Evals Should Look Beyond Primary Complaint

Certain that they needed another five or six years to complete construction of the naval base they were building on the Indian Ocean atoll of Diego Garcia, the US Navy Seabees sent out a call for help to construction workers across the US in 1976.

Bob Villari was among those who answered.
“It was a special enlistment, kind of like the one they had in 1942 during World War II,” Bob remembers. “My whole family had been in construction for years, so I went ahead and joined up. I wound up spending the next 23 years with the Seabees.”
A good part of that time was spent on that rain-soaked, British-owned atoll, where the US Navy Construction Battalions, or Seabees, spent 10 years building what is now known as US Navy Support Facility Diego Garcia.
“I also spent a lot of time in Spain and all throughout the Caribbean while I was with the Seabees,” Bob notes. “When I finally got out of the Navy, I went right back into construction. I became what they call a timber man, doing subway jobs.
“Our job was to shore up the walls so nothing would come down or cave in on people. When you’re doing that kind of work in New York like I did, they’re still running buses and trucks across the roads above you while you’re working, so it wasn’t easy.”
Now 78, Bob often feels as if the world has caved in on him. He’s felt that way for a decade, one in which he’s spent most of his time trying to alleviate himself of debilitating knee and back pain, stemming largely from a knee injury and a condition called drop foot.
Bob sustained the knee injury while in the Navy, and despite a complete joint replacement in the wake of failed initial surgery, he still cannot completely bend his knee.
Drop foot (or foot drop) is a muscular, neurological or anatomical issue that makes it difficult to lift the front part of the foot or keep it in its normal position. As such, sufferers drag their foot behind them while walking.
The knee problems, drop foot and years of construction work have combined to ravage Bob’s back, which he also injured while in the Navy. All told, these issues have left Bob “100 percent disabled.”
“I need constant care,” he admits. “I’ve got the drop foot in my left leg, and the right knee is the one that doesn’t bend all the way. So, I need a cane to walk, and no matter what, my back is always in constant pain.
“The other problem is, the VA (Department of Veterans Affairs) only allows me to get X number of treatments for these problems. So, I get treated for a while, and just as I start feeling better, the VA cuts off the treatments and I wind up back at square one.”

Assessing the Whole Patient

When he does receive treatment, Bob receives it at Regional Rehab, where the physical therapists take pride in treating veterans and take the concept of comprehensive care to a new level by assessing each patient’s entire well-being.
These assessments look beyond the patient’s primary complaint and begin with thorough evaluations by Charles Donley, PT, and Paul A. Ernandes, PT, PhD.
“Once we’ve each completed our individual assessments, we share our findings with each other,” explains Charles, founder of Regional Rehab. “One question we always ask each other is, Do you see anything else here besides the primary complaint that requires our attention?
“What we’re doing is putting our 70-plus years of experience together to ensure that we’re doing everything we can to help each patient in every way possible. So those comprehensive evaluations and collaborations are one of the biggest keys to our success.”
Charles and Paul collaborated on their treatment for Bob, who has benefitted greatly from therapy using two of the practice’s signature tools, the Class IV deep tissue therapeutic laser and the HIVAMAT^® 200 deep oscillation device.
The laser uses wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal damaged cells. It releases nitric oxide, which removes congestion and swelling, promotes healing, reduces discomfort and increases blood circulation.
The HIVAMAT creates gentle impulses that relax muscles and penetrate all tissue layers to remove inflammatory byproducts in cells that cause pain. Bob also receives manual therapy and electrical stimulation treatments at Regional Rehab.
“We used a form of electrical muscle and nerve stimulation to help Bob with his drop foot,” elaborates Paul, the rehab director. “The form of energy we use stimulates the muscles and nerves to contract, which improves muscle function.”

“Best Care I’ve Ever Had”

“When I go to Regional Rehab, I get the best care I’ve ever had, and I always come away feeling really good,” Bob enthuses. “They even found and took care of some problems with my neck.
“The big thing is the back, though, and they’ve done great work with me there. They can get me to the point where I can function and do some things, and the pain isn’t so bad. It’s at least tolerable.”
The therapists also succeeded in restoring movement to the toes on Bob’s left foot, something no physician has been able to do. The staff at Regional Rehab, Bob says, succeeded where others have failed.
“That’s why I wish the VA would allow me to get more visits before they cut me off,” Bob laments. “I get to where I’m feeling better, and then I have to wait six months before I can go back. By that time, I’ve regressed and have to start all over again.
“But I start over anyway because the work that everyone at Regional Rehab does for us vets is incredible. They spend a lot of time with us and do a fantastic job of taking care of us. It’s so good to know we have a place like this that we can go to.”