April 1, 2024

As a traveling physical therapist, Cassie Jones treated patients at organizations around the country. Once she stepped foot in Texas Children’s, it didn’t take long for her to fall in love with her co-workers, patients and the organization itself. As she put it, she couldn’t leave, and has now been with us for 11 years as a pediatric pain physical therapist, currently practicing at Clear Lake Specialty Care.

“I’ve worked at a lot of great facilities, but I really found a home at Texas Children’s,” said Cassie. “As a top pediatric hospital, we have kids come from everywhere with some of the rarest and most complex conditions. Some patients have the only documented case of their condition, so we all have to be at the top of our game to work together and develop the best treatment plans for them.”

Studies show up to one-third of children suffer from chronic pain, yet physical therapists treating chronic pain are very rare. The robust Pain Medicine program at Texas Children’s with dedicated physical therapists at many locations makes us a destination for these patients. The restorative model at Texas Children’s features a team comprised of a pain physical therapist, pain psychologist and physician prioritizing therapy over medication.

One of Cassie’s biggest success stories involves 16-year-old patient Joscey. She had ankle sprains, a tendon repair and multiple surgeries as a result from basketball injuries. She failed four courses of traditional PT focused on sports or traditional concepts. By the time she came to Cassie, she had quit in-person school and attended school online. She gave up the sport she loved and could no longer spend time with her twin sister at the movies or shopping. Her family is avid vacationers, hikers and she was not doing any of that with them. She lost herself and said her identity was gone.

Fast-forward to a year later and she is working to return to school in the fall. She plays basketball on a daily basis and is back to fun outings with her twin. She even went on a three-week vacation with her family hiking in Utah.

Recently, the department held a patient community day in partnership with the U.S. Pain Foundation, inviting current patients from around the system and their families, giving them a chance to get together and meet others going through the similar challenges. Joscey told her inspiring story and several attendees said she was the first person that gave them hope to overcome this.

Many kids dealing with chronic pain are completely isolated from the outside world and have little to no social interaction, which can add to their anxiety, fear and loneliness.

“Community day was more beneficial than we could have hoped for,” Cassie said. “Our patients met others going through the same thing and they instantly became friends. They exchanged phone numbers and Instagram handles. One Mom told me her daughter has social anxiety and hadn’t spoken to another kid in years as she watched her talk with a group of girls. It was amazing. We all cried a lot that day.”

Not all patients see instant success like Joscey, and some go through years of physical therapy. Cassie explained every patient is different, but their team works together to develop treatment plans for each individual. They will never give up finding ways to help these patients deal with their pain.

“Treatment for chronic pain can change someone’s life. It’s more than just getting them back to playing a sport, which is wonderful, but we’re privileged to have the opportunity to turn someone’s life around, and there’s nothing more rewarding.”

August 9, 2016

For most of Kaitlyn Ennis’ 12-year life she has been in physical pain due to pancreatitis, a disease doctors diagnosed her with when she was just 18 months old.

In the beginning the condition and the pain were acute, coming and going in spurts. The past year or so however, Kaitlyn has endured chronic pain on an almost daily basis, causing her to miss school and spend more time than she would have liked in the hospital.

“It makes me irritable,” Kaitlyn said of the pain she feels when her pancreas becomes inflamed. “I just want it to go away.”

In January 2015, Texas Children’s Hospital launched an interdisciplinary pain medicine clinic to treat patients like Kaitlyn, who suffer from chronic pain, a condition that affects 20 percent to 30 percent of children worldwide. The clinic is part of the Pain Medicine Division of the Department of Pediatric Anesthesiology and is one of the only clinics of its kind in the Greater Houston area.

“By the time patients arrive to the pain clinic, they often have seen multiple physicians and specialists and are often frustrated with feeling neglected by the health care system or are feeling a sense of diagnostic ambiguity, as there is often not a clear cut anatomical explanation for chronic pain,” said Grace Kao, a pediatric pain psychologist with the pain clinic and assistant professor at Baylor College of Medicine.

“Meeting families where they are and offering hope and support comprises a substantial part of our role as a pain clinic team.”

In a patient’s initial intake evaluation, members of the pain clinic team provide a thorough pain history assessment, psychosocial interviews and thorough physical exams by pain physicians and physical therapist. All of this information is used to help develop a comprehensive treatment plan which is shared with the family in a joint feedback session at the end of the appointment.

Knowing pain can affect so many parts of life, the pain clinic team typically provides recommendations in multiple arenas: medication management, medical procedures, lifestyle changes, physical and occupational therapy, school accommodation and pain psychology.

“The interdisciplinary clinic model provides the valuable benefit of combining multiple services within the same appointment and creates the opportunity for clinicians to inform each other’s recommendations on the spot,” Kao said. “Patients often return for follow up with multiple team providers to target different parts of their pain picture.”

When Kaitlyn and her family first came to the pain clinic, they were looking for a way to manage the girl’s chronic pain without admitting her into the hospital.

“We wanted to be able to manage her pain at home,” said Kaitlyn’s mother, Sara Ennis. “Admitting her into the hospital every month or so was not working.”

After examining Kaitlyn, the team at the pain clinic put her on a medication regime and armed her with tools in pain psychology, including guided imagery. Soon thereafter, Kaitlyn and her family were managing her episodes of acute pain in the comfort of their home instead of taking her to the hospital. Kaitlyn’s chronic pain was nearly gone.

“The treatment they provided was life changing,” Sara Ennis said. “I am so impressed with the team; nothing is trivial to them and as a result, they made life easier for a lot of us.”

Dr. Caro Monico, a member of the pain medicine clinic team and an assistant professor of pain management at Baylor College of Medicine, said the foundation of the clinic’s treatment is to reintegrate children into school, physical activity and normal life.

“Simply put,” she said, “we want our patients to feel normal and for many we can accomplish that goal.”

Since opening, the pain clinic has seen thousands of patients from around the United States. A director will be coming on board in September and the staff has grown to nine inpatient pain medicine physicians, four chronic pain physicians, two nurse practitioners, two physical therapists, one pain psychologist and one pain registered nurse.

For more information about the clinic, click here.