On the Pulse

Care, cost for diabetes complication varies widely at children’s hospitals

Dictionary Series - Health: diabetes

Diabetic ketoacidosis (DKA), a complication of type 1 diabetes, is one of the most serious and potentially preventable conditions affecting children with diabetes today. A new national study led by Seattle Children’s found a wide variation in cost, length of stay and readmission rates for children with DKA.

“Delivery of care for diabetic ketoacidosis in the U.S. is not ideal,” said Joel Tieder, MD, MPH, of Seattle Children’s Research Institute. “One out of five diabetic ketoacidosis admissions are potentially preventable. Hospitals and doctors and nurses who care for children with diabetes should take a look at our data to see if there’s room for improving healthcare delivery on their home turf.”

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Seattle Children’s offers country’s first physical therapy fellowship in neonatology

Neonatal physical therapy fellowshipIn December 2012, Seattle Children’s became the first (and for now, the only) place in the nation that offers physical therapists an accredited fellowship in neonatology. For seasoned pediatric physical therapists who want to work with the tiniest, most fragile babies, the fellowship offers a unique opportunity for training.

In December, the American Board of Physical Therapy Residency and Fellowship Education (the credentialing arm of the American Physical Therapy Association, or APTA) accredited the neonatology fellowship, which is a partnership between Children’s and Rocky Mountain University of the Health Professions (RMUoHP) in Provo, Utah.

The fellowship, which focuses on babies from birth to 12 months of age, combines six academic credits at RMUoHP with 1,000 hours of mentored clinical training at Children’s. Read full post »

Bioethics experts share personal perspectives on life-changing cases

BioethicsThis week medical experts from across the country will gather in Seattle to discuss “Cases That Keep Us Awake at Night,” the theme of the 2013 Pediatric Bioethics conference. It’s not uncommon for things to keep us awake at night—a disagreement with a friend or neighbor or anxiety over a big work assignment—but the issues that clinicians and bioethicists will tackle at this confab are quite different.

Most of us, for instance don’t often think about the following questions:
• Should an organ transplant be performed over a family’s objections?
• Should Child Protective Services intervene when a family fails to address the eating habits of a morbidly obese child?
• Should healthcare professionals withdraw medical interventions against the wishes of a family?

Doctors, nurses and others will also discuss the intersection of the personal and the professional, and how it affects their work. At last year’s conference, Douglas Opel, MD, MPH, of Seattle Children’s, spoke about being diagnosed with Crohn’s disease and how it altered his role as a physician. Excerpts from that talk, which was published in its entirety in The Hastings Center Report late last year, are included below.

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One mother’s creation provides a valuable tool for tiny cancer patients

Robin in her Hickman HiderOn July 13, 2012, Robin Ulness was diagnosed with leukemia at just 9 months old.  Gayle Garson, Robin’s mother, said the diagnosis was a complete surprise and it all came on very quick.

“Getting the news was devastating,” Gayle said. “It was like getting kicked in the stomach by a horse. It was so surreal; I just kind of went numb.”

Robin was diagnosed with infant acute lymphocytic leukemia (ALL), which arises from white blood cells called lymphocytes that do not mature properly. While ALL is the most common type of cancer in children, infant ALL is very rare.

Robin’s diagnosis marked the beginning of two years of treatment. Robin came to Seattle Children’s Cancer and Blood Disorders Center and began six weeks of inpatient care. She then had four more rounds of chemo, which required a number of inpatient stays.

While Robin was inpatient, Gayle came up with an innovative idea for something that would not only help her daughter but would also help other children going through treatment.

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Seattle Children’s patient has positive response to new cancer treatment

Lynsie Conradi_cropThe first patient in a cellular immunotherapy Phase 1 cancer trial at Seattle Children’s has had a positive response to T-cell therapy. The 23-year-old patient, Lynsie Conradi, from Bellingham, Wash. received the welcome news yesterday. Conradi signed up for the study after experiencing a second relapse of leukemia earlier this year.

The new treatment involves drawing blood from the patient, reprogramming their infection-fighting T-cells to find and destroy cancer cells, and infusing the blood back into their body.

“Results show that Lynsie has had a positive response to the T-cell therapy and, at this time, we do not detect any leukemia cells,” said Rebecca Gardner, MD, principal investigator for the clinical trial.

The next step for Lynsie is a stem cell transplant, with the aim of clearing the cancer from her body. The goal of the immunotherapy cancer trial was to get her to this stage. Read full post »

Helping new parents cope with normal infant crying

Typical newborn cryingOne of the biggest surprises new parents face is just how relentlessly a normal, healthy infant can cry during their first few months of life. This crying can lead people to question their fitness as parents, raise unnecessary concerns about their child’s wellbeing and result in overwhelming feelings of anger, frustration and guilt.

Research shows that bouts of prolonged, unrelenting crying is the No. 1 reason parents – and other caregivers – shake a baby. Shaken baby syndrome can cause blindness, seizures, physical and learning disabilities, and even death.

Thankfully, research also has shown that simply understanding the normal pattern of infant crying and learning a few coping skills significantly reduces the likelihood that a child will be shaken or abused. Read full post »

Teens miss out on recommended vaccinations, study finds

Vaccine vials

Young people who come to their doctor’s office for care are often not offered shots that they should have, including those for tetanus, diphtheria and pertussis, human papillomavirus and meningococcal disease. “Missed Opportunities for Adolescent Vaccination, 2006-2011” was published June 27 in the Journal of Adolescent Health.

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Tips to Keep Kids and Teens Safe this Fourth of July

Fireworks safetyThe Fourth of July is a time for fun and celebration; however, families should follow precautions to ensure a safe and enjoyable occasion. Not only do parents need to worry about firework safety, but families should also keep in mind alcohol and sun safety, too.

Dr. Tony Woodward, medical director of emergency medicine at Seattle Children’s Hospital, recommends some basic safety tips to keep your kids out of the emergency department this year.

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Spinal fusion helps teen gymnast overcome scoliosis

In honor of National Scoliosis Awareness Month, Alexandra “Love” Wahl shares her experience with scoliosis and her path to finding her ‘new’ self.

“Two rods, 16 screws, one new me”

Love Wahl before scoliosis Alexandra “Love” Wahl was an exceptional gymnast. A fierce competitor all of her life, Love grew up in the gym and in 2012 at age 13, she qualified for the Washington state championships.

But one day while practicing her routine on the high bars, a coach told her she needed to “stay straight.” Love was confused – she felt she was as straight as she could possibly be. The coach called Love off the bars and had her bend forward so she could look at her spine. The coach slowly turned and motioned for Love’s mother, Wanda, to come down from the stands. Love’s spine was severely curved, forming a prominent “S” shape.

“From that moment our lives changed,” recalls Wanda. Read full post »

Doctor offers 8 tips to keep kids safe while biking

boybikingThe long, sunny days of summer are the perfect time to get the bikes out of the garage, but parents should hit the brakes and talk to children about bike safety first. Bike accidents are the second-leading cause of serious injury in school-age children. According to the Centers for Disease Control, in 2010, 800 bicyclists were killed in the U.S. and an estimated 515,000 sustained bicycle-related injuries that required emergency department care. Roughly half of these cyclists were children and adolescents under the age of 20.

Tony Woodward, MD, MBA, medical director of emergency medicine at Seattle Children’s Hospital, says most biking injuries occur because a child either isn’t wearing a helmet or is putting themself in a potentially dangerous situation. “Children may see themselves as invincible when they are on a bike, which is not the truth,” says Woodward. Read full post »