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Brain Injury Awareness

Brain Injury Awareness Month – 2017

It’s All About Resources

Every March, Brain Injury Awareness Month, led by the Brain Injury Association of America, kicks into high gear to educate the public on this major public health crisis. From concussion and mild traumatic brain injury (mTBI) to severe brain injury and stroke; all of these conditions have a far-reaching impact. An impact on the individual who has suffered the injury, families and caregivers, communities, and our ever-burdened health care system.

The greatest challenge for those affected by these unfortunate, and often preventable, events is access to resources. Educational and treatment resources beyond the initial stage of injury is often hard to come by and folks are left to their own devices to put the pieces together for the most productive life possible. This, while being told by so many (including their doctors and family) that there is not much hope for further recovery.

Where to Look For Answers

What follows are links to a host of resources exploring many aspects of brain injury. Content related to understanding why so many continue to experience the symptoms they do. Some resources will explain symptoms in detail and why they occur, and others will look into what tests you can have done to determine what path of treatment is best for you. Most importantly, these resources demonstrate a clear message of hope for so many to get beyond their daily struggles. Be sure to watch the videos of those who have done just that!

We understand that those who have injured their brain digest information in different ways, therefore the content is made available in written (blog), audio (podcast), and video formats. Please enjoy, learn something, act on something; and pass the Brain Injury Awareness word on to others who can benefit and renew their hope.

Brain Injury Awareness Links

 

Concussion Frustration: 7 Reasons Your Doctor Doesn’t Listen to You (And, What to Do About It)

As the Old Saying Goes…

…If I had a dime for every time someone with concussion said “my doctor doesn’t listen to me”. Nearly every day in clinical practice patients report to me one way or another this very real concern. While this is true across all areas of specialty at our center, it is far more prevalent in those suffering the effects of concussion and post-concussion syndrome.

There are several theories as to why many doctors don’t take the time to listen. These can be explored at length with a simple internet search. Here, I will briefly explore some of these more accepted views and, more importantly, what I have come to see is the real truth behind why so many are being ignored, and in many cases dismissed, by their ‘trusted’ health care providers.

The Usual Suspects

  • Time. Most primary care physicians are pressured by the demands of heavy patient loads and declining insurance reimbursements. That leaves you as the patient at the mercy of a provider that may only give you one minute or less to voice your concerns; which for those of you with concussion are often too many to list.
  • Distraction. Electronic records, insurance forms, mobile devices, and excessive patient volume can cause doctors to get caught up in things that are not right in front of them. That is you, the patient. If a doctor is distracted, they will not do a great job at listening.
  • Bias. It has been established that many doctors will spend less time with individuals based on race, gender, and other factors such as socio-economic status. Also, patients that come in with recurring complaints are more likely to be dismissed or ignored.

While I believe these are accurate (although unacceptable) reasons for many being short-changed when it comes to their health care provider’s attention; there are more specific reasons doctors don’t listen when it comes to the laundry list of life struggles that can accompany concussion and post-concussion syndrome.

 The Real Story Doctors Don’t Listen to Those With Concussion

  • Ignorance. This may seem like a harsh term to many (particularly the doctors), although it simply means that most primary care providers lack the knowledge and information necessary to properly question and screen for these types of conditions.
  • Invisible. Concussions are not seen on CT scans or found in blood work. They are silent injuries that result in functional problems with balance, vision, cognitive abilities, and more. Conventional medical approaches are not well suited for these conditions; therefore, doctors are less inclined to listen to problems they cannot treat.  
  • Overwhelming. The number of symptoms and conditions that can result from a hit to the head are staggering (we’ve compiled a list of over 50!). Most doctors when presented with 5, 10, or more complaints may focus only on 1 or 2 as this is what they are accustomed to.
  • Unknown. Even with all the attention given to concussion over the past several years in sports, the media, and movies, this is still uncharted territory for most providers in mainstream medicine. This is also true for many of the doctors those with concussion are being referred to.

So, What’s the Answer?

The internet is full of strategies to get your provider to listen better. This, however, is not the focus of this article. And, it will not serve you well to try and get those that don’t understand concussion to listen to you! What you need to do is seek out the services of a qualified functional neurologist who is well versed in the art of listening. And, who understands the multitude of symptoms those with concussion and post-concussion syndrome experience. Only then will you be able to get answers as to what the best method of treatment will be for you. Concussions are real, and so are the symptoms and solutions!

Resources

For more information please call us at 828.708.5274, or visit any of the following resources:

A Pilot’s Success Story with Brain Training

ear anatomyJohn’s Story

John is a 66-year-old grandfather and successful businessman from Asheville, NC who plays tennis and counts flying among his favorite hobbies. But he is concerned that his memory is starting to slip. There’s no family history of Alzheimer’s disease or dementia.

John, however, did have a car accident and subsequent skiing accident in which the fall he suffered was so serious that his helmet broke. He also admits that he is often dizzy, fatigued, easily angered, and frustrated over his physical and mental limitations.

Intervention for balance and cognitive decline

John underwent comprehensive Brain Training at a frequency of three times per day over the course of five days. His brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs, eye movements, balance, mental and physical timing, and more to ensure he was receiving the proper amount of therapy without exceeding fatigue limits that might promote worsening of his symptoms as is often the case in more conventional rehabilitation programs.

Understanding the relationship between physical functions such as balance, timing and eye movements and higher cognitive functions like memory (both major challenges in his case), we implemented the following Brain Training procedures: EEG neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, electrical stimulation, breathing exercises, lifestyle changes and home care therapies.

Outcomes with Brain Training

John reported midway through his five-day training program that he had “one of his best games of tennis.” He also said he felt less dizzy and improvements in his mood and memory were noticeable to him and others. “I walk better, talk better and feel better,” he said.

Actual measurable, objective improvements recorded with post-intensive diagnostic testing included:

  • Interactive Metronome (Timing): 14% improvement in timing accuracy and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. becoming more ‘in-sync’ with a specified reference tone).
  • Videonystagmography (Eye movements): Significant improvements in numerous aspects of oculomotor functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.
  • Computerized Assessment of Postural Stability (Balance): 24% improvement in balance under the most challenging circumstances (eyes closed on an unstable surface – noted as PSEC on charts below below). Near complete normalization of a hazardous posterior center of pressure (tendency to carry his body or sway to the rear):

Pilot 1

Pilot 2

Implications Following Treatment

After his treatment was completed, John says he was able to recapture the moments of joy and sense of accomplishment he experienced through playing tennis and flying his aircraft, his two favorite hobbies; as well as being more engaged with his family.

He reports his memory has improved, he has fewer symptoms of dizziness and fatigue, and most important – he is now a safer, happier pilot following his specific Brain Training program.

Case Study: Post-Concussion Syndrome – Jackie

concussion ep 43Jackie’s Story

At the time of presentation to APEX Brain centers in Asheville, NC in late 2015, Jackie was a 55-year-old, soon to be retired professional female. Post-concussive symptoms of debilitating headaches, memory loss, learning and behavioral issues, fluctuations in heart rate, and difficulty handling visual stimulation such as driving, busy public places and computer screens were preventing her from leading a normal life. Prior to traveling to APEX from Charlotte, NC, Jackie had sought care from several different doctors in her area. Vestibular therapy and chiropractic care had given her some relief of symptoms, although her other experiences were not so positive. At one point a provider told her that she was mentally ill. Jackie was outraged and, as many with post-concussion syndrome report similarly, she offered this statement: “I’m not crazy. I didn’t have any of these symptoms before I had the injury and I am definitely not making them up”. This is the unfortunate reality of many who suffer with brain injury.   

Intervention for balance and cognitive decline

Jackie underwent comprehensive Brain Training at a frequency of 3 times per day over the course of 15 days (with 2 days off between each week for much needed rest and recovery). Her brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs, eye movements, balance, mental and physical timing, and more to ensure she was receiving the proper amount of therapy to be effective without exceeding fatigue limits that could potentially promote worsening of her symptoms. Modalities implemented included, but were not limited to: neurofeedback, Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, electrical stimulation, breathing exercises and home care therapies.

Outcomes after Brain Training

Jackie reported prior to brain training that she would have a constant headache of 6 on a 0-10 scale (0 being no pain and 10 being the worst possible pain) that would escalate into an 8-9 of 10 by the end of the day. The week after her program she reported the headaches were finally manageable at a level of 3-4 of 10 and would not escalate. Jackie has had continued success and reported at 3 weeks after her program that she is headache free, unless she spends too much time in front of a screen or in a busy public place. She also reports that when this occurs, her ‘at home’ brain exercises will relieve them. Aside from headaches, Jackie has reported that she no longer feels like she is in a constant brain fog. Her heart rate has also normalized and no longer fluctuates or spikes. 

Actual, measurable objective improvements recorded with post-intensive diagnostic testing include, but are not limited to:

  • Cognitive Testing: Jackie showed an increase in her Neurocognition Index of 11%. This is a standardized overall score of cognitive performance. Significant improvements in specific areas of memory (one of her biggest concerns) are as follows: 65% in composite memory, 33% in verbal memory, and 67% in visual memory.
  • Interactive Metronome: 56% improvement in motor timing accuracy and normalization of hyper-anticipatory timing tendency with motor tasks (i.e. premature response to a specified reference tone).
  • Videonystagmography (VNG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.

Implications for others:

Diagnostic and functional tests can be used to direct an effective Brain Training program and improve post-concussion symptoms. Increased sensory and environmental sensitivities are common symptoms of post-concussion syndrome. There are several areas of your brain that process information from your environment and from your body. If these areas are damaged then it becomes difficult for the brain to process sensory input, resulting in fogginess, memory and cognitive issues, impaired processing of pain, and the many other symptoms seen after concussions. The frustration felt by individuals being made to feel they are “crazy”, as Jackie noted, is entirely unnecessary and driven by a health care system that is largely focused on diagnostic testing and lacking significantly in functional treatment options. There is great hope for partial and full recovery in most cases of concussion given a thorough investigation and functional interventions addressing the physical, cognitive, metabolic and lifestyle factors that influence brain health.

If you or someone you care about is experiencing ANY of these symptoms, or anything out of the ordinary related to a head or brain injury, call APEX Brain Centers now at 828.708.5274. You may also email us at [email protected] for more information and to set up a free consultation. 

Case Study: Young Mother With Multiple Concussions Finds Relief Through Brain Training

Ali’s Story

Ali presented to APEX Brain Centers in August of 2015 in search of concussion relief. She was struggling with a host of debilitating complaints due to multiple head injuries and concussions over the years. Headaches, brain fog, memory loss, anxiety, emotional distress, restless legs, tightness in the chest, tingling in her limbs, postural orthostatic tachycardia syndrome (POTS), dizziness, spatial awareness difficulties, loss of muscle mass and hair, gastrointestinal (GI) difficulties and more were all part of her normal daily experience. She was in a constant search for concussion relief. She had been to a host of specialists with limited outcomes; including osteopaths, naturopaths, ENTs, cardiologists, allergists, chiropractors, physical therapists, acupuncturists and massage therapists. She was an exceptional student and athlete prior to her injuries.

Ali traveled from Virginia to seek care at APEX Brain Centers in Asheville, NC in late August, 2015 on referral from a friend who had similar problems with exceptional outcomes at APEX. She underwent an intensive course of Brain Training where she was admitted into in an individualized program directed by extensive diagnostic testing, and led by clinicians highly experienced in functional neurology and functional medicine. What follows is a sampling of some of the cutting-edge clinical interventions and amazing functional gains Ali experienced during her time at APEX.

Intervention for Concussion Relief

Ali underwent comprehensive Brain Training at a frequency of 3 times per day over the course of 10 days (with 2 days off between each week for much needed rest and recovery). Her brain function was carefully monitored throughout the training process with measurement of EEG brainwaves, vital signs (particularly important in those with POTS), eye movements, balance, mental and physical timing, and more to ensure she was receiving the proper amount therapy to be effective; but not too much so as to reproduce/amplify symptoms. Laboratory tests were ordered to evaluate for suspected food reactivity, markers of inflammation, altered stress responses and amino acid insufficiencies; among other factors. Modalities implemented included, but were not limited to: neurofeedback (NFB), Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and neurological rehabilitation, whole body vibration, electrical stimulation, cognitive training, breathing exercises and home care protocols.

Ali’s Outcomes after Brain Training

Subsequent to her initial Brain Training program, Ali reported subjective improvements in all areas of pre-intensive complaint. What follows are a sampling of Ali’s words describing outcomes in several of these areas:

  • My heart rate is down significantly and I have fewer palpitations
  • I rarely feel unbalanced anymore
  • The tingling in my hands and feet is gone
  • Brain Training has greatly decreased my widespread pain
  • Since leaving APEX I have only had a few minor headaches, and none that have turned into a migraine
  • Now I can really engage with my children for long periods of time
  • My emotions are on a more even keel
  • I can recover from a workout and exercise again the next day
  • My immune function is improved
  • I expect all of my capabilities to return and even excel beyond what they used to be in light of the new and better lifestyle I’ve adapted!

Measurable Changes

  • Cognitive Testing: Increase in her Neurocognition Index of 13%, which is a standardized overall measurement of cognitive performance. Executive function (reasoning) scores were improved by 35%. Increases in various aspects of memory, attention, processing speed and more were as high as 13%.
  • Interactive Metronome: 43% improvement in task average with motor timing and 15% improvement in  hyper-anticipatory timing tendency with motor tasks (i.e. responding prior to a pre-set reference tone).
  • Computerized Assessment of Postural Stability (CAPS): 8.2% improvement in balance on an unstable surface with eyes closed; which brought her from a moderate to mild reduction in balance compared to her age and gender matched peers.
  • Videonystagmography (VNG): Significant improvements in numerous aspects of oculomotor (eye movement) functionality including: gaze holding, slow and fast eye movements, optokinetic responses, and spontaneous/involuntary eye movements.

It should be noted that due to the overwhelming success of her first program Ali returned for a second intensive Brain Training program in November of 2015. She experienced further objective and subjective benefit and continues to update us on her progress.

Concussion Relief IS Possible

An alarming number of individuals do not seeking care for head injuries. It is important to recognize the symptoms of these debilitating injuries and that something can be done about them. The ‘wait and see’ approach to concussion and mild traumatic brain injury is no longer acceptable. Early intervention is key! The longer one waits, the more difficult it is to recover and have full engagement with life!

If you or someone you love is experiencing ANY of these symptoms, call APEX now at 828.708.5274. You may also email us at [email protected] for more information, or to set up a free consultation. 

APEX Brain Centers is leading the way in neuroplasticity-based brain enhancement programs that are opening new doors for those struggling with addictions, learning and behavioral disabilities, test performance, athletic performance and more.

2 Walden Ridge Drive (STE 80) ~ Asheville, NC 28803 ~ 828.708.5274
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