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Get to Know our Staff: Jaclyn Valeriano, Empower

Get to Know our Staff: Jaclyn Valeriano, Empower

by | Jul 2, 2024 | Spotlight

What is your job title/your role at Scottish Rite for Children?
I am a trainer for our electronic health records system, Epic, for the ambulatory care and outpatient staff.

What do you do on a daily basis or what sort of duties do you have at work?
My role at Scottish Rite is to provide new hire Epic ambulatory care training to our outpatient nurses and ancillary staff. Along with new hire training, I create training materials to inform current Epic users of new builds or changes happening within the Epic system. Our training team also helps with the testing of Epic upgrades, working IT Help Desk tickets, maintaining our training environment and other tasks.

What was your first job? What path did you take to get here or what led you to Scottish Rite? 
My first job was as a file room attendant at a doctor’s office pulling paper files from a small room. I spent a great portion of my time re-alphabetizing that room before I left. 

My degree is in athletic training. I first started at Scottish Rite as a certified and licensed athletic trainer in our Sports Medicine department about 10 years ago! Admittedly, I was not looking to leave the clinical side, but here I am – and I’m loving it!

What do you enjoy most about Scottish Rite? 
I absolutely love that I have a workplace family. Not everywhere you go has a sense of community, and I feel extremely lucky and appreciative of our workplace environment.

Tell us something about your job that others might not already know?
I would imagine that most people think of me as an Epic trainer. What I think some may not know is that I am only certified to train certain parts within Epic. Each of us on the Empower side are certified in specific areas within Epic. For example, I am certified to train outpatient, but I am not certified to train HIM, Billing or Scheduling.

Where is the most interesting place you’ve been?
Guanajuato, Mexico. I learned so much about Mexican history and Mexican independence from visiting Leon, Dolores, Hidalgo and San Miguel de Allende.

What is your favorite game or sport to watch and play?
I love to watch my niece and nephew play in whatever sport(s) they are participating in. When it comes to playing, I absolutely love playing volleyball. I first decided to try volleyball in seventh grade school athletics, and I have not stopped playing since!

If you could go back in time, what year would you travel to? 
Selfishly, I would travel back to 1998. I was young, carefree and saw the world in a different, more innocent light. I would take advantage of the time I had with my grandparents and make more childhood memories with my family and friends.

What’s one fun fact about yourself? 
I asked my family, and they said to tell you all this: I was city champion in eighth grade track for High Jump and the 400-meter dash. Side note – I earned my 400-meter dash, but I won high jump by default because the other girl, who was good at the event, could not compete due to academic ineligibility.

Standing Tall After Spinal Fusion Surgery

Standing Tall After Spinal Fusion Surgery

by | Jun 27, 2024 | Scoliosis & Spine

Previously published in Rite Up, 2024 – Issue 2.

In January of 2023, Delilah, a 12-year-old from San Antonio, was helping her mother, Angie, clean the house. As Delilah bent over to pick up something off the floor, Angie noticed that her backbone protruded from her back at an abnormal angle. “It caught me off guard,” Angie says. She called her husband into the room and asked Delilah to repeat the movement. He looked at Angie with wide eyes and said, “What was that?”

Delilah’s pediatrician suspected scoliosis and referred the family to an orthopedic physician.

“After taking an X-ray, he gave us the news that her spine was at an 84 degree angle,” Angie says. “Delilah and I had tears in our eyes.” Angie explained that because of the curves magnitude, the physician said that he would feel more comfortable recommending them to Scottish Rite for Children. “We had never heard of Scottish Rite, but it was the best advice and decision we ever made,” Angie says.

At Scottish Rite, pediatric orthopedic surgeon Megan E Johnson, M.D., diagnosed Delilah with adolescent idiopathic scoliosis, of which there is no known cause. Because her curve had surpassed the surgical magnitude of 50 degrees, Dr. Johnson recommended posterior spinal fusion, a surgery in which a rod is secured to the vertebrae to straighten the spine and hold the correction of the curve in place.

“Scoliosis progresses more rapidly when kids are undergoing their big growth spurt,” Dr. Johnson says.

“Delilah still had a lot of growth left, so she was at a greater risk of progression.”

Before surgery, Delilah asked thoughtful questions and expressed some worries. “I had a fear of like, what if I wake up during surgery?” she says. “And, what if it doesn’t turn out right, or what if they miss something?” Dr. Johnson marveled at Delilah’s maturity. “For being 11 at the time, Delilah asked great questions, advocated for herself and did her own research,” she says.

In October, the family traveled to Dallas for Delilah’s surgery and stayed at the Ronald McDonald House of Dallas, Scottish Rite’s community partner. “They took such good care of my family,” Angie says. “I’m very grateful for that.” After a successful surgery, Delilah’s curve was corrected from 95 to 20 degrees. She also got two inches taller. “Delilah exceeded our expectations,” Dr. Johnson says. “She has been a champ through it all.” Six months later, Angie cannot believe that Delilah had spinal surgery. “It boggles the mind because she’s back to being herself,” she says. “For us, Scottish Rite means hope, that everything is going to be OK.” Delilah agrees. “You can trust Scottish Rite,” she says, “and know that you are in great hands.”

Read the full issue.

Scoliosis Awareness Month: Wearing Your Scoliosis Brace

Scoliosis Awareness Month: Wearing Your Scoliosis Brace

by | Jun 21, 2024 | Scoliosis & Spine

At Scottish Rite for Children, our spine experts care for the common to the complex of scoliosis curves. The type of treatment required for the condition depends on the child, when they were diagnosed and the severity of the curve.

One treatment option for scoliosis is bracing. At Scottish Rite, our in-house Orthotics department creates custom braces – making sure it fits the child just right. Here are a few basics to know about the scoliosis brace:

  • The purpose of a brace is to help stop the curve from getting worse with a goal of preventing the patient from needing surgery.
  • Although it does not cure the condition, if used on a curve that ranges from 25 to 40 degrees and the child is still growing, it can be extremely effective.
  • Your doctor will determine the number of hours the brace should be worn throughout the day.
  • If the brace is uncomfortable, our team works with the patient to make adjustments as needed throughout treatment.

Different Types of Braces:

  • TLSO (thoracolumbosacral orthosis) – used for curves located in the mid to lower part of the back
  • Providence Brace– also known as the nighttime brace, used for curves that are less severe.

Being Active While Wearing Your Brace:

  • Our team encourages a child who must wear a brace to continue with their sport and/or activity.
  • Bracing for this condition is only temporary, and although adjustments might need to be made to make the brace more comfortable, etc., it is created to fit the child so they can continue being active.

Taking Care of Your Skin
The brace pushes firmly on your body and will cause redness of your skin. Over time the skin in the pressure areas may become darkened and tougher. These changes are temporary and may improve brace comfort. If you develop a sore, your brace needs adjustment.

Clothing Suggestions

  • We recommend you wear a form fitting tank top under the brace. It is more comfortable when there is something between you and the brace.
  • Loose-fitting clothing will hide the brace better than form-fitting clothing.
  • Bras without underwire may be more comfortable.
  • To make using the bathroom easier while wearing the brace, wear your underwear over the brace.

Taking Care of the Brace
To help prevent skin irritation, the inside of the brace must be cleaned at least once a week, or more often as needed. Use a cloth to wipe the brace clean using soap and water or rubbing alcohol.

Learn more about scoliosis bracing.

Making a Game Plan for a Safe Season – Tips for Parents and Coaches

Making a Game Plan for a Safe Season – Tips for Parents and Coaches

by | Jun 18, 2024 | Sports Medicine

The to-do lists for coaches and sports administrators preparing for sports seasons are long. It’s time to meet new players, evaluate the condition and skills of each player, inform the parents of rules and schedules and get the playbook finalized. What may get overlooked is the emergency plan and training. Pediatric sports medicine physician Shane M. Miller, M.D., who has a background as a firefighter and EMT, offers some safety tips for parents and coaches. “Many organizations have the best of intentions to keep athletes safe, says Dr. Miller. “Preparation and practice can make all the difference in emergencies.”

Miller is passionate about helping athletic trainers and others in sports. He conducts training for several school districts including Frisco ISD and Irving ISD. From handling heat illness to spine injuries, athletic trainers are an invaluable resource on the sidelines. Young athletes may be in settings where athletic trainers are not available, so it’s important for parents and coaches to be aware of safety protocols.

Tips for Parents

  • Take the preseason sports physical process seriously. With an accurate and thorough history and exam, the family doctor can identify conditions that may need special attention before and during the season.
  • Get to know the athletic trainer, if available. From emergency care during sporting events to rehabilitation after injury, these health care professionals are knowledgeable about sport-related injuries.
  • Ensure your team/organization has an emergency action plan. These include protocols for lightning safety, preventing heat related illness and communication plans for all emergency situations.
  • Ensure your child’s equipment fits correctly and is worn properly. Poorly fitting equipment misses the mark for protecting the child in the way it is designed. In some cases, this can even cause an injury.
  • Learn signs and symptoms of problems that put young athletes at risk. No one knows your child better than you do. Learn the signs and symptoms of a concussion, heat illness and overuse injuries. Taking the right steps when you recognize these can make all the difference for your athlete.
  • Check the condition of the field and access to emergency personnel. When arriving at practice or a competition, assess the conditions. Is the field in good condition? Is there an automatic external defibrillator (AED) present and accessible? Is there an ambulance or athletic trainer on-site, or will 911 be used for emergencies?

 
Tips for Coaches

  • Review safety guidelines provided by the league and other reputable national sports organizations. These are designed to keep all participants safe.
  • Know your athletes’ major medical conditions and injuries. Because each athlete is unique, it has become more important to recognize individual needs. For example: An athlete with exercise-induced asthma may require use of an inhaler. For someone with an overuse injury, ignoring activity restrictions can shorten his or her season rather than improve performance.
  • Plan rest and water breaks for all activities, these should be modified when the environment is hot. Learn the signs and symptoms of heat illness and heat exhaustion.
  • Review and practice critical decisions and emergency procedures. Establish a plan for making and communicating decisions about weather conditions from heat and humidity to lightning. Identify what resources are available for first aid at each event and how to respond in various emergencies. In many organizations, this is documented in a comprehensive Emergency Action Plan (EAP).

 
“Teamwork is as important in the game as it is in when it comes to emergencies,” says Miller. “When the game plan is clear, situations can be avoided or handled with the best possible outcomes. Take time to prepare for the upcoming season.”

Understanding Hip Impingement in Teens: How it Happens and How to Prevent It

Understanding Hip Impingement in Teens: How it Happens and How to Prevent It

by | Jun 17, 2024 | Sports Medicine

Also commonly referred to as hip impingement, femoroacetabular impingement is a painful condition that occurs in the hips of adolescents and young adults. Two bones fit together to make up this “ball and socket” joint including the head of the femur (ball), which is part of the thigh bone, and the acetabulum (socket), which is part of the pelvis.

Impingement, or pinching, causes pain when the bones in the hip joint pinch the labrum, the soft tissue on the perimeter/edges of the acetabulum.
There are three types of FAI:

  • Cam impingement occurs when the shape of the femoral head or ball is abnormal.
  • Pincer impingement occurs when the shape of the acetabulum or socket is abnormal.
  • Combined impingement occurs when both the ball and the socket are abnormal.

Pediatric orthopedic surgeon Henry B. Ellis, M.D., says, “Repetitive activities make changes in the joints. In the hip, either the soft tissues become damaged, the bone actually changes its shape or both of these occur.” The reason for abnormal bone shape is not known. It may occur during development or may be in response to activity.

Symptoms of hip impingement are more likely to occur in those who perform:

  • Repetitive maximal flexion (bending) of the hip, such as deep squatting or high kicking.
  • Repetitive movements in activities, such as running, dance, gymnastics and hockey.

What are the symptoms of femoroacetabular impingement?

  • Pain in the hip or groin, typically in the front.
  • Tenderness and/or swelling of the hip or groin area.
  • Stiffness or pain after sitting for long periods of time.
  • Aching or pain that worsens with certain activities.

How is it diagnosed?
A thorough history and physical examination are used to diagnose a hip impingement. In most cases, X-rays are used to further assess the shape and fit of the bones. If symptoms do not improve or worsen, additional imaging such as an MRI or MR arthrogram may be recommended to further evaluate the soft tissue, the acetabular labrum. An MR arthrogram uses MRI, fluoroscopy and sometimes an injected medication to show the structures inside the joint.
 
How is it treated?
Treatment depends upon the severity of the condition and typically begins with a nonoperative approach which typically includes resting from activities that cause pain or changing to activities that do not. Other treatment options include physical therapy, joint injections or arthroscopic surgery may be required.
 
In a recently published article “Risk Factors for Suboptimal Outcome of FAI Surgery in the Adolescent Patient”*, Ellis and others reported findings after reviewing 126 hips (114 patients) under the age of 18 who were being treated for symptomatic FAI. This work helps Ellis and his colleagues around the country provide better counseling to patients considering surgery for FAI.
 
Early recognition and treatment are important because hip impingement has been shown to be a risk factor for early development of osteoarthritis of the hip.
 
How can hip impingement be prevented?
Overuse injuries like hip impingement and FAI occur with a high volume of training, repetition of certain movements and early specialization in a sport.
 
“Hip impingement in a growing child is bad news. We need to help them monitor and modify their volume of repetitive activities to prevent the condition from worsening, or even better, developing.”

  • Henry B. Ellis

These suggestions can help to prevent FAI and other similar overuse conditions:

  • Avoid sports specialization and play multiple sports throughout high school.
  • Emphasize moderation with load and training.
  • Encourage free play and lifetime sports like cycling and hiking.
  • Avoid year-round participation and encourage weekly and seasonal rest from activities requiring repetitive maximal flexion of the hip.
  • Perform proper warm-up and conditioning for all activities.                                                           

Learn more from Ellis about Hip Injuries in Young Athletes.
 
*Yen, Y. M., Kim, Y. J., Ellis, H. B., Sink, E. L., Millis, M. B., Zaltz, I., Sankar, W. N., Clohisy, J. C., Nepple, J. J., & ANCHOR Group (2024). Risk Factors for Suboptimal Outcome of FAI Surgery in the Adolescent Patient. Journal of pediatric orthopedics, 44(3), 141–146.