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Month: June 2022

Meet Krestalenn, and Her Journey with Traumatic Brain Injury

By‎: TELETONUSA /

When Krestalenn was just an infant, she survived a head-on collision that left her paralyzed on her right side and blind in one eye. Questions were swirling around Krestalenn’s condition and recovery for many years – Would she learn how to walk on her own? Would she be able to speak? Will she be able to play with other kids her age?

Because Krestalenn suffered a traumatic brain injury (TBI) at such a young age, her family was forced to wait and see how her injuries would affect her development.

Krestalenn’s grandparents became her legal guardians when she was ten months old. Knowing that Krestalenn would need physical therapy to guide her development, her grandparents sought the help of Children’s Rehabilitation Institute TeletonUSA (CRIT).

Today, Krestalenn is walking independently, expanding her vocabulary, and learning how to swim.

Speech and Physical Therapy with CRIT

Krestalenn visits CRIT twice a week for her speech and physical therapy appointments. At this point in her life, CRIT is a part of the routine her grandparents created for her. Krestalenn’s grandfather says that his granddaughter operates on a tight schedule comprising school and CRIT therapies and appointments. 

With regular physical and speech therapy appointments at CRIT, Krestalenn is learning how to walk, use her hands, and verbally communicate with others.

“Krestalenn is really a fighter,” her grandmother says. “She’s a miracle.”

When Krestalenn first came to CRIT, she hadn’t been speaking for over a year. Her physical development was behind others her age.

 “Before CRIT, after the accident, she was quiet for about a year and a half,” her grandfather says. Things look – and sound – different today, however. “She’s talking better. She’s talking in sentences.”

One of Krestalenn’s favorite phrases is “how much?” because every time someone says “I love you” to her, she asks, “how much?” People typically answer her with “this much,” extending their arms as wide as possible. Her vocabulary has expanded considerably, but “how much?” is the phrase that sticks with her.

“[CRIT has] everything in one building,” her grandmother says. “The outcome is unbelievable. She takes off when we put her in the walker. We have to run after her!”

What is a Traumatic Brain Injury?

According to the National Institute of Neurological Disorders and Stroke, a traumatic brain injury (TBI) is “a form of acquired brain injury [that] occurs when a sudden trauma causes damage to the brain.” In Krestalenn’s case, her TBI occurred due to a head-on collision.

Symptoms of a TBI vary, depending on the severity. A mild TBI can result in headaches and confusion, while a severe TBI can result in slurred speech, numb extremities, and loss of coordination.

Typically, there isn’t much to be done for a mild TBI as far as treatment goes. Severe TBIs are often treated with physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/psychiatry, and social support.

Find Care at the Children’s Rehabilitation Institute TeletonUSA

The Children’s Rehabilitation Institute TeletonUSA (CRIT) is a 501(c)(3) non-profit organization offering comprehensive rehabilitation services for children with neurological, muscular, and skeletal disabilities. Contact us today to learn how we can help your child live a healthy and happy life after a brain injury.

Traumatic, Anoxic, and Hypoxic Brain Injuries Explained

By‎: TELETONUSA /

Understanding the different types of brain injuries can help you seek the necessary treatment.

Traumatic Brain Injury

According to the National Institute of Neurological Disorders and Stroke, a Traumatic Brain Injury (TBI) is “a form of acquired brain injury [that] occurs when a sudden trauma causes damage to the brain.” A TBI may be the result of the head violently colliding with an object or when an object penetrates the skull and damages brain tissue. Symptoms of a TBI vary, depending on the severity. A mild TBI can result in headaches and confusion, while a severe TBI can result in slurred speech, numb extremities, and loss of coordination. Typically, there isn’t much to be done for a mild TBI, as far as treatment goes. Severe TBIs are often treated with physical therapy, occupational therapy, speech/language therapy, physiatry (physical medicine), psychology/psychiatry, and social support. The exact treatment plan will depend on a patient’s symptoms.

Hypoxic Brain Injury

A hypoxic brain injury occurs when the brain’s oxygen supply is severely diminished, but not completely cut off. This type of injury can be caused by “interruption of blood flow to the brain, such as cardiac arrest or strangulation, or from systemic derangements that affect the oxygen content of the blood,” according to this study. The same study states that “cellular injury can begin within minutes, and permanent brain injury will follow if prompt intervention does not occur.” Treatment for a hypoxic brain injury involves returning oxygen to the brain. Depending on the duration of hypoxia, psychological, neurological, and physical abnormalities may occur and persist even after treatment. 

Anoxic Brain Injury

Anoxic brain injury occurs when the brain’s oxygen supply is completely cut off. It takes about 15 seconds without oxygen to lose consciousness and 4-minutes without oxygen for brain damage to occur. Clinical research indicates that individuals who sustain an anoxic brain injury exhibit “impaired memory, attention, and executive function, as well as slowed mental processing speed.” Treatment for hypoxic and anoxic brain injuries is the same.

Find Care at the Children’s Rehabilitation Institute TeletonUSA

The Children’s Rehabilitation Institute TeletonUSA (CRIT) is a 501(c)(3) non-profit organization offering comprehensive rehabilitation services for children with neurological, muscular, and skeletal disabilities. Contact us today to learn how we can help your child live a healthy and happy life after a brain injury.

The Re-Eval By CRIT: Season 2

By‎: TELETONUSA /

Disclaimer: The information presented on this podcast is not intended to be used as medical advice. Please continue to follow the recommendations of your physician and/or other healthcare providers. Please refer to your physician prior to initiating any modifications to your current healthcare regimens. 

Please contact us with any questions or concerns at podcast@critusa.org.

Episode 15: Counseling Awareness Month

In April, we celebrated Counseling Awareness month by interviewing our licensed professional counselor, Leticia Cavazos. She tells us about her journey to becoming a counselor, how she navigates the most recent COVID-19 pandemic, and how to prioritize your mental health.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 16: Tiny Superhero

In this episode, Laura interviews Ally, the grandmother of CRIT patient, Krestalenn, to discuss the car accident that led her granddaughter to CRIT. She explains how Krestalenn pushes herself through therapies and achieves success with her charismatic personality. Ally brings awareness to the effects of drunk driving and how to persevere despite adversity.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 17: A Day in the Life of Cecy

In this episode, Cecy discusses and gives insight into what living with a disability looks like for a teenager with dystonia. She explains her diagnosis, how her therapies have helped her, and how she stays positive and wants to impact everyone she meets. She offers tips on how to be an advocate and how to treat others with disabilities.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 18: From One Student To Another

In this episode, recreation therapy student Haley interviews two physical therapy students, Maddy and Brenda, as they finish their clinical rotations and internship work at CRIT. All three discuss their perspectives through graduate programs, expectations, and clinical experiences through their journey to graduation. They offer advice and an outlook on any student considering going into physical therapy or recreation therapy.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 19: Supporting Learning at CRIT

In this episode, recreation therapy student Haley continues to share her perspective of being a student in a clinical setting. Haley interviews internship supervisors Samantha, a physical therapist, and Natalie, a recreation therapist. They discuss how supervisors provide tools for students to succeed and work towards becoming a professional in their fields. Samantha and Natalie offer advice on what students should look for in their rotations and internships.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 20: Meet Diego: A CRIT Graduate Who Proves Anything Is Possible

In this episode, we interview CRIT graduate Diego Rodriguez about life after high school and transitioning into adult life. Diego discusses navigating through the life of a college student with a disability, campus accommodations, class schedule, and goals for the future. He encourages us to chase our dreams and embrace our uniqueness rather than focus on things that hold us back.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 21: The Ronald McDonald House: A Home Away From Home 

In this episode, Natalie and Laura interview Travis Pearson, Chief Executive Officer of the Ronald McDonald House in San Antonio, Texas. We learn about its history, what they do, how they operate, and who they serve. Travis shares his career journey to becoming CEO of the Ronald McDonald House and how they help provide CRIT families with a home away from home during treatment or rehabilitation.

Listen on Spotify here.

Listen on Apple Podcasts here.

The Re-Eval By CRIT: Season 1

By‎: TELETONUSA /

Disclaimer: The information presented on this podcast is not intended to be used as medical advice. Please continue to follow the recommendations of your physician and/or other healthcare providers. Please refer to your physician prior to initiating any modifications to your current healthcare regimens. 

Please contact us with any questions or concerns at podcast@critusa.org.

Episode 0: Welcome to The Re-Eval

Children’s Rehabilitation Institute TeletonUSA (CRIT) therapists bring you into the clinic, introducing you to what makes CRIT what it is.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 1: The Year of the Pandemic from Different Perspectives

Interviews include Doctor of Physical Therapy and tenured therapist Jose Ponce, about how COVID-19 changed therapy; Juan and Desiree, parents of Ryian, discussing pros and cons of Telemedicine with a toddler with Arthrogryposis Multiplex Congenita. Sammi and her mom Priscilla discussing the benefits of Telemedicine for their family while navigating Sammi’s diagnosis of Osteogenesis Imperfecta.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 2: Two Different Diagnosis with One Larger Mission

In October, we honored Rett’s Syndrome awareness by interviewing Olivia and Cruz, parents of Graciela. They share their experience with their child and what resources they have used to guide them through their journey as a family with special needs. Also, how you can get involved as a parent to make a difference in the disability community in the long run. Followed by Kimberley, Damian’s mom, discussing their journey at CRIT and navigating life with a 10-year-old with Spastic Quadriplegic Cerebral Palsy and how the community still has room to grow.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 3: Empowering Your Kids with Social Inclusion and Community Integration

Interviews include Certified Therapeutic Recreation Specialist, Natalie Klinsky discussing her role as a Recreational Therapist, and who may benefit from these services; 6-year-old Brooke and her mother, Natasha talking about how Recreational Therapy has helped them as a family.

After this, Berenice Escobedo, one of our Social Workers will explain how she provides community resources to our families to help navigate through their unique challenges that may arise as our patients transition into adulthood. Followed by Denny, one of our very own CRIT graduates, discussing the new stage in his life how he stays busy with community involvement.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 4: Occupational Therapy and Adaptive Switch Toys

In the month of April, we celebrated Occupational Therapists by introducing you to two of our very own. Rudy Cardenas and Natalie chat about what Occupational Therapy is, and the benefits of adaptive switch toys. Followed by Lucia, introducing us to her adventurous teenage daughter, also named Lucia, discussing the impact that an adaptive switch toy has made on her daily life with Spastic Quadriplegic Cerebral Palsy. While Rebecca Barry, better known as Becky, reviews the selection process of appropriate toys needed for this adaptive switch, factoring in patient’s likes, as well as how it has impacted patient progress.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 5: What is Prader Willi Syndrome?

We chat with a unique family from our clinic on this episode to bring awareness to Prader Willi Syndrome. We are joined by Gabriella and her son Pedrito, discussing what they have done to help Pedro make smart choices independently and the challenges that came with doing that. This followed by our Registered Dietician, Eva Nestor, explaining her role in educating families on how to create and follow a dietary plan and empower themselves when they are making these decisions on their own. For more information about the Prader Willi Syndrome, please visit www.pwsausa.org/resources/wseat.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 6: Let’s Talk About Speech Therapy

In May, we celebrated Better Speech and Hearing Month by interviewing one of our very own Speech-Language Pathologists, Lorena Aceves. Natalie will chat with her about what a Speech Therapist does, how her path led to Speech Therapy, and the schooling needed. She will also review what “The Big Nine” is and how she helps patients utilize different communication tools, including communication boards, and AAC devices, everything from low-technology to high-technology.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 7: What is Hippotherapy?

Today on the show, Natalie and Laura will discuss Hippotherapy, its benefits, and which diagnoses have benefitted from it. Laura will then chat with someone who has had first hand-experience with Hippotherapy, 12-year-old Hayden, on his perspective of his progress since starting back in 2017.

Reference: 1. Silkwood-Sherer DJ, Killian CB, Long TM, Martin KS. Hippotherapy – an intervention to habilitate balance deficits in children with movement disorders: a clinical trial. Phys Ther. 2012:92:707-717.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 8: The Imperfect Gift

In June, we celebrated Father’s day by interviewing super dad Rufus. He will guide us through what he and his wife went through when adopting Adira, making communication and openness a key component in their family relationship. He gives us insight on navigating life with a new daughter who also happens to have a disability. Lastly, he introduces us to his project, a podcast titled “The Imperfect Gift,” where he highlights the ups and downs of parenthood.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 9: What is Spinal Muscular Atrophy?

In August, we celebrate Spinal Muscular Atrophy Awareness Month. We interview the mother of Gabriel, Jenna, who shares their journey through Gabriel’s diagnosis of SMA. She takes us through finding a specialist to diagnose her son, clinical trials, and finding the treatment options for Gabriel and their family. She also mentions how education and advocating through community groups and other families with children with SMA help spread awareness.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 10: How Can a Genetic Counselor Help You?

As we continue to bring awareness to SMA and celebrate Spinal Muscular Atrophy Awareness Month, we interview Rebecca, one of our genetic counselors. Rebecca explains how genetic counselors help people and their families know how genes in family members carry diagnoses. She also describes how she helps families make the most informed decisions when navigating through their diagnoses. She also advocates how working ahead and knowing your gene history can help you and your family in the future.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 11:  “We’re Kids First.”  

In September, we celebrated Spinal Cord Injury Awareness Month. Natalie and Laura interviewed Zivanna and Moises, patients from CRIT, who shared their journey with this condition. They talked about their future goals, and  how they want to change how people on a wheelchair are viewed.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 12: Knowledge is Power  

In this episode, Brooke Matula, Director of Recreational Therapy at Morgan’s Wonderland, joins us. She dives into the mission of one of the most inclusive theme parks, Morgan’s Wonderland. She also discusses what Universal Design is and how we can inspire the San Antonio community to be inclusive.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 13: The Art of Giving Back  

So many organizations rely on volunteers. In this episode, we discuss why our volunteers help make CRIT so special. We interview Alma Gonzalez, Heroes for CRIT Ambassador, and we discuss how her contributions spread awareness for our patients and families. Alma then explains the importance of giving back to the community without expecting anything in return.

Listen on Spotify here.

Listen on Apple Podcasts here.

Episode 14: The Magic Behind the TeletonUSA Event

In this episode, we discuss the TeletonUSA Event and how it supports CRIT’s mission, values, and day-to-day operation. Laura and Natalie interviewed Cristina Prieto, TeletonUSA Foundation’s Corporate Sponsorship Officer, to learn about all of the preparation, hard work, and magic that goes into putting on this nationally broadcast telethon event. She discusses how the passion of everyone involved makes TeletonUSA a success year after year and what this year’s event will look like on December 11. 

Listen on Spotify here.

Listen on Apple Podcasts here.

From Your CRIT Counselor: Start Where You Are

By‎: TELETONUSA /

“You can’t go back and change the beginning, but you can start where you are and change the ending.” – C.S. Lewis

Is there something in your past that you regret? It could be something you said or did or did not say or do. The reality is that we cannot go back in time and change things. However, we do have the ability to make choices today that influence our future. Every day gives us a new opportunity to start again and make different and better choices. Through these choices, we can create opportunities to increase the possibility of a better future.

If you do not know where you are going, how do you know when you will get there? Part of the process is identifying and determining where we want to go. We need a starting point and a final destination. We may not like what is currently happening, but we must assess where we are to plan to get where we want to be.

After the paper maps and before the GPS, I recall looking on the internet for the place I wanted to go, printing out the map, and highlighting the road I was to follow. With the GPS, we provide it an address, and it will direct us on the best way to go. If we make a wrong turn, it will redirect us or provide alternate routes.

Counseling is something like that. You tell me where you want to go or be. Together we assess where you are and get to your desired destination. It is a collaborative effort in which you make the final decisions.

Perseverance, Community, and Good Snacks: Raphael’s Story

By‎: TELETONUSA /

Sitting in the doctor’s office at 31 weeks pregnant, Raphael’s mom, Katie, began to worry. Her son had stopped being the playful, active baby in her womb that she had grown to know. Instead of sleepless nights filled with kicks and days filled with baby flutters, Katie’s belly felt still. Instead of being able to reassure Katie, her doctors insisted that labor induction at 32 weeks was the best option. “It will be easier to diagnose and treat him outside of your belly than from the inside,” they said.

Feeling as if her last few weeks to prepare for her new baby had been ripped out from under her, Katie tried to keep her positive mindset, constantly reminding herself that in a few days, her baby boy would be in her arms. It was not long after he entered the world that Raphael was diagnosed with cerebral palsy, a motor disorder caused by an injury in the brain or the spinal region. The news was devastating; it was difficult for Katie and her partner to know the severity of Raphael’s diagnosis at such a young age, so they thought the worst.

As it turns out, Raphael’s situation is better than it could have been. His paralysis is partial instead of total. With love from his family and resources from CRIT, he has been able to navigate his diagnosis and live a happy life, even if it comes with significant obstacles. The doctors warned Katie that Raphael’s health would become a focal point in their lives; he would have many doctor’s appointments, therapies, and treatments to help him learn how to live with cerebral palsy.

After Raphael’s 3rd birthday, Katie found out about CRIT through some close friends in Houston. She loved the personalized treatment approach that CRIT offered. If she had learned one thing in the first three years of her little boy’s life, it was that every diagnosis is different, and kids deserved personalized care.

At CRIT, Physical Medicine and Rehabilitation Physicians monitor each child’s plans of care to ensure they are always in their best interest. CRIT provides its patients with physical, speech, and occupational therapies, social work, nutrition, and other services with a holistic approach. Wellness is holistic, and CRIT treats it as such. With the help of Raphael’s physician, Katie applied to CRIT, gaining acceptance shortly after.

Katie was unsure exactly what to expect, but she knew that providing her son with resources and trained professionals working together was probably the best approach. When she first walked in, clutching Raphael’s hand, Katie was relieved by the friendly faces that greeted her. She remembers the kind words the receptionists had that time and every time since, making her and Raphael feel more like family than patients.

Raphael’s rehabilitation journey has improved his life over the years, helping him navigate while strengthening his muscles and language abilities. Katie cannot imagine Raphael’s life without CRIT; raising a child always takes a village, and the staff at CRIT are a big part of Raphael’s village.

Aside from the therapies he has received, Raphael has benefited from the sense of community at CRIT. His therapists, past and present, have all left lasting impacts on his life. The community programs offered at the facility help Raphael connect with other kids his age, encouraging play and socialization, which is critical for developing brains.

Though his life has been filled with therapies, treatments, and doctor’s offices, it has also been filled with laughter, memories, and amazing people. Raphael is notorious for showing up to therapy with a snack in hand and a smile on his face. CRIT has become much more than a treatment facility; for Katie and Raphael, CRIT is a second home.

Looking back, Katie is so thankful that those doctors decided to induce labor early. As scared as she was, this enabled her to get a diagnosis for her son and start treatments as early as possible. Though some days are harder for Raphael than others, he has been committed his whole life to give each day his all, even when he was just a tiny newborn.

Katie encourages other parents with children with disabilities to seek treatment and advocate for their kids, but more importantly, keep a positive mindset. Focusing on the diagnosis takes away from allowing each child to flourish as they are. CRIT has helped empower Raphael and hundreds of other kids just like him. With their help and services, these kids are given a better chance at finding a community in this world and leading lives that make them happy, which is all any parent wants for their child.

Scoliosis: Spine Curvature Care

By‎: TELETONUSA /

Scoliosis is an abnormal lateral or sideways curve of the spine. According to the American Association of Neurological Surgeons, scoliosis affects 2-3 percent of the population and typically develops early in childhood. Scoliosis, diagnosed as mild to severe, can be disabling and affect organs, such as the lungs, causing them not to function properly. 

Scoliosis can be congenital, occurring during a child’s formation as an embryo, or neuromuscular, resulting from a neurological or musculature disease. Neuromuscular scoliosis is typically associated with cerebral palsy, muscular dystrophy, or spina bifida and progresses more quickly than the milder forms of scoliosis.  

Symptoms of scoliosis vary and are visible in different forms, such as:

  • Uneven shoulders or waist 
  • Hip higher on one side 
  • A hump on one side of the back when bending over to touch the toes 
  • Body leaning to one side 

Treatment can range in various ways, from observation to bracing and surgery. These treatments also vary depending on the severity of scoliosis.

Observation

Continued observation or monitoring is required as a child grows because there is potential for the lateral curve to worsen. In mild cases of scoliosis, like when the spine has a slight curve and the child is still growing, observation is a typical treatment. 

Bracing

Back bracing is an option for children, typically between 11 and 15, who have not yet reached skeletal maturity. If worn 16 to 23 hours a day, bracing can serve as a safe treatment option and help decrease the rate of the lateral curve progress. This treatment can provide optimal results while reducing the overall spinal deformity.

Surgery

Surgery, typically performed when the spinal curve is greater than 40 degrees, is an option for severe cases of scoliosis. Because severe scoliosis happens over time, the surgery will help straighten the spine’s curve and prevent the curve from worsening. The surgery can result in a more improved quality of life for the individual and provide a pain-free life. 

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