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.

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."

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!

Rare diagnosis, even rarer treatment

Around this time last year, Jennifer Matlock noticed that her 14-month-old daughter, Peyton, was showing some concerning signs. Her stomach hurt and there was drainage from her belly button.

Jennifer didn't know if it was a big deal, but she felt like safe was better than sorry, so she took Peyton to see her pediatrician, Dr. Elenna Chinn at Rockwall Pediatrics. Dr. Chinn decided after examining Peyton that she needed a follow-up appointment with a specialist; so, she referred her to Dr. Patricio Gargollo, a urologist at Children's.

As soon as Dr. Gargollo saw Peyton, he suspected she had a urachal cyst. An ultrasound confirmed his suspicion.

"Urachal cysts only occur in about one in 5,000 patients," Dr. Gargollo said. "I had only seen two cases before Peyton in my career. But her symptoms were distinct, and we take urachal cysts very seriously because they may lead to urachal cancer if left untreated."

Urachal cancer is one of the worst types of urological cancer. It's extremely aggressive and fatal for nearly everyone who gets it.

HIdES procedure saves the day
If you're like me, you'd expect that there would be an extensive, taxing procedure for such a potentially dangerous condition. But if you're like me, you also don't have the medical expertise of Dr. Gargollo.

Dr. Gargollo invented a new surgical procedure called HIdES earlier this year. It's detailed in this article, but the gist is that he's able to perform elaborate robotic surgeries through two tiny incisions directly beneath the waist line and one incision in the belly button.

The benefit of the procedure is that the resulting scars are hidden behind swim suit bottoms when children like Peyton go to the beach. And for Peyton, that meant the day after surgery.

Because the incisions with HIdES are so small, Peyton was fully recovered the day following her cyst removal and able to leave directly from the hospital for a beach vacation with her family.

Now, a couple of months later, Dr. Gargollo is confident her cyst will not return.

"She's doing really well," he said. "There's no reason to worry about the cyst coming back, and there's no evidence that she ever had it removed because her scars are hidden."

Peyton's mom is grateful.

"We were confident going into the surgery, because we had done our research and knew Dr. Gargollo was going to take care of it," Jennifer said. "She's bounced back completely, and we're just happy that what could've been a really big deal didn't have to be."

A search for support

Life is frustrating. Work is hard. Family is harder. And cars always have something wrong with them. But I can at least take comfort in being able to share my gripes with others who endure the same things.

It's not that simple for Jennifer Cagle. Her 6-year-old son, Tanner, suffers from a disease that affects only 15 in every 100,000 people. You don't need to be a mathematician to know that means very few people can relate with what she goes through as Tanner's mother.

"When I tell people that my son has nephrotic syndrome, they don't even know what it is," Jennifer said.

Nephrotic syndrome is a kidney disease that causes the body to excrete too much protein in urine. It results in kidney damage and excessive fluid retention.

Tanner's case is so severe that he will eventually require a kidney transplant to survive. But, because of the way his disease works, his body will most likely attack the new transplant, too.

Focusing on the present with the President
Jennifer doesn't know Tanner's longterm prognosis, but she doesn't focus on the uncertainty.

"I can either mope and be depressed about it and be like, 'Oh, poor me. Poor him.' Or I can enjoy every moment that I have with him, especially when he is in remission because those moments can be taken away so fast. I don't want to have regrets. And I would regret burying my head in a pillow and missing out on his life."

Tanner is currently in remission and has been for the last several months. Although Jennifer is grateful, she knows it won't last forever.

Her main focus now is raising awareness of the disease. She helped organize the NephCure Foundation's first-ever walk in Dallas this past April, which ended up raising around $14,000. She has also gotten the word out by exchanging letters with President Obama about her son's illness.

Looking for a support group
Jennifer hopes that generating attention about nephrotic syndrome will encourage more research of the disease, which hopefully one day will lead to a cure. But her efforts aren't solely geared to that end.

She also just wants to find people to talk with about the disease.

"I want to meet other people in Texas who deal with this disease," she said. "Maybe we could develop some sort of support group and help each other."

Editor's note: If you've personally encountered nephrotic syndrome or know anyone who deals with the disease, will you please post a comment to show Jennifer that there are other people around her going through the same thing?

A first-hand account on sports supplements

Although the image I see in the mirror every day makes it harder and harder to believe, I once was a high school running back. I may not have been a very good running back, but I was a running back nonetheless.

As is the case with most running backs not named Bettis, Dayne or Lane, keeping fit was paramount for me. I'd work out in some form or fashion every day (which I later discovered to be counterproductive) and was an absolute fanatic about what I ate. Ask my poor mother, who had to endure my high-maintenance diet night after night.

"Hey, Craigo, what do you want for dinner tonight? Lasagna? Pork chops?" she'd ask me.

"Anything without fat in it, Ma. I don't want any of the Devil's food (my affectionate term for high-fat items)."

Most nights we'd eat grilled chicken salad. But I had extreme periods where I only ate fat-free deli meats and cheese slices. Obviously, like the daily workouts, this was actually worse for my health, but I didn't see it like that.

I was going to be the best high school running back I could possibly be. Keeping fat and calories out of my body, I thought, was essential to that goal.

Along came supplements
My obsession with fitness eventually led to me looking for some external boosts as well. To my credit, I never tried steroids because I knew about their dangerous consequences. BUT I did try everything I could buy over the counter without knowing a thing about their consequences: protein shakes, amino acid pills, creatine, androstene, fat burners and all sorts of different combinations of them together. I even took pseudophedrine every morning because I heard it increased your metabolism.

By grace alone, I survived all of my supplement experiments without incurring any long-term health damage - at least, that I'm aware of. But the more I learn about supplements as a medical writer, the more amazed I am that I didn't turn out worse for taking them.

Androstene, which Mark McGwire made famous during his "magical" 1998 home run barrage, was taken off the market in 2004 in the U.S. because it was found to potentially have some of the same side effects as anabolic steroids: testicular cancer, infertility, stroke and an increased risk of heart disease. Several of my teammates and I took it because we wanted to get stronger.

The fat burners, which I took daily, have even led to deaths. As for the creatine and protein shakes, they aren't nearly as harmful, although both in excess can lead to kidney issues.

Older and wiser (or, at least, better informed)
I don't obsess about exercise and diet today nearly as much as I did in high school. In fact, I have thought about them so little the past few years that I'm having to re-discipline myself to get in healthy BMI territory. It's hard. My wife can attest, because she's now enduring my same narrow diet demands that my mother dealt with when I was a teenager.

I have entertained the idea of using some of the same supplements I used to take, but those ideas don't last long. I always come back to one main thought: "It isn't worth the risk."

Dr. Shane Miller, a pediatric sports medicine specialist at Children's, agrees, especially in the case of young athletes. Supplements don't require FDA approval, and no studies have been performed to see their effects on childrens' bodies.

Moreover, he adds, they really haven't been proven to increase athletic performance at all. I can personally verify this since all of my supplement ingestion resulted in a whopping ZERO scholarship offers.

"If young athletes are eating healthy and working out, they don't need supplements," Dr. Miller says. "The body makes most of the things in supplements on its own, and we also get them from foods in our diet."

So, if your young athlete insists that he has to have supplements to be a good football player, tell him that he can get all the strength-building nutrients he needs from a balanced diet. Better yet, if he's anything like I was, tell him to enjoy an occasional hamburger.

Back to school

Brianna Lamar is one of many 14-year-olds in North Texas who began their first week of high school on Monday. When I spoke with her a few weeks ago, she didn't seem worried at all about the adjustment.

"I'm looking forward to it," she said. "It's going to be a little different, because I'm going to be doing a lot more. I'm going to have to balance out a way to be on the debate team, student council and band. And all of my classes except for two are going to be advanced placement."

She wasn't worried about fitting in. Or harder classes. Or growing up. She wasn't worried about any of the typical things high school freshmen worry about.

What did worry Briana? Getting a scratch in PE. She's HIV positive and has been since birth.

But there is a lot more to her than that, as you can tell by the excerpts from our conversation below. A full story on Briana will run in the September issue of Children's Connect.

"I went to Camp Hope this summer. It's a camp full of kids who have HIV. This was my seventh year to go. It's pretty neat to see a bunch of kids just like me and make friends with them. We do outdoor stuff like canoeing, kayaking, riding bikes and going down a zip line. It's a lot of fun. I'm sad, because next year will be my last year to be a camper."

"I don't think about HIV all of the time, but there are times when I do. I wonder what stage it's in. I wonder how big it's gotten. I wonder if my medicines are shrinking it any."

"I call the people who don't have HIV 'The Normals.' It takes them days and weeks to get sick. But for me, sickness can advance within a matter of minutes or hours. And if it lasts for days to weeks, that's when it really gets a lot worse for me. That's why I have to take my medicine every day."

"There are two people that I consider my closest friends. You know, you tell somebody and they usually tell someone else. But I told them (about my condition), and they don't tell anyone else unless they ask me first. They keep it to themselves, and they don't threaten to tell other people if we get in an argument or anything. That's what I really like about them. They're the two most loyal friends I've had."

"When I turn 16, I'll have to get a job. I would love to intern at a veterinarian's office. I'd just like to work with animals in any way possible."

"I've already decided where I want to go to college: Texas A&M. They have a great veterinary program. For my undergrad degree, instead of doing it in 4 years, I'm going to do it in 2. And for my grad degree, instead of doing it in 4 years, I'm going to finish it in 2 also. And then I'll have a 2-year internship with a vet. And then I'll set up an animal sanctuary somewhere in the country in Montana. But not too far from the city."

Children's leading the battle against child abuse

While the conclusion of April may mean the end of temporate weather in North Texas, the REACH staff at Children's is making sure that the end of the "National Child Abuse Prevention Month" does not mean the end of child abuse prevention.

Through clinical care, education, research and public advocacy, the REACH team led by Dr. Matthew Cox is setting the standard for child abuse prevention in Dallas.

"We're just trying to get through each day to make a bigger impact in the lives of children," Dr. Cox said.

Read more about the REACH team's efforts in a story on childrens.com.

We're coming to Southlake

As The Dallas Morning News reported in today's paper, Children's is opening a new outpatient specialty care center in Southlake in 2011.


The new 34,000 square-foot facility will be located in Southlake's Carillon development. It will offer pediatric sports medicine, urology, gastroenterology, imaging and other services.

Since more than 500 Children's patients already live in Southlake and recent reserach projects that number to grow yearly, the need for the new facility is evident.

But if you need more convincing, Denise Stone can help. Her son, Billy, has type 1 diabetes, and the two of them have to make the trek from Southlake to Dallas regularly for Billy to receive the care he needs.

"When you've got a child with a chronic, life-threatening illness, you want the best medical care you can get," she said. "Having that right here in our own backyard would just give us so much peace of mind."