Delving Into DBS

Delving Into DBS

Implanting electrodes into the brain may sound like science fiction, but an innovative treatment performed at Jewish Hospital, part of KentuckyOne Health, called deep brain stimulation (DBS) uses that exact process to treat movement disorders.

Movement disorders affect people’s ability to move, walk, speak and otherwise function normally. Many of these issues are caused by malfunctions in the neural processes and circuits of the brain.

“DBS helps stop irregular neural firing and encourages a normal pattern of brain activity,” said Joseph Neimat, MD, chairman of the Department of Neurosurgery at the University of Louisville, who performs the procedure at Jewish Hospital. “The results are amazing.”

Circuit Work

Traditionally, medications are used to treat movement disorders, but over time, they may become less effective. DBS uses electrodes to pulse electricity to the proper area of the brain and alleviate symptoms — often yielding lasting, reproducible results.

“DBS alters the brain’s circuits in the same way as medications, but it does so in a more predictable and measured way,” Dr. Neimat said. “The therapy produces consistent benefits, and can truly change the quality of patients’ lives.”

Prep and Programming

Patients work closely with a team of neurologists, neurosurgeons and other providers to prepare for the two procedures necessary to begin DBS therapy.

First, MRIs, CT scans and microelectrodes are used to discover the area of the brain that is malfunctioning. Once the proper area is found, one or more neurostimulator electrodes are placed in the brain. Patients normally return home the day after this procedure.

A week later, patients return to the hospital for a second surgery. The electrodes are connected to a battery that is implanted in the chest. Over the next few months, providers work with the patient to program the electrodes and make sure they are stimulating the brain with the correct charge, amplitude and frequency.

“Patients who find that their medications are losing effectiveness should definitely consider DBS,” Dr. Neimat said. “The surgery is very safe and effective and changes patients’ lives for the better.”

Movement Disorders Program at Frazier Rehab Institute

Through a partnership with the University of Louisville, the Movement Disorders Program at Frazier Rehab Institute, part of KentuckyOne Health, provides a comprehensive approach to care for individuals with Parkinson’s disease and other movement disorders. For more information, call 502.582.7654.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

Fuzzy, Feel-good Therapy

Fuzzy, Feel-good Therapy

Fuzzy, Feel-good Therapy

Dogs specially trained to provide patients with inspiration and love are key players in the healing process at several KentuckyOne Health facilities.

There’s nothing like a wet nose and kind eyes to warm the heart and revive the spirit. But animals can offer more than companionship. Pets who have been specially trained to provide certain types of support to individuals facing health challenges can help people recover.

The canine companions at Frazier Rehab Institute, part of KentuckyOne Health, are certified to deliver Animal Assisted Therapy services, and dogs at the Saint Joseph Cancer Center, Saint Joseph Hospital, Saint Joseph East and Saint Joseph East Cancer Center, all part of KentuckyOne Health, socialize with patients and visitors, helping keep smiles on their faces even when they’re dealing with medical concerns.

“Interacting with pets is soothing to many people,” said Jamine Hamner, director of Volunteer Services with KentuckyOne Health. “These animals can help lift spirits and calm people down when they are anxious. Our patients’ moods change when an animal is in the room — it’s amazing to see.”

A Tradition of Wagging Tails

 

Dogs began visiting patients at the Frazier Rehab Institute more than 15 years ago as part of a Pet Therapy Visitation program. Volunteer pet owners and certified therapy dogs visited patients on a weekly basis. The visits were a hit, and the staff decided to add a dog to the team permanently to interact with patients and families, as well as be involved in therapy interventions.

“Animal Assisted Therapy is a goal-directed program in which specially trained animals are an integral part of the treatment process,” said Jill Farmer, CTRS, manager of recreation therapy and adapted sports programs with Frazier Rehab Institute. “The therapy promotes improved physical, social, emotional and cognitive function. We saw real value in officially making dogs part of the work we do.”

Watch the video to hear Jill Farmer, CTRS discuss Animal Assisted Therapy and Animal Assisted Activity.

 

A dog named Madison was the first four-legged staffer to join the KentuckyOne Health canine collaboration in 2006. The Paws with Purpose Organization placed her with the Frazier Rehab Institute, where she served solo until 2014, when she was joined by another facility dog named Charlie.

A breeder in Deer Park, Washington, donated Charlie to Frazier Rehab Institute. Like Madison, he was trained as a service animal. In December 2016, thanks to donations to the Jewish Hospital & St. Mary’s Foundation, Frazier Rehab Institute welcomed a new therapy dog named Stanley.

These three four-legged pioneers forged ahead on a mission to help patients facing a variety of conditions, including working with patients who have had a:

  • Stroke — The facility dogs help encourage individuals to talk, walk, or use an affected arm or leg for grooming or petting.
  • Traumatic brain injury — Trained facility dogs can help improve a patient’s communication and thinking skills. For example, a therapist may ask the individual to identify or recall the dog’s age, color and name or to complete basic tasks, such as petting the dog.

The dogs can be especially helpful in pediatric cases, encouraging children to crawl, stand or speak.

“The dogs can motivate individuals to continue working rather than giving up,” Farmer said. “And receiving a service animal for personal use once they have been discharged home can open up a world of independence for a person. The animal can help with opening doors, pulling off shoes and socks, and retrieving dropped items.”

Patients need an order from a physician to work with a facility therapy animal. If a patient has a compromised immune system, this kind of treatment may not be recommended.

Helpful Volunteers

 

Dogs who visit patients at Saint Joseph facilities serve a purpose that is a little less clinical than the dogs at Frazier Rehab Institute. But their work is just as important.

“These dogs are volunteers, and their human parents are volunteers,” Hamner said. “They show up at the hospital according to a self-determined schedule and then walk around to cheer people up as requested. It’s an awesome experience.”

Volunteer dogs who visit Saint Joseph facilities must already be trained therapy dogs. Pet owners may sign up to volunteer online, and when a dog has been approved, the owner can use the same online system to set up visits. These dogs receive special therapy badges, clock in when they are ready for work and visit patients in need of furry companionship.

Partners in Puppy Love

 

KentuckyOne Health partners with community organizations Paws with Purpose, Pet Partners for Independence, Wonderful Animals Giving Support (WAGS), Central Kentucky Love on a Leash and Alliance of Therapy Dogs.

Paws with Purpose puppies in training visit Frazier Rehab Institute patients on the weekends. Pet Partners for Independence offers facility and therapy dog training. And volunteers with WAGS bring in trained therapy dogs to visit patients during the week.

Together, these organizations brighten the days and improve the health of patients.

Funding for the pet therapy program at Frazier Rehab Institute was provided by a generous gift from June and Stanley Atlas.

More Than Man’s Best Friend

 

While it can be tempting to pet and cuddle the doggy helpers, remember that facility dogs who are working as service animals have to keep their focus on their work when they are on the clock.

“Facility dogs like the ones at Frazier Rehab Institute are highly trained dogs who must go through a minimum two years of continuous training,” said Farmer. “They are not pets. They are allowed to be typical dogs when they are not at work but are required to follow specific commands when they are on the job.”

Charlie, a goldendoodleCharlie, a goldendoodle, celebrated his fifth birthday in April.

Teddy Stapleton, a cocker spanielTeddy Stapleton, a cocker spaniel, is one of the many therapy dogs helping KentuckyOne Health patients.

Stanley, a yellow Labrador retrieverStanley, a yellow Labrador retriever, joined the pet therapy program in 2016.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

Finding Hope, One Step At a Time

Finding Hope, One Step At a Time

Finding Hope, One Step At a Time
When Eden Hoelscher became paralyzed during a simple gymnastic move, her family traveled across the country to get her back on her feet.

On Dec. 23, 2015, Eden was a typical 5-year-old playing with her older sister, Isabella, when the unthinkable happened. Eden was performing a backbend — a gymnastic and dance move she had done hundreds of times — when she fell to the ground in agony. She was paralyzed from the waist down.

“We were in absolute disbelief,” said Kylee Hoelscher, Eden’s mother. “We lived in Los Angeles at the time, and every hospital we took Eden to gave us the same answer: She was going to be paralyzed the rest of her life.”

Crossing the Country for Care

Eden HoelscherUnwilling to give up, Kylee and Nicholas, Eden’s father, moved their family to Louisville to work with the team at Frazier Rehab Institute, part of KentuckyOne Health. The team quickly earned the trust of the Hoelscher family.

“They made treatment fun for Eden and encouraged her goofy personality to come through,” Kylee said. “Some physicians and physical therapists just do what they were taught in school. At Frazier Rehab Institute, they look outside the box.”

Little Miracles

Within 50 days, Eden was able to take her first steps with the support of a friend named Violet, who was visiting Eden from California.

Kylee recalls Eden predicting the progress she made with her friend’s support.

“Eden said, ‘Violet loves me so much,’” Kylee recalled. “‘I think when she gets here, her love will be so strong it will make me walk.’”

During a physical therapy session, Eden and Violet had an imaginary swordfight. While the physical therapist held Eden up, she began taking steps toward Violet and eventually made it all the way around the room and into the hallway. The family will always remember the day she took those first steps.

Nicholas, Eden, Isabella and Kylee Hoelscher

Nicholas, Eden, Isabella and Kylee Hoelscher

Grateful for the support and life-changing care Eden has received, the Hoelscher family are now firm supporters of Frazier Rehab Institute. They routinely raise funds for Jewish Hospital & St. Mary’s Foundation to support the facility that changed their daughter’s life, and invite the rest of the community to do the same.

“People come to Frazier Rehab Institute from all over the world. We want to give to a program that really makes a difference in the lives of children,” said Kylee.

This article originally appeared in the 2017 Spring edition of One Health magazine.

The Power of Puppy Love

The Power of Puppy Love

The Power of Puppy Love

Frazier Rehab Institute recently welcomed a new furry friend to the team.

In December 2016, thanks to donations to the Jewish Hospital & St. Mary’s Foundation, Frazier Rehab Institute patients received a wonderful surprise: a 15-week-old yellow Labrador retriever puppy named Stanley. Stanley is joining the pet therapy program at Frazier Rehab Institute, part of KentuckyOne Health. This program plays an important part in providing emotional support to hundreds of patients each year.

The addition of Stanley and other future therapy pets is possible thanks to a generous donation from the June and Stanley Atlas family to the Jewish Hospital & St. Mary’s Foundation.

“The Atlas family graciously provided more than $160,000 in support, which will allow Frazier Rehab Institute to grow the pet therapy program and add an additional three therapy dogs,” said Leslie Buddeke Smart, CFRE, division vice president of development for KentuckyOne Health.

For the Atlas family, this generous donation came straight from the heart.

“We want to help make a difference for patients like my mother, June, who spends so much time at Frazier Rehab Institute,” said LouAnn Atlas, who is also a KentuckyOne Health board member. “Seeing her face light up when she opened this gift and saw Stanley was truly
a priceless moment. We know he will be loved by my mother and so many other patients.”

June Atlas and her granddaughter, Maggie Atlas, introduce Stanley at Frazier Rehab Institute

June Atlas and her granddaughter, Maggie Atlas, introduce Stanley at Frazier Rehab Institute.

Learning the Ropes

Stanley will join forces with Charlie, the Frazier Rehab Institute’s beloved therapy dog who came on board in 2015. Canine Partners for Independence, a local nonprofit, will assist in training Stanley as a therapy pet. He will learn various skills to help promote physical movement, emotional well-being, cognitive function and social improvements in patients.

“The pet therapy program has helped so many patients,” Smart said. “It is a great example of integrative medicine and has been shown to help patients relax, reduce blood pressure
and heart rates, and serve as a calming distraction during procedures.”

Want to help support Frazier Rehab Institute’s pet therapy program? Visit Jewish Hospital & St. Mary’s Foundation to make a donation or learn more about giving opportunities.

This story originally appeared in the 2017 Spring edition of One Health magazine, a free publication distributed quarterly. Subscribe to One Health for more health and wellness stories.