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Switching from Tysabri to another MS medication

August 18, 2015
There has been debate about how to switch patients with multiple sclerosis (MS) from Tysabri to other medications. This happens most often when patients on Tysabri become positive for antibodies to the JC virus. Patients that have these antibodies are at increased risk of a serious infection called progressive multifocal leukoencephalopathy (PML).

New research has studied varying timelines for starting a new medication after Tysabri.

How to help kids prepare for surgery

August 17, 2015
Being scheduled for a surgical or sedated procedure can be a nerve wracking experience for children and their families. Knowing what to expect when you visit the hospital can help relieve many common fears and concerns. 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.

The pre-operative tour is a great place to start.

What to expect from a vestibular balance assessment

August 14, 2015
Vestibular assessments, or balance assessments, are recommended for people who have dizziness, vertigo, imbalance, and other related symptoms, because the vestibular portion of the inner ear contributes largely to our ability to stay upright. Visual input, somatosensory input and the central nervous system also contribute to our balance. Vestibular assessments are usually done by an audiologist. Because several body systems contribute to our balance, a patient who has dizziness may also be evaluated via clinical exam with an otologist or neurotologist or with imaging and blood work.

Here’s what happens during a vestibular assessment or ‘balance test’ and how to prepare:

Why are some people turned down for a liver transplant

August 12, 2015
The decisions of a liver transplant program can sometimes seem unfair or even arbitrary, especially when a loved one is turned down for a liver transplant. While everyone in need of a transplant deserves an opportunity to be evaluated, not everyone can be placed on the waiting list. 

Can multiple sclerosis result in premature death?

August 11, 2015

While we often counsel patients that multiple sclerosis (MS) does not often result in death, we have noticed some MS patients with aggressive disease who clearly succumb prematurely. To understand survival in the MS population with a matched cohort from the general population, a population based study is needed to evaluate the association of comorbidity with survival in both populations. 

Using nitrous oxide to help pediatric patients

August 10, 2015

Although the use of nitrous oxide (N2O) has been used in dentistry for over 150 years, its use in pediatrics for sedation and mild analgesia for procedures outside of the operating room has been gaining favor over the last several decades. Nitrous oxide’s inherent properties, including the induction of euphoria, amnesia, mild analgesia, quick onset of action and rapid removal from the body through exhalation, make it ideal for use in the pediatric population.


Here’s how we use nitrous oxide to help pediatric patients at Swedish:

Should I breast or bottle feed my baby?

August 07, 2015
This is a common question asked during pregnancy but one that it is easy to answer. I often advise to breast feed. There are very few contraindications to breastfeeding such as women that have HIV, herpetic breast lesions, active tuberculosis, or active drug abuse.

Here’s why breastfeeding is better:

Understanding fever in kids

August 05, 2015
As a Pediatric Emergency Physician in practice for 18 years, I have seen a great many children with fever. I also see a great many parents and other caregivers who are very concerned about fever, but are reassured when factual information about fever is provided to them.

Fever is a marker of illness and is very concerning in specific circumstances. Fever over 100.4 in any infant less than 60 days of age is reason to seek urgent medical evaluation. However, once children get beyond the newborn period, fever is much less concerning to medical professionals. The following information can help you better understand fever, and help you care for your child without unnecessary worrying. Fever myths lead to fever phobia while in fact, fevers are harmless and often helpful.

Let these facts help you better understand fever:

Why Have a Day Dedicated to Hepatitis?

July 28, 2015
Viral hepatitis is the most common cause of chronic liver disease worldwide. In fact, the two most common forms, hepatitis B (HBV) or hepatitis C (HCV), infect over 500 million people around the world – compared to 31 million with HIV. Chronic HBV is the most common cause of viral hepatitis followed by HCV. These two viruses are responsible for up to 2 million deaths a year. Therefore, it makes sense to call attention to this important global issue and this is why July 28 is World Hepatitis Day.

Screen Time Suggestions for Kids

July 27, 2015
Like everyone else, I like making resolutions from time to time. While some goals have been easier to attain than others, one resolution that has been frustratingly difficult to achieve has been “digital disconnection. Especially in today's hyper-connected world, it is almost impossible to "unplug". While it may be desirable, and even necessary to be proficient at computers and technology, it is equally important that we also learn to be healthy "netizens", and serve as smart examples for our kids. Children, even infants, are being exposed to a barrage of electronic devices. If smart phones, tablets, computers, televisions and video games weren't enough, we now have toy versions of the same! In fact, the iPad has even become the go-to baby sitter for a lot of families. The negative effects of such unrestricted and early exposure are very wide ranging, and only of late has science been able to shed light on some of these.

What can we do to mitigate this epidemic? There is no one-size guidance for all, but here are some suggestions. Like anything else in life, common sense should be our guiding light.