An emerging specialty at University Hospitals Geauga Medical Center, Physical Medicine and Rehabilitation puts the focus on helping patients improve their quality of life

By Laura Briedis

Medicine doesn’t always center on a cure, as a growing medical specialty—Physical Medicine and Rehabilitation (PM&R)—puts the focus on helping patients improve their quality of life. Though PM&R was identified by the American Medical Association as a board-certified specialty in 1947, it is still an emerging medical field. At University Hospitals, it is a division of the Department of Orthopedics, and there are multiple outpatient physician offices that offer this specialized care, including UH Geauga Medical Center.

Called physiatrists, or PM&R doctors, these physicians help patients who have pain, weakness, numbness or other functional issues stemming from an injury or illness that prevents them from leading active independent lives.

“Our goal is to maximize physical function, decrease pain, foster independence and improve the quality of life for our patients,” says Dr. Yevgeniya Dvorkin Wininger, a physiatrist at University Hospitals Geauga Medical Center, a Campus of UH Regional Hospitals.

“We focus on function—whether that be neurological deficits, musculoskeletal deficits or issues that arise from cancer and cancer treatments,” she says. “Within PM&R there is a subspecialty called cancer rehab that focuses on these issues as a result of cancer or cancer treatments such as surgery, chemotherapy and radiation. We also diagnose and treat impairments with modalities that include rehabilitation, medication, injections and adaptive equipment, to name a few.”

A graduate of Case Western Reserve University School of Medicine in 2011, Dr. Dvorkin completed her residency at University of Pittsburgh Medical Center and a fellowship in cancer rehabilitation at Memorial Sloan-Kettering Cancer Center in New York. She joined University Hospitals last fall and now shares her expertise in Physical Medicine and Rehabilitation with residents in Geauga County. In essence, she helps put the pieces of a person’s life back together after a disease or injury.

“I work with a lot of patients with a cancer diagnosis, whether during treatment or after treatment, to improve their function and quality of life,” Dr. Dvorkin says. “Oftentimes my patients have neuropathy, lymphedema, and musculoskeletal issues such as shoulder and back pain or knee and leg pain that started during cancer treatment. I also work with patients who have had prior musculoskeletal issues that have worsened during their treatment.”

“Patients who have cancer or other medical issues sometimes think this is the new normal, but there are many things we can do to improve their quality of life during treatment and into survivorship,” says Dr. Dvorkin, who is fluent in both English and Russian. “I can work with patients at time of diagnosis, through treatment and into survivorship. The earlier I can see a patient with an impairment the sooner it can be addressed, leading to improved function.”

Dr. Dvorkin works with each patient to develop patient-centered goals. “I help determine what impairments they have and what they want to be able to do but cannot do at the time. I help determine how to overcome any pain or weakness so they can reach their goals,” she says. “For example, if I see a patient who has a hard time walking I will try to determine if it is from neuropathy from chemotherapy, from a knee or back issue, or all of the above, and we will address all of these things so they feel more confidence, more stability and less pain when walking and doing things they enjoy. Another example is chest wall or breast pain after breast cancer and surgery or radiation. This also often affects shoulder and neck range of motion, and restriction can cause pain or exacerbated underlying shoulder or neck problems.”

Always a team approach, the physiatrists collaborate closely with specialists in UH Rehab Services (Physical Therapy, Occupational Therapy and Speech Therapy), the UH Neurological Institute, UH Spine Institute, UH Drusinsky Sports Medicine Institute, trauma surgery, and other medical and surgical programs to offer a multidisciplinary approach aimed at restoring optimal, or prior, level of functioning.

“I’m here to treat any impairments caused by cancer or any other medical issues, so patients can improve their function, and thus their quality of life,” Dr. Dvorkin says.

University Hospitals Geauga Medical Center is located at 13207 Ravenna Road, in Chardon. For more information, call 216-285-4390 or visit UHhospitals.org/Geauga.