Dr. Steve Abrams, Neonatology Fellowship Program Director, congratulates Dr. Sudeepta Basu, third-year fellow, the 20th annual Arnold J. Rudolph Memorial Grand Rounds award recipient. The award recognizes third-year fellows in neonatal-perinatal medicine for outstanding teaching, patient care, scientific inquiry and professional integrity.
By Dr. Steven Abrams
I arrived at Texas Children’s Hospital from Ohio as a newly minted fellow in neonatology in the summer of 1985. At the time, Texas Children’s was one building, now called “Abercrombie,” and was a seven story hospital with a 24-bed Level 3 neonatal intensive care unit (NICU) and another 50 or so Level 2 NICU beds in three separate nurseries. I began research on bone health in infants at the Children’s Nutrition Research Center (CNRC), then housed on a few floors of what is called the Medical Towers building on Fannin Street.
I stayed at Texas Children’s and Baylor College of Medicine for nearly 30 years, except for a brief sojourn in the Washington, D.C. area in the late 1980s for research training at the National Institutes of Health. I returned to Texas Children’s and Baylor as a faculty member in 1991.
Now, it is time to embark on a new and exciting opportunity. Next month, I will be the Chair of the Department of Pediatrics at Dell Medical School at the University of Texas at Austin. This is a new medical school and a new Department of Pediatrics with its primary pediatric teaching hospital being Dell Children’s Medical Center of Central Texas. Both challenges and opportunities abound, and I am grateful for them and for the opportunity to continue to serve the children of Texas in this unique way.
Leaving after three decades is not easy and I wanted to say goodbye with this blog post. I leave Houston with many fond memories of my experiences at Texas Children’s and the incredible importance of Texas Children’s to the city of Houston.
I met my late wife Judy in Houston at Congregation Emanu El where she served as a junior assistant Rabbi. We shared more than two-and-a-half decades together being part of the Houston community, and ultimately I said goodbye to her here. She always told me and our three children to do what we are supposed to do with our lives, and that the pathway would be clear forward. She and I were very proud of being part of Texas Children’s and having our children expertly cared for here.
The most remarkable part of being a faculty member at Texas Children’s is seeing what we can do for children by relying upon the strengths of the people who work here. I was recruited to Texas Children’s by the incredible Dr. Arnold J. Rudolph. Dr. Rudolph was a legendary leader of our field for many years. He taught us to always focus on doing what we knew was the right thing, which was not necessarily the easiest thing, for our young patients, every time, every day. He focused on families and the dynamics of an infant within a family. He never stopped teaching even into his last years of life. His teaching showed us what pediatrics education was about and he made it clear that education should go along with patient care and research as our passions as pediatricians.
Through most of my time here, our department chair was Dr. Ralph Feigin. We all have Dr. Feigin stories, but here is my personal favorite. After the tsunami hit Sri Lanka in late 2004, I wanted to lead a team of neonatologists and staff members (nurses, respiratory therapists and others) to go there and help them rebuild their NICUs. I had identified medical and research connections in Sri Lanka who were anxious for us to make such a trip. I emailed Dr. Feigin with my plan to lead a 10 person team from Texas Children’s to Sri Lanka. I emailed him at 6:30 a.m. At 6:45 in the morning, he called me at home to tell me it was a great idea and by 11 a.m., he met with the Texas Children’s Hospital Board of Directors and the money was approved. So much for months of haggling! We went to Sri Lanka and hopefully accomplished something in that difficult setting. Dr. Feigin’s approach was to quickly and decisively take action on behalf of children everyone and he taught by example every day.
Other memorable moments include waking up one Sunday in 1998 to be told to head in on-call to Texas Children’s for the delivery of octuplets. That was quite a delivery and experience taking care of them! Also, I am proud to watch the incredible work Texas Children’s has done internationally in many settings and the Texas Children’s unending support for the rights of children throughout the world, especially those in Africa and Latin America. I hope that my advocacy for new forms of therapy for children with liver disease, for good nutrition for children, and for health care for newborns throughout the world can be a legacy I’ve provided to the Texas Children’s community that will continue forward.
I want to express my tremendous appreciation to our department chair, Dr. Mark W. Kline, and many others at Texas Children’s and Baylor including Dr. Dennis Bier and Dr. Steven Welty, my section heads at the CNRC and Neonatology, respectively, for their support over the years and their assistance in helping me make a smooth transition to Dell Medical School.
I also want to express my appreciation to the Baylor and Texas Children’s public relations departments for their assistance in teaching me how to do a better job of advocating for children in the media and with the public. These are skills I will need in my new position.
In the end, I am saddened to leave the friend I call Texas Children’s behind, but happy to be able to transmit the skills and values I have learned here over the last 30 years to help develop an outstanding new Department of Pediatrics.
Don’t be strangers if you come to Austin! I hear they have decent barbecue there.
Texas Children’s is excited to announce the arrival of Dr. Gautham Suresh who recently joined the neonatology team as the medical director of Texas Children’s Newborn Center.
Suresh earned his medical degree from JJM Medical College in Davangere, India. He completed his pediatric residency and neonatology fellowship at the Postgraduate Institute of Medical Education and Research in India. Suresh also obtained fellowship training in neonatology at Royal Alexandra Hospital for Children in Sydney, Australia and a fellowship in neonatal-perinatal medicine at the University of Vermont College of Medicine in Burlington. Suresh holds a masters of science degree in quality improvement and evaluative sciences from The Dartmouth Institute of Health Policy and Clinical Practice in Hanover, New Hampshire.
Suresh arrived at Texas Children’s from Dartmouth-Hitchcock Medical Center in Hanover, NH, where he served as the medical director for the hospital’s Neonatal Intensive Care Unit. Armed with impressive credentials, Suresh is known internationally for his expertise on patient safety, health care quality improvement and evidence-based medicine, and has been a guest speaker at numerous scientific conferences and workshops. Suresh has worked extensively with the Vermont Oxford Network as a faculty member of their quality improvement collaborative, the Neonatal Intensive Care Quality Project. Suresh also served on the teaching faculty at the Geisel School of Medicine at Dartmouth and at The Dartmouth Institute of Health Policy and Clinical Practice.
As the medical director of the Newborn Center, Suresh collaborates with leaders from nursing, respiratory care and other disciplines to ensure regulatory, accreditation and risk management requirements are met, while upholding the delivery of high quality patient care to our premature and critically ill infants.
Aside from his leadership role, Suresh serves as an attending neonatologist in the Newborn Center and is actively involved in mentoring fellows, residents, junior faculty and medical students from other disciplines. He is also a big proponent of Mindfulness Based Stress Reduction to improve health professional satisfaction and the quality of patient care. He hopes to share his personal experience and expertise in this field with staff in the Newborn Center and at Texas Children’s.
Suresh is the chair of the American Academy of Pediatrics’s online program on Education in Quality Improvement for Pediatric Practice. He is an associate editor of the Neonatal Review Group of the Cochrane Collaboration and co-editor of “Clinical Guidelines in Neonatology” and “Assisted Ventilation of the Neonate,” a comprehensive resource guide for the care of infants requiring assisted ventilation.
“We are honored to have Dr. Suresh share his extensive knowledge and expertise in quality improvement, patient safety and risk reduction programs to better serve our NICU patients and their families,” said Pattie Bondurant, vice president of nursing at Texas Children’s Pavilion for Women.
The 15th Annual Reba Michels Hill Grand Rounds were held recently. Awards were given to Neonatology non-physicians who have made a significant contribution to advancing the quality to which Dr. Hill was dedicated, compassionate commitment to education, patient care, research and family.
Dr. Steve Welty, chief of Neonatology, presents the Reba Michels Hill Awards to Nurse Coordinator Ann Demny (center), Texas Children’s Newborn Center; Manager Jennifer Gallegos, Advanced Practice Provider Services, Texas Children’s Neonatal Intensive Care Unit; and Manager Shino Thomas (not pictured), Advanced Practice Provider Services, Neonatology.
Dr. Simon Kayyal, an assistant professor of Pediatrics and Neurology at Baylor College of Medicine, recently joined Texas Children’s neurology team. He will develop and co-lead the Neuro-Neonatal Intensive Care Unit (Neuro-NICU) with Texas Children’s Neonatologist Dr. Jeffrey Kaiser, a professor of pediatrics, obstetrics and gynecology at Baylor College of Medicine.
Kayyal received his medical degree from the University of Texas Medical School at Houston before completing his residency in pediatrics and child neurology at UT Southwestern Children’s Hospital of Dallas.
During his postdoctoral training, Kayyal observed many children and adolescent patients with irreversible brain injuries, which immediately sparked his interest in neonatal neurology. Kayyal thought, “The earlier we diagnose and treat neurologic disease, the better chance we have for improving the developmental and overall outcome of our premature and critically ill infants.”
This common goal fueled Kayyal’s passion to collaborate with neonatologists to develop Texas Children’s Neuro-NICU program. “Our goal is to help babies born with severe neurologic issues be able to enjoy life without impairments,” said Kayyal, who will also create a protocol to determine where newborns will follow-up once they have been discharged from the Neuro-NICU.
Just like a cardiovascular NICU houses newborns with heart disease, infants with neurologic disease would be treated in the Neuro-NICU where they would receive multidisciplinary care from specialists in neonatology, neurology, neurosurgery, developmental medicine and neuroradiology. The plan is to also include an MRI machine in the Neuro-NICU that would eliminate the need to transport unstable infants to other parts of the hospital.
“We want to minimize families’ anxieties during this critical time,” said Kayyal. “When they see neurologists, neonatologists, and neurosurgeons working in unison to determine the best treatment plan for their child, they know their infant is receiving the best care possible to improve their outcomes.”
The Neuro-NICU service will eventually include Texas Children’s other neurology services, like the hypothermia program led by Dr. Kaiser. The hypothermia program provides whole body cooling treatment for newborns who are oxygen deprived at birth, reducing their potential risk for severe neurologic damage.
“Dr. Kayyal is bringing an exciting vision to the neurology team with plans to better serve our patients and their families,” said Dr. Gary Clark, chief of Neurology and Developmental Neuroscience at Texas Children’s. “We are pleased to have him join our team to bring more capabilities and expertise to our division.”
In addition to this new role, Kayyal lectures medical students rotating through the neurology clerkship to help them prepare for the neurology shelf exams. He also provides specialized lectures to residents and fellows to prep them for the board exams and get better acquainted with the hospital and outpatient settings.
“I am excited to pursue my passion at Texas Children’s and work alongside some of the best physicians in our specialty,” said Kayyal. “Returning home to Houston is an added plus.”
What is supposed to be a joyous occasion – the birth of your baby – suddenly gives way to anxiety. While you know the next few months are critical to your premature infant’s survival, you never expect to hear this dreaded diagnosis: “Your baby has necrotizing enterocolitis.”
Texas Children’s Neonatologist Dr. Amy Hair is on a crusade to protect fragile and premature infants from necrotizing enterocolitis (NEC), a life-threatening neonatal condition that causes inflammation and death of intestinal tissue. In the worst cases of NEC, perforations develop in the intestine which may require portions of the intestine to be surgically removed.
Since the internal organs of premature infants are not fully developed, they are more susceptible to NEC, which claims the lives of 500 premature infants each year in the United States. Jennifer Canvasser, a mother whose infant son died of NEC, knows this reality all too well. “My son Micah was critically ill when I first heard about NEC. In a matter of hours, Micah went from being a beautiful five-pound baby to being critically ill and intubated with cords, wires and tubes on each of his extremities.”
Micah’s tragic outcome and one from Hair’s earlier years in residency – she treated a baby who died of NEC – motivated Hair to protect premature infants from this deadly disease by encouraging nursing mothers to donate the lifesaving gift of breast milk.
“Breast milk donors are lifesavers,” said Hair. “Unlike formula derived from cow protein – which is known to increase the risk of NEC – breast milk contains antibodies and anti-inflammatory factors that protect babies against NEC and a host of bacterial infections.”
Hair says the most effective way to reduce the rate of NEC is by feeding infants a human milk diet, which supports the guidelines issued by the American Academy of Pediatrics. This diet consists of mother’s own milk, pasteurized donor breast milk and protein fortifiers that add calories and nutrients to human milk to help critically-ill infants grow and thrive.
Since Texas Children’s implemented its exclusive human milk feeding protocol in 2009, NEC rates in our NICU have dropped significantly from the national average of 10 -12 percent to 2 percent. Hair attributes this remarkable decline to the generous mothers who donate their breast milk to Texas Children’s Mother’s Milk Bank, many of whom are Texas Children’s employees.
“Every ounce of donor breast milk improves neonatal outcomes in our NICU,” said Hair. “If more mothers donate their excess supply to our Milk Bank, we can ensure our tiniest, most vulnerable patients receive a constant supply of nourishment and protection to stay healthy.”
As the associate medical director of neonatal nutrition at Texas Children’s, Hair has devoted her entire research to neonatal nutrition and delivers numerous presentations each year touting the lifesaving benefits of human milk at pediatric research conferences wordwide.
She also serves as a scientific advisor to the NEC Society, a non-profit organization that was established by Canvasser to honor her son, Micah, increase awareness about the lifesaving power of human milk, and encourage more mothers to donate their breast milk to protect babies from NEC.
Dr. Hair’s call-to-action is simple: Donate breast milk and save a baby’s life.
Click Texas Children’s Mother’s Milk Bank to learn more about our donor breast milk program.
Texas Children’s employees and former patients’ families gathered at Texas Children’s Pavilion for Women to honor our neonatal nurses for their hard work and dedication. But, this wasn’t your typical celebration.
Nurses traded in their scrubs for creative, yet cringe-worthy pants that probably wouldn’t get the nod of approval from Giorgio Armani or Gianni Versace: green pants with bright yellow flowers, candy corn pants and red slacks with flamboyant feathers, to name a few.
For nurses at Texas Children’s Newborn Center, Bad Pants Day was more than just dressing up in whacky attire. It was their day to shine and realize just how much they are appreciated for the diligent work they do every day to improve the outcomes of critically-ill infants in our Neonatal Intensive Care Unit (NICU).
View the photo gallery:
Several NICU families joined in on the festivities, including David and Lauren Perkins, and their energetic 2-year-old sextuplets – Benjamin, Caroline, Andrew, Allison, Levi and Leah – who teamed up for a game of putt-putt golf with the neonatal nurses.
Ben and Amanda Kopp shared their unforgettable experience about the NICU staff who took wonderful care of their daughter, Cami, who was born at just 25 weeks at the Pavilion.
“Throughout the ups and downs of Cami’s 86-day stay in the NICU, the nurses, doctors and volunteers at Texas Children’s gave us the faith and confidence that our precious little angel would not only survive, but thrive,” said Amanda Kopp. “Today, our 17-month-old daughter is happy and healthy.”
Texas Children’s Bad Pants Day event also marked the official kick off for next month’s 17th annual Bad Pants Open. All proceeds from the golf tournament will support Texas Children’s Newborn Center. Several of the sponsors and organizers of this fundraiser attended Bad Pants Day to show their appreciation for our NICU nurses.
To register for the Bad Pants Open and support a worthy cause, click here.
To learn more about Texas Children’s Newborn Center, click here for a video tour.