{"id":12402,"date":"2017-12-16T14:17:39","date_gmt":"2017-12-16T13:17:39","guid":{"rendered":"https:\/\/kaks.hb-dev.de\/2017\/12\/16\/from-a-pediatricians-perspective-dr-nadine-hess-diagnoses-rb-2\/"},"modified":"2024-09-25T15:32:04","modified_gmt":"2024-09-25T13:32:04","slug":"from-a-pediatricians-perspective-dr-nadine-hess-diagnoses-rb-2","status":"publish","type":"post","link":"https:\/\/kinderaugenkrebsstiftung.de\/en\/from-a-pediatricians-perspective-dr-nadine-hess-diagnoses-rb-2\/","title":{"rendered":"From a pediatrician’s perspective: Dr. Nadine Hess diagnoses RB"},"content":{"rendered":"\t\t
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From a pediatrician’s perspective: Dr. Nadine Hess diagnoses RB<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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For the first time in her twelve years as a paediatrician, Dr. Nadine Hess, a paediatrician in Hamburg-Eppendorf, diagnosed a retinoblastoma last year.
\nIn little Isabel, who was just five months old at the time.
\n“I immediately suspected that it could be a RB,” recalls Dr. Hess in an interview with KAKS.
\nWe naturally wanted to know more about the indications of a tumor and the further circumstances for clarification: <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: How did you notice Isabel’s illness?<\/strong>
Nadine Hess: Well, actually from a distance, not with the naked eye, but with an ophthalmoscope.
\nThe child’s left eye looked kind of cloudy.
\nAs if there was a veil of mist in it.
\nThat’s when I thought: it’s an RB. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: How did you notice Isabel’s illness?<\/strong>
Nadine Hess: Well, actually from a distance, not with the naked eye, but with an ophthalmoscope.
\nThe child’s left eye looked kind of cloudy.
\nAs if there was a veil of mist in it.
\nThat’s when I thought: it’s an RB. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: What was the situation in which you had this suspicion?<\/strong>
NH: An everyday one.
\nThe mother came to my practice with her child.
\nFor the U5 examination.
\nSo it was really a completely normal situation.
\nIsabel was five months old, a super girl.
\nEverything seemed to be in perfect order.
\nAnd it was.
\nUntil, at the end of the examination, I asked the mother to take the child on her lap and sit down a few meters away from me.
\nJust like I always do.
\nBecause I wanted to use the ophthalmoscope to complete the U5 with the early childhood eye examination.
\nAnd then I saw this veil in one eye very clearly. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Did you immediately know how to proceed?<\/strong>
NH: Yes.
\nI did two things straight away: firstly, I made an appointment at the eye clinic at Eppendorf University Hospital.
\nFor the very next day.
\nI didn’t want to lose any time.
\nAnd I told Isabel’s mother that I wanted to have an abnormality checked as soon as possible.
\nThe visual axis in the child’s eye was still developing, of course, and it was important to act quickly.
\nI didn’t express my specific suspicions to the mother.
\nI wanted to spare her hours of uncertainty and fear in case I was wrong.
\nAt that point, I don’t think the mother was too worried. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Did you get the appointment at the UKE quickly?<\/strong>
NH: Yes.
\nI was asked directly: Do you think it’s an RB? <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Do you remember the moment when it became clear that the specialists had confirmed your diagnosis – barely 24 hours later?<\/strong>
NH: Of course.
\n“Oh God, that poor child,” was my first thought.
\nBut then I remembered what I had learned during my studies.
\nWith RB, the affected child has a good chance of recovery.
\nFurther assessment and treatment then took place in Essen.
\nAt the national reference center for retinoblastomas. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: What was the conversation with the parents like when the diagnosis was finally made?<\/strong>
NH: The father came to my practice alone, actually just to pick up the necessary papers for further treatment in Essen.
\nThe conversation was naturally very emotional.
\nAt first he was still calm; as men are.
\nI told him how sorry I was.
\nAnd I hoped that he and especially his wife would forgive me for not confronting them immediately with my suspicions.
\nHe began to cry.
\nBitterly.
\nA moment I will certainly not forget.
\nI remember taking him in my arms. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Isabel has bilateral RB – and this was only finally diagnosed at the hospital.
\nDiagnosed early enough to save the child’s eyesight and life.
\nHow important is the so-called fluoroscopy test according to Br\u00fcckner against this background? <\/strong>
NH: In a word: important.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Is it part of the standard program?
\nAnd what do you do in your practice? <\/strong>
NH: For almost a year now, the Br\u00fcckner test has indeed been mandatory in the children’s guideline for the U examinations four to seven.
\nThis applies to all pediatric practices in Germany.
\nIrrespective of this, I carry out this early detection of all kinds of visual disorders in children from the U3 examination until the child is four years old. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: The Children’s Eye Cancer Foundation is naturally delighted that its efforts to standardize early childhood eye examinations have been so successful.
\nOur focus continues to be on the white pupil, which can be an indication of a disease, a retinoblastoma.
\nDo you make parents aware of the white pupil phenomenon in your practice? <\/strong>
NH: Honestly?
\nNo.
\nYou don’t tell the parents exactly what you’re looking for.
\nUnless the parents want to know in detail.
\nBut once again: the mandatory early detection eye examination is a super important step in preventive screening for children.
\nIt was the only way that Isabel’s retinoblastoma could be detected early and treated quickly.
\nI’m glad about that.
\nAnd also that she is still my only RB patient today. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Nadine Hess, born in Aachen, studied human medicine in D\u00fcsseldorf, Duisburg-Essen and Bochum.
\nShe completed her specialist training in Essen, Switzerland and Datteln.
\nShe has been a pediatrician in private practice in Hamburg-Eppendorf for three years.
\nTogether with Dr. Nicolaus Lingens, she looks after around 1800 children and young people.
\nAround 70 to 100 young patients a day.
\nAn immense responsibility.
\nKAKS also wanted to find out more about this.
\nIn a “hail of questions”, we asked Dr. Hess to keep her yes or no answers spontaneous and her reasons brief: <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Have you ever regretted specializing in pediatrics and adolescent medicine?<\/strong>
NH: Yes.
\nBecause it’s an exciting, enjoyable, but also energy-sapping job that leaves little room for a good work-life balance. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Have you already reached your limits in practice?<\/strong>
NH: Yes.
\nSleepless nights in which I wonder whether
I have done something right are part of it.
\nBecause everyday practice is often nothing more than a snapshot in time, in which I have perhaps three to four minutes to correctly assess a child. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: As a pediatrician, is it right to involve the parents in everything?<\/strong>
NH: Yes.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Can the relationship with a family be too emotional?<\/strong>
NH: Yes.
\nYou have to be very careful.
\nZ. For example, when treating children from your close circle of friends.
\nI would prefer not to treat them.
\nYou always run the risk of losing objectivity. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Do you remember one family in particular?<\/strong>
NH: Yes.
\nIsabel and her family.
\nShe was a seriously ill child.
\nMy first RB patient.
\nYou don’t forget that.
\nJust like two other cancer patients who are currently very close to my heart.
\nAnd just a few weeks ago, we had an unusual, life-threatening situation that I will never forget.
\nA family came to my practice with their baby for a U3 examination.
\nThe child suddenly collapsed and had to be resuscitated. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Is distance part of the “job”?<\/strong>
NH: Yes.
\nBut nobody explains how to do it.
\nYou have to figure it out all by yourself. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Is pediatric and adolescent medicine different today than it was ten years ago?<\/strong>
NH: Yes.
\nParents want to take less responsibility.
\nToday, the child sneezes three times and some parents come to my practice to make sure it’s nothing serious.
\nThe willingness to tolerate a normal infection is often no longer very pronounced.
\nParents today are often overly concerned and demanding.
\nThis attitude is also changing the practice of pediatric medicine.
\nIn addition, the pressure on parents, who often both work and are constantly absent from work, is also great.
\nWhen I was little, my mother was often at home and there was no employer pushing for me to come back to work quickly. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Is it permissible not to tell parents the whole truth?<\/strong>
NH: Yes.
\nIf you’re not 100 percent sure. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: Is expensive medicine the best?<\/strong>
NH (laughs): Nah.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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KAKS: This raises the question: What is the best medicine?<\/strong>
NH: One that comes with patience, affection and love.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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For the first time in her twelve years as a pediatrician, Dr. Nadine Hess, paediatrician<\/p>\n","protected":false},"author":1,"featured_media":7807,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"uix_meta_title":"","uix_meta_description":"","uix_canonical_url":"","footnotes":""},"categories":[87],"tags":[],"class_list":["post-12402","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-unique-stories"],"_links":{"self":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/posts\/12402","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/comments?post=12402"}],"version-history":[{"count":0,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/posts\/12402\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/media\/7807"}],"wp:attachment":[{"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/media?parent=12402"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/categories?post=12402"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kinderaugenkrebsstiftung.de\/en\/wp-json\/wp\/v2\/tags?post=12402"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}