So when we talk about the polypharmacy that individuals have, and that will be
people oftentimes who are on numerous medications. And I look back at this
as a physician, and I can tell you how many times I've sat in the room with someone
and they've come through and they've had problems with sleep or with pain, and
what you want to do is help them, right? You just want to find a way to help them
and do something to make their time with you more valuable and to move on,
so it's unfortunately relatively natural that in the process that individuals who aren't
getting better have a tendency to accumulate medications and these different
things. But that doesn't always work very well. A 25-year-old shouldn't be taking
10 different medications. So part of the way to avoid that is, one, do your best to
listen to the patient--God forbid we actually listen these days--to figure out what's
helping and what isn't helping. What are you on? What can we get you off?
And really then try to find an opportunity for change. People get medicalized after
a period of time, and they come into the doctor's office to try to help with these things.
But how do we help shut that down? How do we help get past that? Is it through
exercise? Is it through different hands-on therapy? We look at--there's some
tremendous charities out there who are helping our service members get back.
I look at the fly-fishing charities--the Healing Waters--Project Healing Waters.
And I see them on the lawn at the VA teaching folks how to cast and how to do
this. It's getting people on horseback, getting them out into environments where they
can forget about things for a while. I think back to one of the service members
who we had met years ago who came in devastated by his combat exposure
and blast exposures. He couldn't walk. He was falling all over the place when he did.
He was having trouble talking. In thorough testing, his brain was actually working
pretty well. It just couldn't handle the pressure of life. We get him into a kayak
and he was fine. He could paddle. He could stay up. He was doing rolls.
He felt great. He was laughing. Then you get him out and it was back again.
So it's about also showing people windows of health rather than always focusing on
the devastation of the disease. So anything that we can do, be it holistic,
complementary, alternative medical therapies to try to help people shift away
from that strict biomedical model of medicine which, again, we don't fix people.
We can help them, and medications can help people and can help people a lot.
But they're not the end of it. We have to find ways to get them to help themselves.
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Healthcare providers can help vets with TBI and combat stress find other ways than pharmaceuticals to help in recovery — from riding horses to kayaking with other vets.
Produced by Victoria Tilney McDonough and Erica Queen, BrainLine, and Dan Edblom.
Shane McNamee, MD serves as chief of Physical Medicine and Rehabilitation at the Richmond VAMC and has worked extensively on the development and implementation of the Polytrauma System of Care in the Veterans Health Administration.
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