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Spain Rehab Helps Patients Get Back to Living Life

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UAB Spain Rehabilitation Center helps patients regain as much mobility and independence as possible following an accident or medical condition. Pictured (from left) are physical therapists Andrew Stanley, Brian Riddle, Robin Riddle, and Becca Iannuzzi.

Many people don’t realize what a tremendous asset UAB Medicine has with Spain Rehabilitation Center. A critical part of UAB Hospital, Spain Rehab is one of the leading providers of comprehensive physical medicine and rehabilitation services in the southeast.

Its physicians (known as physiatrists), physical therapists (PTs), and other professionals work with patients to help them recover from a wide variety of medical conditions and injuries involving the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. These include stroke, automobile accidents, amputations, and much more. Spain Rehab’s specialists provide the highest level of care from the time of admission, through rehabilitation, and often continuing throughout the patient’s lifetime, which is the hallmark of any quality rehabilitation program.

UAB Spain Rehabilitation Center:
By the Numbers

 

Outpatient Stats:

  • 17 physical therapists
  • 4 physical therapy assistants
  • 3,500 new patients per year
  • 21,000 patient appointments per year

Inpatient Stats:

  • 11 full-time physical therapists
  • 11 part-time and as-needed physical therapists
  • 1,200 patients treated per year
  • 1.5 to 2 weeks average length of stay
  • 49 beds

In some cases, the results are no less than miraculous. Some patients recover to the point of full function, but the goal is to help patients regain – as much as possible – the mobility, range of motion, independence, and quality of life they enjoyed before the incident or medical issue that brought them to Spain Rehab. Much of the work is done on an outpatient basis, but the center also includes 49 inpatient beds for the most serious cases.

Physiatrists are responsible for the medical management of patients, including prescribing medications, ordering imaging, and performing certain types of tests and treatments. PTs assess patients, make a PT diagnosis, and create and implement a care plan designed to meet patient-centered goals. We asked four PTs to answer a few questions about their work and patient experiences; their responses are below:

Brian Riddle, PT, DPT, MBA, OCS, ATC, CSCS – outpatient rehabilitation

What has been your most rewarding patient experience? 

Helping a 37-year-old man involved in a significant motor vehicle collision recover from multiple fractures and surgeries to eventually be able to dance with his 7-year-old daughter at a father/daughter Valentine’s Day dance.

What have you learned through engaging with patients? 

People will only go after something when their “why” or reason is strong enough. I ask patients all the time, “What’s your goal for therapy?” The common response is, “to stop hurting.” So when I ask, “Why do you want to stop hurting, and what will you be able to do that you’re having trouble doing now because of your pain?”, most are unable to give me an answer. However, a few tell me something very specific, like a new mom wanting to be able to pick up and hold her baby again without throwing out her back. They are the ones who have the best results from physical therapy.

How do you think your experiences have affected your work? 

I’m reminded not to take for granted my health and ability to get up and move around freely. Being able to do things for myself, like get out of bed, work out, be on my feet, move around all day helping people and then return home to play with the kids and be present with my wife is a gift and blessing. So, when working with patients who have trouble doing these things, helping them reach their goals is a blessing and a way for me to give that truly motivates me.

 

Robin Riddle, PT, DPT, OCS, CEEAA – outpatient rehabilitation

What has been your most rewarding patient experience? 

Two patients immediately come to mind. Both were moms of three teenage kids, busy and in their prime, and both were involved in unexpected and life-altering traumatic accidents – one from a trampoline, and one who was a pedestrian hit by a car. Both rolled into their first PT visit in wheelchairs, afraid and quite literally broken in many ways. I remember that both were accompanied by their equally shocked family members. The doctors and nurses had put them back together (hooray!), but now what? At the risk of sounding quite dramatic, it’s almost as if their very identities had been stolen from them due to no fault of their own, and they didn’t even know who they were anymore or where they were going. We had to work through both the physical and emotional trauma. Will I ever be able to play with my kids again? Am I strong enough? Can I do this? Is there even any hope? These were common themes.

It was hard. But with time, and through pain and vulnerability – one goal, one treatment session, sometimes just one movement at a time – they pushed forward and found (no, they remembered) their inner resilience and strength that had always been there. Their egg had to break in order to realize their true potential to fly. These women are inspirations to me, because when I think about them, I remember how they humbly accepted help, how hard they worked, and how they eventually realized their goals because they never gave up and just kept pushing.

 

What have you learned through engaging with patients? 

Our patients can be the best teachers, and it is important that they are heard. Learning from them is one of my favorite parts of my job. We are all in this thing together. Here are just a few things I’ve learned, in no particular order:

  • It is important to remember where we were when we began, in order to appreciate how far we have come.
  • There will always be a barrier, and when a barrier comes, there will always be a way around it. The tricky part is wanting to find the way around it.
  • There is always more to the story.
  • Real progress happens when we don’t give up and when we give ourselves permission to realize our true capabilities. With this realization comes freedom and responsibility.
  • Progress is painful.
  • Success can be measured in many ways, and every success is worth celebrating!
  • Repetition, repetition, repetition
  • It is OK to make mistakes – that’s when the most impactful learning happens!
  • It is a privilege to work at UAB Medicine, where we come in contact with so many different people from so many different backgrounds and perspectives who teach me so many different things.

 

How do you think your experiences have affected your work?

Just like all health care professions, being a PT is hard work and can be mentally, emotionally, and physically exhausting. We have hard days, too. We need help sometimes, too. When I’m having a hard day and I feel like I literally have nothing left to give, I see and remember my patients – who also seemingly have nothing left to give – ask for and accept help and in the process find that inner strength to take just one more step to work toward their goals. And by seeing and remembering, I realize that it is OK for me to ask for and accept help, and I’m inspired to remember my own inner strength, take just one more step, and keep pushing forward.

 

Andrew Stanley, PT, DPT, MTC, ACSM EP-C – outpatient rehabilitation

What has been your most rewarding patient experience? 

Recently I treated a patient, and near the end of her session she mentioned waking up and feeling that she couldn’t talk and that it felt like her face was twisted. I was concerned about a mini-stroke. We did some preliminary vitals on her and she appeared stable, but her balance was off. After reaching out to her physician, we opted to send her to the emergency room for a neuro workup. The next visit, she came in and gave me a huge hug and said, “I had three strokes and didn’t know it. The doctor said if I hadn’t come in, they would’ve kept going and likely gotten bigger, even fatal. You saved my life!” I thought that was pretty cool.

What have you learned through engaging with patients? 

Engagement with patients has taught me that a huge part of our ability to heal is related to connection. When patients feel heard and understood, it does them good on an emotional level, which has a profound impact on their physical well-being. Some patients just want a simple, one-dimensional transaction – “Fix my knee and I’m out of here.” But most patients understand that they need to be seen as an entire person. When one body part is damaged, it has unavoidable implications for other body regions, all of which will create a cumulative effect on the patient’s quality of life.

In health care, especially in this era of electronic medical records, it is so tempting to keep a distance and push in and out of a room without ever really even making eye contact; just grind and go. But when you take the time to connect, put the computer aside, and really engage your patient – when you look beyond a body part to see an entire person – that’s when we take a step closer to optimizing our role as facilitators of healing.

How do you think your experiences have affected your work?

I used to think I had this therapy gig pretty much under control. Lately, I realize how many huge minds surround me every day. Honestly, it’s my favorite thing about being here at Spain Rehab. The incredible talent of my coworkers encourages me to be better, stronger, more versatile, and more precise in my practice.

 

 

Becca Iannuzzi, PT, DPT – inpatient rehabilitation

What has been your most rewarding patient experience?

It’s so hard to pick just one! Two particular experiences come to mind, and both were rewarding for different reasons. A few years ago I had a patient who was diagnosed with glioblastoma (a type of brain tumor). He and his family acknowledged that his overall prognosis was poor. Nevertheless, he was so motivated to maximize what time he had left so he could spend quality time with his wife, children, and grandchildren. He worked hard day in and day out, and his family supported him every step of the way. What is most memorable about his time at Spain was his infectious smile and laugh and his positive outlook. After the tumor surgery, he slowly but surely began regaining his strength. I worked with him pretty much every day for three months. By that time, his family had become like my family and mine like his (my dog included). About a year after he was discharged, he drove back to Birmingham and was so proud to show me that he not only could attend my wedding but also could stand and walk. Until the day he passed, almost two years after his initial diagnosis, he encouraged everyone around him and set an example for the kind of positivity and kindness we all should strive to show.

Another rewarding experience was a young patient I worked with who had had a spinal cord injury about three months prior to his admission to Spain Rehab. He was diagnosed as an incomplete quadriplegic, and though his prognosis for return and function was good, he was sent home from his initial hospital admission because he did not have insurance through his workplace. He had been bed-bound for the following three months with no equipment, no education, and no hope for getting better. When he began working with us, I could tell from the start that he was motivated and determined to do everything he could to get better. After about a month, he walked out of the building with a newfound outlook on life and hope that he could still have a “normal” life at 35 years old.

What have you learned through engaging with patients?

Our duties go beyond that of strictly physical rehabilitation. Spending 90 minutes with patients and their families daily opens door to new relationships, and patients grow to trust us and depend on us to help them get better. I’ve learned that truly caring and empathizing with these patients makes me more receptive to their needs and a better therapist. I’ve learned that listening to what they have to say and understanding their needs versus just dictating my plan will lead to greater rapport and better overall outcomes. It is a team effort among the therapists, the medical team, and the patients and their families. It takes all of us working together to help prepare these patients to get back into the “real world”.

How do you think your experiences have affected your work?

Most of the time, the patients we see don’t ask or ever hope to be in the position that brought them here. People don’t expect traumatic injuries or strokes or terminal diagnoses. A lot of times they come to us only focusing on things they can’t do, and they feel they are surrounded by reminders of how their life isn’t like it used to be. It’s our job to show them what they can do and open doors to new opportunities for them. It’s our job to find out what motivates each of them and what brings them joy so they feel they’re working hard for a purpose. I’m surrounded by such a compassionate staff and a plethora of knowledge and experience; when there’s something I don’t know the answer to, I have several people I can look to for help. I can truly say I learn new things every day.

 

Click here to learn more about UAB Spain Rehabilitation Center.