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

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

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

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

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

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

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

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

Piper Francis, 17, has been playing softball with lifelong friends since second grade, but last year, she noticed she was having difficulty breathing during practice. She saw multiple doctors who prescribed her asthma inhalers that didn’t help. She was heartbroken and was preparing to transition from an active player to team manager. Then, in early 2025, she was referred to the Exercise Respiratory Center at Cook Children’s – Prosper where her care team identified her breathing issue and helped her recover. Now, she’s back on the softball field and excited to play in her senior year.

Pulmonology Care at Cook Children’s 

John Robertson, M.D., pediatric pulmonologist at Cook Children’s Medical Center - Prosper, was Piper’s advocate, quickly figuring out what she needed to improve her breathing and help her continue playing softball.

“Almost every day last year, I would feel tightness in my chest and throat. It felt like something was blocking my airway,” Piper said. “I’d show up at softball practice and have to sit out through half of it. Now I’ve been able to go back to practice after seeing Dr. Robertson. He immediately recognized my problem and I felt better in less than a month!”

Piper was diagnosed with three conditions – exercise-induced asthma, exercise-induced laryngeal obstruction (EILO) and dysfunctional breathing. 

“The big challenge is that the problems look like each other,” Dr. Robertson said. “Asthma labels are really common and doctors may be right most of the time, but when asthma medications don’t work, there are no standard guidelines pointing at what to do next. The symptoms of these diagnoses – EILO and dysfunctional breathing – aren’t a problem of diseased tissues. They’re normal structures functioning abnormally.”

EILO happens when the vocal cords or neighboring structures collapse on inhalation during strenuous exercise.

Dysfunctional breathing occurs when someone breathes primarily with chest muscles instead of the diaphragm, resulting in inefficient, fast, shallow breaths rather than slower and deeper ones.

Finally Diagnosed at Cook Children’s Exercise Respiratory Center

Piper was diagnosed with EILO and dysfunctional breathing with testing at Cook Children’s Exercise Respiratory Center, which opened in 2023. The Exercise Respiratory Center diagnoses, treats and researches the causes of exercise-induced respiratory symptoms for older children, adolescents and young adults. Some of the many duties of the researchers at the Exercise Respiratory Center, Rebecca Brovina, MSHS, BSN, RN, CPN, and Andy Kreutzer, PhD, CSCS, LSSWB, include gathering data and presenting findings to share with other medical professionals about the diagnosis and treatment of exercise-induced respiratory symptoms.

It’s one of three centers in the U.S. that test continuous laryngoscopy during exercise (CLE) for children and the only center in Texas. During this test, Dr. Robertson will use a scope to view the patient’s voice box and vocal cords while the child exercises. Dr. Robertson was recently named a finalist for D CEO's 2025 Excellence in Healthcare Awards for Outstanding Healthcare Innovator.

“We just finished our 100th CLE test recently,” Dr. Robertson said. “We perform maximal exercise tests, try to provoke the symptoms under investigation while we are examining the patient's voice box with a camera and measuring their breathing efficiency, so we can see what is malfunctioning precisely when symptoms are present.”

Athletic patients like Piper are typically treated within four to six weeks, consisting of four to six visits of physical therapy and/or speech therapy. Piper only needed three visits.

“Piper is a very special person,” Dr. Robertson said. “She’s a dedicated athlete, driven and very competitive and her success story has been inspiring for all of us!”

Physical Therapy and Speech Therapy: Learning How to Breathe Again

Dr. Robertson’s Exercise Respiratory team includes a physical therapist and a speech therapist. Part of Piper’s care includes learning how to breathe again – through her diaphragm instead of her chest.

“Throughout PT and speech therapy, I’ve learned a lot of new breathing techniques,” Piper said. “My symptoms have drastically changed. I can make it through an entire practice now without struggling and missing practice trying to breathe. Learning how to breathe correctly helped me the most!”

Now, whenever Piper feels chest pain, throat tightness, lightheadedness, or breathing difficulties, she first notices if she’s overlooking her breathing techniques and then makes a conscious effort to stay aware and focus on her breathing.

Finding Answers and Hope for Others

Since Piper’s care with Dr. Robertson and the Exercise Respiratory team, her health has drastically changed.

“Emotionally, it makes me feel relieved,” Piper said. “I don’t have to worry about struggling at practice anymore and I can just show up and perform my best.”

Piper’s mom, Kristi Francis, noticed last year that she would come home from softball practice exhausted, had trouble breathing and it would take hours before she felt back to normal.

“It’s been a game changer for Piper,” Kristi said. “We went from doctor to doctor and no one really listened and everyone thought we were crazy. They didn’t believe her symptoms and we finally got to someone who knew exactly what to do.”

When to Seek Further Evaluation

“I feel like this condition needs to be more recognized and that a lot more people actually have it and just don’t know,” Piper said. 

General red flags for people to pay attention to and seek further evaluation:

1. If someone is labeled as having asthma and uses an inhaler, but still has lots of symptoms when the asthma treatment doesn’t help.
2. In EILO, there can be a symptom called stridor, which is exclusive to the voice box: stridor occurs when breathing in, usually as a loud, high-pitched sound that can be heard by others standing nearby. In asthma, wheezing happens during the breath out and is usually a quieter sound only noticed by the person experiencing the symptom.
3. Along with the symptoms above, experiencing dizziness and lightheadedness, passing out/coming close to passing out.

Finding the right diagnosis makes all the difference and can help athletes like Piper feel better, get back to competition and even breathe better than ever before.

Nelson Ku didn’t just attend school, he starred in it. The hallways and classrooms of Fort Worth’s All Saint’s Episcopal School were center stage for his uncanny ability to make his friends and classmates laugh. Nelson was known as a smile maker and deeply loved for it.

“Nelson loved going to school because of his love for his classmates,” said Nelson’s father, Peter Ku, D.D.S., a long-time Fort Worth dentist and a member of the Board of Trustees for Cook Children’s Health Care System. “He loved hanging out with them. His love for his friends is why he enjoyed so much being silly and trying to make others laugh.”

So when an asthma attack during Lacrosse practice took his life in February 2024, it devastated the All Saint’s community and left Nelson’s father, mother, Beth, and big brother, Marshall, reeling from their loss. Nelson was just 11 years old when he died.

“That morning I woke up and got ready to go to the office, kissed him in the back of the head and said, ‘Nelson, I love you.’ And he said, ‘Dad, I love you too,’” Dr. Ku said. “I never imagined I’d get a phone call at 4 that evening and never hear him again.”

It’s a call that no parent can fathom, and many question how anyone could go on after. Yet, while still walking through their own deep sorrow, the Ku family is finding comfort and purpose in their faith in Christ and in bringing awareness to the complications of asthma.

Finding Purpose in Tragedy

Dr. Ku and his wife, Beth, believe proper training and education, coupled with the use of rescue tools, could have made a difference in Nelson’s life that day. In hopes of saving others, they are working with Cook Children’s to educate families, schools and sports organizations about the serious health impacts of asthma and the tools available to intervene when a child experiences an attack. The couple hopes asthma rescue medications and resources will one day be as standard in schools, on practice fields and at every sporting event as automatic external defibrillators (AEDs) are today.

In June, Cook Children’s officially launched a new program to help children and families better manage asthma and its hidden threats. It’s known as the Nelson Ku High-Risk Asthma Program. The goal of the program is to identify and address the barriers to asthma care and symptom control of children who often seek care for the condition in the emergency department. The program aims to give them the education and tools they need to reduce the severity of their attacks and the need for hospitalization.

“We're glad to be able to recognize Nelson, but we don't want it to 100% be about him,” Dr. Ku said. “We want his story to make a difference. We want his story to inspire others to say, ‘Hey, asthma is important. We're going to do whatever we can to better protect our kids when it comes to this stuff.’ We’re trying to do things that make a difference.”

The Ku family wants parents, educators and coaches to know that asthma is a serious condition that cannot be taken for granted.

“I would imagine death from asthma isn't one of the higher children's fatality statistics, but at the end of the day, one life being lost to asthma is too many, which is, in my opinion, very controllable,” Dr. Ku said. “I love that the high-risk clinic allows those kids who really struggle with it to be able to find some hope in it.”

A Life Well Lived

In his 11 years, Nelson lived a lot of life.

When he wasn’t making his friends laugh, he did his best to pester his big brother, as most little brothers do. Although separated by a significant age gap, Dr. Ku says the brothers were “two peas in a pod.” They often spent time together down by the creek on the family’s property.

Marshall has a special memory of helping his little brother collect creek water to view under his new microscope, evidence of Nelson’s inquisitive nature and affinity for science.

“His favorite subject was science,” Dr. Ku said. “His science teacher told us that he would go to her classroom after school and when he had breaks to sit down with her and ask questions regarding things from outer space to creation to the human anatomy.”

In addition to collecting smiles from his friends, Nelson curated an impressive assortment of stuffed animals, including a life-sized plush black cat that became his favorite of all. Dr. Ku estimates he had about 15 piled high on his bed and would nestle into them every night.

“We would call it his nest,” Dr. Ku said. “He would put all his stuffed animals around and just kind of scrunch in the middle of all that, plus have covers on him. Looking back, it just showed his innocence, and I love that about him.”

Like it was for Nelson, that sweet collection of stuffed animals is now a source of comfort for his parents, reminding them of their son’s quirky nature, and in true Nelson fashion, bringing a smile to their faces.

The Nelson Ku High-Risk Asthma Clinic, named in honor of their beloved son, brings them a sense of solace, too.

“It means a lot to be able to find purpose,” Dr. Ku said. “I don't know how families do it if they aren't able to find how to utilize a tragic event to make a difference. It brings healing and it brings comfort and, honestly, in my opinion, it brings significance to nothing.”

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Growing up, Rebecca Brovina always wanted to be a nurse, just like her grandma. “I have always dreamed of being as successful and cool as she was,” Brovina said. Now, many would say, she is living up to that.

Rebecca Brovina, BSN, RN, CPN, Research Nurse Coordinator at Cook Children’s Pulmonology - Prosper, was just recently awarded the Great 100 Nurses for 2025, highlighting her outstanding contributions in her field.

Nurses are nominated for this award by family members, patients, peers, former teachers, physicians, and administrators. Over the past 34 years, this award has become recognized throughout the nursing community in the Dallas/Fort Worth metroplex as an esteemed honor and prestigious accomplishment.

Rebecca's journey began in the Pediatric Intensive Care Unit (PICU), where she worked closely with John Robertson, M.D. Dr. Robertson was starting research focused on understanding and treating exercise-induced respiratory disorders, and when Rebecca heard about it, her interest was immediately piqued. She almost instantly became a vital part of this dedicated research team.

“Rebecca’s superpowers are intelligence, creativity, empathy, and humor, in equal overflowing measure,” Dr. Robertson said. 

These disorders often lead young athletes to quit sports, which can significantly impact their self-confidence. Rebecca vividly recalls a patient who had to quit all her sports due to an undiagnosed condition and suffered a massive blow to her self-confidence. She found no answers until she visited the Cook Children's Exercise Respiratory Center in Prosper. Rebecca remembers witnessing the relief they experienced when they finally felt heard. As the patient's parent put it, "We finally feel like someone listened to us.”

In February 2025, Rebecca received first place in the 2025 Research Poster Presentation Master's Level at the Texas Chapter of the American College of Sports Medicine. The presentation, Estimating Minute Ventilation and Inspiratory Flow to Trigger Exercise Induced Laryngeal Obstruction (EILO) in Pediatric Patients, also led to the team's first published abstract.

At the exercise respiratory center in Prosper, no two days are exactly the same for Rebecca; there is always a unique blend of patient interaction, education and research. One of her primary roles is educating patients prior to their appointments and administering research surveys. Her work often involves looking for a connection between respiration disorders and other neurological conditions. Rebecca is also heavily involved in writing protocols, giving presentations, and videoing the end of procedures.

The respiratory clinic also uses a method that is only employed in three places in the country. In this method, a scope is inserted through the nose and down into the back of the throat while the patient is running on the treadmill. This novel approach helps discover dynamic changes in the airway that occur during exercise. This cutting-edge and unique approach is something Rebecca loves about her job.

“My favorite part of research is being able to develop things and actually be able to help people,” Rebecca said.

Rebecca’s motivation and her “why” stems from a deeply personal place. Having experienced health challenges herself, including worsening asthma and a spinal cord injury, she understands firsthand how not being able to do the one thing you love can impact a child. Rebecca is so passionate about her job because, as she said, she understands "how mentally and physically damaging it is to not be able to do the one thing that keeps you sane.”

Throughout her career as a nurse, she has also witnessed firsthand, patients not receiving the care they deserve, often due to insurance problems. This fueled her desire to change how people are cared for, develop new solutions, and truly help. Rebecca’s passion can be seen in every interaction and shows her commitment to getting patients back to doing what they love.

“I wrote my thesis on discharge delays," Rebecca said. "I would see kids who would have extended hospital stays simply trying to get the gear and medicine they need.”

Rebecca has truly loved her experience at Prosper. She has relished the opportunity to be a part of opening a brand-new hospital. She contributed to the organization of hospital departments and helped figure out staffing and roles. She says that being part of some of the first research initiatives at Prosper and building something from the ground has been incredibly cool and rewarding, even throughout all of the roadblocks.

Rebecca is driven by her patients, a fact evident in each of her interactions. She is dedicated and passionate about what she does. Congratulations on this very well-deserved award!

At 13, Jessye Tout is already a champion. A multi-sport athlete, she has tackled soccer, dance, volleyball and karate since she was a little girl. But sometimes when she was on the soccer field, Jessye’s chest would start to hurt, and she couldn’t breathe. Mysteriously, this never happened while she was at school or doing day-to-day tasks, but only while she was exerting herself on the field. 

A visit with a pulmonologist ruled out a heart problem but did not shed more light on her problem. So, she was referred to John Robertson, M.D., Cook Children’s Pediatric Pulmonologist, at the Exercise Respiratory Center (ExRC) in Prosper. 

To help find out what was wrong, Dr. Robertson and his team in August 2024 performed what is believed to be the world's first continuous bronchoscopy during exercise (CBE) on a pediatric patient. This technique has been used on adult patients but never on pediatric patients.

The team put a camera through Jessye’s nose and past her voice box, conducting a more in-depth look at her breathing capabilities— all while she ran on a treadmill to mimic the same symptoms she had while playing soccer.

Dr. Robertson said by replicating the exercise Jessye was doing on the field, the team could see in real-time whether it was Jessye’s voice box or her windpipe causing her breathing discomfort. For young athletes with breathing problems, doctors often do a bronchoscopy while the patient is under sedation or general anesthesia. But this does not help the team to accurately observe the issue she experienced during exercise.

“The groundbreaking part of our CBE is that it was done in a pediatric patient. So far, all of the published medical literature on the subject has been done in adults,” Dr. Robertson said.

Jessye’s mother, Tracy Tout said it was important to keep pushing for answers because she did not want to see her daughter give up the sports she loves or stop exercising all together because of breathing problems. 

“I thought there had to be a reason why she can't breathe. She's not making it up,” Tout said.

“It was 200 % important [to keep pushing for answers] because she has played select soccer pretty much her whole life,” Tout said. It's hard as a parent to sit there on the sidelines and have these coaches yell at her, saying ‘you just need to be conditioned’. And I thought, ‘You don't understand. She is conditioned, she's in athletics. There is not a kid that's more conditioned than she is.”

Rebecca Brovina, BSN, RN, CPN, Research Nurse Coordinator, and Andreas Kreutzer, Ph.D., Exercise Physiologist and Research Scientist, said they spent three months preparing for the new CBE procedure. Andreas even served as a test patient, twice undergoing the new procedure while running on the treadmill. To get Jessye ready, they shared Andreas’ experience, and also helped her prep for her own treadmill run.

For many young athletes, when treating asthma does not help their symptoms, we often find exercise-induced laryngeal obstruction (EILO), in which the voice box structure closes or collapses during exercise, making it hard to breathe. For these cases, speech therapy can often solve the issue. But if physicians find that the walls of the patient’s windpipe are weak, a condition called tracheomalacia, the treatment could involve open chest surgery.

For Jessye, the combination of CLE and CBE procedure yielded answers. Dr. Robertson concluded she needed speech therapy to help stop her voice box from closing while she was exercising. 

“I was really happy once I finally got answers,” she said, after having symptoms for more than eight months. “It is a long time to not know why you're feeling like you can't breathe.”

It’s not every day that you see a patient on extracorporeal membrane oxygenation (ECMO) walking around the halls of the hospital or taking a turn outside in a wheelchair. Children on this life-supporting device have very sick lungs. Most patients are fully sedated while ECMO assists their lungs in the exchange of blood gasses to properly oxygenate their body and its organs. But Emerson Bellucci is not most patients. 

“People would line the halls when she was up doing therapy,” said Ashlee Bellucci, Emerson’s mother. “Everybody wanted to see because they said this is not your typical ECMO patient. And I said, ‘Well, this is not your typical kid.’”

The 12-year-old from Fort Worth is one-of-a-kind in a lot of ways. Strong, resilient and mature beyond her years, Emerson not only beat the odds on ECMO, she survived a very rare and life-threatening reaction to the common antibiotic Bactrim, which she was prescribed to treat a staph infection she developed from cystic acne. The reaction is so rare, in fact, that few studies on the condition exist.

In 2023, physicians from Children’s Mercy Hospital and Clinics in Kansas City, Missouri, published a review of five cases of severe lung inflammation following the use of Bactrim, or trimethoprim-sulfamethoxazole. Like several in this case study, in the early days of Emerson’s reaction, her symptoms of fever, rash and difficulty breathing were initially thought to be the result of a viral infection. But her breathing became so labored that she was admitted to Cook Children’s Pediatric Intensive Care Unit (PICU) on August 18, 2024, where her care was overseen by a team of intensive care physicians and consulting specialists, including Javier Gelvez, M.D., pediatric intensivist, Krishna Pancham, M.D., pulmonologist, and Raymond Nkwantabisa, M.D., ECMO program medical director. In his 28 years of practicing medicine, Emerson is the first patient Dr. Nkwantabisa has treated for Bactrim-induced pneumonitis.

“Basically, Emerson developed severe inflammation in her lungs as a result of getting the Bactrim,” Dr. Nkwantabisa said. “This inflammation ended up causing pretty severe lung injury and damage to the air sacs in the lungs, resulting in pretty severe air leaks that required the placement of chest tubes to allow the air to escape from her lungs.”

Despite the chest tube placement and subsequently being placed on a ventilator, Emerson’s lungs were so inflamed that no amount of ventilator support could move air in and out of her lungs adequately to support her oxygen levels.

“We all need a certain amount of healthy air sacs to be able to breathe and exchange gases.” Dr. Nkwantabisa explained. “So when you get sick with, for example, very severe pneumonia where you don't have enough healthy open air sacs to exchange gas, we usually will intubate you and put you on a ventilator to breathe for you. But the ventilator only works when you have a reasonable number of healthy air sacs. If every air sac is injured or not working well, then the ventilator is limited in terms of how it can help.”

One day Emerson is a normal pre-teen dealing with all of the things that come with adolescent development and, within a matter of weeks, she’s on life-support with lungs so sick doctors began preparing her and her family for the possibility of needing a lung transplant.

“It's been the worst thing ever I could imagine,” Ashlee said. “But then there's been such high moments, you know, when I see her get up and walk with three ECMO lines in her legs. It's just miraculous.”

A Critical Lifeline

Think of ECMO as an external artificial lung. Tubes are inserted into large blood vessels, like the femoral artery and the femoral vein. Those tubes carry blue blood out of the body and pass it through an external machine that removes carbon dioxide and infuses oxygen into the blood. The oxygenated blood then flows back into the body, delivering vital oxygen to the patient’s organs. It is one of the most advanced forms of life support available.

There are very few patients that meet the criteria for remaining awake while on ECMO, says Danielle Ransonette, Cook Children’s ECMO co-coordinator. For one, the patient must have adequate pain control and tolerance without requiring complete sedation, and that doesn’t happen often, especially in children. The patient also has to be at a developmental level where they can follow directions and be reasoned with to protect the ECMO cannulae. Meeting the criteria meant Emerson had the opportunity to shoot a few basketball hoops, do physical therapy and to stand to hug her parents, all while on ECMO.

Rather than seeing the lung assist device as an obstacle, Emerson saw it as the lifeline that it was, and chose gratitude as her fuel.

“What definitely kept me going is I finally realized that it's my support,” Emerson said. “There was a huge chance I could have been dead without it. And I think that's definitely a huge reason that I'm still going.”

An Elite Force

Cook Children’s has a team of professionals specially trained to operate ECMO, and a member of this team is at the patient’s bedside 24/7 for as long as they are on the device.

Dr. Nkwantabisa likens this team to the military’s Navy SEALs, a team of elite special forces known for conducting high-risk and often covert operations. The ECMO team is called on when things are really dark and dire, he says. They are highly trained, highly competent and very low-key. Like the SEALs, these respiratory therapists and nurses are called away from their daily jobs and units throughout the hospital to accomplish a separate mission to care for an ECMO patient, sometimes for weeks or months on end. When all is said and done, they return to their respective units with little to no fanfare.

“It takes a special kind of person because, not only is it the wear and tear emotionally and physically that you go through, but there's also an intense amount of training that you come in and do over and above your regular scheduled hours,” Ransonette said. “It takes somebody who's truly dedicated, who really wants to further their knowledge and skills and really help take care of these kiddos.”

A Voice for the Voiceless

In late September, while still on ECMO, Emerson was transferred to a pediatric lung transplant center in Houston to prepare for a potential transplant. Once again, she defied the odds. On October 30, she was removed from ECMO and her transplant subsequently denied due to her recovery and progress. 

“It was just such justification for faith and God when we got the [transplant] denial letter,” Ashlee said. “Probably one of the happiest days of my life. Needless to say that that particular letter will be framed and placed at home.”

On December 12, Emerson was transferred back to Cook Children’s and admitted to the Transitional Care Unit (TCU) where her lungs continue to recover as she does daily physical therapy to strengthen her body.

“We consider [Cook Children’s] home,” Ashlee said.

Just as Emerson embraced ECMO as a lifeline, she and her family view her health and healing journey as one with purpose.

“We told Emmie early on when we were all trying to get a grasp on this just sudden change in her health, that God has a plan for her, and that she's got a story to tell when she gets through all of this,” said Robert Dancy, Emerson’s father. “We don't know what it is or how she's going to use it, but she's going to have a story to tell to help other people.”

Part of that story is the role parents and caregivers can play in supporting other children on ECMO. Having experienced ECMO while awake, Emerson was uniquely positioned to share her discomforts, such as feeling cold while on the machine, and how solutions like hot packs and warm blankets helped her feel more comfortable. Emerson hopes to use what she’s learned from the experience to be a voice for the voiceless, guiding caregivers in easing the pain and discomfort of those on ECMO who cannot communicate their needs.

And she has a message for other children facing life-changing circumstances and hardships.

“Never give up,” she said. “You will have days when you don't want to do anything because you're going to feel like you're never enough. But, no matter what, never ever give up. Keep the faith.”

A Pillar of Pediatric Care

James “Jim” Cunningham, M.D. a beloved figure at Cook Children’s, is retiring after a distinguished career dedicated to the health and well-being of countless children. Dr. Cunningham’s journey at Cook Children’s took him from Medical Director of Pulmonology to Chief Medical Officer to Executive Vice President/CMO. All along the way, his path has been marked by compassion, innovation and a steadfast commitment to excellence. He has left an enduring impact on the institution and the community it serves.

Born and raised in Texas, Dr. Cunningham’s roots run deep in the Lone Star State. His early years sparked a curiosity about the scientific world, leading him to pursue a degree in Zoology at Texas A&M University. This academic foundation laid the groundwork for his future in medicine.

A Passion for Pediatrics

After completing his medical degree at the University of Texas Medical Branch at Galveston and his residency at the University of Oklahoma, Dr. Cunningham specialized in pediatric pulmonology at the University of Arizona. His passion for caring for young patients, particularly those with complex respiratory conditions, ignited a desire to make a difference in their lives.

"I was drawn to pulmonary medicine because it offered a unique blend of acute and chronic care. It's incredibly rewarding to treat children with acute conditions like pneumonia, watching them recover and go home,” Dr. Cunningham said. “At the same time, managing chronic diseases such as cystic fibrosis or severe asthma allows you to build strong bonds with patients and their families. It's deeply meaningful to participate in their lives, watch them grow, and help them navigate their health care challenges. The combination of acute care and long-term relationships with patients and families was what ultimately attracted me to pulmonary medicine."

Decades of Dedication to Cook Children’s

Dr. Cunningham joined Cook Children’s in 1987, drawn to the organization’s commitment to providing exceptional care to children. Over the past three decades, he has played a pivotal role in shaping the institution into a world-class pediatric health care provider.

As a physician and administrator, Dr. Cunningham has made significant contributions to the field of pediatric pulmonology. His expertise in managing complex respiratory conditions, such as cystic fibrosis, has improved the lives of countless children. His dedication to advancing medical knowledge through research has led to groundbreaking discoveries and innovative treatments.

Beyond his clinical and research endeavors, Dr. Cunningham has been a visionary leader, guiding Cook Children’s through period of substantial expansion and modernization. His strategic insights and unwavering commitment to quality have helped position Cook Children’s as a leader in pediatric health care.

"This place has been a significant part of my life for a long time. Many of my adult friendships are centered around it, and it's been rewarding to watch its growth. However, I'm confident that the pulmonary program is in excellent hands with (Karen Schultz, M.D.), (Sami Hadeed, M.D.), (John Pfaff, M.D.), and the other talented pulmonologists. I believe the program will continue to thrive and achieve great things."

A Well-Deserved Retirement

As Dr. Cunningham embarks on his retirement, he leaves behind a legacy of compassion, innovation and leadership. His departure marks the end of an era, but his impact on Cook Children’s and the children it serves will continue to be felt for generations to come.

“Over 17 years ago, one of my first decisions as President and CEO of Cook Children’s was to hire Dr. Jim Cunningham as Chief Medical Officer. I had met Jim during my interview process and was immediately impressed by his kind and compassionate nature. His servant’s heart was evident, making him the ideal choice to lead our organization into the future,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System.

Looking ahead, Jonathan Nedrelow, M.D., will assume the role of Chief Medical Officer at Cook Children’s. Most recently, Dr. Nedrelow served as Senior Vice President and Associate Chief Medical Officer at Cook Children’s. A renowned expert in neonatal-perinatal medicine, Dr. Nedrelow bring a wealth of experience and a strong commitment to pediatric health care to this pivotal role.

"I was fortunate to have the opportunity to start succession planning early on,” Dr. Cunningham said. “This led me to think about the future of the program and how to ensure a smooth transition. I immediately thought of Dr. Nedrelow, and we had several conversations about the process. He's been leading the program for about a year and a half now, and he's exceptionally qualified. He's highly intelligent, well-respected, and I'm confident that the program is in great hands with him."

Dr. Cunningham’s colleagues and friends at Cook Children’s extend their heartfelt gratitude for his many years of dedicated service.

Rick W. Merrill, President and CEO of Cook Children’s Health Care System

“For nearly four decades, Dr. Cunningham has been an invaluable asset to Cook Children’s. As our Chief Medical Officer for the past 17 years, he has steadfastly upheld our Promise to our patients, families, physicians, and staff. As he embarks on a well-deserved retirement, he will be deeply missed. We are grateful for his invaluable contributions and look forward to the leadership of Dr. Jonathan Nedrelow. However, Dr. Cunningham’s enduring impact on Cook Children’s will forever be remembered."

Jonathan Nedrelow, M.D. current Chief Medical Officer

“Dr. Cunningham’s patients had the rare privilege of being taken care of by one of the most kind, thoughtful, unassuming, and intelligent doctors I have ever known. His legacy can be found in all the children that had a chance to grow up healthier because of him. Personally, words cannot describe the gratitude I have for the mentorship and friendship he extended to me. I wish him all the best enjoying his family and friends in retirement.”

Bobby Feather, Senior Vice President, Public Policy

“Over the last 30 years, it has been my privilege to labor beside a number of extraordinary people in the Cook Children’s administration.  Jim Cunningham is an incredible individual.  I have known him to be a highly dedicated leader and principled professional colleague.  When it comes to integrity, compassion, loyalty, flexibility and wisdom, Dr. Cunningham is fourteen carat.  As a friend, he is a rare find.”

Karen Schultz, M.D., Medical Director, Pulmonary Services

“There is no way to state how much Dr. Cunningham has meant to Cook Children’s or to me personally. He has been a rock from the day that I started fresh out of fellowship—initially with clinical questions but morphing into advice on how to lead the pulmonary department (and who to ask when I need something). His compassionate care for patients is an example for all physicians to emulate. I can only hope to have a fraction of the impact that he has had caring for pulmonary and all patients and families and Cook Children’s."

Nancy Dambro, M.D., retired, former Medical Director of Pulmonology and President of the Medical Staff

Jim Cunningham and I did our fellowships together at the University of Arizona in Tucson. Subsequently, we and our families moved to Fort Worth and Cook Children’s Medical Center together in 1987. Until I retired in 2020, Jim and I worked together for a total of 36 years! A long time for two physicians.

Through those years, I have seen Jim as one of the most insightful, thorough, and hard-working physicians I have ever worked with. He led the building of a very well-thought-of Pulmonary Department from the ground up, including a nationally recognized Cystic Fibrosis Center. In doing so, he built a cohesive clinical team that continues to be strong.

Later, he became the CMO of Cook Children’s Healthcare System, and lent his collegial leadership style to the entire organization. Jim‘s impact on the growth of Cook Children’s is probably unequaled.

Through this pretty challenging career, I never saw Jim lose sight of the importance of his own family; he is a great husband and father.

And he is a good friend.

Britt Nelson, M.D., retired, CCPN's president from 2009 to 2021, long-time friend of Dr. Cunningham

“Jim Cunningham always brings understanding into a room. He can communicate across many levels of listeners complex concepts in whatever language is needed. He is a honyawker to honyawkers, a kid to kids, an executive to executives and a leader to leaders. He is the brightest guy in the room – always.

His fingerprints are all over Cook Children’s and the success it has enjoyed. Best? He loves children and served them with his every word and action.”

Follow up to Dr. Nelson: What is a honyawker?

“I don’t really know, nor do I know how to spell it. Dr. Cunningham uses that word frequently to describe ‘a good ole boy’ with a slightly goofy slant. He’s used it in the highest level of our organization, and it elicits smiles as he describes folks (usually males) who are freewheeling and a bit (off-the-wall). It’s a term of endearment … sort of. He’ll smile when he sees this and correct me! What I could never discern was whether I wanted to be considered a honyawker. Pronounced –ho’n-yaw-ker.”

Best Children’s Hospitals list for 2023-2024.

The report, which was released today, uses clinical data to measure patient safety, infection prevention and adequacy of nurse staffing. Out of 284 children’s hospitals in the U.S., only 90 ranked in at least one of the 10 pediatric specialties evaluated. The following Cook Children’s specialties were named among the top programs:

• Pediatric Cancer - #30 in the nation
• Pediatric Diabetes and Endocrinology - #31 in the nation
• Pediatric Neurology and Neurosurgery - #36 in the nation
• Pediatric Orthopedics - #40 in the nation
• Pediatric Pulmonology and Lung Surgery - #48 in the nation

Cook Children's Hematology and Oncology program jumped an impressive 20 spots in the rankings, from #50 in 2022-2023 to #30 in 2023-2024.

 “We are focused every day to improve the lives of the patients we serve and enrich the care of children all over the world. We do this by providing innovative care and contributing to the science of future cancer therapies,” said Donald Beam, M.D., medical director of Hematology and Oncology. “We will continue to strive to improve every day, growing beyond what we are and stepping to the future.”

For Cook Children's Health Care System as a whole, the rankings demonstrate a longstanding commitment to excellence in pediatric care.  

"For more than 105 years, Cook Children's has been committed to improving the well-being of every child in our care. We are honored to see our mission validated yet again by U.S. News and World Report,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “With our newest medical center in Prosper now open, we look forward to making an impact in the lives of even more children and families.” 

Cook Children’s also ranked #3 in Texas and #4 in the Southwest on the U.S. News and World Report “Best Regional Hospitals” list. 

Joann Sanders, M.D., chief quality officer, and Matthew Carroll, M.D., associate chief quality officer, credit Cook Children’s employees with top rankings in the U.S. News & World Report’s Best Children’s Hospital list for 2022-2023. Cook Children’s Health Care System ranked in six specialties, a large increase from two specialties last year. Among 284 children’s hospitals in the country, only 90 ranked in at least one of the pediatric specialties evaluated. The report, released on June 14, used clinical data to measure patient safety, infection prevention and adequacy of nurse staffing.

“For more than 100 years, Cook Children’s has been committed to providing the best quality medical care for children. The U.S. News and World Report rankings further validate the tireless dedication of our staff to fulfill our Promise,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “As we look toward the future, with the opening of our new hospital in Prosper, Texas, later this year, we are excited to bring our world-class pediatric care to even more children and families.” 

Dr. Sanders and Dr. Carroll said the top rankings are a testament to the people who work at the hospital and consistently deliver excellent quality care.

“Everyone in the organization has an impact on the amazing care we deliver to our patients and is part of our organization's success in U.S. News & World Report,” Dr. Carroll said. “The high-quality care that our physicians and staff provide every day not only positively impacts the lives of the patients and families we serve but is also reflected in awards such as this.”

Dr. Sanders echoed those sentiments and said the rankings are a huge accomplishment for Cook Children’s.

“It validates what we all have known – that we are a top-tier organization,” Dr. Sanders said.

The report uses clinical data to measure patient safety, infection prevention and adequacy of nurse staffing. The following six Cook Children’s specialties were named among the top programs:

• Pediatric Neurology and Neurosurgery - #29 in the nation
• Pediatric Diabetes and Endocrinology - #38 in the nation
• Pediatric Orthopedics - #41 in the nation
• Pediatric Pulmonology and Lung Surgery - #43 in the nation
• Pediatric Cardiology and Heart Surgery - #48 in the nation
• Pediatric Cancer - #50 in the nation

“The rankings are an incredibly complex process with a large amount of information gathered in two months,” Dr. Carroll said. “It was a great team effort from IT, Quality and the specialties involved.”

Raising the Bar

During the past two years, Dr. Carroll took a detailed look at the survey and partnered with each specialty to discover opportunities for improvement. 

“We didn’t do it just to check off the boxes for U.S. News & World Report,” Dr. Sanders said. “It was all about where it made sense to make changes and ultimately improve patient care.”

One improvement in Endocrinology was the development of a quality metric dashboard that shows how physicians are performing relative to peers on 10 to 15 measures. Dr. Paul Thornton shares the dashboard with the group which highlights roadblocks and successes. As a result of that project, dashboards will continue to be built for each specialty.

Scott Perry, M.D., head of Neurosciences at the Jane and John Justin Neurosciences Center, has worked at Cook Children’s for 13 years, consistently building innovative services contributing to rankings in the U.S. News & World Report. The Center is best known for its patient-centered care model focused on providing easily accessible, comprehensive care. Programs of excellence in epilepsy and movement disorders have been the foundation of their success, in addition to an active research program with multiple NIH grants. The group has grown to serve 13 locations in Texas including full-time clinics in Lubbock and Amarillo.

“We continue to expand the subspecialty neurosciences services at Cook Children’s, for example, our genetic epilepsy and movement disorders programs, offering not only the best in diagnostics and therapeutics but also several research trials offering novel therapies that otherwise would not be available to our patients,” Dr. Perry said. 

After looking at the survey analysis, Sheralyn Hartline,  formerly the RN, NICU/ECMO director and the current AVP of Nursing and Patient Care at Prosper, along with Pharmacy and IT departments at Cook Children's realized the need for a vaccine program geared toward parents who had not received their TDAP and flu shots. This is extremely important for the NICU population due to their immature immune systems.

“The database coordinator in NICU created a system to identify very low birth weight infants whose parents did not receive their TDAP vaccine,” Sheralyn said. “Pharmacy talked to parents to establish who would be eligible and after the program started, we were able to branch out and offer the flu vaccine. It has been a collaborative effort and Pharmacy keeps us afloat.”  

“The employees in these specialties have been very engaged and are the ones committed to making changes,” Dr. Carroll said. “This is part one of a long journey and we will build on this year’s successes moving forward. The next step is to complete an in-depth analysis of the survey and review it with the different medical directors, working with them to identify areas the organization can tackle together as we continue to improve our patients’ care.”

Cook Children’s Health Care System has successfully achieved six rankings in the U.S. News and World Report’s Best Children’s Hospital list for 2022-2023. This is an impressive and exciting jump from 2021 when Cook Children’s ranked nationally in two specialty categories.

The report, which was released today, uses clinical data to measure patient safety, infection prevention and adequacy of nurse staffing. Out of 284 children’s hospitals in the U.S., only 90 ranked in at least one of the 10 pediatric specialties evaluated. The following six Cook Children’s specialties were named among the top programs:

• Pediatric Neurology and Neurosurgery - #29 in the nation
• Pediatric Diabetes and Endocrinology - #38 in the nation
• Pediatric Orthopedics - #41 in the nation
• Pediatric Pulmonology and Lung Surgery - #43 in the nation
• Pediatric Cardiology and Heart Surgery - #48 in the nation
• Pediatric Cancer - #50 in the nation

“For more than 100 years, Cook Children’s has been committed to providing the best quality medical care for children. The U.S. News and World Report rankings further validate the tireless dedication of our staff to fulfill our Promise,” said Rick W. Merrill, President and CEO of Cook Children’s Health Care System. “As we look toward the future, with the opening of our new hospital in Prosper, Texas, later this year, we are excited to bring our world-class pediatric care to even more children and families.”

Out of the six specialties ranked on the Best Children’s Hospital list, all but one are currently operating at Cook Children’s Pediatric Specialties – Prosper. Neurology, endocrinology, pulmonology, cardiology and pediatric cancer services are all available for new patient appointments. 

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

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

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

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

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

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

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

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

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

Mentor Mindset

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

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

Her advice to those young professionals?

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

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

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

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

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

Living Legacies

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

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

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

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

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

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

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

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

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

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

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

Family Matters

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

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

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

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

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

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

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

Anna Carey, 16, spoke at a roundtable discussion about e-cigarettes and vaping on Friday, Dec. 6, 2019, at the UNT Health Science Center. Anna was an invited guest of U.S. Sen. John Cornyn and was joined by Fort Worth Mayor Betsy Price, Karen Schultz, M.D., medical director of Pulmonology at Cook Children's, UNT President Michael Williams and others. Anna made quite an impact. We were so impressed with Anna, we asked her to tell her story. 

My name is Anna Carey, and I am 16 years old. I was hospitalized at Cook Children’s for five days because of vaping and dabbing.

I used to play volleyball and tennis, but now I will never be able to play sports again. I started vaping when I was a freshman in high school with a Vuse Vibe that I got from a senior. I switched to the Juul a few months later just because it was “cooler” than the vibe.

I got caught by my parents too many times to count my freshman year, but I never stopped vaping. The summer going into my sophomore year, I stopped because I had no one to buy pods for me. When school started back up in the fall, I started vaping again. This time, seniors would buy pods for me.

Honestly, anyone who is over 18 would buy for me. It really was not hard at all. Around November of my sophomore year, I started to use THC carts, and I began selling pods and carts to my whole school.

I was known for vaping, and it became my entire reputation. We even had a talent show, and my friends and I were called “The Starter Pack” (which is what Juul calls their packages), and my shirt said “salesman.”

Halfway through the year, I switched to Njoy because it was way cheaper than Juul. I lost a lot of friends from middle school because of this, and a relationship ended because of vaping and dabbing. But I didn’t care. Nothing could make me stop. Not even the random pains in my chest when I would use my dab pen, which I mostly ignored.

I feel like I got the entire freshman class addicted to vaping. This past summer, my mom found all of my vapes and dab pens and threw them all away. Since I had been having some pains and lost some friendships, I decided it was time to quit dabbing. But I didn’t stop vaping.

On the first day of school of my junior year, so many people came up to me asking to buy for them, but I was done selling. The guilt of causing all of these addictions had become too much, and I could not escape my reputation at the school.

I left school and became homeschooled, but now I could use my njoy all day. My siblings bought the pods for me because I would get so angry if I did not have pods, and the withdrawals were not worth quitting to me. I saw the news of people dying or getting hospitalized, and I still didn’t care. Literally, nothing would make me stop. I would say things like, “I guess I’m going to vape more” or “I’m not going to stop until I’m hooked up.”

After about two months of me stopping dabbing, I decided to start again because “why not?” I was completely broke, but every penny would go toward vaping and dabbing. I had a system created in my head. I knew I needed $10 every four days because I would go through two njoy pods in about three to four days. I also needed $35 every two weeks for two carts because one THC cartridge would last me one week.

About one month before I was hospitalized, I went to the doctors and got an X-ray on my lungs, and it came back clear. They gave me an inhaler and told me to stop vaping, but I didn’t listen. The pain was insignificant to me since the X-ray came back clear, and I barely used the inhaler.

Then, one day, I was cleaning my room, and all of a sudden, a wave of exhaustion hit me. I was completely drained of all my energy and laid in bed for two days. I had the most awful pain when I breathed and moved, I honestly thought I broke a rib somehow. The day the pain started, I stopped using my THC carts and cut back on my vaping to about three hits a day just to feed my addiction.

I had the worst aches of my life. We still don’t know if that was from withdrawing or the disease, but the pains lasted a week and a half.

I completely lost my appetite and couldn’t eat anything but a piece of fruit a day. About two days after the pain started, we decided to go to Cook Children’s. We waited in the waiting room while I cried my eyes out because of the pain. They did an X-ray on my lungs and an EKG, and it all came back clear. They sent me home, just as I came, and I laid in bed for the rest of the week, just hoping that the pain would go away with time.

Six days from when the pain started, I decided to go to a basketball game with my friend. We had to go up and down stairs where I had to take breaks every couple of minutes so I could catch my breath. It felt like I was running a marathon, even though I just went up a small hill.

The next day we decided to go to urgent care. Still, they couldn’t find anything wrong with me, so they sent me to the local emergency room and did an X-ray where they found that I had pneumonia.

They immediately sent me in an ambulance to Cook Children’s, where they diagnosed me with chemical pneumonia. I was placed on oxygen and monitoring, and it was the worst pain I have ever felt in my entire life. I could not move without gasping for air, my chest constantly ached, and every time I breathed, a sharp pain went through my entire chest. I felt completely helpless.

The scariest part of this whole situation was how little everyone still knows about this disease or how dangerous vaping is for kids. The doctors didn’t know if I would be OK or how much my lungs would heal or anything. The unknown was definitely not worth the vaping at all. I think I needed to be hospitalized to stop vaping, and I think there is a lot of other people who are the same way. It’s hard for a news article to really make a change with a teenager, and I think the only way to end this, is to end vaping.

I caused so many people to be addicted to this. Now I need to help them stop.

Related To This Topic:

• What Parents Need to Know About E-Cigarettes and Vaping
• Why Doctors Believe Vaping Landed 17 Year Old In ICU
• Tobaccoa Use Increases by More than 38% Among High School Students
• Juul, Other E-Cigarettes Called an 'Epidemic' By FDA Chief
• E-Cigarettes Expose Teens to Cancer-Causing Chemicals, Future Cigarette Smoking

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

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

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

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

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

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

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

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

After all, everything had changed.

Austyn was born Jan. 23, 2017.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sounds fun, right?

But the U.S. Food and Drug Administration has sent out an alert of the “potential for serious injury from eating, drinking, or handling products prepared by adding liquid nitrogen at the point of sale, immediately before consumption.”

If you aren’t familiar with the product’s names, you’ve probably seen them at malls, food courts, kiosks, state or local fairs, and other food retailers. They are food and drinks prepared by adding liquid nitrogen immediately before consumption. The products may include liquid nitrogen-infused colorful cereal or cheese puffs that releases a misty or smoke-like vapor.

The concern is that the liquid nitrogen, although non-toxic, can cause severe damage to skin and internal organs if mishandled or accidently ingested due to the extremely low temperatures it can maintain. The alert from the FDA advises consumers to avoid eating, drinking or handling foods prepared using liquid nitrogen at point of sale and immediately before consumption, due to injury.

A particular worry is for people asthma patients. The FDA says “inhaling the vapor released by a food or drink prepared by adding liquid nitrogen immediately before consumption may also cause breathing difficulty.”

The FDA stated that the organization is aware of severe – and in some cases, life-threatening – injuries, such as damage to skin and internal organs caused by liquid nitrogen still present in the food or drink.

Karen Schultz, M.D., medical director of Pulmonology at Cook Children’s, said this warning is definitely a concern for young asthma patients.

“Inhaling cold air is a known trigger for asthma and, in fact, is used to help determine if someone has asthma (called a ‘cold air challenge’)," Dr. Schultz said.

Worsening signs of asthma include breathing that is hard and fast, trouble talking or walking, inability to work or play, constant coughing, or a color change in the lips and/or nail beds. At this point, rescue medications should be given and the family should seek immediate care.

"General signs of initial worsening of asthma include some difficulty breathing, coughing and wheezing, problems working or playing, or waking up at night coughing," Dr. Schultz said. "At this point families should start using their rescue medications as instructed by their physician. Families should call their physician if their child has required three extra treatments in a 24 hour periods or they need them more frequently than every four hours."

Consumers who have experienced an injury because of handling or eating products prepared with liquid nitrogen at the point of sale, immediately before consumption, should consult their healthcare professional. Consumers should also consider reporting their injury to MedWatch. The FDA encourages consumers with questions about food safety to Submit An Inquiry, or to visit www.fda.gov/fcic for additional information.

* Photo Courtesy of the Food and Drug Administration. Read Alert from FDA.

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"One of the triggers of asthma symptoms are respiratory viruses and we are seeing a large number of those driving people to access Emergency Care," said Corwin Warmink, M.D., medical director of Emergency Services at Cook Children's.

Karen Schultz, M.D., medical director of Pulmonary Services, advises parents of children who have asthma to make sure they have an asthma action plan. An asthma action plan should be provided by the outpatient physician who cares for the child's asthma or, if admitted to the medical center, will be provided by the discharging nurse at Cook Children's.

The written plan helps patients develop with their doctor the methods to help control their asthma. The plan looks at the daily treatment of the patient, including medication to take and how to control asthma long term and how to handle worsening asthma, or attacks.

"General signs of initial worsening of asthma include some difficulty breathing, coughing and wheezing, problems working or playing, or waking up at night coughing," Dr. Schultz said. "At this point families should start using their rescue medications as instructed by their physician. Families should call their physician if their child has required three extra treatments in a 24 hour periods or they need them more frequently than every four hours."

Worsening signs of asthma include breathing that is hard and fast, trouble talking or walking, inability to work or play, constant coughing, or a color change in the lips and/or nail beds. At this point, rescue medications should be given and the family should seek immediate care.

To learn more about asthma, Dr. Schultz answered a few of our questions:

1.What is asthma?

Asthma is an inflammatory process that happens in the lungs that causes swelling and increased mucus down in your lungs so it makes it harder to breathe.

2.When do asthma flare ups occur?

An asthma flare up occurs when someone is exposed to a trigger of their asthma. The muscles around their airwaves actually squeeze down and make it even more difficult for people to breathe. They can also get more mucus and more swelling in their lungs, which also makes it harder.

3.What are the triggers?

People have different triggers for their asthma. The most common ones tend to be weather changes, viral infections and exposure to certain allergens. Cold, dry air can cause bad flare-ups and viral infections are the most common trigger this time of year. Parents should stress to their children the importance of handwashing, especially this time of year.

Allergens could include cats, pollen, grass and mold. Another big trigger is exposure to smoke. Exposure to second-hand smoke is a big issue with kids with asthma. Not only can it be a trigger for an asthma flare, but it can keep your child’s asthma from ever getting under control in the first place. Any parent who has a child with asthma, should not smoke. Even smoking outside exposes your child to some smoke particles and can still keep their asthma out of control.

4.Who gets asthma?

Asthma happens to people with a genetic predisposition who then have the right trigger to start their asthma flaring at the right time.

Depending on the age, asthma can be diagnosed in different ways. In very young children and toddlers, it’s diagnosed based on their symptoms and what their physician on examination. So kids that have recurrent wheezing are diagnosed with asthma.

In older kids, 5 years and up, lung function testing can be done to help determine asthma severity.

5.What are the symptoms?

Common starting symptoms of an asthma flare often are just cough. Sometimes families can start seeing the kiddos breathe harder and faster and sometimes they can actually hear them wheeze. But often the wheezing can only be heard by a physician.

If they start noticing their child is breathing very rapidly, if they are sucking their air in above their sternum or in between their ribs, then those are signs that they are really struggling to breathe and a doctor needs to take a look at them.

6.How is asthma treated?

Asthma is treated with inhaled medications generally. The most common medication we use is albuterol which helps relax the muscles that tighten down around the airwaves. However, this will not prevent asthma attacks. To prevent asthma attacks, patients are often placed on inhaled steroids to help control the swelling and mucus in their lungs so they can breathe easier.

Asthma is monitored mainly by symptoms. Your physician may ask how often you are using your rescue inhaler or your albuterol to help determine whether your asthma is under good control or not.

The best way to control your child’s asthma is for him or her to take the medication that your physician prescribes on a regular basis. Many people will think that their children’s asthma is under good control and they will stop their medications and that’s when they start having more flares of their asthma.

Everyone with asthma should have an action plan. It will list out your child’s medications and what to do when they start having symptoms. It will tell you what to do when they have mild symptoms or more severe symptoms and should direct you to the appropriate health care resource should they start having more difficulty.

When children use inhalers for their asthma, they are more effective if they use a spacer, which is generally a clear plastic tube with a mouthpiece that helps the medicine deposit into your lungs rather than stuck on your tongue if you just puff the inhaler in your mouth.

7.When should I see a pediatrician?

If your child is having an asthma attack that’s difficult to get under control, you can try doing extra albuterol treatments or extra puffs of your albuterol. If your child needs more than three extra treatments in a day, then you need to contact your physician.

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Karen Schultz, M.D., a pediatric pulmonologist at Cook Children’s understands the hype, but she sees at least one potentially dangerous side effect for children with asthma.

“To date, there are no published studies that prove or disprove the benefits of salt therapy,” Dr. Schultz said. “As with any therapy, even natural, there are potential side effects. One known side effect of inhaling a salt solution is constriction of the airways which could worsen asthma. So, even though the idea of a non-medicinal cure is attractive, at this point it cannot be recommended without further studies of both safety and results.”

On a website that lists salt rooms, more than 30 states have them. In Texas, at least two locations are in Dallas, one in Fort Worth and they are also found in Austin, Granbury and Southlake.

Saltescape.com describes a salt room, or halochamber, as “a microclimate designed to simulate the environment of a salt mine. The salt room is a dry, sterile environment that controls air temperature, humidity, air pressure and air content. Salt rooms are covered ceiling to floor in a salt application and utilize a halogenerator to crush pharmaceutical grade salt into small particles for inhalation to create the desired microclimate.”

Salt therapy offers a drug-free, non-invasive treatment where salt micro-particles enter into the lungs to help the healing process. Children as young as 3 months old have received treatment. Proponents of salt therapy believe children benefit from salt therapy because they are more prone to respiratory problems and their lungs aren’t fully developed until they are 9 years old. 

"Treating medical conditions without medications does have its appeal, so we are always on the lookout for new ideas and ways of doing things. We must continue to evaluate new ideas with studies that compare any possible risk against the benefit,” said Dr. Schultz. “You can certainly find multiple testimonies from people who swear that they are better after salt therapy. In fact after people with cystic fibrosis (CF) anecdotally noticed that they did better by the ocean, studies proved that use of an inhaled salt solution slows progression of disease, and it has now become a standard therapy.”

About the source

Karen Schultz, M.D., is a pediatric pulmonologist at Cook Children's. To schedule an appointment with her call 682-885-6299. The Cook Children's Pulmonary team diagnoses and treats children with lung diseases. Our team includes board certified pediatric pulmonologists, clinical nurse specialists, registered nurses, respiratory therapists, Child Life specialists, clinical dieticians and social workers. The professional opinion of each team member, including parents, is considered in developing a plan of care for your child. We place a high value on continuity of care with your primary pulmonologist.

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

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

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

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

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

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

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

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

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

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

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

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

Dr. Schultz is a pulmonologist at Cook Children’s. She teaches children and parents how to control their asthma, but there’s only so much she can do once they leave her.

When children don’t follow their asthma plan, it can be extremely dangerous --even fatal. Every day, nine people die from asthma in the United States and 36,000 children miss school due to asthma-related complications.

What bothers Dr. Schultz is that so often these deaths are a result of patients not following through on their treatment.

“It doesn’t happen very often, but it does happen. Even with all the medications and treatments we have to help children with asthma,” Dr. Schultz said. “One of the big things that lead to children being ill or even death is non-compliance with the medications they should be taking.”

She said she often sees teenagers with a false sense of security because they haven’t had an asthma attack for a while. The reason is because their medication and treatment is working. But the teen forgets why they are doing well and stops taking the medication.

“They think their asthma is better or it’s gone,” Dr. Schultz said. “But it’s just being treated and it’s working. They stop their medications and the kid gets sick really fast.”

Dr. Schultz said it’s important for parents to keep up with their children to make sure they are taking care of themselves. She’s disturbed at the lack of responsibilities some parents have in their children’s treatment.

“Some parents aren’t as good at monitoring their children as others,” Dr. Schultz said. “If mom doesn’t refill the medicine, then the child isn’t going to get it. Some parents think that an 8 year old should be responsible enough to manage his or her own medicine. Teenagers should be taking more responsibility by taking their medicine, but that’s an age when developmentally they think they are invincible. They just don’t take it. As parents, you have to make them take it.

“It’s very frustrating. As parents, you put the pill in front of them and make them take it. It’s just that simple.”