It's About Children - Spring 2005 Issue by East Tennessee Children's Hospital
Spring 2005Spring 2005
BBooaarrdd ooff DDiirreeccttoorrss
James S. Bush
Robert Madigan, M.D.
Robert M. Goodfriend
Lewis Harris, M.D.
Jeffory Jennings, M.D.
Donald E. Larmee, M.D.
J. Finbarr Saunders, Jr.
William F. Searle III
Bill Terry, M.D.
Lewis Harris, M.D.
Chief of Staff
David Nickels, M.D.
Vice Chief of Staff
Lise Christensen, M.D.
Chiefs of Services
John Buchheit, M.D.
Chief of Medicine
Alan Anderson, M.D.
Chief of Surgery
Vice President for Human Resources
Joe Childs, M.D.
Vice President for Medical Services
Vice President for Operations
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.
Director of Community Relations
Director of Development
“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
...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
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.
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
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-
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
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!
and Hunter Marcum
On The Cover-
Feliciah Turner is a patient of the
Children’s Hospital Diabetes Clinic.
Read her story on pages 4-6.
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
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
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.
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
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
"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.
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-
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
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
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."
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
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-
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
• 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.
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 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
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
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
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
• 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
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
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
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
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.
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
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
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
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
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-
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-
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
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
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
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.
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-
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.
Choosing a qualified personal representative
in your estate plans.
Join the ABC Club.
For more information,
call (865) 541-8441.
Please send the free brochure titled “Personal Records.”
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
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
• 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
• 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
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 firstname.lastname@example.org,
or Teresa Goddard, CFRE, Senior Development
Officer, at email@example.com. You may also
reach us by phone at (865) 541-8441.
ing your personal property – items such as
jewelry, home furnishings, autos, antiques,
• 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
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.
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
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."
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 firstname.lastname@example.org.
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.
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
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
Cutest Little Baby Face
Photos: March 5-6
Voting: March 18-19
Parade: March 19
Food City Family Race Night
Nancy Hayes Memorial
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
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-
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
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
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-
ing the third trimester of pregnancy and
the child’s first year when enamel (the
outermost protective portion of the tooth)
QQ:: When should parents begin to look
for primary teeth and start cleaning
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-
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.
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
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
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-
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
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-
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
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
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
• 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
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-
compiled by Seth Linkous,
Associate Director for Public Relations
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.
PA I D
Entertainer Michael McDonald
will perform "Center Stage" at the
13th annual benefit for Children’s
Hospital April 2 at the Knoxville
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’