Today, Dr. Marks looks back at that time as “an interesting diversion,” but it really helps explain who the man really is. After all, he’s built one of the nation’s most highly successful comprehensive clinical centers for pediatric movement disorders.

Dr. Marks, who is one of the first two Endowed Chairs at Cook Children’s, has molded a program where Cook Children’s deep brain stimulation serves as the centerpiece.

Most recently, Dr. Marks has seen the end of years of work with the addition of Cook Children’s Motion Lab, which sees children, teens and young adults who have a variety of complex movement disorders, including cerebral palsy, dystonia and traumatic brain and spine injuries.

He just keeps on adding to a legacy where he has brought together the most advanced technology with a kid-friendly atmosphere.

When he was a kid, Dr. Marks loved science and became fascinated with the brain and how it works. When he entered Texas Christian University, Dr. Marks considered a career in chemistry, earning a Bachelor of Science degree from TCU, and then he took that year to pursue architecture.

But once he entered Texas Tech University School of Medicine, Dr. Marks’ life’s work began to take focus. During his training he returned to studying the brain and found he had no choice but to make his career helping children.

“I always liked it that if you are going to do pediatrics, you know it up front,” Dr. Marks said. “If you look at the personality inventory of pediatricians, they don’t look like the rest of the physicians, they look like social workers. I talk to medical students when I have them over at the office and the ones that are going to go into pediatrics have no doubt that’s what they are doing. The ones who have hesitation about it are usually not destined to go into pediatrics.”

Dr. Marks joined Cook Children’s in 1988 and today serves as the medical director for the Movement Disorder and Neurorehabilitation Program.

Dr. Marks said he loves the multidisciplinary approach he finds at Cook Children’s, often working directly with rehabilitation therapists, orthotists, neurosurgeons, orthopedists and others. He has developed several multidisciplinary rehabilitation teams, including the transitional care unit, and specialized multidisciplinary clinics that have been developed for children with spasticity, movement disorders, and neuromuscular disorders.

“You have different people coming from different backgrounds,” Dr. Marks said. “Everybody’s perspective is different and we are all bouncing ideas off one another. It’s one of the great things about Cook Children’s.”

Dr. Marks said that team approach creates better care for patients. He said the goal of the neurology team at Cook Children’s is not just to treat children or find a quick fix, but to make their overall quality of life better. He calls this an exciting time for the Neuroscience Program at Cook Children’s, exploring new and innovative approaches to complex patient issues such as movement disorders and epilepsy.

“We are doing as much as anybody and more than most in the country when it comes to improving children’s lives,” Dr. Marks said. “We continue to expand our offerings. We continue to push the limits of treatment. In the future we will have the ability to treat more children and more complex neurological diseases and make them even better. I’m really excited about our ability to bring these new and innovative approaches to solving some very complex issues.”

During his tenure, Dr. Marks remembers fondly certain patients and how to see their lives dramatically impacted. He recalls sisters he treated who went from being bed ridden to being in wheel chairs to dancing at their senior prom and eventually getting married, leading normal and productive lives.

“Those are the stories you look back and say, ‘Man was I lucky.’ You found the magic key for those kids.”

An early advocate for distraction osteogenesis in the facial skeleton, he helped to develop one of the first multi-planner devices used for lengthening the mandible in children. After a brief surgery, the device is used to slowly lengthen bones that are congenitally too small. Over the course of two weeks, daily adjustments actively stretch the native structures so that new bone and soft tissue can be created as the surgeon works to restore facial balance and harmony.

Dr. Hubli has crisscrossed the globe in the name of craniofacial and cleft care, operating and educating from Brazil to Romania and from Finland to Saudi Arabia. He has been asked to speak on the topics of quality in medicine, craniofacial and cleft care and enhancing patient satisfaction at sites, including Harvard University and the Mayo Clinic. His work has been featured on the Oprah Winfrey Show and in Parade Magazine.

But Dr. Hubli is known for more than his skill as a surgeon. It’s the approach to the way he cares for “his kids” that makes him special.

“When I meet new families I like to joke with the moms and dads and tell them, ‘Now, these are my kids too,’” Dr. Hubli said. “I have two wonderful kids of my own. These are my extra kids, my extended family if you will. When I offer advice to parents or make medical or surgical decisions for my patients, I make the same decisions based on what I would do for my own child and trust me … I love my children dearly.”

Dr. Hubli has two children – Alexander, 17, and Sidney, 12, -- and has been married to Joni for 26 years.

It was Dr. Hubli’s brain that Joni says first attracted her to him. No so much his intelligence that would make him a world-class craniofacial surgeon, but his sense of humor.

“He likes to make everybody laugh,” she said. “He’s always been that way. I liked him the first time I met him. He had a great sense of humor. It helps him as a doctor, especially treating children and talking to parents. He has a way of lightening up a situation and that helps them to feel good.”

Dr. Hubli has a unique reason as to why he relates well to his patients – he was once in their shoes. As a child, Dr. Hubli spent many hours in a hospital while he was a youngster in Connecticut. He suffered from complications due to allergy induced asthma.

Things were different back then. Parents were only allowed to visit for a couple of hours a day and there were no parental overnight stays. A week-long stay in a cold-multi-bed pediatric hospital ward left a lasting impression on a 5-year old mind. The facilities were grim, but Dr. Hubli found that the caregivers, the doctor and staff could be rays of sunshine when times were trying. Joni believes that’s what led him into a career as a physician.

And what made him work with kids? More than anything else, Dr. Hubli simply wants to repair a child’s face so he or she can smile. After all, smiles and laughs are so important to the self-professed clown.

Watch him walk down the halls of the medical center and you’ll see him stop and joke with almost anyone he sees, especially the children. Maybe, it’s because he identifies with their sense of humor.

“Pediatrics is a perfect fit for Eric because he can still see the lighter side of life,” Joni said. “Like a kid, he looks to have fun in everything he does and that makes him fun to be around. He has a saying, ‘I have to grow old, but I don’t have to grow up.’ He’s a great doctor and very skilled, but he is not afraid to let his silly side out. We were talking at lunch the other day and he said, ‘Our 12-year old daughter is more grown up than I am.’”

But make no mistake; Dr. Hubli takes his career and the kids he cares for seriously. For him craniofacial and cleft surgery is not just a job, it’s a vocation. Joni will tell you that “he takes his work home. He still studies, he still reviews, he challenges himself to be better every case and we see the distracted dad at home sometimes because he’s thinking about a patient.”

His dedication is energized by the strength of his patients and their families whom he calls “an essay in courage.” Dr. Hubli thought of becoming a priest as a teenager, but felt a stronger calling to becoming a physician. Either way, healing was the goal.

“Would that all of us have the same grace as these kids do! I don’t know if I would,” Dr. Hubli said. “But wow, these kids are cool. If you don’t believe in God, take a look at the kid next to you. It’s a miracle. It’s beyond my comprehension. You can talk to me about DNA and all the wonders of science, but how did these little strands make all of that? I have the degrees. I’ve taken genetics. I’m an educated person. But I say, ‘That it’s still a miracle.’”

Dr. Hubli’s surgical work on children varies. At times, he may be preventing a speech impediment that will stop a lifetime of being made fun or getting bullied. At other times, it’s a matter of performing a surgery that saves a child’s life by giving him or her opportunity to eat or breathe properly.

“Each case is unique because each child is unique. It’s not because of what they look like or why I’m seeing them, but because of who they are,” Dr. Hubli said. “Regardless of the child, the surgical goal is always the same. If I’m successful, their life truly becomes their own to mold and make. Their potential and their future are in their own hands.”

And many times, he’s performing that surgery with Richard Roberts, M.D., a neurosurgeon at Cook Children’s.

“I love working with Eric. We have a great friendship and work well together,” Dr. Roberts said. “The days that we have surgery together are among my most enjoyable. He is a funny guy and great entertainment, but when we step in the operating room it becomes all business. We share a common goal of trying to do the best for the children and we both carry that attitude through surgery until we’re finished.”

So you have two sides of Eric Hubli. The funny guy with hyperactivity issues (his word) … and the other guy, who happens to be a brilliant surgeon.

“I love having fun. In general, I think we all take ourselves too seriously,” Dr. Hubli said. “Don’t get me wrong. This work is not a game and I’m wholly committed to what I do. I work hard and I take my job very seriously. That said, there is healing in humor. I want what’s best for the children I care for, but that’s the thing, they are children and we are a children’s hospital. We should have fun so that our kids, our patients, can have fun even when what we do is some of the most serious and important work that you will ever find.”

There is no single criteria that makes a person eligible to lead. Education, job title and seniority can all be a start to establishing a role as a leader. But sometimes, the best leaders aren’t the highest ranking of any of the three. Today we are going to talk about leading when you are starting your career and how an early-career physician can develop leadership skills when they are not the most senior physician on their team.

Today’s guest is Matthew Carroll, M.D. He is a pediatric hospitalist at Cook Children’s and serves on Quality Improvement/Practice Management. Prior to coming to Cook Children’s, he served as the chief resident at Cincinnati Children’s Medical Center.

Questions to work through on the topic:

• What do you think are some personality characteristics that allow you and other young physicians to find roles within leadership?
• How big of a factor is the institutional culture toward the ability to develop young leaders?
• How do you see medicine changing now and as we go into the future?

Ways to listen:

• Listen on Soundcloud
• Subscribe for series on iTunes
• Download/Listen to MP3

With the rates of burnout and suicide in physicians at shocking levels, it’s important that we continue to talk about the satisfaction and mental health of physicians. There are systemic issues at hand that lead to the situation that we are in. In her article “Physician burnout is physician abuse” for kevinmd.com, Dr. Pamela Wible has said that, “Burnout is physical and mental collapse caused by overwork. So why are we blaming the victims? The fact is medical students and physicians are collapsing because they are suffering from acute on chronic abuse.”

There are systemic issues that lend itself to the state that we are in. Many physicians are over-worked and over-stressed. And, it’s not just the grisly 30-year career doctor who is tired that feels burnout, medical students report high levels of emotional exhaustion as well.

There are various numbers in studies but the most recent available studies show symptoms of burnout in 40-50 percent of respondents. It’s a shockingly high number, especially those on the outside looking in. Doctors often appear to have it all together and they can make a great living.

So what’s there to be dissatisfied about? It’s not that simple. Demands to see more patients, giving up less control of our lives and other factors can make what should be a rewarding profession very frustrating.

All this is true and we need to continue to talk about it and continue to search for systematic changes that can lessen the burden on physicians

But, I love my job.

I love going to work every day.

I love the deep relationships I have with my patients and their families.

I love the relationships I have with my staff.

I love the other roles I have carved out within my health care system - Cook Children’s in Fort Worth.

Are there difficulties and frustrations?

Sure. Nothing is perfect but currently, for me, the good far outweighs the bad. Because of this, I walk into and out of work feeling energized and excited about the challenges rather than exhausted.

I certainly don’t think it’s because of anything inherent in me that has allowed me to continue to love my job. Is it just the confluence of good circumstances? Good luck? A great system to work for? Yes, but I’ve also fought to change the system in ways that make life better for myself and others. Maybe I’m just too young and burn out is just around the corner? (Although studies show that people with much less experience than me are already burned out.)

Any of those are probably partially true. But, just like the difficulty in pinpointing the reason for burnout is tricky, pinpointing the reasons for physician satisfaction would be difficult as well.

This post floated through my head for months. I hesitated to put it to paper. How would it be received? Is it trite? Would it be slammed for minimizing the problems?

It’s possible it could be all of those things. I hope not. I hope instead that it is seen as encouragement for those out there that love their job and for medical students and trainees who hear the burnout statistics and wonder if they’ve chosen the right field.

Those of us who aren’t burned out need to listen to those who are.

Together we could take their concerns and our energy and make medicine a fulfilling career for compassionate and empathic people again.

I have been having conversations with some very energetic pediatric leaders and recording them for a new podcast. I hope that you’ll find some piece of their story encouraging: https://soundcloud.com/pediatricleadership

About the author

Justin Smith is a pediatrician and the Medical Advisor for Digital Health for Cook Children's in Ft. Worth, TX. He has an active community on both Facebook and Twitter as @TheDocSmitty and writes weekly for Cook Children's checkupnesroom.com. His interest in communications started when he realized that his parents were relying more on the internet for medical information. He believes that strategic use of social media and technology by pediatricians to connect with families can deepen their relationship and provide a new level of convenience for both of their busy lifestyles. Dr. Smith’s innovative pediatric clinic, a pediatric clinic “designed by you,” is set to open in Trophy Club in the Fall of 2016.

Navigating Transitions in Leadership

Frank McGehee, M.D., is a pediatrician in the Cook Children’s Magnolia clinic. He practices in an office that has roots in an 80-year tradition of providing excellent patient care to the children of Fort Worth. He has seen many changes in medicine, but still believes that the heart of pediatrics lies in his connection with families.

There are probably a bunch but what are a few of the big changes you have seen in pediatrics over your career?

How have you seen your role in leadership change over your career?

What do you see coming for you in leadership in the next few years?

Ways to listen:

Listen on Soundcloud

Subscribe for series on iTunes

Download/Listen to MP3

How do we break down silos for innovative design?

Ways to listen:

Listen on Soundcloud

Subscribe for series on iTunes

Download/Listen to MP3

Innovative ideas often require a team approach. It’s difficult to make changes that truly move the needle when you consider a problem from just one perspective. Broadening the team allows physicians to consider other ideas. These new ideas might just open up possibilities that they may have never thought of.

Dr. Marks is a pediatric neurologist with Cook Children’s in Fort Worth, Texas. He has a particular interest in movement disorders and has been involved in Cook Children’s effort to advance the use of deep brain stimulation in the pediatric population. His latest project has been the design and implementation of an innovative pediatric motion lab, which uses a multidisciplinary approach, and advanced technology to assess and develop plans for children, teens and young adults with movement disorders.

Questions to work through on today's topic:

• How are things going with the new lab?
• Going back to when it started. Walk us through some of the different professionals who had input on the design of the lab. How did each member of the team contribute to the big picture?
• What were some of the challenges associated with having a big/diverse team?
• What’s next on the horizon for the lab?
• What part of your work are you most proud of?
• What is the most important quality for a leader in pediatrics?

Quotes:

In order to develop a lab like this, it takes a lot of people who have a great deal of understanding about all the components.

The most important people are the physical therapists who run the lab every day.

The technology itself is just to tool but it does allow for better procedures and better outcomes.

I enjoy team building. I have done that throughout my career…This team was unique because there are constant moving pieces.

There is a huge need to study how childhood obesity affects movement…it should allow us to intervene and better understand what we are doing.

All the things that I have done have required teams.

Neurologists, orthopedists and neurosurgeons desperately need each other.

At the end of the day, we are all in this to help the patient and to make their life better.

I think it is important to surround yourself with good people…and allow them to be creative.

Re: Good ideas-This is not about ownership, it’s about outcome.

Before we see a kid from far away, we do a lot of pre-screening via video and questionnaires.

Links:

• Cook Children’s Motion Lab
• Cook Children’s Neurosciences
• Dr. Warren Marks
• Referring a patient

Why develop a center for clinical excellence for a rare disease?

Getting help for patients with rare diseases can often be a large struggle for families. Finding someone who understands and has the experience to properly diagnose and treat can lead to frustration for families. Often there is no place to go. For long standing issues, this can lead to bouncing to multiple doctors without resolution of symptoms.

For more acute issues, not having an expert available can cause significant morbidity, even mortality. Today on Pediatric Leadership: The New Medicine, we talk to one of our pediatric endocrinologists who set up a center for treating a rare disease, hyperinsulinism.

Dr. Thornton is a pediatric endocrinologist at Cook Children’s and is the founder of the Cook Children’s Hyperinsulinism Center which is one of only two centers in the country focused on hyperinsulinism. The website for the team lists endocrinologists, pediatric surgeons and many other medical specialities as well as coordination between education, social work and even Ralph Lauren, one of Cook Children’s play therapy dogs.

Questions to work through on the topic:

What is hyperinsulinism and when should a clinician expect it?

What motivated you to begin building a center for treating such a rare condition?

How did you get the institution on board? Who did you have to convince?

What were some of those first steps that got the ball rolling?

What has been the hardest step?

How can someone find out more about the center or refer a patient?

What part of your work are you most proud of?

What is the most important quality for a leader in pediatrics?

To listen:

Download on Soundcloud 

Subscribe for series on iTunes

Download/Listen to MP3

For more information:

• Cook Children’s Hyperinsulinism Center
• Dr. Paul Thornton
• Cook Children's Referral Page

What does servant leadership mean to you?

How has your thinking changed since you transitioned into this leadership role?

How do the principles of servant leadership serve you well as a leader in pediatric medicine?

How does an organization stick to their roots and culture when things are changing?

Quote:

“Sometimes we have a crucial conversation about something that needs to be changed in order to make you better at what you do, about the way you think about things. “- Dr. Britt Nelson

“Always with a heart of: I want something better for you and for the patient you are taking care of.” – Dr. Britt Nelson

“Picture the child in front of you who needs what you are talking about. Will you go to war for that?” – Dr. Britt Nelson

Ways to listen:

Listen on Soundcloud

Subscribe for series on iTunes

Download/Listen to MP3

Listen to episode 2 of Cook Children's podcast - Pediatric Leadership: The New Medicine.

Questions addressed:

1. Have you noticed differences in leading in or advancing pediatric issues?
2. What are some particular challenges in pediatric leadership?
3. Moving forward, what are some particular issues in pediatrics where we need strong leaders to step in and lead?

Important links:

Texas Pediatric Society

Texas Medical Association

“Future pediatric leaders are waiting to step forward and it’s a matter of responding to the tap on the shoulder, the encouragement of a colleague to get involved.” – Jason Terk, M.D.

Jason Terk, MD-Cook Children’s Keller

Read Dr. Terk’s article about low HPV vaccination rates-Epic fail

Subscribe for series on iTunes

Download/Listen to MP3

Listen to episode 1 here. 

Our guest Mary Uhl-Bien is the BNSF Endowed Professor of Leadership at the Texas Christian University Neeley School of Business. She teaches in the Advancing Healthcare Leadership class which is a combined initiative between Cook Children’s and TCU. Participating in the class are about 30 physicians from throughout the Cook Children’s system including both specialists and primary care physicians. The goal is to establish a culture of strong leaders throughout the system so that we can work together to better serve our patients. Listen to episode 1 of Cook Children's new podcast - Pediatric Leadership:The New Medicine.

Listen on iTunes

Download/Listen to MP3

“People told me everybody wants to work in pediatrics until you have kids,” Dr. Honeycutt said. “They said, ‘Then you won’t want to work on kids any longer. It will be too much.’ But it was the exact opposite. When I had my own kids I realized even more this was what I wanted. I wanted to help kids like my own. It gave me much more empathy. It made it much easier to take care of them. In my line of work, I’m asking parents to hand their kids off to me and take care of them. They entrust their kids’ lives in my hands and I understand that.”

As a teenager, Dr. Honeycutt saw first-hand the role a surgeon can play in helping a family after a traumatic event.

One afternoon in his hometown of Paragould, Ark., while “horsing around” after football practice, the then 15 year old broke his neck.

A surgical scar remains on Dr. Honeycutt’s neck and so do the memories of his time in the hospital. He describes the scene at the time like what you would see in a bad TV movie as he was placed in traction.

As a patient, he saw physicians changing patient’s lives and making them better. The straight A student now knew what he wanted to be when he grew up.

Then during medical school, Dr. Honeycutt found his specialty.

“When I was doing my neurosurgery rotation, it all just clicked,” he said. “It clearly had all the parts I really enjoyed. I liked being a surgeon. I liked the neurosciences. I liked the workings of the brain. I just loved everything about it.”

While Dr. Honeycutt is now an experienced neurosurgeon, he still strives to be at the forefront of the latest technology and technique. Working on a child’s brain requires not only a steady hand, but the latest in state-of the-art technology.

Dr. Honeycutt and his fellow neurosurgeons use their expertise to perform the most intricate and delicate surgeries, such as deep brain stimulation, iMRI-guided surgery and laser ablation surgery.

“It’s an exciting time right now because we are learning so much about the brain and how it works and at the same time our technology continues to improve with micro instruments, with robotics and computers,” Dr. Honeycutt said. “If I don’t keep learning and keep up with what’s going on, I can get so far behind, rather quickly. One of the great things about Cook Children’s is we are always on the leading edge.”

Another aspect of Cook Children’s that Dr. Honeycutt said makes it unique is the relationship between the neurologists and the neurosciences. As surprising as it may be, Dr. Honeycutt says it’s rare for other hospitals to have the neurologists and neurosurgeons share a clinic together. He calls the working relationship between everyone involved in the Department of Neurosciences at Cook Children’s unbelievable. A lot of it has to do with that communication and the skill of the surgeons and physicians. They push each other constantly to do better.

At Cook Children’s, the neurologists and neurosurgeons can give each other immediate feedback on a patient. “You look at our situation and say, ‘Why doesn’t everyone do this?’ It’s so silly that people don’t do this everywhere,” Dr. Honeycutt said. “It’s one of the things that makes this place so special.”

In a study that was released early online from the journal Pediatrics, researchers looked at the percentage of girls aged 14-19 years were infected with the types of human papillomavirus (HPV) contained in the HPV vaccine in the years 2003-2006 and compared that to the percentage of 14-19 year old girls infected with the types of human papillomavirus (HPV) contained in the HPV vaccine in the years 2009-2012.

They found that the rate of infection in the years prior to routine vaccination in this group of girls was 11.5 percent. That percentage dropped to 4.3 percent in the years following routine recommendation of a vaccine. This is a rather remarkable finding given the relatively small numbers of girls who had received the full 3-dose series of the HPV vaccine.

It further illustrates how well this vaccine protects against such an important infection that can cause cancer in later years. This evidence of early success will likely lead to even more important measures of success with decreased numbers of women having abnormal pap smears that indicate cervical dysplasia and ultimately decreased numbers of cancers.

Imagine how much better it will be when we improve the numbers of teens getting this important vaccine!

Jason V. Terk, M.D.

1. What Is Turner Syndrome?

Turner syndrome, named after one of the doctors who first described it, is a genetic condition in which all or some portion of the X chromosome is missing. The lack of vitals genes found on the X chromosome affects multiple organs in the body leading to the medical problems seen in girls with Turner syndrome.

The loss of X chromosome genes happens very early in fetal life. In fact, the pregnancy of many babies with Turner syndrome ends in miscarriage. The condition is one of the most common genetic conditions with an estimated 1 out every 2,500 girls born with Turner syndrome.

2. What Health Problems Do Turner Syndrome Girls Have?

The severity of health problems in Turner syndrome is variable and depends at least in part on the loss of gene activity from the missing X chromosome. Many pediatric subspecialists may be involved in the care of Turner syndrome depending on the number and severity of health problems.

Heart problems in particular can be life-threatening and may require surgery early in life. Lifelong monitoring of heart health is necessary as heart problems are the most common cause of early death in Turner syndrome.

There are two primary health problems which need pediatric endocrine care.

· Short Stature

· Ovarian Failure

Short stature is a near constant problem seen in almost 100 percent of girls with Turner syndrome. I, and many other pediatric endocrinologists, use growth hormone treatment in girls with Turner syndrome. Prompt diagnosis is necessary and earlier diagnosis is essential. Prior to the use of growth hormone treatment, the average height for Turner syndrome girls was 4’8”.

The ovaries fail to work properly in most girls with Turner syndrome resulting in inability to go through puberty. Pediatric endocrinologists often start estrogen treatment and monitor puberty progress. Women with Turner syndrome need lifelong hormone replacement therapy. The majority aren’t able to have children without assisted reproduction.

Many other health problems can occur in Turner syndrome, and lifelong medical care is needed to check for these problems and provide proper treatment.

3. How is the Diagnosis Made?

Some families learn about the diagnosis of Turner syndrome in their daughter prior to birth if amniocentesis is done. However, most girls with Turner syndrome are diagnosed after birth.

The process of diagnosing Turner syndrome begins with a careful medical history. Unexplained short stature or delayed puberty may be the first clues in the diagnosis of Turner syndrome.

Blood testing to check chromosomes is necessary to make a definite diagnosis.

4. What else do I need to know ?

I hope this article helps in better understanding Turner syndrome. An early medical check in a girl with signs of Turner syndrome such as short stature or delayed puberty may be the first step in diagnosis.

According to researchers at Albert Einstein College of Medicine in New York, HPV raises the chances someone will get head and neck cancer by at least sevenfold.

For their study, 96,000 people took a mouthwash test for oral HPV infection. Four years later, 132 of them developed some form of head and neck cancer. People infected with a strain called HPV-16 were between two and 22 times as likely to be in the cancer group.

"This study backs up knowledge we already have about how common HPV is and how significant its association with cancer is," said Jason Terk, M.D., a pediatrician at Cook Children's primary care location on Keller Parkway. "HPV is an infectious disease and we all need to be concerned."

By the year 2020, experts believe head and neck cancer will surpass cervical cancer as the most common cancer caused by HPV.

But there is good news. HPV can be prevented.

The FDA has approved vaccines that prevent the HPV strains that are associated with cancers of the cervix and head and neck. Boys and girls can begin the vaccination process as early as age 9. And a new version of HPV vaccine, approved earlier this year, has even more cancer protection.

"Only 39 percent of adolescents in the U.S. have received the HPV vaccine. Here in Texas, that number drops to 33 percent," said Dr. Terk. "This is a relevant issue for all parents. We have a vaccine that can prevent cancer. Parents should start the vaccination process as soon as their pediatrician recommends. "

Some parents may feel uncomfortable talking to their children about the HPV vaccine. For those parents, here's Dr. Terk's advice:

• Explain that the vaccine protects against a very common infection that causes cancer

• · Most people (80%) will get infected with the types of HPV that can cause cancer

• · HPV vaccination equals cancer protection

• · It is best to get the vaccine at 11-12 years of age with the other adolescent vaccine; it works best at this age.

Also good to remember, research shows that youth who receive the HPV vaccine are not more likely to have sex. 

About the Source 

Jason Terk, M.D., earned his medical degree from University of Texas Medical Branch in Galveston, Texas. He completed his residency in pediatrics at Mayo Graduate School of Medicine (Mayo Clinic) in Rochester, Minnesota. His interests include public policy advocacy for children's health issues, focusing primarily on vaccines. Dr. Terk is board-certified in pediatrics.

Even skilled physicians may not be on the lookout for something as uncommon as CHI in newborns, which could be the difference in preventing irreversible damage and improving the quality of a child’s life.

That may all change following an article published in the Journal of Pediatrics titled, “Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants and Children.”

Paul Thornton, M.D., medical director of Cook Children’s Congenital Hyperinsulinism Center and Endocrine and Diabetes program and an Endowed Chair, led the team of experts from around the world in creating new screening for physicians to recognize and manage neonates at increased risk for a persistent hypoglycemia disorder.

“Infants with uncontrolled hypoglycemia caused by CHI are at risk for seizures or permanent brain damage without early identification and screening,” Dr. Thornton said. “These new guidelines will help physicians who recognize these symptoms shortly after birth and then provide the specialty care which may make the difference on whether this child has a productive and fulfilling life.”

The article states that “failure to investigate a neonate, infant, or child with suspected hypoglycemia increases the risk of delaying a definitive diagnosis and instituting effective treatment.”

But quickly identifying the specific cause of hypoglycemia allows for timely and appropriate treatment to begin and decreases the risk of permanent brain injury from persistent and recurrent severe hyperglycemia.

Dr. Thornton was chosen as the principal author of the article because he’s internationally known in the field of CHI. He leads a highly skilled team of specialized physicians and supporting specialists to treat hyperinsulinism.

Cook Children’s Hyperinsulinism Center is the only one of its kind in the Southern U.S. and the second in the country.

Davelyn Hood, M.D., president of the CHI Board of Directors said her organization “is thrilled beyond words” that long-awaited hypoglycemia guidelines have been published this month in the Journal of Pediatrics.

“We consider this a sentinel moment in time for the entire congenital hyperinsulinism community,” Dr. Hood said. “Many patients born with this congenital HI are discharged from newborn nurseries without adequate study of their hypoglycemia, often with tragic consequences. These guidelines give us hope.”

Dr. Hood said she believes the guidelines will save countless lives and improve the well-being of HI children everywhere. She also praised Dr. Thornton for all of his work for CHI patients.

“He cares for children across Texas and the U.S. with one of only two dedicated Hyperinsulinism Centers in the country,” Dr. Hood said. “He speaks to clinicians around the globe about the proper management of hypoglycemia and leads HI research to better understanding of the disease and best treatment options. Most importantly, Dr. Thornton, brought the HI research community together, took all of their collective knowledge regarding hypoglycemia and its underlying causes, and articulated that into clear guidelines for clinicians of all types that care for neonates, infants and children. Dr. Thornton is a definitely a ‘CHI Super Hero.’”

More about Cook Children's Hyperinsulinism Center

One of only two such programs in the nation Cook Children's Hyperinsulinism Center uses a specialized team approach to treat this rare disease. Hyperinsulinism affects many areas of the body, so to truly treat the disease, each child is seen by top physicians, nurses, researchers and specialists in the field. These medical professionals have spent additional years of intense study and have dedicated their practice to focusing on hyperinsulinism so that your child will has access to the medical care that treats all the symptoms. It is this level of treatment that has helped earn our program a distinguished international reputation for extraordinary care and achieving positive results.