With so many specialties and sub-specialties in medicine, it can sometimes be difficult to keep them all straight. Regardless, it can be extremely helpful for patients to maintain a general knowledge of the different branches of the medical field in the event that they have a need for care. To help our readers in this goal, we’re taking some time to explore the specialty of physical medicine and rehabilitation, also known as physiatry. In order to better understand the details of the specialty, we’ll focus in part on the work conducted by Dr. Dov Rand. As a respected practitioner in this area, an examination of his treatment methods can be an instructive look at the broader scope of the specialty at large.
Background and career overview
For more context, we’ll first expound a bit on the doctor’s credentials before moving on to a discussion of his work. Through his practice, the Healthy Aging Medical Centers, the doctor is dedicated to helping his patients maintain their highest possible level of health through all phases of their lives. With a range of treatments available that utilize the latest thinking in the medical profession, the practice maintains a firm commitment to only offer care to patients that is based on peer-reviewed studies from scientific sources. These treatments also stem from the doctor’s rejection of the often-practiced “pill for ill” approach to medicine.
The philosophies used by Dr. Dov Rand are also a result of his life-long interest in accruing knowledge in the medical field. For his traditional education, he attended Rutgers University for undergrad and Howard University for medical school. He went on to intern at the Saint Barnabas Medical Center and complete his residency at the Albert Einstein Medical Center. Beyond these studies, he maintains an ongoing interest in reading literature and scientific studies, engaging in discussion with colleagues, and attending medical conferences. These activities allow him to offer his patients access to the most up to date thinking possible within his profession.
The field at large
The doctor’s specialty, physical medicine and rehabilitation, is primarily focused on functional ability and quality of life. Patients will often see these types of specialists if they are grappling with an injury or disability of some kind. Many practitioners concentrate on issues pertaining to muscles, ligaments, the nervous system, and bones. Practitioners can also work with patients experiencing declining health with respect to age or hormonal disorders. Issues of these types are often complicated and touch on a range of different specialties, so it is not uncommon for practitioners to be part of an interdisciplinary team of medical professionals that all treat different aspects of a medical condition.
When operating in a hospital environment, physical medicine and rehabilitation specialists will very commonly work with patients who are recovering from a traumatic injury to the nervous system. This may include a traumatic brain injury, stroke, or injury to the spinal cord. These specialists will also often work with patients who have undergone an amputation in this setting. This type of work is done in conjunction with nurses, therapists, psychologists, and social workers in order to care for both the physical and mental considerations associated with these types of recoveries.
In order to examine the work of a physical medicine and rehabilitation specialist, let’s explore the treatment of a condition they might encounter in an outpatient setting. To this end, we’ll look to the manner in which Dr. Dov Rand uses bio-identical hormone therapy at his practice to help treat men experiencing declining testosterone levels as they age. To better understand the condition, as well as the therapy that can help treat it, it’ll be necessary to first take a look at what hormones do in the body. From there we’ll be able to elaborate further on how testosterone replacement therapy can help aging patients achieve their highest possible quality of life.
Generally speaking, hormones are chemical messengers that glands in our bodies produce to trigger a wide range of actions. Almost all bodily functions are related to hormones in some way, including aspects of growth, digestions, reproduction, mood, and emotional health. Though these chemicals naturally fluctuate in our bodies over time, as well as in response to a variety of environmental triggers, there are generally agreed upon normal levels for each hormone in the body. When levels of these hormones drop below, or far exceed, normal levels, a host of negative effects can be observed.
A readily understandable example of this is the “stress hormone”, cortisol. As the name implies, though the hormone actually has several important functions, it has become widely known in popular culture for its role in assisting the body in preparing for stress. This is a natural process that is needed when a person is in a dangerous situation requiring a “fight or flight” response. It is, however, true that many people suffer from a chronic state of being over-stressed and therefore have cortisol levels that are dramatically higher than what is considered normal. The longterm effects of chronically elevated levels of cortisol can be detrimental to one’s general health and can include cardiovascular disease, obesity, and depression. This is just one example of what can happen to our bodies if hormones exceed normal levels.
Another important area regulated by hormones is sex and reproduction. While there are a variety of hormones that all have an important role to play with respect to this area, the two main sex hormones are considered to be estrogen, for women, and the previously mentioned testosterone, for men. Estrogen is responsible for puberty in women as well as preparing the body for pregnancy and regulating the menstrual cycle.
Correspondingly, testosterone plays a major role in male puberty as well as reproduction and sexual health. Testosterone also has a role in causing a range of physical changes in men that begin with the onset of puberty. These changes include the growth of facial hair and an increase in bone density. Another defining characteristic of testosterone-related bodily changes is an increase in muscle mass that carries with it a corresponding increase in strength.
Age-related decline of testosterone
Since Dr. Dov Rand treats patients encountering age-related issues, declining testosterone levels can be a commonly seen issue at his practice. This decline can carry with it a range of potential negative health effects. One example of this is a change in sleeping patterns. Since low testosterone can sometimes cause insomnia or other disruptions in normal sleep, an aging male may find their ability to sleep can be compromised. As a full night’s sleep can be a crucial part of maintaining optimal health, a testosterone-related disturbance here can have a number of negative outcomes including erratic energy levels, mood swings, inability to concentrate, and fatigue.
A decline in testosterone can also contribute to a variety of physical changes in the body as well. This can include an increase in body fat, a reduction in muscle mass, or a decrease in bone density. All three of these physical traits are connected to a person’s ability to engage in physical activity, which may drop off if any of these areas are affected. If this happens, overall health may suffer and quality of life and independence may correspondingly drop off as well.
Another key component of health that is related to testosterone is sexual function. When testosterone levels drop, many men find they undergo changes in their libido which can result in a reduction in sexual desire. Many men also experience fewer spontaneous erections as testosterone levels drop and may even experience erectile dysfunction when seeking to engage in sex. With a healthy sex life being a critical part of emotional wellbeing for many people, the severe drop-off in sexual abilities that may accompany falling testosterone levels can be detrimental to a man’s mental health.
Benefits of testosterone replacement therapy
In the face of some of the above negative effects related to aging and a corresponding decline in testosterone, many men look to methods of returning their testosterone to the levels they experienced when they were younger. To this end, there are a number of actions that can potentially help bring a man’s testosterone levels up. These include an increase in cardiovascular exercise, regular strength training, and the implementation of a balanced diet. Though the effect of any single one of these activities is not likely to return a man to youthful levels of energy and vigor on its own, they can collectively be a part of a strategy towards optimizing health into older age.
While the above methods can be effective for some, they may not work for all men. In these cases, an additional strategy that can be used is known as testosterone replacement therapy. This practice involves supplementing the body’s naturally produced hormones with products designed to increase hormone levels. When used properly these products can have the ability to return a man’s level of testosterone to that of a man many decades his junior. Along with this change can often come a decrease in age-related health issues such as low libido, fatigue, and depression.
Bio-identical hormone therapy
The way in which Dr. Dov Rand administers hormone therapy at his practice is through the use of bio-identical hormones. This method of hormone therapy has numerous benefits when compared to the synthetic hormones used at many other practices. Bio-identical hormones, as one might expect, are designed to be identical to the hormones naturally produced by a person’s body, so they are often better tolerated by patients. This can also lead them to be more effective in their goal of raising hormone levels. These types of hormones are also created from more natural sources than their synthetic counterparts, such as soy. This again has the potential to reduce side-effects and ensure the greatest chance of success for the therapy.
Bio-identical hormones can be administered in a number of different ways. One popular method is for the medication to be prepared in the form of a cream or a gel. The product can then be applied to a patient’s skin, allowing it to be absorbed into the bloodstream transdermally. Another method is through the application of a pellet underneath the skin of a patient. While this method can be effective in regulating hormone levels, it also considered by some to be more invasive than the use of a cream or gel.
Physical medicine and rehabilitation and aging
The above anti-aging therapies are connected to the practice of physical medicine and rehabilitation through its philosophy of improving quality of life for patients with existing conditions. Though aging is natural and of course happens to everyone, it is something that can be managed with the help of a doctor in order to achieve the highest possible level of functionality in one’s daily activities. Since practitioners in the field are well-versed in areas related to the musculature and nervous system, anti-aging can be a logical area of focus as these two systems can often be affected as we age. As mentioned above, a drop in muscle mass and bone density can be due to falling testosterone levels, which is something that a physical medicine and rehabilitation specialist can work to address.
Beyond a fall in hormone levels, there are a number of other afflictions that can be encountered as patients age that often fall under the purview of these specialists. Strokes and other disorders that affect the nervous system can become more common with age. Though prevention in these areas is widely considered to be the most effective cure, so to speak, a specialist can also help patients rehabilitate from an acute event or chronic disorder if necessary. This can also be the case for patients recovering from cancer, another illness that becomes more common with age. Depending on the type of cancer a patient is recovering from, a physical medicine and rehabilitation specialist can be of great help in restoring as much functionality as possible to the patient’s life.
Benefits of continuing education
As can be seen from the above summary, the purview of the physical medicine and rehabilitation specialty is quite vast, which is one of the reasons why practitioners in the field often pursue ongoing education in some way or another. One way this is done is through conferences intended to disseminate many of the latest findings coming out of scientific studies. Medical and research professionals attend these conferences to learn about some of the newest ways science is pushing the abilities of modern medicine forward. It is also an opportunity to interact with peers and see how others in the field are handling some of the more difficult issues in medicine at present.
Dr. Dov Rand is one such professional who believes in the power of continuing education and credits much of the success of his private practice to the knowledge he’s gained beyond his formal schooling. This belief in the power of utilizing new research was formed early in his career, when he first entered his profession. At that time, he found that there were many medical professionals who didn’t feel compelled to look to new medical studies for information. The unfortunate result of this type of attitude was that patients weren’t receiving the full benefit of what the medical field had to offer. In his ongoing efforts to bring that benefit to his patients, he set out to create his own practice that could fully utilize medical research wherever possible. This idea would form the foundation of what eventually became the Healthy Aging Medical Centers.
Power of role models
Highlighting the above commitment to attaining knowledge also relates to one last aspect of the physical medicine and rehabilitation profession that can be helpful to patients. With such a vast base of information at their disposal, these doctors are able to put into practice in their own lives many of the things that will also be beneficial to their patients. This can include exercise protocols, dietary guidelines, and supplementation strategies.
By using these techniques themselves, these medical professionals can show the direct benefits of such practices to their patients. As such, the advice given in this area is not only backed by scientific research, but by evidence that is on display at the time of the patient’s interaction with the doctor. This can be a powerful reminder of the importance of utilizing proactive techniques in maintaining one’s health.
Though the field of physical medicine and rehabilitation is not as widely understood and recognized as some other branches of medicine, it is an important specialty in its own right. Practitioners, such as Dr. Dov Rand, often work with injuries and illnesses that span many different bodily systems at once and as such require an extensive base of knowledge from which to draw. It can, therefore, be helpful for patients to understand what these medical professionals do, as they may someday be involved in improving their quality of life.
More about Dr. Dov Rand at https://doctor.webmd.com/doctor/dov-rand-d9cd0e56-3fe1-4ca7-b0f4-4fdae832b4bb-overview