Dr. Alyse Sicklick: 30 Years of Caring for Patients with Brain Injury at Gaylord

Gaylord's ThinkFirst Program is part of the National ThinkFirst Association, which is committed to educating youth about the devastating and life-altering consequences of poor decisions that can lead to a serious brain or spinal cord injury.
 
 Dr. Alyse Sicklick, Gaylord's Medical Director of Inpatient Rehabilitation and a physiatrist, speaks about her almost 30-year career at Gaylord, how the fields of medicine and rehabilitation have grown during her tenure, and how patients with stroke and brain injury have inspired her every day. She shares her expertise and knowledge of brain injury, along with talking about many of the services Gaylord has to offer.
 
 Gaylord Specialty Healthcare is a long-term acute care hospital located in Wallingford, Connecticut.  www.gaylord.org.

To learn more about ThinkFirst at Gaylord

Learn more about the ThinkFirst National Injury Prevention Foundation

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Transcript

Dr. Alyse Sicklick Podcast, April 2022

Host: Welcome to the Gaylord Specialty Healthcare podcast. This podcast will feature patients, families and medical professionals dealing with serious illnesses or injuries and is meant to inspire, bring hope, insight and a message of belief that life after a traumatic illness is possible. 

Host: I am your host Megan Palmer, an occupational therapist at Gaylord and the Think First program coordinator. 

Host: The Think First Association is a nationwide organization devoted to preventing brain and spinal cord injury among our youth and spreading awareness of the consequences of risky behavior. Our first several episodes will feature the Think First program where we will talk with former patients, physicians and family members who have been directly affected by traumatic brain and spinal cord injuries. 

Host: So, whether you're listening in as a former or current patient, you're a mom, a dad or a family member of someone with a brain or spinal cord injury or you're exploring career options in the health field. This special series will highlight those split second decisions that can alter or change a life forever. 

Host: Today we are hosting our special guest Dr. Alyse Sicklick, the medical director of inpatient rehabilitation and a rehab physiatrist for our inpatient traumatic brain injury and stroke population. 

Host: Hi, Dr. Sicklick! 

Guest: Hello, how are you, Megan? I'm doing great. How are you? 

Host: I'm doing just fabulous. Thank you. Thank you so much for coming in and sharing your knowledge and expertise with our listeners here. We are very excited to get to know a little bit more about you and what you have been doing here for almost 30 years of your career? 

Guest: Well, thank you for the invitation, Megan. 

Host: You're very welcome. 

Host: Can you tell us a little bit about what brought you to Gaylord? What do you do here? 

Guest: Well, after finishing my training, about 30 years ago, I interviewed at a bunch of sites in the state of Connecticut, which my husband and I knew we wanted to end up around the state of Connecticut and after many interviews, this was truly the only place I interviewed at and said, this is where I want to work. And I fought tooth and nail and just kept on plugging away until they finally got sick of me and agreed to offer me a job. And here I am! And it's been 29.5 years later. 

Host: What was it about Gaylord that really attracted you to this place? 

Guest: There was something about the vibe when you walked around when you spoke with the folks that worked here, there was something about the camaraderie, there was something about the dedication to the patient and their whole support system that made me feel this was the place where I wanted to devote my time and effort and begin my career. 

Host: And did they actually have a position open for a physiatrist? Or did you come in as something else first? 

Guest: Well, they were interviewing for one position, and ultimately there ended up being two people that they were interested in, me being the second because I think they were just tired again of me saying I really want to come, I really want to work there. And I just wore them down and ultimately they ended up hiring two new physiatrists to add to their staff and the rest is history.

Host: And you don't regret a single moment of being here and fighting for it.

Guest: Never for a moment! As the last 29 and a half years would attest to. 

Host: You didn't initially know you wanted to be rehab psychiatrist. What were you going to school for? What was your interest? 

Guest: My original interest while I was in medical school was orthopedic surgery, specifically sports medicine. And unfortunately when, once I started spending a lot of time in the operating room, I realized I really didn't want to be a surgeon and I was a little bit of a lost soul trying to figure out what I wanted to do and somebody suggested that I do a rotation on a spinal cord injury unit where I was going to medical school and I fell in love with the world of rehab and completely switched my gears and sought after a residency in physical medicine and rehabilitation. 

Host: Where did you get your doctorate?  

Guest: I received my medical doctor degree at Boston University School of Medicine.

Host: Ok, and where did you do undergrad? 

Guest: I also went to Boston University undergrad. So I was there for eight years and then after medical school, I got into a residency program at Columbia Presbyterian in Manhattan. So I was in New York for four years doing my training until I started at Gaylord. 

Host: Oh, wow. So you city hopped.

Guest: I city hopped, but I am a New Yorker. So going back to New York for my training program was exactly what I wanted to do. So it worked out kind of nice. 

Host: Did you grow up in the city? 

Guest: Part of the time, in the city, Part of the time in Long Island and then back to the city. So I've been in most of the boroughs of New York City except for Staten Island. 

Host: And you like Wallingford now? 

Guest: Well, I work in Wallingford. I don't live in Wallingford. I live outside of Hartford. But traveling to Wallingford every day for my job has been my pleasure. 

Host: Oh, that's amazing. So you grew up a city girl, but you're okay being a town and country kind of lady?

Guest: I am totally good with being that way now. And it's been a great way to raise a family. 

Host: So leading into your family, what do you have for children?

Guest: I have two grown boys, a 23-year-old and a 25-year-old. I came to Gaylord as a young married lady without any children. And have gone through two pregnancies and raised my children all whilst being at Gaylord. And again, being a Gaylord has been a great environment to be a mom and raise a family. You have the support and everything from the people who work here to get you through that. It's been wonderful. Everybody has been very helpful and very supportive. 

Host: I can attest to the same. 

Guest: I think you should be the next podcast. 

Host: I do have quite a story to tell. So your boys now, I can imagine raising two boys and being a specialist in traumatic brain injury kind of led to a few mother decisions that you had to make. How did you deal with that? 

Guest: Well, I would love to say that I raised both of my boys inside a cocoon or a bubble or bubble wrap. But that's very hard to do with two boys that are very much into athletics. So it's been quite a challenge being a professional in the world of brain injury, watching my younger son who is a soccer goalie, and my older son who's a baseball pitcher being on the field and knowing how risky it can be and trying to remain calm on the sidelines without looking like an absolute maniac, which often times I felt like I should be an absolute maniac.

Host: I bet. So you were, you didn't hold back though as a sideline mom, you were cheering them on but inside you're like, yes, sort of dying of anxiety. 

Guest; I'm a huge sports fan. So I loved going to the games and I loved participating with my boys. It has truly been one of my greatest pleasures about being a mom. But every now and then I would realize what they were doing and realize how dangerous it was. And I'd have to go back to just being a mom and not being a doctor-mom.  

Host: Right. I know there's a hard balance right there. 

Guest: It's very, very difficult, but you got to do what you got to do and you really don't want to do something crazy and not let your kids enjoy the moment and be part of something that's very, very special. 

Host: That’s right. Team sports have an amazing kind of growth in, um, responsibility on these kids as they are taking part in these athletics. 

Guest: It's a great experience and it's a great part of growing up for children, both boys and girls and they both played all through high school and college and it was just such a great part of who they are. 

Host: Did either of them choose football at any time?

Guest: No that would be a little scarier for me. Nobody chose football. Football obviously is in the spring. Excuse me in the fall. And my younger son who plays soccer, that's also the fall. So he had to choose one or the other. So that was an easy decision. And my older son just never had any interest and played baseball year-round, 

Host: Which as a pitcher honestly is a similar risk as football. You don't have the hard helmet on when you're standing on the mound either 

Guest: Correct, correct. So there's nothing that's completely safe. So you just have to have some faith and hope that your kids get through it unscathed. 

Host: Yeah, it's concussions and wearing helmets and the proper fitting and all that is such a huge topic, and in high schools and doing our Thing First Program. It's just interesting how now they actually have this thing where they do a sort of, concussion tests or something prior to the actual scheduled games. So they know your baseline and then if you get hurt or anything, they can do another test to kind of show, what kind of effects that had on your brain. 

Guest: The world of sports is paying much more attention to concussions now than they did actually when my boys were young. So this is long overdue. And even the coaches and trainers are much more educated about assessment, warning signs, and when people are safe to go back. So we're doing a much better job now certainly than we did 25 years ago. 

Host: Yes, I've, I've seen the change to actually, over the timeline of, of speaking to high schools and having them come back and tell me all the different things that the coaches are now doing. So it's, it's impressive and hopefully, it will decrease the amount of brain injuries that are happening in concussions with these young kids. It's scary out there for my boys too growing up and starting to get into that world of sports. 

Guest: It can be very, very scary. But sports is such a big part for any child that's interested. And certainly is very, very important to them staying healthy and being part of a team environment. 

Host: Absolutely. Now either of your boys following in your footsteps, going towards doctorate degrees or anything?

Guest: Nobody is going to be a physician in my family. My older son is into science. But if you just mention the word blood or anything like that and I think he's close to fainting when something like that happens that will not happen. And my younger one is not a science kind of guy. So it's all good. It's all good. They have to leave and find their own paths and they have done that. I love that. 

Host: What does your husband do? 

Guest: My husband is a lawyer and he works on doing children and family advocacy. So he's saving the world in his little way. Just like I tried to save part of the world in my little way. And that's very interesting. 

Host: So have your schedules ever clashed? Are you able to sort of both have your jobs and then have a family life too?

Guest: Our schedules clash on a regular basis, but that's part of being a, a two professional family and both being dedicated to your family and you figure it out and he's just a fabulous dad and is just amazing with my boys and they have a great, great relationship. 

Host: Oh, I love that. That's very special. So let's kind of go into I guess sort of what a rehab physiatrist does, what, what do you do here for our brain injury and stroke population? 

Guest: Well, the world of physiatry otherwise known as physical medicine and rehabilitation, really deals with the functional ability of our patients dependent on what their issue is. So whether it could be a traumatic brain injury, a stroke, any kind of acquired brain injury, which is the umbrella that both of those things fall under can lead to issues with pain, medical issues, difficulties with your mobility, difficulties with taking care of your own personal needs and physiatry addresses all of those things in different ways and essentially is the team leader for lots of different allied health professionals that work together in trying to maximize a person's ability and improvement after different catastrophic events like acquired brain injuries. 

Host: Now you see patients of all ages?

Gust: Typically at Gaylord, our youngest patients are 16 years of age, but we have not infrequently taken folks that are younger than that based on Medical Director review and often that is based on size and ability to have the proper equipment for whatever their needs are. So, by definition, our criteria is typically 16 but we have on occasion taken folks as young as 13 here.

Host: Wow. Now, have you seen a trend in the type of injuries that these young people are having?

Guest: I don't know so much as a trend. But certainly, we have had a steady stream over the years of sports-related injuries. Certainly, all-terrain vehicles have been a bit more common over the last few years than they were initially. And always motor vehicle accidents as well as bicycle accidents. So, we see it all. The stories we get here are truly amazing and that's why I tried to keep my boys in bubble wrap, but it doesn't work. 

Host: Yeah, I'm sure the gamut of recovery is sort of dependent on the person. But are there any stories that really stick out in your mind of patients who have just come leaps and bounds from when they first got to Gaylord?

Guest: Megan, I have so many of those stories, which is why I've been here for more than 29 years. I see patients that are teenagers that still come back and just make my day when they visit just to say thank you and let us know how well they're doing. And I see octogenarians that continue to do well and come back and tell us "thank you" for helping them get back to what they wanted to do. So being able to span that many decades of different patient populations and allowing us to be part of who they are and how they progress because of some devastating injury is really quite a privilege and very, very special. 

Host: And I stopped by your office last week and there's not a space left on your board of the thank you cards or pictures or just little blurbs about different patients that you've made an impact on during that 29 and a half years.

Guest: Again, I think those are the things that keep somebody coming back to work every day. Getting those little note cards. I think I also showed you some of the frayed note cards that are in my pockets that I wear in my white coat every day every now and then if I need a little inspiration, I reach into my pockets and look at some of those cards and again, looking up from my desk, I see pictures of people's weddings that came to pass after a devastating injury that I was part of their progress and improvement. 

Host: So that was one of the secrets I was going to have you share is I could not believe you actually still have these frayed cards in your white coat that you carry around with you from these patients.  

Guest: There are certain things that you just can't part with and you never forget. And some of those cards just mean more to me than anything of just the impact that you can have on certain people's lives. Again, it's a privilege and something I never want to take for granted. 

Host: And I think that's all a part of the Gaylord culture here because I feel it too. I mean the impact that you have on these people and the way that they come back and share their thank-yous with you and their success stories and keep in touch is just beyond heartwarming. 

Guest: And again, if I if we go back to the beginning of our conversation and I tell you that I felt that the first time I was here and to know that that feeling was true, that it was real and that I have been able to be a part of it. I feel very, very blessed. 

Host: I would absolutely agree. I've been here almost 10 years and the same reason I've stayed is this is just like yours. It's just that feeling that you get that you're helping people in a way that you never thought imaginable, and you never thought that you could actually be that kind of circuit for them to get them better. 

Guest: See now you surprised me, I can't believe you've only been here for 10 years because I feel like you've been here forever! 

Host: Yes, it does feel like it's my whole career, but I was in different places for about five years before that, and then sort of happened upon this place, Gaylord gets under your skin, that's a great way to put it! Yeah, absolutely. And you've also worked with someone? Um, right by your side almost this whole time, Mr. Mark Powers.

Guest: Mr. Mark Powers is a physician's associate. We work together. We started working together very soon after I started here. And it truly is crazy that we are working together still 29 years later and we finish each other's thoughts. We finish each other's sentences and it's really just an incredible experience having that work relationship with somebody. And we are a very, very good team. I think I'd like to think that we are. And I am lost when he is not here and he is lost when I am not here. But people need time off every now and then. 

Host: Right. Yes, definitely. 

Guest: He is the ultimate advocate for patients and families. He will do anything for those that he serves. And he's just a brilliant clinician and I respect him incredibly. 

Host: Was he here when you started or did you start at the same time? He has been here a couple of years longer than I have. So, he had already been working with some of the other practitioners and was a little bit hesitant that there was going to be a new lady in town when I first started in here and made it very plain to those around him that he wasn't going to take anything from the new doctor that was coming on board. And we laugh about that all the time. 

Host: So did you click right away or did it take some time for you to break down his walls? 

Guest: We clicked right away. We did, which if anybody, anybody who knows Mark, it's amazing that we clicked right away because he's a tough cookie to crack and we did.

Host: He is, but if he's listening right now, he's got that softy part inside of him. 

Guest: He will turn five shades of red and laugh if and when he hears this.  

Host: For sure. Yeah. And your plans are to stay. I'm hoping, you and Mark you got this thing down.

Guest: We have this thing down and I think they'll carry us both out and probably carry us both out on the same day. 

Host: Wasn't that a statement to be written down!

Guest: We’ve made a pact. We're a package deal. 

Host: Oh, I love it. Oh, that's brilliant to just to have and in the care of the patients on your floor to have that consistency and have that kind of respect for each other's profession and what you guys do together to make the process work to get these patients better. 

Guest: We're very blessed. We work with a great team on the brain injury unit. Our nurses are fantastic. They know who we are, we know who they are. And again we work together I think really nicely as a team.

Host: We see it too as I'm an occupational therapist and we see that bond and how well you work because you even take into consideration what we do as therapists and come to the gym and your present for the patient's treatment sessions. And that just shows so much dedication and commitment to their whole process of rehabilitation, not just what you're doing for them on the unit. You also come down to the gym and watch them kind of grow and get better.  

Guest: That's part of being a physiatrist, being in the gym and seeing how our patients are working with the different therapeutic staff and interventions and how they respond is part of being a rehabilitation specialist. And if we don't go to the gym, we're not doing our job. So it's part of who we are, how we're trained and we reap the benefit of that. And I'd like to think both the staff and the patients reap the benefit of that daily. 

Host: Oh absolutely. You can see the patients just kind of perk up too and they want to do the best that they can while you're watching and it just helps guide our therapy too, it keeps pushing us to push the patient's harder. We want to all get them better. It's also really exciting over the years that I've been here the various and new technology that we've gotten and have been able to use with our patients in the gym, in the therapeutic environment has just been phenomenal, and seeing how the technology interacts with the patient and the patient interacts with the technology. It's just great. It's awesome! 

Host: It is. We can be safer about getting people on their feet faster. We have something called the Zero G which is basically an antigravity support system overhead and we get the patients walking so much quicker that way and can sort of focus on technique more than just sort of hauling them out of the chair. 

Guest: So the literature is really, really clear the more aggressive we are with our patients and the more we focus on repetitive activities, which the technology allows you to do without needing to rely on an exhausted therapist on an ongoing daily basis is very, very beneficial to the functional improvements of our patients. So we see it and the literature is very clear about the benefits of that with our patient population. 

Host: Yeah, we use the BITS to the Bioness Integrated Technology, which can be used for a lot of different things, but it was mostly for vision therapy, but it ends up being a balance, coordination, a speed, a reaction time sort of memory test as well, all in one and it gets the patient's invested because they're doing something, sort of video gameish. 

Guest: And again, watching the patients interact with the therapists and the technology down in the gym is great and it gives us a picture of how folks are improving what their ongoing deficits are. And it also helps us educate the family about things that need to be worked on and how they're progressing. So it's all part of the whole package of what we do for our patients. 

Host: You’re right and Gaylord, I mean, you've seen the progression for 30 years, how technology has sort of made its way into where it is today. So, have you found that these technologies have really, truly benefited our population?

Guest: It's hard to imagine that they don't. Again, the literature is a bit vague on whether or not it's the specific technology or just the ability to do repetitive activities that are beneficial to the patients. But whatever it is, as long as we can keep having the patients repeat activities, and do the muscle memory progression of the different aspects of mobility and self-care that they are addressing in the therapeutic environment, we're going to go with it. 

Host: And of course, I mean, I can't see you not but recommending Gaylord to any of our listeners out there who have either siblings or sons, daughters, anyone, family members that have had a stroke or brain injury and are looking for a place with intense rehab. I mean this is it. 

Guest: Yes, I invested in who we are and what we do. But I also see our patients and all of our physiatrists for the most part see our patients. So it is not uncommon that we see folks for years on end after they have been on our inpatient units. And we often see people just as initial assessments on the outpatient units. So we have lots of that technology also for outpatients. So depending on what the particular needs are of the folks that we see. We have lots at our fingertips to try. 

Host: Yeah. It all includes a very, very intense rehab that's really important for our people out there who just don't know where to go or know who to turn to or where to look. So it's good for them to know that.

Host: There's lots of stuff on our website. Lots of information. So even if our location isn't ideal we have ideas and resources and manuals on the website with lots of information. We also have you know different folks that are always willing to speak to people to help provide information to help both families, as well as survivors, advocate for themselves. 

Guest: Yeah. And reach out right call Gaylord, let us help you, let us help you find something in your area to maybe we have referral sources or people that we have connections with too that can help if anyone is out there looking for some kind of help for their loved ones or any kind of information on stroke, brain injury, spinal cord injury. We have medically complex patients. The whole gamut of the medical field. 

Host: So as far as s in looking back over the last, you know, half an hour that we've been chatting. What are some of the things that especially made Gaylord's Brain Injury Program especially unique? 

Guest: Well, Gaylord has the only transitional living house in the state of Connecticut, Traurig, which has the ability to take eight survivors either from the inpatient unit at Gaylord or from other institutions in the state of Connecticut. Patients participate in either a cognitive day treatment program or an aphasia day treatment program and it really is a wonderful bridge to ultimate discharge back to their home environment. So that's been just fascinating to be able to refer patients from the inpatient unit to Traurig and see them to continue to improve in all areas that we started to work on as an inpatient and then go back to their community. So that's been very, very exciting.  

Host: Yeah, and I've been over there, it's sort of like a dorm room house, right? Like you get a little bedroom and they have a community kitchen, you make meals together. 

Guest: It's very, very special. Again, it is literally a house, there are four double bedded rooms and the patients have to work on their meals and set schedules and they participate in both individual as well as group therapies throughout the day. That is really unique that you can actually stay at a house on campus and then go to outpatient therapies in our Gaylord outpatient department. And have that kind of continuum of care spread across outside of the inpatient setting. 

Guest: It is a very unique program. 

Host: Yeah. And what is the age range of patients typically seen at Gaylord? 

Guest: As I mentioned before, 16 year old typically is the youngest by our admission criteria. But I have had numerous patients well into their nineties, especially over the last decade or so. As people are living longer and we're doing a better job at providing preventive healthcare. Patients are remaining active longer and living much longer. So we see the whole spectrum from young to quite elderly. 

Host: Oh, yes, absolutely. I mean our bulk is like in that 40-60 range. We go up to 100 at times. We really see people of all ages. 

Guest: I'm always amazed by some people that are still working well into their 80s or managing their own affairs well into their 90s. I find them quite inspiring.  

Host: Absolute. They always have little tidbits to share too little secrets of life. 

Guest: Well, we always need to learn something from people that have been through more than we have and we see them here all the time. 

Host: Yes, that is very special. I love that about this place too. So Dr. Sicklick, thank you so much for taking the time to share. So thank you Dr. Sicklick, for coming in and doing this podcast with us and sharing all of your expertise and opinions about brain injury and how this field has grown over the last 30 years. We really, we enjoyed having you. I enjoyed speaking with you. 

Guest: My pleasure. Megan. Thank you so much for the invitation. I really appreciate it. 

Host: We just, I just have one more quick question. So if you have time actually to, so one would what would you want your great-grandkids to know about you? 40 years from now?

Guest:  Jeez, I would want them to know that I was a great mom who loved my kids and wanted kids always. And they have been my greatest pleasure. And also that I really love my job, that I love helping people with acquired brain injuries. And it truly has been a great passion and a pleasure to be here for what I think will be my entire career. 

Host: I think your legacy will truly show that. And then obviously everyone really wants to know who wins all the arguments in your house, the lawyer or the doctor. 

Guest: Oh, that's an easy one. The lawyer wins every single argument. I think in my next life, I'm going to come back as a lawyer because the ability of lawyers to pose things in a way different than everybody else on the planet never ceases to amaze me, so, hands down. 

Host: I am married too and I can never win anything around the house. 

Guest: I don't even try anymore.  

Host: I’ll learn someday. 

Host: Well, thank you again. Doctor like, like I appreciate you being here. Thank you. 

Host Thank you all for listening to our second episode of the Think first Gaylord series from our Gaylord Specialty Healthcare podcast. We truly appreciate Dr. Sicklick coming and spending the time to tell us more about Gaylord Hospital and all the resources we have. And we would love to help you all out. If you have family members or loved ones who are experiencing anything between pulmonary, cardiac, and neurological deficits. Just go to our website www.gaylord.org and it will show you all kinds of resources that can help you out.  

Host: Thank you for tuning into the Gaylord Specialty Healthcare podcast. We hope that you will join us again to hear more stories that bring hope, insight, and a message of belief that life after a traumatic injury or illness is possible!