A practical guidebook to explain what processes naturally occur inside healthy brains, how traumatic brain injuries derail these natural processes, and what you can do about it.
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The Concussion Repair Manual is partly a guidebook, which will help you to understand what processes naturally happen inside healthy brains, how traumatic brain injury derails these natural processes, and what that means for you. It is also an overview of the most current, comprehensive TBI treatment tools and techniques that holistic and integrative medicine has to offer. Some of these therapies come from the newest frontiers in neuroscience, while others are rooted in ancient medicinal and shamanic traditions. To really get to know the TBI condition and its treatment options, read through each of these chapters at least once.
Next, grab a pen and plan to really get to know yourself by using the worksheets included in the back of this Concussion Repair Manual. You will pay close attention to your symptoms, establish a symptom severity baseline, and systematically track your recovery progress. In the very last chapter of this book, you’ll learn how to weave the various therapies together to create a personalized treatment protocol that works best for you.
The old adage “everyone is unique” will be reiterated many times throughout the Manual and really cannot be said enough. It’s tempting to judge resolution of these chronically held and often frustrating symptoms by expectations of “speed of cure” or “because that person got so much better so much faster than me.” This Manual is not about curing anything. It is about working towards recovery in the best way for each person and assisting in tracking that progress. As such, many factors contribute to symptom expression and recovery, and this Manual is aimed at taking a multi-pronged, holistic, and integrative approach to contribute to a return of optimal physical, neurological, and personal function. Hopefully, the road ahead for you in Re-becoming your
HEADS UP! The Concussion Repair Manual is not intended for acute patients who are currently on life support or those who have not yet been fully stabilized in a medical environment. This manual is intended for traumatic brain injury survivors who already have been medically evaluated and stabilized and are now in transition, gradually healing and returning to their lives, their relationships, and their day-to-day activities.
The Concussion Repair Manual should be used with the awareness, support and supervision of a local physician or primary care provider best self is met with as much ease, effectiveness, acceptance, and inspiration as possible
Cracking My Cosmic Egg
How to Use This Book
Introduction – History of Treatment and Current Trends
- The Big Picture of Traumatic Brain Injury – Past and Present
- Leading Causes of TBI
- Long-Term Effects of TBI
- Just How Far Have We Come?
- How Healthy Brains Are Supposed to Work
- The Injured Brain
- Genetics and the Alzheimer’s Link
- The Limits of Conventional TBI Treatment
- Diagnosis and Classification of TBI
- The Keys to Effective Treatments
Chapter 1: Primal Technologies
- Case Report
- Primal Technologies Overview
- Water: Floatation Therapy
- Light: LLLT (aka Cold Laser Therapy)
- Oxygen: HBOT
- Frequency: PEMF, TMS and tDCS
- Transcranial Magnetic Stimulation (TMS)
- Transcranial Direct Current Stimulation (tDCS)
Chapter 2: Interventional Therapeutics
- Case Report
- Therapeutics Overview
- Hormone Replacement Therapy (HRT)
- Learning: Cognitive Rehabilitation Devices
- Stem Cell Therapy
- viii The Concussion Repair Manual
- Acupuncture – coauthored by Dr. Andy Swanson
- Pharmaceutical Nootropics
Chapter 3: Biological Nootropics
- Fish Oil
- Phosphatidylserine (PS) and Phosphatidylcholine (PC)
- Glutathione (GSH)
- Vitamin C (Ascorbic Acid)
- Lithium Orotate
- B12 (Methylcobalamin)
- Alpha Lipoic Acid (ALA)
- Acetyl-L-Carnitine (ALC)
Chapter 4: Nature’s Medicine
- Case Report
- Sun: Heliotherapy
- Sound: Music Therapy – Authored by Dr. Andy Swanson
- Skin: Earthing
Chapter 5: Personal Practices
- Case Report
- Gyroscopic Repair: Balance and Bodyweight Training
- Movement, Qi Gong and Engaging Vestibular “Flow”
- Centering the Mind, Strengthening the Brain – Meditation.
- Coauthored with Dr. Andy Swanson
- The Pump: Inversion Therapy
- The Gatekeepers: Faith and Perseverance
Chapter 6: Foods for Recovery
- For Those Interested in Detoxification, Vegetarianism and
- Plants-Only Diets
- The Ketogenic Diet
- Oily Fish
- Coconut Oil
Chapter 7: What to Avoid
- Repeat TBI
- Chapter 8: TBI Assessment Tools
- SPECT Imaging
- EEG Supported Testing
- Non-EEG-based Computerized Assessments
- On-Field and At-Home Paper Form Assessments
Chapter 9: Putting It All Together
- TO DO, TAKE & AVOID Checklist Immediately After a
- Suspected TBI or Concussion
- Establishing Symptom Baselines
- Creating Your Treatment Protocol
- Top 10 Rules of Engagement
- Comprehensive Symptoms Log
- Sleep Log
- Activity Levels Log
- Diet Log
CRACKING MY COSMIC EGG
Not till we are lost. . . do we begin to find ourselves. — Henry David Thoreau
It’s safe to say my worldview is a bit wider than that of the average doc—but by no means did it start out that way. I’m board-certified in adult psychiatry and neurology, and I’ve completed psychiatric fellowships in child, adolescent, and forensic psychiatry. Still, I’ve come to realize there are many paths to healing. After deep and gradual exploration of transpersonal psychology, allopathic (i.e. Western medical approach) psychiatry, functional medicine, and many other alternative and integrated medicine practices, I’ve cultivated a mindset that appreciates and honors all aspects of wellness.
Author Joseph Chilton Pearce describes the “cosmic egg” in his contemporary classic, The Crack in the Cosmic Egg, as the way one’s mind sees—and, as a result, the way one experiences—the world. He explains, “This circular trap of how we perceive reality is our cosmic egg, a shell of mind that both defines our world and helps shape it, just as that world, so shaped, defines the nature of our mind and experience.” Furthermore, this bidirectional, interactive relationship between each of us and the world around us is fluid and evolutionary.
As we grow and evolve so does the way we experience the world, and as the cultural identity of the external world around us grows and morphs over time, so it too affects our own sense of self and personal identity.
Pearce also notes, “There are experiences in which a crack forms in this egg, when non-ordinary things are possible, or non-ordinary solutions occur to the mind.” These cracks in our cosmic eggs can be keys to new modes of thinking. Case in point, in some Amazonian cultures, when the medicine keeper of the tribe identifies a potential successor or apprentice, he will club that person on the crown of the head with a mallet. This figuratively (and frequently literally) cracks open the apprentice’s cosmic egg, opening him up to receive the medicine keeper’s teachings. At the very least this also tests the willingness and resolve of a would-be-student to actually go own the path of apprenticeship.
My own cosmic egg was cracked very wide open when I was 21. It happened just two weeks before I started medical school, and I had just arrived at my favorite fishing spot in Texas on the Gulf of Mexico. I was hot and tired after the long summer drive and
had recently returned from celebrating college graduation with cliff diving in the tropics. Needless to say that sense of aerial freedom in flight was still programmed into my subconscious when I dove from 20 feet headfirst off of a pier into knee high water. This abrupt landing on a sandbar, which felt like getting blindsided by a dump truck, resulted in a compression fracture of my C5 vertebra and a newly acquired vulnerability. What also resulted was a healthy respect for the beauty and depth of life.
My newly-liberated cosmic egg (disguised as a diving “accident”) also catalyzed the beginning of an unexpected journey—one that would lead me to see myself and the entire field of medicine in a completely new way and eventually stimulate the deep investigation of brain trauma and the writing of this Concussion Repair Manual. A brief backstory will paint more of the picture. Long before my deep dive into shallow water, I was an incredibly driven scholar and athlete. I grew up with an uber serious “Type A” personality focused on being the best at whatever I did, a natural asset to competitive sports. I played just about every sport in school and on club teams, which included me playing on the US Olympic development team in soccer and a club soccer team that won the gold medal in the Junior Olympics of 1989. At St. Edward’s University, I was Academic All American, graduated Magna Cum Laude with a double major in Chemistry and Biology, and, as team captain, I didn’t hesitate to lay into my teammates or drive them off the squad if they didn’t perform. By the time I had graduated college, my level of intensity was at a fever pitch, and my broken neck associated TBI (traumatic brain injury) was only one in a series of major sports-related concussions. As anyone who’s ever had a major dinger (i.e. concussion) will attest, there’s nothing quite like the experience of not knowing who you are, where you are, and why you’re there. Initially I thought breaking my neck was just another injury to overcome… and then reality and humility set in.
To immobilize my head and broken neck, I wore a halo device for three months and one day. Titanium screws in my skull connected a metal ring around my head to a plastic back plate and a chest plate. For the first time in my life, I felt quite immobile and surprisingly vulnerable. Needless to say, metal bolts screwed into your skull affects your concentration, and with the phonebook levels of information to memorize piling up in the first months of med school, my grades slipped a bit. Frustrated and finally forced to slow down, I reflected on my life. I had gained a wealth of early success and confidence in my life up to that point… and very little happiness. The previous level of drive had drawn me to the fast-paced fields in medicine of surgery and emergency medical care, but after the accident it all shifted. Psychiatry seemed like a much better fit, and, for the most part, it was—except for two little major hurdles.
The first was Pessimism—not mine but the entire field of psychiatry and neurology, and the second was narcolepsy. During my medical training (and pretty widely spread across the training programs throughout the country), many of the conditions assessed in the field of neurology and psychiatry were believed to have no known cure.
The field itself is amazingly sophisticated in diagnosis and assessment, and yet quite limited in regards to resolution of the symptoms involved. Brain scanning machines, cerebrospinal assays, and biochemical blood markers were (and still are) only a few tools of the trade. We as physicians are very good at telling someone what is wrong symptomatically and pointing to the complex array of potential neurological areas affected, however, we are not historically very good at understanding the underlying mechanisms of causation and prescribing an effective intervention for resolution. Today, this is particularly relevant in the fields of autistic spectrum disorders, severe and chronic depression or anxiety, addictions, traumatic brain injury, and narcolepsy, to name just a few.
As mentioned before, I also previously experienced symptoms of narcolepsy, and it’s my belief in hindsight that these were compounded by Post-Concussive Syndrome after multiple previous sports related concussions. I was formally diagnosed with narcolepsy in my third year of medical school by an MSLT (multi-sleep latency test) in the sleep lab of our medical school hospital, although the symptoms had certainly started much earlier. Essentially the core symptom of narcolepsy is consistent uncontrollable experience of falling asleep in situations where it is socially detrimental and physically dangerous.
These issues came to a head in my third year of medical school when I feel asleep while driving home every day after an all-night call shift in the Labor and Delivery unit during my OB/GYN rotation. Even though I lived only 5 minutes away, I still couldn’t’t help falling asleep while driving, and the last time. I woke up in oncoming traffic I knew I had to get it formally evaluated. The MSLT is the diagnostic tool for narcolepsy, and I scored high marks in this test, too. My prize was being prescribed a very effective and heavy-duty pharmaceutical cousin of Ritalin called Cylert. My doctor told me that I would simply have to take it for the rest of my life to manage my condition and that there was no known cure. Not thinking much at the time about the “life sentence” to medication, I took it regularly—and well, it really worked. There’s a reason most people love stimulants. From the US military to peak performance entrepreneurs, from high achieving students to long distance truck drivers, tons of people have been turned on to the pills. Just one pop of pill that neuro-chemically juices your brain like cocaine will most definitely get your attention… and for many hours. This certainly became quite advantageous through medical school and the rest of my psychiatric training. It was only after my medical training completed that I realized I was hooked to these pills with no end in sight, and furthermore, I couldn’t help but notice that we psychiatrists were essentially doing the same thing to most of our psychiatric patients—getting them hooked with no plan or end point in sight. I had been taught first and foremost to prescribe meds to treat patients’ symptoms, rather than start with the mindset of using medications only when necessary and while using a thorough plan to assess the underlying root causes for their problems. There had to be another way—maybe many other ways—to treat myself, not to mention
For the next several years, I studied the myriad branches of alternative medicine, training with chiropractors, naturopaths, homeopaths, Ayurvedic practitioners (focused on holistic, energy-based healing), acupuncturists, herbalists, Reiki healers, martial artists, and just about anyone else with a fascinating skill set in a formalized healing modality that had experience working with any mental health issue and was willing to teach me. When I couldn’t find a living and willing teacher to work with, I dove into the available research and practiced on myself. I decided to put myself in the laboratory, because at the end of the day my own personal experience was the best barometer to assess the appropriateness of each modality. How else would I understand the nuances of so many paths to healing? How did each work? Why did they work? How did each one complement the other modalities I was or had been using?
I became a relentless detective. I analyzed everything I could think of that might have been a contributing factor. I overhauled my diet, regulated my sleep cycle, looked at my stress levels, and evaluated my hormone balance. I experimented with supplementation and used just about every technology and therapeutic device available to me for healing the brain (most of which are in this Manual), and each apparently blind alley opened up to a new wealth of information. When I exhausted all my known local resources, I moved to the Amazon rain forest to study herbal medicine and traditional healing techniques.
What had been a relentless drive for perfection in the classroom and on the field during my childhood had gradually turned into a mission for developing the best strategies for optimal healing of the brain and mind. This became a pilgrimage of personal development, and along the way I came to realize that the journey of healing any condition is a potential road to becoming one’s best self. With experimentation in the reparative strategies making up this Manual, due diligence in my own healing protocols, and the grace of time, the symptoms of head trauma have almost fully abated, the experience of narcolepsy has completely resolved, and I’m off all prescription medications. Like many who have experienced multiple, significant concussions, I do still technically meet criteria for Post Concussive Syndrome, although my relationship to it now is vastly different than before. Now I use it as an ally and a tool. It works as a barometer constantly giving me feedback for how well I’m following my optimal lifestyle program, and how actively engaged I am in my own personal life’s mission. The entire experience has become a form of Resistance Training, not so much for the body as much as for the mind. As such, the massive benefits of mindfulness, true presence, and simplicity and consistency in my daily routines have become paramount, and channeling this renewed passion toward the exciting new and growing field of holistic, integrative psychiatry and functional medicine has led to a whole new toolkit presented here in this Manual—one that I believe can help you on your own journey of recovery, too.