• 01. Words Matter- Talking about Weight and BMI
    Aug 27 2020

    https://swiy.co/WhatAreYourThoughts

    Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I brought in my very own daughter, Julia Parzyck. She works in the eating disorder recovery space and has recovered from an eating disorder, herself.

    Let’s dive into Julia’s story of how society impacts the mental health of patients suffering from eating disorders because of the BMI metric that tells them they are unhealthy or obese and how tough it is to have conversations and educating people more about food.

    [00:01 - 04:52] Opening Segment

    ● I introduce and welcome my guest and daughter, Julia, to the show

    ● Julia talks about her eating disorder recovery journey

    ○ She grew up in a family with body image issues

    ○ She got bullied because of her weight

    ○ She went to a therapist to help her with her eating disorder recovery

    [04:53 - 14:10] Children and Eating Disorders

    ● Julia talks about the turning point of why she decided to recover from her eating disorder

    ● Pediatricians goal with monitoring children's growth

    ○ How we try to prevent kids from having eating disorders

    ● Julia shares her BMI issues

    ○ According to BMI, she was considered unhealthy and obese

    ○ Navigating her eating disorder in a healthier way

    ● Julia weighs in on the mental aspect of patients with eating disorders

    ○ Eating healthy and exercising more is not very helpful advice

    ○ Living in a Fatphobic society

    ○ Having the right resources and education of what should their kids eat or not

    ○ Being compassionate in dealing with these patients

    [14:11 - 22:48] Talking about weight and BMI

    ● Julia weighs in on doctors dealing with kids' nutrition

    ○ BMI is not a measure of health

    ● Having tough conversations with patients

    ○ Listening to patients

    ○ Dealing with families with a history of obesity

    ● Feeding children the right information about food

    ○ Educate yourself so you can guide your kids

    ○ Children getting bad information online

    ● Julia talks about intuitive eating

    ○ Emotional response to eating certain foods that are considered as "Good" or "Bad"

    ○ Society told us that being healthy means you have to be thin

    [22:49 - 30:07] Taking The Right Approach

    ● Having a team to have conversations and educate people about food

    ○ Adding on things instead of taking them out

    ■ The next time you eat a burger, have some salad with it.

    ● Telling people they shouldn't have certain kinds of food in their homes

    ○ Do I have to be a certain weight in order to have these conversations?

    [30:07 - 34:51] Closing Segment

    ● Julia's...

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    35 mins
  • Welcome to Pediatric Meltdown
    Sep 4 2020

    https://cutt.ly/WhatAreYourThoughts

    Hello and welcome to the Pediatric Meltdown Podcast, the podcast for busy pediatricians who want to better understand emotional health and behaviors and gain the skills and knowledge to help them thrive. I’m your hostess Dr. Lia Gaggino, and I’d like you to come on this journey with me to hear from leading experts in the field as well as other parents to become the best health care practitioners and parents/guardians we can be, in a way that feels less like a lecture and more like a conversation over dinner. We need all the help we can get to take care of our kids, and I believe that the more we learn the better this world will become.

    [00:01 - 01:05] Opening Segment

    • Introduction for the podcast
    • Created with pediatricians in mind but hope parents and other professionals will listen in as well

    [01:06 - 06:30] Why Pediatric Meltdown?

    • Imagine and put yourself in the place of children who can’t get through their struggles and their parents who don’t know how to help them
    • I’ve learned that these are unmet needs that are expected to be handled
    • The responsibility is on primary care
    • You will hear from professionals and parents alike
    • I want to share my passion and their voices
    • These won’t be lectures but conversations with friends
    • I will be linking resources form these conversations
    • The goal is inspiration
    • See one, Do one, Teach one
    • Let’s work together to help children thrive

    [06:31 - 8:36] Closing Segment

    • I’d like to hear from you
    • I know how hard it can be
    • Thank you for joining me
    • Please give me your input and reach out to me
    • Links below
    • Closing

    Tweetable Quotes:

    “Imagine a conversation with a parent of a fifteen year old who doesn’t know what to do with their son who’s using drugs, or maybe it’s a six year old who’s throwing chairs at school, or a thirteen year old who overdosed after a bad argument with his dad, a foster child who can’t sleep at night, or one of your patients on the autism spectrum who wants to have friends but just can't figure out the social queues and so on. Imagine these kids’ meltdowns just dripping into puddles and the meltdowns parents have and, well, maybe even our own.” - Dr. Lia Gaggino

    “We need hope, we need ideas, we need each other, to ensure that children thrive.” - Dr. Lia Gaggino

    “When you listen I hope you will find a pearl, maybe a spark of excitement or creativity to help others out of dark places.” - Dr. Lia Gaggino



    If you’d like to connect with me, you can find me at LinkedIn, Facebook, and Twitter or email me at gagginol@yahoo.com to let me know your thoughts and what you would like to hear in upcoming episodes. To learn more about me visit https://www.medicalbhs.com/


    LOVE WHAT YOU HEARD? Leave us a 5-star review so we can continue to provide you with great content. Share this episode and help people know more about children’s health and well-being.

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    9 mins
  • 02. Caring for Children in Foster and Kinship Care: Keeping a Trauma-Informed focus with Moira Szilagyi
    Sep 9 2020

    https://swiy.co/WhatAreYourThoughts

    Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I had the honor of speaking with Dr. Moira Szilagyi. Dr. Szilagyi is regarded as one of the leading experts on the health of children in foster and kinship care and has served as chair of multiple AAP groups over the last 25 years leading the development of health care standards for children and teens in out of home care.

    Let’s dive into Dr. Szilgayi's incredible story of how important it is to know the Three R’s and be a catalyst for change in the child welfare field, as well as to have trauma-informed focus as you learn, grow and impart skills to your fellow workers and the parents of your patients.

    [00:01 - 11:08] Opening Segment

    • Introducing today's guest, Dr. Moira Szilagyi, and her achievements
    • Dr. Szilagyi talks about how she got into her career
    • Medical school at 28
    • Realized she wanted to work with high risk kids
    • Began working in Foster Care
    • “These kids deserve better”
    • Dr. Szilagyi tells a story of the one patient that inspired her to work in this field
    • She realized the foster kinship care needed higher standards and better systems. And that there wasn’t literature on the subject or training.
    • Begins to work on a task force
    • Charged with making different models of care
    • Centralized care
    • Opening 24/7
    • Run like a regular practice

    [11:09 - 25:52] Trauma Informed Focus

    • Dr. Szilagyi tells a story of handling a child victim of fetal alcohol syndrome
    • Dr. Szilagyi now mentors many young people as an academic pediatrician
    • Remain open and find your passion
    • Children in Kinship Care became Dr. Szilagyi’s passion
    • Realizing these kids are coming in with so much grief and loss
    • Most return into family
    • Some disappear
    • Lifelong trauma
    • Dr. Szilagyi talks about their grant with AAP funding
    • Dr. Szilagyi talks about the kids in her foster care
    • You need the skill to actualize love
    • The kids can’t think they are going to be abandoned again even though the foster parent can’t promise a permanent home
    • They need to know they always have a home in the heart of the foster parent

    [25:53 - 36:15] The System of Foster and Kinship Care

    • Dr. Szilagyi talks about her time in Rochester
    • Developmental path of psychology literature
    • Learning what children need to thrive
    • The Adverse Childhood Experience
    • Found problems leading to obesity back from childhood
    • Divided into 10 issues
    • The importance of healthy attachments from a young age
    • Early Brain Development: AQA GCSE
    • Harvard Developing Child
    • Children exposed to a chaotic environment adapt to living in such conditions
    • Knowing that you have to stay with the child THROUGH their trigger response

    [36:16 - 46:53] Advice for the Busy Pediatrician and Parent

    • Dr. Szilagyi talks about the needed skills of the pediatrician
    • “What happened to you”
    • Give tools to the children and the...
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    57 mins
  • 03. Pediatric Hero: Building Safe Spaces for Kid's Emotions with Dr. Mark Sloane
    Sep 16 2020

    https://swiy.co/WhatAreYourThoughts

    Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I brought in Dr. Mark Sloane. He is a board-certified pediatrician and an adolescent medicine specialist.

    Let’s dive into Dr. Mark’s story of how important it is to build a safe space for kids with mental illnesses and how to get involved in your community to help with kids’ healing process. This is a movement that is not restricted to medical practitioners alone, everybody can make an impact on kids’ lives and we are all in this together.

    [00:01 - 11:02] Opening Segment

    • Introducing today's guest, Dr. Mark Sloane
    • Dr. Mark talks about his career
    • He wasn't ready to practice because of limited training
    • He did ADHD-related work
    • Worked in a Trauma Center
    • Most moms were exposed to drugs, alcohol and domestic violence
    • How can we help kids with their functional outcomes?
    • Working across different systems
    • How do we achieve better outcomes and success?

    [11:03 - 28:11] Building Safe Spaces for Kids’ Emotions

    • Dr. Mark talks about continuing to improve the medication process dealing with kid's mental illness
    • Looking for a holy grail pay off
    • How do we make things safe for kids with trauma?
    • Dr. Mark talks about using the same med-model on kids of different ages
    • Some families have no problems with their older kids but struggle on the younger ones
    • Kids being traumatized by the system
    • Getting compared to their siblings
    • Where do kids feel safe?
    • With school, teachers and their doctors
    • Helping them remember somebody they trusted
    • The Power of Adult's Resilience
    • If a kid has an adult that is crazy about them, this will help them big time with their healing process

    [28:12 - 38:36] Collaborating with Other People

    • Medicine and Prescriptions are just not enough
    • Medicine only works to a certain extent
    • Anybody can make an impact on kids' recovery process
    • You don't have to be a psychiatrist
    • Dr. Mark talks about bringing in different people to help with primary care work for kids
    • Making connections
    • Schools need to work with doctors and vice versa
    • How do you get everybody on the table?
    • Having the right infrastructure buildings and personnel
    • We will all benefit from doing it. It's hard but worth it!

    [38:37 - 44:40] Closing Segment

    • There are so many ways that we can help and support these programs
    • We are all in this together
    • Final words from me and Dr. Mark

    Tweetable Quotes:

    "If a kid has one adult that's irrationally crazy about them that can matter and that's enough." - Dr. Mark Sloane

    "Primary care has been traumatized and the answer is relational change by reaching out to other people to help us mend our own trauma" - Dr. Lia Gaggino

    Resources Mentioned:

    • Thinking Developmentally - Andrew Garner
    • Children's Trauma Assessment Center - WMU Kalamazoo
    • Bruce Perry, MD, PhD – www.bdperry.com
    • Ross Greene, PhD – www.drrossgreene.com

    If you’d like to connect with me, you can find me at

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    45 mins
  • 04. Perinatal Mood and Anxiety Disorders: Asking Mom's if They're 'OK' with Kristina Ledlow
    Sep 23 2020

    https://swiy.co/WhatAreYourThoughts

    In today’s episode, I have the pleasure of speaking with my amazing friend and co-chair of the Kalamazoo Perinatal Mood Disorders Coalition, alongside myself, Kristina Ledlow ICCE, CD, CPD. After two very challenging pregnancies and postpartum periods, Kristina became especially passionate about educating families and other healthcare professionals about Perinatal Mood and Anxiety Disorders. Kristina holds certifications as a Childbirth Educator, Birth Doula and Postpartum Doula in Kalamazoo, Michigan. She also works for OB-GYN, P.C. as their Patient Educator, and teaches classes for Bronson Methodist Hospital.

    Let’s dive into Kristina’s story and expertise so that, whether you are in pediatrics, a parent, or someone who knows a parent, you can be well equipped to help moms or even yourself get connected and be okay.

    [00:01 - 07:50] Opening Segment

    • Introducing today's guest and my friend, Kristina Ledlow, and what we will be talking about
    • Certified in Postpartum Support International (PSI)
    • Doula
    • Patient educator
    • Kristina talks a bit of journey to expertise in PMAD and prevention
    • Severe depression and anxiety during two births
    • Several Risk factors going into both pregnancies
    • Manifested OCD tendencies
    • Connected with a therapist and put on medication
    • Went into childbirth education and perinatal mood disorders

    [07:51 - 12:44] The Effects of PMAD

    • I talk about my shared experience with postpartum depression
    • Kristina talks about the impact on partners and babies
    • Mothers mood affects everyone
    • Losing function
    • 1 in 5 moms affected, 1 in 10 dads affected
    • Dad’s can also break down from the stress and exhaustion
    • Each baby comes with their own personality and challenges

    [12:45 - 25:30] Ask Mom’s if They’re Ok

    • Screening moms during pregnancy and postpartum
    • Worry of opening a pandora's box
    • Kristina talks about the importance of asking
    • Using the Edinburgh tool
    • Negative hormones in the mom affect the baby during pregnancy
    • Social workers and network to work with patients
    • Asking is therapeutic
    • You’re not crazy, this happens, let me get you connected
    • PMAD Virtual Care
    • Get them connected
    • Have a plan
    • We need to get moms connected to the right people
    • Use Postpartum Support International and get a coordinator involved
    • 94% of moms have ‘scary thought’
    • 1: OCD thoughts
    • 2: Postpartum psychosis (rare but dangerous)
    • Believing the thoughts to be true and acting on it
    • It’s common to feel like this, it’s ok and there is help
    • Putting strategies in place
    • Getting good sleep by chunking

    [25:31 - 34:46] Practical Advice and Actions to Face PMAD

    • These disorders can last up to two years
    • The strongest moms can feel like a failure
    • Postpartumstress Instagram
    • Don’t tie your self worth to social media
    • It’s ok to feel the way you do
    • Kristina shares self care tips
    • Reach out and ask for help
    • Support is key
    • Ask: how can I help?
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    44 mins
  • 05. Substance Use Disorders and Childhood Exposures: What you need to know with Dr. Allek Scheele
    Sep 30 2020

    https://swiy.co/WhatAreYourThoughts

    Welcome to Pediatric Meltdown, the podcast for busy pediatricians who want to better understand children's emotional health, behaviors, and gain the skills and knowledge to help them thrive. I am your host, Lia Gaggino. In this episode, I had the honor of speaking with Dr. Allek Scheele. Dr. Scheele is currently doing her pediatric hospitalist fellowship at the Helen DeVos Children’s Hospital in Grand Rapids. Her research focuses on pediatric and adolescent substance abuse and exposure.

    Let’s dive into Dr. Scheele’s expertise so we can learn the hard truths behind child substance abuse and what we can do to arm ourselves, the children, and parents with tools and strategies to prevent problems in their lives.

    [00:01 - 04:24] Opening Segment

    • Introducing today's guest, Dr. Scheele, and what we will be talking about
    • Dr. Scheele talks about how she got into her field
    • Opioid epidemic conference sparked her first interest
    • Led a project on marijuana exposure
    • Became addiction medicine certified
    • Reflected on her passion and decided to do a Pediatric hospitalist medicine fellowship in her second year of residency

    [04:25 - 17:53] The Shocking Truth Behind Substance Use and What To Do

    • Dr. Scheele talks about the truths behind adolescent and adult addictions
    • The average age of addiction starts around 12
    • Preventative pediatrics can make a difference
    • I talk about my experience with a 9 year old patient
    • Monitoring the Future Study
    • “You can’t tell who’s a good kid”
    • Anyone can have a use disorder
    • Dr. Scheele breaks down how to deal with prescriptions
    • Talk with the family
    • Don’t over-prescribe
    • Not all pharmacies take back opioids
    • Promote putting out notices for when there is an event
    • Dr. Scheele talks a bit about vaping
    • The last two to three years has shown the largest substance increase we’ve ever had
    • These vaping products are obviously geared towards children
    • All Juul products have nicotine and most teens are being tricked into getting hooked
    • One pod equals a pack of cigarettes

    [17:54 - 32:55] What We’re Seeing in the ER

    • Dr. Scheele talks about the dangers of marijuana vaping
    • Increase in accidental ingestion
    • Decreasing stigma
    • Marijuana ingestion is getting more creative causing kids to take in higher volumes
    • Kids coming in with altered mental status
    • What to screen for
    • Dr. Scheele talks about preventative pediatrics
    • Work asking about substances into your check with the adults
    • The Vapors in the house can cause an infant to test positive for THC
    • This can also be absorbed into their skin affecting long term brain development
    • ADHD
    • Schizophrenia
    • Substance Abuse Issues
    • I talk about promoting awareness
    • How to work with adolescents
    • Get to know who their friends are
    • Make it nonchalant
    • Be non-judgmental
    • Ask what it is they like about what substance they’re taking
    • Know stopping smoking weed will stop cyclical vomiting

    [32:56 - 37:28] How to Deal With Alcohol Abuse

    • Dr. Scheele talks about the current state of AA
    • Know that it is part of the culture
    • Fortunately there is a decline in binge drinking
    • Gear...
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    45 mins
  • 06. Listening to Parents: We don't always have to know everything!
    Oct 7 2020

    https://swiy.co/WhatAreYourThoughts

    Have you ever looked at your child or a patient and just thought, ‘oh my God, I don’t know how to fix this’? You’re not alone and we’ll talk about this today with our guest Sandy Fowler, host of the Mighty Parenting Podcast. Sandy is a stress relief and wellness coach, a wife, mom, and business owner whose passion is teaching people to make powerful choices that impact their lives in the best possible way and help them take back their life from the busyness and stress of modern-day living.

    Let’s get right into the episode and learn from Sandy how we as pediatricians don’t always have to know everything, and what it looks like to partner with parents to learn together.

    [00:01 - 08:13] Opening Segment

    • Introducing today's guest and my friend, Sandy Fowler, and what we will be talking about
    • Met on her podcast to talk about the topic of suicide prevention for parents
    • Listen to my guest appearance on her podcast here
    • Sandy gives us a bit of background on her story
    • Help parents learn emotional wellness tools
    • Why this age group
    • You don’t have to know the answer, just understand that you’re not alone

    [08:14 - 13:01] Shhhh, Just Listen and Check Yourself

    • Sandy talks about common themes she finds on her show
    • Our teens still need us, but it needs to look different
    • Listening - a safe place to talk
    • Coaching
    • Modeling what it is we want them to do
    • Listening and coaching for kids
    • Parents need to be willing to check themselves
    • Pediatricians should help, not judge
    • Recognize and acknowledge things in yourself
    • Self-regulation
    • Try not to blow up

    [13:02 - 24:56] We Don’t Always Have to Know

    • Sandy shares her experience with pediatricians
    • Expectation of partnership
    • Sometimes the doctor just doesn’t know what to do and end up doing the wrong thing
    • Be okay not knowing as a pediatrician
    • Be honest with the parents
    • Explore options as partners
    • Sandy talks about a positive story with her daughter and her doctor
    • Non-disclosure
    • Gave the option to speak directly
    • There is help
    • I talk about our training as a pediatrician
    • Acting on things you may not know
    • A parent wants to know they have help, not just an answer
    • Sometimes it’s a skills issue
    • “I don’t have a pill for a messy family”
    • Chaos impacts behavior
    • Sometimes we can’t just fix the kid
    • Sandy talks about what we can do to help the family
    • Non-judgmental
    • Partnership and options
    • Realize that the issues can connect to a still-developing brain

    [24:57 - 30:07] Calmness is Key

    • Communication with the child is key
    • Don’t panic
    • Our calmness helps the child
    • Pause and let the silence sit until the child is ready
    • I give an example with a code lead manager

    [30:08 - 39:34] Closing Segment

    • A word for parents
    • Your kids will be okay
    • Accept what you don’t know
    • We can be there for parents
    • The silence is...
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    40 mins
  • 07 The Art of Conscious Parenting with Dr. Robert Saul
    Oct 21 2020

    https://302.buzz/PM-WhatAreYourThoughts

    It’s apparent now more than ever, our children need advocacy. Today I’ll be speaking about this with Dr. Robert Saul. Dr. Saul completed his pediatric training at Duke University Medical Center. He deeply cares for all children, and after seeing the need for child advocacy in society he was led to write several books for parents. Dr. Saul believes we need constant reminders about the optimal nurturing of children, and his work provides a multi-dimensional approach to parenting that is refreshingly new.

    Let’s dive in and learn the art of conscious parenting for our own family, and for the parents of our patients.

    [00:01 - 07:03] Opening Segment

    • Introducing today's guest, Dr. Robert Saul
    • Training and studies
    • Author of several books - links below
    • Dr. Saul gives us a bit of background on his story
    • Finished residency in the mid-’90s
    • A need to connect to the community
    • Devoting resources to be the solution
    • The impact of Columbine on Dr. Saul
    • Wrote articles in the newspaper to educate
    • The 5 steps to community improvement
    • Inspired to write books to teach himself

    [07:04 - 14:59] My Children’s Children

    • Dr. Saul’s own experience from childhood
    • Parents divorced at the age of 9
    • Verbally abusive household
    • Read back on his mother’s journals when she passed
    • Becoming the evil parent for your parent
    • Dr. Saul’s insights on parenting and pediatrics
    • The paternalism and maternalism of pediatrics
    • Child advocacy project
    • SSNR vs. SSRI
    • You need both, but SSNR will create lasting change
    • Identifying and boosting SSNR’s

    [15:00 - 24:15] The Art of Conscious Parenting

    • Dr. Saul talks about the basis of Conscious Parenting
    • Dr. Saul’s story with his own child
    • Based on forgiveness
    • The model of the Parental Awareness Threshold
    • Dr. Saul’s story of Conscious Leadership
    • Above the line vs. Below the line
    • Being conscious of where you are on the line
    • Parenting works the same way
    • How to make a conscious effort as a parent
    • Pause, assess, and choose
    • Example

    [24:16 - 33:06] Being and Raising a Good Citizen

    • Separating approaches by age range
    • The value of having a partner along the journey
    • Another point of view
    • Safe stable relationships are for parents as well
    • Dr. Saul talks about how his book aids parents
    • Short read
    • Step by step approach
    • From someone who is also learning
    • Raising a good citizen
    • Don’t become elderly, become an elder
    • Getting socially reconnected
    • Get involved and stay involved
    • Practice forgiveness personally and communally
    • Be part of the solution

    [33:07 - 46:45] Closing Segment

    • A word for parents in hard living environments
    • 3 levels of intervention
    • Active integration and support for these families
    • Advocacy can be part of the solution
    • Engaging the well-being of pediatricians
    • Seek out people who share your values
    • Don’t do it alone
    • Refuse to become discouraged
    • How Dr. Saul stays engaged
    • Dr. Saul talks about his book for children
    • Growing in wisdom
    • Final...
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    47 mins