Share Your Story: A Place of Healing

Share Your Story: A Place of Healing

by | Dec 10, 2020 | Rheumatology

Meet Norah, a patient seen by our Rheumatology experts. Learn more about her journey below.

Blog written by Norah’s mom, Julie of Dallas, TX.

During the summer of 2018 we brought our 3-year-old daughter, Norah, to Scottish Rite for Children with unexplained weakness. Previously a rough and tumble toddler, Norah had stopped running and playing. She requested to be carried everywhere. Her whole demeanor was subdued, and we were desperate to know what was weakening our spunky girl.

The Rheumatology team at Scottish Rite immediately recognized that Norah was suffering from a rare form of childhood arthritis, called Juvenile Dermatomyositis (JDM). JDM is rare enough that many children go months and even years before getting a diagnosis, but Dr. Nassi needed only minutes. The skilled and compassionate nurses began an aggressive treatment course of IV medications that day to slow and reverse the weakness that had overtaken her. 

The initial months of treatment required a very difficult adjustment for our family of five, but it became clear that Scottish Rite was going to have our backs, both medically and emotionally. At her weakest, Norah could not lift her head off the bed or sit without support on her sides. Her swallowing muscles weakened, requiring a nasogastric feeding tube. A port was placed in her chest for her many doses of IV medications. Absolutely everything Norah needed medically, Scottish Rite was able to provide. It was a much needed one-stop-shop for us during a stressful time. For many appointments, Norah and I would stay in her exam room while specialist after specialist rotated in and out to give her the care she needed. Dieticians, occupational therapists, speech therapists, developmental disabilities practitioners, mental health counseling, our heroes in Child Life – the list goes on and on. The level of teamwork across specialties is an inspiration.

It is also an inspiration to know that this level of care is offered at Scottish Rite to all patients, regardless of their ability to pay. 

Now, Norah can run, jump and play again with her two older brothers, plus her new kindergarten friends. She had some hard days and surely those memories are difficult and persistent, but her overall take away is that Scottish Rite is a place of healing and loving attention. Our appointments are less frequent now, but it always feels like we are visiting friends. From the moment we walk in, to the smell of popcorn, to the final minutes when we allow her to finally spend the dime she has been saving all month for the gumball machine, Scottish Rite makes what could be a traumatic day into a treat for her. We credit that atmosphere of positivity mixed with expert care, for her miraculous recovery and continued progress.

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

People Newspapers: Bite Into the Burger that Gives Back

People Newspapers: Bite Into the Burger that Gives Back

by | Dec 8, 2020 | Events, Press Coverage

During the month of December, treat yourself to a Village Burger Bar “Taylor” Burger — a brisket and chuck patty blend topped with mayo, cheddar cheese, monterey jack cheese, hickory smoked bacon strips, pickles, barbecue sauce and hand-battered onion ring served on a locally-sourced brioche bun. This limited-time burger created by our patient, Taylor, will help benefit patients just like her!

Learn more about the Taylor Burger.

Ultrasound in Pediatric Sports Medicine

Ultrasound in Pediatric Sports Medicine

by | Dec 3, 2020 | Sports Medicine

This is a summary of a lecture provided by sports medicine physician Jacob C. Jones, M.D., RMSK, as part of the Coffee, Kids and Sports Medicine educational series.

Watch the full lecture.
Print the PDF.

Basic Ultrasound Physics
Most are aware that ultrasound uses sound waves to create an image, but that’s about where the knowledge stops. Here are a few key points to help with understanding the physics behind this technology:

  • The transducer probe delivers sound waves into the body to reveal a boundary between two types of tissue (e.g. ligament and fluid).
  • Some waves bounce back to the probe and some pass through the tissue to the next boundary.
  • The transducer calculates the distance and speed converts to volts (piezoelectric effect).
  • A 2-D, black and white image is produced on the screen based on a grayscale assigned to distances and intensities.

To improve the images produced, different transducers, also called probes, are available and are chosen based on size of field area, tissue depth and other variables.

Indications, Advantages and Disadvantages for Ultrasound in Pediatric Sports Medicine
Pediatric orthopedists have leaned on ultrasound in diagnosing conditions in the infant hip for many years. With a continued evolution of the subspecialty of pediatric sports medicine, there is a recognition that some conditions can be diagnosed safely and effectively with ultrasound.

Indications include:
Diagnostics 

  • Tendons
    • Tendinopathy
    • Strains
    • Tears
  • Muscles
    • Strains
    • Contusions
    • Tears
  • Nerves
    • Entrapment
  • Ligaments
    • Sprains
    • Tears
  • Joints
    • Effusion (swelling in the joint)

Interventional

  • Guided Injections
  • Tenotomies (procedure to a selected tendon)
  • Aspirations/lavage
  • Tendon/ligament releases
  • Biopsies

Advantages Over Traditional Imaging 

  • Real-time imaging that is also dynamic.
  • Needle guidance for procedures.
  • Allows interaction with patient and family during imaging.
    • Visual feedback can help patient commit to treatment.
  • Less metal artifact compared to MRI in some cases.
  • Contralateral limb can safely and easily be used as a control.
  • Easily used in exam rooms and on the sidelines.
  • Relatively inexpensive with reduced resource dependence.
  • No radiation.
  • Painless.
  • Sonopalpation (palpation during ultrasound) and active or passive range of motion can be performed to enhance exam.

A Few Disadvantages to Consider When Using Ultrasound

  • Limited field of view.
  • Incomplete evaluation of bones and joints.
  • Limited penetration.
  • Operator-dependent.
  • Evolving certification/accreditation standards.
  • Equipment cost and variable quality
  • Anisotropy – a type of artifact in which changing the angle at which the ultrasound wave interact with a tendon or muscle can affect the brightness of the image. Non-perpendicular images will cause hypoechoic (darker) images.
  • Artifacts -causes unclear images.
  • Excessive or disruptive pressure from sonopalpation.

Watch the full lecture to hear case examples of how ultrasound augments musculoskeletal evaluations and interventions:

  • Knee: 11-year-old female soccer player with posterior knee popping and pain.
    • Observe hamstring tendons as patient volitionally caused popping.
  • Shoulder: Young baseball player, pain in cocking phase of throwing.
    • Visualize posterior labral pathology with shoulder active movement.
  • Hip: 17-year-old dancer with ongoing right hip pain.
    • Measure femoral head protrusion in various positions.
  • Calf: 18-year-old tennis player that felt some right calf pain while doing sprints.
    • Compare to normal side and use sonopalpation help to confirm diagnosis.
  • Humerus: Young baseball pitcher/catcher with pain in shoulder when throwing.
    • Quantify physeal asymmetries side-to-side.
  • Wrist: 9-year-old male tripped over opposing soccer player and landed on wrist.
    • Quickly determine need to seek further care or return to play.
  • Hip: 13-year-old male basketball player with chronic right hip pain and h/o a “pop” two years ago.
    • Ultrasound-guided procedure followed by second round of physical therapy.
  • Thigh: 16-year-old male sustained blow to thigh two months ago.
    • Multi-planar view to evaluate.

Changing Your Practice
This information does not necessarily need to change your practice. Ultrasound is a complement to many other evaluation tools and imaging resources.

For practitioners interested in learning more about ultrasound, Jones recommends looking for local workshops to get a feel for using a device before purchasing one. The learning curve is steep, but the flexibility and benefits over time make it a great option for some providers.

Musculoskeletal Ultrasound at Scottish Rite for Children
In addition to Jones use of ultrasound in his sports medicine practice, radiology staff and pediatric radiologists also provide ultrasound for sport-related conditions, hip dysplasia as well as other conditions. Patients referred to Scottish Rite for Children providers all have access to this resource.

About the Expert
Jacob C. Jones, M.D., RMSK, is a sports medicine physician caring for young athletes at Scottish Rite for Children Orthopedic and Sports Medicine Center in Frisco. After a pediatric sports medicine fellowship, he completed intensive training in a musculoskeletal ultrasound fellowship.

Take Flight Approved as Dyslexia Intervention Program in the State of Alabama

Take Flight Approved as Dyslexia Intervention Program in the State of Alabama

by | Nov 20, 2020 | Dyslexia & Learning Disorders

At Scottish Rite for Children, our team of experts strive for excellence – making sure that every child receives the best care. As pioneers and innovators, staff from the Luke Waites Center for Dyslexia and Learning Disorders to share their curriculum for dyslexia with those around the country, with a goal of helping children who struggle with reading.

Recently, another state has approved Take Flight: A Comprehensive Intervention for Students with Dyslexia as a recommended dyslexia intervention for use in public schools. Along with Arkansas and parts of Colorado, Alabama is the latest state where the program has been approved.

This is an important distinction because many products are available for literacy education that do not address the specific needs of students with dyslexia. State approval affords school administrators, educators, trustees and especially parents the confidence needed to allow their students to receive this specific assistance. This approval also satisfies a legislative mandate.

Decades of scientific evidence regarding how the brain learns to read and, consequently, how to effectively teach reading, have traditionally not been incorporated systematically in the education system, particularly in the legislation surrounding instructional practices. Several states (and many more in the pipeline) have recently passed initiatives concerning the importance of the “Science of Reading” (SOR) and have mandated that public schools must use a curriculum based in the SOR for both reading instruction and intervention. This is a critical change because although many education systems mandate dyslexia identification and intervention policies, very few of them outline precisely what methods to use.

A key feature of this recent legislation is the thorough vetting of curricula before they are recommended for approval at the state level. Departments of education call for and review very extensive applications from publishers regarding curriculum content and structure, as well as scientific theory and empirical evidence supporting their program’s effectiveness. Members from our Center for Dyslexia completed the required applications and were notified that we were one of only four intervention programs were recommended by Alabama’s Literacy Task Force as meeting requirements of the Alabama Literacy Act – and Take Flight received the highest score of all intervention programs reviewed by the state. Our team will continue to seek state-level approval for Take Flight as legislature is passed in other states and the opportunity arises.

State approval of Take Flight is a reflection of the powerful efficacy of the curriculum and of the commitment to educational excellence by the State of Alabama.

Helping Young Athletes Manage Stress

Helping Young Athletes Manage Stress

by | Nov 18, 2020 | Sports Medicine

For all kids, managing stress is important. However, young athletes have an added layer of pressures and our team is here to provide tips on properly managing those stressors. Pediatric psychologist Emily Stapleton, Psy.D., works closely with our young athlete population at our Frisco campus. As a former athlete herself, she has a passion for supporting athletes’ mental health for optimal performance, injury prevention and rehabilitation outcomes.

Below are a few tips to help parents, athletic trainers and coaches of young athletes manage stress.

CONNECT and help problem solve.
When overwhelmed, teens may struggle to break down a situation into manageable pieces. Talk to them and help them take one step at a time.

TIME your conversations wisely and keep it positive.
Let emotions from games or practices settle before talking about performance or outcomes. Waiting a couple of hours to discuss these topics allows athletes to reflect on their performance with less stress.

REFRAME success.
Expectations from parents and coaches can unknowingly increase pressure to perform and negatively affect self- confidence. Encourage athletes to focus on putting forth their best efforts and measuring personal progress rather than only focusing on end results or winning.

TEACH coping skills for life.
Coping skills can help an athlete learn to self-manage when stress starts to take over. Expose your athlete to yoga, taking walks, diaphragmatic breathing (i.e., deep breathing), progressive muscle relaxation (i.e., tensing/releasing muscles) and other techniques to relax.

MAKE ROOM for breaks.
Teach athletes the importance of down-time for rest and recovery. Helping athletes develop time-management skills and minimize over-scheduling will improve stress management.

ENCOURAGE life outside of sport.
Making time for other interests and hobbies apart from the primary sport, including fun activities and time with friends, helps create balance and build resiliency. Allowing athletes to have a breadth of interests and hobbies to draw from when experiencing distress.

PROMOTE healthy sleeping and eating habits.
Stress is easier to manage and less likely to build up with healthy habits in place. A balanced, sport-appropriate diet and quality sleep (at least eight hours for teens) support young athletes in academic, sport and social settings.

ASK for HELP when you need it.
Talking through stressors with a licensed psychologist or mental health counselor can be a healthy outlet for chronic stress and help athletes learn positive coping strategies to use in the future when experiencing negative stress.

Print the PDF

Learn more about pediatric sports medicine.