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How can we help teens with bipolar disorder manage their symptoms and transition successfully into adulthood?
In this (part 2) episode of Pediatric Meltdown, host Dr. Lia Gaggino and child psychiatrist Dr. Jeanette Scheid discuss managing bipolar disorder in young adults during major life transitions. From medications for bipolar disorder in youth to support resources, they explore how parents and healthcare providers can identify early signs of a bipolar manic or depressive episode and implement effective treatments. Dr. Scheid shares practical strategies for maintaining stability, including sleep schedules, substance use prevention, and the vital role of college support services.
Whether you're a healthcare provider or parent seeking to understand bipolar disorder treatment for teens, this conversation offers clear guidance for helping young people thrive.
[00:33 -10:28] Critical Warning Signs and Transition Risks for Young Adults with Bipolar Disorder
Poor sleep patterns often emerge as one of the earliest indicators of potential manic episodesEarly symptom recognition training for both parents and youth helps prevent severe episodesRegular psychoeducational conversations with everyone in the youth's support system enhance management successLiving independently introduces new challenges that require careful monitoring and support[10:29 - 19:29] FDA-Approved Medications for Youth Bipolar Disorder: A Primary Care Guide
Key antipsychotics including aripiprazole, quetiapine, risperidone, olanzapine, asenapine, and lurasidone are FDA-approved, for adults with bipolar disorders. There are fewer medications approved for youth due to lack of clinical studies. No anti-seizure medications currently hold FDA approval for bipolar disorder in youth, though some are approved for adultsMost common lithium side effects include headache, nausea, increased thirst, and mild tremorsRegular thyroid function monitoring is essential, often requiring collaboration between pediatricians, endocrinologists, and psychiatrists[19:30 -39:22] Understanding Lithium Treatment in Youth Bipolar Management
Therapeutic window for lithium is narrow, ranging from 0.6 to 1.2 milliequivalents per liter, requiring careful monitoring and frequent lab workDehydration and changes in salt balance can trigger dangerous lithium toxicity levelsFamily medical history plays a crucial role in treatment decisions, as demonstrated by cases where lithium proved more effective than second-generation antipsychoticsRegular lithium level monitoring (1-2 times yearly) is necessary for stable patients, with more frequent checks during dose adjustments[39:23 - 50:50] Building Knowledge Bridges: What Primary Care Needs to Know About Youth Bipolar Care
Utilizing child psychiatry access programs as learning resources for medication managementUnderstanding safety profiles of common medications, even when not directly prescribingRecognition of medication effects similar to monitoring diabetes care in primary practiceValue of ongoing consultation with psychiatric specialists for medication questions[50:51 - 1:04:37] Closing segment Takeaway
Links to resources mentioned on the show
Resources Part 1:
AACAP Facts for Families: Facts for...
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In this episode, child psychiatrist Dr. Jeanette Scheid joins Dr. Lia Gaggino to discuss the complexities of pediatric bipolar disorder, and sorting through the diagnostic possibilities is central to making an accurate diagnosis Dr. Scheid offers insights to tease out what are the childhood behaviors that are developmentally normal, for example imaginary friends, and what are concerning symptoms such as auditory hallucinations. Dr Scheid highlights the critical role pediatricians play in the early identification of youth bipolar disorder with enormous implications for decreasing serious illness in adulthood.
With mental health in children becoming increasingly important, this conversation offers practical guidance for pediatric clinicians.
[00:33 -10:49] Key Diagnostic Criteria for Bipolar Disorder
Major depressive episodes often appear as the first signs, lasting at least 2 weeks with predominantly low moodGrandiosity and racing thoughts are significant indicators, particularly when accompanied by uncharacteristic risk-taking behaviorsSleep patterns change dramatically, with some people feeling rested after less than 3 hours of sleepIncreased talkativeness, faster speech, and heightened distractibility are common symptoms[10:50 - 19:01] Challenges in Early Identification
Distinguishing between normal childhood behavior and pathological symptomsComplexity increases when combined with autism or intellectual disabilitiesInitial misdiagnosis as oppositional defiant disorder or treatment-resistant ADHDNeed to differentiate between typical defiant behavior and true mood episodes[19:02 -31:42] Understanding Trauma's Relationship with Mental Health Symptoms
Trauma symptoms can overlap with other mental health conditions, making diagnosis complexFlashbacks from trauma can present similarly to perceptual disturbances or hallucinationsContent of experiences often connects directly to past traumatic events and safety concernsBoth trauma and other mental health conditions can coexist - it's not an either/or situation[31:43 - 32:13] Adapting Primary Care to Modern Mental Health Challenges
Pediatricians can't opt out of mental health care, just as they didn't opt out of COVID carePrimary care providers are being called upon to manage medications when psychiatric access is limitedProfessional relationships and collegial connections make difficult cases more manageableThere's a growing recognition that early intervention in mental health can prevent future complications, including involvement in the juvenile justice system[50:51 - 58:26] Closing segment Takeaway
Links to resources mentioned on the show
AACAP Facts for Families: Facts for Families
AACAP Resource Center Bipolar Disorder
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What happens when the wealthiest nation in the world fails its children?
In this short but important solo episode, Dr. Lia Gaggino, speaking as a mother, grandmother, and pediatrician, shares her concerns about the state of children's welfare in America. She addresses multiple challenges facing our youth today, from healthcare and poverty to gun violence and education. As the November 5th election approaches, Dr. Gaggino makes an impassioned plea to voters to consider the impact their choices will have on the next generation. Her message transcends political lines, focusing instead on fundamental human values and the moral imperative to protect and nurture our children.
After all, as she poignantly asks, “who will lead, teach, build, and protect our nation if we continue to fail our children today?”
Links to resources mentioned on the show
CDC https://www.cdc.gov/maternal-infant-health/infant-mortality/index.html
Commonwealth Fund: https://www.commonwealthfund.org/publications/issue-briefs/2024/jun/insights-us-maternal-mortality-crisis-international-comparison#:~:text=Recent%20Maternal%20Mortality%20Trends,deaths%20per%20100%2C000%20live%20births.
Annie E. Casey Kids Count: https://datacenter.aecf.org
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151 American Indian/Alaskan Native Youth: Beyond Adversity
Key quotes for Twitter:
"In the United States, 25% of children live in poverty. 50% are covered by Medicaid insurance."... Dr. Lia Gaggino on the child poverty crisis
"Should they bleed out on waiting room floors? Should they die of sepsis because they can't get the care they need to treat a miscarriage because doctors are afraid in states that ban all abortion?".... Dr. Lia Gaggino on the reality of abortion bans
FULL TRANSCRIPTS AVAILABLE UPON REQUEST
THANK YOU FOR YOUR SUPPORT!
Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.
If you’d like to connect with me, you can find me on LinkedIn, Facebook, and Instagram, or email me at [email protected]. To learn more about me visit https://www.pediatricmeltdown.com
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What if the key to happiness lies in thinking like a toddler?
Dr. Lia Gaggino's Pediatric Meltdown podcast features Dr. Hasan Merali, who unveils the wisdom hidden in toddler behavior. Uncover the science behind child development, learning how to handle toddler tantrums and why the "terrible twos" might be a misnomer. Dr. Merali offers unique parenting tips, from encouraging kindness to establishing sleep routines. Explore how childhood creativity can enhance adult life, and gain strategies for improving work-life balance. This episode challenges conventional wisdom about child behavior, offering fresh perspectives on fostering kindness and learning from kids.
This episode will leave you eager to embrace your inner toddler and find joy in life's little moments.
[00:33 -11:26] Toddler Brain Development and Adult Learning
The less-developed prefrontal cortex allows toddlers to live in the momentToddlers have enhanced visual attention, noticing tiny details adults might missYoung children think differently due to fewer preconceived notionsToddlers exhibit twice as much laughter as adults[11:27 - 22:28] Positive Mindset: Reframing Tantrums and Embracing Toddler Traits
The median time for a toddler tantrum is 3 minutes, occurring on average once a dayChanging vocabulary from "Terrible Twos" to "Terrific Twos" promotes learning from toddlersToddlers have a basic tendency to be nice to others, even when faced with selfish behaviorToddlers focus on building relationships and learning[22:29 -30:14] Self-Talk Strategies: Enhancing Adult Mental Well-being
Self-talk is prevalent when kids are little, especially in the toddler preschooler ageThey use it to guide themselves through tasks and to encourage themselvesMRI studies show we can decrease our emotional reactivity if we talk to ourselves in 2nd and 3rd personInstead of "What am I feeling right now," ask "What is [your name] feeling right now?"[30:15 - 39:18] Toddler Sleep Routine for Better Adult Sleep
No screens 1 hour before bedtimeTake a hot bath or shower to cool down core body temperaturePerform a quiet activity, preferably readingPlug your phone in a different room, not beside your bed[39:19 - 45:41] Closing segment Takeaway
You can reach Dr. Hasan Merali
LinkedIn: https://www.linkedin.com/in/hasan-merali/
X: https://twitter.com/Hasan_Merali
Facebook: https://www.facebook.com/HasanMeraliMD/
Links to resources mentioned on the show
Dr. Merali, website: HasanMerali.comBook: Sleep Well, Take Risks, Squish the Peas: Secrets from the Science of Toddlers for a Happier and More Successful Way of Life: https://www.amazon.com/Sleep-Well-Take-Risks-Squish/dp/0757324711 NYT Article: -
What if the key to unlocking your child's potential lies in their natural curiosity?
In this enlightening episode of "Pediatric Meltdown," host Dr. Lia Gaggino welcomes developmental-behavioral pediatrician Dr. Prachi Shah to explore the fascinating world of child development. Together, they unpack the importance of play in child development and reveal strategies to encourage exploration. Dr. Shah shares her expertise on early brain development and cognitive growth. Discover how play and exploration shape a child's future, and learn easy practical strategies for encouraging your little one's inquisitive nature.
This episode is a must-listen for parents and caregivers eager to nurture their child's innate wonder and set the stage for lifelong learning.
[00:33 -15:43] Fostering Curiosity in Young Children: Key Strategies
Curiosity starts with the child's intrinsic motivation and captures their attentionEntering a child's world helps adults see things with "a new set of eyes"Observing nature, like watching insects or plants, stimulates curiositySimple activities, like using a "play right here stick," can encourage wonder and exploration[15:44 - 26:32] Impact of Curiosity on Academic Achievement in Early Education
Higher curiosity at kindergarten correlated with higher academic achievement in reading and mathAt low levels of curiosity, there was lower academic achievementSafe, stable, nurturing relationships (SSNRs) provide the foundation for exploratory behaviorPromoting curiosity can foster academic resilience in children from under-resourced environments[26:33 -36:22] Early Childhood Curiosity and Parental Interaction
Children from under-resourced areas hear fewer words, creating a 30-million-word gap by kindergartenFrequent conversational exchanges between parents and children are associated with higher curiosityHigh-quality linguistic environments lead to better academic, occupational, and social outcomesServe-and-return conversational exchanges are recommended by pediatric anticipatory guidance[36:23 - 55:50] Promoting Curiosity in Pediatric Care:
The American Academy of Pediatrics recommends prescribing play at every well-child visitUnstructured play time and playful learning with parents are crucial for building cognitive and social-emotional skillsSafe, stable, nurturing relationships (SSNRs) are foundational for the development of a child's curiosityPediatricians can encourage parents to engage in scaffolding and special "sunshine time" with their children to boost curiosity[55:51 - 01:02:58] Closing segment Takeaway
Links to resources mentioned on the show
AAP Resources Early Relational Health: https://www.aap.org/en/patient-care/early-childhood/early-relational-health/
AAP Early Relational Health Implementation Guide: Early Relational Health Guide
Reading Tips from AAP http://Healthychildren.org Falling in Love with Reading..
Reach Out and Read https://reachoutandread.org
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In the realm of pediatrics, can a child's ZIP code be a stronger predictor of health outcomes than their genetic code?
Dr. Lia Gaggino examines this critical question alongside pediatric residents Dr. Nicole Hickman and Dr. Kathleen Kelly. These passionate advocates for health equity discuss their innovative work integrating social influencers of health into pediatric residency programs and primary care practices. They address the complexities of tackling food insecurity, housing instability, and other social influencers of health that significantly impact children's well-being.
Drs. Hickman and Kelly provide practical strategies for screening patients and implementing community resource referral systems, showcasing how targeted interventions can yield substantial improvements in care. Their groundbreaking approach to the medical education curriculum and inpatient systems interventions aims to reduce healthcare inequities. Their dedication to advocacy and addressing social determinants in pediatric residency will inspire listeners to become catalysts for change in pediatric healthcare.
[00:33 -14:46] The Role of Social Influencers of Health in Pediatric Care
Social influencers, such as access to healthcare, education, and neighborhood environment, significantly affect children's health outcomes.Pediatricians must recognize the importance of community context, economic stability, and access to quality resources in shaping child health.Families living in food deserts face challenges in accessing nutritious foods, affecting children's overall health and development.Addressing social influencers can help mitigate health disparities, offering opportunities for intervention to improve pediatric health.[14:47 - 24:08] Addressing Structural Racism and Intersectionality in Pediatric Health Outcomes
Structural racism, reinforced through housing, education, and healthcare systems, significantly affects health outcomes, particularly in marginalized communities.In Chicago, a stark 30-year difference in life expectancy exists between predominantly white and Black neighborhoods, exemplifying the impact of systemic discrimination.Pediatric care must acknowledge and address the broader societal factors, like redlining and economic disinvestment, that contribute to health inequities.Developing pediatric training to address structural racism is critical for reducing the health gaps caused by these deeply rooted societal factors.[24:09 -32:16] Trauma-Informed Approaches in Pediatric Social Health Screenings
Using sensitive language during screenings encourages trust, which helps families feel comfortable discussing social challenges over time.Normalizing the screening process by introducing it as a routine part of every patient encounter helps build rapport and reduce stigma.Pediatricians should reassure families that resources are available to help address needs identified during screenings, reinforcing that support is ongoing.Offering social work support and providing a list of community resources upfront can prepare families for future needs, even if they don’t require immediate assistance(pm03).[32:17 - 43:44] Pediatric Screening Tools for Addressing Social Determinants of Health
The hospital system uses a comprehensive screening questionnaire that includes housing insecurity, food insecurity, and physical violence.The tool incorporates questions related to gun access in the home, combining different social screeners and abuse screeners.Pediatricians can track outcomes using a closed-loop referral system, ensuring patients receive the resources they need.Screening tools are integrated... -
How do we address the often-overlooked sexual health needs of individuals with Autism Spectrum Disorder (ASD)?
Dr. Zakia Alavi, a seasoned child and adolescent psychiatrist specializing in pediatric mental health and developmental disabilities, joins Dr. Lia Gaggino to unpack this critical yet often neglected aspect of care for individuals on the autism spectrum. Drawing from her extensive experience in child and adolescent psychiatry, Dr. Alavi reveals the patterns she's observed in patient referrals, particularly concerning autism and behavior problems, including inappropriate sexual behavior. This frank discussion covers everything from understanding puberty in children with autism to addressing the complex challenges surrounding sexuality education for neurodivergent individuals.
Dr. Alavi emphasizes the need for tailored sexual health curricula and the importance of behavioral therapy for youth with autism to manage sexuality-related issues. She also touches on the pressing concern of victimization of youth on the autism spectrum and the role of promoting comprehensive sexual education for these youth..
Listen in and discover why Dr. Alavi believes sexuality is not just a basic human need, but a fundamental right for all, regardless of their neurodevelopmental status, including those with neurodevelopmental disorders like ASD.
[00:33 -10:59] Autistic Traits and Abuse Risk
Explores the higher risk of abuse due to social awareness and communication deficits in youth with autism. Non-verbal children or those who misinterpret situations are especially vulnerable. Defines sexual awareness as understanding feelings, desires, and sexual situations. Highlights the struggle of youth on the autism spectrum in independently navigating sexual awareness.[11:00 - 22:49] Discussion on Sexual Awareness
Defines sexual monitoring as understanding others' impacts on one's sexuality. Emphasizes the importance of sexual assertiveness and consciousness for protection. Single parents, in particular, may struggle with providing comprehensive sexual education. Suggests the presence of another person during these discussions for better handling.[22:50 -28:59] Victimization and the Role of Media
Notes the heightened risk of victimization, especially among females with autism spectrum disorders. Emphasizes the need for protective measures and greater awareness. Role of parents and educators in continual skill-building around privacy and sexual norms. Suggests personalized approaches tailored to each child's level of understanding.[29:00 - 32:13] Sexuality as a Human Right:
Encourage self-reflection about perspectives on sexuality for oneself and others. Highlight the importance of helping children achieve their fullest potential in all aspects. Reiterates the significance of protecting neurodiverse youth from victimization through education. Encourages proactive approaches to ensure youth understand and navigate normal sexual behaviors[32:14 - 40:00] Closing segment Takeaway
You can reach Dr. Zakia Alavi
LinkedIn: linkedin.com/in/zakia-alavi-7289a9118
Links to resources mentioned on the...
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Vaccine Hesitancy and Refusal: Fact and Emotion
Have you ever wondered why vaccines spark such strong opinions, even as they play a pivotal role in infectious disease prevention and public health response?
Join Dr. Lia Gaggino and guest Dr. Robert Frenck as they unravel the complexities of vaccine hesitancy in our pandemic-prepared world. They delve into how the effectiveness of the COVID-19 vaccine and childhood vaccinations paradoxically fuels skepticism, and how public health communication strategies can bridge the gap between medical professionals and parents.
Dr. Frenck shares real-life stories and explains the benefits of childhood vaccinations, emphasizing straightforward conversation to discuss childhood vaccines including the COVID-19 vaccine, side effects, and the importance of herd immunity. Discover strategies for overcoming vaccine hesitancy and infectious disease outbreak management—listen now to rethink your understanding of vaccinations, their role in our society, and their impact on vaccine preventable disease outbreaks..
[00:33 -16:05] Vaccine Hesitancy and Public Health Challenges
Infectious diseases like respiratory illnesses, diarrheal diseases, and malaria are still leading causes of death in children globally.Vaccines play a crucial role in protecting communities through herd immunity.Skipping vaccines can have a significant impact on disease transmission and outbreaks.Healthcare providers have an ethical duty to make recommendations and address vaccine hesitancy.[16:06 - 26:41] Public Health Challenges: Overcoming Politicization and Misinformation
Recognize that infectious diseases do not discriminate based on political affiliation, race, religion, or other factors.Address the concerning trend of public health becoming a political issue, rather than a matter of keeping everyone healthy.Combat the misconception that vaccine-preventable diseases are gone or no longer a threat.Highlight the need for expertise, coordination, and preparedness in public health responses to infectious diseases.[26:42 -35:33] Mandatory Vaccination Policies for Healthcare Workers
Prioritizing workplace safety for patients, especially those with compromised immunityAddressing concerns about mixed messaging from unvaccinated healthcare providersConsidering vaccination as a fundamental requirement for healthcare professionsHighlighting the ethical responsibility to protect vulnerable populations[35:34 - 56:57] Pandemic Challenges: Adapting Medical Practices and Communication
Acknowledging the need to alter recommendations as new data emerges during a rapidly evolving pandemic situation.Emphasizing the critical role of healthcare professionals as experts and trusted sources of information during public health crises.Highlighting the ethical responsibility of leaders and public figures to prioritize public health over personal or political gain.Underscoring the value of respectful dialogue, finding common ground, and starting from areas of agreement in addressing divisive issues.[56:58 - 1:09:23] Closing segment Takeaway
You can reach Dr. Frenck
LinkedIn @Robert Frenck
Links to resources mentioned on the show
AAP Immunization Resources for Parents:
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Have you ever wondered how missing a few school days could dramatically alter a child's future?
In this eye-opening episode of Pediatric Meltdown, host Dr. Lia Gaggino and guest Dr. Heidi Schumacher unravel the staggering disparities in school quality and attendance amplified by the pandemic. As a general pediatrician and health policy advocate, Heidi discusses the urgent need for systemic support, the hidden toll of chronic absenteeism, and the crucial interventions needed to ensure educational equity.
While truancy often leads to punitive measures, chronic absenteeism requires a supportive and compassionate approach to unveil the deeper health and social issues behind missed school days. Pediatricians can play a transformative role by addressing these needs early, fostering environments where every child thrives. Are you curious about the actionable steps you can take to combat chronic absenteeism in your community? Listen to this episode now and empower yourself to make a difference!
[04:39 -15:21] Understanding Chronic Absenteeism in Schools
Chronic absenteeism differs from truancy and includes both excused and unexcused absences.Chronic absenteeism is defined as missing about 18 school days a year, or approximately 10% of the school year.The response to chronic absenteeism is more supportive rather than punitive, focusing on understanding and addressing family challenges.Economic impacts of absenteeism include affecting educational opportunities and potential long-term financial stability.[15:22 - 26:48] The Critical Role of Health Professionals in Boosting School Attendance
Clinical visits offer an opportunity to discuss the importance of regular school attendance with families.Some clinics are piloting the addition of questions about missed school to pre-visit questionnaires or child check-ups.By understanding the reasons behind missed school days, health practices can address specific needs that may hinder attendance.Collaborating with school nurses and advocating for more healthcare resources in schools can improve attendance and engagement.[26:49 -35:25] Addressing Barriers to School Attendance through Health and Community Support
Factors such as toxic exposures, food insecurity, and lack of reliable transportation are identified as key barriers that affect school attendance.The lack of reliable electricity, food, and secure housing strongly correlates with issues in school attendance.Pediatricians are encouraged to inquire about school attendance when they encounter social drivers or chronic conditions in children.Understanding attendance patterns helps identify disparities in educational access related to health and social determinants.[35:26 - 45:46] The Importance of School Attendance and Engagement Strategies
The Everyday Counts Summit emphasized the need for federal investments to support school reengagement and consistent attendance.Leveraging pandemic recovery funds for enhancing school attendance and engagement has been a focus for many states.Collaborative partnerships between government entities and organizations, like the American Academy of Pediatrics, are crucial.Evidence-based interventions and localized data analysis are essential for closing equity and opportunity gaps.[45:47 - 54:28] Closing segment Takeaway
You can reachDr. Heidi Schumacher
linkedin.com/in/heidi-schumacher-md-3504433
Links to resources...
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Have you ever wondered how ancient practices like mindfulness and the Pranayama breathing technique could revolutionize the high-stress environments like the NICU?
In this episode, Dr. Nitin Ron, a neonatologist with a unique perspective, shares his journey of integrating meditation and compassionate care into his medical practice. From scaling Mount Everest to working in an art museum, Dr. Ron's multifaceted experiences have shaped his approach to healing. Discover how these techniques not only benefit patients but also provide crucial stress relief for healthcare workers, particularly during the challenging times of COVID-19. Learn about the science behind these practices and their potential to prevent burnout in medical professionals. This episode offers a rare glimpse into the transformative power of combining ancient wisdom with cutting-edge medicine, promising a new era of holistic healthcare that nurtures both patients and caregivers alike.
[05:42 -17:20] Awareness and Resilience in Pediatric Healthcare
Babies demonstrate an inspiring ability to have present moment awareness, even in challenging medical situations.Healthcare professionals can find inspiration by observing the strength and resilience of babies in the NICU.The ability of infants to smile despite medical interventions serves as a powerful lesson in maintaining a positive outlook.The practice of pediatrics is referred to as a "calling" rather than just a job, emphasizing its profound impact on practitioners.[17:21 - 23:54] Ancient Breathing Practices Meet Modern Medical Science
Pranayama, an ancient Indian breathing technique, has similarities with modern high-altitude acclimation methodsResearch presented at the Pediatric Academic Society's meeting compared ancient pranayama to current medical scienceThe book serves as a textbook for meditation and pranayama research, as well as a practical guideThe project brought together contributors from four different countries, showcasing global collaboration in healthcare[23:55 -44:47] COVID-19 Pandemic: Lessons in Isolation and Community Support
The pandemic highlighted the negative effects of isolation on human well-beingChildren were particularly affected by the inability to see friends and grandparentsThe crisis emphasized the crucial role of community in maintaining hope and mutual supportThe experience reinforced the importance of human connection and support systems in healthcare[44:48 - 55:17] Mindfulness and Meditation in Healthcare: Practical Applications
Even 3 minutes of watching thoughts without reacting can be beneficialRegular practice of meditation helps maintain mental equilibrium, like a movie screen unaffected by the imagesThe intention to meditate and practice self-care is 95% of the journey towards happinessResearch shows brainwaves start changing in 6 weeks with just 8 minutes of practice once a week[55:18 - 59:34] Closing segment Takeaway
Links to resources mentioned on the show
Book - Pranayam Breathing: Techniques for Health, Healing and Tranquility
Pranayam Breathing Techniques for Health, Healing and Tranquility:...
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What happens when personal trauma intersects with professional purpose in the world of child psychiatry?
Discover the compelling story of Dr. Nancy Rappaport, who turned the tragedy of losing her mother to suicide into a life-long commitment to prevent similar losses in others. This podcast episode explores the intricate links between personal history and professional practice with a focus on child and family psychiatry. It illuminates the often-overlooked nuances of family dynamics, the importance of understanding children's challenging behaviors, and the sensitive discourse surrounding suicide prevention. The conversation unearths how small moments of humanity in therapy can bridge profound professional gaps and reinforce the resilience required in dealing with complex familial issues. Listeners will leave with a renewed understanding of why appropriate conversation about suicide is a poignant necessity in both clinical practice and families. Listen now to uncover insights that might just redefine the approach to mental health support.
[03:43 -12:26] Child Psychiatry & Personal History
September marks Suicide Prevention Awareness Month, underscoring the episode's thematic urgency.Discussion on how her experiences informed her choice to focus on child psychiatry.Importance of not using stigmatizing language like "committed suicide."Emphasis on reducing stigma and opening dialogues about suicide.[12:27 - 22:00] Trauma, Suicide, and Professional Development in Child Psychiatry
Personal experiences with trauma and loss can influence a therapist's approach to working with children and familiesThe saying "when someone dies by suicide, they take their skeleton and put it in your closet" highlights the complex impact on survivorsShifting from individual therapy to family therapy can provide new insights into family dynamics and behaviorsBalancing personal emotional experiences with professional rigor is crucial in the field of child psychiatry[22:01 -32:46] Childhood Behavior and Parenting Challenges
Strategies for pediatric clinicians dealing with suicidal patients.The role of programs like the National Alliance on Mental Illness in aiding families with psychiatric issues.The importance of local resources, like those in Boston, for mental health support.Encouragement for clinicians to remind patients of their value, especially post-suicide attempts.[32:47 - 41:46] Childhood Behavior and Parenting Challenges
The behavior code was written drawing on that was published in 2012. It's been on the bestseller of Harvard Ed Press for about 8 years.It was written about angry kids, oppositional kids, kids with sexualized behavior, and kids with withdrawn behavior.As parents, you're doing this dance, and then it's not perfect. Sometimes you step on each other's toes, but there is this room for repair.You have to have a lot of humility when working with parents because Yes. We all are doing the best we can.[41:47 - 48:19] Closing segment Takeaway
You can reach Dr. Nancy Rapaport
Email: [email protected] LinkedeIn:
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Have you ever wondered what keeps pediatricians going despite the challenges of modern healthcare? In this episode of the Pediatric Meltdown podcast, host Dr. Lia Gaggino celebrates four years of insightful conversations while going into the heart of pediatric practice. She talks about the delicate balance between technology and human connection, emphasizing the importance of creating space for magical moments with patients. From the joys of a baby's laughter to the struggles with electronic health records, Lia paints a vivid picture of the pediatric landscape. As she reflects on the evolution of her podcast and the field itself, one question emerges:
How can we preserve the magic of pediatrics in an increasingly technology driven world?
[00:33 - 03:02] Celebrating Four Years of Pediatric Insights
Reflection on the podcast's 4-year journey and growthGratitude for amazing guests and their contributionsAcknowledgment of initial challenges in podcast productionIntroduction of the concept "joy of pediatrics" and "magic in the room"[03:06 - 08:12] Balancing Technology and Patient Care
Importance of creating time for meaningful patient interactionsChallenges of electronic health records vs. paper chartsEncouragement to look away from screens during consultationsHope for future improvements through AI scribing technology[08:11 -10:19] Fostering Professional Growth and Community
Upcoming national meeting in Orlando for pediatric professionalsInvitation for listeners to connect with Lia at the eventEncouragement to find and create magical moments in practiceTeaser for interesting upcoming podcast guestsLinks to resources mentioned on the show
Podcast Production
MouthyBroadMedia.com
Social Media Management
AAP
aap.org
2024 Practical Pediatrics CME Course - San Diego, CA2024 Practical Pediatrics CME Course - San Diego, CA | shopAAP
MIAAP
MIAAP
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Key quotes for Twitter:
"And I have to say, there was a lot of stuff I didn't know. Some of the episodes were pretty rough, but I have had just the most amazing guests."... Dr. Lia Gaggino reflecting on four years of the Pediatric Meltdown podcast.
"The AAP is the best because it is pediatricians. It's us. And there is just nothing better than being with other people who love children and love thinking about ways to make their world better and how to do a better job.".... Dr. Lia Gaggino reflecting on the importance of pediatricians connecting
FULL TRANSCRIPT WILL BE AVAILABLE UPON REQUEST
THANK YOU FOR...
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What if the key to being a better doctor lies in not being a doctor all the time?
Dr. Lia's solo episode of Pediatric Meltdown highlights the critical need for healthcare professionals to cultivate interests and experiences beyond their medical careers. She draws parallels to Mr. Rogers' iconic routine of changing into a cardigan, symbolizing the vital separation between work and personal life. From the joy of reading non-medical literature to the perspective-altering power of travel, Dr. Lia offers a blueprint for a more balanced, fulfilling life. She doesn't shy away from addressing the challenges of maintaining this balance but insists on its necessity. With practical advice and heartfelt wisdom, this episode is a wake-up call for healthcare professionals everywhere: Your life's story shouldn't be written solely in the pages of medical charts.
[01:21 -02:20] Life outside medicine: Why it's important
Set clear boundaries between work and personal lifeMaintain balance to prevent burnout in medical careerImportance of having interests beyond healthcare[02:21 - 08:10] Physician self-care: Reading and traveling experiences
Make time for non-medical reading, even in snippetsTravel to gain new perspectives and experiencesDon't postpone personal experiences for a "magical time"[08:11 - 13:08] Work-life balance for healthcare professionals: Relationships
Nurture relationships outside the medical fieldMake time for people despite demanding work scheduleBalance professional commitments with personal lifeResources mentioned on the show
aap.org
Other episodes mentioned on the show:
https://pediatricmeltdown.com/episodes
190. Recognizing Burnout in Healthcare: Strategies for Self-Care
172 Burnout Prevention: A 15-Minute Game Changer
108 Physician Moral Injury: Healing the Healer
76 Pediatric Practice: Find Your Balance
Building Better Workflows Podcast
Building Better Workflows
Key quotes for Twitter:
"There is just so much more to talk about than medical cases."... Dr. Lia Gaggino on Imposter syndrome in the medical field”... Dr. Lia Gaggino on the importance on non-medical friendships
"I've had a book group for going on 30 years, and there are 4 of us that are still from the original group. I love it. It's mostly to just see my friends and have great food and some wine."..Dr. Lia Gaggino on interests outside of the medical books.
**Transcript of Episode Available upon request**
THANK YOU FOR YOUR SUPPORT!
Pediatric Meltdown was listed as a Top 20 Pediatric Podcast on FeedSpot.
If you’d like to connect with me, you can Tap the “What Are Your Thoughts” button at the top of the notes or you can find me on LinkedIn, Facebook,
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Are you feeling overwhelmed by the constant need to prove your medical expertise?
In this week’s episode, Dr. Lia talks about the challenges and anxieties surrounding board certification for pediatricians, particularly focusing on the evolution of the MOCA peds program. She shares personal experiences with various certification methods, from proctored exams to open-book tests, highlighting the stress and self-doubt that often accompany these processes. The importance of continuous learning in the medical field is also mentioned, recommending resources like pediatric board review materials and various CME opportunities. You’ll hear Dr. Lia will also touch on the prevalence of imposter syndrome among medical professionals, reassuring listeners that it's normal to not know everything and encouraging them to ask for help when needed. Ultimately, she advocates for a balanced approach to professional development, acknowledging both the necessity of expertise and the reality of human limitations in medical practice.
[2:54 -05:07] The Evolution of Board Certification Methods
Proctored exams: Anxiety-inducing and challenging to concentrateOpen-book tests: Time-consuming but aligned with real-world practiceReturn to proctored exams: Disliked by many professionalsMOCA Peds: A modern, quarterly assessment approach[5:08 - 07:14] Navigating MOCA peds and Continuous Learning
Utilize pediatric board review materials for preparationApproach questions as real-life cases, not trick questionsTake advantage of the 5-minute time limit per questionEmbrace continuous learning through various CME opportunities[07:15 - 12:30] Expanding Mental Health Knowledge in Pediatrics
Seek out mental health sessions at national conferencesAttend specialized mental health conferences for pediatriciansConsider long-term training programs like the REACH InstituteUtilize resources from AAP and ACAP for ongoing educationResources mentioned on the show
MOCA-PBR www.pediatricsboardreview.com
Neuroscience Education Institute https://www.neiglobal.com/
REACH https://thereachinstitute.org/
nncpap.org
aap.org
aacap.org
AAP National Conference https://aapexperience.org/
Other episodes mentioned on the show:
https://pediatricmeltdown.com/episodes
116. Physician Wellness Coaching: Proven Benefit!
98. Anxiety? Inattention? Depression?: Prescribe Nature! Dr. Stacy Beller Stryker
76. Pediatric Practices: Find Your Balance
Building Better Workflows Podcast
Building Better...
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Have you ever wondered what parents truly desire from their pediatricians?
In this week's episode of Pediatric Meltdown, Dr. Lia goes into the heart of parental needs, drawing from her 34 years of experience and insights gleaned from her podcast interviews. She explores the universal desire for reassurance, the challenges of modern parenting in the age of social media, and the importance of fostering positive childhood experiences.
Dr. Lia emphasizes the critical role of relational health in supporting families, especially those facing adversity. She reminds us that the most powerful tool in a pediatrician's arsenal isn't fancy gadgets or cutting-edge treatments, but the ability to listen and validate parents' experiences. From navigating preschool expulsions to dealing with developmental milestones, this episode offers a compassionate perspective on the complexities of raising children. Whether you're a healthcare professional or a parent, this episode promises to leave you with valuable insights and a renewed appreciation for the power of human connection in pediatric care. Remember, in the journey of parenting, you're not alone – and sometimes, that's the most important message of all.
[0:00 -01:46] Observations from a Seasoned Pediatrician: Parental Needs
Episode focuses on what parents want most from pediatriciansAddresses the pressure parents face, especially from social mediaEmphasizes that fancy gadgets aren't necessary; however, relationship with the baby is key[1:47 - 17:48] Reassurance: The Foundation of Parent Support
Parents need reassurance that they're not failingImportance of praising parents for their effortsReminder that the parent-child relationship is more important than material things[17:48 - 18:29] Navigating Challenges: A Collaborative Approach
Addresses issues like preschool expulsions and daycare problemsEncourages pediatricians to "ride the ride" with parentsSuggests calling in reinforcements when needed (e.g., social work, community mental health)[18:30 - 26:14] Building Relational Health and Positive Experiences
Focuses on fostering positive childhood experiencesExplains how supportive adults can help children overcome adversityEmphasizes teaching parenting skills, as they're not innateResources mentioned on the show
https://www.healthychildren.org
The Healthy Children Podcast: Healthy Children (pod.link)
Other episodes mentioned on the show:
https://pediatricmeltdown.com/episodes
202. Functional Neurologic Disorders: Recognition and Management
175. Beyond Trauma: Strengthening the Caregiver-Infant Dyad
162. Migraine Headaches: Assessment, Management and Relief
152. The Mysteries of Abdominal Pain: Disorders of the Gut-Brain Interactions
115. Chronic Pain Syndromes: Assessment and Management
114. Palliative and Hospice Care: A Conversation on Grief and Joy
Building Better Workflows Podcast
Building Better Workflows
Key quotes for Twitter:
"Vaccines are the most important public health endeavor that...
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What if you could revolutionize healthcare communication for diverse communities with just a 90-second video?
That's exactly what Dr. Ripudaman Singh Minhas and his team are doing with their innovative approach to health education. Imagine a world where families can access vital health information in their native language, delivered by someone who looks like them and understands their cultural nuances. From TikTok-style snippets to in-depth Instagram lives, this initiative is breaking down barriers and building trust across various cultural and linguistic groups. With a focus on accessibility, hope, and cultural representation, they're transforming how health information is shared and received. By leveraging the power of "trusted messenger models" and collaborating with community advisory boards, they ensure that their content resonates deeply with their target audiences. From pediatricians to psychologists, a diverse team of over 60 clinicians volunteer their expertise to create content that's not just informative, but also engaging and culturally sensitive. This groundbreaking approach isn't just changing how we communicate health information – it's potentially saving lives, one short video at a time.
[02:06 -09:46] Cultural Representation in Online Health Resources
Created resources that were culturally responsive and adapted, translated where neededAimed to build rapport and trust, answering questions families hadApplied the trusted messenger model to an online spaceEach channel has healthcare providers on screen who are from the communities they serve, communicating in bilingual channels where appropriate[09:47 - 17:07] Social Media for Public Health: Innovative Content Strategies
Most videos are TikTok-style, 90 seconds long, offering quick bites of health contentLonger content, up to 45 minutes, delves into specific topics like speech delay or summer safetyContent is community-led, responding to questions and analytics from social mediaVideos feature practitioners from the community, speaking in their native language[17:08 - 21:26] Expanding Digital Health Education for Youth and Diverse Communities
Goal to create more channels and content for families in over 40 countriesPlans to develop content specifically for grandparents and fathers Implementation of the Digital Health Youth Fellowship ProgramTraining young content creators on video creation, self-care, and critical information appraisal[21:27 - 33:48] Social Media Impact on Pediatric Health Education
The project has seen significant impact in terms of audience reach and engagement.Research is being conducted to evaluate how the project impacts parenting journeys.A study is examining how social media was used as a tool in the resettlement process for families displaced by the war in Ukraine.The project aims to do "microdoses of positive pediatric content" amidst other content families are scrolling through[33:49 - 40:23] Closing segment Takeaways
Links to resources mentioned on the show
Newsletter Sign Up: Our Kids Health
Website: Our Kids Health - Our Kids Health
LinkedIn:
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What life-saving benefits can psychopharmacology offer for mental health disorders postpartum?
In this week’s episode of Pediatric Meltdown, Dr. Lia Gaggino unravels the intense highs and lows of perinatal mood and anxiety disorders (PMADs), as she bravely shares her own struggles and triumphs. She highlights the crucial red flags that every parent and healthcare provider should recognize as well as practical strategies from top experts to enhance your clinical practice and better support families navigating this emotional landscape. With this useful advice and resources, Dr. Gaggino provides a beacon of hope and understanding for both healthcare professionals and new parents. Curious to discover the one tip that can transform your postpartum experience? Click here to learn more!
[0:04 - 06:07] Introduction to Perinatal Mood and Anxiety Disorders
The host recounts her personal experience with PMADs during her residency.Discusses the struggle of timing motherhood with professional life.The emotional and logistical challenges of pregnancy, delivery, and motherhood.[06:08 - 13:12] Postpartum Challenges: Real-life Experiences
The intense anxiety and feelings of incompetence in the early postpartum period.Support system breakdown: How a lack of nurturing support impacted mental health.The importance of seeking professional help and the stigma surrounding it.[13:13 - 17:03] Tools and Strategies for Managing PMADs
Routine screening for risk factors using tools like the Edinburgh Postnatal Depression Scale.Normalizing conversations about PMADs with new parents and their partners.Encouraging healthcare providers to ask the right questions to identify at-risk parents.[17:04 - 22:38] Empowering Parents and Clinicians
The impact of social media and unrealistic expectations on new mothers.Practical advice for partners and extended family members to support postpartum parents.A call to action: Encouraging listeners to share their experiences and support each other.Links to resources mentioned on the show
- Edinburgh Postnatal Depression Scale: (https://psychology-tools.com/epds/)
- Postpartum Support International: (https://www.postpartum.net)
- Books by Karen Kleiman: (Amazon.com)
Other episodes you may like:
https://pediatricmeltdown.com/episodes
185. Cultural Competency: Health Equity and Outcomes
175 Beyond Trauma: Strengthening the Caregiver-Infant Dyad
161 Menstrual Equity Changes Lives: The Power of Day
147 Racial Discrimination and Black Infant Morbidity and Mortality
134 Early Childhood Education: Empowering Parents
Building Better Workflows Podcast
Building Better Workflows
Key quotes for Twitter:
"Because the reality is medication for mental health disorders can be life saving.".. Dr. Lia Gaggino on medication and postpartum depression
"Babies eat, sleep, cry, and poop. They don't smile at you to...
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Have you ever wondered what it truly takes to support perinatal mental health in our communities?
This week’s episode goes into just that, featuring expert Kristina Ledlow, who emphasizes the power of community in addressing mental health needs for new mothers. Kristina and Dr. Lia explore the revolutionary risk assessment tool developed by Nancy Roberts, stressing the importance of concrete data in securing sustainable funding and resources. They discuss key strategies for overcoming perinatal mental health disparities, such as finding champions and building coalitions. Christina shares her vision of establishing a perinatal and infant mental health center, aiming to prioritize this crucial issue on both national and international levels. The conversation also explores the negative effects of healthcare silos and the transformative impact of interdisciplinary teamwork.
Furthermore, they tackle pressing issues like social media pressures, mommy shaming, and the fear surrounding perinatal mental health medications. Christina provides invaluable insights into creating a postpartum plan, leveraging support systems, and the indispensable role of partners. From online support groups through Postpartum Support International (PSI) to dedicated resources in multiple languages, this episode is a comprehensive guide to improving perinatal mental health for all.
[05:27 -14:30] The Importance of Community and Data
Risk Assessment Tool: Discussion on Nancy Roberts’ risk assessment tool, highlighting the significance of obtaining tangible numbers and statistics.Championing the Cause: Finding champions, leveraging clout, and building coalitions are essential for addressing perinatal mental health disparities.Sustainable Funding: Emphasizes the need for sustainable funding beyond grants.Communication and Collaboration: Impacts of interdisciplinary teamwork in healthcare, importance of breaking down silos.[14:31 - 23:38] The Role of Therapy and Medication
Medication During Pregnancy: Concerns about medication during pregnancy and the benefits of therapy and medications in treatment.Postpartum Plan: Creating a postpartum plan prioritizing sleep, nutrition, and support from visitors.Online Support Groups: Availability of online support groups through PSI, offering spaces of unconditional acceptance and healing.Mental Health Hotline: Use of resources like PSI's consult lines and maternal mental health hotlines that support in various languages.[23:39 - 34:13] Addressing Disparities and Systemic Racism
Systemic Racism's Impact: Impact of systemic racism, lack of healthcare access, and generational trauma.NICU Family Stress: Stress experienced by families of color in NICUs and the need for inclusive care.Healthcare Professional Support: Role of healthcare professionals in supporting parents and infants, involving families in decision-making.PSI Support Groups: Online support groups for partners, LGBTQ+ individuals, and Spanish-speaking groups for better inclusivity..[34:14 - 46:19] Building a Community-centric Postpartum Program
Local and National Aspirations: Sharing aspirations for establishing a local perinatal and infant mental health center and advocating on a larger scale.Postpartum Challenges: Common challenges for new parents: lack of sleep, postpartum expectations, and pressures from social media.Postpartum Planning: Encouragement to create a postpartum plan and make use of resources like the free postpartum planning class.Role of Partners: Discussing the critical role of dads and partners in supporting new mothers and... -
How can primary care providers better educate themselves about functional neurologic disorders to reduce stigma and support quicker treatment for their patients?
Ever wondered why some neurologic symptoms defy typical diagnostic tests? This week's episode of Pediatric Meltdown will talk about this mystery with guests Dr. Sarah Dixon and Dr. Alex Gamber, two experts in pediatric neurology. Through their expert insights, you'll learn about the difference between epileptic seizures and FND spells, and the importance of therapeutic approaches like cognitive behavioral therapy. With actionable advice for primary care providers and families alike, this episode is a treasure trove of knowledge. Learn about innovative treatment strategies and why understanding both the psychological and neurobiological aspects is so essential. Curious to know the ultimate strategies for tackling FND symptoms? tap on PLAY to discover the key clinical pearls now!
[04:31 -14:11] Defining Pediatric Functional Neurologic Disorders (FND)
FND is a group of conditions causing nervous system symptoms without structural abnormalities.They result from malfunctions in how information is transmitted and received in the brain.The symptoms do not arise due to any other neurologic disorder.It represents an undamaged brain experiencing processing issues.[14:12 - 25:52] Diagnostic Approaches for Functional Neurologic Disorders in Pediatrics
Subconscious learned motor patterns play a significant role in FND.Resting state functional connectivity MRI studies show increased connectivity between emotional processing centers and motor control networks in FND patients.Functional movement disorders, including functional tremor and tics, exhibit distinct physical exam findings.Neurologists heavily rely on physical exam findings to diagnose functional disorders.[25:53 - 34:46] Understanding Psychogenic Non-Epileptic Spells in FND Management
Addressing the need for effective treatment interventions.Ensuring that patient and family concerns are acknowledged and managed.Importance of patient education in understanding their condition.Strategies for managing subacute subconscious pressure or stress in patients.[34:47 - 45:48] Effective Communication in Diagnosing Pediatric FND
Emphasize the importance of clear and compassionate communication when suspecting Functional Neurologic Disorder (FND) in pediatric patients.Highlight how setting the stage correctly can significantly influence the patient's treatment, prognosis, and overall improvement.Include educational information in the referral note to neurology, detailing the basics of FND diagnosis and the treatment plan.Use the referral note to walk through clinical reasoning and explain the natural history of FND.[45:49 - 54:16] Closing segment Takeaways
Links to resources mentioned on the show
Taking Control of Your Seizures: Workbook
Joel M. Reiter, Donna Andrews, Charlotte Reiter, W. Curt LaFrance, JR
https://www.amazon.com/Taking-Control-Your-Seizures-Treatments/dp/019933501X
Neurosymptoms.org
FNDhope.org
Epilepsy Foundation:
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This week we’re tackling the critical issue of child sexual abuse prevention. The conversation goes into various aspects, including the prevalence of sexual abuse among children and the different levels of sexual behaviors in children—normative, cautionary, and problematic. Understanding these distinctions is essential for proper management and intervention. Special guests, experts Dannielle Kostrab-Boyd and Sherri Killiah, who work with sexual assault services, share invaluable insights. They reveal alarming statistics and underscore the pediatricians' role in preventing abuse through early intervention. We also highlight the need for open communication on body safety, urging parents to create a safe and trusting environment for their children.
The episode provides an in-depth look at the services offered by Sexual Assault Nurse Examiners (SANE), covering the meticulous process of forensic examinations in child abuse cases. The discussion underscores the critical need for a compassionate and non-judgmental approach to both care and communication. By fostering open lines of communication and ensuring education on body autonomy for kids, we aim to arm parents, healthcare providers, and specialized services with the tools needed to effectively address and prevent child sexual abuse. To understand the collective effort required to support and protect the most vulnerable members of our society, just tap on “play”
[02:58-17:33 Importance of Recognizing Child Sexual Abuse
Prevalence of Child Sexual Abuse: 1 in 10 children will experience sexual abuse before the age of 18, a statistic likely underestimated.Age Range of Affected Individuals: Victims can range from as young as 5-6 weeks to 96 years old.Levels of Sexualized Behaviors:- Normative: Voluntary, infrequent, easily redirected behaviors with familiar children.
- Cautionary: Behaviors occurring in inappropriate places, increasing in frequency and involving technology.
- Problematic: Behaviors involving self-harm, coercion, and inappropriate sexual content for the child’s age.
[17:34 - 32:25] Emotional and Psychological Impact of Abuse
Behavioral Changes: Indicators include regression, depression, anxiety, and fear.Physical Symptoms: Nightmares, bedwetting, and advanced sexual knowledge are common signs.Educational and Social Challenges: Difficulties in school performance and peer relationships.Clinical Guidance: Clinicians should prioritize open communication, ask about behavioral changes, and provide a private space for discussions.[32:26 - 48:19] The Role of Pediatricians in Prevention
Resource: Pediatricians should ensure prevention information is accessible in waiting rooms, including books and posters.Building Trust: Establish a safe, trusting relationship with both caregivers and children.Body Autonomy : Encourage expectations for body autonomy and offer choices during examinations, especially private areas.Correct Terminology: Using correct medical terminology and explaining the necessity of examinations to create a safe space[48:20 - 51:01] Available Resources and Support Services
SANE Program: Regional program providing specialized medical and forensic exams, victim advocacy, provides empowerment-based care, emotional support, and follow-up for survivors.24-Hour Crisis Line: Immediate support available through a crisis hotline.Comprehensive Services: Individual, family, and group counseling, children’s advocacy center, and prevention programming.National Resources: Accessing services through national organizations and text... - Näytä enemmän
