Virtual care opens doors to more TBI treatment options for Veterans

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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).

Navy Veterans Conan O’Rourke using the VA Telehealth system to connected to healthcare providers from his home.“I am what they consider a high functioning TBI patient – I look fine and I talk fine,” said Conan, “what people don’t see are the times I have to withdraw. My main problem at the moment is struggling with mental fatigue – when I run out of my mental energy, I can’t function for the rest of the day. If I really overdo it, then it takes 3-4 days to recover.”

Mental fatigue is a common symptom for people living with the lingering effects of traumatic brain injuries. Conan has suffered two TBIs from motor vehicle accidents.

“The first TBI happened in 1990 when I was in the Navy. The second – the more severe TBI – was in 2012. That’s the one that changed my life forever,” said Conan.

Conan lost consciousness in the first accident, and the second accident was far worse – he suffered several skull fractures and had 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.”

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

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

“As we build this program,” Dr. Cho says, “we are working to make sure that Veterans have access to TBI evaluation and treatment by supporting VA sites that may have access issues due to vacancies. 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.”

For Conan O’Rourke, this means he receives treatment from Dr. Cho and his Speech Therapist, Mental Health Provider and TBI Telehealth Coordinator from the comfort of his own home without having to travel long distances.

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: