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‘I lived in pain for so long – finally I’ve found a way to manage it’ 

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Despite a cycling accident, Ian has managed to get his life back

Having been left with serious injuries in a cycling accident, Ian recovered from the physical impact but continued to suffer chronic pain. Here, he discusses how he has learnt to deal with it and get his life back on track.

“About two years ago, I was involved in quite a serious accident while I was out on my bike. I flew over handlebars and hit my head on the ground, leaving me unconscious.

I was left with an array of injuries, including decompression of two of the disks in my spine, which needed an operation to resolve. But from being in the ambulance after my accident – the earliest point I can remember after coming off my bike – I was in enormous pain.

While over time I have managed to recover my body functions, having struggled in the aftermath of the accident, I continued to experience pain. Most days were pretty tough. I was on a lot of medication, which contributed to my fatigue.

I was sleeping a lot, spending a lot of time in bed, I was very tired all of the time and in a lot of discomfort.

I’d always been very, very active, and enjoyed cycling, motorcycling, tennis, walks with friends and family, I was a very outdoors person – but that all came to a halt. The most I could manage was a short walk, and even then I was very fatigued.

I didn’t understand what was happening to me or why, it was just continuous, unrelenting pain.

By this point I had returned to work and the demands of my job. I was just about managing to keep on top of my commitments, but only just.

With a wife and two young daughters, my life had typically been very busy and very active, but now I was unable to do as much together, or spend as much time as I’d like with them.

This went on for over a year, and was, without doubt, the toughest time of my life.

My case manager helped me to find a solution which has enabled me to rediscover my life, through a programme called RESTORE, pioneered by RTW Plus. 

Through RESTORE, an online learning programme which supports you to understand and manage pain, and take back control of your body and life – which enables access to a consultant and support from health coaches 24/7 – I have been educated in what I can do to help myself.

All of a sudden, from not knowing what had happened to me and feeling helpless, I was supported in understanding what was going on.

Prior to that, what had happened wasn’t described to me that well, and I had so much medication that everything was often quite blurry. The concept of chronic pain wasn’t something that was addressed once my physical injuries had healed.

Through this programme, I was educated as to what had happened to me. As a keen cyclist, I’d had many accidents in the past, but all were short-term tissue damage, which were very painful at the time, but that pain went away. I now was able to understand why this time was different, and to be realistic in my expectations.

I’ve never been good at pacing myself, but now I was able to stop and think what it was I was trying to do, what I wanted to do, and how to manage and achieve that.

Crucially, by understanding my pain, I became less frustrated and less dependent on medication, meaning my life would not always have to be a cloudy blur. I became more confident as a result.

From believing this was how my life was going to be, not very pleasant and full of pain, now I had hope and confidence it was going to get better. There was light at the end of the tunnel.

Understanding more about pain got me really engaged, and I started reading about it and looking for examples. After work, I’d be picking up books and learning more. Having the knowledge about what is happening to you, and how to help yourself, is so powerful.

Having been able to come to terms with my pain during the 16-week course – it’s usually eight weeks, but was tailored around my busy work schedule – I could then get my life back on track, backed by the confidence I had rediscovered.

I’m now cycling every other day, which I haven’t done since my accident, and am getting my life back to what it used to be. I’m doing things that matter and spending time with my family, which is what it’s all about.

I realise I am on an ongoing journey with my pain, and that hasn’t finished and will continue for some time to come, but I’m in a good place now – a place I could never have imagined being a few months ago.”

Case management

New chair of BABICM appointed

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A new chair has been appointed by the British Association of Brain Injury and Complex Case Management (BABICM).

Vicki Gilman has taken over at the helm of BABICM, which is the representative body for continued professional advancement of case management and promotes best practice in supporting people with brain injury and complex conditions.

She takes over from Angela Kerr, who steps down after five years in the role at the helm, in what is BABICM’s 25th anniversary year.

“I’m delighted to be BABICM’s new chair in our 25th anniversary year.  The organisation has a well-established, powerful and influential voice and we will continue to ensure that the needs of people with brain injury and complex medical conditions are recognised and met,” says Vicki.  

An experienced case manager, health entrepreneur and clinical specialist neurophysiotherapist, Vicki is currently managing director of Social Return Case Management, a company she established over six years ago.

She qualified in physiotherapy at King’s College, London and completed a Master of Science degree in neurorehabilitation at Brunel University.  

For several years, Vicki worked in a specialised military neurorehabilitation unit, treating adults with brain injury, spinal cord injury, and other complex conditions.

Vicki coordinated and worked clinically in NHS and independent sector multidisciplinary community teams treating people with neurological conditions, and she was an expert witness in brain and spinal cord injury for over 20 years. 

Her work in a multidisciplinary team steered her into case management, and for six years Vicki was on the BABICM Council and chaired its training events group, returning last year to BABICM Council for a preparatory year before stepping into the role as chair.

“These are challenging and changing times for everyone in healthcare and beyond,” continues Vicki.  

“As case managers we need to be flexible but quick to respond to new developments and ways of working, ensuring the best possible outcomes for our clients. 

“As an organisation, BABICM has to be responsive to the needs of our members; we must ensure that they receive the training and support required to maintain our high professional standards and to deliver best-practice services.”    

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Case management

Awards to recognise role of case management during pandemic

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An awards event is being held to recognise and reward the role of case management during the COVID-19 pandemic. 

CMSUK is holding its first-ever virtual awards event, which will bring together industry professionals from across the country to reflect on the impact of the pandemic on case management practice. 

The ‘Acknowledgement of Achievement Awards; How the Pandemic Has Changed Case Management Practice’ event has four categories which will allow case managers and businesses the opportunity to review their work and achievements. 

The event, on Friday, September 24, will build further on CMSUK’s commitment to case managers during the past year, during which it delivered a comprehensive offering in online education through an array of lunchtime webinars and study days, culminating in the industry’s first online conference. 

Education and development is currently more vital than ever in case management, with the upcoming launch of the Institute of Registered Case Managers (IRCM) requiring case managers to evaluate heir learning and experiences to shape their professional development and practice.

“We didn’t have an awards event last year, and while we wanted to do something this year, the board felt we needed to do something a bit different,” Niccola Irwin, director of CMSUK, tells NR Times. 

“This will be an opportunity to reflect on how COVID-19 has changed case management. In the submissions, we are asking for reflection on how the pandemic has changed their practice, which will also allow for sharing and showcasing good practice. 

“Case managers have always been very creative and tenacious, and those strengths were never more needed than when the pandemic came and the circumstances were very different. But I think through reflecting on that time, looking at what we did and what we could do differently, will result in an even stronger offering to clients, customers and staff. 

“The awards this year have been pared back a little bit, we have four categories, but we are so pleased to be able to reflect on the past year in this way, in what we hope will be a very nice event as well as a chance to celebrate.”

Categories open for nomination are: 

  • Clinical Case Manager of the Year – Catastrophic
  • Clinical Case Manager of the Year – Moderate/Severe
  • Case Manager Supporter of the Year
  • Case Management Company of the Year

Shortlisted nominees will be invited to present their short reflection at the online networking and award event.

Visit CMSUK here to find out how to nominate, sponsor the awards and book a place at the event. Nominations close on Friday, June 25.

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Case management

Case managers praised for vital work during pandemic

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Case managers have won praise for the “vital role” they have played in their response to the COVID-19 pandemic.

New research has found that 81 per cent of claimant personal injury solicitors believe case managers have risen to the challenges presented by the pandemic.

Solicitors credited case managers for “adapting to an unprecedented situation”, “transitioning to remote working”, “developing bespoke solutions”, “ensuring rehabilitation continued seamlessly” and “facilitating remote rehabilitation”.

The research, by barristers Exchange Chambers and neurorehabilitation centre Calvert Reconnections – a first-of-its-kind brain injury rehabilitation centre in the UK, which opens next month – reflects on a period during which case management had to find alternative ways to provide its services to clients to ensure support continued. 

“This research is well-deserved recognition for the vital role case managers have played during the Covid-19 pandemic.  They’ve worked proactively and innovatively to ensure the most effective outcome for their clients,” says Bill Braithwaite QC, head of Exchange Chambers and a trustee at the Lake District Calvert Trust.

Calling for ever closer working relationships between lawyers and case managers, Bill added: “I’ve always thought that a good case manager was the key to a successful outcome for the injured person, the family, and the compensation claim.

“If you appoint a good case manager early, and that person has the ability to get to know the family, gain their trust and confidence, and help to manage the stormy voyage through recovery and rehabilitation, that person will be an invaluable contact point for the solicitor, frequently helping him or her to avoid disturbing and distressing the family.

“So much of the litigation is bound up with the injured person and the family, and the plan for life.

“Further developing the relationship between the two professions would inevitably improve standards all round.”

Heather Batey, neuro OT, managing director of reach and trustee at The Lake District Calvert Trust, spoke of the vital role case managers have played in supporting clients.

“Over the past 12 months, the health and wellbeing of many TBI patients has been in the hands of case managers who have been supporting their patients and sourcing services as required while being the ‘go to’ point for families,” she says. 

“Throughout the pandemic, it has been a difficult role to navigate, but by using their clinical reasoning skills and thinking ‘outside the box’ in such extraordinary circumstances, they have successfully ensured that treatment has progressed, generally remotely.  

“They’ve also supported their patients’ mental health, which has been paramount.

“Case managers have also been excellent in sourcing iPads, laptops and smart phones for their patients, which has enabled rehabilitation to progress successfully. 

“I totally agree that a good case manager is key to ensuring a successful outcome for a TBI client and their family. I work with case managers and with almost every patient we have seen excellent practice, great communication and holistic problem-solving skills coming to the fore.”

Jackie Dean, clinical director at N-Able Services, also welcomed the findings.

“It is my experience that case managers have advocated for their clients, have ensured that services have continued, both remotely and in person where required, and with appropriate PPE,” she adds. 

“Risk assessments have been conducted and, as is the strength of case management, problem solving has taken place around staffing, mental capacity and continuation of therapy in the community.”

 

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