Toilet training is a natural milestone that many children master by the age of 3. Although accidents are bound to happen from time to time, consistent day time wetting may be linked to a more serious medical condition. On average, daytime wetting, or Diurnal enuresis, happens in about 3-4% of children and is commonly associated with dysfunctional voiding. Today, we are going to unpack some of the common reasons kids experience daytime wetting and what primary care providers can do to treat this in the medical home. Today I am happy to be speaking with  Brian Miller. Brian Miller is PA-C Lead Advanced Practice Provider for Pediatric Urology here at Children’s hospital Colorado.

How to Treat and Overcome Daytime Wetting with Brian Miller, PA-C (S6:E5)

Children's Hospital Colorado experts examine the latest treatment options for the most common chief complaints in pediatric medicine. We will talk about significant research and advances in pediatric medicine, the nuanced art of practicing pediatrics and everything in between.

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 Knowing something is wrong with your child is terrifying for any parent, but the mystery becomes more frightening when the symptoms even puzzle the experts. In 2018, at a peak in cases of acute flaccid myelitis, also known as AFM, otherwise healthy kids experienced debilitating paralysis. Researchers of this perplexing illness braced for a surge in 2022 that never came, and now there is talk about a possible increase of AFM this year. To break down the past and prepare for the future, we are joined by two experts. Kevin Messacar, MD, and Hai Nguyen-Tran, MD, both specialize in pediatric infectious  disease  at Children’s Hospital Colorado. Dr. Messacar is an associate professor and Dr. Nguyen-Tran is an assistant professor at the University of Colorado School of Medicine. Some highlights from this episode include:     What the history of AFM tells the medical community  Why it’s so tricky to diagnose and identify  How primary care providers can properly prepare      For more information on Children’s Colorado, visit: childrenscolorado.org.     

Will an AFM Peak Return?

 In just the United States, more than 15,000 children are diagnosed with cancer each year. Globally, that number is greater than 300,000. As difficult as those numbers may be, there is good news: Our cancer therapies continue to improve. In the 1960s, only about 5% of children survived leukemia. Today, that number is 90% or better. Many more pediatric oncology patients are now transitioning into survivors of childhood cancer and have the opportunity to achieve their hopes and dreams as adults. This means primary care providers are caring for these patients in increasing numbers. What’s important to know about this group of kids? In this episode, we discuss how to best integrate survivorship care with pediatric care. The Children’s Hospital Colorado HOPE Cancer Survivorship Program is one of the longest running survivorship programs in the nation. Leading that charge is Jenna Demedis, MD, who specializes in pediatric hematology and oncology. Dr. Demedis completed her training at Children’s Colorado and is currently an assistant professor at the University of Colorado School of Medicine.  When a patient can transition into survivorship  How to keep patient families engaged in these programs  How primary care providers can partner with survivorship programs       For more information on Children’s Colorado, visit: childrenscolorado.org.     

Shifting Into Survivorship

   The mouth is a fundamental part of the human body. It allows us to eat, drink, breathe, speak, smile and express ourselves. Naturally, that means oral health is connected to our broader physical health, but in the United States, medical and dental care are structurally separate. Despite their connections, the two have entirely different systems of professional training schools, insurance coverage and care networks. This is referred to as the dental divide, and it results in varied levels of access and health outcomes. The repercussions of these barriers are significant, especially for children in our most vulnerable communities. To discuss this important topic, we are joined by Patricia Braun, MD. Dr. Braun is a primary care pediatrician at Denver Health, as well as a professor of pediatrics at the University of Colorado School of Medicine. She is the immediate past chair of the Section on Oral Health for the American Academy of Pediatrics, and her research focuses on oral health outcomes and program evaluation. She also currently directs the Rocky Mountain Network for Oral Health Integration. Some highlights from this episode include:     How to understand the dental divide  Ways this divide leads to poor oral health for children  Options for the medical community to combat these barriers  What primary care providers can look for in their visits with patients     For more information on Children’s Colorado, visit: childrenscolorado.org.     

Dissecting the Dental Divide

  When you work in neonatology, you are surrounded by babies. You’re regularly meeting new parents in the Neonatal Intensive Care Unit, some who are living the best days of their lives, and others who are experiencing the very worst. But as a doctor, you never expect to become  the patient. We go beyond the white coat in this episode with a story of tragedy and personal discovery from  Laurie Sherlock, MD, that changed how she interacts with her patients and practices medicine. “I’ve been gifted through the accident and my son’s death. I’ve been gifted so much compassion for what our families are going through. I think my bandwidth is so much higher because it’s so easy for me to put myself in their shoes,” says Dr. Sherlock. Dr. Sherlock specializes in neonatal and perinatal pediatric medicine at Children’s Hospital Colorado and is an assistant professor of pediatrics and neonatology at the University of Colorado School of Medicine. Mostly importantly, she is a survivor who is using her own narrative to help others. Some highlights from this episode include:     Dr. Sherlock’s personal story and the impact it’s had on her career  Using personal experience to be a better doctor  Tapping into compassion at the bedside  Advice for patients and families experiencing tragedy      For more information on Children’s Colorado, visit: childrenscolorado.org.     

Turning Tragedy into Triumph

  Innovations and techniques to enhance spinal surgical care, and support patient- centric outcomes, have made big strides in the last decade. Technology like surgical robots, 3D printed models customized to the patient, and a new procedure called vertebral body tethering are just a few examples of the many incredible advancements.      Two leading experts on scoliosis surgery at Children’s Hospital  Colorado  join us to discuss these impressive changes and how they are impacting patient care.  Mark Erickson, MD, is the medical director of the Children’s Hospital Colorado Spine Program, as well as a specialist in orthopedic surgery. He’s also a professor of pediatrics at the University of Colorado School of Medicine. Sumeet Garg, MD, a pediatric orthopedic specialist, is the quality and safety director for the Spine Program, as  well an associate professor at the University of Colorado School of Medicine.    Some highlights from this episode include:     An orthopedic surgeon’s approach to spinal surgery and how it’s evolved over time  How surgery can improve a patient’s quality of life    A look at new, customized patient approaches  How the use of robotics is advancing treatment  What’s on the horizon in spine surgery innovation      For more information on Children’s Colorado, visit: childrenscolorado.org.     

How to Treat and Overcome Daytime Wetting with Brian Miller, PA-C (S6:E5)

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