Recovering from spinal cord surgery

Spinal cord injuries are the result of both accidents and lifestyle habits. We can avoid developing a weak spine by adjusting our lifestyles. Unfortunately, the same cannot be said for accidents. A car accident or slipping over can lead to tremendous long-term discomfort and pain with little we can do to prevent these damages, assuming you're wearing your seatbelt and not running on unstable surfaces. Nonetheless, there are ways we can tackle this issue using advances in medical science. Spine surgery can have incredible effects on your quality of life. Let’s investigate how you can plan your recovery after a surgery. Please note that timestamps are generalized and dependent on your health and recovery plan.

Spine surgery is one of the more common types of surgery, and most are minimally invasive.  Let’s take a look at what spine surgery can do for you.

Firstly, when you’re in the hospital, you may have one of these surgeries depending on what type of damage you have incurred.  

·       Diskectomy – surgery to remove all or part of your disk

·       Foraminotory – surgery to widen the opening in your back where nerve roots leave your spinal column

·       Laminectomy – surgery to remove the lamina, two small bones that make up a vertebra, or bone spurs in your back, to take pressure off your spinal nerves or spinal column

·       Spinal fusion – the fusing of two bones together in your back to correct problems in your spine

Your physician will give you a bespoke plan relating to your damage and recovery plan.

Depending on your surgery, recovery could take anywhere between 3 weeks to 6 months to recover. Other conditions that could affect your recovery is your lifestyle and bodily condition before the surgery.

Your bandages have a lifespan of approximately 9 days.  Check to see if the area has changed colour, swollen, or begins to open up. If this happens, contact your surgeon immediately. If there are no issues, you may begin to shower again. Wait 5 days before showering, and cover the incision with plastic wrap. Do not allow shower from the head to spray the wounded area. You should also want to avoid stairs for the first week or so.

Once a few weeks have passed, and the healing process is underway, you should be attempting to work your way into your previous routine. Before continuing your rehab, please note: do not sit still for extended periods of time, and inform yourself on proper posture by reading this. If you are supported by a brace or corset, you should be wearing it when sitting and walking, however, it would be unnecessary to wear the brace when you are sitting for short periods of time or using the bathroom at night. Finally, do not drive for the first 2 weeks.

Now is the point where, as opposed to what you should avoid, we can start looking at how you can actively help the healing process.

Around the 4 week stage, generally, you should be taking light walks to strengthen surrounding areas. Increase the speed or duration of the walk slowly. This allows the spine to heal itself within an active body and correct itself. A sedentary lifestyle will encourage previous problems to return. Continue to up your exercise slowly as your spine recovers.

Please note, you should contact your surgeon immediately if you experience any of the following:

·        Chills or a fever of 101°F (38.3°C), or higher

·        More pain where you had your surgery

·        Drainage from the wound or the drainage is green or yellow

·        Lose feeling or have a change of feeling in your arms (if you had neck surgery) or your legs and feet (if you had lower back surgery)

·        Chest pain, shortness of breath

·        Swelling

·        Calf pain

·        Your back pain worsens and does not get better with rest and/or pain medicine

·        Difficulty urinating and controlling your bowel movements

If this routine does not help, or you need medical attention, please contact us at Mount Sinai Department of Rehabilitative Medicine. A bespoke plan will be necessary if you suffer from other medical problems. Contact our switchboard on: (212) 241-6321

How to Deal With Sciatica, The Do’s and Don’ts

How to deal with sciatica, the do’s and don’ts

This week, we are going to look at ways of managing sciatica. In our previous blog we looked at what sciatica is, and suggested some causes of the problem. To quickly recap, sciatica is the compression of the sciatic nerve – which in turn causes pain down the lower back, through the hamstring all the way to the foot. What is most important to remember when dealing with sciatica, is that is a symptom, and not the underlying problem itself.

The first step when dealing with sciatica is diagnosing the underlying issue. The root of the problem can be anything from a slipped disc in the spine, to a spinal stenosis, or in more serious cases, a tumor. It could even come from a small fracture in the hip. Although we can treat sciatica without dealing with the genesis of the problem, you are more likely to experience a reoccurrence of sciatic pain if we do not.

We recommend that if you suffer from sciatica, get a diagnosis on what caused it. That way we can deal with the pain alongside remedying the original problem, and reduces the chances of it reoccurring.

For now, let’s look at some of Mount Sinai’s recommendations for dealing with sciatica at home.

Conservative (non-surgical) treatment is best in most cases. When you are suffering from sciatica, or begin suffering due to some other cause, apply heat or ice to the painful area. Try the ice first (48-72hrs); then use heat on the pain. Over the counter pain relievers such as ibuprofen or acetaminophen can also help with inflammation and general pain relief.

Surprisingly to a lot of patients, bed rest is not recommended. Although short term bed rest may be needed for patients in extreme pain, staying inactive and reclined for long periods of time weakens the body and extend the life of agonizing symptoms.

Upon first suffering the symptoms of sciatica, it is recommended to tone down your physical activity for the first few days, and gradually work your way back to your daily routine.

You should reduce your activity in the first couple of days – and gradually adjust your body to your usual activities. This will ensure you do not overstress any of the damaged components, and give your body time to adapt.

Patients are recommended to start exercising again after around 2-3 weeks. You should include exercises to strengthen your abdominal muscles and improve flexibility in your spine.

If weightlifting or contact (collision) sports such as American Football are part of your usual exercise routine, you should not return to your sport/hobby for at least 6 weeks since the pain began. Do not lift heavy objects or twist your back. Your physician can help identify good exercises to remedy sciatica.

More serious complications depend on the causes of sciatica, such as slipped discs or spinal stenosis. Call a provider immediately if you have:

·        Unexplained fever with back pain

·        Back pain after a severe blow or fall

·        Redness or swelling on the back or spine

·        Pain traveling down your legs below the knee

·        Weakness or numbness in your buttocks, thigh, leg, or pelvis

·        Burning with urination or blood in your urine

·        Pain that is worse when you lie down, or awakens you at night

·        Severe pain and you cannot get comfortable

·        Loss of control of urine or stool (incontinence)

Also call if:

·        You have been losing weight unintentionally (not on purpose)

·        You use steroids or intravenous drugs

·        You have had back pain before, but this episode is different and feels worse

·        This episode of back pain has lasted longer than 4 weeks

Sciatica usually goes away on its own if you follow our guidelines. However, if you need a consultation, or are suffering from any of the symptoms outlined at the end of the article, please contact us on (212) 241-6321 to book an appointment.

Causes and manifestations of sciatica

Sciatica is the name given to any sort of pain caused by irritation or compression of the sciatic nerve. The sciatic nerve stems from the back of your pelvis, and runs through your buttocks, down the legs, and ends at your feet. It is the longest and widest nerve in the human body. It supplies sensation to most of the muscles and ligaments in the lower body – this ranges from the hamstring all the way to the sole of the foot.

When the sciatic nerve is compressed or irritated it can cause pain, numbness, or a tingling sensation that radiates from your lower back and travels down one of your legs to your foot and toes. Some sufferers also report a weakness in the calf muscles or the muscles that move the foot and ankle. Sciatica can range from being extremely painful to a mild annoyance, usually exaggerated by sneezing, coughing – or any involuntary or sudden movements. The pain of sciatica is localised in the lower body region, stemming from the top of your buttock downward, people also report suffering from back pain. Although this is most likely related to the problem, it will not be the sciatic nerve causing the pain.

Most cases of sciatica stem from a slipped disc. Injury or weakness can cause the inner portion of the disk to protrude through the outer ring. This is known as a slipped, herniated, or prolapsed disc. If the slipped disc compresses the sciatic nerve then we have sciatica. Most people with sciatica experience unrelated back pain. But a slipped disc is an injury in its own right; we should see sciatica as a result of this injury. We can summarise this as: Sciatica often occurs from a slipped disc; however, not all cases of sciatica are from slipped discs; and you can get sciatica without having a slipped disc. There are a myriad of ways a disc can slip. 

You can help prevent sciatica by adopting better posture and lifting techniques at work, stretching before and after exercises, and exercising regularly.

Although most cases of sciatica pass within 6 weeks, sciatica can become extremely dangerous. If you are experiencing a tingling or numbness between your legs and around your buttocks, and have recently lost bowel/bladder control, and have sciatica in both your legs – you must contact a physician immediately. Our physicians can confirm a diagnosis of sciatica based on your symptoms and recommend appropriate treatment.

If you are suffering from any of the symptoms listed, please contact us as it is important you speak to your physician as soon as possible. Contact our switchboard on: (212) 241-6321

How we can help diagnose Carpal Tunnel Syndrome

The carpal tunnel is the space between a group of eight small bones in the wrist joint, and the ligament that links them to the lower neck. Carpal Tunnel Syndrome (CTS) is a medical condition which compresses the median nerve as it travels through the wrist at the carpal tunnel. The median nerve starts at C5 to T1 (the middle lower part of your neck), and travels down the front of the elbow, and into your hand. The nerve gives feeling to parts of your hand. Symptoms materialise as pain, numbness, and tingling in the thumb, index finger, middle finger, and the thumb side of the ring fingers. Due to this, sufferers tend to lose grip strength and if the problem persists, muscles at the base of the thumb may begin to waste away. 

Chances of suffering from CTS increase with obesity, repetitive wrist work, pregnancy, and arthritis. Diabetes has also been shown to have a weak correlation with CTS. There are some things you can do at home to help with CTS. But how can you know if you have CTS?

It has been suggested that there are exercises you can do at home to trigger the median nerve to exaggerate the symptoms. By placing our hands together as if one were praying, and ensure our forearms to our elbows are in a horizontal line, people suffering from CTS are said to feel their symptoms exaggerate. However, this is not a full diagnostic – and will not suffice to tell you if you are suffering from CTS.

We offer full a diagnostic test. An electrodiagnostic supplies us with objective evidence that will tell us if you are suffering from CTS or another medical condition. This helps rule out other medical conditions that mimic the symptoms of CTS, such as cervical radiculopathy.

The symptoms of CTS are equivalent in many ways to cervical radiculopathy (a neurological condition characterized by dysfunction of cervical spinal cords). With home tests, it is easy to conflate the two. Both issues result in numbness pain and weakness in the hand. With an electromyography, physicians can identify not only if you are suffering from CTS, but also – exactly where along the median nerve the problem lies. The root of the problem could be proximal to your lower neck, the median nerve itself, or the three fingers. Our diagnosis will precisely pinpoint the genesis of the condition.

The electrodiagnostic also identifies if patients are suffering from what is called double crush syndrome, where patients suffer from both CTS and cervical radiculopathy – which is increasingly common.

It is important that if you are experiencing the symptoms, you contact us immediately to discuss options. CTS is most easily treatable in the early days, the longer it is left, the higher chance of irreparable damage being caused. Get an accurate diagnosis.  

Mount Sinai specialize in CTS and pain management. If you experience any of the symptoms listed, please contact us as it is important you speak to your physician as soon as possible. Contact our switchboard on: (212) 659-8551 or (212) 590-3300

What Causes Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) is the compression – and sometimes squashing – of the median nerve that passes through the wrist. Its symptoms can include numbness, tingling and pain in the thumbs, fingers and wrists, which can travel as far as to the arms and even to the shoulder. Modern medicine has a firm grip on what CTS is; what causes it is quite a different story.

Diagnosing CTS can be done through a relatively simple physical examination. One test is called the ‘flick signal’, for which the patient is asked, ‘what do you do when your symptoms are worse?’ If the patient responds with a hand movement that resembles the shaking of a thermometer, there is good reason to suspect CTS. There are plenty of other tests such as Phalen’s Test and Tinel’s Sign – yet, despite the relative wealth of ways to diagnose CTS, there actually isn’t any kind of test to identify the precise cause CTS, and – except for patients suffering from underlying diseases – the biological mechanisms that create this inflammatory disorder remain unknown. 

It is a common story that CTS is caused through repetitive and often high-stress tasks that involve the wrists and hands – typing, using a computer mouse, manual labour to even playing the piano. While the correlation between CTS and tasks of this nature is undoubted, there is minimal evidence to suggest any clear causality.

In fact, most studies today indicate that CTS’ causes go above and beyond mere so-called ‘workplace factors’ and that they are rather linked to ailments that cause swelling in the wrist (osteoarthritis and rheumatoid arthritis) and others that obstruct blood flow (hypothyroidism and diabetes). We also see CTS pop up in clusters within a family, which suggests that something genetic is at play. Lifestyle also appears to play a significant factor, as those who smoke, drink alcohol excessively, consume excessive salt and who are obese all show increased risk of developing CTS. Women are also three times more likely to develop CTS than men, particularly after childbirth and during menopause.

Despite the range of medical, physical, genetic and life-style related items that are linked to an increased risk in developing CTS, their relationship is that of a correlation and not one of cause and effect. A modicum of clarity might be achieved, however, by overlapping both ends of the spectrum – the ‘workplace effect’ with medical/genetic/lifestyle factors. When somebody is susceptible to CTS – whether it be through genetics, a medical condition or an unhealthy or stressful lifestyle – and they also subject their hands and wrist to frequent, repetitive task, the likelihood of suffering from CTS will be at its greatest.

If you believe you are at risk of developing CTS, we would like to encourage you to seek medical advice on how to prevent it; if you believe you might already be suffering from it, we suggest you speak to one of our specialists for a suitable treatment. The earlier CTS is treated, the more likely – and easier – a full recovery will become.

Our Tips for Healthy Bones and Reducing Joint Pain

 It is estimated that between one third and one half of the population of the United Stated aged 20 and over suffers from some form of joint pain. This can be caused by a variety of factors, from genetic predispositions to natural wear and tear of bones as we get older. While there may be no definite cure for chronic joint issues, there are ways that pain can be reduced so that it does not restrict everyday activities.

One tried-and-tested technique for reducing pain and inflammation around affected joints is to use temperature therapy. Cryotherapy, or ice therapy, is suggested as colder temperatures reduce the blood flow to the problem area and thus lessen swelling in the surrounding tissue. It is recommended that, on the first day pain is experienced, you should ice the area every hour for 15 minutes, reducing this to four or five times the next day, and each successive day that the pain remains. If the pain is caused by stiffness rather than inflammation, heat therapy can be used to relax the muscles and to warm up the joints so that they move more smoothly. Hydrotherapy with warm water will ease

pressure on the joints, and immersing the affected area while massaging it will stimulate blood flow to the area.

Often chronic joint pain is caused by the breakdown of protective cartilage over time. This can be counteracted to a certain extent by increasing intake of vitamin D, which is needed to help the body absorb calcium to strengthen bones. Increasing vitamin C levels can also be beneficial as it is a key component in making the cartilage that cushion the bones, and as such may reverse some of the damage. Diet plays a large role in join pain, and reducing sugar intake is an effective step to maintaining healthy joints as, if too much sugar is consumed it can begin to bond to proteins in a process known as glycation and can cause further weakening of the bones and joints.

Temporary relief from joint pain can be obtained with pain killers, however, there is also a whole range of more natural home remedies that have been suggested as having pain-alleviating properties. For reducing inflammation around the affected joints, turmeric and ginger tea may prove an effective solution. Turmeric contains an antioxidant called curcumin while ginger is high in compounds known as gingerols. Both of these active substances are known to be anti-inflammatory and as such can reduce painful joint swelling. For pain relief try taking a magnesium supplement or soaking the painful area in Epsom salts, which contain magnesium sulfate. These are effective natural pain relievers as magnesium relaxes muscles and nerve endings while also helping bones to mineralize, making them stronger.

To a certain extent bone deterioration and resulting joint pain is unavoidable, as natural processes weaken them with age. Nonetheless, there are steps that can be taken to keep bones as strong as possible, reducing joint pain to a minimum.  

How does insomnia affect the body?

 Anyone who has had a sleepless night can attest to the fact that they don't feel 100% the next day. However, could lack of sleep be having more effect on the body than just leaving a feeling of tiredness?

The brain is the part of the body that is more dramatically affected by insomnia, and many of its everyday functions are inhibited by insufficient rest. While tests have shown that short-term memory on the whole is unaffected by insomnia, those who suffer from it may have a less active working memory, the part of short-term memory involved with processing and storing information and applying it to a task. fMRI scans showed that those with insomnia had lower activity levels in brain regions involved with this working memory compared with control subjects. As well as impacting everyday thinking, lack of sleep can also result in a slowing of mental processes, reduced concentration and, in cases of extreme sleep deprivation, can restrict the transformation of short-term term memories into long-term memory. As well as reducing the efficienct of the brain, a state of prolonged wakefulness means that activity levels of the emotion-processing part of the brain, the amygdala, rise. This increased activity can cause insomniacs to experience higher levels of frustration and anger throughout the day

Over time sleep deprivation can begin to affect hormonal processes, which can further impact sleep quality. Secretions of the stress hormone cortisol rise, resulting in higher levels of anxiety and a faster heart rate. During normal sleep, a hormone is secreted which suppresses feelings of hunger. When sleep is reduced there is more time for the body to produce ghrelin, the hunger hormone, meaning insomnia patients experience heightened appetite. In order to quickly boost energy levels, the body craves foods with a high sugar or salt content, resulting in an observed link between insomnia and obesity.

As sleep cycles become irregular the body's circadian rhythm is affected, meaning that those suffering from too little sleep are likely to experience more erratic peaks and troughs in their energy levels. It is normal to experience a period of lethargy during the day, however, for insomniacs this period is prolonged, making it harder for them to stay awake in the afternoon. At the other extreme, insomniacs may experience stretches of feeling excessively alert, as they become focussed on the pressures of the day and heart rate and adrenaline levels are maintained at a high level.

In the long term, long periods of limited sleep can have drastic effects on the body and a person's performance during activities. If insomnia persists it is important to see a doctor, who can provide advice or medicinal aid for returning to a normal sleeping pattern, giving the body time to repair and relax.

Sleep Science – The Mechanisms Behind Insomnia

 Everyone is prone to a sleepless night or two, brought on by excitement or stress. However, for some, lack of sleep can last for weeks, sometimes months. Sustained sleep-deprivation is something that is estimated to affect between 20% and 50% of adults. Much work has gone into researching not only how to cure insomnia but also what the mechanisms are that cause it.

The 3 P's of Insomnia

A popular explanation for this sleep disorder looks at three key factors – predisposition, precipitation, and perpetuation. Advocates of the 3-P Model believe that insomniacs have certain characteristics, such as being naturally anxious or being perfectionists, that make them more susceptible to sleep problems. This predisposition, combined with a precipitating event, such as a death of a loved one or job stress, can affect sleep resulting in a period of acute insomnia (short-term sleep loss). The third facet of this model is that anxiety about, and poor attitudes towards, sleep will perpetuate the symptoms of insomnia. This is because, the more uneasiness a sufferer feels about falling asleep, the more active their brain will be, resulting in them actually staying awake for longer.

The Cognitive Processes of Sleeplessness

This idea of perceptions of how one will sleep feeds into the Cognitive Model of insomnia, an idea put forward over ten years ago. The simple concept is that those suffering from insomnia worry about their sleep and what will happen if they don't get enough. These thoughts actually trigger emotional stress and brain activity which causes the individual to search themselves and their surroundings for factors that could interrupt their sleep, such as noise, light, or discomfort. In the process of focussing on these things they actually bring themselves back into a state of full wakefulness, as the brain isn't allowed to wind down. By actively focussing on the act of falling sleep, insomniacs delay it, by maintaining the brain in a state of awareness.

The Brain Chemistry of Insomniacs

Related to the Cognitive Model, but taking a more in depth stance, the Neurocognitive Model of sleep deprivation explores how brain activity may differ between those with regular sleeping patterns and those without. Scientists have observed that those suffering from acute insomnia actually have higher levels of electrical activity in the brain than those who don't suffer sleep problems. The result of this could be that insomnia sufferers may have higher sensory or information processing activity during times when those with regular sleeping patterns don't. This could have drastic effects on a person's ability to fall asleep, as they are more aware of what is happening around them.

The role physiological factors has been more thoroughly researched, as it has come to be believed that insomniacs may have innate characteristics that affect how easily their sleep is disrupted by both external and psychological factors. Elevated levels of brain metabolism have been observed in studies of insomniacs, making it harder for them to switch off at night. Furthermore, it has been seen that patients with insomnia secrete less melatonin at night, the hormone responsible for making us feel tired. This, combined with the observed increased levels of norepinephrine, a hormone similar to adrenaline, in insomniacs have the debilitating effect of making it much harder to fall asleep.

Thankfully, as insomnia becomes better understood, more techniques and medical interventions are being developed to cure it.

Olympic-Level Care With Dr. Gerardo E. Miranda-Comas

This week Mount Sinai is proud to introduce you to Assistant Professor of Rehabilitation Medicine, Dr. Gerardo E. Miranda-Comas. Trained in Physical Medicine and Rehabilitation, Dr. Miranda-Comas has sub-specialized in Sports Medicine, with a clinical focus on a vast range of sports-related injuries. His medical interests include the diagnosis and non-surgical management of musculoskeletal injuries, sport-related injuries, exercise prescription, electrodiagnosis, regenerative medicine, and diagnostic-therapeutic musculoskeletal sonography. With every injury case, Dr. Miranda-Comas believes that the best intervention lies in increasing patient awareness and education, and he aims to aid early return to function, and improvement in the patient's quality of life.

Dr. Miranda-Comas' interest in sports medicine began while completing a fellowship in the field at the University of Puerto Rico School of Medicine. Since then he has been involved in sports medicine at every level, being invited to lecture at scientific meetings at both national and international levels, as well as having published many articles on the subject. His interest in sports stretches beyond his professional life, to his involvement in covering sporting events from high school-level, right through college sports and up to elite-level events.

A true testament to his expertise within the field, Dr. Miranda-Comas was selected to be a member of the medical team at the 2016 Olympic and Paralympic Games in Rio. Only the best physicians are selected to become a member of the Olympic medical team, following a long application process, and are required to have an intimate and expansive knowledge of athletic injuries. However, this is not the only mass participation event that Dr. Miranda-Comas has contributed his medical knowledge to, being present in a professional capacity at both the New York City Marathon and the Pan American Games.

On top of his real-world experience with sports injuries, Dr. Miranda-Comas has earned four board certifications in Physical Medicine and Rehabilitation, Sports Medicine, Electrodiagnostic Medicine, and Musculoskeletal Ultrasound. Holding roles as the Associate Program Director of the Mount Sinai Sports Medicine Fellowship, and as a core member of the of the Physical Medicine and Rehabilitation Program faculty, Dr. Miranda-Comas is extremely qualified to treat a range of sports-related complications. But don't take our word for it – take a look at his customer experience rating of 4.8 out of 5 stars on our website as a true testament to his knowledge and skill in the field!

To book a consultation with Dr. Gerardo E. Miranda-Comas, request an appointment here

Our Tips for Reducing Back Pain

 Back pain can be debilitating and leave one feeling like they cannot do everyday activities. Before seeking surgical solutions, there are a range of activities that may help alleviate the pain, and get you back to moving as normal.

Pain Relief – As a first port of call, and as a short-term solution pain killers can reduce suffering. To counteract swelling and inflammation cold packs can be beneficial while hot packs work to lessen tension, cramping and muscle spasms.

Manual Therapy – This method involves a therapist using their hands to massage, gently move, and apply careful force to the muscles, bones and joints of the spine. This removes tension in the muscles and encourages them to relax though it will only be effective if used alongside other measures, such as those listed here.

Exercise and Stretches – Traditional thinking is that in order to fix back pain bed rest is the best option. It has since been found that it is better to remain active, to retain muscle strength and flexibility. At first avoid any heavy-duty weight bearing exercises and opt more for gentle stretches and yoga. Exercises that lengthen out back muscles, such as back-bends and the cat-and-camel move, are the best for reducing pain.

Aquatic Therapy – If exercise exacerbates back pain at first, this can be countered in aquatic therapy. This involves gentle movement in a pool. The buoyancy of the water helps to remove strain from the joints, putting less pressure on the back, while the warmth of the water can help increase blood circulation, relax the back muscles, and remove tension.

Electric Stimulation – It has been seen that mild electrical currents can reduce perception of back pain. Electric stimulation involves using a Transcutaneous Electric Nerve Stimulator (TENS) machine to send low-voltage electrical currents to the body, through electrodes placed on the back. The exact mechanisms of this therapy are unknown, but one hypothesis is that the currents work to scramble pain messages to the brain, so the brain does not process them. An alternate idea is that the electrical impulses stimulate the body to release endorphins which override the sensation of pain.

For the most effective recovery it is recommended that a combination of these techniques is used. Some, such as pain relief and manual therapy, only alleviate pain in the short term, and so it is necessary to combine them with other techniques, such as stretches, for long term improvements.  

Introducing Our Director of Brain Injury Research - Dr. Dams-O'Connor

 This week we are introducing Dr. Kristen Dams-O'Connor, the new director of the Brain Injury Research Center of Mount Sinai who specialises in traumatic brain injuries (TBI), and more specifically, the recovery process of TBI patients.

When beginning college at Colgate University, Dr. Dams-O'Connor intended to major in international relations; however, after taking an introductory course in neuroscience she was hooked, and chose instead to major in this field. Her research began in controlled laboratory experiments and she fell in love with the accuracy and certainty with which she could observe cause-and-effect relationships in her studies.

Following her undergraduate degree in neuroscience, Dr. Dams-O'Connor decided to do further studies in psychology so she could work more closely with patients who were living with neurological diseases. During her doctoral studies she worked at a clinical site for three years at the University at Albany , participating in programs that helped people with devastating brain diseases live more productive and meaningful lives.

Moving to New York, she carried out an internship in neurorehabilitation at the Rusk Institute of Rehabilitation Medicine at New York University Medical Center. On completion of the internship she progressed to a fellowship in Clinical Neuropsychology at Mount Sinai. During this Dr. Dams-O'Connor began to focus her research more on TBI, taking an interest in the heterogeneous nature of these injuries, with no two cases being alike. This variability allowed her to apply her knowledge of empirically supported neurobehavioral interventions to unique individual cases.

Today, as well as being a director, Dr. Dams-O'Connor is also an Associate Professor in the Department of Rehabilitation Medicine at the Icahn School of Medicine, and the Director of Research. She is PI of two grants from the National Institutes of Health and Co-Project Director of the New York Traumatic Brain Injury Model System which, as well as carrying out research on brain trauma, also provides emergency medical services, acute care, rehabilitation services, and long-term outpatient care. In her career to date she has published over 60 peer-reviewed manuscripts and chapters on traumatic brain injuries, their treatments, and outcomes and her work is internationally recognised. In her current research Dr. Dams-O'Connor works primarily on studying the long-term outcomes of brain injuries including clinicopathological signatures of TBI. A key interest of hers is understanding why some patients display a full recovery after their injuries while others partially recover before regressing later in life.

You can read more about the Brain Injury Research Center here - www.tbicentral.org