Tag Archives: recovery

Catholic rehab makes all the difference

People recovering from serious injuries, strokes, life-changing illnesses, and catastrophic accidents often need more than just physical rehabilitation.

Their spirits also need to be uplifted. That is an important insight the staff at Madonna Rehabilitation Hospitals in Nebraska understands infinitely well.

Rehab involves much more than physical adjustment

“Our patients and our families are sometimes struggling to understand the reason for their condition, not only just the physical aspects of it,” said Paul Dongilli Jr., the president and CEO of Madonna Rehabilitation Hospitals.

Dongilli, a speech pathologist by training who is a member of Legatus’ Lincoln Chapter, said people come from 24 different states, as far away as Alaska and Washington State, to be treated at one of Madonna Rehabilitation Hospitals’ two locations, in Omaha and Lincoln.

Physicians and nurses in those other states often refer their patients to Madonna because of the cutting-edge, first-rate rehabilitative care that is matched by the psycho-social and spiritual care offered at the facilities.

“When those individuals are paired with our social workers and our psychologists, they’re able to deal with the psycho- social aspects of a devastating injury or illness,” said Dongilli, who has been with Madonna since 1983.

Whereas most hospitals and care centers have small rehabilitation units on-site, Dongilli said Madonna Rehabilitation Hospitals are one of the only, if not the lone, freestanding Catholic rehabilitation facilities in the country.

“We’re not part of a larger acute care system, and in most acute care systems, rehabilitation is a small part of what they do,” Dongilli said. “Maybe they don’t invest in the technology and have the resources that are needed to treat patients who have had devastating spinal cord injuries, brain injuries, children as well as adults, where we have, because that’s all we do.”

Founded by Benedictine nuns – with a priest in residence

Benedictine nuns founded Madonna Rehabilitshort-term recovery and room for another 125 individuals who have chronic conditions and require longer-term care. The Omaha facility opened in 2016 and has room for 110 patients.

The facilities today are sponsored by the Diocese of Lincoln, Nebraska, and they retain a distinctive Catholic identity.

Madonna has a Catholic priest in residence, and offers daily Mass and access to the sacraments for patients, their families, and staff. Both locations have beautiful chapels and sacred art throughout the facilities.

“When you come into the facility, the look is such we think that it reinforces that Catholic identity,” Dongilli said, adding that spiritual care is offered for people of different religious and denominational backgrounds.

Patients come from afar

From its beginnings 60 years ago, Dongilli said Madonna Rehabilitation Hospitals has evolved into a health care system that serves patients from around the country, primarily from an eight-state region in the Midwest.

“When individuals and their families are faced with these horrific injuries and they’re looking for a facility to help them, in most areas they’re told that they don’t have those resources,” Dongilli said, adding that trauma centers in other states that work with Madonna are quick to refer their patients to the Nebraska facilities.

“So people are willing to travel to access a resource that they can’t get in their immediate community,” Dongilli said.

Madonna has a dedicated pediatric unit and long-term care for patients who require ventilators. The staff specializes in complex medical, traumatic brain injury, spinal cord injury, pulmonary conditions, severe stroke, other neurological conditions, and pediatric rehabilitation.

Offering hope, spiritual recovery

Dongilli, who worked in Madonna’s brain injury and stroke units and worked his way up to chief operating officer and then CEO three years ago, said Madonna offers hope and healing to thousands of patients every year.

“What we provide is a more holistic approach to care, balancing the more physical aspects of medicine, nursing, and therapy with more of the psycho-social and spiritual aspects of recovery,” he said.

In addition to the chapel, Dongilli said Madonna has a large therapy gym and carefully manicured grounds that contribute to the peaceful, spiritual, and mentally healing atmosphere.

“We have been very careful over the years to have green space and nature and some beautiful settings that are part of God’s creation that our families and our patients can access to have some quiet time or for reflection,” Dongilli said. “Those things, we think, very much make a difference and aid in the recovery process. It helps provide hope.”

In addition to focusing on the mental and spiritual healing, Madonna’s team of specialized physiatrists, hospitalists, therapists, rehabilitation nurses, clinicians, and researchers work with advanced technology and equipment to help each patient achieve the highest level of independence possible.

Research institute developing new technologies

Dongilli said Madonna has “a small but mighty” research institute that has been successful in developing technology to support rehabilitation efforts, and added that the technology is now being commercialized and sold to other health care facilities in the United States and abroad.

“We think we have the opportunity now in working with the University of Nebraska to expand our research efforts and develop equipment and technology that will help advance the field of rehabilitation and the outcomes of the patients that we serve,” Dongilli said.

Dongilli added that Madonna started a department to train physicians, and recently accepted the first group of residents from the University of Nebraska’s College of Medicine who will be trained in physical medicine and rehabilitation.

“I think what the future holds for us is to be a regional center, not only for the treatment of patients, but also a training facility for physicians and other professionals specializing in rehabilitation,” Dongilli said.

Founded with Mary’s blessing

The founding Benedictine Sisters named the facility after the Madonna because 1958 was a Marian year, said Dongilli.

“They had a vision that if individuals could have good nursing care and therapy care, that folks who previously had to be institutionalized could return back to their homes and to their communities,” Dongilli said. “They really established a vision for rehabilitation. They recognized the blessings that Mary would provide for their efforts and for hopefully sustaining the hospital and the facility.”

Despite changes in medicine and technology over the decades, Dongilli said Madonna’s core philosophy remains the same.

“That notion of doing God’s work, a vision for doing rehabilitation under the guidance of the Blessed Mother, has really been a core tenet for us,” he said.

 

BRIAN FRAGA is a Legatus magazine staff writer.

Marijuana – why bother going to pot?

Rebekah (not her real name) was admitted into drug rehab, not her first time around the block. She was typical of over half the patients I saw that day, typical of any treatment center across the nation. The common denominator? Smoking marijuana was her first experience of intoxication.

Marijuana contains two major substances. One is delta-9 tetrahydrocannabinol (THC), the substance responsible for the “high.” It causes most of the adverse effects of marijuana: elevated heart rate and blood pressure, distortions in time perception, anxiety, psychosis, and addiction. Along with alcohol and other potentially addicting substances, THC is a “false messenger,” signaling the brain that something wonderful has happened when, in fact, the only “wonderful thing” has been a fleeting experience of something much less than God. It is also a “virus,” taking control of the parts of the brain that process experience, plan, and strategize for the future. In vulnerable people, there follows a steady progression from pleasure or relief of suffering, to addiction.

The second major substance in marijuana is cannabidiol (CBD). CBD is responsible for many of the medicinal effects of marijuana such as: lowering of the blood pressure and heart rate, reductions in anxiety, anti-seizure effect, and protection from psychosis. (The FDA recently approved a pharmaceutical preparation of CBD (without THC) for use in some seizure disorders.) CBD is not part of the marijuana “high,” and does not produce addiction. In fact, CBD protects against many of the adverse effects of THC, possibly including addiction.

Time marches on and marijuana in the U.S. today is quite different than what was used by “flower children” of the past. Marijuana is now an $11 billion industry and, perhaps in response to industry pressures, the THC content of today’s marijuana has increased significantly. In 1995, THC content was approximately 4%. In 2014, THC content was approximately 14%, a more than three-fold increase from 1995. In contrast, from 1995 to 2014, the CBD content of marijuana decreased by more than 50%. This means marijuana today is a more potent psychoactive substance, containing less of the protective CBD. It’s a small wonder that emergency room visits due to marijuana increased by 50 percent between 2004 and 2011. Studies also show that adolescents using marijuana show impaired IQ, less satisfaction with life as adults, and 16 percent of them become addicted to it.

Rebekah’s childhood was long on suffering and short on supervision, important risk factors in developing addiction. In high school she experimented with alcohol and tobacco. Then came Xanax and concentrated marijuana (hash oil). By age 22, she was using cocaine and at age 23, heroin along with the cocaine. At age 24, Rebekah has survived (four people die every hour in the United States of a drug overdose) without a major health complication. She is hoping for long-term treatment, her best chance for recovery, and a brighter future. May God be with her.

 

DR. JEFFREY BERGER is the medical director of Guest House, the Residential Catholic Addiction Treatment Center in Lake Orion, MI. As well, he is contingent staff at Brighton Center for Recovery in Brighton, MI and has been practicing addiction medicine for over 30 years. He is an active member of the Catholic Medical Association.

Back pain and the realities of surgical recovery

Statistics show that 80% of us will have at least one episode of low back pain during our lifetime. This is especially important when you consider these factors will increase your risk: obesity, smoking, age, female, physically strenuous work, sedentary work, stress, job dissatisfaction, anxiety or depression.

healthnetThere are four main regions of the back: Neck: seven cervical vertebrae (C1-C7), Upper back: 12 thoracic vertebrae (T1- T12), Lower back: five lumbar vertebrae (L1-L5), and Base of spine: sacrum, coccyx (S1- S4). Low back pain is most commonly found in the L4, L5 and S1 areas. However, most people (>85%) have “nonspecific low back pain,” which means there isn’t a specific disease or abnormality in the spine clearly causing the pain.

Causes of low back pain include: degenerative disc disease (wear and tear causing breakdown of spinal discs or loss of fluid in the discs), facet joint arthropathy (arthritis in joints connecting the vertebrae to one another), spondylolisthesis (one of the vertebrae of lower spine slips forward), herniated disc (outer covering of disc is torn, soft inner tissue extrudes), lumbar spinal stenosis (open space inside the vertebrae is narrowed), and spinal compression fractures.

Symptoms include: radiculopathy (nerve root becomes irritated, causing radiating pain, numbness, etc.), sciatica (one of the five branches of the sciatic nerve becomes irritated), neurogenic claudication (pain runs down the back to buttocks, thighs and lower legs, often on both sides and may cause weakness and limping).

Diagnosis: Imaging studies including X-rays, MRI, CT scan. It’s interesting to note that a patient may have an abnormality on imaging and actually experience no symptoms.

Treatment: Remaining active helps to relieve muscle spasms and prevents loss of muscle strength. Also helpful: heat, pain meds, exercise to increase back flexibility and strengthen core muscles, physical therapy, chiropractic manipulation, acupuncture, massage, trigger point injections into the soft tissues of back or epidural injections, traction, ultrasound, electrical nerve stimulation, low level laser therapy.

Surgery is only recommended if more conservative treatments fail. Options include spinal fusion (fusing two or more vertebral bodies together), lumbar disc replacement (may help preserve normal range of motion), discectomy (removes part of/entire disc to relieve pressure on the nerve roots), open discectomy (standard surgical incision), micro discectomy (smaller incision to remove of disc fragment).

Spinal fusion recovery. Pain should decrease gradually. Usually the worst is over by four weeks. However, some patients have pain for three to six months after surgery. Avoid bending, twisting or lifting anything over 10-15 lbs. If a back brace is recommended, wear it for six weeks to three months after surgery. Driving may be allowed after four to six weeks. Outpatient physical therapy may be started at six weeks.

At three to six months’ post-surgery, exercise is the central component of the recovery process. Focus should be on strengthening your back and core muscles for support. Complete recovery may take up to eight months. Bone continues to evolve for 12-18 months.

SUSAN LOCKE, MD is Healthnetwork Foundation’s medical director.

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