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Have you heard the news about heavy metal contamination in commercially produced baby foods in the U.S.? Stay tuned to find out how you can protect your children.Continue reading
Photo Compliments of Eleanor’s Family
As things stand right now, there are only two ways out of the SARS-CoV-2 pandemic: wait until everyone has gotten infected resulting in about 3,500,000 Americans dying and countless others becoming chronically ill or protect our population and children as soon as possible by means of a vaccine. You see, your children’s health and well-being depend on adults opting for vaccination. Stay tuned and I will explain why.
Decision Time is Here
As they say where I live, it’s time to fish or cut bait. We are fortunate to have two highly effective vaccines against SARS-CoV-2 and more in the pipeline that will likely be coming soon. We know the vaccines work and we know they are free from serious short term side effects. As of the time of this writing, which is only a month into the U.S. vaccine campaign, illness numbers in my community of Charlotte N.C. are already starting to fall quite significantly, especially among the health care workers who have been the first to get vaccinated. If you are part of the rest of the population, soon it will time for you to make the big decision… will you get vaccinated? I’m begging you to say yes to that question. In fact, I am making this podcast with the intention of using my name and my influence to convince you to go ahead and get vaccinated as soon as it is available to you. Let me explain to you why this is so important, especially for children.
Children are Being Harmed by SARS-CoV 2
As you are probably aware, children aren’t dying in large numbers from this coronavirus pandemic thank goodness but they are being harmed, nevertheless. Here is a short list of what many children are facing as a consequence of the pandemic- sleep problems, bodily complaints secondary worry, depressive thoughts if not outright depression, as well as anxiety and panic attacks. We also know that not being in school has led to other things that can harm children- fewer reports to social services of child abuse and neglect by teachers, fewer meals being provided at school to children whose families are struggling to feed them, and less time in the secure, safe, enriched environment that schools provide for a child. And what about the loss of quality education and social time in school? How does a child make up for a year of subpar learning and socialization with their peers? The answer is that they likely can’t. Time will tell what effects this has on today’s children, but I as a pediatrician who has spent his adult life with children of all ages, I can tell you that the loss of in-school time for today’s children won’t be positive for most and is likely to be devastating for many.
What the Numbers Show
So, you can see that the quickest way back to normalcy for children is through the administration of effective Covid-19 vaccines to at least 70% of the adult population. But unfortunately, for numerous reasons, acceptance of Covid vaccines by Americans is lukewarm at best. Here is a chart with the numbers from a recent survey published in Scientific American.
What is Causing People to Hesitate about Vaccination?
So, what is causing people to hesitate about getting one of the Covid-19 vaccines? What is at the basis of their hesitancy? I’m sure you have heard of some of the wild rumors going around- the vaccine may, instead of preventing the disease, actually infect you or, the vaccine actually contains a microchip that allows the government to track your whereabouts through cells towers or, this is corporate America’s way of using the U.S. population for biologic experiments. I’ve got to tell you; I haven’t heard so much paranoid thought since I was a medical student interviewing schizophrenics on the locked psych ward. Has the stress of the pandemic, with the help of social media, tipped a large segment of our population into paranoid thinking, devoid of attachment to reality? Or, are we simply being bombarded by confusing messages that are generating fear and causing a paralysis of rational thought. We have well done science, completed by some of the best minds of our time, that shows us that the currently available vaccines are safe and extremely effective. What is the problem?
How Do We Get Vaccine The Vaccine Hesitant to Get a Shot?
So how do we get past vaccine hesitancy and end this pandemic? How can we get 70% of the population immune to SARS-CoV-2 without having to watch 70,000,000 of our fellow citizens get seriously ill or dying? We can’t let that happen to them and we must do everything in our power to convince the “vaccine hesitant” to get vaccinated. With that goal in mind, I have made up a list of things we can do to get life back to normal:
So that’s my plea. We have a short window of time to roll up our sleeves and take control of a terrible situation. I’ve been fortunate enough to get a Covid-19 vaccine already as have most of my healthcare worker colleagues. I still haven’t heard any vaccinated doctors or nurses regret their decision. Soon it will be your turn. Please think beyond yourself and make the effort to get vaccinated. Everyone will benefit, especially our children.
Thank you for joining me for this important episode of Portable Practical Pediatrics. Let’s all do our part and put this terrible pandemic behind us. The choice is clear, we either become immune to SARS-CoV-2 via vaccination or by allowing it to slowly roll through our population with devastating consequences for everyone. For me, it’s a no brainer. I hope it is for you too. Please start today and make the effort to get everyone you know who is old enough to put an end to Covid-19 by choosing to vaccinate. This is Dr. Paul Smolen also known as Doc Smo, hoping you don’t hesitate, to go ahead and vaccinate. Until next time.
Many thanks to Dr. Monica Miller, Dr. Charlotte Rouchouze for their help in writing this pedcast. And of course, a very special thanks to Eleanor’s family for allowing me to share her medical wisdom.
If you know a child who has an incurable genetic disease like sickle cell anemia, cystic fibrosis, or muscular dystrophy…there is good news and it’s called CRISPR technology. Stay tuned to learn more about this incredible technology.
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Today, we’re talking about an interesting development in pediatric medicine that will likely revolutionize the management of childhood onset diabetes, a disease also known as type I diabetes. The advance is known as the “artificial pancreas”. It sounds like science fiction, but as you are about to see, it’s not and it’s almost here.
Detour Down Science Lane
In order to understand this new “artificial pancreas” technology, we need to take a detour down science drive, and make sure your knowledge of glucose metabolism is up to speed. Glucose is what is known as a simple sugar because it is very easy for your child’s cells to burn for quick energy or to store as fat. Your child’s body has to keep their blood sugar in the “Goldie Locks” range in order to be in good health, with a blood glucose not too high and not too low. A high blood glucose will produce diabetes symptoms like excessive thirst, excessive urination, fatigue, and possibly even coma and death. Low blood glucose can be equally dangerous since your child’s brain almost exclusively uses glucose for energy. Without enough glucose in their blood, your child will first get sweaty and weak and, if low enough, then slump into a coma. As you can see, whether high or low glucose, it’s all bad. Insulin, a hormone made in your child’s pancreas, is the hormone most responsible for regulating the glucose system. In a non-diabetic child, insulin unlocks your child’s cells to get glucose into cells and therefore out of their bloodstream, thus lowering their blood glucose. When glucose is scarce, like during fasting at night, insulin levels are usually low. When glucose is plentiful like after a big meal, your child’s pancreas is busy making insulin to push that excess glucose into fat cells. So, you can see that your child’s pancreas, the place where insulin production is controlled, acts as the master regulator of your child’s very important blood glucose level. And remember, a pancreas does this all automatically.
Now let’s consider what is happening in a child with childhood onset or type 1 diabetes. Unfortunately, in this condition, the pancreas cannot make adequate insulin in response to a meal since the cells that produce that insulin were destroyed by an autoimmune process when the child first became diabetic. A type 1 diabetic child has to control their own blood sugar by a combination of carefully measured food intake balanced with exercise and insulin injections. Balancing all this is very difficult as you might imagine. This is a continuous job, 24/7, year in and year out, for the rest of the diabetic child’s life. No wonder so many teenage diabetics rebel and just refuse to manage their disease, often with horrible consequences as a result.
History of the Management of Type 1 Diabetes
To understand just how big a leap the artificial pancreas is in the management of diabetes, it helps to know how it has been managed in the past. The treatment goal when helping a child with type 1 diabetes has always been the same, keep the child’s blood glucose in the narrow range that the child’s pancreas did before they got sick. In the early days of diabetes management, doctors did this by having children taste their urine to see if was sweet or salty. You see, normal urine is salty and diabetic urine has a sweet taste because some of the excess glucose in their blood has spilled over into their urine. When the child’s urine turned sweet, that meant they needed an insulin injection to lower their blood glucose. Next, came what was known as the sliding scale management method, measure the amount of sugar in the urine with as chemical reaction rather than with taste buds. Insulin administration was thus adjusted by the amount of glucose in the child’s urine. This offered a little more refinement than tasting urine but not much. In the past few decades, came the finger stick measurement of blood glucose and adjustments being made based on this data. Still better but really not tolerable for most children. Recently, along came continuous glucose monitors along with insulin pumps. Finger sticks and insulin shots were gone but this type of management still required the child or their parent to make minute to minute decisions about how much insulin to administer via the pump. And of course, this process totally broke down when the child and parent slept since no one was awake to make insulin decisions. Which brings us to the current breakthrough of the “artificial pancreas”. In reality, the artificial pancreas is simply a computer algorithm that links the data from the continuous glucose monitor to the insulin pump, eliminating the need for guesswork by the child’s parent or the child themselves. The biggest advance of this system is that it works when the child is sleeping. The current manual system can’t do that. Recent evidence has demonstrated a significant improvement in blood glucose levels with the artificial pancreas over the manual approach being used today. That improvement will likely lead to fewer diabetic complications and a better quality of life for those children who have access to it.
The Artificial Pancreas is Almost Here
Now you’re all caught up on the science and management of type I diabetes. This brings us to the very exciting technology in development – an ‘artificial pancreas’. The artificial pancreas essentially consists of two parts – a monitoring system for tracking blood sugar levels and a pump that automatically administers insulin to the bloodstream to tightly regulate blood sugar, all controlled by a computer algorithm making the insulin delivery decisions. This algorithm essentially does what the child’s pancreas used to do. Although the child’s pancreas is not making insulin, the artificial pancreas monitors blood sugar and automatically administers insulin via a pump as needed, effectively keeping blood sugar in the “Goldie Locks” range. If all goes as planned, the artificial pancreas will soon eliminate the need for constant monitoring and self-administered insulin, decreasing the risk of hypoglycemia, reducing patient burnout, and overall acting like a normal pancreas would.
The “artificial pancreas” technology is still being developed, and has not been approved yet by the FDA, but the current data looks very promising. I feel confident that soon, the days of patients and their families living minute to minute around their child’s blood glucose will be gone thank goodness. Becoming a type 1 diabetic will no longer mean a life dominated by managing the disease. Type I diabetes still isn’t curable, but the artificial pancreas technology could and hopefully will, significantly ease the life-long burden diabetes management.
Thank you for joining me today for another edition of Portable Practical Pediatrics. My goal is to make you the best informed parent in the room. I hope today’s installment helps toward that goal. If you haven’t taken a moment to write a review of our podcast on Apple Podcasts or where you get your podcasts, please take a minute to do so. That helps other parents find our content. We would really appreciate your support. This is Doc Smo, broadcasting for the 11th year from studio 1E, hoping to keep your knowledge of pediatrics is first rate, and of course, up to date. Until next time.
This post was written by Dr. Paul Smolen and Sonya Corina Williams. Thank you Sonya.