PWG WellChat

Disclaimer: the views, information, or opinions expressed during the PWG wellchat podcast series are solely those of the individuals involved and do not necessarily represent those of Pediatric Wellness Group [PWG] and its employees. PWG is not responsible for and does not verify for accuracy any of the information contained in the podcast series available for listening on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute medical or other professional advice or services.

 This podcast is available for private, non-commercial use only. You may not edit, modify, or redistribute this podcast. PWG and the developers of this podcast assume no liability for any activities in connection with this podcast.

Here's an outline of episode 4:

• Link with wellness  
• General principles 
  • Avoid battling about food: With toddlers you won't win this one 
  • Need to be intentional about good eating.   
• Parents take this opportunity to be more motivated to eat well because now it isn't just for you it is also for your child!
• Nutrition basics 
  • Limit sugar intake and discourage drinking sweetened beverages. 
    • No recommendation for sweetened beverages: drink milk and water 
      • AAP recommends: 
      • < 2 y/o avoid added sugars 
      • Or 2 y/o and up limit to 25 grams or 6 tsp/day 

Reassurance for parents:  Talking about nutrition from Day 1.  "normal kids will eat enough to grow normally"

Nutritionally Complete Diet:

• Recommendations can vary by age and even by gender in the teen years.
• Avoid battles with food
• ChooseMyPlate.gov  
• What to do for the picky eater?
• Whole Grains: 
• Proteins: 
• Fats/Cholesterol: 
• Snacking can be an essential component of the young child's diet

Resources

https://www.healthykids.nsw.gov.au/kids-teens/choose-water-as-a-drink-kids

https://www.choc.org/programs-services/urology/how-much-water-should-my-child-drink/

 http://depts.washington.edu/shsi/article/hydration-in-the-heat-for-young-athletes-medical/

 https://learn.truesport.org/how-much-water-should-youth-athletes-drink/

 https://familydoctor.org/athletes-the-importance-of-good-hydration/

Disclaimer: the views, information, or opinions expressed during the PWG wellchat podcast series are solely those of the individuals involved and do not necessarily represent those of Pediatric Wellness Group [PWG] and its employees. PWG is not responsible for and does not verify for accuracy any of the information contained in the podcast series available for listening on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute medical or other professional advice or services.

This podcast is available for private, non-commercial use only. You may not edit, modify, or redistribute this podcast. PWG and the developers of this podcast assume no liability for any activities in connection with this podcast.

Here's an outline of episode 3:

• Medical evaluation can involve a sleep study, labs
• Tips for better sleep: 
  • Routines 
    • Same bedtime every day 
    • An hour before bedtime, dim the lights and turn off all screens. Blackout curtains are helpful.  
• Avoid caffeine after 1 p.m. and never go to bed tipsy. Alcohol is a sedative and sedation is not sleep. It also blocks your REM dream sleep, an important part of the sleep cycle
• Can use phrases or actions to cue your body for sleep 
  • Bath 
  • Herbal Tea 
  • Reading a story 
  • Audio cues: white noise, music 
  • Read a book 
  • Use essential oils to connect relaxation with sleep 
  • Heavy blanket or massage as tactile cue 
  • Snacks high in protein can help: warm milk, turkey, piece of fruit 
  • Gentle stretching 
  • Mindfulness 
  • Breathing exercises 
  • SNOO for infants 
• Exercising right before you go to bed may make it harder to fall asleep
• Avoid caffeine and nicotine late in the day and alcoholic drinks before bed
• Make room conducive to sleep: keep it dark, quiet, comfortable or slightly cooler temp [65 per Dr. Walker], no TV or computer
• Don't lie in bed awake, if you can't sleep get out of bed and do something like reading a book or listen to music until you feel tired.
• Herbals/supplements 
  • Melatonin 
  • 5-HTP 
• Gratitude [for the day, resets the mind chemistry, sets the tone for your rest, triggers a cascade of autonomic events that can help you get deeper sleep]
• Wearables--> do they work? Maybe, maybe not

Resources

https://www.sleepfoundation.org/articles/melatonin-and-sleep

 https://www.webmd.com/vitamins/ai/ingredientmono-940/melatonin

 https://www.healthline.com/nutrition/5-htp-benefits

 https://www.webmd.com/vitamins/ai/ingredientmono-794/5-htp

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415362/

Disclaimer: the views, information, or opinions expressed during the PWG wellchat podcast series are solely those of the individuals involved and do not necessarily represent those of Pediatric Wellness Group [PWG] and its employees. PWG is not responsible for and does not verify for accuracy any of the information contained in the podcast series available for listening on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute medical or other professional advice or services.

This podcast is available for private, non-commercial use only. You may not edit, modify, or redistribute this podcast. PWG and the developers of this podcast assume no liability for any activities in connection with this podcast.

Here's an outline of our second episode:

• What does it do? 
• How much do you need? 
  • Varies according to age 
• Biology and science of sleep 
  • 2 basic stages: REM [rapid eye movement] and non-REM sleep [which has 3 different stages] and you cycle through these several times per night 
    • Non-REM Stage 3 is the deep sleep you need to feel refreshed in the morning, usually have longer periods of this during the first half of the night 
  • Circadian rhythm [or body clock] controls timing of sleep 
  • Chemical signals or neurotransmitters 
    • GABA is associated with sleep, muscle relaxation, sedation 
    • Norepinephrine and orexin keep brain active while we are awake 
    • Acetylcholine, histamine, adrenaline, cortisol and serotonin all impact sleep and wakefulness 
  • Genetics 
  • How can you tell you are getting good sleep? 
  • When should I worry about not getting enough sleep? 
• Resources
  •  Matthew Walker at UC Berkeley  Center for human sleep science 
    • Why We Sleep 
  • NIH 
  • WebMD
  • Mayo Clinic
  • https://www.sleep.org/articles/sleep-quantity-different-sleep-quality/ 

Disclaimer: the views, information, or opinions expressed during the PWG wellchat podcast series are solely those of the individuals involved and do not necessarily represent those of Pediatric Wellness Group [PWG] and its employees. PWG is not responsible for and does not verify for accuracy any of the information contained in the podcast series available for listening on this site. The primary purpose of this podcast series is to educate and inform. This podcast series does not constitute medical or other professional advice or services.

This podcast is available for private, non-commercial use only. You may not edit, modify, or redistribute this podcast. PWG and the developers of this podcast assume no liability for any activities in connection with this podcast.

Here's an outline of our first episode:

• Episode 1 --> setting the stage 
  • We are located in Redwood City, CA near Silicon Valley aka tech mecca 
    • correction: in the recording we mention that we are south of Silicon Valley, actually we are north of the valley
  • How we met 
    • PICU rotation story 
  • How we designed this practice 
    • Balthazar's in NYC with Tricia creating a vision for our ideal space and practice 
      • Warm, inviting 
      • Art, colors, flooring, etc. 
      • Not sterile, want to make a visit to doc less anxiety provoking because "no one likes to go to the doctor's" 
      • Snacks for kids --> apple, organic lollipops 
      • Coffee for parents "take a break" 
      • Books [for kids and adults], inspiring messages on screen, tactile toys, FISH TANK 
    • We knew we succeeded when a yelp review mentioned that their child is having a tantrum because she wanted to go to doctor's office! 
  • How we opened up the practice 
    • No one would lend us money we were 2 women doctors with no formal management training 
    • First Republic supported us, we love Greg Leando! 
    • Weren't sure how this would be received by people, really grateful that people followed us 
  • Why we are passionate about private practice 
    • Allows us to practice the way we feel is best for ourselves and our families 
    • Build relationships : 
      • People trust us and can open up to us, we can then have an impact esp with teens 
      • We *know* your child and can recognize when something is not right 
      • Important for you to be seen as a whole person, not just a number 
    • Integrate multiple tools for wellness 
      • Western medical tools such as vaccines 
      • Other healing traditions such as acupuncture, Chinese medicine, Ayurveda 
    • HPV vaccine story 
      • We are graded on this as a performance metric 
      • We have more latitude to craft an individual solution rather than strictly following algorithms 
  • Why a trifecta? 
    • Boston Cream Pie story 
    • Really at the heart of what we see every day 
    • What is wellness? We think it represents a healthy body, mind, and heart.
    • Need a healthy body, mind and heart to live a joyous and fulfilling life 
    • Foundation of wellness: sleep, nutrition, exercise -->  like the base of Maslow's triangle 
    • Trifecta for teens: balancing family with job/school and friendships/relationships 
    • Will come back to this idea of trifecta again and again 
  • How our episodes will work 
    • Set up some science, give you overview 
    • Deeper dives into specific areas 
  • Why are we talking about this?