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With Thanks for a Happy Place

With Thanks for a Happy Place

by | Apr 11, 2023 | General News, Prosthetics & Orthotics

Published in Rite Up, 2023 – Issue 1. 

Troy Ratliff has supported Scottish Rite for Children for more than 20 years. He connected with the organization through his participation in the San Angelo Sporting Clay Shoot, an event that was established in 1998 to raise funds for patient care. “I just wanted to win a shotgun,” Troy says. “When Keegan was born, I realized what the shoot was all about.”

Troy and his wife, Wendy, live in Mason, Texas, and have three children — Jonnah, age 21; Keegan, age 15; and Cooper, age 13. Wendy was a teacher and a coach for 25 years and now owns Hilltop Tennis, where she gives private lessons to children. Troy is an entrepreneur in the electrical field and owns three companies, including Ratliff Electric, TW Compressor Company and Dynamo Rentals, a generator rental business.

When Wendy was pregnant with Keegan, they discovered at her 4D ultrasound appointment that something was wrong with his leg. An orthopedic surgeon in Midland diagnosed Keegan with fibular hemimelia, a condition in which the fibular bone had stopped growing in his left leg. “Keegan didn’t have a foot,” Wendy says. “It was like a sack. You could feel where the toes had tried to develop, but they never did.”

“We were pretty much devastated,” Troy says. They were referred to Scottish Rite for Children, and when Keegan was 2 months old, they traveled to Dallas for his first appointment. “We took Keegan to the waiting room and saw wagons with kids with no arms and no legs,” Troy says. “When we got into the room, we broke down crying.”

“Scottish Rite is very touching,” Wendy says. “They cater to the kids, and no matter what their disability, they all seem happy. It was eye-opening, a wake-up call.”

The Ratliffs met J. A. “Tony” Herring, M.D., now chief of staff emeritus, who evaluated Keegan and explained the treatment options. They could reconstruct his leg, but that would require many surgeries throughout his childhood with no guarantee of how functional his leg would be. The other option was to amputate.

Through Scottish Rite’s Peer Support Program, the Ratliffs met a patient from El Paso who had a prosthetic leg. “Looking back, the kid explaining how normal of a life he had was the turning point for me,” Wendy says. “It was a breath of fresh air, like everything was going to be okay.” The Ratliffs went home and made the decision to amputate. “I felt like amputating would allow Keegan to be a kid,” Wendy says.

When Keegan was 10 months old, Dr. Herring performed the amputation. On Keegan’s first birthday, he got his first prosthetic leg complete with his favorite superhero. “He got his Batman® leg,” Wendy says, “and within 30 minutes, he was walking on it.”

Keegan still likes Batman® today. “I was Bruce Lee for my eighth grade graduation,” he says. Keegan is an all-around athlete. He plays football, tennis and basketball, but his favorite sport is tennis. He plays for his high school team and in tournaments through Universal Tennis, an organization that connects tennis and pickleball players through level-based play. At an adaptive tournament in Dallas, he won the junior level and the consolation in doubles.

Throughout his life, Keegan has received care from Dr. Herring and prosthetist Don Cummings, director of prosthetics. “For the first two years of Keegan’s life, I didn’t know Don had two prosthetic legs,” Wendy says.

Cummings lost his legs below the knees to bacterial meningitis when he was a freshman in college. “One day, we were building Keegan’s leg, and Don was trying to explain legs to us,” Wendy says. “He goes, ‘let me show you this one,’ and he throws up one of his legs. Then he says, ‘or my other one.’ It’s so cool that he has prosthetic legs because he knows how it feels. He can truly relate to Keegan.”

Keegan recalls having had 16 or 17 prosthetic legs as he has grown. Depending on the activity, he has worn different types. When he ran track and cross country, he wore a running blade designed primarily for sprinting. Now, he mostly wears a hybrid blade that has similar properties but includes a foot plate and foot shell, which allows him to wear various shoes. “With the foot shell, he was able to quarterback better,” Wendy says, “and he can cut better in football and tennis.” On his next leg, Keegan will display his school logo. “Anything you need, they’ll do it for you,” Keegan says.

“The people at Scottish Rite are pretty special,” Wendy says. “Dr. Herring is always smiling. You can’t help but be happy around him. He always wants to see Keegan run. Every time he sees him, he says, ‘get out there and run for me.’”

“Seeing what Scottish Rite has done for Keegan,” Troy says, “I’m just fortunate enough to have the opportunity to give, and my favorite thing is to donate to Scottish Rite.” Not only does Troy continue to participate in the San Angelo Sporting Clay Shoot, but he also supports the event, as well as supporting the West Texas Golf Classic in Lubbock and Emi’s Color Shoot in Amarillo. All three events raise funds for patient care at Scottish Rite. Whether giving individually or through Troy’s companies, the Ratliff family has contributed more than $550,000.

We are grateful for the Ratliffs’ generosity and the many ways that they have supported and promoted Scottish Rite for Children over the years,” says Stephanie Brigger, Vice President of Development. “It is wonderful to witness Keegan’s success and to know that the Ratliffs’ kindness will help other children succeed as well.”

Scottish Rite has been life-changing,” Wendy says.

It’s a safe zone for kids to be themselves and learn that they’re not alone,” Keegan says.

When you walk in the door, you don’t have a condition,” Troy says. “It’s just happy.”

Read the full issue.

Brock’s Brigade – Fighting Perthes Step by Step

Brock’s Brigade – Fighting Perthes Step by Step

by | Nov 7, 2022 | Hip Disorders

Cover story previously published in Rite Up, 2022 – Issue 3.

by Kristi Shewmaker
Kickball, wiffle ball, four square, taking hikes and riding bikes are a few of the activities 10-year old Brock, of Lee’s Summit, Missouri, enjoys. But, his first love is baseball.
 
“Baseball is his world,” his mother, Rachel, says. “He has played competitive baseball since he was 4.” In the spring of 2021, Brock played shortstop for a local team called the Baseknocks until midseason when he was diagnosed with Legg-Calvé-Perthes disease (Perthes), a rare childhood hip disorder, that temporarily took him out of the game and into a wheelchair.
 
Brock’s symptoms began with a pain in his groin. Then, he started to limp. “It was really bad,” Rachel says. “He couldn’t not limp.” She took Brock to visit his pediatrician who examined him but found nothing obvious like a broken bone. The doctor suggested trying physical therapy. “We thought maybe he had pulled a muscle,” Rachel says. After almost two months of physical therapy, Brock was still limping, and Rachel noticed that the thigh muscle in his right leg was two inches smaller than the thigh muscle in his left leg. “That was pretty alarming to me,” Rachel says. “I thought, ‘There’s something going on. It’s not just a pulled muscle.’” Later, an X-ray revealed that Brock had Perthes, a disease unknown to the family.
 
STEP 1: FINDING AN EXPERT

Perthes disease is a hip disorder that primarily affects the ball of the hip joint. The ball, or femoral head, is the upper part of the thighbone, or femur. The femoral head is normally round and fits inside the round socket of the pelvis. Perthes disease occurs when part or all of the femoral head loses blood supply. Without adequate blood flow, the femoral head bone dies. Over time, the body removes the dead bone and replaces it, initially, with softer bone. This bone is weaker, and the femoral head is more likely to collapse into a flattened position leading to deformity of the hip.
 
Perthes is rare, affecting approximately 15 children per 100,000 and is more common in boys than in girls, with a ratio of 5:1. The cause of Perthes is unknown, and currently, there is no cure. It typically occurs in children between 4 to 8 years old. Brock was diagnosed just before he turned 9.
 
“When you’re diagnosed with something that’s rare, and there’s not a ton of information, you feel like it’s a death sentence,” Rachel says. “I remember crying for the first three or four days because there were no answers, and no doctor could get us in. It was like a big, giant question mark.”
Rachel asked a friend, a physical therapist in nearby Kansas City, if she could recommend someone. Her friend said, “If it were my child, I would go see Dr. Kim at Scottish Rite.”
 
“Late at night, I sent a message to Scottish Rite and received a call the next day,” Rachel says. “Dr. Kim had an opening the day that we were going to be driving back through Dallas after a spring break trip to Galveston. It was clear that it was meant to be.”
 
STEP 2: GETTING EXEMPLARY CARE

A leading expert in Perthes disease, Harry Kim, M.D., M.S., is a pediatric orthopedic surgeon and director of the Center for Excellence in Hip at Scottish Rite for Children. Dr. Kim met with Brock and his family and confirmed the diagnosis.
 
“A perfusion MRI shows how much of the femoral head has blood flow,” Dr. Kim says. “Normally, it should be 100%. In Brock’s case, about 90% had no blood flow, which caused about 90% of his bone to die. His case was severe based on the amount of bone death and his age.”
 
Children ages 6 and younger tend to have better outcomes from Perthes disease because they have greater potential for developing new bone. Also, if half or more of the femoral head dies, the potential for regrowth without deformity is lower.
 
During the family’s initial visits, Dr. Kim and his team, including registered nurse Kristen Odom, explained the disease and Brock’s specific case and outlined the treatment options.
 
“When we came out of that first appointment, Brock said the best thing was that Dr. Kim looked at him, talked to him and asked him questions about how he was feeling, rather than just talking to me,” Rachel says. “It’s so important when you’re scared and uncertain, especially when you’re a kid, and the doctor makes you feel like you truly matter.”
 
After returning to Missouri, Rachel had more questions as the family processed the information. “Kristen spent an hour and 45 minutes on the phone with me,” Rachel says. “When I hung up, I told my husband we won’t ever go anywhere else. That kind of care simply doesn’t exist. When you’re dealing with a rare disease and your baby, that care is priceless.”
 
In May of 2021, Dr. Kim performed surgery on Brock’s right hip. “Brock presented with a mild collapse or deformity of the femoral head,” Dr. Kim says. “Without treatment, it would have degraded much further. We intervened before further collapse occurred.”
 
During the procedure, Dr. Kim cut the bone and positioned it so that he could tuck the femoral head securely into the hip socket. This containment procedure allowed the blood flow to come back naturally. He stabilized the bone with a metal implant that was removed in a later surgery. Over time, the body would remove the dead bone and generate new bone. To ensure healing, Dr. Kim prescribed a controlled weightbearing regimen, meaning Brock was unable to put any weight on his leg.
 
“He couldn’t play baseball, couldn’t run up the street to a friend’s house, couldn’t ride his bike,” Rachel says. “He went to school in a wheelchair, and kids stared at him and asked questions. We thought about ADA (Americans with Disabilities Act) accommodations everywhere we went. We had to rethink everything.”
 
STEP 3: FIGHTING FOR OTHERS

Despite all of these changes, Brock has taken it in stride. “He is my hero,” Rachel says. “Has he complained? Absolutely. Did he hate certain minutes, days and weeks? 100%. But overall, he was relieved to have an answer and a plan and no more pain. He has handled it better than I could have ever imagined.”
 
Last Christmas, Brock wanted to express his gratitude by designing and selling T-shirts as a fundraiser for Scottish Rite. “We called ourselves ‘Brock’s Brigade,’” Rachel says, “and put ‘His Fight Is My Fight’ on the front.” When the family traveled to Dallas for Brock’s second surgery in December, they presented a check for $1,000 to his care team. “Dr. Kim has really made an impression on Brock,” Rachel says. “This was Brock’s way of giving a little back so that hopefully it’s easier for kids in the future.”
 
“This family is so special,” Dr. Kim says. “They have gone through such difficulty, yet they want to help others improve their knowledge and support research. They are not just thinking about themselves but thinking about others.”
 
For more than a year, Brock completed a series of progressive exercises to restore muscle strength and range of motion. He went from using a wheelchair to bearing more and more weight on his crutches. In August, the answer the family had been holding their breath for finally came. Brock was given the all clear to walk.
 
“After we got the A-OK, Brock took his first walk with his dad and his brother,” Rachel says. “They do these “football walks” where his dad throws the football, and they go up ahead and catch it. They got to do that for the first time in a long time.”
 
Brock is especially excited for the day when he is cleared to play the sport he loves most. “Dr. Kim felt confident that Brock would be able to start winter practices and be 100% for spring baseball, which has been his goal from day one,” Rachel says. For now, Brock is easing back into his active life. He walks his dog, Pepper, and plays on the playground with his friends.
 
“The Scottish Rite team has been the biggest blessing to our family,” Rachel says. “Even being eight hours away and having to drive and fly multiple times throughout the last 18 months, I would drive four days to get to Scottish Rite. Our experience has been nothing short of amazing.”

Giving It All – Pushing Through Arthritis One Finish Line at a Time

Giving It All – Pushing Through Arthritis One Finish Line at a Time

by | Sep 14, 2022 | Rheumatology

Cover story previously published in Rite Up, 2021 – Issue 2.
by Hayley Hair
 
Preparing to qualify for the Amateur Athletic Union Junior Olympic Games, the largest national multisport event for youth in the United States, is no small feat. Contenders need intense training and ironclad dedication to be considered among the strongest, fastest, most skilled student athletes competing from around the country.
 
Seventeen-year-old Kelaiah, of Balch Springs, has definitely put in the work. She trains twice a day nearly every day for the 200-meter, the 400-meter and 4 x 100-meter relay races. “I’m training hard every day and giving it my all every time I go out there,” Kelaiah says. “What I have for that day is what I give, and I try to push more if I know I’m not feeling 100%.”
 
Unlike the runners she’s competing against, Kelaiah has been mentally and physically working through a delicate balancing act of becoming one of the best while managing juvenile idiopathic arthritis (JIA).

FINDING OUT ALL ABOUT ARTHRITIS
At 15, Kelaiah was playing basketball, volleyball and running, and when she started having swelling, pain and inflammation around her knee, her pediatrician referred her and her mother, Tanisha, to Scottish Rite’s Rheumatology team.
 
“She had a significantly swollen knee but remained very active,” says Kelaiah’s rheumatologist Katie Stewart, M.D. “Because she’s an athlete, we needed to think about other causes of swelling, more mechanical or injury-related issues.”
 
Arthritis is an autoimmune condition that causes swelling in one or more joints, and after six weeks of persistent joint swelling, it is classified as one of the chronic types of arthritis, including JIA for those 16 and younger. Arthritis can look like other common pediatric problems, so determining the diagnosis is crucial in taming the inflammation and potential damage caused by the condition.
 
“She was one that we were not quite sure of the diagnosis at first, and we were grateful to have great radiology input from our team,” Stewart says. “We work with Orthopedics and Sports Medicine, and in Kelaiah’s case, Radiology really helped us confirm the diagnosis.”

Scottish Rite treats patients from Texas and beyond with JIA and other rheumatic conditions, such as scleroderma, systemic lupus erythematosus, vasculitis and dermatomyositis. “I think people are usually surprised to know that arthritis is about as common as juvenile diabetes,” Stewart says.
 
Working with other physicians, advanced practice providers, physical and occupational therapists, psychologists, radiologists and many others, Scottish Rite’s Rheumatology team helps treat the whole child while supporting one’s hopes and dreams for an active, healthy life. Services provided include infusion therapy, digital X-ray and advanced imaging, orthoses or braces and lab services.

Many parents ask how did this happen. “I try to make it clear that there is nothing that someone did to cause this,” Stewart says. “The short story is that we don’t know how these conditions occur, and hopefully that’s something that science is going to lead us to discover at some point in the future.”
 
Her mother says she went through a lot of emotions learning about Kelaiah’s condition. “I was really taken aback because I thought, ‘oh, it’s arthritis?’ I thought that was something that you got when you were older,” she says. “As a mom, it was painful to hear because I know how much Kelaiah loves sports and how active she is, and all of her siblings are active in sports. That’s basically our life.”
 
For Kelaiah, telling her coaches and teammates led to more questions. “They didn’t know that it is for young people, and they didn’t get that it was my immune system attacking my body,” Kelaiah says. “It has nothing to do with my age.”
 
Kelaiah performs at a high level both athletically and academically, and her natural athletic talent and strong work ethic are driving her to pursue her dream of running NCAA Division I college track. “There’s a lot of competition and skill out there,” Kelaiah says. “People always say running is easy, that you are just running in an oval, but there’s a lot of technique and a lot of skills you need in order to be successful. It takes a lot of mental toughness.”
 
LIVING WITH JIA
Early intervention for JIA is crucial to avoid lasting effects of the condition. Once there’s a diagnosis, rheumatologists, patients and their families work together to control inflammation and keep flare-ups managed. “Initially it was really bad, and she was in a brace,” Tanisha says. “I was wondering, ‘would she ever be able to run again?’”
 
Some symptoms of JIA are fatigue, swollen and tender joints, pain and stiffness as well as fever and rashes. “I probably cry more than she knows I do because I wish I could take it away and help her, but I can’t,” Tanisha says. “I always tell her, ‘you’ve had more good days than bad days, and that’s life in general.’ What an opportunity to learn early on about the ups and downs in life, and that it’s all in how you deal with it.”
 
Stewart has prescribed various medications and injections, also called biologics, along the way to find the best treatment to extinguish the fires in Kelaiah’s body. “I feel very fortunate to live in an age when there are effective treatments for our patients and even more options coming down the pike,” Stewart says.
 
Getting the appropriate type and dosage of biologics has been working for Kelaiah, and with proper rest, good nutrition and hydration, she’s been able to keep training and advocate for herself out on the track.
 
“Because track is a demanding sport, a lot of runners come up with excuses trying not to run,”
Kelaiah says. “I honestly try not to use my knee as an excuse. But when it hurts, I’m like, ‘okay Kelaiah, you don’t want to make it worse,’ so I have to step up and tell my coach my knee is hurting,” she says. “That’s hard for me because I don’t like feeling that something is stopping me from being what I want to be.”
 
Overexertion or overtraining can exacerbate the condition. “A major issue that we see with our younger patients is that they push themselves past the point of comfort, not wanting to disappoint a coach or trainer and not knowing what their limits are,” Stewart says. “Finding your limits is going to help someone with arthritis gain more independence and to really listen to their body.”
 
SPRINTING INTO A BRIGHT FUTURE
Looking forward to upcoming events, Kelaiah continues to work hard each day to move toward her goals. “She’s had a really good year,” Tanisha says. “It’s just trial and error for us now.”
 
Stewart and the team at Scottish Rite continue monitoring her condition and providing support. “When we got to Scottish Rite, we really felt like they cared about us,” Tanisha says. “The care that you get there is just so wonderful. They let us talk about her accomplishments, and they want to know how she is doing.”
 
Those accomplishments are pretty impressive. She was selected by the Texas Girls Coaches Association to represent class 5A-6A schools as a member of the Texas All-Star Team. Her high school track team won district, area, regionals and state in the women’s 4 x 200 and the 4 x 400 relays and placed third in the 4 x 100 relay. Kelaiah competed at the Junior Olympics in 2021 in the 4 x 400 relay, with her team placing fourth.
 
Kelaiah had a strong showing at the most recent regional meet, a qualifier for the 2022 Junior Olympics in North Carolina in August. Her performances have successfully qualified her for the 4 x 100 and the 4 x 400 relays, as well as the 200- and 400-meter individual races, where she also set personal bests.
 
Stewart continues to be a big fan of Kelaiah’s. “She is a resilient young lady,” Stewart says. “She does not let anything stop her. I think just the fact that she’s pushed through all of her obstacles says so much about her.”
 
Kelaiah’s future is bright, and she feels like she’s getting the care she needs at Scottish Rite. “They’re going to get you right,” Kelaiah says. “They’re going to help you, and they’re going to do their best to help you with whatever you are going through,” she says. “It’s a very good support team. You are going to be okay.”
 
Read the full issue.

Caring for the Communities They Serve

Caring for the Communities They Serve

by | Jul 2, 2022 | Spotlight

Article previously published in Rite Up, 2022 – Issue 1.

Scottish Rite for Children is not the only organization celebrating a major milestone. Twenty years ago, H-E-B opened its first Central Market in Dallas at Lovers Lane and Greenville Avenue. Another connection between the two — sharing an unwavering commitment to help strengthen the communities they serve. H-E-B/Central Market and its president, Stephen Butt and his wife, Susan, have worked with Scottish Rite for Children for many years

“The quality of the team and the clarity of its mission have made it very easy to build the strong partnership with Scottish Rite that we have now enjoyed for the past 20 years,” Stephen says. “Our relationship began to grow as we saw firsthand the strong care and compassion they showed for these children and families — a long-standing trait of Scottish Rite.

The Butts and H-E-B/Central Market have been steadfast community partners to cities around Texas. Donating 5% of pre-tax annual earnings to charitable organizations, the company has given more than $10 million to the surrounding areas

”The amazing depth and breadth of Stephen and Susan’s unyielding commitment is remarkable,” Vice President of Development Stephanie Brigger says. “They’ve provided strong leadership for our special events and introduced countless friends to Scottish Rite.

In 2012, the Butts and their good friends Betsy and Richard Eiseman, Jr. were co-chairs of Scottish Rite’s signature event, Treasure Street. Behind the scenes, the couple has hosted fun-filled patient activities as well as provided tremendous support to our staff. “They have gone the extra mile over and over again,” Brigger says. “They have catered and served delicious meals to our teams and given overflowing bags of groceries to brighten the holidays for our staff and their families.

For more than a decade, Central Market has hosted The Foodie Classic Golf Tournament, which provides H-E-B/Central Market suppliers an opportunity to support Scottish Rite as well. The tournament has raised more than $1.2 million directly benefiting patient care

“Susan and Stephen Butt have been wonderful friends of Scottish Rite,” Assistant Chief of Staff and Foundation President Karl E. Rathjen, M.D., says. “They have always been ready to ‘answer the call’ for our patients and their families. Their loving, inclusive leadership is reflected every time you step into Central Market. I am always amazed at the similarities of our two organizations’ team members — great people who love what they do and go out of the way to serve others!

“Scottish Rite for Children holds a special place in the hearts of its many supporters,” Stephen says. “We are proud of the relationship we are building with Scottish Rite, through H-E-B/Central Market as well as personally, and we look forward to our partnership with Scottish Rite continuing to grow into the future.

Congratulations to H-E-B/Central Market as it has broken ground on four new H-E-B locations in Plano, Frisco, McKinney and Forney. We are grateful for the support of Stephen and Susan Butt and H-E-B/Central Market and can’t wait for the next 100 years of serving the community united together.

Read the full issue.

Empowering Women To Become Engineers and Surgeons

Empowering Women To Become Engineers and Surgeons

by | May 20, 2022 | Research & Innovation

Article previously published in Rite Up, 2022 – Issue 1.

Sounds of whirring drills, buzzing bone saws and clattering trays of suture and casting materials filled the room at Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco during the recent Perry Outreach Program (POP) course. The daylong course, created by The Perry Initiative, features mentorship as well as hands-on workshops and training designed to introduce young women to aspects of orthopedic surgery and engineering careers, two fields in which women are drastically underrepresented.
 
Jasmine, former Scottish Rite for Children patient, experienced a light-bulb moment during her POP participation, leading her to study bioinformatics, statistics and biomedical sciences in college. Now a junior at Texas A&M University, Jasmine came back to this year’s POP to help others feel what she felt.
 
“The empowerment I found through the program encouraged me to continue pursuing my interest in orthopedics rather than being deterred by the underrepresentation of females in the field,” she says. Her POP mentors, Scottish Rite medical director of clinical safety and pediatric orthopedic surgeon Amy L. McIntosh, M.D., along with Kirsten Tulchin-Francis, Ph.D., former division director of Movement Science, led the event in Frisco as local hosts providing guidance and education for 30 young women.
 
“There are very few women in engineering and orthopedic surgery, so it is essential that young women like these bring their creativity and diversity of thought to these fields,” Tulchin-Francis says. Participants performed mock orthopedic surgeries and conducted biomechanical engineering experiments, while also hearing from prominent women engineers and surgeons in the field.
 
This course featured suture training on bananas, sawing and drilling synthetic bones and repairing them with plates, screws and surgical devices, and how-tos about applying a cast.
 
“If I feel intimidated being one of the few females in the field, I remember the joy and empowerment I felt holding that drill,” Jasmine says. “I remind myself daily of the lessons I learned from my mentors to not be afraid to be bold.”
 
McIntosh encouraged all the young women in attendance. “Be great!” she says. “When you’re the only woman in a room full of men, you shouldn’t try to hide. Instead, use the situation as an opportunity to shine. Be memorable for your hard work, dedication, determination and poise. Speak up with intelligence and confidence.”
 
“One of my greatest takeaways from the program is to not be afraid to take up the space and make your presence known,” Jasmine says. “You are as deserving to learn as anyone else in the room.” Jasmine was accepted into the Joint Admissions Medical Program (JAMP) in 2021, where she received early provisional acceptance to 11 medical schools in Texas and plans to take the MCAT in April 2022.