CHOC Specialists Rheumatology physicians are committed to the early intervention necessary to maximize quality of life for children with rheumatic diseases. These highly experienced and talented physicians provide innovative, yet cost-effective inpatient and outpatient care for inflammatory and non-inflammatory rheumatic diseases, including:

Clinical services are complemented by the multidisciplinary care provided by other pediatric subspecialists, nurses, pharmacists, therapists, clinical dietitians and social workers at CHOC and CHOC at Mission.

Regionally Recognized for Clinical Excellence

Early intervention is crucial to long-term prognosis and quality of life for a child with rheumatic disease. As part of their professional commitment to serving this especially vulnerable patient population, CHOC Specialists Rheumatology physicians often travel outside Orange County to assess a child in need, in addition to providing outreach to local hospitals.

As CCS-accredited providers in rheumatic disease, CHOC Specialists Rheumatology physicians are available for on-site evaluation within a three-county radius: Orange, Riverside and San Bernardino counties. They are also affiliated with the American Juvenile Arthritis Organization and serve on the board of the Arthritis Foundation.

Care Available for the “Whole Child” and Family

As part of the multidisciplinary treatment milieu, clinical services offered include medical evaluation and therapy, psychosocial support, nursing education, and occupational and physical therapy. Families are encouraged to participate in rheumatic disease support groups.

A CHOC Specialists Rheumatology physician also provides medical care at Camp Esperanza, a summer camp sponsored every year by the Arthritis Foundation for children with rheumatic diseases.

Actively Participating in the Latest Bench and Clinical Research

CHOC Specialists Rheumatology physicians serve as principal investigators for several research studies into inflammation, a significant factor in such autoimmune diseases as juvenile rheumatoid arthritis, systemic lupus, multiple sclerosis and scleroderma. Activities are focused on the genetics of autoimmune disease and DNA repair. Their involvement in this leading-edge research gives patients access to newer medications and treatment.

Available for consultation 24-hours-a-day, CHOC Specialists Pulmonology physicians provide comprehensive clinical services for a full range of genetic, developmental, structural and acquired disorders of the lungs and respiratory system. Board certified in pediatric pulmonology, these highly experienced physicians provide innovative, yet cost-effective inpatient and outpatient care for common and unusual disorders:

• Recurrent pneumonia
• Cystic fibrosis
• Severe asthma
• Chronic cough
• Airway problems
• Sleep apnea
• Chronic lung disease
• Congenital lung abnormalities
• Bronchopulmonary dysplasia
• Tracheotomy care
• Immunology disorders
• Home ventilators
• Neuromuscular problems
• Chronic care of technology dependent children

Regionally Recognized for Excellence : Available for consultation throughout the greater Orange County area, CHOC Specialists Pulmonology physicians are CCS-accredited providers for cystic fibrosis and chronic lung disease. They direct the Cystic Fibrosis Care, Research and Treatment Center at CHOC, which is also accredited by the Cystic Fibrosis Foundation.

In addition to providing medical direction for inpatient and outpatient pulmonology services at both CHOC and CHOC at Mission, CHOC Specialists Pulmonology physicians serve as Directors of the CHOC Respiratory Institute and the CHOC Asthma and Chronic Lung Program, as well as providing inpatient consultation at several community hospitals. They also direct pediatric sub-acute units at hospitals in Orange and Whittier.

Specialized Pediatric Procedures and Services : Fully equipped with sophisticated, leading-edge technology, CHOC Specialists Pulmonology physicians provide tertiary-level, pediatric subspecialty services, including:

• Pediatric pulmonary function testing at CHOC, including spirometry, lung volumes, diffusion capacity, exercise stress testing and the ability to study young children and those with disabilities
• Fiber optic bronchoscopy, including a wide range of bronchoscopes for different sizes and problems
• Full respiratory care program with multiple options for bronchial clearance
• Ongoing management of children with bronchopulmonary dysplasia (BPD) and other oxygen-dependent patients
• Apnea diagnostic center and monitor program, including education for parents of children with sleep apnea
• Cystic Fibrosis Care, Research and Treatment Center
• Respiratory Syncytial Virus Prevention Clinic, offering risk assessment and prophylaxis of high risk infants
• Neuromuscular evaluation and treatment for respiratory complications of neuromuscular disease

Inpatient services provided by CHOC Specialists Pulmonology physicians are complemented by the multidisciplinary care provided by pediatric subspecialty physicians, nurses, pharmacists, therapists, clinical dietitians and social workers at CHOC, the only pediatric hospital serving Orange County.

Family Support and At-Home Care

CHOC Specialists Pulmonology physicians offer a home ventilator program and consultation for chronic, oxygen-dependent patients. Home intravenous therapy is available for children with cystic fibrosis and other lung diseases.

Access To the Latest Clinical Research

CHOC Specialists Pulmonology physicians participate in clinical research, giving patients access to newer medications and treatment. They serve as principal investigators for multiple ongoing studies for new medications developed for cystic fibrosis, bronchopulmonay dysplasia, asthma and other pediatric lung diseases.

CHOC Children’s Specialists Ophthalmology provides the latest, most comprehensive treatment for pediatric eye disorders. We offer both basic eye care and specialty care, as well as surgery, to protect and restore vision for babies, children and teens.

Children often cannot tell you when they are having problems with their vision. We use innovative techniques to test a child’s vision that are different than methods used at adult practices, all in a pediatric setting.

What We Treat

We treat the full spectrum of pediatric eye conditions, including but not limited to:

• Amblyopia (lazy eyes)
• Childhood glaucoma (infantile, juvenile and traumatic)
• Double vision (diplopia)
• Droopy eyelids (ptosis)
• Eye inflammation (uveitis)
• Infantile and childhood cataracts
• Nasolacrimal duct obstruction (blocked tear ducts)
• Refractive errors (need for glasses/contacts)
• Retinopathy of prematurity and its complications
• Strabismus (crossing or drifting of the eyes)
• Tearing eyes
• Traumatic eye injuries.

Our pediatric ophthalmologists also treat eye problems related to other diseases such as diabetes, sickle cell disease, juvenile rheumatoid arthritis, metabolic disorders, brain tumors, genetic and chromosomal disorders, and craniosynostosis.

Vision Screenings

Early diagnosis and treatment is important to ensure a child’s vision develops correctly and to prevent long-term problems. We offer comprehensive eye screenings for every age.

Experts in Pediatric Eye Surgery

Because we perform eye surgery on the smallest patients, including babies as young as one day old, we use the least invasive techniques possible and unique methods to help ensure a child has a lifetime of vision. Eye surgery is performed at the CHOC Children’s surgery center, featuring pediatric-trained anesthesiologists, operating rooms and equipment that are customized for kids, and child life specialists who are at the bedside to reduce a child’s stress. Learn more about having surgery at CHOC.

Innovations in Pediatric Glaucoma Management

CHOC Children’s Specialists Ophthalmology is one of only a handful of centers in the United States that performs illuminated microcatheter-facilitated trabeculotomy, which is a minimally invasive surgical procedure for pediatric glaucoma management. This highly specialized treatment is the newest approach to lowering intraocular pressure in the eye with minimal risk for complications.

The Oncology unit at CHOC is staffed with nurses specially trained to treat the complex conditions that accompany pediatric cancers. In addition, the 28-bed Hematology/Oncology unit and the 12-bed Oncology Intensive Care Unit (OICU) is the only dedicated pediatric program in Orange County. As part of the CHOC Cancer Institute, our program offers the latest in medical and surgical oncology including chemotherapy, radiotherapy and blood and marrow transplantation. The program brings together a full range of pediatric services and multidisciplinary care for our pediatric cancer patients and their families.

Internationally recognized for clinical excellence, CHOC Specialists Oncology physicians provide state-of-the-art diagnostic services and a full spectrum of treatment modalities for pediatric malignancies, including surgical oncology, chemotherapy, radiotherapy, and blood and marrow transplantation. Their services are complemented by the multidisciplinary care provided by other pediatric subspecialists, nurses, pharmacists, rehabilitation therapists, clinical dietitians, child psychologists and social workers at CHOC. Actively involved in clinical as well as translational research, these highly experienced, board certified pediatric oncologists provide patients with access to the latest, often break-through, treatments.

CHOC Specialists Oncology physicians are fully equipped with highly advanced technology available, including:

• Advanced CT, PET, MRI and MRI spectroscopy for the diagnosis and staging of tumors
• Sophisticated radiotherapy capabilities, including a new linear accelerator and CT-based planning system and simulator.

Internationally Recognized for Research

CHOC Specialists Oncology physicians serve as medical directors for the CCS-accredited inpatient and outpatient oncology program at CHOC, including The CHOC Cancer Institute. CHOC is an active member of the prestigious Children’s Oncology Group (COG), a National Cancer Institute-supported program offering patients access to state-of-the-art treatment through research.

By participating in clinical studies through COG and with pharmaceutical, biologic and device companies, CHOC Specialists Oncology physicians are able to provide patients with access to the latest therapeutic advances for cancer and for the side effects caused by cancer treatment.

Comprehensive Blood & Marrow Transplant Services

CHOC Specialists Oncology physicians direct the pediatric blood and marrow transplant program at CHOC, the only program of its kind serving Orange County children. This comprehensive program includes a stem-cell laboratory and umbilical cord blood bank.

Approved by the National Marrow Donor Program, services include pre- and post-transplant care for immune deficiency disorders, hematologic disorders, malignancies and genetic disorders. Transplantation is available using histocompatible, haploidentical and matched unrelated bone marrow and cord blood.

Working in Collaboration With Referring Physicians : Referring physicians are encouraged to participate in the treatment planning process and receive thorough update reports on a timely basis.

Available 24-hours-a-day, 7 days a week, CHOC Specialists Nephrology physicians provide the comprehensive inpatient and outpatient care necessary to maximize quality of life for children with kidney diseases. These highly trained and skilled pediatric subspecialists work collaboratively with primary care physicians and pediatric urologists, meeting the medical and surgical needs of children with acute and chronic renal disease.

CHOC Specialists Nephrology physicians also serve as medical directors for the CHOC Pediatric Nephrology Program, the only CCS-certified center serving Orange County, and the pediatric dialysis unit at the St. Joseph Hospital Renal Center in Orange. Their services are complemented by the multidisciplinary care provided by other pediatric subspecialists, nurses, pharmacists, therapists, clinical dietitians, child psychologists and social workers at CHOC.

Regionally Recognized for Clinical Excellence: Early intervention and consultation with a CHOC Specialists Nephrology physician allows for timely diagnosis, intervention and treatment. Inpatient and outpatient consultation is available for all renal problems, including:

• Hypertension
• Nephrotic syndrome
• Hematuria
• Acute and chronic renal failure
• Proteinuria
• Cystic kidneys
• Recurrent urinary tract infections
• Renal anatomical abnormalities
• Kidney stones
• Calcium and phosphorus metabolism
• Nephritis
• Polyuria and polydypsia
• Renal tubular acidosis and tubular disorders
• Pre-renal transplant evaluation
• Diabetic nephropathy
• Post-renal transplant follow-up care

Specialized Pediatric Procedures

Highly experienced, CHOC Specialists Nephrology physicians have the expertise to perform the following specialized procedures:

• Percutaneous renal biopsies using ultrasound guidance, and
• State-of-the art renal replacement therapy for acute renal failure, including peritoneal dialysis, hemodialysis, and continuous renal replacement therapy using a blood pump for the smallest and most critically ill infants and children

Pediatric Renal Dialysis and At-Home Peritoneal Dialysis

CHOC Specialists Nephrology physicians serve as Medical Directors of the Pediatric Dialysis Unit at St. Joseph Hospital Renal Center, the only pediatric facility of its kind serving greater Orange County. They also provide specialized family training and comprehensive support for at-home peritoneal dialysis.

Family Education and At-Home Care

CHOC Specialists Nephrology physicians combine compassion with education to help parents and patients, as appropriate, understand and manage the condition. By involving the family in treatment planning, many complicated conditions may be managed within the comfort of the patient’s own home – avoiding costly hospitalization. Physicians are available 24-hours-a-day, 7 days a week for phone contact with parents to avoid unecessary trips to the Emergency Room.

Active Participants in the Latest Clinical Research

CHOC Specialists Nephrology physicians serve as principal investigators for several clinical research studies, providing patients with access to the newest treatment options available. Recent studies have included clinical trials to assess the effectiveness of a new anti-hypertensive medication, an active form of Vitamin D for dialysis patients, and a new, long-acting erythropoetin drug for anemia in patients with renal failure

CHOC Children’s Specialists Neonatology Physicians are available around-the-clock to provide the most sophisticated, lifesaving care for critically ill newborns and to attend high-risk deliveries at select Orange County facilities for high-risk deliveries. These board certified pediatric subspecialists are CCS-accredited providers for the region and serve as medical directors for the two primary neonatal centers in Orange County: the 54-bed Neonatal Intensive Care Unit (NICU) at CHOC, and the 16-bed NICU located within CHOC at Mission. For infant birth weight under 2¼ lbs (< 1,000 grams), our Small Baby Unit is staffed with specially trained nurses, respiratory therapists and other supporting staff. CHOC is a member of the Neonatal Centers of Excellence Network. The CHOC Children’s Specialists Neonatology Division also directs neonatal programs at selected hospitals within the community.

More Than 35 Years of Experience in Neonatal Medicine

CHOC Children’s Specialists Neonatology Physicians are experts in treating the full spectrum of newborn illnesses and conditions. Working in a team centered care environment, the NICU programs at CHOC and CHOC at Mission have become recognized for providing the following specialized services:

• More than 25 years experience in providing extra corporeal membrane
  oxygenation (ECMO), heart lung bypass, for critically ill infants
• State-of-the-art respiratory therapy services
• National recognition for the use of immunotherapy and biotherapy to treat
  neonatal infections
• Nitric oxide treatment
• 24-hour transport team, the only one in the region equipped with a pediatric oscillator
• Cutting-edge management, support and treatment of newborns with cardiac conditions

The CHOC Children’s Specialists Neonatalology Division directs medical services provided for premature infants through the Early Development Assessment Center (EDAC). Assessment and treatment of apnea and other high-risk conditions is provided through regularly scheduled outpatient clinics at CHOC. CHOC Children’s Specialists Neonatology Physicians coordinate all necessary follow-up outpatient care, including coordination with pediatricians and planning for at-home care. We provide family-centered care with family involvement in the care and decision-making a priority from admission to discharge.
CHOC Children’s Specialists Neonatology Physicians strive to provide evidence-based quality care in our NICUs by our ongoing effort in the quality improvement arena. The declining rate of infection, increased use of breast milk and increased infant weight at the time of discharge, combined with a decreased length of hospital stay are evidence our ongoing efforts to improve quality.

Prenatal Counseling and Genetic Assessment : Comprehensive prenatal consultation, genetic assessment and advance treatment planning is provided for high-risk mothers. Having assisted in the development of NICU bioethics guidelines, CHOC Children’s Specialists Neonatology Physicians are available to assist families in making well-informed ethical choices.

CHOC Children’s Specialists Neonatology Physicians are in-house 24-hours-a-day, 7-days-a-week at CHOC, CHOC at Mission and select hospitals in Orange, Riverside and Los Angeles Counties and are available to attend high-risk deliveries.

Access to the Latest Clinical Research

The CHOC Children’s Specialists Neonatology Division participates in multi-center studies to assess the potential efficacy of new treatments, giving patients access to the newest medications and the latest medical advancements. Recent studies have evaluated the use of G-CSF to treat neonatal sepsis, and the efficacy of nitric oxide to treat pulmonary vasodilitation and severe pulmonary hypertension.

Watch CBS News Videos Online. This video from CBS News explains the recent FDA approval of the new Cool Cap technology and how it’s use can help save the brain of a baby that suffered oxygen deprivation at birth. Dr. Emily Senay joins Hannah Storm to explain how it works. This technology is now available at CHOC Children’s and is used by the CHOC Children’s Specialists Neonatology Division when indicated.

Participation in multi-center research studies allows CHOC Children’s Specialists Neonatologists to provide the most leading-edge therapies for treating a vast array of neonatal conditions.

The CHOC Specialists Metabolic Disorders Division is committed to diagnosing and caring for children with inborn metabolic diseases. Our treatment protocols and research are built upon the latest findings in our field, through a collaborative approach combining our expertise with other leading experts throughout the nation.

Genetic diseases are becoming increasingly recognized, and early testing, diagnosis and appropriate treatment interventions are critical to prevent complications, permanent disability, mental retardation and even death in children with inborn metabolic disorders. We are hopeful that many more metabolic conditions will be diagnosed by the use of new technologies currently available in newborn screening.

Testing and treatment for metabolic disorders is non-invasive and largely provided in an outpatient setting by the experienced treatment team based at Children’s Hospital of Orange County (CHOC). Testing includes specific metabolites in blood and/or urine (amino acids, acylcarnitines, carnitine, organic acids, mucopolysaccharides, etc.) and/or the assessment of enzyme activities.

Most treatment involves specific diets and formulas that are devoid of the metabolites that cannot be broken down in patients with metabolic disorders. Through treatment, we are able to prevent the natural course of the disease.

Clinical presentation of children with inborn metabolic diseases could be variable and non-specific, including failure to thrive, malnutrition, cyclic vomiting/dehydration, developmental delay/mental retardation or regression.

Patients are referred to our Program with unexplained or persistent:

• Metabolic acidosis or ketosis
• Increased lactic acid
• Hyperammonemia
• Abnormal liver function tests
• Hypoglycemia
• Neutropenia/Thrombocytopenia
• Cataracts or Corneal opacities
• Cardiomyopathy
• Hepatosplenomegaly
• Intractable seizures
• Failure to thrive
• Developmental delay or loss of milestones

Patients are sent to us for consultation when common work-ups based upon any of the symptoms listed above do not lead to a clear diagnosis.

Commonly treated disorders

• Urea Cycle Disorders
• Organic Acidurias
• Amino Acid Disorders
• Vitamin and Cofactor Disorders
• Carbohydrate Metabolism Disorders
• Fatty Acid Oxidation Disorders
• Mitochondrial Disorders
• Neurotransmitter Disorders
• Lysosomal Storage Diseases
• Peroxisomal Disorders
• Other Inborn Errors of Metabolism: Creatine disorders, Purines & Pyrimidines disorders, Congenital Disorders of Glycosylation (CDG)

Advanced Research

There is growing interest and focus in the area of metabolic and genetic disorders. Our bench and clinical research focuses on early detection of inborn metabolic diseases using tandem mass spectrometry, new dietary treatment approaches for fatty acid oxidation defects and identification of defects in purines and pyrimides.

In-House Diagnostic Laboratory

We are in the process of validating a state of the art diagnostic laboratory for inborn errors of metabolism. Primary tests that will soon be performed by the laboratory include:

• Organic acids
• Amino Acids
• Acylcarnitines
• Carnitine (total and free)

Infection can spread rapidly in a small child and involvement of a pediatric infectious diseases specialist can make all the difference. CHOC Specialists Infectious Diseases physicians are available for telephone consultation and inpatient evaluation 24-hours-a-day, 7 days a week at CHOC, CHOC at Mission and select area hospitals.

CHOC Specialists Infectious Diseases physicians are highly experienced, board certified pediatric subspecialists who understand the changing nature of infectious disease, particularly the complexities of pharmacodynamics in relation to a child’s immune status, developmental stage and possible environmental risks. They provide the early diagnosis and intervention necessary to prevent the complication and further spread of serious, life-threatening illnesses, including viral infections and complex or resistant bacterial and fungal infections. CHOC Specialists Infectious Diseases physicians also serve as medical directors of infection prevention. Their expertise has had a measurable impact in decreasing the spread of nosocomial and community infections and reducing the emergence of resistant pathogens. Infections in hospitalized children can evolve quickly and become life-threatening.

The Board Certified Pediatric Infectious Disease physicians at CHOC use their expertise to treat a range of problems – from the child in the community with meningitis or osteomyelitis, to the oncology patient with a complex fungal infection, to the fragile premature infant with sepsis. Their knowledge regarding new therapeutic modalities, emerging drug resistance, pharmacokinetics, and host-microbial interactions are key to successful outcomes for these children.

Early Intervention For Life-Threatening Conditions : The CHOC Specialists Infectious Diseases physician team is available 24-hours-a-day to provide expert diagnosis and treatment for acute or life-threatening conditions, such as:

• Infectious diseases, including those caused by multi-resistant bacteria
• Congenital and perinatal infections, including HIV
• Opportunistic infections in the immunocompromised patient
• Immunocompromised host
• Respiratory infections
• Viral and fungal infections
• Community outbreaks

Inpatient services are complemented by the multidisciplinary care provided by other pediatric subspecialists, nurses, pharmacists, therapists, clinical dietitians, child psychologists and social workers at CHOC.

Outpatient Management for Chronic Conditions

Many conditions may be safely managed through home IVs and oral regimens. For the benefit of patients and their families, every effort is made to transition care to the home environment as quickly – and as safely – as possible. In the outpatient setting, there are several clinics each week for follow-up of hospitalized patients, and evaluation of new patients, such as those with recurrent fevers, travel issues, or international adoptees. There are also special clinics for patients with primary or acquired immunedeficiency. The ID physicians are available to answer questions from community physicians regarding vaccines, and other issues commonly encountered in general pediatric practice.

The CHOC Specialists Infectious Diseases physician team provides comprehensive outpatient care for:

• HIV – an accredited program serving the greater Orange County area
• Recurrent/periodic fever or fever of unknown origin
• Viral hepatitis
• Tuberculosis and other chronic infections
• Coccidiomycosis and other endemic fungal infections
• Travel medicine for children
• Infections in primary immune deficiencies

Active Participants in the Latest Clinical Research

CHOC Specialists Infectious Diseases physicians serve as principal investigators for several clinical research studies, providing patients with access to the newest treatment options available. Recent studies have focused on the development of vaccines, antiviral medications, and anti-fungal treatments for common and serious infections.
CHOC Specialists Infectious Diseases physicians are also active participants in several nationwide collaborations for the study of a variety of infections in children.

The CHOC Specialists Hospitalist program is a timely, cost-effective service available to primary care physicians whose busy outpatient practices limit the amount of time available to care for hospitalized patients.

For Admissions Call: (714) 509-8400
To reach the CHOC Orange On-Call Hospitalists call: (714) 997-3000

CHOC Specialists Hospitalist physicians are board certified pediatricians who specialize in hospital-based medicine. They are available 24-hours-a-day, 7 days a week to provide comprehensive inpatient care, consult with specialists, and coordinate hospital services – all while remaining in contact with the primary care physician at both the Orange and Mission campuses.

Upon discharge, patients are immediately referred back to the primary care physician for follow-up care and management.

Expert Care for Critically Ill or Injured Patients

The CHOC Specialists Hospitalist physician team is highly experienced in providing general inpatient-level pediatric care at CHOC and at CHOC at Mission.
Convenience, Coordination & Continuity

The CHOC Specialists Hospitalist service offers several advantages for referring physicians and patients alike. With 24-hour availability, CHOC Specialists Hospitalist physicians are immediately available to:

• Attend to patients as often as necessary
• Consult with or provide updates to referring physicians
• Consult with parents and family members
• Arrange consultation with specialists as necessary
• Order hospital tests or procedures and are immediately available to review results
• Facilitate transfer of a patient between an intensive care unit and a medical floor
• Access patients throughout the day to identify the optimal time for discharge

The County of Orange (CHDP) program recertifies existing CHDP providers every 3 years. Part of the Certification requires the provider holds Hospital Privileges at a minimum of one hospital OR may designate a Hospitalist Program to cover patients they need to admit to a hospital. For more details, please visit: DHCS.CA.gov/services/CHDP

Committed to serving the pediatric community, the CHOC Specialists Hematology physicians and treatment team provide comprehensive, multidisciplinary evaluation and treatment for hematologic diseases. Care is based on the whole-child/family approach and provided within an atmosphere of compassion and support.

The most highly advanced care is available for all forms of congenital or acquired blood and bone marrow disorders:

• Anemia, including sickle cell anemia and thalassemia
• White cell immune deficiencies
• Coagulation abnormalities, including hypercoagulation, hemophilia, Von Willebrand’s Disease and related bleeding disorders
• Bleeding and clotting disorders as a result of illness or surgery in otherwise healthy children
• Prevention of bleeding and clotting problems, with particular experience in caring for patients on cardiopulmonary bypass
• Hemostatis/Thrombosis Program, including free educational materials for healthcare providers and parents
• Outpatient care for anemia caused by ingestion of lead
• Outpatient care with access to short-term infusions

Family Support and At-Home Care

To help patients and parents become more autonomous in disease management, extensive education is provided. A home healthcare program is also available so that, whenever possible, children may be at home with their families.

Regionally Recognized for Clinical Excellence : CHOC Specialists Hematology physicians are board certified pediatric hematologists/oncologists. They provide medical direction for the inpatient and outpatient hematology services provided at CHOC and CHOC at Mission. They also direct the CHOC Hemostasis/Thrombosis Program and the Blood and Apheresis Center.

CHOC Specialists Hematology physicians are part of the multidisciplinary physician team serving the CHOC Neonatal Intensive Care Unit (NICU) and Pediatric Intensive Care Unit (PICU). Inpatient services are complemented by the multidisciplinary care provided by other pediatric subspecialists, nurses, pharmacists, therapists, clinical dietitians, child psychologists and social workers at CHOC.

Internationally Recognized for Immune, Autoimmune and Inflammation Research

CHOC Specialists Hematology physicians play an integral role in the CHOC Immunology and Inflammation Research Consortium, collaborating with colleagues at Stanford University, Scripps Research Institute and the University of California campuses at Davis, San Diego and San Francisco. They have examined the role of genetic background and immune function in several large-scale research studies, to help identify children predisposed to damage from an overactive inflammatory response, autoimmune disease or immune deficiency.

Their efforts have resulted in world recognition and awards from several prestigious organizations, including the National Institutes of Health, Centers for Disease Control, Maternal and Child Health and Development Bureau, Juvenile Diabetes Foundation and Arthritis Foundation.

CHOC Specialists Hematology physicians also participate in clinical research with pharmaceutical companies, providing patients with access to the latest medications and treatment available.

With multiple offices throughout the greater Orange County area, plus consultative services available at multiple hospitals, CHOC Specialists Gastroenterology physicians are available 24-hours-a-day, 7 days a week to help children experiencing chronic, painful or life-threatening symptoms. Our highly experienced pediatric gastroenterologists provide innovative, efficient treatment modalities to improve quality of life, and to reintegrate the child back to family and school activities as much, and as quickly, as possible.

The CHOC Specialists Gastroenterology Medical Director directs inpatient gastroenterology services at Children’s Hospital of Orange County, the only CCS-certified program serving the county. CHOC Specialists Gastroenterology physicians also provide medical directorship for the Pediatric GI Motility Program, a center for the investigation and treatment of motor disturbances, as well as functional problems involving the gastrointestinal tract.

24-Hour Consultation for Digestive, Nutritional and Liver Disorders

Through global expertise and individual professional areas of focus, the CHOC Specialists Gastroenterology team is able to provide treatment and services for a wide range of digestive, nutritional and liver problems, including:

We commonly treat:

• Abdominal pain – acute and chronic
• Diarrhea – acute and chronic
• Inflammatory bowel disease
• Celiac disease
• Constipation
• Weight loss – unexplained
• Growth failure
• Nutritional problems
• Parenteral nutrition support – TPN and intravenous access devices
• Enteral nutrition support – gastronomy, jejunostomy and enteral devices
• Feeding problems and dysphagia
• Gastroesophageal reflux
• Esophagitis
• Eosinophilic Esophagitis
• Short bowel syndrome
• Gastrointestinal motility disorders
• Functional gastrointestinal disorders
• Liver disorders and gall bladder disease
• Gastrointestinal bleeding

Procedures offered include:

• Upper and lower endoscopy
• Dilation of strictures
• Hemostasis maneuvers, including cautery, sclerosis and banding
• Foreign body removal
• Gastrostomy placement
• pH monitoring studies, including traditional and Bravo
• Impedance monitoring
• Gastrointestinal manometry, including esophageal, antroduodenal, colonic, anorectal
• Rectal suction biopsy
• Liver biopsy

Inpatient services are complemented by the multidisciplinary care provided by other pediatric subspecialists, nurses, pharmacists, therapists, clinical dieticians and social workers at both CHOC and CHOC at Mission.

Family Support and At-Home Care

Treatment planning is based on the whole-child/family approach. CHOC Specialists Gastroenterology physicians examine children and talk to parents to fully evaluate both the physical and emotional needs of the child. Education is also provided, empowering patients and their families to actively participate in care.

Specialized training and comprehensive support for outpatient parenteral and enteral nutrition is provided to help children remain within the home environment.

Active Participants in the Latest Clinical Research

CHOC Specialists Gastroenterology physicians serve as principal investigators for several clinical research studies, providing patients with access to the newest treatment options available. Recent activities have included a variety of medication trials.

Gastroenterology & Nutrition

Mitchell Katz, M.D. Division Chief
Kenneth Grant, M.D. Assistant Division Chief & Gastroenterology Section Chair
Shaheen Idries, M.D.
Michael Wang, D.O.
Bassam Younes, M.D.
Jeffrey Ho, D.O.
Anup Patel, M.D.
Ashish Chogle, M.D.
Gregory Wong, M.D.
Kimberly Silva, M.D.
Keren Appel, M.D.
Katie Ho, RN, MSN, CPNP
Ellen Schonfeld, RN, MSN, CPNP Coordinator – CHOC Eosinophilic Esophagitis Clinic
Janice Fredrickson, RN CCS Case Manager
Susan Alcantara, Office Manager
Yesenia Romero-Hernandez, Procedure Scheduler

Multidisciplinary Feeding Team

Mitchell Katz, M.D. Director
Amber Zaragoza, Financial Coordinator
Natalie Adame, RN,MSN, CPNP Coordinator
Jasmine Busto, RN, MSN, CPNP Coordinator

Regionally recognized for patient care excellence, the CHOC Specialists Endocrinology team provides comprehensive diagnosis and treatment of diabetes mellitus and endocrine disorders at both CHOC and CHOC at Mission.

The CHOC Specialists Endocrinology team offers several innovative specialty programs and outpatient clinics designed to enhance quality of life for patients. The team provides medical or administrative directorship for the Endocrinology and Diabetes programs at CHOC.

Our services are complemented by the multidisciplinary care provided by other pediatric subspecialists, nurses, pharmacists, therapists, clinical dietitians, child psychologists and social workers at CHOC, the only solely dedicated pediatric hospital serving Orange County.

Comprehensive Education, Treatment, Research and Support for Patients with Diabetes Mellitus

CHOC Specialists Endocrinology physicians direct the CHOC Diabetes Center, the first pediatric diabetes program in Southern California to be recognized for meeting and maintaining American Diabetes Association (ADA) standards of care guidelines.

Clinical programs offered through the Center include:

• Outpatient treatment and education for new-onset and new-to-program diabetic patients
• Comprehensive outpatient follow-up programs structured to ADA guidelines
• Parent and patient support group services and educational programs provided by the PADRE Foundation
• School, healthcare provider and community education
• Insulin pump program
• Treatment for children with Type I, non-insulin dependent diabetes mellitus

Specialty Programs for Endocrine Disorders:

• Growth Disorders – including evaluation and treatment for children with Turner’s Syndrome and chronic renal failure, and hypopituitarism.
• Weight Management – including specialized services for children and adults with Prader-Willie Syndrome.
• General Endocrinology Clinic – for pituitary, thyroid, adrenal, gonadal and other hormonal disorders. Immediate evaluation and treatment is available for children with such urgent conditions as newly diagnosed congenital hypothyroidism and uncontrolled Graves’ Disease.

Access to the Latest Clinical Research

CHOC Specialists Endocrinology physicians participate in several areas of clinical research, providing patients with access to the newest medications and treatment. Through their efforts, the CHOC Diabetes Center has become one of the largest screening sites for the NIH-sponsored Diabetes Prevention TrialNet. Additionally, their pediatric growth and hormone research and treatment program is one of the largest in the state.