Answers to Mila’s Pain

In January 2023, Mila was diagnosed with central sensitization syndrome, slipped rib syndrome and hypermobility syndrome. For four years, Mila’s mom, Shelley Hunter, had taken her daughter to countless doctor visits to find answers to why she limped when walking and the extreme pain all over her body. When Cook Children's Pain Management was recommended to her, Shelley was hesitant. She didn’t want Mila to just be given strong pain medications. She quickly realized this was not the approach at all.

At Cook Children's Pain Management, the doctor knew exactly what Mila was dealing with right away. 

“She answered all the questions we had for years,” Shelley said. “Instead of dismissing our concerns, she listened and helped us understand Mila’s conditions.”

Mila was referred to the Comfort Ability Program which she attended in March. The relief Mila felt when meeting others just like her was indescribable.

“For so long I felt alone because I was sick in a way that no one else was,” Mila said. “At the workshop, I learned a lot, but the most important thing was knowing there were other people just like me. I finally felt like I belonged.”

Life-changing Workshops Engage Children and Parents 

The Comfort Ability Program at Cook Children’s is one of a few of its kind in Texas. Boston Children’s Hospital is partnering with children’s hospitals throughout the world to give parents and kids the opportunity to engage in workshops that focus on proven coping skills using cognitive behavioral therapy. 

Artee Gandhi, M.D., medical director of pain management, said the six-hour workshops – one for children and one for parents – help children reduce their pain in non-medical ways. Clinical therapists and pain psychologists explain the science behind the pain and how they can best support their children. Through group therapy, children learn strategies to manage their pain and are taught more about their conditions so they can educate their friends, teachers and others. The program is meant to be one piece of a patient’s treatment plan and complement the entire host of options provided at Cook Children’s.

“Others may not see it on the outside, but these children are struggling on the inside, so we give them tools and strategies to employ anywhere and throughout life,” Dr. Gandhi said. “The brain is a powerful tool, and we help them use it.”

The program teaches both children and parents how the nervous system works in the body and why skills rooted in psychology can help. During the workshop, patients learn how to calm down their nervous system through belly breathing, guided imagery, art therapy, aroma therapy, mindfulness and biofeedback therapy.

Patients from 10 to 17 years old with any condition that causes chronic pain for more than three months can participate. Some of the conditions include central sensitization syndrome, chronic headaches, IBS, fibromyalgia and chronic back pain.

A Program Filled with Hope

Matthew Reed, pain management clinical therapist and site director of the Comfort Ability Program, has been at Cook Children’s for 10 years and treats children with chronic pain on an individual basis. He says the goal is always to reduce the attention on pain and get kids back to living. 

“We see a lot of patients who think the pain will last forever and believe there isn’t a path out of it,” Reed said. “There is a lot of hope built into this program, and one of the greatest benefits is the kids connecting with others.”

Patients who attend the workshops also have access to an online platform where they can engage with others around the world with the same condition. The first couple of workshops have been very successful and are now in high demand. 

“It has been very rewarding to see patients realize there is a path out of their pain,” Reed said. 

‘I feel like myself again’

Shelley said even Mila’s teachers noticed that in a matter of a few months, Mila is now a totally different person. She credits the Comfort Ability Program with Mila’s newfound confidence.

“My mental health is a lot better and so is my pain,” Mila said. “I’m starting to feel like myself again.”

“As a leukemia survivor and pediatric oncology nurse here at Cook Children’s, this fundraiser is close to my heart, and I feel that I have been given the opportunity of a lifetime to help others,” Harris said.

The Man & Woman of the Year program is a philanthropic competition among a group of motivated and dedicated individuals in communities across the United States driven to support blood cancer research.

To participate, candidates form fundraising teams and compete in honor of two local children who are blood cancer survivors. The man and woman who raise the most funds during the campaign will be awarded the title of Man or Woman of the Year.

Harris is one of 11 nominees from Tarrant County, and her 10-week campaign runs through June 10, 2022. To support Harris and donate to the cause, visit her campaign website.

In August 1993, when she was 4 years old, Harris was diagnosed with Acute Lymphoblastic Leukemia. After three years of intense treatment at Cook Children’s, she returned home cancer-free and ready to pursue a new dream: to become a nurse.

She went on to graduate from Tarleton State University in 2012 with a Bachelor of Science in Nursing and became a registered nurse. She now serves as a nurse manager of the same unit at Cook Children’s that treated her when she was a child.

Harris says she is excited to participate in the fundraising competition because she hopes to benefit families who are going through experiences similar to those her family faced.

“I love the Leukemia & Lymphoma Society’s mission because the organization is not solely dedicated to finding new drugs,” she said. “They support families throughout their journeys in many different ways.”

The funds raised through the Man & Woman of the Year are used for continuing research of lifesaving therapies, educating and supporting patients and families, and driving policies that increase the development of and access to new treatments.

Go here to Harris's campaign website to learn more.

#WeAreCookChildrens

Rebecca Benson had a feeling the weather predictions would be wrong when she woke up Thursday, Feb. 11. As she suspected, no winter storm arrived overnight to cancel school for her two children. Like any other day, she quietly put on her scrubs while her family slept and left her North Fort Worth home in the dark. A diligent nurse at Cook Children’s Medical Center for six years, Rebecca didn’t want to be late for her 7 a.m. shift.

As she traveled down Interstate 35’s expressway, everything seemed normal – until it wasn’t.

“The roads were completely dry. There was not even a mist on my windshield, absolutely nothing,” said Rebecca. “All the bridges I went over were perfectly fine until I came across the big Trinity River bridge.”

Driving down the highway for nearly 20 minutes, she had no reason to suspect what lay ahead – black ice, and a crumpled mess of metal and people. Approaching a curve at the top of a hill, Rebecca’s car began to swerve. As she confidently corrected the wheel, she noticed shining taillights getting closer. It was a pileup that would ultimately involve more than 130 vehicles, killing six people.

“I look in front of me and see all of the carnage from the accident. There's absolutely nothing I can do,” she said. “It’s the expressway. There's barriers on both sides of you. You can’t go to a shoulder. You can't do anything.”

Knowing she was about to crash, she aimed her red SUV in between two semi-trucks.

“I put my foot on the brake, said a prayer, and I literally thought to myself, ‘I could very possibly die in two seconds,” she said.

Rebecca tried to relax her body to avoid broken bones and readied herself for impact. She hit the trucks so hard, her ponytail holder came out of her hair.

“I got through that and thought, ‘Okay, I'm alive. I'm not severely injured. And then I looked in my rearview mirror and see all of these lights coming right at me,” she said.

Rebecca says that’s when she realized she wasn’t out of the woods. The chances of her being injured or worse by the oncoming traffic were high. But thanks to her quick thinking before the crash, she had positioned her vehicle in what she calls “God’s triangle,” because the trucks stuck out past her SUV, protecting her.

“Everything that hit behind me, the trucks took the impact from that. Every time another semi would hit, you would hear and feel the car move. It was so unbelievably terrifying,” she said. “I've seen it on videos, but to actually be there, waiting to see if something even worse is going to happen was awful.”

Rebecca stayed in her SUV until she stopped hearing crashes. All four doors were blocked by the trucks, so she waited until someone opened the back hatch of her vehicle. She crawled out and surveyed the situation in shock.

“I'm like, ‘Okay, I'm a nurse. I got this. Who can I help? What can I do?’” Rebecca explained. “But Fort Worth Fire Department was working a wreck on the non-express side of 35 (when the pileup began) so they were already there. There was a car behind me that they were working on with the Jaws of Life to try to help somebody. Everyone from Fort Worth Fire was amazing.”

After the crash, Rebecca called her husband who was ready to come get her. She also had a text message from her coworker, Ed, warning her not to take I-35 because traffic was backed up. Knowing Ed was stuck nearby, she decided to find him and hitch a ride to work.

“I was like, ‘All right, I'm gonna hop the barrier and I'm walking your way because there's nothing I can do. But I can at least get in your nice warm car and be safe that way,” she said. “I walked up I-35 in the ice. It was the weirdest thing to be walking on a highway.”

When she found Ed and his girlfriend, Kim, she told them to take her to work. Rebecca explained that she could have gone to the reunification center set up by first responders and waited for her husband, but she knew that drive would likely take hours due to the shutdown. She also felt the need to do something other than think about what she had just survived.

“Being able to be at work and helping instead of reliving that,” she explained. “I was like, ‘I need to get to work and just see where I can help.’”

Rebecca acknowledges this is something she will be processing for a very long time. She allowed her husband to come get her a few hours later and take her to a hospital. Thankfully, she only suffered bruises. But she’s already dealing with survivor’s guilt, wondering why she was able to walk away when so many others couldn’t.

“My heart breaks for all the people who lost loved ones, and who have loved ones in serious condition,” she said. “It's horrible, awful, terrifying.”

Rebecca remembers seeing many people in scrubs as she was walking along the interstate and calls the situation a ‘perfect storm’ for health care workers, all trying to get to work at the same time. Asked if she felt like a hero, she adamantly says ‘no.’

“I feel like I'm absolutely blessed and had guardian angels surrounding me,” she said. “I did what any other nurse I know would do. I didn't save anybody. I didn't do anything extraordinary. I just did what I'm supposed to do.”

She says the experience also gives her hope. From the first responders to good Samaritans, she says she saw the good in people. Even when she was safely waiting with Ed and Kim, she remembers a man walking car to car with a box of granola bars for anyone who may have skipped breakfast and needed something to eat.

“It gave me a lot more faith in humanity.”

“I make sure my patients are served breakfast, lunch, and dinner. When they get their trays, I love to see that smile so that’s what I’m there for,” Sandra told the show’s producers for a taped segment that aired during the episode.

Sandra is the lead ambassador in Food and Nutrition Services and logs 30,000 steps a day delivering meals throughout the medical center.

Live on the show, Tamron asked Sandra why she does what she does, especially in the midst of the COVID-19 pandemic.

“It’s just natural. I just love to do it. And joy is always in my heart, so I just love it,” Sandra said with a big smile.

Corey was also featured in a segment on the show. He said he finds joy in uplifting Cook Children’s patients and families and shared the story of a little boy who was unable to walk.

“I walked past him one time, and said ‘Hey buddy, how are you doing?’ and he smiled with a big smile and he showed me his muscles, and I said ‘I’m going to show you my muscles,’ and I showed him my muscles and said ‘You stay strong and you keep on getting strong,” Corey explained. “This kid wound up walking three months later in this hospital. That’s what drives me to keep on coming to work.”

All four Cook Children’s employees were part of the virtual audience received gifts from the show as appreciation for their commitment to serving throughout the pandemic.

Despite a recognized need, the majority of families at Cook Children’s are unable to access legal services. Social workers at the medical center are often contacted by patient families who have been unsuccessful in qualifying for public benefits, obtaining a guardianship for their incapacitated adult child or communicating with their landlord to remediate unsafe housing issues. These social, economic and environmental factors have a direct impact on a child’s health.

“The health and wellbeing of our patients is impacted by so many factors beyond the scope of traditional medical care,” said Vida Amin, M.D., medical director of Cook Children’s Neighborhood Clinics. “Having an accessible, dedicated resource for our families to turn to for assistance in navigating their legal challenges will be an invaluable addition to the family-centered care we strive to provide every day.”

The medical-legal partnership allows law students the opportunity to develop and apply their skills on behalf of clients who cannot afford legal representation.

“We are giving these children and their families a chance of success by increasing their quality of life by decreasing their unresolved legal needs,” said Robert B. Ahdieh, dean of Texas A&M School of Law.

The collaboration, which officially launched in March 2020, has already assisted dozens of patient families. Felicia Carey is one of the program’s first clients. She was referred to the TAMU Law after her sister passed away, leaving her to care for three teenagers, including a niece diagnosed with spina bifida.

“At first it was very difficult because I lost the paperwork that allowed me guardianship so I could take the children to the doctor,” said Carey. “A social worker at Cook Children’s referred me to the program and it’s been phenomenal. They made a process, which was unbearable, extremely easy.”

Since finalizing her guardianship issues, Carey is now working with TAMU Law on an adult adoption, veterans benefits and developing her will. The program also provides patients and families with access to legal services in family law, housing and public benefits.

“Our job is to prepare compassionate lawyers who will advocate tirelessly for their clients. That’s what sets Texas A&M Law a part from other law schools. We embody our core values, especially selfless service,” said Ahdieh.

“Similar to what has happened with adults, Hispanic children have been most affected during the COVID-19 pandemic,” said Ana Maria Rios, M.D., infectious diseases pediatrician at Cook Children’s. “Hispanic people have the highest burden of all the races and ethnicities in the U.S. and they have the highest risk of contracting infection, and becoming severely ill.”

The Centers for Disease Control and Prevention (CDC) reports similar statistics nationwide. According to a report released in August, Hispanic children are eight times as likely to be hospitalized for COVID-19 as white children. For Black children, the risk is five times as high.

In Tarrant County, overall infection rates for COVID-19 have hit the Hispanic community hardest. This group accounts for 27% of all positive tests, which is the largest percentage across all races and ethnicities.

Why are Hispanic families being hit the hardest?

Out of the 181 children hospitalized with COVID-19 at Cook Children’s between March and October, 96 were Hispanic. But how can this be when white (non-Hispanic) people make up the majority of Tarrant County and surrounding areas?

One reason many experts point to is large numbers of Hispanic workers who are on the frontlines and considered essential.

“A lot of people don’t have the luxury of being able to work from home,” said Vida Amin, M.D., medical director of Cook Children’s Neighborhood Clinics. “It’s kind of the worst recipe. You have adults who have to keep working to put food on the table. You have kids who have to go to daycare or school. All of these factors go into play.”

She says another risk is that Hispanic families are more likely to have multiple generations living under one roof.

“We saw this in Italy early in the pandemic. I remember I was curious about why is this happening in Italy and I started to look at the literature. I saw many younger people, in their twenties and teens, were working in the city and they'd come back home where they were living with their grandparents,” said Dr. Amin. “I think it’s a very similar situation here.”

Bianka Soria-Olmos, D.O., a pediatrician at Cook Children’s office in Haslet, has been an outspoken advocate in the Hispanic community throughout the pandemic. After speaking on various Facebook Live events and news interviews targeted toward Spanish-speaking audiences, Dr. Soria-Olmos says getting information out has been critical.

“I think for some people, unless they've known someone who has been personally affected, they may not realize how dangerous and unpredictable the virus is, including the wide range of presentations it can cause from mild symptoms of a cold to life threatening illness that requires intensive care and in some cases even death,” said Dr. Soria-Olmos. “I also feel like the great things about our culture, like the importance of family and celebrations and the act of gathering, have been an Achilles heel for us.”

She says the most important thing for everyone to remember, not just Hispanics, is to be mindful of activities she calls ‘extracurricular.’

“It’s choosing not to do those things where you could potentially become exposed,” said Dr. Soria-Olmos. “The bottom line is leaving your house is a risk when you have transmission rates this high in the community.”

Tarrant County is currently averaging more than 1,000 cases of COVID-19 a day.

Why do Hispanic children end up getting sicker?

It’s important to remember that most children who contract COVID-19 have mild symptoms or are asymptomatic. In fact, overall hospitalizations among children remain low. However, Hispanic children are at the greatest risk of becoming severely ill and needing hospitalization. Experts believe higher rates of underlying health conditions in this population may play a pivotal role.

According to the CDC, obesity, chronic lung disease and prematurity are the most prevalent underlying conditions for children hospitalized with COVID-19. They report nearly 46% of Hispanic children have one or more of these conditions.

“I have to be honest with you that even though I am Hispanic, I didn't realize how much inequities we have in the medical system,” said Dr. Rios. “I think this pandemic is making everyone aware of the public health crisis we’re in. The silver lining is that public health has to be reinvented and we need to work harder in prevention.”

Another issue that can lead to children of any race or ethnicity becoming sicker is delaying medical care.

“I think it's really important that we ask families and schools to remain vigilant about any kind of severe symptoms that they may be noticing in children,” said Dr. Amin. “Don’t just ignore it because children are supposed to be safe from the virus. Some kids do get very sick and we need to be taking these cases seriously and seeking out medical care.”

Symptoms of COVID-19 in children include:

• Fever or chills
• Cough
• Nasal congestion or runny nose
• New loss of taste or smell
• Sore throat
• Shortness of breath or difficulty breathing
• Diarrhea
• Nausea or vomiting
• Stomachache
• Tiredness
• Headache
• Muscle or body aches
• Poor appetite or poor feeding, especially in babies under 1 year old

Dr. Amin adds, “As a clinician, I hope my families will recognize if their child is in a high-risk category, and that they take it seriously when their child becomes ill and seek out care early.”

What can families do to protect their children?

First and foremost, take COVID-19 safety precautions as seriously. This means wearing a mask in public, washing your hands frequently and using hand sanitizer when handwashing is not possible.

“Wash your hands every chance you get and wear a mask,” said Dr. Rios. “We now know masks work both ways. At first, we thought they would only protect others, but we now know masks make a big difference in the amount of virus that can get to us and make us sick.”

It’s also critically important to stay home from work and school when sick. If your child is exhibiting any symptoms of COVID-19, make an appointment with your pediatrician or a Cook Children’s Urgent Care. These visits can be in person or virtual from your phone or computer using a MyCookChildren’s account, which you can easily sign up for here.

“Not everyone is aware that we offer virtual appointments at our urgent care clinics and at our community based (Neighborhood) clinics,” said Dr. Amin. “For families who are working and juggling other things, signing up for MyCookChildren’s is a great way to schedule appointments and to make sure they can see a doctor quickly.”

Dr. Amin also urges parents not to skip well-visits and vaccines.

“These appointments are our chance to discuss their child’s health, prevent serious illnesses through vaccines and help them understand what to do in case their child becomes sick,” she says. “If anyone out there is wondering if they should get their child’s flu shot this year, they should know the influenza vaccine is recommended for all children over 6 months of age, with rare exception. Please discuss it with your primary care physician. As for our clinics, we have safety protocols in place to allow families to wait in their cars until they’re called in and have taken many other safety precautions as well.”

Another thing families can do to protect themselves and their children is to limit gatherings with people outside of their household, which can be increasingly difficult with the holidays in full swing.

“We realize how hard it is to say ‘We’re not going to get together this year,’” said Dr. Soria Olmos. “But we have to do our part to get the community numbers down. To do that, we need to keep our holiday celebrations to our households, and we hope that we will not have to do this ever again.”

As a survivor of the Great Depression, Dr. Dambro’s mom knew doctors were needed in times of economic boom or bust, and she wasn’t about to stand in the way of her daughter’s chosen career path. In those days, a mother encouraging her daughter to pursue the male-dominated field of medicine was a rarity.

“My mom was practical and very reinforcing in her recommendations for my career,” Dr. Dambro said. “In the 1960s, not that many girls had their mothers telling them to go ahead and be a doctor.”

Her mother’s refusal to conform to that norm made all the difference to a little girl with a big dream. After 41 years of practicing medicine, Dr. Dambro will hang up her clinical white coat on Dec. 1.

Born and raised in Reno, Nevada, Dr. Dambro received her undergraduate degree from Occidental College in Los Angeles and completed her medical degree at Tufts University in Boston, Mass. A pediatrics residency, pulmonary fellowship and a short stint on the faculty at the University of Arizona Health Sciences Center in Tucson preceded her move to Fort Worth where she joined the medical staff of Cook Children’s Medical Center in 1987.

Dr. Dambro made her way to Cook Children’s alongside her long-time colleague and friend Jim Cunningham, M.D., chief medical officer at Cook Children’s Health System.

“I first met Dr. Nancy Dambro when we were both pediatric pulmonary fellows at the University of Arizona Health Sciences Center in Tucson,” Dr. Cunningham said. “We quickly became good friends and professional colleagues. A few years later, when I was considering returning to Fort Worth and joining Cook Children’s, I was very fortunate to convince her to join me. And now, 33 years later, I face the rather daunting task of bidding her a professional adieu.”

Their arrival at Cook Children’s was a pivotal turning point for the medical center’s pulmonary specialty. The two of them had to start from scratch setting up policies and departmental procedures. Today, that two-person team now includes six additional physicians and many supporting health-care professionals and employees.

During her tenure at Cook Children’s, Dr. Dambro served as medical director of pulmonology for 20 years, in addition to serving as president of the medical staff. She helped grow the department to include the Cook Children’s Cystic Fibrosis Center and a pediatric sleep center, among many other improvements and additions.

“Under her leadership and dedicated guidance, the pulmonary program has grown to one of the largest and most accomplished programs in the country,” Dr. Cunningham said. “She has been a leader in pediatric pulmonology nationally, a leader within Cook Children’s in many capacities, and a leader in our community. She has been a mentor to countless of our young colleagues and her legacy will continue on through their good works.”

Mentor Mindset

Upon retirement, Dr. Dambro will set her sights on time with her family and fostering her love of gardening, entertaining, reading and travel. She says the time is right for her and those she’s passing the torch to.

“I’ve really had a very happy career,” she said. “I wanted to have a good, long career. I really wanted to work past 65 and to go out of my career when I felt strong. I certainly did not want to, in any way, overstay my welcome. And we have a bunch of young physicians now at Cook Children’s who need to grow in their careers and they need to have space to do that.”

Her advice to those young professionals?

“Probably the first thing is give it your all,” Dr. Dambro said. “Remain committed and don’t hesitate to become involved. The second is practice medicine as it’s meant to be practiced, following the Hippocratic Oath, and do not get involved in pressures from the business.”

Karen Schultz, M.D., is a grateful recipient of Dr. Dambro’s counsel. She began working at Cook Children’s fresh out of her fellowship when Dr. Dambro was the medical director. She said Dr. Dambro helped guide her through those early years of on-the-job education that comes with being a new attending physician. Today, Dr. Schultz holds Dr. Dambro’s former position as medical director of pulmonology and praises her predecessor as a physician, advisor and friend.

“She was a mentor to me from the start,” Dr. Schultz said. “Over the 17 years I’ve been here she has continued to advise and counsel me. When I took over as medical director, for the six months beforehand, she passed on her knowledge to me and continues to help even now. There’s always something I’m learning from her every day.”

Dr. Schultz believes her colleague’s retirement is well deserved.

“I hope that she really enjoys her time because she has worked really hard for a lot of years and impacted physicians, nurses, patients and staff more than anybody could really ever explain to her,” Dr. Schultz said. “This place will not be the same without her.”

Living Legacies

Lindsey Marshall, 33, of Fort Worth, cried when she heard the news of her beloved doctor’s retirement.

“We talked about the wonderful things that meant for Dr. Dambro,” Lindsey’s mom, Kim, said about comforting her daughter. “I know they're moving to a new house and she gets to spend more time with her husband, and she won't have to wake up in the middle of the night. You know, all things that relate to why this was good for Dr. Dambro. So she understood.”

Lindsey was born with Down syndrome and multiple heart defects. She developed asthma as a toddler and suffered from multiple bouts of pneumonia. Kim said Dr. Dambro has been a gift, noting her positive, calm and reassuring bedside manner, and gives her credit for Lindsey being alive today.

“As a parent of a sick kid I will tell you Dr. Dambro has always been a bright light,” Kim said. “She's always been positive. Never unpleasant. She's always looking for the positive and that's just a gift. She is one in a million. So, yeah, we adore her. It's a personal loss for our family just because we treasure good medical help so much but, for Dr. Dambro, we truly are thrilled. You know, she's worked so, so hard for so many years. She deserves a wonderful retirement.”

Lindsey is a living testament to Dr. Dambro’s legacy. Today, she is thriving from both a health and developmental standpoint as she participates in a college program where she is learning job and life skills that will help her live more independently.

Petey Hansen, 31, of Winnsboro, Texas, has been a patient of Dr. Dambro’s since shortly after his birth in 1989. Born at 26 weeks, Petey suffered a number of complications due to his prematurity, including bronchopulmonary dysplasia, or chronic lung disease. It’s going to be hard for the Hansen family to say goodbye to Petey’s beloved physician after 31 years of what they describe as devoted care.

“We are going to miss her tremendously,” Janice Hansen, Petey’s mother, said as she choked back tears. “We so appreciate the excellent level of care that she always gave Pete. And the fact that I always felt like she loved Pete and that he meant something to her. She always cared, and we wish her well.”

Petey, an avid sports enthusiast who will win any game of sports trivia, beat the odds on multiple occasions. He survived prematurity when many said he wouldn’t, and he proved doctors wrong when they doubted he’d ever walk on his own due to clubbed feet or ever live without a ventilator or supplemental oxygen. But, through it all, Dr. Dambro was there. Never giving up. Never failing to fight for what was best for her patient. Never abandoning the oath she took as a physician.

“She’s very protective of her patients,” Janice said. “She is very knowledgeable in her field and very caring, and Petey loves Dr. Dambro. He looks forward to going to see her every year at check ups.”

“Words fail to capture all she has done,” added George Hansen, Petey’s father.

Today, Petey is relatively healthy and only needs the occasional breathing treatment when he’s sick with a cold or respiratory virus. All thanks to his fighting spirit and, in large part, Dr. Dambro’s care.

Family Matters

Dr. Dambro is quick to acknowledge her family—husband Mark, also a physician, and daughter, Mary—when she talks about her career. Looking back, she isn’t sure how she managed 60-hour-work weeks while also raising her daughter.

“The other day my daughter told me that she and her boyfriend thought for some time that I lived in an alternate reality where there was more time,” Dr. Dambro said with a chuckle. “My family, my husband and daughter and my parents when they were alive, have been incredibly supportive and reinforcing to me.”

She’s also grateful for the support of her colleagues.

“I work in the greatest department,” she said. “We have very low turnover and everybody is happy to come to work and, I think, when you can say you start your day happy to come to work, that says a lot.”

Her longest running colleague will, perhaps, miss her the most.

“I struggle to contemplate professional life at Cook Children’s without Nancy Dambro,” Dr. Cunningham said. “But I am thankful that she took a leap of faith and moved across the country with me, so many years ago, and that she dedicated her professional life to caring for the children of our region. They are happier and healthier for all of her good works.”

Dr. Nancy Dambro’s imprint on Cook Children’s Medical Center will be everlasting as her fellow physicians and colleagues carry on with the work of the department she helped lay the foundation for so many years ago. Thanks to her, thousands of children can breathe a little easier—now and for generations to come.

All patients with exposure to COVID-19, regardless of symptoms, will need to quarantine for 14 days. This is required, regardless of test results, because COVID-19 can develop between two and 14 days after an exposure.

At Cook Children’s Urgent Care, a patient may be required to have two negative COVID-19 tests before their doctor or nurse practitioner will sign a form allowing the child to return to school. This will likely be the case if the child's symptoms are high risk for the virus. 

If a child tests positive for COVID-19, they will need to stay home for 10 days after the onset of their own symptoms. This could mean a quarantine longer than 14 days. 

Cook Children's Health Care System follows guidelines from the Centers for Disease Control and Prevention (CDC).

We also follow the Infectious Disease Society of America which has issued the following COVID-19 guidelines: 

• Intermediate to high clinical suspicion of COVID-19: A COVID-19 test should be repeated in 24 to 48 hours (different samples if indicated)
• Low clinical suspicion: No re-testing

All patients with high-risk symptoms should be tested for COVID-19 before returning to school based on physician or nurse practitioner discretion.

These symptoms include:

• Fever
• Cough
• Shortness of breath
• Body aches
• Loss of taste/smell
• Headache
• Sore throat
• Sustained vomiting or diarrhea (and usually a combination of the these symptoms)

“Our goal is to make sure we limit the spread of COVID-19 as much as we possibly can to keep everyone healthy,” said Suzanne Whitworth, M.D., medical director of Infectious Diseases at Cook Children’s. “If the first test gives a false negative result, we could potentially be sending a contagious child back into the classroom. That is why a second test is needed in cases of high suspicion.” 

All patients with low-risk symptoms and NO known exposure to COVID-19 can be tested before returning to school based on physician discretion. Low-risk symptoms include congestion or runny nose, rash or a single episodes of vomiting or diarrhea.

Click here to read more about COVID-19 testing.

“September of 2020 has been the highest month ever that we've seen suicidal patients admitted to our medical center,” said Kia Carter, M.D., medical director of Psychiatry at Cook Children’s. “We've seen this number rising year after year, so it's not surprising that it's this high. Suicide has become the second leading cause of death for kids and adolescents in the last year, versus two years ago when it was the third leading cause of death.”

This news comes after a near-record month in August when 29 patients were admitted for intentional suicide attempts. The patients admitted to Cook Children’s in September were between the ages of 6 and 18 years old. Dr. Carter says she feels the pandemic has played a moderate role in the increase, but that we typically see higher numbers in the fall months when kids return to school. In September of 2019, for example, Cook Children’s admitted 32 patients for suicide attempts.

“We've definitely seen this number rising in the last five years, but I do think that the amount of stress that we as a society have experienced in the last six months has caused some of our kids and adults to struggle more,” said Dr. Carter.

Virtual school may also be playing a role in mental health of kids. The Rees-Jones Behavioral Health Center at Cook Children’s has become a resource for children and teens who report feeling hopeless and not knowing how to cope with the isolation the pandemic has caused.

“I think everything in proportion is good, but when something is to this extent where some kids have had to do 100% virtual since March, it’s been very difficult,” Dr. Carter explained. “When kids have school, they have an outlet. They have other people to talk to. They have friends and social activities. Now, it’s just them, their parents and siblings.”

She says it’s important to know that some kids do very well with virtual learning, but it’s up to parents to know what works best for their child. Also, some families may have to choose virtual learning if the child or another family member falls into the high-risk category for COVID-19. In that case, parents should remember to ask for help when they need it. School counselors, nurses, teachers and their pediatrician are all great resources.

Warning Signs

Dr. Carter says the biggest thing to look for is a change in your child’s behavior, which she acknowledges can be difficult during the pandemic. She says little things like sleeping more than usual or not wanting to engage or interact in activities they used to enjoy can be signs of depression.

“Start engaging a little more and check in, like ‘Hey, are you feeling okay? I noticed you were getting a little angry at us for no reason,'” she said.

While it’s easy to write off irritation as a side effect of being a teenager, it is one of the primary symptoms of depression in children and adolescents.

Other signs to watch for include:

• Declining grades
• Lack of concern about appearance and hygiene
• Changes in eating and/or sleep
• Self-injury such as cutting
• Less motivation
• Alcohol/drug use
• Acting highly anxious or agitated
• Recklessness

Dr. Carter says girls are more likely to be hospitalized for attempting suicide, but boys tend to make more lethal attempts. As for age, Cook Children’s data shows 14 to 15 years old is the average for suicide attempt admissions, but more recently, the majority of patients have been around 12 to 13 years of age.

With many kids at home alone due to COVID-19, increased access to things like medication, firearms and the internet may also be contributing to the increase in patients. Dr. Carter says her team has also seen more patients participating in social media challenges where kids are hurting themselves.

“We have seen a rise in cutting behaviors, which are a form of self-injury. This is not always considered a suicide attempt but more of a maladaptive behavioral response to stress.”

She says these are things often picked up on social media, reinforcing the importance of knowing what your child is looking at and who they are talking to on the internet.

What Can Parents Do?

Get help.

If you’re concerned for the immediate safety of your child, take them to an emergency room. Trained professionals will evaluate your child to see what next steps need to be taken.

If you’re concerned about your child’s mental health (but not that they will harm themselves), you can contact your pediatrician, school nurse or counselor for a list of outpatient resources in your area.

If you feel your child may need a higher level of care (but it’s not an emergency), you can call Cook Children’s Behavioral Health Intake Department at 682-885-3917. Our team will help arrange referral for outpatient therapy and medication management, partial hospitalization day treatment options or inpatient treatment if needed.

Partial hospitalization allows children to receive treatment including medication management, family and group therapy at the Rees-Jones Behavioral Health Center during the day, while allowing them to go home at night. Children who are deemed an immediate danger to themselves may be admitted to the inpatient unit for 24/7 monitoring and treatment. The Rees-Jones Behavioral Health Center, is one of the few places in North Texas that offers inpatient psychiatric care for children between the ages of 2 and 12.

“Our biggest hope is that we can help families find the support and resources they need, and that we can educate our school systems about warning signs and screenings because they are hopefully going to come in contact with those kids before we do,” said Dr. Carter. “We don't want the numbers to continue to rise and we continue to lose our children. Remember that suicide is preventable.”

“Congratulations. You’ve been chosen to be the mother of a beautiful baby girl.”

Excited. Shocked. Joyful. Overwhelmed. I imagine most people would have similar feelings upon hearing those words, especially when just 48 hours earlier neither my husband nor I knew that our daughter was preparing to enter the world.

I remember that day vividly--the day of her birth. I lived three states away from her birthplace and spent morning entirely unaware how much our lives were about to change. I’d taken our two- year-old daughter, Gracie (who is also adopted), to the splash pad park. I was watching her with soaked hair in a neon floral swimsuit as she tried to scoot her way down a blue slide when I received an email notification. It was from our adoption agency and was marked urgent.

Four months earlier the adoption of Gracie’s half-brother fell through on the day he was born. Needless to say, our hearts were broken and it took us months to feel ready to begin the matching process with an agency. We had been approved to start again just two weeks earlier. I opened the email to see that a birth mom was on her way to the hospital at that moment and when she arrived she wanted to view profiles of prospective adoptive families. If we wanted to be considered we needed to let our agency know immediately.

As I stared at the words, a half dozen fears came pouring into my head. We weren’t ready. We hadn’t made arrangements. There was so little information available about the situation, etc., etc.—on and on my head went. Yet my heart was strangely warm and still. It was telling me the answer. I quickly called my husband and asked him to read the email. After asking how he felt, he said, “I don’t know if this will be our baby but I feel we need to try.”

She was born that June 5th day. After being told we’d been in the birth mom’s top two, it was radio silence. We’d had situations fall through when trying to adopt our older daughter and, of course, the failed adoption four months earlier. We weren’t strangers to disappointment. Still, we couldn’t help feeling disheartened after jumping at every text, email or phone call for the last 36 hours. My husband and I had determined the lack of news was not good news.

This is likely the reason for my amplified shock when I answered my phone driving home from work that day. I could barely comprehend as I replied in broken sentences (fairly certain I squealed), tearing up as I replied, “Wait, wha... Are you serious? What does that mean?” The social worker chuckled and said, “It means you need to get on an airplane real fast. We need you at the hospital at 9 tomorrow morning.”

Lots of packing, little sleep and a 5 a.m. flight later, we landed in another state, anxiously raced toward the hospital and, with excitement bouncing in our bellies, met the social worker at the nurse’s station of the birth hospital’s newborn unit. Our two-year-old daughter was not allowed back so my husband stayed with her as I was led into the nursery. It’s possibly best described as a slightly humorous reversed telling of the children’s book “Are You My Mother?” as I walked past tiny bundles in clear bassinets thinking as we neared each one, “Are you my baby? Are you my baby? Are you my baby?”

As we approached a far corner I spotted two nurses standing beside a pediatrician carefully examining a small baby with big eyes, a perfectly round head, smooth skin and a slightly upturned nose laying on a fuzzy blanket decorated in pink and blue footprints. She was my baby. Our Everly.

It’s impossible to recount that moment without emotion. Picking up my daughter for the first time. Cradling her to my chest in the dim corner of the nursery. Whispering in her ear as those chocolate-colored eyes absorbed me. Feeling her incredible warmth when we first did skin-to-skin. The absolute unparalleled joy of wheeling her into a room to meet her impatiently waiting daddy and sister. Tears poured from my husband’s eyes as he held her in his big arms. Protecting her, as he has every day since. We both smiled as Gracie kept asking to see Everly’s toes and saying, “Put her in car seat. We take her home now.” Everly patiently tolerated her countless kisses, toe tickles and lots of head patting. They’ve been each other’s biggest fan ever since.

Adoption is a journey. One filled with foreign paths, fear, disappointments and doubts. But watching my two girls, one dark and the other fair, bent over in belly-rocking giggles at the simple bliss of splashing together in a bathtub full of bubbles, I say with ardent assurance that the road they came by holds no regrets. The doors that didn’t open, the opportunities we couldn’t take, they led us all to their loving arms and slobbery kisses. If I lived two lifetimes I would never find adequate words to describe the debt. The small moments I’ve shared with their birth mothers are sacred. They gave our girls life. Then gave us the supreme gift to raise them in it.

Yes, adoption is a journey. Our journey. And the destination is so much better than we ever could have imagined.

Deann Kenaly’s Adoption Story

My husband and I started our domestic infant adoption journey with Gladney Center for Adoption in 2015. We attended classes in person and online, became CPR certified and had our lives and home dug deep into before becoming “ready to adopt.” The waiting was long and hard, until August 2016, when we got a call from CPS asking us to foster our nephews.

This changed everything for us. We were in line to have an infant, not 4 and 6-year-old boys. We soon became foster-certified and were willing to do anything we needed to do for these two boys to come live with us. We put our domestic adoption with Gladney on hold at this time. On November 16, 2017, we welcomed Joseph and Jesse into our lives forever and officially adopted them.

In March 2018, we were ready to continue our journey with Gladney. We had a few more bumps in the road along the way. On December 31, 2019, we got a call from our Gladney caseworker presenting us with a potential birth mom, which is something she commonly did, so not out of the ordinary. She told me the history and background of this little baby girl. She was already born on December 10, 2019, and she is healthy and beautiful. I immediately said, “Yes, please show this birth mom our profile book.” Our caseworker then said, “Deann, she is yours. The birth mom has already given up her rights and this perfect little girl is yours!”

I didn’t know what to do but cry tears of joy and repeatedly say, “Really, are you serious?” I was then able to call and share the news with my husband. That night we shared our happy news with the boys. With the New Year’s holiday and some paperwork that had to be completed we were able to pick up our little girl on Monday, January 13, 2020. We waited to tell our immediate family until the night before we picked up our little girl.

Monday morning came and we all got dressed up to go to Gladney to meet baby Stella and bring her home. We were ecstatic to finally meet and bring home our sweet baby girl. On July 10, 2020, Stella finally became an “official” part of our family. Although it was the longest journey ever, it was well worth it. Within 5 years we became parents to three wonderful children--Joseph, 10, Jesse, 8, and Stella, 9 months.

Claire Cartmel’s Adoption Story

We’ve always wanted to adopt. It’s been part of our conversations for years. My background of volunteering and working social services, combined with our love for children, made this desire a no-brainer. We struggled with knowing when the time would be right to grow our family through adoption. It’s hard to know when to hit the ground running toward a journey well known for its ups and downs.

After wading through mounds of paperwork, we became active in February of 2020 and matched with a mother due six months later. For reasons that are not my story to tell, that match failed, and we found ourselves back at the drawing board sad but hopeful.

The morning after we got this news, our social worker set up a phone call for us to talk with another expectant mother. Instead of a phone call at our agreed upon time, we got a text telling us to hang tight. We soon learned that the mother was on her way to the hospital, unsure if she was in labor. When it was clear that she was, we spent the next couple of hours packing, buying last minute things and trying to enjoy the unfolding journey. Our daughter was born the next morning as we traveled to meet her—22 minutes into our 8-hour drive, and just four days after the news of our failed match.

While 2020 hasn’t been the poster year for many things, it has been a particularly memorable one for us. Stay-at-home orders have afforded us more time with our family than we could have ever imagined. We finalized our adoption this summer and marvel daily at the precious gift that she is to our family.

“We've definitely seen a high number of adolescent suicide attempts over the past couple of months, especially during COVID-19,” said Kia Carter, M.D., medical director of psychiatry at Cook Children’s Medical Center. “We've also seen younger kids endorse suicidal ideation.”

At Cook Children’s, the vast majority of patients treated for self-harming are girls, typically between the ages of 13 and 15. But Dr. Carter says she’s had patients in her unit as young as 4 years old talking about wanting to die.

“We've seen a huge increase with younger kids knowing what death is because of video games,” said Dr. Carter. “We have to assess their cognitive level and find out if they know what death means or do they think it’s like the video game where they die, but get a backup player.”

So far in 2020, 192 kids have been admitted to Cook Children’s for attempting suicide. Compare that to the same time period in 2015 when the hospital saw 88 patients - less than half of the current statistics.

Unfortunately, the data from Cook Children’s Behavioral Health Center is in line with a new study from the Centers for Disease Control and Prevention (CDC). The article, released Sept. 11, shows suicide rates among 10 to 24 year olds have increased 57.4% from 2007 to 2018.

"It's a real trend that has been demanding, for a while, a serious public health and research effort to understand what is happening and why," said Anna Mueller, an associate professor of sociology at Indiana University Bloomington. In an interview with USA Today, Mueller said she doesn’t buy that it’s just social media, though we do know many children express anxiety and depression linked to social media.

“Social media plays a big role in the mental health of children and teens,” said Dr. Carter. “They experience bullying online, they may not feel self-worth because they’re comparing themselves to what they see on Instagram. They’re also getting ideas on the internet about how to harm themselves.”

Dr. Carter says social media and sites like YouTube have made self-harm almost acceptable. She says children are looking to those avenues to find out how many pills to take or other ways they can attempt suicide.

“A lot of kids will research how much medication to take to not wake up,” said Dr. Carter. “I would say 99% of the overdoses we see have some over-the-counter component.”

Since January, 31 children have been admitted to Cook Children’s for ingesting too much Benadryl. At least three of the Benadryl overdoses are linked to a TikTok challenge, but the majority of cases were among patients intending to harm themselves. Other drugs commonly found in medicine cabinets such as Tylenol, aspirin and ibuprofen are also frequently used.

So why do children and teens take these drastic measures?

“When people feel like they're not going to get better and there's no way out, they tend to go to these levels,” Dr. Carter explained. “I think the biggest thing is hopelessness. When kids feel like they don't have anyone to talk to, they don’t feel like they can communicate with their parents or they’re getting bullied and they don’t have a social circle. Some kids also are struggling with gender and sexual identity.”

About 30% of the children assessed by Cook Children’s Behavioral Health Center report issues with gender or sexual orientation. Among those are patients diagnosed with gender dysphoria, a feeling of discomfort or distress that can occur when someone feels their gender identity differs from their sex.

“There are some kids who physically don't feel comfortable in the body they're in and they don't feel that they relate to the other girls or the other boys. We see this occur a lot around age 10,” said Dr. Carter. “A lot of times parents feel like it's a phase, and that might be true, but I would encourage parents to not minimize it because kids can begin to feel hopeless.”

She suggests parents keep an open mind, listen to their children and get them in to see a licensed professional counselor. And she says it’s ok to not agree with their feelings, but to share those thoughts with your spouse or a friend instead of the child.

“If you're resistant to it, your child's going to shut down and that can cause a whole realm of depression, hopelessness and not wanting to be alive anymore,” she said.

With COVID-19 and social distancing, spotting signs of depression and hopelessness can be challenging. Things that may have seemed out of the norm in the past, like avoiding social activities, may not be so odd now. But Dr. Carter says watching for changes in behavior is still key.

“Most kids still want to play video games and have their cell phones, so if they don’t want a new video game and all they want to do is sleep, you’re going to want to assess where that change is coming from,” she said.

Other signs of depression to look out for include:

• Declining grades
• Lack of concern about appearance and hygiene
• Changes in eating and/or sleep
• Self-injury such as cutting
• Less motivation
• Alcohol/drug use
• Acting highly anxious or agitated
• Recklessness

If you feel your child needs help, please talk to your pediatrician or call 682-885-3917 for a referral to Cook Children's Behavioral Health Center.

“We’ve seen gun sales increase significantly nationwide over the past several months,” said Dan Guzman, M.D., a Cook Children’s emergency physician. “Now, with many children being in the home for longer periods of time, curiosity and boredom are something we need to expect. We have to stay vigilant and make sure we’re doing everything we can to prevent a tragic accident.”

According to Small Arms Analytics and Forecasting, this year’s gun sales have already eclipsed 2019 by more than one million firearms.

“With the hunting season about to begin in earnest and the presidential election season about to start in earnest as well, 2020 will without doubt exceed the previous high of 16.6 million units sold in 2016,” SAAF chief economist Jurgen Brauer wrote in an emailed statement provided to FOX Business.

Last year, 41 children were admitted to Cook Children’s for injuries related to guns (including handguns, rifles, shotguns and other firearms such as BB guns.) With 23 children already injured in 2020, Dr. Guzman fears he could see more of these patients this year than last.

“I think most people think this ‘won’t happen to us’ because we’ve taught our kids to never touch guns,” Dr. Guzman said. “But if you aren’t taking the proper precautions as the adult and parent, it’s probably only a matter of when, not if, your life may be affected by an unintentional discharge involving someone you know, and maybe even your child.”

Building awareness for gun safety is a passion for Dr. Guzman. He’s the medical director of the Aim for Safety program at Cook Children’s, which promotes firearm safety for children. The program, which has been featured in several news stories, is a multi-step interactive experience that provides parental awareness and teaches children the steps they should take when they encounter a firearm.

“As parents need to feel comfortable having open-ended conversations with others where our children may play and stay,” he said. “That includes family members and close friends. Don’t be afraid to ask if there’s a gun in the home and if so, how it is stored. Keep the conversation focused on safety and not politics.”

Dr. Guzman offers these safety tips:

The 3 Ts of firearm safety and children

Talk – This includes your family, neighbors and friends. When your child visits other homes, ask the owners if there are guns in their homes and how they are stored. Dr. Guzman said this question is not to be insulting, but to keep your children safe from unsecured firearms.

Teach – Have a conversation with your kids about what to do if they see a gun:

• Stop
• Don’t touch the gun
• Run away
• Tell someone

Take – Dr. Guzman is asking gun owners to take action and store their firearms properly. And, to take personal responsibility for our children’s safety.

Their journeys differ in many ways. Emily is a two-time cancer survivor who says she essentially ‘grew up’ at Cook Children’s, while Jason was diagnosed as a young adult. But both say they were so inspired by their experiences at Cook Children’s, they decided to return to care for patients and families who resemble their own stories.

For Jason, becoming a nurse was not even on his radar. At 20 years old, he was studying to become an opera singer at Oklahoma City University. At first, he thought the shoulder pain he was experiencing was the result of a boxing class he was in. Then the pain moved to his hips. After several visits to different doctors, Jason finally had bloodwork done.

“They discovered that my white blood cell count was crazy high,” he said. “They’re supposed to be about 6,000 and I think mine was 68,000 at the time of diagnosis.”

He was advised to go to Cook Children’s to see Karen Albritton, M.D., who specializes in teenage and young adult cancer. Luckily, Jason was already familiar with Cook Children’s since he grew up in Fort Worth.

“Finding out that the best place you can go is in your hometown was just serendipitous,” he said.

It was at Cook Children’s that Jason received the diagnosis of biphenotypic leukemia, a mixture of both acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). He spent a total of three months receiving chemotherapy and radiation for his cancer. During that time, genetic testing revealed he was highly likely to relapse if he didn’t receive a bone marrow transplant. In another twist of fate, he learned his only brother was a perfect match. Thanks to his sibling’s willingness to become a donor, Jason received the bone marrow transplant that would ultimately make him cancer-free on May 8, 2012.

“I ended up having my transplant on my 21^st birthday,” said Jason. “It's something I always joke about because whatever day you get your transplant is supposed to be celebrated as your second birthday, but I still only get one.”

To make his 21^st birthday even sweeter, Dr. Albritton arranged for three singers from the Fort Worth Opera to come visit him in the hospital.

“She really went above and beyond, and really, it was a very, very special day,” he said.

With the intense treatments Jason had to endure to fight the cancer, he wasn’t sure he’d ever be able to sing again. It had been a dream of his to become a professional performer since early childhood, but he feared his vocal chords had been permanently affected by the medication. But after beating cancer, Jason went on to finish his degree and even received a master’s degree in opera at the San Francisco Conservatory of Music.

“While I was doing all of that, it just felt like something was missing. I had thought about becoming a nurse when I was in the hospital,” Jason explained. “So I went back to my other love and honestly, I've never been happier than I am right now as a nurse. And especially at Cook Children’s, being able to work at the hospital with some of the people who treated me, and being there for these kids the way the nurses were there for me. I've gone home crying happy tears multiple days because I just feel so lucky.”

He says he loved his doctors, but the nurses held a special place in his heart.

“The nurses are the ones who are with the patients most of the time, and it was the nurses who really took care of me when I was at my sickest,” said Jason, his voice cracking as he spoke. “When I was in the most pain, when I couldn't stand or sit, they made my treatments bearable. I actually got to tell one of them that she specifically was the reason I wanted to become a nurse, because of all the ways that she helped me when I was a patient.”

Much like Jason, Emily says the nurses left a big impact on her, though she was much younger when she was diagnosed.

“I spent the majority of my childhood fighting cancer at Cook Children's,” said Emily. “In November of 2001, when I was almost 4 years old, I was diagnosed with Wilms' tumor. I had my kidney removed with my tumor. That was the size of a youth football.”

For Emily, the treatments lasted many years. She relapsed twice and had to have additional surgeries on her lungs and diaphragm, all followed by chemotherapy and radiation.

“Cook Children's quickly became my second home and somewhere that I felt safe,” she said. “I thought this was normal. Cook Children's made it feel fun, like something that I didn't have to do, but it was just part of life.”

She has especially fond memories of the Hematology/Oncology infusion center where she would receive treatments as an outpatient.

“The clinic was like a sanctuary for me. It was somewhere that I felt safe and where there was other kids like me who were bald and had ports and IV poles. That's where I would make most of my friends,” said Emily. “The clinic nurses always were a blast, playing music and giving out prizes. And Child Life made sure that even though we were there for hours, that it was always fun.”

In 2004, Emily received an autologous stem cell transplant and was deemed cancer free. She was on the mend until middle school when she developed a second cancer in her thyroid, likely due to heavy treatments from her first cancer. She had her thyroid removed and she was once again cancer free. She says even then, she knew she wanted to take care of children. When Emily went to college, she considered going to medical school to become a doctor, but quickly realized nursing was her calling.

“I love interacting with people. I love having relationships with people. I love being very hands on,” she said. “I felt like a doctor does all of those things wonderfully, but I felt like as a nurse, I could do all of those things more prevalently.”

She applied to Cook Children’s nurse residency program, but knew the competition would be strong. Out around 600 applicants, only about 5% would be accepted into the 12-month program.

“I knew that working at Cook Children's was a privilege and an honor, and I just had to tell myself that it may not happen right away, but I'll get there someday,” Emily said. “When I got the phone call from the manager of the nurse residency program, I think I cried as soon as she told me who she was. I didn't know if it was going to be a yes or no, but I still cried. As soon as she gave me the offer, I accepted it right on the spot. I think I said yes a hundred times. My mom was in the car with me and we both bawled after I hung up because it just came full circle.”

Both Emily and Jason say they want to work on the Hematology/Oncology floor where they were patients, but also understand the need to keep an open mind since placements for nurses at Cook Children’s are never guaranteed. After rotating through several departments for six months, Emily recently received her permanent placement. She’s officially a nurse in Hematology/Oncology.

“That kind of sealed the deal and it all made sense to me. The plan that God has for my life… all that I went through wasn't just something to go through. It had meaning,” Emily explained. “I always say that I wouldn't go back and change it, because it's allowed me so many opportunities to help other people and, now, children like me.”

Jason, who just began the program in July, is currently rotating through the Hematology/Oncology (H/O) floor. He hopes at the end of his six month rotation, he’ll be joining Emily.

“It's a very special population,” said Jason. “And the nurses just all care so much. I mean the whole staff, everyone cares so much about these kids and just work so hard for them and work so well together because of that common passion. And it's just really special to be here.”

“All of these children presented to the hospital with symptoms that resembled a severe case of Kawasaki disease,” said Nicholas Rister, M.D., an infectious diseases physician at Cook Children’s.

Kawasaki disease is an illness that creates inflammation in blood vessels with no proven cause, but is generally thought to follow various infections after they have otherwise resolved. Dr. Rister said the patients with MIS-C arrived at Cook Children’s following exposure to COVID-19 and had symptoms including fever, abdominal pain and outward evidence of inflammation including diffuse rashes, conjunctivitis and swelling. In the more severe cases, evidence of multi-organ dysfunction including respiratory distress, low blood pressures, liver and kidney damage and altered mental status were also seen.

“Of particular concern to us is inflammation of the heart and surrounding major blood vessels which is also seen in Kawasaki’s disease. We have seen this same thing in several of these COVID inflammatory disease patients,” explained Dr. Rister. “Minimizing the degree of inflammation in these children, while providing supportive care for any organ damage, has been a key component of treatment.”

All four patients were tested for COVID-19. Three tests came back negative and one was positive.

“We believe all of these cases are related to COVID-19,” said Dr. Rister. “The three negative results are evidence of how far the infection had progressed, resulting in the inflammatory syndrome.”

Three of the patients have been released from the hospital. One remains in the pediatric intensive care unit.

In addition to the recent appearance of MIS-C cases, the infectious diseases team at Cook Children’s is also looking closely at increased reports of unexplained fevers in our area.

“We want parents to be aware of these cases as COVID-19 continues to spread in our community,” said Dr. Rister. “Unexplained fevers for several days and evidence of generalized inflammation may be signs of this illness.”

Symptoms of more severe MIS-C cases include severe abdominal pain, shock from low blood pressure, respiratory distress and lethargy. If your child exhibits any of these symptoms, seek emergency medical care immediately.

Less severe symptoms include fever, abdominal pain and rash. Caregivers should call their pediatrician if these symptoms appear, as they overlap with many other common infections and medical conditions. It is important for these children to be fully evaluated.

This is the daunting statistic looming over the heads of the team at the National Marrow Donor Program at Cook Children’s. Each day, this dedicated group of six sets out to see how many people they can enroll in the National Marrow Donor Program, also known as the Be the Match registry. Equally as important, they’re also tasked with contacting, scheduling and counseling donors who have been identified as a likely match.

“We have the potential to save anyone’s life,” said Jamie Kayser, the program’s director. “It’s not just blood cancers, the donors we identify also save the lives of patients with diseases like sickle cell anemia. We find donors for both adults and children.”

For Kayser, her work is more than a job. She’s one of the millions of people who have been deeply affected by cancer.

“When I was 27 years old, my first husband died of leukemia,” she explained. “He underwent two bone marrow transplants over the course of his treatment. I was not a nurse at the time, but going through it with him, I realized how important nursing was and I decided I was going to become a nurse.”

At the time, Kayser vowed to never work in oncology or in a bone marrow transplant unit. She ended up doing both. Her first role was as an oncology bone marrow transplant nurse at Cook Children’s, which she accepted in 1994. Seven years later she took over her current position as the director of the National Marrow Donor Program at the hospital.

“I say I’m doing the other side of transplant,” Kayser said. “There’s the side where the patients receive the bone marrow transplant and then there’s this side where we register donors, find matches for patients and get them ready to give.”

The National Marrow Donor Program is a nationwide registry. For those enrolled, the chance of being identified as the best possible donor for a patient is one in 300.

“There are two ways to donate depending on what the patient’s doctor requests,” explained Kayser. “The most common way is very similar to giving blood.”

Seventy-five percent of donors are asked to provide blood stem cells through a peripheral blood stem cell donation (PBSC) donation. This was the case for 21-year-old Andrew Kozman of North Richland Hills, Texas. He knew the chances of being identified as a match were rare when he signed up for the donor registry in late 2018. During his PBSC donation, he said he was shocked to receive a call just three months after he submitted his cheek swab in the mail.

“You always hear about the people who have been on the list for years and have never received a call,” said Kozman. “I was fortunate to get a call just months later. Everything has moved pretty quickly since then.”

To prepare for his donation, a nurse visited Kozman’s home for five days ahead of the appointment and injected him with a drug called filgrastim. The medication increases the number of blood-forming stem cells in the bloodstream. On the fifth day, blood is drawn and circulated through a machine that filters out the stem cells. The remaining blood is returned to the donor.

“It was just like getting a normal flu shot. I felt a little sore afterwards, but that’s it,” said Kozman. “I never really gave it a second thought. I signed up and found out that someone needed my help. I thought ‘I could sit in a chair for a few hours if it’s going to save someone’s life.’”

The second way to give is through a surgical procedure called a marrow donation or harvest. Only 25% of donors are asked to provide blood stem cells in this manner. This procedure is done at a hospital while donors are under anesthesia.

“Unfortunately, there is a lot of misconception about bone marrow harvests,” said Gretchen Eames, M.D., medical director of Hematology/Oncology and Stem Cell Transplant Program at Cook Children’s. “It is considered a minor surgery. There is no incision; no stitches or sutures are needed.”

During a marrow donation, blood stem cells are withdrawn through two small punctures in the back of the donor’s pelvic bone. Discomfort during recovery varies from person to person, but Dr. Eames says donors are usually able to manage any pain with Tylenol or hydrocodone. Most people will make a full recovery within a week.

Rebecca Proctor joined the National Marrow Donor Program registry in 2014 when she was a college student. Now a Neonatal Intensive Care Unit nurse at a Fort Worth hospital, she was also surprised to receive a call informing her that she was a match for a patient in need of a bone marrow transplant.

“I was definitely a little nervous when I first got the call,” said Proctor. “After agreeing to a marrow donation, I would have days here and there where I would panic. But I knew if this was going to save someone’s life then I could do it.”

Dr. Eames performed the procedure on Proctor at Cook Children’s, which is one of two bone marrow collection centers in Texas and the second busiest center in the U.S.

“We do approximately four to six bone marrow harvests a month,” said Dr. Eames. “Our donors come from all over the place. Many of them live here in the Dallas/Fort Worth area, but we have people who travel here from California, the east coast and the Midwest because they do not have a national marrow donor collection center where they live.”

For Proctor, the process was much easier than she anticipated.

“Besides a minimal amount of soreness, this really hasn’t been a bad recovery,” she said two days after her donation. “There’s some hoarseness in my throat from the breathing tube, but honestly, this is nothing compared to what my recipient has been going through.”

While donors don’t know who they are giving to, they are likely of the same ethnic background since donors and patients need to be a close genetic match. Given the current makeup of the National Marrow Donor Program registry, the likelihood of finding a match for a white patient is 77%. African American or black patients only have a 23% chance of finding a match.

To improve these odds, ethnic diversity among people on the registry needs to increase. To put it simply, more people are needed to join the registry.

“Everyone, when they turn 18 years old, should sign up for the National Marrow Donor Program registry,” urged Kayser. “We believe every patient should have an equal opportunity to find a match, regardless of their ethnicity.”

To increase those odds, Kayser’s team hosts booths at live events in North Texas as well as West Texas to enroll potential donors. They answer questions, collect information and cheek swabs.

Proctor, like most donors, encourages others to join the registry. Having gone through the process herself, she says she is glad she was able to help someone in need.

“This is something I am so proud to say I have done. Looking back, I would do it again in a heartbeat.”

"There are a lot of patients who need specialized care or even higher levels of care and it’s really important that in this rapidly growing community that we have that available to these families," said Dr. Hogan, pediatricitian at Cook Children's Pediatrics Prosper Trail.

Dr. Hogan is one of 24 Cook Children's pediatricians currently treating patients in this region of North Texas. She says patients like hers need a place to access specialized and emergency pediatric care without having to drive 30 minutes to an hour away from home.

"A lot families have hardships and are not able to drive that far, or take off work all the time to go to these visits, and having this inpatient hospital and specialized care right her will make it easier for all the families," Dr. Hogan explained.

Construction of Cook Children's Medical Center North is in the initial phases with plans to have a full service hospital completed in 2022. The new hospital will be located on a 23-acre site in Prosper at Windsong Parkway and Highway 380. Having started in October of last year, phase one is already underway with plans to open a primary and urgent care clinic in the fall. An outpatient surgery center and specialty clinic with imaging and lab services will open in 2020.

"I'm really excited about the hospital opening up and being able to refer my patients to specialists, right here in Prosper, and being able to send my patients to get the specialized care that they need, having higher levels of care right across town," said Dr. Hogan. "I think that is going to be really wonderful for the families here."

Currently, Cook Children’s operates eight primary care offices in and around the Town of Prosper. The expansion near Windsong Ranch marks the first time in Cook Children's 101 year history that a full-service hospital has been built outside of Fort Worth.

"Just like the Town of Prosper is family, a close knit community, so is Cook Children’s," said Dr. Hogan. "We are all here wanting your children to be healthy and do better in life and be able to get the care they need to grow up to be happy and healthy adults."

It may sound like a melee, but this is part of a unique program that launched last fall at the Jane Justin School at Cook Children’s Child Study Center. The program began as a R.A.D. self-defense course and has since evolved into a curriculum called ‘Hard Target.’ The 12-hour class teaches self-defense to students with developmental and learning disabilities in the Center’s Upper School.

On this morning, four female students are participating in a drill. The scenario includes being attacked at an ATM and sadly, because of their disabilities, it’s a situation they’re more likely to find themselves in than the average person.

“We know that individuals with developmental disabilities are three to five times more likely to become victims of bullying, assault and sexual assault,” said Joyce Elizabeth Mauk, M.D., CEO and medical director of the Child Study Center.

According to a recent investigative series by NPR called ‘Abused and Betrayed’, the rate of sexual assault among people with intellectual disabilities may be even higher. Reporter Joseph Shapiro said in his report that unpublished data from the U.S. Justice Department shows people with intellectual disabilities are sexually assaulted at seven times the rate of people without disabilities. His series calls the issue an “epidemic.”

The concern surrounding these statistics sparked an idea with the Child Study Center’s team. What if they taught students how to defend themselves, especially during the transitional years when students are preparing to go out into the world to seek employment and possibly even live on their own? Dr. Mauk and her team contacted Security Services at Cook Children’s, which already provided self-defense courses to employees. Together they developed a curriculum specifically tailored to the needs the school’s students, aged 13 to 22.

“The most important thing we want these students to learn is how to protect themselves,” said Brennan McCullars, ‘Hard Target’ instructor and security services trainer at Cook Children’s. “These are people who are much more vulnerable to predators than the majority of the population. They are often trusting of others. They don’t always know what behaviors are inappropriate, so we have to work on that.”

One of the girls in McCullars’ class is 18-year-old Elizabeth. She’s a soft-spoken junior at the Child Study Center’s school where she also interns as a teacher’s aide. She’s small in stature and supportive of her classmates, cheering them on as they move through the course. When it’s her turn to approach the “ATM” – a punching pad leaned against the wall – Elizabeth transforms. There’s no reservation in her voice as she belts out ‘’NO!” and blocks incoming hits. She throws eight punches before sprinting away from her “attacker.”

When asked what she thought of the course, Elizabeth said she feels more confident now.

“In self-defense class, they taught us how to use our voice and how to use our hands and our feet (against an attacker),” said Elizabeth. “It has eased my concerns because I know I can protect myself when my brothers and my support system are not around.”

For Elizabeth’s father, Lonnie Ramon, these new skills are just one more tool in her toolbox. He and his wife believe Elizabeth will be able to live and work independently. He says he feels better about her future knowing she’s had to think through what should be unthinkable situations.

“It’s a crazy world nowadays. You see too many weird and crazy things on TV. People take advantage of others and I’m afraid of that,” said Ramon. “But that’s part of this self-defense course. It’s helping her think about how to get herself out of situations, God forbid they ever arise.”

Along with the four females, a group of eight male students are also going through ‘Hard Target.’ All of the students who complete the class will have a chance to take a refresher course next school year.

“We are excited to offer this one-of-a-kind curriculum,” said Tracie Mann, Ph.D., LBA, the headmaster of the school. “The ‘Hard Target’ program demonstrates our unwavering commitment to preparing our students for the future, both academically and in life.”

And at no time, do most of us feel more generous than during the holidays.

Sometimes, though, the people on the receiving end of your generosity don’t have the same great intentions as you.

We hear of these reports from time to time in our own community: Someone is going to door-to-door in a neighborhood selling something to support Cook Children’s. The Internet is full of scams in the name of giving that most of us would never dream of committing.

We want to make sure you aren’t scammed, especially in the name of Cook Children’s. :

1. We won’t coming knocking. Cook Children’s never solicits donor support door-to-door.  Cook Children’s also never sanctions door-to-door solicitations on our behalf.
2. We validate. Annually, Cook Children’s has more than 70 community partners who hold special event fundraisers that benefit Cook Children’s.  Each of these partners events have been approved by Cook Children’s Health Foundation and have been provided a letter of authorization to validate the authenticity of the event and its organizers.
3. We give our stamp of approval. The request for a proposed fundraising activity that will benefit Cook Children’s must be submitted for approval, including the use of Cook Children’s name and/or logo prior to the event.  Cook Children’s endorses wholesome, family or child-oriented events that provide a favorable community image.  “Proceeds benefiting Cook Children’s” may be used in promotional materials, invitations or advertising copy, if approved in advance by Cook Children’s Health Foundation.

In order to keep yourself from falling victim to a charity scam, take the time to check out the charity.

1. Visit their website and look for the following things:

• Correct spelling and use of grammar.
• Mission statement.
• List of board members.
• Permanent street address (not a PO Box) and a phone number.
• Statements of financial transparency.

2. Seek proof

• Ask the charity to mail you information on the program they are asking you to support and how the funds will be used.
• Request a copy of their tax information.
• Check the company’s status with the Better Business Bureau.

3. Ask if you can write a check

Donations of cash are not trackable and any legitimate non-profit organization would be willing and able to accept a check.

4. Use common sense

Don’t provide financial information to anyone over the phone.

If you receive a request by email, look at the email. Beware of emails coming from addresses such as Hotmail or yahoo, and not .org. Don’t make a donation through an email that you don’t know or can’t verify. For example, Cook Children’s would send an email such as foundation@cookchildrens.org.

Don’t give in to forceful or demanding requests for your immediate support.

Use caution on social media sites and websites that you are unfamiliar with.

Some organizations, like Cook Children’s, have groups within the community who raise money for the cause. These events are not run by Cook Children’s, but must be approved by Cook Children’s Health Foundation. If you have a question about the validity of a group or individual who is soliciting funds on behalf of Cook Children’s, contact our Community Partners specialist at 682-885-4105.

Don’t let the possibility of charity scam keep you from supporting the causes that you believe in, but do let it raise your awareness and guide you in your decision making. Do your research, identify your top charities of choice and reach out to them. Real charities have nothing to hide.

If you suspect that you are being solicited by or have fallen victim to a charity scam, document the details and contact your credit card company or bank to report the incident.

Cook Children’s is a 501(c)(3). IRS tax number 75-2051646. 

Parents can help by making sure that children plan accordingly for testing days at school. Find out from your children and the school how they’re doing and the likelihood of not performing well on tests. This will help alleviate fears by pacing preparation for the tests, creating a plan to help kids succeed and encouraging them to problem-solve their worries.

Here are steps you can take to help your child during this stressful time:

1. Ask for help. If your child is especially anxious about test taking, set up a meeting with the teacher and school counselor to come up with a plan to ease fears on test day.
2. Go online and get sample items of practice tests from previous years and, if needed, practice with your children at home.
3. Practice deep breathing exercises at home. Then on test day, they will be able to put these practices into action.
4. Make sure your child gets plenty of rest. Studies have found that people who get eight hours of sleep before taking a math test are nearly three times more likely to figure out the problem than people who stay awake all night.
5. Control your children’s anxiety by making sure they are prepared. Focus on good study habits and the importance of not waiting until the last minute to cram before the test. There’s still time. Also, make sure your child has everything he or she needs going into the test. Even if it’s a new sharpened pencil. Make a check list the night before to avoid stress.
6. Stay away from entertainment as test time approaches. It’s not easy, but your child needs to study and not spend all night watching TV, looking at Facebook^® or being on the computer. You can wait on that until after the test.
7. Help your child keep mistakes in perspective. Everyone makes them and nobody is perfect. As you move closer to tests and studying, use wrong answers as a learning opportunity.
8. Eat right. Make sure your child has had enough sleep, exercise and healthy food. Avoid heavy food or desserts that may upset the stomach. Avoid  high sugar foods that may keep your child up all night and  make sure your child has a healthy breakfast (low-sugar cereal or oatmeal) the morning of the test.
9. Expect distractions. Let your child know someone in the class will have sniffles. Some kid will be banging his pencil on the desk. Someone may be humming. Those kids have their own stress. Just warn your child this is going to happen, but don’t let it be a bother.
10. After testing is completed, create ways to celebrate with your child. What you want to focus on in this celebration is the success of managing their stress, and not whether they passed or failed, which they won’t know for weeks.

Targeted cancer therapies are biologic or immunologic drugs or agents that target cancer cells in the body while leaving most healthy cells alone. These drugs have become a common treatment option for adults with certain types of cancer and, in recent years, clinical trials have shown success for some childhood cancers.

“Targeted therapy is the future of pediatric cancer treatment,” said Dr. Vallance. “Being able to offer more targeted therapy through clinical trials means Cook Children’s cancer patients will have access to the newest treatments available.”

The oncology team at Cook Children’s diagnoses approximately 220 new cancer cases each year. Approximately one thousand patients undergo active treatment or follow up through Cook Children’s each year.

The grant money awarded by St. Baldrick’s will be used to fund a Targeted Therapeutics Program Coordinator. Under direction of Dr. Vallance, this person will coordinate and collaborate with consortiums and pharmaceutical partners to open new targeted therapy clinical trials at Cook Children’s.

“We’ll be able to efficiently open more trials, which will give all patients in North Texas and surrounding areas access to leading edge clinical trials closer to home,” Dr. Vallance explained.

Cook Children’s is one of five hospitals in Texas, and the only hospital in North Texas, selected to receive a portion of $2.26 million dollars in infrastructure grants awarded bySt. Baldrick’s this year. All of the grants awarded will support groundwork for childhood cancer research.

The St. Baldrick’s Foundation is the largest private funder of childhood cancer research grants worldwide. Since government funding for childhood cancer research is limited, research institutions like Cook Children’s depend on private organizations like St. Baldrick’s for support in finding new cures and treatments.

“The majority of childhood cancer patients are treated on a clinical trial,” said Kathleen Ruddy, CEO of St. Baldrick’s. “Research relies on enrolling large numbers of patients on clinical trials to ensure results are meaningful and advancements are made. Funding from St. Baldrick’s will ensure more kids have access to clinical trials, giving them a better chance at survival and a future with less long-term effects.”

The infrastructure grant awarded to Cook Children’s is the first step in the creation of a formalized Targeted Therapeutics program.

“As this research continues for all types of childhood cancer, we will see more opportunities for each child and young adult to receive personalized, targeted therapies as part of upfront standard therapy,” said Dr. Vallance. “Hopefully, this will lead to higher response rates, less toxicities and more cures.”

Oehlert is currently a clinical operations manager at Cook Children’s and one of the more than 250 Cook Children’s employees who will be honored this Veterans Day.

Like many people in healthcare, Oehlert was inspired to pursue a job in nursing after a traumatic life experience. In her case, it was the brain aneurysm her mother suffered when she was 13 years old that set her on her path. For two and a half months, Oehlert learned tips from the nurses on how to help her mother recover while doctors worked to reduce the swelling in her skull. She received her LVN while still in high school and, like her father, enlisted in the Air National Guard at the age of 17.

“I was a health service technician, aka a field medic. We trained to take care of casualties either in the field or in a hospital setting,” said Oehlert.

Though most of her service was here in the United States, she was deployed overseas several times. She was sent to Saudi Arabia twice, but luckily never encountered combat.

A separate deployment to Landstuhl, Germany left one of the biggest impressions on her.

“Landstuhl was the first echelon of care that one would receive after being injured in the field,” she said. “I was working on the orthopedic floor during the time the Battle of Fallujah was happening. We were always full. The majority of the injuries were from IED (Improvised Explosive Device) blasts. We saw everything from amputations to broken appendages.”

While taking care of their physical wounds was her main objective, Oehlert also spent a lot of time talking to the service members who found themselves in Landstuhl. She said many didn’t know how to process what they had been through, so she would often sit with them and listen to their stories.

“It just kind of became natural because I’m the kind of person who always asking ‘how’s it going?’ and you could just see that some of them needed to talk about their experiences. It was part of the healing process and a way to make sure they weren’t closing themselves off,” Oehlert explained.

Another life-changing experience came when she was called on to help unload the body of a fallen service member from a rotator.

“I’ll never forget the first body I took off a plane. They’re still bloody and dirty from the battlefield. You’ll never forget those men,” she said in a somber tone. “You always have respect for putting on uniform, but you have even more respect when you see what the individuals down range have been through.”

After 26 years of service, Chief Master Sgt. Oehlert retired last year. She says she still struggles with considering herself a veteran, but is starting to grow into the role. In fact, she is one of the founding members of Cook Children’s newly formed Veterans Group, which aims to increase awareness and recognition for veteran and military families within Cook Children’s.

“I think it’s going to help not only our own employees realize how many military members are at Cook Children’s, but our patient families who may not even know how many of us are helping to take care of their children,” she said.

Why did the cookie go to the doctor? He felt a little crummy.

Why is diarrhea inherited? It runs in the jeans.

When it comes to jokes, Eric Hopkins’, M.D., has got a million of ‘em. As his patients in his Grapevine office can tell you. He is always prepared with a joke as he walks into a patient’s room. So, it only makes sense that we celebrate “World Smile Day” with one of our funniest doctors.

“The kids love it. I’ll walk in the room and the kids, sometimes the parents too, will say, ‘Time for the joke of the day.’” Dr. Hopkins said. “We all enjoy laughter. It makes you happy and makes you feel better.”

There’s a method to Dr. Hopkins’ particular brand of comedy. Kids go to the doctor and they are nervous. He hopes to ease a children’s mind and stress level when they go see him. Then next time that mom and dad say it’s time to go to the doctor, they may actually look forward to it. At least, more than if they weren’t guaranteed a joke or two.

Of course, every good comedian knows how to read the room and Dr. Hopkins is no exception. If the situation is serious, he’s not going to walk into the room and begin cracking wise.

He also knows when to quit. If a too-cool-for-school teen doesn’t laugh, Dr. Hopkins will move on. Ok, he may give it a second or third chance to make the teen at least crack a smile. And he’s not opposed to acting out the joke or using funny accents. Whatever it takes. But then, he moves on.

However, there have been times where a situation that seemed grim was made light. He recently met with a kid who was going through a rough time emotionally. By the end of the session, she was laughing and giving Dr. Hopkins a hug of thanks.

Dr. Hopkins gets his jokes from a stack of joke books and now from parents and kids telling him their jokes. He said recently a child told him he’d been coming to see him too long because he knew the punchlines.

“I’ve always loved jokes,” Dr. Hopkins said. “I think laughter inspires you. You feed off it. It might change a child’s mind who otherwise wouldn’t want to go to the doctor. It opens the door for those children and they may even be a happy to come. Laughter offers a balance in a place where we may see a lot of illness and at times even sadness.”

And that’s no joke.

But this is:

What kind of illness do martial artists get? Kung Flu!!

Read the full story here.

An average of 132 tornadoes occur in Texas each year.  

At some point, probably in the near future, one of those tornadoes will be in our area. Then what?

First of all, have a plan in place.

Sometimes, it’s just as important to know what you shouldn’t do. Kaysey Pollan, Environmental Safety and Emergency Management officer at Cook Children’s, offers these five things you should never do during a tornado:

1. Be unsure of your safeplace. Whether if it’s at your home or your office, know where you are going to go during severe weather. If you don’t have access to underground shelter, move to the interior room or hallway on the lowest floor and get under a sturdy piece of furniture. If you live in a mobile home, get out and find secure shelter.
2. Turn off your TV or radio. You hear it all the time. People calling in complaining to TV stations because their favorite program was interrupted for the weather. Don’t be that person. Pay attention to the weather forecast.
3. Depend on your fast car. Sorry, you can’t, or shouldn’t want to, outrun a tornado. Find shelter. If you can’t find shelter, get out of the car and find the most low-lying area (ditch, ravine, etc.). Lay flat your stomach and cover your head with your hands.
4. Open the windows. It’s been proven that this serves no benefit whatsoever. All an open window does is allow more wreckage to enter your home. During a severe storm, stay away from windows and keep them closed.
5. Drive underneath an overpass The National Weather Service Forecast Office says, “Seeking shelter under an overpass is more dangerous than standing in an open field while a tornado is approaching." When a tornado passes over an overpass, the wind is funneled under the bridge. In turn, this actually increases its velocity.”

Learn more from the source material for this article at the following sites:

• ready.gov
• knowhat2do.com
• accuweather.com/

Marc Keralla knew he didn’t have much time left to prepare before taking a shot at his goal. An avid cyclist for 25 years, he’d soon be on his way to St. George, Utah to compete in the Huntsman World Senior Games.

At least that was his plan, anyway.

On Aug. 29, 2016, the Dallas business executive wasn’t feeling his best, but he still made time for a workout at a cycling studio in Richardson. Then it happened.

Carey Cribbs,M.D., an emergency room physician at Cook Children’s Medical Center, had just finished the same workout. Preparing for an Ironman triathlon, she was about to leave the studio for a run when she heard someone yelling.

“I heard ‘Dr. Cribbs, I need you!’” she said. “When I walked out of the locker room, I saw him on the ground.”

Dr. Cribbs says the coach, Richard Wharton, was already on the phone with 911. They knew first responders were on the way, but needed to start CPR immediately.

“I didn’t feel a pulse so I asked Richard if he’d rather do chest compressions or rescue breathing. He said chest compressions, which was good because I’m only 5 feet tall.”

For several minutes, they worked together to keep Marc’s lungs moving and blood pumping until the Richardson Fire Department arrived.

“When the firemen walked in, it was like ‘the cavalry is here!’” said Dr. Cribbs.

The entire ordeal lasted less than 10 minutes, but Dr. Cribbs says it was a totally humbling experience.

“I’ve been an emergency room physician at Cook Children’s for 28 years, but I have never performed CPR out of the hospital before,” said Dr. Cribbs. “It really makes you appreciate our first responders and the things they do to save lives. I’m used to having everything in perfect order and they’re doing this on kitchen floors and parking lots.”

After a shock from a defibrillator, first responders were able to regain Marc’s pulse. He was rushed to the hospital and underwent a quadruple bypass four days later. He says he’s thankful for Dr. Cribbs, his coach and the first responders.

“I later found out that scar tissue from a stent I had put in led to a blockage. I was a ticking time bomb,” said Marc. “It could have happened anywhere. Thank God it happened where it did.”

Marc has since made a full recovery and is back to cycling. In fact, he’s racing in the Dallas Senior Games next week.

On Feb. 10, he was able to share his story with the audience at an award ceremony honoring Dr. Cribbs and Richard Wharton. The Richardson Fire Department gave the two civilian awards for their quick, life-saving action.

Dr. Cribbs says she’d advise everyone to learn CPR.

“It does work. It saves lives and you never know whose life might be next.”

As for Marc, he says it has been a slow process to get his fitness back to the level it was, but he’s still hoping to win the race in Utah one day.

He also hopes he can help others prevent what happened to him.

“Listen to your body. If something is not right, see your doctor.”

Much like Bowdy and Brock Shoff, Dr. Olvera's twin boys found themselves in a gut-wrenching situation after they were put down for a nap. They were 3 years old at the time and decided climbing on the tall dresser in their room would be more fun than sleeping.

"I had also laid down for a nap and heard a loud noise," said Dr. Olvera, pediatrician at Cook Children's Southwest Primary Care location. "When I ran in their room, one of the boys was trapped underneath the dresser."

She rushed the boys to her pediatrician's office, and luckily both were OK.

When she saw the story about the Utah incident on Checkup Newsroom, she posted the following message on Facebook:

Dr. Olvera's boys are 12 years old now, and the big brothers to twin sisters.    

Since 2009, Cook Children's has seen 137 furniture-related injuries. One child even died in 2014 as a result of furniture tip-over.

About the Source
Rebecca Olvera, M.D. is a pediatrician at Cook Children's Primary Care Location in Southwest Fort Worth. She has been recognized as a Mom-Approved Doctor by DFW/North Texas Child magazine in 2012, 2013, and 2014. Find out more about Dr. Olvera here.  

Obesity? That's one.

Car accidents? That's a big risk too.

But would you guess the number one issue is asthma?

In Tarrant County, 19.5 percent of children suffer from asthma, according to data gathered in a survey sent to parents by The Center for Children's Health led by Cook Children's. The Community-wide Children's Health Assessment and Planning Survey (CCHAPS) was completed by more than 8,600 parents in Tarrant, Denton, Hood, Wise, Parker and Johnson counties.

"We questioned parents on everything from how often their child is buckled in properly to how many grocery stores in their neighborhood sell fresh fruits and vegetables," said Larry Tubb, senior vice president of the Center for Children’s Health. "The information we are gathering is extremely valuable when it comes to measuring the overall health of children in our region."

Overwhelmingly, parents in Tarrant County (and all of the surveyed counties) reported their children are dealing with asthma. In fact, children in this area ages 6-9 are three times more likely to have asthma than children living in other parts of Texas. While we don't know why the numbers are so high, we do know people with asthma have varying triggers, and what affects one person will not necessarily affect another. Those triggers include, but are not limited to, cigarette smoke, indoor and outdoor mold, pet dander, air pollution, dust mites, cockroaches, pollen, smoke and strong odors.

The second biggest health issue on parents minds is obesity, with 17.8 percent reporting concerns about their child's weight, activity level and access to healthy foods.

Accidental injuries rings in third. In Tarrant County, 11.9 percent of parents reported their children had been injured and required medical care. Those injuries range from car and ATV-related incidents to drowning, bicycle falls and crashes.

The fourth issue on the list is a lack of dental care for children. Parents reported 9.7 percent of children either didn't see a dentist regularly, didn't brush their teeth enough or some even reported their child didn't have their own toothbrush.

Finally, mental illness is the fifth biggest issue concerning parents in Tarrant County. Behavioral and emotional development is on the minds of 8.5 percent of respondents. Many reported their children have suffered sleep problems, self-esteem issues or have tried to harm themselves.

The survey used to gather this data is part of a Cook Children's initiative to improve the health and well-being of every child in our six-county region by 2020. This initiative launched in 2009 with the very first survey of its kind sent to parents. Since then, the surveys have been sent out every three years.

"The information provided by parents in our community is available on-line and being used by a host of organizations, including Cook Children’s, to build programs and services. There isn’t one perfect answer, but, together we are making solid progress in improving the health of the children in our community by putting the child and family at the center of our planning," said Tubb.

About The Center for Children's Health

The Center for Children's Health, led by Cook Children's, is home to the Community-wide Children's Health Assessment & Planning Survey (CCHAPS), Community Health Outreach and Community Health Research. The center's goal is to create aligned collaborations that will allow us to make our North Texas region one of the healthiest places to raise a child.

Cheerleading has changed in the past 30 years from yells and claps to routines with high level gymnastic tumbling runs and stunts. It has also become a year-round sport with summer camps and cheerleading competitions. This has increased the number of injuries, especially in females. Most common injuries are fractures, strains, sprains, and concussions. Due to this change in the demands of cheerleading, it is important for coaches and cheerleaders to understand proper techniques during stunts and tumbling, strengthening, leg and arm alignment, core activation and different risks related to floor surface and practice time.

Cheerleading has not historically been recognized as a sport, at many levels. This means cheer may not be under the control of an athletic department.  Cheerleading does not have to follow certain rules and regulations that other sports monitor and improve for  safety. Therefore, increasing safety awareness is key for protecting cheerleaders.

Loading, body mechanics and alignment

The way in which a cheerleader lands when tumbling is also very important in preventing injuries. Soft landings are the way to go. A soft landing is best with knees slightly bent and weight more on the toes rather than heels. Do not allow the knees to go in or forward over the toes; instead, keep toes and knees pointing forward with upright chest and tightened core. Tumbling and stunting on a softer surface is always preferred rather than a hard or wet surface.

Injuries have been related to improper loading due to decreased strength, body awareness and lack of proper alignment with body mechanics.  Loading refers to the pressure or weight a cheerleader has through their arms, legs, and spine while holding a stunt and landing a tumbling pass.

Cheerleaders need  to be aware of their body mechanics. Body mechanics is proper body movements to prevent or correct posture problems, reduce stress on the body, and enhance physical capabilities.   Strengthening cheerleaders’ cores, legs and arms will improve body mechanics and decrease injuries.

Here are some proper basing and spotting techniques from the bottom up, to address proper alignment for good loading and body mechanics: 

• Keep feet shoulder width apart with toes forward or slightly out; heels on the ground.
• Knees should never go forward past the toes or inward.
• Hips should stay over feet with equal weight.
• Trunk stays upright- do not bend or arch the back/spine when spotting a stunt.  
• Arms directly above shoulders; not behind your head when spotting a stunt.

Cheerleaders can be strong too

As cheerleading has become more about stunts and tumbling, it requires strength, balance and stability.  Coaches should be focused on strength-building conditioning, which includes core stability and proper lifting techniques. It is also beneficial for coaches to attend safety certification classes, such as those offered by the American Association of Cheerleading Coaches and Administrators (AACCA). Prior to any cheerleading event, a proper warm up with aerobic activity and dynamic stretching is necessary to prevent injuries. Stretching after cheerleading is just as important to decrease injuries. The longer the practice, the higher the risk for injury is. Most injuries happen between 61 and 90 minutes of practice.

Increasing awareness of concussions 

Cheerleaders are at high risk for sustaining concussions, which is a head injury/trauma to the head when hit.  Cheerleaders sustain concussions with a fall from high heights, being hit in the head when basing, or landing on their head during tumbling.  It is important to stop cheerleading if there is a possibility of a concussion. Signs to watch for include: headaches, dizziness, visual blurriness/double vision, memory issues, decreased coordination and balance problems. If these symptoms are present, the cheerleader should seek medical attention immediately.

Most concussions heal in about a month, however if cheerleaders continue to have the symptoms, they may need active rehabilitation. It is never good to return to cheerleading too early; it may make their full recovery longer.  If a cheerleader has any signs or symptoms of a concussion, they should not be allowed to return to cheerleading until cleared by a physician.  Cheerleaders are 3-6 times more likely to have a second impact concussion after having their first concussion;  the second impact concussion can have more severe complications.

American Academy of Pediatrics recommendations for preventing injuries:                                              

• Cheerleading should be designated as a sport in all states, allowing for benefits such as qualified coaches, better access to medical care and injury surveillance.
• All cheerleaders should have a pre-season physical, and access to qualified strength and conditioning coaches.
• Cheerleaders should be trained in all spotting techniques and only attempt stunts after demonstrating appropriate skill progression. 
• Pyramid and partner stunts should be performed only on a spring/foam floor or grass/turf. Never perform stunts on a hard, wet or uneven surface. Pyramids should not be more than 2 people high.
• Coaches, parents and athletes should have access to a written emergency plan.
• Any cheerleader suspected of having a head injury should be removed from event and not allowed to return until cleared by a health care professional.

Related links

• The Cook Children's SPORTS program
• Cheerleading Injury Prevention
• Top 10 questions parents have about sports injuries

“Prom, graduation and end-of-the-school-year parties are exciting times for teens,” said Lisa Elliott, Ph.D., licensed psychologist and clinic manager with Cook Children’s Denton Behavioral Health. “Parents have a right to know their teen’s plans and to find out whether alcohol or drugs will play a part.”

Having discussions with your teen about drinking and sex can be difficult, so don’t wait until he or she is slipping into formal wear. Let your son or daughter know that safety and trust are very important to you and you want him or her to make smart decisions.

“As teens firm up their prom plans, parents should get a detailed itinerary of exactly where they’ll be throughout the night and get any emergency numbers they might need,” Elliott said. “This includes the numbers for adults in charge of after parties or post-prom activities. Parents and teens need to be informed, and the more informed you are, the better! Teens can create safe, happy, lasting memories just by opening up the dialogue and making smart plans."

Elliott suggests the following checklist to make sure your teen’s prom is memorable for all the right reasons:

1. Get those digits. This includes the numbers of a friend’s house or the after party at a local venue. Make sure you have any contact numbers and addresses you might need. Make sure the cell is charged up for the night.
2. Know the code. Let your teen know to call you at any time, especially if he or she is in an uncomfortable situation. Decide on a code word or phrase ahead of time so your teen won’t be embarrassed if he or she needs to call.
3. Offer street-smart tips. This could be the first “adult-like” event your teen attends without your presence. Talk about things that can happen – from getting a wallet or cell phone stolen to having a drug slipped in his or her drink – and discuss what to do if the teen makes a bad choice to drink or experiences a problem.
4. Play the name game. Know who your teen will be with. If your teen has a date, call his or her parents and talk about your children’s plans for the night so you will all be on the same page.
5. Take driving out of the equation. Many teens may want to drive themselves to the prom, but hiring a limo can be a great way to keep your teen from getting behind the wheel and make the prom more memorable. If your teen is going in a group, ask the other parents if they would be interested in splitting the cost. If your teen does drive, remind him or her to wear a seatbelt and to not get in a car with anyone who has been drinking.

The flu season is upon us once again ... what do you need to know as a parent?

1.What are symptoms of the flu?

The flu may start like the common cold with symptoms of cough, congestion and runny nose, but may also be associated with prolonged fever, muscle and body aches and fatigue. It is spread from person to person when an infected person, coughs, sneezes or talks and droplets are released into the air. It can also be spread less often from touching surfaces where drops are present. The flu virus is contagious from up to 1 day before the person presents with symptoms and up to 5-7 days after the symptoms resolve.

2. How can you protect yourself?

The best way to protect yourself is by getting the flu vaccine as soon as it becomes available. Most doctors’ offices and clinics currently do have the flu vaccine available. Last year, flu activity peaked at the end of December to the beginning of January, but you may start seeing it as early as September-October this year.

Other means to protect yourself are effective hand washing and wiping down surfaces with anti-bacterial/viral cleansers.

3. Why get the flu vaccine?

In the United States each year, more than 200,000 people are hospitalized from seasonal flu-related complications. Last year, there were more than 105 pediatric flu related deaths in the United States. On average the effectiveness of the flu vaccine last season was about 61 percent.

4. Who should get the flu vaccine?

• Everyone over the age of 6 months.
• Higher risk populations include those between the ages of 6 months to 5 years, children with asthma or other chronic disease, pregnant women, people with immune problems and adults  more than 65 years old.
• Children under the age of 8 MAY require 2 doses of the vaccine 4 weeks apart from each other depending on their previous immunization status.

5. Which flu vaccine is recommended?

There are several options for flu vaccines this year. For 2014–15, U.S.-licensed influenza vaccines will contain the same vaccine virus strains as those in the 2013–14 vaccine.

Trivalent flu vaccine protects against two influenza A viruses (an H1N1 and an H3N2) and an influenza B virus. This is only available in the injectable form.

The quadrivalent flu vaccine protects against two influenza A viruses and two influenza B viruses. The quadrivalent form is available as an injection and a nasal spray.

Specific Age Recommendations

• 6 months to 2 years: injectable flu vaccine only.
• 2 years to 8 years: nasal form is preferable according the Centers for Disease Control and Prevention (CDC). There was 50 percent more effectiveness with the nasal form vs. the injectable form in this age group. If the child is between the ages of 2 and 4 and has asthma or wheezed in the last year, then the injectable form is recommended.
• 8 years and above: either form is acceptable.

6. What happens if you get the flu?

See your health care professional as soon as possible because if it is treated with anti-viral medications in the first 48 hours, the duration as well as the severity of the illness can be decreased. The CDC does not recommend treatment of healthy individuals with anti-viral drugs, but certain high risk populations will benefit from treatment.

The Emergency Department at Cook Children’s sees eye and face injuries from projectiles (fireworks that launch or that have parts that explode off), hand and finger injuries from holding items while they explode and burns of every type, especially when children are running around barefoot.

U.S. Consumer Product Safety Commission (CPSC)’s annual death and injury report on fireworks incidents indicates that nearly half of these injuries occurred to children younger than 15 years of age. The culprits? Firecrackers, bottle rockets and sparklers – yes, sparklers.

Sparklers are considered by many to be the “safe” firework. But even an innocent looking sparkler can get as hot as the flame on some blow torches and can easily ignite clothing?

“Every firework has its dangers and there simply isn’t one that I would consider completely safe,” said Justin Smith, M.D., a pediatrician in Lewisville. “Parents would be safest to take their children to an event and watch fireworks. You will have a good time and can view from a distance.”

Remind your friends and neighbors, before they touch a flame to any fireworks, to make sure it’s legal to do so where they live.

Prevent the Tragedies

If fireworks can be used legally where you live and you do want to use them, here are a few guidelines CPSC recommends they follow:

1. Never allow young children to play with or ignite fireworks. Adults should always supervise fireworks activities.
2. Never try to re-light or pick up fireworks that fizzle and don’t go off.
3. Never point or throw fireworks at another person.
4. Keep a bucket of water or a garden hose handy in case of fire or other mishap. After fireworks fully complete their functioning, douse the spent device with plenty of water from a bucket or hose before discarding to prevent a fire.

More guidelines are at CPSC’s Fireworks Information Center. 

Evans is concerned because at Cook Children’s:

• In 2013, there were three motor vehicle crash deaths (compared to 0 in 2012).
• There has been a 10 percent increase in injuries due to unrestrained kids and a 4 percent increase in ejections.

“This is the time of the summer when a lot of families will be traveling on the road,” Evans said. “I’m very concerned about the amount of unrestrained children we are seeing. I would ask all parents to make sure their children are buckled up correctly to prevent a tragedy to their family.”

Graco car seat recall, what you need to know

To see if your model may be covered, or for additional information, call Graco at 1-877-766-7470, or visit www.gracobucklerecall.com, or email consumerservices@gracobaby.com. Sharon Evans, Trauma/Injury Prevention outreach coordinator at Cook Children’s, stresses to parents to register car seats when purchasing them so they will be notified of recalls.

We moved into a new home about three weeks ago. Amid the chaos of boxes and a not quite finished remodel job, I hear the laughter of my kids upstairs. I head up to check on them and realize they are “playing nicely.”  What is interesting is that we have had no access to TV for three weeks. Could there be a connection between my kids getting along and no TV?  What are the results of being unplugged?

The American Academy of Pediatrics recommends no TV for kids under 2 and less than 2 hours per day of media time for kids older than 2 years of age. Why? Because too much media is associated with aggression, inattention, anxiety, depression, sleep problems and obesity in our kids.

We call it TV head at my house. It is a lazy Saturday morning. The kids lounge in front of the TV for a few hours watching a movie. The next thing I know there is fighting, yelling and disagreement between my children. My son never quite recovers the rest of the day. He is a little “fuzzy headed” and a little grumpy.

Many of my patients have found harmony at home by decreasing media time. My parents have returned with true amazement at the difference in their kids once they have unplugged, especially in the evenings. They have reported healthier and happier kids. A number of my families have decided to unplug for the summer, which in all honesty, is probably the hardest time to do so, especially when it is hot outside and not much to do inside. Enter Mrs. Aubrey Conklin, one of the most fun and down to earth moms I have ever met.  I discussed the benefits of decreased media with her at the recent well-child exams for her three children. She is open minded enough to try it, and kind enough to let us join her on this journey.

Watch for Aubrey’s blogs this summer. She will be reporting in on how she and her family are doing cutting back on screen time.

One of the biggest stories centers around the suspension of Luis Suarez for biting an Italian defender.  It’s not the first time he has done it either.

I usually tell families that their kids will outgrow this problem, but I guess if you’re a world-class soccer player, that’s not always true.

What do we do when our child is the biter?

First off, this happens ALL THE TIME…

Your child is not the first child who has bitten and won’t be the last so let’s be calm.

There’s really just a few things you can and need to do in these situations …

When the bite has already happened

Separate biter and the bitten child.  This helps the “victim” feel safer and diffuses whatever frustration caused the biting in the first place.

Try to talk it out.  Often you are dealing with a pre-verbal child, but it is still important to try and talk about the situation that led up to the biting.  Usually the child who bit is just as scared as the child who was bitten.  You are typically dealing with young toddlers with limited verbal skills, but talking with them about their frustration/anger that led up to the biting can help them understand that there is a better way to express these emotions.

Preventing the Problem

The ultimate goal in helping with biting is to prevent the situation that leads to biting in the first place.  The key to this is: distraction, distraction and distraction.  Keep the frequent biters from their trigger situations or be prepared to intervene quickly before the frustration levels begin to rise.

Or, Just Bite Them Back

Of course, everyone has had a family member or someone tell them that this is the best way to get a biter to stop and while it may have worked for them in the past, I feel that this strategy is simply modeling the behavior you are trying to extinguish.  Toddlers learn best through seeing their parents’ actions and having your parent bite you only makes you think that is appropriate behavior.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his three young children, exercising, reading and writing about parenting and pediatric health issues.He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.

The mosquito was recently trapped in Benbrook, near the southwestern border of Fort Worth, and the test results were confirmed Wednesday Last year, TCPH reported its first WNV positive mosquito sample during the last week of June.

Most children with West Nile virus have only mild, flu-like symptoms that last a few days. Symptoms usually appear within three to 14 days of infection. If you expect your child has West Nile, it’s important to get the child seen by a pediatrician who can evaluate the child appropriately and if necessary refer the child to an Infectious Disease specialist or do the appropriate lab work.  

Parents can take care of themselves and their child by taking a few simple protective measures:

The majority of people (70-80%) who become infected with West Nile virus don’t develop any symptoms.

About 1 in 5 infected people will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash.  The majority of those with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months.

Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues).

• The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.
• People with certain medical conditions, such as cancer, diabetes, hypertension and kidney disease are also at greater risk for serious illness.
• Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent.
• About 10 percent of people who develop neurologic infection due to West Nile virus will die.The elderly are more likely to have complications of West Nile Virus.

Treatment:

• No vaccine or specific antiviral treatments for West Nile virus infection are available.
• Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms
• In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.

While I have had previous experience addressing academic issues with my patients, my son is now in elementary school, so I am developing a whole new perspective. I still do not understand all of the intricacies of special education, but I am lucky that I have colleagues who I can contact with questions concerning my own son, as well as my patients. 

The process is incredibly complex and confusing! Despite all of my knowledge, I also admit to sometimes feeling intimidated during school meetings. I frequently help the parents of my patients locate special education advocates because it is very easy to feel that your child's needs are not being addressed they way you would like at school.  Although maintaining a strong cooperative relationship with the whole team of professionals who work with your child is important, it is also sometimes necessary to fight more for your own child. That line, however, is not always clear, and all parents need to trust their instincts.

I considered leaving pediatrics after my son's diagnosis because I was not sure that I would be able cope with developmental disabilities at work and home. However, I soon realized that I would not ever really be able to escape my new role as a "special" mom. Instead, I made the decision to embrace the situation, which eventually led me to Cook Children's and specializing in pediatric stroke in my professional and personal life. 

Although having a child who is a stroke survivor does not make me a better neuropsychologist, it does give me more insight into the day-to-day struggles that my patients and their families face. I know that, in addition to the medical and school issues, my patients and their parents may be dealing with complex family, emotional, and financial issues that go along with having a child with special needs. If you do it right, being a parent to any child is a difficult job, and we all have moments when we look back and wish we had handled a situation differently. 

I have learned that it is extremely important for parents to take care of themselves, especially when their children have complex issues, because a child's needs are best met by a healthy parent.

Related Links

• A stroke at birth - part 1
• Stroke at birth - part 2
• Stroke at birth - part 3
• Cook Children's Stroke and Thrombosis Program

About the author

Carla Hearl Morton, Ph.D., is a pediatric neuropsychologist at Cook Children's. She is a licensed psychologist with expertise in how learning and behavior are connected to the development of a child's brain structures and systems. At Cook Children's, neuropsychologists work closely with a team of neurologists andneurosurgeons to provide the best treatments and interventions that meet the individual needs of each child.

Already in 2014, 14 cases of rabies have been seen at Cook Children’s, with 11 dog cases and three skunk exposures. In the years from 2011 to 2013, 168 cases were treated at Cook Children’s, with animals including dogs, cats, bats, rats, cows, ferrets, raccoons, deer and squirrels.

Chris Curtis, clinical coordinator for Infectious Disease at Cook Children’s, has treated her share of kids for rabies through the years. As more kids head outside for the summer, Curtis offers these seven helpful tips to protect them:

1. Rabies is a deadly disease. Spread of the disease occurs when the saliva containing the rabies virus is introduced into an opening on the skin, usually via a bit (or possibly a scratch) of a rabid animal.
2. If you have a suspected animal, whether it’s a stray or a family pet, it should be taken to the vet or animal control for a confinement of 10 days. If the person who has been exposed to the animal is immediately treated with the vaccine and the animal does not show signs of rabies, it will not have to be euthanized.
3. Bats are extremely dangerous. Not all bats have rabies, but most human cases of rabies in the U.S. are caused by bat bites.
4. If you aren’t sure you’ve been bitten, go to the doctor immediately. Bats are tiny and can leave tiny bites or scratches that humans may not even notice, until it’s too late. If you come in close contact with a bat, go to the Emergency department immediately.
5. If bitten, wash the wound with soap and water and seek medical care immediately.
6. Protect your pets and farm animals from rabies by making sure they are vaccinated. Talk to your veterinarian for more information.
7. Cook Children’s is prepared and experienced when it comes to caring for children and rabies. Cook Children’s has been very invested in making sure that the vaccinations are in stock. The caregivers are specialized in treating children, including Child Life specialists who can help the child throughout the process. Adult hospitals may not be equipped to treat pediatric rabies cases.

After my son came home, I entered the world of therapies, and I became a huge advocate for Early Childhood Intervention (ECI). Having attended over 400 therapy sessions with my son by the time he was 3 years old, I learned a lot about how to work therapeutically with young children, and I picked up a few useful strategies along the way. I also realized that kids (and parents!) can become "burned out" on therapy. Based upon my experience, I encourage parents to focus their energy on whatever activity is most beneficial for their child at that moment and keep the ultimate goal of achieving the child's functional potential in mind when deciding how to best allocate their time.

Although I focus on evaluating children in my professional life, I developed a new perspective on the usefulness and potential impact of evaluations on a parent. For instance, would an evaluation change the current treatment plan or simply confirm that a child has deficits? I also became personally aware of something I have heard from several parents: It is difficult to constantly be reminded of all the things your child cannot do and how it is nice to occasionally hear about their strengths. A large component of the ECI model is teaching parents how to incorporate therapeutic activities into everyday activities. While I believe this approach has immense benefit, it can also have some drawbacks, which I eventually saw in myself and I look for in those extremely attentive and motivated parents. I realized that I was often so focused on making sure everything I did with my son had a therapeutic purpose, I sometimes missed out on the fun of having a baby. Just as children need to have time for fun with no other purpose than having fun, even if your child has special needs, parents need to allow themselves to enjoy their child as simply their child. Children like my son will have numerous therapists and other healthcare providers throughout their lives, but I am the only mother he has, and all of the other roles are secondary.

Having a child who I knew from the beginning may not develop typically was also strangely freeing. Because my job is to track a child's development, I know that I would have fallen into the competitive trap of comparing when my son met each milestone, which was made worse by the fact that many of my friends having children at that time were also neuropsychologists. Because I began to expect delays, my son became free to develop at his own pace. While it is important to know if a child is falling behind so that interventions can be started early, a child's development should not be the contest it has become, and we should allow children some freedom to develop in their own unique way. 

My background in mental health also made it easier for me to acknowledge and process my own feelings of grief.  Although my son survived, it was essential to acknowledge the loss of the "perfect" child that everyone imagines while they are pregnant. That disappointment is a loss and important to honor because any intense emotions that are "buried" do not truly disappear forever. I also sometimes talk with the parents of my patients about their own symptoms of Post-Traumatic Stress Disorder, because experiencing your child's serious medical condition can definitely result in feelings that a parent needs to process. Because of my work, I also do not feel the isolation that many of my families experience. In my world, pediatric strokes are almost normal, and a child whose only healthcare provider is their pediatrician is "weird." I also continue to learn so much from my patients that I am able to use myself and pass along to other families.

Related Links:

• Cook Children's Stroke and Thrombosis Program
• A stroke at birth - part 1
• Stroke at birth - part 2
• Stroke at birth - part 3
• Stroke at birth - part 4

In the morning, they begin with stretching, but by the middle of the afternoon they are running with real-life Olympians or breathing their way across the United States – all from the comfort of their own classroom. GoNoodle is a new interactive resource that allows children to not only increase their physical activity, but improve their academic performance.

Thanks to a sponsorship from Cook Children’s, 60,136 kids in Tarrant County enjoyed GoNoodle this past year. GoNoodle allows children the opportunity to participate in a fun, interactive “brain breaks,” while measuring the minutes of moderate to vigorous physical activity. The brain breaks include running, dancing, stretching and calming exercises. Kids play the games that include spelling, vocabulary and math with physical activity.

“Other programs seem to focus on one or the other – activity or academics; but GoNoodle was unique because it focused on both areas,” said Larry Tubb, senior vice president of the Center for Children’s Health. “We look at bringing GoNoodle as an extension of our Promise, to help the well-being of every child. That doesn’t always mean treating them to get better in a doctor’s office. It also means helping them get better in the classroom. By bringing this physical activity to schools, we are improving the health of these kids. That helps our children and our community.”

GoNoodle brain breaks give the children activities to help keep them focused during the day. They have breaks that help them stretch, release energy or reduce stress. Some of the breaks align with core subjects such as spelling, math, vocabulary, geography, math, reading and even nutrition.

Breaks include:

Airtime. Students “breathe” their way across the United States. They pick their state and begin breathing in and out. The simulation of blowing out blows a balloon on a screen across the country, giving fun facts along the way.

Run with us. Real-life Olympians, on a screen, coach children in track and field events such as the hammer throw, 200-meter sprint and javelin.

To The Maximo. Children perform stretching activities to get their body and mind going early in the morning.

The faculty at A.V.Cato elementary have seen the benefits of GoNoodle. Michelle Miles, the school’s counselor, said she saw the breathing exercises work during the State of Texas Assessment of Academic Readiness tests. The kids did their breathing exercises to calm them before the tests and give them the chance to perform their best.

“GoNoodle has been the greatest opportunity for ADHD students because you can just tell when those students become disengaged from a lesson and are just tired and antsy and unmotivated,” Miles said. “If you can just get them up in between transitions for a few seconds at a time and give them an opportunity to either get the wiggles out or start focusing on how they are going to move forward, it tends to help them just get the energy out; and have it be OK and accepted before they move on to the next lesson. This has been ideal for some of our younger kids who have all that extra energy bottled up.”

Amber Grier, an elementary teacher at A.V. Cato, said she recently saw the benefits of GoNoodle. She had been working with her students throughout the day on mixed fractions and adding fractions. One child in particular just didn’t seem to understand the lesson. She had exhausted her efforts for the day. Then they began to play one of the GoNoodle games and was pleasantly surprised to see the child get every answer correct.

“I had a huge smile on my face because I was so relieved to know that he had learned what we were doing,” she said. “But he wasn’t able to produce the answer quickly until he got moving and stopped worrying about making me happy. He was just playing the game and he was able to get all the answers. True learning is play.”

I hope everyone had a great Father’s Day. I'm sure there were no fights between fathers and their teenage children.

Maybe, you had barbecue and ugly ties mixed with good feelings and love all around. But now back to reality.

Because of that, you can consider this a post for all the other weeks of the year when there might be more "disagreements" between fathers and teenagers. Most of you might be able to file this away under the Common Sense tab of your brain but I think it is a good reminder.

What is the best way for a teenager to resolve a fight with his/her dad?

Find someone else to support them through dealing with the conflict in a healthy way.

Jeff Cookston from San Francisco State University studied almost 400 families asking them questions about how they handled father-child conflict. He released a study in the March edition of the Journal of Research on Adolescence.  

The most common people that teenagers talked to were mothers, then friends and occasionally a stepfather or father (if conflict is with stepdad).

The study compared two positive ways the support person could discuss the problem with the teenager: giving an explanation for dad's behavior and assigning responsibility for the conflict.

So, to make the adolescent happy, just take his or her side and assign all the blame to the father, right? Actually, you may be surprised to learn that’s not true.

In fact, a real discussion about the reasons for dad's opinion and a fair assessment of the responsibility of the conflict left children feeling better about themselves and their fathers in the long run.

So, how does this play out in a real life situation?

Conflict #1:

"But, dad, I really want to go to this party and it won't even get started going strong until 11!"

"Sorry, it's just not going to happen this week."

Bad support:

"That's just how your dad is, he's always been overprotective."

Good support:

"I'm sure your dad is just concerned about you being safe and remember what happened the last time you went to a party and came home hours after your curfew."

Conflict #2:

“But, dad you can’t take away my Xbox!”

Bad support: 

“He’s just being dumb.  You can always play after he goes to bed.  I’ll try to convince him to give it back.”

Good support:

“I think he’s concerned because we’ve noticed that your grades have been dropping and you are having a hard time getting out of bed in the morning.  Maybe if you show him that you can show more responsibility, we can talk about getting it back.”

Give the father in your life the best gift you can give them this year, support your teenager in a way that helps them feel better about themselves and their Dad. (The ugly ties can wait until next year.)

Avery’s due date was supposed to be June 20 but because of my high blood pressure, we knew that I would be induced before my due date. So I knew I would have this year’s Father’s Day gift covered; I would have just given birth to a beautiful baby girl making for the best present ever! Well, obviously things didn’t go as planned and Shawn’s Father’s Day gift came three and a half months early.

Since Father’s Day is this Sunday, this blog is dedicated to all the NICU dads out there. I want you to know how important you are. I’ve seen how everyone is always focused on mom and baby, especially if it was mom's health condition that caused the early delivery but dad often gets neglected. Well, I can honestly say that Shawn is the reason people think that I’m handling this situation so well. Of course, every relationship dynamic is different, but for us, Shawn is the glue that holds our family together. 

He has truly embraced his new role as Avery’s daddy and shown so much strength throughout this whole experience. He stays positive even in our darkest days and truly is my rock. He can always find something to be positive about, no matter what is going on with Avery at the moment.

Once Avery was brought into this world, Shawn walked with the Cook Children’s transport team across the bridge from Harris downtown to the Cook Children’s NICU with Avery in her isolette and has never looked back. For the first few days of Avery’s life while I was stuck in the hospital, Shawn was the one over in the NICU all the time, meeting her doctors and nurses for the first time, learning the terminology and about what battles Avery would face. He would send me pictures of Avery when he was over there and then come back to my hospital room and give me reports. Never once did he seem scared or intimidated. Never once did it seem like it was too much.

Now that we’ve been in the NICU for a few months, Shawn has really gotten comfortable with Avery and all of her equipment. Some people would be overwhelmed by a baby hooked up to so many different machines but I can tell that when he looks at her, all he sees is his beautiful daughter. In fact, he’s so comfortable that he’s learned how to operate some of the equipment and is always willing to give the nurses a hand. As a joke, I’ve started to call him Nurse Wooley.

In talking to several of my friends who are dads, they’ve talked about feeling somewhat helpless in the first few days and weeks of their child’s life. The most important thing that a baby needs, besides sleep, is something they are unable to give them, milk. As a mom in the NICU, I know that helpless feeling all too well but dads, you should never underestimate the role that you play. The moral support that you provide to your wife and child is priceless. Shawn may not be able to provide Avery with the food she needs right now but he stays up late sometimes with me to pump and always encourages me even when I’d rather hit snooze on the alarm than get out of bed for yet another pumping session.

So, to all the NICU fathers, please don’t feel helpless. You are helping more than you know. Keep pushing the wheelchair because your wife isn’t well enough yet to walk to the NICU; offer to wash her pump parts so she can get an extra 10 minutes of sleep, proudly deliver her milk to the milk bank and most important of all, know that just by being there, you are helping.

To Shawn, happy first Father's Day. You are the best father Avery could have ever asked for. I am in awe of the strength you have shown.

Avery update:

We are off the ventilator! In true Avery fashion, Avery pulled her own tube out on the morning the doctor was already planning to take it out. She definitely does things on her terms! She is 5 pounds, 8 ounces and doing great on continuous positive airway pressure (CPAP). Our doctor is hoping to have her off CPAP in the next couple weeks. After that, there are a couple more steps to breathing on her own. We are able to hold her so much easier now. Grandparents are taking turns holding her and she's getting used to sitting in our bouncy seat. She loves being out of her bed and is definitely a very social baby. She is in clothes and already very fashionable! She gets many visits throughout the day from the nursing staff so they can see what she's wearing. We are getting that much closer to be able to take our sweet girl home!

Related links:

• Avery's story - part 1
• Avery's story - part 2
• Avery's story - part 3

I don’t have to look at a watch to know when it’s time for lunch. At around 11:30 a.m. my stomach starts to grumble. I’m ready to eat.

My gut kicked in once again on a Tuesday when my phone rang at 11 in the morning. It was my son’s school. Trouble.

The school nurse, who I have become all too familiar with, was on the line. She told me “Mr. Jack” had bumped heads with another little boy during a game of tag. Jack bled a bit from his mouth, his gums were swollen and his left front tooth was loose. He wants everyone to know that he didn’t cry.

Overall, he was OK, but now my kindergartner needed to go to the dentist to get checked out. Only one problem – I didn’t know the name of his dentist, what her practice was called or the phone number to reach her. I guess technically, that’s three problems, but you get the idea.

My wife flew to Washington D.C. over the weekend for work. She makes this annual trip and during that time I realize how helpless and hopeless I am. As a product of a single mother, I also tend to make more calls to my mom than normal just to say thanks.

As I write this, my wife’s on her way home, but here’s a quick overview of how the two men in her life fared while she was away:

Saturday – I totally caved and bought Jack unnecessary toys that I would have said no to if I had my wife there to back me up. Honestly, I didn’t want to hear him complain. Wimp. Not him. Me.

Sunday – We had cereal for breakfast, a few chicken nuggets from the golden arches for lunch and a flag football game that afternoon. Then that evening, Jack totally ratted me out to his grandparents at a dinner they made for the two bachelors. “I’m starving,” he said. When asked why, he told my wife’s parents how little he had eaten that day.

Monday – We had cereal for breakfast and dinner. That evening, we went out for Jack to work on his bike riding skills. There’s a challenging hill near our house that he’s had trouble conquering. With his helmet safely on, he asked if I would catch him if he fell. I told him I would do my best. He aced the hill. I strategically cut down sidewalk to be there for him as he rounded the corner. The only problem was that he didn’t round the corner. His momentum took him off the path and face first into the grass. As he lay motionless, I hate to admit this, but my first thought was, “His mom is going to kill me!” Jack was OK. Thank you God. He hurt his nose and his knee was scraped up a bit. He cried (don’t tell him I told you), but he was Ok overall. At least physically. That night he had a nightmare that I’m pretty sure was because of the fall and probably new found trust issues with his father.

Tuesday – We’ve covered it. But one thing I really do want to point out in all seriousness, dads know your emergency contact numbers and know the numbers of everyone you may need to call just in case.

Wednesday – Mommy’s coming home! My son can’t wait. He told me this morning that he was going to give her a big hug as soon as he saw her. Me too. 

By now you’ve heard about trans fats so much, you may start to tune out how dangerous they can be for your child. We hear these buzz words all the time and it’s hard to tell any more what is and isn’t a serious threat.

How bad are trans fats for you? Toward the end of last year, the U.S. Food and Drug Administration (FDA) made the decision that hydrogenated oils may no longer be generally recognized as safe. That means if a final determination is made (which should be any time now), food manufacturers could no longer sell food products with trans fats or use them as an ingredient without prior FDA approval.

Here are four things you should know about trans fats to help you the next time you’re out shopping or ordering at a restaurant:

1. What are trans fats?

Trans fats are one of the “bad fats.” Some do occur naturally in foods, but most are created by adding hydrogen molecules to liquid vegetable oils. You’ll see them on food labels as “partially hydrogenated oils” or “hydrogenated oils.”

2. Where are they found?

Companies use trans fats because they’re inexpensive, last longer than other fats (increased shelf life), and give foods a good taste and texture. Trans fats are most often found in processed foods or fast foods.  Examples of trans fats are fried foods, baked goods, shortening and margarines, canned frosting and baking mixes. 

3. Why are they so bad?

Trans fats increase your LDL (“bad”) cholesterol and decrease your HDL (“good”) cholesterol.  They can increase your risk for heart disease and stroke, and there’s an association between trans fat consumption and higher risk for Type 2 diabetes mellitus.

4. What should we do?

• Look for trans fats on nutrition facts labels and look for partially hydrogenated oils in the ingredients list. Try to avoid trans fat (0g and no partially hydrogenated oils).
• Cook and eat at home as much as possible.
• Limit processed foods, especially at snack time. Reach for fruit, almonds or a light string cheese instead of chips or processed snacks.
• If eating out, choose baked or grilled proteins and watch “extras” like breads and sauces that may contain trans fat.

Trans fats are dangerous, but the good news is you can protect your kids from them. Start today by reading nutrition facts labels, ingredient lists, and eating at home as often as possible.

For many families, the summer means boating and swimming season. But it can also mean danger, as one of the worst drowning weekends of the year. Please take these extra precautions for a safe, fun holiday.

1. Don’t drink and drive. This takes on dual meaning, both on the road and in the water. According to the Texas Parks & Wildlife website, open containers on boats are legal, but operators of boats are subject to boating while intoxicated laws, the same as driving a vehicle. “Operators or passengers may also be subject to public intoxication laws. Drinking and boating is DANGEROUS and the cause of most boating fatalities,” the site said.

2. You also need a license. You need to know how to operate your boat, just like a car. The course is $20. In Texas a person cannot operate a windblown vessel over 14 feet in length, a motorboat with more than 15 horsepower, or personal watercraft unless he/she:

• Was born on or after September 1, 1993 and has passed a boater education class or equivalency examination prescribed by the department.
• Is 18 years of age and can lawfully operate the motorboat and is on board the motor boat when underway.
• Is at least 13 years of age and have successfully completed a boater education course approved by the Department.

3. Kids don’t get on a personal watercraft without an adult. Children under 13 are specifically prohibited from operating a PWC unless accompanied on board by a person at least 18 years of age.

4. Life jackets are an absolute must!! Everyone on any watercraft at the lake should be outfitted with a jacket. When selecting a life jacket, size matters. Learn more from the Texas Parks & Wildlife site.

5. Teach your kids to swim. Drowning is the leading cause of unintentional injury-related death in children ages 1 to 4 years old and the second leading cause of unintentional injury-related death for ages 1 to 14. Whether if it’s in a lake or a pool, your child needs to know how to swim. Learn more today or start them on swim lessons this weekend.

Oosthuizen said he was closing the bathroom door Tuesday morning at the place his family is staying for this week's Crowne Plaza Invitational at Colonial. Sophia was on the other side.

"Her finger was on the side of the hinges," Oosthuizen said. "It nearly cut off the finger completely."

Oosthuizen rushed his daughter to the emergency room at Cook Children's, which is located in Fort Worth and is the primary charity for the Crowne Plaza Invitational.

At the hospital, they met with Dr. Pamela Sherman, an orthopedic surgeon and hand specialist. She explained that it was important to repair the nail bed on Sophia's finger and give the new nail a chance to grow in order to save the finger. Dr. Sherman then performed the surgery.

"It was a scary moment," Oosthuizen said. "It was Sophia's first time under anesthesia. You never know what's going to happen.

"Dr. Sherman was great. ... She told us it's important to have the proper people doing it, and they have some of the best there."

Sophia will go to Cook Children's on Sunday for a check-up before the Oosthuizens return home.

Louis Oosthuizen is grateful for the attention his daughter received at Cook Children's.

"If I'm in doubt ever to have any surgery or something for my kids, I'll fly in to see them," Oosthuizen said. "The way they handled it, the way they spoke to us and treated the kids -- it was amazing to us.

"I didn't even know there were hospitals like that."

Safe Kids reports heatstroke deaths have occurred in 11 different months of the year and in nearly all 50 states.

Parents may mistakenly think they can safely leave a child in a vehicle for a “quick” errand, but that's not the case. Temperatures inside the car can be 20 or more degrees hotter than the temperature outside, rising to dangerous levels in minutes. So a nice 70 degrees outside can warm up to the 90s in minutes inside the car. It only takes a few minutes for tragedy to occur.

Heat is much more dangerous to children than it is to adults. When left in a hot vehicle, a young child’s core body temperature may increase 3 to 5 times faster than that of an adult. This could cause permanent injury or death.

Unfortunately, this is an all too common occurrence. Since 1998, at least 605 children across the United States have died from heatstroke when unattended in a vehicle. In Texas, 32 deaths have occurred since 2010, including five last year.

“We still have to get the word out that there’s never a safe time to leave your child in the car,” said Sharon Evans, Trauma/Injury Prevention coordinator at Cook Children’s, said. “We’ve seen children die in February. We hope people will take extra precaution in never leaving a child in the car.”

Safe Kids Worldwide says that heatstroke is the leading cause of non-crash, vehicle related deaths for children and that young children are particularly at risk as their bodies heat up three to five times faster than an adults’.

“It’s difficult to think that we could forget our children, but it happens every year to people from all walks of life, regardless of their socioeconomic or education levels,” Evans said. “Often times, a change in routine, a distraction along the way, or a child falls quietly asleep, unseen, in the back seat, allows for a parent/caregiver to forget and leave a child in the car.”

According to news reports, a 1-year-old girl  in North Richland Hills, Texas,  may have died after being left in a car for too long .The high at Dallas/Fort Worth Airport on April 22 was 84.

Here are some important tips to help prevent unintentional injury to your child:

• Dial 911 if you see an unattended child in a car.
• Never leave your child alone in a vehicle, even for 1 minute, at any time. Even on cool days.
• Set safe habits: leave a cell phone, purse, briefcase, etc. in the back seat before driving, forcing you to always check the back seat and see a child is/is not back there.
• Program your cell phone and/or computer to remind you to drop off your child each day.
• Have a plan with your daycare provider to contact you within a few minutes of being late or absent, even if it’s only one day.
• Teach children not to play in any vehicle.
• Lock all car doors, even at home.
• If a child goes missing, always check the cars and trunks first.

Stop screaming in the car!

That's enough!

Just stop!

I'm the “out-of-home” worker in our family, while my wife is able to do her job mainly from the house. Therefore, I usually have:

1. brief periods of time alone with the 3 kids.
2. time at home when the duties are shared between my wife and me.

Because of Mother's Day Weekend, I got to spend more time alone with the 3 littles this weekend (all under 5).

As the weekend wore on, there were more moments of frustration.  I'd like to think they were just particularly crazy this weekend but I'm sure that would just be lying to myself and trying to justify my frustration.

Finally, on the way to get some tortillas for dinner Sunday night, after repeated attempts to get my kids in the car, listening to them scream at each other and seeing my 3 year old more or less punch my 5 year old in the face....

"Stop screaming in the car!

That's enough!

Just stop!"

I didn't REALLY yell at them. They weren't physically threatened. But, there were three pair of scared eyes looking back at me in the rear-view mirror.

Fortunately, a week before, I'd listened to Michael Hyatt's Podcast: 4 Difficult Sentences for Leaders.

In it, he outlines a four-sentence method for apologizing:

Sentence #1: I am sorry.

Sentence #2: I know that hurt.

Sentence #3: I was wrong.

Sentence #4: Will you please forgive me?

He also reminds us to avoid using terms like if and but...

So, I had the 5 minute drive home to think about it. The kids were quiet by now. They had either forgotten about it, they were too terrified to speak or Thomas the Tank Engine^™ just got much more interesting.

But when we got home, here's how it went:

"Guys, I'm sorry I yelled at you. I know that was scary. I should not have done that. Will you please forgive me?"

Some tips:

1. Apologize specifically for what you did, recognize how they felt, apologize again and ask forgiveness.
2. Don't use ifs or buts.  It was very tempting to say, "I'm sorry I yelled at you guys, but you should have come quicker and you shouldn't have been screaming and you shouldn't..."  But, then I'm not truly acknowledging the fact that I shouldn't have raised my voice.

There has been talk in the media and blogging world lately about how forcing your kids to apologize doesn’t actually teach them to apologize. I’ve seen this to be true in my family, they barely get the “I’m sorry” out before they are running off to do something else and very likely to come back and do the same thing two minutes later.

However, there are many reasons to apologize to your kids. First, modeling that one should apologize when they are wrong is a better method of teaching your children the power of apology. Another benefit is what it does for you. After apologizing, I was back in the right frame of mind to go back inside and parent more positively and with more patience rather than continuing to be angry and letting my kids suffer the ongoing consequences. It sure didn’t hurt that I heard this in return:  

5 yo: Of course, we forgive you.

3 yo: Yeah, we wuv you dad.

Almost 2 yo: Go, go; pway, pway; hungy!!

Well, 2 out of 3 isn't so bad.