CHOC cardiologist implants smallest pacemaker in pediatric patient

A CHOC Children’s Heart Institute cardiologist Dr. Anthony McCanta reached a major milestone in pediatric cardiac care when he joined an elite group of physicians in the world who have implanted the Micra® Transcatheter Pacing System (TPS). Dr. McCanta’s 12-year-old patient, who has Tetralogy of Fallot, is the smallest and youngest patient – quite possibly the only child – to receive the device.

Micra TPS

About the size of a vitamin, Micra TPS, which was approved by the Food and Drug Administration just last year, provides the most advanced pacing technology at one-tenth the size of a traditional pacemaker.  Unlike traditional pacemakers, the device does not require cardiac leads or a surgical “pocket” under the skin to deliver the pacing therapy.  Instead, the device is small enough to be delivered through a catheter and implanted directly into the heart.  This offers patients a safe alternative to conventional pacemakers without the complications associated with leads — all while being cosmetically invisible. “The Heart Institute offers many innovative therapies to treat children and young adults with heart rhythm abnormalities.  We are thrilled to now offer the Micra TPS,” says Dr. McCanta.

A former CHOC resident and pediatric cardiologist specializing in electrophysiology at Children’s Hospital & Medical Center, Omaha, Dr. Vincent Thomas praises his former colleague for his role in advancing care. “Having trained and worked with Dr. McCanta, it is no surprise to me that he is breaking new ground and striving for excellence,” he says. “Having access to this type of innovation benefits patients and families by providing creative solutions to challenging problems.”

Dr. Anthony McCanta, CHOC Children’s Cardiologist

The Micra TPS is designed to automatically adjust pacing therapy based on a patient’s activity level.  It also incorporates a retrieval feature, though the device is designed to be left in the body.  If a patient needs more than one heart device, the Micra TPS can be permanently turned off.  A new device can then be implanted without the risk of electrical interactions.

“The miniaturized, leadless pacemaker is an option for patients with structurally normal hearts and with congenital heart disease,” explains Dr. McCanta.  Not every patient is eligible; those with complex pacing needs require a more complex pacing system.  But, we would be happy to evaluate patients with pacemaker indications to determine if they could benefit from this new therapy.”

To schedule a consultation with Dr. McCanta, call 888-770-2462.

CHOC Children’s to host educational dinner about infantile spasms

Health care providers and family members are invited to learn about infantile spasms at an educational dinner hosted by CHOC Children’s on Oct. 25, 2016, at 6 p.m. – 8:30 p.m., on CHOC’s Orange campus (Harold Wade Education Center, 1201 W. La Veta Ave.)

Undiagnosed infantile spasms can develop into intractable epilepsy, a very common, but debilitating disorder. Each year, 150,000 children and adolescents in the country will have a single, unprovoked seizure, and 33 to 45 percent of these children will develop epilepsy. Infantile spasms are easy to miss for a pediatrician, as they can mimic common symptoms and conditions, such as sleep disturbances, gastroesophageal reflux, startle and shuddering attacks.

The onset for infantile spasm is usually between 4 to 8 months of life, and is characterized by clusters of flexion or extension of upper and lower extremities, occurring for five to 10 seconds every 10 to 20 minutes. Early recognition of this and other epilepsy syndromes is of critical importance in determining a treatment plan. The consequences of intractable epilepsy are multiple and can be very detrimental – including psychosocial and academic effects.

There is a four to six-week window of opportunity to treat infantile spasms most successfully. If infantile spasms are suspected, an urgent appointment with a board certified pediatric neurologist is recommended.

Evening Agenda

Following arrival and dinner, from 6-6:30 p.m., the following schedule is planned for the evening:

6:30-6:45 p.m.           Introduction and case presentation

6:45-7 p.m.                 What are infantile spasms and why the urgency to treat?

7-7:20 p.m.                 Treatment and management

7:20-7:40 p.m.           Latest research

7:40-8 p.m.                 Real stories from the O.C.

8-8:30 p.m.                 Q & A

Expected outcomes for attendees include:  recognizing the presentation of infantile spasms; knowing how to promptly and appropriately refer to a pediatric neurologist; and recalling current research endeavors about infantile spasms.

To register, visit https://infantilespasms.eventgrid.com/.

In the Spotlight: Rahul Bhola, M.D.

An internationally recognized pediatric ophthalmologist with expertise in strabismus, amblyopia, pediatric cataracts and glaucoma has joined CHOC Children’s. Dr. Rahul Bhola is the newest division chief of ophthalmology with CHOC Children’s Specialists.

“The biggest reason I was inspired to join CHOC was the mission of the hospital. I feel that CHOC’s mission to nurture, advance and protect the health and well-being of children is in close alignment with my personal goals as a physician,” Bhola says. “I seek to nurture the health care of children by delivering state-of-the-art ophthalmology care to our community. CHOC has the resources, reputation and experience to provide excellent care.”

Dr. Bhola comes from a family of physicians. His parents practiced internal medicine for more than 40 years in India, and the empathetic and holistic care they provided to their patients inspired him to pursue a career in medicine.

Dr. Rahul Bhola
Dr. Rahul Bhola is the newest division chief of ophthalmology with CHOC Children’s Specialists.

“Very early on in medical school, I developed a special interest in pediatrics, and the surgical finesse of ophthalmology later cemented my passion for pediatric ophthalmology. The gift of vision is the most important sense a child can have,” Dr. Bhola says. “Giving a ray of light to those who struggle with vision is very gratifying to me. Treating children is important to me because they have their entire lives ahead of them, and improving their vision positively impacts their entire family.”

Dr. Bhola attended medical school and completed an internship at University College of Medical Sciences in Delhi, India. He completed two residencies in ophthalmology at Maulana Azad Medical College in New Delhi, India and the University of Louisville, Kentucky. He pursued fellowships in pediatric ophthalmology at the Jules Stein Eye Institute at the University of California Los Angeles and the University of Iowa.

Dr. Bhola has received numerous awards both nationally and internationally and has extensively published in peer-reviewed journals. He has participated as an investigator in many NIH-sponsored trials and has been named to the “Best Doctors in America” and “America’s Top Ophthalmologists” lists consecutively for many years. Dr. Bhola recently started studying the ocular effect of excessive smart device usage in children. His research includes tear film composition in children who are consistently overexposed to smart devices, thereby establishing a link between dry eyes in children and excessive smart device usage.

At CHOC, Dr. Bhola will provide comprehensive eye care, treating patients with a variety of eye diseases and disorders. In addition to treating refractive errors (the need for glasses), Dr. Bhola will provide more specialized care for diseases like amblyopia (lazy eyes), pediatric and adult strabismus (crossing or drifting of eyes), blocked tear duct, diplopia (double vision), pediatric cataracts, pediatric glaucoma, tearing eyes, retinopathy of prematurity, ptosis (droopy eyelids), traumatic eye injuries and uveitis.

Dr. Bhola is among the very few surgeons nationally skilled in treating pediatric glaucoma surgically using the illuminated microcatheter. This highly-specialized, minimally-invasive approach of canaloplasty has been used for treating pediatric glaucoma only within the last few years. Childhood glaucoma, though uncommon, can be a blinding disease causing severe visual impairment if not detected early and treated promptly. The onset of juvenile glaucoma often occurs between the ages of 10 and 20 and can be multifactorial. Glaucoma in pediatric population can also be secondary to trauma occurring from any form of injury including sports injuries.

As a Level II pediatric trauma center, and the only one in Orange County dedicated exclusively for kids, CHOC’s trauma team treats a variety of critically injured children from across the region. This includes children who have sustained sports injuries, during which damage to the structure of the eye can cause glaucoma.

Dr. Bhola is very passionate about educating primary care physicians on the need for regular pediatric vision screenings. For example, children complaining of headaches may be taken to a neurologist. However, eye problems such as refractive errors, convergence insufficiency and strabismus can result in headache from excessive straining of the eyes, which may affect school performance and even social withdrawal in some children. These conditions are likely to be identified at regular vision screenings.

Dr. Bhola’s philosophy of care is to treat his patients as if they were his own children.

“My main philosophy is to deliver patient-centered care with compassion and excellence. I remember their life events and celebrate their achievements with them. It’s important that a patient remembers you in order to start to build trust with them. I love when my patients send me holiday cards and copies of their school photos and let me know how they are doing. They became part of my family. I always treat every patient like they are my own child,” Bhola says.

He also focuses on treating the whole person rather than the disease, and involving patients in their care.

“I don’t treat the disease, I treat the individual. Healing is more than treating the disease. I want to be at their level so I always talk to them directly and not only talk to their parents. I involve their entire group during treatment,” he says.

At CHOC, Dr. Bhola is eager to provide holistic eye care for his patients.

“My practice will offer complete comprehensive vision care to all patients, which includes both medical as well as surgical care. Our patients come to us for glasses, contacts, regular ocular screenings, and we also provide more specialized care like glaucoma, cataract and strabismus surgeries,” Bhola says. “A lot of systemic disorders such as diabetes, sickle cell anemia, juvenile rheumatic disease and lupus, have co-occurring eye issues that may go undetected if children aren’t seen for regular eye screenings. CHOC patients with systemic disorders such as diabetes now have better access to holistic care.”

As division chief for CHOC Children’s Specialists ophthalmology, Dr. Bhola is passionate about providing state-of-the-art care to patients and training the next generation of pediatric ophthalmologists.

My main goal is to build a leading ophthalmology division, not only delivering excellent patient care but also engaging in cutting-edge research and disseminating education to the next generation of ophthalmologists and referring providers,” Bhola says.

When not treating patients, Dr. Bhola enjoys cooking, practicing yoga and meditation, and spending time with his wife and two daughters.

To contact Dr. Bhola or refer a patient, please call 888-770-2462.

Learn more about ophthalmology at CHOC Children’s.

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CHOC Emergency Department Honored for Exceptional Practice and Innovative Performance

The Julia and George Argyros Emergency Department at CHOC Children’s Hospital is one of only three emergency departments in California — and 22 in the country — to be named a 2017 Lantern Award recipient from the Emergency Nurses Association.

The honor recognizes emergency departments across the nation for demonstrating excellence and innovation in leadership, practice, education, advocacy and research.

Recipients of the award went through a rigorous application process, during which they had to provide outcome metrics, as well as descriptive examples that highlighted the following:

  • Practice – qualities that foster professional pride, confidence and a community of support for emergency nurses
  • Leadership – operational improvement initiatives, including new systems and processes that positively impact department operations
  • Education – quality and accessible education that instills knowledge and enhances competencies
  • Advocacy – efforts that enhance the emergency nursing profession and quality patient care
  • Research – quality improvement research and the evaluation of clinical outcomes

“Our team is dedicated to providing safe, quality care based on evidence-based practices.  We are honored to have our commitment recognized by the Emergency Nurses Association, and will continue to push ourselves to provide the best possible emergency medicine and trauma services to the children and families who depend on us,” says Frank Maas, RN, BSN, MBA, director of the CHOC ED.

The 22,000-square-foot, full-service CHOC ED is exclusively dedicated to the treatment of pediatric patients.  It features 31 treatment rooms, including several rapid evaluation and discharge rooms and three triage suites.

The department will be presented with its Lantern Award at the Emergency Nursing Conference 2017 in St. Louis, Missouri later this summer.

The Lantern Award honors the legacy of Florence Nightingale, referred to as the “Lady of the Lamp” for her actions during the Crimean War.  Working throughout the night, she would bring a lantern to help her see and tend to the wounded soldiers.  She is credited with changing nursing from an untrained job to a skilled, science-based profession.

 

Veteran Nurse to Help Lead CHOC Mental Health Inpatient Center

After spending time with a relative with a mental illness, Dani Milliken knew as early as age 6 that she wanted to help people who struggle with mental illness when she grew up.

“From that point on, I dreamed of working as a psychiatric nurse,” Dani says. “I am so fortunate that I get to come to work every day and love what I do. My passion in life is psychiatric nursing; it always has been and it always will be.”

Dani will put that passion – as well as a wealth of experience in establishing a pediatric inpatient mental health unit – to good use as clinical director of the CHOC Children’s Mental Health Inpatient Center, set to open next spring.

“The community is in need, and CHOC is stepping up to the plate in a big way,” she says. “I have been impressed with everyone’s commitment to developing a safe environment that patients, families and staff feel proud of.”

Before joining CHOC in June, Dani helped design and operationalize a pediatric inpatient mental health unit at Nationwide Children’s Hospital in Columbus, Ohio. Previously, she spent four years at Twin Valley Behavioral Healthcare, a state-owned and -operated inpatient psychiatric hospital in Ohio. There for four years, she served in a variety of roles, most recently as assistant director of nursing.

Dani hopes her work at CHOC will set the standard of care for psychiatric nursing across the country, as well as help remove a stigma that persists around patients with mental illness and the clinicians who treat them.

“Unfortunately, there can be incredible amounts of stigma surrounding not only the patients on an inpatient psychiatric unit, but also the staff that works there,” she says. “I look forward to teaching everyone about quality psychiatric treatment, and what it means to be a real psychiatric nurse.”

Dani earned her bachelor’s degree in nursing from Mount Carmel College of Nursing, and went on to receive her master’s degree in nursing administration. She is currently working toward a doctorate in health care administration.

Though much of her free time is spent getting settled in Orange County after a cross-country move, Dani looks forward to hiking and biking with her husband and dog, as well as quilting and sewing.

In her short time at CHOC, Dani already has been impressed with the culture of collaboration, accountability and respect.

“I am inspired at the amount of teamwork, collaboration and respect that I have encountered during meetings with various disciplines,” she says. “All of these things speak loudly about the level of quality care being delivered to patients here at CHOC. I am thrilled to be a part of this amazing team!”

Upon its opening, CHOC Children’s Mental Health Inpatient Center will be the first pediatric inpatient mental health center in Orange County to accommodate children younger than 12.

With 18 private rooms in a secure and healing environment, the center will provide a safe, nurturing place for children ages 3 to 18, and specialty programming for children younger than 12.

The center is the cornerstone of CHOC’s efforts to create a pediatric system of care for children, teens and young adults in Orange County with mental illness. One in five children – about 150,000 in Orange County – will experience a diagnosable mental health problem.

Learn more about CHOC’s efforts to help children with mental illness.