What’s Up Doc?

Illustrated by Christine Georgiades

Q: My 5-year-old is a super picky eater. TV ads claim nutritional supplement drinks, like PediaSure shakes, are great for fussy young diners. Good idea?

An occasional nutritional shake may be OK, but it shouldn’t be a parent’s first line of defense, says pediatrician Alan L. Nager, MD, of Children’s Hospital Los Angeles in Hollywood (and the new CHLA outpatient clinic in Encino). “A better idea is to get creative with food. There are all kinds of ways to mix in vegetables without a child realizing it.”

Some examples: turkey meatballs made with shredded carrot, green mashed potatoes (with a little broccoli), baked sweet potato fries, and fruit and  veggie smoothies and even popsicles. If you’re really adventurous you can find recipes for stuff like chocolate pudding made with avocado..

“Also if you just keep introducing different fruits and vegetables, you’ll find three or four your child will eat,” says Dr. Nager. Bottom line: Unless your child has a specific health issue and your doctor tells you to supplement, in general supplemental products are more effective as parental anxiety-reducers than they are as nutritional must-haves.

Q: In recent years years, I’ve taken a family member in for minor surgery two times. In both cases, I made sure the doctor and surgery center were “in network” for our insurance plan. After both surgeries we were shocked to get bills from “freelance” anesthesiologists who, as it turns out, were not affiliated with our plan. In one case the anesthesiologist’s $5,000 fee was almost as much as the surgeon’s! What gives?

What gives should not be you. What you describe has been deemed by the consumer advocates as “surprise billing.”  
“I get a call from clients about this issue at least once a week,” says Woodland Hills health insurance agent Teri Frankel. “It’s not illegal, but it’s unconscionable and unfair.” She recommends calling the doctor’s billing office. “Oftentimes, if you simply explain that the facility and surgeon were in network and you were shocked to receive this out-of-network bill, they will immediately offer to adjust the bill.”
If that doesn’t work, go online and look for a medical bill advocate who can negotiate the bill down. If you were misled—for example, you were told that the anesthesiologist or other specialist was in-network—contact the Department of Insurance consumer hotline (800-927-4357 or insurance.ca.gov). They will fight the bill for you. There’s pending state legislation on this issue (AB 533) to make this practice illegal.

Q: I’m pushing 40, and my skin is breaking out. Why now, and what’s the best way to treat it?

“Many skin conditions—including acne—present for the first time in adulthood,” says Veena Vanchinathan, MD, a dermatologist at UCLA Health Porter Ranch. So there you go, we are not freaks! “The good news is that there are so many good treatment options for acne, but it will depend on the type of acne you have, your skin type, medical history and any relevant allergies.”
Common acne treatments include benzoyl peroxide washes/foams, salicylic acid spot treatments, topical antibiotic preparations, topical retinoid creams and oral antibiotics. “Keep in mind that other conditions like rosacea and even minor hair follicle infections can mimic acne, so it really is important to see a dermatologist for evaluation and proper treatment,” says Dr. Vanchinathan.

We hope you are enjoying Ventura Blvd’s new health column, where we ask doctors and health pros your questions.
If you have a pressing—or aching, itching, burning—question, please drop us a line at whatsupdoc@venturablvd.com.