Polytrauma Rehab in the VA: Compassionate Care


>>>I DECIDED TO JUMP OUT OF A A — OUT OF PERFECTLY SAFE AIRPLANES FOR A LIVING IN PACKED PARACHUTES.>>I WAS IN THE U.S. NAVY.>>I FIXED THE BROKEN PIECES OF THE SHIP TO GET THE SHIP ROLLING.>>I INCURRED SOME INJURIES FROM TIME ON THE WAY, TIME ON THE WAY SERVING IN DIFFERENT AREAS.>>I WAS IN A SEVERE CAR ACCIDENT. EVERYTHING ELSE IS PRETTY FOGGY.>>I HAD BROKEN RIBS, DISLOCATED JAW, BROKEN BACK.>>I BROKE MY KNEES. NOW HE CAN GET UP AND BE MOBILE. A MONTH AGO, IT WOULD HAVE BEEN A PROBLEM.>>THE POLYTRAUMA UNIT IS VERY GOOD.>>I BELIEVE THAT THERE WAS NO BETTER PLACE IN THE WORLD FOR RYAN TO BE. THE CARRINESS, THE AMOUNT OF PEOPLE THAT WERE — CARINGNESS, THE AMOUNT OF PEOPLE THAT WERE ALL FOCUSED IN ON GETTING HIM BETTER.>>THEY UNDERSTAND THE VETERANS. THEY UNDERSTAND THAT WE GO THROUGH THE TRAUMATIC — IF YOU WANT TO GET BETTER, THAT’S THE PLACE FOR YOU.>>THEY HONESTLY LOVE WHAT THEY’RE DOING, AND THEY WANT TO HELP. JUST TO HAVE THE COMPASSION FOR EACH AND EVERY ONE OF THEM. THERE’S ABOUT FOUR OR FIVE DOCTORS EVERY MORNING. THEY ALL COME IN.>>FEELS GREAT. FEELS GOOD. DOESN’T HURT.>>GOOD. DO YOU LIKE YOUR — WE WERE JUST TALKING ABOUT THIS MORNING.>>HAVING FOUR OR FIVE DOCTORS COME IN, IT’S PRETTY AWESOME. THEY ALL JUST KIND OF TALK RIGHT THERE, KIND OF HOW I’M FEELING, HOW MY LEGS ARE DOING, HOW MY BACK WAS DOING. IT’S MORE PERSONAL, I GUESS YOU CAN CALL IT.>>GOOD MORNING.>>HELLO.>>HELLO.>>HOW ARE YOU?>>I’M WELL. HOW ARE YOU, SIR? HOW WAS YOUR WEEKEND?>>IT WAS GREAT.>>HOW’S YOUR WRIST?>>IT’S JUST LIKE IT WAS. I’M GETTING A LOT MORE MOVEMENT.>>I’M EVALUATING THE PATIENTS, SEEING WHAT ISSUES THEY HAD SINCE THE LAST TIME I SAW THEM OR SINCE THE LAST TIME WE MADE ANY CHANGES, DOING A PHYSICAL EXAM ON THEM AND THEN ANSWERING ANY QUESTIONS THEY MAY HAVE. IF THE RECOVERY STALLS OUT AT ALL IT COULD BE BECAUSE OF SCAR TISSUE, AND THAT’S WHERE YOUR ORTHOPEDIC SURGEON MAY WANT TO TAKE IT LOOK AT IT AGAIN. EVERYTHING ELSE OKAY OTHERWISE?>>OH, YEAH.>>LET ME KNOW IF YOU NEED ANYTHING. SOMETIMES ROUNDS FOR A PATIENT MAKE TAKE 5 MINUTES. SOMETIMES ROUNDS FOR A PATIENT MAY TAKE A HALF AN HOUR. PART OF THAT ROUNDS IS COMING OUT OF THERE AND DISCUSSING WITH THE STAFF WHAT THE PLAN IS FOR THE DAY AND MAKING SURE EVERYBODY IS ON THE SAME PAGE.>>IF YOU DON’T KNOW WHAT’S GOING ON WITH THE PATIENT AND WHAT THEIR GREATEST CONCERNS ARE, THEIR FEARS, THEIR HOPES, IF YOU DON’T KNOW THAT, THEN YOU’RE JUST TOUCHING TISSUE. I MEAN, WE’VE GOT TO GRAB HOLD OF THE PERSON THAT’S INSIDE, THE PERSON THAT’S STRUGGLING WITH WHATEVER THEIR ISSUES ARE. I MEAN, WHETHER IT BE A NEW AMPUTATION, WHETHER IT’S THAT THEIR FACE IS DISFIGURED, WHATEVER IT IS, WE’VE GOT TO KNOW THEM AND LET THEM KNOW THAT WE’RE LISTENING TO THEM, WE HEAR THEM, WE CARE, AND THE ONE THING WE DO IS TAKE TIME WITH OUR PATIENTS.>>GOOD MORNING. HOW ARE YOU? DO YOU MIND IF I INTERRUPT FOR A SECOND? HOW WAS YOUR NIGHT? DOING WELL?>>YES.>>HOW’S THE MEMORY?>>IT’S OFF TODAY.>>IT’S OFF TODAY? CAN I SEE YOUR WRIST HERE? YOU WERE HAVING SOME PALPITATIONS, LIKE YOUR HEART WAS RACING A LITTLE BIT?>>EARLIER THIS MORNING.>>MR. GRAHAM NOW, HAT A HEMORRHAGIC STROKE FROM THIS PRETTY RARE MEDICAL CONDITION. AND HOW DO YOU FEEL OFF? MORE BODY FATIGUE OFF OR MORE MIND, CONCENTRATE OFF?>>CONCENTRATE.>>BECAUSE IT’S A RARE MEDICAL CONDITION, WE LOOK FOR ANY SIGNS OF THAT MEDICAL CONDITION COMING BACK.>>OKAY. SCOTTY, SWITCH TO GALLOPING.>>WE’RE ALL A TEAM, BUT THE PATIENT IS THE TOP, AND ALL OF US ARE HERE TO HELP HOLD THEM UP. THEY’RE ALWAYS NO. 1. THEY’RE THE TEAM LEADER EVEN THOUGH THEY DON’T REALIZE IT SOMETIMES.>>THE BEST THING I LIKE IS THERE’S NO IDLE TIME. 8 O’CLOCK, YOU’RE GOING — YOU’RE DOING SURGERY. AT 2 O’CLOCK, YOU WENT TO RECREATIONAL WHERE I PLAYED THAT LITTLE GAME WITH HIM. IT WAS REALLY VERY INTERESTING. BY THEN, YOU’RE SO TIRED, IT’S TIME TO REST, SO I LIKE THAT.>>I JUST LOVE TO DANCE WITH HIM.>>I’M NOT ALLOWED TO BEND MY LEGS ON MY OWN RIGHT NOW. SO THEREFORE, I HAVE TO HAVE THERAPISTS BEND THEM FOR ME. HAVING THEM THERE GETS IT JUST A LITTLE DEEPER OF A STRETCH OR DEEPER BEND TO REALLY STRETCH IT OUT AND THEN HELP YOU RECOVER IT IN THE END IS GREAT. A LITTLE BIT MORE RANGE OF MOTION FOR THAT DAY AND THEN RECOVER THE NEXT DAY AND COME BACK FOR ANOTHER DAY TO DO THE SAME THING.>>IF I COULD STAY HERE LONGER, I DEFINITELY WOULD.>>FOR ACTIVE DUTY SERVICE MEMBERS, WHEN THEY COME IN, THEIR ORDERS ARE TO RECOVER, AND SO THE MILITARY MAKES IT VERY CLEAR TO THEM THEY HAVE ONE JOB, AND THAT IS TO PARTICIPATE IN REHABILITATION. ♪♪.>>MY LAST YEARS IN THIS BUSINESS, I ESSENTIALLY SPENT WRITING ABOUT MURDER, AND I WAS TRYING TO FIND SOMETHING GOOD. THERE’S GOOD IN PEOPLE OUT THERE. THE ASSOCIATED PRESS WORLD WIDE, IT WAS A PIECE WITH A PHOTOGRAPHER NAMED ANJA NIEDRINGHAUS. SHE HAD BEEN WITH A MEDIVAC UNIT IN AFGHANISTAN IN THE SUMMER OF 2011. THE UNIT WAS SENT OUT TO A WHEAT FIELD WHERE A SMALL UNIT OF MARINES HAD RUN INTO AN IED, AND ONE OF THE MARINES HAD BEEN SEVERELY INJURED. HE HAD SHRAPNEL INJURIES, I BELIEVE, RIGHT AROUND HIS JUGULAR. HE WAS IN A VERY AGITATED STATE, LOSING ALL OF HIS BLOOD, AND HE WAS REACHING AROUND FOR SOMEONE, SOMETHING, AND SHE REACHED OUT HER HAND TO HOLD HIM AND TRY TO COMFORT HIM. SHE HELD HIS HAND WHILE HE WAS BEING FLOWN OUT OF THE WHEAT FIELD. WELL, SEVEN MONTHS HAD PASSED, AND SHE WANTED TO FIND OUT WHAT HAD HAPPENED TO THIS MARINE. SHE BEGAN A LONG ARDUOUS EFFORT TO TRACK HIM DOWN, AND SHE EVENTUALLY FOUND HIM AT THE POLYTRAUMA UNIT AT THE RICHMOND VA HOSPITAL, AND SHE WENT THERE IN FALL 2011 AND HAD A REUNION WITH HIM. FOR CHRISTMAS EVE, SHE WROTE A STORY THAT THE ASSOCIATED PRESS DISTRIBUTED WORLDWIDE. I WAS READING THE STORY, AND I WAS LIKE, WOW, RICHMOND HAS A POLYTRAUMA UNIT? I NEED TO LEARN MORE ABOUT THIS. IN A COUPLE OF WEEKS, I WAS OVER THERE WORKING. IT’S A WONDERFUL PLACE. AFTER YOU’RE THERE A COUPLE WEEKS AND A COUPLE MONTHS AND YOU SEE THE RESULTS AND YOU SEE THE DIFFERENCE IT MAKES, THEN YOU START TO REALLY APPRECIATE WHAT PATIENT-BASED HEALTH CARE IS ALL ABOUT. ♪♪.>>POLYTRAUMA IS PHYSICAL AS WELL AS MENTAL HEALTH INJURIES THAT OCCUR DUE TO ONE EVENT AT ONE TIME, AND THIS CAN BE A BRAIN INJURY. IT CAN BE AMPUTATIONS. IT CAN BE POSTTRAUMATIC STRESS DISORDER, EVERYTHING THAT CAN HAPPEN DUE TO A COT STRAF I CAN CAN — DUE TO A CALF STROF I — CATASTROPHIC EVENT. INITIALLY IT WAS RELATED TO COMBAT OPERATIONS AND BLAST INJURIES.>>CONFLICTS BEGAN AROUND 2001. BY 2003 TO ‘5, WE’RE REALIZING THESE ARE NOT GOING TO BE SHORT-TERM WARS. THEY’RE NOT GOING TO BE ONES WITHOUT CASUALTIES. THESE CONFLICTS WERE GOING TO GENERATE FOLKS WHO NEEDED COMPLEX INTEGRATED CARE THAT CAN BE DELIVERED BY A POLYTRAUMA CENTER. RICHMOND, SAN ANTONIO, PALO ALTO, MINNEAPOLIS AND TAMPA ARE THE FIVE CENTERS. THEY DEVELOPED THE NEXT LAYER, THE SECOND TIER SITE, THIRD TIER, AND THEN FOURTH TIER. SO THERE IS A NATIONWIDE OF MAP OF INTEGRATED CARE THAT WAS RUN THROUGH THE VA’S OFFICE OF PHYSICAL MEDICINE REHABILITATION. THE DEPARTMENT OF DEFENSE, DEPARTMENT OF VETERANS AFFAIRS AND PEOPLE ACROSS THE SYSTEM WORKED TOGETHER.>>THIS IS A HUGE SYSTEM. YOU ARE GOING TO SEE SOME OF THE BASIC SERVICES BEING THE SAME AT ALL FIVE POLYTRAUMA REHABILITATION CENTERS, BUT THEY LITTLE HAVE DEVELOPED INDIVIDUALITY BASED ON THE GEOGRAPHICAL LOCATION, THE POPULATION THEY SERVE, THE KIND OF SUPPORT THEY HAVE AROUND THEM, BUT OVERALL, THE BASIC SERVICES ARE THE SAME.>>WORKING IN AND WITH THE TRAUMA PROGRAM, WE TRACK THE PATIENTS FROM POINT OF INJURY OR IF THEY HAD NONBATTLE INJURIES, WE TRACK THEM ALONG THE PATH FROM THEIR INJURY TO STATE SIDE. THE TRAUMA SERVICES TEAM WOULD REQUEST OUR REHABILITATION LENS ON THESE PATIENTS TO HELP DETERMINE WHAT THEIR OPTIONS ARE.>>THE PROJECT HAS CHANGED OVER THE YEARS. WE SAW THAT A LARGE WAS SERVICE MEMBERS, AND THAT WAS NOT PROBABLY ABOUT 75 TO 80% OF OUR POPULATION. HOWEVER, WE’VE SEEN AN INCREASE IN STATE SIDE INJURIES FOR MOAT MOAT — MOTOR VEHICLE ACCIDENTS. WE HAVE HAD A FEW OF SUICIDE ATTEMPTS. WE STILL USE THE SAME RESOURCES FOR THE COMBAT INJURY, BUT IT’S SLIGHTLY DIFFERENT. WE REALLY FOCUS ON A WELLNESS ASPECT FOR THEM. PERHAPS THEY HAD SEVERE PTSD OR JUST WERE HAVING A REALLY HARD TIME REINTEGRATING INTO THEIR HOME LIFE, AND SO ALL THESE OTHER ISSUES THAT WERE OCCURRING PRIOR TO THEIR INJURY THAT WE WANT TO MAKE SURE WE DON’T IGNORE.>>PRETTY SCARED OF ANOTHER SURGERY.>>MY GOAL IS TO GET THEM HERE AND MAKE THEM FEEL SAFE AND LET THEM KNOW THAT WE’RE NOT ONLY GOING TO TAKE CARE OF YOU, BUT WE’RE GOING TO TAKE CARE OF YOUR FAMILY AS WELL. ONCE YOU FIGURE OUT WHAT THE DIAGNOSIS IS THAT WILL SORT OF DIRECT WHICH PROGRAM WE’RE GOING INTO. WE’RE LOOKING AT THEIR PHYSICAL ABILITY TO TOLERATE WHAT WE’RE DOING, BECAUSE IT’S RIGOROUS.>>BEING ABLE TO ALLOW OUR THERAPISTS TIME TO TREAT OUR PATIENTS, AN HOUR OF THERAPY A DAY FOR EACH OF THE THERAPIES, MORE THAN JUST OCCUPATIONAL THERAPY AND SPEECH THERAPY. IT INCLUDES VISION THERAPY, RECREATIONAL THERAPY, PSYCHOLOGY SESSIONS, AND SO WE HAVE ALL OF THOSE AND WE’RE ABLE TO PROVIDE 3, 5, 6 HOURS OF THERAPY A DAY TO OUR PATIENTS AND JUST GIVES THEM MORE OPPORTUNITY IMPROVE.>>REACH UP AND PULL DOWN.>>YOU ASSESS WHAT THEY CAN AND CAN’T DO FROM A PHYSICAL STANDPOINT, FROM A COGNITIVE STANDPOINT, AND COME UP WITH A TREATMENT PLAN THAT SUITS THEM.>>ONE WHO MAY NOT BE TALKING, MAY HAVE A TRACH, CAN’T SWALLOW, AND I PROVIDE THOSE TOOLS AND STRATEGIES TO IMPROVE THOSE AREAS AND GET THEM EATING AND TALKING AND REMEMBERING AND FUNCTIONING.>>WE ALWAYS WANT TO TAILOR THE TREATMENT PROGRAM TO SOMETHING THAT’S MEANINGFUL AND PURPOSEFUL TO THE PATIENT.>>WE START HERE WITH THE BASICS TO MAKE SURE THAT THE PERSON FEELS COMFORTABLE EATING, BATHING, DRESSING, TOILETING, AND THEN ONCE THEY FINISH WITH THOSE, WE MOVE ON TO THE HIGHER LEVEL INSTRUMENTAL ACTIVITIES OF DAILY LIVING WHICH ONE DOES WITH THEIR ENVIRONMENT. IT REALLY GETS TO WHERE WE HAVE TO BREAK DOWN SO MANY THINGS, LIKE VISION, SPEECH, SWALLOWING, COGNITION, SO IT’S REALLY NICE TO HAVE THE REST OF THE TEAM, BECAUSE IF YOU CAN’T SEE WHERE YOUR TOOTHBRUSH IS, IT’S GOING TO MAKE IT A LITTLE MORE DIFFICULT TO BRUSH YOUR TEETH.>>IF — WELL, ON OUR UNIT HERE, WE HAVE PATIENTS WHO HAVE HAD A BRAIN INJURY OR MAYBE THEY’VE HAD A STROKE, AND THAT AFFECTS VISION, BECAUSE VISION GOES THROUGH BETWEEN 70 AND 90% OF THE BRAIN. SO IF A PERSON HAS LOST VISION, THEN I CAN TEACH THEM SKILLS OF BLINDNESS, HOW TO COMPENSATION FOR THEIR FIELD LOSS OR FOR THEIR INABILITY TO SEE THE WAY THEY USED TO.>>IF THEY HAVE VISION BUT IT’S NOT DYSFUNCTIONAL OR DISTORTED, THEN I TEACH THEM SKILLS OF VISION, HOW TO GET BACK THE SKILLS THEY HAD BEFORE THEIR ACCIDENT OR THEIR INJURY.>>FARTHER AWAY OR CLOSER.>>THE SUCCESSFUL REHAB IS BASED ON THAT PATIENT’S GOALS. WHERE DO THEY WANT TO GO? WHAT ARE THEY TRYING TO ACHIEVE? AND IN ORDER TO GET THERE, YOU HAVE TO HAVE EVERYBODY AS A COHESIVE UNIT.>>THIS HAS THE PHYSICAL AND THE COGNITIVE AND THE PSYCHOLOGICAL AND EMOTIONAL THINGS THAT COME WITH ALL OF THAT. IT’S ALL SYSTEMS, AND IT’S EXTREMELY CHALLENGING FOR SOMEBODY TO GO THROUGH.>>ALL THERAPISTS, ALL STAFF, EVERYONE IS ON THE SAME UNIT. OUR PATIENTS DON’T NEED TO GO TO ANY OTHER UNIT TO FIND ANY OF US. YOU’RE JUST A PART OF THE TEAM ON A DAILY BASIS AT ANY POINT IN TIME. MY JOB IS TO CASE MANGE THE TEAM, SO AS THEY ARE TELLING ME THAT SOMEONE CAN NOW START DOING STAIRS, THEN THAT MEANS HE HAS STAIRS AT HIS HOME AND I CAN DISCHARGE HIM TO HIS HOME. SO AS EACH DISCIPLINE IS PROGRESSING IN THEIR THERAPIES AND REHAB SERVICES, IT LETS ME KNOW WHAT MY SCENE OF THE ACCIDENT STAGE FOR MY PATIENT IS REGARDING FROM A SOCIAL WORK ASPECT AND FOR THE CAREGIVER INVOLVES.>>IT’S PATIENT-CENTERED, FAMILY-CENTERED, AND EVERY SINGLE PATIENT IS DIFFERENT, AND EVERY SINGLE FAMILY IS DIFFERENT.>>I THINK YOU’LL BE FINE.>>THE FAMILY MEMBERS MAY BE THE PRIMARY UNIT THAT WILL BE TAKING CARE OF THE PATIENT, SO WE HAVE TO KEEP THEM STANDING. WE HAVE TO EDUCATE THEM. WE HAVE TO GIVE THEM AS MUCH RESPITE AS POSSIBLE WHILE WE ARE HERE AROUND THE CLOCK TAKING CARE OF THEIR LOVED ONE SO THAT THEY CAN BEGIN TO THINK ABOUT, YOU KNOW, WHAT IS THE RIGHT NEXT STEP FOR US AS A COUPLE OR AS A FAMILY.>>RYAN USED TO RUN, BIKE, SKI, AND HE AND HIS BROTHERS WERE ON A TRIP TO COLORADO AND THEY BIKED ALL OVER THE PLACE. HE WAS IN A MOTORCYCLE ACCIDENT IN DAYTON, OHIO.>>FIRST IMPRESSION YOU GET IS THAT YOU SEE YOUR SON THERE IN A VERY SERIOUS CONDITION, AND HE’S NOT DOING MUCH ON HIS OWN. THE MACHINES ARE RUNNING HIS BODY AND WHATEVER IS LEFT OF HIS LIFE.>>IT WAS VERY SCARY. HE WAS AT WALTER REED FOR ABOUT TWO AND A HALF WEEKS.>>THEY SAID YOU DO HAVE CHOICES. YOU CAN GO TO DIFFERENT FACILITIES, BUT WHY RICHMOND IS GOOD IS BECAUSE THEY HAVE A POLYTRAUMA UNIT THERE, AND IT SEEMED LIKE A PERFECT MATCH. WE KIND OF THOUGHT THIS WAS GOING TO BE HOME FOR A WHILE BOTH FOR RYAN AND US, BECAUSE THE OTHER HOSPITALS WE WERE THERE FOR ONLY A SHORT TIME. AFTER A WHILE, YOU START TO LEARN WHAT THE ROUTINE IS.>>ONE OF THE NURSES TOLD ME THAT RECOVERING FROM A TRAUMATIC BRAIN INJURY IS LIKE RUNNING A MARATHON. IT’S RUNNING IT THROUGH WOODS WITH ROCKS AND TREES AND CURVES AND ALL KINDS, AND SOMETIMES THERE ARE SETBACKS TO.>>DOING FANTASTIC. I AM SO PROUD OF YOU, RYAN.>>I HAD THE GOAL, WHATEVER THE THERAPISTS WERE DOING WITH RYAN, THAT I WOULD TRY TO ENHANCE IT. (LAUGHTER). THERE’S RECREATIONAL THERAPY. PAULETTE ACTUALLY GOT A RECUMBENT BICYCLE FOR RYAN TO RIDE. ONE DAY SHE CLEARED OFF THE FLOOR, AND RYAN WAS AGE TO RIDE IT IN A CIRCLE ALL AROUND. I THOUGHT THAT WAS REALLY SPECIAL, BECAUSE THEY KNEW RYAN, THAT HE LOVED THE BIKE. THEY DID THAT FOR HIM UNIQUELY AS A PERSON. RYAN’S BIG GOAL WAS TO BE A MARINE. HE’S A WOUNDED WARRIOR BATTALION. HE HAS A CHANCE THAT HE MIGHT BE ABLE TO GET BACK INTO THE MARINES AND BE ABLE TO SERVE AGAIN. TO ME, IT’S AMAZING. IT IS AMAZING.>>WE HAVE AWESOME PEOPLE. I SPENT 14 AND A HALF YEARS IN THE ARMY. I WAS AN E 5 WHEN HE COME OUT. I SERVED FROM 75 TO 92. I HAD AN AORTA DIE SESSION. AORTA DISSECTION. I HAD TO GET RUSHED TO THE HOSPITAL AND HAD TO HAVE AN AMPUTATION. I JUST DIDN’T KNOW WHAT IT WAS. THEY KEPT ME INFORMED ON WHAT WAS GOING ON WITH ME, MEDICINE-WISE, INJURY WISE. IT’S A GOOD DEAL. I’M VERY APPRECIATIVE. I’M LOOKING FORWARD TO COMING BACK TO THE BOOT CAMP AND GETTING A PROSTHESIS AND KEEPING MOVING.>>WE LOOK AT THE WHOLE PERSON, HAVE A HOSISTIC APPROACH. HOLISTIC APPROACH. WE MAKE SURE THEIR PAIN IS OKAY. THE PSYCHOLOGY MEMBERS ARE ACTIVE IN THAT. WE LOOK AT THE WHOLE THING AND GET THEM MOVING TOWARD THE DIRECTION OF PROSTHETIC USE.>>I WAS IN AN AUTOMOBILE ACCIDENT, AND I GOT FLIPPED, AND IT CRUSHED MY HEEL. WE TRIED TO SAVE THE FOOT, AND WE TRIED TO SAVE THE HEEL, BUT WE WERE UNABLE TO, AND EVENTUALLY THE HEEL JUST HAD TO BE TAKEN OFF. PROSTHESIS WAS VERY BENEFICIAL TO ME. THEY GET YOU UP AND THEY’RE IMPROVING YOUR LIFE.>>WE HAVE AN INTENSIVE 5 DAY PROS — PROSTHETIC BOOT CAMP PROGRAM. IT’S ONE-STOP SHOPPING.>>LOOK AHEAD ABOUT 10 TO 15 FEET.>>I PERSONALLY HAVE ALWAYS BEEN A FIRM BELIEVER IN THAT WHEN YOU’RE WEARING A PROSTHETIC IT’S ABOUT CREATING GOOD HABITS TO START. BY THE TIME THEY GO HOME ON FRIDAY, THEY PERSONALLY FEEL THEY’VE MASTERED THE PROSTHETIC.>>ANOTHER EIGHTH INCH IN.>>WHAT’S FUNNY IS THAT EIGHTH INCH MAKES ALL THE DIFFERENCE IN THE WORLD.>>IT’S CRAZY.>>SO WEIRD.>>TO SEE THE DIFFERENCE BETWEEN MONDAY AND FRIDAY IS SO EXCITING, AND THEN THEY COME BACK FOR OUTPATIENT THERAPY WITH ME, AND THEN THEY COME BACK FOR JUST FOLLOW-UP VISITS, KIND OF LIKE YOU WOULD SEEING YOUR MECHANIC.>>I WAS ON THE AIRCRAFT CARRIER, THE U.S.S. KITTY HAWK. THAT WAS PRETTY COOL TO BE OUT IN JAPAN. IT JUST WASN’T ENOUGH FOR ME, SO I STARTED TO CROSS TRAIN WITH THE CORPSMEN ON MY SHIP. I JUST WANTED TO GO FIGHT FOR MY COUNTRY, AND SO I WENT TO AFGHANISTAN, AND THAT KIND OF SCREWED ME UP. IT’S JUST LIKE YOU GOT TO GO, GO, GO, AND ADRENALINE PUMPING ALL THE TIME, AND YOU’RE CONSTANTLY, YOU KNOW — ONE DAY YOU’RE AT THE CHOW HALL WITH YOUR BUDDY, AND THE NEXT DAY KIA OR — YOU KNOW, IT WAS JUST A DIFFERENT MINDSET, AND THEN YOU COME BACK, AND IT’S LIKE, OKAY, GOOD JOB. SO I HAVE A PROBLEM WITH TURNING IT OFF.>>YOU JUST ARE EXPECTED TO GO BACK TO YOUR JOB AND BE FINE.>>GO BACK TO EVERYDAY LIFE AND DISCONNECT WITH YOUR FAMILY, DISCONNECT WITH EVERYTHING.>>HE WAS IN A COMA FOR TWO WEEKS, AND WE THOUGHT WE LOST HIM. WE NEVER THOUGHT HE WOULD COME OUT. WHEN BOBBY CAME HERE, HE HAD TRAUMATIC BRAIN INJURY, AND HE WAS PRETTY BAD OFF.>>THE MIRACULOUS RECOVERY THAT HE MADE OVER 18 MONTHS WAS JUST — IT WAS SHOCKING. I MEAN, IT WAS JUST MORE THAN WE EVER COULD HOPE FOR.>>HE WOULD GO INTO THERAPY AND JUST YELL AND SCREAM. IT WAS A SLOW PROCESS, BUT THEY NEVER GAVE UP HERE. THEY JUST KEPT GOING AND PUSHING HIM BUT KNOWING WHEN TO STOP. YOU KNOW THAT THEY CARE FOR YOU HERE. YOU KNOW THAT THEY HONESTLY LOVE WHAT THEY’RE DOING AND THEY WANT TO HELP. JUST TO HAVE THE COMPASSION FOR EACH AND EVERY ONE OF THEM AND UNDERSTAND WHAT THEY WENT THROUGH.>>THIS TREATMENT THAT I PUT IF FOR THE LOWER BACK IS A TREATMENT TO HELP DIFFUSE ENERGY INTO A PERSON. SO IF HE WAS TELLING ME ON TUESDAY HE WAS FEELING KIND OF RUNDOWN, I’M GOING TO CHECK HIS PULSES FROM AN ACUPUNCTURE STANDPOINT, GIVE LOWER CHI IN A COUPLE OF HIS MERIDIANS, OVER HERE AND OVER HERE. DO YOU FEEL IT? NOW THE OTHER SIDE. OVER HERE OR OVER HERE?>>HE HAD CHRONIC ISSUES FOR YEARS NOW. ANYBODY WITH CHRONIC PROBLEMS USUALLY HAS A LOWER KIDNEY CHI, SO THIS IS GIVING HIM MORE ENERGY AND HOPEFULLY REPLENISH SOME OF HIS CHI.>>WHEN I HAVE MY PATIENTS RELAX, THEY’RE LYING THERE OR PERHAPS SITTING THERE AND FOR 10, 20, 15 MINUTES, I TELL THEM I WANT YOU TO RELAX, KIND OF VEG OUT. THINK ABOUT GOING TO PLACE IN YOUR MIND THAT YOU FEEL COMFORTABLE. IT COULD BE ANYTHING. THAT ALLOWS THEM AN OPPORTUNITY TO BE SPIRITUAL WITHIN THEMSELVES. FOR YEARS IN BRAIN INJURY, WE REALLY LOOKED AT THE PHYSICAL, COGNITIVE AND PSYCHOLOGICAL. THAT’S WHERE YOU MISS OUT. SO IT’S VERY EASY TO SHOW THAT FROM A PHYSICAL STANDPOINT WE HAVE OUR THERAPIES. FROM A COGNITIVE STANDPOINT, WE HAVE OUR SPEECH THERAPIES. FROM A MENTAL HEALTH STANDPOINT, OUR COUNSELORS AND PSYCHOLOGISTS AND PSYCHIATRISTS, BUT FROM A SPIRITUAL ASPECT, WE’VE ALWAYS BEEN LACKING. THAT’S WHEN OUR CHAPLAINCY COMES INTO PLAY. SPIRITUALITY IS MORE THAN RELIGION. THAT’S WHERE WELLNESS COMES INTO EFFECT. THAT’S THE SPIRITUALITY ASPECT OF IT. WE HAVE TO MAKE SURE THAT WE HIT ALL FOUR OF THOSE ASPECTS. THAT’S THE WAY WE STRUCTURE OUR PROGRAM SO WE CAN DO THAT.>>HOW DO YOU FEEL?>>WEIRD.>>EXCELLENT. ALL RIGHT. TAKE YOUR TIME.>>OUR HEROES DESERVE EVERYTHING THAT COULD POSSIBLY WORK BUT ALSO BECAUSE THEIR DIFFICULTIES TEND TO BE A BIT MORE CHALLENGING. FOLKS WHO HAVE POLYTRAUMA INJURY OFTEN HAVE NOT ONE, NOT TWO, BUT OFTEN 17 SYMPTOMS THEY’RE HAVING OFTEN AT THE SAME TIME. YOU CAN’T JUST TREAT THEM INDIVIDUALLY OR USING SOME SIMPLE ALGORITHM. YOU NEED TO PULL THE LAYERS APART AND TREAT THEM IN WAYS THAT ARE CREATIVE. LET’S ALWAYS DO THINGS SCIENTIFICALLY AND APPROPRIATELY BUT MAKE SURE WE’RE DOING EVERYTHING TO HELP THAT PERSON. THAT’S WHAT COMPASSIONATE CARE IS ABOUT.>>OUR PROGRAM HELPS TO EVALUATE ACTIVE DUTY IN VETERANS, VETERAE USE TECHNOLOGY TO HELP THEM MEET THEIR GOAL. WE USE THE AMAZON ECHO BUT ALSO JUST YOUR SMART DEVICES, SMARTPHONE, TABLET, TO HELP WITH COGNITIVE NEEDS, SO REMEMBERING TO TAKE MEDICATIONS, PICK UP YOUR KIDS, APPOINTMENTS. SOMETIMES IT’S USING WHAT WE ALREADY HAVE BEFORE WE ADD SOMETHING ELSE TO YOUR LIFE.>>WHEN THINGS DON’T EXIST, WE MAKE THEM. BUT IT COULD BE IN THE FORM OF MODIFYING EXISTING PRODUCTS AND MAYBE TWEAKING SOMETHING VERY SMALL TO MAKE IT WORK FOR THAT PARTICULAR PATIENT AND THEIR GOALS, AND THAT IS A VERY UNIQUE CAPABILITY THAT WE HAVE WITHIN THE VA. (APPLAUSE).>>THANK YOU VERY MUCH. THIS IS OUR FAMILY, AND THAT’S BRYCE. HE JOINED THE AIR FORCE IN 2010. SO HIS FIRST YEAR HE SERVED IN KOREA AND THEN HE MADE IT OVER TO JAPAN, LIVING HIS DREAM. THEN ON OCTOBER 13th, 2012, WE RECEIVED A PHONE CALL THAT BRYCE HAD BEEN IN AN ACCIDENT AND TOLD US WE’RE NOT EXPECTING BRYCE TO MAKE IT THROUGH THE NIGHT. IN TIME, BECAUSE HE LAID THERE ALMOST A MONTH IN JAPAN WHERE THEY WERE JUST WAITING AND WATCHING TO SEE WHAT WAS GOING TO HAPPEN. I GET HANDED A PIECE OF PAPER AND I FIND OUT THAT DR. PAI HAS ACCEPTED HIM IN RICHMOND, VIRGINIA, SO BRYCE HAS BEEN ACCEPTED INTO A 90 DAY EMERGING CONSCIOUSNESS PROGRAM.>>HI, BRYCE.>>I LIKE THAT THEY TREATED BRYCE AT THE POLYTRAUMA LIKE HE WAS AWAKE.>>OKAY, BRYCE. THIS IS THE FIRST TIME YOU’VE BEEN UP IN SIX AND A HALF WEEKS.>>I TALKED TO HIM EVERY DAY, WOULD TELL HIM WHAT’S GOING ON.>>YOU’RE ALL THE WAY UP, MY MAN.>>IT SNOWED ONE DAY. I REMEMBER JUST PROPPING HIM UP IN HIS WHEELCHAIR AND TAKING HIM OUT TO SEE THE SNOW.>>HEY, BRYCE, HI. HI, BRYCE.>>SUSTAINING HIM EVERY DAY, DUMPING FOOD IN THE FEEDING TUBE. I THINK HE WAS ON 27 DIFFERENT MEDICATIONS A DAY JUST KEEPING HIM ALIVE, SO I SAID, I WISH THERE WERE OPTIONS, AND DR. PAI SAID THERE ARE OPTIONS. IT WAS MY BIRTHDAY. I’LL NEVER FORGET THAT DAY, AND MY HUSBAND WAS WAITING FOR THAT PHONE CALL. THE OPTION IS THAT WE COULD LET HIM SUCCUMB TO HIS INJURIES. THEY MOVED US DOWNSTAIRS TO PALLIATIVE CARE. BRYCE DIED IN SLOW MOTION. IT WAS SO HORRIBLE. I STILL HAVE SHAME FEELINGS THAT COME FROM THAT. MONTHS LATER, WE RECEIVED AN AUTOPSY. HIS BRAIN HAD DISSOLVED IN ITSELF. IT WAS FULL OF BLACK HOLES. HE HAD NO CHANCE. AS LONG AS I LIVE, I’LL SET ASIDE A SPECIAL TIME TO HONOR AND REMEMBER HIM AND CONTINUE TO LOVE HIM ALWAYS, KNOWING ONE DAY I’LL SEE HIS BEAUTIFUL SMILEY FACE AGAIN. THIS MORE THAN ANYTHING ELSE BRINGS ME JOY. (APPLAUSE).>>THIS PLACE IS AMAZING. HE HAD ABSOLUTELY INCREDIBLE CARE, EVERYTHING, THE MEDICAL, THE FRIENDSHIPS. I JUST CAN’T HELP BUT THINK WE WOULD HAVE NO PEACE. OUR FAMILY, I’M SURE, WOULD HAVE BEEN DESTROYED, IF IT WASN’T FOR THIS PLACE. SO IT COULD HAVE BEEN A LOSS OF FOUR LIVES. I DON’T SAY THAT LIGHTLY. I’M SAYING LITERALLY IT COULD HAVE BEEN A LOSS OF FOUR LIVES.>>YOU NEED TO KNOW, FAMILY CAN HEAL.>>ACTUALLY GOING THROUGH ALL THE TOUGH STUFF AND COMING OUT OKAY, BROKEN, BUT NOT DESTROYED. MY MARRIAGE IS STRONGER. MY RELATIONSHIP WITH MY DAUGHTER IS STRONGER. I WANT THE REST OF THE WORLD TO SEE THAT YOU CAN HAVE THAT EVEN WHEN THE ENDING IS BAD. AND I’M GOING TO EMBRACE, OFFER HOPE AND FAITH WHENEVER I CAN FOR ANYONE. THAT’S WHAT I WANT TO DO.>>WE HOLD MEETINGS WEEKLY TO DISCUSS OUR PATIENTS ON THE UNIT.>>HE HAS DECLINED TO PARTICIPATE IN IADL RETRAINING SO FAR.>>PERSONS WITH BRAIN INJURY, YOU REALLY NEED A TEAM TO HELP THAT PATIENT AND FAMILY MOVE FORWARD. WE REALIZE THE PATIENT AND FAMILY GOALS ALONG WITH OTHER GOALS WE WOULD LIKE, AND WE COME UP WITH TEAM GOALS FOR THE WEEK AND DISCUSS THAT BACK WITH THE PATIENT AND THE FAMILY, AND EVERYBODY GETS TO BE ON THE SAME PAGE. WE ALSO HAVE A MISSION MEETING, MIDPOINT MEETINGS AND DISCHARGE MEETINGS WITH OUR PATIENTS AND FAMILY MEMBERS.>>THIS IS YOUR HANDOFF MEETING. ALL THAT REALLY MEANS IS SOME OF THE TEAM MEMBERS FROM POLYTRAUMA ARE NOW GOING TO HAND OFF TO YOUR NEW TEAM IN THE TRANSITIONAL PROGRAM THAT YOU’RE GOING TO.>>IF WE DON’T COMMUNICATE APPROPRIATELY, THEN WE’RE GOING TO STRUGGLE, AND IT GOES BEYOND CLINICAL CARE. IT GOES INTO EVERYTHING THAT WE DO.>>CAME IN LAST WEEK ON THURSDAY, YOUNG GENTLEMAN, MULTIPLE SPINAL FRACTURES, INJURIES IN HIS KNEES. HERE MYSELF, DR. ROGERS FROM THE FUTURE PROGRAM, DOCTOR WEBSTER FROM THE STAR PROGRAM, WE GIVE AN UPDATE ON OUR ACTIVE DUTY SERVICE MEMBERS TO THE DIRECTOR AND CHIEF OF STAFF. SO WE USUALLY MEET FOR ABOUT 10, A 15 MINUTES, GIVE THEM A QUICK UPDATE, TALK ABOUT ANY KIND OF MEDICAL ISSUE THAT MIGHT BE CHALLENGING TO DEAL WITH AND THEN WE DISCUSS ANY OF THOSE SERVICE MEMBERS THAT MAY BE TRANSITIONS OUT OF INTO THE SYS.>>ALL THE OTHER SERVICES, THEY DON’T PHYSICALLY TOUCH POLYTRAUMA EVERY DAY, BUT THEY’RE PART OF WHO OUR TEAM IS. THE REALITY IS ALL THE PATIENTS WILL GRADUATE FROM NEEDING REHABILITATION, BUT THEY’LL ALWAYS NEED PRIMARY CARE.>>WHAT ARE YOU DOING?>>WHAT AM I DOING? WORKING ON THIS.>>WHY AREN’T YOU BRINGING ME ANY?>>IT WAS DECEMBER 31st, 2011, AND I GET THE CALL. I WAS JUST DEVASTATED AND NOT THINKING, YOU KNOW, WHAT WAS HE DOING IN AN ACCIDENT? HE’S GETTING READY TO GO TO TURKEY. JANUARY 29th OR SO, HE CAME TO MCGUIRE. MORE PROGRESS CAME ONCE HE FINALLY GOT UP HERE, AND HE REALIZED WHAT WAS GOING ON.>>I THINK IT WAS NATURALLY A GOOD FEELING FOR HIS FAMILY SUPPORT.>>IT’S NOT EASY. IT’S KIND OF LIKE LEARNING A NEW ACTIVITY, AND I HAD A LOT OF DETERMINATION TO DO EVERYTHING OVER AND OVER AGAIN. OVER AT THE FACILITY, IT WAS LIKE TRYING TO GET YOU BACK TO NORMAL LIFE. AFTER PTRP, I TURNED INTO THE OTHER PROGRAM TO GET AN OCCUPATION. NOW I’M CURRENTLY GOING TO CULINARY SCHOOL. OKAY. WELCOME, EVERYBODY.>>I WORK IN THE POLYTRAUMA TRANSITIONAL PROGRAM CALLED PTRP, HELPING PATIENTS RECOVER FROM PARTICULARLY BRAIN INJURE AND I TRYING TO GET THEM BACK TO AS BEING AS INDEPENDENT AS THEY CAN.>>SCOTTY, YOUR JOB IS GOING TO BE NO. 1.>>THEY PROVIDE THE ACUTENESS, AND NOW COMES REALITY. THERE ISN’T A NURSE RUNNING IN EVERY 24 HOURS. THEY’VE GOT TO GET UP. THEY’VE GOT GET THEMSELVES TO THE BATHROOM. THEY’VE GOT TO LEARN HOW TO MAKE A SANDWICH AGAIN. THEIR PERSONALITIES ARE COMING BACK, JUST HELPING THEM TO REALIZE THAT THIS IS THE TIME TO BREATHE.>>THANKS, GUYS.>>FREE TO GO.>>IF YOU WANT TO HELP BY COLLECTING, THERE’S A BOX. IF YOU WANT TO PUT SOME THINGS IN THERE AND COLLECT SOME OF THE ONES YOU SEE, AND THEN WE CAN PUT THEM IN, THAT WOULD BE GREAT. AND YOU CAN EVEN PULL THE ONES OUT OF HERE.>>I WAS IN THE U.S. NAVY, BUT I GOT MEDICALLY SEPARATED. I WAS A MACHINIST. I FIXED THE BROKEN PIECES OF A SHIP TO GET THE SHIP ROLLING AGAIN.>>THE ONLY THING THAT I REMEMBER IS THE FACES, THE FACES OF THE PEOPLE THAT CAME AND TOOK CARE OF ME. THEIR ANGELS. HER NAME WAS MONIQUE. SHE HELPED ME GET OFF MY FEEDING TUBE AND HELPED ME WITH MY SPEAKING SO I COULD SPEAK FLUENTLY AND CLEARLY. HELLO, MY NAME IS DARREN BROOKS. I WOULD LIKE TO WELCOME Y’ALL TO GOALS GROUP. HERE WE’RE GOING TO TALK ABOUT OUR GOALS. WE HAVE OUR GOALS, WHAT WE WANT TO ACCOMPLISH WHILE WE’RE HERE AT PTRP, WHICH IS THE POLYTRAUMA REHAB FACILITY, OR WHATEVER IT IS.>>I REMEMBER WHEN I CAME IN, I WAS USING A WALKER, TRYING TO BECOME INDEPENDENT. I DON’T FEEL LIKE I’M GROWN UP UNTIL I’M INDEPENDENT.>>IT’S LIKE OF LIKE A RESIDENCE. THEY LIVE THERE. THE SETUP IS DIFFERENT THAN A HOSPITAL SETTING, SO THEY HAVE THEIR OWN ROOM AND OWN BATHROOM, BUT THEY HAVE RESPONSIBILITIES. (INAUDIBLE).>>WE’RE TRYING TO TRANSITION THEM BACK, SO IN OUR SETTING, YOU’RE REQUIRED TO CLEAN YOUR ROOM EVERY WEEK. YOU DO YOUR OWN LAUNDRY. YOU CHANGE YOUR SHEETS. THERE ARE SHARED HOUSEHOLD DUTIES THAT THEY ROTATE. SO IT’S REALLY ABOUT GETTING THEM BACK INTO THOSE EVERYDAY TASKS AND EVERYDAY LIVING.>>THAT’S HARD TO DO. YOU SEE WHAT I’M SAYING? WE WANT TO WORK ON IMPROVING THAT OVER A LONG PERIOD OF TIME.>>HERE IS WHERE THE RUBBER MEETS THE ROAD. IT’S LIKE IT IS TIME TO TAKE IT TO THAT NEXT LEVEL. ONCE YOU’RE IN PTRP, ALL OF YOUR REGULAR LIFE IS COMING BACK TO YOU AS WELL. I GET TO BE HERE TO HELP YOU THROUGH ALL OF THAT. WITH BRAIN INJURIES, IF SOMEONE DOESN’T HAVE A LOT OF CLEAR PHYSICAL INJURIES, YOU MIGHT JUST SEE A 25-YEAR-OLD PHYSICALLY HEALTHY GUY WHO LOOKS FINE, BUT SOMETIMES SAYS THINGS THAT ARE INAPPROPRIATE. WE KNOW THAT IS A PRODUCT OF THEIR INJURIES, BUT WE NEED THE FAMILY TO PARTNER WITH US, WE NEED THE PATIENT TO BEGIN TO UNDERSTAND WHAT’S GOING ON. OUT IN THE COMMUNITY, THEY CAN LEARN STRATEGIES TO MANAGE THAT BEHAVIOR AND NOT BE VULNERABLE WHEN THEY GO OUT THERE. IT’S ALL ABOUT REINTEGRATING IN THE COMMUNITY. OF COURSE, THEY HAVE THEIR INDIVIDUAL THERAPY SESSION, BUT THERE IS A HEAVY EMPHASIS ON THE GROUP HERE.>>THEY PLAN WHERE YOU WANT TO GO EVERY THURSDAY. SO I’M TRYING TO LOOK AT THEIR BALANCE, HOW THEY’RE SETTING THEMSELVES UP. WE WANT TO MAKE SURE THEY WANT TO BE BACK AND DOING THIS AS WELL AS THEY CAN.>>JUST ABOVE THE BALL AT THAT TIME. THERE YOU GO.>>BUT I’M STILL TRYING TO BE BACK AND NOT HOVERING, BECAUSE I WANT IT TO BE AS NATURAL AS POSSIBLE FOR THEM, FOR THEM TO HAVE FREEDOM, AND IF THEY’RE IN THERAPY, I’M STILL TRYING TO HELP THEM AS MUCH AS NEEDED.>>THERE YOU GO. NICE AND SMOOTH.>>FROM THE RP STANDPOINT, WE TRY NOT TO SCHEDULE EVERYTHING ALL THE WAKING HOURS OF THE DAY, BECAUSE THAT’S JUST TO ME SETTING THEM UP FOR FAILURE. WHEN YOU’RE MILITARY, YOU’RE STILL USED TO ALL THE STRUCTURE FOR 8 TO 12 HOURS A DAY. YOU COME TO REHAB. IT’S ALL STRUCTURED. IF YOU’RE NOT GOING RIGHT BACK TO ACTIVE DUTY WHEN YOU LEAVE REHAB, THEN YOU’RE GOING TO HAVE A LOT OF FREE TIME. GOING BACK TO THE LONG-TERM GOAL, WE KNOW WHEN THEY LEAVE HERE, WE WANT THEM TO BE ABLE TO DO WHAT THEY WANT TO DO. I WANT TO PUT THEM AS CLOSE TO THAT SCENARIO AS POSSIBLE SO I CAN SEE HOW THEY’RE GOING TO INTERACT WITH OTHER FOLKS, SO IT’S ALL ABOUT THE REAL WORLD.>>IS IT OKAY IF WE WALK AROUND?>>I WANTED TO MAKE SURE YOU HAD A GOOD UNDERSTANDING OF EVERYTHING THAT WAS GOING MEDICALLY-WISE. THINGS GOING WELL SO FAR?>>YES, SIR.>>I GET AN IDEA OF WHAT HE EXPECTS FROM THE VISIT. I HAVE IDEAS ON HOW I MAY BE ABLE TO HELP HIM THROUGH A DISCUSSION WITH MY PATIENT AND MYSELF DECIDING WHAT’S BEST FOR YOU.>>THIS IS A MEASURE OF YOUR KIDNEY FUNCTION.>>YES, SIR.>>TAKE A LOOK AT WHAT YOUR NUMBERS WERE. PRETTY HIGH.>>YES, SIR.>>I WANT YOU TO TAKE A LOOK AT THIS NOW.>>WAY DOWN HERE.>>THAT’S PRETTY COOL, ISN’T IT?>>I JUST FEEL LIKE I CAN CONNECT WITH THESE YOUNG GUYS IN A WAY THAT I’M THANKFUL FOR.>>THE CHANGES THAT I SEE BOTH IN THE COMPUTER AND WITH MY EYES SHOW THAT YOU’RE MAKING A PRETTY TREMENDOUS RECOVERY.>>MY JOB IS OPERATIONS SPECIALIST, AIRCRAFT CARRIER 75. THE ULTIMATE GOAL IS TO GO BACK TO MY SHIP, BE ABLE TO DOUGH EMPLOY AGAIN AND WORK THE SAME JOB I USED TO.>>I HAD BROKEN RIBS, DISLOCATED JAW, BLUNT TRAUMA ON THE LEFT SIDE OF MY EAR, CUT OPEN MY SPLEEN, KIND OF NAIVE OF THE PROBLEMS I WAS GOING THROUGH, AND THEN THEY TOLD ME I WAS COMING TO PTRP, AND THAT’S WHEN THE ACTUAL CHALLENGE STARTED. I KNEW I WAS INJURED, BUT I FELT COGNITIVELY FINE UNTIL I STARTED SEEING SOME EXTENSIVE TESTS ON PAPER, YOU KNOW, PERCENTAGES AGAINST OTHER KIDS MY AGE THAT DIDN’T HAVE A TRAUMATIC BRAIN INJURY. I STARTED SEEING HOW POORLY I WAS COMPARED TO THEM. BY THE TIME I GET OUT OF HERE, I’LL USE A LOT OF STRATEGIES THAT MY TEAM, SPEECH, AS GIVEN ME TO BE SUCCESSFUL IN EVERYDAY THINGS, EVEN IN MY JOB.>>EVERYTHING I DO IN LIFE, WORKING OUT OR BEING AT WORK EVERY DAY, I’M WORKING EVEN HARDER BECAUSE IT ALLOWS ME NOT TO TAKE THINGS FOR GRANTED NOW.>>LOOKING BACK AND SEEING THE PROGRESS I MADE, I NEVER FELT SO GOOD IN MY LIFE. (APPLAUSE) ♪♪.>>I CAME TO THE POLYTRAUMA CENTER HERE WHERE I WAS IN THE STAR PROGRAM. I THINK I HAD, LIKE, 25 YEARS AT THAT TIME, SO I KNEW I WOULD BE RETIRING, SO I HAD TO FIGURE OUT WHAT I WANTED TO DO, WHICH POLYTRAUMA IS A REAL BENEFIT FOR ME, BECAUSE I GOT TREATMENT AND IT HELPED ME KIND OF FIGURE OUT WHAT I COULD DO, WHAT I COULDN’T DO, AND WHAT I SHOULDN’T DO. THEY PREPARED ME FOR WHAT WAS ABOUT TO COME IN MY NEAR FUTURE WITH RETIREMENT AND GETTING SOMEWHERE IN LIFE. WHEN I WAS ACTIVE DUTY, I WAS ON MY FEET. I WAS ON DROP ZONES. I WAS JUMPING OUT OF PLANES. NOW I’M A DESK JOCKEY. I DIDN’T KNOW WHETHER I WAS GOING TO LIKE IT, BUT THEN I LEARNED, HEY, HERE’S MY ALTERNATIVE. AT LEAST I’M DOING SOMETHING THAT I CONSIDERED CONSTRUCTIVE.>>ONE OF THE BIGGEST ISSUES I HAD WAS A CASE OF PTSD. MY BIGGEST THING WAS HOW TO OCCUPY MY TIME, BECAUSE I START THINKING TOO MUCH, AND WHEN I THINK TOO MUCH, I GO INTO SOME DARK PLACES. I WAS GOING TO DO TAI CHI WITH RENE’ AND MARK. I HAD MY OPINION ABOUT IT AT FIRST, BUT THEN I FOUND OUT THAT IT CAN HELP YOU RELAX. I DO IT ABOUT FIVE TO TEN MINUTES BEFORE I LEAVE FOR WORK EVERY DAY TO CALM DOWN A LITTLE BIT, REDUCE THE ANXIETY AND TRY TO RELAX. SO I FOUND THAT VERY BENEFICIAL.>>MY JOB IS TO HELP WITH EXACTLY YOU ARE AND TO FIND OUT EXACTLY WHAT DIRECTION YOU WANT TO GO. WHEN PEOPLE ARE DEPLOYED, YOU DON’T SLEEP MUCH, AND WHEN YOU DO SLEEP, YOU’RE CONSTANTLY ON EDGE. SO THEREFORE, WE HAVE TO TRY TO CHANGE THAT MINDSET, BECAUSE SLEEP IS SOMETHING THAT CAN BE GOOD FOR YOU. WE MIGHT DO DIFFERENT THINGS, CHI GONG, TAI CHI OR ANY OF THE STRETCHES, MEDITATION. SO THERE ARE MULTIPLE TECHNIQUES THAT WE WORK ON, BUT IT’S MOSTLY KIND CHANGING THE MINDSET, CHANGING THE BEHAVIOR.>>THE REAL PRIMARY PURPOSE OF OUR PROGRAM IS TO HELP INDIVIDUALS WHO SUSTAIN SOME KIND OF SEVERE INJURY OR ILLNESS TO BE ABLE TO REINTEGRATE BACK INTO THE COMMUNITY AND HOPEFULLY BACK IN THE WORKFORCE.>>THEY HAVE A PLACE WHERE YOU CAN CREATE RESUMES WITHIN U.S.A. JOBS AS WELL. I THINK USING THEIR TEMPLATE IS A GOOD IDEA.>>WHAT WE RECOGNIZE IS THE FACT THAT THEY’RE RETURNING TO GAINFUL EMPLOYMENT OR RETURNING TO SOME KIND OF MEANINGFUL WORK, WHICH IS EXTREMELY IMPORTANT.>>JOB TITLE?>>YOU WOULDN’T NECESSARILY USE YOUR MLS NUMBER BUT DEFINITELY USE THE NAME OF YOUR MLS.>>THEY MAY HAVE JUST COME FROM OCCUPATIONAL THERAPY, AND NOW THEY’RE GOING TO COME TO VOC THERAPY, AND AFTER THEY LEAVE ME, THEY MIGHT GOING TO PHYSICAL THERAPY OR SPEECH THERAPY, SO WE ARE ENVELOPED WITHIN THEIR REHABILITATION PROCESS.>>YOU CAN VIEW THIS, EDIT IT OR EVEN DELETE ANY ENTRIES THAT YOU PUT IN.>>WE WORK ON WHATEVER THAT PATIENT’S GOAL IS. SO IF THE PATIENT’S GOAL IS TO RETURN TO DUTY, THE FIRST THING WE’RE GOING TO DO IS ASSESS THEIR ABILITY TO DO THAT. YOU KNOW, I’VE HAD PEOPLE WHO HAVE INTERESTS IN SOME REALLY UNIQUE THINGS FROM SOMEBODY WANTED TO BE A WORM FARMER OR A DEER FARMER TO SOMEBODY WHO WANTED TO BE WORKING IN THE INTELLIGENCE FIELD.>>CHANGING OUT THE HANDLEBARS.>>JUST TO SEE THOSE LIGHTS TURN ON AND LET THAT PERSON UNDERSTAND THAT JUST BECAUSE THEY HAVE A DISABILITY DOESN’T MEAN THEY ARE NOT ABLE. THEY HAVE ABILITIES, AND IT’S FIGURING OUT HOW DO WE USE THOSE ABILITIES TO HELP THEM TO GO OUT IN THE COMMUNITY AND SUPPORT THEMSELVES IN LIFE.>>YES. IT GOES IN BETWEEN HERE, WHICH HAS GOT TO BE ON TOP OF HERE. GIVE IT A SHOT.>>I THINK IF SOMEONE LEAVES HERE AND FEELS BETTER IN JUST ONE ASPECT OF THEIR LIFE THAN THEY FELT WHEN THEY GOT HERE, THAT’S SUCCESS.>>WE REALLY DO WORK VERY HARD TO BE ACCOMMODATING AND TO HELP THEM BE SUCCESSFUL IN EVERY WAY POSSIBLE.>>I WAS INVOLVED IN A CAR ACCIDENT IN 2014. I HAD WHAT IS CALLED COMPARTMENT SYNDROME. DOCTORS COME AND DID — WHAT IS IT CALLED? FASCIOTOMY. SO I WAS CUT IN DIFFERENT PARTS OF MY STOMACH AND ARMS SO THAT PRESSURE YOU COULD BE RELEASED. I WAS DISCHARGED FROM POLYTRAUMA. I CAME ON BOARD TO THE PROGRAM. I WASN’T THINKING ABOUT VOCATIONAL THERAPY AT ALL. I WANTED TO GO TO PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND PROBABLY SOME RECREATIONAL THERAPY. I DIDN’T WANT ANYTHING TO DO WITH VOCATIONAL REHAB, PLEASE DON’T TALK TO ME. SHARON BARTON, SHE WAS VERY PATIENT. SHE WORKED WITH ME ON BUILDING A RESUME, SPEECH AND ALL THESE THINGS. YOU NEVER THINK IT’S GOING TO HAPPEN, BUT EVENTUALLY IT WILL. THEN THE WHOLE PROCESS, JUST A WHOLE BUNCH OF AGENCIES. THEY WOULD LOOK AT MY RESUME, AND THEY WERE LIKE, YOU’RE THE GUY. WE NEED YOU. WE NEED YOU TO COME WITH US, AND I WAS LIKE, WOW, I STILL HAVE HOPE. I’M GLAD I GOT THE VOCATIONAL REHAB. WHEN YOU HAVE PROFESSIONALS THAT ARE WILLING TO WORK WITH YOU THAT ARE PATIENT, THAT ARE CARING AND THEY ACTUALLY MOTIVATE YOU AND ENCOURAGE YOU AND TELL YOU, HEY, YOU CAN LIVE. YOU CAN GO THROUGH THE WORST DAY OF YOUR LIFE. YOU CAN DO THIS. YOU CAN GO THROUGH THIS. THEN IT’S A LOT EASIER TO ACCOMPLISH. I WAS OFFICIALLY RETURNED TO DUTY IN FEBRUARY OF 2015. LONG JOURNEY, BUT IT WAS WORTH IT. ♪ THE MARINES ARE BIG AND BOLD ♪♪.>>FROM ’07 TO NOW, IT WAS A ROCKY ROAD, BUT THE END RESULT IS WHAT WE HAVE RIGHT NOW.>>MY GOAL WAS TO GET TO HERE, BUT NOT JUST HERE. I’M GOING TO GET PAST HERE.>>AT FIRST, I WAS MORE SKEPTICAL. I JUST KNEW THAT I WANTED MY BROTHER TO BE CLOSE TO ME. AFTER GETTING HIM HERE AND THE STAFF, THE CASE MANAGERS, THE THERAPISTS, IT’S LIKE THEY CLING TO US LIKE FRIENDS. WE LOTS — WE LOST OUR MOM. THEY HAVE A DIFFERENT CAREGIVER TYPE PROGRAMS YOU CAN SIT IN, SOMEWHERE YOU CAN GO AND KIND OF LET YOUR HAIR DOWN. THAT WAS GOOD FOR ME BECAUSE I DIDN’T KNOW HOW TO — MY WORLD WAS LIKE SUCKED INTO A LITTLE VACUUM CLEANER. THE THIRD PIECE THAT HE’S RECEIVED HERE HAS REALLY BROUGHT HIM TO WHAT HE IS TODAY, AND YOU NEED TOUGH LOVE. YOU CAN’T SIT THERE AND BABY HIM. KICK HIM. GO. THE WHOLE TEAM, THE STAFF, EVERYBODY, PUT HIM ON BOARD. I’M I AM PRESSED. IMPRESSED. IF I STAND HIM UP BY HIMSELF, HE CAN MOVE AROUND LIKE A BOBBLEHEAD AND NOT EVEN FALL. MONTHS AGO, IT WAS A PROBLEM. NOW HE CAN MOBILIZE, AND THAT’S ONE OF THE GOALS HE SET FOR HIMSELF.>>I BECAME A WATERCRAFT OPERATOR. WATERCRAFT IS ARMY BOATS, TUGBOATS. I JUST GOT LICENSED ON EVERYTHING THEY HAD AT THAT TIME. BEFORE IRAQ AND AFGHANISTAN KICKED OFF, THE BOATS WERE ALWAYS WHAT YOU DID FOR MISSIONS. YOU WOULD COME BACK TO FORT EUSTIS, WHICH IS YOUR HOME BASE, AND THEN WOULD YOU GET A MISSION AND OFF YOU’D GO. I HAVE HARDWARE IN MY NECK, MY LOWER BACK, SHOULDER HAS BEEN REBUILT. I HAD MULTIPLE CONCUSSIONS, HEMIFACIAL SEIZURES, LOWER LEFT QUADRANT IMPAIRED, HEARING LOSS IN BOTH EARS. BECAUSE OF MY BREATHING PROBLEM, I WAS NONDEPLOYABLE, WHICH WAS AWFUL FOR ME. WHEN I GOT OUT OF THE ARMY ALTOGETHER, JANUARY 2011, BY THAT TIME MY HEAD WAS SO MESSED UP, I WASN’T TALKING AS WELL. I HAD OCULAR MIGRAINES. I COULDN’T SEE. I TORE TENDONS IN BOTH HANDS. I COULDN’T FIND MY WAY OUT OF MY OWN NEIGHBORHOOD HALF THE TIME. PART OF MY REHAB WAS CYCLING. ONCE THEY PUT ME ON THAT BICYCLE, IT WAS HEAVEN.>>HOW IS IT GOING? HELLO. HELLO. I’M RIGHT.>>DISCOVERED RIDE TO — RIDE 2 RECOVERY, JUST BE REALLY CHALLENGED ON A FIVE-DAY, SIX-DAY RIDE. YOU HAD PLACES TO BE, A MISSION PLAN, AND YOU FOLLOWED IT AND EXECUTED IT. YOU COULD HELP SOMEBODY ELSE. THAT’S THE GOOD PART. YOU WERE ABLE TO BE A LEADER AGAIN. AND SOMETIMES THE HARDER PART IS LETTING SOMEBODY ELSE HELP YOU. AND HERE EVERYBODY WANTS TO HELP, AND THEY’RE SO WILLING, AND THEY’RE VERY, VERY GOOD, VERY, VERY GOOD.>>THANK YOU.>>OUR TEAM MEMBERS DON’T JUST THINK ABOUT THEIR OWN DIFFICULTIES. THEY REALLY LOOK AT THAT VETERAN OR THAT SERVICE MEMBER AT A WHOLE.>>I DO BELIEVE THAT PATIENT CENTERED SHOULD ALWAYS BE FIRST, NO MATTER WHAT DEPARTMENT YOU WORK IN, BECAUSE IF YOU DON’T INCLUDE YOUR PATIENTS, THEN HOW ARE YOU WORKING TOWARD THE GOAL? BECAUSE THE GOAL IS SET FOR YOUR PATIENT, SO YOUR PATIENT SHOULD ALWAYS BE THE CENTER OF EVERYTHING THAT YOU DO, AND THAT SHOULD BE IN THE CIVILIAN SECTOR AS WELL.>>THIS IS A MODEL THAT ABSOLUTELY WORKS. IT’S PART OF THE ENTIRE PROCESS, AND IT MAKES PRIMARY CARE BETTER. WE NEED PRIMARY CARE. IT’S HOW HEALTH CARE SHOULD BE DELIVERED, BUT WHEN FOLKS NEED MORE, THE REHABILITATION PROCESS, THE POLYTRAUMA PROGRAM, INTEGRATIVE MEDICINE, THE EMERGING CONSCIOUSNESS PROGRAM, STAR, PTRP, ALL OF THAT IS THERE FOR THEM.>>SACRIFICED TO SAVE OUR COUNTRY AND NOW SEEING ALL OF THIS CARE, MONDAY COUNTRY IS TAKING CARE — MY COUNTRY IS TAKING CARE OF ME. OUR COUNTRY IS NOT LEAVING ME BEHIND. ♪♪ ♪♪ Captioning provided by
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3 thoughts on “Polytrauma Rehab in the VA: Compassionate Care

  1. I gave 12 years to the military, had a stroke 3 months ago. I have tried and tried to get them to pay for my medical care, all I get in the runaround. I tried to get into their facility, and they said they couldn't care for me. Now they won't pay for my hospital bills! Fuck them!!!

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