Dr. Kevin Most: Physical Medicine and Rehabilitation

Dr. Kevin Most

If I asked you if you have ever heard of a doctor who has a specialty of PM and R, most would probably say “No” and not have a clue what I was talking about. Now ask that same question to a patient who has had a stroke, a brain injury or the mother of a child with Down Syndrome, and you will get a totally different answer.

PM and R, stands for Physical Medicine and Rehabilitation. This specialty is the group of doctors that maximizes an individual’s ability to function at the highest level following a devastating injury, illness or diagnosis. There are some specialties that have unsung heroes and this is one of them.

Imagine a loved one after suffering from a stroke, they used to be right handed and now the ability to function with that hand is hampered. Their life has changed overnight, now fast forward a few weeks and see the change that has occurred, it may be that some of the strength and coordination has been resolved thru physical therapy, it may be that they have been taught to now be left handed, it may be that there is technology to help them return to a close to normal life, all of this is orchestrated  by the PMR physician.

The work they do really impacts the lives of individuals and their family. They also make a huge often overlooked impact on the economics of healthcare. Their work often allows individuals to get back to work, or decrease the need for any additional help in the home setting, they are able to get people back to their home instead of a nursing home.

Adults are not the only ones who need the services of PM and R physicians, there is a large need for children as well. The pediatric needs are a little different. Pediatric PM and R physicians will work with children with many conditions including Autism, Downs Syndrome, and Cerebral Palsy, to name a few. The pediatric needs are growing as the advances in lifesaving medicine has advanced. The Pediatric PM and R team work to improve the quality of life for these children and their families. These experts complement the pediatrician or family doctor, they care for some of the needs that the primary care doctor does not feel comfortable with

The field of PM and R has advanced over the past 20 years and continues to advance. The technology is amazing and the outcomes for both pediatric as well as adult patients is dramatically different than it was a short time ago. The ability to bring normalcy back to someone’s life is very rewarding.

West Nile-  well we are officially in summer as the first mosquitos found with West Nile were identified in DuPage County last week. This is really no surprise as the amount of rain and standing water this spring has been record setting. Now we have not a human case but we will soon. Last year we had 176 cases of West Nile in the state, this a vastly unreported and undiagnosed number. Remember 80% of individuals with West Nile will have minimal symptoms and not seek medical advice or care. Many of those that do seek care are evaluated and no testing is done as the symptoms in most cases are very generic and non threatening. Symptoms for most people will be muscle aches, nausea, headaches and fever. These are often treated with simple OTC medicines as the infection runs it course.

The down side is that for some individuals the infection is much more serious. Patients who are immunocompromised or older have a higher risk that the infection can get into the brain and cause meningitis or encephalitis. Last 17 of those diagnosed died from West Nile in Illinois. The virus was identified in 74 of the 102 counties in Illinois. The treatment for these individuals is difficult as we do not have any medication to treat West Nile and life saving measures in some cases may not work.

Many of you may ask, “Why don’t we have a vaccine for West Nile?”  The answer is the business side of it does not make sense, with 80% of individuals having little to no symptoms and are back to normal after a few days, the need for a vaccine is not thought to be needed. However there is a vaccine being worked on by the National Institute for health, and Has been tested on humans for the past few years. Once fully tested for how well it works the search for a company to make it may be difficult. So even though it is the leading cause of mosquito borne disease in the US, the practicality of getting individuals vaccinated en masse may not occur.

With no vaccine and no treatment, what can you do to prevent the infection. First you can remove any standing water in your yard that you can control. Look for any objects in the yard that have water collected in them and remove it. Standing water is the breeding ground for mosquitos. Second if you are outside try to stay away from the mosquito heavy times of dawn and dusk. If you must be out wear appropriate clothing including long sleeve clothes and pants, any barrier to protect the skin. Finally consider wearing a Deet based repellant. The concentration for Deet should be between 10-30%. Deet has been tested and is approved for use in children.

With the wet spring we expect to see many more cases of West Nile, although it is not life threatening in most cases it is best to be prepared and try to prevent any illness

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