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March is Brain Injury Awareness Month, and to help direct needed attention to the large number of brain injures that go untreated and undiagnosed, we’ve compiled 7 things you need to know about concussions and why it’s important to seek treatment.
1. A concussion is a type of traumatic brain injury It’s caused by a sudden jolt or impact causing the brain to shift within the skull. A concussion does not require a blow to the head. 2. You should limit screen time after a brain injury The CDC recommends limiting screen time and loud music before bed, sleeping in a dark room, and sticking with a daily routine for sleeping and waking. Ease back into activities that cause eye strain and fatigue. 3. Women and girls are at higher risk for concussions But more research is needed to determine the reason why. A 2018 study in the American Journal of Sports Medicine found female athletes are at nearly twice the risk of experiencing sports-related concussions than male athletes. The study concluded this may be due to biomechanical or hormonal differences, or even the fact that female athletes are just more likely to report their symptoms. 4. Concussion treatment promotes faster recovery One of the myths we often hear about concussions and other brain injuries is that only time can heal them. At Neurohealth Services, we offer an array of neurorehabilitative treatment tools designed to locate and stimulate specific areas of the brain compromised by an injury. Our patients have reported significant relief of concussion symptoms following our specialized treatments. 5. Concussion symptoms are not always obvious or immediately apparent Symptoms of post-concussion syndrome (PCS) can include insomnia, confusion, memory loss, or mood swings. Children may not have the vocabulary to describe their symptoms as well as adults and may report “just not feeling right.” 6. Post-concussion syndrome is often difficult to diagnose Up to 95% of brain scans may appear normal after a concussion, even when specific networks have been compromised. If symptoms persist or become worse, it’s important to seek treatment in order to prevent further delays in recovery. 7. Ask for guidance on when you can safely return to activities Routine activities such as work, school, sports, and driving may cause fatigue when your brain is healing, which can prolong recovery. We recommend gradually returning to these activities and easing back if symptoms return or worsen. If you are still experiencing concussion symptoms that are disrupting your daily routines weeks or months after an accident or injury, please seek treatment with NeuroHealth Services. Our functional neurology team specializes in treating patients who have been unable to find relief elsewhere. Call (317) 848-6000 to schedule an evaluation today. Many of our patients experiencing Post-Concussion Syndrome (PCS) come to us weeks or months after a head injury, when they have been unable to find relief anywhere else. Unfortunately, a number of myths still surround concussion symptoms and treatment that can delay people from seeking help. Following are five common myths about concussions and the facts that can help accelerate recovery.
Myth #1: A concussion requires loss of consciousness In fact, a concussion can happen even when a patient never loses consciousness. Only about 10% of concussions include loss of consciousness (University of Pittsburgh Medical Center). Don’t let a mild injury stop you from seeking treatment if you’re feeling symptoms like headaches, dizziness, irritability, and vision problems. Myth #2: A concussion requires a blow to the head A concussion results from the sudden jarring movement of the brain shifting inside the skull, which can be caused by a jolt or shake as well as blunt force. Whiplash from a car accident can cause a concussion just like a blow to the head. Myth #3: A concussion can be prevented by wearing a helmet Again, because the injury is caused by a jolting of the brain, a helmet won’t necessarily prevent it from happening. According to the CDC, helmets are designed to reduce the risk of a serious brain injury or skull fracture. There is no helmet that is designed to prevent a concussion. Myth #4: You must wake a person every hour after a concussion This myth originated from the outdated belief that falling asleep following a concussion could cause a patient to fall into a coma. We now know to check for symptoms before a patient goes to sleep, ensuring these symptoms are not overlooked. If you’ve suffered a concussion, your healthcare provider probably offered guidance on your treatment. If your injury was severe enough to require monitoring, they may have recommended an overnight hospital stay. Myth #5: Concussion symptoms are apparent immediately following an injury Many patients we see report that they didn’t experience concussion symptoms until days after an incident. Because symptoms can progress gradually after an injury, they might not be instantly debilitating or even apparent. It’s especially important to seek treatment if symptoms worsen or new ones arise. If you’re still experiencing symptoms that disrupt your daily routine days or weeks after an injury, download our post-concussion syndrome (PSC) fact sheet for more information and call (317) 848-6000 to schedule an appointment. As early as 2019, the Mayo Clinic began reporting that people, even those who had experienced relatively mild Covid-19 symptoms, suffered what was called “long Covid” or “post-Covid-19 syndrome.” Researchers noted the onset of vestibular symptoms such as vertigo that hadn’t been present during the initial infection.
In 2020, the Journal of Neurological Sciences published further research identifying Post-Covid 19 Neurological Syndrome (PCNS), noting symptoms such as insomnia, anxiety, depression, dizziness, headaches, fatigue, and even symptoms of Post-Traumatic Stress Disorder (PTSD). They also noted that because the pandemic was still ongoing, it was too early to know the full effects of PCNS. In a 2021 article in The International Journal of Audiology, researchers pointed to reports of vestibular symptoms associated with Covid-19 but noted more research would be necessary to fully understand the scope of these symptoms. So while we don’t have a complete picture of the scope of these occurrences, we do know that therapies proven effective in treating vestibular and neurological symptoms caused by other disorders and injuries can also be effective in treating these symptoms caused by Covid-19. Our team at Neurohealth Services in Indianapolis has treated a number of patients still experiencing neurological and vestibular effects of Covid-19. Because we specialize in treating patients who’ve been unable to find relief elsewhere, we have experience using advanced diagnostic tools to uncover metabolic, immune, and psychological factors that may be hindering recovery. Our neurorehabilitation therapies designed to target specific areas of the brain to stimulate cell repair and regrowth, increase circulation, and reduce inflammation have shown to be effective in patients experiencing PCNS. If you’re experiencing long-term symptoms related to Covid-19 such as dizziness, insomnia, confusion, headaches, fatigue, anxiety, or depression, call us at (317) 848-6000 to learn more about the treatment options that are available. Did you know gut and brain health are connected? Many people are surprised to learn that digestive problems are common after a concussion.
Head trauma activates stress response in the digestive system Trauma to the brain activates a stress function in the gut which can cause changes in appetite, increased gas and bloating, heartburn, acid reflux, food sensitivity, and irritable bowels. These issues can lead to something called intestinal permeability, or leaky gut, which can cause critical delays in the concussion recovery process. Fighting inflammation speeds recovery Avoiding foods that cause inflammation is one way to accelerate concussion recovery. Try to avoid or limit these foods as much as possible:
If you need help with concussion or post-concussion symptoms, please call us at (317) 848-6000 or request a post-concussion fact sheet here. By Brad R. Ralston, D.C., DACNB, FABBIR
One of the most common problems I find in patients who have post-concussion syndrome is hypoglycemia (low blood sugar/low glucose). Low blood sugar is characterized by feeling weak, tired, shaky, angry, or nauseated. Some patients who have those symptoms fail to realize that the cause is low blood sugar and that eating would make them feel better. People have certain habits and tendencies in regards to their eating. People who were skipping meals before a concussion are likely to skip meals after a concussion and not realize the impact that has on their long-term recovery. In addition, because your activity level drops dramatically in the days following a concussion, your normal appetite triggers are not as prevalent. This is why low blood sugar is a problem: Glucose is the fuel that powers your brain, and when you’re not eating enough, your brain isn’t getting the energy it needs to function normally. You need to provide adequate fuel for your brain every day, especially following a concussion. What Happens to the Brain and Body After a Concussion After sustaining a concussion, the body enters a hyperexcitable phase characterized by sensitivity to light and sound and overstimulation of the brain. During this phase, the brain uses all of its stored glucose. To restore glucose reserves, you need to eat regularly and get adequate caloric intake; otherwise, your brain will continue operating on decreased glucose, which interferes with your recovery. So, what can you do to boost your brain’s healing power? We often recommend that patients who have a concussion try to eat an Atkins-style or keto-style (higher-protein, higher-fat, low-carb) diet for a couple of weeks. Fat feeds the brain, and it’s superior to carbohydrates in supplying long-lasting fuel for the brain. After a few weeks on this brain-recharging diet, we can test your fasting glucose levels to see if they’ve stabilized. If they have, you should notice an improvement in your symptoms. If you need help with concussion or post-concussion symptoms, please call us at (317) 848-6000.  If you have been researching how to improve your health, you may have heard of leaky gut, also known as intestinal permeability. If that conjures an unpleasant image of your gut contents leaking into the rest of your body — that’s not too far off the mark. Leaky gut happens when contents from the small intestine spill into the sterile bloodstream through a damaged and “leaky” gut wall. This contamination of the bloodstream by not only partially digested foods but also bacteria, yeast, and other pathogens begins to create a foundation for chronic inflammatory and autoimmune health disorders. Symptoms and disorders linked to leaky gut include fatigue, depression, brain fog, skin problems, joint pain, chronic pain, autoimmune disease, puffiness, anxiety, poor memory, asthma, food allergies and sensitivities, seasonal allergies, fungal infections, migraines, arthritis, PMS, and many more. Basically, your genetic predispositions will determine how leaky gut manifests for you. Leaky gut is referred to as intestinal permeability in the scientific research. It means inflammation has caused the inner lining of the small intestine to become damaged and overly porous. This allows overly large compounds into the small intestine. The immune system recognizes these compounds as hostile invaders that don’t belong in the bloodstream and launches an ongoing attack against them, raising inflammation throughout the body. Also, some of these compounds are very toxic (endotoxins) and take up residence throughout the body, triggering inflammation wherever they go. At the same time, excess intestinal mucous and inflammation from the damage prevents much smaller nutrients from getting into the bloodstream, which can lead to nutrient deficiencies and poor cellular function. Leaky gut is increasingly being recognized as a common underlying factor in most inflammatory symptoms and disorders. Medicine finally recognizes leaky gut Conventional medicine has long ridiculed leaky gut information and protocols as quack science and alternative medicine folklore, but newer research now establishes it as a legitimate mechanism. In fact, pharmaceutical companies are even working on drugs to address leaky gut. Research has established links between leaky gut and many chronic disorders. It’s good this long-known information is finally being validated in the dominant medical paradigm as the gut is the largest immune organ, powerfully influencing the rest of the body, as well as the brain. Current studies link intestinal permeability with inflammatory bowel disorders, gluten sensitivity, celiac disease, Crohn’s disease, type 1 diabetes, depression, psoriasis, and other chronic and autoimmune conditions. Given what we know about the connection between gut health and immunity, it’s vital to include a gut repair protocol in overall treatment of inflammatory and autoimmune disorders. How to mend leaky gut Sometimes, repairing leaky gut can be as simple as removing inflammatory foods from your diet. Other times it’s more complicated. Most importantly, you need to know why you have leaky gut. Either way, however, your diet is foundational. Many cases of leaky gut stem from a standard US diet of processed foods and excess sugars. Food intolerances also contribute significantly, especially a gluten intolerance. A leaky gut diet, also known as an autoimmune diet, has helped many people repair intestinal permeability. Keeping blood sugar balanced is also vital. If blood sugar that gets too low or too high, this promotes leaky gut. Stabilizing blood sugar requires eating regularly enough to avoid energy crashes. You also need to prevent high blood sugar by avoiding too many sugars and carbohydrates. Regular exercise is also vital to stabilizing blood sugar and promoting a healthy gut. Also, failure to eat enough fiber and produce leads to leaky gut by creating a very unhealthy gut microbiome, or gut bacteria. Our intestines (and entire body) depend on a healthy and diverse gut microbiome for proper function. A healthy gut microbiome comes from eating at least 25 grams of fiber a day and a wide and rotating variety of plant foods. Other common things that lead to leaky gut include antibiotics, NSAIDs such as ibuprofen, excess alcohol, hypothyroidism, and autoimmunity. A leaky gut protocol can help you improve your health, relieve symptoms, boost energy, make you happier, and clear your brain fog. Ask my office for advice on improving your well being through a leaky gut diet and protocol. Ask my office for more advice on managing autoimmunity or brain inflammation. Should you have any health questions please call the office at 317-848-6000. 
Although we start life with roughly 100 billion neurons, we start to lose neurons the moment we are born due to the effects of stress, toxins, inflammation, aging, trauma, disease, and other factors. So why can some people’s brains stay sharp and vital into old age? The answer is not in the number of neurons, but in neuroplasticity, the ability of your brain to learn and adapt to change by creating additional links to neighboring neurons. While strength in numbers is good, strength in connectivity is better when it comes to the brain. Each neuron can send out thousands of connections to other neurons. As we age, even though we lose many neurons and the ones we retain become slower, neuroplasticity means cells become better over time at making more connections. The resulting network of connection gives us the ability to complete complex tasks and even be that senior with a sharper mind than a PhD student. However, neuroplasticity depends on two main factors: stimulation and the right chemical environment. For example, a stroke patient who has smoked for 20 years (toxins and low oxygen), never exercises (low oxygen), and eats sweets and fast food every day (blood sugar issues) is going to have a different potential for recovery than someone who has a healthy diet, exercises regularly, and avoids environmental toxins. Their levels of plasticity are very different. One way to gauge your brain's potential for plasticity: Ask if it's easier to learn new facts or skills than it was five years ago. If it's easier, your brain has developed greater plasticity. If it's harder, you have inefficient plasticity. If you are in the second category, don't despair. Given the right tools and environment, your brain can improve its plasticity. How to support your brain's plasticity Our brains are incredibly adaptive, and given the right care — oxygen, fuel, and stimulation, they can stay healthy and sharp well into old age. Anti-inflammatory diet. A diet that supports stable blood sugar and addresses inflammation and food sensitivities is the foundation to restoring and supporting your brain's plasticity and health. Eat plenty of healthy fats. Our brains are composed largely of fats,and we need to eat plenty of healthy fats to support them. Focus on fats such as cold-water fish, olive oil, avocado oil, nuts, and coconut oil. Supplementing with omega 3 fatty acids is a great way to support brain health. Exercise daily. A body that moves has a brain that gets oxygen. Exercise also increases BDNF (brain derived neurotrophic factor), an anti-inflammatory brain chemical that helps eliminate brain fog and improve brain function. Stress reduction. Chronic stress causes a cascade of physiological effects that reduces oxygen and increases brain inflammation. Try these time-tested ways to reduce your daily stress level:
Prioritize sleep. Without adequate sleep, the brain and body experience increased inflammation and cannot function at their best. To improve sleep, adopt these daily habits:
Address food sensitivities. Food reactivity can cause systemic inflammation that leads to brain inflammation and degeneration. Ask your functional medicine practitioner for help in determining your sensitivities. Address hormonal imbalances. When hormones become imbalanced you lose neurotransmitter activity and brain function. PMS, perimenopause, menopause, and low or high estrogen in women as well as low testosterone in men can compromise brain health and function. Simple lab testing can help determine your next steps. Brain Based Exercises: My office specializes in prescribing specific brain based exercises to work on targeted areas of the brain we find to be under activated through our testing. Exercises to improve plasticity in networks of the brain can alleviate symptoms such as Migraine, Dizziness, Post Concussion Syndrome, ADHD and more. If exercises are performed 3-5 times a day for 3-6 months the brain can drastically improve over this short period of time. If you just don't feel like yourself, schedule a neurologic examination with us today! Contact my office for more information on how to improve yours.You can call us at 317-848-6000 or contact Dr. Ralston directly as drralston@neurohealthservices.com.  Obviously with the current pandemic of COVID-19, the novel coronavirus, I have been getting a lot of questions from patients regarding optimizing their immune system. So, we have been working with patients to help them understand their immune response and how to improve immune function so that the host, which is us, is less suitable for the COVID-19 virus. As you read in the paper and heard on the news reports, this is a new virus that mutated from animal species to a human virus and it is a new virus, therefore, our body does not have antibodies to this virus as of yet. The virus appears to be highly contagious and virulent to patients who are predisposed to immunocompromised, diabetes, obesity, inflammation, respiratory disorders, particularly targeting those over 60 years old. But for any patient to prevent illness and any one of us trying to ward off the effects of this virus, improving immune function is as important today as in the future. So, understanding your immune system, you basically have two players at hand with the immune system. We have the innate and the adaptive immune response. The innate immune response is basically the immediate immune response that would respond to a virus. The innate immune response is your stomach barriers, skin tissue, and your eosinophils, basophils, lymphocytes that would immediately come in contact with a potential pathogen such as a virus. The innate immune response can be influenced by anything that would stress your body, physical, chemical, psychological stress can all affect your innate immune response. Therefore, during this stressful time, trying to remain calm, trying to do things that are relaxing such as meditation, yoga, exercise, massage, even chiropractic to remove as much stress as possible. In regard to this virus, getting adequate sleep seems to be a definite important factor, especially for autoimmune patients who when their autoimmunity up regulates, their sleep/wake cycles become disrupted and their anxiety increases. Therefore, adequate sleep is probably paramount. And sadly, to say, when this quarantine happened, there is a lot more time to sit around and drink alcohol, but that is probably not a good strategy, trying to mildly to moderately consume alcohol would be a suggestion. Your adaptive immune system is more of your B and T cells. These are activated when the virus is in your body and the immune system is mounting an immune attack on the virus. Therefore, the role of the adaptive immune system is imperative as well. Some strategies we have been using nutritionally to support our patients, both innate and adaptive immune responses are products such as vitamin C. You have probably heard that vitamin C has been used in Shanghai and it has also been used in New York City intravenously. While vitamin C does not kill the virus, it certainly supports the immune system and decreases the effects of the virus on your system. Therefore, vitamin C seems to be a key influencer of the infection, so we are recommending our patients take vitamin C. You can take 1000 mg up to four times a day to bowel tolerance. Probiotics are also important. Probiotics support your gut barriers, as we talked about with the innate immune system. Taking probiotics is a key influencer of the immune system and, therefore, that is a good thing to add as well. Zinc, making sure your zinc levels are adequate is another important strategy. Optimum levels of Vitamin D are also important. Several studies have shown that low levels of Vitamin D make pt.’s susceptible to Covid. In my practice it is common to find pt.’s with low vitamin D levels especially bc of the long winters we have. Therefore, optimum levels of vitamin D are important now and moving forward. You can easily have your levels checked by your doctor; we are happy to provide this. Most pt.’s need on average 3-5K iu/day of vitamin daily just to maintain their levels through the winter. Specifically, in talking about COVID-19, it seems the pathological process is the cytokine storm that happens in the lung that creates significant breathing problems in patients who contract the virus. There are some studies that show that glutathione, which is an immune system booster, an antioxidant and an intracellular detoxifier downregulate cytokine load in the lung specifically. Therefore, I have been recommending my patients take Trizomal Glutathione, which is a product we carry. In addition, resveratrol, which is an antioxidant, has also been shown to be helpful with the effects of the virus, as well as some other Chinese herbs. Another important aspect in this managing stress. The fear and anxiety of this pandemic has been very high on some pt.’s. This stress response puts your body in fight or fight mode. As a result, cortisol, your stress hormone is increased. Cortisol weakens your immunes system, therefore managing stress is an important part of building your immunes system up. I use adrenal adaptogens to help manage cortisol and stress. Ashwagandha, Rhodiola are just a few of the compounds that I find helpful. If you find yourself really stressed, reach out to a provider for assistance. Therefore, in conclusion, if you should have any further questions about specific supplement strategies, you can feel free to contact my office at (317)848-6000. I think moving forward from this pandemic, one of the benefits may be an awakening of our need to prioritize our health and our immune system to make us as healthy and strong as possible. Monitoring your CBC, monitoring your white blood cell count and the factors of your immune system may be things that prove to be beneficial in the future rather than just looking at acute illness, looking at immune health on an ongoing basis. I hope everybody stays healthy. Sincerely, Brad Ralston  Concussions and Traumatic Brain Injuries (TBIs) are brain injuries that can alter brain functions short and/or long term. Brain injuries such as these are often hard to identify and treat, as structural damages are not normally present in brain imaging (MRI, CT). Despite this lack of visual damage to the brain, patients still often experience symptoms such as headaches, dizziness, confusion, fogginess, nausea, head pressure, memory-loss, and decreased brain function, among many others. For many people, concussions and other brain injuries are mild, and recovery takes only a short amount of time. However, for those who suffer from serious concussions and traumatic brain injuries, full recovery is very hard, if not impossible. The changes to the brain can have devastating and life-changing effects. Because of the complexity of concussions and traumatic brain injuries, recovery can be difficult, requiring highly specialized education and training. Additionally, no two brain injuries are alike, and effects of similar injuries can vary from person to person. In order to maximize potential of recovery, it is important for healthcare providers to identify the areas of decreased function and develop a personalized and strategic plan for each individual patient. Severe and even mild brain injuries can result in consequences to a person's life, impacting family, employment, and day to day social interactions. Without proper rehabilitation, individuals may be left in long-term injured states. However, long-term rehabilitation can help improve brain function and regain independence.  NeuroHealth Services aims to help patients restore and/or enhance brain function and independence using a specialized approach, suited to each individual patient. We utilize the following diagnostic equipment and rehab techniques:
Through in-office diagnostic testing, we identify brain impairments and dysfunction. We then develop a specific and individualized care program addressing any deficiency, carefully measure progress via re-examination, and modify treatment therapy based on patient progress. During intensive therapy, in-office rehabilitation can be complete in as little as one week. Interested in coming in?Visit our website for more information:
www.neurohealthservices.com/become-a-patient.html Or call our office to set up an appointment today at: 317-848-6000  When we think of concussions and brain injuries we tend to associate those with men, after all, they’re the ones playing football and predominantly in combat. But studies show both female athletes and women in general suffer a higher rate of concussions than men. Female brain injuries also tend to be more severe and require longer recovery. In fact, a recent study revealed that when it comes to high school athletes, female soccer players outrank male football players in incidences of traumatic brain injury. Almost 30 percent of injuries sustained by female players are brain injuries, whereas male football players have a much lower rate of brain injury at 24 percent. High school female athletes with concussions also reported more problems with sound and light sensitivity, nausea, dizziness, and drowsiness and took longer to recover. Professional female athletes also have significantly more brain injuries than their male counterparts in every sport except swimming and diving.
Why do women have more concussions? Although researchers don’t have definitive answers, looking at the structure of the female neck and head compared to the male can give us insight. The male neck is much stronger, bigger, and better able to handle acceleration than the female neck. When it comes to bone and neck strength, women are at a disadvantage when it comes to impacts, blows, and falls that affect the head and neck. Female hormones and brain injury Scientists have also found that female hormones appear to play a large role in brain injury risk. Female concussion risk and consequences are largely similar to male before puberty and after menopause. However, during the reproductive years, a woman’s menstrual cycle can affect how badly she is affected by a brain injury. For instance, women injured during the last two weeks of their cycle fare worse from a concussion than those injured during the first two weeks. Severity risk also appears to be tied to fluctuations in hormone levels throughout the cycle. The drops in estrogen during ovulation and menstruation trigger migraines in some women and may be periods of increased risk. Misconceptions around gender and concussions compound the problem. Many people still assume girls and women are at less risk for concussion and their symptoms go unreported simply due to lack of awareness. Pink Concussions is an organization dedicated to raising awareness and promoting research on concussions in women and girls. Functional medicine helps you recover from brain injury and concussion more quickly Functional Neurology excels in the field of brain recovery from concussions. In functional neurology we go beyond telling you to rest. A thorough functional neurology exam can pinpoint specific areas of injury to both the brain and the vestibular (inner ear) system. Different areas of the brain and the vestibular system require different rehabilitation strategies — customizing rehab to your areas of compromise will help you recover and improve faster. Plus, we look at functional medicine mechanisms in supporting your brain health. How is your hormone balance, your diet, and your gut health? Do you have chronic inflammation, food sensitivities, autoimmunity, or other unidentified stressors that could be making it harder for your brain to recover? These are important factors to address. You can call us at 317-848-6000 or contact Dr. Ralston directly as drralston@neurohealthservices.com. We offer a 10min consultation to discuss you condition and options to help. |
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