* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project
wonders Spring 2009 small a Publication of maria fareri children’s hospital at Westchester Medical Center Healing a Little Boy’s Heart (Cover Story Pg. 3) Also in this Issue Hope for Kids with Asthma Meet Our New Hospitalists A Big Help for Tiny Babies Spring 2009 cover story Healing a Little Boy’s Heart 3 25 Years of Caring for Kids’ Hearts 5 Healing a Little Boy’s Heart Hope for Kids with Asthma 6 A Doctor’s Advice Wherever You Are 7 Meeting a Critical Need 8 Help Your Child Steer Clear of Colds and the Flu All Year Long 10 Why We Walk 12 Always Here When You Need us 14 Notes from a Hospital Bed 15 A Big Help for Tiny Babies 16 A Place to Belong 18 Kids and Concussions 19 Read Small Wonders online or sign up to receive it electronically at www.WorldClassMedicine.com/SmallWonders. Westchester County Health Care Corporation Michael D. Israel, President and Chief Executive Officer Board of Directors Officers John Heimerdinger, Chair Helen Blackwood, First Vice Chair Mark Tulis, Vice Chair Joseph Tomaino, Vice Chair Emmeline Rocha-Sinha, Treasurer Susan Gevertz, Secretary A Message from Our Physician-in-Chief For the past 25 years, Westchester Medical Center, now home to Maria Fareri Children’s Hospital, has been providing care to children with congenital and acquired heart defects. Thousands of children have come to us seeking care for disorders ranging from simple, isolated heart defects to complex syndromes encompassing multiple heart anomalies. Thanks to dramatic advances in the field of pediatric cardiology, children who might not have survived past infancy a couple of decades ago are now able to lead relatively normal lives with few restrictions on their activities. For example, in this edition of Small Wonders, you will read about two wonderful children and their families who are doing well today as a result of the combined efforts of our talented cardiac surgical experts and interventional cardiology specialists. In fact, while we treat some of the sickest children in the state, our surgical success rate continues to exceed the state’s expected success average. The cardiovascular programs are not the only ones that are growing at Maria Fareri Children’s Hospital. In this issue you will also read about our newly launched pediatric hospitalist program. In 2008, three full-time pediatric hospitalists joined the staff and two more will be added this year. These specialists help coordinate care among many sub-specialties and respond to questions from parents. Around the country, other major children’s hospitals have found that hospitalists add to quality of care and family satisfaction as well as trainees’ academic experience. We are also continuing to support high-quality research into the prevention and management of childhood illness. In this issue you will learn about efforts by our pulmonary specialist to improve treatment methods for children with asthma. With exciting progress like this, it is no wonder that the demand for our advanced services continues to increase throughout the Hudson Valley and beyond. In fact, this high level of need is fueling growth at Maria Fareri Children’s Hospital. You can read about our plans for increasing capacity on page 8. More than ever, as we all face the challenges of our times, we thank you for your continuing support as we strive to enhance our services and expand our capacity to meet the needs of the children and families from throughout our region. It is only with your help that we can continue to serve. Directors Richard Berman Gerard Bernacchia Claudia Edwards Renee Garrick, M.D. Herman Geist Jon Halpern Mitchell Hochberg Michael Israel (non-voting) Patrick McCoy Alfredo Quintero Steven Rogowsky Michael Staib Maria Fareri Children’s Hospital at Westchester Medical Center Michael Gewitz, M.D., Physician-in-Chief Charlotte Cady, R.N., Vice President, Nursing At Maria Fareri Children’s Hospital and Westchester Medical Center, we care for the most severely ill and injured newborns, infants, children and adults from the Hudson Valley region and beyond. Because of the strong partnerships we have forged with community hospitals in the region, with managed care companies, with local doctors, with our patients and within the hospital, Westchester Medical Center has become a major healthcare resource in the tri-state area. With more than 3.6 million people in the region, each day hundreds of sick or injured people need to rely on us…and they can. 2 For physician information, call 1-866-WMC-PEDS Michael Gewitz, M.D. Physician-in-Chief Maria Fareri Children’s Hospital at Westchester Medical Center Published by Westchester Medical Center, Department of Marketing and Corporate Communications 110 Executive Offices, Valhalla, NY 10595, 914-493-8024 Kara Bennorth, Senior Vice President, Marketing and Corporate Communications David Billig, Director, Media Relations Isabel Dichiara, Director, Community Relations and Outreach Leslie Mills, Director, Editorial Information Andy LaGuardia, Director of Communications, Maria Fareri Children’s Hospital Katherine Turiano, Marketing and Communications Specialist Ben Cotten, Gordon Tunison, Digital Imaging Ellen Lane, Staff Writer The information in this publication is written by professional journalists and/or physicians. However, no publication can replace the direct care or advice of medical professionals and readers are cautioned to seek such help for personal problems. Comments about this publication should be emailed to [email protected] wcmc.com or [email protected] Domenick D’Addona Gets the Chance to Be a Regular Kid, Thanks to Cardiac Specialists at Maria Fareri Children’s Hospital T Two days after giving birth to twin boys at her local hospital in March 2007, Sandra D’Addona was told one of them, Domenick, had a heart murmur – a common condition that’s often benign but can sometimes be a sign of a heart defect. To properly diagnose his condition, Domenick’s neonatologist recommended a transfer to Maria Fareri Children’s Hospital at Westchester Medical Center, the only advanced care pediatric hospital in the Hudson Valley capable of diagnosing and treating complex congenital heart defects. “They told us, ‘We’re not sure what’s wrong but we’re sending him to the best place,”’ says Sandra. Within hours, Sandra and her husband, also named Domenick, learned their son’s full diagnosis. Little Domenick had not one but four complex heart defects collectively known as Taussig-Bing Syndrome, a condition that affects about one in 100,000 children. Domenick’s aorta and pulmonary arteries both Toddler Domenick D’Addona receives treatment for four complex arose from the right ventricle, so blood was not flowing heart defects at Maria Fareri Children’s Hospital. correctly through his heart. As a result, his organs weren’t getting enough oxygen and his lungs were overworked. Domenick also had a narrowing of his aorta, or main artery, that restricted blood flow to the lower part of his body, increasing pressure in the right side of his heart. As an additional part of the condition, Domenick had a hole in the wall between the two lower chambers of his heart. “Twenty-five years ago, Domenick almost certainly would not have survived,” says Markus Erb, M.D., Domenick’s primary Pediatric Cardiologist who cared for him along with Suvro Sett, M.D., Chief of Pediatric Cardiac Surgery. “Thanks to the care he received, Domenick is a kid who will go to school with his brother, play in gym and horse around at recess as if none of this ever happened.” continued on page 4 3 25 Years of Caring for Kids’ Hearts cover story overcome, the heart surgery was a success and Domenick continues to grow and develop steadily. continued from page 3 “Domenick has made tremendous strides in catching up to his twin brother both physically and developmentally,” says Dr. Erb. “He was very small for his age initially. Now he is almost as big as his brother.” For now, the biggest challenges facing Domenick, Sandra says, are a tracheostomy, or opening, in his throat for breathing, and a gastric tube used for feeding. Both devices will be removed once his trachea is repaired in the near future, says Dr. Erb. Despite these challenges, Sandra says, Domenick is walking and even talking, “trying to keep up with his brother” at every turn. While the clinical care Domenick received was critical to his recovery, Sandra says, she was equally as impressed with the personal care she and her family received at Maria Fareri Children’s Hospital. Despite his medical challenges, Domenick enjoys games and other activities with his brothers, Matthew (center), and his twin, Giovanni (right). A Long Road Domenick’s journey began shortly after his birth on March 29, 2007. He needed a series of procedures to essentially re-route the blood flow in his heart, says Dr. Sett, who has done well more than 1,000 surgeries to correct congenital heart defects. Dr. Suvro Sett 4 Domenick’s first procedure, done when he was two weeks old, involved placing a band around his main pulmonary artery to restrict blood flow to the lungs. A little later, Dr. Erb performed the second procedure, a cardiac catheterization, in which a long, thin tube was inserted into a blood vessel and directed into Domenick’s heart to open up the narrowing in the aorta. In July 2007, Domenick returned to Maria Fareri Children’s Hospital at Westchester Medical Center for the main event — a complex, multi-step surgery by Dr. Sett that re-routed the blood flow in his heart and patched the hole between the two lower chambers. Although Dr. Markus Erb he still has some hurdles to “The nurses in the NICU (Neonatal Intensive Care Unit) and PICU (Pediatric Intensive Care Unit), the nurse practitioners, doctors and the Child Life and music therapists who would visit Domenick were very compassionate,” says Sandra. “They made an effort to be there for us and to help us get through a very difficult and stressful time in our lives. They not only took care of their patient physically, they took care of the family emotionally.” Domenick D’Addona is just one of thousands of children who have been successfully treated for congenital heart defects by pediatric cardiology specialists at Westchester Medical Center since 1983. Children have come to the Medical Center, now home to Maria Fareri Children’s Hospital, seeking care for problems ranging from a hole in the heart to hypoplastic left heart syndrome, which occurs when a child is born with only “half a heart” or a single pumping chamber. To get the best results, specialists in the pediatric heart program at Maria Fareri Children’s Hospital at Westchester Medical Center work closely with those in other fields. Although the hospital has one of the highest case mix indices in the state, meaning that it treats the sickest patients, our surgical success rate exceeds the state’s expected success average. “Part of the reason we can do what we do in the pediatric heart program is that we are backed by highly trained specialists in every area of pediatric medicine from anesthesiology to critical care to pulmonology and gastroenterology,” says Markus Erb, M.D., Pediatric Cardiologist. “Complex patients like Domenick need to be in a hospital where all these people can get together at a moment’s notice.” The program is supported by a high-tech critical care unit, dedicated operating suite and full staff of medical and cardiovascular specialists who work together closely to help children from all over the Hudson Valley region and beyond. When Antonietta Golia gave birth at Westchester Medical Center to her daughter, Dina, who had been diagnosed with complex heart defects and other congenital anomalies before birth, Suvro Sett, M.D., Chief of Pediatric Cardiac Surgery, and Gustavo Stringel, M.D., Chief of Pediatric Surgery, were both on hand to take immediate action. “We were able to predict everything that Dina would have to deal with based on the fetal echocardiograms that were done repeatedly throughout the pregnancy. That’s why those two surgeons were in the delivery room when she was born,” says Bernard Fish, M.D., Dina’s pediatric cardiologist. “The surgeons worked as a team and were very well organized,” says Antonietta. “She had a lot of problems and needed her first surgery two hours after she was born. But they made us feel like it was going to be all right.” Now four, Dina’s surgeries – she has had five major operations – are behind her and she’s enjoying pre-school like other healthy children. “When people hear my daughter’s story and then see her, they can’t believe it,” says Antonietta. Dr. Sett says children born with heart defects have a better long-term prognosis today because surgical techniques keep improving. In recent years, for example, techniques have evolved to keep blood flowing to the brain for as long as possible during surgery, reducing the risk of side effects. Whenever possible, non-surgical techniques are used to correct defects. Using cardiac catheterization, a procedure in which a long, thin tube is threaded into a blood vessel and directed into the heart, specialists can eliminate irregular heartbeats, close defects using plugs and open narrowed arteries. “These children do very well,” says Dr. Sett, who has performed more than 1,000 surgeries to correct congenital heart defects. “By giving children as full a repair as possible, we make it possible for them to lead ordinary lives, with few or no restrictions on their activities.” The Golias in their family deli, Roma Deli II, in Wappingers Falls (from left to right): Dina, who was born with heart defects, dad, Roberto, sister, Martina, mom, Antonietta, and brother, Giuseppe. 5 research update Hope for Kids with Asthma Research at Maria Fareri Children’s Hospital Could Lead to More Effective Treatment Methods with Fewer Side Effects The research, funded by a seed grant from the Maria Fareri Children’s Hospital Foundation, could ultimately change the way specialists care for children with asthma, allowing them to eliminate or decrease certain medications when inflammation is low. The research also aims to answer the question of why polluted air increases the incidence of asthma in children, which could lead to new preventive measures. the body to allergens, injuries and infections. When the airways are inflamed and a child comes into contact with a trigger such as pet dander or pollen, the child may experience asthma symptoms such as coughing, wheezing and difficulty breathing. Specialists typically prescribe anti-inflammatory medications such as inhaled corticosteroids to control inflammation in children with persistent asthma, but these medications can have side effects. There is currently no ideal non-invasive way to measure airway inflammation; however, people with poorly controlled asthma generally have elevated levels of nitric oxide in their exhaled breath. Subjects in the study are asked to exhale into a frozen tube, which collects condensate, or the fine particles in their breath. Dr. Dozor measures the levels of nitric oxide in the exhaled air and then Dr. Balazy takes the samples of breath condensate to his lab and measures whether levels of toxic fatty acids, another possible marker for inflammation, are elevated. The two doctors will be anxiously awaiting the results of their research because of the way it could affect asthma treatment. “The medications used to treat asthma today are very effective, but everything has side effects,” says Dr. Dozor. “If we can accurately monitor inflammation, we’ll be able to cut down on those medications while still controlling the asthma, which will have a profound affect on the way we treat this disease.” Research Scholars Program Dr. Allen Dozor leads an asthma research program funded by the Maria Fareri Children’s Hospital Foundation. M Most parents of children with asthma view the medications used to control the condition as a necessary evil. Given a choice, they would prefer to give their child fewer medications in smaller doses. Thanks to ongoing research at Maria Fareri Children’s Hospital at Westchester Medical Center, someday parents of asthmatic children may be able to do just that. Allen Dozor, M.D., Associate Physician-in-Chief and Chief of Pediatric Pulmonology at Maria Fareri Children’s Hospital and Professor of Pediatrics at New York Medical College, says he and Michael Balazy, Ph.D., a researcher at New York Medical College, are searching for a reliable, non-invasive way to measure inflammation in the airways of asthmatic children. 6 The project is one of four being funded by the foundation’s Research Scholars Program, launched in 2007. The program awarded $50,000 a year for two years, or $100,000 per project, to specialists conducting transitional Dr. Michael Balazy research, which links research concepts to clinical solutions. Other funded projects are focusing on childhood obesity, brain hemorrhages in premature infants, and targeted chemotherapy for childhood brain tumors. “This is a wonderful program because it allows researchers to develop new ideas and test new hypotheses, which, if fruitful, could lead to successful applications to the National Institutes of Health and other foundations for large-scale studies,” says Dr. Dozor. “We’re very grateful and honored that this project was chosen.” Studying Airway Inflammation Drs. Balazy and Dozor are enrolling 80 children into their study to test new ways to measure inflammation in the airways. Inflammation is a complex response of A Doctor’s Advice WhereverYou Are Maria Fareri Children’s Hospital Offers Health and Wellness Podcasts Wouldn’t it be great to have a host of pediatric experts right at your fingertips to advise you on ways to keep your child safe and healthy, as well as to shed some light on current kids’ health topics? With podcasts from Maria Fareri Children’s Hospital at Westchester Medical Center, anyone with access to the Internet can easily obtain expert advice on a range of issues from children’s sleeping disorders to whether asthma should keep young athletes on the sidelines. The podcasts are audio interviews with pediatric specialists that can be played on your personal computer, burned to a CD or downloaded onto your digital audio player and listened to at your convenience. Scoliosis: Why Early Detection is Important, Concussions, tThe Effects of Maternal Obesity on Newborn Health, and Is Your Teen Ready to Graduate to an Adolescent Specialist? The list of available podcasts continues to grow. To find topics that interest you, visit www.WorldClassMedicine.com/podcasts, and bookmark the page as new interviews will be uploaded regularly. “Maria Fareri Children’s Hospital is the advanced care pediatric facility for the Hudson Valley and our health experts are the region’s foremost authorities in their medical fields,” says Andrew LaGuardia, Director of Communications for Maria Fareri Children’s Hospital. “These podcasts tap into that wealth of knowledge and deliver important health and wellness information in a casual format.” Ranging in length from 10 to 20 minutes, the podcasts are more like conversations between a parent and specialist than formal interviews, says LaGuardia, a parent of young kids himself, who handles many of the interviews. Topics currently available include How to Console a Crying Baby, Dr. Wallace Jenkins covers an important topic in a Maria Fareri Children’s Hospital podcast. 7 feature article Meeting a Critical Need Growing So We Can Treat More Kids With Complex Conditions An expansion of our Emergency Department now allows us to accommodate the 14,500 pediatric patients who pass through our Emergency doors each year. A As a parent, it may seem that every time you turn around, your child has grown another inch — or two, or three. At Maria Fareri Children’s Hospital at Westchester Medical Center, we’re having a growth spurt of our own, fueled by the region’s increasing demand for advanced pediatric healthcare. Since opening our doors in the fall of 2004, Maria Fareri Children’s Hospital at Westchester Medical Center has cared for nearly 90,000 infants, children and teens with a wide range of medical issues including nearly all forms of complex conditions. Families have come to us from throughout the Hudson Valley and beyond seeking care for congenital heart defects, cancer and neurological conditions, as well as chronic ailments such as metabolic disorders, diabetes and cystic fibrosis. The hospital has had an average daily occupancy of more than 92 percent since 2004, with the inpatient units at capacity during the last quarter of 2008. 8 Emergency Department visits have more than doubled, increasing from about 7,000 in 2005 to about 14,500 in 2008, according to David Markenson, M.D., Chief of Pediatric Emergency Medicine. Another sign of increased demand has been the spike in the number of surgical procedures, which have gone from about 250 in 2004 to nearly 500 in 2008. More Patients, More Space To ensure that the healthcare needs of the region’s children are met, Maria Fareri Children’s Hospital at Westchester Medical Center is expanding. In the first half of 2008, the hospital added six pediatric emergency department beds, nearly doubling capacity in that area. In 2009, the hospital will also add four new inpatient beds by relocating three patient lounge areas and an office, according to Michael Gewitz, M.D., Physician-in-Chief at Maria Fareri Children’s Hospital at Westchester Medical Center. Because the hospital is frequently at or near capacity, future plans call for adding another neighborhood, or inpatient unit, with nine beds by 2011. The new neighborhood could be accommodated We are also converting existing space into inpatient rooms to accommodate in the existing more patients. building, while any further expansion would require adding to the footprint of the Children’s Hospital, Dr. Gewitz says. “Adding another neighborhood is in keeping with the overall strategic plan for both Westchester Medical Center and Maria Fareri Children’s Hospital and is imperative to meet the needs of the children and families we serve,” says Dr. Gewitz. “Given the current economic climate in the country and in our industry, we may not be able to complete these expansions as quickly as originally planned, but there is still a need to grow and enhance our services, and we are committed to meeting it.” A Partner in the Community Maria Fareri Children’s Hospital at Westchester Medical Center is serving the community in other ways as well. As the core of a hub-and-spoke arrangement with a large network of community hospitals in the region, the hospital is working to prevent illnesses and injuries and enhance the quality of pediatric healthcare at all levels. “We thought long and hard about how we could benefit the families in the region who may never need advanced care,” says Dr. Gewitz. “We decided to do it with a big health and wellness effort, intertwined with the area’s community hospitals.” One initiative, funded by a grant from the R Baby Foundation, seeks to improve emergency medical care for infants, toddlers and children at community hospitals by ensuring that those hospitals are equipped and trained in the recognition, stabilization and referral of pediatric emergencies. In another outreach, specialty groups from Maria Fareri Children’s Hospital at Westschester Medical Center are collaborating with physicians at community hospitals and clinics in Dutchess, Orange, Rockland, Fairfield and northern Bronx counties. Medical specialists or support staff members visits these community hospitals each day to review healthcare statistics, quality measures and treatment protocols to ensure that all area providers are up to date. “These programs are meant to create a seamless network so kids and their families are confident they’re getting appropriate care in their community, while knowing that when they need specialty care, Maria Fareri Children’s Hospital is available to them,” says Dr. Gewitz. Maria Fareri Children’s Hospital at Westchester Medical Center is also working on many fronts to prevent illnesses and injuries. For example, our Children’s Hospital is one of only two hospitals in New York State involved in a program to educate every new mother about the dangers of Shaken Baby Syndrome, a life-threatening condition that occurs when infants are handled too roughly. Under the auspices of another state grant, our experts identify kids at risk for lead poisoning from lead-based paint and arrange for testing, treatment and even relocation if the housing they live in is dangerously contaminated by lead. “This hospital was conceived from the get-go with two missions in mind,” Dr. Gewitz says. “One is to provide advanced medical care for complex conditions. The other is to be an advocate for children’s healthcare at every level. That includes treatment of acute medical problems and also prevention of these problems.” 9 feature article HelpYour Child Steer Clear of Colds and the Flu AllYear Long If it seems like your child always has a cold, it’s not entirely your imagination — kids get an average of six to eight colds a year, compared to only two to four for adults. As for influenza, or “the flu,” it is not nearly as common but is far more serious, says Allen J. Dozor, M.D., Associate Physician-in-Chief and Chief of Pediatric Pulmonology at Maria Fareri Children’s Hospital at Westchester Medical Center. Although there’s no foolproof way to keep a lid on colds and flu, there are some common-sense precautions — like frequent hand washing and getting the flu vaccine — that can reduce the risk of your child contracting these illnesses. Keeping Colds Away Colds, which can be caused by any one of more than 200 viruses, are spread by contact — either by touching an object that has been touched by someone who has a cold virus on their hands or by inhaling droplets after someone has coughed or sneezed into the air near you, says José Muñoz, M.D., Chief of Pediatric Infectious Diseases at Maria Fareri Children’s Hospital at Westchester Medical Center. To combat the spread of colds, Dr. Muñoz says: • Teach children to cover their mouths when coughing or sneezing or to cough or sneeze into the bend of their elbow. Covering a sneeze with their hands just makes it more likely that the virus will be spread to the next thing they touch, whether it is a toy, doorknob, stair rail or kitchen counter. • Use alcohol-based hand sanitizers when soap and water aren’t available. Older children can even keep a mini-sized sanitizer in their backpacks or desks at school. Do not give sanitizers to children who still put things in their mouths. • Open windows a crack when the weather permits. Even a small amount of fresh air entering a room helps to reduce the presence of viral germs. • Keep fingers and hands away from the eyes and nose where cold virus germs can be spread. • If you use hot air heating in your home, consider using a humidifier to keep the air moderately moist. Dry air makes sinuses and nasal passages more susceptible to infection. Most colds will get better within a few days to two weeks but you should consult your pediatrician if a child has unusually severe cold symptoms, a high fever, sinus headache, ear pain, a cough that gets worse while other symptoms improve or a flare-up of a chronic condition like asthma. Avoiding the Flu When it comes to the flu, the best defense is getting the vaccine, says Dr. Dozor. Specialists recommend getting vaccinated in October or November, however, the American Lung Association says it is “never too late” to get the vaccine. Flu season runs through March and the vaccine takes only two weeks to take effect. “The influenza virus is not that common; most colds and viruses are not due to influenza,” says Dr. Dozor. “But if you get the flu, it is really bad. Children run high fevers, have persistent coughs and generally feel awful. Kids who have asthma will not only be sicker with the flu than non-asthmatics, but the flu will sensitize them for up to six months, turning a child with mild asthma into one with severe asthma.” In the most severe cases, when the flu is complicated by a bacterial pneumonia or infection of the lungs, the flu can even lead to death. “I see parents every year who can’t understand how their child ended up in the Intensive Care Unit from the flu. It can be a very serious illness, and parents need to do everything they can to protect their kids from it,” says Dr. Dozor. • Encourage children to wash their hands frequently — before and after using the bathroom, before and after eating and before and after touching high-use surfaces like computer keyboards or shared toys. 10 11 foundation news Why We Walk Go the Distance Supporters Speak Out A Are you ready to Go the Distance? Since its inception in 2005, more than 20,000 people have turned out for this inspiring walk and family fun day to raise funds for Maria Fareri Children’s Hospital at Westchester Medical Center -- the all-specialty children’s hospital for the Hudson Valley region. extended family members and friends. “That’s why we walk. We want to support the hospital as much as possible.” (Marcello has a rare metabolic disorder that prevents his body from converting certain fats into usable energy.) The Go the Distance event, coming up this year on Sunday, April 19, is expected to draw more than 6,000 participants to the hospital’s Valhalla campus, including patients, family members, neighbors, friends, hospital staff and corporate and community groups. How does it work? These participants form teams, complete with customized t-shirts to wear on walk day, and each team member collects donations from various supporters in their community. Don’t have a team? No worries! Individuals can gather donations on their own or just come out on walk day to enjoy the festivities. This event also brings out an impressive list of sponsors, such as Atlas Air, Emergency Medical Associates, ENT Faculty, Key Bank, New York City District Council of Carpenters, People’s United Bank and the Journal News, just to name a few. Last year’s walk raised approximately $500,000 for enhancing and expanding the services offered at Maria Fareri Children’s Hospital. With all this in mind, we surveyed some of the various team members and sponsors and asked them, “Why do you walk?” Here’s a sampling of what they said: 12 It started with teddy bears. William B. Meyer, Inc., a transportation and storage company, wanted to do something for children who were hospitalized. So the company donated teddy bears to hospitals in its service area, which stretches from New York City to Boston, to put smiles on children’s faces during the holiday season. “When we came to deliver the teddy bears to Maria Fareri Children’s Hospital, we were so impressed by what a remarkable place it is,” says Tom Gillon, president of William B. Meyer, Inc. “We decided right then and there that we wanted to do more and came to participate in the walk, which is a fabulous and fun event that we look forward to doing again this year.” Team Kayla’s Journey “Twelve years ago, I gave birth to a healthy baby,” says Michelle Mattson, Kayla’s mother. “But when she was eight she was diagnosed with rheumatoid arthritis, Raynaud’s phenomenon, mixed connective tissue disease and a clotting disorder.” Rene and Cris Lemieux will never forget the “care we received as parents when our son Tyler was in the NICU” in 2004. “They held us when we cried,” says Cris of the staff. “When we couldn’t support each other, they supported us.” Although Tyler was born with severe heart defects and succumbed to a serious infection a few weeks after his birth, Cris says,“The NICU environment and staff allowed us to bond with our son and have some wonderful memories.” Team KeyBank Team KeyBank is committed to providing the community with resources it needs to improve quality of life. Team Tyler is one of the largest teams that participates in Go the Distance each year. The KeyBank Team provided free water bottles to walkers at the 2008 event. Kayla Cappello-Mattson (right), age 12, and her friend, Mary, enjoyed the festivities at the 2008 event. Team Tyler The William B. Meyer team will again be a valued sponsor at the 2009 walk event. Although Kayla is doing well now, Michelle says, she and her husband, Doug, and younger daughter, Kara, and family and friends walk “because you never know when you are going to need a really wonderful children’s hospital. We want to give back, and we want other families to know that Maria Fareri Children’s Hospital is here.” Team William B. Meyer, Inc. “That’s why Key is so proud to support Maria Fareri Children’s Hospital,” he adds. “By providing severely ill and injured kids with the most unique and advanced care available, the facility and its staff help to keep the future bright and full of hope for so many of them.” To express their gratitude, the Lemieux family, along with 25 to 50 family members and friends who continue to participate in the walk every year, have raised more than $100,000 for a new program in fetal medicine. Marcello Archetti, the inspiration for the Archetti family team, served as Grand Marshal for the Go the Distance walk in 2006. Team Archetti Family “Our son Marcello is doing great, but he wouldn’t be here today without the care he has received and continues to receive from the wonderful doctors and staff at Maria Fareri Children’s Hospital,” says Lisa Archetti, who walks along with her husband, David, Team William B. Meyer, Inc. “Nowhere is this more important than in the level of healthcare available to our region’s children,” says Michael Orsino, president of the Hudson Valley/Metro New York District. If you would like to participate in the Go the Distance event on April 19 or would simply like more information, please call (914) 493-2575 or visit www.WorldClassMedicine.com/walk. 13 feature article child life Always Here When You Need Us Maria Fareri Children’s Hospital Launches Pediatric Hospitalist Program L Like many infants born with complex medical problems, 11-month-old Danny Torres is under the care of a team of specialists including a cardiologist, a radiologist, an endocrinologist, a pulmonologist, a geneticist and a gastroenterologist. His mother, Joanna Guzman, has high praise for all of the physicians treating her son but says the doctor she relies on the most is Dinabel Peralta-Reich, M.D. Dr. Peralta-Reich is a pediatric hospitalist, a physician who specializes in caring for patients while they are hospitalized. Maria Fareri Children’s Hospital at Westchester Medical Center recently hired three pediatric hospitalists and plans to Dr. Caroline Moon hire two more in the near future, which will ensure round-the-clock coverage for inpatients by attending physicians, which isn’t the case at all hospitals. The other two hospitalists now on staff are: Elissa Gross, M.D., and Caroline Moon, M.D. Dr. Elissa Gross “There are many benefits to the hospitalist program,” says Robin Altman, M.D., Chief of General Pediatrics and Acting Director of the Pediatric Hospitalist Program. “If a child has a sudden change in condition such as experiencing respiratory distress or a seizure, the hospitalist is there to help manage it — even in the middle of the night. The hospitalist provides families with a level of comfort.” Hospitalists also coordinate a child’s care, ensuring that tests and procedures are ordered and carried out in a timely manner and that discharge planning is done efficiently. 14 What’s more, the hospitalist is available on a regular basis to speak with families about their child’s progress and treatment. For Guzman, Dr. Peralta-Reich has been an invaluable resource. “She is excellent. When something is wrong with Danny, like he’s vomiting, she comes right away and checks him. Sometimes it is not serious, but sometimes it is, so it is great to have her here,” says Guzman. “She has a good way of explaining things, too. She brought together all the information from the specialists and explained it to me. She makes things easier.” Notes from a Hospital Bed Teen Theater Troop Gives Voice to Patients’ Poetry in a Benefit Performance “I look out my window and what do I see? The birds, the bees and really tall trees. And beautiful butterflies fluttering in the breeze.” I It’s part of an ode to a beautiful summer day -- cheerful on the surface but spurred by the sadness of a seriously ill teenager spending her days and nights in the hospital instead of enjoying “Summer’s Beautiful Bounty,” as the poem is titled. For Arianna Salas, writing the poem in a poetry workshop at Maria Fareri Children’s Hospital at Westchester Medical Center was a release, a way to express her sadness at a time when her body was betraying her. But when she had the opportunity to see her poetry enacted in a benefit performance called “Notes from a Hospital Bed,” it took on a whole new dimension. “I felt as if the teen actors gave our numerous pains and sufferings a voice -- a voice that we were able to reach out to other people with, telling them, in a way, about our lives,” says Arianna. The theatrical performance combining acting, music, dance and video montage came together quickly after Angela Uzzo, a volunteer in the Child Life and Creative Arts Therapy Department at Maria Fareri Children’s Hospital, came upon a binder of collected poems written by patients. Dr. Dinabel Peralta-Reich Hospitalist programs have been growing in popularity since the concept was conceived in the mid-90s. Studies suggest that having hospitalists on staff can improve coordination of patient management, leading to better patient satisfaction and reduced lengths of stay, says Dr. Altman. For her part, Dr. Peralta-Reich says she enjoys hospital-based medicine: “I love inpatient care. I like working with children with a variety of diagnoses and helping parents during a very stressful time.” In addition, the pediatric hospitalists lead a team that includes sub specialists, residents, medical students, nurses and other healthcare professionals. “The hospitalist program is just another example of the continuing commitment of the leadership at Maria Fareri Children’s Hospital and Westchester Medical Center to providing leading edge, patient-centered, high-quality care,” says Dr. Altman. - Arianna Salas With permission from Child Life Therapist Jeannie Sweeney, whose Friday morning Poetry Corner generated the written works, Uzzo jumped into high gear. She contacted Trish’s Ribbon, a Katonah-based, not-for-profit organization dedicated to raising funds for worthwhile local groups, to host the event. And she also reached out to the Infinity Repertory Co., a teen theater troop housed in the Pulse Studio in Bedford Hills, to provide the talent to bring the poems to life. From there the project took on a life of its own. Trish’s Ribbon, which is run by Trish and John Burton, went all out organizing the event, which included a silent auction and receptions both before and after the show. The group also handled the bookkeeping and ultimately raised more than $100 per seat, although tickets were priced at just $75 each. Jennifer Dell, co-founder of Pulse Studio, donated the studio space for the performance, while Paul Perez, Executive Director of the Infinity Repertory Co. and co-founder of Pulse Studio, worked with the young actors to put the show together. Perez says he received a pile of poems in July and passed them on to the two teen directors of the troop, Maxine Builder, 16, of Armonk, and Kendall Collins, also 16, of Ridgefield, Conn. “The kids kept coming up with ideas of what the poems represented and how to carry them out,” Perez says. “They really wanted the audience to experience the emotions of the poets. And since the authors were teens, the actors felt very connected to them.” Members of the Infinity Repertory Co. performed an “unplugged” version of the show in the Children’s Hospital lobby. “I was so moved by the poetry,” Uzzo says. “I really felt that these poems had to be heard.” In September, the troop performed an “unplugged” version of the show in the lobby of Maria Fareri Children’s Hospital. And in October, they performed for a sold-out house at Pulse Studio, raising about $14,000 for the Child Life and Creative Arts Therapy Department at Maria Fareri Children’s Hospital. “Everyone has their own stories,” Sweeney says. “And I believe in stories. Seeing the kids’ poems on stage was the most incredibly moving experience of my life.” 15 donor spotlight A Big Help for Tiny Babies How One Generous Donor Has Made a Vital Difference in the Care of Newborns at Maria Fareri Children’s Hospital Indeed, the NICU at Maria Fareri Children’s Hospital at Westchester Medical Center is one of only 17 Level IV units -- the highest level -- in New York State, and the only one between New York City and Albany, says Dr. La Gamma. “We are a resource for all seven lower Hudson Valley counties and Fairfield County in Connecticut, which account for about 30,000 births a year,” he says. “Of those, about 700 babies a year need treatment at our NICU for premature birth, congenital anomalies, metabolic diseases, enzyme defects and the like.” Westchester Medical Center’s original neonatal unit, which opened about 25 years ago, had just 6,000 square feet of space. Thanks to the Kaplan donation, today’s more cheerful and hospitable unit, nearly four times as large at 22,500 square feet, has become a national model for how such facilities should be designed. “When other centers plan their NICUs, they come to see how this one is laid out,” says Dr. La Gamma. And what they see goes beyond what he calls “hard medicine.” According to Dr. La Gamma, “It’s also a place where babies are M Kaplan’s role as a donor to Maria Fareri Children’s Hospital has made a significant difference in the care given to sick babies in the Hudson Valley. “Naomi Kaplan is a perfect example of a leader within our community who recognized a need at Maria Fareri Children’s Hospital and so generously committed to making a donation that would change the lives of so many children,” says Janelle Hraiki, Executive Director of the Maria Fareri Children’s Hospital Foundation. “Not only is it important for us as a foundation to raise funds in support of our hospital and its programs to stay on the cutting edge of medicine, but it is also crucial that we show donors such as Mrs. Kaplan how their contribution has helped us maintain that status.” Donor Naomi Kaplan “cuddles” a baby girl in the NICU she helped build. Many people love babies, but few love them as Naomi Kaplan does. “Every Tuesday, you’ll see me at my local hospital holding the babies,” says Kaplan. She admits to being “over 80,” but she still makes the trip from her Larchmont home every week to take her post as a “cuddler”— a volunteer who holds infants in the Neonatal Intensive Care Unit (NICU) to add a special level of warmth available only by human touch. Kaplan’s involvement with the NICU at Maria Fareri Children’s Hospital at Westchester Medical Center began when the new unit was first proposed almost a decade ago. But her affinity for babies goes back much further. Born in Poland, she moved to Mexico with her parents at five years old, then to New York about 10 years later. She married Isaac in 1942, and he built a successful real estate company while she raised their five children. But Kaplan has done more than cuddle. She is the single biggest private benefactor to the NICU at Maria Fareri Children’s Hospital at Westchester Medical Center. When it opened in 2004, the Naomi and Isaac Kaplan Family NICU was named in honor of her and her late husband. Kaplan’s gift helped to create a facility with the latest equipment, warm lighting and colors, easy accessibility and a less stressful, more home-like environment for families dealing with seriously ill newborns. “I loved being a mother,” she says. “Those were the best years of my life.” “Her generosity was critical in getting this ICU built the way it is now,” says Edmund F. La Gamma, M.D., Chief of the Division of Newborn Medicine and Director of the Regional NICU. “Other than the National Institutes of Health, which fund much of our research, and the patients we serve, she has been the single largest contributor helping us build this unit in its current form. Without her, there would be no NICU.” 16 cared for so they can grow up to live happily every after.” He explains that human touch is crucial for babies to reach both physical and emotional developmental milestones. “Research proves that this ‘soft’ medicine is very important,” he says. “And Naomi is an especially warm person who has taken a keen interest in the need for personal touch in newborns.” After Isaac died in 1991, just shy of their 50th wedding anniversary, with her own children grown, Naomi “wanted to do something worthwhile,” she says. She contacted people she knew at her local hospital, Sound Shore Medical Center, part of Westchester Medical Center’s network of affiliated institutions. “I thought I could do something with children. So I went to the neonatal unit in New Rochelle, and Dr. Steve Piazza asked if I’d like to hold a baby. I said, ‘Oh, I’d love it!’ And that was it.” A few years later, she learned that Westchester was planning to build a new, state-of-the-art NICU at Maria Fareri Children’s Hospital that would serve the entire lower Hudson Valley and Fairfield County, Connecticut. “They said it would be one of a kind, and I wanted to help,” she says. Surrounded by the blue lighting used to treat jaundice in infants in the NICU, Dr. Edmund F. La Gamma, Director of the NICU, speaks with Mrs. Kaplan. 17 staff spotlight A Place to Belong Mary Delaney Builds a Home Away from Home for Families A As a missionary worker for Maryknoll in Nicaragua in the 1980s, Mary Delaney, now Director of Family Support and the FamilyResource Center at Maria Fareri Children’s Hospital at Westchester Medical Center, arranged for the medical care in the United States of an orphaned boy who needed spinal surgery. Because the U.S. did not have diplomatic relations with Nicaragua at that time, getting permission to bring the child to this country, Delaney says, required the intervention of former President Jimmy Carter. It also required that Delaney accompany the child and stay Mary Delaney with him throughout treatment. These days, it’s a lot easier for Delaney to help children and families in need – all she has to do is come to work. In her position in the Family Resource Center at Maria Fareri Children’s Hospital, Delaney hopes to strengthen and enhance the hospital’s commitment to family-centered care by increasing support services. multiple specialists, Delaney, along with members of the social work team, helps facilitate meetings between a child’s entire healthcare team and the family. One of the questions Dr. Allen Dozor andtime his research team “Having all the specialists sit down at one with a family answer: and answer questions can make it muchhope easiertofor parents to understand their child’s condition and treatment options,” she says. Could medication for acid refluxboard In addition, Delaney plans to create a family advisory help prevent to provide ongoing input on ways to improve the hospital asthma flare-ups? experience for patients and families. By having patients’ family members serve on an advisory board with a physician, nurse, social worker and Delaney, it will ensure that the needs of families, whether emotional, medical or practical, are kept in the forefront. Perfect for the Job The oldest of four children growing up in Jersey City, N.J., Delaney went to Boston College where she earned a degree in special education. For the next several years, she put her training to use with children in need, teaching severely disabled children at St. Joseph’s School for the Blind in her hometown, teaching remedial students in the Bahamas and teaching orphans in Nicaragua during a time of war. “It is a dream come true for me to be able to develop programs and help families who are going through a very stressful period in their lives,” says Delaney, who is fluent in both English and Spanish. A Comfortable Yet Practical Escape For example, Delaney has established both English-speaking and Spanish-speaking support groups for families with children in the hospital. “The support groups bring together families in similar circumstances,” says Delaney. “But any group that brings parents together to talk about their fears and frustrations is helpful.” Because many of the children cared for at Maria Fareri Children’s Hospital at Westchester Medical Center require the services of 18 Time to Get Your Head in the Game F For most parents, the term concussion conjures up images of a child knocked unconscious while playing sports – a football player getting tackled, a hockey player hitting the glass or a soccer player butting heads with another child. While contact sports are a major cause of concussions, this type of head injury also can occur when a child tumbles off a bicycle or a toddler missteps and falls. Concussions can even occur when an infant or young child is handled too roughly by a caregiver. Regardless of the cause, concussions are not to be taken lightly. “A concussion is defined as a temporary disturbance of brain function,” says Michael Tobias, M.D., Co-Chief of Pediatric Neurosurgery, along with Avinash Mohan, M.D., at Maria Fareri Children’s Hospital at Westchester Medical Center. “Not all concussions cause a loss of consciousness.” A parent should suspect a concussion if a child seems confused or dazed, has a staring spell or memory problems, seems unfocused or very emotional, complains of a severe headache, vomits repeatedly or can’t walk properly following a blow to the head. If any of these symptoms occur, you should call your pediatrician immediately or take the child to the emergency room. bottom of stairs, place a self-latching lock on basement doors and cover or soften table edges. Make sure your baby or toddler has a safe place to play and never leave a young child unsupervised. For older children, the best prevention is the consistent and appropriate use of helmets. Children should wear helmets when bicycling, roller skating, skateboarding, skiing, snowboarding or when playing contact sports like football. In fact, Dr.Tobias says, studies have shown that 80 percent of head injuries sustained from bicycle accidents could be prevented with helmet use. “As a pediatric neurosurgeon, I don’t meet kids who use helmets,” says Dr.Tobias. “I meet kids who don’t use helmets or who didn’t use one on the day an accident occurred. Supervision and education are the keys to preventing head injuries.” Most children recover from a concussion with no lasting health problems, provided they follow certain precautions, says Dr. Tobias. But children with an undiagnosed concussion may be at risk for long-term complications like learning difficulties, headaches or even worse outcomes. “When you have a concussion, the brain revs up and remains in a hyper metabolic state for seven to 10 days,” says Dr. Tobias. “During this time, the brain is more vulnerable to secondary injury. As a result, we want to be sure that the brain has healed before returning a child to sports and other normal activities.” Located on the first floor of Maria Fareri Children’s Hospital at Westchester Medical Center, the Family Resource Center looks like an oversized family room with comfortable sofas, tables and chairs, a fireplace, shelves full of children’s books, and five computers for family use. “It is an escape for families who are spending most of their time at the bedside,” says Delaney. Kids and Concussions feature article Mary Delaney counsels a family in the Family Resource Center. After six years in Nicaragua, Delaney returned home to the United States and obtained her master’s degree in social work. As a social worker, she has served breast cancer and AIDS patients at a New York City hospital and burn and trauma patients at Westchester Medical Center. “Everything I have done up to this point has helped prepare me for my position here,” Delaney says. “I am thrilled to be putting my experience to such good use.” A concussion occurs when the brain, which is floating in cerebrospinal fluid in the head, strikes the inside of the skull. This happens when the head is moving and something causes it to stop suddenly. If a child falls down stairs and strikes his head, for example, the brain may be bruised and blood vessels may be torn. There are three grades of concussion: Grade one involves a brain disturbance with no loss of consciousness that lasts 15 minutes or less; grade two involves a brain disturbance with no loss of consciousness that lasts more than 15 minutes; and grade three involves a loss of consciousness for any length of time. Although most concussions heal on their own with rest, no parent wants a child to suffer a head injury. For infants and toddlers, the best prevention is childproofing your home. To prevent falls, for example, install safety gates at the top and Dr. Avinash Mohan (left) and Dr. Michael Tobias are Co-Chiefs of Pediatric Neurosurgery at Maria Fareri Children’s Hospital. 19 Non-Profit Org. U.S. Postage PAID Permit No. 9523 White Plains, NY Department of Marketing and Corporate Communications 110 Executive Offices Valhalla, NY 10595 www.WorldClassMedicine.com/MFCH Upcoming Events 100.7 WHUD Kids’ Fair Saturday, April 18 Now in its 14th year, the 100.7 WHUD Kids’ Fair, presented by Maria Fareri Children’s Hospital at Westchester Medical Center, is an event that unites thousands of families for a day of fun and learning at the Westchester County Center. In addition to the educational displays, games and interactive exhibits, the fair also features a live radio broadcast, other live entertainment and much more, for toddlers to pre-teens. Listen to 100.7 WHUD for more information or call the County Center at (914) 995-4050. Go the Distance Sunday, April 19 Join us for our “Go the Distance” Walk and Family Fun Day to raise funds for Maria Fareri Children’s Hospital at Westchester Medical Center. The 2008 event raised more than $500,000 and everyone who attended had a blast. For more information, visit www.WorldClassMedicine.com/walk or call (914) 493-2575. For more information on events benefiting Maria Fareri Children’s Hospital at Westchester Medical Center, contact Margie Ostrower, Director of Special Events, Maria Fareri Children’s Hospital Foundation, at (914) 493-5414 or [email protected] To learn more about giving opportunities, please contact the Maria Fareri Children’s Hospital Foundation at (914) 493-2575 or visit www.WorldClassMedicine.com/MFCH. Want to hear from us? Sign up for a free weekly children’s health-related email, called Advance Notice, at www.WorldClassMedicine.com/MFCH.