South Texas VA showed Ukrainian delegation technology and a bit of emotion

The collaboration between the VA and the U.S. State Department brought the medical delegation to San Antonio, Texas on a week-long visit to learn more about rehabilitation processes.

The Ukrainians focus was mental health, spinal cord, burns and neurological injuries. The healthcare system was chosen for its rehabilitative capacity because they boast one of the VA’s five polytrauma centers of care.

In addition to polytrauma, the team visited the Spinal Cord Injury and Disorder unit (SCI/D), prosthetics lab, recreation therapy and received briefings from amputees, blind Veterans and Prisoners of War from the Vietnam conflict.

A member of the Ukrainian delegation, Dr. Serhii Kolisnyk, was very interested in the technology that was shown like assistive bikes and prosthetic limbs. He was an eager volunteer throughout the week, wanting to try everything and bring that experience back to the Ukraine.

“This experience was very beneficial and fruitful for us because we have a lot of complex traumas like Spinal Cord Injuries (SCI), Traumatic Brain Injures (TBI) burns and blinded persons,” Kolisnyk said.

Kolisnyk said he finds this experience critical for him as a physical rehabilitation physician.

“You [South Texas VA] have shown us the interdisciplinary or multidisciplinary approaches and this is very important to pay attention in all directions of rehabilitation,” Kolisnyk said.

The group tried gait training, and other demonstrations in a conference room, but activities like rehabilitative drumming and archery provided the group a chance to see patients and South Texas staff in their work environment. One member of the delegation who really impressed her colleagues as an archer was Dr. Daria Melnyk.

Melnyk hit the target regularly, and that is in part to the instruction from South Texas patient and Paralympian, Jeremy Velez. Velez is an expert archer despite temporarily losing the use of his draw hand.

Velez said he got into archery and then started experimenting with different commercial products, modifying them into a chin release mechanism. The Ukrainians were amazed at Velez’s accuracy. Velez says archery is how he makes a living, so knowing that he was losing the strength in his arm, he looked for help at South Texas VA Prosthetics Service. “I was losing all strength in my right arm and that is my drawing arm, “Velez said. “Being proactive, I had the VA here cast my entire shoulder over the summer and the final product was completed early this year so I’m still able to go into full extension and fire my bow while I’m still rehabbing,” Velez said.

Kolisnyk explained that the Ukraine is large geographically like Texas, and because they are attempting to build a network of treatment centers that can provide some of the same services Ukraine’s size will pose challenges.

This issue was in the forefront for Advisor/Commissioner for President of Ukraine for Societal Issues, Tatiana Lomakina.

“For me, it was to get very modern and factual information on developing evidence-based rehabilitation for people who have some injuries,” Lomakina said. Lomakina went on to say the VA serves Veterans, but in the Ukraine, the war creates 300 amputees every day from their entire population.

“After this study and we are back in Ukraine, we will start to implement it in our healthcare system,” Lomakina said.

Kolisnyk, put Ukraine’s rehabilitative needs in perspective. “We have a big population and every family, every child, every woman, every combatant has some signs of PTSD,” Kolisnyk said.

The Ukrainians were not only looking to learn about physical rehabilitation but also mental health rehab by bringing with them psychiatrists and social workers to gather relevant information. Dr. Seth Chandler’s teams set up several panels that addressed PTSD and many of the emotions that go along with traumas.

South Texas prosthetist, Jaclyn Astorga, who lost her leg in a car accident, got emotional describing the night of her accident, even though it was 27 years ago. She told the delegation the different states of mind and challenges she went through, including learning to walk on a prosthetic leg while pregnant. These stories drew the delegation in and will be common challenges they will face in their home country.

SCI patient and Paralympian, Gabe Diazdeleon, who was invited to the Whitehouse by Michelle Obama, got a chance to explain coping mechanisms to the delegation. He explained that he has been a VA patient for 39 years and attributes his success and quality of life to attitude. “The best thing to do, and it doesn’t have to be sports, is just find something you are passionate about and be the best at it,” Diazdeleon said. He advised the Ukrainian medical team to not highlight what their patients can no longer complete, but rather alternatives and adaptations.

He was injured in 1984, and in two short years he found himself at the World Championships in Sweden and never looked back.

“This is a group of physicians, psychologists as well as government representatives and we have spent the past week everything we have learned particularly after the last ten or twenty years of our wartime in Iraq and Afghanistan,” said Seth Chandler.  

The delegation also heard emotional and dramatic testimony from two U.S. pilots who were shot down and taken prisoner for six years.

Col. Joe Milligan recalled his capture first, describing dislocated joints and burns as he flew through the wreckage of his downed aircraft. “During my torture, I had both shoulders dislocated,” Milligan said. “It’s been 56 years, and there isn’t a day that goes by that I don’t experience pain in both of those shoulders.”

Dr. Thomas Mcnish was also captured and recounted his experience. He said he also received torture but did not fear dying because the Vietnamese wanted to use the airmen as propaganda. He told the Ukrainians that his faith kept him going, and the Ukrainians who are captured will need the same.

“I think one of the most important questions I get asked is how did you do it, how did you survive six and a half years of that type of treatment, Mcnish said.”

“My faith was a strong contributor to live through and succeed. My faith in a Supreme being and my faith in country and faith in fellow prisoners, he added.

“Anything that you can do to convince your soldiers that they will never be forgotten, even if they are captured will make a world of difference in their ability to succeed as citizens again, Mcnish said.”

Kolisnyk is responsible for setting up training programs for students and residents in rehabilitative medicine and liked the way Chandler and South Texas used both technology and emotional stories from the patients themselves.

“Your specific methods of transmitting your knowledge and skills was insightful for us. I have written many papers with these new insights and do this as well as I can back in our country,” Kolisnyk said.

The intense week was brought to a close by Executive Director, Dr. Julianne Flynn who provided her personal challenge coin to each participant.   

“I’m sorry I couldn’t be here the entire week with you because this is where my heart was the entire time,” Flynn said. “I admire you and your country so much, and we hope that we helped, not only with the knowledge we imparted, but the partnership and love that went into creating this program,” Flynn said.

Chandler said goodbye to the visiting contingent and was impressed by their fortitude.

“The most impressive thing about the Ukrainians as a whole is the resiliency that they are displaying,” Chandler said. “The job I do here is hard. I could not imagine doing it in a warzone. They are weary, but they also want to do the best they can for their Veterans and for their country.”

Before the Ukrainians gathered their notes, materials and binders of medical information that will change the future of Ukrainian rehabilitative medicine, they showed off a bit of that patriotism by singing their national anthem for their American hosts.