A lot has changed since Joel’s first visit to the Ellis County Family Clinic in late April.

The 4-year-old is a little thinner and has a little less hair, but he still has a vivid imagination and can recite stories to anyone who will listen.

Sitting in the waiting room of the clinic, his mom, Debbie Sanchez, listens as makes up a story about his toy car as he pushes it across the table.

Unlike Joel’s first visit to the clinic, this one is more of a personal nature — an opportunity to say thanks to the pediatric nurse practitioner Sanchez credits with helping saving her son’s life. “I just thank God she was here,” she said, recalling the day in late April when Joel became lethargic and had difficulty eating.

With few health care options available, she turned to Gisela Nelson, a nurse practitioner who operates the Ellis County Family Clinic on Amanda Lane in Waxahachie.

Following Joel’s examination, Nelson ordered additional tests at Baylor Medical Center at Waxahachie, where doctors were able to diagnose Joel’s leukemia and refer him to Children’s Medical Center in Dallas, where he continues to receive oncology care and chemotherapy.

“I know she was just doing her job. But she was accessible and we were able to catch Joel’s illness just in time,” Sanchez said.

While Joel will continue to receive chemotherapy for at least the next 2-1/2 years, Sanchez said he is now in remission, although he still needs frequent blood transfusions to help boost his platelet count.

As Nelson (her patients call her Nurse Nelson) walks into the waiting room, Joel stops playing with his toy car and watches her take a seat next to his mom. Without prompting, he literally runs across the room and climbs into her lap.

“Well, hello there,” Nelson said, as Joel wrapped his arms around her neck and gave her a hug.

“You came to visit me in the hospital,” he said.

“Yes I did. I’m glad to see you’re feeling better,” she said.

“No owies today, OK?” Joel said, as he stared into her eyes, his face only a few inches from hers.

“No owies, I promise,” she responded. “I just wanted to see how you’re doing and say hello.”

The clinic

Nelson purchased the clinic in June 2006 from Betty Trask, who was closing the facility to return to hospital nursing.

Realizing a need in the community, Nelson said she “jumped in with both feet” in order to provide pediatric health care to children who often fall through the cracks.

“My practice is 100 percent Medicaid or cash,” she said, explaining that it is becoming increasingly difficult for families to find health care providers who accept Medicaid.

Too often, she said, families are forced to use the emergency room for routine illnesses or wait until their child’s condition becomes critical before obtaining treatment.

“Many of our Medicaid population believe their only option for health care is the emergency room,” she said.

Nelson explained that nurse practitioners serve as mid-level providers in the health care system. When working in conjunction with a physician coordinator, they are licensed to diagnose and treat patients, as well as refer those who need specialized care, as she did for Joel.

Most of Nelson’s patient visits are for common childhood illnesses and injuries — flu, colds, ear infections, sprains, et cetera.

She also handles wellness visits and can provide follow-up care, which isn’t always an option for patients being treated through the emergency room without a primary healthcare provider.

“I really try to take care of patients and keep them from falling through the cracks while maintaining quality health care,” Nelson said.

By utilizing the clinic for routine health care, she said, it helps reduce emergency room visits, which are more costly and taxing on the medical system.

“I firmly believe that everyone should have access to quality health care,” Nelson said. “That’s why I’m here. I truly love helping children and families.”

While her practice is growing, Nelson said there is still a large portion of the community’s Medicaid population that doesn’t know she’s here and available.

“The majority of my patients have very limited means,” she said. “All of our growth has been strictly through word-of-mouth. While we saw 171 children last month, I know that’s only a small portion of the children in our communities without private insurance.”

As a pediatric nurse practitioner, Nelson only treats children ages newborn-20.

“Every week I have adults who come into the clinic asking me to treat them and I have to turn them away. I only treat children,” she said. “As the practice grows, I would like to be able to bring in a nurse practitioner to handle adult patients — but that’s only if we’re able to grow the practice.”

Prior to opening her practice in Waxahachie, Nelson worked for 10 years as a nurse in the pediatric intensive care unit at Medical City Dallas before returning to school to obtain her practitioner’s license.

“It’s been a good year, but I still feel there are so many children that are in need of healthcare and that I can help — especially in our Hispanic community,” she said, as she introduced Esmeralda Medrano, a key member of her staff who also translates for families who only speak Spanish.

“Esmeralda does a wonderful job helping me communicate with families that only speak Spanish,” she added. “Our biggest need right now is getting the word out in the community. If you can help let folks know the clinic is here, I would be grateful.”

The Ellis County Family Clinic is open four days a week — Monday-Tuesday and Thursday-Friday, as well as one Saturday a month.

Currently, the pediatric clinic only accepts Medicaid and cash-pay patients.

The clinic is located at 201 Amanda Lane, Suite 200, across from the Waxahachie Department of Health and Human Services office and next door to the WIC office. While appointments are requested by calling (972) 937-1300, Nelson said she does serve all walk-in patients.

Joel

Grateful for the care and referral “Nurse Nelson” provided Joel, Sanchez called the clinic — as well as Nelson’s action — a great blessing.

“While the doctor’s at Children’s Hospital tell me that Joel’s prognosis is very good, he still has a long way to go,” Sanchez said. “He’s had to have nine blood transfusions to receive platelets and he will probably need another one in the next week or so.

“There are just so many people to thank, including all of the people who have donated the blood that Joel has received,” she added.

As Joel will continue to need blood, Sanchez is asking that members of the community who would like to help donate blood at upcoming community blood drives.

Carter BloodCare will conduct a blood drive Tuesday during Waxahachie’s National Night Out celebration in downtown Waxahachie. Sanchez said donors can designate their blood for Joel A. Sanchez when they donate.

Another community blood drive has been scheduled for Aug. 25 in the parking lot at Ellis County Diagnostic Clinic. During that drive, Sanchez is again asking members of the community to designate their blood for Joel A. Sanchez.

E-mail Neal at neal.white@waxahachiedailylight.com