TBI Healing Modalities and Treatments

Western Approach to Healthcare

We often seek medical assistance for that set of symptoms distressing us most in the current moment. Have a cold? Take cough syrup. High blood pressure? Have a pill.

The focus of western medicine is emergency triage – detect, treat the obvious and discharge. A patient is frequently sent to various specialists for each unique symptom, system or health issue. Generally, these various practitioners are not communicating directly with one another when coordinating their care.

Your body is a connected system!

Oftentimes, this disjointed approach to a single person’s care causes unintended side effects and may not address the underlying root cause delaying a return to health. Everything in our body is connected. You cannot treat one symptom without considering the impact upon the whole.

The mind, body and soul exist in a delicate balance that must be aligned. I’ve come to embrace Eastern philosophies of Traditional Chinese Medicine (TCM) as a key partner to the western approach as part of my healing.

This is not to say I discount western medical approach. Quite the contrary! I strongly believe it has a place. I just as strongly believe in the philosophy pursuing a life of wellness, the fundamental cornerstone of TCM.

Pursue a life of wellness

I heard a story early in my recovery that I cannot find now. It went a little like this:

A man suffering numerous ailments approached an elderly Chinese Medicine Man. His back hurts, he carries too much weight, has high blood pressure. This man works too hard, and his family didn’t understand him, mostly because he never spends time with them since he’s at work. The Medicine man did not poke or prod. He quietly observed and listened.

When the man had completed recanting his list of complaints and concerns, the Medicine Man stated “I am going to give you homework.”

He quietly packaged up some herbs and said “Take this and make tea each morning and night. Sip the tea in silence facing the rising or setting sun. Breathe deeply.”

The Medicine Man continued, “When you eat, dine with your family. Eat only that which grows from the earth and is prepared with your family.”

“When you feel you need to work harder, get up and work your legs. Go for a walk.”

The suffering man proclaimed “I don’t understand! I thought you were supposed to heal me.”

The Medicine Man answered, “You heal yourself. I just give you the direction.”

Always Seek Emergency Medical Treatment

Always treat the immediate and emergency physical needs first. Ensure you have an appropriate a set of doctors experienced in brain injury, rehabilitation and recovery. This may include your family doctor, neurologist, neurosurgeon, among others. Not all doctors are created equal and we are all human. All TBI cases are unique and the science is changing every day. I personally received outdated, yet common medically accepted advice both initially in my concussion recovery and again at one-year in. I chose to seek a second opinion and a third at times! Keep trying new things and don’t be quick to give up.

The Right Mix of Therapies in the Right Quantity

Listen to your body. I cannot emphasize this enough. This is really hard for a TBI survivor whose thought processing is quite muddied. Well into my recovery, I was asked why I didn’t have a case worker assigned. If it had been mentioned to me before, I’d forgotten. I have six months of very limited memory. A social or case worker can help you connect with the right associations and medical practitioners during your recovery.

There are an increasing number of facilities and rehabilitation clinics across the globe to assist with more complex cases. Recovery is a delicate balance of the right mix of modalities, in the right quantity at the right time. In addition to traditional medical practitioners, your care team and therapies may include some or all of the following:

1. Chiropractic care. Many head injuries are accompanied by neck injuries. The proper alignment of the neck and spine is critical to assist managing and treating chronic headaches. Try to find one who is trained in concussion management and neck injuries!

2. Physiotherapy. Physiotherapy can support realignment efforts of a chiropractor by assisting with muscle manipulation and outlining exercises and an exercise plan. This may be in tandem with a chiropractor and a personal trainer.

3. Personal training and a managed exercise plan. Some of the worst advice I was given, even months into my recovery, was continual do nothing. Immediately post-concussion, your brain needs rest. An increasing body of evidence suggests a gradual return to activity is recommended for faster healing. Return to activity does NOT necessarily mean the same activities one pursued pre-concussion. The best approach includes following an exercise plan directed by and overseen by your care team to monitor for adjustments including periodic rest as needed.

4. Massage. In the early days of a concussion, massage is contraindicative. This means avoid it! I found this out the hard way. In the early days the stimulation of massage can contribute to pressure headaches and dizziness. Work with your chiropractor, physiotherapist and doctor on when to introduce massage safely. Massage therapy was instrumental in my recovery.

5. Osteopathy. This area of manual therapy focuses on the relationship between the structure and function of the human body in a holistic approach to healthcare. Depending on where in the world you reside, your osteopath may be a medical doctor or a specially trained therapist. Techniques include stretching, gentle pressure and resistance.

6. Cranial sacral therapy. This therapy is often practiced by one of a chiropractor, osteopath or massage therapist. A light touch is used to affect the pressure and circulation of the cerebrospinal fluid. This fluid moves with a gentle pumping motion from your brain through the spine and may be impinged or compressed due to injury.

7. Occupational therapy. These therapists can help acquired brain injury survivors carry out daily activities by helping develop or adjust skills.

8. Speech therapy. Some TBI survivors incur speech challenges triggered by ataxia (loss of coordination of voluntary movements). Therapists can use techniques to build social communication skills including memory activities, breathing exercises, swallowing and mouth exercises.

9. Vision therapy (more on this in a later chapter including exercises). TBI or concussion can cause numerous vision challenges. Treatment for vestibular can be contraindicative with other conditions. This topic is near and dear to my heart. I recommend looking for a practitioner (i.e. optometrist) with the letters FCOVD after his or her name. You can have twenty-twenty vision, and still have an impairment. Other practitioners here include neuro-ophthalmologists.

10. Endocrinologist and hormone replacement therapy (more on this to come in a later chapter). A concussion or brain injury can impact your body’s hormones significantly. An endocrinologist can request a full blood panel (or series of) to uncover impacts. This is not restricted to women.

11. Counseling (see also chapter 2, part 2). Brain injury can have significant mental and emotional impacts. There are various forms of therapy available to address.

12. Dentist, Orthodontist. Depending on how a person incurred their injury, he or she may be suffering from TMJ or have shifting in their jaw and teeth. This often is overlooked.

Mix it up! Try different things!

Not all brain injuries are equal. Not all treatments or therapies work for all people. Emerging evidence and new information is coming out daily on brain injury and recovery. No one person can be expected to be on top of it all.

There is a very new area of science and study emerging on neuro-plasticity. The brain is a miraculous and wonderful part of the connected whole of the body. Science to this day does not know fully how it works. There is always hope and room for improvement. Some new therapies to explore may include expanded approaches identified in the prior list in addition to some of the following:

1. Hyperbaric oxygen therapy. Well known in the scuba diving world, this is an known treatment for decompression sickness and involves placing the patient in a chamber with oxygen at a higher pressure than atmospheric sea level. Recent studies have shown that an infusion of oxygen can help heal injured parts of the brain, even years after injury.

2. Acupuncture. In simply western-medicine speak, needles inserted at acupuncture points are believed to stimulate the central nervous system. Traditional Chinese acupuncture studies the flow of energy or Qi in the body and identifies and stimulates stagnant Qi.

3. EFT or Tapping. This involves tapping specific points on the head and face, in a specific sequence. There is a growing body of evidence surrounding neuroplasticity and the remarkable ability of the brain to rebuild neural connections. A little anecdotal at this time, there is a thought that head tapping can stimulate these connections spanning the two hemispheres of the brain.

4. Energy healing (BodyTalk, Reiki). Energy healing is based on the concept that we all have a "life force energy" flowing in our bodies and that energy surrounds it. Reiki and BodyTalk practitioners assist encouraging a healthy flow of energy.

5. Floating or Sensory Deprivation Tanks. Floating is a relaxing experience where a person immerses themselves in a pod of body temperature water mixed with Epsom salts. This therapy may help with stress, anxiety, depression and chronic pain conditions such as arthritis.

6. Meditation, Yoga and other mindfulness practices such as Qi Gong or Tai Chi (see also chapter 2, part 2). Accepting the changed and new you is an important part of the recovery process. Meditation can assist with calming the mind. Yoga can further assist with this mindfulness approach to recovery and assist with balance.

Where do I begin?

There is no magic bullet or formula. Listen to your body as you improve and be prepared to increase, decrease, adjust your therapies as you proceed. Refer to the “10 minute cheat sheet” at the beginning of this book for a good starting point!

What Helps Me

I tried almost all of the therapies listed above. Not all worked for me. I was fortunate to get a great circle of care providers. These care providers were willing to embrace different ideas and consult with one another periodically on my case even though they were across clinics and even cities. There were some not so great practitioners in there for my situation. If it isn’t working for you, be prepared to move on to someone new. Recognize that recovery takes time. I successfully worked with the following practitioners or modalities, in almost this order, over a two-year period.

• Immediate and early medical (hospital) care, CT scans, X-rays, MRI

• Chiropractor (on-going to this day)

• Osteopathy (approximately 1 year)

• Massage (on-going to this day)

• Bodytalk (several sessions)

• Meditation, Daily Affirmations (on-going to this day)

• Yoga (on-going to this day)

• Qi Gong (a few months)

• Physiotherapy (approximately 3 years)

• Personal training / trainer working closely with physiotherapist (approximately 1.5 years)

• Exercise (six years of 3-4 times a week swimming until pool closures in a pandemic, exercise continues)

• Endocrinologist assessment

• Vision therapy (more to follow in a later chapter - 20 months)

• Neurosurgeon specializing in concussion

My journey isn’t over and that I will always be a work in progress. There are times when I get caught up in daily life and post concussive symptoms return. That is when I know my body is signaling me to return to the basics.

Tips and Tricks

1. Treat your recovery as your Full Time job! This is hard work.

2. Continue regular medical check-ins with your primary care provider.

3. Get an advocate if you don’t have one.

4. Try all therapies that are recommended. Not working? Explore others!

5. Interview your prospective care providers. This is your health. It is fine to ask about their experience with your type of injury.

6. Bring in your list of questions and take notes at appointments.

7. Ask to record medical appointments if needed.

8. Exercise as you can (always get medical approval)

9. Meditate for calm.

10. Try Qi Gong or yoga to help balance and calm

Chapter Assignment – Mindfulness, Balance, and Tapping

Continue your work from the last chapter:

1. Have a morning positivity practice in place (series of daily affirmations)

2. Have an evening wind down and gratitude practice in place.

3. Journal daily.

Start new:

4. Use journal to track your appointments and treatments. Write down how you felt both during and after your treatments. You can bring this to your appointments with you!

5. Have you started a brain binder to track all your notes? If not, this is the time! You may need this for back to work planning, insurance or legal purposes.

6. Begin exercise at home (consult your doctors!)

Some Practices You Can Try at Home

1. Meditation.

Each morning as part of your routine, sit quietly in a chair. Feet on floor, hands on knees, palms facing upward. Gently breathe in and imagine your breath spreading through your body. Imagine it spilling out the top of your head and cascading over your body in a waterfall as you exhale. Try to sit in silence focusing on nothing but this sensation for 10 minutes.

2. EFT tapping (head).

Sitting quietly place your left hand across the back of the head spanning the two hemispheres. Tap lightly three times with the right hand while inhaling deeply, then tap your chest with the same hand while you exhale. Repeat moving your right hand slightly forward until you reach your forehead (three or four times). Once complete that cycle, advance your left hand a couple inches forward and repeat the cycle approximately two more times. Once complete you can switch hands to place your right hand spanning the two hemispheres and tap with your left.

3. Yoga.

Each morning, wake up your body with gentle yoga stretches and balance improvement poses. Avoid holding strenuous positions for too long and do not drop your head below your heart (no downward dog). Yoga positions that worked well for me included any seated pose (Childs pose, Easy Pose, Cobblers Pose, Staff Pose, Seated forward fold, Hand to Knee Pose) and standing poses that promoted balance (Mountain Pose, versions of all three Warrior Poses modified to not drop the head, Tree pose, Triangle pose, and when ready Triangle twist). Try to include positions that twist the body and where your arms or legs cross the meridian line to help with reconnecting the two hemispheres of the brain. There are some wonderful resources available on line now. Simply search for simple seated yoga or yoga for concussion.

As you feel better, you can introduce additional meditation or yoga sessions into your day or evening routine. Both are a wonderful way to wind down before bed!

For the non-TBI reader

Recovery from concussion or Traumatic Brain Injury is long and lonely. A TBI survivor lives filled with a lot of self-doubt and questioning of one’s sanity. Thought processing, when it is functioning, is muddied. It is extremely difficult to know which advice to follow. The injured brain cannot sort the good from the bad. A TBI recoverees body is working against them with brain fog, fatigue, dizziness, nausea and vision problems. Staying organized is similarly very difficult, making routine and positive practice important.

I am a support person. How can I help?

1. Be supportive of your TBI survivor in finding therapies that work for him or her.

2. Offer to attend medical appointments and help take notes.

3. Offer to help set up or organize notes in a binder.

4. Help your TBI survivor to find a case worker to navigate all the care practitioners (and the employer or legal challenges).

5. Try some of the therapies and practices yourself. Beginner yoga or Qi Gong classes can be a lot of fun taken together and your support will be appreciated.

6. Assist in outlining a daily routine that works for him or her.

7. Help monitor your TBI survivor to ensure they are not overdoing it!

Additional posts and stories for more information

A TBI story, Green Doesn’t Always Mean Go

Identifying and Coping with TBI, The Early Days

A TBI Story, The Long Winter of Depression

TBI Depression and PTSD

Some sources, resources

The Biology of Belief Bruce Lipton

You Can Heal Your Life Louise Hay

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4572216/#:~:text=TCM%20can%20be%20characterized%20as,the%20body's%20resistance%20to%20diseases.