The Newsletter of Greater Brunswick Physical Therapy Fall 2007

FROM PAIN TO POTENTIAL:
THE ERIC NOLIN STORY

The year 2000 was a milestone for Eric Nolin. He was celebrating his fifth year working as a field engineer for a computer company. He got engaged. He purchased his first home and was living with his fiancée and her two children. The future looked bright for the lanky, soft-spoken red-head.

But on a rush-hour Friday, commuting home from an assignment in New Hampshire, his life took a U -turn for the worst. A traffic jam at a light, solar glare, and a stopped pickup truck in front of him converged disastrously as the vehicle behind him slammed full-speed into his stopped car. The severe whiplash and other injuries he sustained that day sent him spiraling into a life of pain, medications, medical interventions, and loss.

In the weeks and months that followed the accident, Eric’s muscles in his neck and left arm did not heal. He was in constant pain: unable to drive, work, sleep or even function. The prescription medications he was taking also affected his mental and emotional state. “I had difficulty remembering or comprehending simple phone calls and appointments,” he recalls.

With only Workers Compensation benefits to live on, Eric began having financial problems. He tried many times to return to work, but was unsuccessful due to his physical limitations. Two weeks into a new full-time job (the fourth that year), he injured his low back. His blood pressure shot up, he began taking more medications and walked with a limp. His entire left side was affected with muscle spasms. Unable to work, he was forced to sell his new home. His relationship ended and for a short while, he was living out of his truck with his dog Rocco.

“I lost everything: job, house, relationship, financial security. I hit rock bottom more than once,” Eric said, his blue eyes penetrating and intense. “It wasn’t a pleasant ride.”

Over the next several years his odyssey included multiple doctors’ appointments, tests, and specialists: surgeons, neurologists, orthopedic specialists, physical therapists and of course, lawyers and insurance agents. One of the most frustrating aspects of his situation was waiting months to see a specialist, hoping for an answer, only to be told: “There’s nothing we can do for you.”

He waited in vain for a definitive diagnosis. The list kept growing: Thoracic Outlet Syndrome, Chronic Myofascial Pain, nerve damage, a vascular or nerve impingement. He was also told more than once “There is nothing showing in your X-rays or MRI”, the implication being his pain was all in his head.

Faced with financial ruin and battling depression, Eric was forced to file for disability. This made a huge difference in his life. He was no longer homeless and was able to begin re-training for a new career. He felt he had a chance to put his life back together and began reaching out for help and healing.

At a Chronic Pain Support Group in 2006, Eric first heard about Greater Brunswick Physical Therapy. He recalls being told GBPT was “not your typical physical therapy clinic” and that he might find help for his chronic pain.

Once a patient at GBPT, he found the combination of gentle manual physical therapy and home exercises a winning combination. “For the first time in years I felt like I was gaining control again, the pain wasn’t winning all the time. The therapists used many different techniques, some of which were very unique, others I was able to learn and practice at home.”

One of those was Reiki. He began treating himself at home with Reiki which he found extremely helpful.“The idea of having other tools I could use to deal with the pain and muscle spasms besides medication was exciting. I had been researching alternative, complementary healing, but now I was very enthused. I wanted to learn more. I was feeling well enough after a few months (of physical therapy) to take an introductory course in meditation. I started practicing yoga and I began studying Reiki.”

Today Eric is a certified Reiki Master. He volunteers his services at People Plus in Brunswick and is enrolled in an Energy Medicine Certification Program at True North in Falmouth. His long term goal is to work at a hospital or clinic which offers alternative healing therapies like Reiki and Energy Medicine. He plans to name his business “Potential”, representing his journey out of pain back into the fullness of life.

“At times it seems like I am barely making any progress, but this past summer when I attended Donna Maria Bordeaux’s Light Body Healing Clinic (see related story on page 2) as a Reiki Practitioner, she reminded me that just last year I had attended the clinic as a patient,” he reflected.

“I still have some work to do, but the potential to keep improving is there thanks to the help I received at Greater Brunswick Physical Therapy.”

exciting new treatments for i.b.s.

There are many ways that physical therapists can aide those with irritable bowel syndrome: teaching appropriate exercises to reduce stress, patient education about the links between IBS, food choices, medication and emotions, as well as referrals to other medical experts.

Recent advances in Integrative Manual Therapy™ (IMT) offer additional treatment options for those suffering with IBS. Donna Maria Bordeaux, co-owner of GBPT, recently completed an IMT course which included manual treatment techniques to lessen the effects of IBS. The course was taught through the Connecticut School for IMT ™ in association with Dialogues for Contemporary Rehabilitation.

The goal of these IMT techniques is to help de-facilitate the autonomic nervous system to the gastrointestinal tract, thereby decreasing pain, visceral hypersensitivity and inflammation. With less chronic irritation to the area, patients may not only suffer fewer IBS symptoms, but also experience less back and hip pain, as these areas share innervations with the intestines. Many people also note improvement in bowel and bladder function. The hands-on treatments are gentle, non-invasive and can be performed with patients fully clothed.

According to Donna Maria, an imbalance in the digestive system can create many health problems, but of primary concern is the decreased absorption of nutrients that provide energy and vitality for the body. Equally problematic is the ineffective elimination of wastes that “back up” in the GI tract and contribute to muscle, joint and nerve conditions such as back and hip pain, lower extremity referred nerve pain and Fibromyalgia.

Another important aspect of IBS is it’s affect on serotonin. According to the internet encyclopedia Wikipedia.net, 90% of the body’s store of this important neurotransmitter is produced in the “gut”. Serotonin plays a key role in mood regulation, body temperature, sleep, perception and mental function. Low levels of serotonin are associated with IBS and can contribute to other diseases such as Fibromyalgia, Depression, Obsessive Compulsive Disorder or Bipolar Personality Disorder.

For more information or to schedule an appointment, please call GBPT Brunswick at 729-1164.

Do You Have Irritable Bowel Syndrome?

Digestive problems plague many people, in fact it is estimated that 50 to 60% of all Americans have some degree if Irritable Bowel Syndrome (IBS). The signs and symptoms of irritable bowel syndrome can vary widely from person to person and often resemble those of other diseases. Among the most common are:

• Abdominal pain or cramping
  
• A bloated feeling
  
• Gas (flatulence)
  
• Diarrhea or constipation — sometimes alternating bouts of constipation and diarrhea
  
• Mucus in the stool

Like many people, you may have only mild signs and symptoms of irritable bowel syndrome. Sometimes these problems can be disabling and may not respond well to medical treatment. Because symptoms of irritable bowel syndrome can be present with other diseases, it’s best to discuss these symptoms with your doctor.
For most people, IBS is a chronic condition, although there may be times when the signs and symptoms will range from severe to completely absent. No one knows exactly what causes irritable bowel syndrome. The walls of the intestines are lined with layers of muscle that contract and relax as they move food from your stomach through your intestinal tract. Normally, these muscles contract and relax in a coordinated rhythm. In some cases of IBS, the contractions may be stronger and last longer than normal. Food is forced through your intestines more quickly, causing gas, bloating and diarrhea. At other times, just the opposite may occur and food passes too slowly, and stools become hard and dry.

Some researchers believe IBS is caused by changes in the nerves that control sensation or muscle contractions in the bowel. People with IBS may have a heightened sensitivity to stretching of the bowel with gas leading to pain or bloating. Others believe the central nervous system may affect the colon. And because women are twice as likely to have IBS, researchers believe that hormonal changes also play a role. Also, many women find that signs and symptoms are worse during or around their menstrual periods.

Triggers bother some, not others

For reasons that still aren’t clear, those with IBS can react strongly to stimuli that don’t bother other people. Triggers for IBS can range from gas or pressure on your intestines to certain foods, medications or emotions. For example:

• Foods.
  Many people find that their signs and symptoms worsen when they eat certain foods. For instance, chocolate, milk and alcohol might cause constipation or diarrhea. Carbonated beverages and some fruits and vegetables may lead to more bloating and discomfort in some people with IBS. The role of food allergy or intolerance in irritable bowel syndrome has not been well studied to date.
  
  If you experience cramping and bloating mainly after eating dairy products, food with caffeine, or sugar-free gum or candies, the problem may not be irritable bowel syndrome. Instead, your body may not be able to tolerate the sugar (lactose) in dairy products, caffeine or the artificial sweetener sorbitol.
  
  
• Stress.
  Like most illness or injury, stress can lead to increased symptoms. Those with IBS may find their signs and symptoms are worse or more frequent during stressful events, such as a change in your daily routine, an increase in your work demands or during times of conflict in relationships. But while stress may aggravate symptoms, it doesn’t cause them.
  
  
• Other illnesses.
  Sometimes another illness, such as an acute
  episode of infectious diarrhea (gastroenteritis), can trigger IBS.

For more information on IBS try these resources:

Web Resources

• Irritable Bowel Syndrome Self Help and Support Group
  
• National Institute of Diabetes & Digestive & Kidney Diseases
  
• National Center for Complementary and Alternative Medicine: Acupuncture
  
• International Foundation for Functional Gastrointestinal Disorders: About IBS
  Dialogues in Contemporary Rehabilitation

aquatic therapy at lewiston ywca

We’re jumping into the pool at the Lewiston YWCA!

Since October, 2007, the Auburn office of Greater Brunswick Physical Therapy has been offering aquatic therapy for their Lewiston-Auburn patients. Patients consistently remark how pain-free exercising in water can be and report improved mobility after pool therapy.

Jen Dodge, PT and aquatic specialist, heads the new aquatic therapy program, in addition to her office hours at the Auburn clinic, 336 Center St. She has over 10 years of experience and is well versed in aquatic therapy as well as many hands-on treatment techniques.

For many patients the warm-water pool provides the perfect environment to restore function and relieve pain. The Lewiston YWCA pool is heated to 88° F and is handicapped accessible. The warm water allows the collagen and elastin fibers in the body to relax, making it easier and more comfortable for muscles to move and stretch. Water also provides buoyancy and hydrostatic pressure which aides in the return of blood from the feet and legs, reducing edema, as well as assisting the movement of limbs. It is also a great way to strengthen “core” (abdominal) muscles without straining the neck

A 2007 review in the Cochrane Collaboration found that aerobic and stretching exercises in warm water can produce pain relief and improve daily function for those with osteoarthritis of the hip and/or knee. The review analyzed six trials with 800 participants and found those who exercised in warm water for three months reaped the benefits of less pain and improved function. The review, “Aquatic Exercise for the Treatment of Knee and Hip Osteoarthritis”: Cochrane Database of Systematic Review 2007, Issue 4, can be found at www.cochrane.org.
In addition to being the treatment of choice for arthritis, aquatic therapy is also effective in improving a wide variety of patient problems. It is helpful for those with joint and musculoskeletal injuries, low back and neck pain, disc disease, Fibromyalgia and is an excellent rehabilitation choice for pre and post surgery, especially total hip and knee replacements.

Aquatic therapy as part of a physical therapy program is a covered benefit of most medical insurance providers. For more information on the new aquatic therapy program in Lewiston-Auburn call 784-6462.

THE NEW GUY
WITH THE SOUTHERN ACCENT

You may have seen Tom Laudino around the GBPT Brunswick or Bath clinics… his striking mop of silver hair and a laugh the size of Texas… well OK, maybe only the size of Georgia - that’s where he got his southern accent.

Tom is one of the new physical therapists at GBPT, arriving here this past spring with trigger-point manuals tucked under his arm and lots of jokes in his repertoire. He has a rich and varied resume, including tenures in nursing homes, hospitals, outpatient clinics, pediatrics and home care. His favorite style of treatment is trigger point release therapy, but his approach is eclectic. He is a compassionate listener, a great problem solver and a wonderful patient advocate. He has been getting rave reviews for the wonderful outcomes he has been helping patients achieve.

Tom didn’t start his career in physical therapy. He first served in the US Army as a communications officer for eight years and then in the National Guard. He has many fascinating stories about his travels, and especially enjoyed the time he spent in Germany. Following active duty, he earned a degree in Applied Physiology and worked in physical therapy clinics as an exercise specialist. That environment, combined with his passion for sports (especially baseball) inspired him to go back to school. Tom earned his physical therapy degree in 1993 from the Medical College of Georgia.

His many hobbies and interests include sports (hiking, running, bicycling, cross- country skiing), playing baseball for the Roy Hobbs League (as a pitcher), brewing beer at home, and reading Sherlock Holmes mysteries.
He and his partner Dorothy share a home in Brunswick.

WELCOME
TERRY PRATT

Greater Brunswick Physical Therapy is pleased to announce the arrival of its new clinical manager, Terry Pratt, PT, MS, CMPT.

Terry hails from Canada. He earned his MSPT at Andrews University in Michigan, graduating with Phi Kappa Phi honors. He has worked primarily in outpatient orthopedic settings, including Olympic Physical Therapy in Washington State. He has most recently been employed at Bay View Physical Therapy in Machias, ME.
In 2006, Terry earned his Certification in Manual Therapy through the North American Institute of Orthopaedic Manual Therapy (NAIOMT.com). This certification is earned after successful completion of courses in differential diagnosis, biomechanical assessment and manual therapy techniques of the cervical and thoracic spine, shoulder girdle, elbow, wrist and hand joints, and manual therapy techniques of the lumbar spine, the lower thoracic spine, and hip, knee, foot
and ankle joints. There are also two written, oral and practical exam levels which must be passed to earn the CMPT title.

Some of Terry’s other professional contributions include assisting in the development of instructional materials and web-based support for the Spinal, Upper and Lower Extremity courses for The McConnell Institute. He also helped format the reference research on Manipulative Thrust Techniques, a book by Erl Pettman. He developed an online Kinesiology course for the University of Maine, and helped develop a specialty course entitled “The Missing Link” with Ken Cole and Mark Looper for NAIOMT.

Throughout his career he has enjoyed working with injured athletes, has assisted in the development of an injury prevention program for gymnasts and has done injury screening for a variety of sports.

Terry and his wife, Allison (also a physical therapist), have two young children: Joshua, age 4, and Katelyn, 14 months. The Pratt family is excited to move to Midcoast Maine and we are thrilled that Terry is joining our team at GBPT.

Celebrating
20 Years of Healing
in 2008!