Tuesday, June 23, 2009

Horses Provide Alternative Therapy at Windridge Center

Staff Writer

Many people associate the word "therapy" with doctors' offices and prescription medication.

Not Margo Dewkitt.

She and the members of her staff at Windridge Therapeutic Equestrian Center in Gilmer are doing their best to provide a fun alternative to traditional rehabilitation through the use of horses.

"Horses provide therapy, life skills, communication and social skills," Dewkitt said. "Everything should be provided in a session."

Because of the unique benefits that come with riding horses, Ms. Dewkitt said, Windridge is able to help people with all kinds of disabilities, from autism and head injuries to drug addictions and delinquency.

With assistance from the horses, Ms. Dewkitt believes she and her staff can help anybody.One such client is 4-year-old Madalin Kowalik of Longview, who has been diagnosed with Rett Syndrome.

Madalin's mother, Shannon Kowalik, said Windridge was recommended to her while the family was working with the Early Childhood Intervention program.

"We're very pleased. It's wonderful," she said. "I would trade any other therapy for this one."

Ms. Kowalik said that although Madalin receives physical and occupational therapy at school, she can tell Madalin views that those efforts as work, whereas she genuinely enjoys coming to Windridge.

She said Madalin really enjoys spending time with her therapist, Celia Bower, and she can tell that everyone who works with her daughter actually cares about her.

"Celia seems to really click with all kids," Ms. Kowalik said. "She's just blessed with that gift."

Outside of Windridge, Madalin is just another 4-year-old, her mom said. She enjoys watching movies, jumping on the trampoline, swimming and listening to her mother read books to her.

Ms. Kowalik said she is convinced Windridge is the right place for her daughter, not only because it is the best type of therapy physically, but because of the joy in her daughter's face when they go to the center.

"When you tell her we're coming here, she is so thrilled," Ms. Kowalik said.


Windridge was founded as a nonprofit organization in 1988, with Ms. Dewkitt as the lone instructor.

When the center opened its doors in March 1989, it had just two patients.The program was dependant on volunteers at first because it was not generating enough revenue to support a paid staff.

But from there, the program steadily evolved, adding to it a number of trained instructors and more patients every year.

By the late 1990s, it became obvious that the original facilities were no longer large enough to house the constantly expanding group. Plans were formulated to build a state-of-the-art facility that would allow Windridge to not only continue growing, but to expand its research program as well.

The center purchased land next to its original location in 1997 and began the process of constructing a permanent home.

When the current facility opened in 2001, it already was completely paid for, with 78 percent of the funds coming directly from East Texans.

"We are a tribute to East Texas," Ms. Dewkitt said.

The 38,000-square-foot facility was completed with Windridge entirely debt-free.

Today, the center supports nine full-time instructors, all of whom are certified with the North American Riding for the Handicapped Association (NARHA), and helps almost 140 clients each week.

Clients' ages have spanned from 1 year old to 85, and the center has grown from six horses and five volunteers 20 years ago to 22 horses and more than 70 dedicated volunteers today.

They also have expanded what was once solely a therapeutic riding program to include therapeutic driving, hippotherapy and a teenage volunteer program.


Windridge is not just an educational tool for its clients but also serves as NARHA certification for volunteers who want to become full-time instructors.

The nine staff members had a combined 24 years of volunteer time before they becoming instructors.

Because therapeutic riding still is a relatively new concept, there are no universities that offer majors in it, so Windridge works as a school for those interested in pursuing it as a career.

Staff members who hope to become certified attend two taught lessons and two practical sessions each week, usually taking five years to earn certification.

Julia Bourcier, program director at Windridge, was a former volunteer and now oversees the instructors, helping them progress through the programs.

Ms. Bourcier began volunteering when she was 15.

A year later, Windridge began offering certification for those interested, and she made the choice to move forward with the program.

She spent a year volunteering at another center, which she said greatly increased her respect for the Windridge program.

"With that experience, I can tell you that this is one of the most professional and excellent centers there is," Ms. Bourcier said, placing Windridge in the top 10 percent of programs as far as facilities and community support.

The instructors spend time with clients in on-site classrooms as well as on the horses to teach riding skills, which will in turn correct posture, work muscles and evoke the best influence on the body.

The goal of the program is to better develop the rider as a whole person, not just his or her horsemanship.

The instructors play games and have the clients interact with the horse to motivate them to do the things they may not want to do.

"There are very few things that motivate (kids) as much as animals and toys."


Windridge partners with Kidz First Therapy in Longview to provide on-site therapy at its facility in Gilmer.

Ms. Bower, the hippotherapy director from Kidz First, works with the clients at Windridge to provide traditional physical therapy, such as stretching on a mat, in addition to the unique programs at the center.

She said the horse generally acts as a primer to the regular therapy.

She is a self-proclaimed "horse person" and has held a love for the animals her entire life.

She learned about hippotherapy while in physical therapy school, where she wrote papers and completed projects on the subject.

Bower left her home state of California after meeting with Dewkitt and discussing her future in the career. She moved to East Texas and volunteered at the center for a year before affiliating with Kidz First.

"It's phenomenal," she said of her experience with Windridge. "It's very well organized, very well run."

She said the staff at the center communicate well and have strong relationships with each other.

Ms. Bower said she always has been good with children and is grateful for the opportunity to do something she loves for a living.

In addition to helping children in need, the therapy program at Windridge is beginning to focus heavily on research for hippotherapy, which has not yet been validated through controlled testing.

A portion of the organization's new facilities has been dedicated to research and the staff is preparing for its first big project.

Through use of video, a climate-controlled room, a treadmill and multiple cutting-edge tools, such as a sensor that can accurately measure the movement of a rider's pelvis, the researchers are attempting to prove how much riding a horse actually moves a person's body.

The group also is studying how different riding positions and different horses affect the body in different ways.

The study will give the staff a more scientific way of choosing a particular horse based on a child's specific needs.

Madalin, for example, has trouble with balance and keeping her hands down, so with their research, the therapists will better be able to choose an animal that will tap in to her neurological senses.

More information about the programs at Windridge can be found at www.windridgetexas.com.

Updated Monday, June 22, 2009 at 11:18 a.m. CDT

Wednesday, June 17, 2009

Ironman competitor motivates children with personal story

By Anne Hershewe


Sarah Reinertsen is in Joplin for the Boomtown Days Half-Marathon and 5K Fun Run, but the 34-year-old from California is no ordinary athlete.

She is the first person with a prosthetic leg to finish the Hawaii Ironman Triathlon, a race she completed in 2005. That event includes a 2.4-mile swim, a 112-mile bike ride and a 26.2-mile run — all in one day.

Reinertsen brought her message — “Believe in yourself and believe in the possibility that lies ahead of you” — to children and their families at the Freeman East Pediatric Therapy and Development Clinic on Friday morning.

She was born with proximal femoral focal deficiency, a birth defect that led to her leg being amputated at age 7.

“When I left the hospital, they told me I would never be able to run,” she told the children and others at Freeman.

Reinertsen said that she was determined to learn how to run. And she did. Then she said she found out about the Ironman.

“I saw it and thought, ‘Those people are crazy! I want to do that.’ I believed that I could do it.”

Reinertsen passed around her prosthetic leg, a C-shaped “foot” based on the hind leg of a cheetah, for all the children to examine. She explained the different types of legs she has and answered questions from the audience.

Emma and Ella Leach, ages 7 and 6, were among those in attendance.

“It’s just really cool that she was the first woman to do the Ironman with an artificial leg,” said Ella.

Freeman and Reinertsen surprised the children with Sarah Bears — Teddy bears modeled after Reinertsen, complete with a prosthetic leg.

“I like that the bear has an artificial leg,” said Emma.

Reinertsen autographed the bears and was able to talk with the children one-on-one.

“This is my favorite part, talking with kids,” she said. “It’s hard growing up different. I hope they can look at me and think, ‘Maybe I can find a possibility for me, too.’ They just want to know that they can have a normal life.”

She told the children that she remembers being scared and embarrassed because she was different and people stared at her.

Audie Dennis, who organized the Boomtown Days runs, said he asked Reinertsen to come at the suggestion of Bart Yasso, another Ironman competitor who also is in Joplin for the race.

Dennis said he had watched Reinertsen finish the Ironman and had been moved by her story and accomplishments.

Unfortunately, Reinertsen will be unable to participate in the Boomtown run today because of a stress fracture she suffered about three weeks ago. Though she won’t be running, she told everyone she would be there cheering for them.

Race details

Race-day registration for the 5K Fun Run is from 5:30 to 6:30 a.m. Races begin at 7 a.m. Awards ceremonies will be at 8 a.m. (5K) and 9:30 a.m. (half-marathon). For a complete schedule of Boomtown Days visit boomtowndays.com.

Monday, June 15, 2009

Faith, family and fortitude

By all rights, flesh-eating bacteria should have killed Blake Haxton. He and his family credit God, the Upper Arlington community, his doctors and his strong rower's body for helping to pull him through.

Thursday, June 11, 2009 3:24 AM
By Misti Crane and Jeb Phillips


Almost three months after his right calf started hurting, after countless prayers, after nearly 20 surgeries and fear that he wouldn't make it, Blake Haxton sat tall in his wheelchair on Tuesday.

He's thinner than in his senior picture, taken when he was in peak physical form, when many considered him the best high-school rower in the state. A sheet was wrapped around his lap on Tuesday and gauze around his right arm. His Upper Arlington Crew shirt hung off him.

What, he was asked, was the most difficult thing he had to overcome during all of this?

"Learning to eat hospital food," he said.

His friends and family make this point: He's still Blake. He still can crack a joke, even if his voice is a little strained from the tubes that helped keep him alive. He still wants the best from life, even if sitting upright for an hour exhausts him for now.

He believes in himself, his abilities and his own body, even if it's not quite the same body he used to have. He believes that God has seen him through.

Almost anyone else with the same infection would have died, Blake's doctor said. But Blake is not just anyone. Blake has a mother and father who taught him inner strength. He has teammates who love him, dozens of medical staffers trying to save him, a church that prays for God to help him and -- when news of his condition got out -- prayers from thousands of others around the world.

On Saturday evening, March 14, Blake did his usual -- he helped a team win.

In the semifinals of an Upper Arlington recreational basketball league tournament, he hit two free throws that sent the game into overtime. His team pulled out the victory and was scheduled to play in the finals on Sunday.

That night, he told his friend Mike Caligiuri that he thought he had pulled his calf muscle. Blake was never much of a complainer.

"He's a tough kid," Mike said. "If he said it hurt, it must have really hurt."

Blake limped down the stairs the next morning. He couldn't play in the finals, he decided. By late afternoon, his father could see the pain on his face. His calf looked swollen. Blake took Tylenol PM and went to bed.

His mother had already taken his 12-year-old sister, Haley, to school and returned home on Monday morning when he told her he thought he needed to see his doctor. At the appointment, the doctor told him to go to the emergency room.

Click here for more on this amazing story!

Friday, June 12, 2009

Amputee shows off skills

Nine-year-old Lewis Jeon has only been playing violin since January, but he wowed his schoolmates Thursday when he performed a few songs for them.

Jeon, who is in Grade 4 at Valley View Elementary School, was born without his right hand, and he uses a myoelectric arm to hold the bow.

He played the violin as part of his War Amps CHAMP presentation at the school, showing other students although he is missing a hand, he can do all kinds of things.

Jeon is a member of the War Amps Child Amputee Program (CHAMP), and he spread the War Amps’ PLAYSAFE message, as he spoke about spotting dangers and about living with a missing limb.

“Amputees can do anything,” he said.

Besides violin, Jeon also enjoys playing tennis.

“Sometimes it’s hard for people to know what it’s like to live without an arm or leg,” he said. “People don’t know what to say. For me, it’s OK to ask questions like ‘what happened to your hand?’ but it’s not OK to say I can’t play this game with you because I don’t have a hand or whispering or pointing or calling me ‘armee.”

Jeon showed video clips about playing and driving safely, about spotting dangers and about other Champs and everything they can do.

He urged students to be careful and to stay away from dangers such as power lines, trains and machinery.


Tuesday, June 9, 2009

Understanding phantom limb pain

By Louis Neipris, M.D., Staff Writer, myOptumHealth

Content provided by

Foot pain so bad it awakens a deep sleeper. Hand pain so severe it feels like it's in a vise grip. What's unusual about these complaints is that they can come from people whose foot or hand was amputated. But how can something that's not there hurt so badly? This type of pain is called phantom limb pain. It adds to the difficult experience of adjusting to life after injury. Forty percent to 80 percent of people who undergo amputation have some degree of phantom limb pain. To many of the soldiers with traumatic amputations, phantom limb pain can make rehabilitation even more challenging.

Phantom limb pain is different from residual limb pain, which is pain in the remaining limb or stump. Phantom limb pain is also distinct from phantom limb sensation, non-painful sensations in the missing limb. While it's annoying or distracting, phantom limb sensation is not debilitating.

The pain often starts within days after the loss of the limb. For some, though, phantom limb pain doesn't appear until months or even years after losing the limb. In most cases, the painful attacks will become shorter and less frequent as time goes on.

People were once told they were imagining the pain or that it was a psychological problem. Now there is a better understanding of why phantom pain occurs. This offers greater hope for successful treatment.

What are the symptoms of phantom limb pain?

Pain in the missing part of limb
Squeezing, like missing foot or hand is being crushed in a vise
Sensation that missing limb is twisted or distorted
Burning, tingling, throbbing, shooting pain, pins and needles sensation, stabbing, pinching or cramping
Symptoms tend to get worse in cold weather or before a storm. Stress or anxiety can also worsen phantom limb pain. So can pressure caused by a prosthesis.

What causes phantom limb pain?

The exact cause is not known. Imaging studies done during symptoms show that there is activity in the part of the brain that previously controlled the missing limb. It may be the brain's attempt to process information from the damaged nerves. The resulting sensation is pain.

How is phantom limb pain diagnosed?

The diagnosis is made on the basis of a history and physical exam. It is important to give the doctor all details, even if they sound strange. Your doctor will look at the stump for any painful spots that can trigger phantom limb pain. If you have a prosthesis, the doctor will also make sure it fits properly. A poor-fitting prosthesis can trigger phantom limb pain.


Finding the right treatment for phantom limb pain is challenging and can take time. Treatment may include:

Medications used to treat epilepsy and depression may also help relieve phantom limb pain. Your doctor may also prescribe opioids (a type of pain killer). Other medicines such as beta-blockers or anti-inflammatory medications may help, but more studies are needed to test how well they work for this. It may take time to find which medicine is best for you.
Transcutaneous electrical nerve stimulation (TENS). This is electrical stimulation of the skin around the stump to attempt to interfere with nearby painful stimuli. TENS therapy is an effective treatment for many with phantom limb pain.
Other treatments may include different forms of physical medicine, including biofeedback. The goal of biofeedback is to use visual or other sensory stimuli to retrain the brain to stop sending pain signals. Sensory discrimination training is another therapy that has shown promise in helping with the pain.
Relaxation techniques, such as visual imagery, have been shown to help in some other types of pain. But more research needs to be done using these techniques in phantom limb pain.
Nerve blocks or epidural blocks are sometimes used when the pain cannot be relieved with other methods.
Rarely, surgery may be an option when the pain can't be controlled. Spinal cord stimulation or disruption of the nerves that carry pain messages have been tried in a few cases of pain that did not respond to any other treatments.
Team approach and support

For many, a combination of medical, behavioral and social support is the best approach. Losing a limb is a major life-altering event. Sharing your feelings with others going through similar experiences can often help. Work with a team that includes a pain management specialist, psychologist and both a physical and occupational therapist. A social worker can help you coordinate these services.


Amputee Coalition of America. Pain management. Post amputation pain.
American Pain Foundation. Pain question and answer: Phantom limb pain.
Birklein F, Maihöfner C. Use your imagination. Training the brain and not the body to improve chronic pain and restore function. Graded motor imagery. Neurology. 2006;67(12):2115-2116.
Moon SB, Se HJ. Phantom Limb Pain. In: Frontera WR, Silver JK, Rizzo TD. Frontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed. Philadelphia, PA: Saunders Elsevier; 2008.

Monday, June 8, 2009

An inspiration for everyone to become pioneers

Scott Duncan, blind since birth, is sailing around the world on his 39-foot boat, Starship.

Jesse Billauer, paralyzed in a surfing accident, is still surfing the waves off Malibu.

Carlos Moleda, a former Navy SEAL who was shot in the spine, competes in triathlons.

Aimee Mullins, a double amputee, became a Paralympic champion sprinter, fashion model, actress and activist.

Kelly Perkins, recipient of a heart transplant, climbs the world's highest mountains.

Anywhere you turn at the No Barriers Festival, which concludes Sunday at the Shake-A-Leg complex in Coconut Grove, you likely are to meet a remarkable athlete. Their ingenious and courageous accomplishments make the feats of able-bodied superstars seem pedestrian by comparison.

The festival showcases the latest in technology, medical research and can-do spirit through symposiums such as ''Vision Substitution in the Blind by Means of Tactile Stimulation of the Tongue'' and clinics that teach swimming, kayaking, golf, handcycling and wheelchair fencing.

''This festival should inspire all of us to become pioneers, to think about designing our own solutions to roadblocks which stand in the way of us accomplishing our dreams,'' said chairman Erik Weihenmayer, the only blind person to stand on the top of the Seven Summits -- including Mt. Everest.


Gape at a Dwyane Wade dunk, but then think about what Duncan is doing. Duncan and his first mate, Pamela Habek, are attempting to become the first legally blind sailors to circumnavigate the globe without assistance.

They are halfway there, logging 17,000 miles and stopping in 15 countries so far. Duncan's boat is in Australia, undergoing repairs and awaiting the end of cyclone season.

Duncan, 42, was born with congenital calaboma and has no vision in his right eye and 5 percent in his left. But in the middle of the ocean -- and especially in the middle of the night -- he's at no disadvantage to a sighted person. Water is the great equalizer, not only in sailing but in many other sports.

''People ask, `How do you do that? Aren't you going to kill yourself? What if you get rammed by a cruise ship?''' Duncan said while preparing to give a clinic on Biscayne Bay.

He does it using his sense of adventure, sailing skills, a heightened feel for the wind and waves and a Sendero GPS system with a voice note computer that gives directions. He even used the $3,000 device, about the size of a computer keyboard, to walk to a Starbucks from his hotel. Every 12 seconds it gave him a new cue. He used it to map a course on the bay, and he used it to get from San Francisco to Australia.

Navigating through ports is the trickiest part. That's when either Duncan or Habek goes to the bow with a monoscope and gives commands to avoid traffic.

''You put a lot of trust in the GPS system,'' Duncan said. ``Near Tahiti, we were going through a narrow channel with coral reef on either side. We'd never been there in our lives yet it was exactly how it was supposed to be. You go to a place blindly -- pardon the pun -- and you get there. It's amazing.''

Duncan and Habek survived a near-calamity 300 miles off the coast of New Caledonia during a bad storm in the Coral Sea. Duncan almost was washed overboard when a towering wave crashed on top of the boat.

''I grabbed onto a pole and hung on as everything in the cockpit dumped into the water,'' he said.

Their most interesting stop was at Palmerston in the Cook Islands, an isolated island with 67 residents.

Along the way, they have taught blind people how to sail.

''When my parents found out they had a blind kid they looked for role models and there weren't many besides Stevie Wonder and Ray Charles,'' said Duncan, who used to own a computer company in San Francisco. ``I learned to sail at age 13. It was clear I wouldn't be able to drive, so instead I got the keys to a sailboat.''


Duncan wants his voyage (which you can follow at www.BlindSailing.com) to inspire disabled people to broaden their horizons.

''I get treated one way when I have my cane in hand and an entirely different way when it's folded up,'' he said. ``I'm trying to show there's not such a big difference between a person with a disability and a person without one. That should be the case when you're interviewing for a job or ordering coffee at Starbucks or sailing.''

Or surfing. Billauer's message is similar to Duncan's: adapt and barriers disappear.

Billauer, 30, was about to join the pro surfing tour in 1996 when he broke his neck in a surfing accident. Rather than discard his passion, he adjusted his style. Now he lies prone on his board, props himself on his elbows and gets a little help from his friends, who push him into the waves.

''It's still the best feeling in the world,'' said Billauer who runs a foundation that teaches surfing to the disabled. ``And that feeling is -- freedom.''