My husband Dave often reminds me that I am the worst Buddhist he knows, meaning I rarely “slow down” and have only one speed: super fast. He sometimes jokes that he would give me a hug if only he could catch me (our house is not that big, I am just running in small circles rushing to get stuff done based on my self-imposed to-do list and internal imaginary stopwatch).
I have a love-hate relationship with December. Love this month because of the amazing shared expectation by all that we will rejoice, there will be social gatherings, work parties, celebrations with colleagues and family, buying and receiving of gifts, music, family traditions, baking, eating baked goods, time off of school and work, hot chocolate, snow for those who are lucky, movies, Christmas movies, the Elf, all activities if you have young children, and new this year for us, sitting together to watch Hallmark Christmas movies and make fun of them.
Hate is a strong word. Maybe STRONG dislike. The reason I have conflicting feelings all month and resentment every December, is that it’s perhaps the busiest month for surgeons and especially pediatric ENTs. Most families’ deductible is paid, and kids are off of school and parents have time off so everyone wants their surgeries and tonsils done before December 31st. A busy work schedule leaves little time to actually plan presents in a thoughtful manner, ENJOY shopping, so one is equally tired when finally home at night.
The pressure mounts day after day as I think about not only who I have not finished preparing a gift for, all the while thinking about whether it’s really okay not to insist we bake cookies and impose special activities on ourselves. With more occasions that require dressing up and looking nice, yet the numbers on the scale go up since eating Thanksgiving pie and don't decrease well after you have stopped eating the pies and sweets.
In my mind, I fantasize about taking an entire month off, so that I can play tennis daily, slim down for the holiday parties, wander around the mall and shop as if it’s fun (would not know how that feels, shopping has always been time pressured). Online shopping is not my strength but I am working on it. Taking my daughter Claire to holiday shows.
I hope you will enjoy the article! At the very least, I take comfort in ensuring my walking routine still occurs this month and tennis still will be scheduled as if my life depends on it.
]]>As much as I hate to admit it, I would come home after working long hours at the hospital and would ask her, "Honey, did you finish your homework? Did you practice piano? Did you...? Did you...? Did you...?"
I was the "Honey Did You" mom!
Then one day my husband and my daughter called me out.
My husband asked, "Julie, when have we ever answered 'no' when you asked these questions?"
Claire added, "Mom, is that what you really care about?"
Yes, I do care. But I also realized that I was just focusing on the operational logistics of our household. By focusing on these logistics, I was sucking love, life and gratitude out of daily living. I wasn't connecting with my husband and daughter on a deep emotional level.
Now I ask these questions when I get home from work:
What questions do you ask your kids when you get home from work?
Listen to more stories by Dr. Julie Wei on the Janus Henderson Radio Podcast called, 3 Ways to Address the Rising Stress in Our Youth. Listen on Spotify.
PODCAST TESTIMONIALS
"I’ve been listening! I loved Dr. Wei's interview with Dr. J. She was so eloquent and compelling with her personal story. I have already started to make a deliberate effort to not talk about the traffic or any 'noise' when I get home so I live in the moment, give the best me to my family and not spread the stress in my household." —Alexandria
"I listened to the whole thing. I love her emotion when she talks about her daughter." —Catharine
"Dr. Wei was brilliant! Such an important topic. Thank you for sharing." —Loree
]]>A top corporate executive, who is very busy, made a commitment to make it home at 6pm everyday because his family is important to him. He has 2 young boys—5 and 8 years old.
He sticks to his commitment and makes it home by 6pm each night of the week. However, when he gets home, he has his laptop open, his phone by his side and continues to work all the way up to bedtime.
A few weeks go by and then, due to timezone challenges related to work, he can't make it home till much later—after his children have gone to bed. Monday, Tuesday, Wednesday roll by. He misses his kids so much. So, he calls his wife Thursday morning and asks her to keep the boys up till he gets home around 9pm so that he can tuck them in.
He walks in at 9pm, puts down his briefcase and immediately runs upstairs to the boys. He's wrestling with them, reading books to them, tucking them in and, as he's turning off the light and walking out, his 5-year old says, "Hey Daddy, can you come home at 9 o'clock every night?"
We know that it's not just about being physically present in the same space as your children that matters, it's about being fully engaged with them that makes the difference.
Listen to more stories by Dr. Julie Wei on the Janus Henderson Radio Podcast called, 3 Ways to Address the Rising Stress in Our Youth. Listen on Spotify.
PODCAST TESTIMONIALS
"I’ve been listening! I loved Dr. Wei's interview with Dr. J. She was so eloquent and compelling with her personal story. I have already started to make a deliberate effort to not talk about the traffic or any 'noise' when I get home so I live in the moment, give the best me to my family and not spread the stress in my household." —Alexandria
"I listened to the whole thing. I love her emotion when she talks about her daughter." —Catharine
"Dr. Wei was brilliant! Such an important topic. Thank you for sharing." —Loree
]]>INGREDIENTS:
DIRECTIONS:
Not sure how to cut a mango? Check out my video below and go to my YouTube channel for more videos to support the health and well-being of your family.
]]>As a physician, researcher, and scientist, and even if you are not, so many today are blatantly choosing to ignore the science supporting the reality of climate change. Unlike climate change, physicians and providers like myself, who care for children every day, in clinic and in surgery, can attest to the continued increase of the childhood obesity epidemic, as this report warns.
When we see a child, examine an innocent young preschooler or toddler, or of any age, measure and record their weight and body mass index, the obesity is not for debate. When I am preparing to perform tonsillectomy for obstructive sleep apnea in the operating room for a 5 year old who weighs 90 pounds, who has difficulty sitting up and having his torso bend in half, and my colleagues and I are on alert status during anesthesia and after wake up from surgery, this is not up for anyone’s opinion to debate.
Isn’t this child abuse? How can we allow innocent children whose palates and brains are susceptible to sugar addiction, fast food addiction, and processed tastes that achieve the “bliss point”, which industry knows so well and can market to achieve gains at the cost of human health and lives? At what point is the “margin” tolerable or even ethical, at the cost of the future of our human race, our dignity, and freedom from disease?
How do we as parents and caregivers truly speak up? Exert our collective powers? It’s difficult but possible. I for one believe that by not purchasing these products, not visiting these fast food restaurant, sharing awareness and resolve to save our children, we can send a loud message to all who are making “margins” at the expense of our health and lives. Without demand, production will have to decrease. Without purchase, there will be less margin.
My heart aches daily, as my colleagues and I work hard to explain to families WHY their child’s obesity should be of concern, and what their primary care doctors may or may not have told them. Perhaps their primary physicians have given up. How can doctors who have trained for years, in a volume based care model, fight against the giants of industry who spend millions on advertising, marketing to imply health, and perform research that helps them create the addictive behaviors in consumption? None of us were taught how to fight against that as we work tirelessly to help our patients.
Don’t sit and watch this happen, make your vote count, make your purchasing power count, make your voice heard and most of all, let’s stand up and say “Enough!” We will fight for the health and well-being of our children.
Chronic ear, nose and throat symptoms in children are often the result of acid reflux, which is ultimately the cause of eating too much dairy and sugar, especially before bedtime. If your child is experiencing chronic symptoms that just won't go away, check out my course "Curing Acid Reflux in Children: A Guide for Parents" for a natural way to bring your child back to whole health.
This recent NYT article, For a Longer Life, Get Moving. Even a Little., highlights new research which continues to demonstrate repeated findings that the more humans move, the less chance of us dying prematurely. Those studied moved up to a plateau at about 25 minutes per day of moderate exercise, such as brisk walking, or 300 minutes per day of light, gentle activity. Beyond that point, people did not gain additional longevity benefits, although their risks of premature death did not rise either.
Those of us who are so blessed to never have to face hunger, whose children have never been at risk of being hungry, should do whatever is within our abilities to help others. Children do not get to choose if they are born into a family that is struggling and is at or below the poverty line, wherever that may be. Adults joke about being “hangry”. Imagine being child who lacks food security, imagine if that was your child.
Make your voice heard, contact your local representatives, learn about what the current administration is doing, then make your vote count at the next election.
As I start my 18th year of practicing as a physician and surgeon (after 7 years of training to become an ENT surgeon just for kids), it is clear to me that the number of shades of grey increases in direct proportion with my age! How interesting that when I was a young medical student and resident, I eagerly embraced textbooks, what my attendings told me, and the research papers I read as the whole truth and nothing but the truth.
As it turns out, I have realized over the course of my career that science, medicine, and knowledge, just as life itself, is not black and white, and rarely is a “fact” today definitive until the end of time. Frankly, scientific and medical “facts” are about as true until the next larger, better study, or perhaps new knowledge points out flaws in the prior accepted “truths”.
Here are my comments about the 10 medical findings listed in this NY Times article:
Peanut allergies occur whether or not a child is exposed to peanuts before age 3.
NYT: Pediatricians have counseled parents to keep babies away from peanuts for the first three years of life. As it turns out, children exposed to peanuts before they were even 1 year old have no greater risk of peanut allergies.
Me: Allergies aside, nuts for toddlers who do not yet have molars pose significant choking and aspiration risks! See my blog on choking hazards for children.
Before 12 months of age, and likely even those younger than 2, kids at these ages will likely have difficulty and lack oromotor skills to get peanut butter off of the roof of their mouth! To me, risks outweigh benefits in exposing infants and toddlers directly to peanut butter and/or nuts so early in life, even if there is not a greater risk of allergies.
Fish oil does not reduce the risk of heart disease.
NYT: At one point, the notion that fish fats prevented heart trouble did seem logical. People whose diets contain a lot of fatty fish seem to have a lower incidence of heart disease. Fatty fish contains omega-3 fatty acids. Omega-3 supplements lower levels of triglycerides, and high levels of triglycerides are linked to an increased risk of heart disease. Not to mention that omega-3 fatty acids seem to reduce inflammation, a key feature of heart attacks.
But in a trial involving 12,500 people at risk for heart trouble, daily omega-3 supplements did not protect against heart disease.
Me: Be careful! It's really easy to interpret the sentence above to mean the study proves omega-3 fatty acids/fish oil is not beneficial...
The public needs to understand that the study used adult subjects who already received care and who had multiple cardiovascular risk factors or atherosclerotic disease but no previous myocardial infarction (heart attacks). The study concluded no evidence of the usefulness of n−3 fatty acids for preventing cardiovascular death or disease in this population. (Not the same as in the ENTIRE human population.)
Being of Asian descent, fish is almost a daily part of our diet, and even my Slovak grandmother-in-law, who is now 105 and a half, spent years taking fish oil! Of course it’s impossible to say that a fish oil supplement, by itself, without accounting for other factors, is or is not beneficial. For me, my message is that if children or adults who are not exposed to fish and/or other seafood or these foods are not an option in their diet, any potential benefits may be missed.
A lifelike doll carried around by teenage girls will not deter pregnancies.
NYT: These dolls wail and need to be “changed” and “cuddled”. The idea was that girls would learn how much work was involved in caring for an infant. But a randomized study found that girls who were told to carry around “infant simulators” actually were slightly more likely to become pregnant than girls who did not get the dolls.
Me: The focus probably really needs to be honest and gentle conversation about risks and consequences, both emotional and physical, for teenage girls to engage prematurely in any sexual activity. Having an unplanned pregnancy in teenage years has implications and negative consequences far beyond the role of a “doll” and learning to mimic domestic responsibilities and motherhood. The medical and health risks to the teenager, worse, the risk of premature birth to the baby, and finally, immense life changes that may or may not result in a positive and healthy lifestyles deserve to be the focus of conversation and our goals as parents, not whether a doll may decrease premature sexual activities in young people.
My daughter will not be getting a doll, but she has been “brainwashed” since age 8, about all details on the medical (including STDs, pregnancy, etc.), scientific, and most importantly emotional and human implications of “sex” and sex during teenage years and how unplanned pregnancy may impact educational opportunities and change the course of any life.
Ginkgo biloba does not protect against memory loss and dementia.
NYT: The supplement, made from the leaves of ginkgo trees, was widely used in ancient Chinese medicine and still is promoted as a way to preserve memory. A large federal study, published in 2008, definitively showed the supplement is useless for this purpose. Yet ginkgo still pulls in $249 million in sales. Did people just not get the message?
Me: So many supplements, so little science as defined by the accepted medical academic community. Everyone is entitled to believe and embrace supplements as they wish, as based on their cultural background, cultural dietary habits, etc. However, more broadly known and accepted science shows that movement, exercise, sleep, active engagement of the mind and body, along with a healthier diet, support health, life, memory, mood, and frankly no amount of ginkgo or any other supplement can substitute all that I have listed to magically give you incredible health! No short cuts is the bottom line!
To treat emergency room patients in acute pain, a single dose of oral opioids is no better than drugs like aspirin and ibuprofen.
NYT: Yes, opioids are powerful drugs. But a clinical trial showed that much safer alternatives relieve pain just as well among emergency room patients.
Me: This is often where I am disheartened that despite published research and studies that show risk of respiratory depression in young or obese children, if given narcotics, many Emergency Rooms and doctors still prescribe Tylenol with codeine for children, even when the FDA has published a black box warning! Clinical practice always lags research findings, and frankly, so many doctors either don’t believe it matters, or they believe they are too busy to make or find the time to read published and accepted standards of care, and instead may unintentionally increase harm to a patient by doing what they were taught decade(s) ago.
In my subspecialty, we accepted new information and science that shows not every child metabolizes codeine the same and those who metabolize it too fast will have a higher level of morphine in their blood! When data shows that head-to-head, Tylenol and ibuprofen work just as well as Tylenol and codeine after tonsillectomy surgery in preschool aged children, many of us stopped using codeine all together.
Testosterone treatment does not help older men retain their memory.
NYT: Some men have low levels of testosterone and memory problems, and early studies had hinted that middle-aged men with higher testosterone levels seemed to have better preserved tissue in some parts of their brains. Older men with higher testosterone levels also seemed to do better on tests of mental functioning.
But a rigorous clinical trial showed that testosterone was no better than a sugar pill in helping older men avoid memory loss.
Me: As a Pediatric ENT, this is not my area of expertise. I do think about my grandparents and my husband's grandparents, and senior friends, neighbors, and colleagues I respect. Memory is dependent on many factors, in my opinion, but aside from genetic, anatomical, medical factors, I am a firm believer that “if you don’t use it, you lose it”. Much like muscle mass as we age, if we want to avoid memory loss, activity, conversation, reading, mental challenges like crossword puzzles, visually and through our hearing, we make the brain pay attention to something different and it will be stimulated.
To protect against asthma attacks, it won’t help to keep your house free of dust mites, mice and cockroaches.
NYT: The advice from leading medical groups has been to rid your home of these pests if you or your child has asthma. The theory was that allergic reactions to them can trigger asthma attacks. But intensive pest management in homes with children sensitized to mouse allergens did nothing to reduce the frequency of their asthma attacks, researchers reported in 2017.
Me: My curiosity for this study and conclusion is whether all these patients in the study were ONLY allergic to mice, and nothing else. People who suffer from environmental allergies, like me, generally are allergic to more than one allergen. No matter what we do, we can’t really ever eliminate dust and dust mites completely, that’s why I always advocate a holistic approach to managing the nose!
Here is a recent blog I wrote on how to know whether your child has allergies.
Step counters and calorie trackers do not help you lose weight.
NYT: In fact, dieters may be better off without digital assistance. Among 470 dieters followed for two years, those who wore devices tracking the steps they took and calories they burned actually lost less weight than those who just followed standard advice.
Me: 470 people in a study does not lead to a generalization for our entire population, furthermore, there are many reasons the above statement may be true. I suppose those who wear the tracker because it was their Christmas or birthday gift but were not motivated to do so or to exercise, they might have less weight loss. Again, multifactorial; don’t read once sentence and decide it’s the “truth”.
Torn knee meniscus? Try physical therapy first, surgery later.
NYT: An estimated 460,000 patients in the United States get surgery each year to fix knee cartilage that tears, often because of osteoarthritis. The tear is painful, and many patients fear that if it is not surgically treated, the pain will linger.
But when patients with a torn meniscus and moderate arthritis were randomized to six months of physical therapy or surgery, both groups improved, and to the same extent.
Me: I believe in this study because Americans get more surgeries than they need, take more medications than they need, and go to the doctors and even emergency rooms more often than they need because they can…because we simply do not emphasize education about how to maintain optimal health and avoid the health care system. Johnson and Johnson has a great program to optimize patient outcomes after joint replacement all based on what patients do before surgery, and I definitely accept that by not trying non-surgical options first, one may miss out on a chance NOT to need surgery and get better.
If a pregnant woman’s water breaks prematurely, the baby does not have to be delivered immediately.
Me: That depends on the clinical situation—is the baby in distress? Is the mother? There are so many factors to consider...
]]>As tourists, we enjoyed all the incredible history and sightseeing as we visited the Eiffel Tower, Arc De Triomphe, Sacre Coeur, Giverny/Vernon/Monet Gardens and house, a cruise on the Seine, St. Chapelle, Versailles, Champ Elysse, etc.
After Paris we rented a car and drove four hours westward to stay at a Chateau De La Ballue in Bazouges-la-Pérouse, which was built in 1620 with the most breathtaking gardens and flowers. From there we spent a day with a guide in Normandy, profoundly humbled by our world history, an understanding of the immense casualty for many countries, and unmeasurable loss and grief for humankind. We visited Mont St. Michel in complete awe as all senses were engaged in disbelief of what humans can build with their bare hands 1000 years ago: smell the ocean, invigorated by the cool breeze, suppress the nerves from the incredible height at the top of the Abbey, hear calls of the seagulls, and feel our achy calves from climbing so many steps!
I indulged in 12 days of not cooking, enjoying French wines (sulfite free, delicious, and affordable) and cuisine, and yes, amazing pastries and desserts which were NOT sweet compared to what Americans are used to. As I inspected all the incredible dishes, took photos, and tried to chew and eat SLOWLY (highly unusual for me and my body), I was excited and inspired as I gained ideas for cooking which I hadn’t thought possible or at least was in my own routine making similar dishes most of the time.
Since returning back home, here are my 11 insights and inspirations as I savor our memories from each day of our amazing trip:
This recent article highlights and validates my experience over the past 5-6 years as a pediatric ENT, especially practicing here in Florida. The research finds that almost 63% of newborn referrals to pediatric ENTs for nursing difficulty (tongue tie or lip tie), given by lactation specialists, pediatricians and speech therapists, did not need any release.
I feel so validated as I have had the same experience in practice. I have pretty much stopped releasing any isolated LIP TIE due to nursing difficulty, most often for newborns referred to me because it’s assumed that if their upper lip doesn’t “evert” while they are nursing, it must be too short and should be cut. This is currently the most common reason babies are referred to me for a presumed upper lip tie diagnosis as cause for nursing difficulty.
Over 95% of referrals for that diagnosis end up being a reassurance visit with me, and as I watch a mother nurse in the office, I often am helping them understand that the main reason for poor latching is due to the mother having a somewhat flat or inverted short nipple, or a missed diagnosis of tongue tie.
I rarely release ANY infant /newborn lip tie. For newborns and very young infants, the only time I ever release a very short and excessive upper lip frenulum is if there is also tongue tie that is being released. As for older kids, if they have a thick excessively long upper lip frenulum, then I may offer release only if child also has severe tongue tie and will be scheduled for lingual frenotomy under brief anesthesia. As babies grow, the upper lip grows also and will lengthen. I always tell parents that the evidence does not support that a release of the upper frenulum will always lead to the closure of central diathesis between the central incisor for toddlers/older children.
This paper, published in in Jama Oto/HNS, validates our experience and what we message to parents, SLPs, lactation specialists, etc.
We are simply doing “too much” to newborns and babies, and it’s so important to reassure mothers and stop misguiding the public.
Please refer to my prior blog on this topic, if you missed it.
]]>When it comes to beverages we seem to all be convinced that kids need something to drink besides water. The juice box or drink pouch commonly makes its way into the grocery cart. Fresh fruit is a much better source because of the fiber, antioxidants and phytochemicals still present that are processed out when fruit is made into juice. I am a firm believer that if a beverage must be served with a meal, then that beverage should be water.
From the Eastern nutrition perspective, beverages should only be consumed between meals, and cold sweetened beverages during meal-time are a big no-no. It is important to let the stomach receive the meal at a warm temperature and not to shock the digestive system with an ice-cold drink while you are eating warm or hot food. Furthermore, it is believed that juices or sodas will ruin your stomach for a nutritious meal, or what westerners would term "spoil your appetite".
In East Asian culture, elders make sure that any beverage that a kid wants is had after the completion of the meal. Interestingly, western research dovetails on the nutritional merit of this age-old philosophy. Consuming your calories in solid versus liquid form (food vs. beverage) plays a role in whether or not your body knows it is full. We may not get the same satiety cues from drinking our calories than we do from eating them, and there is evidence to show that energy intake and weight gain skews high if calories are consumed as a beverage. Perhaps spoiling your appetite has morphed into not being able to tell if you are still hungry in today's food environment in which we are surrounded by sweetened beverages.
TIP: Even if you don't subscribe to the Eastern practice of drinking beverages except water only between meals, I do recommend that you serve mostly water and limit regular sodas and sweetened beverages to rare occasions for your child.
I invite you to take the Water Challenge: for one week, challenge yourself and your kids to drink more water than any other beverage. Download the Beverages Tracking Log to help track what you and your family drink throughout the week.
For more information on how sugary drinks impact people, read this CNN Health article describing a study that links a small glass of juice or soda a day to an increased risk of cancer.
]]>