228. How a Pediatric Expert Balances Life & Loss

In 2020, I had the privilege of being a guest speaker on Sandy Fowler’s podcast “Mighty Parenting” for a candid discussion about youth mental health, suicide prevention, and the critical role parents play in supporting their children through emotional challenges. I thought it would be interesting to blow the dust off this episode where I was being interviewed by Sandy. As a medical professional deeply committed to improving mental health care in primary care settings, I shared insights specifically for parents about how to recognize warning signs, have difficult conversations, and access appropriate resources. That conversation became a pivotal moment in my career, sparking my desire to reach a broader audience through podcasting… Pediatric Meltdown was born!Today, as the host of Pediatric Meltdown, I continue to build upon that mission, but I thought it would be worth revisiting this discussion that served as a catalyst for my current role as a podcast host. During our conversation, we tackled the crucial topic of youth suicide prevention, breaking down barriers to communication, and providing practical tools for parents to support their children's mental well-being. Unfortunately, with the impact of the Covid-19 Pandemic, this discussion remains as relevant today as it was then, perhaps even more so. [00:05- 21:59] Brain Development & Behavior Teen brains function differently from adult brainsRole of prefrontal cortex in decision makingImpact of developing brain on behaviorUnderstanding cognitive limitations   [22:00 -32:45] Suicide Prevention StrategiesProper approach to discussing suicidal thoughtsImportance of staying calm during difficult conversationsAvailable crisis resourcesSteps for emergency   [32:46 - 42:51] Mental Health Statistics25% of youth screen positive for depressionAnnual screening recommendations for ages 12+15% experience suicidal thoughtsImplementation of 54321 coping technique[42:52 - 53:02] Action Steps for Parents Creating safe environment for emotional expressionUnderstanding brain development impactUsing emotional scale assessments (1-5)Knowing when to seek helpGo to https://lifeaftercorporatepodcast.com/ for all episodes169. Lisa Durante's Strategy for Mastering Your Content Marketing Plan!153  A 3-Step Guide to Skyrocketing Your Income137 Marketing, Management, and Metrics: The Keys to Consistent SuccessTweetable Quotes:"But in terms of completed suicides, it's firearms, and the really sad thing is, suffocation mostly by hanging is the most common and becoming more common and that one, of course, is really hard to restrict because you can hang yourself with so many items."  … Dr. Lia Gaggino on the harsh reality of suicide methods “"If you set the stage that it's okay to talk about your thoughts and feelings, then and and that's just a habit that you've had all along, then I think it makes the conversation easier." … Dr. Lia Gaggino on communicating with kids about Mental Health**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect...

What happens when a physician who regularly discusses wellness and burnout finds herself in need of her own advice? In this personal episode of "Pediatric Meltdown," host Dr. Lia Gaggino candidly shares her journey through an overwhelming period in late 2024, marked by her father's death, her mother's hip surgery and subsequent move-in, and the unexpected loss of her beloved pet. Despite having a strong support system that includes her husband Rodger, adult daughters, and one-year-old grandson George, she acknowledges her exhaustion and struggles with sleep, nutrition, and exercise habits. This episode is an honest confession of how even wellness advocates can find themselves needing to replenish their own spirit, in other words, to walk the walk in self-compassion.  Some deep soul searching led to Lia’s decision to take a month-long sabbatical from the podcast while still ensuring weekly content.  You can look forward to surprise episodes specially curated by her team just for you.Key Takeaways:1. Self-awareness and vulnerability are crucial steps in addressing burnout, as demonstrated by Dr. Lia's honest acknowledgment of her own struggles despite being a wellness expert.2. Setting boundaries and making concrete changes (like designated phone-free zones, scheduled exercise, and sleep routines) are essential components of self-preservation during challenging times.3. A strong support system and a temporary “leave of absence” makes space for her mental health re-boot.  Dr. Lia is privileged to be able to take this break, and recognizes that a break like this may not be an option for many, but she offers some baby steps for herself that can be added to your own self-kindness tool-box.  Making time for self-reflection may be the key to long-term sustainability in both personal and professional life.  Make sure to tune in all month long for some episodes that you most likely have not heard. They were curated by Dr. Lia, and her team and they hold a special place in her heart.**TRANSCRIPT AVAILABLE UPON REQUEST**SUBSCRIBE & LEAVE A FIVE-STAR REVIEW and share this podcast to other growing entrepreneurs! Get weekly tips on how to create more money and meaning doing work you love and be one of the many growing entrepreneurs in our community. Connect with me on LinkedIn; https://www.linkedin.com/groups/12656341/  or on Instagram or our website at www.lifeaftercorporatepodcast.com .  

What does it truly mean to cultivate resilience and well-being in today's challenging world? In this insightful episode of Dr. Lia Gaggino's podcast (episode 227), she thoughtfully explores seven fundamental pillars of well-being while reflecting on the transition into 2025. Drawing from both professional expertise and personal experience, particularly while caring for her aging mother, Dr. Gaggino presents a comprehensive approach to health that encompasses sleep, nutrition, movement, family connections, friendships, creativity, and spirituality. She authentically acknowledges the struggles many face, from avoiding overwhelming news to managing daily stresses, while offering practical, judgment-free advice that balances aspiration with self-compassion. Her message resonates particularly strongly when she emphasizes that relationships are the ultimate antidote to loneliness, fear, and sadness, demonstrating a deep understanding of human nature and the complexities of modern life.Key Takeaways:1. Well-being is multifaceted and requires attention to both physical aspects (sleep, nutrition, movement) and emotional/social components (family, friends, creativity, spirituality).2. Perfection shouldn't be the enemy of progress - it's important to maintain healthy habits while showing yourself grace during challenging times.3. Strong relationships and social connections are crucial for emotional resilience and long-term health, whether these connections are with family of origin or chosen family.Let’s make 2025 the Best Year EVER!!

Ever wondered what it's like to blend personal traditions with familial expectations during the holidays? In this episode of Pediatric Meltdown, Dr. Lia Gaggino shares her experiences with Christmas celebrations, highlighting the unique blend of Polish traditions from her husband's heritage and her own family's rituals.Family Rituals: Dr. Gaggino discusses the significance of family rituals, such as sharing a wafer similar to the Catholic host and wishing each other well, despite some family members finding it cringey.Meal Traditions: She talks about the specifics of their holiday meal, including mushroom soup and homemade pierogies, and how these traditions evolve over time to accommodate changing family dynamics.Importance of Traditions: Dr. Gaggino reflects on the deeper meaning of traditions, emphasizing their role in creating predictability, routine, and reassurance for children.Merry Christmas and Happy holidays to all of you.

Ever wondered how a simple injury can change the course of one's life? This episode explores the fascinating journey of a sports enthusiast turned medical professional, inspired by a personal encounter with a sports medicine provider after a college injury. The conversation delves into the complex world of concussions, discussing the evolution of treatment protocols, the importance of individualized care, and the severe risks of prematurely returning to play. You'll learn about tools like the SCAT symptom score and the VOMS for monitoring recovery, and the often-overlooked psychological impacts of concussions on young athletes. But perhaps the most crucial takeaway is the stark reminder: concussions are no joke, and honesty about symptoms can be a matter of life or death. Are you ready to rethink what you know about concussions? [00:33- 10:59]Initial Assessment and Management of Concussions The SCAT (Sport Concussion Assessment Tool) is mentioned as a crucial tool for evaluating concussions.The importance of understanding the broad nature of concussions and their varied symptoms.Reassuring patients and their families about the management plan.An emphasis on the need for individualized treatment plans for concussions.[11:00 -16:47] Red Flags and Immediate ConcernsRed flags that indicate a more serious condition, such as worsening symptoms and unusual behavior.Specific symptoms like nausea, vomiting, and severe headaches that should raise concern.Trusting your instincts and gut feelings when assessing a concussion.Immediate action is needed if a patient's condition deviates from expected recovery patterns.   [16:48 - 44:47]  High-Risk Sports and Gender-Specific Risks    High-risk sports for concussions, including for men: wrestling, basketball, soccer: For women: cheerleadingThere is a potential for prolonged recovery in athletes with underlying medical issues.Initial visits should focus on identifying concerning symptoms and ruling out underlying conditions.A comprehensive approach to managing concussions is needed, especially in high-risk sports.[44:48- 58:16] Treatment Algorithm and Activity Management Treatment Algorithm and Activity ManagementAn outline of a general treatment algorithm for managing concussions in the first 48 hours and beyond.The importance of gradually returning to activity while ensuring symptoms do not worsen.Provide physical therapy orders and ensuring PT sites treat concussions effectively.Educate patients and families about the expected recovery process and potential setbacks.[58:17 - 01:10:00] TakeawaysResources:AAP Sports-Related Concussion Recommendations:AAP Concussion Recommendations AAP article and Amsterdam Consensus: Statement: AAP and Amsterdam Consensus StatementAAP Vision and Concussion:  Vision and...

Ever wondered how to smoothly transition pediatric patients with complex conditions like ADHD into adult care? This episode talks about the challenges and strategies involved in this critical handoff. Dr. Peter Jensen and Dr. Lia discuss the importance of educating and empowering teens to manage their conditions independently, drawing parallels with other chronic illnesses like asthma and diabetes. They explore the nuances of preparing both the patients and the accepting providers to ensure a seamless transition. Additionally, they discuss resources for understanding adult ADHD and address some of the barriers to care when teens go out of state for college or careers. This episode highlights the importance of systematic, careful planning and open communication to prevent gaps in care during this transition period. [00:05- 17:16] Gender Differences in ADHD DiagnosisLater diagnosis of ADHD in females.Fewer hyperactive symptoms in females leading to delayed diagnosis.Quietly distracted children may be overlooked.Morphing of symptoms towards inattentiveness in teen and young adult years.   [17:17 -23:15] Adult ADHD and Mental Health Risks  Reduction of hyperactivity and impulsivity symptoms over time.Increased risk of anxiety, depression, and substance use in adults with ADHD.Challenges in recognizing adult ADHD due to comorbid mental health issues.The role of family practice providers in identifying adult ADHD.   [23:16 - 43:50]  ADHD Medication and Substance Use Concerns    There is diversion and misuse of ADHD medications.Holding patients accountable for lost or stolen medication.Comparing ADHD medication misuse to other substance abuse issues.Importance of clear communication between providers and patients.[43:51 - 48:50] Recommendations for ADHDMention of the book "Driven to Distraction" by Ned Hallowell.The importance of education and awareness about adult ADHD.The role of pediatricians in thinking about ADHD in adults.Emphasis on ensuring pediatricians and healthcare providers are aware of the Reach Institute.[48:51 - 57:47] Take AwaysConnect with Dr. Peter JensenWebsite: https://thereachinstitute.org/LinkedIn: https://www.linkedin.com/company/the-reach-institute-resource-for-advancing-children-health/Facebook: https://www.facebook.com/REACHInstitute/Twitter: https://twitter.com/reach4kidsRESOURCES MENTIONED IN THE EPISODEThe REACH Institute: www.thereachinstitute.orgDriven to Distraction" by Ned Hallowell. This book is highly recommended for understanding ADHD in adults. It is easily readable and includes stories and checklists of symptoms that can help readers identify ADHD traits in themselves or others.Go to https://lifeaftercorporatepodcast.com/ for all...

Have you ever wondered if ADHD is being misunderstood or misdiagnosed in children, leading to feelings of failure and unchecked anxiety?&nbsp;In this episode of Pediatric Meltdown, host Dr. Lia Gaggino and Dr. Norrine Russell talk about the complexities of ADHD, from its nuances to the pressing need for systemic change in how it's perceived and treated. They shed light on the importance of recognizing ADHD as non-willful behavior, the role of early intervention, and the imperative of individualized education plans. With data-backed insights and real-world anecdotes, this discussion underscores the urgency of a more equitable and comprehensive approach to ADHD treatment.&nbsp;This is a must-listen for educators, parents, and healthcare providers.[00:38 - 7:37] Unpacking ADHD and Common MisinterpretationsDefinition of "pure ADHD," described as a potential "gift," affecting a smaller segment of diagnosed children.Discussion on comorbidities like dyslexia, dysgraphia, mood disorders, and autism, affecting two-thirds of ADHD-diagnosed children.Issues of whether anxiety stems from late-diagnosed ADHD or contributes to its symptoms.Emphasis on early intervention to prevent ADHD from triggering anxiety and encourages proper diagnosis to avoid misunderstanding behaviors.[07:38 - 14:07] Individualized Educational Approaches and Social SkillsImportance of personalized educational strategies for neurodivergent children, avoiding a "one size fits all" methodology.Benefits of involving children in solution-finding processes for tailored educational support.Highlighting social delays in children with ADHD and the role of structured activities in fostering social interactions.Allowing children to build on their strengths and interests to enhance self-esteem and personal growth.[14:08 - 21:15] Challenges in Diagnosing and Treating ADHDDiscussion on the misconception of oppositional defiant disorder (ODD) and its potential misinterpretation as ADHD symptoms.Need for differential diagnosis to distinguish between ODD and ADHD, particularly in the context of trauma.Advocacy for multimodal ADHD treatment plans, integrating medication, parent education, and school plans as per American Academy of Pediatrics guidelines.Addressing systemic inequities in healthcare affecting children on Medicaid and the impact of racial biases on ADHD treatment.[21:16 - 28:22] Tools, Resources, and the Path ForwardDiscussing genetic links and familial patterns discovered during psychosocial intakes.Importance of early identification to prevent negative academic cycles and enhance engagement.Promoting ADHD acceptance and self-advocacy by normalizing brain differences.Recommendations for educational materials, like "ADHD is Awesome" and "The Anxious Generation," and promoting Norrine’s podcast for further insights.Resources Mentioned:Vanderbilt and Connors Symptom Trackers (Symptom Trackers)&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; Vanderbilt ADHD Diagnostic Rating Scale (VADRS) - Psychology ToolsBook: ADHD Is Awesome - ADHD is Awesome: A Guide To (Mostly) Thriving With ADHD: Holderness, Penn, Holderness, Kim, Edward Hallowell: 9781400338610: Amazon.com: BooksBook: <a href="https://www.example.com/" rel="noopener...

Can a doctor's strongest medicine be kindness to themselves?&nbsp;In this candid conversation, Dr. Kathy Stepien, physician coach and advocate for medical wellness, challenges the notion that self-criticism leads to better performance. Speaking with host Dr. Lia Gaggino, she unpacks how physician coaching has evolved from executive suites to mainstream medicine, backed by clinical trials from institutions like Mayo Clinic and Stanford. Dr. Stepien shares powerful stories about identity transitions in medicine, from early-career challenges to retirement questions, while offering practical ways to find the right support.&nbsp;Her remarkable work in bringing hidden struggles to light proves that no physician needs to walk their professional journey alone.&nbsp;[00:05- 15:07] Challenges Physicians Face in Their CareerIsolation despite being surrounded by accomplished colleagues, leading to internal strugglesDemanding nature of the profession requiring significant self-sacrifice beyond typical 9-to-5 hoursStruggle with maintaining autonomy, especially when transitioning from private practice to employed positionsDifficulty in managing time and energy while trying to balance multiple responsibilities&nbsp;&nbsp;&nbsp;[15:08 -26:02] Navigating Challenges in Medical Training and Practice &nbsp;Seek safe persons to confide in when facing discrimination or difficult situations, particularly those slightly removed from your immediate environmentRecognize that no medical professional needs to handle struggles alone - it's acceptable and beneficial to ask for helpAddress issues strategically and wisely, especially in situations with significant power differentialsRemember that supporting each other is crucial - medical professionals need connection and understanding from peers who share similar experiences&nbsp;&nbsp;&nbsp;[26:03 - 39:24] &nbsp;Power Dynamics and Professional Growth in Medicine &nbsp;&nbsp;&nbsp;Early career physicians often feel vulnerable during training periods, but gain more ability to advocate for change as they advance in their careersThe transition from clinical practice to administration reveals different cultural challenges, including slower decision-making processes and risk aversionThe importance of speaking up against inappropriate behavior, such as public humiliation, despite the professional risks involvedThe value of having witnesses and support systems when addressing workplace issues[39:25 - 57:43] Benefits of Physician Coaching&nbsp;&nbsp;Data shows solid evidence of improved physician well-being and quality of lifeLeads to profound improvement in emotional exhaustion reductionEnhances self-compassion among medical professionalsResults in better patient outcomes when physicians are well-supportedConnect with Dr. Kathy Stepien&nbsp;Website: https://www.instituteforphysicianwellness.com/Instagram: www.instagram.com/kathystepienmdFacebook: https://www.facebook.com/physicianwellnessLinkedIn:https://www.linkedin.com/in/kathystepienmd/Important Links To Share:&nbsp;Anti-Burnout Program for Women Physicians: <a...

What happens when a pediatrician hands a free book to a parent and changes the trajectory of a life?&nbsp;Meet Claudia Aristy whose first encounter as a new immigrant mother with “Reach Out and Read” sparked a remarkable transformation. Through her work with the Health Education and Literacy for Parents (HELP) Project, Claudia demonstrates how pediatricians can encourage literacy through books while supporting immigrant families. Her personal story describes the power of how parent-child reading led to her own high school completion and college graduation.&nbsp; Her work showcases how simple interventions can create lasting impact on children's development.&nbsp; Her conversation with Dr. Lia Gaggino explores innovative ways to promote bilingual literacy and to strengthen parent-child interactions through reading, while turning waiting room time into valuable learning opportunities.This episode proves that when healthcare meets literacy, extraordinary changes happen in families' lives.&nbsp;[00:05- 17:39] Impact of Early Reading Programs in Pediatric Settings&nbsp;A powerful moment of transformation occurs when pediatricians gift books to families during well-child visits, creating a bridge between healthcare and literacyThrough programs like Reach Out and Read, medical providers effectively communicate how daily reading routines contribute to brain development and school readinessFree book distribution in medical settings removes financial barriers, especially beneficial for immigrant families who may find traditional bookstores inaccessible or unaffordablePediatricians serve as trusted messengers, helping parents understand the connection between early reading and cognitive development&nbsp;&nbsp;&nbsp;[17:40 -24:13] Bridging Healthcare and Literacy Through Reach Out and Read &nbsp;Pediatricians serve as crucial advocates for child literacy by incorporating books into medical visits, creating meaningful connections with families beyond just medical careThe program transforms routine medical checkups into opportunities for promoting parent-child reading interactions, making healthcare settings more welcoming and educationalFree book programs integrated into medical visits help break down barriers to literacy, especially for families with limited resourcesPediatric literacy initiatives become more effective when healthcare providers take time to make genuine connections and offer encouragement to parents&nbsp;&nbsp;&nbsp;[24:14 - 35:20] &nbsp;Effective Parent-Child Reading Engagement &nbsp;&nbsp;&nbsp;Positive interactions during reading sessions go beyond literacy - making eye contact and smiling are simple yet powerful ways to connect, requiring no formal education or special trainingParents don't need advanced degrees to make meaningful contributions to their children's development through reading and storytellingCreating joyful memories around books is more valuable than perfect reading skills, especially for parents who may struggle with literacy themselvesDaily reading can be adapted to busy family schedules, acknowledging real-world challenges like multiple jobs and time constraints[35:21- 53:07] Empowering Parents Through Healthcare-Based Literacy Initiatives&nbsp;&nbsp;The HELP (Health Education and Literacy For Parents) project maximizes waiting room time by conducting health literacy activities, transforming passive waiting into active learningPediatricians serve as trusted authority figures who can effectively encourage and validate parents' roles as their children's first teachersFree resources are available through greenlighthelp.org, offering evidence-based information aligned...

How can we help teens with bipolar disorder manage their symptoms and transition successfully into adulthood?&nbsp;In this (part 2) episode of Pediatric Meltdown, host Dr. Lia Gaggino and child psychiatrist Dr. Jeanette Scheid discuss managing bipolar disorder in young adults during major life transitions. From medications for bipolar disorder in youth to support resources, they explore how parents and healthcare providers can identify early signs of a bipolar manic or depressive episode and implement effective treatments. Dr. Scheid shares practical strategies for maintaining stability, including sleep schedules, substance use prevention, and the vital role of college support services.&nbsp;Whether you're a healthcare provider or parent seeking to understand bipolar disorder treatment for teens, this conversation offers clear guidance for helping young people thrive.&nbsp;[00:33 -10:28] &nbsp; Critical Warning Signs and Transition Risks for Young Adults with Bipolar DisorderPoor sleep patterns often emerge as one of the earliest indicators of potential manic episodesEarly symptom recognition training for both parents and youth helps prevent severe episodesRegular psychoeducational conversations with everyone in the youth's support system enhance management successLiving independently introduces new challenges that require careful monitoring and support[10:29 - 19:29]&nbsp; FDA-Approved Medications for Youth Bipolar Disorder: A Primary Care Guide&nbsp;&nbsp;Key antipsychotics including aripiprazole, quetiapine, risperidone, olanzapine, asenapine, and lurasidone are FDA-approved, for adults with bipolar disorders.&nbsp; There are fewer medications approved for youth due to lack of clinical studies.&nbsp;&nbsp;No anti-seizure medications currently hold FDA approval for bipolar disorder in youth, though some are approved for adultsMost common lithium side effects include headache, nausea, increased thirst, and mild tremorsRegular thyroid function monitoring is essential, often requiring collaboration between pediatricians, endocrinologists, and psychiatrists[19:30 -39:22]&nbsp; Understanding Lithium Treatment in Youth Bipolar ManagementTherapeutic window for lithium is narrow, ranging from 0.6 to 1.2 milliequivalents per liter, requiring careful monitoring and frequent lab workDehydration and changes in salt balance can trigger dangerous lithium toxicity levelsFamily medical history plays a crucial role in treatment decisions, as demonstrated by cases where lithium proved more effective than second-generation antipsychoticsRegular lithium level monitoring (1-2 times yearly) is necessary for stable patients, with more frequent checks during dose adjustments[39:23 - 50:50] Building Knowledge Bridges: What Primary Care Needs to Know About Youth Bipolar CareUtilizing child psychiatry access programs as learning resources for medication managementUnderstanding safety profiles of common medications, even when not directly prescribingRecognition of medication effects similar to monitoring diabetes care in primary practiceValue of ongoing consultation with psychiatric specialists for medication questions[50:51 - 1:04:37]&nbsp; Closing segment TakeawayLinks to resources mentioned on the showResources Part 1:AACAP Facts for Families:&nbsp; Facts for...