CHOC Children’s wants its medical staff and patients to get to know its growing team of physicians, including primary and specialty care providers. Today, meet one of our pediatricians Dr. Reshmi Basu. Following medical school at University of California, San Diego, she completed her residency at CHOC. She’s been a member of the CHOC medical staff for eight years.
What are your clinical interests?
I am especially interested in asthma, sleep issues in children (infants through adolescents), and helping new mothers breastfeed.
Are you involved in any research?
I am a physician leader for the American Academy of Pediatrics, Chapter Quality Network U.S. Immunization Project. Practices here in Orange County and across the nation are participating in the project to improve vaccination rates for children two years and younger.
What are your most common diagnoses?
In our practice, we see a lot of patients with viral respiratory illnesses, ear infections, abdominal pain, asthma, allergies, eczema and headaches. We also spend much of our time on routine well checks for infants, teens and young adults. These appointments are important for keeping children current on vaccinations, and making sure they are growing and developing normally. We work hard to address parents’ concerns during these visits, as well.
What inspires you most about the care being delivered at CHOC?
I am proud to be a CHOC Children’s provider because CHOC undoubtedly provides the highest quality of care for patients and families. One of my patients was being treated for cancer during the holidays. Not only did CHOC make sure she received the most advanced medical care, the hospital’s child life team did everything they could to bring the holidays to her. Her room was filled with inspirational banners, Christmas lights and even beautiful new bedding on her hospital bed.
When did you decide to become a pediatrician?
I decided to become a pediatrician after my pediatrics rotation in medical school. I had always liked working with children, and was already drawn to pediatrics after volunteering at CHOC Children’s at Mission Hospital. (I grew up in Mission Viejo.) As a volunteer, I enjoyed spending time at the hospital, whether it was holding the babies or coloring with children. After my pediatrics rotation, though, I realized that children need advocates to fight for them, and that is something I wanted to do. My goal is to help all my patients grow and thrive to become healthy, successful adults.
If you weren’t a physician, what you be and why?
I pursued medicine and eventually pediatrics because of my interest in science and my love for children. If I wasn’t a pediatrician, then I think being a teacher would be another way for me to help children.
What are your hobbies and interests outside of medicine?
I enjoy spending time with my husband and children. I have a 5-year-old daughter and 3-year-old son who keep me very busy. We like being outdoors, whether it’s playing at the park or riding our bikes. We travel as often as we can. I also like to read, when I can find any free time.
What’s the funniest thing a patient said to you?
Several of my pre-school aged patients have told me I look like Doc McStuffins. This helps me to connect with them and put them more at ease during their visits. I dressed up as Doc McStuffins for Halloween a few years ago, and my younger patients were star struck!
CHOC Children’s wants its patients and families to get to know its specialists. Today, meet Dr. Katherine Williamson, a CHOC pediatrician.
Q: What is your education and training? A: I studied international relations at Pomona College, then went on to the University of California, San Francisco to study medicine. I completed my pediatric residency training at CHOC Children’s.
Q: What are your administrative appointments? A: I am the chair for pediatrics at Mission Hospital where my practice rounds on newborn babies. I am a partner within my practice at Southern Orange County Pediatric Associates (SOCPA), which is part of the CHOC Children’s Primary Care Network. Within this network, I am the SOCPA lead for the IT team where we are beta testing a new electronic health record system to be used at CHOC Children’s and in the CHOC Primary Care Network.
Q: What advocacy work are you involved in?
A: I am the vice president for the Orange County chapter of the American Academy of Pediatrics, (AAP-OC) where we focus on child advocacy and serve as an academic and resource base for pediatricians and pediatric sub-specialists. Through our legislative advocacy efforts in the last few years, we have helped to pass SB 277 to keep kids vaccinated in California, and raise the smoking age for cigarettes and vaping from 18 to 21 years of age. On a community level, we have created a mental health committee bringing together pediatricians and mental health providers working to address the mental health needs of our Orange County youth. And we have newly created the School Health Committee where we are working to increase communication and collaboration between pediatricians and schools, with goals that include the creation of an electronic HIPAA-protected communication system between teachers and pediatricians, and to better understand how to address the unmet needs of children with learning disabilities.
Q: What are your special clinical interests?
A: Child nutrition and exercise, and healthy body image
Q: How long have you been on staff at CHOC?
A: I did my pediatric residency at CHOC from 2008 to 2011, then stayed on staff as a transport physician which is still currently one of my roles. I joined my pediatric practice, Southern Orange County Pediatric Associates (SOCPA) in 2012, which has partnered with CHOC in the past year to form the CHOC Primary Care Network, thus keeping me in the CHOC family on many levels.
Q: What are some new programs or developments within your specialty?
A: Southern Orange County Pediatric Associates (SOCPA), along with two other pediatric private practice groups in Orange County – Seaview Pediatrics and Pediatric & Adult Medicine – have partnered in the last year with CHOC Children’s to form the CHOC Children’s Primary Care Network. I am very excited to be a part of this partnership because through our collaboration we can share the best evidence-based medicine practices and increase communication between CHOC inpatient services, sub-specialists, and children’s primary care practices, thus improving patient care. In the near future we will have a shared electronic health record system that unlike so many EHRs in the country will be geared toward pediatrics because we are designing it ourselves.
Q: What are your most common diagnoses? A: Pharyngitis, bronchospasm, fever, otitis media, common cold, pneumonia, acne, jaundice
Q: What would you most like community/referring providers to know about you or your division at CHOC? A: Kids come first! And all kids needs a medical home.
Q: What inspires you most about the care being delivered here at CHOC? A: I have been a part of the CHOC family for many years, from residency through now, and I am inspired by CHOC’s multi-disciplinary team approach to take care of our kids. I have seen CHOC grow with the new tower, expansion of the specialty departments, and most recently CHOC’s extension to the community with the CHOC Children’s Primary Care Network to reach out to kids in their medical home. It’s all about the kids!
Q: Why did you decide to become a doctor? A: I believe every person has a right to quality health care, and I have been fascinated by the human body since I was a kid. Like I tell my patients, it’s the coolest machine you will ever own. I love being a part of keeping kids healthy, and I love teaching parents and kids about their own bodies so that they can take ownership in their health and well-being too.
Q: If you weren’t a physician, what would you be and why?
A: One of two things, or maybe both – a journalist, and/or a Broadway performer. I loved to sing and act on stage much of my childhood, and I believe telling a story, whether fictional or non-fictional, is the best way to relate and reach out to others.
Q: What are your hobbies/interests outside of work?
A: Anything outdoors – running, swimming, biking, and scuba diving. And traveling abroad whenever I can.
Q: What have you learned from your patients, or what is the funniest thing a patient has ever told you?
A: I learn every day from my patients to find joy in the little things in life – from seeing how your finger lights up red when you touch the otoscope light to the wonders that bribery with stickers can do. I am laughing every day!
Getting kids out the door on time is stressful, and even more so if you’re headed to the pediatrician’s office for a well or sick visit. To make the process easier, and help parents maximize their time, consider the following guidelines of what to bring with you:
Insurance card + identification
List of medications the child is taking
Paperwork or test results if your child has been seen anywhere else since your last visit, such as urgent care or the emergency department
School paperwork if your appointment is tied to a physical for school activities
Diapers, formula and other baby supplies such as a blanket and pacifier
A favorite stuffed animal that can be “examined” by the doctor if your child is nervous about the visit
A favorite book, game or tablet to keep your child occupied if there is a wait
List of questions you and your family may have
Parents are encouraged to try and make childcare arrangements for other children, especially during flu season. To avoid delaying potential testing, parents are not encouraged to give their child a snack or drink while waiting to be seen.
In addition to a first-aid kit, a well-stocked family medicine cabinet can help families contend with a variety of ailments that children of all ages – and adults alike – might experience.
Here, Dr. Jonathan Auth, a CHOC Children’s pediatrician, lists the essential elements of a family’s medicine cabinet.
Acetaminophen – Frequently known as Tylenol, this common over-the-counter medication is a first-line defense against fever and pain. He recommends that families stock children’s acetaminophen rather than anything labeled as for infants. Though they used to differ in concentration, formulas are now the same, and children’s versions are typically less expensive than those marketed to infants, Dr. Auth says. Download a parent’s guide to acetaminophen for children to ensure you’re giving your child the right dose.
Ibuprofen – Known in stores as Motrin or Advil, this medication also combats fever and pain. It can also help soothe swelling and other complaints associated with an injury, thanks to its anti-inflammatory properties. Ibuprofen’s effects also last longer than acetaminophen, though it can irritate some children’s stomachs, especially if taken on an empty stomach. Dr. Auth does not recommend it for children younger than 6 months old.
Diphenhydramine – Commonly known as Benadryl, this medication can have multiple purposes, Dr. Auth says. It can help children with mild allergic reactions, as well as those who have seasonal allergies and some cold symptoms. Dr. Auth cautions that it frequently has sedative side effects, and should not be given to children younger than 2 without first consulting a pediatrician.
Calcium carbonate – Known as Tums, these chews can help soothe upset stomachs. Dr. Auth recommends consulting your pediatrician before using them in children younger than 6, however.
Dimenhydrinate – Commonly sold in stores as Dramamine, this medication is good to have on hand for travel with children who are prone to motion sickness.
Multipurpose antibiotic ointments – Commonly known under the brand names Neosporin or Bacitracin, these topical medications help reduce the risk of possible infections from scrapes and mild skin abrasions, Dr. Auth says.
Hydrocortisone, 1 percent – This low-potency topical steroid cream can help soothe itchy rashes or irritated skin.
Antifungal cream, 1 percent – Commonly known under the brand name Lotrimin, this cream is good for treating yeast diaper rashes, ringworm, and athlete’s foot, Dr. Auth says.
Sunblock – Dr. Auth recommends families keep plenty of sunblock on hand: Barrier forms, which contain compounds like zinc oxide or titanium dioxide and block out the sun are safe at any age. UV A and UV B light absorbers containing PABAs can be used in children after age 6 months old. Dr. Auth also recommends families choose SPFs around 40 or 50. Anything marked higher than that shows minimal additional benefit.
Diaper cream – For families with newborns and young infants, having a diaper cream on hand is valuable, says Dr. Auth, who also recommends choosing a cream containing zinc oxide.
Petroleum-based ointments – These treatments can be helpful as a barrier, Dr. Auth says. For example, they can protect a cut against infection or can lock in moisture on chapped lips or dry hands.
Nasal saline solution – Dr. Auth recommends these products to help relieve infants’ stuffy noses or older children’s congestion.
Thermometer – Dr. Auth generally suggests families have a very basic and inexpensive digital thermometer that can be used orally for toddlers and children and rectally for infants.
Nail clippers and files – These are a necessity to keep children’s fingers groomed. When it comes to trimming infants’ nails however, files are safer and less intimidating for new parents, Dr. Auth says.
Bulb suction devices – These products are helpful in removing mucus from newborns, as well as in children who can’t yet blow their noses.
Humidifier – This can be helpful for children suffering colds, Dr. Auth says. However, he cautions families to properly maintain humidifiers to prevent mold production or limescale build-up, which can worsen problems. Also, whether to use a warm or cold mist is generally a matter of preference, Dr. Auth says.
By Alexandria Salahshour, CHOC parent and mom of Andre, four months
This story is about my son who got sick with Respiratory Syncytial Virus (RSV) at three weeks old and was hospitalized at six weeks. I’m sharing our story so other parents are aware of the dangers of RSV and know what to look for. It’s important to always follow your own instincts no matter what. YOU know what’s best for your child. You are your child’s voice.
What is RSV?
RSV is a highly dangerous respiratory infection. It can be a potentially deadly virus if not taken care of in time. Most children will catch RSV by their second birthday, but the younger they are, the worse it can be. RSV is primarily spread through child care centers and preschools due to being in close proximity to many children. For most children, RSV will cause nothing more than common cold-type symptoms, but for some children like my son Andre, it can lead to more serious life-threatening problems such as bronchiolitis, pneumonia, collapsed lungs, respiratory failure, airway inflammation and even death.
The early signs of RSV
This roller coaster started when Andre was three weeks old. Before Andre was born, I made everyone in my family get the whooping cough vaccine along with the flu shot if they planned on touching Andre. Paranoid? No. Proactive? Yes. When Andre came it was so exciting! It was the best day of our lives.
Though we allowed people to hold the baby, I would always say “Don’t forget to wash your hands first.” After Andre got sick, I realized that the REAL questions I should’ve been asking were “Are you sick? Have you recently had a cold? Are your children sick? Are people at your work sick? Are children you are around sick?”
When Andre got sick with RSV, it came as a shock. How did he get so sick so fast? I had a healthy pregnancy, and Andre was born healthy. At three weeks old, he became congested and his breathing sounded off. It wasn’t wheezing, but more like a grunting sound. The morning after he started showing symptoms, we brought him to his pediatrician. I brought recorded videos of Andre’s breathing so the doctor could hear the congestion and grunting.
Our pediatrician didn’t think there was anything going on. He advised us to run the humidifier and to use saline drops. He thought Andre would be just fine, but told us to come back if he got worse, or got a fever with wheezing. Andre never ran a fever. We did the saline drops and humidifier, but it didn’t seem to be getting any better.
That night after our first pediatrician appointment while Andre was sleeping, we had noticed that would choke on his phlegm, be uncomfortable and would occasionally stop breathing. We continued to follow our pediatrician’s recommendation of using the humidifier and saline drops, but it wasn’t helping. I knew that there was something more serious going on.
A few days later, Andre started to wheeze and have breathing problems in his sleep. We rushed him to the hospital where I had delivered him. It was scary to be there because we didn’t know what was wrong with our baby. I had never heard of RSV before, but when I researched his symptoms it kept coming up. The doctor tested Andre for RSV and it came back positive. We were discharged with the same instructions his pediatrician had given, and told to come back if it got worse.
A couple of days went by, and Andre wasn’t getting any better. We took him back to the pediatrician for an after-hours appointment. He was their first RSV patient of the season. The pediatrician let us know that RSV is like a roller coaster, especially in someone so young like Andre. We were once again told to use saline drops, a humidifier and aspirations, but Andre continued to get worse.
Caring for a sick baby during the holidays
At this point the holidays were right around the corner, and my family had arrived from Dubai. This vacation meant the world to me, but unfortunately, it was short-lived. As soon as my uncle held Andre for the first time, he could tell something was seriously wrong. He felt vibration sounds through Andre’s back, almost as if whatever he had was in his lungs.
Suddenly, Andre took a turn for the worse. He was starting to sleep a lot more and just seemed so “out of it.” We decided to take Andre back to the hospital. We took him to the closest hospital to where we were at the time. I told the nurse that Andre was diagnosed with RSV about a week ago, and we were told he would get better, but that he was getting worse. I told him that his retractions were so bad you could see his ribs, and that he was congested, looked like he couldn’t breathe, and had been choking on his phlegm. The doctor said he no longer had the virus and that he may have caught a different virus that was causing this to happen. Even though his retractions and wheezing were so bad, she didn’t see it as anything alarming. They did an X-ray to be sure to make sure it wasn’t pneumonia, and thank God it wasn’t
The next day I saw that Andre’s hands were pale and extremely clammy. Even his lips looked somewhat discolored. I didn’t want anyone to think I was crazy or a hypochondriac, especially because every time we went to the doctor for this virus, we were sent home and told it would get better.
The nightmare begins
Two days before Christmas, our nightmare really began. We woke up in the morning and it was as if Andre had somehow taken another turn for his worse. He seemed so out of it, wasn’t eating well, and had zero interest in breastfeeding. Andre stayed asleep a majority of the day, and didn’t have as many wet diapers as he normally did. By the end of the day he looked beyond lethargic, and almost lifeless.
I did more research about RSV and found that a baby should have 50-60 breaths per minute. Andre was only at 40 breaths per minute. We called the after-hours number for our pediatrician, which is initially probably what saved my son’s life. They immediately connected us with the on-call doctor: Dr. Barbara Petty, a CHOC Children’s pediatrician.
I didn’t know this pediatrician at the time, but I’ve told myself that one day I’ll make an appointment with her just to thank her. She got on the phone and was so kind and soft-spoken, she seemed so concerned and you could tell that she probably has the most incredible bed side manner. She was giving us the most information we have heard thus far. Luckily, while on the phone with Dr. Petty, she was able to listen to Andre, heard the way he sounded and listened to how much he was struggling.
She told us that we needed to get to the hospital right away. We let the doctor know that we’ve already gone to two different hospitals, and she told us that we should take him to CHOC Children’s at Mission Hospital. When we got off the phone with her we couldn’t thank her enough. That phone call will forever mean the world to me.
I remember it was raining that night. We quickly rushed out of the house and went to CHOC at Mission. It was a busy night in the emergency department and there were doctors and nurses everywhere. Our nurse checked Andre’s oxygen levels and found it was only at 70. A healthy, full-term baby’s level should be closer to 100!
The doctor came in looked at Andre and just kept saying everything was going to be alright and that they were going to take care of him. He told us that it was good we brought him in because his oxygen was so low. They gave Andre an IV, hooked him up to a heart monitor, and gave him oxygen. It was incredible how quickly a team can work to get a baby stable.
A diagnosis at last
He tested positive for RSV again, but he was also diagnosed with bronchiolitis, rhinovirus and respiratory failure. Finally, Andre was in a relaxing state hooked up to the monitors, oxygen, IV fluids and tons of steroids. When the doctor came in and let us know what was going on, he said that because Andre was so young he needed help breathing to fight off this virus. The doctor admitted Andre into the pediatric intensive care unit (PICU) so that they could keep a close watch on him. When we got into our room, three nurses immediately came in to help care for our baby boy.
Celebrating Christmas at CHOC
The next day was Christmas Eve, our first Christmas as a family, and we were still in the hospital. It was sad being in the PICU and seeing our son struggle in the state that he was in, but we knew Andre was in the BEST place he could be and getting the best care.
Thankfully, Christmas Eve was special at CHOC. A dog named Piper from their pet therapy program visited all the children. We woke up in the PICU on Christmas morning and there was a big bag full of presents for Andre. The tag read “To: Andre, From: Santa.” It was the kindest thing I’ve ever seen.
Though we were in the PICU, CHOC did an incredible job at making a not-so-normal Christmas feel normal. We were so thankful for CHOC and all of the wonderful donated presents from incredible people. Andre got so many toys for Christmas! Because of these kind people, this became a Christmas we will never forget and forever be SO thankful for. It still brings tears to my eyes every time I think about our experience at CHOC Children’s.
When the nurses came in on Christmas, they told us that Andre was doing better and we could start the process of slowly weaning him off the oxygen. His oxygen level was stable, his heart was stable and his retractions were better. It was so nice to see improvements on our little guy!
The next day he tolerated more weaning, and we got to leave the PICU for a room in the regular pediatrics unit. GREAT NEWS! He continued to improve as the days went by. A new doctor came in to give us a run down on what was going on and gave us so much helpful information.
He explained that this virus usually comes from day cares, preschools, and school-aged children and then it’s quickly passed on to others. He let us know that this virus is a roller coaster; it gets bad and then gets better, it gets bad and then it gets better. There’s really no way of telling you when the virus will expel from the baby’s body, especially when they are so young. The doctor told us because he’s so young, the virus can last in his system up to a month!
Bring our boy home
Andre was still doing great and had life back in him. He even smiled for the first time! It was so special and it was the sweetest smile I’ve ever seen. I’ll never forget it. His care team was continuing to wean him off oxygen.
As they got closer to letting him breathe on his own, I was so nervous since that would decide if we got to go home or not. The night went by and our little champion did amazing! I was scared to bring him home but the nurses and doctors knew best, and I knew I had to learn to trust their decision since they’re professionals Before we were discharged, the nurses came in and asked us if we had any questions. They let us know that if Andre started to decline, to come back right away. The hospital was great. They had an incredible staff and we were treated so well! When we left, they gave us a few extra pacifiers, a bunch of swaddles, a nice blanket with bears on it, and a pack of diapers. It was nice to have stuff to go home with in case we were out of anything.
Thankful for CHOC
I can never thank the staff at CHOC at Mission enough for taking care of Andre the way that they did. They made us feel like we were at home, even though we weren’t. Everyone was so comforting and understanding. If we ever have another emergency, which hopefully we will not, we’ll be returning to this hospital.
I hope that no one else’s child has to go through what our baby went through. But just in case, parents should know the symptoms of RSV, be prepared and trust your instincts.
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