Monthly Archives: October 2013

Five Question Friday: Richard Holcomb

It’s Five Question Friday! Meet Richard Holcomb, our Welcome Center supervisor.

How long have you worked at Children’s? Since June of 2012 – a year and a half. 

What drew you to Children’s? A friend, Kendall Munson, convinced me that I would like working at Children’s, and he was correct.
What brings you back to Children’s, day after day? The staff and the children. I work with kind and compassionate people. The culture is positive and accepts that we are human and make mistakes, and most staff, I know work, diligently to provide the best service and care possible. Sometimes when my office door is open, a child will say hello as she/he is passing in the hallway. Or you will get to have a brief interaction with a family – these always remind me why we are here and how wonderful our patients are.
If you could travel anywhere in the world, where would it be and why? Almost too difficult to answer, as I would travel most anywhere. New Zealand, Nepal, West Africa and anywhere in Europe again.
When you’re not at work, how do you spend your time? Bicycling, swimming, workout at the gym, reading, traveling.

Dr. Friedrichsdorf’s top 10 apps for pain management

By Stefan Friedrichsdorf, MD

State-of-the-art pain management in the 21st century demands that pharmacological management must be combined with supportive and integrative (non-pharmacological) therapies to manage a child’s pain. At Children’s, we are using physical methods (e.g. cuddle/hug, massage, comfort positioning, heat, cold, TENS), cognitive behavioral techniques (e.g. guided imagery, hypnosis, abdominal breathing, distraction, biofeedback), as well as acupressure and aromatherapy.

For “needle-pokes” (vaccinations, blood draws etc.), for instance, we expect that kids are sitting upright (use sucrose in the age group 0-12 months), that we numb their skin with topical anesthesia (e.g. EMLA-patch, LMX 4% lidocaine patch, or J-tip) and use distraction, such as bubble blowing or blowing a pin wheel. Alternatives can be apps on your smartphone etc.

My personal favorite technique remains teaching children in self-hypnosis. However, in addition, I’m increasingly using apps on my iPhone or iPad with patients. Here are my top apps for pain and symptom management in kids:

 #10 Chalkboard: Drawing on a realistic chalkboard with different color chalk – much more fun than it sounds. [$ 1.99]

 #9 Talking TomThis is a cat that repeats everything you say in a funny voice. You can then record and share videos and send them by eMail / YouTube / Facebook. Kids really enjoy that they can make Tom the cat say funny stuff… [free]

# 8 Simply BeingProvides relaxation, stress relief and benefits of meditation without prior experience. It allows the child/teenager to choose from 4 meditation times and gives them the option to listen to the guided meditation with or without music or nature sounds. Kids can also listen to the music or nature sounds alone. More for older children and teenagers. [$ 0.99]

 #7 Drums As the name implies, this is a drum kit. Great for kids with too much [or too little] energy. Rock on! [$ 0.99]

# 6 Tesla ToyTesla Toy is a fun interactive “particle toy”. When the fingers touch the screen they generate what looks like a powerful electrical field that makes the thousands of particles react beautifully. 
Kids (& adults) are often mesmerized by this app for a long time. [$ 1.99]

#5 Fruit NinjaA “juicy” action game with squishy, splatty and satisfying fruit carnage! [$ 0.99] 

 #4 Koi PondOne is gazing into a pond of crystal clear water with fish, turtles and more. Kids run their fingers across the cool surface of the pond and water ripples away from their touch.
The koi fish, disturbed, dart away… only to quickly forget and swim close once more… [$ 0.99] 

#3 Easy Bake TreatsThis is a highly recommended app. It let’s children make, bake, decorate, eat and share virtual cakes, cupcakes, cookies, cake pops and pizza. They pick their mix, fill the pan with batter and water, mix it all together and slide the pan into the virtual oven to cook.  Then they can add candles to their cakes and cupcakes too! Candles can be lit and re-lit for even more fun! 
Once they’ve baked and decorated their treats, kids can show off and share their delicious virtual creations with family and friends via email or Facebook. Highly addictive – kids can spend a very long time on this! [free]

#2 The Healing Buddies Comfort Kit™ app provides an interactive, virtual way for kids and teens to engage with the latest in integrative medicine techniques and activities to assist in the management of symptoms they may be experiencing. 
Kids and families are increasingly interested in options to improve health and wellness that involve taking fewer pills and that involve supporting their body’s natural, internal healing systems. -combining kid-friendly activities and pre-recorded audio exercises and instructions that teach self-care skills. The Healing Buddies Comfort Kit™ (mobile app for iPad, iPhone and iPod Touch platforms) offers an interactive, virtual way for kids and teens at home, in a doctor’s office, or in the hospital, to learn and immediately benefit from self-care techniques to manage common symptoms like pain, worries, nausea, fatigue and trouble sleeping. 

The Healing Buddies Comfort Kit™ contains several integrative medicine techniques adapted for use by children and teens that are quick and effective for symptom control so kids can get back to doing what they like to do–and need to do each day. The techniques included in this mobile app are designed by leaders in the field of Pediatric Integrative Medicine (Physicians, Nurses, Psychologists and Child Life Specialists) and have been tested for years in several leading Children’s Hospitals and Clinics. The app leads kids through these various techniques and activities, plus, the Healing Buddies™ make it a fun and engaging experience.

Techniques that kids will learn that are included in the Healing Buddies Comfort Kit™ include:

-Mental Imagery/Visualization: in this technique kids/teens will learn to use the power of their imagination to effect changes in physical and emotional activity.

-Relaxation Exercises: with these breathing and muscle control techniques, kids/teens will learn to calm down and balance the body and the nervous system which helps to reduce symptoms of pain and nausea, improves sleep and can have a powerful effect on controlling & even eliminating worries

-Acupressure: acupressure is part of the ancient Chinese medical system and involves applying pressure to “special points” on the body which in turn releases helpful chemicals and induces nervous system changes that can help to reduce pain, nausea, and anxiety

-Aromatherapy: aromatherapy, which involves smelling oils made from plants, has been around in most cultures for thousands of years. Smelling certain kinds of scented oils offers another tool for kids/teens to use to control unwanted symptoms/feelings

-Positive Self-Talk: this involves learning to be a “self-coach” and harnesses the power of positive thinking. [Disclaimer:

The creation of the mobile app has been a collaborative effort of my department at the Children’s Hospitals and Clinics of Minnesota with Ridgeview Medical Center and DesignWise Medical.]

and the winner is…

#1 Balloonimals Absolutely groovy – kids love it! My favorite app to distract a child in pain or discomfort. Beautifully rendered balloon animals spring to life when you blow into the microphone on your iPhone/iPad or swipe with your iPod Touch. Watch the balloon inflate and then give your phone a shake to start constructing your Balloon animal. With each shake, your animal takes greater shape until… Voila! Your Balloon animal appears and is ready to play. Pet your “Balloonimal” to see what tricks it can do.

Apps, which just did not make the list (but I still like them a lot): Art of Glow, Sand Garden, Build a Zoo, Naturespace, SkyView and Disney’s Small World

This post originally appeared here. You can also download Children’s app.

Five Question Friday: Adriene Thornton

Meet Adriene Thornton, an infection preventionist at Children’s Hospitals and Clinics of Minnesota.

How long have you worked at Children’s? 15 years
What drew you to infection prevention? I have a passion for maintaining a clean environment and taking steps to prevent infections from occurring. I don’t like it when kids (and I) get sick!
What do you love most about your job? The fact that there is always a new challenge, so I never get bored.
Flu season is just around the corner. Do you have any advice for how to prevent it? Get your flu shot! Eat healthy food, do hand hygiene often, and keep a tissue handy for cleaning your nose.
If you could travel anywhere in the world, where would it be and why? Milan, Italy. I love fashion and Milan is the fashion capital of the world so it’s perfect.  Plus I hear the french drink wine with their lunch!

Recipe: Vegetable curry (curry in a hurry)

This Indian-inspired curry is a healthy, meatless main dish that makes for a quick weeknight meal (and great leftovers). Serve with basmati rice and a cool cucumber salad seasoned with mint and lemon juice. — Andrew Zimmern

Photograph by Madeleine Hill

Ingredient list

  • 2 teaspoons minced fresh ginger
  • 1 teaspoon minced fresh garlic
  • 2 tablespoons Madras style curry powder
  • 1/2 teaspoon ground cumin
  • 1/2 teaspoon ground coriander
  • Several pinches red chile flakes
  • 14 ounces canned chopped tomatoes
  • 1 medium chopped onion
  • 3 chopped carrots
  • 1 fennel bulb, trimmed and sliced
  • 2 cups frozen spinach
  • 14-ounce can chickpeas, drained rinsed and drained again.
  • 2 cups chicken or vegetable stock
  • 2 tablespoons olive oil

Instructions

Servings: 3 to 4
Total Time: 40 minutes

Rinse the chickpeas and drain, set aside.

Rinse the spinach and defrost. Squeeze dry and reserve.

Heat a large pan over medium heat.

Add the oil to the pan and swirl once or twice to coat the entire surface.

When the oil ripples and is aromatic, add the ginger, garlic, onion and spices. Cook for a few minutes, stirring frequently.

Add the carrots, spinach and chickpeas, stirring to incorporate.

Add the stock and tomatoes, bring to a simmer.

Adjust heat to maintain a simmer and cook until the liquids in the pan have reduced by 75 percent and the ‘sauce’ is tightened, about 20 minutes.

Season with sea salt and a squeeze of fresh lime and serve immediately, garnishing with a dollop of thick yogurt if you like.

NOTE: Try upping the stock amount by a cup and throwing in a half cup of lentils for a fun twist on this easy recipe.

Get more great recipes from Andrew

The road to a cystic fibrosis diagnosis for Kyra

By Amy Schwanz

My daughter, Kyra, was diagnosed with cystic fibrosis (CF) in September 2004 when she was 3 months old. She was diagnosed through a sweat test done at Children’s Hospitals and Clinics of Minnesota in St. Paul. It was Kyra’s “failure to thrive” that prompted the sweat test. Since other possible causes of her inability to gain weight were ruled out, it was the natural next step/test. After Kyra’s pediatrician gave Mark and me the test results and diagnosis, he comforted us, explained the disease at a high level, and informed us that we were fortunate to live near two excellent CF Care Centers. He also immediately scheduled an appointment for Kyra at Children’s Respiratory and Critical Care Specialists (one of those two excellent care centers).

Mark, Kyra and I met Cindy Brady and Sandy Landvik at Children’s Respiratory and Critical Care Specialists (CRCCS) the morning after Kyra’s sweat test and diagnosis. That first visit, Mark and I were educated about CF, and Kyra had a physical exam. Specifically, Cindy explained the genetics behind the disease and how CF impacts different areas of the body. This helped us understand how the disease resulted in Kyra’s failure to thrive. At that first visit, we were given the option of having Kyra be an inpatient at Children’s in Minneapolis for a few days for testing and education, or for Kyra to continue as an outpatient, which meant we would come back to the clinic/hospital every few days for testing and education, spread out over a few weeks. Since we had another young daughter at home, we elected for the outpatient option. We brought Kyra to CRCCS quite frequently. At first it was every few days and then the time between visits extended as Kyra became healthier, with the visits happening weekly, and, finally, monthly. Although this happened nine years ago, I can still recall how patient, comforting, and reassuring the entire CRCCS staff was with us during those first visits. It was a very difficult time for us, but it would have been much worse without the support and care of the CRCCS staff.

Following the treatment plan prescribed by CRCCS, Kyra VERY rapidly gained weight and finally looked like a healthy baby with pink chubby cheeks. She also didn’t cry as often, slept better, and became a much happier baby. This change literally happened in days; it was amazing!  Over the course of the first few months, Kyra had several diagnostic tests done (chest X-ray, blood work, etc.) to determine her health status. Although these tests were important, more vital was for Mark and I to learn how to care for Kyra. It is not easy to care for a child with CF and it takes a lot of time to learn it all.  We learned the how and why of everything we did for Kyra – from pancreatic enzyme replacements to bronchial drainage techniques. We also worked with all of the CF care team members associated with Children’s to get the specific information about respiratory care, nutrition, etc.

Over the past nine years, our family has fallen into the routine of life with CF. Kyra has certainly had some ups and downs, as is to be expected with a chronic life-limiting illness. But, for the most part she has remained very healthy, and Mark and I are successfully managing the many challenges–medications, respiratory treatments, clinic visits, school health plans, travel considerations and medical bills. Kyra continues to have appointments four times per year at CRCCS, with one of those being her “CF annual visit” where we meet with the entire CF care team. Over our many visits to the clinic and Kyra’s one inpatient procedure (sinus surgery) in 2009, we have become very familiar with Children’s and CRCCS. I cannot say that every interaction at the hospital and clinic over the years has been perfect, but I can say that from the office staff, to surgical staff, and certainly to our great CF care team, I am frequently impressed with the level of care Kyra receives. The CF care team works closely with us to do what’s best for Kyra.

In 2004 when Kyra was born, CF newborn screening was not being done in Minnesota. On one hand, I wish that Kyra would have had the screening and been diagnosed at birth so that she would not have had such a rough start to her life. However, on the other hand, while Kyra’s diagnosis was devastating, it was also somewhat of a relief for us— to finally determine what was causing her inability to gain weight and to be able to “fix” the problem and see an improvement in her health. I think of the parents whose newborns are diagnosed, they must not have that sense of relief that we did and I think that would make the diagnosis more difficult. But, those parents also do not have to go through the first few months of their child’s life wondering why they won’t gain weight and they can get started on treatments right away, improving their outcome. I empathize with parents whose children are diagnosed with CF – at birth or later in life –because no matter when the child is diagnosed, it is a devastating diagnosis. It is a challenging road they will travel. Fortunately, with Children’s CF care team, they will, like us, have an excellent medical support system to help us along that road.