M AT T E R S - Dartmouth

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M
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Summer/Fall 2009
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The Newsletter of the Children’s Hospital at Dartmouth
Seven-year-old Sydney
helps teach Dartmouth
Medical School students
JACOB’S JOURNEY FROM EPILEPSY
The unbeatable combination
of a courageous family and an
extraordinary medical team
CHaD CLASSIC AT 25!
A quarter century of golf in Quechee
to support CHaD kids & families
Welcome to CHaD Matters!
W
hen patients and families are actively engaged as partners with their
CHaD care teams, that’s when the best outcomes are possible. In this issue you’ll read about an extraordinary partnership between a remarkable
family and CHaD’s Neurology/Neurosurgery team. And speaking of collaborations, truly
wonderful things happen when grownups play games for CHaD kids!
You might have run into nine-year-old leukemia patient Cameron Marshall and his
family at the 2008 CHaD Half Marathon. Instead of dwelling on his illness, Cam established the “B+ for CHaD Kids” fund to provide fresh fruit and to purchase small refrigerators for some inpatient rooms. “Be positive” is Cam’s blood type and his personal motto,
and he’s turned it into a way to help others.
It sounds like a cliché, but it’s utterly true that amazing stories emerge almost every
day here at CHaD. We’re only able to bring you a few of them to you in the pages of CHaD
Matters.
Paul A. Merguerian, MD
Director, CHaD
Program Director, Pediatric Urology
Thanks to the 2009
contents
CHaD Partners who have
underwritten and provided
Features
12
Enhanced Pediatric Emergency
4
QLLA Charities: 25 Years of Fun & Services at CHaD • Investing Today in
Games to Support CHaD Kids
CHaD’s Tomorrow • DHMC/CHaD 8
The Journey from Epilepsy: Jacob
Verified Level I Pediatric Trauma Center
Lackie’s Story
Fun & Activities
CHaD Notes
B+for CHaD Kids • Safety Rounds
3
Partners
substantial support of our
events and activities.
14-15Cannon Mountain Ski Day for
Kristen’s Gift • 10th Anniversary 6
LiviNHealthy Pediatric Weight
CHaD Ski and Ride • Warren Miller Management Program • CHaD
Film
Pediatric System Integration Update
New CHaD Provider
10
Hypothermia: Cooling ICN babies to 6
Eunice Chen, MD, Pediatric
prevent damage • At Age 7, Sydney Otolaryngology
Teaches Dartmouth Medical
CHaD Champions
Students an Important Lesson
7
Wal-Mart
11
Families with Babies in Intensive 11
Kohls
Care Benefit from New Project
13 Irving Oil
Back Cover Calendar of Events
CHaD Matters is published by the Children’s
Hospital at Dartmouth. Please address
correspondence to: Sharon Brown, CHaD,
Dartmouth-Hitchcock Medical Center, One
Medical Center Drive, Lebanon, NH 03756,
or email to CHaD.Community.Relations@
Hitchcock.ORG.
© 2009, all rights reserved, Dartmouth-Hitchcock Medical Center
Contributors: Cathy Brittis, Sharon Brown,
Samuel Casella MD, Joanna Celenza,
Elizabeth Clarke, Nicole Drouin, Lori Harris,
Tracey Jacobi, Kim Kraus, Kristen LaFromboise,
David McWilliams, Rolf Olsen, Maia Rutman
MD, Toby Trudel, Jack van Hoff MD, Katherine
Villars. Photography: Jason Aldous, Fred
Kfoury, Tom McNeill, Jim Stankiewicz, Mark
Washburn, CHaD staff. Design: Porter House
Design. Printing: Imperial Company, Inc., on
recycled paper
2
M atters
Printing sponsored in part by:
Imperial Printing
B+ 4 CHaD Kids
B
+ is not just 9 year old Cameron
Marshall’s blood type, it is his, and
his family’s, motto. When Cam was
diagnosed with leukemia in July of 2008,
and found out his blood type, he latched
on to it as a mantra for hope in fighting his
cancer. But it didn’t take long for the Marshall family to realize they were not alone
in this fight and rather than focus inward
on their struggle, they are choosing to focus
on others, and other CHaD families are the
benefactors.
Principal Jeff Valance carries Cam across
the finish line at the CHaD Half.
B+ (B Positive) emerged during the debut
of Cam’s Course, a new component of the
CHaD Half Marathon in 2008. Dedicated to
Cam, members of the Lyme, NH community
emerged 400 people strong to support Cam
during the event. Supported by two anonymous donors who paid for and matched all
the Cam’s Course participants’ registration
fees, Cam’s family, including all 7 siblings,
mom and dad, showed up in yellow t-shirts
sporting the B Positive slogan. But what they
found was a community in support of them.
As Cam was carried across the finish line by
his school principal, Jeff Valance, the crowd
hummed Chariots of Fire, a moment anyone on the Dartmouth Green that day would
not soon forget.
It was about that time that Elena Marshall, Cam’s devoted and inspirational
mother, came to CHaD leaders and discussed expanding their personal motto
of B+ in support of CHaD. Elena’s and the
family’s wishes were to use Cam’s illness
as an opportunity to “pay it forward” and
look for ways to help other CHaD families.
With Cam and Elena, CHaD leaders and
the support of an anonymous donor, work
began to conceptualize the plan. Orange
bracelets with the slogan were purchased
to help spread the word. But who knew, Cam
was about to figure it out on his own.
Cam, on one of his lowest days, lay on the
couch dozing and thinking about what to do
with B positive. There were copyright issues,
design issues; so many things to think about.
Elena shared what happened that day. “I was
carrying him to the bathroom, because he
was too sick to walk, and I said, it’s been a
tough day honey. He replied, ‘It’s been a great
day mom. I’ve come up with the name. It’s B+
4 CHaD Kids. That says it all.’”
Cam was right. It said it all. For Christmas, Cam launched his own personal secret
Cameron, Kennedy and Elena Marshall are all
smiles when dropping off their secret Santa
check.
Santa campaign. Raising nearly $3,500, the
family requested the money be used to provide daily fresh fruit baskets on all three
CHaD inpatient units and purchase several
small refrigerators for patient rooms. The
refrigerators help families afford to nourish themselves while their child is hospitalized, an experience the Marshalls have had
plenty of throughout Cam’s treatments this
past fall and winter. The work and plans
continue as the Marshalls and the Friends of
CHaD work together under the framework:
B+ for CHaD Kids. Watch for more details on
the chadkids.org website.
An online fund has been set up for B Positive. To donate, go to www.chadkids.org
and click on the “Donate Now” button for a
complete list of funds available, including
the B Positive Fund.
Safety Rounds: You can learn a lot by just listening!
I
L-R: Katherine Williams RN, Didi Sheets RN, Bridget Mudge RN, Dr. Paul
Merguerian and Emily Hoffman RN focus on quality and saftey.
n our quest to make CHaD
a safer hospital, we have instituted regularly scheduled
Safety Rounds. During these one
hour sessions we visit the CHaD
unit and invite EVERYONE to
share their ideas about improving safety for our young patients.
The response has been wonderful, and we’re working hard to
address all the concerns that
have been raised. It’s especially
rewarding to hear the different
perspectives of patients, parents,
and the many different staff who
work at CHaD. Our goal is to be
proactive and to prevent errors
and accidents from occurring in
the first place. For those errors
that will inevitably occur, we
strive to create safeguards that
will prevent them from reaching
our patients. This is best achieved
when we recognize that EVERYONE can contribute to making
CHaD a safer place.
M atters 3
CHaD Classic at 25: A Quarter
Century of Golf for CHaD Kids
T
here’s a certain symmetry to the
concept of grownups playing
games and having fun as a way of
helping sick children get well. And perhaps
nowhere else have the games been so robust
and the results over 25 years so generous,
tangible and vital as the annual CHaD Classic Golf Tournament.
interest from the corporate community in
the form of sponsorships, advertising and
other income for the tournament.
Even with prize purses for the professional golfers during the early years and
other expenses of running such a large public event, there was always a considerable
sum left over for the kids.
Modest Beginnings
A Huge Cast of Characters
In 1984, Ginny and Tom Lane, with
their friends and neighbors, established
the Quechee Lakes Landowners’ Association Charities (QLLA Charities) as a way to
channel proceeds from the existing New
England Open Pro-Am Golf Tournament to
support worthy local causes. Their survey
of the region identified pediatric services
at Dartmouth-Hitchcock Medical Center
as one of the charity’s initial beneficiaries.
(Children’s Hospital at Dartmouth (CHaD)
wasn’t formally established as a “children’s
hospital within a hospital” until 1991.)
The Pro-Am Tournament, established
in 1980, had quickly become an important
annual event in the region, attracting many
noted pro golfers to the courses in Quechee
and an abundance of interest from local
amateurs. When you add the element of
charitable support for kids in the hospital
to an event run by community and business leaders, with dozens of energetic volunteers, the combination also generates
Over the years, so many people have
been involved that it would be impossible
to list everyone here, but certainly notable
names and faces spring to mind. Penny and
Drew Cunningham have supported the
tournament since the very beginning. Key
sustaining corporate support has been provided by Centurion Insurance – a company
founded and presided over by Drew Cunningham – as well as Golf & Ski Warehouse
and Quechee Lakes Development Group.
Past chairs of the CHaD Classic include
Vermont Senator John Campbell (no doubt
with much assistance from wife Kathy), Jim
Keighley and Lorraine Guile. This year’s cochairs are Sharin Luti and Gail Ferney.
Any list of key players is bound to be inadequate, as each year’s tournament requires
the orchestrated efforts of dozens and dozens of volunteers. We beg the indulgence
and forgiveness of everyone not mentioned
by name here!
Jim Keighley, Co-Chair, Billy Casper, Golf Legend, John Campbell, Chair, Laura Baugh, LPGA
Pro, John Ziegler, Co-Chair enjoy a few minutes together before teeing off at Quechee.
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M atters
John Ferney, Jim Keighley, Gail Ferney and
Drew Cunningham were honored at a recent
Friends of CHaD Board meeting.
Professional Long Driver Mike Gorton is a
true friend of CHaD.
Favorite Memories
The “Long Drivers” add a thrilling and
sometimes comical note to the Classic.
These professional ‘ringers’ are positioned at
select holes and, for an additional contribution to CHaD from golfers, they “guarantee”
to get the ball onto the green for them in just
one stroke! Notable among regular long drivers at Quechee is Mike Gorton, a four-time
World Long Drive Champion from Colorado.
Not only does Mike help out during the tournament, he also pledges five percent of his
professional long drive earnings to CHaD.
In 1998, despite some concern that the
event wouldn’t survive without the attraction of professional golfers, the CHaD Classic turned fully amateur and all efforts focused on having a great time while raising
as much money as possible for CHaD kids
and families. But that didn’t mean the end
of celebrity sightings on the Quechee links.
Penny and Drew Cunningham have been
there since the beginning.
Golf legend Billy Casper, LPGA pro Laura
Baugh and the late Jeff Julian are among
many notables from the world of golf who
have helped out over the years.
In 2003, QLLA Charities added a pretournament gala event, adding to both the
festivities and to each year’s total contribution to CHaD. Gala events have included silent and live auctions, “A Night at the Races”
Vermont State Senator John Campbell gets a
tip from the late golf pro Jeff Julian in 2001.
and Las Vegas-style casino nights.
And each year the CHaD Classic has ‘sold
out,’ with roster of teams and players that
fully occupies the Quechee Club’s two magnificent eighteen-hole golf courses! Did we
mention that the Club donates the use of the
courses? Yet another substantial contribution to the bottom line for the tournament.
The shotgun start as Quechee’s two pristine
courses fill with CHaD golfers.
Silver Anniversary Milestone
Now, on the eve of the twenty-fifth anniversary of the CHaD Classic, there’s a very
real possibility that the tournament’s cumulative total support for CHaD over the years
will exceed $1.5 million, a milestone that
was most likely never imagined at the outset. But many believe that it sets the pace for
the next 25 years.
Where the Money Has Gone Over the Years
1984-1993: Support during the early
years went to CHaD’s Pediatric Oncology Program and the Intensive Care
Nursery (ICN), including funds for the
“Koala Suite,” named for QLLA (often
pronounced koala). The Koala Suite is a
private room adjacent to the ICN where
families learn to provide total care of
their infant – with medical staff immediately available – before they go home on
their own, often many miles away.
1994-1996: During the period shortly
after CHaD was formally established,
funds were allocated through a minigranting process. CHaD and QLLA leaders would meet to review requests and
provide funding for selected programs
and projects, including the purchase of
chair beds for parents, loaner hearing
aids for deaf children, support of CHaD’s
Child Life Program, the creation of poison prevention displays and more.
1997-1999: QLLA Charities made a
$100,000 pledge to the new Pediatric
Intensive Care Unit, a state-of-the-art,
freestanding unit that remains one of
CHaD’s most distinctive facilities and a
recognized center of excellence.
2000-2001: CHaD Classic funds supported the development of CHaD’s PainFree Program, created to reduce pain
and stress for children who need to go
through some tests and procedures. This
program has become nationally known
for its effectiveness and outstanding
compassionate care for children.
2002-2005: Tournament proceeds
helped construct CHaD’s Outpatient
Center that opened in July 2005. This
remarkable facility offers a child-friendly,
interactive waiting area and a pediatric
center that brings together virtually all
of CHaD’s pediatric medical and surgical
sub specialties. For the first time nearly
all children see their doctor(s) in one
place at DHMC.
2006-present: QLLA Charities has made
a five-year commitment to support one
of CHaD’s most fragile and vulnerable
patient populations – abused and neglected children – through a pledge to
provide operating as well as endowment
funding for the Child Advocacy and Protection Program (CAPP). CAPP collaborates closely with protective services,
law enforcement, schools, social service
agencies, and referring providers, and
offers not only urgently scheduled evaluations, but also ongoing medical education throughout the region.
M atters 5
Welcome to CHaD!
Eunice Y. Chen,
MD, PhD
Medical School: MD, PhD,
Stanford University School
of Medicine, Stanford, CA,
2001; Internship: Stanford
Hospital & Clinics, Stanford,
CA, General Surgery, 200102; Residency: Stanford
Hospital & Clinics, Stanford,
CA, Otolaryngology (Chief
Resident 2005-06), 2002-06;
Fellowship: Children’s Hospital and Regional Medical
Center, Seattle, WA , Pediatric Otolaryngology, 200607; Board Certification:
Otolaryngology; Specialty:
Otolaryngology
2009 Unsung Hero Awards
Diabetes Education Award
Cong rat u lat ions to CHa D/
Dartmouth-Hitchcock Pediatric
Diabetes Education Program for
successfully completing an audit.
During the process of the audit,
this program demonstrated excellent pediatric care standards
and successful implementation
of goal-setting and evaluation
of goals for effective behavior
change, typically more successful in adult programs in a pediatric setting. Kudos to coordinator
Laurie Campbell, RD, LD, CSP,
CDE and staff who demonstrated
a commitment to offering a comprehensive and effective diabetes education program to their
pediatric clients.
There are very few pediatric programs that achieve this
recognition from the American Diabetes Association. The
excerpt above appeared in the
ADA newletter.
LiviNHealthy Pediatric
Weight Management
Program
Y
On April 6, 2009, The Child Advocacy Center (CAC) of Grafton
and Sullivan Counties at DHMC
and The CAC at The Family
Place located in Norwich, Vermont, joined together in their
annual Shield Our Children
From Harm Campaign. Three
individuals were recognized as
“Unsung Heroes” for their efforts in dealing with child abuse
issues in our region. From left
to right, Dr. Martha Robb, Child
Psychologist at the Counseling
Center of West Central Behav-
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M atters
ioral Health in Lebanon; Cindy
Vezina, Victim/Witness Advocate in the Sullivan County Attorney’s Office; and Kelly Wallace, Family Educator at The
Family Place were honored for
their dedication, compassion
and for efforts going above and
beyond the call of duty each day.
Standing behind are Cathy Brittis (left), program manager for
the Child Advocacy Center of
Grafton and Sullivan Counties
at DHMC, and Jeanne McMahan of The Family Place.
ou hear it in the news
and in your child’s
school. According to
the Centers for Disease control
and Prevention (CDC), more
than 17% of children ages 6-19
years old are considered obese.
Children who are obese have an
increased risk of getting health
problems including high blood
pressure and Type 2 diabetes.
For some children meeting with
their primary care provider can
help them get back on track
with good nutrition information and ways to get their family
more active. For those that need
more, CHaD has developed the
LiviNHealthy Comprehensive
Pediatric Weight Management
Program. This team of providers
specifically trained in weight
management including pediatric gastroenterology specialists,
fitness trainers and nutritionists
work with the children and their
families to achieve a higher
sense of self-esteem and to cre-
Kathleen Broughton, a certified
fitness trainer with the CHaD
LiviNHealthy Comprehensive
Pediatric Weight Management
Program, discusses fitness goals
with an adolescent girl and her
father.
ate a long-term change in eating habits and improved fitness
level. The program is offered at
both Lebanon and Manchester
locations, but patients must be
referred by their primary care
provider. For more information, please call (603) 695-2745
in Manchester or (603) 653-9609
in Lebanon.
Wal-Mart Pep Rally
A
new level of excitement and energy was evident at this year’s
annual Wal-Mart and Sam’s
Club meeting at CHaD on Wednesday,
March 18, 2009. The 35 Wal-Mart and
4 Sam’s Clubs had reached an amazing
milestone, raising $430,000 this past year,
bringing the total raised since 2001 to
$2,343,000! Breaking the $2 million mark
was cause for celebration, though tempered by our country’s current economic
situation, and knowing that raising that
amount of money would be much harder
in 2009 than it had been last year.
Dr. Jack van Hoff, Medical Director
for the Pediatric Oncology Unit at CHaD,
spoke about the great strides in care
for children with cancer. He told about
changes that would make it possible for
cancer patients at CHaD to take part in
cancer trials, giving them access to the
latest developments in cancer research.
Following Dr. van Hoff a very personal
and heartwarming film on Avery Forrestall, a CHaD patient fighting leukemia,
was shown. Becky Forrestall, Avery’s
mother, then spoke about the excellent
care Avery and her family had received
at CHaD.
The highlight of the meeting was a
special CHaD/Wal-Mart version of the
TV game show Jeopardy, developed by
CHaD’s own Toby Trudel, and hosted by
young Avery Forestall, who took great delight in picking people from the audience
to answer questions about Wal-Mart and
CHaD trivia.
Paul Busby, Wal-Mart’s Vice President
for the Northeast Region, rose for his much
anticipated portion of the meeting. Paul
spoke eloquently about how blessed they
all were that Wal-Mart and Sam’s Club
had had a very good year, in spite of the
current recession. Their success was all
the more reason why it was important for
them to support CHaD. Quoting from the
Bible, Mr. Busby said “From those to whom
much is given, much is expected.”
Mr. Busby historically has been the
one to set the goal for the coming year.
Based on what had been raised in 2008,
and with the expectation that his Managers and Associates always strive to improve, he set a goal of $475,000. Looking
over to Skip Dykstar, Community Coordinator for the Weymouth store, who was
sitting with Tony Tiner, Store Manager for
the Amherst, NH Wal-Mart store, both
having been very instrumental in leading
Wal-Mart’s annual golf tournament, Mr.
Busby asked “Skip, what do you think of
that goal? Do you think it’s a reasonable
number?”
Skip responded “Mr. Busby, Tony and
I were discussing this as we drove to the
hospital this morning. This year will be
the ninth anniversary of our CHaD golf
tournament. We have set the date for this
year’s event. It will be held on September
9th, 2009. That makes it the 9th tournament on the 9th day of the 9th month in
the 9th year of this century. So our feeling
was that our goal should be $499,999.”
After the laughter subsided, Mr. Busby
said “Skip, I like your number better than
mine!”
After thank you remarks, and information on this year’s New Hampshire Medicaid cut backs from Dr. Paul Merguerian,
Acting Medical Director for CHaD, Nancy
Formella, President of Mary Hitchcock
Memorial Hospital closed out the meeting with thanks to everyone there, from
the vendors to Wal-Mart and Sam’s Managers and Associates. Ms. Formella then
pulled a dollar bill out of her pocket and
with a smile said “Mr. Busby, I have a
dollar here. Let’s make the goal an even
$500,000.” A cheer went up to finish off
the meeting.
New
Integrated
System of
Care
L
ast fall, CHaD leadership initiated discussions to explore
bringing together all pediatric care throughout the
Da r t mout h-Hitchcock
system under the umbrella of the Children’s
H o s p i t a l a t D a r tmouth. Now, in addition to inpatient care
in Lebanon and specialty care in Lebanon, Manchester and
Dover, all pediatric primary care providers
in Canaan, Lebanon, New London, Plymouth, Manchester, Concord, Nashua and
Keene are part of system-wide program for
the delivery of children’s services.
There are significant benefits for all
stakeholders including patients and families,
providers in our own Dartmouth-Hitchcock
Community Practices, providers who refer
patients to us, and to CHaD as part of an
important academic medical institution.
• Clinical Care: Shared protocols and
common standards of care for children
throughout D-H will enhance the care and
provide consistent practices for all children
which represent the best care possible.
• Communication: Improved communication between providers facilitates a standard process for referrals, and feedback on
care to primary care practitioners.
• Access: Enhanced and streamlined
access to CHaD specialty services and for
admissions.
• Planning: Cross system/regional planning for improved service delivery and the
deployment of resources for children of
northern New England to ensure that the
right care is delivered at the right place, at
the right time, every time.
Watch for more information in the coming months, and we welcome your comments and suggestions.
M atters 7
The
Journey
from
Epilepsy:
Jacob’s
Story
“
I remember the day – it was January
24th of ’07,” recalls Heather Lackie.
She and her two children were alone
in her mother’s home in Littleton, NH. She
glanced at three-week-old Jacob, resting in
his car seat, and saw that he was blue, his
eyes were “doing funny things,” and he was
gasping. Frightened, Heather picked Jacob
up and was able to settle him down, but when
her mother returned home a short while later,
the same thing happened again.
They both knew that something was very
wrong, so they called the emergency room
at Littleton Hospital and told them they
were on their way.
“When we got there, he did it again,”
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M atters
Heather recalls. “They called CHaD and
said they had a little boy with seizures and
we don’t know why.” Jacob was immediately
transported to CHaD by ambulance.
So begins the journey together of Jacob
Lackie, his courageous family and CHaD’s
skilled and committed team of pediatric
neurologists and neurosurgeons.
“Jacob was very little when I first met
him, just three weeks old,” recounts pediatric neurologist Richard P. Morse, MD.
“He came to the hospital with intractable
seizures, multiple seizures per hour at that
time.” Dr. Morse and his team first used
video EEG (encephalograph) monitoring to
determine that Jacob was indeed experienc-
ing epileptic seizures.
Jacob’s situation was different in many
ways. For seizures to begin in the first few
weeks of life without an injury often indicates
that there’s a serious underlying cause. Also,
Jacob’s seizures were different from most
baby seizures, and more frequent. Jacob
briefly responded to some medications, but
his seizures always came back.
Looking for Causes
“Once we determined that Jacob was
really experiencing seizures, the next step
was to look for possible causes,” according
to Dr. Morse. In a case like Jacob’s, where
the epilepsy is quite severe and “focal,” the
underlying cause is very likely to be anatomical – some type of malformation in the
brain – so surgical treatment is considered
early on.
“At CHaD, we have an unusually fruitful
and collaborative relationship between the
Neurology and Neurosurgery,” says Tina
Duhaime, MD, director of CHaD’s Pediatric Neurosurgery Program. “Dr. Morse believes that if he’s involved in a case where
surgery may be the best option, you get the
surgeons involved very early. My feeling is
the earlier we’re involved, the better.”
Neurologists help diagnose a problem
like epilepsy and consider how likely it is
that some type of surgery will help a patient.
The role of the neurosurgeon is to determine
the potential risks of an operation. Once the
medical team has as much information as
they can gather, they present it to the family
so they can weigh all the known risks and
benefits and make a decision.
Dr. Morse’s team monitored Jacob’s
brain activity using electrodes attached
to the outside of his head and they identified a “hot spot,” where seizure activity
appeared to originate. “The discovery of
the ‘hot spot’ was exciting and scary,” according to Heather. “We had an answer – at
least somewhat of an answer.”
The Lackie family decided that they
wanted surgery for Jacob. Dr. Duhaime
agreed that it looked like surgery might be
Jacob’s best option, but she asked the family to first try the “ketogenic diet” to see if
he would experience any improvement.
The ketogenic diet helps two out of three
children who try it and it even prevents
seizures in some children. The diet is very
high in fats and low in carbohydrates, and
causes the body to burn fat for energy instead of glucose. For Jacob there was no
improvement after about six weeks, so he
was scheduled for surgery.
Three Surgeries for Jacob
Jacob’s first surgery was to more accurately determine from where in his brain
the seizures were arising. Dr. Morse’s team
used electrodes on the outside of Jacob’s
head to begin this search and now Dr. Duhaime team used probes to measure and
record activity on the surface and inside Jacob’s brain. “From that data, we can tell the
family if we remove or disconnect a certain part of the brain, what’s the likelihood
that it will help the seizures and what’s the
likelihood that can cause harm,” explains
Dr. Duhaime.
In a second surgery, Dr. Duhaime removed a portion of Jacob’s left occipital
lobe that the team determined could be
removed safely and might reduce Jacob’s
seizures with minimal other consequences. This reduced the seizure activity only
briefly, but Jacob’s family was able to report that “we got Jacob back!” During this
respite they were able to see Jacob’s personality re-emerge from the seemingly
endless barrage of seizures, a key encouraging sign for everyone involved.
“Then we needed to have a conversation with the family about disconnecting
the entire half of the brain, a procedure we
believed had an excellent chance of working to stop the seizures,” explained Dr.
Duhaime. The risk was that Jacob would
almost certainly have some weakness in
his hand, but children can often recover
to some degree and the medical team believed he’d be able to walk well and use
his right arm. Having seen a glimmer of
Jacob after the earlier surgery, the Lackie
family was not only willing, but anxious
to move forward with this surgery. Jacob’s
spark is back!
“Jacob is seizure-free,” says Dr. Morse,
“which is a thrill for all of us, most of all for
his family. He has managed to gain back
most motor skills, he gets around quite
beautifully. It’s been a fantastic result.”
“Jacob’s spark came back,” adds Dr.
Duhaime, “and this is exactly what this
family wanted. A great outcome like this
isn’t possible unless you have teamwork,
and the team includes all the people that
are behind the tests and evaluations that
children like Jacob require. It requires doctors with skills like Dr. Morse and his team,
and a surgeon who’s willing to take on this
kind of risk with the family. But most of all
it takes a family that is willing to put aside
the fear that families must face in the longterm best interests of the child.”
Heather Lackie reports, “Jacob is now
mobile, he scoots around on his butt – it’s
quite cute, and he gets anywhere he wants.
He’s your typical boy, into everything. And
he learns something new every day.”
What would she share with other parents facing a similar situation? “Be persistent, be strong, be your child’s best advocate. Push on, because your children need
you and the doctors need your help too.”
Watch Jacob’s video story at www.
CHaDKids.org
M atters 9
Professor
Sydney!
At Age 7, She Teaches Dartmouth Medical
Students an Important Lesson
T
he pituitary gland, sometimes called the “master
gland”, produces eight different hormones that affect
many different parts of the body. During the Endocrinology Section of the Scientific Basis of Medicine Endocrinology course, second year Dartmouth Medical School students
hear multiple educational lectures, and read about each hormone in medical textbooks. The challenge is to comprehend
that huge amount of information and to relate it, in practical
terms, to the care of patients.
Enter Sydney – a beautiful 7-year-old girl whose pituitary
gland was destroyed by a childhood tumor. During a one hour
session, Sydney captivated her audience as she (and her mom)
taught the second year students about the challenges of hypopituitarism. The students learned a lot about diagnosis and treatment, but more importantly they had a refreshing reminder of
the human side of medicine and the tremendous satisfaction
of restoring normal health and development.
Hypothermia: Cooling babies to prevent or
reduce brain and organ damage
S
ometimes at or near the time of a baby’s birth, doctors may suspect a condition called asphyxia – a potentially
serious lack of oxygen supply to the brain and
other organs, such as the lungs, heart, liver
and kidneys. There are many possible causes
for asphyxia and it can happen before birth, at
the time of birth or shortly after a baby is born.
A new treatment protocol in CHaD’s Neonatal
Intensive Care Unit (NICU) offers hope for
reduced risk of injury from asphyxia.
Two large research studies have shown
that when babies who are at risk for brain
injury are treated with hypothermia shortly
after birth, they have less brain injury and
10
M atters
fewer cognitive (thinking) and motor (moving) problems than when they are not treated
this way. Hypothermia is a treatment where
babies are intentionally cooled using a special blanket to a body temperature of about
92 degrees Fahrenheit (down from a normal temperature 98.6 degrees F) for about 72
hours under constant monitoring.
The goal of this treatment protocol is to
return the baby’s oxygen and carbon dioxide levels and blood pressure to normal, and
to support him or her so the body can repair
damage that it is possible to repair. It is very
important for babies who experienced asphyxia to receive close monitoring of their
development either through a neonatal
follow-up program at CHaD or through another early intervention program.
Families with Babies in
Intensive Care Benefit from
New Collaborative Project
T
he hospitalization of a baby in
a neonatal intensive care unit
(NICU) can be one of the most
frightening, confusing and overwhelming
experiences a parent can have. In 2008,
the Intensive Care Nursery (ICN) at CHaD
partnered with the March of Dimes to offer
NICU Family SupportSM to provide comfort to families during their baby’s intensive
care nursery stay.
At CHaD, this support is provided by
a part-time paid parent, Joanna Celenza,
who came to the position with experience
as a parent of a child who received intensive
care at CHaD and also as chair of the Parent
Advisory Council. Joanna helps connect
parents to CHaD’s many care and service
initiatives, and she works closely with the
ICN staff to identify opportunities to improve the care the healthcare team provides
to families.
Dr. William Edwards, the ICN’s Medical Director, commented on the Nursery’s
strong commitment to family-centered
care and their appreciation for the partner-
ship with March of Dimes. “Our ICN has
had a strong Parent Advisory Council for
10 years and the funding we have received
has made this position possible and our
support of families that much stronger.” At
CHaD,philanthropy through Jane’s Trust
provides financial support to complement
funding from March of Dimes.
During its inaugural year, this program
at CHaD has touched many families with
a child in the ICN through distribution of
information, Parent Hour education classes
for families, as well as providing individual
support of families in the Intensive Care
Nursery.
During Parent Hours, parents and families have an opportunity to meet other
moms and dads and participate in activities such as making scrapbooks. They also
learn from guest speakers who provide
information about caring for a baby in the
ICN, infant nutrition and safety, and other
important topics.
“As families cope with and grow from the
intensive care nursery experience, we know
Joanna Celenze (L), paid parent, supports other
moms and dads in the nursery.
that our collaborative efforts have supported them through an extremely difficult time
in their lives,” said New Hampshire March
of Dimes State Director Karen Dennis. “We
want to thank the staff at CHaD and we look
forward to our continued work together.”
Kohl’s Cares for Kids
K
ohl’s Cares for Kids has provided
CHaD with support for the Injury
Prevention Center, and this year
the annual bike rally and safety event at the
New Hampshire Motor Speedway has been
renamed to the Kohl’s Safe Kids 500. The
500 took place on May 4th.
This year Kohls donated $25,000 to CHaD.
All money raised is from customers’
purchase of stuffed animals and books
at the Kohls Cares for Kids display at the
Lebanon store.
Kohl’s Cares for Kids support has focused on programs that take place outside
of the hospital, programs that reach out to
the public through instruction and safety
training. Their goal is to use their support to help prevent childhood injuries and
hopefully keep kids out of the hospital.
The Kohl’s Safe Kids 500 did just that
with booths in the NASCAR race track’s
pits for organizations promoting everything from fire to gun safety, drowning
to bike and traffic safety. Police and fire
departments are regular partners along
with a bike repair shop who help adjust the
kids’ bikes, check their tire pressure and
straighten their wheels. Most important
is the helmet safety check. Everyone must
have a helmet to ride, and this year the
Kohl’s A-Team of volunteers will be checking the fit of everyone’s bike helmets.
M atters 11
Enhanced Pediatric
Emergency Services
C
h i l d r e n’s H o s p i t a l a t
Dartmouth-Hitchcock is pleased
to announce enhanced services
for children needing emergency treatment. In March two new state-of-the-art
pediatric rooms opened in the Emergency
Department (ED).
CHaD is equipped and staffed to handle
the most critically ill or traumatically injured children, whether they live in the Upper Valley or arrive via DHART helicopter or
ground ambulance from anywhere in the
region. The CHaD ED is staffed with pediatric physicians during high-volume evening
and weekend hours 7 days/week.
“CHaD and the ED have demonstrated a
strong commitment to improving emergent
pediatric care at DHMC,” said Maia Rutman
MD, Director of CHaD Emergency Services. “The construction of the new pediatric
rooms allows us to provide even more timely
care for children in the ED, in an environment designed to be functional and comfortable for our patients and their families.”
In the coming months, a third emergency treatment room will be added to the
pediatric emergency suite. With the reno-
D
artmouth-Hitchcock Medical
Center was recently verified as a
Pediatric Level I Trauma Center.
Level I is the highest designation given by
the American College of Surgeons Committee on Trauma, which conducts the rigorous
review process every three years. DHMC is
the only health care facility in all of northern New England with the Pediatric Level I
designation and one of only three with the
Adult Level I designation.
vation of the Pediatric/Fast Track waiting
room to provide more age-appropriate activities for waiting children and families,
these areas will create a dedicated zone of
pediatric care within the existing very active and comprehensively capable DHMC
Emergency Department.
Investing in CHaD’s Tomorrow
C
haritable giving is a critical ingredient in CHaD’s ability to provide
the unique family centered care
for which it is known, and there are many
ways that donors can give.
Hanover resident Barbara Hall and her
late husband, David, chose to support CHaD
through one of several charitable gift annuities they established with DHMC. “CHaD
has become a model of how you can improve the care of children and address the
needs of the parents, too. And to think that
we have it right here,” Barbara noted in explaining why they made this commitment.
Donors who arrange to give to CHaD
through their estates are often able to make
more significant gifts than their resources
allow during their lifetime. Strategies such
12
M atters
DHMC/CHaD:
Only Verified
Level I Pediatric
Trauma Center
in Northern
New England
as providing for CHaD through a bequest or
as the beneficiary of a life insurance policy
or retirement account are simple to do and
may reduce estate taxes. Other forms of deferred gifts, such as charitable gift annuities, can offer immediate financial benefits
to the donor and benefit CHaD.
“These gift annuities help me financially now, but long-term they’re a way to give
back to the hospital to support areas that
have been especially important to us,” said
Barbara. “One of those is CHaD. I think it’s
an exemplary part of the hospital.”
For more information about deferred giving opportunities for CHaD, contact Carol
Olwert, Associate Director of Individual Giving, at 603-653-0723 or Rick Peck, Director of
Gift Planning, at 603-653-0735.
To meet the
stringent Level
I sta nda rd, a
facility must be
capable of providing leadership and total
care for every
aspect of injury,
f rom prevent ion t h roug h
rehabilitation.
In addition to acute-care responsibilities,
Level I Trauma Centers have the major responsibility of providing leadership in education, research and system planning. This
responsibility extends to all hospitals caring
for injured patients in the region. Although
among the most rural Trauma Centers in
the U.S., more than 1,500 trauma cases were
admitted in 2008.
Clinic for Children with Brain Tumors
CHaD has added a Pediatric Neuro-Oncology Clinic to the list of
services to address children’s special needs. The Neuro-Oncology
clinic provides multidisciplinary care to children with tumors of
the brain, spinal cord and peripheral nerves, and is staffed by Dr.
Jack van Hoff (Pediatric Oncology), Dr. Douglas Hyder (Pediatric
Neurology), and Pediatric Neurosurgeons Dr. Susan Durham and
Dr. Tina Duhaime.
Children with brain tumors present special challenges. There
are often special considerations related to the fact that these tumors are located in the brain. These children may have seizure
disorders, vision, hearing, or other neurologic deficits, learning
problems, and even endocrine difficulties, when the pituitary gland
is involved. Although pediatric neurosurgery often has a key initial
role in tumor management, these complex patients receive the best
care when pediatric oncologists and neurologists also collaborate
closely. The Neuro-Oncology Clinic was established to promote
an even closer working relationship among the physicians and to
decrease the number of trips that a family has to make to CHaD.
Patients are often scheduled to have an MRI first thing in the morning on the day of clinic, and then to see the specialists in the Clinic. The
Clinic physicians make a special effort to meet as a group with these
young patients and their parents. This enables the family to participate
in the discussion among team members as they review the MRI and
prepare care and treatment plans. Families are reassured that this
group of physicians is truly working together as a team.
The physicians also appreciate the chance to work together.
Dr. van Hoff comments, “I had directed a neuro-oncology clinic
for many years in my previous institution, but we always saw the
patients sequentially and not as a group. Working together like this
has given me insight into how the other specialists work and has
also been a lot of fun. It may take a bit more time this way, but the
benefits for the patients and families make it worthwhile.”
Irving Oil
D
onna Vega and her son Angel, a
patient at CHaD with Chrohn’s
disease, talk with WMUR TV
news at the Irving Oil Press Conference to
announce Irving Oil’s donation of $40,000
in travel vouchers to CHaD to be given out
to families traveling a long distance to
receive care for their children.
When Angel Vega walked into the lobby
area at DH-Manchester for the Irving Oil
Press Conference, you knew you were meeting a very special boy. Angel suffers from
Chrohn’s disease, a reoccurring intestinal
illness that can be extremely painful and
debilitating. You would never know that
Angel was suffering from Chrohn’s. He exudes confidence and broad smiles. He truly believes that he has beaten the disease,
whereas his mother, Donna, has to remind
him that one of the main reasons that he
feels healthy is because of the medication
his doctor has prescribed for him and because of the care he receives at CHaD.
The Vegas have to travel a long distance
to receive care for Angel and this is where
Irving Oil comes into the picture. Irving
Oil’s travel vouchers have provided much
needed travel support to Donna and Angel Vega and many other families in New
Donna and Angel Vega hold Irving Oil’s check with Dr. Pamela M. Hofley, CHaD’s Southern
Region Medical Director. Lars Trodson, US Manager for Public Relations for Irving Oil
shakes hands with Dr. Steven Paris, Medical Director, D-H Manchester.
Hampshire and Vermont, allowing them
to get to important medical appointments.
This is the 6th year of Irving Oil’s support.
This past December Lars Trodson, Manager of Public Relations for Irving Oil, presented CHaD with $40,000 in travel vouchers, bringing their total since the program
began in 2004 to $232,000.
Channel 9, WMUR TV news asked Angel what he wanted to do after high school.
Angel grinned and said he wanted to work
in medicine. He wanted to become an x-ray
technician, and had to leave soon to get
back to a special program through his high
school for students interested in medical
careers. We all can be very thankful to Irving Oil for helping Angel get to his doctor’s appointments and win his battle with
Chrohn’s, but also for making it possible
for him to succeed in school and hopefully
help others as an x-ray tech in the future.
M atters 13
fun&activities
NH’s Local Heroes on Skates for CHaD Kids!
Things were hot on the ice between New Hampshire’s
Police and Firefighters at the Verizon Wireless Arena in
Manchester, NH on March 1, in the 2nd annual CHaD
Battle of the Badges. The game was intense and it was
clear to the cheering crowds that the players were in
it for the pride of their team and the “battle between
the badges” had become a reality. Jamie Staton of
WMUR Television was the Master of Ceremonies, and
he and Boston Bruins legend Rick Middleton were both
impressed by the level of competition this year, and
the more than $105,000 raised.
A 7-3 victory was claimed by the NH Firefighters
- setting the stage for an intense rivalry at next year’s
game! Continuing a tradition, the NH Firefighters
were the Highest Fundraising Team, raising more
than $32,000. The Highest Individual Fundraiser was
Michael Dore of the Nashua PD, a newcomer to the
event for the NH Police who raised more than $5,000
as part of his team’s total of over $27,000.
New this year was a “JR Police” vs. “JR Firefighters”
game, played by children in the Pee Wee Division of
the New Hampshire Youth Hockey Association, who
raised an impressive $7,500. Volunteers were out in
force keeping things running smoothly for all from
Bank of America, Best Buy, Kohl’s, the New Hampshire
Fisher Cats, and SNHU, among many others.
The CHaD Battle of the Badges proves that our
local heroes in uniform do as good a job on skates, as
they do in the field taking care of northern New England’s children. We are especially grateful to Chief
Wayne Sheehan of the Kensington PD and Micky
Drouin of the Dover Fire Department for the stalwart
teams they assembled and look forward to seeing
them face off again next year.
Thanks to our wonderful sponsors including all
the folks at SMG and the Verizon Wireless Arena;
Bank of America; Margarita’s Mexican Restaurant;
Merchants Automotive Group; Nathan Wechsler &
Company, TMSi, Inc.; Baker, Newman & Noyes, LLC;
Berry, Dunn, McNeil & Parker; Novel Iron Works, Inc.;
Northeast Delta Dental; Howe, Riley & Howe; PLLC;
Hession & Pare, P.C. CPA’s; Catholic Medical Center;
Centrix Bank & Trust; The Granite Group; Wiggin &
Nourie PA; Griffin, York & Krause; Sullivan Construction; Sheehan Phinney Bass & Green; and Electrocraft, Inc.
Clokwise: ‘Badge Dads’ with their biggest
fans; #1 fans; Captains Mickey Drouin (R)
and Wayne Sheehan (L) with Bruin Rick
Middleton; A little crowd support; NH
Firefighter Team Captain Micky drouin and
his son share the game trophy.
Warren Miller’s “Children of Winter”
The historic Palace Theatre provided the venue for
the Manchester showing of Warren Miller’s 2008
snow sports film, “Children of Winter.” Each year, the
Warren Miller event kicks off CHaD’s winter fundraising efforts and this was the 11th consecutive sellout
(over 850!) in its history at the Palace. The show benefits Kristen’s Gift, CHaD’s pediatric oncology fund. The
film, shown for the first time in Blue-ray, showcased
the best extreme snowboarders and skiers at great
14
M atters
locations throughout the world.
The evening’s events included raffles, giveaways
and a silent auction featuring items as unique as a
Polaris ATV, Patriots tickets, Fisher skis and Autocad
design software. New England Picture also auctioned
unique sports memorabilia including autographed
Celtics, Red Sox and Patriots items. The Warren Miller
event raised over $32,000 for Kristen’s Gift. Volunteers from Kohls, Best Buy, the Manchester Wolves
and the Bishop Brady High School ski team helped
make the night a great success. Sponsors included
Bank of America, Ken Jones of Manchester, Holloway
Motor Cars and Northeast Kustom Kreations.
Sponsors are already being sought for the 2009
event. For more information, contact Toby Trudel in
CHaD Community Relations at 603-629-1862 or toby.
trudel@hitchcock.org or visit www.kristensgift.com/
warrenmiller.
10th Anniversary Ski and Ride
Despite the wet and warm weather conditions, this
year’s 10th Anniversary CHaD Ski and Ride Festival
was a huge success; and a true end of winter celebration in New England.
With over 163 participants, 50 volunteers, and
a current tally of over $67,000, the day was nothing
short of amazing! Although Mother Nature gave
us an early dose of spring- like weather conditions,
including April rain, smiling faces and laughter were
a plenty. As best told by Dimatix team member Joel
Wood “… even the rain couldn’t wash that away!”
Highlights of the day included; folks flying over
the Face of the mountain off of our custom made “Ski
Jump”; challenging one another in a race against time
at our “Speed Check”; testing one’s agility at the “Obstacle Course” and other such fun on-hill activities. The culmination of the days’ activities took place
at the site of our inaugural Snow Box Derby. From
purple cows and ambulances to mystery machines
and to a giant, authentic replica of a Toblerone candy;
there was no shortage of creativity and fun. We thank
our participants for their great work in designing and
RIDING sleds using only cardboard and tape.
We hear sled construction for the 2010 Derby is
already under way in some homes across the Upper
Valley, so we hope to see YOU out on the slopes with
us next year.
This year’s event was once again hosted by the
Dartmouth Skiway in Lyme NH, with generous support through other local foundations, organizations
and companies such as The Byrne Foundation, Hypertherm, Mascoma Savings Bank, Delta Dental, The
Lake Morey Resort and Computac.
Lottie Best, dressed as our favorite fourlegged sleuth, Scooby, shows some team
spirit with other members of the “Mystery
Machine” team
The M2S “Medical Moguls” team learns that what goes up, MUST COME DOWN in their
one-of-a-kind cardboard ambulance sled!
Cannon Mountain Ski Day for Kristen’s Day
On what was described as the best mountain conditions of the year, skiers from across New England
came to Franconia New Hampshire for the annual
Kristen’s Gift Ski Day at Cannon Mountain. Along
with some fantastic family skiing, this year’s event
included an exciting racing component with over 40
participants. Advance ticket sales, on-site registration and a lively auction all contributed to the event
raising over $15,000. Proceeds from the Ski Day go to
support Kristen’s Gift, the pediatric oncology fund at
CHaD. This year’s sponsors included Bank of America,
Mountain View Grand Resort & Spa, Verizon Wireless Arena and Next Step Orthotics & Prosthetics.
Key auction donors were Mittersill Alpine Resort,
New Hampshire Fisher Cats, Sunset Hill House, Cannon Mountain, WZID, Sport Thoma, the Hampton Inn
and New England Picture. Special thanks to Best Buy
who provided several volunteers and the PA system. For more information contact Toby Trudel at
603-629-1862 or toby.trudel@hitchcock.org or visit
www.kristensgift.com.
atCHaD
M atters 15
Non-Profit
U.S. Postage
Paid
Lebanon, NH
Permit No. 211
One Medical Center Drive
Lebanon, New Hampshire 03756
Address Service Requested
Calendar of Events
CHaD Classic: 25th
Anniversary Gala &
Golf Tournament
Quechee Club,
Quechee, VT
Monte Carlo Night
Saturday, June 13
Join us for a food and fun as QLLA Charities brings a
little bit of Las Vegas, to the Upper Valley. What happens
in Quechee stays in Quechee as we kick off a weekend
celebration of the 25th Anniversary of the QLLA Charities
CHaD Classic Golf Tournament. For reservations call the
Quechee Club, (802) 295-9536.
CHaD Classic Golf Tournament
Monday, June 15, 2009
Be a part of the celebration as golfers tee off for this
annual tournament! Registration is at 8:30 am with an
11 am shotgun start; dinner immediately following. For
reservations or sponsorship opportunities contact Gail
Ferney, (802) 296-7128 or jngferney@aol.com, or go to
www.dhmc.org/chadclassic.
17th Governor’s
Breakfast at New
Hampshire Motor
Speedway
Loudon, NH
Friday, June 26 @ 8:00 AM
Start your engines...and join us for the 16th Annual Governor’s Breakfast at New Hampshire Motor Speedway. Hear
racing stories from featured speaker and rookie driver
Joey Logano over bacon and eggs with drivers from the
Camping World Series East and the Whelen Modified
tour! Tickets for this sell-out event are $30. Corporate
tables are also available. Doors open at 8:00am. For
reservations or sponsorship opportunities contact Kristin
LaFromboise, (603)-653-3437, or Kristin.P.Lafromboise@
hitchcock.org
4th Annual CHaD Half
Marathon
Hanover, NH
Saturday, August 29
Something for everyone!
Half Marathon - Relay
Team - Walk - or Family
Friendly “Cam’s Course.”
Picturesque scenery, fanfriendly location, FUN-FUNFUN! And stay tuned to
learn more about how you
can be part of an attempt
to break a “heroic” World Record! For more information
or to register contact Kim Kraus, (603) 650-3431, or Kim.
Kraus@hitchcock.org, or go to www.CHaDhalf.org
2nd Annual CHaD
Seacoast Classic
Underwritten by FairPoint Communications
The Oaks Country Club,
aD Seacoast Classic
CH
Somersworth, NH
Thursday, October 15
This year’s CHaD Seacoast
Classic golf tournament
will be held at The Oaks in
Somersworth. Registration includes a light breakfast,
round of golf, tee prizes and lunch. Last year’s event
was sold out well in advance. To reserve your spot or for
more information go to www.chadseacoastclassic.com,
or contact Toby Trudel at 603-629-1862 or Toby.Trudel@
Hitchcock.org.
Warren Miller Ski Film Evening
Sunday, November 15 @ 4:00 PM
The Palace Theatre
Manchester, NH
Join us for what we expect to be the 13th consecutive
sold out showing of the Warren Miller ski film in Manchester. This year’s show will mark Warren Millers 60th
annual feature film and showcases the talents of the best
extreme skiers and snowboarders in the world. Proceeds
go to benefit Kristen’s Gift, the pediatric oncology fund at
CHaD. For more information go to www.kristensgift.com/
warrenmiller or contact Toby Trudel at 603-629-1862 or
Toby.Trudel@Hitchcock.org.