Inside Gillette Blog


For Kids Who Have Disabilities, Keeping Active Means Keeping Healthy

Posted On: 07/24/2014

Jersey Berqual is only 4, but already she wants to keep up with her dad.

That’s a tall order, because he’s a marathoner. And Jersey has spina bifida, which causes weak muscles, a lack of sensation in her legs, and other effects.

Nevertheless, she’s so energetic that she once wriggled out of her leg casts.

Activity Equals Better Health
The Berquals know that physical activity is important to Jersey’s long-term health. They are looking for a running stroller or adapted bike to help Jersey take part in her dad’s training runs.

“But we want her to have her own options, too,” says her mom, Marissa. That’s why Jersey swims, goes to adapted playgrounds and hopes to start adapted skiing next winter.

Regular activity results in better balance, mental health, and fitness. But many people who have disabilities don’t get enough exercise. Obesity rates for children who have disabilities are 38 percent higher than for other children. And adults who have disabilities are three times more likely than others to develop heart disease, diabetes or cancer.

Social Benefits, Too
“The importance of sports and recreation goes beyond physical health,” says Krista Ash, therapeutic recreation specialist at Gillette. “Things like biking and adaptive sports give kids and adults opportunities to be social with their family and peers. That’s huge.”

It’s never too early to start looking for ways to keep kids active. Options might include walking, wheeling in a manual wheelchair, swimming laps, doing water aerobics, or playing adapted basketball, tennis, softball or other sports.

Krista touts the benefits of adapted bicycles, saying that to date she hasn’t worked with a patient who couldn’t benefit from one. Teenagers and adults can get involved, too. “Once a mom came to an adapted bike information session with her adult child, who uses a wheelchair,” Krista recalls. “She said to him, ‘I’m so sorry that you can’t ride a bike,’ and I immediately told them, ‘Absolutely you can!’”

To Learn More
Gillette can help you find resources in your community for beginning or maintaining a physical activity program. To learn more:

  • Email Recreation@gillettechildrens.com.
  • Call Krista Ash or Beth Harmening at 651-312-3138 (for patients 15 and younger)
  • Call Kaitlin Lewis at 651-325-2213 (for patients 16 and older).

Top Summer Injury Offenders (…And How to Prevent Them)

Posted On: 06/26/2014

Stay safe this summer!Summer and kids mean fun, sun and LOTS of activities!  It’s also prime time for injuries—just ask any of our pediatric orthopedic surgeons.  But there’s good news, too: many of these injuries are preventable.

Lawnmowers

A hallmark of summer, lawnmowers and kids don’t go hand-in-hand. Besides the risk of damage from flying rocks at high speeds, lawnmowers can cause permanent orthopedic deformities in children who fall from, or are struck accidentally by, the blade.

Safety takeaway:  Keep young children inside while mowing. Children should be at least 12 years old before operating any lawn mower and at least 16 before operating a riding mower. 

 

Monkey Bars/Jungle Gyms/Playscapes

Approximately 200,000 children are treated annually for injuries sustained at a playground, and over half of those injuries are fractures or broken bones.

Safety takeaway: Set and talk about safety ‘ground rules’ with children before and during play, and remind children to use play equipment properly.  

 

Trampolines

Trampolines are an especially common culprit of summertime injuries. Between 2000 and 2005, there were nearly 90,000 children injured while playing on home trampolines. In addition to broken bones, fractures and sprains, some kids sustained serious head and spinal trauma.

Safety takeaway:  If trampoline use is unavoidable, install safety netting around the trampoline and cover its frame, springs and nearby landing surfaces with shock-absorbing pads. Trampolines should be assessed often for tears or equipment malfunctions. Don’t allow unsupervised jumping, and only allow one person on the trampoline at all times.

 

Skateboards and Ripsticks (modified skateboards)

Skateboards and ripsticks account for approximately 50,000 trips to Emergency Departments per year and 1,500 hospitalizations.

Safety takeaway:  Children under 5 should not use a skateboard or ripstick, and children 6 to 10 should be closely supervised.  All children should wear protective equipment (helmet and knee, elbow and shoulder padding) and avoid areas with heavy traffic.

 

Even when play is carefully supervised, accidents can still happen. Gillette’s Acute Orthopedic Clinic provides same-day appointments and 24-hour consultations with a pediatric orthopedist to give primary and urgent/emergency providers instant access to our specialists. If your child sustains an injury, encourage your doctor to call 651-325-2200 for an immediate referral to Gillette. 

 

 


The Ketogenic Diet- Summer Snack Ideas

Posted On: 06/09/2014

By Karri Larson, Registered Pediatric Dietitian

 

The ketogenic diet is a high fat, low carbohydrate diet that is used as a treatment for difficult to control seizures, or intractable epilepsy. It is a highly specialized diet that should be followed under the direct supervision of a dietitian and physician. We are still trying to understand why and how the ketogenic diet helps to reduce seizures.

 

The summer season often brings a feeling of wanting to cook lighter foods.  Fresh produce is bountiful and frozen treats are extra special when the temps are high. Take that into consideration when planning ketogenic diet snacks.

 

One requirement of the ketogenic diet is weighing out all food on a gram scale. This takes some of the simplicity and spontaneity out of cooking for families.  However, it doesn’t have to mean you can’t have any fun with your food. Below you will find 3 recipes for keto-friendly snacks that are perfect for the summer.  Even better, they are snacks that your whole family can enjoy.

 

Guacamole

Here is some guacamole topped with fresh-from-the-vine tomatoes.  Just fork mash some avocado and chop up a tomato and mix with a sprinkle of garlic salt. You can use carrots and celery as dippers.

 

 

 

Berries and cream

Berries are among the lowest carbohydrate fruits available. Try pairing fresh berries with whipped heavy whipping. You can add a drop or two of some natural food coloring (available at your local co-op or specialty food store) to make some fun colors for variety or put it in a glass to make a fruit parfait.

 

 

 

 

 

 

 

 

 

Creamsicle

Another fun snack is to make your own popsicle or creamsicle. Inexpensive popsicle makers are easy to find at your local grocery store and are so versatile. Here we prepared some sugar free jello and mixed the liquid jello with some heavy whipping cream. Pour it into the popsicle mold and freeze.

 

All recipes are ~200 calories, 3:1 ratio. Please contact your dietitian for a personalized recipe for your child.

 


Rett Syndrome Clinic and Research at Gillette

Posted On: 02/12/2014

Rett syndrome

By Timothy Feyma, M.D. and Arthur Beisang, M.D.

Rett syndrome is a rare genetic disorder that almost always affects females.  It’s associated with widespread developmental delays, epilepsy, scoliosis, and issues with sleep, feeding and movement coordination.

Many children diagnosed with Rett syndrome appear to develop either typically, or somewhat slower than expected, until ages 1 to 4, when they experience a loss of developmental skills. Many patients unfortunately undergo repeated laboratory tests, imaging studies, and medical visits before a diagnosis of Rett syndrome is confirmed. One finding that often leads to diagnosis involves stereotyped hand movements—as though children are repeatedly washing their hands. Children less severely affected may not develop such movements.

Although Rett syndrome no doubt has existed for a long time, as a distinct diagnosis it is rather new. Dr. Andreas Rett first recognized and wrote about the condition in 1966. The gene responsible for the condition wasn’t discovered until 1999. Before that, doctors based diagnoses on their observations of patients who had similar behaviors and symptoms. Since 1999, significant work has gone into identifying the purpose of this gene and considering ideas for treatment. 

Gillette Children's Specialty Healthcare founded our Rett Syndrome Clinic in 2005 in hopes that focusing on this unique group of patients would allow us to better understand the condition and provide help. By partnering with researchers at the University of Minnesota and other locations, we are beginning to understand more. Some of less-discussed effects of Rett syndrome include trouble regulating body temperature, being aware of pain, and sleeping.  We have begun investigating the communication abilities of patients with Rett syndrome in hopes that we can learn more about the thoughts and desires this condition prevents them from clearly expressing.  Beyond characterizing symptoms and treating related Rett syndrome issues, we are working to further collaborate with scientific investigators seeking to treat Rett syndrome and prevent associated symptoms.  Our hope is that some of this research will yield ways to gauge the success of treatments currently under development. As with all research, the pace of discovery can be slow and frustrating, but our hope is to provide not just support for symptoms, but also active treatments for Rett syndrome in years to come.

 

 

Timothy Feyma, M.D., is a pediatric neurologist at Gillette Children's Specialty Healthcare. His professional interests include following neonatal intensive care unit (NICU) babies and seeing patients who have epilepsy, metabolic disorders and movement disorders. After receiving his medical degree from the University of Wisconsin Medical School, Feyma completed a pediatrics residency at Penn State Hershey Medical Center in Hershey, Pa. He then completed a pediatric neurology residency and a fellowship at the University of Washington in Seattle. His professional memberships include the Child Neurology Society and the American Academy of Neurology.

 

 

 

 

Arthur Beisang, M.D., is a pediatrician at Gillette. He sees children who have cerebral palsy, Rett syndrome, and other complex medical conditions. He also works with children whose disabilities result in drooling issues. Beisang received a medical degree from St. George’s School of Medicine in Grenada, West Indies. He completed a residency in pediatrics at the University of Minnesota. Prior to joining Gillette in 2006, Beisang was a pediatrician at Region’s Hospital and an associate professor at the University of Minnesota. He remains an assistant professor of pediatrics at the University of Minnesota. Beisang is certified by the American Board of Pediatrics.

 

 

 

 


Concussions…

Posted On: 02/05/2014

By Angela Sinner, D.O.

A concussion is a mild traumatic brain injury. It’s defined as a traumatically induced disturbance of brain function that is typically temporary.

A concussion happens when someone sustains a hit to the head or a force to the body. By causing the brain and head to move quickly back and forth, it disrupts the balance of chemicals in the brain. Symptoms can include headache, vision changes, dizziness, nausea, difficulty concentrating or sleep changes.  You don’t have to be “knocked out” to sustain a concussion. A health care provider diagnoses the condition.   

Recovery from a concussion involves resting from physical activity—and often from cognitive, or “thinking,” activities, too. Health care providers may administer computerized tests to assess how the brain is healing and follow the patient’s progress. A concussion’s symptoms often resolve within a few weeks.

If you sustain a concussion, it’s very important to sit out of activities that put you at risk for hitting your head again. Time away from sports, gym class or other activities may be necessary. This allows the brain to heal properly. If you sustain a second concussion before healing from a first injury, you are at risk of a more severe concussion and longer-lasting symptoms. You’re also at risk of second impact syndrome. Although second impact syndrome is rare, there are cases in which people received severe brain injuries after a recent concussion.  The reasons are not well understood, but the connection could be severe brain swelling or the loss of the brain’s ability to regulate its blood supply, which could lead to coma or death. 

At Gillette, our team draws on the expertise of health care providers from rehabilitation medicine, neurosurgery, and neurology to carefully assess each injury. If symptoms persist, our therapists, psychologists, and neuropsychologists help with a plan and therapeutic interventions to reduce symptoms while enabling patients to return to school and re-engage in cognitive and physical activities. Our social work team works closely with the school team to smooth the transition. Our team rallies around each student or athlete to support their quickest return to full participation in school and activities.

 

References:

http://www.cdc.gov/Concussion/

Harom, et al.  American Medical Society for Sports Medicine position statement: concussion in sport.  Br J Sports Med (47); 15-26, 2013.

 

 

Angela Sinner, D.O., specializes in pediatric rehabilitation medicine with a special interest in spina bifida, neurotrauma, and spasticity management. She received her doctor of osteopathic medicine degree from Des Moines University’s College of Osteopathic Medicine in Des Moines, Iowa. She completed a physical medicine and rehabilitation residency at the University of Minnesota Medical School in Minneapolis, and then completed specialty training at Gillette Children's Specialty Healthcare through a fellowship in pediatric rehabilitation medicine.

She has made numerous professional presentations on topics including posterior fossa syndrome autonomic dysfunction in severe traumatic brain injury, and spinal cord injury evaluation. Her recent research has focused on intrathecal baclofen pump management as well as hypercalcemia incidence and treatment in spinal cord injury.

 

 

 


Bladder Concerns and Treatments for People Who Have Disabilities

Posted On: 01/29/2014

By Jenna Katorski, F.N.P.

When people have disabilities, they often have trouble with bladder control. Damage to the brain or spinal cord that causes a disability also can affect bladder function. A variety of bladder problems fall under the category of a neurogenic bladder.

Types of Bladder Problems

For the urinary system to work properly, two groups of muscles must coordinate: the bladder (where urine is stored) and the sphincter (muscles around the urethra that prevent urine from leaking). Depending on the nerves involved and nature of the damage, the muscles in someone with a disability might become overactive or underactive. That may cause pressure inside the bladder to increase and places the kidneys at risk.

Underactive bladder: Because the bladder is too relaxed, it doesn’t empty completely during urination. That leftover urine can cause urinary tract infections and give the feeling of having to urinate often.

Overactive bladder: The bladder squeezes (contracts) even when you aren’t trying to urinate. That can cause leakage (urinary incontinence). Otherwise, pressure rising inside the bladder can damage the kidneys.

Underactive sphincter: Because the sphincter is too relaxed, urine can leak even when you aren’t trying to urinate (urinary incontinence).

Overactive sphincter: If the sphincter is too tight, it doesn’t relax enough to let out urine when you want to urinate.

Tests and Treatments

If your healthcare provider suspects that a patient has a neurogenic bladder, they may order imaging tests or a bladder pressure test (urodynamics). Treatments may include behavioral changes, medications, catheterization programs, or surgical procedures.

The main goal of treatment is to maintain low pressure when the bladder fills and empties. That protects the kidneys from damage caused by high pressure in the bladder. Other goals may include decreasing urinary incontinence, minimizing urinary tract infections, and increasing a patient’s independence through a bladder management program.

If you have a neurogenic bladder, be sure to see your urology provider regularly to ensure your kidneys are safe with your current bladder program.

 

 

 

Jenna Katorski, C.N.P., is a family nurse practitioner, who is board-certified through the American Academy of Nurse Practitioners. She works in the physical medicine and rehabilitation department at Gillette Lifetime Specialty Healthcare St. Paul-Phalen Clinic. She cares for adults who have spina bifida, cerebral palsy, traumatic brain injury, or other childhood-onset disabilities. She completed a Bachelor of Science and Master of Science in Nursing at the University of Minnesota in Minneapolis, Minn. She has been a principal investigator or a co-investigator for a number of clinical research studies, made professional presentations, and served on numerous professional and organizational committees. In addition, she is a member of the Society of Urologic Nurses and Associates, Developmental Disabilities Nurses Association and Sigma Theta Tau (an international nursing society).

 


Sleep Technologist Appreciation Week at Gillette Children’s!

Posted On: 10/11/2013

By John Garcia, M.D., Sleep Medicine Specialist

Sleep technologist appreciation week gives everyone an opportunity to celebrate the dedicated service provided by the Gillette Sleep Health technologists. 

Some do not know that four nights a week four technologists are caring for children in the sleep laboratory. During this time the sleep technologist do not take her eyes off the patient. This careful attention allows  for the accumulation of data that is not otherwise easily gathered. It is routine for the Gillette Sleep Health technologists to identify a severe breathing problem or seizure that had been hidden because parents appropriately are not able to stay up all night and gather the data as these trained professionals do.

In addition to providing clinical care Gillette Sleep Health technologists are involved in teaching, policy creation, advocacy, research, and technical applications.  They provide monthly in-service training integrating new technologies in the field.  Two of our group chose to attend the regional policy creation seminar to help begin to alleviate the burden of sleep deprivation on our state's teenagers by advocating for an 8:30 AM high school start time.. The policy and procedure manual integrates recent research into technological applications provided on a nightly basis. These new technologies include average volume assured pressure support, transcutaneous carbon dioxide monitoring and actigraphy to name a few.

The technologists have partnered with almost every clinical subgroup in the hospital here at Gillette including the craniofacial clinic, postoperative nursing group, information technology, and neuromuscular diseases group.  They are involved in ongoing data gathering for research with Rett syndrome, traumatic brain injury, and CPAP mask desensitization.

Together the group of sleep technologist represent over 100 years of total sleep technology experience. Over 1000 children and young adults have been served by the gillette sleep technologist since its inception six years ago. The dedicated service of the Gillette Sleep technologists is appropriately celebrated this week.


Teens and Sleep: How Sleep Affects Learning, Emotions, and Risky Behavior

Posted On: 09/13/2013

Did you know? Teens with fewer than six hours of sleep per night are:

  •     Two-three times more likely to experience depression and suicidal thoughts.
  •     Driving with reaction times equivalent to having a blood alcohol content of .05.
  •     Significantly more likely to use drugs, alcohol, caffeine, and engage in other at-risk behavior.


How do the current findings of nationally recognized researchers on teens and sleep translate to better school performance, improved physical and mental health, and reduced risky choices among teens? Learn more at the Teens and Sleep: How Sleep Affects Learning, Emotions, and Risky Behavior conference. This conference is for: Pediatric Providers, School District Leaders, Educators, Social Service Providers, School Counselors, School Psychologists, Legislators, Policy-Makers, and Parents.

Thursday, Oct 3, 2013 - 8:30 AM - 4:30 PM
Friday, Oct 4, 2013 - 8:30 AM - 3:00 PM
Double Tree By Hilton
1500 Park Place Blvd
Minneapolis, MN 55416

Learn more: https://www.regonline.com/builder/site/default.aspx?EventID=1200146


Think About Your Spine!

Posted On: 09/05/2013

Did you know that September is Spinal Cord Awareness Month?

Here at Gillette Children’s Specialty Healthcare, we provide specialty services that aid in treatment for children and teens who have a spinal cord injury. The spinal cord is made of a bundle of nerve fibers housed within the spine, spanning the length of the back. It carries signals to and from the brain to and other parts of the body.

Spinal cord injuries happen when that cord is injured in some way. The injuries result in a loss of movement and a loss of sensation below the location of the injury. They can occur for a number of reasons, but some common causes are motor vehicle accidents, traumatic brain injuries, falls, sports accidents, certain diseases, and vascular syndromes. 

Here at Gillette, our providers work together to create a customized treatment plan for each of our patients. We provide specialty services including assistive technology, chaplaincy, neurology, nutrition and feeding, orthopedics, therapeutic recreation and rehabilitation medicine. 

This month, take a moment to think of people affected by spinal cord injuries. Let’s celebrate their accomplishments to spread the word on prevention and care.


Tube Feeding FAQs Answered

Posted On: 08/27/2013

Each year, Gillette Children’s Specialty Healthcare sees thousands of children who need or currently have a gastronomy tube (also called a feeding tube) for nutritional support.  For many families, making the decision to place a feeding tube is a difficult one.  Gillette’s goal is to support families who have made the decision to have a feeding tube placed, or who are in the process of making the decision.  That’s why we’re hosting a September 19 workshop, Tube Feeding…With Love, for parents of children who have feeding tubes or who are considering one for their child. We hope you’ll take a moment to read our tube feeding FAQs—and register for this first-of-its-kind workshop

What is a feeding tube?

It’s a soft, flexible tube that can be used to give fluids, formulas and medicine to children who have trouble taking these things by mouth. The tube is placed by a surgeon, and goes through the stomach wall into the stomach.

Why would my child need a feeding tube?

A feeding tube might be recommended for a child experiencing poor growth, significant time and energy with feedings, or aspiration (when contents from the mouth or stomach go into the lungs during oral feedings, which can lead to respiratory problems).

Does a feeding tube mean my child can’t keep working on learning to eat?

Depending on your child’s needs, a feeding tube can sometimes be used in combination with eating by mouth.  In cases like this, a tube can help supplement overall nutrition for a child who is having difficulty taking in enough calories in the day.  It reduces the stress of making sure a child is eating a certain amount of calories each day.

Will my child be able to go swimming?

Yes!  A feeding tube does not limit a child’s ability to participate in any activities including swimming, laying on his or her stomach, or being with friends.  Talk with your physician about ways to disconnect the tubing when mealtimes are finished.

Is a feeding tube permanent?

Sometimes children will regain the ability to meet their nutritional needs by mouth.  If that occurs, a feeding tube can be removed.

Gillette’s nutrition and feeding services team helps families build trusting, supportive relationships through mealtime experiences.  Click here to learn more and register for Tube Feeding…With Love on September 19.


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