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CHOC Now Serving Corona

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I was so lucky 50 years ago to have CHOC Children’s nearby when I fell DSC_0386out of that tree and hurt myself. Ever since, I’ve been a big fan and a grateful neighbor.

And now, my friends to the east are in luck: CHOC has expanded its medical services to Riverside County.

With the recent opening of the CHOC Children’s Health Center in Corona, children in Corona and surrounding areas will have access to quality pediatric specialty care much closer to home.

In this new, state-of-the-art facility, CHOC offers the following pediatric specialty care services in a convenient, family centered-care environment:

  • CardiologyDSC_0356
  • Pediatric Surgery
  • Pulmonology
  • Neurology
  • Endocrine
  • Diabetes
  • Gastroenterology
  • Rheumatology
  • Orthopaedics

Lucky for my fellow tree climbers, patients will also have access to X-ray services on select days, as well as diagnostic services.

CHOC Children’s Health Center in Corona is located at 854 Magnolia Ave. in Corona, CA 92879.

Hours are 8 a.m. to 5 p.m., Monday through Friday. For scheduling and authorizations, call 888-770-2462.

 

Almost 50 years ago, the good doctors, nurses and staff at CHOC Children’s took good care of me after an unfortunate tree-falling incident. I have been their biggest fan (and official mascot) ever since. This post is part of my 50 weeks of gratitude tour. Learn more at http://www.choc.org/thxCHOC.

The Importance of Play

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By Michelle L Wahlquist, M.S., CCC-SLP, The Center for Autism & Neurodevelopmental Disorders

If you’ve ever watched a speech therapy session, you probaimportance_of_playbly noticed a lot of play taking place. Well, there is a reason for that.

Play is the foundation to learning how to communicate and interact with others. From the moment an infant first discovers a rattle to when a child builds a fort and pretends to camp under the stars, they are developing their language, social and learning skills.

Through play, children learn new vocabulary and begin to understand new concepts. During play with adults, children learn to follow rules, negotiate, take turns, cooperate, solve problems and tell stories. Playing with toys allows children to develop their imaginations and to recognize and use symbols. Play is a powerful tool to support a child’s development.

What to play with kids

As a parent, sometimes the hardest part about playing with your child is figuring out what to play. Here are a few ideas to get started:

  • Observe – What are they playing with? How are they using toys? Knowing what your child enjoys is key.
  • Join– Sit down and follow their lead. Make comments about what you or your child is doing. For example, “My car is going to get gas” or “My dog is thirsty. He is drinking water.” Try not to ask too many questions like, “What are you doing?,” as it can interrupt the flow of the play.
  • Use books – Try recreating a story that you have read with your child. Take on the roles of characters or can use toys to become the characters.

Finding time for play

Parents have busy schedules and finding time to play can be challenging. Luckily, play can be done anywhere.

  • Play during routine activities – While folding laundry, have your child pretend the laundry basket is a delivery truck and send them on a mission. Give directions using words like first, after and then (e.g., “First deliver the towels, then deliver the pants.”). While cooking, have your child use the vegetable scraps to pretend they are “making soup.”  During bath time, place a rubber container in the bath and pretend it is an island. Have a toy fish dive under, jump on or swim around the island.
  • Car games – These are a fun way to develop a child’s language skills. Some games include 20 Questions, I Spy, riddles, rhyming games and sound games (e.g., “Tell me all the animals you can think of that start with the letter ‘S.’”).

Most importantly, remember that play should be an enjoyable experience for both children and parents. We learn best when we are relaxed and having fun!

Telemedicine

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child with computerWHAT IS TELEMEDICINE?
“Telemedicine encompasses a broad range of different applications,” says Dr. Knight, CHOC’s Pediatric Transport and Telemedicine expert. In a nutshell, telemedicine, also sometimes called telehealth, is the delivery of health care services using telecommunications or electronic technology. Telemedicine can involve video and audio equipment to assess a patient remotely, patient portals, remote monitoring of vital signs, the use of smartphones and tablets and remote medical education efforts. Telehealth also can include giving consumers medical and health information via the Internet or wireless devices, including access to online discussion or peer support groups.

CHOC AND TELEMEDICINE
CHOC has become a leader in telemedicine nationwide. “The way we utilize telemedicine at CHOC is to help assess and triage patients in settings outside of our own walls. Most hospitals do not have telemedicine capabilities that would allow a pediatric specialist to provide assessment and triage remotely,” explained Dr. Knight. “Our experts can assess patients in emergency departments at other hospitals with a mobile telemedicine unit called the RP-Xpress that the CHOC transport team takes with them into the field. The RP-Xpress works through Wi-Fi or a cellular signal and allows a specialist back at CHOC to evaluate the patient using both video and audio. That assessment happens sooner than if we had waited until the patient arrived at CHOC and it may determine if the patient needs intervention right away.”

FAST FACTS

  • Estimated number of Americans who benefited from telemedicine services in 2013, according to the American Telemedicine Association: 10 million
  • Annual number of patients transported to CHOC in each of the past three years: 4,000 – 4,200
  • Percent increase over the past five years in the number of patients transported to CHOC Annually: 30 %

View the full feature on Telemedicine

Dr. Gurpreet Ahuja

Dr. Jason M. Knight
CHOC Pediatric
Transport and
Telemedicine expert 

PHYSICIAN FOCUS: Dr. Jason M. Knight

Dr. Knight is the Medical Director of the CHOC Emergency Transport Services Program and an Assistant Clinical Professor at UC Irvine. He completed his residency training, including a year as chief resident, at Harbor-UCLA Medical Center. He completed a three-year fellowship program in pediatric critical care medicine at Harbor-UCLA Medical Center and CHOC Children’s. Under Dr. Knight’s leadership, the CHOC Transport team has become one of the busiest pediatric transport teams in the nation, able to pick up patients from 130 different hospitals throughout California. The transport team also arranges long distance and out-of-state transports via both rotor and fixed-wing aircraft.

Dr. Knight’s philosophy of care: “I believe all children deserve to receive world-class care at a children’s hospital. For many children that care begins with CHOC’s Emergency Transport Services Team. Our team is truly an extension of CHOC and the Pediatric Intensive Care Unit, and I take great pride in our team’s ability to assess, resuscitate and stabilize patients before they arrive at CHOC.”

EDUCATION:
Eastern Virginia Medical School, Norfolk, Virginia

BOARD CERTIFICATIONS:
Pediatric Critical Care

More about Dr. Knight | CHOC Children’s Transport Services

This article was featured in the Orange County Register on April 21, 2014, and was written by Amy Bentley.

Watch CHOC’s Telemedicine in Action

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Thanks to CHOC Children’s telemedicine efforts, physicians can remotely care for children from miles away, or even while a patient is riding in an ambulance.

In this video, Dr. Jason Knight, a critical care specialist and medical director of CHOC’s Emergency Transport Services, discusses how CHOC physicians and the transport team use telemedicine to improve care of children.

Watch for a demonstration of this remarkable technology that is advancing how CHOC physicians practice, and aiding CHOC’s ability to care for children beyond Orange County.

Tips for Minimizing Scars After Surgery

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torantoA scar evolves over the course of a year, providing a window of time in which to minimize its appearance, says Dr. Jason Toranto, a CHOC Children’s plastic surgeon and craniofacial specialist.

In this CHOC Radio segment, Dr. Toranto provides helpful tips, from massaging scars to applying ointments, for reducing the “footprint” of a child’s surgery.
Listen to the podcast to hear the advice he offers the parents of his patients.

To learn more about the plastic surgery program at CHOC, visit choc.org/plasticsurgery.

Find the direct link to the audio file here.

Play

Podcast: Play in new window | Download

A Bright Future: Amy’s and Emily’s story

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I’m more than half way through my 50-week CHOC gratitude tour, and I just met two others who want to join me in thanking the hospital for our bright futures: Meet Amy and Emily.

Sisters Amy and Emily believe they IMAGE_2have two birthdays: the days they were born, and the days they were diagnosed with cancer before beginning treatment at CHOC Children’s.

Each day is met with equal celebration. Amy and Emily, ages 29 and 18, see the anniversary or their diagnosis – their cancerversary – as the day they began the long road toward health.

“We think that’s the day of them starting to get better,” says their mother, Denise Justiniano. “We made that day a good memory. We eat dinner together as a family and make a fun time out of it.”

Both women received treatment as children at the Hyundai Cancer Institute at CHOC. Amy spent six months in the hospital after being diagnosed with lymphoma in 2001. Diagnosed with leukemia in 2008, Emily still receives treatment at CHOC’s outpatient infusion clinic.

And today both women are moving forward: Emily graduated from high school last June and is now in her second semester at college. About seven months ago, Amy gave birth to her second daughter.

“The nurses and doctors at CHOC are amazing,” Amy says. “Not only do they offer the best medical care, but they are empathetic and caring, and offer emotional support in a way that you would expect only a friend to. If it weren’t for CHOC, I wouldn’t be here today. They made a huge difference in my life and helped me become the person that I am today.”

Watching two children battle cancer was heart-wrenching, but Denise credits CHOC staff and fellow families and patients with helping to ease the experience.

“When we first arrived at CHOC with Amy, everyone came out of their room as we were coming down the hall,” she says. “They’re were talking to us, patting us on the back. It was like a warm hug.”

And their time at CHOC made an impression on more than Amy’s and Emily’s health: Amy is a nurse at a local hospital, and Emily is pursuing a career as a nurse practitioner.

“For us, it was the nurses who made CHOC home for us and made it manageable and joked with us,” Denise says.

And CHOC’s impression has extended further into the Justiniano family: Inspired by the CHOC child life staff who helped her sisters cope with hospitalization, a third daughter, Sarah, volunteers at CHOC and is pursuing a career in the child life department.

 

Almost 50 years ago, the good doctors, nurses and staff at CHOC Children’s took good care of me after an unfortunate tree-falling incident. I have been their biggest fan (and official mascot) ever since. This post is part of my 50 weeks of gratitude tour. Learn more at http://www.choc.org/thxCHOC.

“Eggs-citing” News, Recipes

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EggsBy Gina O’Toole, RD, MPH, CLEC, CHOC Children’s Clinical Nutrition and Lactation Services

Eggs take the spotlight this month as Easter approaches, but the question remains: Should we consume them at all?

The answer is a resounding yes! Though previously shunned, eggs now have the green light for eating. Though the cholesterol content of eggs was previously thought to increase the risk of heart disease, we now know that eating a diet high in saturated fats and trans-fats (hydrogenated oils) increases the risk of heart disease more so than eating cholesterol itself.

The most recent recommendation in 2010 from the American Heart Association allows 300mg per day of cholesterol. One large egg contains 213mg, about 2/3 of the recommended daily value.

The facts about eggs:

  • Eggs are an excellent source of protein, providing 7 grams of high quality protein.
  • Eggs contain just 75 calories each.
  • Eggs have 5 grams of fat (1.6 grams saturated fat).
  • They are a great source of the antioxidants lutein and zeaxanthin, both important carotenoids that reduce the risk of macular degeneration.
  • Choline is a key nutrient in eggs that is important for brain development and memory.

So-called “designer eggs” may contain omega-3 fats. To make these eggs, chickens are fed omega-3 fatty acids which the chickens then further covert into DHA. DHA is a fatty acid important for brain and eye development in babies and children. Moms who eat DHA transfer that DHA to the baby through their breast milk. DHA also plays an important role to help prevent cardiovascular disease.

So go ahead and enjoy eggs this Easter and beyond. Try using your hard-boiled eggs with these delicious recipes:

Herbed Deviled Eggs

8 large hard-boiled eggs

½ non-fat Greek yogurt

1 teaspoon grainy Dijon mustard

1 ½ teaspoon sherry vinegar

1 teaspoon chopped of each: fresh flat-leaf parsley, fresh thyme, fresh chives

Peel eggs and halve lengthwise. Reserve four of the egg-white halves for another use. Pass yolks through sieve using the back of a spoon. Stir in yogurt, mustard and vinegar. Salt and pepper to taste. Sir in herbs.

Either spoon or put yolk mixture in pastry bag to pipe into egg white halves. Garnish with additional herbs

Curried Egg Salad Sandwich (Serves 4)

6 hard-boiled eggs, using four of the six yolks and dice

¼ cup non-fat Greek yogurt

1 medium celery stalk, diced

1 teaspoon Dijion mustard

¼ teaspoon curry powder

Salt and pepper to taste

Mix previous seven ingredients. Spread on whole-grain bread. Top with radicchio and arugula

 

Kids and Tonsils

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Tonsils_300WHEN SHOULD TONSILS BE REMOVED?
Tonsils are removed much less frequently than in the past, but removal may be necessary under specific circumstances. “There are two predominant reasons for removing tonsils and/or adenoids in children,” says Dr. Ahuja, CHOC Children’s Specialists Division Chief of Otolaryngology. “The primary reason is obstruction, or difficulty breathing, sleep-disordered breathing or sleep apnea. The second reason is recurring infection. Tonsils may need to be removed if a child has seven tonsillar infections in one year, or five infections each year for two years, or three infections each year for three or more years, with the infections being accompanied by one or more of the following features: a fever of 1010F or above, a strep throat infection confirmed on a swab from the throat, white coating on the tonsils, large lymph nodes in the or mouth sores.” Surgical removal of the tonsils is called a tonsillectomy. Surgery should be considered only when necessary, but in appropriate situations, it can make a substantial difference in the quality of life.

SIGNS OF TROUBLE
There are many signs that the tonsils are causing a child enough trouble to warrant removing them, says Dr. Ahuja. A child who has trouble breathing, breathes often through the mouth, snores heavily, sleeps poorly, wakes up tired and fussy, exhibits behavior problems like hyperactivity or aggressive behavior, or is significantly underweight because he is having a hard time eating and breathing at the same time may be a candidate for a tonsillectomy, often with adenoidectomy, says Dr. Ahuja.

WHAT ARE TONSILS AND ADENOIDS ANYWAY?
The tonsils are part of the body’s immune system. Specifically, they are two oval-shaped masses of tissue in the back of the throat that trap germs that could enter the body’s airway and cause an infection. Tonsils also produce antibodies to fight infection. Sometimes, they get infected and swollen, and lead to a condition common in kids called tonsillitis. The adenoids are small pads of lymphoid tissue like tonsils, located in the upper portion of the throat, behind the nose. They serve a similar purpose as the tonsils. “The majority of the time if we are removing the tonsils for obstruction or blockage, we remove the tonsils and adenoids,” says Dr. Ahuja.

FAST FACTS

  • Age range of children most commonly affected by tonsillitis: 3 -7
  • Number of tonsillectomy procedures performed annually in children younger than 15 in the U.S.: 530,000+
  • Percent of healthy children who have tonsils and adenoids removed due to obstruction who will show a marked improvement. The success rate falls for obese children, or children with certain birth disorders: 80

    View the full feature on Kids and Tonsils

    Dr. Gurpreet Ahuja

    Dr. Gurpreet Ahuja
    CHOC Children’s Specialists Otolaryngology
    (Ear, Nose and Throat)

    PHYSICIAN FOCUS: DR. GURPREET AHUJA

    Dr. Ahuja is the CHOC Children’s Specialists’ Division Chief of Otolaryngology, and past president of the medical staff at CHOC. He is a Clinical Professor of Otolaryngology at the University of California, Irvine, and Director of Pediatric Otolaryngology training for UCI’s residency program in Otolaryngology. He completed his residency in Otolaryngology/Head and Neck Surgery at the Manhattan Eye, Ear, and Throat Hospital in New York, followed by a fellowship in Pediatric Otolaryngology at the Children’s National Medical Center in Washington, D.C. Dr. Ahuja specializes in pediatric airway reconstruction, pediatric sinus surgery, childhood hearing loss and congenital head and neck disorders. Dr. Ahuja is actively involved in the Orange County community, serving on the Board of Directors of the OC Human Relations Council.

    Dr. Ahuja’s philosophy of care: “My philosophy is to treat every child as I would have my own child treated. It’s
    very important for me to engage the parents in the care of their child and to have them on board with what I am
    recommending so we have a consistent approach to treatment. I always make it a point to follow the standard of care with up-to-date information about the child’s medical condition. I also consider it important to educate the parents about the child’s condition.”

    EDUCATION:
    All India Institute of Medical Sciences, New Delhi, India

    BOARD CERTIFICATIONS:
    Otolaryngology

    More about Dr. Ahuja | CHOC Children’s Pediatric Specialties Otolaryngology

    This article was featured in the Orange County Register on April 14, 2014, and was written by Amy Bentley.