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  • Easing your child’s anxiety about the new school year

    “Are you excited about going back to school?”

  • Kids should sleep in. Schools should start later, say pediatricians

    If you have a middle or high school student in your home, you may have noticed that their sleep habits have changed as they’ve entered adolescence. They stay up late, find it hard to get up early in the morning and struggle with sleepiness throughout the day. Take heart. It’s not that your kid is being lazy or rebellious. There are real, biological changes happening in their bodies as they mature that make getting enough quality sleep a real challenge.

  • Powdered caffeine is risky business: Why parents should be concerned.

    Most of us look for a boost of energy in our morning (or afternoon) cup of coffee or tea. But what if I told you to just skip the regular cup of Joe and sprinkle some caffeine powder on your morning oatmeal or stir it in a fruit smoothie?

  • Preparing your child for surgery

    Hearing that your child needs surgery is difficult for many families to digest, and can often result in increased stress and anxiety leading up to surgery day. For many parents and children, the fear of the unknown leaves them with many questions relating to the preparation for surgery, the surgery procedure, and recovery after surgery. Sometimes for children, the unknown is their best coping tool in preparation for surgery as they think, “If I don’t know the details of the surgery, then I don’t have to think about it and therefore it won’t happen.” For many children and parents alike, denial and avoidance is a common stress relief tactic. However, the child is probably thinking about surgery day as he/she overhears conversations between adults about the surgery, and is likely picking up on their parent’s stress. The child has also been going to doctors’ appointments that are necessary before surgery, making it that much more real to the child. Knowing what to expect on surgery day can actually help ease those feelings of stress and anxiety, and help to eliminate misconceptions that the child may be envisioning.

    How do we help ease a child’s fears of surgery at Arnold Palmer Hospital?

    At Arnold Palmer Hospital, we offer a free, educational program called Project P.L.A.Y., which is designed to help your child understand what to expect before surgery and during their hospital stay. The program is led by a child life specialist who will walk your child, siblings, and you through what to expect leading up to surgery, as well as what to expect after surgery.

    What does the program entail?

    For younger children, our child life specialists use a teaching doll to explain what’s going to happen before and after surgery – all on an age-appropriate level. This can include things such as: IVs, catheter, and any other tubes or medical items they may see on their bodies before or after the procedure. They also show the child what an anesthesia mask looks like and explains that “sleepy medicine” helps them so they won’t feel anything during surgery.

  • Living to the beat of a normal heart: Cameron's story

    Four years ago when Heather was 36 weeks pregnant, she went in to her doctor’s office for what she thought would be a routine check-up. However, her OB/GYN, Dr. Emma Fritz, told her she needed to go immediately to Winnie Palmer Hospital for Women & Babies, as her unborn son’s heart needed emergency treatment. As a flurry of emotions rushed over her and her husband, Ryan, they put complete faith in the hands of the specialists at Winnie Palmer Hospital and Arnold Palmer Hospital who would soon care for their baby boy.

    Expecting the unexpected leading up to Cameron’s birth

    Heather was used to going in for testing at her OB/GYN’s office several times a week throughout her pregnancy. Her unborn son, Cameron, had been diagnosed with an irregular heartbeat in the early stages of Heather’s pregnancy, requiring frequent check-ups to monitor his condition. Going in for her 36-week appointment, Heather wasn’t expecting anything out of the ordinary. But one look at her doctor and she knew this time, things were different.

  • Tips from a pediatrician on how to have a successful school year

    Another school year has already started. Does your child gladly go to bed on time and jump up refreshed at 0-dark-thirty to pop into school clothes and get to school energized? Or are you fighting to get him to bed, dragging him out in the morning, getting him to the bus with no food in his tummy? If the second scenario is yours, I think I can help you. Even if you relate best to the first scenario, maybe there is something here for you, too!

    Sleep is more important than food!

    I tell my patients, and this is true, that you can go without food longer than you can go without sleep. Sleep supports so many body functions that without enough sleep, your child will not learn, play, or grow well. For starters, get the electronics (TV, phones, games) out of children’s bedrooms. Those should be used socially anyway, and they interfere with both falling asleep and staying asleep. Bedtime should be about the same time every night, even on weekends, and should be early enough to guarantee at least eight hours or so of uninterrupted sleep (up to ten hours for younger children). If your child’s summer bedtime has been ridiculously late, try moving bedtime up by 15 minutes or so every few nights, not allowing for naps or “sleeping in,” so that her clock will gradually reset to a healthy schedule.

    But food is important, too!

    Breakfast is, indeed, the most important meal of the day. Without breakfast, your child’s body will produce calories for the morning by breaking down muscle to release stored energy. This process also produces some chemicals that make your child crabby and groggy. Children who don’t eat breakfast don’t feel or think as well as those who do. That does not mean that your child needs to eat two eggs, bacon, toast, and juice at 6 AM. But it also does not mean that they should have a pop tart and call that breakfast. Even the grumpiest teenager can gag down an instant breakfast drink and a half a banana, or a smoothie made with fruit and yogurt, or a piece of toast with peanut butter and half an apple. A perfect breakfast should include a complex carbohydrate (like whole grain bread or cereal for example), some dairy source for calcium (milk, yogurt), some protein (meat, milk, legume like peanut butter), and a fruit and/or vegetable. A small glass of milk with half a turkey sandwich with lettuce and tomato is a great breakfast, and you could send the other half sandwich for lunch! If your child “is not hungry,” that makes sense, but it does not mean he does not need the fuel. He can eat on the bus or in the car.

    Refill the tank mid-day

    A slice of pizza, juice, and a bag of chips is not a good lunch. If your child buys lunch at school, he can be taught to eat smart; school lunches do provide fruit and vegetable choices. Drinks are healthier now, too; most children (including teens) should only drink milk and water. Everything else (juice, soda, sports drinks) is just sugar-water. Energy drinks are not only empty calories, but also potentially toxic chemicals that interfere with sleep, affect heart rate and blood pressure, and who knows what long term effects that we don’t know yet. Packing a lunch for your child is a great option. I have done it now essentially every day for 17 years. It takes me 15 minutes each morning and my kids leave with a healthy sandwich or hummus and pita, a whole fruit, a bag of berries or grapes, another bag of veggies (carrots, peppers, sliced cucumber, grape tomatoes), one treat (like a 100 calorie bag of cookies or crackers) and a flavored water beverage. When my older children were in high school they actually had friends ask if they could send me money each week so I could make them lunches, too! Children are smart people. If you teach them well, they will get it!

    Spend quality time, but don’t hover

    Your child needs you, but, honestly, not as much as you need her. Asking about school, offering to help with homework or personal issues, helping to set goals to do her best: that is your job. Living her life is not. Helicopter parents are harmful, not helpful. That said, help your child to set up a routine after school so that there is a quiet place to focus on homework, time for physical activity (at least an hour each day), very limited passive “screen time” (less than two hours a day). Be available if she needs help. A family dinnertime, even if it is late, is a great time to talk about the day, to listen and to plan. Organizing in the morning should be your child’s job. You can double check for a while that things are all being completed, packed and turned it, but let it be her job.

    Expect issues

    Listen to your child so that you can help him with what he really needs help with and not with what you want to help with. Don’t be afraid to be MOM (Mean Old Mom), setting limits or making rules that “other kids parents don’t…” Seek help, either from your pediatrician or from a counselor, if you don’t know what to do or say. They don’t come with instructions! Most important, be open and honest with your children. Ask them how they feel and tell them how you feel. You are not your child’s best friend, but you are her best ally. Have a happy and successful year!

  • Pediatricians can’t ask you about guns

    There’s been an ongoing court battle here in the state of Florida over whether physicians have the right to ask families about gun ownership in their home.

  • Six tips to encourage our teens to get involved in healthy, versus unhealthy, relationships

    On the wall above my desk is a bulletin board. There’s a letter pinned to it, written in curvy, girlish handwriting. The letter is one of the thank-you notes I have received over the years I’ve worked at Teen Xpress. It was written years ago by Jen,* a beautiful, sweet 16-year-old girl in an abusive relationship.

  • Get to know Dr. Jeffery Johnson, pediatric nephrologist at the Hewell Kids’ Kidney Center

    The Hewell Kids' Kidney Center at Arnold Palmer Hospital oftentimes becomes a home-away-from-home for many children needing outpatient dialysis treatment in Central Florida. The Hewell Kids' Kidney Center cares for children who have been diagnosed with with kidney-related disease such as end-stage kidney disease and obesity-related kidney disorders, as well as those who have undergone a kidney transplant. The team consists of several pediatric nephrologists, nurse practitioners, renal nurses, nutritionists, and social workers. The team recently welcomed it's newest member, Dr. Jeffery Johnson, pediatric nephrologist, in June of this year. Get to know Dr. Johnson in the Q & A below!

    Where did you grow up?

    I grew up all over since my dad was in the Air Force. We finally settled in Ohio when I was in high school and then I moved to California in my adult years. I had lived in Los Angeles, CA for the past 14 years before moving to Orlando.

    Where did you go to school?

    For my undergraduate I went to Washington University in St. Louis, MO and then attended Case Western Reserve School of Medicine in Cleveland, OH for medical school.

    What did you want to be when you were a little kid?

    I wanted to be a soccer player, even though I was horrible! I didn’t know I wanted to go into the field of medicine until halfway through college. I thought I wanted to do medical research, but after I started doing it I realized it wasn’t for me. With medicine, there is something new every day, which keeps me going.

    What was your first job?

    I worked in a games department at a local amusement park. It was a lot of fun. I worked there in high school and through my first year of college.

    What are your hobbies?

    I run a lot – almost every day. Today I’ll be running eight miles. I like to scuba dive and travel. Bali was probably my most favorite place I’ve traveled to so far.

    What is your favorite sports team?

    The Cincinnati Bengals even they break my heart every year!

    How did you get into pediatric nephrology?

    It was when I did a pediatric nephrology rotation as part of my medical training that I knew that was what I wanted to do – it was very interesting to me.

    How did you know you wanted to work with kids?

    It was probably after my second or third month of working in the adult emergency room that I felt called to work in pediatrics. My mom and sister are both elementary school teachers, so I’ve spent most of my life being around and working with kids.

    When did you start at Arnold Palmer Hospital and what is it like working at the Hewell Kids’ Kidney Center?

    I moved to Orlando for this job and have been here since June 2014. One of the things I love about working here is the team that I am a part of. Everyone is fun and easy to work with. We usually all eat lunch together. It’s like a family here, which is evident in how we care for our patients. We take a team approach in being able to provide comprehensive care to our patients, and everyone is usually on the same page as far as what the protocol should be and what the treatment plan should look like.

    What is it like working with the whole family and not just the patient?

    It’s a fine balance, because I always try to acknowledge and engage the child while also working with the parents and families. But it’s something that I really enjoy. It might not always be an easy day at work, but being able to care for kids and knowing that I am helping them is a great feeling.

    What is one piece of advice that you always communicate to families and patients?

    I think one of the most important things in our patient population is for them to be taking their medicine. In our transplant population, most of them are on an immunosuppressant, and if they don’t take their medication for a few days, they could end up losing their kidney or having recurrent kidney disease. It’s important for me that they understand the importance of taking their medicine and that the family ensures that they will follow through with the treatment plan at home.

    What would you say has been your greatest accomplishment?

    I would say it was when I took over the dialysis unit at Children’s Hospital of Los Angeles. I had to basically redo the unit and start over from scratch, building it from the ground up.

    What is one thing that patients and families wouldn’t otherwise know about you?

    I want families to know that I am honest with them, whether I have good or bad news to share. I would want my physician to be honest with me, so I try and do the same for our families.

    Click here to learn more about the Kids’ Kidney Center at Arnold Palmer Hospital

  • The “thigh gap:” A skinny rule reigning social media sites frequented by teenage girls

    The thigh gap. Have you heard of it? No? Perhaps your teenage daughter has. This “rule” for skinny is permeating social media sites: tumblr, facebook, instagram, to name a few. Even though this seems like a relatively new trend, women have been using their thighs as a way to measure their body image for years. I know, because a particular Oprah show is forever engrained into my mind. A few years back, as I was watching this show, I recall a vivid image of Oprah, standing with her feet touching, looking at the space between her legs and proclaiming that “skinny” women strive to have at least two gaps showing (a gap between the ankles and a gap just below the knees), and if they are lucky, three – the gap between the thighs. I’m even embarrassed to say that I catch myself every now and then looking at my thighs to see if I have “the gap.”

    What exactly is the thigh gap?

    The thigh gap is a one to two inch gap between the thighs when the feet are touching together. However, this “gap” is almost impossible to attain, and the process of obtaining a thigh gap is risky, oftentimes sparking unhealthy fitness and eating behaviors. This trend has also raised concerns among eating disorder experts, as they recognize that in order to obtain a thigh gap, one would most likely take on some form of disordered eating.