Transcription:
Specialty Rehabilitation Programs at Northwestern Medicine Marianjoy Rehabilitation Hospital

Melanie Cole, MS: Welcome to Better Edge, a Northwestern Medicine podcast for physicians. I'm Melanie Cole. Joining me today is Dr. Dennis Keane. He is a lead physiatrist with Northwestern Medicine's. Marion Joy Rehabilitation Hospital, and he's here to highlight the specialty rehabilitation programs at Northwestern Medicines Marion Joy Rehabilitation.

Dr. Keane, it's a pleasure to have you join us today as we get into this topic. Can you tell us what makes Northwestern Medicine's Marion Joy Rehabilitation Hospital? So unique.

Dr. Dennis Keane: Thanks for the questions. I'm a very lucky person. I've been able to work with Marianjoy my entire career spanning over 20 years. And Marianjoy is very unique. We have a tertiary care rehab hospital right in the western suburbs of Chicago right in Wheaton, Illinois. What makes it unique is we have a team approach to treating patients. We do advanced care of rehabilitation conditions. We treat brain injuries, spinal cord injuries, a variety of musculoskeletal conditions, pediatric conditions. We'll treat anywhere from infants to elder adults. And I think what's really unique about it is not just the people, but all the technology we have. We look at cutting edge research. We have cutting edge technology. We have highly trained physicians, nurses, therapists, and psychologists. And we really take that team approach to make sure we're successful with our patients. We know that rehab is more than just an exercise. It's really treating the mind, the body, and the spirit as well. So, we cover all those areas at Marianjoy.

Melanie Cole, MS: Very well said, and it is such a comprehensive approach. So, I'd like to start by talking about some of the programs that you have there. Tell us a little bit about the driver rehabilitation program. What does that involve, and what types of patients and conditions do you work with that would need a program like this?

Dr. Dennis Keane: Our program is a wonderful opportunity for people that want to get back to driving or be assessed for driving. Our driver's rehab specialty program is run by our occupational therapist. It's a state certified driving school. We have therapists that can assess people that have maybe driven before, but acquired a disability such as a stroke, a brain injury, a spinal cord injury, multiple sclerosis. We can even assess younger people that are just getting their driver's license for the first time and had a disability. We also can assess people that maybe as they age, have some impairments with their vision or hearing or cognition to make sure they're safe behind the wheel.

And the nice thing about our driver specialists, they're not just there to assess, but they're very inclusive. So, their job is also to kind of see what kind of modifications might help someone drive. Perhaps an amputee might need an adaptive gas pedal. Someone who's had a spinal cord injury might benefit from some hand controls on their car. And visual impairment, sometimes some adaptive mirrors might help them as well. So, it's not just doing the assessment, but it's also helping people get back to their independence so they get back on the road and do it safely.

Melanie Cole, MS: What an important aspect of that program is to maintain that independence and that by itself really helps to increase the quality of life for the patient for sure. Now, tell us about the wheelchair and positioning center and how does that benefit patients?

Dr. Dennis Keane: Yeah. Our wheelchair and positioning center is unique. We have certified therapists that will have someone in their clinic assess their needs. So, it's not just putting someone into a wheelchair. When people have a disability, we have to consider issues such as their breathing, their pain levels that they have, their muscle tone to make sure they fit properly. So, it's going to be not just a short-term solution, but a long-term solution to improve their comfort, their functioning and independence. Some of the devices we will prescribe for people sometimes is just a standing frame. So, someone that wants to be able to stand and prevent osteoporosis and work on their balance on their own, we can prescribe unique standing frames. We have unique gait trainers. People that maybe can't get up with a walker, there's different types of devices we can help them start learning how to walk. There's specialized bath chairs. There's unique wheelchair cushions. If someone is in a lot of pain or they have a wound, we can design and help prescribe specialty cushions to take the pressure off those areas. And also of our pediatric populations, we can help them get the appropriate car seats and strollers to help independence for our pediatric and youngest patients as well.

Melanie Cole, MS: What great work you're doing. It must be so rewarding, Dr. Keane. Now, what can you tell us about Marianjoy's onsite prosthetic and orthotic clinic? And how is that different than what other hospitals may offer?

Dr. Dennis Keane: Our prosthetic and orthotic clinic at Marianjoy is a wonderful and unique program in the sense that it combines not just a physician, but also a certified orthotist and prosthetist that's onsite, so our physicians can evaluate the needs for an orthotic or a prosthetic. If someone has lost a limb, it could be a lower limb, it could be an upper limb, help them get the right prosthetic to consider their medical conditions as well as their comfort needs. We can also help people that have prosthetics and braces, orthotics from many years ago to make sure we can update them, upgrade them, and make sure they're the appropriate brace for them. We have onsite adjustments to the braces. We can then refer to physical therapy and get people the therapy they need to use their new device in a safe way. Our physicians will also do followups to make sure the prosthetic is working or the brace is working, and adjust any type of issue that might come as they go forward.

Melanie Cole, MS: Wow. You do so much, Dr. Keane. It's just really is so comprehensive. Now, tell us about the Northwestern Medicines Aphasia Center at Marianjoy, and how is it unique in delivering aphasia treatment for patients? Because you can't find this everywhere.

Dr. Dennis Keane: The Aphasia Center at Marianjoy started out of a grant, Innovation Challenge Grant, and has just flourished since then. When someone has aphasia or a language impairment with the ability to either speak or understand, they tend to get some therapy with a speech pathologist. But after that time is done with their therapy, there's not the resources. And at Marianjoy, we actually provide those lifelong resources for people that want to continue to get better, to want to continue to integrate into society. So, our speech pathologists have a variety of different groups that they will work with. And you can work with peers, you can work with other people that have aphasia. We have a math group that focuses on improving language and numerical reasoning skills through time and money management. We have a separate technology group that focuses on improving someone's verbal expression or comprehension using technology such as computers. We have a conversation group that will work on communicating in different environments such as restaurants and different other community settings. We also have a writing group and a book club. We have a music group. So people, they can use their interests and work on their language skills in familiar environments, things that are comfortable, not stressful, that seems to be the best way and the most holistic way to help people speak better.

Melanie Cole, MS: Such a multidisciplinary approach, isn't it? I mean, you're really working with all of the physical medicine specialties, but including the cognitive and the quality of life, yes?

Dr. Dennis Keane: Absolutely. And we know now this day and age with computers, we can also offer virtual visits as well. So, it'll help people that sometimes cannot make it to our facility and want to get better with their language skills.

Melanie Cole, MS: That's so cool, Dr. Keane. And as we wrap up, given these state-of-the-art programs and facilities, I mean, you just have the most advanced technology out there. When does it make sense to refer a patient to Marianjoy for rehabilitation? What would you like other providers to take away and the key messages about the amazing program that you work with at Marianjoy Rehabilitation Hospital of Northwestern Medicine.

Dr. Dennis Keane: Yeah, thanks for that question. We're very passionate about what we do. I think the referral is important for anyone that has a disability. It could be a recent stroke and they didn't even make it to Marianjoy for inpatient care, but they're going to have needs such as, "How do I get back to work? How do I get back to driving?" There may be people with long-term impairments, someone who had CP and wants to continue to improve and get better with their walking or manage some spasticity. I think anyone that has a physical impairment, it could be neurologic, it could be aphasia, it could be a musculoskeletal complaint that wants to improve with a multidisciplinary team. We have therapists, we have physicians, we have nurses, we have psychologists. That kind of holistic approach we think works best. We think that we have great experience. We have a lot of training with our staff. We have the most advanced technology and research backing up the things that we do here. So, I think those are all people that would benefit from our services at Marianjoy.

Melanie Cole, MS: And I have one last question for you, Dr. Keane, because you just mentioned all of the multidisciplinary team and you mentioned psychologists. Can you please just briefly touch, because I think this is such an important part for referring physicians to be speaking with patients and their families about, is that psychosocial aspect of many of the conditions that you discussed here today, and how at Marianjoy you're really approaching those to work with the families because these can be devastating events and sometimes it's not only the patient themselves, but the family and their support staff and their caregivers. Can you just speak to that a little bit and how important that is when you're working with patients?

Dr. Dennis Keane: Psychology is so important to our recovery of our patients. We focus a lot on physical recovery, but emotional recovery and cognitive recovery is part of that as well. And as you said, it's not just our patients, it's our families too. When someone comes in Marianjoy, they sometimes had a drastic and dramatic change to their life and lifestyle. So, helping people cope and manage with the immediate situation in order to find hope, to find motivation to get back to a meaningful life with relationships and people feeling good about theirself is important. Our psychiatrists are part of our team for all of our inpatients. Our psychologists are part of our outpatient team as well. They can help people because, when you have a disability or impairment, you're going to need lifelong support, and we're there to provide that support for people both psychologically and physically.

Melanie Cole, MS: That is exactly what it's all about. Thank you so much, Dr. Keane, for joining us today. To refer your patient or for more information, please visit our website at breakthroughsforphysicians.nm.org/rehab to get connected with one of our providers at Northwestern Medicine's Marianjoy Rehabilitation Hospital. And that concludes this episode of Better Edge, a Northwestern Medicine Podcast for physicians. Please remember to subscribe, rate, and review this podcast and all the other Northwestern Medicine podcasts. I'm Melanie Cole.