Faculty Profile: Charles Mehlman, DO, MPH
"When you're a kid, it's your job to have fun."
A brachial plexus injury is a complicated problem that negatively impacts children and their quality of life. (Brachial injuries typically occur during the birth process, resulting from an excessive stretch of the brachial plexus nerve that results in incomplete sensory and / or motor function of the injured nerve.)
Significantly altering a child's upper-body function, brachial plexus injuries have historically been treated with minimal care. Focusing on that trend, Charles Mehlman, DO, MPH, pediatric orthopaedic surgeon at Cincinnati Children's Hospital Medical Center, along with other physicians, wanted to change that practice. "Based on early evidence, brachial plexus injuries looked like a good opportunity to change the outcome for kids," Dr. Mehlman says.
The Brachial Plexus Team at Cincinnati Children's strives to optimize a child's function at all different levels. "When you're a kid, it's your job to have fun," says Dr. Mehlman. Whenever faced with difficult decisions, Dr. Mehlman always tries to opt on choices that support this philosophy. He also carries this philosophy into his teachings to residents, where Dr. Mehlman offers this advice: "Imagine yourself in that situation with this being your child."
Building on the Practice of Family-Centered Care
"We build family-centered care into every visit," says Dr. Mehlman, "the strongest emphasis being at the beginning with family-derived goals for the child."
The Brachial Plexus Center team at Cincinnati Children's tailors its care for each child's needs based on population-wide outcomes and evidence. Dr. Mehlman and the other team members also ensure the care they provide is personal and patient-family focused, carefully considering the family's hopes and dreams. But providing personalized care sometimes means having to coach and guide families to what are and are not realistic goals for their children.
The team once treated a child with a badly injured right arm. This child aspired to someday be a right-handed pitcher. Though the child made significant improvement, right-handed pitching just didn't seem to be a realistic goal for his future. Wanting this child to reach his dreams, Dr. Mehlman and the Brachial Plexus team worked closely with the patient and his family to establish a more realistic goal: training to become a left-handed pitcher.
Striving to Raise the Bar
"Families of brachial plexus kids are often told, or have been told, 'Be happy with what you've got,'" says Dr. Mehlman. "We're constantly going for more function." But Dr. Mehlman doesn't take any patient decision lightly. "Making decisions for ourselves is easy, but we worry and fret over decisions we make for other children."
"We once had a parent whose wish was for her child to touch and fix her own hair," says Dr. Mehlman. "It seemed next to impossible at the time, but the team made it happen."
A parent's reaction to a child's improved function is one of the most rewarding moments for Dr. Mehlman. "I'm a big softie," he says. "When I see a parent and nurse start crying, I have to leave the room."
