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PediPal

Author: PediPal

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A monthly podcast about pediatric palliative care, hosted by two pediatric palliative care docs, Sarah Dabagh, MD, and Daniel Eison, MD, MS. Sharing the insights, opinions, narratives, commentaries, and invectives of #pedpc.
23 Episodes
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Episode 22: Overfed

Episode 22: Overfed

2022-12-3159:05

The holiday season is ending and boy are we stuffed... with educational and entertaining content about one of pediatric palliative care's more misunderstood and controversial topics: overfeeding. Sarah and Dan round out 2022 talking with skeletal dysplasia expert Ricki Carroll (@RickiCarroll), hospice guru Glen Komatsu, and the inimitable Julie Hauer about those times when our patients are getting too much nutrition and all the problems that can cause. 
Does practicing pediatric palliation promote positive parenting? Does parenthood put palliative practitioners in a preferable position? Dan and Sarah partner up to ponder these profound puzzles and palaver with Jessica Casas and Daniel Mahoney (@DanielMahoneyMD),  and Claire Crawford (@PalliativClaire), all from the Pediatric Advanced Care Team at Texas Children's Hospital.(CN: This episode deals with the topic of pregnancy loss.)
In our final international episode, Sarah and Dan speak with Doctora Rut Kiman (@KimanRut) about pediatric palliative care in Argentina and throughout Latin America.
Curative therapy and hospice... at the same time?! Since the Affordable Care Act, pediatric patients don't have to give up one to benefit from the other. But does this model really work, and does it make sense for the realities of pediatric palliative care and hospice as in 2022? To figure it all out, Sarah and Dan have a concurrent conversation with Steven Smith (@stevenmsmith913) and Conrad Williams (@conradw4) about Cadillacs, cookies, and #PedPC's biggest Twitter rivalry.
Where in the world is PediPal? South Africa! Sarah and Dan interview Julia Ambler (@AmblerJulia), the pediatric palliative care physician for Umduduzi Hospice Care for Children (https://umduduzi.co.za/) in Durban, KwaZulu-Natal.
Episode 17: Endogenous

Episode 17: Endogenous

2022-07-2947:11

How do medical marijuana and pediatric palliative care fit together? In this episode, Sarah and Dan seek some clarity about cannabis, interviewing two experts on the topic, Dr. Bonni Goldstein and Dr. Dustin Sulak. Listen to learn more about the endocannabinoid system and the impact that this much-maligned medicine has on it and on patients, often in ways we're only beginning to understand.Resources mentioned in the episode and recommended by the guests:Society of Cannabis Clinicians: https://www.cannabisclinicians.orgDr. Sulak's book: https://wwnorton.com/books/9780393714180Dr. Goldstein's book: https://www.canna-centers.com/cannabis-is-medicine/Dr. Sulak's website with free patient education: https://www.healer.comDr. Sulak's physician-developed hemp products: https://healercbd.com/
PediPal International steams onward, and we now find ourselves in Tokyo, Japan. In this episode, Sarah and Dan interview Nobuyuki Yotani 余谷 暢之, Head of the Department of Palliative Medicine at the National Center for Child Health and Development.
Welcome to Pediatrics. The first rule is, "Children are not just Little Adults." The second rule is also, "Children are not just Little Adults." But how does this trope fit into Pediatric Palliative Care? And is it possible that, instead, Adults are actually just Big Children??In this episode, Sarah and Dan explore this idea with three different guests. Nimmy Simon (@palliativebear), a fellow who recently completed her pediatrics rotation, shares her reflections on the lessons learned. Sarah Keating, who had largely adult training but now works in pediatrics, shares the lessons she brought over and the culture differences she's seen. And Anand Sandesara, who proudly identifies as a pediatrician, talks about how this training enhances his work in adult palliative care. 
Our world tour continues with this next stop in Wellington, New Zealand.  Dan and Sarah interview paediatric palliative care specialist Amanda Evans (@amaevans), who teaches them a bit of New Zealand history, some Maori concepts of health and illness, and a lesson on just how cool Jacinda Ardern really is.
As Sarah and Dan continue their international tour in 2022, they find themselves surprisingly close to home in Phoenix, Arizona... by way of England, and by way of an inspiring story of community, advocacy, and ingenuity.In this Episode your PediPal crew hears the story of the Cottor family and the founding of Ryan House, as well as the hopes for the future of pediatric hospice houses in the USA. And they learn some of the logistical challenges on the other side of their common "If I won the lottery..." fantasy.
PediPal is going international! In this inaugural episode of our new series, Dan and Sarah interview Dr. Spandana Rayala (@SpandanaRayala), a pediatric palliative care physician in Hyderabad, India.
Episode 11: Liminality

Episode 11: Liminality

2022-01-3139:40

Webster's dictionary defines "liminality" as... Just kidding. But not really. In this episode, Dan and Sarah put on novice anthropologist hats and start to explore the role that ritual plays in Pediatric Palliative Care: in bereavement, in the day to day flow of the team, and in things as mundane as stapling your morning list. Social worker Caitlin Scanlon (@caitlin_scanlon) and music therapist Kristen O'Grady (@KOGrady_MTBC) join us to talk about the ways they participate in ritual, witness ritual, and think about the concept of liminality.
"So, what kind of work do you do?" When you're in pediatric palliative care, what answer do you give? And how do you respond to the inevitable follow-ups? "That's so sad," "You must be so special," "I could never do that..." We've all been there. So in this final episode of 2021, Dan and Sarah interview three peds palliative physicians—Allison Silverstein (@agsils), Jared Rubenstein (@DrJRubenstein), and Chris Adrian—about their responses to the dreaded cocktail party questions, as well as their insights on what these questions and answers teach us about very the nature palliative care and its practitioners. Referenced in this episode:Allison Silverstein and Jared Rubenstein - "Oh, That Must Be So Sad" (pdf on Google Drive)Jared Rubenstein - "Oh That's So Sad" (video on youtube.com) Christopher Adrian - "The Question" (article in NEJM)
Episode 9: Resonance

Episode 9: Resonance

2021-11-3029:35

Music therapy, art therapy, child life, and pediatric palliative care resonate with each other in a lot of important ways. In this episode, Dan and Sarah chat with.... Dan and Sarah?! Yep, that's music therapist Dan Stafford and art therapist and child life specialist Sarah Yazdian Rubin. The Dans and Sarahs discuss creativity and loss, the roles expressive therapies can play in pediatric palliative care, and just how similar our respective fields can be. 
Episode 8: Dolor Finis

Episode 8: Dolor Finis

2021-10-2836:00

If there's something long-acting that targets multiple receptors and has a variable equianalgesic dose ratio in your neighborhood, who you gonna call? Eduardo Bruera (@edubru) and Kevin Madden (@madden_kevin), of MD Anderson Cancer Center!Get ready for chills and thrills as they take Sarah and Dan on a haunted tour of that spooky old opioid, methadone, and bust some of the myths about dosing, QT prolongation, and more.
Was starting this podcast academic suicide for Sarah and Dan? That remains to be seen, but interviewing Joanne Wolfe (@WolfePPC) and Chris Feudtner was definitely a good choice!  In this episode, hear two of the founding figures of pediatric palliative care in the USA discuss the rocky roads they traveled, individually and together, to establish themselves in a specialty that they were creating as they went. What's changed the most since the early days? What prognostications do they have for the future? Is Dan angling for a musical gig on GeriPal? Listen to Episode 7 to find out!---Chris Feudtner, MD, PhD, MPH, is the Division Chief of General Pediatrics, Attending Physician and Research Director of the Pediatric Advanced Care Team and Complex Care, Stephen D. Handler Endowed Chair and Director of the Department of Medical Ethics, and Director of the Academic General Pediatrics Fellowship Program at Children's Hospital of Philadelphia, as well as Professor of Pediatrics, Medical Ethics, and Health Policy at Perelman School of Medicine at the University of Pennsylvania. Chris is also the author of the recently published Light and Shadow: A Novel of Pediatric Internship.Joanne Wolfe, MD, MPH, is a Professor of Pediatrics at Harvard Medical School, Attending Physician in Population Sciences at Dana-Farber Cancer Institute, and Director of Pediatric Palliative Care and Medical Director of the Pediatric Advanced Care Team at Boston Children's Hospital. 
Do you like my hat? No? How about this one?In this episode, Sarah and Dan talk with three physicians who each wear two hats: palliative care and another specialty.Wynne Morrison (Children's Hospital of Philadelphia) dons and doffs a PICU chapeau, Natasha Henner (Lurie Children's Hospital) wears a NICU cap, and Elisabeth Dellon (UNC Children's Hospital) is ready to switch from palliative to pulmonology and back at the drop of a... well, you get it.So what's it like to practice two specialties concurrently? And is this millinery metaphor really a feather in our cap or could we have topped it? Hang on to your hats as we throw Episode 6 into the ring!
Hola, somos el equipo de cuidados paliativos!نحن مجموعة من الأطباء والممرضات والأخصائيين الاجتماعيين والقساوسة ، هنا لتقديم ......wait, how do you say "extra layer of support" in Arabic? And can I scan this POLST form into Google Translate?Welcome to Episode 5, in which Sarah and Dan interview two medical interpreters about the challenges and joys of interpreting in the pediatric palliative care setting. Daniela Obregón (@GetConnCare) is an independent Spanish language interpreter, translator, and cultural consultant, and Amani Zaki is an Arabic interpreter at Children's Hospital Los Angeles. What habits of clinicians drive interpreters crazy? What's it like to be the conduit for so much emotionally-charged language in family meetings? Listen and find out!
How lovely it would be if everyone were as thoughtful and palliative-minded as we are! Palliative care providers are meticulous about language when talking to patients and families, but are we as thoughtful about the words we use to talk about our patients and families? In Episode 4, Sarah and Dan talk to Gitanjli Arora, MD (@pedsworld), and Rachel Rusch, LCSW, MA (@RuschRachel), from the CHLA Comfort and Palliative Care Team. Inspired by Dr. Arora's essay, "A Lovely Family," in the Journal of Palliative Medicine (@PalliativeMed_j), we discuss how even the most lovely of words can prevent us from digging deeper, disrupt the productive tension where palliation dwells, and perpetuate our biases.
As Pediatric Palliative Care grows, new programs are started and restarted, often by recent fellowship graduates. This leaves the landscape of PPC dotted with islands of solo providers or tiny teams in various stages of growing pains. In this third episode of Pedipal, Sarah and Dan indulge their pandemic-thwarted wanderlust, island hopping among three different palliative islands, each with its own unique history: Our first stop is with Dr. Ami Mehta, founder of the first dedicated Palliative Care service at Children's Hospital of the King's Daughters in Norfolk, Virginia. Then we visit Dr. Max Lindeman, who has taken on the challenge of restarting and redefining the program at Columbia NYP's Morgan Stanley Children's Hospital on the actual island of Manhattan. Our last visit is with Dr. Jennifer Kett, who shares her experience on a shrinking Palliative Care team at Mary Bridge Children's Hospital in sunny Tacoma, Washington, and teaches us our new favorite mirror affirmation: "You're the only you, but you're not the only one."Theme music: "Sneaky Adventure," by Kevin MacLeod (2009)
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