September 18, 2018

As part of National Childhood Cancer Awareness Month, Texas Children’s Bone Marrow Transplant Unit (BMT) was transformed for a few hours last week into a full-fledged parade route – music, costumes and all.

The Lace Up 4 Life event – hosted in part by Be The Match, which manages the largest and most diverse marrow registry in the world – began in the inpatient portion of the unit with patients dressed in super hero capes and costumes parading downs the halls with staff members by their side and cheering them on.

“We enjoy this event every year,” said Dr. Robert Krance, director of the Pediatric Bone Marrow Transplant (BMT)/Stem Cell Transplant Program at Texas Children’s Hospital. “It’s a time for us to celebrate the lives of those who have been saved by a bone marrow transplant, and to remember those who are still racing to find a match.”

After several laps around the inpatient unit, patients retired to their rooms while the parade continued to the outpatient portion of the unit, pausing for a special announcement from Hope Guidry-Groves with Be The Match.

“Today, 16-year-old Jacob Bustamente is going to meet his donor, Heather Wallace, for the very first time,” Guidry-Groves said. “We are so fortunate to be a part of an organization that makes moments like these possible.”

Jacob is a patient at Texas Children’s and so is Wallace’s son. When they first laid eyes on one another they quickly embraced in a long, emotional hug.

“Thank you so much,” Bustamente said. “You are such a blessing.”

Wallace told the audience that everyone should join the marrow registry. “There’s no reason not to,” she said.

Texas Children’s Cancer Center has a premier bone marrow and stem cell transplantation program. Our state-of-the-art, 15-bed inpatient transplant unit is among the largest of its kind in the Southwestern United States and focuses exclusively on transplantation. The Bone Marrow Transplant Clinic performs over 100 transplants per year.

Texas Children’s works closely with Be The Match to find donors for our patients. Learn how marrow donation works, the steps of a patient transplant, steps of donation, and factors that can impact the likelihood of finding a match here. A marrow transplant may be someone’s only hope for a cure.

Imagine you’re the parent of a newborn with an arm injury. During your admission you’re told not to move the arm and to protect it all times. Now imagine coming back for your clinic appointment and hearing that it’s time to start moving the arm at home – unsupervised. For parents of children with brachial plexus birth palsy, this moment can be daunting.

Brachial plexus birth palsy occurs when there’s a stretch or tear in the bundle of nerves known as the brachial plexus, located near the neck and upper arm area. These injuries may cause weakness, pain, sensory loss and functional impairment. Sometimes the nerves need time to recover, anywhere from a few days to a year. Other times surgery might be required. Regardless, a focus on treatment during the waiting period can help prevent the shoulder joint from becoming stiff. The only way to keep the joint loose is through passive exercises, which must be performed early and often by the patient’s family.

“If we can find a way to keep these shoulders loose, we can eliminate many of the problems we see down the road,” said Dr. Chris Pederson, head of Texas Children’s Pediatric Hand and Microvascular Surgery programs. “Unfortunately, for a lot of parents performing the exercises can be an intimidating task.”

To help empower parents, Texas Children’s brachial plexus clinic recently teamed up with engineering students at the Oshman Engineering Design Kitchen at Rice University to develop a model that allows parents to practice movement exercises in clinic before performing them on their children at home. The project was part of an ongoing collaboration with Rice begun in 2014 by Texas Children’s Brachial Plexus Clinic Coordinator James Northcutt.

“I originally pitched the idea for the brachial plexus model to the freshman design class at Rice in the fall of 2017,” Northcutt said. “Using the model, I wanted parents to be able to identify the different parts of the shoulder and shoulder blade and feel the difference between a stiff shoulder and a healthy shoulder. And ultimately, I wanted to help alleviate the anxiety parents feel about moving their child’s arm by giving them the opportunity to practice the exercises on the model first.”

Northcutt met with the students monthly to serve as clinical lead on the project, providing information about anatomy, biomechanics, caregiver needs, therapy concerns and overall device application. Less than a year later, design team “Can’t Brachius,” produced a professional and well-functioning prototype. But it needed to be tested by parents. Mayra Oliver was the first.

When she was first told she’d need to perform exercises on her infant son, Raphael, Oliver was nervous and worried. But a demonstration of the model and the opportunity to use it herself had her feeling much more confident.

“When I first knew that Raphael was hurt, I was scared I’d do the exercises wrong and hurt him or somehow make his injury worse,” Oliver said. “Being able to feel the different parts of the shoulder on the model and then on Raphael, and then feeling the way the healthy shoulder should move freely, as opposed to the stiffness of an injured shoulder, was very helpful. I think this model will be very useful in helping families feel less nervous about doing the exercises.”

Using a survey developed in conjunction with the Rice design team, Northcutt will begin conducting a randomized control study over the coming months to determine the device’s efficacy both in educating families and in preparing them for the performing the exercises at home.

“I look forward to finding out more about our parents’ needs in helping these infants grow up to function at the highest level,” Northcutt said. “This project represents an attempt to improve patients’ futures by equipping parents to be informed, active care team members.”

The Brachial Plexus Clinic is part of Texas Children’s Brachial Plexus Program, which comprises plastic surgery, orthopedic surgery, physical medicine and rehabilitation, and occupational therapy. The clinic provides comprehensive care for brachial plexus injuries including specialized assessment, developmental and functional screening, primary nerve surgery when indicated, secondary orthopedic surgery for the shoulder and lower arm when indicated, and preoperative and postoperative care in the therapy setting. The brachial plexus team provides high-level, evidenced-based care, utilizing ultrasound to monitor shoulder integrity in infants recovering from brachial plexus injury, providing specialized splinting for prevention of joint contractures in the arm, and implementing best surgical practices for primary nerve and secondary orthopedic procedures.

Through dedication, hard work, research and partnership, Texas Children’s Newborn Center has lowered its rate of a serious lung condition in premature infants by more than 13 percent over the past year.

The center’s current rate of Bronchopulmonary Dysplasia (BPD) is below the national average for the first time in a decade and is well below what is expected based on the size of the unit and the type of patients cared for in the NICU at Texas Children’s Hospital, according to the Vermont Oxford Network, an organization that helps hospitals track outcomes of premature babies and allows comparison to other institutions across the country.

“This is a dramatic improvement for us,” said Dr. Monika Patil, one of the neonatologists involved in Texas Children’s campaign to lower BPD rates. “We now have the lowest rate of BPD since we joined the Vermont Oxford Network in 2006.”

Patil said every team member in the Newborn Center contributed to this outstanding achievement and that their work has been directed by the Avoiding Lung Injury (ALI) team. ALI is a multidisciplinary group focused on improving the respiratory outcomes of very low birth weight infants in the NICU through quality improvement projects. This team was created by Dr. Lakshmi Katakam, medical director of the NICU, and Dr. Gautham Suresh, chief of Neonatology, with the vision of empowering NICU staff to tackle one of the most important determinants of long-term outcomes in premature babies – that is, whether or not a premature infant develops BPD.

BPD is one of the key conditions that influences long-term outcomes in a low birth weight infant, Katakam added. And, for many infants, it determines whether they go home on oxygen or ventilator. That’s why close monitoring of these patients is so important.

What ALI has found, and clinicians have worked to implement, is that rates of BPD can be lowered if infants who need respiratory aid are treated with gentler modes of therapy that protect the premature baby’s lungs from being injured , such as Continuous Positive Airway Pressure (CPAP) instead of being intubated and placed on a ventilator. If intubation and assistance of ventilator are necessary, the group discovered infants fare better if clinicians closely watch the amount of ventilator support and oxygen being administered, only giving infants what they needed when they need it.

To implement and maintain these changes, the Newborn Center is trying innovative staffing models that enable nurses and respiratory therapists to become even more involved in respiratory care of premature patients. Instead of tending to more than one patient during their shift, nurses caring for infants on CPAP are now assigned to care for only one patient at a time during the first few days of life when premature babies’ lungs are most vulnerable to injury. There is also a team lead respiratory therapist that offers an extra layer of support and keeps a watchful eye to ensure that CPAP is successful.

“This method of care is highly involved and requires a lot of support from our nurses and respiratory therapists, but is what’s best for our patients during such a critical period in their lives,” Katakam said. “It’s also what sets us apart from other institutions that might not have the resources to give patients such individualized care.”

To ensure such close care is continued, the Newborn Center is working alongside nursing leaders, Rebecca Schiff and Heather Cherry, to perform a nursing research project to improve CPAP management. The project is focused on understanding the correlation between nurse-patient ratios and respiratory outcomes in infants on CPAP.

In addition, the ALI group is continuing its efforts to research and implement strategies for minimizing time a newborn spends on the ventilator by extubating as early as possible, using gentle ventilation modes, optimizing use of medications proven to be effective in reducing BPD, and minimizing exposure to oxygen, which can be harmful to premature infant’s lungs and eyes, if used in excess.

The ALI team is hosting a regional respiratory care conference on October 19 at Texas Children’s Hospital. NICU providers from all across the country will share their experiences and learn from experts at Texas Children’s. For more information about the First Annual Baylor Avoiding Lung Injury conference, please contact Katakam at or ext. 6-1365. Online registration is available at

“We are very excited about our progress but still have a long way to go,” Katakam said. “Preventing BPD is an ongoing effort but our team is determined and energized to do everything we can to prevent lung injury along a premature infant’s journey, from the time a baby takes the first breath in the delivery room to the time they leave our NICU.”

Excluding those mentioned above, those involved in the NICU’s effort to lower the rate of BPD in premature infants include:

  • Isa Baruah
  • Dr. Rebecca Cavazos
  • Dr. Milenka Cuevas
  • Dr. Shaeequa Dasnadi
  • Anne Debuyserie
  • Dr. Cary Fernandes
  • Jennifer Gallegos
  • Dr. Behru Gandhi
  • Suzanne Iniguez
  • Sheela John
  • Maxine Keller
  • Dr. Brian King
  • Dr. George Mandy
  • Jessica Ramirez
  • Dr. Rita Shah
  • Kymberly Sherwood
  • Dr. Binoy Shivanna
  • Dr. Nathan Sundgren
  • Eva Vuong

September is National Suicide Prevention Month and along with continuing to inform people about warning signs, Texas Children’s has recently elevated our prevention tactics with the use of the Columbia Suicide Screening Rating Scale (C-SSRS).

“Texas Children’s Hospital recognizes that our team, our system has an essential role to play in helping young people and their families who may be struggling with mental health problems and suicidal thoughts or actions,” said the Chief of Psychiatry at Texas Children’s Hospital, Dr. Laurel Williams. “Over the past 18 months our Psychiatry, Social Work, Psychology, Nursing and Pediatrician partners have been improving our assessment and care for these young people.”

According to the Columbia Lighthouse Project, C-SSRS supports suicide risk assessment through a series of simple, plain-language questions. The answers help users identify whether someone is at risk for suicide, assess the severity and immediacy of that risk, and gauge the level of support that the person needs.

Texas Children’s is currently using the C-SSRS in all three emergency rooms for all youth over the age of 11 since March 2018, and to date we have screened more than 1,700 adolescents. Individuals who screen positive are given specific treatment plans based on the level of severity, including either further assessments by our psychiatry team or our partners, Mental Health Solutions. Mental Health Solutions is an outside team of social workers who will come to our hospital emergency rooms to assist parents. Their health care teams also locate appropriate locations for inpatient psychiatric care within Houston and surrounding counties for youth needing such specialty services.

“Additionally, the inpatient teams have undergone increased training for nurses and patient sitters in order to better address mental health needs for patients with either suicidal thoughts/actions or aggressive behaviors,” Dr. Williams said. “A safety sweep checklist was developed and is employed for any young person identified as having suicidal thoughts or actions to improve the care environment for them while admitted to our care.”

Suicide is the second leading cause of death in the United States among adolescents between the ages of 15 and 24. This is more than cancer, diabetes, cardiac and neurologic diseases and yet there is still a stigma attached to suicide. Over 450,000 emergency rooms visits annually are secondary to individuals who have self-inflicted injuries.

“This screening process has allowed our team at Texas Children’s Hospital to act on the information received to intervene prior to a suicide attempt,” Williams said. “A treatment plan is also designed to avert harm and improve the patient’s mental health.”

Future plans for C-SSRS include screening other localities within our system such as specialty and general pediatric clinics in conjunction with depression screening.

Suicide is preventable and overall, mental health disorders do have effective treatments. We encourage our entire team to fight against the stigma. For those who might be experiencing suicidal thoughts we encourage everyone to consider the following resources:

  • Emergency or urgent needs – 1-800 273-TALK (8255)
  • Texas Children’s Hospital’s Psychiatry Clinic, For outpatient assessments and treatment – 832-822-3750
  • Texas Children’s Hospital Employee Assistance Program – 832-824-3327

Click here to learn more about suicide prevention. Click here to become more involved in suicide prevention awareness.

Some of the smallest and mightiest Houston Texans fans are celebrating #TexansFriday wrapped in new, handmade fleece blankets. As they cheer on their favorite team on Sunday, the blankets will add extra comfort and Texans spirit to patients in the neonatal intensive care unit (NICU) at Texas Children’s Hospital The Woodlands.

This unit is led by a multidisciplinary team of neonatal experts – physicians and nurses – who are internationally recognized for their level of experience and knowledge in the care of premature and critically-ill infants. The NICU at Texas Children’s Hospital The Woodlands means babies can get the care they need closer to home.

Texas Children’s is the Official Children’s Hospital of the Houston Texans. For more information visit

The National Committee for Quality Assurance (NCQA) recently accredited Texas Children’s Hospital’s Centralized Credentialing Office.

The NCQA is a nonprofit organization in that works to improve health care quality through the administration of evidence-based standards, measures, programs, and accreditation. An NCQA accreditation is considered a best practice in the field of credentialing.

To earn the status, NCQA auditors performed a comprehensive evaluation of the Credentialing Office to determine if it met the organization’s standards of having a well-defined credentialing and re-credentialing process. The office demonstrated excellence with a near-perfect score of 99.6 percent.

September 10, 2018

As the opening of the new Heart Center in Legacy Tower quickly approaches, one grateful patient family is commemorating their journey with Texas Children’s with a building project of their own.

Heartwood Acres is a new subdivision being developed by Rodgers Homes & Construction, a business owned and operated by Jenny and Philip Rodgers, who came to Texas Children’s in 2014 after a routine 20-week ultrasound revealed their baby had hypoplastic left heart syndrome. Their doctors in Shreveport, Louisiana, explained that repairing this rare, complex and life-threatening heart defect would require highly specialized care that wasn’t available locally, including at least three open-heart surgeries, the first just a few days after birth. But even with surgical intervention, survival wasn’t certain. The couple was devastated.

“When they told us something was wrong, everything changed,” Jenny recalled. “I cried for months. It was as though we were mourning the loss of the family life we’d envisioned.”

After researching fetal cardiology and surgical options at top regional and national hospitals, they decided their best chance was treatment at Texas Children’s. From the moment they walked in, they knew they’d made the right choice.

“We were immediately blown away by the facilities and how state-of-the-art everything was, but what really floored us were the people,” Jenny said. “Everyone was incredible and comforting. Dr. Nancy Ayres, our fetal cardiologist, met us in the hallway and stayed with us all day. We felt like we were being taken care of from day one.”

Prior to delivery, Jenny moved to Houston to be closer to Texas Children’s, where she would remain until after her baby’s second open-heart surgery. On May 19, 2014, after months of careful planning and monitoring at Texas Children’s Fetal Center®, Jenny gave birth to Aiden at Texas Children’s Pavilion for Women. Just four days later, Dr. Jeffrey Heinle, associate chief of Congenital Heart Surgery, performed the first of Aiden’s surgeries at Texas Children’s Heart Center®. The family stayed in Houston until Aiden was ready for his second surgery, performed when he was only four months old. Less than a month later, they were discharged to return home to Louisiana.

Today, Aiden is a happy four-year-old who loves superheroes and playing soccer. And though there’s another procedure on the horizon, part of Aiden’s three-stage palliative surgical path, Jenny knows her son and family will be in the best hands possible at the No. 1 heart center in the country according to the 2018-2019 U.S. News & World Report hospital rankings.

“Heart parents are fiercely proud of their heart centers,” Jenny said, laughing. “So we’re excited that ours is the actual No. 1 heart center, especially because the rankings are so comprehensive. That kind of transparency is vital for families that need to make important health decisions. The U.S. News rankings are an easy-to-understand resource that I give to any family I meet that’s in need of specialized care.”

Of added comfort to the Rodgers family is the fact that when Aiden undergoes his final surgery, it will be in the new Heart Center in Legacy Tower. The Heart Center will occupy eight floors and will feature four cardiac catheterization labs including integrated MRI scanner, four cardiovascular operating rooms, three cardiovascular ICU floors with 48 private rooms, two cardiac acute care floors with 42 private patient rooms, and a dedicated space for families.

“I’m thrilled that we’ll have access to this awesome new facility,” Jenny said. “It’s huge to know that because of the layout of the new CVICU rooms, I don’t have to leave to sleep or shower. I can be right where I’m supposed to be – with Aiden.”

The road has been long and their journey isn’t over, but the Rodgers family is grateful for Texas Children’s and the care they’ve received. In honor of their experience, and their continued involvement in the pediatric heart community, the family decided to name their company’s first ever subdivision Heartwood Acres. When residents and visitors pass into the neighborhood, they’ll pass a plaque that tells Aiden’s story and how this place and its streets got their names. The first three streets are appropriately named Fannin, after the street where Texas Children’s stands, Ayres Circle and Heinle Way.

On September 6, the Rodgers family presented Drs. Ayres and Heinle with their own street signs, each with a personal inscription to the people who Jenny said held Aiden’s life – and his heart – in their hands.

The inscription reads:
Your care lit the path for our son Aiden’s life and we are honored to pave the streets in your name for others to live theirs.

“We wouldn’t have Aiden without them,” Jenny said. “They mean so much to us and we love them.”

Learn more of the Rodgers family’s story.