Health & Wellness magazine by Solve Publications

THE NEW CHILDREN’S HOSPITAL

2008

THE CHILDREN’S HOSPITAL NETWORK OF CARE Expert Care Close to Home

STRESS: HOW WELL ARE YOUR KIDS COPING? Steps to avoid activity overload

HEALTHY HABITS BEGIN AT HOME Healthy Eating, The Joy of Cooking as a Family and Childhood Obesity

Ranked Among the

Top Five

Children’s Hospitals

in the Nation The Children’s Hospital is No. 4 in U.S. News & World Report’s 2007 ranking of the top pediatric hospitals in the nation. TCH is the only pediatric hospital in the West to make the top five. This year’s ranking was especially significant because it measured each hospital’s ability to successfully treat the children in its care. While in the past, rankings were primarily based on reputation, this year’s methodology also addressed a hospital’s performance of such complicated procedures as heart surgery, brain surgery and bone marrow transplant, as well as its overall quality of care including patient volume, nurse staffing, and the availability of cutting-edge technology, among others. The Children’s Hospital has been ranked nationally by U.S. News & World Report every year since the ranking’s inception in 1993. In 2006, TCH was ranked No. 7. This year’s ranking was not only the highest the hospital has received to date, but in light of the new ranking methodology also demonstrates its ongoing commitment to being the most healing hospital for children.

To learn more, visit

health.usnews.com/pediatrics

Dear Friends, It is with great pride and excitement that I welcome you to The new Children’s Hospital. In our nearly 100-year history of providing outstanding care for children, the opening of our new hospital is a milestone that will lead to even greater success in the years to come. The journey that has led to this important time has been rewarding on many levels. When we first started out in 2001, we had one goal in mind: to build the most healing hospital for kids. After all, pediatric care isn’t a “sometimes” focus for us. Pediatric care is all we do. After one visit to our new hospital, I think you’ll experience that focus and understand what a most healing environment for kids and their families is all about. Everything from the bright, inviting design to the state-of-the-art technologies we’ve implemented have led to a family-centered place of healing that we hope will serve the needs of children for generations to come. With the opening of our new hospital, we also welcome our new Network of Care locations. Our commitment to our former downtown Denver location continues with The Children’s Hospital at St. Joseph Hospital. Care by The Children’s Hospital at Lutheran in Wheat Ridge provides extended after hours care and multiple specialty services to children in the west metro area. And coming in the fall of 2008 is Care by The Children’s Hospital, Broomfield with urgent care and observation care 24 hours a day/7 days a week, ambulatory surgery and imaging centers, comprehensive sports medicine program and more. The addition of these locations brings the total number of our Network of Care facilities to 13. So no matter where you live, you’ll find the Children’s Hospital at a location that’s convenient and close to home. You also can rest assured that at all of our locations your child will have access to the latest technologies and the most accomplished and dedicated pediatric staff in the West. In fact, U.S. News and World Report has ranked The Children’s Hospital first among pediatric hospitals west of the Mississippi and among the top four in the entire country. Throughout the process that has led to the opening of our flagship facility, the dedication, support and insight of our exceptional team of physicians, nurses and staff, as well as our design partners, architects, families and patients has been instrumental to our success. None of it would have been possible without the generosity and support of our community, and we thank the hundreds of thousands of caring people who, through their generosity, have had a role in making this vision a reality. With warm regards,

Jim Shmerling, DHA, FACHE President and CEO

Peter Solveson 303-443-0629 peter@solvepublications.com

Publisher

Creative Director

Patrick Creyts patrick@solvepublications.com

Editor

Anjanette Meyer ameyer@solvepublications.com Kristen Bason Sue Emond Tanya Ishikawa Laura Johnston Katherine Osos

Writers

HEALTH & WELLNESS MAGAZINE Solve Publications

4716 Edison Lane Boulder, Colorado 80301 303.443.0629 www.solvepublications.com

Director of Marketing

Michelle Middleton

Public Relations PHOTOGRAPHER

Chuck Reyman Tia Brayman

The Children’s Hospital

13123 East 16th Avenue Aurora, CO 80045

720.777.1234 www.thechildrenshospital.org

Senior Account Manager

Jennifer Sterling

The Sterling Rice Group

1801 13th Street Suite 400 Boulder, Co 803202 303.381.6400 Www.Srg.Com Copyright 2008 Solve Publications. All Rights Reserved. Reproduction or use of editorial, data or graphic content is prohibited without written consent from Solve Publications. Health & Wellness Magazine is an annual publication of Solve Publications. It is not intended to provide medical advice on individual health matters. Please consult your physician for any health concerns. Every effort has been made to ensure the accuracy of this publication. Solve Publications assumes no responsibility for errors or omissions. Please notify Solve Publications with any changes or additions. Health & Wellness magazine welcomes your feedback. If you would like to add or remove your name from our mailing list, email Peter@solvepublications.com.

44 – 51

Healthy Habits Begin at Home

Tips and information about healthy eating, the joy of cooking as a family and childhood obesity.

16 Ouch-free Blood Draws

Lab assistants with pediatric experience help keep your kids smiling.

17 Ear, Nose and Throat Specialists

Pediatric specialty care is close to home.

18 Urgent Vs. Emergent Care

Have you talked with you physician about where to go if your child is injured or ill?

40 Finding the Right Specialty Care for Your Child

Building relationships and open-communication ensures quality pediatric care.

57 The Prescription Pet Program

Doggie kisses and fuzzy tails can help keep kids happier and healthier.

Ca r e S e rv ices & L oca tion s 24 The New Children’s Hospital 30 The Children’s Hospital Network of Care

Pediatric care in your community

42 In Your neighborhood

List & map to all of to all 13 The Children’s Hospital locations

52 Hospital Information

The Children’s Hospital Physicians Directory • Adolescent Gynecology • Adolescent Medicine • Allergy/Immunology • Anesthesiology • Audiology, Speech and Learning • Cardiac/Thoracic Surgery • Cardiology • Child Advocacy • Critical Care Medicine • Dental • Dermatology • Developmental/Behavioral • Diagnostics and Imaging • Emergency Medicine • Endocrinology • Epidemiology • Gastroenterology • Genetics • Hematology/Oncology • Hematology/Oncology/ Bone Marrow Transplant • Hematology/Oncology/ Neurooncology • Infectious Diseases • Neonatal/Perinatal Medicine • Nephrology • Neurology • Neurosurgery • Obstetrics • Ophthalmology • Orthopaedic Surgery • Otolaryngology • Pathology • Pediatric Surgery • Pediatrics and Primary Care • Physical Medicine and Rehabilitation • Plastic Surgery • Psychiatry and Behavioral Sciences • Pulmonology • Rheumatology • Urology

Fe atur e s 4 Kids Coping With Stress

Whether it’s a soccer practice, piano lesson, Boy scouts or cheerleading, your kids keep their social schedules full. But how do you know when enough is enough? by Sue Emond

7 Moms: Is Your Stress Level Stressing You?

Sometimes we moms get so busy caring for others that we don’t even notice when our stress has gotten out of hand. by Sue Emond

12 Saving Lives – One Shot At A Time

Is it safe to vaccinate? That question is weighing heavily on some parent’s minds. But physicians say there is no need to worry. by Kristen Bason

20 Wheezing And Sneezing

Could your child’s cold-like symptoms actually be allergy indicators? Get to know some basic information on diagnosis, treatment and prevention. by Laura Johnston 20

23 HAVE AN ASTHMA ACTION PLAN

It can’t be cured, but asthma can almost always be controlled. by Kristen Bason

28 On The Spectrum: Living With Autism

need short description by Kristen Bason

32 Keep Your Child Breathing Easy

need short description by Laura Johnston

34 Teenage Knee Pain

Colorado is full of active people, and kids are no exception. But sometimes they don’t realize their bodies can not always keep up with all that activity. by Tanya Ishikawa

36 Help Your Child Get Those ZZZs

need short description by Laura Johnston

38 Treating Cystic Fibrosis

need short description by Sue Emond

54 Those Pearly Whites

need short description by Laura Johnston

58 Dear Abby’s Mom

Is your infant not sleeping through the night? Has your little angel turned into the class bully? Insights on parenting from Health & Wellness’ resident mom. by Kristen Bason

56 Shaken Baby Syndrome

Loss of control can lead to permanent injury or death. by Tanya Ishikawa

60 Who’s Counting?

Stats and data relating to kids.

Saving Lives

One Shot at a Time by Kristen Bason

No doubt about it – misery is watching your baby get poked with needles. However, the possible effects of not getting the recommended vaccinations and boosters would be far more devastating to witness. The fact is, although vaccines have reduced or eliminated many infectious diseases that once commonly killed or debilitated children, the viruses and bacteria that cause these diseases still exist. Anyone not protected by vaccinations is literally a moving target. According to Dr. Robert Brayden, attending physician at The Children’s Hospital Child Health Clinic and vice president of the Colorado Children’s Immunization Coalition, “Kids today are safer than ever in the history of humankind because of the protection they receive from vaccines.” It seems obvious, then, that the right thing to do is follow your pediatrician’s recommendations for immunizations. However, many parents are confused and concerned when it comes to vaccines. As a result, they may hesitate, and even avoid, getting their child immunized against deadly diseases.

Busting the Myths: Information Overload

No Versus Know

In one ear, we hear that vaccinations are absolutely necessary and safe. In the other, we hear cautionary tales of autism and other neurological issues. A quick Google search on the Internet reveals the source of this dichotomy – information overload. Doctors encourage parents to educate themselves and be knowledgeable advocates for their child’s health. However, physicians warn that information on the Internet is often based on propaganda, not scientific evidence. It’s critical to seek out valid sources. “Parents are going to seek information on the internet, says Brayden. “Scientifically well conducted studies by research scientists without biases are the most reliable sources of good information.” Brayden recommends parents gather immunization information from the American Academy of Pediatrics (www. aap.org) or the Centers for Disease Control and Prevention (www.cdc.gov). He cautions that parents who research on unreliable sites also run the risk of basing their decisions on outdated information.

Is your child up to date? 2 mos

4 mos

Kim Smith, a mother of two and resident of Aurora, admits that she was apprehensive about vaccinations. Her concerns were based upon the rumors she heard about the possible side effects of immunizations – autism, lethargy and adverse reactions to vaccines that contain the live virus. Despite her concerns, Smith ultimately got her children vaccinated. “I talked to a lot of people and read up on the shots,” she says. “And, I talked to my pediatrician about the dangers of not getting them vaccinated.” Brayden says that when the parents tell him that they are against immunizing he tries to educate them. “I respond with the facts as they have accumulated over years of vaccination: vaccines work and are very, very safe.” He also has true stories that reinforce the importance of immunizing children. He describes his encounter with a baby who had Haemophilus influenzae. “The baby came off the helicopter at Children’s and barely made it into the PICU before dying. I remember the father in complete agony, crying and saying that he didn’t know his child was that sick, so he waited to get medical care,” he says. “We can prevent Haemophilus influenzae entirely with a vaccine that is essentially 100 percent safe.”

Recommended ages for childhood vaccinations

6 mos

8 mos 10 mos 12 mos 14 mos 15 mos

DtaP

15-18 mos.

Protects against: Diphtheria, whooping cough (pertussis), and tetanus

IPV

Protects against: Polio

6-18 mos.

MMR

Protects against: Measles, mumps, and German measles (rubella)

12-15 mos.

Varicella

12-18 mos.

Protects against: Chickenpox Protects against: Hepatitis B Protects against: Haemophilus influenzae Type B

May not be necessary

PCV

Protects against: Rotavirus, which causes severe diarrhea, vomiting, fever and dehydration

12-15 mos.

Protects against: Invasive pneumococcal diseases

Rotavirus

Chart compiled by Health & Wellness Magazine and verified by The Children’s Hospital.

All shots before 18 mos.

Hep B Hib

16 mos 18 mos 4-6 years

All shots before 32 weeks.

Hep A

Protects against: Hepatitis A, however this vaccine is not mandatory, only recommended Influenza Protects against: The flu

Recommended for all children 6-59 months. Two doses the first year and one dose for all subsequent years.

Health and Wellness Magazine •

“It was awful to watch her suffer like that, especially since it was an illness that I could have prevented.” What You Can’t See Can Hurt You

Many parents assume that because a disease appears to be eradicated in the United States, then their child is safe. Not only is this a naïve assumption, it is a dangerous one as well. According to the Centers for Disease Control, 80 to 90 percent of the population needs to be vaccinated in order to keep the disease out of the community. Most diseases aren’t as prevalent as they were in the past, thanks to better nutrition, less crowded living conditions, antibiotics and, most importantly, vaccines. However, the bacteria and viruses responsible for these diseases still exist. For example, whooping cough, or pertussis, is another preventable disease that should be a major concern to parents, especially in Colorado. “Colorado has a disproportionately high number of cases of pertussis,” Brayden says. “Even though we had fewer cases of whooping cough in 2006 (about 700 preliminary cases) than in 2005 (over 1,300), we still have too many cases in the state.” Whooping cough can be very serious, even fatal, especially in the very young and elderly. Vaccination beginning at two months of age is important for reducing the severity and preventing the spread of the disease. Shelley Clinton of Denver regrets her initial decision not to get her infant daughter vaccinated against pertussis.

The HPV vaccine is predicted to protect thousands of future young women against HPV and cervical cancer. “When Claire was 8 months, she got very sick with whooping cough and came close to dying,” says Clinton. “It was awful to watch her suffer like that, especially since it was an illness that I could have prevented.” Fortunately, Clinton’s daughter recovered, although she has recently been diagnosed with asthma as a result of her bout with pertussis. Clinton’s daughter, now 13 months old, is currently caught up with all of her vaccinations. Clinton admits a former neighbor convinced her that vaccinations were dangerous and that was why she didn’t get her daughter immunized despite her pediatrician’s advice. “I listened to someone who didn’t know all the facts,” she said. “Now, I tell people how dangerous it is not to protect your child with vaccines. I am a believer, but I had to learn the hard way.”

Advances in Immunity

Parents should take comfort in knowing that research is constant when it comes to disease control and immunizations. Just recently, several new vaccinations have been recommended for children and adolescents by the Advisory Committee on Immunization Practices. Receiving the most accolades is the newly licensed (July 2006) human papillomavirus (HPV) vaccine. It is predicted to protect thousands of future young women against HPV and cervical cancer. The ACIP recommendation allows for vaccination of girls beginning at nine years old, as well as vaccination of girls and women 13-26 years old. (See side bar) Another recent addition to the roster of recommended vaccinations is the Rotavirus Oral Vaccination. ACIP is recommending that infants receive the first dose at 2 months, followed by boosters at 4 and 6 months of age. 6

“In the 23 years since becoming a pediatric resident and now an attending physician, I have never seen a life threatening or anaphylactic (severe allergic) reaction.” Ask any parent, and they’ll tell you that a stomach virus is one of the worst ordeals to go through with a child. Now, this miserable experience – for both parent and child – could be a thing of the past . . . or at least not as miserable. Rotavirus causes severe diarrhea, vomiting, fever and dehydration (gastroenteritis). While rotavirus isn’t responsible for all cases of diarrhea, it’s the common cause of severe cases in children. And remember having the chicken pox? Most likely, you have a scar or two that reminds you of your bout with this common childhood illness. For over 10 years, the chicken pox vaccine (varicella) has been given to infants in the U.S. Starting last year, a second dose was recommended between 4 and 6 years of age. The shots have proven to be safe, and very effective.

Benefits Outweigh the Risks

Any doctor will tell you that the benefits of vaccinations far outweigh the minor side effects. The most common side effects are swelling and redness at the injection site. Other side effects are a low fever and some fussiness. A dose of ibuprofen usually takes care of any discomfort. “Serious side effects are extremely uncommon,” Brayden says. “In the 24 years since becoming a pediatric resident and now an attending physician, I have never seen a life threatening or anaphylactic (severe allergic) reaction.” What about vaccinations causing autism? The CDC studied (and continues to research) whether there is a relationship between vaccines and autism. Very strong evidence indicates that vaccines are not associated with autism. As a parent, what can you do to ensure your decisions are based upon fact, not myth? Don’t just do your research, be sure you are doing it in the right places – search on reputable Web sites such as those hosted by the American Academy of Pediatrics and the CDC, discuss your concerns with your pediatrician and, most importantly, ask questions. Brayden sums it up. “Investigate the benefits, as well as the risks of vaccinating and not vaccinating carefully and ask a doctor that you trust for her or his opinion about vaccination.”

What is HPV? The human papillomavirus represents a group of viruses that includes more than 100 different strains or types.

Who gets it? Almost all of these viruses are sexually transmitted. According to the CDC, approximately 20 million people are currently infected with HPV. By age 50, at least 80 percent of women will have acquired genital HPV infection.

What does it do? In some cases, HPV can lead to cervical cancer in women. In 2004, the American Cancer Society estimated that about 10,520 women will develop invasive cervical cancer and about 3,900 women will die from the disease.

Controversy Abounds So, it seems like easy decision to get young women immunized against the disease. However, there is much controversy surrounding the vaccine. Because ACIP recommends that the first vaccination is given to girls beginning at nine years old, some parents think that it will give the green light to sexual promiscuity of their daughters. As a result, some parents choose not to have their daughters get it. “This issue is very, very complex,” says Brayden. “Suffice it to say that thousands of American women could be alive today if they had gotten the HPV vaccine.” He adds, “The values that we hold for our children and the examples that we set for them should be separate from the protection that we provide for them through vaccination.”

How Can I Learn More? • • •

Ask your doctor or nurse for more information Call your local or state health department Contact the Centers for Disease Control & Prevention: 1.800.232.7468 (English) or 1.800.232.0233 (Spanish) or visit http://www.cdc.gov/nip

5 Questions Doctors WANT You to Ask: 1) Is it safe? 2) What disease does this vaccine protect against? 3) Why should I have my child vaccinated? 4) What are possible side effects of the vaccine? 5) Do you have any information I can read about this vaccination?

Health and Wellness Magazine •

Healthy habits begin at home Take an active role in your child’s nutrition.

Healthy snack ideas

Substitute greasy chips or sugary foods with one of these tried-and-true options that kids enjoy. • • • • • • • • •

Low-fat yogurt Unsweetened cereal Celery with peanut butter Salt/sugar-free trail mix Whole grain crackers Apple slices mixed with cheese cubes Animal crackers Snap peas Pretzels sprinkled w/ salt-free seasoning

Just telling your kids to eat healthy foods is not enough. They need help and encouragement to guide them into a nutritious routine.

1. Provide a Healthy Environment “Kids will eat healthy if they have a chance to take part in preparation, help grow the vegetables and if those foods are readily available,” says Dr. Nancy Krebs, medical director of nutrition services and director of the GoodLIFE Clinic at The Children’s Hospital. Keep dinnertime fun by having your kids pick out healthy foods at the grocery store or help rinse the vegetables. Snapping peas and shucking corn are tasks that kids of almost any age can take part in. It’s also a good idea to keep chopped carrot sticks and celery in a bowl in the refrigerator. That way, the veggies are as easy to grab as a bag of potato chips. Often, kids and adults choose unhealthy food because it tends to be more accessible.

2. Try the One-Bite Rule The only way for your kids to try new foods is to make new foods available at mealtime. Enlist the one-bite rule. If your child doesn’t like something after one bite, don’t force it. He or she will eventually come around. “The worst thing parents can do is get into a control 8

Eat breakfast!

Kids who eat breakfast tend to do better in school and eat more appropriately throughout the rest of the day. Is your child tired of breakfast cereal? Mix it up by offering a hardboiled egg with a whole wheat muffin or instant oatmeal with banana slices.

To learn more about how to help support healthy eating habits in your child, contact the Clinical Nutrition Department at The Children’s Hospital: 720-837-2781.

battle over food,” says Marilyn Day, registered dietician and co-director of the Shapedown® program at The Children’s Hospital. Taste buds can be trainable, so start slow. Introduce one new food at a time, and try new ways of preparing it. Don’t expect a child to learn to love asparagus overnight! Try adding asparagus to an omelet or in vegetable soup.

3. Be a Role Model and Set Limits

Kids usually follow the lead of their parents when it comes to nutrition. So be a good leader! “You can’t expect your child to eat fruits and vegetables if you don’t,” Day says. Although healthy foods should be readily available, the supply shouldn’t be endless. So remember to set limits on the intake of food and amount of time your kids watch T.V. If they are eating continually throughout the day and not burning it off through physical activity, their bodies are sure to store those extra calories away. Elizabeth Principato (left) discusses her goals with Marilyn Day (right), a registered dietician and co-director of the Shapedown® program at The Children’s Hospital.

The Joy of Cooking – As a Family Want to get your kids excited about helping out in the kitchen? Here are a few suggestions from Annie Sasseville, a registered dietician at The Children’s Hospital: Kids can easily wash fruit/vegetables in the sink and older kids can help peel these foods (especially if mom or dad help to get the peeling process started for them). Kids can help mix, blend, measure or stir foods (depending on age). They might make a bigger mess than you would, but they will probably enjoy the experience and will be more likely to eat the foods they helped prepare. Take your kids to the grocery store with you and shop together. This will help to give the kids a greater feeling of accomplishment and contribution to the meal. Younger kids will enjoy setting the temperature on the oven and setting the microwave or kitchen timers (you can encourage good math skills here, too!). Consider buying young children a little apron, and try to use smaller utensils that will fit into their hands.

Turn the page for some delicious snack ideas that you can make with your child.

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Oven-Baked Carrot Fries

Spinach Yogurt Dip

• 1.5 lbs carrots (about 10 medium) • 2 tbsp olive oil • 1 tsp sugar • 1 tsp salt • Pinch of pepper (You can also add other yummy herbs, such as rosemary)

• • • • • • •

Bye-bye potatoes! Try this twist on a mealtime favorite.

This quick and easy dip is snack food that’s actually good for you.

1. Preheat oven to 425 degrees Fahrenheit. Line jelly roll pan with aluminum foil. 2. Peel carrots, always peeling away from your body. 3. Cut one carrot in half. Cut each half lengthwise, and then cut them lengthwise again so that you have 8 sticks per carrot. Repeat with all carrots. 4. In mixing bowl, combine carrots and other ingre dients until evenly coated. 5. Spread in single layer. Bake for 20 minutes.

A 10-oz package of frozen chopped spinach, thawed 2-3 scallions (spring onions) green and white parts, chopped 2-3 cloves chopped garlic (or 2-3 tsp. of minced garlic) 2 cups plain yogurt 3 tbsp freshly grated Parmesan cheese A grating of fresh nutmeg Salt and freshly ground pepper to taste

1. Squeeze the spinach to remove as much water as possible. 2. Combine with the remaining ingredients in an electric blender or food processor and process until smooth. 3. Refrigerate for at least 1 hour before serving with raw vegetables. Makes about 2 cups (500 ml).

Childhood Obesity

Keeping your kids active could save their lives

Childhood obesity is on the rise. And with video games, hundreds of television channels and fast food available at a kid’s fingertips, it’s no wonder that many children lack energy and are gaining weight. Obesity can increase a child’s risk for type-2 diabetes, high blood pressure and heart disease. Although eating a healthy diet is one way to combat the problem, staying physically active is important, as well. It is essential for parents to be proactive and begin promoting a healthy lifestyle in their children at a young age.

Get on the move . . .

Colorado is famous for its accessibility to many forms of outdoor activities, so take advantage. Plan a bike ride, a day of snow sledding, trips to the park or even walks around the neighborhood with your child. Organized athletics also are a great way for your kids to stay active and possibly meet new friends. Try to find out what your child likes – team activities, solo sports such as skiing or creative ventures such as dancing. Since kids tend to change their minds often, try renting or borrowing equipment before investing in gear. But remember, the name of the game is fun! 10

Winter Fun in the Rockies! Lace Up Your Ice Skates

• Evergreen Lake – Evergreen: www.evergreenlakehouse.com • One Boulder Plaza – Boulder: www.bouldericerink.com • Belmar – Lakewood: www.belmarcolorado.com

Head to the Zoo

Winter is a great time to visit the zoo. Many animals that shy away from the summer heat are active during the winter months. Visit www.denverzoo.org

Find a Favorite Sledding or Tubing Hill

• Sledding Hill Park – Littleton/Lone Tree: www.ifoothills.org • Winter Adventure Ridge – Vail: www.vail.snow.com • Adventure Point Tubing – Keystone: http://keystone.snow.com/info/winter.tubing.asp

Denver Parks and Recreation www.Denvergov.org/recreation 303-370-6668

Learn to Ride or Ski! program Snowshoe Excursions Ruby Hill Rail Yard

www.skiwinterpark.com/rubyhill.htm

Exercise isn’t just for athletes Not all children are interested in sports or outdoor activities, such as hiking. But there are still plenty of ways to keep an overweight child active. Allison Donohue, a recreation therapist who works with the GoodLIFE program at The Children’s Hospital, says there are three criteria that qualify an activity as exercise. The activity must: 1) Make you breathe heavily 2) Make you sweat 3) Allow you to have fun If bike riding or swimming is not fun for your child, try to think of other creative ways for them to get moving. For example, go to a pottery class together, but walk there instead of drive. Or have fun with sidewalk chalk and draw pictures on the driveway, but place the chalk on the other side of the yard. Allow your child to use only one color at a time, and have him or her walk to the

“To help explain the reason for exercise, I tell kids that food is like a little red ball in the body. If it just sits there, the ball turns flat. But if you go for a walk, run a vacuum or dance, the red ball will turn into energy and muscle…” —Allison Donohue

Recreation therapist at The Children’s Hospital

chalk bucket. And when it is laundry day, have your children bring their own clean clothes to the bedroom. First have them walk their shirts, then their pants, then socks, etc. In the winter, building snow forts or snowmen also are great ways to get your child moving and smiling at the same time!

Communication is Key! Many obese children suffer from psychological and social issues, in addition to the physical health risks their weight can cause. Connect with your kids and ask questions. Be sure to know what is going on outside the home. “Make sure the family has a policy against weight-teasing and that relatives know weight-based conversations are off-limits,” advises Marilyn Day, registered dietician and co-director of the Shapedown® program at The Children’s Hospital. Is your child overweight and suffering from any of the following? If so, your primary care physician can provide guidance or a referral to address these problems. • Depression • Low self-esteem • Difficulties with schoolwork • Bullying • Body image issues If you suspect your child may be obese, contact your family physician. The Children’s Hospital offers professional help with weight loss in its GoodLIFE and Shapedown® programs. Ask your physician if such programs could help your child manage his or her weight. Recreation therapist Allison Donohue (left) works with Jamie Adams (right) in the GoodLIFE Clinic at The Children’s Hospital.

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

S t r e ss How Well Are Your

Kids Coping? By Sue Emond

Stress is a fact of life. And while parents often talk about how stressed

out they are, their kids might be living with more stress than the parents realize. “I’ve definitely seen stress increasing in kids over the past few decades,” says Jeffrey I. Dolgan, PhD, chief of psychology and director of psychology ambulatory services at The Children’s Hospital. More than anything, he says, kids are over-stressed because they’re over-burdened and sometimes unnecessarily.

Sources of Stress for Kids Dolgan explains that kids are vulnerable to stressors in three main areas of their lives: home, school and environments. Family problems are the kids’ problems, too. Whether it’s parental conflicts, financial instability or a death in the family (even of a pet), kids undoubtedly experience some level of stress. And embarrassing situations, as well as extremely challenging events, can be especially stressful. So can sadness and feelings of loneliness. And though kids can feel overwhelmed at times by their schoolwork, their social environment at school can affect them even more. “Overall, kids worry less about academics and more about fitting in,” Dolgan says. Julie Lambert, a Denver financial services VP and mother of two, says her 7th grade daughter has a strong desire to be liked by everyone, and especially girls her age. “Christy can get pretty upset when acceptance issues come up at school,” says Julie. Christy is also a straight-A student and extremely busy. A talented gymnast, Christy trains 16 hours per week and competes at the state level—and deals with regular fatigue from her training schedule, says her mom. And when she’s tired, “she starts worrying more about the little things.” When the stress hits, “I talk to Christy about prioritizing the stressors, and then help her with problem solving,” says Julie.

Are Your Kids Over-Booked? Though Christy is busy, she’s fortunate enough to have parents who insisted she forego softball when she chose to take up gymnastics. Dolgan says that some kids have too much going on and are experiencing high levels of stress because of it. “Sometimes parents can hardly keep up with their kids’ afterschool activities, but unfortunately, it’s sometimes the parents who have engaged their children in too many activities.” After awhile, says Dolgan, parents have to “stop adding and start subtracting activities.” But even a single activity can be too stressful for some kids. “Parents and coaches can have unrealistic expectations of the kids and can put unhealthy demands on them.” What’s important is making sure that kids are involved in the right amount of activities and the right kind of activities—for them. “The fight or flight response to stress is normal, and kids need to understand the best response for them, given the situation...”

Rachel Ancar, a busy Denver high school sophomore, says that “sometimes it’s hard to juggle school, tae kwon do and sports, while trying to still hang out with my friends.” Overall, though, Rachel thinks she handles stress pretty well and hasn’t taken on too much. Yet her hectic schedule does get to her at times, and Rachel tries to find a balance. “I haven’t really found a way to prevent stress,” says Rachel, “but when it hits I like to go home and lie on my bed for a while to relax. Or I might take a break from schoolwork and watch TV, talk to friends or read.” Dolgan says if you ask your kids for some ideas of how they might cope with stress in their lives, they can probably come up with a list pretty quickly.

How Parents Can Help

• Be a good model of how to cope with stress • Help your kids to eat well and to get enough sleep and exercise • Teach them relaxation techniques • Rehearse stressful situations ahead of time with your kids • Limit their exposure to negative media, such as TV news • Monitor your kids daily for stress levels: How are they thinking, feeling, behaving? • Watch for the sources of stress and make modifications when appropriate • If you’re concerned with your child’s stress level, talk to him • If your concerns continue, consult with your pediatrician or family practitioner

How Kids Can Help Themselves

• When you feel stressed, talk about your feelings and thoughts • Make a list of healthy ways to deal with stress, and use it • Exercise regularly, even if it’s walking through the park or around the zoo • Break large tasks into smaller ones—don’t put off writing that term paper until the night before it’s due • Pay attention to negative thoughts—when you notice one, replace it with a positive thought • Make sure your activities are right for you— and most importantly, fun!

Health and Wellness Magazine •

How Kids Can Better Cope with Stress According to Dolgan, children who aren’t handling stress well typically react to it in one of two ways: they internalize or they externalize. Those who internalize stress can appear anxious or they might complain of a tummy ache or headache. Then some might simply withdraw. Yet others are more prone to act out and exhibit aggressive behavior, such as fighting at school. Teaching coping skills to kids is important so they’ll be prepared for stress, which is inevitable. “The fight or flight response to stress is normal, and kids need to understand the best response for them, given the situation,” Dolgan says. “Also, what works at one age might not work at another.” “Don’t let your kids become mysteries. Assess their behaviors, thoughts, and feelings.”

Dolgan explains that relaxation techniques, such as deep breathing and yoga, are particularly important for kids to know. “Once kids know and practice these skills, they can make better choices when stress arises.” Master Chris Natzke, a 6th degree black belt and master instructor at the Family Martial Arts Center in Aurora, sees several important ways that martial arts can help kids deal with stress. “The physical activity of kicking, punching and blocking is a great stress release. So is the yelling (ki hap in Korean) and focused breathing—a technique that can also aid kids in non-violent conflict resolution. Plus, when a child’s confidence grows with their body and mind from martial arts training, an increase in self esteem can have a direct effect on lessening stress,” says Master Natzke. “And for kids who suffer from being bullied, the boost in confidence from martial arts can make them a less attractive target for bullies, and can even eliminate the bullying altogether.” Parents can play a big role in how their children react to stress. Most importantly, says Dolgan, parents need to model healthy coping skills. “Parents who are racing around frantically are not great examples for their kids.” Sleep and diet, as parents can attest, often affect mood and ability to cope with stress. Annie Sasseville, a registered dietician at The Children’s Hospital, offers advice on meal planning: “Make sure that kids eat an adequate amount of carbohydrates for energy, along with protein. But watch their fat intake—too much can leave them feeling sluggish. For finicky eaters, and especially those who don’t get enough fruits and vegetables, consider a children’s chewable multi-vitamin. Also, keep in mind that kids are more comfortable with schedules, and making meals and snacks predictable for them typically works best.”

When Should Parents Seek Help? Parents should monitor kids daily for how they’re responding to stress, Dolgan says. “Don’t let your kids become mysteries. Assess their behaviors, thoughts, and feelings. Take note of anything out of the ordinary, and talk to them to learn more. If you’re concerned, consult with others, like their friends’ parents, their teachers, and their coaches. And watch for the sources of stress.” He explains that if a child becomes anxious for a day or two about a particular event that has happened, or will soon happen, you’re probably okay. But, for instance, if an unusual response to a stressor lasts for a couple weeks or more, consult with your pediatrician or family practitioner—they can refer you to a mental health practitioner, if necessary. The bottom line, says Dolgan, is that parents should seek help if they’re worried. “Parents really do know.”

Some Signs of Stress in Kids Ask yourself, “Is this behavior unusual for my child?” • Difficulty concentrating • Feeling especially down, edgy or guilty • Sleep problems (difficulty sleeping or sleeping too much) • Laughing or crying for no reason • Wanting to be alone all the time • Being particularly pessimistic • Not enjoying activities they used to enjoy • Feeling especially resentful of people or things • Changes in appetite • Headaches, stomachaches or skin rashes • Readily blaming others for things • Complaining about having too much to do

Moms: Is Your Stress Level

S t r e ss i n g

Y o u ?

By Sue Emond Let’s face it—being a mom is a stressful job. From toddlers throwing tantrums to pesky teens to spouses on the road, our stress can be difficult to keep in check. And sometimes we moms get so busy caring for others that we don’t even notice when our stress has gotten out of hand.

According to Dr. Ayelet Talmi, associate director of the Irving Harris Program in Child Development and Infant Mental Health and assistant professor of the departments of psychiatry and pediatrics at the University of Colorado Denver and at The Children’s Hospital, some stress is unavoidable. But too much stress can negatively impact the areas of moms’ lives that they care about the most: • We moms can be so preoccupied with our stressors that we’re not really available to our children and partners • When we feel increased pressure in one area of life—like a demanding job or a sick child—we’re unable to fully engage in the other areas • Those edgy feelings caused by stress can crank up the chances that we’ll take out our stress on those closest to us • Chronic stress can lead to fatigue and may have enduring mental and physical health ramifications for us “Take care of yourself. You cannot be the best mother you can be when you aren’t taking care of yourself.”

Taking Charge of Stress So it’s clear that moms need to care for themselves and not let stress take charge. To feel balanced, energized, and able to thrive under the demands of motherhood, we need to take an active role in reducing stress. Consider the advice of Dr. Talmi: “Take care of yourself. You cannot be the best mother you can be when you aren’t taking care of yourself. Sleep. Eat well. Exercise if you can. Find time every day that is yours alone. The more you enjoy life, the more your children, family, and friends will enjoy you.”

When to Seek Help • Stress seems like a permanent aspect rather than a transient event • Stress is impairing our ability to perform our roles and responsibilities • Stress is causing high levels of distress that can’t be managed using typical coping strategies

Think You May Be Over-Stressed?

• Get social support from family members, friends or hired help • Let someone else know how you’re feeling • Seek professional help from a local mental health center or your doctor

Beating Stress When You’re at Home

• Shower or take a hot bath to relax your muscles and mind • Lie down and breathe quietly • Call a friend • Take a mini-break or two for activities you love • Write in a journal • Take a brisk walk outside or on a treadmill • Practice yoga or simple stretching • Look for relaxation and meditation videos online featuring brief routines • Watch a funny movie! • Try chamomile tea • Use lavender aroma in your home • Learn to say ‘no’ to family members, especially when you’re overwhelmed

Beating Stress While You’re on the Run

• Try some deep breathing—put one hand on your abdomen and the other on your chest, and practice breathing so only your lower hand moves when you inhale • Call a friend • Play your favorite mellow CDs in the car • Snack on healthy foods • Avoid negative self-talk • Close your eyes for a moment and visualize a favorite place of yours • Say something kind to a stranger

Health and Wellness Magazine •

Ouch-free Blood Draws Needles can be scary . . . and so can blood! So when a child hears he is going to get his blood drawn, it might be a bit intimidating. At The Children’s Hospital, staff members work with children everyday and have the experience to draw a child’s blood efficiently – usually with only one poke – and at the same time, keep the child calm. In fact, patients who previously had difficulty getting their blood drawn at another facility are often transferred to the Outpatient Laboratory at The Children’s Hospital. That’s because the staff are specially trained in pediatric blood draws. They also understand each child’s fears and empathize with parents. There’s no getting around it, blood tests are usually necessary to help your doctor make a diagnosis and monitor treatment for your child. But The Children’s Hospital aims to make the experience as quick and painless as possible by exclusively using butterfly needles, which are more appropriate for little ones. And little heating packs are placed on hands and heels to help increase blood flow, making it easier to draw blood and allowing time for the phlebotomist to get to know your child.

Lucas Cardenas gets his blood drawn by Joseph Whisenhunt, a lab assistant in The Children’s Hospital Outpatient Laboratory.

Outpatient Laboratory Team Back Row: (left to right) Joseph Whisenhunt, Mattie Hill, Ken Cook, Brandi Jefferson Front Row: (left to right) Arlene Castaneda, De’nese McGee, Sandi Stephens, Chantelle York

The Children’s Hospital phlebotomists truly enjoy working with children and understand that blood draws are supposed to help – not hurt! That’s why many families choose to visit The Children’s Hospital and its Network of Care locations for all their children’s routine blood draws.

Ear, Nose and Throat Clinic The Children’s Hospital offers specialized care close to home Ear infections may be common, but when your child is crying and in pain, you don’t want common medical care. Those ears are precious; they are your child’s ears! So when there’s a problem, you need help from someone who has experience with children’s health issues. At The Children’s Hospital, Ear, Nose and Throat specialists work exclusively with kids, which means those doctors are focused on pediatric medicine and they know how to put your child at ease. There are very few pediatric ENTs in the U.S., but The Children’s Hospital has six of these specialized physicians on staff. And you don’t have to travel all the way to Aurora to seek their help. Thanks to Children’s Network of Care, your child can get the care he or she needs at a location that’s convenient and close to home. “Families are busy and don’t have the time to travel great distances for healthcare,” says Dr. Gregory C. Allen, a pediatrics otolaryngologist, or ENT specialist, at The Children’s Hospital. “Providing care at a location that’s closer to home makes sense for what’s best for the kids.” Dr. Allen currently sees patients at the new Children’s Hospital at Lutheran twice a month. He also sees patients at the new Broomfield location and at the main hospital in Aurora. “We’re very excited about working with local primary care physicians and hope to increase the

number of providers and amount of time we spend at (Lutheran),” he says. At the new Children’s Hospital at Lutheran patients can get exams, have surgery and receive audiological testing close to home. Whether your child needs a tonsillectomy or antibiotics for an ear infection, The Children’s Hospital provides the care that can keep your child smiling and healthy without leaving the comfort of your community. “We take care of children with uncommon ear, nose and throat problems and children with common ear, nose and throat problems combined with other complex health issues,” says Dr. Allen. “The benefit is having the entire Children’s Hospital staff behind you when issues are difficult to figure out.”

The ENT specialists at The Children’s Hospital offer medical treatment for a variety of conditions, including: • Ear infections • Sinusitis • Hoarseness • Holes in eardrums • Tonsils and adenoids • Ear tubes • Rhinoplasty

• Tympanoplasty • Biopsies • Audiology services • Upper airway obstruction • Noisy breathing • Sleep apnea or snoring • Hearing loss

To make an appointment, call you pediatrician for a referral or Children’s central appointment center at 720-777-8501. The Children’s Hospital at Lutheran is located just southeast of Lutheran hospital in Wheat Ridge.

Greg Allen, MD inspects Hayden Sands’ ear during an ENT visit.

Did you know the cartilage in the human ear and nose continues to grow throughout life?

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Urgent vs. Emergent Care

Have you talked with your physician about where to go if your child is injured or ill? It’s the middle of the night and your 14-month-old child is crying, fussy, running a fever and vomiting. Panic sets in, and all you know for sure is that you want her to feel better – fast. But what do you do? Should you wait to call your doctor tomorrow or go to the emergency room tonight? Or perhaps it’s the middle of the day and your 7-yearold child hurts his arm from falling down the stairs. Amid his screaming and crying, how do you determine the severity of the injury in order to decide whether to visit an urgent or emergent care facility?

Take a proactive approach

As a parent, you will be faced with many questions. But when it comes to your child’s health, getting some answers beforehand could prevent undue pain and frustration or even save your child’s life in the future. Have you previously discussed with your physician what symptoms demand immediate attention? If not, now is the time to inquire. “A proactive approach makes a big difference in the health of your child,” says Dr, Joan Bothner, who oversees all of The Children’s Hospital emergency and urgent care services. In addition to a preliminary conversation with

your child’s physician, Dr. Bothner suggests planning where you will take your child in different situations. She recommends calling care facilities in your area to determine the pediatric expertise of the staff.

The Children’s Hospital is here to help

If your child is injured or ill, your first call should be to your primary care physician’s office. (Of course, in a life threatening situation, call 911 immediately). After business hours, many physician offices have calls routed to a telephone triage team, such as the After-Hours Call Center at The Children’s Hospital, which is staffed with nurses who can help assess a situation. And those who do not have a primary care physician can call The Children’s Hospital ParentSmart! HealthLine for assistance: 720-777-0123. If a medical problem arises that requires emergency care, there is a 24-hour pediatric facility close to home. The staff at The Children’s Hospital has experience with treating children of any size and age. Although no one knows how to predict an emergency, the staff at The Children’s Hospital knows how to treat one.

Care for kids, and only kids, after hours The Children’s Hospital now has 13 locations where you can find pediatric emergency care, urgent after hours care, pediatric specialists, therapy care and more.

For more information on The Children’s Hospital Network of Care, turn to pages 30 and 31, 41 and 42 and/or visit: www.TheChildrensHospital.org and click link ‘map of locations’. Here are two new locations close to home.

The Children’s Hospital at Saint Joseph Hospital 720-777-1360 1835 Franklin Street • Denver, CO 80218

Emergency and Hospital Care –24 hours a day, 7 days a week

Urgent Care Facilities treat minor

illnesses and injuries that require medical attention, but are not life-threatening. These facilities are useful after normal business hours, if you are unable to see your primary care physician. Some commonly treated medical conditions include: • Mild asthma • Colds • Sprained ankle • Ear infections • Diarrhea • Sore throats • Vomiting • Minor burns

Emergency Departments not only

treat minor conditions, but also have physicians trained in dealing with catastrophic illnesses or life-threatening injuries. Some commonly treated medical conditions include: • Severe asthma • Concussions • Dehydration • Severe abdominal pain • Seizures • Severe cuts with excessive bleeding • Fevers in infants younger than 8 weeks

The Children’s Hospital opened a new pediatric hospital at Exempla Saint Joseph Hospital in September 2007. This pediatric hospital is completely staffed and supported by The Children’s Hospital’s pediatricians and nurses. The 12,500 square-foot facility supports The Children’s Hospital’s familycentered care philosophy, helping reduce the stress of a hospital visit for everyone. The 16-bed location has approximately 60 staff members, including doctors, nurses and other care providers. The entrance to Children’s emergency services is on Franklin Street immediately across from the Franklin Street entrance to Saint Joseph Hospital. Short-term parking is available immediately outside the entrance for families with emergencies.

Care by The Children’s Hospital at Lutheran, Wheat Ridge

720-777-1370 Exempla Lutheran Medical Center 3455 Lutheran Parkway, Suite 230 • Wheat Ridge, CO 80033

Urgent Care, After Hours

2 p.m. to 2 a.m. Monday - Friday 8 a.m. to 2 a.m. Saturday & Sunday Children’s After Hours Care at Lutheran Medical Center provides urgent pediatric services when you just can’t wait until the morning to see your child’s doctor. Pediatric specialists provide evaluation, treatment and follow-up care in a broad range of fields such as audiology, cardiology, dermatology, endocrinology, gastroenterology, general surgery, neurology, orthopedics, otolaryngology, pneumology and urology.

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Kids with Allergies

by Laura Johnston You cringe every time you hear it: “Ah-choo!” When that simple sound comes from your allergic child as she struggles to fight off the symptoms caused by allergies, your heart goes out to her.

An allergy is an overreaction of the immune system to a foreign substance, called an allergen. Allergens are harmless to most people, yet in someone with an allergy, the body’s immune system treats the allergen as an invader and attacks it by producing antibodies, such as histamine. It’s these chemicals that result in the allergic reaction affecting the child’s eyes, nose, throat, lungs and skin. Allergic Rhinitis, also known as hay fever, is the most common allergic condition and affects people of all ages, but it can be especially difficult for children. This harsh enemy attacks their immune systems causing a wide range of uncomfortable symptoms for children, while leaving their parents to cope with getting it properly diagnosed and treated.

Is It a Cold or Allergies? You notice your child has been feeling ‘under the weather’ for several weeks with symptoms including a runny nose and cough. As you continue to manage her symptoms with a variety of cold medicines and countless boxes of tissue, you wonder if it will ever end. Then it dawns on you – could it be allergies? How can you tell? According to Dr. Dan Atkins, an allergist at The Children’s Hospital, up to 40 percent of children in the United States suffer from hay fever. However, before investing a lot of time and money, it is beneficial to investigate the cause to determine if allergies really are the culprit. Allergies and colds share common symptoms, such as sneezing, watery eyes and a runny, itchy nose. Yet Atkins says, “Colds cause fever, aches and pain and typically run their course in a week to ten days, whereas allergy symptoms continue for long periods of time during exposure to the allergens. Parents should also consider if it is cold and flu season or if there is a family history of allergies.” Allergies are often hereditary, but just because the parent has an allergy, it doesn’t mean the child will, too. And a person usually doesn’t inherit a particular allergy, just the likelihood of having allergies. Dr. Mark Boguniewicz, an

Up to 40 percent of children in the United States suffer from hay fever. allergist with The Children’s Hospital, says, “Allergy sufferers are born with the disease. In order for the body to make an allergic response, you need to have the genetic predisposition that triggers an allergic overreaction.” Jeff and Heather Karas’ family is a good example. Heather has hay fever, food allergies and drug allergies. Her 10-year-old son, Michael, suffers from hay fever and food allergies, while his twin sister, Marina, is primarily allergic to penicillin (although shows very slight signs of hay fever). “It just doesn’t seem fair to Michael that I handed this down to him,” Heather says. Battling symptoms can be tough on children, but it can be equally difficult for parents and siblings to accept this as part of their lives. It can limit the entire family on outdoor activities or simply owning a pet. “The kids really want a dog,” Heather says, “but we know we have to wait until his symptoms are well-controlled. Instead we make a big deal out of the fish!”

Diagnosis and Treatment If a doctor suspects allergies, he may refer your child to an allergist to diagnose and treat the potential allergy. The allergist will likely ask several questions regarding your child’s health including family history, foods he or she eats and environmental factors, such as exposure to plants and pets in the home. If your child is allergic to one substance, it’s likely that he or she will be allergic to others, as well. Finally, a skin test may be performed to determine which allergens affect your child. Atkins describes a skin test as a simple procedure. “We drop a small amount of the allergen in the form of an extract onto the patient’s skin, and then wait for a certain type of immune response. A small red bump, similar to a mosquito bite, tells us if the body is producing an antibody against the allergen.” Unfortunately, it isn’t always possible to prevent contact with allergens; therefore, medication is the next step in reducing symptoms. Antihistamines are typically used to treat itchiness, sneezing and a runny nose, while nasal sprays are the best treatment for a congested nose. However, these medications only offer symptomatic relief. Boguniewicz says, “Some medications are now approved for children as young as six months.”

A c h i l d w h o i s n o t responding well to medications may be a candidate for allergy shots, also known as immunotherapy. “Once we figure out what the child is allergic to, a small extract of the allergen is made, then is injected into the child in gradually increasing doses on a weekly basis,” Atkins says. Immunotherapy works to change the immune system response to the allergen. Atkins says, “The benefit of allergy shots is that it is one form of therapy that may cure a patient whereas other forms are symptomatic treatments.” Some patients also seek allergy relief by turning to alternative sources, such as probiotics (Lactobacillus), vitamins C and E, and acupuncture. “There is something to alternative medicine, as most of the world practices non-Western medicine,” says Boguniewicz. “However, most of it has not been subjected to rigorous scientific trials.”

Health and Wellness Magazine •

Preventing an Allergic Episode There is no cure for allergic rhinitis, so every time sufferers come into contact with a particular allergen, they will have the same reaction. Having uncontrolled allergies can put your child at risk for getting a secondary sinus infection, ear infections and for having poor concentration at school. It can also make asthma symptoms worse. Yet it is possible to relieve your child’s symptoms and allow them, and you, to maintain a normal lifestyle. The first approach to tackling this unwelcome enemy is by attempting to decrease exposure to the allergens. For some children, this step is enough to prevent symptoms and can reduce, or completely eliminate, the need for medication or other allergy treatments. Some preventative measures include:

• • • • • • • • • •

Eliminate dust collectors such as drapes, rugs and carpeting Keep pets out of your child’s room and other common areas Use allergy-proof covers on pillows and mattresses Wash bedding weekly in hot water Clean and vacuum frequently Use air vent filters Keep windows in the car and home closed and limit outdoor activities when pollen counts are high Change your child’s clothing after being outdoors and have her bathe and wash her hair before bed Avoid damp, mold-prone areas like basements Avoid recently mowed lawns

Prevention also means educating your child about the allergy and the reaction it may cause. In addition, it is important to inform caregivers, teachers, friends and family about your child’s allergy to help keep symptoms to a minimum.

Itchy Eczema

Food Allergies

Eczema, or atopic dermatitis, is a common condition in children, usually developing in infancy. The cause of eczema is unknown, but it seems to run in families with a history of eczema, allergies or asthma. It results in dry, sensitive skin and an itchy rash that can cause skin damage if the child rubs and scratches it. It can occur on any area of the body but most common areas of infection are the face, creases of elbows, wrists, and knees. There is no cure for eczema, yet parents can keep their child’s symptoms under control by limiting exposure to known irritants such as harsh soaps or detergents, rough fabrics, tight clothing and potential allergens. Following a daily skin care routine, including using a mild soap and applying a moisturizing cream or lubricant to eczema-prone areas, helps to control the inflammation and make your child more comfortable. If the itching is severe, consider contacting a doctor to determine if allergy testing or prescription medication is needed.

According to Dr. Dan Atkins, six to eight percent of children in the United States are affected by food allergies, which can be very dangerous, even life-threatening, for children. Common foods that cause an allergic reaction are peanuts, tree nuts, fish, shellfish, eggs, soy, cow’s milk and wheat. Symptoms include hives, vomiting, shock and anaphylaxis (a severe, possibly life-threatening reaction). A reaction can develop quickly, often within minutes of ingestion, and can vary depending on the amount eaten and the child’s sensitivity to the food. In order to avoid a reaction, parents should learn the different names for food allergens, read food labels and take extreme care in monitoring what their child eats. Teach your child what he is allergic to and encourage him to ask an adult if he is unsure. If diagnosed with a food allergy, your child will likely be prescribed epinephrine shots to treat anaphylaxis and should wear a medical alert bracelet to notify others of his allergy.

Have an Asthma Action Plan

by Kristen Bason

Breathe in, breathe out—seems easy enough for a kid to do, right? Unfortunately, asthma is one of the most common chronic diseases of childhood, and it is the most frequent cause of school absenteeism, accounting for an estimated 14 million lost school days! It can’t be cured, but asthma can almost always be controlled. The better parents and children understand asthma and the treatment options, the better they are able to control it.

What is Asthma?

For most children breathing is a subconscious event. However, a child with asthma struggles to breathe because the amount of air that comes in and out of the lungs is reduced. There are typically three reasons for the reduction of air: 1. The lining of the airways become red and swollen, called inflammation. Inflammation can persist for weeks after an acute episode and in some children it is always present. 2. Muscles around the airways tighten, called bronchospasm. 3. Excessive mucous is produced, which can block the airways. It is often difficult to tell if your child is struggling to breathe, especially when they are younger and can’t express to you what they are feeling. According to Diane Herrick, RRTNPS, AE-C, asthma program coordinator at The Children’s Hospital, there are a few symptoms that parents can watch for. “Some of the most obvious signs a parent can look for are persistent cough, particularly at night; wheezing, particularly with exercise or colds; shortness of breath, chest tightness,” she says. These symptoms are often worsened by “triggers” such as tobacco smoke exposure, exercise, allergies and strong emotions.

Catching Your Breath

Your doctor will consider the diagnosis of asthma when your child presents with an acute episode of the above symptoms and/or has a history of persistent symptoms that are impacting sleep, school, and play. The most definitive exam includes a pulmonary function test (PFT) that is done both before and after the child inhales a “quick acting” bronchodilator medicine. Asthma is suspected when the lung function improves after inhaling the bronchodilator. “From there, the doctor can identify any other conditions that could worsen or be mistaken for asthma,” explains Herrick.

Knowledge is Power

At The Children’s Hospital, educating both patients and their parents is essential for effective treatment. Beyond the typical medications that are prescribed, children are taught to have an active role in managing their asthma and understanding what triggers symptoms. “Children and families treated at The Children’s Hospital are given an Asthma Action Plan at every point of care, including the emergency department, inpatient and outpatient visits,” says Herrick. The Asthma Action Plan addresses issues such as triggers, including identification and avoidance measures; medications, including side effects and correct techniques for using them; daily monitoring of symptoms and peak flows; and managing an acute asthma episode, including what to do and when to seek medical care. The asthma education program at The Children’s Hospital is provided by certified asthma educators (AE-C) who have passed a rigorous exam demonstrating expertise in asthma management. The four asthma educators at The Children’s Hospital are among only 38 in the entire state of Colorado

For more information about the Asthma Management Program visit: www.thechildrenshospital.org/conditions/lung/asthma/for-patients.aspx

Health and Wellness Magazine •

The New Children’s Hospital A Hopeful, Healing Environment for Kids A tiny pink bikini and white-rimmed sunglasses brighten the room of 3-and-a-half-month-old Lucy Field-Johnson. Like many patients, Lucy made the move to the new Children’s Hospital in September. The first time her mom, Marlena Field-Johnson, stepped foot into the new hospital, she was overwhelmed. “Everything about it was cheery,” she says. At the old hospital, Lucy was in a room with multiple babies. The limited space limited the amount of time her family was able to spend with her. Visits were shorter and lacked privacy. Since moving to the new hospital, Field-Johnson says her outlook has changed significantly and Lucy now has a more normal sleep schedule. “This feels a lot more like home,” she says. To create an environment that would meet the physical and emotional needs of children, The Children’s Hospital put a lot of effort into meeting the needs of 24

“The moment you walk in the door, the environment is immediately hopeful.”

— Jerrod Milton,

Vice President of Operations at The Children’s Hospital

the people who would have one of the greatest roles in their healing: families. “A lot of thought went into planning from a familycare perspective,” says Jerrod Milton, vice president of operations at The Children’s Hospital. “Amenities were foremost in everyone’s thoughts. How do we make this world-class? The moment you walk in the door, the environment is immediately hopeful.”

For patients like Lucy and their families, having a comfortable, hospitable environment in which to heal has made all the difference. A private room with a sleeper sofa allows Field-Johnson to stay with Lucy all night. The family also has storage space and room for multiple visitors. “I was overwhelmed by how much thought went into families,” says Field-Johnson. “We can bring things and leave things. We can have family here without feeling like we’re in the way. It makes an unfortunate situation bearable.”

The Journey Begins

The Children’s Hospital has earned a reputation for providing children throughout the Western region with access to some of the top pediatric specialists in the nation, even the world in some cases. In 2001, the aging infrastructure of the downtown hospital and a demand for more pediatric-specific care left the hospital with a decision: renovate or build a new hospital. “There are enormous inefficiencies with piecemealing something together,” says Milton. “In a new environment, we had the ability to tear it all apart, redesign it and build it in the most efficient way we could conceive of today.” After a feasibility study determined building a new hospital was the best option, The Children’s Hospital began planning the state-of-the-art facility that opened its doors to the public on September 27. In addition to providing the community with a more efficient facility with room to grow, building the new hospital created an opportunity to provide all of the hospital’s core services in one place. “Before building the new hospital, we never had the opportunity to align our clinical care site adjacent to our research facilities,” says Milton. “This was a once in a lifetime opportunity.”

Lucy was born six weeks early with a rare lung disease. And while she will require long-term care, Field-Johnson is comforted by the knowledge that she is receiving care from the leading specialist in the nation for her condition. “It’s a miracle that Lucy was born here,” she says. “People come from all over the country to seek care from Dr. Deterding. For Lucy’s condition, she is at the forefront.”

As a result of its affiliation with the University of Colorado Health Sciences Center, The Children’s Hospital performs more pediatric research than any other pediatric hospital nationwide. “There’s a lot of collaboration that takes place, and that collaboration ends up helping us develop cutting-edge, miraculous treatments and cures for pediatric medicine,” he says.

The New Children’s Hospital by the Numbers • $560 million to build • A record $250 million raised by The Children’s Hospital Foundation • 1.45 million square feet of space for healing • The capacity to treat more than 100,000 children each year • I9 floors • 270 beds • 14 operating rooms • 2 cardiology surgical operating rooms • 9 minor surgical procedure suites

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Designed with Children in Mind Natural light bathes the 11,000-square-foot, fourstory atrium at the new Children’s Hospital in hues of gold. The heart of the hospital, it is the starting point for most patients and their families. Art based on regional landscape images adorn the walls in intricate patterns. Wide windows provide clear views of the Rockies to the West, making butterflies with wings made of Indian headdresses seem ready to take flight. Light, color, art and nature have proven healing effects. To capture their energy in the new hospital, the design team explored how the senses work together to create a healing environment. “All of the senses were considered when designing the building,” says Jerrod Milton, vice president of operations at The Children’s Hospital. A chapel and adjacent meditation garden provide quiet places for reflection while an intuitive wayfinding system consisting of animals and color helps families find their way around the hospital easily. The ends of all corridors on patient floors end with a view of the outdoors, and absorptive materials on the ceiling create a quieter environment. “Everything in the design has a rhyme or reason to it,” says Sharron van der Meulen, principal at

High-Tech Healing

From Xbox 360s in all patient rooms to the use of portable phones in place of a PA system to cut down on noise, the new Children’s Hospital features a host of new technologies designed to create a healing environment for kids, ease stress for families and streamline patient care. The centerpiece of these technologies is the hospital’s new electronic medical records (EMR) system. “If everything is in one place and online, it’s a lot easier to get information,” says Dena Somers, director of clinical information at The Children’s Hospital. “The EMR system not only streamlines delivery of care and

Zimmer Gunsul Frasca Partnership, interior designers of the new Children’s Hospital. When the design team first set out to develop a plan for the new Children’s Hospital, they focused on creating positive distractions. On every floor color, activities, art and light work to create a comfortable, hospitable environment. “Our goal throughout this process was to create a strong healing environment for kids and their families,” says van der Meulen. “If we can provide things for them to feel and touch and forget if even for a second why they’re there, we’ve accomplished that.” A variety of color palettes derived from the Colorado landscape were selected for different uses throughout the hospital. Active spaces like the atrium were accented with a bright and vivid palette, while a softer, soothing palette was selected for quieter environments, like the chapel. To better relate to all children treated at the hospital, different palettes were selected for different ages. “So much thought was given to the feeling, the color; the child was always in mind,” says Mike Ossian, principal at H+L Architecture, designers of the new Children’s Hospital.

administrative information, it also standardizes data collection.” So if a parent is asked if their child has allergies, the question is always asked the same way to get the same answer. A patient’s electronic record stores all information formerly in the paper record, including a complete medical history, physician notes, allergies, current medications and immunizations, as well as insurance information. It also provides a summary of the patient’s current medical needs so when a physician sees a patient, he or she will be able to access a wealth of vital information instantly.

Access to the EMR system is available in every exam and patient room, physician’s offices and even outside the hospital through TCH Connect, a secure online link that enables physicians to access a patient’s medical history easily. The system also provides a more streamlined appointment and check-in process for patients.

Staying Connected

The EMR system allows The Children’s Hospital to share information internally with physicians in its Network of Care, as well as collaborate with referring physicians.

First to Go Paperless

The Children’s Hospital is the first pediatric hospital in the nation to have a completely integrated electronic medical records system with the most effective clinician use, according to a study by KLAS Enterprises.

Family-Centered Care

Healing a child is a family affair. To foster it, Susan Koch, director of clinical planning at The Children’s Hospital, says it’s important to try and create opportunities for as much family time as possible. “Family-centered research shows that you not only want to foster the families being together but also foster families being together with other families. If you can decrease the stress of the situation, you sleep better, eat better and heal better.” To encourage individual family time, all patient rooms are private and include bathrooms and showers along with sofa beds, reading lights and Internet access. “We tried to look at patient rooms as the child’s bedroom and respecting the fact that families needed to have their own space,” says Koch. There also are public spaces for family bonding, including a family center and quiet lounges on each floor. As an added convenience, the hospital also has 18 additional sleep rooms, laundry facilities, a child care center for siblings, 24/7 room service, a family health library, coffee and gelato bar, and even a spa where families can treat themselves to a manicure or a massage. “There was a definite investment made in families,” says Koch. “We didn’t want to take funds away from equipment or care services for children, but it was important for children not to be separated from their families and to allow them to be as normal as possible.”

New Technologies

• Fully-integrated, comprehensive electronic medical records (EMR) system • Use of portable phones in place of a PA system to cut down on noise • Patient rooms equipped with 32” LCD TVs connected to a patient entertainment portal with movies on demand and web browsing • Xbox 360s in all patient rooms for playing games, watching DVDs, listening to music or browsing photos on a digital camera • A state-of-the-art home theater in the Teen Center • Cell phone access throughout the building • Building security including video surveillance and programmable door access

All patient rooms have Xbox 360s and the new Teen Center has pool tables, a basketball court and theater. “We’ve tried to provide as many positive distractions as possible to children and their families,” says Dr. Stefan Mokrohisky, medical director of physician relations at The Children’s Hospital. A lot of attention has been paid to security. Everyone gets a visitor pass when they enter the building and access is limited the places where visitors need to go. Whether it’s the convenience of laundry facilities or the distraction of an Xbox, Mokrohisky says it’s important to focus on the needs of the entire family. “The idea is that we are treating the whole family. We want to enhance the experience as much as possible while their child is in the hospital.”

Family-friendly Features

• Private patient rooms with sleeper sofas & bathrooms • Family lounges with laundry facilities & kitchenettes • 24/7 room service • Playrooms in the outpatient surgery area • Child care for siblings • Teen Center with pool tables, basketball court & theater • Family health library

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

On the Spectrum Living with Autism

by Kristen Bason

When Jaiden was just 3 months old, his mom knew that he was different. She describes him as a little boy locked in his own world. “He never liked bright lights and avoided eye contact,” recalls his mom, Annie. By the time he was 2, it was clear to Annie and the pediatrician that Jaiden had some obvious developmental issues. He often repeated the same statement over and over and was mesmerized by anything that would spin. “Jaiden would stare at a fan for hours just fascinated by the spinning motion,” says Annie. A variety of screening techniques led to Jaiden’s early diagnosis of Autistic Spectrum Disorder (ASD). While Annie was grateful to have a name for her son’s distinctive behavior, autism was a reality she wasn’t sure she was ready to comprehend. With a team of specialists behind her and the support of programs at The Children’s Hospital, Annie has learned to cope. More importantly, Jaiden is thriving as a happy 5 year old.

“[Jaiden] has made me a better mom, a better person, not because of his challenges, but because of the little gifts he gives me everyday.” What’s in a Name?

Autistic Spectrum Disorder, or ASD, is a broad-based term used to describe individuals who have a socialization and communication disorder. The spectrum includes Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder. “ASD refers to a group of disorders that are considered to be related, even though the developmental course and severity of the diagnostic impairments vary,” explains Child Psychologist Robin Gabriels, Psy.D., clinical director and founder of the Neuropsychiatric Special Care Program at The Children’s Hospital. According to the Autism Society of America, approximately 1.5 million Americans today are believed to have ASD and professionals believe that this number is on the rise, growing at a rate of 10 to 17 percent per year. While the numbers are startling, doctors don’t think parents should view ASD as a kind of epidemic. “We know that part of the increase is due to greater awareness and an expansion of the criteria for diagnosis,” says Dr. Ann Reynolds, a developmental pediatrician and director of the Child Development Unit at The Children’s Hospital. 28

Tell Me What is Wrong

Most parents suspect that something is “wrong” with their child even before the doctor may detect it through routine developmental screenings. According to ASD specialists, it is important to make note of what you observe in you child’s behavior and share this information with your doctor. According to Reynolds, an early diagnosis can greatly improve a child’s chance of success. “Children with ASD have the potential to benefit from early and intensive intervention,” she says. “We should be screening young children between 18 and 30 months for ASD.” In November 2007, the American Academy of Pediatrics (AAP) recommended that all children should be screened for

Autism Support The Children’s Hospital LAUNCH Program 720-777-6630

Neuropsychiatric Special Care Program 720-777-8240

Autism Society of Colorado 720-214-0794 • www.autismcolorado.org

autism spectrum disorders twice by the age of 2, even if they have no symptoms. The AAP also issued two reports on identification, evaluation, and management of children with ASD.

Common Autism Symptoms

Making it Better

• • • • •

Despite abundant research, there is a limited understanding of what exactly triggers ASD in children. What experts do understand is that ASD is a neurodevelopmental disorder that involves various biological and brain irregularities. Knowing this, ASD specialists emphasize that while there is no cure, early intervention is key. “Research indicates that early intervention, such as treating a child prior to age 5 years, can have positive impact on short- and long-term developmental gains,” says Gabriels. “However, there is no one ‘formula’ for what type or how many hours of intervention works for all children with ASD.” The most successful treatment should be a team approach, including a psychologist, occupational therapist and/ or speech therapist, respite care, and other family supports. Many positive outcomes have been associated with programs that address the child’s ability to attend to tasks, imitate, communicate, play, and socialize. “Children with autism, like all children, are unique with individual likes, dislikes, temperaments, and strengths. Understanding the individual first and then applying the cause-and-effect behavioral teaching strategies along with providing visual cues to help them understand expectations and communicate their needs holds the greatest promise for their future success,” she says.

Hope and Support

Once parents finally have that diagnosis of ASD they are often relieved to have an answer, but confused about what it all means for their child’s future. Doctors assure parents that they have many reasons to feel optimistic. “Many children do make very nice improvements as they grow,” says Reynolds. “There is also a great deal of research currently going on. It is important to remain hopeful and to enjoy every child for their own unique strengths.” And, parents need to remember that they are not alone, there are many other families dealing with similar issues. They can request financial and advocacy support for interventions by talking to their pediatrician or visiting the ARC at http://www.thearc.org/. At The Children’s Hospital, a program called LAUNCH offers parents the information they need to make the best care decisions for their child. The program consists of four lectures to help families of newly diagnosed children understand what autism is and what interventions are needed. Additionally, the Neuropsychiatric Special Care Program (NSC) provides inpatient and intensive day treatment care for children and adolescents with ASD or other developmental disabilities, ages 4 through 18 years.

Special Parents, Extraordinary Kids

Parents of children with ASD have a special relationship with their child. The early onset of challenges and heartbreak spawns a unique bond. Instead of focusing on their child’s disability, they quickly learn to bask in the glow of their strengths and success. “My love for Jaiden has never waivered—he is who he is,” says Annie. “His quirky behaviors make him the special little boy that I just adore. He has made me a better mom, a better person, not because of his challenges, but because of the little gifts he gives me everyday.”

Social Doesn’t snuggle when picked up, but arches back instead Doesn’t keep eye contact or makes very little eye contact Doesn’t respond to parent’s smile or other facial expressions Doesn’t look at objects or events parents are looking at or pointing to Doesn’t point to objects or events to get parents to look at them

Communication • • • • • • • • • • • • • •

Doesn’t say single words by 15 months or 2-word phrases by 24 months Repeats exactly what others say without understanding its meaning (parroting or echolalia) Doesn’t respond to name being called, but does respond to other sounds (like a car horn or a cat’s meow) Refers to self as “you” and others as “I” (pronominal reversal) Doesn’t use toys or other objects to represent people or real life in pretend play May have a good rote memory, especially for numbers, songs, TV jingles, or a specific topic Behavioral differences (stereotypic, repetitive, and restrictive patterns) Rocks, spins, sways, twirls fingers, or flaps hands (stereotypic behavior) Obsessed with a few activities, doing them repeatedly during the day Plays with parts of toys instead of the whole toy (for example, spinning the wheels of a toy truck) May have splinter skills, such as the ability to read at an early age, but often without understanding what it means Doesn’t cry if in pain or seem to have any fear May be very sensitive or not sensitive at all to smells, sounds, lights, textures, and touch Unusual use of vision or gaze—looks at objects from unusual angles

For a full list of symptoms and additional information visit: www.aap.org/healthtopics/autism.cfm Source: Understanding Autism Spectrum Disorders (ASDs): An Introduction (Copyright © 2006 American Academy of Pediatrics)

Health and Wellness Magazine •

The Children’s Hospital Network of Care Pediatric Care in Your Community The Children’s Hospital is now closer to home than many families realize. Thanks to the hospital’s new Network of Care, which consists of 13 locations including the new main campus in Aurora, families can access the pediatric care they need at a convenient location. “We realize not everyone can get to the main campus easily, so we’re committed to providing services in more places,” says Dr. Stefan Mokrohisky, medical director of physician relations at The Children’s Hospital. The Children’s Hospital provides emergency care, urgent care, pediatric specialty care, sports medicine, and rehabilitation and therapy at Network of Care locations throughout the Front Range. Through partnerships with Front Range hospitals, including Lutheran Hospital in Wheat Ridge, The Children’s Hospital also has the capacity to treat pediatric conditions typically followed in a community hospital, including mild pneumonia and asthma.

And because the Network of Care will enable Children’s pediatric specialists to hold routine clinic hours at sites throughout the Front Range, patients now will be able to see a specialist at a location that’s close to home. No matter where a family lives, The Children’s Hospital is only minutes away.

“Care by The Children’s Hospital at Lutheran will provide our patients with more convenient and better access to Children’s specialty services.” — Dr. Shen Nagel, Chair of Pediatrics

Care by The Children’s Hospital at Lutheran

Lutheran Hospital

Pediatric Care That’s Close to Home

It’s 11 p.m. and your child has woken you with an ear infection. You know you can’t wait until the morning to call your child’s doctor, but you also know a visit to the emergency room isn’t necessary. Urgent care facilities in Children’s Network of Care are designed especially for situations like these. With the opening of Care by The Children’s Hospital at Lutheran in Wheat Ridge on November 12, 2007 patients in west metro Denver now will have access to pediatric urgent care services right in their community. 30

“The appropriateness and quality of care is better when children can go to an urgent care facility that focuses on children,” says Dr. Shen Nagel, chair of pediatrics at Lutheran Hospital. “Having pediatric-focused urgent care at Lutheran gives community physicians more confidence that the care their patients receive is of the highest quality.” The new urgent care facility at Lutheran will enable an all-Children’s staff to treat everything from the com-

Children’s Certified Medical Technician Daren Anderson gives patient Michael Martinez a high five. Anderson is one of an all-Children’s staff of approximately 40 providing urgent and specialty care to children in west metro Denver at Care by the Children’s Hospital at Lutheran. 70

Care by The Children’s Hospital at Lutheran 3455 Lutheran Parkway, Suite 230 • Wheat Ridge, CO 80033 W 44TH AVE 720-777-1370 • www.thechildrenshospital.org

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• 7,500 square feet • 15 exam/treatment rooms • An all-Children’s staff of approximately 40 care providers • Pediatric Care Offerings: > 24-hour access to our main > Urgent care campus for expert pediatric > On-site radiology microbiology and virology > Outpatient blood testing draw station > Phlebotomy services > Electronic medical record (EMR) system > Pediatric specialty clinics by appt.

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mon cold to mild asthma to sprained ankles, as well as a host of other illnesses and injuries. “Pediatric care is the core competency at our new Children’s Hospital urgent care facility at Lutheran,” says Jana Paquet, director of Care by The Children’s Hospital at Lutheran. “We open our doors to provide after-hours care to support PCPs in the community with same-day sick visits and after they’ve closed for the day. And, you can expect the same high level quality of pediatric care at our newest Network of Care site as you would expect at any Children’s Hospital location.” In addition to urgent care services, Care by The Children’s Hospital at Lutheran will offer specialty care to patients during the day in a broad range of fields including audiology, cardiology, pediatric surgery, orthopedics and otolaryngology. “Care by The Children’s Hospital at Lutheran Hospital will provide our patients with more convenient and better access to Children’s specialty services,” says Dr. Nagel. To maintain consistency in care for all pediatric patients, The Children’s Hospital also is planning to partner with Lutheran Hospital to provide education, Children’s Hospital Clinical Care Guidelines, and proven best practices to Lutheran Hospital’s inpatient pediatric unit. Care by The Children’s Hospital at Lutheran is one of three urgent care locations in its Network of Care. Additionally, Children’s offers urgent care services at Littleton Adventist Hospital and in Broomfield. It’s all part of the hospital’s goal to provide children with the care they need when and where they need it most.

Care by The Children’s Hospital at Lutheran is located on the Exempla Lutheran Medical Center campus just south of the hospital.

Urgent Care Hours

2 pm – 2 am Mon-Fri 8 am – 2 am Weekends & Holidays

Urgent Care: Common Medical Conditions • • • •

Colds Croup Ear infections Fever

• • • •

Strep throat Minor burns Asthma URI

• • • •

RSV GI illnesses Dehydration Diarrhea

• • • •

Vomiting Pneumonia Seizures Fractures

• • •

Lacerations Closed head injuries Rashes

Need Urgent Care After Hours?

Walk right in–no appointment is necessary. Or call the TCH Pediatric Call Center at 720-777-3999 to get advice and determine if urgent care services are needed. After your visit, call your pediatrician to discuss follow-up care.

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

The Children’s Hospital Network of Care Pediatric Care in Your Community The Children’s Hospital is now closer to home than many families realize. Thanks to the hospital’s new Network of Care, which consists of 13 locations including the new main campus in Aurora, families can access the pediatric care they need at a convenient location. “We realize not everyone can get to the main campus easily, so we’re committed to providing services in more places,” says Dr. Stefan Mokrohisky, medical director of physician relations at The Children’s Hospital. The Children’s Hospital provides emergency care, urgent care, pediatric specialty care, sports medicine, and rehabilitation and therapy at Network of Care locations throughout the Front Range. Through partnerships with Front Range hospitals, including Saint Joseph Hospital in Denver, The Children’s Hospital also has the capacity to treat pediatric conditions typically followed in a community hospital, including mild pneumonia and asthma.

“The new Children’s Hospital at St. Joseph Hospital provides pediatric and family practices in central Denver with a convenient method of having the children in their practices cared for when needed in an expeditious and professional manner. The Children’s Hospital has not forgotten central Denver and its pediatric needs.” — Dr. Jay Markson, Pediatrician

Children’s Medical Center

The New Children’s Hospital at Saint Joseph Hospital Pediatric Care That’s Close to Home

For nearly 100 years, The Children’s Hospital has provided care to patients throughout the Denver metro area and the West. That tradition of care continues with the opening of the new Children’s Hospital at Saint Joseph Hospital. Located on the Exempla Saint Joseph Hospital campus, this hospital-within-a-hospital provides 24/7 inpatient and emergency pediatric care to patients and families in the downtown Denver community. “Parents want to stay close to home when seeking care, says Cindy McConnell, director of the new Children’s 30

Hospital at Saint Joseph Hospital. “Having a presence (downtown) ensures that we can continue to provide pediatric-specific care to those patients.” The Children’s Hospital at Saint Joseph Hospital is the newest addition to Children’s Network of Care and demonstrates its continued commitment to providing quality pediatric care to patients in their communities. “The new Children’s Hospital at Saint Joseph Hospital provides pediatric and family practices in central Denver with a convenient method of having the children in their practices

Fast Facts:

The New Children’s Hospital at Saint Joseph Hospital

cared for when needed in an expeditious and professional manner,” says Dr. Jay Markson, a pediatrician at Children’s Medical Center in Denver. “The Children’s Hospital has not forgotten central Denver and its pediatric needs.” The new facility provides 24/7 walk-in emergency care and inpatient care, as well as lab draws and routine operating room services. Patients in need of critical and specialized care services are transferred to the main campus in Aurora. “Patients can get the majority of treatment at the downtown facility,” says Alison Brent, medical director of the new Children’s Hospital at Saint Joseph Hospital. “And everything is new and up to date.” Completely supported by an all-Children’s staff, the new 13,000-square-foot facility has 16 beds and the capacity to accommodate a minimum of 13,000 emergency visits and 850 admissions in the first year. The new site also features the same high-quality patient care families are used to experiencing at all Children’s Hospital locations, as well as a look and feel that is consistent with other Network of Care sites.

Located on Franklin St. across from Saint Joseph Hospital 13,000 square feet 8 beds dedicated to the emergency department 8 beds dedicated to inpatient care An all-Children’s staff of approximately 60 care providers Pediatric Care Offerings: > Private exam and treatment rooms > On-site radiology, laboratory and pharmacy > Electronic medical record (EMR) system > A family-friendly play room Inpatient Room Features: > Spacious private rooms with family sleeping accommodations > Private bathrooms with showers > Internet access for families

Visit Us

The Children’s Hospital at Saint Joseph Hospital is located in the brick building directly east of Saint Joseph Hospital on the corner of 18th Ave. and Franklin St. The Children’s emergency entrance is on Franklin St. directly across from the entrance to Saint Joseph Hospital. Short-term parking is available outside the entrance. And for those patients who need it, complimentary transportation to the main campus is available.

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Medical Director Alison Brent (left) and Director Cindy McConnell

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• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Keep Your Child Recognize the signs and symptoms of common childhood respiratory infections

by Laura Johnston

Breathing Easy

Every child gets sick from time to time. When your child isn’t feeling well, you want to know how to recognize the symptoms of serious infections and when to call the doctor. Find out what you need to know about two common respiratory infections: Respiratory Syncytial Virus (RSV) and bronchiolitis, an illness caused by RSV.

Respiratory Syncytial Virus (RSV)

A major cause of respiratory illness in young children A very common and highly contagious virus, RSV is a viral disease of the lungs. And although your child may simply get a cold from RSV, it is one of the leading causes of lower respiratory illnesses in infants and young children. Most children are infected at least once by 2 years old and may be infected more than once in an RSV season. “Outbreaks of RSV occur annually from fall through spring with peaks usually noted between the months of January through March,” says Dr. Robin Deterding, a pulmonologist at The Children’s Hospital. Dr. Gwen Kerby, also a pulmonologist at The Children’s Hospital, says, “Parents of kids with heart, lung or immune system problems need to be careful during the winter. RSV is highly contagious and spreads easily in schools and daycares in the cold winter months when everyone is indoors.” The virus can be spread from person to person through everyday

contact and is most often spread by sharing food or drink with an infected person or by getting droplets containing the virus on your hands and then touching your eyes, nose or mouth. One major issue with RSV is that it is easily spread before the onset of symptoms and can continue to spread after symptoms subside.

Symptoms Typically in young children, RSV may simply begin to display as a mild cold with a runny nose and fever. As the infection worsens, you may notice wheezing, difficult and rapid breathing and deep coughing. In babies, RSV may begin with these symptoms, but it can quickly worsen. Babies also often develop additional symptoms such as irritability, sleep disruptions and lack of appetite. “Symptoms usually last no longer than a week in previously healthy children but can persist longer in children who develop severe symptoms or have other chronic illnesses or risk factors,” says Dr. Deterding. “If symptoms are severe enough, children may require hospitalization.” Gabriel Logan treated for bronchilolitis (need caption here)

When Gabriel Logan of Aurora was 11 months old, his mother, Olivia, experienced first-hand how severe RSV could be. “Gabriel ended up with bronchiolitis and underwent treatments including deep mucus suction, breathing treatments, steroids and oxygen. This went on at the hospital for days until they were sure that he could maintain a specific level of oxygen intake on his own. When they finally sent him home, we still had to have him on oxygen while he slept for several days.”

“Unlike influenza, there are no vaccines to prevent RSV, and since it is a virus, antibiotics are not effective…” Treatment Most RSV cases are mild with symptoms typically resolving themselves within a week or two. If your infant is otherwise healthy, RSV may not require a specific treatment from your doctor. “Unlike influenza, there are no vaccines to prevent RSV, and since it is a virus, antibiotics are not effective,” says Dr. Deterding. However, medication may sometimes be prescribed to help open airways. There are some things that you can do at home to relieve your child’s RSV symptoms. Provide a cool-mist vaporizer, have your child blow her nose or help remove nasal fluids for your infant with a suction bulb, help make them comfortable and provide plenty of fluids. Babies may not feel like drinking during this time, so offer fluids more frequently to keep them hydrated. Acetaminophen or ibuprofen can help to reduce fever and relieve pain. Prevention RSV can easily be transmitted through contact with contaminated items, such as door handles, shopping carts and more. If your school-aged child has cold symptoms, it is best to keep them away from younger siblings, particularly infants, until the cold has run its course, as family members often pass RSV to one another through casual contact. Dr. Deterding insists that for RSV, “The best offense is a good defense. Good hand washing and disinfection of objects and surfaces is essential.” Olivia Logan knows how hard it can be to keep up with these essentials. With both of her children in daycare she says, “They are constantly exposed to sickness. The only thing we can do is to try and make sure everyone is washing their hands frequently.” Knowing the peak RSV season in your area can help you to take greater precautions with your children’s health by potentially getting an early diagnosis and subsequently managing the illness in its early stages. During RSV season it is important for the entire family to take care to cover their mouths and noses during coughs and sneezes, wash their hands frequently and to dispose of used tissues. Also, avoiding sharing items such as cups, glasses, and utensils with persons infected with RSV can decrease the spread of the virus.

Bronchiolitis

An infection that affects the tiny airways, called the bronchioles, that lead to the lungs A common illness caused by RSV is bronchiolitis. Dr. Lalit Bajaj treats bronchiolitis at The Children’s Hospital and explains that it is a viral infection that begins in the upper respiratory system and then progresses to the bronchioles, which are the tiny airways that lead to the lungs. These tiny airways become swollen and filled with mucus, making it very difficult to breathe. Bajaj says that small infants and babies are more susceptible due to the very small diameter of these airways. “Bronchiolitis is the leading reason for hospitalization of infants in the United States, with more than 100,000 admissions annually,” he says. “Unfortunately there are no treatments that have been shown to shorten the duration of bronchiolitis. Antibiotics have no role since bronchiolitis is a viral disease, not a bacterial disease.” As the disease can be prolonged for two to three weeks, treatment for bronchiolitis mainly includes support therapy such as keeping the nasal passages clear by using a saline wash and a suction bulb and using a cool mist vaporizer to help loosen the secretions. It is also critical to keep the child hydrated with clear fluids, which according to Bajaj, may include using electrolyte solutions such as Pedialyte. “Offering infants smaller volumes of fluid more frequently is often more helpful while they are ill,” Bajaj says. Also, if your infant has bronchiolitis, it is important to avoid smoke exposure as it will further irritate the airways and make breathing more difficult. Breathing treatments, which may be prescribed by your doctor and administered at home using medicines such as albuterol, may help some infants breathe easier. However, Bajaj says that in severe cases of bronchiolitis, hospitalization may be required to provide “frequent intensive nasal suctioning, intravenous fluids, and/or supplemental oxygen. A few infants require assisted breathing support with a ventilator until they are improved.”

Bronchiolitis Symptoms Call your doctor immediately if your child displays the following symptoms: • • •

A worsening cough Blue around the mouth, lips or fingertips Difficulty sucking and swallowing

• Wheezing • Problems breathing or gasping for breath

• Low responsiveness levels • High fever • Thick nasal discharge

that is yellow, green, or gray • Lethargy • Dehydration

• Rapid breathing

Health and Wellness Magazine •

Teenage

Knee Pain Real Common, Real Treatable by Tanya Ishikawa

Everyday, students describe their knee pain to Chris Mathewson. As head athletic trainer at Ponderosa High School and President of Colorado Athletic Trainers’ Association, he works with 900 student athletes on 100 teams. Mathewson estimates 15 to 20 percent of his athletes experience minor to major knee injuries. The most common ones require short rests, modifying training routines, reducing swelling with ice, compression and elevation, and addressing discomfort with pain relievers. The more serious ones demand supervised rehabilitation and often require surgery. “It’s just part of competing hard,” he says. “If they play hard, they’re going to get hurt hard.”

Overcoming ACL injuries

Adolescent knee injuries are classified as chronic – caused by overuse or misuse, and acute – caused by an incident such as a fall. While teens in sports are more prone to injuring knees, their non-athletic peers are at an active age and still growing so are still at risk. “You can be in the school play and have the same chronic knee issues as athletes, though the approach for treating it may be different. Anyone can trip and fall off a curb and tear their ACL,” says Mathewson.

The ACL, or anterior cruciate ligament, and the MCL, or medial cruciate ligament, are connecting tissues between the thighbone and shinbone at the knee. While MCL tears are rare, ACL tears are common, particularly for girls. Female athletes are two to 10 times more likely to tear their ACL, depending on the sport, says Dr. Brooke Pengel, director of adolescent and pediatric sports medicine at The Children’s Hospital.

“Up to 50 percent of adolescents that come into my practice complain of knee pain, and it’s from overuse, not acute problems.” Researchers have found the ligament must deal with extra pressure and less protection in girls. This is attributed to the way female hips and legs are structured, which is more knockkneed than boys, and the way they use their quadriceps more than the hamstring muscles when landing. The Children’s Hospital has an ACL injury prevention program to teach athletes proper stretching, posture and muscle use. Program participants have achieved a three- to four-fold decrease in ACL injuries, Pengel says. If a child does tear this ligament, it requires surgical reconstruction and six months of healing and therapy.

Other common knee problems

Tears of the meniscus disk, the cartilage padding inside the knee, require surgery. This acute injury can be mended either by removing the torn piece and letting it heal for a few weeks, or by repairing it and allowing several months to heal. Two less common culprits for surgery are damage from kneecap misalignment and growth plate fractures. When the kneecap is misaligned, which is called patellar femoral dislocation, it causes pain commonly known as runner’s knee. Normally, it can be healed with rest, retraining and, sometimes, therapy. But recurrent problems may lead to surgery to properly align the knee. Growth plates are cartilage links in the bones that transform to bone by the end of adolescence, and fractures in these plates are more unusual. They can be mistaken for ligament injuries, but growth plate fractures need to be addressed appropriately or the legs could become stunted or crooked. A simple fracture would require only a cast and rehabilitation, while a fracture and dislocated plate calls for surgery and longer healing. Pengel, who has practiced medicine for nine years and sports medicine for five years, says she has seen a growth plate fracture only once. However, she sees minor kneecap misalignment injuries five to six times a day in her practice. “The overuse (injuries) are more common in the general population and acute are seen more in the athletes,” she says. “Up to 50 percent of adolescents that come into my practice complain of knee pain, and it’s from overuse, not acute problems.” While kneecap pain is the top complaint, two other common overuse injuries are tendonitis and Osgood-Schlatter disease, a painful bump over the front of the knee where the kneecap tendon attaches to the front of the lower leg bone. The prescription for both is rest and reducing the swelling and pain, with no surgical intervention. In fact, the majority of all adolescent knee injuries can be treated without surgery. “In my practice, surgeries happen in less than 5 percent of the cases,” Pengel says. “Adolescent knee pain is very treatable and doesn’t usually become a long-term problem.”

Help keep your kids’ knees injury-free by having them follow some simple guidelines: • Avoid overtraining and activities that have excessive repetitive motion • Cross-train to work different muscles • Use equipment properly and wear proper shoes and athletic wear • Learn strong, protective postures including proper leg positioning and alignment of the lower body • Improve flexibility through stretching, especially the hamstrings, quadriceps and pelvis • Develop strength of supportive muscles, such as the inner quadriceps • Stop activity if pain, swelling or a limp develops, and rest until it is comfortable to return to activity

Advice About When to Visit an Orthopaedic Physician Athletic trainers are well-qualified to help with rehabilitation and training, but we usually recommend seeing a doctor in the serious cases when we’re not sure what it is, or when it needs surgical or other medical interventions. – Athletic Trainer Chris Mathewson

Emergency medical care should be sought when there is rapid swelling or the knee cannot bear weight. Most acute injuries should be checked out before returning to activity. For an overuse injury when the child is relatively comfortable, a doctor visit may not be necessary. However, if it is recurrent, it may be masking a more serious condition which a physician could investigate. Generally, if activity is being affected negatively, it deserves medical evaluation. – Sports Medicine Dr. Brooke Pengel Most of our patients are referred from primary care physicians. Typical referrals are injuries and/or deformities associated with the musculoskeletal system, i.e. fractures, sprains, strains, deformity or disease diagnosis and management. Significant swelling, bruising, pain, and deformity as a result of an injury would indicate that the child should see a doctor. – Orthopaedic Dr. Mark A. Erickson

Four Most Common Injuries for Young Athletes

Whether children participate in recreational sports at home and with friends, or compete on a school or extracurricular league, they are at risk of skeletal injuries. The most common injuries for young athletes are wrist fractures, ankle sprains, knee sprains, and collarbone injuries, according to Dr. Mark A. Erickson of The Children’s Hospital Orthopaedics Department. Sprains, strains and fractures are examples of acute injuries, which are usually a result of one specific event that is easily remembered. Other types of injuries are considered chronic and occur in skeletal areas, when they are overused in a repetitive activity over time. When asked about common misunderstandings about bone injuries, Erickson replied, “People commonly misuse the terms fracture and a broken bone, as if they are two separate things. But, when you break a bone you have fractured it, so a fracture and a break are the same thing.”

Common Acute Injuries Common Chronic Injuries Wrist Fractures

Anterior Knee Pain

Ankle Sprains

Elbow Pain

Knees Sprains Collarbone Injuries

Shoulder Inflammation Shin Splints

Health and Wellness Magazine •

Help Your Child Get Those

Recognizing Common Sleep Problems in Children by Laura Johnston Sleep problems are a common concern most parents face in one form or another, whether it is the newborn that wakes several times a night to feed or an older child suffering from nightmares. No matter what the sleep problem, parents often just hope for relief and wonder, “How will we ever get our child to sleep through the night?” The answers aren’t always simple and can differ depending on the child and the situation. It is also important for parents to remember that everyone in the family needs rest and sleep problems are a very real issue that can lead to misdiagnoses and behavior problems in their child.

Obstructive Sleep Apnea

Obstructive Sleep Apnea (OSA) is the most common type of apnea in children. A child with this condition experiences pauses in her breathing patterns, typically caused by an obstruction of the airway such as enlarged tonsils or adenoids. It occurs during sleep when the muscles in the throat are relaxed. During this time, the walls of the throat can collapse, obstructing the flow of air. The child may look like she is breathing, but she is not getting air to her lungs. After a short period of time, she will go through an awakening period where the muscles tighten, thus relieving the obstruction and allowing her to breathe again. Since OSA can result in a poor, interrupted sleeping pattern for the child, she may show attention problems and tiredness throughout the day. Carole Kline, nurse practitioner at The Children’s Hospital Sleep Lab says, “Children can be diagnosed as having ADHD when, in real36

ity, they are not getting enough sleep. Insufficient or poor- quality sleep can lead to difficulty focusing in school and behavioral problems such as impulsivity and moodiness.”

OSA Symptoms

• Excessive daytime sleepiness • Restless sleep • Snoring • Pauses in breathing

Treatment

• Difficulty concentrating • Hyperactivity • Irritability

The most common treatment for OSA is surgery to remove the tonsils and adenoids, which eliminates the obstruction and opens the child’s airways. Kline says, “If there is nothing that can be treated surgically, we look for

medical treatments, which could include allergy management or continuous positive airway pressure (CPAP) therapy.” The CPAP is a mask that delivers air through the nose, keeping the airway open during sleep. According to Dr. Norman Friedman, an ear, nose and throat specialist at The Children’s Hospital, OSA is just one component in a spectrum of sleep-disordered breathing. The gold standard for diagnosing sleep-disordered breathing is an overnight sleep study. The Rocky Mountain Pediatric Sleep Disorders Program at The Children’s Hospital assists physicians with the diagnosis and treatment of infants, children and adolescents with sleep problems. The laboratory provides a child-friendly environment to provide the best experience possible for the family and child.

Parasomnias

Parasomnias, which are more common in children than in adults, are disruptive sleep-related disorders that can occur during Rapid Eye Movement (REM) sleep or non-REM sleep. During a parasomnia, the child will be in a state of partial arousal, which means that they can exhibit symptoms of both being awake and asleep at the same time. Parasomnias include nightmares, night terrors and sleepwalking, and can potentially be harmful to the child.

Nightmares

Nightmares are scary dreams that typically occur in the latter part of the night or early morning during REM sleep, also known as dreaming sleep. Kline says, “Occasional bad dreams are normal at all ages after about 6 months of age and will typically awaken the child. When preschoolers have a nightmare, they usually cry and run into their parents’ bedroom. Older children begin to understand what a nightmare is and put themselves back to sleep without waking their parents.” After having a nightmare, a child will recognize her parents and be reassured by their presence. However, she may have a vivid memory of the scary dream, making it difficult for her to fall back asleep.

Night Terrors

Night terrors differ from nightmares, occurring about an hour or two after the child goes to bed, during a phase of deep non-REM sleep. During a night terror, the child may scream and show an alteration in vital signs or have her eyes open and appear awake even though she is still asleep. Friedman says that during a night terror, which typically lasts from 10 to 30 minutes, the child cannot be awakened or comforted, does not realize that her parents are there, and unlike nightmares, won’t remember what happened. For the parents of 4-year-old Logan Finney of Littleton, night terrors are a scary situation. Logan’s mom, Stacy says, “Logan often frightens us with an ear-piercing scream soon after going to bed. We will find him trembling and sometimes dry heaving or vomiting. If we try to guide him to the bathroom he just continues screaming uncontrollably and never seems to actually wake up.” Logan’s dad, Chris, added, “We find him

“We find him sitting straight up in bed, sweaty or clammy. He makes eye contact but it is like he doesn’t even see us.” sitting straight up in bed, sweaty or clammy. He makes eye contact but it is like he doesn’t even see us.” The Finneys have tried different techniques from comforting Logan to being stern with him about calming down, yet according to the family, nothing seems to work. They often just have to wait it out while he cries until he falls back asleep. Since overtiredness can trigger night terrors, Friedman says, “Make sure your child is getting plenty of rest. Be aware of things that may be upsetting to your child, and to the extent you are able, try to minimize the distress.” He adds that during a night terror, parents should not attempt to awaken the child, just ensure that she is safe.

Sleepwalking

Sleepwalking is a disorder in which a child partially awakens during the night and walks or does other activities without having any memory of the event. She may look dazed, display clumsy speech and movements, and when spoken to, she will usually not respond. If a child has a tendency to sleepwalk, Friedman says family history can play a role, adding that 15 to 30 percent of healthy children have been found to have at least one episode, usually lasting less than 15 minutes. He says sleepwalking typically begins at about 5 years of age and most children outgrow it by the time they turn 15. Parents who find their child sleepwalking should gently steer her away from danger and back to bed.

Creating a Safe Environment

If a child exhibits any parasomnia episodes, parents need to take steps to ensure that the child’s environment is safe during sleep in order to prevent injuries. “Alarming your child’s door is helpful so that you know they are up,” says Kline. “Doors leading to the outside need to have locks that are either up high or need a key on the inside to open.” Additional safety measures can include removing any potentially dangerous items, using toddler gates on staircases and avoiding bunk beds for children who frequently have these episodes.

Health and Wellness Magazine •

Treating Cystic Fibrosis Early Intervention, Team Approach Improving Quality of Life for Children with Disorder

by Sue Emond Cystic fibrosis, a chronic, progressive disease that primarily affects the lungs and digestive system, afflicts 30,000 children and adults in the United States, and 70,000 worldwide. According to the American Lung Association, it’s the second most common inherited, life-threatening, childhood onset disorder in the United States, just behind sickle cell anemia. About 1,000 new cases of cystic fibrosis are diagnosed each year. Yet thanks to devoted research teams from leading organizations like The Children’s Hospital Cystic Fibrosis Program, along with the ongoing dedication of national organizations, especially

the Cystic Fibrosis Foundation, the lives of cystic fibrosis patients continue to improve. In fact, 50 years ago, children with cystic fibrosis typically failed to reach grade school. But now, those afflicted with the disease often live into their 30s, 40s, and even longer. In 2006, the predicted median age of survival for a cystic fibrosis patient was 37 years. Through innovative research, substantial improvements in measures of malnutrition and lung function, and a diverse and comprehensive approach to care, cystic fibrosis patients can today experience a quality of life unforeseen even a few decades ago by those with the disease.

Understanding Cystic Fibrosis Cystic fibrosis occurs in children who inherit the gene from both parents—who are each carriers of the cystic fibrosis gene but who do not have cystic fibrosis themselves. Fortunately, Colorado state law requires that hospitals in Colorado screen all newborn babies for cystic fibrosis. Coloradoans can thank pioneers like Dr. Frank Accurso, director of the Cystic Fibrosis Program at The Children’s Hospital, along with several of his colleagues, for the benefits of early diagnosis and treatment. Their aggressive research in support of newborn screening for cystic fibrosis back in 1987 led to Colorado,becoming the first state to adopt a statewide newborn screening requirement. Nationwide, more than 70 percent of patients are diagnosed by age 2. But now, the U.S. Department of Health and Human Services Centers for Disease Control and Prevention recommends that all states require newborn screening for cystic fibrosis. Symptoms of cystic fibrosis can occur at birth or sometimes later, and can be mild or severe. Children with cystic fibrosis face various challenges, especially respiratory and digestive problems since the defective gene causes the body to produce abnormally thick mucus. The mucus clogs the lungs, causing breathing difficulties, as well as recurring lung and sinus infections. Cathy Lingard, MS RD, a registered dietician specializing in cystic fibrosis at The Children’s Hospital, says the thick mucus also obstructs the ducts of the pancreas, leaving digestive enzymes unable to reach the intestines. So cystic fibrosis patients don’t absorb food nutrients well and have difficulty gaining and maintaining weight—in stark contrast to today’s pediatric obesity epidemic. Lingard notes that cystic fibrosis children particularly can’t digest fats and the fat soluble vitamins, including A, D, E, and K. Other symptoms include reproductive problems, irregular nail beds of the fingers and toes, nasal polyps, and a high concentration of sodium in the sweat. 38

Cystic Fibrosis Symptoms

• Persistent coughing, at times with phlegm • Frequent lung infections • Wheezing or shortness of breath • Poor growth/weight gain in spite of a good appetite • Frequent greasy, bulky stools • Very salty-tasting skin Source: The Cystic Fibrosis Foundation

Dalyn Shkapich blows into a pneumotach, a device used to measure respiratory flow.

Aggressive Treatment for a Better Life The Cystic Fibrosis Program at The Children’s Hospital provides an agressive approach to cystic fibrosis. Both infants and older children receive extensive diagnostic testing at regular visits, and patients are monitored every two to four weeks initially, monthly for the first six months, then every two months up to one year. After that, most patients are monitored every three months throughout their lives. According to Dr. Scott Sagel, associate director of the Cystic Fibrosis Program at The Children’s Hospital, care providers regularly monitor the nutritional and pulmonary status of patients through in-depth testing, assessing problems like malabsorption, maldigestion, and wheezing. Dr. Sagel insists that “frequent assessment and early intervention are key. If there’s a change in clinical status we can intervene early. This allows us to be as aggressive as possible in their care.” Kids with cystic fibrosis can’t help but make lots of new friends at The Children’s Hospital, given the program’s multidisciplinary, collaborative approach. An experienced staff of doctors, nurses, dieticians, social workers, child life therapists, respiratory therapists, physical therapists, and others provide comprehensive evaluation and management of cystic fibrosis, while also encouraging family involvement. Today, the Cystic Fibrosis Center treats 600 patients throughout the region, including children at The Children’s Hospital and adults at National Jewish Medical and Research Center in Denver.

Cystic Fibrosis—A Family Affair Though diagnosis and evaluation for children with cystic fibrosis takes place at The Children’s Hospital, ongoing treatment typically happens at home. Every day these kids need a variety of at-home treatments, including drugs, airway clearance techniques, special diets, and more. Sagel and Lingard describe some of the typical respiratory and dietary treatments prescribed by the Cystic Fibrosis Center at The Children’s Hospital:

ance technologies, and regular care at accredited cystic fibrosis care centers,” like the Cystic Fibrosis Center at The Children’s Hospital.

Instilling Hope through Promising Research Churee Pardee, APN, an advanced practice nurse and research coordinator for the Cystic Fibrosis Program at The Children’s Hospital, says the program currently is involved in close to 40 key cystic fibrosis studies—with particularly promising research in the areas of gene therapy and protein rescue therapy. “Children with cystic fibrosis are born with different proteins than those without cystic fibrosis, so we’re investigating exactly what those differences are,” says Pardee. The program also is involved in several important drug studies, such as trying to develop a drug that will help the defective cystic fibrosis gene work better. The Cystic Fibrosis Center has no problem finding willing subjects for its research and drug trials. Pardee notes that almost all Cystic Fibrosis Program patients are involved in research, either directly or indirectly. Some simply provide their patient data, while others offer regular specimens, participate in extended drug trials, or are willing to try new procedures. These patients are critical to keeping this important research moving forward. According to Dr. Sagel, all current treatments treat the consequences of cystic fibrosis, including airway infection, inflammation, and mucus plugging. And though we can’t prevent cystic fibrosis today, The Children’s Hospital Cystic Fibrosis Center research team, along with others dedicated to improving the quality of life for these patients or even finding a cure, is involved in early-phase human clinical trials of potential disease-modifying treatments. Excitedly, Dr. Sagel says these treatments have the potential to prevent the downstream consequences of cystic fibrosis. “They represent hope for these patients,” he says.

• Nutritional intervention – including digestive enzymes, antacids, and nutritional supplements • A high-calorie diet – typically high in fats, that surpasses the minimum RDA for calories in normal children by 20-50 percent • Antibiotics – to treat bacteria that frequently colonize and infect the airways, resulting in chronic bacterial bronchitis • Airway clearance techniques – done one to four times per day to improve lung function and reduce the sever ity of lung infections, they include chest physiotherapy, where parents and others clap on the child’s chest; hand held mucus-clearing devices; and external devices such as vests that vibrate externally to loosen phlegm • Inhaled mucolytic agents – taken by nebulizers to loosen and liquefy mucus secretions Without such treatments, cystic fibrosis was a fatal early childhood condition. Dr. Sagel says that improvements in survival are due to “better antibiotic options, enhanced mucus clear-

Pulmonary specialist and Director of the Cystic Fibrosis Program at The Children’s Hospital, Frank Accurso, visits with Devin, Daphne and Dalyn Shkapich

Health and Wellness Magazine •

Finding the Right Specialty Care for Your Child When your child needs specialty care, you don’t want to entrust it to just anyone. You need a doctor who can meet his unique needs. “Children are not just little adults,” says Dr. Stefan Mokrohisky, medical director of physician relations at The Children’s Hospital. “They have growth and development issues that have to be taken into account. All those things support the need for parents to think about a pediatric specialist. “

Dr. Edward Hartford is a pediatric surgeon and Program Director for The Children’s Hospital Burn Center

All specialists at The Children’s Hospital are trained in the pediatric portion of their specialty, so whether they’re a pediatric cardiologist, oncologist, orthopedist or other specialist, they become experts in the pediatric illnesses in their fields. By choosing a pediatric specialist, families can be confident that their child is getting the best care possible. “Pediatric specialists are specifically trained to only deal with pediatric problems in their subspecialty,” says Dr. Jay Markson, a pediatrician at Children’s Medical Center in Denver. “When a pediatric problem is beyond the scope of a general pediatrician or family practitioner’s expertise, a pediatric subspecialist is often needed.” Choosing the right pediatric specialist depends on a variety of factors including a child’s age and medical need. A child with Down’s Syndrome, for instance, may have medical needs that require the expertise of several specialists. “For children with complex conditions or multiple issues, Children’s is the best place,” says Dr. Shen Nagel, chair of pediatrics at Lutheran Hospital. “There’s an overall continuity of care you get at Children’s that you may not get at other places. They have it all in one place.” 40

In addition to access to high quality care from leading specialists, The Children’s Hospital provides a comprehensive approach to care that includes access to pediatric-specific nursing care, respiratory specialists, and other ancillary care services often unavailable in other settings. “The Children’s Hospital physicians work within an entire spectrum of a pediatric specificsystem of care,” says Dr. Markson. “There is a pediatrics laboratory, radiology, and even a social work system if needed.”

“For children with complex conditions or multiple issues, Children’s is the best place. There’s an overall continuity of care you get at Children’s that you may not get at other places. They have it all in one place.” — Dr. Shen Nagel, Chair of Pediatrics, Lutheran Hospital

“When a child is sick and it is beyond the scope of general pediatrics, it is incredibly vital to be able to access a pediatric network with such caring and expertise. TCH specialists are responsive to the needs of the general community pediatrician.” — Dr. Jay Markson, Pediatrician, Children’s Medical Center

Building Relationships with Community Physicians Gone are the days of having all your child’s medical needs met by one provider. Advances in health care, insurance pressures, treatment of complex medical conditions, and other issues often require the collaboration of multiple physicians. To better meet the growing and changing health needs of children in the Denver metro area, The Children’s Hospital is working to increase opportunities to collaborate with community health care providers. “We realize the importance of building a strong relationship with the medical community,” says Dr. Stefan Mokrohisky, medical director of physician relations at The Children’s Hospital. “Health care is so complicated, you need a place where someone can monitor the individual needs of each child.” Whether that place is a private family practice or a community clinic, Mokrohisky says every child needs and deserves a medical home. “We appreciate the fact that most of a child’s health care life will take place outside the hospital,” he says. “When a child comes in for a specialty visit, we know that they’ve come from their medical home and that our communication has to be prompt and thorough.” To facilitate communication and collaboration in those instances, The Children’s Hospital has implemented a variety of educational and outreach services and technologies. One improvement that’s making communication easier is the hospital’s new electronic medical records (EMR) system. After a child is seen at any Children’s Hospital location, the EMR system makes it possible for physi-

cians and staff to securely share information about that child’s treatment with his/her pediatrician.

“We’re constantly coming up with new ways to make (referring) doctors feel connected to their patients…” All Children’s physicians also are involved in lecturing and hosting seminars for referring physicians throughout the region. Many also provide tele-care medical analysis for patients at a distance. In addition, pediatricians who have expertise in hospital-related care confer regularly with referring physicians when making plans for a patient’s care at the hospital. “We’re constantly coming up with new ways to make (referring) doctors feel connected to their patients,” Mokrohisky says. The Children’s Hospital is currently streamlining the referral process. So whether a referring pediatrician calls for advice or admission procedures, all patient information now can be taken and assessed during the initial call. “When a child is sick and it is beyond the scope of general pediatrics, it is incredibly vital to be able to access a pediatric network with such caring and expertise,” says Dr. Jay Markson, a pediatrician with Children’s Medical Center in Denver. “The Children’s Hospital specialists are responsive to the needs of the general community pediatrician.” • Allergy

Specialty Care at The Children’s Hospital: Treated Medical Conditions

• Asthma, Breathing & Lung • Behavior & Development • Brain, Spinal Cord & Nervous System • Cancer & Blood Disorders • Dental • Diabetes, Endocrine & Growth • Digestive, Liver, Pancreas • Ear, Nose & Throat

• Eye • Genetics & Inherited Metabolic Diseases • Gynecology • Hearing, Speech & Learning • Heart • Immune System & Infectious Disease • Kidney, Bladder & Urinary • Newborn

• Orthopedic • Psychology & Psychiatry • Rehabilitation & Therapy • Skin • Sleep • Sports Medicine • Teen Health • Weight Management

To learn more about the treatment of these conditions at The Children’s Hospital visit www.thechildrenshospital.org/conditions.

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Network of Care The Children’s Hospital Care Centers

The Children’s Hospital has created a Network of Care to ensure every child and family has access to high-quality pediatric care.

THE CHILDREN’S HOSPITAL Denver, Colorado

Association of Volunteers: 2007 Stats Adult Volunteers Junior Volunteers Pet Volunteers Volunteer Chapters Chapter Members Total Volunteers Total Volunteer Hours

901 292 85 14 519 1,797 132,634

Through our Network of Care, we’re working collaboratively with community physicians, other healthcare institutions and children’s organizations devoted to the special needs of children.

Care Provider Partners _____________________________________ Partners in providing excellent, cost-effective health care. • Centura Health • Colorado Access • Exempla • Kaiser Permanente

Affiliations _____________________________________ These are just some of our community partners in providing care to children. • Barbara Davis Center for Childhood Diabetes • The Brent Eley Foundation • Denver Health and Hospitals • Exempla Saint Joseph Hospital • Exempla Lutheran Medical Center • JFK Center for Developmental Disabilities • Kempe National Center for Prevention and Treatment of Child Abuse • Littleton Adventist Hospital • National Jewish Medical and Research Center • Parker Adventist Hospital • Ronald McDonald House • St. Anthony’s Flight for Life • Sewall Child Development Center • University of Colorado Hospital • University of Colorado at Denver and Health Sciences Center

The New Children’s Hospital Aurora Campus 13123 East 16th Ave., Aurora 720-777-1234 Emergency Care, Hospital Care, Rehabilitation & Therapy, Sports Medicine 1 Care by The Children’s Hospital Broomfield 340 East 1st Ave, Ste 100, Broomfield 720-777-1340 Urgent Care, Asthma, Breathing & Lung, Brain, Spinal Cord & Nervous System, Digestive, Liver & Pancreas, Ear, Nose & Throat, Hearing, Speech & Learning, Heart, Kidney, Bladder & Urinary, Orthopedic, Radiology, Rehabilitation & Therapy, Sports Medicine, Surgery 2 Care by The Children’s Hospital Westminster 7577 W. 103rd St, Ste 200, Westminster 303-837-2580 Hearing, Speech & Learning, Occupational & Physical Therapies

7 Care by The Children’s Hospital Littleton 151 West County Line Rd, Littleton 720-777-1320 Diabetes, Endocrine & Growth, Digestive, Liver & Pancreas, Ear, Nose & Throat, Hearing, Speech & Learning, Heart, Orthopedic, Radiology, Rehabilitation & Therapy, Skin, Surgery 8 Care by The Children’s Hospital Centennial 9094 E. Mineral Ave, Ste 110, Centennial 720-777-1310 Kidney, Bladder & Urinary, Orthopedic, Radiology 9 Care by The Children’s Hospital Parker 9395 Crown Crest Blvd, Parker 720-777-1350 Emergency Care, Hospital Care, 24 hours a day, 7 days a week

10 Care by The Children’s Hospital Parker 19284 Cottonwood Dr, Parker 3 Care by The Children’s Hospital 720-777-1303 Lutheran Medical Center Rehabilitation, Sports Medicine, Asthma, 3455 Lutheran Pkwy, Ste 230, Wheat Ridge Breathing & Lung, Brain, Spinal Cord & 720-777-1370 Nervous System, Diabetes, Endocrine, Urgent Care, Ear, Nose & Throat, Hearing, Digestive, Liver & Pancreas, Gynecology, Speech & Learning, Heart, Lab, OrthopeHeart, Kidney, Bladder & Urinary, Surgery dics & Sport Medicine, Radiology, Surgery 4 The Children’s Hospital St. Joseph’s Hospital 1830 Franklin St, Denver 720-777-1360 Emergency Care, Hospital Care, Lab, Radiology 5 The Children’s Hospital Dental Clinic 1575 Wheeling St, Aurora 720-777-6788 Pediatric Dentistry for all kids 6 Children’s Emergency Care After Hours Littleton Adventist Hospital 303-730-5895 7700 South Broadway, Littleton 24 hours a day, 7 days a week

11 Care by The Children’s Hospital Pueblo 704 Fortino Blvd, Ste A, Pueblo 719-595-0829 Hearing, Speech & Learning, Therapy 12 Memorial Hospital for Children (In Partnership with The Children’s Hospital)

1400 East Boulder St, Colorado Springs 719-444-2273 Emergency Care, Rehabilitation, Asthma, Breathing & Lung, Cancer & Blood Disorders, Diabetes, Endocrine & Growth, Digestive, Liver & Pancreas, Genetics & Inherited Metabolic Diseases, Heart, Immune System & Infectious Disease, Newborn, Orthopedic, Surgery

Weâ&#x20AC;&#x2122;re in your neighborhood!

Pediatric Physicians Directory The following list is comprised of physicians who practice at The Children’s Hospital and its Care Centers throughout the community. Adolescent Gynecology Physicians in this specialty are trained to address the special gynecologic needs of a female adolescent’s reproductive system. This includes menstrual disorders, abnormal pap smears, contraceptive issues and related female health issues.

Judith Mikacich, MD

MD: Univ of Texas - San Antonio Intern/Resid: UCLA

William Schlaff, MD

MD: University of Michigan Intern/Resid: University of Michigan Fellow: Johns Hopkins Medical Center

Steven Scott, MD

Adolescent gynecology MD: Univ of Missouri-Kansas City Intern/Resid: Univ of Illinois, Chicago

Adolescent Medicine Physicians in this specialty are trained to treat physical and emotional problems that are common during adolescence. This includes acne, bulimia, growth/pubertal development problems and sports injuries.

Karoline Kabir, MD

Identification and treatment of antenatal and postpartum depression in teen mothers MD: University of North Carolina Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC MD: University of North Carolina

David Kaplan, MD

Expertise in caring for teenagers with combined physical and emotional problems; An interest in adolescents with migraines and abdominal pain MD: Case Western Reserve Univ Intern/Resid: Univ of Colorado HSC Fellow: Children’s Hospital, Boston Fellowship In order to provide children with the best care possible, pediatric physicians have special training in child-specific medical conditions. Many physicians participate in a fellowship, which is a program of graduate medical education beyond residency that trains the physician in their chosen pediatric subspecialty, such as pediatric orthopaedic surgery or pediatric radiology. The length of such fellowships varies by specialty.

Dan Reirden, MD

MD: University of Connecticut Intern/Resid: University of Connecticut Fellow: Children’s Hospital of Philadelphia

Cardiac/Thoracic Surgery Physicians in this specialty perform surgery on the chest area, most commonly the heart and lungs. The Children’s Hospital has been the top pediatric heart transplant center in the nation for more than five years.

Amy Sass, MD

David Campbell, MD

Clinical interests include caring for patients with gynecological and hormone problems, eating disorders and health problems related to complex medical and psychological issues MD: Univ of Rochester Intern/Resid: Children’s Hospital, Boston Fellow: Children’s Hospital, Boston

Eric Sigel, MD

Violence issues in teens, eating disorders in teens, ADHD, sexually transmitted infections, drug use, depression MD: Case Western Reserve Univ Intern: Case Western Reserve Univ Resid: Rainbow Babies and Children’s Hospital; Case Western Reserve Univ Fellow: Harvard Univ

Allergy/Immunology Physicians in this specialty focus on the diagnosis of disorders caused by hypersensitivity to various substances, such as pollen, nuts or mold. They treat such disorders as asthma, chronic lung disease, and allergic and non-allergic rhinitis.

Daniel Atkins, MD

MD: Univ of Texas Intern/Resid: Univ of Texas Fellow: Univ of Texas

Mark Boguniewicz, MD MD: University of Warsaw School of Med

Anesthesiology Physicians in this specialty are trained to eliminate pain sensation in children and adolescents undergoing surgery or other medical procedures. Patient care in this specialty is not by selected physician or appointment.

Audiology, Speech and Learning The clinical staff have specialty training in the area of pediatrics and provide comprehensive diagnostic evaluation and treatment services to children with speech-language, hearing or learning disabilities.

Deborah Hayes, PhD

Audiology, Speech and Learning PhD: Baylor College of Medicine AuD: Northwestern University

Directs the mechanical circulatory support program at Univ Hospital MD: Rush Medical College Intern/Resid: Univ of Colorado HSC Fellow: Boston Children’s Hospital; Harvard Medical Center

Special interest in treating congenital heart disease using catheters and developing new techniques and devices to treat patients with congenital heart disease MD: St Louis Univ Intern/Resid: St Louis Univ, Cardinal Glennon Children’s Hospital Fellow: Baylor College of Medicine, Texas Children’s Hospital

Jill Ibrahim, MD

David Clarke, MD

International reputation for the pioneering use of cryopreserved allograft valved conduits MD: Univ of Colorado HSC Intern/Resid: Univ of Colorado HSC Fellow: Hospital for Sick Children, London

Francois Lacour-Gayet, MD

World-renowned pediatric heart surgeon for the surgical repair of complex neonatal heart disease MD: Medical Univ of Paris Intern: Medical Univ of Paris Resid: Hospital of Paris Fellow: Marie Lannelongue Hospital, Paris

Max Mitchell, MD

Conducts clinical projects studying outcomes following infant heart transplantation MD: George Washington Univ Intern: George Washington Univ Resid: Univ of Colorado HSC Fellow: The Children’s Hospital, Denver

Cardiology Physicians in this specialty treat diseases of the heart, lungs and blood vessels. They commonly treat patients with congenital and acquired heart disease and heart arrhythmias.

Dennis Chang, MD

Interests include 3D reconstruction of cardiac structures using biplane angiography MD: Univ of Maryland Intern/Resid: Geisinger Medical Center Fellow: The Children’s Hospital, Denver

Eduardo da Cruz, MD

Thomas Fagan, MD

The perioperative treatment and medical management of neonates, children and young adults with simple or complex congenital or acquired heart diseases MD: Facultad de Medicina, Universidad de Costa Rica, San José, Costa Rica Intern/Resid: Hospital Nacional de Niños, San José, Costa Rica Fellow: Pediatric Cardiology and Critical Care, Hôpital Necker-Enfants Malades, Université de Paris V-René Descartes (La Sorbonne)

Work on T-Cell mediated myocarditis and thoracic organ rejection reduction in infants MD: Univ of Missouri Intern/Resid: Loyola Univ Fellow: Washington Univ

D Dunbar Ivy, MD

Primary investigator on several major grants involving novel treatment of pulmonary arterial hypertension MD: Tulane Univ Intern/Resid/Fellow: Univ of Colorado HSC

Jonathan Kaufman, MD

Management of congenital heart disease in neonates and infants, endocrinology of critical illness, resident and fellow education and medically underserved communities. Dr. Kaufman is fluent in Spanish. MD: State Univ of NY Fellow: The Children’s Hospital, Denver MD: State Univ of NY

Joseph Kay, MD

Clinical interests include trans-catheter interventions for adults and children MD: Univ of New York at Buffalo Intern/Resid: Univ of Michigan Hospitals Fellow: Duke Univ

Shelley Miyamoto, MD

Clinical interests include heart failure and cardiac transplantation MD: Univ of Iowa College Intern/Resid: Brown Univ, Providence, RI Fellow: The Children’s Hospital, Denver

Gira Shah Morchi, MD

MD: Dartmouth Medical School Intern/Resid: Brown University Resid: The Children’s Hospital - Denver

Biagio Pietra, MD

Extensive research in cardiac allograft rejection MD: Univ of Southern Florida Intern/Resid: Children’s Hospital, Cincinnati Fellow: Children’s Hospital, Cincinnati

Listed by Specialty, Physician Name

Adolescent Gynecology to Endocrinology 720.777.1234

Michael Schaffer, MD

Adel Younoszai, MD

Specializes in the diagnosis and treatment of cardiac arrhythmias Intern/MD: Univ of Minnesota Resid: Univ of Colorado HSC Fellow: Hospital for Sick Children

Elizabeth Shaffer, MD

Expert in fetal and infant echocardiography Intern/MD: Univ of Minnesota Resid: Univ of Connecticut Medical Ctr Fellow: Univ of Michigan Medical Center

Henry Sondheimer, MD

Heart disease in children with Down syndrome, congenital heart disease, normative ethics Intern/MD: Columbia Univ Resid: The Children’s Hospital, Denver Fellow: Hospital for Sick Children, Toronto

Karrie Villavicencio, MD

Interests include echocardiographic evaluation of pulmonary hypertension and tissue Doppler evaluation of ventricular function MD: Univ of Virginia Intern/Resid: Duke Univ Fellow: The Children’s Hospital, Denver; Vanderbilt Univ

Wei Tan, PhD

Interests include cardiovascular tissue engineering, and micro and nano mechanical devices for biological and biomedical applications Intern/Resid/PhD: Univ of Illinois Fellow: Beckman Institute; Univ of Illinois

Lisa Wise-Faberowski, MD

MD: Ohio State Intern: Duke University Resid: University of Florida Fellow: Univ of Florida, Harvard

Robert Wolfe, MD

Primary research interests include pulmonary hypertension at altitude, normal and abnormal pulmonary vascular hypoxic response in humans MD: Baylor College of Medicine Intern/Resid: Baylor Affiliated Hospitals Fellow: UCLA

Elizabeth Yeung, MD

General pediatric cardiology and adults with congenital heart disease MD: SUNY - Brooklyn Intern/Resid: SUNY - Brooklyn Fellow: The Children’s Hospital, Denver

Interest in digital information technology, Marfans Syndrome, fetal cardiac intervention MD: Univ of Iowa Resid: Columbus Children’s Hospital, OH Fellow: Univ of California, San Francisco; Cleveland Clinic

Child Advocacy This highly trained team offers comprehensive, multidisciplinary consultation, assessment, treatment, and referral services for children and adolescents who may have been physically or sexually abused or neglected.

Dermatology Physicians in this specialty focus on the treatment of pediatric disorders of the skin, such as acne, moles and skin infections. The Children’s Hospital Dermatology program is the only comprehensive pediatric dermatology evaluation and management program in the Rocky Mountain area.

Joanna Burch, MD

Antonia Chiesa, MD

Special interests are in pigmented birthmarks, or moles that are present at birth and dermatologic surgery for the removal of moles, birthmarks and cysts MD: Univ of South Florida Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Andrew Sirotnak, MD

Joseph Morelli, MD

Clinical work, education, outreach efforts, research and advocacy all focus on child maltreatment MD: Thomas Jefferson Medical College Intern/Resid: AI DuPont Children’s Hospital, DE Fellow: The Children’s Hospital, Denver

Kathryn Wells, MD Critical Care Medicine Physicians provide comprehensive services for children with single- or multi-organ system failure, complex severe chronic illness, patients undergoing solid organ transplantation, children recovering from complex cardiac, orthopaedic, neurologic and general surgeries. Patient care in this specialty is not by selected physician or appointment.

Dental These dentists provide comprehensive oral health care, evaluations and referrals for complex dental and craniofacial conditions. Some commonly treated conditions include cavities, malocclusion, soft and hard tissue disease and oro-facial trauma.

Interest in birthmarks, vitiligo, laser treatment, phototherapy and sun protection MD: Harvard Univ Intern/Resid: Univ of Colorado HSC Fellow: Harvard Univ; Univ of Colorado HSC

Bill Weston, MD

Skin diseases in children, birthmarks, epidermolysis bullosa and neonatal lupus MD: Univ of Colorado HSC Intern: Univ of Colorado HSC Resid: Univ of California, San Francisco Fellow: Univ of Colorado HSC

Developmental/ Behavioral Pediatrics These physicians work with children who have developmental, learning and behavioral concerns. Some conditions treated include autism, hyperactivity and birth defects.

William Campbell, MD

MD: Univ of Colorado HSC Intern/Resid: Fitzsimons Army Medical Ctr Fellow: Madigan Army Medical Center; Univ of Washington

Edward Goldson, MD

Mark Koch, DMD

Works with children with special health care needs such as autism, Down syndrome, fragile x syndrome, developmental disabilities, and child maltreatment MD: Univ of Rochester Intern/Resid: Univ Hospitals of Cleveland: Rainbow Babies and Children’s Hospital Fellow: Univ Hospitals of Cleveland; Rainbow Babies and Children’s Hospital

Linda Murzyb, DMD

Ann Reynolds, MD

Ulrich Klein, DMD

Special interest in the dental treatment of autistic children and the use of nitrous oxide DMD: Univ of Nebraska Intern: Univ of Iowa Fellow: Univ of Illinois

Ann Wilson, DMD

DMD: Northwestern Univ Intern: Univ of North Carolina, Chapel Hill Fellow: The Children’s Hospital, Denver

Interests include general child development disorders, autism, fragile x syndrome as well as gastrointestinal and sleep disorders in autistic children MD: Medical College of Georgia Intern/Resid: Children’s National Med Ctr Fellow: Texas Children’s Hospital

Nicloe Tartaglia, MD

MD: University of Colorado HSC Intern/Resid: Children’s Hospital LosAngeles Fellow: Univ of CA - Davis

Diagnostics and Imaging Staff in this department produce and analyze images of the body that are not externally visible, in order to better assess a medical condition. This includes X-rays, MRIs and CT scans. Patient care in this specialty is not by selected physician or appointment.

Emergency Medicine Physicians in this specialty are trained to treat acutely ill or injured children and adolescents who require immediate medical treatment. Patient care in this specialty is not by selected physician or appointment.

Endocrinology Physicians in this specialty evaluate and treat children with growth and puberty disorders, as well as abnormalities of the thyroid or adrenal glands.

Jennifer Barker, MD

MD: Johns Hopkins Intern/Resid: Univ of Colorado HSC Fellow: The Children’s Hospital, Denver Type 1 Diabetes, Pediatric Endocrine Disorders

Francis Hoe, MD Michael Kappy, MD

Interests include the evaluation of children with disorders of growth or early pubertal development, including growth hormone deficiency, thyroid disorders and precocious puberty MD: Univ of Wisconsin Intern: Univ of Colorado HSC Resid: Univ of Colorado HSC; The Children’s Hospital, Denver Fellow: The Johns Hopkins Hospital

David Maahs, MD

MD: Univ of New Mexico Intern/Resid: Univ of New Mexico Fellow: The Children’s Hospital, Denver

Kristen Nadeau, MD

Interests lie in insulin resistance, metabolic syndrome and type 2 diabetes MD: Univ of Wisconsin Intern/Resid: Oregon HSC Fellow: Univ of Colorado HSC

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Pediatric Physicians Directory Sharon Travers, MD

Pediatric endocrinology, growth disorders, precocious/delayed puberty, polycystic ovarian syndrome, Turner’s syndrome, thyroid disorders, obesity MD: Medical College of Virginia Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Paul Wadwa, MD

Type 1 diabetes, cardiovascular disease prevention in T1DM MD: Northwestern University Intern/Resid: Ohio State Fellow: University of Cincinnati

Phillip Zeitler, MD

Osteoporosis, neuroendocrinology insulin resistance/type 2 diabetes MD: Duke Univ Intern/Resid: Univ of Washington Med Ctr Fellow: Univ of Cincinnati Medical Center

Epidemiology Physicians in this specialty study the cause, distribution and patterns associated with diseases among children & adolescents. They also help to improve hospital health care by developing programs that decrease the spread of infections. Patient care in this specialty is not by selected physician or appointment.

Gastroenterology Physicians in this specialty treat pediatric disorders of the digestive system and its organs. Some conditions treated include intestinal motility disorders and abdominal pain.

Glenn Furuta, MD

Specializes in allergic diseases of the intestinal tract, in particular, diseases characterized by eosinophils, an allergic cell commonly seen in diseases such as asthma and eczema. His research focuses on the clinical and basic aspects of these diseases. MD: Baylor College of Medicine Intern/Resid: Baylor College of Medicine Fellow: Children’s Hospital Boston

Edward Hoffenberg, MD

Interests are inflammatory bowel disease, celiac disease and polyps MD: Case Western Reserve Univ Intern/Resid: Rainbow Babies & Children’s Hospital Fellow: Children’s Hospital, Philadelphia

Robert Kramer, MD

MD: Univ of South Florida Intern/Resid: Miami Children’s Hospital Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Amethyst Kurbegov, MD

MD: Baylor College of Medicine Intern/Resid: Univ of Colorado HSC

Edwin Liu, MD

Gunter Scharer, MD

MD: RuprechtKarls University - Germany Intern/Resid: Childrens Hospital Orange County Fellow: Univ of Colorado HSC

Interest in Celiac disease and other diseases of the intestine, research on auto immunity of celiac disease and type 1 diabetes MD: Boston Univ Intern/Resid: St Christopher’s Hospital for Children, Philadelphia Fellow: The Children’s Hospital, Denver

Genetic diseases, birth defects, mental retardation, neurofibromatosis, dwarfism in children and adults MD: Comenius University - Czechoslovakia Intern: Univ of Iowa Fellow: Mount Sinai School of Medicine

Cara Mack, MD

Janet Thomas, MD

Clinical interests are pediatric liver disease and liver transplantation MD: Loyola Univ Stritch School of Med Intern/Resid: Univ of Chicago Hospitals Fellow: Children’s Memorial Hospital, Chicago

Michael Narkewicz, MD

Interest in diseases of the liver and pancreas and liver transplantation MD: Univ of Vermont College of Medicine Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Jason Soden, MD

MD: Emory Univ Intern/Resid: Baylor College of Medicine Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Ronald Sokol, MD

Interests include patient care, teaching and research in children’s liver transplantation MD: Univ of Chicago Pritzker Med Intern/Resid: Univ of Colorado HSC Fellow: Children’s Hospital Medical Ctr

Shikha Sundaram, MD

MD: Univ of Kentucky Intern/Resid: Children’s Memorial Hospital Fellow: Children’s Memorial Hospital

Genetics These physicians study heredity to investigate how particular qualities or traits are transmitted from parents to children.

Gary Bellus, MD

Secondary carnitine deficiency, carnitine transport and small RNAs MD: University of Colorado

Renata Gallagher, MD

Biochemical genetics, genotypephenotype correlations MD: Univ of California San Francisco Intern/Resid: Univ of Washington Fellow: Stanford University

David Manchester, MD

MD: Univ of California, San Francisco Intern/Resid: Univ of Colorado HSC Fellow: McGill Univ

Eva Sujansky, MD

Inborn errors of metabolism, storage disorders MD: Univ of Iowa College Intern/Resid: Univ of Arizona Fellow: Univ of Colorado HSC; Cedars Sinai

Anne Chun-Hui Tsai, MD

Dysmorphology, craniofacial syndromes specifically Parry-Romberg syndrome MD: China Medical College, Taiwan Intern: Mackay Memorial Hospital, Taiwan Resid: Henry Ford Hospital, Detroit Fellow: Hospital For Sick Children, Toronto; Henry Ford Hospital

Main clinical interest is in thrombosis and bleeding disorders in children and adults MD: McGill Univ Faculty of Med, Montreal Intern: McGill Univ Faculty of Med, Montreal Resid: Univ of South Florida, Tampa Fellow: Univ of Colorado HSC

Douglas Graham, MD

MD: University of North Carolina Intern/Resid: Univ of Colorado HSC

Brian Greffe, MD

Principal investigator for the Childhood Cancer Survivor Study MD: McGill Univ Intern/Resid: Children’s Memorial Hospital of Chicago Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Taru Hays, MD

Passion for the treatment and research in congenital and acquired plastic anemia Intern/MD: Seth GS Med College of Bombay Resid: Children’s Hospital, Pittsburgh Fellow: CH, Washington DC

Stephen Hunger, MD

Johan Van Hove, MD

Special interests are in genetic inborn errors of metabolism, neurometabolic disorders, disorders of energy metabolism MD: Catholic Univ, Leuven, Belgium Intern/Resid: Univ Hospitals, Leuven, Belgium Fellow: Duke Univ

Hematology/Oncology Physicians in this specialty diagnose and treat disorders of the blood, spleen and lymph glands, cancer, and other benign and malignant tumors.

Edythe Albano, MD

Interests are in infection prevention and treatment of infection in cancer patients, care for retinoblastoma patients, and program development for adolescents and young adults with cancer MD: Loyola Univ Intern/Resid/Fellow: CH National Medical Center, Washington, DC

Daniel Ambruso, MD

Main research interests are in innate immunity, neutrophil function and the NADPH oxidase enzyme system MD: Univ of Rochester Medical School Resid: Rainbow Babies & Children’s Hospital Fellow: Univ of Colorado HSC

Timothy Garrington, MD

Neil Goldenberg, MD

MD: Univ of Connecticut Intern/Resid: Johns Hopkins Fellow: Stanford University

Kelly Maloney, MD

Chair of the current standard-risk acute lymphocytic leukemia trial MD: Univ of Colorado HSC Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Marilyn Manco-Johnson, MD

Coagulation and thrombosis, pediatric hematology, hemophilia, pediatric AIDS MD: Thomas Jefferson Univ Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Rachelle Nuss, MD

Involved in clinical and research projects involving sickle cell syndromes MD: Wayne State Univ Intern: Children’s Hospital of Michigan Resid: Boston City Hospital Fellow: St Jude Children’s Research Hospital

Christopher Porter, MD

MD: Medical College of Georgia Intern/Resid: Vanderbilt University Fellow: Univ of Colorado HSC/ The Children’s Hospital

Interest is in the development of new therapies to treat pediatric sarcomas MD: Univ of Florida College of Medicine Intern/Resid: Univ of North Carolina Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Listed by Specialty, Physician Name

Endocrinology to Neonatal/Perinatal Medicine 720.777.1234

Christopher Silliman, MD

Local principal investigator for the Children’s Oncology Group study for patients who develop lymphoid malignancies following solid organ transplants MD: Tulane Univ Intern/Resid: Univ of Virginia Medical Ctr Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Michael Wang, MD

Primary clinical interests are leukemia and lymphoma; Research in the potential role of lymphotropic polyomavirus infection in human lymphoid malignancies MD: Univ of Rochester Intern/Resid: Univ of Utah HSC Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Hematology/Oncology/ Bone Marrow Transplant Physicians in this sub-specialty of hematology/oncology specialize in bone marrow transplants, which involve replacing marrow destroyed by chemotherapy or radiotherapy with new bone marrow from a donor.

Robert Garcea, MD

Mary Glode, MD

Interests are in the development of new vaccines for children and Kawasaki disease MD: Washington Univ Intern/Resid: Univ of Texas SW Med School Fellow: Boston Children’s Hospital

Neonatal/Perinatal Medicine Physicians in this specialty care for acutely ill newborns and premature infants. They treat conditions such as congenital anomalies, metabolic disorders and respiratory distress.

Laura Fenton, MD

Myron Levin, MD

James Barry, MD

Pediatric Radiology with a special interest in pediatric brain, spine and tumor imaging MD: Univ of Florida Intern/Resid: Univ of Florida Fellow: Boston Children’s Hospital

Clinical virology, antiviral therapy, herpes virus infection MD: Harvard Medical School Intern/Resid: Bronx Municipal Hospital Fellow: Boston Children’s Hospital

Nicholas Foreman, MD

Medical Director of The Children’s Hospital HIV program and conducts research in the treatment and prevention of HIV infection MD: Duke Univ Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Special interest in the development of clinical protocols for children with difficult to treat brain tumors MD: Univ of Sheffield Intern/Resid: Sheffield Children’s Hospital Fellow: Plymouth General Hospital; Bristol Children’s Hospital

Laurie Gaspar, MD

MD: Univ of Western Ontario Resid: London Regional Cancer Centre Fellow: London Regional Cancer Centre

? ? ? > Julie Ley, MD

Research centers on the structure and assembly of DNA viruses and their relation to cancer MD: Univ of California San Francisco Intern/Resid: Stanford Univ Fellow: Stanford Univ Hospital; Univ of California at San Francisco

Children with tumors in the brain & spine MD: Wright State Intern/Resid: Ohio State, Columbus Children’s Hospital Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Infectious Diseases Physicians in this specialty diagnosis and treat illnesses caused by microorganisms or germs. They treat a variety of conditions including influenza, chicken pox and HIV.

Roger Giller, MD

Expertise in pediatric human marrow transplantation MD: Medical College of WisconsinMarquette Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Mark Abzug, MD

Lia Gore, MD

Research focuses on novel therapeutics in pediatric leukemia MD: George Washington Univ Intern/Resid: Children’s Medical Center Fellow: The Children’s Hospital, Denver

Amy Keating, MD

MD: Northwestern University Intern/Resid: Loyola University Fellow: Univ of Colorado HSC

Ralph Quinones, MD

Hematology/Oncology/ NeuroOncology Physicians in this sub-specialty of hematology/ oncology specialize in the diagnosis of primary brain tumors, metastatic brain tumors and other neurological complications of cancer.

Perinatal infection, enterovirus infections MD: Boston Univ Intern/Resid: Strong Memorial Hospital; Univ of Rochester Fellow: Univ of Colorado HSC

Marsha Anderson, MD

Kawasaki’s disease, bioterrorism, antibiotics, toxin-mediated disease MD: Univ of Tennessee Intern/Resid: The Children’s Hospital, Denver Fellow: Univ of Colorado HSC

Jessica Cowden, MD

Involved in clinical research in allogenic bone marrow transplant, especially in the use of alternate donors MD: Univ of Michigan Intern/Resid: Univ of Minnesota Fellow: Univ of Minnesota

MD: State University of New York Intern/Resid: Wright State University Fellow: Univ of Colorado HSC

Samuel Dominguez, MD

MD: Baylor College of Medicine Fellow: Univ of Colorado HSC

Elizabeth McFarland, MD

Research to better understand the impact of altered pregnancies - such as those with preeclampsia, hypertension; Fetal growth and heart development MD: Creighton Univ Intern/Resid: Univ of Michigan Fellow: Univ of Colorado HSC

Laura Brown, MD

Ann-Christine Nyquist, MD

Primary interests are immunizations, antibiotic use and hospital associated infections MD: Univ of Michigan Intern/Resid: UCLA medical Center Fellow: Univ of Chicago

Neonatal nutritional management strategies in the setting of intrauterine growth restriction, neurodevelopmental outcomes in extremely low birth weight infants, neonatal follow-up for NICU graduates with complex medical problems, perinatal ethical issues MD: University of Colorado Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Sarah Parker, MD

Jason Gien, MD

Conducts research on tuberculosis and has an interest in vaccine safety MD: Vanderbilt Univ Intern/Resid: The Children’s Hospital, Denver Fellow: The Children’s Hospital, Denver

Harley Rotbart, MD

Clinical virology, infections of the central nervous system, laboratory diagnosis of infectious diseases, neonatal and congenital infections MD: Cornell University Intern/Resid: Children’s Hospital of Phila Fellow: Univ of Colorado HSC

Eric Simoes, MD

Pediatric acute respiratory infections, respiratory syncytial virus prevention MD: Christian Medical College Madras Intern: Christian Medical College Hospital Resid/Fellow: Univ of Colorado HSC

James Todd, MD

Bacterial infections, shock, diagnostic microbiology, staph and strep infections MD: Univ of Michigan Intern/Resid: Univ of Michigan Fellow: Univ of Colorado HSC

Adrianna Weinberg, MD

Innate and adaptive immune restoration in HIV infected patients and bone marrow transplant patients MD: Univ of Sao Paulo, Brazil Intern/Resid: Hospital das Clinicas, Sao Paulo, Brazil Fellow: Stanford Univ

Pulmonary hypertension, chronic lung disease, congenital heart disease MD: University of the Witwatersrand Johannesburg, South Africa Intern/Resid: Children’s Hospital of Philadelphia Fellow: Univ of Colorado HSC

Theresa Grover, MD

Pulmonary hypertension of the newborn, cardiopulmonary physiology, congenital heart disease MD: Univ of Louisville, KY Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Daniel Hall, MD

Fetal diagnosis and therapy, neonatal surgery, pulmonary hypertension, congenital heart disease, neonatal infections MD: Northwestern Univ Medical School Intern/Resid: Univ of Wisconsin Fellow: Univ of Colorado HSC

William Hay, MD

Neonatal nutrition MD: Yale Univ Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Jacinto Hernandez, MD

MD: Univ National Mayor de San Marcos Intern: Washington Hospital Center Resid: Children’s National Medical Center Fellow: The Children’s Hospital, Denver

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Pediatric Physicians Directory Peter Hulac, MD

Neonatology, medical decision making, bioethics MD: Temple Univ Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

M Douglas Jones, MD

MD: Univ of Texas SW Medical School Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

John Kinsella, MD

Inhaled nitric oxide, high frequency ventilation ECMO, pulmonary hypertension, acute respiratory failure MD: St Louis Univ Intern/Resid: Letterman Army Medical Ctr Fellow: Wilford Hall USAF

Amy MacRitchie, MD

Clinical interests lie in platelet-activation, gene expression and the incidence of chronic lung disease in low birth-weight infants MD: Univ of Texas SW Medical School Intern/Resid: Children’s Med Ctr, Dallas Fellow: Univ of Texas SW Medical Center

Susan Niermeyer, MD

Hyperbilirubinemia, high altitude physiology and development, neonatal and infant nutrition, neonatal resuscitation, follow-up, acute respiratory infection, international child health MD: Vanderbilt Univ Intern/Resid/Fellow: Univ of Colorado HSC

Jan Paisley, MD Thomas Parker, MD

Hormonal modulation of the developing fetal pulmonary circulation, role of endogenous nitric oxide in the developing lung circulation, use of nitric oxide in treatment of persistent pulmonary hypertension of the newborn MD: Northwestern Univ Intern/Resid: Children’s Memorial Hospital Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Regina Reynolds, MD

Neonatal nutrition MD: Univ of Tennessee HSC Intern/Resid: Univ of Tennessee; LeBonheur Children’s Medical Center Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Adam Rosenberg, MD

Neurologic problems of the newborn especially asphyxial brain injury, periventricular/ intraventricular hemorrhage, respiratory problems of the newborn and surfactant MD: Vanderbilt Univ Intern/Resid: Univ of Colorado HSC Fellow: Johns Hopkins Univ

Paul Rozance, MD

Care for premature and critically ill newborns MD: Georgetown Univ Intern/Resid: Stanford Univ, Lucille Packard Children’s Hospital Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Daniel Satterwhite, MD

MD: St Louis University Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC/The Children’s Hospital

Danielle Smith, MD

Nutrition for the extremely low birth weight growth-restricted infant, outreach to community obstetricians/ pediatrician MD: Cornell University Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC/The Children’s Hospital

Elizabeth Thilo, MD

Twins and multiple births, adrenal function of the neonate, non-invasive monitoring in the newborn and jaundice MD: Thomas Jefferson Univ Intern/Resid: Ohio State, Columbus Children’s Hospital Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Patti Thureen, MD

MD: Univ of Pennsylvania Intern/Resid: Univ of Wisconsin Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Randall Wilkening, MD

Placental transfer and function, fetal metabolic responses to placental dysfunction, IGUR, fetal organ blood flow and metabolism MD: Univ of Missouri Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC; The Children’s Hospital, Denver

Nephrology Physicians in this specialty treat children for a multitude of renal maladies, ranging from mild and transient to complete kidney failure requiring dialysis and kidney transplantation.

Melissa Cadnapaphornchai, MD

MD: Univ of Michigan Medical School Intern/Resid: Univ of Colorado HSC Fellow: Univ of Virginia Medical Center

Douglas Ford, MD

Interested in all aspects of children’s kidney diseases including dialysis and transplantation MD: Univ of Oklahoma Intern/Resid: Univ of Oklahoma, Children’s Memorial Hospital Fellow: Univ of Colorado HSC

Gary Lum, MD

Clinical interests are in chronic renal failure management, glomerular disease, anemia in renal failure, hematuria MD: Bowman Gray Intern: Denver General Hospital Resid: Georgetown Univ Hospital Fellow: Univ of Colorado HSC

Neurology Physicians in this specialty diagnose and treat disorders of the nervous system, which includes the brain, spinal cord and the nerves. They treat conditions such as cerebral palsy, epilepsy and migraine.

Julie Parsons, MD

General pediatric neurology, neuromuscular disorders and neurofibromatosis MD: Univ of Colorado HSC Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Tonia Sabo, MD

Interests include headaches, seizures, tics, and general pediatric neurology MD: Baylor College of Medicine Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Audrey Yee, MD

Timothy Benke, MD

Interests: clinical headache research MD: Univ of Kansas Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Timothy Bernard, MD

MD: University of Rochester Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Neurosurgery Physicians in this specialty care exclusively for infants, children and adolescents undergoing complex brain and spinal cord surgery. Some of the conditions they treat include spina bifida, craniofacial deformities and intracranial cysts.

Kelly Knupp, MD

Michael Handler, MD

Surgical and non-surgical treatment of complicated epilepsy MD: Univ of New Mexico Intern/Resid: NY Children’s Hospital at Columbia Presbyterian Fellow: NY Children’s Hospital at Columbia Presbyterian - Neurologic Institute

Interests include evaluating the use of intravenous fluids and electrolyte levels after craniotomy for brain tumors MD: Univ of Pittsburgh Intern: New York Univ Medical Center Resid: State Univ of New York HSC Fellow: New York Univ Medical Center

Pramote Laoprasert, MD

Sean McNatt, MD

General child neurology, neurometabolic disorders, stroke, and development MD: Baylor College of Medicine Intern/Resid: Baylor College of Medicine; Texas Children’s

Interests include epilepsy MD: Mahidol Univ Thailand Intern: Chaing Mai Univ Thailand Resid: Texas Tech Univ HSC; Univ of Illinois Fellow: Mayo Clinic; Harvard Med School

MD: Univ of Texas - San Antonio Intern/Resid: University of Southern California Fellow: Children’s Hospital of Los Angeles

Paul Levisohn, MD

MD: New York Medical College Intern/Resid: West Virginia Univ Fellow: Univ of CA; The Children’s Hospital, Denver

Interests include pediatric epilepsy, clinical trials, and quality of life related to epilepsy MD: Univ of Colorado HSC Intern/Resid: St Louis Children’s Hospital Fellow: Barnes Hospital, St Louis

Bradford Miller, MD

MD: Univ of Oklahoma Intern/Resid: Brooke Army Medical Center

Corbett Wilkinson, MD

Ken Winston, MD

Pediatric neurosurgery, craniofacial surgery, radiosurgery MD: Univ of Tennessee Intern/Resid: Univ of Colorado HSC

Paul Moe, MD

Interests include general pediatric neurology, teaching, and electroencephalography MD: Univ of Minnesota Intern/Resid: Columbus Children’s Fellow: Univ of Minnesota

Listed by Specialty, Physician Name

Neonatal/Perinatal Medicine to Pathology 720.777.1234

Obstetrics Physicians in this specialty focus on the care of females during pregnancy, childbirth and the recuperative interval immediately following birth.

Ophthalmology Physicians in this specialty diagnose and treat diseases of the eye including complex childhood eye disorders, eye trauma, congenital cataracts and other genetics-related conditions. They also administer routine eye exams.

Lynn Barbour, MD

J Bronwyn Bateman, MD

720-848-1060

MD: Univ of Colorado HSC Intern, Resid and Fellow: Univ of Colorado HSC

MD: Columbia Univ Intern/Resid: UCLA Medical Center Fellow: Johns Hopkins; UCLA; Children’s National, Washington, DC

Gail Best, MD

Rebecca Braverman, MD

Jill Davies, MD

Specialize in the management of high risk pregnancy, first trimester screening and high risk ultrasound, as well as HIV and diabetes in pregnancy MD: George Washington Univ Intern/Resid: George Washington Univ Fellow: Univ of Colorado HSC

Lorraine Dugoff, MD

Specialize in the management of high risk pregnancy, genetics, first trimester screening and high risk ultrasound MD: Georgetown Univ Intern: Pennsylvania Hospital, Philadelphia Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Henry Galan, MD

Specialize in the management of high risk pregnancy, first trimester screening and high risk ultrasound MD: Texas A&M Univ Intern/Resid: Scott and White Hospital; Texas A& M Univ HSC Fellow: Univ of Texas HSC, Houston

Ronald Gibbs, MD

Specialize in the management of high risk pregnancy, genetics, first trimester screening and high risk ultrasound MD: University Of Pennsylvania Intern: University of PA Hospital Resid: University of PA Hospital Fellow: Univ of Texas, San Antonio

John Hobbins, MD

Specialize in the management of high risk pregnancy, genetics, first trimester screening and high risk ultrasound MD: Univ of Texas Medical Branch Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Theodore Curtis, MD

Interests include pediatric spinal deformities, biomechanical aspects of spinal fixation, and neuro-muscular spinal deformities MD: Wright State Univ Intern: Miami Valley Hospital Resid: Wright State Univ Fellow: Scottish Rite Hospital for Children

Gaia Georgopoulos, MD

Interests include spinal deformities, spina bifida, foot and ankle deformities, sports medicine and orthopaedic trauma MD: Univ of Michigan Intern/Resid: Univ of North Carolina Hospital Fellow: The Children’s Hospital, Denver

Gerard Glancy, MD

Interests include general non-surgical and orthopaedic concerns MD: UCLA Intern: Univ of Utah Resid: Fitzsimons Army Medical Center Fellow: Scottish Rite Hospital

Strabismus MD: Pennsylvania State Univ Intern: Good Samaritan Hospital, Cincinnati Resid: Univ of Colorado HSC Fellow: Oregon Health and Sciences Univ

Travis Heare, MD

Arlene Drack, MD

Nancy Miller, MD

Interest in inherited eye diseases, pediatric cataracts, retinopathy of prematurity, and strabismus (crossed eyes) MD: Pennsylvania State Univ Intern/Resid: Georgetown Univ Fellow: Johns Hopkins Univ; Univ of Iowa

Orthopaedic Surgery Physicians in this specialty treat the form and function of the arms, legs, spine and associated parts of the body. They commonly treat fractures, hip and joint problems.

Laurel Benson, MD

Children’s orthopaedics, hand surgery MD: Univ of Colorado HSC Intern/Resid: Loyola Univ Medical Center Fellow: CH Univ of California

Specialize in the management of high risk pregnancy, first trimester screening and high risk ultrasound MD: New York Medical College Intern: Greenwich Hospital, Greenwich, CT Resid: Yale-New Haven Medical Center

Marsha Wheeler, MD

Special interest in diseases that affect the eyes of children These conditions include but are not limited to treating eyes that are not straight (strabismus), lazy eye (amblyopia), tearing from birth, cataracts and traumatic injuries to the eyes MD: Wayne State Univ Intern: Naval Medical Center San Diego, CA Resid: Univ of Florida Fellow: Emory Univ

Mark Erickson, MD

Franklin Chang, MD

Interests include cerebral palsy, gait abnormalities, and disabled sports medicine MD: St Louis Univ Intern/Resid: St Louis Univ Hospital Fellow: Alfred Dupont Institute

Robert Eilert, MD

Interests include hip dysplasia, scoliosis/ spinal deformities, clubfoot, leg length discrepancy and osteotomies for deformities of the skeleton MD: Univ of Tennessee Intern/Resid: Wilford Hall USAF Fellow: OREF Carl Berg

Pediatric orthopaedic oncology MD: Univ of Texas, Galveston Intern/Resid: Univ of Texas, Galveston Fellow: Univ of Florida Pediatric orthopedic surgery, scoliosis, clubfoot, hip dysplasia, cerebral palsy, pediatric trauma MD: University of Maryland Intern/Resid: Boston Univ Medical School Fellow: Univ of Iowa

Brooke Pengel, MD

Non-surgical pediatric sports medicine specialist MD: Univ of Connecticut Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

John Polousky, MD

Interests include congenital and acquired limb deformity surgery, sports medicine and trauma MD: Keck School of Medicine Intern/Resid: Cleveland Clinic Foundation Fellow: The Children’s Hospital, Denver

Aaron Provance, MD

MD: University of West Virginia Intern/Resid: Univ of West Virginia Fellow: The Children’s Hospital, Denver

Ernest Sink, MD

Interests include common hip disorders, and newly realized hip impingement or pain in adolescents and athletes MD: Univ of Texas Southwestern Intern/Resid: Univ of Texas Southwestern Fellow: Children’s Hospital, San Diego

Otolaryngology Physicians in this specialty treat disorders of the ears, nose and throat. Conditions they treat include diseases of the tonsils and adenoids, nasal obstructions, cleft palates and hearing loss.

Gregory Allen, MD

Interests include children with tracheostomy and craniofacial treatment outcomes MD: Univ of Arkansas Intern/Resid: West Virginia Univ Hospital Fellow: The Children’s Hospital, Denver

Kenny Chan, MD

Interest in gait disturbance in children with otitis media and pathogenesis and treatment of chronic maxillary sinusitis MD: Loma Linda Univ Intern: Univ Hospital Oregon Resid: Loma Linda Univ Medical Center Fellow: The Children’s Hospital, Denver

Norman Friedman, MD

Special interest in sleep medicine MD: Univ of Texas SW Intern/Resid: Univ of Texas SW Fellow: LeBonheur Children’s Medical Ctr; Great Ormond Hospital, London, England

Peggy Kelley, MD

Main interests are in pediatric ear reconstruction, facial plastic surgery and airway problems MD: Univ of Pittsburgh Intern: Univ of Pittsburgh Resid: Univ of Rochester Fellow: Children’s Hospital Medical Center, Cincinnati

Orlik Streubel, MD

MD: Univ of Vermont Intern/Resid: Johns Hopkins Fellow: State University of New York

Patricia Yoon, MD

Received Young Investigator Award from the American Academy of Pediatrics in 2001; Interest in childhood hearing loss and craniofacial anomalies MD: Northwestern Univ Medical School Intern/Resid: Stanford Univ Medical Ctr Fellow: Univ of Washington

Pathology Staff in this department analyze blood and tissue specimens and provide clinical laboratory services to physicians caring for hospital inpatients and clinic outpatients. Patient care in this specialty is not by selected physician or appointment.

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Pediatric Physicians Directory Pediatric Surgery Pediatric surgeons treat children for a wide variety of congenital, infectious, traumatic and other specialized problems. Common procedures they perform include appendectomy, hernia surgery and gastrostomy (feeding tube insertion).

John Bealer, MD

Endoscopic surgery, bariatric surgery MD: University of Missouri Intern/Resid: University of Missouri Fellow: Univ of California

Jennifer Bruny, MD

MD: Case Western Reserve Univ Intern/Resid: Univ of Colorado HSC Fellow: The Children’s Hospital, Denver

Ed Hartford, MD

Surgical care of children with burns MD: Temple Univ Intern: National Naval Medical Center Resid: Univ of Iowa Hospital

Frederick Karrer, MD

Hepatobiliary problems, transplantation (liver/kidneys) MD: Univ of Nebraska Intern/Resid: Univ of Arizona Fellow: Children’s Memorial Hospital, Chicago

Steven Moulton, MD

MD: University of Washington Intern/Resid:Univ of CA - San Diego Fellow: Univ of CA - San Diego

David Partrick, MD

Interests are in minimally-invasive surgical techniques in children utilizing laparoscopy and thoracoscopy; Neonatal surgery, pediatric trauma and repair of pectus abnormalities involving the anterior chest wall MD: Univ of WA Intern/Resid: Univ of Colorado HSC Fellow: The Children’s Hospital, Denver

Moritz Ziegler, MD

Surgeon in Chief at The Children’s Hospital MD: Univ of Michigan Medical School Intern/Resid: Univ of Pennsylvania Fellow: Univ of Pennsylvania Residency & Internship: Residencies are usually organized through a university medical school where the physician practices in a local hospital. The physician receives professional training under the supervision of senior physician educators. The first year of post-graduate residency training after medical school is referred to as an “internship.” The physician must complete residency training to obtain a license to practice medicine as an MD or DO.

Pediatrics & Primary Care Physicians in this specialty provide a broad range of health services for infants, children and adolescents, ranging from preventive health care to the diagnosis and treatment of acute and chronic diseases in the Child Health Clinic at The Children’s Hospital.

Allison Kempe, MD

Deidre Arnholz, MD

Mary Kohn, MD

Primary care for children with special health care needs. MD: Univ of Rochester Intern/Resid: Saint Christopher’s Children’s Hospital - Philadelphia

Stephen Berman, MD

Recurrent and/or persistent ear infections, acute lower respiratory infections, international health, health policy and health care delivery MD: Temple Univ Intern/Resid: Univ of Colorado HSC

Robert Brayden, MD

Immunization services MD: St Louis Univ Intern/Resid: Univ of Colorado HSC Fellow: Vanderbilt Univ Hospital

Laura Brown, MD

MD: Univ of Colorado Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Maya Bunik, MD Sara Carpenter, MD

MD: Univ of California San Francisco Intern/Resid: The Children’s Hospital, Denver Fellow: Univ of Colorado HSC

Matthew Daley, MD

General pediatrics, preventive health care, immunizations, medically underserved populations MD: Stanford Univ Intern/Resid: Univ of Colorado HSC Fellow: The Children’s Hospital, Denver

Ellen Elias, MD

Children with special health care needs, children with down syndrome, research involving clinical management of children with smith-lemli-opitz syndrome MD: New York University Intern/Resid: Johns Hopkins Fellow: Children’s Hospital Boston

David Fox, MD

MD: Univ of Medicine and Dentistry, NJ Intern: New York Presbyterian Babies and Children’s Hospital

Health services research, telephone care, immunization delivery MD: Univ of Colorado HSC Intern: Strong Memorial Hospital; Univ of Rochester Resid: The Children’s Hospital, Denver Fellow: Univ of Rochester

Nancy Krebs, MD

Pediatric and general nutrition, breastfeeding, nutrition support, growth problems MD: Univ of Colorado HSC Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Steven Poole, MD

Diagnostic dilemmas, general pediatric consultation, medical care by telephone MD: Univ of Rochester Intern/Resid: Univ of Colorado HSC

Barton Schmitt, MD

Recurrent and/or persistent ear infections, acute lower respiratory infections, international health, health policy and health care delivery; Board certified in Pediatrics MD: Temple Univ Resid: Univ of Colorado HSC

Norman Scott, MD

MD: University of Illinois Intern/Resid: Univ of Colorado Fellow: University of Rochester

MD: Wayne State Univ Intern/Resid: Univ of Colorado Fellow: The Children’s Hospital, Denver

Pamela Wilson, MD

MD: Univ of Colorado HSC Intern/Resid: Univ of Colorado HSC

Plastic Surgery Physicians in this specialty provide acute and long-term care for children with craniofacial, burns, cleft lip and palate, and other reconstructive surgical problems, in all degrees of magnitude, in inpatient and outpatient settings.

Larry Ketch, MD

MD: Univ of Colorado HSC Intern: Johns Hopkins Univ Resid: Univ of Miami Hospital & Clinics

Psychiatry and Behavioral Sciences Professionals who work in this specialty treat children with psychological and behavioral problems ranging from age-typical “problem” behaviors and situational reactions to more serious emotional and behavioral disturbances.

Carol Beresford, MD

MD: Tufts University Intern/Resid: Tufts University Fellow: Univ of Colorado HSC

Debbie Rene Carter, MD

James Shira, MD

Parent and Patient Education MD: Tufts University Inter/Resid: Fitzsimons Army Medical Center Fellow: University of Kansas

Physical Medicine and Rehabilitation Physicians in this specialty work with children who have a variety of health conditions, in order to help each child adapt to the environment, to ease the effects of disability on the child’s development and to allow the child to be fully included in community living.

Public mental health, cultural specific care for African Americans and Native Americans, working with high-risk adolescents MD: Jefferson Medical College Intern/Resid: Thomas Jefferson University Hospital, PA Fellow: Thomas Jefferson University

Mary Cook, MD

MD: Wayne State Univ Intern/Resid: Naval Medical Ctr, San Diego Fellow: Univ of California, San Diego

Bert Dech, MD

MD: Southern Illinois Univ Intern/Resid: North Shore Univ Hospital Fellow: Long Island Jewish Medical Ctr

Jeffrey Dolgan, PhD

Susan Apkon, MD

Interest in osteoporosis and children with disabilities MD: Univ of Vermont Intern/Resid: Univ of Colorado HSC

Dennis Matthews, MD

Joyce Oleszek, MD

PhD: Ohio State Univ Fellow: Univ of Colorado HSC

Guido Frank, MD Robin Gabriels, PsyD

Widely published author on topics related to pediatric physical medicine and rehab MD: Univ of Colorado HSC Intern/Resid: Univ of Minnesota

Autism spectrum disorders and other developmental disabilities PsyD: Univ of Denver Intern: Univ of SC; Dept of Mental Health Fellow: Univ of Colorado HSC

Listed by Specialty, Physician Name

Pediatric Surgery to Urology 720.777.1234

Isabelle Guillemet-Moine, MD

Tami Robleck, PhD

Jennifer Hagman, MD

Wendy Smith, PhD

MD: Faculté de Médecine Paris Ouest V, Université René Descartes Intern/Resid: Hôpitaux de Tours, France Fellow: Centre Hospitalier Universitaire du Kremlin Bicetre” Eating disorders, child and adolescent psychiatry, psychopharmacology MD: Univ of Kansas Intern/Resid: UCLA, Irvine Fellow: UCLA, Irvine

Obsessive compulsive disorder, cognitivebehavioral therapy for OCD PhD: University of Louisville Intern/Resid: UCLA Fellow: UCLA Fellow: UCLA Inpatient, day treatment and outpatient treatment of children and adolescents with particular interest in anxiety disorders, school refusal, depression, insight-oriented psychotherapy and family therapy PhD: University of Denver

Frederick Hebert, MD

Twenty years teaching experience with specialization in difficult ADHD and odd behaviors MD: Univ of Michigan Intern: Highland General Hospital, Oakland, CA Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Mindy Soloman, PhD

Brad Jackson, PhD

PhD: California School for Professional Psychology Intern: Pacific Clinics, Glen Roberts Child Study Center PhD: California School for Professional Psychology Intern: Pacific Clinics, Glen Roberts Child Study Center

Lisa Kaley-Isley, PhD

Brian Stafford, MD

Michele Kelly, PsyD

Evaluation and treatment of possible child abuse and neglect issues; Works with families to help them deal with the effects of trauma and to prevent future problems which may arise as a result of abuse or neglect PsyD: Univ of Northern Colorado Intern: Adams County Community Mental Health Center Resid: The Children’s Hospital, Denver Fellow: Univ of Colorado HSC, Kempe Ctr

Kathleen Kovner-Kline, MD

Depression, bipolar disorder, psychotic disorders in children and adolescents, appropriate use of psychiatric medications in children, mental health promotion at the community level through families, schools, faith-based, and other community institutions MD: Yale Univ Medical School Intern/Resid: Univ of Connecticut Institute of Living Fellow: Dartmouth Medical School

Susan Lurie, MD

MD: MBBCH at Univ of Witwatersan Medical School Intern: Coronation Hospital Resid: St Lukes Roosevelt Medical Center Fellow: Columbia Univ Institute of Human Nutrition

Diane Reichmuth, PsyD

Clinical psychology, working with children, family and adolescents with chronic medical and psychiatric disorders PsyD: Pepperdine University Fellow: The Children’s Hospital - Denver

Early childhood psychiatry ( under age 6), families of infants and toddlers with medical concerns, postpartum depression MD: Tulane Univ Intern/Resid: University of Kentucky Fellow: Univ of Ky, Tulane and Univ of Cape Town, South Africa

Marianne Wamboldt, MD

The reciprocal effects of mental and physical issues in children and adolescents MD: Univ of Wisconsin, Madison Intern/Resid: Univ of Wisconsin, Madison Fellow: National Institutes of Mental Health

Jason Williams, PhD

ADHD and the use of technology in teaching and clinical care PsyD: The California School of Professional Psychology Intern/Fellow: Children’s Hospital of Los Angeles

Pulmonology Physicians in this specialty treat acute and Chronic respiratory conditions such as bronchitis, recurrent croup or stridor and congenital abnormalities in the pulmonary vessels.

Steven Abman, MD

Pediatric lung disease, newborn lung disease, acute respiratory failure, pulmonary hypertension MD: Northwestern Univ Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Frank Accurso, MD

Cystic fibrosis MD: Albert Einstein College of Medicine Intern/Resid: Univ of Colorado HSC Fellow: Univ of Colorado HSC

Vivek Balasubramaniam, MD

Development of pulmonary vasculature, response of developing lung to injury, evolution of chronic lung diseases of childhood MD: Univ of Pittsburgh Intern/Resid: The Children’s Hospital of Pittsburgh Fellow: The Children’s Hospital, Denver

Keith Cavanaugh, MD

Particular interest in helping to address sleep problems in kids MD: Loyola Univ Stritch School of Medicine Intern/Resid: Univ of Minnesota Fellow: Univ of Colorado HSC

Robin Deterding, MD

Helps infants, children and adolescents who need oxygen, breathe too fast or have recurrent pneumonias breathe better through diagnosis and treatment MD: Southern Illinois Univ Intern/Resid: Southern Illinois Univ Fellow: Univ of Colorado HSC

Monica Federico, MD

Interested in caring for children with asthma, specifically difficult to control asthma; Currently establishing an outpatient asthma clinic and a Denver Children’s asthma program MD: Univ of Texas Southwestern Intern: Harvard, Boston Children’s Resid: Boston Fellow Fellow: The Children’s Hospital, Denver

Theresa Laguna, MD

Cystic Fibrosis, Pediatric Lung Disease MD: Univ of CA - San Francisco Intern/Resid: Univ of Washington Fellow: Univ of Colorado HSC

Gwendolyn Kerby, MD

Interested in asthma, infants with lung disease, pediatric pulmonary medicine MD: Univ of Kansas Intern/Resid: Cincinnati Children’s Med Ctr Fellow: Univ of Colorado HSC

Scott Sagel, MD

Jeffrey Wagener, MD

Cystic fibrosis, pediatric lung disease, critical care MD: Univ of Colorado HSC Intern/Resid: Univ of Washington Fellow: Univ of Arizona

Rheumatology Physicians in this specialty diagnosis and treat diseases of the muscles and joints. They treat conditions such as fibromyalgia, lupus and juvenile rheumatoid arthritis.

Leonard Dragone, MD

Pathogenesis of autoimmunity and lymphocyte signaling MD: Univ of Rochester Intern/Resid: Univ of CA, San Francisco Fellow: Univ of California, San Francisco

Roger Hollister, MD

Rheumatic diseases, JRA, vasculitis, lupus and musculoskeletal disorders in children, steroid-induced osteoporosis and growth failure MD: Case Western Reserve Univ Intern/Resid: Boston Children’s Hospital Fellow: Univ of Washington

Jennifer Soep, MD

Specializes in childhood lupus and arthritis; Implementing an electronic medical record MD: Tufts Univ Intern/Resid: Univ of Colorado HSC Fellow: Univ of California, San Francisco

Urology Physicians in this specialty focus on the diagnosis and treatment of abnormalities involving the kidneys, ureters, bladder, urethra and the reproductive organs of children.

Martin Koyle, MD

Pediatric urology including, renal tumors, male/female GU reconstructive surgery, andrology, intersex, renal transplantation, disorders of the adrenals, neonatal renal obstructive problems MD: Facility of Medicine Univ of Manitoba Intern: Univ of Southern California Med Ctr Resid: Univ of Manitoba HSC Fellow: UCLA

Interests are in cystic fibrosis, primary ciliary dyskenesia, general pediatric breathing problems MD: Washington Univ SOM, MO Intern/Resid: Univ of Colorado HSC Fellow: The Children’s Hospital, Denver

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Hospital Information The Children’s Hospital Specialties, Sub-specialties, Programs and Services From A to Z, The Children’s Hospital is the only provider in a seven-state region and is the most experienced at providing many of these specialties, sub-specialties, programs and services. For infants, toddlers, tweens and teens, we offer pediatric expertise that comes from caring for kids and only kids.

Adolescent Medicine • Adolescent Primary Care Clinic • Colorado Adolescent Maternity Program • Eating Disorders Clinic • Young Mothers Clinic Allergy, Asthma and Immunology • Asthma Management Program Ambulatory Medicine • After Hours Telephone Triage and Advice • After Hours Urgent/Emergent Care Centers (4) • KidStreet • Regional Outreach Clinics • Children’s Care Centers (10) Anesthesiology • Pediatric Cardiac Anesthesia Audiology/Speech/Learning • Swallowing Disorders Clinic Bone Marrow Transplant • Bone Marrow Clinic • Thrombosis Clinic Cardiology • Heart Institute • Adult Congenital Program • Arrythmia Clinic • Catheterization Lab • Cardiac Intensive Care Unit • ECHO Lab • EKG Lab • Exercise Testing and Rehabilitation • Lipid Clinic • Transplant Clinic • Heart Lung Center • Pulmonary Hypertension Clinic • SHAPEDOWN Clinic Cardiothoracic Surgery Child Abuse & Neglect • Child Maltreatment • Child Protection Team

Child Development • Developmental & Behavioral Evaluation • Fragile X Syndrome Clinic • Oral Feeding Clinic Critical Care Dentistry • Healthy Smiles Pediatric Dentistry Dental Surgery Dermatology Diagnostics/Imaging • Computed Tomography • Electroencephalography • Interventional Radiology • Magnetic Resonance Imaging • Nuclear Medicine • Radiology • Ultrasound Emergency Medicine • Pediatric Advanced Life Support (PALS) • Prehospital Care Endocrinology • Metabolic Clinic • Pediatric Endocrine and Growth Center • Renal Diseases and Hypertension • Young Adult Diabetes Clinic Epidemiology • Antimicrobial and Microbial Epidemiology • Clinical Microbiology • Infection Control • Nurse/Family Partnership Family Medicine Family Services • Association of Volunteers/Patient • Representatives Bereavement Services • Creative Play Center • Clinical Social Work • Family-Centered Care Consultant

• Junior Volunteer Scholarships • Medical Interpreters • Pastoral Care • Prescription Pets Program • Therapeutic Recreation/Child Life • Youth Advisory Council

Gastroenterology • Inflammatory Bowel Diseases • Encopresis Clinic GI Laboratory General Pediatric Surgery Genetics • Biochemistry/Molecular Genetics • Biophysics • Cellular/Structural Biology • Clinical Genetics • Genetic Counseling • Inherited Metabolic Diseases Clinic • Neurofibromotosis Clinic • Mental Retardation/ Developmental Disabilities Research Center Gynecology • Pediatric/Adolescent Gynecology Clinic Hematology • Hemophilia Clinic • Sickle Cell Clinic Hepatology • Liver Center

Nephrology • Acute/In-Center Hemodialysis Program • Home Dialysis Program • Kidney Center • Renal Clinic Neurology • Electroencephalography • Epilepsy Clinic • Long-term Video Monitoring • Neurotrauma • Neuro-Psychology Neurosurgery • CranioFacial Clinic Nutrition • Clinical Dietetics • Failure to Thrive Clinic • Good LIFE Obesity Clinic • Growth & Parenting/Nutrition Clinic • Weight Management Clinic Oncology • Butterfly Program • Experimental Therapeutics • HOPE/Late Effects Clinic • Neuro-Oncology Clinic • Orthopedic/Oncology Clinic • AYA Clinic (Adolescents & Young Adults) Ophthalmology

Orthopedic Surgery • Cerebral Palsy Clinic • Fracture Clinic Infectious Diseases • HIV/AIDS/Immunodeficiency Clinic • Hand Center • Orthopedic Clinic Minimally Invasive/Robotic Surgery • Spine Center/Scoliosis Clinic Neonatology • Sports Medicine Clinic • Colorado High-risk Maternity Otolaryngology • ECMO Service Ear, Nose, Throat • Fussy Baby Clinic • Airway Clinic • Infant Care Center • Cleft Palate Clinic • Lactation Support Services • Congenital Hearing Clinic • Neonatal Intensive Care Unit • Head & Neck Surgery • Perinatal Medicine/Research • Otitis Clinic • Physiology

Pulmonary Medicine • Asthma Wellness Program • Cystic Fibrosis Center • Pediatric Heart Lung Center • Pulmonary Function Lab • Neonatal Education • Respiratory Care • Sleep Lab

• Sinusitis Clinic • Sleep Disorders Clinic/Lab • Vascular Malformation Clinic • Voice Clinic

Pain Management Center Pathology • Blood Bank • Blood Donor Center • Laboratory • Outpatient Laboratory

Rehabilitation Medicine • Amputee Clinic • Brachial Plexus Clinic • Center for Gait and Motion Analysis • Handicapped Sports Program • Multidisciplinary Outpatient Rehabilitation Evaluation (MORE Clinic) • Muscle Clinic • Neuro-trauma Rehabilitation • Occupational Therapy • Physical Therapy • Rehabilitation Medicine Clinic • Seating and Mobility Clinic • Spinal Defects Clinic • Tone Management Clinic

Pediatric Nursing Pediatrics • Bladder/Bowel Control Clinic • Child Health Clinic • Community Pediatrics • Consult/Continuity Program • Foster Care Clinic • Hospitalist Program • International Adoption Clinic • Locum Tenens • School-Based Health Clinics • Special Care Clinic Perioperative Services Pharmacology/Therapeutics • Pharmacy • Pharmaceutical Biotechnology • Pharmaceutical Science Phlebotomy Plastic and Reconstructive Surgery Preventive Medicine • Biometrics Psychiatry & Behavioral Science • Art Therapy • Child Psychiatry Day Treatment • Consult Liaison • Eating Disorders Program/ Day Treatment • Medical Day Treatment • Music Therapy • Outpatient Clinic • Partial Hospitalization • Psychology > Adolescent Psychology > Concussion Management Program > Neuro-psychology

Research • Bioinformatics • Clinical Trials Organization • Cystic Fibrosis Resource Lab • Developmental Biology • General Clinical Research Center • Outcomes Research • Pediatric Pharmacology Research • Research Institute Rheumatology Telemedicine Transplant Surgery • Heart Transplant Program • Kidney Transplant Program • Liver Transplant Program Trauma • Burn Center • Injury Education • Kiwanis Pediatric Trauma Institute (KPTI) • Transport Urology • Urologic Surgery • Dry Time Clinic

Note: This list does not include affiliate programs of The Children’s Hospital: Kempe Children’s Center for the Protection and Treatment of Child Abuse and Neglect, Barbara Davis Center for Childhood Diabetes, JFK Partners; and is subject to change. Please call The Children’s Hospital at 303-861-8888 or speak with your doctor regarding any questions you may have about these offerings.

Neonatal Nurse Practitioner Program Offering neonatal nurse practitioner services so tiny patients can get The Children’s Hospital care close to home. • University of Colorado Hospital • Parker Adventist Hospital • Longmont United Hospital • Boulder Community Hospital • Platte Valley Medical Center (Brighton) • Banner Health’s North Colorado Medical Center (Greeley) • Poudre Valley Hospital (Fort Collins)

Partnerships with Community Physicians

Working with community physicians to provide The Children’s Hospital expertise across the region. • Neonatology coverage of level II nurseries in nine community hospitals along the Front Range. • Hospitalist coverage of pediatric inpatient units at Lutheran Hospital and Parker Adventist Hospital. • Pediatric locum tenens, in which The Children’s Hospital-contracted physicians provide short-term temporary coverage for private pediatric practices. Currently these physicians cover 500 days a year and care for 10,000 child visits a year for practices throughout Colorado, Wyoming and Montana. • Physician relations program designed to support referring community physician offices.

KidStreet

Therapeutic child care for medically complex children ages 6 weeks to 6 years at The Children’s Hospital.

Medical Day Treatment

In partnership with Denver Public Schools, a multidisciplinary outpatient school program that focuses on academic, medical and psychosocial needs of medically fragile or chronically ill children ages 7 to 21, located at The Children’s Hospital. This program is the only one of its kind located in a children’s hospital.

Psychiatric Day Treatment

A Day Treatment/Partial Hospital level of intervention for psychiatric outpatients, ages 6 to 18, at The Children’s Hospital.

Telephone Triage & Advice ParentSmart! HealthLine A community service offering physician referral, immunization information, triage and advice from skilled pediatric nurses. Families without a health-care provider for their child can call 720-777-0123, 24 hours a day. After-Hours Telephone Care Program Pediatric nurses provide afterhours telephone triage and advice coverage for 127 pediatric practices in Colorado and Wyoming using more than 200 automated medical guidelines. In 2006, more than 121,000 triage and advice calls were made to the After-Hours nurses. Parent Advice Line A free, confidential source of information on 275 health-related topics about the care of infants, children and teenagers. Prerecorded health messages are available 24 hours a day, and provide information to help you handle common questions, problems and illness at home. www.thechildrenshospital.org/ parentadviceline 303-861-6543 or 1-800-613-4130 One Call Physician Information and Referral Service The primary-care providers’ link to pediatric services and information. Health-care provider-only line for specialty consultation, general pediatric diagnostic dilemmas, admission assistance and transport, 720-777-3999.

• 720.777.1234 • www.TheChildrensHospital.org13123 East 16th Avenue • Aurora, Colorado 80045

Protect Those Pearly Whites Good dental care starts early By Laura Johnston

Many parents believe that their young children don’t need to visit a dentist or worry about daily cleanings because after all, baby teeth, also known as primary teeth, are just going to fall out anyway, right? Well according to Dr. Anne Wilson, DDS, and director of the Healthy Smiles Program at The Children’s Hospital, primary teeth are not only necessary for chewing and speech, but also are critical in aiding to form the path for permanent teeth. Dr. Wilson says children with oral disease may experience pain, infection and premature loss of teeth, which may affect a child’s appearance and self-confidence. In addition, children with oral disease of the primary teeth are at greater risk for oral disease in permanent teeth; therefore, keeping your child’s dental health strong is important from the start. Even before primary teeth erupt, which is generally at 6 months, Dr. Wilson recommends cleaning the infant’s mouth using a soft towel to gently remove food after feeding. “Once teeth erupt, daily brushing in the morning and before bed is best using a soft cloth or soft children’s toothbrush.” If using toothpaste, apply no more than a pea-sized amount to the toothbrush bristles. Daily flossing by an adult is recommended when the spaces between the primary teeth close due to ineffectiveness of a toothbrush in areas with closed contacts.

The American Academy of Pediatric Dentistry and American Academy of Pediatrics recommends all children be seen six months after the first tooth erupts, or at one year of age. This enables introduction of appropriate preventive strategies to prevent oral disease and establish a healthy foundation. It may help to talk to your child about what happens at the dentist prior to visiting. At the first visit, the child will receive an infant oral health evaluation, which will include an assessment of general and oral development, diet and nutrition, fluoride exposure, oral hygiene, family dental history and oral habits. The child will be examined and appropriate guidance will be provided based on the evaluation. Home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits. Beginning tooth and mouth examinations early may lead to detection of early stages of tooth decay that can be easily treated. So get an early start in teaching your child a lifetime of good dental habits!

Did you know? According to the CDC, tooth decay (or dental caries) is the single most common chronic childhood disease—five times more prevalent than asthma and seven times more common than hay fever!

Tips for a Great Dental Visit Start now! The earlier the visit, the better the chance of preventing dental problems. Consider a “get acquainted” visit to introduce your child to the dental office before the first appointment. Select an appointment time when your child is alert and rested. Explain before the visit that the dentist is a friend and will help your child maintain healthy teeth. Answer all your child’s questions positively. (Keep an ear out for scary stories from peers and siblings) Be careful about using scary words. Check-ups and 90 percent of first visits do not have anything to do with “hurt,” so do not even use the word! Read your child a story about a character who had a good dental visit. (Ask the dental office for suggested reading) List questions about your child’s dental health in advance. Topics to think about include home care, injury prevention, diet and snacking, fluoride and tooth development. Give your child some control over the dental visit. Choices such as “The red toothbrush or the green one?” and “Will you hold your bear or should I?” will make the visit more enjoyable. Give center stage to the dentist. If the dentist does most of the talking, he or she will build a better relationship with your child. The parent and dentist can talk after the examination.

The Children’s Hospital Dental Clinic 1575 Wheeling St • Aurora, CO 80045 720-777-6788 The Children’s Hospital Dental clinic is located just east of The Children’s Hospital in a separate building with its own patient parking lot. It is open Monday through Friday from 8 a.m. to 5 p.m.

Make sure your child has regularly scheduled dental visits two times a year. Information courtesy of the American Academy of Pediatric Dentistry Web site: www.aapd.org

Did you know? Finger or pacifier habits are normal for infants and young children up to 3 years of age. Children ages 3 and older engaging in prolonged habits may experience delayed speech, changes in position and eruption of teeth, interference with function, and changes in bone growth, including constriction of the palate.

Health and Wellness Magazine •

Shaken Baby Syndrome Loss of Control Can Lead to Permanent Injury or Death

by Tanya Ishikawa

The small baby, who had just arrived from the emergency room, was no more than 6 months old. His tiny body was suffering from several broken ribs and bones and internal injuries, including bleeding around the brain. Registered Nurse Suzy Evans was one of the first staff members to take him into the surgical wing of The Children’s Hospital, as he struggled with the trauma of Shaken Baby Syndrome. “It’s just one of those diagnoses you just never get used to,” says Evans, who has more recently cared for a 30-day-old baby who had been shaken. “Sometimes, I go home crying. You can’t believe someone would get so angry to shake a baby hard enough to cause injury.”

“People just don’t wake up in the morning intending to hurt their baby. It’s just a snap, a quick lapse…” Shaken babies are usually less than a year old, but toddlers are also at risk. Crying is what usually triggers such a violent reaction from a parent or other caregiver. In just an instant of losing control, a caregiver can shake a baby into serious injury, unconsciousness and even death. “It’s frustrating because it is 100 percent preventable and so damaging,” Evans says. “It could be prevented if the parents or caregivers who did this had the education to know ‘if I don’t control my temper, I could hurt or kill this baby.’ “People just don’t wake up in the morning intending to hurt their baby. It’s just a snap, a quick lapse,” she adds. “They need to know that it is OK to put the baby down and walk away for a short while.” Shaken Baby Syndrome is caused by a momentary lapse in judgment that leads to a violent act. It is not the result of normal parenting or play; anyone seeing this type of behavior would know that the action is harmful to the child, says Dr. Antonia Chiesa of the Kempe Child Protection Team at The Children’s Hospital. Child abuse has been the leading cause of death to children admitted to The Children’s Hospital’s trauma service since 2003. A significant majority of the children who died exhibited signs of being shaken. “We see about 50 cases of abusive head injuries a year. Sometimes, it’s from shaking, other times it’s shaking and impact, or impact alone,” Chiesa says. Symptoms caused by injuries from shaking are not always as obvious as unconsciousness or death. They can range from very subtle and easily missed changes in behavior to vomiting, fussiness, lethargy and problems eating. Once admitted to the hospital, treatment of shaken babies mostly consists of supportive care such as helping them breathe 56

by respirator, relieving blood pressure or swelling, stopping bleeding, and setting broken bones. According to Chiesa, about a third of the victims will die, and a third will have severe long-term disabilities such as blindness, seizure disorders, cerebral palsy and paralysis. The other third will leave the hospital looking pretty good, but about half of them will probably have learning or developmental disabilities. “There are some people who think you can’t shake children hard enough to injure them, but we know from seeing these cases year after year, you can do major damage by violently shaking them,” she says. Perpetrators of Shaken Baby Syndrome can be any age and any class. While male caregivers including fathers or boyfriends are frequently to blame, anybody from a babysitter to a relative and even the mother are potential culprits. “We’re all prone to losing control and getting frustrated. It’s not fair to say one demographic is more susceptible than another. You have to know your limits and that taking care of babies can be stressful,” Chiesa says. “It’s normal for babies to cry and be fussy. That’s why you need to take a minute and put the baby in a safe place until you can handle the situation without violence.”

Tips for Calming a Crying Baby • • • • • • • • •

Take care of physical needs first: feed your baby, burp her, change her diaper Check for signs of illness, like fever or swollen gums Rock or walk with the baby Sing or talk to the baby Gently pat or stroke the baby on the back or chest Offer a pacifier or a noisy toy Try swaddling the baby Take the baby for a ride in a stroller or car seat in the car Turn on some music or noise like a vacuum cleaner or clothes dryer

Tips for Calming an Overwhelmed, Frustrated or Angry Caregiver • • •

Set the baby down—it’s okay to leave a crying baby alone in a safe place (like a crib or car seat) for a short time. Go in another room for a quick break. Get control of your emotions—do not return to the baby until you feel calm. Call a reliable adult to help—a friend, neighbor, or relative who can give you a break; or call your health care provider (doctor’s office or nurse line) for advice.

The Colorado Shaken Baby Syndrome Prevention Campaign was launched in 2006 as a partnership between The Children’s Hospital, Kohl’s Department Stores, and The Kempe Foundation for the Prevention and Treatment of Child Abuse and Neglect. The campaign aims to alert the public about the dangers of shaking a baby, educate caregivers about ways to calm a crying baby, and help caregivers manage the frustration that often accompanies the crying.

www.dontshakeababy.com

The Prescription Pet Program Doggie kisses and fuzzy tails can help keep kids happier and healthier

There are many fun, energetic volunteers who walk through the doors of The Children’s Hospital each day. But when that cute, furry, four-legged kind comes trotting in for duty, the resulting smiles are contagious. Grins and giggles spread from the reception desk, to the nurse’s station and into the patients’ rooms. Dogs have been participating in this nationally recognized Prescription Pet Program since 1986. The popularity of this visiting dog program is so overwhelming that it is currently filled to capacity with 70 canine volunteers, and 300 more dogs remain on the wait list.

“The dog made me feel better about getting a heart cath. He helped me calm down.” —Noah McMahon, 12, Heart Transplant Patient But how can these dogs help injured or ill children? Well, children at the hospital not only gain enjoyment from seeing the pups, but also it has been proven that visits from such furry friends can reduce stress and anxiety and improve overall psychological well-being. Heart transplant patient Noah McMahon, 12, can attest to the benefits of the program. “The dog made me feel better about getting a heart cath. He helped me calm down.” Whether a child only wants to view the dog through a doorway or actually play with the cuddly canine, the patient can benefit from the experience. And the visit may help to ease some of the parents’ anxieties, as well. The hospital ensures that each of these pet visits is safe for patients and other visitors. First of all, each dog owner is interviewed and a veterinarian rigorously screens each pup for behavioral and physical issues. Volunteer dogs that are qualified to participate in the Prescription Pet Program suit up in smocks to prevent the spread of hair and dander. And their specially trained volunteer owners guide them to the patients’ rooms and watch over the visit. Nearly everyday, Prescription Pet dogs lend a helping paw at the hospital, and the number of lives they touch continues to grow. Ahleeyah Brown smiles during a visit with Amber, a volunteer Labrador in the Prescription Pet Program.

Dear Abby’s Mom, Insights on parenting from Health & Wellness’ resident mom Kristen Bason, B.A., B.S., is a Boulder-based freelance writer who specializes in health, wellness and parenting topics. A first-time mom to a busy toddler, Kristen is a self-described “research junkie,” and she is always excited to share helpful information she has learned with others. Dear Abby’s Mom, My doctor just told me my 8-year-old daughter is overweight. I was not surprised by this news; it was just shocking to finally hear it out loud. Our family enjoys eating and we are all so busy that exercise is not part of our daily routine. How can I help her lose weight without creating a future issue with her body image?

Chubby Kid in Cherry Hills This is always difficult to come to terms with. The whole family can (and should) be part of this lifestyle change. To keep this from becoming a traumatic issue, do not use the word “diet” with your daughter. Let her know that you are all going to make changes to become healthier. Do not set restrictions; using the scale; or calorie counting. Keep food fun, but focus on healthy choices, and explain why they are the better choices. Let her help you choose and prepare healthy meals. Get rid of unhealthy snack choices – fill the cabinet with wholesome munchies. Most importantly, get your family moving and make it enjoyable. The more activity feels like a game, the less it feels like exercise. Go for walks (get a dog!), take a yoga class together, have a scavenger hunt in the neighborhood. Whatever you do, do it together! Dear Abby’s Mom, I am so embarrassed! My kid is the class bully! She is 9 and already getting a reputation as the “mean girl.” She was always very kind, but ever since her Dad and I separated a few months ago she seems angry. Why is she acting like this?

– Desperate in Denver

Dear Abby’s Mom, Why do I feel guilty about being a working mom? Worst of all, I love my career and enjoy going to work. Most of the moms in my neighborhood stay at home with their children and love to remind me that I am missing out. Help! I feel torn between my career and my child.

Working Mom in Wheat Ridge The Mommy Wars continue. I admit that I occasionally feel a twinge of guilt and even a little jealousy toward those moms that can stay home. When these emotions creep in, I remind myself that being a good mom has less to do with the quantity of time spent with your child and more about the quality of that time. A happy mom is a good mom; and if your job is part of that equation, then embrace your career! Guilt is nothing more than wasted energy. Save the energy to play with your child after a long day of work!

First of all, kudos to you for acknowledging that there is a problem! Too many parents are in denial that their kid is a bully. Your daughter seems to be having a difficult time dealing with your separation. Keep the lines of communication open and tell her that it is OK to be upset, but it is wrong to take it out on others. Encourage her to take an art class, yoga for children or karate. She needs an outlet for her emotions separate from you. If that doesn’t help, contact your family physician for a referral.

Dear Abby’s Mom, I have an 11-month-old who still won’t sleep through the night. She wakes up at least once and won’t settle down until she is rocked. I am exhausted! What can I do?

Exhausted in Arvada When your baby cries out in the middle of the night, look at the clock and wait at least 15 minutes before going to her. It will seem like the longest 15 minutes of your life, but chances are she’ll soothe herself back to sleep. This is an important skill for her to learn, and one that will allow you much needed rest! It worked for us! Dear Abby’s Mom, My 3-year-old is suddenly refusing to eat fruits or vegetables. Mealtime is a battle that I always lose! What am I doing wrong?

Losing it in Lakewood The most important thing to do is to keep offering a variety of nutritious foods. Do not make mealtime miserable or a battle for either of you. Keep it fun and let him have an active role. Go to the farmer’s market together and let him pick out a vegetable or fruit to eat, or let him help you prepare a meal. I found the book Child of Mine: Feeding With Love and Good Sense by Ellyn Satter extremely helpful and full of great advice! Dear Abby’s Mom, I am 17 and starting my first year of college. My mom passed away when I was 10 and I live with my dad. When should I start to see a gynecologist? I’m uncomfortable talking to my dad about this stuff.

Young Woman in Wheat Ridge There are no definite rules as to when you should have your first pelvic exam. Most health care providers agree that you should have your first exam in the first few years after you become sexually active or when you turn 21, whichever comes first. I recommend you ask your current health care provider what they think. While it is understandable that this can be a difficult topic to discuss with your dad, I’m sure he will be proud of the proactive, and mature, stance you are taking as a young woman.

Dear Abby’s Mom, My 20-month old son just started daycare for the first time. Prior to starting at the center, he was never sick. Now, it seems like every other week he is coughing, sniffling, or worse – burning up with a high temperature. Is this normal? More importantly, will it get better?

Ailing in Aurora Let me assure you – it will get better. As you mentioned, this is your son’s first time in daycare, thus his first real exposure to all sorts of new germs. Although it doesn’t seem like it, his immune system is growing stronger. I will tell you what our own pediatrician said when my daughter started daycare and was sick non-stop, “It is either now, or when she starts kindergarten.” Just be sure your daycare center notifies parents when there are outbreaks of contagious diseases (i.e. chicken pox, pink eye, or RSV), has a strict hand washing policy, and that they clean and sterilize toys daily. Everyone says that the first year of daycare is always the worst… Dear Abby’s Mom, My 2-year old is addicted to television. I know it is wrong, but I have to admit there are times when I will put in a DVD and let him watch it so that I can get stuff done around the house. Am I a terrible mom? And, how much TV is too much?

Concerned in Cherry Hills Think quality, not quantity. What are you letting him watch? Is it hours and hours of The Simpsons or a couple of episodes of Teletubbies? Personally, I think a few hours a day of quality TV is fine. I was practically raised watching Sesame Street and as far as I can tell it didn’t have any negative effects. In fact, I think my love for learning was a result of early 70’s Sesame Street and Mr. Rogers’ Neighborhood. Contrary to what most parenting experts say, I think popping in a DVD (preferably one with some educational merit) so that you get an hour of peace is totally acceptable – a happy parent means a happy kid!

by Kristen Bason

Do you have a question or topic you’d like discussed in Health & Wellness Magazine? You can e-mail Kristen at kbason1971@gmail.com. Please keep in mind that Health & Wellness Magazine is a yearly publication. If you need immediate advice, please see the appropriate professional.

Health Healthand andWellness WellnessMagazine Magazine ••

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215Stats and data relating to kids in the United States59

The percentage of children ages 3-5 who are read to daily by a family member

279

Average math score (scale of 0-500) by 8th graders on the National Assessment of Educational Progress

Number of school-age children who speak

10,000,000

a language other than English at home

1,100,000 Number of students who are home-schooled

1,180,000 The approximate number of children under age 18 living in Colorado (as of last census) 60

Percentage of adolescents ages 1217 who do not have health insurance

The rank for Jacob and Emily among baby names:

6091214

521470963

50831

9823603195826

U.S. News & World Report’s ranking of The Children’s Hospital amongst the nation’s top pediatric hospitals. The Children’s Hospital was the only pediatric hospital in the western United States to make the top five

The number of Children’s Hospital locations in Colorado. Wherever you live, there’s a location that’s convenient and close to home.

The rank for Tuesday as the most popular day for delivering a baby

13 99

1,000+ The number of pediatric specialists on staff at The Children’s Hospital – more than any other hospital in our seven-state region.

{

The number

of years The Children’s Hospital has provided

world-class

care to children

$2,327,726.70

The dollar amount contribution volunteers m a d e t o T h e C h i l d r e n ’s H o s p i t a l i n 2 0 0 7

750,500

}

Total square footage of the old Children’s Hospital campus.

1,440,000 Total square footage of the new Children’s Hospital campus.

% of childhood injuries that are sports-related

The number of years

The Children’s

Hospital has been a national center for pediatric research.

The number of locations your family needs to visit to receive access to The Children’s Hospital’s state-of-the-art medical care. At the new Children’s Hospital, all of your child’s caregivers are now in one place.

Health and Wellness Magazine •