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Tackling TBI with Your Care Team

For many Veterans with traumatic brain injury (TBI), recovery takes a team.

A computer graphic of a brain

The Department of Veterans Affairs (VA) screens all Veterans who left military service on or after September 11, 2001, for possible TBI. If they screen positive, a TBI specialist will further assess them. A treatment plan is developed, which is based on their symptoms. Then a team of health specialists' work together to deliver care.

TBI is caused by a blow or jolt to the head. A head hitting a windshield or cement can cause TBI. So can a blast or piece of metal entering the skull. With polytrauma, TBI occurs along with other injuries, such as loss of a limb or spinal cord injury.

How My HealtheVet Can Help You

At the Washington, D.C., VA Medical Center (DC VA), the TBI care team sends the treatment plan directly to the Veteran using Secure Messaging through My HealtheVet. This way, the Veteran can see the plan right away", said Dr. Joel Scholten, who treats Veterans with TBI.

Staying in close touch with health providers is important in TBI treatment. Because of this, Veterans are urged to use Secure Messaging to communicate with members of their care team. Secure Messaging is safe and confidential. All sent and received messages stay within My HealtheVet. To use Secure Messaging, you must be a Veteran enrolled at a VA facility and have an upgraded My HealtheVet account. To upgrade your account, you will need to go through Authentication. This is a process by which VA verifies a Veterans' identity before allowing access to their VA health record. Learn how to upgrade your account by visiting the authentication page at My HealtheVet.

"My HealtheVet has really benefited me because I can contact and communicate with my doctors from home," said Ken, a Navy Veteran who gets TBI therapy at the DC VA Medical Center.

Ken also uses My HealtheVet to read articles, keep track of his daily diet and physical activity and remind himself of appointments, which is very helpful for TBI patients with memory problems.

"The hardest thing for me was memory," said Ken. "I had sticky notes all over my house, reminding myself of things, trying to remember medications."

Part of the Plan

VA therapist Megan Kelly makes learning how to use My HealtheVet part of TBI therapy. Veterans work on visually navigating the site, going over a web page to learn how to read it, and remembering their log-in information and steps for emailing a their health care team.

"One of the most challenging things for therapists is making sure our patients remember and follow through with information and things like appointments," said Kelly. "Repetition is important."

Treating TBI

Male veteran with clinician in exam room

Identifying and treating TBI can be hard because no symptom is unique to the condition, according to Scholten. "Treatment might target a symptom of TBI, rather than the TBI itself. For instance, a provider might prescribe medicine for depression or relaxation therapy for anger and anxiety," Scholten explained. The team approach allows a variety of health providers, each of whom may be treating a different aspect of TBI, to work together toward a common goal.

"If something is happening with you, a provider lets the other team members know," said Ken. "They are very good about communicating with each other and keeping each other in the loop about your care. Everyone on the team knows you and knows your situation."

Ken also gets to meet with his team every other month to discuss his treatment. "It's very good for patients to be able to have direct feedback from all of the providers in the same room," said Kelly. "They feel very empowered to be part of coming up with their treatment plan and discussing their progress."

Ken, who was unable to read following his TBI, is now reading at a ninth-grade level. And after four years of being too anxious to drive, he has taken and passed a driving test.

Did you serve in OEF/OIF/OND? If you think you might have the ongoing effects of a TBI, visit your VA medical center for an assessment. A health team is ready to help.

Read More

Polytrauma/TBI System of Care

Defense and Veterans Brain Injury Center