New Era of Minimal Treatment (Pedcast)

Topic Introduction

The other day I was thinking about how recommended therapies, also known as the “standard of care”, have changed during my pediatric career for routine illness. It struck me that we have entered an era of minimalism with regards to treatment. It seems to me that medicine has aged into middle age, no longer eager to “treat” every condition with a therapy, assuming that medical science was smarter than mother nature. I think that concept is passe. No, we have entered an era where interventionism is out and natural healing is in. Hence the rise of integrated medicine, homeopathic medicines, nutritional and aroma therapies.  Let me give you a few examples of how previously recommended treatments have changed during my pediatric career and I think you will see what I am talking about. Let’s start with a short list of health problems pediatricians are frequently consulted about and I think you will see what I am talking about.

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“Accidental” Psychotherapy (Pedcast)

Today, I am going to tell you about an amazing experience I had last week. A longtime patient of mine, a 12 year old boy who I have known for a decade, came in for his checkup. I had reviewed his chart before walking in the room, an noticed that the last time I had seen him, he came in with classic anxiety symptoms of difficulty sleeping and concentrating, feeling anxious, and having headaches, and stomachaches. When I asked him why he felt so anxious, he said that the social aspects of middle school were overwhelming for him. The academics were easy but the fitting in with his peers…that was a whole nother matter as they say down in the South. After we talked all this over,  it was so clear to me and his Mom that he was exhibiting the somatic symptoms of anxiety. I suggested that they go and try a therapy called “Cognitive Behavioral Therapy” or CBT as it is known in the business. Yes there are medicines for this but CBT is at least as effective. Continue reading

Rethinking Antibiotics (Pedcast)


Fascinating new study in Pediatrics April 2015 that raises new questions about a medical tool that has been around for almost 100 year, antibiotics. First discovered in the 1930s, antibiotics have undoubtedly saved millions of lives and have been a great tool for medical science. Until recently, doctors and scientists thought of antibiotics as targeted weapons that are able to selectively destroy germs that our bodies were fighting, invasive germs, and leave the host, your child, with a balance of  healthy bacteria, so called normal flora. Continue reading

Electronic Anesthesia (Pedcast)

Today I am going to tell you about a fascinating study I read about recently in, of all places, the Journal of Anesthesia.  I know, what was I doing there. Sometimes my reading takes me to strange places.  I read about the article in a Reuters news piece but I thought it was so interesting that I had to do a post on the subject.  The authors were trying to answer the question, “Which is better at lowering anxiety in children about to have surgery, an iPad or traditional anxiety drugs like Versed or Xanax?” Just watch this amazing video from the investigators to see how it can work,   The authors designed a study to answer anaesthsia versus ipad question, using children ages 1-11 who were about to have surgery. To their surprise, they found the the iPad was far more effective at relieving the children’s anxiety about leaving their parents and going into an operating room than the standard drugs that are used for the purpose.  Additional benefits were that the ipad group had a faster recovery after surgery and the ipads were far cheaper than the standard drugs that are used for this purpose. Continue reading