A Biannual Publication of the Children’s Hospital of Georgia
GEORGIA KIDS FIRST
WINTER 2017
Next, Dr. Katie McKie, sleep medicine specialist, highlights the issue both parents and children face with tough sleep issues. CHOG is the area’s only dedicated sleep lab for children with Dr. McKie treating disorders ranging from sleep apnea and snoring to sleepwalkiing and night terrors. Recently, McKie and Dr. Drew Prosser, pediatric ENT surgeon, launched a new multidisciplinary clinic dedicated to more complicated sleep problems that would necessitate further treatment. Prosser reached out to McKie about partnering on the complex sleep clinic last year after seeing the benefits firsthand at a similar clinic during his fellowship at Cincinnati Children’s Hospital.
GEORGIA KIDS FIRST
WINTER 2017
CHAIRMENÔS NOTE
DEAR READERS, A new year means new opportunities to grow and connect here at Children’s Hospital of Georgia. It’s always our mission to provide children with the expert care they need as soon as possible. This year is already off to a great start with innovative research development, advances in specialized care for children and new additions to the CHOG family.
CHOG continues to be the area’s only hospital dedicated exclusively to children. Here at CHOG we are able to fulfill the need for pediatric orthopedic surgeons and other specialties for the ongoing treatment and management of bone issues. After fractures, clubfoot and scoliosis are two of the most common conditions that Dr. Gregory Kalv sees in his pediatric orthopedic practice at CHOG. Drs. Styles Bertrand, David Cearley and Austin Shiver help families that have complex cases that not every hospital can service.
First, Dr. Ted Johnson and his team in the Division of Pediatric Hematology and Oncology are striving to provide hope to relapsed cancer patients through a clinical study that is locally grown and recognized nationally. Dr. Johnson, along with his colleague Dr. Andrew Mellor, has made groundbreaking realizations in a recently developed drug. The focus of Dr. Johnson’s trial is combining the new drug with conventional cancer therapy to target brain tumors. His research has promised a rare second round of funding from the national Hyundai Hope on Wheels grant program to support his work this past year.
CHOG continues to grow, and so does our faculty. We welcome Dr. Linnea Larson-Williams who specializes in Pediatric Endocrinology, Dr. Sheisa Claudio-Sandoval, a general pediatrician in Palmetto Pediatrics Aiken Faculty, and Dr. Natalia Martinez- Schlurmann, a critical care specialist. The newest members of our family are committed to meeting the health needs of the children in Georgia, South Carolina and the region. Welcome to the team! While CHOG provides care for almost every single clinical pediatric specialty, our team also has access to all of the resources of our full academic medical center at Augusta University. We practice a multi-disciplinary team approach across all areas of clinical care with a robust research and clinical trials program – to continue to develop advanced and more effective treatments and cures. When you choose CHOG for your child’s care, an entire team of experts are focused on the health and well-being of your child for optimum growth and development. Best,
Dr. Charles Howell Co-Medical Director and Surgeon in Chief Dr. Charles Linder Chairman, Department of Pediatrics
Drs. Charles Linder (left) and Charles Howell (right) with CHOG mascot, Roary
2
IN THIS ISSUE WINTER 2017
LOCALLY GROWN, NATIONALLY RECOGNIZED________________ 4
Georgia Kids First is published biannually by Children’s Hospital of Georgia and the Division of Communications and Marketing. Please direct comments or questions to Editor Emily Renzi at erenzi@augusta.edu or 706-721-3213.
WHEN A CHILD CAN’T SLEEP______________ 6 CLINICAL SPOTLIGHT: BONE ISSUES_____________________________ 8 CHOG ADVISORY BOARD__________________ 9 NEW FACULTY____________________________ 10 CMN HIGHLIGHT: RADIOTHON RECAP_______________________ 10 CHOG PEDIATRIC CONSULTATION_________ 11
3
augustahealth.org/chog
WINTER 2017 GEORGIA KIDS FIRST
GEORGIA KIDS FIRST
WINTER 2017
RESEARCH
LOCALLY GROWN, NATIONALLY RECOGNIZED
Dr. Ted Johnson’s pediatric cancer clinical trial is based on a drug developed at MCG—and is attracting national attention from families and physicians
Indoximod pill, chemotherapy, Gamma Knife radiation and daily physical therapy.
Eight-year-old Coulter Hnatt had been fighting a brain tumor for more than half his young life—and he was running out of options. But a mom doesn’t give up. Courtney Hnatt was scouring the Internet and its network of cancer parent forums and had been following Dr. Ted Johnson’s Indoximod pediatric immunotherapy clinical trial at the Georgia Cancer Center for six months. It was time to make contact. After the Hnatts met with Dr. Johnson and became convinced of his sincerity, Coulter became the first child enrolled on December 9, 2015. For over a year now, the Hnatt family has lived in the Ronald McDonald house just steps away from the Children’s Hospital of Georgia where Coulter receives his comprehensive treatment, which includes the
4
“This was our only hope,” said Courtney. “Dr. Johnson gave us the time we needed…[and] Coulter is better today than he was 11 months ago. His quality of life is better.” For mom Courtney and dad Mike, the change in Coulter’s circumstances is encapsulated in a family vacation to Wyoming last summer, where the 8-yearold was doing typical 8-year-old things: kayaking, horseback riding, whitewater rafting, ropes and challenge courses and ziplining—without any pain at all. Coulter isn’t out of the woods yet—he is starting a new kind of chemotherapy that required additional FDA and internal IRB approval. He is also one of the many patients that Dr. Johnson and his team are striving to provide hope for through their first-in-theU.S. clinical trial.
Hope for Relapsed Cancer Dr. Ted Johnson was an MD/PhD student at the Medical College of Georgia in the 1990s, working with Dr. David Munn and his colleague Dr. Andrew Mellor, who discovered the role of the enzyme IDO in protecting a fetus from being attacked by the mother’s immune system during pregnancy. They made the groundbreaking realization that cancerous tumors likewise use IDO to fool the immune system into tolerating, rather than attacking, the growing cancer— and developed drugs to block IDO. One of those drugs, Indoximod, is the focus of Dr. Johnson’s trial, which combines the drug with conventional cancer therapy (chemotherapy and radiation) to target brain tumors. The combination therapy creates a synergy that both makes the treatment work more potently and requires lower doses; thus, the overall therapy is meant to be less toxic and children seem to have a resulting higher quality of life and fewer side effects. The promise of the research is such that the national Hyundai Hope on Wheels grant program awarded Dr. Johnson a rare second round of funding to support his work this past year. The trial is also attracting interest from families at major cancer centers from across the nation, who like the Hnatts, have traveled to Augusta for care. “A fairly universal sentiment among the families and the patients is that they are just generally feeling better, generally doing better,” Dr. Johnson said in an interview with The Augusta Chronicle. “They are able to go on vacations, be in school, spend time with their friends. They are able to have their birthday parties, sometimes birthdays they never expected to get to. These are things that really impact how they view the time they are able to spend with their families.”
Rare Find Dr. Johnson’s immunotherapy clinical trial is part of an innovative model developed at the Georgia Cancer Center designed to rapidly bring forward promising new immunotherapy drugs from the pre-clinical pipeline into pediatric clinical trials. The Medical College of Georgia is conducting a fundraising campaign to help significantly increase the number of children who could have access to this trial. To learn more, contact Eileen Brandon at 706-825-4779 or ebrandon@augusta.edu. To learn about enrolling in the trial, contact Robin Dobbins, RN, at 706-721-2154.
5
augustahealth.org/chog
WINTER 2017 GEORGIA KIDS FIRST
WHEN A CHILD CAN’T SLEEP
GEORGIA KIDS FIRST
WINTER 2017
Latest and Greatest (services/new offerings)
A multidisciplinary sleep clinic helps families with tough sleep issues Multidisciplinary Care for Tough Sleep Issues Sleep apnea in children is most commonly caused by large tonsils or adenoids. Obstructive sleep apnea tends to become an issue in kids between the ages of three and eight, which is when these organs can grow large, said McKie. Childhood obesity is another factor. And while sleep apnea affects between 2 to 4 percent of the general population, it can be as high as 50 percent in certain populations such as children with Down Syndrome, according to Prosser.
Sleep: It’s among the top issues for parents—both sleep for themselves and sleep for their children. After some trial and error, most babies settle into a sleep routine, but sleep issues in children can arise anytime from infancy to age 18, says sleep medicine specialist Dr. Katie McKie at the Children’s Hospital of Georgia. And when general pediatricians screen for problems using the BEARS tool during well-child visits, that’s when referrals often come to her. Together with the area’s only dedicated sleep lab for children, McKie treats disorders ranging from sleep apnea and snoring to sleep walking and night terrors.
Removal of the tonsils or adenoids is a surgery that Dr. Prosser performs commonly and with great success to resolve sleep disorders. However, even after surgery, a subset of patients continues to have persistent sleep problems.
But it’s the more complicated sleep problems that could necessitate further treatment—which is why McKie and pediatric ENT surgeon Dr. Drew Prosser recently launched a new multidisciplinary clinic dedicated to those issues.
In most parts of the country, these children might spend months visiting multiple specialists before receiving a
6
treatment plan. But a growing trend at larger children’s hospitals is a complex sleep clinic that combines experts in pulmonary, ENT, nutrition, plastic surgery and respiratory therapy who together see patients at one visit. This strategy rapidly reduces time to treatment, a key factor in improving learning in sleep-deprived kids. “The evidence that poor sleep quality affects a child’s ability to learn is well-recognized,” said Prosser. “But the data also shows that if you treat poor sleep, the ability to learn improves, as do neurocognitive outcomes, inattentiveness, behavior issues and poor school performance.” Prosser reached out to McKie about partnering on the complex sleep clinic last year after seeing the benefits firsthand at a similar clinic during his fellowship at Cincinnati Children’s Hospital: “Instead of all of these conversations with clinicians taking place over several months and several visits, we are able to streamline care into one visit and ensure everyone is on the same page.” Because Sleep is Very Individual The process begins with a referral to either McKie or Prosser for a sleep issue. Once the child has been evaluated and/or treated (but continues to experience sleep issues), either physician can determine to enroll him or her into the complex sleep clinic. Persistent sleep disorders require very individualized treatment, but some of the more common causes can include: • Enlargement of lingual tonsil tissue • Adenoid tissue regrowth • Skeletal or other abnormalities such as a small jaw or small or short tongue • Laryngomalacia or floppy voice box At the clinic, families benefit from McKie’s pulmonary/sleep experience and Prosser’s ENT knowledge. They may also speak with a nutritionist if obesity is a factor. A pediatric plastic surgeon can examine children with certain craniofacial anomalies, and respiratory care may become involved for patients who could benefit from Continuous Positive Airway Pressure (CPAP) or other positive pressure devices. Other specialists are brought in as needed. “It’s wonderful that we’re able to offer this clinic to our patients now,” said McKie. “It’s so beneficial to families and they love being able to see all of their specialists at the same place and at the same time. Families can be surprised that there is a whole specialty dedicated to sleep, especially sleep in children, but they are pleasantly surprised to know that it’s available.”
Slumber On Most children with sleep issues will require a sleep study and are evaluated overnight in the pediatric sleep lab, located on the fourth floor of the Children’s Hospital of Georgia—and may be re-evaluated again following treatment. The sleep lab performs about 50 to 60 sleep studies a month on children, so a kidfriendly atmosphere is a must. Thanks to specially trained pediatric technicians, toys and games, children often feel like they’re at a “spend-the-night party,” said McKie, even when they have to undergo complicated lead and wire placements. As a result, she said, “Rarely have we had a child unable to complete a sleep study. The techs do a fantastic job to make the sleep study like a game so that it’s more fun for the kids.”
7
augustahealth.org/chog
WINTER 2017 GEORGIA KIDS FIRST
BONE ISSUES
SPECIALTY CLINIC SPOTLIGHT
GEORGIA KIDS FIRST
WINTER 2017
Specialized services for clubfoot and scoliosis are available right here in Augusta On paper, the conditions clubfoot and scoliosis are very different. But they have one commonality: the need for a pediatric orthopedic surgeon and other specialties at a major children’s hospital for ongoing treatment and management.
not painful so children can wear regular shoes, walk, run and play.” Scoliosis is a little more complex. This curvature of the spine can occur in different forms—all of which are treated at CHOG—including: congenital scoliosis, where babies are born with an abnormal spine; syndromic scoliosis, which may affect children with cerebral palsy or other syndromes; early-onset scoliosis, which can occur even during infancy; and the most common form, adolescent scoliosis, which typically affects girls ages 10 to 13 during a growth spurt period.
After fractures, clubfoot and scoliosis are two of the most common conditions that Dr. Gregory Kalv sees in his pediatric orthopedic practice at the Children’s Hospital of Georgia. Because of the specialty care required, Kalv and his colleagues, Drs. Styles Bertand, David Cearley and Austin Shiver, help families who drive from as far as four hours away for sometimes weekly visits, depending on treatment.
For adolescent scoliosis, treatments can range from a custom brace to spinal fusion surgery. “But you shouldn’t fuse the spine of a very young child,” said Kalv. In early-onset scoliosis in children younger than 3 or 4, Kalv and his team employ ongoing spinal casting, which is performed under anesthesia using a specially designed table and technique, which is currently only available in the state at CHOG in Augusta and centers in Atlanta.
“There are only a handful of children’s hospitals in the state that offer surgical and nonsurgical treatment for clubfeet and scoliosis, especially when you include early onset and syndromic scoliosis,” said Kalv, “We’re fortunate that we have one here in Augusta. We have three pediatric orthopedic surgeons and a nonoperative specialist with combined experience of over 40 years.”
Similarly, for children ages around 4 to 9, the pediatric orthopedic team at CHOG offers scoliosis surgery using an instrumentation system of growing rods that help anchor the spine but account for growth. The newest system offered at CHOG features growing rods with a magnetic actuator that can be lengthened externally during clinic visits with a magnet, avoiding the need for surgeries every few months for adjustment. There is a similar system being used to lengthen the legs of children with severe leg length differences.
The Difference of a Children’s Hospital With clubfoot, the most common question asked by families is, “Will my child be able to walk normally?” The answer is most likely, said Kalv, but treatment involves years of follow-up. “Many people believe football player Troy Aikman had clubfoot,” he said. “There are people you see every day who had clubfoot and you wouldn’t know it.” Clubfoot is usually diagnosed at birth but can be diagnosed in utero. Services at CHOG include serial manipulation and casting as well as surgical release along with foot and tendon reconstruction for recurrent clubfoot. “We treat in infancy when we can, before walking age,” said Kalv,” but we see all ages from newborn to walking age. Our goal is to get the foot in a walking position that’s functional and
“We’re here as a resource,” said Kalv. “We’re treating complex cases every day using the latest surgical techniques and, in many cases, working alongside colleagues in cardiology, pulmonology, physical therapy, neurosurgery and plastic surgery. We’re treating pediatric patients with fractures, complex disorders of the spine, cerebral palsy, sports injuries, limb deformity, hip dysplasia and even cancer. Not every hospital has that. Families of children who have a complex issue should come to a children’s hospital with many specialties, and that’s what we have right here.”
Road Trip The pediatric orthopedic team at the Children’s Hospital of Georgia also staffs clinics in Dublin, Athens, Valdosta, Albany and Waycross almost every month to care for children and families affected by clubfoot, scoliosis and many other conditions.
8
IN THE NEWS
CHOG ADVISORY BOARD The Children’s Hospital has established a new CHOG Advisory Board. This Board consists of 18 members, including parents of CHOG patients, physicians, community leaders and business owners from Augusta and surrounding communities. All have in common a love of the Children’s Hospital and a desire to see it be one of the best children’s hospitals in the country. The mission of the Board is to raise awareness of the Children’s Hospital of Georgia, identify additional services needed and to help obtain the support needed to promote further growth and development of the hospital. The first Board meeting, held on October 18, 2016 focused on providing members with the information they need to understand the current state of the hospital. This was followed on Jan. 10th, by a “scrubs tour” during which 9 members of the board were given personalized scrub suits and a “behind the scenes” tour of the CHOG Emergency Department, Pediatric Critical Care Unit,
Neonatal Intensive Care Unit and the Radiology Suite. Some hands on simulation exercises were included. Follow up tours are planned for members who missed the first event and other community members who want to be involved with CHOG. The second Board meeting was held on February 21, 2017. The agenda included a meeting with Ms. Lee Ann Liska, the CEO of Augusta University Medical Center. The Board began work on its operating issues such as Board membership, terms of office, committees, and leadership. The Board will continue to meet quarterly with committees of the Board to work on issues between meetings.
2017 Advisory Board Staff Members Ralph Alee Charles Howell MD Charles Linder MD Jim Mumford Kyle Scott Catherine Stewart
2017 Advisory Board Members Kathy Bowman
Robyn Hatley MD
Beth Rocker
Dayle Burns
Kaci Johnson
Turner Simkins
Robyn Dudley
Andy Jones
John Stewart MD
Ivy Elam
Karen Keen
Stacy Tallent
David Freeman MD
Janet McKnight
Robin Ann Allen Wills
Brian Rhodes
Leslie Wyatt
Shelly Griffin MD
9
augustahealth.org/chog
WINTER 2017 GEORGIA KIDS FIRST
GEORGIA KIDS FIRST
WINTER 2017
NEW FACULTY
Christopher Watson, MD
Sheisa Claudio-Sandoval, MD
Natalia Martinez-Schlurmann, MD
Medical Degree: Doctor of Medicine (cum laude), Georgetown University School of Medicine (Washington, DC)
Medical Degree: Doctor of Medicine (Magna Cum laude), University of Puerto Rico School of Medicine.
Medical Degree: Doctor of Medicine (cum laude), Universidad Central del Caribe School of Medicine (Bayamon, Puerto Rico)
Internship: Pediatrics, National Capital Consortium (Bethesda, MD)
Internship: Pediatrics, Medical College of Georgia, Augusta University (Augusta, GA)
Internship: Pediatrics, Kapiolani Medical Center for Women and Children (Honolulu, HI)
Residency: Pediatrics, Medical College of Georgia, Augusta University (Augusta, GA)
Residency: Pediatrics, Nassau University Medical Center / LIJ (East Meadow, NY)
Residency: Pediatrics, National Capital Consortium (Bethesda, MD) Fellowship: Pediatric Critical Care Medicine Fellowship – Johns Hopkins Hospital (Baltimore, MD) Clinical Interests: Patient safety, quality improvement, medical education, and pediatric trauma
CMN Highlight - Radiothon Recap
Clinical Interests: General Pediatrics- Outpatient; Newborn Nursery
Fellowship: Pediatric Critical Care Fellowship, Rainbow Babies and Children’s Hospital (Cleveland, OH) Clinical Interests: Patient quality and safety improvement, Pediatric TBI, sepsis.
RADIOTHON BRINGS IN $216,000 FOR CHOG
The 16th annual Cares for Kids Radiothon, a three-day Children’s Miracle Network Hospitals fundraiser, brought in nearly $216,000 in donations and pledges for the not-for-profit Children’s Hospital of Georgia. Area iheart radio stations 104.3 WBBQ, 96.3 Kiss FM and The Bull 105.7 began broadcasting early Thursday, asking listeners to call in and become “miracle makers” for the area’s only children’s hospital. Also during the broadcast, patients, families and staff shared inspirational stories about the care they have received at CHOG, one of the nation’s best for pediatric care. The Cares for Kids Radiothon is the largest single CMN Hospitals fundraiser for CHOG. This year’s total was $10,000 more than was raised last year. Pledges to CHOG can be made year-round. Call 706-721-4004 or email castewart@augusta.edu for more information.
10
CHOG PEDIATRIC CONSULTATION Allergy/Immunology 706-721-3531 Tony Bonitatibus, MD William Dolen, MD Betty Wray, MD Child Abuse/Neglect 706-721-2456 Maureen Claiborne, MD General Pediatrics and Adolescent Medicine 706-721-2456 Reda Bassali, MD Lynnette Bauza, MD Alice Little Caldwell, MD Maureen Claiborne, MD Jacob A. Eichenberger, MD Davidson Freeman, MD Lisa Leggio, MD Charles Linder, MD Kathleen Mahoney, MD Kathryn McLeod, MD Donna Moore, MD Lauren Newhall, MD Robert Pendergrast, MD Nirupma Sharma, MD Leila Stallworth, MD Christopher White, MD Palmetto Pediatrics, Aiken Shalini Khurana, MD Edward Rigtrup, MD Ronald Rimmer, MD Sheisa Claudio-Sandoval, MD Pediatric Cardiology 706-721-2336 Zahid Amin, MD William Lutin, MD, PhD Kenneth A. Murdison, MD Henry Wiles, MD Pediatric Endocrinology 706-721-4158 Chris Houk, MD Linnea M. Larson-Williams, MD Traci Scott, RN, CDE Pediatric Gastroenterology 706-721-4724 Lashawn Boone, FNP Vita Goei, MD Katy Slagle, PNP Jamie Wolf, DO Pediatric Genetics 706-721-2809 Carolyn Lovell, MAT, MS, CGC
Introducing a new physician referral tool making it simple for you and your patients
augustahealth.org/referral Pediatric Hematology/Oncology/ Sickle Cell 706-721-3626 Afshin Ameri, MD Leila Clay, MD Theodore Johnson, MD Colleen McDonough, MD David Munn, MD Betty Pace, MD Pediatric Infectious Diseases 706-721-4725 Chitra S. Mani, MD Christopher White, MD Pediatric Neonatal Follow-up Clinic 706-721-2331 Chantrapa Bunyapen, MD Pediatric Nephrology 706-721-0177 Luis Ortiz, MD Pediatric Neurology 706-721-3371 Mary Gregory, MD Yong Park, MD Elizabeth Sekul, MD Suzanne Strickland, MD Pediatric Pulmonology 706-721-2635 Maxine S. Eikani, MD Valera Hudson, MD Kathleen T. McKie, MD Nicole Wimmer, RN, MSN, CPNP Pediatric Rheumatology 706-721-8950 Rita S. Jerath, MBChB Lauren Newhall, DO Pediatric Cardiothoracic Surgery 706-721-7608 Anastasios Polimenakos, MD Brent Shafer, PA Whitney Perry, NP-C Lauren Mathis, NP Pediatric Neurosurgery 706-721-9386 Ian Heger, MD Cole Giller, MD (Pediatric Epilepsy) Miranda Wood, NP Pediatric Ophthalmology 706-721-1150 Stephanie Goei, MD Andrea Prosser, MD
11
augustahealth.org/chog
Pediatric Orthopedic Surgery 706-721-2849 Styles Bertrand, MD David Cearley, MD Gregory Kalv, MD Luke A. Shiver, MD Courtney Nuckols, RN Pediatric Otolaryngology 706-721-6387 Jack Borders Jr., MD J. Drew Prosser, MD Brian Shirley, NP Pediatric Plastic Surgery 706-721-2198 Jack Yu, MD Pediatric Surgery 706-721-3941 Diane Bairas, PA Robyn Hatley, MD Charles Howell, MD Walter Pipkin, MD Christian Walters, MD Pediatric Urology 706-721-0982 Ronald Lewis, MD Durwood Neal, MD Pastelle Walston, NP Other Pediatric Services Neonatology 706-721-2331 Jatinder J.S. Bhatia, MD Chantrapa Bunyapen, MD James Holcomb, MD Paul Mann, MD Azif Safarulla, MD Brian Stansfield, MD Pediatric Critical Care 706-721-4402 William Cagle, MD Lyle Fisher Jr., MD Renuka Mehta, MBBS Mary Lynn Sheram, MD Natalia Martinez-Schlurmann, MD Christopher Watson, MD Pediatric Radiology Office: 706-721-5201 Reading Room: 706-721-5209 Kristopher Lewis, MD
WINTER 2017 GEORGIA KIDS FIRST
Communications and Marketing 1120 15th Street, AD-1104 Augusta, Georgia 30912 105532
CHANGE SERVICE REQUESTED
Non-Profit Organization U.S. Postage
PAID
Augusta, GA Permit No. 210
Wrong address? Need to update your information? Tell us by email at marketing@augusta.edu Or call us at 706-721-7406
UPCOMING EVENTS/CHOG IN THE COMMUNITY 11th Annual Heart and Sole 5K & Evening Event • Saturday, March 4th • For additional info or to register/ purchase tickets visit www. heartandsoleinc.org. Kelsi Long Memorial Ride • Saturday, March 18th • To early register visit www. kelfoundation.org or the day of at Augusta Harley beginning at 9 a.m. IHOP National Pancake Day • Tuesday, March 7th • Stop by IHOP and enjoy FREE pancakes with your donation to Children’s Miracle Network Hospitals