Category Archives: Featured

Five Question Friday: Danielle Horgen

March is Brain Injury Awareness Month, and to recognize it, we chose to highlight Danielle Horgen, PA-C, of Neurosurgery at Children’s. She took some time to talk about her work with patients and life outside of Children’s.

Danielle Horgen, PA-C, has been in Neurosurgery at Children's since October 2013.

How long have you worked at Children’s?

I started working in Neurosurgery in October 2013.  I love working with children and their families and am so happy to be a part of the care provided at Children’s Hospital.

Describe your role.

I am a physician assistant in the Neurosurgery department. We have a great team consisting of three neurosurgeons, three nurse practitioners and one physician assistant. We all work together to make sure our patients receive quality care. My role is to interview and examine patients, order and interpret images, prescribe medications and provide education to patients and their families in both clinic and inpatient settings. I get to see many of these children in consultation, first-assist in their surgeries and manage their care during the hospital stay and follow-up visits. It is very rewarding to be present throughout the entire process!

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

It’s difficult to pick a favorite memory. We see some pretty amazing kids, all with unique stories and experiences, and certainly their own little personalities that are so fun to work with! I’ve been told some great jokes, participated in dance parties with nurses and patients on the floor and received some motivational speeches from some pretty inspiring kids. I once got a lesson from a little boy with a brain tumor about being happy and staying positive. Although this field has its share of difficult times, I feel that it’s an honor to be able to guide a family through these moments.

How do you spend your time outside of work?

I have been married to my husband, Darin, for eight years, and we have a chocolate Lab named Casey. I love spending my time with these two! We also have great families in Iowa and Minnesota, including 10 nieces and nephews that we love dearly and see as often as we can.

What’s one interesting fact about you?

I played tennis, softball, gymnastics and volleyball growing up. During my senior year of high school, my tennis team won the state championship in Iowa. (It probably didn’t hurt that the two top ranked players in the state played on my team, too). Despite this, my husband, who never played tennis, still can beat me almost every time.

Sleep health in children

Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. (iStock photo / Getty Images)

By Karen Johnson, RN, CNP

Getting enough sleep is essential for your child’s growth and health. Studies show that many children don’t get enough sleep each night. This can result in behavioral problems, mood swings and poor school performance. A lack of sleep also can cause problems with memory, concentration and problem solving.

Occasional bouts of sleeplessness or restless nights are normal for kids as their bodies and brains develop, and the tips below can help you ensure your kids are getting enough rest.

But sometimes your child may not be getting enough sleep due to a sleep disorder. One of the most common sleep disorders in children is Obstructive Sleep Apnea (OSA). Signs of OSA in children are loud snoring, restless sleep, gasping and hyperactivity when awake. Risk factors for having OSA in children are having enlarged tonsils or adenoids, being overweight or certain other genetic or health disorders. Speak with your child’s health care provider if you think that your child might have OSA.

Here are some tips for helping your kids get a good night’s sleep:

Create a soothing and regular routine for sleep: A routine can help your child get ready for bed much easier. Studies show that children who have a bedtime routine wake up fewer times during the night. The bedtime routine should be the same every night, such as reading one book and singing one song, not lasting more than 15 to 20 minutes.

Maintain a consistent bedtime and wake time: Keeping the wake time and bedtime the same, even on weekends and vacations, is important to help maintain circadian rhythm.

Be conscious of light and darkness: Both are very influential in sleep-wake cycles. Bright light in the morning is influential in setting the circadian rhythm and helping children wake easier. Opening the curtains in the morning to let in the sunlight is the most powerful source of light; artificial light can be helpful as well. Dim the lights in the evening prior to the bedtime routine to cue your child’s internal clock that it’s time for sleep.

Keep electronics out of the bedroom: The light from televisions, computer screens, video games and mobile devices like cellphones can prevent your child from sleeping. It’s best to turn off all electronics at least one hour before bedtime, and in their place, do a calming activity such as reading or coloring.

Naps are important: Younger children need regular and predictable naps during the day. When your child is napping only once a day, don’t let him or her nap late into the afternoon, as this will interfere with the child’s ability to fall asleep at the regular bedtime.

Teach your child how to self-soothe: At an early age, put your child into his or her crib or bed when he or she is drowsy but still awake. Teaching kids to fall asleep on their own at the beginning of the night without your presence is an important skill for them to learn. Children naturally wake two to six times a night, and if they do not know how to self-soothe, they will cry to alert you that they are awake. Not only does that disrupt their sleep, but yours as well.

No caffeine allowed: Caffeine is not recommended for kids, but if you allow your child any, make sure it is before 3 p.m., as it can delay the onset of sleep at bedtime.

Consistency is key to success: Be patient and persistent, as the investment is well worth it when your child is sleeping better.

Make sleep a priority for your child and family: Teach your child about the importance of sleep by being a good role model in your own sleep habits.

Karen Johnson, RN, PNP, is a nurse in the Children’s Sleep Center at Children’s Hospitals and Clinics of Minnesota. Her interest in pediatric sleep medicine stems from her passion to assist children in improving their sleep. She views sleep as a necessary function so that children can be alert, focus in school, reach their learning potential and have energy to play and be kids.

The Children’s Sleep Center is one of the only pediatric-centered programs in the region and one of only a handful that is nationally accredited by the American Academy of Sleep Medicine.

Girl Scout Day at Children’s – Minneapolis

Children's is hosting Girl Scout Day on March 29.

Are you the parent of a Girl Scout or the leader of a troop? If so, mark your calendar for Girl Scout Day at Children’s – Minneapolis 10 a.m. to noon Saturday, March 29.

We’re excited to be hosting our second Girl Scout Day at Children’s to bring troops together and honor their generosity and hard work for Children’s patients and their families. An exciting day of celebration will include Children’s speakers, a tour of the hospital’s public spaces, a few fun activity stations and a photo booth with Children’s mascot, Twinkle!

To learn more about Girl Scout Day, register your troop or learn about ways your troop can make a difference, contact Maggie Overman at Maggie.Overman@childrensmn.org.

NOTE: Space for this event is limited and registrations are taken on a first-come, first-serve basis, so sign up today.

Signs and symptoms of a concussion

(iStock photo / Getty Images)

March is Brain Injury Awareness Month. As part of that, we’re sharing some concussion safety tips.

What is a concussion?

A concussion is a type of traumatic brain injury caused by a blow to the head or body. Symptoms can show up right after the injury or may not be noticed until hours or days later.

Signs and symptoms to watch for:

  • Headache or dizziness
  • Drowsiness or sleepiness
  • Focus or concentration problems
  • Blurry or double vision
  • Balance or coordination problems
  • Disorientation or mental confusion
  • Memory loss
  • Slowed thinking or speech
  • Blank or vacant look
  • Loss of consciousness
What to do if your child displays concussion symptoms:
  • Immediately remove your child from activity
  • Seek medical attention
  • Tell your child’s coach or teacher
Children’s Concussion Clinic

651-220-5230
8 a.m. to 4:30 p.m. Monday-Friday

Children’s Specialty Center (ground floor)
2530 Chicago Ave. S.
Minneapolis, MN 55404

Garden View (third floor)
347 N. Smith Ave., Suite 300
St. Paul, MN 55102

Five Question Friday: Bobbie Carroll

Patient safety is our top priority at Children’s. In recognition of National Patient Safety Awareness Week, Bobbie Carroll, RN, MHA, and our senior director of patient safety and clinical informatics, shares how we’re working to maintain the highest standards of safety and quality for our patients and their families. 

Bobbie Carroll, RN, MHA, is senior director of patient safety and clinical informatics at Children's.

How long have you worked at Children’s?

I have worked for Children’s 12 years.

Describe your role.

I am a registered nurse, and during my clinical career I worked in general pediatrics in the hospital and clinic settings. My interest and career moved into informatics when working on a project to help translate medical terminology for computer programmers when they were starting to develop electronic medical records. In time I started working as a project manager with a consulting firm, working on a variety of projects, which introduced me to Children’s. I started here working on a project converting our organization’s electronic systems onto our electronic medical record. During this project and after, Children’s recognized the value of informatics to assure we look at the clinical workflow and partner with staff as we develop, design and introduce technology at the bedside. Patient-safety opportunities are at the forefront of our efforts. Using technology wisely can help our organization in our pursuit of zero patient harm. I am fortunate to have the opportunity in leading our organization’s informatics team as well as patient-safety efforts.

It’s National Patient Safety Awareness Week. What kind of things does Children’s do to make sure we are providing a safe environment for our patients?

We partner with our employees to support a culture of safety at Children’s and reduce patient harm. Some of the ways we do this is learning about our stories and events reported by our employees through our safety learning reporting (SLR) process. Our Quality and Safety team reviews every SLR that is submitted and look for system gaps and opportunities that we can address to reduce the potential for error. This is a very powerful tool in assuring we have a pulse on the care we provide our patients.

Children’s was the first pediatric hospital in the U.S. to use a closed-loop medication-administration system using two-way communication between infusion pumps and the electronic medical record. The system has helped us avert potential medical errors and has advanced patient safety throughout the hospital.

Across Children’s, we also focus our attention on hospital-acquired conditions such as adverse drug events, hospital-acquired infections, pressure ulcers, patient falls and other preventable harm events. We also work with staff on the creative ideas they have to prevent harm in their care areas.

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

I really wanted to be an airline “stewardess” back in the day! Now they are referred to as airline attendants and, while I respect their work, the position doesn’t seem near as glamorous as it did when I was a little girl.

How do you spend your time outside of work?

I am pretty low-key outside of work and love spending time at home. I am somewhat of a “foodie,” so I like trying new recipes out on friends and family. I also like to plan our various vacation locations to experience new places. I have three beautiful granddaughters that I enjoy spending time with who constantly remind me about the important things in life.

 

Henry’s story: More than a little bump on the head

Bruce and Amy Friedman appear with seven of their nine children, including 2-year-old Henry, in the family's 2013 Christmas card. (Photos courtesy of Bruce and Amy Friedman)

By Bruce and Amy Friedman

We took six of our nine children from our home in Omaha, Neb., to Minneapolis on Dec. 20 to visit their eldest brother, Ricky, who had taken a position in Minnesota. We were excited to see Ricky, do some last-minute Christmas shopping at the Mall of America and spend some good family time together.

After a long day at the mall, which included a visit with Santa Claus, we decided to head back to the hotel before meeting Ricky for dinner.

Our 2-year-old son, Henry, fell asleep in his car seat almost immediately en route to the hotel. We decided to wake him and take him to the pool, as he adores the water, pools, spas and baths.

Henry Friedman, 2, followed Santa Claus at the Mall of America in Bloomington, Minn.

Henry was excited to be at the pool with his brothers and sisters. He had been sitting on his daddy’s lap for a few minutes in the hot tub but clearly wanted to return to the pool where his brothers were playing. 

Bruce lifted Henry out of the spa, and, as he was getting out behind Henry, we watched Henry take two steps on the hard, slippery floor and his legs went out from under him, like someone had yanked a rug out from under his feet. It all happened as if in slow motion.

Boom. Boom. Boom.

Bottom. Shoulder. Head.

We were at his side in an instant. Henry never lost consciousness but was angry and scared. He cried. Bruce picked him up, consoled him and inspected every inch of his body — no marks, bumps, scratches or bruising.

Since he missed most of his afternoon nap, we decided to take him up to the room and let him rest before dinner. About 45 minutes later, we woke him up. He was cranky, but he walked, talked, ate and acted relatively normal, but he was agitated and tired.  Reluctantly, we decided to let him nap again rather than go out to eat.

About 20 minutes into his second nap, Henry broke out in a cold sweat. Bruce decided to rouse him but was unable to get him completely aware. He tried running a bath to see if that would wake him; we saw no reaction.

A light bulb went off. We realized that something major could be wrong. Bruce placed Henry on the bed and pulled his eyelid up. Henry’s right pupil was dilated. Bruce grabbed his cellphone and turned on a flashlight to see if Henry’s eye would react to the light.

Nothing.

Amy had left to pick up pizzas, so our daughter called her to tell her that something was wrong with Henry and that we needed to get to the hospital immediately. She was back in the entryway waiting when we raced Henry downstairs. Amy held him in the backseat of the car while Bruce jumped into the driver’s seat and set the GPS for the Minneapolis campus of Children’s Hospitals and Clinics of Minnesota, about 10 miles from the hotel. 

Henry is intubated in the pediatric intensive care unit (PICU) at Children's — Minneapolis in this December 2013 photo.

Along the way, Amy kept a close eye on Henry. He wasn’t fully conscious but was breathing.

Halfway to the hospital, Henry started to posture; his legs became stiff and rigid. When we arrived at what we thought was Children’s, we followed the signs to the Emergency Department, but unknowingly ended up in the ED of Abbott Northwestern Hospital on the same block.

We were whisked into a room and several people worked to stabilize Henry and assess his condition. Almost immediately, the ED physician said that he needed to go to Children’s and that an ambulance would take us there. They notified Children’s to assemble their trauma team.

Once at the Children’s ED, we met the neurosurgeon, Walter Galicich, MD, almost immediately. He told us that a CT scan and surgery were absolutely required to save Henry’s life.

Things moved fast from there. We followed Henry and the team from the ED to the CT scanner and then to the surgical area. The doors closed, and we were left in the waiting area; it was out of our hands. It was amazing that only minutes earlier we were just arriving in the ED.

After surgery, Dr. Galicich was guarded with his prognosis, simply saying we have to see how Henry comes out of it the next morning. What was clear was that Dr. Galicich and the quick work of the whole team at Children’s had saved our child’s life. We knew at this point that Henry would survive the injury, but we wondered if he would wake up, recognize Mommy and Daddy, speak, laugh, or even be able to walk. 

Henry smiles at his father, Bruce, while recovering at Children's — Minneapolis.

The next morning, in the pediatric intensive care unit (PICU), Henry was taken off of the medication that kept him sedated overnight and extubated. We were ecstatic when he cried and moved his extremities. That excitement gave way to more wondering. Could he see us? Would he recognize us? Would he sit up, walk and talk again? Day after day, Henry began picking up those basic life functions that the injury temporarily had taken from him.

Henry spent nine days recovering at Children’s. And each step brought excitement — then wonder — as to what he’d do next. All along the way we had wonderful nurses, doctors and staff share our joy, strive to make Henry comfortable.

Members of the various teams — including the trauma and neurological teams — answered our many questions day after day. They were patient with us and loving and caring with Henry. It wasn’t an easy job, either — dealing with parents who had almost lost their 2-year-old, and Henry, who was angry, hurting and scared.

Soon, Henry began to sit up on his own in a wagon, lift his sippy cup to his mouth and was saying “Mommy” and “Daddy.” We were able to transfer him ourselves to a pediatric rehabilitation hospital in Lincoln, Neb., on Dec. 30.

Henry spent 23 days there, but he’s home now and continuing to make progress. We are hopeful he will make a full recovery.

A CT scan shows nearly one-third of Henry's skull filled with blood, causing severe pressure on his brain.

The day before we left Children’s, Dr. Galicich came by to see Henry. He was happy to see how well Henry was doing and amazed at the recovery he had made. At that time, he told us how serious the injury was — when Henry fell and hit his head, it caused an epidural hematoma, a brain bleed. Nearly a third of his skull had filled with blood, causing severe pressure on his brain. It’s quite unlikely that an adult would have survived the injury, and we probably were mere minutes away from losing Henry.

In addition to the wonderful care they gave Henry, the staff at Children’s took the time to assure us that there were presents in his room on Christmas morning, and that we, his parents, had a place to stay in the hospital or nearby. They reminded us to take care of ourselves (get enough sleep and enough to eat) so that we were able to take care of Henry.

Our family is tremendously indebted to the doctors, nurses and all of the staff members at Children’s. Thank God that this facility was close, that a neurosurgeon was in the hospital when we arrived and that everyone there knew how to provide our child with the best possible care.

———

What to do in the event of a traumatic brain injury

According to Meysam Kebriaei, MD, a pediatric neurosurgeon at Children’s, if your child experiences any kind of head trauma, keep an eye out for the following signs and symptoms: 

  • Loss of consciousness
  • Progressive and worsening headache
  • Lethargy or fatigue
  • Vomiting
  • Increased irritability
  • Post-traumatic seizures
  • Post-traumatic memory loss
  • Unequal pupils
  • Weakness on one side of the face or body

Should you notice any of them, it’s best to bring your child in for an evaluation by a medical professional.

Children’s at the Capitol: Child health and wellbeing a big focus this year

(Kristin Marz, kristinized / Flckr)

Briefcases and business suits are lining the halls of the Capitol once again as the legislature reconvened for the 2014 session this week. The governor and legislative leaders have been promising a shorter, more focused session, but with all 134 house members and the governor up for re-election in November, legislators will be working on legislative successes they can take back to their districts.

This year, Children’s will be supporting several policies that impact the health of kids in our state.

School lunches
Recently, the internet exploded with stories about a school in Utah that was denying children lunches who couldn’t pay their lunch bill. Not only were they refusing to feed the children but they were throwing lunches away right in front of them. Unfortunately, amidst the uproar and outrage we learned that many schools in Minnesota do the same. A recent report from Legal Aid showed that 15 percent of Minnesota school districts report that their policies allow lunchroom staff to refuse hot meals to students who can’t pay.

As the state’s leading provider of health care for children, we know this is unacceptable. Children need food to grow and to learn. And they shouldn’t be punished or stigmatized because their family has limited resources or because someone forgot to pay a bill.

Children’s is part of a coalition working to put a stop to this practice and will advocate providing all students with access to a healthy school lunch. With an estimated cost to the state of $3.5 million, the costs of not providing children with adequate nutrition are far greater.

Newborn screening
Since its inception over 50 years ago, Minnesota’s newborn screening program has saved the lives of over 5,000 babies. But once a nation-leading program, recent legislative changes have begun to put Minnesota children at risk.

Between 24-48 hours after birth, blood is taken from a baby’s heel and tested for over 50 congenital conditions including cystic fibrosis and sickle cell disease; conditions that often are asymptomatic at birth but that once detected can be treated. Prior to 2013, the test results and data were stored so that at any time they could be accessed for additional testing. Unfortunately, in 2013, changes were made so that test results and blood spots would be destroyed after two years and 71 days, respectively. This means that millions of children’s results are now being destroyed.

We will be working to restore the newborn screening program to ensure that parents and children have the option and ability to save their test results for future use. You can read the stories of just a few of the children that have been saved by the program.

Mandatory flu vaccines for health care providers
This flu season, Children’s has seen over 520 confirmed cases of the flu. For some patients, it’s a quick diagnosis and visit. For others, it can mean an overnight stay, admission to our ICU, or even requiring ECMO (heart-lung bypass) treatment. Children and those with immune-suppressed systems are the most vulnerable, and for a very small few, they may never survive.

We know that a hospital should be the place where people and children go when they are sick, not to become sick. Being protected from the influenza virus is one small but important step in doing that, so Children’s is supporting a bill that would make flu vaccines mandatory for health care providers.

The good news is that Children’s is already a leader among hospitals. Ninety-three percent of our employees receive their vaccination. But we can do better and so can many other hospitals.

Early childhood education scholarships
Healthy children are learning children. Research shows that investment in high-quality early childhood education improves health outcomes, socio-economic status and school achievement. Every year, over 50 percent of new kindergartners are not prepared with the skills necessary to succeed in school.  As a result, many children lag behind their peers never able to catch up.

Our health care providers know how crucial education and developmental opportunities are for children ages 0-5. That is why we have joined MinneMinds, a coalition of non-profits, education organizations, health care providers, and businesses, that are devoted to assuring access to high-quality early education programs for our early learners most in need.

Photo by Kristin Marz (ristinized on Flckr)

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.

Physical 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.

Mindfulness for stress relief

By Leslie 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):

Children’s Integrative Medicine Program has medical providers that work with children to teach relaxation techniques that can include the use of mindfulness. These strategies are very 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.

Getting enough Vitamin D, all year long

By Molly Martyn, MD

Getting enough Vitamin D is an important part of staying healthy. Vitamin D helps with calcium absorption, and thus is a critical part of how our bodies make and maintain strong bones. Research shows that it also plays a role in keeping our immune systems healthy and may help to prevent certain chronic diseases.

Many of us get our Vitamin D from the sun and from drinking milk, but families often wonder how to help their children get enough Vitamin D to meet daily requirements.

The American Academy of Pediatrics recommends that infants receive 400 International Units (IU’s) per day of Vitamin D. For children older than one year, the recommended amount is 600 IU’s per day.

Vitamin D is found in a number of foods, some naturally and some through fortification. Foods that are naturally high in Vitamin D include oily fish (such as salmon, sardines, and mackerel), beef liver, egg yolks, mushrooms, and cheese. Below are some estimates of Vitamin D levels (per serving) of a variety of foods.

TYPE OF FOOD IU’s of VITAMIN D PER SERVING
Salmon, 3.5 ounces 360 IU’s
Tuna Fish (canned), 1.75 ounces 200 IU’s
Shrimp, 4 ounces 162 IU’s
Orange Juice (Vitamin D fortified), 1 cup 137 IU’s
Milk (Vitamin D fortified), 1 cup 100 IU’s
Egg, 1 large 41 IU’s
Cereal (Vitamin D fortified), ¾ cup 40 IU’s
Shitake mushrooms, 1 cup 29 IU’s

All infants who are breast fed (and even many who are formula fed) should receive a daily Vitamin D supplement.

In addition, the majority of children do not eat diets high in foods containing Vitamin D. Thus, a Vitamin D supplement or multivitamin may be an important part of helping them meet their daily requirements. Talk to your child’s health care provider about recommendations.

The National Institutes of Health have more information on Vitamin D on their website, including Vitamin D recommendations for all age groups.