From Emergency to Critical Care
As Victoria and Peter Kropp of East Meadow watch
their 20-month-old daughter Athena laugh, play and
just enjoy childhood, they are reminded of what has
helped make it possible � the comprehensive and
extraordinary pediatric care that she receives at
�Words can�t begin to express how grateful we are to Winthrop. The humanity and attention they�ve shown to our family has been a blessing,� said Mr. Kropp recently.
An Urgent Trip to the Emergency DepartmentWhen Athena Kropp was just five months old, she grew seriously ill. On April 29, 2008, her parents took her to Winthrop�s Emergency Department (ED), worried about her pale color and vomiting.
Athena was seen in the Pediatric Emergency Unit � a separate area within Winthrop�s ED that provides fast and efficient emergency care in a child-friendly environment.
�The full spectrum of pediatric medical and surgical specialists at Winthrop is available in the Emergency Department,� said Joseph Stambouly, MD, Chief of Pediatric Critical Care Medicine at Winthrop. The Unit combines the expertise of a dedicated team of pediatric specialists � including Board-certified pediatric physicians, residents, physician assistants, nurses, and certified child life specialists � with the latest diagnostics to deliver rapid evaluation and diagnosis in a pediatric medical emergency.
�Comprehensive pediatric care at Winthrop includes not only outstanding medical care for the sick child, but compassion, support and education for the family as well,� Dr. Stambouly continued.
Weak and still sick to her stomach, Athena was a good sport as teams of specialists, including phlebotomists, pediatric hematologist/oncologists, and pediatric cardiologists, administered a battery of exams and tests to determine what was making the little girl so sick. When the results came in from blood work and imaging studies of Athena�s spleen and liver, Mr. and Mrs. Kropp learned that their daughter Athena was suffering from acute leukemia � a disease that is characterized by the accumulation of immature, functionless cells in the blood, tissues, bone marrow and other organs.
�Athena�s white blood cell count was extremely high and we were able to make a diagnosis rapidly,� said Winthrop pediatric hematologist/oncologist Philip Scimeca, MD, Associate Chief of the Division of Pediatric Hematology/Oncology, who made the initial diagnosis and has since played an instrumental role in Athena�s care.
Following an initial assessment, the pediatric oncology team moved quickly to determine what specific type of leukemia Athena was suffering from. A swift analysis of Athena�s blood and bone marrow was performed by Winthrop�s specialized diagnostic oncology team in the Hospital�s stateof- the-art laboratory.
�We were able to promptly determine that Athena was suffering from acute lymphoblastic leukemia � a form of cancer that begins in the bone marrow, where blood cells are produced,� said Dr. Scimeca.
Pediatric Intensive Care UnitAthena was quickly transferred to the Pediatric Intensive Care Unit (PICU) � a modern, eight-room patient unit equipped with a broad spectrum of advanced life support modalities and monitoring devices � where she received around the clock care by a skilled team of pediatric specialists.
�This particular area of the Hospital includes the capabilities for high-frequency mechanical ventilation, trauma care, neurointensive care, and renal replacement therapy capabilities, and affords patients the highest level of specialized care in times of serious illness or injury,� said Dr. Stambouly.
When she arrived in the PICU, Athena was placed on a ventilator so that she could tolerate an exchange transfusion � a life-saving procedure that involves slowly removing a patient�s blood and replacing it with donor blood, which was performed by Dr. Stambouly. This also included the placement of large bore intravenous lines to facilitate the process of removing and replacing the blood.
Following the exchange transfusion, a special central-line catheter called a Mediport� � an intravenous tube that administers fluids and medications to infants or children on a long-term basis � was surgically implanted in Athena�s chest to facilitate the start of chemotherapy.
�For young patients who require long-term IV access, central venous lines eliminate the need for repeated IV sticks,� said Dr. Stambouly.
Just as important as the comprehensive treatment modalities that are available at Winthrop is the compassion of the nursing staff and other caregivers who provide special nurturing and care to young patients and their families.
�Caring for critically ill children requires the ability to combine highly professional critical care nursing with a special kind of concern and compassion,� said Mary Ann Dziomba, MSN, RNBC, Nurse Manager of Pediatrics/ PICU at Winthrop. �Winthrop�s PICU nurses provide care in a family-centered atmosphere, encouraging the family to be a part of their child�s treatment and offering emotional support and education.�
�The nurses in the ICU were extremely caring and sympathetic, and explained things to us every step of the way,� said Mr. Kropp. �Many are parents themselves and treated my daughter as if she was one of their own.�
Hagedorn Pediatric Inpatient CenterAfter undergoing several major procedures and continuous intensive monitoring, Athena was stabilized and improved to the point where she was able to move out of the Pediatric ICU to the Jay�s World Children�s Cancer Unit, part of Winthrop�s Hagedorn Pediatric Inpatient Center. There, she continued her chemotherapy regimen while being closely monitored for several days.
The Jay�s World Children�s Cancer Unit consists of five uniquely appointed rooms with state-of-the-art air filtration systems for patients with challenged immune systems � particularly pediatric oncology patients like Athena. Awash in cheerful colors and d�cor, the rooms are also equipped with comfortable sleeping accommodations for parents and a television and video game console for patients� use.
And, when children need something to take their mind off of being in the Hospital, the Child Life Activity Center � also located on the Pediatric floor � can serve as a safe haven. Staffed by a remarkable team of Certified Child Life Specialists who are committed to addressing the unique emotional, social and physical needs of all pediatric patients, the Center is a place where children and teens can spend time on the computer, play video or board games, watch movies and read books.
Cancer Center for KidsJust over a week after her diagnosis and initial emergency care, Athena was able to go home. In the weeks following her initial discharge, Athena occasionally returned to the hospital to receive care for her leukemia and treatment for related problems.
At the present time, her continuing outpatient care is provided at Winthrop�s Cancer Center for Kids Outpatient Center � a state-of-thescience facility where children are given the best possible chance of recovery and cure through superior medical care, constant nurturing and unconditional support in an environment that promotes healing.
There, Athena continues to be monitored by the Center�s skilled and compassionate team of Board-certified pediatric oncologists which include Dr. Scimeca, Igal Fligman, MD; William Gerba, MD; Naomi Moskowitz, MD; and Mark Weinblatt, MD, Chief of the Division of Pediatric Hematology/ Oncology and Director of the Cancer Center for Kids � as well as the Center�s dynamic team of nurses, social workers, psychologists, and child life specialists.
Athena visits the Cancer Center for Kids about every two weeks to undergo the maintenance phase of chemotherapy. Her parents, who also raise funds for the Center whenever possible, are eager to see the day when her chemotherapy regimen concludes but are comforted to know that there is always outstanding care available to them at Winthrop.
�We have complete trust in Winthrop and wouldn�t go anywhere else. Winthrop has been, and will continue to be, our second family,� said Mrs. Kropp.
For more information about the wealth of pediatric care services that are available at Winthrop, visit www.winthrop.org or call 1-866-WINTHROP.
Vol. 19, No. 2
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