What we’re thankful for this year: 2019

The  physicians, nurses, staff and patients that make up the CHOC Children’s healthcare community have much to be thankful for this year. In addition to celebrating our 55th anniversary, expanding our Primary Care Network and preparing to open the Thompson Autism Center, we’re grateful to be able to offer best-in-class care to kids in Orange County and beyond. A few members of the CHOC community share what they are most thankful for this year.

KimberlyChavalasCripe
Kimberly Chavalas Cripe, president and CEO, CHOC Children’s

Kimberly Chavalas Cripe, president and CEO, CHOC Children’s

“I have the privilege of experiencing the magic of the holidays through the eyes of our patients.  Their courage, strength, and optimism inspire our team year-round, and drive us to push the limits of what is possible to ensure the very best outcomes for our community’s children.  From bringing preventive care closer to home, to expanding access to mental health services, CHOC’s mighty brigade is dedicated to keeping kids happy and healthy. And for that, I am especially grateful.”

chris-furman
Chris Furman, chairman, CHOC Children’s Board of Directors

Chris Furman, chairman, CHOC Children’s Board of Directors

“I am grateful for serving as chairman of CHOC’s board of directors.  It’s incredibly heartwarming for me and the entire board to help CHOC’s physicians, staff, volunteers and donors preserve the magic of childhood for thousands of children in Orange County and beyond.”

Emma_Sandhu
Emma Sandhu, vice president, administrator and chief nursing officer, CHOC Children’s at Mission Hospital

Emma Sandhu, vice president, administrator and chief nursing officer, CHOC Children’s at Mission Hospital

“I make an effort to live each day with gratitude. I am especially thankful for my family and for having the opportunity to be together this Thanksgiving. I am grateful for the things that I learn each day that help me to be the leader that this amazing organization deserves. Anyone that knows me knows how much I love CCMH and how blessed I feel to be a part of CHOC Children’s. A mighty brigade of passionate associates working side by side each day to serve our most precious gifts, our children.”

Isabella Valdovinos
Isabella, age 10

Isabella Valdovinos, age 10, CHOC Children’s patient

“I’m thankful for my mom, and the nurses and doctors at CHOC who took out my appendix and took such good care of me. I’m looking forward to a healthy and happy Thanksgiving with my family – especially the mashed potatoes and gravy.”

Liz_Hawkins
Liz Hawkins, volunteer, Mental Health Inpatient Center

Liz Hawkins, volunteer, Mental Health Inpatient Center

“As the first volunteer in CHOC’s Mental Health Inpatient Center, I’m humbled to be of service in the simplest of ways, be it a warm smile, a cup of juice, a compassionate ear or a shared laugh with our patients, families and staff. I’m grateful for all of the little things that I experience with our patients; from painting nails, to working on a puzzle, to learning a new game and even just acting silly by rolling around in the grass in our outdoor play area. I’m honored to be embraced so warmly by our patients and incredible staff as a part of the MHIC “Dream Team.” My husband Ryan and I are thankful for our entire MHIC’s dedication to treating our patients with dignity and respect every day and resetting the standard of care for pediatric mental health in this country. We are making history every day at CHOC. Lastly, I am grateful for all of the lessons our MHIC patients teach me: to face challenges head-on, to develop resiliency and self-awareness, to remember that you are never alone and most importantly, that the little things are always the big things. ”

Sterns
Ralph and Sue Stern, CHOC Children’s supporters

Sue and Ralph Stern, CHOC Children’s supporters

“As the grandparents of 10 grandchildren ages 5 – 17 years and all residing in Orange County, we are so grateful to have CHOC in our backyard. To us CHOC is not just a children’s hospital, it’s a healthcare system staffed by superb physicians, along with caring and attentive nurses, technicians and administrative staff. Each time one of our grandchildren has been admitted to CHOC Children’s Hospital as a patient, he or she has been discharged in much better condition. Our gratitude to Kim Cripe, CHOC’s president and CEO, for providing outstanding leadership and to Kara Kipp , CHOC Foundation assistant vice president, and Brianne Ortiz, manager of the Cherese Mari Laulhere Child Life Department, and the rest of the child life team for the impact of their work.”

Liam Katz
Liam, age 5

Liam Katz, age 5, CHOC Children’s patient
“I am thankful for CHOC, child life, the playroom, the treasure chests, all the doctors and nurses, and the wonderful families and friends we have met.”

dr-tom-megerian-choc-childrens
Dr. Tom Megerian, pediatric neurologist and medical director, Thompson Autism Center at CHOC Children’s

Dr. Tom Megerian, pediatric neurologist and medical director, Thompson Autism Center at CHOC Children’s

“I am so grateful for the opportunity that the CHOC executive leadership team and the Thompson Family Foundation have given us to open a state-of-the-art autism center. This will allow us to provide a medical home for families and children suffering from Autism Spectrum Disorders. My team and I are thankful that we will be able to promote early diagnosis, treatment of co-occurring disorders, education and research for families suffering from ASD.

I am especially appreciative for the gift and privilege of working with colleagues across the CHOC healthcare system in helping make the Thompson Autism Center a reality. Everyone from rehabilitation services, CHOC Children’s Specialists, neurology, psychology, information services, project management, the CHOC Foundation, marketing, and my newfound family within the Thompson Autism Center who have been so supportive and single-minded in their dedication to our patients. Finally, I am grateful to the families who, every day, put their faith and trust in us to care for their children. Thank you for enriching our lives by helping us aspire to be better clinicians, caregivers and citizens.”

Kimberly Burks
Kimberly Burks, charge nurse, neonatal intensive care unit (NICU), CHOC Children’s at Mission Hospital

Kimberly Burks, charge nurse, neonatal intensive care unit (NICU), CHOC Children’s at Mission Hospital

“As we near the end of 2019, I feel so thankful for my CHOC Children’s at Mission Hospital family. Each member of the team — from our volunteers to our managers — is an integral part of our goal to provide excellent patient care. When things get busy, our team pulls together and works hard to get the job done. I am thankful to work in a neonatal intensive care unit (NICU) that values patient- centered care and infant developmental care so much.”

chief residents
2019-2020 chief residents

Dr. Timothy Hicks, Dr. Stephanie Lee, Dr. Majid Husain, Dr. Amanda Schafenacker, chief residents

“For the past three years we have had the honor and privilege of learning from the incredible patients, physicians and medical staff at CHOC Children’s as part of the UC Irvine-CHOC Pediatric Residency Program. This year, we are thankful to be serving as the Pediatric Chief Residents. We are especially thankful for our 90+ residents who serve as the frontline providers taking care of the children of Orange County and beyond, our attending physicians and administrative staff for their commitment to education and teaching, and CHOC leadership for their unyielding support and dedication to our training program. Lastly, as pediatricians, we are grateful have the opportunity to partake in CHOC’s mission to nurture, advance and protect the health and well-being of our children.”

Jessica Ochoa, emergency department admitting representative

“I am thankful for the opportunity to work here at CHOC. I am thankful for all of my coworkers and all of the nurses because without them we would not be able to make a difference in these families’ lives. I am thankful for all the wonderful families that I have been able to meet while working here and last but not least, I am thankful for all the children that come in and continue to brighten our day with all of their little personalities. Happy Thanksgiving to all CHOC employees and CHOC families.”

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Honoring the Veterans Among our Mighty Brigade

This Veterans Day, CHOC Children’s wants to acknowledge the military veterans among our mighty brigade of clinicians and staff, and extend our heartfelt thanks for their service to our country.

We asked our veterans to share how their history of service impacts their work at CHOC, and how it contributes to our mission to nurture, advance and protect the health and well-being of children.

Here are a few of their responses.

Bill Rohde

  • Sergeant (E4), U.S. Air Force
  • Vice president, finance, CHOC Children’s

“Veterans understand what it truly means to defend and protect, making them well qualified to be defenders of childhood and protectors of the health and well-being of children.”

Bill_Rhonde_CHOC

Teela Hernandez

  • Hospital corpsman, pediatric unit, U.S. Navy
  • Registered nurse, multispecialty unit, CHOC Children’s

“Because of my service, I know how to multi-task and roll with the punches. I work well under pressure.”

Teela Hernandez

Daniel Holloway

  • Petty Officer, U.S. Coast Guard
  • Marketing project manager, CHOC Children’s

“I joined the Coast Guard and served active duty for six years because I aligned with the mission to protect lives and the environment, provide life-saving care to those in distress and promote safety through law enforcement. Military service taught me teamwork and discipline to see things through. Transitioning to CHOC was a great fit for me as its mission and values are in alignment with protecting the health and well-being of children and everyone who comes through our doors. I am grateful to work in partnership with the most wonderful people doing incredible, life-saving work within our community. I am a proud veteran and CHOC employee.”

Daniel Holloway

Cortney McKinney

  • Medic, U.S. Army
  • Registered nurse, outpatient infusion center, CHOC Children’s

“While I was a medic in the Army, I found my love for medicine and helping people. I knew I wanted to be a nurse. The Army helped me realize that God gave me the heart of a servant. I now continue my service as a nurse caring for my patients here at CHOC.”

Courtney McKinney

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From CHOC mom to CHOC employee

“You look like you could use a good cup of coffee,” Maria would say from time to time to a tired parent at CHOC Children’s at Mission Hospital. “Oh yes!” they’d reply as she’d make them a cup.

Maria understands that a warm cup of coffee doesn’t just help sustain a parent who’s running low on sleep, but also gives them back a small sense of normalcy while their child is hospitalized.

Maria, a former department assistant in the administrative offices of CHOC at Mission who recently transferred to the laboratory at CHOC Children’s Hospital in Orange, knows this all too well. Her son Nehemiah, who is now a happy and healthy 11-year-old boy, was born with a heart condition and spent the first four months of his life at CHOC.

“If I see a mom struggling, I would try to do my best to be there for them because I understood what they were going through” she says. “They’re comforted knowing that someone understands.”

Delivering next door to CHOC

Thanks to a prenatal ultrasound, Maria and her husband Juan knew there was a problem with their son’s heart. But doctors told them they wouldn’t know the extent of the problem until he was born. Maria chose to deliver her son at St. Joseph Hospital in Orange so that they’d be next door to CHOC, and he would have close access to any specialized care he might need.

Shortly after Nehemiah was born, doctors performed an echocardiogram, a common and safe procedure that helps doctors look at how the heart is working. Dr. Anthony Chang, a pediatric cardiologist who is today CHOC’s chief intelligence and innovation officer, was present at Nehemiah’s birth.

“I was so scared for my son, but I felt like he was in good hands,” recalls Maria. “Dr. Chang explained Nehemiah’s condition and that he needed to be transported to CHOC for emergency surgery. He said it was a race against time.”

Nehemiah was born with interrupted aortic arch and ventricular septal defect, a condition with a large hole in the heart and blockage of the main artery feeding the body. Normally a hole in the heart would be considered bad news, but that hole helped him live because it allowed blood to circulate until corrective surgery could be done.

When Nehemiah was two days old, he underwent his first in what would become a series of heart surgeries, performed by Dr. Richard Gates, CHOC’s medical director of cardiothoracic surgery and co-medical director of CHOC’s Heart Institute.

After Nehemiah recovered from surgery in the cardiovascular intensive care unit (CVICU), he was transferred to CHOC’s neonatal intensive care unit (NICU). He had a feeding tube to help him eat, but as a step towards going home, he needed to work on eating on his own.

Nehemiah spent his first Christmas in the hospital, and his parents weren’t sure when they would be able to bring their baby home.

The day after Christmas, Nehemiah’s condition worsened when he contracted a blood infection called septicemia. Babies under 3 months can contract this because their immune systems haven’t developed enough to fight off overwhelming infections that originate elsewhere in their body. Once he was stabilized, his care team opened his chest so they could administer a vacuum-assisted closure (VAC) to help soak up the infection. A suction pump device connected to a tube with a foam sponge on the end, which was placed into Nehemiah’s chest to soak up the infection. His dressings were changed regularly for several weeks until the infection was gone. Once he recovered, his care team closed his wound and he was transferred back to the CVICU.

It takes a village

It would be another few months before Nehemiah would be able to go home. During that time, CHOC became home for his family. Juan would shuffle back and forth between hospital and the family’s home, bringing Nehemiah’s siblings Ethan and Giovanni, who were 3 years old and 10 years old at the time, to visit their baby brother. Maria’s mom would help the family and visit as well. During Nehemiah’s months-long hospitalization, Maria stayed by his side and never went home.

“It took a village to get my little guy through this ordeal,” Maria said.

A four-month hospital stay

Before Nehemiah was discharged after more than four months in the hospital, his parents received education and training from his doctors and nurses, so they would be able to care for him at home. He was discharged with a feeding tube, oxygen tank and medication.

“We were so excited to finally bring him home. In a sense, it was like we all got to finally go home,” Maria recalls. “My other two kids had essentially been living with their grandma, I had been at the hospital, and my husband had been going back and forth. We were finally together under one roof.”

Nehemiah’s heart was fragile, so as he grew up he would sometimes get sick more easily, and more severely, than his brothers and friends.

“If he would get sick with just a little cold, he would go from zero to 10,” Maria says.

Sometimes that would include seizures, which lead to two hospitalizations.

A second heart surgery

Nehemiah has undergone one additional surgery to repair a blockage that developed between his heart and great aortic artery, called a subaortic membrane.

“After his last heart surgery, his seizures stopped, and he started becoming normal,” Maria said.

These days, Nehemiah, who loves sports and music, visits CHOC every six months for check-ups with Dr. Chang to see how his heart and arteries are progressing as he gets older.

“His team always wants to know as he is growing, are the arteries growing with him? Eventually, he’ll need another procedure someday,” Maria said.

Despite semi-frequent trips to CHOC, Nehemiah is not afraid of doctors because for him, doctor appointments are second nature, according to Maria. Nehemiah has spent so much of his life in and out of CHOC that he refers to it as “My CHOC.”

A few years ago, when Maria was looking for a new job, her personal connection to CHOC was a big factor in her search, she says.

“I felt like CHOC was somewhere I’d want to work because I had so many positive experiences here as a mom. Everybody was very friendly. The nurses were good with all my kids, and with me too,” she said. “I remember that little things went a long way, and I try to bring that to my work here now.”

Learn more about the Heart Institute at CHOC Children's

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How one surgery inspired a career in nursing

By Lisa Turni, surgical unit nurse manager, CHOC Children’s

lisa-turni-rn-choc-childrens
Lisa Turni, surgical unit nurse manager, CHOC Children’s

I’ve been a nurse for 18 years, but the seeds of my career were planted long before I put on my first pair of scrubs. Although I didn’t know it at the time, having surgery as a teenager would ultimately inspire my career path.

Growing up, I was an athlete and especially loved playing basketball. Although I was in good shape, I was always out of breath and would hyperventilate often. I felt insecure because I thought I was giving my best at practice.

When I was 14 years old, my mom took me to the pediatrician who initially assumed I had asthma. But when my doctor lifted my shirt to listen to my breathing, she noticed a depression in my chest. I had always known it was there, but I thought that’s just how my chest looked. He diagnosed me with pectus excavatum, commonly referred to as “sunken chest.” This is when the breastbone, or sternum, and some of the ribs grow abnormally and cause a depression in the middle of the chest. Pectus excavatum is the most common congenital chest wall abnormality in children. Many cases of pectus excavatum are found in the early teenage years because growth spurts during puberty can exacerbate the chest depression.

I was referred to a surgeon, who explained that the depression in my chest was pushing down on my heart and lungs, which make it harder for them to work properly, and harder for me to breathe properly. He told me that I would need surgery to correct the deformity in my chest wall. I hadn’t realized there was anything I could do to fix it. He explained that during surgery, he would make an incision across my chest and reshape my rib cartilage which would keep my breastbone in the correct position.

As my surgery date got closer, I became more aware of the depression in my chest, and the way I thought about and saw myself started to change.

At that age, kids at school can be harsh. Sometimes they would unknowingly ask hurtful questions like, “Oh, why does your chest look like that?”

I started to realize I was different. Not necessarily all of the kids and comments were mean, but I was aware that I stood out. I changed the types of bathing suits and clothing I wore to hide the depression in my chest, a behavior I now know is common among pectus excavatum patients.

A physical abnormality is an emotional thing to shoulder as a child. It can be hard for others to understand how much it can affect a child emotionally. When I became a nurse, I used that understanding to inform the care I provided to my patients.

My surgery went well, and although that occurred in the days before the minimally-invasive Nuss procedure was invented, my surgeon was able to “hide” my scar near my bra line so it wouldn’t show in bathing suits or other clothing. The scar became a badge of honor. It was a sign of my courage.

My hospital stay after surgery is what led me to pursue nursing. I knew from that hospital stay that I wanted to help other kids. Some of my providers during that time got frustrated with me because I couldn’t take a deep breath or cough due to pain. Even though pain management has improved tenfold in the years since, the way my care team acted toward me has made me want to always treat patients better than they did.

After eventually getting my bachelor’s degree in nursing, I came to CHOC Children’s Hospital as a travel nurse. As soon as I stepped foot inside CHOC, I knew it was my forever home because of the people and culture.

I worked my way up to nurse manager of the combined medical/surgical unit. Later, when we created separate medical and surgical units, I chose to stay in the surgical unit. Giving back and taking care of patients undergoing surgery is my way of making a difference. I have a special connection with patients undergoing pectus excavatum surgery.

Even though my surgery was over 20 years ago, I’ve found that many pectus patients have similar journeys. When I share my story with my patients, I let them know they are not alone. When I was younger, I didn’t know anyone else who had this condition or understood what my surgery felt like.

Now, I do my best to connect my pectus excavatum patients with one another for peer-to-peer support. In fact, at CHOC, we’re developing a mentor program where former pectus excavatum patients, along with scoliosis patients, are trained to meet with new patients prior to surgery, and help answer their questions and be part of their support system alongside clinical staff.

I also make sure to be there for my patients’ parents as well. Parents often feel guilty for not noticing how deep the chest depression had gotten – but how could they have known? By the time their kids are becoming teenagers, the period during which pectus excavatum becomes most pronounced, they’re no longer in charge of bathing them and they’re not often seeing them without a shirt. I can comfort them in a unique way because my mom had similar feelings.

They are also understandably worried about their child’s surgery and recovery, and they seem grateful to talk to someone who is so many years post-surgery without any major complications. Parents usually have a lot more questions for someone who has been through it, and I spend as much time with them as they need. Thanks to our new mentor program, it has been amazing to see connections made between our parents and patients, and what a huge support that has been for them.

I’m grateful that I had pectus excavatum because it shaped who I am as a person. When I was younger, I didn’t realize how powerful nursing could be. I’m grateful this has been my journey because it feels right to be able to give back and to help patients and their families.

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A day in the life of a pediatric hospitalist

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

What is a pediatric hospitalist? We are your general pediatricians when your child is admitted to the hospital. I like to think of hospitalists as air traffic control in the busy whirlwind of a child’s hospitalization. There are many clinicians on your child’s care team, but we help direct the flow of traffic and unite everyone in communication and management. CHOC Children’s Hospital and CHOC Children’s at Mission Hospital provides 24-hour hospitalist coverage to provide the best care for our patients.

5:30 a.m.― Alarm goes off. I may or may not be already awake depending on how my three kids ages 5 and under slept that night. So, my alarm is either my cellphone’s gentle tune or a screaming toddler. Dress, feed, and tend to all kids as we all fluster to get ready for the morning. In between walking our family’s dog and making school lunches, I brew my coffee and pack my “to go” breakfast. On my drive to CHOC, I listen to a pediatric podcast to get into the work mindset. 

7:30 -8:00 a.m.― I arrive at CHOC. My team covers CHOC Children’s Hospital in Orange and CHOC at Mission, but today I’m rounding in Orange. When I arrive, I obtain my list of patients from my night-shift colleagues and learn about the patients ’conditions and overnight events.  We usually talk over tough cases and run things by each other for discussion. One patient had increased seizures and required emergent anti-epileptic medications. One patient developed increased respiratory distress and needed to be switched to high-flow oxygen. Another patient was vomiting and unable to tolerate his diet, so IV fluid hydration needed to be established. I look over my patient list and make a plan for what order to visit patients that morning. I also review lab results for my patients and any imaging they’ve recently had done.

8:00 a.m.  – 12:00 p.m. ― Every morning, our team does bedside rounds to learn about our patients’ overnight and current events. The care team is made up of doctors, pharmacists, bedside nurses, social work, nutrition, and case management. With bedside rounds, we visit every patient’s room (and sometimes have to search for them in playrooms), examine them and establish our plan for today and for discharge. Parents are encouraged to participate in family-centered rounds. They ask great questions, and some need emotional support. Some of the children we see during rounds are not feeling well, and others require playful interactions to break the ice. I make silly faces, tell horribly bad jokes, and discuss Elsa’s upcoming Frozen 2 movie to gain trust from the little patients to perform a physical exam. Usually I can reach some sort of common ground and I work hard to get there. Diagnoses of the patients we see can range from pneumonia, bronchiolitis, gastroenteritis, and seizures to even more complex cases with elaborate medical histories. Our patient lists can run from a handful of patients to over twenty during the busy winter season.

12:00 p.m. – 1:00 p.m. ― Time for lunch, and a chance to go over the day’s events with my fellow hospitalists.  We talk, and I listen to everyone’s expertise. We manage to also chit-chat about life and hopefully share a laugh or two to lighten the mood. A few times a year, I also teach noon conference or morning report to our pediatrics residents. We are a training hospital, so we help teach the next generation of pediatricians through case report presentations and specific pediatric lectures.

1:00 p.m. – 3:00 p.m. ― This afternoon I spend a couple hours in meetings, including multidisciplinary care rounds (similar to this morning’s rounds but with a variety of specialists), meetings with patients’ parents, and medical staff committees. I help run the Morbidity and Mortality cases every month, where we discuss ways to improve patient care. I make a few calls to pediatricians in the community whose patients I am caring for while they’re hospitalized and update them on their status and plan of care. I also spend some time circling back to rooms and families from the morning. A baby in my care develops a fever and requires a lumbar puncture, also called a spinal tap, to rule out meningitis. This is a procedure we routinely do where we draw fluid from the spine in the lower back. Another patient is developing a worsening rash, so we reevaluate their antibiotic regimen to make sure it is adequate. Lastly, an emotional teenager having a tough time needs some one-on-one sit-down advice. I pause, take a breath, and tackle each task one by one. Statuses of patients can change so quickly while they are admitted, and it keeps me on my toes.

3:00 p.m.- 5:00 p.m. ― I spend time updating patients’ charts and reviewing their plans of care. Part of this includes collaborating with other specialists and discussing certain cases. During this time, we also receive a few new patients from the emergency department. Some have obvious diagnoses and others were admitted to determine the root cause of their illness. Sometimes patients are admitted from our hospital’s emergency departments or transferred from others via ambulance or helicopter. Often times the work of a hospitalist feels like the TV show “House” because we are solving medical puzzles. Medicine is fascinating and thought-provoking, and part of the reason I love what I do so much.

5:00 p.m. – 8:00 p.m. ― Just like the morning frenzy, my evenings are a rush to pick up my kids, cook and eat dinner, pick up around the house, and walk the dog. These precious hours, although very busy, are a chance for me to spend some quality time with my family and learn about how their days went. We end our nightly family time with bedtime stories and lullabies. 

8:00 p.m-10:00 p.m. ― By this time, my house is finally quiet. This is my chance to get out my yoga mat and do some flow yoga. My husband and I watch our favorite binge show of the season. After he goes to bed, I stay up a little later to check in on what’s going on with my patients and read to keep up to date with current articles in medical review journals.

I go to bed feeling thankful and to be able to do this every day as “work.” Often people tell me, “I can’t imagine doing your line of work,” but I can’t imagine doing anything else. I love who I work with and am grateful to be part of such an amazing place as CHOC Children’s.

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