August 29, 2025 • 58 mins
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.
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Episode Transcript
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Erin Brinker (00:00):
Erin, welcome everyone. This is the
(00:11):
making hope happen radio show,and I'm Erin Brinker. Have a
great guest for you today. Sheis an incredible woman, a
pediatric oncologist andpediatrician, and her story is
really compelling, and theinterview is really fun, so I
hope you enjoy it as much as Idid. But before we get started,
I want to talk to you about whatI'm grateful for. Do you know
that gratitude helps rewire yourbrain, if you take the time
(00:32):
every day to intentionally thinkabout all the things that you're
grateful for, no matter howsmall that you have shoes to put
on your feet, that you have aroof over your head, that you
have money to put gas in yourcar, that you have a car, that
you have people who love you, ormaybe it's just your cat, and
that's okay, that you have yourcat who loves you. The more you
think about the things that youhave, the less you'll think
(00:56):
about the things that you don't.
And that dramatically impactswell being and mental health in
a very positive way. So I liketo make it a habit to as much as
possible talk about on this showwhat I'm grateful for, and I
think I said it last time or thetime before, I'm grateful for
this mild winter, sorry, summer.
It's not winter, this mildsummer that we're having. It has
(01:19):
been milder than I can remember,and last summer was pretty
brutal, with a lot of days over100 and we've had a few it's
been August. You know, July wasreally mild. August, we had some
days over 100 and looking movinginto September, and I'm hoping
that it just continues to bemild and into winter. I don't
know about y'all, but I'malready thinking about the
(01:41):
holidays and, you know, havingfamily in and the things I need
to do to the house to get itready, you know, all of that fun
stuff. It's all very exciting.
So the fall is my favorite andit's not just about pumpkin
spice lattes, although I do likethem. The fall is my favorite
season, and we have a couplethree weeks left before summer
(02:02):
isn't completely in the rearview according to the calendar,
and I'm looking forward to it.
So I'm grateful for a mildersummer, and I'm grateful for
the fall that is almost upon us.
It just makes me smile so andI'm grateful for every one of
you who are listening. Allright, without any further
delay, let's get going. Well, Iam very pleased to be sitting
(02:23):
down with Dr Neha vigashiya. Sheis an MD, MBA combo, something
you don't see very often. She'sa specialist in pediatric
hematology and oncology and theassistant chief of service for
the Department of Pediatrics atthe Kaiser Permanente Fontana
Medical Center, Dr Vikas,
Dr. Neha Vaghasia (02:42):
Thank you so much Erin for having me so to
welcome to the show.
tell us about your your journeyinto medicine.
Erin Brinker (02:50):
What made you decide to go to medical school?
Dr. Neha Vaghasia (02:54):
Yeah, I mean, I think that's always
very popular question that evenmy patients or their families
will ask me. And I think, youknow, when I was young, and even
at the start of college, Ialways thought I was going to be
an engineer and follow in my mydad's footsteps, and I had a
(03:15):
very strong background inmathematics and physics. I
enjoyed those classes. I alwaysdid really well. And I started
college in engineering, andgot to a point, you know, I
think in my second year, where Ijust found a lot of the
(03:38):
mathematics so abstract, soalmost like outer space math,
and just have this likerealization one day, as far as,
like, how does this relate towhat we're doing here on this
earth? Like, how is thisapplicable? And at the same
time, I'd been taking some somecourses in physics. But they
(04:00):
were, they were kind ofapplicable to life sciences. And
so they were looking at, youknow, physics according to,
like, the human skeleton. And Ifound those really, it was
really a fascinating applicationof it. And I switched track a
little bit and learn that, youknow, these, like the
(04:23):
chemistries and some of the moresciences. It didn't come as
naturally to me, but I was sointo it because it was
challenging for me, and I justcontinued to pursue that. And I
was, you know, involved in abasic science research lab as an
undergraduate, and just got moreand more exposure in the life
(04:46):
sciences. I did some volunteerwork at a local hospital, and it
just, it just kind of grew fromthere. I bet you liked puzzles
as a kid. I probably did. I'llhave to ask.
My mom.
I had a brilliant colleague anumber of years ago who ended
(05:07):
up, she got her PhD in in childdevelopment, and she she just
loved doing puzzles. She would,you know, she said, I took the
SAT strategy books and just didthe puzzles for fun. She was
brilliant, like, oh, I don'thave that mind, so I'm in awe of
people like you. And say it'syou say, it was a challenge, but
I enjoyed it. You know, thinkabout organic chemistry and all
(05:27):
of these other things, even, youknow, all the biomechanics, all
the physics, that's incredible.
And so I bet How did your familyreact when you decided that you
didn't want to be an engineer? Imean, I think they were excited.
You know that, you know, there,there was the potential for to
have a doctor in the family. Youknow, my parents were
immigrants. They moved to thiscountry in the 70s, and so, you
(05:49):
know, I'm the first one to to,you know, get my undergraduate
degree here in the US. My my mydad had done a Masters, but, you
know, like, kind of like thefirst one, and so I think they
were excited for that potential.
(06:09):
My, my father, who is nowretired, still has held on to
every single valued engineeringbook that he owns, and every
once in a while will lamentthat, you know he doesn't have
anyone to pass
Unknown (06:26):
this on to that sound
Dr. Neha Vaghasia (06:27):
little part of him, I think that you know
this still exists where, whereyou know there that pride of
like, you know, having, havingsomeone 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 (06:44):
that's awesome.
Well, maybe he'll maybe astudent who needs to be mentored
at some point will need thosebooks, and he can pass it on to
those, to that student Exactly,exactly. So you're in medical
school, and I know that you getto see a lot of different
specialties. And so what? Whatwas it about pediatric health
care that drew you in?
Dr. Neha Vaghasia (07:04):
You know, I actually just recently told this
story to my husband and a goodfriend, and it was this very
interesting journey of where youfelt you fit the best. And I
know people make these careerdecisions for a variety of
(07:26):
things, but for me, it wasreally just like, where do I
feel like I fit in the best? Andpediatrics just was such a
natural fit for my personalityand my comfort level, being able
to talk to children and beingalso an educator. You know, I
(07:47):
think one of the things that'sreally great about this field,
especially in pediatrics, isthat not only are you a
physician, but you're a teacher,also you have to find different
ways to teach, different ways toexplain things to children at
their level, to families fromall sorts of different
backgrounds. And it just was areally nice, natural fit for me.
Erin Brinker (08:12):
That's wonderful.
And pediatrics is from themoment that child is breathing
oxygen through their 18thbirthday, right?
Dr. Neha Vaghasia (08:19):
Yeah, I do have this small little group of
adolescent young adults that wemight follow in their in their
late teens, up to maybe 21 butfor the most part, it's up to
age 18.
Erin Brinker (08:34):
Wow. So what would you say are the most common
health concerns that you'reseeing in children today, and
how has that changed over theyears, over your the course of
your career,
Dr. Neha Vaghasia (08:45):
you know? So that's a great question. I think
when I did my training, I wasreally well trained in, you
know, just the traditionalconcerns, there was things like
infections and asthma andallergies and, you know, the
developmental milestones ofchildren and all those things
still exist, and they still arevery much seen and treated. But
(09:13):
there's a lot of newer thingsthat have come into play, and
there are things like mentalhealth concerns that, you know
is becoming more and more of achallenge with kids. There's a
big rise in anxiety behavioralconcerns. I think a lot of that
has to do with just thepressures of social media,
(09:41):
digital exposures, you know,different social social
pressures, basically. And thenthere's, you know, just other
health conditions that seem tobe more challenging than they
were even 1015, 20. Years ago,such as obesity, and with that
(10:02):
comes a lot of othercomplications that we see, like
diabetes or pre diabetes, fattyliver disease. And then, because
we all like to get better atwhat we do, we you know, there's
a lot more screening forconditions, so screening related
issues like that come up whereyou pick things up because
(10:25):
you're doing a better job at atmonitoring 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 longand go play, right? So they
didn't they, they, if they, ifthey had an issue with another
kid, and they usually resolvethat on the school yard, good or
bad, that's what they did. Orthey in the playground. They'd
hop on their bikes and be outwith their friends all day, you
(10:54):
know, once their homework wasdone and and so they learned how
to manage their own emotions.
They learned how to do conflictresolution. They learned how to
problem solve their way out ofwhatever pickle they got
themselves into. And all of thatis gone, and what they're seeing
now is a hyper curated, scrubbedenvironment where all the people
(11:15):
are beautiful. Everythingthey're doing is perfect. And
then the flip side of that isthe abusive side of social
media, where people will say themost horrendous things to to
each other because they'rekeyboard warriors. And that, you
know, adults have a hard timeprocessing all of that. I can't
imagine what that does to thepsyche 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. Itallows us to make connections
and bridge gaps, and, you know,keep in touch with people or
learn about other people. Butthe bad is, it's ugly and it's,
it puts a lot of pressure onthese kids, you know, the the
(12:01):
influencers and the tick talkersand and it it's whether it's
pressure or it's, you know, justplain bad advice being given
out. But it's, it's not easy formany of the kids to process
that, like, Hey, I don't have tobe like this. I'm comfortable my
(12:23):
own skin.
Erin Brinker (12:26):
Yeah. And so it really they, you know, as
parents, as doctors, as acommunity around them, we have
to teach them, because they haveto learn that that's how they
need to be, right, that that'show they come about. This is to
have this, this sense of whothey are. And, you know, there's
a time when you're, you know,before you're 25 where that that
(12:47):
that idea of who you are isstill 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, notjust for kids, like they're
still growing, they're stilllearning, they're still evolving
into themselves and, and even, Imean, you threw up the number 25
and, you know, I think of myselfas when I was in my 20s. And, I
mean, I just think like, oh mygosh, I was, I was so young. And
yes, some of these things that Imight have done, or, you know,
(13:15):
didn't do, they probably saidsome really stupid things,
exactly like, gosh, and I was,you know, a, you know,
considered an adult, and, youknow, made, made my own
decisions, and I could vote, andI could, you know, have all
these responsibilities. But it'sa lot. It's definitely a lot.
Erin Brinker (13:36):
So, so connecting with the doctor, so creating a
medical home, I think, would isimportant not only for mental
health, but physical health.
And, you know, some people don'tthink about going to the doctor
till they have a problem, youknow, they have the femur or
whatever. And so what would yousay to a parent who's they've
just had a baby, they kind ofwant to figure out how to
navigate the healthcare side ofof parenting. What would you
(13:59):
tell them? You know,
Dr. Neha Vaghasia (14:03):
I am such a firm believer that the well
child visits, they're sofoundational, and especially in
like the newborn, the growingchild, they allow us to monitor
their growth and theirdevelopment. You know, we're
making sure that, hey, you'regaining weight, you're getting
(14:23):
taller, appropriately. It allowsus to catch issues earlier a lot
of times. And more importantly,also, you build that trust with
families. You know, having a newbaby, new parenting, even old
parenting, that's, it's hard,it's hard. Things change. And,
(14:46):
you know, sometimes what youknow we we did as we were
taught, you know, as, asparents, from, you know, by our
grandmothers or whatever, likeyou kind of, you're like, that's
probably not what's best. How weknow this, you know, I have, I
had this attending when I was aresident, and he was a
(15:07):
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 atall, the thing, and you just got
(15:31):
condensed
Erin Brinker (15:32):
milk. I'm a Gen X er, and I, and I know that
that's that is 100% true, andyou have to feed your baby on a
schedule. Baby's hungry. Doesn'tmatter. They're not eating till
one, which is, you know, Ididn't do that with my child,
but my mom and I would get intoarguments in her generation.
That's what they taught,
Dr. Neha Vaghasia (15:50):
yeah, and so.
And it was just, you know, veryit was hilarious. He would tell
you, told the story a milliontimes 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. Butpart of it is also, hey, we have
a lot of evidence that showslike, why breastfeeding is
better or better for your baby,nutritionally, immunologically,
(16:15):
well, it's cheaper and it'scheaper 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 wellchild visits, they're just,
they're so important, they're sofoundational. They just provide
so much opportunity for thedoctors to to educate on, you
know, growth and development andvaccinations and screenings and
all of this is meant tocontribute to just an a
(16:51):
healthier outcome for for foryour
Erin Brinker (16:53):
child. So we're kind of laughing about
differences in parenting, youknow, generational or whatever.
But overall, we're really hardon mothers, and mothers are hard
on each other. You know, likeyou, you have to breastfeed from
here to there. You have to beable to do this. This is the way
it's supposed to be. If they'renot gaining weight at this rate,
or if they're not talking orwalking when I think they should
be, then something wrong withyour parenting. Or it's really
(17:16):
hard to be a mom and and so, youknow, talk to talk to that
mother who may be their child isnot developing where the way
they think they should be, ormaybe they're not taking the
breast milk. You know, whatwould 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 ofpressure. And, I mean, there's
even more pressures now, becausethere's so many working moms out
there, you know, and even ifyou're not a working mom, it's
not easy being a full time momand anything, you know,
(17:52):
sometimes you need to take thatlittle bit of a step back and
say, Hey, I rec. I recognizethat as a doctor, I'm
recommending you know, exclusivebreastfeeding, for example, for
your baby, but I also as a humanbeing, can recognize that this
(18:12):
is really hard, and maybe somepeople are not able to do that
exclusively, and maybe somepeople, just for whatever
reason, aren't able to producethe milk, or they, you know,
there's just so many, so manyreasons why people might not be
able to, and it's a lot ofpressure. And I've seen new moms
(18:33):
like, I mean, just cryingbecause they genuinely are
distressed that they're doingsomething bad for their baby.
And in my heart breaks when youreach that point with a mom,
because that, you know, for me,that's never my intention when I
when I give advice and, like, Idon't know how many times I've,
(18:55):
you know, had to just like, sitdown and say it is okay. Your
baby's dehydrated, your milk'snot in right now, let's we need
to give your baby like, somefluids, or we need to give your
baby a bottle. But I promiseyou, I promise you, your baby is
still going to grow, and yourbaby, you're going to get there.
Your baby will still go tocollege, if you want them to go
(19:17):
to college. Like we're we're notlike, you know, unhinging the
right 20 year trajectory foryour child like by deviating a
little bit from what, what youthink, 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 hislast that child. I was a Jersey
cow, and I just did not haveenough. And so I still breastfed
him, and we supplemented withformula. And by six months he
and I don't know if they do thisthis way anymore, we started
giving him cereal in his milk, alittle cereal in his milk,
(19:53):
because he he he just was hungryall the time. Now, he's six,
three now, and so he was just.
Hungry, and once I got past theguilt of thinking that I didn't
do it the perfect way, it wasfine, and we were able to find a
way that, working with ourdoctor, we're able to find a way
that was able to meet thenutritional needs of our son,
(20:13):
and we were good,
Dr. Neha Vaghasia (20:18):
yeah, and I think that's the biggest part,
is maybe not so much like, youknow, letting go of what you
what you think the path has tobe or should be, because that is
somehow equates to you being thebest parent, right? I think you
being the best parent is workingwith your doctor exactly how you
(20:42):
did, and making sure thatwhatever the needs are of your
child are being met, howeverthat might
Erin Brinker (20:49):
happen. So we talked about, I've had other
physicians on this show talkingabout issues that happen in
adulthood and diabetes, that arethings 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 frontof you, let's talk about
preventative care and what thatlooks like in infancy, moving
(21:10):
through childhood andadolescence.
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, thevaccinations, getting all your
your baby shots in, like, peoplelike to call them, and so those
are things like, you know, yourwhooping cough and your measles
and your your, you know,diphtheria and all of those
(21:37):
things. And it's also meant tobe making sure that the
trajectory of the growth and thedevelopmental milestones are on
track. And then as you getolder, you know the school age
children, I think thepreventative care is the shift.
(21:58):
It's maybe less focused onvaccines, because they're not
happening as quickly, but thereare still the concerns of growth
and development, maybe even ashift of you Know, the
overweight, obese population andnutrition, diet, exercise, and
(22:25):
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 preventivemedicine takes a big change.
There are some vaccines thatcome into play during during
(22:46):
that stage as well, but there'sa lot of mental health, um,
there's still the obesity, diet,nutrition, kind of screening
that happens, but there's alsonow the the education on and
screening for, hey, are therehigh risk behaviors? Is there
concern for substance abuse? Isthere concern for, you know, any
(23:11):
kind of like, unprotected sex,like those, all those, all those
triggers so your conversationscan vary, you know,
tremendously, depending on evenjust what the age of the patient
is that you're seeing inpediatrics.
Erin Brinker (23:24):
Well, you know, you mentioned vaccines, and
there's so much online chatterabout vaccines, and, you know,
there's some people who don'tvaccinate their kids at all, and
I just think that's wrong atevery possible level. You know,
whooping cough can kill yourbaby. So I think that's wrong on
every level, but there are somevaccines that I'm wondering why
(23:46):
an infant needs them, like hep Band so can you kind of address,
and this is really a question ofdosage and timing. I understand
protecting protecting kids, butcan you kind of talk about the
vaccines that happen when you'rewhen 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 theexposure, and, you know, the age
group and who's more high atrisk, right? So your your
whooping cough, you know, orRSV, even where are so heavily
geared towards infants, becausethese are things that you know,
(24:28):
infants can be highlysusceptible to, to having such
bad outcomes if they get sickfrom this, some of it is also
driven by by the data, wherethey look at like a lot of
pharmaco logic,pharmacokinetics, as far as you
know, vaccines based off of ageand what the immune response is
(24:53):
and how good of a robust likeimmune response to people get
from it. So H. Is kind of a goodexample of that. Generally, most
people will start giving it atage 11. You can give it as young
as age nine, and then I believeafter age 13, you go from
(25:14):
needing two doses to actuallythree doses. And that has been
shown in the data, that theolder you are, the less of a
response your body mounts. Andso your protection against the
against the virus, is just notas good. And so that's why they
had to add a third dose in. Sothat's why also a lot of
(25:35):
vaccines might even have a cap,like after a certain age, like,
whether it's the the risk is notthere anymore or it just is not
going to your body's just notgoing 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 towork. Yeah. So do you? Do you
have parents who come to you andsay, yeah, maybe I don't want
that hepatitis B vaccine for mybaby. But, you know, I want all
of the rest of them, do theyhave the flexibility, or are
they required to do the vaccineson 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 differentstyles to vaccination from
parents. And you know, I in myrole as an oncologist now I
probably deal a little bit lesswith that, mostly because when
(26:29):
kids are undergoingchemotherapy, we're not
vaccinating them. But when I diddo general pediatrics, I would
say I had a lot of people whodid not want to do hep B at
birth because they knew it wascoming in the two month and the
four month and the six monthshots. Or, you know, they wanted
to hold off on the vitamin K,which isn't even a a vaccine,
(26:57):
but you know, it's justsomething that they for their
baby, they choose that we justwant a very natural approach to
our baby. Is that vitamin K forclotting, yes, for clotting,
yeah. So it's a very importantvitamin that our liver needs in
order to make clotting factors,where nobody is born with good
levels of it, and so there's astrong risk for for bleeding,
(27:20):
head bleeds, all of that in theinfancy phase. So that's why
vitamin K got added in to helpprevent a lot of those
comorbidities, basically.
Erin Brinker (27:34):
So that is, that is, that is really interesting,
and I get frustrated with theway our media handles this issue
of vaccine. It's either all goodor 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 themdo, you know, tell me why. Tell
me why. This one's important.
Now, you know, saying that thatyour your baby doesn't have the
(27:56):
ability to create clots like heneeds to is, and this is why the
Vitamin K is, is, is required. Imean, that's, that's important.
And I wonder how many people sayI don't want that because they
don't understand what it doesand 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 ofmisinformation out there, or
there's just a lot of partialinformation out there. And you
know, that's part the detrimentof us having information readily
at our fingertips, right? LikeDr Google, you can, you can find
anything on the internet. Andyou know, now we all have
(28:35):
phones, and you know, we canfind anything at any point in
time. And you know, and some ofit's good information, and some
of it's maybe not so goodinformation. And you know, one
of the things I tell my parentsis like, Hey, I have zero
problem in you going out thereand trying to educate
yourselves, but do itresponsibly. You know, don't
(28:58):
maybe get your information offof someone's Facebook post, or,
you know, Tiktok. Like, look atactual reputable sites, right?
Like, look, you know, there's somuch patient handout information
on the American Academy ofPediatrics. There's so much
information through, you know,Mayo Clinic, and a lot of like,
(29:20):
reputable, reputable site. So,so, you know, be a little
responsible for where you'regoing 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 whatyou want to stick to, like
you'll, you'll be able to findinformation out there somewhere
to like, you know, support that,because there's just the
information exists foreverything out there, right? But
(29:42):
you know it, part of it is also,you know, using, using
information responsibly, andthat's, that's my role, is
trying to, you know, hey,educate and let's have a
conversation. What are yourconcerns? Let me hear them, so
that maybe I can help addressthem. And sometimes. That's
literally all it takes, yep, um,that's, you know, and it's just,
(30:06):
it's just helping to fill inthose 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 averageperson can't read and understand
an abstract or, you know, astudy, 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 ascientific 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 starttalking 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 walkingbag of hormones, and your brain
falls out of your head for a fewyears. And so the the change,
you know, the that's when themoodiness and what we would call
(30:58):
surliness appears and all of theand we expect that when you're
1112, 1314, years old, butyou're seeing mental health
issues in younger children. Canyou talk about that?
Dr. Neha Vaghasia (31:09):
Yeah. I mean, I you know, there's so much that
goes into play with mentalhealth now, and we're seeing
just anxiety even in like theyoung kids. And you know, some
of this might be generational,and, you know, like, differences
in, like, parenting style, butyou know, whatever the root
(31:29):
cause is, like, we're seeing itand, you know, it's, um, it's
going to manifest differently. Ayoung, five, six year old is not
going to tell you, like, I feelanxious, right? They're going to
manifest in different ways.
There might be having stomachpains, and that's all that
they're telling you. They mighthave changes in sleep or
(31:52):
appetite, just their moodoverall might seem funky, but
you can't pinpoint it lookingat, you know, school
performance, or school you know,like activity, or they might be
a little bit more withdrawn, orthey might just be more
irritable, but all those littlethings you know, are little,
(32:14):
little flags that kind of comeup. And so, you know, trusting
your instincts as a parent isreally important. So if it, if
something feels off, it'sdefinitely worth exploring and
bringing up to yourpediatrician. 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 kidswho manifest anxiety or stress,
(32:35):
like with with GI symptoms andso, which creates even more more
stress for the parents, becauseI 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 gottado this. I need, you know, to
(32:56):
talk to a specialist. I need,you know, all these tests and
and really the underlying causeis not so much, maybe the gut
system itself. But how are ourmental 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 notunderstand it, but if mom and
dad are always fighting, ifsomebody's lost their job and
they all of a sudden don't haveany money, if a car gets
repossessed, somebody getsdeported. There's a divorce in
the family, and people say kidsare resilient, but, but, and
that's dismissive, because kids,they don't necessarily know
(33:30):
what's happening. They just knowthat 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 toarticulate that, or vocalize
that. It's it's hard, you know,because they're aware, and
they're a lot smarter thansometimes we give them credit
for, a lot more aware than whatwe give them credit for. But how
they display that stressor willbe different than how a 20 year
(33:56):
old or a 30 year old or a 50year old would.
Erin Brinker (33:59):
So, you know, so much of what a child's ability
to manage their own stress andto regulate their own emotions
comes down to parenting, andthat's you know, and a full
disclosure the making hopehappen. Foundation where I work,
we have a program for familieswith children ages zero to five,
in partnership with our localuniversity to help parents
(34:23):
maximize brain development andemotional development during
this window. And so you know howa parent reacts to stress
dramatically impacts a child. Sohow do you talk to parents as a
physician, about about that?
Because I imagine that's prettytouchy subject.
Dr. Neha Vaghasia (34:38):
It is, it is, and you know, it's, it's
something that often I find inmy role as an oncologist, I have
to have this conversation,because the stress levels are
just running high, left, rightand center with everybody you
know, the the parents are superstressed for for their children
who you know are getting.
Seeing, getting chemotherapy andgoing through, you know, cancer
(35:02):
treatment, the stress levels arehigh for their surrounding
family. It's all, you know, on,you know, being kind of funneled
down to the kids. And a lot oftimes it takes just, you know,
taking them aside, separatelyfrom from in front of the child,
and just having thisconversation that you know, like
(35:24):
it's okay to feel sad, it's okayto be frustrated, it's okay to
have you know your your thoughtsand your emotions, that is 100%
natural. But your your kid islooking to you this entire time,
(35:44):
you know, they're having to cometo the hospital, they're having
to go to the doctor, they'rehaving to get, like, you know,
things done, procedures donethat they don't, that they're
scared of, but they, at the endof the day, they're going to be
looking to you. So you have toin the in front of your child.
Have that confidence, have thatyou know that that plan for them
(36:06):
and that comfort for them, thatthey are safe, they are okay,
you are with them, and not letyour 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 areare afraid or stressed, you're
(36:27):
crying, you know, like that, allwill, you know, be noted by your
child and picked up by yourchild. And so I encourage my
families to, you know, to whatthey need to do to to keep up
their strength. You know, takebreaks from the hospital, go for
(36:48):
walks, you know, make sure thatthey're eating their meals and
getting, you know, some steps inand just taking that, that that
time, just even if it's like1520, minutes in the day, just
to kind of step outside fromfrom everything that they're
going through, making, you know,leaning on their support
(37:08):
systems, even, you know, if theyneed someone to talk to, you
know, absolutely like, we have,like, plenty of like therapists
and behavioral healthspecialists that can, that can
help connect with the families.
So there's a lot of opportunityfor early interventions that can
make a big difference in theirjourney.
Erin Brinker (37:30):
Well, that's wonderful. You know, I think a
child having cancer is one ofthe scariest things a family can
face. Are you seeing an uptickin the number of cancers, or
just better diagnosis, earlydiagnosis? 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, Ithink there's maybe we see more
here, more just because peoplehave been, you know, relocating
(38:12):
to other parts of southernCalifornia. And are, you know,
population has kind of grown,but, but overall, I don't know
if there's necessarily, like, ahuge trend upwards. I think
people are definitely gettingbetter at picking up on
symptoms. And, you know,pediatricians are, you know,
great at what they do, as far asyou know, getting workups and
(38:36):
and it's hard with children,because children are supposed to
be they're supposed to behealthy and common things being
common most of the time. Like,if you have a kid that you know
has had some fevers and sometiredness, 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,
(38:58):
like, Oh, it sounds like you'vecaught, like, some kind of a
bug, as all children do, and itshould go away and get better in
five to seven days or so. Andyou know, it's not the most
common thing to say or torealize that, like, Oh, these
little symptoms all ticked up,and this was actually a new
cancer diagnosis in play. And sosometimes it does take, you
(39:22):
know, a couple of trips to thedoctor because things aren't
getting better, but, but I wouldsay that, you know, our
pediatricians do a great job at,you know, screening and and
coming to coming to theseconclusions when things are just
not right.
Erin Brinker (39:41):
So that begs the question, and I appreciate that.
And what begs the question abouthealth, equity and access, you
know, because if you are part ofand I have as a Kaiser member,
and I've been a Kaiser memberfor a really long time, I feel
like I'm super spoiled, becausethe whole system is in the
system. You don't have to waitto the. Referral to get
(40:01):
transferred to here, and youwait for that person. All your
records are over there, and ittakes forever. And, you know,
and, but what if you, what ifyou don't have access? What are,
what are some things being done?
And I know that you work forKaiser, but what are some things
being done to make sure thatthat 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 yourgeography or lack of
transportation, language is ahuge one, lack of awareness or
education, financialconstraints, and it's, you know,
I would say, you know, that atKaiser, there is just so much
(40:41):
that has been pioneered to helpovercome those things. It's
amazing. You know, we have somuch that has come out of covid
with, like, virtual care, and,you know, being able to, like,
send some emails to your doctorand attach a photo. And you
know, there's just so much thatthat can be done to kind of
(41:04):
circumnavigate some of these,these barriers. But I would say
that I think a lot of healthcaresystems in general are
acknowledging that. I did myfellowship training at UCLA, and
I remember we had patients thatcame from everywhere. I mean, we
had patients that, you know,were, were referred to us from
the Bakersfield area. And thatis, that is thought that's a
(41:27):
long way, and it has a long way,a long, long way. And there was,
there was a ride share, therewas a UCLA rideshare van that
that brought these patients, youknow, very early in the morning.
They, I think they left, like at5am or something like that. But
they they would bring thepatients down. People could have
(41:48):
their appointments and then getback on the rideshare and go
back up. And it was a long dayfor these families, but there
was a way to get them, to getthem taken care of. And this was
before you know, anybody wasreally doing virtual care. So
it's nice to see that like,yeah, there are, there are
(42:09):
things you know that are, thatare 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 docommunity partnerships play in
improving pediatric healthoutcomes?
Dr. Neha Vaghasia (42:26):
Um, you community is just so it's just
so strong for pediatrics. Ithink, you know, I see so much
community outreach. As anoncologist, we have just, I
mean, so many foundations orpeople that just donate, either
their time or you know, theirresources towards families in
(42:50):
need, whether it's financialhelp or, you know, help with
gift cards or gas cards for orgrocery cards, you know, or even
donations of like, you know,snacks and toys and backpacks
and things like that. And sothere's, I see so much community
outreach. I think there areprograms that are also being put
(43:15):
forward to help withtransportation. I even recently
have learned that, you know,medical patients do have access
to Uber for their doctor'sappointments. So getting getting
patients, you know, rides,basically to make sure that they
(43:38):
can keep their appointments. Ithink there's a lot more that's
being done now than there waseven, like 1015, 20 years ago.
Erin Brinker (43:46):
So what are some emerging trends or things that
people need to know with theirkids heading back to school and
obviously get a lot of kids inone in one room that haven't
been around each other, they'reall 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 mypatients, are coming in with
sniffles and coughs and stuff,and they've all gone back to
school in the last couple ofweeks. And, you know? And that's
just the the beauty of being achild, right? You You're meant
to build up your immune system.
You're gonna catch everything,and then you're gonna spread the
(44:27):
love and spread spread things aswell. And I do feel that there
is more awareness out there asfar as how things are spread,
right? Like, you know, we didnot completely emerge out of the
code pandemic, like, justoblivious to to how diseases are
(44:48):
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 abit. As most of society has, but
we, we learned a lot. And so Ithink, you know, not forgetting
that, um, and a hand hygiene ishuge, and kids are terrible at
(45:11):
it, like, let's be real. Theytouch everything they do and and
then after they're done touchingeverything, they're touching
their faces, they're touchingtheir mouths and so, and it's
just like, I don't know. There'sjust 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 teachinggood hand washing practices,
like we having those habits,like we wash our hands before we
eat, no exceptions, right?
Putting a little thing a handsanitizer in their backpacks,
like, you know, when cover yourcough, like those are, you know,
(45:53):
like all the kids, they knowabout the cough pocket now,
right? Like this, off in yourelbow. They got that, you know,
using tissues. So there arethings that you can definitely
teach these good habits, um, andthen 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 thathas to be reinforced over the
course of our lifetime. Andhopefully by the time you reach
adulthood, you've got to figureout 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, andin addition to the hygiene
stuff, you know, how does the,how is the covid pandemic? How
did it change the way pediatriccare 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 abacklog of patients, you know,
needing to get in for theirphysicals, for their vaccines.
And so we had to get creative.
We had like an outdoor drive upvaccine tent going on so that
(47:00):
people could still keep up withtheir their well child visits,
at least, get their vaccines,get their vitals taken care of,
you know, and and not be monthsand months delayed, I think, in
terms of practices you know,people are definitely a lot more
(47:22):
aware of of, you know, catchinginfections. I think people have
more awareness about vaccine.
Some of it may be good. Some ofit maybe not so much. Um, you
know, there's a lot of, a lotof, I think, vaccine hesitancy
(47:46):
that also crept up with with thepandemic that unfortunately is
still lingering. But we, youknow, 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 historybehind these? You know, we're so
(48:07):
lucky in this country to havethe amount of healthcare access
that we do, to have thesevaccines. And I think a part of
society has just forgotten whatthese diseases looked like, and
what they did and or what theycan do even, you know, even
things like the flu that it'stalked about every winter
(48:30):
season. And, you know, werecommend flu shots for
everybody every year. And youknow, I think people just kind
of forget or get a littlecomplacent, but we lose lives
every year, every year to eventhese, these simple things, and
people die. You know, people dieof the flu every year, even
(48:52):
including children and family
Erin Brinker (48:55):
members who had the flu this year, right? This
last time was last cycle. Lastwinter, their fevers hit 104
they were at the hospital. Andthe hospital they they went to
the emergency room, and theywere not admitted, but it was
like it would there. They werenot alone. There were a lot of
people who got the flu that bad,and these are healthy adults.
And so you you never know whatthe virus, what this next virus,
(49:17):
set of viruses, is going tobring, yeah,
Dr. Neha Vaghasia (49:20):
and so and flu is one of those things that,
you know, the flu shot they theway they make it is they try to
predict what the most prevalentstrains are going to be, and
that's what goes into thevaccine. And some years, their
predictions are great, and someyears, maybe not so much, but
(49:41):
every boost, the way I think ofit 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 thinkparents 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 tobasically all my teams. I think
you can get it as early as 11. Iwant to say, don't quote me on
that, but, um, but, you know, upto age 18, and it's, it's huge,
(50:27):
you know, you don't think ofmeningitis very often when, when
people think about, you know,what kinds of things they can
catch when you're going off tocollege, I think most people are
probably worried more on the STDroute than anything, in addition
to, you know, the common coughsand colds, but meningitis is
huge. And you know, the dormliving, the crowded situations,
(50:50):
is just a wildfire way of spreadand and meningitis can be
deadly, and it can go quickly.
And if you survive it, you mightnot survive it as like, full and
healthy as you were before. Um,it can really cause a lot of
neurologic devastation, and canthrow blood clots people might
(51:11):
lose, like fingers, toes, arms,legs because of it. And so
there's a lot of devastation itcould 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 issomething 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 oftimes it's, it's, it's the
severity of those symptoms youget something called nickel
rigidity, meaning that your neckarea gets very, very stiff and
(52:02):
you it's just very hard to,like, bend or move. You can be
sensitive to light, even in moresevere instances, like you'll
have nausea, vomiting, or youcan have a lot of confusion. Um,
you're just not actingappropriately, or you're a
little altered. Some people, inthe younger children, they'll
(52:27):
like the infants withmeningitis. They will just be
very, very irritable becausethey're just they're just not
feeling good. They could belethargic 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 aresome people, and I know some
teenage girls that that havethat get really bad migraines,
like, really bad migraines. Andsome 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, peoplecan get nauseous to that as
well, but the fever would be abig differentiation. You should
not be having a fever with asimple migraine. You probably
won't have that stiff neckeither. And migraines, you know,
(53:19):
they usually will be responsiveto, you know, to some kind of
medication, whether you take,like, ibuprofen or, you know,
you just need to rest orwhatever. 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 medicalshows 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 upwatching
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 hadthis conversation about General
Hospital, and we realized weboth watched it because our moms
watched it when we werechildren. And so one of our like
(54:19):
outlets when we were in ourtraining period was we would, we
got back into General Hospital,and we would watch the episodes,
and then, you know, we would, wewould talk about them the next
day, or we'd be texting eachother, and we'd be laughing.
We'd be like, Oh my gosh, howdid they just do that? Like,
that's so not medically correct,and it's so made up. And, you
(54:40):
know, it's just hilarious, like,you know, it's medical TV to its
its finest right there. And, andwe just loved it. And so it
brought us a lot of, a lot of, alot of stress relief. I would
Erin Brinker (54:56):
say, That's awesome. I thought you were
gonna say the pit or. Grey'sAnatomy. But I hadn't even
thought about General Hospitalis
Dr. Neha Vaghasia (55:04):
fantastic. So that was probably my first,
yeah, my first medical show everthat I, you know, religiously
watched. And then I, you know, Inever got so much into Grey's
Anatomy that was during more mymed school years, and a bunch of
my classmates were into it. I Ijust, I felt like it was just so
(55:25):
it was so dramatic. And, youknow, it's a soap opera, but I
did love the two shows that Idid 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'sjust like, this, this odd little
case, and we gotta figure itout. It's still not realistic,
as far as, like, you know, it'sjust this team of like, you
know, one doctor and like, he'sgot a couple of couple of
physicians on his team, hisminions. And they can do
(56:00):
everything. They draw their ownlives, and they can do brain
surgery, and, you know, but, butit 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 yougo through, you know, in your
training years, and things that,like, you know, get get, like,
dumped on you, or the thingsthat 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
(56:40):
lot of good things. But I havenot, I've not watched
Erin Brinker (56:42):
that it's intense.
It's intense. Yeah, it is. It'sa good show. I mean, it's
really, it's really, it's kindof er on steroids. It's really
good. It's, it's an, I've heardfrom er physicians that it's
very accurate. And so because,you know, it takes place in an
ER, and the whole season is oneday. So it's, it's an intense,
it's an intense show. So we arecompletely out of time. So thank
(57:05):
you so much for joining metoday. You've been an absolute
delight. Tell people how theycan, you know, reach out to you.
How they could follow you.
Maybe, if they need a pediatriconcologist, get a hold
Dr. Neha Vaghasia (57:15):
of you. Yeah.
I mean, you know, all of ourKaiser, 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 amcompletely accessible. I don't
actually have social media. Imean, I think I have a Facebook
(57:39):
whose password I can't remember,and I have, like, a fake
Instagram account where I justhave it so that I can watch, you
know, cute dog videos thatpeople send me. But I don't
really do a lot of the socialmedia. I just find that, you
know, once you get going on it,like, two hours go by and you're
just like, what happened withall my time? So but yeah, I'm in
(58:01):
the community. I'm here. I'm atSBC. 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 thankyou for the incredible work you
do with kids who who need it themost.
Dr. Neha Vaghasia (58:21):
Well, it's been my pleasure. Thank you so
much for having me and allowingme 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 timewith me. I hope you enjoyed it
as much as I did. You've beenlistening to the making hope
happen radio show. For moreinformation about the making
hope happen Foundation, go towww.makinghope.org That's www,
dot makinghope. Dot O, R, G, I'mErin Brinker, and I'll see you
next week.
Unknown (58:57):
Erin.
Erin, welcome everyone. This is the
(00:11):
making hope happen radio show,and I'm Erin Brinker. Have a
great guest for you today. Sheis an incredible woman, a
pediatric oncologist andpediatrician, and her story is
really compelling, and theinterview is really fun, so I
hope you enjoy it as much as Idid. But before we get started,
I want to talk to you about whatI'm grateful for. Do you know
that gratitude helps rewire yourbrain, if you take the time
(00:32):
every day to intentionally thinkabout all the things that you're
grateful for, no matter howsmall that you have shoes to put
on your feet, that you have aroof over your head, that you
have money to put gas in yourcar, that you have a car, that
you have people who love you, ormaybe it's just your cat, and
that's okay, that you have yourcat who loves you. The more you
think about the things that youhave, the less you'll think
(00:56):
about the things that you don't.
And that dramatically impactswell being and mental health in
a very positive way. So I liketo make it a habit to as much as
possible talk about on this showwhat I'm grateful for, and I
think I said it last time or thetime before, I'm grateful for
this mild winter, sorry, summer.
It's not winter, this mildsummer that we're having. It has
(01:19):
been milder than I can remember,and last summer was pretty
brutal, with a lot of days over100 and we've had a few it's
been August. You know, July wasreally mild. August, we had some
days over 100 and looking movinginto September, and I'm hoping
that it just continues to bemild and into winter. I don't
know about y'all, but I'malready thinking about the
(01:41):
holidays and, you know, havingfamily in and the things I need
to do to the house to get itready, you know, all of that fun
stuff. It's all very exciting.
So the fall is my favorite andit's not just about pumpkin
spice lattes, although I do likethem. The fall is my favorite
season, and we have a couplethree weeks left before summer
(02:02):
isn't completely in the rearview according to the calendar,
and I'm looking forward to it.
So I'm grateful for a mildersummer, and I'm grateful for
the fall that is almost upon us.
It just makes me smile so andI'm grateful for every one of
you who are listening. Allright, without any further
delay, let's get going. Well, Iam very pleased to be sitting
(02:23):
down with Dr Neha vigashiya. Sheis an MD, MBA combo, something
you don't see very often. She'sa specialist in pediatric
hematology and oncology and theassistant chief of service for
the Department of Pediatrics atthe Kaiser Permanente Fontana
Medical Center, Dr Vikas,
Dr. Neha Vaghasia (02:42):
Thank you so much Erin for having me so to
welcome to the show.
tell us about your your journeyinto medicine.
Erin Brinker (02:50):
What made you decide to go to medical school?
Dr. Neha Vaghasia (02:54):
Yeah, I mean, I think that's always
very popular question that evenmy patients or their families
will ask me. And I think, youknow, when I was young, and even
at the start of college, Ialways thought I was going to be
an engineer and follow in my mydad's footsteps, and I had a
(03:15):
very strong background inmathematics and physics. I
enjoyed those classes. I alwaysdid really well. And I started
college in engineering, andgot to a point, you know, I
think in my second year, where Ijust found a lot of the
(03:38):
mathematics so abstract, soalmost like outer space math,
and just have this likerealization one day, as far as,
like, how does this relate towhat we're doing here on this
earth? Like, how is thisapplicable? And at the same
time, I'd been taking some somecourses in physics. But they
(04:00):
were, they were kind ofapplicable to life sciences. And
so they were looking at, youknow, physics according to,
like, the human skeleton. And Ifound those really, it was
really a fascinating applicationof it. And I switched track a
little bit and learn that, youknow, these, like the
(04:23):
chemistries and some of the moresciences. It didn't come as
naturally to me, but I was sointo it because it was
challenging for me, and I justcontinued to pursue that. And I
was, you know, involved in abasic science research lab as an
undergraduate, and just got moreand more exposure in the life
(04:46):
sciences. I did some volunteerwork at a local hospital, and it
just, it just kind of grew fromthere. I bet you liked puzzles
as a kid. I probably did. I'llhave to ask.
My mom.
I had a brilliant colleague anumber of years ago who ended
(05:07):
up, she got her PhD in in childdevelopment, and she she just
loved doing puzzles. She would,you know, she said, I took the
SAT strategy books and just didthe puzzles for fun. She was
brilliant, like, oh, I don'thave that mind, so I'm in awe of
people like you. And say it'syou say, it was a challenge, but
I enjoyed it. You know, thinkabout organic chemistry and all
(05:27):
of these other things, even, youknow, all the biomechanics, all
the physics, that's incredible.
And so I bet How did your familyreact when you decided that you
didn't want to be an engineer? Imean, I think they were excited.
You know that, you know, there,there was the potential for to
have a doctor in the family. Youknow, my parents were
immigrants. They moved to thiscountry in the 70s, and so, you
(05:49):
know, I'm the first one to to,you know, get my undergraduate
degree here in the US. My my mydad had done a Masters, but, you
know, like, kind of like thefirst one, and so I think they
were excited for that potential.
(06:09):
My, my father, who is nowretired, still has held on to
every single valued engineeringbook that he owns, and every
once in a while will lamentthat, you know he doesn't have
anyone to pass
Unknown (06:26):
this on to that sound
Dr. Neha Vaghasia (06:27):
little part of him, I think that you know
this still exists where, whereyou know there that pride of
like, you know, having, havingsomeone 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 (06:44):
that's awesome.
Well, maybe he'll maybe astudent who needs to be mentored
at some point will need thosebooks, and he can pass it on to
those, to that student Exactly,exactly. So you're in medical
school, and I know that you getto see a lot of different
specialties. And so what? Whatwas it about pediatric health
care that drew you in?
Dr. Neha Vaghasia (07:04):
You know, I actually just recently told this
story to my husband and a goodfriend, and it was this very
interesting journey of where youfelt you fit the best. And I
know people make these careerdecisions for a variety of
(07:26):
things, but for me, it wasreally just like, where do I
feel like I fit in the best? Andpediatrics just was such a
natural fit for my personalityand my comfort level, being able
to talk to children and beingalso an educator. You know, I
(07:47):
think one of the things that'sreally great about this field,
especially in pediatrics, isthat not only are you a
physician, but you're a teacher,also you have to find different
ways to teach, different ways toexplain things to children at
their level, to families fromall sorts of different
backgrounds. And it just was areally nice, natural fit for me.
Erin Brinker (08:12):
That's wonderful.
And pediatrics is from themoment that child is breathing
oxygen through their 18thbirthday, right?
Dr. Neha Vaghasia (08:19):
Yeah, I do have this small little group of
adolescent young adults that wemight follow in their in their
late teens, up to maybe 21 butfor the most part, it's up to
age 18.
Erin Brinker (08:34):
Wow. So what would you say are the most common
health concerns that you'reseeing in children today, and
how has that changed over theyears, over your the course of
your career,
Dr. Neha Vaghasia (08:45):
you know? So that's a great question. I think
when I did my training, I wasreally well trained in, you
know, just the traditionalconcerns, there was things like
infections and asthma andallergies and, you know, the
developmental milestones ofchildren and all those things
still exist, and they still arevery much seen and treated. But
(09:13):
there's a lot of newer thingsthat have come into play, and
there are things like mentalhealth concerns that, you know
is becoming more and more of achallenge with kids. There's a
big rise in anxiety behavioralconcerns. I think a lot of that
has to do with just thepressures of social media,
(09:41):
digital exposures, you know,different social social
pressures, basically. And thenthere's, you know, just other
health conditions that seem tobe more challenging than they
were even 1015, 20. Years ago,such as obesity, and with that
(10:02):
comes a lot of othercomplications that we see, like
diabetes or pre diabetes, fattyliver disease. And then, because
we all like to get better atwhat we do, we you know, there's
a lot more screening forconditions, so screening related
issues like that come up whereyou pick things up because
(10:25):
you're doing a better job at atmonitoring 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 longand go play, right? So they
didn't they, they, if they, ifthey had an issue with another
kid, and they usually resolvethat on the school yard, good or
bad, that's what they did. Orthey in the playground. They'd
hop on their bikes and be outwith their friends all day, you
(10:54):
know, once their homework wasdone and and so they learned how
to manage their own emotions.
They learned how to do conflictresolution. They learned how to
problem solve their way out ofwhatever pickle they got
themselves into. And all of thatis gone, and what they're seeing
now is a hyper curated, scrubbedenvironment where all the people
(11:15):
are beautiful. Everythingthey're doing is perfect. And
then the flip side of that isthe abusive side of social
media, where people will say themost horrendous things to to
each other because they'rekeyboard warriors. And that, you
know, adults have a hard timeprocessing all of that. I can't
imagine what that does to thepsyche 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. Itallows us to make connections
and bridge gaps, and, you know,keep in touch with people or
learn about other people. Butthe bad is, it's ugly and it's,
it puts a lot of pressure onthese kids, you know, the the
(12:01):
influencers and the tick talkersand and it it's whether it's
pressure or it's, you know, justplain bad advice being given
out. But it's, it's not easy formany of the kids to process
that, like, Hey, I don't have tobe like this. I'm comfortable my
(12:23):
own skin.
Erin Brinker (12:26):
Yeah. And so it really they, you know, as
parents, as doctors, as acommunity around them, we have
to teach them, because they haveto learn that that's how they
need to be, right, that that'show they come about. This is to
have this, this sense of whothey are. And, you know, there's
a time when you're, you know,before you're 25 where that that
(12:47):
that idea of who you are isstill 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, notjust for kids, like they're
still growing, they're stilllearning, they're still evolving
into themselves and, and even, Imean, you threw up the number 25
and, you know, I think of myselfas when I was in my 20s. And, I
mean, I just think like, oh mygosh, I was, I was so young. And
yes, some of these things that Imight have done, or, you know,
(13:15):
didn't do, they probably saidsome really stupid things,
exactly like, gosh, and I was,you know, a, you know,
considered an adult, and, youknow, made, made my own
decisions, and I could vote, andI could, you know, have all
these responsibilities. But it'sa lot. It's definitely a lot.
Erin Brinker (13:36):
So, so connecting with the doctor, so creating a
medical home, I think, would isimportant not only for mental
health, but physical health.
And, you know, some people don'tthink about going to the doctor
till they have a problem, youknow, they have the femur or
whatever. And so what would yousay to a parent who's they've
just had a baby, they kind ofwant to figure out how to
navigate the healthcare side ofof parenting. What would you
(13:59):
tell them? You know,
Dr. Neha Vaghasia (14:03):
I am such a firm believer that the well
child visits, they're sofoundational, and especially in
like the newborn, the growingchild, they allow us to monitor
their growth and theirdevelopment. You know, we're
making sure that, hey, you'regaining weight, you're getting
(14:23):
taller, appropriately. It allowsus to catch issues earlier a lot
of times. And more importantly,also, you build that trust with
families. You know, having a newbaby, new parenting, even old
parenting, that's, it's hard,it's hard. Things change. And,
(14:46):
you know, sometimes what youknow we we did as we were
taught, you know, as, asparents, from, you know, by our
grandmothers or whatever, likeyou kind of, you're like, that's
probably not what's best. How weknow this, you know, I have, I
had this attending when I was aresident, and he was a
(15:07):
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 atall, the thing, and you just got
(15:31):
condensed
Erin Brinker (15:32):
milk. I'm a Gen X er, and I, and I know that
that's that is 100% true, andyou have to feed your baby on a
schedule. Baby's hungry. Doesn'tmatter. They're not eating till
one, which is, you know, Ididn't do that with my child,
but my mom and I would get intoarguments in her generation.
That's what they taught,
Dr. Neha Vaghasia (15:50):
yeah, and so.
And it was just, you know, veryit was hilarious. He would tell
you, told the story a milliontimes 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. Butpart of it is also, hey, we have
a lot of evidence that showslike, why breastfeeding is
better or better for your baby,nutritionally, immunologically,
(16:15):
well, it's cheaper and it'scheaper 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 wellchild visits, they're just,
they're so important, they're sofoundational. They just provide
so much opportunity for thedoctors to to educate on, you
know, growth and development andvaccinations and screenings and
all of this is meant tocontribute to just an a
(16:51):
healthier outcome for for foryour
Erin Brinker (16:53):
child. So we're kind of laughing about
differences in parenting, youknow, generational or whatever.
But overall, we're really hardon mothers, and mothers are hard
on each other. You know, likeyou, you have to breastfeed from
here to there. You have to beable to do this. This is the way
it's supposed to be. If they'renot gaining weight at this rate,
or if they're not talking orwalking when I think they should
be, then something wrong withyour parenting. Or it's really
(17:16):
hard to be a mom and and so, youknow, talk to talk to that
mother who may be their child isnot developing where the way
they think they should be, ormaybe they're not taking the
breast milk. You know, whatwould 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 ofpressure. And, I mean, there's
even more pressures now, becausethere's so many working moms out
there, you know, and even ifyou're not a working mom, it's
not easy being a full time momand anything, you know,
(17:52):
sometimes you need to take thatlittle bit of a step back and
say, Hey, I rec. I recognizethat as a doctor, I'm
recommending you know, exclusivebreastfeeding, for example, for
your baby, but I also as a humanbeing, can recognize that this
(18:12):
is really hard, and maybe somepeople are not able to do that
exclusively, and maybe somepeople, just for whatever
reason, aren't able to producethe milk, or they, you know,
there's just so many, so manyreasons why people might not be
able to, and it's a lot ofpressure. And I've seen new moms
(18:33):
like, I mean, just cryingbecause they genuinely are
distressed that they're doingsomething bad for their baby.
And in my heart breaks when youreach that point with a mom,
because that, you know, for me,that's never my intention when I
when I give advice and, like, Idon't know how many times I've,
(18:55):
you know, had to just like, sitdown and say it is okay. Your
baby's dehydrated, your milk'snot in right now, let's we need
to give your baby like, somefluids, or we need to give your
baby a bottle. But I promiseyou, I promise you, your baby is
still going to grow, and yourbaby, you're going to get there.
Your baby will still go tocollege, if you want them to go
(19:17):
to college. Like we're we're notlike, you know, unhinging the
right 20 year trajectory foryour child like by deviating a
little bit from what, what youthink, 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 hislast that child. I was a Jersey
cow, and I just did not haveenough. And so I still breastfed
him, and we supplemented withformula. And by six months he
and I don't know if they do thisthis way anymore, we started
giving him cereal in his milk, alittle cereal in his milk,
(19:53):
because he he he just was hungryall the time. Now, he's six,
three now, and so he was just.
Hungry, and once I got past theguilt of thinking that I didn't
do it the perfect way, it wasfine, and we were able to find a
way that, working with ourdoctor, we're able to find a way
that was able to meet thenutritional needs of our son,
(20:13):
and we were good,
Dr. Neha Vaghasia (20:18):
yeah, and I think that's the biggest part,
is maybe not so much like, youknow, letting go of what you
what you think the path has tobe or should be, because that is
somehow equates to you being thebest parent, right? I think you
being the best parent is workingwith your doctor exactly how you
(20:42):
did, and making sure thatwhatever the needs are of your
child are being met, howeverthat might
Erin Brinker (20:49):
happen. So we talked about, I've had other
physicians on this show talkingabout issues that happen in
adulthood and diabetes, that arethings 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 frontof you, let's talk about
preventative care and what thatlooks like in infancy, moving
(21:10):
through childhood andadolescence.
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, thevaccinations, getting all your
your baby shots in, like, peoplelike to call them, and so those
are things like, you know, yourwhooping cough and your measles
and your your, you know,diphtheria and all of those
(21:37):
things. And it's also meant tobe making sure that the
trajectory of the growth and thedevelopmental milestones are on
track. And then as you getolder, you know the school age
children, I think thepreventative care is the shift.
(21:58):
It's maybe less focused onvaccines, because they're not
happening as quickly, but thereare still the concerns of growth
and development, maybe even ashift of you Know, the
overweight, obese population andnutrition, diet, exercise, and
(22:25):
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 preventivemedicine takes a big change.
There are some vaccines thatcome into play during during
(22:46):
that stage as well, but there'sa lot of mental health, um,
there's still the obesity, diet,nutrition, kind of screening
that happens, but there's alsonow the the education on and
screening for, hey, are therehigh risk behaviors? Is there
concern for substance abuse? Isthere concern for, you know, any
(23:11):
kind of like, unprotected sex,like those, all those, all those
triggers so your conversationscan vary, you know,
tremendously, depending on evenjust what the age of the patient
is that you're seeing inpediatrics.
Erin Brinker (23:24):
Well, you know, you mentioned vaccines, and
there's so much online chatterabout vaccines, and, you know,
there's some people who don'tvaccinate their kids at all, and
I just think that's wrong atevery possible level. You know,
whooping cough can kill yourbaby. So I think that's wrong on
every level, but there are somevaccines that I'm wondering why
(23:46):
an infant needs them, like hep Band so can you kind of address,
and this is really a question ofdosage and timing. I understand
protecting protecting kids, butcan you kind of talk about the
vaccines that happen when you'rewhen 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 theexposure, and, you know, the age
group and who's more high atrisk, right? So your your
whooping cough, you know, orRSV, even where are so heavily
geared towards infants, becausethese are things that you know,
(24:28):
infants can be highlysusceptible to, to having such
bad outcomes if they get sickfrom this, some of it is also
driven by by the data, wherethey look at like a lot of
pharmaco logic,pharmacokinetics, as far as you
know, vaccines based off of ageand what the immune response is
(24:53):
and how good of a robust likeimmune response to people get
from it. So H. Is kind of a goodexample of that. Generally, most
people will start giving it atage 11. You can give it as young
as age nine, and then I believeafter age 13, you go from
(25:14):
needing two doses to actuallythree doses. And that has been
shown in the data, that theolder you are, the less of a
response your body mounts. Andso your protection against the
against the virus, is just notas good. And so that's why they
had to add a third dose in. Sothat's why also a lot of
(25:35):
vaccines might even have a cap,like after a certain age, like,
whether it's the the risk is notthere anymore or it just is not
going to your body's just notgoing 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 towork. Yeah. So do you? Do you
have parents who come to you andsay, yeah, maybe I don't want
that hepatitis B vaccine for mybaby. But, you know, I want all
of the rest of them, do theyhave the flexibility, or are
they required to do the vaccineson 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 differentstyles to vaccination from
parents. And you know, I in myrole as an oncologist now I
probably deal a little bit lesswith that, mostly because when
(26:29):
kids are undergoingchemotherapy, we're not
vaccinating them. But when I diddo general pediatrics, I would
say I had a lot of people whodid not want to do hep B at
birth because they knew it wascoming in the two month and the
four month and the six monthshots. Or, you know, they wanted
to hold off on the vitamin K,which isn't even a a vaccine,
(26:57):
but you know, it's justsomething that they for their
baby, they choose that we justwant a very natural approach to
our baby. Is that vitamin K forclotting, yes, for clotting,
yeah. So it's a very importantvitamin that our liver needs in
order to make clotting factors,where nobody is born with good
levels of it, and so there's astrong risk for for bleeding,
(27:20):
head bleeds, all of that in theinfancy phase. So that's why
vitamin K got added in to helpprevent a lot of those
comorbidities, basically.
Erin Brinker (27:34):
So that is, that is, that is really interesting,
and I get frustrated with theway our media handles this issue
of vaccine. It's either all goodor 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 themdo, you know, tell me why. Tell
me why. This one's important.
Now, you know, saying that thatyour your baby doesn't have the
(27:56):
ability to create clots like heneeds to is, and this is why the
Vitamin K is, is, is required. Imean, that's, that's important.
And I wonder how many people sayI don't want that because they
don't understand what it doesand 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 ofmisinformation out there, or
there's just a lot of partialinformation out there. And you
know, that's part the detrimentof us having information readily
at our fingertips, right? LikeDr Google, you can, you can find
anything on the internet. Andyou know, now we all have
(28:35):
phones, and you know, we canfind anything at any point in
time. And you know, and some ofit's good information, and some
of it's maybe not so goodinformation. And you know, one
of the things I tell my parentsis like, Hey, I have zero
problem in you going out thereand trying to educate
yourselves, but do itresponsibly. You know, don't
(28:58):
maybe get your information offof someone's Facebook post, or,
you know, Tiktok. Like, look atactual reputable sites, right?
Like, look, you know, there's somuch patient handout information
on the American Academy ofPediatrics. There's so much
information through, you know,Mayo Clinic, and a lot of like,
(29:20):
reputable, reputable site. So,so, you know, be a little
responsible for where you'regoing 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 whatyou want to stick to, like
you'll, you'll be able to findinformation out there somewhere
to like, you know, support that,because there's just the
information exists foreverything out there, right? But
(29:42):
you know it, part of it is also,you know, using, using
information responsibly, andthat's, that's my role, is
trying to, you know, hey,educate and let's have a
conversation. What are yourconcerns? Let me hear them, so
that maybe I can help addressthem. And sometimes. That's
literally all it takes, yep, um,that's, you know, and it's just,
(30:06):
it's just helping to fill inthose 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 averageperson can't read and understand
an abstract or, you know, astudy, 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 ascientific 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 starttalking 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 walkingbag of hormones, and your brain
falls out of your head for a fewyears. And so the the change,
you know, the that's when themoodiness and what we would call
(30:58):
surliness appears and all of theand we expect that when you're
1112, 1314, years old, butyou're seeing mental health
issues in younger children. Canyou talk about that?
Dr. Neha Vaghasia (31:09):
Yeah. I mean, I you know, there's so much that
goes into play with mentalhealth now, and we're seeing
just anxiety even in like theyoung kids. And you know, some
of this might be generational,and, you know, like, differences
in, like, parenting style, butyou know, whatever the root
(31:29):
cause is, like, we're seeing itand, you know, it's, um, it's
going to manifest differently. Ayoung, five, six year old is not
going to tell you, like, I feelanxious, right? They're going to
manifest in different ways.
There might be having stomachpains, and that's all that
they're telling you. They mighthave changes in sleep or
(31:52):
appetite, just their moodoverall might seem funky, but
you can't pinpoint it lookingat, you know, school
performance, or school you know,like activity, or they might be
a little bit more withdrawn, orthey might just be more
irritable, but all those littlethings you know, are little,
(32:14):
little flags that kind of comeup. And so, you know, trusting
your instincts as a parent isreally important. So if it, if
something feels off, it'sdefinitely worth exploring and
bringing up to yourpediatrician. 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 kidswho manifest anxiety or stress,
(32:35):
like with with GI symptoms andso, which creates even more more
stress for the parents, becauseI 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 gottado this. I need, you know, to
(32:56):
talk to a specialist. I need,you know, all these tests and
and really the underlying causeis not so much, maybe the gut
system itself. But how are ourmental 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 notunderstand it, but if mom and
dad are always fighting, ifsomebody's lost their job and
they all of a sudden don't haveany money, if a car gets
repossessed, somebody getsdeported. There's a divorce in
the family, and people say kidsare resilient, but, but, and
that's dismissive, because kids,they don't necessarily know
(33:30):
what's happening. They just knowthat 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 toarticulate that, or vocalize
that. It's it's hard, you know,because they're aware, and
they're a lot smarter thansometimes we give them credit
for, a lot more aware than whatwe give them credit for. But how
they display that stressor willbe different than how a 20 year
(33:56):
old or a 30 year old or a 50year old would.
Erin Brinker (33:59):
So, you know, so much of what a child's ability
to manage their own stress andto regulate their own emotions
comes down to parenting, andthat's you know, and a full
disclosure the making hopehappen. Foundation where I work,
we have a program for familieswith children ages zero to five,
in partnership with our localuniversity to help parents
(34:23):
maximize brain development andemotional development during
this window. And so you know howa parent reacts to stress
dramatically impacts a child. Sohow do you talk to parents as a
physician, about about that?
Because I imagine that's prettytouchy subject.
Dr. Neha Vaghasia (34:38):
It is, it is, and you know, it's, it's
something that often I find inmy role as an oncologist, I have
to have this conversation,because the stress levels are
just running high, left, rightand center with everybody you
know, the the parents are superstressed for for their children
who you know are getting.
Seeing, getting chemotherapy andgoing through, you know, cancer
(35:02):
treatment, the stress levels arehigh for their surrounding
family. It's all, you know, on,you know, being kind of funneled
down to the kids. And a lot oftimes it takes just, you know,
taking them aside, separatelyfrom from in front of the child,
and just having thisconversation that you know, like
(35:24):
it's okay to feel sad, it's okayto be frustrated, it's okay to
have you know your your thoughtsand your emotions, that is 100%
natural. But your your kid islooking to you this entire time,
(35:44):
you know, they're having to cometo the hospital, they're having
to go to the doctor, they'rehaving to get, like, you know,
things done, procedures donethat they don't, that they're
scared of, but they, at the endof the day, they're going to be
looking to you. So you have toin the in front of your child.
Have that confidence, have thatyou know that that plan for them
(36:06):
and that comfort for them, thatthey are safe, they are okay,
you are with them, and not letyour 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 areare afraid or stressed, you're
(36:27):
crying, you know, like that, allwill, you know, be noted by your
child and picked up by yourchild. And so I encourage my
families to, you know, to whatthey need to do to to keep up
their strength. You know, takebreaks from the hospital, go for
(36:48):
walks, you know, make sure thatthey're eating their meals and
getting, you know, some steps inand just taking that, that that
time, just even if it's like1520, minutes in the day, just
to kind of step outside fromfrom everything that they're
going through, making, you know,leaning on their support
(37:08):
systems, even, you know, if theyneed someone to talk to, you
know, absolutely like, we have,like, plenty of like therapists
and behavioral healthspecialists that can, that can
help connect with the families.
So there's a lot of opportunityfor early interventions that can
make a big difference in theirjourney.
Erin Brinker (37:30):
Well, that's wonderful. You know, I think a
child having cancer is one ofthe scariest things a family can
face. Are you seeing an uptickin the number of cancers, or
just better diagnosis, earlydiagnosis? 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, Ithink there's maybe we see more
here, more just because peoplehave been, you know, relocating
(38:12):
to other parts of southernCalifornia. And are, you know,
population has kind of grown,but, but overall, I don't know
if there's necessarily, like, ahuge trend upwards. I think
people are definitely gettingbetter at picking up on
symptoms. And, you know,pediatricians are, you know,
great at what they do, as far asyou know, getting workups and
(38:36):
and it's hard with children,because children are supposed to
be they're supposed to behealthy and common things being
common most of the time. Like,if you have a kid that you know
has had some fevers and sometiredness, 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,
(38:58):
like, Oh, it sounds like you'vecaught, like, some kind of a
bug, as all children do, and itshould go away and get better in
five to seven days or so. Andyou know, it's not the most
common thing to say or torealize that, like, Oh, these
little symptoms all ticked up,and this was actually a new
cancer diagnosis in play. And sosometimes it does take, you
(39:22):
know, a couple of trips to thedoctor because things aren't
getting better, but, but I wouldsay that, you know, our
pediatricians do a great job at,you know, screening and and
coming to coming to theseconclusions when things are just
not right.
Erin Brinker (39:41):
So that begs the question, and I appreciate that.
And what begs the question abouthealth, equity and access, you
know, because if you are part ofand I have as a Kaiser member,
and I've been a Kaiser memberfor a really long time, I feel
like I'm super spoiled, becausethe whole system is in the
system. You don't have to waitto the. Referral to get
(40:01):
transferred to here, and youwait for that person. All your
records are over there, and ittakes forever. And, you know,
and, but what if you, what ifyou don't have access? What are,
what are some things being done?
And I know that you work forKaiser, but what are some things
being done to make sure thatthat 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 yourgeography or lack of
transportation, language is ahuge one, lack of awareness or
education, financialconstraints, and it's, you know,
I would say, you know, that atKaiser, there is just so much
(40:41):
that has been pioneered to helpovercome those things. It's
amazing. You know, we have somuch that has come out of covid
with, like, virtual care, and,you know, being able to, like,
send some emails to your doctorand attach a photo. And you
know, there's just so much thatthat can be done to kind of
(41:04):
circumnavigate some of these,these barriers. But I would say
that I think a lot of healthcaresystems in general are
acknowledging that. I did myfellowship training at UCLA, and
I remember we had patients thatcame from everywhere. I mean, we
had patients that, you know,were, were referred to us from
the Bakersfield area. And thatis, that is thought that's a
(41:27):
long way, and it has a long way,a long, long way. And there was,
there was a ride share, therewas a UCLA rideshare van that
that brought these patients, youknow, very early in the morning.
They, I think they left, like at5am or something like that. But
they they would bring thepatients down. People could have
(41:48):
their appointments and then getback on the rideshare and go
back up. And it was a long dayfor these families, but there
was a way to get them, to getthem taken care of. And this was
before you know, anybody wasreally doing virtual care. So
it's nice to see that like,yeah, there are, there are
(42:09):
things you know that are, thatare 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 docommunity partnerships play in
improving pediatric healthoutcomes?
Dr. Neha Vaghasia (42:26):
Um, you community is just so it's just
so strong for pediatrics. Ithink, you know, I see so much
community outreach. As anoncologist, we have just, I
mean, so many foundations orpeople that just donate, either
their time or you know, theirresources towards families in
(42:50):
need, whether it's financialhelp or, you know, help with
gift cards or gas cards for orgrocery cards, you know, or even
donations of like, you know,snacks and toys and backpacks
and things like that. And sothere's, I see so much community
outreach. I think there areprograms that are also being put
(43:15):
forward to help withtransportation. I even recently
have learned that, you know,medical patients do have access
to Uber for their doctor'sappointments. So getting getting
patients, you know, rides,basically to make sure that they
(43:38):
can keep their appointments. Ithink there's a lot more that's
being done now than there waseven, like 1015, 20 years ago.
Erin Brinker (43:46):
So what are some emerging trends or things that
people need to know with theirkids heading back to school and
obviously get a lot of kids inone in one room that haven't
been around each other, they'reall 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 mypatients, are coming in with
sniffles and coughs and stuff,and they've all gone back to
school in the last couple ofweeks. And, you know? And that's
just the the beauty of being achild, right? You You're meant
to build up your immune system.
You're gonna catch everything,and then you're gonna spread the
(44:27):
love and spread spread things aswell. And I do feel that there
is more awareness out there asfar as how things are spread,
right? Like, you know, we didnot completely emerge out of the
code pandemic, like, justoblivious to to how diseases are
(44:48):
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 abit. As most of society has, but
we, we learned a lot. And so Ithink, you know, not forgetting
that, um, and a hand hygiene ishuge, and kids are terrible at
(45:11):
it, like, let's be real. Theytouch everything they do and and
then after they're done touchingeverything, they're touching
their faces, they're touchingtheir mouths and so, and it's
just like, I don't know. There'sjust 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 teachinggood hand washing practices,
like we having those habits,like we wash our hands before we
eat, no exceptions, right?
Putting a little thing a handsanitizer in their backpacks,
like, you know, when cover yourcough, like those are, you know,
(45:53):
like all the kids, they knowabout the cough pocket now,
right? Like this, off in yourelbow. They got that, you know,
using tissues. So there arethings that you can definitely
teach these good habits, um, andthen 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 thathas to be reinforced over the
course of our lifetime. Andhopefully by the time you reach
adulthood, you've got to figureout 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, andin addition to the hygiene
stuff, you know, how does the,how is the covid pandemic? How
did it change the way pediatriccare 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 abacklog of patients, you know,
needing to get in for theirphysicals, for their vaccines.
And so we had to get creative.
We had like an outdoor drive upvaccine tent going on so that
(47:00):
people could still keep up withtheir their well child visits,
at least, get their vaccines,get their vitals taken care of,
you know, and and not be monthsand months delayed, I think, in
terms of practices you know,people are definitely a lot more
(47:22):
aware of of, you know, catchinginfections. I think people have
more awareness about vaccine.
Some of it may be good. Some ofit maybe not so much. Um, you
know, there's a lot of, a lotof, I think, vaccine hesitancy
(47:46):
that also crept up with with thepandemic that unfortunately is
still lingering. But we, youknow, 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 historybehind these? You know, we're so
(48:07):
lucky in this country to havethe amount of healthcare access
that we do, to have thesevaccines. And I think a part of
society has just forgotten whatthese diseases looked like, and
what they did and or what theycan do even, you know, even
things like the flu that it'stalked about every winter
(48:30):
season. And, you know, werecommend flu shots for
everybody every year. And youknow, I think people just kind
of forget or get a littlecomplacent, but we lose lives
every year, every year to eventhese, these simple things, and
people die. You know, people dieof the flu every year, even
(48:52):
including children and family
Erin Brinker (48:55):
members who had the flu this year, right? This
last time was last cycle. Lastwinter, their fevers hit 104
they were at the hospital. Andthe hospital they they went to
the emergency room, and theywere not admitted, but it was
like it would there. They werenot alone. There were a lot of
people who got the flu that bad,and these are healthy adults.
And so you you never know whatthe virus, what this next virus,
(49:17):
set of viruses, is going tobring, yeah,
Dr. Neha Vaghasia (49:20):
and so and flu is one of those things that,
you know, the flu shot they theway they make it is they try to
predict what the most prevalentstrains are going to be, and
that's what goes into thevaccine. And some years, their
predictions are great, and someyears, maybe not so much, but
(49:41):
every boost, the way I think ofit 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 thinkparents 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 tobasically all my teams. I think
you can get it as early as 11. Iwant to say, don't quote me on
that, but, um, but, you know, upto age 18, and it's, it's huge,
(50:27):
you know, you don't think ofmeningitis very often when, when
people think about, you know,what kinds of things they can
catch when you're going off tocollege, I think most people are
probably worried more on the STDroute than anything, in addition
to, you know, the common coughsand colds, but meningitis is
huge. And you know, the dormliving, the crowded situations,
(50:50):
is just a wildfire way of spreadand and meningitis can be
deadly, and it can go quickly.
And if you survive it, you mightnot survive it as like, full and
healthy as you were before. Um,it can really cause a lot of
neurologic devastation, and canthrow blood clots people might
(51:11):
lose, like fingers, toes, arms,legs because of it. And so
there's a lot of devastation itcould 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 issomething 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 oftimes it's, it's, it's the
severity of those symptoms youget something called nickel
rigidity, meaning that your neckarea gets very, very stiff and
(52:02):
you it's just very hard to,like, bend or move. You can be
sensitive to light, even in moresevere instances, like you'll
have nausea, vomiting, or youcan have a lot of confusion. Um,
you're just not actingappropriately, or you're a
little altered. Some people, inthe younger children, they'll
(52:27):
like the infants withmeningitis. They will just be
very, very irritable becausethey're just they're just not
feeling good. They could belethargic 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 aresome people, and I know some
teenage girls that that havethat get really bad migraines,
like, really bad migraines. Andsome 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, peoplecan get nauseous to that as
well, but the fever would be abig differentiation. You should
not be having a fever with asimple migraine. You probably
won't have that stiff neckeither. And migraines, you know,
(53:19):
they usually will be responsiveto, you know, to some kind of
medication, whether you take,like, ibuprofen or, you know,
you just need to rest orwhatever. 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 medicalshows 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 upwatching
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 hadthis conversation about General
Hospital, and we realized weboth watched it because our moms
watched it when we werechildren. And so one of our like
(54:19):
outlets when we were in ourtraining period was we would, we
got back into General Hospital,and we would watch the episodes,
and then, you know, we would, wewould talk about them the next
day, or we'd be texting eachother, and we'd be laughing.
We'd be like, Oh my gosh, howdid they just do that? Like,
that's so not medically correct,and it's so made up. And, you
(54:40):
know, it's just hilarious, like,you know, it's medical TV to its
its finest right there. And, andwe just loved it. And so it
brought us a lot of, a lot of, alot of stress relief. I would
Erin Brinker (54:56):
say, That's awesome. I thought you were
gonna say the pit or. Grey'sAnatomy. But I hadn't even
thought about General Hospitalis
Dr. Neha Vaghasia (55:04):
fantastic. So that was probably my first,
yeah, my first medical show everthat I, you know, religiously
watched. And then I, you know, Inever got so much into Grey's
Anatomy that was during more mymed school years, and a bunch of
my classmates were into it. I Ijust, I felt like it was just so
(55:25):
it was so dramatic. And, youknow, it's a soap opera, but I
did love the two shows that Idid 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'sjust like, this, this odd little
case, and we gotta figure itout. It's still not realistic,
as far as, like, you know, it'sjust this team of like, you
know, one doctor and like, he'sgot a couple of couple of
physicians on his team, hisminions. And they can do
(56:00):
everything. They draw their ownlives, and they can do brain
surgery, and, you know, but, butit 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 yougo through, you know, in your
training years, and things that,like, you know, get get, like,
dumped on you, or the thingsthat 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
(56:40):
lot of good things. But I havenot, I've not watched
Erin Brinker (56:42):
that it's intense.
It's intense. Yeah, it is. It'sa good show. I mean, it's
really, it's really, it's kindof er on steroids. It's really
good. It's, it's an, I've heardfrom er physicians that it's
very accurate. And so because,you know, it takes place in an
ER, and the whole season is oneday. So it's, it's an intense,
it's an intense show. So we arecompletely out of time. So thank
(57:05):
you so much for joining metoday. You've been an absolute
delight. Tell people how theycan, you know, reach out to you.
How they could follow you.
Maybe, if they need a pediatriconcologist, get a hold
Dr. Neha Vaghasia (57:15):
of you. Yeah.
I mean, you know, all of ourKaiser, 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 amcompletely accessible. I don't
actually have social media. Imean, I think I have a Facebook
(57:39):
whose password I can't remember,and I have, like, a fake
Instagram account where I justhave it so that I can watch, you
know, cute dog videos thatpeople send me. But I don't
really do a lot of the socialmedia. I just find that, you
know, once you get going on it,like, two hours go by and you're
just like, what happened withall my time? So but yeah, I'm in
(58:01):
the community. I'm here. I'm atSBC. 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 thankyou for the incredible work you
do with kids who who need it themost.
Dr. Neha Vaghasia (58:21):
Well, it's been my pleasure. Thank you so
much for having me and allowingme 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 timewith me. I hope you enjoyed it
as much as I did. You've beenlistening to the making hope
happen radio show. For moreinformation about the making
hope happen Foundation, go towww.makinghope.org That's www,
dot makinghope. Dot O, R, G, I'mErin Brinker, and I'll see you
next week.
Unknown (58:57):
Erin.
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