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Craniofacial Center at Morristown Medical Center
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craniofacial, pediatric, torticollis, treatment, plagiocephaly, neurosurgery, cranial, hydrocephalus, craniosynostosis, medical
craniofacial, pediatric, torticollis, treatment, plagiocephaly, neurosurgery, cranial, hydrocephalus, craniosynostosis, medical

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CSF presents “Hydrocephalus” – Dr. Catherine Mazzola

YouTube: https://youtu.be/xPdmRFf4QNg

Vimeo: https://vimeo.com/196684917

Dr. Catherine Mazzola discusses what hydrocephalus is, how it is diagnosed and treated in children and how she and a team of fellow expert neurosurgeons were able to develop clinical guidelines for treatment of pediatric hydrocephalus at the first CSF Chapter lecture in Morristown, New Jersey. This lecture was jointly presented by Chiari & Syringomyelia Foundation and the New Jersey Pediatric Neuroscience Institute. Thank you to all who were involved in putting this together!
For more information and educational materials, please visit our website: http://csfinfo.org
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Please JOIN US for an amazing evening for an AWESOME CAUSE. The Goryeb Children's Hospital Craniofacial Center in conjunction with Morristown Medical Center are hosting an evening to benefit infants and children born with facial or skull deformities. These amazing children put their lives in our hands every day; we are honored to care for them. Please come on Thursday, March 23, 2017 and note CHILDREN ARE WELCOME!!
Click the link below for more information.

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Please JOIN US for an amazing evening for an AWESOME CAUSE. The Goryeb Children's Hospital Craniofacial Center in conjunction with Morristown Medical Center are hosting an evening to benefit infants and children born with facial or skull deformities. These amazing children put their lives in our hands every day; we are honored to care for them. Please come on Thursday, March 23, 2017 and note CHILDREN ARE WELCOME!!
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Click below to view an article about Spasticity and Gait Disorders: Navigating a course to the right specialists. This article was in a publication of Goryeb Children's Hospital's Spring 2016 "Well Aware Kids" magazine.

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Please JOIN US if you can for an amazing evening for an AWESOME CAUSE. The Goryeb Children's Hospital Craniofacial Center in conjunction with Morristown Medical Center are hosting an evening to benefit infants and children born with facial or skull deformities. These amazing children put their lives in our hands every day; we are honored to care for them. Please come on Wednesday, February 24, 2016 and note CHILDREN ARE WELCOME!!

Click below for more information.

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“Pediatrician’s perspective on ITB” abstract in NJ Pediatrics

Inthrathecal baclofen (ITB) therapy has been utilized as an established treatment for spasticity, dystonia and hypertonia in children. Pediatricians often are the first medical professionals to report muscle and joint “tightness” in a child’s upper and lower extremities. Click below to read this entire article.

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Please take a look at the January 2016 edition of Focus on Pediatrics from Goryeb Children’s Hospital by clicking below

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Pediatricians and pediatric neurosurgeons are really on the same side: TRANSITION OF CARE FOR THE MEDICALLY COMPLICATED YOUNG ADULT

Catherine A. Mazzola, MD

“Gatekeeper, managed care, comprehensive and collaborative care, interdisciplinary medical homes”…we have all heard the rhetoric. “The train has already left the station”…well, I guess it has but where it is going and who it left behind, only time will tell.

As a parent and as a pediatric neurosurgeon I truly care about kids. I have always been a responsible and diligent care-giver for my patients, for their families and for my own children. During a recent American Association of Neurological Surgeons/ Congress of Neurological Surgeons Joint Section on Pediatric Neurosurgery meeting in Amelia Island, FL, guest speaker David L. Wood, MD, MPH, gave an outstanding talk on the “Transition of Care” for pediatric neurosurgeons.

Dr. Wood spoke about the management of complex pediatric patients as they age, and how we, as their pediatric neurosurgeons, should carefully direct and manage our patients’ transition from pediatric to adult neurosurgical care. He recommended that we commence the process for our patients at age fourteen. His interest in children with developmental disabilities and neurological disorders is similar to that of many pediatric neurosurgeons. As surgeons for children with hydrocephalus, cerebral palsy (CP) and spina bifida, we experience and understand the stress and the challenges that our patients and their families face every day. As physicians, and as caring adults, we often attempt to alleviate this stress by guarding our pediatric patients as much as possible. We provide child-friendly environments for these children. We develop age-applicable educational materials for our patients and their families. We spend hours talking to parents about their child’s diagnoses and prognosis. We have our patients’ BEST interest at heart, and we always have.

Dr. Wood discussed the American Academy of Pediatrics’ Policy Statement: “Care Coordination in the Medical Home: Integrating Health and Related Systems of Care for Children with Special Health Care Needs.” I read this policy statement and found it to be very informative and also very concerning. Many of my patients have many serious, medical co-morbidities. There is additional stress related to socioeconomic status and educational level of the family, which makes caring for these medically-fragile children extremely challenging. It often takes additional time and effort to ensure that the parents truly can give an informed consent for surgery. The length of stay for these children with complicated congenital issues is typically prolonged. In the peri-operative period, these children often require in-patient consultation of other specialists, such as pediatric pulmonologists or critical care specialists. Perhaps because of the Affordable Care Act (ACA) and decreasing reimbursements, many pediatric sub-specialists have stopped accepting patients with Medicaid, Medicaid HMO’s or similar insurance plans. They simply cannot afford to spend the extra time and effort for minimal reimbursement. They are not willing to accept an increased medico-liability risk for caring for these medically complex and fragile children.

Transition of care from pediatric to adult neurosurgery is not an issue for me, since I will care for kids with hydrocephalus, spina bifida and cerebral palsy (CP), who grow up. Here are some strategies I have employed successfully:

• I work with the adult spina bifida patients at Kessler Institute of Rehabilitation, in West Orange, NJ.
• I developed an adult cerebral palsy clinic with Drs. Theodore Feigelman and Michelle Sirak at Morristown Medical Center.
• I have developed a relationship with the Family Medicine Physicians at our hospital, to facilitate the transfer of care and to provide a continuum of care from the clinic, to the emergency room, to the ward.

Despite these efforts, I have seen increasing depression and frustration in my patients and their families as services to these patients are increasingly eliminated. State supported programs in New Jersey have been severely cut and adults with developmental disabilities and neurological problems have been dramatically affected. Some very special doctors still spend hours on the phone advocating for our patients’ wheelchairs, medications and orthotics. Dr. Bruce Gans has become very involved on a national level for advocating for patients with disabilities. Dr. Ted Feigelman and Dr. Michelle Sirak and I are honored and privileged to take care of adults with CP and spina bifida and other developmental challenges. We enjoy caring for our patients and our patients truly appreciate the care that we provide.

It was nice to listen to Dr. Wood’s presentation about the transition of care for complex, pediatric neurosurgery patients. It is clear to me that he really cares about his patients and all patients with developmental disabilities and neurological problems. But it is a chilling reminder that our young patients, who are safely sheltered in their “pediatric” medical “homes,” will soon be facing a scary and unavoidable predicament when they grow up. Not all pediatric specialists can care for adults. Some can’t and some won’t, and for some patients, the adult world will not be as happy and protected as their childhood “medical homes” were. I really worry about his when I think about my patients who are “growing-up” in America, where their medical future is still unclear.
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