sports injuries in kids

Coaches and parents, help your kids avoid sports injuries this year

For many families across Kentucky, the start of the school year also means the start of the fall sports season.

Almost three out of every four families with school-aged kids have at least one child who plays organized sports. That’s great! Sports provide physical, emotional and social benefits for kids of all ages. But with sports unfortunately also comes the risk of injury.

The good news is, as parents and coaches, there are lots of simple things you can do to prevent injuries and keep kids playing the sports they love.

Use proper equipment

Make sure young athletes are wearing appropriate and well-fitted safety equipment. This includes:

  • Helmets, for sports like football and lacrosse.
  • Mouth guards, which are inexpensive and can help reduce injury to the mouth, teeth, lips, cheeks and tongue.
  • Sunscreen for outdoor sports.
  • Properly fitting shoes or cleats.

Be aware of heat-related illness

Compared to adults, children are at an increased risk of suffering heat-related illness because they have a lower sweating capacity and produce more metabolic heat during physical activities.

  • Kids just getting back into sports shape after a summer off are especially vulnerable to heat-related illness. Keep an eye on those children in particular.
  • Recognize the signs and symptoms of heat illness, which include nausea, dizziness and elevated body temperature.
  • Reduce the risk of heat illness by making sure young athletes stay hydrated. That means drinking water before, during and after all activities.

Avoid overuse

Nearly half of all sports injuries are from overuse or overexertion and can be easily avoided with proper rest.

  • Plan at least one day off per week to allow a child to rest and recuperate.
  • Coaches, rest players during practice and games to avoid overuse.
  • Children who play multiple sports that use the same body part (like swimming and baseball, for example) are at a higher risk of overuse injuries and should be extra careful.
  • Kids should take two to three months off from each sport every year to avoid overuse.

Be smart when it comes to head injuries

Concussions are serious, traumatic brain injuries that get worse each time they happen. It’s important to know the warning signs of something as serious as brain trauma. Concussion symptoms include:

  • Headache, vomiting or nausea.
  • Trouble thinking normally.
  • Memory problems.
  • Fatigue and trouble walking.
  • Dizziness and vision problems.
  • Changes in sleep patterns.

These symptoms can occur right away, but may not start for weeks or even months. If your child or athlete has any of these symptoms, contact a doctor immediately.


Next steps:

healthy school lunches

Tips for packing a delicious, nutritious school lunch

Parents, the school year is here – what’s your plan for packing school lunches?

By putting some thought into your children’s lunches, you can help keep them full and able to focus on learning throughout the school day. Here’s how:

Rethink the sandwich

Sandwiches are a staple of school lunches, but they don’t have to be boring or unhealthy.

  • Choose bread that is made from whole grains (terms like “100% whole wheat” or “100% whole grain” should be listed first on the ingredients list). Whole grains have nutrients like fiber and can help lower the risk for diabetes.
  • Instead of cheese or mayonnaise, try healthier options like avocado and hummus.
  • Put sliced apple or pear on a turkey sandwich for an extra serving of fruit.
  • Introduce some variety by using whole-wheat tortillas or whole-wheat pita in place of bread.

Make fruits and vegetables fun

Kids need three to four servings of vegetables and two to three servings of fruit each day. Make sure you’re loading up your kids’ lunch boxes with a variety of each.

  • Keep it colorful. Incorporate fruits and vegetables of different colors, such as red apples, oranges, blueberries and dark leafy greens.
  • Encourage kids to play with their food by packing healthy dips. Hummus is great with vegetables such as green peppers and carrots, while low-fat plain yogurt is a healthy option for fruit like apples and strawberries.
  • Feeling creative? Try “bugs on a log.” Use celery sticks or carrots as the “logs” and load them with peanut butter. Then sprinkle your choice of “bugs” – dried cherries, cranberries or raisins – on top to create a fun and tasty snack. Look online for other creative, healthy snack options.
  • Ask your kids what they like. Find out which fruits and veggies are their favorites and be sure to include those more frequently.

Don’t forget about beverages

An otherwise-nutritious lunch can be undone if a child washes it down with an unhealthy beverage.

  • Encourage your children to drink water throughout the day. Drinking water is essential for good health, and it’s a great habit to build early in life.
  • Choose low-fat or non-fat milk. Children get the same calcium and nutrients from these but without the added saturated fat and calories.
  • Avoid sugary drinks such as soda, sports beverages and even juice (especially if it’s not 100-percent juice). They’re often loaded with extra sugar and calories and contain little nutritional benefit.

Next steps:

back-to-school safety

Back-to-school safety basics

Kids across Kentucky are heading back to the classroom this week. From backpacks to buses, here’s what you need to know to keep the little ones in your life safe and happy as they return to school.

School bus safety

School buses are the safest mode of transportation for getting children to and from school, but injuries can occur if kids are not careful when getting on and off the bus.

Tell your children to:

  • Stand at least three giant steps from the curb while waiting for the bus.
  • Use the handrails while boarding and exiting the bus.
  • Be careful of straps or drawstrings that could get caught in the door.
  • Instead of standing up or moving, tell the bus driver if they drop something.
  • After exiting the bus, take five giant steps in front of the bus and make eye contact with the bus driver before crossing the street.

For drivers, remember to:

  • Follow speed limits and slow down in bus loading/unloading areas.
  • Stay alert for kids walking to and from buses.
  • Stop when driving near a bus that is flashing yellow or red lights.

Backpack safety

When used incorrectly, backpacks can injure your child’s muscles and joints, which can lead to severe pain and other problems. When selecting a backpack, look for the following features:

  • Two wide, padded shoulder straps. A single strap does not distribute weight evenly.
  • Lighter bags decrease the total load weight on the back.
  • Rolling backpack. A good choice for students who must tote a heavy load.

Here are some other tips to help prevent injury:

  • Always use both shoulder straps to distribute weight evenly and decrease muscle strain.
  • Tighten the straps so that the pack is close to the body and two inches above the waist.
  • Pack light. The backpack should never weigh more than 10 to 20 percent of the student’s total body weight.
  • Organize the backpack to use all of its compartments. Pack heavier items closest to the center of the back.
  • Use school lockers to store books between classes.
  • Bend using both knees. Do not bend over at the waist when wearing or lifting a heavy backpack.

Pedestrian safety, especially for older kids

Did you know that pedestrian death and injury rate among older children and teenagers is now twice that of younger children? Unsurprisingly, that increase is believed to be related to distractions caused by the use of cellphones and other electronic devices.

To prevent accidents and injuries, tell your children to avoid these dangerous behaviors while walking:

  • Talking on the phone.
  • Texting.
  • Playing handheld gaming devices.
  • Using ear buds or headphones.

Other tips for pedestrians:

  • Always stay alert and be aware of your surroundings.
  • Remind children of all ages the basics of pedestrian safety:
    • Cross only at crosswalks and obey traffic signals.
    • Look both ways and listen, before stepping off the curb.
    • Walk, don’t run while crossing the street.

Next steps:

Diagnosing eye cancer early preserves girl’s sight

When Kenley Overton’s parents took their infant daughter in for her four-month wellness checkup, they didn’t know much about retinoblastoma, the rare form of eye cancer that most commonly affects children. But that quickly changed.

Kenley was born Aug. 24, 2010, to Jason and Kendra Overton. When Kenley was a few weeks old, her parents noticed that her right eye would cross frequently. They brought it up to their local pediatrician during a wellness checkup and were told that it wasn’t abnormal for newborns.

However, when the Overtons brought Kenley in for her four-month wellness checkup, her right eye was still crossing. The pediatrician suggested Kenley see an eye doctor as it was likely she would need glasses to fix the issue.

In a whirlwind of appointments, Kenley first saw an optometrist who believed she had a detached retina. She was then referred to Dr. Peter J. Blackburn at UK Advanced Eye Care. After some testing, Blackburn diagnosed Kenley with retinoblastoma – a form of eye cancer that begins in the retina. Thirteen days after her wellness check, Kenley was scheduled for surgery with Blackburn to evaluate the situation and decide on a plan moving forward.

The best-case scenario

Retinoblastoma is a rare disease; only 200 to 300 children are diagnosed with it each year in the U.S. About three out of four children with retinoblastoma have a tumor in only one eye. Overall, more than 90 percent of children with retinoblastoma are cured, but the outlook is not nearly as good if the cancer has spread outside the eye.

Blackburn says that although there are no known avoidable risk factors for retinoblastoma, some gene changes that put a child at high risk for the condition can be passed on from a parent. Children born to a parent with a history of retinoblastoma should be screened for this cancer starting shortly after birth because early detection greatly improves the chance for successful treatment.

When Blackburn came out of surgery, he told the Overton family that Kenley’s cancer was only in her right eye – the best-case scenario.

He was pleasantly surprised because at Kenley’s young age, he had suspected the cancer might have been in both of her eyes. The decision was made to remove Kenley’s right eye that day.

In the years following her surgery, Kenley was regularly monitored to make sure the cancer hadn’t spread to her left eye. As Kenley continued to grow and show no signs of the retinoblastoma in her left eye, Blackburn became more confident that the cancer was limited to Kenley’s right eye.

Compassionate care at UK

Kendra Overton looks back on this difficult time in Kenley’s life and remembers how tough it was on her family. While taking care of Kenley, she and Jason also had to care for their older daughter, Jaylen, who was 4 years old at the time. But through the stress, she remembers Blackburn and the care he provided for Kenley.

“Dr. Blackburn was a very confident in the information he delivered about Kenley and her treatment plan, and he had a wonderful bedside manner,” she said.

She said Blackburn even took the time to pray with her family before Kenley’s surgery.

“At a time when we were falling apart, we really needed that and you don’t normally hear of doctors doing that,” she said.

Kenley is now a thriving 6-year-old. Kendra describes her daughter as naturally funny and someone who never meets a stranger. She just has a love for people, her mother says.

“Everyone who comes in contact with her says she is just so amazing,” Kendra said.


Next steps:

  • Learn more about UK Advanced Eye Care, which provides comprehensive care for patients of all ages  from routine eye exams to treatment for the most complex ophthalmic issues.
  • Earlier this year, UK Advanced Eye Care moved into a new state-of-the-art clinic that will allow us to provide even better care for our patients. Find out more about our new location.
benefits of breastfeeding

Breastfeeding gives your baby the best possible start

Did you know that breastfeeding is a healthy choice for both mom and baby?

Celebrate National Breastfeeding Month by learning more about breastfeeding’s benefits. Breastfeeding provides warmth and closeness, and the physical contact helps create a special bond between you and your newborn.

Benefits for babies

  • Breast milk is easier for your baby to digest.
  • It doesn’t need to be prepared.
  • It’s always available.
  • It has all the nutrients, calories and fluids your baby needs to be healthy.
  • It has growth factors that ensure the best development of your baby’s organs.
  • It has many substances that formulas don’t have that protect your baby from diseases and infections. In fact, breastfed babies are less likely to have:
    • Ear infections.
    • Diarrhea.
    • Pneumonia, wheezing and bronchiolitis.
    • Other bacterial and viral infections, such as meningitis.
  • Research also suggests that breastfeeding may help to protect against obesity, diabetes, sudden infant death syndrome (SIDS), asthma, eczema, colitis and some cancers.

Benefits for mothers

  • Breastfeeding releases hormones in your body that promote mothering behavior.
  • It returns your uterus to the size it was before pregnancy more quickly.
  • It burns more calories, which may help you lose the weight you gained during pregnancy.
  • It delays the return of your menstrual period to help keep iron in your body.
  • It provides contraception, but only if these three conditions are met:
    • You are exclusively breastfeeding and not giving your baby any other supplements.
    • It is within the first six months after birth.
    • Your period has not returned.
  • It reduces your risk of ovarian cancer and breast cancer.
  • It keeps your bones strong, which helps protect against bone fractures in older age.

UK HealthCare is Baby-Friendly

At UK HealthCare, we’re committed to ensuring a happy, healthy start for newborns and their mothers. In fact, we’re a Baby-Friendly USA® hospital, which is a prestigious acknowledgment of the top-notch care that we provide.

Baby-Friendly USA is a global initiative sponsored by the World Health Organization and the United Nations Children’s Fund (UNICEF). The initiative encourages hospitals to provide breastfeeding mothers with information, confidence, support and skills necessary to initiate and continue breastfeeding.

Find out more about the Baby-Friendly initiative.


Next steps:

UK begins Pediatric Heart Surgery Program with Cincy Children’s

Last month, UK HealthCare and Cincinnati Children’s Hospital Medical Center completed the first heart surgery as part of a new partnership to provide outstanding pediatric cardiac services for patients in Kentucky and beyond.

The Joint Pediatric Heart Surgery Program is the culmination of three years of work by the two organizations and was announced on Friday. The “one program, two sites” model combines the strengths of UK HealthCare’s advanced subspecialty care with one of the country’s leaders in children’s healthcare, Cincinnati Children’s.

Dr. James Quintessenza, a renowned pediatric cardiothoracic surgeon, was recruited to lead the program. Quintessenza arrived in the Bluegrass last December after having built a reputation as one of the leading cardiothoracic surgeons in the U.S.  He had served at All Children’s Hospital (later named All Children’s Hospital Johns Hopkins) in St. Petersburg, Fla., for 26 years, including 19 years as medical director and chief of pediatric cardiac surgery.

“I’ve found that in Lexington, we have a team of people who are dedicated, caring, experienced and striving to provide the highest-quality care possible for these patients and their families,” said Quintessenza, who is often referred to as “Dr. Q” by patients and staff.

“Pediatric open-heart surgeries, heart catheterizations and electrophysiology procedures are underway at Kentucky Children’s Hospital. The patients and families have been so supportive and thankful for the care we are providing that allows them to receive care closer to their home, their families and their support system.”

Successful surgery

On July 5, Quintessenza performed a complex open-heart surgery on Magdalen Wilson, an infant from Nicholasville, Ky., born with several congenital heart defects.

Magdalen’s surgery was completed at KCH as part of the joint program with Cincinnati Children’s. After Magdalen’s parents, Lauren and Thom Wilson, met with UK pediatric cardiologist Dr. Majd Makhoul and Dr. Q, they felt comfortable and confident in receiving their care at KCH.

“We were impressed that several of Dr. Q’s support staff followed him from his previous location because of his leadership and surgical outcomes,” Thom Wilson said. “At this point, through much prayer and discernment, we decided to pursue Magdalen’s surgery with the joint program at UK.”

With the institution of the “one program, two sites” model, patients from Kentucky now have the opportunity to have surgical procedures, diagnostics and therapeutic interventions performed in Lexington. At all times, recommendations for care are based on what is best for patient safety and quality, allowing families to stay closer to home when appropriate.

“Every member of the joint heart program team – which includes more than 100 physicians, nurses, technicians and other specially trained staff – has one main goal and one agenda, and that is to provide the best care possible to our patients,” said Bo Cofield, UK HealthCare’s chief clinical operations officer. “It was very important for our patients and their families that we do everything we can to provide the highest-quality services and care, and we are confident we have that ability with this program.”

Building a world-class program

UK HealthCare officials voluntarily made the decision to pause pediatric cardiothoracic services in 2012, and a task force was charged with providing recommendations regarding the future of the program. Eventually a Letter of Intent was signed with Cincinnati Children’s in 2015, and an agreement was finalized in September 2016.

While UK HealthCare was working toward the goal of restarting a program to perform complex surgical procedures for pediatric heart patients, it was paramount to be able to deliver the highest-quality services. These standards led to the decision to partner with Cincinnati Children’s, recently ranked third among the nation’s pediatric hospitals by U.S. News and World Report.

Other key components vital in resuming pediatric heart surgeries have been the recruitment and hiring of a world-class team including pediatric cardiac anesthesia, pediatric cardiac critical care, pediatric perfusion, specialized physician assistants and advanced practice nurse practitioners, among others. UK HealthCare has invested in infrastructure enabling success through telehealth and other technologies, specialized equipment and supplies, while staff and faculty have participated in intense on-site training at Cincinnati Children’s.

“Today, this program represents the culmination of three years of work between Cincinnati Children’s and the University of Kentucky to reopen the pediatric cardiac surgical program in Lexington,” said Dr. Andrew Redington, executive co-director of the Heart Institute and chief of the Division of Pediatric Cardiology at Cincinnati Children’s. “By establishing a ‘one program, two sites’ collaboration, we ensure that children will get the right operation, in the right place and at the right time. We are all delighted that the first cases have done well, and anticipate ongoing success in the years to come.”

For the Wilsons, everyone in the family is able to breathe a little easier these days, and Magdalen is enjoying her freedom and health, her mother said. She is being cared for locally by Makhoul since being discharged after her surgery.

“Great love has been shown to Magdalen and our family along this journey,” Lauren Wilson said. “Magdalen’s life is a blessing, and one day she will know about the many hands and hearts at Kentucky Children’s Hospital and beyond that God used to restore her to health. We are truly grateful.”


Next steps:

  • The Joint Pediatric Heart Program provides the full spectrum of high-quality heart care – from assessment and diagnosis to complex surgery and post-surgical care. Learn more about the partnership.
  • Mackenzee Walters was diagnosed with hereditary pancreatitis, a painful condition that had taken the lives of several of her loved ones. Specialists at KCH and Cincinnati Children’s teamed up to help Mackenzee find relief from her painful disease. Read her story.

UK, Cincinnati Children’s team up to help 11-year-old with painful illness

Perched on an examination table at the Kentucky Clinic, Mackenzee Walters revealed a collection of bruises and scrapes on her knees – the traces of trampoline topples and skateboarding scuffs.

The 11-year-old shrugged off the purple blemishes while reviewing her summer routine with Kentucky Children’s Hospital (KCH) pediatric gastroenterologist Dr. George Fuchs. These were minor battle wounds – nothing comparable to the pain she knew just months ago.

Mackenzee was born with hereditary pancreatitis, an inherited disease that causes uncontrollable pain. The condition is marked by inflammation of the pancreas, the organ that makes enzymes to break down and digest food and that produces insulin necessary for blood sugar regulation.

Mackenzee’s life has been filled with extended absences from school due to pain and frequent hospitalizations to manage flare-ups of her pancreas. Since the age of 3, she has taken potent opioid medications in an attempt to control pain and followed a strict diet barring her from the foods children love, such as macaroni and cheese and mashed potatoes.

But this year, after a surgical intervention coordinated through a multidisciplinary team at KCH and Cincinnati Children’s Hospital Medical Center, Mackenzee has adjusted to a new existence — one free of sharp, unrelenting pain and miraculously, without a pancreas.

Innovative treatment for hereditary pancreatitis

In January, surgeons at Cincinnati Children’s performed an innovative procedure reconstructing Mackenzee’s gastrointestinal tract to function without the source of her pain: the pancreas.

Fuchs, Mackenzee’s primary gastroenterologist at KCH, in collaboration with the pediatric medical and surgical teams at Cincinnati Children’s, determined that Mackenzee was a candidate for a Total Pancreatectomy with Islet Autotransplantation (TPIAT) surgery.

Cincinnati Children’s Dr. Jaimie Nathan removed Mackenzee’s pancreas and sent the organ to the islet facility where the islets – or the cells within the pancreas that produce insulin needed for glucose metabolism – were isolated. The islets were returned within hours, with Mackenzee still on the operating table. Nathan transplanted the islets back into her liver, where the cells took up residence and resumed their essential function. Cincinnati Children’s is one of few children’s hospitals in the nation to offer the innovative TPIAT procedure.

The surgery is a new offering for pediatric patients ages 4 and older expecting a life of pain stemming from the disease. Fuchs said scientific knowledge of hereditary pancreatitis has expanded throughout the past decade, although many generations have suffered without medical treatment or relief.

Inflammation of the pancreas can lead to permanent damage and eventual organ failure. Until recently, doctors have focused on trying, with only limited success, to manage symptoms through dietary modification and pain management. Because eating triggers the flare-ups, many children diagnosed with the condition become frail and undernourished.

“If that individual’s eating is one of the stimulators of the pain, or the activity of the pancreatitis, then it’s just awful,” Fuchs said of the disease. “It inhibits their ability to take in food because it hurts. So, they can become undernourished. It can be very difficult for these kids, very difficult.”

Fuchs and Mackenzee at an appointment at the Kentucky Clinic.

‘All we’ve ever known’

Mackenzee is part of a long line of family members to inherit pancreatitis, although most of her relatives died early in life from complications related to the disease. Those victims include Mackenzee’s biological mother and an aunt who died at age 35. Mackenzee’s grandmother died at 36 from complications after an experimental procedure. Several of Mackenzee’s cousins also succumbed to the disease, one passing away at age 23 and another at 4 years old.

Kim Walters is Mackenzee’s mother and biological aunt and the oldest surviving family member with hereditary pancreatitis. She said until Mackenzee’s surgery, members of her family accepted the tragic fate of dying early or living with chronic pain. Walters, who is insulin-dependent because of damage to her pancreas, expected Mackenzee to have a similar fate or endure severe pain for the remainder of her life.

“Hereditary pancreatitis is pretty much all we’ve ever known in my family,” Walters said. “It’s very excruciating every day. I had my children naturally without an epidural – I would rather have a child every day for the rest of my life than live with this disease.”

Teaming up with Cincinnati Children’s

In December 2015, after seeing many doctors around the country, Walters consulted with Fuchs at KCH. At the time, Mackenzee was suffering from unmanageable pain and taking a potentially dangerous level of medications without much relief. After ruling out the possibility of increasing doses of medication, Fuchs recommended Mackenzee as a candidate for the TPIAT surgery at Cincinnati Children’s. He contacted colleagues at Cincinnati Children’s and started the process of referring her for surgery.

“There was just nothing else. There were no other options to give her anymore because she was on [opioid] doses adults should take,” Walters said. “There was just nowhere else to go.”

Traumatized by losing her mom to an experimental surgery and seeing her daughter suffer in spite of 17 experimental surgeries, Walters was at first skeptical of the operation. Mackenzee was also afraid of undergoing a complex surgery removing an essential organ. But Fuchs, along with Dr. Maisam Abu-El-Haija, medical director of the Pancreas Care Center, and Nathan, the surgical director of the Pancreas Care Center at Cincinnati Children’s, explained every detail of the process and provided examples of real cases where children had recovered and enjoyed better lives.

“I came to the conclusion, if nothing else if she would just be pain-free,” Walters said. “If God chose to take her six months later, at least she would have six months of no pain. And that was our goal: to make her not have pain and be able to play and do what normal kids do.”

The 12-hour surgery was conducted at Cincinnati Children’s, with general follow-up appointments at KCH. Since her surgery, Mackenzee’s islets have rebounded in producing insulin. In fact, the amount of supplemental insulin she needs each day has dropped, and she no longer requires pain medication many months following her operation.

“I would predict she has a very high likelihood of becoming insulin independent,” Fuchs said. “She will no longer live in the hospital, which is what these children do before the procedure because they are in so much pain. I anticipate she will get on with her life, including getting into mischief as most kids do when they become teenagers. Hopefully go on to have a productive, full life.”

Helping others with the disease

People from Appalachia experience among the highest rates of hereditary pancreatitis in the nation. Fuchs hopes to extend advanced interventions and therapeutic options to affected children in Eastern Kentucky and surrounding areas.

In his first year working at KCH, Fuchs saw more cases of hereditary pancreatitis than in 15 years at his previous institution in Arkansas. Mackenzee’s family lives in Kenova, W. Va., but she receives primary gastrointestinal care and pain management services from Fuchs and Dr. Lindsey Ragsdale, a palliative and pain specialist at KCH. The ability to partner with Cincinnati Children’s Pancreas Care Center reduced the amount of travel time for Mackenzee and her family, keeping routine healthcare services more convenient while also giving them access to the services of a nationally renowned pediatric pancreas and surgery program.

Dr. Maisam Abu-El-Haija said the success of Mackenzee’s case is the result of like-minded doctors sharing a commitment to improving a child’s condition. The collaboration represented multiple disciplines and experts, including endocrinologists, pain specialists, psychologists, gastroenterologists, and surgeons at Cincinnati Children’s and KCH.

She commended Fuchs for initiating conversations with Cincinnati Children’s and pursuing a surgical intervention he believed would achieve the most advantageous outcome for the child, even if not performed at his own institution. She thinks the ability to collaborate with KCH will ensure more hereditary pancreatitis children will receive advanced surgical care without requiring the child’s primary care institution to “reinvent the wheel.”

“It stemmed from having common personalities and common goals,” Abu-El-Haija said. “I really value physicians like Dr. Fuchs. Basically, we both clicked on what we think is important, which is the outcome for the patient. Patients are best served closer to home, but no institution has everything.”

No longer worried about the future

Kim Walters said nothing makes her happier than to see her Mackenzee flipping on trampolines, eating birthday cake and being well enough to sleep over at a friend’s house.

Fuchs, who said most children gradually recover from the TPIAT over a prolonged period, considers Mackenzee’s rapid recovery an anomaly. Mackenzee came off a ventilator soon after surgery, and off of the feeding tube for nutritional support five weeks after surgery. She left the hospital prior to the expected discharge date, returning to school to finish the spring semester.

Walters doesn’t worry as much about Mackenzee trying once unthinkable foods to digest, such as steak, or passing out from pain at a friend’s house. The thought of losing Mackenzee doesn’t haunt her anymore. After scouring the nation looking for options for Mackenzee, she found an answer in Fuchs and the providers at KCH and Cincinnati Children’s.

“To discover that it’s right here at your back door where they’ve actually accomplished the research and figured out how to give her a better life and prolong her life, I was a little dumbfounded, I guess,” Walters said. “Because everyone thinks living in the boondocks, we don’t have good doctors, but we have some of the best doctors in the world. From Cincinnati to here at UK, there are some of the best doctors.”

Today, Mackenzee radiates with energy and giggles about her second belly button, a token left from her surgery. Mackenzee now thinks about the future and wants to become a fashion designer. She lists off all the activities she can do now, like help her mom cook and mop the floors.

“I can eat. I can go to school,” Mackenzee said. “Now I have more than just one friend. I can do other stuff than just lay in bed all day. Do different things.”


Check out our video that tells the story of Mackenzee’s journey and the collaborative work between KCH and Cincinnati Children’s that helped her find relief from her debilitating disease.


Next steps:

postpartum depression

If ‘baby blues’ persist or worsen, it’s time to talk to your doctor

From sleep deprivation to learning how to breastfeed, you face a lot of challenges as the mother of a newborn.

As you adjust to these challenges, it’s not uncommon to experience mood changes or feelings of sadness. These “baby blues” will often go away after a few weeks.

Sometimes, though, mothers of infants can develop symptoms that are more severe and last longer than baby blues. This is known as postpartum depression. One study has shown as many as one in every seven mothers of newborns suffer from this debilitating condition.

Luckily, most women find that treatment helps.

What is postpartum depression?

Postpartum depression can start at any time during your baby’s first year. Usually, you’ll start to feel its effects during the first three weeks after birth.

You might feel sad, hopeless or guilty because you may not feel like bonding with or caring for your baby.

Postpartum depression doesn’t just affect first-time moms, either. You can experience it even if you didn’t have it with your previous children.

Why does it happen?

There are many causes of postpartum depression, including:

  • Hormone levels. Your hormone levels increase when you’re pregnant. After your baby arrives, they drop suddenly. This quick change can trigger depression in some women.
  • A history of depression. If you’ve previously had depression or if it runs in your family, you may be more susceptible to postpartum depression.
  • Other stress and problems. If you didn’t want to be pregnant or if your partner and family aren’t helping you care for your baby, you’re more likely to become depressed as a new mom. Postpartum depression is also more common among women with other stresses such as financial issues, problems with drugs or alcohol, or relationship troubles.

Symptoms

Postpartum depression varies among women, but here are some of the most common symptoms:

  • Sadness, loss of hope or despair.
  • Feeling unable to care for your baby or do basic chores.
  • Crying a lot, sometimes for no obvious reason.
  • Trouble bonding with or feeling close to your baby.
  • Less interest in other things you used to enjoy.
  • Too much sleep.
  • Trouble with focus, learning or memory.

Diagnosis and treatment

Only a doctor can diagnose you with postpartum depression. But if you think you have it, make an appointment right away. There are treatments that will get you back to feeling like yourself. They include:

  • Medication. Your doctor might decide to prescribe you antidepressants. If you’re nursing, be sure and tell your doctor. He or she can prescribe an antidepressant that is safe for nursing mothers.
  • Counseling. Talking to a psychologist or therapist can also help. You can learn ways to recognize when you’re having negative thoughts so you know how to better deal with them.

Postpartum psychosis

Postpartum psychosis is a rare and serious form of mental illness that can happen with postpartum depression. Symptoms often begin during the first two weeks after your baby is born and are more severe than those for postpartum depression. They include:

  • Frequent crying and irritability.
  • Lack of energy.
  • Trouble concentrating and making decisions or confusion.
  • Inability to sleep.
  • Feeling hopeless.
  • Lack of interest in eating.
  • Thoughts of harming yourself or your baby.

Postpartum psychosis is a medical emergency. If you think you might be experiencing symptoms of postpartum psychosis, call your doctor immediately.


Next steps:

Dr. James Liau

Dr. James Liau: How I help families navigate the cleft care journey

Written by Dr. James Liau, a plastic surgeon at UK HealthCare who specializes in cleft lip and palate repair.

July is a special time of the year for me since it’s Cleft and Craniofacial Awareness Month.

Although I do all aspects of plastic surgery, pediatric cleft care is what I’m passionate about.

So, what are clefts and how are they treated? What can you expect if your child is born with a cleft? I’m here to help answer those questions and help you and your family navigate the cleft care journey – from birth through adulthood.

What is a cleft?

A facial cleft is an area where there is an absence of tissue or abnormal tissue. Although there are multiple types of clefts, cleft lips and cleft palate are the most common. Some patients may have both cleft lips and cleft palate, while others may have only cleft palate.

Unfortunately, we’re not entirely sure why clefting occurs. Although clefts are a lifelong condition, I feel very strongly that there is no reason they should limit a child’s potential in life.

Treatment in the first year of life

I like to fix cleft lips at about 4 to 6 months of age, and then fix cleft palates around 10 months to 1 year of age. Timing varies for each family. I always tell parents that the most important thing is to go home, bond with their newborn and not worry about the cleft until at least several months after birth.

As a parent myself, I understand that no one wants their child to have surgery. Unfortunately, a child with a cleft lip and palate will need two surgeries in their first year of life. Both surgeries will be overnight stays in the hospital to make sure pain is controlled and the family is comfortable with the postoperative care.

The lip repair is the most dramatic, but postoperative care is relatively easy. Cleft palate repair can make eating challenging as it requires the child to temporarily be on a diet of only thickened liquids, such as applesauce.

Childhood

After the first year, cleft care is put on the back burner as we monitor speech development. As a child nears the age of 3, we have to be vigilant about their ability to communicate. Kids with cleft palates can develop hyper-nasal speech, a condition that occurs when the palate can’t close off the nose. This is called velopharyngeal insufficiency, or VPI.

If this can’t be fixed by speech therapy, another surgery may be necessary. I like to do this before the child starts preschool or kindergarten, as this is when kids really start interacting with their peers and speech becomes very important in making new friends.

At this time in a child’s life, we can also discuss whether a small touch-up to the lip or nose is necessary. I defer this decision to the child and family. Kids don’t comment negatively on physical differences until they’re at least 7 years old, so touch-ups at this age are only necessary if the cleft is bothering the child. My goal is that the first repair is perfect enough to avoid a revision!

Between the ages of 7-9, the child will start seeing an orthodontist. If there is a cleft in the gum line, we will need to put a bone graft in that area when the child’s permanent teeth come in, which usually occurs around this time.

The timing of this procedure can usually be coordinated over several months, and most families choose to do it during summer or winter break. For this operation, I use a less-invasive technique that involves harvesting bone from the hip. Postoperative care depends on the child: Some kids will stay overnight for pain control, while others will not.

Teenage years into adulthood

In the teen years, we can revisit the idea of a revision. This is when I do a lot of rhinoplasties, or nose reshaping. Naturally, we are focused on getting the nose to look more symmetrical, but we are also focused on opening the nasal airway so that breathing through the nose is normal. This is an outpatient procedure.

During the teen years, we may also do jaw surgery to improve how the face looks, and in more severe cases, to improve the airway in the nose and upper mouth.

As you can see, cleft care requires lots of coordination over many years. I tell all my families, “My role is to be your quarterback.” Raising a child is hard enough without worrying about cleft care, so my job is to make sure we don’t miss anything and to seamlessly work cleft care into what is happening in the family’s life.

I’m always honored to be able to help patients and their families navigate the process of cleft care. All children deserve a chance at a bright future, and I hope my work can help make that happen.


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Following a few grilling safety tips can keep the focus on good food and fun, not on first-aid.

Planning a cookout? Follow our grilling safety tips

Cookouts and barbecues are a staple of the summer season, but firing up the grill can be dangerous if you don’t follow the proper precautions.

Each year, grilling accidents cause nearly 10,000 home fires and send 16,000 people to the emergency room. But following a few grilling safety tips can keep the focus on good food and fun, not on first-aid:

  • Use grills outside only. Even small grills used inside create fire hazards, plus they release carbon monoxide, which can be fatal to people and pets without proper ventilation.
  • Keep the grill away from the home, deck railing, overhanging tree branches and any flammable decorations. Make sure nothing flammable can blow onto the grill.
  • Use the right lighter fluid for your grill, and store it away from the heat and out of the reach of children.
  • Establish a child- and pet-free zone. Make sure children and pets are indoors and/or being supervised by someone other than the cook. And keep them at least three feet from the grill. Burns from contacting a hot grill are especially common in kids under 5.
  • Clean the grill well before use. Grease and fat can build up on the grill and contribute to fires.
  • Don’t overload the grill. Excess fat dripping on the flames can cause major flare-ups.
  • Keep a spray bottle of water handy. Use it to douse small flare-ups before they get out of control. The bonus? Water won’t ruin the food.
  • Never leave your grill unattended. And remember that charcoal grills can stay hot for hours after use.
  • If your flame dies down, add dry kindling. Never add lighter fluid once the flame has been lit.

When using a gas grill

  • Make sure the lid is open before lighting it. This prevents flammable gas from being trapped in the chamber, which can cause an explosion.
  • If you smell gas and the flame is off, turn the gas off.
  • If you smell gas while using a gas grill and the flame is on, get away immediately. This is a sign that there is a leak. Call the fire department, and stay away from the grill.

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