Healthy Kids - Fall 2023

A REAL game changer, how surgery helped a teen basketball score a slam dunk on sweat

FALL 2023

game changer A REAL

A touching tribute from

HOW SURGERY HELPED A TEEN BASKETBALL STAR SCORE A SLAM DUNK ON SWEAT

Ballast Point’s co-owner The

CHET team celebrates 50 years AND How Rady Children’s is expanding mental health care

A PUBLICATION BY

RADYCHILDRENSINVITATIONAL.COM

Partners in Purpose

THANKS TO OUR CARING NETWORK!

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uring my tenure at Rady Children’s Hospital-San Diego, I’ve learned a fundamental secret to our success: the invaluable impact of aligning with exceptional partners. Teaming up with leading organizations in our community has shaped Rady Children’s present and continues to illuminate our future. Our partnership with UC San Diego Health, for example, stands as a cornerstone of our identity. Together, we conduct cutting-edge research, provide compassionate patient care, and pioneer new treatments. This union of health care and academic medicine has delivered groundbreaking advancements that continue to touch the lives of countless children and families. And I’m proud to say that, for the first time in our history, Rady Children’s is one of the 10 best children’s hospitals in the nation, according to U.S. News & World Report’s 2023-2024 Best Children’s Hospitals survey. Five of our specialties now rank among the nation’s top 10: cardiology and heart surgery, orthopedics, neonatology, neurology and neurosurgery, and diabetes and endocrine disorders. Only 23 hospitals nationwide achieved rankings in all 10 specialties. A remarkable achievement. Beyond the hospital’s walls, our resonance is amplified by exceptional individuals, such as our new ambassador, soccer icon Alex Morgan. Her prowess on the pitch is rivaled only by her dedication to philanthropy; she embodies the spirit of unity that underpins our mission. This is more than mere collaboration; it’s a convergence of shared values, a partnership that empowers us to make a lasting impact on young lives and inspire change. For nearly seven decades, Rady Children’s has stood strong, nurtured by philanthropy, enduring community support and partnerships that transcend traditional boundaries. We are part of a unique network, collaborating with nonprofits, businesses and organizations to create a more compassionate world. Initiatives like the “Little Heroes League” illustrate the potential of genuine partnership, while our collaborations with sports associations, such as the NCAA, have led to transformative events that lift spirits. The memorable and often inspiring stories of those who have grown up under the care of Rady Children’s are woven into the fabric of our history. These stories not only demonstrate the integral role the hospital plays in San Diego and the Southern California region, but also highlight our growing influence across the country and around the world. Our extraordinary partners fortify our mission to heal, nurture, and uplift our families and our community. And for that we are forever grateful.

@radychildrens Little Jazz came all the way from Guam to Rady Children’s, where he was treated for an airway issue that was affecting his breathing and eating. He’s now happy, healthy and headed home.

@rcha_poway Congratulations to the winners of the Backyard Picnic Package at the Rady Children’s Hospital Auxiliary Poway Unit annual Tabletops with a Twist.

STEPHEN JENNINGS Chief External Affairs Officer and Senior Vice President Rady Children’s Executive Director Rady Children’s Hospital Foundation

@radychildrens Rady Children’s patients got a visit and some new furry friends from Major League Baseball umpires and the San Diego Padres.

FALL 2023 HEALTHY KIDS MAGAZINE 1

Hospital Foundation 3020 Children’s Way San Diego, CA 92123 858-576-1700 RCHSD.org

Stephen Jennings Chief External Affairs Officer and Senior Vice President, Rady Children’s Hospital and Executive Director, Rady Children’s Hospital Foundation

Rady Children’s Hospital Auxiliary has been supporting Rady Children’s since 1953 - one full year before the Hospital opened its doors. Today, nearly 1,100 members across 19 units actively advocate for the health and well-being of children, increasing community awareness of Rady Children’s and fundraising. JOIN THE RADY CHILDREN’S HOSPITAL AUXILIARY

President and Chief Executive Officer Patrick Frias, MD President and CEO, Rady Children’s Institute for Genomic Medicine Stephen Kingsmore, MD, DSc Senior Vice President and Chief Operating Officer Chief Medical Officer Gail Knight, MD, MMM Physician-in-Chief and Chief Scientific Officer Gabriel G. Haddad, MD Senior Vice President and Chief Financial Officer James Uli Senior Vice President and Chief Administrative Officer Jill Strickland Nicholas Holmes, MD, MBA Senior Vice President and Senior Vice President, Care Redesign and Managed Care and Chief Operating Officer, Rady Children’s Specialists of San Diego Charles B. Davis, MD Senior Vice President, Executive Director, Rady Children’s Specialists of San Diego and President, Children’s Specialists of San Diego Robin H. Steinhorn, MD

Vice President of Patient Services and Chief Nursing Officer Mary Fagan, PhD, RN, NEA-BC Vice President, Strategic Marketing Irena Boostani Vice President, Government Affairs Clara Evans Vice President, Foundation Fundraising Jean Ford Keane Chair, Rady Children’s Hospital and Health Center Board of Trustees Paul J. Hering, CPCU Chair, Rady Children’s Hospital Foundation

Board of Trustees Douglas M. Arthur Chair, Rady Children’s Institute for Genomic Medicine David F. Hale

1230 Columbia Street, Suite 800, San Diego, CA, 92101 619-230-9292 sandiegomagazine.com

Publisher and Chief Content Officer Troy Johnson Chief Executive Officer Claire Johnson Custom Content Editor Sarah Sapeda Art Director Samantha Lacy

Contributing Writers Megan Matthew Christina Orlovsky Contributing Designer Analia Driscoll Contributing Copy Editor Kelly Davis Contributing Photographer Jenny Siegwart

UNITS 19

MEMBERS 1,000 +

Rady Children’s Hospital-San Diego is the largest children’s hospital on the West Coast and one of the nation’s top pediatric health care systems. Consistently ranked in all 10 pediatric specialties by U.S. News and World Report , Rady Children’s includes a 511-bed pediatric hospital that serves as the largest provider of comprehensive pediatric medical services in San Diego, southern Riverside and Imperial counties. With more than 40 locations, Rady Children’s is the only health system in the San Diego area dedicated exclusively to pediatric health care and is the region’s only designated pediatric trauma center. Rady Children’s is a nonprofit organization that relies on donations to support its mission. For more information, visit www.rchsd.org. Healthy Kids magazine includes third-party content, advertising and/or website hyperlinks from outside businesses and organizations. Their placement in this publication is not an endorsement for these businesses or organizations or their products, materials, services or resources, nor does it reflect the views/policies of Rady Children’s Hospital-San Diego. Healthy Kids magazine and its affiliates shall not be liable to any party as a result of any information, services or resources made available through this publication. Rady Children’s complies with applicable state and federal civil rights and nondiscrimination laws. See www.rchsd. org/nondiscrimination for more information. Language assistance services are available to patients and visitors free of charge. Call 858-966-4096 / TDD: 858-627-3002 for more information.

Learn more about joining the Auxiliary or how to get involved:

radyfoundation.org/auxiliary

FALL 05 HEALTHY HABITS A “Happy Anniversary” to the CHET Team, how Rady

Children’s helped a pole vaulter recover from a hip injury, mental health care in pediatrics and more 14 BRAIN POWER Inside Rady Children’s Neurology and Neurosurgery Division, plus how the Hospital’s chief of pediatric neurosurgery is taking his expertise abroad 18 NO SWEAT Surgery helps a teen basketball star overcome hyperhidrosis and find comfort on and off the court

INSIDE RADY CHILDREN’S

26 THE HEALING ARTS

How artists, musicians, magicians and storytellers

help hospitalized kids heal

32 PAY IT FORWARD A patient’s cookie company for a school project raises money for the audiology department at Rady Children’s

FALL 2023 HEALTHY KIDS MAGAZINE 3

Your investment in future generations will see us through unimaginable discoveries, cures, vaccines and prevention. Join our efforts and name Rady Children’s as a beneficiary of your IRA or other retirement account. It is simple, tax smart and makes a lasting impact on childhood health.

CREATE THE FUTURE SHE DESERVES

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Without having to part with your money today, you know that you are making a gift larger than you thought possible.

Download the beneficiary designation form from your IRA provider’s website

Choose a percentage of the account you wish to gift to Rady Children’s

Sign and return the form to your administrator

To learn about additional ways to make a gift through your will, trust or estate plan, visit giftplanning.radyfoundation.org or call 858-966-5804 + THANK YOU FOR INVESTING IN RADY CHILDREN’S AND HELPING THE CHILDREN OF TOMORROW.

HEALTHY HABITS Insight & Inspiration

When you think of a hospital, smiling faces probably aren’t the first thing that come to mind. In these pages you’ll read about some of the ways Rady Children’s is working to change that. From teaming up with a power player to outfitting new ambulances with TVs to integrating behavioral health into primary care, Rady Children’s is focused on happiness and health—physical, mental, community and more.

FALL 2023 HEALTHY KIDS MAGAZINE 5

HEALTHY HABITS

RADY CHILDREN’S 2023–2024 U.S. NEWS & WORLD REPORT RANKINGS: #3 CARDIOLOGY & HEART SURGERY #6 ORTHOPEDICS #7 NEONATOLOGY #8 NEUROLOGY & NEUROSURGERY #8 DIABETES & ENDOCRINOLOGY #13 NEPHROLOGY #14 UROLOGY #17 PULMONOLOGY & LUNG SURGERY #21 CANCER #34 GASTROENTEROLOGY & GI SURGERY

EXTRA CREDIT

Health Care Honors

ady Children’s, already known as a leader in pediatric medical care, has yet another accolade to add to its roster: It was recently named one R Rady Children’s achieves Honor Roll status in U.S. News & World Report’s annual rankings

Roll designation is the culmination of a collective dedication to advancing pediatric health care. “We at Rady Children’s have taken our mission and our covenant with the community extremely seriously because we know that we are the major pediatric subspecialty provider in this region,” says Gail Knight, MD, MMM, senior vice president and chief medical officer at Rady Children’s. “If we aren’t amongst the best of the best, then that means the kids in our community aren’t getting the best of the best care.” Rady Children’s is the largest provider of comprehensive pediatric medical services in San Diego, southern Riverside and Imperial counties. Though they don’t come with an official ranking—since U.S. News and Report only covers 10 categories— some of its subspecialty programs, such as genomic medicine, even draw patients from around the country due to the expertise of the providers. “Being the only major resource for advanced pediatric health care in this region, it’s a serious responsibility,” says Dr. Knight. “Having access to these types of things is why we’re amongst the best. That’s why we’re on the honor roll.

of the 10 best children’s hospitals in the country by U.S. News & World Report. Aside from making the top 10 “Honor Roll,” Rady Children’s also had five specialty programs rank among the top 10 in the nation (pediatric cardiology and heart surgery, orthopedics, neonatology, neurology and neurosurgery and diabetes and endocrine disorders). U.S. News, together with research and consulting firm RTI International, analyzed data gleaned from a survey of more than 2,000 questions and took into consideration an evolving set of data related to clinical outcomes, quality, resources related to patient care, complexity of cases treated, research, physician training programs, Magnet status and more.

Though the rankings largely apply to pediatric specialties, due to the

comprehensive and collaborative nature of care at Rady Children’s, every doctor, nurse, researcher and other team member in some way played a role. The Honor

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MENTAL HEALTH MATTERS A New Approach

Mental and physical health go hand-in-hand at Rady Children’s

months, or possibly not ever getting it at all,” says Dr. Bird.

KIDS AND TEENS IN SAN DIEGO AND BEYOND ARE FACING A MENTAL HEALTH CRISIS. According to the National Institutes of Health’s 2022 National Healthcare Quality and Disparities Report, nearly 20 percent of youth ages 3 to 17 have a mental, emotional, developmental or behavioral disorder. Furthermore, suicidal behaviors among high school students increased more than 40 percent between 2009 and

Advocacy is also a big part of the Transforming Mental Health initiative. Officials from Rady Children’s are pushing for improved mental heath benefits and reliable insurance reimbursements for the same-day mental health services currently being funded through

grants and philanthropy. The team also regularly travels to conferences to present research showing that the integrated care model works, and partners with workforce development agencies to address the shortage in pediatric mental health care providers. Though the initiative is relatively young, preliminary results show its impact on patients is undeniable: 64 percent of patients have reported an improvement in depression, 43 percent have had a reduction in anxiety and ED visits by behavioral health patients participating in the integration program have fallen roughly 47 percent. “We’re ahead of the curve with what we’ve been able to put together, and our outcomes really show that,” says Dr. Bird.

2019. At Rady Children’s alone, mental health emergency department (ED) visits have increased by 1,700 percent in the last decade. Rady Children’s is confronting the crisis head-on with an initiative called Transforming Mental Health. The program integrates mental and behavioral health into primary care, which helps providers identify problems sooner, intervene earlier and connect patients to additional services when needed. “The volume of kids that are struggling is huge,” says Anne Bird, MD, medical program director, Mental Health Integration and Transforming Mental Health at Rady Children’s. “Our medical system in this country is really struggling to get those kids the mental health care—and the access to the care—that they need.”

WHAT INTEGRATED CARE IS TRYING TO DO IS TO PUT A THERAPIST NEXT DOOR TO THE PEDIATRICIAN SO KIDS AND FAMILIES CAN GET SAME-DAY ACCESS TO CARE. ANNE BIRD, MD

MEDICAL PROGRAM DIRECTOR, MENTAL HEALTH INTEGRATION AND TRANSFORMING MENTAL HEALTH AT RADY CHILDREN’S

For many families, primary care providers are the first point of access

for any issue, physical or mental. The impetus behind Transforming Mental Health is to remove barriers to obtaining mental health care and create pathways through primary care using a “whole child” approach. This is a departure from the traditional model in which patients were given a list of mental health resources and left to figure out the next steps on their own. Through Rady Children’s integrated care model, mental health clinicians are stationed in primary care offices and work closely with primary care physicians. They educate physicians about how to screen for and treat mental health issues, train employees on how the integrated care model works and collaborate with other agencies to establish best practices. “What integrated care is trying to do is to put a therapist next door to the pediatrician so kids and families can get same-day access to care as opposed to waiting for

FALL 2023 HEALTHY KIDS MAGAZINE 7

HEALTHY HABITS

TEAM RADY

Transporting Excellence

Rady Children’s CHET Team goes the distance to provide intensive care

Caring for the medical needs of children throughout the San Diego region and beyond often means bringing that care to them, no matter where they are. That’s the critical role of the Children’s Hospital Emergency Transport (CHET) team at Rady Children’s, which provides 24-hour emergency critical care transport to approximately 2,000 neonatal and pediatric patients throughout Southern California each year. This year, the CHET team celebrates its 50th anniversary—a half century of providing expert critical care. “CHET originally started 50 years ago when two physicians recognized a need to safely transport newborns to the Hospital from other facilities,” explains Dana Patrick, RN, BSN, MHA, CENP, director of critical care and emergency transport. “Since then, there have been numerous studies that have shown that when you transport kids with a specialty team, it’s safer and they have better outcomes.” The CHET team is actually two teams in one: a pediatric transport team and a neonatal transport team. Composed of 11 registered nurses (RN) and 11 respiratory therapists (RT) per team, each clinician must have intensive care experience, trauma care

certification and undergo extensive training. “It takes about four to six months to be trained for transport—it’s a pretty rigorous selection process,” says Patrick. “You must have years of experience, go through an application and interview process and pass a test with at least 90% accuracy. Then you can go on transports and shadow the team. We want everyone to have the experience of transporting a very sick child under their belt during orientation before they’re ready to go out on their own.” Additionally, “on their own” always means a team of two: an RN and an RT. “All of our teams are cross-trained—the respiratory therapists do a lot of what the nurses do and vice versa. That way if one is having trouble doing something, the other can step in,” Patrick explains. “One cannot go on the transport without the other, and you could never do a transport with two RNs or two RTs.” It’s this highly specialized training that makes the CHET team such a standout in the San Diego region. “We are the only specialty transport team within a two-county

To provide immediate response to requests for transport or consultation for ill and injured children throughout Southern California.

To function as an extension of Rady Children’s.

THE MISSION OF THE CHET TEAM IS FOUR-FOLD:

To provide pediatric and neonatal critical care during inter-facility transport.

To enhance the quality of pediatric and neonatal care in the community through outreach, education and support.

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The CHET team got an infusion of three brand-

new ambulances, thanks to American Medical Response, a partner of the Hospital for more than 50 years. During the design process, AMR gained insight from the team who will be working in the ambulances and outfitted them with wireless Bluetooth headsets that enable hands- free communication between team members, solar panels that charge the vehicle and equipment, seven sizes of equipment to cater to kids of all ages and a TV to help keep patients calm during transport. They also feature technology that speeds up loading times, space for ECMO machines, which previous ambulances did not have, and a modular equipment storage system. The new ambulances will ensure that the CHET team

area—San Diego and Imperial counties, as well as southern Riverside; we serve all three of those areas,” she continues. “There is not another specialty team that has the training to do what we do. We work with all of the hospitals in the region and we have even gone to Hawaii, the Midwest, Texas, Seattle and other places outside the region.” The CHET team are ambassadors for Rady Children’s, bringing the Hospital’s exceptional reputation with them everywhere they go, whether it’s by ambulance, airplane or helicopter. “CHET started in 1973 with just ambulance transports, and it continued that way for a lot of years. We would only use the helicopter once a year, on very rare occasions,” Patrick says. “Then a few years ago we partnered with Mercy Air Services and they trained us to be crew. Now we can fly with just a pilot and our two-person team. Since then, we’ve done a lot more helicopter and fixed-wing transports—and they’ve increased over the years as traffic has increased.” In earlier years, a physician also was required to be onboard, Patrick recalls. For the past 20 years or so, however, it’s rare when a physician must be present. “Our teams are such experts at what they do,” she says. “They are able to take the sickest of the sick kids and transport them safely to our facility, providing intensive care services all along the way. Any time a kid needs oxygen or IV therapy or any higher level of care via transport, that’s when we’re called. We are able to do everything.” The CHET team is even equipped to provide ECMO, extracorporeal membrane oxygenation, a form of life support given to those with life-threatening heart and lung problems. Patrick says the need for ECMO has grown, as the CHET team has encountered sicker kids in need of transport. For Patrick, treating these high-acuity pediatric and neonate patients has been the most rewarding part of the job. “There have been so many stories about incredible outcomes. We get kids that are on the brink of death at another facility, we get them here safely, and they thrive,” she says. “It’s a scary job and it can be intimidating. But when you go out and get a kid that’s really sick and are able to provide care, see them get better and see them go home, it’s all worth it. I’ve always said it’s the best job in the Hospital.”

can keep delivering prompt, life-saving care for years to come.

FALL 2023 HEALTHY KIDS MAGAZINE 9

HEALTHY HABITS

R A Winning Play Women’s soccer icon Alex Morgan teams up with Rady Children’s COMMON GOALS

proud to partner with the best in pediatric health care, whose mission and standard of excellence align with my personal values and the core pillars of my foundation.” It’s not the first time Morgan has teamed up with Rady Children’s. Representatives from the Alex Morgan Foundation visited the Hospital on Mother’s Day to gift new moms with essentials kits filled with onesies, socks, baby blankets, and other thoughtful items, like food delivery gift cards to provide a little extra support during what can be a challenging time. “At Rady Children’s, many of our most impactful programs that support families throughout their hospital experience are funded through philanthropy,” says Patrick Frias, MD, president and CEO at Rady Children’s. “I know firsthand that Alex shares our enduring commitment to families in the San Diego region and that her ambition and standard of excellence matches our desire to impact pediatric care not only in San Diego but around the world.”

ady Children’s newest ambassador, soccer star Alex Morgan, will be hard at work this holiday season bringing smiles to patients and families. The forward for the US Women’s National Team and San Diego Wave FC and also mom to a 3-year-old daughter, Charlie, will be the face of the Hospital’s holiday fundraising campaign. Morgan joined forces with Rady Children’s to care for the next generation of healthy kids. In addition to her ambassador duties, she’s designating funds from the Alex Morgan Foundation to support the Hospital’s mission. Rady Children’s was also named as a Starting XI partner of the Alex Morgan Foundation, which invests in sports equity, opportunities for girls and support for moms. “Shortly after moving to Southern California with my family and putting down roots in San Diego, I became aware of Rady Children’s outstanding reputation and commitment to families,” Morgan says. “I’m so

10 HEALTHY KIDS MAGAZINE FALL 2023

ORTHOPEDICS Sports Injury to Surgical Triumph

One athlete’s inspiring comeback story

“My mom always sees me as someone who’s fearless, and I never felt scared of pole vaulting. It was really exciting and gave me a big adrenaline rush.” She pushed through the nagging pain in her hip, not realizing that the injury had not properly healed. Eventually, the pain became hard to ignore. It was interfering with her life and her new love of pole vaulting.

ILIANA DOWNING WOULDN’T LET INJURY DETER HER FROM REACHING NEW HEIGHTS AND RECLAIMING HER ATHLETIC DREAMS. The 17-year- old’s journey began five years ago at a soccer match, when an explosive kick caused a hip fracture, common among young athletes whose growth plates have not fully developed. Though Iliana was advised to take

time off for recovery, her desire to play won out. She was already participating in multiple sports when a new endeavor captured her attention: pole vaulting—fitting for a girl nicknamed “Tigger” for her bouncy demeanor. “I thought pole vaulting looked really different and unique. When I tried it for the first time, I knew right away that I wanted to do it,” Iliana says.

After consulting with various specialists, Iliana and her family were directed to V. Salil Upasani, MD, director of the International Center for Pediatric and Adolescent Hip Disorders at Rady Children’s and professor of clinical Orthopedic Surgery at UC San Diego School of Medicine. Dr. Upasani found that an overgrown piece of bone in Iliana’s hip was impeding her mobility. Immediate surgery was necessary if she wanted to pursue her athletic dreams. The minimally invasive outpatient procedure involved excising the overgrown bone and reattaching one of the primary tendons of her quadriceps muscle using a bioabsorbable bone anchor. She was sent home with a brace and told to use crutches for four weeks.

THE MINIMALLY INVASIVE

OUTPATIENT PROCEDURE INVOLVED EXCISING THE OVERGROWN BONE AND REATTACHING ONE OF THE PRIMARY TENDONS OF HER QUADRICEPS MUSCLE USING A BIOABSORBABLE BONE ANCHOR.

Although the road to recovery was tough, Iliana was determined to get back to pursuing her athletics. Thanks to rigorous rehabilitation sessions and a comprehensive physical therapy program, she was back in action after only a few short months. Today, Iliana has not only recovered but is thriving. She has set a personal record of 14 feet, won a coveted CIF title as a junior, and showcased her skills and spirit at the USA Track and Field Championships. She placed fourth in her division and left a lasting impression on competitors and spectators alike.

FALL 2023 HEALTHY KIDS MAGAZINE 11

HEALTHY HABITS

Ready to Roll Autism-friendly carts made possible through Auxiliary fundraising AUXILIARY

really good at LEGOs. I could come and help.’” Each cart will carry a plaque indicating it was donated in memory of Joanne Mera. Lloyd founded the Bay Park Auxiliary Unit in 2019 with fellow

The Bay Park Unit of Rady Children’s Hospital Auxiliary found a meaningful way to honor a late member. The volunteers used their St. Patrick’s Day “Cheers to Good Health” fundraiser to raise money for autism-friendly sensory carts for each of the Hospital’s seven floors. The donation to the Autism Discovery Institute was made in honor of Joanne

neighborhood moms looking for a way to give back to Rady Children’s. The unit’s previous fundraising efforts have benefitted the Hospital’s emergency care center. The 26-member unit raised $30,000 to purchase the carts and supply kits at a private-venue party attended by 300 people. With the combination of ticket sales, corporate sponsorships, silent auction gift baskets and gift card mystery bags, the event raised enough funds to buy the carts and keep them stocked with hands-on materials for many years to come. The Bay Park Auxilary Unit meets monthly from September through May at a neighborhood school. Lloyd will serve as the unit’s event chair for 2023-2024 before passing the role to Carol Smith. “We would always like new members,”

Mera, a founding Auxiliary unit member who died in a 2022 seaplane accident. Mera’s adult son Donovan has autism spectrum disorder. The brightly colored bedside medical carts, which can be rolled into the hospital rooms of young patients, are stocked with tactile toys and communication tools to help children better understand medical procedures while providing comfort and calm in the sometimes-hectic hospital environment. Through the language of play, nurses and doctors can give patients with autism a way to express their needs and feelings with aids like fidget toys, picture cards and sensory headphones.

THROUGH THE LANGUAGE OF PLAY, NURSES AND DOCTORS CAN GIVE PATIENTS WITH AUTISM A WAY TO EXPRESS THEIR NEEDS AND FEELINGS

Bay Park Auxiliary Unit chair Mia Lloyd said she was heartened to see Donovan’s positive reaction to the sensory carts at the check award presentation. He was particularly impressed with a LEGO model of an MRI machine that helps kids better visualize the imaging technology. “He was super into it. He was saying, ‘I like these colors’ for the carts,” Lloyd recalls. “And, ‘If you need any help, I’m

Lloyd says, encouraging potential volunteers to find a Rady Children’s Hospital Auxiliary unit near them. “There’s always a way to help.”

TO LEARN MORE ABOUT THE RADY CHILDREN’S HOSPITAL AUXILIARY, VISIT RADYFOUNDATION.ORG/GET-INVOLVED/AUXILIARY.

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COMMUNITY Calendar Show your support for Rady Children’s at these upcoming events

COMEDY FOR A CAUSE Laugh yourself silly at Second

RADY CHILDREN’S HOSPITAL ICE RINK AT

IHEART RADIO GIVEATHON Tune in to a number of

OCT. 07

NOV. 17

DEC. 7-8

LIBERTY STATION Lace up your skates and partake in this beloved holiday tradition that raises money for the Thriving After Cancer program at the Peckham Center for Cancer and Blood Disorders.

Chance Beer Company and support Rady Children’s at the same time.

local iHeart Radio stations to hear inspiring stories

from Rady Children’s patients and find out how you can help.

TRICK & TREAT LUNCHEON Soak up spooky season

OCT. 21

HOLIDAY GIFT WRAPPING Let Rady Children’s

DEC. 15-23

at this benefit for the Heart Institute at Rady Children’s at the Admiral Baker Clubhouse.

TURKEY TROT 5K

Hospital volunteers help you prepare for the holidays by wrapping presents at Westfield UTC.

NOV. 23

Move your feet before

you eat at Tidelands Park in Coronado. The fun run benefits Child Life.

DINKING FOR DOLLARS Show off your pickleball

OCT. 21

prowess at the Pickleball Training Center in Poway and raise money for Rady Children’s Copley Psychiatric Emergency Department.

RADY CHILDREN’S INVITATIONAL Watch four

NOV. 23

FOR MORE WAYS TO SUPPORT RADY CHILDREN’S ALL YEAR LONG, VISIT RADYFOUNDATION.COM/ EVENTS

elite college basketball teams square off at the first ever Rady Children’s Invitational. Get tickets at radychildrensinvitational. com

FALL 2023 HEALTHY KIDS MAGAZINE 13

BRAIN POWER RADY CHILDREN’S RESPECTED NEUROSURGERY DIVISION RANKS AMONG THE NATION’S BEST

Heads up! Did you know that one of the nation’s top 10 pediatric neurosurgery programs is located right here in your backyard? This year, for the second year in a row, Rady Children’s Neurology and Neurosurgery Division was ranked no. 8 in the country on U.S. News & World Report’s annual Best Children’s Hospitals survey. The designation demonstrates the Hospital’s commitment to providing the highest quality neurological care to children in the San Diego community and beyond. “We are a busy division, and we have a number of areas of expertise that, in my opinion, are unmatched anywhere,” says Michael Levy, MD, PhD, a pediatric neurosurgeon and chief of pediatric neurosurgery at Rady Children’s and a professor and board-certified neurosurgeon at UC San Diego. “Our brain tumor program, for example, is unparalleled—there are no pediatric

neurosurgeons doing as many brain tumor surgeries as we are,” he continues. “We treat a lot of complex cerebrovascular malformations, and we offer a lot of things surgically speaking that many other hospitals can’t. From robotics to congenital disorders, tumors to peripheral nerve injuries, there is nothing we don’t do.” Small but Mighty Remarkably, the Rady Children’s pediatric neurosurgery division offers an extensive array of services with a small but mighty team of two physicians: Dr. Levy and David Gonda, MD, director of epilepsy surgery at Rady Children’s and an associate clinical professor of neurosurgery at UC San Diego. The division offers five specialty clinics and services, including a multidisciplinary brain tumor program, brachial plexus clinic, vascular lesion program, proton therapy and epilepsy surgery.

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The conditions under the umbrella of pediatric neurosurgery include brain and spinal cord tumors, craniofacial disorders, open and closed neural-tube defects, hydrocephalus, cerebral palsy, vascular diseases of the brain and spinal cord, and more. According to Dr. Levy, who has been with Rady Children’s since 2003, the past 20 years have seen a tremendous increase in the need for pediatric neurosurgery services based on the growth of the population the Hospital serves. “Our population has gotten bigger, which means our program

We also have a tumor board, which has been very positive at providing multidisciplinary insight on complex cases, and we publish a high number of academic papers, thanks to research conducted with other local institutes. All of this work has helped us move quickly in the right direction to provide exceptional care for our patients.” The Rady Children’s difference Reflecting on the Hospital’s U.S. News and World Report ranking—which has improved considerably over

has gotten bigger,” he says. “In addition to expanding our reach into the Inland Empire and farther north, we also have a wonderful partnership with hospitals in Tijuana, treating their pediatric patients. The work in Mexico, which is some of my favorite work, has substantially increased our patient population.” Technological advancements in the field have kept pace with the increased patient population. According to Dr. Levy, the Hospital has supported the division’s growth by providing the state- of-the-art technology. “Over the years, Rady Children’s has been very good at giving

more than a decade until breaking into the top 10 in 2022— Dr. Levy acknowledges that the honor represents his and his colleagues’ dedication to providing the best care in their specialty. “What the rankings show is that we have proven ourselves to be better than anyone in California,” he says. “It’s nice when you see you’ve done well because it supports the belief that what you’re doing is working.” Still, while Dr. Levy is proud of the division’s nationwide success and widespread recognition, he’s also

We treat a lot of complex cerebrovascular malformations, and we offer a lot of things surgically speaking that many other hospitals can’t. From robotics to congenital disorders, tumors to peripheral nerve injuries, there is nothing we don’t do. MICHAEL LEVY, MD, PHD, CHIEF OF PEDIATRIC NEUROSURGERY AT RADY CHILDREN’S

passionate about the impact Rady

Children’s pediatric neurosurgery has on a smaller scale.

us the things we need to remain competitive. From advanced microscopes to 3D modeling and imaging, there is nothing we don’t have or won’t use so we can perform at a higher level,” he says. “Additionally, along with our neuro- oncology program, we were one of the first pediatric medical centers to provide precision medicine, thanks to the work of the Rady Children’s Institute for Genomic Medicine.

“In our service, we are directly involved in an individual’s life—we are doing something significant that really makes a difference,” he says. “When you talk to patients and their families, you are talking about very real, very important health issues. I like the types of surgeries we do, and I like working on kids, but it’s the impact that this work has on families that is truly important to me.”

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NO SW

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WEAT

Surgery helps teen basketball star find comfort on and off the court

Cole Villaflor was in elementary school when he first realized something was off with his body. His hands were so sweaty that it made writing essays difficult. He had a hard time using touchscreens. And basketball, his favorite sport? He may have been able to keep his eye on the ball, but his hands were an entirely different story. “I’ve had really sweaty hands and feet for as long as I can remember—starting at least around second grade,” says Cole, now 16 and a high school junior. “I really started to notice it around fourth or fifth grade. Everyone knew it in my class because it was hard for me to shake hands and give high fives.” Cole’s pediatrician diagnosed him with hyperhidrosis, a condition that causes excessive sweating not always related to heat or exercise. Sweating, the body’s natural cooling mechanism, occurs when the nervous system triggers the sweat glands in response to heat or nervousness. When this mechanism is faulty, it can trigger the sweat glands even when the body’s temperature has not risen, or a person is not anxious. Often an inherited condition, hyperhidrosis is most commonly treated with a variety of non-surgical methods. Cole tried all of them. The first step: an

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over-the-counter antiperspirant lotion applied directly to his skin. “I started using the lotion to help when I was playing basketball—around four doses a day. It would stop the sweating, but my hands would get swollen and puffy,” Cole recalls. “Cole has played a lot of sports since he was a kid, but the sweating and swelling was really bad from so much fluid and gravity,” explains Cole’s mother, Lynn. “Once the prescription antiperspirant stopped working, we were sent to a dermatologist to get oral medication to try to reduce the sweating and the swelling. But those also decreased the amount of fluid in the body altogether, so they caused other side effects. That’s when we moved on to Botox.” TAKING A SHOT As a basketball player, Cole was used to taking shots—but he’d much rather the ones that went out of his hands and into the basket, not the ones that went painfully into them. The next step in his treatment was 30 shots of Botox per hand every six months—all in an attempt to block the nerve signals that activated his sweat glands. “He endured three rounds of Botox in both hands and one more in his right hand,” Lynn continues. “But all that pain only yielded a little relief.” In the meantime, Cole had been doing his own research, seeking a solution to the problem

that had been plaguing him for years. “Once I got to high school, I was so fed up with it. It was always on my mind. It was my biggest worry and my biggest stress,

He endured three rounds of Botox in both hands and one more in his right hand. But all that pain only yielded a little relief.

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Because we operate on the lungs as part of the surgery, some physicians do not think it’s worth it for what they call ‘a small problem.’ But it’s not a small problem.

so I was constantly trying to find new solutions,” he says. “I would ask doctors and read other people’s stories—all out of desperation.” Lynn could tell he was getting more and more frustrated. “In the beginning, he would consistently wipe his hands on his basketball jersey, and we always just thought he had a nervous habit. But then it became, ‘I can’t grip a pencil,’ and all the other classic things that kids with hyperhidrosis report as issues,” she says. “It combines the social aspects with the school issues and the sports challenges. Once he started high school, he was expressing a lot more frustration, and I could hear from his voice that this had really reached a different level.”

nerve behind the third rib. The lung would be reinflated and the process repeated on the other side. The surgery is done in under an hour and the patient can typically go home that day. “When someone has hyperhidrosis, it means their sympathetic nerve chain is overactive. By cutting that chain, you turn it off and take away the neural impulses that are causing so much sweating,” Dr. Levy explains, adding that while the surgery is not routinely performed in San Diego, he has been very pleased with its success rate at Rady Children’s. “Because we operate on the lungs as part of the surgery, some physicians do not think it’s worth it for what they call ‘a small problem.’ But it’s not a small problem,” he says. “These are people that present with an excessive amount of sweating on their hands and feet. They can’t take people’s hands to hold or shake. They can’t slow dance. They are very hesitant to touch other people—they’re just embarrassed by it. It can impact sports and working with smartphones and keypads. There are not a lot of parts of their lives that are not negatively affected by this condition,” he continues. “After we do this surgery, the first thing patients do when they wake up is touch their hands,

FINDING ANSWERS Finally at his wit’s end, Cole showed his mom an article about a minimally invasive surgery called endoscopic thoracic sympathectomy (ETC), in which surgeons cut the nerves that activate the sweating response in the hands and armpits. Although his dermatologists had previously discouraged surgery, Lynn took Cole’s urging seriously and looked into his research. “The article featured two surgeons from Rady Children’s, and since we already knew how good of a hospital Rady Children’s was, I said we could meet with them,” she says. Soon, Cole had a consultation with Timothy Fairbanks, MD, a pediatric surgeon, division chief and co-director of the pediatric surgery program at Rady Children’s and a professor of surgery at UC San Diego; and Michael Levy, MD, PhD, a pediatric neurosurgeon and chief of pediatric neurosurgery at Rady Children’s and a clinical professor of surgery at UC San Diego. Dr. Fairbanks and Dr. Levy, who would each perform a portion of the surgery, explained the procedure in detail. Surgeons would make three small incisions in one side of Cole’s chest, deflate that lung, then cut a section of

and they’re amazed that they’re dry. Universally, everyone has been happy with the

procedure, and we have had great results. It’s

making a big difference.” That described Cole’s

experience to a T, and when the surgery arrived, he faced it with eager anticipation. “I was a little nervous going through with it, but I also knew that if could do this, it would be all over. I knew I didn’t want to live with

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HEALTHY HABITS

this for my whole life, so I was really optimistic and hopeful that this could be the solution I was looking for. It calmed me knowing that it was going to be gone forever,” he says. “I remember waking up and I was really out of it. Then when I looked at my hands and realized they were dry, I was so relieved I went right back to sleep.” Lynn’s relief was also palpable. “It was nerve wracking for me to hear that they had to deflate a lung and book a hospital room just in case one of the lungs didn’t reinflate. That was a little intense,” she laughs. “The wonderful thing was that when Dr. Levy was done in the operating room, he came out and spoke to me. Then, when Dr. Fairbanks was done, he came out,” she continues. “The personal contact they had and the informative nature that they used were truly exceptional. It really calmed me to know I had these two wonderful surgeons operating on my son.” A BETTER QUALITY OF LIFE Cole’s surgery was performed in October 2022, and within six weeks he was playing basketball again. Best of all, he was living his life in a way he hadn’t for as long as he could remember: without sweaty hands and with a newfound confidence both on and off the court. “My daily life is so much better,” he says. “Before the surgery, any time I had to step outside my door I faced the worry and embarrassment of having to shake someone’s hand. It demotivated me from greeting people and having an active social life. Now, the surgery has taken away a lot of my nerves and boosted my confidence—in sports, school, and social activities.” In recent years, Cole has even met other people facing similar struggles with hyperhidrosis. To them he says, when all else fails, surgery may be the solution. “Every year I find more people who are struggling with it. It’s nice to know I’m not the only one and it’s interesting to see that you never really know what other people are going through,” he says. “I know they’re trying the other treatments, and I also recommend other stuff to them. I certainly recommend the

surgery. First, try the smaller things, but eventually, if they don’t work, do your research and move on.” Lynn also has

nothing but positive things to say—both about her son advocating for his own health and about the family’s experience at Rady Children’s.

“In general, I always say you have to advocate for yourself when it comes to your health,” she says. “But sometimes we forget to think about doctors as service people—you think you go to one doctor for an opinion and that’s it. If your hairdresser does something you don’t like, you go and get another one. We forget to do that with doctors, and if Cole hadn’t advocated for himself about this surgery, he’d still be having the same issues,” she continues. “When you start to research hyperhidrosis, you realize it’s actually a huge problem—I didn’t realize how prevalent it is. Since Cole had the surgery, a lot of parents have said either they have it or their child does,” she says. “Rady Children’s is an excellent resource for people looking for additional solutions to their child’s medical

problems. It’s our hope that other kids who may be discouraged by the condition will now know there’s a relatively trouble-free solution to having a better quality of life.”

Every year I find more people who are struggling with it. It’s nice to know I’m not the only one.

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Now, the surgery has taken away a lot of my nerves and boosted my confidence—in sports, school,

and social activities.

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GIVING FOR THE GLOBAL GOOD

Michael Levy, MD, PhD, a pediatric neurosurgeon and chief of pediatric neurosurgery at Rady Children’s and a professor and board-certified neurosurgeon at UC San Diego, joined a panel of experts speaking to a techie crowd about medical, surgical and forensic applications of 3D printing and extended (virtual/ augmented) reality—just one of the many areas in which Dr. Levy is well-versed and eager to discuss. While this speaking engagement was just a short jaunt down the freeway from Rady Children’s, Dr. Levy is no stranger to taking his field knowledge to much farther destinations. In fact, for decades, he has donned his surgical superhero attire and traveled abroad to bring pediatric education to countries in need. From Latin America to Africa, Dr. Levy and a neurosurgical colleague regularly travel the globe, helping establish quality pediatric care in underserved and indigenous communities. “Our goal is to establish relationships with divisions of neurosurgery elsewhere. This a five-, 10- or 15-year effort—it’s not just flying there, doing 10 cases and flying home,” Dr. Levy explains. “It is a long- term approach to building programs and working with motivated and talented people who just don’t have all the resources we do.”

The last week in July every year, Downtown San Diego transforms into superhero central, where regular Joes and Janes don capes and costumes and mix and mingle with celebrities at the annual Comic-Con International. This year, one Rady Children’s physician proved the adage that “not all heroes wear capes” as he represented his superpower: pediatric neurosurgery.

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Currently, the team is focused on Bolivia, Peru, Colombia and Mexico, with other interests in Malaysia and Africa. “Sometimes the things we do in these countries are neurosurgical in nature, but in Africa, our work takes on more of an overall approach to pediatrics, helping develop facilities,” he continues. “It’s building pediatric wards, ICUs, ORs, radiology units and more, just to help them get set up to provide quality pediatric care.” Through the relationships the team has built with medical professionals and residents in these communities, stories have been shared, obstacles observed and disparities discovered—all of which they have started capturing on camera

In recent years, Dr. Levy has worked with a team of

“When we hear these stories, we realize there’s nothing we can do to help from a medical standpoint, but what we can do is raise awareness of the disparities that exist in these communities,” Dr. Levy says. “It is very different from anything we’ve ever done medically in these countries, but I want these stories to get out. Everything we do medically is important, but this is just as important for different reasons.”

photographers and videographers to create four documentaries on unique groups of people and their approach to keeping their culture alive and well. There is a story about a community in Bogota, Colombia, that is using rap to preserve their language; another about convergent strategies to combine the tradition of a medicine man with the advances of modern medicine in La Paz, Bolivia; and yet another about the Uru people in Bolivia. The Uru live on a number of self- fashioned floating islands in Lake Titicaca and their lives

are being compromised by the impact of global warming on the lake.

It is a long-term approach to building programs and working with motivated and talented people who just don’t have all the resources we do. MICHAEL LEVY, MD, PHD, CHIEF OF PEDIATRIC NEUROSURGERY AT RADY CHILDREN’S

in order to create captivating videos that tell the stories of the unique needs of indigenous peoples. “Based on the work we’ve done, we have learned more and more about the trials and tribulations of the people in Central and South America,” Dr. Levy says. “This

is an important topic, because if you want to look at a population that is universally treated poorly, it’s the indigenous population of any country.”

Dr. Levy and neurosurgeon Daniella Rico, MD, in Bogota, Colombia

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