Get to Know our Staff: Lindsey Ham, Therapy Services

Get to Know our Staff: Lindsey Ham, Therapy Services

by | Dec 13, 2021 | Therapy Services

What is your job title/your role at Scottish Rite for Children?  
I am an occupational therapist and certified hand therapist working primarily at the Frisco campus. 

What do you do on a daily basis or what sort of duties do you have at work? 
My primary role is an outpatient occupational therapist, specializing in pediatric hand conditions. While this sounds like a small subset, I assess and treat a wide range of diagnoses, including upper limb and hand differences, traumatic injuries and sport-related injuries involving hand, wrist, elbow and/or shoulder. In addition, I also see patients with cerebral palsy, arthrogryposis, arthritis and brachial plexus injuries. My job is to figure out what deficits are limiting their participation and independence with daily activities, such as dressing, bathing, toileting, school participation, sports and leisure participation and play. I then address these deficits through meaningful activities to get them back to doing what they love. Since we see all ages from newborn and up, every hour of my day looks different, ranging from playing a game of Connect 4 or Mancala to bear walks, push-ups and weight machines. We also fabricate custom orthoses (splints) for children who have fractures or surgeries that require immobilization.

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 as a certified nursing assistant at a hospital while I was in college. I always knew that I wanted to be in the medical field. My high school had an amazing health careers program where we were able to shadow many different jobs across the medical field. It was then that I was able to shadow an OT and fell in love with the career! I have been an OT for 13 years and at Scottish Rite for almost three years. I moved from Nashville to Dallas just to work at Scottish Rite, and it was one of the best decisions I’ve made! 

What do you enjoy most about Scottish Rite?
I love the atmosphere and team here! It is such a positive place to work. I love the collaborative approach to treat every patient. There is an open line of communication between therapists and physicians and that creates great outcomes for our patients. I love that everyone here has the same mission — to give kids back their childhood. 

Tell us something about your job that others might not already know. 
Your hand strength is important! This is something that I preach daily. People know to go to the gym and workout, but no one really focuses on hand strengthening. So, grab a stress ball and keep your hands strong! 

What was the best vacation you ever took and why?
I love traveling, so it is hard to pick just one. I would have to say my favorite was the cruise I took to the Bahamas last month because I got engaged!!  

Do you collect anything? How did you start?
Shoes and sunglasses — I guess not a true collection, but I have a lot of both! 

Do you play any sports or instruments?
I was a competitive cheerleader in high school and then coached through college. My sister owns a cheer and tumbling gym, so I am still surrounded by it. I also belong to a kickboxing gym and love it. 

CBS DFW: Scottish Rite for Children Patient Cedric Has Found His Niche With Sports

CBS DFW: Scottish Rite for Children Patient Cedric Has Found His Niche With Sports

by | Dec 11, 2021 | Events, Press Coverage

Since 2007, the Patient Champion program has enlisted Scottish Rite for Children patients to help encourage and cheer on runners in the BMW Dallas Marathon. This program helps us highlight some of the wonderful kids the marathon generously supports each year. We’re excited to introduce you to Cedric, one of our Patient Champions!  
 
Watch the full story. 

CBS DFW: BMW Dallas Marathon Benefits Scottish Rite for Children

CBS DFW: BMW Dallas Marathon Benefits Scottish Rite for Children

by | Dec 11, 2021 | Events, Press Coverage

The BMW Dallas Marathon named Scottish Rite for Children their primary beneficiary in 1997, and since then has raised more than $5 million for the world-class institution. This year, Scottish Rite is celebrating its centennial, which means for 100 years it has been providing excellent pediatric care for orthopedic, related neurodevelopmental and musculoskeletal conditions, as well as for specific learning disorders, such as dyslexia.
 
“Because of the long-standing relationship and support from the BMW Dallas Marathon, Scottish Rite for Children can continue to provide life-changing, expert care to children with pediatric orthopedic conditions and help give kids back their childhood,” said Bob Walker, president and CEO of Scottish Rite for Children.
 
Watch the full story.

Stress Fractures in the Spine: Spondylolysis

Stress Fractures in the Spine: Spondylolysis

by | Dec 7, 2021 | Research & Innovation

Pediatric orthopedic surgeon Jaysson T. Brooks, M.D., presented this as part of Coffee, Kids and Orthopedics education series. Brooks provided a detailed discussion of evaluating stress fractures in the spines of adolescents.

You can  and print the pdf.

watch the full lecture -What is Spondylolysis?

The facet joints in the back of the spine are connected by small segments of bone called pars interarticularis. Since this portion of the spine doesn’t get a great blood supply, it is at risk for stress fractures. This condition is called spondylolysis. Spondylolysis occurs more commonly at the L5 level and less commonly at the L4 level.

Most kids aren’t born with spondylolysis; it is caused by overuse and repetitive mechanical stress or forces. Activities or sports with repetitive hyperextension can cause a stress fracture of the spine. We see a higher incidence of spondylolysis in adolescents – as many as 47% of those with back pain. This is typically higher during growth spurts. The condition is much less frequent in adults. Some estimate 5% of adults with low back pain have spondylolysis.

In some cases, the stress fracture occurs bilaterally and the vertebra can slip forward, which is called spondylolisthesis. If a slipped vertebra presses on a nerve, it might cause severe shooting pain down the leg, and surgery may be required. However, if it breaks and doesn’t slip forward, surgery might not be necessary.

Spondylolysis: Genetic Predisposition?

  • Spondylolysis occurs in 15-70% of first-degree relatives
  • Prevalence
    • White: 6%
    • Black: 2-3%
    • Indigenous American (Inuit): as high as 40%

History Matters

There is a higher prevalence of spondylolysis in elite athletes who report playing sports with repetitive hyperextension/rotation of the lumbar spine. Back pain should raise suspicion in these athletes:

  • Football lineman
  • Cheerleaders
  • Gymnasts
  • Weightlifters
  • Divers / Swimmers

Back pain without a history of injury or repetitive activities is less likely to be caused by a stress fracture. In cases with shooting or decentralized pain, disc herniation should be considered.

Exam

The physical exam to assess for a stress fracture begins with palpation, and pain should be centralized around L5-S1 area. Active extension and hyperextension will be more painful than flexion. Coordination and strength should not be affected unless there is some nerve involvement, but pain may impact their ability to perform activities like heel walking and single leg hopping.

Imaging

In most cases, especially if the patient heard a “pop” and has acute low back pain, a standing anterior-posterior (AP) and lateral X-ray of the lower lumbar spine is recommended.

A study published in the Journal of Pediatric Orthopaedics looked at 2,846 patients with a median age of 14.6 years that were seen for back pain. 76% had no clear cause for their back pain, and less than 61% had two or fewer follow-up visits. This is a good reminder that not every patient with back pain has a stress fracture.
X-rays may not show early signs of spondylolysis. Rather than automatically ordering advanced imaging, a pediatric sports or spine referral may be the best next step because MRIs may also be inconclusive.

Treatment

Treat conservatively first.

  • Activity Modification: 3 – 6 months
  • Physical Therapy: 3 – 6 months
    • Focus on core strengthening to improve lumbar stability
  • Non-steroidal anti-inflammatory drugs (NSAIDS)
    • Meloxicam and/or diclofenac cream
    • Naproxen
  • Bracing may provide comfort but does not affect return to activities.

Often patients only want to do one of these, but that may make extend their recovery by several months.
It is acceptable if a fracture never heals on an X-ray as long as the symptoms go away. If six months of conservative treatments only show slight improvements, a pars injection may help their symptoms. Some patients are injected every six months.

Surgery should always be a last resort.
If the gap is not too wide, a screw is used for a direct pars interarticularis repair. A fusion of the surrounding vertebra may be considered if a loss of motion is acceptable.

Check out our latest on-demand lectures available for medical professionals.

Iron for the Young Athlete

Iron for the Young Athlete

by | Dec 7, 2021 | Sports Medicine

Iron is a mineral that helps the body make red blood cells. These cells carry oxygen throughout the body.

How much iron do children and teens need?

There are daily recommended amounts of iron based on age and gender. Athletes and active individuals may need more than the recommended daily allowance.

What is iron deficiency?

Iron depletion or deficiency occurs when the body does not have enough iron because of:

  • poor iron absorption.
  • excessive iron losses.
  • low iron intake.

How can iron deficiency affect young athletes?

Low iron and iron deficiency both impair the blood’s ability to carry oxygen to body tissues, including the heart, lungs, and muscles. This can cause fatigue, shortness of breath, and many other symptoms. A young athlete with low iron will often feel tired and burn out early in practices, games, and meets, which can lead to decreased performance and possible injury.

”While risk of iron deficiency is higher in vegetarian athletes and female athletes, these are not the only individuals at risk,” says Taylor Morrison, M.S., R.D.N., CSSD, L.D. “Distance runners, those training at altitude, those going through rapid periods of growth, and those who are underfueling, or not consuming enough total calories and iron-rich foods, are most at risk for iron deficiency.”

What are the sources of iron in the diet?

There are two forms of iron.
Heme iron is found in animal sources and is more efficiently absorbed in the body than non-heme iron.
Non-heme iron is found in plants. Individuals that follow a vegetarian eating plan can still meet iron needs through non-heme food sources if they are intentional.

What affects iron absorption?

Factors That Reduce Iron Absorption

  • Compounds called phytates and oxalates are found in many plant-based foods.
  • Tannins found in tea and coffee
  • Calcium and excessive intake of zinc and manganese

Suggestions to Improve Iron Absorption

  • Add foods containing vitamin C to meals with non-heme sources.
    • Sources include citrus fruits, strawberries, kiwi, bell peppers, tomatoes, cauliflower, broccoli, melon, and mango.
  • Eating heme sources of iron with non-heme sources.
  • Drink tea or coffee separately from an iron-containing meal or snack.
  • Cooking in a cast-iron skillet.
  • Add allium plant herbs like onion and garlic to your iron sources.

Examples of Meals and Snacks That Improve Iron Absorption

  • Spinach salad topped with sliced strawberries.
  • Steamed broccoli with lemon juice squeezed on top.
  • Trail mix includes an iron-fortified cereal and raisins with a glass of orange juice.
  • Cooked whole-wheat spaghetti with marinara sauce and fresh tomatoes topped with grilled shrimp and broccoli.
  • Black bean, quinoa, and mango salad.
  • Raw bell pepper slices, cauliflower florets, and grape tomatoes with hummus.

If you are worried your athlete is struggling with iron depletion or deficiency, visit with your doctor and a registered sports dietitian to see if dietary changes or supplementation are needed.