HCA Midwest Health - December 20, 2017

My pediatrician says my daughter needs to see a pediatric endocrinologist, but I can't get an appointment for 4 months!

We understand how frustrating it can be to not get immediate access to the care you need—especially when it involves your child. That’s why HCA Midwest Health is always looking for ways to improve access by attracting additional specialists to serve our patients—specialists like Dr. Larry Kurt Midyett, a board certified pediatric endocrinologist who will be seeing patients starting August 1, 2017.

What is a Pediatric Endocrinologist?

Pediatric endocrinologists are physicians that specialize in the diagnosis and treatment of diseases of the endocrine system in children. As parents, we’re used to thinking of hormones in terms of puberty and sexual development. But they actually influence almost every body function, from growth and development to mood to metabolism. These are important functions for every stage of life, from infancy into adulthood.

Some of the more common endocrine disorders that occur in children and adolescents include:

  • Type 1 diabetes — the pancreas is not able to produce enough insulin, leading to a lifetime need of insulin. There is a great deal of new technology including insulin pumps and continuous glucose sensors that help kids and their families’ better management their diabetes.
  • Type 2 diabetes — the pancreas produces enough insulin, but the body can’t use the insulin effectively. Carrying excess weight or body fat is believed to play a role as well has someone’s family history. Often this can be initially controlled with diet and exercise but may require medications as well.
  • Growth hormone problems — too little growth hormone can lead to grow during childhood and may indicate a need for hormone replacement or problems with the pituitary gland.
  • Precocious puberty — when children experience the body changes associated with puberty at an abnormally young age. This can lead to problems with normal growth and development. It’s the medical equivalent of kids growing up too soon.
  • Thyroid problems — when thyroid hormone levels are too high (hyperthyroidism) or too low (hypothyroidism). This can be caused by an autoimmune disease (Grave’s disease for hyperthyroid and Hashimoto’s disease for hypothyroid) of abnormalities with the thyroid gland.
  • Adrenal insufficiency — the body doesn’t produce enough adrenal corticosteroid hormones leading to weakness, fatigue, stomach pain, dehydration, nausea and skin changes. It is treated with replacement corticosteroid medications (which are not the same as the dangerous steroid drugs that young athletes are often tempted to use to enhance their performance).
  • Cushing syndrome — Too many corticosteroid hormones circulating in the body from any cause. One cause is Cushing disease (a tumor in the pituitary gland). It can also occur when a child takes artificial corticosteroids to treat an autoimmune disease such as lupus or rheumatoid arthritis.

Why the long wait for some Pediatric Endocrinologist appointments?

There is a shortage of pediatric subspecialists in the United States, which can mean long waits for appointments in some areas. At HCA Midwest Health, we work to attract high-quality specialists to our region and encourage more pediatricians to pursue a subspecialty. We currently have more than 135 pediatricians and family practice doctors on staff and we’re actively adding new specialists to the HCA Midwest Health team — specialists like Dr. Midyett.

About Dr. Larry Kurt Midyett

HCA Midwest Health’s newest pediatric endocrinologist is more than a medical expert—he’s a father of four who understands how busy families are. Originally from Lawrence Kansas, Dr. Midyett completed medical school and his residencies at the University of Kansas before completing a fellowship at Children’s Mercy Hospital. He is board certified in Internal Medicine and Pediatrics and will begin seeing patients August 1, 2017. To make an appointment, call 1-800-386-9355.

Before Your Child’s First Appointment with a Pediatric Endocrinologist

Here are some tips to help you through:

  • Talk to your general pediatrician about the wait and what you can be doing in the meantime to help your child.
  • Gather all your child’s medical records to date from multiple doctors, if needed. While you probably requested these be sent directly to the specialist, it never hurts to cover your bases. And having them on hand for your appointment will make sure there aren’t additional delays because the specialist needs more information about your child’s history.
  • Contact the pediatric endocrinologist’s office to see what diagnostic tests you can have your child complete during the waiting period, rather than ordering after your first visit. If not, talk to your pediatrician. Chances are, your pediatrician saw something in your child’s bloodwork or urine tests that led to your endocrinologist visit. Talk to your pediatrician about repeating those same tests a few weeks before your scheduled visit, so the endocrinologist can compare and also have the most recent data possible.
  • Keep a journal of symptoms—describing what happened and when it occurred (diet changes, sleep patterns, behavior changes, etc.).
  • Make a list of questions. If you’re waiting months (or even weeks) for an appointment, chances are you’re doing research or talking to people about your situation—all of which usually gives you more questions than answers. Write them all down and bring them to your appointment. It’s the best way to make sure you don’t forget to discuss anything important with the specialist.

While you wait, you can also use our Nurses On-Call helpline that HCA Midwest Health provides to the public free of charge. Reach a registered nurse 24/7* by calling 1-800-386-9355.

*Closed Thanksgiving Day, Christmas Day and New Year’s Day.

Making the Most of Your Pediatric Endocrinologist Visit

Here are some things to bring to your pediatric endocrinologist visits:

  • Your lists, journals and records. Keep copies for yourself, but bring copies to leave with the physician. When you check-in at the doctor’s office, let the staff know you brought records. They may want to scan them into your child’s records or provide for the doctor to review briefly before examining your child.
  • Your partner, grandparent or a friend (or two). Having an extra person there to listen, and ask questions, can help you get more from the visit and remember more of it later. Or, they can take your child from the room once the exam is done and allow you to talk to the doctor without distractions. Bringing two people allows you to do both!
  • A notebook and pen. Writing things down can really help you remember key details later. And if your child ends up seeing this specialist regularly, having a single notebook to record notes from all your visits will be more helpful then loose sheets of paper.
  • Toys, comfort items or distraction items for your child. Even if your child loves the doctor’s office, it still gets boring after a while. And you will need to focus your attention on the doctor as much as possible. Make the visit more pleasant for both of you by coming stocked with a variety of activities (and snacks!) to keep your child content during the visit.

Finding a Pediatric Endocrinologist (or Other Doctor)

If you need to find a pediatric endocrinologist (or any other physician), our Nurses On Call line can help. They can even help you make an appointment. Just call 1-800-386-9355. Or, use the online Physician Finder.