Emma McKenzie, PT, DPT, is a physical therapist in Children’s Hospital of Philadelphia’s Seating and Adaptive Equipment Clinic, and she is in constant motion. That’s because her job focuses on helping children with mobility issues more easily move from place to place so they can participate more fully in their own lives. She assesses each child’s changing needs and, working together with their family, carefully selects the proper type and size of equipment to help them strengthen their capabilities or be more comfortable. This is a day in her life.
7 a.m. Gets up and dresses for work. Helps her two sons, ages 4 and 6, get ready for preschool and kindergarten and packs their snacks. Her husband, Chris, who is also a physical therapist, takes them to school as she drives to CHOP’s Philadelphia Campus.
7:45 a.m. Deals with I-76 traffic on her commute.
8:15 a.m. Arrives at the Seating Clinic in the Buerger Center for Advanced Pediatric Care. Reviews the day’s schedule and each patient’s background. Consults with clinic coordinator Deborah Humpl, OTR/L, to gain additional insights into the children she’ll be seeing that day.
9:10 a.m. Eleven-year-old Parker, who has multiple disabilities, uses a wheelchair and a ventilator, and is tube-fed, arrives. While his legs can’t support him, he benefits from using a “stander,” a piece of equipment that securely holds him in a standing position. “Standing for an hour or more a day improves bone density and strengthens muscles,” McKenzie explains. “Gravity is his gym.” Parker has outgrown his current stander. His mother, Jennifer, maneuvers him into the existing one. “He’s grown a lot in the five years since we got it,” Jennifer says. McKenzie measures him for a new version.
“We’ll make some temporary adjustments so it will be more comfortable for him until the new one comes in,” McKenzie says. It can take three to six months from the order date for equipment to arrive. McKenzie will write the “letter of medical necessity.” The order goes to one of CHOP’s equipment vendors, National Seating and Mobility (NSM), that interacts with the family’s health insurance company, which must approve the purchase. Jennifer said it took six rounds of back-and-forth with their insurer to get a new, bigger wheelchair approved for Parker.
NSM’s on-site representative, Tim Flanagan, and McKenzie discuss which stander best matches Parker’s needs while also making it easier for his parents to get him in and out of it. They decide on a three-position electric version that goes from sitting to standing to lying flat.
Parker also needs a new shower chair to accommodate his growth. “One more thing,” Jennifer begins. “Would it be possible to get a positioning chair? It would let us enjoy family time and make it so he doesn’t have to be in his wheelchair 24/7.” McKenzie suggests a P-Pod®, which resembles a bean bag chair but has multiple safety features and supports. “Once everything arrives, Parker is going to be so fancy,” Jennifer says. “Thank you for everything.”
10:45 a.m. Uses a break in the schedule to swing by the Main Building to assist Mah’ki, a 7-year-old who needs adaptive equipment before he can be discharged after months of hospitalization. Because of his severe autism, Mah’ki rocks and kicks forcefully. He needs a medical stroller and activity chair to be safe and still participate in activities. McKenzie makes recommendations, based on Mah’ki’s strength and size. She also checks the status of a previously ordered safety bed — which has a secure top to keep Mah’ki from getting out on his own. “I’m so excited to take him to the beach for the first time,” says his caregiver, Ama. The new equipment “will help give Mah’ki the life he should have.”
Noon Back to the Buerger Center for a quick lunch and to catch up on paperwork.
1:15 p.m. Jaxson, 9, arrives full of energy. In addition to trisomy 21, which manifests as low muscle tone and hip dysplasia, Jaxson also has global delays from a hypoxic brain injury at birth. His mother, Jill, wants to see if a new “gait trainer,” a specialized supportive walker, would advance his ability to walk. “My goal is to have him be more independent,” Jill says.
To allow Jaxson to try out a specific type, McKenzie borrows one from CHOP physical therapy that matches what he’s been using during his school-based PT. She clears a path in the hallway and positions Jaxson in the trainer. His progress is sporadic, but this version offers more support, giving him a better opportunity to gain strength. “Thank heavens for the Seating Clinic,” Jill says after the order is placed. “I don’t know what we’d do without it.”
2:20 p.m. Today is a big day for Kyle, 10, a whiz at video games and all things Pokémon, an interest he shares with McKenzie. His Emery-Dreifuss muscular dystrophy, a rare form of the progressive muscle-weakening disease, has advanced to the point where he can no longer propel himself in his manual wheelchair. He gets to meet his electric wheelchair for the first time and learn how to drive it. Flanagan brings it out and adjusts the footrests and headrest to fit. He explains the controls to Kyle, then they move out to the hallway for a test drive.
Kyle is grinning ear to ear as he gets the hang of making turns, speeding up, slowing down and changing direction. “With great power comes great responsibility,” McKenzie says, intoning the phrase popularized by Spiderman. Kyle shoots back, “I’ll take the power.”
4 p.m. Heads home, picking up her sons on the way.
5 p.m. Outside play time, then dinner and reading one of the Dog Man books before putting the boys to bed, since this is her husband’s late night for his PT practice.
8 p.m. Catches up with Chris and watches a little TV before heading to bed herself.
Emma McKenzie, PT, DPT, is a physical therapist in Children’s Hospital of Philadelphia’s Seating and Adaptive Equipment Clinic, and she is in constant motion. That’s because her job focuses on helping children with mobility issues more easily move from place to place so they can participate more fully in their own lives. She assesses each child’s changing needs and, working together with their family, carefully selects the proper type and size of equipment to help them strengthen their capabilities or be more comfortable. This is a day in her life.
7 a.m. Gets up and dresses for work. Helps her two sons, ages 4 and 6, get ready for preschool and kindergarten and packs their snacks. Her husband, Chris, who is also a physical therapist, takes them to school as she drives to CHOP’s Philadelphia Campus.
7:45 a.m. Deals with I-76 traffic on her commute.
8:15 a.m. Arrives at the Seating Clinic in the Buerger Center for Advanced Pediatric Care. Reviews the day’s schedule and each patient’s background. Consults with clinic coordinator Deborah Humpl, OTR/L, to gain additional insights into the children she’ll be seeing that day.
9:10 a.m. Eleven-year-old Parker, who has multiple disabilities, uses a wheelchair and a ventilator, and is tube-fed, arrives. While his legs can’t support him, he benefits from using a “stander,” a piece of equipment that securely holds him in a standing position. “Standing for an hour or more a day improves bone density and strengthens muscles,” McKenzie explains. “Gravity is his gym.” Parker has outgrown his current stander. His mother, Jennifer, maneuvers him into the existing one. “He’s grown a lot in the five years since we got it,” Jennifer says. McKenzie measures him for a new version.
“We’ll make some temporary adjustments so it will be more comfortable for him until the new one comes in,” McKenzie says. It can take three to six months from the order date for equipment to arrive. McKenzie will write the “letter of medical necessity.” The order goes to one of CHOP’s equipment vendors, National Seating and Mobility (NSM), that interacts with the family’s health insurance company, which must approve the purchase. Jennifer said it took six rounds of back-and-forth with their insurer to get a new, bigger wheelchair approved for Parker.
NSM’s on-site representative, Tim Flanagan, and McKenzie discuss which stander best matches Parker’s needs while also making it easier for his parents to get him in and out of it. They decide on a three-position electric version that goes from sitting to standing to lying flat.
Parker also needs a new shower chair to accommodate his growth. “One more thing,” Jennifer begins. “Would it be possible to get a positioning chair? It would let us enjoy family time and make it so he doesn’t have to be in his wheelchair 24/7.” McKenzie suggests a P-Pod®, which resembles a bean bag chair but has multiple safety features and supports. “Once everything arrives, Parker is going to be so fancy,” Jennifer says. “Thank you for everything.”
10:45 a.m. Uses a break in the schedule to swing by the Main Building to assist Mah’ki, a 7-year-old who needs adaptive equipment before he can be discharged after months of hospitalization. Because of his severe autism, Mah’ki rocks and kicks forcefully. He needs a medical stroller and activity chair to be safe and still participate in activities. McKenzie makes recommendations, based on Mah’ki’s strength and size. She also checks the status of a previously ordered safety bed — which has a secure top to keep Mah’ki from getting out on his own. “I’m so excited to take him to the beach for the first time,” says his caregiver, Ama. The new equipment “will help give Mah’ki the life he should have.”
Noon Back to the Buerger Center for a quick lunch and to catch up on paperwork.
1:15 p.m. Jaxson, 9, arrives full of energy. In addition to trisomy 21, which manifests as low muscle tone and hip dysplasia, Jaxson also has global delays from a hypoxic brain injury at birth. His mother, Jill, wants to see if a new “gait trainer,” a specialized supportive walker, would advance his ability to walk. “My goal is to have him be more independent,” Jill says.
To allow Jaxson to try out a specific type, McKenzie borrows one from CHOP physical therapy that matches what he’s been using during his school-based PT. She clears a path in the hallway and positions Jaxson in the trainer. His progress is sporadic, but this version offers more support, giving him a better opportunity to gain strength. “Thank heavens for the Seating Clinic,” Jill says after the order is placed. “I don’t know what we’d do without it.”
2:20 p.m. Today is a big day for Kyle, 10, a whiz at video games and all things Pokémon, an interest he shares with McKenzie. His Emery-Dreifuss muscular dystrophy, a rare form of the progressive muscle-weakening disease, has advanced to the point where he can no longer propel himself in his manual wheelchair. He gets to meet his electric wheelchair for the first time and learn how to drive it. Flanagan brings it out and adjusts the footrests and headrest to fit. He explains the controls to Kyle, then they move out to the hallway for a test drive.
Kyle is grinning ear to ear as he gets the hang of making turns, speeding up, slowing down and changing direction. “With great power comes great responsibility,” McKenzie says, intoning the phrase popularized by Spiderman. Kyle shoots back, “I’ll take the power.”
4 p.m. Heads home, picking up her sons on the way.
5 p.m. Outside play time, then dinner and reading one of the Dog Man books before putting the boys to bed, since this is her husband’s late night for his PT practice.
8 p.m. Catches up with Chris and watches a little TV before heading to bed herself.