July 14, 2020

The Child Life team at Texas Children’s has a pretty special job. Through a variety of educational and therapeutic interventions, they strive to alleviate stress and anxiety, while promoting positive coping skills for patients and families during their time at the hospital.

Made up of a variety of teammates – including child life specialist, art, music and animal-assisted therapists along with media professionals and activity, school, library and gaming coordinators – the department focuses on the psychosocial needs of children while collaborating with parents and other health care staff.

The need for such services and expertise has grown exponentially during the pandemic with anxiety and stress among patients and parents at a peak. Texas Children’s Child Life team has stepped in to do their part in calming these new nerves and making patients’ experiences at the hospital the best they can be during these unprecedented times.

“We are glad we are able to be in the room to support patients and families during this challenging time,” said Diane Kaulen, manager of the Texas Child Life Department. “We are there in PPE (personal protective equipment) helping support patients and families through all the emotions that come with illness and hospitalization. Our team is happy to still be working with them.”

The power of play

One way child life team members help children express and process difficult emotions is through play, the power of which can be amazingly strong. Audrey McKim has seen play work wonders time and time again during her tenure as an activity coordinator with Texas Children’s Cancer and Hematology Centers.

“As a child life team we make it a priority to bring patients together through intentional programming anchored by play,” McKim said. “We understand the significance of creating connections and building a community among people who are mere doors apart from each other but have the opportunity to share so much more than a diagnosis.”

Creating these connections during the pandemic has been challenging, but not impossible. McKim said an average day for her begins with huddles in the morning and looks over the census. Based on all the things she and her colleagues know about their patients and their needs, interests, strengths and diversity, they create a new daily challenge game.

Cup stacking and collapsing, ping pong challenge, Play Doh sentences, speed Spot-It, balancing building and trivia are just a few of the games the child life team play with patients in their rooms. To ignite competition among the other patients on the floor, scores reflecting speed and number of questions answered correctly are posted on a giant “Leader Board.”

“Imagine the show ‘Minute to Win It’ happening every day inside patient rooms,” McKim said. “We didn’t even need prizes, bragging rights and Leader Board ranking was enough.

McKim and members of her team also have incorporated photo projects into their repertoire and utilized creative themes burgeoning from social media. They have marked holidays with events like timed St. Patrick’s Day gold coin hunts, Mother’s Day interviews and photos from patient beds, individual egg hunts in rooms, Earth Day and super hero day art.

“What we found is how much patients started looking forward to visits from someone bringing something purposeful and fun that tied people and days together,” McKim said. “In the absence of so much, we have discovered a beauty in the challenge of creating and sustaining community through play all while staying apart from each other.”

The COVID effect

Chandler Townsend, a child life specialist in the Emergency Center, said she quickly learned that COVID-19 has more than just medical side effects.

“A hospitalized child within this pandemic is not just experiencing stressors related to hospitalization,” she said. “Our tiny heroes and their caregivers are now walking through our doors with a whole new set of external stressors, already altered from their baseline.”

Children miss their communities of classmates and playdates. Parents find themselves on a seesaw, balancing their work as professionals and as nurturers. The disappointment of a favorite park being closed, a postponed celebration or a canceled trip to see grandparents is felt by all. And, on top of everything, a visit to the hospital.

It takes extra, special intentionality to address kiddos’ fears and foster resilience, and Townsend and colleagues are doing just that and more. They are engaging family members in supportive conversation, recognizing that due to visitation protocols, they may not have their spouse’s hand to squeeze and may benefit from that extra check in.

They are allowing opportunities for control/mastery over a child’s day through procedural preparation, the dissemination of honest information, validating emotions, re-shaping perspectives, being a supportive presence and creating chances for control and facilitating play.

“Child Life is striving to adapt creatively while still keeping patient-and family-centered care at the center of our minds,” Townsend said. “I’ve been so encouraged by my coworkers and their drive to allow kids to be kids.”

June 29, 2020

For many patients and their families, coping with a new illness can be challenging, and often times, can produce anxiety and fear. Since 1997 the Periwinkle Arts in Medicine Program at Texas Children’s Cancer and Hematology Centers, has helped numerous patients cope with their illness through various art opportunities.

“Access to the arts is essential to our every day well-being, especially in the most challenging of times,” said Carol Herron, coordinator for the Periwinkle Arts in Medicine Program. “It gives our patients affected by cancer and blood disorders the opportunity for self-expression, empowerment and healing through the arts.”

Before the COVID-19 pandemic, the program’s community Art Partners frequently visited the Cancer and Hematology Clinic to engage patients and their siblings in fun and educational arts activities. Since the art partners are unable to come into the clinic due to COVID-19 restrictions, the Periwinkle Arts in Medicine Program launched a creative and interactive way to virtually connect with patients and their families.

Creativity Connected is a weekly interactive virtual arts newsletter that the Periwinkle Arts in Medicine program rolled out in response to the COVID-19 pandemic. The newsletter goes out weekly to a database of more than 1,300 Texas Children’s Cancer and Hematology Centers’ patients and their siblings.

The publication provides a collection of enjoyable arts activities for children including video clips on how to build a spaghetti hedgehog or how to make musical instruments using common household materials. Creativity Connected also features a selection of artwork from Making A Mark®, an exhibition of art and creative writing from children touched by cancer and blood disorders at our Cancer and Hematology Centers.

One of the long-time Art Partners that is part of the Periwinkle Arts in Medicine Program is Purple Songs Can Fly, which has provided hundreds of patients and siblings a musical outlet to share their incredible stories and songs of hope which are produced in an in-house studio at Texas Children’s Cancer Center.

Below is a note from a child who wrote a song virtually with Purple Songs Can Fly founder and executive director Anita Kruse, and then had that song shared in the Creativity Connected newsletter.

“I feel happy to make songs with Anita. She is so kind. My sister and I enjoy making and singing songs. I like the way she plays the piano. When I grow up I would love to play piano like her.”

In addition to Purple Songs Can Fly, several other Art Partners that have contributed to bringing art therapy to our cancer and hematology patients include Writers in The Schools, Houston Center for Photography, Young Audiences of Houston, the Houston Symphony, The Woodlands Children’s Museum, the Museum of Fine Arts Houston, River Oaks Chamber Orchestra and DaCamera.

Texas Children’s partners with The Periwinkle Foundation, an organization that develops and provides programs that positively change the lives of children, young adults and families who are challenged by cancer and other life-threatening illnesses and are cared for at Texas Children’s Hospital.

March 17, 2020

 

Texas Children’s Apheresis Program led by Dr. Poyyapakkam Srivaths has reached a milestone with the addition of a new service, photopheresis. Photopheresis is a medical treatment that causes photoactivation of white blood cells by separating them from blood, which are then exposed to a medication called 8-methoxypsoralen followed by UVA irradiation before returning the blood to the patient.

Texas Children’s is currently using this apheresis therapy for bone marrow transplant patients who are experiencing graft-versus-host disease and lung transplant patients who are undergoing organ rejection. Photopheresis is typically used when other treatments have failed.

We are the second institution in Houston to offer photopheresis, and the only program dedicated solely to pediatric patients.

“There was a tremendous multidisciplinary effort to make this happen,” said Dr. Tina Melicoff, medical director of Texas Children’s Lung Transplant team. “We are thrilled to now offer some of our transplant patients with rejection issues another treatment option through photopheresis.”

To be able to offer the service, two photopheresis machines were purchased and a core group of dedicated nurses were trained to operate it. Clinicians expect to treat about five patients a year with each patient receiving about three sessions a week for about 10 weeks. Each session lasts around two hours.

Texas Children’s recently conducted its first photopheresis treatment on a bone marrow transplant patient. The patient is expected to receive additional treatments over the next several months.

“By offering this therapy, we are offering hope to patients who already have been through so much,” said Dr. Robert Krance,” director of Texas Children’s Pediatric Bone Marrow Transplant/Stem Cell Transplant Program. “Photopheresis is a promising therapy for our patients experiencing host-versus-graft and organ rejection.”

Photopheresis is the second new extracorporeal therapy introduced in the past 20 years at Texas Children’s. The last extracorporeal therapy, Molecular Adsorbent Recirculating System, or MARS, was introduced six years ago for liver failure patients.

“MARS helped to transform our liver transplant program,” said Chief of Renal Services Dr. Michael Braun. “I am hopeful photopheresis will have a similar impact for our BMT and lung transplant patients.”

February 18, 2020

On February 13, Texas Children’s Cancer and Hematology Centers hosted a special celebration to unveil the new Sky High for Kids Immunotherapy Center that will officially open on 7 West Tower next month.

Texas Children’s Cancer Center staff, physician and nursing leaders, and invited guests attended the unveiling ceremony which began with a special blessing of the new oncology-hematology unit from Texas Children’s Chaplain Pam Krinock followed by remarks from Dr. Susan Blaney, director of Texas Children’s Cancer and Hematology Centers, and Brittany Hebert, Founder/CEO of Sky High for Kids.

“The Sky High for Kids Immunotherapy Center is a tremendous advance, that will be essential to achieving our goal of curing cancer in each and every child,” Blaney said. “We, along with our patients and their families, are grateful for our partnership with Sky High for Kids. This partnership is incredibly strong, because the founders and leaders of Sky High are equally driven and passionate as we are about caring for children who are diagnosed with cancer and eliminating this disease as quickly as possible.”

In 2018, Sky High for Kids committed $20 million over 15 years to Texas Children’s Hospital to establish the Sky High for Kids patient floor and the nation’s first Immunotherapy Center, along with supporting Texas Children’s Global HOPE initiative to improve pediatric cancer treatment in sub-Saharan Africa. This pledge will provide Texas Children’s with the necessary resources to continue our research and application of immunotherapy treatments, impact around the globe and quality of care and comfort for our patients.

“The Sky High for Kids patient floor is poised to serve children across Texas, in the United States, and ultimately around the world,” Hebert said. “We are grateful to be part of the Texas Children’s family and are honored to be a part of leading the charge to eradicate cancer right here in our hometown.”

After the unveiling ceremony, guests had the opportunity to tour the new Sky High for Kids patient floor on 7 West Tower, which will officially open on Wednesday, March 25. The spacious, state-of-the-art patient care floor includes 22 hematology-oncology rooms and 10 bone marrow transplant rooms. The newly renovated spaces also feature a multidisciplinary work area for the health care teams, larger family lounge and respite areas, a laundry room, and a beautiful art studio for patients and their families.

As Texas Children’s Cancer Center continues to pioneer new and emerging therapies for patients with cancer and blood disorders, the need for additional inpatient accommodations was crucial. The new space will allow care teams to better meet the needs of our patients while continuing to provide the highest quality care.

“We are very excited about the opening of our new oncology and hematology unit, and are very fortunate to have the best and brightest minds, dedicated to finding a cure for childhood cancer,” Blaney said. “Everyone in our Cancer Center, including our physician scientists, our research technicians, our clinical researchers, and the entire medical team, feel a tremendous sense of urgency to attaining this goal.”

Click here to learn more about Texas Children’s Cancer and Hematology Centers. Click here for more information about our philanthropic partner, Sky High For Kids, and their mission to end pediatric cancer.

February 11, 2020

Dr. David Poplack, director of Global Hematology Oncology Pediatric Excellence (HOPE) at Texas Children’s Cancer Center, was recently honored with the first-ever Alex’s Lemonade Stand Foundation (ALSF) Childhood Cancer Lifetime Achievement Award.

The ALSF is a non-profit pediatric cancer charitable organization that funds research to bring better treatments and cures to children with cancer, and provides emotional, financial and logistical support to childhood cancer families that makes their challenges more manageable.

“I am very honored to receive this Lifetime Achievement Award,” Poplack said. Alex’s Lemonade Stand Foundation has raised funds to advance innovative research, leading toward cures and improved quality of life for children with cancer.”

Since joining Texas Children’s in 1993, Poplack served as the Director of Texas Children’s Cancer and Hematology Centers for 25 years, growing the program from seven faculty members to nearly 200. As a world recognized leader and mentor in the field, Poplack has made a profound impact on the education of pediatric oncologists. He is Co-Editor of a textbook, The Principles and Practice of Pediatric Oncology, currently in its 7th edition, which has graced the desks of nearly every pediatric oncologist ever trained, and is the leading textbook in the field of pediatric oncology.

In July 2018, Poplack transitioned his role to serve as the Director of Global HOPE at Texas Children’s. The program is a comprehensive capacity-building program that works to improve pediatric cancer treatment in sub-Saharan Africa, a region that has a nearly 90 percent mortality rate for the over 100,000 children who develop cancer each year. Global HOPE has a presence in seven African countries, has trained more than 1,800 local health care professionals and has treated over 8,000 patients since its inception.

In addition to his leadership roles at Texas Children’s, Poplack has been a guiding force for the ALSF research grant program, having served as a longtime member of ALSF’s Scientific Advisory Board.

Click here for more information about Texas Children’s Global HOPE program.

January 27, 2020

Dr. Stacey Berg and Pediatric Nurse Practitioner Kate Mazur served as editors of the recently published textbook Ethical Issues in Pediatric Hematology/Oncology. The textbook fills a vital gap in currently available literature on ethical issues in pediatric hematology/oncology.

This book identifies the various ethical challenges that arise in pediatric hematology/oncology and provides the necessary tools to overcome these challenges. Aiming to expand upon and strengthen providers’ knowledge and experience in pediatric health care ethical issues, the text positions providers to be beneficial resources to faculty, staff, patients, and families within their institution. It presents a multidisciplinary approach to sound ethical practices that is necessary to effectively care for these patients and their families.

The book reviews the principles of ethical decision-making, the unique difficulties in using children as research subjects, common ethical conundrums involved in providing end-of-life care, and general moralities of professional practice. Written by experts in their fields, Ethical Issues in Pediatric Hematology/Oncology is an innovative and valuable resource for clinicians, practitioners, and trainees who work in the field of pediatric hematology/oncology.

“We’re very pleased to have had the opportunity to work with so many wonderful colleagues to put together a book specifically focused on ethical issues in our highly specialized area of pediatric hematology/oncology,” Berg said. We hope that this text will be a valuable reference for everyone in the field.”

Mazur echoed Berg’s statements and said it’s been a privilege to collaborate with many experts in the field on this important project.

“We hope that this book will increase understanding of the unique ethical dilemmas faced in our practice and provide a useful resource that will ultimately improve our care of patients and their families,” she said.

Those at Texas Children’s Hospital and Baylor College of Medicine who contributed to the effort include:

Editors
Stacey Berg, MD
Kate Mazur, PNP

Chapter Authors
Ernest Frugé, PhD
Amanda Gutierrez, BA
Melody Brown-Hellsten, DNP
Laura Loftis, MD
Mary Majumder, JD, PhD
Amy McGuire, JD, PhD
Stacey Pereira, PhD
Perry Ann Reed, MBA, MS
Michael Sprehe, MD, MPH

Texas Children’s Cancer and Hematology Centers recently honored six team members with the Bravo Award for going above and beyond to ensure our patients and families receive the best possible care.

The award is handed out quarterly and recognizes nurses and other professional staff in the Cancer and Hematology Centers for outstanding performance. Anyone within the Texas Children’s system may nominate a member of the cancer and hematology teams for this award. The team’s clinic leadership will select the winners.

Last quarter’s winners of the Bravo Award were:

Amelia Fleming, a bone marrow transplant consult nurse, plays a vital role in patient care and the education of nursing staff. She is flexible with her schedule to accommodate the needs of patients and provides invaluable continuity for them. She even stays late or comes in on off days (including Sundays) to facilitate cellular infusions.

Jane Head, a 9 West Tower care management nurse, is indispensable in coordinating care needs for inpatients. She is patient, kind and a great communicator who moves mountains to obtain care needed to facilitate patient discharges to anywhere in the world. She also assists new fellows and faculty to learn our system and serves as a liaison to other unit care managers.

Jessica Hernandez, a medical assistant at the Main Campus Clinic, is an outstanding example of teamwork who is always willing to help where needed with a smile on her face. She strives to find out answers to any questions and has a great pulse for everything going on in the clinic on a daily basis. She was specifically praised for putting families at ease by telling them of the virtues of her co-workers. She actively seeks out ways to make clinic flow better.

Melissa Lopez, a nurse at The Woodlands Clinic, goes to great lengths to help families navigate the healthcare and insurance systems. She specifically spent hours helping a patient, whose insurance had changed, find a surgeon who could remove his port-a-cath. She also is a leader in working with charitable organizations on behalf of patients and recently helped start a bereavement group for The Woodlands families.

Leslie Paredes, a social worker with bone marrow transplant, is dedicated, responsible and takes action to ensure the needs of her patients are met in a timely manner. When a patient recently passed away, she ensured the family was flown home in time to make funeral arrangements according to their cultural needs. She is a role model for her co-workers and an example of how we should all care for our patients, families and one another.

Paulette Reed, an administrator at the Main Campus Clinic, is an extraordinary individual who ensures the smooth flow of the share desk, appointments and room assignments in clinic. Her interactions with complicated patients are a model for all in diplomatic problem solving. She is the “go-to” person for scheduling needs and can always find a way to have a patient seen on a non-scheduled clinic day.