Author Archives: Tim Kehoe

Addressing preemie care head on in 2013

By Dr. Ellen Bendel-Stenzel

As the Star Tribune so beautifully illustrated with its Thanksgiving cover story, “Home After 98 Days In Preemie Land,” the issue of prematurity is a heart-wrenching and persistent challenge for doctors and parents-to-be.  Preterm birth can, and does, affect every race, ethnicity, religion, age, socioeconomic status and demographic.

Here in the Upper Midwest, more than 200,000 babies are born every year. And about 22,000 of those babies or little more than 10 percent are born premature. However, as a preterm infant, you couldn’t ask to be born in a better place than Minnesota. We have some of the highest survival rates in the world, and yet we received a “B” on the March of Dimes 2012 Premature Birth Report Card.  Why?  Because even though an infant born beyond 28 weeks gestation, or 7 months of pregnancy, has a nearly 100 percent chance of survival, these infants still remain at risk for respiratory problems, feeding issues, developmental delays and behavioral and social disabilities.

Unfortunately, the amazing medical progress we’ve made over the past 25 years, which lead to the improved outcomes for so many premature infants, has begun to plateau. Now we as health care providers need to take the lead and drive future improvements.

There will always be high-risk pregnancies, and ensuring the best outcomes for these scenarios is not dependent upon reducing the prematurity rate alone.   We need to be proactive and provide optimal care to both mother and baby, so that we can decrease the incidence of prematurity and improve the outcomes of those born early or with complex medical conditions. In short, we need to address the needs of the infant long before a mother’s due date.

In early February of next year, Children’s Hospitals and Clinics of Minnesota and Abbott Northwestern Hospital will open The Mother Baby Center in Minneapolis. It will be the first of its kind in the Upper Midwest, and one of only a few in the nation where mother-baby care is fully integrated. This new Center will bring together maternal and infant specialists, with the understanding that every pregnancy has the potential to be high risk.

With a proactive approach, the goal is clear: optimize care from conception to delivery.  This means the sharing of information across all nine months of the pregnancy whenever possible.  It means providing quick access to specialists when concerns for the health of either the mother or baby arise. It means collecting data to look at the root cause of prematurity in our own community.  It means collaborating in clinical trials that start at the first obstetrical visit and end in the pediatrician’s office at school age follow-up.  And it means continuing to incorporate the latest technologies and therapies on the Newborn Intensive Care Unit (NICU), while simultaneously measuring their effects and proving their validity.

While simple in theory, these are lofty goals that are difficult to implement and execute, but are well worth the effort.  As physicians we must continue to set the bar high and help moms achieve term delivery whenever possible, while at the same time improve the care for the babies that are born early.  In doing so, we’ll create a recipe for success that will provide enormous benefits to Minnesota babies and families.

Dr. Bendel-Stenzel is a neonatologist and co-director of clinical research for the Newborn Intensive Care Unit at Children’s Hospitals and Clinics of Minnesota in Minneapolis.

Will’s story: Back from the bench

When Will Cohen learned he had a benign tumor on his lower spine last January, the 15-year-old was more concerned about missing his basketball season than having to undergo a three-and-a-half hour surgery to remove the mass.

Playing sports was everything to him.

But Cohen – a three-sport athlete and freshman at the time – thought if he applied his same hard-working, can-do attitude on the basketball court to his new diagnosis and his surgery, he wouldn’t be benched for long.

“I learned that you must think positively. When I thought positively, I felt more positive results would come,” he said. “Thinking negatively doesn’t do you any good at all. It just makes you sadder about what happened.”


When Will started feeling pain in his lower back, hips and legs, he thought he was having growing pains. So did the adults around him. He stayed active and continued playing sports, kept up with his daily routine and attended school.

But, the pain got worse. Much worse. Will couldn’t sleep. He couldn’t ride in a car without experiencing jolting pain.

“I gotta do something about this. Something is not right,” he thought. “It’s not just growing pains.”

His gut was right. Will had an MRI and within two hours of his test, his parents got the kind of call every parent dreads from his doctor. The MRI showed a mass.

“His doctor knew she was looking at something that was not normal,” said Bob Cohen, Will’s dad. “It was about the worst moment.”

The family huddled in Will’s parents’ room, where they told him about the tumor.

“We knew he had a tumor, but we didn’t know what kind. It was a shock,” Bob said.

Will, however, remained calm, he says. “I just faced (the news),” he said.

Within hours, Will and his parents were at Children’s Hospitals and Clinics of Minnesota, where they met with Will’s surgeon, Dr. Mahmoud Nagib. He put his hand on Will and looked at the family, Bob said. He had good news for the family: The tumor was benign, but it needed to be removed.

“That was obviously a big relief, but we knew at the same time we were in for quite a road,” Bob said.

That night, life continued as normally as it could for the Cohen family. They attended a Timberwolves game as planned.

Days later, Will played his first and last basketball game of the season before surgery.

The final score

After eight days in the hospital, Will went home. He missed six weeks of school while he recovered and rehabilitated. Through hard work and dedication, Will was still able to earn the Outstanding Academic Achievement award at Hopkins North Junior High School.

Determined to play sports as soon as possible, Will spent three to four days a week working with a therapist at Lifetime Fitness to re-gain his strength and mobility. He lifted weights and ran on the treadmill when his doctor cleared him.

“I just kept thinking about basketball and soccer and Ultimate Frisbee, and that’s all I wanted to do,” he said. “I knew I’d have to work hard to get my speed and stamina back.”

By May, Will was cleared to play competitive Ultimate Frisbee. When he came home after a game with bloodied arms from diving for disks, it was a proud moment for Bob.

Will was back – and better than ever.

“I felt like I could jump higher and run faster. I felt I got more athletic after my surgery,” Will said.

It’s been almost a year since Will’s surgery, and his determination has carried him further than he first imagined it could.  Not only was Will one of only four sophomores to be selected for the varsity Ultimate Frisbee team, he was also elected by his soccer teammates to be a co-captain of the 10th-grade team.

His full recovery didn’t surprise Hopkins High School Ultimate Frisbee head coach Erin Mirocha.

“He’s patient and disciplined, and he’d rather make the right decision than force something to happen (in the game),” she said.

Says his dad, “He’s more mentally strong and determined than I ever thought any kid or most adults could be.”

Will is a first-year member of Children’s Youth Advisory Council

The Windschitl preemies: ‘Ours for the lovin’

By Sara and Nick Windschitl

Sara and Nick are the new parents of twins Bryn and Nora, who were born at 27 weeks.

When we heard that November was Prematurity Awareness Month, we thought, “Wow—people need a month to be aware of prematurity?” People who don’t have preemies probably never think about prematurity (unless they had a preemie Cabbage Patch doll like I did when I was 5), and people who do never STOP thinking about preemies. I know Sara and I haven’t! In June, the two of us wrapped up our school years. I said goodbye to my kindergartners, Sara said goodbye to her third-graders, and we jumped excitedly into a summer of Expecting Twins.

Sara prepared herself for getting huge, I started putting cribs together and we oscillated between excitement, disbelief and freak-out moments. At our 19-week ultrasound, we learned that Sara’s body might not want to hold these babies in as long as they needed to fully cook, and at 22 weeks she was sentenced to Hospitalized Bed Rest—her greatest pregnancy fear.

Five weeks later, the babes had had enough and decided to grace us with their tiny presences at 27 weeks. If you know anything about preemies, you know that 28 weeks is kind of the “safety zone” when it comes to avoiding a laundry list of long-term health issues, but despite Sara’s attempt to keep her legs crossed as tight as she could, the girls chose Aug. 6 as their birthday.

It was scary for us to know we had 27-weekers. Bryn weighed 1 pound, 4 ounces, and Nora weighed 2 pounds. But they were breathing on their own just a few short hours after birth and showing us their fighting spirits. This, along with the prayers being poured out from our friends and family (and strangers!), gave us an overwhelming sense of peace and calm. We also knew that at Children’s Hospitals and Clinics of Minnesota, we were in one of the best places in the world for preemies (yeah, we Googled that, too). The doctors and nurses that we encountered at Children’s were incredible. Each had skills that very few people in the world possess—the ability to not only care for these micro babies but also to work with parents who are scared yet extremely protective of the little lives they created.

Fast forward a month, and the girls were ready to move into the Infant Care Center at Children’s, where we continued to receive great individualized care. They moved into a class of “feeders and growers” with minor hiccups here and there—breathing issues, a hernia surgery, feeding struggles. There were days we just wanted to stick them in our pockets and make a run for it, get them home and start our new normal. After three months in the hospital, all we wanted was to tuck our girls in ourselves and read them a bedtime story without the constant background music of the monitors or to make farting noises on their bellies without wires getting in the way. That’s what every dad wants to do, right?

(As we write this, we are going on Day 98 in the hospital and are preparing to bring our girls home the following day!) What we’ve waited for so long now seems like the most daunting and scary thing we could ever do. We are keenly aware of our blessings these last 98 days, as having 27-week-old twins could have had a lot more downs than ups, but here we are, ready to bring home a 5 ½ pound baby and a 7 ½ pound baby—both healthy and ready to keep their parents from ever sleeping again!

Fast forward another 24 hours and these beautiful girls are home, where Sara and I are doing the normal parenting things, like checking to make sure they are breathing at 3:31 am.  Yep, these girls are healthy!  They are no longer those little translucent red nugget preemies that blessed this world in August.  They are real, wireless, peeing, pooping, crying, smiling, wide-eyed (only at 3:31 in the morning) babies.  Yes, we still need to be very cautious with these girls.  No, we won’t be taking them to the store.  We won’t be able to have many visitors.  We will be hand-washing and “foaming in” so frequently that a person outside of Preemie Land would say, “You MUST be OCD.”  I guess Children’s did one heck of a job on us because, as all parents of preemies know, we need to be!

Just like Sara’s pregnancy, the future is scary and unknown, but thanks to Children’s, we have babies who are breathing, growing and finally ours for the lovin’.



Giving on Give to the Max Day

Today, Children’s Hospitals and Clinics of Minnesota is participating in Give to the Max Day – Minnesota’s day of philanthropy. Over the next 24 hours, we hope to raise more than $100,000 for our patients and families.

We’re a national leader in advancing the health of children, innovating and delivering family-centered care of exceptional quality. But we can’t do it without you.

  • During the first half of 2012 alone, there’s been $7.4 million in generosity at work.
  • 100 percent of your donations help kids. Every cent is kid spent.

When you give big today, we hope you don’t forget the little guys. To donate, please visit

Throughout the day starting at 7 a.m., we’ll aim to keep you updated on our fundraising progress. We hope you follow along here. You can also follow us on Twitter or Facebook.



The 411 on teen sexting

By Amy Moeller

Amy is a therapist who has worked with children and adolescents for 25 years. She works in the Adolescent Health Department at Children’s Hospitals and Clinics of Minnesota and treats teenagers experiencing depression, anxiety, social struggles and chemical dependency. In addition, Amy co-founded The Family Enhancement Center in south Minneapolis 17 years ago. She works at the center part time with children and families who have been affected by physical abuse, sexual abuse and neglect. Amy is married and the mother of three children. 

As if we as parents don’t have enough to worry about, sexting has become yet one more concern for us with our already technologically savvy teenagers. Although teens are typically savvier than their parents, they also lack a basic understanding of the consequences of sending and receiving explicit text and photo messages via phone or computer.

Sexting is defined as “the practice of electronically sending sexually explicit images or messages from one person to another.” Sexting comes from the combination of the two words“sex” and “text messaging” and includes the sending of provocative messages or visual images to and from cell phones and computers.

Our teens often don’t realize the dire consequences of sexting and its ability to live in cyber space virtually forever. This phenomenon is poorly studied to this date; however, this is beginning to change with more data now available about sexting and just how common it is.

Depending on the study or the survey, somewhere between 20 and 60 percent of teens are sexting. As the trend continues, parents, teachers and lawmakers struggle with how to react to a phenomenon that ultimately puts kids at risk.

In a study reported in the September 2012 issue of The Archives of Pediatrics and Adolescent Medicine, researchers questioned a948 high school students in southeast Texas. The students were between the ages of 14 and 19 from seven public high schools. The following are amongst the most notable findings of the study:

  • 27.6 percent of teens reported having texted or emailed a naked picture of themselves.
  • Male and female teens send sexts with nearly the same frequency. Girls are asked more often to send a sext (65 percent) while boys more often ask for someone to send them a sext (46 percent).
  • Sexting is more common among older teens. They reported being less bothered by the requests to send a sext.
  • Of the females who had sexted before, 77 percent also reported having sex compared to 42 percent of the non-sexters.
  • In addition to being sexually active, girls who had sexted were significantly more likely to have also engaged in risky behaviors, such as drinking and using drugs before sex and having more then one sex partner.
  • Among the boys who had sent a sext, 82 percent were sexually active compared with 45 percent who had never sexted. Among males, sexting was not associated with more risky sexual behaviors.

In a nationally representative survey of 12- to 19-year-olds, the PEW Research Center conducted a series of focus groups with teens. Among their findings were that there tend to be three main scenarios for sexting:

  1. Exchange of images solely between two romantic partners.
  2. Exchange between partners that are shared with others outside the relationship.
  3. Exchanges between people who are not yet in a relationship, but where at least one person hopes to be.

Although the number of teens sending and receiving sexts is lower in this study, the study covered only images (not written messages) of sexually suggestive, nude or partially nude texts and videos. Again, there was no difference between girls and boys sending sexts.

Attitudes toward sexting vary among teens. Some feel it’s a major issue, and others think it’s not a big deal. Some view it as a safer alternative to sexual activity. Others see it as potentially damaging and illegal.

Legal consequences

Illegal it is. Many states are now creating legislation to address sexting after cases of sexting have led teenagers to be prosecuted for child pornography and forced to register as a sex offender. Several teens across the country are being faced with child pornography charges after sending or receiving sexually provocative pictures of themselves or other teens. Several cases have arisen that bring charges ranging from a misdemeanor to a felony.

Social and emotional consequences

As stated above, our teens need to understand that anything can be copied, sent, posted and seen by large audiences. It does not matter the intention, or that they trusted a person not to share the photo or message. Once it is in cyberspace, it is there forever. When revealing photos are made public, the subject almost always feels humiliated. There is ridicule and the embarrassment sometimes endless. There have been some high profile cases like Jesse Logan, a Cincinnati teen who committed suicide after a nude photo she sent to her boyfriend was circulated widely around her school resulting in harassment from her classmates.

Advice for parents

  • Don’t wait for an incident to happen, talk to your teen now. Communication is key – come right out and ask them if they have been sexting.
  • Remind them that once the image is sent, it can never be retrieved. They will lose control of it.
  • Talk about the pressures to send revealing photos. Be honest about the risks.
  • Teach your child to delete anything that comes to them immediately. If they do send it on, they are breaking the law.
  • Do not see sexting as an isolated event, but as a new expression fueled by today’s technology and the social and sexual experimentation that has always been a part of adolescence.



Making democracy work for kids’ health: a letter to first-time voters

Dear first-time voters,

You’ve been hearing about the election for months. Maybe you’ve already registered to vote (if not, no worries, you can register at the polls). All that’s left is to wake up next Tuesday morning and head to your local polling place (need help finding it?)

That’s right, next Tuesday, Nov. 6, is Election Day. For many of you, this is the first time you’ll be able to vote. As a new voter, you can bring the issues that matter most to you and your family right into the booth. When you vote, you can be a voice for kids.

How does that work?

Making sure that elected officials help protect and promote children’s health means that we need to participate in the democratic process and speak up for the issues that matter to us. Voting is a critically important part of this advocacy. Your vote matters and the Children’s Advocacy and Health Policy department can help by keeping you up to date on some of the most important policies that affect kids’ health.

Why do young advocates matter?

Last year, Children’s Hospitals and Clinics saw more than 120,000 children and teens. That’s more than the entire city of Rochester. Unfortunately, the majority of them can’t vote. They can’t cast a ballot for the person they think will protect them, and you, the most. But you can.

You are the one with the experience, who knows what’s important to children who are sick or to the family of someone who is. Use this opportunity to advocate for all those who can’t advocate for themselves.

And every vote counts. In fact, during the 2010 election, three races in Minnesota were decided by fewer than 100 votes. If 100 Children’s patients were able to vote, it could have changed the result of the election.

So how do elections impact you?  

Every year, our elected officials consider laws that directly affect you. In the last five years, laws regarding seatbelt use, concussion safety and smoking in restaurants have all been passed at the state level. Legislation at the federal level is also extremely important: in 2012 a bill that would help address drug shortages was passed into law. The impact of this law on kids’ health is big: many kids at Children’s depend on those drugs for life-saving treatments.

In addition, legislation is often considered that impacts the funding we receive to train doctors and nurses that care for our kids, as well as our ability to offer all the great programs we currently provide like the Arts and Healing program.

The Children’s Advocacy and Health Policy department has great information on all the issues that affect Children’s Hospital, from funding to training our doctors and nurses to childhood obesity initiatives.

Get ready to vote

Now it’s time for you to go out and make a difference. Here are some resources that will hopefully make the voting process easy and seamless for you:

We want to know how your first experience at the polls went! Tweet us @ChildrensMN or post on our Facebook page with a photo of you wearing your “I voted” sticker and let us know what it was like.

Continue to be a voice for children

After Election Day, you can stay engaged by joining Children’s Advocacy Network. We make being informed easy: You’ll get an alert whenever your involvement can make a difference! You’ll also get periodic updates on progress on issues and how your elected officials voted on measures before them.

Wishing you the best of luck,

The whole Advocacy and Health Policy team: Anna Youngerman, Kelly Wolfe, Katie Rojas-Jahn and Julia Miller

Common questions about bacteria, viruses and vaccines during pregnancy

By Dr. Deb Krahl

Dr. Deb Krahl has been a practicing OB/GYN for 16 years. She received her medical degree from the University of Minnesota before completing her residency training at the University of California-Irvine. She has been with Aspen Medical Group for the last nine years and is currently the lead OB/GYN physician there. She is excited to be among the OB/GYN’s delivering at The Mother Baby Center.

Another glorious Minnesota winter is just around the corner – yay! Experiencing the first snowfall, sledding with hot cocoa and spending the holidays snuggled up with family are wonderful winter thoughts. Unfortunately, winter is also associated with colds, coughs, strep throat and the flu. That makes it a relevant time to go over possible viruses and infections – weather-related and otherwise – that I always like to discuss with my patients.


If you’re pregnant during the winter, the most important thing you can do is GET A FLU SHOT! Children, the elderly, people with chronic medical problems and pregnant patients are the high risk groups that should get the flu vaccine. Don’t think “I never get sick” or “I don’t want the flu shot because I might get sick from it.”  If you get the flu while pregnant, you could become extremely ill, have severe respiratory problems or even die, so please get your flu shot.


Whooping cough or pertussis has made a comeback nationally. The Tdap vaccine (tetanus/diphtheria/pertussis) is strongly recommended during pregnancy if you haven’t had this vaccine in the past 10 years. This vaccine is important for both you and your baby. It protects your baby against whooping cough from birth to 2 months when the baby gets his or her first pertussis vaccine as a newborn.

Varicella (chickenpox)

Most people have had chickenpox. But if you’re unsure, please tell your OB provider at the first visit. Blood work can be done to check your immunity. If not immune, you should get the chickenpox vaccine after delivery.

Herpes virus

Genital herpes is very common, and it’s important to discuss this with your OB provider so they know your history. Anyone with a history of herpes should be on daily medication the last month of pregnancy to prevent this infection from being passed to the baby in labor. If someone has an active herpes infection in labor, she would need a Cesarean section so the virus does not pass to the baby while going through the birth canal.


Avoid changing or touching cat litter and eating uncooked meats to avoid this infection during pregnancy.


Don’t eat any unpasteurized milks or cheeses, which could cause this infection during  pregnancy.

Parvo virus (Fifth disease)

This virus is most common in young children so teachers, daycare providers and mothers of little kids are most likely to encounter it. If you’re exposed to this in pregnancy, call your OB provider to get blood work done to check your immune status. If you are not immune, repeat blood work will be done to see if an exposure has occurred.

HIV and hepatitis B

All OB patients are encouraged to have these tests done at the first OB visit. If a patient is a hepatitis B carrier, it is crucial the baby gets the hepatitis B vaccine and immune globulin immediately after delivery. If a patient has HIV, treatment during pregnancy is essential to reduce the chances that HIV will be passed to the baby.

Common bacterial infections

Strep throat, sinus and ear infections, bronchitis and pneumonia are all common winter illnesses. Most antibiotics used to treat these conditions are safe in pregnancy, so don’t be afraid to take medication if cleared by your OB doctor.

As winter creeps up on us, get your flu shot, find a bigger winter coat to grow into and make sure to have comfortable winter boots so you don’t slip on the ice…and let the snow fall!

Check out The Mother Baby Center on Facebook and visit the website.

Kids experience stress differently — how parents can help them cope

This is a post by Lizzi Kampf. She’s a Licensed Independent Clinical Social Worker in the Emergency Department at Children’s Hospitals and Clinics of Minnesota in St. Paul. She specializes in working with adolescents and children in acute behavioral crisis.

Children and teenagers today encounter more situations that can introduce stress into their world. Reactions to stress can vary based on a child’s background, coping skills, and their developmental level. Because children and teens tend to exhibit stress in very different ways than adults, challenges arise for parents trying to interpret and address what is really bugging their kids.

Children and teens tend to experience stress from many of the same situations that adults do, whether it is conflict with peers, pressure at school or in sports, family dynamics, or troubles with romantic partners. The difference is their minds are still developing the ability to process, interpret, and cope with these stressors. They also lack the life experience to know that they can make it through tough times and the confidence that they do have the ability to manage these difficult situations.

So what can parents do?

  • Encourage communication – Let your kids know that you are there to talk about what’s happening in their life and want to be a part of what is going on for them. Keep open lines of communication, giving them the ability to come to you and trust that you will listen.
  • Normalize feelings – Kids have an innate desire to fit in and can react strongly if they feel they are alone or different. Help them name the feelings they are having and let them know they are not the only one who has ever felt this way.
  • Model adaptive strategies – Kids learn from their parents how to deal with difficult situations. Show them that you can tolerate distress, and they will learn they have that ability as well.

For example, when your pre-adolescent is getting upset over not being able to complete a challenging math assignment you can say, “You seem like you are frustrated. I feel like that when I have a task that is difficult to finish, even though I am trying my best. Sometimes it is helpful for me to try something else for a while and then come back to it later.”

Finally, monitor your child for increasing stress levels. Kids who are becoming withdrawn from family or friends, having difficulty sleeping, or are missing a lot of school may need additional intervention. If it seems like they are not able to cope with challenges they face daily, or are having difficulty managing the stress in their life it may be time to seek professional help. Call your pediatrician or speak with a counselor at your child’s school if you need assistance getting referrals for a mental health professional.