Pediatric Pulmonologist Tampa, FL. Interests: Severe asthma, Aerodigestive medicine, and medically fragile children. My views are my own and not medical advice
So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day.
2 Cor4:16
Good morning, take a moment this morning for yourself, be thankful, take a deep breath, and get after it.
Saw one of my favorite medical foster moms and her adopted son in clinic. She raised 5 biologic children. The oldest is 40, youngest is 29 & she adopted this young man after being his medical foster mom for years. A true angel and lifesaver
#fosterhero
#medicalfostercare
#bpd
The ride is coming up soon. If there’s anyone in the Tampa area who wants to join me, I would love it.
Any support would be greatly appreciated.
All $$ goes directly to the ALA to fight pediatric lung dz.
@PedPulmonol
“But the path of the just is like the shining sun, That shines ever brighter unto the perfect day.”
Proverbs 4:18
Be an example of brightness and kindness to those around you. We are called to be an example, for our children, our family, and the world.
@RobynCohenMD
Not sure how loud we have to scream this message. Maybe it’s a peds thing (why the rest of the medical community ignores us, or at least the people who sign off on these pictures). Why take a medication if it won’t reach where the disease is located?
Good Morning. There are very few things in this world that we can truly count on every day. It should bring you some peace and strength that God’s love for you is always there.
You are never alone, keep pushing.
We are getting closer to the bike ride - Thank you to everyone who has helped out already. We still have a way to go.
I appreciate any support you can provide. Let's help children breathe easier!!!
Amazing collection of American Lung Association
#ALA
pins that my aunt collected and gave to me. The pins date back to 1918.
Help me support the ALA this year
Gulf Coast Bike Trek
#pedspulm
#asthma
#ATS
#lung
@MSUPedsPulm
This makes me sad….I feel like residents are not being exposed to what a great field pediatric Pulmonary is. I know I’m biased but it shouldn’t be that low. We need to figure out where the breakdown is in their experience.
At times, this life can be hard, cruel, and seemingly unfair. Other times, it is joyful and amazing. I need my faith to remain calm during the hard times. I need my faith to give me strength to serve others during their hard times. Faith brings strength.
@RobynCohenMD
@terrilaguna
@ATSPeds
Terri is amazing and a huge inpiration to me. An amazing leader, educator, clinician and person. I still remember her (as a third yr fellow) covering some of my picu shifts when my mom passed during my first year of fellowship.
Hey pulmonary community, I am the chair for this event. The ALA is near and dear to me for so many reasons. Please consider helping.
#peds
#pedspulm
#asthma
#ATS
#ALA
@RobynCohenMD
@LauraLewMad11
@coyle_deecoyle
@PedLungDoc
One of our smaller Medicaid HMO’s (Florida, i.e. Rick Scott,broke Medicaid up into several HMO’s in an attempt to over complicate an already complicated system) has been covering generic Fluticasone but the largest one is still “working on it”.
@RobynCohenMD
With many insurance providers in Florida only wanting to cover dry powder inhaled ICS products or nebulized budesonide….NO HFA ICS products at all 😬. Its so frustrating
@terrilaguna
@ShivanthanS
@ATSPeds
@EFornoMD
@RobynCohenMD
@SPCpulm
If in hospital, they all have abnormal chest x-ray‘s. Most with elevated inflammatory markers, on Lovenox and remdesivir, A lot of reported dyspnea but typically no obvious bronchospasm. Some with bronchodilator responsiveness clinically though.
@RobynCohenMD
Still waiting to hear from a family who is successful. But I agree, this should be some sort of nationally recognized holiday (I’ve been talking about it for so long, it feels like some special event).
@declairemoore
@WendyHassonMD
As a pediatric specialist who does “sick work-ins” and on call every other night, I can’t tell you how many times I am taking care of routine primary peds issues because we answer the page or can “get them in” faster. Glad to help but it’s not right.
@RobynCohenMD
Yes, saw another medical foster mom that same day. When I walked in, that mom was on the phone offering to do respite care for one of the other medical foster moms and says that she does respite for most of the medical foster moms in our area. Amazing!!!
@atulbutte
@ImmPortDB
@KellyZalocusky
@Sanchitab
Watched the plenary at AAAAI this weekend and I was a little blown away. In my 40’s and somewhere between the digital and analog generation, I still get a little star struck by what computers can do.
@voterdye
@bennyjohnson
I can’t tell you how true this statement is. We take the smallest things for granted until they’re gone. We cant live in fear but trust in God and be grateful for the blessings in front of us today!
@terrilaguna
@ATSPeds
I am super proud and excited for Jorge Valencia. He was an amazing medical student in our clinic and has such a bright future. This was a great experience for him. Exciting to hear the young enthusiasm.
#ATS2022
@ATSPeds
#Pedspulm
@saltinesnack
@bennyjohnson
Thank you, who knew such a small little piece of yellow wax would be so hard to get out. It was so gratifying to have been able help little Theo.
@RobynCohenMD
@PTMcGann
@The_BMC
@caraguenther
@TheBCRP
It seems to help, clinically. Metaneb seems to help with atelectasis on CXR and improve oxygenation so when they start to need o2 and have CXR changes, the SCD kids do better. Problem with home version is cost (like $20,000).
@madams711
Thank you, the story of CF is amazing (new treatments). I just had a former patient (now in her mid 20’s) come back to say hi and brought her new baby!! God bless you as a parent of a CF child…that is a long and hard road.
@cpeltier007
I wish the device was better on most of them. The sensimist spray is so much more uniform, why can’t they all be like that? It’s a topical medication so delivery matters.
@tyromper
Many of my medical foster parents have similar experiences with the most fragile, medically complex children. The wonderful homes they provide and the love they share is such an amazing gift.
@terrilaguna
@ShivanthanS
@ATSPeds
@EFornoMD
@RobynCohenMD
@SPCpulm
Still looking for objective clinical characteristics that may help guide management from a respiratory standpoint. Not having any asthmatics really. Usually if there is a significant asthma component, there’s usually another virus as well.
@RobynCohenMD
That is great…I’ve been out 15 years now so starting to get some of these experiences as well. One of my severe asthmatics on xolair just got a full ride for football to Boston College.
@ScottGBickel
Being in Florida, these were typically not on my radar (although every parent wants to blame every symptom on mold). Everything is moving to Florida.
@Hollyluja6615
@bennyjohnson
Doesn’t matter how much you know (actually, sometimes it worse). When it’s your kid, it all flies out the window and you only want one thing, for them to get better. I’ve been at the bedside of my own children and know…and prayed.
I saw two new patients yesterday (2/02/2022) in clinic (siblings so a “2-fer”) in room 2 and their last name was Tew. I wanted to just call it a day after that…but it was only 2:00.
@RobynCohenMD
@PTMcGann
@The_BMC
@caraguenther
@TheBCRP
No, our children’s hospital has a lot of the hospital version (metaneb) and I have had a lot of clinical success turning kids around and preventing PICU admission if I get involved early enough. The home version just came out and is primarily getting used in neuromuscular patient
@RobynCohenMD
This happened last year around this time. I did 4 news interviews and a Washington post interview about an RSV surge in the south in May and June. It’s like RSV got jealous of COVID. Blamed it on my states “lax” masking practices. Not sure this time.
@RobynCohenMD
@ShivanthanS
@ATSPeds
I have had some amazing success as well, kids with eczema and asthma - life changing. EoE indication is up next, hopefully this year. Some of the younger kids only need it once a month!
@RobynCohenMD
No, they don’t although I’ve been enrolling patients in a study through UF who developed an asthma management app, The pilot study showed improvement in The ACT by several points. It was developed by a behavioral psychologist. I think they’re at 140 with a goal 160 patients.
@MSUPedsPulm
Absolutely. Not sure what to tell parents. Also not sure what the natural history of that population will be. Some very interesting areas for research going forward.
@MSUPedsPulm
Absolutely…if I had a nickel for every time I’ve heard the words “it just seems like ever since he/she had Covid, their asthma seems like it has been worse”. It’s just hard because timing coincided with our horrible viral season. I’ve been calling it “ASTHMAGEDDON”
@terrilaguna
@ShivanthanS
@ATSPeds
@EFornoMD
@RobynCohenMD
@SPCpulm
Sorry I’m doing this wrong and they’re in reverse order. Start at bottom. Right now struggling with developing some hospital policies to help guide bronchodilator use, nebulizer/airway clearance or other tools that we have that increase risk to staff but may help clinically.
Mom broke my heart after 3 min of talking….sounds like dysmotility, J-tube dependent and I bet money he has significant tracheobronchomalacia. She is having a hard time getting people to “listen to her” he is admitted frequently.
@MSUPedsPulm
@tfischer78
@KevinJDownes
Even though I’m on the east coast, I try to join the western states peds pulm case conf whenever I can but the time difference kills me. How can I participate in the Eastern peds pulm version?
@PedLungDoc
@RobynCohenMD
@MassHealth
@ATSPeds
To make it even more complicated, in Florida we have several different Medicaid HMOs ( no straight Medicaid) and they all have their own independent formularies 🙄.