available.

As a parent ...

Eczema season

"It's eczema season" is an often repeated phrase for me lately.

This time of year, I always find myself seeing more patients with eczema. The common presenting complaint is a persistent rash that itches so much that it disturbs sleep. The dry, itchy patches of skin are commonly seen on the back, sides of the torso, arms and legs, but can happen almost anywhere. People with a history of allergies, asthma, or childhood eczema are even more likely to develop eczema in the fall or winter.

There are a number of contributing factors to the increased incidence of eczema in the winter:

Furnaces run more, drying out the air inside homes and buildings. We wear more clothing, increasing the friction on our skin. Hot water feels better, so we tend to spend more time in the shower or bath.

That last one sounds counter-intuitive, but ...

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