Paul Smolen, M.D., affectionately known as Doc Smo, brings you the “Pedcast”: a short, entertaining, and educational set of audio talks about childcare. For over 37 years, Doctor Smolen has listened to the concerns of parents about the health of their babies, toddlers, and teens. The pedcast format offers an innovative way to explore general pediatric and parenting topics in a thorough manner, while giving both Mom and Dad a chance to listen and learn at their own convenience. DocSmo.com provides parents a way to start conversations. So sit back, download a few pedcasts, and “Let’s Talk Kids” today!
Life for Juvenile Diabetics is About to Be Improved by the “Artificial Pancreas”(Pedcast by Doc Smo and Sonya Corina Williams)
Photo compliments of Pixabay
Today, we’re talking about an interesting development in pediatric medicine that will likely revolutionize the management of childhood onset diabetes, a disease also known as type I diabetes. The advance is known as the “artificial pancreas”. It sounds like science fiction, but as you are about to see, it’s not and it’s almost here.
Detour Down Science Lane
In order to understand this new “artificial pancreas” technology, we need to take a detour down science drive, and make sure your knowledge of glucose metabolism is up to speed. Glucose is what is known as a simple sugar because it is very easy for your child’s cells to burn for quick energy or to store as fat. Your child’s body has to keep their blood sugar in the “Goldie Locks” range in order to be in good health, with a blood glucose not too high and not too low. A high blood glucose will produce diabetes symptoms like excessive thirst, excessive urination, fatigue, and possibly even coma and death. Low blood glucose can be equally dangerous since your child’s brain almost exclusively uses glucose for energy. Without enough glucose in their blood, your child will first get sweaty and weak and, if low enough, then slump into a coma. As you can see, whether high or low glucose, it’s all bad. Insulin, a hormone made in your child’s pancreas, is the hormone most responsible for regulating the glucose system. In a non-diabetic child, insulin unlocks your child’s cells to get glucose into cells and therefore out of their bloodstream, thus lowering their blood glucose. When glucose is scarce, like during fasting at night, insulin levels are usually low. When glucose is plentiful like after a big meal, your child’s pancreas is busy making insulin to push that excess glucose into fat cells. So, you can see that your child’s pancreas, the place where insulin production is controlled, acts as the master regulator of your child’s very important blood glucose level. And remember, a pancreas does this all automatically.
Now let’s consider what is happening in a child with childhood onset or type 1 diabetes. Unfortunately, in this condition, the pancreas cannot make adequate insulin in response to a meal since the cells that produce that insulin were destroyed by an autoimmune process when the child first became diabetic. A type 1 diabetic child has to control their own blood sugar by a combination of carefully measured food intake balanced with exercise and insulin injections. Balancing all this is very difficult as you might imagine. This is a continuous job, 24/7, year in and year out, for the rest of the diabetic child's life. No wonder so many teenage diabetics rebel and just refuse to manage their disease, often with horrible consequences as a result.
History of the Management of Type 1 Diabetes
To understand just how big a leap the artificial pancreas is in the management of diabetes, it helps to know how it has been managed in the past. The treatment goal when helping a child with type 1 diabetes has always been the same, keep the child’s blood glucose in the narrow range that the child’s pancreas did before they got sick. In the early days of diabetes management, doctors did this by having children taste their urine to see if was sweet or salty. You see, normal urine is salty and diabetic urine has a sweet taste because some of the excess glucose in their blood has spilled over into their urine. When the child’s urine turned sweet, that meant they needed an insulin injection to lower their blood glucose. Next, came what was known as the sliding scale management method, measure the amount of sugar in the urine with as chemical reaction rather than with taste buds. Insulin administration was thus adjusted by the amount of glu..
Looking Within (Book Review Pedcast) by Doc Smo and Sonya Corina Williams
If you have a child in your family interested in pursuing a career in medicine and healthcare, do I have a great gift that you can give them! Stay tuned to learn more.
The Art of Telling a Story
A good storyteller can take a mediocre story line and make it exciting. Consider what happens when you start with incredibly fascinating stories and have them told by a master storyteller. Then you have greatness. Such is the experience readers will get when reading a new book by radiologist Dr. Cullen Ruff titled Looking Within, published by Torchflame Books.
In the introduction to Looking Within, Dr. Ruff retold an experience he had in medical school when one of his anatomy professors made the comment that professor believed, a person’s soul, their essence, resides in their brainstem, a part of the brain where core body functions like breathing and heart function are controlled. Looking Within, seemed to me to be Dr. Ruff’s quest to understand what a person’s internal organs reveal about their uniqueness. Could the incredible images available to a radiologist be a way of finding where our “souls” actually reside? I think not, but as one reads Looking Within, you will see that standard radiology images do sometimes have revealing stories and secrets attached to them.
As you listen to the vignettes Dr. Ruff spins from his radiology career ( which are fascinating by the way), he shows his readers how his films and scans reveal more than just disease. Each tells a story if they are examined in context with that patient’s life. All from a medical professional that rarely meets the patients they are examining. Amazing! The stories vary from accidentally uncovering child abuse in an infant to discovering anorexia nervosa in a young woman- real life cases that Dr. Ruff retells in a very sensitive and entertaining fashion.
Do radiologists have special powers of looking within that other physicians don’t? No, as I thought of it, you could argue that all medical specialties have the power to look within, using their own tools. Medical specialties like pediatrics, look within using observation, physical diagnosis, interview, laboratory studies, genetic studies, and of course, a little radiology to boot. I must admit however, radiologist have some of the coolest ways of looking within that have ever been invented.
You may be wondering why I am bringing a book about radiology to an audience interested in pediatrics and child wellness? Well, as I read Looking Within, I realized what a wonderful book this is for a young adult interested in pursuing a career in medicine. The book is well written and displays a respect, empathy, and sensitivity for people confronting serious health obstacles that Dr. Ruff obviously possesses. The range of the diseases discussed, looking at the actual images in the cases discussed, as well as Dr. Ruff’s recollections of his medical school experience make this book a fascinating for young readers contemplating a future in healthcare. Revealing secrets about a person’s life via a scan is not only a clever hook for a book, but mighty entertaining. I recommend Looking Within and give it 4.75/5 Doc Smo Stars.
3 Parenting Missteps That Can Harm Your Children (Archived Pedcast)
Image Provided by Paul Smolen M.D.
Huntington Gardens, California
Knowing your own blind spots is an important aspect of being an effective parent. I have been watching my own family, as well as thousands of others for the past four decades, and I think I have identified some parenting missteps that might be helpful for you to recognize, as you try and give your children the best childhood possible. Take a few minutes and read or listen to this installment of Portable Practical Pediatrics to find out what I have noticed.
The Three Doc Smo Observations of Families
Observation #1: Parents and children believe what they want to believe. This is just human nature. For instance, it’s hard for most parents not to think that their children are uniquely and exceptionally talented because they want to believe this. Whether its sports, academics, or musical talent, it is exciting to watch your children grow in their abilities. Of course, all children are special, but super exceptional or world class talented? Probably not, compared to a larger stage of all children. This is hard for parents to accept because... they don't want to believe that their children are not superstars. Conversely, children when very young, think that their parents know everything, possessing God like wisdom... until they become teens, and then most children think their parents know nothing. Obviously, these facts are not right and all of these thoughts are biased: whether it be parents thinking that their children are the most talented child on earth, or a young child thinking that their parents know everything, or a teenager's refusal to believe that their parents have any wisdom at all- all are distortions of reality, altered by preconceived beliefs.
Observation #2: Everyone's view of the world is determined by their experiences. Very similar to principle #1 but a little different. Both these principles involve a distortion or reality but this one is based on our prior experiences instead of projected feelings. As parents and children, we observe the world, through the lens of or life experiences. For instance, one thing I have noticed is that parents who had poor relationships with their own parents may find it difficult to set limits for their own children, making their effective parenting all the more contentious. Similarly, a child who has poor self-esteem that was caused by early childhood trauma, may start acting out, believing that they deserve the negative consequences that have started raining down on them from such behavior. Both parents and children can't shake their pasts- today's reality is an extension of their pasts.
Observation #3: It is easy to dislike people you don't know. This one is rather straight forward but very, very true. In a world full of overt conflict and strife, this one is particularly important to keep in mind during your parenting journey. Familiarity breeds acceptance and unfamiliarity generates distrust and prejudice. The antidote to stereotypes and prejudices is exposure. I believe that it is vital to expose you and your children to a the most diverse range of people, cultures, and ethnicities possible. Your children will follow your lead and become more accepting of others and comfortable with a range of people. Heaven knows we need more of that in today's world. Traveling with your children and experiencing other cultures can be invaluable in this regard but if this is too difficult, just opening yourself up to people in your own community that are different from you will do.
Missteps for Parents to Avoid
So, how does all this translate into some practical advice for your family? How do these observations cause parents to make parenting missteps? Let's start with observation #1- We all believe what we want to believe...
Doc Smo’s Annual Holiday Message 2020 (Pedcast)
Ten years of weekly podcasting, 569 published posts, and I am still going strong connecting to you, my listeners. And, it's time for one of my favorite posts of the year, my annual holiday message. Today's message is kind of personal and equally important. I hope you enjoy listening to it as much as I enjoyed writing it.
Image complements of Pixabay
Why Healthcare for Doc Smo?
As a child, I had no idea that I could or would turn out to be a doctor. I liked math and science in school but mainly I wanted to be outside playing sports. When I got to college, I was forced to confront the question, "What am I going to do with this fancy education I am getting and what am I going to do with the rest of my life?" My strengths were in math, science, and... hard work. The latter being the most important. I was an overachiever who knew my most powerful weapon was a good work ethic and persistence. Hard work and persistence were my secret weapons that had taught me that if I wanted something enough, I could get it with sheer determination. A career in medicine came up on my radar as a career path, initially, because a full 50% of my undergraduate class were pre-med.Maybe I could do that? We all tend to want others around us want, right? So, I set out to find out if it was for me. As an undergraduate, I volunteered at a VA pharmacy, I worked summers in a neurosurgeon's research lab doing dog and cat experiments, I got a part time job in a neurology lab doing some of the earliest research on brain neuro-transmitters, and I helped staff a free community medical clinic for disadvantaged residents in Durham, NC. The more I explored the world of healthcare, the more intrigued I became. Yes, medicine was going to be my path I thought.
I remember coming home during my 4th year of medical school and having a conversation with my father about my future. It's in your fourth year that you have to choose a residency specialty. Its fish or cut bait time for a major life decision. I had decided on pediatrics for two reasons... I enjoyed taking care of acute illness in patients, children, who had incredible powers to bounce back from adversity and I loved the energy that children gave off. I just liked being around them. When I told my father of my decision I'll never forget his response, "You have a license that allows you to do brain surgery and you are going to do what with it?" I explained my reasoning and he just listened. I knew what he was thinking though; he thought I was crazy to go into the lowest paying medical specialty that carried little status when I could have so much more. But to his credit, he never said another thing about my choice. He supported me in my decision. When the time came to start my residency, he even helped drive the 16 hours’ drive to my new life as a budding pediatrician.
The Reality of the Job
Pediatrics turned out to be everything I expected-lots of acute life-threatening illness where quick action rescued a lot of little souls. I was literally saving and changing lives on a daily basis. As my skills grew, the job became even more satisfying. When I entered the world of private practice and was making important decisions without supervision, I knew I had arrived. I was even beginning to get enough life experience to help children and families work through psychological stress and grow. Oh sure, there is a lot not to like about primary care pediatrics in those days, 80-hour work weeks, middle of the night trips to delivery rooms and EDs, and the nearly constant intrusion of phone calls. But underneath all that, there was the knowledge that I was doing something important to improve people's lives. I was helping my patients and they were proving to me that I had made the right career choice.
Would I Do it all Over Again?
People often ask me if I would do it all over ag...
Are Your Children Getting Enough Distraction Free Thinking (Archived Pedcast)
I've got a very interesting subject to talk to you about today that I discovered while listening to a podcast! Yes, not only do I make podcasts but I am an avid listener of them as well. In this particular podcast, I heard Dr. Cal Newport, a computer scientist, interviewed about the negative effects of interruptions on learning, memory, and creativity. I thought that what he was saying had so much relevance for your children that I couldn't wait to introduce my listeners to his research and ideas. Please take a few minutes to listen to this post that I call Distraction Free Thinking Vital for Kids. The message is so vital for all parents to hear that I don't want you to miss it.
Image by Pixabay
The Essence of Dr. Newport's Research
First, a confession. I have not read Dr. Newport's book, Deep Work, Grand Central Publishing, 2016, but I have heard him speak in a fairly extensive interview and I feel I have a good grasp of his main idea! He has coined the term "Deep Work" to describe the kind of quiet uninterrupted thinking time that scientists tells us unleashes our brain's best creativity and important thoughts. The kind of quiet contemplation that so many great thinkers have used to create great works. Dr. Newport says there is good evidence that any interruption to deep work thinking derails and diminishes the creativity of the work we do and degrades our learning ability. I am sure that includes not only your best thinking but also your children's. In fact, deep work is probably more important for your children to achieve than it is for you since you have likely completed your education and they have not!
Your children live in a super distracted world
Now, let's consider the distracted world your children are immersed in today and how it can negatively affect them. Even in the quiet of their bedrooms, they likely are having their studies and thinking time interrupted by texts, cell phone calls, and popup instant chat requests on their computers. They have likely fallen prey to the idea that multitasking is efficient and desirable. It's not! Working with frequent interruptions is rapidly becoming the reality for today's children. Unfortunately, not only does this short attention span work lead to sloppy thinking, but likely contributes to the growing incidence of ADHD. Let me remind you, frequently interrupted learning is totally new. Just a generation ago, most children's study place (likely their bedroom or library) was devoid of all electronics and communication devices. Likely a much quieter place than the bedrooms of today. A place that was much closer to an environment conducive to producing what Dr. Newport describes as deep work.
Limiting access to technology is often unpleasant but necessary
I think it is safe to say that every parent want their children to get the most from their education. But for today's children, the constant distraction of technology limits achievement. This is the point Dr. Newport is making. I'm sorry, but you can see that this forces parents to be at odds with their children's wishes to immerse themselves with technology. It's my opinion that you must deal with this issue. If parents keep the goal of maximizing their children's education as their overarching goal, they just can't avoid putting their mark on their children's study environment. Unfortunately, that intervention is likely to lead some conflict. More on that in a moment.
I think Dr. Newport's research has illuminated the fact that the fewer interruptions your children have when they are doing their schoolwork, or mastering cognitive tasks or just being creative, the better. Their learning, memory, and creativity will be better without distractions. That means limiting all electronics, phones, tablets, TV's, and possibly even some types of music i
Your Children Eating Themselves Sick? (Archived Pedcast)
Many children are literally getting a chronic liver disease from their poor diets. Learn more in today's pedcast.
Photo compliments of Pixabay images
What is NASH?
Today we are going to talk about an emerging disease… not an emerging infectious disease but one that clearly comes back to lifestyle choices. A newly recognized, silent liver disease (hepatitis) is spreading across America among children that is called NASH or non alcoholic steatohepatitis. While the cause is not fully understood, the injury to these children’s livers seems to be associated with an excess intake of food, calories and high fructose corn syrup so common in our diets. Yes, these children seem to be literally eating themselves into a seriously poor health. Their excess consumption of food seems to cause the normal red brown healthy liver tissue to be replaced with yellow fatty sick liver tissue. Recent studies estimate that 1 out of every 10 children in the United States, or more than 7 million children, have fatty liver disease, the first step in the progression to the development of NASH and possibly irreversible cirrhosis or scarring of liver. A cirrhotic liver has had the healthy liver cells replaced with scar tissue...a liver that simply cannot keep a child growing and healthy. Unfortunately, once a liver has become cirrhotic, there is no going back to healthy.
Which Children are at Risk
Here is what experts are currently thinking is behind this newly recognized liver disease: a major excess intake of certain foods first triggers the development of a fatty liver, followed by a type of hepatitis called NASH, and finally for some unfortunate children, cirrhosis. All of this can occur without symptoms. Currently about 40% of obese children (those with a BMI greater than 30) seem to be afflicted with fatty livers and possibly the more serious NASH or cirrhosis. Mexican-American children seem to be unusually susceptible, while interestingly, African American children seem to be more protected from the disease.
Based on current knowledge, many experts suggest the following:
1. Children who are obese should have blood testing to check their liver function as well as the other related conditions such as diabetes, and elevated blood cholesterol.
2. If a child is found to have abnormal liver function tests, weight loss through diet and exercise is imperative.
3. Vitamin E supplement as well as a diet rich in green leafy vegetables seems to help reduce the liver inflammation.
4. Elimination of foods produced with high fructose corn syrup may also help.
If your child struggles with their weight, the emergence of NASH is yet another reason to make some radical life changes for the sake of their health. Remember that DocSmo pearl, Grandma didn’t waste her time telling us things that weren’t important… eat your spinach!
Your comments are welcome at www.docsmo.com. From studio 1E, this is Doc Smo, hoping your family makes a quick DASH to avoid foods that might cause NASH. Until next time.
1.Wang,Shirley, Fatty Liver: More Prevalent in Children, Wall Street journal, September 9th, 2013 http://online.wsj.com/news/articles/SB1000142412788732454900457906490305169278 - See more at: https://www.docsmo.com/are-our-children-eating-themselves-to-poor-liver-health-article/#sthash.RVvP38sh.dpuf
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Positive of Covid
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The power of honey
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