Facilitated

43| How Neurooptometry Can Ease Anxiety, Boost Reading, And Speed Brain Injury Recovery with Dr. Alex Talaber

• The Facility Denver • Episode 43

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A conversation with neurooptometrist Dr. Alex Talaber of Neurovision Therapy Institute in Denver, Colorado. 

We rethink vision as a brain-driven system that shapes attention, mood, balance and recovery—and show how targeted neurooptometry can relieve “ADHD” symptoms, post-concussion struggles and everyday eye fatigue. Real cases reveal how prisms, therapy and metabolic care unlock faster, lasting change.

• vision as neural processing, not just acuity
• convergence insufficiency as a driver of fatigue and inattention
• how kids mask double vision and avoid near work
• why stronger prescriptions miss root causes
• therapy cadence: short, frequent, gentle progress
• stimulants, pupil dilation and light sensitivity
• metabolic health, triglycerides and retinal clues
• nutrients for retinal resilience: omega-3s, lutein, zeaxanthin, B vitamins
• vision-vestibular coupling and sequencing rehab
• prisms enabling immediate function after stroke
• ditching eye patches to retrain fusion and alignment
• hope, pacing and co-creating realistic goals

CONNECT WITH DR. ALEX TALABER:

Neuro-Vision Therapy Institute - Denver, Cherry Creek Clinic 

FREE Vision Symptoms Quiz: A research-validated tool designed to assess vision-related symptoms and their impact on your daily life. While the quiz cannot provide a diagnosis, your responses will help determine if an evaluation from a Neuro-Optometrist is recommended. [Take The Quiz]

Want to take the next step with functional medicine? Learn more about our new patient process and lab testing at www.thefacilitydenver.com 

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Stay curious, stay proactive, and we’ll catch you next time!

Welcome And Big Idea: Vision As Brain

Mitchell

Welcome to Facilitated, where we bring you real stories, strategies, and science from the world of functional medicine. I'm Dr. Mitchell Rasmussen, a functional medicine practitioner.

Kate

And I'm Kate Daugherty, a certified nutritionist. We are the owners of The Facility, a functional medicine clinic here in Denver, Colorado.

Mitchell

We help people improve their biology and get out of their own way. In my view, our work is about getting to know the person with the condition much more than it's about understanding which condition the person has. As I always say, diagnose the biology, not the disease.

Kate

On this podcast, we break down complex health topics, share real patient cases, anonymized, of course, and explore cutting-edge wellness strategies so you can make informed decisions about your health. Quick heads up before we dive in this podcast is for education and general information only. We're here to share insights, not to diagnose or treat. So if you're dealing with a health issue, chat with a qualified healthcare provider before making any changes. All right, let's get into it.

Meet Dr. Alex Talibur And Her Work

Mitchell

All right, welcome back to the podcast, everybody. This is Mitchell, and today is a conversation I've been looking forward to for quite a while. Uh, if you followed our work for any amount of time, you know we're pretty obsessed with how everything in the body is connected, right? From your brain, your metabolism to your hormones, your gut function, your feelings, your environment, all of it. But one system that, in my opinion, does not get nearly enough love is vision. Not just how well you see an eye chart, right? That was before I met Dr. Alex, that was what I thought was vision, was your visual acuity, that was all it was. But really, what I've learned is how your brain processes what you see and how that ties into attention, coordination, learning, mood, and honestly, even recovery after head injuries. Our guest today is Dr. Alex Talaber. She's a neuro optometrist whose work has completely reframed how I think about vision in the brain. She and her team do some really fascinating work from helping people recover after concussions and brain injuries to improving focus and performance in kids and adults with things like ADHD, which we'll talk about a little bit today. Dr. Taliber is a board-certified neurooptometrist and a fellow of the optometric vision development and rehabilitation association and the American Academy of Optometry. She is an active educator and researcher who has published many research articles in esteemed medical journals. She specializes in diagnosing and treating vision performance conditions, including binocular vision disorders, learning-related vision problems, strobismus, amblyopia, that's a fun word, post-concussion and traumatic brain injury vision syndrome. Dr. Talaber studied at the University of Illinois at Urbana-Champaign, where she graduated with honors. While attending the Illinois College of Optometry, she earned the prestigious ICO Trustee Scholarship all four years, recognizing academic achievement and excellence in community service. Dr. Talaber then went on to earn the Irwin B. Sukhoff Residency in Vision Therapy and Rehabilitation at the State University of New York College of Optometry. She was then appointed as clinical professor at that College of Optometry, SUNY, where she instructed optometry residents in the areas of vision therapy and rehabilitation. She has written multiple published studies, including a study with over 500 grade school students that proved how vision training improves reading proficiency. This study and other related studies were published in the Journal of Child Neurology, Vision Development and Rehabilitation, and Clinical Pediatrics Journals. Dr. Talibur formed the Neurovision Therapy Institute, which is a neurooptometry and vision therapy center located in the Cherry Creek neighborhood of Denver, Colorado, to bring her expertise to the community she lives in and loves. After years of research and clinical experience, Dr. Talaber has developed a creative, evidence-based approach to treating vision conditions that impact her that impact everyday life. Her team includes multiple vision therapists and clinicians, and what I love most is their holistic lens. No pun intended. Yeah, I wrote that. They're looking at the why behind vision challenges, not just handing out stronger prescriptions. And what I find cool is there's so much overlap between their work and what we do in functional medicine, literally rewiring systems, not just managing symptoms. Dr. Talaber is a doctor that we frequently refer people to, and we tend to find that our philosophies blend perfectly for many of the patients we treat. So we end up co-treating patients, uh, and we find that the work is quite complementary to each other. So welcome in.

Dr. Alex Talaber

Thanks so much for having me. It's great to be here.

Mitchell

How'd you feel with that intro?

Dr. Alex Talaber

It's really nice to look back and see where I came from because I'm very much engrossed in the the practice and the complexity of the patients I'm seeing right now. So I really appreciate you reading that out loud. Thank you.

Vision Beyond 20/20: Skills And Processing

Mitchell

Yeah, and kind of remembering like how far you've come. Right. We we tend to focus on like that's one of my struggles, is I spend time thinking about the people that I'm struggling to help instead of remembering all of the people that are getting better. So I hope that that could be a good reflection for you of like, dang, I've done a lot. It's pretty cool. So for those of you who've never heard of this term neurooptometrist, can you just kind of get into what does that actually mean?

Dr. Alex Talaber

Absolutely. So neurooptometrists are vision doctors essentially who diagnose and treat vision issues that stem from the brain or a neurological cause. So we are trained in traditional optometry school, so we learn all about the eyeballs, visual acuity, the glasses, contact lens prescriptions, as you were talk describing, you know, being able to see the 2020 line on the eye chart. Um, but we need extra training to learn more about the visual system because it's actually so complex. It's the relationship between the eyes and the brain and the brain to the eyes. But even 50% of the brain is devoted to vision and visual processing. So I'm 13 years in and I'm still continuing to learn a lot about the brain. There's still a lot that we don't know. But luckily, neuroscience research has helped shape neurooptometry, and we're learning a lot more about neuroanatomy, especially in the last 10 years or so.

Mitchell

So you I remember one time when I first went to see you as a patient, you said to me, Well, normally I don't see these kind of things because I don't have an eye doctor. Because you said I'm not a primary care optometrist, and that made me realize like you have that bag of skills, but it's not really what your expertise is lended to.

Dr. Alex Talaber

Yeah, if I'm being completely honest, if I was just doing the one or the two all day, I probably would have found another career just boring many years ago. Because what I what really keeps me going is being able to help people in a deeper way. And just like you said, what we're looking at is functional vision or it how vision is not functioning and how we can help people on that deeper level. Are they driving? Are they reading? Are they struggling with their academics or their their job and looking way beyond that eye chart? And eye health is really important. You know, what what primary eye care doctors do, whether they're ophthalmologists, optometrists, is so key in in detecting eye diseases. But vision is so much more complex than that, and going deeper is also very important.

Mitchell

So it's not about just slapping on a stronger prescription all the time.

Dr. Alex Talaber

That to me is a red flag. You know, if the prescription's increasing, there is something deeper going on.

Mitchell

Which should be hard.

Dr. Alex Talaber

It shouldn't just be slapping on a stronger prescription.

Mitchell

That's in yeah, that's interesting. That's kind of what blew my mind when I first I remember you we were in the same building when we met our clinics, and you guys, your team came down and sat with us, and I had kind of like a duh moment, like, well, of course, I look at everything as being malleable and teachable and mostly improvable. How did I never figure that this was a thing with vision? And it is so much about the brain more than it is the eyes themselves. Right. Which is so interesting. Absolutely. So can you just talk a little bit about this brain vision connection, maybe a little bit on even how the brain interprets visual information, uh, why these issues often go missed after concussions or trauma?

Dr. Alex Talaber

Absolutely. So I'll break it down into different visual performance skills first. So we talked about acuity, or that's clarity of vision, and we meant typically measure that at distance and near, but then also going deeper in eye focusing. You know, can someone keep things clear throughout the day, or do they have fluctuations in that? So that's looking at more focusing stamina and not just can you read five letters on an eye chart really quick. And then eye teaming, eye alignment that is making sure the eyes are aligning at all distances in all fields of view, and that relates to depth perception. So if someone has normal or close to normal eye alignment, that allows the brain to have proper depth perception and perceive where objects are in space relative to where they are. We uh the third visual performance area is eye tracking. So being able to track objects, particularly this is this is so relevant with reading because that's such a fine-tuned eye tracking task where we're making these little micro saccades or micro jumps along that line of print. Um so any one of those areas can be impacted for a person, particularly in in the instance of concussion. And then a step beyond is visual processing. Okay, so that the first three areas are the intake of visual information, and then now what does the brain do with the visual information? Is it can we visualize, can we picture things that we're reading and seeing even when we're not present with them? Can we recall that? Like, do we have good visual memory skills? Uh let's say you're in a really busy room and you're trying to find your wife. Can you find your person easily, or is it just overwhelming to be able to pick out an object with a busy in a busy environment? So those are just kind of quick examples of visual processing skills. There are more beyond that, but those are kind of the ones that us adults struggle with the most.

Kids, Attention, And Hidden Vision Problems

Mitchell

So, you know, similar to us, when you go to a you know a traditional type of doctor, the uh the initial workup is about you know 15, 20 minutes and some quick laughs. One thing I learned about you is that's a typical eye doctor visit too. But the first time I was in, you kept me for two hours. That's right. You know, and now and is the exam the same all the time, or does it really depend on like who's coming in and what issues they're presenting with?

Dr. Alex Talaber

Exactly. It depends uh because vision develops as we age. So we see kids from we see babies from six months, and then I have patients in their 90s. So the testing is really around what phase of life they're in and what we expect them to be capable of. You know, and what a baby's capable of is different from a toddler, it's different from a seven-year-old. So the test battery does evolve. And luckily, just like labs and blood work, we do have normative data in what's appropriate for these age ranges, which is really cool.

Mitchell

So what what what for children, what are you seeing them for?

Dr. Alex Talaber

Um typically I'll see them for developmental vision issues, and what's really interesting about them is they don't really tell parents or their teachers or their doctors, I have double vision, I have blurry vision, I have headaches. They don't offer those symptoms because they think how they see is how everybody sees it. So we have to look at their behavior. And usually the number one issue or number one behavioral symptom why patients come to see us is inattention. They're having difficulty um with their attention span, with reading, writing, uh, certain academic tasks. There are other reasons kids see us, but I would say that's probably at the top of the list. And um sometimes pa those kids are referred to to me or to our practice. Other times it's the parents kind of have having to dig and understand, well, why is my child not reading? And um yeah, so sometimes those those vision-based symptoms can be um misdiagnosed as having attention issues or ADD, ADHD, but we don't really know if it's vision or attention issues until we actually test vision because if you were seeing double when you were reading, would you really want to read?

Mitchell

Yeah, it's almost as if this should be part of every child before they go to school screening. You know, we do the kindergarten screening, can you pick shapes and can you hear beeps in each ear? But like that's not that's picking up the worst of the worst. You know, and unfortunately, we've got all these children. I mean, I was one of them who is incredibly hyperactive and didn't want to sit still and focus. And I know when you dove in at 37 years old to my issues, it was like you said you've got you know a binocular, yeah, your acuity is amazing, but you can't stay focused on a on a on an object very well. And you would you call it a divergence?

Dr. Alex Talaber

I can absolutely get into it.

Mitchell

Okay, I want I'm I'm curious. I I'm yeah.

Dr. Alex Talaber

Yeah, we um we detected that you are experiencing convergence insufficiency, which is really common. It happens in about 10% of the population, and people with ADD, ADHD are three times more likely to have it. And um also if someone suffered a history, they have a history of concussion, that makes someone more likely to develop it. And really what it is is that the brain is unable to fully pull the eyes inward when someone's looking at a target particularly up close, because that's when we need to converge our eyes the most. And it can make it challenging to attend to that material because the brain is working harder than it should just to maintain clarity, comfort, single vision. And so you kind of want to go to the visual task that's easier, like I'm just gonna go to a distance task or something that's even just a little bit further. Or even people will watch videos over reading because if you're watching videos, you're taking you're getting the information in faster. There's usually an audio component, and you don't have to have this perfectly fine-tuned vision motor system tracking that print.

Convergence Insufficiency Explained

Mitchell

So I might get bored or tired doing these tasks simply because I'm the information is having to be I have to my brain has to work so much harder in order to stabilize to get that information.

Dr. Alex Talaber

It's very fatiguing.

Mitchell

Yeah, I'm like overworking just to hit a baseline to read. Because one of my issues is I'll I will read something and I'll have to read it three times. And I know it's not a comprehension issue. I know it's not like an intelligence issue, I don't think. It's interesting to say, not at all.

Dr. Alex Talaber

It's vision. Which is so interesting. So it it the symptoms of it, it's in for people who are like, do I have that? You know, they tend to be headaches, particularly at the forehead or around the eyes, fluctuations in vision. So you don't have to have double vision to have this because people compensate really well. Their brains learn ways to compensate. It's just it's still not optimal. Right. So the brain finds ways of becoming more comfortable by avoiding certain tasks or by suppressing one eye. So the brain will learn that if it's having a hard time using both eyes together, the brain could suppress one eye. Either frequently or even just occasionally when it needs to. I don't think we detected suppression on you, but it doesn't mean it doesn't happen in your day-to-day sometimes as a mechanism to get by because you've had it for so long. That um, but the beauty of this, of having this, is very curable at any age. Okay. Because of neuroplasticity.

Mitchell

Is this why you've been hounding me to do my vision therapy?

Dr. Alex Talaber

Absolutely.

Mitchell

That's funny.

Dr. Alex Talaber

Everything will get easier for you, particularly near work.

Mitchell

And I've always, you know, I've struggled with anxiety since I was a child. I was dropped, I fell on my head as a young kid. I played football for eight years. Um, some impulsivity, but it's so easy to blame those things on, oh, I was a 20-year-old male, my brain wasn't fully developed. You know, it's it's always easy to like reach to those things because that's what we're familiar with. I literally didn't know that this was a thing until five years ago.

Dr. Alex Talaber

This could be from those head injuries.

Mitchell

You know, and it's we just think, oh, I'm just an anxious person. It's like, well, maybe you're taking in so much information because your eyes can't pull things in very well. Of course you're overstimulated.

Dr. Alex Talaber

And there the thalamus is a part of the brain where there's visual pathways as well as emotional relays. It's a relay center. So we have emotional processing happening there too. So the in the in the research that I've done, I'm suspecting that, you know, when there's vision dysfunction, it can absolutely cause emotional changes and changes in our mood and how we feel. And if we don't feel secure in our vision and in our space, I think that can absolutely heighten anxiety. You know, anxiety is definitely more complex.

Mitchell

But that's a piece.

Dr. Alex Talaber

I do have patients that after vision therapy, their anxiety resolves. That does happen. I love that. It's very cool.

Mitchell

It's how I frame things to say you have, you know, a stress response issue, or you're you're stuck in a sympathetic state, or you have blood sugar dysregulation, or your mitochondria are not working efficiently. I I always say the same thing. It's like this isn't, I'm not saying that this is the cause, but this is certainly not allowing you to have less of this issue. Right. It's it's layers of healing that occur, right? And that's where it's so interesting. It's like there can be this is multifactorial anxiety, ADHD, these there's so many things that can contribute to that. But if you also have these vision issues, it's going to be very difficult to get better.

Dr. Alex Talaber

Absolutely. If you also have blood sugar issues, vision issues are curable. So it's like you're managing ADD, ADHD for life, but you could actually cure the visual component, which could really improve attention and even just organization of your life, especially around near space. It's really impactful.

Mitchell

Yeah, you learn to work with it, and we're not taught that. You know, we're taught you need Adderall, you need stimulants, which I'm so against personally, and I won't do that, but it's just this is like low-hanging fruit that's never given to us in stamina.

Dr. Alex Talaber

On stimulants, so I see a lot of side effects from ADHD medications, pupillary dilation, eye focusing issues, like a we call it accommodative spasms. So even though it's enhancing your brain focusing or your brain attention span, it is a f negatively affecting how the eyes are focusing. And that's medicine.

Mitchell

And then it's another side effect. Get another lens, you know, that's that's medicine.

Dr. Alex Talaber

So and the dilation, so if the pupils are overly dilated, that can really contribute to light sensitivity because the brain is ultimately what controls how much the pupils are constricting, but the eye has to listen to that signal. So if the pupils are dilated, it's letting a lot of light in. So people can be really overstimulated just by the lights.

Mitchell

I'm assuming you I mean you work with a lot of people on ADHD medications, right? So you just you do you inform them, you do the best you can. Right.

Dr. Alex Talaber

You let them know. And usually people are very open-minded to changing. I most of my patients in that in this particular instance that they're happy to hear that because I think deep down they do feel it. You they feel it in their body too, because if their pupils are dilated, their heart rate's probably elevated, other parts of their sympathetic nervous system are stimulated. So I think that they do tend to feel it. But I have some that just don't want to change. Like once in a while, I'll have people that just kind of want to stay on what they're on. But it's as long as I educate, at least I planted a seed for them to think about.

Mitchell

Informed consent, right? It's you know, our clinic's similarity in that a lot of the people who come in to see us are typically more motivated to improve, right? It's easy to go to a regular eye doctor and just get a prescription, but if they're seeking you out, they desire more information. Yeah, absolutely. Right, you know, and that's the same with us. It's like I get highly motivated people that want to work with me because they know something's up, they're tired of being gaslit, told that, oh, you're just a mom now, you're just getting older, and they're like 40 years old, and they're having all these issues, and I refuse to believe that you just break down because you're 40.

Dr. Alex Talaber

Right.

Mitchell

I just had a conversation with a gal last night, she just turned 40 and it was like, Oh, I feel like my back is hurting. It's like, well, you're also you sit all day, you have a lot of inflammation, your blood sugars are all over the place, your menstrual cycle is weird. There's like a PCOS picture, and yeah, I can't I refuse to believe that it's just like a state of existence.

Dr. Alex Talaber

Absolutely.

Mitchell

But what's nice is the people that come to see me typically tell me what else I can do.

Stimulants, Pupil Dilation, And Eye Strain

Dr. Alex Talaber

So you probably getting to the root of why they're feeling those symptoms or the multiple problems that they're experiencing that are causing those symptoms as opposed to just masking it or telling them that it's it's not their fault. You know, if you sit all day, I mean that that's gonna cause some postural issues. So they do need to take ownership over that. Um but on the flip side, people who take really good care of themselves. You know, I have I know people in their 40s who say, This is the belt best I've ever felt in my life. You know, so when you do find those healthy, healthy lifestyle habits and you work with functional medicine like yourself, you can you can feel it even better than when you did in your 20s.

Mitchell

This makes me think of a conversation we had before we started recording a recent referral you sent to us. What did you find in this person's eyes on exam? Um because I'll correlate it to the blood work. This blew my mind when you told me this.

Dr. Alex Talaber

So the blood vessels in the retina are tiny. They're um we when we look in the back of the eye, we can we can get a glimpse of even what the blood vessels might look like in the kidneys, because that's how tiny the blood vessels are. So the eye blood vessels are similar to the kidney blood vessels. Um so there is a connection there. But um, because they're so tiny, a lot of times we'll detect vascular issues very early on because you you can see changes in those little blood vessels easier than when you can see changes in larger blood vessels. So this particular patient had exudates, which is when that basically fatty deposits accumulate and leak out of the retinal blood vessels. And what was interesting, there were no cardiovascular diagnoses, there were no reasons why, you know, sometimes all patients with diabetes or high blood pressure, and um so there was yeah, so I knew there was a lot of complexity and that you know a primary care physician might be able to detect something, but I knew if I referred this patient to you, you would be able to really take care of all of the systemic conditions she might be experiencing. So that's when I saw it, and no, we need more fuller a full body of functional medicine testing to learn more.

Mitchell

And then we measured, you know, we ran a bunch of tests, and her lipids were off the charts. Triglycerides were up in the 400s, you know, LDL cholesterol uh on the initial test, the sample was so lipemic that they couldn't get a clean LDL, so we had to rerun it a few weeks later. Just literally, we couldn't even get a number. It was so high.

Dr. Alex Talaber

Wow.

Mitchell

And seeing massive improvement now. And one thing I told her was I believe that you because you in air quote, your her initial couple visits to you weren't helping. And what I said was after a history, like, well, you know, you a lot of poor lifestyle habits, a lot of lack of exercise, high stress, and then I know we're gonna find some things. I didn't know to this extent, but I said, You're I don't believe that this therapy you're doing will ever work if you don't improve your metabolism. You know, and you talk about that a lot with like mitochondrial function and fatty acid balance. Omega-3 is so important for vision. Absolutely. It was so like astute of you to pick up on a simple exam that led to a lifestyle inventory that I took that completely spoke with one another, but from a completely different perspective. And now I believe as these things that we're working on start to improve, I think the therapy you're doing with her will take off.

Dr. Alex Talaber

Right. And we can't expect um some of these vision vestibular issues are s are complex. We can't expect to feel better after a couple of sessions. Yeah. So and and so it's just also a matter of expectations and neuroplasticity takes time. I wish it was a magic overnight thing. I even wish it was a two-week immersion program, but that's not how the brain works. Right. It that's why our sessions typically are once or once or twice a week with home maintenance and home practice, because it takes time. I would again love an immersion, but if you do an immersion, you have to be diligent at continuing home to make permanent change in the brain. And we have a lot of research on that to show.

Metabolic Health Meets Visual Neuroplasticity

Mitchell

I appreciate that you're so upfront about that. Like, look, I can help you, and I say the same thing. I I believe I can help you, but this is not going to be a one-month thing. This is you've got 45 years of of improper biochemistry and things going on, it's going to take some time. You know, and I I think there's a marriage there between the metabolic health and the vision health, because at the end of the day, what neurons I always say this, they need oxygen, they need stimulation, and they need fuel. So if you're not extra, if you're not moving, if you're staring at a screen all day, if you've got really high blood sugar, so you're insulin resistant, and you're iron deficient because you've got you're on a proton pump inhibitor because you've got heartburn because of other medications and stress and all this, all of a sudden, before you know it, you're on nine medications, you're not getting fuel because you can't digest and absorb. So then you're not getting oxygenation because you have no iron and no B vitamins. You're insulin resistant, so you're not getting the fuel there, and you're not moving. You know, so a lot of what you do is the stimulation and the exercise. But if you're not fueled, yeah, it's a ridiculous barrier there. Yeah, it's crazy for a patient to you know think the vision the therapy didn't work when the body literally doesn't have the fuel it needs.

Dr. Alex Talaber

I usually talk to patients not as I can't talk speak to them as in-depth as you about healthy living uh supplements because they need that testing to to know what exactly they should be taking and also what diet would be ideal for where their body is that in that season. Um but I do, especially with my post-stroke patients, I do uh educate them and give them a framework of what would be the healthiest dinner. And so I walk them through like what would be the best dinner that you could eat right now, and I'm happy to share that with what I tell them. But I um I I try to to because I have to talk so much about vision in my in my consults that I I also sprinkle in some of the lifestyle choices, and you also need to go for walks and exercise, and that will enhance your neuroplasticity. But even in some of my patients who don't live healthy lifestyles, even just when they do the practice and they exercise via vision therapy and they're working on their brain, I I sometimes I'm shocked to see the progress. So it's just everyone's brain and body is different. And but I also think could you optimize it even more? Yes. And and just it could be just a huge synergy between um someone being open to pursuing functional medicine. Um, but I also see people who aren't willing to go down that their, they're they love their Pepsi or their coke, and they bring it into the session, and I'm like, can we talk about sugar? And um, but they still make progress and I still want to make a difference, like even if it's not the best environment, like at least we're doing one thing to help them.

Mitchell

But again, you're informing them like, look, this is a multifactorial issue, but I know I can take care of these pieces for you.

Dr. Alex Talaber

Right.

Mitchell

Yeah, and it's it's layers of healing, right? I I always say, you know, everybody's different, everything's connected. And I used to say, and everything matters, and what I've learned is, but not everything is important right now because at the end of the day, there's a human on the other side of that conversation, and they've got their own hangups, their own restrictions. Just, you know, maybe you have a a parent that you're caretaking for. Maybe you just had the death of a family member, you've got three kids as a single parent. Like I'm trying to get so much better at recognizing I want to meet you where you're at. I want to start to build some habits before I even consider optimizing them. Or else you just get stuck in a I'm I can't do all this, so I'll do nothing. And I think that's on me to educate those people better and to literally meet them where they're at. So that's been growth for me, where it's like, I know I want a million things for you, but like if I ask you to do all those, I'll never see you again. Yeah. So I'm learning.

Dr. Alex Talaber

Yeah, I think it's part of being a somewhat of a perfectionist is like kinda letting go of perfection and just starting them where they are and then taking them to a better place. And it's a it's a co-creation of like, well, what are your goals for them? But also more importantly, what are their goals for themselves? Yes. And helping them realize them because they don't always realize them right away. With my patients, a lot of times they just want to feel better. You know, they come in with debilitating headaches or migraines or 10 out of 10 dizziness, and they just want to feel better. So they don't know what activities they want to return to or what they want to get better at because they just want to feel like they can get out of bed.

Mitchell

That's yeah, it's it's an onion, right? And then if you can help someone's uh eyes focus better and they can they can take on a little bit more, that's when you can really start to introduce more things. You know where you think they should be, but they can't get there week three.

Dr. Alex Talaber

Right.

Mitchell

Yeah. Yeah. I love that. I I appreciate that you recognize the healing is so unique for everyone, and you might know where they want to you want to get them, but you've got to really take it just a bite at a time.

Dr. Alex Talaber

Yeah. And it's a co-creation between you and the patient.

Mitchell

Yeah. Right. It's at the end of the day, they need to want it more than I want it for them.

Dr. Alex Talaber

Right. Um well said.

Mitchell

Well, that's that's awesome. I uh I had a little note here about vision therapy is brain therapy, and I'd love to talk a little bit about how your team helps retrain the visual system. Uh and I w I'd like to focus on ADHD.

Dr. Alex Talaber

Absolutely. So that's a that's a big reason that kids and adults will come and see us. So it's it's I mean we talked a bit about kids coming in and kids with inattention, especially while reading, but I see a lot of adults in their 30s particularly coming in. So I think there's some awareness on social media happening with the connection between ADHD and vision issues, which is great. You know, that's some of the beauty behind social media. Um, but yeah, that I would say that those are kind of the two right now most commonly I see is people in their 30s and people in childhood who are who are concerned, you know, is this ADHD or is this a vision issue getting in the way? They're weighing, is it one or the other, or is it both? And it it can go either direction and it can be both. So we when we detect a binocular vision problem, because usually that's what's happening in the case.

Mitchell

And I'm sorry, by can you what binocular vision?

Vision Therapy Structure And Gentle Progression

Dr. Alex Talaber

The convergence insufficiency is one of the types of binocular vision dysfunction, and that's really how the eyes are working together as a team and maintaining alignment, fusion. So what I mean by fusion is that the brain is taking the right eye image and the left eye image and overlapping it and fusing it in space, and it becomes a reference point and an anchor for where that object is in space relative to where the person is in space. And they can use that to then, okay, now I know where that chair is in the room and where you are sitting. And when we have the proper depth of perception and we're building spatial awareness, our brain's a lot more comfortable. Like our brain can relax because we're our brain is binocular. Um but when people have binocular vision dysfunction, it can really impact how they perform visually as well as just how they feel in their brain and body. Um so the most common type is one we were we were talking about earlier is convergence insufficiency. And the most effective, proven most effective treatment is vision therapy. So another treatment is prism lenses, which can be helpful in alleviating symptoms, but it doesn't create permanent change in how the patient's converging or how their binocular system's functioning without the prism lenses. Um yeah, there's lots of actually placebo-based studies on showing vision therapy is highly successful treatment for convergence and sufficiency.

Mitchell

So you've identified this in somebody. And by the way, you mentioned on social media, I've been trying to tell you for years, it's a beautiful clinic. You have a this awesome team, it's a huge this amazing space. Thank you so much. The world needs to see what you're doing. You're you're you're not letting us see how transformative the work you do is. Every time I go into your clinic, I'm like, man, this space is great. I wish you would show the world. I know you're busy treating. I mean, you have people flying in from all over the world to see you.

Dr. Alex Talaber

Yes.

Mitchell

You know, but it's and it's like selfishly.

Dr. Alex Talaber

I feel like I've been hunkering down and seeing a lot of complex patients, and that's been the the season I'm in. Um, I would love to educate the world in that way. Truthfully, I'm just not trying to add screen time to my life. Okay. So that's the only reason. Um, but I know that others are are are happy to do that type of thing. I just something that we're we've been very word of mouth and um building strong connections with our patients, and we are we we really focus on high quality of care and also maintaining a good, healthy, cohesive team. But I agree with you, I think that's important, just like having a good website with with helpful information so people can find you who you maybe don't even live in Denver, can't walk by and see the see the sign on the door, right?

Mitchell

Yeah.

Dr. Alex Talaber

So I appreciate you uh saying that. And yes.

Mitchell

Someday we'll get you.

Dr. Alex Talaber

Future goals. Yeah. Yeah.

Mitchell

Okay, so you've you've diagnosed these binocular vision disorders. You tell someone that you would like to do a you know a trial of vision therapy. How long are these sessions? Um, could you just give us an idea about like what when this person walks in the door? Like, what kinds of things will they be doing during this vision therapy?

Dr. Alex Talaber

Yeah, absolutely. So there the sessions, like I said, usually are weekly or twice a week. They're 45-minute sessions. Usually there's four or five exercises that they'll complete per session. And then we usually give them about four exercises to do at home. We typically recommend 15 minutes five days a week. So short daily practices are better for the brain in recovering than like 60 minutes on a weekend.

Mitchell

Can't make up.

Dr. Alex Talaber

It's better than nothing, right? But it's but it's just like reminding the brain, okay, this is it's basically a reminder of what we've taught them in the office that week in the session and repeating that. And then it changes the next week.

Mitchell

That's what I was so you progress based on how they're doing. And let's say they come in, oh, I'm more because you work with a ton of uh vestibular issues. So if you get more dizziness or vertigo symptoms, then you read that as okay, something we did was maybe a little too frequent or too intense in the office, so we back down.

Dr. Alex Talaber

That's gotta be an art. One of our strengths is that we um we actually see quite a few patients who can't handle vestibular therapy, which is usually conducted by a physical therapist. The reason for that is because they have underlying vision issues that are causing their dizziness, and it's not a pure vestibular dysfunction. So a lot of the dizzy patients, they have vision vestibular dysfunction, and they don't just have vestibular dysfunction or an inner ear problem. So that when we can work on the visual component in a gentle, comfortable way, because if you work your vision too hard too fast, the nervous system says no.

Mitchell

That makes sense.

Dr. Alex Talaber

I'm gonna go into fight or flight. And so we're my our therapists and my team are really educated in the brain and how we can't go into that state of fight or flight or sympathetic nervous system in a session. But it is our job to get our patients to the next level. So there is a push, but it's a gentle push every week. And then we work on improving their vision over time.

Mitchell

Well, people, you know, we always learn that in school, you know, the vis vestibular is proprioception, you know, from the ground, uh, middle ear and cerebellum and vision. And but for some reason, even how we were taught is like you don't really consider the vision. You just say, Oh, send them to an eye doctor. Like, right? That's what I mean. Like when I met you, it's like, well, duh, like there's vestibular therapists, there's PTs and OTs to help work on the proprioceptive pieces. But like, why did we never focus on this literally the thing that gives us all the input of the outside world?

Vision Vs Vestibular: Treating Both Correctly

Dr. Alex Talaber

We really need to be working together. Yeah. You know, that's the I I really appreciate what OTs and PTs and vestibular therapy does, but it's there are different pieces of the puzzle. And so, really, my message is like, let's work together. And so I will refer patients to vestibular therapy when their vision's ready, but if I think their vision, their binocular vision issue will interfere, if they just dive just into vestibular therapy and they all of a sudden do VOR exercises, which is when they fixate on a target and turn their head back and forth really quickly, their binocular vision system is going to go haywire. They're not going to be able to hold alignment. And that's when patients feel even dizzier, they might have headaches or even new symptoms or they feel off balance. So that's when I see those patients drop out because they said I couldn't handle the vision exercises in my PT program. And so we just need to be working together, and then once their vision's better, they can re-enter vestibular therapy again.

Mitchell

And it's almost, yeah, like a lot of the vestibular therapists still kind of do a little bit of vision stuff, but they don't have the level of diagnostic understanding. They don't have those that fancy thing you had me lay my head on, and all the computer programs you have me do. So I think it's like it's a it's a surface level approach, but what you guys are doing is going so deep into that one system.

Dr. Alex Talaber

Yeah, think of it like a screening approach and um which can red flag an issue, which is great, but then they can't fully I mean that's just part of their licensure. They can't fully assess vision. That's what we're that's what we're specialized in. So I think that again, we need to be working together as a team, and with concussion, the number one system affected by a concussion or a traumatic brain injury is vision first, vestibular second. And oftentimes they have both vision vestibular dysfunction.

Mitchell

You literally have to treat both. Yeah. Yeah, that would yeah. It's funny what we did allegedly in college was we had to do a it was it was more about the vestibular system. We had to do this thing called an impact test at the beginning of every season that we would then retest if we had a head injury. You know what we would do? We would purposely fail. Sandbag it, yeah. We would sandbag it. So in that was sick. Like I know, I know. But that was what that was the culture.

Dr. Alex Talaber

You know, the frontal cortex isn't fully developed. That is like and also the athl the athletes, it's like you always want to play, you push, push, push, you know, until you can't push anymore.

Mitchell

And I had so many orthopedic injuries that I was like, if my head hurts, I'm definitely not sitting out because my leg hasn't worked for the last six months. Like I can hide this, I can still run with this. Yeah, how sad.

Dr. Alex Talaber

What are what's and that's why to you you brought this up with words, but that's why it goes undetected a lot of times, because it's an invisible injury until we test these functional skills, and then we can pick up deficits. And a lot of the testing is objective, so you can't have somebody sandbag this type of t neurooptometrics testing. It's just not possible. You can't fake an eye alignment issue that's just especially in the way that we test multiple multiple different ways throughout the exam.

Mitchell

So interesting. Um so okay, that's great. And I think really the talking to that the neuroplasticity, the metabolic uh health, and kind of how we can marry these two things together. From you mentioned, you know, I always think about you know neurons in these small areas. It's I didn't know that kidney neuron or kidney blood vessels were similar to the retinal blood vessels, but what do diabetics get? They get neuropathy, they get nephropathy, and they get retinopathy because of that oxidative stress, driving insulin resistance, those neurons will continue to take up glucose until they fry out. And we see these individuals with diabetes end up getting neuropathy, but I've just blown away that what you picked up on on that gal was it's kind of weird, kind of gross. But you saw fatty exudates coming into the eye.

Dr. Alex Talaber

Yes, into the retina.

Mitchell

Is that common? I mean, I will say those labs I ran were exceptional, exceptionally poor. So, like, are you picking that up a lot?

Dr. Alex Talaber

I would say it's not common, but not rare.

Mitchell

It was such an astute finding, and you because you said to me, I think there's some lipid issues, and you're an eye doctor, and then I'm like, well, I'll see that. And then, oh hey, Alex, uh, there's some lipid issues here.

Dr. Alex Talaber

Okay, so turns out the eyes, you know, really I think of the eyes are windows to the brain because the eyes contain brain tissue, but really they're also windows to cardiovascular health, as you said, metabolic health. It's not like it's going to be the same as running all the tests that you run, but we could detect we can detect some changes in vasculature when someone's health is not in a in an ideal place.

Mitchell

I wish because we've talked about collaboration. I mean, we're we're about what 15 miles apart now, our clinic, so it's not super convenient, but it'd be so interesting to do basic labs, blood sugar, lipids on all of your clients and just start to create like our own study of like what are you seeing show up on the vision exam? I'm just thinking out loud. I love that. Yeah.

Dr. Alex Talaber

Yeah, we're about to get a retinal camera, so that makes documentation even easier of those blood vessels.

Mitchell

And track change over time.

Dr. Alex Talaber

Right.

Mitchell

Um, how are you seeing things like nutritional deficiencies or energy dysregulation show up visually?

Retinal Clues To Lipids And Systemic Health

Dr. Alex Talaber

Well, it's definitely something that comes to mind when patients are compensating for a vision issue. So if they're running around and their their eyes are not working together, they have tracking issues, we know that they're compensating. So automatically that causes brain fatigue as well as visual fatigue or eye fatigue. Some people will call it eye fatigue, some people will call it fatigue. So I'm I'm thinking what nutritional deficits are contributing to it because there are their batteries already draining faster than it should. So are do they have any vitamin B deficiencies? That's of course the the first one I think of because vitamin B is so important for neuronal health, especially optic nerve health. And the the retina is so highly metabolic because it's constantly bombarded with light all day long, all waking hours, and that the retina has to process that light. And so that's why we need a lot of blood flow and mitochondrial density in those areas so that we can quickly rapidly remove oxidation and free radicals and things like that. So um, I I do look for pigmentation in the macula. So when pigment starts to break up, that can be an early sign of macular degeneration. And antioxidants that are really important for macular health are lutein and Z exanthin. And when people supplement or they're eating an insane amount of dark leafy grains every day, um, they can build up their macular pigment again, which will help mitigate the development of free radicals coming in from all of this light that we're bombarded with.

Mitchell

That's so interesting because that was literally my next question was on changing this narrative when pu so many people are told that there's nothing you can do. And obviously, I challenge that notion. If you've got a beating heart in your chest and air in your lungs, things are going okay in the grand scheme of things. So I believe that. But it's that literally, that's funny. That was my next question was how can we change that narrative? And that's what you described is like, well, I see your macula getting healthy when you get healthy.

Dr. Alex Talaber

Yeah, you can actually, there's devices that measure macular pigment density now. And so I just try to put when I see any early changes or a lack of pigment, you know, I'll put them on a supplement or I'll at least educate them that you need to be getting these nutrients because I'm seeing a lack of pigment there, and that could affect you in the future. Um, especially if they have a family history of macular degeneration.

Mitchell

Which I do. And it's a horrible way to go blind. My grandpa, you know, getting those injections, he had wet macular degeneration, getting those injections through his eye, and it was like not really because by that point it was, you know, disease state.

Dr. Alex Talaber

I know. And so sad. My hope is that it slows progression, um, but it doesn't cure or treat it. And hopefully, you know, I'm really hopeful that neuroregenerative medicine uh advances a lot in the coming decades so that people with optic nerve diseases, macular d d diseases, we can actually somehow build new neuronal pathways in a quicker, easier way. Yeah. But right now, those tissues are really sensitive to damage.

Mitchell

So what is uh I'd love to hear like a recent case, something that you're excited about right now?

Dr. Alex Talaber

A lot. Okay, so I thought about this, just just what kind of waves of patience come through every month or every season for me, because I definitely find that I don't have you experienced this where you have a wave of a specific patient type happen. Yeah, we laugh about it. Yeah, like okay. It's a thing, right?

Mitchell

Yeah, today is yeah, this week is fatty liver week. Yeah. Wow.

Dr. Alex Talaber

Okay, so great. I want to hear more about what waves you've been experiencing lately. Um Lately for me, it's been cranial nerve palsies and stroke patients. So those are the cases that are at the top of my mind. Um, I saw a patient with a bilateral thalmic stroke, only 40 years old. And um very this is very rare type of stroke. Um, it's from a heart condition. Uh, that's where the clocks clot stemmed from, and was in an induced coma for 12 weeks. And our healthcare system wasn't able to get him any therapies or rehabilitation. He's on a wait list currently. So um his wife did a tremendous amount of research and found our office and I evaluated him recently, and um what the stroke the stroke has caused him to have visual processing issues, he finds that he feels disconnected from the world. Like what he's seeing doesn't feel like what's actually happening, and he has this kind of disassociation symptom. And then he also cannot move his eyes down at all. So he's able to track his eyes up, to the left, to the right, but he has no ability to move the eyes down.

Mitchell

So you'll trip a lot more. They'll blame the stroke when it's like, well, yeah, that might have led to the vision thing, but that's a and that's a trainable thing for a man like him.

Nutrients, Macular Pigment, And Light Stress

Dr. Alex Talaber

So this is where I did a three-hour evaluation on him because that that's the amount of testing that most of my stroke patients need. And um so no ability to look down in the beginning of the exam. And then we just trial lenses based on, so I'm doing all this testing, and then I come up with different prescription types to see how his posture shifts, how his eye alignment changes, because he also has an eye alignment issue on top of that. So um he's nearsighted like so many of us. So he I put his nearsighted correction up, which cleared everything. Um, he's kind of got some blur, but mostly 2020 in each eye for the most part. So that's good, that's a good thing. Visual fields are normal. That's also a good thing because most of my stroke patients have visual field loss on top of other visual deficits. Um I put a prism. Um, this specific type of prisms called yoked prism, where it shifts the image up. And it the reason the rationale behind why I picked that orientation of prism is because his posture was shifted forward, and I also wanted to see if it could help him engage with his lower field and track better in lower field. So just by shifting his spatial world up slightly, he tracked the target all the way down. And I, because it was such a shocking change from the beginning of the exam, I took a video of it. So I have a before and then during the trialing of these prism lenses. So prisms can be just such an amazing powerful tool when they're prescribed in the right way. And um, I've been doing a lot of thinking since this happened because that not everyone responds beautifully to Prism. So some people do, some people don't. But I've been thinking about his brain and how he just uh unlocked something that he was impossible to do before. So the my best explanation so far is that the prism shifted his spatial world and it improved his brain's ability to have neuromotor control. But in order for that to become permanent, he'll need vision therapy to reinforce it. So it was what a huge success in that moment of telling you can move your eyes down. So will you this is possible for you.

Mitchell

Will you wear the prisms during therapy then?

Dr. Alex Talaber

Yes, yeah, okay. He'll wear them at first full time because we want him to be able to look down. And his posture was so much better. Even in the world.

Mitchell

Because he didn't have to slouch so much because he could see.

Dr. Alex Talaber

Exactly. And even in the video, his face I can show I'll show you the videos. His face muscles relaxed. You can just see just little micro musculature released tension. And I'm still sort of reeling after that that trial frame, just how six I was thinking about it every night since then, how successful that was. Um I made jokes that I should just retire now.

Mitchell

You hit the peak.

Dr. Alex Talaber

But um, so that's really low standout one that I've had recently. Um, so uh I have a lot of cranial nerve palsy patients come in. So there are three cranial nerves that run from the brainstem that innervate the six muscles that surround each eye. And someone can have a very, very, very micro stroke and it can cause a very significant problem to one of these cranial nerves. And a patient basically becomes paralyzed in one field of view and can't move their eyes in a certain direction. And it's extremely debilitating because it causes causes sudden onset, severe double vision. On top of maybe any other symptoms they're experiencing from this micro stroke. So the typical course of treatment is as soon as they uh notice the change, they need to go to the ER because we need to image them. We need to treat that stroke urgently. If it's ischemic, make sure they're getting better blood flow to the brain. If it's hemorrhagic, if they're treating that, usually these are ischemic in nature, or they can be due to a traumatic brain injury. But lately, mine have been the patients I've been seeing, it's ischemic, it's this profile male in their 60s. Um, my dad had one last year. So, and he had no prior medical conditions. So, this can even just kind of happen out of the blue. Um so what's been very rewarding is the amount of tears that some of these 60-year-old men show when they know that they're gonna recover and feel better and that they're not going to have permanent double vision. And so the hard thing for me is that other in other eye care providers will just tell patients like this to wear a patch. And if you wear a patch, you know, it doesn't typically result in full healing. It could. You maybe in some the the blood flow returns, the it re the eye relearn the brain eye connection relearns how to move the eye to the left again. But if you just cover the eye, you're losing input. I was just gonna say that you're getting less from the environment, the brain shrinks. So if the if you have an eye turn in from this palsy, it's it's not it's not getting any engagement from the brain. So I have a much more aggressive treatment. And my the success of this is really dependent on how soon I can treat them. The ones that I treat a year later tend to be in prism for life, but because it wasn't treated properly in the acute phase. So if I can see them sooner, we get them into prism. We remove the patch. No, there's no patching, there's no covering an eye. Um worst case scenario, if they if they need to cover an eye in a moment, like if they're walking and they just can't handle it, we'll put an occlusive tape over one lens or in a sector of the lens that's still it's transparent, it still lets light in, but it blurs the image. And that's healthier than just occlusion.

Mitchell

Yeah, yeah. It's like yeah, that's like the same thing as like you don't have to change anything, just take a statin. You know, like that yeah, put an iPad like that.

Stroke, Prisms, And Rapid Functional Wins

Dr. Alex Talaber

It's almost like they just don't have time for the patient. So they're just like, oh, you have double vision, just cover one eye. Okay. So what we do is is get them into prism lenses so that they can fuse again. So the prism does move the image to where the eye is aligning, but I typically undercorrect it so that their brain starts to learn to fuse fuse again. And then in therapy, we progressively work on range of motion, yeah, fusion, fusional exercises or 3D exercises to get their brain remembering, okay, this is how to align the eyes again. And when they are fusing, they're aligning their eyes. So their sensory fusion vision is a sensory motor system, so we sense light and then our brain tells our eyes how to move. That's the motor part. So that's really important an important piece of the puzzle, too. And so I've had as quick of a recovery as three weeks, and that also in conjunction with health. So they need to be working, they need to eat clean. Like they cannot mess around with their diet anymore. And usually when they have sudden onset double vision like this, they're they're like, I will listen, I will do anything you tell me to do.

Mitchell

Pain is the ultimate motivator.

Dr. Alex Talaber

My dad said when he had it, he said, uh if you tell me to eat a squirrel, I'll eat a squirrel.

Mitchell

I and I remember when you went through that. I I appreciate you sharing that. I mean, how powerful that you got to show up for him in the way that you best know how to serve the world. Like how how awesome that he had you and that you got to show your dad what you're capable of.

Dr. Alex Talaber

And this is how common this problem is, though. One of our staff members' fathers had it this summer. So I was able to treat him right away. And he had a much more severe, he had cranial nerve three palsy, which is harder to treat, and he had he's had a full rec full recovery, full range of motion, no double vision. It's just been really amazing to see the difference in approach. And a lot of textbooks will say, you know, if you just wait and see, it'll resolve in six months. But wouldn't you just want to work on it anyway? And so what what I'm seeing is just more complete recovery and much faster recovery. So for example, my dad had to stop driving. You can't drive with double vision, and so he couldn't drive, he couldn't work. So luckily, that three-week turnaround was very important for him and his quality of life. And so many of my patients feel that way. And so I just saw another patient with two patients this month. One was actually from shingles, so you can get them also from infectious etiologies.

Mitchell

It's funny how much my circle includes individuals who have a hope for healing. You know, my fiance runs a rehab hospital, and she's an occupational therapist by training, did that for I think 10 years or so, and then now she, you know, actually is this badass CEO of a rehab hospital, and it's like her entire message is I get it, they say you know, you might get better over time, but they do I think 18 hours a week when you come to their hospital of OT and PT, because the same thing is the more you do early on, the more recovery you can have. And it's funny as you're talking about that, I'm thinking back to her and her whole philosophy and message and like giving these individuals who just had a stroke or a car accident or ski accident who leave the hospital and instead of just sending them home to slowly maybe get better or maybe rot and lose their joy and lose their hobbies and their purpose in life to do rehab. You know, it's just funny as you're talking. I'm like, God, everyone in my life has this motivation of improvement. It's like it's it's contagious for me to be around. So I'm incredibly grateful.

Dr. Alex Talaber

You're definitely attracting it. Well, she's a rock star. I mean, to help people in that way. There's I feel like they're they're just amazing to get people's lives back on track after something so debilitating. And um, yeah, I treat a lot of stroke patients as well, and so I see the they need. OTPT speech cognitive in addition to vision.

Mitchell

Respiratory therapy. I mean, there's yeah, I love that. I uh looking at the time, this is probably the longest podcast we've ever done. Um I'm honored. Yeah, I I think what your what your work shows, and I think what we try to show in our work is that healing is often about giving the body and brain permission to reconnect, right? Vision is one of the most powerful access points for the brain. And that's what I loved about this conversation. I mean, whether we're talking about your hormones or your brain or your vision, it's kind of the same philosophy, right? The but the body is designed to adapt and heal if given the right inputs, right? Too much bad, not enough good. That's the simplistic way that I look at health is too much bad going in. You know, I always say it's people say the dose isn't the poison of things, right? There's you know, a lot of these Instagram people are mocking the idea of toxins. And I say, well, it's a little bit of heavy metals, it's a little bit of forever chemicals, it's a little bit of mold, it's a little bit of vitamin B12 deficiency, it's a little bit of stress, it's a little bit of lack of purpose and connection, it's a little bit of gut dysbiosis, and then before you know it, there's not really a diagnosis for that in medicine because you're just a little bit shitty feeling.

Dr. Alex Talaber

Wow.

Mitchell

And my whole message is like it's too much bad, not enough good. And it seems exactly like what you do is like let's feed more good to the system through therapy, through helping the patient understand you can get better. I mean, what you did for that guy, showing him he could look down. You have a patient for life because they know they can heal, and that's one of the most powerful things is hope. I joke, I'm a hope dealer. You know, if we leave your first visit and you feel a little bit of hope, we're good. We're good. I don't know how much better you'll get, but you will get better.

Dr. Alex Talaber

Is you you're creating physiological changes when you have even just a smidge of hope because that will grow in the body. Oh well, I want to share some gratitude gratitude towards you and and what you and Kate do and helping people in just such a deep and meaningful way. I'm so comforted to know that I can send patients your way and I know they're just taken care of so thoroughly and well. So just thank you so much for that.

Mitchell

Wow. I appreciate that. That feels amazing. You know, the the sin the the self-conscious person in me wants to come up with some excuse, like, oh, it's not that much, but no, I'll take that. I appreciate that. And yeah, thank you for the work you do. And I I really appreciate it. You're so busy. You've got a little k little daughter at home, and you're taking time on your Friday outside of the clinic to come uh share this message with us. And I'm excited for people to hear it. And just another example of if you're not where you think you should be, find someone who will take your your needs serious and give you a plan forward. And you you do exactly that. So thank you.

Dr. Alex Talaber

Thank you so much. Happy to be here.

Mitchell

All right, thanks for listening, everybody. If uh if this resonated with you, share it with someone who needs to hear that. Um, and also check out, we'll put uh your Neurovision clinic in our show notes. They're amazing, everybody. I trust them so implicitly. So if you've got any concerns about your balance, your vision, your brain function, your attention, seek them out. At least get an opinion and see what possibly we could do to you know take some pressure off your brain so that you can get better.

Kate

For more about what we do at the facility, check out our website, www.thefacilitydenver.com. You can also follow us on Instagram at the facility Denver for extra tips, behind the scenes fun, and updates on new episodes. Thanks for listening now. Go facilitate your own health, and we'll see you next time.