JIPA-sponsored CME Neurological Symposium has full house on TBI and Stroke Rehabilitation

By Caribbean Medical News Staff
The Hilton Barbados was the backdrop for an all-day seminar for health care professionals focusing on Neurological Rehabilitation for Stroke & Traumatic Brain Injury in the Caribbean. Allied health care workers, exercise therapists, physiotherapist, physiatrists, medical doctors and other health care workers packed the room in the JIPA sponsored event CME event.
With several highly qualified and effervescent speakers, the seminar heard from experts in various fields who were able to bring the topical and timely issue of traumatic brain injury (TBI) and stroke rehabilitation to the forefront of everyone’s collective minds.
The Chief Medical Officer in Barbados, Dr. Joy St. John, opened the event. In an ironic twist, the next presenter, renowned Barbadian neurosurgeon Dr. John Gill, was recovering from a crash where he was hit by a drunk driver and was unable to present, though resting comfortably.
Dr. Ivor Crandon, a Jamaican neurosurgeon and member of JIPA paved the way with an overview of traumatic brain injury and stroke rehabilitation and the dearth of access to quality post -injury care in the Caribbean. A particular pet peeve of his was the transportation issues surrounding the transport of patients from where an injury was sustained and to the hospital for treatment. He bemoaned the fact that better must be done to have our EMTs, our transportation vehicles and protocols for transport in place for the injured and suffering. “Time is Brain” was the common refrain all day.
Young neurosurgeon Dr. Sean Smith, a Barbadian, illustrated his own experience with concussion in his PowerPoint presentation when he illustrated his snowboarding experience in Ontario. He spoke on the Pathophysiology of Brain Injury. His remarks were lively and infused with personal experience and practical suggestions for post-injury recovery. He was supported by colleague Dr. Rene Best, who delivered his remarks on Dealing with Recovery from Concussive Brain Injury on the Sports Field. How many times have our children, athletes been injured only to be sent back out to play, having not had adequate rest and recovery? Both Smith and Best warned of the dangerous of returning to work, school or the field after a concussion and the importance of rest dependent upon the type of concussion illustrating the various symptoms that can occur post-injury and which require rest.
NFL litigation and concussion
Citing recent NFL lawsuits and settlements, the suicide of a well-known NFL player and concussions in almost every sport from wrestling (Chris Benoit who killed his wife and child and committed suicide) to cricket, the doctors warned that a concussion must be taken much more seriously even in kindergarten sports. The gathering also heard from Dr. Toni Nicholls, PhD, a neuropsychologist whose practice is devoted to TBIs and stroke victims (among others) and mapping their diagnosis through a series of day long tests which are interactive and “fun” but which can be tiring (in which case she breaks up the day) in an effort to establish the functionalities (psychologically) of her patients. In addition, Nicholls is also able to map out with some degree of probability and possibility, the next few years of a patient’s life based on the injury and said that her services also included recreational and psychotherapy. There is no resident neuropsychologist at the QEH in Barbados and certainly her skills would be a major plus in the rehabilitation of patients with impairments due to cardiovascular accidents or cerebrovascular accidents, concussions and other related insults to the brain.
After a break for a sumptuous lunch, the group resumed to hear from Dr. Harley Moseley, Physiatrist on Cardiac Rehabilitation & Stroke: Does it work? In a lively presentation, he examined the importance of public education on stroke and cardiac arrest and spoke to the issues of whether the region was equipped with state-of-the-art rehabilitative protocols in place for recovery from brain injury, cardiac arrest and stroke. Again, like his colleagues before him, he mentioned the general lack of public education (though much improved) and the dearth of rehabilitation specialist in the region who were able to respond in a timely fashion to brain injury and cardiac rehabilitation. He said that here was no doubt that along with exercise, nutrition and other patient care interventions, recovery was possible but again, time was the issue. How soon does the injured patient get the hospital, how soon are the necessary protocols put in place to minimize cell death in cardiac events or cerebral events? He said these matters need to be addressed not only in the health care setting but also most certainly at schools. Using his son as an example, he said were it not for his son’s school mates saying that his son was hit in the head by a football, he would probably not have known.
Emerging perspectives
Dr. Kester Nedd, head of JIPA, gave a rousing presentation on Emerging Perspectives in Rehabilitation of Brain Injury – The Benefits of Integrated Care. The audience heard of technologies that reminded one more of a sci-fi movie and that were illustrative of the gains that the medical profession had made through the synchronization of research and development and engineering sciences. These new emerging sciences and devices are emerging with a view to assisting those who are recovering from TBIs in particular through a “thought” connecting to perhaps (for example) a robotic arm to complete a task. The speech was fascinating and illustrated the way forward while emphasizing the need for teamwork between and among all professionals through a chain that led to ultimate positive outcomes for each patient.
Dr Alok Kumar, paediatrician spoke to the issue of Childhood Stroke in Barbados, A Brief look at the Incidence, Treatment and Rehabilitation and discussed the incidence of childhood stroke in the region and Barbados in particular, their causes and the presence of stroke in children with sickle cell anemia in particular. He said that the region needed to collect more data and do more documentation on childhood stroke as well. While not always leading to death, he said that children too needed to be monitored for stroke particularly where other diseases existed which made them prone to hemorrhagic or ischemic stroke.
The evening ended with a bubbly presentation from Gina Pitts, CEO of the Barbados Heart & Stroke Foundation who shared the monumental gains that the association had made over the years, its fund-raising efforts, funding challenges and the purpose of the Foundation, which has a fully equipped gym at its new home. The gym now services 83 stroke survivors who are also exercising and receiving therapy alongside those who have suffered heart attacks. The presenters all emphasized that post heart attack exercise actually reduces the incidence of another heart attack much as it does with stroke contrary to what many patients believe.
The evening ended with a panel discussion. JIPA is an Independent Health Care Provider Association with over 16,000 healthcare providers from across the Caribbean, Latin America and the world. Their referral line is available 24/7 877-749-5472 or email them at PCC@JIPAnetwork.com.

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