Throughout the year, Burke will be spotlighting our world-renowned physicians to help patients and their families learn more about the physician's areas of expertise and interest, research and background.
For Carolin Dohle, M.D., co-director of the Stroke Rehabilitation Program at Burke, working in medicine was always a dream. “Human biology and how the body works always fascinated me,” she explains. Growing up in Germany, she pursued her dream of becoming a doctor by attending medical school in her home country.
But then she took a few electives in the U.S. and fell in love with the way the medical system was done here. “In the U.S. there’s so much focus on residency—they are so very closely supervised and attend many conferences. I love the teaching and mentor aspect of the schooling here.” She moved to the States in 2004 and did one year of research in a lab at Yale in New Haven. She was hooked. She then became a neurology resident at Yale, before doing her fellowship at Burke. She then joined the staff at Burke and is now the co-director of the Stroke Rehabilitation Program
Why neurology? “I find it fascinating how brain injuries can affect people. The brain is the most important part of the body,” she explains. She particularly was interested in recovery after strokes. “I thought about going into acute stroke care initially, but I was actually more interested in the long-term effects post-stroke.”
She explains that strokes used to be the third most common cause of death, but it’s dropped down to number five. “There are many more patients that have survived acute stroke,” she explains.“We are medically advanced enough to save patients—they are no longer dying of infections or other complications.” What this means, is that there are many more stroke survivors and many more people living with stroke-related disability. “There’s an urgent need to find new avenues to improve brain functionality.”
What makes Burke so special is that not only is a world-renown hospital, but it’s also at the cutting edge of research, and research is a passion of Dr. Dohle’s.
“Many people are surprised at just how many trials we are doing at Burke,” she explains. The research institute and the hospital have a very strong interaction. “Plus, we have speakers from all the over world talking to us and we’re doing research on so many different areas. We are doing cutting edge therapies—including robotics—with the end goal of how to best serve our patients.”
So when patients are done with rehab (three weeks is the average length of stay for stroke patients at Burke), they can continue on through outpatient care and through trials.
One such trial is the use of stem cell research for those in the chronic phase. “When recovery has slowed down and the patient has plateaued in function, we want to see how stem cells can jump start the brain into re-organizing itself.”
Another important clinical trial she’s overseeing looks at the efficacy of a ketogenic diet—high fat, low carb—for improving post-stroke recovery. “It’s a strict version of the Atkins diet,” Dr. Dohle explains. The purpose of the study it to see if patients’ bodies can break down fat instead of sugar. “Glucose is bad for the brain, so we want to see if a patient can break down the ketones and have the brain use it as energy,” she explains. “This would be an alternative energy substitute for the brain.” The hope is that this would ultimately improve motor function.
Another study looks at weight changes after a stroke. “Clinically a lot of people are losing weight post-stroke, about 20 or 30 pounds,” Dr. Dohle explains. “We want to know why: is it because they’re not eating as much or is there something else going on.”
The goal of all the studies and trials are to improve the lives of those post-stroke survivors. For instance, the use of the medication Prozac in stroke patients has been an exciting breakthrough. “It’s not necessarily used to treat depression, it’s for motor recovery,” she explains. Through trials and research, Dr. Dohle and her team are changing the outlook for neuro-rehab.
In addition to all the research, Dr. Dohle sees patients every day. “I meet with the residents and do teaching rounds every day,” she explains. This is one of the aspects of the American medical system she fell in love with over ten years ago. “I see 15-20 patients a day and check for things like diabetes, blood pressure, pain management and depression.”
She’s also seeing an increase in younger people with strokes. For this demographic, there’s a much broader work-up. She looks at risk of blood clots, genetic predisposition, if they have an auto-immune condition, or an irregular heartbeat.
What is she most proud of? “Helping patients achieve maximum recovery,” she explains. “One of the goals is to keep medical complications at minimum so we can focus on recovery.” This involves working with the families and getting them involved in treatment and educating them about trials.
Her goal is to focus on getting patients back to what they enjoyed. “If they loved golf but now have problems with their arm, I want to get them into the therapeutic department to see what modifications can be done so they can go back to enjoying golf.” She talks to her patients about quality of life every day.
“In our society we seek perfection, but my goal with my patients is not perfection. It’s having independence, not being perfect, but working with the disability they they have to lead an independent life and continue to do the things they love.”