S.M.A.R.T.I.E.S. Class Helps Kids Manage Type 1 Diabetes

According to the American Diabetes Association (ADA), nearly 30 million children and adults in the United States have diabetes. Diabetes is a metabolic disease in which the body’s inability to produce any or enough insulin causes elevated levels of glucose in the blood.

CHOC Children’s endocrinology and diabetes team provides comprehensive diagnosis and treatment of endocrine disorders, including innovative programs and classes designed to enhance the quality of life for patients. S.M.A.R.T.I.E.S. (Smart Kids/Teens Managing and Regulating their Insulin, Exercise and Sugars), a special class that provides education to newly diagnosed type 1 diabetes patients at CHOC, features interactive activities and learning techniques for different ages. Additionally, the class provides an opportunity for patients to bond with other patients with diabetes. The patient’s siblings and parents are also encouraged to attend.

As part of CHOC’s diabetes new onset education program, which is accredited by the ADA, the class helps support better outcomes and management of this life-changing condition.

The experts at CHOC offer the following holiday eating tips for parents of children with diabetes:

  • Talk to your child’s health care provider. Ask how to best manage extra carbohydrates during the holidays, and what else your child should be tracking.
  • Make ready for the feast. When visiting over the holidays, try to learn about the menu beforehand. Bring supplies such as measuring cups if necessary. Practice measuring things at home so you can become a good estimator.  Similarly, plan ahead when going out to eat. Many restaurants post their menus on their websites. Check the nutrition information beforehand.
  • Slim it down. If you are doing the cooking, use skim versus whole milk, or artificial sweetener instead of sugar in your favorite recipes. The rest of your family may not taste the difference and will likely appreciate the fewer calories and fewer carbs.
  • Tell other parents. If your child is going to a party, mention to the host parents that your child has diabetes. This will help them understand why your child is using a meter or insulin pen. Provide phone numbers in case of an emergency.
  • Focus on the festivities. Holidays are often centered around food with family and friends. This can be stressful for parents who are attempting to manage a child’s blood sugar. Where possible, try to implement traditions that focus less on food.

S.M.A.R.T.I.E.S. is for new onset CHOC patients and their families.  Families are scheduled into one of two monthly classes as a follow up to the hospital education.  For more information, including other resources available, please call 714-509-8634.

Don’t Let Motion Sickness Interfere with Holiday Travel Plans

The holidays are right around the corner, often triggering an extra-busy travel season. For some kids, more travel can mean more motion sickness putting a damper on family festivities.

Motion sickness, most common in school-aged children, occurs when one part of your balance-sensing system (eyes, ears, sensory nerves) knows your body is moving, but the other parts don’t, sending mixed signals to the brain.  For example, when riding in a car, a child’s inner ear can sense movement, but if he’s too small to see out the window, the brain is also getting messages that the body is still.  The brain gets a little confused, which can result in symptoms associated with motion sickness.

There are several things parents can do to help prevent their young travelers from experiencing motion sickness.

  • Avoid greasy food or big meals right before a car or airplane ride, since that can upset an already queasy tummy.
  • When possible —and safe to do so— have the child ride in the middle seat, which has the least amount of motion. Keep in mind child passenger safety guidelines.
  • Sing along to music or ask kids to play an “I Spy” game — easy distractions that can help your children keep their minds off potential motion sickness. Reading books or watching movies can make motion sickness worse.
  • Make sure children who are prone to motion sickness can see out the window. If possible, roll car windows down for fresh air.

When packing for holiday travel, be sure to include dry crackers, water or juice, “barf” bags and an extra set of clothes, should your child get sick.  If motion sickness strikes during a car ride, pull over to the side of the road as soon as it’s safe to do so.  If you’re able to, find a safe location for your child to get out of the car. If possible, place other passengers away from kids with motion sickness.  Sometimes, watching someone get sick can trigger a similar response in others.  Remind children that motion sickness is not contagious

Some anxiety could be brought on by getting carsick regularly. Remind kids and other siblings that it’s not their fault, and they didn’t do anything wrong that caused them to get sick.

Motion sickness is not a gastrointestinal disorder. A fever, decreased appetite, or other symptoms may be signs of another illness, warranting a call to the pediatrician.

Although not the first line of defense, there are several over-the-counter and prescription medications that can help kids cope with motion sickness. Check with your child’s pediatrician before administering any medication.

Breast Masses in Teen Girls: Cancer or Benign Tumors?

Breast masses can be a cause of concern for adolescent girls and their parents.  Fortunately, the majority of these masses are benign tumors, and breast cancer remains very rare among this age group. The size of the mass, however, and associated pain may warrant surgery, says Dr. Maryam Gholizadeh, CHOC pediatric surgeon.  A young patient who detects a mass should be seen by a surgeon to evaluate her options before getting a needle biopsy.

Dr. Gholizadeh has experienced an increase in patients with breast masses, which may point to girls being diligent with breast self-examinations.   The patients are healthy and are experiencing hormonal changes fairly common in adolescence.  All of them are incredibly anxious.

“These young girls, who vary in ages from 13 to 17, are of course very scared, as are their parents.  I spend a lot of time educating them and, should surgery be necessary, reassuring them,” explains Dr. Gholizadeh. “As a woman, I have empathy for what these girls are feeling about their bodies and work really hard to make them feel comfortable with me.”

Surgery to remove the mass is performed under general anesthesia—administered by a pediatric anesthesiologist—an outpatient basis, with no hospitalization required.   Dr. Gholizadeh takes great care to preserve the shape of the breast and to minimize scarring by placing incisions either under the breast or around the nipple.   Her patients are home within a few hours of arriving at CHOC.  Patients can usually return to school within 48 hours and resume activities after two weeks.

“These young ladies are eager to get back to school, sports and other activities, and don’t want to be slowed down.  My goal is to provide the best surgical outcome for them, including a quick recovery,” says Dr. Gholizadeh.

A recognized expert in her field, Dr. Gholizadeh specializes in all areas of pediatric and neonatal surgery. Her clinical interests include pediatric oncology, thoracic surgery and minimally invasive surgery. Dr. Gholizadeh is board certified in general surgery and pediatric surgery.  She can be reached at 714-364-4050.

Fostering Philanthropy in Teens

Teens and pre-teens may not always have philanthropy on their active minds, but volunteering their time can have a healthy impact on their development and help establish a sense of community. Encouraging them to commit random acts of kindness is also a wonderful way for them to learn about empathy for others, says Dr. Mery Taylor, a CHOC Children’s psychologist.

“Volunteering helps to broaden teens’ understanding of the world so they can understand there are different types of people with different types of needs. Not everyone may have the same opportunities and abilities they may have,” says Dr. Taylor. “Anybody can use their talents to help others. Altruism can actually grow the areas of your brain involved in emotions, and make you feel good you’ll want to do it again.”

It can, however, be a challenge for young teens and pre-teens to find volunteer opportunities because of age restrictions.  OneOC is an Orange County-based non-profit that helps community members of all ages find service opportunities that match their personal interests.  The organization’s comprehensive volunteer calendar offers a list of opportunities throughout Orange County. OneOC also sponsors five annual days of service that bring individuals, families, businesses and schools together to volunteer throughout the year: MLK JR. Day of Service (January), Earth Day (April), 9/11 Day of Service & Remembrance (September), Family Volunteer Day (November), and Spirit of Giving (December and April).

Additional ways for children and teens to give back include:

  • Clean out bookcases, toy chests and closets, and donate items to organizations that can accept them. Keep in mind that some organizations can only accept new items. CHOC can accept gently used books for our Family Resource Center.  Due to infection control guidelines, all other items must be newly purchased.
  • From selling lemonade to organizing a bake sale, kids can start their own fundraisers to benefit their favorite nonprofits. At CHOC, we’ve witnessed some incredible acts of kindness from children, including current and former patients and their siblings. For inspiration, read about Juneau and Jamie’s Girl Scout troop.
  • Find ways to earn, save and donate allowances. Children who wish to give back to CHOC can consider purchasing items for our patients from our wish list.

Volunteer opportunities at CHOC exist for teens ages 16 and older.

There are numerous ways to instill the giving spirit in children and teens, says Dr. Taylor. Commit to participating in community service as a family, and start a family conversation around why you are giving back. Remind them that there are many different reasons why someone could end up in a position of needing help. Parents are a model for their children, and even if your children are too young to actively volunteer, they will be able to see the impact of your regular volunteer work.

December 14 is National Roast Chestnuts Day

By Jill Nowak, RD, CDE, clinical dietitian at CHOC Children’s

It’s that time of year we sing about “Chestnuts roasting on an open fire….” But, did you know that this delicious chestnut is packed with numerous health benefits?  They are moderately lower in calories and contain less fat than other nuts and seeds.  A 1 ounce serving provides 69 calories and 0.6g fat.  Sounds like the perfect snack this holiday season!

Chestnuts are the edible seeds of the chestnut tree.  The sweet, starchy seeds sit inside a prickly outer shell called the burr, which splits open as they ripen.  Chestnuts are in season and available in markets from October through March. Fresh chestnuts are often displayed and sold in the fresh produce section. You can also buy chestnuts dried, vacuum-packed, or canned.  To verify freshness look for creamy white seeds. Avoid a greenish, mold-like appearance. When preparing fresh chestnuts, they must be peeled and cooked before consuming.

Add cooked, peeled chestnuts to stuffing, rice or savory pie filling. Incorporate cooked chestnuts into soups, stews, casseroles, or vegetable dishes. Or add pureed chestnuts to mashed potatoes.

Here are additional health benefits from chestnuts:

  • Chestnuts are rich in vitamin C. They are the only nuts that contain this vitamin. They also contain B-vitamins and folate.
  • Chestnuts contain a rich source of mono-unsaturated fatty acid (MUFAs). MUFAs are part of a healthy diet and help to improve our lipid blood profile by reducing LDL (bad cholesterol) and increasing HDL (good cholesterol) levels.
  • Chestnuts are a good source of potassium, which helps in lowering blood pressure. In addition, they are good sources of copper, manganese, and selenium, which are all important components in the body’s antioxidant and anti-flammatory responses to harmful free radicals.

 Wild Rice with Water Chestnuts and Mushrooms

1 13 cup wild blend brown rice

2 23 cup 99% fat free chicken broth

1 8oz can water chestnuts (drained)

1 can (8 oz dry weight) mushroom pieces and stems (drained)

1 tbsp butter

Directions:

Cook rice in chicken broth – bring to a boil then simmer, covered for 45 minutes.  Sauté water chestnuts and mushrooms in butter. When rice is done, add together and stir well.

Nutritional Information:

Servings per Recipe: 5, Serving Size: 1 cup

Calories: 202, Total Fat: 3.9 g, Total Carbs: 41.9 g, Dietary Fiber: 4.5 g, Protein: 5.8 g

Source: www.sparkrecipes.com and http://www.healthcastle.com/chestnuts-food-month

Toy Drive to Support CHOC Children’s Patients, Families Dec.19

CHOC is grateful for the support of our community, especially during the holiday season as people wish to remember our patients and families. Our annual holiday toy drive will be held Saturday, Dec. 19 from 8 a.m. – 3 p.m. in our employee parking structure, located at 557 South Main Street, Orange, CA 92868. We are unable to accept donations in the main hospital lobby.

Due to limited storage space, the donation of gift cards is encouraged. This enables our trained child life specialists to purchase toys and craft supplies based on the developmental age and gender of our current patients. Gift cards to stores such as Target, Toys “R” Us, Babies “R” Us, Walmart, Michaels, Barnes & Noble, and Visa/MasterCard gift cards are greatly appreciated.

Those wishing to donate toys can refer to our Wish List to choose from the items we find the most appropriate and popular with CHOC’s diverse patient and family population. We are always in need of more activities for our teen population.

Community members unable to participate in the toy drive but interested in donating can log on to www.amazon.com and search for the “Children’s Hospital of Orange County” wish list. Donations will be shipped directly to CHOC.

Please note that we are unable to accept the following items:

  • Stuffed animals
  • Handmade blankets, hats, socks, etc.
  • Get well cards
  • Big items: bikes, skate boards, etc.
  • VHS tapes
  • Used toys
  • Clothing
  • Promotional items with company logos

For more information, please call 714-509-4519.

Thank you for your continued support of CHOC Children’s!

Keeping Children Safe During the Holidays

The holidays are a wonderful time for family and fun, but they also pose some additional safety hazards, a CHOC Children’s community educator tells CHOC Radio.

In podcast No. 37, Amy Frias reminds parents that shiny, breakable decorations can be an attractive nuisance for toddlers, and also highlights other aspects parents should address during the holidays:

  • How to safeguard against fire hazards
  • Eliminating potential poisonings
  • Safe toy shopping
  • Christmas tree safety

CHOC Radio theme music by Pat Jacobs.

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CHOC Children’s Patient Gives Back: Juneau’s Story

Juneau Resnick Speech

At 8 years of age, Juneau Resnick experienced a life-changing event. A close family friend, Gina, passed away after a devastating battle with brain cancer. Gina had devoted her life to working with infants in a neonatal intensive care unit (NICU). Juneau, who spent the first 40 days of her life in a NICU, developed a special bond with her. Owing to her prematurity, Juneau developed hydrocephalus necessitating numerous brain surgeries. After a series of difficult events, Juneau’s parents transferred her care to Dr. Michael Muhonen, medical director of The CHOC Children’s Neuroscience Institute.

To honor Gina and to thank Dr. Muhonen and the CHOC team who did so much to improve her health, Juneau and her teacher came up with the idea of a fundraiser to coincide with the 100th day of school. In addition to passing out flyers, Juneau spoke in front of 700 people at a school assembly. She shared her personal experience with CHOC, and made a plea for each student to bring in 100 coins. Combined with a baked goods and lemonade sale organized by Juneau, the students’ donations totaled almost $1,000.

“She is truly passionate about helping others. She has an unwavering passion that I’ve never seen before and I work with kids,” says Juneau’s mom Ai, a substitute teacher. “I’ve seen a lot, and she is a rare bird.”

Juneau remains dedicated to continuing to raise money for CHOC. Every month, she partners with her teacher to sell pencils, erasers and other supplies at school to support an initiative dubbed Kids and K9, benefitting a local animal shelter and CHOC.

“I’m doing it to make kids happy and put a smile on their faces,” said Juneau. “I want them to forget where they are and just have fun.”

The young philanthropist is grateful for her renewed health and so happy to be under the care of CHOC Children’s.

Learn how you can start your own fundraiser for CHOC.

Gastroesophageal Reflux Disease and Treatment Options

Gastroesophageal reflux (GER) occurs when a small amount of acidic stomach fluid or food in the stomach goes back up into the esophagus (swallowing tube). This is a normal process with symptoms including regurgitation or pain that can be experienced several times a day, especially after eating, and usually lasting less than three minutes. Some individuals with GER will have no symptoms. GER occurs in more than two-thirds of healthy infants, and half of these infants experience regurgitation or “spitting up” that spontaneously resolves without medication by approximately 1 year of age. A pediatrician or gastroenterologist should evaluate children whose symptoms worsen or do not resolve by the time they are 12-18 months of age.

When to see a doctor
When the reflux causes intolerable discomfort or complications, patients should be evaluated by a doctor for gastroesophageal reflux disease (GERD). GERD in infants is treated with a lifestyle modification approach. Children and adolescents can also be treated with medicine. In rare cases, surgery may be needed.

Lifestyle modifications
If you think your child may have GER or GERD, discuss it with your pediatrician. He or she may recommend lifestyle modifications:

  • For infants
    • Change in milk formulation
    • Hold your infant in an upright position after feedings
    • Avoid placing your infant in a car seat after a meal
  • For children and adolescents
    • Avoid large meals
    • Do not lie down immediately after eating
    • If obese or overweight, lose weight
    • Avoid foods and drinks that can cause acid reflux, such as garlic, peppermint, caffeine, tomatoes, chocolate, citrus fruits, alcohol and spicy foods

Doctors may prescribe medications that lower the amount of acid in the stomach to alleviate symptoms of GERD:

  • Tums (calcium carbonate)
  • Milk of Magnesia (magnesium hydroxide)
  • Pepcid (famotidine)
  • Zantac (ranitidine)
  • Prilosec (omeprazole)
  • Prevacid (lansoprazole)
  • Nexium (esomeprazole)
  • Aciphex (raberprazole)

Remember to always consult your child’s pediatrician, gastroenterologist or pharmacist before starting any medication.

Warning signs or symptoms that immediately require further medical evaluation:

  • Weight loss
  • Seizure
  • Abdominal distention
  • Green or red vomit
  • Persistent forceful vomit

It can be helpful to keep a diary of GERD symptoms. Record your child’s symptoms and bring the diary to doctors’ appointments. This information can help the doctor determine what is causing GERD symptoms and provide better care for your child.

Avoid Becoming Thank-“full” this Holiday

By Sarah Kavlich, RD, CLEC, clinical dietitian at CHOC Children’s 

Today, in many American households, the Thanksgiving celebration is centered on gratitude and sharing a bountiful meal with family and friends. The star of the Thanksgiving meal is arguably a stuffed turkey; and often times after a day of feasting, that may not be too far off from the way we feel. You and your family can avoid overeating this holiday season with these easy steps:

  • Eat breakfast! Although known as the most important meal of the day, it is often thrown by the wayside, especially when we anticipate a larger meal to come. Instead, have a light breakfast before your feast, which can help keep you from overdoing it later.
  • Use smaller plates. We eat with our eyes and when we see a large plate with a lot of empty space, our brain has a tendency to think we are still hungry once we are finished. Instead, serve your appropriate portions on a smaller plate. Once you’ve finished your meal, you’ll be able to listen to your stomach when it tells you you’re full.
  • Load up on non-starchy veggies like salad and green beans. These sides can offer plenty of fiber, which can fill you up with out adding extra calories. If you are the cook, try a new spin on green bean casserole (see below), with all of the traditional flavors but without all of the traditional fat.
  • Hold the gravy. Did you know that gravy alone can add up to 170 calories in a half cup? Try your meal without it this year.
  • Skip the seconds. Just because it’s a holiday doesn’t mean your health goals need to take a holiday too. Focus on visiting with friends and family and not just eating. If you are truly still hungry later in the day, have a light snack to hold you over.
  • Stay active. Use this opportunity to spend time with those you love by going on a walk together before or after your meal.

Green Beans with Shallots and Almonds
Salt
2 pounds green beans, cut into 1 inch pieces
2 tablespoons olive oil
2 cups sliced shallots (about 4 large)
2 tablespoons unsalted butter, at room temperature
1/2 cup sliced almonds, toasted

Fill a large bowl with ice cubes and water. Bring a large pot of salted water to a boil. Add green beans to pot and cook until crisp-tender, about 5 minutes. Drain and plunge beans into an ice bath. Drain beans again and dry on paper towels.

Warm olive oil in a large skillet over medium heat. Add shallots and sauté until softened and lightly browned, about 7 minutes. Add green beans and butter and cook until beans are heated through, about 2 minutes. Sprinkle with toasted almonds and serve.

Yield: 8 servings, 150 calories, 10g fat, 4g protein, 14g carbohydrate, 4g fiber, 8mg cholesterol, 164mg sodium. Source: Myrecipes.com

Learn more about CHOC Clinical Nutrition and Lactation Services.