Lou Gehrig's Disease

Our Experts

Doctors

• Dr. Catherine Lomen-Hoerth, neurologist and director of the ALS Center

Nurses

At the ALS Center, each patient is designated a primary nurse, who is responsible for the overall coordination of care for the patient during the clinic visit and for any follow-up care. Your nurse will greet you at the clinic, obtain your vital signs, review medical records, identify areas of need, educate you and your family about your care and treatment and serve as liaison with other staff members.

Dallas A. Forshew manages and organizes the day-to-day activities of the ALS Center and participates in long-range planning and development of clinical research projects. She is responsible for staff development and evaluations for the 10 team members. She has 13 years experience in caring for patients with ALS.

Jason Mass has been a registered nurse at the ALS Center for eight years. In addition to regular care of patients, he has been the research coordinator for all of the center's ALS drug studies.

Other Experts

Darrell Christensen is an experienced orthotist. His clinic is adjacent to the hospital. He comes to the ALS Center to see patients on an on-call basis to help determine the type of lower limb orthotic device needed. His recommendation is invaluable because of the many options available and the skill needed to match the right device with each patient. He also assesses the patient's current device for proper fit and use and can make some adjustments to devices in use. He is available for separate appointments at the Orthotic Clinic to mold and custom-fit a new device.

Margaret Cotts is a specialist in augmentative communication and computer access. She performs an informal communications needs assessment that covers all forms of verbal and non-verbal communications. Communication strategies are tailored to your individual needs and include devices such as voice amplification, TTY, California Relay and communication boards. Information is provided on assistive technology such as computers, page turners and call buttons. An evaluation is performed to identify the best communication devices to meet your needs, such as a keyboard, mouse or Morse code.

Miriam Crennan is an occupational therapist with broad experience with braces, splints, adaptive equipment, aids and exercises. Crennan, who joined the ALS Center in May 2000, helps assess functional loss related to activities of daily living. Strategies and equipment — including modifications to your home — are recommended to maintain or maximize independence. Occupational and physical therapists work together with you during your visit.

Monica Eisenhardt is an experienced social worker with expertise in grief and loss. She has been with the ALS Center since November 2000 and provides 12 hours weekly to our ALS patients. She assesses the patient and family coping mechanisms and offers guidance and support at every phase of the disease. She teaches techniques that may be helpful in redirecting their feelings. She makes recommendations for further counseling and works with the neurologist to identify those patients who may benefit from psychotropic medication. In addition, she makes referrals to community agencies on an as-needed basis and helps with insurance issues. Eisenhardt has initiated a bi-weekly support group for the staff to help us deal with our own feelings as we learn new strategies to help our clients with theirs.

Dr. Warren M. Gold is the division head of Pulmonology at UCSF Medical Center. He is readily available to answer questions raised by our staff. Patients also may see him by appointment. Our patients usually see pulmonologists in their local area who are affiliated with their insurance program. A pulmonologist is called upon when there are more complex issues than a respiratory therapist can address.

Jill Goldman is a full time member of the Memory and Aging Center at UCSF where a large research project is underway investigating the genetics of ALS and a type of dementia. The genetics counselor evaluates the patient in the ALS Center during regular clinic visits or at a separate appointment. Information is gathered with special attention to family history of ALS, dementia, psychiatric disorders and drug or alcohol abuse. Genetic counseling for the entire family is available as needed.

Dr. Uri Ladabaum is a gastroenterologist, experienced with the placement of percutaneous endoscopic gastrostomy (PEG) tubes, or feeding tubes, and follow-up. Ladabaum's evaluation includes providing the patient and family a complete understanding of the procedure and use of the PEG. Tube placement is an outpatient procedure in most cases.

Susan E. Langmore is a well-known swallowing expert who has published a book describing an endoscopic method of swallowing assessment. She evaluates the patient's speech, communication and swallowing status at each visit. At key intervals, she takes measurements that relate to speech including maximum phonation time, maximum rate of alternating movements of the lips and tongue and reading rate. She informally assesses cognitive-linguistic function and provides tips for better speaking, swallowing and communication.

Andrew Lui is a physical therapist at the ALS Center who joined the team in March 2000. He also participates as a clinical evaluator in ALS drug trials, or research involving patients. The physical therapist evaluation includes a subjective exam including complaints of weakness, stiffness, pain and fatigue and history of falls as well as a physical exam, including gait analysis, balance tests and assessments of strength and muscle tone. Physical therapists also provide recommendations to neurologists regarding therapeutic equipment and services.

Colleen Meier is a registered respiratory therapist and supervisor. She is experienced with respiratory assessment and all of the interventions used by ALS patients.

As a respiratory therapist, she assesses the patient's respiratory status through a variety of measures, including forced vital capacity, maximal inspiratory force and pulse oximetry. With the neurologist, she makes recommendations for non-invasive positive pressure ventilation or other therapies as needed. Meier also instructs patients and their families on the use of respiratory devices such as incentive spirometry, PEP (positive expiratory pressure), tracheostomy and invasive ventilation.

Marsha Melnick is chair of the Physical Therapy Department at San Francisco State University and is a faculty member at UCSF. She has extensive experience as a clinical evaluator in ALS drug trials and has been a part of the clinic since its inception.

Joanne Robinson-Teran is a patient services manager of the ALS Association's Bay Area chapter. She has extensive experience with counseling, support groups, the elderly, caregiver issues, non-profit agencies and community resources. Robinson-Teran spends Tuesday at the ALS Center. She visits with each patient and family while they are in clinic. In addition, she performs ALS needs assessment with patients over the telephone the week prior to their visits.

Linda White is a clinical nutritionist and dietetic technician supervisor in the Department of Nutrition and Dietetics at UCSF Medical Center and a member of the ALS Center staff. Dietitians assess your nutritional status and recommend diet modifications. Currently, she is developing a patient guide for patients who require food processed in a blender.