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  • Get to know Dr. Pinnelas, a pediatric hospitalist

    Over 20 years ago, I began my career in Orlando as a private pediatrician. I was very happy as an office-based pediatrician, and I never dreamed I would have changed my career path. I always enjoyed making hospital rounds before going back to the office for the rest of the day. I also had an opportunity to teach students and residents at the hospital which was intensely rewarding. The hospital approached me over 14 years ago and asked if I would be willing to start something “new” which was to create the Pediatric Hospitalist Service at Arnold Palmer Hospital. Becoming a pediatric hospitalist was a very new specialty in the United States. It had just started to gain some traction in the adult patient population but was rare in pediatrics. I was game, so with my best friend and mentor, Matthew Seibel and two of the best nurses on planet earth, we founded this new venture.

    So what is a pediatric hospitalist?

    A pediatric hospitalist is a physician who only cares for patients in the hospital; most don’t have an outpatient practice. The concept of a pediatric hospitalist makes so much sense for so many reasons and here are just a few.

  • What To Do When Your Child Wants To Quit Team Sports

    Your child wants to give up playing organized sports, but should you agree? There are many reasons why that might not be a good idea. Let’s look at the benefits, how you can encourage your child to keep going, and when it might be the right time to stop.

  • 12 things you can do to support families dealing with childhood cancer

    No one expects a cancer diagnosis, especially not for their child. When cancer shows its ugly face, it comes like a thief in the night, stealing the normalcy the family once enjoyed. Instead of spending time in the carpool line, at playdates, or friends’ birthday parties, these families are spending time in hospital rooms, helping their child cope with the side effects of chemotherapy, and weighing life or death treatment decisions. After spending time with many families who have walked this journey, I can tell you the one thing that nearly every parent of a sick child has said: that the care and support of their friends and family during their difficult time made a world of difference to them. What you do to care for these families really does matter, and they will remember it for the rest of their lives.

  • Dr. Simms-Cendan answers: “When should I take my teenage daughter to the gynecologist?”

    Many parents wonder when they should take their daughter to a gynecologist. Is it with their first period? Is it when they become sexually active? When do they need a pap smear? Some women dread their own appointments and worry their daughters will have a traumatic experience. Well, the good news is that gynecologic care for adolescents has come a long way, and teens can be provided with important information in a sensitive and caring way, and many girls do not even need a pelvic exam!

    What’s Normal?

    First, let me cover a bit of what’s normal. Most girls begin breast development around 10-11 years of age, and the average age girls start their periods in the U.S. is about 12.5 years. Most girls will bleed 5-7 days and cycles occur every 25-40 days. If a girl hasn’t started her period by age 14, she should be evaluated, and although some girls just need more time, others may have a real problem. Many girls have irregular menses for the first 2-4 years after they start their periods, but if a girl has been bleeding more than 10 days per month, they should be evaluated to prevent problems with anemia. I’ve seen girls who have bled for 6 months before seeing a gynecologist and some have been so anemic by then that they required blood transfusion. Most girls will notice an increase in menstrual cramps about two years after they start their periods, as this is when they start to actually ovulate. Severe cramps so that a girl is missing school are not normal and she should also be seen. Finally, if a girl has had regular menses and then the menses become irregular, skipping months or becoming more frequent, she should also be evaluated. Sometimes there is a hormonal disorder that needs to be evaluated.

  • Webinar with Dr. Amy Smith and her team at the Pediatric Brain Tumor Program

    Once a child has completed treatment for a brain or spinal tumor, what comes next? This week, we hosted a webinar with Dr. Amy Smith, pediatric neuro-oncologist at Arnold Palmer Hospital for Children, and discussed how families make the transition from treatment to long-term follow-up. Dr. Smith and her team at the Pediatric Brain Tumor Program explained some of the ongoing physical, emotional and intellectual challenges that a child might face as a result of their disease and treatment. We also highlighted some of the hurdles that families face when children re-enter the school environment and as the child enters adolescence and adulthood. Learn more about how to help your family navigate this next part of the journey.

  • Get to know Dr. Bornstein, pediatric gastroenterologist at Arnold Palmer Hospital

    As chief of the Pediatric Center for Digestive Health and Nutrition at Arnold Palmer Hospital, Dr. Jeffrey Bornstein has been an integral part of our medical team for more than 14 years and has helped thousands of children with gastrointestinal disorders. We sat down with Dr. Bornstein to find out a little more about the man behind the medicine. Here’s what he had to say:

    What exactly do gastroenterologists do?

    We take care of patients who have problems with their liver, stomach or intestines. Some are minor and often get better, like babies with reflux or children with constipation. Many people have abdominal pain or stomach aches. Others are more serious - patients who are unable to eat, or who have inflammatory bowel disease (inflammation in the intestines or colon), or who have liver problems.

    Where did you grow up?

    I grew up in Brockton, Massachusetts about 30 miles outside of Boston.

    Where did you go to school?

    I received my bachelor’s degree in mechanical engineering from MIT in 1985 and then went on to medical school at George Washington University in Washington D.C. I then continued with a pediatric residency at the U.S. Air Force Medical Center and a Pediatric GI and Nutrition fellowship at Walter Reed Army Medical Center.

    What hobbies do you enjoy outside of work?

    I play basketball, and I also enjoy reading. James Michener is my favorite author. I like to do yard work and gardening, and I love to cook.

    What's your dream vacation?

    One month of touring Europe and ending in Israel.

    Do you have a favorite book?

    Lord of the Rings. I read the trilogy with my son when he was in 5th grade. We've shared the books and movies as a special bond since then.

    How about a favorite movie or TV show?

    I don't have a favorite, but I prefer comedies- happy shows and movies. My work days are filled with worrying about my patients. I don't like to see bad things happen to people when I don't need to, even if it's not real.

    Do you have a favorite sports team?

    I'm a Boston boy, so the Celtics, of course!

    If you could meet anyone (alive or not) who would it be?

    The answer to that question has changed, as I've gotten older. At one time, it was sports heroes, and then it was our ancient rabbis. Now, I think that I'd like to meet Ghandi and be able to better understand inner peace.

    Why did you choose pediatric gastroenterology as a specialty?

    It allows me to see patients with many different types of problems. For most of them, I can help make them better. Many of my patients have chronic diseases. I may not be able to cure them, but I can play a part in making them, their quality of life and their family's life, better. I get to have long relationships with many of my patients and their families. I also get to do procedures, which offers a little bit of change from the office.

    What do you enjoy most about your job?

    My relationships with my patients and their families.

    What's one thing that your patients and their families probably don't know about you?

    I love to cook and entertain family and friends.

    Do you have a favorite memory from working at Arnold Palmer Hospital?

    I don’t have a single favorite memory, but the memories that make me feel best are when a patient or family tells me thank you because I have affected their lives in a positive way.

  • How do you know when you’ve crossed the line from effective parenting to control freak?

    Growing up, it seemed like most of the parents I knew were struggling simply to manage the basics for their kids. Perhaps it was where and with whom I was raised, but it stands out to me in stark contrast to my parenting peers today. We aren’t struggling for the basics, but we are certainly struggling.

  • EpilepsyU presents a Q & A webinar on "epilepsy and children" with Dr. Davis

    This week, EpilepsyU, a part of the Epilepsy Association of Central Florida, hosted a Q & A webinar on “epilepsy and children” featuring Dr. Ron Davis, Pediatric Neurologist and Co-Director of Pediatric Epilepsy for the Level 4 Epilepsy Center at Arnold Palmer Hospital.

  • Webinar on "Sudden Cardiac Arrest: what every parent should know" with Dr. Schwartz

    Sudden cardiac arrest. Those are three frightening words. And they are even scarier when they apply to children.

  • Healthy skin habits: Dr. Davis explains why it's important to teach kids at an early age

    With our recent cold snap finally over, summer and warmer temperatures are just around the corner. As we spend more time outdoors in short sleeves and shorts, we need to remember how important it is to protect our skin! Although everyone loves “a tan” for the summer, this is actually a sign of skin damage. Protecting our skin by using sunscreen and other forms of sun block is the first (and most important step) in keeping our skin healthy and preventing the most deadly form of skin cancer, melanoma. Did you know that most of our sun exposure and skin damage from the sun happens before the age of 18? Developing healthy skin habits as children and maintaining these habits through adulthood is essential to keeping our skin healthy over our lifetime!

    How does the sun damage our skin?

    The sun produces invisible ultraviolet (UV) rays as part of the light it radiates to earth. These are the rays that are damaging to our skin and eyes. There are three different kinds of UV rays:  UVA, UVB, and UVC rays. UVA rays are responsible for skin aging, wrinkling and causing melanoma. These rays make up the majority of our daily sun exposure. UVB rays are responsible for causing sunburns and cataracts of the eyes. They also contribute to melanoma as this form of skin cancer is most common in adults who had several severe sunburns as children. What is concerning about melanoma is that we are seeing it in an increasing number of young adults and even teenagers. Both UVA and UVB rays pass easily through the earth’s protective ozone layer. UVC rays on the other hand are thought to be the most dangerous types of UV rays but are blocked by the ozone layer and never reach the earth’s surface.

    What about melanin in our skin?

    Melanin is a chemical in the skin that absorbs UV rays and causes our skin to tan. Everyone has a different level of melanin in their skin. Fair-skinned people have less melanin while darker complexions have higher concentrations of melanin. A common misconception is that darker skinned people do not “burn” or get skin cancer. Regardless of the concentration of melanin in the skin, anyone can get a sunburn or develop melanoma. Any amount of tan is damage to the skin whether you are fair skinned or not.

    So how do we protect our skin from the sun?

    Kids can get a sunburn just from playing in the backyard on a sunny day- not just during a day at the beach!  First and most importantly, all children (and adults) 6 months and older should always wear an SPF 30 before going outside for any length of time. SPF stands for sun protection factor and the number indicates the amount of time you can spend in the sun before getting a sunburn. For example, if you start to burn in 10 minutes without sunscreen, applying SPF 30 will allow you to stay in the sun 30x longer before starting to burn (ie-300 minutes). Other ingredients such as zinc oxide and titanium dioxide offer the greatest protection against the entire spectrum of UV rays. Sunscreen should be applied 15 minutes before going outside to allow for adequate absorption into the skin. For most kids, two ounces (a shot glass full) of lotion should be enough to cover the entire body. Spray-type sunscreen should still be rubbed in after applied to the skin to ensure there are no missed spots.  Don’t forget to apply to commonly neglected areas such as the scalp, lips, ears, back of neck, and tops of feet! Sunscreen should be reapplied every two hours while outside, especially if swimming or sweating.  Remember, there is no such thing as waterproof sunscreen! This means you may go through nearly an entire bottle of sunscreen during a full day at the beach. Children under 6 months of age have more delicate skin and underdeveloped levels of melanin. They should not have sunscreen applied to their skin at all. Keeping young babies out of the sun altogether is best. However, if this is not possible keep them completely covered up with clothing and under a covered stroller or tent while out in the sun.