UVA Health System Blog

Stories about the patients, staff and services of UVA

 

Dermatomyositis: A Pediatric Autoimmune Disease with Alarming Symptoms (Podcast Tuesday)

On July 28, 2015 | At 9:37 am

Muscle weakness. Trouble swallowing. A strange rash. Sometimes, parents take their kids from one doctor to another, trying to find the cause of these symptoms.

It might be dermatomyositis, an autoimmune disease where the immune system attacks the blood vessels under the skin and muscles.

There’s no cure for it, and if untreated, children can start having trouble breathing and swallowing. But treatment reduces the symptoms and allows these kids to live normal lives.

In this week’s podcast, pediatric rheumatologist Aarat Patel explains how his team treats this pediatric autoimmune disease.

 
 

Treating Pediatric MS (Podcast Tuesday)

On July 21, 2015 | At 9:35 am

About 10 percent of people with multiple sclerosis (MS) have symptoms before age 18. Those initial symptoms include:

  • Sudden blurred vision, caused by a nerve inflammation known as optic neuritis
  • Double vision, or seeing two of an object
  • Increasing arm and leg weakness, numbness or tingling
  • Balance difficulties
  • Bowel and bladder control issues
Learn more about UVA’s pediatric MS clinic.

Parents and kids often assume an MS diagnosis means wheelchairs and a shorter lifespan, but new medications offer hope. Listen to pediatric neurologist Nick Brenton explain the latest pediatric MS treatments.

 
 

New Radiation Guidelines for Prostate Cancer (Podcast Tuesday)

On July 14, 2015 | At 11:04 am

In the past, a prostate cancer patient would typically delay radiation therapy after having his prostate removed. While it was once thought that immediate radiation would cause side effects regarding urinary and sexual function, researchers are now finding that immediate treatment doesn’t contribute to an increased risk of complications. Timothy Showalter, MD explains why this common practice is changing, and why new research means some patients will not delay radiation therapy.

Filed under : Cancer,Men's Health,Podcast Tuesday | By
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A Look Back on Maternity Monday

On July 13, 2015 | At 9:07 am

Six months ago, our mostly-female blog team began chatting about pregnancy and childbirth. For those of us who haven’t had kids, it seemed complicated and overwhelming, surprisingly so for something we’ve been doing since the beginning of time.conception, pregnancy, postpartum

The Maternity Monday series was born from our many questions:

We answered those questions and many more, starting with preconception and ending with life after the baby comes.

If you missed a post, make sure to check out the entire Maternity Monday series.

What did we miss? What was your pregnancy like? Leave a comment below to share your story.

 
 

Exercise and Overhydration: How Much Water Is Too Much?

On July 9, 2015 | At 9:06 am

For years, I’ve followed the you-can’t-drink-too-much-water adage, especially when exercising. I’m the person accidentally kicking my water bottle during pilates and heading straight for the water station after 5Ks.Drinking too much water during exercise can lead to exercise-associated hyponatremia (EAH).

But new sports medicine guidelines indicate that actually, you can overhydrate while exercising, and the subsequent low salt levels in your blood can be deadly. Last summer, two young football players died from this condition, known as exercise-associated hyponatremia (EAH). Although the condition used to mainly affect marathon and triathlon participants, doctors are now seeing it in other athletes.

The solution? “We recommend using your thirst as a guide,” says Mitchell Rosner, MD, who led the guideline development group. “If you drink when thirsty, you will not become hyponatremic and you will not suffer from significant dehydration.”

Sports drinks might reduce your risk slightly, he adds, but you’re still mostly drinking water.

Learn more about the research and hyponatremia symptoms.

Filed under : Family Health and Safety,Research | By
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Transient Ischemic Attack: Why You Should Worry (Podcast Tuesday)

On July 7, 2015 | At 9:07 am

They’re often called “mini-strokes,” but they’re not necessarily mini. A transient ischemic attack (TIA) is a serious warning sign that you could have a stroke in the next two days. Symptoms come on very suddenly and include:

  • Weakness
  • Numbness
  • Clumsiness
  • Loss of vision in one eye

If you or someone else is experiencing these symptoms, call 911 immediately.

Listen to neurologist Brad Worrall, MD, explain why doctors take TIA symptoms so seriously.

Filed under : Neurosciences,Podcast Tuesday | By
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Maternity Monday: Newborn FAQs

On July 6, 2015 | At 8:39 am

You’re home from the hospital with your newborn and finally settling into a routine.  But you have questions, lots of questions that never popped into your head until this tiny person was in your arms.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

Lisa Hainstock, MD, wants parents to understand that no question or concern is too insignificant for your pediatrician.

We asked Hainstock some of the most common questions she gets from new parents.

When should parents call the doctor?

If there are concerns, parents should have no hesitation about calling the pediatrician.

Otherwise, call if the baby:

  • Has a fever of 100.4 or higher
  • Is excessively fussy or lethargic
  • Isn’t feeding well
  • Has a decrease in wet diapers

What is a normal feeding schedule like?

There is no normal feeding schedule. I tell parents to aim for eight to 12 feedings a day. But a lot of parents think their baby should feed every three hours. Many parents think their baby should feed every three hours by a clock, but more often than not, they are on their own schedule.

If the parent is waking the baby up to eat by a schedule, it may result in a poor feeding, and both will be unhappy.

How do you know if the baby’s eating enough?

lisa hainstock, charlottesville and crozet pediatrician

Lisa Hainstock, MD

In the first week of life, we go by this rule: The number of wet diapers should equal the number of days of life. So 3-day-old babies should have three wet diapers in 24 hours. During those first days, the baby is learning to eat. It also takes some time for the mother’s milk to come in if she is breastfeeding.

After the first week, the baby should have seven or more wet diapers a day. That’s a good indicator the baby is well hydrated.

What’s a typical weight loss after birth? When will the baby start gaining weight?

We don’t want to see the weight drop by more than 10 percent. Three to 10 percent is typical. If the baby has excessive weight loss, we may need to look at other feeding strategies.

Most babies are back to their birth weight by 10 to 14 days of life. Some signs and symptoms are considered emergencies, including:

  • Green vomit
  • Excessive vomiting
  • A firm and distended abdomen

Parents should call the pediatrician right away if they notice any of these, as it may indicate a surgical emergency. A blockage of the intestines is rare but important to recognize early.

Why is the baby spitting up so much?

100 percent of babies have reflux. The area between the stomach and the esophagus isn’t strong enough to keep the food in when they’re newborns. This often resolves by six months to a year.

As long as the baby is gaining weight, it’s not typically concerning. If you think it’s excessive, you should discuss it with your pediatrician.

How often should the baby be pooping?

It really varies. Some poop eight to 10 times a day; some only every other day. As long as they’re eating and gaining weight, don’t focus on the number.

What about poop color? Is it important?

Don’t worry about the poop color unless it’s overtly white or has blood or mucus. All shades of green, brown and yellow are normal.

Should we be concerned about this rash?

There are so many infant rashes, and the vast majority of them are benign. Parents shouldn’t hesitate to call the pediatrician if they’re concerned. Definitely call if the rash is tender, associated with a fever or excessive fussiness, or there are fluid-filled blisters.

when to call the pediatrician

Don’t be afraid to call the pediatrician if you’re worried about your baby.

With diaper rash:

  • Use an ointment with zinc.
  • Keep the baby’s diaper off if possible.
  • Limit using soaps and wipes with perfume. If the rash is especially bad, use warm water and a soft cloth instead of wipes.
  • Stay on top of diaper changes — check every two hours if the baby is awake.

The baby bumped her head. Is this serious?

It’s worthwhile to call the pediatrician for any fall involving a head bonk or injury. The pediatrician will likely want to know the method of injury and how the child is behaving. A fall from sitting on the carpet is probably OK, whereas a fall from a bed onto a hardwood floor could result in a more serious injury

We get concerned if the baby lost consciousness, is vomiting or is excessively fussy or sleepy.

If the baby’s crying for no obvious reason, how long should we wait before getting concerned?

If your baby is crying and inconsolable for a long period of time, call the pediatrician. It could be something benign like colic or reflux, but it may represent something more serious, such as an infection.

How do we take care of and clean the umbilical cord area?

Less is more in taking care of the umbilical cord.  We do not recommend alcohol wipes to the area anymore. Keep the area as dry as possible. Only give sponge baths until the cord falls off.  After that, it’s fine to give the baby a regular bath.

How should we dress the baby? Should she be warm or cooler?

The best advice I can give is to dress the baby the way you are dressed. If you are comfortable, the baby likely is as well.

Find a Pediatrician

By Your Side Pediatrics, where Hainstock works, makes home visits!

Or look for a pediatrician near you.

 
 

Babies, Neurological Discoveries and More: June 2015 Roundup

On July 3, 2015 | At 10:25 am

School’s out for the summer! Are you ready for more time with the kids? Learn some fun summer activities to do with your family in a parent’s summer survival guide.

The Battle Building celebrated its one-year anniversary! It will continue to provide pediatric primary and specialty care for years to come. Take a virtual tour of our most colorful building.

Our Maternity Monday series is coming to a close. Check out our latest postpartum posts and look forward to our finale on Monday, July 6th.

fun exercise infographic

View full size – summer activities for the family

Like our Virginia weather, our weekly podcasts have been heating up:

UVA In the News

Some of our stories made the news:

Filed under : Monthly Roundup | By
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Podcast Tuesday: Is It a Cold or Allergies? [AUDIO]

On June 30, 2015 | At 9:41 am

Chances are, if you don’t have a runny nose right now, you’ve had one recently. But it can be tough to tell whether you have a cold or seasonal allergies.

Do you have allergies?

Find an allergy clinic near you.

In this week’s podcast, Monica Lawrence, MD, who specializes in seasonal allergies, explains:

  • The difference between cold and allergy symptoms
  • Different over-the-counter allergy medications
  • How to avoid nasal spray overuse
  • How nasal irrigation methods like a Neti pot can help

 
 

Maternity Monday: Sleep Schedules for Moms and Babies

On June 29, 2015 | At 10:37 am

Giving birth puts your body through a lot of trauma, and the baby has gone through an ordeal as well. Your body needs to relax! It may go without saying, but don’t make big plans in the days and weeks following baby’s arrival. Sleep is a priority! Visitors may come and go, but it’s OK to tell people it’s time to relax and ask them to come back another time.

Mommy and Baby Need Sleep

The new baby needs a lot of sleep, anywhere between 16 to 20 hours per day, says pediatrician Heather Quillian, MD. The baby’s sleep schedule will be disjointed and erratic, and you may not be able to predict when the baby will sleep. Your baby will only be comfortably awake for an hour or two at a time.

preconception, pregnancy and childbirth

Join us as we journey through preconception, pregnancy, childbirth and beyond in a series we call Maternity Monday.

Baby will let you know when they are sleepy. Watch for certain signs:

  • Yawning
  • Rubbing eyes
  • Fussing
  • Acting fidgety

Don’t be alarmed if baby sleeps for more than a few hours at a time, but remember your baby will need to eat every several hours, Quillian says, don’t allow or expect your new baby to sleep a full nights sleep (8 hours or more). If this is the baby’s sleeping habit, consult your pediatrician.

Mommy needs sleep, too. Doctors recommend lying down and resting every time baby sleeps, even if you don’t fall asleep. Your body has gone through a lot and needs time to recover. Pregnancy prepares you for a lack of sleep, Quillian points out. It’s rare to sleep through the night at nine months pregnant, and in the first months of baby’s life, mommy and daddy shouldn’t expect a full night’s sleep either.

Getting on a Sleep Schedule

Quillian admits it’s hard to get baby on a sleep schedule until about four months of age. A new baby doesn’t really understand the concept of daytime and nighttime, just that they feel tired and want to sleep. Don’t try to keep baby awake through the daylight hours to ensure they sleep longer at night. It won’t work and you will likely have a fussy baby.

A baby's crib or bassinet should have absolutely nothing in it. "Make it boring," says Dr. Quillian

A baby’s crib or bassinet should have absolutely nothing in it. “Make it boring,” says Dr. Quillian

During the early days and weeks, be sure to cuddle and snuggle your baby as much as you can. “There is no such thing as too much spoiling,” says Quillian. Baby loves to be held and needs the human interaction. The snuggling will help baby feel comforted and will promote sleep.

Baby may sleep as long as four hours at a time, but it may not be at night. It’s easier to adjust our schedule than to try to adjust theirs.

If you try to implement a sleep schedule too early, you may feel like you’re spinning your wheels, and, in fact, even at four months old, baby may not catch on. After a few months though, you can start a routine that implies to baby that it’s nighttime and time to sleep:

  • Keep your household at a manageable noise level during the day and quieter at night.
  • Turn the lights down low at nighttime.
  • Change baby into pajamas.

Remember, sleep promotes sleep, and babies may not learn how to sleep on a schedule if left to do their own thing. Do not leave them to their own devices, Quillian warns. With help from parents they will learn slowly over time that nighttime is sleep time. Getting a baby into a good sleep pattern can take some work, but it is worth it, Quillian advises. A good night’s sleep benefits everyone.

SIDS, Sleep and Safety

There is plenty of information out there regarding baby sleep safety and sudden infant death syndrome (SIDS) prevention. “Make sure there is a firm sleep surface; that’s the most important thing,” says Quillian. “A crib or bassinet will do. There should be nothing in it. No blankets, no pillows.”

Quillian adds that baby should be laid on his or her back, and pediatricians at UVA do not recommend any sleep positioners. It’s okay, she adds, to be swaddled in a light blanket or sleep sack, but keep the crib as boring as possible. All the things that make your bed cozy are an absolute no-no for your baby.

Having a new baby at home will be intimidating, and you may be worried about baby sleeping too much or too little. If you have any concerns, be sure to call your pediatrician.