CUH Logo

Mobile menu open

Mr Thomas Santarius - The key role AHPs play in rehabilitation

As part of AHP day, we spoke to Mr Thomas Santarius, consultant neurosurgeon at CUH, who told us about the vital role speech and language therapists play in neuro rehabilitation.

Link: https://youtu.be/gn4atppqLRA

Video transcript

00:00:03:00 - 00:00:05:19

I'm Thomas Santarius, or Mr.

00:00:05:19 - 00:00:07:10

Tom, how

00:00:07:22 - 00:00:10:02

many of my patients know me.

00:00:10:02 - 00:00:12:24

I'm a consultant neurosurgeon with specialist

00:00:12:24 - 00:00:15:06

interest in treating patients with brain tumours.

00:00:15:14 - 00:00:17:19

Sometimes people have

00:00:18:20 - 00:00:19:22

an impression

00:00:19:22 - 00:00:22:23

that if a patient has a brain tumour,

00:00:22:23 - 00:00:26:10

all they require is a surgeon

00:00:26:10 - 00:00:29:19

and perhaps the surgeon may be one of the first people they meet, but

00:00:30:20 - 00:00:33:03

perhaps the person they meet most

00:00:33:03 - 00:00:35:10

and during the journey

00:00:35:21 - 00:00:38:04

and clearly a surgeon is important,

00:00:38:04 - 00:00:41:07

when the tumour is being removed, but

00:00:41:07 - 00:00:43:22

there's loads of people involved

00:00:45:04 - 00:00:46:17

in that journey.

00:00:46:17 - 00:00:48:18

And I'm certainly postoperatively

00:00:50:19 - 00:00:54:00

people like speech and language specialists

00:00:54:12 - 00:00:56:09

and can be

00:00:58:14 - 00:00:59:08

enormously helpful.

00:00:59:08 - 00:01:05:14

Multidisciplinary approach to a problem like this is vital

00:01:05:14 - 00:01:10:24

because not only because a surgeon doesn't have the expertise and

00:01:12:07 - 00:01:14:16

simply the latest understanding

00:01:14:16 - 00:01:17:09

of every aspect of

00:01:18:16 - 00:01:21:18

speech, sound and breathing

00:01:23:04 - 00:01:29:10

production in the greatest detail, and even less so about the latest methods

00:01:29:10 - 00:01:33:04

and their effectiveness in in rehabilitation.

00:01:33:04 - 00:01:37:16

So having colleagues around, one can trust and learn from

00:01:39:03 - 00:01:43:20

to me at least is very encouraging and tremendously valuable.

00:01:44:16 - 00:01:48:09

I strongly believe that

00:01:48:09 - 00:01:51:20

when we work together and

00:01:53:00 - 00:01:55:02

everybody brings

00:01:55:15 - 00:01:58:11

both the expertise and knowledge and enthusiasm

00:01:58:11 - 00:02:01:06

together, we can just bounce off each other and

00:02:03:06 - 00:02:04:12

simply enjoy

00:02:04:12 - 00:02:08:18

seeing that together, we can do much more than individually.

00:02:09:15 - 00:02:11:17

So interacting with

00:02:14:02 - 00:02:15:16

specialists in

00:02:15:16 - 00:02:18:11

other areas such as speech and language therapy to me is

00:02:19:14 - 00:02:22:24

just gives me extra buzz and

00:02:27:06 - 00:02:30:10

makes me look forward to coming to work.

"Multi-disciplinary care of a patient with a brain tumour is absolutely essential. Dealing with the tumour is not like changing a tyre on a car, the tumour itself affects functionality of the patient but the surgery also has impact on the patient.

"In order for the patient to recover properly from any therapeutic intervention, including removal of the tumour, a multidisciplinary approach involving the relevant speciality, whether it is speech therapy, language therapy or physiotherapy is absolutely central for a proper, speedy and maximum recovery.

"It's been shown very extensively in the literature that early and highly professional input is vital.

It’s not just a journey of the surgery for the patient, sometimes people have an impression that if a patient has a brain tumour all they require is a surgeon but there's lots of people involved in their journey, and certainly post-operatively, speech and language specialists can be enormously helpful.

"I can think of a recent example of a patient who had tumour located in a very densely functionally important area of the brain, areas that control breathing, speaking, the overall production of sound, blood pressure regulation and regulation of the whole cardiovascular system, movement of face and in the body.

"Pretty much all the centres for all these various functions are located there, but also all the cables that run between the brain and the rest of the body run through this area too.

"The tumour affected the patient considerably to the point that the patient was on the verge of requiring a tracheostomy tube going into his trachea to bypass the voice box, which he couldn't operate, simply because the muscles and all the functions were not working properly at the time.

"He could hardly produce any sound or understandable speech; his swallowing was impaired and so on. Although time in itself would likely result in some improvement, to help him through this very difficult period, speech and language therapy input was absolutely vital.

"It was a success story and a heart-warming story because not only did we manage to save him from having a tracheostomy but the speed with which the patient recovered was really great to see.

I've learned a great deal by observing the novel and various specialist methods being introduced to help him in his specific problem by speech and language therapists.

"It was great to interact with speech language therapists, I’ve learned a great deal on the subject of the newest methods that can be used in in this very specific situation and because we worked closely together in a really in a good way, this was an enjoyable journey despite the disappointment that both us and the patient experienced after surgery.

"The patient could sense very much that we work together and we try our best together. We scratch our heads together and we involve the patient to plan the treatment.

I think patients also get encouragement from seeing us working hard for them.

"There’s complexity to understanding swallowing, speech and sound production, there's no way a surgeon could do this because of the different areas of speciality and expertise we have.

"The multidisciplinary approach to problems like this is vital because the surgeon does not have the expertise of the latest understanding of every aspect of speech, sound and breathing production.

"The speech and language team have a greater understanding of the latest methods and their effectiveness in rehabilitation, so having colleagues around that one can trust and learn from, to me at least, is very encouraging and tremendously valuable.

I strongly believe that when we work together and everybody brings both their expertise and knowledge and enthusiasm together, we can just bounce off each other and simply enjoy seeing that together we can do much more than we can individually. So, interacting with specialists in other areas such as speech and language therapy to me is what just gives me extra buzz and just makes me look forward to going to work here.

"On ward J2 I am very encouraged by the setup that we have, our neuro rehabilitation ward, in terms of setting the availability of all the input specialists that we have, the leadership of the ward and the proximity to the rehab gym, the availability of our own little garden is brilliant.

"The importance of having the right environment for rehabilitation and getting in early with rehabilitation is absolutely key to recovery. We see lots of patients going through phases of disheartenment, of simply just feeling like they want to give up and I have no doubt that a nice environment, not only through people being nice and helpful but a simply aesthetically pleasant environment and having access to some nature and beauty in the garden, will go far to help them overcome these periods of wanting to give up."