Antibiotics Aren’t Always the Answer

By Tuan Tran, infectious disease pharmacist at CHOC Children’s

The Centers for Disease Control’s annual recognition of Antibiotics Week, November 14- 20, is a good opportunity to review basic safety practices of antibiotics and educate yourself so that you can protect yourself and your family. Don’t forget:

  • Antibiotics can have reactions and side effects. Harmful effects from antibiotics, such as side effects and allergic reactions, cause 1 in 5 emergency department visits for adverse drug events and lead to 50,000 emergency department visits in children each year
  • Antibiotic resistance is growing. An estimated 2 million illnesses and 23,000 deaths occur each year in the U.S. due to antibiotic-resistant infections. Overuse and misuse of antibiotics are the main drivers of resistance.
  • Antibiotics can only cure infections caused by bacteria. For example, cough and cold illnesses caused by viruses would not be cured by an antibiotic

Parents are an essential part of a child’s care team. You should feel comfortable asking the following questions to your child’s provider when considering an antibiotic:

  • What is the best treatment for my child’s illness? Antibiotics aren’t needed for common illnesses like colds, most sore throats, the flu, and even some ear infections, which are often caused by viruses and do not respond to antibiotics. Sometimes the best treatment is over-the-counter symptom relief.
  • Is this the right antibiotic for the type of infection my child has? If an antibiotic is needed, it’s important to use an antibiotic that is designed to fight the bacteria causing your child’s specific illness. Ask your healthcare professional if it’s the most targeted drug to treat the infection while causing the least side effects
  • What can I do to help my child feel better? Pain relievers, fever reducers, saline nasal spray or drops, warm compresses, liquids, and rest may be the best things to help your child feel better. Ask your healthcare provider or pharmacist what symptom relief is best for your child.
Illness Usual cause: virus Usual cause: bacteria Antibiotic needed?
Cold/Runny nose  NO
 Bronchitis/Chest cold* NO 
 Whopping cough YES 
Flu NO 
 Strep throat YES 
 Sore throat (except strep) NO 
 Fluid in the middle ear** NO 
 Urinary Tract Infection YES 

*In otherwise healthy adults

**Otitis media with effusion

When your doctor prescribes an antibiotic, it’s essential that you take it exactly as prescribed. Follow the directions of your physician and pharmacist, do not skip doses or share the medication, and finish the prescription even if you feel better. Do not save it for later.

There are several things you can do to help prevent infections- starting with receiving an influenza vaccine every year. Aside from getting your flu shot, hand washing is the single most effective way to prevent the spread of pathogens. Scrub for at least 15 seconds when using soap and water. When necessary, cough into a tissue or elbow.

Clinicians at CHOC are committed to optimizing antibiotic use. A multidisciplinary team reviews and monitors antibiotic use to ensure optimal selection, dosing and duration. This reduces adverse events and improves patient outcomes, and slows an emergence of resistance.

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15-Year CHOC Employee Donates Wedding Dress to Create Angel Gowns

Having worked as a community educator at CHOC Children’s for 15 years, Amy Frias knows that all CHOC employees pour their hearts into their work, and would do anything they could to help a child or comfort a family.

Last spring, she saw a post on social media about a group of women dedicated to transforming donated wedding dresses into bereavement gowns for babies who are born prematurely and pass away. Amy knew immediately that she’d found the perfect use for the beautiful wedding dress she’d worn a decade ago and had been sitting in storage ever since.

donate wedding dress, angel gowns
CHOC community educator Amy Frias donated her wedding dress, shown here on her wedding day, to create angel gowns.

“That dress was beautiful, and it was worn during very happy times,” Amy says. “It’s my hope that the angel gowns created from it will bring a little bit of comfort and perhaps even peace to families in need.”

The volunteer seamstresses at Angel Gown Project of California were able to create more than a dozen angel gowns from Amy’s wedding dress. Each angel gown takes approximately two hours to create.

The angel gowns were recently delivered to the Neonatal Intensive Care Unit (NICU) at CHOC. As a community educator, Amy has worked with a variety of families across many units in the hospital, but she’s always had a special place in her heart for NICU patients and their families.

“I often have the privilege of working with NICU families when they’re getting ready to leave the hospital and finally take their baby home, and we teach them things like car seat safety and CPR,” Amy says. “But I know that sometimes despite having the very best care, not all babies make it home.”

Dana Sperling, a social worker in CHOC’s NICU, sees this heartbreak firsthand.

“Neonatologists and specially trained nurses in the NICU do everything in their power and use the most advanced technology available to care for premature infants, but unfortunately, the reality is that not all babies make it home,” Dana says. “Anything we can do to help our families make this heartbreaking experience more cherished, we will. We’ll do whatever we can to help them.”

donate wedding dress, angel gowns
More than a dozen angel gowns were created from Amy’s wedding dress. They will go to NICU families in need.

Bereavement gowns are often the last thing on a parent’s mind when they’re faced with immense grief over the loss of a child and they are unable to focus on all the details that must be tended to.

“Some of these parents have never had the chance to dress their babies themselves due to their level of illness. Parents are so appreciative of these gowns and are quick to notice the love and energy that went into making them,” Dana says. “We are helping parents make memories at a very sacred time and it is important to remember that what we do at CHOC to save a life is just as important as what we do when a life cannot be saved.”

Learn more about the Angel Gown Project of California.

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Seizure-Free at Five, Thanks to Epilepsy Surgery and ROSA Robot

Five-year-old Ian Higginbotham recently enjoyed his best summer yet. He experienced his first family vacation. He learned to swim and ride a bike. He got himself ready for kindergarten. These are milestones most kids and parents, alike, eagerly welcome. But there was a time when Ian’s parents weren’t certain their son, who was born seemingly healthy, would enjoy such happy pastimes.

Ian began talking and walking in his sleep as a toddler. When the episodes, including night terrors, increased in frequency and severity, his mom Lisa made an appointment with the pediatrician. One day, Lisa knew something just wasn’t right and didn’t want to wait for the appointment to get Ian checked out. She and her husband Derek took him to the Julia and George Argyros Emergency Department at CHOC Children’s Hospital. To her surprise, doctors diagnosed her son with epilepsy.   Ian’s “sleepwalking” and “night terrors” were actually seizures.

The family was referred to CHOC’s comprehensive epilepsy program. A national leader in pediatric epilepsy care, CHOC’s comprehensive epilepsy program offers cutting-edge diagnostics, innovative medical approaches and advanced surgical interventions. CHOC was the first children’s hospital in the state to be named a Level 4 epilepsy center by the National Association of Epilepsy Centers, signifying the highest-level medical and surgical evaluation and treatment for patients with complex epilepsy.

Ian’s neurologist Dr. Andrew Mower suspected he was experiencing complex partial seizures, which was confirmed by video EEG monitoring. Complex partial seizures start in a small area of the temporal or frontal lobe of the brain, and quickly involve the areas of the brain affecting alertness and awareness. The pattern of Ian’s seizures suggested they were originating from the right frontal lobe. Dr. Mower knew Ian and his family were in for a tough journey.

“I really don’t think the general public understands the impact epilepsy has on a child and his family. Its effects are multifaceted and extensive. Our team’s goal is to reduce or eliminate our patients’ seizures, helping improve their quality of life,” explains Dr. Mower, who placed Ian on a series of medications.

The medications reduced Ian’s seizures, but did not control them. Dr. Mower was concerned about the seizures affecting Ian’s development, and presented his case to the epilepsy team.  The multidisciplinary team agreed Ian was a candidate for epilepsy surgery. For children who fail at least two medications, surgery may be considered early in treatment versus as a last resort. Surgery can result in an improvement in seizure control, quality of life, and prevent permanent brain damage. Ian’s surgery was going to be performed by CHOC neurosurgeon Dr. Joffre Olaya.

epilepsy surgery
Ian recovering from epilepsy surgery at CHOC.

While the thought of surgery was frightening to Lisa and her husband, they were confident in the team and comforted to know their son was going to benefit from innovative technology, like the ROSA™ Robot. Considered one of the most advanced robotized surgical assistants, ROSA includes a computer system and a robotic arm. The computer system offers 3D brain mapping to aid surgeons in locating the exact areas they need to reach and planning the best surgical paths. The robotic arm is a minimally invasive surgical tool that improves accuracy and significantly reduces surgery/anesthesia time.

Dr. Olaya used ROSA to accurately place electrodes in the area of Ian’s brain suspected to be the source of his seizures. By using the robot, Dr. Olaya avoided performing a craniotomy (surgery to cut into the skull, removing a section called a bone flap, to access the brain).

“ROSA is an amazing tool that yields many benefits for our patients, including less time under anesthesia in the operating room. It reduces blood loss and risk of infections. Patients tend to recover faster than they would if they had craniotomy,” says Dr. Olaya.

Lisa was amazed at the outcome. “I couldn’t believe how great Ian looked after the placements of the electrodes with ROSA. He wasn’t in any pain, there was no swelling. It was wonderful!”

She and her husband were also amazed at how well Ian did following his epilepsy surgery.

“We got our boy back,” says Lisa. “There were no more side effects from medication and, more importantly, no more seizures!  He started developing again and doing all the things a child his age should do.”

epilepsy surgery
After epilepsy surgery, Ian has been able to do things other kids his age are doing, like riding scooters.

Ian’s care team isn’t surprised by his recovery.

“Children are resilient, and their brains are no different. In fact, the plasticity of a young brain allows it to adapt to changes and heal more easily than an adult brain,” explains Dr. Mower.

Learning to ride a bike and swim were among the first of many milestones Ian quickly reached following surgery. He enjoys playing with his younger brother and his friends. And, whether inspired by his experience with ROSA or not, Ian loves robots.

Read stories:

Small Baby Unit Before and After

In observance of Prematurity Awareness Month, meet a few graduates of the Small Baby Unit (SBU) at CHOC Children’s. The only of its kind in Orange County, the SBU focuses on caring for the unique needs of the smallest and sickest babies. This special unit is designed for babies born at less than 28 weeks gestation or who weigh less than 1,000 grams.

moanalani

Moanalani Solomon
Current age: 1
Birthday: July 14, 2015
Gestational age at birth: 28 weeks
Birth weight: 2 pounds, 13 ounces
Personality now: “Moanalani is an extremely happy baby who loves to chat with anyone who will listen.  She can roll over and wants to show that trick off as soon as she’s on the floor. She is feisty and absolutely full of life,” says Noelani, Moanalani’s mother.
Reflections on the journey: “We got to know every family in the unit. We really became such a support group for each other. We exchanged phone numbers and birth dates of all the other babies, and asked ‘How did you get here?’ and ‘What’s your story?’ You become family. You’re here for the same purpose. That’s what we really clung to,” Noelani says.

small baby unit

Lucas Zaragoza
Current age: 1
Birthday: June 16, 2015
Gestational age at birth: 24 weeks
Birth weight: 1 pound, 8 ounce
Personality now: “Lucas is always happy, loveable, mischievous, very alert, and curious,” says Heather, Lucas’ mother.
Reflections on the journey: “The nurses told us we’d be very hands on, take his temperature, change his diaper, hold him. They said, ‘It’s OK, we’ll walk you through it.’ They’re part of our family now. We don’t know we would be without CHOC and the nurses and doctors and everyone who had a hand in Lucas’ care,” Heather says.

small baby unit
Jeremiah Zazueta
Current age: 6
Birthday: March 22, 2010
Gestational age at birth: 25 weeks
Birth weight: 2 pounds, 4 ounces
Personality now: “Jeremiah, known as J.J., is a kindergartner full of life and personality. He is very outgoing and friendly. He enjoys playing T-ball, singing, reading, and playing with Hot Wheels. In other words, he’s a typical active boy,” says Maria, Jeremiah’s mother.
Reflections on the journey: “At that moment, you just want them breathing. The doctor said if he cries when he’s born, that’s a good thing. I heard a whimper like a kitten and that gave me peace. The doctor said he’s a feisty one – he was moving his arms. This one’s a feisty one,” Maria says.

small baby unit

Parker Evans
Current age
: 4
Birthday: Sept. 29, 2012
Gestational age at birth: 23 weeks
Birth weight: 1 pound, 1 ounce
Personality now: “Parker’s battle to survive despite the odds seems to have established a bold defiance of the day-to-day challenges that life presents. Every task, no matter how simple or complex, is something that she routinely and emphatically proclaims, ‘I want to do it all by myself!’ The smallest of her peers and behind in her physical development, Parker seems to be the only one not to notice. She has a zest for life and is intent on taking full advantage of the chance she has been given,” says Kristina, Parker’s mother.
Reflections on the journey: “We ended up falling in love with the Small Baby Unit, the nurses and the consistency. Everyone in that unit made a huge difference,” Kristina says.

small baby unit

Faith and Brayden Kohrs
Current age
: 3
Birthday: Nov. 26, 2012
Gestational age at birth: 24 weeks
Birth weight: Both 1 pound, 10 ounces
Personality now:  “We love their amazing hearts, helpful spirits and beautiful souls. They are truly our two little blessings. The kiddos love to travel. They do really well on road trips. Going out with Grandpa Kohrs on his boat in Lake Havasu is always a blast. Faith loves to dance. Brayden loves blocks and Legos. They both love Mickey Mouse Club House, music and books,” says Marydith, the twins’ mother.
Reflections on the journey: “We love the wonderful, wonderful Small Baby Unit staff. They are the reasons we have our babies today. They are just amazing,” Marydith says.

Feeding your Family Seasonal Vegetables

By Carol Peng, registered dietitian at CHOC Children’s

Winter weight gain is a common problem for many Americans during festive holidays. Instead of trying to lose the extra pounds later in the New Year, it’s a good idea to be mindful now about food choices and consider healthy alternatives in place of some sweets and desserts. Buying fresh produce when it’s in season is an easy and cost-effective way to give your family the nutrients they need.

Consider introducing one of these seasonal fruits or vegetables in to your family’s menu:

Persimmon

Originating from Asia, persimmons are known for their glossy surfaces and deliciously brightly orange and red colors. They are an excellent source of vitamin A (for good vision), vitamin C (to boost the immune system) and fiber (to aid the digestive system). Buy firmer persimmons and allow them to ripen at room temperature. You may peel the skin before enjoying them as snacks or flavorful additions to salads. Be sure to eat the ripe fruit as soon as possible because overripe persimmons quickly turn to a mushy texture. Fuyu persimmons look similar to flattened tomatoes and have a crispier texture. Hachiyas persimmons are acorn-shaped and taste softer and juicer.

Pummelo

Pummelos are the largest members in size of the citrus family. With pale green or yellow skin and thick yet soft white rind, these fruits contain juicy pulps that vary from pale yellow to pink or red. Choose firm and heavy pummelos. They can be refrigerated for up to one week. Pummelos taste like their cousin grapefruits, but sweeter and milder, and they are an excellent source of vitamin C, folate (to help prevent birth defects) and fiber.

Sweet Potato or Yam

Many varieties of sweet potatoes are homegrown in the US. The skin color can range from white to yellow, red, purple, or brown, with the inside ranging in color from white to yellow and orange. The ones with soft orange texture inside are often labeled as yams. However, yams are mainly grown in West Africa and Asia, soo unless you are shopping at an international market, you are most likely buying sweet potatoes. They can be stored in a cool, dark place for up to 3-5 weeks. They are fat free, cholesterol free and are good source of fiber, vitamin A, vitamin C and potassium (which is good for heart health and enhancing muscle strength).

Winter Squash

The most common varieties of winter squash include acorn squash, butternut squash, hubbard squash, spaghetti squash, turban squash, and pumpkin. They come in different shapes, sizes and colors, but all have a hard, thick shell and seeds. The deep yellow to orange flesh is firmer compared to summer squash, therefore requires longer cooking time. Choose winter squash that are heavy for their size. There are many healthy cooking methods to prepare winter squash such as baking, steaming, simmered, or mashed. They can be kept in a cool dark place for a month. They have high levels of vitamin A, C, niacin (important for heart health) and fiber.

Try this recipe as a way to incorporate seasonal squash into your family’s dinner rotation:

Spicy Spaghetti Squash with Black Beans (for 4 servings)

  • 1 medium spaghetti squash, halved lengthwise and seeded
  • 2 teaspoons extra-virgin olive oil
  • 1/2 cup chopped red onion
  • 1 jalapeño pepper, seeded and minced
  • 1/2 cup red bell pepper, chopped
  • 1 cup cooked black beans
  • 1/2 cup sweet corn, frozen or fresh
  • 1 teaspoon chili powder
  • 1/3 cup fresh cilantro, finely chopped
  • 1 tablespoon lime juice
  • 1 teaspoon fine sea salt

Preheat the oven to 375°F. Arrange squash in a large baking dish, cut-sides down. Pour 1/2 cup water into the dish and bake until just tender, 30 to 35 minutes. Rake with a fork to remove flesh in strands, leaving the shell intact for stuffing.

For the filling, heat oil in a large skillet over medium heat. Add onion, jalapeño and bell pepper and cook for 2 minutes or until soft. Add beans, corn and chili powder; cook, stirring frequently, 1 minute longer. Add cooked squash, cilantro, lime juice and salt, cook 1 minute until heated through.

Fill squash halves with filling, mounding mixture in the center.

Per serving: 160 calories (30 from fat), 3.5g total fat, 0.5g saturated fat, 330mg sodium, 29g carbohydrates, (7 g dietary fiber, 5g sugar), 6g protein

Recipe source: Whole Foods Market

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A Pediatrician Explains AAP’s New Safe Sleep for Babies Practices

By Dr. Georgie Pechulis, pediatric hospitalist at CHOC Children’s

The American Academy of Pediatrics (AAP) recently released updated recommendations on safe sleep practices for infants under one year of age, which are outlined below. Safe sleep is a top priority for all parents to reduce the risk of Sudden Infant Death Syndrome (SIDS) and other sleep-related deaths that claim as many as 3,500 infant lives in the U.S. every year SIDS is the unexplained death of an infant, even after thorough investigation, autopsy, and review of medical history.

safe sleep for babies
Dr. Georgie Pechulis, a pediatric hospitalist at CHOC Children’s

What can be done to prevent SIDS and other sleep-related deaths?

We know there are a number of practices proven to lower an infant’s risk of SIDS and sleep-related deaths. Taking these actions can help to create a safer sleep environment for your baby. Here are a few of the key points from the AAP’s updated recommendations.

Back to sleep for every sleep

Research shows that putting your baby to sleep completely on their backs for the first year greatly reduces the risk of SIDS.

Once an infant can roll on their own, they can be allowed to remain in the sleep position that he or she assumes.

To help prevent flat head syndrome or positional plagiocephaly, supervised and awake tummy time is recommended.

It is recommended that infants sleep in the parents’ room, close to the parents’ bed, but on a separate surface designed for infants. This is recommended for ideally for the first year of life, but at least for the first six months.

Evidence shows that sleeping in the parents’ room but on separate surfaces decreases the risk of SIDS by as much as 50 percent.

Separate designated sleeping arrangements can prevent entrapment, suffocation and strangulation that can occur when infants sleep in an adult bed

Keep soft objects and loose bedding away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment and strangulation

Although they are widely available on the market, crib bumpers and pads, stuffed animals and toys, pillows, and blankets are not recommended in the crib as they can easily block your baby’s breathing.  The crib should only contain your baby, the mattress, and a fitted crib sheet.

If appropriate for the climate, infant sleep clothing, such as a wearable sleep sack or blanket is preferable.

Consider offering a pacifier at nap time and bedtime

A pacifier has been shown to have a protective effect, even if it falls out of the infant’s mouth. It doesn’t need to be reinserted if the baby falls asleep. It is not recommended to use any attachments to the pacifiers. Ensure breastfeeding is well established prior to any use of pacifiers in breastfeeding babies.

Avoid overheating and head covering in infants

Avoid the use of commercial devices that are inconsistent with safe sleep recommendations

Ensure that products conform to safety standards of the Consumer Product Safety Commission

Car seats, strollers, swings and infant carriers are not recommended for routine sleep, per the AAP’s recommendations. If an infant falls asleep in any of the above devices, they should be moved to a safe sleep surface as soon as is safe and practical.

Do not use home cardiorespiratory monitors as a strategy to reduce the risk of SIDS.

What else is new in the recommendations?

The AAP’s SIDS Task Force also addressed infant feeding and comforting in bed. As always, it is recommended to have your infant sleep separately in a designated surface apart from the parent sleep area. However, the AAP does recognize that parents frequently fall asleep while feeding their infant and evidence suggests that is it less hazardous to fall asleep with the infant in the adult bed than on a sofa or armchair. No pillows, blankets, sheets, or any other objects should be in the bed. Many infants who die from SIDS and sleep-related deaths are found with their head covered in bedding.

Infants who are brought into bed for feeding or comforting should be returned to their own crib or bassinet when the parents are ready to return to sleep. If a parent does fall asleep, the infant should be returned to their separate sleep surface as soon as the parent awakens.

Among the above recommendations, parents should avoid smoke exposure, alcohol and illicit drug use during pregnancy and after birth, as these can also increase risk of SIDS.  Regular prenatal care and immunizations per the Centers for Disease Control and AAP guidelines are also encouraged. And as always, breastfeeding is recommended and is known to provide a protective effect. Any degree of breastfeeding has been shown to be protective, increasing with exclusivity.

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Holiday Season Kicks off with CHOC Kids’ Cards

 Get a head start on sending out holiday well-wishes by purchasing CHOC Children’s Kids’ Cards, on sale now.

These unique holiday cards feature designs that were all created by current or former CHOC patients. This year several new designs are available, as well as classic designs beloved in years past. Art ranges from festive wreaths, decorated trees, holiday treats, and other traditional images.

Non-holiday greeting cards are also available. All cards can be customized with personal messaging or business logos.

Cards can be purchased in CHOC’s gift shop. Online orders are also available.

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Ten Trick-or-Treating Safety Tips

As your family prepares for the fun tradition of trick-or-treating, keep in mind these easy Halloween safety tips, from the CHOC Children’s community education team and Safe Kids Orange County, to ensure your celebration is filled with treats instead of tricks.

Above all, remember that the busiest trick-or-treating hours are in the evenings during rush hour, so use an abundance of caution in residential neighborhoods that will see heavy foot traffic. Children are excited on this day and can move in unpredictable ways, and are more than twice as likely to be hit by a vehicle and killed on Halloween as on any other day of the year.

Costume Safety

  • Planning a fun and creative costume can be one of the most exciting parts of Halloween for children. Wear costumes that are bright and reflective, or add reflective material to costumes and trick-or-treat bags to added extra visibility. Make sure shoes fit well and costumes are an appropriate length to prevent tripping.
  • Masks can block eyesight, so consider non-toxic makeup and decorative hats to take your costume to the next level instead. Hats should fit properly and not slip down and cover the eyes.
  • Avoid decorative contact lenses without an eye examination and prescription from an eye care professional. Some packaging may claim this is unnecessary and they are a “one size fits all” product, these products can cause pain, inflammation and other serious eye disorders.

Ten Trick-or-Treating Safety Tips

Drive Safely

  • Drive with full headlights on in order to spot kids from as far away as possible.
  • Spend an extra moment at intersections to scan for kids who could be in medians or stepping off curbs. Use extra caution and drive slowly when entering or exiting driveways and alleyways.
  • Although you may see the children, keep in mind their costumes may unfortunately limit their visibility and they may not see you as well as you see them, or at all.
  • Never text or use your phone while driving.

Other Safety Reminders

  • Teach children how to call 9-1-1- in the event of an emergency or if they become lost.
  • Children and guardians should both carry flashlights and/or glow sticks to increase visibility.
  • Double-check the candy your child receives before they sample any treats. Ensure the items are properly sealed and there are no holes in the packaging.

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CHOC Physical Therapy Improves Quality of Life

The American Physical Therapy Association declares the vision of the physical therapy profession as “transforming society by optimizing movement to improve the human experience.” The movement system is complex and includes various conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and integumentary systems and their complex interaction that allows kids and teens to experience their environment and actively participate in the activities they enjoy.

How do physical therapists play into this at CHOC? You may see them addressing a wound care plan, educating a family on developmental play activities after an open- heart surgery, teaching a patient how to use crutches after surgery, helping a child balance and coordinate a multi-step task after brain surgery, or progressing the endurance and strength of a child on chemotherapy. Most of all, you will see them educating CHOC families on self-empowerment and independence.

From working with neonates who are learning to self-regulate, to high school athletes hoping to return to their sports after injuries, CHOC’s physical therapists are involved in improving quality of life for our patients and families.

Meet Amanda Traylor, a pediatric physical therapist at CHOC.

Q: What aspect of pediatric physical therapy are you most passionate about?

A: I love working with kids, and we get to work with a diverse age range. I also enjoy the multi-disciplinary collaboration of the rehabilitation department, which includes not only physical therapy, but also occupational therapy, speech and language therapy, and developmental therapy.

Q: What inspires you most about the care being delivered at CHOC?

A: I am inspired by the constant striving of the care team to provide the best evidenced-based practice for our patients and families. Our staff is so involved in our community with different events, education opportunities, and training of future professionals; we really make an impact on Orange County.

Q: What have you learned from your patients?

A: My patients have taught me to focus on what is important and meaningful. Being a part of the medical field, we often establish a plan of care and goals based off the impairments we see, but ultimately it always comes down to what is meaningful for the patient and their family.

Q: What, if anything, surprised you when you became a pediatric physical therapist?

A: We don’t just treat the child; we treat the whole family. The families are truly our backbones for patient care.

Learn more about pediatric physical therapy being delivered at CHOC.

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Volunteer Role Awakens Professional Calling

Every year, more than 800 CHOC Children’s volunteers provide nearly 100,000 hours of service. They pursue volunteerism for different reasons, but they all donate their time to help CHOC provide the very best pediatric services in Orange County. Some are retired community members looking to give back, and others, like Brianna, come in as high school students seeking new experiences.

Brianna started volunteering at CHOC when she was just 16 years old. She needed to complete volunteer hours as part of a school project and having grown up in Orange, she thought CHOC would be a worthy place to donate her time. Back then, she didn’t know what her eventual career path would look like. Due to her customer service experience as well as her bubbly and warm personality, she was placed as a customer service ambassador. That placement would eventually inspire her to become a registered nurse at CHOC.

Members of CHOC's customer service team celebrating Brianna's graduation from nursing school.
Members of CHOC’s customer service team celebrating Brianna’s graduation from nursing school.

“We could tell she loved working with kids and families,” says Sandra Schultz, customer service manager at CHOC. “She was a comforting presence in what can be a scary and stressful time. Her good energy was contagious, and she loved our mission statement- to nurture, advance and protect the health and well-being of children.”

She was tasked with enhancing the CHOC patient experience by visiting patients and families to welcome them upon admittance and ensure that their non-medical needs were being met. If a need were identified, she helped facilitate a solution by providing time-sensitive and compassionate communications with the appropriate CHOC department.

Sometimes the opportunity to help a family was as small as getting a parent a glass of water.

“As a nurse now, I know that it’s the little things that matter,” Brianna says.

Her ambassador role allowed to her see a variety of environments in the hospital, which sparked her interest in nursing, particularly the pediatric intensive care unit.

“It was the most complex I’d ever seen medicine before,” she says. “But I felt like those kids were the ones I was supposed to be with, the kids who were having some of the hardest days of their entire lives.”

As a volunteer, Brianna was an avid learner and wanted to learn about every department inside the hospital. That passion for learning helped propel her through challenging coursework in nursing school, and eased her transition from volunteer to nurse when she came back to CHOC.

During stressful moments in a crucial unit of the hospital, Brianna relies on lessons she learned during her customer service volunteer days at CHOC.

“It’s important to be able to take a step back mentally when things get stressful. I’ve learned to remember where we are, what we’re doing and why we’re doing it,” she says.

Even after she transitioned into a nursing role, Brianna remains a part of the customer service family at CHOC. Her former colleagues-turned lifelong friends surprised her in the PICU on her birthday with a card and gift, and they celebrated her nursing school graduation right alongside her family. Every year the group reunites to participate in CHOC Walk in the Park.

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