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We are thrilled to introduce photographer Lexi Logan to the blogosphere. Look for her work in our upcoming posts. Busy mother of three,  Lexi holds a Bachelor of Science degree in Fine Art and Art Education from New York University. After graduating with honors, she worked in Manhattan creating original window displays on Broadway, teaching elementary art, and exhibiting her contemporary paintings.

In 2000 Lexi moved to Bucks County Pennsylvania with her Australian husband Andrew Logan, an internationally recognized sculptor. Together they launched Canal Street Studios, LLC., a company that embodies architectural design, sculpture, and a full service bronze foundry. Lexi also serves as Associate Producer for Lunch Productions, a video and New Media production company. Her most recent project, aside from keeping up with our erratic requests, includes providing illustrations for an upcoming children’s book.

Sure beats our blurry iphone photography.  Welcome Lexi!

Naline Lai, MD and Julie Kardos, MD
© 2010 Two Peds in a Pod℠

 


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We were thrilled to record today with National Public Radio’s Robin Young on Here and Now about Two Peds in a Pod. Watch for the upcoming piece where we wax and wane philosophical about topics ranging from our thoughts on poop to our story of how we started. 

 

The recording studio sure beat our kitchen table!


Naline Lai, MD with Julie Kardos, MD

© 2010 Two Peds in a Pod℠
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At this time of the Jewish High Holy Days, Dr. Kardos offers us a glimpse into lessons learned as a doctor in training. This is a true story she wrote years after meeting Beth and until now, had only shared with a few close friends.


Tonight starts Yom Kippur and my two youngest children are asleep in their beds. As my oldest sits in the rocker next to my desk reading the last book in the Lord of the Rings series, my husband relaxes playing a computer adventure game. The Jewish High Holy Days are a time for reflection about the past year. But my mind goes back to a Yom Kippur Eve when I was working as a resident in the Pediatric Intensive Care Unit (PICU) as part of my pediatric training. 


Residents work through most holidays, even ones they consider important. This night, I wished I had off, but I consoled myself with knowing that I would be off on Thanksgiving. Luckily I was partnered with Amy, the lead physician in the PICU.


The sickest patient that night was twelve-year-old Beth. She had leukemia and had just started chemotherapy. Because her immune system was weak, Beth was very ill with a bacterial infection in her blood.  Despite powerful antibiotics, the infection raised havoc in her body. She developed such difficulty breathing that a tube from a mechanical ventilator was placed down her throat to force air into her lungs. Even the comfort of sleep escaped her. Beth was afraid of what was happening to her body. She refused to accept medicine that could help her sleep because she was so afraid that she would never wake up.


That night, despite her incredibly ill state, she got her period. Usually when a girl’s body is stressed, the body preserves all blood and the periods stop. But hers came, and because her blood cells were so abnormal from a toxic combination of infection, chemotherapy, and leukemia, she began bleeding to death.  We transfused her with bag after bag of blood to keep her alive.


In the middle of the night, Beth’s blood pressure suddenly plummeted so we added even more medication. Because my mentor Amy was not certain that Beth would survive the night, we called her family at the hotel near the hospital where they were staying and told them come to Beth’s side. And through it all, Beth refused to sleep. Her eyes always opened in terror whenever we approached her bed. Her face was gray. Her chest rose and fell to the rhythm of the mechanical ventilator, and you could smell the fear all around her.


I stood with Amy just outside Beth’s room as Amy reviewed a checklist for Beth’s care. It went something like: “Ok, we just called blood bank for more blood; we called her family; we called the lab; we called the pharmacy. We are currently attending to all of her problems, we now just have to wait for her body to respond.” She paused,” But you know what?”


“What?” I asked her.


“We need to address her spiritual needs as well. Do we know what religion her family is? They may want a clergy member with them.”


I was startled. In the midst of all the tubes and wires of technology, Amy remembered to summon the human factor in medicine. We looked in her medical chart under “religious preference” and there it was:  Jewish.


“Amy,” I said, “of all nights. Tonight is Yom Kippur…the holiest night of the Jewish year.”


I knew that the hospital had a Rabbi “on call” just like they had priests, nuns, ministers, and other spiritual leaders. But that night I was sure that every rabbi in Philadelphia would be at synagogue for Kol Nidre, the declaration chanted at the beginning of the Yom Kippur evening service. We were unlikely to track down a Rabbi.


Despite this, we asked her mother if they wanted us to call a Rabbi for them. She shook her head no.  I remember feeling relieved, then guilty that I felt relieved.  Amy left to check on another patient. Beth’s mom, dad, and older sister stood together watching Beth. Her sister’s hand lay on her mother’s arm. Her mother’s eyes darted from me to Beth to the mechanical ventilator next to the bed. Beth’s eyes were closed and it was difficult to know if she even knew we were there.


Her family walked out into the hall to talk. Beth at that moment opened her eyes and started tapping on the bed with her foot to get my attention. She couldn’t talk because of the tube down her throat and her hands were taped down with IVs. Yet she reached out with one hand as best she could.


I walked close to her bed so she could touch me and I asked, what is it, Beth?


Her lips formed the words around the breathing tube very deliberately, her body tensing. “Am I going to die?”


All in a split second I am thinking to myself:  How do I know/it could very well happen/how can I lie to her/how can I tell her the truth of what I fear could very well happen/how am I going to answer this child?


What I answered was, “Not tonight, Beth.”


She relaxed into her pillow but kept her eyes on mine. I waited to see if she would say anything else, but the effort to ask that one question had exhausted her. I stood, holding her hand, until her family came back into the room. Her eyes followed them to her bed and I left so they could be together.


Beth did survive the night and in fact survived a month in the PICU. She became well enough to be transferred to a regular hospital floor. By this time I was working in a different part of the hospital, but one of the oncologists pointed her out to me.


I don’t know what happened to her in the long term.


So now I tell my oldest child it’s time for him to stop reading and go to sleep, and I walk him to his room to say goodnight. My husband and I decide what time we’ll attend Yom Kippur services tomorrow. Part of me feels joined with Jews everywhere who will also be spending the next day reflecting, praying and celebrating a new year. But mostly, like every year at this time, I remember the sounds and the smells and the fear in the PICU where sickness doesn’t care who your God is or what your intentions are. I remember Amy caring enough to think about a dying child’s family religion, and always, I remember Beth.


Julie Kardos, MD
© 2010 Two Peds in a Pod

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One year ago today we posted our first blog post Maiden Voyage and what an adventure it has been! In honor of Two Peds in a Pod’s first birthday we reprint Dr. Kardos’s post “Let ‘Em Eat Cake”:

After completing my pediatric training, I worked for a couple of years in a large pediatric office before I had any children of my own. I was always struck by the Life Event of a child’s first birthday. This milestone carries so much meaning and emotion for families. My patients’ parents described huge birthday parties with characters such as Elmo walking around or Moon Bounces, large catered affairs with numerous friends, family members, and entire neighborhoods. Often I would see a child sick in my office a few days before such an event with parents who were panicked that their child might be sick on his Big Day, or I would see a child for his one year well check and hear many details about the enormous party. Of course I also saw plenty of children a few days after their first birthday party who became ill, most likely, from a well-intentioned friend or relative who was already sick and passed the illness on to the birthday child at the party. I heard about the kids who clapped for the Happy Birthday song and kids who cried and one who vomited from excitement… all over the birthday cake. Many of my patients had their first full blown temper tantrum during their own over-stimulating first birthday party.

I remember not quite understanding why parents go through such effort and expense to throw a party that their child will never remember at a developmental stage where 99 percent of children are having stranger anxiety and separation anxiety. Well meaning famillies would often forgo daily routine to skip naps, eat at erratic times, and then expect their birthday child to perform in front of a large crowd singing loudly at them. “My husband and I will do it differently,” I would tell myself.

Now, three of my own children later, I must apologize for not quite understanding about that first birthday. I remember waking up on the day my oldest turned one year. My pediatrician brain first exclaimed “Hurray! No more SIDS risk!” Then my mommy brain took over, “Ohmygosh, I survived the first year of parenthood!” This day is about Celebration of the Parent. I finally understood completely why my patients’ parents needed all the hoopla.

Because I am actually a little uncomfortable in large crowds, my son’s first birthday party included all close relatives who lived nearby, people he was well familiarized with. Some pediatric tips I had picked up which I will pass on:

1)      Sing the Happy Birthday song, complete with clapping at the finale, for about one month straight leading up to the birthday. Children love music and hearing a very familiar song sung by a large group is not as overwhelming as hearing an unfamiliar song.

2)      Plan mealtime around your child, not the guests. If you are inviting people close to your heart, they will accommodate. Dinner can be at 5:00pm if that’s when your child usually eats, or have a lunch party that starts midmorning and then end the party in time to allow your child to have his regularly scheduled afternoon nap. Most one-year-olds are usually at their best in the morning anyway.

3)      If your child becomes sick, cancel the party. Your child will not be disappointed because he won’t understand what he is missing. You as parent would have a lousy time anyway because all of your attention will be on your ill child and you will be anxious. Your guests who are parents will appreciate your refraining from making them and their own children sick.

Recently while performing a one-year-old well check I asked about my patient’s birthday party and her parents told me “Oh, we didn’t have a party. It was like any other day, although we did give her a cupcake for dessert.”

Now THIS is a pragmatic approach to parenting because, again, no child will ever have memories of her own first birthday. However, I hope the parents did take time, at least with each other, to congratulate themselves and to feel really good about making it to that huge milestone in their parenting career. I hope they savored their accomplishment as much as their child savored the cupcake.

_____________________________

How far we’ve come, and it is all thanks to you. We’ve watched with excitement as our readership climbed from two hits (from our husbands) to almost 20,000 hits. Two Peds in a Pod now has email and Facebook subscribers. You can find us through directories such as Technorati and iTunes and recently, Two Peds expanded to the West Coast of the United States with a bimonthly column in Family Magazine Group. Some of our Face book friends hail from Canada and we consistently receive hits from the United Kingdom. Looks like our goal to impact one million kids around the world may not be a far-fetched dream.

Our greatest reward is when people say to us, “That blog post was so helpful.” We are thrilled to reach out to many families.

While our main podcast recording studio continues to be our kitchen table, we also recorded with one mom’s group in their living room and another parenting group in a child care center.  From focus group back out to cyperspace!

We still depend on you to tell other families about our site. Our sources of inspiration continue to be our patients, your children and our own clans. Please keep those topic suggestions coming! As working pediatricians and parents like you, we want to continue to be your reliable (and sometimes amusing) source of sound pediatric information.

Thank you for reading, listening, commenting and letting your friends know about Two Peds in a Pod. Let the adventure continue!

Sincerely,
Julie Kardos, MD and Naline Lai, MD
©2010 Two Peds in a Pod℠

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Two Peds in a Pod has made its way from Pennsylvania to California. Check out The Family Magazine GroupThis informative print and online group of family magazines now features a bimonthly article from Two Peds in a Pod.  The Family Magazine Group reaches a print audience of 350,000 and an online audience of about 100,000 each month.

(We’re on page 16)

Julie Kardos, MD and Naline Lai, MD

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In honor of Father’s Day, we bring you our second “Top Ten” list.

 

Top ten skills you acquire as a father:

 

10. The ability to attract swarms of women if you walk in the park or the grocery store with your infant.

 

9. Tolerance of temperature extremes at the skating rink or on the ball field.


8. Not being completely grossed out by spit up on your nicely pressed shirt.


7. The ability to sit patiently through a 3 hour ballet recital, school music concert or graduation.

 

6. The ability to sit patiently through an endless one hour television show featuring some sort of dancing and singing animal and then to stand in an hour long line to buy the stuffed toy version of the animal.

 

5. The skill to coach teams for which you last played the sport twenty years ago.

 

            4. The ability to swing a child, “again!”, “again!”,  and “again!”

3. The ability not only to get through a day after one (or many) completely interrupted night’s sleep, but to wake up in the morning having forgotten about the interruptions.

2. An ability to seize the moment and create great memories for your child: you ignore the dishes, the garbage, and the dirty bathrooms in lieu of an impromptu wrestling match.


1. Ability to love more than you ever thought possible, and the ability (finally) to understand just how much your father loves you.


Happy Father’s Day from Two Peds in a Pod!


Julie Kardos, MD and Naline Lai, MD

© 2010 Two Peds in a Pod

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As Mother’s Day approaches, we give you our first Two Peds in a Pod “Top Ten List.” 

Top Ten Skills You Acquire as a Mother

     10)  Not being completely grossed out by another person’s poop.

 9)  Ability to sense the “moment before the vomit” and to hustle your child to the nearest garbage can or toilet before it’s too late.

 8)  Ability to lick your own finger and then use it to clean a smudge completely off your child’s face.

 7)  Ability to get through a day (after day after day) after one (or many) completely interrupted night’s sleep.

 6)  Willingness to show up at work or just go out in public with dried spit-up on your shoulder.

 5)  Ability to use your “momometer” by touching or kissing your child’s forehead to tell if he has a fever (with fair degree of accuracy!).

 4)  Ability to see through walls in order to tell that your child did not wash his hands after using the bathroom.

 3)  Ability to see directly behind you to know that your child is getting into trouble.

 2)  Ability to wield the Magic Kiss that can make any and all boo-boos better.

 1)  Ability to love more than you ever thought possible, and the ability (finally) to understand just how much your mother loves you.

Rejoice in your abilities!

Happy Mother’s Day from Two Peds in a Pod.

Julie Kardos, MD and Naline Lai, MD
©2010 Two Peds in a Pod

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Our Face Book fan page was stagnant until now… we’ve finally figured out how to get our posts  out to our fans. Become our fan on Face Book and tell parents about us . Fan page is called Two Peds in a Pod  .What’s the use of an advice blog if no one is listening? 
We’re determined to grow baby step by baby step. 


Drs. Lai and Kardos
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Haiti, one of the poorest countries in theWestern Hemisphere, was struck by a devastating earthquake last week.

If you are looking for a way to help the children, consider donating to the American Academy of Pediatrics Friends of Children Disaster Relief Fund. The American Academy of Pediatrics has used this fund in the past to respond to disasters that affect children in the US, such as hurricanes Katrina and Ike, and worldwide, such as recent earthquakes in China.

 The fund provides emergency relief to pediatricians and the children they treat by:

 Addressing primary health care needs ofchildren;

 Supporting medical services (example: power generators for medical facilities, replacement of medical equipment damaged by the disaster);

 Supporting future disaster preparedness and response programs with a special focus on children.

 http://www.aap.org/donate/fcfdonate.htm

 Naline Lai, MD and Julie Kardos, MD
© 2010 Two Peds In a Pod 

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“Three things we know for certain: a child is a gift, being a good parent is a blessing, and being a pediatrician is a privilege.” –author unknown


This Thanksgiving, we want to thank you, our readers, for allowing us to help you help your children. We are grateful to you for telling other families about Two Peds In A Pod because when you get right down to it, our information is only good if it reaches people. Thank you for your comments and questions. Keep them coming!


From both of our families, we wish you all a Happy Thanksgiving.


Julie Kardos, MD and Naline Lai, MD
©2009 Two Peds in a Pod

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