Radiology
Why can’t some kids eat?
Pediatric Radiologist Stephanie DiPerna, MD
It’s the beginning of a busy afternoon in the Radiology Department’s fluoroscopy unit, and there’s a full roster of babies and children who need an imaging test to determine why they can’t eat or drink properly.
But before attending radiologist Stephanie DiPerna, MD, can start performing the exams, she has to round up a missing radiology fellow, orient a new resident, confer with technologists, nurses and speech pathologists, page a referring physician and steal bites of blueberry yogurt from the open container on the desk.
“It’s hectic, but I love it,” DiPerna says, a petite island of calm in the tiny control room on the hospital’s second floor. “I have to have eyes in the back of my head.”
As a pediatric radiologist who specializes in abdominal/GI imaging, DiPerna spends much of her clinical time performing modified barium swallows. Using fluoroscopy, a technology that produces real-time, moving X-ray images, the radiologist and speech pathologist can watch a child swallow milk or juice that has been laced with barium to make the liquid highly visible on X-rays.
The exam shows whether food and liquids are passing through the throat and into the esophagus properly or if instead they are flowing down the windpipe and into the lungs, causing gagging, coughing, choking and respiratory disease. Premature babies, who lack muscle tone, and others with underlying medical conditions such as Down Syndrome, often inhale their food instead of swallowing it. These patients may need a feeding tube until they outgrow their condition or it is corrected.
GI imaging, happily, gives DiPerna the chance to interact directly with patients and their families. “I like the primary care aspect of caring for kids,” she says. “There’s an overall innocence about them. You’re naturally drawn to helping them be better.”
Jennifer Perez, a speech pathologist who coordinates the hospital’s feeding and swallowing program, often performs the exams with DiPerna. “What strikes me about working with her is the work doesn’t end when the patient walks out of the door,” says Perez. “I feel she’s invested in making sure all the right plans are in place for when the family returns home. She’s very concerned about what happens after the study is over. She’s quite compassionate.”
A radiology colleague, Carlo Buonomo, MD, notes that a barium swallow is a very “hands on” study. “You have to be calm — it’s one of the things parents appreciate the most—you have to be gentle, and you also have to be definitive,” he says, noting that DiPerna is all three.
DiPerna, who runs three miles four to five days a week and is training for her first marathon, decided on pediatric radiology during her residency, when she rotated through Children’s. “I really liked the people I worked with and the atmosphere here,” she recalls. “There’s a unique climate at Children’s—nurturing and supportive both for patients and families and for staff and colleagues.”
She joined the faculty in 2008, after completing a fellowship in pediatric radiology here. This year, DiPerna was appointed physician director of satellites for radiology, overseeing radiology operations at the hospital’s suburban clinics.
The radiologist’s interest in medicine, though, began in high school, when three of her four grandparents were hospitalized in Boston for serious illnesses. DiPerna, her parents and her sister spent long hours in the car driving from their home near Syracuse, N.Y., to visit the ailing relatives.
“I liked science and biology in high school, but being at the hospital so much made me think about medicine for the first time,” she says. “I remember wanting to try to make things better for patients, for families."
Some of that motivation came from watching one of her grandmothers suffer and die from a malignant brain tumor that was initially misdiagnosed as a stroke. Later, she was able to help friends through the hospital experience when their young daughter was treated for leukemia. “That was my first exposure to any really sick child, and I saw what she went through and what the family went through on a regular basis,” DiPerna remembers. “In addition to rotating through Children’s as a resident, my friends’ experience showed me the special support and care available here. The people who work here make it that way.”
