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  • 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

  • Should your toddler have access to your digital devices?

    You’ve probably heard your pediatrician offer this advice: no television for children under two years of age. In fact, the American Academy of Pediatrics has discouraged the use of screens of any kind (television, video, tablets, iPad or iPhones, to name a few) for toddlers.

  • Should I give my child probiotics?

    Did you know that your digestive tract contains over 400 different types of bacteria? This complex ecosystem is called intestinal microflora. The concentration of bacteria in the gastrointestinal tract increases dramatically moving from the stomach towards the colon. In humans, the intestinal microflora is vital in many important functions including digestion of nutrients and prevention of infection. Disruption of the “normal flora” can lead to many problems including diarrhea, bloating, abdominal pain and poor absorption of nutrients.

    What is a probiotic?

    Probiotics are “friendly bacteria” or “good bacteria” similar to those that occur naturally in the digestive tract. A few years ago, the defined “probiotics” as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.”

  • What to expect at your child's therapy evaluation

    Your child has been referred to Occupational Therapy, Physical Therapy or Speech Therapy. So, what's next? First of all, don't dread this appointment. Therapists can be a wealth of information and you will leave that first appointment with some useful tools. Part of a therapist’s job is to share valuable information with you about your child- both their strengths and weaknesses. Their job is to help your child reach their maximum potential and equip you to be an expert about your child’s abilities. This is a good thing.

    For All Evaluations

    Bring your child in comfortable clothing that allow full movement Make sure they are well rested Bring any specific equipment they use such as walkers, splints, or communication devices Be prepared to share concerns you or your doctor may have Provide a list of their medications Be prepared to leave for part of the session if asked (so that therapist can build rapport and see how your child works on their own)

    What to bring for Feeding Concerns

    A hungry kiddo Food you’re sure your child will eat Food you have tried to give your child but they haven’t accepted A drink your child typically accepts: bottle, sippy cup, straw cup, etc. A list of their allergies or recent notes from any specialists

    What to Bring for School Related Concerns

    A copy of their 504 Plan, IEP, Behavior Contract or Health Plan A letter from the teacher expressing any specific concerns (if possible) A sample of their written work from class (if this is a concern) Report a from the school psychologist or therapist (if it’s available)

    During the Evaluation

    Let the therapist take the lead but feel free to comment if you feel your child is not showing their full potential. Be as specific as possible. Remember, you are the expert on your child and the therapist is getting a one-time snapshot. Any information on how your child typically functions is very much appreciated. During the evaluation, your therapists will gather valuable information on how your child responds- or doesn't respond- to certain tasks. The therapist is likely to approach your child in a specific way to achieve a desired outcome. For this reason, resist the urge to help your child complete tasks presented. Remember, therapists are looking to build rapport with your little one and form a partnership with you to ensure your child’s success. They’ll definitely let you know if they need you to jump in and help out.

    After your Evaluation

    Ask the therapist for their professional opinion on what strengths they observe in your child and what areas of concern they have. Would they recommend referrals to other professionals or further testing? If therapy is recommended, how often will they need to be seen to achieve their goals? What skills does the therapist see your child achieving through their intervention? How much work at home will be required to achieve these results? Although most of the recommendations will come during your child’s treatment sessions, you can still leave the evaluation equipped with something beneficial for your child. Ask for a few suggestions on what you can work on at home while you await your first therapy session. Therapists want to build your child’s skills and maximize their strengths so they’ll have great suggestions for toys and fun activities to help your child achieve their goals.

  • Surviving a preschooler’s separation anxiety

    I’ve come to believe that separation anxiety is the straw that breaks the backs of many moms. We can carry our heavy loads through many child-rearing deserts, but we Mom-camels collapse under the pressure of children suffering from separation anxiety. Our children cry as we leave them, and we cry our guilty little hearts out as soon as we are out of our children’s sight. We are left with those lingering questions: Should I leave them? Are they going to be okay? Am I a terrible mother for leaving my child?

  • What we do now may affect our future children’s genetics

    We are all aware that mothers who smoke while they are pregnant run a higher risk of having children who are premature, smaller than they should be, or stillborn. This is likely due to reduced oxygen supply to the baby through mom’s diseased body and to toxins shared by mom with baby. We also know that children who are exposed to second-hand smoke have a higher risk of developing respiratory diseases like asthma, chronic lung disease and even cancer due to direct lung damage from inhaled smoke.

    What you do with your body early in life can affect future generations

    But recent data suggests that a father’s behavior even years prior to conception may affect the health of his children and future generations. For example, early paternal smoking has been associated with increased body mass in children. Paternal alcoholism has been associated with smaller birth weights in babies, and hyperactivity in children. Most recently, smoking even early in life has been found to be associated with an increased risk of certain forms of asthma in a man’s children. A study which was recently presented at the European Respiratory Society International Congress looked at 13,000 men and women and found that non-allergic asthma was significantly more common in children whose fathers smoked before the age of 15. In addition, the longer the father smoked, the higher the risk of his child having this kind of asthma. Interestingly, the same link was not found in children whose mothers smoked before they conceived.

  • Postpartum depression in young fathers

    A recent study published in the journal Pediatrics showed that young fathers, those who became dads at an average age of 25 years, have a 68% increase in depression symptoms within the first five years of becoming dads. This applied to young dads who lived with their children and their wives or girlfriends. Dads who lived away from their children and older fathers did not show that same increase in rates of depression. So why might “postpartum depression” happen to dads? Isn’t that a “hormonal thing” that happens to new moms? But now that we know that this is an issue, can we and should we do something about it?

    What could cause postpartum depression in dads?

    The study carefully made clear that these results only show an association between becoming a dad and an increase in depression. The results do not show that becoming a father actually causes depression in young dads, but it makes sense that it might. They don’t suffer the same physical changes that are going on in new moms, but lots of aspects of parenthood are very stressful for a young dad. First, they are sleep deprived; exhaustion is a known cause of depression. Second, they suffer a kind of loss of their mate. Now mom is busy loving another person, often more than she loves her partner/spouse. Young dads may feel displaced, jealous, and guilty about that at the same time. The relationship between mother and baby is so intense and so culturally unique and special, that a young dad may really feel like a third wheel. Young dads, in particular, may have been enjoying a sort of fantasy new-love relationship with their beautiful partner, and now all of a sudden the rest of life has to do with spit up, dirty diapers, less sex, and a great deal of long-term responsibility. Young dads are also less likely to be secure in their jobs and their income. They may not feel strong in their ability to provide for their new family. All of this can certainly contribute to depression.

    Why does this matter?

    Depressed fathers “read and interact less with their kids, are more likely to use corporal punishment, and are more likely to neglect their kids. Compared to the children of non-depressed dads, these children are at risk for having poor language and reading development and more behavior problems and conduct disorders.” According to lead study author Dr. Craig Garfield, an associate professor in pediatrics and medical social sciences at Northwestern University’s Feinberg School of Medicine, “Parental depression has a detrimental effect on kids, especially during those first key years of parent-infant attachment. We need to do a better job of helping young dads transition through that time period.”

    What can we all do about this?

    Just being more aware of how dads might feel when their babies are born is a start. So much of our focus is on the baby and on how mommy is doing. Dads are usually assumed to be fine, and to be there to help mom. The solution can start with the family and friends. Grandparents, aunts and uncles can offer to change a poopy diaper or two so that dads are not the only ones doing that. It may be a proud role for some new dads to be the diaper guy, but some may really hate it. Friends can take mom out for a walk so that dads can have some quiet, loving, alone time with the new baby if they want that. Or, if dad just needs to get out of the house for a while, friends can offer to watch over mom and the baby so that dad can get a break. Nights can be tough too, especially if dads have to go to work every day. Many young dads cannot afford to take leave from work when a baby is born, so they work all day and then try to spell mom during the night. Family and friends can spend a night here or there filling in for dad so that he can get a few full nights of sleep if that is an issue.

  • Are juice cleanses harmful to kids?

    Juice cleanses are widely popular among adults, especially women, as they are strategically marketed as a powerful way to detoxify the body and “reboot” metabolism, as well as provide a “jump start” in weight loss. As these juice products are showing up in more and more family-shared refrigerators, kids are starting to take notice and want to join in on the juice craze, too. Several recent news articles even highlight stories of young juice devotees, ranging in ages from 6 years old to 18 years old. One story even includes a mother-daughter duo that share a love for organic cleanses, who recently when on a five-day cleansing program because dad was out of town (because of course, I don’t think dad would approve!).

  • Does your child struggle with messy handwriting?

    Writing should be about the art of putting down your thoughts on paper. Whether a child is learning to write their name for the first time, draw a picture to share a story, or compose an essay for class, the most important part of any writing is the message itself. Handwriting that is difficult to read distracts and becomes the focus. So what happens when the mechanics of writing become such a struggle that the child is focusing all their energy on how to write rather than the writing itself? Where do parents go for help when their child just can’t seem to write neatly and every attempt ends up with tears? I’ve got a solution.

  • Emotional Eating: Parenting and its effect on our children’s eating behaviors

    I was asked to speak on TV recently about an article entitled “Eating Your Feelings? Your Mom Might Be to Blame.” Of course, for TV, the story had to sound catchy, so the TV host really played up the blaming mother and grandmother aspect. That made me sad; parenting is really a hard job and it is rough to be blamed for errors we make while doing our best. The data, though, really does suggest that how we were parented may affect eating behaviors and those of our children. The issue is important, since at least a quarter of preschool children in the United States are overweight. Obesity at the age of five is a very strong predictor of whether or not someone will be obese as an adult. So how we feed our young children and how we teach them to eat really matters for their whole lives. My take is that this information is not an opportunity to point fingers, but an opportunity to learn and to do better as parents.

    What the study has to say

    The article was based on a study done by researchers at the University of Illinois and published in the Journal of Developmental and Behavioral Pediatrics. It showed that primary caregivers (usually moms) who had an insecure attachment to their own mothers are more likely to have young children with unhealthy eating habits who are overweight or obese. “Insecure attachment” is a term from psychology that has to do with how we feel about parents who don’t respond consistently to our needs. Parents who grew up insecure tend to have more trouble dealing with their own children’s needs, especially when it has to do with negative things like distress, anger, or sadness. That in turn is connected with some unhealthy behaviors surrounding food and eating.

    Real life examples

    The study clearly showed that homes where children’s sadness or anger are dismissed are also homes where there are fewer family mealtimes, more television viewing time, and more “comfort feeding.” These behaviors are known to lead to obesity in even the youngest of children. For example, an overwhelmed mother might respond to a temper tantrum by feeding her toddler snacks to make him stop crying instead of using appropriate parenting techniques to deal with the tantrum. Another example might be the parent who puts her four-year-old in front of the TV to eat dinner instead of having a family mealtime, since the TV keeps the child quiet and makes her sit still longer than sitting at the table for dinner. Sadly, this also leads to overeating in the whole family.

    So, what do we do with this?

    Well, if you have a two-year-old who is already overweight, maybe there is room to work with your parenting behaviors around food. Look at how you respond to your child’s negative behaviors. Do you tell your child, “that’s nothing to be angry about?” Or do you find yourself saying, “don’t be sad?” Instead you could say, “I hear that you are angry” or “you seem to be sad.” It’s hard to do. If you need to, ask your pediatrician for suggestions to deal with (and to help your child to deal with) those negative feelings. Could you tolerate a little tantrum or some tears instead of abandoning the family table for a meal in front of the TV (we call it the brain sucker in my house)? Could you give up feeding your child snack foods or treats to console them when they are angry or sad? Could you let go of the expectation that your small child will sit still to eat and will clean her plate? Could you serve a healthy, well-balanced meal and deal with it if your “picky” toddler gives you a hard time about it or refuses to eat?