Northwestern Medicine Transplant Rehabilitation Program at Marianjoy Rehabilitation Hospital
Melanie Stearns, MD, a physiatrist and medical director at Northwestern Medicine Marianjoy Rehabilitation Hospital, discusses the importance of rehabilitation following an organ transplant. She explains Marianjoy Rehabilitation Hospital’s multidisciplinary approach to addressing the complexities following transplant surgery. She also discusses how, at Marianjoy, comprehensive care involves collaboration with the transplant team, therapy disciplines working together to achieve the best possible outcomes for the patient and educating the family on the patient’s needs before they return home.
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Melanie Stearns, MD
Melanie Stearns, MD is a physician in Physical Medicine and Rehabilitation.Learn more about Melanie Stearns, MD
Transcription:
Northwestern Medicine Transplant Rehabilitation Program at Marianjoy Rehabilitation Hospital
Melanie Cole, MS (Host): Welcome to Better Edge, a Northwestern Medicine Podcast for physicians. I'm Melanie Cole. And joining me today is Dr. Melanie Stearns. She's a physician in Physical Medicine and Rehabilitation at Northwestern Medicine's Marianjoy Rehabilitation Hospital. And she's here to tell us about transplant rehabilitation.
Melanie Cole, MS: Dr. Stearns, it's a pleasure to have you join us today. Thank you so much. And this isn't something that I think many providers know about. So, can you tell us about the rehabilitation program at Northwestern Medicine's Marianjoy Rehabilitation Hospital that specifically is for transplant patients.
Melanie Stearns, MD: Sure. Absolutely. So, our rehab program at Marianjoy is for patients who have had mostly liver, lung and kidney transplants who might have had a more complicated course after surgery. So, a lot of patients with transplants will be discharged straight home after their surgery, and they do pretty well. And then, other patients have certain complications that make them pretty weak post-operatively and unable to safely return home after being in acute care. So, what we offer at Marianjoy is actually a hospital-based rehab program where patients who have had complications that render them weak will come and stay with us for between usually two to four weeks as part of an intensive inpatient rehab program where they're getting usually between three and four hours of therapy a day. And that can include physical, occupational or speech therapy. We also work very closely with our psychologists, dieticians and nurses in order to make patients stronger and basically more physically capable of going home. So, a lot of times they come here and they're just working on their basic transfers, getting from their bed to the wheelchair or, you know, taking short amount of steps, short amount of stairs, and it really takes some of these patients a couple of weeks to get the strength needed to really go home.
And so, our goal over those two to four weeks is to get them to the point where there are balance and endurance and ability to do their basic self-care tasks is adequate for them to discharge home safely. So, that's kind of a little bit about what we do for our transplant patients and a lot of them do really well. When they get home safely, it just takes a couple of weeks of kind of that hospital-based rehab program. I also wanted to mention they're seen by a physician most days of the week. So, someone like myself, a physical medicine and rehab physician, to kind of lead and coordinate the therapy program and manage any medical problems that come up when they're here, such as lab issues, new symptoms or other complications that we work with the transplant team.
Melanie Cole, MS: Well, I'd like you to expand, Dr. Stearns, on the transplant team and this multidisciplinary approach after surgery. How do you and your team work together with the patient and surgeon and that transplant team to coordinate care and why is that ongoing communication so important for the patient?
Melanie Stearns, MD: So we're at Marianjoy, which is out in the suburbs of Chicago. But we are seeing the patient daily and so we will communicate with the team when new problems come up or just to update them on how their patients are doing and then also update them with lab values, such as their immunosuppressant level medications that are frequently requiring a lot of titration in the postoperative period. So, it's really important, I would say, we're in communication with their transplant team several times a week just because there's oftentimes a lot of followup testing and lab monitoring or other issues that come up. And a lot of times we can take care of those types of problems at Marianjoy. And if they become more serious, then that sometimes causes them to be transferred back to Northwestern. But for the most part, the communication is so important so that we can tackle problems before they become bigger problems and kind of manage things at Marianjoy, make sure their labs are stable, make sure they're progressing well in their program, and also address a lot of their symptoms like pain and sleep and mood and bowel and bladder and those kinds of things that we do as rehab doctors.
Melanie Cole, MS: Well, I'd like you to expand a little bit, Dr. Stearns, on the type of rehab. You and I were talking off the air, that it's not completely different than rehab for any surgery really. But after a transplant, there are other things before they go home. There's medication management, you and I also discussed that a little bit. And then of course, there's pain management and there's moving around, being able to do things, go to the bathroom by themselves. Tell us a little bit about what that comprehensive approach looks like.
Melanie Stearns, MD: Right. So, that comprehensive approach is really about all of the different therapy disciplines working together. So, not only are they getting the physical therapy, occupational therapy and speech therapy where they work one-on-one with therapists, but we're also bringing in the families to learn how to help care for the patient at home, how to motivate the patient, nurses and physicians, we work on educating the patient on their medications when they're taking them, why they're taking them. You know, we provide a lot of education that's kind of in addition to what the transplant team does as well.
There are so many different things that are required for transplant rehab. It's not just kind of getting them moving again, but also getting them used to living with their new organ and how that kind of works with all of the medications and followup needs. So, we do a lot of education on the medications. We help kind of, you know, coordinate their followups and making sure they're plugged in for their followup testing with the transplant team. And we really, like I mentioned, bring in the families to make sure that they're comfortable bringing the patients home, possibly assisting them with their basic self-care, their basic mobility. Although I will say most of our transplant patients go home totally independent after participating in our program. So, they're able to do their basic ambulation, self-care, and those things independently. But usually, you need a little bit of help with family for the medications because it can be very complicated.
Melanie Cole, MS: It can be overwhelming for sure. And as somebody who just went through it, I see how overwhelming it can definitely be. What else would you like other providers to know about rehabilitation after transplant and how being a part of a world-class health system like Northwestern Medicine benefits transplant patients at Marianjoy Rehabilitation Hospital?
Melanie Stearns, MD: I think one thing good to know is that a place like Marianjoy takes care of a lot of patients with transplants, and there are not a lot of rehab centers that will take patients with transplants in the postoperative period, just partly because of the complexity of the rigorous routine, rigorous medication monitoring and complicated followup care that's needed. And so, I think being at Northwestern Marianjoy is wonderful because we are so comfortable with taking these patients. I have a group of patients on my unit and at any given time, we may have several new transplants at a time. Our nursing staff knows how to educate regarding the medications and our physicians are comfortable working with these patients. And I've developed relationships with the transplant teams down at Northwestern where we're really comfortable kind of talking to each other about any issues that come up really when they're undergoing rehab.
Melanie Cole, MS: It's really important work that you're doing, Dr. Stearns. Thank you so much for joining us today and for telling us about the transplant rehabilitation program at Northwestern Medicine's Marianjoy Rehabilitation Hospital. To refer your patient or for more information, please visit our website at breakthroughsforphysicians.nm.org/rehabilitation to get connected with one of our providers.
That concludes this episode of Better Edge, a Northwestern Medicine Podcast for physicians. Please always remember to subscribe, rate and review this podcast and all the other Northwestern Medicine podcasts. I'm Melanie Cole. Thanks so much for joining us today.
Northwestern Medicine Transplant Rehabilitation Program at Marianjoy Rehabilitation Hospital
Melanie Cole, MS (Host): Welcome to Better Edge, a Northwestern Medicine Podcast for physicians. I'm Melanie Cole. And joining me today is Dr. Melanie Stearns. She's a physician in Physical Medicine and Rehabilitation at Northwestern Medicine's Marianjoy Rehabilitation Hospital. And she's here to tell us about transplant rehabilitation.
Melanie Cole, MS: Dr. Stearns, it's a pleasure to have you join us today. Thank you so much. And this isn't something that I think many providers know about. So, can you tell us about the rehabilitation program at Northwestern Medicine's Marianjoy Rehabilitation Hospital that specifically is for transplant patients.
Melanie Stearns, MD: Sure. Absolutely. So, our rehab program at Marianjoy is for patients who have had mostly liver, lung and kidney transplants who might have had a more complicated course after surgery. So, a lot of patients with transplants will be discharged straight home after their surgery, and they do pretty well. And then, other patients have certain complications that make them pretty weak post-operatively and unable to safely return home after being in acute care. So, what we offer at Marianjoy is actually a hospital-based rehab program where patients who have had complications that render them weak will come and stay with us for between usually two to four weeks as part of an intensive inpatient rehab program where they're getting usually between three and four hours of therapy a day. And that can include physical, occupational or speech therapy. We also work very closely with our psychologists, dieticians and nurses in order to make patients stronger and basically more physically capable of going home. So, a lot of times they come here and they're just working on their basic transfers, getting from their bed to the wheelchair or, you know, taking short amount of steps, short amount of stairs, and it really takes some of these patients a couple of weeks to get the strength needed to really go home.
And so, our goal over those two to four weeks is to get them to the point where there are balance and endurance and ability to do their basic self-care tasks is adequate for them to discharge home safely. So, that's kind of a little bit about what we do for our transplant patients and a lot of them do really well. When they get home safely, it just takes a couple of weeks of kind of that hospital-based rehab program. I also wanted to mention they're seen by a physician most days of the week. So, someone like myself, a physical medicine and rehab physician, to kind of lead and coordinate the therapy program and manage any medical problems that come up when they're here, such as lab issues, new symptoms or other complications that we work with the transplant team.
Melanie Cole, MS: Well, I'd like you to expand, Dr. Stearns, on the transplant team and this multidisciplinary approach after surgery. How do you and your team work together with the patient and surgeon and that transplant team to coordinate care and why is that ongoing communication so important for the patient?
Melanie Stearns, MD: So we're at Marianjoy, which is out in the suburbs of Chicago. But we are seeing the patient daily and so we will communicate with the team when new problems come up or just to update them on how their patients are doing and then also update them with lab values, such as their immunosuppressant level medications that are frequently requiring a lot of titration in the postoperative period. So, it's really important, I would say, we're in communication with their transplant team several times a week just because there's oftentimes a lot of followup testing and lab monitoring or other issues that come up. And a lot of times we can take care of those types of problems at Marianjoy. And if they become more serious, then that sometimes causes them to be transferred back to Northwestern. But for the most part, the communication is so important so that we can tackle problems before they become bigger problems and kind of manage things at Marianjoy, make sure their labs are stable, make sure they're progressing well in their program, and also address a lot of their symptoms like pain and sleep and mood and bowel and bladder and those kinds of things that we do as rehab doctors.
Melanie Cole, MS: Well, I'd like you to expand a little bit, Dr. Stearns, on the type of rehab. You and I were talking off the air, that it's not completely different than rehab for any surgery really. But after a transplant, there are other things before they go home. There's medication management, you and I also discussed that a little bit. And then of course, there's pain management and there's moving around, being able to do things, go to the bathroom by themselves. Tell us a little bit about what that comprehensive approach looks like.
Melanie Stearns, MD: Right. So, that comprehensive approach is really about all of the different therapy disciplines working together. So, not only are they getting the physical therapy, occupational therapy and speech therapy where they work one-on-one with therapists, but we're also bringing in the families to learn how to help care for the patient at home, how to motivate the patient, nurses and physicians, we work on educating the patient on their medications when they're taking them, why they're taking them. You know, we provide a lot of education that's kind of in addition to what the transplant team does as well.
There are so many different things that are required for transplant rehab. It's not just kind of getting them moving again, but also getting them used to living with their new organ and how that kind of works with all of the medications and followup needs. So, we do a lot of education on the medications. We help kind of, you know, coordinate their followups and making sure they're plugged in for their followup testing with the transplant team. And we really, like I mentioned, bring in the families to make sure that they're comfortable bringing the patients home, possibly assisting them with their basic self-care, their basic mobility. Although I will say most of our transplant patients go home totally independent after participating in our program. So, they're able to do their basic ambulation, self-care, and those things independently. But usually, you need a little bit of help with family for the medications because it can be very complicated.
Melanie Cole, MS: It can be overwhelming for sure. And as somebody who just went through it, I see how overwhelming it can definitely be. What else would you like other providers to know about rehabilitation after transplant and how being a part of a world-class health system like Northwestern Medicine benefits transplant patients at Marianjoy Rehabilitation Hospital?
Melanie Stearns, MD: I think one thing good to know is that a place like Marianjoy takes care of a lot of patients with transplants, and there are not a lot of rehab centers that will take patients with transplants in the postoperative period, just partly because of the complexity of the rigorous routine, rigorous medication monitoring and complicated followup care that's needed. And so, I think being at Northwestern Marianjoy is wonderful because we are so comfortable with taking these patients. I have a group of patients on my unit and at any given time, we may have several new transplants at a time. Our nursing staff knows how to educate regarding the medications and our physicians are comfortable working with these patients. And I've developed relationships with the transplant teams down at Northwestern where we're really comfortable kind of talking to each other about any issues that come up really when they're undergoing rehab.
Melanie Cole, MS: It's really important work that you're doing, Dr. Stearns. Thank you so much for joining us today and for telling us about the transplant rehabilitation program at Northwestern Medicine's Marianjoy Rehabilitation Hospital. To refer your patient or for more information, please visit our website at breakthroughsforphysicians.nm.org/rehabilitation to get connected with one of our providers.
That concludes this episode of Better Edge, a Northwestern Medicine Podcast for physicians. Please always remember to subscribe, rate and review this podcast and all the other Northwestern Medicine podcasts. I'm Melanie Cole. Thanks so much for joining us today.