All posts by Angelo Antoline

Treating Chronic Pain with Physical Therapy

We’ve probably all experienced the nuisance of minor pain. You get a sinus headache, you reach for a decongestant. A backache? Ibuprofen may do the trick.

But for people with chronic pain (it lasts longer than 6 months), the answer may not be as simple. That’s where physical therapy can help.

Physical therapy can help treat not only the pain, but the underlying cause of it as well. Physical therapy can help decrease pain, increase mobility, and improve overall mood.

There are a number of ways that a physical therapist can help a person manage pain depending upon individual abilities, including:

  • Low-impact aerobics
  • Massage
  • Stretching
  • Use of modalities like ultrasound and electrical stimulation
  • Strengthening exercises
  • Movement therapy

Therapeutic treatments are designed to help a person increase muscle strength, endurance, joint stability, and flexibility. In addition, it can help reduce inflammation, stiffness, and soreness. It encourages the body to heal itself by boosting the production of the body’s natural pain-relieving chemicals.

Now, that seems like a smart move!

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Weekend Warriors – Battle Potential Injuries

Are you a weekend warrior?

Check “yes” if you’re someone who’s physically inactive most of the week, and then approaches exercise on the weekend with the rigor of an elite athlete.

If this is your plan of action when it comes to exercise, you may want to rethink it. Weekend warriors have a higher risk of being injured – both because of overdoing it in a short amount of time and because of poor conditioning.

Reduce your chance of hurting yourself with the following:

  • Realize that exercise doesn’t have to be “all or nothing.” Look for ways to sneak extra movement into your day.
  • Increase activity gradually. The American Heart Association recommends 30 minutes of exercise a day, 5 days a week. Break this into smaller goals for yourself so you can attain it. If three 10-minute sessions are easier for you to accomplish, then do it.
  • The “best” time of day to exercise is whatever time works for you.
  • Start at a lower intensity, and warm up before beginning an activity.
  • With any sport or exercise, always learn and use proper techniques and follow safety guidelines.
  • Put your workouts into your calendar as appointments. Be sure to keep them.
  • Wear comfortable shoes every day that you can move about easily in no matter where you are or what you’re doing…and then move!
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Hospitals and Disasters

Are hospitals prepared for disasters?

The short answer is…yes.

All hospitals are required by laws, regulations, or accreditation requirements to plan for disasters.

Hospitals prepare for both internal and external disasters. Internal disasters are events that occur inside the hospital building like a fire, flood, or power outage and have potential to affect services.

An external disaster is one like Hurricane Harvey or Irma that occurs outside the hospital. This includes severe weather conditions, chemical incidents, or large-scale community accidents. In these situations, the disaster can affect the operations of the hospital or cause an influx of patients to a hospital, depending on the situation and type of hospital.

Every disaster is different. Hospitals prepare for a variety of situations through ongoing planning and practice. This helps everyone understand what to do and how to do it to ensure patients’ safety and well-being.

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Recognizing a Concussion

With fall around the corner, participation in football and other cooler-weather sports and activities will grow – along with the potential for concussions.

A concussion is a brain injury that’s caused by a blow or jolt to the head or body. Concussion symptoms can occur immediately or days/weeks later. Signs of a concussion can include:

  • Headache
  • Nausea
  • Dizziness
  • Blurred vision
  • Concentration or memory issues
  • Change in sleep habits
  • Feeling sluggish/”foggy”
  • Light sensitivity

Early treatment of the symptoms of a concussion may help speed recovery and prevent further injury down the road. If an incident occurs and you suspect a concussion, ask the person immediately and then again a few minutes later:

  • What day is it?
  • What month is it?
  • Repeat these words: Girl, dog, green (ask to repeat again a few minutes later)
  • Repeat the days of the week backward

If the individual appears confused and is unable to answer these questions, it could be a concussion.
End all activity and consult a physician immediately.

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Improving Multiple Sclerosis Symptoms through Rehabilitation

If you live with multiple sclerosis, rehabilitation can play an essential role in helping you function at your best.

From diagnosis on, rehabilitation specialists such as physical, occupational, and speech therapists can help with symptoms of the condition. These usually include muscle control and weakness – affecting the way you walk, move or talk.
Therapies that can help improve these issues include:

  • Physical Therapy – Physical therapists can evaluate and address how your body moves and functions. Therapists can help you with walking, mobility, strength, balance, posture, pain, fatigue, and bladder issues, helping to prevent unnecessary complications.
  • Occupational Therapy – Occupational therapists can help you with everyday activities to increase your independence, productivity, and safety. They can help you modify tasks, use adaptive equipment, and recommend strategies in the home and work place.
  • Speech Therapy – Speech-language pathologists can evaluate and treat any issues you may be having with speaking or swallowing. Some may also help with cognitive issues, which can affect your ability to think, reason, concentrate or remember.
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10 Early Symptoms of Parkinson’s Disease

Michael J. Fox was a 29-year-old actor who woke up one morning and noticed his little finger shaking. What he thought was a side effect of a hangover actually was an early symptom of Parkinson’s disease.

Parkinson’s disease is a chronic and progressive movement disorder that has no known cause. Nearly a million people in the United States live with the disease.

Some symptoms of the disease are easy to see, while others are hard even for a trained healthcare professional to detect.
The National Parkinson Foundation offers these 10 early warning signs of Parkinson’s disease:

  1. Tremor or shaking of a body part
  2. Small handwriting – your handwriting changes to become smaller
  3. Loss of smell
  4. Trouble sleeping
  5. Trouble moving or walking
  6. Constipation
  7. Soft or low voice – your voice changes to be softer
  8. Masked or serious look on your face even when you’re not in a bad mood
  9. Dizziness or fainting
  10. Stooping or hunching over

No one symptom necessarily means that you have the disease; the symptom may be caused by another condition. However, if you feel you are experiencing symptoms, don’t hesitate to visit your physician.

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Rehabilitative Care – It’s Not All the Same

When looking for rehabilitative care, you may have heard of inpatient rehabilitation hospitals, assisted living centers, skilled nursing facilities, and nursing homes. While these may seem like equal choices for care, they’re not.

Each of the facilities mentioned above has rehabilitation professionals on staff, but only one – the rehabilitation hospital – specializes in rehabilitation, offering 24-hour rehabilitative nursing care, along with daily physician management and intensive rehabilitation therapies.

So, why is this important?

Simply put, when it comes to your health, you want the best option provided.

A national study commissioned by the ARA Research Institute shows that patients treated in inpatient rehabilitation hospitals have better long-term results than those treated in skilled nursing facilities.
The study shows that patients:

  • Live longer
  • Have less hospital and ER visits
  • Remain longer in their homes without additional outpatient services

In addition, patients in the study:

  • Returned home from their initial stay two weeks earlier
  • Remained home two weeks longer

So the bottom line is, as a patient, you get to choose where you want to go. Don’t ever hesitate to research, observe and ask questions about a facility to be sure you receive the level of rehabilitative care that you want and need.

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Lower Your Stroke Risks this Summer

Summer is a great time for a lot of things – barbecues, outdoor activities, vacations…but what you may not think about when it comes to summer is using all it has to offer to lower your stroke risks.

Strokes – or brain attacks – are the leading cause of adult disabilities in the United States, and can happen to anyone at any time. According to the National Stroke Association, nearly 800,000 people experience strokes every year.

One of the biggest myths regarding strokes is that they can’t be avoided. But in reality, nearly 80 percent of all strokes can be prevented by controlling lifestyle risk factors, or habits that we engage in that can be changed to improve our health.

Summer provides easy-to-find opportunities to lower stroke risks, such as:

  • Buy and eat fresh produce. Visit your local farmer’s market or grocery store to find in-season, fresh fruits and vegetables. Eat them in their natural states.
  • Eat less salt. Eat fresh vegetables versus canned items, and your salt intake will decrease.
  • Visit the beach. Eat more seafood (at the beach or not) instead of red meat.
  • Enjoy the outdoors. Get active outside during the warmer and longer days.
  • Put the cigarettes down. Summer usually is less stressful. Use it to your advantage to try to break the habit.
  • Shoot for your healthy weight. Healthy eating and activities may help you reach a healthy weight (if you’re not already at it).
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Rostron Named New Nursing Director

Nicole Rostron has been named the new director of nursing at Rehabilitation Hospital of the Northwest.

Rostron has held numerous management and leadership positions as a registered nurse, most recently serving as nurse manager at a rehabilitation hospital in Arizona. She also has served as a charge nurse in a mixed medical-surgical-telemetry and progressive care unit, as well as inpatient rehabilitation and in-home settings.

Rostron earned a a bachelor’s degree in nursing from Grand Canyon University in Phoenix, AZ, and an associate’s degree in nursing and science from Pima Community College in Tuscon, AZ. She also holds a certification in neuroscience nursing.

Rostron has been an expert lecturer and speaker at the Association of Rehabilitation Nurses National Conference. She is the member of the Association of Rehabilitation Nurses, the American Association of Neuroscience Nurses, and Sigma Theta Tau, an Honor Society of Nurses.

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After a Stroke — Finding the Right Words

It’s common to struggle at times to find the right word during a conversation. But for an individual who has had a stroke, finding the right word may be much more difficult.

Aphasia can be a side effect of a stroke, which can affect a person’s ability to communicate by impairing the ability to speak, read, listen or write. When a person with aphasia has word-finding difficulty, it’s called anomia.

Anomia makes it difficult to find the words or ideas that a person wants to share. Sometimes the word may come, and sometimes it won’t.

When this happens in a conversation, the person who is speaking to the stroke survivor may want to jump in quickly to supply the word. But in reality, that can be more of a hindrance than a help. It would be more beneficial to help the person find the word they are looking for rather than supplying it.

So, how can you best communicate with someone under these circumstances? Here are a few suggestions:

  • Allow plenty of time for a response. Talk with the individual, not for him or her.
  • Ask “yes” or “no” questions that can be answered simply and without a lot of explanation.
  • Use photographs or pictures to help provide cues.
  • Write your cues – such as a letter or a drawing – on a piece of paper to share.
  • Confirm and repeat back what the person has said. Use paraphrases or key words to be sure that you’re understanding properly.
  • Use gestures as you ask questions.
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Act FAST and Save a Life

FAST is an easy way to identify the most common symptoms of stroke:

F – Face drooping. Ask the person to smile. Note if one side of the face is drooping.
A – Arm weakness. Ask the person to raise both arms to the side. See if one drifts downward.
S – Speech difficulty. Ask the person to repeat a simple phrase. Listen if the speech is slurred or strange.
T – Time to call 911. If you observe any of these signs, call for help immediately.

Take note of the time of the first symptom so you can tell medical personnel because this can affect treatment decisions. Rapid access to medical treatment can make a difference between full recovery and permanent disability.

Other symptoms of a stroke also may include sudden onset of:

  • Confusion, trouble speaking or understanding what someone is saying
  • Numbness or weakness of face, arm or leg – especially on one side of the body
  • Trouble seeing out of one or both eyes
  • Severe headache with no known cause
  • Trouble walking, dizziness, loss of balance or coordination

Even if you’re unsure if someone is having a stroke, don’t delay in calling 911 to get the person medical help immediately.

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Free Community Stroke Awareness Fair

The community is invited to a free Stroke Awareness Fair at 1:30- 4 p.m. on Wednesday, May 24 at Rehabilitation Hospital of the Northwest.

Individuals attending the event will learn more about strokes and how they can affect you or a loved one.
All-day activities will include:

  • Stroke risk assessments, including blood pressure testing
  • Diet and nutrition education
  • Stroke education, including prevention and warning signs
  • Information from local medical centers and clinics
  • Free healthy snacks, and more.

Presentations will include:

  • 1:30 p.m. – “Heart Health and Stroke Prevention” by Dr. Madeleine Geraghty, Stroke Hospitalist at Deaconess Hospital and Rockwood Neurology Center
  • 3:30 p.m. – “Life After Stroke – Returning Home” by Jennifer Plummer, Physical Therapist (MS, MPT, LVT) and Team Lead at Kindred at Home

For more information, call 208-262-8700 or email stephenchun@ernesthealth.com.

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Don’t Have a Stroke

Dick Clark. Sharon Stone. Rick James.

When you think of these celebrities, you probably think of their talents. What you probably don’t realize is that each suffered a stroke.

Strokes – or brain attacks – can happen to anyone at any time. Strokes are the leading cause of adult disability in the United States, and the fifth leading cause of death.

According to the National Stroke Association, about 800,000 people suffer from strokes every year. What’s notable, however, is that nearly 80 percent of strokes can be avoided.

Certain traits, conditions and habits can raise an individual’s risk of having a stroke. Many of these lifestyle risk factors can be controlled and may actually help prevent a stroke from occurring.

That’s good news, right? So, how do we lessen our chances of having a stroke?

We can start by controlling these lifestyle risk factors:
• High blood pressure
• Smoking
• Diabetes
• Poor diet
• High blood cholesterol
• Physical inactivity
• Obesity
• Heart diseases
• Alcohol consumption

If you think you can improve any of these lifestyle risk factors, do it.
The changes you make now may affect what happens – or better yet, what doesn’t happen – later.

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Inpatient Rehab Hospital improves recovery outlook for stroke patients

During the long and harsh winter, which required what felt like endless hours of snow removal and clean-up, Coeur d’Alene resident Greg Nelson had a stroke.

His wife Jane Nelson noticed something was not right after he spent a January afternoon clearing snow out of the driveway. She recognized the signs of a stroke and they immediately sought help, since quick action and treatment offer the best chances for survival after a stroke and recovery from stroke-related disabilities.

The effects of his stroke initially left Greg unable to walk, speak properly and more.

Jane Nelson knew that they needed to find the best therapy care around for his recovery.

Greg Nelson went to the Rehabilitation Hospital of the Northwest located in Post Falls, Idaho.

“The level of care at Rehabilitation Hospital of the Northwest matched the level of care that we needed,” Jane said. “Greg is a type-A, over-achieving and I knew he needed the intensity of therapy offered here for the fastest recovery possible.”

At the rehab hospital, Greg was assigned a care team that worked collaboratively together to get him home as quickly as possible, ensuring he could get back to the highest level of independence attainable. The care team for a stroke patient like Greg usually includes a case worker, doctor, nurses, physical therapist, occupational therapist and a speech therapist.

Greg was impressed all around with his entire team.

“They always made sure I did everything I was supposed to do. Even when I didn’t think it was something I was ready for yet, they knew exactly how to push me to just the right level. I am thrilled about my recovery,” he said.

The rehab hospital provides patients with 24-hour rehabilitation nursing care and daily physician management.

Greg Nelson had a private patient room and access to well-equipped therapy areas. The therapy areas include a 2,360-square foot therapy gym with private treatment rooms, a heated aquatic therapy pool with an electric lift, and a therapeutic courtyard to allow practice on different terrains such as ramps, stairs, gravel, dirt, curb, curb cut-outs, and wood decking.

“My favorite therapy exercises were the arm bike and the stairs,” he said.

He worked with his team in these state-of-the-art therapy areas every day during his stay. His occupational therapist Melissa Ching focused on self-care goals that would help get him home and gain independence in activities.

“Greg is a hard worker. He was always dedicated to his therapy during his stay,” she said.

He also worked with Candice Frank, a physical therapist. With Greg’s stroke affecting his right side they focused on rebuilding and retraining it with forced use. She helped him stay safe and work at a safe pace for recovery.

“One of our goals is to help patients avoid falling, which can lead to other injuries. We also remind our patients and work with their family to help them know what to watch for when they return home,” she said.

Greg Nelson also worked with Cheri Rose-Kociela, a speech therapist. Her work covers more than just speech: memory, thinking process, actual speech production, language and swallowing.

“I didn’t realize that learning how to swallow properly again would be something that was part of therapy,” he said.

Most of the speech therapy is based on the patient being as functional as possible.

“Sometimes my work also includes teaching patients how to use tools like a smartphone as a memory device, setting alarms and using the calendar function,” Rose-Kociela said.

Most people don’t realize it, but stroke is the leading cause of serious, long-term disability in the United States. In fact, approximately 795,000 people suffer a stroke each year according to the American Heart and Stroke Association.

About 610,000 of these are first attacks, and the rest are recurrent attacks. While strokes can happen at any age, research shows that nearly three-quarters of all strokes occur in people over the age of 65. The risk of having a stroke more than doubles each decade after the age of 55.

The American Stroke and Heart Association released new guidelines strongly recommending that stroke patients be treated at inpatient rehabilitation facilities. The guidelines highlight the effective and important aspects of rehabilitation from an inpatient rehabilitation facility, including:

• Patients participate in at least 3 hours of rehabilitation a day from physical therapists, occupational therapists, and speech therapists
• Nurses are continuously available
• Doctors typically visit daily

The guidelines advocate for patients to go to inpatient rehabilitation hospitals because there is considerable evidence that patients benefit from the team approach in facilities that understand the importance of rehabilitation during the early period after a stroke.

Greg Nelson’s stay at Rehabilitation Hospital of the Northwest was only about two weeks. He made great strides in gaining back his ability to walk, speak and perform self-care activities independently.

In fact, he walked out of the rehab hospital using a walker; and now several months later he only needs a cane when out and about.

“But I can walk around the house without one.” His wife Jane is happy to see him smiling again and getting back to his usual self. Greg notes, “I’m even back to walking the dog now.”

(photo) Greg and Jane Nelson visit Rehabilitation Hospital of the Northwest. Greg was a patient there following a stroke in January.

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Rehabilitation Hospital of the Northwest Provides Nationally Recognized Care to Community for 3rd Year in Row

For the 3rd year in a row, Rehabilitation Hospital of the Northwest has been acknowledged for providing nationally recognized rehabilitative care to its patients. The hospital was ranked in the Top 10% of inpatient rehabilitation facilities nationwide for providing care that is patient-centered, effective, efficient and timely.

“This means that in the Inland Northwest area, we’re providing the highest level of rehabilitative care available anywhere in the United States right now,” says Dave Cox, CEO of Rehabilitation Hospital of the Northwest. “Patients and their families don’t have to leave the area to receive the latest in technology and clinical protocols – we’re providing it here in our own backyard.”

The hospital was ranked from among 781 inpatient rehabilitation facilities nationwide by the Uniform Data System for Medical Rehabilitation (UDSMR). The UDSMR is a non-profit corporation that was developed with support from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research. UDSMR maintains the world’s largest database for medical rehabilitation outcomes.

“This national ranking speaks highly of the commitment and dedication of our employees and medical staff,” Cox says. “Our staff is passionate about helping patients return home at their highest possible levels of productivity and independence. And for anyone who has ever as had a family member or friend needing healthcare, that matters. We consider it a privilege to be able to provide this higher standard of care to our community.”

Rehabilitation Hospital of the Northwest provides specialized rehabilitative services to patients who are recovering from disabilities caused by injuries, illnesses, or chronic medical conditions. This includes strokes, brain injuries, spinal cord injuries, and amputations, along with illnesses such as cerebral palsy, ALS (Lou Gehrig’s Disease), multiple sclerosis and Parkinson’s disease.

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Rehabilitation Hospital of the Northwest helps stroke patients regain what was lost

Alan Golub was starting to feel depressed about his situation.

A stroke had robbed him of movement on the left side of his body and impacted his speech.
He didn’t know if he would be able to walk or continue with his artwork. The Hayden resident was determined to recover, but the seeds of doubt were growing.

Then his doctor got hold of Golub’s mandolin and asked him to play. Golub started playing the Frankie Laine song, “Ghost Riders in the Sky.” Notes filled the halls of the Rehabilitation Hospital of the Northwest in Post Falls. They were the sweet sounds of recovery.

“At first, I couldn’t move my left hand at all,” Golub said. “It sounded bad, but I never imagined being able to play again.”

The unusual approach of blending music with physical rehabilitation played a critical role in Golub’s recovery, said Dr. Neilly Buckalew, who assisted with Golub’s recovery.

“Musicians’ brains are wired differently,” she said. “The second

I found out he was a musician, I knew this would help him recover from the stroke and it did.”

Buckalew is a physiatrist, a medical doctor who treats a wide variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons, using an integrated approach to medicine. Her approach to pain management is different than most.

“I believe strongly in not prescribing narcotic pain medicine,” she said. “We have a real problem in this country with opiate addiction. The sooner we can move away from those prescriptions in a recovery, the better.”

Buckalew also ordered an aggressive regimen of physical therapy —- something Golub embraced with gusto.

“If they said two hours, I would do an extra four,” he said. “Every day I pushed myself.”

The 63-year-old has worn many hats over the years, including real estate broker, substitute teacher, graphic designer and musician.

Last year, Golub created a tribute poster to fallen Coeur d’Alene police officer Greg Moore. His artwork is featured with this sponsored content story.

In addition to his professional and personal accomplishments, Golub almost became a statistic. The Centers for Disease Control says that 795,000 people in the United States have a stroke every year and it estimates 130,000 die of strokes annually.

Alan Golub and his wife went to Northern Quest Resort & Casino on Jan. 23 and nearly cashed in all of his chips. Golub was going for a walk when he began to feel ill. He didn’t get far, collapsing in the hotel. Jim Shaeffer, one of the emergency medical technicians on staff rushed to his side. Golub’s blood pressure was sky high — 256 over 180 — and the EMTs believed he was having a stroke.

“I didn’t feel right and I knew that I was in trouble,” he said. “Luckily, they had EMTs on duty and they were able to get me to the hospital quickly. Ten minutes more and I would have lost my ability to speak; another 10 minutes and I might not be breathing today.”

Golub was treated at Sacred Heart Medical Center in Spokane and the preliminary diagnosis of a stroke was confirmed. He was paralyzed on the left side of his body and he had trouble speaking. Golub was admitted to the Rehabilitation Hospital in order to recover from the stroke.

“Alan is amazing,” Buckalew said of Golub’s recovery. “He’s 120 percent better than when I first saw him. He worked hard and he had a great attitude.”

Today, it would be hard to know Golub had suffered a stroke two months ago. He still walks with the assistance of a walker, but his speech and movement are normal. He is able to crack jokes and he appreciates life.

“I feel like I am totally healed,” Golub said. “I feel stronger every day. I am so grateful for what I have. The people at the hospital were incredible. I am a miracle.”

By MARC STEWART – Coeur d’Alene Press

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Making a person whole again

(photo) Dr. Neilly Buckalew and Dr. Tim Ferrell work at the Rehabilitation Hospital of the Northwest in Post Falls. They treat a wide array of patients and conditions with a holistic approach.

Physiatrists are medical doctors who specialize in nonsurgical-based approaches to medical conditions and disability.

Simple joys like holding hands and going for a walk in the park with your spouse are often taken for granted until you can no longer enjoy them.

Getting back what was lost is the top priority for the medical doctors at Rehabilitation Hospital of the Northwest in Post Falls — along with their team of rehabilitation specialists. Many patients come to the hospital after suffering a life-altering event, such as a stroke. One recovering stroke patient simply wanted to go on daily walks with her husband again.

“We brought her husband in and worked to achieve this goal,” said Dr. Tim Ferrell, who oversaw her recovery. “The damage from the stroke meant she couldn’t walk by herself again, but when she left the rehabilitation facility she was able to leave hand in hand, arm in arm with her husband.”

“The team found a way to accommodate her goals. That’s what we do best,” said Dr. Neilly Buckalew, Associate Medical Director at Rehabilitation Hospital of the Northwest. “We want people to get the most out of life. To not just survive a stroke or life-altering event, but to thrive.”

Ferrell and Buckalew are both physiatrists and a married team. Physiatrists can be pronounced zz-EYE- uh-trist or zz-ee-AT-rist (not be confused with psychiatrists or podiatrist). Physiatrists are also known as doctors of Physical Medicine and Rehabilitation. The specialty has been around since WWII starting with Dr. Howard Rusk who rehabilitated soldiers, notably amputees. The specialty has grown from there, treating a wide variety of medical conditions and physical disabilities, including stroke, traumatic brain injury, spinal cord injuries and joint replacements. They also treat neurological disorders, such as Multiple Sclerosis or Parkinson’s Disease.

They are experts trained in evaluating, treating, and completing comprehensive, patient-centered treatment plans to maximize meaningful function and quality of life. Physiatrists work in both inpatient and outpatient settings.

Functional exercise is a principal tool at the Rehabilitation Hospital.

“Exercise really is the best medicine,” said Buckalew. “It solves so many things. That combined with good nutrition. We have an amazing nutritionist that we work with closely here.”

Added Ferrell, who is the Medical Director of the Rehabilitation Hospital: “We really like that it’s a team effort. We’re the coordinator and facilitator of care, but the patient is the leader of the team. Their goals are our priority.”

Ferrell, who attended medical school and completed his physical medicine and rehabilitation residency training at the University of Missouri, said his interest in sports medicine and his initial career in physical therapy ultimately led him to the eld of physiatry and the passion for working on patient care as a team.

One of the things that makes physiatrists different in the health care system is that they strive to nd nonsurgical solutions to complex medical problems. It’s a holistic approach which attracted Buckalew to the profession. She trained at both Mayo Clinic — where she met Tim — and the University of Pittsburgh Medical Center.

Buckalew deepens that approach at the Rehabilitation Hospital with her training and expertise in integrated and naturopathic medicine, making the healing process at the Rehabilitation Hospital unique.

Buckalew believes many patients, especially older adults, suffer unnecessary injuries (broken hips, arms, legs) from falling down as a result of being over medicated for pain.

“We have a well-documented epidemic when it comes to opiate addiction in this country,” she said. “It’s really sad when you have elderly people who have become drug addicts. They certainly didn’t start off that way. We’re working hard to reverse that situation, but it isn’t easy.”

Buckalew and Ferrell appropriately wean their patients off painkillers and other sedating medications, despite tremendous pressure from some patients and their families.

“On the rst day one of my patients was here, her daughter came to me and said, ‘I really think Mom needs more pain medicine,’” Buckalew said. “We try to help families and patients understand to completely eliminate pain essentially would result in a coma or death. Pain elimination is not possible in most cases. We don’t want anyone to suffer. We are trying to create a paradigm shift to ‘comfort management’ with the patient being an active participant in learning how to function and manage their comfort. It’s about being able to live a full life using as many tools as possible.”

Comfort management is challenging but can be achieved using multiple modalities, such as physical therapy, pool therapy, using heat and ice, electrical stimulation, deep breathing techniques, positive thinking.

“This is what we do best, and with much success,” said Buckalew, who is also developing a yoga-based program for stroke recovery at the hospital. “What we’re doing here, you won’t nd anywhere else in the country. Our integrated approach surpasses what is traditionally seen in rehabilitation using the best evidence.”

Buckalew is passionate about breaking the cycles of addiction. She points to a patient she treated during her training who was addicted to methadone as a prime example of the over-reliance on pain medicine. The patient had suffered a serious back injury 30 years prior and had become so addicted to pain medications, she eventually turned to heroin. In order to treat that addiction, she was given methadone.

“Part of what we do as physiatrists is look at the underlying cause of something,” said Buckalew. “Her chronic pain is what caused the substance abuse issues. She was morbidly obese. She wanted her life back but didn’t know how. We showed her a different way and got her off methadone. She was able to get in the pool and exercise of which was her top goal.”

Anyone can be seen by a physiatrist in the outpatient or inpatient setting. For the inpatient setting to be evaluated for potential inpatient care you only need to have a referral from your primary doctor, said Buckalew.

“You can come from home. You don’t have to be in a hospital facility or any kind of facility,” she said. “We can really help people with chronic pain or other issues that may have caused a decline in function. You’d be amazed at the difference we can make in people’s lives and getting them back home or into the community, living their lives.”

By MARC STEWART – Coeur d’Alene Press

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Patient Outcomes Exceed National Average

Rehabilitation Hospital of the Northwest exceeds national benchmarks in patient clinical outcomes.

The benchmarks, which are reviewed and provided by the Uniform Data System for Medical Rehabilitation, compare patient outcomes of rehabilitation hospitals throughout the nation.

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*The FIM™ instrument is a measure of disability that classifies patients by their ability to carry out an activity independently, set against their need for assistance from another person or device. The FIM™ instrument measures self-care, bladder/bowel management, transfers, mobility/locomotion and cognitions. Lower scores mean greater dependence.

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Case Mix Index: the acuity level of patients Average
FIM™ Change: difference between admission and discharge FIM™ scores
ALOS: average length of stay for patients in this impairment category
ALOS Efficiency: average FIM™ change per day
Discharge to Community: percentage of patients discharged to their homes

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Tim Ferrell, New Medical Director

Rehabilitation Hospital of the Northwest is pleased to announce that Dr.  Tim Ferrell has been named medical director of the hospital. Prior to joining our team, Dr. Ferrell practiced as a physiatrist at the University of Pittsburgh Medical Center in Pittsburgh, Pa.  He has fellowship training in pediatric rehabilitation and was a physical therapist prior to returning to medical school. 

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Monthly Stroke Support Group

The Rehabilitation Hospital of the Northwest hosts a monthly Stroke Support Group for stroke survivors in the region.  The support group is open to all community stroke survivors and their families; individuals need not have been a patient at Rehabilitation Hospital of the Northwest to participate. The group has  guest speakers from around the area with discussion topics focused on physical therapy, occupational therapy, speech therapy services and a variety of post stroke health and wellness topics. 

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