Dr. Sean Skinner teaches surgery basics to first-graders

My experience teaching surgery to first-graders

Written by Dr. Sean Skinner, pediatric surgeon at Kentucky Children’s Hospital.

Dr. Sean Skinner

Dr. Sean Skinner

Not many first-grade science curriculums include hands-on surgical training, but that’s exactly the lesson I taught to my daughter’s class earlier this year.

As a pediatric surgeon, I had the opportunity to talk with my daughter and her first-grade peers at Sayre School in Lexington as part of a larger lesson about machines in workplaces. When she mentioned to her teacher, Mrs. Angela Hardin,  that I “worked with machines and robots at the hospital,” Mrs. Hardin offered me the opportunity to share my experiences with the class.

What followed was an exploration of surgery seen through the eyes of first-graders. I showed them the tools I use on a daily basis and fit them for surgical masks. I then explained to them that laparoscopy is a kind of surgery where we make very small cuts and perform the procedure with the assistance of a small camera that goes inside of a person’s body.

With the basics out of the way, the real fun started. The kids got to try their hands at the same laparoscopic training machines we use at the hospital. Using surgical tools attached to a camera and monitor, they performed a short drill of picking up beads from one cup and moving them to another. It didn’t take long for them to realize just how hard it is to use the instruments while watching a monitor at the same time.

I had a blast seeing how excited the kids were to use the simulators and answering all of their questions about surgery and being a doctor.

Pediatric surgery is no doubt a complicated subject for first-graders, but I think it’s important for children to learn about as many different careers as possible. Through activities like the one at my daughter’s school, kids are able to see what their parents and what other parents do.

I think it would be great to do this type of presentation and hands-on learning activity with more classrooms in Lexington and bring it to different age groups. The more topics children are exposed to at a young age, the better.

Of course, I think learning about science is important for all students and doing so at an early age could spur their interest in science and medicine going forward.

And who knows, maybe an activity like this could spark the next great scientist of the future.


Next steps:

water safety

Going to the pool? Keep the kids safe with these tips

Memorial Day marks the unofficial start of summer, and pools everywhere will be opening this weekend.

Swimming and water recreation can be great fun, but they can also be dangerous. So before you and your family hit the water, check out these tips for keeping the kids safe.

Water safety tips to teach your children:

  • Learn how to swim.
  • Always swim with a buddy.
  • If you can’t swim, don’t get in water deeper than your shoulders.
  • Always wear a U.S. Coast Guard-approved life vest when you are playing water sports, when you’re near an open body of water or when you’re on a boat.
  • Never run, push or jump on others around water.
  • If you see someone struggling in the water, shout for help. Don’t try to rescue the person yourself.

Water safety tips for adults to keep in mind:

  • Never leave children alone near water – adults must supervise at all times.
  • Never let children swim alone – no exceptions to this rule, ever.
  • Children in baby bath seats and rings must be within arm’s reach every second.
  • Teach children to swim after age 4.
  • Never substitute a flotation device for supervision.
  • Do not allow children to run, push or jump on others around water.
  • Learn CPR for infants, children and adults.

In case of drowning

According to the CDC, two children 14 and younger in the United States die by drowning every day. And for every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.

In a drowning accident, seconds make the difference between survival, recovery or death. Drownings occur when a child is left unattended, even for a brief moment. If a child is missing, always check the water first before looking elsewhere. Wading pools, swimming pools, spas, hot tubs, lakes, rivers, oceans, bathtubs, buckets and even toilets all pose a risk of drowning.

If you see someone struggling in the water:

  • Shout for help immediately.
  • Find something you can throw out to the person to pull him or her to safety, such as a life preserver, rope or towel.
  • If you can’t reach the person, throw out a floating object he or she can hold onto until additional help arrives.
  • Never swim right to the person. He or she is scared and may accidentally hurt you.
  • If no one hears your shout, call 911.

Next steps

Epilepsy

13-year-old boy enjoys being “normal kid” again after epilepsy surgery

Anyone who’s 13 years old – or who was once 13 – can relate to the embarrassment of a parent insisting on sitting in the room while they showered.

Unfortunately, that was the reality for 13-year-old Joey Maggard until a delicate surgical procedure eliminated his epileptic seizures this past January.

At the time of his surgery, Joey’s seizures were so frequent and unpredictable – about 20 to 30 per month – that his mother, Erin Smith, would sit in the bathroom in case he seized while showering.

“It was so frustrating for him and heartbreaking for me,” Erin recalls. “He wanted so much to be ‘just a kid,’ but the reality was that being ‘just a kid’ could have been dangerous for him.”

Adding to the disappointment were the other restrictions imposed upon Joey. He could no longer play his beloved sports or have sleepovers with friends. He was forced to follow a restricted diet and reduce Xbox and electronics use. After his seizures increased in frequency, his school district asked that he be tutored at home for the last half of his sixth grade year.

A very understanding doctor

“Epilepsy is often misunderstood by the lay public, and epilepsy patients are often teased or shunned, particularly when they are younger,” said Dr. Meriem Bensalem-Owen, director of the Epilepsy Program at the Kentucky Neuroscience Institute at the University of Kentucky. “As a result, they often isolate themselves for fear of losing control in public, and depression and anxiety commonly go hand-in-hand with the stigma of epilepsy.”

Bensalem-Owen considers it part of her responsibility to reassure patients that they are not alone in their journey.

“More than 150,000 Kentuckians are living with epilepsy today,” she explains. “I think many patients are surprised when I tell them that.”

Even more reassuring, Bensalem-Owen believes, is the fact that she has a personal experience with epilepsy.

“My son had seizures few years ago, and I literally told myself ‘OK, so now I have to be as brave as the parents of my patients and do what I tell them to do.’ So I understand, not just as an epileptologist but as mom, what Joey and his family were going through and I can reinforce with them that there is a team with them step of the way.”

An epilepsy center to get the job done

Joey’s odyssey began when he was 9. Erin said that while Joey’s birth was stressful, otherwise “he was great, he hit every milestone.” With no family history, his first and second seizures – about six months apart – were a shock to his family. After Joey experienced a grand mal seizure – considered the most violent and dangerous of all seizures – a CAT scan at a hospital close to their Lincoln County home found a lesion in his brain. He was referred to Dr. Qutubuddin G. Khan, a pediatric neurologist at the Kentucky Neuroscience Institute (KNI).

The Epilepsy Program at KNI is accredited by the National Association of Epilepsy Centers (NAEC) as Level 4 Center — its highest designation. A Level 4 center provides more extensive medical, neuropsychological, and psychosocial treatment, including thorough and highly technical evaluation for a wide range of surgical treatment for epilepsy. Since 2003, US News and World Report has included NAEC Level 4 adult epilepsy centers as a part of its ranking criteria.

“Level 4 epilepsy centers have the professional expertise and facilities to provide the highest-level medical and surgical evaluation and treatment for patients with complex epilepsy,” said Dr. Larry Goldstein, chair of the UK Department of Neurology and KNI co-director. “To achieve this designation is an apt reflection of our institutional commitment to provide the best subspecialty care to the people of Kentucky and beyond.”

At first, Khan tried a variety of medications, alone and in combination. Each time, says Erin, they would work for a while, but Joey’s seizures would eventually return.

“One of the things I loved most about Dr. Khan was how candid he was,” said Erin. “After each setback, he’d sit with us and explain patiently what our next options were and the pros and cons of each option.”

Based on initial testing to determine what areas of the brain Joey’s seizures came from, Khan felt Joey was a good candidate for surgery, and referred him to Bensalem-Owen for further evaluation.

A crucial step in the process of assessing Joey’s seizures — and a hallmark of centers with NAEC Level 4 accreditation — is invasive brain monitoring, where the skull is opened and a delicate web of electrodes is placed directly on the brain. Over a period of days Joey was monitored and brain mapping was performed to pinpoint exactly which parts of his brain controlled essential functions like speech, and those points were compared to the areas were his seizures arose. It’s a painstaking and uncomfortable process.

“I asked Joey if he was ready for this, and he looked me straight in the eye and said YES,” said Bensalem-Owen. “He said he was tired of missing school and having poor grades. I was impressed by how determined and brave he was.”

Brain mapping indicated three small areas that were leading to Joey’s seizures. Two areas were perilously close to the part of Joey’s brain that controlled vision and motor function; Bensalem-Owen knew that precision was critical to a successful outcome for Joey.

Once the doctors knew which parts of Joey’s brain to target and which parts to avoid, KNI neurosurgeon Dr. Thomas Pittman performed the surgery to remove the lesions that were causing his seizures. Then began the waiting game.

“Joey’s been seizure-free since his surgery,” said Amy. “He now can take showers and be alone outside without my constant supervision. I know we’ve got a ways to go before we’re out of the woods, but this has been a huge burden lifted.”

Furthermore, says Bensalem-Owen, Joey’s vision and other motor function have remained intact. “We couldn’t have hoped for a better outcome,” she said.

Surgery shouldn’t be treated as a last resort

Bensalem-Owen stresses that while surgery isn’t an option for everyone, there are large swaths of individuals with epilepsy who either don’t know about or are afraid of surgery, and those people are suffering needlessly.

“In the U.S., there are more than 100,000 patients who are candidates for surgery, and only about 2,000 people elect to have the surgery every year,” she said. “We need to educate patients and healthcare providers that surgery shouldn’t be treated as a last resort, that patients don’t need to suffer from the physical and emotional effects of epilepsy for ten or twenty years. If someone has uncontrolled epilepsy for more than a year, they should seek an opinion at an accredited epilepsy center.”

In a post-surgery appointment with Bensalem-Owen, Joey was bouncy and talkative. His hair was growing back, mostly covering the scar that extends from the top of his head to just behind his ear. His grades have rebounded since his return to school in March and he has been cleared to play sports in June. He will continue epilepsy medication as an added precaution, but Bensalem-Owen predicts a complete return to the life that allows kids to be just that — kids.

“On my first day back to school, as I was going down the hall teachers were shrieking and kids were hugging me,” Joey recalled with a smile. “I was back with my buddies again, and I was so happy.”


Next steps

lawn mower safety

Mowing the lawn? Keep these safety tips in mind

Even though it’s easy to forget when you’re using it week in and week out, your lawn mower is actually dangerous and potentially deadly piece of equipment.

Each year 20,000 people are injured in the U.S. due to mower-related accidents, and 75 are killed. One in five of those deaths involves a child, and more than 600 children will lose a limb this year as a result of a preventable lawn mower accident. While it’s important to be extremely cautious when cutting your yard, one of the safest things you can do for your family is to keep your children inside while you’re operating a lawn mower. In many cases where children were injured, the adults involved didn’t know they were near the mower when the injuries occurred.

To raise awareness about the dangers lawn mowers pose to children, The Amputee Coalition and Limbs Matter, a group of parents whose children have undergone an amputation because of a lawn mower accident, have partnered on national safety initiatives.

Kids aren’t the only ones at risk from lawn mowers. Here are some personal safety tips to keep in mind:

Wear the right clothing. Avoid shorts or sandals. Long pants will protect your legs and closed-toed shoes protect your feet and provide better traction.

Survey the yard. Before mowing, pick up any sticks, rocks or other debris that could become dangerous projectiles if hit by a mower blade.

Tell somebody. Before you begin mowing, be sure to tell a family member or neighbor that you’re going to be working outside in case an accident happens.

Mow across the slope. If you have to mow a slope, always mow across the slope and never up and down. This removes the risk of the mower rolling back on you.

Don’t mow at night. You should only use your mower in daylight or good artificial light.

Beware the sun. If it’s hot outside, be sure to take frequent breaks and drink plenty of water. Don’t forget the sunscreen.


Next steps:

Learn more about the importance of lawn mower safety by watching the “Limbs Matter” public service announcement.

What you can do to prevent child abuse

Child abuse can happen in any family and in any neighborhood. Studies have shown that child abuse crosses all boundaries of income, race, ethnic heritage and religious faith. The incidence is higher, however, in families in which the parents are in their mid-20s; high school dropouts or lack a high school diploma; below the poverty level or financially stressed; stressed because of a loss of job or home; or have a history of intergenerational abuse, alcohol, or substance abuse problems, a history of depression, or spouse abuse.

Stopping abuse

Prevent Child Abuse America offers these tips for stopping child abuse:

  • Try to understand your children. Learn how kids behave and what they can do at different ages. Have realistic expectations and be reasonable if children fall short.
  • Keep your children healthy. Denying children food, sleep, or health care is abuse by neglect.
  • Get help with alcohol or drug problems. Keep children away from anyone who abuses those substances.
  • Watch your words. Angry or punishing language can leave emotional scars for a lifetime.
  • Get control of yourself before disciplining a child. Set clear rules so the child knows what to expect. Avoid physical punishment.
  • Take a time-out. Stop if you begin to act out frustration or other emotions physically. Find someone to talk with or watch your kids while you take a walk. Call a child abuse prevention hotline if you are worried you may hit your child.
  • Make your home a violence-free zone. Turn off violent TV shows and don’t let kids stay under the same roof with an abusive adult.
  • Take regular breaks from your children. This will give you a release from the stress of parenting full-time.

If you want to go the extra mile for supporting the safety of children, visit the Prevent Child Abuse Kentucky site and join us for the Commit to Prevent 5K Run/Walk on April 10. UK HealthCare is a proud sponsor of this event and we hope to see you there! Also, don’t forget to wear blue April 8 to promote child abuse awareness and stop by the Pavilion A Atrium Lobby at UK Albert B. Chandler Hospital at 1 p.m. for a group photo.


Next Steps:

Tips to poison-proof your home

Tips to poison-proof your home

From misplaced medications to household cleaning items, every house has its fair share of potential dangers for children. In fact, nearly 1.2 million cases of accidental poisoning in children ages 5 and younger are reported each year, with 90 percent of those occurring in the home.

This week is National Poison Prevention Week and a great time to review Safe Kids Fayette County’s tips for keeping your house safe for children. Check out our guidelines below and print this post to hang on your fridge or near your phone.

Store potentially poisonous household products and medications out of children’s sight and reach.

  • Read labels to find out what is poisonous. Potential hazards include makeup, medicine, plants, cleaning products, pesticides, art supplies, and beer, wine and liquor.
  • Never leave potentially poisonous household products unattended while in use.
  • Be aware of poisons that may be in your handbag. Store handbags out of the reach of young children.
  • Never mix cleaning products.
  • Buy child-resistant packages when available. Keep products in their original packages to avoid confusion.

Be safe when taking or administering medication.

  • Always read labels, follow directions and give medicines to children based on their weights and ages. Only use the dispensers packaged with children’s medicines.
  • Do not refer to your medication as candy. Children should not think of prescription or over the counter (OTC) medication as treats.
  • Many parents keep their medications on the kitchen counter, on the nightstand, on the dinner table or in personal bags, such as purses, as a personal reminder to take our pills, but these are all easily accessible areas for children. Instead, write a note to remind yourself so you can keep all medication in a cabinet or area that is up and away from your children’s view and grasp.

Keep the toll-free nationwide poison control center number, 800-222-1222, and local emergency numbers near or programmed into every phone in your house.

  • If you suspect poisoning and a child is choking, collapses, can’t breathe or is having a seizure, call 911. Otherwise, call the poison control hotline and have the ingested product on hand to discuss with the operator.
  • Follow the operator’s instructions.
  • Don’t make the child vomit or give him or her anything unless directed.

 Next steps:

Distractions play a crucial role in car crashes, study says

Chances are you’ve let your mind wander while driving, but that’s more dangerous than you may know. Those little distractions, even if they seem harmless, often result in car accidents, according to a new study published in The Proceedings of the National Academy of Sciences.

The extensive study, published Feb. 22, assessed footage shot inside more than 3,000 vehicles over three years.  During that time, researchers observed more than 900 crashes, almost three-quarters of them caused by distractions such as texting, changing the radio or looking at a cell phone. The researchers found that drivers were “clearly distracted” in almost 70 percent of observed accidents, and not surprisingly, the findings link cell phone use to many crashes.

You can read more about the study at the NIH, but the takeaway is simple: Distracted driving leads to accidents, no matter what you’re doing or how long you’re distracted.

Understanding your bad driving habits is the first step toward being a safer driver. There are three kinds of distractions while driving: manual, visual and cognitive. Manual distractions take your hands off the wheel, visual distractions take your eyes off the road, and cognitive distractions take your mind off of driving.

Check out these six tips for avoiding distractions.

  • Turn it off. Before you get in the car, turn your cell phone off or switch to silent mode. You can wait, and so can others.
  • Be prepared. Review maps and directions before you get on the road. If you need help while driving, ask a passenger to help or pull over to a safe location to review the maps/directions again.
  • Secure pets. Pets can be a big distraction in the car. Always secure your pets properly before you drive.
  • Keep kids safe. Pull over to a safe location to address situations with your children in the car.
  • Stay focused on the task at hand. Refrain from eating, drinking, smoking, reading and any other activity that may take your eyes off the road.
  • Don’t text and drive. It’s the law.

Next steps:

  • Read the Safe Kids Fayette County guide to preventing accidents while driving and get the hard facts about texting behind the wheel.
  • Check out the NIH story for more details on how distracted driving is causing accidents.

Dancing for the kids

When DanceBlue started at the University of Kentucky more than 11 years ago, the group’s goal was simple: bring UK students and staff together to help support children and families fighting childhood cancer.

To say the group has been successful would be an understatement. Since it started, DanceBlue has raised more than $8.2 million for our pediatric oncology clinic at the Kentucky Children’s Hospital. And this weekend, they’ll add to that total.

The DanceBlue Marathon, which starts at 2 p.m. Saturday at Memorial Coliseum, is a 24-hour, no-sitting, no-sleeping dance marathon that culminates in the group announcing how much money it’s raised in the last year. At the 2015 marathon, DanceBlue celebrated raising more than $1.5 million.

That money benefits children and families being treated at the DanceBlue Kentucky Children’s Hospital Pediatric Hematology/Oncology Clinic – named in honor of the group.

The marathon is open to the public from start to finish but only dancers are allowed on the floor of Memorial Coliseum. Family and friends of dancers are welcome and encouraged to come support their loved ones.

If you’re interested in supporting DanceBlue, join us this weekend! Our dancers, children and families would love your support.

For more information about DanceBlue, registration information or to support its efforts, visit www.danceblue.org.

The DanceBlue Marathon benefits the DanceBlue Kentucky Children’s Hospital Pediatric Hematology/Oncology Clinic

 


Next steps:

  • Read about R.J. Hijalda, a UK freshman dancing in this year’s marathon, who was diagnosed with stage IV Hodgkin lymphoma as a freshman in high school.
  • Learn more about the DanceBlue Clinic at Kentucky Children’s Hospital.
  • Connect with DanceBlue on Facebook and Twitter. Use #FTK (For the Kids) to show your support.

Safe sleep tips for newborns and infants

Did you know that unintentional suffocation is the leading cause of injury-related death among children younger than 1? Safe Kids and the American Academy of Pediatrics recommend the following tips to help create a safe sleeping environment for newborns and infants:

  • Always place infants on their backs to sleep, even for naps.
  • Keep your baby’s sleeping area free of anything that may obstruct their airway and increase the risk of suffocation, such as loose bedding, blankets, quilts, stuffed animals and pillows. This includes other children and adults.
  • Babies should sleep alone in their own safety-approved crib or bassinet. For information on crib safety standards, visit the Consumer Product Safety Commission website.
  • Sharing your room is a safer option than having your baby sleep in bed with you.
  • Do not allow your baby to sleep in sitting devices such as couches, chairs or even car seats.
  • Keep your baby’s sleeping areas smoke free and at a comfortable temperature.
  • Try not to be tempted to dress your baby in too many layers. Consider using a sleep sack to keep him snuggled comfortably without the risks associated with loose blankets.

Next steps:

  • Visit Safe Kids Fayette County for more information about preventing childhood injuries and keeping the kids in your life safe.
  • Follow Safe Kids Fayette County on Twitter.
The Markey Cancer Center joined a national movement encouraging people to get HPV vaccines.

Get the facts about the HPV vaccine

On Wednesday, the UK Markey Cancer Center, along with 68 of the nation’s top cancer centers, issued a statement urging young people in the U.S. to get a vaccination against the human papillomavirus, or HPV.

HPV, which is sexually transmitted, is responsible for about 27,000 new cancer cases in the U.S. each year, causing nearly all cervical and anal cancers and also the majority of throat and vaginal cancers, too.

Luckily, the HPV vaccine offers substantial protection against this threat. Unfortunately, not enough people are taking advantage of this rare opportunity to prevent many types of cancer.

In Kentucky, only about 37 percent of girls and 13 percent of boys complete the vaccination schedule, leaving a significant portion of the population at risk. That’s why Markey and others are calling upon the physicians, parents and young adults to learn more about the benefit of receiving the HPV vaccine.

“Although we have made progress in the past several years, Kentucky continues to rank first in the nation for both cancer incidence and mortality,” said Dr. Mark Evers, director of the UK Markey Cancer Center. “We are still in the top 10 nationally for cervical cancer deaths, and increasing the HPV vaccination rates will significantly lower this grim statistic.”

The HPV vaccine offers substantial protection against various cancers but experts say not enough people are taking advantage of it.

Understanding the benefits of the HPV vaccine might convince you that it’s right for you or someone you know.

The HPV vaccine protects against more than cervical cancer.

The vaccine actually protects against several types of cancer. It does so by targeting certain strains of HPV. These infections are spread through sexual contact. They can cause genital warts. But most cause no symptoms and go away without treatment.

Some HPV infections may linger for years in your body. These viruses may damage cells, eventually causing cancer. The HPV vaccine prevents those strains responsible for the majority of cervical cancers. It may also prevent HPV infections that lead to cancers of the throat, anus, penis and vagina.

The HPV vaccine is recommended for boys, girls, young men and young women.

In 2006, health experts recommended the HPV vaccine for females ages 9 to 26. But its potential to prevent other cancers besides that of the cervix made it appropriate for boys and young men, too. Doctors now encourage males ages 9 to 26 to also receive the vaccine.

Two types of HPV vaccine are available. They are Gardasil and Cervarix. Gardasil is approved for use in both sexes. Cervarix is only for girls and young women. Ideally, three doses of either vaccine are given over a 6-month period at ages 11 or 12 before any sexual activity.

The HPV vaccine is effective.

The HPV vaccine may not protect against all HPV infections that may promote cancer. But it can substantially lower the risk. In a recent study, researchers compared the HPV history of more than 4,000 women ages 14 to 59 over two 4-year periods. Those timeframes included 2003 to 2006—before the HPV vaccine became available—and 2007 to 2010—after it was in use. They found that the vaccine cut in half the number of HPV infections in girls ages 14 to 19.

The HPV vaccine is safe.

Past research including nearly 60,000 participants has confirmed the vaccine’s safety. But like all vaccines, side effects are possible. Most are minor. They may include pain and redness at the injection site, fever, dizziness or nausea. Some people have fainted after receiving the shot. In rare cases, blood clots and Guillain-Barré syndrome — a disorder that weakens muscles — have been reported.

Women who receive the HPV vaccine should still schedule regular Pap tests.

Pap tests detect abnormal cells in the cervix. They alert your doctor to potential cervical cancer. The HPV vaccine may prevent future HPV infections, but it doesn’t treat pre-existing ones. It also doesn’t prevent all types of cervical cancer. For these reasons, women should still schedule regular Pap tests.


Next steps:

  • If you or someone you love is interested in receiving the HPV vaccine, schedule an appointment with the Markey Cancer Center online or at 859-323-5553.
  • Read a blog by Dr. Hatim Omar, chief of the Adolescent Medicine at UK HealthCare, about the importance of including the HPV vaccine in all young adults’ health care plans.
  • Learn more about the Gynecologic Oncology Team at the Markey Cancer Center