July 11, 2017

When a patient is transferred to or from Texas Children’s Hospital, several wheels are set into motion to make the process run smoothly for our patients and their families.

People from various areas of the organization jump into action to make the best decision on where the patient needs to go and how they should get there.

For decades, the transfer process has prevailed using little to no technology to transfer an average of about 1,300 patients a year to and from Texas Children’s Hospital in the Medical Center, West Houston and The Woodlands. On April 19, all that changed with the opening of Texas Children’s Nerve Center, a communications hub for everyone involved in the transfer process and beyond.

“This is another great day at Texas Children’s Hospital,” said Texas Children’s President and CEO Mark A. Wallace at the center’s grand opening ceremony. “This Nerve Center is distinctive, innovative, forward thinking and a great example of the amazing leadership we have here at Texas Children’s.”

Equipped with state-of-the-art technology, the Nerve Center is located in a large, high-tech room on the third floor of Texas Children’s Pavilion for Women. Half of the room is occupied by representatives from the hospital’s security and facilities departments. The other half houses representatives from the departments of Room Management, Transport Services and Critical Care.

View photos of the Nerve Center below.

When a call about a transfer comes into the center, representatives from all teams work together to assure an efficient, rapid and accountable, transfer occurs that provides the highest quality and safest care possible for Texas Children’s high risk maternal, neonatal and pediatric population.

“We have all the people in the room we need,” said Assistant Director for Transport Services Deborah D’Ambrosio. “It’s so much easier to coordinate, be efficient and supportive to families in referring hospitals.”

One notable change made with the opening of the Nerve Center was the splitting of responsibilities for transfers and transports. Transfers deal with patients who are either coming or going to acute care and transports handle patients who are much sicker and either need a physician or a higher level of care while being moved to where they need to be. At the Nerve Center, transfer calls go to one team and transport calls go to another. The team that handles the transport cases includes a transport charge nurse and a critical care physician.

“At the Nerve Center, you have one directive and no distractions by competing interests,” said Dr. Mona McPherson, the Nerve Center’s medical director. “Your sole focus is on the transport team and getting the patient where they need to be safely and quickly.”

In addition to getting everyone in the same room and a few organizational tweaks, the biggest change to Texas Children’s transport process was the implementation of technology that enables everyone in the Never Center to do their job better.

When you step into the Nerve Center, there are many different pieces and types of technology. Each workstation has four monitors displaying information vital to the transport process. There is a huge LED display at the front of the room showing a list of patients coming and going from Texas Children’s, the location of all Texas Children’s ambulances, each of the organization’s two, soon to be three helipads, and census data. And, there are several systems operating behind the scenes that connect everyone in the room with the most up-to-date information needed to make the best decision possible about a patient coming to or leaving Texas Children’s.

“We’ve taken a department that was using very little technology to one that uses a lot in various ways, all of which are able to improve their outcome,” said Melissa Witt, a registered nurse and a senior system analyst for Texas Children’s Information Services. “We’re already seeing good results.”

During the first month the Nerve Center was launched, the Transfer Team reduced their time from dispatch to pick up by 20 minutes. It used to take the team 50 minutes to get out the door. Now it takes them 29 minutes. In addition, the number of transfers has gone up, breaking a record in May with 151.

“We’ve had more than one community ER doc say, ‘Wow, this is the easiest I’ve ever been able to get a child into Texas Children’s,” McPherson said. “And that really is our mission central here. We want to make people want to call us, not because we’re just good and give excellent care, but because it’s really easy to get a patient in here.”

June 20, 2017

Just before Father’s Day, 14-year-old Gage Lipscomb received a gift from his father like no other – a kidney.

On June 14, Dr. Richard Link, medical director of living donor kidney transplant at Baylor St. Luke’s Medical Center, removed David Lipscomb’s left kidney and released it to the transplant team at Texas Children’s Hospital.

During a six-hour procedure, Dr. Christine O’Mahony, surgical director of kidney transplantation at Texas Children’s Hospital, transplanted Lipscomb’s kidney into Gage, the youngest boy of 10 siblings.

Gage was diagnosed with solitary kidney as a baby and was placed on medication following the removal of his right kidney at a young age. For many years, Gage experienced a seemingly typical childhood, excelling in academics and devoting his free time to playing soccer, baseball and basketball. But recently, his health started to decline.

“He was not yet on dialysis, but if he didn’t get a kidney transplant soon, he would have had to have gone on dialysis,” O’Mahony said.

So Gage’s dad stepped up and became his donor.

Early Wednesday morning while the teen was being prepped for surgery at Texas Children’s, his dad was in a nearby operating room at St. Luke’s having laparoscopic surgery – a minimally invasive operation – to remove his kidney.

“The two hospitals are attached,” said O’Mahony. “Dr. Link, the urologist who took out the kidney in David, started around 8 a.m. in the morning.”

The timing of the two events is important.

“We want to minimize the time between the kidney coming out of the donor and implanting it into the patient. I walked over to St. Luke’s to help take out David’s kidney with Dr. Link. The kidney still had blood in it so we had to flush the blood out,” O’Mahony said.

Then, she said, “We literally packed it up in a cooler so it stays cold and walked back to Texas Children’s and unpacked it” and “sewed” David’s kidney inside of Gage.

The father and son are doing well and spent a very special Father’s Day recovering and giving thanks for the opportunity to undergo this life-altering operation.

“I’m glad you are my dad,” Gage told his father during one of their hospital room visits. “Thanks.”

David said giving Gage his kidney was the least he could do and that knowing his son is going to be OK is the best Father’s Day gift he could ever have.

To read and watch news coverage of the living donor transplant, click any of the links below. For more information on Texas Children’s Transplant Services click here.

Just before Father’s Day, dad donates kidney to 1 of 10 children (CBSNews.com)
ABC World News Tonight Facebook post
Dad’s priceless gift to son (Houston Chronicle)
Father donates kidney, saves 14-year-old son’s life (CBS 11 KHOU)
Father donates kidney to 14-year-old son who had kidney removed (ABC 13 KTRK)

June 13, 2017

Lynlee Boemer, a miracle baby who underwent fetal surgery performed at Texas Children’s Fetal Center to remove a large tumor (Sacrococcygeal Teratoma) growing from her spine, celebrated her first birthday on June 6.

Last week, Jeff and Margaret Boemer were at Texas Children’s for their daughter’s follow-up clinic appointment with Dr. Oluyinka Olutoye, co-director of the Fetal Center. Since their daughter’s surgery, Lynlee is meeting all of her milestones and is very active. She loves to crawl, pull up to stand and has several favorite words she likes to say like, “hi, bye-bye and Mama and Da-Da.”

“She has been in physical therapy, and thankfully, we have been able to take a break from that since she is doing so well,” said Lynlee’s mom Margaret Boemer. “She’s pulling up and almost walking. But we’re also seeing other doctors to check for GI and urology type issues. But other than that, she is doing really, really well.”

Boemer says one of the biggest blessings of sharing Lynlee’s story has been that other women pregnant with babies who have the same diagnosis as Lynlee are reaching out to her via social media, and she is able to give them hope and often refers them to Texas Children’s Fetal Center.

Boemer was 23 weeks and 5 days pregnant with her daughter Lynlee when she underwent emergency fetal surgery to remove the baby’s Sacrococcygeal Teratoma (SCT), a large vascular mass. Occurring in only 1 in 40,000 pregnancies, Lynlee’s SCT was robbing her blood supply and would eventually cause heart failure.

Lynlee had a 50/50 chance of survival. Olutoye and a surgical team worked for approximately five hours to remove the tumor growing from the baby’s tailbone, which was almost larger than the baby herself.

During the surgery, Lynlee’s heart stopped and had to be re-started and she was also given a blood transfusion. Surgeons made an incision in Margaret’s uterus and pulled out the baby from her legs to her torso so they could remove the tumor. Once the incision was closed, Lynlee was placed back inside of her mother and Margaret’s uterus was sewn shut and she was on bed rest for the remainder of her pregnancy. Surgeons were able to remove about 90 percent of the tumor, but as the pregnancy progressed, the tumor began to grow again.

Margaret was 36 weeks pregnant when Lynlee Hope was born for the second time via C-section on June 6, 2016 weighing 5 lbs., 5 oz. Lynlee was taken to the level 3 NICU for an evaluation, but was doing so well she was transferred to the level 2 nursery. At 8 days old, Lynlee underwent a second surgery to remove the rest of the tumor from her tailbone including some that had grown inside of her body.

Olutoye removed the remaining SCT tissue and Lynlee recovered wonderfully in the NICU and was able to go home just weeks after her surgery.

The family, from Lewisville, Texas, is now enjoying life at home as a family of five and they come to Texas Children’s for check-ups as Lynlee grows.

“We’re thankful that we gave her a chance at life,” Boemer said. “And we’re very grateful for all that the doctors at Texas Children’s have done to give her that life and all the wonderful care that they gave me and Lynlee while we were here.”

May 30, 2017

As chief of the newly created section of Public Health Pediatrics at Texas Children’s – the nation’s largest and first public health section within a children’s hospital – Dr. Christopher Greeley has devoted much of his resources and time toward developing a one-of-a-kind, community wide program aimed at child abuse prevention.

“As a board certified child abuse physician, I kept seeing children after they were harmed,” said Greeley, who also is a professor of pediatrics at Baylor College of Medicine. “It would be a great day if no one were hurt. And the only way for that to happen would be for the health care team to spend more time on prevention.”

Greeley uses this analogy to illustrate his point:

Imagine standing by a river and watching kids floating by. You pluck them out of the river to rescue them. But you need to go upstream to find the break in the fence that is allowing the kids to fall into the water. Going upstream to find and correct the cause of problems is the model of public health.

“We have been spending all of our time scooping kids out of the river, and now we’re developing a program, a strategy to start going upstream,” Greeley said. “We will always take care of these kids, but part of what our team does is focus on socioeconomic factors that place kids and families at risk in the first place.”

Launched in October 2015, the Public Health Pediatrics section has two components – child abuse pediatrics and the Center for the Study of Childhood Adversity and Resilience (CARE). Both components work together to engage the community around perceived risk factors and improve the trajectory for children of abuse and neglect.

The child abuse pediatrics program focuses on four main areas:

  • Excellence in clinical care: About 2,500 suspected victims of abuse and neglect are evaluated annually at Texas Children’s and the Children’s Assessment Center (CAC) in Houston. Care is provided at Texas Children’s Main Campus and planned for the new Texas Children’s Hospital The Woodlands campus. Consultative services are available at Texas Children’s Hospital West Campus. The program provides medical support to CACs in Houston and Brazoria County. Because children in the foster care system are at risk of abuse, Texas Children’s is developing a foster care clinic.
  • Training and education: Baylor and Texas Children’s have three doctors in training in an accredited fellowship in child abuse pediatrics, one of the largest such programs in the country. Besides education for medical students and the greater Houston medical community, a training program is being developed for post-doctoral public health practitioners. An outreach program trains members of the community on signs and symptoms of child abuse.
  • Scholarship and new knowledge: Clinical research varies from early recognition of abuse to improving mental health services for children in foster care.
  • Community presence: The program’s interdisciplinary team of physicians, nurses, social workers and public health practitioners help primary care physicians and nonprofits who care for abused and neglected children and are available to civic groups, church groups and YMCAs.

In conjunction with child abuse pediatrics, the main focus of CARE is community-level research to identify, promote and implement strategies to prevent adverse childhood experiences such as poverty, violence, inequality, homelessness, and lack of mental health, education and nutrition.

For instance, to help relieve parental stress and improve children’s outcomes, the launch of the upWORDS program at Texas Children’s teaches parents how to improve the quantity and quality of language spoken with their children, which has been known to increase brain development and positively impact their child’s future.

The Public Health Pediatrics section is also working with nonprofit communities, city and county agencies to develop partnerships and strategies to help families cope with other issues including postpartum depression, violence, and food insecurity or hunger in Houston.

“Improving the circumstances that cause adverse childhood experiences is a long-term complex undertaking that must be adapted to fit each community,” Greeley said. “But the section of Public Health Pediatrics is ready to do whatever it takes to improve the lives of children.”

Texas Children’s Physician-in-Chief Dr. Mark W. Kline who recruited Greeley to head this new section applauds the success and foresees the future growth and far reaching impact of this program.

“As a transformative figure in the Department of Pediatrics, Greeley will inspire a generation of public health-oriented pediatricians-in-training who, in turn, will populate programs across the country,” Kline said. “His program is a prime example of the things that we are doing that other pediatrics departments in the U.S. can replicate.”

May 23, 2017

Drs. Hsiao-Tuan Chao and Laurie Robak, physician-scientists at the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s, received scholarship grants from the American Academy of Neurology (AAN) to support studies on neurodevelopmental and neurodegenerative diseases.

Chao, a postdoctoral associate in the laboratory of Dr. Hugo J. Bellen was awarded the 2017 Neurology Research Training Scholarship for her proposed study titled, “Transcriptional Dysregulation of Neural Circuits in Neurodevelopmental Disorders.” Using the laboratory fruit fly and mouse, she will explore how changes in the function of master regulators of gene expression, like EBF3, can cause childhood neurologic diseases. Chao’s discoveries will provide some answers and improve the quality of life for many of these children and families.

Robak is a postdoctoral fellow in the laboratory of Dr. Joshua Shulman. She was awarded the 2017 Clinical Research Training Fellowship in Parkinson’s Disease for her proposal titled, “Elucidating Genetic Links Between Lysosomal Storage Disorders and Parkinson’s Disease.” Her study will identify lysosomal storage disorder genes as risk factors for Parkinson’s Disease, which will hopefully lead to improved diagnosis and risk assessment, and development of novel therapeutic strategies.

Twenty award winners, including Drs. Chao and Robak, were recognized at the 69th Annual Meeting of AAN, the world’s largest association of neurologists in April.

Click here for more information about their proposed research studies.

May 16, 2017

Dr. Sundeep Keswani, surgical director of Basic Research and pediatric surgeon at Texas Children’s Hospital and associate professor of surgery in the Division of Pediatric Surgery at Baylor College of Medicine, was recently awarded a $300,000 grant over a period of three years for his project “Targeting the Extracellular Matrix: an Innovative Strategy to Improve Pulmonary Hypertension in Congenital Diaphragmatic Hernia.”

The award was from the March of Dimes Foundation, which supports research consistent with its mission to improve the health of babies by preventing birth defects, premature birth and infant mortality. Less than 10 percent of applications submitted annually to the foundation are awarded.

The focus of Keswani’s awarded research is to understand the molecular mechanisms of neonatal pulmonary hypertension and develop new innovative therapies for these patients.

“The data and ideas in this application were developed here at Texas Children’s and are a direct result of the support we have received from the Department of Surgery and the hard work of our team,” Keswani said. “This work illustrates the need for surgeons to engage in basic science research to take observations from the bedside to the bench with the overall goal of improving patient outcomes.”

Keswani is a member of the pediatric surgery and fetal surgery teams at Texas Children’s and the principal investigator for the Texas Children’s Laboratory for Regenerative Tissue Repair. His NIH-funded laboratory was launched about two years ago and spans all 10 surgical divisions at Texas Children’s. Researchers in the lab study the molecular mechanisms of regenerative fetal tissue repair and are actively developing novel therapeutics to achieve postnatal regenerative wound healing.

“Conducting research is essential to provide new techniques and treatments for children’s surgery,” said Texas Children’s Surgeon-in-Chief Dr. Charles D. Fraser Jr. “Dr. Keswani’s recent award from the March of Dimes is an example of how the Department of Surgery is continuing to grow in this area, bringing in new funding and contributing significant research findings. We are committed to basic and translational research by supporting surgeon-scientists at Texas Children’s Hospital.”

Other recent awards garnered by researchers in the Regenerative Tissue Repair Lab include:

Balaji receives Wound Healing Foundation Research Grant

Dr. Swathi Balaji received the 2017 Wound Healing Foundation-FLASH Clinical Wound Healing Grant Award for her proposal titled “Pathogenesis of Cutaneous Fibrosis and Scarring.”

It is unknown why some individuals heal with robust fibrosis and scarring while others heal from similar injuries with less scarring. Balaji and her colleagues want to understand how immunoregulatory factors, particularly lymphocytes, make decisive contributions to dermal fibrosis. They propose that there are fundamental biologic differences in how fibroblasts and lymphocytes crosstalk to influence scar formation in different people. At the completion of this study, their team hopes to better understand how inflammation shapes scar formation and start working towards the development of innovative tools to promote immune regulatory responses in wounds to prevent dermal scarring as well as help other disease processes characterized by excessive fibroplasia.

The Wound Healing Foundation (WHF), through the support of the Wound Reach Foundation presented this award to Balaji at the 2017 Wound Healing Society Annual Meeting in San Diego.

Basic science research conducted by Balaji received national awards

Balaji was this year’s recipient of the ACell Young Investigator Faculty Award presented to a junior faculty member for a research abstract at the Regenerative Medicine Workshop at Hilton Head. Balaji presented a keynote lecture on her work titled “Effect of Stretch on Extracellular Matrix and Morphology of Fibroblasts in Regenerative Wound Healing.”

Tissue repair after an injury can have a spectrum of fibrosis outcomes, and fibroblasts are the major cell type that regulates the extracellular matrix and fibrosis. Even within a single tissue, fibroblasts exhibit considerable functional diversity in response to different environmental factors such as biomechanical tension and inflammation.

Balaji and her colleagues want to explain the signaling mechanisms among fibroblasts that communicate and regulate their fibrogenic phenotype. Their group is studying the role of exosomes, which are microvesicles on the order of 30-150 nm and contain functional biomolecules such as proteins, lipids, RNA, miRNA, as biomarkers and/or targeted therapeutics to regulate the functional diversity of tissue fibroblasts and their cellular cross talk.

Dr. Monica Fahrenholtz, the postdoctoral fellow on this research project, received the Wound Healing Society trainee travel award at the conference. She gave a quick presentation at this year’s annual meeting.

Texas Children’s joined forces with community leaders on May 5 to celebrate the opening of Specialty Care at Eagle Springs.

The clinic at 5514 Atascocita Road, Suite 190, in Humble is Texas Children’s newest pediatric specialty care clinic, offering convenient services to children and families in Humble and surrounding areas.

Services offered at the Eagle Springs location include:

  • Audiology
  • Otolaryngology (ENT)

Both services are available five days a week.

To make an appointment for Specialty Care at Eagle Springs, please call 281-666-5006.

Texas Children’s will continue to offer world-class care in the areas north of Houston at the health system’s Kingwood Glen location at 19298 West Lake Houston Parkway in the Kroger shopping center.

Services offered there are:

  • Cardiology
  • Full-Service Orthopedics
  • Sports Medicine
  • Pulmonology
  • Plastic Surgery
  • Pediatric Surgery
  • Allergy and Immunology
  • Urology
  • X-rays, EKG, ECHO, Ultrasound

To make an appointment for Kingwood Glen, please call 281-812-0280.