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By Kelly Wilson
Source: Quincy Herald-Whig
When Dr. Carol Espejo entered medical school, her first thought was to become a surgeon.
"I decided I didn't like the lifestyle of a surgeon," she said with a smile. A physical therapist, Espejo said "it was natural to think of physical medicine and rehabilitation as a specialty."
Physical medicine and rehabilitation, also known as physiatry, is a relatively new medical specialty and Espejo is making that speciality available to Quincy area residents for the first time.
She joined Blessing Physician Services in January and sees patients in the Blessing Health Center, 927 Broadway. Her husband, Dr. John DeGuzman, also a physiatrist, will join the practice in August.
A physiatrist uses a variety of non-surgical treaments to help adults with any condition that causes pain or limits physical function.
"It's a very good field," Espejo said. "It's a quality of life specialty. The ultimate goal is to restore the person to their optimal function, and to help them take charge of their pain."
The most common diagnosis she handles in her office is low back pain, with stroke being the most common problem she takes care of in the hospital setting.
She also helps patients suffering from arthritis, fibromyalgia and other pain disorders, patients with musculoskeletal injuries and those who have suffered a spinal cord injury or traumatic brain injury — "anybody that has some form of impairment or disability, from pain to loss of a limb to loss of cognitive abilities," she said.
"I work as part of a team," Espejo added. "Other team members are nurses and physical, occupational and speech therapists, social workers or case managers, and many times the patient's primary care physician. Together with the patient and family the team develops realistic goals and a treatment plan to reach those goals. My job is to assess and reassess the patient medically along the road to reaching their goals."
The goal could be as dramatic as helping a patient with a brain injury to walk and talk again, or it could be as simple as finding the proper shoe insert to relieve a patient's chronic foot pain.
"Sometimes I help the patient find the proper wheelchair or splint or artificial limb, the best device to help them gain the most function in their life," Espejo said.
She stresses her role is not to replace a patient's doctor, but to enhance the care the patient's doctor is providing.
"In a case of diabetes, for example, if a patient needs help due to an amputation, I provide that specialized help," Espejo said. "I leave it to the patient's primary care doctor to follow their blood sugar management."
The physical medicine and rehabilitation specialty was developed in 1936 by Dr. Frank Krusen, and evolved as a result of World War II. Espejo said physiatrists helped restore function to many injured veterans.
She enjoys the speciality because "it's never the same set of treatments for everyone, and that makes it exciting."
Because the limiting effects of some illnesses remain for months or years, or may never go away, Espejo often develops long-term relationships with her patients.
She sees the need for her care growing as the life limiting effects of illness and injury become more common in a population living longer.
One type of care in particular she delivers from her office is acupuncture, the technique of inserting thin needles through the skin at specific points on the body to control pain and other symptoms.
"There are people out there who have tried everything and still find no relief from their pain," Espejo said. "For those select people, I offer acupuncture as an option to the limitation their pain causes."
Espejo underwent special acupuncture training offered by the University of California Los Angeles.
She completed medical school in the Philippines and her residency training at the University of Pittsburgh (Pa.) Medical Center. Board certified by the American Board of Physical Medicine and Rehabilitation, Espejo also is a fellow in the American Academy of Physical Medicine and Rehabilitation.
Before coming to Quincy, she worked in a practice in Booneville, Arkansas for three years. Her husband still practices there, but will join Espejo and their two children this summer.
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