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Pediatric physiatrists work with medical specialists to help young patients “optimize the management of movement disorders” (photo courtesy Kapi‘olani Medical Center).

“PEDIATRIC PHYSIATRY IS A SPECIALTY THAT FOCUSES ON HELPING PATIENTS REGAIN FUNC- TION AND A QUALITY OF LIFE, DESPITE CHRONIC PAIN, WHICH WE ARE SEEING MORE IN CHILDREN, ADOLESCENCE AND YOUNG ADULTS,” SAYS DR. TAMARA ZAGUSTIN.

Pediatric physiatrists like Zagustin work with medical specialists to help young patients “optimize the manage- ment of movement disorders” that can make physical actions that we take for granted—such as walking, playing and even swallowing—painful.

However, Zagustin explains that physiatrists treat more than just chronic pain. They also deal with emotional, behavioral, mobility musculoskeletal, nerve, brain and social pain.

“My role is to optimize the medical management of patients so that they can be more independent in their daily activities and be able to enjoy life within their home, school and the community,” Zagustin explains.


She says that many of her patients have a history of cerebral palsy, stroke, brain injury, spina bifida, brain tumors, spinal chord tumors or injuries, neurological diseases, limb deficiencies, neuromuscular disorders or other conditions that challenge their mobility, ability to think or problem-solve, or cope emotionally and socially with their situation.

Kapi‘olani Medical Center’s pediatric physiatry team collaborates other specialists and health care providers within Kapi‘olani who care for children throughout the state.

Typically, Zagustin will work on a team of providers that may include physical therapists, Child Life staff, occupational therapists, speech therapists, social workers, case managers and more to help the patient and their family ameliorate the child’s quality of life.

“It is all about getting the body and mind to move and function as early as we can, safely, while we medically optimize the management of the patient,” she says.

Zagustin—who has specialized in physiatry since she started her first residency in Caracas, Venezuela in 1993— says that she believes in looking at the whole person when treating them, and that’s what attracted her to physiatry.

“I enjoy being holistic in my medical approach, looking at a person as an individual that has a body, has emotions, has a soul, is part of a culture and community, who has values and has a thought process that is unique to who they are,” she says. “The more medically complex the individual, the more comprehensive I have to be in order to best understand the individual patient…”

She enjoys working with patients, their families and her co-workers— including the support animals—on the journey of making a difference in her patients’ lives.

“At Kapi‘olani, we are constantly working hard to make the pediatric rehabilitation program here in Hawai‘i the best for the children, and we have a great team that is truly dedicated in trying to make a difference, no matter how medically, socially, emotionally or culturally complex or challenging the child and home environment may be,” Zagustin says.

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