It was 3:00 p.m. on October 30, 2007; Troy was in Kindergarten in the bilingual program. His teacher sent him to the clinic based in his elementary school that afternoon because she thought he appeared ill. After arriving in the Clinic, he sat in a chair and almost immediately slumped over. With his head turned to the side, it was apparent that his heart was racing. Troy was placed on his left side on a cot and a pulse oximeter was immediately attached to his finger. Though his oxygen saturation was normal at 98-100%, his pulse rate was extremely elevated at 236 beats / min. The event lasted around 15–20 minutes. During the tachycardia episode the child was listless, pale, nauseated and extremely diaphoretic. His mother was reached by phone and arrived at the school within minutes. Through an interpreter, it was discovered that the child has had similar episodes, since 2 years of age. The mother would notice the “pounding” in the neck, would take him to a local emergency department, but the episode would resolve before any assessment was done. She commented about how one ER physician told her that her son was dehydrated and that all he needed was fluids. During this conversation it was apparent how frustrated she had become over the years, being the only person who saw these turn of events unfold. But on that day, she verbalized a sense of relief that someone else had now been a witness.

After referral to UTMB Pediatric Cardiology, Troy was diagnosed with Wolff-Parkinson-White syndrome. His mother was uneasy when she learned that their approach would be observation only. Upon her urging, the family was referred to Texas Children’s Hospital.

By August of 2008, Troy underwent a procedure at Texas Children’s Hospital which attempts to correct a pathway where electrical impulses are conducted. To this date, Troy has been free of any tachycardia episodes. He is a healthy first grader now!!

James was 4 years old when he was first referred to the School-Based Clinic by the school nurse for an update on his immunizations. After that first visit, his mother often sought the Clinic’s services. James began having ear infections when he was in 1st grade. That first year he was treated twice for an ear infection with a voucher for the prescriptions. For the next three years James treated once a year for an ear infection with a medication voucher. He and his mom would say that the Clinic Nurse was the one who always helped him. Over the years, if James’ ear would start hurting, he would come to the Clinic from class just for me to “check his ear.”

This year James is 9 years old and in 4th grade. He has not had an ear infection, but recently came to me with a toothache. He does not have routine dental care. Fortunately, through the alliance with a local dentist and CHRISTUS Health, we will be able to assist the family in getting the needed dental treatment for James, and both the parent and student are very appreciative. James will be leaving K.E. Little next school year for 5th grade. It is certain because of the relationship that has developed over the years with this family that they will continue to seek the services provided by the Christus St. John School-Based Clinics.