No images? Click here April 2021 SpasticityBy Dr. Mary Elizabeth Nelson Despite a global pandemic, the comprehensive spasticity management team has continued to address spasticity in both the outpatient and inpatient arenas. The management of Baclofen pumps has continued unchanged over the past year, and the Botulinum toxin clinic is back to full capacity. Additionally, non-interventional management of spasticity is ongoing as well as new patient evaluations. The “new world” of healthcare we’ve all been navigating has changed our lives, but our patients' needs are ongoing and the team continues to adapt. As we transitioned to our new clinic space, we increased our room availability and size, and increased the team's real-time communication with our shared workspaces. We are grateful to Dr. McGonigle’s leadership as outpatient director throughout this change, along with Rachel Stauffer and Ken Ludlow, and continue to work to optimize the flow of care. ITB test injections/trials unfortunately were on hold due to the pandemic. After extensive work with Froedtert Hospital and neurosurgery, there is a plan in place to have test injections/trials up and running again in the next month's time. Education continues and is expanding! The fellow, Dr. Nick Wilcox, is more than halfway through his training and has secured a fellowship in sports medicine at John Peter Smith Hosp-TX Sports Medicine in Texas to start in July. An ongoing partnership with MCW and Jefferson PM&R residencies has shared lecture series, and just this month Dr. Wilcox spoke on troubleshooting Baclofen pumps. Mary Elizabeth Nelson, DNP, continues her national (virtual) courses on ITB and now serves as residency co-director for the International Rehabilitation Forum's African Fellows Program, the first and only PM&R training program on the continent of Africa! She has recruited Drs. McGuire, McGonigle, Ketchum, Orr and White for expert lectures, which were instrumental in promoting PM&R across the globe. Research, with the dedicated help of Meghann Sytsma, is again proceeding. Patient enrollment and data collection is taking place in the study validating the RATS scale. Work on the fMRI study "Structural and Functional Connectivity Changes in the Brain in Response to Diagnostic Nerve Blocks in Stroke Survivors" continues in collaboration with Marquette. Also, with Marquette, the study "Gait Compensation while Walking in an Immersive Virtual Environment with and without Coupled Treadmill-based Perturbations" has been enrolling patients and gathering data. Multicenter industry-sponsored studies are also progressing through the IRB and with enrollment; more to come on those in the following months. Publication and dissemination of information continues across the team. A collaborative paper between Drs. ME Nelson, Ketchum and the Neurosurgery team regarding “Low Rate of Intrathecal Baclofen Pump Catheter-Related Complications” has been submitted and is under secondary reviewer approval, pending publication. Final write-up of the ITB dosing study will be submitted for publication in the following months. Finally, a case series regarding spinal surgery in the presence of ITB is in rough draft status with intentions to submit this year. Saying goodbye to old Clinic space. So many memories Celebrating new clinic space ! This year we will graduate our “Lucky 13th” fellow, Dr. Nick Wilcox. We remain one of only two spasticity-focused fellowships in the country, and hope to continue to graduate leaders in our field in the coming years! Festive Spasticity Fellow
The MCW Common Read discussion sessions on How to Be an Antiracist by Ibram X. Kendi are scheduled:
Thank you for providing 30 years of excellent patient care, resident education, leadership of the Brain Injury program, and for cultivating friendships. By Dr. Braza As we joined the PM&R residency program together in 1988, we shared the commonality of seeking dual-board certification. We were the “odd ones” striving to achieve our career goals while blending into two residency training programs. I was so grateful you chose to continue my mentor, and your mother’s work in brain injury rehabilitation! Importantly, over the years working together, I have witnessed your clinical excellence, leadership and dedication to leading the TBI inpatient and outpatient programs to maximize patient outcomes.
Mark, enjoy your retirement to the fullest! You deserve it! Even though I moved to Philadelphia almost thirty years ago, I have warm memories of Mark Klingbeil from the late 1980s and early 1990s. During that time, I participated in his recruitment twice, first as a resident and then as a faculty member. Even though he was completing a residency in Pediatrics, Mark was interested in joining our residency in Physical Medicine and Rehabilitation (PM&R). Of course, we accepted him as he had strong credentials. It did not hurt that his mother, Gerda Klingbeil, MD, was a respected faculty member of the Department. Both Gerda and Mark project unusual caring and warmth. I hoped he would become a Department faculty member after completing the PM&R residency and add capacity to our pediatric rehabilitation program. This hope turned into reality when Mark joined our faculty on July 1, 1991. Although his subspecialty focus changed somewhat over the years, Mark has been a valuable member of the MCW PM&R faculty for the last 30 years. This continuity of faculty members adds to the stability of departments. Mark is the first of two residents who are the sons of residents I previously trained. His mother was also a graduate of our MCW PM&R program. The second is John Vasudevan, who is the son of Sri Vasudevan. Sri is the first resident I recruited after I became PM&R Chair at MCW. Mark’s interest in being boarded in both Pediatrics and PM&R was the stimulus that led to the American Board of PM&R (ABPM&R) establishing double boarding programs, including Pediatrics/PM&R. We reviewed the requirements of both specialties to see if we could develop a rationale for shortening the time in training. This revealed that there were at least 6 months of rotations in both specialties that could count towards completing the training of the other specialty. Thus, there was a potential for reducing six years of training to five years. As Chair of the ABPM&R, I proposed we initiate this shortened double boarding program in partnership with the American Board of Pediatrics. Both Boards approved the Pediatrics/PM&R double boarding program. My other memory of Mark is that he was a serious rock climber. This caused some consternation for his safety, but time has shown that his assurances he had the risks under control were correct. Mark, I wish you a happy and rewarding retirement. Be careful, or you may become so busy that you will wonder how you ever found time to work. John Melvin, MD Dr. Mark Klingbeil is one of the most committed and passionate physiatrists I know. His deep commitment to serving persons who suffer disabling brain injuries and diseases is inspiring. He is a consummate physiatrist, always thinking about how his patients can regain their lives and thrive in their communities. He built a great program at the Medical College of Wisconsin that supported the trauma center and neurosciences programs. As a teacher and educator, he gave our residents not only the medical education they needed regarding brain injury, but he modelled to them an example of a compassionate and dedicated professional. As a physiatrist with subspecialty expertise, he is an excellent clinician and care provider for some of the most challenging patients with profound injuries. I recall that Mark was inspiring to us all when he took up running at a very high level. Maintaining a training regimen was often challenging in Wisconsin with its subzero temperatures, ice, and snow, yet he prevailed! I am proud to call Mark my friend and colleague and thoroughly enjoyed working with him. I wish Dr. Klingbeil and his family all the best wishes as they embark on the next chapter. Tim Dillingham, MD Mark is a good friend and trusted colleague; he always had time to discuss an interesting patient case or difficult clinical scenario. He always kept me grounded, willing to be a sounding board and could easily cut through the BS to give his perspective on different clinical and administrative problems. His take on various clinical and administrative issues was often different with his unique insight. I have fond memories of “debating” with Mark whether a patient was appropriate for the Brain Injury vs. Gen Rehab inpatient service, based on potential involvement “above the foramen magnum." He “taught me the ropes” during my residency… since he was my senior resident when we did inpatient consults together. Mark encouraged me to qualify and run in the Boston Marathon (when I never even imagined that I could do it). I found out one time that only his mom (Dr. Gerda Klingbeil) could keep Mark from leaving early on Friday afternoon to go fishing … a fun story that I will be happy to share. I will miss his daily presence, expertise and friendship in the department and on the IPR unit dearly. David Del Toro, MD It has been a real pleasure to work alongside such professional, knowledgeable and sensitive colleague as Mark Klingbeil. For my whole career at MCW, my office was always next to Mark’s. He was always the first person to go to when I had any clinical questions, concerns, or needed to share my thoughts with somebody. He was always ready to listen, help, and happy to share his knowledge. I always appreciated Mark’s great sense of humor that every so often came up in the conversations. His humorous exchanges with David Del Toro have always brightened my days at work. I wish Mark a happy retirement. I am sure he has plans to catch more fish, make more trips to the North of Wisconsin and do many other wonderful things. All the best! Dr. Mark Klingbeil has been a very dedicated, highly respected colleague of ours. His exceptional cordiality is well known to us. His long service with great expertise in TBI has been highly recognized. His leadership in various programs including contributions at Sacred Heart and Curative Health Network are well known. His contributions to all our academic endeavors have been remarkable. We wish Dr. Klingbeil a wonderful retirement! Muni Reddy, MD Have news to share with your PM&R colleagues? We would love to hear from you for our next issue, so please email any recent publications, awards, presentations, shout-outs, pictures, etc. to Beatriz Envila at benvila@mcw.edu. Medical College of Wisconsin | 8701 Watertown Plank Road | Milwaukee, WI 53226 Connect to MCW on Social |