BMN Blog

JAN 22

Over the last four decades, there has been a tremendous reduction in mortality of patients with cardiovascular diseases. This applies to the entire spectrum of disease, including patients with acute myocardial infarction, heart failure, atrial fibrillation and arrhythmia.

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JAN 14

I have a meniscus tear, now what?

Many patients who come to my clinic with an MRI that shows a meniscus tear are looking for advice on what to do next. Another physician may have told them that they need surgery because the MRI is abnormal. Some people just want another opinion. Not all meniscus tears need surgery.

I first want to understand the patient’s symptoms, and I look to see if the knee is locking, catching, or if it feels unstable. Meniscus tears that are unstable create these problems, which may indicate that more damage is being done to the articular cartilage in the rest of the knee. An additional concern here is that the knee could give way at a bad time, causing a fall or buckle leading to another injury. Be careful.

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JAN 08
Minimally Invasive Treatments for Varicose Veins By Charles Hunt II, MD, FACS, RVT in Clinical

Varicose veins appear as bulging, enlarged, bumpy, purple veins. Symptoms can include restless legs, swelling, aches, and cramps. Varicose veins occur more frequently with age but anyone can get them at any time. The American Academy of Dermatology estimates that about 80 million people in the United States have leg vein problems.

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DEC 05
Spotlight on Salivary Glands By Christopher Clark, MD in Clinical

Saliva is produced by three paired “major” salivary glands in the head and neck – Parotid, Submandibular, and Sublingual as well as ~400 “minor” salivary glands throughout your oral cavity and oropharynx. Saliva is usually plentiful (your mouth makes between one pint and one liter per day) and is important in the enzymatic digestion of food, providing an immunologic barrier for dental protection, and to foster ideal oral mucosal health. Salivary glands may be affected by several different disorders that disrupt their important normal function:

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DEC 02

The effects of a stroke are unique to each patient and everyone’s path to recovery will look different. However, there are inherent truths to stroke treatment that should guide clinical decisions on the best care for patients.

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NOV 14

As the new division director of the Pediatric Hematology-Oncology and Blood Marrow Transplantation program in the University of Alabama at Birmingham (UAB) Department of Pediatrics and Children’s of Alabama, my top priority is to build a well-rounded program; a program that is not only strong in its clinical mission – to provide the best treatment possible for children with cancer and blood diseases – but one that also has a strong research base, which includes clinical, basic and translational research.

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OCT 31

Seasonal affective disorder (SAD), which as its name implies, is a disorder related to the change in seasons. The earlier sunsets cause less daylight exposure which can impact mood and, subsequently, cause depression for many people. Further, SAD occurs like clockwork as the seasons change with certain people exhibiting the first warning signs in the fall which, consequently, worsen in the winter. During this time people with the disorder feel depressed, lethargic and irritable to the point that it interferes with their daily functioning.

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AUG 28

Obstructive Sleep Apnea (OSA) is a common problem affecting nearly one-third of the adult population. The long-term health effects of untreated OSA are beginning to become established and are frightening: increased risk of cardiovascular disease, stroke, dementia, pulmonary hypertension.

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JUN 26
I have a meniscus tear, now what? By Dewey Jones, IV, MD in Clinical

One of the most common operations in orthopaedics and sports medicine is surgery for a torn meniscus. I get a lot of questions about what this surgery involves, how long it takes to recover, and when it should be done.

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JUN 17

Recently, a friend in the pharmaceuticals business asked me about SGLT-2 Inhibitors. He wanted to know what a nephrologist thought of the drugs, and I expressed strong misgivings about potential complications.  

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APR 18

The field of oncodermatology has emerged as a result of remarkable advances in cancer treatment. Unlike traditional chemotherapy, targeted anticancer agents such as epidermal growth factor receptor (EGFR) inhibitors are associated with decreased systemic toxicities.

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APR 09
Sciatica Treatment Options By Jeffrey D. Wade, MD in Clinical

One of the more common complaints evaluated by health care providers on a daily basis is Sciatica which is described generally as pain in the lower back or buttock that radiates into the leg and the foot along the path of the sciatic nerve. Patients will sometimes complain of associated numbness, tingling and even weakness in their lower leg with difficulty sitting. Symptoms can appear suddenly or gradually, and with or without a preceding precipitating event such as lifting or other back straining activities.

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FEB 27
Rising Trends in AFIB By Corey M. Coleman, MD in Clinical

Atrial fibrillation (AFIB), a condition in which the heart fires so rapidly that the upper chambers quiver instead of beating in a normal rhythmic pattern, is the now most common arrhythmia condition worldwide and is recognized as a global health problem with its burden of morbidity and mortality resulting from embolic stroke. AFIB is expected to double by 2030.

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FEB 21

Peripheral arterial disease, or PAD, is a disease process in which plaque buildup causes the arteries to narrow, resulting in reduced blood flow to the limbs. This can lead to a variety of medical emergencies: Claudication, stroke, uncontrolled hypertension, and possibly amputation.

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FEB 12

In 2012, Transcatheter Aortic Valve Replacement (TAVR) became commercially available in the US to treat high-risk patients with severe aortic stenosis. It offered effective, minimally invasive, and often lifesaving treatment to tens of thousands of patients who previously had no option for aortic valve replacement surgery.

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JAN 18

When I speak with a patient regarding knee replacement or hip replacement surgery, he/she often asks in detail about the post-surgical rehab. In my specialty of orthopaedics, rehabilitation is critical to the success of the surgery. However, one of the major risks, although uncommon, facing surgery patients is the formation of a blood clot within a deep vein. This complication is often overlooked, and can be fatal when symptoms are ignored. 

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JAN 16

The dawn of a new year is often a time to reflect on what has been and what is to come. At the Alabama Center for Childhood Cancer and Blood Disorders, we are excited about the opportunities to improve patient care, and we never cease to be amazed by a community determined to change things for the better.

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DEC 05

At this point, nearly every American has heard about the opioid crisis. With increasing scrutiny from governing bodies regarding opioids, pain physicians are tested in treating patients in the challenging chronic pain population. While non-opioid medications, therapy and procedures have their place in treating chronic pain, what are physicians to do when patients fail all of these options? One treatment to consider is spinal cord and peripheral nerve stimulation.

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SEP 25
Children’s at Lakeshore collaborative marks new day in patient care By Drew Davis, M.D. UAB Associate Professor and Medical Director, Division of Pediatric Rehabilitation Medicine at Children’s of Alabama in Clinical

On Sept. 6, representatives of Children’s of Alabama, the University of Alabama at Birmingham (UAB) Division of Pediatric Rehabilitation Medicine and the Lakeshore Foundation gathered to cut the ceremonial red ribbon for the grand opening of Children’s at Lakeshore – the latest chapter in a partnership among the institutions.

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AUG 13
The Benefits of Occupational and Physical Therapy By Melody Cook, OT/L with Alabama Bone & Joint Clinic in Clinical

What is the importance of occupational and physical therapy rehabilitation? Each discipline has its own unique benefits for clients of all age ranges with varying diagnoses and various settings. A common misconception regarding therapy in general is that treatment will elicit pain and discomfort. However, one of the primary goals of both occupational and physical therapy is to control pain in order to increase daily function and skill.

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JUL 18
Concussions By Katherine Weise, OD, Professor of Optometry Director, Pediatric Optometry Services at UAB in Clinical

“We’re all wearing our team colors, but colors don’t matter when it comes to concussion,” says Dr. Jimmy Robinson, University of Alabama lead team physician. This year, at the Children’s of Alabama Annual Concussion Summit, a special science, vision, and engineering breakout session featured the insight of Dr. Robinson and others in the trenches of Division I sidelines. Led by UAB’s director of medical athletics, Dr. Heath Hale, and UAB Team Eye Doctor, Dr. Kathy Weise, lead team physicians and scientists from Alabama, Auburn, Florida and Clemson joined forces to weigh in on UAB’s advancements in concussion expertise. What if a contact lens could determine how much the eye sloshes around in the orbit to predict how much the brain moves in the skull when exposed to impact? What if retinal blood flow could predict cerebral blood flow following concussion? What if an objective pupil test could help predict prolonged concussion recovery?

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MAY 30
Pediatric neurology division continues growth By Leon Dure, M.D. UAB Professor and Director, Division of Neurology & William Bew White, Jr. Chair in Pediatric Neurology in Clinical

Medical advancements through specialized programs and essential personnel are vital to the continued growth of the University of Alabama at Birmingham (UAB) Division of Pediatric Neurology at Children’s of Alabama. Expansion is underway while the unremitting needs of patients are met.

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MAY 23
Hepatitis B: Screening in Primary Care By David M. Fettig, MD, Birmingham Gastroenterology Associates in Clinical

The CDC estimates that 1.2 million people in the United States have chronic Hepatitis B (HBV) but two-thirds do not know they are infected. These unaware patients can have clinically silent infections for decades until developing cirrhosis, end-stage liver disease, or hepatocellular carcinoma (HCC). HBV is transmitted by percutaneous or mucosal exposure to blood or body fluids of an infected person, such as from an infected mother to her newborn during childbirth, through close personal contact within households, through unscreened blood transfusion or unsafe injections in health- care settings, through injection drug use, and from sexual contact with an infected person.

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MAY 22

"I believe it was divine intervention that I was sent to Aspire Physical Recovery Center at Cahaba River. The therapy team brought me back to myself."

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MAY 17
Total Joint Replacement By Daryl Dykes, MD with Alabama Bone & Joint Clinic in Clinical

The question is often asked, at what point should a patient and his or her physician begin to consider a total joint replacement?

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APR 30
Burnout Proof – Healing the Healers By Lori M. Quiller, APR Director of Communications and Social Media Medical Association of the State of Alabama in Business

According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.

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APR 19

More than 10 million people in the United States are affected by Peripheral Artery Disease (PAD). About one in every twenty Americans over the age of 50 has PAD. Smokers are four times more likely to develop the condition. Peripheral Artery Disease is a strong indicator for potential heart attack and stroke. Most people are aware of coronary artery disease but few know the symptoms of vascular disease. The most common symptom of PAD in the lower extremities is a painful muscle cramping in the hips, thighs and calves when walking or exercising.   Other symptoms to be aware of are leg numbness, skin discoloration of the legs or toes & loss of hair on the lower legs.                                                                                                                                    

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APR 02

Lipedema (Lip- fat, edema- swelling) is a disease of abnormal and disproportionate adipose tissue deposition almost exclusively occurring in women1. While the disorder was originally described in 19402, lipedema remains under-recognized and underdiagnosed in the United States3. This article aims to elucidate the salient features of lipedema toward the goal of raising awareness among the medical community.

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MAR 28
Atrial Fibrillation Awareness and Progression Prevention By Macy C. Smith, Jr., MD, FACC, FHRS with Cardiovascular Associates in Clinical

Almost everyone has seen the ads for the new anticoagulants at this point. However, many Americans still remain in the dark regarding what atrial fibrillation (Afib) is and it’s potentially devastating consequences. Despite increasing efforts to improve the awareness for atrial fibrillation, many still do not know it’s signs and symptoms or that it is a progressive disease. Afib is the most common arrhythmia in the world affecting 3-6 million Americans with projections of up to 16 million by the year 2050.

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MAR 13
It’s Not Just Stress: Removing the Cloak of Anxiety By Minerva Amputch Young, LPC, NCC with West Neuropsychology, LLC in Clinical

In a world of rapidly accelerating technology, our lives have become a 24hr sprint of endless tasks to be completed within a certain timeframe. Doctor offices are inundated with patients many young in age presenting symptoms such as high blood pressure, racing heartbeat, headaches, chest pain, random sweats, insomnia, and gastrointestinal problems. With the increased volume of patients and the demanding time constraints experienced in physician offices, these physical symptoms are often treated individually. The physician may prescribe medication, make recommendations on possible lifestyle changes, yet the symptoms remain. Effective treatment has to go deeper. These patients could be simply suffering from stress or they could be dealing with a more problematic subset of mood disorders: Anxiety Disorders.

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MAR 06

The assessment of patient compliance is very difficult. Many patients may not want to disappoint their physician and will not be completely accurate about their degree of compliance. Other patients are not able to accurately evaluate or do not know their degree of compliance. In one study, 10% of patients reported that they were 100% compliant with their medication use. Using pill count methods, however, the use of the prescribed medications ranged from 2% to 130% of the prescribed pills.

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FEB 16

Until recently, sufferers of chronic or recurrent sinusitis were limited to two treatment options: medication therapy or aggressive sinus surgery. Fortunately, advances in medical science have opened new doors.

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FEB 07
Creating a World Where Every Person Matters By Lori M. Quiller, APR Director of Communications and Social Media Medical Association of the State of Alabama in Business

When Michele Kong was a little girl growing up in Malaysia, she knew the world was filled with both wonder and danger. She surprised herself and her family when she managed to kill a not-so-small python that slithered into their home. She laughs now remembering the incident, but she said someone had to do it to protect her family, and she had the shovel.

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DEC 22

Noncompliance (non-adherence) to medical recommendations can have a significant impact on a patient’s overall health quality, resulting in decreased opportunities for prevention, delayed diagnosis, and incomplete or ineffective treatment. There may also be significant liability and financial risks to a responsible healthcare professional treating this patient, particularly as patient outcomes increasingly become connected to quality indicators and reimbursement.

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DEC 21
UAB, Children’s of Alabama Committed to a Cure By Kimberly Whelan, M.D., MSPH Interim Director, Alabama Center for Childhood Cancer and Blood Disorders at Children’s of Alabama Associate Professor of Pediatrics, University of Alabama at Birmingham in Clinical

The Alabama Center for Childhood Cancer and Blood Disorders at Children’s of Alabama actively works toward the goal of a total cure through research and development of innovative therapies. More than a dozen prominent pediatric hematology, oncology and blood and bone marrow physician-scientists provide exceptional programs in patient care, education and research. Currently, the Center provides care or treatment for 90 percent of the pediatric hematology-oncology patients in the state.

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DEC 19

Two million Americans suffer from plantar fasciitis every year and 10 percent of the population will experience it in their lifetime. It has become recognized as one of the most chronic and, often times, most difficult foot problems to treat.

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DEC 05
Depression: It’s Not Just Emotional By Minerva Amputch Young, LPC, NCC with West Neuropsychology, LLC in Clinical

Dr. Sunshine arrives in her clinic at 8 am. Her lobby is full of patients. Mrs. Jane, a 45-year-old widower who has been Dr. Sunshine’s patient for 10 years. Mrs. Jane has recently been complaining about reoccurring back pain, the inability to fall asleep, and indigestion problems. Dr. Sunshine is aware of the sudden passing of Mrs. Jane’s husband a year ago and treats her physical symptoms as they present themselves with analgesics, sedatives and reflux medicine. Yet, Mrs. Jane’s complaints remain. Although compliant with her medications, Mrs. Jane’s symptoms are a result of Major Depressive Disorder. 

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DEC 01
Seniors benefit from physical fitness By Agee Robert, Jr., MD with BBH Specialty Care Network Sports Medicine in Clinical

Just because you’re getting older doesn’t mean that it’s too late to get in shape. In fact, research shows that older people who have never exercised can still benefit from physical conditioning. By starting a regular exercise program, you can help prevent coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancer. Physical fitness reduces the effects of osteoporosis and arthritis — two conditions which can severely limit an older person’s lifestyle. Being in good shape physically can help you remain independent as you age and improve the quality of your life.

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NOV 06
Parkinson’s By Cheryl Pierce, Occupational, Certified LSVT BIG Therapist at Healthsouth Lakeshore in Clinical

Parkinson’s is recognized as the second most neurodegenerative disorder right behind Alzheimer’s. An estimated 7 to 10 million people have Parkinson’s disease worldwide, with 60,000 new cases of Parkinson’s being diagnosed just in the U.S. every year. Parkinson’s is known as a progressive condition and symptoms will affect patients differently. Typically, people diagnosed with Parkinson’s will portray some degree of difficulty with shaking or tremor, slowness of movement or bradykinesia, stiffness in movement or rigidity of the arms, legs and trunk and gait imbalance. Because of the loss of dopamine producing brain cells, patients will see their movements become slower and smaller, creating risk for falls and impairing their quality of life.

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OCT 23
Controlling Myopia Progression By Andrew D. Pucker, OD, PhD, FAAO with UAB eye care in Clinical

What is myopia?

 

Myopia is a condition that results in distant objects appearing blurry to a patient when not being corrected with glasses or contact lenses.1 Myopic blur typically results from the eye being too long for its optical focusing components (cornea and crystalline lens), which causes distant objects to be in focus in front of the retina (back of the eye) instead on the retina, a requirement for the eye to be able to see clearly.1 About one third of Americans have myopia, and its prevalence is likely increasing because of factors associated with living in a developed country (e.g., decreased time outdoors).2-5 With that said, the scientific community only has a vague understanding of how genetics and the environment influence the development and progression of myopia.1 While myopia’s visual affects can be a costly nuisance and strain on the health care system,6 myopia also places the affected individuals at a greater risk for developing vision-threatening conditions like cataracts, retinal detachments, and glaucoma.1 Once present, myopia cannot be cured; therefore, preventing it or even reducing the amount of myopia that a patient develops is an upmost priority for the scientific community.7

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OCT 10
Billing Under Another’s Provider Number Can Land Physicians in Hot Water By Emma Cecil, JD, Senior Regulatory Attorney & PolicyHolder Advisor with MagMutual in Regulatory

An Oklahoma physician agreed on August 28, 2017 to pay the government $580,000 to resolve allegations that he violated the False Claims Act by submitting claims to the Medicare program for services he did not provide or supervise. According to the government, the physician allowed a company that employed him and in which he had an ownership interest to use his NPI numbers to bill Medicare for physical therapy evaluation and management services that he did not provide or supervise. The government further alleged that after he separated from the company and deactivated his NPIs associated with the company, he reactivated those NPIs so that the company could use them to bill Medicare for services he neither performed nor supervised.

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SEP 28
Peripheral Arterial Disease By Monica G Hunter, MD, FACC, FSCAI with Birmingham Heart Clinic in Clinical

Most people are aware that atherosclerosis can cause blockages in the coronary arteries, resulting in chest pain or heart attack, or in the carotid arteries, precipitating a stroke. But atherosclerosis can lead to another serious but often under-diagnosed condition: peripheral arterial disease (PAD). Defined as atherosclerotic obstruction of the arteries to the lower extremities, PAD causes leg pain and is associated with other cardiovascular disease. Although lower extremity PAD affects an estimated 12 to 20 million people in the United States, only four to five million of them are experiencing symptoms.

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SEP 27
September is Prostate Cancer Awareness Month By The Doctors of Urology Centers of Alabama in Clinical

Did you know that prostate cancer is the second most common cancer among American men? In fact, an average of 480 American men are diagnosed with prostate cancer every day - that’s one every 3 minutes.

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SEP 12
Prostate Cancer By Medical West Hospital in Clinical

The prediction: 161,360 new diagnoses and 26,730 fatalities.

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AUG 23
Tennis Elbow…? But I don’t even play tennis! By Michael D. Smith, MD with Southlake Orthopaedics Sports Medicine & Spine Center, PC (Hand and Upper Extremity Surgeon) in Clinical

As a hand and upper extremity Orthopaedic surgeon, I see many patients that present to my office with pain in their elbow and forearm. For a certain subsets of these patients, I ultimately diagnose them with lateral epicondylitis, or tennis elbow. Oftentimes, their reaction is the same. They say, “Doc, I don’t even play tennis, how could I have tennis elbow?!” Unfortunately, many people assume that lateral epicondylitis will only affect those individuals that are active in racquet sports, when in reality; tennis elbow can affect both men and women regardless of their hobbies.

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AUG 03
OMNIVR system By Stirling Shirah, MD medical director at Aspire Recovery Center at Cahaba River & Member of Hospitalist Services of Alabama, P.C. in Clinical

"Aspire Physical Recovery Center at Cahaba River is proud to offer its guest use of the OMNIVR system. The OMNI is a virtual reality augmented rehabilitation system that allows trained clinicians the opportunity to work with guests in novel, yet functional ways.

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AUG 02
New Therapy for Malignant Brain Tumors By Christopher Jahraus M.D. with Shelby Baptist Medical Center and Generations Radiotherapy & Oncology PC in Clinical

Tumor Treating Fields or TTF as it is more commonly known is a recently developed method by which malignant brain tumor cells are prevented from reproducing. Shelby Baptist Medical Center and Generations Radiotherapy & Oncology PC has begun therapy on its first patient using this entirely new approach in the treatment of malignant brain tumors with the Optune TTF system.

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JUL 20
Prostate Cancer and Modern Medicine By Joelle Hamilton M.D., Medical Oncologist with Urology Centers of Alabama in Clinical

Prostate cancer is the second most common cancer diagnosed in American men and the second leading cause of cancer death. While a majority of men will be diagnosed after the age of 65, younger men do need to consider screening for prostate cancer, especially if risk factors are present such as African American heritage or a family history of prostate cancer.

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JUL 12
Hard-to-heal wounds can be a problem for many people By Matthew Reed M.D.,Justin Moellinger M.D. & Beatrice Chaicharncheep M.D. with Medical West Advanced Wound Center in Clinical

Hard-to-heal wounds can be a problem for many people. One way that Medical West is offering treatment is through hyperbaric oxygen therapy at the Advanced Wound Center.

Hyperbaric oxygen therapy is the application of 100% oxygen that is applied to a patient under pressure. The therapy is used for decompression sickness, for infections, air pockets in blood vessels, and for diabetic wounds that won’t heal.

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MAY 05
The 3 Pillars of Athletic Health: Rest, Conditioning & Nutrition By : Ricardo E. Colberg, M.D. with Andrews Sports Medicine & Orthopaedic Center in Clinical

You may have thought that a sports orthopaedic center would be a place to go only after a catastrophic sports injury—something breaks or tears or starts hurting so badly you can’t physically use it.

 

“Most athletic injuries seen in sports clinics are indeed overuse injuries that have reached a point of taking the patient out of the game,” said Dr. Ricardo Colberg of Andrews Sports Medicine & Orthopaedic Center. “Although 85% of sports injuries do not require surgery, many patients wait until they are unable to compete to start correcting their issues.”

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APR 20
Pain with intercourse? Vaginal discomfort? Not for me! By : Rupa Kitchens MD with Urology Centers Of Alabama in Clinical

As we women age, we do not always know what is coming next. We think we do, but we may not. We all know the stereotypical changes that happen with menopause, and of course, chronic diseases such as diabetes, heart disease, etc. that can occur with age.  I can tell you that many women in their late 40s to late 70s are not expecting pain with intercourse, vaginal pain and discomfort, or both. It is honestly a surprise. And not a good one at that. It can make a healthy sexual relationship go sour very quickly, which not only hurts the woman’s quality of life, but her partner’s as well. This can affect the relationship as a whole, and both parties’ overall health, which can then lead to other medical issues. In our practice, we traditionally have treated men for erectile dysfunction and other sexual issues, but we understand that female sexual health is important as well. 

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APR 12

CASE STUDY

A 34-year-old male presented to a family medicine physician for chronic low back pain. The physician is comfortable prescribing opioids and has many patients on scheduled drugs. The patient has had chronic pain for many years and has undergone multiple treatments including physical therapy, steroid injections and many medications. On presentation, the patient was on Robaxin and oxycodone (four times a day). His past history is positive for hypertension and alcohol abuse, although he stated he hasn’t drank in the past year. He works as a laborer.

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APR 10
Coronary artery calcium score. What is that? By John D. McBrayer, M.D. with Heart South Cardiovascular Group, PC in Clinical

Early detection of coronary artery disease is a significant problem. One third of deaths after 35 are secondary to cardiovascular disease. One half of middle aged men and one third of middle aged women will develop coronary artery disease. Currently our ability to detect early disease is limited. By the time symptoms occur there is usually 70% obstruction of the coronary artery. Data from autopsies on Korean War casualties indicate initial signs of development of coronary plaque in the early 20’s of age. Theoretically it would seem appropriate to begin prevention therapy as soon as possible but who should get it? Obviously, the patients with known vascular disease and equivalents such as diabetes would need this therapy. Those without established disease need an estimate of their risk.

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MAR 03
Communicating With Aphasic Patients after Stroke By Shelia Carlisle, Speech Pathologist, HealthSouth Lakeshore Rehabilitation Hospital in Clinical

A common diagnosis patients present at HealthSouth Lakeshore Rehabilitation Hospital is stroke. One of the many deficits a stroke patient may incur is aphasia, a speech and language disorder that causes difficulty using or comprehending words during listening, speaking, reading and writing. Although symptoms may vary from patient to patient, the difficulties and frustrations people with aphasia and their families encounter are consistent. 

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