“I was in a coma for a week. My speech was gone, and my memory was gone,” explained Jason. “It took me a decade to fully recover cognitively.”

Nearly 25 years later, that same injury threatened to derail his life again when the scar tissue from his TBI developed into epilepsy.

Epilepsy triggered by TBI

Epilepsy is a neurological condition caused when abnormal brain cells that are hyperexcitable short-circuit the brain and spark unprovoked seizures. One in 5 people who suffer a TBI will later develop epilepsy.

“This is one of the most common causes of what we call acquired epilepsy,” explained Samden Lhatoo, MD, a UT Physicians epileptologist at UTHealth Houston Neurosciences — Texas Medical Center and co-director of the Texas Institute of Restorative Neurotechnologies at UTHealth Houston.

Following a TBI, the brain will begin a process of rewiring to heal, but that isn’t perfect, and during the healing process, epilepsy can slowly develop.

“It’s not unusual for epilepsy to present many years or even decades after the original injury,” said Lhatoo, a professor and the John P. and Kathrine G. McGovern Distinguished Chair in the Department of Neurology at McGovern Medical School with UTHealth Houston.

Texas Comprehensive Epilepsy Program at UTHealth Houston

By the spring of 2022, Jason was having up to six complex partial seizures a day.

“I was nonfunctional,” said Jason. “I was going through medication after medication, and nothing was working.”

He turned to the Texas Comprehensive Epilepsy Program (TCEP) at UTHealth Houston, where Lhatoo works alongside a multidisciplinary team of highly trained epileptologists, neurosurgeons, neuropsychologists, neuroradiologists, and others in one of the busiest epilepsy surgery programs in the country.

Focal onset seizure

Jason’s seizures were focal onset, which means the seizure originates from the same side of the brain each time. These are the most common types of seizures in people with epilepsy.

“His epilepsy was in a part of the brain called the hippocampus, which controls memory and learning,” said Lhatoo. “Once we determined the seizures were originating in the right hippocampus, we knew we had the option to laser it.”

Jason was a textbook candidate for laser interstitial thermal therapy (LITT) surgery.

Laser interstitial thermal therapy

In April 2022, Jason underwent LITT surgery performed by Nitin Tandon, MD, a UT Physicians neurosurgeon at UTHealth Houston Neurosciences — Texas Medical Center and chief of epilepsy surgery at TCEP.

LITT is laser brain surgery. The procedure occurs inside an MRI scanner to precisely monitor the laser’s work.

Tandon began the surgery by creating a small hole in the skull, where he inserted a very thin plastic probe carrying a laser fiber into the brain. The fiber emits infrared laser light.

“We carefully map out the trajectory of the probe,” said Tandon, a professor in the Vivian L. Smith Department of Neurosurgery at McGovern Medical School and founder of the Texas Institute for Restorative Neurotechnologies. “The probe is so small the brain doesn’t even know it’s there.”

Over the course of several hours, Tandon and his team carefully mapped the route to maneuver the probe through his brain, and then he used laser ablation to destroy the cells that spark seizures.

Tandon has completed more than 250 LITT surgeries since 2013 for patients with tumors and epilepsy.

“Laser ablation carries a high rate of success with a low risk of causing collateral damage to the brain and minimizes the neurocognitive impact,” said Tandon, who holds the BCMS Distinguished Professorship in Neurological Disorders and Neurology at the medical school and the Nancy, Clive and Pierce Runnells Distinguished Chair in Neuroscience of the Vivian L. Smith Center for Neurologic Research. “It is minimally invasive brain surgery that has changed the landscape for patients who want to avoid craniotomy.”

Benefits of LITT

Patients who undergo LITT surgery have a 70% chance of never having a seizure again, and another 20% of patients will be vastly improved.

“About 90% of patients benefit from this operation,” said Tandon.

“Ten years ago, the only recourse for patients like Jason was to do open brain surgery. We now know in carefully selected individuals that we don’t need to put them through such an invasive procedure,” said Lhatoo. “With laser surgery, we minimize risk, shorten their hospital stay, and improve overall recovery.”

Risks of LITT

While the risks associated with this particular brain surgery are low, depending on which side of the brain the laser ablation targets, there could be some impact.

On the right side of the brain, there are minimal risks to memory.

On the left side of the brain, there is a small risk of reduced peripheral vision or reduced memory for complicated tasks like listing objects.

Care and recovery

Jason’s surgery was a success.

“This was a miracle surgery for me. They burned away the epilepsy that was created from a TBI,” said Jason.

Within weeks of LITT brain surgery, Jason returned to his daily routine and spent a year weaning off seizure medication.

“He has done extremely well,” said Tandon.

Now off medication and seizure-free, Jason continues follow-up care with Lhatoo once a year.

Epilepsy surgery options

“When you have ongoing uncontrolled seizures, it is very important to be assessed by an expert. There are surgical options available for epilepsy that can help people become seizure-free,” said Lhatoo.

“We treat people from around the U.S. and the world,” said Tandon. “We want to give people their lives back. This minimally invasive procedure enables people to return to normal, healthy, independent living.” “This team is extraordinary,” said Jason. “Before surgery, I was so restricted from having a life. Dr. Tandon, Dr. Lhatoo, and their team gave me my life back.”

When Blake injured his thumb during football practice in September 2023, the high school sophomore feared his season might be over. With aspirations to follow his father’s path of playing college and professional football, this injury threatened to derail those dreams.

Blake’s injury occurred during a routine seven-on-seven varsity drill when a teammate accidentally tackled him, causing his thumb to hyperextend. He tried to play through it but soon realized something was seriously wrong.

Blake’s mom took him to the ER, where initial X-rays didn’t indicate anything concerning. Nevertheless, his parents immediately decided to seek specialist care. Blake’s father, Brandon, knew exactly who to call: Courtney J. Amor, MD, an orthopedic surgeon at UT Physicians Orthopedics – Memorial Villages, whom he had met years before when Amor was doing his residency.

“As soon as he was injured, Dr. Amor was the first person I thought of because of his attention to detail,” Brandon said. “I entrusted my son to him for surgery.”

Understanding the injury

Amor saw Blake two days after he was injured when he was still experiencing quite a bit of pain and swelling in his thumb.

“His parents made the wise decision to seek evaluation with a specialist right away,” said Amor, assistant professor of orthopedic surgery at McGovern Medical School at UTHealth Houston. “Routine X-rays will pick up fractures and dislocations, but they can miss important injuries to other hand structures, like ligaments and tendons.”

The diagnosis revealed a complete tear of the ulnar collateral ligament (UCL) in Blake’s dominant thumb. This is sometimes known as a skier’s thumb since it often occurs when skiers fall while holding ski poles. Blake’s case was particularly unusual due to the location of the tear. The majority of UCL tears involve the portion of the ligament that attaches to the phalanx bone. Blake’s MRI showed it was torn off the metacarpal bone on the other end, which Amor said is rare.

Taking in the reality

Blake was surprised by the magnitude of his injury.

“At first, I thought it was going to be a quick injury,” Blake said. “When they told me it was torn and a possible season-ending injury, I was a little anxious.”

As a father watching his son’s injury and a former football player who played at Tulane University, in the NFL with the New Orleans Saints, and for 10 years in the Canadian Football League, Brandon focused on maintaining family positivity.

“A lot of things go through your head as a parent,” Brandon said. “Is this it for the season? Is this going to be a setback for him with his goal of playing on the collegiate level?”

Moving into thumb surgery

Amor said complete tears like Blake’s often don’t heal without surgery. With elite athletes like Blake, Amor said they place a high priority on getting them back to the game as quickly as possible.

Four days after Blake’s injury, Amor reattached the ligament to the bone using a special suture anchor device. This internal brace helps reinforce and protect his ligament repair while it’s healing.

“The brace reduces the need for post-op immobilization, allows early motion, and reduces the risk of the repair failing,” Amor said. “All of these things help the athlete return to their sport sooner.”

Brandon is quick to praise Amor, not only for his skills but also for his bedside manner.

“He loves his patients and is the best teammate you can have,” Brandon said. “He wants to do whatever it takes to get you back where you want to be.”

Making a comeback

Blake’s remarkable return to football just two weeks after his thumb surgery exceeded typical recovery timelines. He worked on his thumb’s flexibility by stretching it to regain movement.

“This is an incredibly rapid return to play,” Amor said. “Most surgeons would advise a minimum of six weeks out from contact sports after this type of injury.”

Blake returned to practice by switching from wide receiver to defensive back with a protective brace on his hand. His determination paid off with incredible achievements: He caught two interceptions that season and earned all-district honors. Blake couldn’t believe all he accomplished, especially in his first year on varsity.

“It’s crazy because I started the season as a receiver, I get this injury, and think I’m done for the year,” Blake said. “All of a sudden, I’m catching interceptions, making tackles, and making plays. It’s a true blessing. I didn’t think I’d make it that far.”

The success story wasn’t just about precise surgical techniques. Amor calls Blake a uniquely talented athlete who continues to excel in multiple sports and has an amazing drive to get better every day.

“I couldn’t believe my eyes when his dad showed me a highlight reel of him making an interception, even with his thumb immobilized,” Amor said. “The surgical technique was adapted to suit Blake’s individual situation, but Blake’s talent and motivation were key to his ultimate success.”

Blake’s athletic achievements continued during his junior year in 2024. He led the state in interceptions with eight catches. He made all-state in both offensive and defensive positions, which is uncommon. Blake’s talent is already being recognized in the recruiting world with several offers from Division I colleges to play football.

“Dr. Amor is a miracle worker,” Blake said. “He’s greatly affected my future.”

Garnering family support

The support of Blake’s medical-savvy parents also played a crucial role. Despite both parents being busy professionals, Amor said they made time to be present at every office visit.

“They asked good questions and helped me reinforce with Blake what he needed to do to ensure the best possible outcome,” Amor said. “As a surgeon, I couldn’t ask for a more ideal patient and family.”

Brandon’s relationship with Amor spans years, which makes the success even more meaningful.

“God put Dr. Amor in my life a long time ago, and for this reason alone,” Brandon said. “He knew I was going to need him down the road. When Blake goes to the NFL, Dr. Amor will be right there in the stands.”

A bright orange monster truck costume hung in the closet, ready for 2-year-old Ignacio (Iggy) Rubio’s Halloween adventures. But instead of trick-or-treating through his neighborhood that evening, a routine ultrasound appointment transformed into urgent hospital orders. It was the start of a medical journey that showcased a little boy’s extraordinary courage and a UT Physicians multidisciplinary team that saved his life from a rare pediatric cancer.

In September 2023, Iggy’s symptoms started as common and a nonconcern. His parents, Manny and Monique, thought his condition was related to constipation, with some pain and cramping. They made trips to the pediatrician’s office almost once a week for guidance. Nothing was helping the pain. Later, they realized his urination had slowed significantly, too.

An ultrasound on Halloween revealed urine backed up in his kidneys and a mass in his bladder. The family was told to go to the hospital immediately. More testing revealed his diagnosis. Iggy was battling childhood rhabdomyosarcoma, a rare pediatric cancer that had developed in his prostate and grew to invade the base of his bladder. The tumor was massive, like a softball occupying his entire pelvis.

Chasing rare pediatric cancer

Months later, Iggy’s family sought additional options after chemotherapy treatments weren’t successful in shrinking his tumor. The family lived in Albuquerque, New Mexico, but their second opinion brought them to Houston and UT Physicians.

A local pediatric oncology team worked with Iggy’s family to determine the best treatment strategy for his cancer: radiation therapy or surgery. The concern with radiating his pelvis was the potential for a nonfunctional bladder in the future. Surgery would be aggressive, but it would allow the tumor to be removed and Iggy to be disease-free.

“Given his age, I knew that I needed to partner with a pediatric urologist who has done this operation with me in the past,” said Mary T. Austin, MD, pediatric surgeon at UT Physicians Pediatric Surgery – Texas Medical Center.

Partnering for success

Austin codeveloped a bold surgical plan with Jason K. Au, MD, a pediatric urologist at UT Physicians Pediatric Surgery – Texas Medical Center. Rather than subjecting Iggy to radiation therapy, which could affect his bone growth and development, the team opted to remove both the bladder, prostate, and nearby lymph nodes. This procedure is common in adult cancer patients but rarely performed on young children.

When Au first met Iggy, the 2-year-old had already been through more medical procedures than most people face in a lifetime. This included multiple rounds of chemotherapy, countless imaging scans, and most challenging of all, two nephrostomy tubes that protruded from his back to help his kidneys function and drain urine into a bag outside his body. Monique said Iggy looked like a small squid with tentacles hanging off his back. Managing the tubes, which are made for adults, was a constant source of anxiety for his parents.

Despite it all, the young patient’s spirit was bright when they met.

“He was just full of joy and optimism,” said Au, an assistant professor in the Division of Pediatric Urology at McGovern Medical School at UTHealth Houston. “Despite looking frail and not having hair, his spirits were so high.”

Making a tough decision

When Iggy’s parents learned he needed his bladder and prostate removed to save his life, they faced an overwhelming decision. The surgery would impact him forever, but it offered the best chance at survival. Right away, Monique said her first concern was if Iggy would be able to have children.

“It’s so heartbreaking – who was I to make that decision for him?” Monique said. “As parents, it’s our responsibility to do everything we can to keep him safe, to give him the best chance at living a full, normal life. Never in a million years would we ever think our family would be affected by cancer, let alone pediatric cancer.”  

While it was a difficult decision to make on Iggy’s behalf, his parents said knowing it was the best way forward for him made it a little easier.

“And then meeting Dr. Au and Dr. Austin, I felt comforted knowing their history and background. I realized they are the best people to take care of our son,” Monique said. “How lucky we are to have these people work with our family to help us.”

Moving forward with rare surgery

The procedure would be complex, especially given Iggy’s age, the small internal space for the procedure, and his narrow pelvis. Austin said her expertise is in pediatric solid tumors, but the prostate is Au’s expertise in urology. The six- to eight-hour surgery, a radical cystoprostatectomy, was particularly rare.

“It’s something that you would do once every few years, maybe, and some surgeons have never done this operation with a child,” said Austin, an associate professor of pediatric surgery at McGovern Medical School.

The surgery in March 2024 was successful. This allowed doctors to remove Iggy’s kidney tubes and create a temporary solution for urination using a urostomy. His parents say he’s adapted remarkably well and will never remember a time not having it.

Iggy stayed in the hospital nine days. Although he had difficulty walking initially, due to pain, once he started, he didn’t stop!

Monique said Iggy’s energy levels are out of this world, and he runs laps around his older brother. Recent scans show no disease in his body, though he’s completing a final round of maintenance chemotherapy through spring 2025. The family credits their medical team for Iggy’s success.

“We’ve been dealt the right cards with the right people, the right team,” Monique said, becoming emotional. “They saved our son’s life. What can you say to people when they do something like that for you?”

Iggy’s case represents more than a successful surgery for the medical team. Through their partnership, they were able to offer hope to a young patient who needed it most.

“I think he’s going to have a great prognosis,” Au said. The surgeon credits much of the success to the strong partnership between specialists and their experience handling complex cases together.

Looking to the future

While Iggy will need ongoing monitoring to ensure the pediatric cancer doesn’t return, his medical team is optimistic about his future. Around age 7 or 8, doctors can perform another surgery to create an internal solution for urination.

Through it all, Iggy’s resilience left a lasting impression on his medical team.

“It’s incredible to see these kids who are going through something like this, and they are still laughing and smiling,” Austin said. “Their biggest concern is when they can eat and get to the playroom. They’re just incredibly resilient.”

Au shared similar observations about Iggy’s family.

“It was honestly very uplifting and reassuring to see they were coming into this huge operation for such a young kid with a rare disease with so much support and optimism,” Au said. “They made the best of a terrible situation.”

For future fun, the family is already planning their next trip to Houston. This one won’t be for medical treatment but to visit the Houston Zoo and attend a Houston Texans football game. They want to be in the stadium instead of looking at it from a hospital window.

“Iggy has been a fighter and very resilient, and I know he’s going to help people,” Monique said. “As he gets older, he’s going to be an advocate.”

Iggy’s family hopes his story helps other families facing similar challenges.

“If this could help us understand how and why it happened or how to attack it as soon as possible and save more lives, that would be the silver lining of this experience,” Manny said.

While Tara waited at an intersection, a car stopped short, cut the wheels, and struck Tara head-on, launching her into a fight for survival. The collision tested not only her physical resilience but her entire spirit.

“Your first thought when you get hit is, ‘Why would somebody want to kill me?’” Tara said. “Then your fight-or-flight response kicks in.” That survival instinct proved crucial as she held onto the vehicle’s grille guard, desperately trying to avoid being pulled under the wheels.

The extent of her injuries was severe — a completely severed quad tendon, extensive leg trauma, and a broken wrist. Miraculously, Tara remained conscious. She was airlifted to a Houston hospital to begin her lengthy medical journey. Her knee injury — a 20-centimeter (8-inch) laceration exposing her knee joint with muscle and tissue severely damaged — required immediate surgical intervention.

“She had a traumatic injury to her right knee, where the skin, muscle, and tendons around the knee were torn open,” said Stephen Warner, MD, an orthopedic surgeon at UT Physicians Orthopedic Trauma Clinic who treated Tara. “While Tara did not have any fractures around her knee, the soft tissue injuries to her knee and leg were extensive and severe.”

Warner, who’s also an associate professor and the Emmanuel Manny G. Melissinos, MD Chair in Orthopaedic Surgery at McGovern Medical School at UTHealth Houston, said Tara’s helmet likely saved her from severe neurological damage.

“I tell people that God had a miracle to give out that day, and he picked me,” Tara said. “And my mom, who passed away 23 years ago, wrapped every single angel around me and protected me.”

Saving Tara’s leg

The initial surgery on Tara’s leg was critical. Warner and his team repaired the damaged tissues using sutures to reconnect the muscle and tendon to her kneecap and then close the skin, creating the foundation for Tara’s recovery.

The first six weeks of mobility were challenging. Her left arm was in an elbow cast, and her right leg was encased in bracing. Crutches, a walker, and a wheelchair weren’t options for getting around.

For weeks following the traumatic accident, Tara wasn’t mentally prepared to see her bike, which she had named “Silver Bullet,” now sitting in five pieces in her garage.

“There aren’t enough words to describe all the emotions I experienced when I saw my bike for the first time,” Tara said. “We went through so much together. I’m not at a place mentally and emotionally to say goodbye. And I don’t know that I’ll ever be.”

Improving mobility with a second procedure

At 12 weeks post-surgery, Tara’s recovery plateaued. The extensive soft tissue damage led to significant scar tissue formation, which restricted her knee’s range of motion to 70 degrees. Tara needed a second procedure to help regain mobility. This was particularly important for someone who loved high-intensity activities.

Randal M. Camarillo, MD, an orthopedic surgeon with UT Physicians Orthopedics — Katy, said it’s common for patients to develop scar tissue during the healing process after big traumas. He recommended a procedure called arthroscopic lysis of adhesions. After making two small incisions, Camarillo broke up the scar tissue around her kneecap and inside her knee.

Recovery took time. Camarillo emphasized that patients must be diligent after scar tissue removal.

“The first month is all about motion, motion, motion,” said Camarillo, assistant professor of orthopedics at McGovern Medical School. “The brain has been programmed that the knee won’t bend, so you have to work at it. Tara was motivated so she could continue to physical therapy.”

Tara’s athletic background was invaluable as she took charge of her own recovery, incorporating formal therapy with home exercises. She described her house as a therapy unit after investing in a rowing machine and stationary bike to help rebuild her strength and mobility.

Reclaiming independence

Tara achieved a significant milestone on her birthday in November 2023, when she could finally drive again three months after the traumatic accident. She calls it her birthday present to herself. That first solo drive to therapy marked a crucial step toward reclaiming her independence. Up until that point, she had to rely on others for transportation. “When you’re so independent, and you have to switch to being dependent, it’s hard,” Tara said. “Emotionally, mentally, physically — it’s hard.”

Through it all, Tara’s spirit remained unbroken. She chronicled her recovery journey in photos and video, demonstrating her progress and determination. She praised her surgeons for their expertise.

“I like to say Dr. Warner saved my life, as in having a leg and everything, and Dr. Camarillo gave me my life back, as he had to help me with my mobility,” Tara said. 

After several months of follow-up care and rehabilitation, the goal — getting Tara back to 100% — was finally within reach. Amazingly, she was walking, playing volleyball, and preparing to run a 10K in the 2024 UTHealth Houston Half Marathon & 10K.

“It’s not always possible with trauma patients who are hit by a car to get back to what they were doing, but she’s doing it,” Camarillo said. “She’s just a great story of a good outcome despite a bad injury.”

Tara’s determination impresses Warner.

“Tara was a phenomenal patient, highly motivated to return to all of her activities,” Warner said. “She demonstrated such resilience. For us, treating patients like her is truly a privilege.”

Moving forward

Despite her broken bike, Tara isn’t broken. She achieved her goal of running a 10K with a quick, personal pep talk from Warner before the run. She later saw him cheering from the sidelines as she approached the finish line.

“That solidified how important this was for me,” Tara said. “I felt it was only appropriate to train for this UTHealth Houston-sponsored run because if it weren’t for my UT Physicians doctors, I probably wouldn’t have my right leg.”

View Tara’s inspiring video.

“This injury changed my perception of trials and tribulations we experience throughout our lifetime. I am truly blessed to have the care and medical treatment that assisted my recovery,” said Lauryn.

Her sense of gratitude changed profoundly in November 2022. She was walking through her living room when she slipped and fell, tearing three of the four ligaments in her knee.

“It felt like something moved that wasn’t supposed to move, and it was extremely painful,” said Lauryn. “I couldn’t get up. I had to stay on the floor while waiting for an ambulance because my knee looked contorted and misshapen.”

A disheartening diagnosis

Lauryn was diagnosed with left knee dislocation with vascular injury.

She had torn several tendons and ligaments: anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), along with her posterolateral corner (PLC) which includes the lateral collateral ligament (LCL).

She had also torn her left popliteal artery. This large vessel is just behind the knee and is the primary blood supply to the lower leg and foot.

“I was in emergency surgery within hours of falling in my living room,” said Lauryn. “My unknown future was frightening. The artery tear was serious, and I was close to losing my foot.”

Following emergency surgery to redirect blood flow from the torn artery, she was referred to Paul Shupe, MD, an orthopedic surgeon with UT Physicians.

Lost mobility

“When she came to me, her knee was like a rag doll. It was unstable, and she had no confidence in it,” said Shupe, an assistant professor with McGovern Medical School at UTHealth Houston.

The ligaments she tore are vital to stabilizing the knee. The ACL prevents the shinbone from sliding forward through the knee when stepping and pivoting. The LCL and PLC give rotational stability to the knee. The PCL prevents the shinbone from sliding backward when walking on uneven surfaces.

Without the functional use of these ligaments, Lauryn lost her independence. She had to quit her job and move home to live with her parents.

“Leaving my career as a barber in Arlington, a place I called home for 14 years, to return to Beaumont was life-changing,” said Lauryn. “I abruptly lost my independence and witnessed my aging parents become my full-time caregivers. I wanted to do more for myself, but physically couldn’t.”

Multiphase treatment plan

The injury to her knee was complex and extensive, but Shupe, because of his expertise, was able to create a personalized treatment plan for Lauryn quickly.

“I felt there would be a better outcome if we separated the repairs into two surgeries,” said Shupe.

Physical therapy was a major component of Lauryn’s treatment and began even before her first surgery.

“I had her go to physical therapy for a month beforehand to restrengthen her legs,” said Shupe.

Surgery to repair PCL, PLC, and LCL knee ligaments

During the first surgery, Shupe reconstructed her PCL and repaired her PLC, which included the LCL.

Rehabilitation for this surgery required Lauryn’s leg to stay locked in full extension for three weeks, followed by another three weeks of her leg in a brace. She wasn’t allowed to put any weight on the leg during this round of physical therapy.

“The goal during this phase of physical therapy was to build strength in her quadricep, but the only way to do that was by sitting and doing straight leg raises,” said Shupe.

Surgery to repair ACL

Six weeks later, Shupe performed the second surgery to reconstruct Lauryn’s ACL.

Physical therapy started the next day.

“Unlike the first surgery, after this surgery, she had to begin bending her knee immediately,” said Shupe. “I wanted her to start working on range of motion.”

A challenging recovery

Patience was the key to staying optimistic through a long, painful, and mentally challenging recovery.

“My parents cared for me every day for more than 18 months,” said Lauryn. “It weighs heavily on you when you constantly depend on others.”

Lauryn alternated between a wheelchair, walker, and crutches for several months after her last surgery.

“I was doing everything I could to get better,” said Lauryn. “I knew I had to put in the hard work to regain my independence.”

Back to walking

Seven months after the injury that left her immobile on her living room floor, Lauryn was finally able to take her first steps unassisted.

“When I first started my recovery, I couldn’t see the light at the end of the tunnel,” said Lauryn. “This experience helped me realize what I’m capable of through the power of prayer, hard work, and determination.”

One year later, her persistence with physical therapy paid off, and she regained total confidence and motion in her knee.

“She is back to the functionality that she had before her injury, which is the goal,” said Shupe.

Confidence in care

For more than a year, Lauryn and her parents drove from Beaumont to Houston for regular checkups.

“It was worth the drive to receive care from Dr. Shupe,” said Lauryn. “He is very personable and explains everything to me in a way I can understand.”

During many of her post-op visits, Shupe even got down on the floor to explain physical therapy exercises.

“Finding care with Dr. Shupe was the best decision I think I’ve ever made,” Lauryn said. “He is passionate about his work with patients, and it shows.”

From shock to support

Krystal knew nothing about spina bifida when her daughter was diagnosed at her prenatal, 20-week anatomy scan.

“I didn’t want to go down the Google rabbit hole before I talked with a professional. We didn’t know the extent of her defect or where it was located. I wanted information from a specialist, and because I knew nothing about spina bifida, I wanted it quickly,” she said.

Her OB-GYN in Austin referred her to a local maternal-fetal medicine specialist who recommended a trip to Houston for expert examination and diagnosis. With the help of the specialist, she arranged an appointment at the UTHealth Houston Fetal Center with Ramesha Papanna, MD, MPH, professor and UTHealth Houston chair in fetal intervention; Kuojen Tsao, MD, professor and The Children’s Fund, Inc. Distinguished Professor in Pediatric Surgery; and Stephen A. Fletcher, DO, professor of pediatric neurosurgery. All three are faculty at McGovern Medical School at UTHealth Houston, and Papanna and Tsao are co-directors of the center. Because the physicians understood the urgency of an accurate diagnosis, they scheduled an appointment for Krystal and her husband, Jordan Grayson, the following day.

Journey to advanced care and innovative options

Krystal and her husband made the two-and-a-half-hour drive to Houston to meet with Papanna, Tsao, and Fletcher in July 2021.

“The doctors gave us a lot of clarity about our options,” Krystal said. “Spina bifida is a snowflake condition in the sense that it affects each baby differently. We left with more understanding about the challenges Luna would face as a toddler, those we would face as parents, and the steps we needed to take to ensure she could live her best life.”

Krystal was offered the traditional open repair procedure, and she and Luna also qualified for a fetoscopic clinical trial that was then underway at UTHealth Houston. The fetoscopic procedure differs from in utero repair, which requires a large incision on the uterus and delivery by cesarean section. Instead, the fetal intervention team repairs the spina bifida defect in two layers through three small incisions in the uterus using a fetoscope, a high-resolution camera, and tiny surgical tools. The first layer is closed using a cryopreserved human umbilical cord (HUC) patch placed over the spinal cord, followed by a second layer of primary closure of the skin. Mothers undergo vaginal delivery, unless there is an obstetrical indication for C-section.

Fetoscopic procedure for spina bifida

Krystal decided to undergo the fetoscopic procedure “to give my daughter the best possible quality of life” and returned to Houston for surgery the first week of August 2021. She was the 15th patient treated in the medical school’s trial of the NEOX patch, called “Early Feasibility Study for Fetoscopic Spina Bifida Repair,” which ended in June 2023 and continues in a five-year follow-up protocol.

During the procedure, Tsao opened the uterus, and Fletcher revealed Luna’s spinal cord and sewed the patch in place over the small defect on Luna’s spine. Following the surgery, Krystal stayed at her father’s home in Houston for two weeks, after which her follow-up care was transferred to her maternal-fetal medicine specialist in Austin, who reported the results of her weekly ultrasounds to Papanna.

A successful delivery

At 34 weeks, Krystal returned to Houston and checked into a hotel near the Texas Medical Center. When her water broke at the hotel, her sister took her to the hospital to check in. The emergency center team prepped her for an emergency C-section, which is standard procedure for pregnant women who have delivered previously by C-section. Papanna arrived and told her he believed she could deliver vaginally.

“That’s exactly what I wanted, as I had delivered my son by C-section and had just undergone the fetoscopic surgery two months earlier,” Krystal said. After a relatively short labor, Luna was born on Oct. 1, 2021.

Luna’s time in the NICU

“My husband arrived in Houston before Luna came, so he held her a bit before they put her in the warmer and took her to the NICU,” she said.

Krystal stayed in the hotel and took breast milk up to the neonatal intensive care unit at the hospital each day during Luna’s 29-day stay. Her husband and 4-year-old son drove from the Austin area on weekends.

“It wasn’t terrible to be there a month, but the hardest part was not being able to hold Luna,” she said.

“Krystal was able to go full term with no complications during pregnancy,” Papanna said. “Luna’s back looked normal, with no cerebrospinal fluid leakage. The skin had healed in the uterus, she had no hindbrain herniation (when lower portions of the brain are displaced due to increased pressure inside the skull), and her legs were moving.”

Embracing life with joy

Patients who participated in the trial return for checkups over five years.

“Luna is the beneficiary of all the research and patients who came before her,” Papanna says. “We work hard to ensure that each patient has access to the best health care. Krystal’s surgery was straightforward and uncomplicated. A diagnosis of spina bifida doesn’t necessarily indicate a bad outcome.”

“Luna can walk independently, although she still prefers to crawl – and she crawls very fast,” Krystal said. “She wore a Ponseti brace for two years, the standard of care to correct clubfoot. Her foot is fine now, and she wears an ankle-foot orthosis (an external medical device such as a brace or splint) to set her feet forward. She’s talking and has some enunciation problems but will get it in her own time. My first one was also slow to start. She loves to laugh. We’re blessed with a very happy child.”

“Without Dr. Numan, I think I’d still be lying in a bed and not living the life I’m currently living,” Natalia said.

Misdiagnosed and dismissed

As a preteen, Natalia’s symptoms worsened when her family moved from Florida to Texas. She started fainting regularly, requiring frequent trips to the emergency room.

“They had no idea what was wrong with me,” Natalia said.

It wasn’t until Natalia was 13 that she finally got answers. Her mom made an appointment with a neurologist who immediately suspected Natalia had dysautonomia. He referred her to Mohammed Numan, MD, a pediatric cardiologist at UT Physicians Pediatric Center Cardiology – Texas Medical Center.

Listening with an ear to heal

“When people hear ‘it’s all in your head,’ over and over from doctors, it breaks them,” Numan said. “Natalia came to me worried that I’d dismiss her symptoms just like others had.”

Instead of brushing off her complex symptoms, Numan conducted detailed tests, including a tilt table test and heart ultrasound. His diagnosis confirmed Natalia has dysautonomia. This disorder affects the autonomic nervous system that controls involuntary body functions such as heart rate, blood pressure, and temperature regulation. Numan compared dysautonomia to your body’s autopilot system not working properly.

“For most people, things like standing up, dealing with heat, or digesting food happen automatically,” said Numan, professor of pediatric cardiology at McGovern Medical School at UTHealth Houston. “But for someone with dysautonomia, these simple tasks can trigger dizziness, fainting, nausea, and severe fatigue.”

The condition often has a genetic component and can be triggered by various factors. Not everyone experiences the same symptoms or severity, which can make it challenging to diagnose. For Natalia, it affected multiple systems, from gastrointestinal issues to chronic headaches. The hardest times were during puberty, when hormonal changes were also impacting her nervous system.

“Dr. Numan has helped us navigate treatments and manage my symptoms so I can live as normal a life as possible,” Natalia said. “He’s been our quarterback ever since.”

One of those treatments was discovering and repairing a small hole in Natalia’s heart, which improved her headaches by 70%. Combined with careful medication management, this intervention helped Natalia regain the functionality she’d lost. Now 24, Natalia said her symptoms have calmed down quite a bit since her teenage years.

Pursuing her passion for archery

Despite the challenges, Natalia has found a sport that brings her joy. Archery is the one thing that makes her feel normal and in control of her body.

“When I’m shooting, the rest of the world just fades away,” Natalia said. “It’s like meditation for me. When I release, I’m releasing anger, resentment, and bad feelings.”

Natalia is pouring her heart and hands into this new sport and working toward qualifying for the Paralympics. While she narrowly missed making the 2024 team, she has set her sights on the LA 2028 Paralympic Games.

“Archery has opened up so many amazing opportunities for me to travel and compete,” she said. “It’s been life-changing.”

Inspiring others

Natalia has some advice for others struggling with dysautonomia or other mysterious, chronic illnesses.

“Keep searching for the right doctors who will listen and validate you. They’re out there, I promise,” Natalia said. “Don’t let your condition define you — there’s so much more to life.”

After following Natalia’s progress for a decade, Numan is inspired by her determination. She has never surrendered to her condition. Even after moving back to Florida, she maintained her connection to UT Physicians to ensure she improved.

“Natalia has shown us that dysautonomia doesn’t have to be a crippling disease,” Numan said. “She has achieved so much despite her symptoms. I hope her story inspires other patients to keep pushing forward.”

“She wanted to be a typical 20-something where she could get around without having pain,” said Steven J. Schroder, MD, an orthopedic surgeon at UT Physicians Orthopedics at Memorial Hermann | Rockets Orthopedic Hospital. “She had muscular pain and range of motion dysfunction, and it was definitely affecting her daily life.”

Learning to adapt as a child

Anh’s family learned of her DDH diagnosis when she was an infant and that her ball-and-socket joint hadn’t properly formed. It limited her childhood and prevented her from participating in sports and activities due to her increased risk of hip dislocation.

Despite bracing, regular physical therapy sessions, and multiple surgeries, Anh’s condition progressed. In her early teens, doctors revealed her condition had advanced too far to be corrected without a hip replacement, which would be required once she finished growing.

Searching for a solution

Through research, Anh realized a hip replacement procedure would enable her to reclaim her life. She described her first consultation with Schroder as incredibly positive. She said he displayed empathy and kindness with a full understanding of her daily pain. The idea of living without pain seemed distant to Anh in early adulthood, as just sitting at work caused excruciating pain.

“Dr. Schroder addressed all of my questions, which were numerous given my thorough research,” Anh said. “He couldn’t guarantee complete relief from pain due to the complexity of my case, but he assured me he would give his utmost effort.”

Planning the hip replacement procedure

Anh was not the typical dysplasia patient, according to Schroder, an assistant professor of orthopedic surgery at McGovern Medical School at UTHealth Houston. Her case required reverse engineering and an outside-the-box surgery. This procedure is unlike anything Schroder has seen in his practice, fellowship, or medical meetings.

“It’s atypical based on the original orthopedist years ago putting a revolutionary growing nail (metal rod) into her femur, with the idea it would provide some benefit in the short run,” Schroder said.

At age 15, Anh underwent a nine-hour leg lengthening surgery as a temporary measure until she stopped growing and a hip replacement could be done. At the time, lengthening her femur bone was a first-of-its-kind procedure at the hospital where it was performed.

“A lot of engineering and math went into our surgery because we had to determine Anh’s actual leg length discrepancy and how much bone we needed to subtract from her femur to match the femur length on the other side,” Schroder said. “It ended up being about 4 centimeters.”

The concern was lengthening too much, and it could stretch the sciatic nerve. This translates to a leg with nerve palsy that could create muscle weakness, elasticity, and sensation problems.

Another concern was the muscles around the hip girdle, which had never been used in the usual way. As a result, they were scarred, shortened, and weak.

“The challenge was to bring the hip down to its normal position,” Schroder said. “But we didn’t know if she would have significant control of these muscles and how they would respond.”

Achieving a surgical success

Schroder said the surgery would entail a long day with unknowns and thinking on the fly. Thankfully, it went as planned for her and the surgical team. They did a large release of the capsular tissue from the top of the hip, removed the femur rod, and subtracted the prescribed amount of bone. They placed the implant in the bone and the shaft of the bone to build the replacement back up to the normal femur length.

“I knew we would be able to put her in a better situation after surgery by taking away her arthritic pain and the pain she was having from the previous surgery and dysplasia,” Schroder said. “The real question concerned her functionality because it hadn’t been used as a normal limb.”

Living with a new hip

The change was immediate. After surgery, Anh’s legs initially felt heavy and sore, but the pain she had grown accustomed to was gone. For the first time, Anh didn’t have to wince through every movement or calculate whether her daily activities were worth the discomfort.

“Now, I can aimlessly wander or handle daily tasks without thinking twice — or bracing myself for the pain,” Anh said. “Simple things, like going to the grocery store or climbing a flight of stairs, no longer feel like a struggle or something I think twice about. They just come naturally now.”

Schroder said he held Anh back the first couple of weeks to allow things to settle and ensure she had proper stability. Then, she knocked it out of the park in therapy. Through dedicated physical therapy and personal determination, Anh returned to the gym six months after surgery. She even achieved personal milestones like a 380-lb. leg press.

“Unlike before, where weightlifting was a means to manage pain, I now experience consistent progress and strength gains, a feeling that’s truly liberating,” Anh said. “I feel like a new person, full of optimism for the future. The journey has been transformative, allowing me to take control of my health and life.”

New lease on life

Today, Anh’s life is dramatically different. She has traveled extensively, often walking 10,000 to 30,000 steps daily during her adventures. Japan, Switzerland, Italy, South Korea, and Canada provided a beautiful backdrop to explore. She can now confidently pursue an active lifestyle, which includes cycling, weightlifting, and long walks with her dog, Bumi.

“The surgery was a pivotal moment, allowing me to overcome challenges and focus on getting stronger each day,” Anh said. “Dr. Schroder believes this is just the beginning of my journey and said we’ll be friends for life. I need to return every five years or so for checkups!”

Uncertainty of future surgery

As a younger patient with a high level of activity, Schroder acknowledges there is some uncertainty about how long the hip replacement will last. He tells hip replacement patients the metal is not going to wear out, so it should last Anh a lifetime.

“Historically, the plastic side of the implant on the cup is the weak link and determines the longevity of an implant,” Schroder said. “Current in vivo data (real-time conditions with a living organism) shows 20-25 years without significant wear, so there may be a need for another surgery. It would be a much smaller surgery and much further down the road. My hope is we don’t have to do anything.”

Focusing on the goal

Schroder describes Anh as a needle in a haystack when it comes to patients. She outperformed expectations, was always reliable, met responsibilities, and asked for more therapy to ensure she achieved her goals.

“She’s definitely had her eye on the ball and pushed through many challenges,” Schroder said. “It’s hard to believe that she’s getting even better after two years. That’s a tribute to her dedication and drive to get as normal as she can on that side.”

His mom, Beth, recalls two of his friends suddenly running up to the house yelling that Cole had an accident. “Is he dead?” she asked. The boys just looked at each other and didn’t say anything.

Cole was alive but had lost consciousness and wasn’t responding. It took flight paramedics an hour to stabilize Cole after he regained consciousness. He was then moved to a hospital in Houston.

The emergency department determined he had a concussion and admitted him for treatment.

“What makes concussions unique is that no two are alike,” said Summer Ott, PsyD, director of the UTHealth Houston Concussion Program and neuropsychologist at UT Physicians Orthopedics at Memorial Hermann | Rockets Orthopedic Hospital. “Unlike other sports injuries that follow predictable patterns, concussion recovery can vary significantly from person to person. The severity of initial symptoms doesn’t always predict the recovery timeline.”

It was a scary time for Cole’s family. He slept a lot after he was released from the hospital, but the medical team reassured his parents it was normal.

“You can hear that as many times as you want, but as a parent, when your child sleeps for four days, that’s hard,” Beth said.

A positive improvement

On the fourth day, Cole took a turn and started asking questions. He was confused, and Beth realized he had no memory of the accident and the days following. The last thing he remembered was fishing with his friends two hours before the accident.

Doctors referred the family to Ott, and Cole showed remarkable improvement at his first visit, a week after the accident. The dizziness, balance issues, and headaches that had troubled him were subsiding. However, he was having difficulty remembering some things and still experiencing confusion.

Ott completed a physical exam of Cole, as well as a balance assessment and cognitive performance assessment. He did well on all of them.

“Cole was eager to get back to playing baseball, because he thought there wasn’t anything wrong with him,” said Ott, associate professor of orthopedic surgery at McGovern Medical School at UTHealth Houston. “He didn’t know everything mom and dad had viewed at the accident scene.”

Navigating the concussion treatment journey

For Cole, a talented baseball player longing to return to his sport, the path forward required patience and a structured approach. His medical team developed a careful plan to ease him back into normal activities — from screen time to schoolwork to sports.

Part of Ott’s role with families is to let them know she understands the challenges. She said seeing a child out of their element or out of the sport they love is tough. Ott has personally experienced it with her child.

“I think being a mom has probably made me a better doctor,” Ott said. “In the case of Cole, I could see the fear on his parents’ faces at the first visit. I recognize that with families, provide lots of reassurance, and validate their feelings.”

Beth said Ott took her time answering their questions, even if they asked them four times differently.

“Dr. Ott was amazing and just calmly reassured us,” Beth said. “She made a great plan for Cole to return to baseball, his life, school, and friends. I still get emotional because it hasn’t even been a year yet.”

Back to school and baseball

Cole’s return-to-school plan included accommodations such as extra time for assignments and carefully spaced medical assessments. The family alerted teachers to watch for signs of cognitive fatigue, as sometimes symptoms don’t appear until a student faces the full mental demands of a school day.

“Getting back to school was really hard because I couldn’t focus,” Cole said.

The family’s dedication to following medical guidance paid off. Within two weeks, Cole was symptom-free and cleared to return to normal activities. Baseball was a more gradual return, with Cole’s father taking on the unexpected role of an athletic trainer. With guidance from medical professionals, he helped implement a day-by-day plan to gradually return Cole to physical activity and eventually to baseball.

Ott said this careful progression was crucial, especially in youth sports where formal concussion treatment protocols might not be as established as in professional leagues.

“You can’t be half-healed,” Ott said. “You want the patient to be back to themselves in several different domains. If they get hit in the head again while they’re still having cognitive deficits, they probably will get worse.”

Positive results

Ott said Cole’s case illustrates that while concussions require serious attention and careful management, young athletes can make full recoveries with proper care and patience.

Beth calls it a miracle and proudly shares some of Cole’s impressive accomplishments after the accident: being inducted into the National Elementary Honor Society, playing saxophone in the band, and making the All-Star Baseball team and seventh grade football A team.

“He sat out of baseball four weeks, played through the season, and then made the All-Star team,” Beth said. “He’s doing so well, and we owe a lot to Dr. Ott and the medical team who were so supportive.”

Research shows that people are more prone to concussions once they’ve had one. Ott had no concerns with Cole beginning seventh grade football following his concussion.

“Dr. Ott released him and said he’s good to go and live his life,” Beth said.

“I am so proud of her,” said her mother, Ronit Konwar.

The exciting moment was profound for Ariella after being diagnosed with juvenile idiopathic arthritis (JIA) at 6.

Arthritis diagnosis

Over several weeks in 2021, Ariella began experiencing progressive leg pain and woke up one morning unable to walk.

“She was screaming and crying,” recalled Ronit. “She said, ‘Mommy, my legs are hurting me. I can’t move my legs.’ They were swollen, and her knees were pointed inward.”

Ariella was diagnosed with JIA and referred to Monica A. Bray, MD, a pediatric rheumatologist with UT Physicians, for treatment.

Juvenile idiopathic arthritis

Arthritis is a general term for joint inflammation commonly associated with older adults.

JIA is a specific condition that impacts children and can be diagnosed in kids as young as 2. This form of arthritis occurs when the immune system chronically attacks the joint, causing inflammation that lasts until it is treated.

It is an autoimmune disease that can present anywhere there is a joint, such as the jaw, hands, ankles, wrists, and knees.

Symptoms include swelling, inability to straighten the joint, reduced range of motion, persistent limp after laying down for a long period, and sometimes mild pain.

“When Ariella came to me, she was dealing with bilateral knee effusions, meaning she had extra fluid in her knees, which were swollen,” said Bray.

Left untreated, the disease can change the way the bones develop. It can speed up bone growth, cause premature fusion of growth plates, and damage joints.

“We usually don’t see permanent damage if we can diagnose and treat it within the first six months of symptoms,” said Bray, an assistant professor with McGovern Medical School at UTHealth Houston.

Timely diagnosis

Ariella’s mother was also diagnosed with JIA as a child. Because of her own experience, Ronit recognized the symptoms and was able to help her daughter receive a timely diagnosis and treatment plan.

“There is a sweet spot when diagnosing JIA,” said Bray. “We want to see patients within the first one to two months of symptoms but not within the first few days because it could be swelling from something else, such as an injury.”

Risk factors

There is no known cause of JIA and no specific gene associated with it, but there could be a family link.

“We don’t think it’s directly inherited,” said Bray. “There is genetic susceptibility, and we believe something triggers it, like an infection.”

Treatment

Ariella first began seeing Bray every few weeks for routine bloodwork and to monitor signs of inflammation.

Her JIA treatment involved steroid injections in her knees, which reduced the initial swelling. Over the course of several months, she developed pain in her jaw and a complication with her right eye. She was placed on a biologic medication, given by injection in her leg every two weeks.

Eye complication

In addition to being watched for inflammation, pediatric patients are monitored by an ophthalmologist for a condition called uveitis, which is associated with JIA. Uveitis occurs when the immune system attacks the uvea, a layer in the eye wall. This causes inflammation in the eyeball, which can lead to blurred vision or vision loss if untreated.

“The condition is painless, and by the time it affects vision, the damage is already done,” said Bray. “The only way to detect it ahead of time is through screening by a trained ophthalmologist.”

Ariella was diagnosed with mild uveitis in her right eye and treated with eye drops for about six months.

Recovery

Treatment for JIA will often last through childhood as pediatric patients deal with flare-ups from infection.

The goal for all children with JIA is to go into long-term remission and continue their active life.

“JIA is a disease we can treat with minimal side effects,” said Bray.

Ariella took a short time off from sports as she adjusted to her medication but was back to her usual routine within several months of her diagnosis.

“With Dr. Bray’s approval, she resumed sports, playing with friends, and running around at school,” said Ronit. “As long as she wanted to do it and wasn’t in pain, she was allowed to do it.”

Back to the green

It was no surprise to her family when Ariella returned to the golf course ready to focus.

“From day 1, she followed instructions and knew exactly what she needed to do for her recovery, what medicine to take, how often, and when,” said Ronit. “Her passion is what got her through all this.”

The young athlete was just 4 when her father introduced her to golf. Now 9, she is looking ahead to her future.

Her dedication to the sport means practicing nearly every day and participating in six to eight tournaments a month.

“Her prognosis is excellent,” said Bray.

Medical care

Thanks to the advanced and compassionate care she received from her team at UT Physicians, this young girl isn’t letting a JIA diagnosis define her childhood.

“Dr. Bray is a gem,” said Ronit. “I was really worried about how serious this would be, but Dr. Bray and her staff were amazing. They were professional, calming, and attentive from day 1.”

Ronit says sharing her daughter’s story of perseverance is important to comfort other families.

“Stay focused on staying calm and do your research. Every question is a good one because this is your child’s health,” said Ronit. “Be an advocate for your child.”