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Recognized Among Top 10% in the Nation

Rehabilitation Hospital of the Northwest has been named in the Top 10 percent of inpatient rehabilitation facilities in the United States for the 4th year in a row. The hospital’s care was cited as being as being patient-centered, effective, efficient and timely.

“We strive to deliver this higher level of care as our standard,” says Jennie Pipoly, Chief Operating Officer, Rehabilitation Hospital of the Northwest. “We have graciously been recognized as a top performing facility for many years now, but we never take it for granted.”

“Our staff is exceptionally passionate about helping patients reach their full potential through the care we provide,” says Maureen Fakinos, Interim CEO and Senior Vice-President of Operations. “We work daily to ensure patients are reaching their highest levels of ability and independence.”

Rehabilitation Hospital of the Northwest was ranked in the Top 10 percent from among 870 inpatient rehabilitation facilities nationwide by the Uniform Data System for Medical Rehabilitation (UDSMR), a non-profit corporation that was developed with support from the U.S. Department of Education, National Institute on Disability and Rehabilitation Research. The UDSMR maintains the world’s largest database of rehabilitation outcomes.

“If you take into account that a national study has previously shown that inpatient rehabilitation facilities provide better long-term results for patients, being ranked at the top of that group validates the quality of care we provide,” says Dr. Steve Foster, Associate Medical Director for  Rehabilitation Hospital of the Northwest, referencing a study commissioned by the ARA Research Institute that showed patients treated in inpatient facilities experienced improved quality of life as compared to skilled nursing facilities.

“To provide the highest level of rehabilitative care available to our own community is truly rewarding,” says Dr. David Duba, a physical medicine and rehabilitation physician at the hospital.  “This means our family, friends, and colleagues don’t need to leave the area to receive this level of care.”

Through the UDSMR, Rehabilitation Hospital of the Northwest also will collaborate with peers throughout the nation to share information and establish best practices for patients. “This helps elevate rehabilitative care for everyone across the United States,” Duba says.

Rehabilitation Hospital of the Northwest provides specialized rehabilitative services to patients who are recovering from or living with disabilities caused by injuries, illnesses, or chronic medical conditions. This includes, but is not limited to, strokes, brain injuries, spinal cord injuries, orthopedic injuries, cerebral palsy, ALS (Lou Gehrig’s Disease), multiple sclerosis, and Parkinson’s disease.

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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.”

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(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 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.”

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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.”

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By MARC STEWART – Coeur d’Alene Press

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