Here's an edited Q&A from the conversation.

Q: What's one of the biggest misconceptions parents have about sports injury prevention?

Bass: Many parents focus on game day. They focus on when the whistle blows or when the competition starts. What often gets overlooked is everything that happens before that. Preparation, practice habits, warmups, conditioning and recovery all play an important role in helping reduce injury risk and improve performance.

Q: What does a good injury prevention routine look like before practice or a game?

Bass: It starts with a proper warmup. We want to warm up before we stretch, not stretch before we warm up. The goal is to create blood flow, get muscles and joints ready to perform, and make warmups a consistent part of every practice routine.

Sports are all about routines, and creating healthy routines can help reduce injury frequency.

Q: Does playing one sport year-round increase injury risk?

Bass: Research suggests that sports specialization can contribute to higher injury rates and burnout. Younger athletes should be encouraged to participate in multiple sports.

As young athletes grow and mature, their interests usually become clearer. In many cases, specialization happens naturally over time rather than needing to happen at a very young age.

The goal should be helping kids enjoy sports while developing a variety of skills.

Q: What are some signs that an athlete may be pushing too hard?

Bass: Parents and coaches should pay attention to changes in performance, soreness, swelling, stiffness and limping.

Athletes are often pleasers. They don't want to disappoint coaches, teammates or parents, and sometimes they don't immediately report that something is hurting.

That's why communication is so important. The earlier we identify a problem, the more options we have to help the athlete recover and continue participating safely.

Q: Why is it important for athletes to be honest about injuries?

Bass: Many athletes worry that reporting an injury will immediately take them out of competition. What I want them to understand is that athletic trainers and sports medicine professionals are advocates for the athlete.

Our goal is not to keep them from participating. Our goal is to help them recover, perform at their best and stay healthy over the long term.

Building trust helps athletes feel more comfortable speaking up when something doesn't feel right.

Q: What should parents know about concussions?

Bass: Concussions are medically classified as traumatic brain injuries, and they deserve serious attention.

One of the most important things parents need to know is that no two concussions are exactly alike. A concussion may look very different from athlete to athlete. Some athletes may experience headaches. Others may become sensitive to light or sound. Some may struggle with sleep, concentration or mood changes.

If symptoms develop after a collision, fall or impact, it's important to have the athlete evaluated by a medical professional.

Q: Can athletes drink too much water?

Bass: Parents ask that question quite a bit.

While it is technically possible to overhydrate under certain circumstances, most young athletes are much more likely to be under-hydrated than over-hydrated.

Hydration should be consistent throughout the day. Athletes should not wait until they feel thirsty to start drinking fluids, especially during practices and competitions in hot weather.

Q: Is heat illness preventable?

Bass: Heat illness is one of the most preventable sports injuries we see.

Proper hydration, acclimatization to heat, regular breaks and recognizing warning signs early can make a tremendous difference.

Parents should pay attention to symptoms like headaches, cramping, fatigue, dizziness and unusual behavior changes during or after physical activity in the heat.

When athletes begin experiencing heat-related symptoms, it's important to cool them down, rehydrate and seek medical attention when necessary.

Q: What's one thing every athlete should do before practice?

Bass: Say thank you.

Thank the parents, caregivers, coaches, teammates and everyone else who helps make it possible for you to participate.

Playing sports is a privilege, and gratitude is something every athlete can carry with them onto the field, court or track.

The Bottom Line

Preventing sports injuries isn't about one single technique or piece of equipment. It starts with consistent habits: proper warmups, good nutrition, hydration, recovery and honest communication when something doesn't feel right.

By helping young athletes build healthy routines and recognize warning signs early, parents can play an important role in keeping kids healthy, safe and in the game.

Q: How can parents tell the difference between a child who is occasionally distracted and one who may have ADHD?

Dr. Watkins: The biggest difference is consistency across multiple settings. Children with ADHD often struggle not just at home, but also at school, during extracurricular activities and in other environments.

Parents and teachers may notice difficulties staying seated, following directions, waiting their turn, staying organized or completing tasks. Teachers often report that these children require more redirection to stay focused and on task.

Q: What are some common signs of ADHD that caregivers and teachers may notice?

Dr. Watkins: ADHD symptoms generally fall into three categories: inattention, hyperactivity and impulsivity.

Signs may include:

• Frequent daydreaming
• Becoming distracted easily
• Needing repeated reminders to stay on task
• Excessive fidgeting
• Difficulty remaining seated
• Trouble standing in line or waiting their turn
• Blurting out answers
• Interrupting conversations or activities
• Difficulty organizing schoolwork or belongings

These behaviors occur more frequently and persistently than what would typically be expected for a child's age.

Q: At what age can ADHD be diagnosed?

Dr. Watkins: According to the American Academy of Pediatrics, ADHD can typically be diagnosed starting around age 4. Before that age, many behaviors associated with ADHD, such as impulsivity, high energy and short attention spans, are also normal parts of early childhood development.

Most children in the United States are diagnosed between ages 6 and 7, often after concerns are raised by teachers.

Q: If parents are concerned about ADHD, where should they start?

Dr. Watkins: Start by gathering information from the people who spend the most time with your child. Teachers are often the first to notice patterns because they work with many children and can compare developmental behaviors across age groups.

Parents know their children best, though, and their observations matter too. Coaches, dance instructors, childcare providers and other trusted adults can also provide valuable insight.

Once concerns are identified across multiple settings, families should talk with their pediatrician or primary care provider about an evaluation.

Q: What if a child is homeschooled?

Dr. Watkins: It can be more challenging because there are fewer opportunities for comparison. However, parents can still look for patterns.

Is your child taking significantly longer to complete assignments than siblings or peers? Are they becoming distracted more frequently during lessons? If they participate in homeschool co-ops, sports, church activities or other group settings, do they require more redirection than other children their age?

Looking at behavior across different environments remains important.

Q: What is a 504 Plan?

Dr. Watkins: A 504 Plan provides accommodations that help students access learning more successfully in the classroom.

Examples may include:

• Preferential seating near the teacher
• Modified assignments
• Frequent check-ins for understanding
• Small-group testing
• Additional support with organization
   

Creating a 504 Plan typically involves collaboration among parents, teachers, school staff and the child's healthcare provider.

Q: How is an Individualized Education Program (IEP) different from a 504 Plan?

Dr. Watkins: An IEP, or Individualized Education Program, falls under special education services and is intended for students who require more comprehensive support.

While a 504 Plan focuses on accommodations, an IEP provides specialized educational services and goals tailored to a student's needs. The process is more involved and often includes formal evaluations from educational specialists, school psychologists or speech-language pathologists.

Because of those evaluations and planning requirements, IEP implementation typically takes longer.

Q: What is the Child Find program, and how can it help families?

Dr. Watkins: Child Find is part of the Individuals with Disabilities Education Act and requires public schools and charter schools to identify and evaluate children who may need special education services.

The program serves children from birth through age 21. Younger children may qualify for early intervention services, while school-aged children can receive evaluations and support through the public school system.

Parents who have concerns can discuss them with their child's pediatrician or teacher to begin the process.

Q: Are children being overdiagnosed with ADHD?

Dr. Watkins: Parents are exposed to an overwhelming amount of information, and much of it can be contradictory.

Rather than focusing on debates about overdiagnosis, it's important to focus on the child in front of you. If a child is struggling academically, socially or emotionally, an evaluation can provide answers and guidance.

On the other hand, not every energetic, daydreaming or quirky child has a disorder. Every child has unique traits and develops differently.

Q: What's the biggest misconception about ADHD?

Dr. Watkins: One of the biggest misconceptions is that children with ADHD are behaving badly on purpose.

ADHD is a neurodevelopmental disorder. Many of the behaviors associated with it stem from impulsivity and difficulty regulating attention, not deliberate defiance. These children are not trying to be disruptive. Their brains simply process information differently.

Q: Is it better to wait and see or ask questions early?

Dr. Watkins: Both.

If you're concerned, ask questions early. Gathering information helps you understand what to watch for and what may be developmentally appropriate. Then you can continue observing your child with better context and guidance.

There's no harm in learning more.

Q: Should parents worry if their child learns differently than other children?

Dr. Watkins: No. Every child learns differently.

Differences in learning styles do not automatically signal a problem. The key question is whether the child is thriving and progressing or struggling significantly compared to expectations for their age and environment.

Q: What's one thing you wish every child could hear from the adults in their life?

Dr. Watkins: “You're doing a good job.”

It's easy for adults to focus on correcting behaviors, improving grades and helping children meet expectations. But being a kid is hard. Children need encouragement, reassurance and reminders that they're loved and valued for who they are, not just for what they accomplish.

Q: What's your message to parents who worry they're not doing enough?

Dr. Watkins: If you're concerned about your child, showing up, asking questions and looking for ways to support them, you're doing enough.

Parents often put tremendous pressure on themselves, but perfection isn't the goal. Being a caring, engaged and "good enough" parent matters far more than having all the answers.

Final Thoughts?

Dr. Watkins: In today's world, it's easy to assume every challenge means something is wrong with your child. But sometimes kids are simply kids. They may be energetic, distracted, imaginative or a little wiggly, and that's perfectly normal.

Pay attention to patterns, trust your instincts and seek guidance when concerns arise. Most importantly, remember that every child develops in their own way and deserves support, understanding and encouragement along the way.

As summer winds down and school begins, families face the challenge of shifting back to structured routines. In the first episode of For Kids' Sake, a new

Q: What's at the top of the back-to-school checklist for families?

Dr. Arnaout: Sleep. During the summer, schedules often disappear. Bedtimes get later and routines become more relaxed. Before school starts, it's important to help kids get back on track because sleep affects attention span, mood, decision-making and learning.

The best approach is to start a few weeks before school begins. Move bedtime earlier by 10 to 15 minutes every few days and gradually adjust wake-up times. Small changes can make the transition much easier.

Q: How much sleep do school-aged children need?

Dr. Arnaout: Most school-aged children need about nine to 12 hours of sleep each night, depending on their age and individual needs. A typical 10-year-old should be getting somewhere between nine and 11 hours.

If caregivers are unsure whether their child is getting enough sleep, it's always a good conversation to have with their pediatrician.

Q: What is something parents often overlook during back-to-school season?

Dr. Arnaout: Emotional readiness.

During the summer, many families relax routines. There may be more screen time, more snacking and less structure overall. Going back to school requires kids to adjust to schedules and responsibilities.

A few weeks before school starts, begin reintroducing routines such as regular meals, consistent bedtimes, and limits on screen time. That gradual transition can make a big difference.

Q: School vaccines can feel overwhelming. What should parents know?

Dr. Arnaout: There are several recommended immunizations for school-aged children, and your pediatrician can help you understand what's appropriate for your child.

One vaccine I remind parents about every year is the flu vaccine. The flu spreads easily in schools. While a flu shot may not prevent every case of flu, it's very effective at reducing the risk of serious illness, hospitalization and death.

We typically begin receiving flu vaccines in our offices around the end of August, and I generally recommend getting vaccinated in September or October.

Q: How can parents help children who are nervous about going back to school?

Dr. Arnaout: First, don't dismiss their worries. It's easy to say, "You'll be fine," but it can be more helpful to ask, "What's your biggest concern?" Let them talk about what they're feeling.

One of my favorite strategies is doing a practice run. Visit the school if possible. Walk the halls, find the classroom, visit the cafeteria, locate the bathrooms and meet the teacher. When kids know what to expect, school feels much less intimidating.

An anxious child often benefits greatly from preparation and planning.

Q: What are some signs that a child may be experiencing anxiety about school?

Dr. Arnaout: Anxiety doesn't always look obvious. Some children become quieter. Others may have trouble sleeping. They may complain of stomachaches or headaches.

These symptoms are real. Stress can affect the digestive system and lead to physical discomfort. If you're seeing more tummy aches, headaches, difficulty sleeping or changes in behavior as school approaches, anxiety may be part of what's going on.

The good news is that these feelings are normal. Most people experience stress and worry at times, and parents can help by offering support and preparation.

Q: What emotional skills help children succeed during the school year?

Dr. Arnaout: For younger children, skills like empathy, patience, listening and following directions are incredibly important.

Simple games can help build these skills. Games like Simon Says or Red Light, Green Light teach children to listen carefully, pay attention and follow instructions.

Reducing screen time before school starts is also helpful. Screens can affect attention and behavior. Instead, encourage activities like coloring, drawing, reading or creating stories. These activities help children practice focusing and creativity.

For older children, emotional readiness often involves organization and routine. Helping them clean their rooms, organize school supplies, set up study spaces or use planners can help them feel more prepared and confident.

Q: Is it okay for children to have a desk in their bedroom?

Dr. Arnaout: It depends on the home and the space available. In our house, we've found that our children are less distracted when they have a quiet area to work. The key is maintaining boundaries. Homework happens at the desk, but the bed remains for sleep. Once homework is done, we leave the room and move on to other activities.

Q: How should families think about germs and illnesses when school starts?

Dr. Arnaout: Young children have developing immune systems, and part of growing up involves being exposed to new germs. Schools bring children together, and illnesses are inevitable.

That's why vaccines are important. It's also why good hygiene habits matter. Teach children proper handwashing and how to use hand sanitizer appropriately. Those simple habits can go a long way.

Q: What should parents keep on hand during cold and flu season?

Dr. Arnaout: A few basics can make life easier:

• Tissues
• Hand sanitizer
• Acetaminophen (Tylenol)
• Ibuprofen
• Antihistamines
• A good thermometer
• Your pediatrician's phone number

Remember that pediatric offices often have nurses available to answer questions after hours. Illnesses rarely happen at convenient times, so it's helpful to have a plan before you need it.

Q: In our "Asking for a Friend" segment, a listener asks: Is it okay if my child eats the same lunch every day?

Dr. Arnaout: Yes. Many children are creatures of habit and prefer familiar foods. Try to offer variety at other meals and on weekends, but don't stress if your child chooses the same lunch repeatedly. There are bigger things for parents to worry about.

Q: What's the biggest sleep mistake parents make?

Dr. Arnaout: Screens in the bedroom. Many parents believe children need a television, tablet, or other screen to fall asleep, but screens interfere with sleep quality. The light from screens signals the brain that it's daytime and can affect melatonin production.

Make the bedroom as dark as possible. Avoid screens before bedtime. Instead, read books, tell stories or listen to calming activities that promote sleep.

Q: What's one of the best ways to reduce first-day-of-school stress?

Dr. Arnaout: Do a practice run. Visit the school if possible. If that's not an option, look at pictures of the school, the classroom or the teacher online. Familiarity helps children feel more comfortable and confident.

Q: What about parents who are nervous on the first day?

Dr. Arnaout: Parents experience first-day jitters too. When my children started school, I was nervous because they were no longer under my constant watch. One thing that helped was walking through the day's schedule.

I'd remind them, "You're going to have lunch, then recess, then class, and then I'll be there to pick you up."

Parents can do the same for themselves. Focus on how you'll spend your day and keep yourself occupied rather than dwelling on the separation.

Q: What's one health habit that pays off all year long?

Dr. Arnaout: Handwashing. Teaching children how to wash their hands properly and regularly is one of the most effective ways to reduce illness throughout the year.

Final Thoughts?

Dr. Arnaout: If you care enough about your child to listen to a podcast about getting ready for school, you're already doing a great job.

Give yourself some grace. Let go of the guilt.

You've got this.

For Kids’ Sake and its Spanish-language companion, Por Su Bienestar, debut today as extensions of Checkup Newsroom, Cook Children’s award-winning source for pediatric health news since 2014.

The podcasts bring Cook Children’s physicians, specialists and clinicians into conversations about the health topics families are talking about most. Guests will offer clear, balanced perspectives and understand the thoughtful decisions parents make every day.

"Our goal is to give caregivers trusted information directly from the people who care for children every day," said Chelsea Kretz Howell, director of Public Relations at Cook Children’s and host of For Kids’ Sake. "Families are constantly sorting through information online. These podcasts create a place where they can get clear answers to the questions that matter most."

The first episodes focus on back-to-school health and wellness, including immunizations, establishing healthy routines and helping children manage first-day anxiety. Future episodes will explore a wide range of pediatric topics, from seasonal illnesses and safety concerns to mental health, nutrition and emerging health trends.

Each episode features conversations with Cook Children’s experts who break down the latest pediatric health news and offer practical takeaways families can use at home. Episodes also include an "Asking for a Friend" segment, where clinicians answer listener-submitted questions and common concerns families may hesitate to ask.

"Providing trustworthy health information in both English and Spanish allows us to better serve the diverse families in our communities," said Lourdes Vazquez, multimedia storyteller at Cook Children’s and host of Por Su Bienestar. "We want parents and caregivers to feel informed, supported and confident when making decisions about their children's health."

New episodes of For Kids’ Sake will be released weekly, while Por Su Bienestar will publish new episodes every other week. Both podcasts will be available in video and audio formats.

Parents, grandparents, guardians and caregivers can watch full episodes on the Cook Children’s YouTube channel. The podcasts are currently available on all major podcast platforms, including Apple, Spotify, Google Podcasts, as well as through Checkup Newsroom. Follow Cook Children’s Instagram page @Cookchildrens, @ForKidsSake, @PorSuBienestar to submit questions to be addressed on the shows.

Media Contact

Chelsea Kretz Howell
Director, Public Relations
chelsea.kretz@cookchildrens.org

Resources and tips for finding immunizations for children:

Navigating vaccines can feel overwhelming. Talk to your pediatrician.

• Schedule an appointment through Cook Children's.
• Find your nearest Texas Department of State Health Service Clinic.
• Call 211 for help.
• Call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic.
• Check with your local school district for vaccine events.

Just weeks before students return to the classroom, the Texas Department of State Health Services (DSHS) issued a health alert following four reported cases of measles in July. According to DSHS, all four cases occurred within a single family after a family member traveled out of state.

With back-to-school season underway, pediatricians at Cook Children’s Health Care System are sharing key information about how measles moves through communities and how families can protect their children.

Measles is highly contagious. One infected person can potentially infect 12 to 18 unvaccinated individuals. The virus spreads through infectious respiratory droplets and airborne transmission (from coughing or sneezing), where tiny droplets can remain suspended in the air.

Cook Children’s experts say the best way to prevent getting and spreading the virus is to get the measles, mumps and rubella (MMR) vaccine.

The MMR vaccine is required by most school districts and Cook Children’s understands that navigating conflicting information about vaccines can feel overwhelming. Mary Suzanne Whitworth, M.D., medical director of Cook Children’s Infectious Diseases, explains the key facts about the measles and the MMR vaccine.

What is measles

Measles is a viral infection caused by the rubeola virus, which is not the same as rubella. The virus is very small, which makes it more contagious. It can remain in the air of a room for up to two hours after an infected patient leaves. Measles symptoms typically appear seven to 14 days after infection.

Symptoms include:

• Rash
• Fever, sometimes over 104º Fahrenheit or 40 º Celsius
• Runny nose
• Cough
• Red, watery eyes
• Sore throat
• Tiredness

Complications can include ear infections, diarrhea, pneumonia and, in rare cases, brain damage or death.

How can measles be prevented?

Vaccination is the most effective way to prevent measles. The first dose of the MMR vaccine is typically given to children on their first birthday (12 months old), followed by a booster at age 4. Talk to your pediatrician about questions and concerns. Children traveling outside the United States may be able eligible to receive the vaccine before their first birthday.

Because measles remains airborne for up to two hours, if 10 unvaccinated children are in a room with one infected child, nine of them will likely contract the virus.

In addition to getting vaccinated, the spread of measles can be mitigated by proper hygiene. This includes:

• Handwashing
• Covering your mouth and nose when you cough or sneeze
• Avoid sharing drinks or eating utensils
• Disinfect frequently touched surfaces

What would you like families to know about measles and the MMR vaccine?

Measles was declared eliminated from the United States in 2000. However, measles immunization rates have declined in recent years due to missed checkups during the pandemic, parental concerns and vaccine misinformation.

Measles also remains common in many parts of the world. Most recent U.S. cases stemmed from unvaccinated travelers returning from abroad. This drop in vaccination coverage makes communities vulnerable to disease resurgence.

Related Stories

• Mindful Monday Medicine: Back-to-School Checklist

• Top 10 Questions Parents Ask About Vaccines

• Measles Mythbusting with Laura Romano, D.O.

Wellness

• Schedule a Check-up: The American Academy of Pediatrics (AAP) recommends annual checkups from age 3 through adolescence. Schedule early to secure an appointment before the school year starts.
• Mental Health: Have open and honest conversations with children about their concerns. Speak with the pediatrician on tools to help with anxiety.
  • Parenting & Back-to-School: Emotional Safety Starts at Home
  • Raising Joy Podcast: Back to School Anxiety
• Oral health: Children should visit the dentist every six months. Make sure kids brush twice a day for two minutes and floss daily. Make an appointment.
• Update child vaccinations: Navigating vaccines can feel overwhelming. Talk to your pediatrician. The Texas Department of State Health Services requires certain immunizations before children can attend school.
  • To schedule an appointment, visit Cook Children's website or your county's health department website.
  • If a child is not of school age but attends daycare, other requirements may apply.

  • College students are required to receive the meningococcal vaccination.

    

• Sport physicals: The annual UIL pre-participation physical evaluation form applies to middle school and high school students. Sports physicals give doctors the opportunity to check for a variety of concerns, from vision issues and asthma to a lingering sprain or even a serious heart condition.

Healthy Routines

• Sleep: Sleep fuels a child's memory and concentration. Without consistent rest, children struggle to focus in class and retain what they learn, impacting their academic performance.
• Key elements for building a bedtime routine:
  • Establish a consistent schedule by going to bed at the same time each night.
  • Limit screen time at least one hour before bedtime.
  • Keep bedrooms quiet, cool and dark.
  • Create a calming routine, such as reading together.
• Transportation safety:
  • E-Bike and E-Scooter safety: Always wear a helmet.
  • Driving: Drive slowly through school zones and watch for pedestrians.
  • Car Safety: Ensure your child is in the correct car seat or booster for their age and size.
• Nutritious meals: Plan balanced breakfasts and lunches to keep energy levels stable throughout the day.
• Screen time: According to the American Academy of Child and Adolescent Psychiatry, children ages 8 to 18 in the United States spent an average of 7.5 hours a day using screens in 2025. Set clear daily limits for non-academic screen use.

Make a Plan

• Virtual care: If school district offers it, sign up for the Cook Children’s School-Based Virtual Health Program.
• Allergy action plan: Provide updated emergency allergy plans and medications to the school nurse.
• Medication management plan: Submit required doctor authorization forms for any daily or emergency medications needed during school hours.

To a parent living through their most terrifying moment, only one thing matters - that help is on the way for their child experiencing a medical crisis. Nothing brings relief like the sight of

With a moment’s notice, this team of critical care experts can be wheels up in one of Cook Children’s air ambulances to travel to points all over the United States, Canada and Mexico. While these aircraft are known to air traffic controllers by their unique call signs, to the anxious parents waiting on the ground, these identifiers are more than a string of letters and numbers. They are a declaration of the help and hope on the way.

“We’re walking in on a family’s worst and darkest day, and we are always cognizant of that,” said Deana McLelland, RN, Cook Children’s Teddy Bear Transport nurse. “They are always relieved to see us. I like to say our name is ‘Oh good, they’re here’ because that’s what we always hear when we walk in to pick up the tiniest of babies or the sickest of kids. I love taking care of them and feel so lucky that this is my job. I get emotional just talking about it.”

McLelland has been doing this job for 29 years. She is an original member of the Teddy Bear Transport team, having joined during its start up after working as a critical care nurse at Cook Children’s Medical Center for 6 years.

In May, she climbed aboard and began flying the friendly skies in a new addition to Cook Children’s fleet of mobile intensive care units - a Pilatus PC24 twin engine jet. The aircraft replaces one of two Cook Children’s airplanes currently in operation and enhances the health system’s ability to transport sick and injured children to Cook Children’s Medical Center for care.

“Our older airplane, which is a 1982 Beechcraft King Air twin turboprop, has served us well, but it’s time to retire,” said Stacy Putman, Cook Children’s director of Transport. “Now, we’ll have two jets to transport children from all over the country and even internationally from Canada and Mexico.”

Rapid Response

In emergency medicine, every minute counts. Cook Children’s new jet is bigger and faster than its turboprop predecessor, and can travel further distances before needing to refuel. To sick children and anxious parents, this means they get the help they need sooner.

Teddy Bear Transport averages about 30 flights per month. Many of those bring children back to North Texas to receive care close to home after becoming sick or injured while traveling. Premature babies or critically ill children from rural areas of Texas and surrounding states who need advanced care in Cook Children’s neonatal, pediatric or cardiovascular intensive care units are transported by air, too. Teddy Bear Transport also regularly flies infants diagnosed with a rare and severe genetic disorder called congenital hyperinsulinism (HI) to Cook Children’s Hyperinsulinism Center, one of only six HI Centers of Excellence in the world. Congenital hyperinsulinism can lead to dangerously low blood sugar in infants. Without timely intervention, these infants are at risk of seizures and permanent brain damage.

Cabin Features

The new jet joins a transport fleet that includes a Cessna Citation Encore+ jet, an American Eurocopter 145 helicopter and six specialty/critical care ambulances. All are equipped with medical technology comparable to what is used in neonatal and pediatric intensive care units.

“We are a mobile ICU,” Putman said. “So everything we can do in our pediatric or neonatal ICU, we can do in the airplane. We can even transport cardiovascular ICU patients on ECMO (advanced life support).”

Every transport carries a team that includes a nurse, paramedic and respiratory therapist. They are the elite of the elite when it comes to pediatric emergency medicine, as they must be as proficient in caring for a micro-preemie born at 21-weeks as they are at caring for an 18-year-old teenager. Expert skill is a must, coupled with the composure to deliver care while flying through the air or traveling the highways below.

In addition to having a little extra in-flight leg room for the transport team, the bigger plane allows for more equipment, staff and passengers when needed.

“When we transport kids on ECMO, it doubles our equipment and our on-board staff,” McLelland said. “This jet gives us more room to take anyone we need with us, and that includes parents. In the past we’ve only been able to take one parent with us because of our team configuration, but this allows us the seating to bring two with us if necessary. Sometimes that child’s survival is on the line and we don’t feel good about leaving one parent behind if we don’t have to, so this is a really important feature for keeping the family together in these critical moments.”

Engineered for Safety

In addition to its critical care capabilities, both of Cook Children’s jets are equipped with leading-edge safety features, including a Wide Area Augmentation System (WAAS) and Traffic Collision Avoidance System (TCAS). The WAAS enhances GPS navigation, turning it into a precision guidance system that allows aircraft to land in lower visibility and at smaller regional airports, like those in rural areas frequented by Teddy Bear Transport. One of the most important safety features of modern-day jets, the TCAS prevents potential mid-air collisions by giving pilots a heads up warning of aircraft in the area and, if needed, escape guidance to avoid collision.

Other on-board assists, like a Nexrad weather radar and a terrain warning system, guide pilots in flying above storms, avoiding dangerous wind sheer and navigating obstacles on the ground.

Grounded, But Not For Long

Even after 29 years, McLelland says her job never gets old.

“Every time that motor starts, my heart skips a beat,” she said. “Every day is a new place, a new diagnosis and a new family, and I love the variety. I still say I cannot believe I get paid to do this job.”

When a breast cancer diagnosis last year temporarily grounded her, McLelland persevered and returned to work in March after a six-month leave of absence.

“When all of this cancer stuff started, my doctor asked what three things scared me the most,” McLelland said. “I told him leaving my job was one of them and he assured me I would go back to the work I love. I could not wait to get back. I’m really lucky to get to do it for as long as I have, and I’m not done.”

McLelland can’t wait to step aboard for her first transport in the new plane. Although flying on new wings, her wheels-up preparation will be the same as it has been for two decades—suit up and pray up.

“Every single morning on the way into work, I pray for my patients and their families,” she said. “And I pray for my crew that we will be wise and discerning and tender and take good care of the children we transport.”

Teddy Bear Transport by the Numbers:

• Operates 24/7/365

• 4,100 transports annually

• 10,000 referral calls handled each year by dispatch

• Staff includes 60 neonatal/pediatric nurses, paramedics and respiratory therapists

“A lot of times the students are receiving a lot of their meals at school but in the summer months that primarily falls on the parent,” said Maya Rashad, nutrition program coordinator at Cook Children’s Health Care System.

According to data from the Cook Children’s Center for Community Health 2024 Community Health Needs Assessment, about 390,100 children from birth to 17 years old live in households that sometimes or often couldn’t afford nutritious meals. 

To help address those needs Cook Children’s Health Care System's Nourishing Communities program partners with R.E.D. Mobile Market, the Good for You Healthy Hub, and other Texas Health Resources Healthy Hubs to fight food insecurity and continue expanding community partnerships.

Free Summer Meals for Kids

Healthy breakfast, lunch, or to-go meals are available to children 18 and under all summer long.

• Fort Worth ISD Summer Food Program: Schedules and school locations
• USDA Summer Meals Site Finder: Find local distribution sites near you

“Healthy diet is the foundation of a healthy life,” said Rashad.

To put those words into action, Rashad hosts cooking classes twice a week at the Las Vegas Trail Neighborhood Health Center focusing on eating healthy while on a budget.

Lily Han, M.D., a pediatrician at Cook Children’s Windhaven and Rashad share practical tips families can use to stay healthy during the summer without breaking the bank.

“The summer is a great time to introduce new fresh, colorful and fun foods,” said Dr. Han.   

 One key strategy is choosing seasonal produce. Look for fruits and vegetables at their peak, like berries, avocados, watermelons and tomatoes.

Balancing Energy and Hydration

Nutrition during the hot summer months is also about maintaining proper hydration. With children constantly on the move between sports clinics, day camps, pool days and play dates, structured eating can easily slide.

Dr. Han said it is important for families to aim for three meals a day and two to three snacks to keep energy levels stable.

“Keep in mind you are fueling for both energy and hydration,” said Dr. Han.

Experts recommend keeping easy, ready-to-eat items on hand to curb hunger, stabilize blood sugar levels and provide sustained energy throughout long days of play.

Smart on-the-go snack options include:

• Trail mix
• Nut butter and whole grain crackers
• Frozen yogurt tubes
• Veggie sticks and fresh fruit
• Granola and cheese sticks

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That advocate was Eliza Head, a clinical coordinator for Global Health Services (GHS). First, Eliza used her experience with international insurance companies to obtain the necessary approval for coverage. Then she made an appointment for 6-year-old Sofia to see pediatric gastroenterologist Clifton Huang, M.D. in Fort Worth.

Santiago Morett and Cristina Domenech Fernandez are grateful for the support they received before, during and after their daughter’s two-day visit to Cook Children’s Medical Center- Fort Worth in February 2026. Eliza was there to greet them and show them to the registration desk, food court, playground and Peaks Tech Zone to download the MyCookChildren’s app.

Eliza also accompanied the family to Sofia’s appointment and procedure with Dr. Huang. Santiago and Cristina speak English as a second language, but they weren’t familiar with some of the medical terms. Because Eliza is bilingual and a certified medical interpreter, the family relied on her for accurate translation in their native Spanish.

“Eliza was so kind and reassuring,” Santiago said. “She made it so easy for us so we could focus on Sofia and not worry about anything else.”

Cook Children’s reputation for clinical expertise, leading-edge technology and innovative research draws patients from across the United States and around the world. GHS makes the journey of international patients easier.

Thanks to Dr. Huang’s state-of-the-art technique, Sofia and her family found some answers and relief for her gut issues. They also encountered kindness and a touch of Cook Children’s magic. Sofia’s story reflects how GHS delivers the Cook Children’s Pinky Promise -- Everything for the Child – to international patients.

Making Connections

When Sofia began complaining of tummy aches in 2025, her pediatrician in Mexico City prescribed probiotics and medications that treat acid reflux. Better for a while, her pain returned. A pediatric gastroenterologist did a colonoscopy that showed seven polyps, or growths, in the lining of her intestines. The polyps were removed and weren’t cancerous. But her parents were still concerned.

Sofia underwent a second colonoscopy, four months after the first one, in hopes of finding the cause of blood in her stool. The colonoscopy discovered six more polyps. That’s when the pediatrician recommended that Sofia get checked out at Cook Children’s. Sofia’s pediatrician had met Dr. Huang in 2025 at an immersive academic experience hosted by Cook Children’s at the Fort Worth medical center.

“He personally knew Dr. Huang and thinks he’s one of the best in the world for strange diseases in gastrointestinal tracts in kids,” Santiago said.

So, Santiago and Cristina called GHS. Monica Martina, M.D., a pediatrician and liaison for Cook Children’s in Latin America, obtained Sofia’s medical records to share with Dr. Huang. Eliza, meanwhile, worked with Payor Relations and the international insurance company to cover the costs of treatment. With the paperwork in place, Sofia’s journey to Cook Children’s had begun.

Trailblazing Technology

At their initial visit with Dr. Huang, he explained a minimally invasive technique to get a closer view of Sofia’s intestines. The technology, called confocal laser endomicroscopy (CLE), uses light and lenses to magnify tissue up to 1,500 times. Cook Children’s is one of only a few pediatric centers in the United States with CLE for gastrointestinal diagnosis and therapy.

“Technology added to the current endoscope technique puts us in a better position to assess the patient,” he said. “You have a live microscope and a better way to understand how the bowel tissue looks.”

Dr. Huang, a native of El Salvador, spoke Spanish with the family. He told them a probe would go through the endoscope working channel into Sofia’s gut, the view would be greatly magnified, and he’d be able to spot in real time any abnormal tissue that mostly is seen through processing of biopsies. He assured them a precise, thorough, risk-free inspection.

Her procedure on Day Two revealed a polyp that Dr. Huang believes wasn’t caught during Sofia’s earlier colonoscopies in Mexico. Everything else looked good. After a popsicle and apple juice, Sofia was discharged.  She and her family toured the Fort Worth Stockyards the following day. And the day after that, they headed home.

Follow-up Support

A few weeks later Dr. Huang spoke with Sofia’s parents to let them know the biopsy of the polyp came back cancer-free. Dr. Huang recommended repeating the endomicroscopy in a year. Call Eliza, he said, to set up the appointment. 

Dr. Huang also diagnosed an enzyme deficiency that was interfering with Sofia’s ability to absorb sugar. The resulting inflammation was the cause of her tummy aches, Dr. Huang explained. He advised that they consult with a local dietitian to limit how much fruit and sugar Sofia eats.   

She feels much better these days. What does she want other kids to know about Cook Children’s? “The hospital is amazing, the playground is so much fun, and the doctors and nurses are very kind. They make you feel better and make sure nothing hurts.”

Dr. Huang reassured Santiago and Cristina that Sofia’s prognosis is good. Cook Children’s gave them the comfort of expert medical care as well as empathy and attention to detail. They appreciated how Child Life specialists kept Sofia entertained with toys and stickers. All the staff showed concern for Santiago and Cristina too, making sure they understood everything.

“I saw Sofia happy and secure, and she was very relaxed and smiling and talking to everyone,” Cristina said. “I was like this is OK, this is a safe place. It was a hospital, and I was afraid, but it was a great experience. I want to go again.” 

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• Navigating Pediatric Emergency and Urgent Care During the Tournament

• Cook Children's Language Services Department Offers 200+ Languages to Empower Families

Warm-Ups & Stretching

Physical therapist assistant Kim Barb, OPTA, of Cook Children’s Pediatric Specialties Walsh Ranch, says it’s important to stretch and warm up before playing or practicing, as doing so prepares the body for fitness. After a game or practice, incorporate flexibility stretches with static stretches and holding positions, like the typical hamstring stretch, calf stretch and quad stretch. A five- to eight-minute dynamic warm-up prepares the muscles for a better stretch.

Why?

• To increase blood flow
• To improve muscle flexibility
• To prevent injury and tearing of muscles, sprains and strains
• To improve performance

Agility drills prepare the muscles and joints for running, jumping, cutting and footwork.

Examples of agility drills are:

• Soldier kicks
• Knee hugs
• Hamstring scoops
• Skipping
• Hip openers

ACL-Injury Prevention for Soccer Players
Barb recommends strengthening large muscle groups typically used in soccer, such as the hamstrings, quadriceps and the gluteals (including the glute medius, minimus and maximus), with exercises such as squats, lunges and hamstring curls.

Strengthening exercises can help prevent the risk of injury by teaching muscles and joints to be stable and strong. Strengthening hip and core muscles also helps with the reactive forces created when making contact with other players.

Single-leg balance drills increase stability by training your body to stay balanced on one foot while moving, cutting and changing directions.

Examples of single-leg balance drills are:

• Stand on one foot and pass the ball.
• Stand on one foot and head the ball.

Plyometric drills teach athletes how to land with control – a skill that boosts the body’s ability to absorb impact and protect the joints. According to Barb, landing with poor alignment can cause the knees to cave inward, a position known as “knee valgus.” This inward collapse is a common culprit behind serious injuries, making proper landing technique an essential part of any training routine.

Examples of plyometric drills are:

• Box jumps
• Lateral bounds/skater lateral hops
• Depth jumps

Turf Burn Prevention & Treatment

These raw, red friction burns can be very painful, says Cook Children’s physical therapist Jessie Fernandez, PT, DPT, OCS, COMT, of Cook Children’s Rehabilitation (South).

If you have turf burn:

• First, be sure to clean it with soap and water to rinse out any dirt or debris and help to prevent infection.
• Next, treat the burn with an injury ointment, such as Neosporin.
• Cover it with a dressing or bandage. Waterproof bandages can help prevent the bandage from falling off during exercise.

Players can wear tighter-fitting, sliding shorts underneath their regular shorts to reduce the risk of skin damage when sliding on the field. Staying hydrated and keeping skin moisturized can also help reduce the risk of turf burn.

Whether your child plays on a natural grass field or turf, it’s important to continue practicing on the same surface so the athlete can get used to controlling their body on it. Turf fields absorb shock less effectively than natural grass, so running, jumping and playing on them will feel different.

What to Know About Concussions and “Second Impact Syndrome”
The American Academy of Pediatrics (AAP) defines a concussion as “a type of mild traumatic brain injury (mTBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.”

This sudden movement can cause the brain to move or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells. 

A concussion can sometimes be hard to spot. After all, it’s an internal injury.

There are times when a concussion is more easily identified, such as if an athlete loses consciousness. But it’s important to know that anytime there is a blow to the head, a concussion is possible.

“Monitor the athlete immediately after but be aware that sometimes it can take one to three days for symptoms to come on,” Fernandez said.

Immediate symptoms to watch out for and not to delay emergency medical treatment:

• Severe headache
• Blurred vision
• Trouble walking
• Confusion
• Slurred speech
• Unresponsiveness

Symptoms to watch after one to three days:

• Dizziness
• Headache
• Nausea
• Sleep changes, like sleeping too much or not enough
• Changes in mood or emotions
• Difficulty concentrating

Symptoms often resolve on their own, but one extremely important thing for parents to know about is second impact syndrome, which is when a person has a second concussion occur prior to resolution of symptoms from a previous concussion. This is the reason children and teens must sit out of a sport while recovering from a concussion.

“Playing through something like a knee injury is not ideal, but playing when you have concussion symptoms can be extremely dangerous, and can cause permanent brain damage or even death,” Fernandez said. “It’s just not something to mess around with.”

This is why Fernandez says that if there are any symptoms or concerns, the athlete should wait to return to play until they resolve. Usually, return-to-play protocols are overseen by a physician, athletic trainer, or physical therapist to work on the step-by-step process.

While neck strengthening and stability exercises can help prepare players for planned contact, like heading the ball, Barb notes that many concussions are harder to prevent because they stem from unexpected collisions that a player can't brace for.

“If you go up for a ball and someone hits you on the side of the head, you’re not prepared for that or it’s likely that you’re not stabilizing your neck muscles and that’s when the problem arises.”

Navigating Cook Children’s Health Care System

Quick Facts:

• A Fully Integrated System: Cook Children’s Health Care System is a comprehensive, not-for-profit pediatric organization encompassing two full service hospitals, physician network, home health care, surgery centers, a health plan, and a dedicated health foundation.
• Cook Children's: Within our network, our two full-service pediatric hospitals are officially named and referred to as Medical Centers (located in Fort Worth and Prosper).
• Urgent Care: For non-emergency medical needs that still require prompt attention, the system also operates seven Urgent Care Centers across the region.

An unexpected visit to the doctor can be stressful, especially when traveling. Cook Children’s Health Care System ensures that families can access health care at any time through its seven Urgent Care Centers (UCCs), or its two 24-hour emergency departments. With help from the Cook Children’s Language Services Department, families can receive care in their native language. 

Know before you go 

Whether visiting the emergency room or urgent care clinic, being prepared will help ensure care is timely and the child is back in action as quickly as possible. 

To be able to treat a child, a parent or legal guardian must be present or provide permission for treatment. If a parent or legal guardian is unavailable, a written letter of permission or immediate phone access to obtain verbal consent from the parent or legal guardian is needed. 

The adult accompanying the child should bring:

• A form of identification.
• Traveler’s insurance information (if available).
• A list of the child's medication. 

When to use the Cook Children’s Emergency Department 

With full-service medical centers in both Fort Worth and Prosper, Cook Children’s provides emergency care for children across North Texas.  

“We are always happy and prepared to help,” said Julio Castillo, M.D., medical director of emergency services at Cook Children’s Medical Center – Prosper.  

Cook Children's cares for more than 300,000 children every year through urgent care and emergency room visits, providing care in more than 200 languages.  

“We have local Spanish translators and multilanguage computerized access,” explained Dr. Castillo. 

Caregivers should take their child to the Emergency Department if their child is unconscious, not responding, a bone is sticking out, or the situation seems critical. For immediate assistance, dial 911. When a condition is sudden, life-threatening, or risks causing permanent harm, transport by ambulance is safest for the child. 

Take the child to the emergency department if your child is experiencing:  

• Severe bleeding that does not stop after 15 minutes of direct pressure
• Severe allergic reactions
• Difficulty breathing
• Bluish tint to the lips
• Coughing up or vomiting blood
• Sudden severe joint pain with swelling
• Insect stings accompanied by breathing difficulties
• Accidental swallowing of medications, chemicals or other substances
• Not being able to move or speak
• Severe or persistent vomiting or diarrhea
• Gaping wound (edges won’t come together)
• Head injury with loss of consciousness, vomiting or causing dizziness/confusion
• Visible broken bones or dislocated joints
• Fever higher than 100.4 F in infants under 8 weeks old
• Diabetes/blood sugar issues 

Urgent Care 

“For simple fever, cough, and congestion, your child can be seen in urgent care or by their pediatrician,” said Taylor Louden, M.D., medical director of emergency services at Cook Children’s Medical Center- Fort Worth. 

When a child needs same-day medical attention for non-life-threatening illnesses or injuries such as X-rays or stitches,a Cook Children's urgent care clinic can provide the necessary care.

“Cook Children’s Urgent Care Centers are available to see patients needing routine or urgent care while visiting our city for the event,” said  Kara Starnes, D.O. medical director of Urgent Care at Cook Children’s. 

Not all urgent care centers are the same. Cook Children’s Urgent Care clinics are not just kid-friendly; they are kid-only. Because childhood injuries and illnesses require specialized pediatric expertise, families must make an appointment prior to ensure a smooth, efficient visit.

When to use Cook Children’s Urgent Care 

• Ear infections/pain
• Strep/sore throats
• Cold symptoms
• Flu
• Mild dehydration
• Respiratory illnesses – including respiratory syncytial virus (RSV), bronchitis, bronchiolitis, pneumonia and asthma without severe breathing difficulty
• Sprains and possibly broken bones
• Minor cuts
• Prolonged vomiting
• Persistent diarrhea
• Infected bug bites
• Foreign body removal (marbles, beans and other interesting things)
• Urinary infection symptoms
• Pinworms, ringworm, rashes and pink eye
• Painful muscle strains
• Head injuries without loss of consciousness or vomiting 

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Big Crowds Anxiety

Excitement and anxiety can sometimes look similar in children before a major event. A child with “excited jitters” may still eagerly talk about the game and respond well to reassurance, while a child experiencing genuine anxiety may become consumed by worry or even try to avoid attending altogether.

Physical symptoms can also appear in anxious children, including headaches, stomachaches and trouble sleeping leading up to the event.

“Excited jitters usually come and go, but anxiety tends to stick around and interfere with daily routines,” said Amanda Jordan, PsyD, psychologist with the Cook Children’s Psychology Department.

Preparing children ahead of time by showing them videos or photos of the stadium, discussing what they can expect and creating a clear game-day plan, can help prevent anxiety symptoms. Parents can also use “first-then” language to help children mentally organize the experience.

For example: “First we’ll find our seats, then we’ll get a snack.”

Families can also benefit from creating a safety plan before arriving at the venue, including identifying meeting spots and teaching children how to find stadium employees for help. Creating a funny family code word for moments when a child feels overwhelmed can also ease stress and remind children it’s okay to ask for a break.

Stadiums Sensory Impact

For many children, sport venues can overload the senses with bright lights, loud music, strong smells and tightly packed crowds. Dr. Jordan says sensory overload can trigger the body’s “fight, flight or freeze” response, making emotional regulation difficult. Children experiencing sensory overload may become irritable, restless or emotional. Others may withdraw, stop talking, cry or struggle to make decisions.

Several sport venues, especially the newest stadiums, now feature dedicated sensory rooms or quiet spaces designed to help guests decompress. Dr. Jordan encourages parents to research venues ahead of time to learn what accommodations are available and where they are located.

Even if a stadium does not offer a formal sensory room, quieter areas such as patios, hallways or less crowded sections may provide children with a chance to reset before returning to the event.

“These spaces can help lower anxiety and give children a place to regulate during stressful moments,” Dr. Jordan said.

Behavioral Challenges

Emotional outbursts during games can happen when children become overstimulated or overwhelmed. In those moments, Dr. Jordan says parents should focus less on discipline and more on helping children feel safe and calm. Getting down to the child’s eye level, speaking in calm tone and validating the child’s feelings can help them decompress and rebalance their emotions.

Parents can also use grounding techniques, such as deep breathing exercise or offering simple choices to help restore a sense of control.

For example: “Would you like to sit with me for a minute, or would you rather go walk around for a little bit?”

Dr. Jordan also encourages families to discuss coping strategies before the event so children know what support may look like if emotions escalate.

The emotional energy inside a stadium can also affect how children interpret social situations. Aggressive reactions from adults or fans may increase a child’s anxiety or sense of insecurity.

“Kids learn how to respond by watching the adults around them,” Dr. Jordan said.

Parents can help by calmly explaining emotional reactions happening around them, such as cheering after a goal or frustration following a penalty call.

Practical Advice

It is recommended to pack a few “mental health essentials” before attending a major sporting event with children.

Some of these items can include:

• Noise-canceling headphones, or earplugs
• Comfort items like a soft blanket or a plush toy
• Sensory or fidget toys
• Snacks

 These items can help children self-regulate and make the big game day more enjoyable.

Parents should also recognize when it might be time to leave early. If a child cannot recover emotionally after taking breaks or using calming strategies, it is time to prioritize the child’s wellbeing and step away from the event.

It’s also important to emphasize that sensory sensitivities are not limited to children with Autism spectrum disorder (ASD). Children with attention deficit hyperactivity disorder (ADHD), anxiety or trauma histories may also struggle in overstimulating environments.

“Sensory overload can affect many different children – and sometimes even parents too,” Dr. Jordan said.

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At Cook Children's, we're here for it all.

Norovirus is a highly contagious virus that typically occurs during the winter months (November to April).   

Cook Children’s Medical Center Fort Worth and Prosper has seen a 26% positivity rate of norovirus during the week of Feb. 22 to Feb. 28. Tarrant County Public Health maintains regular surveillance of norovirus. 

What parents should know about Norovirus: 

1. Norovirus can cause SEVERE vomiting and diarrhea. Treating children with fluids and monitoring for dehydration is critical. 

2. Norovirus is HIGHLY contagious by contact with another person with the virus, eating food that is contaminated or touching contaminated surfaces and putting your fingers in your mouth. Symptoms usually develop 1-2 days after you have been exposed. 

3. Prevent infection by washing food well, washing your hands with soap and water frequently and disinfecting contaminated surfaces. 

4. Monitor for the following signs of dehydration including: dry mouth or lips, decreased activity level or decreased urine. 

If you have had a child (or you have had) with norovirus, here is a cleaning plan to help “decontaminate” your house: 

• Wash your hands with soap and water frequently.
• Wear gloves for everything (diaper changes, cleaning and handling clothes).
• Clean all toys and surfaces with a bleach solution (5-10 tablespoons in 1 gallon of water).
• Wash laundry on the hottest, longest cycle available and machine dry. 

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The current season, which began Sept. 28, 2025, and runs through May 23, 2026, continues to see a steady increase in cases across Cook Children’s Health Care System, primarily within primary care and urgent care offices. 

During the first week of February, the positivity rate for the flu hovered at approximately 30% in urgent care clinics, according to Kara Starnes, D.O. medical director of Urgent Care at Cook Children’s. 

Pediatricians encourage caregivers and families to take preventive steps, noting that a previous infection does not mean immunity for the season. 

“Even if you have already tested positive for the flu this season, it is worth getting your flu shot to protect against other strains,” said Phillip Scott, M.D., pediatric hospitalist, medical director for the Nelson Ku High Risk Asthma Clinic. 

While Cook Children’s Medical Centers in Prosper and Fort Worth have not seen a significant spike in hospitalizations, the system reports an increase in visits for the common cold. 

Don’t Let the Flu Stall Your Spring Break 

With Spring Break just a few weeks away, medical experts share tips to ensure families spend their vacation making memories instead of making visits to urgent care.  

“If you are traveling and will be in large crowds such as at the airport or at a large event, it is worth getting your flu shot for protection against the flu,” said Dr. Scott. 

Beyond prevention, the flu vaccine can significantly reduce the severity of symptoms if an individual does become sick, lowering the risk of hospitalization. 

Pediatricians also recommend the following: 

• Wash your hands
• Get a flu vaccine for you and your child
• Avoid touching your nose, mouth and eyes
• Cover your nose and mouth when sneezing and coughing
• Avoid close contact with people who are sick
• Keep your children at home and away from public areas if they are not feeling well 

Signs and Symptoms  

 Flu, RSV and COVID-19 are caused by different viruses, but all are upper respiratory illnesses that share similar symptoms such as:  

• Fever
• Cough
• Fatigue
• Sore throat
• Runny or stuffy nose
• Muscle pain and body aches
• Headache
• Vomiting and diarrhea
• Loss of appetite, taste, or smell
• Shortness of breath  

 Managing Symptoms  

If your child is sick, call your pediatrician first who can help you decide whether the level of sickness escalates to the doctor's office, urgent care, or the emergency room. For many children, viral illnesses like the flu, RSV, and COVID-19 can be managed at home with supportive care. Over-the-counter medications like acetaminophen or ibuprofen can help reduce fever and discomfort. Avoid ibuprofen in infants younger than 6 months.  

Maintaining hydration is crucial. Please encourage your child to drink fluids and consider giving them electrolyte drinks or popsicles. Saline nasal drops and cool-mist humidifiers can help alleviate congestion.  

A fever is defined as a temperature of 100.4 or above. A temperature above 100.4 in babies less than 2 months old is a medical emergency and needs to be evaluated in the emergency room. Any fever lasting longer than four to five days, or one that continues to climb and does not break with fever reducers, should be evaluated by a physician.  

 When to Seek Medical Attention  

While most cases can be managed at home, it's essential to recognize the signs of respiratory distress or dehydration, which require immediate medical attention.  

 Signs of respiratory distress:  

• Increased number of breaths per minute
• Increased heart rate
• Bluish color around the mouth, on the lips, or on the fingernails
• Pale or grayish skin
• Grunting sound during exhale
• Nose flaring
• The chest appears to sink in with each breath
• Head bobbing when breathing in
• Change in alertness  

Signs of dehydration:  

• Urine output is significantly below the child’s normal (at least once every 8 hours)
• Not producing tears when crying and the eyes appear sunken
• In infants, the soft spot on top of their heads looks sunken
• Dried mucus membranes (lining within the nostrils, mouth, throat)
• Sleepy and unresponsive  

If your child exhibits any of these signs, seek immediate care at an urgent care facility or the emergency department. Reserving visits to urgent care or the emergency department for truly urgent needs helps ensure timely care for those who need it most, reduces waiting times for everyone, conserves resources, and limits your child’s exposure to other viruses.  

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A winter storm that turned North Texas into a sheet of ice has led to a spike in emergency room visits related to sledding accidents, prompting pediatricians to urge parents to take immediate safety precautions.

Cook Children’s Health Care System has treated more than 60 children for sledding-related trauma since this weekend, with children as young as 2 years old. Injuries include bone fractures, head and facial trauma and internal organ lacerations.

Medical experts emphasize that the region's current conditions are far more dangerous than typical soft snow.

“This is not snow that we have here in Texas; this is ice,” said Taylor Louden, M.D., medical director of emergency services at Cook Children’s Medical Center – Fort Worth. “When kids hit their head on ice, it can cause catastrophic injuries.”

Dr. Louden warned that because most sleds are not equipped with a braking system, children have little to no control once they gain momentum on icy slopes.

“Sledding can be extremely dangerous,” said Dr. Louden.

As children head outdoors to enjoy their day off from school, Cook Children’s urges families to follow these safety guidelines to prevent injuries:

• Always wear a helmet.
• Never be pulled behind any sort of motorized vehicle.
• Do not sled on pool equipment or other non-sleds. These "non-sleds" offer no stability or steering.
• Avoid sledding on city streets or where objects that people can run into are located. 

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• Preparing for the 2026 Freeze: Experts Share Lifesaving Tips
• Arctic Cold Front: Readiness Tips for Parents
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With bags of candy and toys in hand, it was a beautiful day for a walk with Santa Claus. Families cautiously peeked out from their balconies and windows at first, hearing the Christmas music playing from Cook Children's Teddy Bear Transport and a loud "Ho, ho, ho!" from Santa.

For the first time, the Teddy Bear Transport team gave Santa's reindeer some extra nap time before Christmas Eve, taking Santa on a ride-along through the Las Vegas Trail Community on Saturday.

“Seeing children light up as Santa arrived in their own neighborhood was a powerful reminder that joy and connection can be created anywhere, especially when families are met with care and heart," said Sky Ramos, a community health worker at Cook Children’s Neighborhood Health Center Las Vegas Trail.

The Fort Worth Police Department guided Santa and Teddy Bear Transport through three neighborhoods: Broadmoor, Cambridge, and Casa de Los Sueños.

Children rode on their bikes, while others ran with their arms wide open; parents followed closely, carrying their babies. Santa greeted everyone while his "elves" distributed candy canes, small presents and information about the health center.

“We were handing out candy and small toys to kids and parents, but we were the ones actually receiving a gift,” said Veronica Tolley, Cook Children’s vice president of primary and specialty services. “It really hit home when one of our recently graduated students from the training center ran out of her apartment smiling ear to ear so we could see her graduation certificate.”

In true holiday spirit, Cook Children’s Health Care System showed up for its community. All goodies were prepared by Cook Children's administration, the Center for Community Health (C4CH), Cook Children’s Health Plan (CCHP), and Child Life.

It’s just one small step towards a big effort to enhance the quality of life for this Fort Worth Community. 

"It was a great morning, change takes time and we will not give up,” said Lenee Bassham, Director, Child Safety at The Center for Community Health at Cook Children's. 

For the staff on the ground, that change begins with a single point of connection. 

“Just sharing a smile and a candy cane can make a difference in one's whole mindset, for both the children and adults,” said Dana Walraven, strategic partnerships manager at the neighborhood health center. “I think we achieved that, along with letting families know about the services available.”

Santa's work is never done. He continued the celebration at the Las Vegas Trail Rise Community Center. Paige Charbonnet, executive director of LVT Rise, led her annual Christmas event, ensuring families all across the community received a bit of cheer. According to Santa, almost everyone was on the Nice List this year.

Sergeant A.S. Owen of the Fort Worth Police Department was excited to see Santa and the community gather for holiday fun.

“I can tell you that effort changed the sentiment around that neighborhood, even if it's just a little, for everyone that saw y'all and will continue to chip at that community in such a positive way year-round,” said Sgt. Owen.

Learn more about the Cook Children's Neighborhood Health Center Las Vegas Trail and its services, classes, and events click here.

Holidays often mean more car trips as families drive to visit relatives. Sharon Evans, trauma injury prevention manager for Cook Children’s Health Care System, explains that during the holidays, there is an increase in motor vehicle collisions and related injuries.

Texas law requires children under the age of 8 and those under 4 feet 9 inches to be in a child safety seat. Failure to properly restrain a child can result in a ticket of up to $250.  Despite these laws, NHTSA data shows that 46% of car seats are installed incorrectly.

“There are more kids in the car than there are seatbelts and/or car seats, or the car is loaded with gifts and food,” said Evans. “So parents don’t make the child sit in their car seat, booster seat or wear their seat belt.”

Unfortunately, that leaves children unprotected in a crash and often results in severe injuries or death. 

“Don’t skip on safety over this holiday season,” said Evans, “make sure you and your children are buckled up correctly on every ride, no exceptions.”

A Child Passenger Safety Technician (CPST) can help ensure a child is safely and correctly secured in their car seat. Cook Children’s Health Care System has 66 CPSTs across North Texas.  

The Injury Prevention Collaborative offers free car seat checks with a CPST. Additionally, assistance is available to families who may need a car seat. To schedule an appointment, please call 682-885-2634 or click the link. You must have your child with you, unless you are an expectant parent.

Know the Four Stages of Car Seats

1. Rear-facing

Rear-facing car seats are the first stage of restraint for children ranging from newborns to preschoolers. This stage supports their head, neck, and back while riding in a vehicle until they meet the maximum weight OR height of their car seat. Experts highly recommend keeping your child in a rear-facing car seat for as long as possible, as it is the safest option available.

2. Forward-facing

Forward-facing is the second stage of car seats for preschoolers through school-age kids. Children should remain in a forward-facing car seat with a five-point harness until they meet the maximum weight OR height, then move into a booster seat.

3. Booster

Children must be at least four years old before transitioning into a booster seat. The booster seat stage is crucial for children who have outgrown a harnessed car seat, but do not yet fit safely behind a lap-shoulder belt. Still, booster seats are skipped over all too often. 

4. Seat Belt

A seat belt is the final stage of restraint. The safest time to transition to a seat belt is when your child is at least 4’ 9”, or 57 inches tall. Although the law states that children can transition to seatbelts at eight years old, Evans cautions that many children won’t reach 57 inches in height and should therefore remain in a booster seat until closer to 10 or 12 years old.

Firearm Safety

According to the 2024 Community Health Needs Assessment of households with guns in our eight-county service area, approximately 1 in 5 children live in a home with guns that are not always safely locked away.

Between 2022 and 2024, Cook Children's Health Care System in Fort Worth treated 179 individuals for firearm-related injuries. 10 were fatal and 169 were non-fatal. The majority of fatalities were from handguns and 136 were unintentional firearm injuries.  

The Aim For Safety program focuses on educating about firearm safety to decrease the number of youth injured or killed by a firearm.

The program shares these safety tips:

• Safe Storage
  • Store firearms unloaded and in locked locations, out of reach of children.
  • Use cable locks and gun boxes.
  • Secure ammunition separately.
• If You See a Gun
  • Stop.
  • Don't touch.
  • Run away.
  • Tell a grown-up.
• Safe Play
  • Ask the parents of your child's friends if they have guns in their homes and how they are being stored.
  • If you are asked about your guns, don't be offended.
  • Never aim BB guns or pellet guns at another person.

Poison Prevention

More than 800 children are treated at Cook Children's Health Care System every year due to accidental poisoning, and 65% of those poisonings are medication-related. According to the 2024 Community Health Needs Assessment, 1 in 2 children live in homes where medications are not always locked up and 4 in 7 children live in homes where cleaning products are not always stored in a locked area.

Tips for Poison Prevention

• Safe Medication Dosing
  • Follow the dosing directions listed on the medication by using the appropriate measuring items, such as a medicine cup or oral syringe.
  • Double dosing is NOT twice as effective, and in many instances can cause internal damage.
  • Adult medications may be too strong for children and should not be given in half doses. Only give medicine to your child that is intended for children.
  • Print the medication schedule to keep the right dosage for your family.
• Safe Storage
  • Many people leave medications on bathroom and kitchen counters as well as bedroom nightstands as a visual reminder to take them. Avoid unintentional injury and store medication up high, locked, and out of reach.
  • Hang purses and personal bags up high so children cannot reach prescriptions, vitamins, or other regularly used medications.
  • Remember, when visiting friends and family, it is ok to have an open discussion about safe storage.
• Safe Disposal
  • Visit a medication drop box at a local pharmacy. For more information on poison prevention, visit www.meddropbox.org.
  • The best disposal option is to find a drug take-back location, which may be found in retail, hospital, pharmacies, and/or law enforcement facilities.
  • Removing any unused or expired medication in the home can reduce the risk of access.

Safe Sleep

Each year in the United States, 3,500 babies die unexpectedly during sleep, according to the Centers for Disease Control and Prevention (CDC).  In Tarrant County, between 2018 and 2022, there were 124 deaths due to Sudden Unexpected Infant Death (SUID).

Sudden Unexpected Infant Death (SUID) can happen in any sleep environment, but it is less likely to happen if the baby is in their own crib, bassinet, or portable crib," explained Samantha St. John, safe sleep program coordinator at Cook Children's Center for Community Health.

Caregivers should remember the ABC's of Safe Sleep:

• Alone: The sleep space should be clear of any soft items, such as blankets, stuffed animals, pillows, and bumper pads, leaving only a mattress with a tight-fitted sheet.
• Back: Babies should always be placed flat on their back for every nap and every night.
• Crib: A crib, bassinet, or portable play yard with a firm, flat mattress and a fitted sheet is the safest sleep surface. 

More than a dozen officers with the Fort Worth Police Officers Association (FWPOA) visited Cook Children’s Medical Center in Fort Worth on Wednesday, greeting families and bringing a piece of holiday magic to patients.

Through the FWPOA’s nonprofit Cops for Kids, 700 teddy bears were donated and distributed to patients at the medical center. Each teddy bear was prepared with extra care, dressed by FWPOA officers and volunteers, and made at Cook Children’s Build-A-Bear workshop.

 “Some of these kiddos don’t get to go home for Christmas, and we want to give them something to be comfortable,” said Sgt. James Novak, chairman of Cops for Kids, FWPOA.

 With teddy bears in hand, officers divided into groups to spread holiday cheer, visiting with families and their little ones. Some patients were even able to check out their SWAT unit outside the medical center. The FWPOA has donated bears for more than a decade.

 “People love it, and we hand deliver them,” said officer Bel Haddad, co-chair of Cops for Kids, FWPOA.

 Officers share that it’s a joy to see the patient's excitement and the lasting impression it makes.

The Texas Department of State Health Services (DSHS) has issued a health alert for pertussis, also known as whooping cough, for the second consecutive year. From January through October, more than 3,500 cases have been reported throughout the state. Initial data indicate that 85% of cases are pediatric.

Pertussis is a highly contagious respiratory infection, according to KidsHealth, an educational partner of Cook Children’s Health Care System. In children and adults, whooping cough often presents as a common cold in the early stages, with symptoms that could include congestion, fever, and a cough.

Alice Phillips, M.D., director of Ambulatory Quality and Safety at Cook Children’s Health Care System, explains that in infants, a coughing fit may cause them to struggle to catch their breath. They breathe in as hard as they can to get oxygen, creating the characteristic “whooping” noise. 

“In Texas, as of October 2025, there have been over 3,500 cases of whooping cough reported compared to 1,907 in 2024,” said Dr. Phillips. “With most cases occurring historically in November and December, more is likely to come.”

Children less than a year old are most at risk of complications, with infants less than two months old being at the highest risk. However, immunizations can protect the most vulnerable, Dr. Phillips explains.

“Vaccination is key to protecting your child,” said Dr. Phillips.

The Tdap and DTaP (diphtheria, tetanus, and pertussis) vaccine protects people from diphtheria, tetanus, and whooping cough. Dr. Phillips explains the difference between the two: DTaP is for children younger than 7 and Tdap for patients older than 7. 

Vaccine Recommendation:

As of October 2025, Cook Children’s Health Care System had 28 admissions due to whooping cough, with seven being infants less than 2 months old.

“Because of this, it is recommended that all adults caring for newborns receive a whooping cough vaccine booster,” said Dr. Phillips.

Adults do not present the same symptoms as children, making them vulnerable to giving an infant whooping cough. The American Academy of Pediatrics (AAP) recommends vaccines for protection.

Vaccine schedule:

• DTaP for infants: receive vaccines at 2, 4, 6, and 15 months.
• DTaP for Children: receive boosters to maintain their immunity at ages 4 and 6 years.
• Tdap for Children: 11 to 12 years.
• Tdap for Adults: Recommended during pregnancy or for adults who will be around newborn babies.

Treatment: Since bacteria cause whooping cough, antibiotics are the trusted standard of care by physicians, but early recognition is important for the best response to treatment and to prevent spread.

Symptoms: Infants may experience symptoms like struggling to breathe, unexpected intervals where breathing stops, and apnea.

Prevention:  In addition to getting vaccinated, there are other ways to prevent the spread of whooping cough.

• It is recommended to stay home for at least five days after starting antibiotics or at least 21 days if not treated.
• Washing your hands.
• Cover your mouth and nose when coughing or sneezing.
• Avoid close contact with a sick person.

If you think your child has pertussis or has been exposed, contact your pediatrician. If difficulty breathing occurs, call 911 or go to the nearest emergency department.

You've got questions? We've got answers covering everything about immunizations and vaccines. They each have a different role, but they both have the same goal. Learn more here: Immunizations and Vaccines Resources

Raising a child can come with a lot of questions, especially when it comes to their health and well-being. Vaccines, in particular, often spark a lot of conversation and curiosity among parents. It’s our priority to provide parents and caregivers with clear, reliable guidance. That’s why we asked Laura Romano, D.O., a hospitalist at Cook Children’s, to share the top 10 questions she receives from families.

1. Should my child receive the flu and RSV vaccines now? There seems to be so much confusion in the news, plus I’m not sure my insurance is going to cover all of this anymore.
Yes they should. Please get your seasonal vaccines as soon as possible!

Infants under 8 months whose mother did not receive an RSV vaccine while pregnant should receive their RSV immunization in October. If you did receive an RSV vaccination while pregnant, your child might still need their immunization. Please talk to your pediatrician to see if your child is eligible. RSV immunizations protect up to 90% of severe RSV infections.

Everyone in your house 6 months and older should also receive their seasonal flu vaccine. Ask your pediatrician whether your child should receive the COVID vaccine. These vaccines are recommended by the AAP among other organizations. Unfortunately, healthy children and adults can still have serious complications from the flu and COVID. 

I encourage you to have a conversation with your doctor and the financial representative in your primary care office. We all want to help your family and do what is best for your child.

2. Are vaccines safe and effective? 
Yes. Each vaccine is rigorously studied prior to its approval and is monitored even after it's approved to make sure it’s safe. 

Vaccines have saved nearly 200 million lives in a century, many of those lives were young children and babies. 

3. Do vaccines cause autism?
No. Decades of research have shown over and over again that there is not any link between vaccines and autism. The overwhelming majority of articles that have tried to show any association have been widely discredited by the medical community at large.

4. I heard vaccines contain things like aluminum and formaldehyde. Is that safe to put in my child's body?
Yes! Many of the ingredients found in vaccines are necessary to help the body produce an immune response, like aluminum, and can be found in nature. Aluminum is actually found in fruits and vegetables. It is also found in meat, dairy and produce in small amounts.

And yes, by itself, formaldehyde is dangerous and you wouldn’t want to ingest in any way. However, the amount contained in vaccines is so minimal, so it is very safe. The formaldehyde prevents bacteria from getting into the vaccine vial. 

These ingredients are necessary to make sure the vaccine is safe to give and that the body produces the best immune response. Think of these ingredients like baking cookies. You have to put baking powder and baking soda into the cookies for them to turn out delicious. 

5. Why are there so many shots these days? 
It is a good thing! Science and technology have allowed us to study more diseases and develop more vaccines to prevent children from getting sick! 

Also, many vaccines are now given in combination so there are less injections. 

6. Why don't you recommend a delayed vaccination schedule? 
We know based on years of study how the newborn’s immune system works and when the maternal antibodies begin to fade so vaccines are recommended at specific intervals to provide the most protection to the baby.

7. Will vaccines weaken my child's natural immune system?
Absolutely not! Multiple studies have shown that children who are fully vaccinated are not more at risk for other illnesses. 

On the other hand, certain vaccine-preventable illnesses like measles can cause complications like “immune amnesia” that damages their immune system and makes them more susceptible to other illnesses. 

8. Why does my healthy child need vaccines? Won't their immune system naturally protect them? 
Some vaccine-preventable diseases can cause serious complications including meningitis, seizures, blindness, hearing loss, loss of a limb, permanent brain damage, developmental delays, and pneumonias. Some diseases can be fatal. 

These are complications that we need to protect your child against. While their immune system might be able to fight off the disease, the complications would be devastating and life-changing. It is not worth the risk. 

9. Isn't Hepatitis B an STD? Why should my child get that vaccine? 
Yes, one of the ways that Hepatitis B is spread is through intimate contact but it can also pass from the mother to the baby and cause serious liver damage. Some mothers are not able to receive prenatal care and wouldn’t be tested for Hepatitis B prior to delivery so we vaccinate all babies to protect against liver damage. 

Hepatitis B can also be spread through blood transfusions, bites, lesions, certain sanitary habits, or contact with an infected person’s secretions. 

Vaccinating your child early against a potentially chronic disease is always a good idea! 

10. Are your kids vaccinated? 
Yes! I have two kids (a 7-year-old daughter and a 4-year-old son). Both of my kids are fully vaccinated for all the reasons listed above. 

Vaccines protect my children, my patients, my husband, and our community. Children who are fully vaccinated are less likely to spread disease to at-risk individuals, like my dad with diabetes, my daughter’s best friend who has a new baby sister at home, our friend who had a kidney transplant a few years ago, our neighbor who is undergoing chemotherapy, a co-worker whose daughter has congenital heart disease. 

Vaccines protect my kids and our friends and family. We vaccinate because it is the right thing to do and it is the safe thing to do.

Our goal at Cook Children’s is for our community, our patients and our patient families to stay as healthy as possible. If you have any questions, please contact your pediatrician. We’re here to help!

All for One

Just a few months before Elliana’s diagnosis, the Reyes’ relocated from their urban North Texas home to their rural Oklahoma property, where they planned to take a year-long hiatus from city life. They wanted to homeschool their children, and slow their pace to one more suitable for savoring family time. While cancer changed their plans and their location, it didn’t change their hearts. 

The family determined that they would be as purposeful in their time together helping Elliana beat cancer as they had planned to be at their Oklahoma getaway. They would walk this road together and all for one. 

By day, Leόn, Lauren, their 15-year-old son, Micah, and 9-year-old daughter, Bella, joined Elliana at the hospital, where the two oldest continued their homeschool studies. 

“It wouldn’t have been safe for them to go to school,” Lauren said. “With Elliana’s condition and the danger of exposing her to germs, they would have had to choose between school and being with Elliana. So we just continued our plan of homeschooling for the year, which ended up being a gift for our family.” 

Once Elliana was asleep for the night, Leόn, Micah and Bella would retire to their room at the Ronald McDonald House just down the street from the hospital while Lauren remained at Elliana’s bedside. Micah and Bella became well-known fixtures on the Hematology/Oncology floor and throughout the hospital. Whenever Bella played in the halls of the unit, young patients came out to join her. Little did the Reyes family know, Bella’s magnetic energy was actually helping patients in their recovery. A doctor told them as much the day Elliana was discharged. 

“A doctor came to us in tears and said they were going to miss Bella,” Leόn said. “The reason being, the doctor said, is they try to get these kids to get out of the room to walk around. They have to move their body and can't just sit in the bed, but they can’t always get them to agree to do it. Chemo is tough on the body. But Bella used to have this little play stretcher and she would put her doctor gear on and walk the hallways. The doctor said as soon as the kids heard her voice, they all suddenly felt well enough to come out to the hallway and play.” 

Micah, a budding musician and athlete, could often be heard playing the piano in the atrium, and found a grassy corner of the campus to practice his football drills. He even endeared himself to Cook Children’s Medical Center president, Stan Davis. 

“Micah loves baseball and football,” Davis said. “I saw him on many occasions during their stay and he would always greet me as Mr. Stan and give me an update on his training and how his family was doing. The last time I saw him, he ran up to me with the most excitement I had ever seen from him and said, ‘Mr. Stan, my sister is ringing the bell this week. She is going home.’ I hugged him and it brought tears to my eyes. They trusted Cook Children’s and our team fulfilled our Promise!”

Supportive Therapies Help Heal

 Elliana’s parents say hearing the word “cancer” was a gut punch. Leόn had already walked this road with two brothers who had cancer, one who survived and another who passed away. For Lauren, who follows a natural and holistic approach to health and well-being, the thought of injecting chemotherapy into her baby’s body was difficult to reconcile. 

“I’m very holistic by nature, so it’s really hard for me to wrap my mind around the fact that I’m about to give my baby these extremely high-powered drugs that also require a series of other drugs on top of that because her immune system is so compromised,” Lauren said. “I had to go from zero to 1,000 with all of the medications that I had to sign off on for my baby. It was just overwhelming.” 

Elliana’s care team met the family, their fears and their many questions with compassion and understanding. They not only took the time to listen to the family’s concerns and explain the necessity of each treatment, but also encouraged the use of a host of complimentary mind and body therapies provided at Cook Children’s, such as acupuncture, music therapy, aromatherapy, visits from the medical center’s therapy dogs, as well as integrative vitamin and nutritional support. 

“They offered a lot of holistic things that align with who we are as a family that we were able to do in conjunction with everything else,” Lauren said. 

The family particularly enjoyed the Laughter League, a troop of playful clowns who travel the hospital with the sole purpose of inciting smiles. After all, laughter is the best medicine, and play is a child’s universal language. 

Leόn, Lauren, Micah and Bella worked together to keep Elliana’s spirits up, too. When Elliana had trouble keeping food down during chemo treatments, Micah would make her laugh to take her mind off of her nausea. Bella pulled her around the medical center in the wagons reserved for patients undergoing treatment. Leόn, a musician, would often pull out his guitar and sing to her. 

“Every time she saw the guitar come out, she would immediately calm down,” Lauren said. 

When the family needed uplifting, there was help for them, too. 

One evening, two members of Cook Children’s security team ran into Leόn and Micah playing guitars and singing worship songs atop a medical center parking garage. Following that encounter, the security team went out of their way to find Leόn a safe and solemn space where he could play his guitar and sing. 

Music was medicine for Leόn’s aching heart throughout Elliana’s treatment. He even wrote several songs about the family’s experience while Elliana was in the hospital. Leόn recorded one of them, called “The Unknown,” in Cook Children’s Sparklefly Recording Studio with the help of Raymond Turner, Sparklefly Recording Studio producer, and Sonny Burgess, Texas Country Music Hall of Famer and Cook Children’s director of Clinical Arts. When new patients arrived on the unit, Lauren says Leόn played the song for every parent who looked lost in a new diagnosis, and it uplifted many people along the way. “The Unknown” music video can be seen here. 

“Cook Children’s treated our family like their family,” Leόn said. 

When Leόn and Lauren needed to focus their full attention on Elliana’s care, Cook Children’s volunteers stepped in to help support Micah and Bella. 

“It was amazing how the volunteers loved on our kids, and our kids had a blast with them,” Leόn said. “They'd come up to the Oncology floor and were kind of like grandmas taking care of our daughter.” 

One even played the patient while Bella pretended to take her vitals, draw fluids and insert a central line that Bella had drawn on paper and cut out—all things she learned from watching nurses take care of her little sister. 

Even with all of the support, the journey was not easy. There were so many ups and downs that Leόn and Lauren say it felt like a rollercoaster ride where they could do nothing but hold on tight, while trusting the doctors and care team to keep Elliana’s treatment and healing on track.

Seasons Come and Seasons Go

On May 5, 2025, following her last round of chemotherapy, Elliana rang the bell on the Hematology/Oncology unit signaling the completion of her treatment. Her cancer is in remission. Elliana’s prognosis is excellent. According to Lauren, she has a greater than 90% chance that her cancer will not return. 

During a recent follow-up visit with Elliana’s specialists, the family watched as the giant pumpkin in the medical center’s circular courtyard was inflated—a small preview of the holiday magic Cook Children’s brings to life each year. 

“Last year we celebrated every holiday in the hospital and watched the decorations for every season go up in the circle. The giant turkey, Christmas lights, Valentine’s Day decorations, Easter eggs, and it all started with the big pumpkin when we first arrived at the hospital,” Lauren said. “Now, the big pumpkin is back a year later, and it’s like we have come full circle. Even though things are not quite back to normal this year, we’re grateful to be able to spend every holiday outside of the hospital. But we still look back and remember how magical Cook Children’s made those holidays and can say we had a very good year of celebrations while there. It was so beautiful.” 

The family has yet to return to Oklahoma, except for a brief visit. It was surreal, Lauren says. 

Their lives had changed forever, yet with last year’s Halloween decorations still hanging in the trees, their land appeared untouched by time or by the trial the family had endured. 

“It felt like a year was just gone, but also a reminder of all we lived through,” Lauren said. “It was a hard season but we look back on it now and are so grateful for how it knit our hearts together.” 

Now on the other side of that sharp and unexpected detour their lives took one year ago, Leόn and Lauren say they clearly see the beauty that rose from the ashes of cancer. Not only did it strengthen their faith, but they accomplished what they originally set out to do during their break from city life—draw closer together as a family. 

“Going through something as profound as cancer reminds you of what's really important,” Lauren said. “Prior to this we had a thriving business and a great life, but none of that matters when you're talking about one member of our family possibly not making it. It just shifted our every focus, and it fundamentally and foundationally challenged us as a family to get back to what is rudimentally important.” 

Halloween is a fun time where kids and caregivers can let their imagination take hold. Children and adults alike dress up as various characters. A mix of spooky and fun costumes will adorn the streets of North Texas this year, and Cook Children’s Health Care System wants to make sure families are not spooked by any preventable mishaps.

Sharon Evans, trauma injury prevention manager and Laura Romano D.O., hospitalist at Cook Children's, share their expert tips to stop the scariest spooks of the night: preventable injuries.

Pedestrian safety:

Research shows children do not have the cognitive ability to safely cross the street, unsupervised, until they are ten years old.

Evans shares that most pedestrian injuries occur between 3 p.m. and 7 p.m., especially as Daylight Saving Time ends. Pedestrians who are distracted (on the phone, listening to music, etc.) are four times more likely to be injured or killed.

Evans emphasizes that parents are role models and can set a good example by putting down the phone when walking.

“Follow the same rules you want your child to,” said Evans.

• Look left, right, and left again before crossing the street. Then remind them to continue looking until safely across the street.
• Watch for cars backing out or pulling into driveways.
• Put phones, headphones and devices down when crossing the street. It is particularly important to reinforce this message with teenagers.

Dr. Romano adds these pedestrian safety tips for everyone:

•  Make sure your child stays on the sidewalk and crosses at crosswalks or at corners.
• Slow down: Remember to drive very slowly, particularly when coming home from work in the evening.

Trick-or-Treat: Staying Safe in Costume

Your child’s costume should prioritize visibility and mobility to prevent common trip-and-fall injuries.

•  If possible, avoid all black costumes, particularly if your kids are trick-or-treating later in the evening, as dark costumes can be hard to see.
• If your child is wearing a dark costume, make sure that your child is bringing a flashlight or wearing glow sticks to help them be visible.
• Make sure to purchase costumes that are labeled “flame-retardant”. For any DIYers, nylon and polyester are materials that are known to be flame-retardant.
• Use caution with wigs, masks, or other accessories that may cover your kids’ eyes, nose, and mouth, making it difficult to see or breathe.
• Prevent falls by avoiding ill-fitting shoes and costumes that may become tripping hazards.
• Only use make-up products that are “non-toxic”. Test a small area of their skin a few days before use.
• The use of colored contact lenses could lead to eye infections or injuries—stick to only prescription contact lenses!

Tips for Teens

• Sending a responsible adult is always a good idea.
  • Older kids who can go trick-or-treating by themselves should only visit houses they know and follow routes that parents preapprove.
• Trick-or-treat in large groups, not alone or with just one other friend.
• Arrange specific check-in times throughout the evening.
• If your teen is driving to a party, make sure they are driving slowly and know to watch out for little kids.

By Laura Romano, D.O., hospitalist at Cook Children's Medical Center- Fort Worth

 The season of the Great Pumpkin, falling leaves, and fun Halloween costumes has officially arrived! My kids are so excited to show off their Halloween costumes this year. If you see a Fairy Princess and Thomas the Tank Engine wandering around your neighborhood, make sure you say hi!

 As kids get ready for trick-or-treating, there are some important things parents can do to keep them as safe as possible! Here are some answers to some frequently asked questions about Trick or Treating!

 Prepare your little ones for Halloween

• Trick or treating can be fun, but slightly intimidating for little ones. Practice trick-or-treating with your kids. Have them come to your door and say “trick or treat!” and practice saying please and thank you!
• Practice handing out candy. Handing out candy is my daughter’s personal favorite. You MUST take candy from her before you are allowed to leave our yard. She will follow you.
• Talk about what they might see on Halloween and walk around the neighborhood beforehand.

For older kids

• Sending a responsible adult is always a good idea.
• Older kids who can go trick-or-treating by themselves should only visit houses they know and follow routes that are pre-approved by parents.
• They should avoid going by themselves or with just one other friend, and instead go in large groups.
• Arrange specific check-in times throughout the evening.
• If your teen is driving to a party, make sure they are driving slowly and know to watch out for little kids.

Trick or Treat: Give me something good to eat

• For little kids: Avoid candies or treats that are small and might be a choking hazard.
• Check the candy: Practice going through the candy haul with your kids before allowing them to eat any.
  • You want to look for candy that may have been tampered with or look-alike food items that might contain illicit substances like THC or CBD.
• Giving out candy: I always try to make sure we have a peanut-free option for kids! We keep a separate bowl with non-peanut candies like Skittles or Smarties.
• Allergies: Regardless of your child’s allergy status, inspect all candy before they eat any. You want to look out for food allergens like peanuts or candies that are made in nut-containing facilities.

Too much candy?

As a Reese’s lover, my answer is that there is never too much candy. However, as a mom, I try to remember that the combination of sugar, chocolate, and the excitement of Halloween can lead to an upset stomach. Try to limit the intake to just a few pieces on Halloween night.

Keep It Reel: Staying Safe in Costume

• If possible, avoid all black costumes, particularly if your kids are trick-or-treating later in the evening. Dark costumes can be hard to see in the evening.
• If your child is wearing a dark costume, make sure that your child is bringing a flashlight to help them be visible or wear glow sticks.

 The display, put together by Cook Children’s Center for Community Health, will travel throughout the Cook Children’s Medical Center in Fort Worth.

 “SUID can happen in any sleep environment but is less likely to happen if the baby is in their own crib, bassinet, or portable crib,” explains Samantha St. John, program coordinator at Cook Children’s Center for Community Health.

 “By placing a baby in a safe sleep space, the risk of SUID is lowered significantly.”

 St. John explains that safe sleep refers to the safest environment for a baby under a year old to sleep.

 Safe Sleep: ABCs of Zzzs

“Babies should sleep in their own sleep space, such as a crib, bassinet, or portable crib, in the same room as the caregiver, but not the same bed,” explains St. John.

 Remember the ABCs of Zzzs:

• Alone: The sleep space should be clear of any soft items, such as blankets, stuffed animals, pillows, and bumper pads, leaving only a mattress with a tight-fitted sheet.
• Back: Babies should always be placed flat on their back for every nap and every night.
• Crib: A crib, bassinet, or portable play yard with a firm, flat mattress and a fitted sheet is the safest sleep surface. 

Reducing the Risk

 The American Academy of Pediatrics (AAP) recommends these tips to reduce the risk of SUID:

• Offer a pacifier with every sleep.
• Feeding human milk (whether breastfeeding or bottle-feeding).
• Avoid smoke and nicotine exposure.
• Avoid overheating.

 Understanding SUID

The crib and onesies are a stark reminder of the importance of safe sleep. According to the Centers for Disease Control and Prevention, there were 3,700 sudden unexpected infant deaths in the United States in 2022. Of those, 1,529 were deaths from Sudden Infant Death Syndrome (SIDS), 1,040 deaths from Accidental Suffocation and Strangulation in Bed, and 1,131 deaths from unknown causes.

 “SUID can occur any time before a baby turns 1 year old; however, the majority of instances occur between 0 and 4 months,” said St. John.

 There are three categories of SUID: Sudden Infant Death Syndrome (SIDS), Accidental Suffocation and Strangulation in Bed (ASSB), and Unknown/Undetermined reasons. 

 What is SIDS/ASSB or unknown?

• SIDS is a specific cause of death used when a baby dies for unknown reasons, even after an investigation. This means the infant was in a safe sleep environment, and there was no medical reason or external factor for why the infant died.
• ASSB is often used when the cause of death is related to an unsafe sleep environment, such as having soft items in the crib, becoming wedged between the mattress and a bedframe, or becoming entrapped under another person.
• Unknown/Undetermined is used when a death is unexplained even after an investigation; however, the Medical Examiner does not feel it meets the criteria to label it as a SIDS death.

Safe Sleep in Colder Months

 With fall and winter weather approaching, keeping infants warm is a priority for caregivers, and it is essential to do so safely.

 “Caregivers often use extra blankets and hats for warmth, but these soft items can easily become a suffocation or entanglement hazard,” said St. John.

 A safer alternative is a sleep sack, also called a wearable blanket. A sleep sack provides warmth and comfort without risk because it fits securely around the baby's upper body and is sized so the fabric cannot cover their face, while still allowing plenty of room at the bottom for comfort and movement.

 St. John adds that overheating is also a concern. She suggests a general rule to follow: dress the baby in no more than one layer of what an adult is wearing.  For example, if the caregiver is wearing pants and a long-sleeve shirt to bed, then they could dress the baby in a long-sleeve fleece onesie and add a cotton wearable blanket/sleep sack.

 Talk about Safe Sleep

When having conversations with family members about safe sleep, focus on the recommendations from the AAP on how to create safe sleep spaces and how to reduce the risk of SIDS, versus focusing on what they are doing wrong.  This allows everyone to move forward with the gained knowledge and make a more informed decision when creating a baby’s sleep space.

“A drowning can occur in any body of water at any time,” said Jillian Mitchell, community health program coordinator at Cook Children’s Health Care System.

Mitchell explains that data shows infants have the greatest risk for drowning inside the home, while children ages 1-4 have the greatest risk for drowning overall. Cook Children’s has developed strategic partnerships and efforts to inform and educate families on water safety.

“After seeing that a majority of drownings were occurring during a planned swim time, it became clear that strong messaging around adult supervision is key,” said Mitchell.

Eighty-eight percent of drownings occur with at least one adult present. The “Lifeguard Your Child” program teaches parents how to create a safety plan for children anytime they are around water.

Those tips include:

• Designate an adult Water Watcher to ensure constant visual supervision of children in and around water.
• Implement 15-minute shifts for Water Watchers.
• No Distractions: The Water Watcher must have no distractions, including conversations, phones, reading, or consuming alcohol.

“We know that distractions are a key component of unintentional injuries around planned swim time, so sharing these messages are strong reminder that drowning-related injuries and fatalities are preventable with non-distracted supervision,” said Mitchell.

Swim Lessons

Learning to swim can reduce drownings by more than 80%. Cook Children’s recognizes there is a disparity in access to swim lessons and saw an opportunity to collaborate with swim schools in the community. As a result, free Water Safety lessons are provided in select areas in under-resourced neighborhoods through community partnerships.

“By committing to taking a multi-layered strategic approach, the goal is to encourage safer choices in and around open water activities,” said Mitchell.

It is not just pools but ponds and lakes where water safety is important, and life jackets can help. Cook Children’s has a partnership with the Brazos River Authority in Granbury and Possum Kingdom Lake to provide water safety education at local schools and camps. The efforts extend into more than a dozen counties with loaner life jacket stations that Cook Children’s has built and supports.

“We hope to instill the importance of choosing the safest floatation device for their child,” said Mitchell. She adds that life jackets are not a substitute for supervision.

Choosing the right life vest:

• If the lifejacket does not say “U.S. Coast Guard-Approved” or “USCG approved,” you can assume it is not safe. Always check the label.
• As your child grows, the lifejacket needs to meet their new weight.
• Get a new lifejacket if there are rips and tears or if the straps are fraying.
• Do not rely on floats or other toys to keep children safe.
•  Always assign an adult water watcher when children are swimming, even if they are fitted with a life vest.

Water safety is year-round

Mitchell adds that water safety continues well into the winter months.  Drowning can happen in only an inch or two of water, just enough to cover your child’s nose and mouth.  Last year, Cook Children’s saw an uptick in bath-related drownings.

“We know that bath-related drownings are 100% preventable,” said Mitchell. “Much of our education focuses heavily on behavior change around preparedness, 100% adult supervision, and general safety concepts.”

Bathtub safety tips:

1. Ensure an adult stays at the side of the tub within reach of the child throughout the entire bath. This is too big of a responsibility for siblings and other children, so don’t ask them to take over for you. 
    
2. Avoid multitasking. Preparing dinner, folding laundry, or any other housekeeping tasks can and must wait until after the bath is over.
    
3. Ignore distractions like the doorbell or cell phones. Stepping or looking away from your child for even a few seconds can put them at risk of drowning.
    
4. Be prepared. Keep a towel and bath supplies close at hand, so you do not need to get up and leave during bath time. 
    
5. Treat every bath as a time to relax and bond with your baby or toddler. Bath toys like foam letters, animals that shoot water, and waterproof books are a great way to make the bathtub more fun and teach your child new things at the same time! 
    
6. Safety proof your home to prevent young children from accessing the bathroom without an adult. The more barriers in place, the safer your child will be.
    
7. If you absolutely have to leave during bath time, swaddle your child in a towel and bring them with you. 
    
8. Remove all toys and drain the tub immediately after each use.

“I dropped off Avyee and asked my dad if I could go one more ride,” Wyatt recalls.

Jimmy agreed. Wyatt drove to a new subdivision, where many of the homes were still being built or were vacant. The road was unpaved. Wyatt hit loose gravel while making a sharp turn, causing his golf cart to tip over. The cart landed on his foot, causing severe injuries.

“I was yelling for help,” said Wyatt.

The accident happened in front of a home where a family had just moved in that day. The mother there picked up Wyatt and rushed him to his home. As the unfamiliar car pulled up with Wyatt, Avyee rushed inside to tell April.

“I got outside and just saw this stranger holding Wyatt like a baby, and Jimmy wrapping his feet in a swim towel,” April said.

Jimmy sprang into action, grabbing his car keys and rushing him to the local emergency room, where Wyatt was stabilized and transferred to Cook Children’s Medical Center-Fort Worth.

The 11-year-old’s innocent evening stroll ended with scattered road rash along his side, three broken bones, and two ripped tendons.

April shares that it was not until the next day, when they met with the plastic surgeon, that they realized the severity and trauma their family had endured.

“I realized this is our new reality right now,” April said. “We’d have full days of surgeries, with doctors and nurses constantly in and out.”

During the first few days, the Hatchers were overwhelmed with friends and family pouring in to tend to their two youngest children at home. Their youngest was just 8 months old and breastfeeding. It was then that she realized the trauma affected her whole family.

She recalls one moment in the hospital where she was caring for Wyatt and his baby brother, Bodynn. April explained to Wyatt that while the trauma happened to him, it affected everyone.

She told him, "You must be patient versus expectant. We are all learning new things."

“It was a hard lesson for him, and just a beautiful opportunity to remind him that he was the one in the hospital bed, but it was changing all of our lives,” April said.

In the two years since the accident, Wyatt has undergone 11 surgeries and one tendon release. Wyatt's last tendon release surgery with a podiatrist will be when he is 18.

He says it was the words of an anesthesiologist that helped him face those surgeries head-on.

“He said, ‘When you face a challenge, you have to meet it, greet it, and then defeat it,’” Wyatt recalls.

Camp RISE

The family came to know their Cook Children’s child life specialist well. She suggested they attend Cook Children’s Trauma Support Group. Through the group, they learned about Camp RISE, a camp focused on families who have experienced a traumatic event. The camp helps families build coping skills, process trauma, and meet other families, all while taking part in fun activities like zip lining.

“It was an escape from the city life,” April said. “Being out where the stars are so numerous and it's just an oasis, and it’s just such an excitement.”

As the Hatchers arrived for their first day of camp, they were greeted with cheers and welcomed to their private cabin. Avyee, Bodynn, Wyatt, Jimmy, and April were excited for the experience.

Wyatt admits his favorite part of camp was archery, but during his second year, he felt compelled to encourage other children through their trauma. He credits Matthew 17:20-21 for finding that courage.

“If you have faith, faith the size of a mustard seed, you could tell a mountain to move and jump,” Wyatt recites.

To Wyatt, it was about giving hope to someone else.

“This is never going to be normal, but it will become a new normal, and it's going to be okay eventually,” said Wyatt.

After two years at Camp RISE, the Hatcher family graduated in 2024. April said it was a bittersweet moment. The family received a book signed by all the Trauma Support Group staff.

“The ripples were extensive, in what they had us do,” April said. “It’s just a scaffold to bring such healing.”

Just two weeks after the accident, wound vac and all, Wyatt used the anesthesiologist’s wise words to conquer any fears or hesitation he had about getting back in the golf cart. His dad placed him in the seat and gently drove him around the front yard, eventually taking him on the road.

Two years later, at 13, he shows his scar without hesitation. He openly shares and explains the accident with maturity.  

 For Wyatt’s 13^th birthday, he wanted to see starfish and swim with the dolphins. It was being with the dolphins that captivated him. He now has aspirations of becoming a Marineland dolphin trainer.

During that birthday adventure, April says Wyatt found his voice. On his own, while his parents watched, the 13-year-old had to explain to employees and the dolphin trainer why he wears a scuba sock on his injured foot. A scuba sock was something dolphins had never seen before. The trainer told Wyatt he would teach the dolphin what the sock was.

"It was the coolest moment for our kid," April said. "He just walked away with so much more confidence."

Through it all, laughter has been Preston’s best medicine, and he used it to draw smiles from his nurses during his most recent hospital stay following surgery at Cook Children’s Medical Center.

“He had a rubber chicken, and when the nurses would come in, he would just lay there while recovering from brain surgery and squeak the chicken,” said Preston’s mother, Meghan Czarobski. “He brings so much joy and light to our lives. Not many people can always have a smile on their face despite having seizures every day. He is the most resilient kid. He lets us recognize the small stuff, even on the darkest days, and it's the little things that count. He shows us that by his personality.”

But caring for Preston is a heavy, exhausting and financially draining responsibility. He requires around-the-clock care. For years, Meghan and her husband, Arty, traded work shifts and sacrificed sleep so that Preston was never alone. One would work during the day and the other at night to help keep the family afloat. The stress took a toll on their entire family, including their three other children ─ Payton, 9, Piper, 8, and Parker, 5.

The Czarobskis had commercial insurance, but their policies did not cover critical services that Preston and the family needed to thrive, not just survive. Resources like in-home nursing and respite care were out of reach for the family, who would have had to pay out-of-pocket for these services. On top of that, the couple had to take out additional policies for Preston just to ensure he could continue to receive care at Cook Children’s Health Care System ─ his long-time medical home.

“We were just doing it on our own. No in-home nursing care, and we were having to pay for everything, like durable medical equipment supplies, out of pocket,” Megan said. “It was a struggle. Honestly, we were in survival mode for most of those years.”

Then, the Czarobskis discovered Cook Children’s Health Plan, where they were able to enroll in Texas’ STAR Kids Medicaid program for medically dependent children ─ and it changed everything.

The family no longer has to jump through insurance hoops to see their Cook Children’s physician of choice. Cook Children’s Health Plan has a network of more than 1,400 primary care providers and more than 2,500 specialists, many of them members of Cook Children’s Physician Network. Thanks to Cook Children’s Health Plan, Preston now has in-home nursing, respite care, and critical speech, occupational and physical therapy sessions, giving Arty and Meghan the break they need to rest and recharge, and allowing them precious time with their other children.

“It gives me peace of mind,” Meghan said. “Preston requires one-on-one support, even when he walks, because he could have a drop seizure at any time. Knowing that he has a nurse with him, I can work during the day and spend time with my other kids. Even if it's just doing the simple things like play a game with my kids or cook a meal for my family. It has given me an extension, and the benefits from Cook Children’s Health Plan have just been such a blessing to our family.”

But all of it – the collaborative and comprehensive care from trusted physicians, the in-home nursing care and therapy services, the medical equipment for Preston’s comfort and safety – is in jeopardy, as the Texas Legislature is just days away from allowing the largest Medicaid upheaval in state history. It will unravel the lifeline that allows the Czarobski family to survive, and even thrive, against overwhelming odds.

In 2024, the Texas Health & Human Services Commission (HHSC) denied contract renewals to several Medicaid providers, including Cook Children’s Health Plan and two other non-profit, Texas-based children's hospital plans. Despite their 60-plus years of proven, high-quality care, HHSC awarded the multi-billion-dollar Medicaid STAR/CHIP contracts to several publicly traded insurers beholden to out-of-state shareholders.

Unless legislators act now, 1.8 million Texas children and pregnant women, including 125,000 North Texas families like the Czarobskis, will be forced off their current health plans and into unfamiliar, for-profit insurers headquartered outside Texas. The consequences will ripple even further — costing Texans nearly 2,000 jobs and draining millions in taxpayer dollars.

If legislation isn't adopted immediately, vulnerable families could lose their lifeline to pediatric specialists, hundreds of local jobs will be eliminated, and taxpayers could possibly pay the price through ER overcrowding and higher uncompensated care costs when families have a gap or lapse in coverage as a result of this disruption.

“I'm going to try not cry, but it would be devastating to our family because it's literally like our right arm, and an extended part of our family and of Preston’s health care” Meghan said. “With the type of epilepsy he has, it is severe and progressive which can lead to worsening neurological outcomes over time, so as his needs increase, to lose something so valuable, it would be devastating to our family.”

The Czarobskis, and thousands of Texas families like them, need the Texas Legislature to do the right thing and adopt a law this session that extends existing contracts through 2027, preventing immediate upheaval. Lawmakers should preserve the right for families to stay with the health plans they trust to provide vital access to the medical services and physician relationships they depend on every day. 

For Arty and Meghan, it’s not just about Preston, but about Payton, Piper, and Parker, too.

“I want lawmakers to really think about the Texans that they are impacting, not just the patients, but the whole entire family,” Meghan said. “As a mom whose child’s life depends on the care and services provided by Cook Children’s Health Plan, my child is not just a number on a budget sheet. Behind every number is a child with dreams and a family fighting for support, stability, and hope for their child with complex medical needs. Like thousands of other Texas families, we rely on Cook Children’s Health Plan. Cutting it would be devastating to real people and strip away lifelines for so many families just like mine. I urge lawmakers to choose compassion. Chose humanity. Choose to protect Texas children and families so they can continue to get their dedicated care through the Cook Children’s Health Plan.”

To learn more about how you can help save Cook Children’s Health Plan, go to savecookchildrenshealthplan.com.

Many of our 125,000 health plan members and others have asked how they can help us #SaveCookChildrensHealthPlan, and this is one way.

Show your support:

• Take a photo of the display or snap a selfie.
• Post it on your social media pages.
• Tag Cook Children’s.
• Use the hashtags #savecookchildrenshealthplan and #SaveCCHP.

Thank you for making a difference!

(Fort Worth, Texas – May 9, 2025)—Cook Children's expresses profound concern Today over a looming crisis that threatens health care access for Texas' most vulnerable children. A staggering 1.8 million children and expectant mothers statewide, including 125,000 within Cook Children’s Health Plan’s Tarrant County service area, face potential disruptions in their health coverage due to the current situation. 

This precarious situation will have devastating consequences for 10,000 children with complex medical conditions, including 170 relying on ventilators and 1,700 who use wheelchairs. Beyond the direct impact on these children and their families, the repercussions extend to our community's economic stability, potentially costing 400 jobs in Tarrant County and up to 2,000 jobs across the state within Texas-based children’s health plans if this issue is not resolved. 

Despite hopeful signs earlier this session, with bill language from Representative Charlie Geren and Senator Juan “Chuy” Hinojosa making its way to the Senate Committee on Health and Human Services, recent legislative inaction suggests a willingness not to address this critical matter during the current legislative session as intended by the courts. This is an urgent situation demanding immediate attention. June 2, 2025, is the critical deadline.

 At the heart of this crisis is a flawed procurement process by the Health and Human Services Commission (HHSC) that inexplicably favored large, for-profit, out-of-state national plans over established local children’s health plans like Cook Children's, Driscoll Children's Hospital, and Texas Children's Hospital in Houston. These Texas-based organizations possess a proven track record of delivering high-quality care while achieving positive patient outcomes and maintaining high member and physician, and provider satisfaction. HHSC’s process failed to adequately consider past performance, quality of care, and health plan member satisfaction, leading to this deeply concerning outcome. 

The potential consequences of inaction are dire, inevitably leading to further costly litigation and, more importantly, threatening to disrupt the vital health care services that countless Texas children and their families depend upon.

 The question remains: why has decisive action not been taken? 

For more than 107 years, Cook Children's mission has been unwavering: to do everything for the health and well-being of the children we serve. This commitment compels us to continue fighting tirelessly for these children and their families. The stakes are simply too high to do otherwise. Our state's leaders have a critical 24-day window to rectify this flawed procurement process. We urge them to prioritize Texas children by investing in their health care and ensuring local, proven children’s health care providers can continue serving our communities. Allowing the current HHSC contract awards to stand will drain millions of dollars from our state, benefiting out-of-state shareholders instead of Texas children and businesses. Cook Children’s alone reinvests $200 million annually in our community, demonstrating our commitment. We implore our leaders to choose Texas children and Texas-based, non-profit children’s health plans over out-of-state, for-profit interests. The exclusion of dedicated children's health plans from this process demands explanation, as the health and stability of our health care system are at stake. 

The time for action is now! Before it’s too late.

Corbin and his grandson, Jordan Walker Ross, have experienced Cook Children’s care and kindness first-hand as Ross’ childhood was filled with regular visits to the medical center in Fort Worth.

Like many of the characters he’s played on stage, television and film, Corbin was a stalwart presence at his grandson’s side. He’d often sit outside Jordan’s hospital room and read the newspaper. Far enough to stay out of the way but close enough to keep watch over Jordan and his mom.

Because of its impact on his family, Corbin holds Cook Children's close to his heart. He is issuing an urgent call to action to our elected officials in Austin to help save Cook Children’s Health Plan. HIs full message is below:

“Hi, I'm Barry Corbin. You might know me from the screen, but my most cherished role is being a grandfather to Jordan. Cook Children's was a lifeline for him, and their care meant the world to our family, just like it does for so many in Texas.

That's why I'm speaking directly to our lawmakers in Austin. We're facing a critical deadline: June 2nd. Unless you act, 1.8 million Texans, including 125,000 North Texas children relying on Cook Children's Health Plan – kids with complex needs, even those on ventilators and in wheelchairs – could lose access to their trusted doctors.

This is about our children and our communities and giving families the option to stay with a trusted health plan that has proven health and quality outcomes and high member, family and physician satisfaction. For over 107 years, non-profits like Cook Children's have reinvested in Texas, over $200 million annually in their case. However, the state's consideration of multi-billion dollar Medicaid contracts for numerous out-of-state, for-profit insurers threatens local families. This move, driven by shareholder interests, would force vulnerable families and children to switch plans, causing harmful disruption.

Lawmakers, your urgent legislative action is needed. We risk losing local jobs and sending Texans’ tax dollars out of state. Please remember the crucial role of these community health plans and act now to protect our children before time runs out.”

Fort Worth, Texas Magazine also picked up this story and had this to share with their readers: “Barry Corbin Urges Action to Save Cook Children's Health Plan: The Fort Worth actor and grandfather is making a heartfelt plea to lawmakers as the future of Cook Children’s Health Plan hangs in the balance.”  Read more here.

Imagine being forced to forfeit a local, trusted resource that serves as your medically fragile child’s lifeline to out-of-state strangers for no good reason at all. That is exactly what Texas’ Health and Human Services Commission will do by cutting off access for Texas families to long-established, community-based health services.

Last year, the Health and Human Services Commission, which oversees the contracts and funding for the state’s Medicaid STAR and CHIP programs, denied Cook Children’s Health Plan renewed contracts to serve its membership. It did the same to two other nonprofit community health plans in South Texas and the Houston area. Instead, the commission chose to give those contracts to numerous for-profit health care companies, most of which are not based in Texas. The decision would force 1.8 million children and pregnant women who qualify for the Medicaid STAR and CHIP programs to switch from the health plans they rely upon to unfamiliar, corporate insurers beholden to shareholders.

We are doing everything we can to protect North Texas families from this harmful decision. But we can’t do it without the support of Texas Legislators.

If lawmakers do not intervene, the commission’s decision will upend the lives of Texas families, including 125,000 vulnerable North Texas children who rely on Cook Children’s Health Plan. They’ll have to start from scratch with a new health insurer and possibly new doctors after years of establishing a specialized medical team and complex care plans for their children. This could result in delayed or disrupted care, including for patients on a ventilator who are enrolled in Cook Children’s Health Plan.

Very soon, Texas Legislators are expected to consider several bills to protect the health care of vulnerable Texas children.

These bills would change the law on how the commission awards contracts for the management of its STAR and CHIP programs. Simply put, they would give Texas families a choice in health insurers and protect their right to have their Medicaid-dependent child’s health care managed locally.

Needlessly foisting a change onto the most vulnerable in our community could be disastrous for Texas families. Change is hard even in the best of circumstances. When you have a medically fragile child, forced changes pile hardship onto an already heavy burden. Just ask Breanna Hernandez.

Her son, MJ, was born prematurely at 27 weeks. Now 10 years old, MJ requires complex care from multiple specialties like neurology, pulmonology and gastroenterology, to name a few. All of MJ’s current doctors, along with many of his therapies and services, are part of the Cook Children’s Health Plan network. His family relies on the STAR Kids program through the health plan to cover most of MJ’s health care costs, including the supplies that allow him to receive nutrition safely through a port in his stomach.

“Losing the health plan would be like a tsunami or a tornado coming through our lives,” Hernandez said. “We never know what we’re going to get every morning when we wake up, but waking up with the knowledge that we have this established resource is a lifeline, a constant. It being taken away is something else that we would also have to worry about.”

Hernandez is on a first-name basis with MJ’s case manager at Cook Children’s Health Plan. That type of connection, where everyone feels like family, is central to Cook Children’s culture. Knowing the people who manage your child’s care also live and raise their families in the same area is another key benefit of a community-based health plan. They have first-hand knowledge of the local resources and how to help members navigate them. They understand the unique needs of local children and care deeply about the health of the community because it’s their community, too.

Private, out-of-state insurance companies can’t offer the same connection. The majority aren’t embedded in the communities they serve.

Cook Children’s Health Plan has been providing health care coverage for families and children with limited resources for more than 20 years, and Cook Children’s itself has been serving this community for more than 107 years. As a nonprofit organization, we use our resources to support our promise of improving the well-being of every child in our care and in our communities.

This year, Cook Children’s will open two new neighborhood health centers, for a total of nine centers strategically located throughout Tarrant County in areas with little access to health services close to home. The majority of neighborhood health center patients are dependent on Medicaid. These centers offer basic, yet critical, health and wellness services, including behavioral health, for children who otherwise might go unserved. It’s your health care dollars in action, making a real difference in the lives of children in your community — a stark contrast from several out-of-state corporate insurers selected by the Texas Health and Human Services Commission whose profits flow to shareholders.

The commission’s decision is flawed and wrong for Texas families. It’s the result of a subjective and unsound contract-renewal process that is not consistent with the law. Instead of considering past performance and quality when awarding these contracts, which the commission was legally required to do, it ignored decades-long telling track records, like Cook Children’s Health Plan’s high member ratings and demonstrated quality of care, and chose untested promises made by many for-profit insurance companies.

The proposed bills would replace the current error-prone, subjective bidding process with a more modern and straightforward system. Most important, the bills would allow families enrolled in STAR, CHIP and other Medicaid programs to choose whether they want to remain on their current health plans or switch to the private insurers.

“I would ask lawmakers to spend one day, or a week, in our lives,” Hernandez said. “There are a lot of things that us parents go through daily with these kiddos’ lives, and seeing it from somebody else’s perspective, really digging in there and living that day-to-day, would change your mind on a lot of the decisions you make. Please, save Cook Children’s Health Plan.”

We urge the Legislature to join us in viewing the world through the eyes of the Hernandez family and the thousands of others like them. Support the proposed legislation, and give Texas families the power to choose. Focus on the well-being of the children in our communities, and not the countless out-of-state shareholders, by supporting nonprofit community-based health plans. Let’s protect our children and ensure they receive the quality health care they deserve.

Rick W. Merrill serves as president and CEO of Cook Children’s Health Care System.

As of Tuesday, April 8, the Texas Department of State Health Services (DSHS) reports 505 cases and 57 patients hospitalized. Of the 505 confirmed cases, 495 are either unvaccinated or their vaccination status is unknown. No cases have been reported at Cook Children’s Medical Centers in Fort Worth or Prosper.

Cook Children’s Health Care System, through Marc Mazade, M.D., medical director of infection prevention and control, and Alice Philips, M.D., director of ambulatory quality and safety, explained what this means and what families should know.

The measles virus is highly contagious and can remain in the air for up to two hours.

“If the children at Great Wolf Lodge (during the exposure dates) were vaccinated then only observation is needed,” Dr. Phillips said. “Vaccination provides excellent protection and these kids have little risk to develop measles.”

Dr. Mazade explained that if a child visited either of these locations during the exposure period and was not vaccinated, they should watch for symptoms related to measles.

“Parents should watch for fever, congestion, cough, and red eyes and development of a rash,” Dr. Mazade said.

There is a 21-day incubation period, which means a child could develop the measles during that time. Children who develop any symptoms during that period should contact their doctor.

Dr. Mazade explained if symptoms develop, the family should keep the child at home and call their primary care physician.

Cook Children’s primary care clinics and neighborhood health centers can do testing on site for existing patients. 

If a parent suspects their child may have measles, they should call the primary care doctor before arriving at the office so arrangements can be made for safety and to minimize potential exposure in the waiting room.

“Parents should not hesitate to call their primary care physician for any questions,” Dr. Phillips said. “We are here to answer them.” 

Cook Children’s Health Care System continues to work with county health departments where clinics, medical centers and urgent cares are located.

DSHS recommendations

DSHS released new guidelines Monday now recommending children living in Cochran, Dallam, Dawson, Gaines, Garza, Lynn, Lamar, Lubbock, Terry, and Yoakum.

Infants
Immediately administer an early dose of measles, mumps, and rubella (MMR) vaccine for infants aged 6-11 months.

Children
Administer a second dose of MMR vaccine for preschool-aged children aged 1 to 4 years who received one prior dose.

Children at least one year of age with no documentation of vaccination history should receive two doses at least 28 days apart.

Adults
Administer a second dose of MMR vaccine for adults who received one prior dose.

Adults with no documentation of vaccination history should receive two doses at least 28 days apart.

Dr. Phillips advised parents that while this does not include Tarrant County, families should watch for any updates to this recommendation and discuss any questions or concerns with their doctor.

Where can you get immunized?

Vaccinations and immunizations 
Here are a few resources and tips for finding a place to take your child for immunizations. 

• Check with your child’s doctor. Ask which vaccines are due and make an appointment. If your child needs a doctor, see our locations or call 211 for help. 
• Visit a public health vaccine clinic. Anyone from any county can call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic. 
• Check with your local school district for vaccine events. 
• Enter your zip code at Vaccines.gov to find other options. 
   

What are symptoms of measles?

Measles symptoms typically appear seven to 14 days after infection. They can include:

• Fever, sometimes over 104º Fahrenheit or 40 º Celsius
• Runny nose
• Cough
• Red, watery eyes
• Sore throat
• Tiredness

Following the initial symptoms, a rash will develop that starts on the forehead and spreads down the body and out to the hands and feet.

Related Stories

What Parents Need to Know About the Measles Vaccine
Proactive Protection: Cook Children's Measles Response Plan
Cook Children's Addresses Rising Measles Concerns
Measles FAQs: What Parents Need to Know
Measles and Community Health 

Marc Mazade, M.D., Cook Children’s medical director of Infection Prevention and Control, encourages anyone who has not received the vaccine to do so. Vaccinations not only protect you, but also help limit the spread to others.

As of March 14, the Texas Department of State Health Services reported 259 cases of measles in Texas.

“I'm worried. It's a real dangerous situation right now,” Dr. Mazade said.  “There are lots of people who are eligible to receive the vaccine and haven't. There are areas where vaccine uptake has been really poor and it is likely to rip through these communities like wildfire, like it did in West Texas.”

The best way to prevent getting and spreading the virus is to get the measles, mumps and rubella (MMR) vaccine. We talked with Dr. Mazade about what makes this vaccine effective, who can get it and why vaccination is important.

Measles is one of the most contagious diseases humans have faced. Descriptions of the disease date back to at least the 9th century, according to the World Health Organization (WHO), and became more widespread in the 16th century. Prior to the vaccine, the Centers for Disease Control and Prevention (CDC) estimates three to four million people became infected per year, and 400 to 500 died.

Before the measles vaccine, which became available in its current form in 1968, most everyone got measles, Dr. Mazade said. While measles can be mild, it is “pretty miserable.” The virus can cause a fever from 104 to 106 degrees, congestion, cough and a red rash that spreads across the body. Complications from the measles are not uncommon, including ear infections and pneumonia. As of March 14, one child has died from the current measles outbreak.

“People don’t understand how dangerous it is and how dangerous vaccine preventable diseases are,” Dr. Mazade said. “It can be really serious for people who are pregnant, people with immunodeficiencies and people who are on immunosuppressants that would make them more susceptible.”

Herd Immunity

The current measles outbreak shows just how contagious it is.

In general, measles has not been transmitted within the U.S. for years due to herd immunity.

Herd immunity is the idea that when enough people are vaccinated against a disease, it is much harder for the disease to spread. Herd immunity for measles is reached when 90% of a population is vaccinated, Dr. Mazade said.

Imagine a group of 100 people spread out across a room. Ninety of them have been vaccinated and cannot get or give anyone else measles. One person in the room brings in the virus.

Perhaps the people nearby are all vaccinated; the virus will likely not spread or will only spread to a few people.  But if only half of the people are vaccinated, the infected person is likely standing near at least one other unvaccinated person. The disease can spread through the community, and can do so at an increasing rate.

With measles, face-to-face contact is not required to contract the disease, Dr. Mazade said. The infectious aerosol that is created when someone with measles coughs or sneezes fills the entire air space and even lingers in the air for up to two hours after a person with measles leaves the area. To go off of the room metaphor, measles can spread throughout a space quickly and endanger more people.

For years, the U.S. was like the first room. Sometimes, an unvaccinated person would travel abroad and bring back measles, but it was not able to spread due to herd immunity. In 2000, the U.S. documented zero cases of measles, and the virus was declared eliminated from the United States.

About 92 to 94% of a population needs to be vaccinated in order to achieve herd immunity for measles, according to the American Academy of Pediatrics. The current outbreak is due to that vaccination percentage dropping, Dr. Mazade said. Over the past few years, fewer and fewer people received the MMR vaccine.

Misinformation about vaccines has contributed to that decrease. Mazade encouraged people to seek direct sources for accurate vaccine information. The CDC, WHO and Cook Children’s vaccine resource page are good places to find accurate information.

Asking your doctor directly may be the best way to get information on your vaccine questions.

 “Trust your doctor,” Dr. Mazade said. “He or she is the best source of information about vaccines and vaccine safety.”

Getting Vaccinated

Fortunately, future measles outbreaks are preventable.

The MMR vaccine is safe and available for unvaccinated adults to receive -- and it is extremely effective. The first dose grants about 93% immunity and the second, and final, dose grants 97% immunity. This means that 97 out of 100 vaccinated people exposed to measles will not become sick.

The measles vaccine can be administered to children who are 12 months old and is part of the recommended vaccine schedule that the CDC recommends. If you did not get the vaccine as a child -- or are not sure if you did -- talk to your doctor.

Some people may want their children to get the vaccine early due to the outbreak. As of now, this is not recommended by our local health department. Babies who are younger than six months will likely not respond to the vaccine and not achieve immunity, Dr. Mazade said. Even if the baby has been exposed to measles, the vaccine is not recommended at this age. Dr. Mazade recommends talking to your doctor if you have concerns about measles exposure.

Even if this outbreak slows down, it is still important to get vaccinated.

“If people who are fully eligible are not fully vaccinated, we will be in the spot time and time again,” Dr. Mazade said. “Until we have a huge outbreak with lots of sick people."

Vaccinations and immunizations

Here are a few resources and tips for finding a place to take your child for immunizations. 

• Check with your child’s doctor. Ask which vaccines are due and make an appointment. If your child needs a doctor, see our locations or call 211 for help. 
• Visit a public health vaccine clinic. Anyone from any county can call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic. 
• Check with your local school district for vaccine events. 
• Enter your zip code at Vaccines.gov to find other options. 
   

“It takes planning,” explained Suzanne Whitworth, M.D., Division Chief of Pediatric Infectious Diseases.

The unit has six beds and dedicated areas for visitors and staff to put on and take off personal protective equipment (PPE). The rooms also provide a bed for family members and have specialized air ventilation systems. In the negative-air-pressure rooms, air is pulled inward, preventing recirculation.

“We are so grateful to have this unit here primarily because these children will be able to stay with their parents and keep our staff safe,” Dr. Whitworth said.

The unit focuses on keeping children with their parents and avoiding exposure to others. The rooms provide space for two parents or guardians to sleep and a bathroom with a shower.

Dr. Whitworth adds that any medical personnel in the unit will don PPE similar to that used during the pandemic.

“They would wear a gown with long sleeves, gloves, an N95 mask, and eye protections,” said Dr. Whitworth.

Currently, Cook Children’s Medical Centers in Fort Worth and Prosper have not had a measles case.

Dr. Whitworth explains the unit is not new. In 2022, the unit opened although Cook Children’s had discussed the need long before, and the need became more pronounced during the COVID-19 pandemic.

“This unit allows us to have a space where we are always ready for the next thing that comes along,” said Dr. Whitworth.

The unit provides staff with an area for them to shower and change before going home.

System-Wide Solutions

Dr. Whitworth said a meeting was held with Cook Children’s Health Care system stakeholders to ensure a synchronized response in case of a measles outbreak. This includes the medical center in Prosper, primary care and urgent care offices.

The medical center in Prosper also has negative-pressure rooms, which would be used if a child were diagnosed with measles.

Clinics have adopted updated policies for testing, identifying people with measles, and caring for those patients.

“Everything is really full-court press right now for preparation in case we have to do that here, and hopefully we won’t,” Dr. Whitworth said. 

Vaccinations and immunizations

Here are a few resources and tips for finding a place to take your child for immunizations. 

• Check with your child’s doctor. Ask which vaccines are due and make an appointment. If your child needs a doctor, see our locations or call 211 for help. 
• Visit a public health vaccine clinic. Anyone from any county can call Tarrant County Public Health at 817-248-6299 to make an appointment or to find a walk-in clinic. 
• Check with your local school district for vaccine events. 
• Enter your zip code at Vaccines.gov to find other options. 
   

Related Stories

Cook Children's Addresses Rising Measles Concerns
Measles FAQs: What Parents Need to Know
Measles and Community Health

 People will see temperatures from 7 degrees to 17 degrees, with wind chills as low as minus 10 degrees. Families need to take precautions. 

Keep Warm 

Babies less than a year old should not sleep in a cold room because they lose body heat more easily than adults, according to the Centers for Disease Control and Prevention (CDC). Yet, it is important to keep infants warm safely. 

• Do not have any pillows or other soft bedding in the crib or bassinet.  
• For sleep, dress babies in footed pajamas, one-piece wearable blankets, or sleep sacks. 
• Make sure newborns are dressed appropriately. Dress them in layers and cover their heads, hand,s and feet. 
• For the most warmth, dress your little ones in wool instead of cotton.  
• Essential winter items include hats and gloves, as well as sweatshirts or T-shirts that can be layered under overcoats or jackets. 
• It is important to remember to take off winter coats and jackets when the child is in the car seat.  

Know the Signs of Hypothermia 

 According to the CDC, hypothermia, or abnormally low body temperature, "is a dangerous condition that can occur when a person is exposed to extremely cold temperatures." This is a medical emergency, and treatment should be sought immediately. 

 Symptoms of hypothermia include: 

• Blue skin, shivering, and a cool chest and stomach are signs that children may be dangerously cold. If you see these signs, take action immediately to get kids out of the cold. Seek immediate medical attention if you are not able to warm the body. 
• Victims of hypothermia can include babies sleeping in cold rooms. 

 Warning signs for infants include: 

• Bright red, cold skin 
• Very low energy 

 Warning signs for adults include: 

•  Shivering, exhaustion 
• Confusion, fumbling hands 
• Memory loss, slurred speech, drowsiness 

Winter Heating Safety  

Keeping warm in frigid temperatures is important, but do so safely. Make sure to have functioning carbon monoxide detectors and fire alarms installed in areas that will wake you up. If you are unable to keep safely warm in your own home, check local resources for warming shelter information. Seek medical attention if you suspect carbon monoxide poisoning. 

•  Use electric space heaters with automatic shut-off switches. 
• Keep heat sources, like space heaters, at least 3 feet away from drapes, furniture, bedding, or other flammable materials. Never cover your space heater. 
• Do not leave children unattended near a space heater. 
• Make sure that the cord of an electric space heater is not a tripping hazard, but do not run the cord under carpets or rugs. 
• Avoid using extension cords to plug in your space heater. 
• Use fireplaces, wood stoves, or other combustion heaters only if they are properly vented to the outside and do not leak gas from the flue or exhaust into the indoor air space. 
• Do not use anything, such as a barbecue grill or propane tank to heat your home. 
• Do not run a vehicle inside of a garage attached to your home. 
• Do not heat your home with a gas oven or stovetop. 
• Do not burn charcoal inside your home. 

 Signs of carbon monoxide poisoning can include: 

• Headache 
• Nausea 
• Dizziness 
• Vomiting 
• Upset Stomach 
• Chest Pain 
• Confusion 

Car safety in frigid temperatures

Proper car seat use is one of the most critical ways parents can keep their young children safe when driving during inclement weather conditions.  

 Here are a few safety tips to consider: 

• Do not strap your children into their car seats with their heavy coats on. In a crash, padding from a coat or thick layers will flatten out, leaving room under the car seat harness. This increases the risk of a child slipping through the straps and being thrown from the car seat. Instead, dress your child in thin layers. Once buckled up, slip the coat on backward with the sleeves on the child’s arms. This way, the coat acts as a blanket and does not affect the fit of the harness. 
• Give yourself extra time to get where you are going. Do not forget to account for traffic.  
• Pack an emergency bag for your car. It’s a good idea to have blankets, warm clothing, hats, and gloves available in case you become stuck in winter weather. You will also want to have nonperishable snacks packed away. 
• Avoid overpasses if possible. Plan alternate routes to your destination and avoid high-traffic areas when possible. 
• Give yourself enough space from the car in front of you to gradually brake. When weather conditions are poor, give yourself double the time it normally takes to come to a complete stop. 

When the Padilla family of Fort Worth adopted their son, Eduardo, from a town north of Mexico City when he was just 3 months old, they dreamed of giving him a future full of opportunities he likely wouldn’t have in Mexico. He was a tiny baby. So tiny, in fact, that even preemie clothes were too big for his little frame.

“Since he was given to us, the whole idea was to change his life with a better future and nicer opportunities,” said Eduardo’s father, who shares his son’s first name. “But the reality, at least in my case, has been the opposite. He’s been changing my life with a lot more motivation. Eduardo has always been a good son, a good brother, and I believe he’s a good citizen. He’s a good guy, a cool guy.”

But those opportunities didn’t come easy. Early in his childhood, Eduardo began to show signs of a learning disability, and the dreams his parents Eduardo Padilla and Karla Tamez once had for their middle son were dimmed at the reality of growing up in a world that often disqualifies those who are differently abled. Eduardo attended several schools, none of them a good fit, and his dad worried that he’d never learn to read or write.

For many parents, learning that their child has a developmental disability is one of the most difficult days of their lives. With the news comes a realization that special milestones parents often look forward to for their children — prom, a first date, college, holding a job, marriage and having children — may never become reality. 

“Their grief with the loss of these dreams comes in waves that hit at every missed milestone and with every announcement received from loved ones or seen on social media,” said Kimberly James-Kelly, assistant principal of the Jane Justin School at Cook Children’s Child Study Center, where Eduardo became a student.

The Jane Justin school is a state-of-the-art, individualized, evidence-based private school for children kindergarten through twelfth grade with developmental, intellectual and learning disabilities. With an annual enrollment of 90 students, it has both a Lower School for elementary through junior high education and an Upper School for high school and career readiness training. Through individualized learning plans, it is the vision of the Jane Justin School to develop capable scholars, responsible citizens, and loyal friends prepared to succeed in every step of their educational journey.

A Photographer is Born

Eduardo excelled at the Jane Justin School and his parents' doubts and fear quickly began to melt away. Not only did he learn to read and write, he achieved a number of educational milestones, including graduating from the Upper School in May 2024. Thanks to supportive parents who encouraged their son to find and pursue his talents, Eduardo also discovered a passion and gift for photography and video editing. Eduardo is now taking part in the Upper School’s Post-graduate Program where job coaches equip students with job skills and pair them with community organizations, including Cook Children’s Medical Center, for volunteer opportunities or internships that provide students on-the-job training.

The program helped Eduardo turn his photography talent into a marketable skill, and he landed an internship with Cook Children’s Public Relations and Communications Department, where he has worked for the past 18 months. He is the first Jane Justin School intern to become a hired employee at Cook Children’s.

“One of my favorite memories has to be going to the groundbreaking for the Las Vegas Trail Neighborhood Health Center because I got to see the Mayor of Fort Worth and that’s pretty cool,” Eduardo said. “I got to see the whole team for the first time, and that was my first off-site from school. It was really cool.”

Cook Children’s became a partner in the intern program in 2022. Since then, the partnership has grown to now include three to five student interns per semester who work in various departments throughout the hospital. Other community partners hosting Jane Justin School students and volunteers include Tarrant Area Food Bank, Fort Worth Botanic Gardens, Ronald McDonald House and Welman Project.

“The Jane Justin School has done such an incredible job of preparing these students and they were looking for other partners to hire them,” said Wini King, senior vice president and Cook Children’s chief Communication & Employee Connections Officer. “These are our children. They are a part of the Cook Children’s family so it just made sense for the medical center to be one of those partners. So far, we’ve been able to place interns in Volunteer Services, Radiology, Zooty Fruity Yogurt Shop, Build-A-Bear and some of our retail spaces, and I’m extremely proud that they are also working in my own department.”

Eduardo has more than proven himself to be a valuable member of the communications team. He’s often called upon to photograph patients and families for stories that appear in the health system’s online newsroom, CheckupNewsroom.com, and to take photos at various medical center events. He even took many of the photos accompanying this article.

“At the beginning of Eduardo’s internship, he came in very shy, but as he became more comfortable with us and just photography in general, he’s become very proactive in his projects in that he’ll think of ideas of things to do or things to shoot,” said Sydney Hanes, Cook Children’s manager of Public Relations. “He’s very open and much more comfortable talking to everyone. We all love having him on the team.”

During his internship, Eduardo says he’s learned about various camera settings, video editing software, how to shoot different angles and how to get the perfect shot. The job, his dad says, changed Eduardo’s outlook.

“When he noticed that this was something with a future when they offered the opportunity to be an intern here helping with pictures and videos last year, that’s the first time that I really saw on his face a passion for something,” Eduardo’s father said.

From Classmates to Colleagues

Eduardo joins four other interns currently working at Cook Children’s.

Luke Harris and Zachary Pollack are the dynamic duo who travel throughout the medical center with the comfort cart, which is stocked with items such as toiletries and snacks to make a hospital stay a little more comfortable for children and families. The two are often a welcome sight, not only for their cart full of goodies but also for their enthusiasm and smiles.

Harris says he wanted to be an intern so he can “be a helpful person.” He doesn’t just enjoy his job, but loves it.

“I really like to take care of the patients, because I feel like I’m a superhero,” Harris said.

Pollack hails all the way from Edmond, Okla., where his family resides. He spends weekdays in Fort Worth with his grandparents in order to attend the Jane Justin School and travels home to Oklahoma every weekend to spend time with his parents. He recently passed his driver’s exam and is now a licensed driver.

Hannah Washington works at the medical center’s Build-A-Bear Workshop, a favored stop for patients and visitors alike. She helps keep the bears’ clothes and accessories stocked and organized, and does it all with a thankful heart.

“It makes me more grateful than ever,” Washington said of her internship.

Her favorite bear is the Fairy Bear because, like most things at Cook Children’s, it’s magical and enchanted, she says. Hannah has also worked in Radiology and at the Under the Peaks retail space. When she isn’t at school or work, you’ll find her singing. Mariah Carey and Whitney Houston are two of her favorite artists.  

Brooklyn Dilworth is an administrative ace. She works for a number of departments throughout the hospital making binders and folders that contain educational materials for patients. She also attends Tarrant County College where she is studying money management, math skills and taking cooking classes. Fried chicken is her favorite dish to cook. This holiday season, she’ll be rocking around the Christmas tree with fellow singers in the Jane Justin School choir as they present “Rock and Roll New Year’s Eve.”

As manager of Cook Children’s Volunteer Program, Marie Howell interacts with many of the Jane Justin School students and interns and says the departments and people who host them often learn as much from the interns as the interns learn from them.

“Our interns show us how to be understanding and empathetic, and how to tailor opportunities to the abilities that the person has,” Howell said. “We have a lot of people with different kinds of challenges, but there is a place for everybody. There's a task for everybody. It's just a matter of finding the right fit.”

Coaches of Confidence

All of the student interns are led by Jane Justin School job coaches. Together they help shepherd the students in their various roles and act as liaisons between the interns and their department managers.

“We go to the job with them, so we're just there basically as a support and to train them on those basic job duties,” said Courtney Galindo, Jane Justin School job coach. “Our main goal is that we can kind of transition out and that they're able to be independent in their job. We want to get them to that point. Eduardo is now an actual hired employee, which is amazing. He's the first one that we've had get to that point.”

The job coaches are key to the students’ success. Without them, says James-Kelly, students like Eduardo, Harris, Pollack, Washington and Dilworth wouldn’t have the opportunities that are presented to them.

“The contributions of our job coaches in the lives of these students are invaluable,” she said. “We have three incredible professional women who work alongside every single student that we serve in our school and help them achieve their goals with respect to their career and post-secondary education. That is a lot for three people but they do it with such grace and professionalism. They create a bond with our students that really helps to garner trust, not only within our community of families we serve, but within every organization that we enter.”

This job, Eduardo says, is an opportunity he never thought possible. He hopes his success will inspire others and pave the way for his classmates to use their skills and talents to achieve personal success while contributing to their communities and workplaces.

James-Kelly couldn’t agree more.

“The restoration of hope and the understanding that it is okay to want and expect more for your child is the best gift we can offer the families we serve,” James-Kelly said. “Eduardo’s story is a great example of this and I hope it inspires more like it in the future.”

Football players and cheerleaders surprised patients in multiple departments at the Fort Worth Medical Center to spread some holiday cheer. Everyone was so excited to greet the team, especially after their Thanksgiving Day win against the New York Giants!

Each child receives a stocking loaded with goodies from the Dallas Cowboys and a special toy provided by the UnitedHealthcare Children’s Foundation.

Under the guidance of Mrs. Gene Jones, the entire Cowboys team has conducted annual holiday visits to local children’s hospitals for the past 35 years – a very special tradition that we are all grateful to experience.

Media partners may use this content for news stories and broadcasts with credit to Cook Children's.

Iann Ledesma spent nearly half of his first year of life in the Neonatal Intensive Care Unit (NICU) at Cook Children’s Medical Center in Fort Worth. For 193 days, his mother, Giselle, rarely left her son’s side. Having had two previous miscarriages, she relished every moment with her newborn, not knowing if her baby would live to be held again.

“It was challenging since I had previous miscarriages,” Giselle said. “With my first baby, he was a 16-weeker, he just passed in my hands. So it was challenging for me to hold Iann when he was very tiny because he would give me flashbacks.”

Even so, Giselle says holding him was a dream come true.

Iann was born prematurely at just 22 weeks, which is considered the edge of fetal viability. As the only Level IV NICU in Tarrant County, Cook Children’s is equipped with the highest level of neonatal care available. Families with critically ill or premature babies come to Cook Children’s from all over the city, region, state and beyond when their infants need complex care.

However, the unit is bursting at the seams.

As recently as September, 102 of Cook Children’s 106 NICU beds were filled—an unprecedented level of demand that shows no signs of easing given Fort Worth’s population boom. Cowtown is now the 12th largest city in the United States, with 59 people moving to the city every day. As Fort Worth’s population grows, so does the demand for pediatric critical care.

Big Growth Fuels Big Plans

Cook Children’s Medical Center has been a fixture in Fort Worth and a trusted leader in pediatric health care for 106 years, consistently rising to meet the needs of the children and families in the communities it serves. To keep pace with current and projected growth in the area, the health system is preparing to meet the moment once again by embarking on a 10-year master plan to expand and enhance its Fort Worth medical center.

“Our place in this world is to be there when kids need us, and to provide that necessary support for that family and that child so that they’re able to have as productive of a life as they possibly can,” said Stan Davis, president of Cook Children’s Medical Center. “So the belief is we do that by having the facilities, having the physicians and caregivers, having the technology, but also having the heart and the commitment of our community and our team to be able to do that when it’s necessary. That’s why we’re here. We stand in the middle of being able to and not being able to provide that necessary critical care.”

The plan includes a new 700,000-square-foot medical tower, known for now as the West Tower, which will add another signature blue peak to Cook Children’s flagship campus and Fort Worth’s skyline. It will be a seamless extension of the existing medical center, connected both above and below ground, and make way for an expansion of the NICU with an additional 37 beds. It also allows for an expansion and redesign of the Pediatric Intensive Care Unit (PICU), and increases capacity for Hematology/Oncology services and research, as well as additional operating rooms and imaging services.

“We have capacity issues in these areas we’re expanding,” Davis said. “We, unfortunately, from time to time have had to divert kids to other places as far away as San Antonio, Oklahoma and Louisiana. We feel like we provide the best care possible for the kids in our community. In order to do that, we need to have the facilities and the accommodations to keep kids here and close to their home.”

Giselle and her husband, Franco, live in Arlington. She says having access to Cook Children’s expert level of care and technology close to home gave them hope for Iann’s future.

“At the beginning, we didn't know what to expect from Cook Children's, to be honest,” Giselle said. “But now I can tell you that if they didn't have a bed for Iann, I would feel hopeless, because I know from my experience that's where miracles happen.”

Connecting the Dots to Peaceful Healing

Much like the NICU, the PICU is experiencing ever-growing patient volumes. During busy sick seasons, it’s not uncommon to see 500 to 600 patients in a single day in the Emergency Department (ED), with many requiring admission to the PICU. Respiratory illness is the top driver of PICU admissions, followed by neurologic injury and disorders of the endocrine system.

“If we don’t have adequate beds in the PICU, kids end up waiting or being held in the ED, which is not the ideal environment for them. They need to be in that critical care environment,” Davis said.

But Cook Children’s isn’t just building to increase bed space. It’s evolving, innovating and advancing to connect the dots between health care delivery and an enhanced patient and family experience.

The medical center’s current 20-year-old ward-style PICU, where nothing more than a curtain separates patient beds, is no longer conducive to the type of experience Cook Children’s believes in giving patients and families. One that balances expert medical care with the creature comforts that support healing of the whole person. 

For example, children in neighboring PICU beds and their families often absorb the sights, sounds and intensity of another child’s situation, especially when there is an emergency. In an already high-stress and emotionally charged environment, this can be a source of increased anxiety and fear for patients and families.

The redesigned PICU will feature 56 private rooms where patients can heal peacefully. Plans call for ample natural light in each room to aid in sleep cycles and support the mental health of patients and their families.

“One thing that always gets asked of me is ‘Are we building for the future?’ Yes, we are,” said Spencer Seals, Cook Children’s vice president of Construction and Real Estate. “While this tower is over 700,000 square-feet, we have about 160,000 square-feet of shell space. What that means is, as we’re going through the programming of everything that has to go in this tower for this campus, we want to make sure that we have the ability to continue to expand services and continue to serve that growing population in Fort Worth.”

Big Steps for Iann and Cook Children’s

Just as Cook Children’s takes a big step forward in its growth, Iann is making significant strides towards his future, too. Now 19 months old, he’s crawling and pulling up to stand. He’ll be walking in no time, his proud mom says.

“It's just been amazing that he's getting things done, but it's on Iann's timing,” Giselle said with a chuckle. “We learned that from the beginning.”

As Iann continues to make progress at his own pace, Cook Children’s is advancing with a similar sense of purpose—one that ensures every child will have access to the care they need when they need it most.

“It’s an ambitious plan, but it’s exactly what we need to support the growing population and demand for services in our area,” said Rick W. Merrill, president and CEO of Cook Children’s Health Care System. “Kids and families rely on us, and have for more than a century, and we want to make sure we’re in a position to continue to be a beacon of hope, where every child receives the care they deserve now and for generations to come.”

About Cook Children's

Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health.

Based in Fort Worth, Texas, we’re 10,000+ dedicated team members strong, passionately caring for over 2 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation. In 2024, Forbes named Cook Children’s the top health care employer in the U.S., and third on the list of ‘America’s Best Large Employers.’

And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect—with an extra dose of magical wonder.

Discover more at cookchildrens.org.

The report, released today, analyzed data from 108 children’s hospitals and surveyed thousands of pediatric specialists.

The following Cook Children’s specialties were named among the top programs:

·         Pediatric Behavioral Health – Top 50

·         Pediatric Cancer - #37 in the nation

·         Pediatric Cardiology - #37 in the nation 

·         Pediatric Endocrinology - #44 in the nation

·         Pediatric Neurology and Neurosurgery - #45 in the nation

·         Pediatric Orthopedics - #24 in the nation

·         Pediatric Pulmonology - #48 in the nation

This is the first year for U.S. News & World Report to include Pediatric Behavioral Health as “Top 50” programs and Cook Children’s was named to the inaugural list. Other highlights include Cook Children’s Cardiology jumping to #37 and Cook Children’s Orthopedics moving an impressive 16 spots in the rankings, from #40 last year to #24.

“We’re thrilled to see our Pediatric Behavioral Health services recognized on a national level,” said Kia Carter, M.D., co-medical director of Inpatient and Consultation Liaison Psychiatric Services. “Our team's expertise in child and adolescent mental health is unparalleled. These rankings reflect our commitment to providing evidence-based care that empowers young people to thrive.”

U.S. News & World Report evaluated children’s hospitals based on a variety of factors, including quality of care, clinical research programs, services and surgeries performed, patient and family involvement and access to resources, staff dedication, recognition as a Nurse Magnet Hospital, and more.

For Cook Children’s Health Care System as a whole, the rankings highlight longstanding excellence in a variety of areas. 

"It's a tremendous honor to be recognized by U.S. News & World Report once again," said Rick W. Merrill, President and CEO of Cook Children's. "This recognition is a testament to the exceptional work of our doctors, nurses, and staff, who consistently strive to provide the best possible care for every child, every day. Our dedication to our promise and values, combined with our strong culture, sets us apart, and we're proud to be named a top children's hospital."

Vivienne Molen, a 15-year-old with type 1 diabetes, is one of thousands of children who rely on the Cook Children’s Health Plan (CCHP) for life-saving treatment. Now, she is at risk of losing insurance coverage for the care she needs.

On March 7, 2024, CCHP was denied a new contract for STAR & CHIP Managed Care Services by the Texas Health and Human Services Commission (HHSC). Though CCHP’s initial protest to the state’s decision was rejected, the team has filed another appeal and continues to fight for a contract renewal.  

If not reversed, this ruling will result in a serious disruption in care for nearly 125,000 low-income families, pregnant women, and medically complex children like Vivienne. 

Vivienne's Story 

In December 2019, when Vivienne was 10 years old, she became critically ill with both the flu and strep throat. When she wasn’t responding to typical treatments, her mother, Tricia Moon, brought her to the emergency room. From there, Vivienne was rushed to the ICU, where she was diagnosed with type 1 diabetes. “It was confusing, scary and overwhelming,” Tricia said. “Vivienne’s care became quite complex.”

When Tricia went through a divorce, she and Vivienne lost their health insurance coverage. Since then, they have been members of the CCHP STAR Medicaid plan. 

“Insulin is so expensive and we are so grateful that it’s covered under the STAR plan,” Tricia said. “We’ve always felt supported. I think it would just be terrible [if the new contract is denied].”

For Vivienne, getting diagnosed with type 1 diabetes was life-altering. Her chronic health issues have robbed her of the opportunity to be a normal teenager, but she has found a safe space in Cook Children’s. 

“I always love coming to Cook Children’s and I look forward to coming to my appointments,” Vivienne said. “It is the one place where I feel like I can try to gain control of my diabetes.”

Vivienne’s robust care plan involves seeing numerous specialists and getting labs and scans on a regular basis. She also frequently visits the emergency room. 

“I couldn’t imagine the stress it would put on my family, my mom, to have to pay for everything,” Vivienne said. 

As Tricia reflects on Vivienne’s journey, she becomes overwhelmed with emotion. 

“Vivienne is so resilient,” Tricia said. “She should never ever have to worry about how the adults in her life are going to care for her. That responsibility is not hers to bear.” 

What's at Stake  

Vivienne and other STAR and CHIP members could not only lose their health coverage, but also the vital support of their case managers. 

The CCHP case management team helps members in countless ways, from connecting them to food and transportation resources, to coordinating appointments and follow-ups, to ensuring they receive the medications they need.  

“Our health plan staff is very knowledgeable about the programs and resources in this community. They know how to access those services and get things for families that they need,” said Vivienne’s case manager, Jami Jensen, RN, CCM. 

If the STAR and CHIP contract is ultimately denied, more than one hundred thousand members and children could be forced to switch health plans, find new in-network doctors, and undergo lengthy authorization processes for life-saving treatments. 

“There could be issues with getting the care they need in a timely manner,” Jami said. “It’s just added stress on them, trying to navigate something from the start when there were services already in place that they were happy with.”

Without the STAR and CHIP programs in place, CCHP would likely become unsustainable—and Jami, along with hundreds of other CCHP employees, could lose their jobs. 

“I want to make sure these families get the things they need for their health, and I have a lot of experience and skills doing that,” Jami said. “Not being able to continue to help would be hard.”

What's Next? 

The current CCHP STAR and CHIP contracts will remain active through Aug. 31, 2025. At that time, families currently enrolled in CCHP will be forced to choose a new plan from four national, for-profit insurance companies— Aetna, Blue Cross Blue Shield of Texas, Molina, and UnitedHealthcare—three of which have no experience in our local market. Until then, CCHP will continue to appeal the state’s flawed decision.

“We’re putting our money back into the community, and we feel like that is what makes us different from the national companies,” said CCHP president, Karen Love.

Love is ready and willing to compete with other plans in the area, as long as families continue to have meaningful options. 

“This is not about money for the system. This is because Cook Children’s Promise is to care for every child who needs us,” Love said. “This is a fight for the children in our community, to make sure they still have access to the high-quality care that we provide.” 

For more information, including key facts, videos, photos and recent media coverage, please visit SaveCookChildrensHealthPlan.com.  

Newsweek, in collaboration with Plant-A Insights Group, conducted a large-scale employer study to recognize the nation’s top workplaces. The study encompassed over 1.5 million comprehensive company reviews from more than 250,000 employees, showcasing the best places to work across all industries in the United States.

“Being named one of the best workplaces in America by Newsweek is an incredible honor and a testament to the unwavering dedication of our remarkable team at Cook Children’s,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “Our employees are the heart and soul of this organization, and their compassion, resilience, and commitment to our Promise inspire me every day.”

The selection process for America’s Greatest Workplaces 2024 involved a rigorous five-stage evaluation. Initially, HR professionals were interviewed to identify key drivers of employee satisfaction. Following the interviews, a main employee survey gathered reviews from U.S. employees familiar with their employers. Additionally, an elaborate desk research project was conducted, collecting 15 KPIs relevant to a great employee experience, including social media reviews and information on corporate culture, work-life balance, and career opportunities.

“Finding a great workplace is an important decision that needs to factor in pay, respect, training and advancement as well as healthy work-life balance. Newsweek and market-data research firm Plant-A Insights are proud to publish ‘America’s Greatest Workplaces 2024,’ the second annual ranking that highlights companies which are committed to offering a positive and supportive working environment,” said Nancy Cooper, Global Editor in Chief of Newsweek.

Fostering a Nurturing Workplace and Exceptional Patient Care

In recent years, Cook Children’s launched several initiatives to uphold these gold standards, ensuring a healthy and happy workforce.

Through internal surveys and listening sessions, Cook Children’s identified burnout among employees at all levels and responded by implementing programs aimed at reducing stress and supporting employee well-being both on and off the job. This approach fosters a culture where employees feel like family and are encouraged to see the world through the eyes of others, be it patients, family, or staff.

Employee feedback has been instrumental in developing initiatives such as Employee Resource Groups, which support the diverse faces and voices within the organization. Cook Children’s comprehensive employee benefits includes primary care and mental health counseling for staff and their families, tuition reimbursement for career development, and expanded parental leave.

These efforts are designed to connect the dots for employee well-being, facilitating the delivery of safe, kind, respectful, collaborative, generous, and imaginative care to patients and their families.

“We have always strived to create a supportive, family-like environment where every employee feels valued and included," said Mr. Merrill. “This recognition reflects our collective efforts to make Cook Children’s not only a place of healing and hope for children but also a nurturing workplace for those who devote their lives to this vital mission. Thank you to each and every one of our employees for making Cook Children’s such a special place.”

For Immediate Release
June 26, 2024  

Fort Worth, Texas - Cook Children’s Health Plan today announced it is taking legal action to stop the flawed process that led to the Texas Health and Human Services Commission (HHSC) taking away Cook Children’s longstanding contract administering Medicaid to local families. Cook Children’s has successfully run the Medicaid STAR and CHIP program for more than 20 years and has provided more than $200 million in charity care and other community benefits out of its own pocket to families not covered by Medicaid.

“The State got it wrong, and we are asking the courts to make it right,” said Karen Love, President of Cook Children’s Health Plan. “We have taken such good care of our Members for so many years because we live here, and they are our neighbors. We genuinely care about them. And our providers know them by name. Now, thanks to a flawed process that did not follow the guidelines set by Texas law, these families will be at the mercy of national for-profit insurance companies.”

The HHSC process was deeply flawed and failed to follow the law requiring it:

• Recognize and give preference to health plans with long and successful track records of facilitating care for the children and mothers in our community and with ties to charity care providers.
• Give weight to health plans that provide care to special populations like children.
• Consider how continuity of care would be impacted, as well as costs to the state.

Finally, HHSC did not go through the proper rulemaking process for making critical changes to the Request for Proposal (RFP). Their scoring was riddled with mistakes, and they gave one of the winning bidders an unfair advantage by prematurely disclosing copies of its’ competitors’ proposals.

Cook Children’s has filed a Petition for Declaratory Judgment and Injunctive Relief against HHSC Commissioner Cecile Erwin Young. This is the lawsuit to overturn the decision. In the meantime, Cook Children’s has also filed a Temporary Restraining Order request to stop HHSC from finalizing its procurement results. Both actions were filed in Travis County.

Cook Children’s also filed a protest of the STAR Kids RFP to stop HHSC from making the same mistakes it made in the STAR & CHIP RFP and from taking away options from the kids who need help the most.

“These actions we take are strong but necessary,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “For more than 20 years, Cook Children’s has set the standard for serving Medicaid families in outstanding fashion. Our reviews from our Members are always high. And we go the extra mile to cover costs they can’t. There is zero chance that a national for-profit will care about these patients the way we do.”

For more information, including key facts, videos, photos and recent media coverage, please visit SaveCookChildrensHealthPlan.com.  

Patients and families putted their way through whimsical courses inspired by the Lion King, Willy Wonka's Factory, a construction zone, and a speedway. Teams from Volunteer Services, the Linbeck Group, and Child Life designed each course and helped patients through the putting green.

Adding to the excitement were four professional golfers from the Charles Schwab Challenge, happening this week at The Colonial. PGA players Tom Hoge, Tom Whitney, Austin Smotherman, Paul Haley II and Mac Meissner were on hand to meet patients and bring some cheering to the competition.

And keeping with the lighthearted theme, each hole has a bedpan at the end – that’s why it’s called the Bed Pan Open!

Texas Health and Human Services made a concerning decision recently. It announced its intent to award contracts in our area to four national, for-profit insurance companies through a questionable bidding process. Shockingly, it did not renew Cook Children’s Health Plan, despite our 20-year record of excellence serving our community. This disrupts a vital system, without any explanation or justification. 

For over a century, Cook Children’s has been a pillar of our community. We’ve grown alongside generations of families, weaving a promise of exceptional health care into the very fabric of our city. That promise is clear: Every child, especially those most vulnerable, deserves the best possible care, delivered with both excellence and compassion.

Our strength lies in our integrated pediatric health care system, a model of efficiency that provides children and families with a seamless experience. From preventive care to emergency and specialty medicine, all the way to home health, our system offers everything a child might need. The Cook Children’s Health Plan, a vital component of our system, serves families enrolled in Medicaid and the Children’s Health Insurance Program, or CHIP. This integrated design, admired by health care leaders across the nation, ensures smooth coordination between all our services, ultimately leading to the best possible outcomes for our young patients. 

There is more reason to be concerned about Texas HHS’ decision. The Texas Tribune reported that the re-contracting process was deeply flawed, with Aetna receiving advance copies of proposals from 17 competitors, including ours, likely. This gave Aetna an unfair advantage and demands a swift correction from the state.

Beyond the procedural problems, the decision itself is devastating. It robs hundreds of millions of dollars from our communities, and places those checks in the pockets of out-of-state corporate shareholders. This isn’t just about paperwork; it jeopardizes the well-being of 125,000 children and mothers, including over 170 ventilator-dependent patients who rely on our seamless care. The impact goes far beyond Tarrant County — it affects 1.8 million children and expectant parents across the state, according to The Texas Tribune. 

For more than two decades, Cook Children’s Health Plan has been a trusted and proven model for managing care. We urge the state to reverse its recent decision to ensure Cook Children’s Health Plan, along with other qualified plans, can continue seamlessly serving our communities and caring for our most vulnerable children and families.

Without the health plan, our ability to deliver exceptional care across the system will be crippled. Children relying on Medicaid would be disproportionately impacted, left vulnerable and more at risk. 

I want to share a few facts and scenarios with you that might help paint this picture more clearly: 

• In our service area alone, more than 75% of the children and mothers on Medicaid will be forced to switch plans, causing an unnecessary shift in care, and this is on the heels of the unwinding of the pandemic and the disruption these families have already experienced with re-enrolling in a health plan. 
• Imagine the chaos this change will cause for the family of a child with complex medical needs on a ventilator and in a wheelchair — being forced to find new doctors, new in-home therapy and nursing, and a whole new system to navigate. If you’ve ever been frustrated trying to obtain a simple pre-authorization for a routine surgery, imagine that frustration tenfold. 
• We are passionate about and uniquely equipped to serve our community. Every year, Cook Children’s provides more than $200 million in community benefits and uncompensated care to families in need. 
• We reinvest our dollars back into countless programs like our Neighborhood Health Centers in underserved areas rather than for-profit shareholders. Our upcoming ninth center in the Las Vegas Trail area will be another beacon of hope for families struggling to access quality care when it opens next year. 

This fight is for our children, for a system that works, for stability, and for the health of our community and the promise we have made to every child. We have the facts on our side, and we will not give up on the families who need us most. This is about protecting a legacy built on decades of trust and data-driven results. 

Texas HHS, it’s not too late to do the right thing. Let Cook Children’s Health Plan continue to coordinate and manage the care for the children and families who depend on us. 

The health and well-being of our children depends on a proven and trusted system, not a gamble on the unknown.

At the beginning of this year, Catie Pulsifer, RN gave birth to the first set of quadruplets Cook Children’s has seen in over a decade. Catie is a Psychiatric Nurse in the Behavioral Health Unit at Cook Children’s, making this extraordinary event all the more special for everyone at the hospital. 

While she was in the NICU with the quads, Catie would often run into her coworkers in the hallways. 

“They were all so sweet and supportive,” she said. “A lot of them gave us their hand-me-downs and sent things from our registry.”

The Pulsifers' Journey

Catie and her husband Cameron already had two children—3-year-old Allie and 5-year-old Robin—when they decided they wanted a third. On July 4, 2023, the pair discovered they were finally expecting.

When Catie went to her first ultrasound, her scan showed not one, not two—but five gestational sacs. Cameron was out of town on a work trip during the appointment, so Catie had him on speakerphone when the doctor broke the news. 

“It was definitely silent on the other end of the line,” Cameron laughs. “We had a feeling we might be dealing with multiples, but we did not anticipate that many.”

After the initial shock passed, the couple was unbelievably excited. Their doctor, however, warned them of the high risk of miscarriage with that many embryos. At around 10 weeks gestation, they lost one of the babies. 

“It was really tough, but I'd had a miscarriage the year before and I think that prepared my heart to know what it felt like,” Catie said. “At the same time, we were just glad we had four that were doing so well.”

Week after week, Catie, Cameron and their doctors continued to monitor the quads, who just kept growing and getting stronger.   

“We celebrated every week that passed,” Catie said. “When I started getting really big and feeling them kick, that was really exciting.”

The Quads Make Their Entrance

Catie was admitted to Texas Health Harris Methodist at 26 weeks gestation so that she and the babies could be under constant observation until she gave birth. 

“That's when it really set in, and I was like, it’s happening! We’re having four kids,” she said.

On Jan. 8, at 30 weeks and one day, the quadruplets made their debut. James was born first, followed by Hannah—the only girl of the four. Next came Mark, thenLogan, the tiniest of them all, came last. All of the babies were born at least two pounds or bigger—a feat Catie had hoped for.  

After they were born, the quads were transported to the Cook Children’s NICU, where they were kept together in a suite known as “The Quad Room.” With a rotating group of nurses assigned to them alone, the four received round-the-clock care and attention. It didn’t take long for them to capture the hearts of the NICU staff. One of their primary nurses, KK Harding, joked that everyone fought over who would take care of the quads each shift. 

“They're so precious,” she said. “It brought us such joy to help this amazing family care for their babies and to help them grow.” 

“Even though I don’t work in this unit, I know firsthand how great the caliber of care is at Cook Children’s,” Catie said. “All of the nurses, doctors, staff, and respiratory therapists made this journey smoother than we could have ever imagined, and we are so thankful the babies could come to this NICU.”

Finally Home With Family

After eight weeks in the NICU, the quads made their way home at the beginning of March. Catie and Cameron transported the babies in their new Sprinter van—the only vehicle that could fit all four of their car seats.  

Catie is happy to report that the babies are doing great and continuing to develop their own distinct personalities. James, who she calls their “little James Bond,” loves being the center of attention. Hannah is leading the pack by being the best eater and sleeper, and Mark, who’s either stoic and brave or pouty, can’t decide what he wants. Logan loves cuddles and is the most pensive of the group—he’s also the tiniest and hungriest, trying to catch up to everyone else’s size.

Though Robin and Allie didn’t realize how much crying they would have to endure, they love being a big brother and sister. They especially enjoy having family reading time before bed and helping mom and dad out with diapers, bottles, and pacifiers.

It’s safe to say the Pulsifers have their hands full. They go through upwards of 64 total diapers and bottles per day, but they have been fortunate to have an outpouring of support from family, neighbors, and their church community. 

The days ahead for Catie and Cameron will certainly be far from boring. At one point, all six of their kiddos will be in elementary school together. Helping just one child through life’s major milestones is a lot for any parent—and the Pulsifers will have four navigating growing pains simultaneously. But if there’s anyone who’s equipped to handle it and ready to enjoy the ride, it’s this family.

“We can't really prepare for it, but the thought of what our life is going to look like is really exciting,” Cameron said. “A little scary, a little nerve-wracking, but exciting more than anything.”

Cases of accidental marijuana ingestion increased again in 2023, a trend reflected in data from the Cook Children’s Emergency Department (ED).

Statistics from the ED at Cook Children’s Medical Center – Fort Worth show 50 patients between ages 0-3 whose urine tested positive for the main psychoactive ingredient in the cannabis plant. Another eight patients in the same age group at the Cook Children’s Medical Center – Prosper ED also had positive screenings last year.

That’s 58 babies and toddlers whose urine contained a molecule called tetrahydrocannabinol (THC), a marker of marijuana intoxication. For comparison, here are the yearly totals for THC-positive urine screenings in patients ages 3 and younger at the Fort Worth ED in recent years:

• 2019: 8
• 2020: 13
• 2021: 29
• 2022: 33

In all those years, the vast majority of patients with THC-positive urine screenings were teens. But there’s a special concern for babies and toddlers because of the drug’s stronger impact on their small bodies.

“Cannabis has the potential to cause significant harm to children in this age range over any other age range. These are the kids who are going to have the most serious side effects,” said Anelle Menendez, M.D., CSPI, clinical educator for the North Texas Poison Center. “It has the potential to cause very significant toxicity in children.”

No amount of marijuana is safe for children. A child who swallows a marijuana product – edibles like gummies or baked goods, or oil from a vaping cartridge – can become extremely sleepy or unresponsive. Their heartbeat could soar. They might struggle to breathe or have trouble crawling or walking.

Calls to the North Texas Poison Center regarding children exposed to cannabis rose more than 1,000% from 2019 to 2023, Dr. Menendez said.

That’s why parents, caregivers, siblings and guests are urged to take precautions with any marijuana in the home. Young children are curious; they put everything in their mouths. They could quickly eat a marijuana-infused candy or cookie they find on a nightstand or in a purse, for instance, leading to an accidental cannabis poisoning.

Klaressa Broughton works to raise awareness in her role as coordinator for the Poison Prevention program at the Center for Community Health, led by Cook Children’s. Broughton said the best safeguard is keeping marijuana out of the home altogether. But if it’s present, keep it locked up, out of reach and out of sight.

“I tell parents to be aware of who’s in their household,” she said. “Do you have toddlers? Do you have teenagers? Keep in mind who’s in your home, and then create a plan to have safe storage instead of leaving those gummies out on the counter.”

March 17-23 is National Poison Prevention Week, which promotes safe use of all drugs, chemicals and products that could be harmful in the wrong amounts. To amplify that message, here’s a closer look at what happens to young children’s brains and bodies from the “high” of ingesting THC.

Get Help Right Away

If a parent or caregiver suspects a child has swallowed an item containing THC, they should immediately seek medical help or call the poison control hotline. The experts who take calls at the hotline will ask how the child is acting and how much time has passed.

“We’re going to go through a thorough evaluation over the phone,” Dr. Menendez said. “What exactly did they get into? How much are you missing?”  Depending on the severity of symptoms, such as seizures, the caller might be instructed to call 911.

“It's going to have a very negative effect on your baby, and it will be one of the scariest moments you ever go through in your life,” she said. “There’s no judgement here; we’re here to help you the best we can.”

She advises adults not bringing marijuana into the home -- or if it’s there, to keep products locked up so that they’re not accessible. Don’t vape, smoke or consume edibles in front of children.

Emergency Care

When children come to the ED with suspected marijuana ingestion, the medical team will do a urine screening for the diagnosis. They’ll monitor the child’s vital signs and fluids, protect the airway, and watch for worsening symptoms. Extra oxygen or a breathing tube could be needed if the patient’s breathing rate becomes short and shallow.

The intoxicating effects wear off usually within about 12 hours. Children treated for marijuana ingestion can typically be discharged to go home from the ED after they become alert, act playful, and resume eating and drinking. High concentrations of THC tend to cause more severe cases, which may require being admitted to the hospital for additional monitoring.

Jamye Coffman, M.D, MPH serves as medical director of the Cook Children’s C.A.R.E. Team, which works to prevent child abuse and neglect. One of the team’s roles is providing medical evaluations for children injured by drug exposure. She’s seen a preschooler wind up on ventilation in the intensive care unit (ICU) from eating just one gummy with a potent THC level.

“A single gummy in the carpet or in the crevice of a couch can be found by a child and be toxic,” Dr. Coffman said.

Even more alarming is the danger of fentanyl ingestion for people of all ages. Dr. Coffman strongly cautioned parents and caregivers to understand that even a small amount of fentanyl can be lethal.

“One pill dropped on the floor or forgotten on a bedside stand could mean the death of your child,” she said. “There are no do-overs. To see a normal healthy child die so needlessly is heartbreaking.  I don’t know how to stress enough the dangerousness of this drug.”

Education and Resources

Poison prevention at Cook Children’s falls under the scope of injury prevention along with gun safety, drowning prevention, safe baby sleep and car seat safety through the Center for Community Health.

“The three things we focus on in my program are Safe Dosing, Safe Storage and Safe Disposal,” Broughton said.

She provides training and teams up with partners such as the North Texas Poison Center and Challenge of Tarrant County. They supply educational materials for events at schools, churches, community centers and other locations. Broughton also distributes resources such as medication lock boxes, cabinet locks and kits for disposing unused medications.  

She said marijuana should always be kept in locked storage because young children are attracted to colorful packaging and the sweet smell of edibles. And if they see a parent consume a marijuana product, they’ll want to try it too. Toddlers can climb onto counters, and it only takes a minute for them to get into something they shouldn’t have, Broughton pointed out. 

What should parents know? “If you choose to use marijuana, keep in mind who's in your home and how to keep your children safe,” Broughton said. “If you do expose them, know what happens and what to look out for.”

If you think your child has ingested marijuana, get medical help or call the Texas Poison Center at 1-800-222-1222. For more information: Marijuana Edibles - Texas Poison Center Network (poisoncontrol.org)

RELATED STORY:

• Statistics from Cook Children’s Emergency Department Show Increase in Marijuana Ingestion Among Children Ages 0-3 (checkupnewsroom.com)

A little over a year ago, Robert and Christina Ryan couldn’t imagine their daughter’s future. They were struggling just to come to terms with her present as their baby lay fighting for her life in the Cardiovascular Intensive Care Unit (CVICU) at Cook Children’s Medical Center - Fort Worth. 

In early January 2023, an illness sent Dorothy “Dottie” Ryan to Cook Children’s Emergency Department where the Ryans learned their daughter’s heart was failing. Dottie was 2 months old at the time. While her illness was brought on by a common cold virus, its severity was exacerbated by a congenital heart defect known as ventricular septal defect (VSD).

A VSD is a hole in the wall between the two lower chambers, or ventricles, of the heart. In the United States, about 1 in every 240 babies are born each year with the defect, making it the most common heart defect in infants, according to the Centers for Disease Control. 

The presence of a VSD allows blood to flow abnormally between the two ventricles, impairing the heart’s ability to pump blood throughout the body and to the lungs. Large VSDs can cause too much blood flow to the lungs, leading to difficulty breathing and fatigue with exertion. 

Because a baby’s greatest form of exertion comes when eating, the presence of a large VSD can lead to poor feedings and inadequate growth. If left untreated, it may also cause irreversible damage to the lungs and to the heart. 

The Ryans knew before Dottie was born that she had a VSD. However, in many cases, the hole closes on its own in-utero or after birth, so they weren’t overly alarmed by the diagnosis. 

But an echocardiogram soon after Dottie’s birth revealed she had not one, but four, VSDs. Dottie would eventually need surgery to close the holes. Over the next few months, Dottie’s cardiologist followed her condition and progress closely, giving her time to grow and develop as much as possible before undergoing a complicated surgical repair.

“Having multiple VSDs is relatively rare, occurring in about 10% of VSD patients,” said Greg Barker, M.D., Dottie’s cardiologist at Cook Children’s Medical Center - Fort Worth. “Often small VSDs will close on their own while large defects need to be repaired. Patients with multiple VSDs often have small defects that ultimately close spontaneously or do not require treatment. So Dottie’s case, with multiple large defects requiring surgical closure, is quite rare, and quite challenging to treat, requiring a very skilled surgeon.”

The Journey to Surgery

The multiple defects meant Dottie’s heart struggled to pump efficiently on a good day. Add to that even a mild cold, like the one that sent her to the Emergency Department in January 2023, and you have a recipe for the heart becoming overwhelmed and unable to pump oxygen-rich blood throughout the body to support healing. Dottie’s heart simply could not cope with the increased workload necessary for fighting infection.  

“So we got admitted into the CVICU and that's when this journey started,” Christina said. “I remember the doctor telling us she’s in heart failure and we need to schedule surgery, but we had to let her get better from the cold first.”

Dottie did get better and was released from the medical center on January 18 to await surgery in February. But two days later, Dottie began having trouble breathing again and the family returned to the Emergency Department. Within 45 minutes of arriving, the Ryan’s baby girl was on a ventilator. 

The culprit this time? Three bacterial blood infections. 

“It was the hardest night of our lives,” Christina said. “But I felt like the team was amazing. Two cardiologists and the ER physician were there. I was so scared, but I was so thankful for that team that was saving her life in front of my eyes. I hope to never be in that situation again, but it was amazing to see all of these people who spend their whole lives saving children like Dottie. That whole night was miraculous.”

Over the next few weeks, Dottie’s condition improved again but she needed to remain in the hospital to continue the intravenous medications that helped fight infection and stabilize her heart. As the days went by, her heart needed more and more support, prompting doctors to schedule her surgery sooner rather than later.

The Best Gift

On the evening of February 22, 2023, which happened to be Christina’s birthday, Dottie’s physicians convened to discuss a surgical plan. That night, Christina took a rare break from the hospital to have dinner with her older children while her husband stayed with Dottie. While at dinner, she received an unexpected call with surprising news that moved her to tears. Dottie’s surgery was scheduled for the very next morning. 

“It was the best birthday gift ever,” Christina said. “To see this whole team of people mobilize 12 hours before surgery was amazing to me.”

On surgery day, many of the cardiac intensivists who cared for Dottie in the weeks prior stopped by the waiting area to visit with the family, with one taking a moment to pray with them. 

“Before they took her away to surgery it just felt like Dottie was so important,” Christina said. “Even though they see hundreds, if not thousands, of kids every year, in that moment they saw so much value in her little body and showed she was worth fighting for. We already knew that, but it was amazing to see these doctors and nurses value and love her, too.”

During the 8-hour surgery, Vincent Tam, M.D., medical director of Cardiothoracic Surgery at Cook Children’s, successfully patched three holes in Dottie’s heart. The fourth, which could not be patched, closed on it own a few months after surgery. 

Dottie spent the next few weeks at Cook Children’s recovering from surgery. Because she stopped taking a bottle or nursing while on the ventilator before surgery, she needed a feeding tube for adequate nutrition. Shortly after an additional procedure to place the feeding tube, Dottie was able to go home in March 2023. 

Little Girl, Big Smile

Although a tiny infant at the time, Dottie made a big impact on the staff at Cook Children’s. She’s known for her smile, even attempting to grin while on the ventilator. 

“As Dottie’s condition improved, we learned her sweet smile and endearing demeanor which made caring for her such a joy,” said Brynli Clayton, BSN, RN, CCRN, CVICU nurse supervisor at Cook Children’s. “Working in a high acuity environment our staff knows all too well the reality of patients who do not get better, which makes the ones that do that much more special. Watching Dottie continue to grow, when she comes by for visits, and hearing updates about her development seals in our minds that the work we are doing matters.”

To celebrate Dottie’s first birthday, the Ryan family collected pacifiers and donated them to the CVICU in recognition of the kindness the family says they experienced at Cook Children’s.

Now 16 months old, Dottie is in full toddler mode and doing her best to keep up with her siblings, 5-year-old Eddie and 3-year-old Lucy. She still requires nutrition support but is learning to eat on her own more and more each day. 

And the future the Ryans couldn’t imagine for their daughter a year ago is now full of hope and as bright as her signature smile.

“Thankfully, Dottie has had an excellent repair,” Dr. Barker said. “While there are still things that we are watching, I expect her to do very well and be able to have a normal, healthy life.”

Through it all, the Ryans learned to cherish the triumphs, no matter how small. 

“I’d encourage other families facing a challenge to find joy in and celebrate the tiny victories because those can give you tremendous hope,” Christina said. “They did for us.”

Cook Children’s Health Care System earned a top spot on Forbes America’s Best Large Employers 2024 list, debuting at No. 3 out of a lineup of 600. The rank acknowledges something we already knew — Cook Children’s is one of the best places to work among all large businesses across all industries nationwide.

Cook Children’s was also named No. 1 in the health care and social industry category among large employers on the list. View the entire list here.

Rankings are determined by a survey of thousands of Americans working for large companies defined as having more than 5,000 employees. The survey was administered by a national market research firm. Respondents remain anonymous and the companies on the list do not pay a fee to be included.

“It’s a huge honor to be recognized in this way on such a national level because it speaks directly to the culture we are working so hard to build here. One where our employees feel valued, supported and connected to our Promise, to our patients and to each other,” said Rick Merrill, Cook Children’s president and CEO. “It’s our people that make this place magical, and now the entire country is getting a glimpse of that magic.”

A number of criteria was used in the survey to evaluate companies, including working hours, gender pay equity, opportunities for training and promotion, workload expectations, parental leave benefits, the degree of diversity on the management team and whether employees would recommend the company to their friends and family, according to Forbes. 

In recent years, Cook Children’s launched a number of initiatives to promote many of these gold standards for growing a healthy and happy workforce.

Healthy and Happy Employees Lead To Excellence

Working in health care can be personally and professionally fulfilling, but it’s no secret that it can also be hard. The COVID-19 pandemic took a toll on health care workers across the globe, and exposed the burnout weighing on physicians, nurses and staff. Several internal surveys and listening sessions gave us a glimpse into the burnout Cook Children’s employees at all levels of the organization were experiencing.

“Our listening strategy is an investment in our people. Honest feedback helps us discover opportunities to improve and helps bring together leaders and teams to collaborate on solutions. No matter what your role is at Cook Children’s, your well-being matters,” said Kathy McLean, Cook Children’s Vice President of Brand and Team Experience.

In response, we are making meaningful changes and developing programs that reduce stress, support employee well-being both on and off the job, and cultivate a culture where employees feel like family.

“When we use our culture to build everything – from system strategies to our day-to-day work – we can deliver care that puts our employees and the children at the forefront of everything we do,” Kathy said.

It all starts with seeing the world through the eyes of others, whether it’s patients, family or staff. This gives our team members a unique perspective on where things are working well, as well as the opportunities for growth. Our employee feedback has been the catalyst for initiatives like the Employee Resource Groups supporting the many faces and voices within our organization.

In all of our employee benefit efforts — from providing primary care and mental health counseling for staff and their families, to supporting career development through tuition reimbursement, to expanded parental leave — our goal is to connect the dots for employee well-being. We know that helps pave the way for the safe, kind, respectful, collaborative, generous and imaginative care of our patients and their families. A healthy, valued and supported workforce allows us all to deliver on our shared Promise of “Everything for the child.”

“You cannot pour from an empty cup,” Megan said. “We believe in protecting the noble profession of caring for others by protecting our staff’s well-being and allowing them the autonomy they need to bring their best self to the job. We have the honor of caring for families, often on their worst day. That can take a toll, and we recognize and support the healing needed to continue to be present for the next situation we will encounter.”

The flu is an infection of the respiratory tract (nose, throat, and lungs) that is caused by a virus. It can spread easily from person to person. Usually during cold and flu season, most children will experience very mild symptoms that normally self-resolve within a few days, said Cook Children’s hospitalist Laura Romano, D.O.

Flu activity is considered widespread in Tarrant County, according to Tarrant County Public Health. This flu season, we are admitting larger numbers of older, previously healthy children with difficulty breathing and flu-related pneumonia at the Cook Children’s Medical Center - Fort Worth, Dr. Romano said.

Most are requiring supplemental oxygen and some require ICU admission. While this has not been uncommon during prior flu seasons, this is now becoming the norm for admissions rather than the exception, Dr. Romano said.

“Overall, it seems that the flu is not going away anytime soon this season,” Dr. Romano said.

From Feb. 4 to Feb.10, out of 1,593 tests conducted, 16% were positive for flu A and 21% were positive for flu B, according to lab data at Cook Children’s Medical Center - Fort Worth.

This is a decrease compared to the prior week (Jan. 28 to Feb. 3), which showed a 22% positivity rate for flu A and 24% positivity rate for flu B.

High Patient Volume

Cook Children’s Urgent Care Centers and the Emergency Department at Cook Children’s Medical Center - Fort Worth are experiencing high volumes from circulating viruses such as COVID, flu and respiratory syncytial virus (RSV).

From Jan. 9 to Feb. 5, Cook Children’s Urgent Care Centers saw 6,806 patients, and the Emergency Department in Fort Worth saw 3,437. These numbers are almost double what they were in early January and leading to crowded medical facilities and long wait times.

On Friday, Feb. 9, our UCCs saw 760 patients in 24 hours and the Emergency Department at Cook Children’s Medical Center – Fort Worth saw 435 patients.

“We are seeing tons of flu,” said Kara Starnes, D.O., medical director of Cook Children’s Urgent Care Centers. “I have three kids of my own, so I know having a sick child can bring some anxiety but, in many cases, children with upper respiratory illnesses like COVID, flu and RSV do just fine being cared for at home and do not require a visit to urgent care or the ER.”

Dr. Starnes says it is safe to manage your child’s symptoms at home as long as they are not displaying signs of respiratory distress or dehydration. Reserving visits to urgent care or the emergency department for truly urgent needs will help reduce wait times, conserve resources and limit your child’s exposure to other viruses.

Signs and Symptoms

COVID-19, flu and RSV are caused by different viruses, but all are upper respiratory illnesses that share similar symptoms such as:

• Fever
• Cough
• Fatigue
• Sore throat
• Runny or stuffy nose
• Muscle pain and body aches
• Headache
• Vomiting and diarrhea
• Loss of appetite, taste or smell
• Shortness of breath

Managing Symptoms

There are a few things you can do to keep your child comfortable while the illness runs its course.

Over-the-counter medications such as ibuprofen and acetaminophen can help reduce fever, aches and pains. Ibuprofen should not be given to infants younger than 6 months.

A fever is defined as a temperature of 100.4 or above. A temperature above 100.4 in babies less than 2 months old is a medical emergency and needs to be evaluated in the emergency room. Any fever lasting longer than four to five days, or one that continues to climb and does not break with fever reducers, should be evaluated by a physician. Otherwise, it’s safe to manage fever at home.

Keep your child hydrated by encouraging fluids every few hours. Electrolyte drinks can be helpful if you suspect your child is dehydrated or at risk of becoming dehydrated. If they aren’t interested in drinking, have them suck on a popsicle.

To help reduce congestion, keep the sinuses moist with saline drops and a cool-mist humidifier. This is especially helpful during sleep times.

If your child appears to be in respiratory distress or severely dehydrated, it’s time to go to urgent care or the emergency department.

●      Signs of respiratory distress:

• Increased number of breaths per minute
• Increased heart rate
• Bluish color around the mouth, on the lips or on the fingernails.
• Pale or grayish skin
• A grunting sound during exhale
• Nose flaring
• Chest appears to sink in with each breath
• Head bobbing when breathing in
• Change in alertness

●      Signs of dehydration:

• Urine output significantly below the child’s normal (Your child should be producing urine at least once every 8 hours.)
• Not producing tears when crying and eyes appear sunken
• In infants, the soft spot on top of their heads looks sunken
• Dried mucus membranes (lining within the nostrils, mouth, throat, ears, genitals and anus)
• Sleepy and unresponsive