Precious Gift of Life

Noah Brooks may seem like just a normal five-year-old boy. He is a strong, happy, energetic child who loves life. Yet his struggle to live at birth, although not apparent to most, were dramatically real.

Noah Brooks was born with a serious heart defect called hypoplastic left heart syndrome. In a child with hypoplastic left heart syndrome, all of the structures on the left side of the heart are severely underdeveloped, leaving the heart unable to support the circulation needs by the body's organs. The right ventricle must then do twice the work to make sure that the blood gets pumped to both the lungs and out to the rest of the body.

Without treatment, infants with hypoplastic left heart syndrome usually die within the first hours or days of life.

Fortunately for Noah, his family chose for him to be born at Duke Children's Hospital & Health Center so he could receive expert care immediately after birth to save his life.

Doctors kept him heavily medicated and monitored him closely and determined Noah would need a heart transplant in order to survive. His family, in a state of constant worry, prayed for a heart to come along for Noah.

At midnight on Good Friday, the Brooks family received hopeful news. A heart had become available from an anonymous donor in New York, and Noah would receive his transplant.

The Brooks family was extremely grateful for the bittersweet blessing they had received.

During a four-hour operation, surgeons at Duke Children's removed Noah's damaged heart and replaced it with the new one. Noah had a very successful recovery.

Doctors say that Noah's new heart should last twelve years, and then he may need another transplant. But for now, thanks to Duke Children's and an answered prayer, Noah is just a regular boy—strong, energetic and full of life.

Cavities a Big Problem with Kids

More than one-fourth of children between ages two and five suffer from tooth decay in the U.S. Half of kids between ages 12 and 15 have it. The problem has become so bad that many kids need surgery to have their numerous cavities filled. How can you stop the problem with your kids?

Five-year-old Audrey Baright brushes her teeth twice a day and flosses regularly. So her parents were shocked at her last dental appointment "(They said) hey, your child has eight cavities," Herbert Baright, Audrey's dad, told Ivanhoe.

Because there were so many, Audrey had to undergo general anesthesia to have them filled. Duke pediatric dentist Martha Ann Keels says it's a scenario that's becoming much more common. "Every new patient is coming in with a mouth full of cavities," Martha Ann Keels, DDS, Ph.D., Pediatric dentist at Duke University Medical Center told Ivanhoe.

Using anesthesia while filling them could cause vomiting, nausea, and in rare cases, brain trauma or death. The cost can range from $2000 to $5000. "The cost is expensive," Dr. Keels explained.

Dr. Keels says eating at bedtime when there's decreased saliva, drinking bottled water that doesn't contain fluoride and consuming sugary drinks are all cavity culprits. Perhaps the worst offenders are sugary, gummy candies that stick between the teeth. If your child doesn't floss often enough, the candy stays and the teeth rot.

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Safety Tips for Riding the School Bus

School buses are a safe way to get to school

For approximately 24 million children across the country, the school day begins and ends with a ride on the bus. Statistics show that traveling to school by bus is one of the safest modes of transportation. In fact, according to the National Highway Traffic Safety Administration, school buses have a rate of 0.2 deaths per 100 million miles traveled; the rate of deaths in automobiles is eight times higher.

Passing motorists can endanger children getting on and off buses

Still, accidents do happen. The NHTSA reports that each year, an average of 11 passengers under the age of 19 die in school bus accidents. Most of the most serious injuries and deaths occur when children are hit by a school bus or by passing motorists while getting on or off the bus. Studies have shown that in a single day, hundreds of thousands of cars pass stopped school buses illegally.

School bus safety rules
To keep your children safe, the NHTSA and American Academy of Pediatrics suggests discussing rules for riding the bus with them.

Avoid the Danger Zones at all times:
Front danger zone. It's never safe to walk close to the front of the bus, as the driver may be sitting up too high to see a child crossing in front of it. Instruct your child to walk five giant steps ahead of the bus before crossing in front of it. Make sure he can see the driver, and the driver can see him.
Side danger zone. Tell your child to take at least three giant steps away from the side to avoid being in the driver's blind spot.
Rear danger zone. Caution your child to never walk behind a school bus, as the driver will not be able to see her.

Rules for getting on the bus:
When waiting for the bus, stay away from traffic and avoid roughhousing or other behavior that can lead to carelessness. Do not stray onto streets, alleys or private property.
Line up away from the street or road as the school bus approaches.
Wait until the bus has stopped and the door opens before stepping onto the roadway.
Use the hand rail when stepping onto the bus.

Rules for behavior on the bus:
Find a seat and sit down. If you bus has a seatbelt, make sure to belt in immediately.
Keep the noise level down. Loud talking or other noise can distract the bus driver.
Never put head, arms or hands out of the window and never throw anything out of the window.
Keep aisles clear, as books or bags are tripping hazards and can block the way in an emergency.
At your stop, wait for the bus to stop completely before getting up from your seat. Then, walk to the front door and exit, using the hand rail.

Rules for getting off the bus:
Make sure that the driver can see you once you are off the bus.
Wait for a signal from the driver before beginning to cross.
When the driver signals, walk across the road, keeping an eye out for sudden traffic changes.
Do not cross the center line of the road until the driver has signaled that it is safe for you to begin walking.
Be aware of the street traffic around you. Not all drivers follow the rules of the road, so before stepping into the street, look to be sure a car isn't coming.
Don't linger or play near the bus after you leave it.

A Healed Heart

By Jason Hawkins
Special to The Chapel Hill Herald

When people become parents for the first time, they soon learn to expect the unexpected. Such was the case one year ago for Emily and Matthew Purcell of Hillsborough.

Emily, 29, had what she described as a "normal" pregnancy. Normal, even including the monumental, 26-hour labor she endured before delivering the couple’s first child, Thomas Purcell, by cesarean section.

For them, life had turned another chapter and the young couple – married eight years – began their first hours as parents in celebration.

Emily, a nurse at Durham Regional Hospital, was well schooled with medical knowledge and had recently begun advancing her degree at UNC-Greensboro to obtain her bachelor’s degree in nursing. Matthew, 32, a former infantry soldier in the U.S. Army, having served in the heat of war in Iraq, quickly adopted the role as a young father and together they experienced the swing of emotions new parents find in a newborn’s life.

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Duke begins transformation to system-wide electronic health record

By Duke Medicine News and Communications

Duke University Health System will implement the first phase of a massive transformation of its information systems on Wednesday that will eventually unify electronic medical records and other data across its three hospitals and growing network of clinics and doctors’ offices.

The effort, designed to enable “one patient, one record, one system,” represents a $500 million investment in information technology over the multi-year project. Wednesday’s initial rollout involves 33 primary care practices, including pediatrics, throughout the Triangle and beyond. Additional phases will add all ambulatory clinics and Duke University Hospital (2013), followed by Durham Regional and Duke Raleigh hospitals (2014). By completion in two years, all of DUHS doctors’ offices, clinics and hospitals will utilize a single, integrated technology.

“This is a remarkable achievement and represents our ongoing commitment to constantly improve the outstanding care delivered by Duke providers through Duke facilities,” said Victor J. Dzau, M.D., president and chief executive officer of Duke University Health System. “We will exceed the new requirements established by the Affordable Care Act, and have the foundational platform to better manage the health of larger populations across a wider geographic area.”

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Cord blood saving lives

Grayson Ommert is less than a day old, but he’s already a hero. The infant and his mother, Suzanne, donated their umbilical cord blood after he was born.

What used to be discarded afterbirth, the blood from a mother’s placenta and umbilical cord is now being used as a potentially life-saving treatment for patients around the world.

“When Grayson was born we donated the blood from the umbilical cord he was connected to me with, and they used that to hopefully heal other children who are sick with different types of cancers,” Ommert said.

Cord blood is really unique because you can collect it, save it and use it years later to transplant to a patient who suffers from cancer or rare genetic disorders.

Dr. Joanne Kurtzberg has been a pioneer in using cord blood as a treatment for decades. In 1993 she performed the world's first cord blood transplant at Duke University Medical Center.

The stem cells that exist in the cord blood can be critical components in life-saving procedures that used to require bone marrow donations. Kurtzberg says a major advantage is, that unlike bone marrow, cord blood doesn't have to match completely. So people who can't be matched with a donor - which can be more than half of the people on transplant lists, can use a cord blood donor.

It helps patients suffering from Leukemia, sickle cell anemia, other blood disorders and immune and metabolic disorders. It even can change the life of patients who were injured during childbirth.

Kurtzberg is quick to point out that treatments and research using stem cells in cord blood are completely different than the often controversial stem cell research using embryonic cells.

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CT Scans Boost Cancer Risks for Kids

 

Children who get CT scans are at slightly increased risk for brain cancer and leukemia, according to a large international study released Tuesday.

CT scans create detailed images of the inside of the body. So they're great for diagnosing all sorts of medical problems — so great that their use has soared in recent years. More than 80 million are being done every year in the United States.

But the scans use a lot more radiation than standard X-rays, and evidence has been mounting that they may increase the risk for cancer. But no one could say for sure.

"This is the first study that's looked at patients that had CT scans and then looked at their subsequent cancer risk," said Amy Berrington de Gonzalez of the National Cancer Institute, who helped conduct the new study.

 

The study involved nearly 180,000 British patients who got CT scans between 1985 and 2002 before their 22nd birthdays. The researchers looked at kids because they are more sensitive to radiation than adults.

"We found that the radiation exposure from the CT scans was associated with a subsequent increased risk of both leukemia and brain tumors," she said.

Based on the findings, researchers calculated that the amount of radiation from two or three scans of the head before age 15 would increase the risk of brain cancer threefold. It would take five to 10 head scans to triple the risk of leukemia.

Now, the researchers stress that the overall risk for brain cancer and leukemia is very low, so the risk remains quite low even among those who get scans.

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Argentinian Boy Finding Hope at Duke

Celebrating National Nurses Week at Duke

 

National Nurses Week, May 6-12, is the perfect time to thank a nurse who made a difference in your life. Duke nurses are the backbone of its world-class health care, and are greatly deserving of recognition for their professionalism and patient-centered care.

To celebrate nurses, the Duke International Fair is scheduled for 10:00 a.m. – 2:00 p.m. on Tuesday, May 8, in the North Courtyard of Duke University Hospital. The fair is presented by the International Nurses Committee, Friends of Nursing, and the Health Arts Network at Duke. There will be information tables from China, India, Iran, Kenya, Liberia, Nicaragua, Peru, The Philippines, Trinidad and Tobago, Sierra Leone, the United States, and Vietnam.

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A Nurse Who Can Say: 'Yes, I’ve been there’

GREENSBORO — There have been times during her stays at Duke Children’s Hospital that 11-year-old Kaylin Martin couldn’t even sit up in bed, much less take her medicine, said her mother, Sandra Martin.

It was Kaylin’s nurse aide, Matthew Williamson, a UNCG nursing student, who taught her tricks to make it go down easier.

And Kaylin, who has the bone marrow disease aplastic anemia, listened to him.

After all, Matthew knows what it feels like to be sick.

To lie in a hospital bed recovering from a bone marrow transplant.

To just want to feel better.

Matthew’s diagnosis of Hodgkin’s lymphoma as a teenager had more than a physical effect on him. The illness inspired him to switch his major from music to nursing.

After graduation from UNCG this week, he’ll start work as a full-time nurse in Duke’s pediatric blood and marrow transplant unit, the same place he received a life-saving bone marrow transplant almost three years ago.

“I realized I’ve got a special ability with this patient population to help like most other people or nurses can’t because they can’t say that, 'Yes, I’ve been there,’” said Matthew, 24.

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