RUSK Insights on Rehabilitation Medicine Dr. Thomas Elwood

Dr. David Jevotovsky is in the second year of a residency program at the Rusk Rehabilitation Institute at NYU Langone Health. A former graduate of NYU Grossman School of Medicine, he is keen on pursuing a fellowship in interventional pain medicine. Having experienced a traumatic brain injury during his medical training, he possesses a unique understanding of both the patient and provider perspectives of this condition.


As patients differ on the basis of age, gender, and racial/ethnic background,  whether they also tend to differ in how they express what it is like to experience a TBI and live with its aftermath; the role played by social media in the residency program; whether beneficial outcomes can result from having patients with a TBI participate in physical exercise activities; why it is hard for many patients, their loved ones, and even PM&R physicians to understand how a brain could be rewired; and different perspectives that patients and physicians may have regarding agitation/delirium, cognition, return to work, and support systems. 

 



 

This unique episode features course directors Dr. Salvador Portugal, Dr. Surein Theivakumar, Dr. Julia Iafrate, Dr. Jina Libby and Dr. Haruki Ishii for the course taking place 6/7-6/9.
The following link has more information, if you or anyone you know is interested in registering: https://www.pathlms.com/nyurusk/courses/66458.

Dr. Jina Libby completed her PM&R residency in Michigan. Her dedication to that profession and sports medicine extends beyond clinical practice as she serves on the executive committee for the International Rehab and Global Health Committee of AAPM&R. Her fervor for education is evident through her commitment to teaching physical medicine and rehabilitation, not only locally, but also by championing its integration on an international scale.
Beyond her current role as a fellow physician, Dr. Laurenie Louissaint's compassionate spirit leads her on frequent global impact trips, where she provides critical medical support to underserved communities, such as Haiti and Namibia. She also is an active member of the New York City cycling community while also providing medical care for injured cyclists and developing related research.
Part 1
The discussion in Part 1 included the following items: demographic aspects of Namibia, major health problems in that nation, how health care is financed, similarities with western allopathic health practices, use of traditional and alternative health care interventions, status of health professions educational institutions, and nature of the auspices sponsoring the visitation trip by U.S. clinicians to that country.
Part 2
The discussion in Part 2 included the following items: types of health professionals in the group visiting Namibia, kinds of Namibian practitioners interacted with during the visit, most evident aspects of health care in that nation where improvements would appear to be beneficial, possibly reversing the flow of clinicians to enable Namibians to spend time in U.S. clinical facilities, and health professional literature produced in that country.

Dr. Jina Libby completed her PM&R residency in Michigan. Her dedication to that profession and sports medicine extends beyond clinical practice as she serves on the executive committee for the International Rehab and Global Health Committee of AAPM&R. Her fervor for education is evident through her commitment to teaching physical medicine and rehabilitation, not only locally, but also by championing its integration on an international scale.
Beyond her current role as a fellow physician, Dr. Laurenie Louissaint's compassionate spirit leads her on frequent global impact trips, where she provides critical medical support to underserved communities, such as Haiti and Namibia. She also is an active member of the New York City cycling community while also providing medical care for injured cyclists and developing related research.
Part 1
The discussion in Part 1 included the following items: demographic aspects of Namibia, major health problems in that nation, how health care is financed, similarities with western allopathic health practices, use of traditional and alternative health care interventions, status of health professions educational institutions, and nature of the auspices sponsoring the visitation trip by U.S. clinicians to that country.
Part 2
The discussion in Part 2 included the following items: types of health professionals in the group visiting Namibia, kinds of Namibian practitioners interacted with during the visit, most evident aspects of health care in that nation where improvements would appear to be beneficial, possibly reversing the flow of clinicians to enable Namibians to spend time in U.S. clinical facilities, and health professional literature produced in that country.

Dr. Sharon Kolasinski is a professor of clinical medicine at the University of Pennsylvania and chief of the Division of Rheumatology at Penn Presbyterian Medical Center.
Part 1
Her objectives in the presentation are to help listeners by learning about evidence-based treatment for patients with osteoarthritis (OA), to understand the process by which guidelines are developed that might help us figure out our evidence-based approach, to review the recommended treatments for OA, and to review some treatments that are not recommended for OA. Her basic evidence-based reference is a University of Pennsylvania guideline that was published in 2020. Numerous other guidelines are available, which she described. She discussed her work with a case involving a 55-year-old male patient. He arrived for routine follow-up care for immunosuppressive medication monitoring. He described pains that he was experiencing and was diagnosed with OA. She indicated the impacts OA has on patients. Clinicians find it a daunting challenge to provide satisfactory treatment. For example, for some clinicians, the guidelines do not appear to be clear and provide a roadmap. Also, they do not always believe in the recommendations contained in the guidelines. In this presentation, she wants to see if she can change some minds about guidelines. She provided an example based on investigations conducted at her institution. The outcome was a series of recommendations that she described.
Part 2
Dr. Kolasinski began Part 2 of her presentation by continuing to focus on the importance of having patients with OA engage in physical activity. She stated that “they are worn out and the implication is that a doctor is needed to fix them.” Perhaps a perspective should be taken of a more participatory discourse where we encourage physical therapy and emphasize that physical exercise is safe when you have arthritis and focus on what the patient can do, empowering them to exercise. A starting point is to give patients a physical therapy prescription. She discussed the extent to which physical therapy is useful, along with indicating how much and how frequently exercise is beneficial (e.g., for 20 minutes, three times a week). Losing weight is an effective way of reducing symptoms. Food choices can affect OA symptoms. Diet and exercise used together can produce effective results. References were made to several studies that involve the status of steroid injections on improving patient health status. Acupuncture also was mentioned. She indicated conditional recommendations on the use of pharmacological interventions. She concluded by describing how to treat the 55-year-old patient she mentioned in Part 1 of her presentation.

Dr. Sharon Kolasinski is a professor of clinical medicine at the University of Pennsylvania and chief of the Division of Rheumatology at Penn Presbyterian Medical Center.
Part 1
Her objectives in the presentation are to help listeners by learning about evidence-based treatment for patients with osteoarthritis (OA), to understand the process by which guidelines are developed that might help us figure out our evidence-based approach, to review the recommended treatments for OA, and to review some treatments that are not recommended for OA. Her basic evidence-based reference is a University of Pennsylvania guideline that was published in 2020. Numerous other guidelines are available, which she described. She discussed her work with a case involving a 55-year-old male patient. He arrived for routine follow-up care for immunosuppressive medication monitoring. He described pains that he was experiencing and was diagnosed with OA. She indicated the impacts OA has on patients. Clinicians find it a daunting challenge to provide satisfactory treatment. For example, for some clinicians, the guidelines do not appear to be clear and provide a roadmap. Also, they do not always believe in the recommendations contained in the guidelines. In this presentation, she wants to see if she can change some minds about guidelines. She provided an example based on investigations conducted at her institution. The outcome was a series of recommendations that she described.
Part 2
Dr. Kolasinski began Part 2 of her presentation by continuing to focus on the importance of having patients with OA engage in physical activity. She stated that “they are worn out and the implication is that a doctor is needed to fix them.” Perhaps a perspective should be taken of a more participatory discourse where we encourage physical therapy and emphasize that physical exercise is safe when you have arthritis and focus on what the patient can do, empowering them to exercise. A starting point is to give patients a physical therapy prescription. She discussed the extent to which physical therapy is useful, along with indicating how much and how frequently exercise is beneficial (e.g., for 20 minutes, three times a week). Losing weight is an effective way of reducing symptoms. Food choices can affect OA symptoms. Diet and exercise used together can produce effective results. References were made to several studies that involve the status of steroid injections on improving patient health status. Acupuncture also was mentioned. She indicated conditional recommendations on the use of pharmacological interventions. She concluded by describing how to treat the 55-year-old patient she mentioned in Part 1 of her presentation.