237. Physician Wellness: Needed Now More Than Ever

Are pediatricians prepared for the mental health crisis that’s impacting so many of our children today?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino sits down with nationally recognized child psychiatrist and podcast host Dr. Elise Fallucco to uncover the urgent realities facing pediatric practice. From understanding why a simple podcast name change can transform the reach of critical mental health education, to exploring the real-world, stepwise journey pediatricians navigate when facing complex child anxiety and medication management, this episode is a masterclass in practical empowerment. Listeners will discover actionable strategies for burnout, the evolving landscape of pediatric mental health treatment, and authentic stories of resilience, support, and resourcefulness. The stakes have never been higher—and the need to equip pediatric clinicians with the right knowledge and mindset is more critical than ever. Don’t miss this invigorating roadmap for providing exceptional care in panicked times.[00:02 - 05:46] Branding, Access, and Reaching Pediatric CliniciansPediatric mental health education is increasingly being disseminated beyond in-person local trainings, leveraging digital platforms like podcasts to amplify access and reach.Clear, descriptive branding ensures the right clinicians can find mental health resources at the exact moment they need support in practice.The main driver in choosing content is what pediatricians most urgently seek: practical, actionable advice about managing medications for anxiety and ADHD.Making specialized knowledge accessible via on-demand, digestible podcast episodes empowers clinicians to feel less isolated and more competent.[05:47 - 13:30] The Ongoing Challenge of Anxiety, Burnout, and Self-CareAnxiety has emerged as the most common and burdensome mental health concern for children, exacerbated by societal stress and recent global events.Differentiating normal anxiety from clinical anxiety is crucial: functional impairment and life disruption are key markers for escalated intervention.Coping strategies for clinicians are vital; the “three pillars” are staying busy with purposeful activity, reaffirming personal/professional mission, and prioritizing self-care.Peer connection, exercise, and carving out time for meaningful relationships are highlighted as essential personal de-stressors.[13:31 - 25:00] Building Skill, Facing Complexity, and the Realities of CarePediatricians experience a four-stage progression from fear and avoidance to high-confidence care in managing pediatric mental health—each with unique challenges and rewards.Access limitations to child psychiatry have forced primary care clinicians to expand their skillsets and comfort zones, often out of necessity.Collaborative consultation programs, like psychiatric access hotlines, accelerate learning, build confidence, and foster an environment where sharing expertise is normalized.Developing fluency with diagnoses and medication management leads to more effective and streamlined care; “herd immunity” and practice culture shifts increase collective capacity.[25:01 - 36:05] Pain Points, Solutions, and Sustaining Progress in Pediatric Mental HealthBarriers to therapy—including logistics, family skepticism, and stigma—limit effective care, even as access improves; motivational interviewing is a partial solution but not a panacea.Integrated behavioral health models and school-based clinics offer promising solutions by reducing friction and meeting children and families where they are.Time constraints and misaligned incentives remain top frustrations; procedures are often reimbursed more than complex mental health care, despite the latter’s intensity and impact.Empathy,...

Can one person truly make a difference in the complex world of pediatric healthcare?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino explores how primary care pediatricians can step up amidst the chaos in Washington DC and stand as the trusted advocates children need. While Lia prepares for the pediatric academic society PAS in Honolulu, she is wrestling with the disastrous current health policy challenges and calls for local action. Lia pleads with her peers to organize and cause “good trouble”. This episode underscores that our most vulnerable population — children — deserves the unwavering dedication of empowered and informed advocates. In pursuit of crafting a brighter future for children's health, will you rise to meet the challenge?[00:00:04 - 00:01:21] Preparing for Change and ConnectionPediatric Meltdown is dedicated to children's mental health and emotional well-being.Dr. Lia Gaggino shares her passion for facilitating thoughtful conversations with experts.New and creative medical approaches are thriving and contributing to community upliftment.Enjoying family time and Hawaii's scenic beauty is part of Lia’s plan to recharge.[00:01:21 - 00:04:19] The Chaos in D.C. - A Call to ActionThe state of national politics is concerning, described as a "dumpster fire."Staying informed plays a crucial role despite the overwhelming current events.Balancing leisure with staying critically aware of policy changes affecting pediatrics.Connecting with pediatric colleagues to brainstorm actionable steps.[00:04:19 - 00:08:39] Advocacy for Children’s NeedsEmphasizing the trust placed in pediatricians and the responsibility that comes with it.Safe health practices are under threat from misinformation spreading rapidly.Vital programs and advisory committees crucial for child safety are being dismantled.Highlighting the unnecessary and detrimental effects of defunding health initiatives.[00:08:39 - 00:12:39] Empower Your Voice and CommunityHighlighting real stories as powerful tools for advocacy.Breaking down scientific data into relatable family narratives aids understanding.Demystifying Medicaid's role as crucial support for countless families.Urging listeners to take definitive action, whether through social media or community forums.Resources Mentioned:AAP Advocacy Guide  Member log-in required to accessOn Tyranny Timothy SnyderAAP MMR Vaccine InformationAAP Medicaid State Fact SheetsHere are some more episodes you may likehttps://pediatricmeltdown.com/episodes231. Raising Good Citizens Through Conscious Parenting186.  Immigrant Children and Families 158.  Preventing Youth Suicide 100. The Art of Medicine Tweetable Quotes:"We've witnessed chaos, unprecedented and relentless. The landscape of Washington DC is reflective of a larger societal unrest, a crucible that now must forge strength and

Are you feeling overwhelmed by the world's chaos and seeking hope amidst uncertainty?&nbsp;In this moving episode of Pediatric Meltdown, host Dr. Lia welcomes Dr. Robert Saul to discuss the powerful principles guiding his commitment to advocacy and change. Dr. Saul introduces the transformative 12 words that have anchored his life's work and how these principles can propel communities forward. Together, they examine the impact of truth, trust, and the little-known role of the communal aspect in tackling societal issues. As Dr. Saul passionately delves into historical and modern-day examples of lying within power structures and challenges us to confront uncomfortable truths. Discover where the true power of change lies and how understanding our roles can lead to actionable advocacy.&nbsp;This episode isn't just a conversation—it's a call to action for those yearning to make a difference.[00:00 - 05:09]&nbsp; The Art of Medicine and the Value of ListeningDiscussing the importance of comprehensive clinical encounters beyond quick checkupsStressing that empathy and genuine presence build deeper connections in healthcareHighlighting the responsibility to offer hope and guidance, not merely prescriptionsSuggesting that professionals and caregivers must pause to recalibrate when stress levels rise[05:10 - 12:31] Accepting Responsibility: “I Am the Problem, I Am the Solution”Exploring the idea that acknowledging our collective part in societal problems is the first stepUnderlining the distinction between culpability and willingness to engage in solutionsDiscussing how seeing oneself as part of the issue spurs commitment to meaningful actionReminding listeners that we are interconnected in every community concern[12:32 -31:06]&nbsp; Truth, Trust, and Social FabricDefining trust as the “currency” of relationships and community lifeArguing that telling the truth consistently is essential for building and preserving trustNoting that children thrive when caregivers, professionals, and policymakers work together with integritySuggesting that widespread misinformation undermines the health and wellbeing of communities[31:07 - 42:06]&nbsp; Looking Ahead: Ongoing Work and HopeEncouraging continued involvement in committees, local boards, and mentorship rolesHighlighting the drive to create community programs focused on healing and trauma-informed carePlanning future projects that address truth, trust, science, diversity, and civilityEnding with an affirmation that sustained efforts at all levels can foster a more promising future[42:07 - 55:46] &nbsp; Dr. G’s TakeAwaysAdditional Resources Mentionedhttps://mychildrenschildren.com/my-childrens-children-name/https://mychildrenschildren.com/better-is-good-incremental-steps-forward/Power S. The Education of an Idealist: A Memoir. Dey St. 2019; 580 pp. (p. 282)Snyder T. On Freedom. Crown, New York; 2024. 345 pp.https://mychildrenschildren.com/infant-mental-health-part-i/<a href="https://mychildrenschildren.us20.list-manage.com/track/click?u=3bbab703022c75848c8064077&amp;id=f881828ccb&amp;e=a4c348d109" rel="noopener...

Have you ever wondered how pediatricians balance autonomy, mentorship, and the pressing demands of modern healthcare?&nbsp;In this episode of “Pediatric Meltdown,” host Dr. Lia Gaggino welcomes Dr. Chris Peltier, MD, FAAP, who describes the rewards and hurdles of serving children through private practice, collaborative initiatives, and academic roles. He underscores the power of supportive peer networks to tackle shifting hospital structures, financial complexities, and the mental health needs of growing populations. His reflections reveal how advocacy, teaching, and flexibility can sustain a genuine passion for pediatrics.&nbsp;Will these strategies ensure a vibrant future for the next generation of caregivers?[00:00 - 22:18] Autonomy and Private vs. Hospital-Owned PracticesShifts toward hospital system acquisitions reduce physician independence.Succession planning gaps leave practices vulnerable to buyouts or closures.Administrative decisions can feel distant from day-to-day patient care.Becoming an employed physician can alleviate the stress of business management.[22:19 - 37:04] Collective Approaches to Independent Practice SuccessCollaborating across independent practices can reduce expenses, such as vaccine costs.Sharing vendors and resources fosters a supportive rather than competitive environment.Group quality improvement projects tackle issues like asthma or anxiety in children.Large networks can negotiate better insurance contracts on behalf of multiple practices.[37:05 -51:42]&nbsp; Preceptor Support and Compensation StrategiesIntrinsic motivation—such as the joy of mentoring—often drives physicians to teach.Efficient time management (e.g., scribing during patient visits) enables bedside teaching.Chapters and national organizations collaborate to advocate for preceptor stipends.Small but meaningful policy changes (like state tax incentives) can bolster teaching efforts.[51:43 - 1:07:43]&nbsp; Local Chapters and Advocacy for Child Health InitiativesMental health screenings, including suicide risk assessments, become embedded in well visits.Working with community partners and even firearm ownership groups promotes harm reduction.Coordinated action with lawmakers helps defend programs that protect vulnerable populations.Sharing successful programs across state lines broadens the reach of proven solutions.[1:07:44 - 1:19:52] &nbsp; Dr. G’s TakeAwaysContacting Dr.Peltier&nbsp;FaceBook:: https://www.facebook.com/cpeltier007X:@cpeltier007INstagram:: https://www.instagram.com/cpeltier007/Additional Resources MentionedThe Pediatric Management Institute https://pediatricsupport.comAAP Section on Administration and Practice Management SOAPMAAP Council on Community Pediatrics COCP&nbsp;AAP Advocacy...

What does it really take to guide a teenager toward independence in an ever-changing world?&nbsp;From managing IEPs and beginning transition planning at 14 to fostering self-awareness and skills for adult life, the journey is layered with challenges and growth. Parents like today’s guest, Natasha Robertson grapple with teaching social media safety, addressing emotional needs, and balancing day-to-day struggles with long-term goals. The process is both exhausting and inspiring, requiring patience, persistence, and firm advocacy. While the tools like coaching, therapies, and community support help, the weight often falls on families to navigate complex systems, such as educational frameworks and disability services. For teens, building independence means developing judgment, learning routines, and understanding boundaries in a digital age. For parents, like Natasha, it means preparing them for emotional, financial, and social self-reliance while ensuring basic skills are mastered.&nbsp;Are we as a society truly equipping these families and teens with the tools they need, or are we still leaving them to figure it out in isolation?[00:00 - 08:34]&nbsp; Evolving Services and Self-AdvocacyRealizing that past trial-and-error with therapies informs current decisionsThe child’s ability to describe symptoms (e.g., stomach pain, insomnia) guides interventionsEmphasizing the shift from purely parent-led advocacy to incorporating the teen’s direct feedbackPreparing for ongoing changes in support needs as the child advances academically and socially[08:35 - 15:47] Navigating the Teen YearsAddressing the impact of puberty and hormonal shifts on behaviorConsidering new social interactions and the need for structured supportImplementing coaching strategies for everyday routines (e.g., chores, picking out clothes)Recognizing that independent living skills build gradually through guided practice[15:48 -28:40]&nbsp; Managing Digital BoundariesEstablishing phone usage restrictions (e.g., set times) to protect against late-night browsingFinding monitoring tools (apps that flag concerning words) to balance privacy and safetyRealizing that direct honesty about monitoring builds trust with teensCoaching the teen on responsible online communication and the risks of oversharing personal data[28:41 - 53:19]&nbsp; Caregiver Self-Care and ResilienceCarving out small daily moments for personal relaxation (e.g., a movie break or foot soak)Relieving stress by connecting regularly with supportive friendsObserving that the teen’s increased coping skills allow the caregiver to pause before interveningTrusting the cumulative impact of years of therapies and interventions[53:20 - 1:01:50] &nbsp; Dr. G’s TakeAwaysContact Natasha Robertson&nbsp;[email protected] Resources MentionedCommunity Living Supports: Services that assist with daily living skills and social engagement.Individualized Education Program (IEP) &amp; Transition Planning: Formal educational plans that outline services and future goals for adolescents.Career-Connect Programs: Local agencies or initiatives that help teens explore job training, résumé building, and employment opportunities.Book: A teen parenting guide by Dr. Ken Ginsburg, titled Congrats, You’re Having a Teen, referenced for positive perspectives on adolescence.&nbsp;<a...

Have you ever wondered what happens when children's healthcare programs like Medicaid and CHIP face cuts?&nbsp;In this episode of Pediatric Meltdown, Dr. Lia Gaggino emphasizes the urgent need to stand up for kids, who are disproportionately impacted by shifts in policy and funding. She highlights the power of sharing real-life stories and forging unexpected partnerships to protect essential resources. Advocacy takes perseverance and creativity, as complacency only enables political and social obstacles to harm children. Pediatricians and other advocates must unite, use their voices effectively, and push for healthier, safer lives for all kids.&nbsp;So now the only question is….. Will you help safeguard the well-being of the next generation?[00:00 - 05:07] Advocacy Conference Insights for Child HealthA large percentage of children rely on public insurance programs, underscoring the high stakes of legislative decisions.Some decision-makers do not fully grasp the consequences of cutting critical services.Hope fuels long-term efforts and energizes those championing children’s well-being.An “advocacy wave,” highlights the need for a strong, collective push for change.[05:07 - 12:32] Medicaid Challenges and Coverage GapsPublic health emergency rollbacks led to reductions in child enrollment due to procedural missteps.Many children lost insurance coverage not because of ineligibility, but because of bureaucratic hurdles.70% of youth are deemed unfit for certain national service due to physical or mental health issues.Call to safeguard essential child services (such as preventive care and immunizations) from budget cuts[12:32 - 21:07] Immunization and Food Security ConcernsRenewed challenges to routine childhood vaccinations, with instances of preventable diseases appearing again.Politicians downplaying vaccines, prompting greater vigilance in safeguarding public health.Proposals to cut school meal provisions, raising ethical questions about denying basic nutrition to children.Caring for children’s fundamental needs (like food and healthcare) should not be up for debate.[21:07 - end] The Urgent Call to Protect Future GenerationsRejecting indifference and uniting for children’s rights and well-being.Communities where basic resources, such as clean air, safe neighborhoods, and equitable opportunities, are universal.Use every possible platform—professional and community-based—to champion the needs of children.Final rallying cry to stay focused, gather supportive voices, and take concrete steps to safeguard the next generation.Connect with Dr. Gagginowebsite at www.lifeaftercorporatepodcast.com &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;LinkedIn; https://www.linkedin.com/groups/12656341/Resources mentioned in the show:AAP Advocacy Guide: Located at aap.org/advocacyguide (helpful for step-by-step approaches to policy engagement).Store It Safe Program: https://ohioaap.org/storeitsafe A collaborative initiative addressing firearm...

Could coaching be the key to overcoming burnout and moral injury that plagues the medical profession?&nbsp;In this episode of Pediatric Meltdown, Dr. Lia Gaggino welcomes back Dr. Adrienne Mann and Dr. Tyra Fainstad, pioneers in physician well-being research, as they unpack the results from their studies on the impact of group coaching on physicians. Drs. Mann and Fainstad share their journey from a "cute little study" to a groundbreaking national program that offers a lifeline to medical students, residents, and faculty. As they study the struggles and triumphs of physicians battling burnout, moral injury, and self-compassion deficits, they reveal a whole new approach to healing and growth.&nbsp;Hear how their innovative program is providing solace to thousands and lighting a path to flourishing in medicine.[00:05 - 01:17] Transforming Physician Wellness through CoachingExplore the origins of a simple idea during the pandemic that blossomed into a renowned coaching programUnderstand how pivoting to online platforms expanded their coaching reach significantly beyond initial expectationsDiscover the importance of addressing burnout, moral injury, and imposter syndrome in healthcare professionalsLearn about the innovative group coaching model and its profound impacts versus traditional one-on-one methods[01:18 - 03:54] Impactful Outcomes of Group CoachingRecognize the need for a targeted approach focusing initially on women due to higher burnout representationEvaluate the coaching methodology's evolution from novice trials to thousands of residents in randomized control settingsAppreciate insights into baseline distress levels and how these reveal prevailing systemic issuesAnalyze how group coaching effectively elevated self-compassion, reduced moral injury, and tackled burnout[03:55 - 06:06] Inclusivity and Institutional PartnershipsGrasp the expanding scope to now include men and diverse genders, enhancing coaching accessibilityReveal the collaboration with institutions to democratize coaching, offering programs at low costs per participantExamine how privacy and anonymity are maintained to encourage participation without stigmaRecognize the structural evolution from restricted groups to open participation for trainees at all career stages[06:07 - 8:52] The Future Direction of Physician Coaching ProgramsInvestigate the ongoing research into why and how coaching uniquely benefits medical professionalsThe potential restructuring of medical leadership to address autonomy and eradicate systemic burnoutAppreciate the continuous refinement and adaptation of the coaching model based on participant feedbackFact-check how empirical evidence supports the coaching method's resilience against challenges posed by modern healthcare[48:51-32:50]&nbsp; Dr. Lia’s TakeAwaysConnect with Dr. Adrienne MannInstagram: @amw1983Connect with Dr. Tyra FainstadInstagram: @TyraindenverResources Mentioned in the EpisodeBetter Together Coaching &nbsp;https://bettertogetherphysiciancoaching.com/-Major updates: You can see our website here for&nbsp;research and peer-reviewed evidence&nbsp;updates.&nbsp;&nbsp;Of high interest is our most&nbsp;<a href="https://www.jabfm.org/content/early/2024/12/23/jabfm.2024.240022R1" rel="noopener noreferrer"...

Are today's youth the missing voice in mental health advocacy?In this episode of Pediatric Meltdown, host Dr. Lia Gaggino invites passionate mental health advocate Ria Babaria to talk about the unique struggles and strengths of today's youth. In&nbsp; her journey from high school advocate to college policy specialist, Ria emphasizes the need for youth representation in mental health decisions. She discusses the Youth Power Project's initiatives, access to mental health resources, and the importance of bridging societal and systemic gaps. From personal challenges to state-wide advocacy, Ria highlights the transformative power of youth voices in policy-making. Join us as we explore the potential changes when youth are given a platform to be heard.&nbsp;The future of mental health is their future— but are we ready to listen?[00:05 -15:21] The Birth of Youth AdvocacyThe significance of amplifying youth voices in education and policy through advocacy organizationsImportance of bridging education gaps and providing resources for low-income and vulnerable youthEmpowering youth to assert confidence and influence in advocacy spacesThe transformative impact of including diverse backgrounds in policy discussions[15:12 -22:22] Mental Health Advocacy and Cultural ChallengesAddressing mental health struggles within POC households and breaking cultural taboosThe importance of emotion integration for personal growth and social interactionsBuilding confidence to engage in mental health advocacy at a young ageShaping policy through lived experiences and peer discussions[22:23 -38:50] Expanding the Youth Power Project ReachThe national evolution from initial state-focused youth groups to broader advocacy at YPPStrategizing for impactful health reform through youth collaboration and legislative workNavigating peer-to-peer networks to bolster the youth advocacy movementTailoring mental health and educational policies around authentic youth voices[38:51-48:50] Enhancing Access and System ReformsAddressing consistency and discrepancies in mental health resource access nationwideInnovative strategies to demystify access and eliminate stigma around mental health supportStrengthening first aid mental health training to improve communication and supportDeveloping legislative frameworks to integrate youth insights within mental health policy48:51-32:50] Dr. Lia’s TakeAwaysConnect with Ria &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; [email protected] Mentioned:PHQ-9 Screening Tool for Depression:PHQ-9 QuestionnaireYouth Power Project Website:Youth Power ProjectMental Health First Aid Training:Mental Health First AidYouth Power Project<a...

Have you ever wondered what to do when traditional treatments for chronic pain in children don’t seem to help?&nbsp;In this episode of Pediatric Meltdown, Dr. Lia Gaggino chats with Dr. Lonnie Zeltzer and Kim Poston Miller about innovative ways to address pediatric chronic pain. They discuss CHYP (Creative Healing for Youth in Pain), an organization offering hope to families through a creative, holistic approach to healing. Kim shares her personal story of supporting her son Grant’s remarkable recovery, showing how creativity can play a powerful role in pain management.&nbsp;Tune in to learn how these approaches are opening new doors for children and families. Could creativity be the missing piece in chronic pain care?[00:02 - 08:46] From Suffering to Hope – Introduction to CHYPKim talks about her personal journey as an advocate for CHYP, and the pivotal role creative arts played in her child's recovery.Unpack the story behind Dr. Zeltzer’s influence in reshaping pediatric pain management.Learn about the resourcefulness of a mother navigating her child's illness in a segmented medical landscape.Understand CHYP’s role as a free, accessible solution to complex chronic pain issues for any child worldwide.[08:47 - 14:53] Kim’s Inspiring Journey: Transforming Tragedy into TriumphSee the power of combining modern medicine with creative healing arts.Examine the interconnected struggles of family members often overlooked in medical treatments.Discover how social engagement became a lifeline for healing and improved quality of life.Find out how a mother's intuition and creative willingness conquered skepticism in professional medical advice.[14:54 - 23:30] The Creative System: Dr.Zeltzer's Vision and CHYP’s FoundationExplore Dr.Zeltzer's 30-year journey of treating kids with chronic pain and the birth of the CHYP initiative.Appreciate the need for an online platform providing holistic, no-cost care to children globally.Grasp the significance of the biopsychosocial model in comprehending pediatric pain.Understand the empowerment and education process for both children and parents under the CHYP program.[23:31 - 54:36] Creating Magic: Camp as a Vessel for Change and ConnectionHighlight the access to interactive platforms and workshops designed to enhance creative healing for youth.Recognize the significance of larger social networks in managing pain through shared lived experiences.Celebrate the impactful break-through of barriers, from timidity to friends on social platforms.Appreciate CHYP’s strategic growth with events uniquely catering to different age brackets for maximal impact.[54:37 -&nbsp; 1:00:53]&nbsp; Dr. Lia’s Takeaways&nbsp;Connect with Lonnie Zeltzerhttps://linktr.ee/mychyphttps://www.instagram.com/my_chyp/https://www.linkedin.com/company/creative-healing-for-youth-in-pain/https://www.facebook.com/creativehealingforyouthinpainConnect with Kimberly MillerLI Kimberly Miller, MBAFB <a href="https://www.facebook.com/creativehealingforyouthinpain/"...

Did you know that&nbsp;nearly twenty-five percent of adolescents suffer from chronic pain, and for some, it’s severe enough to impact daily life?&nbsp;In this episode of Pediatric Meltdown, Dr. Lia Gaggino and guest Dr. Lonnie Zeltzer talk about the complexity of chronic pain in children and adolescents—a subject often misunderstood and inadequately addressed in pediatric medicine. Through personal anecdotes and expert insights, Dr. Zeltzer shares her journey from a curiosity about adolescent medicine to specializing in pediatric chronic pain using modern pain science. This conversation not only unravels the preconceived beliefs surrounding chronic pain but also offers&nbsp;potential pathways and methods to manage and reframe the experience of pain in young individuals.&nbsp;The episode is an eye-opener for anyone seeking to understand and support children grappling with chronic pain.[00:00 - 17:02]&nbsp; Prevalence and Challenges of Pediatric Chronic PainChronic pain affects 15–30% of adolescents globally, with 15% experiencing severe impairment.&nbsp;&nbsp;70% of adolescents with untreated chronic pain develop adult chronic pain.&nbsp;&nbsp;Pediatricians often lack training in modern chronic pain management concepts.&nbsp;&nbsp;Subspecialists frequently struggle to address chronic pain after ruling out organic causes.&nbsp;[17:02 - 27:55]&nbsp; Neurobiological and Psychosocial Factors&nbsp;Chronic pain correlates with limbic system hyperactivity and prefrontal cortex underdevelopment in adolescents.&nbsp;&nbsp;Neurodiverse individuals may experience heightened sensory sensitivity, amplifying pain perception.&nbsp;&nbsp;Hypnotherapy and cognitive behavioral therapy (CBT) retrain pain-related neural pathways.&nbsp;&nbsp;POTS (postural orthostatic tachycardia syndrome) reflects autonomic nervous system dysregulation linked to chronic pain.&nbsp;[27:56 - 21:06] Gastrointestinal and Autonomic Dysregulation&nbsp;&nbsp;Irritable bowel syndrome (IBS) stems from brain-gut axis dysfunction, not structural gastrointestinal issues.&nbsp;&nbsp;Autonomic dysregulation in POTS requires salt intake, hydration, and compression garments for management.&nbsp;&nbsp;Acupuncture and acupressure offer nonpharmacologic relief, particularly for needle-tolerant patients.&nbsp;&nbsp;Abdominal pain often involves muscular tension, addressed through targeted physical therapy.&nbsp;&nbsp;[21:07 - 48:48 ]&nbsp; Practical Clinical Interventions &nbsp;Brief in-office mindfulness exercises (e.g., guided breathing) provide immediate stress relief.&nbsp;&nbsp;Motivational interviewing helps adolescents identify achievable goals, like gradual physical activity.&nbsp;&nbsp;Parent-child dyads benefit from joint mindfulness apps (e.g., Insight Timer) to reduce household stress.&nbsp;&nbsp;The "five golden minutes" of non-directed play or connection improve emotional regulation.[48:49 - 54:23]&nbsp; Dr. Lia’s Takeaways&nbsp;Connect with Lonnie Zeltzerhttps://linktr.ee/mychyphttps://www.instagram.com/my_chyp/https://www.linkedin.com/company/creative-healing-for-youth-in-pain/https://www.facebook.com/creativehealingforyouthinpainResources mentioned in the...