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APP Spotlight: Kim Struble, PA-C

Monday, February 12, 2018

For Kim Struble, PA-C, the path to our Morreene Road clinic was a roundabout one, starting with a degree in biochemistry and early work in pharmaceutical research, before opting for a career as a physician assistant specializing in movement disorders. In this week’s Staff Spotlight interview, Struble talks to us about why she enjoys working with this patient group, how she’s able to provide individualized care to patients with Parkinson’s and related conditions, and the surprisingly family friendly aspects of Mardi Gras she experienced while living near the Mississippi gulf coast for a decade.

What are your responsibilities within the Neurology Department? What does a typical day for you look like?
I work as a physician assistant in neurology, specializing in movement disorders. I am primarily a clinician and most of my time is spent seeing patients in an outpatient setting at the Morreene Road clinic. The vast majority of my patients are treated for Parkinson’s disease, although I also treat essential tremor, dystonia, tardive dyskinesia and other movement disorders. In addition to seeing return patients, I also program deep brain stimulators (DBS) which are approved for use in Parkinson’s disease, essential tremor and dystonia. DBS involves high frequency electrical stimulation delivered to specific areas of the brain which helps with the symptoms of tremor, rigidity, bradykinesia and dystonia. I really enjoy programming as the results are often immediate and a patient will leave my office feeling better than when they walked in!

How did you decide to become a physician assistant?  How did you decide to focus on neurology in particular?
I have always been very interested in math and sciences. I graduated from NCSU with a B.S. in biochemistry and worked for a pharmaceutical company in RTP doing research after graduation. However, I knew that I wanted a career with more direct patient care. I chose to go to PA school over medical school because I recognized that a good work/life balance was very important to me. I actually ended up in neurology by “accident”! I did not have much exposure to neurology in PA school and initially wanted to work in primary care. However, I knew that it was more important who I worked with than the actual field that I worked in as I love many aspects of medicine. I wanted to work with a physician that would take the time to teach a new graduate. The perfect fit just happened to be in neurology!  I have grown to really love neurology. The brain fascinates me and I love the fact that the vast majority of diagnoses can be made with a thorough history and physical exam.

What do you enjoy most about working with neurology patients?
The best part about my patients is that they are all so different. Although Parkinson’s disease is the majority of what I treat, no two patients are the same and treatment is very individualized which keeps it a challenge. In addition to the motor features of Parkinson’s disease such as tremor, rigidity and bradykinesia, patients may have trouble with non-motor symptoms such as autonomic function, cognitive impairment, hallucinations, dysphagia, REM sleep behavior disorder, or postural instability which all have to be considered. I am fortunate to work with a great multi-disciplinary team that can help me address these concerns.

What’s the most difficult part of your work?
The toughest part of my job is treating patients with severe Parkinson’s disease who suffer from symptoms such as cognitive impairment, psychosis, freezing of gait, severe orthostatic hypotension and knowing that while there are medications that can help the symptoms, there is currently no cure or treatment for Parkinson’s disease itself.

What passions or hobbies do you have outside of the Department?
When I am not at work, I love spending time with my family. My husband and I have three daughters that keep us busy! We love doing anything outdoors such as biking, hiking, camping or going to the beach. I also enjoy running when I have the time. We enjoy puzzles and games as well.

What are a few things that people may not know about you?
I was on the track team in high school and college and competed in pole vault. After I graduated from NCSU, I spent a month in Hawaii with my roommate from college. We backpacked, camped and hitch-hiked our way around the islands and managed to survive on less than $1000 for the entire month (including airfare)! Finally, although my husband and I are both from Raleigh (high school sweethearts!), we lived on the Mississippi Gulf Coast for 12 years before moving back to North Carolina in 2016.

What is something that you enjoyed about your time in Mississippi?
One part of the culture that we really enjoyed was Mardi Gras. Contrary to common stereotypes, Mardi Gras is more than just the wild partying associated with New Orleans. It is actually very family friendly and includes parades, extravagant balls, and king cakes that span an entire season starting January 6th and lasting until Fat Tuesday. While New Orleans is most well-known for Mardi Gras, it is a celebration that spans the entire Gulf Coast from Alabama to Mississippi to Louisiana. Schools and many places of work are closed on Mardi Gras as it is an official state holiday! So grab a piece of king cake if you can and Laissez Les Bon Temps Rouler!

Struble and family enjoy some time outdoors during this photo from last year.