Danielle Gross a physical therapist at FYZICAL Therapy and Balance Wellness Center in Rockville, Md. She specializes in Vestibular Rehabilitation Therapy and Balance.
Here she shares one of her favorite patient success stories, offers advice to students and discusses how she tries to help in her community. Read on:
Tell us about your practice. What sets you apart from other practitioners in your area?
Aside from our full suite of physical therapy services, FYZICAL Therapy and Balance Wellness Center is very unique in our area due to our comprehensive balance program. Our practice has a combination of cutting edge balance technology and highly trained specialists who are able to efficiently recognize the area of dysfunction, and create a highly individualized plan of care that directly addresses the patient’s cause of the problem, whether it be vertigo, imbalance or other symptoms.
We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did they learn about your practice?
Our clinic is very proud of our many success stories that our patient’s take away with them once they are discharged from treatment. One of our more recent patients came to FYZICAL directly from the hospital with severe vertigo.
Why did this patient come to your practice? What problems were they experiencing?
This particular patient woke up one morning with severe dizziness/vertigo. He began vomiting due to the dizziness and became very dehydrated. He was admitted to the hospital for three days where doctors ran tests and were able to get the patient to stop vomiting. All of his tests were negative and he was given medication to help with the dizziness. However, upon leaving the hospital, he continued to feel very dizzy and could no longer walk without the assistance of a cane. He was a previous patient of our clinic for back pain, and remembered that we also worked with balance and dizziness patients.
How did you go about diagnosing him?
During his first visit, the patient spent an hour one-on-one with a vestibular therapist. His initial evaluation consisted of multiple tests including a functional gait exam, balance testing on different surfaces, special tests involving the eyes and inner ears, and vestibular testing with special infrared goggles. The goggles used were extremely helpful in watching involuntary eye movements that were being produced by the dysfunction in his inner ear. With his reported symptoms and special testing, it was determined that the patient was suffering from an acute form of Vestibular Neuronitis in his right ear, but this wasn’t the end of the story! After performing positional testing with the infrared goggles, the patient also had a severe case of Benign Paroxysmal Positional Vertigo (BPPV) in his right ear. Not only did the patient have an acute vestibular disorder, but he had two!
What treatment course did you decide on?
The treatment plan that was created consisted of two parts. The vestibular issues that the patient was experiencing are both treated very differently. Fortunately, BPPV is a disorder that has great success rates with simple in office maneuvers. We were able to perform an Epley maneuver during the initial evaluation to resolve the BPPV. He no longer experienced vertigo with sudden changes in position. However, he continued to feel very off balanced, and dizzy constantly due to the Vestibular Neuronitis. The course of treatment for Vestibular Neuronitis involved two treatment sessions per week over a four to six week period. In that time, we initiated gaze stabilization exercises, exercises on a balance shuttle, computerized force-plate technology to measure different aspects of the patient’s balance, and exercises to strengthen his legs.
What was the impact your treatment had on the patient? How did you help him or her?
By the end of the treatment, the patient no longer experienced dizziness or vertigo, he was able to walk without using a cane, and he was able to embark on a service trip overseas for a month without symptoms of dizziness or imbalance.
What advice would you give PT/Chiro students today? For instance looking back at your own career is there anything you would do differently?
My advice to PT/Chiro students today is to be aware of the vestibular system, and the common conditions that many patients experience due to vestibular dysfunction. Over the course of my time treating patients, I have seen patients for various other orthopaedic conditions who have undiagnosed BPPV that has contributed to falls and other injuries. Many patients think that their dizziness is a normal part of aging and that they can’t be helped. However, with the knowledge of a simple Dix-Hallpike Test and an Epley maneuver, you can greatly improve a patient’s quality of life! It is important to screen and educate your patient’s about balance and potential fall risks.
Please talk about any ways you are trying to impact the community you’re a part of.
We are always trying to impact our community by providing the best possible care for our patients and Wellness members. First, we believe in honoring God and serving others in all areas within the clinic; patient care, human resources, business ethics and corporate finances. At FYZICAL Therapy and Balance Wellness Center, our patients’ needs are our first priority, deserving our greatest attention and resources. We believe patient care is best delivered in a friendly atmosphere where caring for patients and staff is more important than the bottom line. Our “Team” approach is fundamental to building a basis for superior patient care. Overall, our excellence in patient care and patient relations is the norm at FYZICAL Therapy and Balance Wellness Center.
In our clinic, we as a staff are either mentoring or teaching on a daily basis. We have many volunteers and students that come in to shadow therapists. Our aides are also learning from each other and the therapists about different aspects of physical therapy and patient care. All therapists also excel in different areas of treatment, allowing therapists to learn from each other whether it’s regarding orthopaedic physical therapy, pelvic health or vestibular rehabilitation.
