Three months ago, the world of 23-year-old Wahab Davis came crashing down after a motoring accident. He suffered serious spinal injuries that caused quadriplegia (paralysis of all four limbs). The young man from Gujranwala in Pakistan was airlifted to the trauma care centre at Rashid Hospital and admitted to the special ward of the Physical Medicine and Rehabilitation (PM&R) department. Whilst Davis is undoubtedly traumatised after the horrific experience, he refuses to yield to depression – every day spells out new hope for him. A team of dedicated physiotherapists and occupational therapists work with him every day in intensive two hour sessions of bed exercises like passive cycling and hand gripping movements to improve his condition. “I am a quadriplegic today, but I remain positive that I will walk again someday because everyday I can feel some strength returning to my hands and feet; I can sense a flicker here and there,” says Davis, who takes each day as it comes.
In another section of the ward, Dmitrov Mohammad from Bulgaria is learning to walk again. On a business trip to Dubai the 43-year-old suffered a brain haemorrhage that left him paralysed. He had to undergo brain surgery, and for six months suffered tremendously as a result. However, the integrated approach of the PM&R department has attended to a variety of his physical, neurological and psychological needs. Every day Dmitrov undergoes up to four hours of intensive physiotherapy in order to teach him how to walk again. He has since re-learnt his old skills and has full use of his hands again. He is slowly but surely working through this phase of his life. Overwhelmed by the kindness and generosity of the staff, he says: “I have been give a new lease on life here.”
Twenty-two-year-old Verena Furtado, a student in Scotland who spent her childhood in the UAE, was referred to the PM&R department for physiotherapy. After having a road accident in Scotland she suffered a double fracture in her ankle and tibia. An orthopaedic surgeon in London set her bones under anaesthesia. She arrived at Rashid Hospital’s PR&R department hobbling on two crutches. “In the UK, I was put on a long National Health Service waiting list and wouldn’t have been able to start my rehabilitation for a long time. Here, after a week of therapy, I could discard one crutch. In the second week I discarded the other. After about four weeks, I was able to walk again and today, I can say I have gained 90 per cent of the movement of my foot. My pain is gone thanks to the guidance of the physiotherapists here,” she says.
Residents of the UAE can feel secure in the knowledge that Rashid Hospital has the largest trauma care centre in town. It has established a multi-disciplinary and integrated system of physical medicine and rehabilitation.
Prior to this, a patient who sustained injuries in an accident and faced trauma would have to undergo surgery. Once he/she recuperated from that, he/she would be discharged and then be required to come every alternate day for physical therapy as an outpatient. Alternatively, if the patient required speech therapy or psychological rehabilitation for post-traumatic disorder, he/she would have to do it in a piecemeal fashion. If he /she lost an arm or leg and required an artificial limb or cosmetic correction, the patient would be referred to yet another set of doctors. All these referrals often meant that the patient had to struggle to get to so many doctors to address the different aspects of treatment. Thankfully, this is no longer the case.
The hospital has integrated all the respective units under one umbrella in the PM&R department says the head of the PM&R department, Dr Suad Trebinjac: “This department was established 30 years ago and was like any other physiotherapy department back then. We have since adopted a holistic and integrated approach. We have been working on developing this department little by little over the past ten years. Today, it is one of the best the country has to offer in this field. Our aim is to deliver a complete, multidisciplinary and individual-specific approach. We want to help disabled individuals achieve the highest level of functionality, independence and quality of life. With a staff of 67, the new department endeavours to place all the services required – both medical and paramedical – under one roof.”
When a patient suffers trauma through a sudden burn or automobile accident and undergoes neurosurgery, he/she needs to be attended to by surgeons, but he/she also need physical rehabilitation, speech therapy and possibly a host of other physiological and psychological support programmes. A patient who may have lost a limb or disfigured their face not only needs an artificial limb or cosmetic work, but may also need to go through psychological rehabilitation.
A patient does not have to undergo chronic trauma to need rehabilitation. Someone with a frozen shoulder or lower back pain for example may be in need of some form of rehabilitation.
Dr Trebinjac continues: “Sometimes, we have patients with chronic conditions such as spondylosis, musculoskeletal disorders, osteoarthritis and arthritis who will require regular physiotherapy. The same applies for patients with neurological issues such as multiple sclerosis or stroke. Then there are those trauma cases that result in brain damage and spinal cord injuries. All of these patients require rehabilitation, some long term and some short term.
The goal of treatment is to bring about functional independence for patients. Doctors work to alleviate pain so that they may walk and talk again, regain their balance and be able to manage their lives better.
“Earlier, many patients did not have the opportunity to go to one place where they could seek rehabilitative treatment to enable them to resume their normal lives.
Considering the demands of the community and the lack of existing multidisciplinary rehabilitation centres offering an umbrella of services, we decided to establish one here,” explains Dr Trebinjac.
The multidisciplinary approach consolidates a variety of services. The department has included a physiotherapy unit, which includes facilities for electrotherapy, a hydrotherapy pool and specialised gymnasiums (separate facilities to cater for both genders). Then there’s the occupational therapy unit as well as the orthotic/prosthetic section, which manufactures and makes adjustments to artificial limbs. The anaplastology laboratory creates cosmetic replacements for eyes, face, ears and so on.
The department also employs various specialists such as speech therapists, respiratory therapists and psychologists. Patients can expect any problems they have relating to their condition dealt with under one roof.
Among the unique treatments offered at the PM&R department are prolotherapy and lymphatic drainage. Lymphatic drainage is an important treatment for cancer patients who experience lymphatic swelling after radiology and chemotherapy. The treatment drains excess fluid and brings limbs back to a normal state.
The section also has a unique hydrotherapy unit. Here, a qualified physiotherapist assists geriatric and stroke patients to exercise in warm water. Senior physiotherapist Zafar Nazim talks of the benefits: “There are three primary objectives to conducting physical therapy in warm water. The buoyancy allows the body to float and strengthens weakened muscles. This allows greater movement of a specific limb or joint. The warm water relaxes muscles and eases pain. Besides this, the resistance to movement in water is useful for exercise.”
It is of little surprise then that Rashid Hospital’s PM&R department has received government accolades. It was the recipient of the Outstanding Clinical Department Award and the Sheikh Hamdan Award for Excellence in 2008. This year, one of the anaplastology laboratory technicians, Ashwaq Hamood, received the Shaikh Mohammad Award for Excellence.
The department continues to develop and was commended by the International Joint Commission for International Accreditation (JCIA).
For queries contact Dr Suad Trebinjac on firstname.lastname@example.org or Zafar Nazim email@example.com