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Bear Essentials Online - August 2012


Articles in this issue

Pioneering Minimally Invasive Surgery in Children

Imagine your child having surgery free of pain. Children’s National is closer to achieving that goal by offering minimally invasive surgery using the DaVinci surgical robotic system. Thanks to the Sheikh Zayed Institute for Pediatric Surgical Innovation, which focuses on finding more precise, less invasive, and pain-free surgical approaches for children, this innovation is the first step toward a broader program that will increase the availability and efficiency of additional pediatric minimally invasive strategies in many specialties.
The system has been in use since 2000 in adults, and urologist Craig Peters, MD, who started the program at Children’s National, performed the first pediatric cases in 2002. Patients who have undergone minimally invasive surgery including those performed with the Da Vinci Surgical System have smaller incisions, less pain, and often a shorter recovery time.
For more information on the DaVinci robot and Dr. Peters, visit the Sheikh Zayed Institute for Pediatric Surgical Innovation blog at:

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The Basics About Tonsils and Adenoids

Tonsils are the small, round glands in the back of the throat. Adenoids are similar to the tonsils and located above the soft roof of the mouth in the back of the nose. Both glands are composed of lymphoid tissue which helps fight infections, but may become excessively enlarged and chronically inflamed. The decision to have surgery is often based on the frequency, duration, and severity of your child’s symptoms.
Symptoms of obstructive sleep apnea:
  • Pauses in breathing
  • Restless sleep
  • Daytime sleepiness
  • Labored breathing while asleep
  • Chronic fatigue
Symptoms of adenoid hypertrophy:
  • Noisy breathing or breathing through the mouth
  • Snoring
  • Congested and nasal sounding speech
  • Halted breathing at times during the night
Obstructive sleep apnea is one of the primary reasons your child might need to have tonsils and adenoids removed. Other reasons include:
  • Frequent infections (seven or more strep throat infections a year)
  • Infections resulting in a significant number of missed school days
  • Recurrent peritonsillar abscesses
Tonsillectomy and adenoidectomy are common procedures. They are usually done on an outpatient basis, which means your child can go home the same day as the surgery. Full recovery from a tonsillectomy and adenoidectomy typically takes about 10 to 14 days. During that time, it’s important for your child to drink a lot of fluids, eat soft foods such as pastas and pudding, and avoid any significant physical activity or exercise.
Click here for more information about the Division of Otolaryngology (Ear, Nose, and Throat).

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Keeping Hydrated in the Heat

Sports are a great way for kids to get exercise and have fun. But physical exertion and sweat during play can deplete stored fluids. And if these fluids are not replenished, your kids can be at risk for dehydration.
Nailah Coleman, MD, of Children’s National Specialists of Virginia, LLC, explains that, "Adequate hydration is essential for life and extremely important for those participating in athletic activities. With water loss through sweat and increased breathing, maintaining adequate hydration before, during, and after athletic activities and events is a must."
Even mild dehydration can affect a child’s athletic performance, as well as lead to other, more serious heat-related illnesses such as heat exhaustion. Don’t wait until your athlete complains of thirst to take action—by that time dehydration has already set in. Instead, take these preventive steps:
  • No matter the intensity of the sport, ensure your child drinks lots of fluids before, during, and after exercise. Aim for at least one-half cup of fluid every 20 minutes during play. Water is best. Sports drinks, which replenish the body with carbohydrates but pack extra calories, aren’t necessary unless your child is participating in at least 90 minutes of hard and continuous exercise. If your child prefers the taste of sports drinks, you can reduce calories by mixing them with water.
  • To help keep cool and reduce sweating, dress your child in light-colored, loose-fitting clothing.
  • If possible, have your child avoid exercise during mid-day, when the sun is at its hottest.
  • Talk to your child’s coach about any heat-related illnesses your child has experienced and ask him or her to enforce proper water breaks.
Nailah Coleman, MD, is a sports medicine pediatrician in the Division of Orthopaedic Surgery and Sports Medicine at Children's National Medical Center. She is board certified in both pediatrics and sports medicine.

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Overcoming Sleep Obstacles

Children have trouble falling asleep at night for different reasons. Parent-child interactions before bedtime may reinforce the child’s multiple bids for attention and delay sleep times as well as decrease the child’s total sleep time (or disrupt the child’s optimal sleep schedule). Children may try to avoid falling asleep by using tactics to delay leaving their parent’s side. These problems are common in children ages 2 to 10.
As a parent you can play a major role in helping your child fall asleep at appropriate times by being supportive while setting limits and by establishing good sleep habits for your child. The following tips are helpful ways to start:
  • Establish a regular bedtime and wake up time.
  • Establish healthy bedtime rituals and routine. This could include: reading, taking a bath, quiet conversation, and other relaxing activities shared by parents and children.
  • Use the bed for sleep or a quiet pre-sleep activity. Do not use the bed for watching TV or doing homework.
  • Eliminate the use of caffeine near bedtime.
  • Eliminate the exposure to electronic media within an hour of bedtime, particularly violent and scary TV show and movies.
  • Avoid parent/child conflicts at bedtime, which can lead to increased frustration.
  • Address nighttime fears and worries early in the evening so that bedtime preparation can be focused solely on relaxation and positive thoughts.
Judith Owens, MD, is the director of Sleep Medicine at Children’s National.

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Roasted Vegetables


Preparation time: 55 minutes


  • 1 small butternut squash, peeled and cubed
  • 1 sweet potato, peeled and cubed
  • 3 Yukon Gold potatoes, cubed
  • 1 red onion, quartered
  • 1 tablespoon chopped fresh thyme
  • 2 tablespoons chopped fresh rosemary
  • ¼ cup olive oil
  • 2 tablespoons balsamic vinegar
  • Salt and freshly ground black pepper


  • Preheat oven to 475 degrees Fahrenheit.
  • In a large bowl, combine the squash, red bell peppers, sweet potato, and Yukon Gold potatoes.
  • Separate the red onion quarters into pieces, and add them to the mixture.
  • In a small bowl, stir together thyme, rosemary, olive oil, vinegar, salt, and pepper.
  • Toss with vegetables until they are coated. Spread evenly on a large roasting pan.
  • Roast for 35 to 40 minutes in the preheated oven, stirring every 10 minutes, or until vegetables are cooked through and browned.
Serves: 12


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The Parent’s Letter Project

The Parent’s Letter Project lets families of patients at Children’s National share letters of advice and support to parents going through the same thing. Now you can view videos on Youtube.

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We Are Moving!

Children’s Northern Virginia Outpatient Center is moving. This new space will offer an updated, family-centered environment for our patients and families.

New Address:
3023 Hamaker Ct
Suite 300
Fairfax, VA 22031
Appointment Line: 888-884-2327

We look forward to serving you at our new location!

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