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Old 16.03.2021, 13:17
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Rehab Clinic for Traumatic Brain Injury

Thanks for trying to help.

I am looking for a rehabilitation clinic for a victim of an accident, who has suffered a severe traumatic brain injury. This person is privately insured, and so far, the Doctors at one hospital have recommended Bellikon, and the other hospital has recommended Rehaklinik Zihlschlacht AG. Are these two clinics considered the best in Switzerland? I have tried researching the various possibilities and these two clinics seem to be very big. I would think a smaller private clinic would be better, but the doctors gave these two recommendations. Any experiences, with either one of these clinics or any other clinics (in or out of Switzerland) that people are willing to share would be greatly appreciated.
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Old 16.03.2021, 15:56
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Re: Rehab Clinic for Traumatic Brain Injury

You might want to add a bit of detail (without going too deep into things) that might help people direct you a bit more.

First of all does the person speak German or only English?

Is the person able to communicate (orally, writing etc.)?

What are you/the doctors hoping to achieve with this "rehab"?

You say you are willing to look at anything in CH. Is that practical for you in terms of visiting etc. ?

Good luck in finding the best option.
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Old 16.03.2021, 16:38
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Re: Rehab Clinic for Traumatic Brain Injury

I have to say the Rehaklinik Bellikon is very impressive, I filmed a patient's recovery over many months, they definitely know what they are doing.

I also involved in filming patient interviews, one of whom had had an accident with farm machinery & lost both arms, I full leg & 1 half leg. He had his Ford car keys around his neck as he had driven himself to the clinic that morning!
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Old 16.03.2021, 16:54
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Re: Rehab Clinic for Traumatic Brain Injury

Oh, I'm sorry to hear about this!

I had not heard of Zihlschlacht, and had a look at their website. Looks competent, but that's all I can say.

Bellikon has a good reputation. I visited someone there several times, and each time was impressed to see patients moving throughout the building, active, each according to his/her ability. In addition to rehab, they have a strong focus on sports medicine. Depending on the extent of the injuries in your person's case, that may be a possibility.

The advantage of going to any large clinic is that there is almost automatically an interdisciplinary cooperation between the departments. Since, in such matters, every case is different, the staff in such an institution is accustomed to calling upon others for their opinions and expertise. The smaller the clinic, the more likely it is to have fewer staff members per discipline.

If the patient is likely to have a long road ahead of them, then it could be to their advantage if they can, for example, see different physiotherapists according to their skills, but also just according to whether things click on an interpersonal level. That's not so important for short-term treatments, but can be enormously motivating for anything that is going to take time.
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Old 16.03.2021, 19:50
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Re: Rehab Clinic for Traumatic Brain Injury

The person speaks German and can speak but has certain cognitive difficulties, a broken shoulder and nose, and problems with the third cranial nerve. The hospital that he was treated at (a well-known hospital) suggested, in consultation with a Neurologist, Ophalmologist and an Orthopedic surgeon, that the best place to be treated was at Bellikon. As they knew that it could be a long wait, and he was 2 hours away from his home they transferred him to a Kanton Hospital in his area until a place became available in Bellikon (hopefully by the end of this week). He arrived at the Kanton hospital yesterday and today the new Dr. (who specializes in Internal Medicine) said there was a place free at this other clinic. No communication with the original hospital was done and the decision needs to be made right away. The new doctor informed him that he needs cognitive therapy as soon as possible, which cannot be provided at the current hospital. The suggested rehab clinic looks nice, but I have no experience with this and was hoping someone out there does.

Doctors said rehab could take months.
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Old 16.03.2021, 20:19
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Re: Rehab Clinic for Traumatic Brain Injury

I'm sure this must be very stressful for all concerned. Here, in case it helps in any way, is a suggestion to help make the decision.

Bellikon
  • Pro: they have a good reputation, they work in an interdisciplinary way, they understand about injuries of all kinds, they have a strong focus on re-gaining as much as possible of one's functionality, and they know about sport, both about injuries and in the sense of using [modified] sport to recover.
  • Contra: he might have to wait.
  • Distance to visit: pro or contra?

Otherclinic
  • Pro : available right away.
  • Contra the other clinic?
  • Distance to visit: pro or contra?

Is the actual transport a risk to him, in his current state? If not, could he go to the other clinic immediately, and then move to Bellikon when there is a place available?

I recommend that you try to ask both clinics for their advice. Set out here for Bellikon, but try to do the same for Otherclinic.

Tell the doctors or admission officer at Bellikon what the Cantonal Hospital doctor said the patient needs, and that it should be immediate, and is not available at the Cantonal Hospital. Ask Bellikon for their advice about:
  1. Forgo that specific treatment ("cognitive therapy") for the next few days until a place is available in Bellikon?
  2. Get in that treatment immediately, possibly at the patient's own expense, so something is started during those days of waiting?
  3. Anything that a layperson could do, to support or prepare for the "cognitive therapy" in the meantime?
  4. Any chance of a bed, sooner, even in a different insurance class?
  5. Good or bad idea to transport him to another place, for the next few days, and then perhaps to Bellikon after all?

You could also ask the doctor at the original hospital, and at the Cantonal Hospital, for their recommendations, as in: what would they do if this was their own father, son, brother?

If this were me, I'd have to write down their responses in a list, otherwise I'd end up forgetting which doctor said what.
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Old 17.03.2021, 00:33
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Re: Rehab Clinic for Traumatic Brain Injury

I once heard this advice, about a major health event: treat it as a separate person. Make it a lever arch file and put everything in there, chronologically.

Meticulously write down all the doctors' names and dates when you saw them. If ever a doctor explains something, ask him/her to draw a diagram, if possible, right there and then, (in the little booklet you always carry along) and label it. If the doctor shows you models, ask to photograph them. Especially when there are injuries and treatments of various kinds, it can help to be able to look through this later, again, to understand it better. Put that in your file, together with all the doctors' reports. These belong to the patient, so they must not merely be sent from one doctor to another, but the patient must always get a copy.

That way, I was told, you have all the papers together, but also a reminder, at each next step, that the accident is a separate entity from the person who suffered it, i.e. the accident does not consume all of him, and his being comprises more than the accident. I tried it. It worked very well, to get that organisational but also mental separation.
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Old 17.03.2021, 20:41
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Re: Rehab Clinic for Traumatic Brain Injury

For traumatic brain injury I would highly recommend having a QEEG(quantitative encephliogragh) done and then train with neurofeedback. This is neuiroscience. I had being doing neurofeedback here for 23 years. (retired now) I did work for a med Dr. who said that there was more success with his clients with neurofeedback than anything else. Many of the TBIs are treated with various meds which do not help. The QEEG mapping finds the cause rather than focusing on the symptoms.You may want to try Unigue therapy in Zurich.

Please see the attached for some information

https://www.appliedneuroscience.com/...ain_Injury.pdf

You you want more info you can contact me by private messagte
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Old 17.03.2021, 22:53
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Re: Rehab Clinic for Traumatic Brain Injury

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I once heard this advice, about a major health event: treat it as a separate person. Make it a lever arch file and put everything in there, chronologically.

Meticulously write down all the doctors' names and dates when you saw them. If ever a doctor explains something, ask him/her to draw a diagram, if possible, right there and then, (in the little booklet you always carry along) and label it. If the doctor shows you models, ask to photograph them. Especially when there are injuries and treatments of various kinds, it can help to be able to look through this later, again, to understand it better. Put that in your file, together with all the doctors' reports. These belong to the patient, so they must not merely be sent from one doctor to another, but the patient must always get a copy.

That way, I was told, you have all the papers together, but also a reminder, at each next step, that the accident is a separate entity from the person who suffered it, i.e. the accident does not consume all of him, and his being comprises more than the accident. I tried it. It worked very well, to get that organisational but also mental separation.

Thanks for the suggestion! What seems to be the current problem is getting the hands on the reports. The doctors have been asked on several occasions to please provide the reports, but they are never provided. It seems crazy and I am not sure if its because of Covid times or what but I find it totally unprofessional. How long should one reasonable expect to wait for such reports?
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Old 17.03.2021, 22:54
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Re: Rehab Clinic for Traumatic Brain Injury

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For traumatic brain injury I would highly recommend having a QEEG(quantitative encephliogragh) done and then train with neurofeedback. This is neuiroscience. I had being doing neurofeedback here for 23 years. (retired now) I did work for a med Dr. who said that there was more success with his clients with neurofeedback than anything else. Many of the TBIs are treated with various meds which do not help. The QEEG mapping finds the cause rather than focusing on the symptoms.You may want to try Unigue therapy in Zurich.

Please see the attached for some information

https://www.appliedneuroscience.com/...ain_Injury.pdf

You you want more info you can contact me by private messagte
Thank you for the suggestion. I will pass the info on.
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Old 25.03.2021, 20:27
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Re: Rehab Clinic for Traumatic Brain Injury

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Thanks for the suggestion! What seems to be the current problem is getting the hands on the reports. The doctors have been asked on several occasions to please provide the reports, but they are never provided. It seems crazy and I am not sure if its because of Covid times or what but I find it totally unprofessional. How long should one reasonable expect to wait for such reports?
Does your friend have a GP here in Switzerland? It's common for specialists to send copies of reports to the GP. Patient records should also be available from each clinic/hospital.
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Old 26.03.2021, 01:26
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Re: Rehab Clinic for Traumatic Brain Injury

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Does your friend have a GP here in Switzerland? It's common for specialists to send copies of reports to the GP. Patient records should also be available from each clinic/hospital.
The records were finally sent yesterday to the rehabilitation clinic as well as to the patient.
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Old 26.03.2021, 08:06
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Re: Rehab Clinic for Traumatic Brain Injury

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Thanks for the suggestion! What seems to be the current problem is getting the hands on the reports. The doctors have been asked on several occasions to please provide the reports, but they are never provided. It seems crazy and I am not sure if its because of Covid times or what but I find it totally unprofessional. How long should one reasonable expect to wait for such reports?
I had this experience in New Zealand. So now, with every "event", I even take pictures of on screen MRIs.

To the original question - Bellikon. Had a colleague there with a cycling injury last year. Broken skull, loss of cognitive and motor. They allowed 1 visitor per day during covid.

Great doctors, they even have hands on training to return back to the workforce. Lovely views.
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Old 01.04.2021, 02:23
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Re: Rehab Clinic for Traumatic Brain Injury

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Does your friend have a GP here in Switzerland? It's common for specialists to send copies of reports to the GP. Patient records should also be available from each clinic/hospital.
Yes, it is customary that the reports are sent from a hospital to a doctor, or from one hospital to another, over the head of the patient. I find this very annoying, as in this way, the patient never really knows who has received what. Getting the full medical recor is, however, not a special favour, but is the legal right of every patient in Switzerland, as these medical records belong to the patient.

If at all possible, before the patient leaves a hospital or clinic, or the practice of a doctor, ask for the full records to be handed out, right there and then, before leaving the premises. If the discharge date is known, in advance, state, a day or two beforehand, that you will need the full record ready for you before the patient checks out of the room. (In one case, I over-heard a cleaner urging the nurse to get the papers ready, because the man was refusing to vacate his bed without it, and she wanted to get on with cleaning the room. That did the trick within minutes!)

Often, the staff will try to fob off the patient or their helpers by saying that the report will be sent to the doctor (just as you say, 3Wishes). Unless there is a medical reason to leave immediately, I've found that staging a sit-in is very effective. I say that I understand that they are busy right now, but when they get a moment I'd appreciate their making all the copies, and I'll just sit here and wait until they do. Every 15 minutes or so, I pop back to the counter, especially if someone else seems to be on duty, and say that since Time o'clock I've already spoken to Name, Name and Name (note what's written on their name-shields, or else describe them, if no names) and am still waiting for all the copies, which I need to take along with me now.

Although, ideally, one wants one's hands and eyes on the reports as they are current, the following can also help: once the patient has left a hospital, clinic or practice, write a letter (not a mail, but a physical letter on paper, sent in an envelope, signed by the patient or their legal representative) requesting a copy of the full file, including all test results, all scans and images, all lists of medication, all progress reports and all doctors reports.

Before going to a new doctor, make copies of the reports and take them along to the next appointment. Never, ever give a doctor your original, but only always a copy. Once you see the doctor, say that these copies are for him/her, and that you think that especially this page and that are relevant, or you have questions about them. Offer to send them the reports electronically, (or have them sent), if they would prefer.
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