All posts by CHOC Children's

The benefits of music therapy: Antonio’s story

A typically happy and energetic Antonio began to feel isolated during an extended hospitalization. His music therapist Rebekah helped him feel more social, while providing “normalized” experiences for Antonio and his family.

At CHOC, music therapy is just one of the specialized therapeutic programs offered through the Cherese Mari Laulhere Child Life Department.

When Antonio was a baby, he was diagnosed with an immune system disorder called chronic granulomatous disease (CGD), which meant his white blood cells couldn’t properly fight bacteria and infections. He got sick more than other kids and took twice-daily medications, plus injections three times per week. Antonio was 9 years old when doctors determined he was a good candidate for a bone marrow transplant, so that his body could learn to make infection-fighting blood cells. His infant brother was a perfect match and served as his donor.

After a bone marrow transplant, the immune system is very weak, and patients are typically kept in isolation with limited visitors and other precautions in place in order to protect their fragile health. Antonio spent about six weeks in isolation.

At first, he was skeptical of music therapy, but he came around quickly.

“When I first went to Antonio’s room, he was playing video games in bed. He didn’t look at me or respond to me, so I told him I would simply tell his mom who I was and what music therapy was about, and he could listen if he wanted to,” Rebekah said. “By the time I sang the second line of his favorite song, he transitioned from lying in bed to sitting up, smiling and singing along with me. His mom played along with an avocado shaker, his infant siblings were both shaking maracas. The feel of the room had been transformed”

Since hospitalizations also impact siblings and parents deeply, Rebekah strives to include families in music therapy sessions whenever she can. After their initial session, Antonio was eager to engage in any musical experience that Rebekah suggested.

“In the middle of a long hospitalizations, there would be days Antonio was in a funk and the only thing he wanted to do was play video games,” his mom Maria said. “But when Rebekah came to his room, he would immediately turn off his video games, smile, happily get out of bed, and interact with her.”

At first glance, music therapy might look like simply singing or playing instruments, but the evidence-based work of a board-certified music therapist supports a patient’s clinical goals. In the medical setting these goals may range from promoting symptom management, like pain or nausea; increasing emotional expression related to diagnosis and hospitalization; or normalizing the hospital environment and promoting typical developmental milestones.

Antonio and Rebekah have a jam session in Seacrest Studios.

Some of Antonio’s goals for music therapy included decreasing isolation, increasing engagement in preferred activities, and managing stress and anxiety. Children who remain engaged with their environment typically respond to stress in a more positive way. By creating songs about Antonio’s favorite foods and hobbies, he can focus on the healthy aspects of himself—a reminder that he is more than his diagnosis, treatment or hospitalization. These goals were established to counteract the potential negative impacts that a prolonged isolation and hospitalization can bring.

Sessions were filled with creativity, laughter and smiles – from Antonio, his siblings and his mom. Some days, he and Rebekah wrote songs about Antonio’s favorite things.  Other days they wrote about his mom or favorite nurses. During music therapy, Antonio also frequently created original music through playing ukulele, drums and guitar. Since young patients often don’t get to make many decisions, they worked in opportunities for Antonio to feel autonomous and “direct” the other band members (his siblings and mom).

“Music therapy cheered up my son while he was in isolation,” Maria said. “It makes me happy that CHOC has things like this for kids when they can’t leave their rooms.”

Related posts:

  • Music therapy in a mental health setting
    Music therapy has been part of CHOC Children’s specialized therapeutic programming for more than 10 years. The program has grown recently, due to increased awareness of its effectiveness and a ...
  • Olivia’s Journey with Music Therapy
    Olivia was unexpectedly born two months premature and spent the first seven months of her life in the CHOC Children’s neonatal intensive care unit (NICU). The more music therapy sessions ...
  • The Power of Music Therapy: Darlyn’s Story
    The 7-month-old’s daily music therapy sessions in the NICU, conducted in tandem with occupational therapy, have helped her make progress on clinical goals.

A day in the life of a pediatric pharmacy technician

By Harumi Hope, emergency department pharmacy technician at CHOC Children’s

A pharmacy technician works under the direct supervision of a licensed pharmacist and perform many pharmacy-related functions.

At CHOC Children’s Hospital, pharmacy technicians prepare, dispense and deliver medications and make sure required administrative work is kept up to date. They take on these responsibilities so the pharmacists can focus on assisting patients and healthcare providers to ensure patient safety and satisfaction.

In addition to CHOC’s inpatient and outpatient pharmacies there are three satellite pharmacies—the operating room pharmacy, the emergency department (ED) pharmacy, and the intensive care unit pharmacy.

This is a typical day in my life as an ED pharmacy technician.

6:45 a.m. — My alarm goes off. I make breakfast, get my kids ready and choose colors for my scrubs (my favorite is maroon!), and drop kids off before work.

8:25 a.m. — Arriving at work a little bit early, I stop for a cold brew to jump start my day. My shift as an ED pharmacy technician starts at 8:45 a.m. Before heading to the ED pharmacy, I spend a few minutes catching up with my colleagues in the main pharmacy. Getting handoff from the morning crew helps me plan and prioritize my work.

8:45 a.m. — As soon as my shift starts, my first priority is to determine if there are any urgent medications to dispense. Keeping a watchful eye over the programs we use to manage these is essential to preventing delays in drug delivery. My first order to fill today is an IV antibiotic that is commonly used to treat infections.

As soon as the pharmacist verifies the order, I start preparing the medication in our sterile hood. Mixing ingredients together to prepare a medication is known as compounding. It is a specialized skill that requires clean technique, strong math skills and attention to detail. This is a very important task that can help to save the lives of sick or injured patients. I find this part of my job as a pharmacy technician especially rewarding and satisfying. After compounding this medication, I deliver it to the nurse who is taking care of the patient.

9:15 a.m. — I go to the MRI suite to replenish emergency medication trays and replenish them. Ensuring that emergency medications are available is an important function of my job.

10 a.m. — An emergency code is called, and I grab our emergency medication cart quickly and go to the patient room along with the ED pharmacist. A patient is seizing and needs a rescue medication immediately. After the pharmacist receives an order from the doctor, I draw up the dose have the pharmacist double-check prior to handing the medication to a nurse. Thankfully, the patient responds to the medication quickly. Once the patient is stable, we return to the ED pharmacy.

11 a.m. — Throughout the day, I check inventory and replenish medications stored in the two medication rooms and medical supply carts to ensure the medical team has the supplies they need to take care of patients.

Harumi_ED pharmacy
Harumi, a pharmacy technician, checks medications in the ED pharmacy.

12:15 p.m. — A patient in the ED who takes multiple medications at home is going to be admitted to the hospital, so I stop by her room for medication reconciliation. This is where we take a thorough medication history in order to make sure the appropriate medications and doses are continued while the patient is in the hospital. .   .

1 p.m. — I try to eat healthy, so I pack salad with homemade dressing, spaghetti and fruits. When there is not a lot of time for cooking, pasta is always the answer.

1:30 p.m. — When I return to the ED pharmacy, I continue with drug preparation, inventory replenishment and medication reconciliation.

4 p.m. — While my priority is ED patients, I try to help the main pharmacy whenever I can. This time is usually the busiest time in there as they have the biggest medication batch for the entire hospital.

5 p.m. — The ED pharmacy receives a page of an incoming trauma patient. The pharmacist and I go to the assigned room with our emergency medication cart and wait for the patient to arrive.

When the transport team arrives with the patient, a paramedic explains what happened, and I try to catch all the important information in case medications are needed. Although the patient has some wounds on his forehead, fortunately, he is stable and doesn’t seem to need any medications at the time.

6:30 p.m. — After several orders and a medication reconciliation, I start cleaning my work station, IV hood, and other areas in ED pharmacy.

7 p.m. — The night shift ED pharmacy technician comes in, and I update him on the day. After making sure everything is clean and stocked up, I head home.

7:50 p.m. — My kids have already eaten dinner, so I quickly eat when I get home. Before tucking the kids to bed, we spend some precious time reading together. They both like to read a lot, and I am very proud of them especially because I never liked to read as a kid. Although there isn’t much time with them around this schedule, I do my best to support them in different ways, and I really appreciate my family for understanding my work.

8:30 p.m. — After preparing lunch for tomorrow and giving the kids a shower, there is finally some time to myself. I enjoy unwinding with music. It is my favorite time of day.

In bed, I think about what I can improve the next day for a better patient care. Sometimes, I dream about making medications.

Although the days can be hectic, I enjoy being a mom and working as a pharmacy technician. There is so much to learn every day and so many opportunities for growth in the pharmacy. It can be stressful, but I work with a passionate group of people who like what they do for our patients, and I am proud to be part of the team.

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Three gifts support mental health, research and neonatal care

CHOC Children’s is so grateful to recently have received three very generous gifts that will help CHOC continue to care for more than 185,000 babies, kids and teens each year. CHOC believes that all children deserve a chance at a happy, healthy childhood.

Transformational gift to benefit the pediatric mental health system of care

CHOC received a transformational gift from the Cherese Mari Laulhere Foundation to enhance and expand its pediatric mental health system of care. The announcement comes on the heels of the Conditions of Children in Orange County report, which highlights alarming increase in the number of children hospitalized in the county for mental illness.

The gift from the Cherese Mari Laulhere Foundation will:

  • Endow CHOC’s mental health inpatient center. Opened in April 2018 for children ages 3 to 17, the center is the only inpatient facility in Orange County that offers specialized programs for kids younger than 12. The center will now be named the Cherese Mari Laulhere Mental Health Inpatient Cente
  • Establish the Cherese Mari Laulhere Young Child Clinic for children ages 3 to 18 who are experiencing behavioral and emotional challenges, mental health issues and school readiness challenges.
  • Expand CHOC’s Intensive Outpatient Program, a mental health treatment program for high schoolers with moderate to severe symptoms of anxiety, depression or other symptoms related to mental health conditions. The program will be expanded to middle school-aged children.
  • Advance trauma-informed care, including providing tools to pediatricians to help in identifying adverse childhood experiences, and connecting patients and families with resources.
cherese
Cherese Mari Laulhere

“Our donations are gifts from our daughter, who brought so much light and love into this world. As someone who advocated for the underserved, Cherese would be very proud of her role in supporting CHOC’s mental health efforts and helping change the trajectory of thousands of young lives,” says Cherese’s parents, Chris and Larry.

Learn more about this gift to CHOC Children’s.

$8 million to advance research for rare disorder

An $8 million gift from the Foundation of Caring will help CHOC advance research for a rare lysosomal storage disease, ultimately leading to an improved understanding and more effective treatments.

The gift will support CHOC researchers working to develop next-generation therapies for Pompe disease, a lysosomal storage disease wherein glycogen builds up in the body’s cells and causes life-threatening heart failure and muscle weakness in affected babies. In honor of the gift, the program will be named the Foundation of Caring Lysosomal Storage Disorder Program at CHOC Children’s.

The work of Dr. Raymond Wang, a CHOC metabolic disorders specialist and director of the Foundation of Caring Lysosomal Storage Disorder Program, drew the attention of the Foundation of Caring several years ago when Dr. Wang began treating the great-granddaughter of the Foundation’s founder after she was diagnosed with Pompe disease.

raymond-wang-md
Dr. Raymond Wang, a CHOC metabolic disorders specialist and director of the Foundation of Caring Lysosomal Storage Disorder Program

With previous support from the Foundation of Caring, Dr. Wang and his team have already made significant strides in its study of Pompe disease, having built a growing research team that’s used CRISPR/Cas9 technology to edit the genome to create animal models of Pompe disease. The Foundation of Caring’s gift will allow Dr. Wang and his team to expand upon this work and use CRISPR to cure Pompe disease and lysosomal storage disorders.

“We are so pleased to support the important work of Dr. Wang and his team at CHOC to help find better treatment or, even better, a cure for Pompe disease for patients affected by the condition worldwide,” says the Foundation of Caring Board of Directors.

Learn more about this gift to CHOC Children’s.

$2 million to CHOC’s neonatal intensive care unit

Newborn babies requiring critical care have gained a big ally in the William, Jeff and Jennifer Gross Foundation. A recent $2 million gift to the neonatal intensive care unit (NICU) on CHOC’s main campus in Orange rounds the Foundation’s support of CHOC’s neonatal services to $7 million in the past year.

choc nicu

Many hospitals offer intensive care units but only a select few are rated by the American Academy of Pediatrics as Level 4 – the highest rating available – and even fewer are ranked among the best in the nation, according to U.S. News & World Report. CHOC’s program features three NICUs, a team of board-certified neonatologists and special units for the smallest preemies, infants who need complex surgery, and babies who have neurological and cardiac concerns.

“CHOC’s neonatal services are unlike anything else offered on the West Coast, providing the highest levels of care and tremendous hope to families in the region. We are honored to continue our commitment to CHOC and the care of newborn babies,” says Jeff Gross.

Learn more about this gift to CHOC Children’s.

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Celebrating CHOC’s longest-serving blood and platelet donor

Ron Shepherd understands the importance of blood and platelet donations. Although he’s never needed a transfusion himself nor has he met any of his beneficiaries, he’s become CHOC Children’s most tenured donor.

Ron has been donating blood and platelets for 30 years and cites the family environment of CHOC’s blood bank – everyone knows his name and greets him with a smile – as one of the reasons he keeps coming back.

Throughout more than 180 visits to CHOC’s blood bank, he has donated more than 225 units of whole blood and platelets.

Whole blood is needed by patients of all ages for a variety of reasons – someone undergoing surgery or who has been involved in a car crash or other trauma, or a child fighting cancer are a few examples of those who benefit from blood donors.

Platelets are the component of your blood that help form clots and stop bleeding. Patients that have cancer, aplastic anemia and blood disorders especially benefit from platelets. Chemotherapy and radiation often times kills cancer and healthy cells and platelet transfusion greatly improve the outcome of our children.

Growing up, Ron’s parents were regular blood donors. This means that Ron understood from an early age that blood donations can have a big impact, and the process takes a relatively short amount of time. On one occasion, he even came in for a last-minute appointment on Thanksgiving Day for a child in need.

Ron’s advice to anyone considering becoming a blood donor is simple.

“The need is great, and there’s nothing to be afraid of.”

Please call the Blood Donor Center at 714- 509-8339 to make an appointment. Walk-ins are always welcome.

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Organic fruits and vegetables vs. conventionally grown

By Colleen Trupkin, registered dietitian at CHOC Children’s

Many of us start the new year with a goal of eating healthier, but sometimes it’s hard to know what that means. Eating more fruits and vegetables is often a good place to start, but a common question is whether organic fruits and vegetables are a better choice.

For starters, it helps to understand what the label “organic” means in the U.S. For fruits and vegetables to be labeled as organic by the U.S. Department of Agriculture (USDA), it means that items cannot be genetically-engineered and no man-made fertilizers or pesticides may be used in the growing process. While people often think of organic produce as having no pesticide residue, this may actually not be the case. Organic produce may still have pesticide residue from the environment or processing facilities, but there is no need to panic! The USDA Pesticide Data Program  has been monitoring our food supply since 1991 to ensure safety. While pesticide residue may be found in both traditionally and organically-grown produce, levels are very low — well below the already low threshold set by the Environmental Protection Agency (EPA) for pesticide residue.

It is important to remember that whether you choose to buy organic or conventional food items, it is the quality and variety of your diet that is most important. Eating fruits and vegetables is an important part of a healthy diet, but only one in 10 Americans consume the recommended amounts. Eat a rainbow of color and variety of produce to get the most health benefits and aim for at least five servings per day, regardless of whether that produce is organic or traditionally grown. Don’t forget to wash all fresh produce before cooking or eating; it is dirty until washed!

The Food and Drug Administration (FDA) also recommends several tips for reducing pesticide residues and preventing foodborne illness from any produce:

  • Always wash your hands for 15-20 seconds with soap and warm water before handling produce.
  • Wash all fruits and vegetables before eating.
    • It is important to wash items before you peel or cut them to ensure residue from the outside is not transferred to the portion you will be eating.
    • Use a brush for heartier vegetables such as potatoes or carrots, especially if you will be eating the skin.
  • Throw out the outer leaves of leafy vegetables, such as the outer leaves from a head of lettuce.

Whether you choose to buy organic foods is a personal decision. At this time, there is not conclusive scientific evidence that shows that organically grown produce is necessarily healthier. However, if you choose to go that route, consider organic options for items without a protective skin to scrub or peel. Most importantly, kick off the new year with a resolution to get “Five a day” of fruits and vegetables from all colors of the rainbow!

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