Shine, A Publication of Texas Children's Hospital

shine
SUMMER 2008
Progress, Patients and Philanthropy at Texas Childrens Hospital
Giving New Life Every Chance to Thrive

TREATING BABIES INSIDE AND OUTSIDE THE WOMB
Food for Thought

HOW DIET MAY INFLUENCE GENE EXPRESSION IN THE NEXT GENERATION
A Gift to Heal Sick Children

THE BROWN FOUNDATION COMMITS $10 MILLION TO TEXAS CHILDRENS CAMPAIGN
OFFICERS
MAX P. WATSON
CHAIRMAN OF THE BOARD
BRAD TUCKER
MESSAGE FROM THE PRESIDENT AND CEO
PRESIDENT
KEVIN C. KING
VICE PRESIDENT
ANN LENTS
VICE PRESIDENT
By linking our pediatric mission with our neonatal and maternal fetal medicine vision and extending the services we already offer, we are creating a new paradigm for what tomorrows childrens hospitals will look like.
MARK WALLACE
A circleone of natures simplest forms. No shape better represents life. We at Texas Childrens Hospital embrace the circle as an inspiration for a unique project dedicated to bringing new life into the world and to ensuring the health and well being of future families in our community and beyond. Earlier this year, we broke ground on Texas Childrens Maternity Center and thus began our journey to unite world-class obstetrics, gynecology and maternal/fetal medicine services with our already outstanding neonatal program and comprehensive array of pediatric subspecialty servicesall in one centralized location. By linking our pediatric mission with our neonatal and maternal fetal medicine vision and extending the services we already offer, we are creating a new paradigm for what tomorrows childrens hospitals will look like. Texas Childrens Maternity Center will provide an unparalleled continuum of pediatric and womens services, a complete circle of care to meet the growing and changing needs of families in our community. Texas Childrens Maternity Center will have the Baylor College of Medicine full-time faculty in obstetrics and gynecology, including the maternal/fetal medicine experts like those at Texas Childrens Fetal Center, where we are performing some of the most leading-edge surgeries and intervention procedures in the country. We also are recruiting outstanding private obstetricians and gynecologists like the Womens Specialists of Houston group, as well as the best and brightest fertility experts. The facility will house ob/gyn offices, birthing units, neonatal intensive care unitsall right across the street from the hospital and from all of our pediatric specialists and subspecialists. The facilitys 15-story, 720,000-square-foot tower will be an environment for families that is not only state-of-the-art in terms of technology, research and innovative treatment, but also warm, inviting and acutely focused on surrounding mothers and babies with comfort and care. Texas Childrens Maternity Center is an incredible opportunity. Stories like the ones in this issue of Shine are proof of the powerful results possible when we bring all of these experts, resources and specialty services together, each reinforcing the other. You too are a critical part of our circle, for we need our generous supporters to help our vision for Texas Childrens Maternity Center take shape. Just imagine, once the doors open, how many Houstonians, how many future leaders of our city, state and even nation, will get their start right here at Texas Childrens. Together, what a future we are building and securing for the next generation.
ANTHONY G. PETRELLO
VICE PRESIDENT
RONALD C. HULME
TREASURER & ASSISTANT SECRETARY
Y. PING SUN
SECRETARY
DACE REINHOLDS
ASSISTANT SECRETARY [NON TRUSTEE]
EMERITUS TRUSTEES
JOSEPHINE E. ABERCROMBIE ALFRED C. GLASSELL, JR.

ADVISORY BOARD
EDUARDO AGUIRRE, JR. KIRBY ATTWELL BEN A. BROLLIER GEORGE H. JEWELL R. BRUCE LABOON VIRGINIA MCFARLAND DARRELL C. MORROW PHILIP R. NEUHAUS MACONDA BROWN OCONNOR, PH.D. LOIS F. STARK PHOEBE C. WELSH
ASSOCIATE BOARD
TOM BACON FREDA BASS LEWIS E. BRAZELTON III O. HOLCOMBE CROSSWELL DONALD P. DEWALCH JAN ELLIS DUNCAN ROBERT L. GERRY III BARRY MARGOLIS WILLIAM MATHIS EDWARD S. MCCULLOUGH WILLIAM K. MCGEE, JR. TOWNES G. PRESSLER GARY L. ROSENTHAL
BOARD OF TRUSTEES
On the cover: Christopher and Jonathan Martinez
WILLIE J. ALEXANDER MERRELL A. ATHON JAMES A. ELKINS III RALPH D. FEIGIN, M.D. NANCY R. GORDON VICTOR E. HARRIS JOHN B. HOWENSTINE RONALD C. HULME JODIE LEE JILES KEVIN C. KING ANN LENTS BEN B. MCANDREW III ROBERT E. MEADOWS DAVID L. MENDEZ GEORGE A. PETERKIN, JR. ANTHONY G. PETRELLO L.E. SIMMONS JOEL V. STAFF Y. PING SUN BRAD TUCKER MARK A. WALLACE PETER S. WAREING MAX P. WATSON
shine
SUMMER 2008
PROGRESS, PATIENTS AND PHILANTHROPY AT TEXAS CHILDRENS HOSPITAL
g .or at ns ne dre nli hil w o asc No e.tex hin w.s ww
FAITH & FETAL MEDICINE Pioneering fetal procedure removes rare tumor, gives mother and baby hope
TWIN TRIUMPH Twin to twin transfusion patients depend on fetal intervention for survival
Texas Childrens Hospital is dedicated to providing the finest possible pediatric patient care, education and research.
EDITOR
AMBER LEWIS TABORA

CONTRIBUTORS
THE WAY HOME Team-based developmental care helps ensure better quality of life for high-risk infants
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ANGELA DOLDER DAWN DORSEY ERIKA DURHAM HARGROVE KATHY ISDALE TRAVIS MCCLAIN SHANNON RASP ANN SAYE HEATHER MCLEAN WIEDERHOEFT
PHOTOGRAPHERS
PAUL VINCENT KUNTZ ALLEN KRAMER

SENIOR VICE PRESIDENT OF DEVELOPMENT
A NEW LOOK AT HEREDITY Researching how a womans diet during pregnancy could influence her childs health for life
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JOHN J. SCALES
VICE PRESIDENT OF DEVELOPMENT
LAURA SHUFORD
DESIGN
DOUTHIT DESIGN GROUP
THE FACTS BEHIND THE FICTIONS OF PREGNANCY Demystifying some of the myths of motherhood
20
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2008 Texas Childrens Hospital. All rights reserved.
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LEADERS IN GIVING 2 THE BROWN FOUNDATION 28 CONOCOPHILLIPS 32 SIMMONS FAMILY FOUNDATION 33 NIJAD AND ZEINA FARES H-E-B TOURNAMENT OF CHAMPIONS PIN OAK CHARITY HORSE SHOW
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UPDATES @ TEXAS CHILDRENS ON THE SCENE PLANNED GIVING GRATEFUL FAMILY
H O S P I TA L N E W S A N D E V E N T S | S U M M E R 2 0 0 8
@ Texas Childrens
Texas Childrens Maternity Center acquires Womens Specialists of Houston
With the construction of its new Maternity Center underway, Texas Childrens Hospital has acquired the Womens Specialists of Houston (WSH), a private physicians group practicing obstetrics and gynecology, to help care for the women and families the new center will serve. We founded the Womens Specialists of Houston to help all people, and the new Maternity Center is a manifestation of that vision, said Edward Yosowitz, M.D., managing partner and founder of WSH. The group handles 34-40 percent of the deliveries in the Texas Medical Center. By merging with Texas Childrens, the groups seven physicians and four nurse midwives will have resources to expand, adding at least five more staff physicians over the next five years and helping recruit additional private physicians to office in the new Maternity Center facility after completion in 2011. Were very excited about the Maternity Centerits never been done before, added Yosowitz. For patients to have their babies and have pediatric services right there, to have research and collaboration with an institution like Baylor right there, its a model that just makes sense.
Once again ranked among the nations best

For the ninth consecutive year, Texas Childrens has been ranked among the countrys top 10 foremost pediatric health care facilities in U.S. News & World Reports annual Americas Best Childrens Hospitals publication. This year, Texas Childrens maintained its No. 6 national ranking and No. 1 ranking in this part of the country. In addition, the hospitals overall score and reputation perception reached new levels. We are excited about this ranking, which is a tribute to the hard work and commitment of all our employees and physicians. As we move toward the expansion and 2010, we expect to continue to blaze trails at the forefront of pediatric health care, said Mark A.Wallace, Texas Childrens president and chief executive officer. Texas Childrens did exceptionally well in the pediatric subspecialty categories, placing in the top 10 of each category, including No. 2 for respiratory disorders, No. 3 for cancer and for cardiology/heart surgery, No. 4 for digestive disorders and No. 5 for neurology/neurosurgery.
Breaking new ground in West Houston

Physician-in-chief announces search for his successor
Ralph D. Feigin, M.D., physician-in-chief of Texas Childrens Hospital and chair of the department of pediatrics at Baylor College of Medicine, recently announced his intentions to step down from his leadership roles and is helping Texas Childrens and Baylor conduct the formal, national search for his successor. For more than 30 years, Dr. Feigin has provided extraordinary leadership for our institutions, said Mark A. Wallace, president and chief executive officer of Texas Childrens Hospital. He has cared for thousands of young patients, trained hundreds of residents and medical students and led groundbreaking research. Under his leadership, Texas Childrens Hospital and Baylors department of pediatrics have grown to international prominence, and he will continue to be an invaluable resource to both of our institutions. Feigin will continue to serve as physician-in-chief and chair of pediatrics until a successor is named and, at that time, continue to serve as a professor of pediatrics at Baylor and a pediatrician at Texas Childrens. Donors, community leaders, area families and Texas Childrens Hospital Board of Trustees members gathered May 15 to celebrate the groundbreaking of Texas Childrens Hospital West Campus. The first phase, scheduled to open in the spring of 2010, will include a 190,000-squarefoot outpatient clinic with physician offices, and the second phase, opening in the fall of 2010, will feature a 280,000-square-foot inpatient facility with 48 intermediate and acute care patient beds, surgical suites, advanced imaging and diagnostic services and the only dedicated pediatric emergency room in the greater West Houston area. Eventually, Texas Childrens Hospital West Campus will be one of the countrys largest suburban pediatric hospitals, with up to 500,000 square feet and 96 licensed beds. Located in the midst of one of the nations fastest growing areas, the West Campus will serve children and families from Sugar Land all the way up to Bryan-College Station. Since 2000, this pediatric population has been growing rapidly and is expected to have increased 51 percent by 2015. Our new West Campus will provide families greater access to the same unsurpassed standard of care for which Texas Childrens Hospital is internationally recognized, said Mark A. Wallace, president and chief executive officer of Texas Childrens. It will be a premier pediatric treatment facility and a leading community resource center for child wellness and healing. At the groundbreaking ceremony, Wallace announced a $3 million gift from ConocoPhillips to the West Campus and to the Jan and Dan Duncan Neurological Research Institute. He also thanked Mary and David Wolff, who donated 10 acres of the site on which the hospital will be built, a gift valued at $4.5 million.
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faith
By Angela Dolder
To the casual observer, it may not look like a miracleKeri McCartney cradling her 1-month-old daughter, Macie Hope. Making her debut in the world, Macie doesnt realize that hers is one of the most miraculous births ever to happen at Texas Childrens Hospital. Nor does she know that she had made medical history even before she was born. After all shes been through, shes just at peace now, said McCartney. Indeed, Macie is content to doze quietly in her mothers arms, blissfully unaware of the herculean effort of faith and fetal medicine that it took to bring her into the world a healthy girl. Its a miracle from God that she is here with usGod and Texas Childrens Hospital, added McCartney.
& fetal medicine

Faced with this dismal future, Hope was all we had, said McCartney. That hope brought them to Texas Childrens Fetal Center at Texas Childrens Hospital, one of only a handful of centers in the United Statesand the only center in the Southwestto offer the full spectrum of fetal therapies including fetal surgery, fetal diagnosis and minimally-invasive fetal intervention. By the time the McCartneys made the trip from their home in Laredo to the Fetal Center, Macies health was already fading. Macie had whats known as a sacrococcygeal teratoma, a rare tumor that forms at the base of the coccyx. It occurs in about 1 in 35,000 births, said Darrell Cass, M.D., co-director of the Fetal Center and associate professor of pediatric surgery at Baylor College of Medicine. A fetal echocardiogram to study her heart, a level two ultrasound and an MRI were done to help evaluate Macies condition and determine the next course of action. Tests revealed the monstrous growth was rich with blood vessels and thieving blood, causing Macies heart to beat frantically. As the tumor grew, she continued to struggle. Macies heart was in the process of failing, said Nancy Ayres, M.D., director of the echocardiography laboratory at Texas Childrens Hospital and fetal cardiology at Texas Childrens Fetal Center. She didnt have much time.
A pioneering procedure at T exas Children s gives the McCartney family hope for their daughter s life
Elijah Graff with mother, Cynthia
Holding onto hope

Macies extraordinary medical odyssey began rather mundanely with a routine ultrasound at 23 weeks gestation. We had hoped to determine the sex of the baby, explained McCartney. My husband, Chad, and I had brought along our four children to hear the news. But the ultrasound revealed that their babya girlwasnt alone in the womb. A tumor, nearly the size of the baby, had mushroomed from her tailbone. Macie Hope, they would call her, would likely die inside her mother. Macie McCartney
www.texaschildrens.org TEXAS CHILDRENS HOSPITAL | 5
The Fetal Center treatment teamincluding Cass and co-director Oluyinka Olutoye, M.D., maternalfetal medicine specialists Anthony Johnson, D.O., and Kenneth Moise, M.D., as well as neonatologists, obstetricians, fetal cardiologists, anesthesiologists and other expertsconvened and presented the McCartneys with their options. They could let nature take its deadly course; or the team could remove the tumor during a daring open fetal surgery that would make medical history in the process. Fewer than 15 of this type of procedure had ever been done before, according to Cass. Fewer still produced positive outcomes. While Texas Childrens Fetal Center had performed open fetal surgery for fetal lung masses, Macies procedure would be the first open fetal surgery for a sacrococcygeal teratoma at Texas Childrens Hospitaland it would be Macies only hope for life. We were hoping to do everything we could to save Macie, said McCartney. We surrendered Macies fate to our faith and chose the surgery.
Making medical history

Two weeks after the diagnosis, McCartney, 25 weeks pregnant, lay prepped for surgery in a Texas Childrens Hospital operating room, ready to risk her own health to save Macie.
With such a procedure, Keri was at risk for bleeding and early labor, said Richard Todd Ivey, M.D., assistant professor of obstetrics and gynecology at Baylor College of Medicine and McCartneys ob/gyn at Texas Childrens Hospital. Even after viewing photos of the surgery, McCartney still cannot fathom what the Texas Childrens Fetal Center team did next. With McCartney under many times the standard dose of anesthesia, surgeons sliced a wide arc across her lower abdomen, reached inside with gloved hands, plucked the uterus from her depths and laid it atop her torso. Ivey and Moise massaged the uterus in order to properly position Macie for the surgery; Ayres monitored Macies heart. Lead surgeon Cass made a seven-inch incision into the uterine wall, lifted Macies lower half into the world and resected the parasitic growth. The teratoma was about the size of a grapefruit, said co-surgeon Olutoye, associate professor of pediatric surgery at Baylor College of Medicine. Then Macie was returned to the life-sustaining pool of amniotic fluid in the confines of her mothers womb. The uterus was reinserted into McCartneys abdomen and the maternal flesh sewn closed.
There, in the secret place, breached only by a gifted few, Macie remained to strengthen herself for life outside the womb. Our hope was to allow my pregnancy to progress to 28 weeks so that Macie could develop, said McCartney. 30 weeks would have been great; 32 weeks would have miraculous. Macie had other plans. She stayed put for an astonishing 10 weeks postsurgery until she was born, at 35 weeks, via cesarean section on May 7, said Ivey. Macie spent a month in the neonatal intensive care unit at Texas Childrens Newborn Center and later underwent a second surgery to remove some internal cysts spawned by the tumor. Meanwhile, McCartney recovered nearby at St. Lukes Episcopal Hospital Labor and Delivery Unit staffed by Texas Childrens. Macies successful surgery is just one more example of the kind of expertise that has solidified Texas Childrens Hospital among the elite institutions capable of saving babies before they are born said Cass. This is the first of many firsts for the Fetal Center, he added. Particularly now, with Texas Childrens Maternity Center on the horizon, the future of fetal medicine here is bright.
Building life
For families like the McCartneys, Texas Childrens Hospital is creating a comprehensive maternity center where world-class
experts will provide care to mothers and babies at every stage of pregnancy, birth and infancy. Slated to open in 2011, the new Texas Childrens Maternity Center will galvanize top talent from Texas Childrens Fetal Center, Texas Childrens Newborn Center, obstetrics, maternal-fetal medicine and related specialtiesultimately at one location. Our ability to ensure comprehensive, multidisciplinary care under the auspices of Texas Childrens Maternity Center will give high-risk patients like Keri and Macie the best hope for life, explained Ivey. Macie is the perfect example of what modern medicine is capable of when the circle of care is complete. For the McCartneys, hope came full circle in June when they headed home to Laredo as a whole familywith a perfectly healthy Macie in tow. The only visible evidence of the harrowing circumstances surrounding Macies start in life is hidden beneath a preemie-sized diaper. If God had not brought us to Texas Childrens, our little girl would not be here today said McCartney. I am grateful that Texas Childrens is building a place like the Maternity Center, but really what they are building is life for more babies like Macie.
Above Left: An MRI shows Macies sacrococcygeal teratoma at 24 weeks. Above Right: Chad, Keri, and their daughter, Macie McCartney Right: The Fetal Center treatment team, co-directors Drs. Darrell Cass and Oluyinka Olutoye, and maternal-fetal medicine specialists Drs. Kenneth Moise and Anthony Johnson
Macie is the perfect example of what
modern medicine is capable

of when the circle of care is complete.
- Dr. Richard T odd Ivey, ob/gyn at Texas Childrens
TWIN
TRIUMPH
Mother and her twins rely on Texas Childrens fetal intervention team for support and survival
BY ERIKA E. HARGROVE
Anayele Martinez knew her stomach would get big, maybe even huge. After all, she was having twins. She figured a protruding stomach and backaches came standard with morning sickness and swollen ankles. But by her 24th week of pregnancy, big just wasnt the word to describe her. My belly was sticking out so far, and the skin on my stomach was pulled so tight it felt like it was going to pop, the first-time mother recalled. On top of that, my back hurt terribly. Everyone kept telling me it was normal, but I knew it wasnt. I knew something had to be wrong. During her next check-up at Ben Taub General Hospital, Martinez explained her pains to her resident doctor, who had a hunch what the problem might be. Kenneth Moise, M.D., member of the fetal intervention team at Texas Childrens Hospital, was immediately called in and the diagnosis was confirmedtwin to twin transfusion syndrome (TTTS).
Anayele with Christopher and Jonathan Martinez
TWIN TRIUMPH
less urine so its amniotic fluid disappears and it becomes wrapped by its amniotic membrane (known as a stuck twin). According to Moise, the condition is extremely severe and can be fatal for one or both babies. But Martinez was diagnosed at just the right timetwo weeks after the arrival of the fetal intervention team to Texas Childrens Fetal Center. A NEW MODEL OF CARE FOR MOTHERS AND BABIES Recruited in 2006 from the University of North Carolina, Chapel Hill, the fetal intervention team of Moise, Anthony Johnson, D.O., and coordinator Karen Moise, R.N., came to Houston to establish and operate this much needed service. Prior to their arrival, there were no such services provided in the central part of the country, said Karen Moise. If Anayele would have not had the resources to travel to San Francisco or Pennsylvania, it is highly likely that she would have lost the pregnancy. During Martinez treatment in 2007, she was transferred to the St. Lukes Labor and Delivery Unit, staffed by Texas Childrens. By 2011, however, mothers with this kind of condition and other pregnancy complications will have the opportunity to be treated at Texas Childrens Maternity Center, currently under construction. The center will provide the finest prenatal and obstetrical care to women and perinatal care for their babiesall in one state-of-the-art facility. Along with Baylor College of Medicine, Texas Childrens is assembling a team of physicians and administrators to lead the Maternity Center and actively recruiting medical staff that will be focused on high-risk deliveries. The fetal intervention team is especially excited about the arrival of the Maternity Center. The unique services of Texas Childrens Fetal Center will be provided to patients in one location on the fourth floor of the new center. There patients can receive the expertise of perinatal specialists as well as a broad spectrum of pediatric subspecialists who will care for their unborn child after birth. We are excited to be a part of this world-class opportunity, Moise said. SAVING TWO TINY LIVES Once diagnosed, Martinez was briefed on the best option to save her childrena procedure called laser photocoagulation. The procedure requires doctors to make a small incision in the skin over the uterus through which a very small telescope, called a fetoscope, with a small laser fiber is inserted directly into the
recipient twins pregnancy sac. The fetoscope is used to look at the blood vessels on the surface of the placenta. Vessels that are found to communicate between the twins are then disconnected with the laser energy. This process is followed by the removal of the extra amniotic fluid around the recipient twins sac to achieve a normal volume. Prior to the surgery Martinez said she understood that the risks were great, but so were the possible rewards. According to Johnson and Moise it takes about 75 cases for a surgical team to reach peak performance with laser photocoagulation. Once that is achieved 50-60 percent of the
important to ask the right questions. If you are pregnant with twins then ask if there is one placenta or two. Johnson further recommended that mothers carrying monochorioinc or twins with one placenta receive an ultrasound every two weeks and are also seen by a maternal-fetal medicine specialist in addition to their regular obstetrician. Patients need to stay informed because most obstetricians will only see about two to three cases of TTTS in their careers, added Moise, and they may not know exactly what the signs are right away. All the more reason for mothers to have a resource to turn to
While on bed rest I just kept talking to my boys and telling them to keep growing. I would get depressed, and then I would feel them kicking in there and reminding me that I wasnt alone. We were all fighting together.
Anayele Martinez time the mother will take home two babies, approximately 20-30 percent of the time she will take home one baby, and about 20 percent, or less, of the time she will take home no babies. I heard the risks and statistics, but Dr. Moise also told me his intentions, Martinez said. He told me the goal was to go in and get two healthy babies. I believed in him, and I believed in my boys. He told me that if we were a praying family this was the time to start praying. Prayers were answered when Martinez surgery was completed without complication. However, she did require strict bed rest for three months after going into pre-term labor a few weeks later. While on bed rest I just kept talking to my boys and telling them to keep growing, Martinez said. I would get depressed, and then I would feel them kicking in there and reminding me that I wasnt alone. We were all fighting together. I have some brave little boys. They never gave up. The Martinez twins were delivered by c-section in March 2007 and are now 15 months old. ANGELS OF MEDICINE Johnson said he cannot stress enough how important it is for patients to be their own best advocates in these situations. TTTS is a very bad disease. If you do nothing, there is a 90 percent mortality rate, he said. It is like Texas Childrens Maternity Center. Including the Martinez procedure, Johnson and Moise have performed approximately 100 laser photocoagulation surgeries, and counting. The team attributes much of its success to the environment Texas Childrens Hospital has provided. Anytime we need to do a surgery, we have the staff, space and resources24/7, Karen Moise said. She added that the fetal intervention team is greatly supported by a trained group of nurses and other professionals. The support is especially welcoming since Texas Childrens Hospital has been in the childrens business. These are moms, adults, so its a different realm for them, but we always have everything we need. Johnson and Moise both said they often have to pinch themselves when they think about their teams progress and possibilities within Texas Childrens and with the new Maternity Center. At Texas Childrens Hospital the priority is always the patient and decisions are made around that central focus, Johnson said. Martinez couldnt agree more. Today she has two healthy 15-month-old boys who are active, alert and developing normally. I was a single mom trying to get through a very difficult situation on my own, she said. Dr. Moise and Dr. Johnson not only saved my boys but were there for me every step of the way. They are my angels.
Drs. Anthony Johnson and Kenneth Moise
TTTS is a condition where the babies share one placenta as opposed to each having their own. This placenta contains blood vessel connections between the twins that are not balancedblood moves one way but does not return. In TTTS, the smaller twin (donor twin) sends blood to the larger twin (recipient twin) who becomes overloaded. In an attempt to reduce its blood volume, the recipient twin increases the urine it makes, which eventually results in the twin having a very large bladder and too much amniotic fluid. This causes a quick increase in the size of the uterus, which is often the first sign of trouble that many mothers, including Martinez, notice. As the disease progresses, the donor twin makes less and
10 | TEXAS CHILDRENS HOSPITAL www.texaschildrens.org
the way home

FOR HIGH-RISK INFANTS, GETTING HOME FROM THE HOSPITAL CAN BE A LONG ROAD PAVED WITH OBSTACLES, BUT TEXAS CHILDRENS DEVELOPMENTAL CARE PROGRAM IS HERE TO HELP WITH THE JOURNEY.
BY HEATHER MCLEAN WIEDERHOEFT
Like most expecting moms, Kate Harrison anticipated the day when she would carry her second child, Chloe, home to be with her family. On Oct. 6, 2007, she and her husband, Rex, drove to their local Wharton, Texas hospital for the long-awaited arrival. Little did they know that their babys first home would turn out to be the neonatal intensive care unit (NICU) at Texas Childrens Hospital. None of my prenatal exams indicated that Chloe had any health problems, and she was a near-term delivery, explained Harrison. After she was born, the doctors noticed what they thought was a cyst on the outside of her abdomen. Within two hours, she was transferred to Texas Childrens where she stayed for the next three months.
Texas Childrens physicians quickly realized the cyst was actually part of her bladder, and Chloe was diagnosed with cloacal exstrophy, a rare condition. As their exams continued, doctors realized Chloe also had a congenital heart defect, one of her ankles had not developed, and her foot was severely deformed. Testing also showed that Chloe was missing the tip of chromosome 1 that indicates she has Monosomy 1p35, a syndrome that can be characterized by developmental delay. At only 4-days-old, Chloe had surgery to begin addressing some of her health conditions. Due to complications and the forming of a fistula at the incision point, her stay at Texas Childrens extended much longer than originally anticipated. Chloe was a patient for more than three months.
CHLOE AND KATE HARRISON
the way home

During that time, her treatment and recovery were prioritybut so was her continued developmental growth that is so critical for every newborn. Luckily for Chloe, she was one of the first Level 3 NICU patients to participate in Texas Childrens new developmental care program. Developmentally-supportive care primarily focuses on three areas for high-risk newborns: positioning of the infant, light and noise, explained LuAnn Papile, M.D., neonatologist who was recruited to Texas Childrens to develop this unique multidisciplinary program. From a physiologic standpoint, we try to determine what elements stress a newborn and find ways to limit the stress so the newborn can continue to develop. The key to this approach is the family-centered aspect. We work with the families so they can learn how to better read their babys cues and clues and learn how to approach their baby so when they eventually graduate from Texas Childrens, they have a much more successful transition home, said Papile. For example, during the final trimester, the growing infant is in a very flexed position in the womb which is a critical component for development, said Papile. Because pre-term newborns automatically adjust to the flat surfaces in their nursery environment, the developmental care team works to keep the infant in the appropriate third trimester position to encourage better development. IT TAKES A TEAM Developmental rounds are a key part of the program. Different members of the teamincluding doctors, nurses, physical therapists, occupational therapists, social workers, clinical specialists, child-life therapistsmeet at least once a week to discuss each baby. Their goal is to work together as a team to
ensure the babys developmental growth as well as the familys understanding. Everyone on the team has a different perspective about the baby and the family, explained Papile. As we share information, we are able to develop a holistic picture of what is going on with the baby and the family which should make the transition from the birth of a high-risk newborn to the infant eventually being discharged as smooth as possible. Carol Turnage-Carrier, M.S.N., R.N., newborn clinical nurse specialist, is a member of the team and has worked in the area of developmental care for 11 years. Until this program was launched, it was as if we had been preparing for Dr. Papile to join us so we could move forward. Working together with our staff and families, we are focusing on providing our babies the best opportunities that will lead to the best outcomes, said Turnage-Carrier. Marcia Berretta, licensed clinical social worker, coordinates follow-up with patients after they graduate from the hospital. Currently, the follow-up program only applies to high-risk infants who weighed less than 1,000 grams at birth or who received extracorporeal membrane oxygenation (ECMO). In the future, the program may extend to all newborns in Texas Childrens Level 3 NICU. We feel it is so important to maintain a relationship with all of the patients from this program so we can track how each infant is doing as well as provide support to the parents to help ensure their baby is developing as he or she should, Berretta said. Our follow-up clinic, which opened in late June, will provide us with real-time information on our patients. We can provide support to parents who are anxious and help answer any of their quesDR. ANN STARK tions so they can continue to support their infants developmental progress. According to Ann Stark, M.D., chief of neonatology service, having this real-time information on all of the NICU graduates will be important to Texas Childrens ongoing efforts to improve care and outcomes for newborns. This program also is going to be greatly enhanced with the addition of Texas Childrens
FROM LEFT, CAROL TURNAGE-CARRIER, MARCIA BERRETTA AND DR. LUANN PAPILE.
None of my prenatal exams indicated that Chloe had any health problems, and she was a near-term delivery. After she was born, the doctors noticed what they thought was a cyst on the outside of her abdomen. Within two hours, she was transferred to Texas Childrens where she stayed for the next three months.
Kate Harrison
Maternity Center. The best outcomes are when you have a high-risk baby born in the same hospital where the NICU care is available. With moms being able to deliver at Texas Childrens instead of having to transfer their high-risk babies, well be creating a more ideal situation for treatment. HOME AT LAST For young Chloe and her family, her first several months of life were a true challengethe majority of her time spent in the hospital overcoming some tremendous hurdles. Today, Chloe is at home with her family and has begun her outpatient treatment through Texas Childrens Hospital. We would not be where we are today without the care Chloe received at Texas Childrens, said Harrison. Dr. Papiles developmental program gave us the tools we needed to help Chloe succeed developmentally. This is really one of the best hospitals in our country, and the developmental care program has meant so much to us.
HEREDITY
Researchers at Texas Childrens Hospital and Baylor College of Medicine are investigating how a womans diet during pregnancy may affect her childs health throughout his or her lifetime.
A NEW LOOK AT
BY SHANNON RASP
All babies are born with much of their biological profile predeterminedhow tall they will be, if they will have curly hair or straight, if they are predisposed to being slender or obese. But recent discoveries in the field of epigenetics are causing some researchers like Kjersti Aagaard, M.D., Ph.D., to question previously accepted ideas about heredity. Epigenetics is the study of heritable changes in gene function that occur without a change in the DNA sequence. Is it possible, Aagaard and her associates at Baylor College of Medicine wonder, to alter a persons inherited traits while he or she is still a developing fetus? Can simple changes to a pregnant womans diet, for instance, help her offspring lead a healthier life?
HEREDITY
Aagaard, an assistant professor of maternal and fetal medicine who sees patients at Baylor and St. Lukes Episcopal Hospital in partnership with Texas Childrens Hospital, is fascinated by the link between a mothers health and that of her offspring. Ive always been interested in understanding the relationship between the most common exposures encountered in pregnancy
A NEW LOOK AT
delivered, not surprisingly, very small babies. However, when those children grew up, they were disproportionately overweight with high rates of diabetes, cardiovascular and pulmonary disease, high cholesterol and other weight-related illnesses. What made these people, who started out so tiny, grow to be so large? Scientists believe that the malnutrition the women suffered somehow caused profound reprogramming changes to their babies in utero. The womens bodies communicated to the embryos that food was scarce and of low nutritional value, so the babys genetic makeup programmed its body to store fat in large amounts. By the time the children were born, The Netherlands had been liberated and food became abundant. But by then, the childrens fate had been secured-their bodies would store fat, reduce insulin secretion, and otherwise protect them from a famine that no longer existed. This example, in combination with a large number of other epidemiology studies as well as observations from animal models, have led the medical and scientific community to coin
but also can be modified by nutrition. They observed that supplementing essential nutrients in the first generation of offspring from childhood through pregnancy and lactation can reverse these changes in the next generation. We found that a diet supplemented with essential nutrients, yet unaltered in its caloric content, prevents adult metabolic disease and can reprogram the offsprings genes, she said. Aagaard and her colleagues also are studying the effects of a high fat diet and obesity on development. Given our current adult epidemic of obesity and the rise in juvenile diabetes and childhood obesity, we were curious whether the framework for obesity was being laid out in pregnancy or early lactation. We were especially interested in looking at this issue in a primate model, with the hope of eventually using our findings clinically to benefit patients. Aagaard and her co-authors from the University of Utah teamed up with researchers at the Oregon National Primate Research Center. In their studies, recently published in the Journal of Molecular Endocrinology, primates were placed
Giving people a better chance of living a healthier life may be as simple as cutting down on high-fat foods or taking a nutritional supplement, said Aagaard. We are finding that simple interventions could potentially cut the rate of obesity dramatically in the next generation and decrease the risk for developing diabetes, hypertension and cardiovascular and lipid diseases. Providing women with such interventions is one of the goals of the new Texas Childrens Maternity Center, currently under construction. The center not only will combine the clinical advantages of Baylor and Texas Childrens, but also the significant research strengths of both institutions, according to Amy Young, M.D., executive vice chair and director of general obstetrics at Baylor and Texas Childrens Maternity Center leader. Young said, The Maternity Center will enable us to bring the laboratory to the bedside to more effectively translate this kind of current research activity into meaningful patient care and improved outcomes.
We found that a diet supplemented with essential nutrients, yet unaltered in its caloric content, prevents adult metabolic disease and can reprogram the offsprings genes.
DR. KJERSTI AAGAARD
The Maternity Center will enable us to bring the laboratory to the bedside to more effectively translate this kind of current research activity into meaningful patient care and improved outcomes.
DR. AMY YOUNG
and how it affects the next generations health, she said. It is really evolution on a shortened scale. You can appreciate how a pregnant womans health and wellbeing affects that of her child, both in the immediate time after delivery and quite probably throughout the life of that same child.
the term developmental origins of adult disease to explain the phenomena.
EATING FOR THE NEXT GENERATION

What does all of this mean for moms? Aagaard and others theorize that what a woman eats during pregnancy can not only affect her childs health at birth, but also affect it throughout his or her lifetime. While your genes provide the basic building blocks, they dont necessarily create the final heritable code, said Aagaard. Outside influences can change the way in which genes are expressed. As an example, she explained, she is studying histone changes in rodent models. Histones are the chief protein components of chromatin, which act as the spools DNA winds around and play a role in gene regulation. Aagaard and her colleagues have discovered these changes not only can be transmitted across generations
HISTORY RAISES IMPORTANT QUESTIONS

Aagaard traces her interest in this particular research to reading a scientific report on the health of the children born to women who suffered through the 1944-1945 famine in The Netherlands. The German forces occupying the country at the time blocked food deliveries to the western half; combined with an unusually harsh winter, the situation resulted in the starvation deaths of over 18,000 Dutch people. The pregnant women who lived through the famine
on control and high fat diets for up to five years. Over the course of the study, many of the animals became obese. However, Aagaard and her team learned that even in the absence of maternal obesity, the high fat diet still affected the offspring. Whether the moms were on the diet for two years or four years, their offspring developed non-alcoholic fatty liver disease, Aagaard said. Moreover, if we put obese moms back on a control diet after five years, there was some improvement among their offspring following the diet reversal. These changes were accompanied by a significant change in the histone code, which is also associated with changes in the expression of a number of genes.
BUILDING HEALTHIER LIVES

Though still gathering and sorting data, Aagaard said they hope to have answers within five years.
Currently, Aagaard is taking her research in new directions, using large databases and preserved human samples to investigate the effects of tobacco use and air quality on developing fetuses. My work is focused on understanding how we can use these unique early periods in human development to help people live longer, healthier and more enjoyable lives, Aagaard explained. Advances in our understanding hopefully will enable us to treat common adult diseases at potentially their earliest point-before birth. That vision is shared by Texas Childrens Maternity Center, added Young We are caring for women at every stage in their livesits the circle of life, and answers like those Dr. Aagaard is uncovering will have important implications at every turn. The ultimate goal is to build a better quality of life for the generations that follow.
erhaps you saw the prophetic pink plus sign. Maybe your doctor told you. Or maybe you just knew. Regardless of how you discovered it, youve now found yourself in a state of great expectan cy youre pregnant! Its a time of joy, anticipation and often anxiety. What if you do something wrong? What if you dont do enough of the right things? And can you do enough right things to ensure your child is the smartest, strongest, fastest, most talented on the planet? Of course, your doctor will have answers, but so will all of your friends, your relatives, your trainer at the gym, your favorite barista at Starbucks and plenty of total strangers. Even the most well-intentioned advice may be completely untrue or medically impossible. With the help of Amy Young, M.D., executive vice chair and director of general obstetrics at Baylor College of Medicine and physician leader at Texas Childrens Maternity Center, and the American College of Obstetrics and Gynecology (ACOG), we s et out to give you the facts in place of some of the ctions surrounding pregnancy.
Dont exerciseyoull take blood away from your baby.

MOSTLY FICTION. Generally speaking, keep doing what you do. If you want to begin a new exercise program, start slowly and listen to your body. There are no rules specifying the maximum heart rate you may a chieve during pregnancy, and moderate exercise has been shown to have many benets, including leaner babies, shorter labor courses and reduced complications like pre-eclampsia and gestational diabetes. And of course, women who exercise during pregnancy gain less weight and tend to take it off faster after delivery. ACOG recommends avoiding contact and extreme sports during pregnancy, as well as scuba diving. Also avoid supine exercise after 20 weeks gestation.
No morning sickness? Theres probably something wrong with your baby.

FICTION. Approximately 50 percent of women will experience nausea and/or vomiting in early pregnancy, but the remaining 50 percent will have no morning sickness with perfectly healthy pregnancies. Morning sickness is associated with the rise in pregnancy hormones that peaks around 10-12 weeks. A sudden decrease in symptoms prior to 10-12 weeks could indicate a decline in these hormones that could be associated with miscarriage. Morning sickness normally dec lines around 10-12 weeks gestation.
Rub cocoa butter on your belly to prevent stretch marks.

FICTION. There have been multiple products evaluated for the prevention of striae or stretch marks in pregnancy. The data is limited because studies were conducted in small populations, but really, no formulation ha s been found to be adequate for the prevention of stretch marks. In one small trial, a combination of Centella asiatica extract, alpha tocopherol and collagen-elastin hydrolysates demonstrated some preventive effect for women who already had stretch marks in a subsequent pregnancy. But sorry, ladies, theres nothing conclusive regarding the striae-prevention properties of cocoa butter. Risk factors for striae incl ude family history, higher birth weight, larger weight gain in pregnancy and race.
Dont raise your arms above your head the umbilical cord will strangle your baby!
FICTION. First, there is no evidence of this ever happening, and more importantly, the baby and placenta are in an independent, almost weightless environmentlike oating in water. There is almost no activity that a mother can do that will have a signicant impact on the position of her baby with respect to the uterus, umbilical cord or placenta.
The Facts Behind the Fictions of Pregnancy

Dont starve your baby remember youre eating for two!
FICTION. Being pregnant is not a free pass to the all-you-can-eat buffet. When you are pregnant, you need only about 300 calories more per day than you usually eat about two extra glasses of milk per day. The av erage weight gain during pregnancy is only 25-35 pounds depending on your pre-pregnancy weight. As well, pay attention to your nutrition. Prenatal vitamins or a good multivitamin taken in pregnancy provide nutrients such as iron and folic acid which are more difcult to obtain through a normal diet and are important in conception and in growing more blood cells to sustain the pregnancy.
Dont get a foot massageit will trigger labor. (So will spicy foods and sex.)
FICTION. No evidence indicates a foot massage or acupressure on the point on the tip of the little toe (BL67 acupuncture point) plays any role in the onset of labor. Some acupuncture treatments may be useful in the successful change in position of a fetus at or near term from a breech presentation to a head down position. Also, no foods have ever been shown to trigger labor, and sex is safe in most uncomplicated pregnancies. Seminal uid does have high concentrations of prostaglandins which have a known role in the onset of labor and which is likely why sex is often suggested as a labor trigger. But as far as a foot massage? Go aheadput your feet in your partner s hands and tell them not to worry.
Dont eat sh.

SOME FACT, SOME FICTION. When you eat, small quantities of all protein, fat, sugar and minerals youve digested are in your blood stream and available to pass across the placenta to your baby. Raw sh such as sushi and unpasteurized foods may be contaminated by viruses and bacteria and are thus not recommended in pregnancy. Cooked sh in general is a healthy, recommended source of protein, but because sh absorb mercury, yo u want to limit your intake. The FDA recommends no more than 12 ounces per week of shrimp, canned light tuna, salmon, cod and/or catshabout two meals per week. For albacore tuna, limit to one meal per week. Fish with very high levels of mercury include shark, swordsh, king mackerel and tilesh. Dont eat these sh while pregnant.
But a full moon denitely triggers labor.

ALSO, FICTION. Its long been postulated that lunar phases or atmospheric changes act as triggers for labor. However, in two large trials completed in the U.S., neither atmospheric changes nor lunar phases were found to be associated with any increase in delivery rates.
For more Facts & Fiction visit www.shine.texaschildrens.org.

NOTE: All content is based on data and standards compiled by the American College of Obstetricians and Gynecologists.
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Historic Gift to Help Heal Sick Children
The Brown Foundation, Inc. commits $10 million to Texas Childrens campaign
BY ANN SAYE
In May 2008, Texas Childrens Hospital received word that it would be receiving the second largest gift commitment in its history$10 million from The Brown Foundation, Inc.to support the Heal Sick Children campaign. The funds will be dedicated to Texas Childrens Maternity Center and to the Jan and Dan Duncan Neurological Research Institute, two of the most pronounced campaign priorities. The Brown Foundation, Inc. has been serving the Houston community for nearly 60 years and has contributed to Texas Childrens since 1962, totaling more than $23 million in gifts and commitments, noted Ralph D. Feigin, M.D., physician-in-chief at Texas Childrens Hospital. Over the years, the trustees generosity has made an impact throughout the hospital, with gifts to support each of Texas Childrens previous campaigns in
The Brown Foundations support to help build the institute will someday provide physicians like Dr. Gary Clark, chief of pediatric neurology, with better treatments for patients like Kevin Sharp.
addition to Texas Childrens Cancer Center, infectious diseases, autistic spectrum disorders, the congenital heart surgery service and many other areas. This outstanding new commitment will have an even more far-reaching effect. The Brown Foundation, Inc. was founded in July 1951 by Herman and Margarett Root Brown and George R. and Alice Pratt Brown. As of last summer, the foundation had awarded more than $1.1 billion in grants, approximately 80 percent of which were awarded within the state of Texas, with special emphasis on the city of Houston. Since its inception, the foundation has given to programs that address root causes rather than symptoms, stimulate collaborative effort and create long-lasting impact beyond the value of the actual grant. We believe that Texas Childrens Maternity Center and the Jan and Dan Duncan Neurological Research Institute meet each of these criteria in truly significant ways, said Mark A. Wallace, Texas Childrens president and chief executive officer. Texas Childrens Maternity Center will provide comprehensive services for mothersand for babies even before they are bornin a facility that combines the most advanced treatments and technology with family-centered, compassionate care. And through the multidisciplinary collaboration that will occur in the Jan and Dan Duncan Neurological Research Institute, Texas Childrens aims to accelerate in a dramatic way the study and treatment of the neurodevelopmental disorders that afflict millions of children in the United States and around the world. The Brown Foundations involvement and partnership in these two endeavors will help ensure a brighter future for mothers and babies and will help change the future for children with neurological diseases, said Wallace. The foundations generosity has touched so many lives already, and through this gift, millions more will be affected in ways that cannot even be imagined today. Texas Childrens is fortunate to have this kind of commitment and support. We are truly grateful.
LEADERS IN GIVING
Texas Childrens Physician-in-Chief Dr. Ralph D. Feigin, President and CEO Mark A. Wallace, and ConocoPhillips Chairman and CEO Jim Mulva break ground with help from Texas Childrens patients.
For Families Near and Far
ConocoPhillips pledges $3 million to help children in Houston and around the world
BY ANGELA DOLDER
ConocoPhillips has pledged its support to heal sick children with a $3 million commitment to Texas Childrens Hospital. As the largest corporate contribution in Texas Childrens history, the ConocoPhillips gift will help create Texas Childrens Hospital West Campus, Houstons first community childrens hospital, and the Jan and Dan Duncan Neurological Research Institute, the nations first facility designed to use multidisciplinary research to accelerate the discovery of treatments for pediatric brain disorders. Mark A. Wallace, president and chief executive officer of Texas Childrens Hospital, together with Jim Mulva, chairman and chief executive officer of ConocoPhillips, announced the gift during the groundbreaking ceremony at the site of the new West Campus. ConocoPhillips is proud to support Texas Childrens new West Campus, which will bring expanded access to world-class pediatric care for families in this community, including so many ConocoPhillips employees and families who live and work in West Houston, said Mulva. At the same time, as a global company, we are committed to supporting causes that benefit the worlds children, such as the research conducted through the Jan and Dan Duncan Neurological Research Institute. ConocoPhillips has designated $1.5 million of the contribution for each initiative. Headquartered in Houston, ConocoPhillips is the third-largest integrated energy company in the United States and currently operates in 37 countries with approximately 32,600 employees. This generous gift underscores the commitment of ConocoPhillips to making a difference for children and families in Houston and around the world, said Wallace.
L.E. and Virginia Simmons with their children, William and Virginia
Pursuing Partnerships
Simmons Family Foundation gives $3 million to create collaborative research fund

BY ANGELA DOLDER
L.E. and Virginia Simmons have added a new chapter to their familys legacy of support for Texas Childrens Hospital, and two other Texas Medical Center institutions, with a commitment of $3 million to establish the Simmons Family Foundation Collaborative Research Fund. The five-year gift from the Virginia and L.E. Simmons Family Foundation will galvanize top talent from Texas Childrens Hospital, Rice University and The Methodist Hospital Research Institute to pursue collaborative biomedical research aimed at speeding the development of lifesaving breakthroughs in pediatric and adult medicine. The future of biomedical research will involve skills and knowledge that draw from highly specialized and premier institutions like Texas Childrens, Rice and Methodist, said Simmons, president of the Simmons Family Foundation and a trustee of all three institutions. Through this collaborative research fund, we will create powerful synergies in the Texas Medical Center such that the scientific community here becomes much greater than the sum of its individual parts. The foundations gift is designed to help scientists
with new ideas, such as junior researchers who require financial support to jump-start their projects and experienced investigators who might not otherwise collaborate with their counterparts at other institutions. To inspire collective scientific pursuit, the principal investigator of each project considered for funding must be from Texas Childrens, Rice or Methodist, and at least one other investigator must be from one of the remaining institutions. Through his exceptional leadership and service, L.E. has demonstrated his untiring devotion and personal commitment to the mission of Texas Childrens and these other fine institutions, said Mark A. Wallace, president and chief executive officer of Texas Childrens Hospital. This thoughtful gift from the Simmons family may prove to be one of the most important commitments ever made toward advancing research in the Texas Medical Center that will help people in Houston and around the world. The foundation will make the final decisions on which research projects to support, based on the recommendations of a review panel comprised of experts from each of the three institutions. The first awards will be announced in October of 2008.
LEADERS IN GIVING
In a Fathers Footsteps
Fares family commits $250,000 to advance neurological research

BY ANGELA DOLDER
Nijad I. Fares learned early on that giving to others is an important aspect of lifeits a lesson he attributes to his father, Issam. True to his fathers vision, Fares and his wife, Zeina, have given back in a big way, committing $250,000 to the Jan and Dan Duncan Neurological Research Institute at Texas Childrens Hospital. The Fares gift will establish the Issam M. Fares Family Lectureship at the Institute, in honor of the patriarch. My father is my best friend and I am glad to recognize him, while at the same time, give hope to millions of children and families who are afflicted by neurological disease, said Fares. Worldwide, one billion people, including 300 million children, suffer from some form of the more than 600 disorders that afflict the nervous system. The Jan and Dan Duncan Neurological Research Institute will be among the first facilities dedicated to accelerating the study and treatment of pediatric neurodevelopmental disorders including autism, Rett syndrome, Angelman syndrome, epilepsy, cerebral palsy and language disorders. For Zeina and me, this was a once-in-a-lifetime opportunity to make a meaningful impact on the condition of childrenincluding those in our adopted hometown of Houstonand in our homeland of Lebanon, explained Fares. We are excited to make this donation to the Institute, knowing it will help advance research and treatment of neurological disorders in children, as well as have the potential to impact adult neurological conditions such as Parkinsons disease, added Zeina. Unprecedented hope exists to develop treatments for brain-related disorders, and we are grateful that such caring community leaders, like Nijad and Zeina, share our vision for the future, said Huda Y. Zoghbi, M.D., director of the Jan and Dan Duncan Neurological Research Institute. The Issam M. Fares Family Lectureship will attract renowned speakers here and will allow our faculty and staff to remain at
Zeina and Nijad Fares with their girls, Sara, Mia and Sonya
the leading edge of research. With this gift, Texas Childrens Hospital joins an elite group of institutions, including Tufts University and the American University of Beirut, that have benefited from the Fares familys generosity in the name of Issam M. Fares. It is in my fathers nature to help people. We are just following in his footsteps, said Fares.
LEADERS IN GIVING
Ensuring the Best Care for Tiny Hearts
H-E-B Tournament of Champions gives $500,000 to congenital heart surgery

BY TRAVIS MCCLAIN
Thanks to a $500,000 gift from the 2008 H-E-B Tournament of Champions, Texas Childrens congenital heart surgery service is advancing its efforts to heal sick children with heart defects. Now in its 23rd year, the H-E-B Tournament of Championsa three-day series of events at tennis courts and golf courses across San Antonioprovides an opportunity for vendors, who supply H-E-B with products and services, to get actively involved in supporting organizations across Texas. Led by Charles D. Fraser, Jr., Texas Childrens congenital heart surgery service is the only one of its kind in Texas. Pediatric heart surgery has been performed at Texas Childrens Hospital since it opened in 1954, and Heart Center surgeons will perform more than 800 surgeries this year. This very generous gift is laying the initial groundwork for much needed advances for pediatric patients with congenital heart diseases, said Fraser, chief of cardiac surgery and the Donovan Chair in Congenital Heart Surgery at Texas Childrens. Frasers current plan for the congenital heart surgery service includes the development of a center for cardiac valve disease research, a center for clinical outcomes research, provision of seed funding for novel pediatric heart research, the build-out and equipping of laboratory space and provision of funding for endowed chairs, professorships, fellowships and lectureships. The resources necessary to improve surgical outcomes, advance research and provide the education and training needed to ensure the knowledge and skills of our highly specialized team are passed on to the next generation of congenital heart surgery professionals wouldnt be available without philanthropic support, added Fraser.
Dr. Fraser and his team are making an invaluable contribution to the science of pediatric heart surgery, and we are pleased to support their efforts, said Winell Herron, H-E-B Tournament of Champions trustee. Texas Childrens is fortunate to have the commitment of generous community partners like the H-E-B Tournament of Champions, said Mark Wallace, president and chief executive officer of Texas Childrens Hospital. This gift will help accelerate Dr. Frasers vision for the congenital heart surgery service, ultimately advancing research and ensuring the best, most innovative care for tiny hearts.
From left, standing, William, Joseph and Eva Bisso, Pin Oak executive board member; Barbara Stewart, Compass Bank Wealth Management Group advisor; Ed Perwein, Pin Oak participant since its earliest days; the award-winning horse MacArthur Park; Lynn Walsh, Pin Oak president; Fiona Dawson, assistant vice president with Compass Bank; (kneeling, left) Wendy Cook, Pin Oak managing director; and Susan Pelletier, Pin Oak executive board member
Shaping the Future
The Pin Oak Charity Horse Show pledges $300,000 to new West Campus
BY KATHY ISDALE
Without The Pin Oak Charity Horse Show, there might not be the Texas Childrens Hospital known today. And now, Pin Oak is helping launch the Texas Childrens of tomorrow. The Pin Oak Charity Horse Show got its start as a fundraiser for the first hospital in Houston dedicated to children, and proceeds of the 1947 show provided a considerable portion of the initial backing that established Texas Childrens Hospital in the Texas Medical Center. With a recent commitment of $300,000, Pin Oak is now helping build Texas Childrens first hospital outside the medical center and one of the largest suburban pediatric hospitals in the countryTexas Childrens Hospital West Campus. The gift will support hematology/oncology services at the new hospital. According to Lynn Walsh, president of The Pin Oak Charity Horse Show Association since 1995, One of the things that spurred the executive committee to make this gift is the opportunity to continue and strengthen the connection between these two history-making organizations. Walsh says, It is so interesting that this connection has continued over more than 60 years in a young cosmopolitan city like Houston that is very nontraditional in its thinking and that has evolved so much since the early days of Pin Oak. The event that became known as The Pin Oak Charity
Horse Show debuted in 1945 and was soon one of the preeminent horse shows in the nation. Today, with support from its presenting sponsor Compass Bank Wealth Management Group, it has become the very first show to be nominated by the U.S. Equestrian Federation (the national governing body for equestrian sports) as a Heritage Designated Horse Show because of its history, its efforts in promoting equine sports, its community involvement and its charitable giving. Together, The Pin Oak Charity Horse Show and Texas Childrens Hospital helped shape the landscape of the Texas Medical Center, and thus the city of Houston, more than 50 years ago. In recent years, Pin Oak has grown to a strong position that heralds even further growth, says Mark A. Wallace, Texas Childrens president and chief executive officer. We are equally grateful to benefit from Pin Oaks growth and proud to have Pin Oak as a partner in ours. Another reason we want to continue to support Texas Childrens is that most of us are mothers with children and we very much understand what it means to Houston and Texas to have this great hospital here, Walsh adds. And the new hospital is going to be much closer for so many of our riders and families!
I M P O R T A N T
D E V E L O P M E N T S
On The Scene
Frasers Friends launch another year of support
From left, Shannon and Mark A. Wallace, president and CEO of Texas Childrens Hospital; Terri, Prentiss and John Havens; and Helen and Charles D. Fraser, Jr., M.D., chief of congenital heart surgery at Texas Childrens, were among the crowd of nearly 400 who gathered at the Havenses historic home for the second annual Frasers Friends event in April. At the event, the Havenses shared the story of how their son Prentiss was born with a congenital heart defect, Tetralogy of Fallot, and how Fraser and his team repaired his tiny heart to save his life. The 2008 Frasers Friends event has helped raise more than $450,000 to advance the priorities of the Texas Childrens congenital heart surgery team. Mark A. Wallace, president and CEO of Texas Childrens, joins event emcees Shara Fryer, KTRK news anchor, and Nancy Ames, owner and founder of Ward & Ames Special Events.
Celebrating Dr. Denton Cooleya world-renowned Texas Legend
On February 26, Texas Childrens hosted its fourth annual An Evening with a Texas Legend, presented by Wachovia and honoring medical legend Denton A. Cooley, M.D. (right). More than 600 guests gathered at Hilton Americas-Houston to hear CNN host Larry King (left) interview Cooley about his life and many pioneering accomplishments. The event, chaired by Janet and Tom Walker, raised almost $450,000 for Texas Childrens Cancer Center. Meg Goodman and Mike Bonini graciously hosted a reception in their home several nights before the event to honor the top underwriters and sponsors. Cancer Center patient Sabrina Hunter, 3, gets entertained by Lori Vetters, regional president of the Gulf Coast region at Wachovia, and Legend honoree Denton A. Cooley, M.D.
Davids dream lives on
Right, Event Chair Janet Walker with Underwriter Chair Emily Crosswell.
Nearly 1,000 children and adults ran in the 10th annual Davids Dream Run in May 2008, put on by David Elementary School PTO in The Woodlands. The school and the run are named after David Vetter, the Bubble Boy, who was born with severe combined immune deficiency (SCID). This years run raised more than $20,000 for Texas Childrensbringing the schools total giving to the hospital to more than $270,000. Recently, Davids family including (from left) his nephew Cameron David Canion, sister Katherine Canion and mother Carol Ann Demaret gathered at Texas Childrens with Lee Allen, principal of David Elementary School, and Davids Dream Run volunteers Sandra Fuentes and Michelle Barrell to celebrate the unveiling of the commemorative wall for the David Center for allergy and immunology.
Wal-Mart continues to rally For the second year in a row, Wal-Mart achieved its goal of for Childrens Miracle Network raising $10 million for Childrens Miracle Network nationwidethis time, in just eight weeks. Stores in the greater Houston area raised $264,340 during the campaignall going to support Texas Childrens Hospital.
Top left, Wal-Mart Supercenter #2993 in Sugar Land hosted a kickoff for the national fundraising effort, where store manager Jesse Thompson (left) and Kevin Kline, morning show DJ on The New 93Q (right, pushing cart), helped Texas Childrens patient Mary Jo Stavinoha, 8, select $1,000 worth of donated toys and craft supplies to give to patients at the hospital. Right, Wal-Mart Distribution 7010 employees including (from left) Wendy Bowan, training manager, Rick Johnson, transportation manager, and Adam Gilliam, human resources manager, helped host the third annual Childrens Miracle Network Golf Tournament and raised more than $10,000 to help Texas Childrens patients and families like Norma Dean (far right) and her daughter, Rylee (center). Bottom left, Last year, Wal-Mart Supercenter #400 in Conroe was the top fundraising store in the Houston market, collecting more than $20,900 for Childrens Miracle Network thanks to the efforts of associates like (from left) Susan McDowell, Marie Thurmon and Cheryl Garrett.
On The Scene
Carousel rounds up support for pediatric cancer
In April, Carousel, Young Friends of Texas Childrens Cancer Center, hosted more than 650 guests, including (from left) David Poplack, M.D., director of Texas Childrens Cancer Center; Audry Black, and her mother and event committee co-chair, Kim; Maggie Stacy, event chairman, and her husband, Will, for the Give a Hand to Raising the Roof family fun event at the Houston Zoo. The event grossed more than $200,000 for Texas Childrens Cancer Center, and participating families had the chance to finger-paint on ceiling tiles to help decorate the roofs of Cancer Center patient rooms at the hospital.
Randalls shows its kindness for kids

By donating $1 at a time, Randalls customers and associates helped raise $84,863 for the pediatric gene research program at Texas Childrens Cancer Center through the 2008 Kindness for Kids campaign, in partnership with the Houston Chronicle. The Clear Lake store alone raised $6,406the most of all the local Randalls stores. At the official check presentation, (from left) Jack Sweeny, president and publisher of the Houston Chronicle, Ralph D. Feigin, M.D., Texas Childrens physician-in-chief, Tom Schwilke, Randalls president, and ZoAnn Dreyer, M.D., director of the Cancer Centers long-term survivor program, congratulated Randalls Clear Lake store employees David LaCour, store director, Sandy Crowder, customer service supervisor, and Byron Myers, assistant store director, on their incredible success and generosity.
Thetas show support for pediatric faculty training

In Spring 2008, the Theta Charity Antiques Show of the Houston Alumnae of Kappa Alpha Theta donated $196,935 to permanently endow the annual lecture series they established at Texas Childrens, now named The Donald J. Fernbach, M.D., Endowed Lecture Series, presented by the Houston Alumnae of Kappa Alpha Theta. Recently, Theta alumni (from left) Carol Herder, president, Liz Rigney, philanthropic committee chair, and Janet Lionberger, 2007 Theta Charity Antiques Show chair, joined lecture namesake Fernbach and David D. Poplack, M.D., director of Texas Childrens Cancer Center, to unveil a special plaque at the hospital honoring the Theta Charity Antiques Show.
Kroger miracle balloons rise to the top

This summer, all 98 greater Houston area Kroger Food Stores participated in the companys Childrens Miracle Network miracle balloon campaign. Thanks to the efforts of many employeeslike District Manager Jeff Roberson (back row, center) and his District 2 store representativesKroger raised more than $100,000 for Texas Childrens Hospital. Roberson and his team visited the hospital prior to the campaign, gaining inspiration from seeing firsthand where the money they help raise goes.
HJWC celebrates 40 years of dedication to children

This spring, Houston Junior Womans Club members and guests, including (from left) Dianne Demny and Brenda Werner, 2007 fundraising chairs; Debbie Bauer, 2007 HJWC president; and Nancy Shomette, 2008 HJWC president, celebrated their 40th anniversary at the annual Donations Coffee. The event was a celebration of HJWCs longtime dedication to children and successful fundraising in 2007. Thanks to funds raised through HJWCs 24th annual Holiday Photo by Alexanders Fine Portrait Design Happening, their first annual golf tournament and charitable fund contributions, the organization was able to award more than $254,000 to 17 Houston area childrens charities, including $72,645 to Texas Childrens Cancer Center.
PLANNED GIVING
GIVING TO A WORTHY CAUSE

BY KATHY ISDALE
Most people may not think to name Texas Childrens Hospital as the beneficiary of an IRA. After spending many hours at Texas Childrens with his granddaughter, Jackson O. Wilson did. Wilsons 9-year-old granddaughter, Emily Otto, was diagnosed with cystic fibrosis almost immediately after she was born and spent her first three months of life in Texas Childrens neonatal intensive care unit. Emilys been in and out of Texas Childrens ever since, Wilson says. Ive been up there with her numerous times and have seen the good work they do. It was an easy decision to support Texas Childrens. Wilson and his late wife, who had severe multiple sclerosis (MS), retired to Houston three years prior to her death in 2005. He recently remarried, and his wife, Marion, has become just as doting a grandmother to his grandchildren as she is to her own. Wilson says he has often stayed at the hospital with his lively granddaughter to give her mom a break. This is particularly helpful when Emily is hospitalized for her annual tune-up, that is, the yearly extended stay when she spends up to 10 days as an inpatient receiving intravenous antiviral treatment for chronic severe infection that most cystic fibrosis patients experience. I dont know that I would ever have really seen all the good work Texas Childrens does if I hadnt spent so much time there with Emily, he says. She knows everyone on the pulmonary floor and they know her, and her doctor is great; she and Emily have a very nice rapport. Emilys physician is Khoulood Fakhoury, pediatric pulmonologist in Texas Childrens Cystic Fibrosis Clinic and assistant professor of pediatrics at Baylor College of Medicine. As an accountant for over 30 years, including many years as a controller for Reynolds/Alcoa, Wilson knows the advantages of tax-deferred savings vehicles. My late wife and I both had Roth IRAs, he explains. After she died, I combined them and designated 50 percent of the combined IRAs to The Maxine Mesinger MS Clinic at Baylor College of Medicine and 50 percent to Texas Childrens cystic fibrosis research. As for the mechanics, it was easy to do online on my financial service providers Web site. Physician-scientists at Texas Childrens are on the leading edge of research into new therapies for cystic fibrosis, including developing more effective drugs as well as gene therapies that offer great hope for a cureadvancements made possible by gifts like Wilsons. You know, he adds, I like what Joe Jamail [Houston attorney renowned for his philanthropy] said: There are no vaults where Im headed, up or down. When you think of that, its easy to give to a worthy cause.
We invite you to include Texas Childrens Hospital in your estate/financial plan through your will, trust, charitable gift annuity, retirement plan, or life insurance policy. All gifts, no matter their size, are appreciated. When you notify us of your intentions to make a planned gift, you will be honored as a member of the J.S. and Lillie Abercrombie Society. Each Abercrombie Society member receives a gift of appreciation, invitations to a luncheon and other special events, and recognition in Texas Childrens publications. To learn more about creating an endowed fund or to confidentially discuss a charitable gift, please contact Geri Jacobs, ChFC, CLU, director of planned giving, at (832) 824-2718 or via e-mail at gxjacobs@texaschildrens.org.
G R A T E F U L
F A M I L Y
MAUREEN DIMARCO: GRATEFUL GRANDMOTHER

My daughter, Noelle Reed, was hospitalized this past March for almost four weeks while she was pregnant with triplets. She suffered from cholestasis and preeclampsia, and one of the babies was diagnosed with intrauterine growth restriction (IUGR), meaning she was small for her gestational age. As a result, Noelle was in great discomfort, and of course she was very anxious about keeping the pregnancy going long enough for the babies to survive and do well. We will never be able to say enough superlatives about her physician, Dr. Robert Carpenterhis skill and care (and his wicked sense of humor). His medical skill is certainly the main reason my daughter and her husband are now the very proud parents of three healthy babies who have had remarkably few difficulties other than simply needing to grow. But Im not writing just to praise Dr Carpenter; rather, I want to explain that the other critical part of this success story is the Texas Childrens nurses and staff who operate the Labor and Delivery Unit at St. Lukes. With no exceptions, every nurse and clerical staff member was phenomenal. And after four weeks I think we knew every single person there whether full-time or part-time. They are clearly the elite of the nursing corps and take pride in their skill and also in their ability to relate to each patient and truly make a difficult time as easy as possible. Their care was always delivered with warmth, patience and understanding of the physical and emotional stresses their patient was experiencing. We knew they would never compromise the quality of their care, but they were always willing to work with my Maureen DiMarco (center) with her daughter and daughter to make that care respectful and flexible if at all possible. son-in-law, Noelle and Eric Reed, and their triplets, When the time finally came for the babies to be delivered, the Jack, Cayden and Finley nurses and staff showed us yet again how professional, skilled and understanding they were. Things moved very fast, but each one of them explained what was being done, what would happen and maintained that upbeat and positive mood that was critical to my daughter, her husband and Grandma too. Once the babies were born, the special care needed by my daughter after the surgery was as superb as it had been before. And the nurses were as excited as we were about everything. There were a lot of hugs that night in the L&D Unit. I have seen some of the best and unfortunately some of the worst standards of medical care in my time ... but I have never seen the unique skills and personal traits that are clearly the standard at St. Lukes L&D Unit and Texas Childrens Hospital. We were very sad to leave each of them even though we were leaving for the best of reasons and with the best of results. We are eternally grateful for the superb care and compassion we experienced and will always feel the presence of Dr. Carpenter and the Texas Childrens L&D staff as we treasure these three precious new lives. With deepest gratitude, Maureen DiMarco
Tell us how Texas Childrens has made a difference in your life or in the life of your family. Send your story to: Texas Childrens Hospital 1919 S. Braeswood MC 4-4483 Houston, Texas 77030-4412 Attn: Shine magazine or via email to altabora@texaschildrens.org. Please include a phone number for verification.
CALENDAR
TEXAS CHILDRENS HOSPITAL EVENTS September 25, 2008
Celebration of Champions benefiting Texas Childrens Cancer Center Hilton Americas Houston
Texas Childrens Hospital 832-824-1000
COMMUNITY EVENTS BENEFITING TEXAS CHILDRENS September 20, 2008

Nicholas Alexander Higgins Memorial Golf Tournament benefiting Texas Childrens Heart Center Wildcat Golf Club
Development Office 832-824-2107 Texas Childrens Health Plan 1-800-990-8247 Texas Childrens Pediatric Associates Referral Line 832-824-7700 Texas Childrens Home Health Services 832-824-2400 Texas Childrens International 832-824-1138 Texas Childrens Health Centers 832-824-2868
October 14, 2008

The Bad Pants Open benefiting Texas Childrens Newborn Center Cypresswood Golf Club
September 25, 2008

Lewis Jewelers An Emerald Evening benefiting Texas Childrens Renal Dialysis Center Lewis Jewelers in Webster, Texas
November 18, 2008

Whats Up, Doc? benefiting Generation to Generation River Oaks Country Club
September - December 2008

Kris Browns Kick Club benefiting Texas Childrens Charity Care
Now online at www.shine.texaschildrens.org

For information on any of these events, please contact the Office of Development at 832-824-6818 or e-mail jsdumolt@texaschildrens.org.

Shine, A Publication of Texas Children's Hospital

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Shine, A Publication of Texas Children's Hospital

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Giving New Life Every Chance to Thrive

Food for Thought

A Gift to Heal Sick Children

MESSAGE FROM THE PRESIDENT AND CEO

JOSEPHINE E. ABERCROMBIE ALFRED C. GLASSELL, JR.

On the cover: Christopher and Jonathan Martinez

PROGRESS, PATIENTS AND PHILANTHROPY AT TEXAS CHILDRENS HOSPITAL

g .or at ns ne dre nli hil w o asc No e.tex hin w.s ww

AMBER LEWIS TABORA

PAUL VINCENT KUNTZ ALLEN KRAMER

DOUTHIT DESIGN GROUP

UPDATES @ TEXAS CHILDRENS ON THE SCENE PLANNED GIVING GRATEFUL FAMILY

Once again ranked among the nations best

Breaking new ground in West Houston

2 | TEXAS CHILDRENS HOSPITAL

FOR MORE NEWS, VISIT US ONLINE

TEXAS CHILDRENS HOSPITAL | 3

& fetal medicine

Elijah Graff with mother, Cynthia

Holding onto hope

www.texaschildrens.org TEXAS CHILDRENS HOSPITAL | 5

Making medical history

Macie is the perfect example of what

modern medicine is capable

Drs. Anthony Johnson and Kenneth Moise

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the way home

CHLOE AND KATE HARRISON

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the way home

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the term developmental origins of adult disease to explain the phenomena.

EATING FOR THE NEXT GENERATION

HISTORY RAISES IMPORTANT QUESTIONS

BUILDING HEALTHIER LIVES

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Dont exerciseyoull take blood away from your baby.

No morning sickness? Theres probably something wrong with your baby.

Rub cocoa butter on your belly to prevent stretch marks.

The Facts Behind the Fictions of Pregnancy

Dont eat sh.

But a full moon denitely triggers labor.

For more Facts & Fiction visit www.shine.texaschildrens.org.

Historic Gift to Help Heal Sick Children

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For Families Near and Far

Simmons Family Foundation gives $3 million to create collaborative research fund

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Fares family commits $250,000 to advance neurological research

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H-E-B Tournament of Champions gives $500,000 to congenital heart surgery

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Shaping the Future

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Celebrating Dr. Denton Cooleya world-renowned Texas Legend

Davids dream lives on

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Randalls shows its kindness for kids