Polytrauma/TBI System of Care

Dr. Mi-Hyon Cho, a specialist in brain injury medicine at the VA Hudson Valley Healthcare System, connects virtually with her team.

Earlier this month, Navy Veteran Conan O’Rourke took a break between personal meetings and a VA Speech-Language Pathology telehealth appointment to talk about living with traumatic brain injury (TBI).

Though he looks and speaks normally by most people’s standards, he is one of many Veterans whose life has been negatively impacted by TBI.

“I am what they consider a high functioning TBI patient,” said Conan, “[But] what people don’t see are the times I have to withdraw.”

Mental fatigue makes him lose functionality for whole days at a time. According to VA experts, this is a common symptom for people living with the lingering effects of TBIs. Conan has suffered two TBIs from motor vehicle accidents one in 1990 while he was in the Navy and the second in 2012. The second TBI left him with life altering injuries such as skull fractures and bleeding inside his brain.

“It took nearly two years to come to terms with my brain injury. There was a lot of denial before I could come to some degree of acceptance,” he said.

Acceptance and moving forward with VA’s Polytrauma System of Care

After receiving initial treatment and rehabilitation outside VA, Conan enrolled in VA care in 2015.

“The first couple of years of VA treatment were ok but didn’t address some of the needs related to my TBI,” he continued. “Things changed in 2018 when I attended the Brain Injury Awareness Day event on Capitol Hill and learned about the Polytrauma System of Care.”

After connecting with the Polytrauma System of Care at his local VA facility, Conan was referred to Dr. Mi-Hyon Cho, a specialist in brain injury medicine with the VA Hudson Valley Healthcare System.

“Mr. O’Rourke sustained significant injuries in 2012, and our system of care is designed to manage complex injuries,” said Dr. Cho. “We focus on helping cognition and behavior, physical rehabilitation, and mental health. There can be many layers to treatment and each Veteran’s care plan is designed specific to their needs.”

Telerehabilitation for TBI

While virtual care has been part of VA for years, adapting to the COVID-19 pandemic has enabled Veterans to access more online options. For Conan and other Veterans receiving TBI/Polytrauma care, this means having access to specialized polytrauma and TBI clinical services no matter where they live– it means having treatment options that may not be available locally.

One example is the Tele TBI Program at VA Hudson Valley. Comprised of a TBI Specialist, Speech Therapist, Mental Health Provider, and TBI Telehealth Coordinator, the program specializes in managing TBI and co-occurring conditions.

“Currently, our Tele TBI Program is seeing Veterans from rural areas around the country including Veterans enrolled at VA Medical Centers in Erie, Augusta, Albany, Montana, Memphis, Tennessee and Northern Indiana, Dr. Cho explains.”

For Conan, this means he receives treatment from Dr. Cho,his Speech Therapist, Mental Health Provider and TBI Telehealth Coordinator from the comfort of his own home.

Living with the long-term effects of TBI

Even with the most advanced care possible, Conan is realistic about his condition.

“I’m not going to go back to being the same person I was; my brain will never fully recover. What I have learned are coping strategies. I am now more aware of what I need and how I can become stronger,” said Conan. “I am much happier now with Dr. Cho. I feel like I am getting someone who is like a Primary Care doctor for my brain injury – I have someone who is looking at all aspects of my care.”

To learn more about the VA Polytrauma System of Care, visit: www.polytrauma.va.gov.