Top Procedures for Kids

Are Children’s Eye Exams Overlooked?

Dr. Jim demonstrates a typical pediatric eye exam and screening on Francesca and Leo, two young volunteers. The pediatrician says that his eye chart of choice uses animal shapes rather than letters because children tend to verbalize them better. He attempts to take pictures of Leo’s eyes with a Welch Allyn SureSight Vision Screener, but Leo squirms and wiggles in his chair. “Welcome to my world!” the doctor jokes.


Dr. Jim explains that the device takes pictures of the pupils and measures refractions and compares the readings between the two eyes. Dr. Jim stresses that children should have a vision check before the age of 3; sooner if there’s a history of vision problems in the family. He stresses that squinting and tilting the head at an angle are warning signs that your child might have vision problems, so be alert! If treated early, vision problems can usually be corrected, but the longer you wait, the higher the risk that the problems will worsen.


Do Ear Infections Cause Obesity?

A recent study suggests that chronic ear infections may lead to childhood obesity. Dr. Ordon explains that chronic infections in the ear may affect or change a child’s sense of smell and cause him to eat more. However, he quickly debunks the study, citing that the House Ear Institute in Los Angeles did not see a correlation.


Top Five Pediatric Medical Procedures

The Doctors count down the top five medical procedures for kids. Are they really safe?


5. Newborn Testing

Newborns are screened for metabolic disorders with a blood test. The disorders are often difficult to diagnose on their own until it’s too late, so the tests are meant as an early diagnostic tool. Dr. Jim explains, “If you find out early, often there are simply dietary changes that you can make.”


Sometimes the tests are incorrect, such as a false-negative or a false-positive, which can be misleading. Actor Scott Baio’s newborn daughter tested positive for GA-1, a rare but serious metabolic disorder, which required doctors to take a skin biopsy for further examination. Grief-stricken, Scott and his wife waited 10 agonizing weeks for the results. “How do you love a child that’s potentially going to die?” Scott asks.


Happily, the couple learned that they had received a false-positive test. “Well, we went through hell, now we’re going through heaven!” his wife concludes. Though the potential for misdiagnosis can deter parents from the screening process, The Doctors implore that it is vital to have these tests performed.


4. Open Wide!

Jaw widening is an orthodontic procedure that expands the upper and/ or lower jaw to create more room for permanent teeth. The expansion takes several weeks to complete and is relatively painless. Orthodontist Dr. Atoosa Nikaeen says that once the metal contraption is fitted and in place, a key is turned every other day to stretch the jaw at .25 mm intervals.


Jaw widening acts to prevent future extractions of permanent teeth or other potential surgeries that arise from an over-crowded mouth. Nine-year-old John had a jaw widening device placed in his upper jaw a few days ago and reports that he feels fine. “I’m talking a little weird, but overall, it’s not hurting,” he comments.


Dr. Nikaeen notes that the American Association of Orthodontists recommends that all children should have an orthodontic evaluation at the age of 7. 


Signs that Jaw Widening Might Be Needed: 

• The upper jaw is very small and narrow

Teeth are crowded


Trouble breathing

Large tonsils

Large adenoids

Hereditary problems

Tongue thrusting habits

Thumb sucking habits


3. Ear Tubes

Ear infections occur more frequently in children because their Eustachian tubes -- the funnels that link the pharynx to the middle ear -- are shorter, narrower and more horizontal than in adults. This particular alignment can impede the flow of air and fluids through the tubes and lead to infection; the fluid pools and bacteria grow.


If children are plagued by frequent ear infections, physicians can surgically insert ear tubes, or shunts, into the ears to alleviate the problem. The tubes ventilate the area behind the eardrum and equalize the pressure in the middle ear.


Although the surgery takes approximately 15 minutes, general anesthesia is required, so talk to your doctor about the risks and benefits of the procedure.


Symptoms of a Middle Ear Infection:

Pulling or rubbing ears


Fussiness or irritability

Fluid leaking from the ear

Changes in appetite or sleeping patterns

Trouble hearing


2. Circumcision

Circumcision comes under the knife; is it a necessary medical procedure or purely cosmetic? A circumcision removes the foreskin from the tip of the penis.  Dr. Jim maintains that circumcision is a cosmetic procedure and a boy should have the option to choose whether he wants it performed or not. Dr. Lisa maintains that circumcision is a type of preventative medicine and is the better hygienic choice; it also reduces the risk and rate of sexually transmitted diseases and penile cancer. Dr. Jim then demonstrates a circumcision on a banana tip.


1. Tonsillectomy

Tonsils are lymph node tissues in the throat that are meant to fight infection, but sometimes they can they can turn into the source of infection. If the tonsils are regularly infected, they need to be surgically removed, which is called a tonsillectomy. A patient must be put under general anesthesia, which carries its own set of risks in children.   


Steve and Kristen were alarmed to learn that their 4-year-old son, Caden’s, excessive snoring actually stemmed from his considerably enlarged tonsils interfered with his breathing. Pediatric ear-nose-throat surgeon Dr. Nira Shapiro noted that Caden’s airway was nearly obstructed by his tonsils. She performed a cutting-edge tonsillectomy on Caden and brought the surgical tools she used to the studio.


Dr. Shapiro “operates” on a raw chicken breast to demonstrate the difference in cutting results with the old and new technology. She explains that electrocautery is the old technique, which cuts tissue by burning through it at 400 degrees Celcius; it causes a deep scarring and increases the patient’s recovery time. Conversely, the new technology, coblation, uses a cooling technique that simultaneously emits saline and irrigates the surgical area. The coblation wand operates at only 40 to 70 degrees Celcius, which greatly reduces tissue damage and lessens recovery time.


Where in the World?

Gloria from Great Falls, Montana, writes to ask about her daughter’s patchy tongue and sends a picture to illustrate her concerns. Dr. Jim explains that her Gloria has geographic tongue, also called benign migratory glossitis. The “patches” are actually denuded areas of the tongue where the papillae have fallen off. Although the papillae will grow back in seven to 10 days, the denuded areas form a “geographic” or patchy pattern. The causes of geographic tongue are still unknown, but some explanations include allergic reactions, sensitivity to certain environmental factors, vitamin deficiencies and hormonal changes.  


Plan B

Sandra from Washington, D.C., writes to ask about the Plan B morning-after pill. She and her husband are considering starting a family but have had second thoughts since they had unprotected sex three days ago. Dr. Lisa explains that Plan B is an emergency morning-after pill that blocks ovulation and is 95 percent effective if taken within 24 hours of sexual intercourse. The pill’s efficacy decreases over time, but if taken 72 hours after intercourse, is only 80 percent effective.


Celebrity Medical Scares

All eyes turn to Hollywood for the latest in film, fashion, gossip and television. But the stars of Tinseltown are human too and have their share of medical scares and crises, just like the rest of us.


Pancreatic Cancer

The function of the pancreas is to secrete enzymes and hormones that aid in digestion and the metabolism of sugars. Pancreatic cancer spreads rapidly, is extremely aggressive and is often referred to as a “silent disease” because those affected rarely show any signs or symptoms of it. By the time the cancer is detected, it’s virtually untreatable. The prognosis for most pancreatic cancer is poor; it’s a leading cause of cancer death. 


Actor Patrick Swayze was diagnosed with pancreatic cancer in late January 2008, and has been undergoing chemotherapy and other treatments to combat the disease.



Songstress Natalie Cole Diagnosed with Hepatitis C

Singer Natalie Cole revealed that she is battling Hepatitis C. Although the virus lay dormant for the last 25 years, it has recently awakened and Natalie is combating her liver infection with chemotherapy.


Learn more about hepatitis.

For more information about the products mentioned on this show, please go to Related Resources
Sign Up for The Doctors Newsletter| Show Page |Talk About the Show!
OAD 11/19/08