Mayo Clinic has challenged its researchers to transform the practice of medicine with research that leverages multidisciplinary expertise, technology and therapeutic advances to address unmet clinical needs. This story describes how one team has risen to the challenge, elevated the level of teamwork across disciplines and achieved novel results using spinal stimulation to enable function after spinal cord injury. The story focuses on two team members — both alumni of Mayo Clinic College of Medicine and Science schools in different disciplines.

The two first authors on a recent publication in Nature Medicine have personal connections to the groundbreaking research they reported in the manuscript. Peter Grahn, Ph.D., a senior engineer in the Department of Physical Medicine and Rehabilitation and alumnus of Mayo Clinic Graduate School of Biomedical Sciences; and Megan Gill, D.P.T.,, an alumna of Mayo Clinic School of Health Sciences who also has a doctorate in physical therapy, have worked on a team of researchers from Mayo Clinic, UCLA and Houston Methodist during the last four years. The team has studied an emerging research approach to restore function in people with paralysis due to spinal cord injury. From a personal perspective, Drs. Gill and Grahn have each had a health-related event that affected their mobility

The study

In 2014, a team of 15 Mayo Clinic scientists and clinicians from neuro-engineering, neurosurgery, and physical medicine and rehabilitation acquired internal funding to collaborate with V. Reggie Edgerton, Ph.D., of UCLA, to establish his team’s spinal neuromodulation approach at Mayo Clinic. The approach was developed in conjunction with Susan Harkema, Ph.D., from the University of Louisville. Building on Dr. Edgerton’s work, the Mayo team designed the clinical trial protocol and acquired Mayo Clinic Institutional Review Board approval and an Investigational Device Exemption from the Food and Drug Administration (FDA). Mayo Clinic received FDA permission to use an electrical stimulation device for research purposes to study a condition not covered by its approved label. Co-principal investigators were Kendall Lee, M.D., Ph.D., Department of Neurologic Surgery and director of Mayo Clinic’s Neural Engineering Laboratories; and Kristin Zhao, Ph.D., Department of Physical Medicine and Rehabilitation and director of Mayo Clinic’s Assistive and Restorative Technology Laboratory.

The Mayo Clinic team’s objective was to determine whether spinal cord circuitry could be modulated with electrical stimulation and rehabilitation to restore function lost to paralysis. Two patients with complete spinal cord injury were enrolled in the trial.

“Dr. Edgerton’s team showed us the ropes of how to program the epidural electrical stimulator so we could replicate what they’d achieved in their studies,” says Dr. Grahn. “During our initial programming session, the subject moved his leg using his own intent. When we observed this ability, everyone in the room gasped.”

The Mayo team replicated the UCLA team’s results within the first week of the study and continued to see what more they could achieve. They accomplished much more than basic leg movements.

Jered Chinnock, who injured his spinal cord at the thoracic vertebrae in the middle of his back in a snowmobile accident in 2013, was the first participant in the Mayo Clinic study. He had complete loss of function and feeling below the middle of his torso. Dr. Lee and his neurosurgery team had implanted an electrode array in the epidural space at a specific location below Chinnock’s injury. The electrodes were connected to a pulse generator that was implanted near the patient’s abdomen. The generator communicates wirelessly to an external controller.

Chinnock participated in 113 rehabilitation sessions in the lab over 43 weeks in 2016 and 2017. Team members programmed the stimulator and recorded electrophysiology and biomechanical data. Dr. Gill led the physical therapy team and provided expertise about how rehabilitation with the device should occur. They provided Chinnock with physical assistance and used a body-weight harness to help him stand and step. With electrical stimulation, he was able to stand, swing his legs and shift his weight to maintain his balance. Because he didn’t regain sensation in his legs, Chinnock initially used mirrors to view his leg movement while rehabilitation team members provided verbal and tactile cues to describe his leg position, movement and balance.

“ Seeing our research subjects’ accomplishments is exciting, We’re grateful for their phenomenal effort and contributions to our research.”

Peter Grahn, Ph.D.

The results

By the end of the study, Chinnock no longer needed a harness and had only occasional help from the therapists. He learned to use his body to transfer weight, maintain balance, and propel forward on a treadmill while using his arms on the support bars to help with balance. He required minimal verbal cues and periodic glances at his legs. He progressed to using a front-wheeled walker to step with minimal assistance from the team.

“I was surprised by the amount of motor activity Jered was able to do with stimulation,” says Dr. Grahn. “Looking at past studies, we thought he may be able to stand without assistance and move his legs while lying down. No studies had shown that someone with complete paralysis could stand and take steps. With the stimulator off, the subject remains completely paralyzed below the level of his injury. These findings suggest that even the most severe cases of paralysis likely have some connections intact across the injury, and that neural networks below the spinal cord injury can be facilitated by epidural stimulation to restore functions such as standing and stepping. Altogether, these results support the concept that task-specific rehabilitation performed during spinal stimulation can enable functional reorganization of the spinal cord to recover functions lost due to spinal cord injury.”

Dr. Grahn says the results generated by the Mayo team could be attributed to factors such as the patient’s specific injury, some aspect of the rehabilitation or key changes made to stimulator settings. Certainly, their findings have sparked more questions to investigate.

The team is endeavoring to further explore the use of epidural electrical stimulation and other emerging spinal neuromodulation techniques, combined with intense physical therapy, to help paralyzed patients regain function. A subsequent trial will help answer some of the unknowns from the first — to gain a better understanding of how and why the epidural electrical stimulation enables these functional gains and which patients will respond to stimulation.

Now that Chinnock is home in Tomah, Wisconsin, he works on an exercise program the Mayo team specified. He has approval to use the device for standing with a walker and to improve his trunk strength and balance during daily activities in his wheelchair.

The personal connection

While it can’t be measured as part of the data, Dr.Gill and Dr. Grahn say their personal experiences had a significant impact on their perspectives and dedication to the project.

At age 18, Dr. Gill developed a systemic infection that required a year of rehabilitation and healing to allow normal use of her left leg. That experience led her to pursue a medical career and develop personal drive to help patients achieve their goals.

Dr. Grahn has had quadriplegia due to spinal cord injury since 2005 and uses a powered wheelchair for mobility. When he was 18, he dove off of a dock in central Minnesota and hit the shallow bottom of a lake, fracturing the fifth vertebrae in his neck. He was instantly paralyzed and spent almost a year in rehabilitation.

Dr. Grahn, whose injury has affected his motor functions more than the patient in the Mayo Clinic study, says he felt a strong sense of excitement as Chinnock’s abilities progressed during the study. “In the early stages of my own recovery, I admit there was a sense of jealousy when someone in the rehab gym with a similar prognosis as mine would recover to walk again. My point of view is different now. For the first couple of months after my accident, I thought if I worked hard enough at rehabilitation, I’d get better as I had with past sports-related injuries. Over time I realized my disability was permanent, and I experienced dark times during that period in my life. Eventually I realized that life is full of challenges, and learning to live with my disability was one of those challenges. I was also curious why the spinal cord doesn’t heal.

“Fast forward 13 years, and I’m in a unique position to contribute to making discoveries and generating information to advance the research fields of neuromodulation and spinal cord injury. It was exciting to see the potential of what our patient could do when we turned on the stimulator. Our work demonstrates that spinal cord injury severity is more of a spectrum. We may be able to improve function even in severely injured patients who are diagnosed with the worst category of injury.”

Dr. Gill says Dr. Grahn advocated for epidural stimulation research at Mayo Clinic. “Peter is a prime example of someone living to their greatest capacity. Never has his disability held him back. He has gained a deep understanding of the neuromodulation literature and has developed the skills to communicate this information to all team members regardless of the level of expertise in paralysis research. And, because he has a spinal cord injury, he has unique understanding of our research subjects’ situation.”

###

The post How spinal stimulation research is working to restore function after paralysis appeared first on Mayo Clinic News Network.

Empowered living

Bridging ancient knowledge with new science, the Mindful Breathing Laboratory of Roberto P. Benzo, M.D., focuses on the study of how self-awareness, mindfulness and self-management impact chronic diseases, including lung cancer and chronic obstructive pulmonary disease (COPD).

Based at Mayo Clinic in Rochester, Minnesota, the Mindful Breathing Lab develops and tests interventions that empower people to be more present and open to living better through self-awareness and self-exploration. Dr. Benzo and his research team seek to improve the quality of life for people with life-limiting conditions through the use of such interventions as meditation, behavior change, rehabilitation and physical activity.

Dr. Benzo launched the Mindful Breathing Laboratory with initial funding from the National Institutes of Health (NIH) to explore how a healthier lifestyle could impact health outcomes in people with chronic lung disease. The lab has expanded its scope to investigate the potential beneficial effects of purposeful attention (mindfulness) and how the willingness of patients to participate in their own health (participatory medicine) may affect disease outcomes.

In partnership with the Department of Psychiatry and Psychology at Mayo Clinic, the Mindful Breathing Lab aims to understand aspects of the inner process of personal healing, behavior change and care in chronic diseases. Motivational interviewing is used to investigate how listening aids in guiding patients.

Ongoing research in the Mindful Breathing Lab shows that the motivation to change best comes from within an individual, not when it's imposed from the outside by family, friends or the media. The results of several interventions in the lab indicate that a quiet and eliciting style of communication is more effective than persuasion to create the conditions for behavior change. Read Dr. Benzo's article for the COPD Foundation, Changing Outcomes in COPD through Motivational Interviewing, about using motivational interviewing to inspire behavior change and improve outcomes in chronic obstructive pulmonary disease.

About mindfulness

Research led by mindfulness expert Jon Kabat-Zinn, Ph.D., has been seminal to the use of participatory medicine in this laboratory. In the context of chronic health conditions, mindfulness offers the opportunity to focus energy on what is right about your health in the present moment and to come to terms with your disease without focusing on the past or future.

Being positive requires hard work — particularly inner work — and willingness to carve out time each day to practice. This can be accomplished by sitting meditation, very simple movements, yoga, silent slow walking or a meditation exercise called a body scan.

The systematic practice of paying attention can change how the brain is wired and may have the potential to change the progress of disease, perhaps leading to greater well-being and a reduced need for care.

About awareness, physical activity and rehabilitation

Changing behavior requires will and motivation. Dr. Benzo postulates that increasing awareness of what you do or don't do each day may trigger behavior change.

Several research projects within the lab use technology to increase awareness of daily activities, such as counting the number of steps taken, and test if that awareness, guided by motivational interviewing-based coaching, can increase physical activity in daily life.

Research affiliations

Dr. Benzo's Mindful Breathing Lab has several Mayo Clinic research affiliations, including:

• Cancer Education Center
• Dan Abraham Healthy Living Center
• Muscle Performance and Physical Function Lab
• Physical Medicine and Rehabilitation Research
• Psychiatry and Psychology Research

The post Mayo Mindfulness: Learn about mindful breathing appeared first on Mayo Clinic News Network.

A serious accident left Gene paralyzed and in critical condition. Doctors in Oklahoma didn’t think he would survive. Longtime patients of Mayo Clinic, Gene and his wife, Barbara, were determined to get him back to Mayo's Rochester, Minnesota, campus for care.

“The doctors at Mayo Clinic knew what was going on, and they assured us they could do something for him,” Barbara says. “We knew he had to get up here. The care at Mayo Clinic is like nowhere else. We’re used to it, and that’s what we wanted.” 

Ultimately, Gene was flown from Oklahoma to Minnesota on Mayo Clinic’s medical aircraft. Once there, he underwent surgery, followed by months of rehabilitation. Although progress has been slow at times, and he still requires assistance to walk, today Gene is back to enjoying life on his farm.

“I try to do more all the time,” he says. “I have some neighbors I go visit. I’ve got a four-wheeler I drive around, and I mow the lawn. I haven’t gotten on a tractor yet, but that’s my next goal. Mayo Clinic didn’t give up on me, and I’m not giving up, either.”

Receiving a grim diagnosis

Gene’s medical ordeal began when he and several others were unloading the hay from his trailer at a friend’s farm in Oklahoma. One of the large bales, weighing about 800 pounds, came over the top of the loader and hit Gene. He was knocked unconscious. Tests later revealed that the impact broke bones in his neck and caused severe injury to his spinal cord.

When he woke up in a hospital, Gene was stunned learn the extent of his injuries. “I couldn’t move. I couldn’t do anything,” he says. “I could wiggle my toes. That was it.”

“The doctors at Mayo Clinic knew what was going on, and they assured us they could do something for him. We knew he had to get up here.” - Barbara Franke 

Given Gene’s age at the time, 73, and the severity of his spinal cord damage, doctors were reluctant to move forward with any treatment. But Barbara and the couple’s children, who had all come to Oklahoma when they learned about the accident, were not willing to leave it at that.

“They told me I’d probably die before they got me to Mayo Clinic, so there was no sense in moving me,” Gene says. “They said my injuries were permanent, and I would never get any better. If I would have stayed down there, there would have been no surgery, no rehab.”

Taking steps forward

Despite the dire predictions, physicians at Mayo Clinic familiar with Gene’s situation were still confident they could offer treatment that could help. With that, Barbara was determined Gene would go to Rochester.

“We were going to get him to Mayo Clinic, whatever it took,” she says. “When someone in the hospital in Oklahoma told me he wouldn’t make it up here. I said, ‘Well, we’re going to find out.’”

Fortunately, the travel went well. The crew on board the Mayo medical airplane provided care at an intensive-care-unit level throughout the flight, and Gene arrived at Mayo Clinic without incident. Soon after, he underwent surgery to repair and stabilize his spine.

After surgery, Gene began the long process of regaining his ability to walk and perform other daily tasks. He went to rehabilitation every day he was in the hospital, a stay that lasted three months.

“It went little by little. I felt like a kid learning all new things,” Gene says. “There were times I’d say, ‘Hey, I haven’t done that before.’ I remember the first time I could get my hands around a cup of coffee and drink it by myself. You can’t believe the little things that a person does every day and doesn’t think a thing about until you lose it.”

Returning to everyday life

After Gene left the hospital in December 2011, he continued to attend rehabilitation sessions at Mayo Clinic twice a week for eight more months. He then transitioned to an outpatient rehabilitation center, where he still attends sessions as he is able.

“You can’t believe the little things that a person does every day and doesn’t think a thing about until you lose it.” - Gene Franke

“When I had surgery, they didn’t know how well I’d do. In rehab after surgery, though, they thought I’d be able to get up on my feet, and I did,” Gene says. “I do use a wheelchair most of the time now. But I can get up and move around with a walker. I can shave, eat on my own. I have workout equipment I use. I do as much as I can.”

Throughout Gene’s recovery, the Frankes have remained grateful for his care at Mayo Clinic.

“We’ve always gone to Mayo Clinic, so we were extremely pleased to get him here,” Barbara says. “We knew we could rely on them to give Gene the best care he could get.”

“Everyone was just wonderful,” says Gene. “The people in rehab especially were unbelievable. Just the best. Mayo Clinic gets an A+ from me.”

HELPFUL LINKS

• Learn more about spinal cord injury.
• Explore the Departments of Neurosurgery and Physical Medicine and Rehabilitation.
• Request an appointment.

The post Refusing to Give Up After Devastating Accident, A Farmer Finds Help and Healing at Mayo Clinic appeared first on Mayo Clinic News Network.

Due to Brennan's extensive injuries, doctors were concerned he might not be able to walk again. But with the help of a supportive care team and the love and encouragement of his fiancée, Kayla, Brennan progressed enough in his recovery to go home in December 2015. And to walk down the aisle at the end of his wedding ceremony a month later, with a little help and with his new bride by his side.

"The people at Saint Marys really cared about me," Brennan says. "They want their work to be great, and it shows. It really shows." And he would certainly need their best efforts. 

A devastating crash

Brennan's ordeal began near the end of an otherwise routine autumn workday. Driving a 30,000-pound feed truck near the town of Rollingstone in southeastern Minnesota, Brennan was at the crest of a hill when he tapped the brake pedal and came to a scary realization. He had no brakes.

"I knew I was going to need help. I knew it right away," Brennan says.

He tried to hail his boss on his two-way radio, but it was too late. Brennan and the out-of-control truck careened down the incline and ran out of road at a T-intersection. The truck vaulted into a nearby creek embankment, where it lodged itself about 10 feet into the dirt. Brennan lost consciousness.

Brennan and the out-of-control truck careened down the incline and ran out of road at a T-intersection. The truck vaulted into a nearby creek embankment.

As a result of the accident, the truck's mixing tub was sheared off. It pushed the cab on top of the engine. Brennan's right leg was bent behind him and pinned against the engine. When he came to, Brennan grabbed his radio microphone, which was soaked with blood, and told anyone who could hear him he was in a ditch and needed a medic.

Help came quickly. A co-worker who is also a first responder heard the call and raced to find Brennan. A passing milk truck driver stopped when he saw the wreck and called 911. A neighbor brought over a backhoe to help move debris.

"There were some nice coincidences," Brennan says. "God was really looking out for me."

Paramedics arrived to direct his care and guide the task of cutting Brennan free from the wreckage. After nearly four hours of effort, Brennan was moved to an ambulance and taken swiftly to Mayo Clinic Hospital in Rochester.

A team of support

The next week was a blur of surgeries for Brennan. His list of injuries included a crushed right heel, several broken bones in his right leg, fractured ribs, a damaged auditory canal, and a broken pelvis, tailbone and jaw. His colon had to be reattached. He suffered serious cuts under his chin and on his left leg. He had a partial tear to his sciatic nerve. His left forearm needed a tendon repair, and his entire right calf needed a skin graft.

The injuries required Brennan to be in an intensive care unit at Mayo Clinic's Saint Marys Campus.

During his stay, Brennan's spirits were buoyed by his care team, especially Mike Diekmann, one of his nurses. Mike shared his artistic talents by drawing in Brennan's notebook and leaving him encouraging messages. He also fashioned a race car out of hospital supplies to keep Brennan amused.

"Whether it's good therapeutic communication with patients and their families, or something simple like drawing a picture to give them a smile after the worst days are behind them, we do whatever we can to make their time with us go as smoothly as possible," says Mike. "There were so many people instrumental in Brennan's recovery. I was just doing my part at the bedside."

A steadfast love

Through it all, Kayla was by Brennan's side. A nurse at Mayo Family Clinic Northeast in Rochester, Kayla wanted to help her fiancé while he was in the hospital.

At first, though, she was at a loss to know what to do. "When he was in ICU, I more or less felt helpless," she says. One of the nurses on Brennan's care team, Rhonda Overkamp, saw opportunities for Kayla to put her health care experience to use. She allowed Kayla give Brennan a bath, brush his teeth, change his dressings, and help him feel comfortable.

"There were so many working for me, praying for me, thinking about me. I'll never be able to thank everyone." - Brennan Farley

"When he was in the Intensive Care Unit, I said, 'I'm not going anywhere.' And he said, 'Damn right you're not,'" Kayla recalls with a laugh.

"Brennan is one of those patients I'll never forget," says Rhonda. "The progress he made over his first weekend in ICU was remarkable. I am certain his determination to walk down the aisle with his soon-to-be bride kept him going. His story is a prime example of why I love what I do."

The will to heal

As he recovered, Brennan moved to the hospital's acute care unit. There, he met Brianna Skrukrud,  a nurse practitioner in Trauma, Critical Care and General Surgery, who he says was critical in aiding his recovery.

"She was a daily visitor to my room," Brennan says. "If there was something medically that she had to talk with me about, she would do so, and then I would ask her to call Kayla and tell her what was going on. Brianna would go to the nurse's station right away and call Kayla, no questions or excuses."

That extra step, he says, was crucial, as he was working through memory issues resulting from his injuries. "This extra effort that she did for us definitely made my recovery more enjoyable," he says. "Brianna has some of the best bedside manor that I came across." She was also one of the last people he saw the day he was discharged.

One of Brennan's first exercises was to sit on the edge of his bed three times a day for 20 minutes. After seven weeks off his feet, he was able to walk 20 feet during his first day of rehabilitation. He used a walker to leave the hospital in early December.

"I never thought I wouldn't walk again. I just knew it was going to happen," Brennan says. "I was going to make it happen, or I was going to find someone to make it happen."

"He had that attitude from day one," says Kayla. "Since the beginning, he's been very positive and determined."

That determined attitude helped as Brennan and Kayla planned a special surprise for the guests at their wedding in January. Brennan's parents pushed him to the front of the church in a wheelchair at the beginning of the service. Then, with the aid of a walker, Brennan stood for the ceremony.

At the end of the service, the happy couple walked out to thunderous applause, cheers and tears.

A community of care

Even though he still has a lot of rehabilitation ahead of him, Brennan is hopeful he will be able to return to work soon. He and Kayla have delayed their honeymoon in anticipation of the progress he expects to make.

"We have too many dreams to conquer yet," Kayla says.

As Kayla reflects on all the people involved in Brennan's care, she sums up the experience in one sentence. "Seeing everything Mayo has done for him has been absolutely phenomenal," she says.

"I wish I could shake all the people's hands that helped me, and say thank you to each of them. There were so many working for me, praying for me, thinking about me. I'll never be able to thank everyone," Brennan says.

"It just kind of goes to show that love conquers all," he says. "It's not about money. It's not about prizes. It's about the people."

HELPFUL LINKS

• Learn more about Trauma, Critical Care, and General Surgery at Mayo Clinic.
• Learn about Emergency Medicine in Rochester, Minnesota.
• Connect with other patients talking about rehab and determination on Mayo Clinic Connect.
• Request an appointment.

The post Love and Determination Help Brennan Get Back on His Feet in Time to Walk Down the Aisle appeared first on Mayo Clinic News Network.

It’s been almost three years since Sean Bretz collapsed. Unbeknownst to the then 23-year-old U.S. Coast Guardsman, a giant aneurysm had burst in his brain, causing a massive stroke.

“His prognosis was grim,” neurosurgeon Rabih Tawk, M.D., recalls. “We used every technology available to help him.”

Despite complications and issues, which required him to be induced into a medical coma, Bretz made an almost full recovery.

“I realize I was lucky and recovered pretty well. A lot of other people who have this type of stroke do not,” says Bretz, who attributes his success to the large team at Mayo Clinic’s Comprehensive Stroke Center.

“All the different doctors, nurses and technicians who would see me on a daily basis, they were all fantastic. But they looked at me as a whole person and not just another stroke patient.”

His experiences at Mayo Clinic are part of what has motivated Bretz to become a physical therapy assistant. “I remember some days it was very hard and frustrating. I'd struggle to find the motivation to work harder in therapy," he says. "I feel like I can offer some motivation to others, having been there.”

Bretz will graduate from school and begin his new career in April 2015. In the meantime, he’s advocating and educating. He often visits patients at a local rehab facility and was one of the survivors featured in a nationally syndicated public service announcement supporting the American Stroke Association.

May is Stroke Awareness Month. Stroke affects more than 795,000 people annually. It is the leading cause of disability in America and the fourth leading cause of death. Mayo Clinic in Florida is certified as an Advanced Primary Stroke Center by The Joint Commission, which recognizes excellence in diagnosis, prevention, treatment and rehabilitation of stroke patients. 

.......

HELPFUL LINKS

• Learn about stroke services at Mayo Clinic.
• See services offered through the Mayo Clinic Cerebrovascular Diseases and Critical Care Group.
• Join the conversation about stroke on Mayo Clinic Connect.
• Request an appointment at Mayo Clinic.

The post #StrokeMonth: From Victim to Therapist appeared first on Mayo Clinic News Network.

Thanks to a “wickedly good team” of rehabilitation specialists in the Mayo Transitional Care program at Mayo Clinic Health System in Waseca, however, she was back on the dance floor by winter.

The Transitional Care program provides a step between hospital and home for patients, who are supervised by physicians and receive daily care from nurses and therapists. A multidisciplinary team of providers sets up an individualized plan of care for each patient designed to get them back home as quickly as possible.

“Without their help I wouldn’t be where I am today,” says Dyson.

When she arrived in Waseca three days after having surgery at Mayo Clinic, Dyson was in “excruciating” pain.

She understood that the pain she was experiencing wasn’t unusual immediately after knee replacement surgery, but Dyson was not happy about it. And not shy about letting people know it. But that didn’t scare staff away. Dyson says someone checked on her every 30 minutes the first week she arrived, always meeting her tears and frustration with kindness and encouragement.

“I was so impressed by how pleasant and upbeat they were,” she says. “The staff did everything they could to make me comfortable. If I’d have asked for the moon, they would have given it to me.”

Though compassionate, the rehab team in Waseca also knew they had a job to do. With patience and persistence, they led Dyson through twice daily physical therapy sessions designed to help her regain flexibility and strength, while also developing the stamina she’d need to resume her regular activities.

“I can’t say I looked forward to therapy,” Dyson says of the sessions that initially left her in tears. “But they knew how to push just enough to keep me moving forward. And they did it with such kindness and encouragement that I wanted to do what they asked.”

Josh Berndt, a physical therapist, says one of the best parts of his job is developing relationships with patients like Dyson.

“We often see patients twice a day for two or three weeks, which really allows us to get to know them and develop personal connections,” he says. “Our team is small and efficient, and in many ways like a family. I think that carries over into how we care for our patients, and they pick up on that.”

Dyson certainly did.

“You could feel the camaraderie and the warmth,” she says. “They were professional, loving and caring. They really were like a family.”

So much so that after the first week, Dyson felt comfortable staying in Waseca without her husband Dick making the 400-mile trip from South Dakota to visit.

“I felt so well taken care of that I didn’t need my own family there,” says Dyson. “Dick came to see me the first weekend, but after that, I didn’t think it was worth all the driving plus the gas, motel and food expenses.”

As therapy progressed and Dyson began to feel more like herself, staff saw more of her personality emerge. “I still remember the daily riddles and jokes Sandy told me during her stay as well as the dance steps she pioneered,” says Berndt.

Dyson says she appreciated the laughter and banter she shared with Berndt and his colleagues. “They laughed with me and they sympathized with me,” she says. “I didn’t meet one aloof person while I was there. They went out of their way to make me feel comfortable.”

One of Dyson’s favorite examples of this involves root beer. “I had a craving for root beer, but they didn’t have any,” says Dyson. “A while later, here comes one of the gals with a liter of root beer. She’d gone and bought it for me herself.”

Dyson says that was just one gesture of many that made her feel supported and helped her heal. “Misery shared is misery halved,” she says. “Without them, I wouldn’t be where I am today.”

Berndt says he’s proud of the impact of the small-but-mighty team in Waseca.

“We want patients to feel that they receive Mayo Clinic-quality care in a 25-bed hospital,” he says. How does he do that? “I try to treat our patients like I would want my family members treated.”

Mission accomplished, says Dyson. A few days after she returned home, she received a call from Abby Bartz, the nurse manager in Waseca. “Abby said they’d been wondering how I was doing, so they picked up the phone and called to check on me,” she says.

Just like you’d check on your own family.

The post Transitional Care Team Helps Sandy Dyson Get Back on the Dance Floor appeared first on Mayo Clinic News Network.

My name is Mark Gilbertson, and here’s my story.

I am originally from Brainerd, Minn. I joined the Air Force following high school and retired in 2009 after 22 years of active duty as an aircraft mechanic. I now work for the Boeing Company as an aircraft mechanic at an air base in Hungary. My family and I have lived there for nearly four years.

On Dec. 19, 2012, some workers at the airbase were opening a large hangar door using a steel cable attached to the front of a large truck. The cable was stretched across the road. The weather was rainy, and it was a little dark. As I approached in my car, I did not see the cable, and struck it at about 29 MPH. 

The cable ripped off my car's hood, cut through the windshield and posts, and struck me in the mouth. The seat back in my car broke backwards, sending me into the back seat and, ultimately, saving my life. I sustained multiple skull fractures on the right side, including my right eye socket. The left side of my lower jaw was broken into about five pieces, and the bone exited under my face through a laceration. I went into shock immediately.

The ambulance arrived, and a co-worker at the accident scene returned to our building, and with tears in his eyes announced that he didn’t think I would survive. “Mark’s not going to make it. He’s really messed up,” he said to my other co-workers. I was evacuated to a Hungarian hospital, where they stabilized me and patched me back together, securing the jawbones into their original place.

I was in a coma until Christmas Day, Dec. 25, 2012. When I woke up, I had no recollection of the events that brought me there. Prayers from family and friends around the world sustained me. I remained in the ER recovery ward until they released me on Jan. 3, 2013. My wife and I, and our five children celebrated Christmas the following day on Jan. 4.

I had some difficulty in the next few days, as the jawbones were not healing. One by one they were becoming necrotic and infected. This resulted in another surgery on Feb. 13 to remove two dead pieces of bone. Then a lower piece of my jawbone died and required removal. I became frustrated and discouraged not knowing the Hungarian language very well (I could not communicate with nurses and doctors) and a socialized health care culture.

Another surgery in Hungary was not an option for me. I received approval to travel to Mayo Clinic in Rochester, Minn., for the remaining required procedures. This was my primary option, knowing the talent and great reputation of the doctors there.

When I arrived in March, I met Dr. Kevin Arce, Dr. Eric Moore, and their teams. I have never been in the care of such quality health care professionals who were greatly concerned for my medical needs. On Apr. 18, I went into a 12-hour surgery to remove 4.5 inches of fibula bone from my left leg to rebuild my left jaw. The technical medical advancements are astounding!

The doctors were in agreement that the procedure went very well, and I healed rapidly. Following six weeks of physical therapy for my leg, I returned to Hungary and back to work on Jun 10. I returned to the Mayo Clinic again in August for teeth implants. I am currently recovering well, but I am still on a soft food diet. I've lost a total of 16 teeth since the accident.

The care and concern of the Mayo doctors in whose care I am under is amazing. They take the time necessary to ensure I understand the procedures. They also ensure I am comfortable and have all my questions answered. I have never experienced this level of care with any medical procedure in my life to this point.

I have complete faith in the skill of the Mayo Clinic doctors. I am very thankful to receive the care that I need from these health care professionals.

The post Mark Gilbertson 2.0 – Putting the Pieces Together Again appeared first on Mayo Clinic News Network.

Our Labor Day weekend program (8/31) will feature a rebroadcast of a previous show with Mark Christopherson, M.D., during which we discussed spinal cord injuries.  What happens in a spinal cord injury and what’s the most common cause?  How can a rehabilitation program help?  How close are we to having a cure for spinal cord injuries?  It’s an interesting conversation!  We hope you’ll listen.

Note: You can listen to the program LIVE Saturdays at 9 am CT on I Heart Radio via KROC AM. The show is taped for rebroadcast by some affiliates. On Twitter follow #MayoClinicRadio and tweet your questions.

Listen to this week’s Medical News Headlines here:        

Mayo Clinic Radiois a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post MAYO CLINIC RADIO appeared first on Mayo Clinic News Network.

ANSWER: Symptoms caused by a concussion often go away within several weeks. But sometimes they may last much longer. In those cases, it can be useful to consult a physician who has expertise in treating concussions. Ongoing care, including rehabilitation therapy, may help your grandson better manage his symptoms and return to a more active lifestyle.

A concussion is a mild traumatic brain injury, usually caused by a blow to the head. When the head is hit, the brain moves inside the skull. In some situations when, for example, an elbow or shoulder hits against a person’s head, the impact can make the head and brain rotate rapidly at different angles. This movement can cause abnormal function of individual brain cells, along with inflammation and swelling in the brain. It also may disrupt the delicate nerve fibers that connect brain cells to each other. These changes within the brain interfere with its ability to function normally.

A concussion can cause a wide variety of symptoms. They may include physical problems, such as headache, blurred vision, nausea and vomiting. Symptoms often include cognitive complaints, too, such as confusion, amnesia, slowed thinking or mental fogginess. Concussions can have emotional effects. A person with a concussion may be irritable or depressed and show changes in personality. A concussion may lead to sleep problems, as well.

Signs that a physician may see when someone suffers a concussion often include balance problems, slowed visual tracking and impaired memory. Computerized neurologic testing may be used to help assess brain function. Such a test works best when a similar test performed before the injury is available for comparison. Many sports teams — both professional and recreational — now use these tests.

About 80 to 90 percent of concussion symptoms resolve within 7 to ten days. When symptoms persist well beyond the expected time frame, they fall into a category known as post-concussion syndrome.

Immediately after a concussion — for the first 24 to 72 hours — rest is the cornerstone of treatment. Once the initial symptoms go away and, if used, computerized test results are within an acceptable range, a physician determines whether it is safe to begin a step-by-step return to an exercise program. If a patient can go through those steps without symptoms, a return to full activity may be possible.

In the case of your grandson, it seems his initial symptoms never cleared and left him in what is known as a post-concussive state.  He should consider consulting with a neurologist or a sports medicine physician who specializes in concussion management.

Several therapies may be useful. He may benefit from a type of therapy called vestibular rehabilitation, which would help him work on his vision, balance and hearing. A consultation with an expert in psychology, as well as cognitive rehabilitation, may help him manage the mental slowness and emotional impact of his injury. This is particularly significant because some research has shown a correlation between concussions and depression.

Research currently is ongoing regarding the way exercise may be used in treating post-concussion syndrome. But for people in this situation, exercise should always be done under the direction of a physician.

Each person responds differently to a traumatic brain injury such as a concussion. Therefore treatment must be individualized. It is important for your grandson to find a concussion expert who can help him create a treatment plan that fits his unique needs. — Jennifer Maynard, M.D., Family Medicine, Mayo Clinic in Florida.

The post TUESDAY Q & A: Ongoing care may help grandson return to more active lifestyle following concussion appeared first on Mayo Clinic News Network.

/// Sound bite  ( Brian Carlsen, M.D., Mayo Clinic Plastic Surgeon)  "We can put things back together and get the x-ray to look good and even get the leg to look good, but if it's painful or it doesn't work or there is no sensation, then even that situation can be difficult for the patient.  And the patient may in some situations be better off with an amputation."  TRT :17 

Dr. Carlsen says much has been learned recently about treating severe limb damage through the unfortunate injuries of soldiers in Afghanistan and Iraq.  One of those lessons is to engage the patient in the decision-making process to best tailor limb reconstruction to their needs.

/// Sound bite  "When you're considering the patient, you have to think about what are their hobbies? What is their work? Are they able to go through a prolonged rehabilitation process?  How far are they from home? All of these issues."  TRT :13

Dr. Carlsen says the more patients participate in their health care decisions, the more likely they are to follow a doctor's advice and, ultimately, the higher their quality of life will be.       

The post Boston Marathon Bombing: Healing the Wounds appeared first on Mayo Clinic News Network.