Experiences that met expectations

Before Destani Anderson served as the ballgirl at the NBA All-Star Celebrity Game last weekend, her grandmother told me that she believed it was the chance of a lifetime.

Destani rebounded balls for celebrities during warm-ups and passed out water and towels to them during the game. She met Terrell Owens, Magic Johnson, and Mario Lopez, but her favorite encounter was with Drake.

“I went up to him and said, ‘I’m your biggest fan. I love you so much,’" said Destani. "And he autographed my shirt and gave me a hug. It was awesome.”

Another life-changing experience

Less than a year ago, Destani would not have been able to have an experience like that. Her end stage renal disease prevented her from doing "the things I wanted to do." She couldn't even sleep over at friends' homes, because she had to undergo dialysis at her home every night.

But in Sept. 2009, Destani became the 367th recipient in the kidney transplant program at Children's, which is a leader in the number of pediatric transplants performed each year in Texas. Her life made at least a 175-degree, if not 180-degree, turn following that surgery.

"I feel like a new person," Destani said. "I can't explain it, but once I got the new kidney, everything just became clear."

So, Destani is a pretty fortunate girl. She has had two "chance-of-a-lifetime" experiences in the last six months. How many people can say that?

Dasia's oxygen

Dasia White, 6 years old, looked quizzically at the machine that was about to take her oxygen measurements, but once the nurse touched her forehead with a probe from the machine, she was OK with the whole process.

Dasia has sickle cell disease and is part of a clinical study at Children’s of cerebral oximetry, a non-invasive technique to measure the levels of oxygen in the brain. The study is led by Dr. Charles Quinn, a pediatric hematologist-oncologist at Children’s and director of the Sickle Cell Disease and Thalassemia Program.

Children with sickle cell are at high risk for stroke, a consequence of the blood disorder where sickle-shaped red blood cells tend to “stick” together. Because sickled cells do not flow readily past one another, they can more easily form clots that can cause a blockage or rupture of a blood vessel in the brain — a stroke — leading to a host of serious problems such as paralysis, speech problems and poor coordination.

By measuring oxygen levels in the left and right brain, Dr. Quinn aims to determine normal values for cerebral tissue oxygenation in children with sickle cell disease. Eventually, he hopes to find there is a connection between a lower oxygen-carrying capacity of the body’s blood and stroke.

Children’s, one of the top hematology-oncology centers in the country, sees nearly 700 patients with sickle cell each year.

Because the hospital has such a high volume of patients with the disease, we can offer research studies like Dasia’s that can help researchers to better understand the disease and perhaps one day cure it.

All-Star opportunity worth a trip in the snow

Well, if you heard about Dallas' record snowfall yesterday, you can be sure of one thing: Only the truly motivated are braving the roads today. One of those is one of our patients, Destani Anderson. The 15-year-old cheerleader from Italy, Texas, is making the trip to Dallas to be a ballgirl in the NBA All-Star Celebrity Game, which will air live on ESPN at 6 p.m. tonight.

Destani, who received a kidney transplant at Children's in Sept. 2009, was invited to participate in this unique opportunity by Zo's Fund for Life. The charity's namesake, Alonzo Mourning, is a former NBA All-Star who received a kidney transplant of his own during his playing days. Tonight, he will coach one of the celebrity teams that includes Terrell Owens, Chris Tucker and Dr. Oz. The other celebrity team includes Dallas Mavericks' owner Mark Cuban and will be coached by Magic Johnson.

"I'm so excited," Destani said. And she wasn't just talking about interacting with celebrities on national TV. She is genuinely excited about seeing some basketball. Her condition prevents her from actually playing, but she serves as the manager on the varsity girls basketball team at Italy High to be close to the game.
"I love basketball," she told me. "It's fun. It has energy. It's fast-paced. And I like that it requires teamwork."

For those of you who will be thawing out inside tonight, please tune in to ESPN to see our All-Star ballgirl in action. She'll be the one with the big smile on her face. I'll follow-up early next week with an account of Destani's experience.

Time to untip the scales

Let me share a few facts with you:

• One in three American children is overweight or obese.
• Billions of dollars are spent every year treating obesity-related conditions.
  
• Public health experts say this generation of children is on track to have shorter lifespans than their parents.

I (like you may already have done) read these facts in a news story about Michelle Obama’s new campaign against childhood obesity called “Let’s Move.” And they shocked me. And I was shocked that they shocked me. I work in a pediatric hospital. I write about programs whose sole purpose is to treat childhood obesity. I hear these facts all the time. I should be used to them by now.

But daily seeing so many children who have no control over their diseases or injuries or the ability to cure them has made me sensitive to an epidemic that could be resolved with positive habits.

Dr. Jon Oden, a pediatric endocrinologist at Children’s who works in the Center for Obesity and its Consequences in Health (COACH) Clinic, says the best way to combat pediatric obesity is early prevention. Instead of waiting until your child has become obese and begun suffering negative health effects like Type 2 diabetes, it's better to instill healthy routines that prevent your child from becoming obese in the first place.

Not easy but simple
As I’ve written here in a previous blog, I struggled with weight issues as a child. I know that kids don’t decide to be fat. Some of us are naturally disposed to being overweight or obese. Overcoming that requires supernatural discipline. And parents don’t always have the time to monitor their kids’ diet and activity. Simply put: Preventing obesity isn’t easy. On the other hand, the steps to take are not complex.

A new study that will be published in the March issue of Pediatrics suggests that three simple home habits go a long way toward preventing preschoolers from becoming obese:

1. Eating the evening meal as a family five or more nights a week.
2. Getting more than 10.5 hours of sleep per night.
3. Watching less than two hours of TV, video or DVDs a day.

What does the latest vaccine news means for parents?

You may have seen in the news this week that the major British medical journal The Lancet has fully retracted from the medical record a controversial 1998 paper that proposed a link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders. The 1998 report led a number of parents to decide not to immunize their children against MMR.

About the retraction, The Lancet said it was “because it has become clear that several elements of the 1998 paper by Wakefield et al., are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were ‘consecutively referred’ and that investigations were ‘approved’ by the local ethics committee have been proven to be false.”

What does the retraction mean for parents? It means that, as before, you should continue to get your children immunized against contagious diseases such as measles, mumps and rubella, polio, diphtheria, tetanus and pertussis and yes, the flu . Since these routine vaccinations became available, the number of children with these potentially deadly diseases has declined dramatically and epidemics of these diseases have virtually disappeared.

Children’s head of infectious disease Dr. Jeffrey Kahn had this to say: “Hopefully, the retraction by The Lancet will finally put to rest the notion that vaccines are somehow associated with autism. Vaccines are the safest and most effective means to protect children against many severe and often life-threatening illnesses.”

Parents can benefit from medical articles

Robotic-assisted laparoscopic surgery in pediatric urology

When a parent faces a health crisis in a child, he or she will search far and wide for answers or information that will help. Every month, Children's publishes a mini medical journal focusing on the very latest diagnostic or therapeutic information. This information is faxed and emailed to thousands of pediatric physicians.

We know families can be desperate for any and all credible information pertaining to a child's health needs. We are now posting our journal articles online so parents with no medical training can read and learn more. This month, our FaxNotes features information on robotic-assisted surgery, what doctors call minimally invasive surgery.

Erroneous e-mail about medications falsely tied to Children's

E-mail has added a lot to our lives – maybe too much. The average person’s inbox is flooded with advertisements, inspirational poems with pictures of kittens, requests for money from exiled African royalty and the ever-present forwards from our newly-introduced-to-e-mail family and friends. With so many messages bombarding us, it’s difficult to decide which to open and read, much less to figure out what’s truth and what’s fiction.

For example, a viral e-mail is currently making the rounds between private accounts and public message boards warning of a danger posed by mixing the over-the-counter medications Motrin and Robitussin. The e-mail suggests a female hospital patient (usually named Madison or Madeline) died from cardiac arrest after her parents gave her a combination of Motrin and Robitussin. Different versions of the e-mail have been circulating the Internet for more than a year.

Don't believe it
In 2009, a Children’s employee received the e-mail from a friend and inadvertently forwarded it from a work account. Because the employee’s professional signature was included at the bottom of the e-mail, the information appeared to come from a reliable source at Children’s Medical Center. This is not the case.

And, in regard to the claim that the combination of Motrin and Robitussin causes death, don’t worry. There is no evidence to suggest that ibuprofen, dextromethorphan or pseudoephedrine can cause heart attacks in otherwise healthy children or adults when combined (if taken in the directed amounts). The FDA says so.

However, all medications can have side effects, and parents of children with underlying medical conditions must always be vigilant about the medications their child is taking. When in doubt, consult your child’s healthcare provider or a pharmacist before mixing over-the-counter medications.

So, parents, please check the sources of information you receive on the Internet when it comes to decisions about your children’s health. Their safety is too important to base off of an e-mail your great-grandmother forwarded you from a neighbor of a Bingo club friend. The best place to go for information from the pediatric specialists at Children’s Medical Center is our official Web site, childrens.com.

‘Sims’ allow medical training in real-life, real-time emergencies

“Sims” may have started with a computer family living the life you programmed for them, but it has since spread far and wide as a training concept. You may have seen medical simulation training labs on "Grey's Anatomy" where the television doctors train by using models for surgery.

Now, imagine that you’re a real doctor racing to save a dying baby. The infant is having difficulty breathing; bells and alarms are going off; and you may have to intubate. Seconds tick off as the child’s condition deteriorates, and the stress level is high.

Medical personnel can experience that sense of urgency using computer-controlled, interactive, life-size mannequins that simulate medical emergencies and function in real-time. That’s the beauty of the state-of-the-art high-fidelity simulators (sims) available at Children’s Medical Center.

The sim lab is the only one of its kind in North Texas for a pediatric hospital, making it just one more way Children’s provides unmatched expertise in pediatric healthcare.

Highly realistic, mobile sim baby, sim man and the pedi sim are the mainstays of the high-tech simulation center. The 3,000-square-foot simulation lab houses two team training rooms that recreate Intensive Care Unit and inpatient settings. The rooms, which have a separate control center, are equipped with the sims hooked up to computers, medical monitors and audiovisual equipment so the scenarios can be played back for training purposes. The center features computer stations with emergency scenarios programmed in, as well as virtual IV trainers.

In addition to the basic life support equipment, there are skill stations with task training simulators for IV starts, chest tubes and other medical procedures, as well as classrooms for debriefings after computer simulations.

The center also manages three Basic Life Support (BLS) mannequins so medical personnel can certify or re-certify in cardiopulmonary resuscitation (CPR).

An issue bigger than sports for athletes

Football is on a lot of our minds today. In Dallas, most of us are disgusted that the Cowboys only scored 3 points against the Vikings and that Favre (from Mississippi like moi) tossed his fourth touchdown with less than two minutes left in a game that was well-past competitive. I don’t really care that much about the games played this weekend, though. I am a Chicago Bears fan, which means I’m usually done cheering for NFL games long before the playoffs come around.
However, a piece of football news that did catch my attention this weekend was that Gaines Adams, a newly-acquired defensive end for my beloved Bears, died of cardiac arrest on Sunday at a hospital in South Carolina. If you ever saw pictures or video of the guy, you would be a little shocked that he died of a heart attack. He was built like a Greek god – 6’5” and 258 lbs. of granite – not like “Refrigerator” Perry. And he was only 26. But, evidently, heart problems don’t just affect the old and obese. They affect the young and seemingly healthy, too.
If you’ve been a sports fan for a while, you’ll remember the names of Reggie Lewis and Hank Gathers. Both were world-class, long, lean basketball stars when they suddenly died of heart issues playing the game they loved. Lewis was 27. Gathers was 23. Just last week, Southern Indiana basketball player Jeron Lewis collapsed in the middle of a game and died from heart complications. He was 21.

Doctors at Children's working on prevention
Stories like those initially make me feel helpless – like the sky is falling and I can’t even lift my arms to slow it down. Then I remember that – fortunately for us all – I am not a doctor, and people like Drs. William Scott and Ilana Zeltser, pediatric cardiologists in The Heart Center at Children’s, are. Instead of acting passive and defeated, they are participating in a research study to identify children who may be at-risk for sudden death episodes.
Sudden death episodes primarily occur in apparently healthy children during a time of strenuous physical exertion, and are most often attributed to previously undiagnosed cardiac diseases. Children’s is one of three institutions leading a state-wide cardiac research study to address the need for a pre-sports screening program in Texas so heart problems in young athletes can be identified before it’s too late.
Over the course of a year through this study, 15,000 student athletes received an electrocardiagram — a test measuring the electrical activity of the heart. Dr. Scott, professor of Pediatrics at UT Southwestern, and Dr. Zeltser, assistant professor of Pediatrics at UT Southwestern, are examining the electrocardiograms.
“Our goal is to establish new standards for normal electrocardiogram values in the adolescent athlete,” Dr. Zeltser said. “We are focusing on the degree to which gender, race and body mass index affect the interpretations. We hope to increase the sensitivity and specificity of the electrocardiogram as a screening tool for sudden death in young athletes.”

New warnings about an old problem: toxic chemicals in toys

New reports indicate there may be another safety hazard concerning toys manufactured in China. The issue this time is the presence of cadmium, a highly toxic heavy metal which has been found in high levels in some cheap metal jewelry.

Like lead, cadmium can hinder brain development in children and even cause cancer, according to recent research.

The danger has prompted the head of the Consumer Products Safety Commission to issue a warning advising parents to take cheap metal jewelry away from children.

Over the past couple of years, a number of toy recalls due to high levels of lead have received a lot of media attention. Toxicologists at Children’s, however, explained that the actual risk of harm was relatively small.

Still, parents should know that swallowing, sucking on or chewing a metal charm or necklace could result in exposure to lead, cadmium or other heavy metals.

The first thing parents can do is check recalls listed on the CPSC Web site. If you see any of your children's toys on the list, get rid of them. If you are still concerned about cadmium exposure, talk to your pediatrician.

For more information, Children’s has a page about poisonings and even features a list of links to other resources on the Web.

Learn More
Centers for Disease Control and Prevention

Toy Safety Shopping Tips from the CPSC