Your frequent questions answered by the experts at Nationwide Children's Hospital

What exactly happens when someone has to go under general anesthesia? Our son, who's in high school, needs to have oral surgery, and we have heard about young people having bad reactions like depression, even if they were only under for a short amount of time?

Anesthesia is the use of medications (given as an injection into the vein or inhaled) to prevent one from remembering or feeling pain or other sensations during surgery or other medical procedures. An anesthesiologist administers the medications during surgery and will also monitor and treat changes in your son's major bodily functions.

There are three main categories of anesthesia: general, regional and local. With general anesthesia, your child will be completely unconscious during the procedure, with no sensations, pain, awareness, movement or memory of the surgery. General anesthesia can be given through an intravenous catheter or by inhaling gases or vapors.

Anesthesia continues to get safer as medications improve and many anesthesiologists continue to receive specialized training. Many children's hospitals have a full staff of anesthesiologists with specialized training to care for infants and children.

In very rare cases, anesthesia can cause complications in children such as changes in the heart rhythms, breathing problems or allergic reactions to medications. The risks depend on the type of procedure, the condition of the patient, and the type of anesthesia used.

Be sure to talk to your son's doctor, surgeon and/or anesthesiologist about any concerns. It is important that you answer all of the anesthesiologist's pre-surgery questions honestly and thoroughly, and that your son follow the doctor's instructions about what not to do before surgery.

Dr. Joseph Tobias is Chief of Anesthesiology at Nationwide Children's Hospital and a Professor of Anesthesiology and Pediatrics at the Ohio State University.



My 10-year-old daughter was just diagnosed with type 1 diabetes. How is this different from type 2 diabetes and how will it affect her everyday life?

Type 1 diabetes results when the person's own immune system destroys cells in the pancreas that produce insulin. Once this happens, those cells will never make insulin again.
Type 1 diabetes can't be prevented or predicted. There is nothing that either a parent or the child did to cause the disease. Once a person has type 1 diabetes, it requires lifelong treatment with insulin. Kids and teens depend on daily insulin injections (or an insulin pump) to control blood sugar levels.

People with type 2 diabetes usually produce a high level of insulin, but the body requires more than it can produce. Some people with type 2 diabetes can restore their insulin balance by weight loss or by oral medications.

Be sure your daughter has a balanced, healthy diet, and pay close attention to the sugar and starches she eats so you know how much insulin she'll need to match the carbohydrates. She should also get regular exercise to help control blood sugar levels.

Be sure to discuss diabetes with your primary care physician, who may ask you to consult with a pediatric endocrinologist and a diabetes team. Your health care team will work with you to prevent complications of diabetes and make life as normal as possible by teaching your family how to keep your daughter's blood glucose in control and monitoring her success over time.

Dr. David Repaske is Chief of the Section of Endocrinology at Nationwide Children's Hospital and Director of the Division of Endocrinology and Metabolism in the Department of Pediatrics at the Ohio State University.



At a dance school we're considering enrolling our daughter in, it seems that a lot of the girls start using pointe shoes at around age 10. But I've read that beginning pointe dancing before age 12 can be harmful to one's feet because they might still be growing a lot. How can we figure out what's best for our daughter?

Starting in pointe shoes depends as much on the strength of the legs as much as it does on the maturity of foot growth. The average age for children to start in pointe shoes is 12. At this age, many children with years of experience have enough technical skill and physical strength to correctly maintain the difficult position.

It's important that kids who want to go on pointe have years of training under their belt. The introduction must be gradual, or kids risk serious injury to the soft tissue surrounding the bones of the feet and knees. This can cause painfully enlarged joints and injury to the lower spine. All children should be supervised closely by a trained dance teacher to decrease the risk of injury.

For most dancers - children and adults - dancing on pointe is painful. Many will use lamb's wool, gel pads or other similar cushions in their shoes to make dancing easier.
Talk to your primary-care physician if you aren't sure whether or not your daughter is ready for pointe shoes.

Dr. John Kean is Chief of the Department of Orthopaedics at Nationwide Children's Hospital and a Clinical Assistant Professor of Orthopaedics at the Ohio State University College of Medicine.