It's About Children - Spring 2005 Issue by East Tennessee Children's Hospital

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It's About Children - Spring 2005 Issue by East Tennessee Children's Hospital

  1. 1. Spring 2005Spring 2005
  2. 2. BBooaarrdd ooff DDiirreeccttoorrss James S. Bush Chairman Robert Madigan, M.D. Vice Chairman Robert M. Goodfriend Secretary/Treasurer Michael Crabtree Dawn Ford Peyton Hairston Lewis Harris, M.D. Jeffory Jennings, M.D. Bob Koppel Donald E. Larmee, M.D. Dugan McLaughlin Alvin Nance Dennis Ragsdale J. Finbarr Saunders, Jr. William F. Searle III Bill Terry, M.D. Laurens Tullock Danni Varlan Medical Staff Lewis Harris, M.D. Chief of Staff David Nickels, M.D. Vice Chief of Staff Lise Christensen, M.D. Secretary Chiefs of Services John Buchheit, M.D. Chief of Medicine Alan Anderson, M.D. Chief of Surgery Administration Bob Koppel President Paul Bates Vice President for Human Resources Joe Childs, M.D. Vice President for Medical Services Rudy McKinley Vice President for Operations Jim Pruitt Vice President for Finance Laura Barnes, R.N., M.S.N., C.N.A.A.,B.C. Vice President for Patient Care A quarterly publication of East Tennessee Children’s Hospital, It’s About Children is designed to inform the East Tennessee community about the hospital and the patients we serve. Children’s Hospital is a private, independent, not-for-profit pediatric med- ical center that has served the East Tennessee region for more than 65 years and is certified by the state of Tennessee as a Comprehensive Regional Pediatric Center. Ellen Liston Director of Community Relations David Rule Director of Development Wendy Hames Editor Neil Crosby Cover/Contributing Photographer “Because Children are Special…” ...they deserve the best possible health care given in a positive, child/family-centered atmosphere of friendliness, cooperation, and support - regardless of race, religion, or ability to pay.” ...their medical needs are closely related to their emo- tional and informational needs; therefore, the total child must be considered in treating any illness or injury.” ...their health care requires family involvement, special understanding, special equipment, and specially trained personnel who recognize that children are not miniature adults.” ...their health care can best be provided by a facility with a well-trained medical and hospital staff whose only interests and concerns are with the total health and well-being of infants, children, and adolescents.” Statement of Philosophy East Tennessee Children’s Hospital www.etch.com 2 December 27, 2004 Dear Children’s Hospital, My son Tyler was having a severe asthma attack with no relief from his nebulizer treatments, and I ended up taking him to Children's Hospital's ER. The person at the front desk was very attentive and nice and was not rude at all. She got everything done; she checked us in, got us in the computer and took us straight back. Within less than a minute, they put Tyler on another nebulizer treatment and steroids. Everyone there was very professional and listened -- really listened -- to me. And what I like the most is everyone talked to Tyler, looked him in the eye and talked to him on his level. That, to me, speaks volumes. Because it's not me on the table, but my 6-year-old child who is very upset, can't breathe and is very scared. So, a huge thank you to Children’s Hospital. The new rooms were very nice and pleasing to the eye. One gets a calming effect coming through the ER. It makes you think you are underwater with the fish and all. My son is now much better and back to himself. Thank you very much. Tonya Cinnamon Knoxville October 6, 2004 Dear Children's Hospital, This message is a long time in coming, but we want to say a huge "thank you" to the Children's Hospital staff, nurses and doctors. In January 2004, our eight-year-old son had gone to his pedia- trician for a "routine" visit, only to be then transported by ambulance to Children's Hospital for an undiagnosed case of Type 1 diabetes. We were met in the emergency room by a wonderful group of caring and attentive nurses and doctors. We were in shock with his diagnosis and a bit overwhelmed with everything we were hearing, but they all listened and answered our questions. They did everything they could to keep both our children and us calm. They brought in food, drinks and video games -- anything that would make us com- fortable. Getting to our room, we were so taken care of. Anything we needed, we received. A parking pass was given to my hus- band so he and our other son could travel back and forth and not worry about parking fees. Our son was given video games to play and movies to watch to keep his mind occu- pied. One of the nurses had to come in at 2 in the morning to take Hunter's blood and couldn't get enough blood for the test. He went out and gave Hunter a break and came back in a little later to collect his blood. Just little things like thinking about how the children feel to be in a strange place with a dis- ease they know nothing about means so much. All of our questions were answered, and everyone there talked to our son like he was a "real" person. For the next two days, the training we received on taking care of him was wonderful. Every time they told us something, they asked Hunter to repeat what they had said. They wanted him to know that this was his disease and that his healthiness depended on him taking care of himself. During our stay they had to move us from a private room to another room, and they even put our son in a room with another child who had just been diagnosed with diabetes. It was so neat to see their interaction, talking about this disease they suddenly had in common. This was our first visit to Children's Hospital, and it will defi- nitely not be our last. We have told everyone we know how impressed we are with the service we received and also with the Diabetes Clinic. Dr. Mary Gwyn Roper, the nutritionist (Sarah Mathis), the nurses (Cheryl Dotherd, Cathy Van Ostrand, Bob Hunt, Anita Courtney and Sara Norton) and everyone else there is wonderful! We have never had a doctor who cares so much about her patients. We even get phone calls from the doctor -- not always a nurse. It's just one more thing that shows a genuine concern for the children. Thank you so much for the care that you give to children and their families! You are very much appreciated! Sincerely, Brian, Rebecca, Shay, Charley and Hunter Marcum Morristown “DearChildren’s”“DearChildren’s”1 On The Cover- Feliciah Turner is a patient of the Children’s Hospital Diabetes Clinic. Read her story on pages 4-6.
  3. 3. 3 Pediatric And Neonatal Conference Celebrates 25th Year Nurses and other pediatric and neonatal health care workers areinvited to join Children’s Hospital as we take "A Retro-Spective Lookinto the Future of Health Care" at this year’s 25th Pediatric and Neonatal Conference. Since 1978, Children’s Hospital has been providing the most up-to-date advancements in pediatrics at this conference. This quarter-centurymilestone will take a look at the advancements pediatric health carehas made as well as look at trends and knowledge being added to thepractice of pediatric health care. This conference draws on the combined expertise of national andlocal experts for a series of five keynote sessions and more than 20breakout sessions. The conference not only has a new location, theKnoxville Convention Center, but also has added evening sessionsdesigned just for office practices, additional vendors and exhibitors,and a recruitment party sponsored by Star 102.1 aboard the Star ofKnoxville Riverboat -- all of which is included in the registration fee.For more information about this year’s conference or to register,visit our Web site at www.etch.com/pnconf.cfm or call Children’s Hospital’s Education Department at (865) 541-8618. Auxiliary elects new officers, discusses new projects The Children’s Hospital Auxiliary installed new officers for 2005 at their meeting in January. Officers are President Kathy Payne, Vice President Donna Hoadley, Treasurer Jo Ann Hackler, Recording Secretary Ann Tipton and Corresponding Secretary Nancy Finley. At the meeting, the members of the Auxiliary presented a check for $40,000 to the hospital. These funds are the net proceeds from the Auxiliary’s Gift Shop sales and have been designated as follows: • $10,000 for a Welcome Guide for patient families • $10,000 for the Star 102.1 Radiothon • $5,000 for an oxygen concentrator for Children’s Hospital Home Health Care • $4,615 for a Capnocheck Sleep Capnograph for Neurology • $4,500 for notebooks for chronically ill children • $2,700 for a Med Cart for the Rehabilitation Center and Children’s Corner • $2,195 for digital scales for the Outpatient Clinics • $850 for a sleeper/recliner chair for Hematology/Oncology • $140 for the Meal Fund During the meeting, the Auxiliary discussed a major change in its pro- grams. Because of the new, expanded play areas on each patient floor and the upcoming installation of a closed-circuit digital television system in all patient rooms, the Auxiliary will no longer provide the toy and video carts. For more than 30 years, the toy carts have been available, and the video cart has been in service for more than 10 years. The carts were provided through fund-raisers the Auxiliary conducts throughout the year including plant sales, jewelry sales and the annual holiday greeting card sale. Special thanks from Children’s Hospital Children’s Hospital would like to extend its appreciation to Sam Franklin of Samuel Franklin Floral Design, Knoxville and Clinton, for graciously allowing us to shoot our Winter 2004 cover of It’s About Children magazine at his store in Clinton. Elizabeth Thomas, Director of Volunteer Services and Resources said, "The Auxiliary is now looking forward to embracing new areas in the hospital to support." The Auxiliary has donated its entire stock of toys, games, videos and DVDs to the Child Life Department . In the future, available funds will be used to provide children’s books and activities to the waiting areas of the Laboratory, Radiology and Neurology. The Auxiliary also will continue to provide chil- dren’s materials for the Admitting and Emergency Department waiting areas. For the first time, Auxiliary funds will provide for adult reading materials for the Critical Care waiting room on the fifth floor and books and activities for children and parents in the lobby of the Rehabilitation Center. Thomas said, "The importance of this new project is supporting literacy of children by providing quality reading materials and encouraging parents to read to their children." by Rupal Mehta, publications specialist New Auxiliary officers (left to right) Jo Ann Hackler, Kathy Payne, Ann Tipton, Donna Hoadley and Nancy Finley were inducted at the January 18 Auxiliary meeting. BulletinBoard V V V
  4. 4. 4 The signs were fairly typical – constant thirst, constant hunger but yet a small appetite, frequent need to go to the bathroom, weight loss and fatigue, final- ly a vision disturbance. But Feliciah Turner’s symptoms continued and pro- gressed for several months and included several doctor visits. "Finally it just became so apparent," said her mother, Teresa. "She was drink- ing enormous amount of water. We have a container of water we keep full. Normally I fill it up at the end of the day, and it's really cold the next day. I was filling it up two and three times a day, and this holds like a gallon of water. So finally we said, ‘Ok, how much water are you actually drinking?’" "And then she was just wiped out the moment she sat down," Teresa continued. “She was just exhausted. She would fall asleep within minutes of sitting down." Finally, right before she was diagnosed, "she looked at me and said, ‘Mommy, I can’t see anything.’ And I said, ‘What do you mean, you can’t see anything?’ She said, ‘Everything is so dark.’ And I got right in front of her and put my hands in her face. She said, ‘Never mind, I can see you now. But Mommy, everything got real dark.’" Following the advice of a relative who is a nurse, Feliciah was tested for dia- betes the following day. Based on the results, she was sent to Children’s Hospital for more comprehensive testing and to meet with a pediatric endocri- nologist, Carmen Tapiador, M.D. She was diagnosed with Type 1 diabetes (sometimes called juvenile diabetes or insulin-dependent diabetes) in April 2003 and was eight years old at the time. A resident of New Tazewell, Feliciah is the third of Jeff and Teresa Turner’s four daughters. "It's a pretty big blow when your fam- ily is stricken with a disease like that," Jeff said. "We didn't know exactly what we were in for. We heard ‘diabetes.’ But we didn't know what it was." They quickly learned. Cathy Van Ostrand, R.N., M.S.N., C.D.E., endocrinology clinical nurse specialist (educator) and Linda Hankins, M.S., R.D., L.D.N., C.D.E., clinical nutrition specialist and certified diabetes educator, spent two consecutive eight-hour days in a small conference room with Jeff and Teresa teaching them more than they ever wanted to know. "How to treat it, how to care for it, how to take care of the high, take care of the low, how to do the checks …" Jeff said. And they continue to learn. "She picks up new symptoms or new actions every day," Jeff continued. "It used to be tired and irritable when she's low; now it could be sweaty, shaky, nervous when she's low instead of the irritable. We’re still learning every day on this." Learning to give Feliciah her insulin shots, which she needs several times a day, was "traumatizing," according to Teresa. Jeff added, "That's hard to handle. You look at your little ones and realize you have to give them that shot every day to keep them alive." The Turners had always encouraged good eating habits and making healthy food choices for their daughters, so their transition to a healthy diet for Feliciah was not as difficult as it is for some fami- lies of newly diagnosed diabetics. Probably the biggest change was switch- ing to eating six small meals a day instead of three larger meals. The entire family eats that way now. Feliciah
  5. 5. 5 Besides modifying their own diets, Feliciah’s sisters have taken an active role in helping care for her. The oldest, Mariah, keeps an eye on her and helps with her checks, while Sierrah is the "dia- betic police," the one who asks, "Does Feliciah have her snacks? Does Feliciah have her insulin?" And then Dakotah is the "watcher" because she and Feliciah share a bedroom and therefore spend more time together. Because of Feliciah’s diagnosis, the Turners felt it was an absolute necessity for her school to have a nurse on hand full-time. But her school had neither a nurse nor any other diabetic students. Children with diabetes must be moni- tored very closely for "highs" and "lows" in their blood sugar, and the Turners put a great deal of effort into getting a nurse hired for the school, but there was a peri- od of time where Feliciah was in school without a nurse. So Teresa and Feliciah planned their own education session with Feliciah’s teachers. "Feliciah gets this idea of taking a stuffed banana," Teresa said. "You think your kids are eating healthy when they pick up an apple or an orange. Well, they're loaded full of carbs. They're healthy carbs, but nonetheless, a large banana is basically 30 carbs." Feliciah told her teachers she wanted them to inject the banana to learn how to correctly do an insulin injection, and they were more than willing to try. When one hesitated, Feliciah gently prodded, "If it kept me alive, you can do it." Monitoring a child’s diabetes during the school day can be a challenge. “It was a learning environment for all of us" at the school, said Jeanine Sweet, the school nurse. "I was used to taking care of adults with diabetes in the hospital setting. In school, we have to count carbs, make sure teachers are aware that the children need to come to the nurse’s office when they’re feeling low or high, or they have many bathroom breaks." Feliciah recently switched to an insulin pump, a method of delivering insulin that is more flexible and consis- tent and offer patients a great deal of freedom. When she made the switch, her school nurse attended an in-service program about the pump. She said she truly felt the hospital staff wanted her to learn and understand the pump. Families with diabetic children become regular patients at Children’s Hospital, usually through the Diabetes Outpatient Clinic. Feliciah visits the clin- ic once every three months. The clinic staff members are "all family now," Jeff said. "The reason is we can't do it with- out them." Teresa added, "They're very close to Feliciah, and she's very close to them." Feliciah and Teresa have had the opportunity to be at Camp Cure, the Children’s Hospital diabetes camp. Camp Cure is designed like most tradi- tional summer camps, with crafts, swim- ming and other fun. But campers also have daily educational sessions to learn more about their disease and how to manage it on their own. They also bene- fit from the interaction with other chil- dren living with the disease. Thanks to significant funding assistance from WATE-TV Channel 6, campers can attend Camp Cure for a very small regis- tration fee each year. Camp Cure is, according to Teresa, "One of the most crucial parts of our year." While the benefits to the children are obvious, the benefits to the parents may not be so obvious, but Teresa called Camp Cure a healing environment for the parents, too: "A lot of us say this is for the parents as much as it is for the kids because we get there, and we’re working together and seeing all these little children lined up and getting their finger sticks. We like to see our kids doing things together. They don't feel abnormal. They feel nor- mal, and that's what you want for your life. You want to feel normal. You want to fit in. You want to be part of the whole picture," she continued. "And that's what Camp Cure does for us. It allows the kids to be who they are without trying to hide that they're getting a shot or trying to hide that they're sticking their finger." Children’s Hospital was not unfamiliar to the Turners before Feliciah’s diagnosis. Several of the girls had tubes placed in their ears and tonsils and adenoids removed. The family felt Children’s offered the best staffing for those needs of their daughters. Of the hospital, Jeff said, "There's no other place like it. They have been nothing but a blessing to us; they've been our rock since day one when she was diagnosed. The patients are treated as people, not lit- tle bitty kids. And that's cool." Feliciah does scrapbooking and jour- naling to tell her own story. She writes down many of her feelings and always wants them to be in her words, not her mother’s words. She wants people, espe- cially her peers, to know just what it’s like to be diabetic. "She wanted them to know how diffi- cult it is to go to a birthday party and to not have the cake, ice cream, chips and everything that is associated with a birth- day party," Teresa said. "She said, ‘Who wants to eat two potato chips, Mom?’ When you're supposed to eat a whole handful." Having to explain diabetes is some- thing the Turners wish Feliciah never had to deal with. "Our family tradition is when you go across a bridge, you hold your breath all the way across the bridge, and you close your eyes as tight as you can, and you make a wish," Teresa said. "And if you hold it until the end, then your wish will come true. It's a hard thing to swallow knowing that child never wishes for any- thing but a cure. And that's why I think it's so important for people to know Children's Hospital is pushing as hard as the parents are to, to get that wish and to have it to come true."
  6. 6. What is diabetes? Diabetes is a disorder of the pancreas, an organ located behind the stomach that plays a key role in the digestive and meta- bolic process. The pancreas produces hor- mones that enable the body to break down ("metabolize") foods and also enables the body to use the food for energy and growth. One of those hormones is insulin, which is typically produced shortly after a meal, when the amount of glucose (a simple sugar derived from food) in the blood increases. When an insufficient amount of insulin renders the body unable to use glu- cose in the blood stream, diabetes mellitus results. About one in 10 diabetics has Type 1 diabetes (commonly known as juvenile diabetes or insulin-dependent diabetes), like Feliciah, meaning they must take insulin through injection to control the dis- ease. Some adults and children who have Type 2 diabetes also need insulin injections to control their blood glucose, but others with Type 2 diabetes may be able to con- trol their disease without insulin injections through a carefully planned diet or with oral medicines. Neither form of the disease can be cured at this time. More than 100,000 children inAmerica are affected every day by Type 1 insulin- dependent diabetes. The Children’s Hospital Endocrinology Department is committed to the education and health of the more than 800 diabetic patients seen each year from throughout East Tennessee in the hospital’s Diabetes Clinic. The appearance of some or all of these symptoms may indicate an insulin defi- ciency in yourself or your child. Please seek medical treatment if the following symptoms appear: • Increased thirst • Increased urination (both in frequency and in volume) • Weight loss • Fatigue, nausea, vomiting • Vaginitis, skin infections, blurred vision, frequent bladder infections Patients who are diagnosed with dia- betes at Children's Hospital are usually admitted for a three- to four-day stay. During this time they are started on insulin therapy while they and their fami- ly undergo intensive education about the disease and how to maintain overall good health through nutrition and medication. After that initial admission, patients are followed several times each year through the Diabetes Outpatient Clinic, one of Children’s Hospital’s clinics for chronical- ly ill children who require regular care in an outpatient setting. Clinic visits streamline the health care process for diabetic patients by offering all the services they regularly need under one roof at one time. Children with diabetes who are in the care of Children's Hospital also enjoy the benefits of a team. In the team approach to diabetes care, patients see not only a pediatric endocrinologist but also a social worker, a dietitian and a diabetes nurse educator. Each of the team members plays a key role in ensuring the patient and his or her family understand and follow through with the treatment and nutritional needs of the child. 6 Feliciah and a fellow camper have fun playing a game during the 2004 Camp Cure. Feliciah and her sister Sierrah with Lori Tucker of WATE-TV 6 during the 2004 Hope-A-Thon. The event was on Feliciah’s ninth birthday. After getting over the initial shock of the diagnosis and learning how to treat the disease, parents often begin to look at the big picture and see the lifelong diffi- culties their children will face because of diabetes. The disease can lead to a num- ber of serious complications as the diabet- ic person ages. These complications can include periodontal (gum) disease; visual impairment and even blindness; serious foot problems; heart disease; kidney (renal) failure; and nerve damage. For these reasons, most parents of chil- dren with diabetes believe finding a cure is of tremendous importance. Agreat deal of research is underway, and although a cure is not yet here, improvements in diabetes care have arrived. The insulin pump is a relatively new method of delivering the insulin diabetic children need daily to stay well. The user-friendly pump eliminates the need for insulin injections and offers users more freedom and independence. Information recorded by the pump can be downloaded, enabling the child’s endocri- nologist to review the rate of insulin deliv- ery and learn a great deal about how the child is responding to treatment. To learn more about diabetes, visit the Web site of the Juvenile Diabetes Research Foundation at www.jdrf.org or the Web site of the American Diabetes Association at www.diabetes.org. Diabetes care at Children's Hospital Finding a cure
  7. 7. 7 Marymer P. Perales, M.D. B.S. (nursing) – Southern Adventist University, Collegedale, Tenn., 1994 M.D. – Loma Linda School of Medicine, Loma Linda, Calif., 1998 Residency (transitional year) -- Texas Tech University, El Paso, Texas, 1998-99; Residency (general pediatrics) -- Wesley Medical Center, Wichita, Kan., 1999-2002 Fellowship (pediatric forensic medicine) – Children’s Hospital, New Orleans, 2002-04 Family – a son, Jacob (15 months) Personal interests – spending time with her son, rollerblading, scrapbooking As a Pediatric Forensic Medicine specialist, Marymer Perales, M.D., is charged with determining whether or not a child has been abused. She considers it an important opportunity to help children. "They have no voice; they don’t even know they need one," she said. "What better population for me to try to help?" Dr. Perales began her forensics practice at Children's Hospital in September 2004, and she is one of three physicians who consults on cases of suspected child abuse at our pediatric medical center. Mary Campbell, M.D, directs the hos- pital’s Forensics Service. "My job is not just to prove there was abuse but also to prove there wasn’t" abuse in any given case, she said. "Cases like that are very fulfilling and are what I long for – to prove that it’s NOT abuse." The "suspicion" of abuse by a treating physician will result in consultation with the forensics specialist. A case might involve suspected sexual abuse, physical abuse or neglect, but the signs of apparent abuse can occasionally be signs of an underlying medical condition. In a suspected abuse case, Dr. Perales will examine the child, take a medical history and listen closely to the par- ent’s version of how the child’s injury occurred. "The difficulty with these cases is that the child often can’t talk for himself or herself," so the physician must rely on the parent’s version of the events leading to the injury, she said. If an infant arrives in the Emergency Department with a single broken bone, the physicians will look at the break’s appearance, because bones break in certain ways. Dr. Perales can determine if a broken bone’s appearance is consis- tent with the parent’s explanation of what happened. In rare cases, the child might have a medical condition such as osteogenesis imperfecta (OI), where the bones are more fragile. In many fields of medicine, technology has changed the way physicians work and has led to significant improvements in care. Technological advances such as DNA are of tremendous help in cases of suspected abuse, but Dr. Perales says that research studies are of even greater value to forensics specialists: "We need research to better prove what we know is true. It’s hard to break myths." There are many myths, particularly related to sexual abuse. Research has, for example, proven in recent years that boys are sexually abused at a rate similar to girls. This challenges a long-held assumption that girls were abused at higher rates. The fact that is now known is that girls are not any more likely to be abuse victims – they are just much more likely to report the abuse. When Dr. Perales must testify in court in an abuse case, she needs the research to support her conclusions to help convince a jury of a defendant’s guilt or innocence in a case. Many members of the jury might have heard a myth and believe it, so she must depend on research to refute that myth to the jury members. Born in Mexico to Puerto Rican parents, Dr. Perales moved with her family to the Nashville area when she was 4 years old. Growing up in Middle Tennessee, she had a love for and a special connection to children even when she was still a child herself. She was a nursery provider for her church and a frequent babysitter and truly enjoyed caring for children. When Dr. Perales entered medical school, an aunt who is an obstetrician/gynecologist suggested she consider pediatrics. "She said to me, ‘What better way to serve children than to be their doctor?’" Dr. Perales said. When she was in residency, Dr. Perales seemed to be the resident who was most comfortable dealing with the abuse cases that came through her hospital’s Emergency Department -- so much so that she eventually was assigned to those patients on a regular basis. This experience led her to the pursuit of a fellowship in Pediatric Forensic Medicine. Acquaintances will often ask Dr. Perales how she can make a career out of working with children in such difficult circumstances. Her culture and her faith help her through the hard times. "Children are so innocent and bring such a special quality of life to every experience," she said. "I am confident that if they die, they are going to heaven. "Abused children teach me about hope and forgiveness – they love the person who hurt them," she continued. After multiple moves throughout the educational process, Dr. Perales was ready to again be close to family in Tennessee, and an opportunity to practice Pediatric Forensic Medicine as well as to work as a hospitalist in Children's Hospital’s inpatient service proved to be a good fit. Pediatric hospitalists are physicians who exclusively devote their practice to caring for hospitalized children with any diagnosis. In this role, Dr. Perales sees sick and injured patients on the inpatient floors at Children's Hospital and directs their treatment plans during their hospitalizations. Children's Hospital welcomes Dr. Perales to our facility and looks forward to working with her as we continue our efforts to provide the best health care to the children of this region. Physician provides a voice to abused children Subspecialist Profile
  8. 8. 8 In the past two years, Children’s Hospital has undergone many changes and renovations. Construction at the cor- ner of Clinch Avenue and 20th Street has transformed a parking lot into a seven- story addition to the hospital. • In October, the telephone system was updated to accommodate the need for additional patient room phone num- bers. All patient rooms are now called by dialing (865) 246-7 and the room number. • In early November, new areas on the second, third and fourth floors opened, featuring patient rooms with full baths, expanded play areas and new fea- tures for patients and families. • The Pediatric Intensive Care Unit (PICU) opened its new area in November. The former PICU area is being renovated for the expansion of the Neonatal Intensive Care Unit. • In December, the new surgery recovery room on the sixth floor was opened. The family waiting room and endoscopy suite on the surgery floor opened at the end of January. • A $75,000 donation from the Children’s Hospital Auxiliary, their largest single contribution ever made to the hospital, provided for a closed-circuit digital television system to replace the video cart that provided VHS movies for patients. The new system is being installed in each room, and each room will feature a TV/DVD combo. In the upcoming months, Children’s Hospital continues the renovation and completion of other areas of the hospital. • The cafeteria seating and kitchen areas are in the middle of renovations. The new, larger seating area opened in February, and the former cafeteria and seating area is now closed for renova- tions. The former cafeteria space will become additional servery and office space. The new servery area, projected for completion in May, will have a differ- ent food service layout and more food and beverage options. • The critical patient side of the emer- gency department will open in part of the former ED area in May. • In May, the Radiology department will expand into another area of the for- mer ED space. • Renovation of existing areas of the second and third floors will be completed in April. • After May, outpatient surgery and first floor renovations will begin. • When the entire project is complete, the hospital will feature 95 private inpa- tient rooms with full baths, and the num- ber of beds in the hospital will increase from 122 to 152. by Rupal Mehta, Publications Specialist Hospital renovations continue
  9. 9. 9 Children’sNews... New officers of the Children’s Hospital Medical/Dental Staff took office on January 1, following elections last fall. Officers are elected for a two-year term, continuing through the end of 2007. Lewis Harris, M.D., who most recent- ly served as Vice Chief of Staff, is the new Chief of Staff. Harris, pediatric neu- rosurgeon in practice with Neurosurgical Associates, joined the hospital’s medical staff in 1995. Dr. Harris is responsible for a variety of tasks, including serving as a standing member of the Children’s Hospital Board of Directors; enforcing Medical Staff bylaws, rules and regula- tions; reporting to the hospital’s Board of Directors on the performance and main- tenance of quality of the Medical Staff’s provision of medical care; receiving and interpreting the policies of the board to the Medical Staff; and representing the views, policies and needs of the Medical Staff to the board. The new Vice Chief of Staff is David Nickels, M.D., pediatric endocrinologist. He also joined the hospital’s medical staff in 1995. The Vice Chief of Staff is responsible for assuming the Chief of Staff’s duties in his absence and also attends meetings of the Board of Directors in preparation of assuming responsibilities of Chief of Staff in 2007. The other 2005-06 Medical/Dental Staff officers are: Secretary, Lise Christensen, M.D.; Chief of Medicine, John Buchheit, M.D.; Chief of Surgery, Alan Anderson, M.D.; Members-at-large to the Executive Committee of the Medical Staff, from the Department of Medicine, Lori Patterson, M.D., and from the Department of Surgery, Mark Cramolini, M.D. In addition to the new Medical Staff officers, Children’s Hospital is pleased to welcome the expertise of the following new medical staff members who have joined our staff in recent months: Javier Amadeo, M.D., neurosurgery; Cathryn Angel, M.D., pediatrics and neonatology; Stephen Beasley, M.D., pediatrics and emergency medicine; Yvonne Bremer, M.D., pediatric cardiology; Kevin Carl Brinkmann, M.D., pediatrics and critical care; Marla Brumit, M.D., pathology; Kelly Butler, M.D., pediatrics and emer- gency medicine; William T. Cain, M.D., allergy and immunology; Heather K. Cash, M.D., pediatrics; Christopher M. the election affirms your colleagues’ recognition of your service to both them and medicine in general." The Board of Governors was estab- lished in 1987 to identify state legislative, socioeconomic and public relations issues confronting otolaryngologists and the specialty and to respond to them. They also are the representative board on the academy, working closely with gov- ernment, insurance, pharmaceuticals, other health care industries and other groups that impact the profession. Dr. Brown’s goals in his new position are to work with the academy member- ship toward implementing physician- controlled electronic medical records (EMR), which will provide immediate feedback to practicing doctors as to the current recommendations and treatment plans. He also plans to encourage contin- uing medical education about EMR for doctors. Dr. Brown has been on staff at Dr. Leonard Brown, M.D., has been elected Chairman of the Board of Governors of the American Academy of Otolaryngology–Head and Neck Surgery. He is currently serving as the chair-elect, and he will assume the offi- cial chair position in September 2005. The elected position is a three-year commitment as chair-elect, chair and post-chair. Dr. Brown has been on the Board of Governors for the past eight years, and he has been on the executive committee for the past three years. The Board of Governors includes the representative members of the governing body of the academy. The academy is a network of several thousand members, primarily community practitioners from Otolaryngology–Head and Neck Surgery societies from throughout the United States and Canada. "To be elected Chairman of the Board of Governors is a great honor," Dr. Brown said. "It is a coveted position, and Frost, M.D., pediatrics and internal medi- cine; Garth Graham, M.D., radiology; Richard Greene, M.D., pediatrics and genetics; David E. Hill, M.D., pediatric urology; Anne Frances Howard, M.D., pediatrics and emergency medicine; Cecil B. Howard, M.D., pediatrics; John L. Howard, M.D., otolaryngology; Alfred Kennedy, M.D., pediatric surgery and critical care; James H. Mann, Jr., D.D.S, oral and max- illofacial surgery; Henry Lau, M.D., fami- ly practice; Garrett Lischer, M.D., urolo- gy; Heath A. Parker, D.O., pediatrics and emergency medicine; Marymer Perales, M.D., pediatrics and forensics; Russel Rhea, M.D., pediatrics; Allan Rosenbaum, M.D., otolaryngology; Calvin Schaerer, M.D., pediatrics; Charles Shanks, D.D.S., oral and maxillo- facial surgery; Alarice Tan-Jagueri, M.D., pediatrics; Heather Wight, M.D., pediatrics; Elizabeth Wirthwein, M.D., pediatrics, emergency medicine and endocrinology; and Joseph Wisniewski, M.D., pediatric allergy and immunology and internal medicine. by Amber Birdwell, student intern New Medical/Dental Staff officers installed, new physicians added to staff Children's Hospital for 13 years after moving to Knoxville from Memphis, where he had practiced at LeBonheur Children's Hospital and assisted in teach- ing a Pediatric Otolaryngology Fellowship. He has been practicing with Otolaryngology Head and Neck Surgery Associates and Farragut Ear, Nose and Throat since 1995. by Rupal Mehta, publications specialist Dr. Leonard Brown elected to national board Leonard Brown, M.D., visits with one of his patients, four-year-old Harrison Ogburn.
  10. 10. Children’sNews... 10 Each year, the Great Smoky Mountain Chapter of the Association of Fundraising Professionals presents the Philanthropy Day awards. In 2004, one of the major award winners was nomi- nated by and is a supporter of East Tennessee Children’s Hospital. The Wal-Mart Corporation was recog- nized with the 2004 Outstanding Corporate Philanthropist Award for its contributions to the Knoxville communi- ty. Wal-Mart Stores, Inc., believes that each of its discount stores, Supercenters, Neighborhood Markets, Sam’s Clubs and distribution centers should contribute to the well-being of the local community. In 2003, Wal-Mart contributed $196 mil- lion to the communities it serves nation- wide through a variety of local grants and programs. Wal-Mart is also the leading support- er of children’s health in the United States. The company raised and con- tributed $30 million to local children’s hospitals in 2003 through the Children’s Miracle Network and has contributed $290 million to local children’s hospitals since 1987. In East Tennessee, Wal-Mart and its employees have raised more than $2,814,000 for Children’s Hospital since 1988. In 2003, the 22 local Wal-Marts and two Sams Clubs raised $1,263,132 for their communities (in addition to what was raised for Children’s Hospital). by Kathryn DeNovo, student intern Wal-Mart associates and managers attended the 2004 Philanthropy Day awards program sponsored by the Great Smoky Mountain Chapter of the Association of Fundraising Professionals. The Wal-Mart Corporation was recognized with the 2004 Outstanding Corporate Philanthropist Award for its contributions to the Knoxville com- munity. Pictured are (left to right): front row: Dorothy Cain from Sam's Club 6572 at Knoxville Center; Charlotte Bates from Wal-Mart 578 in Sevierville; Tammy Gaddis from Wal-Mart 366 in Madisonville; Rochelle Chesney from Wal-Mart 2065 at Walker Springs; Tammy Kearney and Becky Gaut from Wal-Mart 685 in Morristown; and Renee Soloe from Wal-Mart 1466 in LaFollette; and back row, District Managers Bruce McKee and Allyn Hosman; Gary Qualls, Manager at Wal-Mart 2065 at Walker Springs; Scott McClain, Manager at Wal-Mart 1466 in LaFollette; and Scott Nickens, Manager from Wal-Mart 1318 at Clinton Highway. Local Children’s Hospital supporters honored Blue Cross/Blue Shield gives $500,000 gift to hospital Children’s Hospital had a lot of things to celebrate in December, including a gift of $500,000 from Blue Cross/Blue Shield of Tennessee. This gift will help Children’s expand its programs to address childhood obesity. The incidence of childhood obesity has grown by 30 percent since 1980. The latest national figures show that 13 per- cent of children and adolescents are seri- ously overweight. In Tennessee the issue is more serious, with 13.6 percent of chil- dren and 24.5 percent of adolescents seri- ously overweight. Obesity can aggra- vate other medical conditions and poses a danger into adulthood. "Blue Cross/Blue Shield has given us an opportunity through this gift to address this important issue in ways that we could only dream about before," said Laura Barnes, Vice President for Patient Care Services. Funds from this gift will enable Children’s Hospital to focus on obesity prevention and disease management. Prevention program funds will be used to develop printed educational materials for pediatricians and school nurses. These materials also will be available to the community through the Children’s Hospital Web site. These resources will encourage a healthy lifestyle to prevent obesity. The disease management component will help overweight and obese children get support to treat this potentially dan- gerous condition. This will include expansion of the hospital’s Healthy Kids Community Education Program, particu- larly the Making Healthy Choices class- es. The classes teach families how to make better food choices, develop a more active lifestyle, modify unhealthy behaviors and assess and meet their health and weight loss goals. Funds from this gift will also provide new equipment to help health care pro- fessionals better measure patients’ progress in meeting their weight loss goals and design individualized treat- ment plans when needed. "We are so grateful to have Blue Cross/Blue Shield as our partner in this critical effort," Barnes added. by Rupal Mehta, publications specialist
  11. 11. Children’s Hospital’s Web site now offers a safe and convenient way to make donations to the hospital. All donations made through the Web site at www.etch.com go to Children’s Hospital to directly benefit the children of this region. All donations are processed through a secure online server, and donations can be made by MasterCard or Visa. A receipt for the donation will appear on the com- puter screen at the end of the transaction, and a receipt also will be sent to the donor’s e-mail address. When making a donation at www.etch.com, donors have the option to be included in future e-mail correspondence from Children’s Hospital, or they may make their dona- tion anonymously. When a donation is made, individuals can designate which area of Children’s Hospital their money will benefit. Individuals, companies and organiza- tions can make donations. Donors also have the ability to "Tell A Friend" with a link that allows sharing information about making online dona- tions at www.etch.com with others via e- mail. To donate to Children’s Hospital, visit www.etch.com and click on "Make A Donation" on the home page. by Rupal Mehta, publications specialist Hospital Web site offers online donations option 11 20th Annual Fantasy of Trees a success For the 20th year, the Fantasy of Trees ushered in the holidays in East Tennessee with a festive event that delighted 53,238 visitors to the Knoxville Convention Center and benefited Children’s Hospital. Highlighting a theme of "Where Your Heart Finds Christmas," the show fea- tured a Fantasy Forest of trees and designer-decorated holiday items, contin- uous entertainment, children’s activities, decorating demonstrations, special events and holiday shops. The proceeds from this year’s 20th anniversary show -- estimated at more than $295,000 -- will benefit the Children’s Hospital Open Door Endowment Fund, which ensures medical care can be pro- vided to any child in need, regardless of their parents’ ability to pay for services. As always, the real stars of the 2004 Fantasy of Trees were the record number of volunteers -- 10,480! -- who donated more than 142,000 hours throughout last year to make the 2004 event such a suc- cess. Children’s Hospital extends many thanks to all volunteers and visitors to the 2004 show. The Fantasy of Trees has raised more than $3.6 million for Children’s Hospital since it began in 1985. by Kathryn DeNovo, student intern Upcoming Community Education Classes Making Healthy Choices Monday, March 14, 7 p.m. Thursday, April 14, 7:00 p.m. Location: Children’s Hospital Koppel Plaza Because food habits often are family-cen- tered, it is important to recognize unhealthy habits and take steps to correct them. A registered dietitian will discuss how to make appropriate healthy food choices, provide substitutes for foods that promote weight gain and suggest methods for increasing daily activity. This course is free. Safe Sitter Saturday, March 12, 9 a.m. to 3 p.m. Saturday, April 16, 9 a.m. to 3 p.m. Saturday, May 14, 9 a.m. to 3 p.m. Location: Children's Hospital Koppel Plaza Safe Sitter is a national organization that teaches young adolescents safe and nurtur- ing babysitting techniques and the rescue skills needed to respond appropriately to medical emergencies. Instructors are certi- fied through Safe Sitter nationally. Participants must be ages 11-14. This course is $18 per person. Infant and Child CPR Monday, March 14, 6:30 p.m. Monday, April 25, 6:30 p.m. Monday, May 23, 6:30 p.m. Monday, June 20, 6:30 p.m. Monday, July 18, 6:30 p.m. Location: Children's Hospital Koppel Plaza This class will teach caregivers cardiopul- monary resuscitation and choking maneuvers for children ages eight and younger. This class also gives general home safety advice and tips. This course is $18 per person. Class size is limited, so preregistration is required. For more information or to regis- ter for any of these classes or to receive our free Healthy Kids parenting newsletter, please call (865) 541-8262. Announcements about upcoming class- es can be seen on WBIR-TV 10 and heard on area radio stations. Or visit our Web site at www.etch.com and click on "Healthy Kids Education and News." Children’s Hospital’s Healthy Kids Campaign, sponsored by WBIR-TV Channel 10 and Chick-Fil-A, is a communi- ty education initiative of the hospital’s Community Relations Department to help parents keep their children healthy.
  12. 12. 12 Estate Planning... Choosing a qualified personal representative Include Children’s Hospital in your estate plans. Join the ABC Club. For more information, call (865) 541-8441. Please send the free brochure titled “Personal Records.” Name______________________________ Address__________________________________________ City___________________________ State_______ Zip_____________ Phone#(______)___________ Please call me at the above phone number for a free confidential consultation concerning planned giving. Please send me more information about deferred giving. I have already included Children’s Hospital in my estate plan in the following way: __________________________________________________________________________ Please send me information about the ABC Club. Children’s Hospital Development Office (865) 541-8441 You probably didn’t get up this morning thinking about going to see your lawyer and drawing a will. Drawing a will is usually something we put off until we simply can’t avoid it any longer. But why not start today? Our last article discussed the importance of preparing your will and the special role your lawyer plays in that process. We also reviewed the information you should take to your lawyer when drawing your will. One of your most important choices will be to appoint a qualified personal representative, or executor, if you prefer that term. This choice ranks in importance with choosing a guardian for your minor children, which will be the subject of our next article. Your personal representative is responsible for taking charge of your affairs after you are gone and can do only what the instructions in your will allow. Before taking any action, your personal representative must file your will with the appropriate court in your home coun- ty and obtain the documents needed to verify his or her status as your duly authorized repre- sentative. These documents are usually referred to as "letters testamentary," and your personal representative will need them to con- duct your business with banks, insurance com- panies and many others. Your will can allow or even require your personal representative to: • Make certain your minor children are safely in the custody of the people you have chosen as their guardian; • Make arrangements for management of money you have left to provide for your minor children; • Hire professionals such as a lawyer or an accountant to work on your estate. You can specify who these should be or leave it to the discretion of your personal representative; • Assume responsibility for gathering your assets including bank accounts, securities, con- tents of safe deposit box, home, furniture, autos and more; • Publish a notice to creditors and pay your remaining expenses; • Follow your instructions about distribut- You can place wording in your will that relieves your personal representative of the responsibility to file reports with the Probate Court. You should understand, however, that some states, including Tennessee, permit a ben- eficiary to request an accounting from your personal representative even if you excuse him or her from filing reports with the court. There is much less potential for conflict when the personal representative keeps a record of hours and the type of work done and submits it to the Probate Court for approval. An attorney or trust department can serve as your personal representative and can explain the fee schedule for their services. You will generally pay a larger fee with a corporate personal representative because you are hiring trained, experienced personnel to work on your estate. Choose your personal representative wisely. Speak with him or her about your wishes and expectations. Have your lawyer make your will and then relax in the knowledge that, by plan- ning properly, you have removed a potentially great burden from your loved ones. Get your free copy of our planning booklet, "Personal Financial Affairs Record," and fill in as much information as you can before visiting your lawyer. You will have a more thorough plan and will save time and money. Please send your name and address to us via the reply form below. Or you may e-mail David Rule, Director of Development, at dsrule@etch.com, or Teresa Goddard, CFRE, Senior Development Officer, at tgoddard@etch.com. You may also reach us by phone at (865) 541-8441. ing your personal property – items such as jewelry, home furnishings, autos, antiques, clothing, etc.; • Follow your instructions for distributing your real property – house, farm, vacation home, etc. Your lawyer can advise you about property that is held in joint names; • Pay your bequests to family members and friends as well as to Children’s Hospital and other favorite charities; • File reports with the court on progress in settling your estate, including a summary of income and assets received as well as expenses and bequests paid. • Honesty and integrity are two essential qualities in a personal representative. This person should be knowledgeable in busi- ness matters and in good enough health to be capable of conducting your business until it is completed. This can be your spouse or some other trusted family member or friend. If your spouse is not especially skillful in business matters, you could specify that your spouse and another trusted, business-savvy individual serve together. You should also select an alternate personal representative in case your first choice is unable or unwilling to serve. You should dis- cuss this in advance with the individuals you want to choose to make certain they are willing to accept this responsibility. Though this can be a sensitive subject, you would be wise to also discuss your views about reasonable hourly fees to pay your per- sonal representative for his or her services. Spouses rarely accept fees but will sometimes accept reimbursement for out-of-pocket expenses. Other relatives may choose to serve without pay, but you should not expect them to do so -- they are entitled to reasonable com- pensation for their time. We suggest you consult your lawyer for advice about an appropriate fee. Your personal representative will perform many types of work for you, and fees can vary according to the going rate for the type of work being done. If your personal representative chooses to mow the lawn before placing your house on the market, he or she should be paid the same as any other lawn care worker for those hours.
  13. 13. 13 Star 102.1 Radiothon Join Marc and Kim from the Star 102.1 morn- ing show at the West Town Mall amphithe- ater on March 3 and 4 for the fourth annual Radiothon. The duo will be on air both days from 6 a.m. to 6 p.m., and the event will fea- ture interviews with Children’s Hospital patients and their families. Listeners will be encouraged during the two-day radiothon to make personal pledges or to bid on silent auction items donated by Marriott Business Services to help support Children’s Hospital. The event also offers the community an opportunity to come to the broadcast area and meet the children and families who ben- efit from their generosity. Proceeds from the 2005 event will be used to purchase new medical equipment for Children’s Hospital, including a Transport Airborne isolette for the Neonatal Intensive Care Unit; pulse oximeters, wheelchairs and infusion pumps for Home Health Care; and Transtar stretch- ers and digital wheelchair scales for the Outpatient Clinics. Cutest Little Baby Face Contest Do you think you have the cutest baby in East Tennessee? The Sevierville Kiwanis Club is giving you the chance to prove it at the 15th annual Cutest Little Baby Face Contest. On March 5 from 9 a.m. to 6 p.m. and March 6 from noon to 5 p.m., children six years old and younger can be pho- tographed by Gary Woods Photography at Belz Factory Outlet Mall. Registration is $7 per child. Shoppers at Belz will then vote on March 18 and 19 for the child they think has "the cutest little baby face." TK’s Breakfast Join TK Townshend, his morning co-host Kristen Hammond and B97.5 on March 12 for a delicious breakfast, entertainment and silent auction benefiting Children’s Hospital. Local and national celebrities, including Jim Brickman, Anne Cochran and Jordan Hill, will provide entertainment for the event. The 10th annual event begins at 8:30 a.m. in the Knoxville Convention Center Ballroom and continues until 10:30 a.m. Tickets can be purchased at the door and are $10 for adults. Children 9 and under will be admitted free. Runners support Children’s Hospital Two University of Tennessee students will raise money for Children’s Hospital with every stride they take at the Knoxville Marathon on March 20. Scott Kaylor and Stephen Hauser are asking sponsors to pledge donations for every mile they run, and their goal is to raise $2,000. For sponsor- ship information, contact Scott at (615) 293- 8181 or by e-mail at tkaylor@utk.edu. Food City Family Race Night Meet some of your favorite NASCAR driv- ers at the Knoxville Civic Coliseum on March 30 from 5-9 p.m. There will also be fun family activities and free food compli- ments of Food City. Tickets can be pur- chased in advance for $4 at any Knoxville Food City or for $5 at the door. Children 12 and under are admitted free. Nancy Hayes Memorial Baseball Tournament Step up to the plate May 5-8 at the third annual Nancy Hayes Memorial Baseball Tournament. The event is sponsored by the Hayes family of New Market in memory of their daughter, Nancy Elizabeth Hayes. Teams must register by April 25. Supporters who wish to watch the games at Powell-Levi Park can purchase tickets for $5 per day or a weekend pass for $10. Children 12 and under will be admitted free. For more infor- mation about registration, contact Lenny Hayes at (865) 382-1133 or by e-mail at lhayes22@earthlink.net. Children’s Hospital Invitational Golf Tournament It’s time to tee up for the 22nd annual Children’s Hospital Golf Tournament to ben- efit the Oliver William Hill, Jr. M.D. Pediatric Neurology Laboratory. Opened in September 1983, the lab was the first pedi- atric neurology lab in Tennessee. The event is set for May 9 at Fox Den Country Club, with morning and afternoon shotgun starts. The rain date is May 16. For more information about any of these events, contact the Children's Hospital Development Office at (865) 541-8441. by Kathryn DeNovo, student intern U P C O M I N G E V E N T S T O B E N E F I T C H I L D R E N ’ S Mark your calendars now for several upcoming events to entertain families and benefit Children's Hospital. Thanks to the generous people of East Tennessee who host and participate in these events, Children's Hospital can continue to provide the best pediatric health care to the children of this region. DatestoRememberUpcoming events to benefit Children’s Hospital March Radiothon March 3-4 Cutest Little Baby Face Photos: March 5-6 Voting: March 18-19 Parade: March 19 TK’s Breakfast March 12 Food City Family Race Night March 30 May Nancy Hayes Memorial Baseball Tournament May 5-8 Children’s Hospital Invitational Golf Tournament May 9 (rain date is May 16) For more information about any of these events, call (865) 541-8441 or visit our Web site at www.etch.com and click on "Coming Attractions." Specialty license plates still available Are you looking for an easy way to support Children's Hospital? Consider purchasing a Children's Hospital specialty license plate. The Tennessee General Assembly approved a specialty plate in 2003 to benefit the hospital, and the colorful plates became available in early 2004. If you purchased one of the plates last year, we hope you’ll renew the plate when it comes due sometime this year. This is an easy way to help Children's Hospital on an ongo- ing basis. The plate is available continuously through each County Clerk’s office, and the cost of the plate is $35 in addition to each county’s renewal fee. Fifty percent of the rev- enue generated from the specialty plates directly benefits Children’s Hospital. If you have any questions about the spe- cialty Children's Hospital license plate, con- tact your local County Clerk's office or the hospital’s Development Department at (865) 541-8441. by Amber Birdwell, student intern
  14. 14. 14 At Children’s Hospital, hundreds of dental surgeries are performed each year, second only to tonsillec- tomies/adenoidectomies in the total number of procedures performed annually. Horace Blanton, D.D.S., Pediatric Dentist and member of the Medical Staff at Children’s Hospital, offers the following information on children’s dental health. QQ:: When do a child’s teeth begin to form? AA:: A baby’s primary teeth begin to form during the first trimester of pregnancy. By the time of birth, the crowns of the 20 primary teeth are almost completely formed, hidden beneath the gums. Mothers should optimize nutrition dur- LLooookkMMoomm,,nnoo ccaavviittiieess!! ing the third trimester of pregnancy and the child’s first year when enamel (the outermost protective portion of the tooth) is maturing. QQ:: When should parents begin to look for primary teeth and start cleaning them? AA:: Primary teeth usually begin to come in between the ages of eight and 12 months, with the incisors coming in first. Proper cleaning routines should be estab- lished immediately. Cleaning the child’s gum tissue with a soft washcloth or gauze can begin even before the first tooth comes in. Brushing should begin as the primary teeth start to come in, and the parent should assume major responsi- bility for cleaning teeth and gums for sev- eral years. QQ:: At what age should I begin taking my child to the dentist? AA:: Parents should be aware of children’s dental health at an early age by watching the development of their child’s teeth.
  15. 15. Children can always benefit from visiting the dentist, establishing good nutrition habits and beginning early dental hygiene. The American Academy of Pediatric Dentistry and Children’s Hospital suggest the first visit to the den- tist should be before an infant’s first birthday. At this time, oral hygiene infor- mation can be given to parents or care- givers, feeding practices such as bottle- or breastfeeding can be assessed, counseling for thumb sucking or pacifier habits can be provided, and assessment of the child’s risk for oral disease can be made. Routine six-month examinations and cleanings should begin around the age of 2 to 3 years for cavity prone children. QQ:: What is tooth decay and how can it be prevented? AA:: Dental caries (decay) is caused by acid resulting from the action of microorgan- isms in the mouth. These tiny organisms contain many forms of bacteria, some of which produce acid as they process car- bohydrates we eat. This acid breaks down the tooth’s enamel, which in time causes pits to form. The saliva in our mouths and fluoride found in toothpaste help re-mineralize or repair the enamel damaged by the acid. With proper brushing and flossing shortly after eating, it is possible to allow the repair process to happen with little damage to a child’s teeth. One of the single most effective things a parent can do to prevent smooth sur- face decay is to vigorously "scrub" the child’s gums, using a soft bristle brush. If your child’s gums bleed easily, this is a sure sign of a lack of adequate and daily care of the child’s teeth and gums, which permits plaque buildup and subsequent "white line" decay to begin. Your child may object to this vigorous brushing; but if it is performed daily, gums will rapidly shrink and toughen in 10 to 14 days. QQ:: Is there a certain diet that is better for my child’s teeth? AA:: Along with keeping teeth clean, par- ents should remember that good dietary habits are essential for a healthy smile. A diet with frequent carbohydrate con- 15 sumption greatly increases the likelihood of dental caries. The amount of time foods stay in contact with teeth is just as important as how often a child eats. An infant may only take a small bottle of juice to bed at night but that last sip before going to sleep may coat his/her teeth all night long. This particular event leads to "nursing bottle decay," one of the more serious dental problems seen in young children. It occurs in children who use a nursing bottle containing milk, juice or soda as a pacifier or who are breastfed on demand – specifically at times other than normal feedings and throughout the night. Nursing practices such as these should be strongly avoided and water encouraged for between meal drinking. QQ:: Are there guidelines to follow for using fluoride supplements? AA:: Consult a dentist or pediatrician about the appropriate dosage of fluoride for your child, depending on the level of fluoridated water in your home. By the time a child is 18 months old, parents can begin using a pea-sized amount of fluori- dated toothpaste on the child’s tooth- brush. Additional fluoride supplements such as fluoride-containing mouth rinses may be recommended by the child’s den- tist. Care must be given to not give too much fluoride; this will cause problems ranging from nausea and vomiting to a condition known as dental fluorosis, where teeth appear pitted and discolored. QQ:: What should I do if my child falls and breaks or knocks out a permanent front tooth? AA:: Remain calm and contact your pedi- atric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. If the tooth is broken or chipped, rinse the mouth with water and apply cold compresses to reduce swelling. If the tooth is completely knocked out, try to find the tooth. Hold it by the crown rather than the root and try to reinsert it in the socket. If that is not pos- sible, put the tooth in a glass of milk and take your child and the glass immediate- ly to your pediatric dentist. QQ:: Are there specific guidelines to follow for the overall dental health of children? AA:: The following are just a few tips for parents and caregivers to use in the den- tal health of children: • If breast-feeding, avoid "on- demand" feeding and feeding during the night. • Avoid bedtime bottles and the use of bottles as pacifiers. • Offer only water in a bottle given at naptime or nighttime. • Wean the baby from breast-feeding or the bottle by 12 months of age. • Avoid allowing a child to sip juice, milk, or soda continuously from a cup during the day. • Remember that medications may contain sugars and should be cleaned off teeth whenever possible. • Brush teeth and gums after each meal or snack. • When a toothbrush is introduced, it should be soft-bristled and small enough to fit comfortably in a child’s mouth. • Limit "gooey" sweets that stick in the pits of back teeth. • Care should be taken in the amount of fluoride ingestion. Because young children often swallow toothpaste, no more than a pea-sized amount should be dispensed onto the brush. • Children should be seen by a dentist prior to their first birthday to determine caries risk. Early examination and inter- vention with fluoride supplements, dietary changes, or other preventive measures can aid in the reduction of decay. With children, prevention is always better than a cure. Promoting good den- tal health even before a child gets that first tooth will ensure a lifetime of beauti- ful smiles. compiled by Seth Linkous, Associate Director for Public Relations
  16. 16. Children’s Hospital 2018 Clinch Ave. • P.O. Box 15010 Knoxville, Tennessee 37901-5010 We always try to stay current with friends of the hospital. If for any reason you should receive a duplicate issue, please notify the hospital at (865) 541-8257. NON-PROFIT ORGANIZATION U.S. POSTAGE PA I D PERMIT 433 KNOXVILLE, TN Entertainer Michael McDonald will perform "Center Stage" at the 13th annual benefit for Children’s Hospital April 2 at the Knoxville Convention Center. Perhaps best known as lead singer for the Doobie Brothers, McDonald began his singing career providing backup vocals on several Steely Dan albums. He influenced the Doobie Brothers to move to the jazz style for which they are famous. Some of their most popular hits include "What a Fool Believes" and "Taking it to the Streets." McDonald started a solo career in 1982 with the hit "I Keep Forgettin’ (Every Time You’re Near)." He released two solo albums and began to work with artists like Patty LaBelle; he also performed the theme song "Sweet Freedom" for the Billy Crystal/Gregory Hines comedy "Running Scared." With his distinctive vocal style, McDonald has regained popularity through two recent albums of popular Motown hits. The Center Stage benefit will begin at 6 p.m. with cocktails and hors d’oeuvres, followed by dinner and McDonald’s performance. The dance band Chameleon will perform following the concert. Underwriting support for Center Stage is provided by Goody’s, Clayton Homes, Pilot Corporation and LandAir. A special thanks goes to Bob and Wendy Goodfriend, who will serve as co-chairs for the 13th year. Benefactor and corporate tables are currently being reserved, and individual tickets may be avail- able if space allows for $350 per person. Call the Children's Hospital Development Department at (865) 541-8244 for table and ticket availability. Center Stage has raised $1.5 million for Children’s Hospital since its inception in 1993. by Amber Birdwell, student intern Michael McDonald to take ‘Center Stage’Michael McDonald to take ‘Center Stage’

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