Hudson - Litchfield News January 14, 2011 - 15


by Laurie Lavoie, MSOTR/L, Clinical Specialist, Northeast Rehabilitation Hospital Network Do you have trouble reading medicine labels, ingredients, or directions on food labels, or enjoying small print text in books, magazines, or newspapers? What about trouble recognizing familiar faces, watching the television, or reading road signs? Do you find yourself bumping into objects or tripping while you walk because of difficulty with your vision? You, along with 14 million other Americans, may be suffering from a low vision diagnosis. Low vision is a general term associated with a group of diagnoses that significantly impairs a person’s daily functional ability and cannot be adequately corrected with eyeglasses, contact lenses, medical treatment, and/or surgery. The term low vision includes the following eye conditions: age-related macular degeneration, glaucoma, diabetic retinopathy, cataracts, and neurological disorders affecting vision (i.e., brain tumor, traumatic brain injury, stroke, etc.). These conditions can be treated with the help of an occupational therapist (OT) using several different customized treatments. Many individuals who have been diagnosed with low vision feel that they are blind or that there is little hope of living a meaningful


Well Care Well Care


The National Committee for Quality


Assurance (NCQA) and the American Diabetes Association (ADA) has announced that Srilatha Kodali, MD of Pelham Healthcare Associates in Pelham has received recognition from the Diabetes Recognition Program for providing quality care to her patients with diabetes. The Diabetes Recognition Program


was designed to improve the quality of care that patients with diabetes receive by recognizing clinicians who deliver quality diabetes care, and by motivating other clinicians to document and improve their delivery of diabetes care. To receive recognition, which is valid for three years, Dr. Kodali submitted data that demonstrates performance that meets the program’s key diabetes care measures. These measures include eye exams, blood pressure tests, nutrition therapy, and patient satisfaction, among others. When people with diabetes receive quality care as outlined by these measures, they are less likely to suffer complications such as heart attacks, stroke, blindness, kidney disease, and amputations. “For a person with diabetes, the right clinician can make the difference between living with diabetes as opposed to suffering from diabetes,” said Richard M. Bergenstal, MD, President, Medicine & Science, American Diabetes Association. “Clinicians


who earn recognition through the Diabetes Recognition Program have an established track record of providing excellent diabetes care. The list of recognized clinicians is the first place to look if you or a loved one has been diagnosed with diabetes.” To find out if your clinician has been recognized by the Diabetes Recognition Program or for further information, visit www.ncqa.org/dprp or e-mail drp@ncqa. org. To order application materials, call (888) 275-7585 or order online at web. ncqa.org/dprppubs.aspx.


Diabetes is a serious disease that affects


the body’s ability to produce or respond properly to insulin, a hormone that allows blood sugar to enter the cells of the body and be used for energy. An estimated 16 million Americans have diabetes; it is the sixth-leading cause of death by disease in the U.S. and it has no cure. Celebrating its 20th anniversary in 2010, NCQA is a private, non- profit organization dedicated to improving healthcare quality. NCQA accredits and certifies a wide range of healthcare organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s


Are You Dizzy?


by Rebecca Underwood, PT, Salem Sports and Rehab Dizziness is the second most common complaint heard in


doctor’s offices after lower back pain. Dizziness is a sensation of lightheadedness, faintness, or unsteadiness. Almost everyone experiences a few seconds of spatial disorientation at some point; for example, when a person watches a 3-D movie in the theater and momentarily perceives an illusion of moving or falling as the images rush past. Or when you are in your car at a stop and the car next to you begins to move and you think it is your car moving, so you press a little harder on the brakes, thinking they are not working. However, frequent episodes of vertigo – whether lasting only for a few seconds, or days on end – are a primary sign of vestibular dysfunction, especially when linked to changes in head position. Vertigo can be caused by problems in the brain or in the inner


ear. Vertigo implies that there is a sensation of motion, either of the person or the environment, often perceived as if the room is spinning around you. This should not be confused with symptoms of lightheadedness or fainting. If true vertigo exists, symptoms include a sensation of disorientation or motion. In addition, the individual may also have nausea, sweating, and abnormal eye movements. Benign paroxysmal positional vertigo (BPPV), the most common form of vertigo, is rarely serious and can be treated. While there are many causes of vertigo, BPPV is the term that is use for vertigo that comes and goes without a specific associated illness. It is often a frustrating situation for patients because the episodes are frightening and difficult to predict. However, it is related to the labyrinth system inside the inner ear, which is responsible for maintaining balance in the body. There are three semi-circular canals that contain nerve endings and fluid that tell the body where it is in relation to gravity, acting almost like a gyroscope. Small crystals in the inner ear can fall into the canals, causing inflammation, and this can lead to vertigo. The definitive treatment for BPPV requires that the crystals causing inflammation in the semi-circular canals be moved out of those canals. This can be done by using a maneuver, where the head is taken through a series of position changes that allow the crystals to be emptied out of the canals. These maneuvers require a special skill set; first, to know which canal the crystals are in, and second, how to “shake” the head to get them removed. Both Salem and Derry Sports and Rehab both have therapists


who are trained to work with patients with BPPV and other forms of vestibular problems. In the case of BPPV, a person can become symptom-free in one to two visits. Vestibular problems are not something to be ignored, however, as they can be the sign of a much more serious problem, and patients should therefore be seen by their doctor and/or a neurologist who can determine the cause of the vertigo. We are more than happy to talk with you about your problem and help you where appropriate. After all, who wants to live life being “dizzy”?


healthy body, mind, and spirit.


Occupational Therapy for Low Vision Diagnoses: The Key to Unlocking an Improved Quality of Life


and independent lifestyle. But there is hope! Occupational therapists are trained to help teach these individuals to compensate for their vision loss and in some cases are able to help individuals regain lost vision. Patients are provided with the skills and adaptive techniques needed to use remaining vision effectively and efficiently in daily activity. Occupational therapy sessions may include instruction in the use of visual aids such as optical aids (e.g., magnifiers) and non- optical aids (e.g., big button phone, large print checks, etc.), daily activity re-training, progressive vision exercise, and resource recommendations. Perhaps the biggest focus of OT is to create a home exercise program that the patient can use to practice these skills in the home environment. Home carry-over of therapy techniques is crucial for obtaining desired results. Medicare and most private insurance companies will pay for occupational therapy for low vision diagnoses. The patient’s vision must be considered moderately/severely impaired and cannot be corrected by conventional means. The patient must also have a clear potential for significant improvement in function following rehabilitation over a reasonable period of time (usually nine visits). In addition, the patient must have a functional impairment associated with the visual deficit and must have a written script


Clinician Receives National Recognition for Providing Quality Diabetes Care


Healthcare Effectiveness Data and Information Set (HEDIS) is the most widely used performance measurement tool in health care. NCQA is committed to providing healthcare quality information for consumers, purchasers, healthcare providers, and researchers. The American Diabetes Association is the nation’s leading voluntary health organization supporting diabetes research, information, and advocacy. Founded in 1940, the Association has offices in every region of the country, providing services to more than 800 communities.


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from his/her doctor. The prescription should read “occupational therapy evaluation and treatment for (insert diagnosis here).” If you would like more information about Low Vision Rehabilitation, call 893-2900, ext. 3210. To speak directly to an OT regarding your low vision questions, call 681-3212. And remember, there is hope for people living with low vision diagnoses. Let the specially trained therapists at Northeast Rehab Hospital be your key to unlocking an improved quality of life.


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