January 6, 2015

bump-watch

By Dr. Gail Demmler-Harrison

Congenital cytomegalovirus (CMV) is the most common virus that most people have never heard of. Most everyone will catch CMV at some time in their lives and never know they have it.

If a woman gets CMV for the first time while she is pregnant, she can be in a potentially dangerous situation. CMV infects almost 1 out of every 100 newborns in the United States and is the most common congenital infection.

The virus is passed to the unborn baby from the mother and can cause serious complications in the newborn, like platelet problems, liver disease and lung disease. It can also cause long-term effects on hearing, vision, growth and development by invading the brain, eyes and ears.

What makes CMV even more dangerous is that most people, including pregnant women, have never heard of CMV. Since CMV does not cause a rash like its cousin, chicken pox, you do not know who is infected and shedding the CMV.

The good news is CMV infection is potentially preventable.

If a pregnant woman is aware of CMV, she can take simple hygienic precautions to reduce her exposure to the virus. Toddlers are a “hot zone” for CMV, and by slightly modifying your behavior while pregnant, you can reduce your risk of catching this silent virus.

CMV is present in saliva and urine, so…

  1. Do not share food or drink with your toddler — no more “one for mommy one for baby” mealtime games while you’re pregnant.
  2. Do not kiss your toddler on the lips or cheek, rather hug them and give them a loving kiss on the top of the head while you’re pregnant.
  3. Wash your hands carefully after changing diapers and wiping your toddler’s nose and face.

An ounce of CMV awareness and three simple hygienic precautions while you’re pregnant are all it takes to save your unborn baby from a potentially devastating infection.

But, what if you contract CMV during pregnancy? I’ve put together a list of questions and answers with basic information that I hope you’ll find helpful. Click here to read my other blog.

December 23, 2014

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Conjoined 8-month-old twin girls, Knatalye Hope and Adeline Faith Mata, underwent a five-hour surgery December 16 at Texas Children’s Hospital Main Campus to place custom-made tissue expanders into their chest and abdomen area. The tissue expanders will help stretch the babies’ skin in preparation for their separation surgery, which is expected to take place early next year.

During their recent surgery, the infants also had an examination to help assess their anatomy and the placement of PICC catheters in preparation for the twins’ separation. Dr. Alberto Hernandez with Interventional Radiology performed the examination. Chief of Plastic Surgery Dr. Larry Hollier and Dr. Ed Buchanan with the Division of Plastic and Reconstructive Surgery conducted the tissue expander placement surgery. Dr. Helana Karlberg led the anesthesia team and Audra Rushing led the surgical nursing team.

“We are pleased the babies did so well during the surgery,” Hollier said. “A multidisciplinary team continues to monitor them in our neonatal intensive care unit as they recover.”

The tissue expander placement surgery requires a recovery time of six to eight weeks, during which additional fluid will be added to the tissue expanders, which are like balloons, to allow the skin to be stretched gradually. The extra skin is needed to provide coverage once the babies are separated.

During the girl’s recovery, the planning process for the separation surgery will continue among a team of multidisciplinary specialists in pediatric surgery, urology, plastic surgery, orthopedic surgery, cardiovascular surgery and pediatric gynecology.

“We have been preparing for the twins’ separation surgery for months and the process is ongoing,” said Dr. Darrell Cass, pediatric surgeon and co-director of Texas Children’s Fetal Center. “In addition to multidisciplinary meetings, our plans have included, among other things, building a 3-D model of their organs, conducting simulations of the surgery and post-operative care they will receive, as well as helping create devices to support their care, such as a swing which will hold the girls upright to alleviate pressure on their healing incisions.”

Anticipated to take approximately 24 hours, the separation surgery will involve two teams of surgeons who will work together to separate the twins, who share a chest wall, lungs, pericardial sac (the lining of the heart), diaphragm, liver and pelvis. The separation team will start the surgery and the reconstruction team will complete the procedure.

Surgeons at Texas Children’s Hospital in 1992 successfully separated Tiesha and Lesha Turner, who were 1 year old and shared a sternum, liver, entwined intestines and fused organs. The separation of Knatalye and Adeline will be the second such procedure performed at the hospital.

Cass said he expects the surgery to go well and for each child to be able to live independently and to have a good life.

Knatalye and Adeline were born April 11 at Texas Children’s Pavilion for Women. Delivered via Caesarean-section at 31 weeks gestation, the twins each weighed 3 pounds, 7 ounces.

The girls’ parents, Elysse and John Mata, and their 5-year-old brother, Azariah, learned during a routine ultrasound on Jan. 13 that Elysse was carrying twins and they were conjoined. Subsequently, the family was referred from a physician in Lubbock, their hometown, to the Texas Children’s Fetal Center where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care.

Now 8 months old, the babies weigh about 15 pounds each and are doing well as they continue to be cared for by a team of specialists in the Level IV neonatal intensive care unit at Texas Children’s Hospital.

Elysse Mata said the day before the tissue expander placement surgery she is confident her girls are in good hands at Texas Children’s Hospital.

“I have an extreme amount of faith in the team at Texas Children’s and in God,” she said. “I know He put us here for a reason.”

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The Solutions for Patient Safety (SPS) network has named Texas Children’s Hospital of the Month for the month of December in recognition of the organization’s efforts to improve patient safety and decrease patient harm. The award recognizes the hospital for many steps taken toward increasing patient safety including the organization of 10 different hospital acquired conditions (HAC) teams which include more than 100 employees and clinical staff. These teams review best practices from other hospitals within the network and implement those that work, while also sharing our successes with others. The award also recognizes the teams which have seen significant improvements since taking on new protocols. Over the last year, five teams have demonstrated significant decreases in harm by implementing process recommendations from the SPS network. The falls, surgical site infections, central line associated bloodstream infection and urinary tract infection HAC teams have fully adopted SPS prescribed bundles.

“As an organization, we are proud to be a part of a nationwide effort to decrease harm to patients,” said Trudy Leidich, director of quality and safety. “Through the Solutions for Patient Safety initiative, we have been able to share our best practices with other children’s hospitals and learn from their efforts as well. Being named hospital of the month is simply an acknowledgment that we are doing everything we can to improve safety within our hospital and we are honored to get this recognition.”

The SPS, formerly known as the Ohio Collaborative, began as a group of Ohio children’s hospitals working toward eliminating patient harm and soon expanded to a network of more than 80 hospitals across the nation, including Texas Children’s, which lead a national effort to implement the best strategies for creating the highest possible safety protocols for patient care.

Data sharing in the form of outcomes and process measures is another key component of the hospital’s participation in the collaborative. This data is combined with data from other participating hospitals to help identify trends and refine practice which result in an improvement of care. Since January 2013, Texas Children’s Hospital has submitted 100 percent of its HAC and Readmissions outcome data to the SPS.

Teams from Texas Children’s will continue this ongoing partnership with SPS and children’s hospitals across the nation to improve the quality and safety of care to our patients.

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Five years ago, Priscilla Boos heard the worst news she could ever imagine – her husband had been given six months to a year to live.

“I was devastated,” said Boos, who is a business manager in the Department of Pathology. “I started grieving the loss of my husband of 39 years that day.”

To deal with her feelings and to try and prepare for when her husband really was gone, Boos said she attended the Texas Children’s Employee Assistance Program’s Grief Recovery Group.

The free 10-week program is dedicated to helping people find the support they need to move beyond grief, whether it’s over the loss of a loved one, a divorce or a situation at work. Facilitated by EAP staff and open to all Texas Children’s and Baylor employees, the program follows specific tasks outlined in The Grief Recovery Handbook by John James and Russel Friedman.

“Recovery from loss is accomplished by discovering and completing all of the undelivered communications that accrue in relationships,” said EAP Program Manager Brent Lo-Caste-Wilken. “If you have experienced one or more losses, and you wish to move beyond the pain, this program offers you the probability of a richer and more rewarding life.”

Boos said the group made a huge difference in her life and that it made the journey toward her husband’s death much easier to bare.

“When it was time for him to go, we talked about a lot of things most couples don’t talk about during that time,” she said. “We wouldn’t have been able to have had that conversation had I attended the Grief Support Group.”

Most people don’t get the opportunity to complete unfinished conversations like Boos did because their loved is already gone or their loss has already occurred. Grief recovery helps people who are both anticipating a loss as well as suffering the effects of a loss that has already happened. In short, it helps people complete anything that was left unfinished at the time of a loss.

“Successful completion of unfinished emotions allows us to become complete with the often painful reality that the physical relationship has ended,” James and Friedman said.

To sign up for the next session of the Grief Recovery Group see below. Space is limited, so don’t delay.

What do I need to know if I am interested in participating in the Grief Recovery Group?

  • For the safety and success of all participants, commitment to and attendance at the 10-week program are essential.
  • Group sessions will be held in the Meyer Building first-floor conference room from 5:30 p.m. to 7 p.m. every
  • Thursday beginning January 22 and ending March 26.

To register for the program go to the Learning Academy webpage, call Ext. 4-3327 or email eap@texaschildrens.org.

December 16, 2014

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Representatives from seven Houston area Chuy’s Mexican Food restaurants presented on December 9 a Vecta Distraction Station to Texas Children’s Hospital West Campus. The machine, which helps promote a calming and relaxing environment for patients, was purchased with $7,000 raised at participating restaurants.

The Vecta Distraction Station aids in normalizing the hospital setting and turns an unfamiliar environment into a friendly and inviting space. The machine moves from room to room and transforms the space with a bubble column, projector and fiber optics. Child life specialists use the machine as a distraction tool during procedures, to normalize the hospital setting and to build rapport with patients during hospital visits.

“We are so appreciative of the continued support from our local Chuy’s restaurants,” said Katy Williford, child life specialist at Texas Children’s Hospital West Campus. “This donation will impact many patients and families who walk through our doors and will make their stay a little bit brighter.”

December 2, 2014

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Following Black Friday and Cyber Monday, Tuesday was a day to give back and you helped us reach more than 400 online gifts on Giving Tuesday.

The Tuesday after Thanksgiving is known as Giving Tuesday – a global day dedicated to giving back. Now in its third year, this day was founded with a simple purpose: to celebrate generosity and give. More than 10,000 organizations have engaged in the movement since it was started, and Texas Children’s was happy to make this a new tradition of giving back to our patients.

Texas Children’s celebrated this day of generosity with an online fundraising drive in honor of our patients. Our goal was 500 online gifts in honor of each of the patients staying with us each day – one child, one gift.

We are happy to see the community give back to our organization helping us set a record-breaking day for online donations, but the holidays are still upon us and we hope the generous donations will continue to pour in as we think of the families still in the hospital this holiday season.

We are very close to reaching our goal! You can still make a donation toward this effort to help the patients at Texas Children’s. Give today.

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Texas Children’s Hospital West Campus has been recognized as a top children’s hospital by the Leapfrog Group for the second consecutive year.

The Leapfrog Group is an organization that provides the only national, public comparison of hospitals across safety, quality and efficiency dimensions.

Texas Children’s Hospital West Campus is among an elite group of only nine children’s hospitals selected out of more than 1,400 rural, urban and children’s hospitals surveyed, and the only children’s hospital in Houston to be recognized with this prestigious distinction.

“We are honored to again be recognized as a top performing children’s hospital,” said Michelle Riley-Brown, president of Texas Children’s Hospital West Campus. “Our physicians, nurses and employees continuously strive to provide high quality care for our patients and families while keeping their safety our top priority.”

This year’s list of recognized hospitals includes 60 Top Rural Hospitals, 25 Top Urban Hospitals and nine Top Children’s Hospitals. To be selected as a Top Hospital, organizations must meet or exceed Leapfrog criteria in three critical areas of hospital care: how patients fare, resource use and management structures in place to prevent errors.

The Leapfrog Group was founded to work for improvements in health care safety, quality and affordability. The annual survey is the only voluntary effort of its kind. The Top Hospitals will be honored at Leapfrog’s Annual Meeting on December 2 in Arlington, Virginia, which gathers key decision-makers from Leapfrog’s network of purchaser members, industry partners, health care stakeholders and national collaborators.

For more information, or to see a complete list of The Leapfrog Group’s 2014 Top Hospitals, visit www.leapfroggroup.org/news.