Share Your Story: Take Flight

Share Your Story: Take Flight

Meet Levi – a patient who is seen in the Luke Waites Center for Dyslexia & Learning Disorders. Learn more about his journey below.

Blog written by Levi’s dad, Josh.  

My wife Kelly and I have eight children, as young as five and as old as 24. We have homeschooled our children since our oldest daughter was in first grade.

Around the time our second oldest daughter, Grace, was in kindergarten and first grade, my wife noticed that Grace was having difficulty reading. At that time, we were living in Austin. Grace was evaluated with a local diagnostician and diagnosed with dyslexia. We worked with a local language therapist, and Grace was provided her the tools she needed to learn to read. Grace will graduate college in about a year.

A young boy is sitting at a table with lego toys on it

Levi is seven years old and our second to youngest child. When Kelly started teaching kindergarten with him, she noticed almost right away that he was having similar struggles, like Grace did when she was younger. By now, we had moved from Austin to Arlington, and we reached out to Scottish Rite for Children in Dallas.  
 
They evaluated him, and Levi was diagnosed with ADHD and dyslexia. We were looking into finding private language therapy for him, just like we had done for our daughter, Grace. It turned out that there was an opening for Levi to do the Take Flight program at Scottish Rite starting in fall of 2021. We jumped at this chance.
 
We have seen a great deal of progress since Levi started this program. We thank God for connecting us with Scottish Rite. He loves everyone who has taught him, and he loves to learn!

Last December, Levi fell while playing basketball. He came to his Take Flight class with his arm in a sling, from the ER visit the night before. The leaders of his class were able to get us connected with some of the orthopedic experts and he was able to get the care that he needed. Turns out he had broken in his arm in three places, and Scottish Rite was just the place he needed to help treat his arm.

The Luke Waites Center for Dyslexia and Learning Disorders at Scottish Rite has been a blessing to our family, and we are incredibly thankful for the impact they are making on Levi’s life.

 

DO YOU HAVE A STORY? WE WANT TO HEAR IT! SHARE YOUR STORY WITH US.

A young boy in a suit and bow tie smiles in front of a fireplace

Does my child need surgery to fix a clavicle fracture?

Does my child need surgery to fix a clavicle fracture?

Pediatric orthopedic surgeons Henry B. Ellis, M.D., and Philip L. Wilson, M.D., along with colleagues from the multicenter study group Factors Associated with Clavicle Treatment Study (FACTS) have published another set of findings in the American Journal of Sports Medicine. This group, like many others in pediatric orthopedics and sports medicine, merges the experiences and data from across institutions to provide the best evidence for care in the pediatric population. This group focuses their efforts on collarbone (clavicle) fractures and injuries in children and adolescents.

Here are some highlights from the publication. You can also visit the journal’s website to read the full article.

  • Midshaft clavicle fractures most often occur in adolescents, yet, most medical evidence is in adults until now.
  • More than 400 patients (10 to 18 years) with 100% displaced clavicle fractures were included in the study.
  • After two years, there was no difference in outcomes between those that had surgery and those that did not.
  • Those who underwent surgery had more nerve damage (loss of sensation on their chest wall) and more second surgery to remove plates and screws.
  • The study conclusion states, “Surgery demonstrated no benefit in patient-reported quality of life, satisfaction, shoulder-specific function or prevention of complications after completely displaced clavicle shaft fractures in adolescents at two years after injury.”

So, the answer to the question, “Does my child need surgery to fix a clavicle fracture?” is not yes. But, that also does not mean it is no. The study describes the general experience of a large group patients who have and have not had surgery for this condition. The individualized assessment of the patient is still important and necessary, but the study does show that there is not an obvious answer that applies to all patients. “This work is new and very important for the growing body of evidence in caring for this population,” Ellis says. “We can confidently tell families that one path is not yet obviously better than another.” In our individualized patient care, it is important for us to provide evidence-based recommendations, and in our research, we aim to define the recommendations.

This study, Two-Year Functional Outcomes of Operative vs Nonoperative Treatment of Completely Displaced Midshaft Clavicle Fractures in Adolescents: Results from the Prospective Multicenter FACTS Study Group, was published in the American Journal of Sports Medicine in September 2022.

Get to Know our Staff: Fabiola Reyes, M.D., Neurology and Rehabilitation

Get to Know our Staff: Fabiola Reyes, M.D., Neurology and Rehabilitation

What is your job title/your role at Scottish Rite for Children?
I am a pediatric physical medicine and rehabilitation physician. I work with children who have mobility impairments. Because cerebral palsy is the leading cause of physical disability in in the United States, this population makes up the majority of my practice. My goal as a pediatric physiatrist is to facilitate mobility, function, activities and care for children with physical disabilities using nonoperative means.

What do you do on a daily basis or what sort of duties do you have at work?
I work with an awesome team of physician assistants, nurse practitioners, nurses, medical assistants, orthotists and therapists to assess function and rehabilitation needs of children with cerebral palsy. In my clinics, I help identify and set therapy goals for children. I also treat conditions that may interfere with mobility and function, such as tone. I use a variety of tools, including therapy, orthoses, oral medications, botulinum toxin injections, intrathecal medications and casting to help children be comfortable, active and participate in activities they enjoy. In addition, I also assess and diagnose causes of motor control disorders in children when they come into clinic without a diagnosis.

What was your first job? What path did you take to get here or what led you to Scottish Rite? How long have you worked here?
My first job was doing administrative work in an environmental engineering firm in my hometown of El Paso the summer after my first semester in college. I was inspired by my father — an engineer, and my mother — a nurse, to study biomedical engineering in college. I worked for GE Healthcare after I graduated. My job at GE Healthcare required spending time with cardiologists. This experience helped me see how doctors solve problems like engineers, but they also get to form strong relationships with people of all backgrounds. This led me to apply to medical school. I then chose physical medicine and rehabilitation because it allowed me to follow patients with complex medical conditions longitudinally and help them achieve goals that sometimes seem insurmountable.

What do you enjoy most about Scottish Rite?
My favorite thing about working at Scottish Rite is that we are guided by the CARE RITE values. Specifically, being child-focused allows me to build strong rapport and have fun with my patients in clinic. I always leave clinic with a huge smile on my face and am excited to tell my husband how much fun I had at work. In addition, by putting children and family first, the CARE RITE values promote excellent teamwork and multidisciplinary care of children with complex needs. This means that my colleagues and I are always on the same page — we will do what is best for the patient and families always.

Tell us something about your job that others might not already know.
I completed six years of residency and fellowship training in order to become a pediatric physiatrist. I did one year of internal medicine at Parkland/UT Southwestern. I then did three years of physical medicine and rehabilitation at Columbia/Cornell in New York. Finally, I completed two years of pediatric rehabilitation medicine at Baylor College of Medicine/Texas Children’s in Houston. All this training is needed to help physiatrist learn function from a multisystem perspective. In training I learned about diagnosis and management of bowel and bladder dysfunction due to spinal cord injuries; neuropathies and muscular dysfunction from cancer and cancer treatments; cognitive impairments from traumatic brain injuries; among many other conditions that affect function. The year I spent doing internal medicine at Parkland Memorial Hospital was very challenging, but it gave me a very good perspective on the medical and social challenges some of our patients will face once they age out of the pediatric medical system.

What is your favorite game or sport to watch and play?
Volleyball. I played middle blocker in high school in El Paso. I love volleyball because it requires a lot of practice to develop skills, but it also requires very good communication with your teammates. For example, without letting your backrow teammates know that you are bumping the ball, or letting the setter know that you are ready to strike as a middle hitter, that ball will drop on the floor. In fact, volleyball reminds me of health care — it can be very intricate, requires a lot of coordination and requires players to be excellent at their individual position. Without good teamwork, communication and flexibility, though, a play can easily fall apart. Again, this is why I love working at Scottish Rite. If we were a volleyball team, I have no doubt we would be national champions!

How has your heritage shaped the person you are today?
My family is from Mexico. My parents were born and grew up there. Because of many psychosocial challenges my grandparents faced in Mexico, none of them were able to complete elementary school. My maternal grandfather was a silver miner, and my paternal grandfather was a carpenter. Despite their limited education, my grandparents instilled the values of hard work and education on my parents. Through these values, my mother became a nurse and my father an industrial engineer. Seeing my parents work hard to meet their professional goals when we moved to the United States has been an enormous inspiration for my siblings and me. We have always been so proud of my parents and our heritage for this reason.

Does your family have any traditions that are especially important to you?
My birthday is on Christmas Eve. In Mexico, a lot of families celebrate Christmas on December 24th. Getting together with extended family at my grandmother’s home in Juarez, Mexico, eating tamales and breaking a birthday piñata are some of the most cherished memories I have from childhood. To this day, we still make tamales and break a piñata for Christmas.

What is your favorite meal or recipe?
Chile Rellenos. My grandmother used to make them for us when we would visit her on the weekends in Mexico. And now that we are older, this is one of the meals my mother makes for my husband and me when we visit her in Houston. Chile Rellenos was also the first meal I cooked for my husband when we were dating, and when I started working at Scottish Rite, my mother came to my house to help me cook a big batch for a work celebration. They are very time consuming to make, but they are also delicious in a corn tortilla with beans and salt!

What is your favorite travel destination?
Big Bend National Park. It sits on the Chihuahuan Desert and is on the border with Mexico, similar to El Paso, where I grew up. It is very remote and isolated, so it is easier to find solitude and time to reflect while hiking. Surprisingly, it has a significant amount of bird, insect and plant diversity, as it is the only national park that houses a whole mountain range — the Chisos, a desert and a river. The flora and fauna have to be tough and resilient, but still thrive, and it houses the Mexican Black Bear, which was extirpated, but made a comeback into Big Bend National Park in the 1980s.

What does Hispanic Heritage Month mean to you?
It means connection. Not only to my parents, grandparents and traditions but also to my patients. I chose to practice in Dallas partly because it has a substantial Hispanic population — 41.5% per the 2021 census. Being able to celebrate National Hispanic Heritage Month gives me a reason to celebrate together with a large portion of my patients.

How do you identify within the Hispanic community?
I identify as Mexican-American. While the people with Hispanic and Latino heritage can be very diverse in geography, culture and colloquialisms, I love connecting through our shared values. For example, I love bonding over music with one of our Neurology/Rehab nurses whose family is from El Salvador but grew up listening to the same music that our parents listened to. In New York, being able to communicate with a large population of Dominican patients was also very gratifying. One of my favorite memories in residency was when an Ecuadorian hospital worker brought me Mexican tamales from New Jersey because he knew I was missing my family during Christmas.

What brings you joy about your heritage and culture?
Being able to bond with patients with similar heritage. While doing a botulinum toxin injection, one of my patients was listening to Vicente Fernandez, a Mexican singer and songwriter who is considered one of the greatest by many. After completing the injection, I knew my patient had tolerated it well when he belted one of Vicente’s most famous songs at the top of his lungs. At that point, I had no other choice but to join him in singing!

What does community mean to you?
Community means shared values and beliefs. This in turn helps me find connection and rapport with my patients. By being part of the same community, I hope to inspire my young Hispanic patients to aspire to become doctors too.

What do you enjoy most about your role at Scottish Rite for Children?
Being able to work with a diverse group of people in skill and background with similar goals and values. Every person I have worked with, and those who have supported me at Scottish Rite, have not only shown kindness and excellence but also a strong commitment to deliver the best experience and care for the diverse group of patients we see.

What’s one fun fact about yourself?
I was named after my older sister’s imaginary friend! She had a slew of imaginary friends, and my parents like the name Fabiola.

On The Move: Unstoppable

On The Move: Unstoppable

Article previously published in Rite Up, 2022 – Issue 2.

It is not uncommon to see Michael, of Redmond, Washington, posing like his favorite superheroes. He loves playing Minecraft™, riding his bike, swimming, wearing costumes, acting, dancing and singing. In January 2021, this highly active and vivacious young man had a life-changing surgery performed on his left forearm by pediatric orthopedic experts from our hand and limb lengthening and reconstruction teams at Scottish Rite for Children.

“I have no words to describe the blessing it has been for Michael and myself,” Berenice, Michael’s mother, says. “Scottish Rite is simply amazing.”

Michael was born premature at 23 weeks and stayed in the NICU for four months. At 3-months-old, the family realized he had a bump on his left arm and worked with Michael’s doctors to investigate the issue. Following a biopsy, it was determined that Michael had congenital pseudoarthrosis, which caused a deformity in the bones in his left forearm.There are very few teams that could successfully manage the complexities and intricacies of Michael’s treatment, but Scottish Rite for Children could. “To me Scottish Rite is a place where miracles happen, where the prayers of many parents come true,” Berenice says. “The doctors really care, and all the staff understand you and want to help in any way they can. Somehow you know your child is in the best hands, and you trust they are going to be okay.”

 

Watch Michael’s Story and learn more about Scottish Rite’s extraordinary care.

Read the enitre issue.

D CEO: Ask the Experts

D CEO: Ask the Experts

Previously shared in D CEO Magaizine.

How early will a child show signs of having an orthopedic issue that may need medical attention?

DR. DANIEL SUCATO: Orthopedic issues can present as congenital abnormalities of the bones, meaning the bones were not completely or normally formed in utero. This can occur in the spine or the upper and lower extremities. Often these patients do not require treatment early, or sometimes ever, but they should be evaluated to see if treatment is necessary.

DR. PHILIP WILSON: As a pediatric cartilage and ligament surgeon, we often see children with congenital meniscus or cartilage conditions within the knee. Sometimes these can present as early as toddler age, but more often young school-age with a loss of full extension or occasional limp.

What should I expect at our first visit to a pediatric orthopedic specialist?

DR. DANIEL SUCATO: At the initial visit, the family and patient will first meet with the provider to discuss the concerns and note any family history regarding the issue. A physical and orthopedic examination will evaluate the areas of concern. If necessary, appropriate imaging studies, such as ultrasound, plain radiograph, CT or MRI scan, will follow. Let your child know the imaging studies, if necessary, will not hurt.

DR. PHILIP WILSON: We also make sure the child is directly involved in the discussion. As kids get older, the perception and magnitude may be different for parents than it is for the child. Prior to the visit, parents can help by letting them know we are just going to check their muscles-no shots.

What are common issues in children that fall under the category of “pediatric orthopedics?”

DR. DANIEL SUCATO: Pediatric orthopedics involves anything related to children’s muscles, joints or bones, so that would be conditions like clubfoot, scoliosis, developmental hip dysplasia, and even traumatic or sports injuries. We also have subspecialties in spine, upper and lower extremities, foot and ankle, sports injuries, and fractures.

DR. PHILIP WILSON: Within pediatric sports medicine, conditions involving the cartilage or instability of the joint or injuries affecting the tissues around the joint are common reasons for treatment.

Do all orthopedic issues require surgery? What are other forms of treatment?

DR. DANIEL SUCATO: Most can be treated without surgery. Physical therapy can improve range of motion, strength, and flexibilit. Other treatments include bracing, casting, and anti-inflammatory medications.

DR. PHILIP WILSON: We always reserve surgery for use when other options are not available. In addition to what Dr. Sucato mentioned, sometimes simple reassurance to the family that the orthopedic condition is normal or will improve with age may be all that is required.