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Coma, Vegetative State, Locked in
State, Pain
Management and Spasticity Treatment
Coma, locked in state, and vegetative state commonly result from
traumatic
brain injury (TBI) and stroke. Comatose, vegetative, and locked-in
patients
appear irreversibly unconscious, asleep, and encephalopathic, but the
person
in coma, persistent vegetative state (PVS), and locked in state can be
treated, and the condition may be reversible. Head injury or brain
injury
can precipitate unconsciousness or coma. When eyes are open, the
patient
may be either locked-in or vegetative. The patient suffering from
locked
in state is awake and aware, but cannot move or speak. Vegetative
individuals
are awake and open their eyes, but are felt to be unaware of their
surroundings.
Recognition of the potential reversibility of coma, the vegetative
state,
and locked in state is critical. Offensive medications may prevent
ascension
from locked-in, comatose, and vegetative conditions. Dopaminergic and
noradrenergic
stimulant medications promote ascension from COMA, PVS, and locked in
state.
The brain can be jump-started from the vegetative, locked in, and
comatose
states. Coma, vegetative state and locked in syndrome may be sequelae
of
aneurysm bleed, infection, trauma, epidural hematoma, subdural
hematoma,
subarachnoid hemorrhage, and any cause of brain injury or stroke.
Treatment
may return a parent or child from a hospital bed to sitting at the
table,
eating dinner again with a loved family. Every patient deserves a
chance.
Coma awakening is one of Dr. Geller’s areas of specialty
training.
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Welcome to www.comawakening.com
Aaron S. Geller, M.D.
Nashua Pain Management Corporation
154 Broad Street
Nashua, NH 03063
Exit #6 Office
Building
near the Nashua Mall, one block from the Everett Turnpike
Dr. Geller's philosophy of being a medical
doctor is
treating every patient as if that person was his parent or child.Every
patient must receive the highest quality of care.
Welcome in your search for treatment!
Dr. Geller graduated with highest honors from the University of
Pennsylvania
School of Medicine. He completed his residency training at Tufts
University
– New England Medical Center. Tufts was affiliated with Spaulding
Rehabilitation
Hospital, now Harvard School of Medicine. Dr. Geller graduated Phi Beta
Kappa and Summa Cum Laude from the University of Pittsburgh as a
Provost
Scholarship recipient with degrees in neuroscience, chemistry, and
biology.
Dr. Geller is triple board certified by the American Board of
Pain Medicine,
the American Board of Electrodiagnostic Medicine / EMG / Peripheral
Neurology,
and the American Board of Physical Medicine and Rehabilitation. The
board
exam for the American Board of Electrodiagnostic Medicine is a three
part
and two day written, video, and intense oral examination. EMG's are
integral
to comprehensive pain evaluation and diagnosis to achieve the highest
quality
individualized successful treatment.
Dr. Geller serves as assistant professor of rehabilitation
medicine
at Tufts University School of Medicine. Dr. Geller also taught clinical
neuropharmacology of the brain as assistant professor of pharmacy for
Northeastern
School of Pharmacy in Boston as well as served as clinical instructor
at
Dartmouth School of Medicine. Dr. Geller has published extensively, and
he has been invited as guest lecturer to departments of neurosurgery,
orthopedics,
neurology, internal medicine, and physical medicine and
rehabilitation.
How do I reach Dr. Geller?
Dr. Geller’s office in Nashua can be contacted via e-mail atGellerTreatment@hotmail.com
To get to Dr. Geller’s NASHUA office near the Nashua Mall, one
block
off the Everett Turnpike, 30 minutes south of Concord, take 93 South to
293 South, then veer left to the Everett Turnpike and take exit #6 to
130-West.
At the first set of lights, make a U-turn back to the highway. After
you
pass the Shell gas station, take an immediate right at 150 Broad Street
at the Carlson Real Estate Building. Continue through the parking lot
past
the Japanese Bistro to the adjacent building at 154 Broad Street,
Nashua,
NH 03062.
Nashua Pain Management
Notice of Privacy Practices
This notice describes how health information about you may be
used and
disclosed and how you can get access to this information. Please
review it carefully.
Uses and Disclosures of Your Health Information
1. In some circumstances we are permitted or required to use
or disclose
your health information without offering you the opportunity to
object.
These circumstances include:
a. Uses or disclosures for purposes relating to treatment,
payment and
health care operations:
i. Treatment. We may use or disclose your health information
for the
purpose of providing, or allowing others to provide, treatment to you
or
any other individual. An example would be if your pain care
physician
discloses you health information to your primary care physician. Also,
we may contact you with appointment reminders or information about
treatment
alternatives or other health-related benefits and services that may be
of interest to you.
ii. Payment. We may use and/or disclose your health information
for the purpose of allowing us, as well as other entities, to secure
payment
for the healthcare services provided to you. For example, we may
inform your health insurance company of your diagnosis and treatment in
order to assist the insurer in processing our claim for the health care
services provided to you.
iii. Health Care Operations. We may use and/or disclose your
information for the purposes of our day-to-day operations and
functions.
We may also disclose your information to another covered entity to
allow
it to perform its day-to-day functions, but only to the extent that we
both have a relationship with you.
b. To create material(s) that originally had any identifying
information
concerning you deleted from the final material(s);
c. When required by law;
d. For public health purposes;
e. To disclose information about victims of abuse, neglect or domestic
violence;
f. For health oversight activities, such as audits or civil,
administrative
or criminal investigations;
g. For judicial or administrative proceedings;
h. For law enforcement purposes (any patient who violates there opioid
contract agrees to have Nashua Pain Management send records to law
enforcement,
all past and present clinicians, and all past and present pharmacies.);
i. To assist coroners, medical examiners or funeral directors with
their official duties;
j. To facilitate organ, eye or tissue donation;
k. For certain research projects that have been evaluated and approved
through a research approval process that takes into account patients’
need
for privacy;
l. To avert a serious threat to health or safety;
m. For specialized governmental functions, such as military, national
security, criminal corrections, or public benefit purposes, any patient
in the past or future applying for social security, medicare, medicaid,
disability, or welfare may have records sent to these agencies to
assist
in patient evaluation; and
n. For workers’ compensation purposes, as permitted by law.
Your Rights
1. To Request Restrictions. You have the right to
request restrictions
on the use and disclosure of you health information for treatment,
payment
or healthcare operations purposes or notification purposes. We
are
not required to agree to your request. If we do agree to a
restriction,
we will abide by that restriction unless you are in need of emergency
treatment
and the restricted information is needed to provide that emergency
treatment.
To request a restriction, submit a written request to the contact
listed
on the final page of this notice.
2. To Limit Communications. You have the right to receive
confidential
communications about your own health information by alternative means
or
at alternative locations. This means that you may, for example,
designate
that we contact you only by mail or at work rather than at home.
To request communications via alternative means or at alternative
locations,
you must submit a written request to the contact listed on the final
page
of this notice. All reasonable requests will be granted.
3. To Access and Copy Health Information. You have the right
to inspect and get a copy of any health information about you other
than
information compiled in anticipation of or for use in civil, criminal
or
administrative proceedings, or certain information that is governed by
the Clinical Laboratory Improvement Act. To arrange for access to
your records, or to receive a copy of your records, you should submit a
written request to the contact listed on the last page of this
notice.
If you request copies, you will be charged our regular fee for copying
and mailing the requested information.
Despite your general right to access your Protected Health
Information,
access may be denied in some limited circumstances. For example,
access may be denied if you are an inmate at a correctional institution
or if you are a participant in a research program that is still in
progress.
Access may be denied if the federal Privacy Act applies. Access
to
information that was obtained from someone other that a health care
provider
under a promise of confidentiality can be denied if allowing you access
would reasonably be likely to reveal the source of the
information.
The decision to deny access under these circumstances is final and not
subject to review.
In addition, access may be denied if (i) access to the
information in
question is reasonably likely to endanger the life and physical safety
of you or anyone else, (ii) the information makes reference to another
person and your access would reasonably be likely to cause harm to that
person, or (iii) you are the personal representative of another
individual
and a licensed health care professional determines that your access to
the information would cause substantial harm to the patient or another
individual. If access is denied for these reasons, you have the
right
to have the decision reviewed by a health care professional who did not
participate in the original decision. If access is ultimately
denied,
the reasons for that denial will be provided to you in writing.
4. To Request Amendment. You may request that your
health information
be amended. Your request may be denied if
the information in question: was not created by us (unless you show
that
the original source of the information is no longer available to seek
amendment
form), is not part of our records, is not the type of information that
would be available to you for inspection or copying, or is accurate and
complete. If your request to amend you health information is
denied,
you may submit a written statement disagreeing with the denial, which
we
will keep on file and distribute with all future disclosures of the
information
to which it relates. Requests to amend health information must be
submitted in writing to the contact listed on the final page of this
notice.
5. To an Accounting of Disclosures. You have
the right
to an accounting of any
disclosures of your health
information
made during the six-year period preceding the date of you
request.
However, the following disclosures will not be accounted for: (i)
disclosures
made for the purpose of carrying out treatment, payment or healthcare
operations,
(ii) disclosures made to you, (iii) disclosures of information
maintained
in our patient directory, or disclosures made to persons involved in
your
care, or for the purpose of notifying your family or friends about your
whereabouts, (iv) disclosures for national security or intelligence
purposes,
(v) disclosures to correctional institutions or law enforcement
officials
who had you in custody at the time of disclosure, (vi) disclosures that
occurred prior to April 14, 2003, (vii) disclosures made pursuant to an
authorization signed by you, (viii) disclosures that are part of a
limited
data set, (ix) disclosures that are incidental to another permissible
use
or disclosure, or (x) disclosures and only if the agency or official
asks
us not to account to you for such disclosures and only for the limited
period of time covered by that request. The accounting will include the
date of each disclosure, the name of the entity or person who received
the information and that person’s address ( if known), and a brief
description
of the information disclosed and the purpose of the disclosure.
To
request an accounting of disclosures, submit a written request to the
contact
listed on the final page of this notice.
5. To a Paper Copy of this Notice. You have the right to
obtain
a paper copy of this notice upon request.
Our Duties
1. We are required by law to maintain the privacy of you
health information
and to provide you with this notice of our legal duties and privacy
practices.
2. We are required to abide by the terms of this notice. We
reserve
the right to change the terms of this notice and to make those changes
applicable to all health information that we maintain. Any
changes
to this notice will be posted on our website and at our facility, and
will
be available from us upon request.
Complaints
You can complain to us and to the Secretary of the federal
Department
of Health and Human Services if you believe your privacy rights have
been
violated. To lodge a complaint with us, please file a written
complaint
with the contact set forth below. This contact will also provide
you with further information about our privacy policies upon
request.
No action will be taken against you for filing a complaint.
Designated Contact;
Aaron S. Geller, M.D.
Medical Director
Nashua Pain Management
154 Broad Street
Nashua, NH 03063
Phone: 603-882-9872
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