April 14, 2015

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Surrounded by Disney’s “Frozen themed party decorations and pink and purple birthday hats, Knatalye Hope and Adeline Faith Mata reached a monumental milestone April 11 when they turned 1 year old.

The girls’ birthday fell almost a month after their successful separation surgery, during which a team of highly-specialized surgeons worked in shifts for more than 24 hours to make the girls two.

“I can’t believe it’s been a year,” said Elysse Mata, the twins’ mother. “It’s gone by so fast.”

Knatalye and Adeline were born at Texas Children’s Pavilion for Women on April 11, 2014 via Caesarean-section at 31 weeks gestation after weeks of extensive prenatal imaging, multidisciplinary consultation and planning at Texas Children’s Fetal Center. The babies each weighed 3 pounds, 7 ounces. Surgeons allowed the girls to grow and gain strength for 10 months before undertaking the difficult task of separating them. Since then, the twins have been progressing well as two separate little girls.

On April 8, Adeline underwent surgery to place a tracheostomy to aid in her breathing and lung development. The surgery also included removing the metal rods placed in her pelvis during the initial separation surgery, removing some shunts in her bladder and also placing a gastrostomy button, a special tube which helps to deliver food and medicines until a child can chew and swallow. Adeline remains in the hospital’s Pediatric Intensive Care Unit and continues to receive daily physical and occupational therapy.

On April 13, Knatalye underwent surgery to remove the rods in her pelvis and also to add a gastrostomy button for her feedings. She is currently on room air (no breathing assistance) and recovering from surgery in the PICU. She will resume daily physical and occupational therapy once fully recovered.

“The progress both of the girls have made has been amazing,” said Dr. Darrell Cass, lead surgeon and co-director of Texas Children’s Fetal Center. “I wouldn’t be surprised if both of them are going home within the next few months.”

Cass was one of several people who stopped by a celebration held by Elysse Mata on April 9 at the hospital to honor all of the Texas Children’s staff involved in the girls’ care over the past year.

In between bites of birthday cake, Warren Boudreau, the surgical business analyst who helped prepare the operating room for the twins’ separation surgery, said he stopped by the party because he wanted to meet Elysse and tell her how proud he was to be part of something so unique and interesting.

“It was an experience I will never forget,” Boudreau said. “I’m glad I had the opportunity to be a part of it.”

Alvin Perkins, the supply chain manager for the operating room during the separation surgery, said he came by the party for similar reasons.

“I wanted to tell the mother that it was a pleasure having her girls in my operating room,” Perkins said. “Every kid who comes in here is my kid and these girls are no exception.”

Chief of Pediatric Gynecology Dr. Jennifer Dietrich, one of the surgeons who operated on the girls during their separation, popped in between procedures to wish the girls a happy birthday.

“I wish they could be here,” she told Elysee.

Although the girls could not attend the celebration for their care givers, Knatalye was able to participate in a Disney’s “Frozen” themed birthday party for family and friends.

“It was such a great day,” Elysee Mata posted on her Facebook page. “We had a great turn out and the girls received lots of gifts, love and hugs! Thank you to everyone who came to the party, sent birthday wishes, and prayers and support. We are extremely grateful! Looking forward to celebrating many more!”

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While Ebola is no longer dominating the headlines, ongoing training and preparations ensure we remain ready to handle highly infectious diseases.

In the months since the Ebola concern, Texas Children’s has stock piled personal protective equipment (PPE) and, most recently, acquired 30 powered air purifying respirators (PAPRs). A PAPR covers the head to protect emergency responders from chemical, biological, radiological and nuclear agents. This addition to our PPE inventory helps ensure the safety of our health care professionals when they are treating patients with highly infectious diseases.

“We were well-prepared before, and we’re even better prepared now,” said Dr. Judith Campbell, medical director of Infection Prevention and Control. “We’ve always been in compliance with the CDC. Now we have the benefit of having visited both Nebraska and Emory where patients with highly contagious infectious diseases are frequently cared for, giving us an added level of knowledge.”

The infectious disease leadership team recently observed a PPE donning and doffing exercise used to successfully contain the disease at Emory Healthcare and Nebraska Medicine. The team also received a tour of their special isolation units (SIU).

The visits to Emory and Nebraska also helped in the design of Texas Children’s first special isolation unit. The unit is designed to care for a broader range of infectious diseases. Campbell said the unit and a special response team will be dedicated to caring for patients with highly contagious infectious diseases.

“When we talk about the SIU, it really is with the intent of taking care of any unusual infectious disease that’s highly contagious,” Campbell said. “There are a lot of infectious diseases emerging. Given we are a global society, it’s certainly possible that there may be another pathogen that could have the kind of impact that Ebola has had.”

Texas Children’s leaders have worked with health care facilities across the country and with the Centers for Disease Control and Prevention to share best practices that will continue to prepare us for the possibility of receiving a patient with highly contagious infectious diseases, such as Ebola. The organization continues to monitor the situation with information from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

“We’re confident that, in many aspects, our preparation exceeds that of most other hospitals,” Campbell said. “We want to make sure we have the highest level of protection for our health care professionals.”

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Texas Children’s mission is to create a community of healthy children through patient care, education and research. One way our physicians advance the health and safety of children is through their membership with the American Academy of Pediatrics (AAP) and the Texas Pediatric Society (TPS).

On September 30, 2013, Texas Children’s and the AAP signed a first-of-its-kind partnership agreement whereby every eligible faculty member of the Baylor College of Medicine Department of Pediatrics will be given membership in the AAP and the TPS.

“This partnership enhances Texas Children’s and Baylor’s visibility and representation on AAP committees and programs,” said Texas Children’s Physician-in-Chief Dr. Mark W. Kline. “Our physicians will have a greater voice in many issues impacting the health and well-being of American children and families.”

As members of the AAP and the TPS/TX Chapter, Texas Children’s faculty can access critical information on all child health-related issues and topics, advocate for children at the local and national levels to promote key child health care initiatives, and engage in scholarly pursuits and membership in AAP sections/councils in their respective areas of expertise.

“This is an important collaboration because it strengthens our shared dedication to the health of all children,” said Tina Morton, director of membership outreach and marketing at the American Academy of Pediatrics. “We are working together to further enhance quality health care delivery and advocacy for children and we are proud to have Texas Children’s as our partner.”

Since this partnership began a year and a half ago, Texas Children’s faculty has been actively involved with the AAP and TPS to champion the health, safety and well-being of children. Many of our physicians have been appointed to AAP committees/councils to spearhead child advocacy efforts.

  • Dr. Robert Voigt is editor of the AAP’s textbook, “Developmental and Behavioral Pediatrics” and is program chair of the AAP section on Developmental and Behavioral Pediatrics.
  • Dr. Robert Ricketts received the AAP’s prestigious Anne E. Dyson Child Advocacy Award celebrating the outstanding efforts of pediatricians-in-training as they work to improve the health of children in their communities. Ricketts recently wrote a children’s book titled, Our Little Soldiers, to encourage children with HIV to take their medicine.
  • Dr. Mark Gilger is on the executive council of the AAP section of Gastroenterology and played an instrumental role in getting the U.S. Consumer Product Safety Commission to impose swift regulatory action that banned the sale of high-powered magnets in toys to prevent children from accidentally ingesting super strong, rare- earth (or Neodymium) magnets.
  • Dr. Fernando Stein is one of the founding members of the AAP section on Critical Care, Dr. Carl Tapia serves on the AAP Community Access to Child Health Program, Dr. Mark Ward serves as president of the TPS, and Dr. Krithka Lingappan is the chair of Trainees and Early Career Neonatologists within the AAP section on Perinatal Pediatrics.

“We encourage our physicians to take advantage of their membership with the AAP and TPS,” said Texas Children’s gastroenterologist Dr. Bruno Chumpitazi, who is a member of the Texas Children’s/Baylor-AAP oversight committee. “Together, we can create a lasting and meaningful change for the patients we serve.”

Click here for more information about the AAP. Click here to learn more about the TPS.

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Shelley Ellison, director of Physical Medicine and Rehabilitation, was strapped inside an evacuation sled holding a doll, which represented a baby, and was evacuated from the Inpatient Rehabilitation Unit (IRU) down 12 flights of stairs and across a street to the Feigin Center for safety. It was just an exercise, but it was an exercise in preparedness.

The IRU practiced their vertical evacuation procedures to learn what it would take for the entire eight-bed unit to leave using the exit stairs in case of an emergency. This was the second time the team has taken part in this exercise that is required by the Commission on Accreditation of Rehabilitation Facilities (CARF), an international, independent, nonprofit accreditor of health and human services. The IRU received the highest level of CARF accreditation, last year. The Texas Children’s Hospital IRU is the only pediatric inpatient rehabilitation facility in the state of Texas, and one of only 31 worldwide with this accreditation.

These annual evacuation exercises, while required for CARF accreditation, are an excellent demonstration of preparedness and interdisciplinary teamwork.

“We want to demonstrate our proficiency in safely evacuating these patients who are “mobility impaired,” said Shelley Ellison, director of Physical Medicine and Rehabilitation. “The exercise goes beyond teaching us what needs to be done in an emergency; it gives our staff a sense of confidence in case they ever have to evacuate in a real scenario.”

The unit learned many lessons that are now being put into motion as they prepare for future exercises and education that is being presented to the staff.

See photographs from the evacuation drill below.

Lessons learned
Once the drill began, each “patient” in the exercise was assessed for medical stability and was paired with two staff members deemed appropriate for the level of medical complexity for the entirety of the evacuation drill. In some cases, it was determined that the patient required extra medical equipment, so a third person was added to carry the equipment and perform “in transit emergent” procedures such as suctioning. From preforming this exercise twice, the team has determined that caregivers should be pre-assigned a patient for emergency evacuation procedures each shift in preparation for an emergency.

Evacuation from the 12th floor to the first and across a street to a pre-designated evacuation point is not an easy task, even given the EvacusledsTM that are designed for this specific instance. The sleds were difficult to maneuver down the narrow stairways, leading the two member teams to switch off their positions to share the burden of the weight.

Amy Puglia with Emergency Management said while the exercise isn’t being performed in every other unit, it helps our Emergency Management department determine the system-wide needs to best prepare for an emergency that would require a vertical evacuation.

“In these exercises we are demonstrating the plan and making sure the plan works,” Puglia said. “We have evacuation plans in place and these exercises are a way for us to ensure those plans are up to date and tested.”

A team effort
It took teams from across the organization including emergency management, security services and even the Houston Fire Department to pull off this exercise.

“To make this exercise successful, it took a lot of preparation and hard work on the part of many teams,” said Dr. Christian Niedzwecki, medical director of Inpatient Rehabilitation Unit. “It really is an indication that the caregivers of this institution are dedicated to ensuring the safety of our patients in an emergency.”

“All it takes is that one time,” Ellison said. “We hope it never happens, but we want to prepare in the event that it does. Catastrophic events have happened across the country and could happen anywhere.”

For Ellison, being on the evacuation sled gave a perspective of how the patients would feel in an emergency, giving another dimension to the emergency preparations.

Evacuation Drill Photo Gallery

41515TuDuong175Texas Children’s Hospital is excited to announce Dr. Duong Dai Tu has joined the hospital as a new pediatric urologist. Tu, whose appointment was effective April 1, also has been appointed assistant professor of urology and attending surgeon in Urology at Baylor College of Medicine.

“Dr. Tu is bringing an exciting vision to the surgery team that will help us continue to develop a preeminent program, enabling us to better serve our patients and their families,” chief of Urology Dr. David Roth said.

Tu’s clinical interests include complex urogenital reconstruction, such as treating patients with spina bifida, hypospadias and disorders of sexual differentiation. His research will focus on improving the quality and safety of care for such patients and developing stronger outcomes for pediatric patients with both acute and chronic urologic conditions.

Dr. Tu is trained in the pediatric robotic surgery program and has experience with the da Vinci Si Surgical System. Through the use of robotic surgery, surgeons are able to perform minimally invasive reconstructive procedures in patients of all ages.

Tu earned his bachelor’s degree from the University of Missouri and his medical degree from The University of Texas Medical Branch in Galveston, Texas. He completed his surgical training at St. Louis University Hospital and urologic residency at Columbia University Medical Center/New York Presbyterian Hospital. Additionally, he completed his pediatric urology fellowship at Harvard Medical School and Boston Children’s Hospital.

The Texas Children’s Urology Division offers the most advanced surgical care for routine urological needs, as well as genitourinary problems related to congenital birth defects, trauma and a range of other medical conditions. The team has special expertise in minimally invasive, laparoscopic surgical techniques, including extremely delicate procedures in newborns and infants, anorectal malformations, urological conditions caused by neurological problems, such as spina bifida, and management of stone disease.

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Dr. Wesley Lee, co-director of Texas Children’s Fetal Center and section chief for women’s and fetal imaging at Baylor College of Medicine, recently received the William J. Fry Memorial Lecture Award from the American Institute of Ultrasound in Medicine (AIUM).

The award recognizes a current or retired AIUM member who has significantly contributed in his or her particular field to the scientific progress of medical ultrasound.

Lee’s lecture titled, “Great Expectations: The Way Forward in Fetal Imaging,” was presented during the opening session of the 2015 AIUM/WFUMB Annual Convention in Lake Buena Vista, Florida.

Among his many accomplishments, Lee has authored 148 peer-reviewed articles and 20 book chapters pertaining to maternal-fetal medicine, prenatal detection of congenital anomalies, 3-/4-dimensional fetal sonography and fetal magnetic resonance imaging.

April 7, 2015

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“I sat for a long time over that child’s body. He was cute as can be with his hair all over, almost like beach hair, and that look that he had always been a playful boy. But play was not in his future, at least not here anyway.”

They’re the words Texas Children’s Hospital Chaplain James Denham spoke before the annual blue ribbon tying ceremony on April 1, which kicked off Child Abuse Prevention Month. Denham wrote about just one of the many children who he’s seen affected by child abuse and neglect. This little boy didn’t make it. He represents some 17 children who have died as a direct result of their abuse or neglect over the last year at Texas Children’s. Last year, 1,319 children were identified as being victims of neglect or abuse after being treated at Texas Children’s Hospital. 1,319 blue ribbons and 17 black ribbons were tied on the fence of the children’s playground just outside the Abercrombie Building in remembrance of these children. Blue pinwheels were also placed around the playground, a national symbol for child abuse prevention efforts.

“By tying those blue and black ribbons on a fence that hundreds pass by every day, we dignify each of those children’s lives,” Denham said. “We proclaim that their story matters. The ribbons do not honor a statistic, they honor a child.”

Employees gathered to hear about the dreadful statistics and thank those who work tirelessly to advocate for these children. According to The Texas Association for the Protection of Children, in our state, there is an average of more than two deaths from child abuse or neglect every single week. Each day, 182 children are confirmed victims and more than seven children are maltreated every hour. As the largest children’s hospital in the nation, Texas Children’s advocates for these children. The Child Abuse Prevention team (CAP) works to identify abuse and educates families and the community in an effort to prevent it from happening.

“We are very fortunate at Texas Children’s Hospital to have the CAP team to care for this very delicate patient population,” said Roxanne Vara, director of CAP. “It takes a very special skill set to be faced with the complexities that our CAP team is faced with serving these maltreated children.”

The ribbons will remain on the fence for the month and serve as a constant reminder of the disheartening reality.