It's About Children - Spring 2009 Issue by East Tennessee Children's Hospital

B o a r d o f D i r e c t o r s Dennis Ragsdale Chairman Jeffory Jennings, M.D. Vice Chairman Michael Crabtree Secretary/Treasurer Debbie Christiansen, M.D.Dawn Ford Keith D. GoodwinSteven HarbLewis Harris, M.D.Dee Haslam A. David Martin Dugan McLaughlinChristopher Miller, M.D. Steve SouthBill Terry, M.D. Laurens Tullock Danni Varlan

M e d i c a l S t a f f John Buchheit, M.D.

Chief of Staff Lise Christensen, M.D. Vice Chief of Staff Mark Cramolini, M.D. Secretary

C h i e f s o f S e r v i c e s Lori Patterson, M.D. Chief of MedicineAlfred P, Kennedy, Jr., M.D. Chief of Surgery

A d m i n i s t r a t i o n Keith D. Goodwin President/CEOBob Koppel President/CEO EmeritusBruce Anderson Vice President for Legal Services & General Council Laura Barnes, R.N., M.S.N., C.N.A.A.,B.C. Vice President for Patient Care Paul Bates Vice President for Human Resources Joe Childs, M.D. Vice President for Medical Services Zane Goodrich, CPA Vice President for Finance & CFORudy McKinley Vice President for Operations

A quarterly publication of East Tennessee Children’s Hospital, It’s About Children is designed to inform the East Tennessee community about the hospital and the patients we serve. East Tennessee Children’s Hospital’s vision is Leading the Way to Healthy Children. Children’s Hospital is a private, independent, not-for-profit pediatric medical center that has served the East Tennessee region for more than 70 years and is certified by the state of Tennessee as a Comprehensive Regional Pediatric Center.

Ellen Liston, APR, Fellow PRSA Director of Community Relations David Rule Director of Development Wendy Hames, APR Editor Neil Crosby Contributing Photographer

“Because Children are Special…” ...they deserve the best possible health care given

in a positive, family-centered atmosphere of friendliness, cooperation, and support - regardless of race, religion, or ability to pay.”

...their medical needs are closely related to their emotional and informational needs; therefore, the total child must be considered in treating any illness or injury.”

...their health care requires family involvement, special understanding, special equipment, and specially trained personnel who recognize that children are not miniature adults.”

...their health care can best be provided by a facility with a well-trained medical and hospital staff whose only interests and concerns are with the total health and well-being of infants, children, and adolescents.”

Statement of Philosophy East Tennessee Children’s Hospital

www.etch.com2On the cover: The Van Tol quintuplets are 5 years old. Read their story on pages 4-5.

“ D e a r C h i l d r e n ’ s ”

December 6, 2008

Dear Children’s Hospital,

I would like to extend a HUGE thank you to the staff at Children’s Hospital’s Emergency Room. My son, Jonah, who is almost 21 months old, was scheduled for his first cochlear implant with Dr. Little on Tuesday, Dec. 9. Keeping him from getting sick during the cold weather months is of the utmost importance. Unfortunately, we had to get him in with Dr. Little at the last minute yesterday. He developed bilateral ear infections, which would possibly derail the plans for his surgery the following week, so we were sent to the ER to get his Rocephin injection yesterday afternoon. The staff was quick, kind and very accommodating. Unfortunately, I did not get any of their names. I do remember that one of the girls at the front was very sweet and got things moving pretty quickly. We got in and out in less than 2 hours, which is great for any ER. Jonah was due to have a second injection with his PCP this morning (Dec. 6). They had closed early yesterday so I had to call and see if he could get in at their urgent care clinic this morning. They couldn’t work him in and told us that he would have to go to the ER. I was honestly ready to fall to pieces. I was frustrated at the thought of bothering the ER staff because I thought they were probably plenty busy with it being a weekend and all. It wasn’t exactly life threatening, but it was a big deal to us. When we got to the ER a little before noon, I walked up to the desk and spoke with Ron C. I explained to him that we had been there yesterday and that this was pretty important. He asked me to wait just a moment while he went to get the ER Admitting Secretary. He came back in just a couple of minutes and sent me back to room 3, where Fredia G. got all of our information in order very quickly and had us ready to go. I went back to the front desk with all the paperwork and another very sweet young lady did a few things quickly and then took us back to an ER room. Once there, we met with a nurse named K.D., who was just beyond wonderful. I don’t know how anyone can stand to have to give shots to kids; it takes a special person to be that strong. I couldn’t do it. She was fast, understanding and very loving. I don’t know what else I can say to explain how much this helps. The last few months with the doctor’s appointments and the emotional part of dealing with Jonah’s deafness have been really hard on my son, myself, my husband and my family and friends. It’s never going to be easy for anyone involved but just knowing how great everyone has been puts me and my family at ease. We knew he would be in good hands. Thank you so much!

Thanks,The Fuston FamilyKnoxville

December 8, 2008

Dear Children’s Hospital,

My 10-year-old daughter had Outpatient Surgery on her elbow

on November 18. I am a single mother and was at the hospital

alone. As you can imagine, I was a nervous wreck! The

employees at Children’s Hospital not only gave my daughter

excellent care but gave me moral support as well. The staff

ensured that both Ashley and I were comfortable. I don’t know how I would

have made it through her surgery without the support of the employees and

volunteers! You will never know how much you helped me “emotionally”

through her surgery!

Thanks, Zena Yank and Family

Knoxville

Jonah Fuston

Ashley Yank

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Safe Kids of the Greater Knox Area, along with lead organization Children’s Hospital, has been involved in a number of recent child safety events. The mission of the local Safe Kids coalition is to reduce unintentional injuries in children up to age 14 in the East Tennessee region by promoting awareness and implementing prevention initiatives. The local Safe Kids is part of Safe Kids Worldwide, a network of coalitions whose primary purpose is to prevent unintentional injuries in children by providing children and adults caring for them with information about how to stay safe. The following are some of the events Safe Kids has recently participated in:

Boys & Girls Club Healthy Life Choices Carnival

Safe Kids of the Greater Knox Area coordinated with Blue Cross Blue Shield to address pedestrian and wheeled sports safety at the Healthy Life Choices Carnival in October. Six hundred students ranging from 6-14 years old attended the event at the Halls/Powell Boys & Girls Club. Children rotated through several stations during the event, including the Safe Kids area.

Children learned the proper use of helmets and participated in demonstrations to show the difference in response time between walking and wheeled activities, such as rollerblading.

Ollie the Otter Presentation at Norwood Elementary School

Safe Kids of the Greater Knox Area partnered with Anderson County Coordinated School Health to present Ollie the Otter, Tennessee’s mascot for booster seat usage, at Norwood Elementary School in December. Ollie the Otter’s child booster seat safety program teaches children about Tennessee’s child booster seat laws in a fun and interactive way. Teachers chose students at random to be measured with a “measuring stick” that shows their height, and the rest of the student audience determines whether the person’s height meets the booster seat requirement of 4 feet, 9 inches or shorter. Each child received information about the car seat/booster seat law, as well as information about the common mistakes to avoid when using child restraint seats.

by Logan Clark, student intern

2008 Fantasy of Trees raises $320,000 for Children’s Hospital The 24th annual Fantasy of Trees fundraiser kicked off the Knoxville holiday season in November with the entertaining theme of “There’s No Business Like SNOW Business.” The successful event raised more than $335,000 for Children’s Hospital that will be used to purchase equipment for the Surgery and Radiology departments, including a portable X-ray machine and hydraulic wheelchairs that convert into stretchers. Nearly 55,000 guests visited this festive holiday wonderland at the Knoxville Convention Center. The event showcased hundreds of designer trees and decorations, a Gingerbread Village, children’s activities and entertainment for all ages at the Fantasy Theater. Other attractions included visits with Santa, carousel rides, holiday shops and the Babes in Toyland Parade. More than 10,000 volunteers contributed 157,000 hours to make the 2008 Fantasy of Trees a success. Children’s Hospital extends its sincerest gratitude to all visitors and volunteers for their support. Fantasy of Trees has welcomed more than 1 million guests and has raised nearly $5 million for Children’s Hospital since it began in 1985.

by Logan Clark, student intern

Children’s Hospital is pleased to welcome the expertise of the following new medical staff members, who joined our staff in 2008:

Michael Adler, M.D., Radiology •Sheri Armstrong, M.D., Radiology •Marc Vincent Courts, M.D., Pediatrics •Jay Crawford, M.D., Pediatric Orthopedics • Turner Emery, D.D.S., Oral & Maxillofacial Surgery • Brock Evans, D.M.D., Oral & Maxillofacial Surgery •Ju Haq, M.D., Pathology •Evon Hulse, D.D.S., General Dentistry •Robert Keeton, M.D., Allergy & Immunology •Zachary Lewis, M.D., Pathology •Mark McClinton, M.D., Otolaryngology •Debra McGill, M.D., Pathology •Robert Noel, M.D., Pediatric Gastroenterology •Heather Philips, D.O., Pediatric Anesthesiology •Todd Pillion, M.D., Pediatric Dentistry •Timothy Ragsdale, M.D., Otolaryngology •Richard Mark Ray, M.D., Pediatric Otolaryngology •Jeffrey Brent Roaten, M.D., Pediatric Surgery •Richard Schultz, M.D., Otolaryngology •Charles Sewall, M.D., Otolaryngology •Angela Smithey, M.D., Pediatrics • Troy Tronsdon, D.D.S., Oral & Maxillofacial •Surgery James Vinson, M.D., Pathology • Rita Westbrook, M.D., Pediatric Emergency •Medicine

by Christie Sithiphone, student intern

Safe Kids update

Hospital welcomesnew medical staff

Five years ago in January, Tennessee’s first set of surviving quintuplets made their appearance. Now those five children are active and healthy five-year-olds, enjoying life and getting ready for kindergarten this fall. The quintuplets’ parents are Willem and Shannon van Tol of Knoxville. “We learned that we were having 5 at the first ultrasound at around 8 weeks,” Shannon said. “We were shocked and had mixed emotions. We were thrilled that I was pregnant and thrilled to be parents. However, we were very concerned about the risks involved.” Those risks were many: • The only certainty with a quintuplet

pregnancy is that the babies will be premature.

• The average length of a quintuplet pregnancy is 27 weeks (normal gestation is 40 weeks).

• If they could reach 24 weeks, there would be a chance the babies could live outside of the womb, but they would need extensive medical care and likely have disabilities.

• At 28 weeks, there was still a 10-percent chance of long-term disabilities.

• The risk that some or all of the babies would not survive was also quite high.

“‘Conventional medical wisdom’ was that the outcome of the pregnancy would be more successful for mother and children if we ‘reduced’ a couple of the babies,” Shannon said. “For us, personally, reduction was not an option, so we needed to decide where we would have the babies.” After Willem and Shannon received the difficult statistics related to quintuplet pregnancy, they visited the Haslam Family Neonatal Intensive Care Unit at Children’s Hospital. “We met Dr. Steve Prinz [neonatologist], and he showed us around the NICU,” Willem said. “We had never been to a NICU and had never seen such small, fragile babies struggling for life. We were overwhelmed and teary-eyed by the end of our tour. The tour helped us understand the reality of the risks involved and how extremely

vulnerable our children would be.” The van Tols chose Drs. Perry Roussis and Gary Stephens, perinatologists (high risk pregnancy specialists) at Fort Sanders Regional Medical Center to manage the pregnancy

and Children’s Hospital to take care of the babies after they were born. On January 14, 2004, Willem and Shannon welcomed their five babies during a Cesarean section at Fort Sanders. The birth took place during Shannon’s 33rd week of pregnancy, after she had been on bed rest for about eight weeks. Willem Scott, Sean Connor, Isabella Marie, Ashley Faith and Meghan Ann were born between 12:22 and 12:24 p.m. and weighed between 2 pounds, 8.8 ounces and 4 pounds, 0 ounces. Among the 28 health care professionals attending the delivery were five neonatologists, five neonatal nurses and five respiratory therapists from Children’s Hospital. They were on hand to immediately provide neonatal care to the babies and transport them to the NICU. “We were blessed that we managed to make it to 33 weeks’ gestation and that our kids were born without major complications,” Shannon said. “However, they were still extremely fragile and required around-the-clock care. Two of them had brief stints on ventilators, one had a lung collapse, and another developed an infection. For us as first-time parents, it was a roller-coaster experience.” Willem and Shannon said the NICU nurses genuinely cared about the babies and enjoyed taking care of them. Beth Hilbelink, Ann Kennedy, Lisa Grover and MeLisa Davenport, the rest of the nursing staff and Sheri Smith, then the nurse manager of the NICU (now Nursing Director for Critical Care Services), were extremely helpful in preparing them to care for the babies at home. “In the hours that we could not be with our babies during those first few weeks, we took great comfort in knowing that they were in the care of such knowledgeable and nurturing nurses,” Willem said. “It is hard for us to imagine a more caring or devoted group of nurses. “In addition to the state-of-the-art medical care and expertise you expect at a Level 3 NICU, the doctors were accessible and eager to help us understand the treatment each of our babies was receiving,” Willem added.

Life at home It is typical for a premature infant to remain in the NICU until right around its due date. The

van Tols were due on March 1, but they were discharged in stages, beginning just three weeks after their birth. The bigger, stronger boys went home first, on February 6. Isabella went home February 9, and the other two girls went home February 15. Adjusting at home presented its own set of challenges: for example, feeding 5 babies every four hours around the clock. For the first several months, they charted the feedings and diapers for each baby. “We have always been fairly private and independent, so it was an adjustment for us to have to rely on our family and friends to help care for the babies,” Shannon said. Friends at work (Willem works for the White Stone Group and Shannon worked at Lewis, King, Krieg & Waldrop, PC), family, neighbors and other friends helped with feedings, provided meals and offered prayers. Adriance Guider, an Enfamil representative, supplied formula by the truckload delivered right to their house. The babies did need some special care and monitoring because of their prematurity. They received shots to prevent respiratory syncytial virus (RSV), had a few visits from Home Health Care staff for monitor checks, were evaluated through Children Hospital’s high risk clinic (but none required any treatment or therapy) and had their vision checked (it is normal). As they have grown The family has experienced different challenges with each stage of the children’s lives. “With the baby stage, the biggest challenge was providing total care for each of them – feeding every four hours, baths, diapers, laundry,” Shannon said. When they were toddlers seeking to explore and be independent, the biggest challenges were keeping them safe and teaching boundaries. “Though we still worry about their safety and they still test boundaries, preschool is a great stage because we can communicate so much better with them,” Willem said. “They have become quite articulate at expressing themselves, and they can understand everything we tell them. They are so inquisitive and eager to learn about everything. The biggest challenges at the preschool stage are keeping them busy and challenged and having the energy to keep up with them.” The van Tols believe a key challenge at all stages is focusing on the children as five individuals. Although they may go through various stages at the same time, each child has a different personality and perspective, and each requires individual attention. The van Tols are grateful for that challenge every day and are “forever grateful” to Children’s Hospital for caring for Willem, Sean, Isabella, Ashley and Meghan.

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The 5 turn 5

Willem and Shannon van Tol with their newborn quintuplets – Willem Scott, Sean Connor, Isabella Marie, Ashley Faith and Meghan Ann (left to right in birth order) – at Children’s Hospital in January 2004.

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Personality –• gregarious, confident, competitive, persistent and persuasive Favorite color• – blue Favorite food• – potatoes Favorite movie• – Snoopy Favorite song• – Jingle Bells Favorite game –• foosball Favorite preschool activity• – painting Hero• – Sean Likes• – cars and motorcycles and anything outside Dislikes –• naptime and “tasting grease and slime” What I do for fun• – bike, skateboard and color The best thing about being a kid• – get to do special things Childhood dream/what I want to be •when I grow up – engineer

Personality –• thoughtful, independent, spirited and loves to help Favorite color –• pink Favorite food –• pineapples Favorite movie –• Snoopy and Woodstock Favorite song –• Twinkle Twinkle Little Star Favorite game –• computer games Favorite preschool activity –• making crafts Hero –• Ms. Nancy (preschool teacher) Likes –• princesses and chocolateDislikes –• naptime and “sitting in time out” What I do for fun –• write, slide, swing, bike and swim The best thing about being a kid –• “You play and not do bad stuff” Childhood dream/what I want to be •when I grow up – Sleeping Beauty

Personality –• outgoing, playful, considerate and entertaining Favorite color• – purple Favorite food• – macaroni and cheese Favorite movie• – Tom & Jerry Favorite song• – Love Blowing Down Favorite game –• computer game Favorite preschool activity• – make jewelry Hero• – Mom Likes• – “I like being lovable.”Dislikes –• “I don’t like being bad to other people.”What I do for fun• – sing, dance and play with babies What’s the best thing about being a kid• – hugging Childhood dream/what I want to be •when I grow up – dancer or a doctor

Personality –• imaginative, creative, articulate, organized and cautious Favorite color• – green Favorite food• – macaroni and cheese Favorite movie• – Horton Hears a Who Favorite song• – Away in a Manger Favorite game –• Charades Favorite preschool activity• – write Hero• – Sean Likes –• princesses and fairies and booksDislikes –• naptime at preschool What I do for fun• – arts and crafts, playing dress-up, swimming, biking, roller skating and skateboarding The best thing about being a kid• – playing Childhood dream/what I want to be •when I grow up – painter

Personality –• tender-hearted, patient, easy-going, energetic and fun-loving Favorite color• – red Favorite food• – macaroni and cheese Favorite movie• – Snoopy Favorite song• – Puff the Magic Dragon Favorite game –• Candy Land Favorite preschool activity• – play with two friends named Collin Hero• – Willem Likes• – smiley faces, skateboarding and sandDislikes –• naptime and teasing, especially Isabella drawing on other people’s art What I do for fun• – computer games, foosball without keeping score, bike, play super hero and bad guys with Willem The best thing about being a kid• – playing Childhood dream/what I want to be •when I grow up – builder

Subspecialist ProfilesSubspecialist ProfilesDr. Hopp wants to guide children on a path to healthy adulthood The rise in childhood obesity is commonly in the news these days, and with good reason. Overweight children frequently have high blood pressure, and they experience many negative side effects throughout their lifetimes. Laszlo Hopp, M.D., a pediatric nephrologist who joined the Children’s Hospital Medical Staff in January, has a special interest in childhood hypertension. He hopes to help his young patients start on the path to a healthy adulthood. He wants to get them on the right track to avoid serious problems such as hypertension (high blood pressure) and to encourage healthy eating and exercise. “I love children, and that was my main reason for entering pediatrics,” Dr. Hopp said. “Of course that is true for 99 percent of pediatricians. I completed a hypertension research fellowship between 1982-84 with a pediatric nephrologist in New Jersey. That was my inspiration that led to my interest in this field.” As a pediatric nephrologist, Dr. Hopp is an expert in the care and management of patients with kidney problems. Besides the traditional kidney problems, a large number of his patients are referred to him because of high blood pressure. It is increasingly recognized that pediatric high blood pressure is quite harmful to children’s health. High blood pressure in children was long thought to be caused by hidden kidney disease. However, “more and more we see that it is genetic,” Dr. Hopp said. “But it can also come from kidney problems, which is why nephrologists are involved in the child’s care.” Other common conditions he treats include urinary tract infections, kidney failure, kidney dysplasia and hyperplasia (kidney abnormalities that develop before birth), proteinuria (protein in the urine), hematuria (blood in the urine), and glomerulonephritis (an inflammation of the kidney). Dr. Hopp also provides management of care for children needing dialysis and for those requiring kidney transplants. Describing dialysis as a machine that functions as an artificial kidney, Dr. Hopp said improvements

Laszlo Hopp, M.D.M.D. –• Semmelweis Medical School, Budapest, Hungary, 1977Rotating Internship –• Semmelweis Medical School, 1977Residency (Pediatrics) –• University of Medicine and Dentistry of New Jersey, Newark, 1986-88Fellowship (Pediatric Nephrology) –• Albert Einstein College of Medicine, New York City, 1988-91Experience• – Children’s Hospital of Pittsburgh (1991-94), University of Medicine and Dentistry of New Jersey (1994-96), Nemours Children’s Hospital in Delaware (1996-2006), Greeneville Hospital System (2006-09). Family• – wife, Evelyn Hopp, a case management nurse; and children, daughter Timea (20-year-old college student) and Daniel (17-year-old high school student)Personal Interests –• photography (his major pastime), fine arts, reading, watching old black and white movies, all kinds of music (including bluegrass) and the outdoors (especially the Smoky Mountains)

in kidney transplantation and kidney dialysis are the biggest advances in both general and pediatric nephrology. Nephrologists such as Dr. Hopp are not surgeons – they provide only medical care to their patients. This can include supportive care and pre- and post-operative care for kidney transplant patients. Nephrologists also help patients to get “the most mileage” out of failing kidneys before referring the patients for transplantation. For patients requiring a kidney transplant, nephrologists will help with management, including monitoring anti-rejection drugs to help keep the patient’s new kidney functioning. One of the biggest challenges Dr. Hopp sees in his practice relates to patients with high blood pressure and to certain types of kidney disease that “don’t hurt” and can be diagnosed only with laboratory tests. In fact, high blood pressure is sometimes referred to as “the silent killer” because other than the high reading on a blood pressure monitor, patients typically do not show any other symptoms. Sometimes parents and patients don’t take the child’s condition seriously enough because it seems to be a minor problem. “That’s one of the more critical and troublesome challenges. Just because it doesn’t hurt doesn’t mean it’s not a problem,” Dr. Hopp said. “So sometimes there are compliance issues with patients or parents. The child’s problem can seem fairly innocuous, and so the patient thinks he or she is fine.” Dr. Hopp, who most recently practiced in Greeneville, S.C., came to East Tennessee in search of a different and “more progressive” pediatric nephrology program. He and his wife are looking forward to making the most of their close proximity to the Smoky Mountains. At the same time, Children’s Hospital is looking forward to working with Dr. Hopp to enhance care for children living in the East Tennessee region with high blood pressure, kidney disease and other related health issues.

Laszlo Hopp, M.D.

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enjoy performing the surgery, which offers a relatively quick solution to many deformities,” he explained. During his pediatric otolaryngology fellowship at Arkansas Children’s Hospital, Dr. Ray participated in training that was heavily weighted toward cleft lip and palate repair. He was involved in the care of hundreds of cleft patients while he served as co-director of the cleft team. Two years of specialty training in pediatric facial plastic surgery qualifies him to care for routine as well as very difficult problems these patients face. Also during his fellowship, he worked extensively treating facial vascular malformations and hemangiomas (two types of birth marks) while studying all other aspects of pediatric otolaryngology. Dr. Ray believes in proactive treatment of hemangiomas. “These lesions may be watched for years, when early surgery and/or laser therapy could easily treat them,” he said. “Some physicians have the philosophy to ‘wait five years and it will go away.’ But many do not go away, and it can destroy normal tissue, including cartilage, in the process.” As a pediatric ENT, Dr. Ray treats the full spectrum of ear, nose and throat conditions in children, such as obstructive sleep apnea, surgery to implant tubes in the ears, facial trauma and small jaws. Dr. Ray has developed skills in a procedure called mandibular distraction to stimulate growth in the mandible in patients with a small jaw. Commonly caused by Pierre Robin Sequence, a disorder with a small jaw accompanied by the patient’s tongue pushed too far back in the throat and a cleft palate, these patients often have difficulty breathing and feeding, historically requiring a tracheostomy and a feeding tube for two to three years. The use of mandibular distraction can eliminate the need for the tracheostomy and a feeding tube. The procedure has been done for ten years in the general population but has only been in use for newborns for the past 8-10 years, and few surgeons are trained in it. “It will become the gold standard treatment for many patients as more surgeons begin to perform it,” he said. Preventing a tracheostomy and feeding tube can have a major impact on early development for these patients.

R. Mark Ray, M.D. • M.D. – Wake Forest University School of Medicine, Winston-Salem, N.C., 1997 Internship (General Surgery) –• University of California at Davis, Sacramento, Calif., 1997-98 Residency (Otolaryngology Head and Neck •Surgery) – University of California at Davis, 1998-2002 Fellowship (Pediatric Otolaryngology) –• University of Arkansas for Medical Sciences/Arkansas Children’s Hospital, Little Rock, Ark., 2002-04 Experience –• formerly Pediatric Otolaryngologist at Nemours Children’s Clinic, Jacksonville, Fla.; Assistant Professor, Mayo Clinic; and Co-Director, Cleft and Craniofacial Team of Arkansas Children’s Hospital. Family –• wife, Angel; and children, Savannah (15), Amanda (13), Hudson (8), Sara (6) and Tom (3) Personal interests –• fly fishing, scuba diving, U.S. history, landscaping and medical missions work overseas

Pediatric otolaryngologist (ENT) brings special skills to Children’s Hospital An exposure to a large number of patients with congenital facial anomalies (birth defects) such as clefts and birthmarks led a new Children’s Hospital pediatric subspecialist to his passion and the pursuit of specialized skills. “Children are a special patient population and they deserve good care,” said Mark Ray, M.D., pediatric otolaryngologist. “They have their whole lives ahead of them. What attracted me to this specialty is the opportunity to improve a child’s life early on.” Dr. Ray joined Pediatric Otolaryngology-Head and Neck Surgery, PLLC, in January, bringing specialized experience in cleft surgeries to this growing practice. “I have seen a lot of cleft patients in the United States and abroad, and I

But his biggest interest remains cleft lip and palates, one of the more common birth defects. About 1 in every 800 children is born with some form of cleft lip and/or palate, ranging from mild to severe. The rate is higher, closer to 1 in 600 children, among Native American and Latin American Indian populations. Dr. Ray travels abroad once a year to participate in medical missions work. He has directed surgical outreach teams to the West Bank, China, South America and the Philippines, returning most frequently to the West Bank, a Middle East territory occupied by Israel on the west bank of the Jordan River. “We see kids who do not have care available, including older kids who come in who have never had their clefts repaired,” Dr. Ray said. “The ideal window for repair is infancy, so for these older kids, the cleft and the surgery are more challenging.” The problem of clefts in older children is three-fold. First, the child’s social framework is marred by ridicule and perhaps by not being accepted by peers -- Dr. Ray once treated a 12-year-old girl in the Philippines who had been kept out of school and hidden away simply because of her cleft lip. Second, speaking and eating patterns are established early, so children with clefts develop compensatory speech patterns that are difficult to undo and reverse. And third, the patient’s tissue is much more primed for healing during the first year of life. During a mission trip to China, Dr. Ray met Tom, a baby with a cleft. He operated on the little boy and then adopted him. Tom, who is now three years old, joined the Ray family about two years ago. Dr. Ray is excited for the opportunity to join a practice at Children’s Hospital. While he was a medical student at Wake Forest, he met Dr. John Little, who was at that time the chief resident there, so their friendship goes back a number of years. Dr. Little opened Pediatric Otolaryngology-Head & Neck Surgery in 2002 and recruited Dr. Michael Belmont in 2003. Working together with Drs. Little and Belmont, Dr. Ray is looking forward to the chance to build a cleft and vascular malformation program at Children’s Hospital to serve this region’s children.

R. Mark Ray, M.D.

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Sedation service marks 5 years at hospital

The Sedation Service at Children’s Hospital recently passed two major milestones – five years and 10,000 cases – as it moved last fall into a new, dedicated suite on the hospital’s First Floor. Patients requiring sedation for all types of tests and procedures in Neurology, the Gastroenterology Lab, Oncology and other areas of the hospital – basically anything that can be done outside of a traditional Operating Room – can be sedated in the new Sedation Suite, which is staffed by sedation physicians and nurses who have completed a certification in sedation. In addition, the Sedation Service staff sedates patients as needed for Radiology testing within the Radiology Department. “The key to the service is the team,” said Mick Connors, M.D., medical director of the Sedation Service. “Our goal is to improve access to safe sedation.” Patients may need sedation for a variety of reasons – a test that requires them to remain completely still for longer than an awake child could be still, or a difficult or painful procedure that would be more easily tolerated by a sedated patient. Dr. Connors said some examples

include a patient who needs daily radiation oncology for cancer, a child with special needs who requires lab draws, a young child who needs a certain type of hearing test, or a patient who needs an abscess drained. Parents and patients alike have expressed a great appreciation for the benefits the service provides to them during difficult procedures and tests. Sedation at Children’s Hospital is highly monitored, and the capability of this service at the hospital is important to the

safety of this area’s children, according to Dr. Connors. “We want to help area physicians be more aware of this capability at Children’s Hospital,” he said. “It’s a safely monitored alternative to at-home sedation, which is still occasionally prescribed by doctors for their patients who are scheduled for tests.” Dr. Connors has a very personal interest in the sedation service at Children’s Hospital. Before he was born, an older brother died of cancer at age 5. While he never knew the brother who died, he grew up in a household that was forever affected by that loss. It was a big influence on his decision to become the first physician in his family – he wanted to help children with cancer have an easier path to treatment. “My mom said she was often waiting for someone to come into my brother’s hospital room with a smile on their face, but that didn’t happen much,” Dr. Connors said. “So I try to help my patients have something to smile about – besides helping them be comfortable, I tell them bad jokes. Having this opportunity to help care for children in a positive atmosphere is an awesome responsibility for me.” The sedation service is staffed by Drs. Connors, Frances Craig, Bob Dickson and John Williams; coordinator Laura Ellis; and nurses Karen Carson, Wanda Dietz, Sandy Dutton, Kim Hill, Jeff Mayberry, Carrie Millsaps and Nancy Timm.

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Pulmonology a growing service at Children’s Hospital

There is no question Children’s Hospital has grown tremendously in recently years. The hospital staff has doubled in size in the past 15 years, the facilities have been substantially expanded and patient visits have grown exponentially.

Part of the hospital’s growth can be traced to the addition of new pediatric subspecialties and the expansion of existing subspecialties. One significant example is the Pediatric Pulmonology Department.

Fifteen years ago, Dr. John Rogers was in solo practice in pediatric pulmonology at Children’s Hospital. Today, the practice has three physicians (Rogers, who is Medical Director of Respiratory Care at Children’s Hospital, has been joined in recent years by Eduardo Riff, M.D., and Sterling Simpson, M.D.) and four nurse practitioners (Judy Marciel, Phil Noe, Mary Miller and Erin Walker). The practice also has two respiratory therapists and several registered nurses.

“There is an incredible need in this area,” Dr. Simpson said. “Pediatric pulmonology is an under served population. Three physicians is just barely enough.”

The practice has grown from providing basic pediatric pulmonology services to participating in the development of multiple subspecialty clinics and has expanded its offices to also provide services in Upper East Tennessee. Currently the practice has about 5,000 total patients. Much of the growth is because the practice has made an effort to better educate primary care physicians of the services they offer and to help physicians know when patients need a referral.

Patients are referred to the practice for many different types of problems: asthma, extreme prematurity with lung disease, apnea, neuromuscular disorders such as muscular dystrophy, profound neurodevelopmental delays, children with tracheotomies or on home ventilators, cystic fibrosis, chronic lung disease of any type, sleep disorders, recurrent pneumonia, chronic cough and breathing problems with exercise.

As the practice has grown, inpatient care for the practice’s patients has quadrupled. In the warmer months, the practice has 10-20 of its patients hospitalized per month, while in the colder months, that increases to 25-35 patients per month. The practice also performs 25-30 outpatient bronchoscopies each month at the hospital (a bronchoscopy is a procedure where a physician examines the inside of a patient’s airway with an instrument called a bronchoscope).

The pediatric pulmonology staff works hand-in-hand with Children’s Hospital on the Cystic Fibrosis Clinic, which follows about 150 children, including most CF patients from upper East Tennessee. This clinic includes physicians, physical therapists, nutrition, social work and respiratory care staff to serve children as well as young adults under age 24 with CF. Through their work with the CF clinic, the staff members are involved in clinical research trials for the treatment of cystic fibrosis. Dr. Rogers is the CF Center director.

Pulmonology staff members also take part in the hospital’s new Weight Management Clinic, helping with the patients’ overall physical health. Overweight children often experience pulmonary complications, such as asthma or obstructive sleep apnea, specifically because of their weight.

Other clinics include:Home ventilator patients (the practice manages all patients in this region on home vents)• Infants on apnea monitors (generally newborns, especially premature infants requiring •oxygen or babies with lung diseases) Pediatric sleep medicine (Dr. Simpson and Noe are active in the promotion of this service •to regional physicians, and the pulmonology office interprets about 450 of the Sleep Lab’s sleep studies each year. Dr. Riff co-directs the Children’s Hospital Sleep Lab with pediatric neurologist Chris Miller, M.D.) Synagis (an immunization clinic for babies at risk of respiratory syncycial virus during •the winter months). The Synagis clinic provides most of the Synagis vaccinations in East Tennessee.

The practice also has branched out in a number of other areas. Staff recently began performing pulmonary function testing in their office for some inpatients at the hospital to help the hospital’s busy Pulmonary Function Lab accommodate patients in a more timely manner.

“Our biggest asset is our relationship to Children’s Hospital,” Noe said. “Parents like that we are located in the Medical Office Building at Children’s Hospital, and we like that the hospital is offering tests and support services just across the street from our office.”

Pediatric pulmonology also has launched a Web site at www.pedslungs.com to provide a resource for parent feedback, patient blogging and pulmonary health information.

Mick Connors, M.D.

Children’s NewsChildren’s Hospital’s

new vision statement is “Leading the Way to Healthy Children.” In this series in It’s About Children magazine, we are sharing with our readers some of the many ways we are “Leading the Way.” Each article highlights outstanding practices by Children’s Hospital departments – things that are, although quite commonplace

at our pediatric medical center, actually rather unique. This series highlights the exceptional work done at Children’s Hospital and demonstrates how the hospital is a great place to work.

Respiratory, nursing staff create asthma booklet

Service Excellence and Family-Centered Care are at the forefront of care at Children’s Hospital. Recently, staff in two hospital departments made those initiatives their focus when they began a project to better educate patients with an increasingly common but serious diagnosis – asthma. In the past 12 months, Children’s Hospital had 2,023 total patient visits for asthma, an average of more than five visits per day for this single illness. Just over 400 of those visits were

Retiring physician honored Longtime Children’s Hospital pediatric orthopedic surgeon Bob Madigan, M.D., was honored recently upon his retirement from the Medical Staff. During a recent meeting of the hospital’s Board of Directors, a plaque in Dr. Madigan’s honor was unveiled. The plaque is being placed on Fourth Floor East (the Inpatient Surgery unit). The plaque reads, “In recognition and celebration of Robert R. Madigan, M.D., on his retirement – December 2008. The Board of Directors, Medical and Hospital Staffs recognize his enduring commitment, devotion and skilled care as a pediatric orthopedic surgeon to our hospital, our vision and the children of this region. The hospital family expresses its profound appreciation to Dr. Madigan for his leadership and service to the Medical Staff and the Board of Directors for over three decades. Dr. Madigan was a member of the Medical Staff from 1975-2008, serving as Chief of Surgery, Vice Chief of Staff and Chief of Staff in 1993 and 1994. He also served on the hospital’s Board of Directors from 1995-2006, chairing the Quality Improvement and Strategic Planning Committees and providing valuable guidance as Vice Chairman for seven years.” During the presentation, pediatric neurologist Chris Miller, M.D., praised Dr. Madigan’s dedication to the hospital and his willingness to take on so much leadership of the Medical Staff.

“Dr. Madigan, more than anyone else I’ve known here, recognized the importance of nurturing medical staff leaders and went out of his way to encourage and promote the involvement of individuals he saw as being dedicated to the development of a strong institution and a strong medical staff,” Dr. Miller said. “As we move to develop mechanisms to promote formal leadership training, it would be wise to look to Dr. Madigan for advice and wisdom in an area in which he has ample expertise.” Pediatrician Debbie Christiansen, M.D., with Knoxville Pediatric Associates also spoke about Dr. Madigan during the board meeting: “Reading a ‘Dr. Madigan dictation’ will most assuredly bring a smile to your face or sometimes an out loud chuckle as he describes the patient’s antics that resulted in a need for orthopedic intervention,” Dr. Christiansen said. “Through the tales of the aspiring NBA superstars to the young lasses who chase boys, the reader gets a glimpse of Bob’s wit. His thorough evaluation, sound medical judgment and efficient treatment inspired confidence for both referring physicians and patient families which is unsurpassed as he has cared for the orthopedic needs of children in East Tennessee. “Bob Madigan has been the type of individual who leads by example,” she continued. “He listens intently, does not make rash, impulsive comments, and has the ability to look at situations from several

serious enough to require admission.The Respiratory Care and Medical Nursing

Services Departments created a 24-page booklet to use for asthma patient education. The books are now being used throughout the hospital. In the Emergency Department, for example, ED physicians or respiratory therapists give the books to asthma patients. The pulmonary clinical nurse specialist or a respiratory therapist attempts to make a room visit to all admitted patients to discuss the contents of the book in detail and answer any questions the family may have.

“Those visits often have a huge payoff for all involved as we are able to let the family get comfortable and discuss without feeling rushed,” said Bob Yost, Respiratory Care Coordinator. “The book’s design also seems to invite someone to open and read it. I’ve been surprised at how many family members have done so before we visit.”

It is hoped the books can soon be made available to Pediatric Pulmonology and pediatrician practices to offer to their asthma patients when appropriate. The books will eventually also be provided at community and school programs related to asthma. Initial grant funding has been secured from the Will Rogers Institute to fund printing of more booklets and broaden the booklet’s distribution. The booklet also is being translated into Spanish to benefit our

growing Spanish-speaking patient population.The creation of the booklet puts

understandable and detailed information about asthma right into the hands of patients and parents. The booklets are written in a simple question-and-answer format and include space in the back for families to add notes or list questions.

“This has been a dream several years in the making, and we are quite proud of how it’s turned out. It is going well, and we have received a lot of compliments on it,” said Casey Norris, pulmonary clinical nurse specialist who educates patients in the hospital and gives presentations outside the hospital about asthma. “It’s a great resource, and I’m hoping to be able to use the booklet at school and community talks as well.”

Yost and Connie Meredith of Respiratory Care and Norris of Medical Nursing Services created the “Asthma Q&A” booklet. Susan Clevenger in Community Relations served as the booklet designer.

Leading the Way

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angles, thus his opinions are respected by his colleagues. It has been a privilege to work with him, and hopefully I have learned a thing or two over the years.” Children’s Hospital President/CEO Emeritus Bob Koppel, who worked with Madigan for 30 years, said, “In the history of every organization, there are people who become known as ‘difference makers’ – Dr. Bob Madigan has unquestionably been one for Children’s Hospital. “For more than three decades, his service as a pediatric orthopedic surgeon to the children of our region has been a beacon of hope for a better tomorrow,” Koppel said. “His leadership as a member of Children’s Hospital’s Medical Staff and Board of Directors helped pave the way for Children’s Hospital becoming a nationally respected medical center for children. His commitment and unwavering support of Children’s Hospital have been exemplary and a model for future leaders to follow.”

Bob Madigan, M.D.

Casey Norris, R.N., provides education on respiratory illnesses to many Children’s Hospital patients.

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Goodrich promoted to Finance VP Zane Goodrich, Controller for Children’s Hospital for the past 15 years, has been promoted to Vice President for Finance and Chief Financial Officer. Goodrich replaces Becky Colker, who resigned in mid-2008. Goodrich has twice served as interim CFO – first, during a medical leave for retired Vice President Jim Pruitt a few years ago, and second, following Colker’s resignation last year. According to Children’s Hospital President/CEO Keith Goodwin, Goodrich’s promotion to Vice President/CFO comes as a direct result of his performance during his two terms as interim CFO. “Zane has served Children’s Hospital with distinction for the past 15 years, and his two terms as interim CFO have demonstrated that he is the right choice for our new Vice President for Finance and CFO,” Goodwin said. “In each [interim] situation, Zane has done a good job and added value to the senior leadership team. His commitment to Children’s Hospital has never wavered, and his willingness to tackle difficult issues has been commendable. We look forward to working with Zane in his permanent elevation to this new role.” Goodrich will oversee all aspects of Finance, Registration, the Billing Office, Switchboard/Admitting, Payroll and Health Information Management. He will also assume board membership on Partners in Pediatrics and the Children’s West Surgery Center. Other areas where he will be involved include managed care contracting, new ventures and physician partnerships. Having served as the interim CFO twice and as the hospital’s controller for the past 15 years, Goodrich is well versed in the hospital’s staff, finances and other operations. He said the most important focus of his new role for the immediate future will be the successful implementation of changes in TennCare, Tennessee’s managed care insurance program for low-income residents (it replaced Medicaid in Tennessee in 1993). The current weak state of the U.S. economy – and its impact on the hospital – will also be a focus of his work. TennCare is in the midst of the most significant program change in its history, returning in some respects to the original program model of 1993. New contracts for TennCare payments will require an emphasis on case management and utilization review. “This will primarily affect how we get paid for inpatient services,” Goodrich said. “Also, as the economy has slowed down, we are seeing a general slowdown just like everyone else,” Goodrich added. “We are getting paid less and paid more slowly, so we’re having to react more quickly to these changes.” Goodrich said some small changes will be made in the Financial Services Department, including the promotion of longtime hospital Accounting Manager Lesa Hawkins to replace Goodrich as Controller. “We will evaluate the department, which is natural when the leadership changes,” he said. “As the new controller, Lesa will have input as well.” During his decade and a half at Children’s Hospital, Goodrich has seen many changes. “Information Systems plays a much greater role now in everything we do, not just finance – but in all areas of the hospital,” he said. “We’re spending a lot more money in IS and are expecting financial returns more there than in the past. “And the size of the hospital workforce has more than doubled in 15 years,” he added. Goodrich, a certified public accountant, holds a bachelor’s degree in accounting from East Tennessee State University and a master of accountancy from the University of Tennessee. Before joining Children’s Hospital, he worked for seven years at St. Mary’s Medical Center, first as Director of Internal Audit and later as Director of Finance. Before joining St. Mary’s, he was an internal auditor at TVA and was approached to start the Internal Audit Department at St. Mary’s.

Zane Goodrich

Dr. Brinkmann wins state awardTennessee Emergency Medical Services

for Children Foundation (TN EMSC) has selected Kevin Brinkmann, M.D., of Children’s Hospital as the 2008 recipient of the Joseph Weinberg, M.D., Leadership Award. This award recognizes Dr. Brinkmann’s dedication of long-standing service to the life saving needs of the children of Tennessee and support of the principles of the national Emergency Medical Services for Children program.

Dr. Brinkmann, a pediatric critical care specialist at Children’s Hospital since 2004, was appointed a member of the Department of Health, Committee on Pediatric Emergency Care (CoPEC) in 2005. CoPEC is an advisory committee to the Board of Healthcare Facilities and the state Emergency Medical Services Board, which recommends standards for quality care of critically ill and injured children in Tennessee. Members of this committee serve voluntarily as a public service without compensation.

As part of his duties, Dr. Brinkmann served as a member and chair of the Standards Committee. Working with his colleagues, he coordinated and edited a comprehensive revision of the rules and regulations that provide guidelines for the preparedness to management of pediatric emergencies for all hospitals and ambulance services in Tennessee. The original guidelines had been drafted by CoPEC and accepted by the Tennessee Board of Licensing of Healthcare Facilities in 1998. The revision drew upon the expertise of representatives from the four children’s hospitals in the state, the Tennessee Hospital Association, the Tennessee Ambulance Services Association, the Rural Health Association of Tennessee, the state Parent-Teacher Association, the Tennessee Department of Health and the Emergency Medical Services Board, as well as many individuals.

Organizing, analyzing and formulating the input from these various sources and ensuring the results were in agreement with all nationally recognized standards was a process that took 18 months to complete and resulted in a 100-page document.

The Standards Committee, under Dr. Brinkmann’s leadership, is now working on developing a standardized hospital transfer agreement for pediatrics. Since not all hospitals in Tennessee have the capabilities to provide highly complex medical and surgical services for rare pediatric conditions and life-threatening illness, hospitals must have agreements in place for transferring these patients to hospitals that provide these specialty services. The administrative forms and requirements for transfer of medical information had not been uniform across the state, so referring hospitals had a separate form and transfer data requirements for each specialty hospital with which they had a transfer agreement. Dr. Brinkmann and the Standards Committee of CoPEC are bringing together the medical, administrative and legal counsel of the hospital systems, and together with the Tennessee Hospital Association, are developing a uniform transfer form for pediatrics for use across the state.

For these and other leading efforts to promote the best quality care of critically ill and injured children in Tennessee, Dr. Brinkmann was awarded the TN EMSC Joseph Weinberg, M.D., Leadership Award, named in honor of a former Children’s Hospital Emergency Department physician, Dr. Joseph Weinberg, who spent the latter part of his career at LeBonheur Children’s Hospital before his retirement. Previous winners of the Weinberg award include Drs. Mick Connors and Joe Childs, both of Children’s Hospital.

Dr. Brinkmann received his undergraduate degree from the University of Tennessee at Chattanooga and his medical degree from the University of Tennessee College of Medicine in Memphis. He completed a residency in pediatrics and a fellowship in pediatric critical care at LeBonheur Children’s Medical Center in Memphis.

Children’s News

Kevin Brinkmann, M.D.

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Children’s NewsHospital Web site features expanded offerings Have you visited the Children’s Hospital Web site recently? As part of Children’s Hospital’s ongoing commitment to this region, the hospital provides a wealth of free information on our Web site, www.etch.com. We continue to provide the CarePages service to help families stay in touch throughout the difficulty of a child’s illness. CarePages, an Internet-based communications system, offers an opportunity for families to create simple web pages about a sick or injured relative who is a patient at Children’s Hospital. CarePages offers patient web pages that deliver emotional support to Children’s Hospital patients and families by making it easy for them to stay in touch during a hospital stay or any time the child is receiving medical care. The service provides patient families with an easier way to update relatives and friends without the need for repeated phone calls or e-mails. CarePages also makes it possible for relatives and friends to send messages of encouragement, giving the patient and family much needed emotional support. A patient’s CarePage can be updated as often as the family chooses, and guests to the page can see the updates about the patient any time they access the family’s web page. Children’s Hospital’s CarePages can be accessed through computers in the hospital’s Family Resource Center, in a patient family’s home or from any computer by visiting www.etch.com. CarePages are password-protected, secure and comply with all patient privacy regulations. The service is offered free to Children’s Hospital patient families, thanks to funds raised by the annual Star 102.1 Radiothon.

Other site features: Visit our Web site to subscribe to E-Kids News, a monthly email •newsletter. In addition to news about Children’s Hospital and a wealth of pediatric health news from KidsHealth, E-Kids News features color, graphics and links to many topics. Subscribers can also partially customize the newsletter, according to their children’s ages and medical conditions. To subscribe, visit our Web site at www.etch.com and look for “Newsletters” on the right side of the page. We also offer New Parent E-News, an emailed newsletter geared •to expectant parents as well as parents of newborns. Also featuring pediatric health information from KidsHealth, this newsletter comes out weekly for expectant parents and monthly during a baby’s first year. To subscribe, visit our Web site at www.etch.com and look for “Newsletters” on the right side of the page. KidsHealth, the provider of pediatric health information on the •Children’s Hospital Web site, continues to expand its library of articles, videos, interactive features and Spanish-language information. KidsHealth articles target three specific audiences with age-appropriate topics and language – parents, kids (elementary age) and teens. Visit the Children’s Hospital Web site at www.etch.com and click on the KidsHealth icon in the top right corner to enter this informative section. Safe Kids of the Greater Knox Area now has a presence on the •Children’s Hospital Web site. Children’s Hospital became lead organization for the local Safe Kids coalition in the summer of 2008. Visit www.etch.com/safekids.cfm to learn more about this organization and its efforts to keep children safe from accidental injury.

Pointer Sisters to take Center Stage for Children’s HospitalThe 17th annual “Center Stage” concert for Children’s Hospital will feature the legendary trio, The

Pointer Sisters. The concert will take place Saturday, April 18, at the Knoxville Convention Center.The Pointer Sisters first began singing in their father’s church in West Oakland, Calif. Critics called

them “the most exciting thing to hit show business in years” when they first gained popularity and fame during the early 1970s. Their debut album featured the single “Yes We Can, Can,” which landed at #11 on Billboard magazine’s pop singles chart. Their follow-up album included a hit country-western song that was their ticket to become the first black female group to perform at the Grand Old Opry. Another first for the sisters came when they won their first Grammy Award in 1975 for the hit “Fairytale.”

While the 70s proved to be a decade of firsts for the Pointer Sisters, their success continued into the 80s. In 1983, they released their biggest selling album, “Break Out,” which was certified triple-platinum. Their most popular songs include “I’m So Excited,” “Jump (For My Love),” “Neutron Dance,” “He’s So Shy,” and “Slow Hand.”

The Pointer Sisters celebrated their 20th year in the music business in 1993 with the release of the album “Only Sisters Can Do That,” and they received a star on the Hollywood Walk of Fame.

The Center Stage benefit will begin with cocktails and hors d’oeurvres, followed by dinner and the Pointer Sisters’ performance. A dance band will perform after the concert.

Patron, Benefactor and Corporate Supporter tables are available at $10,000, $6,000 and $3,000, respectively. Each table seats 10 guests, and if space allows, individual tickets will be sold for $350. Contact Children’s Hospital’s Development Department at (865) 541-8244 for more information about purchasing tables or tickets.

The Center Stage concert series has generated more than $2 million for Children’s Hospital since it began in 1993.

by Logan Clark, student intern

Grant to fund respiratory equipment purchase Knoxville has been known as the #1 Asthma Capital, according to the Asthma and Allergy Foundation of America, which has awarded the city this designation three times in the past five years. At Children’s Hospital, asthma is the third most common diagnosis for admitted patients. In the past year, nearly 360 children were admitted to Children’s Hospital with asthma as their primary diagnosis, and 1,611 children were treated in the Emergency Department for asthma-related illnesses. The East Tennessee Foundation is helping Children’s Hospital deal with the challenges of asthma by awarding a generous grant to fund the purchase of some vital equipment for respiratory care services at the hospital. The $30,000 grant is targeted for the purchase of cardiopulmonary stress testing equipment for the hospital’s Pulmonary Function Lab to aid in diagnosis of asthma. The East Tennessee Foundation’s funding came from its Respiratory Disease Fund. This fund is derived from the earnings of the Shields/Jennings/Pierce/Hall memorial trusts, which are used for purposes directly related to the diagnosis, research, treatment, education, prevention and cure of respiratory diseases in Knox County. “Children’s Hospital’s request for funding to purchase equipment to help in the diagnosis of asthma and other respiratory-related illnesses is a great fit with the wishes of the donors,” said Terry L. Holley, Senior Vice President for Programs and Regional Development for the foundation. “Children’s Hospital provides services to children and families from all of the 25 counties the East Tennessee Foundation serves,” Holley said. “With one or two children out of 10 having asthma or needing some type of evaluation and treatment for respiratory illness, ETF believes the $30,000 grant to purchase new diagnostic equipment is a wise investment. “Children’s Hospital is highly regarded in the region as one of the very best hospitals to meet the medical and emotional needs of children and their families when they are faced with illness. We are pleased to be able to support a non-profit medical institution that cares for so many children and families in our region,” Holley added. In the Pulmonary Function Lab, an asthma stress test takes place on a treadmill. Licensed, credentialed respiratory therapists Vivian Henderson and Janice Line first perform a pulmonary function test on the patient while he or she is breathing normally. Then, while being carefully monitored by Henderson and Line, the child walks briskly on the treadmill on an incline (to make the walk more strenuous) for six minutes in an attempt to cause asthma-like breathing symptoms. The therapists have the patient perform a pulmonary function test at five-minute intervals for the next 20 minutes to evaluate reaction to the exercise challenge. The results help determine if the child does, in fact, have asthma, which can be controlled with appropriate medication. If the test indicates the child does not have asthma, then the patient can be referred for other testing to determine the correct diagnosis. It takes about an hour and a half to run the full test on a single patient, and the lab performs an average of eight such tests per month. In addition, the lab runs more than 150 additional tests per month to help patients maintain control of already-diagnosed asthma. Most of the patients are middle-schoolers without a history of asthma. They are generally becoming involved in competitive sports in school and are experiencing new symptoms of possible exercise-induced asthma. Due to the symptoms, they are unable to pass their mandatory school sports physical, so they are referred to Children’s Hospital for a full assessment before they can be cleared to participate in school sports.

good for area children. A portion of the Perry family legacy will increase the endowment that supports Camp Eagle’s Nest for our Hematology/Oncology patients. The bulk of the Perry bequest will help area children by providing medical technology that was yet to be invented when the Perry sisters retired.

Bequests like that of the Perry family have been a vital source of funding for progress at Children’s Hospital for decades. Please consider joining the Perrys in ensuring excellent health care for future generations via a bequest. Gifts of all sizes are needed and appreciated; all will be put to good use helping area children enjoy better health.

We would like to send you a complimentary

The rolling hills of East Knox County near Strawberry Plains Pike were a beautiful and peaceful place at the dawn of the 20th century. Perhaps that appealed to Walter Perry when he returned there after experiencing the carnage and bloodshed of the Spanish American War. Like many of us today, he probably saw East Tennessee as a good place to raise a family. But it would be nearly four decades before community leaders established Children’s Hospital with our Open Door Policy making care available to all children regardless of their race, religion or their parents’ ability to pay.

Perry, a stonecutter by trade, was married to Margaret Alice Luttrell. Theirs was not a luxurious life. Stonecutting is difficult, tiring work with an element of physical danger always lurking. In those years, he probably rode a horse or mule home after a day of backbreaking physical labor. Like most rural East Tennesseans of that time, the Perrys found gardening necessary to put food on the family’s table.

They named their first child Clara Cecile Perry when she was born on August 23, 1901, two weeks before President William McKinley was assassinated. In the next several years, as Thomas Edison was inventing motion pictures, they were blessed with a son they named Ardell Earl Perry, followed by daughter Iola Perry. Their youngest child, Gladys Elizabeth Perry, was born February 15, 1911, three years after Henry Ford began manufacturing the Model T automobile. They were an industrious family, and in 1910, the year before Gladys’ birth, they purchased a small farm with a four-room house. The unnamed country lane leading to it would later be called Perry Road.

As adults, Clara and Gladys Perry worked on the production line at Knoxville’s Standard Knitting Mills, amassing over 43 and 39 years of service, respectively. The work was hard, and the pay was meager. The two sisters were the last surviving members of their immediate family, and when preparing their wills, they asked their lawyer, Jim Kennedy, about worthy charities. Having been a patient at Children’s Hospital as a child, Kennedy suggested the Perry sisters consider Children’s among the charities to benefit via a bequest. And they did.

Clara Perry died in 2002 at age 101. Gladys Perry passed away in 2006 at age 95, and Children’s ultimately received over $615,000 from her estate -- representing assets accumulated by her frugal, generous family during more than a century of living and working. Her parents would never have imagined that their family could do such

copy of our Personal Information Record booklet to use in preparing the important financial and legal information your lawyer needs to prepare your will. Just call, write or email us, and we will send it promptly. We stand ready to work with you and your legal advisors at any time to provide the information you need for a bequest. Your gift could literally change a child’s life.

Please contact us at your convenience: David S. Rule• , Director of Development, (865) 541-8172, [email protected] Teresa Goddard• , CFRE, Senior Development Officer, (865) 541-8466, [email protected] Joe Brandenburg• , Major Gifts Officer, (865) 541-8467, [email protected]

Estate Planning From humble beginnings to amazing generosity

Include Children’s Hospital in your estate plans.Join the ABC Club. For more information, call (865) 541-8441.

Please send the FREE planning booklet, “Personal Information Record.”

Name______________________________ Address____________________________________________________________

City___________________________ State_______ Zip_____________ Phone (______) ____________________________ r Please call me at the phone number below for a free confidential consultation concerning planned giving.

r Please send me more information about deferred giving.

r I have already included Children’s Hospital in my estate plan in the following way:

__________________________________________________________________________

r Please send me information about the ABC Club.

Children’s Hospital Development Office • (865) 541-8441

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The Perry family circa 1918 (left to right): Joseph Walter Perry, father; Ardell Earl Perry, son; Iola Perry, daughter; Gladys Elizabeth Perry, daughter; Clara Cecile Perry, eldest daughter; and Margaret Alice Luttrell Perry, mother.

The state of Tennessee has given Children’s Hospital an extension to increase its number of specialty license plates. The hospital is required to maintain a minimum of 1,000 tags to keep the plate in effect, but as of press time, the hospital was still slightly below the required minimum.

With your help, there is still an opportunity to do more for the children the hospital serves by enhancing your car with an attractive Children’s Hospital plate. But most importantly, you can help make Children’s Hospital an even better place for area children.

The specialty license plate has been a labor of love from the beginning. After Children’s Hospital applied to the legislature in 2002 and received approval, Morris Creative Group in Knoxville donated their artists’ time to prepare the plate’s design. Volunteers

stuffed mailings to help sell the initial 1,000 plates. Since the plate first became available, Children’s Hospital has received $71,894.95.

The plate is available at any time through your local County Clerk’s office, and the cost of the plate is $35 in addition to each county’s renewal fee. Children’s Hospital receives nearly $16 from each plate sold. Simply drive to your local county clerk’s office, take in the plate from your car and your registration, and tell them you would like a Children’s Hospital plate.

Purchasing a license plate is an easy way to support the hospital. Please consider renewing your Children’s Hospital plate each year and encouraging friends and family to join you.

If you have questions about the specialty license plate, contact your local County Clerk’s office or the hospital’s Development Department at (865) 541-8441.

License plate deadline extended; purchasers can still help area families

UPCOMING EVENTS TO bENEfIT CHILDREN’S

calendar of eventsMark your calendars noW for several upcoming events to entertain families and benefit Children’s Hospital. Thanks to the generous people of East Tennessee who host and participate in these events, Children’s Hospital can continue to provide the best pediatric health care to the children of this region.

Cutest Little Baby Face The 19th annual “Cutest Little Baby Face” contest, sponsored by Sevierville Kiwanis, will begin March 7 at Belz Outlets in Pigeon Forge. The contest is open to children ages 6 and younger, with Gary Woods Photography in Sevierville taking photos of the participants. The entry fee for preregistration is $5, and registration at the event is $7. The fee includes a 5x7 portrait of the participating child, a T-shirt and goody bag. Pictures will be taken on March 7-8 and posted for voting on March 20-21 at Belz Outlets. A $1 donation to Children’s Hospital will count as 100 votes. The child with the most votes is named the winner and will be announced on March 21 during the “Baby Face Parade.” Last year’s event raised more than $18,000. Contestants may preregister by completing a registration form at Belz Outlets, Gary Woods Photography or by calling the Children’s Hospital Development Department at (865) 541-8745.

“Big Ed” Fishing Tournament The eighth annual Walter “Big Ed” Purkey Memorial Fishing Tournament will take place May 9 at Anderson County Park. Fishermen will blast off at 7 a.m., and weigh-in is set for 3 p.m. No preregistration is required. A cookout and prize giveaway will follow the

weigh-in, and first place prize is a guaranteed $1,500. Additional prize payouts will be determined by the number of tournament participants. Proceeds of the tournament will benefit Children’s Hospital. For information, call Ed Moore at (865) 947-4449 or Jesse Redmond at (865) 938-3804.

Nancy Hayes Baseball Tournament The seventh annual Nancy Hayes Memorial Baseball Tournament will take place June 4-7 at various parks throughout Knoxville. The Hayes family of New Market sponsors the event in memory of their daughter, Nancy Elizabeth Hayes, who passed away in the Children’s Hospital Neonatal Intensive Care Unit. Proceeds from the event will benefit Children’s Hospital. For more information, contact Lenny Hayes at (865) 441-1367 or by e-mail at [email protected].

Re/Max Preferred Properties Charity Golf Classic Area golfers are invited to be part of the Re/Max Preferred Properties Charity Golf Classic at Egwani Farms in Rockford. Re/Max is the sole sponsor of the “Josh the Dog” program, which is designed specifically to help answer any questions children may have and ease anxiety before they are admitted for surgery at Children’s Hospital. Each child who participates in a pre-admission tour at Children’s Hospital receives a free Josh plush puppy as well as a book titled I’ll Be O.K., written by Knoxville veterinarian Dr. Randy Lange. All proceeds raised will benefit Children’s Hospital’s pre-admission tour featuring “Josh the Dog.” The date will be announced soon.

Star 102.1 Radiothon The eighth annual Star 102.1 Radiothon will take place May 14-15 at West Town Mall. Morning show personalities Marc & Kim and Frank will host this live event from 6 a.m. to 6 p.m. both days, encouraging listeners and those who stop by to make a personal pledge to benefit Children’s Hospital.

A silent auction at Radiothon will feature great items from local and national companies. In its first seven years, Radiothon has raised well over $1 million for Children’s Hospital. All net proceeds will benefit Children’s Hospital Home Health Care and the CarePages service. To help with Radiothon, please call the Children’s Hospital Development Office at (865) 541-8441.

Helicopter Awareness Day Scenic Helicopter Tours in Sevierville will again host its annual Helicopter Awareness Days to benefit Children’s Hospital and the Smoky Mountain Children’s Home in Sevierville and to raise awareness of the importance of helicopters in society. The date for this event will be announced soon.

by Christie Sithiphone, student intern

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whole grains, fiber and protein while low in added sugar may boost kids’ attention span, concentration and memory – all of which they need to learn in school. Also, since breakfast is your first opportunity to provide servings of fruit or vegetables to your children, take that step to encourage them!

Toaster pastries and some breakfast bars are portable, easy and appealing to kids. But many have no more nutritional value than a candy bar and are high in sugar and calories. Read the nutrition labels carefully before you toss these breakfast bars and pastries into your shopping cart.

How can I get my children to eat a healthy breakfast?

As a mom, I understand how difficult it can be to make a healthy breakfast happen when you’re rushing to get yourself and the kids ready in the morning and juggling the general household chaos.

Here are some ways to ease the morning chaos: Stock your kitchen with healthy breakfast •

options such as whole fruit, whole wheat waffles, low sugar and high fiber cereals, oatmeal, eggs and peanut butter.

Prepare as much as you can the night before (get •dishes and utensils ready, cut up fruit, etc.).

Get everyone up 10 minutes earlier. • Let children help plan and prepare breakfast. • Have grab-and-go alternatives (fresh fruit, •

individual boxes of cereal, breakfast bars or trail mix, Carnation Instant Breakfast) on days when there is little or no time to eat.

You may also want to check out the breakfasts offered at your child’s school or daycare. Some offer breakfasts at free or reduced prices for families with limited incomes. However, if your child eats breakfast outside the home, be sure to talk with him or her about how to make healthy selections.

My child doesn’t like typical breakfast foods. What are some other options?

Breakfast can be just about anything your child will eat – even the leftovers from last night’s dinner – as long as it provides the nutrients and energy kids need for the day. A piece of cheese pizza and some fruit, a turkey or peanut butter sandwich, or a bowl of pasta would be good options.

Try to serve a balanced breakfast that includes some carbohydrates, protein and fiber. Carbohydrates are a good source of immediate energy for the body. Energy from protein tends to kick in after the carbs are used up. Fiber

helps provide a feeling of fullness and, therefore, discourages overeating. And when combined with adequate liquid consumption, fiber helps move food through the digestive system, preventing constipation and lowering cholesterol.

Good sources of these nutrients include: Carbohydrates:• whole-grain cereals, brown

rice, whole-grain breads and muffins, fruits and vegetables

Protein:• low-fat or nonfat dairy products, lean meats, eggs, nuts (including nut butters), seeds and cooked dried beans

Fiber• : whole-grain breads, waffles and cereals; brown rice, bran and other grains; fruits, vegetables, beans and nuts

Here are some ideas for healthy breakfasts to try: Whole-grain cereal topped with fruit and a cup of •

yogurt Lean turkey on a toasted English muffin with a •

tomato Whole-grain waffles topped with peanut butter, •

fruit or ricotta cheese Heated leftover rice with chopped apples, nuts and •

cinnamon, plus fruit juice Whole-wheat pita stuffed with sliced hard-cooked •

eggs or turkey or light sausage Shredded cheese on a whole-wheat tortilla, folded •

in half and microwaved for 20 seconds and topped with salsa

Hot cereal topped with cinnamon, nutmeg, allspice •or cloves and dried fruit.

Peanut butter on a bagel with fresh fruit (banana or •apple wedges) and low-fat milk

Breakfast smoothie of milk, fruit and a teaspoon of •bran, whirled in a blender

Vegetable omelet with toast and orange juice • Bran muffin and yogurt with berries • Hummus on whole-wheat toast and milk • Cream cheese and fresh fruit, such as sliced •

strawberries, on a bread or a bagel

What else can I do to encourage my children to eat a healthy breakfast?

Be a good example! Let your child see you making time to eat breakfast every day. As parents, we all understand that sometimes our actions are more powerful than our words.

You probably heard it from your own parents: Breakfast is the most important meal of the day. But now you’re the one saying it — to your sleepy, frazzled, grumpy kids, who insist “I’m not hungry” as you try to get everyone fed and moving in the morning. It can be tough to get your children fueled up in time for school, child care or a day of play. But it’s important to try. In this issue of It’s About Children, Heather Edgley, pediatric emergency and inpatient physician at Children’s Hospital, discusses the basics of a healthy breakfast.

Is it true that “breakfast is the most important meal of the day”?

Breakfast is certainly a very important meal because it gets you ready for the day. In general, children who eat breakfast have more energy, do better in school and eat healthier throughout the day. They also are more likely to participate in physical activities, which is a great way to maintain a healthy weight. Without breakfast, children can get irritable, restless and tired.

Why should I bother with breakfast if my children don’t want it?

Each morning, our bodies need to refuel for the day ahead after going without food for 8 to 12 hours during sleep. Your child’s mood and energy can drop by midmorning if he or she doesn’t eat at least a small morning meal.

Breakfast also can help keep kids’ weight in check. Breakfast kick-starts the body’s metabolism, the process by which the body converts the fuel in food to energy. And when the metabolism gets moving, the body starts burning calories.

People who don’t eat breakfast often consume more calories throughout the rest of the day and are more likely to be overweight than those who skip lunch. That’s because someone who skips breakfast is likely to get famished before lunchtime and snack on high-calorie foods or overeat at other meals and in the evening. Overeating in the evening continues the cycle of not being hungry in the morning.

Research has shown that children who eat breakfast get fiber, calcium and other important nutrients. They also tend to have lower blood cholesterol levels, fewer absences from school and make fewer trips to the school nurse with stomach complaints related to hunger.

As long as my child eats something, even a doughnut, is that OK?

It’s important for kids to have breakfast every day, but WHAT they eat in the morning is crucial, too. Choosing breakfast foods that are rich in

Breakfast BASICS

Content and recipes edited and abridged from the KidsHealth section of www.etch.com. © 2009 The Nemours Foundation/KidsHealth. Used under license.

Yogurt on the goPrep time: 5 minutes

Ingredients:

3/4 c. light fruit-flavored yogurt 1 tbsp. raisins 1 tbsp. sunflower seeds 1/3 c. strawberries

Directions:

Mix all ingredients in a plastic cup. 1.

For variety, try using different flavors of 2. yogurt as well as different fruit and nuts.

Serves: 1Serving size: about 1 1/4 cupNutritional analysis (per serving):

Note: Nutritional analysis may vary depending on ingredient brands used.

232 calories•7 g protein•4 g fat•0 g saturated fat•40 g carbohydrate•

3 g fiber•3 mg cholesterol•88 mg sodium•222 mg calcium•0.9 mg iron•

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UPCOMING COMMUNIty edUCatION Classes

CPR Certification CourseDates: March 23, April 20, May 18,

June 15 and July 20Time: 6-10 p.m.This certification course teaches the American Heart Association chain of survival -- from when to call 911 to how to effectively administer CPR to an infant, child or adult. This course is designed for anyone who may be expected to respond to emergencies at home or in the workplace. Participants must be at least 14 years old. Following the course, participants will receive an American Heart Association Heartsaver certification card. This course is $40 per person.

Safe SitterDates: March 7, 14 (at the Women Today

Expo, Knoxville Convention Center), 21 and 28; April 4, 18 and 25; May 2, 9, 16 and 30; June 6, 13, 20 and 27; and July 11 and 18

Time: 9 a.m. to 3 p.m. (lunch is provided)Safe Sitter is a national organization that teaches young adolescents safe and nurturing babysitting techniques and the rescue skills needed to respond appropriately to medical emergencies. Instructors are certified through Safe Sitter nationally. Participants must be ages 11-14. This course is $20 per person.

Class size is limited, so preregistration is required. All classes are offered in the Koppel Plaza at Children’s Hospital, unless otherwise noted. For more information or to register for any of these classes or to receive our free Healthy Kids parenting newsletter, call (865) 541-8262. Announcements about upcoming classes can be seen on WBIR-TV 10 and heard on area radio stations. Or visit our Web site at www.etch.com and click on “Healthy Kids Education and News.” Children’s Hospital’s Healthy Kids Campaign, sponsored by WBIR-TV Channel 10 and Chick-Fil-A, is a community education initiative of the hospital’s Community Relations Department to help parents keep their children healthy.

He a l t h y B re ak f a s t Reci p e s

Strawberry smoothiePrep time: 5 minutes

Ingredients:2 ice cubes 1 c. milk 1/3 c. cottage cheese 2/3 c. frozen strawberries 1 1/2 tsp. sugar 1 tsp. vanilla extract

Directions:

Pour all of the ingredients into a 1. blender.

Put the lid on the blender and blend for 2. 45 to 60 seconds until smooth.

Pour your smoothie into a glass and 3. enjoy.

Serves: 1Serving size: 1 large glassNutritional analysis (per serving):

Note: Nutritional analysis may vary depending on ingredient brands used.

289 calories•19 g protein•2 g fat•49 g carbohydrate•3 g fiber•

7 mg cholesterol•430 mg sodium•369 mg calcium•0.8 mg iron•

to ensure that all patients will continue to receive the best medical care available. Children’s Hospital would like to thank everyone who was involved with this year’s telethon, including corporate sponsors Walmart, Kroger, Food Lion, RE/MAX, Love’s Travel Center, Kiwanis and USA Gymnastics. Also, special thanks to WBIR-TV Channel 10 and its entire staff for 27 years of support and dedication to improving the lives of children.

by Logan Clark, student intern

The 27th annual Children’s Miracle Network Telethon was again

a great success, raising $1.4 million for Children’s Hospital through individual pledges and corporate donations. The telethon took place Sunday, January 25 from 3 to 11:30 p.m. and was broadcast live on WBIR-TV Channel 10. As a charter member of the Children’s Miracle Network, Children’s Hospital was one of only 22 hospitals in the nation to participate in the first telethon in 1983, which raised more than $95,000. Since the telethon’s origin, community support for the event has grown substantially each year. The event has generated $29 million in funds over the years. All money raised enables the hospital to purchase advanced medical equipment for various departments

27th annual Children’s Miracle Network Telethon

raises $1.4 million