Nick’s Story: A Clinical Care Manager’s Perspective- You can see how Nick’s bright smile always lights up the room. With his sweet smile, you would never imagine the challenges Nick has faced at such a young age. Nick was born with several disorders that eventually led to a tracheostomy and gastrostomy in 2011 when he was 2 years old. This is when PSA got a chance to meet this sweet little boy. Six years later, Nick has come a mighty long way. Nick continues to light up every room that he enters, and we at PSA are so happy to be a part of his life.