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