Enlist the help of a ticklish child when palpating his or her abdomen. I find having the child place his or her hand over mine and help guide it as I examine the various regions reduces the child’s squirming. — Renee Barall, FNP, Colorado Springs, Colo.

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.