Stories about: Practice

Functional abdominal pain: ‘The pain is real’

A guide for PCPs to functional abdominal pain

As physicians, we are trained on the classic medical model. A patient has a symptom, we do a test, we find a disease, we give a therapy, and the issue goes away. Unfortunately, chronic diseases like functional abdominal pain do not fit neatly into this model.

The majority of the hundreds of thousands of children a year who experience abdominal pain will improve with time. But for some children, their pain becomes chronic and debilitating. According to the Rome IV guidelines, once a child has experienced eight weeks of abdominal pain, we have to consider functional abdominal pain. …Read More

Learning disabilities: Kids and families struggle beyond the academics

Boy with learning disabilities struggles with homework

Most research on learning disabilities focuses on remediating specific academic skills like reading and math. But struggles at school and with homework can create an enormous amount of stress and anxiety for children and families, says neuropsychologist Deborah Waber, PhD, who directs the Learning Disabilities Program at Boston Children’s Hospital. …Read More

Notes from a nurse on the stem cell transplant unit

Stem cell transplant nurse with patient
Colleen caring for a child on 6W

I have worked at Boston Children’s Hospital for the last 10 years, the first two as a co-op and the last eight as a staff nurse — all on 6W. I just love this floor. We’re a small, 14-bed unit that provides longer-term care for children undergoing bone marrow transplants. We see different types of leukemia and other cancer and blood disorders such as neuroblastoma, aplastic anemia and myelodysplastic syndrome. We also see other genetic, metabolic and hematologic diagnoses like CVID, Wiskott-Aldrich syndrome, SCID, adrenoleukodystrophy and sickle cell disease, some of which we treat with gene therapy. …Read More

Hypertension in kids: When to refer

high blood presssure
(Illustration: Fawn Gracey)

We typically associate hypertension with older people, but elevated blood pressure isn’t an uncommon finding in children and adolescents. According to the American Academy of Pediatrics (AAP), pediatric hypertension occurs in 2 to 5 percent of kids and is one of the top five chronic diseases in children.

Despite those numbers, the diagnosis is missed in up to 75 percent of pediatric patients in primary care settings. “We should be checking blood pressure at every routine well-child visit for kids age 3 and older, and more often in kids with cardiometabolic risk factors, such as obesity and diabetes,” says Corinna Rea, MD, MPH, a pediatrician in Boston Children’s Primary Care at Longwood. …Read More