March 05, 2014
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 bec...
February 28, 2013
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 ...
September 17, 2012
The most common thing that I see as a pediatric surgeon is a child with a lump that is thought to be a hernia. A hernia is a bulging of tissue through an opening in the muscle layers that isn’t normally present. In children, these openings are usually the result of a developmental process that just didn’t quite reach completion. Some hernias need surgery emergently, while others are observed for years with the expectation that they will close on their own. Here are some pointers to help understand this wide range of approaches to hernias: Location is very important in considering how aggressive to be with hernias. Belly button (umbilical) hernias are...
August 17, 2012
As a pediatric surgeon with a special interest in intestinal issues, I am often contacted by worried parents regarding their baby's infrequent bowel movements. This can be caused by a variety of problems such as blockages of the intestines or abnormal intestinal function (including a condition called Hirschsprung's disease); but most frequently babies are just efficiently absorbing and thus not needing to poop very often. This is especially true for breastfed babies. So, how can a parent tell the difference? I would offer the following "red flags" as issues that may indicate a problem needing further medical evaluation:
August 14, 2012
The interventional neuroradiologists at Swedish Neuroscience Institute in Seattle are rapidly building experience performing Pipeline® embolization on patients with certain types of brain aneurysms. Dr. Joe Eskridge and Dr. Yince Loh are both performing this new ‘flow diversion’ technique, where the pipeline device is placed across the aneurysm neck to divert blood flow back to the normal vessel. This technique is a new treatment option for large, complex and wide-necked brain aneurysms, which can be challenging to treat with traditional methods.
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August 08, 2012
Men, what’s your excuse for not going to the doctor? Everyone has them and they’re about as unique as our fingerprints. But put your finger on this: studies from the Centers for Disease Control (CDC) show that American men have worse health than American women and they are less likely to go to the doctor. Help change these stats, stat! We’ve all heard this advice: eat more veggies, watch your weight, exercise more—the list goes on. But going to the doctor is more than just a chance to be reminded of this advice. It’s a time to
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July 25, 2012
Pectus excavatum often referred to as either "sunken" or "funnel" chest is the most common congenital chest wall deformity affecting up to one in a thousand children. It results from excessive growth of the cartilage between the ribs and the breast bone (sternum) leading to a sunken (concave) appearance of the chest. (Image source) Although present at birth, this usually becomes much more obvious after a child undergoes a growth spurt in their early teens...
July 06, 2012
I have never met a baby that didn't on occasion spit-up. Many perfectly healthy babies can even spit-up quite a bit. Reflux is often the label given to babies who vomit, and this rarely amounts to a significant problem. However, there are a few things that a parent should watch out for: The most important thing is the color of what a baby is throwing up. Dark yellow and especially green vomit is never normal in a baby and demands immediate medical evaluation as this could represent a dangerous twisting of the intestines (midgut volvulus), which is linked to abnormally positioned intestines (intestinal malrotation). Another consideration is quantity. If a baby is throwing up...
July 03, 2012
As many as two-thirds of patients with multiple sclerosis have tremor as one of the manifestations. Tremor predominantly affects the upper extremities, adds to disability, and can be severe in as many as 15 percent of cases. Dr. Angeli Mayadev, a physiatrist with the MS Center at Swedish, talks about the use of Botox for MS-related tremors based on positive results from a small, randomized crossover trial showed that upper limb tremor in patients with multiple sclerosis improved significantly within 6 weeks after a single injection of botulinum toxin A. Click here to watch and learn more.