Nora Redulla M.D. - Pediatrician

28/03/2024

ARE YOU BUILDING? OR ARE YOU TEARING DOWN?

In medical school, I was so sure I would specialize in Internal Medicine. Then reality descended on me during my clinical clerkship and Postgraduate Internship. My heart ached when I saw patients suffering from chronic diseases and I would burst into tears when one of them died. That’s why I became a pediatrician. I focus on keeping my patients healthy from birth (even from conception, if I get to advise pregnant women). I tell parents that I want their kids to live until old age with no need for maintenance medications!

Vaccinations and access to clean water have prevented countless illnesses and saved millions of lives. Numerous social media warriors, conspiracy theorists, and various know-it-alls have been attacking vaccines for some time now. Who knows how many unnecessary deaths have resulted from their efforts?

In the early eighties, the government’s vaccination program was in its infancy. I always asked parents about their kids’ vaccination status, and it was common to get the reply, “Wala” or nothing. It felt like an uphill climb convincing them, one family at a time. One day, my husband (pediatrician Dr. Vidal Redulla) and I decided to produce mini-skits for radio broadcasts. It was my first and only foray into acting. With our 6-year-old daughter and another pediatrician, my good friend Dr. Janet Porcia, we taped scripted dramas about different diseases and the vaccines that could prevent them. Looking back, it makes me laugh how we used our little portable tape recorder and cassette tapes. Then we made the rounds of radio stations, successfully begging them to air the brief skits for free. Many listeners heard them. I am convinced that God blessed our efforts and many went to the health centers to get their children vaccinated.

The social media warriors, conspiracy theorists, and various know-it-alls are still at it. They did not help build, but they are zealous at tearing down. Please get your information from your physicians. If your physician is an anti-vaxxer, he/she needs to learn evidence-based medicine and review what he/she either never learned or forgot about. I guess I’m going to get bashed now!

27/03/2024

Reposting this with update

P is for Pertussis

I’ll never forget the babies I saw with pertussis. They would cough non-stop with their eyes bulging, not taking a breath until their faces turned blue. Their mothers would be terrified as they (and we) watched helplessly. Sometimes the coughing was so violent that blood vessels in the whites of their eyes would burst.

Some very young infants stop breathing for a length of time after a bout of coughing. This is extremely frightening. Many will vomit after a coughing spell. Some babies will have brain hemorrhage. Another cause for concern is that the illness lasts for many weeks, even with treatment. It used to be called the 100-day cough. In fact, bouts of coughing spells can occur throughout the first year of life after a baby has pertussis.

The word pertussis means intense or violent cough. It is also known as whooping cough, but most patients do not actually whoop. Early in the 20th century, 5 out of every 1000 children died of pertussis before their 5th birthday. Most were below a year old. By the middle of that century, pertussis vaccine had become widely given, usually together with Diphtheria and Tetanus toxoids (DPT).

Pertussis is extremely contagious. Like Covid-19, it can be airborne and is also transmitted through aerosol droplets. I am so grateful for the vaccine that put this disease under control. Unfortunately, with the fall in vaccination rates during the pandemic, this disease is having a resurgence.

Update your family’s DPT or TdaP vaccinations, especially if there is an infant in the home. Pregnant women should receive Tdap (Tetanus, Diphtheria, Pertussis), not just tetanus toxoid, to provide antibodies to the fetus before birth. This practice is called cocooning – surrounding babies with vaccinated household members because they are too young to be fully vaccinated.

Let’s make pertussis a disease of purely historical interest.

07/03/2024

Reposting this article I wrote in 2020:

As children, we all learned the rhyme:
Mother! Mother! I am sick! Call the doctor very quick!
Doctor, doctor, shall I die? No my darling, do not cry.

Indeed, we should call when we are sick; but it is even more important to visit the doctor when we, especially our children, are well. WHY?

1. DISEASE DETECTION

A trained physician does not just know how to diagnose and treat an illness; he or she can detect early signs of disease before you even notice them. Your pediatrician will monitor your child’s growth and development to allow early intervention when necessary.

2. DISEASE PREVENTION

Beginning at the birth of a child, parents must be guided on how to raise one who will have lifelong health. Breastfeeding, good nutrition, immunizations, and exercise are only some of the areas that every pediatrician must emphasize. I joke with parents that my goal is for their child to grow old without serious health problems. I say that their internists will think they are very boring patients!

3. HEALTH PROMOTION AND ANTICIPATORY GUIDANCE

Each visit should include discussions about how to promote health at every stage of the child’s development. Parents should ask questions if they have any. For example, care of the teeth, understanding of behavior, mental feeding, and accident prevention are essential aspects of child care and should never be neglected.

Trust is built over the years when there is a good relationship between a child and her pediatrician -- a trust that will extend into her teens and even way into adulthood!

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