Yevgeniya Sergeyenko, MD, MPH, serves as the Clinical Director of the MossRehab Institute for Brain Health, which treats military Veterans and First Responders with lasting effects of brain injury.
What is your background?
I am board certified in Physical Medicine and Rehabilitation (PM&R) and Brain Injury Medicine. I did residency training in PM&R through a joint program with MossRehab and Temple University Hospital in Philadelphia. After my residency, I completed a fellowship in Brain Injury Medicine at Shepherd Center and the Emory University School of Medicine in Atlanta, GA. I'm a graduate of the University of Miami Miller School of Medicine, where I received a master's degree in public health.
Can you tell me about your role in the MossRehab Institute for Brain Health (MRIBH)?
I serve as the Clinical Director for the MRIBH. It is a new program that provides comprehensive and individualized care to military veterans and first responders experiencing the long-term health effects of a traumatic brain injury (TBI). Our clinic combines the best tools in traditional rehabilitation with complementary medicines. It is modeled after the Marcus Institute for Brain Health and the National Intrepid Center of Excellence at Walter Reed National Military Medical Center.
How does your experience support your role?
My training includes rehabilitation for mild, moderate, and severe brain injuries as well as strokes. As a physiatrist (PM&R physician), I am trained in evaluating and treating musculoskeletal conditions. Individuals living with the long-term effects of a brain injury often have physical, emotional, cognitive, and behavioral symptoms. A key guiding principle of rehabilitation medicine is the importance of using a team-based approach where clinicians of multiple specialties work together to improve a patient's function and quality of life.
Following this principle, the MRIBH team includes clinicians specialized in neuropsychology, behavioral health, physical therapy, occupational therapy, speech therapy, art therapy, and case management. Our team will work together to evaluate each patient to develop and execute a comprehensive plan that treats their symptoms and ultimately improves function and quality of life. Treatments can include therapies that address cognitive and behavioral issues and problems with balance, vision, and other symptoms.
In some cases, medications or procedures are a helpful addition to treatment. In those cases, I can prescribe medications to help with headaches, attention, cognitive function, sleep, and pain. In addition, I can use different procedures to help treat headaches and neck pain such as nerve blocks, Botox injections and trigger point injections.
Why did you decide to take this role?
I have a background in public health and am interested in our healthcare delivery systems and how we can improve the quality of care and access to it for individuals with TBIs. The majority of TBIs - more than 80% - are mild. Military veterans and first responders are at a higher risk for these injuries due to the nature of their jobs, so there's a big need for brain injury treatment in these populations.
Additionally, many people may not know that they had a brain injury. People think that a brain injury results from a hit to the head. Any impact to the body or neck that causes the brain to move forward and backward or around the skull can cause a brain injury. Impacts can result from motor vehicle collisions as well as exposure to explosions or blasts.
Brain injury symptoms can be physical, emotional, cognitive, and/or behavioral. They can last for months to years after a brain injury, which can seriously impact a person's ability to function and their quality of life. Our veterans and first responders put their bodies and minds on the line to serve at home and abroad. Now, it's our job to serve them by providing the treatment and tools needed to recover from their injuries and thrive.
How will the MRIBH fill a void in healthcare?
In the outpatient setting, care can be fragmented, with individuals having a brain injury seeing physicians, therapists, and behavioral health professionals across different healthcare systems. When this occurs, it is difficult, if not impossible, for all of the clinicians who are treating one patient to be on the same page. Long wait lists can further exacerbate the problem, delaying care. MRIBH will take an interdisciplinary, team-based approach focused on treating the different symptoms of brain injury simultaneously. Our clinicians will work together to evaluate each individual and develop a comprehensive plan to treat his/her symptoms at the same time.
What are your goals for the MRIBH?
My goal, first and foremost, is to improve access to brain injury care for our military veterans and first responders as well as to raise awareness of the risk for and high prevalence of brain injury in these two populations. The MRIBH offers an exciting opportunity to pilot a different model of care for a mild TBI (concussion). While most individuals completely recover after a mild TBI, many live with persistent symptoms that affect their physical and mental health. They would benefit from the comprehensive, interdisciplinary treatments offered by the MRIBH. Once demonstrating how well this model of care works for veterans and first responders, we can expand to the civilian population and ultimately change how we treat mild TBIs.
Who can seek care from the MRIBH?
Any military veteran or first responder with long-term effects of brain injury can seek care at MRIBH. The brain injury does not have to be sustained during military service, active duty or on the job as a first responder. We will care for veterans of any discharge status. There is no out-of-pocket cost for veterans or first responders receiving treatment in this program.
We expect to treat patients from the MossRehab Drucker Brain Injury Center and those referred by clinicians from the Einstein Healthcare Network and Jefferson Health, and other healthcare networks. We are recruiting patients from all over the country. The MRIBH will offer on-site housing during a patient's evaluation and over the three weeks of intensive treatment, making the program accessible to individuals outside of the local area. There is no out-of-pocket cost; the program will cover costs for travel, housing for the duration of evaluation and treatment, and food.
What are the services offered by the MRIBH?
We have a three-step process that consists of patient evaluation, intensive outpatient treatment, and follow-up. Once an individual contacts us about the program, we will conduct a phone screening and, if appropriate, invite them to complete an online application. The application asks for information on their medical history, brain injury history, symptoms, and previous treatments. Upon application completion, the team will review materials, then arrange for the individual to come on-site for a three-day evaluation by every clinician. At the end of the evaluation period, we determine if the person is a good fit for the program and discuss the findings of the evaluations and treatment goals.
The next step is scheduling the intensive, three-week outpatient program. During treatment, the individual would stay on-site and receive a mix of medical care, behavioral health services, therapies, and other complementary medicines. Services are received five days per week. After the program completion, we would meet with family or other supporting individuals and review the completed treatment. We also would connect the individual with community services and resources. Our case manager would follow up with the individual for the next year to assess how they are doing and provide continued support.
Can you give an example of patient treatment at the MRIBH?
As noted, brain injury symptoms can be physical, emotional, cognitive, and/or behavioral. Some common symptoms after brain injury include dizziness or difficulty with balance, headaches, double vision, memory, attention, and/or sleeping. Someone with persistent dizziness and balance issues would benefit from vestibular rehabilitation therapy, a specialization of our physical therapist Similarly, a patient with double vision would benefit from vision therapy, which can be performed by our occupational therapist or physical therapist. An individual experiencing difficulty with memory and attention can receive cognitive therapy from our speech therapist. For someone with sleep issues, we might try behavioral and environmental interventions (such as halting the use of electronic devices at a certain hour) to improve sleep. Our behavioral health provider also could teach relaxation techniques like progressive muscle relaxation and diaphragmatic breathing. In some situations, a trial of a specific medication may be appropriate. Most people may have more than one symptom, so a combination of therapies and techniques would be the best approach.
Where is the location of the MRIBH?
We are in the process of constructing a clinical space at The Station in Willow Grove. Three apartments will house up to six patients during their three-day evaluations and three-week treatments. We hope to expand our capacity to serve more patients in the future.
When will the clinic open?
We started evaluating patients for the program at the MossRehab Elkins Park location in November 2022 and anticipate beginning treatment with the intensive outpatient program at the Willow Grove site at the beginning of 2023.
What inspires you on the job?
There are many things that I love about the treatment of TBI and rehabilitation medicine. Every individual with a brain injury has different symptoms, triggers, and responses to therapy. I love getting to know each patient and their unique situation and being creative and tailoring my treatment specifically to each person. I also enjoy working with other like-minded clinicians to help a patient reach specific goals. More than anything, though, I am inspired by the hard work that my patients and their loved ones do to seek brain injury care and participate in treatments to improve their situation. It's amazing to support them in their journey.
What's something your co-workers might not know about you?
I'm 5'4" and can't jump, so my co-workers might be surprised to know that I played NCAA Division III college volleyball for four years while attending Vassar College. I also played at the University of St Andrews for a semester while studying abroad in Scotland.
What are your interests outside of work?
I love curling up with a good book and consider myself an armchair critic as I sit in my armchair and critique books aloud while reading them. I particularly enjoy fantasy and science fiction with strong female leads. I try to stay active by hiking, rock climbing and walking my 80-lb kangaroo (dog).
What's your favorite place to vacation?
My favorite vacations are less about the place and more about the opportunity to spend time with loved ones. My husband and I most recently returned from Iceland where we visited friends. It was a lovely trip with a perfect combination of seeing friends, relaxing in hot pools, and hiking glaciers and mountains.
What's your life motto?
My college volleyball coach was big on team core values. One of them was "flexibility and willingness to change provide strength and power." I tried to carry that motto with me in my personal and professional life. I'm a big planner and gather input and information from multiple sources before making a decision. I also am very cognizant that healthcare is constantly evolving and the way that I've always done something is not necessarily the way that I should keep doing it.
Read more about the MossRehab Institute for Brain Health.