Although she was born in North Carolina, 16-year-old Shapre has practically grown up with Children’s Hospital of Richmond. In the last 13 years she has received services as an inpatient, through two of the hospital’s physician clinics (which she still visits) and at a community Therapy Center, where she gets weekly therapy.
Born 12 weeks prematurely, Shapre was eventually diagnosed with cerebral palsy, a chronic condition affecting body movement and muscle coordination caused by damage to the brain during fetal development or early in life. When she was three, Shapre came to Richmond for a rhizotomy, a surgical procedure where certain spinal nerve roots are cut to relieve muscle tightness and pain, and began receiving physical and speech therapy during her four weeks as an inpatient at Children’s Hospital of Richmond. Even after being discharged, Shapre and her mom, Michelle, commuted from their home in Chatham, Va. for physician appointments, finally moving to Richmond nine years ago.
Today, Shapre, who has also undergone eye and three orthopedic surgeries, attends the hospital’s Physical Medicine & Rehabilitation and Cerebral Palsy clinics and receives weekly physical therapy at the West Therapy Center in Glen Allen.
Physician Specialty Services
Children’s Hospital of Richmond offers five physician clinics—Cerebral Palsy (CP), Muscular Dystrophy, Physical Medicine & Rehabilitation (PM&R), Spasticity and Spina Bifida—where physician specialists, nurse practitioners and physical therapists work with other clinical and therapy staff to provide coordinated, interdisciplinary care in an outpatient setting. Patients are able to receive evaluations, therapy sessions and other related services such as equipment fittings and educational consultations at the same location on the same day.
Shapre attends the CP and PM&R clinics led by Eugenio Monasterio, MD, FAAPMR, at the Brook Road Hospital. Every six months during her PM&R appointments, she receives botox injections to help control muscle spasticity, relax her muscles and allow better movement.
Dr. Monasterio, who has known Shapre for eight years, consults with the teenager, her mom and the rest of her team, to determine how medical treatments can help meet personal goals. When Shapre was trying to improve her ability to raise her arms and get dressed with less assistance, Dr. Monasterio prescribed botox injections in her back and arms to provide the range of motion she needed. His medical treatment combined with regular physical therapy sessions—and a lot of hard work—helped Shapre reach this goal.
PM&R clinics are held at the Brook Road Hospital three days a week and in March were added at the Fredericksburg Therapy Center twice a month. Although Lucille O’Neil, PT, Shapre’s physical therapist, does not attend the PM&R clinics, she does participate in the CP clinics held at the main hospital twice a month. Because Lucille is on-site during the CP clinic, she and Dr. Monasterio can discuss goals, issues and treatment options with Shapre and her mom. Yet even when Lucille is not in clinic, she and Dr. Monasterio share thoughts and concerns via email, by phone and during face-to-face meetings to determine the best outcome for Shapre and all patients.
“Treatment is goal-oriented,” commented Dr. Monasterio. “It works best when it’s not just my goal but also the patient’s, family’s and therapist’s.”
“Dr. Monasterio wants to know the physical issues impacting progress toward goals,” said Lucille. “He also works integrally with therapists, consulting on bracing and equipment issues including arm and leg splints, wheelchairs and walkers.”
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