Victoria Peripheral Nerve and Spasticity Clinic

A clinical team dedicated to bringing the best possible outcomes for those with neurologic injuries and diseases with an open mind and big dreams.

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

Dedicated to changing spasticity from the nerve up.

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

Thanks to @VIHealthRes and @ourvichospitals the research you support and the equipment you buy is spreading function all over the world. As usual patients &doctors were in 😭 here in Oxford 🇬🇧 at the end of the day. I NEVER THOUGHT I WOULD WALK unbraced barefoot @UBCmedicine

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

The UK has skated into the ice age at @OUH_OCE with a quadruple axel under @anton_pick With enthusiastic consent. Patient’s wife was overjoyed and was able to “propose” with his ring back on the left side. His shoulder is front crawl ready and gait is easier. Bravo OXFORD! 🇬🇧

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

@VIHealthRes

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

As someone who runs an urgent triage for side effects of trauma and surgery. Transparency on #cryoneurolysis is key. Of 277 nerves 113 study patients 1/3 were mixed motor sensory unlike phenol. 96.75 % no side effects. 9 nerves had sensory dysesthesia 4 required treatment. All resolved. Tibial trunk most common affected.

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

The Victoria Peripheral Nerve and Spasticity Clinic is 100% reliant on donor support to advance care in Spasticity, nerve trauma, and complex regional pain syndrome. 🙏 @ourvichospitals

[Victoria Hospitals Foundation @ourvichospitals]

Congratulations to Dr. Paul Winston, Physiatrist, Researcher, & Innovator! A grateful patient has recognized you with a #CaringSpirit Award & donation! We are so grateful for your talent & dedication! 💚

Learn how @drpaulwinston is transforming care: https://t.co/xeSeCaKPrW

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

We really need to rethink what spasticity means in CP, as we are seeing tremendous change in CP @yourcpf @CPAllianceAU @Dr_Gorter

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

Dear @AveryBrohman @ourvichospitals when you told donors that you heard about a doctor in Victoria unparalyzing people 2 years ago. I said well not quite. Maybe you are clairvoyant as we can make movement. You have given us a force field against the healthcare crisis.@ceharnett

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

And that's a wrap. My first fellow flies away after today's clinic @med_umontreal A wonderful journey for us both. Presenting in France, Montreal, Portugal, hundreds of patients, a new treatment for spasticity, textbook, chapters, +++papers & joy. @BoissonnaultEve @RogerWong10

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

In the mail today. Thank you @BCPSQC For 15 years it has been a slog in a province with the least support for disabilities that shuns interdisciplinary care teams. I won’t stop fundraising and researching for better quality care. @AmandaMayo @UBCDoM @UBC @SouthIMSA @VIHealthRes

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

We look forward to welcoming @ourvichospitals believers for a tour of our facility next week. Especially those with sore knees. @AveryBrohman

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

My secret power is showing real video of research in rehab. Thrilled to use @ourvichospitals @VIHealthRes prize to study how treating knee osteoarthritis with #cryoneurolysis during inpatient neurorehab could immed. affect outcomes. Pilot left knee case. @PainBC @ubcorthopaedics

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

When @AveryBrohman told @ourvichospitals that a doctor was “unparalyzing” people. Whoa! Not quite. However we are now restoring hand function! So maybe a new “event” in Victoria weekly? @ceharnett Tears of joy on our end. @UBCDoM

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

Project open hand @VIHealthRes Yes Cerebral palsy can unleash new function @ResearchForCP like hand opening. @HBKidsHospital @PatientVoicesBC @BCPSQC #cryoneurolysis @DrWillerth @UBCDoM Sound! @AAPhysiatrists on our way. @BCCHresearch

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

The elbow is so important in spasticity. The brachialis is most commonly implicated in spasticity, but the biceps often contracts. We nerve block and decide which to target or both(left brachioradialis alone) #cryoneurolysis #spasticity

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

@SouthIMSA @UBCIMP @UBCISU

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

When they love perfecting ultrasound sometimes the fellow must be told its time to go home. But remember to mentor joy in medicine @UBCDoM @VIHealthRes @ourvichospitals #physiatry @AAPhysiatrists @AAPhysiatrists @JillianHortonMD #ballet @BalletVictoria #MedTwitter @marshalederman

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

@VIHealthRes

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

Does it make me 🇨🇦 that what keeps me awake at night is how to convince my Province/Country to provide our study treatment to all for free? I’m just not that doc that charges $800-1200 for procedures. I can’t even extra bill for migraines like neurologists @DoctorsOfBC @PHSAofBC

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

At @NerveVictoria we do our CME on paddleboards, hiking, and "en l'air" to keep it fresh. @UBCCPD

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

See people always ask of I miss dance. Medicine should never be allowed to take away YOU. I rejected the shame model that @JillianHortonMD has so amazingly outed. No one has the right to shame, humiliate. Med students/residents become trusted peers @JRossfamilymed @UBCmedicine

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

We ⁦@NerveVictoria⁩ Are shooting for more double rainbows in #2022 ⁦@ourvichospitals⁩ ⁦@MatthieuGahier⁩ #medtwitter . Stroke will always be the poor cousin for ⁦@HeartandStroke⁩ But not if we can help it

[Jordan Silverman @jdsilvermanPMR]

@NerveVictoria I also learned last month that you could get quite a wicked motor radiculopathy in about 5% of shingles cases. My patient had a dense C8 myotomal weakness, comanaging him with my plastic surgery colleagues for consideration of options.

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

And yes #CRPS type 2 from post zoster brachial plexitis is a thing! Prednisone and aggressive therapy!

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

I am 50 = shingles vaccine. GET IT! @BrianJovesMD @adfurlan It can be a horrific disorder, herpetic neuralgia, encephalitis is like altering. @CraigDiTommaso @LindsayDixonFP5 Why does it cost $150? @DrRitaMc @drcadesky

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

@drpaulwinston @SimaADesaiMD @NRomanoskiDO @ShengLiMDPhD @daddyrv @wustl_pmr @USGuidance @CraigDiTommaso @KU_PMR @jtylerbates @MVGutierrezMD Pleae @threadreaderapp unroll

[Paul Winston MD - Restoring Movement is the goal. @drpaulwinston]

1/. Obturator nerve localizing for spasticity. A thread @SimaADesaiMD @NRomanoskiDO @ShengLiMDPhD @daddyrv @wustl_pmr @USGuidance @CraigDiTommaso @daddyrv @KU_PMR @jtylerbates @MVGutierrezMD

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

If the pectoralis is a firm band at less than 90 degrees of abduction, its contracted, if nerve block does not release call your fav ortho or plastic surgeon if they have active movement ⁦@MVGutierrezMD⁩ ⁦@PicelliAle⁩ ⁦@drpaulwinston⁩

[Victoria Peripheral Nerve and Spasticity Clinic @NerveVictoria]

Thanks Dr Reebye and @VIHealthRes Dr Winston @drpaulwinston are proud to innovate “free to all” learning here and around the world as a gift. Some of our friends!