I was on a plane and the attendants called overhead for medical help. I went to the front of the plane, got down to eye level and started asking the story when a man comes running up and pushes me out of the way, exclaiming “I’m a doctor!” Um….so am I. 👩⚕️
#WomenInMedicine
Having just landed after a long flight, I was greeted at baggage claim by my husband holding up this sign! 🥰🥰 I am so grateful to have been promoted to Professor of Pediatrics
@harvardmed
but even more grateful for my friends and family who supported me in this journey.
I just got my NOGA for my R01 renewal on the impact of dysmotility on aspiration pneumonia development! So grateful for
@NIDDKgov
and
@NIH
for supporting clinical research in children. And 🙏🏻❤️ to my research colleagues
@NurkoSamuel
@PeteDuncanMD
@SuzannaHirschMD
& Bridget Hron.
Just heard the BEST talk ever on belching and bloating by
@josemgarza
. Distention is more than 💩 or SIBO. Think about the diaphragm! And gas is rarely increased in the intestines of patients that report bloating.
#notfullofhotair
#anms2022
Flying out early to get back home to homework, grocery shopping and hugs. Meetings are exhilarating but it’s great to head back home. Thanks
@NASPGHAN
@LauraElizSmith
for making
#NASPGHAN22
a huge success!
So grateful to
@NIH
and
@NIDDKgov
for increasing pediatricians on study sections! Sometimes an ideal study for adults is not possible in children and pediatric reviewers totally get that!
Just saw a talk where a mentor interrupted their mentee EVERY time he tried to answer a question from the audience. And she said “he’s just a medical student…”as she interrupted. Mentors, do NOT do this. We learn by answering questions. We are cheering for mentees! Let them fly!
One of my ⭐️⭐️⭐️mentees got a fundable score on her K and I can’t stop crying happy tears. Stay tuned for some 🔥🔥upper GI motility clinical research! Thanks
@NIDDKgov
for supporting women in science!
#WomenInMedicine
#shepersisted
#proud
#pedsGI
Gastric emptying scans can lead to misleading diagnoses. But where your meal sits in the stomach may matter. Currently symptoms, not testing, are most important for diagnosis in patients with N/V symptoms. Agree completely!
@KatjaKovacic2
@RomeFoundation
My first DDW was as a resident and I still remember the awe I felt seeing so many people who loved endoscopy as much as I did. I knew then that I found my people. Walking into the convention center today, I felt the same excitement!
#GI
#womeninGI
#DDW2023
Blenderized feeds do not delay gastric emptying, may increase volume tolerance, and improve health outcomes ❤️🍎🥑🥦🧀🥥
@BridgetHron
is taking the field to the next level!
#NASPGHAN22
#clinicalresearch
#ANMS2022
was great for learning. But it was even better for catching up with motility friends. Any GI fellows considering a career in neurogastroenterology? We would love to see you at
#ANMS2023
#💩🤮💩🤮friends
Dr. Benninga at the pediatric
@RomeFoundation
symposium talking about how increasing water and fiber intake does NOT improve pediatric constipation. Myth busting by showing high quality pediatric data on a snowy Sunday morning. ☕️
This is my MOST favorite tweet as a mentor to send! Super big congratulations to
@SuzannaHirschMD
who just got her K23 NOA for her work on feeding intolerance in children! And a big thanks to
@NIDDKgov
for supporting pediatric research!
#womeninmedicine
#PedsGI
Packed pediatric motility session
@DDW
. Maybe motility will become a more popular subspecialty than IBD? 😜 Maybe we need more sessions on 🤮💩next year?
#motility
#DDW2023
@umfoodoc
gave an incredible talk about AI advances. One app turns your 💩pictures into a Bristol Stool Score with incredible accuracy. Does that mean I won’t get any more 💩pictures emailed to me?
#ANMS2022
Birthdays can be really hard, particularly when you have lost family members with whom to celebrate. But I am so lucky to have been adopted by an amazing family at work who made this celebration one of my happiest ever! ❤️❤️ 🙏🏻🎉
#aerodigestive
#glutenfree
#Womeninhealthcare
It’s not all about biologics! You would think based on twitter that IBD p2p/PAs are the only struggles for a GI. Has anyone tried to get prucalopride approved lately? Or even a compounded PPI? Or a formula?I’m just saying…
#motilitywoes
#PEDIGI
Listening to endoscopy guru Brad Barth talk about polyp removal in a PACKED room
#NASPGHAN22
postgrad course. Kudos to
@molivahemker
and
@NASPGHAN
for planning an amazing program!
More evidence, this time prospective, that BoTox to the pylorus works! And that pyloric FLIP doesn’t predict BoTox response. How many studies will it take before insurance covers BoTox for kids???
@SuzannaHirschMD
@NurkoSamuel
If gastric emptying cannot differentiate FD/gastroparesis patients, why are we still mandated to get gastric emptying scans to get patients into trials/consortia?
@NurkoSamuel
outlines the flaws of using gastric emptying as a biomarker. Love the discussion
@RomeFoundation
!
Great to have this evidence by
@NehaSantucciMD
! Nausea is such a brutal symptom. And, appreciate
@PediatricDrugs
commitment to advancing science in gastroenterology!
Do you think Tesla will go the way of the Delorean? Where in 10 years you’ll be at a dinner party and someone says “Remember that car with the doors that open upward? Did that guy ever go to jail?”
🤩Gene-hunter 🕵️♀️
@LaurenCollenMD
identifies gene mutations that help to explain seemingly disparate clinical symptoms in 3 different patients with IBD symptoms. And one even had pulmonary sx making my aerodigestive heart happy!
#WomeninGI
#PedsGI
#DDW2023
The 4-hour solid food gastric emptying standards and protocols, breath testing, and smart pill do not work for young children who may have gastroparesis. Children are not little adults.
@NurkoSamuel
#gastroparesis
But behind this awesome news were 100s of rejected grants and papers that you didn’t see. Amazing colleagues, fascinating, science, and a very supportive family kept me going. ❤️❤️to everyone who is making pediatric care better, even on really rough days.
Key point that mentors need support/recognition for
efforts before they become part of the leaky pipeline.
❤️the 💡of:
⭐️Mentoring awards
⭐️University/hospital funded chairs to support effort of women who mentor
⭐️Reduced clinical responsibilities for mentors
#WomeninMedicine
This is a critical study. Now let’s get women and URIMs into C-suite and Chair roles so they can promote more women and URIMs into real leadership roles.
#diversitywins
#nomanels
Listening to
@GutGirlMD
talk about challenges that women physicians face.
☹️Women get more inbox messages
☹️Women are leaving medicine at higher rates
☹️Women are paid less for equivalent work
☹️Satisfaction surveys biased against women
#ANMS
#womeninGI
#motility
Awesome work by
@SuzannaHirschMD
who highlights how very young children with EoE may present with aerodigestive symptoms… and how complex maintaining remission can be.
A 2 year study characterizing
#EoE
in kids <2 years:
- Most common symptoms are feeding difficulty, vomiting, and cough/wheeze
- 75% had abnormal MBS studies
- 2/3 achieved histologic remission during this study
@SuzannaHirschMD
@aerodr
My Friday? Another security threat at the hospital. Mansplained by a pulmonologist about how to diagnose and mange GERD in a infant. Two calls with insurance companies with patient care in limbo.
#walkamileinourshoes
All day we have been dealing with the formula recalls. What a mess. And so stressful for families going into a long weekend during the pandemic where formulas are already in short supply. But thank you
@NASPGHAN
for providing helpful guidance during this chaos!
🔥🔥Talk about imposter phenomenon by
@AmyOxentenkoMD
and an amazing panel discussion with leaders like
@LaurenNephewMD
. Take aways:
⭐️Normalize imposter feelings
⭐️Call out microaggressions
⭐️Women chairs/chiefs matter
⭐️Intentionally sponsor women
#WomeninGI
#DDW23
Our blend motto is “go thick or go to the hospital!” Thanks
@JPGNonline
for the shout out! And to
@SuzannaHirschMD
one of our super star junior faculty members for getting this into the literature!
Hirsch et al examined the addition of 💧 to blenderized feeds:
Wide range from 0 - 1000 mL daily
⬆️ CXRs with ⬆️ thin liquids
Could adding 💧 lead to worse pulmonary outcomes❓
Flowers and a Diet Coke from a long time patient who knows me well. Seeing patients year after year growing up is so rewarding. Pediatrics is truly the best!
Dropped 17 at college visiting weekend. Remember like yesterday dropping him off at preschool. Proud. Happy. Sad. Excited. Every emotion in these tears.
Recruited our first patient into a new trial today! So grateful to families for allowing their children to participate in clinical research studies to improve care for all!
@karagm2009
is giving a RIDICULOUSLY state of the art talk on the relationship between the vagus nerve, the intestine and mood. This interaction may result in more precise, targeted therapies for mood and pain 🧠😩😫 🤢
#PNM2023
#womeninmedicine
I finally submitted my reimbursements from August! I think this is as painful as submitting a paper. And the forms will likely get rejected as fast as a paper too!
One of the joys of my week is watching the Mandolorian with my son Fridays after school. And listening to him go on about the lore behind each episode. I just nod my head. I’m just here for the bonding time, the green guy and cantina scenes
#Mandalorian
#Grogu
#family
#FridayFun
@NurkoSamuel
reviews nutritional complexities in kids with DGBIs and ARFID. Use multidisciplinary care to avoid NG placement in children with DGBIs. You must address symptoms in order to get patients back to eating.
#NASPGHAN22
@RomeFoundation
Listening to
@PeteDuncanMD
@APGNN1
. Feeding difficulties in premies persist long after discharge, even for years, and this is not related to the degree of prematurity. And GERD is over diagnosed and over treated!
#itsnotGERD
#NASPGHAN22
#apgnn22
After a harrowing 48 hours filled with cancelled flights and no sleep, I finally landed, saw this out the plane window and thought “what planet am I on??” Surreal
#ATAT
#StarWars
Listening to superstar blend-master
@ToniSolari_RD
talk about how prescribed diets like low FODMAP diets can result in ARFID. Take home point: always involve an RD when prescribing special diets! Thanks
@APGNN1
for highlighting this topic!
Does your greenness index impact IBD risk in adults? Michaela Tracy shows that there is no impact of greenness 🌿🌲on UC or Crohn’s. But it does make me curious to know the greenness level where we live! What a fascinating concept!
#DDW2023
#WomeninGI
@josemgarza
is unraveling the mysteries of gas 💨💨💨. It is not always GERD. Excessive belching is most likely supragastric belching. CBT is very helpful.
#naspghan2022
Why is pediatrics the best?
Because one of my patients today had his endoscopy while hugging a Dino chicken nugget stuffed animal. Totally adorable and we giggled about it the whole case. 🦕🦖🍗🍗
🔥Presentation by
@SuzannaHirschMD
on EoE in infants and toddlers.
⭐️EoE presents as respiratory symptoms in infants
⭐️EoE can develop in infants on PPI and on allergen-restricted diets
⭐️Rates of histologies remission is low in infants
#DDW2023
#pedsGI
#WomeninGI
Everyone needs a vacation. If an out-of-office is on and a pager is off and the EHR is forwarded, respect it. Show some grace. There is always someone covering.
I just got back from vacation! My first in 3 years with my family. It has been a very long 3 years and very needed! Because of my amazing colleagues who were covering me, I was able to sign off my pager, set an out-of-office message and turn off internal secure text messages. 🧵
Thanks
@NurkoSamuel
! And thanks to
@AmJGastro
for caring about pediatric gastroenterology! Infants turn into adults so understanding early life events is important in diagnosing and managing adult diseases 👶🍼👶🍼
Fantastic perspective and superb review across ages.
@AerodDr
. Children are not little adults, masqueraders may be confused with reflux, treatment tailored to right diagnosis, use genetic tools, role of motility and appropriate use of PPIs
July is almost here!! Hanging out with
@ChristineLee_MD
and Meena Rao and our 😎🤩😎🤩first year fellows talking about how to succeed in clinical research as they transition to second year! What advice would you give?
#clinicalresearch
#celebratehard
#publish
#I
❤️NASPGHAN
Dropped my oldest at college 10 days ago. Had to go back today because he forgot a list of things. He looked so happy and much more grown up already. My heart was pounding with excitement for him. Anyone else feeling this today?
#hope
#potential
#freshman
#mamabears
Thanks
@JPGNonline
! Loving how FLIP is opening our 👀 to a new group of motility abnormalities➡️secondary peristaltic disorders! Is there anything better than HRIM+FLIP? Complementary data that directly improves care!
@josemgarza
@NurkoSamuel
How useful are functional luminal imaging probe (FLIP) measurements in assessing esophageal
#motility
disorders?
@AerodDr
and colleagues set out to find out!
#infographic
✅ Grand grounds talk ✅ Research patient recruited ✅ Rounding on aerodigestive inpatients ✅ OR case ✅ Case discussion on dumping syndrome. Love academic medicine ❤️! Always diverse and interesting!