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.
…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!
For more information please call us at 828.708.5274, or visit any of the following resources:
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):
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.
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.
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!
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.
As the buzz surrounding the release of the projected Christmas blockbuster movie Concussion grows; the evidence continues to mount in support of the seemingly insurmountable challenges posed by this ‘silent epidemic’.
Continued reporting from one of America’s most trusted public television investigative news sources, PBS’s FRONTLINE, demonstrates the urgency of the matter at hand; and the extremes to which it can lead… Dementia and, in severe cases, death!
The most recent FRONTLINE update from September 18, 2015, based on research from the Department of Veterans Affairs and Boston University, can be viewed in their article entitled New: 87 Deceased NFL Players Test Positive for Brain Disease. The most shocking part of this reporting is that the disease, chronic traumatic encephalopathy (CTE), was found in 87 of 91 player’s brains tested. Let that soak in for a moment… That is 96% of the brains tested in this particular ongoing study showing signs of a potentially avoidable killer disease. We will come back to this in a moment.
Some definitions, facts, and stats to ponder:
Concussion is a traumatic brain injury that alters the way your brain functions
Most sport-related concussions (almost 90%) occur with NO loss of consciousness (LOC)
A median 2.7 million TBIs occur in the US each year (think about how many go unreported), at a cost of nearly $50 billion annually
Symptoms of concussion include: headache, dizziness, balance and speech problems, nausea, light and noise sensitivities, memory and concentration difficulties, behavioral and emotional struggles, and anything out of the ordinary observed that was not an issue prior to the event/s
Risk factors for concussion include: prior concussion, vertigo/dizziness, alcohol/drugs, high-risk behaviors and sports (e.g. football, hockey, soccer, etc.), military conflict, abusive relationships, driving, and high-risk occupations (e.g. construction, utility work, etc.)
Mild traumatic brain injury (mTBI) is another word for concussion; even though, in my opinion, there is no such thing as a ‘mild’ brain injury
Chronic traumatic encephalopathy (CTE) is a progressive degenerative disorder of the brain found in those with a history of repetitive brain trauma
Symptoms of CTE include: memory and executive function decline, depression, irritability, impulsivity, aggressiveness, suicidal behavior, eventual progression to dementia
(All facts and figures presented are courtesy of the Centers for Disease Control and Prevention and The Mayo Clinic)
***Did you know??? Those with ADHD are significantly more likely to experience worse outcomes with a concussion than their non-ADHD peers. This is of extremely important note as many children are placed in sports to control problematic behavioral and academic challenges. Read the abstract from a paper on this topic presented in the Journal of Neurosurgery: Pediatrics***
Back to the FRONTLINE reporting of 96% of the NFL players’ brains containing direct indications of CTE. What is being revealed in this ongoing study is one of, if not the most, statistically significant findings of our times. Consider for a moment if you will… If there were an outbreak of any communicable disease in a family, school, small town, cruise ship, or some similar controlled group separate from our general U.S. population; it would take, in most cases, less than 1% of the population being affected to mobilize critical resources to control and eliminate such an outbreak. Why is nothing being done to prevent and treat this largely controllable epidemic that has been unfolding before our very eyes for some time now?
While there is an extraordinary amount of activity and funding being directed towards this catastrophe, we are still largely no further along in the detection, advocacy, and treatment for this ‘silent epidemic’. As a clinician who has been in the trenches working with concussion and TBI for over 15 years, the stark reality is that the vast majority of patients that have walked through the doors of our Center have been given the same advice: “Wait and see”. That is, to go without treatment in hopes of symptoms subsiding; which, in rough estimates from various sources, will not happen in approximately 25% of cases! In other words, at least one in 4 will continue with any or all of the debilitating symptoms listed above long after a blow to the head.
Why “wait and see”? The primary tests utilized after one has sustained a hit to the head and suspected brain injury are structural in nature. What this means is if you have nothing that shows up on a CT scan or MRI, you are structurally ‘OK’ and sent on your own to wait out the symptoms – possibly with the assistance of medications for pain, dizziness, nausea, etc.
What are often overlooked, or not acted upon if they are in fact implemented, are tests of brain function. There are a great number of ‘biomarkers’ of brain function that can be measured with great precision – that is, tests that tell us what’s going on in the body as a result of commands from the brain; and what might not be working well after a particular region of the brain area has been injured. What follows are some examples of these biomarkers that can be measured and improved in most cases of concussion and TBI:
Blood sugar, hormone regulation, and other metabolic functions
Once functional deficits are identified; a host of neurological, cognitive, and metabolic rehabilitative interventions and processes can be employed to normalize these functions as best possible – and, in many cases, entirely! Examples of such would include: eye movement therapies, gait training, neurofeedback, physiotherapeutic modalities such as electrical stimulation and vibration, nutritional therapies, aromatherapy, visual and auditory training, meditation, lifestyle changes, and more.
While the quest continues to identify the best, evidence-based practices to combat this growing epidemic with little to no therapeutic intervention being rendered in most cases; there are a small number of progressive centers that strive to provide highly effective functional clinical interventions, as opposed to “wait and see” that has failed so many. Given the apparent lack of immediate shifts in the cultural circumstances that are causing brain injuries, and the inability or lack of desire of many to abstain from behaviors that are causing them, it is imperative that intervention with any head injury be focused largely on the therapeutic aspects once adequate healing time has passed.
One parting thought: There remains a sentiment in opposition to studies of the nature of the one referenced in FRONTLINE; dismissing the evidence as an overreaction to, and sensationalizing of, data from a highly specific group of individuals (i.e. football players get head injuries). My question to you is: If just one person in your family, community, etc. were to contract a disease like polio; do you think there would be any discussion of overreaction to the impending action that would be taken to remediate the cause of this potentially crippling disease?
If you knew there was something you could do, then why “wait and see”?
Every breath you take, every move you make (enter the distinct guitar sounds of The Police’s wildly popular 1983 hit) is controlled by your brain’s innate timing system. Whether physical movements or production of thoughts, your brain’s ability to time these magical feats appropriately is the difference between unnoticed normal everyday functioning and disastrous consequences.
Most can relate to the impact timing has on the way we move. We’ve all seen someone with Parkinson’s disease or brain injury, or simply decline in function with aging, struggle with what most of us take for granted (i.e. walking, tying shoes, speaking, etc.). Our ability to effortlessly time movement is taken for granted… Until that ability is lost.
On the other hand, it might be a bit more difficult for one to consider that the disorganized thoughts of those with schizophrenia or similar conditions has anything to do with timing. This is in fact a growing area of research where disorganized or uncoordinated thoughts are being related to uncoordinated motor activity such as walking and speech. When movements are improved through various types of physical training, individuals experience more efficient thought processing and communication of these thoughts. Through this lens it is quite easy to see how our thoughts, and even emotions, can be impaired by improper mental timing.
Can I improve my brain’s timing???
Musicians, dancers and other athletes would tell you… Absolutely! Simply involving yourself in activities that revolve around a regular beat or rhythm (cadence) will help to strengthen your mental timing ability. The obvious here would include activities such as music and dance.
But what if there are problems with my brain???
Previously mentioned brain injury and Parkinson’s disease would be natural barriers to improving timing in the brain. Studies also show that key physical abilities (bio-markers) such as balance and eye movements are impaired in those experiencing cognitive decline with aging. Challenges in these and other abilities will undoubtedly have an impact on our ability to improve timing. Addressing the physical and metabolic aspects of these conditions would be the logical first step in improving mental timing in any situation. For those with severe impairment, and for those looking to be the best they can be, there are other options.
Can my mental timing be measured and improved???
Fortunately, yes! With sophisticated measurement and training tools such as the Interactive Metronome, those with neurological conditions and peak performers alike can have their brain’s timing measured quite accurately. This particular program utilizes auditory (sound) cues to first measure and then train one’s mental timing capacities. Through matching body movements to a standardized metronome beat, the computer software can determine (down to the millisecond) how accurately one is timing. Numerous aspects of timing can be measured including early and late timing tendencies, left vs. right side of body differences, upper vs. lower body timing differences, consistency in timing from one beat to the next, and much more. Armed with this information, experienced clinicians such as those at APEX Brain Centers in Asheville, NC can design and deliver specific Brain Training programs to repair the deficient timing issues to the highest degree possible.
What does this all mean for me???
With intact and efficient mental timing our risk of injury due to falling decreases… Thought processing and problem solving become more efficient… Attention and focus get sharper… Memory formation and retrieval becomes much easier… Certain unwanted behavioral traits improve… Academics and test taking require less effort and produce less anxiety… Our limits of physical performance can skyrocket…
I believe you get the point. There are few aspects of humanism that are not positively impacted by an improvement in our brain’s innate timing abilities. Go exercise that rhythm – your brain will thank you!
Everyone that signs up for a 5 or more day full intensive training program at APEX Brain Centers in Asheville, NC, that is! (Unique offer details below).
While technology and all that come with it can cause significant impairment for many, it can also be used to provide an extreme advantage when it comes to Training your Brain. The ever-growing list of hi-tech applications (apps) for mobile devices and tablets is astounding, many of which hold significant promise for re-training brain dysfunction, and for improving upon already strong performance in those looking to reach their peak potential. As with anything, there is a downside – apps used improperly and not under expert guidance can, in some cases, be counter-productive, and even harmful!
The following are the main areas of apps for brain performance:
Memory and Attention: We have all heard of that brain training program that begins with ‘L’ that most folks pronounce incorrectly! While this and many other similar apps are quite useful and largely without side-effects, they may not be providing all they claim in the absence of a comprehensive brain health program.
Eye movements: The secret is out, eye movements are directly related to our higher, more human, cognitive brain functions. A simple Google search of ‘eye movements and cognition’ should get you rolling there! The challenge is that these sensitive windows into higher brain function can very easily be trained incorrectly, leading to further dysfunction or significantly limiting peak performance. User beware: Expert direction is essential with these type of apps!
Neurofeedback/Biofeedback: By far the newest and most concerning area of mobile brain training, app stores are piling up with programs that will help you regulate your brainwaves, heart rate, muscle tension, and more. Common sense should let you know that training your brainwaves in the absence of higher education in neurophysiology and neuroplasticity might not be a very wise choice. Once again, user beware!
Although just a sampling of what’s available in the various app stores in the cyber world, the take home message here is that ANY effort in training your brain should be directed by a qualified health care provider trained in these areas of brain performance for maximum benefit and decreased probability of side-effects.
Enter the iPad…
All clients entering into a 5 or more day full intensive training program at APEX Brain Centers in Asheville, NC through May 31, 2015 will receive a FREE iPad Mini with Retina Display (or comparable device) as a valuable aid to your brain training program, and to help you continue progress once discharged. All you would need to do is have an iTunes account to purchase any needed applications (typically less than $35.00), and the desire to make your brain the best possible brain it can be.
This special offer is not to be combined with any offers and you must reference this post at the time of consultation or admission for validation purposes. Let us help you harness the power of technology and put you in the driver’s seat on your journey to Building a Better Brain!
Liz is a 29-year-old female entrepreneur, designer, and athlete who came to APEX Brain Centers with a history of post-concussion syndrome from previous car accidents and sport related head injuries. She reported symptoms that are often seen in cases of mild Traumatic Brain Injury (mTBI) including brain fog, fluctuating and elevated heart rate, fatigue, incoordination, excessive emotionality, sharp head pains, and decreasing ability to think critically and effectively. Liz’s symptoms have been nothing short of debilitating and have taken away her ability to work full time at the career she loves. She was also very concerned that her future plans of having a baby and starting a family would be compromised due to the health risk to both her and a developing fetus.
Liz traveled from Virginia to the APEX Brain Centers office in Asheville, NC to participate in our targeted, high frequency, high intensity Brain Training program. She began a 10-day course of Brain Training in November of 2014 with a goal of alleviating her concussion related symptoms. With her sincere efforts and dedication to recovery, we were able to record significant measurable changes related to her symptomatology.
Intervention for mTBI
Liz underwent Brain Training 3 times per day over the course of the 10-day period. Her brain function was carefully monitored throughout the training process to ensure she was receiving enough treatment to be effective, but not too much so as to be counter-productive. Modalities delivered included, but were not limited to: neurofeedback (NFB) and transcranial magnetic stimulation (rTMS), Interactive Metronome, vestibular rehabilitation, metabolic/nutritional therapies, eye movement and other aspects of neurological rehabilitation, electrical stimulation, breathing exercises and home care recommendations.
Outcomes after Brain Training
Subsequent to her Brain Training program, Liz reported significant subjective improvements in the vast majority of her post-concussion syndrome symptoms including: fogginess and “wandering” of thought, fluctuating heat rate, ability to control emotions, head pain, sleep, intensity at which she was able to exercise, balance, and levels of energy.
Actual, measurable objective improvements recorded with post-intensive diagnostic testing include:
Cognitive Testing: Improvements in 4 aspects of memory, attention, executive and other cognitive functions ranging from 14% – 800%.
Interactive Metronome: 42% improvement and normalization of hyper-anticipatory timing tendency with motor tasks. 68% improvement in task average with motor skills. 30% improvement in overall response accuracy with motor skills.
Computerized Assessment of Postural Stability (CAPS): Elimination of mild reductions in stability with balance and complete normalization of balance abilities in eyes closed scenarios.
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.
Autonomic Testing: Stabilization of heart rate from an erratic range of 90-150 bpm, to 60-90 bpm; saving her over 30 million heartbeats per year!
With an ever-increasing number of individuals experiencing mTBI, it is important to recognize the symptoms of these oftentimes debilitating disorders and, more importantly, that something can be done about them. Borrowing a phrase from the Brain Injury Association of America, “Brain injury is the last thing on your mind, until it is the only thing on your mind”!
Football can be a brutal sport full of heavy hits and injuries. All too often bravado (or, as some would see it, ignorance) keeps players on the field after they have suffered devastating injuries. As a clinician who has helped many young athletes who are struggling with life altering symptoms caused by concussions, I have seen the high costs paid for this ignorance. Players, teams, and families all suffer when coaches choose to ignore the signs that a player has an injured brain.
Case in point…the recent University of Michigan football game where the Wolverines were trailing significantly late in the game and quarterback Shane Morris took what appeared to be a blatant illegal hit to the chin from a Minnesota defender (Watch the video at Deadspin).
That hit would have stopped any person of great strength dead in their tracks, and could have potentially killed one of lesser stature.
Sure, roughing the passer was called on the defender that inflicted the blow. That was the lesser of disciplinary options for this type of aggressive action that was clearly delivered to take Morris out of the game, even though he was no longer a threat to the Minnesota squad.
But What About the Coaches?
What about the very individuals that this young man’s safety, well-being, trust, and livelihood were entrusted to?
Certainly there is a mindset and code of conduct in the ultra-competitive sports world that many on the outside will never understand, but there is also a time when common sense prevails and stories like this need to be used as an example to protect those that have given their all to the sports they love.
Cries for the removal of Michigan Head Coach Brady Hoke, and even Athletic Director Dave Brandon, have been pouring in to the University since the time of the incident, mostly from University of Michigan fans. Rallies are being held on the Michigan campus and awareness is spreading nationally in protest of the ignorant inactions taken on the sidelines at this particular game. Director Brandon was quoted as saying, “Ultimate responsibility for the health and safety of our student-athletes resides with each team’s coach and with me, as the Director of Athletics.” He further noted, “We are committed to continuously improving our procedures to better protect the health and welfare of our student-athletes.”
These words are mere lip service. What Brandon said does not change the fact that that this young man continued to play after suffering a traumatic brain injury, as evidenced by his incoherence and inability to stand on his own two feet. How is it that the announcers immediately recognized the severe nature of Morris’s injury and suggested he be sidelined, yet the coaches on the field made no attempt to remove and evaluate the young star? You would think they would want to preserve and protect one of their biggest assets, particularly in the case of an impending loss.
What Should Have Been Done
Morris should have immediately been removed from the game the moment he started showing signs that he had a concussion; which was the moment he went to the ground and barely got up! Whether he was facing a loss in the last quarter or playing for a national championship, his inability to walk, focus, and communicate was of no great service to himself, his team, or his University. Further, this put him at an alarming risk for an even more serious head injury (think of a fighter waiting for the knockout punch when his opponent is dazed and confused). Morris’s basic physical and cognitive functions should have been tested immediately after he took the hit. Tests measuring his basic memory and cognitive skills (i.e. name, date, hometown, basic addition, etc.), eye movements and light responses, gait, balance, and vital signs (i.e. blood pressure, heart rate, etc.) should have been performed.
After a period of rest, more advanced tests of function would be warranted: videonystagmography and saccadometry for eye movements, Computerized Assessments of Postural Systems (CAPS), cognitive testing batteries for focus, memory and attention, and more advanced studies such as quantitative EEG for measurement of brainwave activity. Effective intervention to eliminate his functional deficits and decrease the probability of future injuries can only be delivered if thorough examinations are performed.
What Good Will Removal of the Coaches Serve?
While I am entirely in favor of the removal of the coaches who did not protect the interests of Shane Morris, I’m not certain this will prove any more effective than the penalties placed on the players delivering these hits that are often not appropriately enforced in cases such as this. There will always be the next Brady Hoke in line to take the job of protecting our athletes. In my opinion, the cultural norms in this high performance world need to shift in order to ensure incidents like this are minimized, and hopefully eliminated. That can only come from the top and I sincerely hope that the NCAA and other organizations take copious notes here to develop action plans to truly protect the players and hold those accountable that put them in harm’s way.