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 Clinical Director 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. 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. 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.
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.
Marie Pace, OT
Senior/Certified hand therapist
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.
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
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.
Paula Kovanic Spiro, LSW, MPH
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.
The following physicians/staff do not attend clinic, but they participate in management of our patients.
Pulmonary Care Team
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, John Lee and Patrick Strollo, at UPMC Health System in the Comprehensive Lung Center can provide:
Recommendations for non-invasive ventilatory assistance and mechanical ventilation.
A discussion of other options for ventilatory assistance.
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.