By Becky Wiese
Dr. Ann Stroink’s vision for bringing neurosurgical care to Bloomington-Normal and the surrounding central Illinois communities began in 1985 when she established her practice on Franklin Avenue. “There had never been a neurosurgical practice established here,” she recalls. “And people were dying from things like stroke, brain tumors, and neuro trauma because of it. I simply wanted to serve the community that had raised me.”
Her vision for providing the best neurosurgical care through the evaluation and treatment of neurological disorders by physicians who are similarly dedicated to this community has continued to expand over time and will “carry the legacy going forward.”
Central Illinois Neuro Health Sciences (CINHS) now provides comprehensive care for both pre- and post-surgical treatment with diagnostic imaging tools, surgical expertise and enhancements, and physiatry and physical therapy services to help relieve pain without surgery when possible and speed recovery when surgery is the best answer.
The goal has always been to provide the best neurosurgical care; the ways of doing so have evolved and grown over time so that patients experience the benefit of the comprehensive range of services provided literally within the CINHS facility itself, with the network of specialists and care providers throughout the community, and most of all, through the compassionate care and individualized attention provided to each patient.
Neurosurgery: The Foundation
The foundation of the practice is, of course, neurosurgery, a term which covers surgical procedures for everything from carpal tunnel to complex spine and brain tumors. The team of neurosurgeons at CINHS includes Dr. Ann Stroink, Dr. Emilio Nardone, Dr. Jason Seibly, and Dr. Charles Rosen.
In general terms, neurosurgeons evaluate and treat all parts of the nervous system’s anatomy, meaning the structural problems, found in the spine, brain, neck, and extremities. Neurosurgical procedures are also used for treating seizure disorders, brain or spinal tumors, herniated discs, aneurysms, carotid stenosis, vascular lesions, and trauma to the brain or spine.
While each board-certified neurosurgeon has similar skills and education, their different backgrounds as far as training and specialties and “passion” areas provide patients with a distinct benefit. Dr. Stroink has a passion for treating neurological trauma, spinal disease, and brain tumors. Dr. Charles Rosen, who joined the practice in April, offers a skill set that fills in nuances that weren’t previously represented, such as cranial base surgery (tumors in unusual or hard to reach places in the skull), vascular surgery (carotid artery and vascular lesions), and Chiari malformations.
“It also helps the practice to have a diversity of training,” Dr. Rosen states. “Patients get multiple opinions for free because cases are discussed among the surgeons, each coming from a different training background and programs.”
Dr. Rosen’s educational path is unique: He holds a Ph.D. and a master’s degree in addition to an M.D. He also came from an academic background, serving as Department Chair of Neurological Surgery at West Virginia University (WVU) School of Medicine. All of this in addition to seven years of training in neurosurgery.
Dr. Emilio Nardone, a 19-year neurosurgical veteran on the CINHS team, agrees that the comprehensive approach to neurosurgery at CINHS is beneficial to patients. “We have physicians with different interests and experience — so we cover the whole spectrum, including tumors, functional issues, vascular concerns — we now offer help for patients with Parkinson’s disease.” Dr. Nardone’s areas of interest are brain and spine tumors, as well as minimally invasive spine surgery.
Recent changes in the procedure for deep brain stimulation (DBS) for Parkinson’s patients appealed to Dr. Jason Seibly, who joined the practice in 2008 after completing the neurosurgical residency program offered through CINHS. Deep brain stimulation involves a process by which electrical pulses are sent to the areas of the brain that control involuntary movements. While not a cure for the disease, DBS can improve quality of life for patients by lessening the symptoms and allowing for a decrease in medication. Dr. Seibly also has special interest in brain tumors, spine surgery, and carpal tunnel syndrome.
Technology has played a significant role in the progress made over the past 30-plus years regarding neurosurgical advances. One of the biggest is surgical navigation — using computers and other high-tech instruments that allow surgeons to be more accurate and perform intricate procedures — even those once considered to be “risky”— more safely and with less damage to surrounding structures and tissues.
Hand-in-hand with surgical navigation is minimally invasive surgery, which involves performing surgery with several small incisions instead of a large incision. “Minimally invasive surgery allows us to accomplish the same result that previously involved a large incision and accompanying damage to muscle, bone, and ligament. Now we use small incisions, so there is less soft tissue damage and less damage to surrounding structures,” explains Dr. Nardone. “This decreases the chance of needing further surgery, decreases post-op pain, recovery time, length of hospital stay, and the time it takes to return to normal activities and work.”
Before Surgery: Diagnostics and Non-Surgical Strategies
Of course, before the surgery is even considered, the correct diagnosis must be made. And to make a correct diagnosis, the physician/surgeon needs to “see” exactly what is going on inside the patient — that is, they must have an accurate picture. Enter the team from Diagnostic Neuro Technology (DNT), the in-house imaging team that provides detailed and crucial information for the doctors to use in making a diagnosis and offering subsequent care options for patients at CINHS.
Improved patient care was one of the main reasons for establishing an in-house diagnostic imaging center, according to Dr. Stroink. “Patients could go wherever to have an MRI done, but the lack of good communication and oversight regarding exactly what the surgeon needed to see made for fragmented information.” For example, monitoring the size of a brain tumor over time — meaning several scans’ worth of information — is much easier when the surgeon can study all the scans over time, not just the most recent one or two.
To get that information, DNT uses machines that will deliver images the doctors need to decide next steps. These include a short-bore, 1.5T MRI scanner for detailed pictures of internal organs and structures and X-ray for seeing hard structures such as bone as well as some soft tissue.
Armed with these details, the surgeons discuss the patient’s history and symptoms with each other as well as with Dr. Won Jhee, a physiatrist with Bloomington Rehabilitation Associates (BRA). Like the diagnostic team, BRA shares the same physical space as CINHS, making communication among all the team members much easier, as well as making it easier for the patient to see all the members of the health care team in one stop.
Dr. Jhee has been associated with CINHS for more than 20 years. His role as a physiatrist (a specialist in physical medicine and rehabilitation) includes helping make a proper diagnosis in order to develop appropriate treatment options through a physical exam, review of previous test results, and ordering additional tests as needed.
At times, more conservative treatment (non-surgical) may be appropriate. “If we treat a patient with non-surgical methods and the patient improves, then surgery is not needed. If not, surgery is the next step,” Dr. Jhee explains.
After Surgery: Recovery and Rehabilitation
Dr. Jhee serves as a case coordinator for the patient to the rest of the CINHS team. He works with everyone, from the medical team — the surgeons, nurses, other specialists, physical and occupational therapists, social worker — to the insurance company, employer, family members, and of course, the patient.
The collaborative efforts and more organized comprehensive care provide a more streamlined flow of information and feedback which serve to provide the best care for the patient. The patient doesn’t have to feel responsible for sharing complex or confusing medical information, and the care providers get the details they need from other health professionals to make next-step decisions based on the individual’s needs. Overall, the process provides better care for the patient. “The physiatrist gives the full picture of treatment and rehabilitation, which is especially important for specific occupations,” adds Dr. Stroink.
One specific type of care that has recently been added to the CINHS on-site team is physical therapy services. In the past, physical therapy was more piecemeal — getting specific information from the physician for physical therapy and then feedback from the therapist was not always clear or easy. “Now, with the service in the same facility, physical therapy is included in the treatment plan more comprehensively,” says Tim Highland, physical therapist.
“The focus is more streamlined — we have more interaction with the doctors and have access to each other’s notes and can monitor progress more easily,” he goes on to say. This new piece of the puzzle adds clarity to everyone’s picture of the patient’s status—knowing more about the patient’s case prior to their first PT session helps them be more effective and efficient and more specific with their physical therapy treatment plan.
“Working under the same roof gives everyone a better understanding of how the patient is progressing,” says Highland. “We have a better relationship and communication with the doctors, which lets us better help the patients.”
Dr. Stroink agrees, adding that the “face-to-face interaction between care providers allows for much better communication — more than what is possible through case notes or electronic communication. It lets us add a more personal touch, and the give and take in conversation helps narrow down differentials to get an accurate diagnosis.”
Providing excellent neurosurgical care to the residents of central Illinois by creating a team of highly skilled surgeons covering the spectrum of neurosurgical needs is the foundation of Dr. Stroink’s vision.
“The more integrated and comprehensive the care in an environment, the better chance a patient has of successfully navigating their health care,” says Dr. Rosen. The future for CINHS will continue to be patient-focused. “Times are changing as far as health care goes,” says Dr. Stroink. “We don’t want to see patients lost in those changes. We want to make sure people get good care — because, in reality, it’s all about the patient.”
Central Illinois Neuro Health Sciences is located at 1015 S. Mercer Ave. in Bloomington. For more information or to schedule a consultation, you may contact them at 309-662-7500 or through their website, www.cinhs.com.