Charting Pediatrics

Over the last decade, we've watched childhood obesity emerge as a major health concern, taking over news stories and social media posts worldwide. The evaluation and treatment of children with obesity has evolved, and how we handle these diagnoses today is different than in years past. What's important to emphasize is that obesity is a chronic disease, and the medical community needs to treat it as such.

To learn more about this important topic and highlight an impressive woman in medicine, we are joined by Ihuoma Eneli, MD. She is the Section Head of Nutrition at Children's Hospital Colorado and a visiting professor of pediatrics at the University of Colorado School of Medicine. She is an internationally recognized expert on pediatric obesity and serves in leadership and advisory roles for many organizations.

Some highlights from this episode include:

• A discussion of the new AAP obesity guidelines
• Genetics and how clinicians can reframe their understanding of obesity
• Suggestions for motivational interviewing with patients and families
• Treatment options that are available to patient-families
• The stigma around fault versus genetics
• New drugs and their future impact

For more information on Children's Colorado, visit: childrenscolorado.org.

Hirschsprung disease. Anorectal and colorectal malformations. These are some of the most challenging surgical problems encountered in young children. The precision of surgical technique required to achieve optimal outcomes takes many years, if not decades, to develop. Colorectal surgery has become a subspecialty in pediatric surgery, requiring close collaboration with other specialists. At Children's Hospital Colorado, we offer this care through our International Center for Colorectal and Urogenital Care, and our surgical team has some of the most experience in the world.

In this episode, we are joined by Andrea Bischoff, MD, and Luis De la Torre-Mondragon, MD. They both specialize in pediatric surgery at Children's Colorado and are associate professors of surgery and pediatrics with a specialty in colorectal surgery at the University of Colorado School of Medicine. Dr. Bischoff is also the Medical Director of the International Center for Colorectal and Urogenital Care here at Children's Colorado.

Some highlights from this episode include:

• The importance of pediatric colorectal programs.
• A discussion of when surgical intervention is necessary.
• A look at what procedures are offered at Children's Colorado and how they work.
• The role primary care providers can play as it pertains to identification, referral and care of patients who might need colorectal surgery.

For more information on Children's Colorado, visit: childrenscolorado.org.

Sleep problems can occur at any age, but when toddlers, children or young adults are the ones experiencing them, they can have a big impact on the entire family. Specifically, one to five percent of children, from newborns to teenagers, experience obstructive sleep apnea. While the effects may be significant, many children are not diagnosed or treated due to insufficient access to testing. A team at Children's Hospital Colorado has been preparing a recommendation on how and when to use home sleep apnea testing in kids.

To explore this topic, we are joined by Antoinette Burns, DO, who specializes in pediatrics and sleep medicine at Children's Colorado. She is also an associate professor of clinical practice, Department of Pediatrics-Pulmonary Medicine, at the University of Colorado School of Medicine.

Some highlights from this episode include:

• An explanation of obstructive sleep apnea.
• New modalities for sleep apnea testing.
• Barriers for accessing testing and how to combat them.
• Suggestions on what primary care providers should do when they think their patient might have obstructive sleep apnea.

For more information on Children's Colorado, visit: childrenscolorado.org.

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.

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.

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.

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.

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.

When babies enter the world, there's a plethora of diagnoses providers need to look out for. Some are simple fixes, while others are a bit more complicated. When parents take their kids home, how should they know what to keep an eye out for?

In this episode, we explore one potential diagnosis for an infant: tongue ties. How can you tell if a baby has one, and if they do, when should it be fixed? Looking at the concerns and consequences of tongue ties is important in making a decision on how to treat it.

To provide guidance in making these decisions, Soham Roy, MD, is our guest for this episode. Dr. Roy specializes in pediatric otolaryngology at Children's Hospital Colorado, and he's a visiting professor of otolaryngology at the University of Colorado School of Medicine.

Some highlights from this episode include:

• How to identify a tongue tie and variability in diagnoses
• Why tongue ties are controversial
• Identifying fact versus fiction in understanding tongue ties
• The upsides and downsides of the tongue tie procedure
• How providers can learn more

For more information on Children's Colorado, visit: childrenscolorado.org.

The care of children with cleft lip and palate spans an entire lifetime. It requires methodical care with a multidisciplinary team, and a special emphasis on the family. Integration with a child's pediatrician, medical home and their loved ones is key. While the oral cleft is the most common craniofacial malformation in a newborn, the three main types differ vastly.

We are in for a treat with the guest for this episode. We are joined by a gifted plastic surgeon who has traveled the world to perform these life-changing surgeries and bring smiles to everyone involved. Phuong Nguyen, MD, specializes in plastic and reconstructive surgery here at Children's Hospital Colorado. In addition, he is the associate vice chair of global surgery, chief of plastic surgery, co-director of the cleft lip and palate program and a professor of surgery at the University of Colorado School of Medicine.

Some highlights from this episode include:

• Prevalence and diagnosis of cleft lip and palate
• The role of the pediatrician or PCP throughout the lifespan of these patients
• Understanding if treatment is unique per patient
• Global impact of specialists, like Dr. Nguyen, traveling to treat patients

For more information on Children's Colorado, visit: childrenscolorado.org