In the Spotlight: Amber Leis, M.D.

Since joining CHOC’s plastic surgery divison two years ago, Dr. Amber Leis and an expert multidisciplinary team at CHOC have developed a one-of-a-kind brachial plexus surgery program for children in the region and beyond. She is also working with her team to continue to expand services for children with facial paralysis, cerebral palsy and complex wounds.

A board-certified plastic and reconstructive surgeon, Dr. Leis treats everything from brachial plexus birth palsy, trigger thumb, syndactyly, and thumb hypoplasia, to ganglion cysts.

“I love the challenge of these cases, especially pediatric congenital hand anomalies, and I cherish the long-term relationship I build with patients,” she says.

Additionally, Dr. Leis is working on several research projects tied to brachial plexus reconstruction.

“One of these projects aims to gain consensus from experts around the globe regarding the management of specific nerve injury patterns. I spent some time in Toronto and Taipei this past year as part of this project. I am also working closely with our therapists to understand the way different rehabilitation techniques improve our outcomes,” she explains.

Dr. Leis’s interest in surgery dates back to her college years. “When I was in college I went to work in a hospital in Zimbabwe for four months to do research. While there, I ended up assisting in surgery. It changed my life, and I have been passionately pursuing surgery ever since.  My parents were both artists, and I think surgery brought my life into harmony: being from an artistic home, and being a good scientist,” she says.

Dr. Leis attended medical school at Johns Hopkins University School of Medicine. She completed her residency in plastic surgery at Loma Linda University Medical Center, and a fellowship in orthopedic hand surgery at University of Southern California Keck School of Medicine.

Today, Dr. Leis’s philosophy for caring for her patients is compassionate and straightforward. She puts the emotional well-being of her patients first. Her highest priority is that they feel cared for and healed, she explains.

“My patients have such a deep strength to them. They allow me into their lives and let me be part of their healing journey. They have taught me about compassion, love, and the capacity to overcome,” she says.

Dr. Leis is a member of the American Association for Hand Surgery and the American Society of Plastic Surgeons, among other professional organizations. She has presented at many conferences throughout the country and published in various publications, such as the Annals of Plastic Surgery and Aesthetic Surgery Journal.

When she is not taking care of patients at CHOC or UC Irvine Medical Center, Dr. Leis loves spending time with her husband, a filmmaker. Together, they hike, travel and dabble in photography. She also enjoys running, drawing and baking.

Learn more about plastic surgery services at CHOC.

CHOC Children’s to Participate in Children’s Hospitals Neonatal Consortium

The opportunity to collaborate on research and quality improvement initiatives with neonatal intensive care programs at the nation’s top children’s hospitals is a key benefit of CHOC Children’s membership in the Children’s Hospitals Neonatal Consortium (CHNC).  Dedicated to optimizing neonatal care, the CHNC is led by neonatologists, fellows, nurses, respiratory therapists and other NICU champions for quality and patient safety.  In addition to being pediatric tertiary referral centers, members must have level IV NICUs with a minimum of 25 beds and annual admissions greater than 400, of which at least half come from out-born deliveries.

The Children’s Hospitals Neonatal Database (CHND) serves as the platform for the consortium’s quality improvement efforts and benchmarking research.  As of July 2016, the database covered more than:

  • 108,000 patients
  • 120,000 admissions
  • 6 million patient days
  • 78,000 surgical procedures
Dr. Michel Mikhael, CHOC neonatologist

“CHND is not your typical NICU database,” explains Dr. Michel Mikhael, a neonatologist who will serve as the consortium’s physician sponsor on behalf of CHOC.  “NICU patients at children’s hospitals are different from those treated at perinatal NICUs.  Many of our patients have pre-existing diagnoses or complications and are at a higher risk of poor outcomes.  Even though our patient population has the highest resource utilization, we – as a collective group – do not have much shared data.”

The database will help members

  • identify variations in diagnoses and outcomes
  • improve care in specialized populations
  • provide better information for families
  • provide guidance for local, state and national mandates
  • ensure appropriate reimbursement by improved, detailed documentation

CHOC will begin submitting data in April 2017, says Dr. Mikhael, who is already preparing for a strong CHOC presence at CHNC’s annual meeting in October, with small baby unit, surgical NICU and other quality improvement and research projects presented. The ultimate goal will be for CHOC’s neonatology team to contribute and participate in multicenter research projects and publications.

For more information about CHOC’s role in CHNC and its participation in the consortium’s database, contact Dr. Michel Mikhael at mmikhael@choc.org.

Patients Say the Darndest Things – Happy Doctor’s Day!

In celebration of Doctor’s Day, we asked a few of our physicians what’s the funniest thing a patient has ever told you?

Dr. Mary Jane Piroutek

Dr. Mary Jane Piroutek, emergency medicine specialist

Q: What’s the funniest thing a patient has ever told you?

A:  Kids say funny things all the time. One of my favorites was a little 4 -year-old girl who had ingested coins and they were stuck in her esophagus. When I asked her what happened she shrugged her shoulder and with a mischievous look in her eyes said, “I ate the money, I’m not supposed to eat the money.”  Also recently a patient told me I looked like Snow White (which I don’t) and she called me Dr. Snow White the whole time I took care of her.

 

Dr. Gary Goodman

Dr. Gary Goodman, medical director, pediatric intensive care unit, CHOC Children’s at Mission Hospital

Q: What’s the funniest thing a patient has ever told you?

A: Just recently, I had a patient, who has a mild developmental delay, call me “the boy.”  I would stop in the patient’s room each morning, at which point I’d get asked, “What do YOU want?”

 

Dr. Kenneth Kwon

Dr. Kenneth Kwon, emergency medicine specialist

Q: What’s the funniest thing a patient has ever told you?

A: An adage in pediatric emergency care is when a child comes in with a nosebleed, you don’t ask if he picks his nose, you ask him which finger he uses. When I asked this question to one of my pint-sized patients, he answered that he used all of them, and then proceeded to demonstrate by sticking each of his 10 fingers in his nose individually. It was priceless.

 

Dr. Maryam Gholizadeh

Dr. Maryam Gholizadeh, general and thoracic surgeon

Q: What’s the funniest thing a patient has ever told you?

A: There was a young child around 8-9 years old and we were going to remove his appendix with laparoscopy. I was standing on his left side because with laparoscopy we make our incision on the left side. Just before he went to sleep he looked up at me and said, “Why are you standing on my left? My appendix is on the right.” I was amazed at how knowledgeable this kid was!

 

Dr. Jennifer Ho

Dr. Jennifer Ho, hospitalist

Q: What’s the funniest thing a patient has ever told you?

A: “I want to be a doctor like you … but only for unicorns and fairies.”

 

Dr. Andrew Mower

Dr. Andrew Mower, neurologist

Q: What’s the funniest thing a patient has ever told you?

A: “I don’t eat apples, doctor.”

“Why?”

“Because they keep the doctor away, and I like you, Dr. Mower.”

 

Dr. Laura Totaro

Dr. Laura Totaro, hospitalist

Q: What’s the funniest thing a patient has ever told you?

A: I was examining the mouth of my patient when he proudly showed me his loose tooth and whispered to me that his family had a secret. He then excitedly admitted that his mom was the tooth fairy!  His mother looked at me quizzically and then burst out laughing when she realized what had taken place. Earlier she had admitted to him that she played the role of tooth fairy at home but her son took this quite literally and believed it to actually be her secret full time job for all children.

 

Dr. Mustafa Kabeer

Dr. Mustafa Kabeer, general and thoracic surgeon

Q: What’s the funniest thing a patient has ever told you?

A: A patient asked me what my first name was, and I told him it was Mustafa. He then promptly told me that was the name of his pet lizard!

 

Dr. Sharief Taraman

Dr. Sharief Taraman, neurology

Q: What’s the funniest thing a patient has ever told you?

A: One of my patients told me that I look like the character Flint Lockwood from Cloudy With A Chance of Meatballs and another one thinks I look like the character Linguini from the movie Ratatouille, both of which I found very funny.  Apparently, I give off the nerdy guy vibe.

5 Tips on Connecting with Your Pediatric Patients

In recognition of Child Life Month, we are highlighting the Cherese Mari Laulhere Child Life Department at CHOC Children’s, a critical partner to physicians and an essential part of the multidisciplinary team at CHOC ensuring the continuity of care.

We spoke to Brianne Ortiz, child life clinical educator, who shared the following ways in which physicians can better connect with their patients:

  1. Greet the patient first and let them know they are important to you. It’s natural to address the caregiver first, but ultimately you need the patient’s buy-in for compliance and a valued relationship with the family.  After introductions, explain your job in a way that your patient understands. If you are going to listen to your patient’s lungs, show her your stethoscope first.  Let the child touch it and have her practice taking big deep breaths.  Listen to the caregiver’s lungs first and then tell the child it is time to listen to her lungs.  Always tell a child what you are going to do before you approach the patient.  Language and delivery is powerful and giving basic and honest information in a non-threatening manner goes a long way.
  1. Do your homework. Patients will be more cooperative and trusting if you find something in common with them.  Ask non-medical questions to find out what makes them happy.  Be in touch with what various age groups enjoy right now (Mickey Mouse Clubhouse, Minecraft, the Lego Batman movie, Snapchat, Spotify, Taylor Swift and Shawn Mendes, for example). If your patient is more reserved, remember that communication is multifaceted; patients may warm up to you based on your facial expressions, tone of voice, if you’re eye level with them, if you’re friendly and keep them in involved in the exam or check-up.  You may not even speak the same language as your patient, but all children understand the language of play.  At the end of your appointment, take notes about what your patient enjoys, so when you see them again you have something to talk about and they’ll feel special because you remembered what is unique to them!
  1. Offer choices and utilize positioning for comfort. Even young children have preferences and like to feel included. When you are checking a patient’s tympanic temperature, ask the patient which ear she prefers.  The power to choose provides feelings of control and autonomy and allows the child to anticipate what is ahead.  Positioning for comfort helps children feel more secure and less vulnerable.  Sitting in an upright position is always more desirable than lying down.  If a child needs help holding still, ask the caregiver to assist the child during an invasive procedure.  If a patient can sit on her mother’s lap during an IV start, the child will have positive support from a person she trusts rather than a negative restraint from a stranger.  A sense of dignity and respect is earned when patients feel more comfortable and less helpless.
  1. Let your professional guard down. Take off your doctor cap for a few minutes and tell a silly joke, help build a Lego car, make pizza out of Play-Doh or have a lunchtime dance party.  This will foster a safe place for families and make you more approachable.  Your clinical expertise will be apparent by the medical treatment you provide; however, being relatable and understanding will convey a human connection.
  1. Less is more. Unfamiliar faces can be intimidating, so only allow for medical personnel who are absolutely necessary in the patient’s room during an exam. If an invasive procedure is scheduled, designate one person who has a calm tone of voice to speak to the patient. Several people speaking and giving directions at the same time may feel chaotic and can cause more anxiety for the child. Having age appropriate distraction items available can also help decrease anxiety. If you have a toddler who is afraid of the blood pressure cuff, ask her caregiver to blow bubbles while staff obtains her blood pressure. Nursery rhymes, counting and interactive toys with sounds and lights, work well for distracting young children. I Spy books, cell phone apps, belly breathing and conversation are better ways to engage older children during stressful situations.

 Learn more about the child life experts and services at CHOC.

Meet Dr. David Chang

CHOC Children’s wants its referring physicians to get to know its specialists. Today, meet Dr. David Chang, a pediatric otolaryngologist.

Q: What is your education and training?

A: I attended University of Michigan for undergraduate studies in chemical engineering. I then attended Case Western Reserve University School of Medicine, in Cleveland, for medical school and graduate school where I obtained a PhD in biomedical engineering. I completed my otolaryngology residency at Stanford University and a pediatric otolaryngology fellowship at Boston Children’s Hospital.

Q: What are your special clinical interests?

A: As a pediatric ear nose and throat specialist I love working with kids and managing the variety of ENT disorders affecting children.  I do have a special interest in treating kids with airway, breathing issues, and obstructive sleep apnea.

Q: What are your most common diagnoses?

A: Obstructive sleep apnea and recurrent ear infections.

Q: Are you working on any current research?

A: My background is in biomedical engineering and biomaterials.  My goal is to develop new technologies and devices that will improve the care of children.  We have several research pursuits in our division currently.  We are applying new imaging technology to the management of ear infections, obstructive sleep apnea, sinusitis, as well as cholesteatoma.

Q: How long have you been on staff at CHOC?

A: This is my first year at CHOC.

Q: What are some new programs or developments within your specialty at CHOC?

A: In our division, I’m leading two multidisciplinary clinical programs. Our aerodigestive clinic treats kids with airway and feeding issues. The sleep surgery clinic will open in the near future and will treat kids with persistent obstructive sleep apnea after initial tonsillectomy and adenoidectomy.

Q: What would you most like community/referring providers to know about you/your division at CHOC? 

A: Our pediatric otolaryngology group at CHOC is all fellowship trained and love caring for children. We work collaboratively to provide high quality, evidence-based care. We have expertise in the breadth of disorders in ENT and have established a multidisciplinary approach in our cochlear implant, thyroid, aerodigestive, vascular anomalies, cleft and craniofacial programs.  Our newest multidisciplinary program will be in sleep surgery.

Q: What inspires you most about the care being delivered here at CHOC? 

A: I’m inspired by CHOC’s dedication to continually improve patient care and safety. CHOC was named a 2016 Healthcare Information and Management Systems Society (HIMSS) Enterprise Davies Award recipient for achieving improvements in patient care through the use of health information technology.

Q: Why did you decide to become a pediatric otolaryngologist? 

A: I have always been interested in working with kids.  In medical school I enjoyed head and neck anatomy and surgical procedures which led me to an otolaryngology residency. My experience on the pediatric otolaryngology rotations confirmed my decision to focus on caring for children.

Q: If you weren’t a physician, what would you be and why?

A: I would either be a musician or a biomedical engineer. I grew up playing the violin, piano, and percussion and have always had a love for music. I would have wanted to be in percussion performance. As a biomedical engineer, I like to think of ways to apply engineering principles or biomaterials towards developing innovations to bring to patients.

Q: What are your hobbies/interests outside of work?

A: I love spending time with my wife and two daughters. I am thankful for their support and appreciative that my daughters make me laugh every day.  I also enjoy playing basketball and salsa dancing.