School Intervention Series: Making a Difference

Continuing our September Back-to-School theme, we are excited to introduce guest writer Kyle Herma, School Intervention Specialist at Children’s Hospital of Wisconsin. Kyle is blogging a 3-part series for PCHA beginning with an introduction on what she does and why. Over the next couple weeks, Kyle will share tips, tricks and recommendations for navigating a school’s system without a dedicated school liaison (and how to start advocating for one in your cardiac center) and provide a collection of resources on how to ensure your child is getting all of the services and supports required to have equal access to a quality education.

Twenty nine years ago my sister was born with Hypoplastic Left Heart Syndrome (HLHS), a congenital heart defect that left a chamber of her heart severely underdeveloped at birth. This was at a time when medical technology and surgical repairs options were very limited for a complex baby like my sister. While she ended up losing her battle with HLHS, her short time on Earth ultimately began a battle much greater – the fight to eradicate congenital heart defects completely and in the process, improve medical outcomes and quality of life for those currently affected. Today, the Herma Heart Center (HHC) at Children’s Hospital of Wisconsin is known for having the best published survival rates of HLHS in the world. However, a top recognition like this is not achieved without constant work towards excellence and innovation in all areas of care.

Herma Heart Center

How does this relate to PCHA’s “Back-to-School” theme this month? It does on so many levels! Two years ago I was a kindergarten teacher, loving every minute of every day guiding 4 and 5-year-old kids as they discovered their world. I worked in the inner city of Milwaukee at a low-income Charter School – all of my students considered “at-risk” due to a variety of different statistics. Every day I sought to plan lessons that not only were rich in academic content and student engagement, but also focused on building a classroom culture of strong future leaders and community advocates. While I had always been involved with the Herma Heart Center on various levels because of my family’s deep connection, I was a teacher. I loved being a teacher.

In 2015, I got a call. The Cardiac Neurodevelopmental Follow-Up Program, one of the HHC’s leading whole-child focused programs, was expanding and looking to hire a School Intervention Specialist after they noticed a very high need for multifaceted school intervention in students with complex health needs – specifically in the area of pediatric cardiac neurodevelopment. The job requirements outlined a liaison-type service, with the goal of working to ensure clear and consistent communication between the medical staff, the family, and the child’s school at all times. I began researching far and wide. I wanted to learn everything I could about how CHD affects a child’s neurodevelopmental functioning and what type of supports schools have in place to modify for or accommodate these children. All of my searches came up empty! There was nothing. While significant literary research supported that children with complex health needs and chronic illness are at a greater risk of reduced student engagement, higher disruptive behavior, lower academic achievement, an increased exposure to bullying (among many other well-documented negative educational outcomes), structured programs for school re-entry and intervention are rare. In this moment I knew that I needed to step in to fill a role much larger than a classroom teacher.

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The School Intervention Program officially “went live” in February 2015. I began with a very focused population of heart transplant patients that pinpointed those re-integrating into school post-transplant, but also offered intervention services to all of our heart transplant patients no matter how many years post-transplant they were. The response was huge. My patient population quickly grew to all heart transplant patients (including those wait-listed for transplant) and several patients with advanced heart failure who were anticipating a future transplant. My pilot study served 55 cardiac patients, ages 3 (preschool) to 24 (college). The schools’ concerns that were addressed included: attendance and absence support, special education support, attention and behavior plans, and documentation/medical record communication – just to name a few of the big categories. Of those 55 patients, 57% have exited the program with their school concern fully resolved, 36% still receive ongoing school intervention but are making great progress towards their school goals, and 7% transitioned to different medical centers where school intervention could no longer be followed. I’ve witnessed one of my high school student graduate with his class just 5 months post-transplant, I’ve heard from a school nurse that she could not believe a student is finally getting to live a “normal” life without any medical interventions needed during the school day, and I’ve helped a mom send her 7 year old to school for the first time because she finally felt confident the school could handle his needs.

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You may be thinking, “That’s great, but my child did not have a transplant. This doesn’t help us.” I am hear to tell you that it does! By doing a formal pilot study on a small population of patients and proving there is an urgent need for formalized school support, I am establishing both attractive outcomes data and the sustainability of this type of position. I frequently share these outcomes with colleagues, speak about my work at a director and leadership level, and even present at international conferences just so people can see how this seemingly non-medical work is directly related to improved medical outcomes. And guess what? People ARE listening.

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I am excited to be sharing with you over the next couple weeks to help bridge the very different worlds of medicine and education to ensure that children with complex health needs, specifically CHD, are not falling though the gaps. Here’s to a great school year!


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Kyle Herma is the School Intervention Specialist serving the Herma Heart Center at Children’s Hospital of Wisconsin. Kyle has been at Children’s since February 2015 conducting a formal pilot study on school intervention and the impact it has on a child’s overall medical outcome and quality of life. Prior to this position, Kyle was a teacher at Milwaukee College Prep’s 38th street campus. In both roles, Kyle has shown her dedication to serving children who are placed at-risk for school failure and ultimate mission to achieve equal access to quality education for all.

Back-to-School Q&A Panel

This September, PCHA is celebrating the start of the 2016-2017 school year with our Back-to-School series. For our Q&A Panel this month, we interviewed three people to gain a greater perspective on how CHD affects kids differently during this exciting time of year.

Congratulations on the start of a new school year! Please introduce yourself. What grade will you or your child be entering?

Frances: My name is Frances and I volunteer as the blog coordinator for PCHA. My husband and I live in California and have a confidant and outgoing 3-year old daughter who was born with severe mitral valve prolapse and a VSD. She had a very successful open heart surgery at 8 months old. She’ll be starting a couple mornings of preschool this year.

Margaret: Hi! My name is Margaret and I’m a heart mom to an awesome 8-year old heart hero named Kieran who will be starting 2nd grade. We’ve been through Birth to 3, as well as the IEP and 504 Plan process. I am also a parent adviser to our local hospital’s School Intervention Program.

Jack: Hello, my name is Jack Radandt and I was born April 15th, 2001, with Hypoplastic Left Heart Syndrome (HLHS). I had three open heart surgeries by the age of three, Norwood, Glenn, and Fontan. I lived a pretty normal life after my Fontan surgery. I was able to attend school, and even keep up with the other kids my age. At age eleven I experienced heart failure. I went to Children’s Hospital of Wisconsin in Milwaukee and was placed on the transplant list in October of 2012. I then needed to be on a device to bridge me to transplant. In December of 2012, I had surgery for a device called Heartware Ventricular Assist Device or (HVAD). I was the first single ventricle child in the United States to have the device and second in the world. I was also the first single ventricle child in the world to go home on this device. I had the HVAD for five months, until I received a heart transplant on May 20th, 2013.

What are you or is your child looking forward to most this school year?

Jack: I am looking forward to all the speaking events that I was able to get this school year.

Margaret: Kieran says, “gym!”

Frances: Making new friends. She has the ability to make a friend wherever we go, even when we run errands!

Do you notify your or your child’s school or teacher about your or your child’s heart condition? If so, how do you go about doing so?

Margaret: We definitely do. I’ve learned that teachers and school staff really appreciate being informed. Not every CHD student will need an IEP or a 504 plan, but we have both. Each teacher gets documentation about his HLHS, health, and classroom needs. Each year, I’ve met with school staff before school starts to make sure we’re all on the same page and to answer any questions. He has an excellent team at school that is communicative and proactive. We don’t just think about the regular classroom teacher — it is important to have a plan in place so that the school nurse, office staff, lunch and recess supervisors, gym teacher, substitute teachers, and any other school professional who might work with Kieran be informed of his health plan.

Jack: I do notify my school’s faculty, staff, and students of my condition, and I am very open about my scar and surgeries.

Frances: When filling out her general medical information for the preschool, we noted her cardiologist in addition to her pediatrician. She also has a medical device identification card for her annuloplasty ring in case any emergency arises affecting her heart. While our daughter has zero restrictions and no known issues otherwise, we included a copy of this card for the preschool and let the director know about it as a precaution.

Do you or your child have any limitations or require medication during school? If so, how do you handle this?

Margaret: Kieran has HLHS, and his cardiologist has requested that he stay indoors when it is below freezing. On these days, he gets to pick a classmate to stay inside and play board games with. He also has an adaptive PhyEd teacher working with him in gym class. He has a water bottle with him all day to prevent dehydration. For fire drills, he has instructions in his health plan to be allowed to wear a coat outside if it’s cold out. There are certain things we take on a case-by-case basis, such as field trips and walking trips.

Frances: Our daughter doesn’t have any limitations or medications, though the future is uncertain. Her heart will need to be monitored more closely during puberty as her device may be affected during this exponential growth period.

Jack: I don’t have to deal with this because I take my medication right before I go to school and right before I go to bed.

What reaction do you get from the staff if you notify them? Do you feel this affects how the teacher and/or staff interacts with you or your child?

Frances: They thanked me for sharing the information. They haven’t mentioned it otherwise, and from what I’ve seen do not give her any special treatment.

Margaret: We’re fortunate to have a neighborhood school that fosters a very positive learning environment for everyone, and is innovative about classroom adaptations. When we’ve notified them, they’ve responded very positively with a can-do attitude. Last year at our back-to-school meeting, not only did Kieran’s new teacher attended, but the office staff, principal, school nurse, and almost everyone involved with his IEP. Shedding light on the HLHS and the secondary challenges we’ve faced helps them understand how to meet Kieran’s needs better, as well as helps them understand why he (and we as parents) sometimes act the way we do.

Jack: Some of the faculty and staff that find out about my condition feel very uncomfortable about the whole situation.

How open are you or is your child about CHD with peers at school? How does this affect your or your child’s relationships?

Jack: I am very open about my condition. This is my life and I’m not ashamed of it at all.

Frances: Since she’s still very young, our daughter doesn’t make a point to either hide or reveal it. While I want her to be proud of her scar, I also want to allow her to talk about CHD on her own terms whether that’s mentioning it to close friends or being a vocal advocate. She is a naturally confidant and extroverted individual, so it doesn’t seem to bother her when someone points it out or asks. For now we focus on making sure she knows her scar is something good and how to respond in situations. I don’t make any consideration with clothing when it comes to her scar, choosing her outfits based on the weather and her own personal preferences.

Margaret: Kieran is very sensitive about his heart condition. We don’t actively keep it a secret, but we don’t actively volunteer information about it to his peers, either. He feels very strongly that he is a “normal” child and wants to be seen that way. Everyone is different, and I know many heart parents who believe it’s important for their child to be CHD advocates, but I feel it’s important for now for him to feel comfortable at school and have it be a “safe space” for him to feel normal. He sometimes does participate in CHD activities with me outside of school, but he doesn’t understand why they’re important. He sees his “heart friends” as regular friends. Many heart kids don’t truly know the gravity of some of their heart defects until they are much older. A cause that affects him much more, and has for years, is hunger and his desire to see everyone in the world have enough food to eat. I think that’s wonderful. We should all be able to focus on areas of need that spark our sense of fairness.

What is your or your child’s favorite subject or activity?

Frances: She loves the arts – dancing, painting and music.

Jack: My favorite subject in school is biology.

Margaret: Definitely gym. He also likes math and music.

What, if any, concerns do you or your child have in regards to CHD for the school year?

Margaret: My biggest concern is that somewhere, at some point, there might be a breakdown in coordination at school. I worry most when there is a substitute teacher in the classroom, because I’m not informed of it, and I have no idea if they’ve read his 504 plan and understand it. Luckily, he comes into contact with many staff throughout the school day, and I think they all do a good job keeping an eye on him and all the students. Sometimes, because he wants to be seen as “normal” in front of his peers, he’s not as assertive as he should be. I also worry about rough play during recess. This has been a problem at times throughout the past school years, where he will be tackled or otherwise roughed up during normal play, which has resulted in some bruising because he is on blood thinners.

Frances: You would have no idea our daughter has CHD besides her scar, so my only concern is her peers setting her apart in a negative way because of it. Her preschool focuses very much on emotional competence and socialization in a play based setting, and what we liked most about it when touring was how respectful every child was to each other regardless of their differences.

Jack: I am in a very small school so I really have no concerns besides being ill.

If you or your child has a high sensitivity to illness due to CHD, how do you or your child combat this at school?

Frances: While she doesn’t have a high sensitivity, her pediatrician still errs on the side of caution by making sure she gets the first flu vaccination that comes in for the season which we are thankful for. We also chose a preschool with a smaller class size and a strong emphasis on cleanliness.

Jack: I am sick a lot so missing school is always a big concern.

Margaret: The school nurse, or sometimes the classroom teacher, is really great about informing us about illness at school. They will email us personally if a lot of kids are out sick, or with certain communicable illnesses requiring all parents at school to be notified, the school nurse sends home flyers. We are most concerned about things like strep and seasonal flu. If it’s an outbreak the classroom, we would most likely keep him home until it had passed. We use hand sanitizer, get a flu shot, and try to get enough sleep and eat healthy. We emphasize to Kieran the importance of good hygiene. His school has a great custodian and they are good about keeping the classroom and school wiped down.

What is your biggest hope for yourself or your child this school year?

Jack: To remain on honor role and avoid illnesses.

Margaret: That he will make more friends and feel more included socially. Not only is he an only child, but like many CHD kids, especially those with critical heart defects, he is a bit behind for his age socially. Add to that the fact that he easily tires during playground games and has to take breaks during physical activities, he sometimes feels frustrated that he can’t keep up with other kids, especially most of the boys. Of course, I also hope he has a great learning experience this year and finds areas of learning he really loves.

Frances: I hope she will be able to make new friendships and start a solid foundation of a love for learning!

What area(s) is your child most successful at school?

Frances: Since day one, my husband and I have never experienced separation issues with her. She’s very adaptable, confidant and according to her preschool teacher, not at all afraid to ask questions.

Margaret: He a wonderful singer, and is also very creative when it comes to visual art. Last year, he did after school Spanish and book club, which was good for him. He is successful at reading, although he pretends to think it’s “boring.”

Jack: Science class over any other classes.

Thank you all and best wishes for the new school year! Be sure to check back throughout September for our guest writers covering relatable Back-To-School topics and be on the lookout for your children being featured in a blog post. Share your first day of school photos at advocacy@conqueringchd.org by Friday Sept. 9th to be included!

Songs of Love for the Heart

“When words fail, music speaks.”

Once said by Hans Christian Andersen, best remembered for his fairy tales like The Little Mermaid and The Snow Queen that inspired Frozen, this renown Danish writer understood the importance of music.

With any serious child illness, there are times when words fail us. PCHA was asked to try out a product that steps in for your child in these moments. It’s called Songs of Love, a nonprofit foundation dedicated to providing personalized uplifting songs, free of charge, for children and teens currently facing tough medical, physical or emotional challenges. At this early stage in our 3 year old daughter’s journey with CHD, we want to instill the fact that her scar from open heart surgery is something to be celebrated. It is a beautiful reminder that she is with us, happy and healthy. So we requested a song for her.

The process was very simple. We went online and filled out the form. We waited five weeks and received an email that it was complete and on it’s way in the mail (and to note, I appreciated that they realize to a young child, physically receiving this gift gives it greater anticipation and awe versus opening an email, though you can request a digital file be sent). And then we waited.

As my husband and I are both lifelong musicians, we weren’t expecting the next masterpiece or top 40 song, but we also weren’t expecting her reaction when we played her personalized song. When filling out the form, I had put in more than enough special interests, hobbies and favorite things to give the musician something to work with, and I also was very specific in that she loves a heavy beat she can dance to, pop or rock, noting that she really loved the song Immortals (which we discovered while watching Disney’s Big Hero 6). So when we popped the CD in and it began to play, we just had to smile at the instant burst of excitement and energy as she twirled, danced and bopped around for her entire 3 minute song. And then we knew we would be singing it for weeks, when she told us to replay it three more times in a row.

Words sometimes fail us, especially in trying to explain to young children about a complex condition, and in our case, how to embrace a lifelong journey with CHD full of the unknowns that await. Songs of Love is a fun resource that PCHA members find fitting for younger children. While we cannot fully explain to our daughter just how miraculous her repaired heart is, and how her scar is a beautiful reminder of that, Songs of Love helps her understand this in a small way as someone wrote a special song, just for her, in celebration of her heart.

To request a free, personalized song and for more information, visit Songs of Love.


Frances volunteers as the blog coordinator for PCHA. She graduated from USC and previously worked in film, marketing, and software consulting. Frances resides in California with her husband and daughter – who was born with severe mitral valve prolapse and a VSD and underwent open heart surgery at 8 months old.

Happy Birthday PCHA – #ConqueringCHD Week!

There are so many ways to help us recognize our 3rd Birthday!


1) Use your Social Media talents as we work to reach 250,000 people!

It’s your week to shine as a PCHA #ConqueringCHD social media ambassador!

In February, our education efforts had a total weekly reach of 210,000 people for our #CHDAware campaign.  Wow- that is a huge impact!  Let’s do it, again!!!

Join the Social Media Blitz 

During the week of August 21-27 help us cover social media with facts and faces. Like, share, comment and tag using the hashtag #ConqueringCHD.

In the know – Help others understand the impact of CHD and what the Pediatric Congenital Heart Association is doing about it by sharing our memes throughout the week.

Make it personal – Using the hashtag #ConqueringCHD, share stories and photos about those in your lives who are Conquering CHD. Tag us on Facebook, Twitter or Instagram. Whether it is conquering CHD at the doctors office, at school, on the playing field, welcoming a rainbow baby, helping others, advocating, or celebrating a birthday of your own, during #ConqueringCHD week, August 21-27, we want to celebrate with you!!

Invite others – we can do the work for you – simply guide them to our media pages.  Ask them to like or follow us.  We’ll make sure they STAY engaged!  Click on an icon to find us:

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2) Help us raise $10,000

It couldn’t be easier –  simply click here or text CHD2016 to 71777 to donate or become a fundraiser yourself.

Give a gift that really makes a difference:

Help us reach our goal of $10,000 to support vital programs including helping patients talk to their doctors, making sure kids get great care their whole life, and fighting for more federal research funding.

  • $25 allows us to reach 1000 people through social media
  • $50 helps 10 newly diagnosed families through our Guided Questions program
  • $500 sponsors one key hospital site visit

Join in on the fun and earn great party favors:

Become a fundraiser yourself – simply ask 10 friends to give $10! All the tools you need are right there on your phone!  As a fundraiser, you will receive regular emails to provide inspiration and support in your efforts.  When you reach your goals, we will send you party favors:

  • Raise $100 and receive a free PCHA “Conquering CHD” t-shirt
  • Raise $500 and receive a t-shirt and PCHA Canvas tote bag
  • Raise $1000 and receive a t-shirt, tote bag, and exclusive PCHA baseball cap!

Need inspiration?  Check out these ideas:

  1. Simple Facebook Post: our experienced fundraisers said that with a simple post on Facebook and one email to their families and friends, it doesn’t take long to reach $100!
  2. Night Out for CHD: Mary Adair from San Antonio, Texas has arranged for several charitable nights out at local restaurants where proceeds earned during a specific time period benefit PCHA.
  3. Lemonade Stand: Nicholas Basken from Wisconsin is planning a lemonade stand on the corner, he will also invite friends and family to participate through the Virtual Party fundraising platform (above).
  4. Check out our Fundraising Toolkit for more fun and easy ideas!! Any funds raised off-line can be added to your online fundraising total.  Want to learn more, email advocacy@conqueringchd.org

3) Write your Members of Congress

AA - Futures ActTell them it is #ConqueringCHD Week.  Ask them to join you in #ConqueringCHD by becoming cosponsor of the Congenital Heart Futures Reauthorization Act (CHFRA).  Click here to learn more and see if your lawmaker has already signed-on.  If they have, be sure to thank them for #ConqueringCHD!!


4) Get the Swag:

Tori - Bat KidCheck out our online store for #ConqueringCHD apparel and buttons.  Don’t miss our great strawberry smelling pens, too!!


Click to sign-up and saveAnd don’t forget to Put Safety First and sign-up for the Rapid SOS.  You can learn more and sign-up, here.


Social Media Log 2016The party goes on after #ConqueringCHD Week.  Consider joining us for our Second Annual Congenital Heart Gala on September 24th, 2016 at the Milwaukee Art Museum, Milwaukee Wisconsin.


Finally, Celebrate all you are doing as, together, we are #ConqueringCHD!

Knoweldge. A Voice. Hope

Transparency Blog Series Recap

For the month of July, PCHA recognized the importance of transparency. Our goal is to inform, educate, and empower patients and families to actively participate in data-driven, shared-decision making. The fight to conquer CHD is strengthened by the involvement of all of those who share our mission. It takes a community coming together around education, research and awareness to make an impact. Volunteer, join our advocacy network today, and connect with us on Facebook! In case you missed a post, below is the full Transparency Blog series:

Passion and Progress: A Provider’s Perspective

A Life Raft: A Parent’s Experience using the Guided Questions Tool

A 2nd Opinion: Finding the Right Care

A Lesson in Learning To Be a Better Patient

The Importance of Information to Support Shared-Decision Making

The Importance of Information to Support Shared-Decision Making

The Pediatric Congenital Heart Association firmly believes that patient-engaged care leads to improved patient experience and outcomes. In this tragic story, one family believes that they did not have the information needed to properly understand the expectations for their child. We encourage patients and providers to work closely together to find a balance between hope and expectations to maximize the experience. While recommendations that follow are the opinion of this family, we do believe they should be included as part of a broader discussion.

Our daughter Sadie was diagnosed with Tetralogy of Fallot (TOF) in July of 2014 shortly after our 20 week ultrasound. We were not only shocked and terrified, but we also could not find anyone we knew to talk about this with. Congenital heart defects (CHDs) were a mystery to our friends and family. Even our OB had limited information regarding Sadie’s diagnosis. We immediately began researching to find out as much as we could about Sadie’s condition, including potential surgical options, outcomes, potential complications and information regarding quality of life. We quickly learned what most parents with children with CHDs already knew – that this information is not only widely unavailable, but extremely difficult to understand.

My husband and I considered our family fortunate to live close to a reputable children’s hospital with a high-ranking pediatric heart center. We also felt lucky that Sadie’s defect was diagnosed early – it would give our doctors several months to prepare us to care for a child with a CHD. We assumed our doctors would empower us with all the information we needed to become an integral part of Sadie’s care team. We now feel those assumptions were incorrect and that we were ill-prepared to effectively care for our daughter.

Before Sadie was born we had multiple appointments with Sadie’s care team, including multiple cardiologists and support providers. Every doctor we met with was extremely optimistic regarding prognosis, surgical outcome and quality of life. The two-stage repair was explained as well as long-term outcomes that included decreasing frequency of follow-up appointments with the expectation of a third surgery in her teen years. Over the course of these appointments, our doctors focused on making sure we understood the anatomy and physiology of Sadie’s defect, how she would be cared for in the hospital after she was born, and the specifics of her surgery.  Although we were upfront about wanting as much information as possible so that we could be prepared for every scenario; there was little discussion regarding risks, complications or adverse outcomes. We were told with great confidence that Sadie would have an excellent quality of life, equal to or at least extremely close to that of a non-CHD child.

However, every step of the way there were unexpected findings. A week before delivery Sadie was diagnosed with pulmonary atresia (a more severe form of TOF). Only after her death were we told that this significantly increased her mortality rate. Then, the evening before her surgery, we were presented with a new surgical strategy that we were hearing about for the first time.

We felt we could not effectively take part in the decision making process regarding our daughter’s care when we were being presented with new information on an as needed basis. Putting us at an even bigger disadvantage was the fact that we were trying to understand and process this new information at an extremely emotionally charged time.

Shortly after her discharge home, we took Sadie to the ER. She was experiencing several complications from her condition and was admitted back into the cardiac care unit. Most of these complications had not been previously discussed with us as possible outcomes yet were quickly dismissed with phrases like “these things sometimes happen” and “this isn’t abnormal to see in a child with her condition.”  These responses made us increasingly anxious, fearful and confused. As the disconnect between what we had been prepared for and what was happening grew during this second hospital stay, we increasingly felt that our doctors hadn’t been truthful with us regarding Sadie’s condition, and, in turn, had not realistically prepared us to care for our daughter. We began to question our doctors, Sadie’s future, and our own ability to care for our daughter. Less than two days after she was discharged, Sadie suddenly stopped breathing at home and died at the nearby hospital.

We learned a lot during our 23 days with Sadie. We will never dispute that our doctors only wanted the best possible outcome for our daughter. We are grateful that people with their knowledge and skill exist to give children like Sadie a chance at the best possible life. But there are many areas where our doctors and medical team could have done a better job to ensure Sadie got the best possible care.

We depended on our doctors to prepare us for ALL realistic outcomes. Overstating the positives and understating the potential risks and complications robbed us of our ability to make informed decisions regarding our daughter’s care. Perhaps our doctors were trying to protect us by omitting scary and complicated outcomes or to shield an expectant mother of a sick child from what they perceive as unnecessary stress. I don’t know. What I do know is that the lack of information made us feel like helpless bystanders instead of informed parents who were part of a team of people making decisions together in the best interest of a sick child.

Our lives will never be the same after experiencing Sadie’s life and death. We can never go back to re-advocate for our daughter and we will never be able to change the outcome. We have spent a lot of time replaying the events of Sadie’s life and death. In doing so, we have been able to identify several things that we wish our doctors had considered, as we would have been better prepared to care and advocate for our daughter.

Timing of information sharing. Parents deserve as much information as possible as soon as possible for several reasons.

  • Start building trust between doctors and parents through honesty and transparency.
  • Providing comprehensive information early and often allows families to absorb different information over time as stress levels go up and down.
  • Parents need the full spectrum of information to be able to plan and prepare to care for a child with a CHD.

What information to share. It would be helpful for medical teams to come up with standard information for each diagnosis to share with parents. Such as:

  • Hospital outcome data that includes number of patients, surgical cases, and both surgical and long-term mortality rates.
  • Benefits, risks and recovery (in and out of the hospital) for each planned surgery, as well as unplanned but possible alternate surgeries.
  • Additional treatment approaches necessary including common medications and their side effects.
  • Potential complications that children with this defect may experience.
  • Possible associated disorders.
  • Long-term outcomes and challenges children with this defect may face such as physical or neurological challenges.
  • The full spectrum of what caring for a child with this defect looks like, not only during the hospital stay, but at home and on a long-term basis.

How to effectively communicate information. Given the complexity of the information, how it is communicated is just as important as when and what. The more resources and open lines of communication that parents have, the more supported and connected they will feel.

  • Find the balance between benefit and risk, between optimism that all will go according to plan and concern regarding complications that may arise.
  • Use multiple modalities – verbal, video, images and writing. A written reference can be very helpful and could eliminate miscommunication and provide clarification for parents.
  • If possible, it would be helpful for medical teams to assign one point of contact to make sure all the agreed-upon standard information has been communicated to parents, especially when one specific doctor is not assigned. At the very least, doctors should let parents know who to follow up with and how to reach them should they have questions or concerns at any time.

We wanted, expected and deserved to be presented with all the information needed to be able to advocate for our child. Many complications and outcomes may be out of the doctor’s control, but providing parents with ALL the relevant information at the earliest possible time is well within it.


Erin Schuster is the mother of three little ones, two sons and one daughter. Her daughter, Sadie, was born with multiple congenital heart defects and died from complications from her defects at 23 days old. Since Sadie’s death, Erin has been working to raise CHD awareness and funding for CHD research. She is also interested in raising awareness and educating others regarding infant loss and the life-long grief journey experienced by bereaved parents. Erin strongly believes in the Pediatric Congenital Heart Association’s goal to empower CHD parents with the information necessary to become effective advocates for their children. For more about Sadie’s story, please visit www.rememberingsadie.org

A Lesson in Learning To Be a Better Patient

As CHD is a lifelong condition, an important aspect of transparency is knowledge of a complete medical history. PCHA welcomes Meghan Chell, a CHD survivor, who speaks about her recent challenges in finding the right care as an adult CHD patient. 

If you don’t learn your medical history, you’re doomed to repeat it.

Three years ago, my life as a mostly-healthy person fell apart around me. Sure, I was born with coarctation of the aorta and had three surgeries as a child, but for over 20 years I’d been incident free.  I rode my bike, did yoga, hiked, swam, basically did whatever I wanted, and every year grew more distant from my congenital condition. I went to my annual visits, and every now and then had to explain the source of my sternotomy scar, but acted as though my struggles with CHD were behind me.

Until I was suddenly reminded that they weren’t.

I was 33 years old, recently engaged, and working as a wastewater and remediation engineer in Portland. A typical fair-weather cyclist, I started biking to work again once the “frozen mix” of winter turned into the random rains of spring. I was having trouble with uphill stretches of my commute but simply wrote it off as loss of stamina due to winter laziness. When I had an offer of interesting but strenuous field work at a remote mining site, I scheduled my annual visit to get my cardiologist’s seal of approval before committing.

It started off as a typical visit: an echocardiogram to be followed by an appointment with my cardiologist. He’d overseen my care since I was in recovery from my last coarctation repair in 1992. We had discussed transferring my care to another doctor, but decided that it was best to stay with the doctor who was most familiar with my case. He was in California where my family had moved right after my heart surgery, so I used the travel as a chance to see friends and family in the area.

I knew something was wrong before the echo was halfway through. The technician was warm and gregarious, so the two of us typically gab throughout the test. But at some point he became quiet and focused. I waited for an hour while my doctor was reportedly reviewing my files before I finally learned what happened. My 21-year old coarctation repair, an ascending to descending aortic conduit, had clotted and was no longer providing a bypass for blood flow to my lower body. This explained my fatigue and headaches with exercise – my lower body had insufficient blood flow, while my upper body was hypertensive. He proposed a quick and easy solution – a stent to widen the narrow portion of my aorta, which could be performed with a catheter, and I could be back to work within a week. First more tests to confirm – an MRI, a fit test, and blood work. Then we’d schedule for the procedure in Southern California.

Fast-forward three months. I’ve had all my tests and dealt with the fragmented, back and forth communication with my doctor through his receptionist. Once the diagnosis is finally confirmed, I travel to Los Angeles for the cath procedure. While in recovery and barely conscious, the surgeon then tells me that they didn’t place the stent. Why? Apparently there was no need! My aorta was only slightly narrowed and shouldn’t cause a restriction. So the aorta wasn’t the problem! I protest as much as I can – the tests, the conduit being clotted, my symptoms. He shows me a grainy photo from the cath procedure and points to measurements that I can’t see through the fog of anesthesia. He says we’ll discuss this further when I’m more awake, but he doesn’t reappear that day. Eight hours later I’m driven to my father’s house, where I promptly have a good cry and fall asleep.

When I got home to Portland, I put my recovery time and mounting frustrating to good use, investigating local cardiologists for more engaged care. I found a clinic at Oregon Health and Science University, a mere 3 miles away, which had multiple adult congenital specialists. I also requested records from my California cardiologist to familiarize myself with the details of my 30-year medical history, many of which I only barely recollect. When they arrived, I was shocked to find that there were only records through 2008. I realized that when my doctor was supposedly reviewing my files, he was in actuality probably trying to locate the other 16 years of them! I also learned that my coarctation is mainly due to a hypoplastic, inflexible portion aorta, presumably due to scarring from my original repairs in 1984. Though it looks fairly normal at rest, it doesn’t expand as it should during exercise. Had my doctor known my medical history, he would have known that a stent was not a viable option and never would have given me the false hope of a quick and easy fix.

In retrospect, though I do hold my doctor accountable for being unfamiliar with my history when he recommended this unsuccessful procedure, I realized I needed to be a better patient. I had lived in a dream world for over two decades, and hadn’t kept up to date with my care or what was best for my condition. Had I been seeing an adult specialist, they would have been monitoring for this failure, and could have prolonged the usefulness of my conduit. It’s a heavy weight to bear, but we survivors and family members of congenital heart disease need to remember that we have to be the most knowledgeable about our specific conditions and cases. As such, we need to always be active members in our treatment which sometimes means questioning an easy solution when we know it isn’t the right one.


Meghann ChellMeghann is a congenital heart disease survivor, born with coarctation of the aorta and a bicuspid aortic valve. She lives in Portland, Oregon and works as an environmental engineer. Her focus in CHD activism includes patient engagement, transparency, and medical records availability.

A 2nd Opinion: Finding the Right Care

In continuing our topic of transparency, PCHA shares this family’s story in navigating the difficulties of finding the right care for their little boy, John. 

We moved to a new community a couple of years ago and it was time for my three young children to see a dentist. We had no information to assess what dentist was the right one for our family. Who specialized with children? Who had years of experience in order to master their skills? Who had qualified assistants who performed the important cleanings and post care? Which dentist had their patient’s best interest in mind instead of lining their own pockets? But when I stepped through the front door, I knew I was in the right place. On the bulletin board in the waiting room were the hand-written words, “Love People. Use Money. Don’t Love Money and Use People.”

Five years ago we stepped into the new community of Congenital Heart Defects (CHD’s) when I was pregnant with our third child, John. He was diagnosed with Hypoplastic Left Heart Syndrome (HLHS) and would need three open-heart surgeries within his first few years of life. The first, and most invasive, surgery would be needed within days of birth. The limited information parents have when researching a dentist is eerily similar to choosing a pediatric heart surgeon. But this was not a small cavity that needed to be filled.

Norwood

Finding this care was not easy. It’s a big decision left to chance because factual information is difficult to find and, if you’re like me, parents often don’t know who or what questions to ask. My conscience propels me to publicly explain the difficulties we had leading up to our son’s care decisions, in hopes of raising awareness as to what’s been termed as the “transparency issue” in the pediatric heart world.

DIAGNOSIS

I was around 22 weeks gestation when the ultrasound technician couldn’t find the left side of John’s heart. The left ventricle is responsible for pumping blood to the body. Hypoplasia means “under formation”. I wondered what I did to cause this severe heart defect. Was there a day I forgot to take my prenatal vitamins? My husband and I both shut down. We were hurting deeply and naturally concerned for our unborn child and the ramifications this would have on our marriage, other kids, finances, job, and all the responsibilities it takes to be a good parent to a child affected by CHD.

Family Reading

Together as a family, pregnant with baby John, HLHS

We had a hard time remembering what the acronym HLHS even stood for. It was all very overwhelming. The internet was our first teacher, but later, when we met with a perinatologist (a high risk OB physician), our suspicions were confirmed. We were completely unaware that there are hospitals willing to perform invasive, complex surgeries on fragile infants with limited experience or success.

DOCTOR APPOINTMENTS

The doctor, in his quiet voice, told us it was an especially bad case of HLHS because of John’s extremely small aorta. He said there was a chance we could lose the baby in utero. Twice, he brought up termination. Thinking back now, I find it illogical that presenting termination of our child as an option was legally required, but presenting transparent information about various pediatric heart centers and their outcomes, which can give heart kids a fighting chance at a qualitative life, was not.

So many questions were racing through our minds by the time we met with the pediatric cardiologist. We were eager to trust someone knowledgeable and get a feel for what life was going to look like for our family.

I was pregnant and tired when the cardiologist performed a thorough and exhaustive echocardiogram of all the tiny little valves, vessels, and arteries of John’s quarter-sized, two-chambered beating heart. Afterward, the cardiologist sat at eye level with us, showed us diagrams of the heart, and confidently began to explain the three open-heart surgeries that were needed to save John’s life. The cardiovascular system of our newborn baby’s heart needed to be completely reconfigured, including extensive reconstruction of his tiny aorta.

But a thick, confusing blanket of vagueness descended when I asked where we needed to go for these invasive surgeries. He shrugged his shoulders in response. I asked about heart kids I was following on social media and he told me their hearts were great, but it was the eating issues they struggled with. There was a negative connotation in his voice when he answered our questions about other hospitals in the area, suggesting that a teaching hospital would just have a lot of doctors running around, telling us what to do. His expectation was to stay local for the surgeries.

The cardiologist removed himself from the conversation. He never gave us any qualitative facts about statistics, credentials, or historical experience. There was no discussion about recovery and the complications that can easily arise after surgery. His indifference was hurtful and placed John in a dangerous position. Something inside me told me to protect my child from this practice.

Hands on Pregnant Belly

Therefore, we entered into our own research process completely blind and on our own. There was so much at stake and the pressure was emotionally exhausting.

FINDING THE RIGHT CARE

We had no idea where to start. On the internet I read dozens of blog posts, describing the daily ups and downs of post-surgery recoveries. Almost every writer was advertising whichever hospital or doctor they had become emotionally attached to. Hospital websites were filled with marketing techniques. The culmination of everything I was reading on-line only caused me to withdraw further.

Out of desperation, I called four different heart moms who all went to four separate heart centers and started to compare notes. My husband spoke with another heart dad that traveled a substantial distance for his child’s surgeries. We called a family practice doctor we knew, who talked to other doctors he trusted. Hard facts were nowhere to be found.

While searching for information, I attended a local support group meeting filled with some of the strongest mothers I have ever met. It was like a tidal wave of one horrific tragedy after another. Tangible information was hard to find, but thankfully there were whispers and private conversations. I ended up getting a name of a surgeon’s nurse who I could call for help.

After consulting with two different surgeons, both at their respective hospitals, we decided for John to receive care at a nationally ranked center of excellence. It was their seasoned experience, as a whole, that set them apart. As I type this, I’m fighting back tears of relief and joy, because there was a high likelihood that John would be dead or disabled had we not found our own way to this great hospital.

Docs Surrounding Bedside

Doctors and nurses surrounding John’s bedside after his 2nd OH surgery, the Glenn.

If you are a soon-to-be heart parent, your child is amazing and worth fighting for! When it’s your blue baby coming into this world, gasping for breath, and about to be placed on that operating table, you’re going to want to be at a hospital that’s not afraid to truthfully share their outcomes of whatever procedure your child needs. If you need help or guidance during your research process, you can use PCHA’s Guided Questions Tool for practical advice.

Transparency improves trust and is essential to improving quality and outcomes. Parents deserve to be properly and truthfully educated on their viable options of where to go for surgery and recovery. Choosing which hospital to go to for invasive surgeries can be the difference between life and death. It can be the difference between your child walking off the school bus to go to Kindergarten or spending the rest of his life in a wheelchair. And what we discovered is, finding a good surgeon isn’t enough. Infants and children recovering from open heart surgery need a supportive and organized system in place due to complicated recoveries. Thankfully, John was at a center that had specialized equipment and experienced cardiac sub-specialists readily available. He is one of the lucky ones. He is the real, beautiful, amazing little boy behind this transparency story.

Toddler Pic, looking down (1280x853)

John was a breastfeeding 9 month old when he crawled across the living room. He took his first steps at 14 months of age. And today he continues to develop normally, graduating from preschool, alongside peers his own age.

We vacationed over the 4th where he:

Jumping into lake

Jumped into the lake with his family and yelled, “CANNON BALL!”

Standing on Head

Stood on his head.

Climbing

Climbed the playground equipment.

Fishing

Learned how to fish.

Ice Cream

Ate Ice Cream.

Boating

And shouted from the hull of the boat, “To the beach, daddy, full speed ahead!”

And that’s exactly what he’s doing. He’s a precious little boy moving full speed ahead as he grows, develops, and begins to understand his important place in this world.


John

John turns 5 years old this month with a bright and promising future in front of him! He lives in West Des Moines, IA with his parents and two older siblings, Abigail and Caleb. He receives care at The University of Iowa Children’s Hospital in Iowa City, IA where he successfully underwent the Norwood, Glenn, and Fontan open-heart surgeries as well as an interventional cardiac catheterization where a permanent fenestration was inserted. He has dealt with complications including Chylothorax, NEC, Embolic Stroke, PLE, and Plastic Bronchitis. He sends out a huge thanks to all who have worked together to make his life what it is today.

A Life Raft: A Parent’s Experience using the Guided Questions Tool

Esther Kinney

Esther Kinney

The Guided Questions tool was designed to help parents promote discussion with their cardiac care team. At the Pediatric Congenital Heart Association (PCHA), we believe that information is important when making decisions about the care of your child. The tool is broken into three key aspects of care: quality data, patient experience and looking ahead. Esther Kinney shares her own experience using the Guided Questions during pregnancy, after her daughter was diagnosed with CHD.

 

How did you learn about the Guided Questions tool?

I learned about the Guided Questions tool during my first telephone conversation with Amy Basken, co-founder of PCHA. I was a desperate emotional wreck. I still remember the relief I felt when she described the pamphlet.

Why did you decide to use the tool?

After learning of my daughter’s heart condition, I felt completely lost and overwhelmed. My world was rocked to find out that my daughter Sophia would need open heart surgery immediately after birth. I knew that I didn’t have the necessary knowledge to manage all of the decisions. I had to ensure she received the best possible care, but wasn’t sure where to start. When Amy mentioned the Guided Questions, I felt as if I was handed a life raft. And it was. It would be one of the most important resources for selecting the best location for my daughter’s care.

When using the Guided Questions, did you bring in the actual pamphlet or prepare a list of questions on your own?

I printed the brochure and kept it in the front of my “Sophia binder”. I brought the questions with me to the appointments, read them verbatim, and took the time to write down the answers.

Which questions were the most helpful to you and why?

How many procedures do you perform each year? | How many times have you and your program performed this procedure or ones like it in the last year? Over the last 4 years? | What is the survival rate for this type of procedure at the time of hospital discharge? After one year? | How do your results compare to other centers’ results?

The responses I received from facilities differed significantly. I think I had the expectation that this type of specialty care would have similar outcomes no matter which hospital you go to, but I was very wrong.

What are the most likely complications or things that can go wrong with this procedure and how often do they happen within one year of this procedure? | Do you share your results with national data programs such as the STS Database or Impact Registry to help improve care? Is this information open to the public?

In my experience, there are hospitals that focus on things they are good at and sweep their areas of deficiency under the rug. Unless questions are asked directly and consistently, it is difficult to compare the answers.

Did the tool help you discover new questions that you hadn’t thought of?

Yes! I was an emotional wreck. I had no idea to ask if there was a dedicated CICU.

How did the questions impact your confidence in talking to your care team?

It gave me a voice. It empowered me by helping me feel competent.

Tell us about the reaction from your doctors when you asked the questions from this tool.

One of the providers shrugged off the necessity of such a tool and completely disregarded some of the questions. He told me that I shouldn’t go through life focusing on all the things that could go wrong. He said that any one of us could walk across the street and get killed by a car. I wanted to ask him if he realized we were talking about the health and well-being of my precious child.

Another team of providers took each question seriously. They provided thorough answers. They went above and beyond to make me feel as comfortable as possible, while providing a realistic prognosis and expressing genuine concern for the well-being of my daughter.

What impact did the tool have in your own knowledge and in your child’s care?

As a nurse, I understand basic medical terminology. However, I haven’t worked on a general cardiac unit, and neonatal open heart surgery is even more complex. This tool gave me the correct language to use. It identified the expectations that were appropriate. For example, it is okay to expect that the hospital has a dedicated CICU, with specialized CICU nurses. It is okay to expect that hospitals are transparent with their statistical outcomes. It is always okay to seek a second opinion.

As a mother, I often second-guess many of the parenting decisions I make. Using that tool and going to the hospital that respected my need for information are two decisions I have never regretted.

Would you tell others to use these questions and why?

Yes! I share this brochure all the time. I will always be a heart mom. Amy will always be a heart mom. She handed me a gift when she told me about these questions. I want to pay it forward and pass that gift along as often as I can.

Passion and Progress: A Provider’s Perspective

In July, PCHA is highlighting the need for transparency. Our goal is to inform, educate, and empower patients and families to actively participate in data-driven shared-decision making. Julie Slicker, a member of the PCHA Medical Advisory Board and lead on the Guided Questions Tool, speaks about the importance of transparency from a provider’s perspective. 

“We didn’t know until after our child was born,” “How could we predict what to ask the doctors? We had to just blindly trust in their skills,” “We were so afraid that we felt paralyzed and we didn’t know how to ask the right questions.” These are the parental anxieties that we, as providers, hope to have the power to impact. And today, with the effort of PCHA and their new Guided Questions Tool (GQT), maybe we can. But first, a story.

I will never forget the first time I had the privilege of caring for a child with congenital heart disease (CHD). It was 10 years ago, and the honor I felt being able to care for that child’s nutritional needs has never left me. As a Registered Dietitian (RD), I have had the opportunity to meet with countless other families since then. That said, every provider has a memory of one child that pulls at their heart strings.

He was a tiny infant named Joe, with a family that had no idea they were having a child with CHD and whose unexpected rush to the hospital changed their life forever. Joe’s tiny little round head, his blue lips and fingers, the fear and anxiety his family had to face, the multiple hospital admissions and the surgical interventions he had to endure will remain with me forever. I have heard so many stories over the years that started out the same way: A time that is supposed to be filled with joy and excitement quickly turned to one of stress, anxiety, and a feeling of being overwhelmed and powerless. I wanted to help to heal Joe and take away the pain and worry of his parents. I wanted to make a difference.

Together with PCHA, I feel that we’ve discovered a way to make that difference. A Guided Questions Tool (GQT) was created to facilitate relationship building and transparency between patients, families and their providers when discussing surgical interventions for infants. This tool is designed to result in data driven answers that promote discussion, leading to the balance between accurate information and reassurance. The first phase of this effort included the development of a list of “Suggested Questions” that parents could ask their providers. Parents and medical providers joined efforts and vetted the questions to identify those that reflect quality of care and outcomes. The questions were sorted into categories to address center outcome data, hospital experience and long-term outcomes. The questions were further edited by a multi-disciplinary team of providers and parents to ensure that they would meet health literacy goals and result in a transparent discussion between parents and providers. From this effort, the first true iteration of the GQT was born.

The next step is to test the GQT’s efficacy in practice. We have gathered a multidisciplinary team comprised of four CHD centers from all over the country to validate this tool via surveys for both providers and parents. We plan to initiate this phase next month.

The mere existence of PCHA, and the GQT that they have helped develop, speaks volumes about where we have come from as a discipline practicing in CHD. A nurse scientist colleague of mine who has dedicated her life’s work to improving the quality of life and developmental outcomes of children with CHD once showed me an old tattered notebook that forever changed my perspective on CHD. In this notebook she showed me the meticulous handwriting of one dedicated surgeon’s log of procedures from the 1980’s. This notebook held a list of patients with Hypoplastic Left Heart Syndrome (HLHS), one of the most severe forms of CHD. Written in front of the first 12 names was a capital letter D, denoting the passing of every single one of those infants. The nurse scientist explained the struggles in the early years of the Norwood procedure. Twelve names. Twelve families. Twelve tiny little infants with so much hope … and ultimately twelve deaths due to complications from this poorly understood physiological nightmare. Then miraculously, after twelve failures, there was a name in the book that stood alone; there was not a letter D written next to it.  The thirteenth child lived. And is still living today. This story makes me remember why sometimes failure is a greater lesson than success. It is often said that it is much worse to never try at all than to suffer repeated failure. I cannot imagine the perseverance this cardiac team maintained as they pushed through so much devastating failure. However, it is due to those families and the trust they placed in the medical team that the surgeons learned what they needed to. Yes, these early families lost their infants and have experienced unimaginable pain, but I can only hope they gained solace in the fact that their infant’s death led to the life of thousands more. They changed the course of cardiac surgical history. Today our facility, Children’s Hospital of Wisconsin, proudly touts that greater than 90% of these patients survive surgery to go home with their families. In the 1980’s these babies did not make it through their first months of life, and today our expectation is that most will grow into adulthood.

So, keeping this story in mind, here we stand. We can now save the lives of thousands of individuals with CHD all over the country. Cardiac programs have been built surrounding the ideals of survival and excellent outcomes, but as far as most of us working with CHD families are concerned, it is still not enough. Survival rates are high, we have surpassed that hurdle, and now we are focusing on improving care even earlier, particularly, during the prenatal period. In order to help families navigate the difficult world of congenital heart disease, PCHA, along with other cardiac providers from across the country, have implemented the GQT for this exact reason. This tool elicits discussions among providers and families around transparency and quality of care at cardiac centers. Joe’s family, like countless others, experienced extreme stress, confusion, and anxiety. They had to blindly trust their local CHD program. Our goal with the GQT is to give families a guide to discuss important topics with their fetal cardiologists before their baby is even born. This tool offers a list of questions that inquire about outcomes at each cardiac center, as well as what parents can expect during their hospital stay. Additionally, the GQT prompts parents to ask about what the expected long term results are for their child’s particular lesion. The GQT also focuses on the type and number of procedures children may undergo, the survival rate for their diagnosis, and the type of training and experience that the providers have. This tool will empower parents to ask the right questions, and will prompt providers to anticipate these questions and become knowledgeable about the answers. Utilizing this tool will allow transparency to take place, trust to be built, and knowledge to be gained.

Providers and parents alike push aside their fears and try to maintain hope that each child with CHD will have a positive outcome and achieve the quality of life deserved. It is because of this passion that I believe the field has progressed so far in the last 30 years. As PCHA and four other sites across the country embark on this small initiative to test and validate the GQT, I cannot help but think about the particular surgeon and his team in that notebook, and how they truly changed the world of CHD forever. This tool may be a drop in the bucket in comparison, but we aim to continue raising the bar for families with CHD to help support and empower them as much as we can.

It is truly an honor and a privilege for all of us that work with CHD families to help change the world – one CHD family at a time.

Julie Slicker MS RD CSP CD CNSC with edits by Sydney Allen, MPH


Julie SlickerJulie Slicker is currently the Quality, Outcomes and Research Manager of the Herma Heart Center at Children’s Hospital of Milwaukee in the Division of Cardiology. Julie has been at Children’s Hospital of Wisconsin since June 2006. Pediatric nutrition for infants with complex congenital heart disease is Julie’s passion, and since 2006 she has dedicated her time to caring for the nutrition of this patient population. In conjunction with patient care, Julie’s research focuses on hypoplastic left heart syndrome (HLHS) and single ventricle physiology. She pursued her Master’s Degree at the Medical College of Wisconsin in Clinical Translational Science and graduated in 2013. She is currently pursuing a degree as a nurse practitioner in order to  continue her work in the cardiac ICU, caring for the patients she has come to cherish over her career thus far.

Blog photoSydney Allen is a Program Coordinator for the Herma Heart Center at the Children’s Hospital of Wisconsin, focusing on quality improvement initiatives. Many of her projects revolve around improving patient outcomes, patient satisfaction, quality of life, and optimizing clinical process flow. She obtained her Master’s in Public Health Nutrition in 2014 and when she’s not busy working on healthcare quality improvement, she enjoys recipe testing in her kitchen to find simple, delicious, and nutritious plant-based meals to share with her friends and family.