Vaccines, Obesity Have Changed Pediatric Practice During Dr. Van Sickle’s Career

By Sarah Gooding
Thursday, August 17, 2017

The Topeka physician has devoted more than three decades to the health of up-and-coming generations.

Greggory Van Sickle, MD

Greggory Van Sickle, MD, has played an active role in nurturing the Topeka area’s youngest residents since beginning a practice in the community more than 35 years ago.

“In my medical training, children were the most rewarding and fun patients that I’d ever seen,” he says. “That’s how I made my decision to go into pediatrics.”

Dr. Van Sickle arrived in Topeka as a solo practitioner in 1980, and a practice merge a few years later paved the way for the formal creation of Pediatric Associates in 1988.

While some elements of pediatric practice have remained consistent throughout the years, Dr. Van Sickle says the decline of one major type of epidemic and the rise of another predict the conditions all other specialists will see in the years to come.

“The biggest change — one single, huge change in my professional lifetime — has been the decline in vaccine-preventable diseases,” Dr. Van Sickle says, adding that he trained in an era of spinal meningitis and widespread fear of bacterial diseases. “Also, we used to admit many, many kids a year with vomiting and dehydration from rotavirus. All of this has dramatically decreased with the development of appropriate vaccines.

“I tell people if there’s any advantage to getting older, it’s that I’ve seen virtually every disease that these vaccines prevent,” Dr. Van Sickle says. “As these diseases recede into the background, people begin to think they don’t exist. Very few diseases have been eradicated, but these other diseases, given the opportunity, could still be among us without vaccination.”

However, a new epidemic — childhood obesity — is now one of the biggest challenges pediatricians face.

“Increasing incidence of obesity is a new pediatric problem, which has turned into a whole plethora of adult problems as well,” Dr. Van Sickle says. “Quite clearly, we’re seeing much, much more obesity now than when I finished my training in the late 1970s and early 80s. From that time to now, obesity has really reached epidemic proportions, with obesity tripling among children and quadrupling among adolescents.”

One of the flummoxing challenges of the childhood obesity epidemic is that pediatricians know what is needed to prevent it. The difficulty is helping patients and their parents implement the advice into everyday life.

“The experts are now saying that almost all obesity is due to sedentary lifestyle, an intake of calories beyond what the body needs, or both,” Dr. Van Sickle says. “You try to figure out if there’s anything you can change, and it’s frustrating because you’re talking about lifestyle changes.”

But addressing this issue is critical for the physicians who play a formative role in the health of up-and-coming generations.

“We’re in the unique position of trying to prevent overweight children from becoming overweight adults,” Dr. Van Sickle says.

To do so, they encourage at least one hour a day of vigorous physical activity for each member of the family, as well as reducing sweetened beverages and increasing consumption of fruits, vegetables and whole grains. In the past couple of decades, Dr. Van Sickle says, screen time has become more prominent, and he says children should spend fewer than two hours a day in front of screens, unless that time is clearly associated with academics.

“These are things that we encourage, and ultimately I think everyone realizes this has to be an affair for the entire family to get involved in,” he says.