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Deborah Howell (Host): Welcome to our series About Your Health. I’m Deborah Howell and we all know someone who has had surgery and then blew off doing the physical therapy or speech therapy afterwards. Because it just seemed like it might be too hard, or they didn’t think that they had the time. You know, the usual excuses. Well today, I have two experts with me to tell us why therapy is so doggone important and where you can go to get expanded physical, occupational, speech and pediatric rehabilitation in the Sauk Valley.

Geoff Wright is a Doctor of Physical Therapy, an Orthopedic Clinical Specialist and Speech Therapist at CGH Rehab Services at CGH Medical Center. Nolan Wolfe is a Doctor of Physical Therapy and Physical Therapist at CGH Rehab Services at CGH Medical Center. So, Nolan, let’s start with you. What is occupational therapy?

Nolan Wolfe, PT, DPT (Guest): Occupational therapy, it really covers a wide spectrum of the rehabilitation area. It helps people across a wide – their lifespan, really helping them adapt back to their environment. focuses a lot on kind of the dexterity of the upper extremities as well as kind of their participation in what we call ADLs or activities of daily living such as grooming or getting dressed, feeding; that sort of thing.

Host: And who is a good candidate for physical rehab?

Nolan: Really any patient who could benefit from physical rehab or people who are struggling with their day to day sort of tasks. Whether it be pain, deficits in strength, mobility, balance, that sort of thing. Patients can respond well to just the physical exercises and physical activity that we can do with physical therapy.

Host: And of course, it’s all wrapped in the mind as well, physical stuff. So, what are some of the other challenges adolescents face who come to you for treatment?

Nolan: I’m sure there can be some sort of a stigmatism sometimes with adolescents coming in to physical therapy. But really, a lot of patients – a large amount of our patients are within that 18 and younger age group whether it be coming back from an ACL. There are research studies that show that there is kind of a fear avoidance or just a kind of a mental scarring what I like to call of getting back into return to play. So, there’s a lot of obviously psychological as well as emotional barriers to physical therapy when patients come in here.

By getting people back into their day to day sort of function, they are able to enhance their movement patterns and movement quality.

Host: I can definitely, definitely relate to that, having had the ACL surgery. You are kind of a different person for a little while. You are just more tentative, a little more scared and especially if you are an athlete; it’s like wow, do I really want to go at it as hard as I did before. So, what would you say to that?

Nolan: I think for a lot of patients; it’s really just being patient with your rehab process. A lot of people sometimes it is their first major injury and when it’s your first major injury, it can be a little bit intimidating rehabbing and focusing on specific movements and specific activation of muscles and then when you are starting to start to see the progress; do you really want to kind of get back into return to play and doing what all your fiends are doing and things like that. So, the big – being patient is the biggest key, knowing that there’s a timeline to our tissues healing in our body that we can do as physical therapists, promote that tissue healing as fast as we can, however, there is a limitation there.

Host: Absolutely. Now what do you actually do in a treatment session Nolan?

Nolan: So, with physical therapy here at CGH, we focus on 45 - 60 minutes of skilled care. That could be like I said, kind of graded exercises where we are kind of gradually increasing resistance or motion. We are doing hands-on techniques to improve mobility in certain joints or reducing pain. There are even therapeutic modalities that we will do such as electric stimulation, traction, ultrasound as well as even light dexamethasone which is an iontophoresis which can help with anti-inflammatories.

Host: So, tell me a little bit more about that, because that’s kind of new.

Nolan: So, iontophoresis has been around for a little while but it’s something that a lot of people don’t know about. What it is, is more of a topical kind of medication that we can do to do a localized kind of delivery of a medication under a doctor’s script for the delivery of that drug. And so what it does is to help kind of reduce any sort of inflammation around the area. That way they can move their arm or leg better with less pain.

Host: Got it. I have one more question for you and then Geoff, I promise to get to you. How involved is the family in a patient’s treatment program?

Nolan: I think the family has a large role to play. A supportive family or supportive cast can be all the difference in someone recovering well from an injury or having maybe a little bit more tougher time. When you have support at home, that will help you incentivize you to do your exercises at home, kind of be an active participant in your recovery process.

Host: Got it. all right Geoff, what’s the most common type of treatment you do?

Geoff Wright, PT, DPT, OCS, SCS (Guest): Well I’m actually a physical therapist just like Nolan is so, I do carry board certifications in orthopedic and sports medicine, so I tend to see more of the athletic and post-surgical patients but also treat common musculoskeletal injuries, chronic pain, vestibular dysfunction and even work a lot with sports concussions.

Host: That must be incredible to work on people who have concussions to get them back to their normal lives as much as possible.

Geoff: Yeah, I mean obviously, sports concussions is kind of one those growing things that’s out there in the media now. One preventing concussions, but then two when an athlete does sustain a concussion, making sure that they safely transition back to full academic activities and then eventually back to full sporting activities. So, working with a physical therapist can be beneficial especially in that transition back to sport.

Another provider group within our rehab facility is speech therapy and so, we have speech therapists here at CGH who also work with sports concussions and they deal with more of kind of the cognitive side of the dysfunction so, if athletes are having trouble with memory, concentration, maybe getting caught up on school work if they had some time out of school when the initial injury occurred; the speech therapy group can help with that too.

Host: What would you consider a successful outcome of a speech therapy?

Geoff: Well so, speech therapy is kind of a very unique population that those therapists treat. So, it’s more than just speech dysfunction. Obviously, they work with speech and language. Our speech therapy department here also performs swallow studies so, in patients who are like post neurological injury, if they are having trouble swallowing liquids or chewing food, the speech therapy group would help treat those dysfunctions.

Similar to the sports concussion, our speech therapists also work with memory care, cognitive care. They can help with dementia. Kind of a little bit of everything. So, in general, more than just speech therapy. But a good outcome I think for them would be on the speech and language side obviously improving one’s ability to communicate with others. On the swallowing side and feeding side, being able to maintain independence in those activities and lowering the risk of choking on either food or liquid. And then on the memory and cognitive side of things, just being able to once again, interact with family members or friends and speech therapy is really helpful in teaching people ways to kind of accommodate and little tricks to help with memory and some of those cognitive activities.

Host: So, some of the things that you do in a speech therapy session might involve what?

Geoff: Well I’m not actually a speech therapist. But I do kind of lead and coordinate the outpatient rehab side of things here at CGH. So, a lot of what speech therapy involves, in pediatric kids maybe working on how to enunciate or say different letters. In a geriatric population, an older population, it might be a patient who has just had a CVA, a stroke and they are working on swallowing or feeding. It could also be in that same population maybe working on voice or articulation.

We actually have a couple of speech therapists here at CGH who are certified in what is called LSVT LOUD and this is actually kind of – it’s a neurological rehab protocol that’s specifically geared towards neurological patients who may be dealing with Parkinson’s Disease. And so, a lot of the LSVT LOUD treatment focuses on really vocalizations, pronouncing words, trying to improve one’s ability to communicate with others. And it’s a pretty effective treatment that our therapists here use in that population.

Host: And what are some of the advantages of having speech and occupational therapy right there at CGH Medical Center?

Geoff: Well I would even go a little step further and say that having physical therapy, occupational therapy and speech therapy within our facility here at CGH, it builds on that comprehensive care. So, the nice thing about having all three disciplines within one facility is one, if you are a patient who is seeking care through rehab; you have access to the occupational therapists. Like Nolan said, they are going to deal more with maybe upper extremity fine motor skills. Physical therapy might seal with more lower extremity or kind of gross motor functional activities and then speech therapy in let’s say the instance of like a stroke or neurological injury or a concussion; they can deal with more of the cognitive, memory, voice and articulation.

So, being able to come to one facility, have access to all three providers or all three types of providers; it improves coordination of care, it improves our communication with referring providers and it really just builds on that comprehensive rehab network that we’ve tried to establish here at CGH.

Host: Sounds great. Nolan, what’s the best thing about your job?

Nolan: I think the best thing about my job is it’s very rewarding seeing patients get better. You are seeing them walk in at a time where typically, most patients who are going to physical therapy probably aren’t too happy to be there just because they are in pain or they can’t do what they love to do. So, when you get them back to the point where they are getting back into golfing, fishing, whatever the case may be; I think it’s really rewarding, and you can see the amount of improvement that they have made.

Host: There’s real relationships that form between the patient and their PT instructors or what Bill Clinton used to call their pain and torture instructors, their therapists. I just went through shoulder surgery and I had a year of PT and I am so grateful for all of you in that field that just bring you back from complete powerlessness, not even being able to hold a cup of coffee in your hand to full let’s get back on the hill and start skiing again. And we just want to thank you for all that you do.

Nolan: Well thank you. It’s absolutely a pleasure to be able to work with patients who are motivated and driven to get back into their daily life. You, yourself have known kind of where people start off in some instances when they come to therapy and obviously, you have seen the benefits the physical therapy can do for people.

Host: Well I do want to thank both Geoff Wright and Nolan Wolfe for all the good work they do for getting people back to their daily routines and living their best lives. We really appreciate it.

Nolan: Thank you so much for having us on. I really appreciate it.

Host: I’m Deborah Howell. Thank you for listening to CGH About Your Health. Head on over to our website at www.cghmc.com to get connected with one of our wonderful providers. Oh, and if you found this podcast helpful, please feel free to share on your social channels and be sure to check back in soon for the next podcast. Have yourself a fabulous day.