Monthly Archives: July 2012

Children’s performs well in 2011 report on pediatric surgical outcomes

This is a post by Dr. Rob Payne, a pediatrician and neonatologist with over 30 years of experience here at Children’s Hospitals and Clinics of Minnesota. He previously worked as a neonatologist at our Minneapolis hospital and now is Medical Director of Quality.

Children’s has always believed that providing high-quality surgical services was central to our mission. We thought that our services met this goal, but now we have proof.

Children’s is one of 43 hospitals from around the country that submits data to the American College of Surgeons‘ database on pediatric surgical outcomes (NSQIP). Our Health Information Management staff selects cases and verifies the data according to stringent criteria and subject to periodic audits. These are the most accurate and comprehensive data available on pediatric surgical outcomes. We recently received our report for 2011, which showed:

1.  Outcomes do not vary in most areas of measurement among the 43 participating hospitals. Since these hospitals all volunteered to be measured and compared, one could assume that only organizations with a high level of commitment to excellence would participate in the program. These are probably the best hospitals for pediatric surgery in the country.

2.  Children’s was among the 10 hospitals in the database with the (6th) lowest rate of complications from all types of surgery after adjusting for risk factors. This is a tremendous compliment to everyone in our organization who works with surgical patients. It is a particularly high accolade for the surgeons, anesthesiologists and perioperative staff. Children are less likely to suffer a complication from their surgery here at Children’s compared to other excellent hospitals in the database.

3.  Children’s had the lowest rate of complications in newborn infants with abdominal surgery of any hospital in the database. This did not quite achieve statistical significance but was so close as to indicate that Childrens’ is almost certainly better in this area. Congratulations to the surgery and neonatal staff for their superb work on these very ill patients.

When you see any of the perioperative staff, anesthesiologists or surgeons, please compliment them for their excellent work.

A mom’s story: My baby’s delivery included a ‘high-speed footrace’

This is a guest post by Veronica Stoltz, who delivered Katherine 15 weeks early at Abbott Northwestern Hospital. Katherine was taken via tunnel to Children’s Hospitals and Clinics of Minnesota, where she remained for 99 days. Today, Katherine is a healthy 3-year-old who has three big brothers at home.

Stoltz Family

I never expected my baby’s delivery to include a high-speed footrace under a major metropolitan thoroughfare just minutes after her birth. But that is exactly what happened following our daughter’s premature birth on the morning of Jan. 3, 2009.

Our daughter, Katherine, was still 15 weeks away from her due date when it was discovered that the amount of amniotic fluid surrounding her had become dangerously low. My care team decided that I should stay overnight at Abbott Northwestern Hospital for observation.

At about 2 a.m., I was situated in my hospital room with monitors and encouraged to get some rest. My husband went home to be with our other three children overnight. However, as soon as he returned home, he heard the phone ringing. With fear in my voice, I said, “I think you’d better come back. The doctors and nurses don’t like what they’re seeing.”

He made the 20-minute return trip to the hospital and arrived on the floor in a panic—but he was too late. The medical team had just delivered our daughter via emergency C-section in order to save her life. A nurse threw him a pair of scrubs and told him to join us in the delivery room.

At the time of her birth, our teeny, tiny daughter weighed 470 grams and was 11 inches long. She looked like a featherless bird that had fallen out of its nest. I was whisked away to a recovery room while tears streamed down my face as I lay helplessly still in the middle of the biggest tornado my little family had ever experienced.

Meanwhile, my husband went to be by our daughter’s side. He watched as the neonatal transfer team frantically worked to stabilize her enough to move her. Moving her to Children’s was the only way she would be able to continue to get the life-saving treatments she required.

Katherine Stoltz

A medical team of neonatal doctors and nurses ran alongside her isolette through a half-mile underground tunnel that connected Children’s and Abbott Northwestern and admitted her into Children’s Neonatal Intensive Care Unit (NICU).

My husband accompanied the team in his socks, trying to keep up and avoid tripping on his ill-fitting scrubs. He remained with my daughter as long as possible and tried to learn all he could about her condition and chances of survival before returning to Abbott Northwestern to check on me.

The two most important girls in his life were in separate hospitals – each with significant needs. He desperately wanted to be a comforting presence to each of us. He traveled the underground tunnel several times during the next few days until I was well enough to be discharged and join him full time at Children’s.

Thanks to The Mother Baby Center opening this winter, families who find themselves in situations similar to ours will no longer be separated from one another. Babies will be delivered just down the hall in a top-notch facility with a world-class neonatal team ready to care for them 24/7 if it’s needed.

We spent 99 days at Children’s before our daughter was well enough to be discharged and join her three big brothers at home. I am unabashedly proud of the fact that I was able to be by her side each and every day she was hospitalized. Even though I was unable to care for her in a traditional way, I knew she recognized and found comfort in my voice, my touch, my smell, and my presence.

Being able to do nothing more than hold her precious little hand through the small holes on the side of the isolette will always be one of the most sacred moments of my life. As she was clinging to life, it was imperative for her to know she had somebody who desperately loved her clinging right back.

Thank you, Children’s and Abbott Northwestern, for your innovative and incredible new partnership and facility. You are giving  families what they need the most in times of crisis…each other.

Learn more about The Mother Baby Center at http://www.TheMotherBabyCenter.org. You can also visit our Facebook page here.

More kids covered

This is a post by Children’s Health Policy and Advocacy team. They’re nonpartisan and proudly serve as child health experts and as a resource for our elected officials. Follow Children’s Policy and Advocacy staff on Twitter.

Approximately 16,000 children will now be insured and have access to healthcare thanks to a finally implemented 2009 law. That is great news for kids and their families.

The healthcare expansion will cover working families who make between 150 percent and 200 percent of the federal poverty guideline(FPG) and will improve their access to care and preventative services. The new law eliminates the current four-month waiting period previously required and will allow every child under 18 to be eligible for MinnesotaCare, Minnesota’s subsidized insurance program for working families.

Those children under 200 percent of the FPG will be eligible for MinnesotaCare without premiums. Prior to the changes, a family of four earning less than $46,000 would have to pay premiums of up to $70 per child in order to participate in MinnesotaCare.

The new healthcare expansion is estimated to cost $11 million a year when fully implemented with the federal government covering half.

While this is certainly great news for the newly covered 16,000 children, officials estimate there are anywhere from 71,000 to 84,000 children who still lack health coverage. Minnesota is also the only state in the country that saw an increase in the number of children covered by health insurance last year, dropping in rankings to 27th in the country. According to the Annie Casey Foundation 2012 Kids Count Data Book, Minnesota also dropped from second to fifth in the nation in the overall well-being indicators for children.

While we applaud the new law and successes in getting more kids covered, it’s clear there is still a lot of work to do. Every child deserves a chance to be healthy.

To read the entire Kids Count Report, click here.

Pertussis: High number of cases cause for concern

Pertussis. It sounds foreign, doesn’t it?

But Pertussis, also known as “whooping cough,” is a highly contagious respiratory disease that can strike infants to the elderly. And there’s currently an epidemic underway in Minnesota.

There were 1,758 Pertussis cases reported in Minnesota as of June 30, according to the Minnesota Department of Health. More than 400 cases have been reported so far in July alone. Nationally, the number of cases could reach its highest level in 50 years, according to the Centers for Disease Control and Prevention.

Children’s Hospitals and Clinics of Minnesota saw nine Pertussis cases just this past week and 41 in the month of July, said Patsy Stinchfield, director of Infectious Disease/Immunology and Infection Prevention. The hospital typically sees 32 cases over the course of a year.

The numbers are concerning.

“Everyone should be on their toes thinking about and testing for Pertussis for people with a cough lasting more than a week,” Stinchfield said.

Pertussis can be a serious illness in infants, children and adults and can be life-threatening, especially for infants. A person with Pertussis develops a severe cough that usually lasts four to six weeks or longer, even up to 100 days. It can make it hard to breathe or cause vomiting. The “whooping” sound isn’t always present.

It’s unknown what has caused the spike in cases. While Pertussis occurs in all age groups, the average age is 14 and outbreaks have occurred in middle schools, according to the Minnesota Department of Health.

“Teens are like a perfect storm of infection,” Stinchfield said.

They may not have gotten their Tdap booster yet, and they tend to continue socializing when they’re sick, spreading their infection to others in their social groups and communities, she explained.

The good news is that Pertussis is preventable. Stinchfield offered the following tips to protect your children and yourself:

  • Children need their primary series of DTaP vaccinations
  • All adolescents and adults need a Tdap booster—one dose for anyone 10 and older
  • Women who are 20 or more weeks pregnant, adults who have significant contact with children and elderly need to make sure they get a Tdap booster
  • Thoroughly wash hands and avoid touching eyes, nose or mouth
  • Those who have Pertussis should not leave home until they have completed their entire antibiotic treatment which is generally five days.  If no antibiotics are taken, Pertussis can spread during the first 21 days of the cough.  Avoiding social contact (stay home from work, school and daycare) until five days of antibiotics are completed is essential
  • It’s called “The 100 day Cough” for a reason—the antibiotics reduce spread to others, but it does not repair damage in the airways which can cause the person to have a harsh cough for many weeks and even a few months
  • Babies too young to be immunized are the ones most likely to die from Pertussis and usually get it from their mom, dad or grandparent.  Vaccinating anyone in contact with a newborn helps prevent needless tragedy

Patsy Stinchfield talks more about Pertussis by video. To watch the series, click here.

For more information or to contact a provider, please visit www.childrensmn.org.

 

 

Family gives back with Bags of Smiles

Editor’s note: In an earlier version of this post, Dr. Rustad’s first name was misstated. It is Dr. Dave Rustad. 

This is a guest post by Aric and Kristen Burma, parents of 2-year-old Zachary Burma, a patient at Children’s Hospitals and Clinics of Minnesota.

Zac Burma shows off his silly bands.

Just before Zac turned 1, he came down with a high fever that we initially thought was teething. But it didn’t go away. His pediatrician ordered an X-ray, which showed a spot on Zac’s lung. Worried he might have pneumonia, his doctor sent us to Children’s.

After taking antibiotics, Zac began feeling better. However, as we celebrated Zac’s first birthday, the spot remained. Zac underwent a CAT scan. Before we even pulled out of the parking lot after the test, we received a call from our pediatrician that we needed to return to Children’s to see an oncologist.

We returned and met Dr. Nancy McAllister, who delivered scary news that our perfect and healthy young son needed surgery to remove a tumor. She assured us that it was completely treatable.

Dr. Dave Rustad performed the surgery and removed the entire mass, which was a Stage I Neuroblastoma. Fortunately, no cancer cells had spread and the tumor was completely removed.

Everyone at Children’s treated us so kindly. Our most memorable experience was when Kelly, a nurse in the Pediatric Intensive Care Unit (PICU), visited Zac when he woke after being sedated so she could see him smile. He had been sedated when she was his nurse. All the doctors, nurses and staff are the most amazing people we have met, and we’re truly thankful!

After our experience, we knew we had to give back. We sold raffle tickets at work to raise money to make “Bags of Smiles” – filled with games, arts and crafts, toys and more for kids who are being treated in the Cancer and Blood Disorders Clinic. Our mission is to provide children battling cancer and other serious illnesses a chance to be a kid and smile.

On Aug. 18, we’ll host our first golf tournament to raise money for Children’s patients and Bags of Smiles. Please visit www.bagsofsmiles.org to learn more.

Preparing for our new delivery: The Mother Baby Center

This is a post by Dr. Michael Slama and Jennifer Olson. Dr. Slama is president of The Mother Baby Center’s clinical service line. Jennifer is the executive director and vice president of operations for The Mother Baby Center’s clinical service line.

The Mother Baby Center

We have a big announcement, and we’re excited to share it on the Kids’ Health Blog. We’re expecting an exciting addition to Children’s Hospitals and Clinics of Minnesota and Abbott Northwestern Hospital – The Mother Baby Center. Due date: February 2013.

We conceived The Mother Baby Center after years of working together almost exclusively to deliver the best care to new mothers and high-risk newborns. In the event of a high-risk delivery at Abbott Northwestern, babies are historically taken a few blocks away by way of underground tunnel to Children’s neonatal intensive care unit (NICU) in Minneapolis. While this partnership has worked well, we wanted to provide better care and a better experience at the most appropriate cost for our families.

Enter one of our many crowning achievements – The Mother Baby Center. Located on Children’s – Minneapolis campus and connected by skyway to Abbott Northwestern, The Mother Baby Center will integrate Abbott Northwestern’s maternity and newborn services with Children’s NICU, Special Care Nursery and Infant Care Center (ICC), all under one roof.

The Mother Baby Center reflects a unique partnership that brings together two of the best-known names in mother and baby care. With
more than 4,000 babies born there each year, Abbott Northwestern delivers more babies than any other hospital in the state. Children’s cares for children in all stages of life and was named one of America’s “Best Children’s Hospitals” for its neonatal care, which delivers some of the nation’s best outcomes. These two forces combined make The Mother Baby Center a great place to have a baby and a great place to be a baby.

In the years ahead, we’re committed to delivering an exceptional experience for patients, families, referring physicians and staff; effective outreach programs and services; advanced innovation; programs for healthy families including lactation, maternal mental health and maternal fetal genetics services; and continuous pursuit of quality and research.

We’re also committed to taking our mission beyond the walls of The Mother Baby Center. Through the Kids’ Health Blog, we’ll deliver important information and stories around children’s and women’s health from our physicians, medical experts and our patients. We hope to create a greater sense of community here where staff, families and others can connect. We invite you to leave comments, ask questions, give us feedback and share your stories.

Learn more about The Mother Baby Center at http://www.TheMotherBabyCenter.org. You can also visit our Facebook page here.

Talking to your kids about tragedies in the news

By now, you’ve likely read or heard about the violence that took place at an Aurora, Colo., movie theater during the midnight showing of the new Batman movie, “The Dark Knight Rises.” According to the Denver Post, a gunman entered the theater and allegedly shot 71 people, killing at least 12. Police arrested a suspect, who is in custody.

We at Children’s Hospitals and Clinics of Minnesota are disturbed and saddened by this tragedy, and we extend our thoughts and prayers to everyone affected by it.

Today and over the next several days and weeks, the story around this mass shooting will continue to develop in local, national and world news outlets, as well as on social media. As a parent, you want to protect your children in every way, including sheltering them from this horrific event. Yet they may still be exposed. They may hear about the shooting from friends and other adults, social channels like Facebook and the news. Tragedies can hit home – no matter where they happen.

We reached out to some of our therapists and child life specialists, who offered tips about how to talk to children when there’s a tragedy:

Limit their exposure to media coverage

    • Don’t assume your children won’t pay attention to anything that isn’t “kid” programming. News media often display dramatic images that capture the attention of young children.
    • Be aware that media may break into a children’s program with updates.
    • Choose to watch a DVD or listen to a CD instead of watching TV or listening to the radio.
    • Consider activities away from media sources such as going to the park, reading books or playing board games.

Watch what your child watches and discuss what you see and hear together

    • Ask your children what they think and feel about what they hear and see.
    • Clarify any misconceptions they have about the information presented in the media.
    • Be certain to include information that older children may receive through social media and texting.
    • Monitor adult conversations. Children will often listen when adults are talking and may confuse facts for opinions.

Reassure your child of their own safety

    • Remind your children that you love them and are doing everything you can to keep them safe.
    • Educate them about the role of community service agencies such as police and firefighters that help to keep them safe.
    • Acknowledge a child’s emotions and take them seriously. Don’t try to minimize or talk them out of their fears.
    • Answer their questions directly but don’t give them more information than necessary.

Pay attention to changes in your child that may be a result of what they have seen or heard

    • Younger children are significantly more impacted by the reactions of adults around them as well as the visual images on television. They are more likely to exhibit behavioral changes as a result.
    • Older children may need to talk about what happened and their feelings about the events. They may ask more questions related to the event/attack or make speculations through “what if” questions.
    • Children may exhibit behaviors related to stress such as generalized fear that something might happen, changes in sleep habits or appetites, avoidance of places that are similar to the site of the attack/shooting, poor concentration and separation anxiety.

Be honest with your teenager

  • Be up front and frank. Teens have a higher understanding of the world than young children.
  • Invite them to share their opinions. They have them.
  • Be aware of their reluctance to go to a movie theater or similar environment. Be willing to accompany them until they feel more comfortable.
  • Talk about ways they can protect themselves and create a plan together should they find themselves in a dangerous situation.

For additional information about talking with your children about tragedies and trauma, please visit the American Academy of Pediatrics.

 

 

Sarcoma: Greater awareness key to early diagnosis

This is a post by Dr. Nancy McAllister, a pediatric oncologist in Children’s Hospitals and Clinics of Minnesota’s Cancer and Blood Disorders Clinic. She treats patients with sarcomas, and she focuses on children with head and neck cancers. She’s also a clinical partner to the Karen Wyckoff Rein in Sarcoma Foundation. The foundation will throw their 12th annual Party in the Park on July 23 from 6 p.m. to 9:30 p.m. at Como Park in St. Paul.

Dr. Nancy McAllister

Sarcoma is a type of cancer that occurs in a variety of tissues. It can show up in nerves, muscles, joints, bone, fat and blood vessels. Because these tissues are found everywhere in the body, sarcomas can occur anywhere. They can be found in people of all ages, from young children to adults. In fact, fifteen percent of children and adolescents with cancer suffer from sarcomas. The majority of sarcomas in this age group are one of three types: Rhabdomyosarcomas, Osteosarcomas and Ewing’s sarcomas.

Sarcomas most frequently occur in the limbs. They may be hidden deep in the body so often they’re large by the time they’re diagnosed. Delay in diagnosis can create tumors that are more difficult to treat, so early recognition of these tumors is critical. In order to get a proper diagnosis, a surgeon with expertise in cancer surgery needs to do a biopsy.

Unfortunately, patients and doctors often miss signs of sarcomas or mistake them for something harmless. In an effort to increase awareness around sarcomas, Children’s is participating in the Rein in Sarcoma Foundation’s Party in the Park on July 23 at Como Park in St. Paul.

The Rein in Sarcoma Foundation and their Party in the Park help raise awareness about sarcomas and encourages families and medical providers to be especially aware of lumps.

Did you know…

People experiencing the following symptoms should be evaluated by a medical professional familiar with sarcomas as soon as possible:

  • Any lump or bump, 2 inches or greater in size
  • Deep lumps that increase in size
  • Pain, anywhere in the body, that isn’t explained by injury or increased activity that worsens or lasts longer than a month

At Children’s, we have several pediatric oncologists who can evaluate patients with the above symptoms:

Dr. Julie Chu, Dr. Jawhar Rawwas, Dr. Susan Sencer, Dr. KrisAnn Schultz and myself. We’re dedicated to diagnosing sarcomas early and treating children with sarcomas in the best way possible.

To read more about Dr. McAllister’s involvement with Rein in Sarcoma, click here. For more information about the Party in the Park, click here.

 

 

 

 

How do we teach our kids to be sad?

This is a post by Jeri Kayser, a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota.

Yep, you read that right. How do we teach our kids to be sad when every natural inclination tells us that kids need to always be happy? As parents, we tend to measure our self-worth in the reflection of our child’s emotions. As soon as our child cries, we seek a solution to sooth in a sympathetic response. But sympathy can sabotage self-esteem. No one wants others to feel sorry for them.

Empathy is more powerful. When you’re empathetic, you let your children know that you understand their distress and are prepared to support them as they develop their coping skills. This is much easier said than done. It’s painful to see your child in pain. Plus, learning to cope with sadness is a skill set that needs to be learned, so how can we help teach our kids how to be sad?

First Step: Embrace your own sadness. Kids learn by example. When you’re feeling overwhelmed, fatigued, frustrated, or generally not pleased with the status quo, do some self-exploration. There is much to be gained from trying to figure out why you aren’t happy. Seeking solutions is a way to gain control and find balance and when your children observe you work through something, they learn the value of the effort. Plus, they’re comforted by the fact that you have some of the same emotions as they do and have learned to deal with them.

Second Step: Remember everybody gets to own their emotion and every emotion is valid. We can go through the same event and have different responses to it, each equally relevant. There’s no “bad” emotion, just the one that’s present. If you can retain a calm presence, it’s easier to be supportive and not have your emotional response get mixed up with your child’s.

Third Step: Help give your child the vocabulary to express their emotion. Teach your child descriptive words that more accurately express their feelings. As they’re learning these words, encourage them to use art as well to express what they’re feeling.

Fourth Step: Help your child discover coping skills that work for them. One of my kids likes to write down her feelings in the privacy of her room (after the door has been slammed!). We know now to wait for the essay to be finished before she is ready to talk.

Last and most important step: Cut yourself and your child some slack. Being emotional is being human. Emotions are how we embrace life and experience it fully. It is not neat or perfect but real and messy and rich.

The Johnston family goes to Washington

This is a guest post by John Johnston, dad to patient Mike Johnston, who was diagnosed with a tumor in 2011. His family will be in Washington, D.C., next week for Family Advocacy Day. In its eighth year, the Children’s Hospital Association 2012 Family Advocacy Day brings patients from children’s hospitals and their families to tell their stories to lawmakers on Captiol Hill.

The Johnstons

On April 18, 2011, we took our 13-year-old son Mike to Children’s in St Paul. That day, our family began receiving treatment from Children’s. It turned out that Mike had a cancerous Germinoma tumor that was blocking the flow of cerebral spinal fluid. The fluid was building up in his skull, putting pressure on his brain and causing him to have tremors and headaches. As we began Mike’s cancer journey, it became obvious to our family that Children’s not only treated the patient, but they treated the entire family. Every staff member who came into our room introduced themselves to all of us, including 7-year-old Emma. We felt secure with the staff since they all made time for us and made us feel like we were their only patients at the moment.

Throughout Mike’s treatment, several important events were planned. The first was the American Cancer Society’s Relay for Life in White Bear Lake, Minn. Mike was one of the featured speakers. The oncology team scheduled chemotherapy and other appointments to make this special event possible for Mike and our family. The second major event for Mike that summer was his junior high school trip to Washington, D.C. This was an opportunity he couldn’t pass up since the teacher in charge was Mike’s favorite teacher and helped Mike get passionate about history. Mike enjoyed the monuments and museums in our nation’s capital and was able to take it all in despite his low blood counts.

Throughout our family’s journey with Children’s, we all felt blessed to have this institution charged with our son’s care. We felt so proud to have Children’s in our life that our family made a commitment to give back. Mike is now a member of the Youth Advisory Council, and my wife and I participate in the Families as Partners program. This all led to the upcoming opportunity for our family to travel to Washington, D.C., to advocate on behalf of Children’s. We’re very excited for this chance to give back. We even accepted this opportunity knowing that we would travel on Emma’s ninth birthday. We can hardly wait to see the sites as a family and meet many wonderful people who’ve also been touched by Children’s.

See you in Washington!