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Real Time Parenting

In this day and age of Real Time Parenting … in other words, “I need it now” parenting, I have a few words of caution.  As parents, we run the risk of becoming enablers to the on demand, real time parenting issue that have consumed our generation.  Believe me, I am in the trenches with you.  As the proud father of five I try to straddle the perils of parenting by giving in to certain requests, but laying the law when it comes to other requests.  Communication is the key to these issues.  Understanding and acting is the key to maintaining steady and buoyant waters with our children.   Ensuring they know you love them, will support them and always be there for them seems to be the only recipe for success here.  And that does not come easily or at a predetermined time.

Make sure your kids know you love them.  Make sure you keep the lines of communication open.  And maybe, just maybe you will see that the recipient of your love, your child, responds positively.  And maybe you will have to wait for the answer.

In the trenches with you.

Neal Alpiner MD, FAAP, FAAPMR

The Rehab Doc

 

 

 

 

November 17, 2012 | 0 Comments | Filed under Uncategorized

Why I Became The Rehab Doc

 

I am fortunate and blessed to be a Physician, specializing in the field of Pediatric and Adult Physical Medicine and Rehabilitation. Working with children and adults who strive continuously to improve and move beyond their physical, cognitive and psychological challenges is a daily reminder that hope, determination and will continuously trumps defeat and negativity.

I treat patients with many different conditions, including those with neurologic, orthopedic and musculoskeletal issues.  I see patients in the hospital, in subacute care facilities as well as in my office.  Don’t know if my profession found me or I found my profession, but here is the background into how and why I chose to become a Rehabilitation Physician.

When I was nine years old, I went to my pediatrician for a regular check-up.  Seemed like the usual type office visit as I remember my vision being tested, my eyes and ears checked out with a cool mini light, and the typical stick in the throat, say ahhhhh.  But when the doctor listened to my heart, what had been a typical exam turned into anything but usual.

I don’t remember all of the specifics from that point on, but do remember the doctor telling me I could play out in the waiting room and that he needed to talk with my Mom, who at this point had a look I had never seen in her eyes before.

The next stop was the hospital where I was told I would come the next week for surgery.  I hadn’t remembered being in a hospital before that time.  At first I remembered the feeling of fear and concern, but upon hearing about all of the cool tools and instruments they had there, that the people who worked there would help to make people better and stronger, I was fascinated.  And the fact that the hospital was always open for me was just too good to be true.

As it turns out I had a patent ductus, which literally means that I was born with a valve in my heart that remained open, rather than shut.  The doctors needed to go in and close the opening.  Sounded easy enough.  Only that they would have to literally cut me open across my entire rib cage to get to my heart.  And that they would also need to cut my leg open to place a tube for drainage … surely they had to be kidding. 

Thankfully the surgery went well.  The surgeons were able to go in and “fix” the problem I had lived nine years not knowing that I had.  I remember vividly after the surgery not being able to walk well, hunching over literally guarding my left side in a cradled position.  Not only was the recovery painful, but it was long and I didn’t understand why I couldn’t just hop of the table and go on with my life like before.  After all, they went in, fixed the problem, so why couldn’t I just move on now?  I remained in the hospital for three weeks where I worked to get stronger, going through what was then considered an extensive therapy plan.

The rehabilitation process was lengthy.  I had to work at what had been so easy for me to do perform earlier.  I have always been an athlete, enjoying virtually every sport known.  Now after my surgery I was faced (at the ripe old age of nine) with this frustrating, depressing situation of not being able to function and perform at the level I was at prior to surgery.

The people at the hospital (physicians, nurses, therapists, etc.) were all wonderful.  They were compassionate yet persistent, assisting in my recovery, empowering me to get better.  I was always told I had great potential.  I quite literally made a decision at that moment then that I was going to be a doctor.  I would get to work with people, diagnose a medical condition or problem, and figure a way to get them better and stronger.  My path was now forged.

As dramatic as that sounds, it really did happen that way.  I did not know that my medical path would specifically guide me to become a rehabilitation physician who treats both adults and children.  I have always loved working with children, but I have always enjoyed working with seniors as well.  Becoming Board Certified in Pediatrics as well as Board Certified in Physical Medicine and Rehabilitation allows me to see patients of all ages (I literally treat patients ages birth to I think the oldest patient I ever treated was 103).   One patient may be a newborn, and my next patient may be an octogenarian.  I love meeting people, listening to what their medical issues are, and then figuring out how to get them to a better place.

I feel that I can relate to my patients based upon my own personal experience.  Many patients I see after they have been injured or have had surgery.  Some injuries come with repetition, while others come after an incident or specific trauma.  I see exceptionally high numbers of sport injuries.  You name the sport, I have seen an injury related to it.  From concussions to traumatic brain injury, tears, sprains, strains to syndromes of all kinds, I treat patients with a wide variety of ailments.

The most gratifying part of what I do is talking, listening and learning from my patients.  I learn from every patient I treat.  I get to work with amazing people every day who inspire me.  Some of my patients I may evaluate and treat only once, while others may come for treatment for years.  I look through the lens of potential and how can I help someone reach their own potential.

My professional path was created early on in my life.  I was blessed to have received the medical care, attention, treatment and hope that I received.  I feel if I can pass those same gifts along to my patients I will have reached my own potential.

April 22, 2012 | 2 Comments | Filed under Uncategorized

Concussion Management in the Year 2020

 

Lisa, a 14 year old soccer player comes into the University Medical Center Emergency Department after hitting her head on the ground after contact with another player. The nurse at triage takes a glance at the intake forms, looks at Lisa and says, “Tell me your name and what date it is”… “My name is Lisa, and I think it is Tuesday June 3 … 2020.” “Very good, young lady,” the nurse responds. “That is correct.”

The nurse then asks her mom when Lisa had her concussion blood typing done.   Lisa’s mother then reaches into her purse and grabs a flash drive with all of Lisa’s medical history, including the genotypic screening for concussion risk.

We are not far from the ability to all carry our own health information on our phones or on flash drives.  And we are not far from understanding the relationship between how an individual’s genetic makeup may either increase or decrease their risk for concussion post.

Let me preface by stating the type of injury, mechanism of injury, the forces applied to the head, early evaluation by medical specialists, and extent of trauma are all important factors.  But the brain’s ability to resist injury or incur injury may very well be woven into a code created at the time of conception.

For example, it has been known for quite some time that individuals who have a certain gene called Apo e4 have a higher incidence of developing Alzheimer’s Dementia (AD). Additionally, those individuals who have had severe traumatic brain injury and have Apoe4 are also at an increased risk for developing dementia. This does not mean an individual who has the Apo e4 gene will get AD or post (severe) traumatic dementia.  It does mean the risk for developing AD is raised in those individuals.

What all this means is still too early to say. However, one day in 2020 a parent might bring their child to the doctor for a pre-sport health exam and besides the usual heart, lung and vision screening the doctor may draw blood to screen for biomarkers (gene patterns) that will assist you in determining if your child should play a high or low risk concussive sport.

Dr. Neal Alpiner sees patients daily who may potentially be suffering from concussions.  If someone you know could potentially be affected by this type of injury, make an appointment today but contacting our office at 877-433-7767 or contacting us at therehabdoc@gmail.com

February 25, 2012 | 0 Comments | Filed under Uncategorized

Are Female Athletes More Likely to Get Injured?

 

When I am seeing patients in my office I sound like a broken record. Whenever, a young female athlete comes in to see me, no matter what the reason the come in (concussion, shoulder injury, back pain…), I inevitably will lean back in my chair and say,  “Do you know that you are 6 times more likely to blow out your knee than your male counterparts?”

The statistics are alarming when it comes to knee injuries in the youung female athlete. When I tell my female patients this important fact, they typically respond that they know someone who had surgerythe last summer.

Why girls are more likely to get injured relates to several possible factors:

Anatomic: female pelvis has a forward tilt, is broader; hip-to-knee angle is different in females wider; knee meniscus and knee geometry is more narrow

Hormonal: ACL complex has estrogen receptors that alter the ligaments firmness

Biomechanical: girls land more stiff-legged, less bent, less bounce

What can be done to prevent these injuries.

  • First, condition well.  Learn proper landing, jumping and knee sensory techniques.
  • Second, don’t try to do things beyond your skill level.  Always beware of what your body can and cannot do.
  • Third, give your body breaks.  Training year round, doing school and travel squads without relative-rest will place your body in a fatigue state leading to injury.

Remember, always play smart … use your mind first.

Dr. Neal Alpiner sees patients daily who may potentially be suffering from concussions.  If someone you know could potentially be affected by this type of injury, make an appointment today but contacting our office at 877-433-7767 or contacting us at therehabdoc@gmail.com

February 12, 2012 | 0 Comments | Filed under Uncategorized

This Ain’t Your Brother’s Sports Anymore: Concussions in Female Athletes

 

Think concussions are just for boys?  Think again!  In today’s blog post, Dr. Neal Alpiner, The Rehab Doc, shares a personal experience from when he treated a talented, female soccer player.  While female competitiveness can rival that of any male athlete, don’t forget that a concussion is an injury that no fearlessness can overcome.  Check out the post below for insight and share the link with a the parent of a female athlete today!”

 

Jessica was sitting on the exam table, her mom in the chair next to her. I walked into the room to see this petite 12 year old girl with a slightly dazed look on her face. My first response was you must be a soccer player. She glanced up at me, slightly bothered by the lights in the room, and softly said yep, I play a defenseman.

Girls’ sport injuries, especially concussion, are occurring at an incredibly high rate. I cannot tell you many girls I see that have bruised, bopped, and banged their heads around like the ball used in their very own sports.

The patients who come through my office practice mimic the findings found in a study done in the American Journal of Sports Medicine, Trends in Concussion, Incidence in High School Sports.  Girls are rapidly approaching the boys in regards to the total number, incidence and frequency of sport based concussions. Studies reveal girls soccer is only second to boy’s lacrosse in incidence of concussive episodes and another found girls soccer and girls basketball ranked second and fourth.

So for all of you who believe girls cannot play sports, know this. Not only can they play like the boys, but they can get injured like the boys as well.

Dr. Neal Alpiner sees patients daily who may potentially be suffering from concussions.  If someone you know could potentially be affected by this type of injury, make an appointment today but contacting our office at 877-433-7767 or contacting us at therehabdoc@gmail.com.

 

January 31, 2012 | 0 Comments | Filed under Uncategorized

Where did 2011 go?!

Season’s Greetings!

 

Looking back the past year seemed to fly by.  Don’t know about you, but to me it seemed like just yesterday I was creating my list of New Year’s resolutions.  Admittedly, I still have work to do on some of 2011’s list, but already I have made room for my new list of “I know I can do this.”   Always seeming to make my list is that I will make time for the people and things that are important to me AND that I will make sure to convey to them all how much they mean to me. So to my wife and children, friends and family, patients, coworkers and caregivers … thank you for a wonderful year’s past.  My wishes for you all are that you will enjoy a happy, healthy new year filled with joy and happiness.

December 17, 2011 | 0 Comments | Filed under Uncategorized

Ready, Set, Go Blogging!

My first “official” blog, and I am thinking I must write something unique, mind boggling, something that absolutely amazes you … and yet, when I sit to write this first blog I really find I first and foremost want to simply thank my patients who inspire me every day. Some patients I see and treat only once or twice, others I have seen and treated throughout the years. I have learned a little something from each and every patient I have seen, and I do not take that for granted. Strength, tenacity, optimism … you truly inspire me and teach me. I am indeed very blessed to do what I love to do. And I thank you for teaching me every day. So to all the Charlies, the Aprils, the Maxs, the Alvins, the Madysons and the Arthurs (and countless others) … I thank you for all you have done for me. Be Well.

October 9, 2011 | 0 Comments | Filed under Uncategorized

Welcome to the blog!

We’re just getting started here, so be sure to come back for great articles, information, and videos about your health and wellness by Dr. Alpiner.

August 2, 2011 | 0 Comments | Filed under Uncategorized
The Rehab Doctor: Be Well