Trauma Bonding with Pediatricians The PediPals (Dr. Anandita Pal and Dr. Samira Armin)

KKH Trailer Wide


Will: [00:00:00] Knock, knock, hi! Knock, knock, hi!

Hello and welcome to Knock, Knock, Hi! with the Glock um Flock ums! Well, you’re coming 

Kristin: in hot today. I 

Will: feel like I got to get my energy up. It’s where, where I’m running low. I’m just, I’m getting toward the end of the day, I’ve, I’ve, I’ve been in clinic all day and we were recording and it’s just. You know?

Yeah, it’s 

Kristin: been a long day. I’m 

Will: trying to do it. I’m trying to. Because the people, I don’t want to project my exhaustion onto our audience. They have 

Kristin: their 

Will: own exhaustion. Everyone’s exhausted about something. What excuse do I have? No excuse. Anyway, I’m Dr. Glaucum Flecken, also known as Will Flannery. I 

Kristin: am Lady Glaucum Flecken, also known as Kristen 

Will: Flannery.

So, uh, we thought about what we were going to talk about with the intro here, but, um, And then we recorded our episode. [00:01:00] Uh, and that’s 

Kristin: what we do first people may not know that we first we do the interview, you know the Stories and the games and all that with the guests So that they can you know, we can be use their time efficiently and we do the other parts Where they’re not involved separately and we do it afterward and so, you know, it’s a little bit out of order from what people hear.

Will: So we were about 20 minutes into our interview, our wonderful time with Dr. Sammy and Dr. 

Kristin: Anna. We were so engrossed in the conversation that we didn’t even 

Will: notice that we didn’t start recording the audio. 

Kristin: Or the video. So we really just failed at our job 

Will: entirely. We have the audio and video, like you’re going to hear it, but it’s through Riverside, it’s through our recording app.

We have 

Kristin: backup files. Let’s just put it that way. We have some backup 

Will: files. Exactly. It’s not going to be the high quality, uh, the beautiful 4K HD that you see of me, uh, Kristen too, but you know, mostly me. I’m sure people Love the beauty [00:02:00] here of me post, you know, clinic, beautiful 

Kristin: hair. Most people do love you.

It’s fine. It’s fine. 

Will: I’m sure they come to see you. They don’t come to see me. Um, and, uh, so we We have all those things you’re going to see and hear them, but, um, it’s just not going to be the quality that you’re used to, the quality that you’re hearing right now. 

Kristin: So, yeah, we’re just going to tell you that up front and that way we save ourselves all the 

Will: comments.

That’s right. That’s right. We get it. We know, uh, and we will never do it again. So sorry. And now we have to buy our audio producer, audio engineer, uh, Jason. Uh, a very nice, like, I’m sorry present. 

Kristin: Mm hmm. Right. He probably puts up with a lot from us. He does. 

Will: Yeah. We have wonderful people, uh, that are, that are helping us put all this together and, uh, he is definitely one of them and, uh, you know.

It’s, it’s, you know, it’s, it’s long 

Kristin: suffering at this point [00:03:00] is, 

Will: is what it is. He’s, he’s, um, you know, he’s got his work cut out for him on this one. So, uh, but we’re excited for the guest. 

Kristin: It’s a really fun 

Will: episode. We talk cause we don’t, we haven’t talked a lot about pediatrics. Yeah. I feel like, and 

Kristin: these two are a fun time.

Like they are knowledgeable. They. Are well spoken. I like that, you know, they’ve got this like good cop bad cop thing almost. I mean not really they’re both They’re both good cops, but like dr. Sammy’s a little like you say in the episode She’s a little fiery and then dr. Anna’s like a little cooler calmer, you know kind of reminded me of us 

Will: Which one is which?


Kristin: don’t know. I’m afraid to say. I think that tells you right there which one you are 

Will: Well, you guys tell us what we are. I was thinking 

Kristin: I’m the fiery one and you’re the calmer, cooler. 

Will: I can see that. So does that mean you’re a bad cop? Am I a good cop? 

Kristin: No, I shouldn’t say good and bad. It’s not good and bad.

It’s just that it’s just like, you know, spicy and then soothing. [00:04:00] 

Will: Yeah, I, I, I guess I think you’re right. I think you’re right there. It does help to have two people that are a little bit slightly different. Yeah, just like 

Kristin: balance each other out, you know, 

Will: compliment each other. We had so much fun. Um, I, I enjoyed just like throwing topics at them.

Yeah, they were good 

Kristin: sports. They were kind of all over the place. 

Will: We were. I have so many questions of it because we’re parents. Right? 

Kristin: And kids are so fascinating because their bodies are just like always changing and so it’s different at different ages what they need. So 

Will: I’ve got so much respect for the, the, um, the unicorn hat wearing physicians out there and people taking care of kids.


Kristin: have some really good stories too 

Will: from their training. They do. Absolutely. So let’s get to it, huh? Yes. All right. Here is Dr. Anna and Dr. Sammy. Thank you.

Today’s episode is brought to you by the Nuance Dragon Ambient Experience, or DAX for short. This AI powered, ambient technology is helping you, physicians, be more efficient and reduce clinical documentation [00:05:00] burdens that cause us to feel overwhelmed and burnt out. To learn more about how DAX can help reduce burnout.

and restore that joy of practicing medicine. Kristen, you gotta have that joy. You gotta have it. Stick around after the episode or visit nuance. com slash discover dax. That’s n u a n c e dot com slash discover d a x.

All right, we are here with Dr. Anna and Dr. Sammy of the Petey Pals. Fame, the, uh, the, I, I think probably the, the best, uh, pediatrician presence on TikTok by far in my, in my honest, humble opinion as an ophthalmologist. How many of them are there? I don’t know. You’re the only ones I see. So, but, but, but I love it.

I love, I love what you, what you do. So thank you so much for joining us. It’s really a pleasure to get to talk with you finally. Well, 

Dr. Sami: thank you for having us. I’m pretty sure all our friends are going to be jealous. 

Sr. Ana: [00:06:00] Yeah. We’re big fans. So you, you guys are definitely our favorites. Oh, 

Dr. Sami: thank you. 

Kristin: And likewise, I watch your stuff like as a parent, um, I subscribe to you on my personal Instagram channel to kind of keep up with.

Because I do about 

Will: these children because I I because I don’t I don’t help I I’m not I’m so far removed from pediatrics in a lot of different ways that it’s I I come to you for education as well So, um, but we I want to start off by talking about Texas because we were just there We you guys where exactly are you working?

We’re in Houston You’re in Houston. Okay. That’s where I grew up. Not too far from Houston. So I grew up in Deer Park, Texas. That’s um, um, you’re, you’re like looking at me like, really, that’s where you grew up. No wonder you got cancer. 

Dr. Sami: No, we’re looking at you with different reactions. I’m looking at you like someone who grew up in Canada, like, oh, Deer Park, sure.

And Anna’s the one that grew up [00:07:00] there. 

Sr. Ana: Yeah. I know exactly where that is. 

Will: Yeah. It’s, it’s right where all the refineries are. Not wrong. This permanent, permanent glow from the refinery. We call them cloud makers actually. No, but, um, uh, so you’ve been in Houston. How long have you two been working together in Houston?

Dr. Sami: It’s 2015, I guess. Yeah. Yeah. Around there. Our relationship predates that, but we’ve been, uh, I was her resident upper level. And so, it began a long, long 

Sr. Ana: time ago. Yes, I grew up in Houston, uh, for most of my, like, high school, middle school. So, my family’s from here. And then Sammy decided to cop meet me and move to Houston.

Or that’s what we, that’s exactly what happened. So, yeah, we met in residency and then we both ended up. Um, back in Houston and working together and haven’t looked back since what actually happened I 

Dr. Sami: had a couple of match with my husband who’s a texan [00:08:00] Yeah, there you go see 

Will: He’s that was gonna be that was gonna be my next question.

Like, okay, you you come you came from canada It’s it’s just quite a it’s very different. Yeah, very different. Well, I want to I want to get to Obviously talk about the PD Pals and the origin of it and what you’re doing on social media because I think it’s so great. But let’s, let’s first figure out how you got to that point.

So you said you, you, you both are in residency together, uh, and, and what was it that drew you to each other in terms of wanting to work together? Uh, there must’ve been some kind of experience you had where you’re like, Oh, I like this person. Or at least, I 

Kristin: don’t hate this person. That’s where we are. No, I’m just kidding.

Trauma. Yes. Trauma, right? Trauma bonding. Very 

Sr. Ana: powerful. And sarcasm. And humor. And sarcasm. That’s great. Combined with the trauma. 

Dr. Sami: Well, it all started, I was telling Anna when we were talking about, you know, this, this, what we were going to. talk [00:09:00] about with you guys. I was like, we can be those people that are like, back in our day when we had paper charts.

Um, yeah, before, before Epic and all that fun stuff. Uh, I was a third year resident. She was an intern and we got paired together just by luck of the draw. When we were doing, uh, you know, inpatient call and it, it was just like one miserable call night after another. Our first night of call was epic and then it just kind of all kind of flew, flew downhill from there.

Um, and we, we learned that both of us are the kind of people that’ll laugh in the face of like very You know, traumatic experiences are situations where you shouldn’t be laughing. Of course. Yeah. Yeah. 

Will: Yeah. Gotta have that. There’s always a little dark sense of humor because it helps you get through those times, right?

Yeah. Did you have anything in particular that happened? During those call 

Sr. Ana: nights. Where do we start? So I was, I was an intern off the bat, so I was already [00:10:00] traumatized from the get go. And so I was just trying to hold on to somebody, somebody for support, as you probably remember your intern days. But, you know, you just kind of get thrown in and You know, back in our day, we, um, it didn’t, we were, we kind of ran, the residents kind of ran the hospital.

So we didn’t always have attendings or, you know, attending physicians there, uh, in the nighttime. And so me and Sammy got paired up on our nights. And so it was just. It was us, you know, against the world and, um, we had a couple, I think both of our in medicine, we call it like a black cloud, you know, if you’ve had just everything attracts you, you know, all, all the darkness attracts you.

And so we were kind of two black clouds combined. And so we had a pretty horrific night, the first night where, um, we. That was our first call together. Sammy was like, oh gosh, I have this intern. It’s like her first night ever on call I hope she can, you know, just keep up [00:11:00] Um, and I was just hoping not to die myself.

So we had um survival. That’s all you were going for here Yeah. And people think, you know, pediatrics is, is, is so, so much fun and so much, you know, but it gets intense when these kids are sick and they are, you know, we call it crumping or they’re getting really sick. Um, it gets very intense and you’re it, you know?

Um, so there was definitely a night where, um, we were. kind of covering the whole hospital because at nighttime you’re just kind of in the bare minimum group. And so we were, uh, you know, Sammy was on one floor, I was on one floor, and we were just having kids just getting sick. And of course, they all get sick at the worst moments when you have the least amount of people there.

And, you know, that’s just how How it always goes. So, you know, she was running one code. I was running one code. It was just, we were just trying to put out flyers left and right. And so, um, yeah, I mean, I can let Sammy tell the rest of the story, but wait. Go 

Kristin: ahead. What, you were run, you were [00:12:00] both running a code.

Does that, does that just mean any code or do you mean like so it was, there were like, was two kids simultaneously coded? 

Dr. Sami: Yeah, no, it was more than two . Multiple. Multiple. I, I we’re not even exaggerating. It was RSV season and the PICU whistle. The pediatric ICU was fault was just her and I, like we were the only two physicians in the children’s hospital.

And I was like, Hi, I’m Sammy. Nice to meet you. And it was like, our little page was like, beep beep beep beep beep beep. So we like run off to the first, it was a rapid at first, where you it’s not quite a code situation, but the kids starting to deteriorate. So we both go off and I’m thinking I’m going to get a chance to teach her something.

And we get there and and then I’m like, Okay, you know, let’s get the kid oxygen. Let’s do this. Let’s do that. And then I get another another page. And I and I pick it up. And they’re like, They’re like, this nurse, Jessica, is getting CPR in room like four, whatever. And I was like, excuse me? They’re like, yeah, she’s getting CPR.

Like, you gotta get here. And so I turned to Anna and I was like, you’re on, kid. 

Kristin: Oh, man. Good [00:13:00] luck. Good luck. Yeah. I was like, call me if you need anything. 

Dr. Sami: Yeah. I was like, call me if you need anything. And so I ran off to the other kid that I like started to run a code and it was just, it was like that. It’s just like one after the other.

Kristin: I didn’t know what code meant before it happened to you, so can you tell people who may not be in medicine what that means exactly? 

Dr. Sami: It’s basically that their heart has stopped and they’re dying. So what you have personally done yourself, you have written the code, but it’s, you know, but it, you know, starts with CPR, but then it also starts with all kinds of other assistance as well.

So medications and, uh, starting IVs and central lines and. And doing whatever you can to keep the person alive, depending on what it is that, you know, had them decompensate, essentially. 

Will: Yeah, and this wasn’t, Anna, was this, this was like day one of residency? Yeah, pretty 

Sr. Ana: much. Uh, it was, it was literally my first night, my first like 30 hour call.

It was like, yeah, it was pretty much, I was barely [00:14:00] learning. How to write orders and prescribe medications, like, you know, and you, you learn all that stuff in medical school, but then practically speaking, you know, it’s like a whole nother thing. So luckily I had an awesome upper level over there. Yeah. To save lives that day, you guys, we were, we were all, we, there was also other things that happened, but we definitely.

We were just flying by the seat of our pants at that point, you know? And the nurses, of course, I mean, the nurses that run the hospitals, they really are, um, not appreciated enough because they help us a lot, um, through it all. Yeah. So, yeah. And Rapids, just to clarify, rapids, uh, in the pediatric world is, let’s say they’re not fully coding, so their heart hasn’t stopped, or we haven’t stopped completely breathing, but they’re getting to that point where we’re having to escalate care to either move them to the ICU or figure out next steps.

So. She was handling the codes and I was trying to manage the rapids that were going on at the same time. 

Will: I think, I think [00:15:00] everyone’s, every, every physician has like a, a story or like vivid memories of like their first serious experience as a physician, whether it’s like a first night of call, first night doing something.

For me, it was my, my first night in the ICU, like by myself. And like, Googling what is ECMO, trying to like, figure out, like, what on earth I’m supposed to be doing. And you’re so right. Not only, like, do you rely on the other people that are there that, that, you know, cause it’s such a team sport, right? All of this stuff.

Um, but also the, the bonding with your co residents and your co interns, like it’s, it’s, there’s nothing like it. And you, that’s why you end up friends for life with these people, right? And people that you still call on like 10, 20, you know, 30 years later. And sometimes you, You end up, uh, you know, making a TikTok account with them, apparently.

So it happens all the time. Very, very [00:16:00] common. You guys, you guys did send us some, some interesting, uh, I love it when you send us, when our guests send us like little teaser stories. Of like, and I just put myself in your position, like what on earth would I do in that situation? Like, one of them you sent was a toddler that was given 10 times the dose of Toradol.

Dr. Sami: That was that same night. That was 

Sr. Ana: literally 

Will: the same night. What do you do? So Toradol is um, is a, is an anti inflammatory, like IV. It’s an inset that you give Ivy, right? Yeah. 

Sr. Ana: So yeah, during this all happened during these rapids, you know, because we, because Sammy’s over there, you know, trying to save a life and we are.

um, taking care of these kids that are really sick. And so this is what happened from my perspective. Um, there was a child, um, that was, I think, had a broken bone and was in a lot of pain. And so the nurse that was taking care of that [00:17:00] child came to me and said, okay, we need, uh, pain medicine, you know, and they had Toradol that was on, on file.

And so they said, how much pain medicine can we give? And so I’m over here trying to make sure this other child doesn’t stop breathing, right? So I calculated the dose and I gave them a verbal order. Which was, again, back in our time, we could give those verbal orders. Now they’re a little bit more strict about it.

But, you know, in a very, um, you know, rapid or code situation, that’s what we do, right? And so I gave a verbal order. And that nurse, it was her first night. It was her first night. So she, so she gave 10 times the dose of Toradol. And yes, and then came back to us a little bit later. And we were both like, uh.

Excuse me, how much short all did this baby get? And so of course, you know, at that point, we are, um, you know, we went to go check on the baby and the baby is living their best life. They are so happy and [00:18:00] they’re so pain free. And so we’re like, okay, what do we do? You know, do we call her attending? The baby is fine.

You know, how it was a toddler. So we were like, how do we handle this? So we were checking, you know, creatinine levels, which are your kidney levels because Toradol can affect your kidneys. So we’re doing serial labs on the baby. We’re checking on the baby, like every, you know, 10 minutes, even after the call finished, I was, Um, you know, on my computer checking the labs, luckily everything turned out okay, but it was definitely, um, yeah, it was a 

Will: night.

The nephrologist would not be happy with you guys. They’d be shaking their salt, salt canister right in your face. Like, what are you doing? That, that, um, one of the things that always scared me the most about pediatrics was, was the, all the calculation, the dosage, the, it’s, it’s like I, that might have been enough to just make me not want to do pediatrics.

I was, I was just terrified of giving the wrong amount of medication because [00:19:00] there’s so little, like little bodies. So it’s 

Kristin: based on body size, right? 

Dr. Sami: Body weight. Like weight. Most of it. Fascinating for us because we’re so used to it. Right. Like. It’s, it’s just weight based. That’s all it is, you know, right?

And so we know and we can buy, when you get experience, you do it in your head and it’s all good. Uh, so, but when they turn 18, it’s, it’s so, like, easy. 

Will: They’re immediately not 

Dr. Sami: kids anymore. Right, and so, so easy that it almost feels arbitrary when you’re writing the script. It’s like 20 milligrams, like, it’s just, like 40.

How’d you get to that number? Okay. 

Sr. Ana:

Kristin: mean, I’m curious about that because like we still are different sizes as adults in different ways. So how come, I guess 

Will: maybe should we all be? Because adult doctors are lazy. That’s why. 

Kristin: And I think this has a lot to do too with, I mean, it’s kind of related to like gender.

issues in medicine, right? Like generally [00:20:00] speaking, women are smaller than men because we are a, what is it like, oh man, I’m digging into freshman biology or something. When you have a species where the men are bigger than the women, that’s what we are. 

Will: So. I believe that’s correct. Yes. 

Dr. Sami: I think so too. Yeah.

Kristin: But so, so then that means that women are probably getting. Not the right dose all 

Dr. Sami: the time, right? There’s a range, right? Like still like I think 20 to 80 milligrams of whatever and I feel that they’re very arbitrary in the way that they pick that number. Leave 

Will: it up to the patient. 20 milligrams, 80 milligrams.

But what do I know? 

Dr. Sami: I’m just 

Sr. Ana: a computer. Take 10 times what it says. Yeah, and so Yeah, go ahead. So I was just going to say, usually like the pharmacy, you know, in hospital settings, they usually catch this stuff, right? Because they’re looking at what the max dose is and, and, you know, they have like little checks and balances at every point.

But of course, this was the one night on my first night where all the checks and balances were missed. So. [00:21:00] 

Will: It happened. Well, the pharmacist was probably checking like the four or five other interns in other areas. No, no, the 

Kristin: pharmacist was also there first night on the job. So, 

Dr. Sami: well, or they were also overwhelmed because they’re having to send all the medicine for the code.

Kristin: Right. Yeah. I’ll never 

Dr. Sami: forget when the nurse came to tell us, it was like, Her, Anna and I had just regrouped in the hallway and she was like, I was like, I did this and this and this and she did that and we bought our little papers with all patient’s names and we’re trying to whatever and then she like, she officially came up and she’s like, Um, Dr.

Anna? And we’re like, Yes? She’s like, No, we didn’t say that toward all dose. Did you say like six? Or a 60. She was like, definitely six. She’s like, okay, because the kid got 60. And then I’m like, oh my god, run to up to date. 

Will: Now I know that there are probably people listening to this or they’re like, like white knuckling it like, oh my god, I gotta be in the hospital.

What if this happens? Like, this is why [00:22:00] quality improvement projects exist. You know, like, this is why, um, Uh, you know, verbal orders aren’t probably not, you know, accepted as much as they used to be and, and, and why, how we improve things in medicine because, you know, stuff like this happens. And I mean, 

Dr. Sami: and it was the one and only time in, in both our careers that it really was like a perfect storm, but, but absolutely these are the types of situations and, and boy, we made sure like everything was made right.

We filed incident reports, we talked to the family, we, you know, we did everything that you have to do when something, a medication error happens, but yeah. This is exactly how we improve. 

Will: And you, so you, so you trauma bonded over this. I, I, I will admit it does sound like a traumatic experience to have to go through all of this, but, uh.

Um, and then that has really been ever since then you’ve worked together. Is that pretty much at once you finished your training, you’re like, Hey, let’s go into practice. And


Sr. Ana: more attached to whom here? I mean, she really couples match with [00:23:00] me. She’s just saying she couples match with her husband. But yeah, we just ended up 

Kristin: triples match. 

Sr. Ana: That’s what happened. I’m the third wheel that just wouldn’t let go. Nope. Um, yeah, we just ended up, um, I think working together, uh, she actually moved to Houston, started with a practice, and then I was like, hey, I know you, and I like you, and she was like, yeah, you know, so then we ended up at the same practice, and, um, we, yeah, somehow trauma bonded our way to TikTok, apparently.

Will: Yeah. Yeah. So, so when did you pick this up? When did you, was it with like the rest of us during lockdown and you just started making content basically? It 

Dr. Sami: was during lockdown, but we’re, we’re, we’re so technologically like challenged that it wasn’t like we woke up one day and we’re like, let’s get on social media.

We were like, how do we give our patients like. Just access to information that they’re asking us that we can’t give them as readily as we [00:24:00] could five minutes ago before lockdown and We were like they’re asking us the same thing. Like what do I do if they can’t sleep? What do I do if they’re constipated?

What do I do if you know same it’s so if we could just have like some kind of library of Like something and we actually thought let’s make a podcast first So we were not neither of us were on social media. We had no like interest in being on social media. So we actually thought of making a podcast first, which we did actually, we do have a podcast.

Um, but then we were like, well, how do we advertise? So I guess we’ll start a social media just to start advertising it. And then we like, we couldn’t even, I mean, when I tell you, we had no clue, like we couldn’t even figure out what a reel was like how to do anything on Instagram at first. And then when we finally kind of got the hang of it, we were like, Whoa, what is happening?

Like, what’s everyone saying? Is this what parents are listening to? Like, no, this is not, this is not good. And then, and the [00:25:00] podcast just became this like afterthought. And we were like, wait, everything is not toxic. Hold on. Vaccines are good. Like do this, don’t do that, you know? So yeah, then it just took a life of its own.

Yeah. I mean, 

Kristin: that’s kind of what we always talk about with your. Stuff on social media too is like you need doctors, you know It’s a it can be a good thing to be on social media because there is so much misinformation out there That we need accurate information to counterbalance it. So if everyone just avoids it then that’s not gonna 

Will: happen, right?

Yeah, and and it’s I sometimes like worry for your well being the two of you because like you’re like everything I see like you’re like there’s so much misinformation and and you’re like constantly battling this stuff Uh, so like, take care of yourself, please, because I’m worried about you. You know what?

We’re actually really You do such a good 

Dr. Sami: job with it, though. We’re actually really lucky, because we like, take turns, so Oh, good. Yeah, so she I log off You’re sharing the burden. Yeah, I log off for a week, and then she logs off for a week, and we just like, tag, [00:26:00] you’re it, and we don’t even look when it’s not our turn.

I mean, we 

Sr. Ana: talk about quitting like almost every other week. I mean, it does get to you. I mean, we’re not gonna lie, right? We have another full time job where we’re taking care of patients and it takes everything out of you. And then you go on to this another world, you know, and then you’re. Trying to do that.

But when we see kind of the response where one of our videos might reach more people than we see in a year, you know, and then we get a lot more positive comments than the negative ones. And people are like, please don’t stop. And you know, then it, it, you just, you’re just like, okay, fine, . But it is, it is, it’s a lot of work.

I mean, it’s a whole other job, um, altogether. Right. Um, but yeah, it is definitely rewarding. 

Will: It must be hard to balance that though, having your, you know, people always ask me, do you still practice? And I’m like, yeah, I do. I still practice. And, and, [00:27:00] uh, juggling the two is sometimes very challenging. And so, you know, how do you manage that?

Are you You know, you know, weeknights, weekends, you know, is that when you’re making all your content and, you know, at the end of a long day where you’re, you know, seeing however many kids you’re, you’re seeing throughout the day or 

Dr. Sami: Yeah. 

Sr. Ana: Pretty much. You’re like, how do you manage it? Not well. You don’t, 

Will: you You half ass two things.

Is that what you’re doing? Pretty much. Yeah. Uh 

Dr. Sami: Is Yeah, go ahead. Whenever we, I think whenever we can fit it in, um, I might drive to work and record a video real quick in my car. Thankfully it’s kind of like, it’s stuff I know, right? Like it’s not, we don’t have to, it’s like, you know, you with anything to do with ophthalmology.

When you’re talking about a specific condition, it’s not like I have to go research it. So thankfully it’s in here, right? And so it’s just like regurgitating what I would tell my patients. Most of the time. Some of it we have to really be thoughtful about because you can, it could be misconstrued and whatever and it really has to, you know, but most [00:28:00] of it it’s, it’s pretty like bye.

Um, there’s, I, I don’t know if you’ve noticed, but like our content doesn’t have that much editing or it doesn’t have any like anything flashy because we don’t really spend that much time on it. We probably should, but we don’t. Um, but I feel like, yeah, we just. Squeeze it in any place we can. After hours, weekends.

Uh, I like to like kind of film in bulk. Uh, I’ll film like five or six of them, you know, and then. That’s 

Will: smart. You’re always telling me to do that. Yeah, I just don’t I don’t know cuz I just like I feel like I’ve finished one thing and I’m like, oh man, I did one thing. I did it. It’s done and now I get to not do anything for a little while and it seems hard to like say, oh, I’m gonna do another thing right now.

Good for you for like, that’s smart to like batch it 

Kristin: like that. I think it would be difficult with a field like pediatrics, right, where there are parents involved and what is more passionate than, you know, a parent about their child. [00:29:00] And then also all this misinformation around vaccines and all these things that, you know, like in ophthalmology, I don’t know.

I can’t think of very many like negative comments you might get about talking about ophthalmology, but. You know, in pediatrics, I feel like you probably have to deal with a different level of trolling maybe than some of the, you know, other specialties. I don’t know. I mean, well, 

Will: everybody’s very concerned about kids, you know?

Yeah. And we’ll have a lot of opinions. People have a lot of opinions. I mean, we don’t have to tell you that. Right. Um, yeah. And so it must be hard. I, I know like whenever I make a piece of content that I feel like might get a bit of a, you know, response and make some people angry. It’s like, I feel like I don’t, I have to like time when I’m going to post something like that.

Totally. Because then it just sucks you in and then all of a sudden your morning is ruined because like you’re Replying and or you know, just it’s just on your mind and you can’t think [00:30:00] about anything else. And so how do you I guess, how do you manage that aspect of it, the, the anger, the, the kind of the, the, the random comments?

You probably see it 

Kristin: in your offices as well, like in person and online. No. I think 

Sr. Ana: it’s an online phenomenon. I think, um, the, the, I think it’s a lot easier to troll, you know, behind a phone. And so there’s definitely people that are not really mincing their words and it’s just all coming out, you know? And then.

It’s just, it’s very hard to, I think, completely disconnect from it. Um, you know, my kind of, uh, defense mechanism is I just sometimes don’t read the comments and I try not to get into this, like, rabbit hole that you end up getting into. Um, I think we, it’s very, you have to be very strategic about what comments you’re going to use to kind of improve.

Um, your content and to be more, you know, to give, put [00:31:00] out information that’s going to actually help rather than just getting swept away by the trolls. Um, and there’s definitely a lot of them. Um, so I think it’s, it’s finding that balance, but I mean, Sammy doesn’t, she’s very effective with her time. You know, I’m, I’m kind of like you, where I like do one thing and then I’m exhausted and I can’t do anything else for a while.

And then I have to regroup. So, um, I think we just both kind of handle it in our own ways, but it’s nice when we’re kind of, one person is just having a hard time and the other person can kind of take over. So that’s really helpful. Yeah. You 

Kristin: get a break 

Dr. Sami: built in. And by now you’ve realized probably at this point in the podcast that Anna is the wiser of the two.

She’s very like Zen and like, I just don’t read the comments. 

Will: I, I do, I got to say the video, cause I’ve seen quite a few of your videos, uh, uh, Sammy, you are a little bit more fiery, um, and, uh, tend to really get into it with people, which [00:32:00] makes for great content. So I want to, I want to explore, um, uh, this idea of.

backlash on social media a little bit further, but let’s take a break first.

Hey, Kristen, what do you know about hearts? Well, I know they need to beat. That’s true, and you’re really good at making them do that. Yeah, I did that one. You helped me with mine. I did. Oh, I still appreciate that, by the way. Oh, well, you’re welcome. You know what would help you learn even more about hearts?

What? The ECHO Core 500 digital stethoscope with three lead ECG. This thing is awesome. How do I look? You look so fancy. Doesn’t that look nice? Yeah. It’s like anybody who listens to hearts in your job could benefit from one of these. That’s right. It’s got 40 times noise amplification, noise cancellation, three audio filter modes.

and a full color display. 

Kristin: Yeah, so you can listen and see the ECG. 

Will: That’s right. It’s really cool. I mean, what stethoscope allows you to do that? I know we live in the future. It’s incredible. It’s also the best sounding [00:33:00] digital stethoscope that you’re going to find out there. Trust me on that. We have a special offer for our U.

S. listeners. Visit echohealth. com slash KKH and use code NOC. to experience ECHO’s Core500 Digital Stethoscope Technology. That’s E K O Health slash K K H and use NOC50 to get a 75 day risk free trial and a free case and free shipping with this exclusive offer. Hey, Kristen, do you mind if this little guy stares at you while you talk?


Kristin: you know, they’re kind of growing on me. I mean, hopefully not literally, but, but these cute little guys. 

Will: You know what they are, right? Yeah. Demodex mites. That’s right. They cause itchy, red, scaly skin on the eyelids because they live on the eyelash follicles. 

Kristin: Yeah, just eating up all your dirts and 

Will: oils.

That’s why it’s important to get your eyelids checked out if you have those types of symptoms. Don’t freak out, get checked out. To find out more, go to eyelidcheck. com that’s E Y E L I D check. com [00:34:00] to get more information about demodex leviritis.

All right. We are back here with Dr. Anna and Dr. Sammy of the PD pals. And so here’s what I want to do, because I get asked a lot. about how I deal with negative comments. All right. And, and I, as much as I get that from time to time, you get, I feel like you get so much more of it just because of the sensitive nature of.

Pediatrics, and like Kristen, like you mentioned, everyone like has an opinion on these things and there’s a lot of misinformation and so I think you deal with that a lot more than I do. So, uh, I thought we could maybe help people kind of, you know, understand this, this point a little bit better by playing a little game.

It’s called Backlash. All right. All right. It’s called Backlash. I’m going to give you a topic. All right. And you’re going to tell me on a scale from one to 10, how much [00:35:00] backlash you get. Oh, I love it. On social media. Bring it. And let’s do it. All right. Okay. So the first, we’re going to maybe start off, um, a little lighter.

All right. Let’s go with, um, how about. Helmets. Helmets. Using helmets. How much backlash from a one to one? One is, uh, um, like, everyone’s happy with you. Like, yay, good content. Good job. I love all of you. Everything you say. Uh, ten is, uh, death to Petey Pals. Okay. 

Dr. Sami: I would say, I don’t know if you agree with me, Anna, this is, this is a two.

Because there’s some random ones that are like, why don’t you just Put them in a bubble, you do get like a little bit of that where you’re like, come on, most people agree, helmets are good. 

Will: Good. Okay. All right. That’s what I thought you’d say. All right. So helmets one, one to two. Here we go. Um, how about, uh, uh, how about fluoride use?

Kristin: We’re in Oregon. So this is particularly salient. Oh, here. Yeah. [00:36:00] Yeah. 

Sr. Ana: I would say like eight. Really? Yeah, it’s a, it’s a buzzword. It’s a trigger word for a lot of people on there. And there’s like a community, there’s like a loud community. So I mean, maybe we’re, we’re kind of, you know, listening to those people.

It’s maybe not the majority, but yeah, those people get loud. 

Dr. Sami: Yeah, I don’t know if you guys have heard, but fluoride’s toxic. 

Sr. Ana: And we’re against the fact that dose 

Dr. Sami: matters. 

Will: Fluoride, 

Dr. Sami: arsenic, they’re interchangeable. 

Will: You might as well be just trying to kill 

Dr. Sami: our kids, right? We’ve made a couple of dentist friends online, um, and they’re, they get it way worse than we do.

Cause we don’t do that much fluoride content, but yeah, I would, I’d agree with Anna. It’s up there. 

Will: Physicians tend to stay away from teeth. We’re not, we’re not big into, into the teeth business. They’re luxury bones, as you call them. Yes, exactly. Well, it’s funny because I’ve, I’ve used that joke once, [00:37:00] uh, in my videos and then I have like You got backlash.

I got back, I got teeth backlash. Yeah. Uh, people saying, oh, well, teeth are not actually bones. It’s actually the orthos, the orthopods. They’re all, they’re pointing, uh, don’t, please do not disrespect bones by calling teeth bones here. Okay. So, you know, everything, everybody’s got a thing that they are passionate about.

Um, okay. Also follow up, Texas, do you guys have fluoride in the water there? I didn’t have any cavities growing up. So I think probably, right. Oregon. No fluoride in the water. No fluoride. We gotta use, like, special, like, mouthwash. And 

Kristin: then you get, like, the really, I don’t know what’s in it, but you get that treatment, like, painted on your teeth when you go to the dentist.

If you want it, they let you 

Will: refuse it. And it’s because like the, the crazy people that were like, no, do not, do not poison our, our teeth. 

Dr. Sami: I don’t know. That guy on YouTube told me it was bad. [00:38:00] 

Will: Exactly. Right. Okay. So that’s fluoride. Um, okay, here we go. Sleeping. Just in general, what kind of sleeping stuff do you, do you get?

How about, I know, I know for a fact that co sleeping thing, that’s a big deal. That’s a big deal. So tell me about that. One to ten. Yeah, 

Dr. Sami: it’s it’s a nine because if it’s not the controversies that surround bed sharing Then it’s that you let your baby cry it out. You’re a terrible parent and then I held my baby.

You’re a terrible parent So there’s a lot of mom shaming that goes on with this one and we’re right and smack dab in the middle of that so Damned if you do, damned if you don’t. 

Kristin: Exactly. Like most of motherhood, really. 

Will: Is that a social media phenomenon, or do you get some upset people in the actual exam 

Dr. Sami: room?

No, I mean, the thing is, you know, and it’s such a good question you kind of brought up before, that it’s What we like the connection we have with our patients one on [00:39:00] one We’re not like we’re not coming at anyone, right? So there’s like yeah, we ask questions and then if a parent says like I’m struggling with sleep Then we’re like, well, how can I help you?

Where were you at? What do you want to do? What are your goals blah blah blah and if they’re bed sharing it’s a simple listen I’d be a terrible pediatrician if I didn’t tell you that that is very risky and could lead to your baby dying. Um, so let me help you. I have resources. I have, you know, I could do stuff and I’ll hold your hand the whole way, you know?

Um, so it’s just, this is a different environment than what we deal with on social media. When you’re like connecting with a person one on one, I think they, they feel that you care for them online. It’s just. It’s that, what you said, death, death to 

Will: the people. It’s chaos. Death to 

Sr. Ana: people. I think it’s that mommy guilt and daddy guilt.

It’s that parent guilt that on social media, you’re not having that conversation. So you’re making a statement and so it kind of taps into people’s guilt or whatever [00:40:00] triggers them and so it just kind of escalates, you know. We’re having conversations. We’re not, you know, saying there’s one way to do anything.

I mean, everybody has a different life. Everyone has a different environment. Family, everything. So it’s more collaborative, like Sammy’s saying, when we’re one on one. But when we make statements, then it’s automatically like we’re tapping into that guilt somewhere with someone can’t do that or, you know, it kind of triggers them.

And then they’re not really listening to the whole conversation. They’re just very upset by that. 

Will: Like when I tell people not to use Visine. Yeah, yeah. Or 

Kristin: you tell emergency doctors not to use ultrasound on the 

Will: eyeball. Yeah, like the stakes are a bit lower here with Visine use, but to an ophthalmologist It’s it’s um, you know, one of the most important things you can talk about.


Dr. Sami: and then there’s also like an element of like people don’t know what pertains to them and what doesn’t like there’s so much like You’ll tell someone for example, don’t use Visine and then there’s this guy that’s like I used it in 1986. [00:41:00] How dare he? And it’s like, you know what? Maybe we weren’t talking to you.

And so 

Kristin: Right. Maybe your situation is not exactly the same situation as this person’s. Yeah, 

Will: for sure. Um, all right. Okay, that’s that’s uh, so sleeping that that gets people riled up, right? 

Kristin: It’s hard to because if your kid is not sleeping well, then you’re not sleeping well And so it you know, you’re not in the best state of mind to begin with Oh, I remember that like we had a terrible sleeper when she was a baby and it Was brutal like like like torture level brutal, right?

Like it got really 

Will: bad Sympathy for 

Kristin: people that are struggling with that particular issue, but yeah, 

Dr. Sami: it gets dicey I do too I had one of those two and the thing is I can say that to someone who I’m talking to one on one like guess what? I’ve been right shoes before but on social media they again They just don’t feel we care because we’re not writing so it’s just like accusations.

Will: Yeah. All right [00:42:00] Alright, I got, I got one still off the wall here. Haircuts. I don’t know if we’ve even done that before. Have we? I just, I totally made that up. I’m just trying to come up with something, uh, that, uh, that maybe somebody has gotten mad at you about, uh, getting your kid’s hair cut. I’m totally making a video that piss anybody off?

Kristin: No. Yeah. 

Sr. Ana: Ear piercings. We get it more in clinic. Yeah, we get ear piercings a lot in clinic, and when to cut hair, and Things like that in clinic, but no one really gets angry about it that I know of. 

Will: That’s a one. Piercings, I bet, yeah. 

Kristin: Especially in little, you know, in baby girls, a lot of people think. It’s a cultural thing, right?

I think there is, there are some cultures, yeah, that do that, but also just, some people think, well, you know, if I do it now, then the kid won’t remember the pain of it. And, you know, like, you’re like, you think you’re doing them a favor, you know, like, I think that’s where the intention might come from. But then obviously you run into issues of like, well, but maybe the kid would have decided they [00:43:00] didn’t want pierced ears.

And now it’s too late. 

Will: So how old were you when you got your ears pierced? 

Kristin: Well, I, uh, was seven or eight, and I had to go back to get the second one done. Oh, really? 

Will: I got the first one. First time through, and you 

Kristin: were? I was like, nope, I am out of here. All right. So, yeah, it took me a couple days to muster up the courage to go back.

Will: Mm hmm. That sounds like one of our kids. It does. Yeah, for sure. Um, okay. All right. This is the moment everyone’s waiting for. Vaccines. Mm. Mm. 

Sr. Ana: Look. 580. 

Will: Is that, is that the, the most, the, the hottest topic? Uh, in, in pediatrics, it’s gotta be, right? I mean, we 

Dr. Sami: knew the anti vaccine movement had gained a lot of popularity.

I mean, it started, you know, a couple of decades ago, honestly, but it’s taken a life of its own. And then throw in a pandemic and [00:44:00] a new vaccine. Right, right. 

Will: Yeah. That’s right. Oh, 

Kristin: so. And now there’s the RSV vaccine I think that’s what I’m talking about. No, the COVID vaccine. 

Will: Well, obviously the RSV now. But I was actually hoping you could tell us about the RSV vaccine, because I’ve had people ask me about it.

I’m like, I don’t know anything about the RSV vaccine. So. So tell me about this vaccine. I’m kind of just for my own curiosity. It’s awesome. 

Dr. Sami: It’s a, it’s actually a monoclonal antibody. Yeah. I mean, we literally like pediatricians, like we were like, we had our popcorn ready. We’re like ready to go. 

Will: You just talked about how during intern years, like the RSV season is a thing.

It’s a big 

Dr. Sami: thing. It’s one of the highest causes of infant mortality. It causes recurrent wheezing. It’s just a. The bane of, you know, our existence and parents existence and RSC is no big deal for an older child or an older person, but for the extremes, the super young and the super old, it can be really, really dangerous.

And there’s no, there’s no real [00:45:00] treatment for it either. Like, so once they get it, you just have to offer supportive care in the hospital, oxygen fluids, you know, potentially intubate and just cross your fingers, uh, which stinks. So we felt like it was a long time coming. And now there, they actually, there’s two, uh, options.

There’s parents can get, or mothers can get, uh, a vaccine while pregnant, which offers, you know, passive immunity to baby. Uh, and, and you want to do that, I think in the third trimester, right, Anna? Obviously closer to delivery. And then there’s this monoclonal antibody, uh, that, that recently came out that’s, that we’re, everyone’s calling the vaccine for kids.

But, uh, it’s just offered to babies eight months and younger, because they’re the ones that are at higher, highest risk of being hospitalized. Um, from RSV. And so we just try to give it in that first eight months and then get them through that first season, essentially. So you’ve just given them the tool, the antibody to fight it.

And yeah, it’s, I mean, it’s great. It’s already, it’s already a shortage. Just a few 

Sr. Ana: weeks. Yeah. It just came out. Um, yeah, we, [00:46:00] we’ve had an RSV, another vaccine for like preemies, very, very micro preemies, you know, in the past, but we were waiting to have it for the general population for the healthy newborn for all of that we’ve been waiting.

Um, so yeah, there’s already a shortage and, um, I feel like this is the one vaccine though that I’m not getting a lot of push back on because parents that have had. Other children that have gone through RSV or have had family or friends, they know kind of the toll that it takes on them. And, um, with COVID, we have had a ton more pushback with the COVID vaccine.

And even with the flu yearly, you know, the flu has been around forever. But I feel like with COVID, with the RSV vaccine, it’s like we’re in shortage and everybody’s asking me for it. And so, um, it’s something I think parents are actually really on board for. So I haven’t had much pushback on it. Oh, that’s 

Kristin: great.

Like the others. 

Will: And it’s just the one, one dose. One and done. Yeah. 

Dr. Sami: That’s great. 

Kristin: Which is also probably pretty. [00:47:00] Yeah. Right. I have one if 

Will: we’re. Oh, please. I have a few more, but I want to hear. I want to, I want to 

Kristin: know about. About screen time. Oh, 

Will: that was on my list. Yeah. Yeah. So Vaccines is a 50, 000 on a scale from 1 to 10.

If you did a video about screen time, what would be the reaction? 

Sr. Ana: Me personally, I would say like a 6 or 7. I think we get, we definitely do get a lot of, you know, Passing judgment, and I think we both are kind of conscious because we recognize that screen time is a thing, you know, like, we’re not getting away from technology, we’re not getting away from screen time, it’s the world we live in, you know, and so we try to come at it from a perspective of, it’s okay, it’s okay if your child gets screen time, you know, but here are the things that you can control, these are the things that you can manage with screen time, how you can avoid it in certain situations, or the length of time that you do screen time, And what ages, you know, it’s better to stay away from screen time when they’re, [00:48:00] when they’re younger.

Um, so I think we don’t come at it from like, you know, uh, we, we, we’re a little bit more, I think, understanding. And so we get some pushback when we talk about it, but I don’t feel like we get too 

Dr. Sami: much. No, I agree. I think we have a series called, If It’s Okay With You, It’s Okay With Me. Essentially . I love that.

That’s great. And essentially everything is on that list with the exception of things that can harm your child. So like, as long as you’re not actively, you know, putting your child in danger. IE not vaccinating, IE not putting a helmet on, or, you know, um, water safety, all the things that could actively endanger your child not using a car seat.

If it’s okay with them, it’s, it’s really okay with us because that’s kind of. I don’t know that person’s personal situation. I don’t know if I’m talking to a single mom who like, you know, is just trying to put dinner on the table and needs to plop her kids down in front of a TV for an hour or two so she can shower, get dressed and get the rest of the night on board.

I don’t know. I’m not going to sit there and tell her she’s doing a [00:49:00] bad job. Um, and that’s, that’s on her to try to juggle. We, we all know that we don’t offer parents nearly as many resources as we should just to raise their kids. And everyone’s just kind of, you know, especially since the pandemic, we’re all just.

Like, just doing what we can to get by, so. Do the best you can. Yeah. So I think because we have that approach, the pushback we get are from those who are like, it rots their brains, what kind of a doctor are you that you’re like normalizing it? Blah, blah, blah. I think that’s kind of. I don’t 

Kristin: see how it’s avoidable.

Kind of like what you were saying, like, even, what is the AAP recommendation? It’s like two hours a day or something. Even that is like. Ambitious. Yes, thank you. That’s a nicer word than I was thinking. So yeah, like, I mean, for one thing, it is, like you said, the world that we live in. So as a parent, don’t you want to prepare your child for the world they’re going to live in, right?

Like, let’s teach them some things around this digital citizenship and media literacy and, you know, all of these things that [00:50:00] they need to be on screens for. Then there’s our kids are a little older now, they’re eight and 11. So now it’s social time on screens. And so if you limit their social time, then, or if you limit their screen time, then you’re, then you are, that does have real social ramifications for them.

It’s just so complex, like, as we’ve, you know, gotten further into it. It’s just, it used to be very black and white, like no TV, you know, until they were two or something, I think is what we tried to do. But now it’s just like, I don’t know what the right answer 

Dr. Sami: is. Balance. There’s got to be a balance in there for everyone.

And, and, and not everyone’s balance is going to be exactly the same because of their circumstance and their situation. But I think you nailed it on the head. Like we just have to empower parents to know the dangers and to teach their kids how to navigate the dangers. Like, obviously there’s a lot of online predators looking for kids.

So that’s an immediate, you know, threat that we need to. We need to help guide parents about but when it comes to like [00:51:00] them sitting and watching miss Rachel for an hour Right go for it. You know, she’s teaching you something. 

Will: Yeah They’re watching Bluey right now. Yeah, so 

Kristin: I know blue is one of those like it’s a good like something for everybody.

But what do you think about social media? For kids, since you are on social media now, like you, like you are, you have a company around social media, so you’re kind of seeing the, the ins and outs of it, plus Um, so I think that’s the pediatrician perspective, 

Dr. Sami: I think, I mean, I, what are you 

Sr. Ana: going, sorry. I was just going to say, I think social media is something that affects all of us.

And then for a growing brain and a child that’s kind of shaping their identity at that time. I mean, we see a lot of teenagers in the office and I think teenage depression, anxiety, mental health is on the rise and, um, we can’t contribute everything to social media, but it does play a role, you know, because of, um, kind of.

They’re at that [00:52:00] vulnerable phase in their life where their identity is being shaped and what they think about the world. So I think just like everything else, um what they’re exposed to matters, whether it’s social media, whether it’s in their personal life, their friends, their family, I mean all that’s impacting.

And the social media is kind of that that realm that is not as You know, always as filtered, right? And so, um, it takes, I think it’s very difficult to be a parent in this day and age to be able to juggle, you know, how much, how much access they get to social media. And that’s, again, you know, there’s a thousand ways to parent, and this is for each family and each person to kind of decide what their limits are, what their balance is.

And it’s our job to say, okay, you know, we see if we’re on screens right before bed, this is going to affect your sleep. You know, if you’re, there’s online predators, there’s all these risks that are available so that parents are aware, um, because we see it kind of on a bigger scale, you know, and then [00:53:00] it’s for each person to kind of decide, okay, how much, how much interaction they want to.

Let their teen have on social media and, you know, sometimes it can be really beneficial. We see teens doing great things on social media and, you know, making a big difference. But, um, at what point will it affect their mental health? And, and I think that’s the hardest thing is to juggle that. 

Dr. Sami: Right. Yeah. I, I have two girls too and, uh, they’re 11, uh, sorry, 10 and 13.

I don’t even know how old. They’re, um, . They’re 10 and 13. My husband and I always joke the 13 year old’s the guinea pig, but the 10 year old’s the one that gets like, the parents actually knowing what they’re doing. Um, so with the 13 year old, our approach, you know, I got scared at first. Like, I know that it’s, it’s a bottomless pit with social media.

And I, I don’t know what content she will be exposed to. Like I can’t really monitor it. I can’t control everything they see. Exactly. I can put some like controls and stuff, but like, [00:54:00] do I really know? Right. But then on the other hand, I didn’t want her to be like the kid that didn’t get, like, I didn’t want to say like a hard stop.

No. And then, and then she’s out of my house. And then it’s like the kid that never got candy that like binge eats Kit Kats, you know, and then like, just then ends up like thinking that it was this like forbidden fruit. So. I’ve felt, and I don’t, I hope I don’t end up eating my words someday when she’s like 18 years old, but I felt that it’s so much about like trust between parent and child and so I, you know, she asks Can I now blah blah blah and then I kind of go like okay, but just know that that means blah blah blah So you need to tell me If, like, a friend is posting something funny, or if you come across something that doesn’t feel right, you need to tell me so that I can look and I can protect you.

And I have been, perhaps, too honest with them. Like, I do tell them about online predators. I do tell them that there’s people looking for them. I do, you know, um, I, I hate Roblox. Oh my [00:55:00] god. I don’t know if your kids play Roblox. Yes. 

Kristin: Yes, they do. They love Roblox. I hate it. It’s, yeah, I am with you. It’s, ugh.

It’s so hard, there’s so many nooks and crannies to Roblox and how can you know all the time like where they are and what they’re doing and is it safe and who are they talking to and oh my gosh. And all their friends are on it too. But all their friends, they’re right, that’s where they hang out, so. 

Dr. Sami: So yeah, I just like constantly hammering in that if I don’t know I can’t protect you, if I don’t know I can’t protect you, so if I don’t, you know, so they just like, they report everything for now, you know, and we just, they’re tiptoeing our way through, 

Will: but.

Your oldest could really play some, some nice little practical jokes on you and be like, Mom, I I’ve just, I don’t know about this fluoride thing. It’s just, I’ve seen some, you know, uh, some pretty compelling content, uh, you know. You know 

Dr. Sami: what? She helps me with my videos because she’s more technologically savvy than I am.

So when I do need editing, she’s my go to person. So she’s actually well aware [00:56:00] of my pain points with PDFs. And she’s actually the one that she’s like, that’s so boring, mom. You just, you don’t have a catch, you don’t have anything, there’s 

Kristin: like, you need to start off like You should hire her! You said you needed some editing and stuff, like give that to her.

Yeah. Open an IRA for her while you’re at it. There you go. 

Dr. Sami: You sound like Anna. 

Sr. Ana: That’s literally what I tell her. I believe she does half of our editing. I think we need to, you know, give back. Yeah. I hope, 

Will: I hope your daughter listens to this and she starts hitting you up for a, a paying gig. Yeah. Um, all right, I have one more.

Okay. Actually, maybe one more plus a bonus. That’s strictly for me. Um, all right, here’s, this one is not for me. Using deodorant. That’s more something that we’re dealing with now as our kids get older. Well, 

Kristin: I mean, so yeah, there’s a whole thing about like aluminum and deodorant, right? And so there’s like a movement against just like using [00:57:00] natural 

Will: deodorant.

I had no idea if there’s a movement against it. I’m just curious, like, do you ever get any pushback on deodorant? 

Sr. Ana: You’re giving me ideas for videos, though. Yeah, I mean, 

Dr. Sami: could you just send us these 

Will: once in a while? Sure, absolutely, yeah. 

Kristin: As long as you promise to give me an answer, I’ll send you all the questions.

Will: I’ve never seen you refute any myths about deodorant use in teenagers, so. 

Kristin: Because wasn’t there a link about like deodorant and breast cancer or something that people were worried about, they weren’t sure? I don’t know. where that 

Dr. Sami: landed. Yeah. Um, so it’s kind of like the microplastics water bottle, like there’s evidence but there’s no conclusion kind of thing and the evidence is inconclusive for now, you know?

And so those are, those are the tough things I think we navigate online, right? It’s like red dye, bad or not bad, you know, aluminum, bad or not, like the dose matters, right? And everything, right? And so. Are you like licking the aluminum or are you just applying it like a normal person, um, under your arms? So for [00:58:00] parents who are hesitant, I think, right, I think that, um, like for a lot of parents, Probably like you guys too, like it sneaks up on you, the need for the kid to use deodorant sneaks up on you way before you think it will.

Yes. I was shocked. And so when it happens, you’re like, well, we got to take care of it. But like, I can’t believe my 10 year old is going to need deodorant, you know, so you’ve got this. So I always like say like, look, you have other options for us. Like, let’s talk about like antibacterial soaps or actually certain acne cleansing products help.

Um, if they use that under their arms, you could start there. And then, uh, if that doesn’t work, then, you know, you can always put a deodorant, but we, we all use it. 

Kristin: How do you recommend that you tell your child that they smell 

Sr. Ana: horrible? Honestly, I was just going to say that I don’t get as much pushback on the deodorant, but I get all the parents coming to me, please tell them about everything puberty related.

Yeah, [00:59:00] so true. They literally just come in and they’re like, okay, now there’s this smell. And I need you to handle this and I need you to tell them everything that will happen from here on here on out and you know just take it so we get a lot of that in the clinic I think and just the whole the steps so I think we like I mean I think I start talking about it sometimes that like Seven, seven or eight with some kids that will start showing those signs with body odor, you know, as early as that.


Dr. Sami: so awkward because they’re not like grooming themselves well yet. And so they don’t care. They still want to play. They’re so little. But like, I mean, how I told my girls, we, you know, we’re a family of jokesters. So I literally like, Hey, 

Kristin: you, is that you?

Yeah. All right. I guess, you know, once. Once people like, once their peers start making fun of them and they care about their peers making fun of them, I feel like it’s self correct. You know, they figure it out. 

Dr. Sami: Oh, yeah. Once they get into middle school, then you got the opposite problem. It’s like, I can’t leave my [01:00:00] house until it’s all perfect.

And there’s this one thing here that won’t fit. Yeah. 

Sr. Ana: Does that happen? What? 

Kristin: That? Yes. Oh, okay. Especially for 

Will: girls. Oh, yeah, I guess I’ve never experienced that. But you can probably tell by looking at me. That’s never been a concern for me. You’ve seen my videos. So anyway, all right, I got one more. Self indulgent?

Just a little bit because it’s something that I’ve talked about on social media and that’s glasses.

Who would oppose glasses 

Kristin: on kids? 

Will: So actually, this is a really big problem. Where there’s a myth that’s, that’s out there, it’s been there, it’s been out for, for decades and, and you have this, this group of people, a lot of people, that have in their head that glasses make your vision worse, that make you, you’re, you’re dependent on glasses.

Right, like they make your eye 

Kristin: muscles 

Will: weaker. Right, they make your eyes [01:01:00] weaker and you just have to wear glasses more and then I, I have to tell people, no, it’s just physics, like your eye is a different shape and you have to wear glasses, but it’s dangerous in kids. That, that thinking because, um, sometimes kids, you can end up with amblyopia, which is essentially your brain just doesn’t develop the ability to see normally out of one or both eyes.

And so, and sometimes that’s treated with glasses. And so I’ve seen it before where parents. You know, they were told either by their parents or sometimes by social media that this is going to make my kid’s vision worse. And so they don’t enforce glasses wear, they don’t tell their kids to wear the glasses, and then the kid ends up with, you know, less than perfect vision.

So that’s, that’s kind of my I hate and I always get tagged in those videos, too. 

Kristin: Yeah, all the do you guys see those? Do you get any backlash on those? Um, 

Dr. Sami: you know what? I think I should do a collaboration video [01:02:00] Yeah, 

Will: I’d love to say my parents still live in Houston so, you know next time I’m in town I’m gonna 

Kristin: be in town you can just Well, it’d be great, it’d be fun to do something in person too.

Old school, we’re all, we’re all old here. Shahnti’s listening, she’s writing 

Will: it down. Yeah, Shahnti, that’s right. Um, so, but anyway, that’s, that’s like, I don’t know, I don’t know if you 

Sr. Ana: I feel like I get less of, I mean, I think what I see more in practical, like in practice, is that parents are just not as compliant with getting the routine eye, you know, like we do a lot of education about, okay, you know, they’re having headaches or they’re having, you know, some other symptoms that this could be related to their vision and to get routine care.

Um, I, I do see. Some, I do see that mentality where they say, well, you know, do they really need it? Or is this going to make it worse? Are they going to get dependent on it? We get that a little bit. Um, but on our social media, I haven’t seen too much of that pushback. [01:03:00] It’s more just getting people to take it seriously because they’re like, Oh, they haven’t complained.

They act fine. They play, they see it, you know, but a lot of these things get missed. So that’s the biggest thing. 

Dr. Sami: Yeah. Like we did a myopia awareness video about a year ago and that didn’t get much, much pushback. But I actually, I don’t know if you agree with me, Hannah, that I feel that like, Below a certain age, we get more pushback on glasses.

And then once they’re school age, they’re way more open to it. Uh, but I think it’s cause the kids can vocalize like I can’t see, you know, and it’s just very, like, I can’t see that letter mom. And then they’re like, well, I have no choice. You need glasses. But if they’re like one, two years old and we notice some strabismus, which basically means like a lazy eye or your eyes kind of drifting and we’re like, Hey, guess what?

That’s not really supposed to happen. Let us send you off to ophthalmology. Hopefully, all they need is some glasses. They’re like, no, we’re good. We’re like, wait, no You don’t have that much time to submit that visual 

Kristin: cortex. Better glasses than surgery to fix [01:04:00] that issue. 

Will: Well, that’s why it’s Preschool or really, you know, screening by the age of four or five is so, so critically important because, yeah, the kids aren’t going to be really verbalizing because most of their world at that age is up close is right here.

Right. So, um, they’re, they may not have any symptoms and so you got to have that screening, you know, at the age of four, by the age of four. Every kid should, you should see 2040. 2040 by age four. That’s like the general rule of thumb there. And so, um, and, and, and it’s, uh, in fact, there are 10 states that don’t require a bilingual interpreter.

Screening for, you know, pre K, kindergarten. Most states do now, but there’s a good number that don’t require 

Kristin: it. Um, is there a, how to put, is there a geographical pattern to which states those are? 

Will: Uh, as a matter of fact, there is. Okay. I don’t have the list in front of me, [01:05:00] but you know, there’s a good number of them.

You know, I would say there’s a good number of red states, you know, that, uh, that are just generally against, you know, government regulation. And so it’s not so much about like, they’re, they’re out to get kids eyeballs. Right. No, we want them. We want our children blind. No, it’s just, it’s more like the anti government regulation and that has other consequences.

And it’s not just that, it’s also just driving laws and vision requirements for driving and so it’s all kinds 

Dr. Sami: of stuff. You know, it’s crazy. My 10 year old needed glasses and even as a pediatrician, totally missed it. Like she was, she went five years and she had terrible astigmatism, like just the worst.

And I just thought she was terribly clumsy. I mean, just like, and she had to do a placement test, uh, to get into her school and she just bombed the visual spatial aspect of it and did well on everything else. And they, uh, when they were telling us [01:06:00] the test results, they were like, you know, that’s really odd when they score really well and everything except this.

And usually that means that they need glasses. I was like, what? And lo and behold, I was like, okay, I guess I’ll take her. I never saw any other signs, you know? Just totally in denial. And then, yeah, it turned out, like, coke bottle, like, kind of, yeah. Oh 

Kristin: my goodness. Isn’t it funny how you, when it’s right under your nose all the time, yeah, it’s harder to see.

Certainly for you. I, I went, I might have to change eye doctors. I went to him one time for my, for my, you know, ophthalmology exam or whatever. And, you know, there’s that, that he says all the time, but also it was like end of the day appointment or something. And so you were just in a hurry. And I don’t know, I think we had to go pick up a kid or something.

And so you were really in a hurry. And so he just like, Bria like barely looked at me and I was like, we had to have a talk afterward when we got home. I was like, I want the same level of care that you provide to all of your other patients. . 

Will: I was being [01:07:00] compassionate. ’cause I know you don’t like bright lights.

What’s the 

Dr. Sami: problem? I’m the lord that you guys care for each other. ’cause like my husband and I, , I mean it. He wouldn’t even go there. My husband, like he’s, you know. He’s an, um, he monk, but he’s also internal medicine, so if I have, like, a thing, I mean, he’s like, I don’t know, ask 

Kristin: your doctor, like, he will not touch that with a ten foot pole.

Dr. Sami: implore you guys to do that. 

Sr. Ana: Mine calls me a fake doctor until he’s, like, dying somewhere, and then he’s like, now I need you to be my doctor, but until then You’re just not a real one. You take care of the little people. 

Kristin: Right. 

Will: Yeah. Well, let’s, uh, let’s take another break and we’ll be back to wrap it up.

All right. We are back with Dr. Anna and Dr. Sammy. And we are, uh, going to read a story that was sent in by one of our listeners. This is a good one. This is from Laura. Uh, and Laura says, during my internal medicine rotation, one of [01:08:00] my patients, uh, was a woman who routinely received peritoneal dialysis and now presented with peritonitis.

Okay. What does all that mean? Peritoneal dialysis is when you got to stick a big giant needle in the abdomen and take out a bunch of fluid. And anytime you stick a needle in anything, you can make that thing infected. So, so that’s what was going on here. Um, eventually she also developed constipation and a small bowel obstruction.

That’s where the small bowel, okay. Uh, which failed to respond to a nasogastric tube and enemas in treatment. Our team was considering putting a longer tube down to better decompress the bowel, which was called a canter tube. You guys heard of a canter tube? I’ve never heard of that. I 

Kristin: had no idea. I can’t.

So am I to understand that goes into your mouth? To start. 

Will: Uh, an NG tube goes, goes through the nose down into the stomach. All the way 

Kristin: down. And they were thinking, then you just keep it on going. A longer tube. And you just 

Will: keep [01:09:00] feeding it through to the intestines. I had no idea they had longer ones that, uh, I don’t know how long they go.

I don’t know. Do you guys deal with, like, pediatric gut stuff? Totally, 

Dr. Sami: but we’re not hospitalists anymore, so that, that stuff is like a distant memory now. Do you 

Will: call it pediatric gut stuff, or is that just me? Yeah, okay, all right. I guess gut shit would be more of a, more of a, appropriate. Like a good student, I took the time to tell my patient what was being considered that they had to put on this canter tube.

She sat quietly and nodded her head the entire time, but did not ask any questions. I left her room, patting myself on the back for how well I was informing the patient. Later that day, the resident approached me to ask what I had told that woman. Apparently, as soon as I left, she had called her family to tell them that I told her she had cancer.

Oh, no. She had misheard canter as cancer. Oh no! Cancer. You can imagine my horror at this news. I immediately [01:10:00] ran to the room and apologized profusely, but I had learned my lesson. Be careful about the specifics that you share with the patient, especially words that rhyme with cancer. My 

Kristin: goodness. Oh, that would be so scary.

Will: Yes. I, there was a similar, uh, story back when we talked to my, so we had my, uh, my residency program, um, director, uh, came on as a guest and he has a very similar story cause we operate with patients who are awake during cataract surgery. So sometimes we, we chat with them and we, we talk to each other.

Well, there is this, this disease, this thing in ophthalmology that’s called malignant glaucoma. And, uh, and it has nothing to do with cancer or malignancy. Uh, but w you know, it came up during a conversation we were having with each other during a surgery. And then that patient showed back up to clinic for a post op a couple weeks later.

Yeah. Like 

Kristin: it 

Will: had been a while. Several, yeah. It was like several weeks later and he was like, doc. When are you going to tell me about the cancer? 

Kristin: [01:11:00] Living with that that whole time. 

Will: So, yes, it’s absolutely true. You gotta, you know, be careful what you, what you say and make sure you’re very clear. I learned what a canter tube is.

It’s some kind of long tube that goes an indiscriminate amount of the way through your intestines. It 

Kristin: doesn’t sound comfy. 

Will: Uh, you can send us stories, uh, your stories, knock, knock, hi, at human content. com. Thank you, Anna and Sammy for coming on. It really was a pleasure to finally get to, to talk with you.

And, uh, just, I was so impressed by what you guys are doing. Honestly, it’s, um, yeah, 

Kristin: it’s really great. And it’s needed. Yeah. 

Will: Oh my God. It’s so needed just fighting against all the misinformation and, and just setting the record straight and telling people. Just informing people about what they need to know about kids.

Like it’s like, how awesome is that? So thank you for being here and tell us, uh, uh, so where we can find you and what you’re working on and what are your goals in life? [01:12:00] 

Sr. Ana: Well, thank you for having us. We’re, and thank you for making us laugh through it all because really your videos crack us up. All the time.

So do you 

Will: have a unicorn headband? 

Sr. Ana: Yeah. Okay, good. In COVID we got those like special unicorn, you know, shields too. So we definitely, but, um, yeah, no, see, we are the PD pals on all of the social media accounts. So we’re on Instagram. We’re on Tik TOK. Um, we have a podcast as well. It’s called the well child.

So that’s still available for parents. Um, we did a couple of seasons of it, so there’s a lot of good information there. Um, and so, yeah, we’re everywhere. You want to find us. 

Will: That’s great. Yeah. Check it out. Thank you guys again. And, uh, we’ll talk, uh, maybe sometime in Texas at some point. Yeah. There you go.

Thanks for having us. All right. Take care. Oh, so fun to talk to the Petey Pals. Yeah, they are fun. I always watch their videos. Oh yeah, I do. I [01:13:00] do. I was really impressed. I always, uh, I am always impressed by people who can, like, face adversity, like, in stride on social media. You know, because it really starts to wear on you to, like, get a lot of people who, even if they’re wrong, like, they’re just, like, and you know you’re right about something, it still 

Kristin: is, like, hard to Yeah, it hurts to have people say mean things to you, no matter 

Will: Yeah, it’s never fun.

Yeah. And people can say whatever they want behind a computer screen. You know, so and they’re the point about like the difference in person and on social media is so important to remember It’s like it’s not the real world social media, right? So let us know what you guys think Do you have any other like social media doctors that yeah?

Do you want us to talk to because we get a lot of requests for those and we’ve had a number of them And it’s always a fun conversation Lots of ways to hit us up. You can email us knock, knock, hi at human content. com. Visit us on our social media platforms, like all of them, pretty much. [01:14:00] Um, kick it with us and our human content podcast family on Instagram and Tik TOK at human content pods.

Thanks you. Thanks you. Thanks you. Thank you to all the great listeners leaving feedback. We love to see good feedback. Everybody loves, I mean, the angry comments are no fun. You know, just generally on social media, but good comments are great. We like those. If you subscribe and comment on your favorite podcasting app or on YouTube, we can give you a shout out like today, Morbid.

On Spotify, said, hilarious and informative. Keep them coming. Yeah, nice. That’s great. I’m sure, like, you’re hilarious and I’m informative, right? 

Kristin: Yeah, that’s 

Will: the order. I’m sure. Um, and, uh, full episodes of this podcast drop every week on my YouTube channel at DGlockenflecken. We also have a Patreon. Yes, 

Kristin: it’s 

Will: fun time over there.

We just had, uh, not too long ago, we had a hangout. We got to just chat, talk about life, talk about things. Yeah, 

Kristin: had some [01:15:00] cocktails while we talked to our patrons. It was 

Will: fun. Epiphanies and just glorious times. It’s wonderful. Don’t oversell it. Okay, well, you know, it’s good. It’s good. My mom was there and my dad was there.

They were involved. Lots of cool perks, bonus episodes, or react to medical shows and movies. You can hang out with us and the other members of the Nottinghack High community. We’re there. We’re interacting. We’re having videos and comments and whatever everything early ad free episode access interactive Q& A live stream events and much more Go to patreon.

com slash glockenflecken or glockenflecken. com Speaking of patreon community perks new member shout out Bella E And Bubbly Salt. Ooh, we’re 

Kristin: getting some really good names lately. I 

Will: like the fun names. The fun names are fun. Bubbly Salt. Uh We’re really struggling at this point. It’s late! We’re recording this lately late.

Uh, shout out of, as always, a, a, a virtual head nod to the, to [01:16:00] the Jonathans. Why can I not talk today? I spent all day talking. 

Kristin: Yeah, you’re kind of at your quota. I’ve talked all day. I’ve, I’ve not It’s been about 12 hours of talking. I don’t 

Will: normally use this many words in the course of a day. Patrick, Lucia C, Sharon S, Omer, Edward K, Steven G, Jonathan F, Marion W, Mr.

Grandaddy, Kaitlin C, Brianna L, Dr. J, Ross Box, Taver W, Leah D, KL, Rachel L, Ann P, Keith G, JJ H. Abby, H, Derek N, Jonathan A, Mark, Mary H, Susannah F, Mohamed K, Aviga, Bubbly Salt, and Pink Macho! 

Kristin: I like that those are together now. Bubbly Salt and Pink Macho. Yeah, I’m glad Bubbly Salt Thank you for being a Jonathan because then we get to say it next to Pink 

Will: Macho.

You can never cancel your subscription. Patreon Roulette, random shout out to someone on the emergency medicine tier, Ruth H. Thank you for being a patron. And thank you all for listening. We’re your hosts, Will and Kristen Flannery, also known as the Glockenfleckens. Special thanks to our guests today, the PD Pals, Dr.

Anna and Dr. Sammy. Our [01:17:00] executive producers are Will Flannery, Kristen Flannery, Aron Korney, Rob Goldman, and Shahnti Brooke. Editor in Engineer is Jason Portizzo. Our music is by Omer Ben Zvi. To learn about our knock knock highs, program disclaimer, and ethics policies, mission verification, licensing terms, and every release terms, you can go to Glockenflecken.

com or reach out to us. Sounded like you’re turkey. Knock, knock, hi. Oh, oh, oh. At human content. com with any questions, concerns, or fun jokes, medical puns, whatever. I don’t know. Let’s just finish this. Knock, knock, hi. It’s the Human Content Production. Knock,

knock. Goodbye.

Hey, Kristen, you ready for the holidays? I 

Kristin: am. I’m excited, but I’m also a little nervous because it’s a really busy time of year. We 

Will: don’t have time to do anything. I know. And it’s really hard for physicians around the holidays. Yeah. 

Kristin: Everybody trying to sneak in before January. 

Will: Everybody. Everybody wants an appointment.

And so you’re just, you’re pressed for time. You have to multitask and just try to [01:18:00] get it, fit it all in. That’s right. You know, with work and with home life and everything. But you know what helps? What’s that? 

Kristin: DAX. Oh yeah, 

Will: saves you some time. The Nuance Dragon Ambient Experience or DAX for short. It’s, it’s great.

It sits in the room with you and helps you with the documentation burden. So it’s like one less thing you have to think about. 

Kristin: Yeah, and it helps you connect with your patients better, which is always really important, especially around 

Will: the holidays. Absolutely. We need to turn attention back to the patient physician relationship.

And you should ask for it. Ask your company for DAX. Like who wouldn’t want a little DAX, like a little Jonathan, just hanging out with you around the holidays. It’s fantastic. To learn more about the Nuance Dragon Ambient Experience or DAX, visit nuance. com slash discover DAX. That’s N U A N C E dot com slash discover D A X.