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University of Pittsburgh

Center Director

David Lacomis, MD

David Lacomis, MD

Dr. Lacomis is a Professor of Neurology and Pathology as well as Chief, Division of Neuromuscular Diseases. In addition to directing the MDA-ALS Center and multidisciplinary clinic, he is the Director of Clinical Research for the Live Like Lou Center for ALS Research. He also co-directs the electromyography laboratory, and is in charge of the muscle and nerve pathology service. Dr. Lacomis has been named annually among the “Top Doctors” by Pittsburgh magazine, and in both “Best Doctors” and “America’s Top Doctors” nationally. He lectures extensively and is a contributing author for numerous medical journals and books regarding his major clinical interests of ALS, myasthenia gravis, and muscle diseases. Dr. Lacomis has been a site Principal Investigator (PI) in numerous clinical drug trials in ALS, biomarker studies, DNA banking, and diaphragm pacing. He has been a coinvestigator in ALS research regarding environmental toxins, noninvasive ventilation, high field MR imaging, and caregiver burden. With Drs. Donnelly, Carlisle and Friedlander, he is helping to generate motor neurons from skin stem cells of ALS patients. He teaches and mentors clinical fellows, medical students and house staff from Neurology and Pathology. Dr. Lacomis is a member of the editorial board for the Journal of Clinical Neuromuscular Diseases and two scientific advisory committees as well as the Northeastern ALS Consortium

Profiles of each of the specialists from the multidisciplinary team are included below:

 

Sasha Zivkovic, MD, PhD (left) and Araya Puwanant, MD (right) also treat patients with ALS. They are Neurologists in the Neuromuscular Division and are University of Pittsburgh faculty members, board certified, and have sub-specialized training in neuromuscular disease.  Dr. Zivkovic is also listed in Best Doctors.  They also perform electrodiagnostic testing and are active in clinical research in ALS and other neuromuscular disorders.

Neuromuscular Nurse Practitioner
Rebecca Molczan, MSN, CRNP

The MDA-ALS Clinic’s team of caregivers is coordinated through the specialized training of a neuromuscular clinical nurse specialist. While facilitating patient care, the nurse clinician is also relied upon as an educational resource for patients and their families. By assessing each patient’s general health and care problems, the nurse clinician is able to route patients to the appropriate consultant for immediate attention and also manage problems via telephone between appointments. The nurse practitioner also assesses breathing function at clinic visits.

Physical Therapist
Kathleen Brandfass, MS PT
Director of Neuro, Vestibular and Geriatric Outpatient Services
UPMC /Centers for Rehab Services

By evaluating each patient’s joint range of motion, strength, and general mobility skills, physical therapists can provide guidance for such tasks as walking or getting out of a chair. They specialize in:

  • Improving function and balance and providing instruction on managing physical disabilities.
  • Recommending appropriate exercises to maintain flexibility, while preventing and reducing pain.
  • Providing instruction regarding the use of assistive devices, braces, or other mobility aids to maximize independence.

Occupational Therapist
Lauren Oschwald, MOT, OTR/L
UPMC/Centers for Rehab Services

The occupational therapist evaluates a person’s performance with activities of daily living to assist in maximizing functional independence. Personal care, mobility, and work activities are assessed through interview and functional evaluation in the ALS Clinic. Recommendations for upper extremity strengthening and range of motion, assistive devices, durable medical equipment, and home or outpatient therapies are made.


Registered Dietician

Kathleen M. Zatavekas, MBA, RD, LDN
Ambulatory Dietitian Coordinator
UPMC Presbyterian Shadyside

 

Registered dieticians provide nutritional counseling through diet management to promote good nutrition while preventing malnutrition. She is available to:

  • Assess each patient’s nutritional needs based upon the progression of the disease.
  • Develop individual care plans for each patient to promote a good nutritional status.
  • Suggest calorie and protein supplements to increase daily caloric and nutrient consumption.
  • Adapt the consistency of foods and liquids when swallowing becomes difficult.
  • Recommend other forms of nutrition (such as tube feedings) when patients are not able to maintain adequate nutrition.

Patient Service Coordinator
Patricia McGuire

Representatives from the Muscular Dystrophy Association work with our patients to inform them about services that their organization provides to them. These services include:

  • Educational information
  • Equipment loans
  • Support groups for patients and caregivers.

Social Workers


Ann O'Leary Amato, MSA

Social workers provide personal support to people with ALS and their families by offering:

  • Referrals for ongoing counseling.
  • Information about homecare assistance services.
  • Recommendations of community resources and local and national agencies that offer both information and support for ALS.
  • Financial resource information such as social security disability, supplemental security income, Medicaid and financial assistance programs.
  • Assist with Advance Directives.

Swallow Evaluation and Management (Swallow Therapy)

 


Cara Donahue, MA, CCC-SLP

James L. Coyle, PhD, CCC-SLP, BCS-S

Speech-language pathologists who specialize in swallowing at the ALS clinic provide the following services to patients:

  • Education to patients and families regarding dysphagia (swallowing difficulties), signs and symptoms of dysphagia, and risks associated with dysphagia.
  • Screening for dysphagia to assist patients in maintaining safe, efficient, and enjoyable eating and drinking despite disease progression.
  • Instruction to patients regarding diet modifications and adaptions to eat and drink safely and efficiently.
  • Referrals for instrumental swallowing evaluations to further assess swallow function as needed.
  • Education and instruction about respiratory interventions that may help to maintain respiratory, cough, and swallow function in patients with ALS.
  • Discussion of patient care goals for maintaining nutrition, hydration, and quality of life throughout disease progression.

Speech Therapy and Augmentative Communication

 

Katya Hill, PhD, CCC-SLP, Michael O'Leary, MS, CCC-SLP

See http://www.icantalkclinic.com/     

For an appointment call 412-489-5527

 

Katya Hill, Ph.D., CCC-SLP or Michael O’Leary, M.S., CCC-SLP from the ICAN Talk Clinic attend multidisciplinary clinic and follow patients in the AAC Institute in Carnegie,  a full-service speech and language pathology outpatient center with a specialty in providing professional services to individuals with severe communication disorders, particularly those who rely on Augmentative & Alternative Communication (AAC) systems or benefit from other assistive technology to support treatment.  AAC systems include eye gaze and brain computer interface (BCI) access.

 

The following physicians/staff do not attend clinic, but they participate in management of our patients.

 

Pulmonary Care Team

 

Respiratory Therapist

The respiratory therapist’s responsibilities include:

  • Facilitating referrals to our experienced pulmonologists and follow-up appointments in the sleep/pulmonary clinic (phone 412-648-6161)

  • Acquiring authorization for respiratory equipment such as cough assist devices and BiPAP

  • Assessing cough and breathing function

  • Assess proper utilization of equipment for treatment of sleep disordered breathing, ventilatory dysfunction, and weak cough

The pulmonologists, especially Dr. David Kristo at UPMC Health System in the Comprehensive Lung Center can provide:

  • Recommendations for cough assists, non-invasive ventilatory assistance and mechanical ventilation.

  • A discussion of other options for ventilatory assistance.

Surgeon

Surgeons from Trauma and General Surgery at UPMC, especially Graciela Bauza, MD are experts in placement of gastrostomy tubes (feeding tubes) for ALS patients. They can also switch the tube to a Mic Key button and manage any complications. They coordinate feeding tube placement with Nutritional Services.

 

CAT (Center for Assistive Technology)

We refer patients to the UPMC and University of Pittsburgh CAT for power wheelchair evaluations, augmentative communication, specialized computer equipment, and adaptive driving and evaluation.