April 8, 2014

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Everyone hears that proper nutrition plays a significant role in your overall health though it’s not often as easy as it sounds. A healthy meal is the best start to achieving your optimal health and wellness goals but where do you start?

Texas Children’s is dedicated to supporting you as you strive to meet your health and wellness goals. Employee Health and Wellness is sponsoring an upcoming nutrition program, MyPlate Challenge, so gather your co-workers and join together or start planning goals of your own to make Texas Children’s a healthier campus all around.

Don’t eliminate, just add! It’s a refreshing and positive way to shift the way we look at food and have fun with your coworkers along the way.

Follow these simple weekly themes and eat at least the recommended amount of a particular food group four days a week or more. It’s about being consistent, not perfect!

Week Number
Dates
Weekly Theme
Week 1
April 21-27
Fruit
Week 2
April 28- May 4
Whole Grains
Week 3
May 5-11
Lean Protein
Week 4
May 12-18
Vegetables
Week 5
May 19-26
Dairy
Week 6
May 27-June 1
Eat Well
 

Throughout the program, participants will receive an incredible amount of nutrition information and support through such things as Motivational Monday emails, interactive discussion boards, and online resources. In addition, all participants will receive a Texas Children’s MyPlate mouse pad and have the opportunity to earn bonus points toward a drawing for one of ten Fitbits.

The challenge begins Monday, April 21.

Click here to join the challenge! (This link will only open internally)

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April marks Child Abuse Prevention month. The Child Abuse Pediatrics team hopes this is a reminder for all of us to pay attention to the signs of abuse and take action. Last year, more than 1,400 children who came through the Texas Children’s Hospital doors were identified as being abused or neglected. Twenty-six of them died as a result of suspected abuse or neglect. The CAP team relies on you, the staff, to take action.

Child maltreatment can take on many forms. While a list of indicators would be very long, here are some red flags to watch out for:

  • If a child tells you they are being mistreated, take action. Call the child abuse hotline to help make that child safer.
  • Sudden unexplained changes in child’s behavior (regressive, aggressive, or sexualized).
  • Unexplained burns, bites, bruises, or black eyes particularly to the head, neck, torso, buttocks and insides of the thigh.
  • A parent who shows little evidence of care or concern for the child, or even expresses that the child is a burden.
  • Parents who appear to be overwhelmed or use unusually harsh forms of discipline. Offer comfort and support instead of criticism.

Ways to prevent or stop child maltreatment include:

  • Share information regarding appropriate child development. This may reduce unrealistic parental expectations on a child.
  • Offer resources for parents struggling emotionally and physically. When provided in a supportive and helpful manner, most parents are appreciative. 2-1-1 is available in most communities, and is an excellent general resource.
  • Listen to children when they are talking about their lives. Stay calm and do not show emotional reactions. Many children who have been the victims of chronic maltreatment may not be able to correctly interpret your emotions.
  • Call Children’s Protective Services if you suspect child maltreatment. CPS exists to help families get stronger, while keeping children safe.

The annual Doctors’ Day celebration took place during a luncheon honoring the hard work of our physicians. The event was attended by doctors and members of the leadership team who stopped by to say thank you.

April 1, 2014

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On February 23, 2012, the Fetal Center announced the birth of baby Charlotte, the first baby at Texas Children’s to receive in-utero surgery to treat spina bifida. Now, a little more than two years later, the center is celebrating another milestone with 20 cases completed.

After years of treating spina bifida by a neurosurgical closure of the spine defect during the first days of life, research breakthroughs prompted the Texas Children’s Fetal Center team to begin performing in-utero surgery on patients with a prenatal diagnosis of spina bifida.

Myelomeningocele, also known as spina bifida or open neural tube defect (NTD), is a developmental defect in which the spine is improperly formed and the spinal cord is open to and fused with the skin; it is usually associated with hydrocephalus, which requires surgical treatment to drain the fluid via a shunt. Myelomeningocele occurs in 3.4 out of every 10,000 live births in the U.S. and is the most common permanently disabling birth defect for which there is no known cure.

Advancements in fetal imaging and early prenatal diagnosis allow the team to gain access to a fetus while still inside a mother’s womb. Texas Children’s Fetal Center has developed extensive screening and diagnostic algorithms for pregnancies with fetal spina bifida. These algorithms determine which patients are appropriate candidates for the in-utero surgery.

The surgery is a huge, multi-disciplinary effort, bringing together a team of specialized experts, who all play a vital role in the medical treatment of both mom and baby. The team includes maternal-fetal specialists, led by Dr. Michael Belfort, fetal surgeons, led by Dr. Darrell Cass and Dr. Oluyinka Olutoye, and a neurosurgery team, led by Dr. William Whitehead. Once the fetus is exposed, Dr. Whitehead and his team surgically close the spinal defect before fetal surgeons return the baby to the womb. This procedure reduces the risk of hydrocephalus and may improve motor function in select patients.

A NICHD-funded study entitled the Management of Myelomeningocele Study (MOMS) published in the New England Journal of Medicine demonstrated a significant decrease in the risk of hydrocephalus for select patients undergoing fetal closure of the spine, as well as possible improvement in lower extremity function, compared to patients who underwent standard closure after birth. The MOMS trial is the second fetal intervention that has proved beneficial through a multi-center randomized clinical trial. The first was the Euro FETUS trial for laser ablation in the treatment of twin-to-twin transfusion syndrome (TTTS).

“Breakthrough studies like the MOMS trial are exciting and reaffirm our commitment to advancing fetal medicine and giving babies with complications and anomalies the healthiest possible start to life,” said Dr. Darrell Cass, co-director of Texas Children’s Fetal Center. “Our program has grown exponentially since we completed our first NTD repair in 2012, and we remain cautious, but it seems as though our center’s results are exceeding even those of the trial.”

The final piece to this puzzle is Dr. Kathryn Ostermaier, clinic chief of the Spina Bifida Clinic. It is under her guidance that the hospital provides long term care to surgical patients. The hospital’s Spina Bifida Clinic is a specialized program that serves only those patients with spina bifida, and includes several specialty services: orthopedics, neurosurgery, pediatrics, physical medicine and rehabilitation and urology.

The team that cares for NTD patients before birth, after birth and into childhood includes physicians from maternal fetal medicine, pediatric surgery, neurosurgery, anesthesiology, neonatology, pediatric radiology, cardiology, orthopedics, urology, physical therapy, and a highly dedicated group of specialized nurses, ultrasound technologists and genetic counselors.

“The confirmation that fetal surgery may decrease the physical challenges some of these babies face is not only a ray of hope for families, it is also a significant achievement for fetal medicine,” said Cass.

March 25, 2014

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March 21, 2013 was the day our relationship with Texas Children’s Hospital changed. My husband, Matt, and I are both employees at the hospital, so Texas Children’s is very near and dear to us. We have enjoyed our many years serving our patients and working with the wonderful employees of this organization. I have been a nurse here for 16 years and my husband has worked here for 13 years, currently in the Texas Children’s Heart Center. We’ve spent so many days throughout the years walking the halls of Texas Children’s doing what we love, but on March 21 we realized we were going to be experiencing the hospital as parents, not just as employees.

Luke, our unborn son had been diagnosed with a congenital heart defect – coarctation of the aorta. The fetal cardiac imaging team at Texas Children’s detected this defect through a fetal echocardiogram. This enabled them to see the function of Luke’s tiny heart, at just 22 weeks gestation! Although in disbelief, we were thankful for this early detection as it was critical for many reasons. Not only did it help the medical teams plan for Luke’s delivery, but it also allowed Matt and me to ask questions and fully understand the defect and how it might impact him. Even though we work in health care, we had so many questions and were increasingly anxious about the health of our son. Between our wonderful OB, Dr. Kimberly Bobo, at Texas Children’s Pavilion for Women, and the Heart Center and Fetal Center teams, we felt less anxious and certainly very prepared for the possibilities. We were comforted by the countless support staff and multidisciplinary experts we worked with for the months leading up to Luke’s birth. We were never treated as if our questions and concerns were naive and always felt as if each person we encountered was giving us their full attention and compassion for our situation.

As Luke’s birthdate neared, our excitement, as well as our fears grew – the unknown factors were many, but we knew that his care teams were as prepared as possible to handle any situation. His delivery was uneventful (thank goodness!) and there was a NICU team on hand to start his care immediately. He spent a few days in the NICU being monitored closely. Luckily, he remained stable and after a reassuring echocardiogram, we were sent home. It wasn’t until our one month follow up appointment that we learned the narrowing in his aortic arch had worsened and it was time for surgery.

No parent should ever have to experience their child going through heart surgery and the related recovery. It can be a frightening experience and one that we hope to never have to go through again. That being said, the team of experts at Texas Children’s who cared for Luke is among the best in the country. We found comfort in knowing that this is a very typical day for the surgical and medical teams who cared for Luke as they encounter highly complex cardiac patients on a daily basis and perform high volumes of surgical procedures just like Luke’s frequently. We knew he was in the best hands possible for a positive outcome.

32514TimmonsB640After a very long day of waiting while Luke was in the operating room, we learned his surgery was extremely successful and spent the next several days recovering with him in the cardiovascular intensive care and cardiac acute care units. Luke had an uneventful recovery period so we were able to take him home just a few days after his surgery. Since that time, we have been followed by his cardiologist and Luke is currently a very happy, healthy 7 month old boy.

We are so thankful for the numerous individuals who looked after Luke during this phase of his life and who continue to ensure he remains healthy. One of the reasons Texas Children’s is so remarkable is the sheer number of clinical and technical experts who are involved in the care of just one child. From cardiology, congenital heart surgery, obstetrics, maternal fetal medicine, cardiac imaging, critical care, and acute care, Luke encountered truly inspiring individuals who are experts in the care of children with congenital heart disease. As a parent, it is almost hard to believe that so many experts are available to us to care for our child. As fellow employees, we are proud to be a part of the amazing team at Texas Children’s and know that we are providing this level of care and compassion to all patients and families.

You can learn more about Luke’s journey by watching this video.

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When a boy arrived at Texas Children’s with massive, progressive swelling caused by a bite from a southern copperhead, toxicologist Dr. Spencer Greene knew just what to do.

“Doctors at an outside hospital minimized the significance of the bite and had no intention to treat him, even though he was very symptomatic,” said Greene. “We started antivenom, and he responded well. Not only is he back to playing sports and acting like a normal boy, he now is fascinated with snakes, which I think is pretty neat!”

32514toxicologist6403Greene’s passion for helping those who suffer from accidental poisonings and his enthusiasm for the obscure field of toxicology make him an exciting addition to our medical staff. He joined Texas Children’s as a consulting medical toxicologist this past October, and the timing proved fortuitous. Texas now leads the nation in number of snakebites per state, and with the addition of Greene, Texas Children’s boasts the only board-certified medical toxicologist in Houston.

But Greene’s role will extend well beyond the treatment of snakebites. He will diagnose and manage the effects of other poisonous or harmful substances that are hazardous to children and adolescents. Also board-certified in emergency medicine, he will be called upon for his expert opinions on treating accidental and intentional ingestions, toxic substance exposure, envenomation, occupational and environmental exposures or severe alcohol and drug abuse reactions. Greene also will continue his roles as director of medical toxicology and assistant professor of medicine at Baylor College of Medicine.“I consider my consultations to be an opportunity to educate everyone involved in the case, including the patient and/or his or her family, the nurses, the students, and the physicians,” said Greene. “By consulting on patients with toxicological emergencies I can help the admitting physicians and the doctors in the emergency department diagnose and treat patients efficiently and safely.”

Greene takes pride in collaborating with physicians from other specialties and using his unique fund of knowledge to help diagnose and treat patients with an illness or injury that is rarely encountered. His varied list of successful cases range from a young girl who ingested her father’s muscle relaxant and presented to the hospital with altered mental status, and a young man who was having a rare idiosyncratic reaction to the medications he had been given after sustaining a major trauma, to a high-profile case of a man with massive bee envenomation who was stung over 3000 times.

“Medical toxicology has a whole body of knowledge that is not commonly taught to most physicians, and often times toxicologists get to use this information to arrive at some pretty obscure diagnoses,” said Greene.

With his involvement, the goal is to reduce the amount of unnecessary testing that is often performed on patients with toxicological emergencies. Greene also hopes to dispel some myths that may surround toxicology patients and recommend therapy that is evidence-based rather than done “because we have always done it that way.”

In previous positions, such as his post as the program director for the University of Arizona Medical Toxicology Fellowship, Greene worked with adult patients who have chronic psychiatric illness or substance abuse, meaning even if he helped treat the acute toxicological condition, it was often only a matter of time before the patient returned with a similar emergency. He’s looking forward to focusing on pediatric patients, many of whom are victims of accidental poisonings and can expect a full recovery with proper treatment.

“It is very gratifying to know that I can make a real difference in my patients’ lives,” said Greene. “I hope that my involvement will help prevent poisonings at home and will give health care providers some information they can use whenever they treat toxicology patients in the future.”

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Out West is a story of tremendous growth. Over the past three years, Texas Children’s Hospital West Campus has been serving one of the fastest growing pediatric populations and as the population grows, so has the community hospital. To meet the needs of the community, the hospital has expanded its services already and continues to look at the patients to determine what programs, services and initiatives may make the most impact in West Houston.

More than 400,000 patients have taken advantage of the Texas Children’s brand of care provided through West Campus since it opened its doors in 2010. The campus which sits on 55 acres, houses 19 subspecialty outpatient clinics, inpatient hospital services and the only 24/7 dedicated pediatric emergency center in the West Houston area.

Most recently, West Campus opened a new eight-bed Pediatric Intensive Care Unit, allowing the hospital to accommodate patients with higher acuity. Because of the increasing demand for emergency care, the hospital also doubled the number of beds in the emergency center which is staffed by board-certified pediatric emergency medicine physicians. In addition, a 28,500-square-foot, state-of-the-art sports medicine clinic was built, which houses a 3,000-square foot gym, two x-ray rooms, three casting bay sand 16 exam rooms for seamless, patient-centered service. The new space houses advanced technologies, including robotic dynamometry for isokinetic testing, motion recording and analysis to enhance rehabilitation.

Texas Children’s Hospital West Campus has been successful for many reasons, including the dedicated staff. There are currently more than 500+ passionate, hard-working team members who care for patients each day. The team of nurses, child life specialists, imaging technologists, therapists, renowned physicians, and many others are specially trained to diagnose, treat and care for children.

The success story is in part due to the support of the West Houston community. From the beginning, leaders and staff have cultivated these relationships, ensuring that patient families know about the care that is being provided in their own backyard.

Don’t expect the growth to stop any time soon. As leaders and West Campus employees continue to assess the needs of patients, families and the community, they will determine what programs, services and initiatives are most beneficial in the community setting.