just kids | winter 2016

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

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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


Reasons YouR Child SkipSlunCh—and how to Fix them

5


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.


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


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.”


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.


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.


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

just kids | winter 2016

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