Caitlin Whyte (Host): Welcome to Healing Heroes PDX, the podcast series from the specialists at Shriners Children's Portland. Today we are discussing rehab options for an elbow broken in multiple places with senior occupational therapist Anne Murphy-Hagan. Her patient, June, and June's mother, Sadie, will also be joining us. So I'll start with you, Anne. Can you tell us about your experience and what drew you to occupational therapy in the first place?

Anne Murphy-Hagan, OTR/L, BCP: That's a very good question. And it could have a very long answer, but in summary, I actually started off working with women, families, and children, in sort of social services Family Advocacy role. I was with this wonderful organization called Head Start doing family advocacy work, and just during that time, I got to know a number of early childhood special education providers, and they were very welcoming and inviting me along with home visits and partnering on the kids that we were working with, and I really got to see through them at what a difference play could make with development, and I absolutely loved that idea at the time, that play could help make a child stronger and result in really tangible outcomes. And that was my first introduction to occupational therapy and I ran with it.

Host: Oh, I love that description. Well, my next question, Anne, how do you measure the success your patients are having? How do you know when therapy is no longer needed or you need more of it? Where do you think about all that stuff?

Anne Murphy-Hagan, OTR/L, BCP: Yeah. So it's all about function over perfection. So, to use the example of a broken arm, we don't really care if you can fully straighten it and fully bend it if you're not using it, if you're still too afraid to go back to your activities. And so, I know things are working when children and parents start telling me that they have gone back to doing the things they love and it doesn't seem like there's any difference anymore.

That's kind of our goal always as an occupational therapist to find those things that the patient really finds meaningful and get them back to it.

Caitlin Whyte (Host): And we have June here, one of your patients. June, can you tell us what happened to your elbow and why you had to come to Shriner Children's?

June: Back in April 2023, my family and I were in Hawaii and we went to the park and I went on the monkey bars and I broke my elbow. We went to the emergency room and they had to help me undislocate my elbow because I broke it in two places and dislocated it and I ended up having to have three surgeries.

Host: Wow, well that is quite the experience. Can you tell me a bit about how therapy with Anne was important in your healing journey? How did that help you and your elbow?

June: Therapy was very important to me because once I got my cast off, I was scared to use my arm. So having therapy with Anne helped me gain more confidence and strength to use my arm again.

Host: Awesome. So June, you broke your elbow in a couple different places you were saying. And Anne, I'd love to ask you, what were the benchmarks that you were looking for in June's rehab process and how did you assess them?

Anne Murphy-Hagan, OTR/L, BCP: Yeah, so as June was saying, I met her about four weeks after her surgery, right when she got her cast off. And at that point she was able to move her elbow just a little over half way through what we would consider to be a fully functional arch and I knew she was a student and a good student, and so she was going to need to be able to turn her hand over to type.

And, I knew that she loved soccer and being a goalie, which is my favorite position. And so that she was going to be able to need to put her palm up in order to catch the ball. And so I started with knowing what a functional range is for an arm, so that you have to be able to extend your arm to at least within 30 degrees of fully straight.

And you have to be able to bend it within at least 130 degrees of fully flexed to be able to do most activities. And then I thought about the things that June wanted to do. Also for palm up, palm down, there's, there's a range for that. And so, I went from there and just designed activities around trying to get her to move again. 

In the beginning, maybe focused a little too closely on just the movement. And then it just kind of became clear that, like, we needed room for fun in therapy and being a kid in therapy. And so that's when we started bringing in activities and really seeing the results take off.

Host: I love how tailored your approach was to June and her specific needs with soccer and typing. Can you talk more specifically about her regimen and the methodology that you employed?

Anne Murphy-Hagan, OTR/L, BCP: When I have a patient, basically, that has come out of a cast or has had surgery, they're, they're always stiff. And so, the best thing to get muscles moving is heat, so we would heat her arm, and then we would start, kind of, with some gentle stretching, and then after really focusing on moving the arm up and down, we would move into activities.

So the type of things where you would have to move your arm, but you're not necessarily thinking about it. A really fun one we discovered was actually virtual reality. Kind of new at that time, our, department had acquired a rehab specific virtual reality system. And there were games specific to moving the arm.

And so with June, we were able to, put these goggles on her and have her pop balloons or catch fruit in baskets and she would wave her arm around the room and the beautiful thing is she couldn't see it as she was moving it and that helped, I think, push past some of that fear. She also happened to have a VR at home so she would come back to therapy next time and be like, oh, I discovered this, this, and this can work at home for therapy for my exercises.

So she started kind of coming up with her own activities. And then also we got Child Life involved, because they were wonderful in terms of like toys and, just ways of making, June and our patients here at Shriners feel, feel comfortable.

Host: That is so cool to incorporate that VR element. And June, I'd love to know, you said this happened to you in April 2023, so how long was your therapy journey with Anne?

June: It was about two months.

Host: Okay, cool. And how are you doing now? We're in 2025. Tell me about your elbow. Are you back in soccer? What's going on these days?

June: Yes, I am back in soccer and I'm doing well, but sometimes my arm hurts a little bit, but it's nothing I can't handle.

Host: Awesome. That is so cool. Thank you so much, June. And Sadie, as a mom, we'd love to hear, how was it watching your child go through a traumatic injury like this, and her journey with Shriners Children's?

Sadie: So watching June go through such a traumatic injury, it was absolutely heartbreaking actually. As a mom, you know, you kind of feel helpless not being able to take the pain away and you're just there trying to support her and be strong for her. So it was definitely tough. But, you know, once we got to Shriners and we walked through the doors, like, you just kind of feel a sense of relief.

Everyone was so sweet and kind. I mean, from the receptionist to the people checking us in. The level of care and support they provided was not just to June, actually, it was to our entire family. I mean, we always, we all felt supported. The doctors, the nurses, all the staff, physical therapists, Anne, I mean, everyone was just comforting and they gave us all the guidance we needed.

June's been incredibly strong and brave. She had to face three surgeries, which was tough for somebody, you know, she was nine when the injury happened. And you know, she faced it all with such resilience and she really didn't complain. I mean a little bit, you know when we had to do our therapy exercises, but we got through it. But she showed so much courage and I'm just so happy with the progress that she's made.

Host: Thank you so much. I'm so sorry you had to go through that, but it sounds like, you know, a couple years out, y'all are getting back into the swing of things, and thank you for sharing with us. Well, in your experience, Anne, how is Shriner's Children's so unique?

Anne Murphy-Hagan, OTR/L, BCP: There's just no other care experience like it. I mean, we're a small hospital and we're able to provide just incredibly quality outcomes. I mean, if I ever have any questions about June or, or any patients I work with, the surgeon who does their surgery is really accessible to me, and so I can ask a question right away.

If I have a patient that's nervous about a treatment, I can get Child Life to join. There's just so much wrap around care that I think really drives our outcomes and I remember at the very kind of end of June's treatment cycle, we had this fundraiser called Walk For Love and it was this fundraiser at the zoo and it's almost Halloween and it was really cold in the morning and I see June's whole family there dressed up as a team of June's geniuses. And I'm thinking you know when you're injured, the last thing you want is to go back and spend time at the place where you're getting therapy or hospital and seeing like June's whole family show up at 7:30 in the morning for a Shriners event, literally spoke volumes about the Shriners experience.

Sadie: And I'd like to actually pop in with that too, because I just feel like Shriners, you know, is definitely unique in the way that everything that you need, all the services are here at the hospital. So as a busy mom of three, my husband and I both work full time, you know, getting to physical therapy and to the doctor's appointments and to all the different things that she may need, just having it all here in one location made all the difference for us. And, you know, just having, you know, the therapist be able to talk with the doctor and just have everybody, you know, it's like one big team versus having to go to a different location. And, and so I just, I really find that as a family was, you know, super busy that it, it really did help for June.

Host: Absolutely, that central location to access all those resources is so, so critical. Thank you for sharing. And to wrap up our session today, Anne, how would you describe the unique rehab experience at Shriners Children's? What are y'all doing?

Anne Murphy-Hagan, OTR/L, BCP: My rehab team that I work with is some of the most, educated and driven that, I have been in the company of, I mean, really the knowledge, of my coworkers is advanced at a level that, that really impresses me on the day to day. And, I, we're a wonderful family, we're supportive of one another, and the amount of resource sharing and thinking outside the box, is, is just on a level that I haven't experienced anywhere else.

And that's not to knock other places, I'm just, I, I think Shriners really has something special going on.

Host: Well, thank you so much to Anne, June, and Sadie for taking the time to chat with us today. And that concludes this episode of Healing Heroes PDX with Shriners Children's Portland. Head on over to our website at ShrinersPortland.org to find out more information. And thank you for listening.