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MS team care will unify at Northwest Hospital

Patients with multiple sclerosis will have one-stop access to a rich concentration of therapies for cognitive, physical, vocational and psychological needs.

UW Medicine will open a dedicated multiple sclerosis center in July and staff it with one of the region’s strongest concentrations of MS-focused specialists.

The facility, on Northwest Hospital & Medical Center’s campus, will assemble neurologists, physical medicine and rehabilitation specialists, therapists (occupational, physical and speech), counselors and a psychologist – all seasoned in treating the constellations of physical and cognitive problems that MS patients encounter. The center also will be equipped with an infusion suite and have direct access to a new 3 Tesla MRI scanner.

Dr. George Kraft, UW professor of rehabilitation medicine, discusses the fits of a foot brace with a patient.UW Medicine has a long history of approaching MS care comprehensively, said Dr. George Kraft, who led the clinic for more than a decade in its former location.

“We think of MS as symptoms we can see, but fatigue, sleep problems, cognitive impairment, pain, depression – you can’t see. One thing that’s preserved, almost to the end, even as brain cells are lost, is a person's ability to speak. So they see a doctor and speak well about their symptoms and the average physician is not going to pick up that major problems exist,” he said.

Kraft continues to run the Multiple Sclerosis Rehabilitation Research and Training Center, a globally recognized program in its 13th year. “We do groundbreaking work; we were the first to recognize that fatigue is a problem with MS patients, and now everyone agrees it's the most common problem,” he said.

For 10 years the program has trained clinical fellows to meet the great need, locally and nationally, for MS providers.

“To stop a patient from falling, you need to understand why they are falling,” said Dr. Shana Johnson, UW assistant professor of rehabilitation medicine.Improved access on two fronts
The new locale will improve patients’ access to care, said Dr. Shana Johnson, a rehabilitation medicine specialist. A dedicated clinic coordinator will help facilitate patient referrals, “and it’s a short, straight shot from the parking lot into the clinic – no more elevators or long corridors,” Johnson said.

Patients will appreciate that. Many MS symptoms can make walking difficult. In fact, interpreting patients’ ambulation problems is a consequential part of Johnson’s job.

“You might expect that a patient falls because of weakness, but it can be due to foot drop or sensory ataxia or cerebellar ataxia, loss of balance, lack of safety awareness, motor fatigue, poor vision. To stop a patient from falling, you need to understand why they are falling.”

“We are no longer satisfied with sub-optimally controlled MS,” said Dr. Annette Wundes, UW assistant professor of neurology.Johnson will co-direct the new center with Dr. Annette Wundes, an MS fellowship-trained neurologist who treats the range of demyelinating diseases that involve the central nervous system.

Cases as unique as fingerprints
In the last few years, pharmaceutical treatment options for MS have improved, making its management more complex and requiring treating physicians to be familiar with higher-risk medications.

“In the right person, they control the disease much better than what we are used to. But they also are associated with safety and toxicity issues, and that’s where special knowledge quickly comes into play,” Wundes said. “How we use these drugs, and for which patients, and the risk-benefit assessment, have all changed dramatically.”

ARNP and MS specialist Lynda Hillman palpates a patient’s forearm to localize areas of pain. Patients will work with Northwest Hospital’s physical and occupational therapists, who are recognized regionally for their expertise in neurologic rehabilitation. Easy Street, a life-size replica of a city plaza, is available for patients to experience very realistic and practical environments in their quest to relearn motor skills. Speech pathologists provide cognitive therapy and voice retraining.

Johnson, the rehab specialist, said multiple sclerosis cases are as unique as fingerprints.

“Some are very mild and relatively controllable, and there are very severe cases that we cannot control. It's a huge spectrum. Every patient’s cluster of symptoms, their progression, their treatment needs, their rehab, is different. That's why a multidisciplinary center with expertise in all those areas results in the best care for those patients.”

To refer a patient or learn more, reach the UW Medicine Multiple Sclerosis Center at 206.598.3344. The center will be in the McMurray Building on the campus of Northwest Hospital & Medical Center.

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