Pediatrics FOCUS ON SSM Cardinal Glennon Children’s Medical Center Spring 2011

SSM Cardinal Glennon Children’s Medical Center
Spring 2011
www.cardinalglennon.com
Pediatrics
TM
FOCUS ON
MEDICAL NEWS FROM SSM CARDINAL GLENNON CHILDREN’S MEDICAL CENTER AND
THE DEPARTMENT OF PEDIATRICS, SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
ON THE COVER
Lauren Lee
Lauren, 11, who was diagnosed with Hodgkin’s Lymphoma
in December 2010, begins a chemotherapy treatment at
the Bob Costas Cancer Center at SSM Cardinal Glennon.
“The kids never cease to amaze me,” says Abby Sharamitaro,
CPNP. “No matter how sick, kids will be kids. They’re
resilient.” With the knowledge that she has another 7
straight days of treatment ahead, and more after that,
Lauren still lights up in front of the camera.
FOCUS ON
Pediatrics
TM
Editor In Chief
Medical Editor
Editor
Writer
Sherlyn Hailstone
Kenneth Haller, MD
Andrew Sutton
Jessica Hedges
President
SSM Cardinal Glennon
Children’s Medical Center
Associate Professor of Pediatrics
Saint Louis University
School of Medicine
Physician Services Manager
SSM Cardinal Glennon
Children’s Medical Center
Physician Services Communications Specialist
SSM Cardinal Glennon
Children’s Medical Center
For comments and suggestions, please email [email protected]
Announcements
SSM Cardinal Glennon
Welcomes Faculty
Appointments
Koenig, Joyce MD
To shorten wait times for specialists, and see your patients quickly,
Cardinal Glennon recruited 24 specialists in 2010.
2012 President-Elect, Midwestern Society for Pediatric Research
Walentik, Corinne MD
Missouri Medicaid Oversight Committee
Awards
Cruz, Oscar MD
2011 Senior Honor Award, American Association for Pediatric Ophthalmology and
Strabismus
Presentations
Werner, Jason MD; Bruzzini, Daniel MD; Garrett, Jeremy MD; Sallee,
Heidi MD
Dianne S. Elfenbein, MD
Chetana M. Reddy, MD
Angela Sharkey, MD
Adolescent Medicine
Cardiology
Cardiology
“Pediatric Fundamentals of Critical Care Support and Intern Perceptions of Self-Efficacy.”
Society of Critical Care Medicine’s 40th Annual Congress. San Diego. January 19, 2010.
Publications
Sharkey, Angela MD
“Getting Beyond Good Job: How To Give Effective Feedback.”
Pediatrics. 2011 Jan 17.
Jeyakumar, Anita MD; Mitchell, Ron MD
“HPV Vaccination and Recurrent Respiratory Papillomatosis.”
Head & Neck Surgery. 2011 Jan.
Havranek, Thomas MD
Barbara A. Braddock, PhD
Theresa N. Villaflores, MD
Joshua M. Colvin, MD
Developmental Pediatrics
Developmental Pediatrics
Emergency Medicine
“Effects of Maternal Magnesium Sulfate Administration on Intestinal Blood Flow Velocity
in Preterm Neonates.” Neonatology. 2011 Jan 4.
Braddock, Barbara PhD
“Gesture and Motor Skill in Relation To Language in Children with Language
Impairment.” Journal of Speech, Language and Hearing Research. 2011.
Brink, David MD
“Inborn Errors of Metabolism.” Stocker & Dehner’s Pediatric Pathology: Third Edition.
2010 Dec.
Mitchell, Ron MD
“Clinical Practice Guideline: Tonsillectomy in Children.” Head & Neck Surgery. 2010 Dec.
Havranek, Thomas MD
Kristi L. Kinder, DO
Jerry L. Rosenblum, MD
Stephen R. Braddock, MD
Emergency Medicine
Gastroenterology
Genetics
“Increased Poly (ADP-ribose) Polymerase (PARP)-1 Expression and Activity Are
Associated with Inflammation but Not Goblet Cell Metaplasia in Murine Models of
Allergen-Induced Airway Inflammation.” Exp. Lung Res. 2010 Sept.
Cruz, Oscar MD
“Honing Your Skills to Improve Outcome.” Journal of the American Association for
Pediatric Ophthalmology and Strabismus. 2010.
Cruz, Oscar MD; Elaine Siegfried, MD
“Propranolol Treatment for Periocular Capillary Hemangiomas.” Journal of the American
Association for Pediatric Ophthalmology and Strabismus. 2010.
Outreach
Shermini Saini, MD
Richard J. Cooke, MD
Elizabeth C. Abraham, MD
Hematology/Oncology
Neonatology
Nephrology
SSM Cardinal GlennonWelcomes Faculty continued on page 2
Faye Doerhoff, MD, and Julie Gammack, MD, accompanied 27 Saint Louis
University students majoring in health-related studies to Honduras from January 10-16,
2011. The purpose of the trip was to provide in-depth medical care to residents of a
small village. The group that organized the outreach effort is a primarily student-run
organization called Global Medical Brigades.
1
SSM Cardinal Glennon
Welcomes Faculty
To shorten wait times for specialists, and see your patients quickly,
Cardinal Glennon recruited 24 specialists in 2010.
continued from page 1
Cardinal Glennon Access Center
Easy Access Emergency Department
Cardinal Glennon’s Access Center – the first and
most comprehensive pediatric access center in
Missouri – has gotten even better with the Easy
Access Emergency Department!
Ann Marie Flannery, MD
Vincent P. Gibbons, MD
Sean E. Goretzke, MD
Neurological Surgery
Neurology
Neurology
“The Easy Access Service has made referring
patients to Cardinal Glennon’s Emergency
Department quick and seamless. My patients
say they are greeted when they arrive, are seen
quickly and are well cared-for.”
~ Linda Tackes, MD
Preferred Pediatric Associates, St. Louis
Call your patients ahead to have them seen
and treated quickly in the Cardinal Glennon
Emergency Department.
• Just dial 1-888-229-2424 and tell the Access
Center Nurse that you have an “Easy Access”
patient
Adnan Cutuk, MD
David D. Greenberg, MD
Jessica C. McMichael, MD
Orthopedics
Orthopedics
Orthopedics
• A 24-hour a day, 365 days of the year service
through the Cardinal Glennon Access Center
• Patients referred through the Access Center’s
“Easy Access” service are personally greeted
upon arrival, experience an expedited triage,
and are placed quickly in a patient care room
• Referring physicians will receive a follow-up
call as requested through the Access Center
Pediatrics on Demand
Start earning free CME credits now!
Mary E. Rashid, MD
Alexander Y. Lin, MD
Christina M. Plikaitis, MD
Orthopedics
Plastic Surgery
Plastic Surgery
New lectures available:
“Hematopoeitic Stem Cell Transplant for Primary
Immune Deficiency”
-Deepika Bhatla, MD
“To Bleed or Not To Bleed”
-John Puetz, MD
To view a presentation:
Logon to www.pediatricsondemand.com
Username: ds\r010-online • Password: webcme
2
Jamie L. Wooldridge, MD
Richard J. Bower, MD
Janet E. Tuttle-Newhall, MD
Pulmonology
Surgery
Surgery
To earn 1 CME Credit from St. Louis University
School of Medicine: Choose the link icon above
the presenter’s window. Click TEST LINK. Register
(if you haven’t already), take the quiz and finish
the evaluation. Certificates generate to your e-mail
address within 48 hours.
Market Leading Communication
With Community Pediatricians
Outside of providing leading-edge medical care, communicating
with community pediatricians is a top priority at Cardinal Glennon.
A Communications Task Force of Cardinal Glennon leadership and physicians examined the way we communicate
with community pediatricians, identified process improvements and named market-leading communications as a
key hospital initiative.
Specific Areas of Concentration:
• Capturing the community pediatrician name at registration, to ensure consistent communication
• Physician-to-physician communication, so pediatricians are always aware of patient admissions, status, discharge and
necessary follow-up
• Timeliness and consistency of sending all patient information to referring pediatrician
• Engaging the referring pediatrician as a partner in discharge planning by calling prior to discharge, discussing plans and
promptly sending the discharge summary
Cardinal Glennon Communications Expectations
Inpatient/Outpatient/Emergency Department Registration
• Referring pediatrician name captured each time
Emergency Department
• Hospital operator calls pediatrician/exchange to notify
of visit to Emergency Department
• ED Resident note is auto-faxed to pediatrician
• ED Attending note for all admitted patients is signed
and sent to pediatrician within 24 hours of patient
visit
• Records completed on all patients discharged by the
ED within 48 hours of patient visit
Patient Admission
• For PCPs known to follow their own patients,
Emergency Department physician will call PCP to
determine if patient should be on hospitalist service or
private service before admitting patient
• Emergency Department Unit Secretary calls
pediatrician to notify of patient admission
• Floor Team Resident calls pediatrician at the time
of admission, or the morning after for overnight
admissions
• If unable to reach pediatrician, Floor Team Resident
leaves contact information of Supervising Resident
with pediatrician office
• For Surgical patients, surgery nurse calls pediatrician
the day after admission
• For Floor Team patients, admitting Attending faxes
notification of admission to pediatrician on the first
day of admission
Change in Patient Status
• Floor Team Resident calls pediatrician for change in
patient status or when patient is transferred from one
unit to another due to change in status
• Floor Team faxes a notification of patient status change
to pediatrician
Discharge
• Floor Team Resident calls pediatrician prior to
discharge to discuss plan and any follow-up required
• Floor Team Attending faxes notification of discharge to
pediatrician
• Discharge summary routed to pediatrician per their
preference, within 24 hours of Attending’s signature
3
Send Us Your E-mail Address for
24/7 Access to Cardinal Glennon
Service Updates!
To devote more resources to patient care and operate in an environmentally responsible manner, Cardinal Glennon will be
phasing out some of its printed publications. In order to provide you with timely, accessible updates about new and improved
SSM Cardinal Glennon services, we are launching an informational blog for community physicians. The blog will be updated
consistently with news that helps you and your patients. To stay in the loop, we will send you monthly e-mail updates with
links to pertinent blog posts. The best part, you can check the blog any day, any time for the latest news you can use.
More blog information to follow.
Send your e-mail address (and your office manager’s too) to Jessica Hedges at [email protected]
NOTE: We respect your privacy and are sensitive to the amount of electronic communication you receive. Your e-mail address
will not be shared with anyone outside the Cardinal Glennon Physician Services Department.
Diversions
Andrew Sutton Physician Services Manager
Dining
I was very nervous when Monarch
closed for “re-concepting” last year
and was afraid that too many
changes would be made to what
I consider one of the most elegant
and imaginative restaurants in
St. Louis.
Chef Josh Galliano’s creative bent crossed over from the
proven winners of Monarch’s yesteryear, and his refocused
lineup of Southern classics shows that it is possible to
improve what was already near perfect.
Tricia and I started with the Boudin Balls, Cajun pork
and rice sausage coated with Japanese bread crumbs. If
they had put one thousand of them on the plate, I would
have asked for more. A little bit of heat, and just the right
amount of crunch.
I highly recommend the Oysters Monarch. The oysters
are charbroiled on the half shell, and topped with an herb
vinaigrette and grated parmesan.
4
Tricia delighted in the Crispy Black Cod, served with a
dark roux fettuccine, grilled andouille, and basil succotash.
I knew they nailed it when she remained quiet throughout
our meal. Months later, she still talks about it and recently
recommended it to a friend headed to Monarch.
The simple preparation of BBQ Shrimp & Grits belies the
complexity of flavors, which straddle between savory and
spicy, with neither one crossing too far over the line.
Sauteed jumbo shrimp are served on a bed of roasted garlic
grits. I yearn for more as I write this.
Service was present when needed, helpful and not the least
bit overbearing. The wine list is deep, and full of hard to find
gems. I could not recommend Monarch more strongly.
Beverages
A friend recently gave me a bottle of 2008 Sequana Sarmento
Vineyard Pinot Noir. Hailing from the Santa Lucia Highland
area of California, this blissfully deceitful Pinot Noir benefits
from cool mornings, afternoon sun and moderate evening
temperatures. Upon first glance, the light color indicates shy
flavor, but it’s a much bigger wine than it appears. An old
world nose of dusty road, roses, earth and brown sugar, this
wine tricks the mind as it bursts forward with the intensity
of new world flavors of ripe fruit and black cherries. Layered
with moderate tannins, and viscous (14 percent alcohol), the
finish sails on and on.
www.sequanavineyards.com
“The Ultimate Recycling Project”
The St. Louis Cord Blood Bank
at SSM Cardinal Glennon
Children’s Medical Center
The St. Louis Cord Blood Bank at SSM Cardinal Glennon
Children’s Medical Center offers hope for anyone around
the world in need of a stem cell transplant. For children
being treated for cancer and life-threatening blood and
immune disorders at Cardinal Glennon, this invaluable
resource is right next door.
Founded in 1996, the St. Louis Cord Blood Bank
(SLCBB) was formed to create an inventory of stem cell
products for transplant, with a focus to treat more patients
of all racial and ethnic backgrounds – and that it did.
One of the largest public cord blood banks in the world,
the SLCBB has received more than 100,000 cord blood
donations and holds a repository of 23,000 units, of which
20 percent come from minority donors.
SSM Cardinal Glennon Division Director of HematologyOncology William Ferguson, MD, serves as the St. Louis
Cord Blood Bank Director, and Pediatric HematologistOncologists Deepika Bhatla, MD, and Shermini Saini,
MD, specialize in bone marrow transplantation at
Cardinal Glennon. The Hem-Onc Division’s close working
relationship with the St. Louis Cord Blood Bank supports
the leading role its physicians have taken in developing the
use of stem cell transplants.
“Cardinal Glennon and the St. Louis Cord Blood Bank
have a great symbiotic relationship. Together we can
treat more patients and work to find cures for diseases
like Sickle Cell Anemia,” says Donna Regan, Executive
Director of the St. Louis Cord Blood Bank. Usually
discarded as medical waste, cord blood has been used
to treat more than 70 different diseases. Donation is
free, safe and painless for the mother and baby, and the
collection process is facilitated on a voluntary basis by
delivering physicians, midwives, and the delivery staffs at
participating hospitals. “The cord blood that gave life once
has the potential to save another life. We like to call it the
‘ultimate recycling project,’” Donna says.
Cord blood saved the life of now 22-year-old Jessica Hahn.
“I was 8 years old when I learned I had cancer,” Jessica
says. “I had never heard of cancer before, but the doctors
and nurses at Cardinal Glennon helped me understand
what was going on in my body and what was going to
happen during treatment. We watched a Charlie Brown
video that explained things on an 8-year-old level.”
As a result of Jessica’s chemotherapy treatments for
osteosarcoma, her cancer went into remission, but she
developed myelodysplastic syndrome, a disease of the bone
marrow. In order to repopulate her blood-forming cells,
Jessica would need a bone marrow transplant. Her parents
and siblings were not matches, but before they could
worry, Jessica’s doctor told the Hahn’s about cord blood.
In 2001, she received a transplant at Cardinal Glennon
with cord blood stem cells provided by the St. Louis Cord
Blood Bank.
“Cardinal Glennon became my home away from home. I
still look forward to checking in with my former nurses
and doctors; they have become not only friends of mine
but extended family,” Jessica says.
On a follow up appointment to the Costas Center, Jessica
expressed her interest in the medical field and learning
more about potential job opportunities at Glennon.
One of the Hem-Onc nurses initiated a meet-and-greet
with Donna Regan and in the summer of 2009, Jessica
completed an internship at the St. Louis Cord Blood Bank.
“It was so exciting to learn more about the procedure and
to give back to the same bank that my cord blood came
from,” she says.
Jessica now works as the Bank’s Operations Assistant. “The
best part about my job is knowing that with each exported
cord a patient’s life could be saved, just like it saved mine.”
5
Forming Bonds,
Forging Hope
SSM Cardinal Glennon
Division of Hematology-Oncology
It’s apparent that patient and family care are the main
concerns within the Hematology-Oncology Division
at SSM Cardinal Glennon Children’s Medical Center.
While the reason behind an appointment with a
Hem-Onc specialist may be unpleasant, the Hem-Onc
team works together to make their young patients’
experiences the very best.
Outpatient services are provided within the Bob
Costas Cancer Center at Cardinal Glennon. Smiling
faces greet visitors, colorful butterflies paint the
ceilings and a large play area decorated with
patient artwork welcomes children
of all ages. After a couple of
appointments at the Costas
Center, John Mossman, HemOnc Information Specialist,
is one of those happy faces
that becomes familiar to
parents and children alike.
On a cold Friday
morning in January, John
warmly checks patients in
and answers phone calls.
“No problem, I’ll get that
appointment rescheduled
for you,” John tells a caller.
“Hopefully the roads will be clear
of snow by next week.”
It wouldn’t be unusual to find a small patient
sitting with John at the front desk while he multitasks.
“My favorite part about my job is interacting with the
t’s apparent
thattopatient
care are
kids.
They come
know and
us asfamily
the people
theythe
can go
main
concerns
within
the
Hematology-Oncology
to when they’re scared,” John says.
Division at SSM Cardinal Glennon Children’s
Medical
Center.
While
reason
behind
an Ashley
Like John,
the kids
arethe
what
Clinical
Nurse
appointment
with a Hem-Onc
specialist
may be
Hite looks forward
to everyday.
“We develop
special
unpleasant,
the
Hem-Onc
team
works
together
relationships with our patients,” she says. “We to
also
make
young patients’
experiences
very best.
help their
to facilitate
relationships
betweenthe
patients
as they
I
6
find comfort in each other. The Costas Center is kidfriendly and provides a lot of space and openness to
encourage interaction.”
Ashley’s professional connection to Cardinal Glennon
stemmed from a personal one. “My cousin was treated
at Cardinal Glennon for leukemia,” Ashley says. “He
became close to all the doctors and though it was
difficult, it was also an amazing experience for my
entire family.” Since joining the Hem-Onc team in
July 2010, Ashley says her connection to Cardinal
Glennon and the Hem-Onc Division has
only become stronger.
From appointment setting to
nursing and physician care,
team work and collaboration
are essential components
of the Hem-Onc Division.
Abby Sharamitaro, CPNP,
is one of the Hem-Onc
team’s Nurse Practitioners,
serving as a support and
advocate for the Division
and bridging the gap
between nurses and doctors.
“As a multidisciplinary
team, we utilize our resources
with Child Life, Psychology and
Social Work, and meet regularly to
discuss new and existing patients and
their families,” Abby explains. “We always take
the patient and their family’s emotional and financial
concerns into account and work to make things better
for them.”
The emotional aspect of treating children and
adolescents with serious and sometimes lifethreatening illnesses is one the team must address with
nearly every patient encounter. “I get down on their
level and try to take the ‘medical’ out of it,” Abby
says. “I’ll sit next to the patient on the exam table and
initiate age- and personality-appropriate educational
activities. Depending on the situation, I may ask the
parents about the best way to approach their child.”
Each faculty and staff member has their own approach,
and personal contact is key at Cardinal Glennon.
“Glennon has a small hospital feel. The attending
physicians take care of their patients here; they know
their patients and their medical conditions and are on
call nights and weekends in case they’re needed,” Abby
says.
David Greenberg, MD, is the Orthopaedic Oncologist
who works with the Hem-Onc Division. He says, “The
care of cancer patients today truly requires a multidisciplinary approach. Cancer patients often require
multiple methods of treatment, including surgery,
medicine and radiation therapy. One of the advantages
of Cardinal Glennon and Saint Louis University is
that we approach cancer as a team, with frequent
communication among the physicians.”
Despite his full clinic schedule today, Dr. Greenberg
arrives early to discuss one of his inpatient cases with
Division Director Dr. William Ferguson. After some
collaboration, they decide that Dr. Ferguson will see the
patient the following day, and then he’s off to his first
appointment of the morning.
The Division of
HematologyOncology
Provides six clinical services to
children and adolescents with
blood disorders and cancer:
1. Hematopoietic Stem Cell Transplantation – fourpatient transplantation unit
2. Neuro-Oncology Program – Neuro-Oncology
long-term follow-up clinic recently added
3. Hemostasis Program – only federally-designated
pediatric Hemophilia Treatment Center in the
St. Louis area and includes an expanding 340B
program that facilitates distribution of clotting
factor concentrates to patients
4. Sickle Cell Anemia/Hemoglobinopathies Program
– includes a monthly clinic in Centreville, Ill.,
at the Southern Illinois Healthcare Foundation
Mother & Child Center
“How’s our little girl doing?” Dr. Greenberg greets his
patient, a 2 ½-year-old with a benign tumor in her
femur that is causing inflammation and discomfort.
5. Apheresis Program – team of nurses and
physicians trained in apheresis on infants to
adolescents
“Her leg is hurting her,” the little girl’s father answers.
6. Long-term Follow-up
With that, Dr. Greenberg outlines the surgery plan,
cast options for the rambunctious toddler, and offers
to show his patient’s great-grandmother – who hasn’t
seen the x-ray – the study of her granddaughter’s bone.
After explaining the x-ray to the family, Dr. Greenberg
assures them that he will schedule the surgery as soon as
possible.
Is committed to advancing the care
of children through collaboration
with basic science research and
clinical research programs:
“My patients are often sent to me with unknown lesions
and fearing the worst. Going over the imaging studies
and allowing them to visualize what we are dealing with
helps,” Dr. Greenberg says. “Regardless of the outcome,
patients generally have added comfort when they
understand their disease. An important part of my job is
to provide that understanding.”
The little girl waves goodbye over her daddy’s shoulder,
and before they are out the door, Dr. Greenberg is on
the phone making arrangements to remove the tumor.
•
Active participant in the National Institute’s of
Health-sponsored Children’s Oncology Group
•
Active participant in the Center for International
Blood and Marrow Transplant Research
•
One of the founding institutions of the newlyformed Neuroblastoma and Medulloblastoma
Translational Research Consortium
7
The Port of Dr. Ferguson-Yang
Lauren Lee
“You look awfully good,
what are you doing at the
doctor’s office?” Dr. Ferguson
teases Lauren during a
checkup and chemotherapy
treatment at the Bob Costas
Cancer Center at SSM
Cardinal Glennon Children’s
Medical Center.
8
t was December 22, 2010. Christmas was just around the
corner. At the top of 11-year-old Lauren Lee’s Christmas
wish-list was an iPod Touch. She also wished to feel better.
I
Rachel called Cardinal Glennon immediately to schedule an
appointment for Lauren to see a Hematologist-Oncologist
specialist.
That day, Lauren and her family viewed an x-ray of her
chest with SSM Cardinal Glennon’s Division Director of
Hematology-Oncology, William Ferguson, MD. The image
revealed a large mass and Lauren’s diagnosis – Hodgkin’s
Lymphoma.
“I refer my patients to Cardinal Glennon because I’ve had a
great personal and professional experience with the hospital,”
Rachel, who is a graduate of Saint Louis University School
of Medicine, says. “Cardinal Glennon also offers a nonintimidating environment for children.”
“She looked pale, anemic,” says Tim Lee, Lauren’s father.
“That was the clue something was wrong.” Rachel Tarr,
Physician Assistant, of Family Medicine Associate’s in
Collinsville, Ill., examined Lauren in December after she had
been running a fever, vomiting and experiencing night sweats.
A blood test indicated that Lauren was severely anemic.
When you’re looking for a combination of advanced
research and technology, expert faculty and resources and
compassionate care, there is no better place than Cardinal
Glennon. “We have access to all the latest information and
newest medications, including many new investigational
drugs,” Dr. Ferguson says. “As part of the
NIH-sponsored Children’s Oncology Group,
we are not only provided with the latest
research and protocols, but have access to
physicians and researchers throughout the
world with the most up-to-date information
for any given disease. At the same time,
we strive to provide a friendly, comforting
and accommodating environment where
patients and families are not only treated
as individuals, but as partners in working
towards a cure.”
Within a day of Rachel’s phone call to
Glennon, Lauren had her initial visit with
Dr. Ferguson. Within an hour of Lauren’s
appointment, Dr. Ferguson was on the phone
with Rachel to discuss the results. “I’ve been
receiving regular, thorough updates from
Dr. Ferguson on Lauren’s status; usually the
same day he sees her,” Rachel says. “The notes
indicate that he’s discussed Lauren’s treatment
plan and possible outcomes with the Lees. It’s
obvious they are spending a lot of time with
the family.”
After a series of questions and examination, Dr. Ferguson addresses the entire family - Lauren, mom, dad
and sister - to go over Lauren’s progress and medication. In regard to the steroid medication Lauren has been
taking, Tim, Lauren’s father, mentions that her appetite has increased. A side-effect the Lees are aware of, Dr.
Ferguson jokingly assures them, “I do not get kick-backs from Dierberg’s or Schnuck’s.” Laughing, Tim says,
“Maybe you should!” Before leaving, Dr. Ferguson checks with Lauren - “Anything else I can do for you?”
On December 27, 2010, Lauren began
treatment at Cardinal Glennon. For any pre-teen, the
thought of needles and doctors can be scary. For Lauren,
those fears were real. “She’s always been scared of needles
and doctors,” says Angie, Lauren’s mother. “But Dr.
Ferguson was great at explaining the treatment process to
Lauren in a way that made her feel comfortable. You don’t
get that with every doctor.”
“I try to explain things using ‘plain English,’” Dr. Ferguson
says. “Since successful treatment depends as much upon
the family as it does upon what we do in the hospital, it
is very important to work extra hard to educate patients
and families. I also try to emphasize that our entire team is
available to answer questions; sometimes another doctor or
nurse will explain things a little different, but in a way that
just ‘clicks’ better.”
to David Ish, Director of Child Life. “I met the toy guy. He
brought me ceramics to paint and stuffed animals,” Lauren
says. Child Life Services provides activities and opportunities
for patients to help reduce stress and anxiety and gain a sense
of control over their hospital experience.
Another big support has been Lauren’s older sister Morgan,
22. Both Tim and Angie agree, “Morgan is the rock.” In
regard to Cardinal Glennon faculty and staff, Morgan says,
“They’re all really nice and try to make everything as painless
as possible.”
Recently, Lauren confided in her mom – “After all of this, I
just may like doctors.”
In order to receive her medication, SSM Cardinal
Glennon Pediatric Surgeon, Edmund Yang, implanted
a Portacath under Lauren’s skin in her chest. Before the
surgery, Dr. Yang visited with the Lee’s. “He came in and
explained every step of the way,” says Tim of Dr. Yang.
Lauren may not like her port – “It’s disgusting,” she says –
but she’s affectionately coined it “Dr. Ferguson-Yang.”
To pass the time during her inpatient and outpatient visits
to Glennon, Lauren listens to her new iPod Touch that she
unwrapped this past Christmas. She also was introduced
(From left to right) Lauren, Morgan, Tim and Angie Lee
9
Making a Difference
Grayson Miller
(From left to right)
Dr. Puetz consults with the
Millers – Grayson, Shelley
and Brent.
G
rayson, 3 ½, acts just like any other little boy. In the
Costas Center’s play room, his attention is diverted by
trains, cars and building blocks. He runs from one thing to
the next, pushing past unappealing toys that get in his way.
“People always say, ‘You would never know he’s sick,’”
says Grayson’s mother, Shelley Miller. “I always say, ‘That’s
because he’s not a sick kid; he’s a normal 3 ½-year-old.”
Four days after birth, Grayson was diagnosed with
hemophilia. “In his first few months, Grayson had
numerous problems. He was having constant screaming
fits, and we were in the ER all the time,” Shelley recalls.
10
The screaming fits turned out to be bleeding episodes.
Recognizing the severity of Grayson’s condition, the
Millers started their search for a hemophilia specialist and
comprehensive hemophilia center that could provide their
son the care he needed. Since the Miller’s meeting at Cardinal
Glennon with Hematologist John Puetz, MD, in December
2007, Grayson has come a long way.
The John Bouhasin, MD, Center for Children with Bleeding
Disorders at SSM Cardinal Glennon Children’s Medical
Center is the only one of its kind in the region. Federally
recognized, grant support allows the Center to provide
comprehensive care that includes two attending physicians
whose primary clinical and research
focuses are bleeding and clotting
disorders, and a nurse coordinator,
physical therapist and social worker,
all of whom are dedicated to the
Center and its patients.
no matter what time. I called every
day for the first year of Grayson’s life
and they were always helpful.”
When Grayson was 7 months
old, he had a spontaneous brain
hemorrhage and was rushed to
“Members of our team are required
Cardinal Glennon in the middle of
to attend an annual regional meeting
the night. Hematologist Christopher
with other hemophilia treatment
Hugge, MD, was on-call and arrived
centers to ensure that we are up-toat Glennon at 4 a.m. to attend to his
date with leading edge care,” says
patient. “That’s when we found out
Dr. Puetz. “Our patients have the
Grayson was a severe hemophiliac,”
“Hi Grayson! You remember me. We go way back.” Dr. Puetz
opportunity to participate in research
Shelley remembers. Grayson had
says. “I haven’t heard from you lately, so that’s good news.”
studies and various bleeding disorder
developed an inhibitor that makes
databases, and our facility at the
it difficult to obtain enough clotting
Costas Center allows us to provide care in one place, even if
factor to control bleeding. Concerned for their baby’s life, the
the patient needs an infusion.”
Millers say they were “extremely grateful” Grayson was being
cared for at Cardinal Glennon.
Brent Miller, MD, Grayson’s father, is a nephrologist. Both
he and Shelley have had many personal and professional
“When we first met Dr. Puetz, he told us his goal was to turn
experiences at health care institutions, and they agree that
Grayson’s hemophilia from a tragedy to an annoyance,” Dr.
the care Grayson has received at Glennon is unmatched. “In
Miller says. “In the beginning, we always thought it would be
my healthcare experiences, I always ask the question: ‘Are
a tragedy. But three years later, it’s just an annoyance we have
these people here to benefit themselves or their patients?’ I
to deal with everyday.”
can truthfully answer that the faculty and staff at Cardinal
Glennon are here for the patients. From the people making
Grayson is seen by Dr. Puetz on an as-needed basis, and
the food to the doctors, the feeling that everyone at Glennon
annually for a comprehensive evaluation. Shelley administers
is concerned for the well-being of your child is palpable and
Grayson’s daily medications through a portacath and draws a
comforting,” Dr. Miller says, adding, “Even the parking is
lab once per month that she takes to Glennon for testing.
easy, and times when we’ve had to come to the ER, we are
always taken care of right away. ”
Just the other day, the Millers received Grayson’s lab results for
the month. “Dr. Puetz called and was so excited. Grayson’s level
“You wouldn’t understand until you’ve had a child treated at
was at 15, which is the highest it’s ever been. We celebrated.”
Glennon,” Shelley says. “One of the biggest differences is that Shelley says. “Those are the things you hold on to.”
we can always get in touch with an attending hematologist,
Dr. Puetz asks Grayson if he can take a look at his port, but Grayson is less
than willing. “Let me tell you a secret,” Shelley, Grayson’s mother, says to him.
After a quick whispered exchange, Grayson willingly reveals his port and talks
about the pirate bed his daddy is building him.
“Everything looks good,” Dr. Puetz says. But before Dr. Puetz can consult
with the family, Grayson makes a request – “Can I have my tootsie roll now?”
11
Q&A
William Ferguson,
M.D.
Division Director of HematologyOncology
Q: Why did you choose to specialize in HematologyOncology? What do you like best about your job?
A: Part of what attracted me to Hematology-Oncology
was the challenge of skillfully providing very intensive and
complex medical care to children with life-threatening
diseases. However, unlike certain other specialties where this
is also true (such as critical care or neonatology), we also get
to have the same sort of close, long-term relationship that
primary care physicians value so much. There’s nothing quite
like a visit from a former patient who is not only cured of
what was once incurable cancer, but who is now showing off
their own child!
Q: How does the Division of Hematology-Oncology work
as a team to provide the best possible care for patients?
A: The entire team of physicians, nurse practitioners, and
outpatient nurses meet every day to discuss all of the patients
seen that day either in the hospital or in the Costas Center.
This allows us to regularly stay informed on our entire patient
population and get everybody’s input on how to best care for
our patients. We also meet very frequently with our affiliated
specialists – social workers, psychologists, child life specialists,
etc. – in order to get their perspective and to identify patients
and families who would benefit from their special skills.
In addition, we have several multi-disciplinary clinics that
incorporate other medical specialists, with the same goal
of providing timely and cooperative care for these complex
patients.
12
Q: How does your Division keep in contact with your
patients’ primary care physicians?
A: For efficiency, we stay in contact by routinely e-mailing
or faxing our own documentation. This keeps the primary
physician up to date, but avoids the delay of regular mail. We
used to rely more on phone calls; but as practices have gotten
busier, we try to avoid taking busy doctors away from their
patients, unless it is an urgent manner.
Q: Do you have a particular patient care philosophy that
has guided you throughout your career?
A: Very simple – we should strive to treat our patients and
families the same way we would want ourselves and our own
children to be treated.
To reach Dr. Ferguson,
please call: 314-577-5638
To reach the Bob Costas
Cancer Center, please call:
314-268-4000
Hematology-Oncology
Faculty
William Ferguson, MD
Christopher Hugge, MD
Division Director, Hematology-Oncology
Medical Director, Bob Costas Cancer Center
Professor of Pediatrics, Saint Louis University School of Medicine
MD: New York University School of Medicine
Residency: Massachusetts General Hospital
Fellowships: Massachusetts General Hospital, Massachusetts Institute of
Technology
Administrative Director, Hemostasis Program
Director, Apherisis Program
Assistant Professor of Pediatrics, Saint Louis University School of Medicine
MD: St. Louis University School of Medicine
Residency: Saint Louis University/Cardinal Glennon Children’s Medical
Center
Fellowship: Washington University/St. Louis Children’s Hospital
Deepika Bhatla, MD
Dennis M. O’Connor, MD
Assistant Director, Stem Cell Transplantation Program
Associate Professor of Pediatrics, Saint Louis University School of Medicine
MD: Lady Hardinge Medical College and Smt Sucheta Kripalini Hospital,
New Delhi; University College of Medical Sciences and Guru Tag Bahadur
Hospital, New Delhi
Residency: University of Kentucky Chandler Medical Center
Fellowship: Cincinnati Children’s Hospital Medical Center
Gordon B. Gale, MD
Professor of Pediatrics, Saint Louis University School of Medicine
MD: Saint Louis University School of Medicine
Residency: Saint Louis University/Cardinal Glennon Children’s Medical
Center
Fellowship: Children’s Hospital of Philadelphia
Karen Gauvain, MD
Director, Neuro-Oncology Program
Assistant Professor of Pediatrics, Saint Louis University School of Medicine
MD: Saint Louis University School of Medicine
Residency: Washington University/St. Louis Children’s Hospital
Fellowship: Washington University/St. Louis Children’s Hospital
David Greenberg, MD
Assistant Professor of Orthopaedic Surgery, Saint Louis University School of
Medicine
MD: Georgetown University School of Medicine
Residency in Orthopaedic Surgery: University of Missouri – Columbia
Fellowship in Musculoskeletal Oncology: University of Chicago
Professor of Pediatrics, Saint Louis University School of Medicine
MD: Saint Louis University School of Medicine
Residency: Saint Louis University/Cardinal Glennon Children’s Medical
Center
John Puetz, MD
Medical Director, Oncology Long-term Follow-up Clinic
Clinical Director, Hemostasis Program
Clinical Associate Professor of Pediatrics, Saint Louis University School of Medicine
MD: Washington University
Residency: Washington University/St. Louis Children’s Hospital
Fellowship: University of Utah
Shermini Saini, MD
Assistant Professor of Pediatrics, Saint Louis University School of Medicine
MD: University of Wisconsin-Madison
Residency: Tulane University
Fellowship: Duke University
Hematology-Oncology
Professional Staff
Jeanne Harvey, APRN, PNP-C
Pediatric Nurse Practitioner
Abby Sharamitaro, RN, MSN, CPNP, CPON
Pediatric Nurse Practitioner
13
Non Profit Org
U.S. Postage
PAID
Physician Services Department
1465 South Grand Blvd.
Saint Louis, Missouri 63104-1095
St. Louis, MO
Permit No. 2412