Winter 2018 Edition

Studies have shown that 35% to 40% of patients diagnosed as being in a vegetative state are in fact conscious when evaluated by formal clinical examinations. More recent evidence suggests that there may be an additional 15% whose consciousness cannot be detected even by the best clinical examination. Led by medical director Sunil Kothari, MD, the Disorders of Consciousness (DoC) team at TIRR Memorial Hermann is incorporating ancillary technologies to detect signs of covert consciousness as a supplement to the clinical examination.

Two years ago, the department of Physical Medicine and Rehabilitation at UTHealth was No. 29 in the country in National Institutes of Health funding for research. Today, we’re No. 11 among all departments of PM&R in the U.S. I give credit for this giant leap forward to Carl Josehart.

For patients who face amputations, the road to recovery is a long one, filled with physical, emotional and social challenges. For those like Yvonne Thiem-Hester, who undergo multiple-limb amputations, the impact of limb loss is magnified. Thiem-Hester is among the large population of multiple-limb amputees to benefit from the close collaboration of Danielle Melton, MD, director of the Limb-loss and Orthotics and Prosthetics Program at TIRR Memorial Hermann, and P. Jacob Joseph, MD, director of medical affairs and services at the rehabilitation hospital.

Carl Josehart has retired as chief executive officer of TIRR Memorial Hermann, a position he held for 11 years with a long list of accomplishments. Stepping into the role is Jerry Ashworth, FACHE, who assumed the position of interim CEO on Nov. 1, 2017.

Richard Huang, MD, participated in a one-year administrative fellowship in brain injury rehabilitation at TIRR Memorial Hermann. The fellowship is highly competitive among physicians; the rehabilitation hospital is a Traumatic Brain Injury Model System sponsored by the National Institute on Disability, Independent Living and Rehabilitation Research and serves as the training ground for residents from two prominent medical schools. Today, Dr. Huang is medical director of TIRR Memorial Hermann-Greater Heights and considers himself fortunate to have had the opportunity to gain insight into the challenges facing health care administrators.

We had planned teams of residents to sleep in the hospital. Team A consisted of three residents, Dr. Abana Azariah, Dr. Patrick Mollett and Dr. Kevin Cao, who stayed in the hospital over 50 hours when the storm was at its worst. They divided work and responsibilities. They rested in shifts. They checked on patients frequently, and two of them slept on couches. While the water level rose outside the hospital, they worked, they comforted, they prevented emergent transfers and they made my job easier.

With a $300,000, three-year grant from the National Institutes of Health’s National Library of Medicine (NLM), Margaret A. Nosek, PhD, is developing a website that will house comprehensive information for women with mobility disabilities across the entire spectrum of participation limitations.

Physiatrist Brian Brendel Jr., MD, is in his fifth year as medical director of the 14-bed inpatient rehabilitation unit at Memorial Hermann Southeast Hospital. He received his undergraduate degree cum laude at Texas A&M University in College Station and completed medical school at The University of Texas Medical Branch at Galveston. He completed residency training in physical medicine and rehabilitation at the University of Washington in Seattle, where he was chief resident.

At the TIRR Memorial Hermann/UTHealth Spinal Cord Injury and Disability Research Center, Argyrios Stampas, MD, and his team are investigating the potential for home use of transcutaneous tibial nerve stimulation (TTNS) in patients with spinal cord injury. The research is funded by a TIRR Memorial Hermann Rehabilitation Innovations Award.

The best way to reduce CAUTIs in non-paralyzed patients is by removing the catheter. Hospitals and other care facilities around the country have lowered their CAUTI rates by paying closer attention to whether patients actually need a Foley catheter. If a patient is in a nursing home and the catheter stays in only because staff members are too busy to help the patient to the bathroom, that’s bad. But in the case of spinal cord injury patients, the bladder works differently.

One of the primary principles of caring for people with neurobehavioral issues is maintaining a calm and controlled environment. TIRR Memorial Hermann’s new Neurobehavioral Program houses these patients in a dedicated area of an established brain injury unit, where they are cared for by a highly trained group of clinicians.

A research and clinical leader in the field of physical medicine and rehabilitation, Gerard E. Francisco, MD, has been elected to the prestigious National Academy of Medicine (NAM). Dr. Francisco, chief medical officer at TIRR Memorial Hermann and professor and chair of the department of Physical Medicine and Rehabilitation at McGovern Medical School at UTHealth, is one of 80 professionals elected to the academy for outstanding professional achievement and one of only 17 PM&R specialists in the world elected to the 2,127-member academy since its inception in 1970. Of that small number of physiatrists, 13 are from the United States.

At TIRR Memorial Hermann, we change lives by rewriting stories. Our therapists, nurses, affiliated physicians and other health care professionals work daily to improve outcomes, offer hope and maximize independence for people whose lives have been affected by disabling illness and injury.