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For the latest in pediatric health treatments, research and the amazing stories of our patients, bookmark www.childrensmedmag.com.

Two brothers, One diagnosis - Part 2

With the help of the Nephrology team at Children’s, Maria Alias and her husband came up with a treatment plan that would allow their two sons with kidney failure, Najib and Safie, to maintain as regular lives as possible.

They elected for both of them to do peritoneal dialysis at home every night while they slept instead of coming to Children’s three times a week for hemodialysis treatments. That allowed them to minimize school absences by only having to visit Children’s for monthly lab workups.

Educators from the Nephrology department – which treats more pediatric dialysis patients than any other hospital in North Texas – then trained them how to operate the home dialysis machine during an intensive three-week session.

“They’re a fantastic family,” the boys’ nephrologist, Dr. Katherine Twombley, said. “They’ve done everything we’ve asked of them to take care of their sons.”

Kidney transplant could be in Najib’s and Safie’s future. One benefit of them being seen at Children’s is that the staff who works with them in the Nephrology department is in constant collaboration with the team in the Transplant department.

“All effort is made to make the transition from dialysis to kidney transplant as seamless as possible,” Dr. Mouin Seikaly, a nephrologist and the medical director of renal transplant at Children’s, said. “The Nephrology and Transplant teams collaborate to make sure there is no disruption in the process for patients or their families.”

In the meantime, Najib is bouncing around everywhere acting like he’s Spiderman, and Safie is playing video games like any other third grader. Yet, it’s likely that the only way they will be able to continue to live with such vitality in the long run is to receive new kidneys.

April is National Donate Life Month, and Children’s is encouraging everyone who is able to register to be an organ donor by registering at http://donatelife.net/. It’s free, only takes about a minute to do and saves lives.

“The need is real when you consider the facts,” Stephen Pottoore, administrative director of Nephrology, said. “Someone is added to the transplant waiting list every 10 minutes. On average, 18 people die each day waiting for a transplant because of the shortage of donated organs.”

Two brothers, One Diagnosis - Part 1

Maria Alias had no idea what nephrophthisis meant when she brought her two sons, Safie and Najib, from Malaysia to America in 2005.

But she learned very quickly in the summer of 2011. The boys’ father noticed that Najib, then 6, had uncontrollable tremors in his hands one morning in July when Maria was out of town. By the time she returned, Najib had been given the strange-sounding diagnosis at Children’s. It meant his kidneys were failing him.

She didn’t even have time to process Najib’s diagnosis when 8-year-old Safie developed a continuous nosebleed in August. She and her husband knew by then that nephrophthisis was genetic.

So, instead of taking Safie to the closest emergency room to their Kaufman home, they brought him directly to Children’s, assuming he had the same disease as his brother. And their assumption was right.

The boy’s nephrologist at Children’s, Dr. Katherine Twombley, had never seen anything like it. Out of the hundreds of patients she had treated for various kidney ailments, she’d never had two brothers with nephrophthisis. And the fact that both presented within a month of each other made their situation even more unusual – and challenging for their mother.

“It was very difficult to deal with,” Maria said. “But I didn’t have a choice.”

Come back to our blog tomorrow morning to learn how the Children’s team is helping Maria take care of her two boys.

What to look for in Episode 7

Let's be honest. Every episode ending in a cliffhanger makes us all anxious.

We want to know how these patients who we've come to know and care for turn out. Moreover, we want to know that those patients turn out well. Well, we'll get our wish this Saturday on the series finale.

How has Rylynn been since receiving her heart transplant (hint: that's her with her parents in the picture above)? What does Taylor's nose look like following reconstructive surgery? Is baby Dakayta healthy after surgery to repair her spina bifida? What about the Kirby twins? How are their parents handling one being at the hospital while they have to be with the other one at home?

And what about that nice neurosurgeon with the long hair? What's his home life like?

This episode will answer all of those questions. We'll also give you a chance to see all of the physicians from Season 1 again.

So, please watch at 6:30 p.m. this Saturday on WFAA. In my humble and unbiased opinion, I think it's our best episode yet.

Teens smoke popular drug and damage hearts

You may have seen the recent news story on CBS about K2 sending more local teens to emergency rooms.

Watching your teen experiment with his hairstyle or wardrobe is one thing. A harmful drug disguised as incense is another. Teens treated in The Heart Center at Children's are dealing with cardiac issues from dabbling in K2 or "spice," a chemically-enhanced marijuana substitute. The drug has been sold in head shops and online, marketed as a harmless blend of herbs and spices that's inexpensive. The biggest selling point for student athletes is that screening tests won't pick up this drug.

Dr. Colin Kane, pediatric cardiologist at Children's, had never heard of K2 until teens came into the Emergency Department with unexplainable chest pain. In fact, medical literature about K2 doesn't exist so, after his experience, Dr. Kane worked with toxicology experts at UT Southwestern Medical Center to publish his findings. Since K2 is undetectable, there is no way for doctors to know how much of the drug is in the body or the long-term effects.

Only after some prodding did the teens admit to using K2. Unfortunately one of the boys, a high school football player, has permanent heart damage and will be on the sidelines.

Tips for keeping your teen out of danger:

• Keep communication lines open - ask not only about K2 but also drugs in general
  


• Watch for tracings of an herb-like substance in your teen's bedroom or backpack



• Educate your teen about the real dangers of smoking K2



• Be on the lookout for side effects of K2 use including paranoia and a soaring heart rate
  

Watch Dr. Kane explain why he's worried about widespread use among high school students and athletes:

What to look for in Episode 6

This Saturday at 6:30 p.m. on WFAA, you'll get to see some of the hardest and sweetest issues that parents of Children's patients face. Episode 6 of Children's Med Dallas picks up the stories of two families in the NICU who were introduced in Episode 5.

You'll get to see how newborn Dakayta fares following surgery to treat her spina bifida. And you'll get to see how her parents process the bittersweet emotions of having a new baby who is facing significant health obstacles.

The other parents in the episode also have to deal with mixed emotions. Their 23-week-old twins, Kennedy and Audrey - both born 17 weeks early, are progressing at different rates. One will be discharged while one will have to stay behind a little longer.

Spoiler alert: both cases will warrant some Kleenexes, but both will also inspire you.

The episode isn't all serious, though. We'll also take you away from the hospital with one of our physicians who was willing to dress up like Dumbledore at his daughter's Harry Potter-themed surprise birthday party.

A delayed flu season in North Texas

It's common knowledge in the medical community that viruses like the flu mutate and adapt to maneuver around the latest immunizations. In fact, that's the reason we have to get flu shots every year - because the strains of the flu we were immunized against in prior years have evolved and require us to develop new vaccines for them.

But even as ingenious as mutation is, it may not be as tricky as what the flu did over the past several months in North Texas. You see, the typical peak of the flu season is in January and February here. But not this year. North Texas had an extremely mild amount of flu cases in the first couple of months of 2012.

That lulled most of us into thinking that we were just going to have a flu-less year. However, as you'll learn from our infectious disease expert Dr. Jeffrey Kahn in the WFAA news clip below, the flu just faked us out. There has been a significant increase in flu cases over the last several weeks, which implies that we're just now entering the throes of "flu season."

So, if you haven't had your child vaccinated against the flu yet, it's still a good idea.

A Family Affair - St. Baldrick's

Editor’s note: Andy Lautzenheiser and his mom Kelly, an oncology nurse at Children’s, shave their heads every year to raise money for the St. Baldrick’s Foundation, a nonprofit, volunteer charity that funds research to find cures to childhood cancer. We asked Andy to share with us why the event is so important to him and why he chooses to shave his head every year.

Hello All. My name is Andy and I wanted to share my story with St. Baldrick’s. You can raise money by having people donate money to your cause and at the end of the event you have your head shaved as a thanks to everyone. Right now I am 15 years old and this March will be my 4th year to shave my head for St. Baldrick's.

I first did it when I was in 6th grade when I heard that my mom was going to shave her head for St. Baldrick’s. My mom is a nurse practitioner at Children’s and takes care of kids with cancer. I thought it was a great idea, so I asked my mom if I could shave my head with her and she said I could if I really wanted to. So, for the next few months I grew out my hair until it was the day of the event. My goal was to raise $500 and at the end I raised $925! The event where you shave your head was amazing. It is a whole festivity where everyone that gets their head shaved goes on a stage and there is a ton of cheering. You tell everyone about yourself and then you get your head shaved while everyone cheers. Then you stay and watch everyone else get there head shaved. You get a t-shirt and pictures and then you get to go home with a great summer cut!

I was kind of nervous about what people would say when I went to school. The next Monday when I was walking into school I could tell that everyone was staring at me, and I was thinking that it was actually kind of cool. Through the day I got a bunch of comments like "did you lose a bet?" or "you have cancer!" and they were kind of getting annoying but I didn't really care about what people thought about me and after I told them that I shaved my head to raise money to find a cure for kids cancer everyone went pretty quiet about their comments after that.

It feels great having no hair because you feel a lot lighter and your head is cooler. It was so much fun that I have been shaving my head every year since. One year there was a kid at my school that had cancer, I asked him to shave my head for St. Baldrick’s that year which was really fun. I love shaving my head for this good cause and I will continue to do this every year.    

What to look for in Episode 5

Episode 5 of Children’s Med Dallas focuses on the youngest and smallest patients at Children’s – the ones who occupy our neonatal intensive care unit or NICU. You’ll get to see three families who entrust their babies’ lives to our staff, believing that the “Level 3C” NICU accreditation means the most delicate and complex cases can be figured out and rescued here.

Drs. Rashmin Savani and James Moore, the medical directors of the NICU, will be shown caring for the patients and counseling their parents. Viewers will also get to see Dr. Savani interact with his own family at home, including teaching his teenage son how to drive.

The first patient shown will be newborn Dakayta, who was introduced at the end of Episode 4. Dakayta was born with spina bifida and needs immediate surgery to enclose her spine. Dr. Dale Swift, a Children’s neurosurgeon, is introduced in Episode 5 as he’s called in to correct Dakayta’s condition.

Three new patients will also be introduced: 9-month-old Zoe and 23-week-old twins Kennedy and Audrey. Zoe is experiencing mysterious episodes of breathlessness. Kennedy and Audrey came to Children’s from Longview after being born 17 weeks early at 15 ounces and 19 ounces respectively.

So, please watch at 6:30 p.m. this Saturday, March 31, on WFAA Channel 8 or afterward on our Facebook page to see how the Children’s staff tries to rescue these babies who won’t survive without medical intervention.

'Child Life is a calling, not a job'

In honor of Child Life Month, we are highlighting three of our child life specialists - Ashley Brady, Jill Bringhurst and Ruthie Davis. Read below to find out why they pursued child life as a career and more about their roles.

What is Child Life and how did you discover the profession?

Ashley Brady: Child life specialists work in many areas of the hospital from the Emergency Department to the ICU. I discovered the child life profession in my second year of college when I was looking for a career that combined the medical field and working with children. I graduated from college and did my child life internship, which is a 15-week unpaid clinical experience. During my internship, I fell in love with the field of child life and truly feel that being a child life specialist is a calling rather than a job.

Jill Bringhurst: A child life specialist will prepare a patient for surgery or an invasive procedure, provide support during imaging or medical testing and debrief those involved in a traumatic event. The role of a child life specialist in a pediatric setting is a key component to the psychosocial support families receive at Children's.

Ruthie Davis: Our job is broad, ranging from community outreach, school re-integration, new diagnosis teaching on an age appropriate level, medical play and normative play, playrooms to encourage normal growth and development, sibling support and education, procedural preparation and support, bereavement care and legacy building activities for both patients and siblings, and developmental assessments.

Why is Child Life important in a hospital setting?

JB: Child Life is an entire discipline focused solely on the psychosocial needs of pediatric patients. At Children's, we have many people caring for the medical needs of a patient, but the child life specialist can address the developmental, emotional and social needs of the patient.

AB: We understand that children are not little adults. Children of every age have specific needs. Hospitalized children need to be involved in play which promotes normalization of a sometimes scary environment as well as way to express feelings. Teens have their own space in the hospital where they can hang out with kids their age.

How does Child Life make a difference in the child's care?

AB: We use our expertise in child development to tailor our interventions to help the children cope. Studies show when children know what to expect in the medical setting, they do better. I have had many experiences in the surgery unit where I walk into a room and the child is hiding in the bed, scared and crying. When I begin to blow bubbles, the child slowly comes out from under the covers. The child then makes eye contact with mom to make sure I am a safe person and engages in the bubble play which helps me build rapport with him. Once the child is comfortable with me, I am able to talk with him about things that might be scary or hard, such as the upcoming surgery. We also work with the entire family. When siblings come to visit their brother or sister in the ICU, we educate the siblings about what to expect. When a child is newly diagnosed with a chronic illness, we explain the complexities of the diagnosis using kid friendly language and teaching dolls.

RD: We give the child tools they can use in the future, control when most of their control has been lost or taken away, and predictability with a routine or structure. We also provide toys and activities in the playroom which can help make a scary or unfamiliar place fun, give the child age appropriate information and knowledge about their disease or condition, and take away their fear of coming back to the hospital.

Why did you decide to pursue child life as a career?

JB: I was fascinated by the hospital and medical field and also drawn to working with children and making things better for them.

RD: I didn't want to be a doctor or nurse but still wanted to work with children in the hospital setting, making their experience better.

AB: It is a job that challenges me in many ways but is so rewarding. I feel very blessed to have a job that I love, and that every day I have an opportunity to directly impact patients and their families.

Why One Doctor is Shaving Her Head

Editor’s note: Dr. Rachel Thienprayoon, a second-year pediatric oncologist at Children's Medical Center, shares the special reasons why she is raising money and shaving her head March 31 at an event put on by the St. Baldrick’s Foundation, a nonprofit, volunteer charity that funds research to find cures to childhood cancer.

My first experience with St. Baldrick's was during my residency in general pediatrics at Children's, about four years ago. A group of oncology fellows, including Dr. Martha Stegner, shaved their heads for St. Baldrick's. I thought it was so amazing that “Dr. Martha” was willing to go bald for her patients! As I applied for my fellowship in pediatric oncology, I thought about St. Baldrick's and whether someday, I would want to do the same.

During my first year as a pediatric oncology fellow, four of my beautiful, spirited and brilliant patients died of their cancer. I was very close to one patient in particular, a teenage girl named Micaela White. Micaela was diagnosed with cancer just before her 18th birthday. I remember how difficult our first conversation was about her diagnosis. I was amazed by her calm demeanor and poise. She maintained that tremendous grace throughout all phases of her treatment. As her cancer progressed, she had many complications, but still her spirit remained strong and courageous. One of my best days as a doctor was when I told her that she could go to her high school graduation. To be honest, we both cried!

Micaela lost her battle with cancer last fall. I think of her often, and I always remember the look of clear determination on her face during our first conversation. It reminds me of how determined we all must be in the fight against pediatric cancer. I believe that in my lifetime, we will be able to cure all children's cancer. But the only way this will be possible is through continuing aggressive research efforts to find a cure.

The St. Baldrick's Foundation is a unique organization in so many ways. They provide funding only to pediatric cancer research. They provide research grants both nationally and locally and they even support research projects led by fellows like me. Today, the St. Baldrick's Foundation funds more in childhood cancer research grants than any organization other than the U.S. government.

I am very lucky to say that St. Baldrick’s is funding my current research project on hospice use in pediatric oncology patients. As I wrote my thank you note to St. Baldrick's donors and participants, I realized how deeply touched I am by those who give their time and energy in the fight against kids cancer. I understand why Dr. Stegner and so many of our colleagues volunteer in the St. Baldrick's event each year. I needed to participate too!

I feel like my role in this event is easy: I just show up and get a haircut. It is our sponsors and donors who are the critical link in this event. So many lives have been touched by pediatric cancer, and I am so grateful to each donor who is willing to support our patients in the fight for a cure. I hope that the determination Micaela inspired in me will be shared with readers of this article, and they might consider donating to St. Baldrick’s or attending the event. It is only by working together that we will achieve our goal of curing all children affected by cancer.

What to look for in Episode 4

So, you need a reason to return to your TVs and/or computers to watch the next episode of Children’s Med Dallas at 6:30 p.m. on Saturday on WFAA-Channel 8? Well, we have plenty.

For starters, you’ll get to see the conclusion of 3-year-old Nathan Chase’s story. The last thing you saw in Episode 3 was Nathan being examined by Dr. Pam Okada in the Emergency Department. He had fallen down a stairwell at home and landed on his head. His skull looked like it had a fracture and a hematoma, and it was uncertain if he would need surgery. Episode 4 also shows how the Emergency staff responded to a baby involved in a car accident that made her car seat wind up like this.

Another reason to watch is that you’ll get to see our Level 3C Neonatal Intensive Care Unit (NICU). What does “Level 3C” mean? It means that our NICU can respond to the most acute and complex conditions. The leaders of the NICU, Drs. Rashmin Savani and James Moore, are shown responding to several of our tiniest patients, including newborn Dakayta Givens, who was born with spina bifida.

Lastly, Dr. Okada will be shown away from the hospital. While you know from Episode 3 that she’s a high-intensity, super-sharp Emergency physician, you probably didn’t know that she was a mother of five. And I’m willing to bet you didn’t know she boxed in her free time. Well, you’ll get to see both of those aspects of her this weekend.

So, please make sure to watch live/DVR/watch on our Facebook page as we reveal more of Children’s and our amazing staff and patients this weekend. Remember: 6:30 p.m. on Saturday on WFAA-Channel 8.

'Rylynn made me a better nurse'

Katie Mikeworth, RN, cared for 2-year-old Rylynn Riojas while the toddler waited for a new heart. Katie's shifts with Rylynn were not only medically focused. Katie and Rylynn spent time painting nails, playing with dolls and bonding over all things girly. Read Katie's blog about their times spent together and how one little girl changed Katie's perspective on nursing...and life.

Nursing is not a glamorous job. It involves masks and gowns, diapers and throw-up, and many other not-so-glamorous things. So, receiving a manicure within the first hour on-the-clock was beyond a glamorous treat for me. No, it was not Nurses' Week, nor was it a surprise from my manager. This special manicure was a surprise insisted upon by my patient, Rylynn Riojas.

Rylynn is a 2-year-old little girl I had the pleasure of caring for last year in the cardiac intensive care unit at Children's. My very first shift with Rylynn was the night she came back from the operating room after the implantation of a Berlin Heart. I joined Rylynn's care team in the cardiac ICU after a few shifts taking care of her last summer, and I was part of her care team until she was discharged with a new heart to the cardiology floor. She instantly touched my heart, and it's not rocket science (or heart surgery!) to figure out why. Rylynn took a while to warm up to me, but after a couple of weeks...we were pals. I always looked forward to work, hoping that I'd be her nurse. Rylynn's personality is - in one word - fun. Did I always get to take care of the fun, happy, smiley Rylynn? No, but that's the case with any toddler. There were some really tough shifts, there were some really busy shifts, but mostly there were the shifts where everything went smoothly and Ry was awesome.

Coming into work and getting a sparkly rainbow manicure from Ry sitting at her Dora the Explorer table was a highlight of my time with her. We played with Play-Doh, watched Dora and other cartoons, played with her stuffed puppy and baby dolls, and colored pictures a lot. There was even one time when I was convinced by this 2-year-old's laughter to dance with her stuffed giraffe - that was my height. I couldn't help myself; hearing Ry giggle after she had gone through so much was just the best. So, I danced.

Joining Rylynn's care team impacted me more than I thought it would. A care team isn't just for the patient; it's for the family as well (and, as it turns out, the nurses benefit, too). The Riojas family is warm and caring, silly and friendly, but most importantly, they are genuine. Not only did I become a better nurse while caring for Ry, but I feel like I grew as a person from being around her family. Taking care of Ry and her family for four months was more than a positive experience for me. Rylynn's parents fought hard every day for her and supported each other, never losing hope and always staying positive. This is the attitude I want to have every day for my patients and their families: an attitude of hard work and selfless giving with complete faith in miracles.

So, I said before that nursing isn't a glamorous job, but maybe I was totally wrong. Miracles are pretty glamorous, and as a nurse, I got to be part of one.

Clowning around at Children's

Crystal Goss is a senior communications specialist at Children's. This blog is her account of a day spent with the Funnyatrics clowns.


I knew the clowns from the Children’s Funnyatrics Program were going to be funny. I mean, they are clowns.

We asked them to hang out with us for a behind-the-scenes photo and video shoot for the second season of the hospital’s documentary Children’s Med Dallas. As expected, they were FUNNY. So funny. Our group – consisting of a videographer, creative director, support staff and photographers – were all in stitches laughing at their goofy antics and general silliness, from kazoo-playing to dancing. One of the products of that silliness was an impromptu song about Children’s Med Dallas, which you can watch below.



The thing I didn’t expect though was the heart that our clowns would bring to the shoot, the heart they bring to their work every day. Beyond the silly, our clowns are really all about healing by the power of laughter. And they love working with our patients and staff. Take a look for yourself at the funny and serious moments during our shoot with these clever and compassionate clowns.



Catch the clowns' cameo on Children’s Med Dallas at 6:30 p.m. this Saturday on WFAA Channel 8.

A new perspective and a new season of Children's Med Dallas

I began working on Season 2 of Children’s Med Dallas about a month after the birth of my first child, a daughter named Emerson who’s usually called Emmy.

Emmy had already changed a lot in my life, namely my sleeping, eating, thinking, TV watching. Etcetera. (See the change represented in my face in this photo ------->)

But she hadn’t changed my work yet.

As a story producer on the show, my job is literally to produce stories. A lot of times that means talking with physicians about cases they’re working on, what they do away from the hospital and how we can film those things. That part didn’t change after Emmy was born.

Another part of story producing, though, is asking patients and their families about their stories. Emmy affected that substantially. Instead of approaching parents as a mere representative of Children’s, I had to approach them as a fellow parent.

Bluntly: That made my job painful, especially in the emergency department – a new area that we’re covering this season. Every baby that came in with breathing problems or seizures or worse made me imagine Emmy in their position. Then it would occur to me that their parents were actually dealing with the reality of having a baby needing rescue. And I would feel like a jerk for approaching them.

But, to my surprise, the parents usually got what the show is about in those moments better than I did. When I felt intrusive, they felt the poignancy of their situation and the expertise of the team caring for their child. More often than not, they responded to my request to film them by saying, “I want other parents to be aware” or “I want to help the hospital”.

We hope this season fulfills their hopes by raising awareness of both pediatric health/injury issues and the tremendous staff at Children’s who treat those issues. The first episode will air at 6:30 p.m. this Saturday, March 3, on WFAA Channel 8. And there will be six more 30-minute episodes following that premiere, each also airing at 6:30 p.m. on consecutive Saturdays on WFAA.

In addition to showing you our emergency department, we’ll show you what real-life brain surgeons do. And you’ll see how our caretakers handle some of the most critical and delicate patients in the neonatal ICU and the stem cell transplant unit like Sophia Tilley, a 14-year-old girl from Arkansas who needed new bone marrow to battle her leukemia.

The first episode will pick up where last season left off with the case of Rylynn Riojas, a 2-year-old girl who was in dire need of a heart transplant. You’ll see how Dr. Kristine Guleserian and the rest of the heart team continued to fight for Rylynn’s life when the odds of her receiving a transplant were minute. We’ll also reintroduce you to plastic surgeon Dr. Alex Kane later on this season as he works to create a nostril out of forehead skin for a teenage boy.

However, even though some of the same characters will be featured, this season will be different than the first – for me, at least.

I’ll be watching through a parent’s eyes for the first time.

Flu questions and myths cleared up

It's been an unseasonably warm winter, and with January and February days in the 60's and 70's, flowers are blooming early and grass hasn't completely gone dormant. The warm winter has also kept flu season from hitting North Texas, but the experts assure us the virus is still sure to hit. It's not an issue of if the flu will hit, but when.

Dallas County Health & Human Services and Children's Medical Center's Infectious Diseases experts both report that there has been a very low incidence of the flu virus in the DFW region so far this winter. But the latest numbers from the County suggest that the virus is ramping up and ready to do its seasonal damage. So, are you protected? The easiest, and safest way to keep you and your family protected from the flu this season, even this late into the winter, is to get a flu shot. And it's not too late, says our Infectious Diseases expert, Dr. Jeffrey Kahn.

Dr. Kahn answered some questions we had in our office about the flu and clears up some of the myths about the flu, like if you can get the flu from a flu shot or not.

Q: What time of year is flu typically at its peak? And why?

Dr. Kahn: Influenza, or the “flu,” typically circulates in the late fall and winter months in the northern hemisphere. During most years, the flu season can last up to 3 months with peak activity lasting 1-2 weeks or more. There is some variability in the start of the flu season—some years it starts in November, while in others (like this one) it can start in February or later. The seasonality of the flu remains one of the great mysteries in infectious diseases. Several potential explanations have been proposed (air temperature, humidity, etc) but none have been proven.

Q: Does wet hair actually make you more likely to catch a cold/the flu?

Dr. Kahn: That’s what our mothers and grandmothers tell us and I am not going to argue with them. So dry your hair and wear a hat!

Q: Can you get the flu by being out in cold weather? And… why is there a flu season?

Dr. Kahn: The flu is typically spread from person to person (so temperature and weather may not have a direct impact) and as we learned with the swine (H1N1) flu, cold weather is not required. The peak of H1N1 activity in Dallas in 2009 was early September when the daily temperatures were in the 80’s and 90’s!

Q: Why do kids’ fevers tend to spike at night? Why do their stuffy noses and coughs seem to get worse at night?

Dr. Kahn: While these are common observations, there is no single answer to these questions. Increase in cough and congestion at night may be the result of position effecting nasal drainage (upright vs. lying down). As for fevers being worse at night, I am not sure that there is solid evidence for this but we know that body temperature varies with the circadian rhythm.

Q: How can you tell the difference between a cold, the flu or some other respiratory virus?

Dr. Kahn: Typically, the flu has a sudden onset with high fevers and body aches. However, it is difficult at times to tell the difference between infection with influenza and infection with other respiratory viruses. But, if it is in the middle of flu season and you suddenly get sick with high temperatures and feel like you’ve been hit by a bus, it’s most likely the flu.

Q: Does Tamiflu really work?

Dr. Kahn: Absolutely! For maximum effect, it should be taken within 48 hours of the onset of symptoms.

Q: Does getting a flu shot give you the flu virus? Will you get sick from the flu shot or flu mist?

Dr. Kahn: The injectable flu vaccine is inactivated (killed) virus so you can’t get the flu from the shot. Flumist is a weakened form of the virus that can only replicate in the nose and does not result in flu symptoms in the VAST majority of recipients. Bottom line: either flu vaccine is SAFE and EFFECTIVE.

Q: Is it too late to get a flu shot?

Dr. Kahn: Since we are just beginning to see flu activity in north Texas, there is still time to get vaccinated. So if you have not already done so, GET THE VACCINE! It’s the best way to protect yourself and your loved ones from getting the flu.

What being a marrow donor really means

Last week, a throng of Children's employees, including myself, got to watch an amazing meeting here at Children's. It was a long-awaited reunion of sorts between 6-year-old Laurel Good and Krista Katris, 23. Krista donated her bone marrow to Laurel over a year ago, a gift that saved Laurel's life.

Laurel, who was diagnosed at birth with TAR syndrome, a rare genetic disorder which can lead to bone marrow failure and is marked by low platelets and the absence of radius bones in the forearms, is now in perfect health thanks to Krista's willingness to join the Marrow Registry and donate once she was called.

Krista said she couldn't wait for the day when she could meet Laurel. Laurel and her dad Ken and sister Darby, 12, gave Krista many gifts, including a homemade beaded necklace Laurel made for Krista. Laurel's mom Terri and grandmother Jan were also apart of the meeting.


Krista had gifts of her own. She gave Laurel an Americal Girl Doll she had custom made to look like Laurel. The 6-year-old's eyes lit up when she saw Krista's dad Chris carry over the shopping bag with Laurel's doll and accessories it. "It's my very own," Laurel shouted while she showed off her new doll.We've asked you all month to get typed to be on the Bone Marrow Registry, telling you that you could save a life. But when you see a little girl meet the stranger who saved her life with a simple, generous donation, you understand why it's so important to join the Registry.

Through the end of February, Children's will pay for your online registration. For a free kit, visit and enter the coupon code "childrens."

And share your story with us. Why did you decide to get typed?

Bullying shouldn’t have to be a part of growing up

I, unfortunately like many others, was teased in middle school. My peers would ridicule me for being too shy and quiet. I remember staying up nights wondering if I was weird. I struggled with that insecurity so much that I felt like I might even deserve the bullying.

But that was a long time ago. Long enough for me to forget how bad it was, at least. But all of it came flooding back to me when I attended the premiere of The Secret Life of Girls at the Dallas Children’s Theater. The play, which is about the challenges middle school girls face every day, gave me déjà vu, making me relive my days as an awkward middle schooler.

I believe I can speak for most females in the audience when I say it was difficult to revisit that experience. And based on the play, it seems like the conditions for junior-high girls are worse today than they were when I was their age. The bullying does seem to stop once you leave school anymore. Technology like cell phones and social networks are now used for bullying 24/7.

While I was watching the play, I kept thinking to myself, “These poor girls. Why is nobody stepping up to stop this?” The choice to take action against bullying is one that teenagers face every day. Since most bullying seems to be done in front of an audience, it’s common for bystanders to watch and shake their heads but not to intervene.

After the premiere, a group of panelists including Children’s psychologist Dr. Andy McGarrahan all stressed the importance of being an “active bystander” during a Q & A session with the audience. They said that even though standing up for someone else isn’t easy, especially for a teenage girl, it makes a big difference

Even though parents can’t speak for their children, Dr. McGarrahan said he believes parents can help their children become active bystanders. He referenced tips from Dan Olweus, Ph.D., one of the leading researchers in bullying prevention, that can be found on Olweus.org:

• Encourage your child to verbally intervene if it is safe to do so, by saying such things as: “Cool it! This isn’t going to solve anything.”
• Tell your child not to cheer on or even quietly watch bullying. This only encourages a child who bullies – who wants to be the center of attention.
• Encourage your child to tell a trusted adult about the bullying. Talking to an adult is not “tattling” – it is an act of courage and safety. Suggest going to an adult with a friend, if that will make it easier.
• Praise and reward “quiet acts of courage” – where your child tried to do the right thing to stop bullying, even if he or she was not successful.
• Work with your child to practice specific ways he or she can help stop bullying. For example, role-play with him or her what he or she could say or do to help someone who is being bullied.

One way to open the discussion on bullying is to take your child to a showing of The Secret Life of Girls. The final opportunity to see it is this weekend at the Dallas Children’s Theater. Just think – this could be the perfect opportunity to be an active bystander.

The Secret Life of Girls brings bullying to light

One of the main issues brought up in the Dallas Children's Theater's production of The Secret Life of Girls, which is running now through Feb. 26, is bullying. As Kristen brought up in an earlier blog, growing up is hard enough and bullying has always been a rite of passage, but with the technology of today, it can be impossible for kids to escape their tormentors.

This Saturday, Feb. 18, one Children's experts, Dr. Gabby Reed, Ph.D., will join other experts and teens for a Q&A Talk Back session, as part of the day-long Teen Scene Summit. We invite you to come and take part.

We asked Dr. Reed and a couple of our other experts at Children's what parents can do if they suspect their child is being bullied or is a bully. And then, what can be done to prevent it? Our conversation is below:

Q: Are certain types of children or teens more susceptible to bullying?

Dr. Gabriela Reed, Ph.D., pediatric psychologist: There are usually two types of kids who get singled out to be bullied. There are the kids who come across as anxious, insecure and cautious, and then there are the kids who are easily emotionally aroused and perceived by their peers as aggressive, argumentative and annoying. Bullies are like sharks in that they "bump" their targets before deciding which to choose. Kids who have better social skills and who know how to assertively set limits with their peers are often not chosen to be bullied.

Dr. Jane LeVieux, Ph.D., licensed professional counselor and registered play therapist: Anybody could be bullied. For kids with a medical illness, it could be their overall appearance that makes them a target. There's also research that says kids with low self-esteem may be targets, and some kids may not have the social skills to say, "Leave me alone."
Dr. Crista Wetherington, Ph.D., pediatric psychologist: There's some literature to suggest that rejected children, such as children who are difficult to get along with or have poor social skills, are more likely to be bullied than the quieter, shy child.

Q: What makes some kids want to bully others?

Reed: It is a common bullying myth that bullies have low self esteem and are loners. In fact, most bullies have average to above-average self esteem and usually have little trouble making friends. It's important to remember that bullying is not a form of conflict, it is a form of victimization. Bullies often act out of a feeling of contempt toward their victim, whom they feel is somehow inferior.

LeVieux: There's a nonprofit group in Dallas called the Bully Suicide Project, and they've interviewed kids about this. They've found that a lot of kids who've been the bully said they didn't understand the person they were targeting, or they thought of their targets as different from them. Also, if children or teens are being bullied at home or by their peers, bullying others is a way to take it out on someone else.

Q: If a child is being bullied at school, what steps should parents take with school representatives?

Reed: Parents should contact their child's teacher or school counselor to ask for an in-person meeting, and emphasize that they want to work with the staff to find a solution. Set a follow-up appointment to talk about any progress that's been made. Make it clear that you expect the bullying to stop.

LeVieux: If the parents have already talked to the school and nothing's being done, then use other approaches, such as going to the school principal. If that doesn't work, then go one step above and talk to the school district.

Q: Jane, you meet with patients in the Emergency Room at Children's who come in when they're in emotional distress and may be having thoughts of suicide. How many children come to the ER in this situation?

LeVieux: We see about 20 kids a week who are in a moment of crisis, and I'm estimating about 35 to 40 percent bring up bullying.

Q: For those who have been bullied and have thought about suicide, what tools do you provide them with?

LeVieux: We help them write down the triggers that cause the emotional distress. That way, when they have these thoughts, they know some things they can do to alleviate the feelings. We teach children deep breathing techniques, or we find out what they can do physically to alleviate those feelings — like bouncing a basketball or kneading some clay or doing artwork.

Q: How can parents help their child who has been bullied?

Reed: It's important to try to empathize with your child. Don't blame your child for being bullied, and don't minimize your child's feelings. Kids who have been bullied need to know that the bullying is not their fault and that you intend to do everything in your power to make the bullying stop.

At the same time, parents can also help kids figure out what, if anything, it might be that makes them less socially successful. For example, if the child has trouble with interrupting people, it would be great for a parent to say something like, "I've noticed that sometimes when your friends are talking, you jump in and interrupt them. Do you think that maybe that bothers them? Would you like it if someone interrupted you when you were talking? What can we do together to help you to be better about not interrupting people?"

Parents can also role-play assertive ways for kids to communicate with bullies. When approached by a bully, parents might recommend walking away to a friend or safe person, laughing it off, directly telling bullies to "knock it off" or, if the bullying persists or becomes physical, telling a trusted adult that you and your child have identified ahead of time.
Assertiveness and strong social skills will help kids now and in the future.

Most importantly, make sure your child has a safe and loving home environment where he or she can take shelter physically and emotionally. Parents can help make this a reality by eliminating sibling bullying and by keeping lines of communication open with their kids.

Q: Is there a way to prevent bullying?

Wetherington: This really comes down to changing the culture of schools and other environments where children are to not tolerate bullying. It requires a strong commitment from school staff, school administration, and from parents.

A big thank you 191 new registrants!

The 21st annual Be The Match Bone Marrow Drive was quite the success yesterday, and we want to thank the 191 people that came out to our Dallas and Legacy hospitals and joined the Marrow Registry. That means potentially 191 children could receive a life-saving bone marrow or stem cell transplant.

For those of you who still want to get on the registry and be available to save a life, Children's will pay for your online registration through Feb. 29. To send away for a free kit, visit http://marrow.org/Join/Join_Now/Join_Now.aspx and enter the coupon code "childrens."

Many thanks again. We would love to hear from those of you that came out the drive yesterday and what made you want to join the registry.

The Secret Life of Girls

I can’t imagine being in middle school today. When I was in seventh grade the first online instant messenger was launched, the likes of Cindy Crawford graced magazines, and the only phone I had was connected to a wall. But today, girls in middle school now send hundreds of text messages each day, are connected to more friends than I can imagine online, and the pressures of being perfect seem to be much greater.

When did growing up get so hard?

This Friday Dallas Children’s Theater kicks off the production of The Secret Life of Girls - a play that looks into the world of a group of girls who struggle with issues of body image and the destructive effects of bullying. And, on Feb. 10 and 18 two of our experts from Children’s Medical Center will host a live Q&A to answer any questions you might have.

The Secret Life of Girls will run Feb. 10-26 with tickets starting at only $20. You can purchase your tickets online at the Dallas Children’s Theater Web site by visiting, www.dct.org.

If you plan to attend here are a few questions to think about. Do you have any questions of your own? How do you talk to your girls on topics such as these? Let us know.

• Think about the play’s title, “The Secret Life of Girls”. Why do you think the author chose this title? Do girls tend to lead “secret lives”?
• What qualities does a good friend possess? Is it possible to be a good friend to others if you’re not a friend to yourself?
• How does our society contribute to the lack of esteem in girls today? What issues do girls face that have arisen from our society’s projected image of “the perfect woman”? Consider the physical, intellectual, social, and emotional expectations of a “perfect woman”.
• What do you feel is the greatest source of pressure for teens today? Is it society’s expectations, the media’s perceptions, peer pressure, parental pressure? What can be done to alleviate some of the pressures you face as an adolescent in today’s world?

Sea World Visit Makes a Splash

A few dozen patients had the chance to shake their tail feathers with some exotic visitors yesterday. SeaWorld San Antonio was gracious enought to bring a few of their non-marine animals for a show and learn visit.

Keepers talked to patients and their families about the importance of protecting our costal marshlands so native Texans like Padre the Roseate Spoonbill, pictured below with keeper Clay, could continue to call Texas home.

Below, Luna the Virginia Opposum, another native Texan, was a hit with patients.

Although shy, Tafari the Red Ruffed Lemur shown below with keeper Clay, drew oohs and ahs.

But the visitors that really stirred up the patients and drew the most questions were Pete and Penny the Magellanic Penguins, which are native to South America. Magellanic Penguins are one of 17 species of penguins and are a temperate species, meaning they like warm weather, unlike their Arctic cousins, who have twice the number of feathers as Penny and Pete to keep them warm.

The number one question from patients about the animals was, "Can I touch it." But no need to fear, the animals kept their distance and posed no infectious risk.

Some solutions for "lifestyle change"

So, we bogged you down with the dilemma of the pediatric obesity epidemic yesterday. Then we told you that you shouldn't have your child diet if he or she is obese. And, to top it all off, we gave you the vague solution of "lifestyle change" as an alternative to dieting.

We're aware of how ineffective that advice would be without more details. So, we went back to our clinical dietiatian and pediatric obesity expert, Deborah Stern, to get some specific ways to encourage your child to adopt a healthy lifestyle instead of a one- or two-month dieting fad.

1)It all starts with you - Stern sees patients who struggle with obesity every day. The ones who succeed, she says, are the ones who have parents not only encouraging, but participating in the weight-loss process. "It's the parents who have instilled these behaviors in the kids. So, the parents need to decide to change as a family. It's nice when the parents switch their eating and exercise habits, too. That shows the kids that getting healthy isn't a punishment for something they've done wrong and that they aren't in it alone."

2)Make activity changes before diet changes - Increasing activity can be a fun way of easing children into a healthy lifestyle, Stern says. "That way, you're making it more about what you can do instead of what you can't do. You can go to the park and play ball as a family, or you can go to the mall and walk if it's cold outside. You can also set up the Nintendo Wii or Xbox Kinect and do a dance video together."

3)Make fruits and veggies plentiful and available - Repeatedly offer fruits and veggies to your children throughout the day. Leave some (ones that don't go bad in room temperature) out on display. Basically, inundate your kids with the idea of eating fruits and veggies. "If children aren't offered fruits and vegetables multiple times, then they aren't going to choose fruits and vegetables," Stern said.

4)Pack their lunches - Although it's getting better in some places, our children are still basically offered what we were offered in school cafeterias - soggy, greasy pizza; french fries; sodas; corn nuggets; taquitos; and other various non-green things. They aren't exposed to a whole lot of variety there. And since they spend more waking hours at school than at home, guess where they're forming their eating habits? "I know that packing a lunch is a time and money challenge for families, but if you can do it, I think it's very helpful," Stern said.

One basic packed-lunch menu she suggested: a wholegrain or wheat sandwich/wrap with lean protein like ham or chicken; chopped up cucumbers or carrot sticks; granola bar; light yogurt; and a bottle of water.

5) Do it all gradually - "I would advise against bombarding them with lifestyle changes," Stern said. "Maybe there are three things they can work on one month. When the month is over and those are accomplished, we can give them three new goals. But when they have 10 things to change at once, they generally get more discouraged - especially if it's 10 things thrown at them at the beginning of the weight-loss process."

Dieting isn't the way to lose weight for kids

As we've addressed many times and as you've literally seen hundreds of times on the news, childhood obesity is a problem in America. Many well-informed, concerned people would even take it a step further and say that it's an epidemic. That group includes many experts on our team at Children's.

So, it seems like we should be doing whatever possible to get kids to lose weight, right? (For examples of "whatever possible," see this story on tracking devices in a New York school district and a recent ad campaign by the Georgia Children's Health Alliance.)

Maybe not, revealed a recent University of Minnesota study . The results of that study indicate that teens shouldn't even be dieting.

Why? Children's clinical dietitian Deborah Stern said dieting "implies the starting and stopping of something. And eating healthy shouldn't be a temporary thing. It should be a lifestyle change."

The teens who participated in the Minnesota study proved Stern's point. The ones who regularly dieted, skipped meals and took weight-loss pills actually gained more weight in young adulthood than the ones who didn't take any of those measures.

The problem with diets, medicines, fasts and cleanses is that they're usually unsustainable over the long haul. "They set you up to fail," Stern said. Teens (and some adults like the one writing this blog) get pulled into them because they often do provide significant short-term results, and they see the dramatic transformations people undergo from drastic diet and fitness adjustments on shows like NBC's "The Biggest Loser."

"I have to admit that it's one of my favorite shows; I watch every episode," Stern said. "But kids have to understand that all the contestants do 24 hours a day, every day is workout and diet. They don't see family. They don't go to work. It's unrealistic."

Stern said that it's vital that weight loss goals be realistic for kids. Instead of focusing on losing 20 pounds in one month by eating only lettuce, they need to look at getting healthy as a process, adjusting their lifestyle a couple of steps at a time. That may result in less drastic weight loss in the short term, but it will equip them to be healthier in the long term.

"If kids don't look at being healthy as a lifestyle, they're never going to develop healthy habits," Stern said. "Instead, they'll develop habits of trying new diets and then dropping them entirely, which isn't healthy at all."

So, how do you help your child make being healthy a lifestyle instead of just a one-month goal? We'll talk about that in tomorrow's blog.

Celebrating Dr. King

If you will be at the hospital this week, be sure to stop by these events in honor of Dr. Martin Luther King, Jr.

Monday, Jan. 16Noon to 1 p.m.
Character Chorus, Bray Elementary School, Cedar Hill
Butterfly Atrium, Dallas campus

2 p.m.
Service honoring The Rev. Dr. Martin Luther King, Jr.
Abbott Chapel, Legacy Campus

Tuesday, Jan. 172 to 3 a.m.
Chapel Service for night staff
Haggerty Chapel, Dallas campus

Thursday, Jan. 192 to 3 p.m.
“A Slice of the Rainbow” – Storyteller/Musician Doralynn Breedlove,
Butterfly Atrium, Dallas campus

Friday, Jan. 2011:45 a.m. to 12:30 p.m.
“Remembering The Rev. Dr. Martin Luther King, Jr.”
Haggerty Chapel, Dallas campus

Week-long Events

Daily devotionals in Haggerty Chapel from 11:45 a.m. to noon featuring tributes to world leaders who stand for peace; musicians and vocalists invited to perform

Poster display featuring winners of Nobel Peace Prize

Table tents and quiz cards in The Dining Car

The flu frenzy

My first child, the darling Emerson Lee Foster, was born at the end of November. The first six weeks of her life have been full of love, joy, celebration and... a lot, lot of paranoia.

Seems like all I can think about sometimes are bad drivers, BPA, blocked airways, falling picture frames and contagious diseases. Yes, I drive myself crazy. And it's been especially difficult to keep my sanity as I've started hearing an excessive amount of sniffling and coughing the past few weeks. In the office. At the store. All over the mall.

I can't escape it. The flu season is revving up. But, luckily, I have the experts at Children's to help me make it through - as you do, too.

So, I asked the director of the infectious disease department at Children's, Dr. Jeffrey Kahn, if he could give us some advice on keeping our children healthy the next couple of months.

Me: When is it safe for parents of babies to take their children out in public places? 8 weeks, 12 weeks, 6 months? Or should they just refrain from taking babies out into crowds during flu season?

Dr. Kahn: There are no official recommendations from the Centers for Disease Control that specify the age that young children can be safely taken to public places during influenza season. The best advice for parents and other caretakers would be to be cautious when influenza is circulating in the community. That information can be found at the CDC website (or follow the CDC's Twitter account that focuses entirely on flu news, @CDCFlu). Good hand washing for anyone who will hold/touch the child will also decrease the risk of influenza transmission. The best way to protect young children from the flu is vaccination (when they reach the appropriate age of older than 6 months). Also, vaccination of all those who come in regular contact with the baby (since a large proportion of influenza infections are acquired from infected individuals within the home) is the best way to protect children who are too young or not eligible to receive the vaccine.

Me: Is it a good idea for children to receive a flu vaccination now if they haven’t already received one? Is it too late?

Dr. Kahn: There is still time for children to get the influenza vaccination. At this time, there is still little influenza activity in north Texas suggesting that the “flu” season is yet to come. Vaccination is the BEST way to protect children from the flu. There are no school requirements for flu vaccination BUT All children who are eligible should be vaccinated.

Me: Is there a difference in the effectiveness of the flu shot and the flu mist?

Dr. Kahn: For the most part, these vaccines are of equal efficacy. For children who are eligible for either vaccine, the decision can be made by the parent, clinician and/or the child!

A visit with a "notorious" patient

A few weeks ago, I had the opportunity to meet a special patient, Zach Guillot. The 7-year-old is notorious, as his mom says, around the hospital because of the “antics” he’s involved in on the floor where he is undergoing chemotherapy and waiting to receive a second bone marrow transplant.

Zach was readmitted to Children’s Dec. 16 after relapsing from his battle with acute myeloid leukemia.

One of his antics includes riding his Big Wheel around his impatient floor at night. And he's recently found fame among Children’s employees for the videos he and his Child Life specialist have recorded.

Among the 14 videos on his YouTube channel, there’s a legendary lightsaber duel between Zach and his “Sith Nurse” caught on camera, animated shorts and adventures as Indiana Jones and Ironman.

When I walked into his room, he introduced himself with some playful meowing. Being a bit of a kid myself, I thought it was hilarious. But I really had to hold back from laughing when he welcomed his doctors to his room by hissing.

Zach’s mom Julie said she and her husband Jeff have appreciated how the staff at Children’s has allowed Zach to be himself during his stay in the hospital.

“There’s more to recovery than medicine,” Julie said. “The staff keeps it lighthearted and play with him. It really helps with the whole experience. It’s the little things that can make a kid feel better.”

I certainly saw that's the case with Zach. It’s so encouraging to see a young child being himself, in high spirits, playing Wii and meowing at guests, while going through something as challenging as chemotherapy.

If you’re interested in helping kids like Zach, join the bone marrow registry or participate in the Be a Match Bone Marrow Drive held at Children’s annually on Valentine’s Day. For more information on times and locations for the drive visit marrow.org.