Get to Know our Staff: Marilyn Ambrose, Human Resources

Get to Know our Staff: Marilyn Ambrose, Human Resources

by | Apr 26, 2023 | Spotlight

What is your job title/your role at Scottish Rite for Children? 
I am the Talent Acquisitions Partner, and my role is to recruit the best talent possible for Scottish Rite for Children.
 
What do you do on a daily basis or what sort of duties do you have at work?
Interviewing candidates, talking to managers about their open positions, scheduling interviews, making offers and reviewing candidates in our system.
 
What was your first job?
My first job was at a dental office while in college.
 
What do you enjoy most about Scottish Rite?
I enjoy the staff and potential candidates, the families and the culture of the organization and mission.
 
Tell us something about your job that others might not already know?
You have to source candidates on the internet through LinkedIn and other avenues to find the best candidate.
 
Where is the most interesting place you’ve been?
Maui, Hawaii. I love the ocean and the people and the culture of Hawaii. The sea turtles and dolphins are amazing.
 
What is your favorite game or sport to watch and play?
I love to watch the Dallas Cowboys.
 
If you could go back in time, what year would you travel to?
1995 – the year my daughter was born.
 
What’s one fun fact about yourself?
I enjoy being at the beach, and I love to travel.
Modern Luxury: Champions for Change

Modern Luxury: Champions for Change

by | Apr 26, 2023 | Press Coverage, Psychology

Scottish Rite for Children is leading the charge to ensure that children’s mental health is top of mind.

By. Abra Garrett

In 2021, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association joined together to declare a national state of emergency in children’s mental health. Drawing on data from the National Survey of Children’s Health, 2022 showed children in the United States to be experiencing unprecedented rates of depression and anxiety. Scottish Rite for Children (scottishriteforchildren.org) has worked extensively treating kids with orthopedic conditions and researching how these disorders impact their mental health. To be seen by their in-house psychologists, a child needs to be an orthopedic patient at Scottish Rite; however, their expertise is useful for all parents, teachers and caregivers.

Dr. Jill M. West, the director of psychological services at Scottish Rite for Children and a licensed pediatric psychologist, as well as the parent of two young children, understands the importance of talking about mental and behavioral health, both personally and professionally. “The rates of mental and behavioral health needs of children and adolescents have steadily increased since 2011,” West explains. She says this change corresponds with the growing availability of smartphones and daily usage becoming a ubiquitous part of being an American youth.

“COVID-19 undoubtedly exacerbated an already building problem,” West says. “It’s not all bad, though—kids and teens appear to feel more comfortable sharing what they are experiencing and reaching out for help.” She says this helps to decrease stigma around mental and behavioral health needs and is serving as a catalyst for efforts to attempt improving access to care.

“Unfortunately, the demand for mental and behavioral health services presently has outpaced the number of clinicians available to offer support in most places, yielding long waiting lists and sometimes leaving parents feeling helpless,” West says. Tools like the Stress Management Workbook, created by the staff at Scottish Rite for Children, give families access to strategies they can begin to implement on their own.

For additional help, West had suggestions for healthy ways for parents and children to interact with digital media together. “Another one of my favorite strategies is the idea of co-using screens with your kids,” she says. “For instance, if your child loves TikTok or loves playing Minecraft, make a point to view it with them for 15 or 20 minutes per day.” She explains this gesture can take an activity that is usually done independently and make it an activity that becomes more social. “Spending time engaging with your child in something they enjoy is important, and it may naturally spark conversation or interest in what they are doing,” West says.

Parenting-related stress is an important variable to attend to as well. “You may be feeling as though every time you look at social media, there is another recommendation about how to be a ‘better’ parent,” West says. “That can be overwhelming and confusing when you know you are already doing your best.” She recommends setting aside some time each day that is screen-free, for you and your children, to give everyone a chance to reset and focus on real-life connections. “Remember that your pediatrician’s office is also a good place to bring up concerns about your child’s mental or behavioral health,” she says. “Primary care practices increasingly have access to embedded or co-located behavioral health services and can make a referral for services.”

Meanwhile, in Houston, Texas Children’s Hospital (texaschildrens.org) announced in December of 2022 the implementation of a communitybased approach to the rising pediatric behavioral crisis. One of the nation’s largest children’s hospitals, Texas Children’s raised over $11 million to launch several behavioral and mental health initiatives, which include the following priorities: training frontline pediatricians on behavioral healthcare, embedding psychiatrists and psychologists in Texas Children’s Pediatrics clinics, building an intensive outpatient program, increasing emergency center staff and safe treatment spaces, and implementing specially designed programs to help employees identify warning signs of suicide and tools for navigating these challenging situations. “These services are desperately needed, and we are committed to providing them because we believe that the behavioral and developmental health of children, adolescents and teens is just as important as their physical well-being,” says Dr. Kirti Saxena, chief of psychiatry at Texas Children’s Hospital and associate professor of psychiatry and behavioral sciences at Baylor College of Medicine.

While the statistics can be daunting, if not downright discouraging, it is vital to note that some of the most celebrated experts in the state have made it their mission to address head-on the issues that our children, teens and young adults are facing today. With their commitment to normalize the conversation and proactively address the challenges that have accompanied the last decade plus, parents and caregivers will have access to guidance and expertise to help navigate these unprecedented times.

Read the full issue.

Does a Discoid Meniscus Injury Need Surgery?

Does a Discoid Meniscus Injury Need Surgery?

by | Apr 25, 2023 | Sports Medicine

A discoid meniscus is an abnormally shaped piece of cartilage found in the knee joint, and due to its shape, twisting knee movements can sometimes cause it to tear. When determining whether treatment for this injury is necessary, it is important to consider why, when and how the condition was discovered.

What is a meniscus?
The round end of the femur (thigh bone) sits on the flat top of the tibia (shin bone) to make up the knee joint. The femur is supported by the meniscus, which is composed of two soft “c” shaped cartilage structures. They act like soft cushions that help support the knee joint. The one that sits on the inner side is called the medial meniscus, and the one on the outer side is called the lateral meniscus.

What is a discoid meniscus?
Instead of having the typical “c” shape, a discoid meniscus forms as a solid piece, like a disc or a Frisbee®. The tissue grows thicker and larger than a normal meniscus and also has an abnormal texture, which makes it more likely to cause problems.

What causes a discoid meniscus?
A discoid meniscus is a congenital (at birth) defect and does not grow into the normal shape. This defect is not caused by trauma (i.e., an accident) or an injury. One to two out of every 100 children have a discoid meniscus. The condition is found more often in boys.

A discoid meniscus cannot be prevented. As the child grows, injuries and/or changes in the alignment of the hip, knee and ankle may cause symptoms.

What are the symptoms?
A discoid meniscus does not always cause symptoms. It may go unnoticed until symptoms begin. Symptoms can include pain, popping or snapping, limping, inability to bear weight (stand or walk) and inability to straighten the knee.

How is a discoid meniscus diagnosed?
A thorough history and physical examination are used to diagnose a discoid meniscus. Common findings on the outside of the knee (lateral joint line) include a bulge that can be seen or a “snap” that can be felt and heard.
X-rays are used to look at the alignment of the bones in the knee and leg. Other imaging, such as an MRI, may be used to look at the condition of the meniscus and other tissues in the knee.

What is the treatment?
For children who do not have symptoms or if they have a “clunk” when they move their knee, yet do not experience pain or difficulty conducting daily activities, no treatment is needed.

Early symptoms, such as swelling and pain, can be managed by resting, elevating the leg and other common strategies for knee injuries, such as ice and anti-inflammatory medications.

Surgical treatment is needed if there is a concern regarding the development of the knee with a large discoid or when symptoms begin to interrupt daily activities.

A knee arthroscopy, a type of minimally invasive surgery, may be recommended. The goal of surgery is to improve the shape of the meniscus and remove any loose or extra tissue that may cause the joint to become stuck. Rehabilitation and a slow return to sports may be necessary after surgery to change the shape of the meniscus.

A discoid meniscus increases the risk of a meniscal tear, and therefore, the condition is often found when evaluating an MRI of the knee after an injury. In these cases, treatment may be recommended to improve the shape of the meniscus. This can be done at the same time as surgery for other problems diagnosed in the knee.
What is the long-term outlook?

A discoid meniscus should not prevent normal daily activities or participation in sports. Diagnosis and management of symptoms can reduce the risk of further damage in the knee joint and prevent long-term problems. Regular follow-up to monitor the growth and health of the developing joint is very important after diagnosis, even if treatment is not needed in the early stages.

An important initiative of the Center for Excellence in Sports Medicine team at Scottish Rite for Children is a quality improvement registry designed to learn about the care and outcomes of treatment for discoid meniscus, among other conditions. This multi-center collection of data is led by pediatric orthopedic surgeon and director of clinical research Henry B. Ellis, M.D., is called the Sports Cohort Outcomes Registry (SCORE).

“This large collection of data allows us to compare surgery findings and outcomes across different age groups. The data set is unlike any other and will help to define care for this condition and many others. Early results were shared at the Pediatric Research in Sports Medicine annual meeting in 2022 and have already shaped more studies and better patient care.”        
– Henry B. Ellis, M.D.

Each institution in the SCORE group may take care of a handful of patients with this condition each year. The compiled data, reviewing nearly 300 patients and their outcomes helps to provide better education to patient-families, improve surgical decision-making and setting better expectations for outcomes.

Differences in the appearance of the meniscus as well as the ability for the meniscus to be repaired were apparent. In younger patients, the meniscus:

  • Is larger and covers more of the bone.
  • May have loose, unstable edges.
  • Is more likely able to be repaired.

These early findings help pediatric orthopedic surgeons know what to expect and how to counsel parents about who may or may not need surgery. Ultimately, the registry will be able to provide standard outcome expectations which will further improve the patient experience and outcomes.

Pain-free and Positioned for Speed

Pain-free and Positioned for Speed

by | Apr 24, 2023 | Rheumatology

Published in Rite Up, 2023 – Issue 1. 

“When I’m on the snow, I’m not really thinking, I’m just skiing,” says 15-year-old Banks, of Beaver Creek, Colorado. “I like to go fast!”

Banks is an alpine ski racer. He skis for Ski & Snowboard Club Vail and attends high school at Vail Ski & Snowboard Academy where he trains and competes in races across the nation and internationally. Banks started skiing when he was 4. At age 6, he told his dad he had found his sport. In a typical year, he skis in alpine events, including slalom, giant slalom, super-G and downhill.

When Banks was in 4th grade, he started having hip pain. “I would wake up in pain and not want to go skiing,” he says. “In class, I had pain in my tailbone from sitting in a chair.” Doctors in Denver diagnosed him with juvenile idiopathic arthritis (JIA). Banks’ parents, who are from North Texas, decided to seek a second opinion from Scottish Rite for Children.

At Scottish Rite, rheumatology experts confirmed JIA as well as a diagnosis of bilateral sacroiliitis, an inflammation of the sacroiliac joints that connect the spine to the pelvis. The team prescribed weekly injections, and after getting his medication just right, they were able to manage his condition.

“The last time I had pain was in 5th grade, and I was on crutches,” Banks says. “Now, I almost forget that I have JIA.” His mother, Brandi, says that his care has been handled so well that his diagnosis has not held him back from accomplishing what he wants to do. “I want to make the U.S. Ski Team,” Banks says, “and my ultimate goal is to ski in the World Cup.”

“Without Scottish Rite, I wouldn’t be able to ski,” he says. “They not only care about how you are doing as a patient, they care about your life.”

Read the full issue.

American Society of Hand Therapists – Prosthetics Series: Pediatric Upper Extremity Prosthetics

American Society of Hand Therapists – Prosthetics Series: Pediatric Upper Extremity Prosthetics

by | Apr 21, 2023 | Press Coverage, Prosthetics & Orthotics

On this episode, we are joined by Dwight Putnam, a certified prosthetist who works at a pediatric hospital in Texas. He brings a unique perspective to his job as a prosthetist as he previously worked as a professional sculptor. In his job, Dwight works with kids born with congenital hand differences and he builds terminal devices that allow them to participate in the activities that are meaningful to them.

Listen to the podcast.