Pediatrics
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Pediatrics:
I love pediatrics. I love the kids. I love to watch them grow up.
In any medical specialty, there are practice standards that we follow. The differences between doctors can best
be discerned in terms of style.
I like knowing my families. I like taking time to explain things to parents and if they are uncertain about anything
at all, I like to discuss and make a treatment plan.
I use medications to calm things down. I minimize antibiotic use if I can. I use steroid medications when I have to.
My first choice is always preventive, natural approaches. Even with this, there are cases where I recommend,
strongly recommend and occasionally insist. Some of my patients' parents have commented that they like that I
do not beat around the bush and give them the lowdown. In truth, when I have "my talks" with parents, I tell them
"what I am supposed tell parents (standard of care)," then I tell them I think (with a wink), and finally I tell them
what I would actually do (with another wink) for my friends, family and child.
I minimize vaccines. I give vaccines that are required. I discuss the ones that are recommended. Parents who do
not want any vaccines at all for their children are welcome. They are cautioned of the risks. Ultimately, it is about
parental informed choice.
Cases
Cough
L.V. came to me when she was 4 months old. As an infant she coughed the day she came home from the
hospital. Her mom told me that she had a "diva" cough, as if she was trying to get attention. It took us 2 weeks
to clean her up and she became cough free, without meds!
Constipation
J.H. came to me already on mineral oil for constipation every night for the last 2 years, since he was 9 years
old. He was seen by a pediatric gastroenterologist for constipation and chronic abdominal pain. His specialist
put him on the regimen but it did not resolve his abdominal pain. It took me 1 year to ease him off the mineral
oil. He is now pooping daily on his own and his abdominal pain is gone (his parents and the specialist attributed
the abdominal pain to anxiety/stressors). No prescription meds, no OTC meds!
ADHD
V.V. is a 9yrs old when he came to see me. His mother brought him for a second opinion consultation because
she had heard about me from a friend. V.V. was diagnosed with ADHD. He was started on Ritalin by another
local pediatrician. The Ritalin gave him tics (a common side effect) and another medication, Strattera, was
started. V.V. developed PALPITATIONS with this new medication. [I actually like Strattera, it is dosed by weight,
even if dosed on the high end, the most common side effect is insomnia. It is not an amphetamine like Ritalin.
Because it is not a controlled substance, once we find the correct dose, we can refill by phone. There is no
dependency, and it is quite liberating for the patient and family]. V.V. was then sent to our local pediatric
neurologist who started him on Prozac. V.V.’s mother did not like the fact that her child was on an
antidepressant and worse, it did not seem to be working. I reassured his mother that V.V. was treated
appropriately by the other pediatrician, and if the specialist had him on Prozac, it is one of the safer
antidepressants (in terms of side effects). We proceed to the physical exam. I told her that he has headaches,
he does not sleep well and this was due to a recent head trauma. What happened? She admitted that he was
waking up at night complaining about headaches for the last 2wks and that he was hit in the face by a baseball
just prior to the onset. I proceeded to treat his head trauma with OMT. I then reassured her that he would sleep
like a baby and the headaches would go away. We planned to continue his Prozac to see if the head trauma
and headaches were interfering with the way he processed medications. Throughout the visit, shy guy that he is,
V.V. did not say a word to me. By the end of the visit, I knew that I had helped him and he confirmed it by
wrapping his arms around me and giving me a great big hug. V.V. and his mother were very good in continuing
the visits with me for the next 7 weeks. We retried him back on Strattera and this time, no palpitations. I don’t
see V.V. anymore because the teacher is happy with his self-control. I know he is still my patient because his
mom calls for refills. Mom is satisfied with staying on the Strattera. They come in to adjust the dose for his
weight and he is still on the lowest dose. Osteopathically speaking, I believe he can continue treatments to
eventually cure the ADHD, but it would cost too much in terms of time and money. Both parent and patient need
to be invested in osteopathy in order get off meds and heal.
Wheezing/ADHD
I first met CC when he was 1year old. They came to me because he was wheezing and my hours were
convenient. I gave him the standard treatment: antibiotics, steroids, and nebulizer treatment. Throughout the
winter, he returned several more times and I continued to give him the same standard treatment. One day, I
couldn’t take it anymore. I sat down with CC and his parents and had “my talk.” I told them that I did things
differently. I said that his regular doctor very likely told him what we are all taught to tell patients. I, however, did
things a little different for my patients, based on my own clinical as well as personal experience. I suggested that
they needed to do 3 things differently. It would not cure him, but it would certainly get him better. I asked them
to give my instructions a chance, and if they did not see improvement, they could go back to doing what they did
before. He got better. Instead of wheezing 5 times a month, he went down to 2-3 times a month. Sometimes he
would go through stretches of no wheezing for months at a time. One year later, we had a bad allergy season
and he started up wheezing again. I checked him and stated that he had head trauma as an infant. What
happened? Mom denied any head trauma at first. He never had a fracture, he was never hurt badly enough to
go to the ER. But yes, there was a time when he was an infant when they were walking through a parking lot.
He was in his carseat. His parents thought that he was strapped in. He was not. As his mom picked up the car
seat, he slid out from under the straps and rolled onto the pavement. His parents report that they took him
immediately to his MD and he seemed okay. CC had to be treated for his head trauma. We scheduled 2 visits
for OMT, but each time, he would not lay still or even sleep. He is also ADHD and runs all over the place. He
would not cooperate. They stopped making appointments. Several months later, he wheezed again. They
brought him in and wanted to know why the wheezing was acting up again. I paused and did not answer for the
longest time. Finally, I sighed and said, “He has head trauma and it needs to be treated. I wasn’t going to say
anything at all, because the last time we talked about it, you blew me off.” They responded, “We didn’t blow you
off last time, Dr. Hoang. He just won’t lay still. We trust you, and that’s why we keep bringing him back to you.”
They continued with an interesting story. Two weeks ago, they consulted a Feng Shui expert to evaluate their
home. [Feng-Shui is the Chinese practice of arranging furniture for good energy flow]. The consultant saw CC
and stated that he had head trauma and that he needed treatment. I was shocked !!!??? They would believe a
Chinese lady and not their doctor?? She recommended that they put a rock under his bed to prevent further
head injury. I teased them, "so how's the rock working out?" They decided to bring him in as needed and wait
until he is old enough to cooperate with treatment.
I love pediatrics. I love the kids. I love to watch them grow up.
In any medical specialty, there are practice standards that we follow. The differences between doctors can best
be discerned in terms of style.
I like knowing my families. I like taking time to explain things to parents and if they are uncertain about anything
at all, I like to discuss and make a treatment plan.
I use medications to calm things down. I minimize antibiotic use if I can. I use steroid medications when I have to.
My first choice is always preventive, natural approaches. Even with this, there are cases where I recommend,
strongly recommend and occasionally insist. Some of my patients' parents have commented that they like that I
do not beat around the bush and give them the lowdown. In truth, when I have "my talks" with parents, I tell them
"what I am supposed tell parents (standard of care)," then I tell them I think (with a wink), and finally I tell them
what I would actually do (with another wink) for my friends, family and child.
I minimize vaccines. I give vaccines that are required. I discuss the ones that are recommended. Parents who do
not want any vaccines at all for their children are welcome. They are cautioned of the risks. Ultimately, it is about
parental informed choice.
Cases
Cough
L.V. came to me when she was 4 months old. As an infant she coughed the day she came home from the
hospital. Her mom told me that she had a "diva" cough, as if she was trying to get attention. It took us 2 weeks
to clean her up and she became cough free, without meds!
Constipation
J.H. came to me already on mineral oil for constipation every night for the last 2 years, since he was 9 years
old. He was seen by a pediatric gastroenterologist for constipation and chronic abdominal pain. His specialist
put him on the regimen but it did not resolve his abdominal pain. It took me 1 year to ease him off the mineral
oil. He is now pooping daily on his own and his abdominal pain is gone (his parents and the specialist attributed
the abdominal pain to anxiety/stressors). No prescription meds, no OTC meds!
ADHD
V.V. is a 9yrs old when he came to see me. His mother brought him for a second opinion consultation because
she had heard about me from a friend. V.V. was diagnosed with ADHD. He was started on Ritalin by another
local pediatrician. The Ritalin gave him tics (a common side effect) and another medication, Strattera, was
started. V.V. developed PALPITATIONS with this new medication. [I actually like Strattera, it is dosed by weight,
even if dosed on the high end, the most common side effect is insomnia. It is not an amphetamine like Ritalin.
Because it is not a controlled substance, once we find the correct dose, we can refill by phone. There is no
dependency, and it is quite liberating for the patient and family]. V.V. was then sent to our local pediatric
neurologist who started him on Prozac. V.V.’s mother did not like the fact that her child was on an
antidepressant and worse, it did not seem to be working. I reassured his mother that V.V. was treated
appropriately by the other pediatrician, and if the specialist had him on Prozac, it is one of the safer
antidepressants (in terms of side effects). We proceed to the physical exam. I told her that he has headaches,
he does not sleep well and this was due to a recent head trauma. What happened? She admitted that he was
waking up at night complaining about headaches for the last 2wks and that he was hit in the face by a baseball
just prior to the onset. I proceeded to treat his head trauma with OMT. I then reassured her that he would sleep
like a baby and the headaches would go away. We planned to continue his Prozac to see if the head trauma
and headaches were interfering with the way he processed medications. Throughout the visit, shy guy that he is,
V.V. did not say a word to me. By the end of the visit, I knew that I had helped him and he confirmed it by
wrapping his arms around me and giving me a great big hug. V.V. and his mother were very good in continuing
the visits with me for the next 7 weeks. We retried him back on Strattera and this time, no palpitations. I don’t
see V.V. anymore because the teacher is happy with his self-control. I know he is still my patient because his
mom calls for refills. Mom is satisfied with staying on the Strattera. They come in to adjust the dose for his
weight and he is still on the lowest dose. Osteopathically speaking, I believe he can continue treatments to
eventually cure the ADHD, but it would cost too much in terms of time and money. Both parent and patient need
to be invested in osteopathy in order get off meds and heal.
Wheezing/ADHD
I first met CC when he was 1year old. They came to me because he was wheezing and my hours were
convenient. I gave him the standard treatment: antibiotics, steroids, and nebulizer treatment. Throughout the
winter, he returned several more times and I continued to give him the same standard treatment. One day, I
couldn’t take it anymore. I sat down with CC and his parents and had “my talk.” I told them that I did things
differently. I said that his regular doctor very likely told him what we are all taught to tell patients. I, however, did
things a little different for my patients, based on my own clinical as well as personal experience. I suggested that
they needed to do 3 things differently. It would not cure him, but it would certainly get him better. I asked them
to give my instructions a chance, and if they did not see improvement, they could go back to doing what they did
before. He got better. Instead of wheezing 5 times a month, he went down to 2-3 times a month. Sometimes he
would go through stretches of no wheezing for months at a time. One year later, we had a bad allergy season
and he started up wheezing again. I checked him and stated that he had head trauma as an infant. What
happened? Mom denied any head trauma at first. He never had a fracture, he was never hurt badly enough to
go to the ER. But yes, there was a time when he was an infant when they were walking through a parking lot.
He was in his carseat. His parents thought that he was strapped in. He was not. As his mom picked up the car
seat, he slid out from under the straps and rolled onto the pavement. His parents report that they took him
immediately to his MD and he seemed okay. CC had to be treated for his head trauma. We scheduled 2 visits
for OMT, but each time, he would not lay still or even sleep. He is also ADHD and runs all over the place. He
would not cooperate. They stopped making appointments. Several months later, he wheezed again. They
brought him in and wanted to know why the wheezing was acting up again. I paused and did not answer for the
longest time. Finally, I sighed and said, “He has head trauma and it needs to be treated. I wasn’t going to say
anything at all, because the last time we talked about it, you blew me off.” They responded, “We didn’t blow you
off last time, Dr. Hoang. He just won’t lay still. We trust you, and that’s why we keep bringing him back to you.”
They continued with an interesting story. Two weeks ago, they consulted a Feng Shui expert to evaluate their
home. [Feng-Shui is the Chinese practice of arranging furniture for good energy flow]. The consultant saw CC
and stated that he had head trauma and that he needed treatment. I was shocked !!!??? They would believe a
Chinese lady and not their doctor?? She recommended that they put a rock under his bed to prevent further
head injury. I teased them, "so how's the rock working out?" They decided to bring him in as needed and wait
until he is old enough to cooperate with treatment.
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