Where would you go for after-care for stroke in Spokane, Washington?
September 4, 2014 11:38 AM   Subscribe

Can you reccomend a specialist in stroke after-care in the Spokane or Coeur d'Alene area?

My partner had a stroke 2 years ago. We have only seen General Practitioners in our small town for after-care. We want to see a stroke specialist in the city. But I have no idea where to go or if we need to.

Spokane, WA is our nearest city. We could also go to Coeur d'Alene, ID.

We have seen two General Practitioners in our small town and both have made some bad decisions so we are now going to go see our third GP next Wednesday. When I asked the first two GPs if my partner should see a stroke specialist (a neurologist?) both said no, that was not necessary. Now, because I don't think some of there other advice was smart, I am now questioning if he should see a specialist.

I called a hospital in Spokane and they gave me the name of Dr. Jennifer Pary, a neurologist. Sort of implying that she is THE stroke specialist in Spokane. I called her office and they said the soonest we could get in is December (4 months from now). I have questions right now that I think are beyond a GP.

I called the Stroke.org help number and they have a message that they will get back to me within 48 hours. I'm pretty shocked by their inaccessibility. There doesn't seem to be any organized guidelines for care-givers after a stroke. I feel like I have been totally alone in figuring out his care since the stroke happened. So I thought maybe I could get some advice here at Metafilter. I guess I have two questions:

1. If you have a stroke can you just see a GP for after-care or should you see a specialist?
2. What kind of specialist? Is a cardiologist enough? A cardiologist and a neurologist? I really want to see just one doctor - a stroke specialist - and my information so far is that Dr. Pary is the only stroke specialist in our area and she is a 4 month wait. Am I reading this situation correctly?
posted by cda to Health & Fitness (3 answers total)
Hi, I had a stroke at birth so I know something about this. I'm now a fully-functioning adult with left hemiplegia as a result. I don't have location specific advice for you since I'm in Canada.

You haven't mentioned the type or severity of the stroke your partner had 2 years ago, so answers may vary but here are my thoughts:
a) Your GP's advice of not seeing a neurologist is ok. I had a stroke before age 6 months and didn't see a neurologist until I was 25 for an unrelated medical incident. Unless your partner has experienced profound changes to their health and well-being, I'm not sure a neurologist 2 years post-stroke will do much besides give you an MRI to show if/where damage occurred in the brain. If your partner has notable changes to their health, then you might want to consider options like getting a recommendation to a physiatrist.

b) Physiatrists may be the closest thing to a "post stroke specialist" there is. They are MDs who aim to enhance and restore functional ability and quality of life to those with physical impairments or disabilities. They are often found in physical rehabilitation centres, which I'm sure there are near you. They do both outpatient and inpatient work, and co-ordinate with other doctors for the care of the patient. If you want "one" doctor for your post-stroke needs, they'd be the place to go. Get a referral from your GP.

c) I mostly use a GP for my needs (medication refills, random medical questions, etc.) and physiatrists for more yearly/in-transition (eg. moving/job change/life change situations). Since they are specialists of the whole body after injury or stroke, they have access to orthopods, physical and occupational therapists, neurologists, etc. Depending on your needs. This includes cardiologists, but you haven't communicated what they might be needed for.

d) Sure, schedule the appointment with Dr Pary. You never know what you might learn.
posted by carabiner at 1:57 PM on September 4, 2014

I think St Luke's Rehab in Spokane is great and you should definitely get your partner evaluated there. They're dedicated to rehabilitation for strokes and other brain and spinal injuries and they have a reputation for doing good work.

St Luke's Rehabilitation Institute
711 South Cowley
Spokane, WA 99202

posted by aryma at 4:42 PM on September 4, 2014

Thank you so much for your answers so far. I think my new plan is to make an appointment with Dr. Pary and also maybe rent a house in Spokane for a few months so we could go to St. Lukes several times a week (which would be impossible if we had to drive into Spokane from home every day). Trying to think outside the box.

He only has about 60% use of his hand so we were hoping with more physical therapy we could improve that. But we want to go to the city where they would be up on the latest methods.

I had never heard of a physiatrist and now I will try to find one, thanks!

The reason I want to see a specialist is because we are trying to prevent another stroke and I want someone with experience with stroke to evaluate our plan and not just our GP who may not have much experience with stroke.

The Rehabilitation Hospital of the Northwest in Post Falls called me back and said he may be too functioning for their program but they said they had a stroke support group - we will definitely be driving in for that. We have no support group here and we don't know anyone who has had a stroke.
posted by cda at 6:05 PM on September 4, 2014

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