Dr. O'Toole's Blog

Eating "too much"

Jun 23 2009 - 9:49am

I just read a parent’s thread on Laura Collin’s FEAST website called “Eating Too Much”. It made my hair stand on end. And it clearly resonated with more than one parent on the FEAST site.

It is the old story of a weight restored child with anorexia nervosa continuing to eat a lot and moving up way past their weight goal. Both the child and the parent are panicking.

Take time to smell the azaleas...

Jun 9 2009 - 6:02pm

I am a gardener when I am not in the clinic. It used to be that I did all my best thinking in the shower. Now I do it in the garden. So some musings from there.

Thinking about stress today. Stress and our patients. What does the word stress mean for all of us?

Delivering Better Care

May 13 2009 - 11:02am

How can we do it better?

Bones and Anorexia Nervosa: osteopenia/osteoporosis

Mar 27 2009 - 1:29pm

As we all know, weakening of bones is one of the most concerning effects of the malnutrition associated with anorexia nervosa (AN) in girls and boys.

What is the problem?

Osteopenia (“weak bones”) is a precursor to osteoporosis (“bones full of holes”). It is not uncommon for a young patient with anorexia nervosa to present to their doctor with a stress fracture as the first manifestation of their illness. And sometimes even that gets ignored.

Submissions for the Title: Most Ignorant Comment Ever

Feb 24 2009 - 1:59pm

A note from the editor: We are pleased to announce the launch of a new feature to our blog that will allow viewers to leave comments and share their thoughts with us and each other. Simply enter your comment at the bottom of the this page. All comments will be approved by our moderator before being posted. Please always be appropriate and considerate of others' opinions and feelings. Thanks.

***********

Submissions for the Title: Most Ignorant Comment Ever

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.

Read more » 0 comments

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.

Read more » 0 comments

"Water weight"

Oct 17 2008 - 10:35am

Water Loading Before Appointments

Read more » 0 comments

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.

Read more » 0 comments