No parent ever wants to end up in the Pediatric ICU, but we know it happens and we want you to be informed and know what to expect. I invited my social media friend and Pediatric Critical Care Doctor, Dr. Anita Patel on the show to chat about the Pediatric ICU and what to expect.

We discuss:

• The common reasons children end up in the Pediatric ICU and what to expect
• The questions to ask your care team in the ICU
• How we manage health anxiety as a pediatric ICU doctor and general pediatrician

 

To connect with Dr. Anita Patel follow her on Instagram @anitakpatelmd and check out all her resources on https://linktr.ee/anitakpatelmd.

 

00:00 Introduction & Why This Conversation Matters

02:00 Meet Dr. Anita Patel

04:10 Common Reasons for Pediatric ICU Admissions

10:46 What Happens Inside the PICU?

14:23 Navigating the ICU Experience as a Parent

20:27 Key Questions Parents Should Ask the Care Team

24:46 The Emotional Toll on Parents & Doctors

31:14 Balancing Medical Knowledge with Parenting Anxiety

35:16 Final Thoughts & Words of Encouragement

37:59 Where to Follow Dr. Anita Patel & Closing Remarks

 

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00;00;00;02 – 00;00;23;08

Dr. Anita Patel

So not that I wouldn’t talk to the parents, but I maybe wouldn’t talk to them for half an hour to 45 minutes. That is completely changed as a mom, because I know if I was that mom in the ICU and I had no medicine in my brain, I would just be sitting there shocked, shell shocked. So I do I do want to empower parents like you’re all the care team is always there in an ICU.

 

00;00;23;11 – 00;00;33;23

Dr. Anita Patel

Most ICUs have 24 hour doctors. If you ever feel like you need to talk to your doctor, you tell the nurse. And I tell that to every single one of my patients. Just because I’m not here doesn’t mean I’m not available to you.

 

00;00;33;25 – 00;00;55;15

Dr. Mona

Hi, everyone. Doctor Mona here. Your favorite pediatrician, educator and hope. Caring confidant and supportive mom. Friend of all things parenting. Welcome to the PedsDocTalk podcast, where we have real, honest conversations to help you navigate parenthood with confidence. Today we’re talking about a place no parent ever wants to be. But if you ever find yourself there, you’ll want to be prepared.

 

00;00;55;15 – 00;01;19;00

Dr. Mona

And I say this not just as a pediatrician, but as a mom who has had a child in the NICU, whether it’s the NICU or the pick, you so neonatal ICU or pediatric ICU, it can be an overwhelming experience filled with uncertainty, fear, and so many questions. But one thing I can tell you firsthand, some of the best doctors and nurses you will ever meet are in these units.

 

00;01;19;02 – 00;01;36;16

Dr. Mona

They are there to guide you, advocate for your child, and provide the highest level of care when it matters most. And did you know that some of the most common reasons kids end up in the ICU are things most parents may not expect? Do you know what happens behind those ICU doors and what decisions you’ll have to make?

 

00;01;36;18 – 00;01;59;26

Dr. Mona

And here’s a big one. Can you actually prevent an ICU admission in some cases? I’m joined by Doctor Anita Patel, a pediatric ICU doctor who has seen it all, from severe respiratory illnesses to trauma cases to critical post-op recoveries. She’s here to pull back the curtain on what really happens in the pediatric ICU. What every parent should know and how to manage your own anxiety if you ever find yourself in the situation.

 

00;02;00;04 – 00;02;12;07

Dr. Mona

This is one of those episodes that you don’t think you need that I hope you will never need. But I hope that if you ever do, you feel supported. So let’s get to it.

 

00;02;12;09 – 00;02;14;10

Speaker 3

Thank you so much for joining me today, Anita.

 

00;02;14;12 – 00;02;19;06

Dr. Anita Patel

Well, I am so excited. And as you said, this is a long time coming.

 

00;02;19;09 – 00;02;34;26

Speaker 3

Well, you know, you were kind of busy in the pandemic, you know, just a tad and, you know, managing am I see and all the other other things that we were seeing. Oh my goodness. So I don’t I’m not surprised that it took forever to have this happen. But I’m grateful. You know, I love I love that we’re gonna talk about this.

 

00;02;35;01 – 00;02;52;08

Speaker 3

It’s stuff that I hope parents never find themselves in. I know you can relate to that. We hope that, you know, for listen to this. And you end up in the ICU for your child. But we also want to have expectations and what happens there. And, you know, Anita is one of my most favorite pediatric ICUs, follows on social.

 

00;02;52;08 – 00;02;55;12

Speaker 3

And so it had to be her that came on. So thank you again.

 

00;02;55;13 – 00;02;56;19

Dr. Anita Patel

Thank you. Thank you.

 

00;02;56;19 – 00;03;04;22

Speaker 3

So tell you know, for anyone who’s not familiar, tell us a little bit more about yourself, your training or whatever it is that you want to share with us why you do the work that you do.

 

00;03;04;24 – 00;03;26;01

Dr. Anita Patel

Yeah. So, I mean, I’m one of those weirdos whose wanted to be a doctor since I was two. I feel like they’re actually similar in that respect. Maybe they’re both weirdos. We’re both. Yeah. And then, I actually got into research also really early in my life. I started in high school at the NIH and loved it and kept going.

 

00;03;26;01 – 00;03;45;25

Dr. Anita Patel

So exactly what you said I did my residency and and pedes and my training and, higher training in pediatric critical care. And then I really did a lot of research. And so I’m really lucky now in my current job, and I’ve been an attending for eight years, almost eight years, that which is crazy to say. Yeah.

 

00;03;45;28 – 00;04;03;16

Dr. Anita Patel

But I have a great mix of clinical care as like right now I happen to be in the hospital. And I also get to do a lot of research. I have an NIH grant, study ways in which we can augment our care using artificial intelligence and machine learning.

 

00;04;03;18 – 00;04;04;11

Speaker 3

Oh.

 

00;04;04;13 – 00;04;10;25

Dr. Anita Patel

I can do everything from the bench to the bedside or the computer bench to the bedside, I guess. And then, I mean.

 

00;04;10;28 – 00;04;14;19

Speaker 3

Besides that, you have two kids I know.

 

00;04;14;22 – 00;04;15;07

Dr. Anita Patel

And and.

 

00;04;15;08 – 00;04;17;13

Speaker 3

Oh, man. Yeah.

 

00;04;17;15 – 00;04;30;13

Dr. Anita Patel

That’s one of them. Mona and I both had our kids very at similar time. Yeah, we definitely had text chains many times lamenting about our challenges and yeah, successes of, oh yeah.

 

00;04;30;18 – 00;04;48;17

Speaker 3

We have children, similar ages. We also had I like motility struggles. You know, we’ve done. Yeah. I think again, I feel like you’re my, my like a good friend even though I haven’t met you and knowing you, you know, I know at the time of this reporting it’s before Pinnacle Conference in May. But yes, we will be seeing each other there.

 

00;04;48;17 – 00;04;53;29

Speaker 3

And I cannot wait to be a big hug. And I won’t, like, go for a long time. Just heads up.

 

00;04;54;01 – 00;04;57;22

Dr. Anita Patel

Same same same. Oh, yeah. Because social media.

 

00;04;57;27 – 00;05;18;03

Speaker 3

Yes. And, you know, again, I wanted to have this conversation not to scare families, just for families to be more informed about what they can expect in the pediatric ICU. And I know you see so many things, but of course, there are many reasons that they can be admitted to a hospital. But tell us more about common reasons why they can end up in the pediatric ICU.

 

00;05;18;05 – 00;05;51;21

Dr. Anita Patel

It’s a great question. And I will say the top five reasons are respiratory failure, respiratory failure, respiratory failure, respiratory failure. So that sounds really dramatic. And so to parents, I want you to know that I know I’m using the word failure, but we use that term really to describe a wide range of breathing issues. And, you know, you guys hear both Mona and I and basically every pediatrician on social, social media talking about viruses, and how to, you know, they’re inevitable.

 

00;05;51;21 – 00;06;10;11

Dr. Anita Patel

So I always tell parents, because the first thing they say when they come to the ICU is, oh my gosh, I wish I could have done something more to prevent this. And the first thing I say is there is absolutely nothing you can do. Even if you put your kid in a bubble in a room in your house, they’re eventually going to get a virus.

 

00;06;10;11 – 00;06;32;06

Dr. Anita Patel

So it’s not an if it’s a one, right? Of course we do all the things that we talk about hand-washing, vaccines and everything, but unfortunately we don’t have vaccines for everything. Yeah. And, you know, the most common types of breathing problems we see are from viruses. As I mentioned, on rare occasions, they can be caused by bacteria.

 

00;06;32;08 – 00;06;54;25

Dr. Anita Patel

And for most kids that enter the ICU for breathing issues, they are on what’s called high flow nasal cannula. And I hope that this gives some peace of mind, actually, to parents, because high flow nasal cannula is what it sounds like. It’s just a nasal cannula. So two prongs in each one prong in each nostril.

 

00;06;54;28 – 00;07;17;10

Dr. Anita Patel

And what high flow allows us to do is give, higher rate of air that’s nice and humidified. So it doesn’t actually bother their noses as much as even a normal nasal cannula. So that allows us to deliver more oxygen at a higher rate. And it’s nice and humidified. And I would say 80% of the kids just need high flow.

 

00;07;17;12 – 00;07;39;19

Dr. Anita Patel

Then we step them down to normal nasal cannula, send you to the floor, regular pediatric floor. And then they go home. For some kids they need a little higher support. And for them we put BiPAP on them, which is a mask either completely over their face, over their nose and mouth, or just over their nose. And what that does is it helps with each inhale and exhale.

 

00;07;39;23 – 00;08;03;02

Dr. Anita Patel

So it just supports their breathing. Sometimes your kids need a little bit of a medicine to keep them calm while they’re on the BiPAP. Because, you know, whenever parents ask me like, what is how does it feel? Like? I say, well, I don’t actually want them to do this, but if you stick your head out of a car when it’s moving over 30 to 40 miles an hour and that air is coming at your face, that’s kind of what it feels like.

 

00;08;03;05 – 00;08;20;25

Dr. Anita Patel

Yeah. So and that sounds really uncomfortable. But what I will tell you and I tell this to parents as well, if you ask a teenager who can talk to you and, you know, can really you can reason with 9 to 10 times out of ten they’re like, I feel better. And they actually want it on them.

 

00;08;20;28 – 00;08;44;12

Dr. Anita Patel

So it really does help with their breathing. And then on rare occasions, what can happen also is a breathing tube. And that’s where we make sure that your child is completely asleep and not feeling anything. We put the breathing tube in and then we help them breathe at the ventilator. And your kid is sedated throughout that experience.

 

00;08;44;14 – 00;09;08;21

Dr. Anita Patel

Some kids need, don’t need a lot of sedation and, you know, actually holding their parent’s hand is the best thing for them, more than any of the medications we can give them. So I definitely encourage parents always to be participating in their care. I know we’ll get into that, but, I know you talked about breathing problems a lot because that honestly is probably 80% of the ICU.

 

00;09;08;24 – 00;09;29;06

Dr. Anita Patel

Other things we see are, of course, we see infections, and the infections that end up with us in the ICU are septic shock. And that means that the infection has gotten so bad that, you know, your body is just not working in the same way. So you come up to the ICU so we can support the body and treat the infection.

 

00;09;29;09 – 00;09;50;14

Dr. Anita Patel

And when I say support the body, I mean giving them medications to help, maybe with their blood pressure, we give them extra fluids. And of course we give them antibiotics. And most kids turn around just fine. And I would say maybe the last, most common, thing that we care for in the ICU is trauma.

 

00;09;50;16 – 00;10;13;21

Dr. Anita Patel

That can be from motor vehicle accidents, most commonly. Of course it can also, you know, unfortunately, in this day and age, we do see gunshots. Of course, you know, rare. I wish it was more rare to me, but it’s not, and, of course, normal falls and things like that. So we do take care of a lot of those.

 

00;10;13;21 – 00;10;37;21

Dr. Anita Patel

And lastly, I should mention this is post op. So if your child needs a surgery, there are certain surgeries that are always cared for immediately after the operation. And the ICU. I don’t want parents to worry about that, though, because your surgeon will always tell you, and most frequently, neurosurgeon. Our brain surgery is not surprisingly, comes comes to us.

 

00;10;37;23 – 00;10;46;19

Dr. Anita Patel

And then and then they they always do. Well, they almost always do well. And they go right to the pediatric inpatient floor.

 

00;10;46;21 – 00;10;52;27

Dr. Mona

Now, let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;10;53;00 – 00;11;11;19

Speaker 3

Oh, oh. And I love the way you broke down the respiratory distress. And also what sort of modalities are there, because that’s something that a lot of my followers are surprised about. You know, when they’re like, oh my gosh, I got into the ICU and it was all this hoopla of like people coming in and putting all the stuff on my can, and it’s so helpful.

 

00;11;11;19 – 00;11;27;19

Speaker 3

And obviously, besides that, IV lines and other, you know, things to just give fluids, support and all of that. Is there anything else that, you know, a family can expect that may be on the child? Besides, you know, if they’re a respiratory distress situation to kind of, you know, normalize those.

 

00;11;27;21 – 00;11;44;17

Dr. Anita Patel

Yes, absolutely. So thank you so much for mentioning an IV line. You’re absolutely right. If you’re in the ICU, you have an IV. Unless you’re on the tail end of your disease. And in those circumstances, I am actually very free with the you don’t need it anymore. So we can take it out because nice to free the kids.

 

00;11;44;23 – 00;11;45;20

Dr. Anita Patel

Yeah, I.

 

00;11;45;20 – 00;11;58;01

Speaker 3

Know, I know, Vanessa, 35 year old, having a baby when I was postpartum, I was like, get this thing out of me. So I know, I know, I give, I give these. It’s a lot of credit. It’s hard. It’s not having it’s not easy having all this stuff on you. Yeah.

 

00;11;58;08 – 00;12;18;18

Dr. Anita Patel

It’s not. And I also, you know, the other thing I should mention, since we’re talking about IVs, is parents. Don’t be surprised. We often put what’s almost looks like, a splint. If you’re if the IV line is in a hand and that’s just so that your kid can’t, you know, move their hand around and dislodge the IV.

 

00;12;18;20 – 00;12;42;20

Dr. Anita Patel

So nurses are sort of the heroes, who have these magical ways of dressing guidelines. But do expect that, one tip, though, is if your child has sensitive skin, please tell the nurses and doctors, because there are different types of tape that we can use. You know, we always like to use sort of stronger tape, so that it doesn’t fall out.

 

00;12;42;20 – 00;13;07;21

Dr. Anita Patel

But we absolutely switch to, more comfortable tape when a parent tells us that their child has sensitive skin. The other thing that you should expect is if you’re in the ICU, you’ll definitely have, leads on your chest, which are just stickers. And that allows us to monitor breathing your heart rate. And, and those are the main things that those leads do.

 

00;13;07;24 – 00;13;29;21

Dr. Anita Patel

And then in some circumstances, particularly if you have a breathing tube, we might place and what’s called an esophageal temp probe. And all that is, is a tiny little tube that we put, right next to the breathing tube just to get a continuous temperature as well. I think besides those, those are the most. Yeah.

 

00;13;29;21 – 00;13;30;07

Speaker 3

The things I.

 

00;13;30;07 – 00;13;55;07

Dr. Anita Patel

Would say, but the only other thing I always tell parents to expect is, you know, there is going to be a lot of beeping, unfortunately. And, you know, there are units. Ours is one of them here where we really try to minimize the number of alarms. Because that obviously bothers, patients and their families. But it is an unfortunate side effect of being in the ICU that there are a lot of sounds.

 

00;13;55;10 – 00;14;13;26

Dr. Anita Patel

And I just would say to parents, try to just let go of the sounds of the monitor because there’s so many sometimes it’s real, sometimes it’s not. But if your child is on a monitor in an ICU, I want you to be comfortable knowing that there are doctors and nurses that always have eyes on that monitor, even if they’re not inside the room.

 

00;14;13;26 – 00;14;23;26

Dr. Anita Patel

And I think that’s a really important thing for parents to understand. Because I know some sometimes parents can feel a little lonely in the, in the room, so, Yeah, totally get it.

 

00;14;23;29 – 00;14;29;03

Speaker 3

But we’re all. Oh, yeah. I know the and I know I’ve been in ICU is to not like, I.

 

00;14;29;11 – 00;14;30;07

Dr. Anita Patel

Know you have.

 

00;14;30;07 – 00;14;46;00

Speaker 3

And it’s been, you know, I, I not that it makes it any easier if I ever watch my child go through it or if I go through it again, it is really hard. The lines, the beeping, it’s like noisy and you’re trying to rest. It’s super nice. Like you said. I know it needs to happen, you know? And I know it can be frustrating for listening, but it’s for a reason.

 

00;14;46;05 – 00;14;47;25

Speaker 3

There’s a method to it in this year.

 

00;14;47;25 – 00;15;17;02

Dr. Anita Patel

Yeah it is, it is. It really is. And I will say this, becoming a mom myself, especially after having setup my first came back, it completely changed. Oh yeah. How sure. I mean, you know, I think as an ICU attending, we start, the common easy patients like the high flow, the high flow patients that I was telling you about, those are the quote unquote, easy ones in the sense that you kind of know how they’re going to do.

 

00;15;17;05 – 00;15;35;14

Dr. Anita Patel

They’re going to get better with time. So not that I wouldn’t talk to the parents, but I maybe wouldn’t talk to them for half an hour to 45 minutes. Right. That is completely changed as a mom because I know if I was that mom in the ICU and I had no medicine in my brain, me just be sitting there shellshocked.

 

00;15;35;20 – 00;15;53;18

Dr. Anita Patel

Yeah. So I do I do want to empower parents. Like you’re all the care team is always there in an ICU. Most ICUs have 24 hour doctors. If you ever feel like you need to talk to a doctor, you tell the nurse, I tell that to every single one of my patients. Just because I’m not here doesn’t mean I’m not available to tell the nurse.

 

00;15;53;18 – 00;15;57;08

Dr. Anita Patel

And they know how to get me. So it’s it’s hard.

 

00;15;57;11 – 00;16;12;25

Speaker 3

Yeah, it is. And, you know, I know you talked about obviously the things on the child, but what else can a family expect during their admission. You know, like how workflow happens. And I know this can vary from ICU to ICU, but sort of things that you wish parents would know before they came in on how things happen and work there.

 

00;16;12;27 – 00;16;19;20

Dr. Anita Patel

Yeah, absolutely. Also, I’m just realizing I am wearing, a jasmine necklace that my daughter gave me this morning. Oh.

 

00;16;19;21 – 00;16;20;19

Speaker 3

So beautiful.

 

00;16;20;19 – 00;16;25;17

Dr. Anita Patel

I love it, I love it, I love it, like.

 

00;16;25;19 – 00;16;26;07

Speaker 3

I like it.

 

00;16;26;13 – 00;16;49;14

Dr. Anita Patel

I exactly, exactly I promise hardware. I keep my bra. Oh, I love it. So things to expect. So most ICUs in this day and age do family centered rounds and what that means. And I’m, I’m using this term very specifically because I think all parents should ask when they get there. Do you have family centered rounds?

 

00;16;49;16 – 00;17;13;18

Dr. Anita Patel

And what family centered rounds is, is when the entire care team rounds and the care team, at the very least, includes the attending, maybe a pick you fellow. A fellow is, someone who’s completed their pediatric residency and is training specifically in ICU. And you’ll have a likely a pediatric resident. You will have the bedside nurse.

 

00;17;13;18 – 00;17;38;19

Dr. Anita Patel

You may or may not have a charge nurse. You may or may not have a pharmacist nutritionist. We’re lucky here. We have all those services. So you’re going to see a lot of people, and they’ll invite you outside. And what they’ll do is they will present your child. They’ll probably use a lot of medical terminology. What I would say is allow them to, finish their stories about your child and once they’re done.

 

00;17;38;19 – 00;18;04;17

Dr. Anita Patel

Or you can even ask when, when is it appropriate time to ask questions? They’ll tell you, and then ask the questions, and what I will tell I tell it to every family to bring a pen and paper whenever questions pop up at any time, whether it’s a 3 a.m., write it down because one thing I’ll promise you is the first time you see that big crowd of doctors and nurses, all your questions are going to sort of go out the window.

 

00;18;04;17 – 00;18;27;15

Dr. Anita Patel

So I feel like we should give every family a pad of paper. Yeah. Because honestly, write things down, ask questions. It’s your job as a parent. You’re not bothering us. And that’s an important point. You are not bothering us. You are helping us care for your child. And you know, another thing I tell every family is you know your child better than me.

 

00;18;27;15 – 00;18;53;17

Dr. Anita Patel

I know medicine, but you know, your kid, and parents, do. They really do. They always do. And, you know, I always ask their guidance when I’m titrating sedation, like, Yeah, you could do with this that, you know? So, I say all this because, you know, I know a lot of parents can feel really helpless in the ICU, but on rounds, first of all, you are a participant in rounds.

 

00;18;53;17 – 00;19;11;18

Dr. Anita Patel

You’re not a watcher. And you should feel empowered to participate when it’s your turn. Generally, that’s after everyone is gone. But even beyond that, like, if you know your kid and you know that they like to lie on the right side and you notice that when they’re lying on their left side, they’re getting a lot more sedation.

 

00;19;11;20 – 00;19;39;07

Dr. Anita Patel

You tell the nurse and the care team, hey, my child likes to lie on the right side, and that’s the best information you could give me, because then we turn them on their the side they prefer. Kids are still kid. They’re still going to prefer what they want, right. So all those little tidbits really help also bring parents bring in their favorite stuff from home, their favorite blanket, normalizing that room as much as possible.

 

00;19;39;09 – 00;20;02;03

Dr. Anita Patel

And then, you know, another thing that they should expect, particularly when their kid is getting better, is we’re pretty, strict here as much as possible about, opening the windows during, you know, opening the blinds during the day or keeping the lights on during the day and turning them off at night. If the if you hear the care team harping on that, it’s because we’re trying to prevent your child from getting confused.

 

00;20;02;09 – 00;20;18;18

Dr. Anita Patel

Yeah. And there’s a term for that called ICU delirium. So that’s another thing to expect is that, you know, there are certain things that we do in the interest of your child, although sometimes, you know, I know it can seem in the moment like, my child just wants to sleep. And we’re like, yeah, but we want them to stay awake right now.

 

00;20;18;21 – 00;20;27;03

Dr. Anita Patel

Yeah. You know, there’s seems to be conflicting things, but I promise you, they’re not as conflicting as as they sound, I guess so.

 

00;20;27;05 – 00;20;46;21

Speaker 3

Yeah. And, you know, you mentioned already that you want families to be involved in the, in the rounds and obviously that how scary it can feel when all those people walk in. I mean, I’ve been I don’t know if people are familiar. So when you’re in when you’re in residency for pediatrics, everyone in residency has to rotate through the pediatric ICU, the neonatal ICU, the floors.

 

00;20;46;28 – 00;21;09;25

Speaker 3

And then some of us, like Anita, Doctor Patel, decides to go into fellowship for three years. Right. So myself, even though I’m a general pediatrician right now, I went through the pediatric ICU rotations. And so I can I can attest to that. You know, we all walk in, there’s a pharmacist, there’s a there’s three residents, there’s medical students, there’s a physician, there’s the out, you know, the outgoing team, the in going team.

 

00;21;09;25 – 00;21;28;15

Speaker 3

I mean, it can be like eight, nine people at times and it can feel very daunting when they all show up in your room. And, you know, Ryan was in the nick. You same thing happens in the nick year. And I love that you said that because people may not have that medical brain and that medical knowledge. So it can feel so overwhelming when all of a sudden they’re throwing out, you know, this is they’re on high flow.

 

00;21;28;18 – 00;21;40;29

Speaker 3

This is what happened with their ins and outs like overnight. You’re going to hear all this terminology. And you know, you said that, you know, just ask the questions and really just say, hey, can you explain to me and and they should. Right. I mean, I think.

 

00;21;41;02 – 00;21;42;07

Dr. Anita Patel

They’re supposed to. Yeah.

 

00;21;42;07 – 00;21;59;07

Speaker 3

Yeah, they should like, I’ve never been on rounds where we don’t turn to the family and then say, hey, let’s talk about this in a way that everyone understands how if you, you know, could tell everyone in a way what would be those questions you would want families to ask. Maybe these are questions that you never get asked and you wish they would.

 

00;21;59;12 – 00;22;07;00

Speaker 3

Or maybe you just want people to know like, hey, these are really great questions to ask your care team, right?

 

00;22;07;02 – 00;22;13;23

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

 

00;22;13;25 – 00;22;39;29

Dr. Anita Patel

So yeah, so I think first of all, asking, what is your child being treated for? And that sounds like such a obvious question, but sometimes I truly feel like parents are afraid to ask because so much is going on. So just asking the general question, why is my child here? And what are you guys doing to treat it?

 

00;22;40;01 – 00;23;08;08

Dr. Anita Patel

Yeah. And I think starting from the place of okay, my child is here for x x issue and this is what they’re doing to treat it. The next question I would ask is what metrics are you guys looking at to determine when my child is starting to improve? And the reason I like that question over the question every parent asks, which is when is my child leaving the ICU?

 

00;23;08;15 – 00;23;35;28

Dr. Anita Patel

Yeah, I of of course I’ll give them an estimate, but I give them an estimate along with, just so you know, the metrics I’m looking for are I want your child to be on normal nasal cannula while asleep, you know, and doesn’t have a desaturate. The oxygen doesn’t drop while while asleep on is okay. Mila. That’s when I know your child is ready to go to the regular inpatient floor.

 

00;23;36;00 – 00;23;50;14

Dr. Anita Patel

So yeah. And that way, you know, they understand what is why the kids, they’re they understand what we’re doing to treat it. And they understand the metrics to watch for when I know my child is getting better.

 

00;23;50;16 – 00;24;08;24

Speaker 3

And I love that you mentioned that one thing, because I think sometimes there’s an assumption from a lot of parents that just because you’re in the ICU, you’re going to get discharged from the ICU and go home. But a lot of the times it’s getting downgraded to a regular floor bed because you no longer need that ICU care, and you may need to be in the hospital for another few days or whatever it is.

 

00;24;08;24 – 00;24;32;24

Speaker 3

So there’s a whole process here, guys like of like, okay, here you’re going to go here with me. And sometimes like for, you know, you get admitted to the floor which is the inpatient non intensive care. And then you get transferred which during the season I know that very familiar. It’s amazing how many times we have to go and assess the child and say okay now they’re going to the ICU or then I have to do a, you know, transfer or get the transfer from the ICU.

 

00;24;32;24 – 00;24;46;04

Speaker 3

So there’s a lot of logistical things that parents may not understand. And I love that we’re talking about this because it can help just not feel isolated and fearful of the process and just know that we’re obviously doing everything in the best interest of the family and child.

 

00;24;46;07 – 00;25;13;04

Dr. Anita Patel

Yes, and that’s exactly right. And I would also encourage parents to ask, like what medications my are being administered to my child. You know, I, I do think that there’s a lot of fear in some families. I don’t want to be the difficult family. I just want to empower you. The asking questions is not being difficult. And if anyone makes you feel that way, they’re in the wrong, not you.

 

00;25;13;06 – 00;25;35;20

Dr. Anita Patel

You know, there might be circumstances where, you know, the nurse or doctor says, I can’t give that to you right now, but I’ll come back. And that is an appropriate response, because there might be someone who’s a little sicker that needs, their attention, but really asking. I think the more information parents have and I will say this mychart and portals have really improved a lot of time.

 

00;25;35;22 – 00;25;59;16

Dr. Anita Patel

But but asking, you know, which medications your kid is on is also really important. Another tip, that I should have mentioned in the beginning, if your child is on any medications at home, I always encourage parents, not because we’re going to use them, we’re going to use the hospital meds, but that way you don’t forget, especially for kids that are on a lot of medications, it can be really difficult for parents to remember everything.

 

00;25;59;16 – 00;26;04;21

Speaker 3

So oh yeah, names, frequency, all of that. It means a lot for anybody. Yeah.

 

00;26;04;24 – 00;26;11;10

Dr. Anita Patel

It’s too much. It’s too much. So. So yeah. So just to empower you to just remember to grab those before you go.

 

00;26;11;12 – 00;26;27;26

Speaker 3

Yeah. This is so wonderful. I just love that we’ve talked about so much of the experience there. And you you speak you speak about it in such a positive way, which I so much appreciate because I think there can be a lot of fear around the ICU. And of course, it’s not easy. I mean, I don’t think either of us are ever going to say that.

 

00;26;27;26 – 00;26;46;14

Speaker 3

Oh yeah, whatever. It’s not a big deal. Of course this is a big deal. So now my question for you being a mother now of two children, you know. Yeah, you mentioned already that after CTA you came back and you spent a little more time. But how has being a mother or even maybe before being a mother, how is it impacted your anxiety?

 

00;26;46;14 – 00;27;03;12

Speaker 3

Because obviously you’re seeing things that are very unfortunate, right? We see a lot of healing in children, but there’s no denying that you see a lot of sad stuff or things that you’re like, wow, this could happen to anybody. How do you manage it? Or maybe are you even managing at this point?

 

00;27;03;14 – 00;27;32;15

Dr. Anita Patel

I think I’m managing it now. Yeah. I will say this, I so a little backstory on me for people that don’t know is I had my first child seat, a month into lockdown. Yeah. Into the Covid lockdown. And so because it was such a new disease, and despite what the media was saying that kids don’t get it, we had an ICU full of kids and a lot of them had it.

 

00;27;32;15 – 00;28;06;27

Dr. Anita Patel

So, I, I’m reason I’m mentioning that is because I absolutely had, a disproportionate fear of Covid and my, my daughter getting it. And not to say, you know, none of us knew what was going on there. So I give myself a little bit of grace. But I know that my experience, my isolated experience in the ICU definitely affected my general view of the pandemic.

 

00;28;07;01 – 00;28;07;11

Speaker 3

That makes.

 

00;28;07;11 – 00;28;38;26

Dr. Anita Patel

Sense. And, you know, and even when I realized it, I also just had to accept and so to answer your question, you know, I think just knowing when my experience is affecting my judgment has absolute helped, to understand what is rational and what is. I hate using the word irrational, but I, I what I’d like to say is clouded by my ICU experience, I guess.

 

00;28;38;28 – 00;29;11;28

Dr. Anita Patel

So in that way when I know. So another example is, you know, I definitely have an over exaggerated fear of my daughter walking across roads. Because of what I said. Trauma. Right. And I unfortunately see a lot of kids that were hit by cars or kids in cars getting hurt. So, you know, I would say that’s one of the fears that has actually served me, though, because Lisa is she’s not terrified of crossing the road, but she reaches for my hand.

 

00;29;11;28 – 00;29;44;06

Dr. Anita Patel

You know, there’s no way she’s not running across a road because I’ve been so crazy about don’t do that. But, in general, I have realized I see when my experience is clouding my judgment and I have been able to overcome that. So just knowing, okay, this is not a reality. This is, really just my judgment based on the experience, allows me to sort of walk through it.

 

00;29;44;08 – 00;30;10;04

Dr. Anita Patel

And I’m seeing that in real time, you know, not to say that I’m throwing caution to the wind with Covid, but we absolutely are having a birthday for Seeta and we still do activities with her indoors. You know, I, we make sure she’s fully vaccinated. We do all the things that you know, are dictated and we know that will help protect her against severe disease from anything.

 

00;30;10;06 – 00;30;33;17

Dr. Anita Patel

But we are living life and I. And whenever I think about what I’m doing, and if I start to get fearful about it, whether it’s from a infection, reason or whatever other reason, I say to myself, is this going to bring joy to me and my family? And if the answer is yes, I go through it, eyes open that, you know, yeah, rare things happen, but they happen rarely.

 

00;30;33;23 – 00;30;42;21

Dr. Anita Patel

Yeah. And I just that’s like my mantra. Rare things happen and rarely. So. So I was a long winded answer. I apologize, but no.

 

00;30;42;21 – 00;30;57;19

Speaker 3

I love it. I think it and also it’s obviously it’s bringing back memories of, you know, four years ago now at the time of this recording and, you know, me and you had spoken a lot in the pandemic and yeah, I, I love that I’m having you. Come on. Because you saw the worst of the worst of Covid.

 

00;30;57;19 – 00;31;14;17

Speaker 3

I actually saw general pediatrician children heal from Covid, right. So yeah, I loved being able to speak with you because we were able to bring a middle ground. Right. Like I would say, hey, you know, I’m not I’m seeing a lot of healing. So I don’t want us to feel sort of, oh my gosh, it’s horrible thing. Obviously it’s a threat.

 

00;31;14;23 – 00;31;36;08

Speaker 3

But that’s that perspective, right? That’s what I saw because I’m exactly. So I would see kids back then, but I’m not seeing the kids who get admitted. So of course yeah it’s going to be perspective. I, I use the example like my husband, as you know, and a lot of my listeners, my husband’s in here, not even just from Covid, but my husband is never going to go on a jet ski because the things that he sees happen on the Jets.

 

00;31;36;08 – 00;31;58;23

Speaker 3

Yeah, he will like never setting foot. And I used to jet ski back in California all the time. Like it was such a fun thing. I’m like, sweetie, you’re seeing intoxicated jet skiers that aren’t really mindful of the thing. So that’s your, you know, your bias there. And he’s like, there’s certain things as an ER physician that he will never do because of the things that he sees and I don’t I’m not going to make him do it right.

 

00;31;58;23 – 00;32;16;18

Speaker 3

He’s like, listen, no, I just never get on it. Like I won’t do it like motorcycles. He will. And I also would never but he will never get on him. No, like he will never. And every time we drive by a motorcycle, I think he has a little bit of PTSD because he’s like, that person is going to end up in the hospital and he gets so nervous about it.

 

00;32;16;21 – 00;32;37;26

Speaker 3

You know, both of us did eMDR doing eMDR therapy for all of the trauma that the pandemic caused. Oh, and I don’t think you are. But like, I mean, I am floored with how much it’s helped me with not even my birth trauma, but all this micro trauma, like the pandemic was trauma. Right? And also this like my husband having to go back into the thing.

 

00;32;37;26 – 00;32;52;21

Speaker 3

So, you know, when people ask about how I manage health anxiety, I love to hear how other people in the specialty and field have managed it. But understanding that there’s nothing, like you said, not getting mad at ourselves for ever feeling that because we’re trying to protect ourselves and our family.

 

00;32;52;23 – 00;33;19;29

Dr. Anita Patel

Yeah. And and and Mona, I do have and I’m very public about this. I, I’m not doing eMDR, although I have looked into it. I, I am in therapy. I have been in weekly therapy since my last year of fellowship. So that’s a home for us. And, you know, if I didn’t have that, there’s I would not be able to know when my judgment is clouding things.

 

00;33;19;29 – 00;33;29;07

Dr. Anita Patel

So the only reason I can have that perspective is because I have been and I’m currently in therapy. I feel like it’s like a requirement for all physicians.

 

00;33;29;09 – 00;33;47;15

Speaker 3

I mean, like my husband says, everyone needs a behavioral therapist or a therapist. Everyone likes. Yeah. So anyone, I mean, any parent. Because how much of this affects us, right. And thank you for being open about that, because not only am I happy about that because of just being a female in medicine, but because we’re talking about this whole experience.

 

00;33;47;15 – 00;34;02;02

Speaker 3

We’re talking about families coming into the ICU. But as you know, I love sharing compassion for caregivers like ourselves, like wanting to understand that we, as your caretaker for your child, also deal with the vulnerabilities that we’re seeing of you and your family. I mean.

 

00;34;02;07 – 00;34;03;18

Dr. Anita Patel

I sorry.

 

00;34;03;20 – 00;34;22;02

Speaker 3

Every day for you, I think about you and it’s about my husband. Like, Jen, I see a lot of sad things too, but not nearly as much as my ICU colleagues and my E.R. colleagues that deal with trauma and the fragility of human life coming through your doors every day, you know? And so thank you for doing that work.

 

00;34;22;04 – 00;34;40;17

Dr. Anita Patel

Thank thank you. I mean, honestly, it’s I don’t see it as a choice. It was like the second I walked into the pick, you as a resident, I was like, oh, I guess I’m doing. And I had already applied for a different fellowship and this is what I’m doing. So I just, I just knew, I mean, and everyone tried to convince my parents, especially, but I, I’m lucky.

 

00;34;40;17 – 00;35;03;10

Dr. Anita Patel

I’m, I feel like the luckiest person in that I, I love it, and, you know, I love it. You’re talking before I sometimes when I’m going through a really difficult time, which I am going through a hard time right now. Honestly, I feel better in this moment, obviously talking to you because it’s fun to talk to you. And I’m also in the hospital and like getting to take care of patients and parents.

 

00;35;03;10 – 00;35;16;25

Dr. Anita Patel

Let’s just be honest, I don’t just take care of patients. I see doctor take care as parents too. And the parents just see, you know, you are our responsibility. It’s not really. And I mean that, so.

 

00;35;16;29 – 00;35;37;17

Speaker 3

Oh, I cannot wait to give you the biggest hug. When I see you, I, I, I cannot wait like, the hug is going to, like, be so therapeutic because we’re just over having pandemic babies. The IVF. I might, I guess I would I know it’s I we’ve been through so much and I really appreciate.

 

00;35;37;17 – 00;35;38;02

Dr. Anita Patel

You coming.

 

00;35;38;02 – 00;35;53;20

Speaker 3

On, and talking about this and really empowering parents to be, you know, their advocate for their child in the ICU. The questions that you pose for them are so important, and also just the way that you just lined up everything. You know, how what happens with options and support and the things that are going to be happening.

 

00;35;53;23 – 00;36;11;06

Speaker 3

I just hope everyone listening, if they find themselves in the ICU and maybe you’re going to be listening to this, everyone, when you’re in the ICU, maybe like I remember, I remember Doctor Mona and Doctor Anita, they did a podcast. And I hope our calming voice and our, you know, understanding of what’s happening gives you some peace as you watch your child heal.

 

00;36;11;11 – 00;36;14;02

Speaker 3

So thank you so much for joining me today.

 

00;36;14;04 – 00;36;15;07

Dr. Anita Patel

Thank you. Thank you.

 

00;36;15;10 – 00;36;21;25

Speaker 3

And where can everyone yeah. Where can everyone find your social media to stay connected? Share that with us.

 

00;36;21;27 – 00;36;27;15

Dr. Anita Patel

Yeah. I am on Instagram just like Mona at Anita K Patel, MD.

 

00;36;27;17 – 00;36;28;12

Speaker 3

So perfect.

 

00;36;28;12 – 00;36;30;03

Dr. Anita Patel

And that safe place to reach me.

 

00;36;30;05 – 00;36;48;10

Speaker 3

Yeah. And you know, doctor. And she shares a lot of the perspective of being a mom and medicine behind this and parenting stuff. Similar things to what I do. Obviously a lot of health information, evidence based information. So I love, you know, obviously I love following her. And like you can hear from her words a compassionate physician, which we need so much.

 

00;36;48;13 – 00;36;53;16

Speaker 3

And the system can break us, but it’s not going to break us. I’m going to we’re going to have to, you.

 

00;36;53;19 – 00;36;56;01

Dr. Anita Patel

Know,

 

00;36;56;04 – 00;37;16;00

Speaker 3

So everyone listening, if you love this episode, first, make sure you follow Doctor Anita on Instagram. I’ll be attaching that to my show notes. But like I mentioned at the beginning, make sure you leave a review or a rating because it’s how the show continues to grow, because we can reach more people that way. And I cannot wait to chat with another guest next time.

 

00;37;16;02 – 00;37;37;04

Dr. Mona

I have walked those walls of an ICU, not only as a resident, when I had to rotate through the pediatric and neonatal ICU, but when I was a mom and had Ryan in the NICU. And although we’re talking about the pick you experience, which is older children, obviously not in that neonatal time frame, the feelings are there. And if you ever find yourself in the ICU with your child, remember that you are not alone.

 

00;37;37;04 – 00;37;59;29

Dr. Mona

As pediatricians, both Doctor Patel and I have seen parents walk through those doors scared and overwhelmed. And as moms, we know just how hard it is to face the uncertainty of your child’s health. But here’s what I want you to take away. The more you know, the more empowered you feel. The ICU can feel intimidating, but the doctors, the nurses and specialists are there to guide you and you are part of the team advocating for your child.

 

00;38;00;04 – 00;38;16;07

Dr. Mona

A huge thank you to Doctor Anita Patel for bringing it all down with us today. You can follow her for more pediatric critical care insights at Anita Patel, MD on Instagram. If this episode gave you one of those wait, I had no idea moments, share it with another parent because the more we know, the better we can show for our kids.

 

00;38;16;07 – 00;38;33;13

Dr. Mona

Even in life’s toughest moments. Now, I’d love to hear from you what resonated most. What’s one thing you’re taking away from today’s conversation? Join the discussion over on my socials at PedsDocTalk and leave a comment on our latest post about this episode. And if this conversation moved you, share it on your stories and tag PedsDocTalk and our guest.

 

00;38;33;17 – 00;38;56;14

Dr. Mona

Your circle might need this today. Thank you for being part of this amazing community. Have a great week! And next week I have Doctor Harvey Karp, pediatrician and creator of Happiest Baby, aka the company who made the Snoo who lost his home in the California wildfires earlier this year. We’re chatting about loss, natural disasters, communicating with kids about natural disasters, and so much more.

 

00;38;56;17 – 00;38;58;27

Dr. Mona

Catch you all next week. Stay well and stay tuned.