September is National Sickle Cell Month

Sickle cell disease is an inherited disorder wherein the red blood cells are misshapen, and can lead to painful episodes and even hospitalization.  The disorder is usually diagnosed at birth during newborn screening tests.

In honor of National Sickle Cell Month, we spoke to Dr. Geetha Puthenveetil, a pediatric hematologist and director of blood and donor services at CHOC Children’s, about the multidisciplinary care and other resources available to sickle cell patients at CHOC.

CHOC Children's

Q: How do patients with sickle cell benefit from CHOC’s comprehensive red cell clinic?

A: I started this clinic for patients with a number of red cell disorders—including sickle cell disease, thalassemia, aplastic anemia, and Diamond-Blackfan Anemia. The clinic is attended by a cardiologist, endocrinologist, and hematologist and provides comprehensive care for patients.

Our multidisciplinary clinic offers continuity of care and expedited service for patients and families that they don’t find elsewhere. Since their entire care team is in one place, families can get more immediate answers to their questions. All members of the team are involved in creating the care plan for how best to treat each patient.

Q: What should parents know about the hematology program at CHOC?

A: Along with other centers, we are a part of a growing number of clinical trials to decrease pain crises in patients with sickle cell, and their amount and length of hospitalizations. We are also part of international study looking at standards of patient care.

Patients can also benefit from neuropsychology evaluations. Our pediatric neuropsychologist is specially trained in working with patient with sickle cell disease, and can help evaluate if their medic al condition is affecting their cognitive functioning, and lay the groundwork for treatment.

We also offer a support group for families of patients with sickle cell. Families who are new to their diagnosis or our program have the opportunity to be mentored by more experienced families who can relate to what they’re going through. This group is open to all caregivers of our patients, from teachers and principals to babysitters and day care operators, who are interested in learning more about sickle cell, and what they can do to offer better care.

Q:  What aspect of pediatric hematology/oncology are you most passionate about?

A: No two patients are alike. Each and every sickle cell patient has their own challenges and battles, and each requires a unique strategy. As a hematologist/oncologist, you need to constantly think outside the box.

Despite all the health challenges my patients are facing, they always keep me laughing. In pediatrics, you’re not just treating the child, but the whole family. It adds to the challenge of providing care, but it’s essential to engage their entire environment in order to create the best outcomes for them.

Q: What impact do blood donors have on patients with sickle cell?

A: Blood donors are of utmost importance, and they are crucial for patients with sickle cell disease. Sickle cells have a shorter life span than normally-shaped cells, which can lead to anemia, or a low red blood cell count. Our patients depend on the generosity of blood donors.

Patients with sickle cell can develop antibodies after their great number of transfusions, so our team is focusing on red blood cell genotyping, so we will be able to more closely match them to specific and regular blood donors. Our ultimate goal is having patients develop fewer antibodies because they’d be better matched with their donor at a gene level.

To contact Dr. Geetha Puthenveetil, please call 714-509-8459. 

Meet Dr. Hoang “Wayne” Nguyen

CHOC Children’s wants its referring physicians to get to know its specialists. Today, meet Dr. Hoang “Wayne” Nguyen, a child and adolescent psychiatrist.

CHOC Children's

Q: What is your education and training?

A: I received a Bachelor in Computer Science with a minor in Electrical Engineering and Technical Writing from Texas A&M University.  I completed Medical School at Texas A&M Health Sciences Center and did a Psychiatry Internship at University of California, Irvine.  My residency in Adult Psychiatry, Child and Adolescent Psychiatry, and Pediatrics was done at University of Utah Health Science Center.

Q: What are your administrative appointments?

A: Director of Psychiatry, Chair of the Physician Well-being Committee

Q: What are your special clinical interests?
A: Psychosomatic medicine including eating disorders, psycho-oncology, tic disorders, and Autism spectrum disorder and intellectual disability.

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

A: Sixteen years.

Q: What are some new programs or developments within your specialty?
A: Our most exciting program is the building of an inpatient child and adolescent mental health unit. We are also involved in integrating psychiatric care and mental health in various outpatient specialty clinics.   We are also a provider for county Medi-Cal program for patients with co-occurring medical illnesses and psychiatric disorders

Q: What are your most common diagnoses?
A: Anxiety, depression, ADHD

Q: What would you most like community/referring providers to know about you or your division at CHOC?
A: We are in the beginning stage of building capacity to see more outpatients.

Q:  What inspires you most about the care being delivered here at CHOC?
A: It’s comprehensive and we are always striving to do better.

Q: Why did you decide to become a doctor?
A: At the age of 19 and having graduated from college, I was working as a software engineer at a startup, and there was a realization that there was more to life than what I was doing.

Q: If you weren’t a physician, what would you be and why?
A:  Ideally, a rock and roll star, but most likely a software entrepreneur because I like to create new solutions

Q: What are your hobbies/interests outside of work?
A: I enjoy being with my five children and participating in their activities.  I’m also very active in practicing my faith.  In my spare time, I enjoy outdoor activities and playing tennis.

Ryan Hansen Named Director, CHOC Children’s Heart Institute

Following a nationwide search, Ryan Hansen has been named director of the CHOC Children’s Heart Institute. In his new role, Ryan will work closely with hospital and physician leaders to advance strategies designed to make the Heart Institute a leading destination for pediatric and adolescent cardiovascular care.

“CHOC is clearly an organization on the rise with a talented medical staff, engaged employees and a very supportive executive leadership team dedicated to the hospital’s mission and vision. I look forward to bolstering CHOC’s excellent cardiovascular services, including embracing innovation and new technologies to better serve the children and families in our community and beyond,” said Ryan.

Ryan joins CHOC from Texas-based Memorial Hermann Health System, where he served as director, hospital operations, Heart & Vascular Institute.  During his six-year tenure there, he launched the Advanced Heart Failure, Heart Transplant and Lung Transplant Program, which has become the second largest transplant program in Texas and 13th largest in the nation.  Under Ryan’s leadership, the program developed into the top implanting center in Texas for transcatheter aortic valve replacements (TAVR) and total artificial hearts (TAH), while maintaining quality with clinical outcomes superior to national averages.  Additionally, Ryan was instrumental with the construction of the flagship, multidisciplinary advanced heart failure clinic and network of five cardiology clinics.

Prior to Memorial Hermann Health System, Ryan was the administrative director for the division of cardiology and heart failure at Baylor College of Medicine in the Texas Medical Center with responsibilities for the academic, research and clinical missions.  Ryan also served as a project manager in the institution with a focus on physician revenue cycle optimization and new EMR implementation.  He bridged the practice of medicine and the business of medicine to increase practice profitability and efficiency for the college.

After earning his bachelor’s degree in biology from The University of Texas at Austin, Ryan completed the dual master’s degree program (MBA/MHA) at University of Houston Clear Lake.  He currently resides in south Orange County with his wife and three young children.

“I am very excited to be in Southern California and to have the opportunity to partner with CHOC’s talented and highly-skilled medical staff to advance education, research and evidence-based medicine practices for the Heart Institute.  In addition to playing a vital role in preventive cardiology and improving the cardiovascular health of Orange County children, CHOC will be the healthcare provider of choice for advanced cardiac therapies,” stated Ryan.

Ryan can be reached at

CHOC Children’s Expands Fetal Cardiology Program

Approximately 1 percent, or 40,000, babies in the United States are born with a congenital heart disease each year. That’s almost 5,000 babies in California alone. In order to catch problems as early as possible, fetal cardiology specialists at the CHOC Children’s Heart Institute work with pregnant women to evaluate, diagnose and manage babies in utero who may be at risk for congenital heart defects, heart failure or rhythm disturbances.

CHOC offers the only comprehensive fetal cardiology services in Orange County, and our team has advanced training in fetal echocardiography, fetal magnetic resonance imaging, electrophysiology and genetics.

“Fetal echocardiography is a powerful tool that helps identify significant abnormalities and allows for family, delivery and interventional planning as necessary,” says Wyman Lai, MD, who recently joined CHOC from Columbia University in New York to lead CHOC’s non-invasive cardiac imaging program.

Fetal cardiac imaging is performed using ultrasound machines with the highest resolution imaging available, including 2D and Doppler analysis, as well as 3D technology. This allows us to perform first trimester screening so that patients can be referred at the earliest stages of pregnancy.

CHOC board-certified cardiologists perform fetal echocardiograms in their offices to help detect heart abnormalities before birth. At the time of appointment, patients receive a comprehensive diagnosis and care plan. Depending on the child’s condition, referrals to other experts, such as cardiac interventionalistscardiac electrophysiologistscardiac surgeons and heart failure specialists will be provided as needed. Early intervention improves the chance of survival after delivery for babies with severe defects.

Who Should Have a Fetal Echocardiogram

Pregnancies may be at risk for congenital heart disease for a variety of reasons.

Fetal risk factors include:

  • An abnormal appearing heart
  • Abnormal heart rate or arrhythmia on routine screening ultrasound
  • Aneuploidy (chromosomal abnormality)
  • Increased nuchal translucency thickness at first trimester evaluation
  • Noncardiac fetal structural abnormalities
  • A two-vessel umbilical cord
  • Identical twins
  • Fluid accumulation in the fetus.

Maternal risk factors include:

  • Maternal diabetes, lupus or other systemic disease that involves the heart
  • First-trimester use of known teratogens
  • Assisted reproduction technology
  • Maternal congenital heart disease.

Familial risk factors include:

  • A history of a previous child being born with a heart defect
  • The father being born with a heart defect
  • Other close relatives being born with heart defects or syndromes known to involve the heart.

Fetal Cardiology Referrals

If a pregnant woman is at high risk for delivering a child with congenital heart disease, our fetal cardiology specialists are available for consultation and referral. They can be reached at 714-509-3939, or you can find a fetal cardiologist here in our directory.

Dr. Mary Zupanc joins national pediatric neurology board of directors

A CHOC Children’s neurologist has been elected to the board of directors of a national pediatric neurology organization.

Dr. Mary Zupanc, Division Chief of pediatric  neurology at CHOC and director of the pediatric comprehensive epilepsy program, has been named councillor of the west for the Child Neurology Society, a nonprofit professional association of pediatric neurologists in the United States, Canada and worldwide.

CHOC Children's

“I’m thrilled for an opportunity to expand my work of advocacy for children with neurologic conditions at CHOC to a global level,” Dr. Zupanc said.

She begins her term in October 2016 at the organization’s annual meeting in Vancouver, Canada. The Child Neurology Society’s board of directors comprises councillors of the east, Midwest and west; a president; a past-president; and a secretary-treasurer.

“The Child Neurology Society is fortunate to be able to draw on such a deep pool of bright, capable, community-oriented leaders willing to offer their time and talent to help shape the future of child neurology through the Child Neurology Society,” the group said in its announcement.