When it comes to accessing pediatric specialty care, the more appointment options, the better- especially for busy families caring for a child with complex medical needs. Beginning May 4, families living in the Plano area have another close-to-home location for connecting with Cook Children’s Health Care System and its vast network of pediatric specialty physicians.

Conveniently located just off the Sam Rayburn Tollway between Plano, Frisco, Allen and McKinney brimming with young families, Cook Children’s new multispecialty clinic gives patients increased access to pediatric physicians specializing in neurology, endocrinology, pediatric surgery, pulmonology, gastroenterology, nephrology, urology, plastic surgery and orthopedics. Cook Children’s physician specialists from the Prosper Specialty clinics will rotate through the clinic regularly, giving parents more choice and flexibility in scheduling appointments at a location most convenient to them.

“Patients requiring specialty care often need to see their specialist multiple times, and those with complex medical conditions may see multiple specialists across several departments regularly, said Teresa Baker, Cook Children’s vice president of Primary and Specialty Services. “In addition to the convenience of closer-to-home care, the new clinic increases appointment availability so busy families have more options when scheduling visits. The new location also provides additional space to add more physicians and advanced practice practitioners to meet the needs of families in the fast-growing communities of the region.”

This will be Cook Children’s seventh multispecialty clinic in the Metroplex. Others are located in Alliance, Denton, Hurst, Mansfield, Southlake and Walsh Ranch. The Plano clinic offers 10 exam rooms, including one that will flex as a procedure room, as well as an X-ray unit. While Cook Children’s physicians will rotate through the clinic, it will have full-time, on-site clinical staff, an X-ray technician and front desk personnel.

Damian Campbell, D.O., a Cook Children’s pediatric neurologist, will see patients at the new Plano clinic on Thursdays. He’ll have the ability to offer many of the same evaluations in Plano as in his primary office at Cook Children’s Pediatric Specialties Clinic in Prosper, with the exception of electroencephalograms (EEGs) and some concussion evaluations.

"We’re aiming to be available for patient families every week right from the start of this new project,” Dr. Campbell said. “We know that life gets busy, and juggling work and school can make finding time for appointments a bit tricky. Having more availability close to home is designed to help make that easier. Our goal is for this new venture to help make sure families have more access to the high-quality care and attention that Cook Children’s is known for.”

This new addition to the health system’s network is one more example of Cook Children’s keeping its Promise to the children and families in the communities it serves, says Kevin Greene, president of Cook Children’s – Prosper.

“Our Promise is to improve the health of every child in our care and our communities,” Greene said. “By opening this new specialty clinic in Plano, we are bringing that Promise to the doorsteps of the families we serve. We are no longer asking parents and caregivers to endure long commutes for specialized care. Instead, we are meeting them where they live, work, and go to school—ensuring every child has access to high-quality pediatric care and the opportunity to grow up healthy, regardless of their zip code.”

Story by Jean Yaeger. Video by Tom Riehm.

When she was an elementary school student, LaQuatre Rhodes, D.O. had a passion for science projects and a big goal: to become a doctor.

“Your experience at the pediatrician's office is one that either excites you as a kid or makes you nervous,” said Dr. Rhodes, pediatric gastroenterologist. “I would be excited because I knew I was probably going to get a little treat, and I liked all the things that were happening there.”

That same enthusiasm carries over these days in her practice at Cook Children’s Specialty Clinics in Prosper. As she treats children and teens who have GI issues - diseases and disorders of the digestive system – Dr. Rhodes provides medical expertise and an example for aspiring physicians. She often notices a special look of recognition and wonders on the faces of her Black patients when they meet her in the exam room. Feeling at ease, those patients will approach her in very close contact.

“It’s just the exposure. It’s a joy and humbling to know that seeing someone who looks like you makes you feel more comfortable,” she said. “Some of them will let me know that they want to be a doctor. Seeing me definitely helps to put that in reality for them.”

According to the Association of American Medical Colleges (AAMC), about 5% of physicians in the United States identify as Black or African American, like Dr. Rhodes. That proportion could increase as medical school demographics shift. The AAMC reports that 11.3% of students entering med school in 2021-2022 cited Black or African American race or ethnicity, up from 9.5% the previous year.

As we celebrate Black History Month in February, Cook Children’s wants to salute Dr. Rhodes and everyone who brings diverse representation and voices of advocacy to health care.

“You can be the face of change you want to see by going into a field where you’re a minority,” said Dr. Rhodes, who never encountered a Black pediatrician growing up in Shreveport, La. “Having a seat at the table and more diversity is what changes the field and allows people to see things from a different lens.”

Path to her Goal

Science was Dr. Rhodes’ favorite subject, stemming early on from her participation in science fair competitions. One of her projects measured the effects of antacids (Rolaids, Tums etc.) on indigestion; as a fourth-grader, she already showed a preference for GI topics. Dr. Rhodes took Advanced Placement courses in high school. But academics wasn’t her only love … ballet, student council and sports also kept her busy.

Dr. Rhodes gives credit to her mother for modeling the core values of perseverance and hard work. Even though her mother was 18 when Dr. Rhodes was born, she was determined to achieve higher education. She was the first in the family to graduate from college and obtain a master’s degree.

“I was raised by a single mother who always instilled in me to reach for the stars, to be bold, be brave, and dare to be different,” Dr. Rhodes said. “Everything I learned, everything that has driven me to be very independent and focused, has come from her.”

She also volunteered at a free health care clinic where she saw the need for greater access to care. Her aspiration grew even stronger when she saw several slightly older Black acquaintances from her hometown enter medical school.

She earned a bachelor’s degree in biology from Baylor University and a master’s in biology from Louisiana Tech University. A summer program allowed her to shadow physicians, go to an anatomy lab, and preview other facets of medical careers.

But the MCAT tripped her up. Dr. Rhodes took the medical college admission test three times before scoring high enough to submit an application. She cites the MCAT as her biggest hurdle. “Once I got in, I was able to soar” at Ohio University Heritage College of Osteopathic Medicine, where she earned her medical degree.

While on a clinical rotation at the Cleveland Clinic, Dr. Rhodes crossed paths with a pediatric resident named Anthony Anani, M.D. Fast forward several years, and Dr. Anani was medical director for Clinical Services at Cook Children’s Medical Center reaching out to Dr. Rhodes about job openings in Prosper. Dr. Rhodes joined Cook Children’s in August 2022 as Dr. Anani’s colleague in pediatric gastroenterology.

Helping Sick Kids Get Better

Dr. Rhodes enjoys working with adults as well as children. But she decided to focus on pediatrics because of the resilience of children.

“Children are just pure joy,” she said, “and when they're sick, you want to make them well. And when they're doing well, it's a rewarding, humbling feeling.”

Her love for the human digestive system developed in part from research on the livers of rats that were fed various diets. The structure and function of the GI tract key parts – including the esophagus, stomach, intestines, liver and pancreas – fascinate Dr. Rhodes.  As she puts it: “All roads end up leading to GI.”

Reflux and constipation are common concerns for the patients she sees. More complicated cases include inflammatory bowel disease, chronic liver disease, and unexplained vomiting/nausea and bleeding. Dr. Rhodes provides biopsies, endoscopies, colonoscopies and other services.

Finding Inspiration

Dr. Rhodes points to Dr. Rebecca Crumpler as a health care pioneer for her achievement in 1864 as the first Black female physician in the United States. Dr. Rhodes predicts the physician workforce will continue to become more diverse. Cognizant of the opportunity to influence future doctors, she makes herself available to young people seeking reassurance about medical school.

One of Dr. Rhodes’ favorite quotes embodies her philosophy of pursuing your goal even in the midst of challenges: "Every dream begins with a dreamer. Always remember, you have within you the strength, patience, and the passion to reach for the stars to change the world." – Harriet Tubman

“That quote just really inspires and motivates you to want to be great and to dream big. It gives you the inspiration that it's possible, and to embrace things that come along the way.”

Thanksgiving is only a couple of days away: turkey, casseroles, mashed potatoes and more! It’s also GERD Awareness Week to raise awareness of the complications of gastroesophageal reflex and to know the symptoms to look out for as you gather around the table. LaQuatre Rhodes, D.O, Gastroenterologist at Cook Children's Specialty Clinics in Prosper, breaks down what parents need to know or look out for when it comes to this common disorder.

What is GERD?

Gastroesophageal reflux is the passage of gastric/food contents into the esophagus with or without regurgitation or vomiting. It is defined as gastroesophageal reflux disease when reflux leads to troublesome symptoms or complications. A muscular valve is at the end of the esophagus to help prevent backflow of food/gastric contents, but when it doesn’t close well, it results in irritation of the esophagus and reflux symptoms. Symptoms of reflux vary by age.

What are the symptoms?

Infant/Toddler reflux symptoms:

•  Crying
• Fussiness
• Back arching
• Regurgitation
• Vomiting
• Dry cough
• Feeding difficulties
• Poor weight gain
• Breathing difficulties (wheezing, pneumonia, stridor, apnea)
• Recurrent ear infections

Older children reflux symptoms:

• Heartburn
• Abdominal pain
• Regurgitation
• Vomiting
• Acidic or sour taste
• Sore throat
•  Hoarseness
• Dry cough
• Difficulty swallowing
• Choking

Gastroesophageal reflux may be seen more in children with certain medical conditions including neurologic impairments, prematurity, and pulmonary problems (ex. cystic fibrosis, asthma, laryngomalacia).

What are the “red flag” symptoms?

Other conditions which can mimic reflux require further evaluation especially in the setting of red flag symptoms. Some of those conditions include infections, pyloric stenosis, brain tumor, meningitis, hydrocephalus, increased intracranial pressure, metabolic disorders, inflammatory bowel disease, obstruction, anatomical abnormalities, and decreased gut motility.

Red Flag Symptoms suggesting a disorder other than gastroesophageal reflux:

• Weight loss
• Lethargy
• Fever
• Irritable, severe crying, or inconsolable
• Seizures
• Bulging fontanelles in infants
• Increased head circumference in infants
• Small head circumference in infants
• Recurrent forceful or projectile vomiting
• Vomiting blood
• Vomiting bile
• Vomiting overnight
• Rectal bleeding
• Bloody stools
• Abdominal distention
• Breathing problems (difficulty breathing, stops breathing, turns blue, wheezing, frequent choking, recurrent pneumonia episodes)

How do you treat GERD?

Reflux can be concerning as a parent, but in the absence of “red flag symptoms” and if the child is gaining weight well, there's no need to worry. Symptoms should improve with time, lifestyle modifications, diet modifications, and/or acid suppression. If at any point your child develops worrisome or alarming symptoms please have evaluated by primary care physician, gastroenterologist if established care, or local emergency department.

If there are no red flag symptoms present, initial management of GERD is conservative:

Lifestyle modifications

• Staying upright at least 30 minutes after meals
• Burping infants during feeds
• Avoid tobacco smoke exposure
• Avoid tight diapers or elastic waistbands
• Weight loss if child overweight or obese
• Elevate head of bed 30 degrees

Diet modifications

• Thickening feeds with cereal or thickeners
• Formula change to hydrolyzed or amino acid based formula
• Avoid overfeeding
• More frequent smaller meals
• Avoid eating at least 2-3 hours before bedtime in older children
• Avoid large meals before exercise or increased activity
• Avoid acidic foods (ex. pickles, red sauces, citrus) spicy foods, carbonated drinks (ex. sodas, seltzer beverages), high fat foods, chocolate, and caffeine

Trial acid suppression for 4-8 weeks which may be extended longer based on clinical response and/or physician assessment.

• Proton Pump Inhibitors (ex. omeprazole, pantoprazole, lansoprazole, esomeprazole)
• Anti-histamine (ex. Famotadine, Cimetidine, Ranitidine, Nizatidine)

If alarming or worsening symptoms despite initial management, physician may proceed to gastroenterology referral and/or further evaluation including:

• Esophagogastroduodenoscopy (EGD)
• pH probe
• Abdominal ultrasound
• Barium studies (ex.  Upper GI series, esophagram, swallow study)
• Motility studies
• Severe reflux resulting in complications must consider surgery referral for Nissen fundoplication if not responding to medications and no other disorder cause of severe vomiting.

The family finished eating dinner when the girl told her mother, Katie Jacobsen, that she swallowed a button battery that was from a toy. They had extra honey packets on hand, which helped ease the battery through the girl’s stomach.

Button batteries and lithium coin batteries are dangerous for children if ingested. These small, shiny batteries are found in remotes, key fobs, thermometers, toys, and many other devices found in the home.

When a child swallows a button battery, the saliva triggers an electrical current. This causes a chemical reaction that can severely burn the esophagus in as little as two hours, according to Safe Kids Worldwide.

If a battery is ingested, parents should immediately call 911, and seek medical attention at the emergency room. If your child is over 12 months old, Cook Children's experts confirm that parents can offer the child honey, if available.

LaQuatre R. Rhodes, D.O., says battery ingestions are seen a couple of times per month by the Cook Children’s Gastroenterology team in Prosper.

“Ingestion of button batteries can cause severe complications including respiratory difficulty, injury to the respiratory tract, injury to esophagus, stomach, or intestines, bleeding, and even death so it’s very important to seek immediate medical attention and ultimately prevent ingestion,” Dr. Rhodes said.

She says if a mucosal injury is present, monitoring is required after removal. Repeat endoscopy and imaging are done on the patient to assess for complications. Long-term follow-up may be needed depending on the severity of the injury, Rhodes said.

From 1997 to 2010, an estimated 40,400 children 13 years and under were treated in hospital emergency departments for battery-related injuries, including confirmed or possible battery ingestions, according to the Centers for Disease Control and Prevention. Nearly three-quarters of the injuries involved children 4 years and under; 10% required hospitalization, the CDC said.

Dr. Rhodes answered more questions for us about coin battery ingestions:

What are the symptoms to look out for that might indicate that my child swallowed a button battery?

Abdominal pain, bleeding, cough, breathing difficulty, sore throat, chest pain, fever, and weight loss are symptoms to look for if a child swallowed a button battery.

What should parents do if their child swallowed a battery?

Seek medical attention: call 911 or head to the emergency room. For children over 12 months old, give Carafate or honey soon after ingestion. This may help improve injury to the esophagus and stomach, but do not delay seeking medical attention. The National Battery Ingestion Hotline is available at 800-498-8666, 24 hours a day, seven days a week.

How soon should you give honey or Carafate to your child after swallowing a button battery?

Immediately and ideally less than 12 hours of ingestion. However, do not delay seeking medical attention to administer honey.

How do honey and Carafate help prevent injury? How much should I give?

Honey and Carafate coat the battery, which limits electrode activity and neutralizes generated hydroxide. This prevents damage and perforation to the esophagus and stomach.

Carafate is a prescribed medicine that coats and covers the mucosa of the esophagus and stomach to help protect it from injury.

Recommended doses for both honey and Carafate:

• For children over 12 months old,  give 10 ml or 2 teaspoons every 10 minutes with a maximum of 6 doses of honey and 3 doses of Carafate.
• However, do not delay medical attention to administer.
• Do not induce vomiting. Do not delay emergency care to look for honey.

What can medical professionals do if my child swallows a battery?

1.    Check vital signs and evaluate to see if stable.

2.    An X-ray is done to identify the location.

3.    If the battery is in the esophagus less than 2 hours after ingestion, then immediate endoscopic removal. It will be removed by Ear-Nose-Throat or GI depending on location.

4.    If the battery is in the esophagus less than 12 hours after ingestion, the child is stable and able to swallow and ingest consider honey (>1 years) or Carafate while waiting for endoscopy. But do not delay endoscopy to give it.

5.    Beyond esophagus and symptomatic (abdominal pain, bleeding, cough, breathing difficulty, sore throat, chest pain, fever, weight loss) or magnet co-ingestion less than 12 hours of ingestion immediate endoscopic removal if in the stomach. Consult surgery if in the small intestine or colon.

6.    Beyond esophagus and asymptomatic less than 12 hours of ingestion repeat X-ray in 7-14 days or sooner if develops symptoms. If no passage, proceed to endoscopic removal.

7.    If it's been more than 12 hours of ingestion, your child may need an endoscopy, CT scan or endoscopic removal.

8.  If it's been more than 12 hours of ingestion, in the small intestines or colon, and asymptomatic repeat X-ray in 7-14 days or sooner of develops symptoms. If no passage, consult surgery.

What else should parents and caregivers be aware of?

The presence of an ingested button battery is considered a medical emergency, so do not delay seeking medical attention.

Make sure battery compartments are secured and screwed properly. Button batteries are shiny and attractive to children so avoid leaving loose batteries around.

Keeping Children Safe at Home from the American Academy of Pediatrics:

Crawling infants, toddlers and young children often put things in their mouths. Because of this, there are a few things you can do to reduce the risk of accidents.

• Look for batteries in child-resistant packaging. There is one type of lithium coin battery with a bitter coating to discourage swallowing.
• Make sure battery compartments are secure, especially for commonly used items like remote controls and key fobs. Consider taping them shut for an additional layer of security.
• Know what items in your home contain button batteries and lithium coin batteries, including older siblings' toys, calculators, and games.
• Store items that use these batteries out of reach, and out of sight if possible. For example, keep thermometers or remote controls in a secure drawer or cabinet when not in use. Hang keys up high on hooks. If someone receives a musical card, make sure to throw the card out when done or remove the battery before allowing children to keep it in their room. Remind older siblings to keep their stuff off the floor.
• Make sure childcare providers and family members are aware of the safety concerns. Post the number for the National Battery Ingestion Hotline (800-498-8666) with other emergency information in your home.
• Throw out or recycle old batteries right away. Even batteries that are "dead" can be dangerous. To safely dispose of button batteries and lithium coin batteries, wrap them in tape and place them in an outside garbage can.
• Talk with your children about safety. We teach kids to hold hands and look both ways when crossing a street and that a stove is hot. In the same way, we can teach them that handling batteries is for grown-ups. Talk to older children as well to make sure they keep track of items responsibly.

If a child ingests a button battery, immediately call for help, either through 911 or the National Battery Ingestion Hotline at 800-498-8666, which is available 24 hours a day, seven days a week.

The phone from Clinical Genetics came at 5:12 p.m. on April 10, 2018. Grace Wilson-Rabel remembers the exact time and date because it’s the moment that changed her life.

Candace Gamble, M.D., is a clinical geneticist with Cook Children’s, and the call was to let Grace know her daughter’s diagnosis.

Wilson was a secretary for Cook Children’s NICU and she motioned for her charge nurse to say she needed to take the call.

“OK, we received Austyn’s test results back. Her test is positive.”

Austyn had been diagnosed with neurofibromatosis type 1 (NF1), a genetic disorder that affects 1 in 3,000 people throughout the world. NF1 impacts children in many different ways, including light brown skin spots, neurofibromas (small benign growths) on or under the skin and/or freckling in the armpits or groin.

About 50 percent of people with the condition have learning challenges. Health concerns also include the softening and curving of bones, and curvature of the spine (scoliosis), and occasionally tumors may develop in the brain, on cranial nerves or the spinal cord.

While these tumors are usually not cancerous, they can cause health problems by pressing on nearby body tissues.

Following the diagnoses, Grace immediately felt cold fear run through her entire body and she broke down in tears.

After all, everything had changed.

Austyn was born Jan. 23, 2017.

Grace’s pregnancy was normal until her thirty-fifth week when she began to experience high blood pressure. Because it continued to be elevated, she was induced at 37 weeks. Austyn was born weighing 6 pounds, 12 ounces.

“There were absolutely no signs that she had a genetic condition hiding inside of her,” Grace said. “At 2 days old, we had her newborn check-up and discovered that her bilirubin was high.”

At 2 weeks old, Grace noticed her daughter was working hard to breathe and made a “horrendous noise” every time she inhaled, so back to the pediatrician’s office she went with her daughter.

Following three more visits to the Emergency Department at Cook Children’s, Grace made an appointment with Pulmonology where Austyn was diagnosed with laryngomalacia, a congenital softening of the tissues of the voice box, or larynx, above the vocal cords. This new diagnosis caused a whole other set of issues. Austyn’s suck/swallow/breathe coordination was off, which caused failure to thrive and a hospitalization at 7 months.

Due to her low weight and delayed development, Austyn was tested for cystic fibrosis.

“Thankfully that test came back negative, but we were placed in physical therapy because despite working with her every day, she did not crawl until 11 months and did not walk until 19 months,” Grace said. “We would find out later, with her diagnosis, that this is all very common for kids with NF.”

At 3 months, Grace noticed Austyn had three brown spots on her abdomen.

“I didn’t really think too much of it other than I thought they were cute birth marks,” Grace said.

At her 4-month checkup, Grace pointed out the spots to her pediatrician, Joyce Rafati, M.D. Dr. Rafati looked at them and said she thought it could be neurofibromatosis, but it was too early to tell.

By the age of 10 months, Austyn had 13 spots. Dr. Rafati referred Austyn to be seen by Dr. Gamble in Genetics to test for NF.

“The earliest we could be seen by the geneticist was January 29, 2018 – which was four months out,” Grace said. “The hardest part of this whole journey is patience. The wait time to see a specialist always feels so far away and then after the specialist visit we are left in limbo because there are so many ‘wait and see’ moments with NF.”

Austyn received a simple blood draw to test for the genetic condition, but it would take six or more weeks for the results. The test is expensive and has to be approved through insurance, which took another four weeks.

Once she received the approval, she took Austyn to the lab at the Dodson and had Austyn’s blood drawn on March 1, 2018.

Six weeks after the test, Grace received the phone call with the results.

“Processing that was one of the hardest things I’ve ever had to do,” Grace said. “I’m still processing it to this day. You have to go through a grieving process that sometimes takes months to years. You may grieve it your whole life but you have to be strong and you have to push through. NF1 brings lifelong doctor appointments and ‘what if’ questions. And, every day that there isn’t something going on and you’re not in the doctor’s office is a win.”

Grace said what helped her get through the most difficult time of her life was her husband, George. “He’s been my rock through this,” Grace said.

A few months later, Grace and George took Austyn to meet her new neurologist, Jeff McGlothlin, M.D.

“He was amazing, so gentle and thoughtful with Austyn and her condition,” Grace said. “And with talking to us. He answered all of our questions and gave us an idea of what the game plan would be.”

Austyn was supposed to have surgery to fix her airway a couple of weeks after her neurologist appointment so Dr. McGlothlin decided to piggy back on the surgery and do her first MRI to test for optic nerve gliomas the same day so she would only have to be sedated once. Gliomas are non-cancerous brain tumors that can affect a child’s vision.

“The day of the surgery came and we anxiously handed our sweet 18- month-old baby over to the arms of the doctors and nurses,” Grace said. “We knew she was in great hands but it didn’t take away that fear and sadness of what she is having to go through.”

About four hours later Austyn was out of surgery and recovering in the PICU at Cook Children’s. All went well. She had a great night and the next morning she was in good spirits and eating. The MRI was the last thing on Grace’s minds.

Around 10:30 in the morning, while still at Cook Children’s, Grace received a call from the neurologist’s office.

“I didn’t even think that they would be calling me to tell me bad news, I just thought they might be calling to tell me everything looked great. I was wrong,” Grace said. “The woman on the other end said, ‘Dr. McGlothin wanted me to let you know that there are two optic gliomas.’ I couldn’t even breathe. ‘What?’ I asked, choking back tears. She repeated the news and all I could say was, ‘This has been the worst year,’ and I sobbed and sobbed.”

Grace watched Austyn sleeping peacefully. She was so small and innocent and unaware that she had something so concerning inside her “precious little head.”

“Austyn has had a few more eye appointments and another MRI and I am happy to report that as of today her vision is unaffected and her tumors are stable,” Grace said. “We hope and pray that they stay this way. Her neuro-oncologist is pretty confident that she will never need treatment. Since these tumors are inoperable the only treatment option is chemotherapy.”

Grace said Austyn has been through more needle sticks, tests, hospitalizations, etc. in her short two years of life than most adults have. But throughout the process, Grace said she couldn’t be more grateful for Cook Children’s and the team that has taken care of her daughter since that day when her life changed: her pediatrician Dr. Joyce Rafati, gastroenterologist Danny Rafati, M.D., endocrinologist Teena Thomas, M.D., neurologist Dr. McGlothin, neuro-oncologist Jeffrey Murray, M.D., her ENT Michelle Marcincuk, M.D., and pulmonologist Nancy Dambro, M.D.

“Austyn has rocked everything like a champ,” Grace said. “She knows when they want to listen to her lungs, heart and belly, where the stethoscope goes. She knows where the blood pressure cuff goes and holds her arm or leg out for it. She never complains. And all of her doctors and nurses are her friends.”

I got to spend some time with my buddy and colleague Samson Cantu, M.D., and his wife Clara (a former educator) last month, along with 18 local high school juniors and seniors. We had an awesome time together and I wanted to tell you about it.

Many of you may know Dr. Cantu. He’s been treating kiddos with the Cook Children’s Gastroenterology team since 2011 and probably takes care of many of your kiddos. He’s a popular guy. Last year, you all chose him to be the doctor who was slimed during our annual Slime-A-Doc competition. I think that means you love him, right?

He is a true gem of a doctor – real, funny, honest, kind, and smart. So when he told me he was running year two of a program called “Saturday Morning Medicine” and would I like to volunteer my time, how could I say no?

Dr. Cantu grew up with asthma, so his childhood was spent seeing a lot of doctors and nurses, like his pediatrician and all the different types of ER staff. The constant exposure to medical folks peaked his interest in a career in medicine. At the end of high school, “[he] was fortunate enough to be accepted into an 8-year combined undergraduate and medical school program, and this paved the way for me to become a doctor!”

Since becoming a pediatric gastroenterologist, Dr. C decided it was time to give back to his community.

Dr. Cantu and Mrs. Cantu decided to develop a program in Fort Worth that would encourage and nurture the participation and education of high schoolers who were interested in a career in the medical field.

Last year, the Cantus went to all the Fort Worth ISD high schools that offer Anatomy and Physiology classes and proposed their program “Saturday Morning Medicine” to the students.

The students had to apply and be accepted into the program. Parts of the application included essay questions asking the students why they were interested in a career in medicine. It was no joke – they really needed to be serious about their career plans!

Applications trickled in year one, and more than doubled for this year’s session! The students love it!

The seniors and juniors learn about medical careers over four Saturday sessions per spring. They get to visit different parts of Cook Children’s Medical Center including the simulation lab, hear various speakers (doctors, nurses, therapists), and also get some one-on-one time with volunteers (that’s where I came in)!

My two students and I talked about all sorts of things – what they hoped to do one day, how school was going, how to plan for the future, and what to do to meet those big goals.

It was so fun – and it was really cool to watch these kids soak in all the information and get ahead of the game. I found myself wishing I had had this opportunity as a high schooler!

If you’re in a medical field (doctor, nurse, child life, therapist of any type, allied health, everyone!) and you’re interested in giving back to the community and these amazing kids, please leave your email address in the comments and the Cantus may contact you soon to volunteer for “Saturday Morning Medicine”!

You won’t regret it and can really make an impact in these teenagers’ lives.

Six days after her high school graduation, Harkey found out she was pregnant. During her pregnancy she faced several complications due to the fact that her son’s intestines were located outside his belly, a condition known as gastroschisis.

Once Aiden Wayne Harkey-Ellis entered the world, Harkey got to hold her son. But only briefly before he was rushed to Cook Children’s Medical Center where Chip Uffman, M.D., performed surgery on Aiden.

Healthy babies are born with about 200 centimeters of the small intestine. Aiden now has 20 centimeters and only one-third of his colon. He has severe short bowel syndrome (SBS) and will always have trouble gaining weight and absorbing nutrients.

He has had 26 surgeries since birth, including  two transverse enteroplasty procedures to lenghten his bowels and exploratory bowel surgery, a G-button where he receives feeding through a tube and several line placements.

“He is now home safe and sound, however we have been in and out of the very place that saved his life, Cook Children’s, and will be here for years to come,” Harkey said. “I was recently reminded, even if it seems like we’re not progressing, every breath is a miracle and progress.”

Short bowel syndrome occurs any time enough intestine is lost to cause poor absorption of nutrients. There are many causes of SBS. The most common cause in children is necrotizing enterocolitis, a rare complication of prematurity or other serious illness in the newborn period. Other causes include congenital intestinal anomalies (such as gastroschisis, malrotation or intestinal atresias), surgical resection for Crohn disease, trauma, malignancy, radiation, or vascular insufficiency, to name a few.

“SBS is a problem because affected individuals may not be able to absorb enough nutrition and water to grow and thrive,” said Danny Rafati, M.D., Ph.D., a gastroenterologist at Cook Children’s. “Also, because certain parts of the gastrointestinal tract perform unique roles, even losing relatively short segments can lead to a problem absorbing important nutrients.”

Individuals with SBS may need special formulas or even intravenous supplementation (often called TPN) to ensure they have enough nutrition and fluid to stay healthy and thrive. Due to these special needs some children require feeding tubes or long-term central venous lines.

And this is where Harkey becomes upset. She’s seen in the news lately where celebrities have been using the same IV nutrition that children with conditions like SBS need to survive for preventing hangovers or jet lag.

Beth Deen, a pharmacist at Cook Children’s, says that most of the components of the parenteral nutrition solutions have been on back order at some time in the past few years. One of most problematic has included intravenous calcium that premature neonates and cardiac infants cannot live without.

The reasons for shortages include a shutdown of a manufacturing plant due to contamination, which has stopped the production of important products.

When this happens, it creates shortages of needed medication.

Deen said the government and agencies such as the Food and Drug Administration have been involved in the past five years to help solve this problem, but it remains a day-to-day struggle.

“Judicious use of medications includes reserving it for those who truly need it,” Deen said. “We give these medications and vitamins we place in IVs to provide these kids with the nutrition that sustain them. To use them for any reason other than to help the patients in need  are a waste of the materials needed to save lives.”

Now she prays for Tre’s caregivers to make her son all better.

Tre, who is 9 years old, has been seen by the Rehabilitation Services team at Cook Children’s since his parents adopted him as an infant. Most of those issues centered on his articulation skills. Tre’s history with Rehabilitation Services started with audiology and other physician specialists; speech therapy services began at 7 years old working on articulation skills. 

Then about 15 months ago, Sara Adams, Tre’s speech pathologist, received a call from Jennifer to say her work with him would have to go on hold indefinitely.

Tre was involved in a horrible boating accident. He sustained a head injury and was in a coma at another hospital. But the miracle for the Faulkner family occurred and within two weeks, Tre was up and walking.

After his accident, Tre returned to therapy at Cook Children's Urgent Care and Pediatric Specialties – Mansfield and worked with Occupational Therapy, Physical Therapy and Speech Therapy to regain skills that were lost after his brain injury.

A year later, much of Tre’s care takes place at the Cook Children’s Rehabilitation Services at Mansfield. The focus is on Tre’s short-term memory loss and his severe ADHD, as a result of the injury.

“God has blessed us so much,” Jennifer said. “The Mansfield community has been with us since the beginning, I’m so thankful. I’m also thankful for the amazing care Tre has received since his injury. At Mansfield, Tre has really been helped in many ways, through his physical, occupational and speech therapy. They have helped him so much with his memory and his balance. It’s truly been miraculous.”

The rehab at Mansfield is working for Tre. Academically, Tre’s test scores are in the average range for a child his age. His mom says he’s learning and making strides every day.

And Tre’s doing very well physically. He recently received his gold belt in karate. Makes sense for a kid who has proven time and time again how tough he is.

“The progress Tre has made since his accident is truly remarkable,” Adams said. “Tre still has some struggles with his attention and memory that impact him every day. However, he continues to improve and learn how to work through these struggles. Tre’s sense of humor, determination, and supportive family are his greatest strengths. Tre is such a funny kid! He loves to tell jokes and riddles. One of his favorite jokes is: ‘Why don’t ducks tell jokes when they are flying? … They might quack up!’”

To see how far Tre’s come since his injury it’s hard not to smile at the miracle that’s occurred and the occasional duck joke.

For more information

At Cook Children's, we provide more than 60 pediatric medical and specialty clinic offices throughout Texas. Thanks to our skilled group of clinicians who support the leading-edge technology found among our specialty services, Cook Children's is the destination when it comes to taking care of your children.

Cook Children's Urgent Care and Pediatric Specialties - Mansfield is located at:

801 Matlock Road

Mansfield, TX - 76063

To make an appointment, call 817-347-8400.

Specialty services at Mansfield inlcude:

• Endocrinology and diabetes
• Gastroenterology and nutrition
• Nephrology and dialysis
• Neurosciences
• Orthopedics
• Pediatric surgery (inpatient/outpatient)
• Psychiatry and psychology
• Rehabilitation
• Urgent care

Who were they kidding? There's no emotional prepping anyone could do at that time. So, off to the OR for delivery we went. Talk about scared! They gave my baby a 10 percent chance of survival and they gave me a death sentence if they didn't deliver right then and there.

Graysen was brought into this world three months early weighing 1.4 pounds and not crying, or breathing. I remember seeing that he was the size of the nurse’s hand when she was working on him. I got to take one look at him before they had to intubate him immediately to get him breathing, since he was turning blue.

They then hurried away with him to the delivering hospital’s NICU. He was supposed to be born on March 15th (spring break baby) and he came into this world right before Christmas. With only a diaper the size of a tiny flip cell phone (which was the phone we had 10 years ago!), and under a heat lamp for warmth, inch by inch, ounce by ounce, he grew.

Weeks into life, the doctors decided to start feeding him by NG tube (Nasogastric tube that runs through the nose and into the stomach for feeds).

He did fine tolerating the feeds until he got an infection in the intestines, called necrotizing enterocolitis, also known as Nec. This made his belly swell up and, if not cured properly, could have resulted in a hole in the intestines, which is fatal. Surviving Nec was thought to be low. The doctors called to inform me that he was not doing so well and needed to be transferred by Teddy Bear Transport to the Medical Center’s NICU.

They loaded him up and took him by ambulance after two months in the NICU where he was born to begin his next few months of growing. Cook Children’s slowly nursed him back to better health, and, luckily, Graysen did not need surgery on his intestines. Miraculously, he pulled through another obstacle.

Weeks went by before they attempted to feed him again. In the meantime, the doctors had a central line surgically put into his chest so he could receive his nutrients properly. After a few weeks of feeds, the doctors started to see major improvement. They took him off the respirator and put him on a high flow nasal cannula to help with Graysen’s oxygenation and breathing. He did great with this new machine. Now breathing well, it was time to introduce the bottle at around 3 months. He took it, but not all of it.

The doctors had to decide what to do about the feeds he was leaving behind. They decided to put a G-button surgically into his stomach so that the left over feeds could be received by tube. This was the turning point. The hardest decision I had to make. Once that G-button was placed, I would have a medically dependent child.

After being in the NICU for five months, this was the only way he would be able to come home, and I was ready for that day. I gave the doctors the approval, and off to his first surgery he went. That was the first of 14 surgeries he would have throughout his first 10 years of life. Surgeries followed including fundoplication (an operation to prevent stomach contents from returning to the esophagus), hernia repairs, tonsillectomy, and a tethered spinal cord repair. Just to name a few. His spinal cord was taut at the end and neurosurgery was scheduled at 12 months. He caught meningitis after the surgery and, once again, beat dangerous odds.

Graysen went through so much that he didn’t eat. For six years, he was completely tube fed. He went through many years of intensive feeding therapy. He still didn’t want to eat orally. I put him in kindergarten and he saw his peers eating by mouth. That sparked an interest and, at 6 years old, he started eating. Now he demolishes whole cheeseburgers and fries! Not only has he beat death numerous times, he's gone through 14 surgeries and countless doctor appointments getting him to where he is now. This kid is here for a reason. This month we celebrate Graysen's 10th year of LIVING! Graysen is my Christmas miracle.

I could not have done this alone. I am so thankful that I had, and still have, a great network of people working together at Cook Children’s. Without their dedication to their job and to children, I don’t know if Graysen would have made it. Dr. Nancy Dambro was one of his main doctors from the time Graysen was born. Dr. Michael Deitchman has been his pediatrician through all the rollercoaster ups and downs. I can’t thank him enough for his support, countless visits and patience with us. We also see Dr. Jose Iglesias, Dr. Jill Radack, Dr. Bankole Osuntokun and Dr. Fernando Acosta.

It takes a village in Graysen’s case, and I’m glad our village is Cook Children’s!