MDNews - Long Island

"My goa l is to improve the qua lit y of life for my patients a nd t heir fa mi lies," she says. " Ma ny of t he patients I see live with conditions, such as cerebra l pa lsy, for which there is no cure. We use ev idence-ba sed procedures to restore a nd ma inta in f unction a nd mobi lit y. For exa mple, we ca n per for m mu lti-level chemodener vation injections under sedation using ultrasound or electrica l stimulation g uidance to decrease muscle tone." Functional outcome tests before and after each procedure, Dr. Tan adds, help establish if patients are moving toward their goals, while also laying a foundation of evidence for the care of future patients. Most important, these procedures and services are part of a coordinated approach to care, where all team members — physiatrist, pediatric hospitalists, nurses, speech and language pathologists, physical and occupational therapists, music and recreational therapists, prosthetic and orthotic specialists, dietitians and nutritionists, and social workers — are in com- munication about the best treatment plan for each child. Dr. Tan also offers another rare gift — time. Outpatient sessions are long enough to allow for answering all questions, and even performing multiple injections in an unhurried manner. If a child needs more than four injections, she adds, he or she may warrant sedation. This is another method used to avoid "white coat syndrome," a fear of physicians, in children who will likely have to see many physicians throughout their lives. FURTHERING A PATIENT-CENTERED MISSION Dr. Tan also does outreach through lunch-and-learn sessions with community pediatricians, for instance, or through visiting private practices. "The administration at St. Charles supports my outreach to other physicians to educate them about what pediatric physiatry does and when to send us their patients," she says. This outreach is necessary because pediatric physiatry is a rare specialty with fewer than 300 board-certified pediatric physiatrists nationwide. It's this sense of scarcity that motivates Dr. Tan to treat as many patients as possible and educate as many physicians as possible. She knows that the caliber of rehabilitation services at St. Charles can be difficult to find. "I can't stop because there are so few of us," Dr. Tan says. "It's our mission as a specialty. Plus, my team members and I must teach, research, spend time with our families and be happy in our own lives. This balance reflects in the patient care we deliver. We must be happy so we can provide happiness. We must be complete ourselves so we can provide complete and compassionate care to our patients." A PHILOSOPHY OF HAPPINESS Working with patients, many of whose conditions are lifelong, Dr. Tan not only shares treatments but also a can-do optimism that's infectious. She and the therapists she partners with prepare children to live as fully as possible. They establish child-centered — rather than treatment-centered — goa ls, reflecting the patients' desires and ambitions. "A clinical goal may be ankle dorsiflexion of 5 degrees, but we need to translate that to 'walking better' so the child can feel better and gain weight," she says. She describes a child with spasticity, who was also having trouble gaining weight. After the neurosurgeon performed a specialized procedure, selective dorsal rhizotomy, to decrease muscle tone, the child's mother reported that he was eating her breakfast as well as his own. "I told her, 'It's not magic. Now that he is in rehabilitation, his tone has improved, he's working muscles he's never used before, so he's hungry!'" Dr. Tan exclaims. "His mom was thrilled." MAKE A REFERRAL Children with a wide range of conditions, from short-term to lifelong and from simple to complex, can benefit greatly from pediatric rehabilitation, as can trauma survivors and patients who have undergone complex surgery. Area physicians are encouraged to reach out to Dr. Tan with any questions about a particular patient or about St. Charles Rehabilitation's range of services. Dr. Tan can see patients across a wide catchment area. In addition to caring for children undergoing acute intensive inpatient rehabilitation at St. Charles, she sees outpatients at St. Charles in Port Jefferson and Melville. To learn more, visit stcharlesrehab.org/pediatric-rehabilitation- program. n Care for a Range of Conditions PEDIATRIC PH YSIATRIST PATRICIA Tan, MD, FA APMR, and the rehabilitation team at St. Charles treat patients with conditions, including: + Brachial plexus injury + Cerebral palsy + Developmental delays and fine motor, gross motor and visual problems + Developmental coordination disorder + Excessive drooling + Feeding and swallowing difficulties + Gait abnormalities + Genetic and chromosomal disorders + Limb deficiencies + Muscular dystrophy + Musculoskeletal disorders + Muscle weakness + Plagiocephaly + Pediatric stroke + Scoliosis + Sensory integration disorders + Spasticity of cerebral and spinal origin + Speech and language disorder + Spinal cord injury + Tone abnormalities + Traumatic injury, including TBI + Torticollis M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 019 1 3

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