The following case was developed in order to educate individuals regarding the use of complementary and alternative medicine (CAM) in the care of a child with a chronic condition.
The case is about Ruby, a 14 year old girl with spina bifida. She has recently moved to the Houston-Galveston area from McAllen and has just entered seventh grade. She presents to her holistic pediatrician with complaints of headache and back pain. The case seeks to demonstrate an integrative approach to three major issues - relief of pain and stress, management of a neurogenic bowel and bladder, and promotion of self-efficacy. The initial part of the case addresses the diagnosis and management of her acute issues. Subsequently, the case turns to more long-term promotion of wellness.

Ruby Rodriguez and her mother, Rose Rodriguez are Hispanic, from McAllen, Texas. They enjoy the strong supportive presence of Ruby's grandmother in their lives. Ruby's grandmother lives in Mexico and subscribes to traditional approaches to wellness and healing. Emphasis on cultural awareness and respect are highlighted in this aspect of the case.

Ruby and her mother go to the Internet for information on alternative approaches to the complications of her spina bifida. They encounter Pediatrician Kathi Kemper's model of integrative care - The Therapeutic Mountain. It is through their research via this model that they are able to work with the rest of the health care team in constructing an integrative, evidence-based approach to promoting Ruby's wellness.