The saying “timing is everything” could not be more true for Crystal Schnabel, Eric Massey and their son Rogan Massey. Rogan was born on April 13, nearly six weeks early, but not a minute too late.

A few days prior to her son’s birth, Schnabel had an appointment scheduled with maternal-fetal specialist Holly Dunn, M.D., an Abilene-based high-risk obstetrician with Cook Children’s Health Care System. Because Schnabel experienced low amniotic fluid levels in her first pregnancy, she needed to be monitored closely. But a scheduling conflict led her to cancel her 34-week appointment. Two days after her missed appointment, just to be on the safe side, Schnabel, a radiology technologist, asked a fellow sonographer to do a quick ultrasound to check her fluid levels. Her colleague told her to stop by the next day during a break in her schedule.

On April 13, at 2:45 p.m., Schnabel met her colleague for the scan, and they both noticed something peculiar. Rogan’s heart rate was irregular and beating faster than normal at 254 beats per minute. The sonographer urged Schnabel to go to the labor and delivery department at Hendrick Health in Abilene for an exam. Schnabel alerted her obstetrician, called her husband and made her way to the hospital.

There, she was hooked to a fetal heartbeat monitor that produced what appeared to be normal readings for the baby’s heartbeat, but Schnabel’s obstetrician asked Dr. Dunn to take a second look.

“Her OB called me, had me look at the monitor strip and something didn’t sit right with me. So I told her to send mom over,” Dr. Dunn said.

Schnabel and Massey immediately made their way to Dr. Dunn’s office located just across the street from the hospital. By this time, it was a little after 3 p.m.

Schnabel was seen and counseled by Dr. Dunn’s nurse practitioner who recommended that she be admitted to the hospital for overnight monitoring. As the couple left to make the short trek back across the street to the hospital, Dr. Dunn reviewed her sonogram images and made the call to act sooner than later.

When the couple arrived at Hendrick Health’s labor and delivery department they received shocking news. Schnabel needed an emergency cesarean section.

In the five minutes it took Schnabel and Massey to walk from Dr. Dunn’s office to the hospital, the labor and delivery team received a call from Dr. Dunn to alert them that Rogan’s heart was in supraventricular tachycardia (SVT), a fast and erratic heartbeat that prevents the blood from pumping throughout the body, potentially leading to congestive heart failure and death.

“The baby’s heart was barely moving,” Dr. Dunn said. “The rate was quick, so the electrical conductivity was passing through, which is what we were detecting on ultrasound and monitors, but the heart itself was barely moving and weary from working so hard. There can be some arrhythmias that are benign, that are sustained for days to weeks. But SVT, in this case, is something that can only be sustained for a few minutes to hours before the baby either comes out of it spontaneously or death occurs.”

Rogan needed to be delivered immediately. His life depended on it.

“We walked in and all of the nurses are standing around and anesthesia is ready,” Schnabel said. “The doctor was ready. The NICU team was there, and I was in a gown with all my jewelry off and an IV going within a matter of probably four minutes. It was very fast.”

The couple knew something was wrong but they had no idea how serious it was.

“Everything happened so fast that it was hard to understand the severity,” Massey said.

Rogan was born at 5:25 p.m., a little more than two hours after Schnabel met her colleague for that impromptu ultrasound.

Schnabel and Massey were able to see their newborn for a few brief moments before he was whisked off for care. Around 8:30 p.m., Cook Children’s Teddy Bear Transport arrived at Hendricks Hospital to transport Rogan to Cook Children’s Medical Center – Fort Worth for treatment of his dangerous heart arrhythmia.

Collaboration Counts

Schnabel’s on-the-fly ultrasound that fateful Thursday set in motion a number of collaborative efforts between pediatric specialists that resulted in an accurate diagnosis and treatment plan, and much of it came together during the couple’s short walk from Dr. Dunn’s office to the hospital.

“It's a reassurance to know that they're in sync with one another to be able to communicate so quickly and get an accurate specialty-type diagnosis within five minutes of the scan,” Massey said.

After connecting the dots between Rogan’s unusual heart rate, the ultrasound, monitor readings and the report from her nurse practitioner, Dr. Dunn made an urgent call to Lisa Roten, M.D., a pediatric cardiologist at Cook Children’s Medical Center. Dr. Roten is the medical director of Cook Children’s fetal electrocardiography program. Scott Pilgrim, M.D., medical director of Cook Children’s adult congenital heart disease program, was also looped into the case.

“There's constant collaboration between us, but in this case, it was just so seamless and easy and I was able to orchestrate the management plan between Dr. Roten and myself, and then Dr. Pilgrim became involved as the handoff happened from here to the medical center in Fort Worth,” Dr. Dunn said. “There was also so much collaboration with the Hendricks Health staff, with anesthesia, the nursing staff and the neonatologist.”

Dr. Roten recommended an immediate c-section for any chance of saving Rogan’s life.

“SVT, or atrial flutter in this case, is not life-threatening if for a short duration,” Dr. Roten said. “However, if it does not break, as was the case here, it results in death. This baby’s heart function was very poor and we did not have time for medicines to be given to mom to try to correct the rate.”

Undetected arrhythmias are the suspected cause of many stillbirths where there is no known genetic syndrome or structural problem, according to Dr. Dunn. If the sequence of events had been any different, Dr. Dunn says it’s likely Rogan would not be alive today.

“I think a lot goes into Rogan’s story,” Schnabel said. “I had the sonogram on that specific day and at that specific time when my coworker had an opening on her schedule and I could have her scan me, and the fact that his heart did what it did at that exact moment is proof that he is here for a reason. We were able to go to labor and delivery and have him within 15 to 20 minutes of showing up and the OR team was ready. Every little thing had to happen for him to still be alive. Through it all I was reminded I’m not in control, God is. This was his plan, not mine. The progress we’ve made over the past few weeks has been from above and I’m thankful for every moment.”

It’s unclear what caused Rogan’s arrhythmia, as is the case with many babies who develop the condition. Rogan spent 19 days in Cook Children’s Neonatal Intensive Care Unit where he was diagnosed with a type of SVT known as atrial flutter, in which the upper chambers of the heart pump rapidly. He underwent two cardioversion procedures to shock his heart back into a normal rhythm and is now on medication to control his heart’s pumping function.

It’s possible he’ll grow out of the condition altogether. If not, he may need a cardiac ablation in the future. An ablation is a procedure where doctors burn or freeze tiny scars into the heart to block irregular electrical pulses so that the heart stays in a normal rhythm.

“The electrical system of a newborn is immature and most babies outgrow the arrhythmia by one year of age,” Dr. Roten said. “But this rhythm was harder to control and sometimes they need to go to the cath lab to have an ablation.”

For now, Schnabel and Massey, are back home in Abilene with their newborn enjoying their full house, which includes Rogan’s brother and sister, both 10 years old.

“I'm just thankful for the support that we've had from the community,” Massey said. “Our friends and family have been overwhelmingly supportive.”

 highlights the region’s best physicians as chosen by their peers. Votes are tallied and sorted by the editorial staff, and the remaining votes are vetted by an anonymous panel of esteemed doctors.

Join us in congratulating the following doctors who were honored last week: 

• Lauren Akers, D.O.
• Mouhammed Alwazeer, M.D. 
• Anthony Anani, M.D.
• Kanika Bowen-Jallow, M.D.
• Amy Brenski, M.D.
• Pamela Burg, M.D. 
• Damien Campbell, D.O.
• Celina Cepeda, M.D.
• Lily Han, M.D. 
• John McClay, M.D.
• Sireesha Mutyala, M.D. 
• Sandra Peak, M.D. 
• Nicole Pitts, D.O.
• Brittney Pryor-Craig, M.D.
• John Robertson, M.D.
• Nancy Taneja, M.D.

We are so grateful for our doctors who work tirelessly every day to make a difference in the lives of patients and families.

To view the full list of 2022 Best Doctors and Pediatric Specialists.

But spend some time in one of those rooms and you will see a big part of the child life specialist’s job is to help patients through tests and procedures, as well as coping with any life changes they may face. Even though NICU patients are tiny, child life specialists still play a vital role in not only providing support and stimulation for the child, but for the whole family.

“A lot of our parents need support during this time,” said Lauren Bridge, one of two child life specialists in the NICU. “In a way, it's a loss for them because they didn't have the pregnancy they expected. If they delivered early, they may have never had some of the experiences they anticipated.”

With the young patients, Bridge says she tries to focus on infant development and milestones. She and the other child life specialist, Lisa Pool, are always looking for ways to foster development, which could mean putting a mobile over the infant’s bed, making sure the lights are turned down or even just talking to them.

The other huge role they play is working with siblings. Often, parents aren’t sure whether or not they should bring their other children into the NICU. Bridge encourages NICU parents to include siblings in the baby’s care, though she says regressive behavior is common, especially among preschool age kids. This can mean wetting the bed even though they are potty trained, becoming clingier or refusing to sleep in their own bed. Child life specialists are there to help families navigate this stressful time and help siblings understand what is happening to their little brother or sister.

Ultimately, Bridge says she hopes she can help make NICU families’ time at Cook Children’s a little better.

“The best part of my job is seeing families become increasingly comfortable in the NICU and being an integrated part of their child’s care.”

Don’t be confused though. Julia and her dog, Journey, have a big responsibility at Cook Children's. Yes, they are there to play, but their mission is always to give patients and their families a sense of normalcy during a stressful time. From visiting children in their hospital rooms to supporting them during procedures, child life specialists, like Julia, help patients cope with what they are experiencing while giving them a sense of control.

"My favorite part of the job is being able to help children overcome their anxiety. It's incredible to watch something that was really scary to a patient at first become no big deal," she said.

If you've ever been to Cook Children's Medical Center, you may have seen Julia or others in child life shooting Nerf guns in the hallways, painting with patients or taking a golden retriever for a walk. Their jobs are fun, but also very important. They help educate, prepare and support children through tests and procedures. They are specially trained to speak to each child on his or her learning comprehension level.

"When I was a freshman in college, I couldn't decide whether I wanted to become a nurse or a teacher," said Julia. "Then a family friend was hit head-on by a drunk driver."

That friend was 9 months pregnant. Both survived, but the baby had a stroke and required extensive time in the hospital. It was a child life specialist who was called in to help the baby's older sibling during the family's difficult time.

"Helping siblings feel included is a big part of what we do," said Julia. "After I learned about child life, everything fell into place. For me, it was the perfect combination of medicine and child development."

She went on to get a bachelor's degree and become a certified child life specialist, taking a position with Joe DiMaggio Children's Hospital in Hollywood, Florida. In 2009, Julia packed her bags and took off for Texas where she would soon find her calling.

"I wanted to have Journey with me because I've seen the difference these dogs make," she said. "We visit a lot of patients with serious illnesses and it helps them open up. For some reason, when they are petting a dog they will start talking about things that they haven't mentioned before."

Journey not only accompanies Julia during her 8 hour shift, she also lives with her.

"In the morning, I put her vest on and she knows it's time for work. But at the end of the day, she rests and plays just like a regular dog," she said.

There are four certified therapy dogs at Cook Children's and more than 50 staff members in the child life department. Their roles range from specialists like Julia to music therapists, artists, educators and even clowns. It's one of the largest child life departments in the country and a vital part of Cook Children's promise to improve the health of every child in our region, by giving patients and their siblings the opportunity to be who they are first and foremost, kids.

One of the tops reasons is that younger kids are doing more than their growing bodies can withstand. Children are no longer just playing outside for fun. They are playing at a higher skill set than in the past, often times with parent coaches who aren’t formally trained to stretch their players in the correct manner. Make sure your young athlete stretches for his or her game.

Other causes of injury include weakness to the gluteus medius, loose joints, tight muscles, decreased balance and motor control and coordination.

I’ve spent the first two paragraphs talking about the injuries, but I actually feel the ACL has gotten a bad reputation because it’s a very important ligament that allows an athlete to run, jump and cut. Many non-contact ACL injuries can be avoided if athletes understand the issues that lead to ACL tears.

If you have a child who is an athlete, it’s important to know the proper way to stay safe during athletics and preventing ACL injuries. Below are 6 steps to preventing an ACL injury.

1.Strengthen your gluteus medius - The gluteus medius (located in the buttocks) weakness are common culprits in ACL injuries. This is one of the muscles that stabilizes your hips and in terms of ACL injuries prevents the knee from pointing too far inward when landing during jogging, hopping or cutting. A good way to know if this muscle is working the correct way is to watch the knees while performing squats or single leg squats. If the knees point inward past the inside of the ankle, the athlete may have weakness in his or her gluteus medius. To strengthen the gluteus medius, the athlete should perform exercises that cause his or her hip to come away from the body such as side steps, clamshells, or side lying leg raises.

2.Strengthen your hamstrings- Another important thing that should be looked at is the strength of the hamstrings (large muscles at the back of your thigh) in relation to the quadriceps (large muscles at the front of your thigh). When the quadriceps are significantly stronger than the hamstrings it can pull your tibia (shin bone) too far forward causing stress on the ACL. This is common with female athletes.

3.Stretch your quadriceps- When the quadriceps (large muscle on the front of the thigh) is too tight, it is similar to them being stronger than the hamstrings. It creates a forward pull on the tibia (shin bone). To stretch this muscle, grab the shin to bend the knee and hold it for 30 seconds repeat this 3 to 5 times. Make sure your young athlete stretches when he or she has been active. Stretching when not warmed up, is not as effective.

4.Work on your balance- Balance is another important part of any injury prevention program. People often think that their balance is poor but do not realize that it can be improved. Children who can’t stand on one leg for 1 minute without placing their toe to the ground, need to work on their balance. Have your child practice standing on one leg for a minute. Once this becomes easy, have your child try doing this with his or her eyes closed. For safety, always make sure your child has something steady to grab onto if he or she starts to lose balance.

5.Strengthen your core- Like the gluteus medius, the core assists with control of legs when athletes are active. It is important to have good control if you are an athlete. There are many ways to strengthen the core but some examples are planks, side planks and/or exercises on a stability ball.

6.Wear good shoes- Proper shoes are especially important if your child has flat feet. Shoes that are too flexible or without arch support may cause an increased risk of injury. If your child has flat feet ask the shoe salesman for shoes that help with control to help prevent injuries.

Following surgical repair, ACL injuries require 6 to 9 months of rehabilitation. However, athletes can prevent non-contact ACL injuries by strengthening their muscles properly, having a good stretching routine, working on balance, and wearing supportive shoes. Although it is important to properly maintain all leg muscles these are six of the most important ways to prevent an ACL injury.

SPORTS resources

• Anterior knee pain
• Top 10 questions parents have about sports injuries
• Injury Prevention Guide
• Strength training in children/adolescents
• Core beliefs
• Young athlete's injury prevention guide
• Strength training in children/adolescents (5-15 years)
• Rise of overuse injuries in school-age athletes
• The basics of sports injury prevention for kids
• When growing pains are not growing pains
• Preventing children's sports injuries
• Pain that won't go away

Oosthuizen said he was closing the bathroom door Tuesday morning at the place his family is staying for this week's Crowne Plaza Invitational at Colonial. Sophia was on the other side.

"Her finger was on the side of the hinges," Oosthuizen said. "It nearly cut off the finger completely."

Oosthuizen rushed his daughter to the emergency room at Cook Children's, which is located in Fort Worth and is the primary charity for the Crowne Plaza Invitational.

At the hospital, they met with Dr. Pamela Sherman, an orthopedic surgeon and hand specialist. She explained that it was important to repair the nail bed on Sophia's finger and give the new nail a chance to grow in order to save the finger. Dr. Sherman then performed the surgery.

"It was a scary moment," Oosthuizen said. "It was Sophia's first time under anesthesia. You never know what's going to happen.

"Dr. Sherman was great. ... She told us it's important to have the proper people doing it, and they have some of the best there."

Sophia will go to Cook Children's on Sunday for a check-up before the Oosthuizens return home.

Louis Oosthuizen is grateful for the attention his daughter received at Cook Children's.

"If I'm in doubt ever to have any surgery or something for my kids, I'll fly in to see them," Oosthuizen said. "The way they handled it, the way they spoke to us and treated the kids -- it was amazing to us.

"I didn't even know there were hospitals like that."