'pediatric' posts

Have you noticed that your child walks with his or her feet rotated inward instead of pointing straight ahead? This could be described as intoeing and is sometimes referred to as being “pigeon toed.”

As a parent, you may raise concerns with your child’s physician about how your child is walking or running, or perhaps a concern was raised by the child’s grandparents who may have known a child years ago who was treated with a brace or special shoes for a similar issue. Intoeing gait is a common reason for referral of your child to a pediatric orthopedic surgeon.

Intoeing stems from one of, or a combination of, three areas: the foot, the lower leg and the hip. Which area is contributing determines the likelihood that it will resolve over time and determines up until what age one may expect improvement.

The most frequent case of intoeing in infants and young toddlers arises ...

“Cough, cough!” “Achooooo!” “Wheeeeeeze!” The sounds of spring are all around us and the woes of allergy season are plaguing many of us. With the weather warming, you and your loved ones are likely spending a lot of time outside. Though the stuffy nose, dry throat and scratchy eyes may seem like a seasonal nuisance you and your family just have to get through, there are solutions. Here are some tips to keep you from suffering through this beautiful but allergy-ridden time of year (to watch the video click here).

Seasonal allergies, often called hay fever or allergic rhinitis (swelling of the nasal passages) vary season to season but can be brought on by pollens, grasses, molds and dust. Right now, in Western Washington the culprit is likely pollen from the trees that have exploded with fresh foliage. Of course, there are many other allergens and the only true way to know what is causing your, your partner’s or your children’s sniffles and sneezes is to talk to a health-care provider. However, if hay fever is getting the best of you this spring, you may find some relief from the following:

I am a pediatric hospitalist. That is, I am a pediatrician who takes care of children sick enough to be hospitalized. So my writing about the importance of children spending time outdoors and enjoying nature might be surprising. Even though I may only take care of a child for the worst few days of their life, I am still quite passionate about the fundamental role of outdoor play in a child’s health and well-being.

Even during acute illness, I find that children often heal faster when they are given more opportunities to be playful and (illness-allowing) go outdoors to allow Mother Nature to heal them from within. So needless to say, I am often amazed at how little exposure many of these children have had, even prior to becoming ill, to spend time playing outdoors and getting to know their environment.

Now especially, as the days begin to get longer, and the refreshing spring air returns to our beautiful Pacific Northwest, I start thinking about all the wonderful outdoor fun I used to have as a child, and the importance such activities had on my own health and overall sense of well-being.

I worry that children of today encounter ....

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 their face to see if they wince. Typically with appendicitis, a child will either refuse to jump or may try it once but will not continue due to the pain.

Distraction is also frequently used in children that seem to be particularly “focused” on their pain. In gently feeling the abdomen of a child with early appendicitis that is distracted, the abdomen is soft until palpating the area of the appendix. This right lower part of the abdomen is...

With the vague hint of spring in the air, many families are gearing up for the onslaught of practices and games that come with spring sports. As the kids strap on their pads and cleats again, keep in mind that a healthy athlete needs more than just good physical conditioning; fueling their bodies with proper nutrition is just as important to keep them competitive!

Nutrition is vital for the health of people of all ages and activity levels but young athletes have higher fluid and energy needs. Nutrition can also help prevent injury and keep your young athlete competitive. Help your young athlete become a nutrition champion before the starting buzzer even goes off!

• For healthy bones...

ISSAQUAH, WA, Jan. 23, 2013 - With spring sports starting, don't drop the ball on nutrition. Nutrition is just as important as physical conditioning for athletes. So, as spring sports begin, let Swedish help you and your children prepare to hit it out of the park. Join Registered Dietitian Ally Colson for an interactive training on game-winning meals and snacks and help your young athlete become a nutrition champion.

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 ...