Building a Family, Day Trippin’ with Red Blood, inside: Building a Bridge • Pedi Rehab • Blue • summer/fall PAGE 6 PAGE 12 PAGE 18 2005 A SAN FRANCISCO COUPLE A TRIP TO THE ZOO IS REAL- MAKING DYLAN’S HEART ADOPTS AN ETHIOPIAN ORPHAN. WORLD REHAB. WHOLE. 2 CHILDREN’S HANDPRINTS table of contents 6 3 DEAR READER Letter from the president

4 THIS AND THAT Beads of Courage Mapping the journey to good health starts with a strand of beads. Waves of Hope in Tsunami-ravaged Indonesia Children’s nurses bring their talents to Indonesia. Rare Blood, Found! Matching Aaron’s very rare blood type was a life-and-death matter. Cooking for a Family of 100 How Children’s feeds a hundred hungry mouths 10 and keeps them all smiling. 6 IN THEIR OWN WORDS Building a Family, Building a Bridge Children’s Hospital’s International Adoption Clinic recently helped a San Francisco couple deal with the health concerns of an orphaned child they adopted from Ethiopia.

10 FEATURE: SPORTS MEDICINE Comeback Kid The Sports Medicine Clinic helps a talented teen bring his baseball-pitching career back to life.

12 PHOTO STORY Day Trippin’ with Pedi Rehab When the Pediatric Rehabilitation staff take their 12 patients to the zoo, it’s not just to see the animals. 16 PHYSICIAN PROFILE Staying Balanced Buddhist meditation and personal art-making helps psychotherapist Joanne Yeaton keep her balance while she helps kids keep theirs.

18 FEATURE: CARDIOLOGY Red Blood, Blue It took a team of pediatric specialists, hundreds of community friends, a caring employer and the spirit of a family to see Dylan through four open heart surgeries before he turned 4.

20 CHILDREN’S HOSPITAL & RESEARCH CENTER FOUNDATION Children’s Helps Homeless Mothers A grant-funded study will help Children’s 18 Hospital learn how to keep homeless women and their children together, to not let substance abuse or mental health problems lead to family dissolution. Grateful Families Give Back to Children’s Saying thank you is one more way to help. Children’s Miracle Maker Awards Children’s Miracle Maker Awards honor staff with a history of extraordinary patient care. The American Dream Realized Alfredo Moreno left Children’s a substantial bequest after a life filled with hard work and a loving family.

24 BOARD LIST

26 RESEARCH What’s Up with Diabetes The best way to beat disease is to prevent it.

ON THE COVER: Dylan’s heart defect opened the heart of a community. See “Red Blood, Blue” starting on page 18. Photo by Gary Turchin. SUMMER/FALL 2005 3

Children’s HandPrints is a publication of Children’s Hospital & Research Center at Oakland, 747 52nd Street, Oakland, CA 94609; 510-428-3000.

Written, designed and produced by: Marketing Communications Dept. at Children’s Hospital & Research Center at Oakland 665 53rd Street Oakland, CA 94609 Phone: 510-428-3367 Fax: 510-601-3907 Frank Tiedemann Dear Reader: President and Chief Executive Officer Mary L. Dean Senior Vice President, External Relations Welcome to the Summer/Fall 2005 edition of HandPrints, the magazine of Children’s Hospital & Research Center at Oakland. Vanya Rainova Director, Marketing Communications The first thing that distinguishes a children’s hospital from other Editor facilities is that our specialists care just for kids. The word “just” can Tina Amey be misleading. There is nothing limiting about pediatrics. On the Receptionist contrary, while we focus on ensuring the well-being of children, our Debbie Dare areas of expertise and communities of care are constantly expanding Senior Graphic Designer to adjust to the needs of kids and their families. Susan Foxall Operations Manager For example, on page 10 you can read about how a three-sport Nina Greenwood high school athlete’s pitching career came dangerously close to an Marketing Manager end before sports medicine specialists helped him back into the Tom Levy game. The Sports Medicine Clinic for Young Athletes is a new and Senior Writer unique service, the only such program in Northern California. Venita Robinson Our vision of health mirrors the broadness of our community Director, Media and Community Relations of care: it reaches beyond ensuring physical health to include Gary Turchin addressing the psychosocial challenges that kids face. A Children’s Writer psychotherapist (page 16) uses modern biofeedback techniques to Diana Yee Media Relations Specialist ease kids’ anxiety. Our work is varied and far-flung. But the disparate storylines of Contributing Writer: Melissa Diagana our patients and providers all reflect our commitment to providing the best pediatric care. Contributing Illustrator: Neile Shea Sincerely,

Story requests, comments or Frank Tiedemann suggestions for Children’s HandPrints President and Chief Executive Officer may be e-mailed directly to Vanya Children’s Hospital & Research Center at Oakland Rainova ([email protected]), or sent to 665 - 53rd Street, Oakland, CA 94609. 4 CHILDREN’S HANDPRINTS this this this this this this this this this ANDthat ANDthat ANDthat ANDthat this ANDthat ANDthat ANDthat ANDthat ANDthat ANDthat Beads of Courage Waves of Supportive care gets a new tool, Hope in and it’s a beaut! Tsunami- Kids with cancer endure countless probes, injections and ravaged tests. It takes courage and resilience Indonesia to get through the treatment. They Children’s nurses should get medals. bring their talents to The new Beads of Courage program Indonesia. SHIP SHAPE: Mary Frazier with a young at Children’s Hospital & Research Center at Oakland does just The tsunami of patient and his mom aboard the USNS that. Patients are awarded beads for each procedure or treatment Mercy. milestone. By the end of their treatments, kids have a strand of 2004 created an inter- colorful beads, a map of their journey to good health. national humanitarian crisis. Answering the call for help were “To see Patricia’s history visually like this is pretty over- Children’s Mary Frazier, RN, and Tammy Leung, RN, who whelming,” says Dina Macdonald, mother of 3-year-old Patricia, volunteered for assignment aboard a Project HOPE ship, the while studying her daughter’s first strand of beads. Patricia has USNS Mercy, in Banda Aceh, Indonesia, for earned enough beads for at least two strands, including 33 red three and four weeks of what Mary calls beads for 33 blood transfusions, 100 white beads for 100 days of “grinding nursing duty.” chemotherapy and 8 glow-in-the-dark beads for 8 radiation By the time the two nurses arrived, the treatments. There’s also a special hand-made glass bead to first wave of tsunami victims had already acknowledge the day Patricia met Sam, a special friend in her been treated. But there was plenty to do. unit, and a blue glass bead for a particularly courageous day. The local hospital, some 20 blocks from “That’s when we got over our pity party,” Dina remembers. # shore, was devastated. A six-foot wall of mud had wiped out the pediatric ward, SILLY MOMMY: Patricia shares a light moment with mom. killing the children and many of the The 3-year-old has earned enough Beads of Courage to fill medical staff. two full strands. “The culture accepts death as a part of life,” Mary emailed from aboard ship. “They expect God to give them challenges on earth. They are grateful for our care and very gracious. They are humble, modest and respectful. I feel blessed to be among them.” Both nurses worked night shifts, Mary in the medical/surgery ward, Tammy in the pediatric intensive care unit (PICU). They didn’t go ashore often, but when they did, they were flown on military helicopters. Patients were brought in the same way. AIRBORNE: Tammy [above] and Mary Shortly after the nurses returned home, aboard helicopters Indonesia was struck by a huge earthquake. on their way ashore. Tammy promptly returned to Project HOPE, which had moved near the quake’s epicenter in Niaz Island, Indonesia, for another three weeks of duty in the ship’s PICU. # SUMMER/FALL 2005 5 this this this this this this this this this ANDthat ANDthat ANDthat ANDthat this ANDthat ANDthat ANDthat ANDthat ANDthat ANDthat Rare Blood, Found! Cooking for a Family of 100 Matching Aaron's very rare blood type was a life-and- How Children’s feeds a hundred hungry mouths and death matter. keeps them all smiling.

Sometimes at Children’s It’s hard enough feeding a family of four, with everyone’s we’re forced to seek the prover- taste buds different. Imagine feeding a family of a hundred, all bial needle in the haystack. kids, every day, three squares and snacks, with as many dietary Case in point: Aaron, 4, needs, restrictions, allergies, calorie and fat content guidelines, has sickle cell anemia, an inher- religious and flavor preferences as there are mouths. And imag- ited blood disease. It caused his ine offering them on-call room service, any time between 7 a.m. spleen to enlarge and in and 7 p.m., ordered from a full-scale restaurant menu. Finally, December, Keith Quirolo, imagine keeping all the patients happy and satisfied. That’s the MD, the boy’s longtime pedia- task Children’s Food Services faces every day. trician, said the spleen would It takes a tag-team-like effort, starting with dietetic assistants have to be removed. who answer the phone and take orders. They pass the orders to But routine blood tests EXTRA EXTRA: Aaron’s story chef Irma Villagomez-Miranda, a trained culinary expert. was front page news in the revealed something startling— “It’s not always the most glamorous cooking,” says Irma, San Jose Mercury News. Aaron had one of the rarest who has worked in many upscale cookeries, “but I get a great blood types in the United States. Finding a match would be diffi- deal of satisfaction from cooking for these kids. When I see cult. Without a match, there could be no surgery and he could die. them going home, I know we contributed in some small way.” Aaron’s already rare hrB negative blood type had changed as Irma, or her colleague, chef Arturo Garcia, makes everything a result of a transfusion he had received a few months earlier. to order, then hands the dish to tray-line aid Genet Gebru, who American Red Cross specialists who performed DNA testing on puts the final touches on the presentation before handing it off the blood found that it lacked a common antigen (proteins that to Franklyn Neckles, who delivers the fresh, hot meal. attach to the red blood cells) and had developed antibodies that “I’m the one who gets all the smiles,” he says, smiling. # were molecularly different from anything they had ever seen. His parents and relatives from all over the state were tested, but none matched the boy’s type. As an African-American, Aaron’s best hope was another African-American donor. The Red Cross launched a national search and consulted the American Rare Donor Program in Philadelphia, Penn. They suggested the blood type might only be found in South Africa. The story does have a happy ending. After a three-month search, two compatible donors were located in the Midwest. Today, Aaron is well. Future blood donations from the two compatible donors are earmarked for the Hayward youngster. But Aaron’s story is a cautionary tale: without more African- American blood donors, people with sickle cell anemia (the large majority of whom are African-Americans To donate blood, who require frequent call 1-800-GIVE-LIFE blood transfusions and (1-800-448-3543) or log medical interventions) on to www.beadonor.com. are always at risk. # BON APETITE: Chef Irma puts years of culinary training to work feeding our kids. 6 CHILDREN’S HANDPRINTS

A San Francisco couple adopts an Ethiopian orphan with help from Children’s Hospital’s International Adoption Clinic.

Building a Family, Building a Bridge One month after my surgery, I was hiking in the he same week I had my uterine fibroids IN THEIR removed in a comfortable, modern Berkeley Rocky Mountains with my sister, while half a world hospital, our future daughter, Asmina, was away, Asmina’s birth mother had died. Sadly, no one in T OwnWORDS born in a small hut in southern Ethiopia. The next the village realized she had been so ill. week I was home, with painkillers and my loving hus- BYMELISSA The three orphaned girls needed a caregiver, so some- band, Thierry, helping me recover. DIAGANA body sent for their mother’s sister. It took her several The week after Asmina’s birth, her days to walk to the children’s village. EXTENDED FAMILY SNAPSHOT: Melissa and While the aunt could feed the older birth father died, probably of AIDS, Thierry Diagana, at left, pose with members of leaving his wife with their new baby their adoptive daughter’s extended family, from sisters injera bread, made from teff, and two other daughters, ages 3 and 5. left, Asmina’s aunt — Zinesh Bekele, Asmina’s the local grain, she could not feed Suspecting she also had AIDS, sister, Alemtsehay, 5, another aunt, Zenebech injera to the baby. Asmina’s birth mother refrained from Gabre, Asmina’s other sister, Netsanet, 3, and A neighbor alerted a local social Asmina’s adoptive grandmother, Gete Tadew. worker affiliated with Wide breast-feeding, hoping to reduce the [Right] Typical rural huts, called tukuls, near the chance the HIV virus would infect her southern Ethiopia home village of the Horizons For Children, our adop- baby. Diaganas’ adoptive extended family. tion agency, telling her there was a

www.childrenshospitaloakland.org SUMMER/FALL 2005 7

International baby next door who was not going to survive spot test), both measure the level of anti-HIV Adoption Clinic without help. The social worker and Asmina’s antibodies in the blood. Because it was believed In 2004, American families grandmother brought Asmina to an orphanage Asmina’s mother had died of AIDS, we expected adopted more than 22,000 children in Addis Ababa. When she arrived there, positive results from the antibody-based HIV from other countries, more than Asmina, 3 months old, weighed only a bit more tests; Asmina should at least have received triple the number adopted 10 years than six and one half pounds. maternal antibodies against HIV, even though ago. But the nannies, nurses and direc- she herself could be free of the virus. We had Making sure these kids are tor of the orphanage were wonder- serious questions: could the clinical labora- healthy can be difficult. Many don’t ful, and soon Asmina was growing tory have made errors in its HIV analyses, have medical histories available, or rapidly. She endured a couple of and by extension, the others? have spent months or years in an trips to the hospital for bouts of We later discovered that the lab institution. Most internationally bronchitis and pneumonia, but in question is recommended by the adopted children come from poor our tough little cookie weathered American consulate in Addis Ababa, and is countries where nutrition and those storms as well. one of several Ethiopian Voluntary Counseling healthcare may be marginal. During all of this, we were unaware and Testing Centers for HIV, so we assumed Some kids may have problems of Asmina’s existence and knew nothing they knew what they were doing. Perhaps stemming from these origins. One of what she was going through. But Asmina’s mother had not died from AIDS, but study showed almost 60 percent about three weeks after she arrived at the from another disease. have a serious medical problem on orphanage we got a phone call from our We spoke with a nurse practitioner friend initial screening, 80 percent of adoption agency: We had a daughter! We specializing in AIDS who suggested that which are unsuspected before received a pixilated photo and some very Asmina’s mother could have been so sick she no arrival. Some growth and develop- scanty medical information. longer produced anti-HIV antibodies. She mental lags are seen in nearly all We thought about adoption for years warned us that without a test for viral load, the children; vitamin deficiencies, before actually taking our first steps to which measures the number of HIV particles, infections and inadequate adopt. Both Thierry and I traveled widely we would be gambling. Unfortunately, it wasn’t immunizations are common. while growing up, and our four parents possible for such a test to be run. Early exposure to toxins, such as alcohol and lead, and unrecog- were born in four different countries, on Our heads were in a tizzy. But after days of nized congenital conditions are also three different continents, so it felt natu- worry and indecision, we realized we were concerns. These children may also ral to think about expanding our own family’s already in love with Asmina and ready to take exhibit problematic behaviors horizons with an international adoption. that gamble. If our little girl turned out to be related to institutionalization and At first we thought of making our family a HIV-positive after all, whatever treatment we psychological trauma. mix of biological and adopted children. But would be able to give her in the United States Working with providers experi- when we started trying to have our own biologi- would be vastly superior to what would await enced in detecting the medical and cal child, we ran into problems. After some dif- her in her village. psychosocial problems these ficult times, we decided not to go through the We excitedly made our travel arrangements children share can be crucial to effort and uncertainty of a high-tech approach and started looking for a doctor to see Asmina helping families adopting children to dealing with infertility. Instead, we agreed to once we returned home. We wanted someone from overseas diagnose and deal use our energies and money to bring into our experienced with diseases common in the devel- with such problems quickly. lives a child who was already born and needed oping world, who wouldn’t freak out if our little The International Adoption loving parents. babe had a few parasites or was smaller than the Clinic at Children’s Hospital & Once Asmina arrived at the orphanage, her average bouncing American baby. Our nurse Research Center at Oakland is the blood was examined twice for hepatitis B, practitioner friend suggested we “Google” for first clinic of its kind between syphilis and HIV. All the tests came back nega- “international adoption clinic.” That’s how we Seattle and Los Angeles. Clinic staff tive. But we were perplexed by the HIV test found the International Adoption Clinic at members, including Nancy Curtis, results. The test methods used, ELISA (enzyme- Children’s Hospital & Research Center at MD, and Teresa Courville, RN, are linked immunosorbent assay) and RST (rapid Oakland. eager to help families planning to adopt internationally. For more information call 510-428-3010. 8 CHILDREN’S HANDPRINTS

BACK IN THE CITY: In their San Francisco home, Asmina sits on Melissa’s lap while Thierry holds her hand. Above them is artwork from Sri Lanka. [Right] Thierry and Melissa take Asmina on a weekend walk from their hilltop home down to a nearby playground.

Photos by Tom Levy.

We got in touch with clinic staffer with sleep deprivation, became a little During our week in Ethiopia we trav- Teresa Courville, RN, but decided against hysterical. eled south to meet Asmina’s sisters, aunt the pre-adoption evaluation because we The next morning I looked at her fat and grandmother, as well as the social had so little medical information about belly and thought “enlarged spleen or liver worker, a wonderful man completely Asmina, typical for many international due to HIV,” looked at the two odd white devoted to children. We left Asmina with adoptions. But we did make an appoint- spots on her tongue and thought “thrush, her nannies at the orphanage for the night ment for Asmina once we got her home. due to HIV,” heard her sneeze, and because she was sick and so little and Twelve hours after we landed in Addis remembering her previous bout with because her village was several hours away. Ababa we met our smiley little Asmina. pneumonia thought, “immunocompro- It was unfortunate that we couldn’t She was perfect. And tiny. And so, so mised due to HIV.” show her to her family, but they saw sweet. We took her to the doctor and were a pictures of her and were amazed at how The next day we took Asmina with us bit reassured that he, used to regularly healthy she looked. Meeting everyone was to our hotel, so the three of us would have seeing children and mothers with AIDS, an incredibly emotional experience, one time to adapt to one another before leav- commented on how good she looked. we would not have missed for the world. ing a week later. That night she developed He had seen her just after she arrived at We’ve hugged and been hugged by her a cold and had a hard time breathing. We the orphanage two and one half months birth aunt and grandma, and the social were new, particularly inept parents, and earlier. But still… worker gave us a bracelet for her to wear

Buildingwww.childrenshospitaloakland.org a SUMMER/FALL 2005 9

once she stops putting everything into her practiced eye, and requested the appropri- Adopting from mouth. We now have pictures for Asmina ate HIV tests (the most common HIV of her birth relatives, her first home and serotype in Ethiopia, for example, is Ethiopia the Ethiopian countryside. HIV-2, not HIV-1). There are currently four American adoption Because Wide Horizons required our Dr. Curtis called every day to see how agencies approved by the Ethiopian child to be seen by a doctor within 24 Asmina’s ear infection was doing, and she government; they are listed below. Check hours of arriving home in the States, we called each time she received any new lab the U.S. State Department Web site for up-to-date approval information at Because Wide Horizons required our child to be seen by a doctor http://travel.state.gov/family/adoption/ within 24 hours of arriving home, we went to the International country/country_380.html. Adoption Clinic barely 16 hours after landing. Wide Horizons for Children, Inc. went to the International Adoption Clinic results, again to reassure us step-by-step. 38 Edge Hill Road barely 16 hours after landing. Soon we She also referred us to a pediatrician with Waltham, MA 02451 Phone: (781) 894-5330 were talking to Dr. Nancy Curtis and whom we are very happy. Fax: (781) 899-2769 Teresa Courville; they said Asmina would Asmina has been with us for more email: [email protected] probably be fine. than six months now, and is a very happy, www.whfc.org/ Her big belly was not caused by a dis- curious little girl with a perpetually sunny tended spleen, but was simply a fat belly disposition. She continues to grow, has Children's Home Society & Family Services waiting for her little arms and legs to recently become an adept crawler and is 1605 Eustis Street catch up. The white spots on her tongue extremely proud of herself when she St. Paul, MN 55108 were not thrush, but a couple of over- stands, with some help. Ella the cat is her Phone: 651-646-6393, 800-952-9302 Fax: 651-646-0436 grown papillae. Her colds were nothing best buddy and happily endures ear email: [email protected] unusual. Whew! She did have an ear pulling, fur tugging and tail nibbling. www.childrenshomeadopt.org/ infection along with her cold, but surpris- Asmina is an utter joy. ingly she had no intestinal parasites. And Asmina’s two birth sisters still live in Adoption Advocates International while her length and weight were below their village, with their aunt. We are 701 South Peabody the lowest curve of the growth charts, her “sponsoring” them, hoping the money we Port Angeles, WA 98362 head circumference was right on the send not only improves their lives but also Phone: 360-452-4777 curve. Dr. Curtis did notice several little helps their aunt. The children will be able www.adoptionadvocates.org/ things that she often saw in children to eat properly, go to the clinic when they Americans for African Adoption adopted from abroad, but other than the are sick and have books and clothes for 8910 Timberwood Drive ear infection there was nothing that school. We want our daughter to know Indianapolis, IN 46234-1952 warranted treatment. her birth sisters “back home,” even if she Phone: 317-271-4567 The day we spent with Dr. Curtis and grows up here with other siblings, so we Fax: 317-271-8739 Ms. Courville was exhausting—they’re plan to return to Ethiopia for visits. email: [email protected] very thorough—but reassuring. To begin We have learned that adopting inter- www.africanadoptions.org/ with, it was the first time we hadn’t felt nationally is so much more than “just” Bay Area Ethiopian Adoption hurried at a doctor’s office. They were adding a child to one’s family. We have This on-line group is for San Francisco Bay very patient and explained everything to also added a bridge between our family Area families who have adopted or are us—what they were looking for, what we and another family and to its culture, as considering adopting children from should watch for, what tests would be run different from our affluent Western world Ethiopia. It is a great source of information and why. as you can imagine. # and lets you talk with and meet people Because Teresa Courville has years of who have already adopted. Several families HIV experience she understood our who are part of the group brought their concerns. She looked at Asmina with a children to the International Adoption Clinic at Children’s Hospital. Contact the group by visiting http://groups.yahoo.com/ Familygroup/bayethioadopt/. 10 CHILDREN’S HANDPRINTS

ComebackOveruse injury nearly took pitcherKid Eric Olveira out of the game, but Children’s sports medicine clinic helped him come back.

Written and photographed by Tom Levy

Even though his game at the request of his coach even first word was “ba’kket- though he hadn’t practiced pitching for ball,” 14-year-old Eric months. By the second inning Eric’s pitch- Olveira began his sports ing arm was sore. By the end of the game career as a baseball he couldn’t throw at all. pitcher at age 5. When A referral from Robert Butts, MD, a chronic overuse injury Eric’s primary care physician, brought him recently brought his to the sports medicine clinic at Children’s pitching career close to Hospital. Here, where about 75 percent of a premature end, the the young athletes seen suffer from over- sports medicine clinic at use injuries, Eric began working with Children’s Hospital & physical therapist Robin Bergquist. Research Center at Eric had the classic pitcher’s ailment, Oakland helped bring irritated wrist flexor tendons. These ten- him back from the dons connect forearm wrist flexor muscles brink. to an upper arm bone knob at the elbow, Eric, now a three- called the medial epicondyle. An x-ray sport high school ath- showed the knob had probably broken off lete in football, basket- and then healed in place after his injury ball and baseball in the previous year. The tendons, pulled by Alameda, got his first tight, sore muscles, were stronger than the baseball overuse injury still-growing bone, which gave way under when he was 12, a the stress of throwing a pitch. “blown-out” deltoid Bergquist prescribed ice, rest, stretch- muscle in his right ing and strengthening exercises over the shoulder. Rest and course of many weeks. She also gave Eric therapy helped. and his father, Andy, an education. One year later, pitching gave him Pitch counts for boys 13 and 14 TAKE ME OUT TO THE BALLGAME: Eric elbow problems. Again, rest and physical should be no more than 75 pitches per Olveira, wearing a Babe Ruth League’s New York Mets uniform, gets plenty of therapy alleviated the problem. But some game, according to USA Baseball, the support from his dad, Andy. [Right] Eric coaches drove him too hard. sport’s national amateur governing body. gives his arm a light workout during the This year Eric hit the wall, partly Eric and his pitching teammates had rou- one inning he pitched at a Babe Ruth because he jumped overnight from one tinely thrown 90 to 100 pitches a game. League game on June 2. In the back- sport to the next without preparation. On Boys at 13 should throw only fastballs ground is a fully loaded container ship at anchor in Oakland’s harbor. The field was a Friday he played basketball, helping high and changeups, says USA Baseball. At 14 once used by sailors based at the school teammates finish their season. The they can add the curve. But when Eric now-closed Alameda Naval Air Station. next day Eric played baseball, pitching a was about 12, a coach taught him the

www.childrenshospitaloakland.org SUMMER/FALL 2005 11

knuckle curve, said not going to do them playing catcher, where his knowledge of Andy. At 14, after his any good in the future,” pitching is a special asset. injury, another coach Robin says. “We caught (Eric’s injury) early,” says encouraged him to While Eric’s pitching Robin. “He’s starting up pitching again, throw the forkball. USA injury is classic, his sta- he’s doing well. As long as he stays with Baseball says you may tus as a three-sport ath- low pitch counts right now, and brings add the knuckler to lete is not. Most them back up slowly, he’s going to be your repertoire at 15 overuse injuries fine.” and the fork only when are occurring Now that he knows more about you’re 16. because young youthful pitching limitations, Eric is The reason? These more athletes are philosophical. “I just need to work on my exotic pitches put tremendous playing the other pitches I guess,” says Eric. “I need to strain on developing muscles and same sport all get better control. Because sometimes you bones. Even though Eric at 14 is year round. need that pitch and you can’t use it. I have nearly 5 feet 11 inches tall, “Now we’re to work with my other ones. It’s harder to weighs 180 pounds and has seeing overuse do, but it’s worth it, I guess, if I don’t hurt hands considered large even for a because it’s the my arm.” full-grown man, he’s still a boy same sport over Eric’s favorite major league pitcher with growing bones. His body and over and supports his strategy. “When they’re in a couldn’t handle the stresses those over,” says jam, a lot of pitchers try to throw harder,” Robin. “They says Greg Maddux, a 20-year veteran of never get a the Atlanta Braves, in a quote on thebase- chance to rest. A long time ago there’d be ballpage.com Web site. “Me, I try to locate kids switching sports, so you’d go football, better.” Maddux, a four-time winner of then baseball, then something else.” the Cy Young pitching award, helped the This trend is seen nationally as kids Braves win the 1995 World Series. train harder, start younger and do single Eric’s goal is to play as long as he can, sports all year round. “Because training has maybe at the college level. “The school become more sport-specific and nearly that I’m going to go to is Oklahoma,” says continuous, overuse injuries are now com- Eric. “For some reason I’m just a big mon among young athletes,” wrote John P. Oklahoma fan of any sport.” # DiFiori, MD, in the January 1999 issue of The Physician And Sports Medicine. Eric is on the mend after seven sessions If you’re concerned about a with Robin. He’s following her instruc- young athlete, the Sports pitch counts and pitch types threw at him. tions and using the blue elastic resistance Medicine Center for Young “The Eric story for me is about bad band he got at the sports medicine clinic. Athletes at Children’s Hospital & information and bad coaching,” says Andy. After tying one end of the band to a door, Research Center at Oakland is ready to help. The clinic’s team approach includes “The (USA Baseball) information did not Eric takes the other and pulls, straighten- physicians, nurse practitioners and physi- filter down at the coach/manager level.” ing his arm out and pulling the band taut, cal therapists, all eager to help young Robin agrees that education is away from the door. He’s also using ice on athletes learn how to stay healthy while critical, that the player, parents and coach his arm after every pitching bout. excelling at their sport. For more infor- need to be a team, working together to After about eight weeks rest, Eric mation call 510-428-3558. ensure kids stay healthy and active. pitched two innings in a Babe Ruth For a PDF version of USA Baseball’s “Guidelines for Youth Baseball Pitchers” “Parents are very, very proud of what their League game May 28 and threw another go to www.collegesports.com or visit the kids are doing in sports, but our concern inning June 2. When he’s not pitching, American Sports Medicine Institute’s here is that pushing them at a young age is he’s fielding at first or third base, or Web site at: www.asmi.org. 12 CHILDREN’S HANDPRINTS Day Trippin Written by Gary Turchin Written Levy Photography by Tom with Pedi Rehab

Recovering from surgery or illness and learning to cope with disability need not be painful or tedious. Children’s Pediatric Rehabilitation staff know how to make it fun. SUMMER/FALL 2005 13

ROAD TRIP: [Left page top]: Docent Cindy shows Grace how to pet a California King Snake while Carol looks on.

[Left] Diviany boards the Rehab department’s Adventure Van with help from van driver Nantambu Mwanga, a physical therapy aide.

[Bottom left and right] A Reticulated Giraffe and a White-handed Gibbon ponder their visitors.

It’s Fun Friday in Pediatric Now everyone boards the special- of the funds as well as a grant to Rehabilitation at Children’s Hospital & ly equipped van. Diviany, a spunky maintain the program. Not only are Research Center at Oakland. Time to 12-year-old, rolls on to the van’s lift in the trips easier, now they happen load up Children’s green Rehab her wheelchair and up and into the more often, usually three or four Adventure Van with a gaggle of van, where her chair is strapped times a month. A trip can be as patients and head out on an adven- down for safety. She will be leaving simple as a visit to an ice cream ture. Oakland’s Knowland Park Zoo is the hospital soon, after a five-month parlor or to a shoe store to buy today’s destination. recovery from a spinal cord infection, sneakers that fit over new leg braces. Six patients and a team of physical and is learning to navigate the world Once a month there is a special and occupational therapists, and from her wheelchair. Off they go. outing, like this one, to the zoo. speech and language pathologists “Sometimes these kids are in the “We used to take public buses for will go along for more than the ride. hospital for months and would never our trips,” says physical therapist Fun Friday is Therapy Friday as well. get outside during their stay,” Shelley Shelley Talajkowski. “Since buses only Everything the kids do in their rehab says. “Or maybe they were in a car have two tie-downs for wheelchairs, it sessions during the week will be rein- accident and this is the first time in a meant taking three separate buses to forced in the real world, with a few car again, or it’s the first time they are get all the patients to where we were tigers and giraffes thrown in for color. going.” A two-hour outing could take “It’s a fun and functional journey,” four or five hours with travel time. says Donna Minkler, senior speech Shelley is grateful for the conven- and language pathologist, of the ience the van offers, though it’s a trip’s agenda. bittersweet reward. When her dad, The day before, Grace, a tall 14- Michael Goddard, died suddenly four year-old with a stylish haircut and years ago, her family and friends sweet disposition, asked all the raised money in his honor and patients what they wanted for lunch donated it toward the van. The during the trip and called in the Children’s Hospital Branches, an orders to the cafeteria. It was good auxiliary fundraising group that practice for improving her cognitive supports Children’s, provided the rest skills. 14 CHILDREN’S HANDPRINTS

seen in public in a wheelchair. It’s a At the zoo, the group out and whole new way for them and it’s so transfers into two tour carts important to get practice. If we don’t and heads off to see the take them out to practice, when we birds and beasts. Daniel send them home with their parents Jackson (“call me Jack”) they won’t want to go out.” Clough, 7, and Seth about Junqueiro, 9, are encouraged to rise from their seats using process some on his own. leg power alone to see the “There’s something huge about giraffes. They need to regain the baboon,” speech and language trunk and leg strength after pathologist Carol Rojano suggests. recent surgeries. “Do you see it? Something about his John Scheumann, 13, is bottom half,” Carol urges. learning strategies to “His butt,” John says. process information. He is Everyone stops in awe at the prodded to repeat details Bengal tiger’s den. “Can you see the docents provide, and to second tiger?” docent Cindy Margulis

ROAR: [Above] Jack gets a good look at one of two elusive Bengal Tigers.

[Right] Therapists Donna Minkler (standing) and Suzi Vojescu (kneeling) encourage Seth to stand and reach, working his muscles and helping develop flexibility. Behind, Shelley helps Jack to stand.

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SPEED RACERS [Above] With grit and side- asks. It’s a bit of a Where’s Waldo test ways glances Seth, Diviany and Jack race because one tiger is hiding behind uphill. Therapists Suzi, Shelley and Donna the bushes. support the racers. “There it is,” Grace points. [Left] Diviany having a laugh. Cindy explains how these two rare Bengal tigers were rescued from a circus where they’d spent their entire lives on concrete and the hard surfaces of cages. When brought to the zoo a few years ago, the must go up!” She’s had a han- they luxuriated in the splendor of real kering all day to race up a hill grass and dirt for the first time. and now she gets her chance. They couldn’t get enough of it. A few therapists stay close Children’s patients can’t seem to but leave most of the effort to get enough of the zoo either. This is race the kids. There’s plenty of real grass and dirt for them too. huffing and puffing. Arms As the day winds down, Diviany, strain, teeth grit, competitive Jack and Seth play a game of “red fires burn. There are no losers light, green light” rolling down a hill. in this race. # The Children’s Hospital On “green,” they let their wheel- Branches, a women’s auxiliary, chairs roll down, then stop when a provides funding for Fun Fridays therapist calls “red.” When they and the Adventure Van. To join or reach the bottom of the hill, Diviany support the Branches, call them announces, “If you go down, you at 510-428-3355. 16 CHILDREN’S HANDPRINTS

aven, a teenager trying to shake chronic stress headaches and anxi- R ety, sits quietly, staring at a laptop screen. Slowly spiraling out from the screen’s center, a photograph of three big-eyed rabbits appears, one square-inch at a time. A low beep sounds when each square materializes. Sensors attached to a pair of Raven’s left-hand fingers and across her belly measure her ability to slow her breathing and heart rate. Each photo square appears when Raven keeps her breath and heart rates calm for a pre- set number of seconds. Raven is learning to relax, thanks to biofeedback techniques and software used by only a handful of Bay Area pedi- atric psychotherapists. Sitting by Raven’s side is one of them, Joanne Yeaton, LCSW. Staying Balanced Joanne, 56, started helping children A psychotherapist uses biofeedback and hypnotherapy to help with behavioral health problems at patients, and meditation and art-making to help herself. Children’s Hospital & Research Center at Oakland more than 30 years ago. Her Written and photographed by Tom Levy part-time schedule as a psychotherapist has suited her ever since; the arrange- her own. Joanne’s freshman year room- “I didn’t just want to do psychology; ment left her time to raise two children mate was the dorm’s only African- I wanted to be part of the social change and to explore her own inner world — American. at that time,” says Joanne. through art and Buddhist meditation. It was 1968. White and African- It was the year a Black Panther went In the quiet rural county where American activists were registering voters on trial for murder in Yale’s host city, Joanne grew up in the 50s, dairy cows in the South. When Martin Luther King New Haven, Conn. That controversy outnumbered people. A bright, bookish Jr. was assassinated Joanne’s roommate and the burgeoning anti-Vietnam War tomboy and an atheist, she felt out of didn’t speak to her for several days. “It movement dominated the region’s place in the small, church-going town of was a real eye-opening, knock-you-over- political climate. Newton, New Jersey. So she turned the-head experience in how racism Joanne participated in a letter-writing inward, developing a fascination with the affects individual relationships.” Joanne campaign questioning whether a fair trial mysteries of the psyche and the cross- says it sensitized her to America’s racial was possible, got her letter published in roads where inner life meets outside divide in a way mostly-white Newton Newton’s New Jersey Herald and stirred world. never had. up the town and her own family. Both Two years at Smith College, a But Smith’s conservative environment her grandmothers wrote her chastising women’s school in rural Massachusetts, also proved suffocating. Joanne was ready letters. confirmed Joanne’s interest in psycholo- to leap headlong into the political fer- In New Haven, Joanne got her first gy. At Smith, the non-conforming, expe- ment of the late 1960s. She transferred experience working with poor children of rience-seeker who had outgrown to Yale University in 1969, one of 125 color as an Upward Bound volunteer. Newton, requested a dormitory room- women helping to crack the school’s The program gave inner city kids inten- mate with a different background than 268-year-old gender barrier. sive tutoring for six to eight weeks at a

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university or prep school. It also gave Hospital’s oncology unit convinced her Participating children gain confidence Joanne a chance to work with kids in to become a pediatrician. in their ability to learn focus and con- the program’s art center. * * * centration. After two Upward Bound summers, Back in a Children’s Hospital Before learning about biofeedback, Joanne knew she wanted to work with Psychiatry department office, Raven Joanne had been using hypnotherapy disadvantaged children. “The personal winds up her biofeedback session. techniques to help kids with pain man- is the political in my life,” she says. “This has really helped Raven to agement and anxiety control. “Because Later, she completed two years of focus,” says her mother, sitting in on kids’ imaginations are so vivid, they graduate school at the University of the session. “Her memory seems better. have an easy time with hypnotherapy,” Denver and earned a master’s in social All her teachers mentioned she’s doing she says. work. It was the fastest, most affordable better.” Guided imagery coupled with hyp- way to become a psychotherapist. Raven had been labeled “attention- nosis helps change patients’ perception A conversation with her grandfa- deficient,” and Joanne wasn’t sure of the pain experience, including their ther, a physician, confirmed the path biofeedback could help her. But the emotional response and the attention she’d chosen. “He started to talk about child’s mother had asked for biofeed- they give the pain. Changing how one how a lot of patients came into his back help and was referred to Joanne by experiences the pain can actually reduce office with this complaint or that a neurologist, so Joanne gave it a try. It suffering. complaint, but what they really wanted worked. “Don’t believe everything you The biofeedback and hypnotherapy to do was talk to him,” says Joanne. think,” says Joanne. techniques she uses fall into the twilight Healing professions run in the The laptop screen’s concrete visual region between the inner and outer family—from Joanne’s physician grand- display helps kids watch themselves world, the realm Joanne began explor- father to her veterinarian father, and learning to relax. The display’s activity ing as a girl in rural Newton. Drawing now, through Joanne, to her oldest mirrors in real time each child’s ability and painting was another, more person- child. Amanda, 26, completed pre-med to control heart and breath rates. al way. But until 1987, when she courses after a stint in Children’s Slowing these rates leads to relaxation. enrolled in an expressive painting class as part of her own personal exploration and healing work, she only dabbled. Joanne Yeaton, LCSW, is one of a handful of Bay Area The deep satisfaction she found in pediatric psychotherapists this class led her three years later to an intense one-on-one work with creativity ,using biofeedback techniques expert Margaret Blackwell, and eventu- to teach kids how to relax. ally to a retreat for helping professionals and software led by Thich Nhat Hanh, a noted Buddhist writer, teacher and spiritual GETTING WIRED leader. [Opposite page] Joanne Joanne calls Thich’s five-day retreat Yeaton, in her painter’s in 1991 a “life-changing experience” apron, contemplates her next project. Attached to that planted the seed of her now-daily the wall behind her is Buddhist meditation practice. She “Beginning Again,” a 2001 found an overlap between the open, piece she’ll be matting for exploratory attitude Margaret encour- an upcoming show. aged Joanne to develop while doing art [Left] Joanne attaches and the receptive attention meditation sensors to a patient’s demanded. fingers before starting a biofeedback session in her [CONTINUED ON PAGE 25] Psychiatry division office. 18 CHILDREN’S HANDPRINTS

On a sunny spring day in Tracy, Calif., on the northern edge of the San Joaquin Valley, Dylan, almost 4, bounces around like a wound-up pogo stick. He jumps into a motorized cart, and he and brother Derrick, 5, tool around the cul-de-sac in match- Red ing carts in front of their house. When he’s had enough, Dylan rousts about the family’s garage and tries to copy Derrick by Blood, dribbling a basketball. When he’s bored with that, he gets his mom to blow bubbles. He catches Blue some and karate-kicks others. Re-routing This amuses him to no end and he goes on and on. You’d never guess Dylan has four Dylan’s red open-heart surgeries under his belt. and blue blood streams took Heart Failure four open-heart When Jim and Melanie Dunniway first took surgeries and a their son to Children’s Hospital & Research Center community’s at Oakland, Dylan was a pale emaciated 5-month- old. He hardly smiled and didn’t have enough help. energy to suck on a bottle. Cardiologist Gregg Helton, MD, knew imme- Written and diately Dylan was a “cardiac baby.” An echocardio- photographed gram soon provided a clear picture: Dylan’s heart by Gary Turchin had a single ventricle anomaly; he was born with a left ventricle only. Because his heart lacked a right ventricle, it was working twice as hard and Dylan’s body was oxygen-starved. Technically, he had been in heart failure since birth. “It takes you out from the knees,” Jim says about the diagnosis. “Your whole life as you know it comes to a complete stop and everything you thought was important becomes so non-impor- tant.” “I knew from that day on,” Melanie adds, “that there was going to be a lot of hospital stays and surgeries, that this was the kind of life it was going to be with Dylan.” What she didn’t know was how her caregivers at Children’s and her own community of Tracy HEAD RUSH [Top] An upside-down Dylan and brother Derrick horse around would rise to the occasion to help her son and with dad in the family’s living room. [Right top left] Pensive Dylan gets x-rayed. family get through. [Right top right] Dr. Helton checks Dylan’s surgically repaired heart.

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Blood Traffic A few days after that visit to Children’s, little Dylan underwent the first of four major open-heart surgeries (plus ten lesser procedures). The series of sur- geries creates what’s known as a Fontan Circulation, after Francis Fontan, MD, who first performed the procedures in 1968. The Fontan is designed to reroute some of Dylan’s blood so his heart can function efficiently with its left chambers alone. In a normal heart, the right chambers pump low-oxygen ‘blue’ blood to the lungs, where it picks up oxygen and returns to the heart as oxygen-rich ‘red’ “It takes you out from the knees,” Jim says about the diagnosis. blood, which is then pumped out of the left heart chambers to the body. The blue “Your whole life as you know it blood and red blood remain separate. In Dylan’s heart, all the blood, red and blue, comes to a complete stop and everything was mixing in the left chambers. This you thought was important becomes so non-important.” didn’t allow his body to get enough oxygen-rich red blood. The goal of the surgeries was to third surgery, all the blue blood coming cal nutritionist Gail Seche prescribed a separate the red and blue blood streams. from his upper body was sent directly to specially balanced feeding solution to be After the surgeries only oxygen-rich red the lungs. Doing the same for the lower dripped in five times a day. By March blood would be pumped through his body blood stream required one last oper- 2005, he weighed the necessary 30 heart. The blue blood would bypass the ation. pounds. heart and be sent directly to the lungs. Before that fourth surgery, Dylan But while Dylan was growing, so were The first operation helped Dylan’s needed to reach 30 pounds in weight. A his medical bills. He was near the $1 plum-sized heart pump more oxygen to permanent Gore-Tex tube would be used million limit on his health insurance his body. Because of the malformations, to connect a vein to an artery; his heart policy. Jim and Melanie aren’t rich, but too much blood was pumping into his needed to be large enough so it wouldn’t like most middle-class families, they had lungs. His lungs had expanded to accom- outgrow the tube. too much income to qualify for assistance. modate, leaving a bulge in his chest. Gaining weight wasn’t easy for Dylan. Surgeons placed a restrictuve band on a As an infant, he hardly ate. It took too Dollars for Dylan lung artery, reducing the flow there and much energy to chew and swallow. In the Tangles Salon & Spa in Tracy, redirecting it to the body. They also “Eating becomes like an athletic event Michelle Quarry was cutting Stephanie repaired a valve. For the first time, Dylan for medically fragile infants,” says Dunn’s hair. Michelle had met Jim was a smiley baby. Elizabeth Gleghorn, MD, a gastroenterol- Dunniway when his company, Arizona A scant four months later, Dylan ogist at Children’s. “It’s very strenuous. Tile, laid the salon’s tile floor. Michelle underwent a second open-heart surgery Unless you eat, you don’t develop the knew a little about Dylan’s story, and in- and eight months after that a third. instinct for it,” she explains. between the snips and brushings she Doctors took one of his veins and con- To get Dylan enough nourishment, shared the tale with Stephanie. The two nected it directly to the lung artery, then Dr. Gleghorn inserted a gastrostomy tube spliced two arteries together. After the (g-tube) into his stomach. Children’s clini- [CONTINUED ON PAGE 25] 20 CHILDREN’S HANDPRINTS Grateful Families Children’s Helps Give Back to Homeless Mothers Children’s A grant-funded study will help Children’s assist homeless women who have, or who are at risk of, substance abuse and family dissolution problems.

very day, thousands of families in The ultimate goal is figuring out the Bay Area struggle with pover- how best to intervene and help homeless E ty, unstable housing or homeless- women receive the services they need, so ness, abuse, neglect and substance abuse. they can overcome substance abuse, gain Children in these families are at high risk stability and keep their families together, for social, educational, physical and or if the children were placed into foster mental health problems. care, to help them reunite. But they are not alone. The Center Cheryl Zlotnick, RN, DrPH, is the for the Vulnerable Child at Children’s principal investigator for the study, with [l to r] KFRC’s Dean and Cammy with Grateful Families chair Terri Hospital & Research Center at Oakland collaboration from Tammy Tam, PhD, Phelps. has been helping these struggling and Kimberly Bradley, PsyD. families and children for nearly 20 years. You can help the Center for the The center provides clinical and social Vulnerable Child assist homeless women services, including medical service and their children with your tax- coordination, mental health services, deductible charitable donation. The parental education, child developmental center, part of Children’s Hospital, is screenings and support for families in partially funded by philanthropy. If you transition. would like to make a gift to the center, Sadly, the fastest growing segment please call Ken McKinney at of the homeless population is women 510-428-3885, ext. 2846, or email and their minor children, who now Ken at [email protected]. # make up 15 percent of people without homes. What’s more tragic is that 70 percent of these homeless women are not living with their children, often because parental substance abuse led to placement of their children in foster care. Thanks to an $87,135 grant from the Substance Abuse Policy Research Program of The Robert Wood Johnson Foundation, the center will look at how substance abuse problems affect the risk of child neglect among homeless women with children. The study will examine what services such homeless women need, but aren’t getting, such as substance abuse treat- ment, mental health care services, parenting assistance and help to prevent dissolution of their families.

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ow do you say “thank you” to a doctor who diagnosed and cured your child of a disease or Hsaved her life after an accident? What can you Children’s Miracle do to express your heartfelt gratitude to the nurse who showed caring attentiveness and kindness during the Maker Awards most trying of times? A group of families whose kids The Children’s Miracle Maker were treated, and in some cases saved, at Children’s Awards honor each year’s best of pondered these very questions, pooled their resources the best. Nominated by their col- and came up with a remarkable and creative solution— leagues, they are Children’s they formed the Grateful Families Program. Hospital staff who have a history The Grateful Families Program is made up of the of extraordinary patient care. They also demonstrated exception- parents, grandparents, relatives, extended families and al efforts in furthering health edu- friends of children who have been treated at Children's cation and serving the community. CLEO Hospital & Research Center at Oakland and who are This year, the awardees were dedicated to giving back to the hospital, to its staff, and Patricia Chase, MD, medical most importantly, to its patients—the children. director, Primary Care; Cleo Rice, LCSW, Primary Care Clinic and Through fundraising and volunteer activities, Teen Clinic; and Mary Jane Levy, this generous and active team has dedicated itself to RN, Intensive Care Nursery. Jerry ensuring that the hospital can continue to provide its Brody was named Volunteer of the life-giving care to children now and into the future. Year for his work in the Family The program’s signature event is the annual Resource & Information Center. In addition to Miracle Makers JERRY Springtime Gala at the beautiful Oakwood Athletic Club at the hospital, Children’s is in Lafayette, which donates the use of its spacious honored to have thousands of facility. The most recent Gala was held on May 14; more dedicated partners in the than 400 guests enjoyed a delicious meal, live and silent community who provide support auctions, and dancing to the 16-piece Bob Saul orches- through their participation in the Children’s Miracle Network. tra. The event raised $80,000 for Children’s. This year, Rite Aid received a The annual Gala also includes an awards ceremony Miracle Maker Award for raising where “Thank You” awards are presented to doctors, significant funds and awareness MARY JANE nurses and other hospital staff who have been nomi- for Children’s. nated by families for their outstanding contributions to And, finally, without the sup- port from friends in the commu- caring for kids. To see a list of this year’s recipients visit nity, Children’s would not be able www.gratefulfamilies.org. to continue providing the excellent If you are interested in joining the Grateful Families care patients and families have Program, call Wendy Borden at 510-428-3885, come to expect. The Brian Angen ext. 5344, or email her at [email protected] for Memorial Foundation received the Miracle Maker Award for donating more information. You will find it a fun, rewarding PATRICIA thousands of dollars each year to experience. Also, visit the Grateful Families Web site at help kids with facial anomalies and www.gratefulfamilies.org. The third annual Springtime head injuries. Gala will again be held at Oakwood Athletic Club in We extend our sincere gratitude to all the Miracle Makers at 2006, and you are invited to join other grateful families the hospital and throughout the community for contributing their talent and resources to help kids in the region. # and hospital supporters to coordinate and fundraise for the event. # 22 CHILDREN’S HANDPRINTS

Growing up in Monterrey, worked at the Carnation and Mexico, in the 1920s, without Contadina canneries until he  running water or heat, Alfredo O. retired in his 60s.  Moreno learned first-hand that Family was very important to romise childhood isn’t always easy. His Mr. Moreno, and he had a large father passed away when he extended family—his five daugh- was only 1 year old, leaving a ters gave him 15 grandchildren,  wife and three young chil- and he had 17 nieces and nephews, ulfilled dren, Elvira, Pedro and 41 grand nieces and nephews, and Alfred. But his mother was a 5 great-grand nieces and nephews. strong influence on her three “He was a really warm, wonderful children and encouraged man with us kids,” Maria recalls, them to succeed. The chil- “He would always make us laugh, dren’s chores included carry- and pinch our cheeks.” ing water from the well and Unfortunately, his only son, chopping wood for fuel Antonio, named in honor of his before heading off to father, passed away as an infant. school. This loss affected him strongly, and “Sometimes they only he was always concerned with had an egg or a handful of infant care. beans to share between Mr. Moreno was an entrepre- them—they lived in pover- neur, and used his hard-earned ty, but they were always money to invest in distressed rental ready to help others,” says property in San Jose and Mexico. Maria Diaz, Mr. Moreno’s Because he excelled at carpentry, niece. tile work and plumbing, he fixed As a determined his buildings up himself. He was a young man, Mr. Moreno kind landlord who took the time came to the United to get to know his tenants well. States in the 1950s and One of the tenants he befriended found seasonal work as a in Mexico was a shoemaker who laborer, harvesting and lived in one of his buildings for packing produce. many years. When the elderly “It was hard times, shoemaker went blind, and was no living at the plantation longer able to do enough work to by himself in a shack make ends meet, Mr. Moreno with no indoor plumb- allowed him to live in the building ing or heating. There rent-free for the rest of his life. was a scrub board and “My uncle had a big heart and was a spigot to do your always ready to lend a helping Raised in poverty and hardship, Alfredo laundry, and the work was back- hand,” says Maria. Moreno built a successful life. He left breaking,” explains Maria. In May 2004, Mr. Moreno the legacy of a loving family and a He would travel back home to introduced himself to the ambassa- Mexico in the winter to be with dor on duty at the main entrance generous gift to benefit generations of his wife, Ana Maria, and five of Children’s Hospital & Research sick and injured children. daughters (Alica Guadalupe, Maria Center at Oakland and asked to Alma, Juana Maria, Maria Trinidad speak to someone about making a By Lynn Sagramoso and Martha Patricia). Later he sizable gift to the hospital. If the

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staff was a little surprised when Mr. Moreno ery little bit helps.... arrived unexpectedly, his family was not. “He In 1912, a group Your bequest, no continue providing care always told us that because this country had of nurses led by for sick and injured chil- so blessed him, he promised God that he Bertha Wright matter what the dren. would give back to this community’s chil- collected the first Bequests are a good dren,” explains Maria. philanthropic gifts for size, will enable way for you to create a Children’s Hospital. Children’s Hospital significant legacy, while They went door to still maintaining control door and collected to continue helping of your assets while you $5 from every family children long into are alive. And, when you that could afford it— make a bequest, you are a huge sum in the future. making a clear statement those days—so that of what was important to together they could build a high- you during your life. quality, specialized healthcare Each of us reaches a point in our facility for infants and children in a life when we ponder our “legacy”— community where it did not yet exist. what we leave on Earth after we pass Philanthropy is nothing more than on. A bequest is a simple way to a community of people working leave your mark on a cause that you together for the common good, mak- support. ing sure that important shared goals You can leave a specific dollar are met. Sometimes it arrives as a bequest by using these words: large gift from a famous family like “I give to Children’s Hospital & the Gates or the Gettys. More often it Research Center Foundation, located is from ordinary people making ordi- at 5225 Dover Street, Oakland, nary gifts. And many times the gift California 94609, the sum of [Left] Alfredo Moreno. [Above] Mr. comes as a bequest—a gift made as $______.” Moreno’s wife, Ana Maria, poses with part of a living trust or will, or as a Or, you can leave all or a percent- four of the Morenos’ five daughters. beneficiary designation on an insur- age of the remainder of your estate ance policy or retirement account. to Children’s Hospital & Research The Foundation’s staff helped Mr. Those small gifts add up. Center Foundation (after the payment Moreno set up a charitable gift annuity in Nationally, bequest giving reached of any specific bequests and all honor of his parents, Antonio Moreno and an estimated $19.8 billion in 2004 estate-related expenses) by using Maria Trinidad Olvera de Moreno. and represented 8 percent of all these words: “The American dream came true for charitable giving that year. “I give to Children’s Hospital & him,” Maria says of her uncle. “He worked Over the years, Children’s Research Center Foundation, located hard to build a life here and was always help- Hospital has built its endowment fund at 5225 Dover Street, Oakland, ing people who were in need. That’s what I almost entirely from gifts made at the California 94609, ______percent of time a person passes away. We rely the residue of my estate.” remember most about him, his laughter and on those gifts to provide the safety For more ideas, go to kindness.” And when Mr. Moreno passed net Children’s Hospital needs to www.legacyforchildrenscare.org. away in early 2005, he left another wonder- ful surprise. He had arranged for all of his substantial estate to come to Children’s The Children’s Hospital & Research Center Foundation can work with you or Hospital, to provide care to newborn babies. your financial advisor to establish a framework for charitable giving that meets Mr. Moreno’s generous spirit and love of your philanthropic and financial goals. For more information about bequests children will live on through his legacy bene- and other charitable planning options, call Margaret Zywicz at 510-428-3361. fiting Children’s Hospital, and through his # children, family and many friends. This is not legal advice. Any prospective donor should seek the advice of a qualified legal, estate and/or tax professional to determine the consequences of his/her gift. 24 CHILDREN’S HANDPRINTS

Children’s Hospital & Research Center at Oakland Leadership Board of Directors Harold Davis, Chair Edward Ahearn, MD Watson M. Laetsch, PhD Mary Rutherford, MD Pamela Cocks, Vice Chair Jeffrey Cheung Alden McElrath Peter Sheaff, MD Arthur D’Harlingue, MD, Henry Gardner Masud Mehran Frank Tiedemann Vice Chair Donald Godbold, PhD Linda Murphy Howard C. Warner, PhD Robert C. Goshay, PhD,Vice Chair Scott Hoffinger, MD Betty Jo Olson Sharon Williams, MD Barbara May, Vice Chair Howard Jackson Howard Pien Senior Leadership Frank Tiedemann Howard Gruber, MD Douglas T. Myers, CPA Nancy Shibata, RN President and Chief Executive Interim Senior Vice President, Senior Vice President and Chief Vice President, Nursing Officer Medical Affairs Financial Officer Greg Souza James Betts, MD Bertram H. Lubin, MD Marva L. Furmidge, Esq. Vice President, Human Resources Senior Vice President and Senior Vice President, Research Vice President, Legal & Risk Surgeon-in-Chief Management Michael Petrini Anne McCune President, Children’s Hospital & Mary L. Dean Senior Vice President and Don Livsey Research Center Foundation Senior Vice President, Chief Operations Officer Vice President and Chief External Relations Information Officer

Related Organizations Children’s Hospital Oakland Foundation Board of Trustees James Hanson, MD Karin Franchuk Research Institute Board of Harold (Tim) C. Warner, PhD, James J. Keefe Belinda George Chair Directors William S. Keller Tina Gomez Watson M. Laetsch, PhD, Chair Marc R. Kunney, Vice Chair Sharon A. Le Duy Madeline Newkirk Edward Ahearn, MD Thomas Bret. Esq., CPA, CFP, Bertram H. Lubin, MD Orvie Pamp Secretary James Betts, MD Douglas T. Myers Mary Jane Rogers Jack Carlson Sanjiv Sanghvi, Treasurer Liliana Nordbakk Cyndi Santaella Jeffrey Cheung Jane Logan, Board Advisor Betty Jo Olson Mary Ann Suva Harold Davis Cornell C. Maier, Board Advisor Michael Petrini Cece Werson Arthur D’Harlingue, MD James Armstrong Robert Rowell Lynne Wilson Leila Gough James M. Betts, MD Eric Rudney Howard Gruber, MD Sharon Brandford Family House Tom Herman Mary Rutherford, MD Renee Christensen Board Members Gordon “Skip” Huber Wallace Smith, Esq. Harold Davis Sandra Humphries, President Bertram Lubin, MD Frank Tiedemann Steven J. Didion Penny Johnson, Vice President Alex Lucas, PhD Mark A. Ericsson, Esq. Jan Wolfe, Treasurer Carol Mimura Branches Board of Directors Jackie Baker Belinda George Linda Murphy Betty Jo Olson, President Sophie Bedrosian Erol Gokbora Mary Rutherford, MD Rosa Anderson Sharon Braun Robert (Bob) Goshay, PhD Debbie Civello Jackie Ducey Leila Gough Mary Davis Mary Lanctot Howard Gruber, MD Barbara Demmon Sharon Smith Randolph W. Hall Joy Fassner Ayn Thorne

www.childrenshospitaloakland.org SUMMER/FALL 2005 25

[CONTINUED FROM PAGE 17] Dylan decided right then and there to do more the $18,000 for Dylan. something for Dylan, a child nei- When a separate local charity group, ther had met. Hearts of Harvest Foundation, heard “It touched a chord,” Stephanie says. Dylan’s story, they donated $5,000 toward “We wanted to help.” his care as well. Stephanie and her husband Larry own More support was forthcoming. When the Tender Loving Care Day Care centers Jim’s company, Arizona Tile, realized the in Tracy. Children at the centers began Dunniways’ insurance policy was inade- cutting out pink and red hearts for a quate, they helped get the family a new Dollars for Dylan fundraiser. For a dona- plan with a $10 million cap. tion, a heart was hung up at Tangles, in Today, Dylan’s blood oxygen level is Mom frets about TENDER MOMENT A little grooming the three Tender Loving locations, or at normal and his complexion is healthy. sending him off to from mom. the Great Plate restaurant in town, filling He’s as feisty and frisky as any 3-year-old school one day and windows and walls. Donors inscribed per- and doesn’t have to stop and rest while his wonders if she’ll be able to let him go. sonal notes on each heart. Kids held friends and neighbors keep playing. “Do I volunteer all day at his school?” she lemonade sales and brought in their pen- Dad, a sports lover and gamesman, asks. A couple of years ago, they weren’t nies. Reports of the program turned up in understands that contact sports aren’t in sure they’d have this problem. the news, and calls came in from around Dylan’s future, but he’s already prepping “Every day, I wake up and I walk into the country. him for golf and billiards (a table fills the his room. I love to see his breathing. Stephanie’s husband Larry arranged a family’s foyer), and another of Jim’s Believe me, I don’t take it for granted,” golf tournament fundraiser as well. In favorite games, poker. says Jim. # short order, the Tracy community raised

DREAMING OF [CONTINUED FROM PAGE 19] THAILAND Joanne’s No overnight transforma- [Vippasana] watercolor study, made during her Myanmar Yeaton tion, it was years in the making, Buddhism. She visit, shows the from periodic several-times-a-week medi- endured heat, dust, Irrawaddy River and in tating to what has become for Joanne a bedbugs and a hard the foreground, part of devotion to practice. mattress, but enjoyed a temple. “I get a sense of really being a part of the daily meditation something bigger than myself, of tapping and discussion sessions, and made new work together, just as she has put together into a force beyond the personal,” says friends among the 25 other attendees hail- the pieces of her life. Joanne of especially deep meditation ing from 11 countries. “Wisdom alone can lead to detach- sessions, the flow feeling she gets when Back home in Berkeley, the round sit- ment and a kind of dryness, while compas- making art and her best psychotherapy ses- ting cushion Joanne uses for meditation sion alone can lead to a level of emotional sions. “It’s so all of a piece.” rests on the floor between her bed and a overinvolvement that (can make you feel) Joanne took her Buddhist life to a large circular art piece on the wall. overwhelmed or burned out,” says Joanne. more intense level in February when she “Fragments of a Broken World” is con- “But together they provide a balance—a traveled to Myanmar, formerly called structed from sewn-together fragments of place where my feeling and thinking can Burma, for a retreat in the fabled Sagaing torn paper. Painted landscapes and human work together.” # Hills outside Mandalay. It was her first trip forms intermingle across the piece. Willow Joanne Yeaton is a member of outside the United States in 30 years. branches harvested from a site near Pt. the Northern California Women’s Joanne spent three weeks at the Reyes are tied together in a hoop frame, Caucus for Art and has a Web page at Kyaswa (pronounced Chawz-wa) stiffening and supporting “Fragments.” www.ncwca.com/generic104.html. She’ll be holding an open studio in December. For Monastery, one of hundreds in the Sagaing After two years dreaming it up, it took biofeedback inquiries, please call the Division Hills, world center of Theravadan six months to put the pieces of the art- of Psychiatry at 510-428-3570. 26 CHILDREN’S HANDPRINTS

Type 1 diabetes is an autoimmune disorder in which the body destroys the insulin-producing beta cells in the pancreas. Type 2 diabetes is characterized by pancreas dysfunction in the production of insulin or an insulin- resistance.

Illustration by Neile C. Shea SUMMER/FALL 2005 27 researchrundownresearchrundown What’s Up with Diabetes Children’s diabetes research is moving closer to the best cure—prevention.

You must know at least one person that children who are related to patients and Stanford University. For example, who has diabetes; one of 17 people in the with type 1 diabetes have similar genes kids with beta cell antibodies can partici- United States suffers from the disease, and a similar environment, and that pate in a trial determining whether and incidence, especially of type 2 dia- those kids tend to be at a higher risk for immunosuppressive medications can keep betes, is on the rise. Patients at Children’s developing diabetes later in life.” the immune system from attacking the Hospital & Research Center at Oakland Nine medical centers and more than pancreas. are no exception to this national trend: 350 clinics in the United States and over the last five years the number of kids Canada took part in the two trials of the Could what you see be with diabetes seen at Children’s has more DPT-1, screening 600,000 relatives of than tripled, going from 200 to 900. people with diabetes. The trial’s findings what you get? Blindness and kidney failure are Although these children account for were that neither low-dose insulin injec- among the common severe complications about a third of Endocrinology’s patient tions in people at high risk for developing of diabetes. They result from damage to load, their care demands two-thirds of type 1 diabetes nor insulin capsules taken the tiny blood vessels in the eyes and staff’s time. The race to defeat this life- orally by people at moderate risk for type kidneys, respectively. Is there a way to long chronic illness is intense, and in the 1 diabetes were successful at preventing predict and prevent such damage without long run, the most viable chance of gain- or delaying diabetes. The lesson learned, painful invasive liver biopsies or dilation ing a lead over diabetes is figuring out however, showed that large studies— of the eyes, which, though less intimidat- how to prevent it from happening in the common in Europe where organized ing, slips down the priority lists of first place. Enter research. Read here healthcare systems ease the logistics— families whose kids are diabetic? This is about two diabetes research projects hap- were possible in the United States as well. the question that Children’s Susan pening at Children’s. Trial Net is the phoenix that emerged Conrad, MD, is trying to answer by from the ashes of DPT-1. Children’s looking at the vasculature under the Hospital is an affiliate under the Trial Net Getting Diabetes Before it tongues of kids with diabetes. Using a umbrella, a group of diabetes studies special device, physicians can capture Gets You approached by the same people who par- One of the best things that happened video of these blood vessels. Because they ticipated in DPT-1. Children’s specialists recently in diabetes research in the are similar to the vessels in the eyes and screen siblings of kids affected by diabetes United States was a trial intervention that kidneys, there could be a correlation for antibodies against the insulin-produc- failed. The Diabetes Prevention Trial— between damage under the tongue and ing beta cells in the pancreas. Presence of Type 1 (DPT-1) consisted of two clinical damage in the other organs. If true, such antibodies indicates an increased trials that sought to delay or prevent type the hypothesis will lead to a quick risk of becoming diabetic later in life. 1 diabetes, also known as insulin-depend- screening test that could be done in The next step is to look at specific genes ent diabetes. the Endocrinology clinic, detecting to determine if a person’s body might “Type 1 diabetes is an autoimmune problems before they wreak havoc on a react against itself. Finally, kids get a disorder, which seems to strike children child’s health. sugar drink, or an oral glucose tolerance out of the blue,” explains Suruchi Bhatia, “Improving diabetes control is the test. The closer one is to having diabetes, MD, director of Endocrinology at primary method of preventing these com- the less insulin the body will produce and Children’s. “Seventy-five percent of kids plications,” Dr. Bhatia says. “In the case the higher blood sugars might be during who have type 1 diabetes have no family of the kidneys, using an ACE inhibitor the test. Depending on the results of history of the illness. We know there is a has been shown to prevent further kidney these tests, children can get appropriate genetic predisposition to the disease, but damage and even reverse some of it. Laser treatment or participate in a number of there is also some sort of environmental therapy is available for the eyes, but studies in nearby Trial Net sites, such as insult that contributes. The theory was again, diabetes control is key.” # University of California, San Francisco, 444 Number of neonatal admissions 31,524 Number of volunteer hours served

Number of cardiac procedures done on 105 kids younger than 12 months 1,064 Number of volunteers

Number of pediatric orthopaedic children’s 772 surgeries performed Number of outpatient 4,157 hematology/oncology visits index 2004

Number of pediatric open-heart Dollar amount of grants, contracts, fellowships 171 procedures performed 47,260,604 and awards the hospital received

Number of children served Dollars raised by Children’s Hospital 65,447 21,900,000 & Research Center Foundation

Number of Emergency Dollar amount of government 47,408 Department visits 31,837,334 grants and awards

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