Congress has designated September as National Spinal Cord Injury (SCI) Awareness Month.
In addition to raising awareness and support for much-needed cure research, National SCI Awareness Month aims to further educate the public about how paralyzing accidents can be prevented.
There is no cure for spinal cord injury, nor is there an FDA-approved therapeutic or device that can restore function.
But researchers are working toward these goals, and more research dollars are needed to continue that work.
For now, people who sustain a spinal cord injury receive acute care in trauma hospitals and then typically undergo rehabilitation, which can help to restore some function and independence.
Early, comprehensive rehabilitation – such as what Shepherd Center provides – yields the best outcomes.
Anna Choo Elmers, M.D., is here to discuss how efforts are under way across the nation to prevent spinal cord injuries, especially those caused by distracted driving, falls and diving.
Selected Podcast
Spinal Cord Injury Research: Working Toward a Cure While Injury Prevention Efforts are Expanding
Featured Speaker:
Learn more about Anna Choo Elmers, M.D., J.D
Anna Choo Elmers, M.D
Anna Choo Elmers, M.D., J.D., first worked at Shepherd Center as an Emory University resident in 2006. She officially joined as a staff physiatrist in July 2009 in the Spinal Cord and Brain Injury programs. Upon completing medical school at the George Washington University School of Medicine in Washington, D.C., she moved to Atlanta to complete her residency in physical medicine and rehabilitation at Emory University, where she served as chief resident in her final year. As part of her residency, she worked at Shepherd Center, Atlanta Veterans Affairs Medical Center, Children’s Hospital at Scottish Rite, Emory Sports and Spine, Emory Center for Rehabilitation Medicine and Wesley Woods. Before completing medical school, Dr. Elmers received her juris doctorate from the University of San Diego School of Law, following which she practiced for a couple years in California. She is licensed to practice law in the state of California.Learn more about Anna Choo Elmers, M.D., J.D
Transcription:
Spinal Cord Injury Research: Working Toward a Cure While Injury Prevention Efforts are Expanding
Melanie Cole (Host): Congress has designated September as National Spinal Cord Injury Awareness Month. In addition to raising awareness and support for much needed cure research, National SCI Awareness Month aims to further educate the public about how the paralyzing accidents can be prevented. My guest today is Dr. Anna Choo Elmers. She is a staff physiatrist in the spinal cord and brain injury programs at Shepherd Center. Welcome to the show, Dr. Elmers. What are some of the most common causes of spinal cord injury?
Dr. Anna Choo Elmers (Guest): Melanie, thanks for having me. It’s great to be here. So glad to be here today to talk about injury prevention and spinal cord injury in general. What I’ve noticed is, when someone has a spinal cord injury, those around them really don’t know much about what’s going on with their bodies. Prevention is really important and one of the things that we can do--one of the most important things we can do--is prevent spinal cord injuries by doing things like not diving head first into anything. For example, I hear patients say, "Well, I've done that a million times", and it could be on the million and first time that they dive head first and break their neck. The other things that we look at are wearing seat belts, making sure that when you're driving, you're not texting. That is very important—that you're paying full attention to what’s going on around you while you’re driving.
Melanie: So, diving and distracted driving--two of the most common causes that you see. What happens when someone gets a spinal cord injury and what do you do about it? What’s the first line of defense?
Dr. Elmers: The most common cause is actually car accidents and what we're seeing is that a lot of these car accidents now are being caused by the distracted driving and also not wearing seatbelts, drunk driving, and things like that. So, what we can do is, we can make sure that our patients get to us early and they get good trauma care. So, it’s very important for the initial responders to observe spinal cord precautions and then treat the spinal cord injured patient properly at the acute care facility, and then get them to Shepherd as soon as possible so that we can start rehab on them. And Shepherd, as you may know, has our own intensive care unit, so we can take patients a lot earlier than other facilities may be able to take them. And once we get here, whether they are in ICU or not, we start rehabilitation on them.
Melanie: So, tell us Dr. Elmers, about that unique brand of aggressive rehab that you do at Shepherd Center?
Dr. Elmers: Part of what’s so special about Shepherd is the culture here and so everyone here works as a team. You’ve got a physician leading the team with a physical therapist; occupational therapist; a speech therapist, where needed; therapeutic recreationalist; nutritionists; nursing team; techs and everyone who is here cares deeply about the patient and their well-being and is very interested in getting our patients as functional as possible. That may mean tough love for our patients because often times what we see is when we push patients to do all that they can for themselves, that’s where we're going to get the best results and make them as independent as possible for when they leave here. So, the culture here is very important because not only do we have all these therapies, we have peer support and we get our people out in the community before they get home so that after all their rehab, they know that they are going to be able to go into the community and be comfortable navigating a store, the movie theaters, the restaurants, or whatever it might be, that they liked doing in the past.
Melanie: Does this aggressive rehab involve the family as well? Where do they come in?
Dr. Elmers: The family is a very important part of the aggressive rehab. We have a very high rate of returning patients home versus a nursing home setting. Part of that is getting the family on board very early, not only to understand what’s happened to their loved one but also to get them involved in doing some of the care that’s going to be important for the loved one once they leave Shepherd. The family trains here and then, before discharge, we do a three to three--where the family of the patient will be in charge of their care to demonstrate to us that they can do all that they need to do for their loved one here and then later at home. Family support is so important.
Melanie: Tell us a little bit about the rehab and some exciting developments that are recurring in the field of spinal cord injury research. People think that this is sort of a hopeless situation but there's a lot of research going on, isn’t there?
Dr. Elmers: There is. One of the most exciting areas is the stem cell research and Shepherd is very involved in that. We just finished the first round of patient enrollments. Three patients have been provided with stem cells and the second round is opening up soon. The first patient was treated here at Shepherd. The second and third patients were treated in Chicago. The first patient did very well converting from an Asia-A injury to an incomplete injury. It’s very early still but this is very exciting for the people in spinal cord injury. From simply the functional research, you can look at research in different ways. You can look at, “Well, what can we do at the basic cellular level when someone has a spinal cord injury?” versus “What can we do functionally for the patient to get them more function back?” We have different things like tendon transfers that can help people get more function. We also have the indigo trials that is an exoskeletal trial going on here at Shepherd right now as well. So, all of these things are very important and exciting and, hopefully, will ultimately result in better function for someone who has been spinal cord injured.
Melanie: Dr. Elmers, speak a little bit more about prevention. You mentioned diving and distracted driving and prevention is so important. Give us your best advice about the best ways, when you say, “No diving anywhere, anytime.” Speak about prevention now.
Dr. Elmers: Prevention is so important. In Japan, they showed that once they outlawed diving in the school settings, their number of spinal cord injuries went down to almost zero. That occurred over a whole decade. I know here it’s going to be very difficult to outlaw diving head first. In fact, we can’t do that but if we can just get the word out that people go feet first instead of head first into anything, that'd be so important. You never want to lead with your head when you can injure your neck and, in fact, break your neck and have a spinal cord injury. So, we have an injury prevention program here and I think it’s really important to get kids on board when they are very young, just like bicycle helmets. As far as distracted driving, same thing. People don’t realize that being distracted for five seconds is enough to cause a major accident and imagine if you weren’t injured but you caused a spinal cord injury to someone else. That would be devastating.
Melanie: It certainly would. So, tell us about what’s the outcome? What’s the outlook on the horizon for spinal cord injury research and rehab. Give us your best advice, Dr. Elmers.
Dr. Elmers: I think the best advice for spinal cord injury rehab is to get to Shepherd early or a facility that does specialized care. And so, once you have a spinal cord injury, get to a center that does just spinal cord injury or focuses on spinal cord injury because then, you are going to be with a group of peers who is going through the same thing that you are going through. So, vitally important. And then, preventing spinal cord injury in general. Don’t go head first; don’t drive distracted. Wear your seat belts. If you’re tired pull over. All of these are very important tid bits that altogether will, hopefully, prevent you from getting injured.
Melanie: And in just the last minute, where do you see the world of spinal cord injury research going and why should patients come to Shepherd Center for their care?
Dr. Elmers: The world of spinal cord injury research is an exciting one right now because of all the new things that are happening with stem cells. Stem cells is just an exciting area where we are now finding out what they can do and so, we're very early still in the stem cell trials but so far, it looks promising in that there's no harm resulting from putting stem cells into people. There’s other research going on with functional rehab and getting patients as involved in the research as possible and picking those perfect patients would be very important.
Melanie: Thank you so much, Dr. Elmers. It’s fascinating information. You’re listening to Shepherd Center Radio. For more information, you can go to shepherd.org. That's shepherd.org. This is Melanie Cole. Thanks so much for listening.
Spinal Cord Injury Research: Working Toward a Cure While Injury Prevention Efforts are Expanding
Melanie Cole (Host): Congress has designated September as National Spinal Cord Injury Awareness Month. In addition to raising awareness and support for much needed cure research, National SCI Awareness Month aims to further educate the public about how the paralyzing accidents can be prevented. My guest today is Dr. Anna Choo Elmers. She is a staff physiatrist in the spinal cord and brain injury programs at Shepherd Center. Welcome to the show, Dr. Elmers. What are some of the most common causes of spinal cord injury?
Dr. Anna Choo Elmers (Guest): Melanie, thanks for having me. It’s great to be here. So glad to be here today to talk about injury prevention and spinal cord injury in general. What I’ve noticed is, when someone has a spinal cord injury, those around them really don’t know much about what’s going on with their bodies. Prevention is really important and one of the things that we can do--one of the most important things we can do--is prevent spinal cord injuries by doing things like not diving head first into anything. For example, I hear patients say, "Well, I've done that a million times", and it could be on the million and first time that they dive head first and break their neck. The other things that we look at are wearing seat belts, making sure that when you're driving, you're not texting. That is very important—that you're paying full attention to what’s going on around you while you’re driving.
Melanie: So, diving and distracted driving--two of the most common causes that you see. What happens when someone gets a spinal cord injury and what do you do about it? What’s the first line of defense?
Dr. Elmers: The most common cause is actually car accidents and what we're seeing is that a lot of these car accidents now are being caused by the distracted driving and also not wearing seatbelts, drunk driving, and things like that. So, what we can do is, we can make sure that our patients get to us early and they get good trauma care. So, it’s very important for the initial responders to observe spinal cord precautions and then treat the spinal cord injured patient properly at the acute care facility, and then get them to Shepherd as soon as possible so that we can start rehab on them. And Shepherd, as you may know, has our own intensive care unit, so we can take patients a lot earlier than other facilities may be able to take them. And once we get here, whether they are in ICU or not, we start rehabilitation on them.
Melanie: So, tell us Dr. Elmers, about that unique brand of aggressive rehab that you do at Shepherd Center?
Dr. Elmers: Part of what’s so special about Shepherd is the culture here and so everyone here works as a team. You’ve got a physician leading the team with a physical therapist; occupational therapist; a speech therapist, where needed; therapeutic recreationalist; nutritionists; nursing team; techs and everyone who is here cares deeply about the patient and their well-being and is very interested in getting our patients as functional as possible. That may mean tough love for our patients because often times what we see is when we push patients to do all that they can for themselves, that’s where we're going to get the best results and make them as independent as possible for when they leave here. So, the culture here is very important because not only do we have all these therapies, we have peer support and we get our people out in the community before they get home so that after all their rehab, they know that they are going to be able to go into the community and be comfortable navigating a store, the movie theaters, the restaurants, or whatever it might be, that they liked doing in the past.
Melanie: Does this aggressive rehab involve the family as well? Where do they come in?
Dr. Elmers: The family is a very important part of the aggressive rehab. We have a very high rate of returning patients home versus a nursing home setting. Part of that is getting the family on board very early, not only to understand what’s happened to their loved one but also to get them involved in doing some of the care that’s going to be important for the loved one once they leave Shepherd. The family trains here and then, before discharge, we do a three to three--where the family of the patient will be in charge of their care to demonstrate to us that they can do all that they need to do for their loved one here and then later at home. Family support is so important.
Melanie: Tell us a little bit about the rehab and some exciting developments that are recurring in the field of spinal cord injury research. People think that this is sort of a hopeless situation but there's a lot of research going on, isn’t there?
Dr. Elmers: There is. One of the most exciting areas is the stem cell research and Shepherd is very involved in that. We just finished the first round of patient enrollments. Three patients have been provided with stem cells and the second round is opening up soon. The first patient was treated here at Shepherd. The second and third patients were treated in Chicago. The first patient did very well converting from an Asia-A injury to an incomplete injury. It’s very early still but this is very exciting for the people in spinal cord injury. From simply the functional research, you can look at research in different ways. You can look at, “Well, what can we do at the basic cellular level when someone has a spinal cord injury?” versus “What can we do functionally for the patient to get them more function back?” We have different things like tendon transfers that can help people get more function. We also have the indigo trials that is an exoskeletal trial going on here at Shepherd right now as well. So, all of these things are very important and exciting and, hopefully, will ultimately result in better function for someone who has been spinal cord injured.
Melanie: Dr. Elmers, speak a little bit more about prevention. You mentioned diving and distracted driving and prevention is so important. Give us your best advice about the best ways, when you say, “No diving anywhere, anytime.” Speak about prevention now.
Dr. Elmers: Prevention is so important. In Japan, they showed that once they outlawed diving in the school settings, their number of spinal cord injuries went down to almost zero. That occurred over a whole decade. I know here it’s going to be very difficult to outlaw diving head first. In fact, we can’t do that but if we can just get the word out that people go feet first instead of head first into anything, that'd be so important. You never want to lead with your head when you can injure your neck and, in fact, break your neck and have a spinal cord injury. So, we have an injury prevention program here and I think it’s really important to get kids on board when they are very young, just like bicycle helmets. As far as distracted driving, same thing. People don’t realize that being distracted for five seconds is enough to cause a major accident and imagine if you weren’t injured but you caused a spinal cord injury to someone else. That would be devastating.
Melanie: It certainly would. So, tell us about what’s the outcome? What’s the outlook on the horizon for spinal cord injury research and rehab. Give us your best advice, Dr. Elmers.
Dr. Elmers: I think the best advice for spinal cord injury rehab is to get to Shepherd early or a facility that does specialized care. And so, once you have a spinal cord injury, get to a center that does just spinal cord injury or focuses on spinal cord injury because then, you are going to be with a group of peers who is going through the same thing that you are going through. So, vitally important. And then, preventing spinal cord injury in general. Don’t go head first; don’t drive distracted. Wear your seat belts. If you’re tired pull over. All of these are very important tid bits that altogether will, hopefully, prevent you from getting injured.
Melanie: And in just the last minute, where do you see the world of spinal cord injury research going and why should patients come to Shepherd Center for their care?
Dr. Elmers: The world of spinal cord injury research is an exciting one right now because of all the new things that are happening with stem cells. Stem cells is just an exciting area where we are now finding out what they can do and so, we're very early still in the stem cell trials but so far, it looks promising in that there's no harm resulting from putting stem cells into people. There’s other research going on with functional rehab and getting patients as involved in the research as possible and picking those perfect patients would be very important.
Melanie: Thank you so much, Dr. Elmers. It’s fascinating information. You’re listening to Shepherd Center Radio. For more information, you can go to shepherd.org. That's shepherd.org. This is Melanie Cole. Thanks so much for listening.