Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
What does a pediatric urologist do? In adults they almost
always deal with problems in men, but in kids, there are
different problems. First, urinary tract infections under the
age of five require investigation for a problem called reflux
when urine goes the wrong way up towards the kidney from the
bladder. This could lead to kidney failure and sometimes needs
to be corrected surgically. In boys, an undescended teste and
a twisted one are causes for surgery. The latter is an
emergency and should be taken very seriously. The former
should not be left alone, but watched closely as surgery is
occasionally required there.
One disease in the same area that is common to kids and old
men is a hernia, where a piece of bowel slides through the
stomach wall and can get caught. This could be an emergency.
Again, take stomach pain with an abdominal mass seriously.
What does a pediatric ophthalmologist do? Infants can be born
with glaucoma and, of course, scratched eyes are quite common.
Most deal with "lazy eye," that is strabismus. Often this can
be corrected by patching and/or glasses.
What does a pediatric dentist do? Fluoride treatments are a
must for children's developing teeth, especially in places
that do not fluoridate drinking water. Children often have
teeth knocked loose. If they are baby teeth, we do not replace
them. Another common problem is that people put their children
to bed with bottles of milk, which rot children's teeth while
they sleep. Braces for crooked teeth are commonly taken care
of at this time.
What does a pediatric orthopedist do? Kids' bones are a lot
softer than adults' and often the breaks are only halfway.
This is termed a greenstick fracture and heals very well. A
buckle fracture is also common and is due to forces on the
bones that cause it to fracture in one small area. Again, they
do very well. Genu Vera, or bow-leggedness is now left alone,
as it often heals itself. Osgood Schlatter's disease is common
in teenage boys. It is pain from a tendon that pulls off a
piece of developing bone in the knee.
Pediatric neurologists spend most of their time dealing with
seizures, especially one seen only in kids called petit mal
where children seem to be somewhere far away for a few
seconds. Write me in care of the Yated.
A message from Glaxo, sponsor of this column. Some
seizures are tough to treat with conventional anti-seizure
medications, and this is where Lamactil can be helpful. Proven
effective--speak to your neurologist.
* * *
What does a pediatric oncologist do? These are the saddest
cases, but there is a ray of hope here too. The most common
cancers: colon, lung, prostate, cancer of the mammary glands,
are just not seen in children. They suffer from cancers like
leukemia, Hodgkin's and various rare cancers like Wilm's tumor
of the kidney and Ewing's sarcoma of the bone.
However, kids are more resilient than adults and as a result,
Hodgkin's now has an almost 99 percent cure rate when
treatment is begun in a timely fashion. ALI, a form of
leukemia that is lethal in adults, has about a 75 percent cure
rate. While cancers in adults often have remission before
returning, in these two diseases in kids the cancer is cured
forever.
While it isn't my practice to mention organizations, here I
must say a word about the cancer help organizations. One of my
readers is Rav Pinsky, who organizes activities for children
stricken by cancer here in Israel. I am very impressed by his
work and those of all organizations who help these people and
hope that the zechus of their chesed will lead
to a cure for this terrible scourge in the near future.
What does a pediatric ENT do? These doctors deal with problems
of the ear, nose and throat. In kids that usually refers to
tonsils and adenoids, which are now recognized to serve as
disease fighting organs. Nevertheless, if your child suffers
from frequent strep throat, that is, more than two a year,
then you should consider having these removed, as the
operation is much more painful as a child gets older.
They also deal with tubes in ear drums for children with
frequent ear infections. Lastly, they deal with foreign bodies
in these orifices which in the case of the ear can be pretty
tricky. It should be noted that nosebleeds in children, unlike
with the elderly, are usually of no consequence.
I'll just take this opportunity to address a question about
exercise for infants. We do know that infants needs to be
stimulated to develop properly, but this should be in the form
of games that stimulate grasp, colors and the like. True
exercise is unnecessary for babies. However, professional
programs such as Gymboree can be tried. This information was
provided to me by Dr. Lazar, who is the head of the pediatric
emergency department in my hospital. Write me in care of the
Yated.
A message from Glaxo, sponsor of this column. We just
spoke about strep throat, and while Penicillin is the first
drug to use, occasionally strep can be hard to eradicate.
Augmentin never fails in strep throat and can be given twice a
day.
