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即使工作繁忙，身边仍有很多美好的事物为生活注入正能量。诚邀香港儿童医院同事们用镜头记录「感恩一刻」与大家分享，一经选中便有机会在《香港儿童医院通讯》刊登，详情如下：

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医院行政总监李子良医生

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Hong Kong Children’s Hospital Newsletter Issue 14 (June 2020)

Message from HCE

Moving Forward

I am often asked about our development progress. In fact, we will have up to 194 beds up to July and our services are quite comprehensive. Taking the outpatient clinic as an example, many specialties are now providing service, and there are multidisciplinary consultation sessions for some complex diseases, such as brain tumors, skeletal dysplasia, inflammatory bowel diseases and cleft lip / palate. This arrangement saves patients’ hassles and effectively enables team members to discuss diagnosis and treatment plans together. It may seem an extravagant use of manpower and time, but is indeed cost effective in the long run.

Meanwhile, our new cardiology and cardiothoracic surgery services are already in the pipeline. Manpower and patients will be translocated from the Queen Mary Hospital gradually.

Under the COVID-19 pandemic, the Patient Resource Centre has quickly pulled our NGOs partners together to launch an in-house TV channel for patients to stay connected. This is a good example of using innovation, flexibility and concerted effort to provide psychosocial support, which is an essential part of our service.

I am also pleased to announce that the long awaited staff canteen will soon be in service. I hope colleagues would find it more convenient.

Dr Lee Tsz-leung, Hospital Chief Executive

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Sending love and care amid pandemic

In response to the COVID-19 outbreak, visiting of visitors and volunteers has been suspended in public hospitals. At HKCH, alternative ways are taken to support patients to go through this difficult time.

Transmitting fun through TV

The Patient Resource Centre has lined up seven NGOs to launch the “Children’s TV Channel” in late March. Inpatients can tune-in on weekdays in their bed to enjoy a series of tailor-made programmes which cover entertainment, learning, infection control knowledge and emotional support.

11-year old Pui-pui shared, “I get bored as the volunteers cannot come these days. We used to play and chat. But now I can see their faces on TV. I am happy that we can do artwork and origami together again!”

Support pours in from community

We have been receiving donated items such as masks and hand sanitizers for fighting against the pandemic. Under the global shortage, these timely gifts really help us ensure appropriate protection for our staff. A big thank you to all donors!

An unusual nurses day

This year’s International Nurses Day was celebrated in a simple but meaningful manner. On 12 May, the Hospital Chief Executive and General Manager (Nursing) took a photo with a group of nurses as a recognition of all nurses’ contribution as gatekeepers against institutional outbreak of diseases, as well as their dedication in providing quality healthcare and supporting service expansions.

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Clinical Services Available at HKCH

Since our opening, the following clinical services have gradually commenced to provide children with diagnosis, treatment and rehabilitation; and 194 beds will be in use as of this July.

Paediatrics & Adolescent Medicine

• Critical Care Transport
• Endocrinology
• Gastroenterology
• Haematology & Oncology
• Immunology
• Metabolic Medicine
• Neonatal Intensive Care
• Nephrology
• Neurology
• Paediatric Intensive Care
• Palliative Care
• Rheumatology

Surgical Services

• Dentistry & Maxillofacial Surgery
• Ear, Nose & Throat
• Neurosurgery
• Ophthalmology
• Orthopaedic Oncology
• Paediatric Surgery

Anaesthesiology & Perioperative Medicine

Pathology

Radiology

Allied Health

• Clinical Psychology
• Dietetics
• Occupational Therapy
• Physiotherapy
• Prosthetic & Orthotics
• Speech Therapy

Pharmacy

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Helping cleft lip and palate children smile again

Cleft lip and palate is a congenital deformity which can cause problems to appearance, eating, speaking, hearing and dentition. The HKCH cleft team has begun one-stop outpatient services since May 2019, providing multidisciplinary primary cleft care and early secondary treatments. About 700 children are currently managed under HKCH, and secondary cleft services will expand in due course.

Consultant in Paediatric Surgery Dr Nicholas Chao who coordinates the service explained the merits of the multidisciplinary care approach,“As children grow, their facial structure changes and different problems emerge. It’s important for us to work together to give the right treatments at the best timing during the long journey.

Dr Nicholas Chao said that joint consultation facilitates communication in the team. They feel motivated seeing children thriving in society and accepting themselves after treatments.

Repairing the face and the heart

Little Ho-yiu came to the HKCH cleft clinic days after birth. His mom shared, “Though our son would undergo many surgeries and have scars, our love shall overcome. I’m grateful for the cleft team’s support which has prepared us to face the challenges ahead.”

Children with cleft lip normally have their first reconstructive surgery at around three months. Ho-yiu’s father recalled keeping him home before the surgery to avoid strangers’ look. “Honestly, I didn’t have high hopes in the surgery. But to my surprise, when the gauze was removed, the closure looked really flawless!”

This surgery is in fact highly technical. It involves repairing the lip defect and the nose in layers with meticulously designed tissue flaps to achieve a symmetrical alignment. The team has also introduced prophylactic laser treatment to reduce scars after surgery in collaboration with Paediatric Dermatology.

For palate repair surgery, it is usually done at one year old. If necessary, ENT surgeons will simultaneously perform grommet insertions to prevent associated recurrent ear infection.

Orthodontic treatment to go along surgeries

Before undergoing their first surgery, infants have to wear a moulding device daily. Consultant in Dentistry & Maxillofacial Surgery Dr Ricky Wong explained that it is to reduce the severity of the deformity in order to improve surgical outcome.

Multiple orthodontic treatments would be arranged for patients after they reach six. “They are mainly to complement surgery at different stages. For example, we may need to widen the maxillary arch to prepare for the alveolar bone grafting surgery, after which we may apply braces to move the dental roots into the bone-grafted area to prevent bone resorption.” Dr Wong added.

First Cantonese cleft speech assessment tool

For cleft palate patients, the dysfunction of soft palate and pharyngeal wall may cause articulation errors and nasal sounding speech with nasal emission which warrant speech therapy from the age of two. Speech Therapist Yoyo Yiu, together with other therapists, developed Hong Kong’s first Cantonese cleft speech assessment tool during HKCH’s commissioning phase. “Local children have their unique speech problems. This dedicated tool helps us provide more accurate assessment and training direction.”

Cleft Lip & Palate Team

• Paediatric Surgeons
• Paediatricians
• Otorhinolaryngologists and Audiologists
• Geneticists
• Speech Therapists
• Clinical Psychologists
• Occupational Therapists
• Nurse Specialists
• Craniofacial Orthodontists and Technicians
• Oral Maxillofacial Surgeons
• Obstetricians

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Detectives who bring hopes to cancer patients

Acute leukemia is the top childhood cancer. In the Hospital Authority, HKCH is the only centre for treating paediatric acute leukaemia and performing paediatric haemopoietic stem cell transplantation. Besides frontline doctors, the“detectives” in the Division of Haematology under the Department of Pathology work relentlessly on blood and bone marrow samples to identify the culprit behind the diseases.

“When children get very sick without a reason, parents often feel anxious and guilty. Our timely and accurate laboratory reports help attending doctors to confirm diagnosis and formulate treatment plans. Telling parents what is going wrong also puts their mind at rest,” says Dr Jason So, Chief of Service (Pathology) who also heads the Division of Haematology.

The blood and bone marrow of a child suffering from acute leukaemia provide important clues for diagnosis, treatment, prognosis and monitoring after treatment. In the laboratory, team members employ different technologies, from morphology examination under the microscope, chromosome analysis, to the use of advanced equipment to detect traces of cancer after treatment. “As our sick kids require frequent blood-taking and their blood volume is small, we have selected testing platform which requires as little as 1 ml of blood for multiple testing,” Dr So says.

With the help of an advanced flow cytometer, medical technologists are able to classify the exact type of acute leukaemia that is harming the patient, so that doctors can prescribe the right therapy. It is also used for counting the quantity of residual leukaemic cells to evaluate treatment effectiveness and guide further management. “This machine can scan hundreds and thousands of cells in minutes. Even if there is only one cancer cell among 10,000 cells, it can still spot it,” Dr So says.

Dr So described the collective effort of the clinical and laboratory teams in treating patients as movie-making, “A successful movie needs great actors as well as great script, costume design, cinematography and editing. We at Pathology are like those working behind the scene. I find it rewarding to be able to use our professional knowledge and experience to produce quality laboratory reports and crack difficult problems in our patients with the clinical team.”

Although Dr So spends most of his time in the laboratory, he always keeps patients in his mind. “Whenever a child is diagnosed with leukaemia, I feel sorry knowing that another family has to suffer, and that always reminds me to do my best for them.”

Haemopoietic stem cell transplant

The haemopoietic stem cells inside our bone marrow produce all types of blood cells. In acute leukaemias, these cells are either suppressed by cancer cells or damaged by the intensive treatment. While most leukaemias are curable with chemotherapy or targeted therapy, some patients may eventually require haematopoietic stem cell transplantation (HSCT). HKCH is equipped with a stem cell laboratory to support the territory’s only paediatric HSCT service.

In the laboratory, staff carefully process the harvested haemopoietic stem cells, such as removing components that may cause rejection and other serious complications after transplantation. Microbiological culture is also performed to ensure safety.

Stem cells that are not used immediately are stored in a cryogenic container at -190℃ . They will be thawed for use when a patient requires transplantation later.

Haemopoietic stem cells are stored in cryogenic containers filled with liquid nitrogen to keep them in good condition.

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Staying healthy mentally

The COVID-19 pandemic is causing changes and uncertainties to people’s daily lives and the global political and economic landscape. It is understandable to feel unsettled. Here we would like to share some tips for maintaining psychological health during this difficult time:

• Give yourself some space. Observe bodily sensations, thoughts and emotions non-judgmentally. Then, attend to breaths. Notice the here-andnow experience, and make room for it.
• The pandemic situation and its consequences change day by day. Let go of whatever that is out of your control. Where feasible, take actions that are consistent with your values and directions.
• Challenges posed by the pandemic can elicit and enhance our inner strengths and potentials, such as courage, wisdom and compassion. Such challenges may also lead us to decipher the meaning of life from a broadened perspective.
• Make good use of technology to stay connected with loved ones. Care for others, for example, donate to strangers if you can.
• Spare some time to nourish your mind, body and soul. Engage in activities you find pleasurable, such as listening to music and reading books. Maintain adequate physical activity.

May you be well!

Clinical Psychology Team

Text: Dr Connie Poon, Clinical Psychologist Illustration: Thomas Chiang, Patient Care Assistant

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