Spinal Cord Injury Care Line

The Houston Spinal Cord Injury Care Line is the spinal cord center for the Veterans Integrated Service Network 16 (VISN 16). It is located on the first floor of the Houston Veterans Affairs Medical Center at 2002 Holcombe Boulevard, Houston, Texas, 77030. The service includes forty inpatient beds on Nursing Units 1A and 1B, the Spinal Cord Injury Outpatient Clinic, the Spinal Cord Injury Home Care Program, Occupational Therapy Clinic, Physical Therapy Clinic, Kinesiotherapy Clinic, Urodynamics Laboratory, Therapeutic Pool and Transitional Living Apartment.

The Spinal Cord Injury Care Line at the Houston Veterans Affairs Medical Center provides comprehensive rehabilitation services and sustaining medical care for veterans with spinal cord injury or dysfunction. Sustaining medical care includes preventive care, treatment of acute illnesses and treatment of medical and surgical complications related to spinal cord injury/dysfunction.

MISSION
The mission of the Houston Spinal Cord Injury Care Line is to restore and maintain maximal health, independence, productivity and quality of life in persons with spinal cord injury/dysfunction. This is achieved in an interdisciplinary continuum of care, from the delivery of acute rehabilitation through primary, secondary and tertiary care of medical, surgical and rehabilitative disorders that arise throughout the lifespan of the person served.

The Houston Spinal Cord Injury Care Line is also dedicated to providing clinical and research training opportunities in the care of persons with spinal cord injury/dysfunction.

SCOPE OF SERVICES
A broad array of services is available to all patients admitted to the Spinal Cord Injury Care Line, determined by the individual's needs. They may include:

The core interdisciplinary treatment team consists of an SCI staff physician and resident physician, psychologist, case manager, nurses, occupational therapist, physical therapist, kinesiotherapist, recreation therapist, dietician, pharmacist and social worker.

Multidisciplinary support is obtained on a consultative basis from a broad array of services, but most frequently includes Urology, Plastic Surgery, Plastic Hand Surgery, Orthopedic Surgery, Neurosurgery, Infectious Disease, Respiratory Therapy and Vocational Rehabilitation.

SCI Physician - A physiatrist with special interest and training in the medical and rehabilitative management of persons with neurologic impairment due to spinal cord injury/dysfunction. A physiatrist is a physician who specializes in disorders of the neuromusculoskeletal system, with the goal of reducing an individual's disability, and maximizing functional independence.

Psychologist - Specializes in assisting the patient and family members or significant others overcome personal and social problems that may be interfering with maximal functioning.

Case Manager - Coordinates and facilitates the patient's treatment plan that is generated by the interdisciplinary team, and serves as the patient's advocate as a member of that team.

Nurses - Provide day to day care and train the patient, family and significant others in self care, especially in regards to bowel, bladder and skin care.

Occupational Therapist - Works with the patient to achieve maximal independence in activities of daily living (such as bathing, dressing, cooking, etc) by improving strength, range of motion and prescription of appropriate assistive devices.

Physical Therapist - Works with the patient to achieve maximal functional mobility (such as bed mobility, transfers, wheelchair mobility and gait) through exercise, muscle re-education and modalities.

Kinesiotherapist - Works with the patient to achieve maximal functional mobility (such as bed mobility, transfers, wheelchair mobility and gait) through exercise and muscle re-education. Other programs include pool therapy and driver's training.

Recreation Therapist - Works with the patient to achieve social/community reintegration through leisure and athletic activities as well as social and community interactions.

Dietician - Works with the patient to achieve optimal caloric intake to maintain ideal body weight in light of alterations in activity and reduced muscle mass. Also adjusts diet to maintain proper bowel and bladder function.

Pharmacist - Works in educating the patient about the uses and potential side effects of their medications, and with the treatment team to minimize the possibility of drug interactions.

Social Worker - Works with the patient to apply for benefits to which he/she may be entitled, and to plan for re-entry in the community in terms of housing, school, work and attendant/nursing needs.

Respiratory Therapist - Works with patients who require supportive care for their breathing, including patients with tracheotomies or ventilator dependence, and those needing extra pulmonary support through acute illnesses. They also provide training in the use of various equipment and supplies that may be needed at home.

Vocational Counselor - Works with the patient in the development of vocational and/or educational plans with specific regard to the individual's impairments, disabilities and handicaps. Also refers patients to appropriate agencies that may assist further with these plans.

Urologist - A surgeon who specializes in the management of the urinary tract system (the kidneys and bladder).

Plastic Surgeon - Specializes in reconstructive surgery. After spinal cord injury/dysfunction, this most commonly includes flap coverage for pressure ulcers, and tendon transfer procedures to enhance hand function.

Orthopedic Surgeon - Specializes in surgical and nonsurgical management of disorders of the musculoskeletal system. After spinal cord injury/dysfunction this can include spine stabilization, management of chronic shoulder pain, carpal tunnel syndrome, fractures, and problems of excess bone deposition (heterotopic ossification).

Neurosurgeon - Specializes in surgical management of the nervous system. After spinal cord injury/dysfunction this can include spine stabilization, management of brachial plexus injuries and syrinx.

Infectious Disease - An internist who specializes in the diagnosis and treatment of all types of infections. Most commonly after spinal cord injury/dysfunction, this includes infections of the urinary tract, skin, lung and bone.

CONTACT AND REFERRAL INFORMATION
SALLY ANN HOLMES, MD
Spinal Cord Injury Care Line Executive
e-mail: holmes.sally@med.va.gov

EDWARD J. BORN, JR.
Administrative Officer
E-mail: born.edwardjjr@med.va.gov

HELPFUL LINKS
Paralyzed Veterans of America *
National Spinal Cord Injury Association*
National Multiple Sclerosis Society *
Americans with Disabilities Act *