As an ex-concussed individual who lost an appealing soccer scholarship, I was inspired to scuba-dive in the ocean of Functional Neurology with Dr. Frederick Carrick after chiropractic education to find some answers to my never-ending post-concussive miseries as a young professional. I found that too many of my untrained colleagues in the medical world claimed to have the answer to concussion and too many call themselves the “complete” concussion treatment or management centers. Unfortunately, very few can live up to that claim. Not my intention to criticize anyone’s approach to concussion, as I only intend to shed light on what could be a realistic approach and goal for the patients.
There are many great ways to treat symptoms of concussion, but not many clear methods to treat the “epicenter” of it! I don’t want to oversimplify the word epicenter, but I would like you to imaging that epicenter in your mind to help you understand better what I am about to say. In the language of functional neurology, we call the epicenter the Longitudinal Level of Lesion (LLL). But, who cares!
A little information: Concussion is a disturbance in brain function that occurs following either a blow to the head or as a result of the violent shaking of the head (i.e., whiplash). Existing research suggests that concussion produces metabolic rather than anatomic injury to the brain (unless there is evidence of Diffuse Axonal Injury or imaging indicating other lesions). In other words, following concussion there is a temporary disruption of energy utilization in the brain that does not appear to produce permanent injury in the majority of cases. Patients can complain of headaches, neck pain, pressure, dizziness, light/sound irritability, smell/taste issues as memory decline, balance issues and brain fog could turn into more longer-lasting (sometimes hope-draining) symptoms.
Treating ONLY the balance issues or just the headache would basically seem like changing the tires of a wrecked Ferrari and expect it to start again. Treating the anxiety associated with concussion would be more like a changing the brake pads of the same wrecked car. Don’t get me wrong! They all need to be fixed. Headaches are debilitating and you need to address them correctly and thoroughly. So are other symptoms. The point that I am trying to make is that if I address the vestibular system (balance and motion) without addressing the energy-producing units or metabolic issues of the same areas, pretty soon the system will break again. So, how do we test for dysfunctional metabolism?
Many Naturopathic doctors, functional medical doctors and some chiropractors prefer to start with a regular complete blood work (which includes Chem 14, hematology profile, Iron/Ferritin, Cardiovascular/lipid profile, thyroid study, Glucose/HA1C, Homocystine, CRP-hs, etc) to assess the excesses or deficiencies of very important markers which can shed light on the person’s blue print function. Other studies such as post-concussive hormone disruption, neurotransmitter study, vitamin/mineral levels and Salivary Cortisol Profile may be of great importance in the comprehensive management of the concussion dysfunctions.
Treatments like spinal manipulation, cranio-sacral therapy, massage, nutrient-specific IV therapy, acupuncture, neuro-biofeedback, physiotherapy, occupational therapy, clinical counseling or drug-based therapies could all be beneficial for some patients. However, a collective approach as a team is the most desirable one. A team that addresses the physical, psychological and metabolic aspects of concussion in a multi-disciplinary system under supervision of a Functional Neurologist, not a Medical Neurologist! Again, nothing against MD Neurologists. I have worked with many and for few of them in US and co-treated many patients with some of the most brilliant Neurologists in North America. The only problem is that most of them did not like to see concussion patients because these patients (including myself) walk in with TOO MANY complaints and most of them cannot be addressed with medications, or imaging evidence!
To assemble a team of doctors and practitioners that can address concussion and post-concussion symptoms and dysfunctions is a hard task and you will notice the difference between the doctors/practitioners that themselves HAVE BEEN A CONCUSSION PATIENT and those who, luckily, have never had to deal with it. My neurologist friend tells me that concussion patients are the most difficult patients because he doesn’t understand most of their complaints and if you fix one issue they will always come back with another one!
That’s why it is so important to LISTEN to the patient and look at each of their individual cases as a unique out-of-the-book issue with a unique approach! I am sure some of the critics may say, frontal lobe is frontal lobe! But the function of compromised frontal lobe pathways with the neighbouring neural networks is very different when there is a leaky Blood Brain Barrier, Reactive Hypoglycemia, low DHEA, imbalance of Testosterone or Progesterone in the equation. Everyone is unique!
There are some patients that I cannot start on treatment unless I am sure their autonomic nervous system won’t crash due to exceeding their brain’s metabolic demand. In this instance the “No Pain, No Gain” theory does not apply. Some miscalculated, cookie-cutter and one-size-fit-all applications could be devastating for the brain and could send the patients’ into a severe Fight or Flight wind-up, creating anxiety, panic, depression and insomnia, to name a few.
The moral of this story? Concussion treatment requires a multi-specialty approach under the guidance of an experienced doctor with Functional Neurological background who understands blood chemistry analysis and other functional laboratory tests in order to address the Metabolic dysfunction of concussion. A knowledgeable Physiotherapist, Clinical Counselor, and an experienced Naturopathic Doctor would improve the chances of the patients full recovery and return to normal life.
I have to disclose that I am the clinic director of Equinox Integrative Wellness Center, a doctor of chiropractic with Fellowship in Functional Neurology (Diplomate in American Chiropractic Board of Neurology) and Fellowship from American College of Functional Neurology, as well as Fellowship in American Board of Metabolic Medicine. Health and wellness never stops at our degrees on the wall, as we constantly learn from our patients and doctors that we work with. We address the epicenter and not just the symptoms.
You can always contact me for any questions, polite criticism, constructive criticism or anything pertinent to this topic at firstname.lastname@example.org