To complete a thorough abdominal assessment on a squirmy toddler, tell the child you are going to use your hands to guess what he or she has had to eat. I can generally palpate for as long as I need by reporting what I am feeling (e.g., bananas, spaghetti, Cheerios, etc.). — Jean Gale, NP, South Beloit, Ill. (175-6)

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.

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