On the Pulse

Mom and Baby – India
© Paul Joseph Brown/GAPPS

Projects seek to undercover how the following conditions lead to preterm birth, low birth weight and stillbirth:

• Malaria infections of the placenta
• Infections of the female reproductive tract
• Disruption of the normal bacteria and other micro-organisms of the lower female genital tract
• Body’s receptors for progestin-based therapies
• Infections that cause inflammation in the uterus

Dr. Kevin Kain had completed medical school and was about to embark on a career as a surgeon in Canada, but on a whim he and some friends decided to take a trip to Africa.

He ended up spending a year driving the entire length of the continent, camping along the way.  “I was immediately struck that people were dying from diseases all around me that I had never even been taught about,” he says.

He returned to North America and decided to devote his career to global health. “It seemed this incredible inequity in education about what the major burdens of disease were in the world and that we didn’t know anything about them. I got very passionate about learning about them and then wanting to do something about them.” Read full post »

If we needed additional evidence, Brad Snyder’s story makes it perfectly clear that just because you’re a child with a disability, you don’t have to settle for second place.

An American swimmer on the United States Paralympic team, Snyder graduated from the Naval Academy and went to Afghanistan to serve his country. In September 2011, a roadside bomb exploded in his face and cost him his eyesight. But he still managed to find the finish line first, winning two gold medals in the summer of 2012 at the London Paralympic Games. And, among fully blind swimmers, Snyder is currently the best in the world for the 100-meter and 400-meter freestyle events. His story can be found at NBCNews.com. Read full post »

Unfortunately, many children are bound to face occasional teasing and rejection throughout their school years, and we now know that this bullying can affect more than just egos. Previous studies have found kids and teens who are bullied tend to be more depressed, lonely and anxious, and perform worse in school than those who aren’t picked on. So when this bullying is paired with particularly vulnerable students, such as children with autism, life can become even more difficult.

A new survey of parents shows that close to half of teens with an autism spectrum disorder (ASD) are bullied at school. This rate of 46.3 percent, published in the Archives of Pediatrics & Adolescent Medicine, is much higher than the estimated 11 percent of bullied teens in the general population. Read full post »

Hold off on using antibiotics unless truly needed, says Seattle Children’s researcher

Children who receive antibiotics may be more likely to develop inflammatory bowel disease, according to a new study led by Matthew Kronman, MD, of Seattle Children’s Hospital.  The study, “Antibiotic exposure and IBD development among children: A population-based cohort study,” was published September 24 in Pediatrics.

Read full post »

In June 2006, just five days before high school graduation, Heather Krich was diagnosed with cancer. She was 18 years old and while all of her friends were about to go off to college and taking senior trips to Mexico and Hawaii, she took a trip to the inpatient clinic at Seattle Children’s Hospital.

“Just as my adult life was supposed to be starting, I was faced with the possibility of life-ending,” said Heather. “It was really overwhelming as dealing with cancer just wasn’t what I was supposed to be doing at that time in my life.”

Heather was diagnosed with non-Hodgkin lymphoma. Doctors at a different Seattle area hospital had initially thought her appendix had burst but discovered in surgery that she instead had cancer.

After receiving the alarming diagnosis, one of Heather’s main concerns was attending her high school graduation. Luckily, with a little help, Heather was able to make it.

“I was in a wheelchair and my twin sister pushed me up the ramp onto the stage so that I could accept my diploma,” said Heather. “It wasn’t how I imagined it would be but I was very happy I could be there.”

After graduation, her doctors referred her to Children’s as they determined her cancer would be best treated at a pediatric hospital. Research shows that, for certain kinds of cancer, teens and young adults have dramatic improvements in long-term survival when they are treated on pediatric treatment protocols. In fact, when young adults are treated on pediatric protocols, their long-term survival improves by about 25 percent.

Heather spent the next 13 months in treatment at Children’s. In July 2007, she was thrilled when her cancer went into remission and she ended treatment.

Facing the Challenges

In looking back, Heather said there were many challenges in facing cancer as a young adult, from adapting to the physical changes to following all the rules that go along with inpatient treatment. However, at an age when peer support is so important, she said that the biggest challenge was feeling alone and isolated after having her life derailed with the diagnosis.

“It was a rough time already because it was that transition period into adulthood where you don’t really know where you fit in, especially going through cancer, and you have no one to talk to or relate to,” said Heather. “All of my friends were moving on with their life and they couldn’t grasp or understand my situation. Some of my best friends even stopped calling me.”

Now at 24 years old, Heather was excited to reach her five-year cancer-free mark which happened in July 2012. But her experience has left its mark and it has inspired her to be a resource and support for other patients like her.

Finding a Calling to Give Back

About three years after Heather’s treatment ended, Children’s Adolescent and Young Adult (AYA) Oncology Program sought out to create an online resource that would provide education and peer support to teen and young adult patients across the globe. They brought together a group of AYA cancer survivors, including Heather, and created the video series, “Good Times and Bald Times”, to show how a group of teens and young adults talk to one another about coping with cancer.

“It was so much fun to be involved and it is such a great therapy tool for other patients out there,” said Heather. “It was incredibly therapeutic to look into the eyes of someone else that understands your experience and hear that you aren’t the only one that has gone through these struggles.”

Children’s AYA oncology team asked Heather if she would be interested in being a resource for other teen and young adult cancer patients and she happily agreed. She now serves as a mentor for a patient that recently ended her treatment. They get together to share their experiences and Heather offers insight about transitioning into life after cancer.

“Having that mentorship and camaraderie is wonderful,” said Heather. “Transitioning into regular life is very difficult and it’s hard to even know where to begin and how to navigate back to normalcy. It gives so much hope to see someone on the other side, and I am glad I can provide that perspective.”

Feeling like she has found her calling, Heather is now going back to school in February to become a child life specialist who works with teen and young adult cancer patients.

“I feel such a pull to young adult and teen cancer patients and survivors and I would love to be able to give back and offer support,” said Heather. “I feel it is what I am meant to do.”

A Shoulder to Lean On: Children’s AYA Oncology Program

About 70,000 young people in the U.S. aged 15 to 39 are diagnosed with cancer each year. Teens and young adults comprise a significant population of patients receiving cancer treatment at Seattle Children’s. About a fourth of the patients treated in Children’s inpatient unit are age 15 and older.

The difficulty of facing cancer at this age and the need for psychosocial support is something that Dr. Rebecca Johnson, medical director of the Adolescent and Young Adult (AYA) Oncology Program, understands all too well, not only as a doctor but also as a cancer survivor.

“Teens and young adults have a greater reliance on their peer group as they look to one another to see what milestones they should be reaching,” said Dr. Johnson. “Cancer treatment takes them away from their peers, which can be very distressing. It is important to provide our teen and young adult patients with an enhanced package of psychosocial support in order to improve their treatment experience and help them better process what they are going through.”

Dr. Johnson and her team are working to provide innovative programs and resources at Children’s that will improve the lives of adolescent and young adult cancer patients that will provide this much-needed support.

In addition to the “Good Times and Bald Times” videos mentioned above, here is a sampling of some of the other programs and resources, many of which have been made possible by Seattle Children’s Guild Association Teen Cancer Fund:

Not Now Program

This May, you might have heard some buzz about a music video on YouTube where patients on Children’s Hematology Oncology floor sang and danced to Kelly Clarkson’s hit song “Stronger.” The video received worldwide attention and it was thanks to 22-year-old patient, Chris Rumble, who made the video as part of Children’s Not Now creative arts program. This was just one example of the work being done within the program.

The aim of Not Now is to help teens and young adults cope with cancer and provide psychosocial support through creative projects and by connecting them with peers. Led by John Blalock, Children’s Hematology Oncology Artist in Residence, the program gives patients a voice in telling their story through a variety of mediums including photography, video and music.

“What is so neat about the program is that it not only lets patients process their own cancer experience in a way that is creative and fun, but their art projects also give them a wonderful way to share their journey with friends and family,” said Dr. Johnson.

Other projects within the Not Now program have included:

• The Cat Immersion Project: The Next Best Thing to Being There in Purrrson
• Cancer Patient Raps “Look At Me Now” in Music Video
• The Hidden Shadows of Cancer: Photography by Ruby Smith at Seattle Children’s

Inpatient Gatherings

In order to help provide a peer group for teens and young adults with cancer, Children’s AYA life specialist hosts regular inpatient gatherings where patients can come together to talk, play games and do different activities.

“Teens and young adults use interactions with peers to process and reflect upon their life experiences. We provide sessions where they can come together and see that they are not alone in their experience,” said Dr. Johnson.

With the hospital’s expansion and opening of Building Hope next year, Dr. Johnson and her team also aim to increase the number of inpatient and outpatient psychosocial offerings in the new dedicated floor for AYA patients. In order to connect AYA patients from other hospitals, and inpatients who are in isolation, they are also looking into using video conferencing technology for the sessions.

Look Good Feel Better Classes

In order to improve patients’ self-esteem, Children’s hosts quarterly Look Good Feel Better classes, which are offered through the American Cancer Society. The classes help patients learn beauty techniques to help them manage the appearance-related side effects of cancer treatment.

Patient Advisory Board

Children’s has also created a Patient Advisory Board comprised of AYA cancer survivors who have expressed a desire to give back after their treatment. The group meets and consults with the AYA Oncology Program to offer their perspective on new programs and act as a support for current patients when needed. The group was also instrumental in providing input about the design of the new dedicated AYA floor that will be in Building Hope.

Heather is a part of this group as well and she is happy to be involved. She is also excited to see all of the tools and resources that are becoming available through the AYA Oncology Program.

“I’m so happy that there are so many tools at Children’s directed at teen and young adult cancer patients,” said Heather. “Having those available will help them better cope and get through their treatment with more ease.”

It’s back-to-school time and back to heavily scheduled days of after-school activities, homework, sports, music lessons, and more. With all there is to juggle in a day, it’s tempting to believe some of the myths about nutrition that may promise to make it easier and faster to feed our children well.

We checked in with Seattle Children’s nutrition team to find out the truth behind some of the more common nutrition myths. Here’s what we learned:

Myth #1

My child takes a daily multivitamin, so they’re getting all the nutrients they need.

Fact

Multivitamins provide only some of the vitamins and nutrients a child needs for good health.  Multivitamins are intended to supplement a balanced diet, not substitute it. Children (and adults, too) need the nutrients found in fruits, vegetables, protein, and complex carbohydrates. And, certain nutrients, such as Vitamin C and Potassium, are easily found in fruits and vegetables, but not in significant amounts in a basic multivitamin.

What parents can do

Continue to give your child a multivitamin, but encourage them to eat a variety of foods. Use food color as a guide. Generally speaking, the more naturally colorful the food, the more nutrients it has. By keeping their diet colorful, you’ll not only give them the nutrients they need, but the variety will keep them interested in food. Think colorful vegetables such as carrots, spinach, broccoli, eggplant, and kale; fruits such as red grapes, oranges, mangoes, and apples; and lean meats, salmon, dark or yellow tuna, shrimp, and poultry for protein. Even snacks such as almonds, walnuts, and whole-grain crackers have more color than highly-processed chips.

Myth #2

If I give my child non-fat food, they won’t become overweight.

Fact

Our bodies need fat: it nourishes the developing brain and protects our organs. It also helps us feel satisfied after a meal. Fat is helpful in giving flavor and taste.  If your child doesn’t feel satisfied after a meal, they may consume more food that may be low in nutritional value and high in sugar and sodium to make up for it, which could lead to excessive weight gain. Some examples of “good fats” include nuts, seeds, olive oil, and lean meats.

What parents can do

Stick to low-fat options rather than non-fat options, such as low-fat yogurt and milk. Many non-fat foods have added sugar and sodium to offset the loss of taste from the lack of fat in them.

Myth #3

My child plays a lot of sports so they need to have extra carbohydrates in their diet.

Fact

If your child has a well-balanced diet, then there is no need for them to change it while they’re training for a sport. It’s not necessary to load up on extra carbohydrates before a game that may last only an hour at the end of the day. If they’re participating in extended games, such as weekend-long tournaments where they’re playing for hours at a time, then adding extra carbohydrates to a meal prior to the game makes sense.

What parents can do

Make sure your child has a good mix of protein and carbohydrates throughout the day so they’re well-fueled for after-school and weekend sports. If they’re playing sports for hours at a time on the weekend, then adding more complex carbohydrates, such as pasta or potatoes, to their dinner the night before a game will help them sustain their energy throughout the game the next day. To help them maintain the energy they need to stay in the game, try the following:

• Provide your child or teen with three meals and two-three snacks per day, especially on event days.
• Bringing food from home can help eliminate the need for convenience and fast food at the last minute.
• Teaming up with other parents can help ensure that there are plenty of well-balanced meals and snacks available for the team at longer events such as soccer tournaments and swim meets.
• Provide your child or teen with plenty of water. Sports drinks such as Gatorade or Powerade should be used during play that lasts longer than 60 minutes.

Myth #4

I can’t control what my teenager eats; they’re old enough to decide for themselves what to eat.

Fact

Education about nutrition begins at home. As a parent, you can still control what they eat for breakfast and dinner. Yes, they are independent enough to make or buy their own lunch, but you can provide healthy choices for at least two meals a day.

What parents can do

Set an example for your child about how to eat a well-balanced diet. Studies have shown that children are more likely to develop good eating habits if their parents have demonstrated them at home. In addition to using color as a guide to choose foods, also keep in mind portions: fill one-half of your plate with fruits and vegetables and round out the other half with protein on one quarter and carbohydrates on the other quarter. Involve your teenager with meal preparation so they can see the fruits of their efforts and possibly develop an interest in food.

Myth #5

My child eats a good lunch and dinner, so it’s OK for him to skip breakfast.

Fact

Your child needs three meals per day that are a mix of protein and complex carbohydrates. This is especially true if your child plays sports. If they skip breakfast, they will not have the stamina and energy for a game late in the day.

What parents can do

If carving out time for breakfast seems just too much, consider having some quick, healthy protein on hand, such as hardboiled eggs or low-fat yogurt to pair with carbohydrates such as whole grain toast or plain instant oatmeal. Round it out with a piece of fruit or a small glass of juice.

Myth #6

Each of my children has very different tastes in food. I need to prepare multiple meals to get them all to eat!

Fact

Try to make one meal for the whole family.  With kids of varying ages and appetites it can be a real challenge to find a meal that appeals to everyone, but it can de done.

What parents can do

Don’t be a short order cook for your family!  Instead, prepare a meal (in this case, dinner) that has at least one food that each child likes. This may be a far cry from your current reality, but try it even one day a week to start; change takes time.  They don’t need to like everything on their plate, just one food item. One may like the chicken; the other may like the mashed potatoes. Regularly preparing only one meal for the entire family will make the transition to introducing new food to your children much easier in the long run. And remember, it often takes as many as 15-20 attempts before a child may try a new food. Stick with it!

“Food is your medicine – hence let your medicine be your food”  – Hippocrates, circa 400 BC

Hospitals are places where healing and wellness are promoted, yet the food and drink that are served at them may not always be the healthiest options for patients, their families and staff.  Seattle Children’s is tackling this challenge head on.

Today, Children’s announced the launch of Mission: Nutrition – a new initiative aimed at improving the nutritional quality of the food and drinks served at all Children’s properties. Improving our nutritional offerings will happen in several phases over time. Here’s a look at phase one improvements, some of which are already underway:

• Deep-fat fried foods are no longer offered in the hospital’s cafeteria. Instead, french fries, onion rings, fish fillets, egg rolls, empanadas and other traditionally deep-fat-fried foods are now baked.
• Beginning this month, all sugar-sweetened beverages in cafeterias, vending machines and gift shops will be removed – one of the more sweeping changes of the initiative.
• Wild salmon with tomato pesto, cod fillet and country baked steak have been added to the cafeteria’s rotating menu as healthy alternatives.

Read full post »

It’s back-to-school time, so it’s back to wellness basics for our children.  One of the most effective ways we can keep our children healthy is to keep them up-to-date with immunizations. And one of the most important immunizations a child (and parents and grandparents) can get protects against pertussis, also known as whooping cough.

We’ve talked about this before, but it’s well worth discussing again. Read full post »

From the time Logan Ellingsworth was born in June 2007, it was clear he was a fighter. Born prematurely with a variety of health issues from exposure to methamphetamines while in utero, Logan had a difficult journey ahead.

Brenda and Randy Ellingsworth, Logan’s grandmother and grandfather who adopted him after he was born, remember the first time they saw him in the intensive care unit at the hospital.

“Out of all the babies in the room, I was surprised to see that one was actually raising his head up as if to see who was coming in,” said Brenda. “I asked the nurse, ‘Who’s this little curious one?’ She said, ‘That is your precious little grandson and he is going to be a fighter.’  I started to cry because at that moment, we knew he was going to have major obstacles to overcome.”

The First Step: Facing Cerebral Palsy

Among the host of medical issues Logan faced, he was diagnosed with cerebral palsy, a disorder of the brain that affects muscle tone and the ability to coordinate body movements. It is caused by an injury to the brain, which can occur when a child is born prematurely.

Read full post »

Dr. Douglas Diekema, a member of the American Academy of Pediatrics (AAP) Task Force on Circumcision, talked with On the Pulse recently about the updated AAP policy released August 27. Dr. Diekema is the director of education in the Treuman Katz Center for Pediatric Bioethics at Seattle Children’s Research Institute and was named to the task force to represent the AAP Committee on Bioethics.

Q. What has changed since the last time the AAP looked at the circumcision policy, and what are the key points in the new policy?

A. The task force concluded that there are significant health benefits of newborn circumcision and that those benefits outweigh the risks of the procedure.  Because of the health benefits, the task force also recommends that Medicaid and other insurance cover the cost of circumcision.  Those points are the key changes from previous policy statements. Read full post »