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A Slice of Humble Pie with P2
🥧 A podcast where we curiously explore nutrition, fitness, mindset, sports, wellness, & beyond. ☕️Host @parastoobadie
A Slice of Humble Pie with P2
Early Signs and Long-Term Impact: Understanding Concussions
Are you aware of the subtle signs of a concussion? Join me, P2, for an enlightening conversation with Dr. Isaiah Redfern as we debunk common misconceptions about concussions. Dr. Redfern will guide us through the brain's anatomy and physiology, highlighting how delicate structures like the brainstem are vulnerable to impacts. Understanding and addressing concussion symptoms early is essential to prevent long-term health complications.
What are the real risks of rushing back to work or sports after a concussion? Dr. Redfern explains the protocols for safely returning to activities and athletics. He details the dangers of premature returns, including increased brain inflammation and the potentially fatal secondary impact syndrome. This conversation emphasizes a careful and gradual reintegration process, supported by a solid recovery plan.
Nutrition is key to brain recovery, and Dr. Redfern provides actionable strategies to optimize healing. This episode also explores the specific needs of female athletes, highlighting the heightened risks due to hormonal fluctuations. This comprehensive discussion offers practical advice for immediate post-concussion care and underscores the resilience—and fragility—of the human brain.
Tune in to gain valuable insights and ensure you're equipped to recognize and manage concussions effectively.
To connect with Ottawa Performance Care:
info@ottawaperformancecare.com
https://www.ottawaperformancecare.com/
Additional resources:
Rowan's Law - https://www.ontario.ca/page/rowans-law-concussion-safety
Website: https://parastoobadie.com/podcast/
Email: asliceofhumblepiewithp2@gmail.com
Instagram: @asliceofhumblepiewithp2
Welcome back to A Size of Humble Pie. I'm your host, pitu. I'm a nutrition and fitness professional, a lover of pie and a curious human on planet Earth. Our guest today is Dr Isaiah Redfern, the owner of Ottawa Performance Care in Ottawa, canada. Isaiah studied kinesiology in his undergrad and continued to earn his doctor of chiropractic degree Soon after graduation. He chose to approach treating pain from a different perspective than what he was conventionally taught and he decided to focus on concussions and brain health. Taught, and he decided to focus on concussions and brain health. Isaiah applies clinical, neuroscience-based strategies to treat traumatic brain injuries in an industry-leading timeframe. Patients travel far and wide to visit him, some of whom have been struggling with concussion symptoms for years.
Speaker 1:I met Isaiah literally on the first day of him launching OPC and within five minutes he figured out that I was dealing with post-concussion syndrome and that was very validating to the experience I was having for a long, long time. But the specifics of that story are for another episode. This one is all about education about concussions. So let's get back to our guest. When Isaiah isn't being a nerd and treating brain injuries, he's eating ice cream, lifting weights and getting more jacked. Honestly, his doubts are the size of my head.
Speaker 1:Besides that physical feature, isaiah is a rad dude, just awesome person and really good to talk to, and I always learn something and I'm super, super pumped to share this conversation with you. So let's get right into it. We were chatting about how we first met and actually, within the first five minutes of meeting you, you had already asked me if I was, you know, experiencing a hidden question. And that was really, you know, an eye-opener because in retrospect, when I was initially experiencing some of those symptoms, there was a peer who mentioned hey, maybe you should go see an OT, an occupational therapist, but I even dismissed it because to me I'm like well, I didn't have a concussion. This doesn't make any sense and I was coming from 17 years of remedy and you know, I thought, I thought I knew.
Speaker 2:So I'm just curious what you feel people still get wrong about the lashes I think the biggest thing is that we we just assume that everyone balances back super fast. Go, go in a dark room, lay on the couch for about a week, maybe two. You should be fine, you should be normal, everything should be okay. But that's rarely the case and a lot of people involved in sports or busy at work don't really have the time to kind of put themselves first right. There's life, there's your sport, there's kids, there's anything that really needs to get done right now, no matter how I feel.
Speaker 2:So I feel like a lot of people get stuck in just the pushing through right and just kind of putting their symptoms on the back burner. And just kind of putting their, their symptoms on the back burner and the next thing we know we're six years out, we still get these, these migraines coming every week or hard to like, stay on tasks, but that's that, that's become our norm because it's been there for so long. So I think a lot of times we just get stuck in just the pattern and it takes someone else to say, hey, stop Like the pattern. The pattern you're currently in is not, is not like your program, it's it's. It's not your, your normal.
Speaker 1:Fair enough. So let's let's build on that a little bit more. So we know that when it comes to concussions now we know this we know that the brain tissue itself isn't necessarily damaged, and so nothing shows up on MRIs and CTs. And I feel like maybe that part is unknown either, like across, like you know, everyone doesn't know that, and so in preparation, you know, for this podcast, as well as for my own curiosity and education over the years, I've learned that the brain is more like jello. It's a different texture and whether it's a direct hit to the head or an indirect hit to the body, the jello sort of morphs, it stretches and the cells in it respond accordingly. So can you please describe what is actually happening in the brain? And then I have a few follow-up questions.
Speaker 2:How science-y can I go here?
Speaker 1:Oh, bring on the nerds, let's go.
Speaker 2:It's rarely ever where the cortex, like brain, with all the folds up here gets into the skull. That's that's. That's that's usually not where the issue is right. I'll get a lot of patients that say, oh, I was hit here, I think I have damage here and it's like honestly right if you had it in the in the brain. So literally like larger brain up here, it's going to be on the opposite side, but where, where the majority of the issues are is going to be in the brain stem, but where, where the majority of the issues are is going to be in the brain stem. That's that's. That's the region of anatomy between spinal cord and and the brain. A good way to visualize it is if you're holding the flower and you kind of like whip the flower back and forth. The spinal cord is the stem, the brain is the flower, but where those two meet, that's where the brain stem is. That's where all the centers for your eye, movements, your balance, whether you feel nauseous, sensitivity to light and sound. So a lot of the problems happen there because we're having that torsional piece.
Speaker 2:When a person gets hit, they rarely are just moving in a straight line. There is usually a rotational piece and tissue. So the nervous system takes that. So oftentimes we're not looking at cortical stuff. Everything is usually brainstem-based, which also aligns with all of our symptoms. Brain stem based right, which also aligns with all of our symptoms.
Speaker 2:Now, if we go on like a deeper dive of actually what, what happens when a person's hit? Think of it like every, every cell in in the brain has these doors. Some of these doors open up if they're, if there's a protein there. Some of these doors open up. A voltage is exactly right. Some of these doors open up at a voltage, it's exactly right. Some of these doors are open if they're mechanically forced open. So when a person is hit, a lot of those mechanical doors are opening up.
Speaker 2:When those doors open up, you have those positive and negative charge ions. Sodium, potassium, those types of things are all now being dumped out. What's going to happen is that you're going to get widespread activation through the whole brain, followed by a wave that kind of shuts everything. You just put the brain through so much fuel demand that that's why a lot of people can pass out immediately after this. There was just such a revenue for every region of the brain to turn them on at the same time you don't have that much ATP or carbs readily available out of notice. So now it's going to speed all that.
Speaker 2:The cascade that follows is that one of those ions is calcium. Calcium does amazing things, but when it's dumped into the mitochondria of a cell it acts like rust. It's not going to let the mitochondria work as efficiently. So now, now we have, we have the engine of the cell, that's covered in that, so the person can't produce as much ATP or that fuel they're going to heal the injury. That's where taking a magnesium type of supplement works out great, because now it plugs a lot of those doorway on the outside of each cell so it can keep the calcium sequestered in the right spots.
Speaker 1:Cool, that wasn't that science-y, I could follow along.
Speaker 2:Good good.
Speaker 1:Sometimes, as you're describing this stuff too, do you remember Magic School Bus?
Speaker 2:I sure do, Perfect.
Speaker 1:I have a literal scene of, like we're going on a field trip guys and you're explaining it and following along with you. For our listeners that aren't familiar with the terminology, let's just clarify that for a moment. So when we're talking about traumatic brain injury, minor concussion, can you just sort of just explain what those are?
Speaker 2:Yeah, so an MTBI, a mild traumatic and a concussion are the exact same thing. You can swap those names back and forth. We can still up the scales where we take the M and CBI out A lot of the same symptoms, obviously now to a larger scale. But when you get into that TBI we're going to get some of those hard lines. Is this the cool thing? To mechanically walk, having to learn Difficulty when a person walks right, having to mechanically learn that all over again Something that's as common as using a spoon. We'll also get a lot of those lifelines. We're going to see some heart stuff, some lung stuff. To be more specific, a person is going to spend a lot of time in hospitals just so that they can get that supportive piece and those certain pieces of equipment to do those brain-based tasks okay, so that makes sense.
Speaker 2:It goes up in intensity and the more traumatic the brain injury, there's obviously other consequences impacting physicality yeah, if I was going to put a number on it, I would say that at least for myself. In office I'm dealing with TBI almost exclusively. It's not as common to really see that TBI. It's a sad reality but it's sad. But a lot of times when the severity is that bad, it's really likely that it might affect some critical parts of the brain where, uh, carrying on life afterwards may not be like a realistic option yeah, okay, let's focus on not that part.
Speaker 1:I'm gonna go to the part that's slightly more mild. So when we're talking about concussions, there are some clinical symptoms, and you know a few of them for our listeners from nausea, headache, light or sound sensitivity, memory loss, fatigue that we mentioned already. Mood changes, personality change. It could also lead to insomnia and sleep issues. So some of these can show up within minutes, hours, days, weeks after the fact, and if it's a really minor concussion, some of the symptoms can completely resolve on their own within two to three weeks. Being an organized sport, especially if it's one of the sports that we know are a bit more conducive to concussions, there's usually an athletic therapist or physio around who leads the return to play. But if that's not the case, how does someone actually know that they're healed enough to return to sport or work? Because some of these symptoms are that's a lot, that's a laundry list of symptoms and they do overlap with other things.
Speaker 2:So I'll break the two apart, because return to work and return to sport are two different worlds. Right on on on the return to work side, right, um, I'm. I'm fine with with the patients being back at work, as long as they're useful after the day's done, right? So they buy the patient that they have a job that is mainly on screens, and whether they're working three hours or nine hours, right, my, my rule for if we keep on working or not is can, can you do some of the things that you love after work, or can you do some of the things that you love afterward, or can you do some of the things that you have to do? You have to think of milk on the way home, or there's no more milk, right? If you're not useful for those baseline tasks, then we are in the place where we should be at that actual amount.
Speaker 2:When it goes to the sports side, very different, especially when we look at the contact piece, as a simple rule, we're not going back to full active sport until full active practice is fine, right, because if I'm looking at, let's say, a combat sport, I can at least tell the person in my gym who I'm practicing, with what's happening and say, hey, maybe don't hit me in the head, but if I'm in an active match I can't tell the other, take a later on me.
Speaker 2:So when I go to a sport piece, I really need practice to be full of 100% burst, without provocation of symptoms, until I'm even thinking about about like a full out match or a full out um floats what wording of that, I guess. I guess another way that I I could look at it is I would want to make the most intense practice scenario. I possibly could write one of those practices that your coach puts you through Once you, once you guys have a horrible game, something like that, and if someone can pass that that test now, now I'm saying, okay, things are not fine. I'm saying, okay, things are fine, I'm comfortable with you going out, full out in a more uncontrolled space.
Speaker 1:Fair enough, it's a little bit of dose to see how someone handles it and then you just keep refacing it. Small steps Now, in the context of someone not taking the small steps and sort of jumping, what actually happens if you go back too early?
Speaker 2:A lot of people get, in some aspects, overly concerned and in some aspects people are the exact opposite. So I would say the safest way is that if someone goes back too soon, that inflammatory cascade inside the brain hasn't calmed down yet. They're still in play. So if someone hasn't fully recovered yet, if they've had a concussion and they still are experiencing sensitivity to light or sound or getting eye pain when they're on screen and they go back into a full sport and have a subsequent narrative, right, it's going to make that second impact dynamically works. I don't have a good kind of analogy. Let's think about it as you sustained a secondary injury right before the the first rehab process was even done, kind of like you broke your arm and then you broke it again before you took the first. Cast on that that a second break is going to take you so much more time yeah, well explained.
Speaker 1:I appreciate that. Of course, sometimes you know we're being overly cautious. We're entering the world, especially in sport, where it's part of the mindset where you're a bit concerned that you're going to get injured, so maybe you're a bit apprehensive. And on the flip side, when you're being a little bit too arrogant and not giving yourself that compassion, that hey, maybe, maybe I'm not actually where I thought I was and I need some rest. So it's a little bit easier when you're in an environment where you have teammates or peers or coaches, because they'll hold you to it. They'll be like, hey, if you do, maybe you shouldn't. You know, we're not cleared yet. But my major concern is for anyone that's in individual sports or if you're not surrounded by people that are aware of this, that pull you back.
Speaker 2:Yeah, absolutely. It's a really hard line. So, for instance, I don't do any baseline testing on athletes because a lot of times athletes want to intentionally score poorly on a baseline test so that if they do sustain an injury, their scores don't look like that, so you won't take them out of sport. I totally understand why someone would do that. But when you're on the other side of it, your season's done right and now you have to fix all of this and you're saying, well, was my extra four matches or four games really worth it? Because right now, trying to rehab this kind of this, this, this type of injury, is a real uphill fight.
Speaker 1:Right, it just compounds, it's going to take us way and the compounding is the subconcussive right as well it could be if you have small, yeah. So I think I think that's what sometimes myself, perhaps other people like me where we didn't have a very major event, it could be just subconcussive that we kind of dismiss and then they calm down and then you end up with a series of symptoms.
Speaker 2:Absolutely.
Speaker 1:So I have two other questions on this topic, but it's more on the intense side. So I have two other questions on this topic, but it's on the intense side. So the opposite, where it becomes really really high risk or even fatal, is when you do go back too early and you haven't healed, right? The actual name is secondary impact syndrome. Rowan's law that we're familiar with in Ontario, canada, was created because Rowan passed away from secondary impact syndrome in the middle of a game, essentially, and the law was created to bring awareness and education. So in this context it would be what you just described, as this person already had that injury, they didn't even start the healing process and then they just got injured again, right?
Speaker 2:So Calcultivate to more intensity so somebody had a event or a sport on like a monday and they they sustained an obvious injury, but it's a very important game and maybe they went back in on the same on the same day. Now that person's at a dynamically greater risk because the nervous system is electric and when, when, when you have that original impact, there's no inflammation. Inflammation is going to be a positive charge for all of ourselves. To work at their absolute best. We need to be in as much of a negatively charged charge state right. So if we go back into our sport after we just had, possibly, a concussion and we're trying to shake it off, we're now dynamically closer to the threshold of having a second one right, and if we have that second system's impact so close to the first, it can now really exceed our body's capability of being able to compensate and keep those vital life ones still on and in function For some individuals, depending on their overall health status.
Speaker 2:We can now see that I played the game on the Monday. My next game wasn't until Wednesday or Thursday, but I wasn't in a healthy place to actually start. I had some gut stuff, I had chronic inflammation already. That's where the point of that return to a sport is huge and it's not something of oh, I didn't throw up, I didn't pass out, I didn't see starts, I must be fine. It's saying, no, are you the exact same that you were before the impact? If you're not since any way, shape or form, then we are doing a return to a sport. In my eyes. I need you to be identical to the way you were right before the impact.
Speaker 1:The inflammation that you just brought on. In the grand context of things, inflammation is necessary for healing, but in this specific context, when there's an overwhelming amount of it or there's a cascade sort of continue some of these symptoms, Is that what's happening for people that sometimes still have concussion symptoms for years?
Speaker 2:The main reason is that before the impact you were in program A. Once you have the impact, you're now in program B. Unless you do some specialized treatment, you're never going back to program A. Physiologically it's impossible. When you're in program B, if your brain is healthy enough, your overall health status is within that right range you can compensate just fine and perform life fine. But now our shoes are a mess, our sleep's a mess, right? A lot of us have something that is going on at the same time, so a lot of us can't stay in that program with the compensation for extended periods of time. It's funny.
Speaker 2:I had a patient just this week Similar idea. There was an impact. She was doing great, she was able to still work, still enjoy life. Six months after now, all these symptoms come out of nowhere. What happened? There was a stressful event, a major one, but now that was now enough to exceed her cup. So now she can no longer compensate for that program B and everything that was wrong now shows up. It was there the whole time, right, but the brain was just strong enough to kind of hide it. So that's usually why a lot of us can go for weeks, months, possibly even years, without things being that bad is just because our brain isn't a great place but, like like a lot of things, enough time of something working more than it should, it's going to fatigue out.
Speaker 1:That makes perfect sense. It's just how much it can handle. You just brought all the interventions, so let's dive in a little bit more. At OPC, auto-informance care, I don't know how many patients. Do you know how many patients you've helped at this point?
Speaker 2:No, no, no. I know how many appointments that I have in a year, but it's really hard to actually see how many it is from start to end.
Speaker 1:Well, let's just say hundreds. I'm sure you've helped hundreds because it's been six years. So you've seen a lot of people over the past six years, years and, uh, I know that you've had a high standard of care and you've built a great reputation where people come internationally and they travel to you because they've experienced some of these symptoms for years and they were maybe still suffering and they're like oh, I don't, I don't have to feel this this whole time. So if you, you started talking about some of the interventions, but I'm just curious if you can share with our listeners what types of treatments you offer and what those interventions are yeah.
Speaker 2:So the biggest art is diets, diet and supplements. At the start I kind of think about it like if we're gonna plant the the garden, I need to make sure the soil is great first. So if I can make sure that dietary piece and then accentuate that through supplement use, we now set the stage for where we should be able to get a pretty rapid change. The other things I'm using is I'll do a lot of vestibular work, work with the accuracy of the eye movements. I'm using electrical stem for cranial nerves 5 and 10. I'll use a lot of infrared tools, right, like red and infrared LEDs or lasers, and I'm trying to do all of this at the same time. Right, I want to actually do as much specific stimulation towards the brain as I can in a single appointment without provoking a symptom, and that's where that electric stem of cranial nerves 5 and 10 helped me out. Huge, because that's kind of like plugging the person in so they don't ting them, right.
Speaker 2:I think what separates how I approach a problem from someone else is that it's exactly that I'm doing everything at once where a lot of other offices are doing. This is our six weeks of working on just the eyes. Then this is going to be our six weeks of working just on this, but the brain is using everything at the same time when you're walking down the street. There's vestibular input, visual input, there's the autonomics. There's so many components that if they aren't working perfectly, you're gonna feel something. So I try to treat the exact same way, but ultimately it all starts with the, with what's the food and supplementation piece absolutely.
Speaker 1:We'll get into that more in a second. What you were describing with doing everything at the same time, that just makes so much sense, which really it's curious why there isn't more peers of your peers doing things like this other practitioners that are incredible as well, but like that type of standard of care or intensive therapy isn't a norm, like it's the I I just assume you make an appointment hey, I went and saw this person and then they give you a bunch of appointments for weeks and months. But how, what is the frequency of your appointments that, if you're doing everything once, is that days, weeks? What's the typical?
Speaker 2:yeah, so, um, usually when I have someone who's not from ottawa, I'll see that person nine to 13 times in five days. I would like to do that for everybody, but it's funny, the people who live here in Ottawa don't think that they need the appointments back to back. But the methodology behind it is rooted in how do you approach a stroke patient, and a stroke is honestly a much more severe injury than a, than tbi is. So if that approach works great on a stroke case, it should work all the more here. I will say we see the best outcomes when, when, when, we're as aggressive as possible. And when I say when, I think being as aggressive, it's always keeping in mind what can the patient handle? So, so how aggressive I'll be with patient A is not going to be the same with patient B, right?
Speaker 2:I ultimately can't have anybody feel worse at the end of an appointment because all that's saying is that the brain is trying to communicate hey, you're doing too much. I don't like this. I need to create a symptom to make you stop. So in a perfect world I would do that nine appointments over five days. But if I can't, I'm all for that, and I really like doing one to two appointments every five to seven days and in between those appointments I'm giving people tons of exercise, tons in terms of how frequently it's being done. It's not like they're going to be doing an hour of exercise each and every day. It's usually hey, do this exercise, it'll take you 90 seconds, but I need you to do it eight times a day just so we can get small little hits throughout the day, just so we can nudge the neurologic anatomy in the right way.
Speaker 1:That's really cool. The very first thing you mentioned, the first intervention, is nutrition, so let's talk about that. It's favorite topic, of course, and I think I'm going to do a follow-up episode of the podcast just on this, because we could probably talk about that for hours. Absolutely so. We.
Speaker 1:We know nutrition is critical for a healing brain. We just said that and so we have the amino acids, which are protein. We have our fatty acids and specific key nutrients we already mentioned magnesium, but another one being creatine. They're really important for helping recovery and healing in general and obviously from my perspective and yours too you know you eat ice cream, we both. In a world where someone is healthy, having a good relationship with food is important, and so you know I never discourage having hyperpalatable, simple parts. Sometimes that's absolutely necessary, but in this context, having hyperpalatable, ultra processed foods could be harmful to healing. So we briefly spoke about magnesium, but I just want to know, from your perspective, how does nutrition impact compassion, recovery, and obviously for you and your clinical approach is the first step of what happens if you stick that step.
Speaker 2:So all the chemicals that the brain makes and needs all come from protein and fat. None of them come from carbs. When you're looking at basic anatomical life, carbs are not an essential Like protein and fat, right, and you can get carbs for the brain from that. So the biggest thing for us on a brain rehab standpoint is I need to have you as anti-inflammatory, which is going to really come more from the supplement side of things, because the rest of my rules cancel it out. But we also need to have the person's blood sugar as stable as possible. The reason for that is when someone sustains this type of injury, the circulation towards the brain isn't the same all day long. They're going to have periods of time where the blood flow towards the brain is pouring in. They're going to have other periods of time where it's very low. And if you think of that in an analogy of a computer, right, and, and it's power supply, if we're on this podcast and and the power supply to our laptops is turning on and off, we are going to be here forever, we're not going to get a lot done and you and I are going to probably both get extremely upset. So so it's the same story for our nervous system. If the brain isn't being fed well and being fed consistently, without having those peaks and valleys that happen with carbs, someone's going to have symptoms that don't make sense. They're going to be able to go on their computer at 10 am, feel fine, go again at 2, and have a headache and it not make sense. Why is all this happening?
Speaker 2:So I like people to really cut out carbs. Ideally, I'll put them on a keto type of diet Because, again, a keto diet was originally made for for epilepsy. Right, epilepsy is more severe than a concussion. So it's the same idea as as with the interventions based on stress. If I can apply an intervention for epilepsy that works great, it's going to work even more more effective here.
Speaker 2:So essentially I I put them on a diet where there's a dedicated protein source with each, each meal vegetables that are non-starch, have as much as you want, and then for some people, if they're, if they're still able to be active, I want their fats high. But for for most people, I'll hey, use fats as your snack, go for mixed nuts, have avocado, those types of things. The fats are really what's going to keep us full in between those meals, if a person can follow that type of diet. The majority of the time they're going to improve drastically again when I see someone for that for that five day stretch, I only have them on this diet for probably four to six weeks.
Speaker 2:Right, I'll get them to start the diet two weeks before I see them, but one week I do see them and then two weeks afterwards and they're done right, right, everything's fine. They can then go back to how they want it. A lot of patients actually stay with a higher protein and fat diet because they're like whoa the energy I have is great, my brain feels sharp. I'm a fan of this.
Speaker 1:And the one thing I just wanted to clarify, for whoever's listening as well, is you brought up keto for epilepsy and anyone that's heard me talk about nutrition all the time I always say you know, context is king. This is a perfect example of how something that is actually really helpful keto, high protein fat really helpful in this context, but it's not a universal definition. We're not talking about the best fat loss. We're not talking about making weight. We're specifically talking about brain health and we're not demonizing something. But in this context, carbohydrates are necessary and they may be harmful Not that carbs are harmful, but in this context and I appreciate that you're saying that. So I wanted to clarify that this is a perfect example of when you're applying something.
Speaker 2:Yeah, you had just reminded me of a really great, great point. So females and males are not the same when it comes to how our systems work. Males' hormones stay the same each and every day throughout the year. So, guys, I'm sorry you don't need carbs. You'll be fine for your six weeks with no carbs in sight, but on the female side, the menstrual cycle needs those carbs. But on the female side, the menstrual cycle needs those carbs.
Speaker 2:So when I'm working with a female case, I will allow them to have some of those minor, like starchy carbs, but it'll be planned so as an example, they'll still have those same rules a protein source right with every meal as snacks. But at lunch or supper I want to have a little bit of those slower carbs, something as small as like half a cup of chickpeas or a hundred grams of like a, like a really slow digesting carb, just so that we don't get that vast spike. And if we have that at night, those carbs are going to help us with how people to sleep. So let's just keep that in mind, that it's females and males from the nutritional piece, not the same thing.
Speaker 1:I agree fully and I appreciate that you brought that up. I have a follow on that topic. Also, when you're on your menstrual cycle, you are Hold on. Let me preface this Technically, you can do everything right, but you can't necessarily prevent injuries, especially in sports. Sometimes things happen, but you are more susceptible to certain things, especially if you haven't slept, you're eating not well, then you're just a little bit more prone to denatured. But in terms of concussion you are more at risk for a certain part of your when you're on your menstrual cycle, right.
Speaker 2:Yeah, absolutely, yeah, absolutely. So if there was a perfect time for someone to sustain an injury during their cycle, like if you know, hey, I'm going to get a concussion this month, let me pick and Alzheimer's in males sooner, all the time, because males don't have nearly as much. So now, if the best time to have an injury is in that first half, technically the worst time is our second half, but it has a twist the the worst time it is our second half, but it has a twist. Having an injury in when, when estrogen is coming down, will not make your anatomical condition worse. It will make your subjective experience worse. So the level of damage will be the exact same, but you don't have as much of that rebuilding. Uh, call it protective shield that it is a hormone, estrogen to really help you balance that. So injury is the same. You'll just feel dynamically worse and probably take you a little bit more time to balance that.
Speaker 1:Fascinating. Another thing we have to worry about when am I on my period?
Speaker 2:Let me plan my practices.
Speaker 1:Sheesh, yeah, yeah, there's always more, there's always more when, oh, this, this one's going to open up a can of worms, but let's say okay. So I was a coach for high school and for junior levels, but in general a lot of coaches and other professionals that are not necessarily aware of the severity of concussions are really able to do so. The main suggestion is to call 911 or whatever your number of emergency is. Whoever is listening to this, and that's important because we're not first responders, we're not trained medical professionals and especially if someone has a brain bleed, like you don't know, so it's important that they have that checked at the hospital, because obviously that's fatal. That could be a whole other cascade of events.
Speaker 1:But when we were talking about some of the symptoms beforehand, especially if it's like light and sound sensitivity, some of these can really get exasperated when you're in the hospital and then you end up in even more of a worse off situation than you started with, because some of those suggestions you've already told our listeners about what to shift immediately is not necessarily given as a directive. So then you just end up spending 12 hours in the hospital, frustrated, and then you leave to be told to go home and rest. That was me venting, that wasn't a question yet. So you said we know what to do in your setting, in your clinical setting, but what would be your ideal approach to an immediate aid with a possible concussion in our current metaphylisis?
Speaker 2:So in a perfect world a person sustains an impact, we take them out of that sport immediately. We can do a rough baseline test if we want to, but at the end of the day, even if they feel fine, if they just sustained a fairly intense, it's better to err on the side of caution. You say, hey, like that was big, I know you feel fine, but let's just stay safe. Stay safe if they have symptoms, right, you um on the side of the field. That's where that person just needs rest. Just give them quality food, water, rest. I can understand the want to keep that person awake. You don't have to deprive them of sleep. But if it's the middle of the afternoon, keep them awake for just a little bit, just to stay on the absolute side of just staying safe.
Speaker 2:The only time I'm looking at taking someone to to the emergency room is if we're starting to get like those outside the box types of simple, involuntary movement of limbs, those those types of things, uh, fainting right, passing out middle of the conversation and someone out. I'm going to the hospital immediately. But if it's the more year standard, my head hurts, I'm off balance, I'm throwing up, I'm sensitive to light and sound. I'm going home. Right, not me taking myself home, but sending that person home with the care of somebody else. But I think you're exactly right. A lot of times the emergency room environment isn't the best place to be right, and those are critical first couple of hours or possibly days.
Speaker 1:Fair enough. So on the topic of that initial testing, I'm aware of a few and depending on what sport you're in, they usually have their own, but a couple of resources. I think it's Parachute. You can actually download a PDF of the initial concussion assessment of the when you were just describing, like what to ask and when you're trying to recognize the symptoms, to determine the severity. So I'll I'll link that in the show notes. Is there any other resources that you're familiar with, like parachute off the top of your head?
Speaker 2:One that I really like. It doesn't bring the, it doesn't bring the cognitive piece in, but it's called the VOMS V-O-M-S. Okay, that one's great because it's going to assess visual and the vestibular piece, which are usually the two first signs. So I'd be looking at a VOMS test. It's super easy. Anyone can perform it basically anyone awesome.
Speaker 1:I'm gonna check that one out. I don't know if I've seen that one before, but I I love how there is a lot more resources now, because even when we were having, when we were having this conversation, even in the past six years or six years ago it was it was still. It was still different world and there wasn't as many resources. And now that you can find them a bit more, every, every different organization is linking and I love that. There's a lot more data, but it's still hard to find a lot of statistics that are pretty accurate. So I was trying to find just you know, I'm like Rob, my fast, let me use I mean that didn't sound money but I had a challenging time so I just decided I wasn't going to.
Speaker 1:I was trying to find the number of concussions, like worldwide and different categories. But yeah, they were very inconsistent because I recognize that some of them go unreported. Maybe someone isn't describing, like what you were saying earlier an athlete isn't sharing their experience, or it could be in the dead end in terms of a high school or youth recreational program where there's a lack of resources. You know a lot of coaches or parents or just volunteers just trying to have youth play sports. We don't have that capacity or for whatever other reason.
Speaker 1:But what I did find for data is that we can all agree that the collision sports or the contact sports, specifically being American football, soccer, rugby, boxing, basketball and hockey, have the highest prevalence of concussions. But there was still a list of like 20 other sports so like, but for our purposes those are the top five. Well, you and I had an interesting conversation before where you mentioned that a lot of your patients aren't even necessarily athletes. So I'm just curious and obviously we know delusion and combat sports, but what else have you noticed? Has, uh, your patients suffered from concussions?
Speaker 2:just playing normal life, right like most of my. Most of my patients are teachers and nurses. So a ball goes flying at recess, right on a shelf door opens up, you bend down, you forget it's open so you can come back up. Just life things getting out of the car, putting something into the back of the car and the door hitches. So I see a lot of impacts come from just normal things, normal things. So I think it's important to just not so much stay alert, but just be aware that these types of injuries can happen literally everywhere and anywhere.
Speaker 1:Absolutely. That part is essential because we do emphasize obviously we both work with a lot of athletes. We talk about this a lot, but I think people underestimate that you can be at risk for anything just existing. I've had clients that haven't hurt themselves in sport but they were just walking and they just stepped on a curve and broke their ankle and it wasn't in a contact sport, it just you were walking down the street. That feeds into some of the misinformation that some of us may still have about concussions, but there's still a lot of stigma. That's been mentioned and there are more resources for organized sport. But I'm just wondering, as a collective, what advice you have for coaches, parents, guardians to prepare or prevent or support concussion health?
Speaker 2:Yeah, it would mainly be for the athlete to be honest with themselves the entire time and realizing that if I'm honest with myself, I'm going to get to enjoy my sport for a lot longer. Maybe I'll miss a couple of games right now, but I'm going to be able to play for dynamically more years if I take care of this right now. If I try to sweep it under the rug and push through and be tough, it's not going to go well and I'm not going to be the best athlete I possibly can, because with a concussion my processing speed is down. I can't react as fast as my mom does and ultimately, what separates an athlete from someone else is just who can process and interpret information as fast as possible. I think for the parental side coaches, the people that didn't sustain the athlete injury it's better to be cautious than to just throw it to the wind. I'd rather someone maybe goes back to sport a week or two weeks later than they could have than going back to sport or work two weeks sooner than they should have.
Speaker 1:All sad, the tics that honest with oneself is really important because you can't Like. It also hinders your healing because you're not fully committed to it. Yeah, but it's like even if it's not about concussions, just as a collective, just anything to do with wellness. You have to take that self-initiative and then rely and lean on your support network and know that this isn't personal.
Speaker 1:Someone isn't pulling you out because you're not a great athlete, but it's because they care about you and they don't want you to have permanent damage or not be with us because of the sport that's exactly it okay, that one got, and I don't see this adding to copy myself there because, yeah, that's really good, that's really good, it's a big topic and I don't actually need to copy myself there because yeah that's really good.
Speaker 2:That's really good.
Speaker 1:It's a big topic yeah, sometimes it's not serious, but it's also serious because we're super resilient and humans are fascinating. We're so resilient, we're so capable, but we're also super fragile in the grand context of things. So it's like we're not superhuman. We're not. You know, our kryptonite isn't kryptonite, it's just life sometimes.
Speaker 2:So, you know, be good to yourselves, yeah, yeah, and with injuries like this, there's no signs for the external world to really see. There's no task on that that says, hey, I can't play right now, guys, my foot is broken. There's also that external force from people thinking, hey, I look fine, why am I not in the game right now with the rest of the team? I totally understand that. There's a big social component. Social component.
Speaker 1:Social component and I'm so glad you brought that up. The emotional and the mental consequences, like when your personality is shifting or you're getting frustrated or just impact on mental health. Those are all very real consequences that we've improved. We've improved talking about it, but it's still a stigma and we don't necessarily correlate that.
Speaker 1:Someone is experiencing that, like in this case we were talking about gut inflammation, but some of those some I'm opening another can of worms but when we're getting into mental health conversations it's like we don't know if someone had had a brain injury or has an inflamed gut and that they're dealing with something else. But it is an invisible experience but it's still dismissed because, like you said, someone doesn't see a cast or they're not seeing the actual injury. Uh, but anyway, all of that to say that rant, to say that it's valid if you're feeling frustrated and to lean on your support system and to be kind to yourself, because your capacity until you return to base normal is much lower and it's frustrating sometimes to do normal things. Before we wrap up, I'm just wondering. We talked about some of your initial response with concussion care and I know that on the website you have a couple of free downloads, so you have the four ways to faster concussion recovery. Can you please share what that resource is and then any other suggestion you have for our listeners to uh check out?
Speaker 2:yeah. So that um, that pdf that pops up when you go on our website is really a lot of the things we talked about here. It's the dietary factors, it's the fact that you got to be active, but leg right, like this is, the brain needs to increase circulation, but it also needs stimulation of all types in order to bounce back faster, so we can't go and hide in a dark room for extended periods of time. I'm okay with that for the first couple of days, but after day three, day four, let's start having a podcast on having some of the lights on, just so we can feed the brain. Well, because the longer the brain goes without interpreting information, the longer it's going to take for it to get back to the way it was. So the resource there is really just a pretty loose guide on how to just speed things up via diet, activity and lifestyle things, and they're all pretty easy to actually implement tools.
Speaker 1:So I'm sharing in the show notes how they can contact you. There'll be the OPC website if you can check it out in the show notes and honestly this was a wonderful talk and for contacts for anyone listening. Right now I am in Pattaya, thailand, and Isaiah is in Ottawa, canada.
Speaker 1:We are making this work with the time difference and if you're wondering why I'm extra sound, extra weird, it was 6 am my time and and some of this stuff in retrospect, just listening to you talk it, it's like it brought up things for me subconsciously that I wasn't even aware of. So you can probably tell that I'm a little bit like my eyes were twitching, a little bit Like when you were talking about some of the symptoms. It was like bringing up my past experiences. So I wasn't the most like grounded with this conversation, but I really wanted to have it because of personal experience and to share some of the expertise that Isaiah has, and it's an important conversation that really does impact everyone, especially athletes, but everyone, as we talked about, and we don't talk about it enough, and I strongly feel that as adults, we have consent. So if we were choosing to partake in something, at least it's good to be educated on the choices you're making, if you're choosing to play rugby or Muay Thai, like I am in Thailand, like doing it to myself.
Speaker 2:Absolutely. I know Very true, very true.
Speaker 1:Thank you so much for your time, as always. I learned so much and it's just such a fascinating conversation. Is there anything you'd like to leave our listeners with your final golden nuggets?
Speaker 2:uh. Well, first, uh thanks p2 for uh making, making this this uh time time work. I feel like we uncovered a lot of great, great, uh thing. Um, if I could leave the listeners with something, it would honestly be eat great food, be as active as you possibly can it's going to pass right and cut yourself some slack. You don't have to be still doing all the things that you normally would. This will be here for a short period of time, Simple, but so so powerful.
Speaker 1:Thank you so much Of course.
