August 19, 2014

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A pediatrician sees hundreds of patients a year. Some stick out in their mind more than others, but for Dr. Michael Bishop, pediatrician at Texas Children’s Pediatrics Grand Parkway, the Stovall family is one that he will never forget.

Last year, while on vacation in Galveston, Bishop experienced shortness of breath which prompted his wife to drive him back to Houston for immediate evaluation. Following a week in the hospital with more questions than answers, he was diagnosed with atypical hemolytic uremic syndrome (aHUS), a rare genetic disease that affects kidney function. Once diagnosed, Bishop was given both oral and IV medication, but dialysis four nights per week also was required due to the failure of his kidneys to recover from the illness.

Shortly after the diagnosis, his daughters started a Facebook page to raise awareness about aHUS and the importance of kidney donation. Because the disease is genetic, none of his family members were able to donate, thus the need to broadly share his story. Patients at his practice started asking about the Facebook page and how they could help.

“The support from my patients and their families was overwhelming,” said Bishop. “I believe that I have been blessed by God to be given the privilege of taking care of children and their families. I never thought I’d receive the greatest gift of all from one of them.”

Jennifer Kennedy-Stovall’s three sons have been patients of Bishop’s since they were born. Now 10, eight and four, the boys are frequent visitors to Texas Children’s Pediatrics Grand Parkway whether for a well-child check-up or an acute illness. Bishop had been out of the office during a few of the Stovall boys’ visits and Jennifer wondered if he was battling a serious health issue. When the family saw Bishop during their next visit, they noticed that he just wasn’t the same – he wasn’t cracking jokes, he was more introverted and more than just the physical changes that occurred since his diagnosis, his personality had changed as well. Bishop shared the news of his diagnosis and his need for a kidney. Kennedy-Stovall walked out of the room and had a feeling.

“I walked out of the room and knew that I had to do something to help,” said Kennedy-Stovall. “I began the living donor kidney screening process that day.”

Kennedy-Stovall went through four rounds of intense screening to determine if she was a match for Bishop. Through blood tests, numerous blood pressure screenings, medical history reports, scans, x-rays and consultations with a nephrologist and social worker, Kennedy-Stovall found out that she was a match.

“When I found out I was a match, my husband and I didn’t hesitate,” Kennedy-Stovall recalls. “I felt like this was something I had to do from the moment Dr. Bishop told me he needed a transplant and I couldn’t have been happier to do this for him.”

Ironically, Kennedy-Stovall and one of her sons had a visit scheduled for the next day with Bishop. She went to the appointment not knowing if he had heard the news yet. She asked if he had any news to share and Bishop said there was testing ongoing, but that no match had yet been reported to him. Little did he know that, momentarily, she told him that she was going to be his living donor.

The families prepared, and the surgery was scheduled. The surgery was successful for Bishop and Kennedy-Stovall, and their recoveries were seamless. On July 16, Bishop celebrated his one year transplant anniversary and is thriving. The Bishops and Stovall families have grown incredibly close through their journey, oftentimes sharing lengthy family dinners together.

“I can’t believe it’s been a year,” said Bishop. “So many thoughts come to mind, but unpayable gratitude is at the top of the list. My patients are my second family, and they mean a lot to me. I’m so proud that I can come back to the practice and continue to do what I love because of this unbelievable gift from Jennifer and her family.”

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Imagine preparing more than 600 syringes or bottles of milk every day for an average of 80 hungry infants in the Neonatal Intensive Care Unit (NICU) at Texas Children’s Newborn Center. That’s roughly eight feedings per day for each baby in the NICU who receives human milk prepared by the Milk Bank.

Preparing milk for these fragile newborns is more than just pouring it into a bottle. Our Milk Bank technicians follow strict procedures and high quality standards to ensure the right milk is delivered to the right baby.

“It’s one of the hardest jobs to fill because it requires meticulous attention to detail, exceptional math skills, the ability to multi-task and follow procedural guidelines at the same time,” said Kristina Tucker, manager of Texas Children’s Lactation and Milk Bank Services. “Our technicians spend most of their time on their feet preparing the milk that will nourish our tiniest and most vulnerable NICU patients.”

82014MilkBankinside640After the mothers’ expressed milk is delivered to the Milk Bank on either the fourth floor of the West Tower or the eighth floor of Texas Children’s Pavilion for Women, our technicians verify the information on the labeled bottles, scan it into the system, and store the mother’s breast milk and pasteurized donor milk in large freezers and refrigerators until they are ready for use.

Every day is a busy day at the Milk Bank. From the time our technicians begin their 10-hour shift at 7:30 a.m., they’re working around the clock to ensure all feed orders from physicians are filled and ready for delivery to the NICU at 5 p.m. Despite working in a fast-paced environment, there is no room for error. Every order, which contains the physician’s instructions, is examined numerous times before the milk bottles and syringes are sent to the NICU nurses who feed the babies.

“Sometimes physicians will request that certain fortification products be added to the milk,” said Michelle Jones, a Milk Bank technician at Texas Children’s. “Since each baby’s nutritional needs are different, our primary goal is to make sure the babies receive the right fortified milk which is critical to their care.”

When fortifying the milk, technicians may add complex proteins, carbohydrates and minerals including Prolacta® products which include a cream supplement made from human milk fat that is added to the diet of premature infants who weigh less than 3.3 pounds. These products are derived from pasteurized donor breast milk and when added to mother’s own milk, provide an exclusive human milk diet for these small, vulnerable infants thereby protecting them from infection and disease.

“Most premature babies require these additional additives to help them grow,” said Nancy Hurst, director of Women’s Support Services at Texas Children’s. “The fortifiers add calories and nutrients to the milk without changing the volume since premature babies can tolerate only a certain amount of feedings.”

Once the milk is mixed, prepared and delivered to the NICU, the mission is accomplished.

At the end of the day, it doesn’t matter how many hours these Milk Bank technicians work or how much their feet hurt from standing all day. What matters the most to them is that all the babies receiving breast milk have been fed.

“It’s all about feeding the babies,” said Jones, who has worked at Texas Children’s Milk Bank for eight years. “It brings me great joy to see the positive impact that my colleagues and I have on these infants, and the trust that the parents have in us to ensure their babies’ nutritional needs are met.”

KTRK recently spotlighted a Houston-area family whose NICU baby benefited from Texas Children’s Milk Bank services. Click here to watch the video.

For more information on how to donate breast milk to the Milk Bank, click here.

August 12, 2014

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Young Mia Spargo clutched her stuffed animal from her seat to the microphone stand where she gently placed the stuffed cat on the floor, picked up a purple microphone and began to sing. She looked out at the audience filled with her doctors, nurses and other staff from Texas Children’s Cancer Center and sang with emotion. Her first song was titled, “God help all the kids on the planet.” The lyrics portrayed a day without cancer and a time without mothers’ tears.

“I want the staff to know they helped save my life,” said Mia in an interview before the concert.

If it weren’t for her beautiful bald head, you would never know little Mia was a cancer patient. She seems strong and energetic. Prior to the concert she was running around at full speed. She said she will never forget her doctors and nurses. Several other cancer survivors joined Mia for the Purple Songs Can Fly staff appreciation concert. The Concert was organized by the Purple Songs Can Fly group which allows children to record songs during their hospital visits on the 14th floor of the Clinical Care Center. Stephen Makia is a nine year cancer survivor who took the mic next.

“Every time I heard the word cancer, I heard death,” said Makia who credits the staff and his grandmother for helping him through the toughest days of his life.

Former American Idol contestant Christian Spear now works for Purple Songs Can Fly in a fellowship. She was a patient at Texas Children’s and dedicates her days now to the patients and staff here by using her talent of singing to bring small moments of joy.

“The work of the doctors and nurses at Texas Children’s is what saved my life 15 years ago,” said Spear who brought the audience to tears with a song dedicated to the staff.

The concert concluded with all the participants standing up to sing to the staff that has helped them make it to today followed by a standing ovation by all of the parents who stood up to thank the staff. A room filled with happy tears for the survivors who have so much to be thankful for.

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The chikungunya virus has been identified in the U.S. – and more specifically, in Houston – which has medical professionals here on alert said Dr. Kristy Murray, director of Texas Children’s Laboratory of Vector-borne and Zoonotic Diseases.

“Considering the number of travelers coming from the Caribbean by plane and by sea, as well as the vast mosquito populations that are more than capable of transmitting chikungunya, we have high concerns that the disease could take hold and begin its spread here in the United States, particularly in Texas, Louisiana, Florida, and New York,” Murray said.

Chikungunya – pronounced like “chicken goonyah” – is a crippling virus that is spread by mosquitoes. The virus has no known treatment and can cause fevers, headaches and painfully debilitating joint pain that lasts for months to years. The word “chikungunya” is African (Makonde) in origin and translates to “that which bends up.” People infected with this virus are literally “bent up” from the extreme joint pain they experience, Murray said in a recent blog post she wrote about the virus.

In early December of 2013, chikungunya was found to be circulating in the Caribbean, the first evidence that the virus made the massive jump to the Western Hemisphere. Now, according to information from the Centers for Disease Control and Prevention, 17 countries are reporting local transmission, with more than 135,000 suspected or confirmed cases.

Several imported cases have already been reported in the US. The first case in Texas was reported on July 7, 2014, and according to information from the Texas Department of State Health Services, as of last week, 10 confirmed cases have been reported across the state. In each of the cases so far, the patients had contracted the virus outside Texas, while traveling to overseas regions where the virus is more common.

So far, there is no evidence of transmission from the mosquito populations here in the Houston area. However just last week, health officials in Harris County say a mosquito tested positive for the chikungunya virus. It is the first chikungunya-positive mosquito detected in the state of Texas. Health officials have not determined whether the mosquito carrying chikungunya in Harris County obtained the virus from an infected person already in Texas, or if it traveled to the United States trapped in large cargo.

“We need to be proactive in our approach to this new disease threat, and think not ‘if’ it will hit but ‘when,’” Murray said.

Texas Children’s is among the state’s first health care organizations to take a proactive approach, conducting active surveillance to identify any positive chikungunya cases in children who come to the emergency clinic with a fever. Murray and her team have already tested hundreds of children with potential warning signs. So far there are no positive test results, but Murray explains that quick and early detection of cases will be critical for an adequate public health response to prevent an epidemic.

“We are laying the groundwork to educate both the public and physicians about this potentially serious disease and create a surveillance network among affiliated hospitals in Texas in collaboration with the Centers for Disease Control and Prevention,” she said.

Thanks to the hospital’s efforts, word is already starting to spread. USA Today and local KPRC Channel 2 interviewed Murray and published stories about chikungunya virus just last week. Murray is hopeful that increased awareness will lead to preventing bites and slow the spread of the disease.

“It is critical that physicians recognize the clinical features of this disease and keep it on the forefront of their minds when treating a child with a clinically-compatible febrile disease,” Murray said. “Considering the fact that we have the right mosquitoes and conditions here in Houston, we must not exclude chikungunya as a possibility in a child with no history of travel.”

Prevention tips from the CDC

No vaccine exists to prevent the chikungunya virus infection or disease. However, you can take steps avoid mosquito bites which could lead to infection. The mosquitoes that spread the chikungunya virus bite mostly during the daytime.

How to protect yourself and your family:

  • Use air conditioning or window/door screens to keep mosquitoes outside. If you are not able to protect yourself from mosquitoes inside your home or hotel, sleep under a mosquito bed net.
  • Help reduce the number of mosquitoes outside your home or hotel room by emptying standing water from containers such as flowerpots or buckets.
  • When weather permits, wear long-sleeved shirts and long pants.
  • Use insect repellents

Symptoms of chickungunya include fever, rash, severe joint pain and fatigue. To read more about the virus, visit the Centers for Disease Control and Prevention.

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The Family Fertility Center recently hosted an open house to showcase its impressive, state-of-the-art laboratory and in vitro fertilization (IVF) clinic located on the third floor of Texas Children’s Pavilion for Women.

Dr. William Gibbons and his team provided tours to demonstrate how the laboratory’s high-tech equipment is helping couples reach their dream of starting a family.

“We use the most advanced fertility treatments available to help families achieve healthy pregnancies,” said Dr. William Gibbons, director of the Family Fertility Center and chief of reproductive endocrinology services at Texas Children’s. “We want our patients to know they’re not alone in this journey, and that our highly-skilled team of endocrinologists and obstetric anesthesiologists will provide the most comfortable treatment possible to meet each couple’s individual needs and concerns.”

81314FertilityClinicinside640Unlike other fertility clinics out there, Texas Children’s Family Fertility Center is the first in Houston to offer the EmbryoScope, an embryo monitoring system that provides continuous moving time-lapse images of embryos as they grow. This technology allows our physicians to identify the healthiest embryo to transfer to the patient, which has been shown to improve IVF success. Our facility also features micro-incubators equipped with fiber-optic, real-time pH monitoring to protect the quality of the embryo environment.

Additionally, the Family Fertility Center has partnered with The University of Texas MD Anderson Cancer Center to help cancer patients achieve their dream of conceiving a baby; Women faced with cancer have the option of preserving their fertility before they undergo chemotherapy and/or radiation treatments.

“Building families is what our mission is all about,” said Gibbons. “We’re here to serve you, and we look forward to offering the most advanced fertility treatments available in our new state-of-the-art facility.”

Click here to view a video tour of Texas Children’s Family Fertility Center. If you have questions, want to schedule an appointment, or learn more about the benefits available to full-time Texas Children’s Hospital employees, call Ext. 6-7500.

August 7, 2014

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On the 12th floor of West Tower, in an eight-bed rehabilitation unit, the rehab team including therapists, nurses, neuropsychologists, child life specialists and physicians,  are helping children relearn how to do those things that we all take for granted; walk, talk, stand, eat, bathe and play. It’s the daily tasks that they once knew well but after being impacted by a disease or accident, these children must relearn the basics. Just two years after opening its doors, the unit has seen 262 patients many who, with intensive rehabilitation, progressed from little or no functional independence to actively participating in their lives outside of the hospital walls.

Watch a short video explaining why we opened the unit in May of 2012

Now, the unit is celebrating a major milestone after receiving the highest level of accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF). It is the only pediatric inpatient rehabilitation facility in the state of Texas and one of only 31 worldwide with this level of accreditation. CARF international is an independent, nonprofit accreditor of health and human services.

“We built this unit with the understanding that we wanted to be leaders in the pediatric rehabilitation community and we wanted to lead in the nation,” said Dr. Christian Niedzweicki, medical director of inpatient rehabilitation. “We wanted to be a center of national prominence and CARF is the gold standard.”

The CARF accreditation means the rehab program has demonstrated significant conformance with at least 1,500 standards signifying quality care for children with multiple disabilities in the inpatient rehab setting. The CARF accreditation survey team who conducted the survey  interviewed physicians, nurses, therapists, patients and patient families as well as system-wide organizational representatives to determine the level of care and service that was being provided.. Accreditation is predicated at least in part on how well the rehab program addresses the individual needs of the patients and families.   Texas Children’s inpatient rehabilitation team creates an individualized and family centered plan of care for each patient based on their needs and levels of disability and ability. The rehab team sets daily, weekly and discharge goals unique to each child and their levels of progress. The child’s every activity from waking up in the morning and brushing their teeth, eating breakfast, attending therapy sessions, school, playing and each step until bedtime is dedicated to their recovery.

“Our team is passionate and dedicated to helping each child and their family achieve the best possible outcome,” said Shelley Ellison, director of physical medicine and rehabilitation. The team members, including the patients and their families, work collaboratively to achieve the identified goals throughout the day and night through hands-on intervention as well as ongoing progressive education to patients, families and others.

The program’s newest recognition is just the beginning of an on-going process of continuous performance and quality improvement. Niedzwecki said most programs don’t attempt accreditation until they’ve been open for at least five years. The Texas Children’s Hospital rehab unit submitted their letter of intent to be surveyed for accreditation at just 18 months.  The rehab team works collaboratively to embrace the culture of ongoing improvement while striving to be the best in the country.

“We will continue to constantly reassess the input from our patients and their families to continue improvement,” said Niedzwecki. “This accreditation means we are doing what is right for the patient and are now recognized by an international accrediting organization that helps us become a leader in the field.”

Niedzwecki and Ellison both emphasize the commitment of the entire IRU team and numerous others across the organization that made this major accomplishment a possibility.

August 5, 2014

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Riki Graves was already fighting a battle when she found out, at 20-weeks pregnant, that her unborn daughter, whom her and her husband, Chris, planned to name Juliana, had a complex heart condition, with the full and final diagnosis listed as, unbalanced AV canal with severe bivetnricular dysfunction, small arotic arch, severe right AV valve regurgitation, parachute left sided AV valve with regurgitation in heart failure. Juliana would likely need several heart surgeries, and even with the surgeries might not survive.

Riki describes how she felt when she received the devastating diagnosis, “Hearing those words sent a panic through me that, even now, is hard to describe. After the initial diagnosis, my doctor referred us to the Texas Children’s Fetal Center.”

Riki’s journey actually began at 8-weeks pregnant, when she was diagnosed with breast cancer. Riki made the painful choice to pause treatment while still pregnant, fully understanding that it may make her own battle more difficult.

“It was an extremely difficult and highly personal decision. In the end I wanted to provide my daughter with the strongest pregnancy and healthiest beginning to life possible. During that time there was a lot of things out of my control, but with my treatment, I was able to take the reigns, make a decision to provide for my baby,” said Riki.

When Riki presented at the Fetal Center, it appeared that her unborn daughter would likely require three heart surgeries – the Norwood, Glen and Fontan. But, as the pregnancy neared the end it became unclear what surgeries could be expected when Juliana was born.

Christie Moran was the Fetal Center coordinator who cared for the Riki. She developed a special bond with the family, “Mrs. Graves pregnancy was further complicated by the fact she had been diagnosed with breast cancer during this pregnancy. Either diagnosis during pregnancy can be challenging to manage but the combination made Riki’s case very unique. I felt very privileged to help guide them through this pregnancy, to provide information, to give support and to offer hope.”

Riki’s team of doctors at the Fetal Center continued to monitor her pregnancy very closely. Dr. Wesley Lee, co-director Dr. Nancy Ayres, director or non-invasive imaging and fetal cardiology at the Fetal Center, were among the multi-disciplinary team that cared for Riki during her pregnancy.

Juliana was born on April 9, 2014 and, it was determined that her heart was too structurally abnormal and weak to undergo surgery. Juliana was placed on the transplant list on April 21. On April 26, at 17 days old, she received her new heart.

Dr. Jeffrey Heinle, associate chief of Congenital Heart Surgery led the transplant surgery. Juliana’s transplant surgery was a success, and she is recovering smoothly. Since the transplant, Dr. Aamir Jeewa, pediatric cardiologist, has been following Juliana and working with the Graves to provide them with continuous, ongoing care. The Graves family is relocating from Corpus Christie to Houston to be closer to Texas Children’s, and Riki is currently undergoing treatment for her cancer at M.D. Anderson, staying positive and hopeful for the future.

Riki reflects on her time at Texas Children’s, “We made it with the help of the staff of Texas Children’s Hospital. From my maternal-fetal doctor Dr. Ramirez, who was beyond supportive, to our fetal cardiology nurse coordinator Christie Moran, who helped us get settled in Houston, to all of the doctors, fellows and nurses that helped us get through, we can’t thank them enough. They were there for Juliana and my family during the entire process.”

To read more about the Graves, please visit the Today Show or ABC News websites.