Kolishtin Lyadov, academician Kostyantin Lyadov, the largest general director of the Federal Budgetary Institution "Rehabilitation and Rehabilitation Center" (LRC) of the Ministry of Health of the Russian Federation, having abandoned his estate after the scandal with the admission of state officials to academicians, having honed the "Stationary Cluster of Medsi" - the project of the largest private facility of clinics Group of companies "Medsi". At the same time, Tetyana Shapovalenko moved from Kostyantyn Lyadov to Medsi, as she had previously captured the head doctor of the LRC.
Medsi Kostyantin Lyadov will develop the pilot project "Stationary Cluster of Medsi", in which it is planned to unite a polyclinic in Solyanets, a medical assistance service, a polyclinic in Shchelkovo, Stupino, Krasnogorsk, Vidradny, Mitino, clinics chnu likarnu in Vidradnoe and sanatorium "Otrad .
At "Medsi" rozakhovuyut, scho in such a rank to form a new cycle of providing polyclinic, inpatient and rehabilitation services at the borders of the city.
Following Kostyantyn Lyadov, Professor Tetyana Shapovalenko crossed to Medsi, as earlier she had caught the head doctor of the LRC. Vaughn is the author of numerous publications in vicissitudes and foreign medical schools on the nutrition of rehabilitative medicine and medical rehabilitation, as well as the leading doctor of the cycle of TV programs “Give Your Life” on the Rosiya TV channel, dedicated to a healthy way life.
About the appointment of the director of the FDBU LRC, who became an academician of the Russian Academy of Sciences Kostyantin Lyadov, it became known for example the day of 2016. The same academician explained his decision with an ambiguous suggestion of the country's education about the impossibility of joining the key state settlements from membership in the Russian Academy of Sciences and scientific activity.
The President of Russia, Volodymyr Putin, announced the call of officials, who became members of the Russian Academy of Sciences or were elected academicians, like the year of 2016. So, by a presidential decree, Oleksandr Fisun, head of the Head Military Medical Department of the Ministry of Defense, and Kostyantin Kotenok, head of the Head Medical Department of the Rights Department of the President of the Russian Federation, were imprisoned. Following them, the director of the Department of Science, Innovative Development and Management of Medical and Biological Health Risks of the Ministry of Health, Sergiy Rumyantsev, followed them behind the vlasny bazhanny.
Kostyantin Lyadov was born in Moscow in 1959. Vіn graduated from the First Moscow Medical Institute named after. I.M. Sechenov, and in 1997, having conquered the tenure of the head doctor of the Moscow Central Clinical Basin Medical Center. Years later, becoming the vice director of the National Medical and Surgical Center named after. N.I. Pirogov. Since 2006, Kostyantin Lyadov has been studying the Federal Budgetary Institution “Rehabilitation and Rehabilitation Center” of the Ministry of Health of the Russian Federation. Lyadov is the author of over 300 scientific articles and 12 monographs.
ZAT DK "Medsi" is one of the largest medical holdings in the Russian market of commercial medicine. There are 13 clinics near the Moscow region, three clinical diagnostic centers near Moscow, seven regional clinics, three sanatoriums, a Swedish medical assistance service, three wellness centers and 55 first-aid posts in the regions. In 2015, the turnover of Medsi's turnover shrank by 15.7% - to 8.2 billion rubles, the net increase was 127 million rubles. With such indications, the holding has taken a position among the TOP100 private rich-profile clinics of the Vademecum Analytical Center.
Academician, professor, doctor of medical sciences Kostyantin Viktorovich Lyadov Earlier, in 2006, Kostyantin Lyadov hit the head of the Federal Budgetary Institution “Little-Rehabilitation Center” of the Ministry of Health of the Russian Federation.
Kostyantin Viktorovich Lyadov was born in Moscow in 1959, graduated from the First Moscow Medical Institute named after I.M. Sechenov. Since 1997, he worked as the head physician of the Moscow Central Clinical Basin Clinic, later director, senior director of the National Medical and Surgical Center named after. N.I. Pirogov. Kostyantyn Viktorovich is a member of the working group of cardiorehabilitation of the European Association of Cardiologists and the editorial board of the journal "Bulletin of Advanced Medicine", the author of over 300 scientific articles and 12 monographs. Academician K.V. Lyadov is a leading expert in the rehabilitation of ailments after stroke and myocardial infarction with lesions of the musculoskeletal apparatus and rehabilitation of ailments with injuries. Rightfully respected by one of the pioneers in the promotion of new modern technologies in rehabilitation.
The company MEDS Kostyantin Lyadov will develop the project "Stationary Cluster of MEDS" until the clinic in Vіdradny, the sanatorium "Vіdradny", the Polyclinic in Shchelkovo, the Polyclinic in Stupino, the Polyclinic in Krasnogorsk, Poli clinic in Vidradny, Poli dopomogi, Polyclinic in Solyanci. Successful implementation of the project "Inpatient Cluster MEDSI" will allow the company to strengthen its position in the market for providing outpatient, inpatient and rehabilitation services.
Together from Kostyantyn Lyadov, a strong team of facilitators from various medical departments came to MEDS, including Professor, Doctor of Medical Sciences Tetyana Volodymyrivna Shapovalenko, the head physician of the Clinical Hospital of MEDS near Vidradny, as earlier embraced the settlement at the intercessor of the director of s likuvalnoї work of the Federal Budgetary Institution of Ukraine » Ministry of Health of the Russian Federation. Tetyana Shapovalenko is the author of numerous publications in vicissitudes and foreign medical schools on the nutrition of rehabilitative medicine and medical rehabilitation, as well as being the host of the leading doctor for the series of TV programs “Give Your Life” on the Rosiya TV channel, affiliated healthy way of life.
“Coming to the team of MEDS fahivtsіv of such a level to allow expanding the competence of the company, uniting all the stages of medical assistance and helping directly medical rehabilitation”, - appointing the medical director of JSC “Group of companies “Medsi”, candidate of medical sciences Pavlo Bogom tin.
Є. Kryukov:
Hello, tse Mediadoctor, "Online reception", on air, Katerina Kryukova. Today we have the Day of the Rehabilitator, at the meeting with which we were chosen by Kostyantin Lyadov, doctor-surgeon, oncologist, doctor of medical sciences, professor, academician of the Russian Academy of Sciences. Good afternoon.
K. Lyadov:
Good afternoon.
Є. Kryukov:
Kostyantina Viktorovich, let's figure out who such a medical rehabilitation specialist is and why do we need medical rehabilitation?
K. Lyadov:
You start from the best food. The name of the specialty changed frequently. I doctor-rehabilitator - tse, singly, people, yak vindicated for those that our patient after the operation, after the treatment, after the troubles, with some faults, opined in the hospital, or with some faults, he came to the doctor outpatient reception, vresti-resht turning as much as possible resurrect to a normal life.
The ideal doctor-rehabilitator is a fahivets of a wide profile, a kind of intelligence, as a way to restore the functions of the body as a whole. Oskіlki most people come from a specific problem, this problem is escalated. Ale pіd hour vyrіshennya tsієї problems vinikayut іnshі, oskolki operation prizvodit until kakihos skladnen. Exciting folding, vashka, chemotherapeutically produce the same way to side effects on the body. І rehabilitologist can minimize the shortcomings of healing and optimize the process of renewal of the body.
The ideal doctor-rehabilitator is a specialist of a wide profile, a kind of intelligence, as a way to restore the functions of the body as a whole
Є. Kryukov:
Chi correctly I understand that the doctor-rehabilitator cannot graze a skin patient after a skin operation, feed, how can you do it? That the nutrition of the rehabilitation depends on the equal care of the clinic, establish, what are we talking about?
K. Lyadov:
Shvidshe, on a par with the appearance of a doctor, a specialist (neurologist, oncologist, gynecologist) about those who are in rehabilitation. If we speak with colleagues, we read lectures, we ask, and who prescribes some methods of treatment, non-drug, and other drug methods. We are directed to the doctor of exercise therapy or a rehabilitator. I'm trying to explain what kind of jubilation the doctor is giving. That is why a gynecologist, urologist, oncologist, neurologist is obliged to know as much as possible about the changes in the methods and the ability to do so, in order to encourage the patient.
What is the need for physiotherapy in resuscitation? You come with some unreasonable accessories and take care of the sick stomach, and mi yogo was operated on light or on your feet. We say that if the patient is lying down, the intestines are no better. And if the intestines are swollen, then the legs are pressed, the diaphragm is lifted. So I blame my mother for chronic pneumonia. As we work so that the intestines are pracyuvatime good, the legends do not rise.
I most often teach literate fahivtsy to explain that the body of a person is just a folding mutual mechanism. You can pour in on a call, it would have been possible, without giving a moment to solve problems, as if you were unsuccessfully trying to win in the forehead. The doctor-rehabilitator is such an integrative fahivets, which from different sides can reach the problem and propose a solution, vicorist different methods.
Traditionally, the statement about rehabilitation is exercise therapy and physiotherapy. The main part - just see training, simulators, mechanisms, everything that is not related to faces. Tim is not less, we actively zastosovuєmo and medicines, to encourage the patient, to prepare him to the farthest exultation. І tse zovsіm іnshiy pіdhіd to people. So you can rehabilitate yourself, be it as it is, and її even more smoothly finish it. Because if we go to the fitness center, we can say that we are doing rehabilitation. If we induce a child, as we can’t get angry at the training, and our psychologists are engaged in it in order to learn how to concentrate and not be thrown off by respect (respect is often a problem at times), vicorist methods of rehabilitation, electrical stimulation, b іologichny zvorotnyy zv'azok, vikoristovuyuchi methods be-like a singing correction, the same rehabilitation, if the child is healthy, there, in a bad way, nothing is ill. And if we go to the hall, we won’t be sick. Alemie we can paint ourselves indistinctly. And so the very rehabilitation. You can look up whether you are mitigated: before the operation, under the hour of healing, after the injury. And finish її even more smoothly, for that person who wants to achieve such an ideal and become better, lower it was before the operation. That’s why it’s not easy to eat here, and it’s possible to drink a lot, a pro-rehabilitologist is a person, like to marvel at a patient, like on the same line, not succumbing to the disease.
Rehabilitation can be different, whether it is a mit: before surgery, at the hour of healing, after injury. And finish її even more smoothly, to the fact that a person always wants to achieve such an ideal and become better, lower it before the operation
Є. Kryukov:
How can I do it, if a person is put into a situation, if an operation is needed, then the task of the entire medical team, the staff is to make life as easy as possible after the operation, to shorten the post-rehabilitation period, and it is unacceptable stі, z tsim pov'yazanі, that vrahuvati all riziki zazdalegіd.
K. Lyadov:
Most of all, it is best to respect that the robot is repaired before the operation. We begin, if we can help the patient and help us understand that in the new, we will see these problems, for some reason, we can prepare the heart-vascular system, the dichal system, before the operation, psychological characteristics. Shards of some people are more afraid, lower is normal, and it is also possible to produce summation. It is best to operate on the day of hospitalization of the patient, there are no fears, there are no hospital admissions. It’s even better to change our colleagues, and even more our clinics to come before the patient can be prepared, come early and the same day to be operated on. It’s even more difficult to change the surgeon’s mind about the fact that the patient needs to be lifted up once, as if only after anesthesia, and let him take a walk. That is why a whole complex of mechanisms is included here: the mechanism of proprioception, the mechanism of inclusion of dyhal analyzers. We called to the upright, we lie not guilty. And if a person is stale to make a profit, then we will inspire more importantly. It’s easy to change our colleagues at the fact that only a person came to you, the instructors of jubilant physical education at the resuscitation department come to her, lift her up and walk with her for a little while.
We called to the upright, we lie not guilty. І as a person is stale to make a profit, then we will innovate more
Є. Kryukov:
Did you at once describe really sound scientifically grounded recommendations?
K. Lyadov:
I really understand, scientifically grounded methodology, and the stench is described in our monographs, and it has already been published in Russia and discussed more than once. All the same, one has to change people, which is right and safe, little fears are present not only in patients, fears are present in doctors, it’s like sounds.
Є. Kryukov:
Tell me more of these chips. You said that it is necessary to get up early on the first day of hospitalization.
K. Lyadov:
Without a doubt, you know the situation, if it seems to you that before the operation it is not necessary to eat, drink, or even eat or drink. And the whole world knows what is wrong. І 2 years before the operation, it is necessary to drink a bottle, 200 g, as a minimum, sometimes a troch more, fallow water, high-energy drink, or special or just licorice tea. It is easier for someone who has a brain to endure anesthesia. And anesthesiologists seem: "Like drinking, the new one will vomit." We have a slut for the second time for a year of freshness of the heart, since we drank 200 g of licorice, the energy of the heart, there was no more. But it’s easier for our brain, and it’s easier for our intestines, for those who don’t like the intestines, if you don’t take food away, you start to swell, bacteria grow there, and we will take on the problems themselves, about which I have already said. We take care to choose a diaphragm and problems with legens. Like a person of a frail age, and like a wine chicken, like a yoma, it was so important to go wild, then they killed me more. Through what? Through those who we, like before, we are talking about those who are not guilty, neither eat nor drink on the day of the operation, nor in any way. Hi, drink 200 g in 2 years and it will be better.
It seems that there is no need to eat or drink before the operation. And the whole world knows what is wrong. І 2 years before the operation, it is necessary to drink a bottle of high-energy drink or licorice tea, so that it is easier for the brain to endure anesthesia
Є. Kryukov:
Those themselves with an enema, at the same time, they swear at themselves.
K. Lyadov:
Chi is not robimo, and you know, there are no everyday problems.
Є. Kryukov:
All the same cares, or else I’m a little as a basis, like sanitation of the intestines and adjacent organs, starving meagerly.
K. Lyadov:
You know, it’s rather tricky to ask for power, maybe not enough. We started then, if it was obov'azkovym, and then new preparations for anesthesia were presented, new possibilities were quickly introduced to the patient from anesthesia. So at once we can bring the patient under anesthesia for a few seconds, the wine will end, and we can contact the patient and activate yoga. Surely, at that time it was really impossible, as a person was put under anesthesia for 3-4 years, it was hardly possible to think about those who could be so quickly activated. Here everything is mutually explained: and the introduction of medical technologies, and the change of methodical approaches, how to prepare a patient, how to operate, how to work with him.
Let's move on to oncology, we need another oncology. Let's move on to neurology, remembrance, we've made absolutely nasty changes, and 10 years ago, if we inspired patients, we didn't win and 30% of what was victorious at the same time. It's just that there were no buildings, there were no technologies. The stench showed up and other results showed up.
Є. Kryukov:
Mi troch began to describe the Fast track, I so understand.
K. Lyadov:
So, closer to surgery.
Є. Kryukov:
What is it? What is the complex of entrances for?
K. Lyadov:
Tse complex of approaches, directives for minimal trauma in any kind of operation: gynecological, oncological, traumatological, be it. Preparation, special approach until the patient is taken to the hospital. I already said: hospitalization on the day of surgery, daily fasting, daily enemas, early activation of the patient, low recommendation for medication. І our task is to work so that the patient will commemorate the evening after the operation, he will drink on his feet at the buffet and have a bite to eat. Axle ideal Fast Track.
Our task is to work so that the patient will sing in the evening after the operation, he will be on his feet, drink at the buffet and have a bite to eat
Є. Kryukov:
For oncological illnesses, chemotherapy, undergoing surgery. You seem to see some special features here, come in and rehab.
K. Lyadov:
Luckily, oncology has become another. We, like rehabilitators, started to get better, the shards began to appear in other operations. We have been showing the patients all the time that they don’t need to be afraid of liquor, afraid of surgery, afraid of drinking before the doctor, because the stench has become different. We went to carry out operations for cancer of the mammary gland, to go through large incisions in case of thyroid colitis, we were infected through the groin. Therefore, the annual roses are not deprived. Women do not go to the doctor, being afraid of a rose and start their thyroid disease to quiet stages, if they are already busy with them.
First, the technologies of operations have changed, the technologies of anesthesia have changed. But by itself, the process of healing oncological illnesses has become trivial, effective, but, unfortunately, painful for the patient. The successes of modern oncology are known by all, including surgeons, the successes of chemotherapy, promenotherapy. New targeted preparations are being introduced, which are directly injected into a specific puffer in a specific patient. Ale stink smells toxic to the body.
Previously, if we talked about the rehabilitation of oncological ailments, it was a struggle with the problems after the removal of the milk insufficiency, the observation of the stoma during major operations on the intestines. And at the same time, we will go to something else, we say that we need to work so that the patient can endure chemotherapy. The operation has already become less traumatic. But six courses before, six courses after and if they don’t grow, then there will be no effect, we can’t give a dose of the drug, so as to allow the cancer cells to be driven in, which are found in the body of a person. The first axis here comes to us, if we are engaged in an invigorating mood, fighting with boredom, depression, neuropathies. The whole word, perhaps, is not enough to understand a wide audience, but, unfortunately, more often than not, having shown the convenience of chemotherapy, if sensitivity is involved. And you wouldn’t see anything, and the person doesn’t see the tips of the fingers, you can’t take a cup, a toothbrush. Use sensitivity nіg. Everything is fine, but a person cannot be seen, because she doesn’t see anything in front of her.
If we started to develop a complex of approaching how to fight with these neuropathies, sing-songly, five or five years later, it became clear that the problem is, with which we are more and more frequently affected. We immediately went to the complex of calls, the shards began to close the mechanisms. There is a hypoxic mechanism, a toxic one, a food disorder, a metabolic mechanism. Here, the role is played if we introduce preparations in order to live the nerves, we introduce them, the growth of m'yazyv, the growth of tissue, but they didn't kill me, and the drug didn't work to the point, and we didn't take away a good effect.
The sequence of procedures is very important: if there are physiotherapy procedures, if there is exercising physical culture, inhalations and dychal gymnastics. For we feed: what about now? We explain: but you don’t get sour, and so we fought with these consequences, we are guilty of fighting with hypoxia, with hypoxic stress. The axis of the whole complex, like, well, and virishuє likar-rehabіlіtologist, which allows us for 3-4 days between courses of chemotherapy to bring people up and allow them to continue chemotherapy.
Є. Kryukov:
Where is it better for us to establish such a communication with a rehabilitation doctor? Lyudina herself can come and get better in the minds of the likarni, chi sanatoriums? How do you know what is more effective?
K. Lyadov:
Yakshcho tse important arrangement, tse spetsializovani centers. І rehabilitation is the very technological part of medicine, like cardiosurgery. For serious problems, more often than not, there is a specialized center that deals with these specific problems. It's just that people who are busy with innovations after having problems with their backs do not take good care of their heads, but they don't take care of oncology. Tobto -Tobo the Great Bagatoprofili Rebilitatsky Center, Yaki Fakhivtsiv іz Tsikhimkiv, submarbed to re -re -read the books of the Books, rumored to the lecturer with the Dopagati. Tse is not easy.
Rehabilitation is the very technological frontier of medicine, like cardiosurgery
Є. Kryukov:
But with all the help of meta-rehabilitation - achieving self-reliance of the patient.
K. Lyadov:
Reach the maximum quality of life. To feel yourself as comfortable as possible and as comfortable as possible in society. Sob she could independently operate, function. I still have problems, so that it wasn’t a psychological problem for him. That's why there are situations: a new suglob has been put in, everything is still not in control. I can’t get hung up on the fact that I want to be like this, like 20 years later, if I’m guilty of mine. Henceforth, it is our fault to reconcile, that we have reached the maximum effect, You can do everything you want, you don’t hurt anything, it’s wonderful.
Є. Kryukov:
Let's talk a little about a heart attack, a stroke.
K. Lyadov:
Stroke, neurorehabilitation - ce, obviously, a great problem. Stroke, craniocerebral trauma - even similar changes, three more, three less. The tissue of the brain is being damaged, functions are being ruined, like people were born from childhood. І our task is to restore the functions, alevicorist plasticity of the brain, vicorist dylyanki to the brain, which had not been shown earlier at any price. Tse duzhe tsіkave zavdannya, tse neurorehabilitation. All the rehabilitators are clear, the oscars of the intensive care doctors are living life and it’s great, absolutely without irony. But did they allow such patients to come to them, and the patient to go where? Go to rehabilitation. I need to work for an hour of intensive rejoicing at the resuscitation department.
Є. Kryukov:
That is the system of sovereign assistance.
K. Lyadov:
Obov'yazkovo the first stage of rehabilitation to do good, for happiness, rehabilitation, it is necessary.
Є. Kryukov:
Without whom not to let the patient go without the first stage?
K. Lyadov:
At the first stage, those who could be crushed will be crushed as much as possible. And the axis is a viishov, the result of which one cannot say anything. Someone will have a miracle and the patient will go home, you will get the first stage. Who needs another, who needs a third. I axis here is a problem, yak іsnuє dosi, kudi vin pіde to another stage, and chim yomu at tsmuy other stage after a stroke, after a craniocerebral injury can help.
Є. Kryukov:
Chi mozhut not those robiti?
K. Lyadov:
In the sovereign system, marriage of bones is reasonable for a trival, serious rehabilitation of another stage. Significant part goes to help. However, we are talking about serious consequences, unfortunately, we are deprived of paid help and work in a rather small number of centers near the country. They can criticize me, but I think that there are not a dozen centers for serious neurorehabilitation, as if they really take care of patients in a very difficult state, even if the warm period has already passed. The damage to the functions of the flooring is serious, which is to be dealt with in a complex way by everything: the ruh, the sieve system, the dichal, the nervous system, and the whole mustache. The topic is OK, the category of patients is important, and the rehabilitation is paid.
As we are talking about serious consequences, it is a pity that they are deprived of paid assistance and carried out at a small number of centers near the country
Є. Kryukov:
But is it true that it is not possible for us to call, for example, through rіk mi it is no longer possible to work with a patient?
K. Lyadov:
It’s better to fix it right away, I repeat. But I won’t wait, I don’t have an effect through the river, after two and after three. We often have a lot of patients, as if they dare to come before us and go with others, but we don’t know much about our brain, which we don’t know, as we can respond to new methods of rehabilitation. I repeat, there are new methods of stimulation, new methods of brain development, electrical stimulation of the brain, those that were not mentioned before.
Є. Kryukov:
Tell me a little.
K. Lyadov:
At the same time, it is already fashionable to use the word Brain Fitness, if we train the brain for additional special rights and for additional stimulation techniques, computer techniques, methods of biological reversal. We have a healthy people can increase the operational memory even more quickly. So after a 30-minute training session, you can take two sides and, having read it, immediately repeat it.
Є. Kryukov:
Tse to what extent?
K. Lyadov:
A rehabilitator, obviously, as a rule. Ale, we are constantly saying that you are guilty of training. If you go to fitness, you will understand that you are right to repeat yourself. With your own brain. That brain demonstrates the same speech. We remember the school, so we repeat the verse, we train the brain, and we remember it, remember, remember. Let's spend an hour, we stopped exercising the brain, we forgot this verse. It is worth noting that the brain is undergoing rehabilitation, it is necessary to renew, and it is not necessary to lie down due to the prescription of injuries. We can know those villagers, so that we can allow people to feel richer and richer.
If you go to fitness, you will understand that you are right to repeat yourself. With brainy te same
Є. Kryukov:
Ale tse not one fahivets can buti, tse neuropsychologist, physiotherapist, and so on.
K. Lyadov:
Understanding of the multidisciplinary team. Obviously, a doctor of exercise therapy and again, a rehabilitator and a doctor-specialist, a neurologist and an oncologist, as we work with an oncological patient. The understanding of the multidisciplinary team has been in rehabilitation for a long time, if everyone enters the process of healing, they join the process of healing. Ale, all the same, zavzhdi є htos, who coordinates the whole process of likuvannya. Let's call yoga a rehabilitation therapist.
Є. Kryukov:
At the same time, our patients have slipped out, and they are choosing an operation, trying to fix a laparoscopic one. Why do we need to know about the children of the patients? Well, I know, sticking around the Fast track, I’m going to get out of the way.
K. Lyadov:
You know, Fast track was developed by Dr. Kelet, as proof that the operation is ideal, following all the rules, it was said that you can achieve the same results, as with laparoscopic surgery, but with open wounds. Vіn proving that it is more important for the patient to follow all these rules, straightened out on the same flap, lower one 10-centimeter or three 1-centimeter cuts.
Є. Kryukov:
Ale, we are sensible to you, and the patient believes, admittedly, the woman does not want a scar, I want laparoscopy.
K. Lyadov:
I don't believe in you, you don't want to. I won't be absolutely right, if you want it laparoscopically, then, you need to try to keep it simple. At the same time, in my opinion, there are more doctors in our country, centers equipped with laparoscopic facilities. Somehow doctors don't get carried away, they stink to go for an operation. I can't say what's bad. But I will understand the patient, I will understand the patient. Obviously, at the first stage of introduction, after laparoscopic surgery, it was richer. And yet, in this plan, laparoscopic surgery is less traumatic, more sparing and physiological, lower impact. Ale bova in a different way. There are fluctuations, if you don’t go into laparoscopy, and їх, to the point, the daedals are less. Technologies are moving forward quickly, the robot da Vinci has appeared, now blaming 3D-sticks, 4K-racks. So, entering into the empty hearth, you can improve the image, you can make the flooring reportable, but you can’t help the surgeon at all. Tse all the advantages of laparoscopic surgery, and the stench is endless. To that, everything is one for the doctor, we try to follow the patient's wishes.
My thought is that laparoscopic surgery is less traumatic, and it is the fault of protruding, and it is the fault of the development. If I want to, I repeat once again, if the doctor knows for any reason that the operation can be broken, the patient needs to listen to the doctor’s thoughts. The task of the doctor is to work in such a way that the trauma is the least possible, having respected the patients in life, or having respected them during the same day after the operation. Thoracoscopic operations, it’s a new word, if we can operate on the legs for additional accessories and punctures, inspiration for laparoscopic operations may not be as clear as in operations on the legs.
Є. Kryukov:
What is oncological surgery?
K. Lyadov:
Nairiznomanіtnіshi buvayut, buvayut and good-natured, emphysema legen, buloznі emfіsemi. But all the same, traditional thoracic surgery - all the great traumatic cuts in the intercostal spaces. These are folding with dihannyam, tse are rich, rich of problems, and in people the stink is most often overdue on long-term fates. Thoracoscopic surgery allows you to vanish from one another. So here it is, if you can work thoracoscopically, you need to go there, de її roam, and do not get lost there, de її do not roam. That is why there is efficiency, safety and greed for a sick person, maybe, lower in abdominal surgery.
How can you perform a thoracoscopic operation, you need to go there, de її work and not get lost there, de її do not shy away. That is why there is efficiency, safety and greed for a sick person, lower in abdominal surgery.
Є. Kryukov:
And we teach doctors in laparoscopy in medical institutions, what kind of special initiative, like courses of seminars, master-class?
K. Lyadov:
At the same time, a large number of simulation centers are being created at medical universities, at the first medical institute, at the Botkinsky likarni.
Є. Kryukov:
Tobto, who wants to do it without problems?
K. Lyadov:
And whoever you want to direct, you don’t want to navit, and you’re afraid. The preparation of laparoscopic surgeons should be done actively. In addition, the surgeon is still guilty of something specializing, so that this efficiency will be richly rich, as if wines do not spread and are supposed to be engaged in one straight line. Let laparoscopic surgery, but also intestinal surgery, or surgery to the stravokhod, the stench still stinks, and laparoscopic tezh. Tsezh okrema topic, not only for a rehab specialist, what is more effective, what kind of fakhivtsya to choose, to whom to drink, if decisions are accepted, to fakhivtsya of a wide profile, or to a person, as if they are engaged in less similar operations. I would, perhaps, choose the one who deals with less similar operations.
Є. Kryukov:
Logic. Kostyantina Viktorovich, you are considered a pioneer of the region, that you brought new rehabilitation systems, you were honored by the rehabilitation center. Would you like to ask for help, around some conceptual solutions, sing-songly, there were folded government officials, organizations, and what happened to compromise in this sense?
K. Lyadov:
The main compromise, like a buv, virnish, the main problem, like a bula and a compromise, on which we have to go all the way to do it, after all, the organization of rehabilitation, inclusion її to the health care system and financing of rehabilitation. Oskіlki mi pratsyuєmo in the system of holders of guarantees, we have prescribed no cost of medical assistance. Ale, sorry, we can’t give a low speech. Behind the law, a person may want to take paid help, but here I am, for example, it’s wrong, if it’s a person’s job, primhi, wanty, like it’s always. So, I know what I can take here, but I want to drink there, I want to pay pennies and earn more money, how can I ask, what is true. Unfortunately, the problem of rehabilitation is already troubling, it is too expensive, and the state cannot pay. If it is shown, it is necessary, and there is no opportunity to professionalize, and people need to speak, you know, it is still necessary to pay for it. This has been a problem for us for 20 years, and yet we still had to go to those that directly pay for it, unfortunately, it gets so bad all the time. The richness has changed, the first stage has appeared, at the hour of jubilation, we began to take up rehabilitation visits. I here the merit of the Ministry of Health. Ale, it's an objective situation.
Є. Kryukov:
Why don't you pick up?
K. Lyadov:
Marriage of pennies for the treatment of a small number of serious patients after a stroke, traumatic brain injury, neurosurgical operations, or any other situation. Їx is not richly visible, but stinks. As long as the HMI system is not involved, as long as there are no pennies. At the same time there were federal quotas, then the stench was charged for the hours of the Ministry of Golikovo Tetyana Oleksiivnoy. They knew before her that rehabilitation is a high-tech medical aid. And it was more true, and it helped people more. The Rehabilitation Center, and our center, and the Institute of Neurology, and the Center of the FMBA of the Medical and Biological Agency could help even a great number of patients and give them the right to live on a different level.
The rest of the years of rehabilitation were withdrawn from the system of high-tech assistance and transferred to the ZMS system. Ale OMS is not borderless, OMS cannot close everything for now.
Those who are full of state speeches, organizations, teachings, we, singly, were pioneers in the fact that one of the first began to actively introduce multidisciplinary teams of intelligence, which rehabilitation is the same as surgery, therapy and obstetrics-gynecology, scho all the same, it’s straight forward, it’s necessary to do it professionally. Sponsors helped us on the cob, singly, it’s more correct to say, and more organizations, like they helped us, they didn’t check pennies, they didn’t ask pennies back, they invested in new development.
So, there were no serious centers, we created the center behind the back, rich in profile. The only thing that blew up in the eyes of our western colleagues, the stench of the deshcho was specializing. And the oskіlki were federal, and the task was great, so they were small and musculoskeletal apparatus, neurorehabilitation, urological, and gynecological. When colleagues came, they said: why do you have so much of everything? Because we have a federal center, we are responsible for everything. Ale from the other side, tse buv majestic report, and then we already received our report to take over, and we had a lot of talk with colleagues. And at the same time, if we are creating a new center, vikoristovuyuchi already accumulating dosvid, I don’t worry about global problems. The information has already changed, 20 years ago it was not clear that such a vision of rehabilitation is, at the same time, you can’t forget anything.
The rest of the years of rehabilitation were withdrawn from the system of high-tech assistance and transferred to the ZMS system. Ale OMS is not borderless, OMS cannot close everything yet
Є. Kryukov:
If it’s possible, only in extreme situations, our people think about it, and if the operation can be foldable, then the stink, better for everything, fly to Germany, Israel, as if it’s worth oncology.
K. Lyadov:
All the same, the majority of our citizens are left to rejoice in the country. And our task was to work so that the stench didn’t mess around about it, so that people, like they came from Nimechchini, explained that the people, like they were left in Russia, took away the same additional help, and that’s how they themselves carried out rehabilitation. Ale tse koshtuє pennies, and in our country tezh.
Є. Kryukov:
But after the operation, not related to a stroke, will the state authorities help us in any way?
K. Lyadov:
If the stroke helps at the first stage, it’s not bad, but then it’s the same. Tariffs are already low, let's talk openly. 18 days - 48.000 rubles, 50.000 rubles. 18 days of rehabilitation of another stage, call to pay the regional fund. 2000 rub. in a day. And from them, 1000 vodkinte on їzhu, on lіzhko, on іnshe. 1000 rub. per day, x 300 krb. need to pay a salary. There, an instructor, a physiotherapist, a psychologist, a neurorehabilitator, and all the stinks will cost 300 rubles for each patient. in a day. Well, it's just impossible for the viconate to oblige, which youmu needs. You can fight, but not in that obsyazі, what is needed.
On the right, because many patients do not require serious rehabilitation, the stench is slowly being restored at home. We speak for ourselves about quiet, who needs it. We can work on the biggest equal, cheaper, lower abroad, but all the same for pennies. Rehabilitation, foldable rehabilitation - all the same way river. I Russia has a road river. It is effective, it allows you to stand on your feet, it allows you to turn to life, and actually turn to life.
We have recently had a situation, we say, skilki kshtuє. Before us, for the recommendation of our colleagues, a son of a person came, as if she suffered a stroke. To milk a young man, on aphids of hypertonic ailment, 50 years, having actively practiced, having taken up rozumova pratseyu. The stinks were in one center, they were in another center, they went through all those that lay down, and it was quite decent. Ale farther ended with the power of empowerment, but there was no rest left. And this is a small dilemma: they throw a mustache, hire a spy, you are left with a severely disabled person, otherwise there is a chance to try all the same turn yoga to life, knowing pennies. And if you have arrived: "Let's marvel at the first stage, the next two." Two days, then two more days, having tasted three and a half months with us, it cost more than a good penny, but turning back to life. And for three months they told them that if they were to be deprived of guilt by a severely disabled person, we would tie her up to her bed until she was a watcher. That’s why there’s food here, it’s varto that chi is not varto, it’s necessary to know pennies.
Є. Kryukov:
Bezperechno, varto and it is required to explain to people. Let's destroy the nutrition of the child's rehabilitation. It’s better for me, it’s better in our country, so we can put more and more essential options on the market.
K. Lyadov:
More charitable funds to help. Tobto again turn to the point that the same zahid, which is financed by the kimos, here by the power, here by the benefactors, here by the fathers.
Child rehabilitation is also very different. Є children of cerebral palsy - tse one topic, collapsible, zrozumіla, razroblena. There are many schemes, regional programs, Moscow has a miracle center for the rehabilitation of children with cerebral palsy. We do a lot of work with children and with grown-ups remotely, to that they gave everything one thing people are left at home, and we help them for the help of the Internet, for the help of the video cameras, our instructors marvel, like the stench works at home.
The axis of the program itself is now available, which is brought home to children by the department of social security, children with disabilities, as a rule, cerebral palsy. And, it’s very, very important, so that the stench did the right thing, so that the fathers understood what you can work, what you can’t. Tobto cі programs vіdpratsovani. We help with oncological rehabilitation, є hematological patients, і hospital, і Dimy Rogachov center, і sanatoriums, where we then move on to children and try to deal with them and find out, from one side.
On the other hand, we have little respect for the prevention of child injuries and the recovery of children after injuries. Mi iz tsim often met at sports rehabilitation. Because the child can fall, it can be evil, and the group, the section, will move forward quickly, so if it came there in three months, it already saw the flooring, so it won’t work anymore. Vіn is already not the one that is not promising, just stink to throw the ball at the ring, and Vіn is still out of it at that stage, if the wine is only a little bit rolled yogo along the path. And we try to help such children, take care of them, bringing them to the level of readiness, in which children are known, as if they did not suffer injuries. Tse okrema theme of sports rehabilitation, to the fact that an athlete is a child, if it doesn’t matter, if you want to go in for sports, it is our responsibility to bring it to the level of sports readiness to sports visits. It’s also a good topic, it’s important for children, children’s floors are different, the stench of the floors is experienced, if we come to the section and opine at the right, what we are doing, and this cicava, vdyachna theme.
Scoliosis, heart failure, follow-up after heart surgery, follow-up after cardiological surgeries, a lot of problems. And here, for goodness sake, they help charitable fondies, we borrow a lot, we work a lot with funds, more with neurological ailments, and also with cardiological ones.
We still have little respect for the prevention of child injuries and the rehabilitation of children after injuries
Є. Kryukov:
Is it better to go to higher education centers more quickly from the side? What is the cost of adult rehabilitation, sports, child rehabilitation, cerebral palsy? Chi є tsentri, yakі good poednuє everything is rehabilitated?
K. Lyadov:
You know, it’s quiet, it’s like going down, it’s not 10, you’ll get five at the countryside, and you know, we all know one. Patients go from us to colleagues, from colleagues to us. 4-5-6 tsentrіv, tse not only Moscow, tse i Yekaterinburg, professor Belkin's center. But I know, Yekaterinburg, the center of Professor Belkin, and we don’t talk anymore about the specialization of the center, more unimportant to the presence of the department in the regional, regional likarnyah, but not the specialization of the center. It is necessary to choose all one center, which one is engaged in, for example, after the operation on the ridge, if the stench is engaged in less than this, they are engaged successfully, then you can calmly go there.
Є. Kryukov:
Your problem, otherwise it seems.
K. Lyadov:
So, that's your problem. And then there is no need to go with the problem of urological, or for the renewal of the post-gynecological surgery, on the right of our rich-profile centers.
Є. Kryukov:
I may but the team is rich in profile, bazhano.
K. Lyadov:
It is rich in profile and there are not many such centers.
Є. Kryukov:
Due to you for the miraculous ether. Our guest is Kostyantin Lyadov, physician-surgeon, oncologist, professor, doctor of medical sciences, academician of the Russian Academy of Sciences.
K. Lyadov:
Є. Kryukov:
We discussed rehabilitation, such as, be healthy, until the end.
K. Lyadov:
K.V. Lyadov is one of the leading Russian rehabilitation specialists. Qiu specialty, as it appeared on the horizons of the witchcraft and the light protection of health, not long ago, respecting the profession of the future. And even 15-20 years ago, it was not very clear that such doctors were needed, then at the same time, rehabilitation medicine took its own place among the few medical specialties - such as surgery, therapy and resuscitation became x an irreplaceable helper. Adzhe without daily rehabilitology zusillya reshti likarіv hour vyyavlyayutsya marimi. About those who are for the specialty, how they changed for the rest of the fates and who checks on us from the future, - our rozmova.
Kostyantina Viktorovich, adzhe you started not as a rehabilitator. The 1st candidate dissertation was assigned to you as a candidate.
At that time, if I had begun, there was no rehabilitation in our mind. In all richly specialized likarnyah and clinics of the First Medical Institute, when I started pracsyuvati, they carried out jubilant physical culture and physiotherapy, but it was not important, the main specialty, on the basis of respect.
- Why?
If we came to the clinic earlier, there were such patients that we would write home at once. Because the stench didn’t vibrate. There is no field for serious rehabilitation. For example, if we are talking about rehabilitation with problems of the musculoskeletal system after endoprosthetics, then it is necessary to understand that 30 years later, having directly started their development, and patients with lesions of the knee or knee joint could develop ovuvat mainly on medical treatment and trochs on physiotherapy. If I started, surgery, oncology, gynecology developed at a boisterous pace, but, as they developed, the stench flooded a great number of problems, about which the emergence of patients with these problems began to be considered in the world.
In my opinion, in our country, rehabilitation in a modern sense began with cardiology, with post-infarction ailments, if thrombolysis, stenting, successful cardiosurgery operations, and then began to understand, in a row vipadkіv not enough just to rob the operation. It is necessary to think about how these patients should be recommended after the operation. І in the fact that rehabilitation as a system began to develop in our country, є the majestic merit of Evgen Ivanovich Chazov, who had begun to take into account the need for a comprehensive approach to the healing of ailments. Without a doubt, constantly sharpened the robot in neurorehabilitation, and in other areas.
- When did rehabilitation get you like a bogeyman of medicine?
If I have already been the head doctor of the Moscow pool liquor, I have already given respect to the whole straight, shards of wine on the sciences. Having found a contingent of ill people, who demanded a permanent rehabilitation to support their professional skills. The whole thing was too cicavo. We were engaged in ryatuvalnymi commands, and my doctoral dissertation was dedicated to the diagnosis of some cordon camps, if a person is no longer functionally building. To be able to feel the wine normally, but we understand that it is not possible to keep the entire shift of the wine, it is not possible to completely change one’s shoes. That was the first part, which we began to take care of. And the other part is to work, so that you can win over everything.
- Did you understand?
We realized that there is a need in the organization of introductory visits. Began to travel, marvel, to work on this topic in the world - Nimechchina, Switzerland. That's right buv 1998–99th river. It came to mind that this rehabilitation, as it had already begun to develop in the circus beyond the cordon, we did not care. These are the same as the implementation of likuvalnaya physical culture and physiotherapy, sanatoriums, for example, the sanatorium named after Herzen The administration of the rights of the president and the famous sanatorium "Blakitne" of the Third Administration, and now the FMBA, where, for example, people have mercy lo, she could have had a stroke, a craniocerebral chi spinal injuries, and there they began to take care of him. But the systemic approach itself in hospitals practically did not exist.
We began to develop neurorehabilitation in our hospital in Persh Cherg, and it was announced with great difficulty that rehabilitation would require practically all directives.
Years ago, if colleagues came before us, the stench wondered why the center was so diverse. Even more traditionally, it is important that one center deals with neurorehabilitation, another center deals with cardiological diseases, and a third center deals with cardiosurgery. Moreover, it is necessary to vary the number of patients after cardiosurgery and endovascular interventions. Rehabilitation is necessary in one and the other case, but the specifics are present.
- What about arthroplasty?
Not all colleagues are good for me, but I think that we still have a good attitude, if we are talking about the rehabilitation of patients after endoprosthetics. Ruinuvannya kulshovogo or kolіnnogo suglob - ce bolіsno for the patient. Vin can't walk, he's in constant pain. I immediately give you pain relief, some internal, some endotracheal anesthesia, some conduction anesthesia, changes in the snow - and more and more. And the person herself became another. Youmu doesn't need to be afraid to step on the whole driftwood. The main problem here is psychological. The work of a psychologist is very important, which is the same as the patient in whom perekonati. Axis to which we attach a great role to schools for patients. Insurance is too rich. On the vіdmіnu vіd іnultіv, yakі attack raptov, here is another specificity. Bula my colina - became not mine. The patient lies down, does not sleep, he sees that his leg is now alive and well. Here our achievements go in parallel to the achievements of our foreign colleagues. Zustrichayuchisya at congresses and discussing with those, we Bachimo, that the situations are similar, and we try to verbalize their verses. Those English vcheni, on which we love to consult, the problem was thoroughly vindicated and carried out by such visnovkiv themselves as they were. It appeared, in a small way, similar to the fact that the patient was put on his feet on the day of the operation for arthroplasty of the knees. Why? If you don’t grow something, then we’ll become richer later.
- Be afraid?
So. And here you can’t guess your own fears. The day of anesthesia had just ended - and before the next one, the instructor would come and say: “Get up! Go!" On the next day, the new one takes care of himself, that he can walk. Well, we gave him the opportunity to lie down, sleep, snuggle up to see his own problems, if it’s “alien” it’s too tight for the knee, then hospitalization in the new one will be greater. Tse already perevіreny fact. Two days go to those to reconsider yoga, which is not scary.
- Is it worth the cost of all rehabilitation ailments?
Too rich. So understand - multidisciplinary teams. Tse rozuminnya, as a referral to surgery can mothers and exercise therapy, physiotherapy, psychologist, nutritionist and so on. Aje the robot needs to organize all of these fahivtsiv, assign the time for the rehabilitation process to pay. Before the speech, I had occasion to give interviews more than once, explaining that telemedicine is like a doctor’s robot, like a great trick. It takes an hour, the consultation may come before the work schedule and may be paid. Incorrectly notified that I called up - and they all told me once. So don't.
Here you are. It was required to know all of them fahivtsiv and pennies to pay for their work. Understand, if they need to connect. Get group activities. Then we went to school, realizing that, in principle, it’s easier to take 20–30 patients before surgery, while the stench can come by themselves, explaining to them behind the scenes, with such problems the stench can stop and yak їх need to swear. Then after the operation, less than 2-3 patients will be left without knowing who. It will definitely make the job easier. Ala had to start from scratch, more, I repeat, there was no understanding of rehabilitation. Step by step, it came to mind, as if it were necessary to practice such ailments to slander.
Why did you have to deal with all the ailments - neurological, orthopedic, and cardiological? Hiba tse right?
Ninі tse would be wrong. Well, if you are sick, you can take care of specialized medical centers. Ale mi were pershoprokhіdnikami, to that the hoarseness seemed to be even wider. We have departments of neurorehabilitation, cardiorehabilitation, orthopedic rehabilitation.
- What about oncology?
Obov'yazkovo. Vіnkorehabіlіtаtsіya has been and is being abandoned. With this, oncologists have only recently begun to recognize rehabilitation. They didn’t understand for a long time, now they need it. Miraculous surgeons-oncologists told me: “Navishcho? The main thing is the operation, which was done competently, radically and everything is safe. Tse those who were earlier in the other directions of surgery: having done the operation - and everything can be as if by itself.
- Tse not so?
We don't call it that. Oncological rehabilitation of infections, in our opinion, is no longer the rehabilitation of women after mastectomy or patients with colostomies after operations on the rectum. This was 20 years ago. Just as we have such patients at once, it’s important that there were mistakes and wrong exaltation before the arrival of a person before us, so that today’s combination of exultation does not transfer great traumatic operations, it would lead to such consequences.
- However, stink.
Yes, stink. Patients with traces of important traumatic cases come to us, and we help them in the world. But after all, after a radical mastectomy with lymph node dissection, it is important to achieve an ideal effect. Blisters, lymphostasis. It's nasty, to the fact that these patients are the example of that, as they cannot be. The very reason for a woman to be afraid to go for a mammography: I have to know - and then it will be like that. All one life is mute, breasts are mute, the hand does not bend, man is not, it is impossible to go to work. And true - her hand is like a deck. The woman is a profoundly disabled person. It stinks to think: I won’t go better, I’ll be patient, maybe I’ll pass myself.
- І z tієї zh causes everyone to be afraid to go for a colonoscopy and to go to the hospital. And how can I buti?
And can be more competently combined likuvannya, correctly selected chemotherapy in the right way to an individual assessment of the swelling. We know at once a sprat of dozens of puffs that are less than milky. The stench is grouped in a large complex, and in the skin condition, a specific complex treatment is needed, in some cases, genetic therapy is needed. And here the first plan is to come to the forefront of our rehabilitation - rehabilitation between courses of chemotherapy, as it sounds badly tolerated, calling out a number of side effects, d chemotherapy, and the work of psychologists is important. Call it after the third or fourth course of chemotherapy. The first one or the other is easy to pass - farther problems begin. Moreover, people are treated more like chemotherapy for women. Obviously, the stink is less emotional. The stench is calmer to endure the experience of sensitivity and tedium. Їx tse not hvilyuє. The woman takes everything dramatically, I don’t want to hear that there is only one or two courses, the operation is all, you are healthy. More patience - and life ahead. She doesn't want to hear and throws everything. And it is even more important that in these intervals we had a low correct entry, directing to a decrease in depression, turning sensitivity, changing the quality of low parameters, like respecting life.
- Abo oblisinnya, for example.
It's the least that praises patients in the process of healing. So, before the cob of jubilation, there is a lot of turbulence, but then we will fear fears. That's why the hair is growing, but the real problems of health are under the hour of courses in chemotherapy or promenade therapy are present: anemia, neuropathy, postmenopausal cystitis, colitis. Our main task is to choose a complex of drug therapy, physiotherapy, psychological correction for stabilization of patients. Our task today is to help the patient to go through the trial course of healing as comfortably as possible. That rehabilitation after the operational recovery was lost. Ale, she's changing.
- What has become different?
Let's turn to breast cancer. Although the bula vikonana was a sparing operation, we already know that it is not so traumatic. Whether it is a seminal mastectomy or a radical resection. Even though the surgeon considered it necessary to commit himself to lymph node dissection, the consequences will also be significantly less pronounced. There are also their own problems, but they stink more, less pronounced.
It's a pity we don't have a lot of information to send to the masses. We ourselves know, but it’s hard to convey to the people that everything has changed. Everything changed. Come for a mammography, a fluorography, a colonoscopy, a gastroscopy, an ultrasound and a screening examination, donate blood for tumor markers, so that oncological illness today can be changed radically, forget about the disease forever. Became іnshoy і rehabilitation. Our efforts are collaborating with the achievements of other doctors and psychologists, and we are working on the results of our joint work.
Kostyantina Viktorovich, for a long time you worked at the great sovereign medical mortgages, planted stones there. I raptom of the second half of the year will go to MEDS - the first and largest private medical clinics in Russia today, de vite a stationary part. Why does vinyl need to go to MEDS?
So, this is one of the largest medical associations in our country. Under my cursing, only a small part of it was slumped - the clinical librarian and the polyclinic “Vtishne” that had been adjacent to it. And it all happened for a whole bunch of sensible reasons. My rich colleagues know that you can do more, but you will drag out the routine of ceramic work. Nothing else is simply not deprived of an hour. I arrived just before Veronika Ihorivna Skvortsova, as literally a day before that she signed me a non-linear contract on the plantation of a cerivnik of the medical and rehabilitation center of the Ministry of Health, and said that I still wanted to try to implement my idea rozrobki. In this fluid work, everything was unbearable.
- Did she fool you?
So, she understood less, and we continue to contact her, she supports our developments on the level of the Ministry of Health, and at the same time helps us.
However, even here you have a graveyard and dosit vіdpovidalna. Isn't the turnover here zasmoktuє?
Here, at the sensi, everything is organized far away. I was given the opportunity not to engage in routine activities. I'm doing strategic work. I am learning the work of ambulatory nurses. For me, the price is straight forward. But my main task is the strategy itself, and to this, an hour is left for the implementation of ideas, bringing them to the required condition, patenting and otrimannya result.
- What kind of ideas seem to you the most relevant?
For a long time I wanted to bring a new type of rehabilitation complex into harmony, and in the leaf fall of 2017, mi yoga was released. This complex is our test to eliminate the failure between the patient's camp, if we are vipisuemo, and then, if we are drunk at home. For a short time, the oskelki were engaged in home rehabilitation, they worked hard: those who the patient could work in the hospital for a moment, stop working at home. Vіn vіdmovlyаієє get up, walk, vikonuvat like speeches, like vikonuvat with us. And it seems so. If a person is sick and is in a hospital, especially in such a difficult situation, like a stroke of a craniocerebral injury, then he must be helped there. I'm right. Ale, up to this arc, it sounds loudly. Moreover, you sound not in terms of what you want to be an Utriman, but in terms of what you can’t get into, let’s say, pull in your shirt - nothing, they will help you. I missed the moment. They lifted it, put it, win pishov. Ale, I’ve been in charge for the whole hour. Doctors, watchers, relatives, staff. And the person is calling to the point that he needs to help. Ale vins appear at home - and there they stick with a whole series of speeches, like vins do not understand, like robit independently. We need a buv complex, which would bring us as close as possible to reality. Yes, it's a simulator. But the reality is that it creates situations that are close to life. We tried to deal with all situations, with which a person might get stuck, leaning at home, on the streets, near the public transport, shops too thin.
- Why did you start?
Started with clothes. Indeed, if we help the patient to dress, we cannot understand that you should not go out. To that dress - one of the main heads of the head.
When tsimu іnstructor and operator perebuvayut behind the fold. Fuck yoga. The stench can come to the rescue. Price stovidsotkovy security guarantee. Ale stink is not in order. The patient will do everything himself. And it's super important. We have a special system of fixation, and only one person is responsible for everything.
- How many hours do you give for the vikonannya zavdannya?
We marvel at the hour, as if Bachimo, that with a stretch, let’s say, three people can’t pull in a jacket, then they won’t bother for a year. We understand that youmu should not go out, and we begin to work on the task at once with the instructors. Change the parameters of the task.
Most of the time, we cannot understand what is in the brain of a sick person. We and the healthy brain cannot grow. We’re sure that everything is fine, but, first, let’s go home, we’re guilty of speaking on the TV screen, as we need it. We understand this task, as we cope with the tasks of recognition, recognition, then give respect to the neuropsychologist, even if we allow them to live, and we can learn to orient ourselves independently. Even if you can’t understand, you can’t understand, you start to zamikatisya. A little bit of aggression - then we win at our “shell”. "I'm not going anywhere." - "What?" - "I'm not going." And we rozkruchuєmo їх for help of psychologists and psychotherapists. It is clear that we are guilty of teaching them to understand what is necessary for a soul, for going to the store, for preparing food.
- Your complex has been given respect for virtual reality. But then you won’t replace life.
So, at the same time, we are already clamoring for virtual reality. But if wine on the screen is pressed against hamanets, then in real life you don’t know yoga. To that yogo was taught to squeeze on a hamanets. That's why the friend in us is tasked - choose the right subjects. Vin rested. In real life, Ale is shameless. That's why doors are opened on the screen - and you can go out from real life. Tse imitation to the store, de є real, reference items: a package of milk, a jar of peas, bread, butter, sir. Abo pharmacy, de you need to buy faces. Abo just a walk. What's the weather like there? Take a parasol chi nі? All tse vin maє perebachiti. Tse all and є complex raznomanіtnykh zavdan, є є "reasonable" hall of rehabilitation. So, the price is not an apartment and not a store, but a designer, a kind of model for a series of jobs, with some kind of faults in real life.
- What is more important?
The sounds of Mi do not give much respect to those who are quiet at the liquorice. Lyudina at the likarni is awake on walking, on vikonannі zavdan. And then the wines appear at home - and raptom flicker. We start talking with relatives, z'yasovuvati, if it became zamikannya, and it turns out that we are vin viyshov overhead. And there is the noise of cars, the barking of dogs, voices. Win turning around and pishov. To that scho mi did not accustom yoga to react to sounds and concentrate, unimportantly on tse. Tobto vykonuє svіy Rukh, wanting to dovkol noisily.
We began to understand the causes of the fall of our patients. On the right, in the fact that at the first stage of rehabilitation, we might marvel at our feet. And if you're viyshov and you're on your feet, then you forget about your legs. And the sound of the sound of a support under the feet. The first task of this “reasonable” hall is as follows: the axis in front is shown as an image, and it is right to go along the road and immediately see the task. Needless to say, some red cars passed in front of him. You can forget about those who marvel at your feet. And if we find one on one all the versions of reality, of course, what we didn’t get.
- Yake zavdannya showed up as a naivachim?
One of the most important heads, as it was said, is an escalator. Moreover, the very similarity of the escalator. Understand why?
- Visibility of the support?
So. The road has ended, there is nothing to worry about. I'm falling. Descent from the escalator turned out to be the biggest problem for patients. And in Moscow, for example, there are escalators near the metro, near shopping centers. The stench was simply afraid to go at them. It was necessary to solve this problem. We specially tidied up the support of the simulator, so that the patients could be deprived without it. The stench didn't fall. Please save them jealously. Step by step, the stench ceases to be afraid, wanting to start panicking a little.
- And the entrance to the bus or tram?
Don't think about it. And if we started to educate the relatives of the patients, it turned out that there was a problem. Where stink to blow a club, if you can get to the tram or bus? The new one has paresis, his arm is rotten, his leg is rotten collapsing, he can't walk, he's active. Youmu needs to go to the pharmacy or shop. І axis go to the tram. A wand in the left hand. She is guilty of getting behind the turnstile. The club falls. Vіn ruin. We are trying to pick up... That's it. Pishov tram. Abo yoga pіdhoplyut, pіdnіmayut by the tram. Ale tse youmu is not too welcome. At the same time, the tram is not useful.
- How can you solve this problem?
Mi yogo vchimo: you can put a reed on your hand, which is nasty work. You can look at the Gudzik coat. Є different options, and їх it is also necessary to opt for it. You don’t need to be afraid of anything - you can learn how to use it. You hang a stick on an ailing hand, pull up with a healthy one, lift up, take a stick with a healthy hand - and you go to your right.
- Have you all said that you are constantly revealing new unsettled problems?
In the course of the work, it is constant to see new and new problems, as you need to learn how to overcome. Let's say, you see the surface. Slimy, shorty. People can fall, more on the streets it's slimy. Chi there brukivka - how to walk on it? We need to orient ourselves and take a decision, as it is in this situation. Don't be shy, don't swear.
We were on the vіdkritti "reasonable" halls chotir a month ago. We talked with the first patient, who seemed to be already a positive person. An hour passed. Can you make yakіs visnovki?
You know, if you take a stink from this hall, they become richly positive. Mi even for the sake of this effect: later, the patient learned that the robot in this room means one more short to a normal life. Rich someone from them without revealing himself. Ale tse vіdbuvaєtsya. The stench continues with phobias, fears, they begin to live life to the fullest. Let's let such a patient move from the corridor space to the real life and understanding, which is what he continues to practice. It seems that life is getting better. And before, they often thought that life was over, the stench was just living out its life.
- Patient, with which I spoke, I suffered a stroke for several years. Tse was also created even more invisible.
More tsіkavіshe those, scho all tsі chotiri rocky vin not sitting at the public transport. I went out at the door, walking, but not getting close to the teeth, for I didn’t understand, how you can curl up.
- What about now?
Ninі їzdit mayzhe schodnya. We continue to contact him, as with a solution of patients. Lyudina lives an active life, serving herself.
Those who are even more important: after undergoing rehabilitation, they are absolutely cost-free. At a private clinic. And not only wines. It appears, as if it were a state program, within the framework of which people who have suffered a stroke and may have a disability, can undergo rehabilitation without a cost to visit the walls of a private clinic, such as MEDS.
The program, about which we are talking, is still only in Moscow. Tse program of the capital's Department of Social Protection, and Tse is also important. In MEDS, within the framework of the program, there were about 300 cases of rehabilitation for this region, and in Moscow, a thousand. This is a large-scale program, as it develops, expands, and it gives dazzling results. We work with mature, but also great programs for children. Tse і simulators, і rehabilitation centers, sanatoriums. Even more ambitious is the work that is really being done in Moscow. In other regions, there is still no such systemic work. Alece is a majestic podtrimka like the people themselves, so be it.
- What are your further plans?
Our topic is coming, over what we can do at once - we want to within the framework of cost-free rehabilitation from compulsory medical insurance to increase the maximum number of procedures. Exchange tariffs cannot give people all those that are necessary. We try to solve this problem with additional simulators, computer programs, modern digital technologies.
A topic of great importance at the same time is state-private partnership. MEDS is the butt of a successful butt of this kind. Even people in their own mass do not know that in a commercial clinic it is possible to go through cost-free jubilation.
Bagato who wonders what it is.
Ale, I don’t know more. Prote z'yasovuєtsya, scho є low program, for some it is possible. Do some other direct MEDS spy from the state?
Illness with acute coronary syndrome, endovascular surgery, stenting, oncology and chemotherapy, arthroplasty of the hips, part of the surgical and gynecological operations, moreover, to achieve folding and high-tech, all this is possible within the framework of the state program for rahunok power. You may need to be careful, talk about it, so that people know that they were not afraid to go before us.
- Chi іsnuyut at tsemu directly reshkodі that problems?
Perfectly. Rehabilitation of serious ailments in resuscitation departments is the “black dira” of our medicine. No one wants to take such patients, because it’s a penny tariff, but it’s even more important to work. Postiyny sight and even specific procedures. The simplest and most important thing is to take a person for an operation. It’s a lot of money when organizing such a work to lay a foundation in the form of associations of enthusiastic enthusiasts and scientists of the regions. An example of effective interaction - Clinical Institute of the Brain of Yekaterinburg, as a professor A.A. Belkin, the most enthusiastic and professional.
- We wrote about the clinical institute of the brain.
So, but there are only a few such applications. Most of the vipadkivs do not want to deal with them for those reasons, which I have named.
At the same time, it is important to understand that rehabilitation did not just help people, as they stumbled in a complicated life situation. You turn them back to a normal life, give you the opportunity to practice, take care of your home state, do not be a burdensome person.
Yes, yes, absolutely, yes. Rehabilitation for this is so contagious and necessary for the whole world, for the best result. No one gave the bim a style of respect, the yakbi would have been otherwise. I remember well the hour, if we didn’t realize it too well, it’s time to shy away from neurosurgical training. Doctors spoke of people's lives - and robbed them at the camp, which required a fast watch. The concept of "rehabilitation" did not even exist. Ninі here becoming a right coup. The reabili-soldiers of the Patsіntіv izhlitava tu izhfarktiv, Pisly oncologic vitruchan, the nestle-tone of the therapy, the total ledoprotzuvanna Suglobiv, not just a turbot about people, are not able to Kidatati. We learned how to turn their suspіlstvo.
Besidu led Natalia Leskova
Yak zasuvav Vademecum, Academician Kostyantin Lyadov left the recreation center "Medsi" to take up his own medical project. Vіn may namir organize a hospital with a rehabilitation center under the name "Lyadov Clinics". The main investor of the project will be Viktor Kharitonin, Pharmstandard's chief clerk.
Yak rozpov_v Vademecum Kostyantin Lyadov, go about the creation of a rich clinic with a hospital and a rehabilitation center near Moscow. “Business model for the project of insurance features of work in the system of health insurance. I strongly believe that it is possible and necessary to provide medical assistance effectively within the framework of the guarantees program, not including paid services, ”explaining the wine.
The object of "Lyadov's clinic" has already been selected. The area of the future medical center will be 14 thousand square meters. m.
In the present hour, we are taking up patents for new technologies for inpatient rehabilitation: “I’m willing, we can organize a full-scale rehabilitation, having invested in the CHI tariff, we know.” The scale of this part of the project is planned for the sale of rights to selected technologies to regional partners.
Earlier, Kostyantin Lyadov presented a system of remote rehabilitation of patients at home under the control of a doctor - a telemedicine link. This project, thanks to Vademecum, is already being tested in pilot regions.
Since February 2017, Kostyantin Lyadov has moved to the recreation center "Medsi" business unit Vidradne, which includes a rich hospital and a low polyclinic near Moscow and the Moscow region. We continue to take part in the robotic group for an hour - before the launch of a new project.
“Kerivnitstvo of the recreation center “Medsi” to Kostyantyn Viktorovich for his work. For a record-breaking short term, the opening of the city, the clinic on the P'yatnitsky highway has become one of the leading assets of the city. Kostyantin Viktorovich has created a unique team of specialists to continue the work of the group. Thank you for the logical and final result of the creation of a good clinic by him,” commented one of the key managers of the group at Medsi.
“I respect that the project may have prospects - Kostyantin Lyadov may have a great hope for the sale of state and commercial services. Positioning the clinic as an inexpensive hospital, you can get quotes for both surgery and basic recruitment of rehabilitation assistance, and earn money from the sale of supplementary medical services,” Volodymyr Geraskin, an important partner of the DMG company, says.
Information about two new companies, controlled by Kostyantin Lyadov, appeared in the IDRYL on 15 cherny. Tse TOV "Multiprofiled Medical Center" Clinics of Lyadov" and TOV "Moscow Center for Excellence". Von Lyadov to lie down for 10%, for 90% of the volume of TOV "MIG". This company is 70% dependent on Viktor Kharitonin.
In parallel, TOV "MIG" registered more companies - "Clinic of Innovations", "Nuclear Medical Technologies", "High Technologies", "Clinic Group". IPT Group, which is responsible for the medical projects of Viktor Kharitonin, did not recognize any new legal issues.