Traumatic Brain Injury has a higher frequency of being accompanied by Post Traumatic Stress Disorder. This video presents the multidisciplinary approach to treating traumatic brain injury. The treatment includes neuropsychological assessment, behavioral intervention, cognitive processing therapy, cognitive therapy, cognitive rehabilitation, post traumatic stress disorder treatment, and addresses the concerns in communicating compassionately with patients diagnosed with Traumatic Brain Injury.The National Institute of Health states that the term concussion lacks any diagnostic precision and at worst encourages a lazy diagnostic approach. At Denver Health the diagnoses of a severe injury to the head is Traumatic Brain Injury. From the very beginning the seriousness of brain injury is addressed by a multifaceted approach with a group of providers working together. At Denver Health this team includes Psychologists, Speech Therapists, Medical Doctors, Neurologists and Neuropsychologists working together to help the patient understand what has happened to the brain as a result of the trauma, what has changed and how the patient shall proceed to daily overcome the struggles of TBI.In this video Dr Rafer Leach, a former staff physician at Denver Health does the narrative as compassionate health care provider. I was able to structure this video because of training from Sarah Strebel (Director Rehabilitation Services Cleveland Clinic) Dr Rafer Leach monitors the endocrine system which is important after Traumatic Brain Injury. Inflammation of the HPA-Axis or Hypothalamus, Pituitary and adrenal function is compromised due to inflammation of the brain. The areas covered in this video are mostly around communication. The first episode illustrates what happens when a provider makes a judgement without any scientific basis which is detrimental to the patients mental health.
In the second segment the health care provider acknowledges the patients use of exercise to mitigate stress and this has a tenfold positive affect on the patient .
The next segment presents the common issue of a busy medical center where those with traumatic brain injury are easily confused because of the mount of sensory information that is coming in to the brain. With brain damage the sensory apparatus is compromised and so it would be better to speak to TBI patients in a quiet office or space.
The next segment presents how to communicate compassionately and effectively to patients diagnosed with traumatic brain injury and the use of recored when the physician is explaining the diagnosis and treatment to the patient. This is very important since the patient may not have the cognitive ability to understand what has happened. However with the recording of the diagnosis and treatment plan they can review many times and also with a caregiver to understand or inquire further.
The next segment of the video presents the concept of visual spatial impairment where the traumatic brain injured patient processes visual information at a slower rate than auditory information. This means that information is not being received in a coherent or understandable way. Here the patient sees his doctor outside of the clinic but does not recognize him, this illustrates that even familiar people in unfamiliar environments or in the urban environment where there is a lot of noise and other stimulus that prevent the tbi patient from recognizing someone they are familiar with. This can happen to family members and close friends as well.
The next segment shows the physician identifying himself outside of the clinic and welcoming the patient. If you know someone has a Traumatic Brain Injury and meet them someplace random it would help them if you introduced yourself and conversed where it is quiet.
The next segment of the video on traumatic brain injury show a frustrated patient who cannot process anything the physical is saying because he is speaking too fast and using a dry erase board to illustrate as he speaks what parts of the brain are affected for the traumatic brain injury and what the treatment plan for a compromised endocrine system is. The patient who only processes in a singe sensory mode would do better if he or she was able to record what was being said and then perhaps review later with the visual explanation.
A short episode presents the visit to legal or an attorneys office where Cruel and inhumane words can trigger emotions that are traumatic and for those with post traumatic stress disorder this can lead to relapse. the severity of the relapse can feel catastrophic to those diagnosed with TBI or traumatic brain injury. The purpose of this section to educate providers and even attorneys who deal with people that had a brain injury so that they can help and not hinder the recovery or treatment process by their use of language and processes that expose their clients with TBI to more stress and danger. Thank You for believing in me Sarah Strebel.
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