Category: Health Care & Medical

Since the COVID-19 pandemic started, telehealth visits with doctors have been on the rise — and for many reasons, they are likely to be part of medical care for the foreseeable future.

While they aren’t the same as an in-person visit, I’ve found as a pediatrician that telehealth visits can be very useful. I can accomplish more than I would have expected while my patients can stay in the safety and convenience of their own homes (or wherever they are — I have done some where the patient was in a car or playing outside).

As I’ve done more and more of these visits, I’ve found that there are things parents can do to make the most of telehealth. Below are some helpful tips.

Handling software, lighting, and logging on

• Make sure you have downloaded the software ahead of time and know how to use it. Avail yourself of any technical information and support your doctor’s office has to offer. A laptop or tablet allows for a broader view than a cell phone, if possible.
• Sit somewhere with a strong internet connection that is quiet with good lighting. It’s not going to be the best visit if you can’t see or hear each other.
• Log on at least five to 10 minutes before the visit, in case there are any technical problems. If your doctor is ready early, you might even be able to start early. It’s also important to be on time, because it’s harder for doctors to run late with video visits, so you may end up with a shorter visit if you are late.

Steps to help you and your child get the most from each telehealth visit

• Be prepared for the visit. Know what you want to cover. Have any medications handy so that you can

The first thing that came to mind when I heard about COVID restrictions and mitigation strategies was how exceptionally dangerous this time could be for women living with abusive partners. “Self-isolate,” “stay at home,” “practice social distancing,” and “recession” are all words likely to be terrifying to many women who are living with intimate partner violence (IPV). The lives of these women are often filled with fear and danger under normal circumstances, but during this new normal of the global pandemic, the lives of these very often “invisible victims” are at an increased risk for more violence — and even murder.

Prior to the COVID pandemic, epidemiological estimates showed that nearly one in three women experience IPV, and approximately one in four women experience severe IPV. Other data show that nearly half of all female homicides are from a current or past male intimate partner. Although these numbers are already unacceptably high, historical data show increases in rates of IPV during pandemics and times of economic crisis. Other data show that domestic violence tends to increase when families spend more time together, such as over the holidays.

COVID restrictions have caused a spike in IPV

Unfortunately, the realities of COVID-19 and its restrictions have indeed caused a perfect storm for women experiencing IPV. First, there have been numerous media reports indicating huge spikes in calls to IPV hotlines, sometimes doubling and tripling the typical number of requests for help, after stay-in-place orders were mandated.

Second, reports have indicated frightening increases in femicide from IPV. The UK has reported femicide rates higher than they have been in the past 11 years, double the average for a 21-day period. Mexico has reported an 8% increase in femicides, with nearly 1,000 women murdered in the first three months of the year. These

Functional dyspepsia (FD) is a common condition, loosely defined by some physicians as a stomach ache without a clear cause. More specifically, it is characterized by the feeling of fullness during or after a meal, or a burning sensation in the mid-upper abdomen, just below the rib cage (not necessarily associated with meals). The symptoms can be severe enough to interfere with finishing meals or participating in regular daily activities.

Those with FD often go through multiple tests like upper endoscopy, CT scan, and gastric emptying study. But despite often-severe symptoms, no clear cause (such as cancer, ulcer disease, or other inflammation) is identified.

Acid reflux, the stomach, and the small intestine

Because there is no clear cause for symptoms, treating FD is challenging as well. The first step in treatment is usually to check for bacteria called H. pylori that can cause inflammation of the stomach and small intestine. If H. pylori is present, the person is treated with a course of antibiotics.

For those without H. pylori infection, or with symptoms that persist despite elimination of this bacteria, the next step is usually a trial of a proton-pump inhibitor (PPI). PPIs, which include omeprazole (Prilosec), esomeprazole (Nexium), and lansoprazole (Prevacid), suppress the stomach’s acid production. PPIs may help those patients whose FD symptoms are driven in part by acid reflux disease. PPIs may also reduce the concentration of certain inflammatory cells in the duodenum (the first part of the small intestine), which may also play a significant role in functional dyspepsia.

The brain-gut connection

Tricyclic antidepressants (TCAs) are another class of medications that are often used to treat FD. In some people, FD is thought to be due to an abnormal brain-gut interaction. Specifically, these individuals may have overactive sensory nerves supplying the GI tract, or abnormal

The COVID-19 pandemic has been stressful for all of us, and this includes our youngest children.

It’s easy, and tempting, to think that infants, toddlers, and preschoolers aren’t affected by the pandemic. The truth is, though, that that life has changed for them, too — and for some of them it has changed dramatically. Even if the change is mostly positive for them — such as having their parents home all the time — it’s still a change that can be confusing and unsettling. Young children are less able to understand the nuances of all of this; for them, the world truly is all about them. And they also have very acute radar when it comes to the emotions of their caregivers.

As a pediatrician, I’ve been hearing from families about young children who are having trouble sleeping, whose eating habits have changed, who are crying or throwing tantrums for no good reason, or are just generally crankier and more irritable than usual. Some are more clingy, which can get tough for parents who are working from home.

So what can a parent do? It should be said up front that there are no magic answers or quick fixes; this is a hard time, and it’s going to stay hard until case numbers go down a lot or there is a vaccine, or both. But that doesn’t mean that there aren’t some strategies that can help.

Talk to your children about the pandemic — but keep it simple and optimistic

Obviously, this is more about preschoolers than infants and toddlers, but you need to have an explanation for why you can’t go on the swings or visit Grandma, or why you have to do a Zoom meeting instead of playing with blocks. Tell them that there is a germ that