She was barely tall enough to reach the elevator buttons but she bounced on her tiptoes, stretched her tiny arm upward and pushed the first floor button for me in the parking garage. Her mom smiled and then turned a concerned face to the little one’s sister standing next to her with a surgical mask covering her mouth. I smiled at the sister as well and, while I couldn’t see her mouth, her eyes smiled back.
We reached the first floor and all of us went through the glass doors to Children’s Hospital of Michigan. We were greeted by brightly colored walls, lots of light and, a little further down the hall, a book shop and cafeteria. I smiled at the mom and her children as we parted company and I headed to the office of Dr. Steven Lipshultz, professor and chair of pediatrics at Wayne State University and pediatrician-in-chief at Children’s Hospital of Michigan in Detroit.
Children’s Hospital of Michigan is ranked among the Top 50 best in the country in eight pediatric specialties according to the U.S. News & World Report’s 2014-15 Best Children’s Hospitals report. It is nationally ranked in cancer, cardiology and heart surgery, nephrology (kidney disease), neurology and neurosurgery, neonatology (newborn critical care), pulmonology, urology and gastroenterology.
“Children’s builds programs and brick and mortar,” said Lipschultz.
Children’s Hospital is in the midst of constructing a six-story, 185,000-square-foot critical care patient tower. When finished in 2017 it will have an expanded neonatal and pediatric intensive care unit space, a new emergency department, new imaging equipment, larger operating rooms and advanced surgical equipment, and a patient-centered and lean architectural design. Its new design will cut the time it takes a child to get through the system by about 30 percent.
Children’s is also building a $42 million, 70,000-square-foot pediatric outpatient center in Troy that will bring specialized care and expertise closer to children and families in Oakland County and other nearby communities.
The five-level, $43 million Specialty Center opened in June 2012 and houses a pediatrics clinic, adolescent medicine, outpatient rehabilitation, specialty clinics and 200 physician office suites.
That’s the brick and mortar. The medical staff’s commitment, skill and research are responsible for the high ranking in the U.S. News & World report.
Lipshultz specializes in pediatric cardiology and is first and foremost a pediatrician with a passion for helping sick kids get better and go on to live healthy lives. That requires research, which often is done in partnership between Children’s and Wayne State University.
Three of his most recent data-driven research projects were how chemotherapy impacts the hearts of children later in life, the effect of energy drinks on kids and how anti-HIV medicines can cause damage to fetal hearts.
The research on how chemotherapy impacts the hearts of children later in life showed that more than 50% of patients exposed to anthracyclines during chemotherapy developed some form of cardiac dysfunction within 20 years and about 5% developed heart failure.
The study found that a drug called dexrazoxane can suppress the toxic effects of chemotherapy and recommended that it be available to children with high-risk cancers. The findings played a large role in the U.S. Food and Drug Administration’s (FDA) recent decision to award “Orphan Status” to the drug for the prevention of the heart muscle disease cardiomyopathy in children and adolescents 0 through 16 years of age treated with anthracyclines.
That designation is “extremely important,” Lipschultz said. It will help accelerate the process through which major pharmaceutical companies decide to seek FDA approval for and then the manufacture of the compound for the marketplace.
The study offers new hope to the approximately 12,000 American children diagnosed with cancer and treated with chemotherapy each year. About half of them receive chemotherapy that may eventually result in the development of significant heart problems that can lead to shortened lifespans and reduced quality of life.
“We’ve made terrific progress in the battle against childhood cancer during the past 40 years and the survival rate has more than doubled,” Lipshultz said. “But at the same time, we don’t want to be curing these kids of cancer only to see them develop heart problems because of their chemotherapy.
“This new study provides a perfect example of how research conducted at the bedside, in a clinical setting, is crucial to accomplishing our mission of providing the very best possible care for patients,” he said.
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The second research project involved the impact of energy drinks on children … and it’s not good. More than 40 percent of the drink exposures reported to U.S. poison control centers involved children younger than 6 with some suffering serious cardiac and neurological symptoms.
“Energy drinks have no place in pediatric diets,” Lipshultz said, “And anyone with underlying cardiac, neurologic or other significant medical conditions should check with their healthcare provider to make sure it’s safe to consume energy drinks.” Some energy drinks contain up to 400 milligrams (mg) of caffeine per can or bottle, compared to 100-150 mg in a typical cup of coffee.
Caffeine poisoning can occur at levels higher than 400 mg a day in adults, above 100 mg a day in adolescents and at 2.5 mg per kilogram (2.2 pounds) of body weight in children younger than 12.
“With every new finding we can see how our research directly impacts the health of children,” Lipshultz said. He recently presented the study’s findings at the American Heart Association’s Scientific Sessions 2014 in Chicago.
“The reported data probably represents the tip of the iceberg,” he said.
Finally, the study on how anti-HIV medicines can cause damage to fetal hearts showed a long-term price for protecting the children of HIV-infected mothers from the virus.
The study recently published in the journal AIDS showed the drugs can cause the impaired development of the heart muscle and reduced heart performance in non-HIV-infected children whose mothers received the medicines years earlier.
“Thanks to the new anti-HIV medications, the rate of transmission has been lowered from 26 percent to less than 1 percent during the past few decades, and that has been a miracle of life for the children involved,” Lipshultz said. “Still, we don’t want to be protecting these children from one disease, only to give them another one.”
The study results pointed to a significant association between lagging heart muscle development and impaired pumping ability in the children of the HIV-infected mothers who had received the medications. “These findings clearly indicate the need for further study,” he said.
For a pediatrician whose passion is helping sick kids get better and go on to healthy lives this kind of research is more than rewarding for Lipshultz, as is working at Children’s Hospital of Michigan.
“With a couple of hundred doctors here who are leaders in their field and a terrific nursing staff, Children’s is the nation’s powerhouse for giving hope to kids,” he said.
I don’t know if the young girl with the mask covering her face I met in the elevator was a patient of Dr. Lipshultz or not but with the smile in her eyes and the smile on her mom’s face I’m sure they believe Children’s Hospital of Michigan is a powerhouse for giving hope to kids.