Dr. O'Toole's Blog

And you think we have it bad...some consolation

Feb 9 2009 - 1:06pm

It is no secret to anyone who is breathing that our economy has taken a few terrifying turns these past four months or so and has slowly but surely begun to affect everyone. When parents get laid off, they lose their health insurance, not to mention any leeway they had in their budget to seek medical care for themselves and their children. In the case of Kartini Clinic parents, in the past, one parent could afford to seek family medical leave of absence to engage in family based treatment here while the other kept earning an income…as long as the other was earning an income.

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Dr. Brazelton on Self-Esteem in Children

Dec 19 2008 - 1:12pm

Happy Holidays and Holy Days to all our Kartini Clinic friends. This blog is a quote from one of my “most admired” pediatricians and another doctor named Joshua Sparrow on the subject of “self esteem”, a term I have come to hate for its over-use. As usual, Dr Brazelton has something useful and instructive to say on the subject. I would encourage you to google him for other pearls of wisdom.

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"Water weight"

Oct 17 2008 - 10:35am

Water Loading Before Appointments

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Wearing Weights

Oct 7 2008 - 11:41am

I remember the first time a patient of ours was “caught” wearing weights. I was examining her with her mother and a young resident pediatrician in the room. I noticed that her weight was up, but she looked terrible! So I thought to myself: back to basics, re-examine her carefully in case you have missed some physical sign, maybe she has grown in height and weight has not caught up…..so I repeated her physical exam with an eye to re-assessing her pubertal development.

Is Anorexia Nervosa a Chronic Illness?

Sep 10 2008 - 2:53pm

Recently, while responding to a struggling parent who had posed a specific concern on the F.E.A.S.T. website, I used the word “remission.” Another mother on the forum responded that she did not like my use of the word “remission” since she preferred to think her daughter’s illness was not chronic. Until that moment it had not occurred to me that this question of chronicity was a controversial one for some parents.

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Returning to college

Sep 2 2008 - 5:28pm

I got off the phone with a college student health doctor last week with the sinking feeling that I get when I have not been able to convey the rationale for what we do here at Kartini Clinic.

Food Phobia of Childhood: a "new" eating disorder

Aug 25 2008 - 4:51pm

By Julie K. O'Toole MD, MPH

I have decided occasionally to write about topics that may be of more interest to practicing physicians and other providers confronted with difficult or unusual cases related to disordered eating. This is one of those topics.

The Very Young Patient with Anorexia Nervosa

Jul 30 2008 - 11:09am

This morning I was reading a mother’s cry for help on Laura Collins' blog “Around the Dinner Table." The scared mother spoke of her 10 year old daughter’s struggle and her own ambivalence about what to do. There were many supportive responses from other parents and although I have a lot to say on this subject, I did not chime in for fear of sounding self-promoting. Yet the very young child is Kartini Clinic’s special area of expertise.

Determining Ideal Body Weight

Jul 22 2008 - 2:32pm

Determining "ideal" body weight in children who suffer from anorexia nervosa is complex. Pediatric patients cannot be treated like “little adults”. An example of this principle is the way medication is dosed in childhood. The right dose of an antibiotic for a newborn is different than the right dose for a two year old or for a 14 year old. And so it is for setting “weight goals” in pediatric eating disorder patients.

First Menstruation in very young eating disorder patients

Jul 2 2008 - 4:50pm

Reporting on a new article

I just reviewed an article which should help us answer the question: how much will my young daughter with anorexia nervosa need to weigh in order to grow normally again and to get a period?

First a few jargon words to know: