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Shepherd Center Cultivates a Community of Care

Shepherd Center’s Outpatient Services offers coordinated, lifelong care for patients with complex conditions and injuries.

When Carla White, 42, walked into the emergency department at her local hospital on Jan.12, 2016, she had no idea it would be the last time she would be able to walk for another 10 months.

She came in with numbness in her legs, referred there by her doctor who had ordered an MRI just two days before. After a thorough exam, a radiologist told the Atlanta native that she had transverse myelitis, an inflammation of the spinal cord. The doctor would call soon, the radiologist told Carla. In the two days between the exam and her doctor’s call, the numbness had spread from her legs to her hips. He told her to go to the ER immediately. In the five hours she waited before being called back to the exam room, her situation had changed drastically, yet again.

“I told my mom, ‘I can’t get up,’” Carla recalls.

It wasn’t her first time dealing with a serious medical condition. Diagnosed with lupus in 1997, Carla had learned how to manage her health. But, this was Carla’s first experience with paralysis. Over the next week in the hospital, the numbness moved into Carla’s chest. After a week in the hospital – and a strong course of steroids – Carla transferred to Shepherd Center’s Spinal Cord Injury Rehabilitation Program, where she stayed for a month. That May, she became a patient in Shepherd Center’s Multi-Specialty Clinic, one of Shepherd Center’s outpatient clinics.

Every year, more than 6,600 people visit one of Shepherd’s seven outpatient clinics, which include the Multi-Specialty Clinic, Andrew C. Carlos Multiple Sclerosis Institute, Shepherd Spine and Pain Institute, Upper Extremity Clinic, Urology Clinic, Wound Care Clinic and the Complex Concussion Clinic, which assists in the estimated 20 percent of concussion cases where the client needs more care than his or her primary care physician can provide. Shepherd Center’s outpatient clinics include a powerful mix of highly specialized physicians, physician’s assistants, nurse practitioners, nurses, medical assistants, case managers, therapists and neuropsychologists.

At-a-Glance: Outpatient Services at Shepherd Center

The Multi-Specialty Clinic offers clients expertise in treating and managing secondary complications – such as pressure sores, respiratory concerns or spasticity – associated with complex injuries over the span of a lifetime, says Angela Beninga, D.O., a physiatrist and director of Shepherd Center’s Spinal Cord Injury Day Program.

“This level of expertise continues into their long-term care, which can extend out five, 10, 20 years or more after the injury,” Dr. Beninga says.

Carla, who sees Dr. Beninga in the Multi-Specialty Clinic, is paralyzed from the waist down. But with hard work and the help of her care team, she has been able to regain the ability to walk.

“She’s been doing very well,” Dr. Beninga says. “She’s been very active in her healthcare, and that helps a lot.”

Being an active participant in their healthcare is key for patients.

“We strive to make patients independent,” says Emily Cade, director of Outpatient Services at Shepherd Center. “You are more than your diagnosis, and we are here to lend a hand and to help you get where you want to be with your life.”

Erin Boyt, who is a patient at the Andrew C. Carlos Multiple Sclerosis Institute at Shepherd Center, can attest.

“The clinicians and the therapists all take time to work with you and find out what your goals are,” Erin says. “I’ve found that across the board, from the doctors, the nursing staff and the rehabilitation professionals. It’s very different from what I’ve seen elsewhere.”

Erin first came to the MS Institute in 2002.

“One of the big things that I have found at Shepherd Center is that the doctors are treating the whole illness, not just the symptoms,” the 42-year-old from Lawrenceville, Georgia notes.

Erin has received help from doctors and therapists throughout the clinics, including the Shepherd Spine and Pain Institute, to help with nerve pain. She’s also received speech therapy, cognitive therapy and occupational therapy at Shepherd Center.

“At Shepherd Center, they all listen to you,” Erin says. “You’re not just told what to do. You’re a partner in your care.”

Shelley Mitchell, a case manager in the Multi-Specialty Clinic, Wound Clinic, Urology Clinic, and the Spine and Pain Institute, says that’s vital.

“My personal philosophy is self-advocacy,” Mitchell says. “I want to teach my patients to advocate for themselves and be active in their own care.”

“There’s a lot of support and encouragement from the staff for me to be the driver of my disease, so to speak,” Erin says. “I’m given the opportunity to be a part of the decision-making process. That doesn’t happen in a lot of practices that I’m familiar with. A lot of time they just tell you what to do, and that’s it. You don’t get to ask questions. You don’t get to pursue different avenues. At Shepherd, I find that they all want to work with you.”

In addition, having all of the outpatient centers located in one location allows continuity of care.

“Shepherd has such a multitude of world-renowned specialists and technology, and it’s all in one place,” Carla says. “You don’t have to go from one facility to another across town.”

That’s also important because it allows the medical staff to regularly confer with one another about their patients, Dr. Beninga notes.

“Not only do we share the same information system containing details on treatments, medications and physician recommendations, but I can just walk down the hall to talk to another clinician about a patient,” she adds.

As one of Shepherd Center’s earliest patients, Andy Byrd, of Walnut Grove, Georgia, has experienced the continuum of care. Since sustaining a C-5 to -6 incomplete spinal cord injury in a diving accident in the mid 1980s, he’s received care at the Wound Clinic, the Urology Clinic and the Multi-Specialty Clinic.

“They’re very personal and always glad to see you, so when you’re there, you always feel like you’re in good hands,” Andy, now 60, says. “They always ask about your needs, and they’re open to hearing what you have to say, no matter what it is.”

It’s not just the clinicians who make a difference, Erin says. It’s also the guidance she receives from the case managers.

“When I was first diagnosed with MS, I was working full time and was encouraged to keep working as long as I could,” Erin explains. “Eventually, I had to take disability, and the case managers at Shepherd helped me through that, too.”

Case managers guide the patients through their care at the outpatient clinics, help patients live successfully with their condition and encourage engagement in the community, be it vocational or recreational.

“We want to foster your independence,” Cade says. “And we really believe in that part of our mission.”

Though many patients come to Shepherd Center’s Outpatient Services Department through their experience with the inpatient programs, for others, Shepherd’s outpatient services are a point of entry.

“We see people who never got to come to Shepherd as an inpatient,” Mitchell says. “Once they get a taste of what Shepherd is, they feel it’s a great thing.”

Case managers, like Mitchell, stress that it’s important for patients to stay connected to Shepherd Center throughout the year, or at least once per year, so the treatment team can stay up to date on medical conditions, offer referrals and maintain prescriptions. If a patient doesn’t live close by, case managers encourage them to stay connected to their primary physician back home. For many, staying in touch requires no convincing.

“Shepherd is an amazing place,” Erin says. “It’s a place you can’t truly know until you come through those doors. And although you never want to have to go to a hospital, if you do have to go, you’ll see that the people at Shepherd are just like family, and when you leave, you really do miss seeing them all.”

At-a-Glance: Outpatient Services at Shepherd Center

The Multi-Specialty Clinic provides a comprehensive care program for treating the secondary conditions of patients who have experienced traumatic and non-traumatic spinal cord injury and/or acquired brain injuries. Our comprehensive team includes physicians, nurse practitioners, nurses, medical assistants and case managers who help coordinate your care. To make a new patient appointment, call: 404-350-7602. 

Shepherd Spine and Pain Institute believes it takes a comprehensive treatment plan to effectively and successfully manage pain. Our practice model is geared toward treating both the physical and emotional components of pain to restore and maintain function and improve quality of life. We use the latest imaging technology to establish a precise diagnosis, treating pain at its source and providing a comprehensive rehabilitation plan to ensure the best possible opportunity for long-term improvement. We offer acute and chronic pain management and rehabilitation for spine, joint and other pain-related conditions. To make a new patient appointment, call: 404-603-4203. 

The Andrew C. Carlos Multiple Sclerosis Institute has extensive experience treating people with multiple sclerosis (MS), suspected MS or related disorders. The MS Institute at Shepherd Center has treated thousands of people with MS using a wide range of neurological and rehabilitative services. This comprehensive program offers treatment through FDA-approved medications, research opportunities, a rehabilitation and wellness program dedicated to individuals living with MS, as well as neuropsychological services. To make a new patient appointment, call: 404-603-4962. 

The Wound Care Clinic offers a comprehensive wound care program for patients in the community who have experienced a wound, which may require surgery. Our comprehensive team is able to assess the condition and determine what path may be best to promote healing. While our goal is to decrease surgical and hospital admissions, at times, patients may require surgical intervention. Our clinic is able to coordinate that process and works to insure a positive experience for the patient. To make a new patient appointment, please have your physician fax a referral including demographics and wound information to 404-603-5070. 

The Upper Extremity Clinic offers a comprehensive therapy and treatment program to improve upper-extremity function for people with catastrophic injuries who have limited function in their arms, wrists and hands. This comprehensive team is comprised of orthopedic upper-extremity and hand surgeons, occupational or physical therapists, a nurse, medical assistant and case manager who coordinate your care during the process. To make a new patient appointment, call 404-350-3102.

The Urology Clinic offers outpatient urological services to patients who are experiencing urological issues. Our urologists and staff perform clinic visits and offer procedures, including suprapubic catheter placement/change, Botox injections and urodynamics. To make a new patient appointment, call 404-352-2020. 

The Complex Concussion Clinic offers comprehensive assessment and treatment by a team of specialists in neurology, vestibular and balance disorders, athletic training, rehabilitation medicine, neuropsychology and neurosurgery for the patient with concussion-related complications that fall beyond the scope of their primary treating doctor. To make a new patient appointment, call 404-603-4980. 

Written by David Terraso
Photos by Louie Favorite

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.