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O.I. Coordinated Care Center: A Multidisciplinary Approach to Care

O.I. Coordinated Care Center: A Multidisciplinary Approach to Care

by | May 6, 2020 | Spotlight

At Scottish Rite for Children, our experts care for the common to the complex of pediatric orthopedic conditions. Depending on the severity, a child might require treatment from various disciplines – needing specialists who can provide care for the different aspects of the disease. In order to do this, we have developed specialty clinics – like the Osteogenesis Imperfecta (O.I.) Coordinated Care Clinic.

Osteogenesis Imperfecta (O.I.), also known as brittle bone disease, is a group of genetic disorders that predominantly impacts the bones. Children born with O.I. have bones that break and/or fracture very easily from a minor injury or even from no apparent cause. Other common characteristics of the disease include:

  • Skeletal Deformity
  • Short stature
  • Severity of the disease determines the type: Type I, II, III, IV

As an institution who is dedicated to caring for the whole child, the purpose of the O.I. Coordinated Care Clinic is to provide comprehensive treatment for every aspect of the disease – making it easy for families to receive expert care for their child from different specialists in one location. Led by Chief Medical Officer B. Stephens “Steve” Richards, M.D., medical director of Abulatory Care Brandon A. Ramo, M.D., and pediatric nephrologist Mouin Seikaly, M.D., the clinic includes experts from the following disciplines:

  • Orthopedic surgery
  • Bone metabolism
  • Occupational and Physical Therapy
  • Psychology
  • Nutrition
  • Child Life
  • Therapeutic Recreation
  • Dentistry
  • Family Services
  • Developmental pediatrics

Our team understands that this can be an overwhelming diagnosis. We are here to help guide our families and provide support wherever it is needed.

Share Your Story: Andi’s Life Changing Journey

Share Your Story: Andi’s Life Changing Journey

by | Mar 19, 2019 | Hip Disorders

Meet Andi, a patient who is treated by our spine and hip experts. Learn more about her journey below.

Blog written by Andi’s mom, Tera, of McComb, Mississippi. 

Andi’s life changing journey started the moment she was born. At birth, we were told something was severely wrong with her hips and we would need to double diaper her to keep her hips spread apart. Nobody actually went into details with us until later at our post-delivery follow-up when Andi was three days old. At that time, our pediatrician told us he had never heard or felt a clunk in hips the way Andi’s hips were reacting to the hip check. Our pediatrician told us he thought she had hip dysplasia and we would need to meet with an orthopedic doctor.

We were initially referred to Children’s Hospital of New Orleans and Andi was just 1 week old when we had our first appointment with the orthopedic doctor. She was officially diagnosed with bilateral hip dysplasia and was put into a Pavlik harness, which was to be worn 24/7 for three months. We did harness adjustments every couple of weeks and after three months, the X-rays showed that the left hip responded to treatment, but the right hip did not. Our doctor, at the time, decided to try the Rhino abduction brace. It was then that we noticed that Andi was in a lot of pain. Hip dysplasia is generally not painful, but for her it was very painful.

When you touched her right leg or made any hip movement, her entire spine curved like a ‘C’ and she screamed in pain. She had X-rays done on her spine, but this did not give us any answers. We were told her spinal curvature (32 degrees) was not severe enough to be true scoliosis.
 
My husband and I began to research our options and that is when we found Texas Scottish Rite Hospital for Children. We live eight hours away and did not even hesitate about travelling to Dallas for a second opinion. The appointment process was quick, easy and we were able to get something scheduled right away.

Our first appointment was wonderful. 

Andi had Dr. Ramo and the staff scratching their heads, but they never gave up on her. They saw how much pain she was in and were able to pick up on developmental delays that nobody else had mentioned before. X-rays showed her right hip was still out of socket, her spinal curvature was now 42 degrees and the pain she was experiencing was being caused by inflammation.

Dr. Ramo suggested we allow Andi to continue to grow and develop and the plan was to repeat her scans in a couple of months. Time passed and we made another trip to Dallas. Her scans showed that her spinal curvature had since progressed to 54 degrees and Dr.Ramo decided to focus on her spine before we continued with further hip treatment. She was then placed in a Mehta cast – this process was rather simple, and the hospital staff made it easy.
 

From the moment we walked in the doors of the hospital to when we were discharged, our family felt comfortable, safe, loved and we knew our daughter was receiving the best care possible.

 
Fast forward a year later and Andi’s last Mehta cast was removed. Her spinal curvature had improved to 28 degrees and we were over joyed. She continues with nighttime bracing for a few months and then decided it was time to fix her hip.

Andi underwent a pelvic Osteomoy of the right hip and was placed in a unique spica/Mehta combination cast. She was in the combo cast for 13 weeks and at the end of this treatment, her hip looked wonderful! She did lose a little correction in her spine, but Dr. Ramo knew this would improve once she was able to wear a brace. She wore a rhino abduction brace for a month and then we continued with nighttime bracing.
 
Andi has been such a trooper throughout this entire process. For her, this is her normal nighttime routine – take a bath and then put on her brace. We had a follow-up appointment in December 2018 and her spinal curvature is now just 16 degrees. We will continue with her nighttime brace until our follow-up this summer and hopefully then, she will become an observation patient.

Everyone at Scottish Rite Hospital – from the registration staff, to the volunteers, nurse Marviel, Dr. Ramo and the cafeteria staff – they are all amazing. So kind, helpful, caring and welcoming! All of the hospital volunteers are always so giving and constantly put smiles on people’s faces.

This hospital made our struggles bearable.

Additional information on Developmental Dysplasia of the Hip

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

Medical Staff Attend the 11th International Congress on Early Onset Scoliosis

Medical Staff Attend the 11th International Congress on Early Onset Scoliosis

by | Nov 15, 2017 | Research & Innovation

Doctors and researchers from Texas Scottish Rite Hospital for Children are attending the 11th International Congress on Early Onset Scoliosis (ICEOS) meeting in San Diego, California. This annual conference brings together medical professionals who specialize in treating pediatric spinal deformities to discuss the latest research and innovations.

The Growing Spine Foundation (GSF), established in 2008, is a non-profit organization that supports education and research efforts to enhance the care and treatment of early onset scoliosis (EOS) patients. The GSF educational mission is carried out through the annual ICEOS meeting as a commitment to finding new techniques to help this patient population. Several of Scottish Rite Hospital’s doctors are members of this group. Over the years, ICEOS has grown to be known as the premier medical conference for clinicians and researchers who are dedicated to researching innovative techniques to care for children with early onset scoliosis (EOS).

Members of GSF from the hospital include Assistant Chief of Staff Charles E. Johnston, M.D., Medical Director of Ambulatory Care Brandon A. Ramo, M.D., staff orthopedist Amy. L. McIntosh, M.D. and research coordinator Dong-Phuong Tran, M.S.

As a faculty member of ICEOS, Ramo understands the value this meeting brings to the overall care for patients diagnosed with EOS. “Early onset scoliosis can range from the common to the complex,” says Ramo. “The ICEOS meeting enables collaboration and focused discussions regarding this patient population to ultimately educate specialists on the latest treatment techniques to enhance the standard of care.”

This year, the hospital has several projects selected for presentation. In addition, staff are leading various educational sessions throughout the three-day meeting. The research projects selected include:

  • Continued Deterioration in Pulmonary Function at Minimum 18-year Follow-up from Early Thoracic Fusion in non-Neuromuscular Scoliosis – Nominated for a Behrooz A. Akbarnia Award for Best Paper
  • Short Term HRQoL Results in MCGR and TGR patients – Divergent from Long Term EOSQ Results in TGR Graduates

Scottish Rite Hospital is honored to have the opportunity to educate and share research with medical professionals from around the world. It is conferences like ICEOS that allows our doctors to have a farther reach to bring the best possible treatment back to our patients and children everywhere.