Moderator Band (1982)

The Moderator Band, named after a structure in the right ventricle of the heart, formed in spring 1982 when I and a group of fellow first-year medical students/musicians got together to play at the ALL Hill Talent Show on Marquam Hill. We played at the talent show every spring, along with a few All Hill Dances and parties, until graduation in 1985.

After graduation came years of residency training and the start of new medical careers and no time for music. About 10 years ago, we re-started the Moderator Band with five of the original physicians still living in Portland. We get together every Wednesday night in Brenda and Jim Kehoe’s basement for great fun, music and friendship.

Moderator Band (2012)

Each year we support a charitable organization by providing musical entertainment at fundraising events. Last year we raised more than $2,000 for the Nick Wilson Charitable Group, a foundation that helps kids and families in the Doernbecher Pediatric Blood and Marrow Transplant Program.

This year we are playing for the Oregon Food Bank.

The Oregon Food Bank benefit concert will be held Saturday, Feb. 9, from 6 to 10 p.m., at the Lucky Labrador Public House, 7675 S.W. Capitol Highway, Portland. Admission = cash or a food donation.

Come and hear:

• Brenda Kehoe, M.D., OB/GYN, Everywoman’s Health, on vocals and percussion
• Jim Kehoe on keyboards, guitar and vocals
• Bill Rashid on vocals, lead and acoustic guitar
• Rob Skinner, M.D., Urology, Kaiser Permanente, on vocals, drums and mandolin,
• Steve Urman, M.D., Radiology, Mt. Hood Medical Center, on rhythm guitar
• Bob Bailey, M.D., Internal Medicine, Providence, on base guitar and vocals
• Mike Powers, M.D., Pediatric Pulmonology, Doernbecher, on vocals and percussion

The Moderator Band is still rockin’ after 30 years, and this is great chance to help those in need and have fun. Hope to see you there!

Mike Powers, M.D.
Professor of Pediatrics
Head, Division of Pediatric Pulmonology
OHSU Doernbecher Children’s Hospital

Middle ear infection, or acute otitis media, is one of the most commonly diagnosed infections during the preschool years. If your child develops an upper respiratory infection that lasts for one to three days prior to the onset of ear pain, she may have the beginnings of a middle ear infection.

Ear infections are the most common reason for which physicians prescribe antibiotics in children.

In the past decade, there has been a significant increase in antibiotic resistance to certain bacteria, which is now a very important public health concern.

To help prevent the unnecessary prescription of antibiotics for ear infections, we recommend parents and providers consider the following, based on national, evidence-based guidelines:

• To properly diagnose an ear infection, the provider must be able to clearly see the ear drum.
• Ear pain should be treated most often with ear drops and ibuprofen.
• If an ear infection is confirmed, providers and parents may consider a “wait-and-see prescription,” where instead of giving the child antibiotics immediately, the parents delay filling the antibiotic prescription for 48 hours. If the pain improves and the fever is gone, parents may elect not to fill the prescription.
• High fever, infections in both ears, or severe fussiness may be important reasons to start antibiotics immediately.

According to published research on the “wait-and-see” antibiotic prescription method:

• Approximately two-thirds of parents do not fill the antibiotics prescription and their child recovers uneventfully.
• Routine follow-up after diagnosis of ear infections is unnecessary and not recommended.
• Reducing unnecessary use of antibiotics may prevent vomiting, diarrhea, rashes and resistance to further infections for children and family members.

David Spiro, M.D., M.P.H.
Medical Director, Doernbecher Emergency Department
Associate Professor of Emergency Medicine and Pediatrics
OHSU Doernbecher Children’s Hospital

Flu season is in full swing across the country, including the Pacific Northwest. In our state, influenza activity remains moderate — thus far, Oregon hasn’t been severely affected. There have already been 29 pediatric flu-related deaths in the United States this season alone, but none in Oregon.

You can help control influenza activity in our community by getting vaccinated. It’s not too late to protect yourself and your loved ones! 

This season, OHSU Doernbecher has given free flu vaccines to more than 1,000 of our patients’ parents and other adult close contacts. This “Free Vaccine for Parents Cocooning Project“ is intended to protect OHSU Doernbecher’s youngest and most vulnerable patients by “cocooning” infants and other high-risk children, insulating them from infection by ensuring everyone they come into contact with has been immunized.

Vaccinations are still being offered to our established patient family members Monday through Thursday from 1 to 3 p.m. in the OHSU Doernbecher lobby, while supplies last.

For tips on how to avoid the flu, check out the Oregon Health Authority website: “What to do to Avoid the Flu.”

Judith Guzman-Cottrill, D.O.
Associate Professor of Pediatrics, Division of Infectious Diseases
OHSU Doernbecher Children’s Hospital

Eric Thompson, M.D.

I am very proud of each and every resident trained in the neurosurgery residency program at Oregon Health & Science University Doernbecher Children’s Hospital.

Recently, we got some news that one of them will join us in the small but important specialty of pediatric neurosurgery, caring for children with surgical disorders of the brain and spinal cord.

Dr. Eric Thompson joined the OHSU neurosurgery training program in 2005. Raised and educated in Nebraska, Eric was a young and quiet resident who developed an interest, and great talent, caring for children and their families. He also went into the laboratory to help develop better ways of treating children with brain tumors: understanding how to stop tumor growth and reduce the impact of chemotherapy on kids.

In the meantime, Dr. Thompson also developed a leader’s voice. He took a role in teaching students and younger residents. He spoke about his research at national meetings. He represented all OHSU residents on the institutional education committee and won a socioeconomic fellowship for leadership development from our national neurosurgical societies.

It was no surprise to me that my colleagues at the world-leading pediatric brain tumor clinical and research program in Toronto, Canada, selected Dr. Thompson to serve as their 2013-14 Chief Fellow. They see both the accomplishment and promise for our field that he carries with him.

I am excited to see our resident succeed, but also very excited for the future of my chosen field, pediatric neurosurgery. I am also delighted that the experience of caring for children at Doernbecher Children’s Hospital is inspiring the best of our young trainees, in many fields, to dedicate their careers to carrying on and improving the tradition of pediatric medicine and surgery.

Nathan Selden, M.D., Ph.D.
Mario and Edie Campagna Chair of Pediatric Neurosurgery
Director, OHSU Neurological Surgery Residency Program
OHSU Doernbecher Children’s Hospital

This time of year, we pediatricians are inundated with all sorts of sick kids. Colds, influenza and a host of other respiratory illnesses fill our waiting rooms with mucus and coughs. We also tend to see lots of intestinal viruses, and nothing is less fun for a parent than caring for a child with constant vomiting and diarrhea.

What about stomach flu?
First and foremost, stomach flu is not really flu. We reserve the term “flu” for cases of influenza virus, which tends to show up in Oregon right about now. It involves high fevers, muscle aches and bad respiratory symptoms — think of it as a cold on steroids.

What lots of folks call “stomach flu” we call viral gastroenteritis, or inflammation of the stomach and intestinal tract. It is generally caused by a host of different viruses.

What does viral gastroenteritis look like?

The most important thing to pay attention to when your child is vomiting and has diarrhea is preventing dehydration. If kids are losing lots of fluid, and not able to keep their tanks full, they can get pretty sick, and the younger the kid, the more risky it can be. However, if you can help your child keep up with their losses, then everything will be fine.

Most gastroenteritis starts with vomiting. Usually, it is just the stomach contents, but sometimes it includes mucus, or even some yellowish-looking stuff. As long as there is no blood or bright green substance, the child will likely be OK.

What can parents do?

The hardest part about managing vomiting is giving your child fluids that keep coming right back up. The trick is to offer lots of fluids (I’ll explain what kind further along in the post). Give him/her a little bit at a time. We recommend starting with 1 to 2 tablespoons of fluid every 5 to 15 minutes (2 tablespoons = 1 ounce). If that stays down, then slowly increase the amount.

If the child drinks too much too fast, vomiting is likely to occur. In general, the vomiting will last one to three days. If it lasts any longer than that, you should call your health care provider.

Can medicines help?

There is no magic medicine for viral gastroenteritis. And there are no over-the counter remedies that parents can safely give their child. Sometimes, we will give a child with severe vomiting a prescription medication called “ondansetron” to lessen the symptoms and discomfort. Sometimes, we will prescribe anti-vomiting meds like Phenergan or Compazine, but most pediatricians don’t use these drug because of some very well-recognized, and common, bad side effects.

Diarrhea can follow vomiting, or it can start all on its own. In general, the stool will be loose and watery. If you see frankly bloody or mucus-y stools, or your child has a high fever (greater than 102 degrees), it is worth a phone call to your provider. Diarrhea is a bit easier to treat than vomiting because you can give your child as much as she wants to drink without worrying about her vomiting!

Viral diarrhea usually is bad for a couple of days, but it would be fair to expect it to take a week or so for your child’s stool to get back to normal. As with vomiting, there is no magic bullet for viral diarrhea. Again, over-the-counter stuff is not a good choice, as it can be dangerous for little ones.

Now let’s talk fluids

What can you give a child with gastroenteritis? The easy answer is whatever they will drink, with a few caveats. If the child is breast- or bottle-feeding, the best thing to give him/her is breast milk (or formula if that is what they take). Solutions like Pedialyte are specifically designed to rehydrate kids and replenish some of the salts they lose. It is always a reasonable choice, but is not always necessary. Some kids like it, and some do not — they taste pretty salty.

Water, milk, diluted juices, herbal teas and sodas can all be used, and it is a good general rule to give a variety of different liquids. Juice has a lot of sugar and can sometimes make diarrhea worse, so dilute it down to half-strength. Sports drinks have a good amount of sugar as well, so use them with caution.

Some kids will have worse diarrhea with milk, but it is fine to try it. Caffeine can worsen diarrhea as well, so be careful with sodas and teas.

What about food?

As far as eating goes, it is pretty normal for kids who do not feel well to not want to eat much. This drives parents nuts, but it is fine for a child to go a day or two without eating much, as long as she is drinking. If she is hungry, give her what she wants to eat. We used to talk about the BRAT diet (Banana, Rice, Applesauce and Toast). Bland starchy foods are fine, but it turns out that they do not make much of a difference. Just hang tight for a couple of days, and your child will eat again when she feels better.

Dehydration is the biggest worry for us pediatricians. Decreased urine output, lack of tears when crying, dry, tacky mucus membranes (in the mouth, for example) and just feeling cruddy and listless are all signs that your child’s tank could be a bit low. Try and push the fluids as described above, and if you are worried, call your health care provider. Usually, we can get by with fluids by mouth, but sometimes, we need to use more aggressive measures like intravenous therapy.

Remember to practice good hand hygiene

Finally, gastroenteritis is pretty contagious, so be sure to wash hands often, and keep things as clean as you can to prevent a mini-epidemic in your home!

With a few simple tricks, you can keep your kids hydrated and safe if they get hit with a gastrointestinal bug. And remember, your pediatrician is always ready to help when needed!

Ben Hoffman, M.D.
Medical Director, OHSU Doernbecher Tom Sargent Children’s Safety Center
Assistant Professor of Pediatrics, OHSU Doernbecher Children’s Hospital

Alaina

In health care today, innovation is the newest buzzword. We all strive to find new innovative ways to treat certain diseases, to provide safe health care, to create value in our systems.

There are lots of “fits and starts” because not everything always works the way we envision, but when we land on something that does work, it’s like putting that last piece into a puzzle … it feels just right.

That’s how I feel about the OHSU Doernbecher Fetal Therapy Program we developed here about a year ago.

Pregnancy is a unique time in a woman’s life — the only time in medicine where we are caring for two patients at once. When a woman discovers that there may be a serious threat to her developing child, she needs answers and hope.

The OHSU Doernbecher Fetal Therapy Program brings together an interdisciplinary team of maternal-fetal medicine specialists from the OHSU Center for Women’s Health, pediatric subspecialists from OHSU Doernbecher, and experts in fetal imaging, interventional radiology, genetic counselors, clinical nursing and bioethics to help these families obtain a prompt, accurate diagnoses, minimally invasive therapies before birth, and planning for treatment after the baby is born.

Our goal is to ensure that every mother and child has the very best chance for a healthy future.

Ryan

With this goal in mind, we knew that OHSU Doernbecher was uniquely situated to provide a coordinated, one-stop shopping experience by virtue of the fact that we are integrated — all of our services, specialists and resources are in one place.

All of our best resources are focused on one patient at a time, working together to create a coordinated plan that will provide the optimal outcome for each family.

At the center of all of this is the nurse coordinator, Cathy Cromett. She has many years of experience working with women who are facing difficult pregnancies. Every patient we see is guided through the program by Cathy. She is always there to answer questions, hold a hand or just listen.

We recently saw our 200^th patient in this program. I sat in on the care conference for that patient, watching a room full of neonatologists, pediatric surgeons, cardiologists, pediatric urologists, obstetric radiologists, maternal fetal medicine specialists, genetic counselors and our nursing coordinator work together to find the best solution for this woman and her baby. It was incredible to watch the coordination and the integration of the family’s needs and the baby’s medical needs after birth.

I found myself thinking … this is the way it should be, we are really helping people who are facing very difficult situations. It felt just right … the puzzle piece fit perfectly

To learn more about the OHSU Doernbecher Fetal Therapy Program, we invite you to read the following stories submitted by our patient families on “My Doernbecher Story“:

• Ryan’s story
• Alaina’s story

Jan Freitas-Nichols, M.N., P.N.P.
Director, Women’s and Children’s Services
OHSU Doernbecher Children’s Hospital

It’s the end of the day and you’re looking forward to sitting down and relaxing, if only for just a minute, when it begins … the crying.

She doesn’t want to feed. She doesn’t need to be changed, and none of your regular tricks for soothing her are working. She just keeps crying. You are at your wits’ end, but the screaming continues.

You have entered: “The Period of PURPLE Crying.”

Infant crying typically starts to increase when your baby is 2 weeks old and usually ends by 5 months of age. All babies go through this period of crying as part of normal infant development, but some babies cry more than others.

Infant crying can be very stressful for parents and other caregivers, and it’s one of the most common aggravating factors leading to shaken baby syndrome. Young infants are particularly susceptible to brain injury after shaking, which often results in brain swelling and bleeding. This can result in blindness, learning difficulties and in the worse case, death. These injuries can be prevented by learning coping strategies to deal with infant crying.

The Period of PURPLE Crying is a program developed by the National Center on Shaken Baby Syndrome. Each of the letters in the word PURPLE stands for a characteristic of normal infant crying:

• P stands for “Peak.” This is the peak of the crying pattern that increases gradually from birth, peaking in the second month of life then improving thereafter.
• U stands for “Unexpected.” The crying occurs unexpectedly with out any clear precipitating event.
• R stands for “Resists soothing”. The crying may not stop no matter what you do to calm the baby.
• P stands for “Pain”.  The infant looks like she is in pain even though she is not.
• L stands for “Long.” These episodes can last for hours.
• E stands for “Evening”. Most commonly the crying episodes occur in the late afternoon or evening when the caregiver is most exhausted.

Inconsolable crying can be extremely frustrating for caregivers. The period of PURPLE Crying program provides three “action steps” that can help reduce some of the stress of dealing with these episodes.

1. Keep walking, talking and comforting your baby, even if she does not seem soothed by this.
2. If it is safe to do so, put the baby down in a safe place, such as their bassinet, and walk away for a few minutes to collect yourself. Breathe! Then return to your baby to check on them.
3. Most importantly, never shake or hurt your baby.

These steps may not calm your baby every time (remember, the crying is resistant), but they may help reduce your baby’s crying as well as help you stay calm so you and your baby can safely make it through this challenging period.

Your OHSU and Doernbecher physicians and nurses are here to help. Please call if you are feeling frustrated with infant crying.

Ruth White, Ph.D.
Student, OHSU School of Medicine

Carrie Phillipi, M.D., Ph.D.
Associate Professor of Pediatrics
OHSU Doernbecher Children’s Hospital
Director, OHSU Mother-Baby Unit

Thomas Valvano, M.D.
Medical Director, Suspected Child Abuse and Neglect Program
OHSU Doernbecher Children’s Hospital

Resources:

• Period of PURPLE Crying Shaken Baby Syndrome Prevention Program
• The Whiplash shaken infant syndrome: what has been learned?
• Shaken baby syndrome: Rotational cranial injuries—technical report

Editor’s note: Noelle Crombia with The Oregonian recently interviewed Dr. Phillipi about the Period of Purple Crying. You can view the article here.

On a recent morning, I dealt with the death of one of my patients.  As sometimes happens with this job, instead of having time to process this, I was immediately faced with a busy clinic.

After all of the patients were seen, and I had time to reflect, I realized that on the same day that cancer took the life of one of my patients, I had referred three other patients to our survivorship clinic.

And then I thought, “How fitting, because this is what we do.”

For every child that dies of cancer, we save at least three others. Obviously, the death of any patient hits us hard — and it should. But sometimes I think we forget to appropriately acknowledge the successes. Those three kids going to survivorship clinic had aggressive cancers, and each one certainly would have died without our care.  But with our help, each child is cancer free, thriving, and looking forward to a long and fulfilling life with the same hopes and dreams that any other young person may have.

Yet, these “cures” come with such little fanfare. Maybe it’s because it takes such a long time to get through treatment and sufficient follow-up before we can be certain that a patient won’t relapse. Or maybe it’s because there is no exact time that we can say a patient is cured or there’s that little bit of doubt or fear that something bad may still happen.

Whatever the reason, we probably don’t reflect enough on the good outcomes.

I think as the year comes to an end, we should remember to honor all of the patients we’ve lost this year. But we should also not forget to celebrate the lives that we’ve saved.  Each and every one of us should be proud of the collective good that we do.

Suman Malempati, M.D.
Assistant Professor of Pediatrics, Division of Hematology/Oncology
OHSU Doernbecher Children’s Hospital

The horror of this past week is not easily understood. First holiday shoppers in our own community and then school children and teachers in Connecticut were victims of mass murder. The Newtown tragedy was particularly jarring to those of us who have dedicated our lives to caring for children and families.

Through our daily work caring for seriously ill children at Doernbecher, we are accustomed to helping families through the pain and suffering that accompanies caring for a child facing long odds. However, when death comes so quickly and unexpectedly, we are at a loss for words. We find ourselves hurting, as many emotions that we don’t get the chance to deal with in our work rush to the surface.

At a time like this, we need to grieve – individually, as a community and as a nation. We also need to be more mindful of letting those we care for know how important they are to us. We need to give and receive a few more hugs this week, and we all need to take extra time and steps to let those we love know just how much they mean to us.

But if we only grieve, we dishonor the young lives we’ve lost. I believe we need to move on to action to improve ourselves, our communities and our nation. Our children deserve better.

The status quo is unacceptable:

• I believe we must fight a culture that glorifies violence as entertainment.
• I believe we must view gun violence as a public health issue and apply all the tools at our disposal to fight this epidemic.
• Finally, I believe we must examine and improve our mental health system so that help is more available to our young people before they break.

Together, we can rededicate ourselves to making America the very best country in the world to be a child.

H. Stacy Nicholson, M.D., M.P.H.
Professor and Credit Unions for Kids Chair
OHSU Department of Pediatrics
Physician-in-Chief
OHSU Doernbecher Children’s Hospital

John L. Scott team

My father was a pediatrician and my mother is a nurse, so I grew up around hospitals and medical offices.

That exposure has given me an appreciation for how difficult it can be to provide the care necessary for families and children, and Doernbecher has been a strong leader in the community, providing children’s health and supporting families that need assistance.

It means a lot to me that the company I work for has an 80-plus year tradition of community giving and supporting children’s health care.

What’s incredible is that the contribution of both time and money comes not only from the top, but from nearly every one of our employees and broker associates. It always feels good to partner with people that share your passion for children and our community.

The John L. Scott Foundation was formed in 1997 and supports events that have helped raise more than $7 million last year for children’s hospitals throughout the Northwest.

Our mission is to help kids stay healthy and get home as soon as possible. That’s why John L. Scott and OHSU Doernbecher Children’s Hospital are a natural fit. Their partnership has continued to grow and thrive every year since it first began at Doernbecher’s inagural Radiothon in 2001.

Joe Reitzug, vice president, John L. Scott R.E.

The radiothon is an event that I really enjoy doing. You get to interact with the public who are so generously donating, and the event is located in the hospital lobby so it really hits home with how important it is.

My wife and I had some personal interaction with Doernbecher many years ago, and that has really provided a lot of passion for helping them further their mission.

It’s just a really neat way to help out. This is a time of being thankful and for giving. That’s really what Doernbecher Children’s Hospital and the John L. Scott Foundation are all about.

Joe Reitzug
Vice President
Residential Operations for Oregon and Southwest Washington
John L. Scott Real Estate

Editor’s note: Be sure to tune in to 99.5 The Wolf between 9 a.m. and 7 p.m. Dec. 13 and 14 to hear inspirational stories from Doernbecher patients and their families.