What is Epidural Stimulation?

October 10th, 2018

Traumatic brain or spine injuries often have prolonged and lasting impacts. As recently featured in Men’s Health, Jeff Marquis suffered a tragic injury after a mountain biking accident in 2011. Doctors said he would never walk again and his life would be forever changed.

Then Marquis was one of four patients with a form of paralysis to experience and be treated with epidural stimulation. Through the epidural stimulation treatment and extensive physical therapy, Marquis is now able to independently stand and take steps as well as walk with the assistance of braces and walkers.

Spinal cord injuries (SCI) are uniquely individual making diagnosis and management therapy challenging. Back in 2011, when epidural stimulation therapy was first announced and successfully assisted a patient in their recovery, the potential seemed endless. SCI research has made significantly strides, but there are four main ways epidural stimulation assists patients.

Before diving into these four benefits, let’s define and understand what epidural stimulation is. Epidural stimulation therapy is a form of treatment for patients with a form of paralysis, in which the patient has an electrical chip implanted in their spinal cord that receives various frequencies and intensities of an electrical current. These levels of electrical currency coupled with intensive physical training has allowed patients with paralysis to regain the ability to voluntary move their limbs.

While the return of sensory neurons is still not possible, epidural stimulation therapy has shown to give paralysis patients better:

Motor Return: Patients proved the ability to voluntarily extend knees, increase hip flexion movement and flex leg muscles after the chip had been deactivate in partnership with intensive physical therapy.

Better control and return of bladder and bowel function: Participants of spinal epidural therapy were able to control their involuntary bladder and bowel functions with the stimulation therapy and physical training. 

Return of Sexual Appetite: Patients also reported they experienced an increase or return of sexual appetite after multiple weeks of training of the combination therapy.

An Improved Mental State: All the patients shared an improved mental state. The combination of endorphins from the physical activity and an renewed sense of hope from the potential to moving independently or making progress are a few of the notable reasons for the healthier mental state seen in patients.

Epidural stimulation therapy is just one of the few developing technologies for SCI. Kuether Brain and Spine stays current on these developing technologies and continues to follow the amazing strides of progress in medical research in our field of work.

 

 

Entry Filed under: Patient Story,Spine,Surgery Comments

Kuether Brain & Spine Stresses the Importance of Helmets for e-Scooters

September 26th, 2018

In the last week, California made headlines for legalizing the practice of riding e-scooters and other shared modes of transportation without a helmet. E-scooters from companies like Lime, Bird and Skip can reach speeds up to 35 mph and are allowed to ride on the street with traffic. This piece of legislation is especially controversial for various cities’ public safety and transportation practices.

Unfortunately, as this new legislation was being passed, the United States’ first e-scooter fatality happened in Dallas, TX. Jacoby Stoneking of Dallas passed away from blunt force trauma to his head. The cause of the accident is still under investigation. Additionally shortly after Stoneking’s tragic passing, another death was recorded in Washington DC. Carlos Sanchez Martin, a 20-year-old male, collided with a vehicle and passed away from injury shortly after the accident. Both of these tragedies occurred while the victims were riding Lime e-scooters.

Kuether Brain and Spines send their thoughts and best wishes to the families and friends of the two victims who have passed in the past few weeks due to these tragic accidents. Kuether Brain and Spine is invested in following this news because transportation-related accidents are one of the most common causes for traumatic brain injuries and/or head injuries.

A few weeks ago, we shared a blog post regarding the importance of wearing protective headgear while enjoying the increasingly popular new transportation options of shared bikes and e-scooters. We wanted to share the news above to reiterate the critical need for riders to wear well-fitting, protective helmets. As well, Kuether Brain and Spine believes the companies behind the ride share scooters should also promote and find a way to supply protective headgear with its products.

We also hope our home state of Oregon advocates for the use of helmets for e-scooter or bike riders as again, these modes of transportation can reach up to 35 mph and are on the roads with and against oncoming traffic. The more prepared and informed riders are the better chances they’ll have in potential accidents.

Entry Filed under: Brain,General Comments

Celebrities with Previous Spinal or Brain Injuries: Tracy Morgan

September 12th, 2018

The scripted comedy, 30 Rock, cemented itself as an American mainstay alongside other comedies like Modern Family and The Office. The 30 Rock actor/actress roster included comedians Tina Fey, Alec Baldwin, and Tracy Morgan. Tracy Morgan is an American actor known for his realistic sense of humor and his roles on Saturday Night Live and in movies like Cop Out and The Boxtrolls.

In June 2014, Tracy Morgan’s success, hard work and life nearly ended due to a horrific car crash. Morgan was a passenger in the terrible car crash, which caused Morgan severe traumatic brain injuries leaving him in a coma for eight days and his future as an actor as well as fully functioning person pending.

Fortunately, Morgan awoke from his coma and then began his journey of recovery with months of physical rehabilitation and cognitive therapy. In addition to Morgan’s long enduring physical and cognitive recovery, Morgan previously survived a kidney transplant and lives everyday as a diabetic. In the recovery period of Morgan’s traumatic brain injury, it took well over a year to only live with minor symptoms. Tracy Morgan cited he walked with cane due to both physical and cognitive injuries and suffered headaches, nosebleeds, and memory shortages.

Automobile accidents are one of the most common reasons for traumatic brain injuries that require hospitalization. Tracy Morgan is extremely fortunate he was able to make a full recovery as some people will face prolonged symptoms for the rest of their lives. The rehabilitation process is also particularly critical to traumatic brain injury recovery as the brain needs to repair and strengthen its neuroplasticity. Speed of cognition and memory are two commonly impacted brain functions; however, every case is unique. Another highly important element to recovery is sleep as sleep helps promote healing.

Traumatic brain injuries are particularly interesting as each case is highly individualistic to the patient as well traumatic brain injuries are extremely dangerous and scary. While isolated instances such as car accidents are often unpreventable, it is important to remember to take safety recommendations and precautions like wearing seat belts and following traffic laws seriously as they help to keep passengers safe.

Kuether Brain and Spine is one of Portland, Oregon’s premier neurosurgery practices and it specializes in helping those who have suffered from emergency traumatic brain injuries. Dr. Todd Kuether and Legacy Emanuel Hospital will always be ready to assist those in need, especially those who are recovering from the intense experience of traumatic brain injury.

Entry Filed under: Brain,Patient Story,Spine Comments

E-Scooters are everywhere and helmets should be too

August 29th, 2018

You may have noticed the recent flood of motorized scooters and shareable Nike bikes filling the streets of Portland. While these new modes of transportation can encourage a healthy lifestyle, promote environmentally friendly commuting and hopefully, lighten Portland’s growing traffic problem, they can also present a serious safety concern: head protection.

Cycling and biking with proper head protection, such as a well-fitted and tightly strapped helmet has long be advocated.  However, the new surge of motorized e-scooters and shareable bike services are not receiving the same push of important messaging — that the need for protective helmets while using these options is so important.

Kuether Brain and Spine finds the new options like the Nike bikes and e-scooters from companies like Lime and Bird as a fun way to explore our favorite city. As a neurosurgery clinic, we’ve seen the negative impacts of traumatic head injuries and recognize the concerning potential of riding bikes and e-scooters in traffic without available head protection. Therefore, it is important to remember to bring your own protective headgear when using these services, especially when riding in traffic.

Over 45 people died in traffic-related pedestrian or cycling accidents in Portland, Oregon in 2017. While Portland is working to make our streets as safe of possible, accidents can happen to anyone, at anytime. Head protection is the only way to better protect the most important organ in the body: the brain. And while helmets don’t guarantee harm-free accidents, they do improve a bicyclist or e-scooter riders’ safety and chances of coming out unscathed in the unfortunate event of an accident.

Kuether Brain and Spine wants to advocate for safer practices with these fun, convenient and healthy modes of transportation by reminding all riders to wear properly fitting helmets. Traumatic brain injuries are serious and often life-threatening. To protect your head, wear a helmet and then go out and have fun exploring our beautiful city on two wheels.

Entry Filed under: Uncategorized Comments

Our Top Three Outdoor Parks to Exercise in the Portland-Metro Area

August 15th, 2018

 

 

Photo Courtesy of Umit Aslan, Unsplash

Kuether Brain and Spine is located in the beautiful city of Portland, Oregon. We feel so lucky to have such a diverse natural environment as our backyard. With the summer winding down, it is best to take advantage of Oregon’s best weather and get outside to be active.

The staff at Kuether Brain & Spine spends most of their free time getting outside and staying active. Running, jogging, hiking and walking are options to stay healthy and explore our favorite city. Here’s our top three places in or around our hometown:

Forest Park

Forest Park is one of the largest urban forests in the entire country. There’s over 5,200 acres of protected forest to enjoy and escape the busy atomsphere of city life. With over 80 miles of trails, Forest Park allows visitors to explore a different side of Portland and get lost in a forest paradise without ever leaving the city.

Mt. Tabor 

Located in Southeast Portland, Mt. Tabor is one of the city’s most beautiful parks. The park is built on top of a dormant volcanic hilltop. It offers three official hiking loops, which are great for any level of fitness and age. Each of the three hiking loops are easy to moderate and it is a great way to spend a few hours on a summer afternoon getting light exercise.

Tyron Creek

Tyron Creek is a state preserved nature area in between the city of Portland and the Lake Oswego suburb. There’s over 8 miles of available hiking trails, 3.5 miles of horse trails and a 3-mile bicycle path. Hiking, walking, running, biking or horseback riding are all options here so there’s no excuse not to get out and explore this stunning nature park.

Kuether Brain and Spine hopes you enjoy these parks as much as we do and hope you enjoy the rest of your summer!

Entry Filed under: General Comments

Three Mental Health Tips to Remember while Recovering from an Injury

August 1st, 2018

Photo Courtesy of True Katsande, Unsplash

Mental health has always been a critical aspect to living a healthy life; however, it was not until recent years that we realized how mental health can deeply impact physical well-being. The connection between mental and physical health is especially emphasized when a person faces an injury or a negative mental experience.

At Kuether Brain and Spine, there is often a period of recovery and/or physical therapy training for patients. While physical therapy is typically a mark of progress in the recovery process, it can be difficult to remain positive during a time of slow healing. It can be even more challenging to remain positive when a patient’s day-to-day exercise routine is interrupted due to recovery. Exercise is proven to increase positive mental health by reducing anxiety, depression, negative moods and improve cognitive function, according to the National Institute of Health. Below are three helpful mental health reminders for any person recovering from any kind of injury.

Resting and recovery is productive

It may be difficult to think of the resting phase or early stages of recovery as productive, especially if a patient is used to a highly active lifestyle; however, after injury, the body needs to heal. They only way it will be able to do so is by properly resting it and following the medical advice given by a medical professional. The body is busy repairing itself while it is resting so it is productive to give the body the downtime it needs rather then pushing through and further injurying or prolonging the healing process.

There are things you can’t control like the speed of your healing

There is no way to speed up the healing process, despite the best intention or desperate desires of the patient. Thus, it is better to accept the timeframe of the recovery and try not to stress or worry about the duration. It can be helpful to celebrate small wins such as succeeding in doing one more rep during a physical therapy session or attending a follow-up appointment.

Find the right way to cope for YOU

Some patients find writing in a journal a helpful mental coping mechanism while other patients prefer to confide in a trusted friend or even a support group. There’s no right way to better an individual’s mental health – it should be personal and unique. However, it is important to find the support and healthy coping habits that fits your lifestyle and personality.

Maintaining a positive outlook can be an extremely effective way to improve the recovery process as again, mental and physical well-being are closely linked. If a patient’s mental health begins to suffer due to their physical state, it will only negatively and potentially delay the healing process. Kuether Brain and Spine wants to be a resource for its patients during their experiences. If you would like to learn more about the Kuether Brain and Spine practice, please visit our website.

Entry Filed under: General,Patient Story,Spine Comments

Celebrities with Previous Spinal or Brain Injuries: Tiger Woods

July 18th, 2018

Photo Courtesy Ben Hershey, Unsplash

Arnold Palmer, Sam Snead, Phil Mickelson and Tiger Woods are some of the most prominent golf players to ever live. Tiger Woods, in particular, captivated the professional golfing world in the late 1990s and early 2000s by breaking nearly every record and winning nearly every tournament.

Tiger Woods started playing golf from an early age and rapidly progressed in his career. Woods entered the PGA in 1996 and within a year, at age 21, Woods won the Masters with a record breaking score of 270 and the highest margin of victory ever to become the youngest Masters champion. His success continued until 2009 before he faced personal scandal, which drove his professional career into a downward spiral. Outside the continuous personal scandals, Tiger Woods’ career has also been marred by injury.

As early as his college days at Stanford, Woods underwent more than one surgery for his knees. Woods also competed with major injuries at some of his most legendary tournament moments including playing with a torn ACL and stress fractures in his tibia; however, his back injuries have been his most prolonged and influential on the state of his career.

Tiger Woods has undergone a total of four major back surgeries. Woods’ first back surgery was in 2014 and then two more followed in 2015. Although, he underwent two discectomies and a pain alleviating surgery, Woods suffered from ongoing back spasms, debilitating pain and sciatica, which is “pain affecting the back, hip, and outer side of the leg, caused by compression of a spinal nerve root in the lower back, often owing to degeneration of an intervertebral disk.”

Finally, in April 2017, Tiger Woods underwent a spinal fusion surgery for his lower back. He had a spinal fusion at the L5-S1 vertebrae. Months prior to this surgery, Woods announced he may never play golf again, but less than year after receiving his spinal fusion surgery, Woods returned to the PGA tour. He even competed in the 2018 Masters tournament.

Spinal fusion back surgeries aim “to stop the motion at a painful vertebral segment, which then ideally decreases pain generated from the joint,” according to Spine Health. There are three common approaches to spinal fusion surgeries including:

  1. “Adding bone graft to the damaged or painful spine segment”
    • Tiger Woods’ spinal surgery adopted this approach of adding bone graft
  2. Inserting a biological response to grow between the two involved vertebra forming a bone fusion
  3. A boney fusion, which causes one fixed bone to replace a mobile joint — meaning it stops the motion at that joint segment”

Spinal fusion back surgeries are for candidates who suffer from prolonged back injuries, pain or severe traumatic back injury. It is typically a last resort after other alternatives such as physical therapy or naturopathic remedies fail to relieve pain.

Dr. Kuether at Kuether Brain and Spine performs spinal fusion surgeries for patients when it is the appropriate course of medical action. Dr. Todd Kuether is always happy to meet with new patients and he strives to find the least invasive option while still attempting to relieve and manage pain. If you have any questions about Kuether Brain and Spine’s surgical offerings or Dr. Kuether’s approach to health, please visit our website: https://kuetherbrainandspine.com/

Entry Filed under: Spine,Surgery Comments

Three Common Neck, Head and Back Injuries seen in Baseball

July 4th, 2018

Photo Courtesy of Christopher Campbell, Unsplash

The NCAA Division One College Baseball World Series just wrapped a few weeks ago with the Oregon State Beavers taking home the national championship. The MLB is in full swing of its very long season and even little leagues across the country are participating in summer baseball fun. However, baseball can be challenging on the body due to the repetition of motions and extended seasons. Kuether Brain and Spine wanted to analyze some of the injuries seen in the popular American sport.

An estimated 13.96 million Americans play baseball and like any sport there is the possibility of injury during training or competition. Three injuries sometimes seen in baseball players outside of the very common elbow and shoulder injuries include neck strains, concussions and back pain.

Neck Strains

Baseball players can suffer from neck strains from improper throwing technique, collision with other players during play or lack of necessary stretching. Another reason some players may experience a neck strain is due to imbalanced neck muscle strength; it is critical to strengthen both sides of the neck to protect it. Players can perform resistance exercises in all motions of the neck such as flexion, extension, rotation and lateral flexion, which can be done manually with the help of a coach or teammate or through a recommended and advised equipment workout routine. It is also important to note the difference between sprains and strains. A sprain is the stretching or tearing of ligaments (commonly seen with ankles) whereas a muscle strain is the stretching or tearing of muscle tendons. If a player strains their neck muscles, he/she must take the healing process seriously by resting and participating in recommended physical therapy to help prevent further or prolonged injury.

Concussions

Although baseball is categorized as a low contact sport, concussions are still relatively common. Players do take precautions by wearing helmets while batting, but concussions can still occur by being accidentally hit by the bat, player collision or being hit by the ball during play or practice. In order to best protect players, all participants should partake in concussion baseline testing to allow for proper identification if a concussion occurs. Protective headgear and helmets are also helpful in addition to education of proper bat safety and sliding techniques. Coaches and parent volunteers should also be educated in identifying possible concussion symptoms such as confusion, nausea, fatigue, mental fogginess, headache and loss of consciousness among others.

Back Pain

The extreme motions required in pitching, catching and throwing techniques coupled with baseball’s requirement of constant repetition of these motions can put strain on the back and spine. Poor mechanics and improper technique in any of these common actions can increase the likelihood of injury to the back and spine for baseball players. In some cases, for those who are susceptible, adolescent players can develop spondylolysis, which “is a defect in the connection between vertebrae that affects 3 to 7 percent of the population” correlated with the repetition of strenuous motions and/or overuse from playing.

These injuries are something to be aware of as children, teenagers and adults play baseball. Kuether Brain and Spine hopes the thousands of Americans who participate in baseball are able to stay safe during their seasons of play and in their careers. For those local players who experience an injury to their neck, head, back or spines, Kuether Brain and Spine can help. To find out more about Dr. Todd Kuether, please visit our website.

Entry Filed under: Brain,General,Spine,Surgery Comments

5 Things Patients Should Prepare Before Surgery

June 20th, 2018

Every patient story is different. For those whose journeys require surgery, there are many steps to consider and prepare prior to operation day. Kuether Brain and Spine compiled a few items in the list below. During the preparation prior to surgery, the Kuether Brain and Spine team will specifically discuss and educate its patients on all the necessary prep for their more specific medical needs. The list below includes commonly forgotten, but highly important action items.

  1. Prepare Transportation To & From Surgery Facility

A patient should arrange transportation with a family member or trusted friend to arrive and more importantly, depart the surgery facility. Patients are not allowed to call a cab or driving service post-operation; therefore, it is important to arrange transportation and aftercare with a trusted ally well in advance to ensure a safe beginning to post-operation recovery.

  1. Establish a Support System

It is also critical to establish a support system for the post-operation recovery process, especially for the first 48-hours. Again, a family member or trusted friend should stay, monitor and/or check-in with a recovering surgery patient to ensure there are no complications or accidents. Frequent check-ins in the following weeks are also strongly recommended to encourage both physical and mental well-being during recuperation.

  1. Surgery-Proof Your Living Situation

In the weeks before a patient’s scheduled surgery date, it can be helpful to “surgery-proof” the home. Some helpful recommendations include: placing a slip-proof chair in the shower, installing a toilet seat riser, and purchasing non-slip slip-on shoes and/or an “reach and grab” tool to make the little things slightly easier.

  1. Plan Activities

Mental health is equally as significant as physical health during a recovery journey. It can be helpful to have a few activities picked out to keep the brain engaged. Some recommendations include having a handful of movies chosen, curating a list of new books and scheduling both phone calls or in-person visits with family or friends.

  1. Have Food, Fluids and Prescriptions Ready

It seems obvious to have food, water and prescriptions prepared before going into operation; however, it can be easy to forget. Healthy, easy-to-digest food like sautéed vegetables, fresh fruit smoothies and other high-fiber meals should be prepped prior, plenty of drinkable water should be available and prescriptions should be picked up from the pharmacy all before the surgery date.

Again, these are just a few of the many important things to do prior to surgery. Your medical professionals, including the staff at Kuether Brain and Spine, can help educate you on all necessary arrangements and guidelines.

Entry Filed under: Brain,Patient Story,Spine,Surgery Comments

Celebrities with Previous Spinal or Brain Injuries: Sharon Stone

June 6th, 2018

Photo Courtesy of Flickr. Sharon Stone 2007

Sharon Stone is famous for her roles in movies like Basic Instinct (1992) and Casino (1995); however, in 2001, almost 17 years ago, Sharon Stone lost stability in everything: her career, her family and most importantly, her health. After checking into the emergency room for an extremely painful headache, Stone learned she was experiencing a cerebral hemorrhage in her brain. A cerebral hemorrhage, according to Healthline, is “when blood suddenly bursts into brain tissue causing damage to the brain.” Blunt trauma, high blood pressure or a brain aneurysm bursting can cause a cerebral hemorrhage. Any internal bleeding, especially in the brain, needs immediate medical attention.

Like Stone experienced, one of the symptoms of a cerebral hemorrhage is a severe and sudden headache. The other symptoms can include “sudden weakness, numbness or paralysis in an arm, leg or face on one side, trouble swallowing, vision loss, coordination loss/dizziness, trouble with speech, nausea, confusion and/or loss of consciousness.” Some of the factors that increase a person’s risk of a cerebral hemorrhage are “smoking, heart disease, high blood pressure, diabetes and generally, an unhealthy lifestyle.”

If a person experiences a cerebral hemorrhage, immediate emergency medical attention is required. The size of the area impacted and the duration of the bleeding typically determine the lasting implications. Sharon Stone reported both long and short-term memory loss, numbness in her legs and face, hearing loss as well as cognitive function loss with her speech and ability to read. It took her over 2 years to start to see improvements in these areas. Other complications can consist of “impaired language skills, emotional problems, vision loss, fatigue, coordination and movement loss, cognitive dysfunction, seizures and swelling of the brain.

Fortunately, most of us will not experience this extremely dangerous health condition like Sharon Stone and others. Although knowing the symptoms, risk factors and complications can only assist in being more aware of possibly fatal injury. Dr. Todd Kuether is equipped to handle any problem, which may cause cerebral hemorrhaging as well as many other cranial and brain disorders, diseases and injuries. If you are interested in reading more about Sharon Stone’s experience, additional interviews can be found from the Hollywood Reporter and USA Today.

Entry Filed under: Brain Comments

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