a publication of ucsf benioff children’s hospital … · louis j. lavigne, jr. michael lenoir, md...

HANDPRINTSCHILDREN’S

Children’s pediatrician Dr. Gena Lewis explains why bed sharing is not recommended.

DANGEROUS CONDITIONS FOR HEAT ILLNESS Learn the signs of heat- and hydration-related illness types and symptoms.

A PUBLICATION OF UCSF BENIOFF CHILDREN’S HOSPITAL OAKLAND

SUMMER 2015 childrenshospitaloakland.org

Is co-sleeping with your baby safe?

SLEEPLAB

HEARING & SPEECH CENTER

OUTPATIENT SURGERY

SPORTS MEDICINE CENTER FOR YOUNG ATHLETES

MOTION ANALYSIS & SPORTS PERFORMANCE LAB

DIAGNOSTIC IMAGING

SPECIALTY CARECLINICS

1

BENICIA

PLEASANTON5

Walnut Creek

TREAT BLV

D.

SHADELANDS

LEN

NO

N

WALNUT

YGNACIO

VALLEY RD.

UCSF Benioff Children’s Hospitals Walnut Creek

Campus is Contra Costa County’s only outpatient

medical center just for kids.

Our Walnut Creek location houses the latest

technology and services for pediatric care. All care is

provided by physicians who are members of Children’s

attending physician staff.

UCSF BENIOFF CHILDREN’S HOSPITALSWALNUT CREEK CAMPUS2401 Shadelands Dr.

Walnut Creek, CA 94598

(Cross street is Lennon Ln.)

925-979-3434

2401 Shadelands Dr.Walnut Creek, CA 94598

www.childrenshospitaloakland.org

Table of Contents

4 MODERNIZATION PROJECTUCSF Benioff Children’s Hospital Oakland Modernization Project is approved by Oakland City Council.

5 A WORD FROM DR. LUBIN, PRESIDENT & CEO

6 PERSPECTIVEWhy I Ask About Guns. Written by Heidi Roman, MD.

7 ASK AN EXPERTIs Co-Sleeping With Your Baby Safe? Bed sharing is a no-no for good reasons. There are safer ways to nurse, soothe and bond with your newborn. Written by Linda Childers.

8 THINGS TO DOSports Medicine Center for Young Athletes Lecture Series 2015 Calendar

9 KIDS CORNERLogic Puzzle #13

10 RESEARCH UPDATE Eating and Living for Heart

Health Written by Patty Siri-Tarino, PhD.

11 FOOD CORNER Heart-Healthy Foods

12 DIABETES Getting Healthy—Managing

Your Diabetes Being a kid with diabetes isn’t fun, but Children’s Endocrinology Team recommends these Bay Area programs that help you stay healthy by staying active.

12 FOOD CORNER Apple Walnut Muffi ns These

muffi ns are a heathy option for breakfast or an after school snack.

13 CHILD LIFE SERVICES/SURGERY/ ANESTHESIOLOGY

Calming a Child’s Fear of Surgery Child Life Services and pre-operative consultations help young patient cope with severe anxiety. Written by Susie Caragol.

15 100% HEALTHYVaccinations Children’s pediatricians address concerns on childhood vaccinations. Written by Gena Lewis, MD, and Diane Halbert, MD.

16 Q&ASports Injuries Athletic Trainer and Certifi ed Strength and Conditioning Specialist James Faison answers questions about sports injuries for young baseball and softball players.

17 100% HEALTHYDangerous Conditions for Heat Illness Written by Athletic Training Services Program Manager Bruce Valentine, PTA, ATC.

21 100% HEALTHYTalking Is Teaching 80% of a child’s brain is formed by age 3. When you talk, read, and sing with your child you’re helping them become smarter and happier.

22 GIVING BACKNew MRI Goggles Soothe Young Patients

Costco Employee Gives Back After Terminal Diagnosis

6th Annual Notes & Words

18 “A Team of Angels Saved His Life”Mom credits fi refi ghters and Children’s team of doctors, nurses, and therapists for son’s recovery after fall off 230-foot cliff . Written by Susie Caragol.

To contact the UCSF Benioff Children’s Hospital Oakland departments and services featured in this issue: Heart-Healthy Foods, page 11:Clinical Nutrition, (510) 428-3772

Getting Healthy—Managing Your Diabetes, page 12:Diabetes Clinic, (510) 428-3654

Calming a Child’s Fear of Surgery, page 13:Child Life Services, (510) 428-3520 Vaccinations, page 15:Primary Care Clinic, (510) 428-3226

Sports Injuries, page 16:Sports Medicine Center for Young Athletes, (925) 979-3430 A Team of Angels Saved His Life, page 18:Rehabilitation Medicine, (510) 428-3655

CHILDREN’S HANDPRINTS SUMMER 2015

4 CHILDREN’S HANDPRINTS SUMMER 2015 • www.childrenshospitaloakland.org

Children’s HandPrints is a publication of UCSF Benioff Children’s Hospital Oakland, 747 52nd Street, Oakland, CA 94609; 510-428-3000.

Bertram Lubin, MDPresident and Chief Executive Offi cer

Marketing Communications DepartmentLisa OzaetaSenior Vice President & Chief Strategy Offi cer

Tina AmeyAdministrative Assistant

Debbie DareCreative Marketing Director

Kevin KimbroughMarketing Manager

Melinda KrigelMedia Relations Manager

Michele RepineInternet Marketing Director

Erika SandstromSenior Graphic Designer

Stephen LowryCommunications Intern

Contributing WritersSusie CaragolLinda ChildersChildren’s Endocrinology DepartmentJames FaisonDiane Halberg, MDJackie KershGena Lewis, MDHeidi Roman, MDPatty Siri-Tarino, PhDBruce Valentine, PTA, ATC

Contributing PhotographerAlain McLaughlin

The medical information contained in this newsletter should not be substituted for advice from your child’s pediatrician.

If you do not wish to receive future issues of this publication, please email to [email protected] your name and address as they appear on the mailing panel.

If you’d like to write to the editor of Children’s HandPrints, please send an email to [email protected].

HANDPRINTSCHILDREN’S

www.childrenshospitaloakland.org

Aida AlvarezBarbara Bass BakarDavid Beier Jeff rey Cheung James Feusner, MD

Mark Laret Louis J. Lavigne, Jr.Michael LeNoir, MDBertram Lubin, MDEdward Penhoet, PhD

Shahan Soghikian Robin WashingtonCarrie WheelerBruce Wintroub, MD

UCSF BENIOFF CHILDREN’S HOSPITAL OAKLAND BOARD OF DIRECTORS

UCSF Benioff Children’s Hospital Oakland achieved a major milestone on May 19, 2015, when the Oakland City Council unanimously voted to approve the Environmental Impact Report (EIR) certifi cation of the hospital’s Master Plan. Our modernization project will rebuild and expand the medical facilities at the main hospital and outpatient center. Now with the Oakland City Council’s approval, construction on the 10-year project is expected to begin in late summer. The project will include seismic upgrades, creation of individual patient rooms, expansion of the outpatient center, and modernization of our facilities to support the advancement of medical technology. For more details about the Master Plan/modernization project, go to www.CHOnext100.org.

UCSF Benioff Children’s Hospital Oakland Modernization Project is approved by Oakland City Council

Children’s staff and supporters wore bright yellow shirts to show their support to the Oakland City Council. Members of the Child Life team made colorful letters spelling out UCSF Benioff Children’s Hospitals’ new brand tagline, “Redefining Possible.”

Go Team!

I want to tell you about Ann Petru, MD, Children’s Co-Director of Infectious Diseases. She was recognized as the 2015 Honoree in the Health category for the Alameda County 22nd Annual Women’s Hall of Fame. Her recognition by the Alameda County Board of Supervisors and the Alameda County Commission on the Status of Women highlights her pioneering efforts in the treatment of HIV and in battling the stigma associated with the infection.

Dr. Petru cared for the Bay Area’s fi rst pediatric HIV/AIDS case in 1983. In 1986, she started the Pediatric HIV/AIDS Program at Children’s, through which she has treated more than 800 HIV-infected and HIV-exposed infants, children, and adolescents. Many of her patients were among the fi rst to participate in AZT treatment and other clinical trials. These groundbreaking studies were instrumental in the development of drug therapies that, over time, have been very successful in extending the lives of young HIV/AIDS patients. Dr. Petru has also been advocating the early testing of pregnant women and encouraging the widespread use of maternal drug therapies that have, in turn, greatly reduced the transmission of HIV from mothers to their infants. She also became a leader in educating health providers and the public about pediatric HIV issues, and her work has been pivotal in reducing the stigma associated with such cases.

Dr. Petru is one brilliant example of the type of care and dedication that you can expect at Children’s. I salute her and all the pediatric specialists at Children’s.

Yours in health,

Bertram Lubin, MDUCSF Benioff Children’s Hospital OaklandPresident & Chief Executive Offi cer

CHILDREN’S HANDPRINTS SUMMER 2015 • Donate at www.childrenshospitaloakland.org 5

A WORD FROM

DR. LUBINPRESIDENT & CEOPRESIDENT & CEO

Dear Friend and Neighbor,

Dr. Petru has been with Children's since the 1970s!

the stigma

tment and

Posters hung at Children’s

clinics try to normalize and

de-stigmatize HIV testing.

UCSF Benioff Children’s

Hospital Oakland offers

testing as part of routine

care for all patients 13 years

of age and older.

To see Dr. Petru discuss her HIV work, go to http://bitly.com/annpetru


PERSPECTIVE

June 21 was ASK (Asking Saves Kids) Day. This collaboration between the American Academy of Pediatrics and The Center to Prevent Youth Violence is an eff ort to encourage

parents to help keep kids safe by asking, “Is there a gun where your child plays?”

I’ve long asked families whether there are guns in their home during well child visits. As my son gets older and goes on play dates, I’ll need to start asking parents whether there are guns in the home he is visiting and whether they are safely stored. These are not easy questions. Sometimes we avoid asking because it feels awkward. Some criticize or worry that asking is an invasion of privacy. These questions should be considered neither awkward nor invasive. They must become the norm. This is an essential part of keeping our children safe.

Here’s why I ask.I ask because kids are curious. They like to explore their

environment. This is their job, essentially. If guns are in that environment, they will touch them, play with them. They will shoot them, even if they’ve been told not to. In 2010, there were 134 deaths and 2,886 injuries in the 0 to 19 year old age group due to unintentional fi rearm injuries. Those are the numbers. The stories behind those numbers are absolutely heartwrenching. In my time as a pediatrician, I have already been involved in the care of a number of kids whose lives and families are forever altered by devastating fi rearm injuries. Young children who undergo multiple surgeries and excruciating rehabilitation after a terrible accident. Families with good intentions. Parents who desired to protect their family from intruders with a fi rearm, but who didn’t realize that their child would fi nd the gun and accidentally shoot a loved one. Take one look into those parents’ eyes, and I can assure you, you’d start asking, too.

I ask in memory of a teen patient lost to suicide. A friend’s father’s gun to his head. 749 children and teens died due to fi rearm suicide in 2010. Some argue that these kids would have found another way to take their lives even without access to a gun. The thing is, suicide attempts by fi rearm are far more likely to be successful than attempts by other means. I’ve cared for a number of patients after unsuccessful non-fi rearm–related suicide attempts. With these kids, there was time to get them to the

hospital. Time to help them heal physicially. Time to get them the mental health care they so desperately need. With fi rearm suicides, we don’t get this chance.

I ask. In clinic, it is a matter of routine. Like bike helmets, and tobacco exposure, and car seats. I ask, “Is there a gun in the home?” If the answer is yes, I ask if the gun is unloaded. I ask if the gun and the ammunition are stored and locked up separately. I don’t judge. I don’t report to anyone. I just ask. I’ve had many more “yes” answers than I would have expected just a few years ago. I’ve had parents realize that a relative’s gun was loaded and available in the home where their young children were staying and thank me for bringing it up. I’ve had families wonder why I ask, and we’ve had some good discussions.

And, as awkward as it might feel, when my son starts playing at friends’ homes, I’m going to have to ask, “Is there a gun where our children will be playing?” If the answer is yes, I’ll ask, “Is the gun unloaded and locked up separately from ammunition?” I’ll ask because I care too much about him and other kids not to, and because I know that 40% of homes with children in America have guns. If they’re stored safely, not a problem. If not, maybe we can meet at the park.

Why I Ask About Guns

Heidi Roman, MD, graduated from the University of Wisconsin School of Medicine and Public Health and completed her pediatric residency and chief residency at Children’s Hospital Oakland. She currently lives in Dallas, Texas, with her husband and son and is an Assistant Professor of Pediatrics at UT Southwestern Medical Center and a pediatrician at Children’s Medical Center of Dallas. She writes about children’s health at http://mytwohats.com and tweets from @hkroman.

FOR MORE INFORMATION:ASK (Asking Saves Kids) campaign from The Center to Prevent Youth Violencehttp://askingsaveskids.org/www.bradycampaign.org/our-impact/campaigns/asking-saves-kids


100% HEALTHY

ASK AN

Is Co-sleeping with Your Baby Safe?

EXPERT

Bed-sharing is a no-no for good reasons. There are safer ways to nurse, soothe, and bond with your newborn.

Written by Linda Childers (@Lindachilders1), May 21, 2015; www.safebee.com/family/co-sleeping-your-baby-safe

A safe bed includes swaddling your baby and clearing her crib of blankets, pillows, and toys

Tucking in your tiny one next to you at bedtime may seem like the sweetest way for you both to get a good night’s sleep. But sharing a bed with a baby is controversial at

best. Although it’s common in some cultures, research shows it’s dangerous, putting infants at an increased risk of suff ocation, strangulation, and sudden infant death syndrome (SIDS).

In fact, a recent study found that bed-sharing is the biggest risk factor for sleep-related infant deaths.

Some parents still believe it’s the best way to bond with their baby, make nighttime breastfeeding easier, and help their infant sleep well. But there are better, safer options.

Defi ning the dangers“During the fi rst couple of months after a baby is born, parents

are sleep-deprived. It can be hard for them to make sure their baby is safe in their bed,” explains Gena Lewis, MD, a pediatrician at UCSF Benioff Children’s Hospital Oakland.

Lewis cites incidents of babies rolling out of bed or being pushed into the crack between the mattress and the wall.

Pillows, blankets, and other bedclothes add to the danger. The Consumer Products Safety Commission found that between 1992 and 2010, more than 700 infants under 12 months died in incidents involving pillows, thick quilts, and overcrowding in the baby’s sleep space.

Napping on the sofa with your baby is no safer. Often, exhausted parents who breastfeed or try to comfort a colicky baby on a couch inadvertently fall asleep. A 2014 study found that of the nearly 8,000 SIDS cases in the United States, about 12 percent involved infants sleeping on a sofa. The study also found that babies who died sleeping on a sofa were nearly twice as likely to have suff ered from suff ocation or strangulation as babies who died sleeping elsewhere.

Safe alternatives to bed-sharingAlthough sleeping in the same bed with a baby is a bad idea,

sharing a room has benefi ts. In fact, the American Academy of Pediatrics (AAP) advocates that parents sleep in the same room as their infant for the fi rst six to 12 months.

According to the AAP’s most recent report about co-sleeping, “There is evidence that this arrangement decreases the risk of SIDS by as much as 50 percent and is safer than bed-sharing or solitary sleeping (when the infant is in a separate room).” The report adds, “Room-sharing without bed-sharing allows close proximity to the infant, which facilitates feeding, comforting, and monitoring of the infant.”

HOW TO SAFELY SHARE A ROOM WITH YOUR BABY

Set up a bassinet or crib near your bed.

You can also purchase a special type of bassinet, often called a co-sleeper bassinet, that attaches to the side of the bed. That way your baby will have a safe place to sleep, and you’ll have easy access to her.

Make up a safe bed for your baby.

“Babies should sleep on a fl at surface that is fi rm and covered by a fi tted sheet, with no other bedding or pillows,” Lewis says. “To keep an infant warm at night, swaddle her with a blanket, or dress her in a fi tted sleep sack.”

Find other ways to bond.

“Many parents believe that bed-sharing helps them to bond better with their infant,” Lewis says. “But bonding is a process that happens over time. It can be done by touching your baby, responding when she cries, holding her close, making eye contact, and breastfeeding.”

Learn what will soothe her to sleep.

A baby, especially a very young one, may need help drifting back to Dreamland after waking up to nurse or take a bottle. Swaddling can help. So can off ering a pacifi er. (Note that if you’re nursing your baby, it’s best to hold off on using a pacifi er until after breastfeeding has been established.)

FREE AND OPEN TO: • Athletes age 9 to 25 and parents

• Youth sports coaches

• Athletic trainers

• Athletic directors

RSVP / MORE INFO:

Walnut Creek (925) 979-3420

Oakland (510) 428-3558

Monthly Lecture Series 2015

Sports Medicine CenterFor Young Athletes

sc

ien

ce

+spp

orts

Cheer FLY HIGH & STUNT HARD Saturday, June 27, 2015

10 a.m.-1 p.m.

Lecture & Hands-On Workshop

Walnut Creek Campus

RunningTHE ART AND SCIENCE OF RUNNING IN YOUNG ATHLETES Tuesday, July 14, 2015

7-8 p.m.


Walnut Creek Campus

FootballCURRENT CONCEPTS IN CONCUSSIONS IN YOUTH FOOTBALL Tuesday, August 11, 2015

7-8 p.m.

Oakland Campus

ACL ACL INJURIES AND PREVENTION IN YOUTH SPORTS Tuesday, September 15, 2015

7-8 p.m.


Walnut Creek Campus

BasketballBASKETBALL INJURY PREVENTION 101Tuesday, October 13, 2015

7-8 p.m.


Oakland Campus

NurtritionSPORTS NUTRITION: FUELING THE FURNACE Tuesday, November 10, 2015

7-8 p.m.

Walnut Creek Campus

Ski/SnowboardingWINTER SPORTS CONDITIONING (SKIING/SNOWBOARDING)Tuesday, December 1, 2015

7-8 p.m.

Walnut Creek Campus


Walnut Creek Campus2401 Shadelands Dr., Suite 180 Walnut Creek(925) 979-3420

Oakland Campus744 52nd St.Outpatient Center Auditorium Oakland (510) 428-3558

Schedule

Locations


THINGS

TO DO

Submit your answer, and if it’s correct, you’ll win a prize. Send in a photo of you holding the solution, and you might be in the next issue!

Send your answer by July 24, 2015, to: CHILDREN’S HOSPITAL OAKLANDCOMMUNICATIONS DEPT.747 52ND ST., OAKLAND, CA 94609

NAME ___________________________________________AGE ______

ADDRESS __________________________________________________

CITY ______________________________________________________

STATE ________________________ZIP __________________________


Children’s Hospital’s

Whiz Kids

I hereby give my consent to UCSF Benioff Children’s Hospital Oakland and its organizations, including its fundraising foundation, (“Children’s”), to do any or all of the following with respect to me/my child:

Child’s name________________________________________________

� I agree that pictures may be used in and/or shared with Children’s publication HandPrints.

� The information to be released or used includes pictures or recordings of me/my child.

I understand: • Pictures/Information published online before the expiration date may

remain online after the expiration date but will not be used in a new way without my consent.

• I may cancel this consent up until a reasonable time before the picture/information is used, but I must do so in writing and submit to: UCSF Benioff Children’s Hospital Oakland, Marketing Communications, 747 52nd Street, Oakland, CA 94609.

• My cancellation will be eff ective when received by Children’s, except where use or sharing has already occurred in accordance with this consent.

• I will not receive any fi nancial compensation for agreeing to this consent.

• I have a right to receive a copy of this consent.

Please make a copy of this form for your records.

This consent expires 3 years from today. Date ____________________

Parent/Guardian signature ____________________________________

Parent/Guardian printed name ________________________________

Relationship to child _________________________________________

Phone ____________________________________________________

Email _____________________________________________________

Address ___________________________________________________

City_____________________________State_______Zip ___________

CONSENT TO PHOTOGRAPH, PUBLISH, USE, AND/OR SHARE INFORMATION

Fill out the consent form only if you are sending in your photo!

PUZZLE #12 answerProblem: Move only 2 toothpicks to create 7 squares.

Answer:

PUZZLE #13

ABCDx4______

DCBA

Problem: Can you fi nd the numbers A, B, C, and D so that the following works?

Answer:

KIDS CORNERCCCCCCCOOOOOORRRRRRNEEERRRRRRRRRRNNNNN

Props to our Puzzle Masters: Mariana and Viviana from Newark; Abby from Oakland; Riya from Pleasanton; and Aarushi, Arjun, Haasika, Juliette, Krishiv, Timothy, and Vibha from San Ramon. Awesome stuff !

Thank you all for your entries!


RESEARCHUPDATE

Eating and Living for Heart Health

What we eat and what we feed our children are

decisions that we make every day. And in making some of those choices, we rely on advice from expert panels of doctors, scientists, and nutritionists to guide us towards better food choices. But what if there’s controversy among the experts? What do we make of the news headlines now saying that butter and eggs are good for you? Is it time to ignore all of the advice we grew up hearing?

CHORI Director of Atherosclerosis Research and former Chair of the American Heart Association Council on Nutrition, Physical Activity and Metabolism Dr. Ronald M. Krauss lends some insight: “There are some major points on which all experts agree. We should all be eating more vegetables, fi sh, nuts, and whole (versus processed) grains. And at the same time, we should be reducing to the greatest extent possible our consumption of added sugars and processed foods.

“A major focus of dietary guidelines has been on reducing saturated fat, but the most recent research—including fi ndings from our group as well as others—are showing that the food context matters, and that there are different types of saturated fats that have different effects on biology. So focusing on overall saturated fat intake is too simple a notion.”

Even more important than limiting saturated fats is focusing on what a person eats instead. If you are like most Americans, processed carbohydrates have been the foods of choice, with national trends showing increases in overall carbohydrate consumption from 40 to 50 percent over the last several decades. Marketing of processed food products as “low in fat” and “heart-healthy” has in part been responsible for their increased consumption, with serious implications for heart health. When processed foods and refi ned carbohydrates

are consumed in excess, obesity can develop, and even when consumed within caloric balance, they can worsen blood fat and cholesterol profi les.

“For some people,” says Dr. Krauss, “eating excess carbohydrates has been worse for their cardiovascular health than eating a moderate amount of saturated fat would have been.”

With over 30 years of research, Dr. Krauss and his research team based at CHORI since 2002 have contributed to understanding the relationships between diet, genetics, and heart disease risk. In addition to evaluating how different nutrients affect heart disease risk, Dr. Krauss’ research has focused on understanding what happens physiologically in response to diet, including the possibility that a particularly dangerous form of cholesterol transport particle may be created when the body takes in too much refi ned carbohydrate. According to Atherosclerosis Research Program researcher and Associate Program Director Sally Chiu, PhD, “The work we do here has shown that the type of LDL a person has may affect cardiovascular disease risk more than his or her LDL cholesterol. We are working now to identify the most dangerous type of LDL particles.”

Importantly, although heart disease is usually thought of as an adult disease, it actually begins in childhood. An appreciation for this fact is underscored by the recent 2011 recommendation by the American Association for Pediatrics for universal cholesterol screenings in children 9 to 11 years old and again between

17 and 21 years. Says Dr. Chiu, “We’ve made a lot of progress in terms of understanding how diet affects heart health in adults. But we still have a lot of work to do, especially in kids.”

Given heart disease’s continued standing as the number one killer in the United States and the world, its onset in childhood and the fact that heart health can be substantially modifi ed by how we eat and live, Dr. Krauss launched the Family Heart & Nutrition Center in 2011 with support from the Children’s Hospital Branches, the Dreisbach Family Foundation, and

individual donors. As a signature program of the UCSF

Benioff Children’s Hospital Oakland, the new center brings together research, clinical care, and community outreach with the goal of providing the most up-to-date knowledge for improving heart health in a family-based approach. With programs under continuing development, the Family Heart & Nutrition Center is seeking support to expand its reach and position itself as a nationally and internationally recognized center of excellence aimed at the acquisition, implementation, and dissemination of knowledge for reducing the burden of cardiovascular disease across the full age spectrum and among diverse populations.

or

Which could be worse for your health?

LDLAn LDL (bad cholesterol) level of 130 or above is considered a serious risk factor for heart attack, stroke, and other problems caused by clogged arteries. In the past, guidelines focused on lowering LDL levels to specifi c “target” numbers that were considered safer. However, the type of LDL a person has may aff ect cardiovascular disease more than the level.


Heart-Healthy Foods

RESEARCHSTUDIESHelp advance

medical discoveries!Dr. Krauss’s team is currently recruiting participants for these diet studies:

• Studies are conducted at the Cholesterol Research Center at 3101 Telegraph Avenue in Berkeley.

• Compensation is provided for study participants.

• For details and to determine eligibility, go to www.CRCstudy.org, or call (866) 513-1118.

DIETARY RESEARCH STUDYMEN/WOMEN AGE 21-65

The Cholesterol Research Center (CRC) at the Children’s Hospital Oakland Research Institute (CHORI) is looking for men and women, ages 21 to 65 for an 18-week research study on food sources of dietary protein and risk factors for heart disease.

If you qualify and complete our study, you will receive:• Free food for 14 weeks, eat your own food for 4 weeks

• $1200 upon completion of the study

• Lab work results• An optional 4 weeks of free weight-loss counseling after you complete the study

DO YOU HAVE EXTRA WEIGHT AROUND YOUR WAIST?

Excess fat around the waist (“apple shape”) is associated with greater heart disease risk than excess fat in other places. The Cholesterol Research Center is recruiting individuals who are “apple shaped” for a 13-week diet study on the eff ects of almonds on heart disease risk.

For more information about the studies or the Family Heart & Nutrition Center: • Go to http://bitly.com/CHORI-FHNC • Call Dr. Ronald M. Krauss at 510-450-7912.

FOOD CORNER

BLUEBERRIES Blueberries are high in antioxidants and a good source of vitamin C. It is best to eat them raw.

YOGURTYogurt is a good source of protein and calcium and contains “good” bacteria for the gut. Be careful to choose yogurts that are low in added sugars.

AVOCADOSAvocados are fi lled with heart-healthy unsaturated fat and nutrients known to lower blood pressure. Try smashed avocado on whole wheat toast for breakfast.

SALMON/OTHER FATTY FISH The omega-3 fats in fi sh, especially fatty fresh fi sh like salmon, swordfi sh, and rainbow trout, can help reduce the risk of sudden-death heart attacks.

WHOLE FRUITS It’s better to eat your fruit instead of drink it. Eating it means you get all the fruit’s nutrients and fi ber content.

BROCCOLI Broccoli is rich in vitamin C, carotenoids, and folic acid.

WHOLE-GRAIN BREAD Whole-grain bread has more fi ber and about a dozen more vitamins and minerals than enriched white bread or “wheat” bread.

NUT BUTTERSNuts are fi lled with heart protective nutrients. Have a handful of nuts as an afternoon snack, or spread a nut butter on whole wheat toast.

BEANS Beans are inexpensive, low in fat, and rich in protein, iron, folic acid, and fi ber. Choose from garbanzo, pinto, black, navy, kidney, and lentils. Eat them as a side dish or a snack, in a tortilla with salsa, or in a soup.

SPINACH, KALE These greens are loaded with vitamin C, carotenoids, calcium, and fi ber. Steam ’em and eat ’em.

Eligible participants must be:• Male: 20 years or older, with a waistline more than 40 inches.• Female: 20 years or older, with a waistline more than 35 inches.• Participants will receive $900 and lab work results for completing

the study.

Grocery list cheat sheet


DIABETES FOOD CORNER

APPLE WALNUT MUFFINSMakes 12 muffi nsNutrition information (per muffi n): 185 calories, 3.8 g protein, 21 g carbohydrate, 10 g fat, 13 mg cholesterol, 3 g fi ber, 261 mg sodium

Source: www.100daysofrealfood.com

1½ cups whole-wheat fl our

2 teaspoons cinnamon

1 teaspoon baking soda

½ teaspoon salt

¼ teaspoon baking powder

¼ teaspoon nutmeg

2 eggs

⅓ cup pure maple syrup

⅓ cup water

5 tablespoons melted butter (can substitute melted coconut oil)

1 cup shredded apple (see instructions below)

¾ cup chopped walnuts

DIRECTIONS1. Preheat the oven to 350°F. Line a muffi n pan

with paper or silicone liners and set aside.

2. In a large mixing bowl, whisk together the fl our, cinnamon, baking soda, salt, baking powder, and nutmeg. Make a well (hole) in the center and drop in the eggs, syrup, water, and melted butter. Stir with a fork until well combined.

3. To shred the apple, either use a cheese grater or use a food processor fi tted with the shredding disk. Discard any big chunks of apple peel that don’t get shredded all the way. There is no need to remove any liquid or squeeze the apples dry. Gently fold both the apple shreds and chopped walnuts into the batter.

4. Divide the batter among the 12 muffi n cups, and bake for 18 to 20 minutes. Enjoy!

Getting Healthy—Managing Your DiabetesBeing a kid with diabetes isn’t fun, but Children’s Endocrinology Team recommends these Bay Area programs that help you stay healthy by staying active.

Approved by our diabetes team!

UCSF BENIOFF CHILDREN’S HOSPITAL OAKLAND PROGRAMSHEALTHY HEARTSHealthy Hearts is a program designed to prevent and treat childhood obesity and related illnesses, such as diabetes, for youths up to age 18. More info: http://bitly.com/cho-healthyhearts

NATURE SHUTTLEEnjoy an active and educational afternoon in the park, including lunch and transportation. This free program takes place at one of the East Bay Regional Parks on the fi rst Saturday of every month from 1 to 4:30 p.m. Bus transportation is available from Children’s Primary Care Clinic. Families can register for the Nature Shuttle at the front desk of the Primary Care Clinic, located at 5220 Claremont Ave., Oakland, or call (510) 428-3885, ext. 2209. Please provide names, a phone number, and the number of people going on the trip. Youths must be accompanied by an adult.

ADDITIONAL RESOURCESThese resources are not sponsored by or affi liated with UCSF Benioff Children’s Hospital Oakland. They are provided for your convenience. They are intended solely as general educational and support aids and do not substitute for professional advice and services from a qualifi ed provider. Users of these resources assume all risks of doing so. Parents are responsible for determining their child(ren)’s access to any online resources and ensuring their use of safe social networking practices.

DIABETES CAMPDASH (Diabetes and Sports Health) Camp DASH (Diabetes and Sports Health) Camp is a place for youth and friends, ages 6-18, living with diabetes to play non-competitive sports in a safe and supervised environment. Contact Lucas Fogarty, Co-director, [email protected], or call (510) 982-9006. www.DASHCamp.org

ONLINE SUPPORTTudiabetes A community of people touched by diabetes, Tudiabetes is a social network for support, education, and sharing. www.tudiabetes.org

FITNESS APPS: IPHONE AND ANDROIDGlucose BuddyA free phone app to log information related to diabetes, including carbs, medication, activities, A1C, blood sugar, and weight. www.glucosebuddy.com


Kaden Fogelman, who turns 9 years old in August, has undergone more surgeries than most people

experience throughout their entire lifetimes. Arriving three to four weeks prematurely,

Kaden was born with a combination of rare congenital physical anomalies: microtia, in which the person is born with a severely misshapen or absent external ear; atresia, the absence of a normal ear canal; and hemifacial microsomia, in which the lower half of one side of the face is underdeveloped, affecting the jaw and mouth and possibly other facial structures.

“Kaden’s birth at a hospital in San Francisco was diffi cult and complicated,” his mother Reina Fogelman recalls. “He had an erratic heart rate, and the umbilical cord was wrapped around his neck. So right after he was born that night, they whisked him away to the NICU (neonatal intensive care unit). I didn’t get to see him until the next day.”

After about a week in the NICU, Kaden was allowed to go home.

“Nursing was diffi cult because of the underdeveloped jaw,” Reina says. “Fortunately, the hearing tests performed on all infants at birth showed his left ear was fully functional.”

At age 3, Kaden had a CT scan that showed the bones for his right ear canal never developed, so construction of the

ear canal was not an option. There were options, however, for creating an outer ear, and at age 3½, he underwent his fi rst ear construction procedure in Los Angeles. Several months later, he underwent another surgery to refi ne the appearance of the ear and earlobe.

The list of Kaden’s subsequent surgeries at various hospitals over the next several years is extensive. Those multiple surgeries generated increasingly intense fear and anxiety for Kaden whenever he faced another

medical procedure, to the point where a child psychologist diagnosed him with post-traumatic stress disorder (PTSD).

Kaden’s extreme anxiety surfaced again last winter when he was scheduled for surgery at UCSF Benioff Children’s Hospital Oakland. Thanks to

the members of the Children’s surgical team and the services of Children’s Child Life Specialist Tom Collins, MA, CCLS, however, Kaden actually had a positive surgical experience, going into surgery willingly and waking up without the “post-anesthesia rage” that had become the norm for him.

Reina explains, “Just after Thanksgiving

last year, I noticed something was not right with Kaden’s new ear. The surgeon in Los Angeles wanted to redo the ear construction, but Kaden had a serious sinus infection because the sinuses on the right side of his face are smaller and don’t drain properly. So he needed to have that surgery fi rst, enabling his body to be in optimal condition for proper healing of what would be a newly constructed ear, and we decided to have the sinus surgery done at Children’s.”

Garani Nadaraja, MD, a pediatric otolaryngologist (ear, nose, and throat physician) and surgeon at Children’s, met with Kaden and Reina to evaluate his case.

“Kaden’s mom mentioned his severe anxiety, and his psychiatrist called to give me her perspective about his fears,” says Dr. Nadaraja. “At Children’s, we provide the special care that children need—not just the medical aspects of care, but the psychosocial factors as well. I asked Tom to work with Kaden and his mom. For kids who require surgery, Child Life professionals can help put the child at ease, reducing anxiety and fear of the unknown, while also making it easier for the parents.”

“Dr. Nadaraja was amazing,” Reina says. “She’s a doctor through-and-through, but her manner was so calm and relaxed. She

CHILD LIFESURGERYANESTHESIOLOGY

Child Life Services and Pre-Operative Consultations Help Young Patient Cope with Severe Anxiety

Calming a Child’s Fear of Surgery

“You can’t do things to children; you need to do things with children to alleviate their fears,” says Tom Collins, MA, CCLS, Senior Child Life Specialist

Kaden and mom Reina at Children’s Hospital Oakland.

CHILD LIFESURGERYANESTHESIOLOGY


really aligned everything so that Kaden would have a positive experience.”

“When we work with children, we always try to address the child directly and work with the family dynamics,” says Tom, who retired in February after 35 years with the Child Life Program. “There is no ‘recipe’ for how to do this work; every single family is different, and we have to frame the experience in a way that works for them. One of the things we have learned over the years is that approximately 50 percent of our patients have multiple surgical procedures, so it’s important to do things right the fi rst time. In Kaden’s case, he had been diagnosed with PTSD because of previous bad experiences, so I asked about those experiences. If we know what he has gone through before, we can work with the child and family to ‘undo’ some of what was done.”

Tom spent several hours with Kaden and Reina, explaining everything the boy would experience the day of surgery.

“Tom came in and introduced himself,” Reina remembers. “He was calm, kind, and friendly, playing games with Kaden and comparing what they each had on their iPads. He really focused on my child, rather than addressing all the comments to me. For Kaden, Tom’s smile and demeanor were like a warm hug. No one at any of the other hospitals had ever done this for us before. Kaden felt very much at ease.”

“You can’t do things to children; you need to do things with children to alleviate their fears,” Tom emphasizes. “I showed Kaden how the anesthesia mask would go on. I also showed him around the pre-op area, to let him physically see that he would be in a comfortable, non-threatening space that is less imposing than most other hospitals.”

Kaden’s mom requested to be allowed to be with Kaden as he was going under anesthesia, so Tom introduced them to anesthesiologist Dan Abelson, MD.

“Dr. Abelson agreed to my request to be with Kaden, and he really listened and

was open to what I was saying,” Reina says. “For other surgeries, Kaden had suffered severe separation anxiety, and he was afraid that strangers would take him away.”

Kaden had previous bad experiences with the use of sedation prior to anesthesia, coming out of anesthesia in a rage and out of control.

“This type of ‘emergence delirium’ after anesthesia is not uncommon,” says Dr. Abelson. “In fact, most people are disoriented after anesthesia, but Kaden’s history of post-anesthesia agitation was much more extreme. In a case like Kaden’s, we would allow a parent to be with the child while going under

anesthesia, as opposed to just administering a sedative prior to surgery.”

Prior to surgery, Tom was present with Kaden, his mom, and Dr. Abelson in the pre-op area. “With Tom there, Kaden seemed pretty calm, and his mom felt good about being actively involved in the process,” Dr. Abelson recalls. “After surgery, Kaden’s parents were pleased when he woke up in a much better state than in the past.”

Reina adds, “Dr. Abelson took every possible measure to make sure that going down and waking up were positive experiences for Kaden. He just wasn’t as scared. The experience at Children’s was so

dramatically different from previous surgeries.”

Before sending Kaden home later that day, Dr. Abelson gave

Kaden’s mom a letter, outlining his anesthesia protocol, and what he saw as the main priorities in managing Kaden’s airway constraints and psychological history.

“I knew that Kaden was facing additional surgeries, so I described techniques that would help the parents and other anesthesiologists who would take care of Kaden,” Dr. Abelson explains. “I also wanted to reassure other anesthesiologists that they could be comfortable allowing his mom to be present while he was going under anesthesia.”

“My experience at Children’s and Dr. Abelson’s letter made me feel more empowered as a parent to advocate for my son’s needs,” Reina asserts. “The surgeon in Los Angeles who would be performing the additional ear construction surgery in March agreed to follow the same protocol for anesthesia.”

Following that subsequent surgery in L.A., Reina noted that Kaden did do better at facing surgery than he had on some previous occasions, but she still felt his experience at Children’s was far superior.

“I’ve told my husband Jeremy that because of our incredible experience at Children’s, I’m interesting in learning more about a career in Child Life and doing for others as Tom did for us,” she says. “I’m looking into what the requirements for training would be.”

(l) Kaden after his surgery at Children’s Hospital Oakland. At age 5, Kaden had a bone-conduction hearing device implanted in his skull. A half year later, when complications with the hearing aid developed, he had an additional procedure to repair it. He then had surgery to remove his tonsils and adenoids to open up his breathing passages so he could sleep properly. At about age 6, he had “jaw distraction” surgery—inserting a device to stretch the jaw and create a more natural jawline. Surgery to remove the jaw distraction device followed a year later.

Thanks to the surgical team and Senior Child Life Specialist Tom Collins, MA, CCLS (l), Kaden finally had a positive surgical experience.

“At Children’s, we try to address not just the medical aspects of care, but the psychosocial factors as well,” says Dr. Nadaraja.


100% HEALTHY

Recommended Childhood Vaccines

VACCINATION AGE

DTaP for diphtheria, tetanus, pertussis (whooping cough)

2, 4, 6, and 12 to 15 months, and again after 4 years

IPV for polio 2, 4, and 6 months, and again after 4 years

HIB for hemophilus influenza

2, 4, 6, and 12 to 15 months

Hep B for hepatitis B At birth, and 2 and 6 months

PCV for pneumococcus 2, 4, 6, and 12 to 15 months

Rotavirus 2, 4, and 6 months

MMR for measles, mumps, and rubella

12 to 15 months, and again after 4 years

VZV for chicken pox 12 to 15 months, and again after 4 years

Hep A for hepatitis A 12 to 15 months, and again 6 months later

Many parents are questioning vaccinating their children. Pediatricians have the same goals as parents—to protect children—and science has shown that routine vaccinations play a key role in helping children grow into healthy adults.

A vaccine is a small dose of an infection that triggers the immune system to make antibodies that “remember” the specifi c type of infection so that when a person is exposed to the actual disease, their body is already protected.Vaccines elicit fear for many families due to negative media reports.

A fraudulent study from the 1970s has led to a persistent and unsubstantiated concern of an association between the MMR

(measles, mumps, and rubella) vaccine and autism. In fact, autism rates have actually increased in countries where vaccination rates have gone down. Unfortunately, the widespread misinterpretation of the facts has resulted in many parents deciding not to fully immunize their children, which has contributed to the outbreaks and new epidemics of old diseases. As a result, many parents are questioning vaccinating their children. Pediatricians have the same goals as parents—to protect children—and science has shown that routine vaccinations play a key role in helping children grow into healthy adults.

During the fi rst two years of your child’s life, he is most at risk for the life-threatening diseases that vaccines can prevent. A child’s immune system is not equipped to fi ght off disease, and an unvaccinated child can become deathly ill with a disease that only causes mild illness in adults. This is why your child will receive the bulk of his vaccinations as an infant and toddler.

In order to create the immune response that provides your child with protection, vaccines must be administered over time on a specifi c schedule. In the fi rst year, your child will receive his “primary series” of vaccines every couple of months in addition to a set of booster shots at 12 to 15 months, followed by the “secondary series” of pre-kindergarten vaccines.

While most of the media hype about the danger of vaccination is inaccurate, there are some side effects associated with receiving vaccines because the body interprets a vaccine as a small dose of an infection it needs to fi ght. Most side effects are uncomfortable, but not dangerous. For instance, a child may come down with a fever or soreness in the muscle where the vaccine was injected. More serious side effects are extremely rare.

Our children are lucky to be vaccinated and protected against many serious diseases that once caused paralysis and even death. Preventing disease is much more successful than trying to cure someone once they are already sick. Vaccines remain one of the most successful public health measures developed in the last century.

Vaccinations: Your child’s fi rst line of defense

Good for your baby,good for everyone

Q&A


SPORTS INJURIES

Baseball& Softball

—Jamie Faison, Physical Therapist Assistant,

Athletic Trainer, Certifi ed Strength and Conditioning Specialist,

Sports Medicine Center for Young Athletes

Q: What is the best way to prevent arm injuries for kids who play baseball or softball?

A: Most baseball/softball injuries are due to overuse. These overuse injuries are caused by repetitive stress on the shoulder and/or elbow. The combination of poor throwing mechanics with year-round baseball/softball leads to a substantial increase of injuries in our young athletes. Recent studies on arm injuries in young baseball/softball players report that the best ways to keep your young athlete in the game are:• Warm up properly by stretching, running, and easy-gradual

throwing.• Rotate playing other positions besides pitcher and catcher. • Adhere to pitch count guidelines and rest days

(go to www.asmi.org and search for “research”).• Avoid pitching in multiple games in overlapping seasons. • Don’t ever pitch with elbow or shoulder pain. If it persists,

see a specialist. • Don’t play year-round, and don’t do any overhead throwing

of any kind for at least 2 months of the year.

Q: What types of injuries are most common for kids who play baseball or softball?

A: The most common injuries occur in the shoulder and elbow. Most of the power from throwing should be generated from the legs; however, when kids have poor throwing mechanics, they tend to use their arms too much during the throwing motion. The down side to this is that the skeletal system of young athletes is still developing, and the excess forces placed on the arm can damage or irritate the growth plates. In the shoulder, this can commonly occur as “Little League Shoulder”; in the elbow, it is called “Little League Elbow.” These growth plate injuries can occur until puberty, but the stresses at these areas may continue to cause pain past puberty. In older kids, elbow pain can be due to either injury or insuffi ciency of the ulnar collateral ligament. Shoulder pain can mean labral or rotator cuff injuries. The common thread in all of these injuries is that they are overuse injuries and preventable by seeing a health care provider when the pain starts.

Q: My child always says, “I feel fi ne,” but when is it bad to play through pain?

A: Your young athlete will most likely not complain of pain because he/she wants to play. Instead you might hear the athlete complain of arm fatigue or local soreness. Even if they don’t complain, there are things you can look for, such as a more erect delivery, poor arm position/low elbow height, poor or no follow through, improper foot positioning on plant leg, or something as simple as shaking the arm frequently between throws. Playing through any type of shoulder, arm, or elbow pain is bad for your young thrower. This pain will likely result in a change of mechanics during the throw and can in turn lead to more serious injuries.


Dangerous Conditions for Heat IllnessIt has been said that “It’s not the heat; it’s the humidity.” Actually, it’s both. Sweating by itself does nothing to cool the body unless the water is removed by evaporation—and high relative humidity retards evaporation. Under conditions of high temperature (above 90 degrees) and high relative humidity, the body is doing everything it can to maintain 98.6 degrees. When heat gain exceeds the level the body can remove, or when the body cannot compensate for fl uids and salt lost through perspiration, the temperature of the body’s inner core begins to rise, and heat-related illness may develop.

HEAT- AND HYDRATION-RELATED ILLNESS TYPES AND SYMPTOMS

AVOIDING HEAT ILLNESS

SIMPLE FACTS ON PROPER HYDRATION FOR ATHLETES

HYDRATION DO’S AND DON’TS

HEAT CRAMPS • Drink suffi cient cool water (should be about 50°F).

• Wear light, refl ective, sweat-wicking clothing.

• Wear a brimmed hat.

• Keep cold towels handy.

• Limit activity in very hot and humid conditions.

• Acclimate to physical activity in heat.

• Utilize shade.

• Those who have suff ered heat illness in the past are at greater risk for repeat events.

• Losing 1 to 2 percent of your body’s water will harm sports performance.

• Feeling thirsty is equivalent to losing 1 to 2 percent of your body’s water.

• Conditioned athletes need more water, not less.

• Hydration must be accomplished around the clock.

• It is best to consume cool water (40-50° F).

• Sports drinks (5-7% carbohydrates [sugars]) are okay but not necessary with activity of less than 90 minutes of constant play.

• Making weight (e.g., wrestling, crew) by restricting fl uid harms performance; rehydration takes time.

• Don’t wait until you are thirsty to drink water.

• Drink more than enough to satisfy your thirst.

• Drink more than you think you need before participating in a sports event or practice.

• Take weather into consideration.

• Don’t discount your needs when it is cool.

• During activity: Drink 6 to 8 ounces of cool water every 15 to 20 minutes.

• It is important not to overhydrate with excessive amounts of plain water.

• Severe pain and spasm in leg muscles

HEAT EXHAUSTION

• Pale, cool, clammy skin• Profuse sweating• Nausea• Fainting• Thirst

HEAT STROKE

• Red, dry skin• Headache• Dizziness/Disorientation• Seizure• Hallucination• Rapid heartbeat• Increased core temperature

100%HEALTHYSummer is here, so be careful!

HOW FAST CAN THE SUN HEAT A CAR?

TEMPERATURE IN CAR5 MIN 10 MIN 30 MIN 60 MIN

115°F 122° 128° 144° 162°

110°F 117° 123° 139° 157°

105°F 112° 118° 134° 152°

100°F 107° 113° 129° 147°

95°F 102° 108° 124° 142°

90°F 97° 103° 119° 137°

85°F 92° 98° 114° 132°

OU

TSIDE

TE

MP

ER

AT

UR

E

Your car is an oven!Do not leave children or pets unattended in vehicles. If possible, try to schedule activities for the coolest time of the day.

I flew, Mommy, and then I fell. And then I died and God brought me back to life, and the angels rescued me.”That’s how 4-year-old Sebastion

Johnson described his memories to his mother several months after he survived a 230-foot fall down a cliff at Bodega Head in Sonoma County on November 10, 2014.

“I think the angels Sebastion described were the firefighters who brought him back up the cliff, because he recalls the ropes they used and the yellow blanket they wrapped him in,” says his mother, Jamie Guglielmino. “But I believe there were other angels taking care of him, too, including the staff at Children’s.”

Sebastion was hiking along the bluff overlooking the ocean that day with his mom, father Daryl Johnson, and big sister Cura, age 7. His baby sister Ayla was staying with family friends.

“We were hoping to see some whales offshore at Bodega Head,” Jamie recalls. “Sebastion and I were hanging back from

the others so that we could throw rocks toward the ocean. We were several feet away from the edge of the cliff. As I was bending down to pick up a rock, Sebastion moved closer to the edge to throw his rock. He slipped on an ice plant, and the ground crumbled underneath him. I lunged toward him, trying to grab the hood of his blue jacket and I missed him by inches. I watched helplessly, screaming for my baby, as he tumbled downhill, bouncing several times like a rag doll. I couldn’t see where he landed. I was afraid he had been washed out to sea.”

Frantically, Jamie called 911. As father Daryl ran about the bluff trying to find a way to get down the cliff, emergency dispatcher Alma Bowen stayed on the line with Jamie until the rescue team arrived. “Alma was beyond helpful and encouraging,” Jamie says. “At that point, she was my angel.”

The rescue team from Bodega Bay Fire and Rescue arrived within a few minutes. It

was growing dark, and the fog was rolling in. Tying their ropes to the fire truck, two of the firefighters went over the edge of the bluff and rappelled down the cliff.

The firefighters found Sebastion on a rocky beach, face down in tide pools, just above the water line. They hauled the boy up the cliff in a basket.

“The firefighters had Sebastion up from the bottom of the cliff within an hour after he fell,” Jamie marvels. “There was an ambulance waiting, and they sped him away to Santa Rosa Memorial Hospital. I got to the hospital about 8 p.m. By 8:30 I was in an ambulance with Sebastion, heading to Oakland, while Daryl went home to Santa Rosa to stay with our daughters.”

Sebastion was sent to UCSF Benioff Children’s Hospital Oakland and was immediately sent for X-rays and CT scans.

“Sebastion had suffered significant injuries, including a broken arm and a broken leg on his left side, hip fractures, facial fractures on both sides of the jaw


SURGERYREHABILITATIONTRAUMA CARE

“A Team of Angels Saved His Life”Mom credits fi refi ghters and Children’s team of doctors, nurses and therapists for son’s recovery after fall off 230-foot cliff

“


and the left eye socket, and a head injury comparable to a severe concussion,” says Children’s Medical Director of Surgery James Betts, MD, who works on trauma cases.

“He had what we call a ‘sheer’ injury to the brain, where the brain shakes around like Jell-O in the skull, causing cracks in the brain matter,” Dr. Betts explains. “That type of injury short-circuits the electrical function of the brain, so he was ‘obtunded,’ meaning he had a greatly reduced level of consciousness. He was looking around, but he was not tracking or communicating.”

Sebastion was sedated into a medically induced coma to keep his brain from swelling and to limit his movement and alleviate pain. Children’s Director of Trauma Care Christopher Newton, MD, notes that the first 24 hours of Sebastion’s care was critical. He credits Dr. Betts and Chair of the Critical Care Department Sharon Williams, MD, with heroic efforts during that time. Dr. Newton also commends the staff in the Intensive Care Unit (ICU) and Rehabilitation Medicine for their skills and expertise.

“What you see with Sebastion’s case is the exceptional quality of the care you get at a pediatric trauma center,” says Dr. Newton. “Sebastion’s treatment involved great coordination of high-level care provided by people who are the best at what they do. In addition to the medical professionals, we are privileged to have services that help families through such traumatic times—pediatric-specific experts in social services, clergy, and Child Life

professionals. It’s an environment that is different from other places that don’t have the same focus on pediatrics.”

After spending a couple of days in the ICU, Sebastion was deemed stable enough to begin a series of orthopedic surgeries to repair his various fractures. While he was recovering in the ICU, physical therapists began to work with him.

“Physical therapy starts early, even when patients might have breathing and feeding tubes,” says Lucy Little Tomlinson, DPT. “We would go in to work with him, particularly on his breathing and preventing pneumonia, which can develop if you are lying in one position all the time. At first, Sebastion was extremely lethargic, so we worked on having him open his eyes in response to stimulation. We also worked on sitting up in bed and transferring to a wheelchair.”

Once most of his major orthopedic surgeries were completed, the physical therapists began working on passive range-of-motion exercises to maintain Sebastion’s joint function and avoid muscle “contraction” (shortening of the muscles). Ankle-foot “orthosis” splints were used to keep his ankle muscles stretched and in a position where they wouldn’t shorten.

As his recovery progressed, Sebastion was transferred from the ICU to the Rehabilitation Medicine unit at the hospital. The most comprehensive inpatient pediatric center in northern California, Children’s Rehabilitation Medicine provides physical therapy, occupational therapy, and speech therapy. Pediatric

Rehabilitation Medical Director Christine Aguilar, MD, and

Pediatric Rehabilitation Associate Director Robert Haining, MD, supervised much of Sebastion’s care. Mai Ngo, MD, and Nancy Showen, MD, were also part of Sebastion’s physician team in Rehabilitation Medicine.

“It really is a team effort to care for our rehab patients,” says Dr. Aguilar. “Once Sebastion came to our unit, we first had to deal with slowly bringing him out of the medically induced coma. When people come out of a coma, they generally become agitated. With Sebastion, he was crying a lot, grabbing at things, thrashing and pulling away from people. We didn’t want to overmedicate him with sedatives because we wanted him to be able to take part in his physical therapy. At the same time, we had to take care not to over-stimulate him.”

“Once he came to rehab, Sebastion progressed really nicely,” says Dr. Tomlinson. “He started with no reaction to audio stimulus—no ‘startle’ response. He was not communicating. Within a week of his transfer to rehab, he localized to auditory stimuli, he could open his eyes without stimulation, he could fixate on objects with his eyes, and he would target objects with his left arm.”

Sebastion had to return to the ICU for several days because of breathing problems. Dr. Betts performed a tracheotomy to insert a tube into the boy’s windpipe. Once he returned to rehab, Sebastion continued his amazing recovery. Every day except Sunday, he took part in physical therapy for 45 minutes twice a day, occupational therapy for 45 minutes twice a day, and speech therapy once a day.

“Because of his fractures, Sebastion was not able to bear weight on his left side,”

(l) “Lucy was extremely helpful, teaching us how to care for Sebastion,” says mom Jamie. “The doctors, nurses, and therapists all made me take responsibility for his care, and I really appreciate that because it made me feel more empowered to care for him when we got home.” (previous page) Lucy Little Tomlinson, DPT, with Sebastion in Children’s physical therapy room.


“Part of the treatment process is to teach the family how to do the physical therapy exercises, too,” says Dr. Tomlinson.

Sebastion during physical therapy at Children's


Dr. Tomlinson notes. “In addition, his right side had limited motor control due to the traumatic brain injury to the left side of his brain. We initially focused on training him to transfer to and from his wheelchair. He got very good at transfers. When his casts came off, we began to work on weight-bearing exercises. By the time Sebastion was discharged, he was walking, holding his mom’s hand—this was a miraculously fast progression.”

The speech and occupational therapists worked hard with Sebastion, too.

“Because of the tracheotomy tube, Sebastion had to use a ‘speaking valve’ to speak, but he left here speaking in age-appropriate sentences,” Dr. Tomlinson adds.

“Lucy was extremely helpful, teaching us how to care for Sebastion,” Jamie notes. “She was very patient and involved me a lot in his therapy. The doctors were also wonderful. They spoke regular English to me, rather than ‘doctor speech,’ and they made sure I understood what was going on so I could make informed decisions. Dr. Aguilar became his favorite—he called her ‘Nurse Christine.’ The doctors, nurses, and therapists all made me take responsibility for his care, and I really appreciate that because it made me feel more empowered to care for

him when we got home. My mom—who was here the entire time Sebastion was in the hospital and was a godsend—lives 700 miles away in Overton, Nevada. So I am especially grateful that the staff at Children’s helped me feel competent and capable of caring for Sebastion on my own.”

Dr. Aguilar has seen Sebastion for outpatient visits since his discharge in January, and she continues to be impressed by his recovery. “The last time I saw him, he was doing great,” she says. “He was able to walk more than 100 feet. He had no problem dressing. He is not on any sedatives or medications for controlling his body tone, which is remarkable considering his brain injury. He was calm and spoke well. He’s a delightful little boy, and considering what he’s been through, he’s a miracle!”

Sebastion and his family have appreciated their return visits to Children’s, too. “It has been good to see the people back at Children’s,” Jamie reflects. “After being there for so long, it feels like I’m missing a part of my family now that we’re home. I am very, very grateful for the people at Children’s and for my son’s life. I don’t believe he would be where he is today without Children’s. They were part of the team of angels who saved his life.”


When you talk, read, and sing with your child—even before they can use words—you’re helping them become both smarter and happier. Research shows that talking, reading, and singing with your child every day from birth helps build their brains as well as important language, math, and reading skills for use in school and beyond.

The “Talk Read Sing” campaign at the UCSF Benioff Children’s Hospital Oakland will run for the next three years. This campaign is supported by Lynne and Marc Benioff, who have donated $3.5 million to Too Small to Fail to create a model program for how children’s hospitals can actively address the word gap as a health issue.

Talking IsTeaching

The rescue team from Bodega Bay Fire and Rescue—Fire Captain Jason Downing, Firefighter/Paramedic Marcos Barros, and Firefighter/EMT Lou Stoerzinger, and 911 dispatcher Alma Bowen—visited Sebastion while he was still a patient at Children’s. On the left is Sebastion’s grandmother, Leisa Davidson; mom Jamie is on the right.

Sebastion’s family has established a “Go Fund Me” account to help defray his medical expenses and the costs of his ongoing physical, occupational, and speech therapy. Sebastion Johnson’s Hope Fund can be found at www.gofundme.com/h7fg3w.


TALKREADSING

TIPS FOR TODDLERS

TALK• Everywhere you go, talk about what you see. A stop sign,

a traffic light, or a tree might seem boring to you, but it’s a whole new world to your child, so teach them about it!

• Young children learn best during playful, everyday activities. Play “I-Spy” in the grocery store together. Choose a color and encourage your child to point out objects that match the color.

• Try some early math activities: Point out shapes on your child’s plate or around the kitchen. Ask your child, “How many sides does a square have?” “How about a triangle?”

• Play games during bath time to help your child learn new words. Take turns dropping toys in the water. Say, “Watch it sink!” or “It floats!”

READ• You can inspire a love of books and words in your young

child by reading or telling a story together every day.

• Point to the pictures in books, and ask your toddler questions about what you see as you share the book together. You can make up a story, too!

• Let your child turn the book’s pages. It’s OK if they skip pages, or like a few pages better than others. You just want your child to get used to touching books.

SING• Sing during everyday activities like driving in the car, or

during bath time. It can be repetitive and simple, like “Wash your toes, wash your nose!”

• Singing songs that have basic counting or rhyming patterns also helps children learn basic math skills. “One, two, buckle my shoe. Three, four, open the door.”

• Your toddler loves to get positive attention from you. Singing is a great way for you and your toddler to share an activity together.

TIPS FOR INFANTS

TALK• Your touch and voice help your baby learn.

• Listen to the fun sounds your baby makes and repeat them. When they coo, coo back. Hold their hand gently, and when they smile, smile back. Your loving touch combined with this “baby language” are the first steps in talking.

• Everywhere you go, talk about what you see and what your baby is looking at: “Wow, I see the four dogs, too!” “I love that red truck you’re playing with. It goes beep beep!”

• Play “Peek-a-boo” while getting your baby dressed. Ask, “Where’s (baby’s name)?” when you pull a shirt over your baby’s head. Then say, “There you are!”

• As you feed your baby, use words to describe what foods taste, feel, and look like. “This yogurt is smooth.” “That yellow banana is sweet!”

• Looking into your baby’s eyes, holding your baby’s hand, and talking to your baby in a high voice are all ways that you can help your child grow up to be a confident, loving adult.

READ• Read a book or tell a story to your baby every day—in whatever

language you feel most comfortable—beginning at birth.

• Cuddle with your baby as you share a book. It doesn’t matter how young your child is; even newborn babies show excitement when their parents read with them.

• Point to the book’s pictures: “Look, the train goes choo-choo!” Using words to describe what you see builds language.

SING• Hold your baby close during bedtime and sing a favorite song again

and again. Singing the same song can help your baby feel calm and safe.

• Sing silly songs about your day to help get your baby’s attention during diaper changing.

• Your baby loves to hear your voice even if you think you can’t sing! The sound of your voice is comforting to your baby.

New MRI Goggles Soothe Young Patients

An 8-year-old cancer patient can now watch “Big Hero 6” while technicians

capture images of his brain tumor during a 2½-hour MRI, thanks to the new MRI-compatible video goggles at the UCSF Benioff Children’s Hospital Oakland’s Walnut Creek Campus.

Funding for the goggles, which cost $50,000 a pair, was spearheaded by Tara Buttles, an exemplary Child Life volunteer. This new child-specifi c medical equipment helps soothe anxious patients, minimize claustrophobia, and reduce the sedation required for MRI scans. The shortened procedure time with the goggles will also improve scan accuracy, leading to better and faster diagnoses as well as decreased expense for the patient family.

“An MRI scan can be an overwhelming or scary experience for some patients,”

says Senior Child Life Specialist Christy Johnson, CCLS. “It can be a challenging task for anyone to hold still for the pictures. The MRI goggles will offer patients a wonderful distraction and relaxation tool to help them through their test.”

Tara’s enthusiasm spread quickly to her friend Melissa Hilal, whose son Holden continues to undergo many MRIs for his neuro-oncology treatment. Together, the two women raised over $31,000 from 54 donors through networking, birthday party proceeds, and school bake sales. The UCSF Benioff Oakland’s auxiliary group, the Children’s Hospital Branches, closed the funding gap to secure the hospital’s fi rst pair of MRI video goggles. “We are so grateful to the families and staff who helped champion this project into a reality,” Johnson says.

Arlie Smith, 45, known as the “Costco Guy,” is that cheerful greeter at the

Danville Costco who always says hello, draws funny sketches on the backs of store receipts for kids, and knows many of his customers by name.

During his two decades at the wholesale warehouse chain, Arlie has been an active fundraiser for the company’s annual campaign for Children’s Miracle Network Hospitals. He was one of the top fundraisers in North America during the store’s 2014 fundraising campaign.

Recently the beloved store employee made headlines for being exceptionally giving. Diagnosed with bone cancer last September, Arlie was told he may have just two years to live—but he hasn’t let that stop him from sharing a little sunshine.

Faced with this devastating diagnosis, Arlie made it his mission to be the top fundraiser during Costco’s “May is for Miracles” icon campaign. “My goal is to be number one, and not for me,” Arlie said in an interview with KGO-TV before the campaign started. “It’s just so I know that I made a difference in this world. That I’ve put a mark in a positive way to make this world a better place.”

Welcoming warehouse customers with a superhero cape, fl ashy glasses, and an upbeat attitude, Arlie made his dream come true. He raised over $100,000 for the young patients at UCSF Benioff Children’s Hospital Oakland during the month-long campaign.

Thank you, Arlie, for your continued support and dedication to helping save and improve the lives of sick and injured kids—your generosity inspires us.

Costco Employee Gives Back After Cancer Diagnosis


Holden Hilal, pictured at the MRI suite on the Walnut Creek Campus, joined the community effort to fund a pair of MRI goggles by donating proceeds from his birthday party to the cause.

Arlie Smith, the beloved “Costco Guy,” with his wife Shari.

Arlie Smith the beloved

Holden Hilal pictured at the MRI suite on the

GIVINGBACK

The Notes & Words motto—Have fun, do good—was especially fi tting for this year’s lineup of writers and

musicians onstage to support UCSF Benioff Children’s Hospital Oakland. Over 1,500 people turned out at the Paramount Theatre on April 25 for the hospital’s signature fundraising event, and it was truly a night to remember!

Writers included political commentator David Brooks; Pulitzer Prize-winning author, journalist, and opinion columnist Anna Quindlen; author Daniel Handler, known by children the world over as Lemony Snicket; and New York Times bestselling author Kelly Corrigan. Guests grooved to tunes by Kelly McFarling and Tom Rhodes, Mike Errico and Paul Leo, WJM The Band and Brass Magic.

There were also some fun surprises, including a live performance by one of our rock star patients and animated vignettes designed by the creative team at Teak. Not to mention the incredible VIP reception produced and hosted by The Performance Group.

Most importantly, we would like to extend our thanks to the many friends who joined us in celebrating our mission to provide the best health care to all children. Your tremendous support makes our work possible.

6th Annual

Notes & Words

(1) Notes & Words performers Anna Quindlen, Daniel Handler, Kelly Corrigan, and David Brooks; (2) Don and Ellie Knauss; (3) Grateful patient Kimberlee Hennessey-Berndt performing with UCSF Benioff Oakland music therapist Matt Logan; (4) William, Jeremy, and Max of the talented middle school rock band, WJM; (5) TPG team members Debbie Parsons, President; Jen Pointer, VP, Sales & Marketing; and Monica Logan, VP, Operations, with Carrie Cameron, Regional Director at Four Seasons Hotels and Resorts; and (6) Laura and Gregg Perloff with Children’s President & CEO Bertram Lubin, MD, and his wife, Vivian Scharlach.

GIVINGBACK

1

2 3

4

5

6

UCSF Benioff Children’s Hospital Oakland747 52nd St. Oakland, CA 94609-1809

F.A.S.T. FUNCTIONAL STRENGTH, AGILITY, AND SPEED TRAINING CLASS

• A progressive approach to speed and agility techniques

• Introduces the proper techniques of functional strength training and power exercises for young athletes

Athletes that benefit: Football, Soccer, Basketball, Volleyball, Lacrosse, Baseball, Track & Field, Softball, Tennis

WHO Athletes ages 14 to 18

COST 12 Sessions for $144; $20 Drop-In

OAKLAND LOCATION Thursdays, 7-8 p.m.Sports Medicine Center744 52nd St., Oakland

WALNUT CREEK LOCATION Tuesday and Thursdays, 5:30-6:30 p.m. Motion Analysis & Sports Performance Lab2401 Shadelands Dr., Suite 170, Walnut Creek

Sports Medicine CenterFor Young Athletes

SIGN UP! SPORTS MEDICINE CENTER FOR YOUNG ATHLETES CLASSESRSVP/INFO Krisi Bruce (925) 979-3420

Athletes that benefit: All sports

• Increased speed and agility

• Improved fl exibility so you can run faster

• Core stability for more effi cient movement

• Fun teamwork drills and games

WHO Athletes ages 13-18. Space is limited to 15 athletes.

LOCATION Berkeley High School, Yellow Jacket Stadium, 1980 Allston Way, Berkeley

TWO SESSIONS July 6-17, 2015, Mon-Fri, 1-3 p.m.; Aug. 3-14, 2015; Mon-Fri, 1-3 p.m.

COST $250/athlete

TWO-WEEK SPORTS SPEED CAMP

a publication of ucsf benioff children’s hospital … · louis j. lavigne, jr. michael lenoir, md...

Documents