Southwest Virginia

physician (and mother), heal thyself

I did nothing yesterday, well, almost nothing. Nothing important.  Sometimes doing nothing IS important.

I awoke at about 8:30 (usually I am up at 5:15), took my time getting ready and having breakfast, then went to the salon for a decadent "fire and ice" pedicure, followed by lunch with my daughter and baby grandson, a trip to a park with them to watch the ducks and geese, and more of "nothing" when I got home. Fixed a lovely dinner of lamb, rice, portabellos and fresh strawberries, spent some time in my craft room, and then watched a really useless movie with my husband on pay-per-view.

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caring for our youth means accepting them

Today's blog deviates a bit from my usual. I am sharing a video that makes me proud of my youngest daughter,  Rachel Fogel, a student at American University, fighting to prevent bullying of gay and lesbian teens. She appears toward the end of the video. This is from USA today.

As a community concerned with supporting all aspects of health for our children, adolescents and young adults, I urge us all to fight against the kind of bullying that has resulted in the recent increase in notable suicides among gay youth.

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pediatric asthma; a real challenge in management

Asthma is the most common chronic disease of childhood. Continuing on a theme we started yesterday, talking about children with chronic disease, I was very interested to read an  article by Kevin Dubrowski and colleagues from this month's edition of Pediatrics about one way to follow children with this disease, called spirometry.

I have asked my colleague, Dr. Andre Muelenaer, head of the Carilion Clinic Children's Hospital section of pediatric pulmonology and allergy, to comment on this article. Here is what he has to say:

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more complex children in our hospitals

Those of us who provide inpatient care for children have been saying this over and over for the last decade or so: "children in our hospital are more complex to care for than ever before." However, most of the time, we were saying this based solely on our feeling, and the nature of the children we were seeing in the institutions in which we worked. 

This month's issue of the journal Pediatrics, published by the American Academy of Pediatrics presents two articles and a  commentary that address the issue of what types of children are being admitted to our hospitals.

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optimal care for children in the emergency department

Did you know that of the approximately 119 million visits to an emergency department (ED) each year, nearly 20% are made by children? That means that nearly 24 million children are seen in EDs each year. There are nearly 4000 EDs in the US, and only a minority of those are in children's hospitals, or hospitals with pediatric training programs, or clearly identified pediatric ED's. Emergency care for children was identified by the institute of medicine (IOM) in 2003 as woefully in need of improvement. The IOM found that EDs often lack the expertise and equipment needed to provide appropriate care for childre during emergencies.

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another word on flu vaccine

We have seen some questions and comments on the issues of getting vaccinated or having children vaccinated.

The original post, comments and replies can be accessed here

But I would also like to provide another link from the Centers for Disease Control and Prevention that has information about the  intranasal spray form of the vaccine known as flu mist

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what do you expect from your physician?

On Monday night I watched the latest episode of the medical series "House" on Fox. I watch this program for amusement, and to some extent because it annoys my twenty-somethng daughter to hear me discount many of the thought processes the "team" is supposedly engaging in to demonstrate how smart they are. This week, for example they tried to "rule out lead poisoning" by sending someone out to the patient's home to look for something she might have been exposed to. I know this is good TV, but it is VERY BAD medicine.

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confessions of call night accountability

I did something last night I cannot remember doing in all of my 30 plus years of taking phone calls from referring physicians requesting hospital admission of a patient. Instead of following my usual policy of "just say yes" to a request for transport and admission of a young child, I spent ten minutes on the phone reviewing the case, and then explaining to the physician in a rural Southwest Virginia emergency department why the patient would not benefit from the admission.

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