All posts by Jason Glogau

World Kidney Day: Get to Know Your Kidneys

World Kidney Day is celebrated on March 12th. Our kidneys are vital organs that play a key role in keeping us healthy. But what exactly do our kidneys do and how we keep our kidneys functioning properly? Let’s find out.

What is a kidney? What do our kidneys do?

“A kidney is a filter that removes toxins and fluid from your body,” says Dr. Tony Alvarado, a nephrologist at New Braunfels Regional Rehabilitation Hospital. “Most people have two kidneys. They are the size of a fist, and they filter 200 quarts of blood per day.”

How do we keep our kidneys healthy?

As it turns out, staying physically fit has a positive effect on your kidneys according to Dr. Justin Black, a physical medicine and rehabilitation doctor at NBRRH. “Physical fitness helps improve a person’s endurance, strength, balance, and overall independence. But it also helps you with decreasing your blood pressure, improving circulation, and helping with your blood glucose,” notes Dr. Black. “Those things are all very important for your overall kidney health – maintaining good blood pressure and blood glucose.”

What are the signs of kidney disease?

Kidney disease can be a silent issue that many people don’t even know they have. Because of that, it can be challenging to diagnose. Certain factors increase the risk of kidney disease. “Patients with high blood pressure, diabetes, or a family history of kidney issues should look into getting checked,” Dr. Alvarado shares. Speak with your doctor about having blood work or other tests done if you have any of these risk factors.

What can I do to prevent kidney disease?

“Kidney disease, and the progression of kidney disease, is often preventable with lifestyle modifications,” adds Dr. Alvarado. “These include drinking enough water, avoiding smoking, making sure you’re physically active, and controlling any medical problems you may have.”

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Physical Therapy for Pelvic Floor Dysfunction

Pelvic floor dysfunction is a common condition, affecting about 25% of women age 20 and over. Unfortunately, many suffer in silence. But pelvic floor physical therapy can address urinary incontinence and other symptoms of this condition.

What is a pelvic floor?

The pelvic floor refers to a group of muscles, ligaments, and connective tissues in the lowest part of your pelvis. These tissues work together to provide support to the contents above them, such as your bowel, bladder, uterus, vagina, and rectum. They lend to pelvic stability and help with the function of pelvic organs, such as voiding and sexual function. Additionally, they play a huge role in posture and breathing.

What is a pelvic floor physical therapist?

Pelvic floor physical therapists are specially trained in the anatomy, physiology, and function of the lumbopelvic region. Pelvic floor physical therapists are trained to identify and treat dysfunction with the pelvic floor, as well as the contributing systems. The goal is to have a positive effect on the system as a whole.

What is pelvic floor dysfunction?

Pelvic floor dysfunction presents in many ways. One of the most common and easily recognized is urinary incontinence. Urinary incontinence refers to accidental urinary leakage. This can occur with urge, but also with intra-abdominal pressure. Examples include coughing, sneezing, and laughing. Functional activity, such as walking, standing, lifting, exercising, etc., may also be a cause.

Though very common, urinary incontinence is not normal. Television commercials suggest the use of protective pads to deal with the symptoms of urinary incontinence. However, pelvic floor physical therapy can have such a positive effect, these things are not necessary. A complete resolution to urinary incontinence is possible.

How does pelvic floor physical therapy work?

You may have heard about Kegel exercises as a means to strengthen the pelvic floor. Pelvic floor physical therapy goes way beyond Kegels. Examples of common treatments include strengthening muscles that are weak and relaxing muscles that might be too tight and not doing their job effectively. Soft tissue manipulation may be involved to help with soft tissues and joints that may be contributing to pelvic floor dysfunction. Patients are educated on lifestyle modifications, bladder retraining, and other ways to have a positive impact on the individual’s symptoms.

Who suffers from pelvic floor dysfunction?

Pelvic floor dysfunction is very common. Women of all ages are affected. Statistics suggest that about 25% of individuals aged 20 or older suffer from some level of pelvic floor dysfunction. Most likely you or someone you know is affected by this. Unfortunately, many individuals suffer in silence for years.

“I wish I would have come in sooner,” is something pelvic floor PTs hear often. Many times individuals are embarrassed or feel this is a normal part of aging. Others are unaware physical therapy can treat their condition, while some are afraid of what pelvic floor physical therapy entails. Hopefully reading this eases any discomfort you may have. These are muscles like any other, and a pelvic floor physical therapist will treat them as such.

Kelsie Martin is a physical therapist at New Braunfels Regional Rehabilitation Hospital. Kelsie holds a bachelor’s degree in Family and Consumer Sciences, with a focus on family and child development, and a Doctor of Physical Therapy degree from Texas State University. Kelsie has completed specialized training in the treatment of pelvic floor dysfunction, through Herman and Wallace Pelvic Rehabilitation Institute, as well as pregnancy and postpartum care through the American Physical Therapy Association. Kelsie loves having the opportunity to positively impact the lives of members of her community through physical therapy and is passionate about providing patient-centered care. 

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9 Health-Related Podcasts Worth Checking Out

Podcasts are a great way to learn something new. You can listen anywhere: in the car, at the gym, at your desk, while cleaning your house. They come in many different formats: interviews and stories, short and long, daily, weekly, and monthly. And you can find them on any topic you could imagine. We’re most interested in health-related topics, so here’s a list of 9 health-related podcasts worth a listen!


TEDTalks Health


Is any list of top podcasts complete without the inclusion of a TEDTalks series? Probably not! TEDTalks Health is a collection of short (appx. 15 minutes long) presentations on health-related topics. Bonus: these episodes include video. With over 150 episodes covering a wide range of topics, you’ll have no problem finding something new to learn.


Ten Percent Happier with Dan Harris

iTunes | Spotify

Dan Harris, a journalist at ABC News, has an incredible story. A wartime correspondent, Dan found himself hooked on drugs and struggling after returning stateside, culminating with an on-air panic attack. He found relief through daily meditation. “Ten Percent Happier” began as a book about his experience, since evolving into an app for meditation and this podcast. In the podcast, Dan interviews “smart people” from all walks of life about meditation, including physicians, celebrities, executives, and even the Dalai Lama.


JAMA Clinical Reviews

iTunes | Spotify

An interview series from the American Medical Association’s peer-reviewed medical journal. JAMA Clinical Reviews features interviews with authors of the latest clinical reviews. Recent topics include “A New Path for Gun Research Funding,” “Bariatric Surgery and Cardiovascular Outcomes in Patients with Type 2 Diabetes,” and “Responsible Use of Opioids to Treat Cancer Pain.” The interviews are high-quality and accessible, even if you don’t have a clinical background.


Nursing Podcast by NRSNG

iTunes | Spotify

If you’re a nursing student, this podcast is for you. The episodes are short (under 30 minutes) and focus on helping nursing students to feel more confident. The host, Jon Haws, RN, uses anecdotes from his own experience in nursing school to relate to the anxieties and struggles of aspiring nurses, providing tips along the way.


Louisville Lectures: Internal Medicine Lecture Series Podcast


This video podcast from the University of Louisville is published approximately once per month. Episodes are recordings of internal medicine lectures from university staff and guest lecturers. Over 200 lectures are available on-demand. Geared toward clinicians.


The NeuroNerds

iTunes | Spotify

This unique podcast was created by two survivors: Joe Borges (stroke) and Lauren Manzano (brain injury). Joe and Lauren, self-described nerds, designed The NeuroNerds to “create a community for like-minded nerds and fans of pop culture, who have suffered from brain injuries and are looking for support on their journey to recovery.” Episodes vary – some more “neuro” and some more “nerd” – but the unique and personal approach to this podcast makes learning about and understanding stroke and brain injury very accessible.


The WoMed

iTunes | Spotify

A relatively new podcast, The WoMed is hosted by nurses Danielle (D) Maltby and Danielle (Dani) LeVeck. D & Dani focus on “all things Women in Medicine” in an honest and raw way, sharing their experiences and interviewing other women from the world of medicine. There’s a good reason this podcast has shot up the charts just 19 episodes in.


Continuum: A Healthcare Podcast

iTunes | Spotify

Focused on educating and inspiring, Continuum is a monthly podcast published by Vibra Healthcare and Ernest Health. Covering a broad range of topics, from heart disease in minority populations, the current state of ventilator weaning, and tips for new amputees, we interview experts from throughout the healthcare world.


Progress Notes: Inspirational Stories of Patient Success

iTunes | Spotify

Every day, incredible people conquer serious health issues. Strokes survivors, quadruple amputees, people living with spinal cord injuries – their perseverance, determination, and grit are sure to inspire. In Progress Notes, these moving stories are shared in bite-sized episodes (about 5 minutes long) each week. If you find yourself struggling, be it with a health issue or some other challenge, check out this podcast and draw motivation from these amazing individuals.

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What is Sepsis?

Sepsis is the body’s extreme response to infection — and a life-threatening medical emergency. More than 1.5 million people contract sepsis in the United States each year. Over 200,000 of those people die from sepsis. As such, preventing infections that can lead to sepsis is a critical task in any hospital.

Who is most at risk for sepsis?

Anyone can contract an infection that leads to sepsis, but certain populations are at higher risk. These include:

  • Individuals aged 65+ or less than one-year-old
  • Those with weakened immune systems
  • People with chronic diseases, such as lung or kidney disease, diabetes, or cancer
  • Patients who have recently had surgery, have an open wound or burn, or invasive device, such as a catheter

What are the signs and symptoms of sepsis?

Symptoms of sepsis include an elevated heart rate, low blood pressure, and shortness of breath. A person with sepsis will also appear confused or disoriented. And since sepsis is the body’s response to an infection, common signs of infection will often be present. These include fever, chills, clammy or sweaty skin, and extreme pain or discomfort.

How do hospitals prevent sepsis?

Preventing sepsis is rooted in preventing the infections that can lead to sepsis. With healthcare-acquired infections affecting one in every 20 to 30 patients in the United States, this is no small task. Every person who enters the hospital plays a role in prevention.

Proper handwashing is one of the most critical components of infection prevention in a healthcare setting. Vaccinating staff and patients against influenza, pneumonia, and other illnesses also reduce the risk of infection. An antibiotic stewardship team ensures antibiotics are administered properly and remain effective. And when patients arrive with an infection, precautions including proper signage and the use of personal protective equipment minimize the risk the infection spreads.

What if I think I have sepsis?

If you have an infection that isn’t healing, or if you suspect that you or a loved one has sepsis, seek medical attention immediately. Sepsis is a medical emergency.


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Are Vaccines Only for Kids?

When we think about vaccines, we think about children. Measles, mumps, rubella, and chickenpox. We (hopefully) get our kids vaccinated, to protect them from these diseases. But are vaccines only for children?

Absolutely not! Vaccines protect people of all ages from disease. But adults often neglect to immunize themselves, putting themselves at risk of serious illness. But this doesn’t only affect ourselves — it affects our communities, too.

The Front Lines Against Disease

The most vulnerable people are those whose health is already compromised. For that reason, hospitals and other healthcare facilities are on the front lines of fighting disease. By keeping disease out of our hospitals, we keep that at-risk population safe.

A critical component of this is ensuring hospital staff are fully and properly vaccinated. Hospitals screen new hires to make sure they are immune to specific types of diseases. If they need vaccines, they’ll be provided to protect themselves and their patients. Flu shots are administered each fall. These vaccines, in conjunction with other precautions, such as proper handwashing and seasonal visitor restrictions, go a long way toward keeping patients healthy.

Additionally, an infection control nurse will work with patients to receive vaccinations. This includes the aforementioned immunizations, but also vaccines against diseases like pneumonia and the shingles. The infection control nurse meets with patients to educate them on these diseases and their vaccinations.
Immunizations are indispensable in protecting the health of our communities. While hospitals take care to vaccinate employees, please don’t wait to immunize yourself! Get your vaccines and guard yourself — and your community — against serious disease.

Liz Morris, RN, MSN is the Employee Health/Infection Control Nurse at Southern Indiana Rehab Hospital in New Albany, IN. She received a bachelor’s degree from Spalding College and a master’s degree from the University of Louisville. Liz is a member of APIC (Association for Professionals in Infection Control and Epidemiology).

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Every Step Counts: Tips for Beginning a Heart-Healthy Diet

When most people hear “heart-healthy diet,” they think they will never be able to eat salt again. Reducing sodium intake is an important part of a heart-healthy diet. But there are other ways to adjust your diet to improve your heart health, too.


The DASH diet stands for Dietary Approaches to Stop Hypertension. This diet has been found to improve blood pressure, even without a full reduction in salt intake. The diet focuses on eating lots of fruits and vegetables, lean meats, low-fat dairy, legumes, nuts and seeds, and whole grains.

You can start working toward this diet with small, simple changes each day. Add in an extra serving of fruits and vegetables. Swap out white bread or white rice for their whole-grain counterparts. These changes are easy to make and will get you started down the right path.

What About the Salt?

If you are ready to cut back on your sodium intake, there are few things to keep in mind. One is that sea salt and regular table salt contain roughly the same amount of sodium. Sea salt should not be considered an adequate salt alternative.

Salt substitutes, such as potassium chloride, may not be the solution, either. People with kidney disease, or those taking certain medications like diuretics, should avoid these alternatives. They can cause a dangerously high spike in potassium levels in these individuals. Before using a salt substitute, check with your doctor.

Salt-free seasoning blends, such as Mrs. Dash, can be a great option for cutting back on your sodium intake. These alternatives use herbs & spices to flavor your food, rather than salt.

Every Step Counts!

Most importantly, remember that every step counts! Whether you just shake the salt shaker once instead of twice or add in an extra helping of vegetables, each step gets you closer to a heart-healthy diet and keeping your heart and blood vessels healthy.

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Rehabilitation After a Lower Extremity Amputation

There are currently about two million people in the United States living with limb loss. Every year, 185,000 people undergo an amputation, with below-the-knee amputations most common. With that number expected to double over the next few decades, the need for rehabilitation after a lower extremity amputation is likely to grow.

Why are amputations becoming more frequent?

There are several factors contributing to the increased frequency of amputations. One of which is the result of medical advances. Such advances in surgical amputation have saved the lives of many patients with life-threatening infections, such as sepsis.

However, the most serious factor involves diabetes. Foot ulcers precede about 85% of lower extremity amputations. This wound on the foot starts a cascade of events leading to an amputation. This occurs most commonly in diabetics. Statistics paint a sobering picture, with amputations caused by diabetes increasing 25% from 1988 to 2009. That number isn’t expected to decrease, either.

How does rehabilitation help after an amputation?

If you or a loved one are facing a lower extremity amputation, your physician might recommend rehabilitation. Inpatient rehabilitation hospitals are uniquely positioned for recovery from a lower limb amputation. As a new amputee, there are two key goals to focus on in rehabilitation.

The first is to regain function. This includes the ability to manage your own daily self-care without the benefit of both of your lower extremities. This can be very difficult for a new amputee. Inpatient rehabilitation provides techniques and interventions to help you become successful and independent. The second is to prepare your body, including the amputated lower limb, for use of a prosthesis.

This process takes time and specialized care. In a rehab hospital, you will be seen by a physician and participate in three hours of therapy each day. Your physical and occupational therapists will work on addressing your unique needs for returning to your home and community. Medication management, pain control and healing of the incision are all priorities for your interdisciplinary care team.

During your stay, objective information is obtained and documented. This information goes with you for consultation with a prosthetist. The prosthetist can use this information to help make the right decision on your individual prosthetic limb. This level of communication is important to ensure you get a prosthetic limb suited for your individual case, and to help you transition to a productive life following your amputation.

Kevin Nicholson, PT is the Director of Therapy Services at Vibra Rehabilitation Hospital of Amarillo. He is passionate about stepping out of the normal “therapy box” to help patients improve and return home. He has also worked as a PT assistant prior to becoming a PT, and has a combined 31 years of experience in the field of physical therapy. In his off time he enjoys watching professional basketball and mixed martial arts, and he enjoys barbell training.

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Infection Prevention in Hospitals

Hospitals are a place of healing and recovery. But they are also a place where infections can spread easily if proper precautions aren’t taken. In the United States, healthcare-acquired infections are an all-too-frequent occurrence, affecting one out of every 20 to 30 patients. Fortunately, with everyone working together, the risk of infection can be greatly minimized.

What are the risk factors for infection?

There are a number of factors that contribute to the high risk of infection in a healthcare setting. Because patients are in a state of reduced health, their immune systems are often weakened. This leaves them more susceptible to infection. Additionally, they may have an open surgical wound, central line or catheter, all which make it easier for bacteria to enter the bloodstream.

Bacteria can also be quite resilient. If left alone, some bacteria are able to live on surfaces for up to eight months. Patients, visitors, and staff may also contribute to this risk if they arrive with the flu. Each year, approximately 36,000 people die of the flu in the United States. Finally, antibiotics can be a factor, with one in four prescribed inappropriately.

How do we minimize the risk of infection in a hospital?

Minimizing the risk of infection in a hospital begins with education and prevention. An infection control nurse works in tandem with hospital leadership to lead these efforts. Patients, visitors, and staff all play a role in preventing infections.

Proper handwashing is at the center of these efforts. This involves every person washing their hands thoroughly before entering and leaving a patient’s room. Hand sanitization stations are also placed outside of each patient room and at all entrances and exits. Secret surveyors and ongoing education reinforce compliance.

Particularly during flu season, visitor restrictions exist to limit the spread of germs. Staff and patients are vaccinated as recommended, and staff remains at home when sick. Staff health is one of the best ways to prevent the spread of flu in a healthcare setting.

Interdepartmental collaboration is also key in defending against the spread of infection. This involves making sure all surfaces are thoroughly disinfected and oversight for administering antibiotics. An antibiotic stewardship team reviews prescribed regiments for appropriateness and effectiveness. This team involves the infection control nurse, pharmacist, and medical director, among others.

What about patients who arrive with an infection?

Hospitals prepare for a patient with an infection before they arrive on site. Outside of the patient’s room will be a station containing all the necessary personal protective equipment (PPE) to enter the room. This PPE might include gowns, masks, and gloves, and is available for both staff and visitors. PPE is used when a patient has contagious organisms to prevent the spread of those organisms. Signage is also posted on the patient’s door, alerting everyone of what precautions need to be taken. These signs are often color-coded for ease of recognition.

Once the patient arrives, the infection control nurse meets with the patient. The nurse provides education on what organisms they are dealing with and what protocols should be followed. This helps the patient to be an advocate for themselves, both with their care team and their visitors. Patients play a key role in their own safety by knowing the signs of infection and encouraging everyone to keep their hands clean.

Patients, staff, and visitors all play a role in preventing the spread of infection in a hospital through education and collaboration.

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A Unique Perspective: International Nurses in the United States

With the United States facing a shortage of nurses, many healthcare organizations are looking abroad to meet demand. Those nurses, while highly qualified to care for their patients, also offer a unique perspective on healthcare in America. We spoke to several international nurses from Vibra Hospital of Fargo about their experiences.

Why did you decide to become a nurse?

Wangari (Kenya): It is something I wanted to do since I graduated from high school.

Abu (Nigeria): As a child, I always liked nurses, and later learned that it is a profession that helps humanity.

Anne (United Kingdom & Nigeria): I have a passion to provide evidence-based nursing care to patients.

Mary (Nigeria): My passion to care for the sick.

Patience (Nigeria): Because of my passion to care for people.

Ruth (Kenya): I love to take care of people who are not able to care for themselves.

What made you want to come to the United States to work as a nurse?

Ruth: I wanted a change, having worked in different capacities as an RN. I wanted to experience what being an RN in the US is like.

Wangari: To advance my career and hopefully use the experience and knowledge gained to help my home country, Kenya.

Abu: The United States offered broad opportunities for development professionally through education and best practices.

Anne: I needed to experience nursing in a different setting and grow rapidly in my career.

Mary: I decided to come to the USA to gain more experience in nursing and to put in my best in applying evidence-based practice in caring for the sick.

What are some of the differences between being a nurse in the US and where you worked previously?

Mary: The computer charting, digital vital signs and feeding pumps, infusion pumps, PEG tubes…I’m used to manual and paper charting. Also, the use of narcotics. Where I’m coming from, they are basically for surgery or terminal ailments, like cancer. In America, it is used constantly, even for minor pain.

Patience: In Nigeria, we use paper charting and its computer charting in the US. Most of the equipment here we didn’t have, such as a tube feeding pump. Frequent use of narcotics is common here.

Anne: In Nigeria, most of the procedures are carried out manually, such as giving feed through PEG tube and not using the syringe pump.

Ruth: Learning the different cultural practices.

Wangari: There are quite a number! Insurance covers relatively more in Kenya. Management of pain is different. There is less and more restricted use of narcotics in Kenya. The technology in the US is more advanced. More machines that make work easier. I appreciate that here in Vibra, we have an education department that helps keep us abreast with knowledge changes in healthcare and makes room for consultation when the need arises.

Abu: Here in the US, you have all you need to function optimally and according to standard procedures. In my previous country, so many things necessary may not be readily available and can sometimes be frustrating. Also here in the US, there is advanced technology that simplifies and makes your work easier, such as the Hoyer Lift.

What was your experience like coming to Vibra?

Patience: It has been nice. I learned new things and met new friends.

Mary: It has been pleasant and goal-oriented.

Ruth: Every day I’m learning something new. Friendly and supportive staff.

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How to Keep Safe After Hip Surgery

Falls and accidents can happen to anyone, but patients who have been hospitalized, weak, and had recent surgeries are at greater risk. This is especially true for those who have recently had hip surgery. By taking proper precautions you can reduce the risk of injury. Here are some tips on how to keep safe after hip surgery.

Start with the Basics

The first thing you can do is adhere to some general home safety practices for all households. Make sure that you have proper lighting throughout your home. Remove clutter near rugs. Secure your pets to keep them from getting underfoot. Install handrails on all stairs. And keep your floors dry to prevent slipping, especially in the bathroom.

Stairs and Ramps

When you return to your community, you may be faced with obstacles. During an inpatient rehabilitation stay, your therapist will prepare you to handle the challenges that may arise. It’s not uncommon for people to use equipment for walking assistance immediately after hip surgery. You may be issued a walker to aid in dealing with obstacles. For your safety and balance, remember to remain close to your walker at all times. After an operation, your physician may issue you hip precautions to follow, so there may be positions and movements that you should avoid. When going up stairs, you may want to lead with your stronger leg, but when stepping down, use your operated leg.

Bed Transfers

When approaching your bed, stand with your back to the bed, then back up until the back of your good knee touches the bed. You will bring your operated leg forward. Remember to move your body as one, and do not twist. Your therapist may issue you a leg lifter to help you get your operated leg onto the bed. Keep your walker within easy reach of your bed.

Car Transfers

It can be helpful to put the seat as far back as it will go. Keep your hips above your knees, especially if the seat is low. Stand with your back to the car, feel with the back of your good knee and sit, but watch your head. Finally, lift your legs one at a time.

Tub Bench Transfers

Install grab bars in your shower or tub for support as you get in and out. With your walker, back up until you feel the tub bench behind you. Reach back for the bench with one hand first, then the other. Then sit down.

Using a Hip Kit

To protect your hip, you must learn safe ways to do daily tasks. This includes getting dressed and undressed. Be sure to continue to follow your hip precautions according to your surgery. Your therapist may have issued you a hip kit package with tools to help manage getting dressed. This may include long-handled equipment to remove and retrieve your socks. Pull your sock onto the front of the sock aid device, slip your foot into the sock, and then pull back on the sock aid.

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Treating the Whole Trauma Patient

Motor vehicle accidents. Gunshot wounds. Workplace accidents. When we think of a trauma patient, the intense physical recovery from their injuries is what often comes to mind. And while treating those injuries is of great importance, a full recovery is much more complex. In order to treat the whole trauma patient, we must also consider the mental and emotional side of trauma.

Trauma can be defined as any life-threatening event or a psychologically devastating event that can affect a person’s ability to deal with it, or affect their coping mechanisms. This can be very overwhelming for the patient, which can hinder their recovery.

Or worse.

People who have experienced trauma are 15 times more likely to commit suicide. It is imperative that people who have experienced a traumatic event get the support and guidance that they need from those around them.

A treatment plan that works with the trauma patient and their family to address these concerns is critical to achieving the goal of returning the patient to their community.

Patients who have experienced trauma often struggle to understand what happened to them. They wonder “why me?” and may struggle with communicating effectively. This can lead to outbursts, mood swings, and different behavioral patterns. Understanding this and adapting their treatment plan accordingly is key to their recovery.

If you or your loved one has experienced a traumatic event, please speak with your care team to ensure you receive the support and resources you need.

Kelsi Clark, RN is a nurse supervisor at Vibra Hospital of Denver. A graduate of Concorde Career College, Kelsi is very passionate about nursing and began her career at Vibra as a CNA. Kelsi and her husband love to spend time with their family, especially outdoors, and have another baby on the way.


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Tips to Stay Safe This Summer

Summer brings many fun activities for us to enjoy, such as swimming, barbecuing and gardening. But along with the sun and fun comes certain safety concerns. Here are some tips to stay safe this summer.

Stay Hydrated

Hydration is important for all ages, but especially for small children and older adults. The summer heat and humid conditions make it easier to become dehydrated. Be sure to drink plenty of water throughout the day, even if you don’t feel thirsty. Water and sports drinks hydrate you much better than sodas.

Sun Safety

If you are going to be exposed to direct sunlight, take steps to prevent sunburn. Sunburn can be not only painful, but dangerous, as well. Take care to select the right sunscreen. Look for one that is waterproof and at least 15 SPF. If possible, apply the sunscreen 30 minutes before sun exposure. Cover all areas that will be exposed, including the scalp and lips. Reapply the sunscreen every 2-3 hours or more frequently if you are swimming or sweating.

Water Safety

Enjoying the water, whether in a pool or natural body of water, is a great way to relax in the heat of the summer. But caution should always be taken when doing so. Never leave a child unattended in the water, and stay alert when watching them. Use life jackets when on watercraft, and only use life jackets approved by the US Coast Guard. Also be sure to keep an eye on changing weather conditions, which can quickly make the water a hazardous place.

Grilling Safety

The summer also brings barbecue season. If you’re on grill duty, never leave your grill unattended. Use long-handled tools to minimize the chance of getting burned. Prevent foodborne illness by keeping your meats below 40°F until you’re ready to grill them. Cook to the recommended temperature, and after cooking, keep them above 140°F. When finished grilling, clean the grill to prevent fires and flare-ups.

Firework Safety

While beautiful to watch, fireworks can also be very dangerous. Always read the directions and warning labels before attempting to light fireworks. Keep a bucket of water or a water hose close by to extinguish any accidental fires. And only use fireworks outdoors, with plenty of space around you.

Mark Prickett is the Chief Marketing Officer at Vibra Hospital of Amarillo and Vibra Rehabilitation Hospital of Amarillo. Mark was born and raised in Texas and joined the Vibra Healthcare team in 2016. He and his wife of 12 years, Erin, have a 9-year-old son named Stoney who keeps them on their toes. Mark enjoys traveling and anything that allows him to spend time with his family.

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What is Aphasia?


About two million Americans live with aphasia, but many of us don’t know what it is. So what is aphasia? Aphasia is the inability to comprehend or formulate language. Aphasia is usually caused by a neurological insult, such as a stroke, brain injury, or other neurogenerative diseases, such as dementia. While aphasia impacts communication, it is not uncommon for a person’s intellectual and cognitive abilities to remain intact.

There are three main categories of aphasia: Broca’s aphasia, Wernicke’s aphasia, and global aphasia.

Broca’s Aphasia (Expressive Aphasia)

Broca’s aphasia is also sometimes referred to as expressive aphasia. This is because a person living with Broca’s aphasia will struggle to express themselves. They may speak with just a few words, rather than full sentences. Finding the right word can be difficult. They may also experience difficulty with writing. Broca’s aphasia results from damage to the frontal lobe of the brain.

Wernicke’s Aphasia (Receptive Aphasia)

Wernicke’s aphasia is generally the opposite of Broca’s aphasia. It is often called receptive aphasia, as comprehension is the area of communication most affected by this type of aphasia. A person living with Wernicke’s aphasia may speak well, but what they say may not always make sense. Often times, they do not realize they aren’t making sense. These individuals will also commonly struggle with reading and writing. Damage to the temporal part of the brain is generally the cause of Wernicke’s aphasia.

Global Aphasia

The most severe form of aphasia is global aphasia. With global aphasia, a person struggles with both expression and comprehension. They will speak very few words, understand little of what they hear, and be unable to read or write. People living with global aphasia often have damage in both the frontal lobe and the temporal part of the brain.

Diagnosing and Treating Aphasia

Most often, a person’s physician identifies difficulty with language first. The physician then refers them to a speech-language pathologist. The speech-language pathologist will perform a comprehensive examination to determine the extent of the impairment. Treatment varies depending on several factors, including what region of the brain is damaged and the patient’s individual needs. The sooner treatment begins, the more effective it is.

Jessica Garcia is a speech-language pathologist at Laredo Specialty Hospital and Laredo Rehabilitation Hospital in Laredo, TX. Jessica holds a bachelor’s degree in Communication Sciences and Disorders from Texas State University and a master of science in Speech-Language Pathology from Texas A&M Kingsville. She is also certified in VitalStim®, a therapy designed to treat dysphagia. Jessica is passionate about her profession because of the difference she is able to make in the everyday lives of patients throughout their lifespan.

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Treatment for a stroke often involves inpatient rehabilitation

Treatment and Recovery from Stroke

Treatment and recovery from stroke will vary from patient-to-patient. Some of the factors that will determine your treatment include the type of stroke, its location and effects, and your individual goals for recovery.

How are different types of strokes treated?

The two main types of strokes are treated differently. There are three main treatments for ischemic strokes. They include clot-busting medication (such as tPA), anticoagulants (such as warfarin), and surgical procedures (such as carotid endarterectomy, angioplasty, or stent placement). Hemorrhagic strokes are treated with surgical interventions and/or endovascular procedures, such as coiling or clipping. This is where the “T” in F-A-S-T becomes important. Receiving treatment quickly minimizes the damage done by the stroke.

Inpatient rehabilitation for stroke recovery

If you have had a stroke, participation in a rehabilitation program will aid in your recovery. In an inpatient rehabilitation hospital, you receive care from a physician-led multidisciplinary team. These teams are usually comprised of physiatrists, rehab nurses, case managers, dietitians, pharmacists, speech, occupational, and physical therapists and YOU. Each team member has their own role in your recovery. But as a team, they will be responsible for ensuring that you and your family are properly educated. You will not only learn what a stroke is, but how to prevent another stroke in the future. Your therapists will rely on the principles of neuroplasticity to optimize your recovery while you are in inpatient rehab.

Neuroplasticity is the brain’s ability to reorganize itself by forming new neural connections. The brain can compensate for the damage caused by a stroke by reorganizing and forming new connections between the neurons that are still intact. In order for those connections to form, they must be stimulated in the proper fashion. This is where therapy will play a vital role in your recovery.

Meet your therapists

Your physical therapist will assess your overall ability to move and how you keep your balance. He or she will help you improve your ability to stand up, sit down, walk and maintain your balance. This will be done by leading you through exercise and repeated practice of functional mobility.

Your occupational therapist will assess your ability to complete your activities of daily living, or ADLs. ADLs are activities such as bathing, dressing, grooming, toileting, writing, and cooking. You will learn techniques to succeed in your ADLs and regain as much independence as possible. This is accomplished by addressing fine motor coordination, upper body strength, endurance, and balance. Your OT will also teach you the use of adaptive equipment and compensatory strategies.

Your speech therapist will assess your communication, cognition, and ability to swallow food and water. He or she will help you improve your ability to communicate and remember and process information. You will also learn to problem solve through practice and compensatory strategies. If there are changes in your swallowing function, your speech therapist will complete a swallow study and can recommend a modified diet, if needed.

Monika Pawar, DPT is the Lead Physical Therapist at the Rehabilitation Hospital of Northwest Ohio. Monika has practiced physical therapy for 12 years in multiple settings, including day rehab, skilled nursing, and home health, however, her passion remains in inpatient rehabilitation. During her free time, Monika likes to hang out and laugh with her amazing work family and explore National Parks and eat good food with her beloved husband, Jim.

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Types of Strokes

A stroke occurs when there is a blocked or burst blood vessel in the brain, cutting off blood flow. However, not all strokes are the same. The location and type of stroke will impact how a patient is affected, as well as how they are treated. What are the different types of strokes?

Ischemic Stroke

Ischemic strokes are caused by a blockage in the blood vessels to the brain. The blockages in the blood vessels can be caused by a thrombus. A thrombus is a blood clot at the site of a fatty deposit lining the wall of a blood vessel. They may also be caused by an embolus. An embolus is a traveling particle (clot or debris) that is too large to pass through a small blood vessel. This accounts for approximately 87 percent of all strokes. Ischemic strokes are the most common type of stroke.

Hemorrhagic Stroke

Hemorrhagic strokes are caused by a burst or leaking blood vessel in the surrounding brain. Blood accumulates in the surrounding area where the blood vessel burst or ruptured, compressing the brain tissue. There are two types of weakened blood vessels that usually cause hemorrhagic strokes: aneurysms and arteriovenous malformations (AVMs). An aneurysm is a weak area in a blood vessel that usually enlarges. This is sometimes described as a “ballooning” of the blood vessel. AVM is a cluster of abnormally formed blood vessels, any one of which can rupture, causing a bleed in the brain. Hemorrhagic strokes account for approximately 13 percent of all strokes.

Transient Ischemic Attack (TIA)

A transient ischemic attack is often referred to as a “mini-stroke.” This is caused by a temporary clot. Although TIAs do not cause permanent damage, they may signal a full-blown stroke in the future. Up to 40% of people that have had TIAs will go on to have a stroke.

Other Types of Stroke

Additionally, you may hear of a few other terms used to describe a stroke. A cryptogenic stroke is simply a stroke with an unknown cause. Strokes can also sometimes occur in the brain stem. These strokes can be difficult to diagnose, as they often have more complex symptoms. There are three areas of the brain stem where a stroke may occur: the midbrain, the pons, and the medulla.

Monika Pawar, DPT is the Lead Physical Therapist at the Rehabilitation Hospital of Northwest Ohio. Monika has practiced physical therapy for 12 years in multiple settings, including day rehab, skilled nursing, and home health, however, her passion remains in inpatient rehabilitation. During her free time, Monika likes to hang out and laugh with her amazing work family and explore National Parks and eat good food with her beloved husband, Jim.

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What is a Stroke?

According to the American Heart Association, stroke is the fifth-leading cause of death in the United States. It is also the leading cause of disability.

The good news? As many as 80% of strokes may be preventable, mainly through lifestyle changes.

What is a stroke?

A stroke occurs when blood flow to the brain is cut off suddenly. This may be caused by a blocked blood vessel or a burst blood vessel. This abrupt cut off prevents the vital blood and oxygen that a brain needs, and results in brain injury.

The area of the brain where a stroke occurs plays a key role in how a patient is affected. A stroke on the left side of the brain will affect the right side of the body, while a stroke on the right side of the brain will affect the left side of the body. This may manifest as paralysis or weakness, particularly in the arms and legs. Left brain strokes can affect speech and language, while right brain strokes might affect vision. The type of stroke and how it affects the patient will determine treatment and recovery.

Risk Factors for Stroke

Some risk factors for stroke can be treated while others cannot. Treatable risk factors include:

  • High blood pressure
  • Tobacco use
  • Heart disease
  • High cholesterol
  • Poor diet
  • Physical inactivity
  • Obesity

Risk factors that cannot be treated are:

  • Age
  • Family history
  • Race
  • Gender
  • Prior history of stroke or heart attack

If any of the risk factors apply to you, please consult your physician to determine how you can minimize your risk.

Knowing the signs & symptoms of stroke could save a life!

Recognizing a Stroke

In the event someone is suffering a stroke, knowing the signs and symptoms could save the person’s life and even minimize the effects of the stroke. All you need to remember is F-A-S-T:

     F: Face Drooping

     A: Arm Weakness

     S: Speech Difficulty

     T: Time to Call 9-1-1

Monika Pawar, DPT is the Lead Physical Therapist at the Rehabilitation Hospital of Northwest Ohio. Monika has practiced physical therapy for 12 years in multiple settings, including day rehab, skilled nursing, and home health, however, her passion remains in inpatient rehabilitation. During her free time, Monika likes to hang out and laugh with her amazing work family and explore National Parks and eat good food with her beloved husband, Jim.

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Health Benefits of Dance

From ballroom to hip-hop and salsa to ballet, there are many forms of dancing. And dancing is as popular today as it’s ever been. We love to watch other people dance. Reality shows like So You Think You Can Dance and World of Dance are dominating TV.

But we also love to dance ourselves. Dance is often about creativity and self-expression, but it is also an effective and enjoyable way to get active and exercise! Studies show that dance can help with weight loss, flexibility, balance, and reduce stress. It is also a great way to socialize and make friends! Dancing is a fun way to get active and stay fit for people of all ages, sizes and fitness levels.

What are the health benefits of dancing?

Dancing can help you improve your health in many ways, including:

  • Improving heart and lung condition
  • Increasing strength and endurance
  • Providing aerobic exercise
  • Helping with maintaining a healthy weight
  • Improving coordination and flexibility
  • Strengthening bones and reducing the risk of osteoporosis
  • Increasing confidence and self-esteem
  • Improving balance and spatial awareness
  • Improving general and psychological wellbeing
  • Increased social skills
  • Boosting memory

How to get started

If you are thinking of taking up dancing, be sure to protect yourself against injury by taking the following precautions:

  • Check with your doctor before beginning any new exercises
  • Wear appropriate clothing for comfort and to prevent overheating
  • Do warm-up stretches before you begin a dance session.
  • Be sure to drink plenty of water before, during and after dancing
  • Make sure you rest between dance sessions
  • Don’t push yourself too far or too fast, especially if you are a beginner
  • Wear properly fitted shoes appropriate to your style of dance
  • Check with your dance instructor that you are holding the correct form
  • Sit and watch new dance moves first. Learning new moves increases your risk of injury, especially if you are already tire
  • Perform regular leg-strengthening exercises
  • Move as fluidly and gracefully as you can
  • Cool down after a dance session, including stretching

There are many different styles of dance, so be sure to choose a style that works best for you and what you would like to accomplish. Consider whether you prefer slow or fast dancing, dancing solo, with a partner or in a group. The most important part is to make sure you are having fun and get moving! There are no wrong moves, just unexpected solos!

Danielle Ball, MOTR/L, CLT, CKTP is an occupational therapist at Gateway Rehabilitation Hospital. She has been an occupational therapist for over seven years with experience in inpatient and outpatient rehabilitation, long-term acute care and skilled nursing facilities. She graduated from Xavier University with her master’s in occupational therapy in 2011. Danielle is a certified lymphedema therapist and also a certified Kinesio® tape practitioner.

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Health Benefits of Reading

Reading is one of the most powerful and inexpensive tools we have for improving our health. The health benefits of reading are wide-ranging and span our entire lives. From developing our cognitive abilities as children to frequently reading to ward off dementia as we age, studies show that reading is the best exercise for our brains. Here are three compelling reasons to pick up a book today, no matter your age!

Reading Protects Your Brain from Dementia

Mentally stimulating activities, such as reading a book, can help keep memory and thinking skills intact. Research has shown that these activities can stave off a decline in memory as we age. In one such study, the rate of decline in memory was 32% slower in those that participated in frequent mentally challenging activities versus an average frequency. The difference between average frequency and infrequent participation is even more extreme, at 48%.

Reading is a Powerful Stress-Buster

Many have opined that we are as stressed today as we’ve ever been. While it’s hard to define and measure stress, especially over time, who couldn’t use a little less of it? Fortunately, we have a powerful stress-buster available to us in reading! One recent study aimed to find what activities were most effective at lowering stress levels. Using physical indicators of stress, such as heart rate, the study found reading to be the most effective, reducing stress levels by as much as 68%. Reading silently for just six minutes had a greater impact on stress levels than listening to music, drinking a cup of tea, going for a walk, and playing video games. The good news for those who think we’re as stressed as ever? Millennials take advantage of public libraries more than any other generation.

Reading is Great for Kids & Teens, Too

The earlier we start reading, the bigger impact it can have on our health! Beside cementing a good life-long habit, reading has many short-term benefits for our youth, too. Reading to our children helps to develop stronger parent-child relationships. Additionally, reading helps children develop stronger comprehension and vocabulary skills, which lead to better school performance.


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Introducing…Progress Notes: Inspiring Stories of Patient Success

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At Vibra Healthcare and Ernest Health, we are privileged to encounter some of the most incredible people on a daily basis. Our patients face, and overcome, serious health issues, doing so with a fierce and unwavering determination to succeed. In doing so, they inspire us all, each and every day.

We want to share these incredible stories with the world. Because maybe you, too, are recovering from a stroke or amputation or traumatic injury. Maybe a loved one is living with MS or a brain injury or Parkinson’s disease. Maybe you just need a little motivation to tackle whatever you’re facing today.

That’s why we created this short-form podcast called Progress Notes.

Every week, we’ll tell the inspiring story of another individual on the podcast. We hope that these stories make your day a little brighter and help you to believe that anything is possible if you put your mind to it.

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Understanding Spinal Cord Injuries

The spinal cord is a part of the central nervous system, along with the brain. Your brain and your body communicate by sending signals through the spinal cord. When the spinal cord suffers an injury, it affects the ability of your brain and body to communicate.

Causes of Spinal Cord Injuries

Spinal cord injuries are usually categorized as either traumatic or atraumatic. Common causes of traumatic spinal cord injuries include car accidents, falls, and unfortunately, acts of violence. Atraumatic spinal cord injuries can be caused by things like infections, abscesses or even cancer.

Risk Factors

There are a number of risk factors for spinal cord injury. Men are much more likely than women to suffer a spinal cord injury. About 80% of those who suffer a spinal cord injury are male. Age is another risk factor. Spinal cord injuries occur more often in individuals between the ages of 16 and 30. But there is also a non-demographic risk factor: engaging in risky behavior. Unsurprisingly, this largely surrounds alcohol intake. Consuming too much alcohol increases your risk of suffering a spinal cord injury. Remember, never operate a vehicle if you’ve been drinking.

How are Spinal Cord Injuries Classified?

Spinal cord injuries are classified in a few different ways. One is the level of injury. This ranges from the cervical spine in your neck down to the lumbar spine in your lower back. Injuries can happen anywhere along the spinal cord. The location of the injury will impact how it affects a person. Typically, the higher up an injury occurs, the more impairments you will see. There are nerves coming off the cervical spine that help innervate your arms and your hands. The lower down in the spinal cord an injury occurs, the lower the impairments.

Additionally, spinal cord injuries are classified by how complete the injury is. A complete injury results in the patient having no sensation or motor function below the level of injury. With an incomplete injury, the patient retains some muscle activation below the injury. They may also have some sensation remaining.

Treating a Spinal Cord Injury

Physical therapy focuses on treating the injury with the goal of improving the patient’s mobility. That might mean getting in-and-out of bed or a wheelchair or propelling a wheelchair. Occupational therapy focuses on helping individuals with daily tasks. These include dressing, bathing, and cooking.

Another important component of recovery is working with the patient’s family. Educating and training the family should be a part of any rehabilitation program. This not only helps the patient with their day-to-day lives, but also with preventing the secondary effects of spinal cord injuries.

Taylor Carlson PT, DPT is a physical therapist at the Rehabilitation Hospital of Northern Arizona. Taylor recently graduated from Northern Arizona University with his Doctorate degree in Physical Therapy. Taylor enjoys working and treating all patients and diagnoses, but especially patients with spinal cord injuries and other neurologic conditions. While currently gaining clinical experience, Taylor would like to pursue his Neurologic Certified Specialist (NCS) certification. Taylor enjoys staying active, being outdoors, and spending time with family and friends.  

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Nutrition and Recovery from Brain Injury

It’s easy to make the case that the brain is one of our most important organs, perhaps the most important. When the brain gets damaged, it can affect how we speak, behave, move, and eat. As a registered dietitian, nutrition is my passion – so let’s take a closer look at how nutrition can affect our ability to heal and recover from a brain injury.

There are two main types of brain injury – traumatic and non-traumatic. Traumatic injuries include just that: trauma, such as falls, car accidents, sport injuries, and more. Non-traumatic brain injuries include strokes, seizures, infections, and lack of oxygen to the brain.

With either type of brain injury, it can become difficult, dangerous, or simply impossible, to eat. But, your body (and your brain!) still needs nutrition to survive. In fact, the body’s protein and calorie needs can rise to double the normal resting requirements after a brain injury. We also know that early ‘feeding’ is critical to good outcomes. So how do we do this?

A feeding tube can be critical for survival when a patient cannot safely eat by mouth. Best practice guidelines recommend early use of enteral nutrition – optimally in the first 72 hours after the injury. This is associated with improved outcomes. Tube feeding can provide the body with the protein and calories it needs to slow breakdown of lean body mass, and help control the extent of the body’s inflammatory response. There are specialty tube feed formulas that your clinical dietitian may use to help manage this response. Nutrition needs, along with fluid and electrolytes requirements, may change and fluctuate frequently during the immediate days and weeks, and require close monitoring.

In the recovery phase, it is time to start evaluating whether the patient can eat and drink by mouth again. Depending on the part of the brain that was affected, dysphagia, or difficulty swallowing, is common. Patients may work with a speech therapist to help them start eating and drinking safely. This phase may also still require nutrition support, tube feeding, or nutrition supplements, until the patient is able to eat and drink enough on their own to meet their nutrition needs.

So, what can we do to help ourselves and our loved ones in the event of a brain injury?

Good nutrition before the injury happens is linked with better outcomes. So take a few moments to evaluate your nutrition, and reach out to a registered dietitian if you need support. Once in the hospital, advocate for your (or your loved one’s) nutrition – find out what the nutrition plan is and speak with the clinical dietitian at the facility. Good nutrition before, during, and after a brain injury can help support healing, strength, and improve outcomes.

Kate Nelson, MS, RD, CNSC is a Clinical Dietitian at Vibra Hospital of Denver. She is passionate about clinical nutrition and recently passed her Certified Nutrition Support Clinician (CNSC) exam in April of this year. She has also worked in acute care and skilled nursing facilities, and had a previous career as a Park Ranger with Colorado State Parks. At home, she spends her time cooking delicious meals for family and friends, cheering on the Denver Broncos, and spending time with her husband and beloved Boxer pup, Nemo. 

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Concussions in Youth Sports

In the world of sports, a mild traumatic brain injury is also known as a concussion. Despite the word “mild” and the frequency with which we hear the term, concussions should be taken seriously.

If your child competes sports, take some time to speak with your coaching staff about concussions. This is especially important with contact sports. To stay informed on how the coaches manage a suspected concussion, ask the following three questions.

1. What is your procedure if you suspect someone has suffered a concussion, either in practice or a game setting?

It is important to know how this is managed in practice, as well as a game setting. Game settings tend to be more formal as compared to practice, but the risk can be the same in both settings.

2. Do you have a concussion management protocol?

This would be something that spells out clearly how they manage someone they suspect has suffered a concussion. It should cover from the suspected injury through a return to competition.

3. Do you have staff on site during practice and games that are trained in assessing for concussions?

Make sure you know the signs and symptoms of a concussion, as well. They include:

  • Slowed thinking, or feeling that you’re in a fog
  • Trouble concentrating
  • Trouble remember new information
  • Constant headache
  • Changes in balance
  • Lack of energy
  • Mood changes
  • Increased anxiety
  • Change in sleep patterns, sleeping more or less than usual

The ultimate goal is to be confident that if your loved one suffers a concussion, they can be properly treated and safely return to competition. If you suspect your child has suffered a concussion, follow up with your physician, or another care provider trained in managing concussions.


Kevin Nicholson, PT is the Director of Therapy Services at Vibra Rehabilitation Hospital of Amarillo. He is passionate about stepping out of the normal “therapy box” to help patients improve and return home. He has also worked as a PT assistant prior to becoming a PT, and has a combined 31 years of experience in the field of physical therapy. In his off time he enjoys watching professional basketball and mixed martial arts, and he enjoys barbell training.


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Concussion Facts: True or False?

Mild traumatic brain injuries, also known as concussions, are the most common form of brain injury. Yet, there are many misconceptions regarding concussions. Unfortunately, this can lead to undiagnosed and untreated brain injuries.

To help raise awareness about concussions, we’ve assembled this short quiz. How much do you know about concussions? Test your knowledge of concussion facts with the “True or False” questions below.

True or False: A concussion is defined as a blow or jolt to the head that causes changes in brain function?

True. Our brains use nerve impulses to talk to different parts of the brain. When there’s a jolt or blow to the head, it can cause changes in the flow of those impulses, which then causes changes in brain function.

True or False: You can only get a concussion if you play sports?

False. While it is true that concussions can happen during sports, they can also happen to anyone, at any age, at any time. A few examples of where brain injury occurs is in falls, both in the elderly and in children, motor vehicle accidents, and even bike accidents in children.

True or False: You must “black out” in order to have a concussion?

False. Losing consciousness happens in only approximately 20% of concussion cases. Some signs to watch out for besides the “blacking out” include loss of memory of the events before, during or after the event, and feelings of confusion or even slowed thinking.

True or False: It is possible to have a concussion and not realize it?

True. Sometimes, changes in the brain following a concussion will not show up on brain imaging. However, there are several signs to watch out for after a concussion. They include:

  • Slowed thinking, or feeling that you’re in a fog
  • Trouble concentrating
  • Trouble remember new information
  • Constant headache
  • Changes in balance
  • Lack of energy
  • Mood changes
  • Increased anxiety
  • Change in sleep patterns, sleeping more or less than usual

If you feel like any of these things pertain to you or a family member, speak to your primary care physician about your concerns. He or she may refer you to a speech language pathologist, a physical therapist or occupational therapist who are trained to help those following brain injury.

Eva Baltz is a speech-language pathologist at Elkhorn Valley Rehabilitation Hospital in Casper, Wyoming. She obtained her bachelor’s degree in Speech, Language, and Hearing Sciences from the University of Wyoming and her master’s degree in Communication Sciences and Disorders from Rockhurst University. Eva is passionate about providing individualized treatment of aphasia and traumatic brain injury. She is an educator at heart and constantly seeks opportunities to promote education of her field. In her spare time, Eva enjoys exploring new places and photography.

Danielle Nielsen, OTR/L, CMPT is an Occupational Therapist at EVRH. She completed her master’s degree in Occupational Therapy from the University of North Dakota in 2016. She enjoys providing the best care for each and every one of her patients. Danielle is passionate about everything she does and always strives to find the fun in life. She is a Certified Manual Trigger Point Therapist, completing her dry needling certification in 2018. In her spare time, Danielle enjoys spending time with her friends, family and her dog, Franklin.

Colleen Powers is a speech-language pathologist at EVRH. She obtained her bachelor’s degree Communicative Sciences and Disorders and master’s degree in Speech-Language Pathology from the University of Montana. Colleen focuses on providing personalized and evidence-based therapy for people with communication, cognition, and/or swallowing disorders. Outside of work, Colleen enjoys skiing, hiking, and traveling.

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Living with MS: 5 Ways Rehabilitation Can Help

According to the National Multiple Sclerosis Society, rehabilitation is “an essential component of comprehensive MS care.” This starts at the time a person is diagnosed with multiple sclerosis, and can be used to achieve many goals.

Here are some ways rehabilitation can help a person living with multiple sclerosis:

Walking and Mobility

Individuals living with MS often find difficulty with walking and mobility. These problems can manifest in a variety of ways. They include balance issues, muscle tightness or spasticity, numbness, weakness and fatigue. Physical therapy helps to address these issues, reducing the risk of falls that might cause further injury.

Activities of Daily Living

Multiple sclerosis can also pose challenges when it comes to caring for oneself. Many of the same symptoms that affect mobility can make it difficult to complete tasks we often take for granted. Occupational therapists work with patients to insure they can safely groom and bathe themselves, get dressed and cook their meals.


MS can affect speech in several different ways. Lesions in the brain can cause changes in speech patterns, while muscle weakness in the mouth and tongue might result in words being slurred. Speech disorders are known as dysarthrias. Speech language pathologists provide therapy to address dysarthria and improve verbal communication.

Additionally, speech language pathologists work with patients to treat issues with swallowing. Difficulty swallowing is known as dysphagia. Because speaking and swallowing involve many of the same muscles, it’s not uncommon for a person living with MS to also suffer from dysphagia. Speech language pathologists treat dysphagia by strengthening the tongue and swallowing muscles. They do this through targeted exercises and other treatments, such as VitalStim.

Overall Conditioning

Improving your overall conditioning is one of the most impactful things you can do to limit the effect of MS on your daily life. Doing so can decrease fatigue, improve muscle strength and stability, and reduce pain. The goal is to achieve optimal function at home, at work and in your community.

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5 Rules for Managing Congestive Heart Failure

Congestive heart failure is an entity that affects many individuals, and is related to many different causes.

The best way to manage congestive heart failure can be quite simple. Its five simple rules:

Rule #1: Manage your liquid intake

Average liquid intake for people with congestive heart failure should be around two liters per day.

Rule #2: Take your medications

It’s very important to consistently use the medications that your doctor or caregiver has prescribed for you.

Rule #3: Weigh yourself every day

Make sure to weigh yourself at the same time of day and record it. Watch for a weight gain of five pounds over three days. This may mean that you need to adjust your medications, and should speak with your care provider.

Rule #4: Manage your sodium intake

This doesn’t just apply to the salt on the table. Look at the sodium content on the nutrition labels of the foods you are buying, as well. Processed meats and cured items are a couple examples of food items with a lot of sodium in them.

Rule #5: Exercise!

Get out and use your heart muscle to help it stay strong. Remember, your heart is a muscle, and it needs to be exercised like any other muscle.

With these five simple steps, managing congestive heart failure can be a lot easier, and you can improve your quality of life significantly.

Dr. Sheldon Goldberg is a Board-Certified Specialist in Physical Medicine and Rehabilitation. He has a special interest in the area of wound healing and pain management. He is currently the Medical Director of Vibra Rehabilitation Hospital of Denver. Dr. Goldberg is a Clinical Assistant Professor of Medicine at the University of Colorado at Denver Medical School. He has done research in the area of sound healing and pain management in the past. He is graduate of the Autonomous University of the City of Juarez and his undergraduate background includes national certification as a Physician’s Assistant with special interest in cardiology, rheumatology, and orthopedic surgery. He also holds a degree in Dietetics and Nutrition.

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Deb’s Heart Attack Story: From Director of Therapy to Therapy Patient

Unfortunately for Deb Campbell, suffering a life-threatening heart attack on April 2nd was not an April Fool’s joke.

Deb is the Director of Therapy Operations for Northern Colorado Rehabilitation Hospital and Northern Colorado Long Term Acute Hospital in Northern Colorado. An occupational therapist, herself, Deb never thought she would

Deb Campbell is the Director of Therapy Operations at Northern Colorado Rehabilitation Hospital & Northern Colorado Long Term Acute Hospital

be a heart attack survivor just a few days before her 47th birthday.

Deb’s father suffered a heart attack, which led to her interest in heart health and education. “I’ve always known that women often have abnormal symptoms when having a heart attack,” Deb noted. “I have educated many patients on eating a healthy diet and exercise. When it came time to recognize my own symptoms, I did not trust my gut feeling.”

Deb had been experiencing symptoms of being extremely tired, feeling her heart flutter, and burning chest pain on-and-off for months. She “kept talking myself out of it,” thinking it was heartburn, stress or a virus.

While on a boat in Costa Rica, Deb could no longer ignore the symptoms. She thought she was getting sea sick and laid down. Next thing she knew, Deb woke up to a stranger screaming for her to open her eyes.

Deb’s heart had stopped beating, and she was unconscious.

Eventually aroused, Deb was taken to a local hospital. Doctors found the primary artery sending blood to her heart was 96% blocked. The medical staff treated the blockage and she left for home 10 days later.

Upon returning home, Deb started a 12-week-long intensive cardiac rehab program. She admitted to “feeling embarrassed,” recalling she was the youngest one there. “However, I knew I could trust the therapists to get me back to my life.”

Deb knows this experience has affected the way she cares for patients. “I have more empathy and relate to what they are feeling at a visceral level,” she said. “I understand being scared and nervous. I understand the discomfort of moving from one hospital to another. I can appreciate the behaviors of families and patients – appreciate that they are coming from a place of fear and concern.”

Deb tells anyone with symptoms of a heart attack–but especially women–to “trust your instincts. If you are trying to talk yourself out of thinking you’re having a heart attack, you should seek medical attention immediately.”

Deb knows she is lucky to have survived. She has a holiday celebration on the anniversary of her heart attack. “I celebrate life,” she said with tears in her eyes. “I trusted the therapists and doctors, so I wasn’t afraid. I learned to take advantage of my life now – you never know when it may end.”

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Your Data Privacy Rights as a Patient

The Health Insurance and Accountability Act (“HIPAA”) has been providing federal protections for your medical information since 1996. Under HIPAA, you are the driver of how your healthcare provider uses your medical information. It is thus important that you know your medical privacy rights and your healthcare provider’s responsibilities when it comes to your medical information.

As a patient, you have the right, among others, to:

  • Decide if you want your care provider to talk about your medical information in front of your family or friends, or if you would like to talk in private
  • Decide if you want your family or friends to see your medical record or if you want us to keep it private
  • Request access to, or a copy of, your medical record, or authorize that we provide a copy of your medical record to another person or company
  • Request that we amend your medical record if you believe it is wrong or request that we place a written correction in your medical record if we cannot amend your medical record
  • Tell us how you want to be contacted or request that we restrict the way that we contact you
  • File a complaint with the facility or provider that treated you or with the Health and Human Services, Office for Civil Rights

Ernest uses your medical information, as allowed by HIPAA, in a number of ways that assist us, and others, in providing care for you. Some of the ways that HIPAA allows us to use your medical information when providing care are:

  • For your treatment and care coordination
  • To pay doctors and hospitals for your health care
  • With your family, relatives, friends, or others you identify who are involved with your health care or your health care bills, unless you tell us not to
  • To make sure doctors give good care and nursing homes are clean and safe
  • To protect the public’s health, such as by reporting when the flu is in your area
  • To make required reports to the police, such as reporting gunshot wounds

There are certain times when HIPAA requires that we ask you before we share your medical information. Some of the times we are required to ask for your permission before sharing your medical information include:

  • Before we share your medical information with your employer
  • Before we use or share your medical information for certain research purposes
  • Before we use or share your medical information for marketing or advertising purposes

In order to ensure that your medical privacy is protected according to your wishes, it is important to know your privacy rights as a patient and to inform your healthcare providers of how you want your medical information used or shared. It is also important that you review your medical records periodically to ensure that they are complete and accurate. Should you identify what you believe to be an error in your medical record, you should contact the healthcare provider that authored the medical information to find out how to request amendment to your medical information.

Knowing your medical privacy rights puts the power in your hands to control who can see and hear your medical information, as well as how your healthcare providers can use and share your medical information!

*For more information on how Ernest uses and shares patient medical information please request a copy of your Ernest facility’s Notice of Privacy Practices.

Angelique Culver, Esq. has been an Attorney for 15 years, specializing in Healthcare Compliance and the privacy and security of patient information for last 9 years.  She is the Chief Compliance and HIPAA Officer for Vibra Healthcare.  She has long been an advocate for patients’ rights, serving as a member of the bio-ethics committee of an urban academic medical center and the Georgia Department of Public Health’s Health Information Exchange Legal/Ethical Workgroup.  She currently serves on the Board of Directors for WITF, Inc., a Central Pennsylvania public broadcasting company committed to increasing cultural access and knowledge, extending public education, and strengthening community life through all channels and platforms, including broadcasting, online, social media, print, and in person events.

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Why Donate Blood?

Every two seconds, someone in the U.S. needs blood. And while many donate blood frequently, there hasn’t been enough supply to meet demand.

But why should you donate blood, if you are able?

You can save a life

Donating blood is an easy, selfless way to help others. People with all kinds of health issues need blood for a variety of reasons. Some examples include:

  • Cancer patients who cannot produce platelets due to treatment
  • Trauma patients suffering blood loss
  • Patients undergoing heart surgery and organ transplants
  • Sickle cell patients, who require frequent transfusions
  • Burn patients, needing plasma to help maintain blood pressure
  • Patients with chronic diseases

There’s an urgent need for blood donors

Unfortunately, there has been a consistent shortage of blood donations across the nation. At the time this blog was written, the American Red Cross has issued an emergency need for blood donors. A blood shortage can lead to delays in providing medical care to patients, which in many cases is lifesaving. There is a particular need for Type O blood, which is often in high demand.

You may have a rare blood type

There are eight common blood types, but many more rare blood types. For a safe transfusion, there are very specific ways in which blood types much be matched. For example, someone with Type O blood can donate to all other blood types. However, they can only receive Type O blood.

To donate blood, you can find a Blood Drive near you on the American Red Cross website. Additionally, many of our hospitals host blood drives regularly, and usually announce them on Facebook.

If you haven’t donated blood before, check out these common concerns for first-time donors.

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3 Brain Safety Tips for Winter Sports

The winter months bring many wonderful things. The start of a new year. A beautiful, fresh fallen snow. Fun on the slopes.

But the winter also brings something of great concern: a spike in traumatic brain injuries.

Despite the drop in temperature, many still enjoy the outdoors during winter by participating in sports like skiing, snowboarding, ice skating, sledding and ice hockey. But winter sports pose a legitimate danger to your brain if you do not take proper care to protect yourself.

To fully enjoy these winter activities, it is important to understand and respect the risks that winter sports pose, including concussions. Know these winter sports safety tips to enjoy all winter has to offer.

Wear a Helmet

Protecting your brain starts with wearing a helmet. Be sure to choose a helmet that fits properly, and is designed for the sport you’ll be participating in. Regularly check your helmet for damage, including dings and scratches that may limit its effectiveness.

Know Your Surroundings and Limitations

When planning a trip to the slopes, look at the weather forecast. Try to plan for optimal conditions to reduce the risk of injury. Know how the trail is laid out, and where the boundaries are. Stay near the center to avoid obstacles, and try to avoid crowded areas. Headphones are a big no-no, as they won’t allow you to hear what’s happening around you. Don’t opt for an advanced trail or equipment if you’re a beginner. Before getting started, know where medical help is available. The same goes for skating rinks and sledding trails.

Know the Signs of Concussion

The signs and symptoms of a concussion may appear immediately after a hard fall, or not for days or even weeks afterward. And it doesn’t always require a direct hit to the head for a concussion to occur. Symptoms of a possible concussion include:

  • Headache
  • Weakness
  • Numbness
  • Dizziness
  • Balance/coordination issues
  • Confusion
  • Slurred speech
  • Ringing in the ears
  • Nausea and/or vomiting

If you or a loved one are experiencing any of these symptoms, seek medical attention within 24 hours. Sometimes, a person loses consciousness after suffering a concussion. In that event, call 911 or seek emergency medical help, immediately.


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7 Myths About Long-Term Acute Care Hospitals

Long-term acute care hospitals (LTACHs) are designed to help patients advance their recovery when traditional hospitals may not have the time or resources to help them. But, when it comes to long-term acute care, there are many misconceptions. From the services provided to admissions requirements and insurance coverage, we’ve taken some of the most common myths about long-term acute care hospitals and clarified them below.

Myth #1: Long-term acute care hospitals are nursing homes

Fact: Long-term acute care hospitals provide a much higher level of care than nursing homes and skilled nursing facilities (SNFs). An LTACH is similar to an intensive care unit (ICU). Because LTACHs are hospitals, they have 24-hour physician coverage along with many specialized services on-site, including:

  • Full nursing staff
  • Physical, occupational, speech and respiratory therapy
  • Dietary
  • Pharmacy
  • Laboratory
  • Radiology

Long-term acute care hospitals are uniquely designed to provide care for patients with complex medical needs.

Myth #2: Patients admitted to an LTACH are required to stay 25 days

Fact: The amount of time a patient stays in an LTACH is dependent upon their illness or injury, complications and goals. Every patient is different because every human is different. In an LTACH, physicians collaborate with patients and their loved ones to create an individualized plan of care to achieve those unique goals.

Myth #3: LTACHs are where people go to get hospice care

Fact: Most patients do not receive hospice care while staying in an LTACH. Long-term acute care hospitals focus on getting patients back to their life in their community. Patients and their families choose LTACHs because they offer aggressive treatment for the disease or injury.

Myth #4: Patients don’t get physical therapy or occupational therapy at an LTACH

Fact: While most patients in an LTACH are quite ill, early mobility is essential to a patient’s long-term outcome. LTACHs have therapists on staff who provide services specific to this level of care. Patients in an LTACH may begin receiving physical and/or occupational therapy even while on a ventilator. The physical and occupational therapists will create a therapy regimen appropriate for each patient.

Myth #5: LTACHs can’t accept ICU-level patients or patients on an IV drip

Fact: Much like an intensive care unit, LTACHs focus on critical care of patients. Nurses and staff are specially trained to care for patients who are critically ill or have a complicated medical history.

Myth #6: A patient must spend at least three nights in an ICU before admitting to an LTACH

Fact: There are no stay requirements for LTACH patients. Patients can admit from a doctor’s office or even their home, if needed.

Myth #7: Insurance won’t pay for an LTACH

Fact: Most LTACHs have contracts with numerous insurance companies. LTACHs work directly with insurance providers to ensure coverage prior to a patient’s admission.

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