just kids | spring 2015

JustKidsSpring 2015ChildrensOmaha.org

NEW CLINICSOphthalmology and ACHD 2

HEALTHY VALUESCook with Your Children 4

FUN IN THE SUNPick the Right Sunscreen 10

Meet Children’s Ambassadors p6

Your Online Source for Health InfoFor the latest information and news, support groups, events, patient stories, recipes and perspectives from our physicians, check out these online resources:

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JustKids is published by Children’s Hospital & Medical Center to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from a physician. © 2015. All rights reserved. Printed in U.S.A.

➍ Cook with Your Children to Instill Healthy Values

➎ Healthy Kohl’s Kids

➏ Ambassadors Represent Children’s Commitment to Quality Care

➑ Disciplining with Love

➒ Parenting U

➓ Fun in the Sun: Pick the Right Sunscreen

Children’s Pediatric Anesthesiologists Skillfully Manage Patient Pain

New CT Scanner

Contents

ChildrensOmaha.org JustKids Gary A. Perkins President and CEO Martin W. Beerman Vice President, Marketing

& Community Relations David G.J. Kaufman, MD Medical Advisor Dannee Schroeder Senior Editor

SeeinG iS BelievinG: eYe CliniC OFFerS COMPrehenSive CAre

Whether it’s treating disorders such as lazy eye and

congenital cataracts or dealing with eye injuries, patients

are benefiting from Children’s new Eye Clinic. Dedicated

to finding the latest and best treatments available for pediatric eye

care, the clinic is directed by Donny Suh, M.D., clinical service chief

of Ophthalmology with Children’s Specialty Physicians and associate

professor of the Truhlsen Eye Institute at the University of Nebraska

Medical Center (UNMC) College of Medicine.

Along with correcting and preserving eyesight, early detection and

examination can help indicate conditions affecting other areas of the

body, including the brain. Children’s new Eye Clinic offers expertise

for these more complex pediatric cases.

“Eye problems should be treated in a timely fashion,” Dr. Suh

says. “After a sensitive or critical period, many eye problems can

be irreversible and seriously affect a child’s development.”

In addition to Dr. Suh, Children’s ophthalmology service includes an

optometrist, the only practicing orthoptist in Nebraska, certified ophthalmic

technicians and a pediatric nurse. Besides the new clinic, a full-service

optical shop is now open in the Children’s Specialty Pediatric Center.

The fact that Children’s is the most comprehensive source of pediatric

care in the region instills a sense of pride and responsibility, Dr. Suh says.

“Many patients’ eye problems are the result of other conditions

that also require treatment at Children’s. To be able to receive the

multidisciplinary care they need all in one place is extremely

convenient for families,” Dr. Suh says. “Working together as we do

here creates better communication and collaboration, which enables

us to provide better care.”

For appointments at the Eye Clinic, call 800.833.3100.

CLINICS opENINg To MEET groWINg CoMMUNITY NEEd

2 To find a provider, call 1.800.833.3100

What’snew?CLINICS opENINg To MEET groWINg CoMMUNITY NEEd

ChilDren’S neW PArTnerShiP TreATS UniqUe heArT PATienTS

Children’s Hospital & Medical Center and the University

of Nebraska Medical Center (UNMC) have partnered to

launch the region’s only clinical service devoted to adult

congenital heart disease (ACHD). The ACHD Clinic – currently the

only accredited program in the region to include multiple physicians

with dedicated training in this subspecialty – focuses on

compassionately caring for heart patients as they transition

into adulthood.

Congenital heart disease is a condition present at birth. While once

considered to be a childhood condition, advances in medical and

surgical treatment have allowed congenital heart patients to live into

adulthood. In fact, there are now more adults than children living

with congenital heart disease. For this reason, experts from both

Children’s and UNMC are partnering to treat this growing and

complex patient population.

To provide the best and most innovative treatments, the ACHD

program offers a myriad of services, from non-invasive monitoring

to cardiac surgery and heart transplantation. While each situation is

unique, the services encompass every stage of care and include support

for adolescents and young adults as they transition to adult health care.

Adult Congenital Cardiologist and Electrophysiologist Shane Tsai,

M.D., serves as the medical director. Dr. Tsai is assistant professor of

Internal Medicine-Pediatrics, division of Cardiology at UNMC College

of Medicine. He is joined by Pediatric and Adult Cardiologist Jon

Cramer, M.D., assistant professor of Pediatrics at UNMC College of

Medicine; and Anji Yetman, M.D., director of Vascular Medicine,

Cardiology at Children’s and professor of Pediatrics & Internal

Medicine, UNMC College of Medicine.

The program’s physicians are pleased to advance this unique

collaboration, a logical progression of congenital heart care for

this region.

“Simply surviving these complex lesions is no longer the goal, it’s

the expectation,” says Program Director Shane Tsai, M.D. “We have

different interventions and surgeries we can perform, and we work

together as a group to decide what is best for each patient.”

For appointments with the Adult Congenital Heart disease program, call 800.833.3100.

Children’s Hospital & Medical Center has expanded its outpatient specialty clinics to better serve the needs of patients across the region.

ChildrensOmaha.org 3


healthy eating

Cook With Your Children to inStill heAlthY VAlueSif you feel like you’ve tried everything to help your children choose healthy meals and snacks rather than fried or fast food, here’s one more trick: invite them into the kitchen to cook with you.

A study published in Public Health Nutrition

found that learning to cook helps children eat

healthier. Researchers from the University of

Alberta who followed close to 4,000 fifth-

graders found those who most frequently

helped prepare and cook meals at home also

had the highest consumption of fruits and

vegetables. They also had a better ability to

choose and eat healthy foods.

Other benefits of cooking with your children

include giving them a real-life opportunity to

use their math skills and a chance to mutually

discuss the link between a healthy diet and a

healthy body. Cooking with your children also

is a perfect opportunity to pass on family and

ethnic traditions and customs.

“Involving children in grocery shopping and

meal preparation is a great way to promote

lifelong healthy eating habits,” says Rachel

McCann, M.D., a pediatrician with Children’s

Physicians. “Children are more likely to try

new foods if they have a hand in making the

meal. They will be proud to share their

accomplishment with the entire family.”

If thinking about a messy kitchen or safety

concerns give you pause about cooking with

your children, you can overcome these issues.

Use the following tips and tricks to make the

experience fun for you and your children.

1. Keep it SimpleUnless your son or daughter appears to be a

budding Julia Child or Iron Chef, it’s best to

keep the dishes you prepare together on the

simple side at first. Let your child begin with

easier jobs and work up to tasks and recipes

that are more difficult or complex.

Simple child-friendly recipes include salads,

yogurt sundaes, mini pizzas, healthy nachos

and decorated whole wheat bread made with

prepared dough, chopped dried fruit and nuts

and sunflower seeds.

2. Keep it SafeAny time knives, hot ovens and cooktops are

involved, safety concerns need to be considered,

explained and enacted. Some to enforce include:

• Always have children wash their hands with

soap and water before preparing food and

after touching raw meat, poultry and fish.

• Closely supervise knife use and

demonstrate proper cutting techniques

before letting children cut anything on

their own. Teach children to cut away,

not toward, their fingers.

• Use one cutting board for meat and poultry

and another one for fresh produce.

• Defrost frozen meat in the refrigerator,

under cold running water or in the

microwave instead of on the countertop.

3. Keep it Age-AppropriateThe kitchen tasks your children can

accomplish depend on their skill, experience

and ability to follow directions. Some tasks

they may be able to perform at different grade

levels include:

Preschool • Retrieve ingredients from the

refrigerator or cupboards

• Stir batter

• Sprinkle grated cheese or carrots

Grades K–2 • Break eggs

• Cut soft foods with a table knife or scissors

• Mash and knead

• Measure

• Toss a salad

• Squeeze a lemon

• Tear lettuce leaves

• Use an apple peeler or egg separator

Grades 3–6 • Carefully cut vegetables

• Double or cut recipes in half

• Grate

• Sauté

Grades 7–12 Depending on their previous experience,

children in these grades are likely capable

of performing most preparation and

cooking tasks. Rachel McCann, M.D.Children’s Physicians


Learn More Online with Healthy Kohl’s Kids

Healthy Kohl’s Kids is a partnership between Children’s Hospital & Medical Center and Kohl’s department Stores focused on educating children and families on the importance of good nutrition and fitness. The program’s website, www.healthykohlskids.com, features up-to-date fitness and nutrition info and advice for children and parents. The site also has a library of healthy recipes with how-to videos of young chefs making nutritious meals and snacks.

Healthy Kohl’s Kids invites parents to engage via social media on Facebook, pinterest and Twitter (@HealthyKohlsKid). Share your own healthy recipes, activity ideas and fitness- and nutrition-related links, and receive updates about future Healthy Kohl’s Kids events.


success stories


Jack Strohmyer - OrthopedicsAfter going in for his 1-year wellness-check

with his primary care physician in Lincoln,

Nebraska, Jack Strohmyer was referred to the

Orthopedic Clinic at Children’s, where he was

diagnosed with infantile idiopathic scoliosis.

Jack spent the next nine months in a back cast

to treat his condition.

The Orthopedics Team at Children’s is the

largest and most comprehensive group in

the region, specializing in the diagnosis and

treatment of orthopedic conditions in all

children, infants through teens.

Having doctors with experience and training

in treating pediatric orthopedic conditions is

critical to the healing and health of your child.

Because children are still growing, treating

fractures and other orthopedic-related conditions

requires certain considerations and customized

treatments to ensure continued growth and a

successful outcome free of long-term problems.

Following his cast, Jack’s physician, Brian

Hasley, M.D., a pediatric orthopedic surgeon

at Children’s and associate professor of

Orthopedic Surgery at University of Nebraska

Medical Center, transitioned Jack to a brace in a

successful effort to avoid surgery to treat his back.

Jack is now brace-free and enjoying life. From

playing in the park to dancing and singing

along to Disney’s Frozen, Jack’s spine keeps up

with his energetic personality, so well in fact

that he only has to follow up with Dr. Hasley

every six months. And that’s the best fact, Jack!

GraceAnn robinson — Pulmonology Omaha native GraceAnn was just a year old

when she was diagnosed with persistent asthma.

While she has been fortunate enough to stay out

of the hospital for treatments, her family works

closely with Children’s pulmonology team to

keep her asthma under control.

“Asthma makes me cough, and I have to use

a machine,” GraceAnn says. Her treatment

includes using a nebulizer, a device that

Ella Cook is like most 6-year-old girls. Her imaginative personality keeps her busy; she loves her two cats and fills the family dinnertime with stories. Unlike most first graders, though, Ella has survived multiple surgical repairs to her heart. Pulling through each procedure with tenacity and endurance, this tiny titan has spent her young life battling hypoplastic left heart syndrome, a condition in which the heart’s left ventricle is underdeveloped.

Along with three other patients from Children’s Hospital & Medical Center, Ella serves as a Children’s ambassador. Each patient represents the four specialty areas in which Children’s received a national ranking by U.S. News & World Report’s Best Children’s Hospitals for 2014–15.

“This is our highest level of recognition to date. We believe it reflects our ongoing commitment to high-quality, subspecialty care that makes a difference in the lives of children and their families,” said Carl Gumbiner, M.D., senior vice president of medical affairs and Children’s chief medical officer.

Each of the four ambassadors was nominated by the physicians, nurses and health care professionals who care for them. They represent Children’s commitment to providing the best possible care to children.

AMBASSADOrS rePreSenT ChilDren’S COMMiTMenT TO qUAliTY CAre


administers medicine through a mist, every

morning. She also uses an inhaler before play

and exercise and takes medication at night.

Children’s Pulmonology Department is the

region’s largest and most comprehensive

center for the diagnosis, management and

treatment of respiratory, pulmonary, lung and

allergy conditions in children. It is the region’s

only accredited Cystic Fibrosis Center, which

is operated in conjunction with the University

of Nebraska Medical Center. It also is the only

outpatient clinic that provides full-service

diagnostic testing including exercise, food

and allergy challenge testing, as well as sweat

chloride measuring for cystic fibrosis.

GraceAnn’s specialist, Toni Blazeck, APRN-NP,

says the treatment has kept her asthma under

control. Still, temperature extremes keep her

inside and acid reflux can cause a flare-up.

Even though she’s just in second grade,

GraceAnn understands schoolwork is

important and loves to read. She also values

her family and enjoys playing with her baby

sister, who she can keep up with thanks to

the treatment she’s received at Children’s.

eduardo Parra — Gastroenterology & Gi SurgeryTwelve-year-old Eduardo Parra from Nickerson,

Nebraska is known for his energy and

enthusiasm on the soccer field and basketball

court. Despite a diagnosis at age 10 of

ulcerative colitis, a chronic disease of the

colon, Eduardo loves making people smile

with his positive attitude and inner strength.

Every two weeks, Eduardo visits his

physician, Pablo Palomo, M.D., a pediatric

gastroenterologist at Children’s to discuss

his symptom management. Children’s

Gastroenterology (GI) Department features

sub-specialty clinics unique to Nebraska,

including food and hypersensitivity disorders,

liver disease and inflammatory bowel disease.

Staffed with pediatric specialists, certified

pediatric nurse practitioners, nutrition

specialists and registered nurses, the GI

Department offers comprehensive diagnostic

procedures to aide in diagnosis and long-term

treatment plans for patients like Eduardo.

And that’s enough to keep him smiling.

ella Cook — Cardiology & heart SurgeryEven with one ventricle, Ella’s energy and activity

level are on par with any other first grader,

thanks to the level of care she’s received from

Children’s team. The cardiac program at

Children’s has all the elements in place to provide

world-class care, including extensively trained

and highly skilled cardiac surgeons, a dedicated

and experienced pediatric anesthesiology team,

experienced nurses and operating room team

and a passionate and knowledgeable team of

nurse practitioners and physician assistants.

There are no surgeries on the horizon,

but she follows up with Pediatric Cardiologist

Rob Spicer, M.D., every

nine months.

Ella’s spirit, as well as

the spirit and energy from

each ambassador, serves

as a good reminder of

Children’s commitment

to being the best place

for kids.

AMBASSADOrS rePreSenT ChilDren’S COMMiTMenT TO qUAliTY CAre

Find the Right pRovideR Selecting a provider who’s a good fit for your family is important. You—and your child—should feel comfortable with the provider. To find the right one for your family, call Children’s Find-A-Provider service at 1.800.833.3100 or visit ChildrensOmaha.org/findaprovider.

parenting

dISCIpLININg with LoVE

Balancing ‘Time out’ with ‘Time In’ for a Happy Household

No one said that raising a child is easy. In fact, it can often seem like

an epic battle of wills between parent and child. “Time out” is often

the intervention of choice for parents, but some parents find that, for

one reason or another, it is not working for them or their children.

Often forgotten, but vitally important, is the fact that the time kids

spend outside of “time out” is actually much more important than the

time spent in it.

Kids learn in all kinds of ways, so it is important to teach children

how you do want them to act as much as it is to teach them how you

don’t want them to act. Think of this concept as “time in” as opposed

to “time out.” Without “catching them being good,” you will probably

never achieve effective “time out.”


Upcoming parenting U SchedUleWith the arrival of a child, there are some things parents learn automatically. For other lessons, there’s Parenting U from Children’s Hospital & Medical Center, free classes given by professionals known for their knowledge of children to help you through some of a parent’s most challenging times. Space for each class is limited, so call 800.833.3100 or log onto ChildrensOmaha.org/ParentingU today to register for one or more of our upcoming educational sessions.

tuesday, March 24 at 6 p.m. Potty TrainingChildren’s Hospital & Medical Center, Glow Auditorium

tuesday, March 31 at 6 p.m. Healthy NutritionChildren’s Hospital & Medical Center, Glow Auditorium

Sunday, April 12 Baby Love Essentials Baby Fair• at 10:30 a.m Preparing for Your Newborn• at 11:30 a.m When to Call Your Pediatrician• at 12:30 p.m Surviving the Trying Twos• at 1:30 p.m Preparing for Your NewbornRamada Plaza Convention Center

tuesday, April 21 at 6 p.m. Everyday DisciplineChildren’s Hospital & Medical Center, Glow Auditorium

Time in: Praise a Good Behavior“Time in” means working hard to make sure the time you spend

with your child is enjoyable, engaging, responsive and nurturing.

Pay attention when you are with your child. When you see him or

her doing something you want to encourage, take a moment to

praise that behavior. This teaches your child what behaviors you

support and want to see more often. Engaging in rich, nurturing

experiences to encourage good behavior is called “time in.”

Try to be as specific as you can when giving praise, so your

child understands exactly what you liked. For instance, you might

say, “Good job sharing with your brother,” or “Thank you for

being patient while I finished my phone call.” Praise is even

more effective at reinforcing a behavior when you give it with

a smile or a gentle touch. A hug or high five works great, too.

And remember, the better you get at using time in, the more

effective time outs will be when needed. It isn’t always easy, but

in the long run disciplining your child with love will be worth it.

Time Out: Stop a Bad Behavior Once you’re utilizing good “time in” techniques, you can start

using time out effectively. Time out helps children learn which

actions you want to discourage. If they break a rule, they will

have to sit in time out. The goal of time out is to stop an action

or behavior that’s not allowed. Time out works best for children

ages 2 to 5.

Before implementing time out, choose the behaviors that will

cause your child to be sent to time out. Explain what those behaviors

are ahead of time so your child is aware. To make time out most

effective, limit it to a few behaviors. For example, you may decide

Ashley Harlow, Ph.D.Children’s Behavioral Health

to use time out when your child does not follow directions or acts

aggressively toward a sibling.

For time out, choose a dull spot with no distractions. Be sure it’s in

a place where you can still keep an eye on your child. Sending your

child to a bedroom or bathroom alone can be dangerous. It also can

be ineffective if your child stays entertained or has too much fun in

that space.

When using time out, tell your child what he or she did wrong.

Keep it short, limit eye contact and use as little emotion as you can.

Finally, set a time limit for time out. A good guideline is one

minute of time out for each year of the child’s age. So a 3-year-old

would get a three-minute time out. Set a timer so you know

when time out is over. When the time is up, allow your child

to return to play with no further discussion.

“When it comes to time out, parents are learning how to

discipline effectively just as children are learning how to behave

appropriately,” says Ashley Harlow, Ph.D., a psychologist with

Children’s Behavioral Health. “Time in and time out are tools, and

it takes practice – and sometimes a lot of mistakes – to learn to

use these tools skillfully.”


viTAMin D AnD The SUnBe wise about sun protection but don’t completely avoid the sun. Sunlight is a good source of vitamin d, which can help a child’s body absorb calcium and keep bones strong.

Children like being outside in the sun. But to

protect against skin cancer, painful burns and

even wrinkles, it’s important to use sunscreen

year-round. So how do you choose the right one?

The ABCs of SunscreenSunlight consists of two types of harmful

rays: ultraviolet A (UVA) rays and ultraviolet B

(UVB) rays. The UVB rays are the sun’s burning

rays and are the main cause of sunburn.

However, it’s important to be on guard against

UVA rays as well since this type penetrates

deeper into the skin and can suppress the

immune system. Excessive exposure to both

forms of UV rays can lead to the development

of skin cancer.

Begin your selection by choosing the right

sun protection factor (SPF). The higher the

number, the greater the protection. Experts

recommend an SPF of 30 or higher, regardless

of age, skin color or how long you’ll be in the

sun. To find sunscreen that protects against

damaging UVA rays as well, look for formulas

labeled “broad-spectrum.”

“The best time to avoid the sun during

the summer is from 10 a.m. to 4 p.m.,” said

Anthony Yaghmour, M.D., a pediatrician with

Children’s Physicians. “Outside of that time,

the sun is not damaging.”

Here are some other tips to help keep you

and your children protected from the sun’s

damaging rays:

• reapply after swimming. Brands marked

“water resistant” will last longer. Reapply

after swimming or sweating.

• Do not use a combination of bug spray and sunscreen. They are not truly as safe

and effective together.

• Think of the children. Children’s

formulas aren’t essential for little ones.

Always choose a broad-spectrum

sunscreen with an SPF of at least 30.

Children 6 months or younger should

be kept out of direct sunlight entirely,

if possible. Protect them with shade

or clothing. For infants over 6 months

of age and younger children, try a “no

tears” sunscreen.

• Check the ingredients. Vitamins C

and E and beta-carotene boost

sunscreen’s blocking powers.

Ingredients such as titanium dioxide,

zinc oxide and avobenzone ensure

you’re getting broad-spectrum coverage.

• Cream, stick or spray: it’s up to you. Certain forms can work better for some

skin types or body parts. For instance,

gels apply easier on hairy spots, while

creams soothe your face and dry skin.

• look to the pros. Bottles or tubes

with the American Academy of

Dermatology seal meet dermatologists’

recommendations for sun protection.

FUN IN THE SUN:Pick the Right Sunscreen

hAve A heAlTh qUeSTiOn?

If you have questions about children’s health topics, you’ll find a variety of information on our website. Visit ChildrensOmaha.org/HealthAndSafety.

Anthony Yaghmour, M.D.Children’s Physicians


iS YOUr ChilD COnneCTeD?

To learn more about our online health portal and better manage

your child’s health care, visit Childrensomaha.org/Connect

Undergoing surgery can be a scary prospect at any age, but it

can be especially frightening to children. As a parent, you also

may be anxious, worried and feel like you have more questions

than answers. This is where Children’s pediatric anesthesiologists

provide expertise.

Pediatric anesthesiologists play a key role in your child’s care.

They are responsible for managing pain and vital life functions,

like breathing, heart rate and blood pressure before, during and

after surgery. Because children are not small adults, they have

unique medical needs that require the knowing attention from our

pediatric anesthesiologists who treat these needs on a daily basis.

Children’s offers the region’s most comprehensive source

for pediatric anesthesiology. Our 20 board-certified pediatric

anesthesiologists are specially trained to take every precaution

to ensure the right amount of anesthesia is used for each child’s

unique circumstances, guaranteeing the safest and most

efficient care.

“Outcomes indicate that having specialized pediatric

anesthesiologists as part of the operating room team decreases

complications,” says Mohanad Shukry, M.D., Ph.D., chief of

Anesthesiology at Children’s.

“That makes our team at Children’s

a valuable resource for children

throughout the region.”

The experience and skills of trained

pediatric anesthesiologists can make a difference, whether

the child’s condition is extremely complex or considered routine,

Dr. Shukry says.

Specializing Sets Children’s ApartChildren’s provides the only pediatric cardiac anesthesiologists

within Nebraska who are specially trained to care for even the

most complicated cardiac surgical procedures, including heart

transplants. Outside of the operating room, Children’s team

provides services to patients who may need sedation to undergo

tests or procedures. An additional eight anesthesiologists are

experienced in treating post-operative pain.

“No matter the area of interest or specialty, we want

everything we do to be protocol-driven and focused on

patient care,” Dr. Shukry says.

pEdIATrIC ANESTHESIoLogISTS SKILLFULLY MANAgE pATIENT pAIN


Physicians use technology like CT scanners, X-rays and MRIs to

determine a child’s condition; however, these procedures can be

difficult to perform on younger children who have trouble

holding still. That’s why Children’s Hospital & Medical Center

has installed a new CT Flash Scanner in its Radiology

Department, which scans much faster so patients spend

less time on the scanner.

A CT scan produces multiple images of the inside of

the body and can be performed on newborns, infants

and older children. This new scanner elevates our

quality of care by reducing the need for children to be

sedated or hold their breath while their chest is being

examined. Ensuring safety and comfort, the scanner

operates at the lowest possible radiation dose, but its

flash technology can get a clear picture at any heart rate.

To minimize exposure to radiation, CT scans are

used only when absolutely necessary, such as in

trauma situations. When CT scans are required,

Children’s uses the minimal radiation dose possible,

carefully calculated based on the child’s age and weight

to decrease any long-term cancer risk. This scanner

upgrade is one more example of Children’s commitment

to providing the best care possible for children.

Non-Profit Org.U.S. Postage

PAIDChildren’s Hospital & Medical Center

8200 Dodge StreetOmaha, NE 68114402-955-5400

881MChildrensOmaha.org

TiP: When choosing health insurance, be sure to select a

plan that includes in-network (Tier 1) coverage for care provided by Children’s Hospital & Medical Center and its physicians.

Selecting a provider who’s a good fit for your family is important. You—and your child—should feel comfortable with the provider. To find the right one for your family, call Children’s Find-A-provider service at 1.800.833.3100 or visit Childrensomaha.org/findaprovider

FinD The riGhT

PrOviDer

NEW CT SCANNEr INCrEASES pATIENT CoMForT, CArE

just kids | spring 2015

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