Health

Get to Know Pediatric Liver Transplant Surgeon Frank DiPaola

Published

3 weeks ago

April 15, 2024

Adults aren’t the only ones who need organ transplants. Many children also need this life-saving surgery. Unfortunately, there aren’t enough organs available for all the kids who need them. To combat this problem, pediatric transplant surgeon Frank DiPaola, MD, performs living donor liver transplants in children. DiPaola serves as medical director of pediatric liver transplant at UVA Health Children’s.

Get To Know a Pediatric Liver Transplant Surgeon

We asked DiPaola our 7 quick questions.

1. What has most inspired and shaped your approach to patient care?

I love having an extended connection with kids and families. Our team wants to treat kids and families like their our own because they deserve that level of care. and the bond that forms is really one of the most satisfying parts of our job.

2. What’s your favorite part of your job?

The bond that forms over time with kids and families is really one of the most satisfying parts of our job. Also, seeing kids smile.

3. What’s your biggest fear when you’re a patient?

Not being in control. Not knowing exactly what to expect.

4. What do you do for stress relief?

I spend time with my wife, watch movies, read books, and play with our children.

5. Dogs or Cats?

Dogs. I love cats, too, but I’m allergic to them.

Ready to Save a Life?

You can save someone’s life — a child or an adult — with a living kidney or liver donation.

6. What’s the last movie you saw? Thumbs up or down?

I recently watched Star Wars: Episode IV – A New Hope for the first time ever (finally!). I have since seen the other 2 from the original trilogy. Thumbs up!

7. What’s the best advice you’ve ever heard?

Love your family; love your neighbor.

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Health

Anorexia: The Body Neglected

Published

11 hours ago

May 7, 2024

Charlotte E. Grayson Mathis, MD

Anorexia nervosa takes an enormous toll on the body. But that’s not all. It has the highest death rate of any mental illness. Between 5% and 20% of people who develop the disease eventually die from it. The longer you have it, the more likely you will die from it. Even for those who survive, the disorder can damage almost every body system.

What happens exactly? Here’s a look at what anorexia does to the human body.

The first victim of anorexia is often the bones. The disease usually develops in adolescence — right at the time when young people are supposed to be putting down the critical bone mass that will sustain them through adulthood.

“There’s a narrow window of time to accrue bone mass to last a lifetime,” says Diane Mickley, MD, co-president of the National Eating Disorders Association and the founder and director of the Wilkins Center for Eating Disorders in Greenwich, Conn. “You’re supposed to be pouring in bone, and you’re losing it instead.” Such bone loss can set in as soon as six months after anorexic behavior begins, and is one of the most irreversible complications of the disease.

But the most life-threatening damage is usually the havoc wreaked on the heart. As the body loses muscle mass, it loses heart muscle at a preferential rate — so the heart gets smaller and weaker. “It gets worse at increasing your circulation in response to exercise, and your pulse and your blood pressure get lower,” says Mickley. “The cardiac tolls are acute and significant, and set in quickly.” Heart damage, which ultimately killed singer Karen Carpenter, is the most common reason for hospitalization in most people with anorexia.

Although the heart and the bones often take the brunt of the damage, anorexia is a multisystem disease. Virtually no part of the body escapes its effects. About half of all anorexics have low white-blood-cell counts, and about a third are anemic. Both conditions can lower the immune system’s resistance to disease, leaving a person vulnerable to infections.

Even before a person with anorexia starts to look “too thin,” these medical consequences have begun.

Many young women who begin eating a severely restricted diet stop menstruating well before serious weight loss sets in. Since so many people with anorexia are teenage girls and young women, this can have long-term consequences on their ability to bear children.

“In truly, fully recovered anorexics and bulimics, it looks like the rate, frequency and number of pregnancies is normal,” says Mickley. “However, if you look at infertility clinics, and those patients in the clinics who have infrequent or absent periods, the majority of them appear to have occult eating disorders. They may think they’re fully recovered, but they haven’t gotten their weight up high enough.”

Many women with anorexia would rather seek fertility treatment than treatment for their eating disorder, Mickley says. And even among women who have fully recovered from their anorexia and bulimia, there may be a slightly higher rate of miscarriages and caesarean sections. “There also may be up to a 30% higher incidence of postpartum depression as compared to other women,” she says.

Bulimia, which often goes hand in hand with anorexia, does its own unique health damage. Bulimics who purge by vomiting wreak havoc on their digestive tracts by chronically bathing them in stomach acid, which can lead to digestive disorders like reflux esophagitis.

“It feels like I’ve been drinking Draino,” said one woman who posted to a forum on digestive diseases about the consequences of her lifelong anorexia and bulimia. Some reported cases suggest bulimia may have led to a condition called Barrett’s esophagus, which may can lead to esophageal cancer.

The good news: Many of these complications can be reversible — if the person returns to a normal weight. “The real focus has to be on weight restoration if you want to reverse outcomes,” says Rebecka Peebles, MD, a specialist in adolescent medicine at the Lucile Packard Children’s Hospital in Palo Alto, Calif. “That’s the most essential part of treatment. You can’t wait around for it to happen. It really is an essential first step in treatment and recovery.”

Unfortunately, say experts, too many people believe that anorexia is strictly a psychological disorder, and ignore its medical complications unless the patient becomes visibly, dangerously thin. “A lot of people — parents, and even some doctors — think that medical complications of anorexia only happen when you’re so thin you’re wasting away,” says Peebles. “Practitioners need to understand that a good therapist is only part of the treatment for anorexia and other eating disorders, and that these patients need treatment from a medical doctor as well.”

Studies have found that many people who need treatment for anorexia aren’t getting it. In large part, this may be due to cost. Inpatient treatment can cost more than $30,000 per month, while outpatient treatment can run as much as $100,000 per year.

Melissa Román, a Miami woman who’s been in recovery from anorexia for several years, pays $800 per month out of pocket for therapy sessions that insurance won’t cover. According to the National Eating Disorders Coalition, health insurance companies pay for an average of 10 to 15 treatment sessions for people with eating disorders, when more long-term care — as many as 40 sessions — may be needed for true recovery.

“Access to care is a huge issue,” says Mickley. “Eating disorders aren’t staged the way cancer is, so we don’t have the way to convince insurance companies that a low potassium level can be like a small metastasis. It’s only recently that we’ve begun to understand the genetic and neurochemical basis of anorexia and say that this is a real illness, not a whim of spoiled rich girls. It’s been treated like it’s voluntary and willful as opposed to what it is: a serious, life-threatening psychiatric and medical illness.”

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Health

Your child’s pee: An ultimate guide – CHOC

Published

20 hours ago

May 7, 2024

CHOC

Advice for parents about their child’s urine colors, hydration and health

Although it may sound silly, here at CHOC, we encourage you to take a periodic peek inside the toilet bowl! The color, odor and nature of your child’s urine (pee) can tell you a lot about their hydration — and overall health.

Here, Dr. Monica Molina, a pediatrician in CHOC’s Primary Care Network, provides an ultimate guide to your child’s urine. Get answers about the common urine hues and smells, how much water your child should be drinking and when to seek help if your child complains of pain while peeing.

What can my child’s pee color tell me about their health?

Typically, the color of your child’s urine depends on how hydrated they are, says Dr. Molina. Babies, kids and teens will have urine colors ranging from clear to amber color.

By keeping the occasional pulse on your child’s urine color, you may be able to monitor their water intake, spot signs of potential infection and seek help from your doctor when needed.

CHOC’s Pee Palette: How to decode your child’s urine colors

CHOC Pee Palette graphic - What does the color of my urine mean?

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Common urine colors for babies, kids and teens

Clear. When urine appears clear, it’s most often a result of drinking a lot of water. Babies will often have similar urine colors to kids and teens, but it’s common for their urine to be pale or colorless for the first few days after birth. Then, as babies start to feed, their urine will become more concentrated and turn pale yellow.
Pale Yellow. This is the ideal color for urine. It indicates that the body is well-hydrated and functioning properly. You can tell your kids that this color means they are drinking enough water.
Dark Yellow: If urine is darker than pale yellow, it might mean that your kids need to drink more water. It could indicate mild dehydration. With increased hydration, your child’s urine color should become paler after a few hours.
Amber or honey: If urine appears amber or honey-colored, it’s a sign of dehydration. Encourage your child to drink water immediately.
Orange: Orange urine can be caused by certain medications or foods, but it can also indicate dehydration or liver problems. Encourage your child to drink water and monitor their urine color.

Less common urine colors in babies, kids and teens

Pink or red: Although foods and drinks may cause urine to appear red or pink, it could also be a sign of blood in the urine, which could indicate a health issue. If your child’s urine is pink or red, they should see a doctor right away.
Blue or green: Sometimes, certain foods or medications can cause urine to appear blue or green. While this is usually harmless, it’s a good idea to mention it to a doctor if it persists.
Cloudy or foamy: Cloudy or foamy urine might indicate a urinary tract infection (UTI). If your child’s urine appears consistently cloudy or foamy, they should see a doctor.

Share this pee palette with your kids and encourage them to peek at the toilet bowl every so often (since they probably already do anyway!) so they are more aware of their bodies and health. Always reassure them that it’s normal to talk about bodily functions and that it’s important to let an adult know if something seems unusual or uncomfortable.

For more toilet bowl tips, visit CHOC’s ultimate guide to your child’s poop.

Why does my child’s pee smell?

Urine does have a slightly “nutty” or “ammonia-like” odor, which is entirely normal. It’s usually mild, but sometimes, other factors may change the smell of urine, like:

Diet. Foods like asparagus, certain spices and coffee can cause urine to have a stronger odor. Dehydration can also concentrate the waste products in urine, making the odor more noticeable.
Medications. Some medications, like antibiotics, may change the smell of your child’s urine temporarily.
Health conditions. Certain conditions like urinary tract infections (UTIs), diabetes, liver or kidney problems and metabolic disorders can cause changes in the smell of urine. For example, UTIs often produce a stronger, foul odor.

In most cases, a slight odor in your child’s urine is not cause for concern and should be resolved on its own. However, if your child’s urine has a strong, foul smell that lasts multiple days and is accompanied by other symptoms like pain, fever or changes in urine color, call your doctor.

My child is complaining that it hurts when they pee. What should I do?

Pain while peeing can be caused by different things. Most commonly, it’s caused by UTIs.

Irritation or injury of the genital area or kidney stones (small masses of minerals) in the urinary tract may also cause pain while peeing.

Encourage your child to drink water and keep an eye out for other symptoms of infection like fever, abdominal pain or changes in urine color or odor.

If your child experiences these symptoms, or the pain persists, call your doctor.

How much water should my child be drinking?

At CHOC, we recommend that kids drink the amounts of water below according to their age, says Dr. Molina. It is important to note that children should drink the number of 8-ounce cups of water equal to their age, with a minimum of 64 ounces of water for children over the age of 8.

Get more hydration tips for kids from CHOC experts.

Keeping track of the nature of your child’s pee can be a helpful way to make sure they are staying hydrated and feeling well. So don’t be afraid to investigate the toilet bowl and encourage your kids to report anything unusual to you. Your child’s pee can provide helpful clues to dehydration and infection prevention!

For more health and wellness resources from the pediatric experts at CHOC, sign up for the Kids Health newsletter.

Find a CHOC Primary Care Pediatrician

From babies to teens, pediatricians from CHOC’s Primary Care Network partner with parents to offer immunizations, sick visits, sports physicals and more.

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Health

How Mindfulness Reshapes Lives – Teaching Children Meditation

Published

24 hours ago

May 7, 2024

lorraine

Transformative stories

For two decades, navigating the twists and turns of my own business journey has been a profound experience. Yet, amidst the challenges and victories, some moments touch the soul. Take, for instance, the story of a freshly certified Connected Kids Meditation Tutor in the Middle East.

Working within an orphanage, they became a beacon of hope and resilience for a 13-year-old girl, imparting mindful skills that lit up her world with possibility. These moments infuse every struggle with purpose and make the journey truly meaningful.

Our tutors are trained to help children of all abilities and needs, including trauma. I hope this demonstrates the journey that helps us create powerful, mindful healing sessions for the children we connect with.

I have permission to share what happened…

Our trainee tutor taught 13-year-old ‘Zara’ (name changed to protect her identity) in 3 sessions.

In the first healing, meditation session, Zara was a little resistant. The tutor helped her connect to her breath and her body and Zara started to relax “I feel comfortable, nice feeling, maybe I will like it”. After the session Zara felt sleepy.

In the 2nd healing, meditation session, more mindful movement while connecting her to her breath. The tutor focussed on helping her gently move her body to release energy that connected to trauma. Zara felt sleepy again, wanted to cry at some moments but was quiet. She didn’t go to play afterwards (as normal) but took herself to her room and spent the time drawing. The tutor used her skills to support her through this.

In the 3rd healing, meditation session, she guided Zara to work with the energy system of the chakras to balance and release using meditation – using mindful movement and guided meditation. After this Zara told the tutor “I love it, I feel happy, my body is light, my heart feels nice.” She hugged the tutor and thanked her.

The tutor noticed the progression for Zara and gave her some home practice to help her stay connected.

Above are photos of the bracelets and necklaces she started to create after the above sessions.

Our tutor share’s her observations of Zara’s mindful journey.

Zara’s journey

“Zara came later to the orphanage. She experienced many difficult things and feelings: sadness, frustration, fear in trying to understand and cope with the new situation. She talks about her sadness. I feel she feels lost. She is a nice, kind girl and paints and colours in a beautiful way.

After sitting talking with Zara, and doing my (CK) heart meditation to connect to her energy, I felt my intention was to help her feel safe with her feelings and to help ground her energy and connect to the new situation and life (the orphanage); she needed to find and build internal self strength. So with her, I built a little program of daily practice. I was with her, step by step at first, until she could do it herself.

After 3 to 4 sessions, I can see how Zara could touch her own feelings and deal with them in a better way. She feels more safe and grounded than before and sleeps better.

Zara now shares simple mindful movement exercises with children younger than her. I knew she likes to make bracelets by beads so an idea came to me to help her use this to heal. I encouraged her and to sell them to friends, staff etc) in the orphanage. She is creative and doing that helps her in many ways (like feeling she can do something valuable) and I felt it grounded her and helped her heal emotions even indirectly. It seems that Zara has some strength now. There are still many things that need deep healing, but she is on her own life journey, and she now has some key life skills.”

Becoming a Meditation Teacher

For adults seeking to train professionally to offer meditation skills to children, the Connected Kids Professional Course offers a comprehensive and accredited learning experience. This certificated course provides professional tools and strategies to train you as a meditation teacher for children and teens.

Professional Resources

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