Author Archives: ChildrensMN

8 tips to prevent poisoning

With one of the busiest pediatric emergency medicine programs in the nation and more than 90,000 emergency department visits annually for a variety of reasons, you can trust we’ve treated just about everything. We love kids here at Children’s, but we’d rather see them safe at home.

In recognition of Poison Prevention Awareness Week (March 15-21), we’ve gathered tips from our experts. Share these tips with your kids and print them to share at their schools or with your friends. Together, we can make safe simple.

Keep all potential poisons up high and out of the reach of children — in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze. (iStock photo / Getty Images)

What is Poison Prevention Week?

National Poison Prevention Week was established by Congress in 1961 for annual, national recognition. The goal of the week is to educate the public about poisoning risks and what to do to prevent poisonings.

What you should know

Did you know that injuries are a leading cause of death in children? Each year, 5,000 kids die and another 6 million are hurt as a result of unintentional injuries. One in 4 children is hurt seriously enough to need medical attention. Most childhood injuries occur at home, and many of these injuries, including poisoning, could be prevented.

Facts about poisoning

  • More than 1 million accidental poisonings per year occur in children younger than 6 years old.
  • Approximately 1 in 10 poisonings involves cleaning products.
  • Approximately 1 in 10 poisonings involves indoor and outdoor plants.
  • Approximately 1 in 20 poisonings are caused by cosmetic and personal-care products.

Tips to prevent poisoning

  • Review the poison prevention home checklist from the Minnesota Regional Poison Center.
  • Keep all potential poisons up high and out of the reach of children — preferably in a locked storage container. Set up safe storage areas for medications, household cleaners, and chemicals like antifreeze.
  • Keep medications and vitamins out of the reach of children. Never call medicine “candy.”
  • Keep foods and household products separated.
  • Keep products in original containers. Do not use food storage containers to store poisonous substances (i.e. plant food in a drink bottle).
  • Destroy old medications.
  • Identify all household plants to determine if poisonous.
  • Post the Poison Center phone number, 1 (800) 222-1222, near each phone in the home.

subscribe_blogWhat do you do if you suspect someone has been poisoned?

  • Swallowed poison: Remove anything remaining in the mouth. If a person is able to swallow, give about 2 ounces of water to drink.
  • Poison in the eye: Gently flush the eye for 10 minutes using medium-warm water.
  • Poison on the skin: Remove any contaminated clothing and rinse skin with large amounts of water for 10 minutes.
  • Inhaled poison: Get fresh air as soon as possible.
  • Call the Poison Center, 1 (800) 222-1222, immediately.
CROSSWORD PUZZLE: Poison Search

Cognitive-behavioral therapy for insomnia an option for kids with sleep trouble

Cognitive-behavioral therapy for insomnia (CBT-I) requires regular visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. (iStock photo)

Cognitive-behavioral therapy for insomnia (CBT-I) requires regular visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. (iStock photo)

Terese Amble, PsyD, LP

Insomnia is broadly defined as difficulty falling asleep, staying asleep and/or subjective, poor-quality (“non-restorative”) sleep.

Everyone has problems sleeping at times; however, a diagnosis of insomnia is made if sleep problems persist for more than one month and result in some degree of daytime impairment. Untreated insomnia can result in chronic sleep loss that can cause excessive daytime sleepiness and impact daytime functioning, which may range from fatigue, moodiness/irritability or mild cognitive or behavioral problems (difficulties with concentration/attention, hyperactivity) to significant effects on mood, behavior or school performance. Chronic insomnia also increases the risk of physical and mental illness.

Given the negative impact of chronic poor sleep, it is important to have sleep problems evaluated and treated. Behavioral treatments are the first line treatment for insomnia and involve improving sleep without the use of medications, as there are no medications that are FDA-approved for the treatment of insomnia in youth. Cognitive-behavioral therapy for insomnia, commonly referred to as CBT-I, is a safe and effective treatment that aims to help children and adolescents identify and replace thoughts and behaviors that cause or worsen sleep problems with thoughts and behaviors that promote sound sleep.

CBT-I requires regular (usually weekly or biweekly) visits with a sleep provider who will work with you and your child to help change the way he or she sleeps. The frequency of treatment may vary from as few as two sessions to as many as eight of more sessions, depending on the specific sleep concerns and progress. At the beginning of treatment, a comprehensive sleep evaluation will be conducted to determine factors that are underlying or contributing to sleep difficulties and to help develop an effective treatment plan. As part of this initial evaluation, you will be asked to keep a sleep log of your child’s sleep patterns for one to two weeks and your child may be asked to wear an actigraph, a portable wristwatch-like device which records and stores more objective information about body movements and sleep-wake patterns.

subscribe_blogAfter this initial evaluation, treatment is individualized and each session is focused on learning specific cognitive and behavioral strategies to improve sleep. The cognitive part of CBT-I involves teaching your child techniques to quiet his or her busy mind at night to relax and fall asleep. Your child will learn strategies to recognize, modify or eliminate unhelpful/negative thoughts or worries that interfere with his or her ability to sleep, including unrealistic beliefs and attitudes about sleep and the possible daytime consequences of poor sleep (e.g. “I’ll never be able to fall asleep tonight,” “If I can’t fall asleep, I won’t be able to get up in the morning and I’ll miss my test”).

The behavioral part of CBT-I involves identifying and changing behaviors that may keep your child from sleeping well and developing good sleep habits to promote quality sleep. Treatment is tailored to each child or adolescent and may include some combination of the following techniques:

  • Sleep restriction: This strategy involves temporarily restricting the total time in bed to current amount of sleep each night to decrease the amount of time spent in bed awake. Being extra-sleepy can help your child fall asleep quickly and stay asleep. Once sleep has improved, the amount of time in bed is gradually increased until desired bedtime is reached.
  • Stimulus control: This technique involves eliminating any activities in bed that are not conducive to sleeping to disrupt the association between being in bed and wakefulness (and strengthen the association between being in bed and sleepiness). Stimulus control instructions often include only going to bed when sleepy, leaving the bed (and possibly bedroom) to engage in a quiet activity if not asleep within 15-20 minutes and only using the bed for sleeping both during the day and at night (not watching TV, doing homework, worrying, etc.).
  • Sleep hygiene: This involves learning positive sleep practices and habits that are important for getting sound sleep, such as establishing an optimal sleep environment, implementing a developmentally appropriate and consistent bedtime and wakeup time (no matter how much sleep you got the night before!), avoiding naps, establishing a calming, consistent bedtime routine, decreasing stimulation near bedtime (caffeine, physical activity, conflict/stress) and removing electronics from the bedroom.
  • Relaxation training: Increased mental activity at night (such as worrying or not being able to “switch off” an active, busy mind) or stress about not being able to fall asleep leads to increased activity and tension in the body, which further interferes with the ability to unwind and fall asleep. Relaxation strategies, such as deep breathing, visual imagery, progressive muscle relaxation, autogenics, meditation and mindfulness can be used to help quiet the mind and calm the body at night and improve sleep.

Given the potential negative consequences of chronic sleep loss, it’s important to actively treat sleep problems. CBT-I is a safe and effective way to treat insomnia in children and adolescents without the use of medications. CBT-I is generally short term, but the skills learned during this treatment can lead to lasting, improved sleep if positive habits are maintained.

Terese Amble, PsyD, LP, is a pediatric psychologist in the sleep center at Children’s Hospitals and Clinics of Minnesota.

Children’s welcomes new neurologist

five_question_friday111In recognition of Brain Injury Awareness Month and our focus on neurology, we’d like you to meet Douglas Hyder, MD, in this edition of Five Question Friday.

Douglas Hyder, MD

Douglas Hyder, MD

What is your job at Children’s? Describe your role.

I am a pediatric neurologist. Pediatric neurology is a medical field focusing on the growth and development of the central nervous system, peripheral nervous system, and muscles. There is significant overlap with developmental pediatrics, psychiatry, psychology, neurosurgery, orthopedics, physical medicine and rehabilitation (PM&R), ophthalmology, genetics, physical therapy, speech therapy and occupational therapy. My job is similar to a detective. I look for clues in a patient’s history and physical exam to find out why something is happening and what can be done about it. Not all of the symptoms we see are necessarily abnormal.

We’re fortunate that there has been tremendous progress in diagnosis and treatment of neurological conditions over the past few decades. The work is far from complete, but we can offer so much more to patients today than when I first started in neurology 20 years ago.

How long have you worked at Children’s?

I’ve only been here a couple of months, but I’m originally from the Midwest, so the Twin Cities already feels like home.

What do you love most about your job?

I most enjoy teaching. Many of the conditions we diagnose need to be explained well in order for parents to understand what is going on with their child. I try to do that with all of my patients, but those light-bulb moments are especially gratifying.

subscribe_blogWhen you were a kid, what did you want to be when you grew up?

Everything; a cowboy, scuba diver, race-car driver, drummer, police officer, astronaut, president, boxer, baseball player!

I still want to be a race-car driver.

What do you enjoy doing outside of work?

Bicycling. I try to ride every day when it’s not too cold.

Prepare your child’s sleep for daylight saving time

Four days before daylight saving time starts, get your child to bed 15 minutes earlier the first night. (iStock photo)

Four days before daylight saving time starts, get your child to bed 15 minutes earlier the first night. (iStock photo)

Karen Johnson, APRN

Preparation is the key to minimize the impact of daylight saving time on your child’s sleep patterns. It’s a good idea to get your child into bed a little earlier in the week leading up to the time change.

subscribe_blogChange the child’s body clock

Four days before daylight saving time starts — it takes place at 2 a.m. Sunday, March 8 — get your child to bed 15 minutes earlier the first night. Your child may not actually go to sleep earlier, but by getting him or her to bed sooner, you are encouraging the body to relax earlier than usual. This will lead to falling asleep earlier, too. Make the child’s bedtime progressively earlier by 15 minutes each of the four nights before daylight saving time until it adds up to an hour the night of the time change.

Daylight saving time sleep tips

Make sure that the bedroom is dark. The big challenge for parents during daylight saving time is having the child go to bed when the sun is out. Sleep is influenced by having a dark environment, as this allows for the natural secretion of melatonin that is needed to invite sleepiness.

Calm bedtime routine

Take extra care to ensure that the bedtime routine is calm and as relaxing as it can be. A calm and regular bedtime routine is best, without debates and arguing to promote sleep.

Waking too early

Ensure that your child understands that it’s not time to get up for the day. Encourage him or her to go back to sleep. Some parents put a clock beside their child’s bed and explain what time it has to be before the child can get up for the day. If you have a toddler or young child, use a sleep clock such as the Good Nite Lite. The light is a cue that informs your child to stay in bed until the sun shines on the clock in the morning. This isn’t just effective for time changes; it also can help you train an early riser not to wake Mommy and Daddy too early in the morning and may help with bedtime battles.

Get some sun

Besides making sure to get the proper amount of sleep, early morning bright light exposure also can help set a regular sleep-and-wake pattern called a “circadian rhythm.” Eating breakfast in a bright part of your house or going for an early morning walk outside in the sun will help you and your child wake easier as well.

Daily physical activity is recommended for all children, but don’t try to wear your child out in an effort to get him or her to sleep earlier. Overtired children often take longer to fall asleep and may even resist sleep completely.

Be consistent

While your child is getting used to the new sleep schedule, stick to your usual bedtime rules and routine.

Be patient during this time adjustment as you may have a tired and grumpy child on your hands in the days after the time change. It generally takes about a week after the clocks have changed to be in a new sleeping pattern. Prepare to feel unfocused in the days after you set clocks forward. You might want to keep your family’s schedule more open in the days after daylight saving time in case you aren’t well rested.

Other tips

  • Newborn babies usually are not affected by the start and finish of daylight saving time.
  • Change clocks Saturday evening before going to bed.
  • Check the smoke alarms. Changing the batteries as a good safety rule.
  • If your child has difficulty sleeping, please contact the Children’s Sleep Center.

Karen Johnson, APRN, is a certified nurse practitioner at the Children’s Sleep Center.

Meet a familiar face from Children’s

five_question_friday111If you’ve visited Starz Café at Children’s – Minneapolis, there’s a good chance you’ve seen Latisa Tyus. She and her smile are a Starz staple. Get to know Latisa in this edition of Five Question Friday.

Latisa Tyus has been with Children's for 17 years.

Latisa Tyus has been with Children’s for 17 years.

What is your title? Describe your role.

I’m a dietary aide in Nutrition Services. Currently I work as the cashier in Starz Café.  I ring up customers, set up food and beverages and clean the tables in the café.

How long have you worked at Children’s?

I have worked at Children’s for 17 years.

What do you love most about your job?

The thing I love most of all is putting a smile on people’s faces when they are having a tough day. Whether it’s a patient’s family, staff or a visitor, I love being able to make people smile.

Do you have a favorite memory from working at Children’s?

subscribe_blogI remember when I started here and had been here only three days. Christine from the lab came in to collect a prize from the café, and I told her I was new and had to find someone to give her the prize. She was just so nice to me, and I still remember what she was wearing. To this day we still talk about how nice it is to work in such a great community here at Children’s.

How do you spend your time outside of work?

I enjoy spending time with my family and friends. I love going to sporting events and love watching them on TV. I enjoy reading thriller books and am a music fanatic. I especially like music from the ’70s-’90s.

Mindfulness a technique to relieve stress

Many teachers of mindfulness suggest visualizing thoughts as leaves floating down a stream or as clouds drifting by in the sky. (iStock photo / Getty Images)

subscribe_blogLeslie Partin

Whether you’re a busy, working parent or a teen trying to balance a full social calendar and school, life can be stressful at times. Mindfulness, otherwise known as mindful meditation or mindfulness-based stress reduction (MSBR), is a tool any one of us can use as we navigate through the demands of our days.

The basic tenet of mindfulness is paying attention to the present moment. So much of the time we’re thinking ahead to the next task or mulling over something that happened in the past. For example, have you ever driven past the exit you intended to take, only to realize you missed it because you were thinking of something else? When we are caught up in our thoughts, we miss what is happening around us like that missed freeway exit.

Our minds are powerful, and we can harness that power to help us manage difficult experiences and distressing (or afflictive) emotions. When we are in the midst of a strong emotion or physical sensation like anger, sadness, disappointment or physical pain, it can feel like things will never get better. But if we’re able to step back and observe our distress, we may notice that it changes, ebbs and flows. Noticing and recognizing that the intensity varies, whether it’s an emotion or physical sensation, offers hope and reassurance that it won’t always be so hard. And when we focus on what we’re experiencing right now, instead of what’s going to happen — “I don’t want to have a headache at the dance,” “I don’t want to be stressed out at my child’s game,” etc. — then we don’t add the additional suffering of anticipation or worry. We suffer when we focus too much attention on what may happen in the future.

Mindfulness doesn’t mean trying not to think or making one’s mind blank. Instead, mindfulness teaches us to watch our thoughts, observe them while not attaching to them. Many teachers suggest visualizing thoughts as leaves floating down a stream or as clouds drifting by in the sky. Practitioners of meditation say that having a regular “practice” — a time set aside to practice meditation — allows us to develop our capability to be mindful in times of distress. It’s like building our mental muscles in the same way we build physical muscles by lifting weights or working out. Committing to a meditation or mindfulness practice helps us develop those muscles so we have the ability to use them when we need them most.

Neuroscience studies show us that the brain develops neuro-pathways as a result of our thinking habits and patterns. Similar to the way a trail through the woods is developed by animals and people following the same path over and over, our neuro-pathways, or thought habits, are made as we repeatedly take the same path of worry, fear, joy, happiness, etc. Mindfulness is one technique we can use to help form new neuro-pathways or mental habits. When we practice mindfulness we increase awareness of all of our thoughts and emotions, the positive as well as the afflictive ones. We then can choose which thoughts, emotions and sensations we want to focus on and nurture, and of which ones we want to let go. Remembering that we have this choice can help us cope when we hit stressful times.

If you’re interested in learning more about mindfulness, here are few links that can help you and your family get started (the first six links are centers that are located in the Twin Cities):

The Kiran Stordalen and Horst Rechelbacher Pediatric Pain, Palliative and Integrative Medicine Clinic at Children’s – Minneapolis has medical providers that work with children to teach relaxation techniques that can include the use of mindfulness. These strategies are helpful for chronic conditions such headaches and abdominal pain or problems with sleep and anxiety.


[1] Jon Kabat-Zinn developed Mindfulness Based Stress Reduction programs in Massachusetts and has several books and CDs, which provide a good starting point. “Everyday Blessings” is his book on mindful parenting, with Myla Kabat-Zinn.

Leslie Partin is a social worker at Children’s Hospitals and Clinics of Minnesota.

Wisconsin boy overcomes tumor inside heart

Doctors discovered a tumor inside the heart of Cole Eckes, 4, of Hayward, Wis., when he was an infant. (Photos courtesy of Kylah Eckes)

Doctors discovered a tumor inside the heart of Cole Eckes, 4, of Hayward, Wis., when he was an infant. (Photos courtesy of Kylah Eckes)

Kylah Eckes

Three-year-old Tara was excited to become a big sister. Cole was perfect when he was born; he had beautiful skin, bright eyes, and long fingers and toes.

He was perfect.

Little did we know, there was something imperfect about our baby boy.

When Cole was 12 weeks old, he had a funky cough, so I brought him to Essentia Health-Hayward (Wis.) Clinic to see our family physician. After reviewing the symptoms, our doctor ordered a chest X-ray to determine the problem. Of course, I cringed at the thought of my baby having pneumonia. Cole also had mild pectus excavatum — a sunken-in chest — so an X-ray would help monitor, too.

As I left the clinic, I told the receptionist that I was worried about pneumonia. In hindsight, we would have given anything for the diagnosis to have been pneumonia.

We spent most of the next 12 days at Children’s – Minneapolis, meeting people with titles we didn’t know existed. We waited for an official diagnosis and to meet someone who knew what to do. Cole underwent all kinds of tests, imaging and exams. Ultimately, the diagnosis was cardiac fibroma, a rare tumor of the heart. One day during morning rounds, we heard one of the cardiologists tell the other specialists that the main potential side effect of the mass is “sudden death.” Those words still ring loudly in my ear. Cole is only the 21st living case of this type of tumor, so there wasn’t much data to help lead the specialists. The surgeons didn’t want to perform surgery to remove the mass because of its large size — same size as his heart — and location — inside the back wall of the left ventricle. Surgery was too risky, and the tumor wasn’t impeding on the functions of the heart, so we just had to “keep an eye on it.”

Cole had surgery Feb. 8, 2011.

Cole had heart surgery Feb. 8, 2011.

At Children’s – Minneapolis, my husband, Zac, and I learned infant CPR and how to use an automated external defibrillator (AED). We received two AEDs but were terrified to bring Cole home, an uncomfortable three hours away.

Over the next five months, every nap that lasted a bit longer than normal sent my mind racing; I was scared to go in and check on Cole. During that period, we gave Cole antiarrhythmic medication every six hours and saw his electrophysiologist, Dr. Chris Carter, regularly.

On Dec. 26, 2010, when Cole was 7 months old, he experienced ventricular fibrillation, a rapid heartbeat, at home. Zac administered CPR and used our AED to put Cole’s heart back into normal rhythm. Cole was flown to Children’s that night.

He went into v-fib, again, four days later.

“Dr. Blue, fourth floor, CVCC,” the voice over the intercom said.

That was a call for our son. The staff at Children’s seemed to come out of everywhere, flooding Cole’s room with the best team for which parents could ask. Zac and I stood in the hall as they worked on Cole for 55 minutes. One of the intensivists informed us that it was time for us to make a decision: ECMO (extracorporeal membrane oxygenation), a type of life support; or end resuscitation. No one knew how Cole would respond to ECMO. There was no guarantee Cole would survive, and, if he did, everyone was unsure about the status of his cognitive functions. We couldn’t give up on him, so we chose ECMO.

For four days, Zac and I watched the staff care for Cole. All we could do was kiss his cold forehead and hold his cold little hand. Cole slowly was weaned off of ECMO, although it was discovered that he suffered numerous strokes and bleeding in the brain.

It was obvious that something needed to be done about the tumor. Surgery was scheduled for Feb. 8, 2011, Tara’s fourth birthday.

Life was an absolute roller coaster, but one thing remained constant: the care Cole received from the staff at Children’s. These people became like family to us. We trusted them to care for our son, and they did so with evident care and dedication. They were with us for the highest of highs and the lowest of lows. They stood by our sides when we looked at Cole lying in his hospital bed. We truly felt Cole was in the best hands when we went to the Ronald McDonald House, one floor below Cole’s bed, every morning for breakfast. This is where we spent time with Tara when she came to visit us with other family members.

I remember numerous conversations with doctors that put my mind at ease. I sat for nearly two hours on Cole’s couch, talking to one of the intensivists. She was able to help me understand what was happening.

Kylah and Zac Eckes with children Cole and Tara

Kylah and Zac Eckes with children Cole and Tara

On the morning of Cole’s surgery, we said goodbye to him because no one knew if he would survive surgery. Would his heart be able to function without the tumor? A large group of family members sat with us in the waiting room for eight hours. We received periodic updates from staff we had gotten to know well.

Dr. David Overman walked down the hall a little past 6 p.m. to deliver the most amazing news we could have heard: Cole made it through surgery. Not only did he survive, but he didn’t need the help of ECMO, which was a possibility had he made it through surgery.

Although surgery was over and the tumor removal was successfully, Cole wasn’t out of the woods. The next 12 hours were critical. Nurses spent the night stripping Cole’s tubes to make sure there were no blood clots; their dedication was remarkable. They weren’t just doing their jobs; they were helping a baby they cared about.

We were on our way home 10 days later. Walking out of the doors to the cardiovascular care center was bittersweet. We said goodbye to people who came to mean a great deal to us and thanked them over and over for all of the amazing things they did for Cole and our family even though “thank you” wasn’t nearly big enough to show our appreciation.

Today, Cole is 4 and in preschool, getting ready for kindergarten in the fall. He continues to beat the odds. He has fun playing with Tara and his little sister, Ayda. He loves to golf and is looking forward to start logrolling this summer. He still has an internal cardiac defibrillator (ICD) that was placed during the early part of his stay at Children’s. The ICD continuously monitors his heart rhythms and would deliver a shock if his heart were to have another episode, but we’re hopeful and optimistic that Cole will never need that type of intervention again.

Cole

From left: Siblings Tara, Ayda and Cole Eckes

subscribe_blogTara, now 8, participates in Jump Rope For Heart at her school. The annual event raises money for the American Heart Association. She raised more than $2,500 at last year’s event. She tells people about the importance of helping others and paying it forward because so many people helped us when we needed it. Her dedication to helping others landed her on the cover of Time For Kids magazine.

Cole sees his team at Children’s Heart Clinic every six months for checkups. We look forward to these visits to hear good news and to show everyone how far Cole has come. We repeatedly have heard from various staff members that Cole is a reminder to them of why they do what they do.

What you may not know about eating disorders

You may think you know a lot about eating disorders — that they’re caused by the social pressure to look like models, or that they’re all about weight loss and excessive exercise — but there’s more than meets the eye when it comes to identifying and treating these serious conditions.

In recognition of National Eating Disorder Awareness Week, our team from Children’s Center for the Treatment of Eating Disorders clears up some common misconceptions about anorexia nervosa, bulimia nervosa and binge-eating disorder as well as provides signs that may indicate that your child or teen is suffering from an eating disorder.

Full recovery can take months or years but is possible. Many individuals go on to be free from their eating disorder, while others may have residual symptoms or remain at risk for relapse. (iStock photo / Getty Images)

Myth No. 1: People choose to have this illness.

Eating disorders develop as a result of complex genetic, psychological, social or environmental factors. They’re serious and potentially life threatening, and serious physiological (e.g., cardiac arrhythmias, kidney failure, death) and psychiatric (e.g., depression, substance abuse, suicidality) costs can accrue. In fact, among mental health diagnoses, eating disorders have the highest mortality rate. Someone doesn’t choose to have an eating disorder, just as people don’t choose to have cancer.

Myth No. 2: Eating disorders are caused by families.

Families do NOT cause eating disorders. This is a common myth that must be emphasized. There is no evidence showing that parenting styles or family dynamics play a role in the onset of eating disorders. Eating disorders can affect anyone.

Myth No. 3: Eating disorders are all about food.

Extreme or unhealthy dieting behaviors are associated with eating disorders, but eating disorders simply are not about food or controlling eating. In fact, people with eating disorders may either have a false sense of or complete loss of control over their eating. The core features of eating disorders are theorized to be the over-evaluation of weight and shape.

Myth No. 4: Only females are affected by eating disorders.

Eating disorders can affect anyone, males or females, across all cultural and socioeconomic backgrounds, and among all age groups ranging from young children to the elderly. However, eating disorders predominantly target females and typically strike during adolescence and young adulthood.

Myth No. 5: You have to be thin to have an eating disorder.

It is impossible to know whether a person has an eating disorder just by looking at him or her, as people with eating disorders can appear thin, normal weight or overweight. Regardless of how a person appears or how much a person weighs, he or she might have an eating disorder and be engaging in harmful eating disorder behaviors.

Myth No. 6: People with an eating disorder can change but choose not to.

Although people with eating disorders may resist treatment or push family or friends away if they try to help, this is just a symptom of his or her illness. They also cannot choose to “just eat.” Eating disorders are serious mental illnesses that require professional treatment. The sooner a person with an eating disorder gets help, the better his or her chances are of recovering. Fortunately, we have effective therapies to treat eating disorders. At Children’s Center for the Treatment of Eating Disorders, our clinicians are trained and have experience in delivery of these evidence-based treatments.

Myth No. 7: Once someone is treated for an eating disorder, he or she is cured for life.

Full recovery can take months or years but is possible. Many individuals go on to be free from their eating disorder, while others may have residual symptoms or remain at risk for relapse.

How to recognize an eating disorder

As illustrated above, eating disorders are complex. They may begin with a well-intended attempt to “get healthy” or “eat healthier.” Eating disorders also may look different for each child or adolescent. Some of the following may be warning signs that your child or adolescent is developing or has developed an eating disorder.

subscribe_blogPhysical signs:

  • Rapid or excessive weight loss
  • Dramatic weight gain
  • Development of fine facial or body hair
  • Lack of energy
  • Dizziness or fainting
  • Feeling or complaining of being cold
  • Constipation
  • Vomiting
  • Dry skin
  • Hair loss
  • Dental erosion
  • Calluses on knuckles from self-induced vomiting
  • Decreased heart rate
  • Absent or irregular menstruation in females

 Cognitive signs:

  • Belief that he or she is “fat”
  • Afraid of gaining weight or becoming fat
  • Afraid of being able to stop eating
  • Denies having a problem or an eating disorder
  • Obsesses about body image, appearance or clothing
  • Difficulty concentrating
  • Depression or withdrawal
  • Irritability
  • Self-worth appears strongly related to weight or shape
  • Obsessiveness 

Behavioral signs:

  • Refuses to eat normal types or amounts of food
  • Eats large amounts of food in a short period of time (binge-eating)
  • Self-induces vomiting
  • Over-exercising
  • Takes laxatives or diet pills
  • Hoarding, hiding or throwing away food
  • Engages in food rituals or has food rules, including calorie limits, measuring food or rules about what he or she should or shouldn’t eat
  • Categorizes food into “good” and “bad”
  • Refuses to eat “unhealthy” or “bad” foods
  • Eats only certain foods or only eats at specified times
  • Often says “I’m not hungry”
  • Makes excuses to avoid eating at mealtimes
  • Withdrawal from friends or activities
  • Eating in secret so that you are not aware of what he or she is eating

If you suspect that your child has an eating disorder or you have noticed some of these symptoms, it’s important to seek professional help as soon as possible. Trust your instincts as parents. Don’t wait until things get worse.

We encourage you to educate yourself and ask questions. We also encourage you to contact the Center for the Treatment of Eating Disorders at Children’s to schedule an appointment for your child to have a thorough evaluation and to explore treatment options. Contact us at (612) 813-7179.

Preparing yourself for your child’s surgery

Visiting the hospital ahead of time gives everyone a chance to learn more about what to expect and what’s helpful to do ahead of time or bring with you when you come to the hospital. (2013 file photo)

Jeri Kayser

When a child needs surgery, the focus of preparation usually is with the child.

That makes sense.

We want our kids to understand what’s about to happen so they aren’t overwhelmed or traumatized by the event. They’re kids, after all, and we adults have to deal with it, right? Or, perhaps, wrong.

After more than 30 years as a child life specialist, 20 of those in surgery, I have observed that the first person to be well-prepared should be the parent. Children respond most directly to how their parents are reacting emotionally to the event to gauge their own response.

Imagine you are 3 years old and about to get your tonsils out. This is scary because it’s hard to understand what’s about to happen and frustrating you can’t control it. Age-appropriate information and a supportive staff are helpful, but if you notice your mom or dad is anxious, nothing else matters. You got the message: You should be anxious, too, especially if your parents are trying to suppress their emotions – that is even scarier to a child. You can tell that they are upset, but you don’t know why, so you imagine the worst. If you’re a teenager, you might pick up on the message that we don’t talk about this and it will upset your mom if you bring it up to her. It’s hard to deal with the unspoken stress of your family as well as your own fears and concerns.

When I’ve observed kids coping successfully with the challenges of a health care experience, I have noticed that their families have prepared themselves with some or all of the following techniques:

Seek information

Find out what is happening and why. What are the expected outcomes?  What types of things can you as a family plan on doing to foster your child’s healing?

Attend a pre-admission tour

On our hospital’s website there is helpful information about surgery and how to sign up for a tour. Visiting the hospital ahead of time gives everyone a chance to learn more about what to expect and what’s helpful to do ahead of time or bring with you when you come to the hospital.

Make a list

Write down a list of questions to bring to meetings with health care providers. I remember one family kept an ongoing list in their kitchen for anyone to write down questions, and they all contributed, even the siblings. Everyone had a say, and the questions helped everyone feel a part of the event. Knowledge helps you be in control and having specific tasks you can do to support your child in his or her recovery provides focus and direction.

subscribe_blogBe honest with your emotions

As a parent, our job is to love and protect our kids and guide them towards being an independent adult. It can be overwhelming to have to make decisions for your child that includes any potential discomfort since we so desperately want to keep him or her safe from life’s struggles, but learning to deal with life’s struggles is what helps kids learn to be independent. We also carry with us our own memories and experiences with health care that may help or cloud our emotional response to our child’s experience. It helps to pay attention to where your emotions about surgery differ from your child’s. You each get to own your own perspective.

Kids do best when we are honest with them. When you label your emotions and show your child what you’re doing to help yourself, your child gets to experience some phenomenal role modeling on how to cope with challenging situations.

“I am sad that your tonsils need to come out, but I am glad that the doctors can fix this and soon you will be able to breathe better at night when you’re sleeping,” a parent can say. “Let’s think of some fun things to do while you are healing!”

Take care of yourself

You know yourself best. Helping your child through the experience of surgery can be exhausting. Think about what will help you be in your best place. Whom can you call on for support? Even small favors like having someone else pick up your other kids from school can be a great stress reducer.

Plan on something nice you can do for yourself while waiting for your child’s surgery to be done or when you get home. This also can help you and your child focus forward and be reminded of the time-limiting nature of the experience. It won’t last forever, and soon you’ll be looking back on this adventure.

Cut yourself some slack. There is no perfect person, so there can be no perfect parent. Your effort is what your child will notice and appreciate.

We grow as individuals and we grow as a family when we figure out what works best for us to deal with life’s challenges. This knowledge is precious and affirming and gives us all the more strength to deal with the next adventure.

Jeri Kayser is a child life specialist at Children’s Hospitals and Clinics of Minnesota.

Children’s care shared with worldwide audience

Buildings can be seen just beyond the marina in Dubai. (Photos by Jill Bauer)

Buildings can be seen just beyond the marina in Dubai. (Photo by Jill Bauer)

Jill Bauer, MA

Recently, I was asked to represent Children’s Hospitals and Clinics of Minnesota at the four-day Arab Health Exhibition & Congress in Dubai. The invitation came from Children’s leadership and Minnesota International Medicine (MIM).

Jill Bauer stands with the spire Burj Khalifa in the background.

Jill Bauer stands with the spire Burj Khalifa in the background.

As Children’s neonatal outreach nurse for the past nine years, my role has been to network with hospital leaders and educators in our region to strengthen relationships and offer our resources, services and expertise to promote best-care practices. My role in Dubai was similar, but on a larger, international scale.

After about 20 hours of air and ground travel, I arrived in Dubai late evening Jan. 24. During the taxi ride to my hotel, my first glimpses of the city were futuristic buildings that towered to the sky and gave me impressions at times of being thrown into a sort of sci-fi movie.

Known as a “wonder of the modern world,” Dubai is full of luxury and wealth but continues to have areas where traditional souks and desserts remain; these reminded me of its Arabian heritage. Although still primarily a Muslim city, it has become a multicultural, globalized business hub with many people speaking English and obvious signs of western culture everywhere.

Members of Minnesota International Medical

Members of Minnesota International Medical

On the first morning, our group — including representatives from MIM, University of Minnesota Medical Center, Regions Hospital, North Memorial Health Care and Noran Neurological Clinic — got up early to go to the Dubai International Convention & Exhibition Centre. Upon arrival at the convention center, we definitely were not alone. More than 100,000 attendees and vendors joined us from 151 countries. It took some time to reach our booth, which was positioned in the midst of 322 U.S. vendors, including Johns Hopkins, the Mayo Clinic and Boston Children’s Hospital, in an area the size of two football fields known as the “U.S. Pavilion.” That gave some perspective about the size of the remaining convention area that housed the additional 150 countries.

During the taxi ride to my hotel, my first glimpses of the city were futuristic buildings that towered to the sky and gave me impressions at times of being thrown into a sort of sci-fi movie.

During the taxi ride to my hotel, my first glimpses of the city were futuristic buildings that towered to the sky and gave me impressions at times of being thrown into a sort of sci-fi movie.

Throughout the convention, I spoke to vendors and attendees from all over the world about MIM and Children’s services and expertise. Our group’s work created various types of relationships, including one formed with a hospital in Abu Dhabi. Networking with their group resulted in a visit to their hospital on the final day of the convention. During the visit, I was asked to do an initial assessment of their nursery and make recommendations for advancing their level of care. After an interview with the CEO, chief nursing officer and nursery manager, as well as a quick nursery tour, I was able to summarize some initial recommendations for the types of resources needed to achieve their goal. MIM will use this summary to create a service proposal for them.

I am honored to have been invited to attend the convention. I have a sense of pride and passion about representing Children’s within our region and in international settings like Arab Health. Experiences like these emphasize to me how blessed we are to possess the level of expertise and technology at Children’s that allows us the ability to offer such a high standard of cutting-edge, quality, safe care to our patients each day.

Similar to outreach in our region, international gatherings like Arab Health offer opportunities to network with the goal of improving care internationally. This leaves me with hope that one day all will have access to the quality of care that we give to our patients and families daily.

Jill Bauer, MA, is neonatal outreach nurse at Children’s Hospitals and Clinics of Minnesota.