Category Archives: News

Cities 97′s Paul Fletcher to host Baby Steps 3K

Paul Fletcher of Cities 97 will be the emcee for Baby Steps 3K walk and party, taking place on Saturday, May 31, at the Minnesota State Fairgrounds. Paul and his wife, Spencer, their family and friends will walk in honor of their daughter, Elsie, who was born with Hirschsprung’s disease and continues to receive care at Children’s. All proceeds from Baby Steps 3K will go to support the neonatal program. Learn more about or register for Baby Steps 3K.

In 2013, Paul and Spencer shared their story about Elsie and the care they received at Children’s and the Ronald McDonald House:

Photo gallery: 2013 Baby Steps 3K

Minnesota spring means ticks, health risks

Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Erin Fritz, RN, CNP

The snow has now melted and the temperatures are rising, allowing our energy and activities to bring us outdoors. Spring weather brings sprouting trees, blooming flowers – and creepy crawly ticks that lurk in the woods, grass and marshy areas.

Whether you are heading up north to the cabin or playing in your backyard, ticks may be present and a tick bite may occur. Due to the extreme seasonal temperature changes and high humidity, Minnesota has a lot of ticks and high rates of tick-borne illness such as Lyme disease, and the risk remains high. Lyme disease is an infection caused by bacteria that is carried by some deer ticks. Deer ticks are tiny – about the size of a pencil tip – and brown-black in color. Wood ticks are larger and do not carry Lyme disease.

Prevention

Playing outdoors increases the risk of encountering a tick, but there are ways to prevent a tick from attaching and biting. The American Academy of Pediatrics recommends the following for tick and Lyme disease prevention:

  • Cover arms and legs by wearing long-sleeved shirts and pants tucked into socks
  • Wear a hat to cover hair
  • Wear light-colored clothing in order to see ticks more clearly
  • Wear enclosed shoes, use insect repellent with DEET
  • Stay on cleared trails whenever possible
  • Routinely check for ticks immediately after coming indoors

When you find a tick

Most ticks are noticed when crawling around on clothing or skin and easily can be removed by taking it off before it attaches to the body. If a tick already has attached, removal is rather easy and should be removed as soon as possible. While prompt removal is important to decrease the risk of developing Lyme disease, be aware that most medical experts agree that the tick must be attached for at least 24-36 hours before Lyme disease is transmitted.

In order to remove the tick:

  • Simply grasp the tick with a tweezers as close to the skin as possible
  • Without squeezing the tick’s body, slowly pull the tick away from the skin
  • Clean the bitten area with soap and water
  • Apply an antiseptic ointment

Be on the lookout

After tick removal, it’s important to monitor the site for expanding redness that might suggest a “bull’s eye” rash. This particular rash can be the first and most obvious sign of Lyme disease.  The rash usually doesn’t cause other symptoms, but burning or itching is a possibility. Further examination by a health care professional is needed if there is a bull’s eye rash, headaches, chills, fever, fatigue or muscle aches. If Lyme disease is suspected, a health care professional probably will prescribe an oral antibiotic for treatment. There’s no benefit in testing for Lyme disease at the time of the tick bite; even people that become infected will not have a positive blood test until approximately two to six weeks after the infection post-tick bite. Early identification and treatment is important to reduce the risk of worsening illness.

While ticks and tick-borne illness easily can be overlooked, prevention is vital. This is the time of year to take full advantage of the long-awaited summer. Get outside and play safely.

Erin Fritz is a certified nurse practitioner at Children’s Hospitals and Clinics of Minnesota.

Kangaroo Care a tranquil experience for parent, child

Newborn Azarias has skin-to-skin contact with his mother, Veronica Engel, as part of a Kangaroo Care exercise. Thursday, May 15, is International Kangaroo Care Day.

This month, the Neonatal units in St. Paul and Minneapolis are celebrating the importance of Kangaroo Care, a technique where an infant is held skin to skin with mom or dad. Kangaroo Care promotes bonding, provides comfort for the baby and parent and has potential to improve a baby’s medical condition. In honor of International Kangaroo Care Awareness Day, a mother shares her experience holding her newborn son skin to skin.

Veronica Engel of Chippewa Falls, Wis., holds newborn son Azarias skin to skin as part of Kangaroo Care.

By Veronica Engel

My husband and I found out at my 10-week ultrasound that we were having a baby boy, but we also found out that our son, Azarias, had a birth defect called gastroschisis.

Due to his condition, doctors informed me that I wouldn’t be able to hold Azarias until after his surgery. This had me worried because I was afraid of missing out on that special bonding time that you immediately have with your newborn. When he was born, I was able to put him on my chest momentarily but then he had to be rushed off in an isolette to be prepared for his stay at the hospital until the doctors could perform the surgery he needed.  He was staying in the neonatal intensive care unit (NICU) at Children’s – St. Paul, which has private rooms. I am grateful for this because it allowed me to stay in the room with him around the clock.

I wasn’t able to hold him for the first week of his life due to his condition; however, I was able to hold his hands and feet or rub his head. After his surgery, I was able to hold him the next day. This was special because I got to hold him skin to skin; I held him for three hours straight. It was relaxing and soothing for both of us to be able to have this closeness, which we weren’t able to do at the beginning of his life. I continued to stay with Azarias in the NICU, and each day I would hold him once or twice using skin-to-skin – anywhere from an hour to three hours at a time.

The doctors told me that he was doing excellent for his condition. Not only was he gaining weight at a good pace, but he also was moving along quickly for what he was able to consume and digest.

When I’m holding Azarias skin to skin, I don’t even notice the time fly by; it’s such a relief to be able to help calm and comfort him just by this simple action. Kangaroo Care truly is a tranquil experience for parent and child and has helped us build a lasting bond with each other. I believe that being here and holding him skin to skin has made a difference in Azarias’ ability to recover and heal from this whole ordeal.

Children’s, Allina Health break ground at Mercy Hospital

Leaders from Children's and Mercy Hospital break ground on the new Mother Baby Center at Mercy on Wednesday, May 14, 2014.

Allina Health and Children’s Hospitals and Clinics of Minnesota are growing their birthing center partnership with the ground breaking of The Mother Baby Center at Mercy, part of Allina Health, in Coon Rapids, Minn. The new Center, targeted to open mid-2015, will provide all mothers and families in the north Twin Cities metro area – including Coon Rapids, Anoka, Buffalo, Maple Grove and neighboring communities – access to a network of world-class, family-centered birthing options closer to home.

The Mother Baby Center at Mercy, a $30 million initiative, will feature the only Level II special care nursery in the north metro with private patient rooms, providing in-room accommodations for families to stay together with their baby. For babies born at less than 34 weeks gestation, or for those who require a higher level of care, there will also be a seamless transition to and from The Mother Baby Center at Abbott Northwestern Hospital and Children’s in Minneapolis.

The ceremonial dig site for The Mother Baby Center at Mercy Hospital in Coon Rapids is seen Wednesday, May 14, 2014.

“Adding more specialized services at Mercy, especially for high-risk mothers and babies will mean fewer will need to go farther from home for care. We want to keep mothers and babies as close together as possible. Patients are happier when they can receive the care they need close to home. That is what Allina Health aspires to do in all of the communities we serve,” said Penny Wheeler, MD, president and chief clinical officer, Allina Health.

Mercy Hospital will ultimately move its current birth center to a new 62,200-square-foot, two-story Mother Baby Center attached to the hospital. For high-risk patients, a skyway will grant connection to the hospital’s main operating room. Initial capacity of The Mother Baby Center delivered by Mercy and Children’s will accommodate 2,700 births annually, with shelled space for growth for up to 3,500 births annually.

“Mothers and families want a personalized and safe birthing experience in a space that is thoughtfully designed, features state of the art technology and is staffed by the highest trained professionals. With Children’s as a partner, The Mother Baby Center at Mercy will optimize the quality of care for all mothers and babies in the north metro,” said Alan L. Goldbloom, MD, chief executive officer, Children’s. “Building on the experience and success of The Mother Baby Center at Children’s and Abbott Northwestern in Minneapolis, I’m confident this expansion will continue to advance the standards of maternal, fetal and newborn care across the state.”

Additional features of The Mother Baby Center at Mercy will include:

  • A designated entrance with valet services and immediate access to triage
  • 10 labor and delivery rooms
  • 22 post-partum rooms
  • Two large operating rooms
  • An infant resuscitation room
  • A 10-room Level II special care nursery with 14 bassinets
  • A newborn nursery
  • Five triage rooms
  • All private patient rooms with full bathrooms, luggage carts, hospitality amenities (hairdryers, large screen TV, iPod docking station, fold-out sleeper sofa, etc.)
  • A family lounge dedicated to families whose baby requires neonatal care
  • Provider call rooms

The announcement of the ceremonial groundbreaking of The Mother Baby Center delivered by Mercy and Children’s comes just over a year after the grand opening of The Mother Baby Center at Abbott Northwestern Hospital and Children’s, which opened in February 2013.

Austin’s story: A pioneering surgery provides hope

For 3-year-old Austin Graue, his short life has been anything but typical.

At birth, he was delivered via emergency C-section after doctors determined he wouldn’t be able to breathe on his own. He was rushed from the hospital in his family’s hometown of Northfield, Minnesota, to Children’s – St. Paul.

Austin Graue, of Northfield, Minnesota, was born in August 2010.

“It was disbelief and shock,” said Mary Graue, Austin’s mother, when she thinks back to her baby’s first days. “What we thought was happening [having a healthy baby boy] was exactly the opposite. We asked ourselves: ‘Is he even going to survive?’ ”

Confusion and doubt swirled.

After discharge and a precious few days at home, Austin was readmitted to Children’s when he continued to experience breathing problems and near-constant vomiting prevented him from gaining weight. Diagnosed with pyloric stenosis (a narrowing of the pylorus, the opening from the stomach into the small intestine), Austin would require surgery.

Surgery was a success and Austin was discharged, albeit with a tracheostomy (a hole made in his neck that went through to his windpipe) to help him breathe (“His nasal passages were the size of pencil tips,” Mary said) as well as a gastronomy tube for feeding. His only visits to Children’s now would be for quarterly checkups. However, things quickly changed during his three-month visit when doctors told the Graues that the “soft spots” on Austin’s head were closing too quickly and he would need surgery, again.

A new diagnosis: Austin had Pfeiffer syndrome.

“Austin had experienced challenges since birth and now we finally had the answer why,” Mary said. “It was such a relief to finally have an answer.”

Hope for Austin’s future was growing.

Pfeiffer syndrome is a rare genetic disorder which only affects about 1 in every 100,000 people. Because of his condition, the bones of Austin’s skull had prematurely fused together, putting increased pressure on his brain. If left untreated, Austin’s brain would not be able to fully develop, causing a host of developmental problems. Physically, Austin would begin to develop bulging and wide-set eyes, a high forehead and an underdeveloped jaw.

At just 1 year old, Austin and his family met Robert Tibesar, MD, one of the craniofacial surgeons at Children’s ENT and Facial Plastic Surgery, the first and only ENT and facial plastic surgery practice in Minnesota that cares exclusively for kids.

“Austin had fusion of many of his sutures – or joints – in his skull,” Tibesar said. “That meant that his mid-face, forehead and the back of his head were not growing properly. The fused sutures had constricted growth and were causing Austin to have an abnormally shaped head, as well as put him at an elevated risk of pressure inside his skull.”

First, Tibesar, along with Joseph Petronio, MD, Children’s neurosurgery medical director, performed surgery to advance the front part of Austin’s head and eyebrows, allowing him to better close his eyes and improve the contour of his forehead.

Pfeiffer syndrome is a rare genetic disorder which only affects about 1 in every 100,000 people.

“As expected in children with Pfeiffer syndrome, the problems with Austin’s skull could not be solved with just one operation,” Tibesar said. “The fused sutures in the back of his head continued to constrict the growth of his skull.”

“The back of Austin’s head was flat,” Tibesar continued, “and that was preventing his brain from fully developing. The back part of the brain serves important functions for vision and balance, and we needed that to be decompressed to allow his brain to grow normally.”

Tibesar would use his knowledge of the jaw distraction procedure – a procedure pioneered at Children’s – to perform a “cranial vault expansion” on Austin, which would be coupled, for the first time, with image-guidance technology.

“In looking at the literature, there are no other case reports of this exact procedure for this exact problem,” Tibesar said.

As Austin’s dad, Phil, described it, Tibesar and his team were going to “move an island of bone” on Austin’s head.

Tibesar likened image guidance to using a GPS in favor of a paper map. “When you’re trying to get somewhere using a map, you may not know exactly where you are; sometimes you have to make your best guess. With GPS, you know exactly where you are at all times. The same is true with image guidance. During surgery, we know exactly where we need to make each bone cut.

“For Austin, and for many other kids to come, this represents a significant advance in terms of precision, and, therefore, safety for these types of surgeries.”

Austin would become a pioneer.

In the operating room, Tibesar and his colleagues opened Austin’s skull and attached four “distractors” over his head from ear to ear – these distractors would allow Austin’s skull to expand and grow. At the completion of the surgery, four small key holes protruded from Austin’s head, and his parents were entrusted to turn a special key twice a day to slowly expand his skull, causing little to no pain for Austin.

Doctors opened Austin’s skull and attached four “distractors” over his head to allow his skull to expand and grow.

“It was really hard at first,” Phil said. “You are literally moving his skull… I couldn’t believe I was doing it.”

After 30 days back home, Austin’s skull had expanded nearly 3 centimeters and was starting to grow properly on its own.

In February 2013, Tibesar and his colleagues removed the distractors in order to allow the bones of Austin’s skull to fill in more completely. Since the surgery, Austin has experienced few complications and has only been back to Children’s for routine check-ups.

Before (right) and after (left) X-rays of Austin's skull

According to Tibesar, the next-closest place that offers surgery for kids with Pfeiffer syndrome is in Chicago. Thankfully for Austin and his family, he would be able to be treated less than an hour from home.

“Things have been normal,” Mary said. “We have our daily worries, but otherwise Austin is going to school, talking more and making friends. As time goes on, we are getting more normal around here.”

Austin Graue with his mother, Mary

For other parents that will face a similar journey, Mary encourages them to “take things one day at a time.”

Austin will have to undergo another surgery in a few years to ensure that the bones of his face grow along with the rest of his skull, but he’s well on his way to a much more typical life.

“We need parents who put their trust in us,” Tibesar said. “It’s a big honor to have that trust, but really, [the children] become the pioneers and we are able to apply this technology to the benefit of others.”

More about Austin Graue’s story is available here.

Surgery before birth saves lives of preemie twins

Amina (left) and Rania Abdi were born Feb. 11, 2014, at 25 weeks. The twin sisters were diagnosed with twin-to-twin transfusion syndrome while in the womb. (Jimmy Bellamy / Children's Hospitals and Clinics of Minnesota)

We continue our focus on fetal care this month by honoring Siman Abdi and her twin daughters, Amina and Rania, who were born Feb. 11 at 25 weeks.

Earlier in Siman’s pregnancy, the sisters were diagnosed with twin-to-twin transfusion syndrome (TTTS), which is a rare condition that occurs when one twin donates blood to the other while in the womb and, if left untreated, potentially can be fatal for both babies.

Thanks to the work of the Midwest Fetal Care Center, a collaboration between Abbott Northwestern Hospital and Children’s, Siman’s daughters are recovering at Children’s and continue to grow stronger each day.

Learn more about twin-to-twin transfusion syndrome:

Twin-to-Twin Transfusion Syndrome from The Mother Baby Center on Vimeo.

Honoring patient- and family-centered care

If there is a Children’s staff member who has made a difference to your family, nominate him or her for the Excellence in Patient- and Family-Centered Care Award.

When Deb’s daughter was born prematurely at 28 weeks, Kathy Wharton, RN, in Children’s neonatal intensive care unit, was there to comfort her, teach her and laugh with her.

“Kathy was calming, funny and professional,” Deb said. “She was our decoder for this confusing, unplanned madness we got thrown into. I can’t imagine getting through the first few weeks without her kind words, explanations and hugs.”

Deb honored Kathy by nominating her for the Excellence in Patient- and Family-Centered Care Award, which is organized by Children’s Family Advisory Council. The award, which is given out twice a year, gives families an opportunity to recognize and honor care providers who demonstrate an outstanding commitment to patient- and family-centered care.

For Kathy, the award was a touching reminder of why she comes to work every day.

“I have spent over 30 years in nursing and have done it all – from bedside nursing to supervising, from hospital to clinic, NICU to dialysis and back to bedside NICU,” Kathy said. “This award reminded me why I came back to bedside nursing. It renewed my spirit and reminded me that I can make a difference.”

If there is a Children’s staff member who has made a difference to your family, nominate him or her for the Excellence in Patient- and Family-Centered Care Award. Families can nominate any Children’s staff member from whom they have received services in the past 12 months. The next awards will be presented in May and October.

Questions? Please email familyadvisorycouncil@childrensmn.org.

Minneapolis among 10 best U.S. cities for health care

Minneapolis was named one of the 10 best U.S. cities for health care, according to Becker’s Hospital Review and a release from iVantage Health Analytics and its Hospital Strength INDEX, a rating system analyzing publicly available data to measure hospitals across 10 pillars of performance and 66 metrics.

Minneapolis was named one of the 10 best U.S. cities for health care. (2014 file / Children's Hospitals and Clinics of Minnesota)

List of cities in top 10 (in alphabetical order):

  • Atlanta
  • Boston
  • Charlotte, N.C.
  • Chicago
  • Minneapolis
  • New York
  • Philadelphia
  • Portland, Ore.
  • St. Louis
  • Washington, D.C.

The 10 cities serve approximately 60 million people, 19 percent of the U.S. population, according to the report.

Sources: Becker’s Hospital Review and iVantage Health Analytics

Study: Concussion recovery time doubles when injury is sustained during school year

A patient visits the concussion clinic at Children's — St Paul on March 11, 2014. (Photo by Scott Streble)

A patient visits the Concussion Clinic at Children's — St Paul on March 11, 2014. (Photo by Scott Streble)

Concussions and the treatment after one is sustained have been at the forefront of media coverage in recent years. What once was viewed by some as brag-worthy or a badge of honor now is being taken seriously for its potential immediate and long-term effects.

While progress has been made in how the seriousness of a concussion is perceived, it’s still relatively unknown when it’s acceptable for individuals, including children, to return to normal cognitive and physical activity after suffering one.

According to a study by the Concussion Clinic at Children’s Hospitals and Clinics of Minnesota, a child who sustains a concussion during the school year takes significantly more time to recover than one who suffers a similar injury during the summer.

“We were surprised at the magnitude of the differences,” Robert Doss, PsyD, co-director of the Pediatric Concussion Program and one of the study’s researchers, said. “We weren’t surprised that it was in that direction; just simply that the magnitude was what it was.”

Researchers took patients seen in the Concussion Clinic at Children’s from 2011-12 — 43 children who suffered concussions during the school year and 44 injured in the summer — and monitored their progress. For the children who sustained a concussion in the summer, the average number of days to recover was 35. Recovery time more than doubled (72 days) when the injury was sustained during the school year.

Another study, “Returning to Learning Following a Concussion,” published in October in Pediatrics, the official journal of the American Academy of Pediatrics (AAP), explains the difficulties children experience in a school setting after suffering a concussion. Post-concussive symptoms often can linger or increase in severity without proper adjustments to a child’s environment or academic routine. Research suggests that academic demands and school environment may be a barrier to recovery.

Because each concussion and child is different, the AAP study recommends creating a multidisciplinary team to facilitate a student’s recovery and help him or her return to normal activities. Those four teams are: 

  • Family (student, parents, guardians, grandparents, peers, teammates and family friends)
  • Medical (emergency department, primary care provider, concussion specialist, clinical psychologist, neuropsychologist, team and/or school physician)
  • School academic (teacher, school counselor, school psychologist, social worker, school nurse, school administrator, school physician)
  • School physical activity (school nurse, athletic trainer, coach, physical education teacher, playground supervisor, school physician).

“It’s important to understand the individual child,” Doss said. “It seems like our practitioners are noticing more responsiveness by the schools to put forth accommodations for these kids. Some schools are more accommodating than others. Some seem to have a grasp of concussions.

“Overall, I think our perception is that schools are more receptive and thinking about it more actively. They’re instituting programs on their own, so they’re prepared for what comes next.”

Subjects were evaluated and treated in the Concussion Clinic after presenting with symptoms consistent with mild head trauma.

Researchers identified two groups based upon whether they recovered from their concussions during the school year or summer months and were ages 7 and older. The school year was defined as September through May. The school group was matched to the summer group by age and gender.

The average age of the children in the study at the time of injury was 14 years old.

Date of recovery was defined as the final visit date in the Concussion Clinic.

Doss also cautions parents and kids that they aren’t out of the woods once recovery is complete.

“It seems pretty clear in some of the guidelines that prior history of a concussion puts you at a higher risk for subsequent concussions,” he said.

However, according to the Children’s study, there’s little empirical support for the amount or duration of cognitive and physical rest after a concussion and the time frame for children to safely return to normal daily activities without experiencing ongoing cognitive or physical deficits.

According to the “Returning to Learning” study, cognitive rest refers to avoiding potential cognitive stressors, such as texting, video games, TV exposure and schoolwork. However, to date, there is no research documenting the benefits or harm of these methods in either the prolongation of symptoms or the ultimate outcome for the student following a concussion.

“Should the kids not be on Xbox versus playing a little bit of Xbox?” Doss said. What may be best during recovery depends on the case. “How much schoolwork is appropriate?”

Doss said the perceptions families and academic institutions have about concussions are evolving.

“Schools across the U.S. did not seem to be prepared. You bump up against the usual: The kids look fine. They’re not limping. They have an injury that’s not visible,” he said. “The general population is dealing with this heightened awareness of concussions.”

Variables collected for analysis included school grade, prior concussion history, loss of consciousness with presenting injury, first clinic visit ImPACT computerized cognitive testing raw scores — verbal memory composite, visual memory composite, visual motor speed composite, reaction time — ImPACT post-concussive symptom  scores, and history of depression and anxiety, migraine, other neurological problems, learning disability or ADHD.

The study was conducted by Robert Doss, PsyD, Neuroscience Center of Children’s Hospitals and Clinics of Minnesota, and Minnesota Epilepsy Group, P.A.; Kara Seaton, MD, Emergency Department of Children’s Hospitals and Clinics of Minnesota; and Mary Dentz, RN, CNP; Joseph Petronio, MD; Julie Mills, RN, CNP; Jane Allen, RN, CNP; and Meysam Kebriaei, MD, of the Neuroscience Center of Children’s Hospitals and Clinics of Minnesota.

Girl Scout Day at Children’s – Minneapolis

Children's is hosting Girl Scout Day on March 29.

Are you the parent of a Girl Scout or the leader of a troop? If so, mark your calendar for Girl Scout Day at Children’s – Minneapolis 10 a.m. to noon Saturday, March 29.

We’re excited to be hosting our second Girl Scout Day at Children’s to bring troops together and honor their generosity and hard work for Children’s patients and their families. An exciting day of celebration will include Children’s speakers, a tour of the hospital’s public spaces, a few fun activity stations and a photo booth with Children’s mascot, Twinkle!

To learn more about Girl Scout Day, register your troop or learn about ways your troop can make a difference, contact Maggie Overman at Maggie.Overman@childrensmn.org.

NOTE: Space for this event is limited and registrations are taken on a first-come, first-serve basis, so sign up today.