Pediatric Care During COVID-19

Like most seniors, Ja’Quan Hart was very much looking forward to going off to college in the summer of 2023.

The Thomson, Ga., resident had just graduated high school and as a linebacker and tight end, helped lead his Thomson High School Bulldogs to win the Class AA State Championship.

“I had these big tackles, and I caught like an 89-yeard interception pass,” he said. “That was like my best game. We won state!”

Ja’Quan’s talent and skill on the football field—and his love of the game—earned him the opportunity to play for the University of Kansas with a full scholarship.

Unfortunately, life had other plans.

Amid packing for school and booking his flights, Ja’Quan learned from a routine sports physical that he had an irregularity in his heart that could be life-threatening.

That irregularity turned out to be a leaky aortic valve—and an abrupt end to his aspirations of a college football career.

“Blood was flowing back into my heart. It wasn’t going all the way through,” Ja’Quan explained.

In a healthy heart, leaflets between the left and right ventricles open to allow blood to flow through the heart one way and then close fully to keep blood from flowing back into the heart. In a condition like Ja’Quan’s, the leaflets do not close all the way and blood does leak back into the heart.

For most people the treatment for a leaky aortic valve involves a valve replacement. But a valve replacement now will often require another replacement surgery at some point in the future, and probably more than one, said Dr. Brian Bateson, a pediatric cardiothoracic surgeon and co-director of the adult congenital heart program at Wellstar MCG Health Medical Center. The younger the patient, the more potential surgeries the patient will need to have to replace the valves when they wear out.

Because Ja’Quan had not yet reached 20 years of age at the time of his care, a valve replacement would mean multiple surgeries over the course of his life.

The solution is a new device called the HAART ring that is affixed to the support structure of the aortic valve. This stabilizes the valve and allows for further repair of the leaflets themselves, meaning the valve can close properly and prevent leakage.

“If you’re using Ja’Quan’s own valve, keeping it in place and it functions, potentially he wouldn’t need another procedure again in his life because it’s still his own tissue. It’s not going to break down. Any prosthetic valve, whether it’s mechanical, bio-prosthetic will fail over time,” Dr. Bateson said. “Nothing’s better than what you’re born with.”

The HAART device is ideal for a young patient like Ja’Quan, but would also be a good treatment option for any person—pediatric or adult—with the same condition.

Ja’Quan spent three days in the hospital recovering from his surgery. Since, he has been slowly increasing his cardiovascular activity, such as walking, and following up with Dr. Bateson for regular checkups, who said he has been recovering very well.

Ja’Quan said he plans to continue to play sports, but will need to be more selective about the sports he can play.

“I play basketball. I just won’t be playing contact sports (like football),” he said.

Though he said it was disappointing to have to change direction as far as playing college football is concerned, Ja’Quan hasn’t let it dampen his spirit. Instead of college football, he is now exploring the possibility of driving trucks with the intention of going into business for himself—as long as it isn’t too strenuous for his heart.

“I’m not going to give up. I’m going to regroup and keep going and find another path to being successful in life,” he said.

At Wellstar, we understand how important your family’s health is to you. That’s why we partner with people and families across all ages to provide the continuing care each person needs to live their healthiest, fullest life.

By following tips from Wellstar pediatric and primary care experts to prioritize healthy habits at every stage, families can work together to take charge of their health and foster a lifetime of well-being.

Toddlerhood & early childhood

Building a strong foundation

Early childhood is a prime time to establish healthy behaviors as children’s brains are rapidly developing, making them highly receptive to learning.

“Nurturing healthy habits in childhood provides a strong foundation for long-term physical, emotional and social success,” said Dr. Joanna Dolgoff, a pediatrician at Wellstar East Paulding Pediatric Center and spokesperson for the American Academy of Pediatrics.

By incorporating several key habits into their children’s daily routines, parents can set the tone for a healthy, thriving life.

Prioritize a balanced diet: Preparing meals with plenty of fruits, vegetables, whole grains, lean proteins and dairy not only supports children’s growth and development, but also introduces positive eating habits that can last a lifetime.

Additionally, “Let kids decide when they are full,” Dr. Dolgoff said. “Avoid using food as a reward or punishment.”

Establish routines: This includes fostering healthy sleep habits by creating a consistent bedtime routine, instituting regular meal and snack times, keeping kids active and limiting screen time.

“For children under 2, avoid screens,” Dr. Dolgoff advised. “For ages 2 to 5, limit to one hour of high-quality programming a day.”

Model healthy habits: “Children naturally observe and mimic their parents’ actions,” Dr. Dolgoff shared. “Be a role model by making healthy choices yourself, like exercising regularly, eating well and managing stress effectively. Kids are more likely to adopt positive habits when they see their parents practicing them.”

Middle childhood & adolescence

Encouraging healthy choices

As children grow and desire more of a say in the decision-making that affects them, parents should actively encourage their involvement while still ensuring their choices align with healthy behaviors.

Cook and eat meals together: Healthy foods fuel children’s physical growth and brain development. Involving kids in meal planning and cooking not only teaches them about the importance of healthy eating, but also fosters connection and quality time.

“Create the weekly grocery list together, cook and eat together,” said Dr. Neety Patel, a primary care physician (PCP) with Wellstar in West Cobb. “Eating together is a great way to set aside 30 minutes (or more) to enjoy your food, talk about your day and bond.”

Swap screen time for movement and creativity: Set boundaries around recreational screen time and encourage activities like reading, drawing, storytelling or outdoor play, Dr. Dolgoff suggested. Limiting screen time an hour before bed can help ensure kids get the recommended amount of sleep (9 to 12 hours for ages 6 to 12; 8 to 10 hours for teens).

“Too much screen time can negatively impact mental health,” said Dr. Dolgoff, “while creative activities boost cognitive development and emotional expression.”

According to Dr. Dolgoff, parents should also schedule time for at least 60 minutes of physical activity daily. “This can include walks, sports, dancing or family games. Movement promotes physical health, reduces stress and helps kids focus better in school."

Make it a team effort: Instilling healthy values takes a village, so remember to involve the whole family in decision-making. “Kids feel more motivated and empowered when they are part of the process,” explained Dr. Dolgoff.

Wellstar Primary Care Physician Dr. Nikia Garland, who practices family medicine in West Cobb, added that setting realistic goals together promotes a sense of shared responsibility. “Use each other as an accountability partner,” she said.

And when children show progress or achieve success, don’t forget to celebrate. “Celebrations reinforce the idea that healthy habits are rewarding,” Dr. Dolgoff said.

Young adulthood

Taking charge of health management

Young adulthood is a period marked by significant life changes and evolving responsibilities. By teaching young adults to make healthcare a priority—even though they may feel invincible—parents can help set them up for future success.

Coordinate the transfer to adult-oriented care: Between ages 18 to 21, as students graduate or transition to life beyond high school, parents should coordinate the “handoff" from their pediatrician to an adult PCP.

“The transition from a pediatrician to an adult PCP is a critical step in helping teens take charge of their healthcare,” said Dr. Patel. “Transitioning ensures no gap in care.”

Making this switch empowers young adults to proactively take charge of their health management by establishing a plan to continue with annual physicals and age-appropriate health screenings.

Encourage discussion: Parents can further support their children during this transitional stage by maintaining open and honest communication about health topics.

“Parents can help by starting the conversation early, discussing the upcoming transition and why it’s important,” said Dr. Dolgoff. “Involve the teen in the process. Let them participate in selecting an adult PCP. Show them how to schedule appointments, refill prescriptions and understand health insurance. Teach them about their medical histories, including allergies, medications and any chronic conditions. Emphasize the importance of annual physicals and the benefits of preventive care.”

Adulthood

Maintaining long-term wellness

By the time young adults reach their mid- to late-20s, they should strive to have an established relationship with their primary care team, helping them stay ahead of injury and disease with regular screenings and preventative care.

Schedule annual physicals: Annual checkups create a baseline that can be used to track a person’s health over time. These exams are one of the best ways to catch and treat early signs of illness before they turn into serious health problems.

“During patient’s physicals, I review my wellness tips with them,” Dr. Garland shared. "It includes how to eat healthy (and what to do if you don’t), how to get restful sleep, getting physical activity, adequate water intake and daily stress relief.”

Limit processed foods and sugar: Eating a balanced diet rich in whole foods can make a huge difference when it comes to maintaining a healthy weight, lowering the risk of chronic diseases like heart disease and diabetes, and improving energy levels.

“It seems simple and obvious to preach, but in our busy lives, we often tend to eat on the go,” said Dr. Patel. “A freshly cooked meal can do wonders for your day.”

Stay active to age well: Exercise has many benefits for adults as they age, from staving off chronic disease to enhancing strength and balance to boosting mental health.

“Regular movement can maintain your muscle and bone strength and improve most musculoskeletal pains,” said Dr. Patel. For adults, Dr. Garland noted that she typically recommends getting 30 minutes of daily continuous physical activity or 10,000 steps a day.

“If you enjoy the gym, go for it,” said Dr. Patel. “If not, get active any way you are able—go for a walk, a hike, a bike ride, take a dance lesson with your loved one, do a Zumba class on YouTube (it's free!) or some chair yoga.”

However, it’s important to know your limits, added the physician. “If something starts to hurt excessively, scale back and talk to your provider if you're not sure,” she said. “Some movement is better than no movement!”

Take control of your family’s health by finding a Wellstar pediatrician or a Wellstar primary care provider near you.