just kids | winter 2016
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Iowa ClInICNow Open Every Day 2
CHIlD SKIPPInG lUnCH?Five Reasons Why – And What to Do 4
nEw YEaR IDEaBaby-Proof Your Home for 2016 10
JustKidsWinter 2016ChildrensOmaha.org
Children’s Ambassadors: Sharing Our Dedication to the Best Possible Care p6
Your Online Source for Health InfoFor the latest information and news, support groups, events, patient stories, recipes and perspectives from our physicians, check out these online resources:
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ChildrensOmaha.org
JustKids is published by Children’s Hospital & Medical Center to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2015. All rights reserved. Printed in U.S.A.
➍ Five Reasons Your Child Skips Lunch — and How to Fix Them
➎ Healthy Kohl’s Kids
➏ Children’s Dedication to Best Possible Care Impacts Lives of Children’s Ambassadors
➑ Pulmonary Hypertension: Treating a Complex Condition Through Collaboration
➓ Baby-Proof Your Home for the New Year
Choose the Right Pediatrician
Fend Off the Flu
Contents
ChildrensOmaha.org JustKids Richard G. Azizkhan, M.D. President & CEO Martin W. Beerman Vice President, Marketing
& Community Relations David G.J. Kaufman, M.D. Medical Advisor Dannee Schroeder Senior Editor
Iowa families no longer have to cross the
Missouri River to receive specialized pediatric
care from the experts at Children’s. This fall,
Children’s Physicians opened its first Iowa
clinic, and 13th location overall, at 1022
Woodbury Avenue.
“Children’s Physicians is excited to lead
this expansion into Iowa for Children’s,”
says Steve Burnham, senior vice president
of Physician Networks and president of
Children’s Physicians and Children’s Specialty
Physicians. “We’ve launched a new model of
care in this new market that will improve
access to quality care for Iowa families, and
could become the model of care for the future.”
This new blended model of care
accommodates both scheduled appointments
and walk-in (urgent care) visits seven days a
week, including holidays. The expansion of
hours is part of Children’s Physicians’ patient-
centered medical home philosophy. A patient-
centered medical home is an approach to
providing comprehensive primary care where
the health team works with the family on all
Children’s First Iowa Clinic offers Expanded Hours of Service
2 To find a provider, call 1.800.833.3100
What’sNew?
For more information on the Children’s Physicians, Council Bluffs office or to schedule an appointment for your child, call 800.833.3100 or visit www.ChildrensPhysiciansOmaha.org.
aspects of a child’s well-being, including
medical, behavioral, physical and social needs.
Improving access to care is one of the tenants
of medical home, which is why the Council
Bluffs office offers expanded hours to be
available for families whenever needed.
This clinic is open for scheduled
appointments weekdays from 8 a.m. to 8 p.m.
and Saturdays from 8 a.m. to noon. Walk-in or
urgent care visits are welcome Mondays
through Saturdays from 8 a.m. to 10 p.m., and
Sundays and holidays from noon to 10 p.m. In
addition, the office offers radiology, behavioral
health and certain lab services onsite.
“Our presence in Council Bluffs allows us
to better serve children and families in Iowa,”
Burnham says. “Families can expect high-
quality care that’s convenient, accessible
and focused exclusively on kids.”
Beyond offering hours not available at
other Council Bluffs clinics, the Children’s
Physicians, Council Bluffs office offers the
benefit of a patient care coordinator. The
patient care coordinator works in collaboration
with the Children’s Physicians pediatrician to
make sure a patient’s – and family’s – entire
medical and non-medical needs are met.
They also work with schools, community
organizations, behavioral health and pediatric
specialists the child may see.
Children’s Physicians further provides
convenience to families through a free, online
health portal called Children’s Connect.
Anytime day or night, parents can schedule or
request appointments online, message their
child’s health care team or access and print test
results, immunization records, growth charts
and much more.
Nicole Villarreal, M.D., FAAP, will practice
at the Council Bluffs office. Dr. Villarreal
received her medical degree from Creighton
University School of Medicine and completed
her pediatrics residency through the Creighton-
Nebraska Universities Health Foundation
Pediatrics Residency Program. She has
been a practicing physician since 2008,
with the past four years at Methodist
Physicians Clinic at Jennie Edmundson
in Council Bluffs.
Several non-physician providers
will work with Dr. Villarreal to provide
both primary and urgent care services
for patients, including nurse
practitioners Amy Jorgenson,
Cheryl Calabro, Tara Goodman
and Chelsey Turner, and
physician assistant Kelsey
Stoysich.
From the specialized staff
to the state-of-the-art services
to the expanded hours of care,
Children’s newest clinic proves
it is the best place for kids in
Council Bluffs.
3 To find a provider, call 1.800.833.3100 ChildrensOmaha.org 3
4 To find a provider, call 1.800.833.3100
Reasons YouR Child SkipSlunCh—and how to Fix them
5
4 To find a provider, call 1.800.833.3100
healthy eating
ChildrensOmaha.org 5
LeARN MORe ONLiNe WiTh heALThY KOhL’S KiDS
Healthy Kohl’s Kids is a partnership between Children’s Hospital & Medical Center and Kohl’s Department Stores focused on educating children and families on the importance of good nutrition and fitness. The program’s website, www.HealthyKohlsKids.com, features up-to-date fitness and nutrition info, and advice for children and parents. Healthy Kohl’s Kids invites parents to engage via social media on Facebook, Pinterest and Twitter (@HealthyKohlsKid).
Kirstin Grahn, M.D.Children’s Physicians
You spend hours finding and preparing just the right mix
of healthy, kid-friendly foods. You slice off crusts and use
cookie cutters to turn sandwiches into hearts and stars.
But still, at the end of the school day, you open your child’s
backpack and find lunch unopened.
Many factors can lead kids and teens to snub their
midday meals. Some of these reasons have nothing to
do with taste or even presentation. We’ve identified five
reasons home-packed lunches go uneaten – and how to
pack the box or brown bag to ensure your child consumes
a full, nutritious meal.
“Consuming a nutritious lunch benefits kids in many ways, including keeping their bodies healthy and giving them the energy to power through the school day,” says Kirstin Grahn, M.D., Children’s Physicians. “It is critical to instill healthy eating habits in young children as this carries with them through their lifetime.”
1 The issue: Loose or missing teethAround age 6, kids start shedding their baby teeth.
Wobbly or missing canines and incisors can make some
foods difficult to bite.
The Fix: Choose easier chewsTry chopping foods up into smaller pieces – say, wedges
instead of whole apples. Steer clear of sticky items like
raisins and dried apricots. And cut back on sugary
beverages, hard candies and caramels. They cause
cavities in both baby and permanent chompers.
2 The issue: Quitting meatAt about age 6 or 7, kids start to understand
where food comes from and what it means to eat animals.
Some may suddenly turn vegetarian.
The Fix: Pack alternate proteinsRegardless of whether they follow it for a day or a lifetime,
kids can get all the nutrients they need from a meat-free
diet. Just swap out that turkey sandwich for a veggie-
friendly protein source. Healthy, portable options include
hard-boiled eggs, peanut butter sandwiches and cartons
of Greek yogurt.
3 The issue: Fear of weight gainPreteen and teen years bring peer pressure to a
whole new level. Suddenly, adolescents become aware
of their weight and body image in an entirely new way.
Some start cutting calories or food groups.
The Fix: Straight talkDon’t mess around with this one. Fad or overly restrictive
diets can deprive your child of the nutrients needed to grow
and develop. Keep tabs on your child’s eating, and speak to
your child’s physician if you have concerns about your child
regularly skipping meals or unhealthy weight loss.
4 The issue: Feeling forced You might have gone out of your way to choose all
your kid’s favorite foods. Still, kids who don’t have a hand in
deciding what goes into a meal are less likely to consume it.
The Fix: Offer optionsAgree on some basic ground rules. For instance, each lunch
should contain a protein, a whole grain, a fruit and a veggie.
Then let your child select the specifics. Even better, involve
young hands and minds in making the shopping list, filling
the cart or stacking and packing the bag or box.
5 The issue: SpoilageNothing ruins lunch more quickly than sour meat,
rotten veggies or a moldy cheese wedge. Perishable foods
require proper chilling. Otherwise, you risk making your
child sick from food poisoning.
The Fix: Use cool toolsIf you pack lunch the night before, keep it in the fridge
overnight. Send it off in a thermos or an insulated lunch
bag with an ice pack. Or use a frozen water bottle as an ice
pack – when it melts, it doubles as a healthy beverage.
ChildrensOmaha.org 5
6 To find a provider, call 1.800.833.31006 To find a provider, call 1.800.833.3100
success stories
CAMPBeLL — GASTROeNTeROLOGY & Gi SURGeRYPlaying with her friends and dancing – those are
two of Campbell’s greatest joys. But life hasn’t
always been graceful for this rising star.
Diagnosed with Crohn’s Disease and
autoimmune hepatitis as a toddler, 5-year-old
Campbell has been partnering with Ruben
Quiros, M.D., clinic service chief for
Gastroenterology, and the entire GI team at
Children’s to keep her healthy. They lend
expertise and steady reassurance; Campbell
takes her medication several times a day
and comes in for her regular checkups.
“We love the doctors and the nurses,” says
Breann, Campbell’s mother. “They’re all very
understanding, caring people. When we have a
setback, Dr. Quiros shares our pain with us and
understands. He is very personable and reassuring.”
Staffed with pediatric specialists, certified
pediatric nurse practitioners, nutrition
specialists and registered nurses, the
Gastroenterology Department at Children’s
offers comprehensive diagnostic procedures to
aide in diagnosis and long-term treatment plans
for patients like Campbell. The department also
features sub-specialty clinics unique to
Nebraska, including clinics for food and
hypersensitivity disorders, liver disease and
inflammatory bowel disease.
At one point, Campbell wasn’t growing quite
as fast as she should be – but now she’s back on
the charts, and her sense of humor and
signature dance moves are in full effect.
“She’s very happy,” Breann says. “She loves
being around people and playing with her friends.”
a bUDDInG DanCER. an oUTGoInG aRTIST. a THREE-SPoRT aTHlETE. Their passions vary, but they share one very important distinction – each affirms the high quality, pediatric care that distinguishes Children’s Hospital & Medical Center and makes a difference in the lives of children and their families. Campbell, Femi and lawson are Children’s patients who now serve as Children’s ambassadors. nominated by the physicians, nurses and health care professionals who care for them, they represent the three specialty areas in which Children’s received a national ranking by U.S. News & World Report’s best Children’s Hospitals for 2015-16.
Find the Right pRovideR Selecting a provider who’s a good fit for your family is important. You — and your child — should feel comfortable with the physician. To find the right one for your family, call Children’s Find-a-Provider service at 1.800.833.3100 or visit ChildrensOmaha.org/FindAProvider.
Children’s Dedication to Best Possible Care Impacts Lives of Children’s Ambassadors
ChildrensOmaha.org 7
Children’s Dedication to Best Possible Care Impacts Lives of Children’s Ambassadors
LAWSON – ORThOPAeDiCSFrom a baby born with clubfeet to a super-active young
man, it’s been quite a journey for 8-year-old Lawson –
even if he doesn’t remember all of it.
The third grader from Seward, Nebraska, started seeing
Children’s orthopaedic surgeon Brian Hasley, M.D., as a
baby. They went through braces, surgery and casts together.
“Dr. Hasley did a great job of relieving any fears. He and
the entire team gave us hope that Lawson would be an active,
fully functioning little boy,” says Melissa, Lawson’s mother.
The Orthopaedics team at Children’s is the largest and
most comprehensive group in the region, specializing in
the diagnosis and customized treatment of orthopaedic
conditions in all children, infants through teens.
That experience and pediatric training is critical
to the healing and health of developing children,
ensuring continued growth and a successful
outcome free of long-term problems.
Today, Lawson is fully recovered – and doing awesome.
He plays baseball and basketball, and is down, set and
“psyched up” to add flag football to his athletic resume. His
parents say the experience was very eye-opening, emotional
and positive for them, but Lawson hardly remembers it now.
“It isn’t even an issue. It was addressed at the beginning
of his life, so he has nothing that hinders him,” Melissa says.
FeMi – CARDiOLOGY & heART SURGeRYOutgoing and chatty, 11-year-old Femi loves
to read and do crafts, but her real passion is
painting – a swirl of strokes and color: red for
energy, yellow for joy and green for renewal.
Femi says she used to get dizzy and pass out
frequently. That’s before she came to Children’s
and was diagnosed with hypertrophic
cardiomyopathy, a common cause of sudden
cardiac arrest. Careful consultation with Femi’s
cardiology specialist, Robert
Spicer, M.D., clinical service chief
of Cardiology, led to the pivotal
phase of Femi’s treatment and
recovery – a heart transplant
in July 2014.
Launched more than two
years ago, Children’s pediatric
heart transplantation program
is the only one of its kind in the
region. Dr. Spicer says it has
been nothing but successful.
“That’s a testament not only
to the families, but to the
workers who do the ‘day-to-day’ in the
transplant program and everyone at
Children’s who has been a part of this
process,” Dr. Spicer says. “I know that we
will continue to provide the highest quality,
most personalized care to these sick and
complex patients.”
Aside from not being able to run long
distances, Femi’s parents say the budding
artist gets along beautifully. She continues to
come to Children’s for regular follow-up and
has heartfelt praise for a cardiac care team
that includes extensively trained and highly
skilled cardiac surgeons, dedicated pediatric
anesthesiologists, experienced nurses and
operating room staff and a passionate and
knowledgeable team of nurse practitioners
and physician assistants.
“They really do know kids and how to treat
them,” Femi says. “They become part of your
family. They didn’t keep any secrets from me,
and they told me what was happening.”
ChildrensOmaha.org 7
patient care
PulmOnAry HyPertenSiOn:Treating a Complex Condition Through Collaboration
8 To find a provider, call 1.800.833.31008 To find a provider, call 1.800.833.3100
Fifteen-year-old Briana is, in many ways, your typical high school
freshman. She likes to sleep and hang out with her friends. And like
her peers, she carries an IV infusion pump with her at all times and
isn’t allowed to participate in organized sports. Typical teenage stuff.
Not quite.
The truth is – beyond the sleeping and the hanging out – Briana is
not very typical. Diagnosed with pulmonary hypertension three years
ago, she receives regular follow-up care at the collaborative Pulmonary
Hypertension Clinic at Children’s Hospital & Medical Center. Before
her diagnosis, she had the prominent red flags: shortness of breath
and fainting.
“I would faint all the time,” Briana says. “I remember I fell on the
gym floor while we were playing a game. I got dizzy, and I fainted.”
Her sister Rosa adds, “She couldn’t walk far distances. We would
enter the mall and five minutes later, she would be really tired.”
The theory, at first, was that Briana wasn’t eating properly. Further
investigation revealed pulmonary hypertension (PH), a type of high
blood pressure that affects the arteries in the lungs and the right side
of the heart.
The condition is difficult to diagnose. First, patients undergo an
echocardiogram, an ultrasound-based test that estimates pressure in the
heart’s right ventricle. Once PH is suspected, the gold standard is cardiac
catheterization – a thin, flexible tube inserted into the heart through
blood vessels – to directly measure pressure in the pulmonary arteries.
“If we get to patients early on, we have a much better chance of keeping
them from progressing to the severest forms of the disease,” says Scott
Fletcher, M.D., medical director of Children’s Cardiovascular MRI and
Exercise department. He launched the clinic with Paul Sammut, M.D.,
clinical service chief, Pediatric Pulmonology – two specialists collaborating
in a crucial space where cardiac and pulmonary care intersect.
The Pulmonary Hypertension Clinic team also includes a pulmonology
nurse and a cardiology nurse. The premise is straight-forward:
collaborative expert care, intense follow-up and the use of advanced
medications to improve outcomes for a complex class of patients.
Briana visits the clinic every three months. Her appointments
include an echocardiogram, a six-minute walk test to gauge her progress
and a joint meeting with Drs. Fletcher and Sammut, a reflection of the
cardiac-pulmonary partnership that makes the specialty clinic so unique.
“Dr. Sammut and I visit the patients together. Families hear us speak
one after another. I’m listening to Dr. Sammut and Dr. Sammut is
listening to me as the family is listening to both of us,” says Dr. Fletcher.
“We speak with a more common voice, and our care is much more
coordinated than it would be if there was one cardiologist seeing patients
independently and one pulmonologist seeing patients independently.
That is not optimal. Teamwork is critical.”
In addition to shortness of breath and fainting, red flags for PH
include a family history of the disease, a diagnosis of pulmonary
veno-occlusive disease or certain forms of congenital heart disease,
and cases in which infants born with chronic lung disease do not
show a typical pattern of improvement.
Although PH is not curable, current treatments can minimize
symptoms and improve quality of life. Drs. Fletcher and Sammut are
managing Briana’s condition with a variety of medications, including
prostanoids administered through her ever-present IV infusion pump.
Briana says she feels more active since she began her treatments.
Her doctors are encouraged by her progress.
“They say they want to take it slowly,” she says, “step by step.”
hAve A heALTh QUeSTiON?
If you have questions about children’s health topics, you’ll find a variety of information on our website. Visit ChildrensOmaha.org/HealthAndSafety.
Scott Fletcher, M.D.
Paul Sammut, M.D.
ChildrensOmaha.org 9
With the New Year upon us, families are busily
setting household goals for 2016. Start the year
off right by making it your resolution to ensure
there are no hazards for your baby or toddler
within your home.
Parents should check their homes at least
once a year for basic safety precautions. The
first step in childproofing your home is to
explore every room at a child’s eye level. Get
down on your hands and knees and crawl
around your home like a baby. Imagine how
your infant will see things for the first time:
electrical outlets, dangling tablecloths, cabinet
pulls and more.
“Household injuries are one of the most
common reasons for Emergency Department
visits in children under age 4,” says Chandrika
Rizal, M.D., Children’s Physicians. “Baby
proofing your home, along with supervision,
plays a very important role in providing a safe
household environment as babies grow,
develop and explore the world around them.”
As you see hazards, get rid of them. Here
are tools and gadgets that can help:
• Safety latches and locks. Use these on
all cabinets and drawers to keep baby away
from poisons and other harmful substances,
including medicines and cleaners.
• Safety gates. Install hardware-mounted
gates at the top and bottom of every
stairway to prevent falls.
• Doorknob covers and locks. Use these to
keep baby out of rooms that are off-limits.
Also use knob protectors on the stove knobs.
• Secure furniture. Larger pieces of
furniture, such as bookshelves or dressers,
should be strapped to the wall to avoid
tipping. Additionally, no matter the size of
television, secure it to a wall or anchor it to
a dedicated TV stand with an anti-tipping
strap specifically designed for that purpose.
• Window guards. Don’t rely on window
screens to prevent falls from upper-story
windows. Install safety bars or window
guards. The bars should be no more than
four inches apart.
• Corner and edge bumpers. These keep
baby safe from falls against sharp edges
on tables and other furniture.
• Anti-scald devices. Control your water
temperature to prevent accidental burns.
Make sure the thermostat on your hot
water heater is set below 120°F.
• Outlet covers and plates. To prevent
electrical shock and electrocution, install
protectors on all unused outlets. The covers
should not be easily removed by tiny fingers.
• Blind and curtain cord safety devices. Look for safety tassels for miniblinds and
tension devices for vertical blinds and
curtains to keep dangling cords and
curtains away from baby.
• Doorstops and door holders. These
prevent little fingers and hands from getting
pinched or crushed in doors and hinges.
• Smoke and carbon monoxide detectors. Install smoke detectors in the hallways
between all bedrooms and test them each
month. If you cook or heat with natural gas or
oil or have an attached garage, install a carbon
monoxide detector near sleeping areas.
Safety comes first, even if childproofing each
room is time consuming. With a childproofed
home, parents should take comfort knowing
that they’ll have many more New Years to ring
in with their family safely by their side.
Dr. Chandrika RizalChildren’s Physicians
babY-PRooF Your Home for the New Year
10 To find a provider, call 1.800.833.3100 ChildrensOmaha.org 10
As a parent, you want the best health care available for your child. Choosing the
right provider can be a difficult task. However, with a little legwork, you’ll be
able to find the pediatrician that’s right for you and your child.
In order to help make this decision easier, first understand the benefits of
using a pediatrician for your child’s care. According to the American Academy
of Pediatrics, pediatricians spend anywhere from three to six years in pediatric
residency training after medical school, whereas other doctors can spend as little
as three months in pediatric training.
Because they care only for children, pediatricians have the skills to treat a
wide range of ailments, and they are experienced not only in the physical, but
also in the emotional and social development of children.
Knowing the benefits a pediatrician can offer your child is only the start. Next,
you must decide which pediatrician to trust with your child’s care. The following
tips can help guide your choice:
• Start with recommendations. Ask your own doctors, family members,
coworkers and friends for recommendations for a good pediatrician.
In addition, check with your health insurance provider to see which
pediatricians are covered under your plan.
• Do your research. Check to see if the doctor is
board certified, if he or she has an independent
practice or belongs to a network of
physicians. Also see which hospitals or
other medical facilities the doctor is
associated with and where the doctor’s
office is located.
• Meet pediatricians face-to-face. Schedule a “get-to-know-you” meeting
with any prospective pediatrician.
Interview as many pediatricians as
necessary until you find one that is
trustworthy, compassionate and
shares similar views and philosophies
on caring for your child.
By following these guidelines, you will help
ensure that your child receives the best health
care available.
Choose the Right PEDIaTRICIan
FiND The RiGhT PeDiATRiCiAN
For more information on how to choose the right pediatrician for your child, call Children’s Find-A-Provider service at 1.800.833.3100.
ChildrensOmaha.org 11
The flu is no fun. That’s why it is important
to protect your child from it with a flu vaccine
every year.
“Giving your child a flu vaccine every year is
a simple step for families to take that can make
a significant difference as flu season begins,”
says David Kaufman, M.D., Children’s
Physicians. “We recommend that all children
starting at 6 months of age receive a yearly flu
vaccination. Since the vaccine is not approved
for younger infants, we also encourage the
parents of these babies and their caregivers to
be vaccinated to better protect the youngest
ones. It is especially beneficial for
breastfeeding moms to receive a flu vaccine.”
Since the flu season can occur anytime from
November through April, it’s still not too late to
have your child receive the vaccine in January.
Children under 9 years of age who have never
received a flu vaccine will need two doses in
their first year of influenza vaccination to
maximize effectiveness during the year.
Winter also means it’s the time of year
for sniffles and sneezes. Colds often spread
throughout the family, although different
members of the family may experience
different symptoms. If your child has a
persistent fever for more than three days,
or a fever that reaches 103 to 104°F, you should
contact your physician.
In addition to the flu vaccine, remind your
child about these everyday precautions to help
prevent catching or spreading illnesses:
• Wash your hands well and often.
• Cough and sneeze into your elbow, rather
than your hands.
• Keep hands off your eyes, nose and mouth.
• Avoid contact with others who have a cold
or the flu, if you can.
The best treatment for an illness is prevention.
A well balanced diet, plenty of fluids and rest
also should help to keep your little ones
healthy this winter.
Non-Profit Org.U.S. Postage
PAIDChildren’s Hospital & Medical Center
8200 Dodge StreetOmaha, NE 68114402-955-5400
881MChildrensOmaha.org
TiP: when choosing health insurance, be sure to select a
plan that includes in-network (Tier 1) coverage for care provided by Children’s Hospital & Medical Center and its physicians.
Selecting a provider who’s a good fit for your family is important. You—and your child—should feel comfortable with the provider. To find the right one for your family, call Children’s Find-A-Provider service at 1.800.833.3100 or visit ChildrensOmaha.org/FindAProvider.
Find the Right
PROviDeR
FEnD oFF THE FlU
David Kaufman, M.D. Children’s Physicians
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