Two-year old Emmitt Elijah Sky McMurry got off to a rocky start. While he was in utero he was positioned head up ―or breach― instead of head down. As a result, his hips were unable to develop correctly, and he was born with hip dysplasia― an unstable joint dislocation where the upper leg bone does not sit properly in the hip socket.
In an effort to treat the dysplasia, Karl E. Rathjen, M.D., Emmitt’s doctor at Texas Scottish Rite Hospital for Children first placed Emmitt in a detachable brace, however the family was soon told that surgery was inevitable. In preparation for the procedure, Emmitt’s legs were wrapped and stretched. This photo was taken at one of the pre-op stretch sessions.
To help recognize National Diabetes Month, Maureen Dever, MSN, CRNP, CDE, PPCNP-BC, nurse practitioner in the Diabetes Center at Children's Hospital of Philadelphia, is here to talk about the growing issue of type 2 diabetes in children and teens.
Type 2 diabetes is occurring more often in children and teens.
Here are some facts about this disease.
What is diabetes?
Diabetes is a chronic disease, which affects the way the body processes blood sugar. There are two main types of diabetes, type 1, which is an autoimmune disease (the immune system attacks the beta cells of the pancreas) and type 2, which does not have an autoimmune component.
We first met Kelsey when she represented Dayton Children's Hospital at the 2015 Speak Now for Kids Family Advocacy Day. Now 21 years old, she is currently studying elementary education at Sinclair Community College and plans to become a special education teacher.
In most households a week before Christmas is filled with excitement and anticipation for the upcoming holiday. However, in 2000 none of these things were felt by my family. Instead, we were learning what blood glucose is, how to give an insulin shot, and how to precisely count carbohydrates, all of the things that would become a daily ritual. When I was 4 years old, my parents were given the first of multiple diagnoses, “Your daughter has Type 1 Diabetes.” Five words that would changes our lives in an instant.
Type 1 Diabetes is an autoimmune disease where the white blood cells destroy cells in the pancreas called beta cells, which are the cells that produce insulin. Insulin is a hormone that is used to digest carbohydrates and turn them into energy.
Wyatt Keeton is a typical two-year-old. He loves puzzles, Play-Doh and playing fetch with his dog. He knows his colors, numbers and alphabet and loves reading books. But, unlike most kids his age, Wyatt has a rare form of dwarfism and has had to overcome many obstacles in his young life.
Wyatt spent a week in the NICU, then only needing physical therapy for some low muscle tone, got to go home. It wasn’t until he was 10-weeks-old that it was discovered Wyatt had significant spinal cord stenosis. His doctors were unsure if surgery was needed to prevent further damage to his spinal cord.
A temporary solution was introduced, and Wyatt was fitted with a cervical neck brace to see if any damage to his spinal cord could be reversed. Because Wyatt was so little, the specialists had a hard time finding a cervical collar small enough to fit his tiny neck. Coincidently, Kevin Keeton, Wyatt’s dad worked for Medicraft – a surgical equipment company that specializes in spinal implants. With the help of donations from his employer, Kevin began making his own cervical braces for Wyatt at home. So far, after two years of constantly wearing the custom cervical braces, Wyatt’s spinal cord stenosis has almost completely resolved, and he is catching up and meeting many developmental milestones.
Carter has spina bifida, but it doesn’t let it slow him down. He’s a happy, energetic 8-year-old boy who loves school, competitive cooking, playing adaptive sports and best of all—being a big brother to little brother Cohen.
Spina bifida is a neutral tube defect. It ocurs when the bones of the spine don't form properly around part of the spinal cord. Spina bifida can be mild or severe and can affect the ability to walk as well as bladder and bowel control.
Carter was diagnosed while in utero. Carter’s mom, Courtney and dad, Webb—both medical professionals—were prepared. Educating themselves with all the research material they could find on spina bifida, they also had the good fortune of having world-renown neurosurgeon, Fredrick Boop, MD, and his team at Le Bonheur Children’s Hospital.
#WhatsUpWednesday is our chance to hear from the teens who are involved with the Speak Now for Kids community. This week’s post will focus on William, a patient at Children’s Hospital and Medical Center in Omaha, NE. Even though he’s only is 16, William has already climbed the Sydney Harbor Bridge, and....get this, hugged a koala bear!
So William….what’s up?
Noble, 6 years old, is described as “an old soul,” and a patient child that displays great joy. Since birth, Noble has always done his best and tried his hardest to overcome all the difficult things life has tossed his way. At just 3 days old, Noble was diagnosed with Prader-Willi Syndrome (PWS) after being taken to the neonatal intensive care unit.
His mom, Crystal, describes how she and his dad, Jameson, were “devastated” when they were told of the diagnosis.
On March 11, 2014 my world changed when I heard the words “your daughter has cancer,” and I joined a club no parent wants to be in.
Kaylyn was a healthy baby and at 16 months of age she had reached all customary milestones including crawling and walking. But one day she stopped walking. Doctors thought it may be due to a double ear infection. Ear infections were common for her so we didn't think much of it. But as the days went on, she became sicker.
Yesterday, Dr. Raffalli described the connection between smart technology and cyber bullying. Today, he looks at how adults can work with both the victim and bully to help stop the cycle.
By: Peter C. Raffalli, MD, FAAP
But what of the bully? Pediatricians will encounter both bully and victim in their practices. Bullies have been shown to have a significantly increased risk for both psychological and legal problems later in life (Englander, 2013; Olweus, 1993; Nansel, Overpeck, Pilla, Ruan, Simmons-Morton, Scheidt, 2001; Turcotte-Bennedict, 2015; Radliff, Wheaton, Robinson, Morris, 2012). Both victim and bully are developing children/teens and a doctor’s approach should be more therapeutic than punitive. In other words, we want to help the bully; parents will look to the pediatrician for guidance when their child is accused of bullying behavior. In order to help, a physician must first understand why a child might decide to bully. It is interesting to note that many bullies do not realize that what they are doing actually qualifies as bullying. Often they are upset or angry and feel that they are retaliating for an annoyance or even frank injustice done to them. They may, for example, have difficulty understanding that a high functioning autistic child’s disregard for personal space or other problems with self-regulation isn’t meant as an intrusion (Raffalli, 2015; Sania, Jaffey, Bowes, 2012; Sterzing, Shattuck, Navendorf, Wagner, Cooper, 2012). Sometimes, bullying starts as what is perceived as a joke by the bully, not realizing the damage that that joke is doing emotionally to the recipient. Child rearing issues, including lack of warmth and support at home and/or overly permissive parenting with regard to a child’s aggressive behavior, have been shown to be associated with risk for development of bullying behavior in children (Olweus, 1993).
It must be remembered that, when the definition of bullying is met, bullying is abuse of a child or teen, and abuse is never the victim’s fault. There will often be attempts by the bully or even the school to blame the victim. Bullies will often claim that the victim “deserves it.” It is not uncommon for a school official to tell the parent of a bullying victim that the child is a target because of his/her shortcomings. The mother of an ADHD child who is being bullied might, for example, be told by the principal, “Well, you know, he is annoying.” This is unacceptable and points to the continued need for education of all school staff, not only in bullying prevention, detection and intervention, but also to some degree in victimology, at least as it applies to pediatric peer victimization.
By: Peter C. Raffalli, MD, FAAP
In 1972, Lou Reed released his album Transformer, the fifth track of which was the debut of the song Take a Walk on the Wild Side, one of, if not the most iconic of Reed’s immense catalogue of work. It was raw and unconventional, a departure from the style and prosody of the rock that had come before. Young people, particularly teens, are attracted to the raw and unconventional. It fulfills a need in them for departure from the dependent years of their childhood — when their parents’ experiences and values dominated — toward something all their own. Of course, an element of danger is usually considered necessary on the part of the teen. Rock and roll and the culture that came with it would transform not only music, but generations of young people through the sixties, seventies and eighties.
With the inception of the internet, we humans have created another dimension — one in which some people dwell without break for extended periods of time. And, like the streets and scenes that Reed described on his jaunt through New York City in the early seventies, there are places in the internet where our teens travel secretively that certainly contain the same themes of sex, gender identity, race, drugs, violence and coercion conjured in Take a Walk on the Wild Side. If we who care and advocate for children are to help our patients and their parents navigate this brave new world, we too need to take a walk there if we are going to have any hope of relating to what they are going through. A review of the various ways the internet and smart technology has impacted our kids will be presented in the paragraphs that follow.