The neonatal intensive care unit (NICU) at Texas Children’s Pavilion for Women celebrated babies this past week in recognition of Prematurity Awareness Month. Infants on the unit received superhero capes, created by FirstMemories Texas, an all-volunteer organization dedicated to teaching families whose infants are in the NICU and CVICU at Texas Children’s Hospital how to celebrate, honor and tell their children’s stories through photography and album making.
One family got three capes – one for each of their triplet sons, Barrett, Calvin and Jacob. The brothers were born on November 1 at 34 weeks gestation and have been in the NICU ever since. All three babies are healthy but need some extra attention and care before going home.
Dara Miller, the boys’ mother, said the care she and her boys have received at the Pavilion for Women has been incredible and that everyone they have encountered has been professional, compassionate and kind.
“We have had complete confidence in everyone who has taken care of us,” Miller said. “Everyone has always kept us informed and made us feel like we are in the best possible hands.”
The day her boys received their black and yellow batman capes was icing on the cake and ended up sparking a milestone moment. Until that day, she had never held her boys together, only separately. Joined by her husband, Mason, and 2-year-old daughter, June, Miller held her babies donned in capes big enough to cover almost their entire body and grinned widely.
“In that moment, we all came together as a family,” she said. “Until then, something felt incomplete.”
Kellie Kainer, assistant clinical director of nursing for the NICU, said comments like Miller’s and special events like the one with the capes bring smiles to her and her staff as well. Knowing that patients and their families are comfortable with the care they receive is huge.
“Everyone in the NICU has a passion for what they do,” she said. “We truly love caring for some of Texas Children’s most fragile patients.”
Texas Children’s Hospital, together with Texas Children’s Pavilion for Women, house the nation’s largest level IV NICU, the highest level of care available for premature and critically-ill newborns. Babies born prematurely require round-the-clock care and often need access to highly specialized services to have the most optimal outcomes. Complications from premature birth (before 37 weeks gestation) are the #1 cause of death of babies in the United States and 1 in 10 babies in the U.S. are born too soon.
November 13, 2018
On November 8, Texas Children’s friends and supporters attended The Forum Luncheon highlighting the amazing work of Texas Children’s Pavilion for Women. Held at The Post Oak Hotel at Uptown Houston, the program shined a bright light on the many successes the Pavilion for Women has had since opening its doors in 2012.
In just six short years, more than 37,000 babies have been delivered at the hospital, including 1,200 sets of multiples, one of which was a set of sextuplets. Almost 8,000 babies have been treated in the hospital’s Neonatal Intensive Care Unit, and many lives have been saved or greatly altered by the talented clinical staff that works tirelessly to improve the lives of women and children.
“I can’t imagine Texas Children’s without the Pavilion for Women and am thrilled we had the vision, aspiration and courage to build it,” said President and CEO Mark Wallace during his opening remarks at the forum. “In just five years, we translated our vision for this new paradigm of care into a reality that has helped countless mothers and their children.”
Hired to lead Texas Children’s Pavilion for Women shortly after it opened, Dr. Michael Belfort, fetal surgeon and Ob-Gyn-in-chief, headlined the forum’s program taking the almost 400 people in the audience on a journey through the organization’s wide variety of services offered to women and children.
Some of those services areas include:
Pediatric and adolescent gynecology
Fetal surgery and prenatal care
Global women’s health
Menopause and urogynecology
“I was drawn to Texas Children’s from the very beginning because of the vision they had for women and children,” Belfort said. “We have come a long way in a short time, and while I’m proud of our accomplishments, I don’t think we should ever stop trying to be even better.”
The forum’s program ended with an emotional story told by Emma Tramuto, who at 17 weeks pregnant was told her baby, Ella Rose, was diagnosed with gastroschisis, which is failure of the abdomen to close completely, resulting in the baby having her intestines outside of her body.
Emma and her husband James visited many physicians and surgeons, and were told multiple times their only choice was to terminate the pregnancy – that is until they came to Texas Children’s Pavilion for Women where a team of clinicians cared for Emma and Ella Rose, who is now a vibrant 6-year-old little girl.
“Miracles happen every day at Texas Children’s Hospital and perhaps the biggest miracles are the ones for the tiniest patients,” Emma said. “Our daughter is one of these incredible miracles. Had it not been for Texas Children’s Hospital Ella Rose would not be here today. The doctors and nurses who cared for Ella gave her a chance at life she would not have had one otherwise.”
August 27, 2018
Texas Children’s Pavilion for Women and two of its surgeons recently received superior patient care designations from the Surgical Review Corporation, which develops and administers best-in-class accreditation programs for surgeons, hospitals and freestanding outpatient facilities throughout the world.
After a rigorous review process, the SRC accredited the Pavilion for Women as a Center of Excellence for Minimally Invasive Gynecology and two of its surgeons – Dr. David Zepeda and Dr. Xiaoming Guan – as Surgeons of Excellence in Minimally Invasive Gynecology.
The Pavilion for Women is now one of three hospitals in Houston and one of five in Texas with the Center of Excellence designation.
“Earning this accreditation signifies our ability to consistently deliver the safest, high-quality care to our patients,” said Nakeisha Archer, director of perioperative services for the Pavilion for Women. “Our program fosters quality improvement in surgery, and commitment to this process has focused our team on exceeding clinical benchmarks and guidelines. Most importantly, our commitment to excellence will improve the health and well-being of our patients. We are so proud to be leaders in quality care for women.”
Minimally invasive gynecologic surgery includes hysteroscopic, laparoscopic and/or vaginal procedures such as hysterectomies, fibroid removals and myomectomy excisions. Surgeons at the Pavilion for Women did almost 500 minimally invasive surgeries in 2017 and are on track to do more this year.
Karen Rosser recently had a minimally invasive procedure done with Zepeda and said her experience with the surgeon and the Pavilion for Women was incredible.
“I felt comfortable every step of the way,” said Rosser, who suffered chronic pain for years due to adenomyosis. “I never flinched at moving forward with surgery and am confident I received the best care.”
Zepeda said he is proud of the designations and believes they distinguish the Pavilion for Women as a leader in minimally invasive surgery.
“SRC’s accreditation program recognizes surgeons and facilities that demonstrate an unparalleled commitment and ability to consistently deliver safe, effective, evidence-based care,” he said. “This has always been our focus at the Pavilion for Women and always will be.”
Guan agreed and said he hopes patients looking for quality care can now be even more assured that the Pavilion for Women is the place to be knowing we have met rigorous standards for delivering high-quality perioperative and long-term follow-up care.
More about the surgeons
Dr. David Zepeda was born and raised in Houston and attended The University of Texas at Austin. Zepeda received his medical degree at the University of Texas at San Antonio Health Science Center in 1974. He completed obstetrics and gynecology residency at Baylor College of Medicine in Houston in 1978. Zepeda maintains an academic appointment as clinical associate professor at Baylor College of Medicine, where he is involved in residency and medical student education. He’s recognized in the Texas Medical Center for his expertise in gynecologic surgery, including pelvic reconstruction, DaVinci Robotic Surgery and advanced laparoscopic and hysteroscopic procedures. He is board-certified by the American College of Obstetrics and Gynecology and has voluntarily recertified numerous times. He has been awarded the Distinguished Surgeon of the Year in Houston and has been voted among the Best Doctors of America. In addition to teaching, Zepeda has been involved with National Scientific Meetings in Ob/Gyn and has published on laparoscopic surgery. He is actively involved in continuing medical education through the medical center and national meetings in the specialty as well as numerous professional societies.
Dr. Xiaoming Guan
Dr. Xiaoming Guan is the Section Chief and Fellowship Director of Minimally Invasive Gynecologic Surgery at Texas Children’s and is an associate professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine. Dr. Guan earned his medical degree at Fujian Medical College, Fuzhou in Fujian, China. He completed his Obstetrics and Gynecology residency at St. Joseph’s Hospital, a Mount Sinai School of Medicine affiliated hospital, in Paterson, NJ, followed by a fellowship in Minimally Invasive Gynecologic Surgery at Baylor College of Medicine in Houston. Dr. Guan brings extensive experience in treating complex and challenging cases of endometriosis, uterine fibroids, and pelvic masses. He is a leader in minimally invasive gynecologic surgery and a pioneer in the use of state-of-the-art robotic single-site technology and traditional single site and transvaginal Natural Orifice Endoscopy Surgery (NOTES) for advanced pelvic surgery. He also applies single-site or NOTES surgical technique in treatments of cervical incompetence with abdominal cerclage, urinary incontinence with sling, and pelvic organ prolapse with sacrocolpopexy. He serves on the editorial boards of the Journal of Minimally Invasive Gynecology and he is the author of numerous more than 40 publications.
More about SRC
Established in 2003, SRC is an internationally recognized patient safety organization dedicated to recognizing and refining surgical care. SRC is the leading administrator of quality improvement and accreditation programs for surgeons and hospitals worldwide. SRC’s proven methodology, known as the “Cycle of Excellence,” results in quantifiable and unparalleled improvement in the outcomes, patient safety and costs across surgical specialties. To measure improvement and develop best practices, SRC offers a multispecialty outcomes database that is the world’s largest repository of clinical patient data for minimally invasive gynecologic and bariatric surgery.
May 1, 2018
Hope Elizabeth Richards, one of the formerly conjoined twin girls separated at Texas Children’s earlier this year, was discharged April 25 after spending 482 days in the hospital. Hope joined her sister, Anna Grace, who was discharged on March 2.
The Richards family is looking forward to returning to their North Texas home soon. They are grateful for all of the support and prayers they received throughout their daughters’ journey.
“This is the moment it all feels real,” said Jill Richards. “We are so excited for Hope to join Anna and her brothers at home. Our family is eternally thankful for the doctors, nurses, child life specialists, physical therapists and many others at Texas Children’s who took incredible care of our precious girls.”
On January 13, Anna and Hope were successfully separated by a multidisciplinary team of nearly 75 surgeons, anesthesiologists, cardiologists and nurses from eight specialties performed the seven-hour procedure. In preparation for separation, on November 6, 2017, Anna and Hope underwent surgery to place tissue expanders in order to allow their skin to grow and stretch.
The girls were born on December 29, 2016 at Texas Children’s Pavilion for Women, weighing a combined 9 lbs. 12 oz. Delivered via Cesarean-section at 35 weeks and five days gestation, Anna and Hope were conjoined at their chest and abdomen, through the length of their torso and shared the chest wall, pericardial sac (the lining of the heart), diaphragm and liver. In addition, they had a large blood vessel connecting their hearts. They were welcomed by their parents, Jill and Michael, and older brothers Collin and Seth.
The Richards family, learned Jill was carrying conjoined twins during a routine ultrasound. The family was then referred to 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. They temporarily relocated to Houston in order to deliver at Texas Children’s and to be close to the girls during their hospital stay. For the past year, Anna and Hope have been cared for by a team of specialists in the level IV and level II neonatal intensive care units (NICU).
April 17, 2018
For many patients and their families, trying to find parking in the garages at Texas Children’s Medical Center Campus can be challenging at times. But Texas Children’s employees and staff are finding creative solutions every day to address the concerns and needs of our patients and their families.
Coupled with the hospital’s on-going efforts to provide patients, families and visitors priority access to proximal parking to help get them to their clinical appointments on time, new enhancements to our parking garages are making it easier for patient families to find available spaces quickly while saving time.
To optimize the patient parking experience and meet the current parking demand, construction on the Parking Guidance System (PGS) in Garage 21 (Pavilion for Women/Legacy Tower) is almost complete. This project involved the installation of light sensors over parking spaces to help visitors identify whether a space is occupied (red) or available (green).
“The lights are clearly visible from several hundred feet away and electronic signage helps drivers identify the number of spaces available in various directions,” said Texas Children’s Facilities Project Manager Ted Gillis. “Since its installation, the Parking Guidance System in Garage 21 has improved the flow of traffic, and is making it easier for hospital visitors to find a spot in the garage more quickly.”
The installation of the red and green light sensors is currently in progress in Garage 16 (Wallace Tower). The PGS installation in Garage 12 (West Tower) will begin after the project is completed at Wallace Tower.
Texas Children’s continually receives feedback from patient families – and employees and staff – about impactful changes that can be implemented across the organization to promote a positive patient experience.
“By ensuring patients and families are considered first through both organization practices like the recent parking guidance enhancements and through decisions we each make as individuals, we personalize and improve what might otherwise be a stressful event for a family,” said Katie Kalenda Daggett, director of Patient and Family Services.
Additional enhancements to Garage 21
In preparation for the opening of Legacy Tower on May 22, Garage 21 under the Pavilion for Women and Legacy Tower is undergoing additional enhancements to create garage elevator lobbies for Legacy Tower, improve traffic flow and wayfinding, and increase public parking capacity.
Traffic flows have been re-configured to direct pediatric patients to Legacy Tower and women’s services patients to the Pavilion for Women. Below is a list of the designated parking areas in Garage 21.
Level B1 – Executives and Pavilion for Women physician leaders; valet, Wells Fargo Bank reserved spaces
Level B2 – Patient and visitor parking; Legacy Tower physician leaders, Wells Fargo Bank reserved spaces
Level B3 – Patient and visitor parking
Level B4 – Patient and visitor parking overflow, physicians and contract parking
March 13, 2018
Less than two months after being separated from her sister Hope in a seven-hour surgery at Texas Children’s Hospital, Anna Grace Richards got to go home.
Anna was discharged from Texas Children’s on March 2 after spending 428 days in the hospital. Hope is expected to be able to go home in the near future. The formerly conjoined identical twin girls were successfully separated at Texas Children’s Hospital on January 13. A multidisciplinary team of nearly 75 surgeons, anesthesiologists, cardiologists and nurses from eight specialties performed the seven-hour procedure.
The girls were born on December 29, 2016, at Texas Children’s Pavilion for Women, weighing a combined 9 lbs. 12 oz. Delivered via Cesarean-section at 35 weeks and five days gestation, Anna and Hope were conjoined at their chest and abdomen, through the length of their torso and shared the chest wall, pericardial sac (the lining of the heart), diaphragm and liver. In addition, they had a large blood vessel connecting their hearts. They were welcomed by their parents, Jill and Michael, and older brothers Collin and Seth.
The Richards family, from North Texas, learned Jill was carrying conjoined twins during a routine ultrasound. The family was then referred to 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. They temporarily relocated to Houston in order to deliver at Texas Children’s and be close to the girls during their hospital stay. For the past year, Anna and Hope have been cared for by a team of specialists in the level IV and level II neonatal intensive care units (NICU).
The Richards family will remain in Houston until Hope is able to go home.
Click here to read a more detailed story, to watch a video and view a photo gallery below about the separation of Anna and Hope.
February 13, 2018
On January 13, Texas Children’s successfully performed its fourth conjoined twins separation, giving identical twin girls Anna Grace and Hope Elizabeth Richards a chance at a normal life.
The 7-hour procedure was performed by a multidisciplinary team of nearly 75 surgeons, anesthesiologists, cardiologists and nurses from eight specialties. Click here to see a list of surgeons, clinicians and nurses in the operating room during the milestone procedure, and here to view a photo gallery documenting the twins’ journey the day of their separation.
“The success of this incredibly complex surgery was the result of our dedicated team members’ hard work throughout the last year,” said Surgeon-in-Chief and Chief of Plastic Surgery Dr. Larry Hollier. “Through simulations and countless planning meetings, we were able to prepare for situations that could arise during the separation. We are thrilled with the outcome and look forward to continuing to care for Anna and Hope as they recover.”
The girls were born on December 29, 2016, at Texas Children’s Pavilion for Women to their parents Jill and Michael, and two older brothers Collin and Seth. Weighing a combined 9 lbs. 12 oz. and delivered via Caesarean-section at 35 weeks and five days gestation, Anna and Hope were conjoined at their chest and abdomen, through the length of their torso and shared the chest wall, pericardial sac (the lining of the heart), diaphragm and liver. In addition, they had a large blood vessel connecting their hearts.
The Richards family, from north Texas, learned Jill was carrying conjoined twins during a routine ultrasound. The family was then referred to 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. They temporarily relocated to Houston in order to deliver at Texas Children’s and be close to the girls during their hospital stay. For the past year, Anna and Hope have been cared for by a team of specialists in the level IV and level II neonatal intensive care unit (NICU).
Planning and preparation
During much of that time, medical staff prepared for the separation, using extensive imaging with ultrasound, echocardiography, CAT scans, magnetic resonance (MRI) and even a virtual 3-D model of the girls’ anatomy. Closer to the surgery date, almost 50 medical personnel involved in the procedure participated in a lengthy simulation of the separation.
“These are the kind of procedures you plan for the worst and hope for the best,” said Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Oluyinka Olutoye. “We were blessed that this was the best case scenario. Everything went very well. The procedure was as well as we could have hoped.”
The Richards family is grateful to Texas Children’s for the care provided to their daughters since they found out they were expecting conjoined twins.
“We’ve thought about and prayed for this day for almost two years,” said the girls’ mom, Jill Richards. “It’s an indescribable feeling to look at our girls in two separate beds. We couldn’t be more thankful to the entire team at Texas Children’s for making this dream come true.”
Anna and Hope are recovering in the CVICU and expect to be released to a regular room soon. Both girls will face additional surgeries in the future to ensure their chest walls are stabilized. Otherwise, doctors expect them to lead normal lives.
“What we try to do here at Texas Children Hospital is essentially provide our patients with as normal of a life as we can,” said Pediatric Plastic Surgeon Dr. Edward Buchanan. “I think in this case with these two little girls we were able to achieve that.”
A history of success
The Richards separation is the fourth conjoined twins separation performed at Texas Children’s. The first pioneering procedure occurred February 16, 1965, when a team of surgeons separated 9-week-old conjoined twins Kimberly and Karen Webber. The Webber twins were connected at the liver and pericardium. The second separation happened on June 9, 1992, when Texas Children’s surgeons successfully separated Tiesha and Iesha Turner, who were 1 year old and shared a sternum, liver, entwined intestines and fused organs.
The third conjoined twins separation happened nearly three years ago on Feb. 17, 2015, when a team of more than 40 clinicians from seven specialties separated 10-month old Knatalye Hope and Adeline Faith Mata during a marathon 26-hour surgery. The twins were connected from the chest to the pelvis and shared a chest wall, pericardial sac, diaphragm, liver, intestinal tract, urinary system and reproductive organs. Today, Knatalye and Adeline are almost 4 years old and are doing very well, walking, talking, even learning how to ride a bike.
Since Texas Children’s opened its doors in 1954, multiple sets of conjoined twins have been referred to the hospital for consideration. However, in many of these cases, separation was not medically possible. Olutoye, who has participated in five conjoined twins’ separation surgeries, two at Texas Children’s Hospital and three at the Children’s Hospital of Philadelphia, said he and a team of experts from various specialties look at every case very closely and consider many factors before deciding how to move forward.
“Separating conjoined twins takes a tremendous commitment,” Olutoye said. “We all are privileged and honored to be part of each and every case, especially the ones where we can help.”