Local osteopath Dr. Chris Doerr is a proponent of healing through physical therapy. Surgery, he says, should be the last option.
Fifteen years ago, Dr. Eugene McCarthy, a retired UGA geneticist, had excruciating lower back pain from an old sports injury. He had been advised to have surgery to fuse two vertebrae by screwing them together with a metal bracket.
“That sounded like a definite ouch,” McCarthy says. He had heard Dr. Chris Doerr helped many people with back and neck injuries without surgery, so before going under the knife, he decided to give him a try.
“After a thorough examination, he set me up with a physical therapy program that largely eliminated my problem. Then he prescribed an individual exercise regime that I’ve continued to the present day. Amazingly, it’s kept my back problems at bay ever since.”
Dr. Chris Doerr
Dr. Doerr moved to Athens from Ohio in 1991 to work as an emergency physician at what is now Piedmont Athens Regional. Because of his training—a master’s in exercise physiology and a degree in Osteopathic Medicine—he originally envisioned himself as a small-town family doctor who preached the benefits of exercise in healing a multitude of ills. By 1999, he was able to fulfill that dream when he left ER medicine behind and opened a small spine rehabilitation clinic in the basement of the round Walgreen’s building on Prince Ave. The practice thrived, becoming a full-service physical therapy clinic (Athens Physical Therapy), and moving to a larger space. And then an even larger place.
“In the world of bones, joints, muscles and pinched nerves, there are just three things you can do: therapies, injections/medications, and surgeries,” Doerr says. “For people hoping to avoid injections or surgery, they will need to invest themselves in the therapy chosen, and if it is not ultimately helpful—or is helpful only to a point—they may need another therapy approach. Another way of looking at this is ‘surgery should be earned’ by failing good therapy and even injections.”
“If I have a pet peeve, it’s that some people don’t give therapy enough of a chance to see results. If they have gotten ‘stronger but not better’ it is our duty to help determine the next step—modify the therapy, acquire imaging studies, get the insights of another physician—this is not a ‘turf battle.’ Our job is to help the patient get to the bottom of a problem.”
Three years ago, Doerr moved his practice into a 12,500-square-foot space. Doerr’s wife Stephanie, a contractor, designed and built a huge, colorful open space with soaring 15-and-20 foot ceilings. that contains exercise tables, balance bars, and a range of state-of-the-art gym and aerobic machines to help patients with a broad array of spinal, neck, knee, hip and shoulder conditions.
The aging body
Many of Doerr’s patients are dealing with severe pain and the inevitable physical decline of age. Some have hurt themselves because they simply kept doing the things they did when they were younger, whether lifting heavy objects or climbing ladders that result in a fall.
“Our body mechanics and aging catch up with all of us at one time or another,” Doerr says. “Lifting something too heavy or exercising with poor form seem to be the greatest risk factors for acute injuries. When we’re younger, our muscles aren’t as strong as our bones but as we age our muscles are stronger than the bones. This is a transition that happens to all of us.
“Unfortunately, the older we get, there is more day-to-day management and less cure. As therapists, we feel we are not done unless we have taught our patients the dos and don’ts of activities and their proper mechanics, as well as a home exercise program to maintain their status.”
When patients are first referred to Doerr, they meet with him in his office and go over a detailed history and exam, and review any prior MRIs, x-rays and bone density tests together.
“It is important that people understand their condition, not just take my word for it,” Doerr says. Once a plan is determined, patients set up a schedule with a certified therapist and begin working out.
“I am a true believer in the basis of physical therapy—and the other facilitating arts such as massage therapy, chiropractic, acupuncture, and the disciplines of Yoga, Pilates, traditional Chinese and naturopathic medicine,” Doerr says.
“We are in the helping profession,” Doerr says. “We are body, mind and spirit. In my osteopathic training, we learned the role of the physician: We are not the healer, but we are facilitators of healing.”
Doerr recommends walking for seniors without arthritic knees and hips. For those with such mobility issues, he recommends a stationary bike or recumbent bike at home. He also says a good diet is important because obesity can harm the knees, hips and spine among other health risks.
Medical insurance policies typically limit the number of formal visits with a therapist so the practice operates an “RxGym” membership gym adjacent to the physical therapy area where therapy “graduates” and others can work out in a carefully cleaned environment with routines designed by their therapists.
“Because people kept asking, ‘what do I do now that I feel better from therapy?’ we started the RxGym to provide specially chosen equipment to help former patients maintain their gains, avoid injuring themselves, and continue their therapeutic exercise independently,” Doerr says.
The Better Bone Clinic
As the base of his patients broadened, Doerr began seeing more and more people with osteoporosis, which led him to form the “Better Bone Clinic” five years ago, held on Fridays.
“There are things you can do for osteoporosis now that one couldn’t do in years past and it’s thrilling to be able to help,” he says. “Many people get a diagnosis of osteoporosis and say, ‘That’s the end of my life!’ And a sobering statistic is that 33 percent of adults who break a hip after age 50 will be dead within 12 months due to complications.
“There are good medicines to consider and some ‘musts’ in the nutritional world like Vitamin D, calcium and Vitamin K2. We check labs on all our osteoporosis patients to rule out secondary causes like chronic kidney disease, celiac disease, parathyroid tumors and so on. Treating osteoporosis requires surveillance and thoughtful choices regarding treatment. Many people want to treat their osteoporosis naturally, but if the development of osteoporosis is because of their genetics, ethnicity or family history—and all else is normal—they may very well require medication to offset the progression. There is a lot of misinformation out there, and a lot of fear. I reassure people this is a collaborative process, and I promise to give good information to help them make an informed decision.”
Related story: Best Exercises for Bones
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Who ya gonna Zoom? Gloombuster!
When older citizens were urged to isolate at home during the COVID-19 pandemic, Licensed Professional Counselor Rita Macari began using “telemed”—real-time online telemedicine sessions—to meet with her clients, who are predominantly seniors. Using telemed, the client and Macari see each other face-to-face—live on their computer screens—and talk directly to each other. The sessions have proved quite effective.
“A lot of people now prefer telemed sessions because it’s safe, convenient, and it saves time and money to stay in their homes while talking with me online,” Macari says. Being isolated, fearful, not eating out, not attending church, not going to see movies or sporting events, all have taken a psychological toll on some seniors in Athens. Many of us still can’t go out during the collision of coronavirus with the fall-winter flu season. And some of us may have had to face the lingering aftermath of long-ago trauma we had avoided by staying busy all our lives.
Macari is working with a number of isolated seniors now. Some of them are so lonely they tell her, “You’re the only person I’ve talked to all week.” But Macari is not the kind of counselor who uses “sweet talk.” No way. She is a first-generation Italian-American, raised in Queens, New York. “I don’t mind asking hard questions,” she says.
For some seniors she might ask: “Oh, you bought your son a new car? Yet I noticed you’re still driving a 2001 model. And when was the last time he called you?” Then, perhaps for the first time, seniors might unearth deep-seated resentments they were afraid to share with anyone.
Rita Macari, LPC
Macari has been at Athens Behavioral Medicine, headed by Psychiatrist Thomas W. McCormack, M.D., since 2012. Prior to that she had been caregiving for 10 years for her aging mother and her husband, who died slowly of A.L.S. (Lou Gehrig’s Disease). After they died, she worked as an addiction counselor in Ocala, Florida, but her son, who lived in Jefferson, Georgia, had a new daughter and called to say: “You’re a grandma. When are you moving?”
She loves to work with seniors because she was around older people all her life. “I love their wisdom. I have learned so much from my clients about how they get through life. Now I’m old and I’ve gained some wisdom along the way that I can share.”
She prominently mentions in her online bio that she is a widow because her client base includes both widows and widowers. “I’ve cried with many women and men,” she says.
The loneliness imposed by the pandemic can trigger painful memories for some clients, from childhood or sexual abuse or other traumatic events that have long been buried. “Trauma is trauma and it lasts forever until you process it,” Macari says. She specializes in helping people with Post Traumatic Stress Disorder, which could date back decades.
“We get triggered through our senses. We smell something or see something on TV that triggers a memory. With trauma, the memory in the brain seems like it’s happening right now.”
As a practical matter, she urges clients in Athens to combat isolation using coping mechanisms such as physical activity, walking outdoors with friends and neighbors, “making sure you get out every single day.” She also recommends OLLI classes or forming “quaranteams” with four to six friends to meet socially in a safe setting such as a yard or patio.
And if depression, loneliness, sadness, anxiety, or panic attacks become overwhelming, Athens seniors could consider telemed therapy to ease the pain.
“I’ve got a huge basket of tools and tips,” Macari says. She often recommends books to her clients. Her favorite, which she calls “the book that changed my life,” is The Four Agreements: A Practical Guide to Personal Freedom by Don Miguel Ruiz.
The Four Agreements are:
- Be impeccable with your word.
- Don’t take anything personally.
- Don’t make assumptions.
- Always do your best.
Macari loves seeing her clients light up when they suddenly see the truth in such a book.
“My work is my bliss,” she says. “Other than being with my grandchildren, it’s the most rewarding part of my life.” For more information, go to athensbehavioral.com.
Related stories: Tips for conquering loneliness, Older adults showing resilience
