Keep your children well

Routine medical examination saves the life of Kalispell woman's 3-year-old grandson

Boni Stout, public health nurse and director of community health, has more than professional training behind her message that well-child exams save lives.

She has a grandchild whose life likely was saved because his mother, Stout's daughter, took Jak, 3, for his well-child appointment.

"I'm so thankful that she did," Stout said.

Just a few weeks ago - Dec. 28 - Laura Mortensen drove 90 miles with her three children in tow to Spokane to keep Jak's appointment with pediatrician Dr. David Bennett.

The couple live in the tiny town of Ione, Wash., just a stone's throw from the Canadian border. Mortensen's husband, Clint, works as an engineer at the area's zinc mine while Mortensen, an environmental engineer, stays home with Bo, 7, Kira, 5, and Jak.

Stout said her daughter made the appointment near Spokane with a pediatrician with 25 years of experience for a routine well-child visit. The little boy had no symptoms of any illness.

While palpating Jak's abdomen, Bennett felt a lump. Without delay, the pediatrician sent the child to Sacred Heart Children's Hospital for a CT scan, which revealed a tumor behind one of his kidneys.

A surgical biopsy took place the next day. The surgeon found the tumor between his spine and kidney wrapped around his renal artery. It was diagnosed as a neuroblastoma, a common cancer in children, Stout said.

Because of the tumor's location, chemotherapy was ordered because removing the growth might damage the artery feeding his kidney. As a result, Jak had more surgery to install an access for treatments and blood draws.

During that second operation, the surgeon also removed bone marrow from each hip to learn whether the cancer had spread to his bones. Tests showed that Jak's tumor was confined to one spot.

Stout said that about 70 percent of these tumors have spread before detection because the victims have no symptoms.

"I'm just in awe that this was picked up in a well-child exam before it metastasized," she said with a smile.

Jak's oncologist was impressed that the pediatrician picked up the tumor in the general exam of a seemingly healthy child.

Even after his biopsy, the little boy continued his high-energy antics, racing about the household with his monster trucks. He celebrated his third birthday Jan. 4 with blue cupcakes with - what else - monster trucks and Gummi Worms.

After his first round of chemotherapy, a couple of bouts of nausea barely slowed him down. Stout doesn't want to think about how different this story might have been had her daughter postponed or ignored the well-child exam.

"What if it had gone into his bones?" she asked. "I don't even want to go there."

She understands why many parents don't schedule such exams. Finances tops the list.

"They think, 'My child is not sick - why should I spend the money to take him to a doctor?' '' Stout said.

However, the state's Children's Health Insurance Plan provides coverage for well-child visits.

Stout said the program now has nearly 700 openings for eligible families. Aimed at families with too much income for Medicaid but too little for health insurance, the program allows more income than people might assume.

"Flathead County has the most children enrolled in the program," Stout said. "We have applications [at the Health Department]."

Families have the option of scheduling well-child appointments with their private health-care providers or with the nurse practitioner on Tuesdays at Flathead City-County Health Department. Fees are charged on a sliding scale based on income, Stout said.

She said the visit takes between a half hour and 45 minutes and includes some developmental assessments of language and social skills.

Stout said that an annual exam is equally important for babies as well as adults. She said people need to understand the importance of preventative screenings for themselves and their children.

No one wants to hear a cancer diagnosis. The only worse scenario, she said, is having the cancer discovered too late.

Her grandson Jak's smiling face, even with tubes hanging from his chest, tells the story.

"It could have been so much worse," Stout said.

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com