justkids summer 2009
Children’s Hospital & Medical Center
New Options for Young Heart Patients • Keeping Kids Busy on a Budget • Adolescence and Self-Esteem
Keeping Kids Busy on a Budget
“I’m bored! There’s nothing to do!” If you have children, chances are you’ve heard these words many times since summer vacation started. And if your family is one of the many now on a tighter budget, it can be even harder to keep kids busy. With a little imagination, however, you can find plenty of relatively low-cost or free activities.
Make a Plan A good place to start is at the kitchen table. Gather the kids and discuss what they’d like to do with their free days. Write each idea on a piece of paper and drop it into a shoebox. Explain that the ideas should be realistic, close to home and within the family’s budget. Then the next time they’re looking for something to do, have a child pull an idea from the box.
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If the kids have trouble brainstorming ideas, here are a few you can suggest: ■ Search the newspaper for special discount days at local family-friendly establishments, including your local zoo, children’s museum, theaters and more. ■ Check out your local parks and recreation department Web site and make a point to visit every park in your area. Also, click on the links for camping, day camps, community centers, skateboard parks, summer programs and swimming pools. ■ Take a family bike ride or rollerblading trip. Don’t forget your helmets and pads! ■ Hit the books. Many libraries have summer reading programs, which offer incentives to children for reading over the summer.
Create Family Traditions Summer’s a great time to create new family traditions
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together. Traditions don’t need to be complex to make a positive impact. They simply need to focus on family. One simple, yet effective, tradition is to make meal time family time. Have the kids help plan menus, shop for food items and compare prices, and help cook the meal. Create your own table decorations using colored construction paper, pipe cleaners, buttons or anything else lying around the house. Use mealtime conversations as a way to learn about and become involved with your children’s lives. Another inexpensive
Summer Safety Guide Every spring and summer, countless children are injured in their own yards. Parents can help keep their children safe by keeping in mind these tips: family-focused activity is to host a weekly family game night. Let each member of the family take turns choosing which game to play. Invite your child’s neighborhood friends over for a daytime version of game night.
Foster Self-Reliance, Too Be sure children understand that you cannot ensure their happiness every moment of every day. They will be bored at times—and that’s okay! Encourage them to come up with ideas that don’t require your direct involvement. For example, they could write and act out a skit, build a fort in the living room, jump in the sprinklers, decorate the sidewalk with chalk drawings or play cards.
Clip & Save
This handy checklist for
Safe Summer Fun!
Bicycling Basics ❏ Be sure that you and your children wear helmets every time you ride. ❏ Attach reflectors to the front, rear, pedals and both wheels of your bicycle. ❏ Ride on the right side of the road with the traffic flow, not against it. ❏ Walk your bike across busy streets, especially if traffic is heavy. ❏ Use the proper hand signals and teach them to your children.
Play It Safe on the Playground ❏ Avoid playgrounds with concrete, asphalt, dirt or grass under the equipment. Safe surfaces include 4 to 6 inches of mulch, wood chips, fine sand or pea gravel. ❏ Never dress children in loose or drawstring clothing that can catch on equipment and cause strangulation. ❏ Test for hot surfaces. Metal playground equipment in direct sunlight can cause serious burns within seconds.
Lawn Safety ❏ Keep young children inside or send them over to a neighbor’s house to play if you’re getting ready to mow the lawn. ❏ Never give a child a ride on a riding lawn mower or pull them in carts behind a riding mower. ❏ Don’t allow children to play on grass that has been chemically treated for at least 48 hours after treatment.
Water Warnings ❏ Install a fence around pools and make sure the gate is childproof. ❏ Provide constant supervision when children of any age are in the water. ❏ Never use flotation devices as a substitute for supervision. ❏ Check the depth of the water before diving.
Always Committed Children’s Hospital & Medical Center is committed to the health and well-being of all children. The Kohl’s Keeps Kids Safe program, a joint venture between Children’s Hospital & Medical Center and Kohl’s department stores, is dedicated to reducing the number of accidental injuries in children. Since 2000, Kohl’s has donated more than $700,000 in support of child injury prevention programs. For more information on safety programs sponsored by Children’s Hospital & Medical Center, visit
ChildrensOmaha.org. Simply click on Health and Safety, then on SafeKids.
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Tiniest Babies Thrive Under Children’s Care the latest in cutting-edge technology and medical advances within the 46bed unit.
Dedicated Team
Imagine newborns born so tiny, they can fit into the palm of your hand. These infants, the smallest and most critically ill, need specialized care to help in the hardest fight of their lives. Children’s Hospital & Medical Center is home to the largest Newborn Intensive Care Unit (NICU) in Nebraska, a 46-bed unit that combines the medical skills and technology necessary to care for babies born as early as four months premature and weighing as little as 1.2 pounds. Babies like Kyla Wharton.
When Kyla Wharton was born at 23 weeks gestation in Lincoln, she weighed just 1 pound, 3½ ounces and was smaller than a Barbie doll.
Smaller Than a Barbie Kyla was smaller than a Barbie doll and weighed just 1 pound, 3½ ounces when she was born at 23 weeks gestation in Lincoln, Neb., where her parents, Tracy and Phil, live. An infection that Tracy developed caused the early delivery. “My OB told me during delivery that we were right at the edge of viability,” says Tracy. Statistics show that only approximately 25 percent of babies born at 23 weeks survive. “But they told me she would have a better chance if I gave birth so they could give her antibiotics than if we were to prolong the pregnancy.”
Unsurpassed Skill and Care Days after her delivery, Kyla developed a bowel perforation and was transferred to Children’s Hospital &
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Medical Center. Later that month, she developed a more serious bowel perforation. “They had the capability at Children’s Hospital & Medical Center to perform the surgery she needed for the more severe perforation,” says Tracy. “I felt very confident in everybody’s ability and skill at Children’s—and that really helps.” The ability to treat the most critically ill infants in the region is testimony to the level of skill of the neonatologists, experienced nurses and specialists from diverse areas of pediatric medicine all working at Children’s to increase the chances for these fragile lives. It is also testimony to Children’s dedication to employing
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Children’s level III facility combines compassion with technology to create a center of unparalleled medical support. It provides intensive medical, surgical and nursing care, life support systems, electronic monitoring and a complete range of diagnostic and therapeutic capabilities. It is also equipped to provide ECMO services. ECMO, or extracorporeal membrane oxygenation, uses a heart-lung machine to oxygenate the blood. The NICU team also includes respiratory therapists, full-time social work and case management staff in the unit, as well as a developmental specialist to ensure the environment remains developmentally friendly, clinical nurse specialists and a lactation consultant. In addition, pharmacists dedicated to the unit manage all medication and IV orders to assure a high level of safety and accuracy. “We thank God every day for the doctors and nurses at Children’s,” says Tracy. “They work miracles there every day.”
Learn About NICU To learn more about the NICU at Children’s Hospital & Medical Center, visit ChildrensOmaha.org and click on NICU under Featured Services. Or, call us toll-free at 1-800-833-3100.
A Fragile Road: Adolescence and Self-Esteem Even self-assured children can lose self-esteem when they move into adolescence. It’s naturally a selfconscious age. Plus, teens begin junior high and then high school, where their performance and looks are constantly being judged.
What Affects Self-Esteem? Some experts think a teen’s selfesteem reflects the difference between her ideal and her actual self. If a teen thinks there is a great disparity between these two selves, then she may have self-esteem problems. Low self-esteem problems may stem from displeasure with appearance. Societal and cultural standards can cause teens to develop unhealthy views about attractiveness and body size. Two factors seem to positively influence a teen’s self-esteem: ■ Accomplishments in school, sports, and
Parenting U: We Understand Children Children’s Hospital & Medical Center is continuing its popular Parenting U series through the summer and fall seasons. The classes are FREE, and are led by professionals known for their knowledge of children, to help you through some of a parent’s most challenging times. Along with a great topic, we’ll provide food, child care and prizes. Each session will be held in the Glow Auditorium at Children’s Hospital & Medical Center from 6 to 7 p.m. Space is limited, so call 1-800-833-3100 or log on to ChildrensOmaha.org today to register.
other activities that are socially valued ■ Support and approval from people they care about.
How to Boost Self-Esteem To help boost your teen’s esteem, try the following strategies: ■ Encourage your teen to get involved in sports and other activities. ■ Celebrate your teen’s successes. ■ Teach your children to question the standards of attractiveness set in the media. Point out that few people really look like models or bodybuilders. ■ If your teenager has a weight problem, help her or him achieve a healthy weight in a safe way. Emphasize good nutrition and an active lifestyle. ■ Pay attention if your teen uses a lot of self-defeating statements. Negativity can signal low self-esteem. But reciting positive statements, such as “I can do anything that I set my mind to,” may
brighten one’s outlook. In one study, students increased their self-esteem by saying 15 affirmations three times a day for two weeks. ■ Avoid criticizing teens too much. When you do criticize, attack your teen’s actions, not your teen. Saying “I get upset when you’re on the phone for an hour” is better than “You’re a phone addict.”
If you’re worried about your teen’s self-esteem, speak to your child’s primary care provider, who can offer you advice or refer you to a specialist. Need a physician or behavioral specialist for your child? Call the Children’s Hospital & Medical Center Find-A-Doctor service at 1-800-833-3100, anytime, day or night.
Monday, Aug. 3 Preparing for Your Newborn Clancy McNally, MD, Children’s Physicians
Tuesday, Oct. 20 Baby’s First Years Monique Macklem, MD, Children’s Physicians
Tuesday, Sept. 22 Preparing for Your Newborn Steve Sindelar, MD, Children’s Physicians
Tuesday, Oct. 27 Why Is My Teen So Tired? Amy Lacroix, MD, UNMC Physicians, and Brett Kuhn, PhD, Children’s Sleep Disorders Clinic
Tuesday, Sept. 29 Good Night, Sleep Tight Rosanne Bosch, MD, Omaha Children’s Clinic Tuesday, Oct. 6 Everyday Discipline Meg Flores, PhD, Children’s Behavioral Health, and William Warzak, PhD, Munroe-Meyer Institute, UNMC Tuesday, Oct. 13 Speech Development and Delays Sue Flynn, MA, Children’s Rehab Services
Tuesday, Nov. 3 Potty Training Speaker TBD Monday, Nov. 9 Children and Bullying Mike Vance, PhD, Children’s Behavioral Health Tuesday, Nov. 17 Preparing for Your Newborn Rachel McCann, MD, Children’s Physicians
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Three-year-old Erykah Moore of Crete, Neb., suffered from an abnormal heart rhythm, or arrhythmia.
Erykah, pictured at right with her mom, Laurie, was one of the first heart patients to be treated at Children’s using the new electrophysiology capabilities in the hospital’s hybrid pediatric heart catheterization laboratory.
Today, Erykah is an active and playful little girl after undergoing a radiofrequency ablation procedure. “It was such a gift, it felt like Christmas Day,” says her father, Shawn.
A High-Tech Option for Young Heart Patients Pediatric heart care at Children’s Hospital & Medical Center has expanded. New electrophysiology (EP) capabilities in the hospital’s hybrid pediatric heart catheterization laboratory are helping to cure abnormal heart rhythms, called arrhythmias. “This is a significant step for the pediatric cardiology program at Children’s,” says John Kugler, MD, director of cardiology at Children’s Hospital & Medical Center, and chief of the UNMC/CUMC Center Joint Division of Pediatric Cardiology. “Not only can serious arrhythmias disrupt everyday life for children and their families, they can become quite dangerous. Our ability to provide such a specialized and advanced form of treatment in a setting designed to meet the specific needs of pediatric patients is important.” Three-year-old Erykah Moore of Crete, Neb., was one of the first patients to be treated at Children’s with this technology. Erykah was born with Wolff-Parkinson-White Syndrome, or WPW.
Abnormal Heart Rhythms In a normal heart, one pathway allows an electrical signal to move between the upper and lower chambers. When this signal reaches the
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heart muscle of the lower chamber, blood is pumped out of the heart and the heart beat is completed. In patients with WPW, an extra pathway provides the potential for the electrical signal to beat down the normal pathway and back up the extra pathway. This creates an abnormal heart rhythm and very rapid beating known as tachycardia. Pediatric cardiologist and electrophysiologist Christopher Erickson, MD, director of electrophysiology and pacing at Children’s, began seeing Erykah at Children’s when she was an infant. “Early on, Erykah had few effects of WPW. As she grew, some of the symptoms began to show,” he explains. “In June 2007, she became noticeably pale and fatigued. She had a decreased appetite and she’d been vomiting.” Erykah’s heart was beating 270 times per minute, much more rapidly than the normal 120 to 130 beats per minute of a child her age and size. “We began to notice that she would become physically ill when her heart rhythm wasn’t normal,” says Erykah’s mother, Laurie. “This started happening when she was about 18 months old.” Erykah tried several medications in an effort to
control these episodes of tachycardia, but they were not effective. “If she was playing hard and running around, we would stop her and put a hand on her chest to see how her heart was beating. She started doing that to us, too, and she would say, ‘Let me check you,’” shares her dad, Shawn Moore. “You don’t think of your child doing that.”
Blocking Unwanted Pathways It became clear that Erykah needed a more advanced form of treatment. “Erykah was making regular trips to the Emergency Department and the only other medication we could’ve tried is known to have serious side effects. We decided that we could best help her by performing a procedure called a radiofrequency ablation,” says Dr. Erickson. The goal of this procedure was to permanently block the extra electrical pathway in Erykah’s heart. While a pediatric anesthesiologist provided essential general anesthesia, Dr. Erickson and the cath lab team at
Children’s carefully inserted small catheters in large veins in Erykah’s upper legs, as well as a catheter in her esophagus. The team induced a fast heart rhythm to confirm that WPW was the cause of Erykah’s arrhythmia. Once that was done, they mapped out the extra pathway. “Once we identified the unwanted pathway, we used radiofrequency energy to create a small burn, eliminating the pathway and causing a permanent interruption,” Dr. Erickson explains. “This is not just a treatment. For most children, it is a cure.” Erykah spent about four hours in the cath lab, followed by several hours in the Children’s Ambulatory Recovery and Express Services (CARES) unit. No overnight stay was needed. “After the procedure, we were just so relieved,” says Shawn. “It was such a gift, it felt like Christmas Day.” A checkup with Dr. Erickson in December 2008 showed Erykah’s recovery had gone perfectly. She hasn’t needed any hospital stays and her mom says the
active and playful little girl is doing great. “It’s great to offer this technique at Children’s. We’re excited for the possibilities that exist and look forward to continued success,” says Dr. Erickson. From September 2008 to February 2009, Children’s has used its electrophysiology capabilities to treat and help 18 children. The Children’s hybrid lab was one of the first such pediatric facilities in the nation. The hybrid designation means the lab meets strict standards and can double as an operating room, should combination procedures or emergency procedures be needed.
Need a Doctor? Call the Children’s Hospital & Medical Center Find-A-Doctor Service at
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Children’s Rehab Opens Second Clinic New West Village Pointe office opens new doors for pediatric rehabilitation patients. On May 19, Children’s Rehab Services opened its doors to new and current patients at West Village Pointe, 110 N. 175th St. (175th and Burke). This is the second location for the clinic, which continues to offer rehabilitation services at Children’s Hospital & Medical Center. The West Village Pointe clinic offers physical, occupational and speech therapy for children from infancy to age 21. Our staff have experience in treating a wide variety of pediatric diagnoses and conditions, including those that result in lifelong challenges, as well as those that can be resolved within a few months of treatment. The space design mirrors the look of the hospital—it’s pediatric friendly, brightly colored, and has rooms for privacy but also wide open spaces for movement. Rehab Services at West Village Pointe will have the same equipment and therapy tools available at the hospital
while offering convenient access and parking for all patients and families. Deglutition (swallowing) studies and special needs car seat evaluations will be done at the hospital location only. “By opening Rehab at West Village Pointe, Children’s now offers pediatric therapy services, skills and expertise with improved access and convenience for our families who live in western Omaha, Gretna, Elkhorn, Bennington, Fremont and other surrounding communities,” said Rhonda Ervin, PT, manager of Children’s Rehab Services. Rehab Services joins the Children’s Physicians office and Urgent Care Center at West Village Pointe, both of which opened recently. Rehab Services at West Village Pointe is open Monday through Thursday from 8 a.m. to 6 p.m. Appointments for this location are scheduled by calling 402-955-8350.
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Kindergarten Readiness:
When Is the Right Time for Your Child? Being ready for kindergarten means a lot more than simply reaching the age of 5 by a certain date. When considering kindergarten readiness, parents, physicians and teachers must consider each child’s intellectual, physical, social and emotional development. Experts say that if you are not sure your child is ready, holding him back is better than setting him up for failure. But how do you know if your child is ready? Here is a guide. Following are general indications that your child may be ready for kindergarten: ■ Plays well with other children ■ Conforms to simple rules regarding behavior ■ Recognizes shapes and symbols ■ Listens to a story for five to 10 minutes and understands it ■ Speaks clearly enough to be understood ■ Can bounce and catch a ball. “If your child attended pre-school, utilize your child’s pre-school teacher as a resource,” says David Kaufman, MD, a pediatrician with Children’s Physicians. “Ask your child’s preschool teacher for their input on your child’s readiness to
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attend kindergarten. If the teacher has only minor concerns, they can probably be addressed before your child starts the school year. If there are more significant issues that can not be addressed within a few months during the summer, consider delaying kindergarten entry.” Parents can also ask several questions to help determine if their child is ready. Does the child display poor coordination? With poor finger dexterity, the child may experience difficulty using a pencil. In addition, a child who is not as physically coordinated as other children may find physical education activities difficult and could develop a poor self-concept. Is the child psychologically immature? A child who cannot concentrate, make simple decisions, wait for his turn, follow directions or remember events may have trouble learning. Is the child emotionally immature? A child who cannot separate from mother and home will not adapt pleasantly to school. Expecting a child to compete in a situation that is beyond her present capacity may cause her to develop a negative self-image and a desire to avoid
all types of competition. Parents who are still in doubt about their child’s kindergarten readiness can participate in a pre-kindergarten screening. Or, visit the kindergarten your child will attend and talk with the teacher. You can even discuss your concerns with your child’s physician who is able to assess the child’s growth and physical and developmental readiness. Remember, the object of kindergarten is not to make your child a star in the academic Olympics. It is to guide your child to the overall maturity that is needed for a solid start to a good education. Have questions about your child’s physical and developmental readiness? Speak to your child’s primary care provider, who can offer you advice or refer you to a specialist. Need a physician or specialist for your child? Call the Children’s Hospital & Medical Center Find-ADoctor service at 1-800-833-3100.
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