Jill’s Jottings – Washington DC (Part B)

Visited Dr. Lauro Halstead at the National Rehabilitation Hospital, Washington DC

The clinic was begun by Dr. Lauro Halstead in the 1980’s after he started experiencing new weakness that was puzzling doctors at the time. Clinic PPS numbers soon swelled, but are now slowing up. The clinic now only sees about 50 new patients a year, plus f/u visits on an as needs basis for PPS folk already assessed by the clinic.

The Post Polio Clinic team work closely together and conclude their assessment review by round table discussion with PPS team members, the patient and patient’s ‘significant other’.

First day - PT, OT & Doctor assessment AM. Afternoon is for other tests such as MRI, X-Ray, other allied health disciplines etc. The patient then overnights in ‘hotel’ style accommodation on site and returns to the clinic next day. The overnight ‘time-out’ is important as it gives patients time to absorb and reflect on the day’s information, and to contact other family members to clarify early polio history or take measurements etc for future home modifications.

Second day - Provides time for additional questions that have arisen overnight & for further individual needs such as exercise programs, ADL, home modification etc.

The PT & OT staff share common treatment areas, with overlapping responsibilities. They have gait training equipment that will take a patient’s full standing weight, on a stationary/moving platform. The mechanical leg walking facility can be strapped to someone with no/minimal movement leg movement to simulate walking patterns and avoid the need for a therapist to bend and manually move legs.

One impressive area is their Daily Living simulations. They have mock up street crossings, with traffic lights, curbs, shop fronts, 2/3 of an adapted car, as well the usual bedroom, bathroom/toilet & kitchen areas for assessment, practice and prescribing assistive devices. The adapted car has equipment that can show, for example reaction time from accelerator to break etc. Once a patient has adequate skill & control for driving on the mock-up car, they are assessed on the road by a qualified driving assessor.

This clinic also uses seat mapping technology in conjunction with other verbal & manual assessment to prescribe and confirm correct seating. We were told the orthotic department workshop was very small, but its services were frequently used.

Next day Mary-ann & I headed to the FDR Memorial by the river near ‘Downtown’. I was impressed by its simple design and open spaces with samples from each of FDR’s Presidential 4 terms in office. Mary-ann then did a great job pushing me for 30 mins into the central Mall area in hot conditions. We separated by a green shaded area where I ate my lunch leftovers. As I and other folk were crossing a busy street, a truck with flashing lights & siren blaring suddenly turned and we all scattered! Had pleasant time in the Air & Science Museum before heading back to Mary-ann at the University via Metro rail & shuttle bus. By now I am very proficient and arrived ‘home’ by 6.15pm. Tea at the student canteen then bed. Ready for Pittsburg – Johnstown.

Jill Pickering