Say the name Shodair Children’s Hospital in Montana and chances are your listener will recognize it as a facility that serves children.
Yet while your listener may recognize the name, they may not be as sure about the services the hospital provides today.
That could be due to the many important roles Shodair has played for Montana residents throughout the years since the hospital began caring for orphaned and abandoned children in 1896. In addition to adoption and medical services for children, Shodair was the first facility in Montana to treat polio patients, the first with a chemical dependency program dedicated to adolescents, and the first facility in the region with a medical genetics program.
Shodair no longer treats polio patients, and the chemical dependency program has been replaced by a child and adolescent psychiatry program that helps troubled Montana youth meet significant mental health challenges. The medical genetics program has continued to grow, earning national renown and providing cutting-edge services that residents would otherwise need to travel out-of-state for. Patients of all ages are seen at the hospital facility in Helena, and in more than 70 outreach clinics in communities around the state.
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Not many people are familiar with the medical genetics field. Until recently, when topics in genetics made headlines in national media, medical genetic services, terminology, and implications were discussed most often with personal physicians. Now, as science unlocks more of the secrets about the most basic elements of the human body, genetics is becoming a topic with meaning to more and more people.
Shodair has remained at the forefront of this wave of medical discoveries and capabilities. The hospital’s medical genetics department includes physicians, counselors and a large laboratory with state-of-the-art technology and skilled staff dedicated to helping patients learn more about existing or potential health concerns.
“Each person is a unique combination of the genetic material inherited from their parents,” said Dr. Helen Drwinga, director of Shodair’s medical genetics laboratory. “Many diseases are now known to have a strong genetic component and it is important to consider how the genes we inherit can affect our health.”
Because of the vital information that can be discerned through genetic assessment and testing, more patients and their doctors are turning to Shodair for these services. And if the associated terminology is new and big, so are the benefits for patients.
“It’s an exciting new landscape in health care,” said Shodair marketing director Renee Hofeldt. “People will continue to hear more about genetic testing. If they’re not familiar with some of the terms now, they will be before long.”
Inside Shodair’s medical genetics laboratory, one can glimpse some of the services available to Montana residents. The laboratory specializes in three testing areas referred to as Maternal Serum Screening, Genetic, and Pharmacogenetic testing. These are complex tests, and a complete discussion would involve a visit with a staff member; however, following are descriptions of each:
Maternal Serum Screening
A blood sample from a pregnant woman is tested to determine the level of several proteins present in the serum. This information is then used to determine if her baby is at increased risk for certain birth defects such as Down syndrome (trisomy 21) or spina bifida (neural tube defect).
Genetic testing
Normal cells contain 46 chromosomes (23 pairs) that are inherited from an individual’s parents. Changes in chromosome number or structure can result in physical malformations and/or developmental delays in individuals. There are several tests that may be used to identify changes or abnormalities. Shodair’s lab offers cytogenetic testing on a variety of sample types. Shodair uses an extremely sophisticated imaging system employing digital technology to perform these high complexity studies.
The genetics lab also performs multiple forms of molecular diagnostic screening for other diseases that may impact health care for patients of all ages. These tests range from diagnosis of developmental disorders, to identification of abnormalities that impact the ability of blood to clot, to verification that identical twins really are identical.
Pharmacogenetic testing
An addition to Shodair’s genetic laboratory services is pharmacogenetic testing — a specialized form of DNA testing directed at genes involved in drug metabolism. This testing examines how specific changes in an individual’s DNA profile impact their ability to metabolize certain drugs.
“One-size-fits-all dosing of prescription drugs doesn’t work for everyone, and pharmacogenetics has uncovered some of the reasons why,” said Dr. Robyn Temple, clinical molecular diagnostics specialist. “Testing can allow physicians to select the most effective drugs and doses for their patients — resulting in optimal patient care.”
The new pharmacogenetic testing capabilities will play an important role in the care of children hospitalized at Shodair for psychiatric treatment. Pharmacogenetic testing will be employed as an additional tool to assist in developing good treatment plans and accelerating the overall treatment process for children in its care.
Shodair will expand its pharmacogenetic and other genetic testing services to include outside physicians and their patients, potentially impacting care in psychiatry, cardiology, oncology, and other medical practices. In addition to these critical laboratory services, Shodair has specialists for genetic counseling and pediatricians specializing in medical genetics who are now also treating adults. This comprehensive approach to genetics in medicine — where a patient can get the full spectrum of services that might be needed — sets Shodair apart from other facilities in the state, and is one of its greatest strengths.
