patients out of wheelchairs, baric chambers as part of his reclining adjustable exam practice, he became board- chairs and a roll-in shower for certified in undersea and clean-up, if needed. hyperbaric medicine, which Every room is modified for includes treating people with comfortable access, exceed- decompression sickness. ing ADA (Americans with Hyperbaric oxygen therapy Disability Act) requirements. takes place when a patient is For example, the counter area placed in a special chamber in the waiting room serves as a that is pressurized with 100 desk for wheelchair patients. percent pure oxygen to get A small operating room high levels of oxygen into their for skin grafts also is part body. These high doses can of the office plan. The air in help heal damaged organs and that room exchanges 15 times promote the healing of chronic a minute to minimize the wounds, especially wounds chance for an infection. located in bones. Also included in the office "This therapy is important space are a staffed pharmacy for some treatments because and several enclosed exami- it can promote the growth of nation rooms for patients' new tissue, decrease swell- exams. ing and inflammation, and The second impression usu- clear out toxins and metabolic ally comes when patients get waste products from the body:' used to watching one of two Ruben says. "Interestingly, hos- Patient Jack Ginsberg of West Bloomfield talks on the phone with employee Kitty Carpenter of Redford as he trained family dogs interact pitals are reimbursed for their gets his treatment in a hyperbaric oxygen chamber in the office. with patients. An exotic caged use of chambers for identical bird joins the menagerie. assessments and traditional Chinese medi- treatment while some insur- The pets physiologically and psycho- Evaluating Wounds cine at this outpatient facility. ance companies refuse to reimburse our logically aid in healing, says Ruben, who According to Ruben, there are five main Ruben also is planning to include more treatments when we use the chambers. It assures there are no contagious nor infec- reasons why a wound won't heal: Chinese Traditional Medicine (CTM) for doesn't make sense because treating people tious diseases that can pass between these • Pressure wound treatments in the future. The once- as outpatients costs so much less than treat- domesticated dogs and his patients. • Infection weekly trips to Chicago where he studied ing patients who are hospitalized:' One of Ruben's goals is to make this • Edema (accumulation of fluids) with seventh-generation master Chinese One of Ruben's goals is to keep his facility environmentally friendly. He often • Impaired circulation herbalist and acupuncturist, Dr. Zhengang patients out of the hospital to eliminate the attributes the considerations of caring for • Poor nutrition Guo, are now less frequent. However, Guo health risks and bureaucracies associated people beyond their problem to the prin- "We evaluate each of these areas one at occasionally visits Michigan to train Ruben with hospital care. ciples of tzedakah, lovingkindness. a time because if any one of the five is not and his staff about herbal medications. Dr. Scott H. Cooper, an internist, said, "'Love your fellowman as yourself' is managed, no matter what I do with the A primary tenet of Chinese Traditional "Many of my patients have cellulitis [a part of our morning prayers:' Ruben says. other four, I won't be able to accomplish Medicine is to rebalance the body so that skin infection] or wounds that won't heal The office is open seven days a week, healing; he says. "That's why just focusing the body itself can do its own healing. because of diabetes, or they have pres- although Ruben doesn't work on Shabbat. on the wound doesn't work. I've found that Sharon Brown of Oak Park was referred sure wounds because they're confined to a Ruben's journey to a more spiritual life nutrition is the single most common over- to Ruben for treatment of cellulitis. wheelchair. I often take the patient by the began when he asked Rabbi Finman if looked factor in wound medicine. Just ask "They have a trained therapist who hand and go with them down to Dr. Ruben's he knew someone who could teach him any mother what's important:" worked on reducing lymphadema in my office since we're in the same building. My Hebrew and Jewish studies. Ruben was As an example, Ruben explains that when lower leg through massage so that the patients tell me he's very thorough and they raised in a Conservative family, but felt his you have a wound, your body is never at wound could heal; Brown says. "Combined love him. The fun part for me is that Bruce Jewish education was lacking. Finman told rest because it's trying to heal the wound. with the family-friendly atmosphere and and I attended the same elementary school him that teaching was all that he did. To increase its effort, your body starts using the technician's skill, my experiences there together. We go way back:' The studies began six years ago and more protein and you become protein defi- were very pleasant and supportive. During Ruben was recently invited to serve on continue today. Ruben also studies with cient. The longer you have the wound, the my visits, I've met Dr. Ruben's parents, his the advisory board of the National Spinal more protein deficient you become. Rabbi Shneur Silverberg at the Sara and wife and his children:' Cord Injury Association's Medical and To manage this problem, Ruben increases Morris Tugman Bais Chabad Torah Center Dr. Lawrence M. Dell, a West Bloomfield Scientific Advisory Committee (MSAC). the caloric intake for some patients and in West Bloomfield. internist, says, "I refer my patients to Bruce MSAC is a group of health care profes- makes sure patients understand the nutri- "Bruce is Orthodox and attends Bais Ruben because they have a wonderful facil- sionals whose expertise includes caring for tional value of different foods. The office Chabad Torah Center for early morn- ity, but more importantly they are compas- disabled persons living with spinal cord maintains a nutrition counter on one side ing and Shabbat services:' says his wife, sionate. injuries (SCI) and who are committed to of the infusion room to help patients con- improving the quality of life of people living Mindy, who was raised Reform. "They personally follow up with patients with this injury. She does much of the public and patient sume the right amount and the right kind and make sure the patients understand relations for Encompass HealthCare, of calories. Fresh fruit, energy bars, protein their treatment. I've sent him patients who In addition to giving his input on heath which is in the Lakes Medical Center. The powder and information about nutrition are were told that their limb would eventually care policies, Ruben will assist in finding Rubens live in West Bloomfield and have readily available. be amputated because a wound wouldn't ambulatory resources, reducing the need three daughters ages 23, 15 and 12. The treatments available in Ruben's office heal. Ruben avoids loss of limbs for my for hospitalization for SCI patients. "Our family will be dedicating a new compare favorably to most wound centers patients with his multidiscipline approach. Ruben continues to declare that one day Sefer Torah, written in New York, this com- at local hospitals. Rather than sending a He has better outcomes, fewer complica- he's going to petition the AMA (American ing Labor Day to Bais Chabad," she says. patient to different specialists, treatments tions and is less expensive than going to a Medical Association) to make wound medi- Individuals will be able to purchase a letter include IV antibiotic therapies, hyperbaric hospital:' cine a separate division requiring board to be written in the Torah to fulfill the 613th oxygen treatments, stem-cell and artificial Ruben is board-certified in internal certification. Those who know him are commandment. (An upcoming IN story will skin grafts, wound debridement and wound medicine and infectious diseases. Once he convinced he's going to carry out this proc- provide more details.) vacuum systems, complete nutritional determined that he needed to use hyper- lamation. ❑ July 25 • 2013 65