ROCKY MOUNTAIN KIDS

A Health Publication for Parents

FALL/WINTER 2010

Special Deliveries

page 3

SurvivingNeonatal Surgery page 4

Care for Mom and Baby–In One Place page 2

Going Extra Miles:AirLife Denver page 10

2 Rocky Mountain Kids | fall/winter 2010

When parents learn that they are expecting a new baby, the hopeis that the mother will do well during her pregnancy and that the baby will be healthy.

We know, however, that complications can occur—due either to the health of the mother or the baby, or both. In a high-risk pregnancy, there are two patients who need care: the mother and her unborn child.

!at’s when high-risk obstetrical specialists, known as perinatologists, becomes a vital part of the mother’s health care team.

Doctors and hospital sta" in the HealthONE system have the most experience with high-risk pregnancies in the region. !ese services for high-risk obstetrical patients include specialty care for the mother as well as the highest level of neonatal intensive care for premature

or ill newborns. By providing this coordinated care in our hospitals, pregnant women have the comfort of knowing that their medical needs will be closely managed by a team of physician specialists, nursing sta" and all the other highly skilled medical professionals who have experience working together in the same hospital.

Sometimes high-risk obstetrical patients can continue their care at their “home hospitals,” while at other times they need the highly specialized monitor-ing, technology and services available at a regional hospital such as Presbyterian/St. Luke’s (P/SL).

Our partners in this team approach to high-risk obstetrics and neonatal intensive care are perinatologists and neonatologists who are among the most experienced and skilled in their respective #elds. But more importantly, because of

their experience working together, they communicate and coordinate care rapidly and e"ectively for both mother and child.

Women throughout the Rocky Mountain region look to hospitals in HealthONE for superior obstetrical services and the delivery of healthy babies. When healthy pregnancies become complicated, women can also be reassured that all the services they need for themselves and their babies are immediately available in the same system.

I hope that you enjoy reading some of the heartwarming stories about the mothers and their children who have bene#ted from our experience and expertise.

Reginald Washington, MD

Reginald Washington, MD, FAAP, FACC, FAHA Chief Medical Officer Rocky Mountain Hospital for Children

Coordinated Care for Mother and Child—In One Place

RMHC at P/SL is now open at 19th and High, with a 24/7 pediatric-staffed Emergency Department.

State-of-the-art operating room at RMHC at P/SL.

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High-risk pregnancies require special care. Fortunately, moms and babies with special needs in the Denver-metro area can turn to Richard Porreco, MD, an internationally recognized perinatologist (maternal-fetal specialist) and director, Maternal-Fetal Medicine, at Presbyterian/ St. Luke’s Medical Center, who has delivered more than 10,000 babies over the years—many of them involving high-risk pregnancies.

Experienced Teams, Latest TechnologyCommon complications, such as gesta-tional diabetes, o$en can be managed by traditional providers and hospitals, but high-risk pregnancies—including early labor pregnancies where the mother is carrying more than one fetus and where either the mother’s or the infant’s health is threatened—require specialists with experienced teams who have access to the latest medical technology.

“Over the last two decades, our ability to identify high-risk mothers and infants has improved dramatically,” Dr. Porreco explains. “It’s imperative we identify medical problems ahead of time so we can provide the care that’s needed.”

In this regard, Rocky Mountain Hospital for Children (RMHC) at Presbyterian/ St. Luke's Medical Center (P/SL) is the only facility for mothers and children in the region that has a Level III Neonatal Intensive Care Unit (NICU) sta"ed 24 hours a day. !e board-certi#ed neonatologists specialize in: • Resuscitation • Assisted breathing• Surgery for newborns requiring

advanced medical care

In addition, RMHC at P/SL has 300 a%liated physicians practicing in 40 pediatric specialties, including pediatric cardiology, gastroenterology, neurology and surgery.

!e maternal-fetal team can o"er high-risk mothers the following services: • Reproductive genetic counseling • Comprehensive fetal evaluations• Targeted ultrasound evaluation,

including Doppler velocity studies, fetal echocardiography and 4-D imaging

Maternal-Neonatal Care CrucialDr. Porreco also insists RMHC at P/SL ’s unique ability to care for and closely monitor two at-risk patients—the mom and

the baby—in the same facility is something the hospital and sta" are really good at.

“At RMHC at P/SL, we are a team—the doctors, the specialists, the nurses, the imaging technicians—everyone contributes, everyone has a role to play in the safety and well-being of the mothers and infants we care for,” he explains. “As a result of the high level of our multidisciplinary capabilities, we are able to manage virtually any condition or health issue that arises for a mother, fetus or newborn.”

Special DeliveriesColorado’s leading maternal-fetal specialist is dedicated to caring for mothers with high-risk pregnancies.

”RMHC at P/SL’s unique ability to care for and closely monitor two at-risk patients—the mom and the baby—in the same facility is something the hospital and staff are really good at.”

—Richard Porreco, MD

Dr. Porreco with one of his many “special deliveries.”

4 Rocky Mountain Kids | fall/winter 2010

Surviving Neonatal SurgeryJust the beginning for a Highlands Ranch bouncing baby boy

After their first child, Evan, was born following a normal pregnancy, Jennifer and Jon Badding of Highlands Ranch expected more of the same when Jennifer’s second pregnancy came around.

!at dream came to an end when a routine ultrasound at Jennifer’s 13-week checkup picked up an abnormality.

RMHC at P/SL the Place to GoUpset by the news, Jennifer was referred to maternal-fetal specialist Richard Porreco, MD, director, Maternal-Fetal Medicine, at Presbyterian/St. Luke’s Medical Center.

“He saw me right away and immediately knew what was going on,” Jennifer explains. “He said the baby had an obstructed bladder that needed immediate attention. Right there in the o%ce, he inserted a needle into my belly and extracted the urine.”

As crucial as the extraction was, it was only the #rst step in Ian’s treatment for a bladder obstruction that would be life threatening if le$ untreated. Dr. Porreco told the Baddings the baby was a good candidate for the insertion of a small shunt into his bladder while he was in the womb.

In Good Hands“When it all started, it was pretty disheartening not knowing what was going on, but once we met Dr. Porreco, we immediately felt like we were in good hands,” Jon says. “We were so grateful to have someone of his knowledge and experience.”

Jennifer’s water broke at 18 weeks, and at 24 weeks she checked into Presbyterian/St. Luke’s, where she spent the rest of her pregnancy on complete bed rest.

”We knew Ian would be born early, and I wanted to be where both he and I would have the best care available.”

—Jennifer Badding

“!e biggest factor that led us to P/SL was the high-level NICU [Neonatal Intensive Care Unit]. We knew Ian would be born early, and I wanted to be where both he and I would have the best care available,” Jennifer explains.

A$er #ve weeks in the hospital, Jennifer went into labor on April 29, 2009. Weighing just 2.5 pounds at birth, Ian was rushed from the delivery room to the NICU, where he stayed for a little more than three months. On July 4, having reached a sound 5.5 pounds, he went home.

Growing and ThrivingSince then, Ian has had two follow-up surgeries and is currently wearing a cast to treat hip dysplasia that occurred in the womb.

Even so, his prognosis is excellent. “Ian is doing great—he’s a healthy 19-pound baby who is growing and thriving and moving forward,” Jennifer says. “And despite all he’s going through, he’s happy and peaceful.”

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Swedish Medical Center

Four medical groups say children should be screened at school for scoliosis, an abnormal curve of the spine that can cause problems if severe cases go untreated.

!e sideways S- and C-shaped spines that mark scoliosis occur in both girls and boys. !e most common form of the problem appears a"er age 10.

Girls reach adolescence about two years earlier than boys. Girls also need treatment for scoliosis three to four times more o"en than boys. So the medical groups suggest girls should be screened twice, at ages 10 and 12, and boys once, at age 13 or 14.

“Untreated, scoliosis, in some cases, can lead to physical deformity, breathing trouble and other prob-lems,” says Timothy Kuklo, MD, Colorado Comprehensive Spine Institute. “Scoliosis usually causes children no pain. It can run in families, but the cause is not known.”

A trained professional screens children with a quick visual back test to see whether a child’s spine shows any signs of sideways curves. A normal spine should look like a straight “I.” A screener who sees a curve refers the child to a doctor for more tests.

Experts have been split on whether screening at school is e#ective from medical and cost viewpoints. A task force of the American Academy of Orthopaedic Surgeons (AAOS), the American Academy of Pediatrics, the Scoliosis Research Society and the Pediatric Orthopaedic Society of North America drew up new recommendations.

Screening Sought to Spot Curved Spines

!e AAOS lists these scoliosis treatments:• Observation is appropriate when the

curve is mild or the child is near skeletal maturity.

• Bracing prevents worsening of scoliosis. Doctors consider bracing when a growing child has a spinal curvature of 25 to 45 degrees.

• Surgery is an option when thecurvature is more than 45 degrees and the child is still growing. Surgery may also be suggested if the patient’s skeleton has matured but the curvature of the spine is more than 50 to 55 degrees.

Untreated scoliosis can lead to physical deformity and, in severe cases, can cause breathing trouble and other problems.

X-ray showing significant scoliosis of the thoracic and lumbar spine.

6 Rocky Mountain Kids | fall/winter 2010 Swedish Medical Center

How to Cope With Multiple BirthsGiving birth to one child creates plenty of challenges—but giving birth to two or three? Coming home from the hospital with more than one baby can be overwhelming, and it’s far more common than it was a generation ago.

Twice as many twins and more than four times as many triplets are born today than in 1980. Why? Experts cite the growing number of older moms (who conceive multiples more o"en than younger women) and the use of therapies that enhance fertility.

If you’ve just had twins, triplets or even more babies all at once, the next few months will be intense. But a little planning can help ease the transition. Here are some tips:• Ask for help. Line up aid from family and friends.

Extra hands can give you the time you need to get to know your babies and recover from delivery.

• Rest. Chances are your babies—and you—won’t be sleeping through the night for a few months. Take

advantage of the babies’ nap times during the day to get some rest.

• Get on a schedule. Try to get your babies to feed and sleep at the same time. It may take some coaxing, but it will make life easier. Creating a daily routine for other tasks, such as walks, changing diapers and bath time, may help, too. A wall chart can help you track each baby’s needs, especially if others are assisting you.

• Be patient if you’re breast-feeding. Breast-feeding multi-ples takes a bit more patience and persistence, but it can be done. A lactation specialist can help with technique.

• Spend time with each baby. Bond with each infant individually and encourage your partner to do the same. Try to get into the habit of referring to them by their names, not “the twins” or “the triplets.” !is will help you think of them as individuals and give them a sense of identity as they grow.

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• Take time for other children. If your new arrivals have siblings, make sure you spend some time with them, one on one.

• Join a support group. Look for local groups for parents of multiples. Talking with other parents who are going through the same experience can be helpful.

Twins: Predisposed to Premature Birth?

Most births of single babies occur at 39 weeks. But the average length of a twin pregnancy is 35 weeks. About 50 percent of twins are born preterm, or earlier than 37 weeks.

“Preemies” tend to weigh less than 5.5 pounds. This increases their risk for many significant health problems. Some may be temporary, such as jaundice, anemia and diffi-culty breathing. Others have lasting effects, such as respiratory problems, cerebral palsy, and vision and hearing loss.

To lower the chance for early births, women who are pregnant with twins typically see their doctors more often. They also are monitored for signs of preterm labor. Their doctors may treat preterm labor with bed rest and medications to stop contractions. And they may advise mothers to start being less physically active sometime between weeks 20 and 30, even if there are no signs of problems.

If you’re carrying twins, closely follow your doctor’s guidance about diet, exercise and rest, and avoid harmful substances, such as tobacco smoke and alcohol. Prenatal care is also impor-tant. Make sure you keep all your doctor appointments. Learn the symptoms and signs of preterm labor and know what to do if you experience them. Do all you can to lessen your risk of having your babies too soon.

Please visit www.swedishhospital.com for information on multiples and childbirth classes specially designed for families expecting multiples.

Meningitis can strike fast and hard. Some forms of this disease can kill a healthy child in as little as 24 hours.

Meningitis is an in$ammation of the membranes that cover the brain and spinal cord. A virus or a bacterium usually causes meningitis. It’s important to try to %nd out as quickly as possible what’s causing the illness. !at’s because the severity and the treatment di#er depending on the cause.

You can help by learning the signs and symptoms of meningitis and having your child evaluated as soon as possible. Prompt diagnosis and treatment give your child a better chance for complete recovery. David Stocker, MD, Pediatric Emergency Medicine at Swedish Medical Center, recommends taking your child to either your pediatrician or the nearest ER if you suspect meningitis.

Bacterial meningitis—a more severe form of the illness—can have very serious complications, such as brain damage, hearing loss and learning problems. Even with treatment, there is still a risk for death.

You can prevent many forms of meningitis by having your child vaccinated as recommended.

The SymptomsIf your child has any of these warning signs, contact your doctor immediately:• Sti# neck• Fever• Headache• Nausea and vomiting• Red or purple rash• Fatigue or extreme sleepiness• Seizures• Irritability, lethargy and poor feeding,

which may be the only symptoms in infantsA physical exam and a history of

symptoms help tell a doctor if meningitis is likely. A blood test and a spinal tap can determine whether a virus or bacterium is causing the infection, which determines treatment.

Viral meningitis, which isn’t as severe, usually goes away on its own. Doctors treat bacterial meningitis with intravenous antibiotics. Serious cases may require intensive care.

Prevention!e Centers for Disease Control and Prevention (CDC) recommends that children be vaccinated against bacterial meningitis. !ese vaccines are safe and e#ective, the CDC says. Di#erent vaccines

are given to infants and young children, preteens and teens, and college freshmen who have not been previously vaccinated.

Some forms of bacterial meningitis are contagious and can be spread through coughing, kissing and sneezing. Anyone in the same household, day care center or other site who has been in close contact with someone with these forms of the disease should receive antibiotics to prevent infection.

!ere are no vaccines for viral meningitis. However, you can reduce your risk for infection by washing your hands thoroughly and o"en. You should also avoid kissing or sharing glasses or eating utensils with someone who is sick.

Meningitis Requires FAST ACTION

Need to Know More?

To learn more about the symp-toms and treatments for the different forms of meningitis, visit the National Meningitis Association at www.nmaus.org.

8 Rocky Mountain Kids | fall/winter 2010 Swedish Medical Center

All kids who suffer concussions need the support of a multidisciplinary team that includes the athletes, their parents, school personnel, coaches and medical professionals.

“Kids should not resume sports until their symptoms are gone completely, and then their participation should increase gradually,” says Karen McAvoy, PsyD, director of the Center for Concussion at the Rocky Mountain Youth Sports Medicine Institute, a program of Rocky Mountain Hospital for Children at Presbyterian/ St. Luke's Medical Center. “Those who have one concussion are three to six times more likely to suffer a second concussion.”

Dr. McAvoy has written a REAP (Reduce, Educate, Accommodate, Pace) Manual outlining a six-step plan to manage concussions in children, adolescents and teens. To download the manual, visit www.youthsportsmed.com.

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Caring for Your Child’s Concussion

A concussion is a change in the way the brain functions that results from an injury to the head.

What to Look ForSome of the immediate signs of a concussion include:• Blank stare• Responding slowly to questions• Confusion• Slurred speech• Stumbling when walking

• Ringing in the ears• Loss of consciousness, even

if only for a few seconds

What to DoParents should contact a hospital or doctor immediately if their child has lost consciousness for any amount of time or if any other symptoms get worse or start up days or weeks later. Otherwise, rest is the only way to care for a mild concussion.

Be Cautious With Concussions

Ski, Sled, Skate and Snowboard SafelyYoung athletes should take steps to stay safe on theslopes or the ice this winter:• Strap on a well-#tting helmet

and wear other safety gear. • Take lessons to learn proper

form and how to fall safely. • Use the right equipment and

make sure it’s working properly. • Quit when you’re tired. • Wear sunscreen.

Specialists at the new Rocky Mountain Youth Sports Medicine Institute provide an unparalleled level of care to young athletes suffering with sports-related injuries.

“Kids don’t always bounce back from injuries as quickly as many people think, and they often require a different type of care than adults do,” says K. Brooke Pengel, MD, medical director. “Our multidisciplinary team is dedicated to helping kids heal so they can continue to enjoy sports safely.”

“The Institute is one of only a handful of facilities across the nation with a comprehensive pediatric sports medicine program,” says John Polousky, MD, surgical director. “We not only treat kids’ injuries, we also focus on injury prevention, community education and research.”

For more information, visit www.youthsportsmed.com.

Getting Young Athletes Back in the Game

10 Rocky Mountain Kids | fall/winter 2010

Expectant moms don’t have to live in Denver to have access to some of the best specialty care available. AirLife Denver—HealthONE’s medical transport service—has the only dedicated obstetrical (OB) &ight team in the Denver area. !e team transports patients with pregnancy-related complications to the Center for Maternal-Fetal Care at Rocky Mountain Hospital for Children at Presbyterian/St. Luke’s Medical Center.

“We’re available around the clock to help women who have preeclampsia, preterm labor, gestational diabetes or other medical conditions that a"ect their pregnancies,” says Susan Tishendorf, RN, high-risk OB &ight nurse/coordinator. She has been a member of AirLife for 14 years.

Air and Land TransportationAirLife has three helicopters, two Learjets and two ambulances that travel within a 500-mile radius of Denver to patients who live in remote areas or are in hospitals that don’t o"er services for high-risk pregnancies.

“Many facilities don’t have the sta", facilities or technology to treat expectant moms coping with medical conditions,” Tishendorf says. “I grew up in a small town of 900 people, so I relate to patients in rural communities. I treat them as if they

Going Extra Miles to Get Patients the Care They Need

”Our goal is to get pregnant women to Rocky Mountain Hospital for Children at P/SL before they deliver.”

—Susan Tishendorf, RNHigh-Risk OB Flight Nurse/Coordinator

are part of my own family and do everything I can to get them the right medical services. I know that without proper treatment, the lives of the moms and their babies are at risk.”

Expert OB Care !e team for each trip includes one of AirLife’s seven OB nurses and another registered nurse (RN) who specializes in emergency or critical care. Richard Porreco, MD, the center’s medical director, is available for consultations as needed.

“It’s important to have OB nurses caring for pregnant patients,” Tishendorf says. “Safety is our #rst consideration. Babies have better outcomes when they’re delivered at the hospital, where they’ll receive care a$er birth. But we have to make sure patients are stable enough to travel. Our goal is to get pregnant women to Rocky Mountain Hospital for Children at P/SL before they deliver.”

Helping Children ThriveIf a mother delivers before she’s transferred, the OB &ight team helps stabilize the newborn until an AirLife neonatal &ight team arrives to take the infant to the hospital. AirLife’s 12-member neonatal team is comprised of neonatal nurse practitioners, RNs and respiratory therapists. Team members travel within the coverage area to provide care to very sick infants, toddlers, children and adolescents during their trip to Denver.

The AirLife Denver Team

AirLife Denver was recently selected by the Association of Air Medical Services (AAMS) as “Air Medical Program of the Year.” AirLife Denver outshined hundreds of other medical flight programs around the world for this prestigious honor.

The AAMS Air Medical Program of the Year award recog-nizes an emergency medical program that demonstrates the highest caliber of patient care, management expertise, strong leadership, exceptional customer service, supreme quality and safety, marketing ingenuity, service to the community, and commitment to the medical transport community.

With bases at Swedish, P/SL, Sky Ridge, The Medical Center of Aurora North and the Frederick-Firestone fire station, AirLife Denver is the Emergency Medical/Critical Care Transport Service of HealthONE and provides air and

AirLife Denver:ground critical care transport for both adult and pediatric medical/trauma patients.

HealthONE and Rocky Mountain Hospital for Children extend congratula-tions to the 120 AirLife Denver Team members and thank them for all their hard work. And we encourage you to look up and look around—you’ll undoubtedly see the blue and sonic green flight suits, helicopters, critical care ambulances, Learjets, and all the wonderful people that make up AirLife Denver.

Best in the World!

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Sky Ridge Medical CenterDr. Sears’ L.E.A.N. Essentials Workshop Two hours—$20 (includes workbook). For parents and caregivers with children ages 3 to 12 years old. !is one-time, two-hour interactive workshop provides simple, e"ective, practical and fun tools and information that will help you create and maintain a healthy lifestyle for your entire family that they will enjoy.

Classes are held in the Sky Ridge Medical Center Board Room, Garden Level, 10101 Ridge Gate Parkway in Lone Tree. For class dates and times, more information, or to register, call 720-225-5362 or visit www.skyridgemedcenter.com.

Presbyterian/St. Luke’s Medical CenterParent Education Classes To register for classes, call 87-PSL-Cares(877-752-2737)• Baby 101: Understanding Your Newborn

One three-hour session, $40 !ursday, December 9, 2010, 6 p.m. Saturday, January 15, 2011, 9 a.m.

• Infant SafetyOne three-hour session Wednesday, December 8, 2010, 6 p.m., $50 (includes CPR book) Tuesday, January 11, 2011, 6 p.m., $55 (includes CPR book)

• Boot Camp for New DadsOne three-hour session, $40 !ursday, January 13, 2011, 6 a.m. !ursday, February 24, 2011, 6 a.m.

Rocky Mountain Hospital for Children at P/SLExceptional Images Mean Outstanding CareRocky Mountain Hospital for Children at Presbyterian/St. Luke’s is the #rst facility in Colorado equipped with the Toshiba America Medical Systems, Inc., Aquilion® ONE—the only 320-slice computed tomography (CT) scanner available. CT scanners use special X-rays to create detailed 3-D pictures of structures inside the body.

“!e Aquilion ONE takes CT scanning to a new level,” says David Fanning, director of Radiology. “We’re able to take high-resolution images of one organ or an entire anatomical area in a child with just one rotation of the scanner.”

!e new system was designed to meet the special needs of kids who are more sensitive to radiation exposure and have smaller blood vessels, less body fat and lower body density than adult

Rocky Mountain Hospital for Children at...news & events from

patients do. It includes Toshiba’s SUREExposure™ Pediatric so$ware, which tailors the radiation dose based on the child’s size and age and the type of exam. Children receive the lowest radiation dose needed to produce high-quality images.

Rose Medical CenterRose Medical Center proudly announces the arrival of the newest “Rose Baby”—the new Rose Neonatal Intensive Care Unit (NICU). Opening in late November, this new NICU features private rooms for each family, state-of-the art design and brand new, cutting-edge equipment, allowing for the best care for our most precious Rose Babies. To learn more, go to www.rosebabies.com.

Introducing HypnoBirthing® Preparation Classes at Rose Medical Center. !is program teaches new mothers how to call upon their bodies’ own natural relaxants and thus lessen, or even eliminate, discomfort and the need for medication. !rough self-hypnosis, special breathing and visualization, HypnoBirthing teaches mothers how to trust their bodies and work with them. To learn more, go to www.rosebabies.com.

North Suburban Medical CenterCongratulations to North Suburban Medical Center Celebrating 25 Years of MedicineAt the heart of all that matters are people—connected in purpose. North Suburban Medical Center’s doctors, nurses and employees are committed to changing lives. For 25 years, they have been providing excellent care to patients when they are most at risk.

The Medical Center of Aurora!e Medical Center of Aurora recently received two prestigious awards: the GWTG Stroke Silver Performance Achievement Award for quality stroke care and the GWTG Gold Performance Achievement Award for quality cardiac care.

!ese awards recognize hospitals that have excellent— 85 percent or better—performance rates in treating cardiac and stroke patients.

Rocky Mountain Kids is published by Rocky Mountain Hospital for Children’s family of hospitals from HealthONE. !e information is intended to educate the public about subjects pertinent to their heath, not as a substitute for consultation with a personal physician.

Beverly Petry Editor

Rocky Mountain Kids welcomes feedback from our readers. To o"er feedback, please go to www.RockyMountainHospitalForChildren.com and click on "Contact Us." ©2010 Rocky Mountain Kids. All Rights Reserved.Permission to reprint or quote excerpts granted by written request only.

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