Nurturing Hope: Pediatric Health, Parenting, and Resilience with Dr. Neha Vaghasia

In this episode of the Making Hope Happen Radio Show, host Erin Brinker interviews Dr. Neha Vaghasia, a pediatric oncologist and pediatrician. They discuss Dr. Vaghasia’s inspiring journey into medicine, the evolving landscape of pediatric health—including mental health, the impact of social media, and vaccine hesitancy—and the importance of preventative care and community support. The conversation also offers practical advice for parents, explores health equity, and reflects on lessons learned from the COVID-19 pandemic, all while highlighting the resilience of children and families.

Transcript

Erin Brinker: 0:00

Erin, welcome everyone. This is the making hope happen radio show, and I'm Erin Brinker. Have a great guest for you today. She is an incredible woman, a pediatric oncologist and pediatrician, and her story is really compelling, and the interview is really fun, so I hope you enjoy it as much as I did. But before we get started, I want to talk to you about what I'm grateful for. Do you know that gratitude helps rewire your brain, if you take the time every day to intentionally think about all the things that you're grateful for, no matter how small that you have shoes to put on your feet, that you have a roof over your head, that you have money to put gas in your car, that you have a car, that you have people who love you, or maybe it's just your cat, and that's okay, that you have your cat who loves you. The more you think about the things that you have, the less you'll think about the things that you don't. And that dramatically impacts well being and mental health in a very positive way. So I like to make it a habit to as much as possible talk about on this show what I'm grateful for, and I think I said it last time or the time before, I'm grateful for this mild winter, sorry, summer. It's not winter, this mild summer that we're having. It has been milder than I can remember, and last summer was pretty brutal, with a lot of days over 100 and we've had a few it's been August. You know, July was really mild. August, we had some days over 100 and looking moving into September, and I'm hoping that it just continues to be mild and into winter. I don't know about y'all, but I'm already thinking about the holidays and, you know, having family in and the things I need to do to the house to get it ready, you know, all of that fun stuff. It's all very exciting. So the fall is my favorite and it's not just about pumpkin spice lattes, although I do like them. The fall is my favorite season, and we have a couple three weeks left before summer isn't completely in the rear view according to the calendar, and I'm looking forward to it. So I'm grateful for a milder summer, and I'm grateful for the fall that is almost upon us. It just makes me smile so and I'm grateful for every one of you who are listening. All right, without any further delay, let's get going. Well, I am very pleased to be sitting down with Dr Neha vigashiya. She is an MD, MBA combo, something you don't see very often. She's a specialist in pediatric hematology and oncology and the assistant chief of service for the Department of Pediatrics at the Kaiser Permanente Fontana Medical Center, Dr Vikas,

Dr. Neha Vaghasia: 2:42

Thank you so much Erin for having me so to welcome to the show. tell us about your your journey into medicine.

Erin Brinker: 2:50

What made you decide to go to medical school?

Dr. Neha Vaghasia: 2:54

Yeah, I mean, I think that's always very popular question that even my patients or their families will ask me. And I think, you know, when I was young, and even at the start of college, I always thought I was going to be an engineer and follow in my my dad's footsteps, and I had a very strong background in mathematics and physics. I enjoyed those classes. I always did really well. And I started college in engineering, and got to a point, you know, I think in my second year, where I just found a lot of the mathematics so abstract, so almost like outer space math, and just have this like realization one day, as far as, like, how does this relate to what we're doing here on this earth? Like, how is this applicable? And at the same time, I'd been taking some some courses in physics. But they were, they were kind of applicable to life sciences. And so they were looking at, you know, physics according to, like, the human skeleton. And I found those really, it was really a fascinating application of it. And I switched track a little bit and learn that, you know, these, like the chemistries and some of the more sciences. It didn't come as naturally to me, but I was so into it because it was challenging for me, and I just continued to pursue that. And I was, you know, involved in a basic science research lab as an undergraduate, and just got more and more exposure in the life sciences. I did some volunteer work at a local hospital, and it just, it just kind of grew from there. I bet you liked puzzles as a kid. I probably did. I'll have to ask. My mom. I had a brilliant colleague a number of years ago who ended up, she got her PhD in in child development, and she she just loved doing puzzles. She would, you know, she said, I took the SAT strategy books and just did the puzzles for fun. She was brilliant, like, oh, I don't have that mind, so I'm in awe of people like you. And say it's you say, it was a challenge, but I enjoyed it. You know, think about organic chemistry and all of these other things, even, you know, all the biomechanics, all the physics, that's incredible. And so I bet How did your family react when you decided that you didn't want to be an engineer? I mean, I think they were excited. You know that, you know, there, there was the potential for to have a doctor in the family. You know, my parents were immigrants. They moved to this country in the 70s, and so, you know, I'm the first one to to, you know, get my undergraduate degree here in the US. My my my dad had done a Masters, but, you know, like, kind of like the first one, and so I think they were excited for that potential. My, my father, who is now retired, still has held on to every single valued engineering book that he owns, and every once in a while will lament that, you know he doesn't have anyone to pass

Unknown: 6:26

this on to that sound

Dr. Neha Vaghasia: 6:27

little part of him, I think that you know this still exists where, where you know there that pride of like, you know, having, having someone to pass on all, all his engineering gadgets to is not, is Not there, but, but he still held on to everything. So

Erin Brinker: 6:44

that's awesome. Well, maybe he'll maybe a student who needs to be mentored at some point will need those books, and he can pass it on to those, to that student Exactly, exactly. So you're in medical school, and I know that you get to see a lot of different specialties. And so what? What was it about pediatric health care that drew you in?

Dr. Neha Vaghasia: 7:04

You know, I actually just recently told this story to my husband and a good friend, and it was this very interesting journey of where you felt you fit the best. And I know people make these career decisions for a variety of things, but for me, it was really just like, where do I feel like I fit in the best? And pediatrics just was such a natural fit for my personality and my comfort level, being able to talk to children and being also an educator. You know, I think one of the things that's really great about this field, especially in pediatrics, is that not only are you a physician, but you're a teacher, also you have to find different ways to teach, different ways to explain things to children at their level, to families from all sorts of different backgrounds. And it just was a really nice, natural fit for me.

Erin Brinker: 8:12

That's wonderful. And pediatrics is from the moment that child is breathing oxygen through their 18th birthday, right?

Dr. Neha Vaghasia: 8:19

Yeah, I do have this small little group of adolescent young adults that we might follow in their in their late teens, up to maybe 21 but for the most part, it's up to age 18.

Erin Brinker: 8:34

Wow. So what would you say are the most common health concerns that you're seeing in children today, and how has that changed over the years, over your the course of your career,

Dr. Neha Vaghasia: 8:45

you know? So that's a great question. I think when I did my training, I was really well trained in, you know, just the traditional concerns, there was things like infections and asthma and allergies and, you know, the developmental milestones of children and all those things still exist, and they still are very much seen and treated. But there's a lot of newer things that have come into play, and there are things like mental health concerns that, you know is becoming more and more of a challenge with kids. There's a big rise in anxiety behavioral concerns. I think a lot of that has to do with just the pressures of social media, digital exposures, you know, different social social pressures, basically. And then there's, you know, just other health conditions that seem to be more challenging than they were even 1015, 20. Years ago, such as obesity, and with that comes a lot of other complications that we see, like diabetes or pre diabetes, fatty liver disease. And then, because we all like to get better at what we do, we you know, there's a lot more screening for conditions, so screening related issues like that come up where you pick things up because you're doing a better job at at monitoring and screening. So there's, it's a mix these days, I feel,

Erin Brinker: 10:33

you know, it's, it's interesting. And you bring up social media. You know, before the internet was a thing, kids would go out all day long and go play, right? So they didn't they, they, if they, if they had an issue with another kid, and they usually resolve that on the school yard, good or bad, that's what they did. Or they in the playground. They'd hop on their bikes and be out with their friends all day, you know, once their homework was done and and so they learned how to manage their own emotions. They learned how to do conflict resolution. They learned how to problem solve their way out of whatever pickle they got themselves into. And all of that is gone, and what they're seeing now is a hyper curated, scrubbed environment where all the people are beautiful. Everything they're doing is perfect. And then the flip side of that is the abusive side of social media, where people will say the most horrendous things to to each other because they're keyboard warriors. And that, you know, adults have a hard time processing all of that. I can't imagine what that does to the psyche of a child.

Dr. Neha Vaghasia: 11:37

Yeah, you know, and it's social media, it's, it's good and it's bad. It allows us to make connections and bridge gaps, and, you know, keep in touch with people or learn about other people. But the bad is, it's ugly and it's, it puts a lot of pressure on these kids, you know, the the influencers and the tick talkers and and it it's whether it's pressure or it's, you know, just plain bad advice being given out. But it's, it's not easy for many of the kids to process that, like, Hey, I don't have to be like this. I'm comfortable my own skin.

Erin Brinker: 12:26

Yeah. And so it really they, you know, as parents, as doctors, as a community around them, we have to teach them, because they have to learn that that's how they need to be, right, that that's how they come about. This is to have this, this sense of who they are. And, you know, there's a time when you're, you know, before you're 25 where that that that idea of who you are is still very fluid. And so it's kind of a treacherous way to go.

Dr. Neha Vaghasia: 12:52

Oh, I agree. I mean, and even, you know, not just for kids, like they're still growing, they're still learning, they're still evolving into themselves and, and even, I mean, you threw up the number 25 and, you know, I think of myself as when I was in my 20s. And, I mean, I just think like, oh my gosh, I was, I was so young. And yes, some of these things that I might have done, or, you know, didn't do, they probably said some really stupid things, exactly like, gosh, and I was, you know, a, you know, considered an adult, and, you know, made, made my own decisions, and I could vote, and I could, you know, have all these responsibilities. But it's a lot. It's definitely a lot.

Erin Brinker: 13:36

So, so connecting with the doctor, so creating a medical home, I think, would is important not only for mental health, but physical health. And, you know, some people don't think about going to the doctor till they have a problem, you know, they have the femur or whatever. And so what would you say to a parent who's they've just had a baby, they kind of want to figure out how to navigate the healthcare side of of parenting. What would you tell them? You know,

Dr. Neha Vaghasia: 14:03

I am such a firm believer that the well child visits, they're so foundational, and especially in like the newborn, the growing child, they allow us to monitor their growth and their development. You know, we're making sure that, hey, you're gaining weight, you're getting taller, appropriately. It allows us to catch issues earlier a lot of times. And more importantly, also, you build that trust with families. You know, having a new baby, new parenting, even old parenting, that's, it's hard, it's hard. Things change. And, you know, sometimes what you know we we did as we were taught, you know, as, as parents, from, you know, by our grandmothers or whatever, like you kind of, you're like, that's probably not what's best. How we know this, you know, I have, I had this attending when I was a resident, and he was a neonatologist. He's now retired, and he, you know, always used to say, you know, my sister and I, we were fed condensed milk, yes, in the bottle. Growing up, yes, like mothers were not, you know, encouraged to breastfeed, not at all, the thing, and you just got condensed

Erin Brinker: 15:32

milk. I'm a Gen X er, and I, and I know that that's that is 100% true, and you have to feed your baby on a schedule. Baby's hungry. Doesn't matter. They're not eating till one, which is, you know, I didn't do that with my child, but my mom and I would get into arguments in her generation. That's what they taught,

Dr. Neha Vaghasia: 15:50

yeah, and so. And it was just, you know, very it was hilarious. He would tell you, told the story a million times and, you know, and I think part of it was just like, hey, look, I turned out just fine on condensed milk as an infant. But part of it is also, hey, we have a lot of evidence that shows like, why breastfeeding is better or better for your baby, nutritionally, immunologically, well, it's cheaper and it's cheaper and or, you know, if you're not able to breastfeed, why is my formula might be better than

Unknown: 16:26

not just about calories.

Dr. Neha Vaghasia: 16:29

So, yeah, like, things change. And so, you know, I think these, these well child visits, they're just, they're so important, they're so foundational. They just provide so much opportunity for the doctors to to educate on, you know, growth and development and vaccinations and screenings and all of this is meant to contribute to just an a healthier outcome for for for your

Erin Brinker: 16:53

child. So we're kind of laughing about differences in parenting, you know, generational or whatever. But overall, we're really hard on mothers, and mothers are hard on each other. You know, like you, you have to breastfeed from here to there. You have to be able to do this. This is the way it's supposed to be. If they're not gaining weight at this rate, or if they're not talking or walking when I think they should be, then something wrong with your parenting. Or it's really hard to be a mom and and so, you know, talk to talk to that mother who may be their child is not developing where the way they think they should be, or maybe they're not taking the breast milk. You know, what would you say to that mom?

Dr. Neha Vaghasia: 17:28

Yeah, you know, it's, there's, there's so much pressure on, on, on moms, whether you're a new mom or not a new mom. It's, it's a lot of pressure. And, I mean, there's even more pressures now, because there's so many working moms out there, you know, and even if you're not a working mom, it's not easy being a full time mom and anything, you know, sometimes you need to take that little bit of a step back and say, Hey, I rec. I recognize that as a doctor, I'm recommending you know, exclusive breastfeeding, for example, for your baby, but I also as a human being, can recognize that this is really hard, and maybe some people are not able to do that exclusively, and maybe some people, just for whatever reason, aren't able to produce the milk, or they, you know, there's just so many, so many reasons why people might not be able to, and it's a lot of pressure. And I've seen new moms like, I mean, just crying because they genuinely are distressed that they're doing something bad for their baby. And in my heart breaks when you reach that point with a mom, because that, you know, for me, that's never my intention when I when I give advice and, like, I don't know how many times I've, you know, had to just like, sit down and say it is okay. Your baby's dehydrated, your milk's not in right now, let's we need to give your baby like, some fluids, or we need to give your baby a bottle. But I promise you, I promise you, your baby is still going to grow, and your baby, you're going to get there. Your baby will still go to college, if you want them to go to college. Like we're we're not like, you know, unhinging the right 20 year trajectory for your child like by deviating a little bit from what, what you think, or you know, hoped for yourself to be this, this

Erin Brinker: 19:32

path. I remember because my my son approached every meal like his. It was his last that child. I was a Jersey cow, and I just did not have enough. And so I still breastfed him, and we supplemented with formula. And by six months he and I don't know if they do this this way anymore, we started giving him cereal in his milk, a little cereal in his milk, because he he he just was hungry all the time. Now, he's six, three now, and so he was just. Hungry, and once I got past the guilt of thinking that I didn't do it the perfect way, it was fine, and we were able to find a way that, working with our doctor, we're able to find a way that was able to meet the nutritional needs of our son, and we were good,

Dr. Neha Vaghasia: 20:18

yeah, and I think that's the biggest part, is maybe not so much like, you know, letting go of what you what you think the path has to be or should be, because that is somehow equates to you being the best parent, right? I think you being the best parent is working with your doctor exactly how you did, and making sure that whatever the needs are of your child are being met, however that might

Erin Brinker: 20:49

happen. So we talked about, I've had other physicians on this show talking about issues that happen in adulthood and diabetes, that are things that are that are perhaps that happen over a very slowly, over a very long term. Okay, so now you've got a child in front of you, let's talk about preventative care and what that looks like in infancy, moving through childhood and adolescence.

Dr. Neha Vaghasia: 21:14

Yeah. So I think for all the stages, it's different. In infancy, preventative care is heavily focused on, you know, the vaccinations, getting all your your baby shots in, like, people like to call them, and so those are things like, you know, your whooping cough and your measles and your your, you know, diphtheria and all of those things. And it's also meant to be making sure that the trajectory of the growth and the developmental milestones are on track. And then as you get older, you know the school age children, I think the preventative care is the shift. It's maybe less focused on vaccines, because they're not happening as quickly, but there are still the concerns of growth and development, maybe even a shift of you Know, the overweight, obese population and nutrition, diet, exercise, and then even things like anxiety, those stressors can happen even in the younger child. And then, you know, shifting more to your teen years. Oh, the preventive medicine takes a big change. There are some vaccines that come into play during during that stage as well, but there's a lot of mental health, um, there's still the obesity, diet, nutrition, kind of screening that happens, but there's also now the the education on and screening for, hey, are there high risk behaviors? Is there concern for substance abuse? Is there concern for, you know, any kind of like, unprotected sex, like those, all those, all those triggers so your conversations can vary, you know, tremendously, depending on even just what the age of the patient is that you're seeing in pediatrics.

Erin Brinker: 23:24

Well, you know, you mentioned vaccines, and there's so much online chatter about vaccines, and, you know, there's some people who don't vaccinate their kids at all, and I just think that's wrong at every possible level. You know, whooping cough can kill your baby. So I think that's wrong on every level, but there are some vaccines that I'm wondering why an infant needs them, like hep B and so can you kind of address, and this is really a question of dosage and timing. I understand protecting protecting kids, but can you kind of talk about the vaccines that happen when you're when you're an infant, and why they're necessary at that time, and this

Dr. Neha Vaghasia: 24:05

is a big question, yeah, so some of it is definitely related to the exposure, and, you know, the age group and who's more high at risk, right? So your your whooping cough, you know, or RSV, even where are so heavily geared towards infants, because these are things that you know, infants can be highly susceptible to, to having such bad outcomes if they get sick from this, some of it is also driven by by the data, where they look at like a lot of pharmaco logic, pharmacokinetics, as far as you know, vaccines based off of age and what the immune response is and how good of a robust like immune response to people get from it. So H. Is kind of a good example of that. Generally, most people will start giving it at age 11. You can give it as young as age nine, and then I believe after age 13, you go from needing two doses to actually three doses. And that has been shown in the data, that the older you are, the less of a response your body mounts. And so your protection against the against the virus, is just not as good. And so that's why they had to add a third dose in. So that's why also a lot of vaccines might even have a cap, like after a certain age, like, whether it's the the risk is not there anymore or it just is not going to your body's just not going to mount a very good response to it. And so that

Erin Brinker: 25:51

kind of defeats the purpose of getting the vaccine if it's not going to work. Yeah. So do you? Do you have parents who come to you and say, yeah, maybe I don't want that hepatitis B vaccine for my baby. But, you know, I want all of the rest of them, do they have the flexibility, or are they required to do the vaccines on schedule? No,

Dr. Neha Vaghasia: 26:09

there's, you know, there is flexibility, and it's, it's kind of interesting. I feel like I've seen different styles to vaccination from parents. And you know, I in my role as an oncologist now I probably deal a little bit less with that, mostly because when kids are undergoing chemotherapy, we're not vaccinating them. But when I did do general pediatrics, I would say I had a lot of people who did not want to do hep B at birth because they knew it was coming in the two month and the four month and the six month shots. Or, you know, they wanted to hold off on the vitamin K, which isn't even a a vaccine, but you know, it's just something that they for their baby, they choose that we just want a very natural approach to our baby. Is that vitamin K for clotting, yes, for clotting, yeah. So it's a very important vitamin that our liver needs in order to make clotting factors, where nobody is born with good levels of it, and so there's a strong risk for for bleeding, head bleeds, all of that in the infancy phase. So that's why vitamin K got added in to help prevent a lot of those comorbidities, basically.

Erin Brinker: 27:34

So that is, that is, that is really interesting, and I get frustrated with the way our media handles this issue of vaccine. It's either all good or all bad. It's like, no, let's hang on a second. You know, assume the parents have brains in their heads, and most of them do, you know, tell me why. Tell me why. This one's important. Now, you know, saying that that your your baby doesn't have the ability to create clots like he needs to is, and this is why the Vitamin K is, is, is required. I mean, that's, that's important. And I wonder how many people say I don't want that because they don't understand what it does and why it's important.

Dr. Neha Vaghasia: 28:12

Yeah. I mean, I think there's a lot of, there's, you know, a lot of misinformation out there, or there's just a lot of partial information out there. And you know, that's part the detriment of us having information readily at our fingertips, right? Like Dr Google, you can, you can find anything on the internet. And you know, now we all have phones, and you know, we can find anything at any point in time. And you know, and some of it's good information, and some of it's maybe not so good information. And you know, one of the things I tell my parents is like, Hey, I have zero problem in you going out there and trying to educate yourselves, but do it responsibly. You know, don't maybe get your information off of someone's Facebook post, or, you know, Tiktok. Like, look at actual reputable sites, right? Like, look, you know, there's so much patient handout information on the American Academy of Pediatrics. There's so much information through, you know, Mayo Clinic, and a lot of like, reputable, reputable site. So, so, you know, be a little responsible for where you're going to get your information from, like, if you, if you know, and if you're, if you're, if you have a belief, and that is what you want to stick to, like you'll, you'll be able to find information out there somewhere to like, you know, support that, because there's just the information exists for everything out there, right? But you know it, part of it is also, you know, using, using information responsibly, and that's, that's my role, is trying to, you know, hey, educate and let's have a conversation. What are your concerns? Let me hear them, so that maybe I can help address them. And sometimes. That's literally all it takes, yep, um, that's, you know, and it's just, it's just helping to fill in those knowledge gaps, or, you know, leave someone's concern.

Erin Brinker: 30:15

You know, it's a and now with AI, if you don't understand, because your average person can't read and understand an abstract or, you know, a study, but you can plug it into chat, GPT, or into Google, Gemini, or into grok and and have it right in plain English, and it will do that for

Dr. Neha Vaghasia: 30:31

you. Yeah, that's true. Actually, you know, you can even just take a scientific paper and say, can you explain

Erin Brinker: 30:36

this to exactly? And it will exactly, exactly, exactly it will. So let's talk. Let's switch gears and start talking about mental and emotional well being. And we've, we've always known, you know, nobody likes Middle School. You're, you're, you're a walking bag of hormones, and your brain falls out of your head for a few years. And so the the change, you know, the that's when the moodiness and what we would call surliness appears and all of the and we expect that when you're 1112, 1314, years old, but you're seeing mental health issues in younger children. Can you talk about that?

Dr. Neha Vaghasia: 31:09

Yeah. I mean, I you know, there's so much that goes into play with mental health now, and we're seeing just anxiety even in like the young kids. And you know, some of this might be generational, and, you know, like, differences in, like, parenting style, but you know, whatever the root cause is, like, we're seeing it and, you know, it's, um, it's going to manifest differently. A young, five, six year old is not going to tell you, like, I feel anxious, right? They're going to manifest in different ways. There might be having stomach pains, and that's all that they're telling you. They might have changes in sleep or appetite, just their mood overall might seem funky, but you can't pinpoint it looking at, you know, school performance, or school you know, like activity, or they might be a little bit more withdrawn, or they might just be more irritable, but all those little things you know, are little, little flags that kind of come up. And so, you know, trusting your instincts as a parent is really important. So if it, if something feels off, it's definitely worth exploring and bringing up to your pediatrician. And I would say, Yeah, I just, I would say, like, the stomach pains is like such a big one. We get a lot of kids who manifest anxiety or stress, like with with GI symptoms and so, which creates even more more stress for the parents, because I think they go down the rabbit hole of, oh my gosh, there's, there's something wrong with my kids, like stomach or their gut. I gotta change the diet. I gotta do this. I need, you know, to talk to a specialist. I need, you know, all these tests and and really the underlying cause is not so much, maybe the gut system itself. But how are our mental stresses are taking a toll on it

Erin Brinker: 33:10

well, and kids can feel what's going on in their families. They may not understand it, but if mom and dad are always fighting, if somebody's lost their job and they all of a sudden don't have any money, if a car gets repossessed, somebody gets deported. There's a divorce in the family, and people say kids are resilient, but, but, and that's dismissive, because kids, they don't necessarily know what's happening. They just know that the ground under their feet is moving, and it's scary.

Dr. Neha Vaghasia: 33:35

Yeah, absolutely. And for, you know, for a young child to be able to articulate that, or vocalize that. It's it's hard, you know, because they're aware, and they're a lot smarter than sometimes we give them credit for, a lot more aware than what we give them credit for. But how they display that stressor will be different than how a 20 year old or a 30 year old or a 50 year old would.

Erin Brinker: 33:59

So, you know, so much of what a child's ability to manage their own stress and to regulate their own emotions comes down to parenting, and that's you know, and a full disclosure the making hope happen. Foundation where I work, we have a program for families with children ages zero to five, in partnership with our local university to help parents maximize brain development and emotional development during this window. And so you know how a parent reacts to stress dramatically impacts a child. So how do you talk to parents as a physician, about about that? Because I imagine that's pretty touchy subject.

Dr. Neha Vaghasia: 34:38

It is, it is, and you know, it's, it's something that often I find in my role as an oncologist, I have to have this conversation, because the stress levels are just running high, left, right and center with everybody you know, the the parents are super stressed for for their children who you know are getting. Seeing, getting chemotherapy and going through, you know, cancer treatment, the stress levels are high for their surrounding family. It's all, you know, on, you know, being kind of funneled down to the kids. And a lot of times it takes just, you know, taking them aside, separately from from in front of the child, and just having this conversation that you know, like it's okay to feel sad, it's okay to be frustrated, it's okay to have you know your your thoughts and your emotions, that is 100% natural. But your your kid is looking to you this entire time, you know, they're having to come to the hospital, they're having to go to the doctor, they're having to get, like, you know, things done, procedures done that they don't, that they're scared of, but they, at the end of the day, they're going to be looking to you. So you have to in the in front of your child. Have that confidence, have that you know that that plan for them and that comfort for them, that they are safe, they are okay, you are with them, and not let your fear show in front of them. And the second that happens, they pick up on it. You know, if you're, if you as a parent are are afraid or stressed, you're crying, you know, like that, all will, you know, be noted by your child and picked up by your child. And so I encourage my families to, you know, to what they need to do to to keep up their strength. You know, take breaks from the hospital, go for walks, you know, make sure that they're eating their meals and getting, you know, some steps in and just taking that, that that time, just even if it's like 1520, minutes in the day, just to kind of step outside from from everything that they're going through, making, you know, leaning on their support systems, even, you know, if they need someone to talk to, you know, absolutely like, we have, like, plenty of like therapists and behavioral health specialists that can, that can help connect with the families. So there's a lot of opportunity for early interventions that can make a big difference in their journey.

Erin Brinker: 37:30

Well, that's wonderful. You know, I think a child having cancer is one of the scariest things a family can face. Are you seeing an uptick in the number of cancers, or just better diagnosis, early diagnosis? What's the state of that?

Dr. Neha Vaghasia: 37:49

Um, I don't necessarily think there's been a global uptick, per se. Um, I, I'm just trying to think in, you know, my career here at SBC, I think there's maybe we see more here, more just because people have been, you know, relocating to other parts of southern California. And are, you know, population has kind of grown, but, but overall, I don't know if there's necessarily, like, a huge trend upwards. I think people are definitely getting better at picking up on symptoms. And, you know, pediatricians are, you know, great at what they do, as far as you know, getting workups and and it's hard with children, because children are supposed to be they're supposed to be healthy and common things being common most of the time. Like, if you have a kid that you know has had some fevers and some tiredness, and you know these little, you know, low appetite, these little, vague symptoms, like, most of the time people, it's going to get chalked up to, like, Oh, it sounds like you've caught, like, some kind of a bug, as all children do, and it should go away and get better in five to seven days or so. And you know, it's not the most common thing to say or to realize that, like, Oh, these little symptoms all ticked up, and this was actually a new cancer diagnosis in play. And so sometimes it does take, you know, a couple of trips to the doctor because things aren't getting better, but, but I would say that, you know, our pediatricians do a great job at, you know, screening and and coming to coming to these conclusions when things are just not right.

Erin Brinker: 39:41

So that begs the question, and I appreciate that. And what begs the question about health, equity and access, you know, because if you are part of and I have as a Kaiser member, and I've been a Kaiser member for a really long time, I feel like I'm super spoiled, because the whole system is in the system. You don't have to wait to the. Referral to get transferred to here, and you wait for that person. All your records are over there, and it takes forever. And, you know, and, but what if you, what if you don't have access? What are, what are some things being done? And I know that you work for Kaiser, but what are some things being done to make sure that that there are people who are not locked out of a good system?

Dr. Neha Vaghasia: 40:19

Yeah, I mean, like, there's so many barriers, right? Like it could be your geography or lack of transportation, language is a huge one, lack of awareness or education, financial constraints, and it's, you know, I would say, you know, that at Kaiser, there is just so much that has been pioneered to help overcome those things. It's amazing. You know, we have so much that has come out of covid with, like, virtual care, and, you know, being able to, like, send some emails to your doctor and attach a photo. And you know, there's just so much that that can be done to kind of circumnavigate some of these, these barriers. But I would say that I think a lot of healthcare systems in general are acknowledging that. I did my fellowship training at UCLA, and I remember we had patients that came from everywhere. I mean, we had patients that, you know, were, were referred to us from the Bakersfield area. And that is, that is thought that's a long way, and it has a long way, a long, long way. And there was, there was a ride share, there was a UCLA rideshare van that that brought these patients, you know, very early in the morning. They, I think they left, like at 5am or something like that. But they they would bring the patients down. People could have their appointments and then get back on the rideshare and go back up. And it was a long day for these families, but there was a way to get them, to get them taken care of. And this was before you know, anybody was really doing virtual care. So it's nice to see that like, yeah, there are, there are things you know that are, that are being done, even outside of Kp, to help families get access.

Erin Brinker: 42:16

So what role do community partnerships you talk about the rideshare what role do community partnerships play in improving pediatric health outcomes?

Dr. Neha Vaghasia: 42:26

Um, you community is just so it's just so strong for pediatrics. I think, you know, I see so much community outreach. As an oncologist, we have just, I mean, so many foundations or people that just donate, either their time or you know, their resources towards families in need, whether it's financial help or, you know, help with gift cards or gas cards for or grocery cards, you know, or even donations of like, you know, snacks and toys and backpacks and things like that. And so there's, I see so much community outreach. I think there are programs that are also being put forward to help with transportation. I even recently have learned that, you know, medical patients do have access to Uber for their doctor's appointments. So getting getting patients, you know, rides, basically to make sure that they can keep their appointments. I think there's a lot more that's being done now than there was even, like 1015, 20 years ago.

Erin Brinker: 43:46

So what are some emerging trends or things that people need to know with their kids heading back to school and obviously get a lot of kids in one in one room that haven't been around each other, they're all going to give it get each other sick. That's just the way, the way it works, little vectors that they are. So, you know, what are some things that people should

Dr. Neha Vaghasia: 44:06

know? Oh my gosh, we're seeing that right now. I have, like so many of my patients, are coming in with sniffles and coughs and stuff, and they've all gone back to school in the last couple of weeks. And, you know? And that's just the the beauty of being a child, right? You You're meant to build up your immune system. You're gonna catch everything, and then you're gonna spread the love and spread spread things as well. And I do feel that there is more awareness out there as far as how things are spread, right? Like, you know, we did not completely emerge out of the code pandemic, like, just oblivious to to how diseases are spread. So we all learned a lot. We all learned a lot, you know, whether we continue to keep up with practices or have relaxed a bit. As most of society has, but we, we learned a lot. And so I think, you know, not forgetting that, um, and a hand hygiene is huge, and kids are terrible at it, like, let's be real. They touch everything they do and and then after they're done touching everything, they're touching their faces, they're touching their mouths and so, and it's just like, I don't know. There's just no, no answer for

Erin Brinker: 45:25

it. Yeah, hygiene, my gene, yeah,

Dr. Neha Vaghasia: 45:29

kids, right? They're, they're, they're just, they're not the the most hygienic, oh, they're not, like, they're just not. But, you know, like, hey, at least teaching good hand washing practices, like we having those habits, like we wash our hands before we eat, no exceptions, right? Putting a little thing a hand sanitizer in their backpacks, like, you know, when cover your cough, like those are, you know, like all the kids, they know about the cough pocket now, right? Like this, off in your elbow. They got that, you know, using tissues. So there are things that you can definitely teach these good habits, um, and then hope that it kind of sticks

Erin Brinker: 46:11

well, it's over a lifetime, right? You know, some we humans are a little thick. Sometimes it's something that has to be reinforced over the course of our lifetime. And hopefully by the time you reach adulthood, you've got to figure out so you can do it with your own kids, right? So, you know, what are some of the things that we learned in covid, I mean, and in addition to the hygiene stuff, you know, how does the, how is the covid pandemic? How did it change the way pediatric care is delivered?

Dr. Neha Vaghasia: 46:37

Um, you know, it covid was, it was, I think it was just an interesting time, regardless of what field you're in. It really created a a backlog of patients, you know, needing to get in for their physicals, for their vaccines. And so we had to get creative. We had like an outdoor drive up vaccine tent going on so that people could still keep up with their their well child visits, at least, get their vaccines, get their vitals taken care of, you know, and and not be months and months delayed, I think, in terms of practices you know, people are definitely a lot more aware of of, you know, catching infections. I think people have more awareness about vaccine. Some of it may be good. Some of it maybe not so much. Um, you know, there's a lot of, a lot of, I think, vaccine hesitancy that also crept up with with the pandemic that unfortunately is still lingering. But we, you know, all we can do is kind of do our best as far as, like, educating and making sure that people understand, you know, hey, this why, why these things came about. What's the history behind these? You know, we're so lucky in this country to have the amount of healthcare access that we do, to have these vaccines. And I think a part of society has just forgotten what these diseases looked like, and what they did and or what they can do even, you know, even things like the flu that it's talked about every winter season. And, you know, we recommend flu shots for everybody every year. And you know, I think people just kind of forget or get a little complacent, but we lose lives every year, every year to even these, these simple things, and people die. You know, people die of the flu every year, even including children and family

Erin Brinker: 48:55

members who had the flu this year, right? This last time was last cycle. Last winter, their fevers hit 104 they were at the hospital. And the hospital they they went to the emergency room, and they were not admitted, but it was like it would there. They were not alone. There were a lot of people who got the flu that bad, and these are healthy adults. And so you you never know what the virus, what this next virus, set of viruses, is going to bring, yeah,

Dr. Neha Vaghasia: 49:20

and so and flu is one of those things that, you know, the flu shot they the way they make it is they try to predict what the most prevalent strains are going to be, and that's what goes into the vaccine. And some years, their predictions are great, and some years, maybe not so much, but every boost, the way I think of it is, is better than not having any kind of protection.

Erin Brinker: 49:50

Now let's talk about kids heading off to college, because there's a very, very important, especially if you're going to be dorm living, there's a very, very important. Vaccine that I don't think parents really pay attention to, and that's meningitis. Yeah, talk

Dr. Neha Vaghasia: 50:06

about meningitis is a big one. I, you know, recommend that one to basically all my teams. I think you can get it as early as 11. I want to say, don't quote me on that, but, um, but, you know, up to age 18, and it's, it's huge, you know, you don't think of meningitis very often when, when people think about, you know, what kinds of things they can catch when you're going off to college, I think most people are probably worried more on the STD route than anything, in addition to, you know, the common coughs and colds, but meningitis is huge. And you know, the dorm living, the crowded situations, is just a wildfire way of spread and and meningitis can be deadly, and it can go quickly. And if you survive it, you might not survive it as like, full and healthy as you were before. Um, it can really cause a lot of neurologic devastation, and can throw blood clots people might lose, like fingers, toes, arms, legs because of it. And so there's a lot of devastation it could cause, even if, even if you do, survive it. So it's not, it's not a, it's not a pretty disease at all, and it is something that is, you know, very

Erin Brinker: 51:31

preventable. So what are some of the symptoms of meningitis? So meningitis,

Dr. Neha Vaghasia: 51:37

you know, people think of meningitis as fevers, headaches, but a lot of times it's, it's, it's the severity of those symptoms you get something called nickel rigidity, meaning that your neck area gets very, very stiff and you it's just very hard to, like, bend or move. You can be sensitive to light, even in more severe instances, like you'll have nausea, vomiting, or you can have a lot of confusion. Um, you're just not acting appropriately, or you're a little altered. Some people, in the younger children, they'll like the infants with meningitis. They will just be very, very irritable because they're just they're just not feeling good. They could be lethargic as well and not feeding as good.

Erin Brinker: 52:41

Wow. So that is, I

Dr. Neha Vaghasia: 52:43

could go down to the more scary

Erin Brinker: 52:44

symptoms. No, no, that's scary well. And I'm thinking, you know, there are some people, and I know some teenage girls that that have that get really bad migraines, like, really bad migraines. And some of those symptoms sound like migraine symptoms,

Dr. Neha Vaghasia: 52:57

yeah. So, like, the the sensitivity to light and the headache, definitely, and sometimes migraines can, you know, people can get nauseous to that as well, but the fever would be a big differentiation. You should not be having a fever with a simple migraine. You probably won't have that stiff neck either. And migraines, you know, they usually will be responsive to, you know, to some kind of medication, whether you take, like, ibuprofen or, you know, you just need to rest or whatever. And you know, for meningitis, you wouldn't have, like, your symptoms would continue to worsen, basically.

Erin Brinker: 53:35

So the most important question of the whole interview, do you watch medical shows and which one is your favorite?

Dr. Neha Vaghasia: 53:44

Oh my gosh, that's hilarious. So, you know, I so I won't lie. I grew up watching

Unknown: 53:53

General Hospital, great,

Dr. Neha Vaghasia: 53:58

and so I know all the old school characters. And then the funny thing was, was, when I was in my fellowship myself, my co fellow, we had this conversation about General Hospital, and we realized we both watched it because our moms watched it when we were children. And so one of our like outlets when we were in our training period was we would, we got back into General Hospital, and we would watch the episodes, and then, you know, we would, we would talk about them the next day, or we'd be texting each other, and we'd be laughing. We'd be like, Oh my gosh, how did they just do that? Like, that's so not medically correct, and it's so made up. And, you know, it's just hilarious, like, you know, it's medical TV to its its finest right there. And, and we just loved it. And so it brought us a lot of, a lot of, a lot of stress relief. I would

Erin Brinker: 54:56

say, That's awesome. I thought you were gonna say the pit or. Grey's Anatomy. But I hadn't even thought about General Hospital is

Dr. Neha Vaghasia: 55:04

fantastic. So that was probably my first, yeah, my first medical show ever that I, you know, religiously watched. And then I, you know, I never got so much into Grey's Anatomy that was during more my med school years, and a bunch of my classmates were into it. I I just, I felt like it was just so it was so dramatic. And, you know, it's a soap opera, but I did love the two shows that I did love were

Unknown: 55:36

house, oh yeah,

Dr. Neha Vaghasia: 55:38

and that was, it was a lot of like, that's puzzles, right? Like, yes, it's just like, this, this odd little case, and we gotta figure it out. It's still not realistic, as far as, like, you know, it's just this team of like, you know, one doctor and like, he's got a couple of couple of physicians on his team, his minions. And they can do everything. They draw their own lives, and they can do brain surgery, and, you know, but, but it was a lot of good puzzle work, and then I loved

Unknown: 56:10

scrubs. Oh, me too. Me too is probably,

Dr. Neha Vaghasia: 56:16

in some ways, so realistic to like a lot of the trials and tribulations you go through, you know, in your training years, and things that, like, you know, get get, like, dumped on you, or the things that you know, you just have these little inner dialogs of, like, Is this really happening? So the scrubs, scrubs is great, and then the pit. I've heard a lot of good things. But I have not, I've not watched

Erin Brinker: 56:42

that it's intense. It's intense. Yeah, it is. It's a good show. I mean, it's really, it's really, it's kind of er on steroids. It's really good. It's, it's an, I've heard from er physicians that it's very accurate. And so because, you know, it takes place in an ER, and the whole season is one day. So it's, it's an intense, it's an intense show. So we are completely out of time. So thank you so much for joining me today. You've been an absolute delight. Tell people how they can, you know, reach out to you. How they could follow you. Maybe, if they need a pediatric oncologist, get a hold

Dr. Neha Vaghasia: 57:15

of you. Yeah. I mean, you know, all of our Kaiser, Kaiser community is just so amazing. And so that's like, the the best way to get a hold of me is just, you know, like, ask your pediatrician, or, you know, just reach out. I am completely accessible. I don't actually have social media. I mean, I think I have a Facebook whose password I can't remember, and I have, like, a fake Instagram account where I just have it so that I can watch, you know, cute dog videos that people send me. But I don't really do a lot of the social media. I just find that, you know, once you get going on it, like, two hours go by and you're just like, what happened with all my time? So but yeah, I'm in the community. I'm here. I'm at SBC. My office is out of Fontana, and I'm I'm here for

Erin Brinker: 58:11

anything awesome. Dr, Vigo, thank you so much. You've been amazing, and thank you for the incredible work you do with kids who who need it the most.

Dr. Neha Vaghasia: 58:21

Well, it's been my pleasure. Thank you so much for having me and allowing me to advocate for some of our tiniest humans out there. Well,

Erin Brinker: 58:29

that is all we have time for today. Thank you so much for spending this time with me. I hope you enjoyed it as much as I did. You've been listening to the making hope happen radio show. For more information about the making hope happen Foundation, go to www.makinghope.org That's www, dot makinghope. Dot O, R, G, I'm Erin Brinker, and I'll see you next week.

Unknown: 58:57

Erin.