Interventional Radiology program at Lucile Packard Children’s Hospital Stanford leads the way with a child-friendly approach
Benjamin Boersma was born with a complex set of medical issues, including severe digestive problems. Ben, 2, is fed through a gastro-jejunostomy tube – more commonly known as a GJ tube – that goes directly through his stomach into his small bowels. The feeding tube is literally a lifesaver, but it has to be replaced every few months.
Until recently, it was time-consuming to swap out the old tube for a new one because Ben needed to be under general anesthesia for the procedure.
But thanks to a new Pediatric Interventional Radiology program at Stanford Children’s Health, the first of its kind in the Bay Area, kids like Ben can often forgo anesthesia and, in some cases, surgery for many treatments. Instead, doctors use minimally invasive tools and digital imaging to make hospital trips shorter, less painful and much less nerve-racking for parents.
Led by Glen Seidel, MD, a nationally recognized pediatric IR specialist, the child-friendly staff and clinic at Lucile Packard Children’s Hospital Stanford does everything from needle biopsies to tube placements — all without open incisions.
“From a health-care delivery point of view, from a cost point of view and from a convenience point of view, this is a dramatic change for the families,’’ said Seidel, a clinical professor of radiology at the Stanford University School of Medicine. “Everybody has the same reaction: ‘Wow, this is so much easier on my kid and it’s not hurting them.’”
Before Ben became Seidel’s patient, replacing the tube required Ben to be fully sedated, meaning that he and his parents, who live in Mountain View, Calif., had to spend an entire day at the hospital. But when Ben’s most recent GJ tube was replaced in July, Seidel performed what he likes to call his “drive-up” GJ tube exchange service because it takes less time than getting a car’s oil changed.
No sedation was needed, just some numbing gel at the tube site. With Ben’s father holding his son’s hands, Seidel stepped to the table and, before starting the procedure, began singing to Ben: “Twinkle, Twinkle Little Star.” One by one, the nurses, technicians and his dad sang along with Seidel. As Ben listened calmly, one of the nurses distracted him with a spinning-light toy. Seidel carefully and gently changed out the tube in less than 15 minutes.
“It didn’t even feel like an operation, it was just a quick procedure,” said Ben’s father, Christiaan Boersma. “I think we were in and out of there in an hour. The last time, it took at least a whole day.”
Even more helpful, Ben arrived home without any of the breathing or recovery problems that he experienced in prior treatments that required anesthesia. “All those stresses have been lifted,” said his mom, Claire Boersma.
That’s the way it’s supposed to work. “When possible, we help keep kids out of the operating room and avoid general anesthesia,’’ said IR specialist Matt Lungren, MD, Seidel’s colleague and an assistant professor of radiology at the School of Medicine.
Like the Boersma family, 2 ½ -year-old Davan Jones and her two moms, Leanne Jones and Arica Stiliha-Jones of Chico, have come to regard hospital stays and medical procedures as practically routine.
By the time she was 15 months old, Davan had undergone open heart surgery, a liver transplant and two other major surgeries to remove life-threatening blockages in her intestines. Each new symptom brought a new wave of fear and anxiety.
But Seidel’s handling of a recent biopsy to determine why Davan was experiencing periodic abdominal pain showed the uniqueness of what his team offers.
Biopsies in patients as small as Davan present particular risks because of the danger of puncturing the bowel with the biopsy needle. Normally, surgeons would perform an open procedure to remove tissue samples for a biopsy, but they felt this might be too difficult for Davan after all the other operations she’d endured. Seidel felt he could safely guide the needles through Davan’s abdomen to the lymph nodes and avoid surgery.
Before the IR procedure, a nurse began showing Davan the toy animals hanging from the ceiling. Then Davan took over. With a point of her tiny finger, the toddler, barely able to talk, began orchestrating a symphony of elephant sounds, starting with her moms and then the nurses and technologists.
“She wanted the entire team to make the elephant sound,’’ Leanne said of the child-friendly atmosphere. “The radiology team allowed Davan to have a voice, and this made her feel comfortable.”
The minimally invasive process resulted in no scarring and no need for recovery time. It was later determined that the episodic pain Davan was experiencing was the result of an intestinal blockage.
“Dr. Seidel is like Patch Adams. He comes in and sings and does whatever it takes to make kids comfortable,’’ said Shannan Church, a radiology RN.
“I’ve never seen a doctor so committed. He is so skilled, and I am constantly amazed at how quickly he can do a procedure and do it right.”
The Jones and Boersma families say Seidel and his IR team are like so many at Lucile Packard Children’s Hospital and Stanford Medicine, always looking for ways to improve their children’s health care, both in the delivery and the experience.
- Diana Walsh
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