Physiatry - Barbara Bammann, MD

Barbara Bammann, MD
Physical Medicine and Rehabilitation

Q: What is Physiatry?
A: Physiatry is a medical specialty also known as Physical Medicine and Rehabilitation. Physiatrists, or Rehabilitation Medicine Specialists, treat patients with musculoskeletal injuries and neurological conditions with a focus from a rehabilitation perspective.

Q: When are patients usually referred to a Physical Medicine and Rehabilitation Specialist?
A: In the outpatient setting, I see patients with long-term disabilities and certain injuries such as to the shoulder, back and neck. Patients are referred to me by their primary care physician and some self-refer, often by the recommendation of a friend or family member. Patients come to me with questions like, “What is causing my pain?” or “What’s making me weaker?” and “Why can’t I do the things I used to?” I work to answer their questions by diagnosing the problem and then prescribing a treatment plan.

I am also referred to see inpatients at the Medical Center when their doctors feel they need additional rehabilitation to overcome their illness or injury. If appropriate, the patient is transferred to our Transitional Care Unit (TCU), where he or she will receive the therapy needed to regain independence and return home. I see patients five days per week in TCU.

Q: What is a Transitional Care Unit?
A: A transitional care unit (TCU) is a licensed, skilled nursing unit for patients who can’t go home when discharged from acute care in the hospital. Patients receive the additional therapy they need which can include physical therapy, occupational therapy, speech therapy, and/or IV therapies.

We help to restore normal function, helping patients with mobility, self care, pain control, and communication. Our focus is on independence, getting the patients to where they can go home and safely participate in the activities of daily life. Depending on the diagnosis and amount of therapy required, patients can spend a few days to a few months in TCU.

Q: Does insurance pay for treatment in TCU?
A: Medicare and most private insurance cover treatment in TCU. Medicaid programs such as Medi-Cal do not.

Q: What are some of the conditions you diagnose and how do you diagnose them?
A: Carpal tunnel syndrome is a condition I commonly diagnose utilizing nerve conduction studies. A patient may come in suffering numbness and tingling in his or her hand. To diagnose the condition, I place several electrodes directly over the nerves. Quick electrical pulses are sent through the nerve and the time it takes the pulse to travel down the nerve is recorded. Damage to the nerve is indicated by slow muscle response to the electrical pulse.
An electromyography study can also be used to diagnose pinched nerves in the back or neck that cause radiating pain down the arms or legs. The nerve conduction study is not a painful procedure however it does cause a sensation of mild shocks.

Another test is the electromyogram (EMG). This test is similar to an electrocardiogram (EKG) which records the electrical signals in your heart. An EMG records the electrical signals in other muscles and can help diagnose the cause of muscle weakness caused by injury to the nerves or by neurologic disorders such as ALS. An EMG involves the insertion of a thin needle electrode into the muscle that picks up the electrical activity in the muscle. There can be some discomfort when the needle is inserted but most patients tolerate the test without any problem.

Q: What are some of the treatments you prescribe?
A: Depending on the diagnosis, treatment plans may include medication management and cortisone injections along with rehabilitation – physical, occupational and/or speech therapy as indicated by the patient’s condition. Once the patient is diagnosed, I prescribe general treatment plans. Then the therapists, utilizing their specialized training and experience, come up with specific treatments to achieve the best outcome for the patient.

Rehabilitation involves exercise as well as patient and family education. It is especially helpful for family or caregivers to come with the patient to appointments. They are a great source of information. They provide information to me and the therapists about symptoms or issues at home and are great at retaining information to help the patient at home.

Bio:
Barbara Bammann, MD, received her medical degree from Mayo Medical School in Rochester, Minnesota, and is board certified with the American Board of Physical Medicine and Rehabilitation. Dr. Bammann is the medical director for Sonora Regional Medical Center’s Rehabilitation Services as well as for the Medical Center’s Job Care Occupational Health Clinic. She has been practicing in Sonora since 1995 and has also practiced in the San Francisco Bay Area. When asked what her favorite aspect of her work is she responds, “Listening to patients and helping patients and their families.”
In addition to her busy work schedule, Dr. Bammann and her husband run a small ranch. She enjoys horseback riding, skiing, scuba-diving and riding on the back of her husband’s Harley Davidson.