Making Headway

Have you ever wondered what the long term effects of your brain injury will be?  We know that brain injury is a risk factor to developing types of dementia like Alzheimer’s.  BUT not all who have brain injury get dementia.  Today in our See BI segment, we are joined by The Ohio State University’s CBI researcher Olga (Niki) Kokiko Cochran to discuss TBI + what = Alzheimer’s.  Could sleep disruption in TBI have chronic effects that lead to long term neurodegenerative consequences? Listen to learn more about the emerging research on this topic.  

We are super excited to announce our series: SEE BI! in partnership with The Ohio State’s CBI Program.  The Ohio State Chronic Brain Injury program (CBI) works on improving our understanding, detection, and treatment of brain injuries through research and community partnership.  Over the next few months, we’ll be chatting with brain injury researchers about their work and findings in the brain injury field. We are honored to be joining with them to bring you this educational series!!! 

Covered in this episode:

• Chronic outcomes after brain injury
• How does the experience of traumatic injury set the stage for neurodegenerative disease?
• If you experience traumatic brain injury your risk of developing dementia or  Alzheimer’s is higher 
• BUT traumatic brain injury doesn’t cause brain injury
• In Nikki’s lab they wonder, Brain injury + what= Alzheimer’s
• Mouse models used for her research
• Models used mimic different types traumatic brain injury
• Trauma is induced on mouse brains several different ways which allows researchers to study and explore
• They need to carefully select which type of mouse model to use to most closely mimic the population they hope to study
• Niki’s Research
• Niki’s initial research focused on giving mice who have a genetic predisposition to Alzheimer’s disease a traumatic brain injury.  Her hypothesis was that brain injured mice would have a worse pathology (worse Alzheimer’s).  This was not true at all.  The brain injured mice did not do worse and in some cases did better.
• What they did see was that the inflammatory response to traumatic brain injury was different in mice genetically predisposed to Alzheimer's. That suggested that the presence of pathological proteins that predispose you to Alzheimer’s (which causes inflammation) was changing the inflammatory response from the traumatic brain injury.  
• This got Niki thinking about brain injury + what= Alzheimer’s
• Niki started thinking about common symptoms seen in TBI and Alzheimer’s--sleep disruption is present in both.  
• Could sleep disruption be the stressor that predisposes brain injured people to Alzheimer’s?  
• Brain injury alone can cause sleep disruption.  Then you have other life stressors (positive or negative) that disrupt sleep.  How does this combination impact your brain function?
• Sleep disruption is a common symptom of any type of stress. In Niki’s lab, they look at how sleep disruption, which is a common physiological consequence to stress, complicates recovery after brain injury.
• To research the connections, the researchers disrupt the brain injured mice’s sleep.  Their models mimic humans who have trouble falling asleep and staying asleep.  The mice are only disrupted for four hours at a time.  After the 4 hours, they are no longer disrupted and can sleep as much as they need to.  They are not sleep deprived, only disrupted.
• They study the effects of this sleep fragmentation through:
• Behavioral testing:They test the mice to see how the stress of sleep disruption affects their cognitive performance--their tests look at the mouse’s spatial memory, information processing, motor function, and aspects of anxiety.
• Tissue analysis: looking for inflammatory changes and hallmarks of Alzheimer’s disease and other neurodegenerative diseases (axonal damage, cell loss, microglial activity) 
• Measuring the quality and type of sleep
• Early findings of sleep disruption with brain injury
• REM sleep seems to be vulnerable to sleep disruption
• Cognitive deficits occur especially on days that the animals get sleep fragmentation
• When animals are allowed to recover for 7 days after 7 days of sleep disruption; they see that the animals have positive changes (i.e. they are able to recover from the effects of sleep disruption)
• Neuronal activity is compromised in the hypothalamus and other areas of the brain that are susceptible to stress
• The hippocampus is affected which means that the animal’s spatial awareness and memory are affected
• The brain’s inflammatory response is changed but doesn’t necessarily exaggerate what the brain injury alone has done
• The light at the end of the tunnel is that our brain’s do have the ability to recover 
• We need to consider the effect of chronic stress and chronic sleep disruption--chronic stress leads to poorer outcomes
• They have work to do with figuring out where the line is that causes permanent consequences.  Where is the boundary between acute and recoverable and long term consequences of stress?
• Summary-sleep disruption does alter stress pathways, results in behavioral changes, and alters inflammation.  We still need more information to know what that means long term. 
• They do not see a complete loss of REM sleep in their brain injured mouse models. Their mice only represent certain types of injury so they cannot make sweeping statements about REM sleep and all brain injuries.
• Early takeaways
• The timing of sleep disruption matters
• There is an ability to recover
• Sleep disruption is a stressor to the brain
• Sleep disruption changes inflammatory response and has cognitive and behavioral effects
• Brain injury and development of Alzheimer’s
• In the lab they can ask questions and test what it takes for a genetic predisposition to turn into Alzheimer’s disease.  This is a field of ongoing study.
• Protect your sleep.  Strategies to help:
• CBD oil to help calm
• Meditation
• Yoga nidra
• No screens before bed
• Reading
• Stress management
• Acknowledge the stressors in your life--it can be positive and negative experiences that cause stress and influence your sleep
• Identify what works for you
• Find support from others
• Examine what the root causes of your stress are
• Prioritize--is it worth it? Can it go? Does it make you happy? Does it add value to my life?
• Are you adding more pressure to yourself than is needed?
• The lab exists to elevate the quality of life that brain injury survivors have.

Links to any resources mentioned:

• Connect with Niki and find our more about her lab’s research at:
• Twitter: @kokicolab
• Niki’s lab: https://www.kokikocochranlab.com/ 
• Email: [email protected]
• For more information about the CBI program at the Ohio State University, visit discovery.osu.edu/cbi

Since brain injury is invisible, survivors are often left on their own to figure out their cognitive and mental health.After injury, it can be hard to recognize what is going on, realize that this is not how your brain would normally function, and that you need help. Survivor Sara Howe joins us in this episode to share her story and her realistic perspectives on recovery. She has found physical and mental fitness to be monumental to feeling well. Listen on to be encouraged.  We promise you’ll be nodding your head in agreement and leave feeling inspired. We know we did! 

In this episode:

• Sara tells her survivor story
• Playing hooky from college takes an unexpected turn
• Falling asleep behind the wheel led to a motor vehicle crash, many injuries (see below), an ICU stay, and moving back home with the parents
• Right vertebral artery occlusion that led to a right cerebellar stroke and subdural hemorrhage
• Cervical and thoracic spinal fractures, collar bone fracture, left arm and wrist fracture, right hand fracture, lacerations
• Punctured lung
• Compartment syndrome
• Outpatient PT, OT, Speech
• The invisible brain injury
• The fractures are the easy thing to address
• Sara and her mom needed to advocate as they were told she was “neurologically sound” when she didn’t feel it and knew things were off.  Find a doctor that will listen to you!
• Stimulant medications post brain injury helped for years with attention deficit issues post brain injury.  It was very helpful, but she eventually wanted to wean off of them
• Ways to cope with attention deficits without medicine: lists, to-do-lists, reminder app on your phone, take it day by day and be patient with yourself
• Sometimes you do need to be on medicine for a little bit; it’s ok to have help.  If the first med doesn’t work, work with your doctor to find something that does
• Sara’s experience rehabbing from multiple injuries
• She could walk post injury but needed to be cared for by her mom for 4 months
• PT/ OT for hand and neck. 
• Speech therapy (SLP)-Sara was in denial that anything was wrong, “I can talk fine.”  Denial was very strong
• Speech is more than talking. It's your organization and processing  
• 4 Phases after trauma: denial, anger, depression, acceptance.  You cycle in and out of these throughout recovery.  It takes a long time to get through all of these
• Physical recovery was a lot shorter than mental recovery.  It took Sara a few years to recover mentally.  You never really get back to your preinjury self. Post injury Sara feels even stronger because she has a different perspective on life,  she doesn’t take things for granted, she has patience for people, and she’s learned so much through it.  She’s not the same but she ended up better. (14:07)
• Mental and cognitive health are often the hardest parts to get over. People assume that since you are physically fine you are also mentally fine
• Since brain injury is invisible, brain injury survivors are often left on their own to figure out the mental health piece.  It can be hard to recognize what is going on and realize that this is not how your brain would normally function and that you need help. (15:40-16:14)
• Mental health therapy
• People wait until something is wrong to go to therapy but “You go to the gym to keep your body in shape, You go to therapy to keep your mind in shape” (16:40) 
• You shouldn’t wait until you’re super out of shape to go to the gym, if you do it is harder to get back into shape.  Therapy gives you support in your day to day life.  It’s good upkeep
• You don’t have to have a brain injury to go to therapy
• Grief and anger post brain injury
• Anger isn’t always a part of the injury. It is always part of the grieving process
• Hearing you should be thankful and grateful makes you feel like you aren’t allowed to feel anger or be mad.  It’s ok to feel one with the other.  You can be grateful and angry. You don’t have to have one without the other, you have to feel the anger to get through it (19:30)
• Caregivers feel all this too--they too will need help and therapy
• Feeling hard emotions--all of your feelings are telling you something.  You don’t have to be afraid of them. It is a clue to be curious as to what negative feelings are telling you.  Welcome them, pause, sit with it, and be curious (20:15)
• You ping pong in the 4 phases of trauma--it is not linear and just because you’ve had one phase of it doesn’t mean you won’t be there again
• Part of being an adult is learning to live in the gray.  You don’t have to be just one emotion at one time, we’ll likely have many feelings at once and have to live through them
• If you don’t feel all the feelings you won’t appreciate happiness as much
• You learn more about yourself when you are going through hard times
• Do something really small everyday to make you happy. Even if you don’t feel it, do something that used to make you feel happy.  For Sara it is being outside.  
• Science behind being outside and how it helps mental health. Book recommendation: The Nature Fix by Florence Williams --speaks about the importance of children being outdoors and the science behind it
• Sara’s journey out of depression using exercise
• It really took getting back into working out to get Sara feeling better
• Running and being outside
• Sara is now an Occupational Therapy Assistant who works with stroke and neuro patients.  Being someone who has been through it herself has added another layer of empathy and understanding.  Patients have found it invaluable.  You can be an inspiration to those recovering. It gives hope.  
• You don’t have to be all put together.  You being imperfect and real makes others at ease to be their true selves as well.
• If you have to tell somebody something, tell them! Tell people if they mean something to you.  
• Exercise after injury
• Consistency can be a struggle
• Advice for those trying to create a new habit: do your new habit right after something you already do everyday. Start very small I.e. do 5 squats while making your coffee.  Go for a half mile run
• Doesn’t need to be all in or all out
• Keep your goals small and once you see yourself succeeding stack on more slowly instead of wearing yourself to the ground and being zonked for a week
• Thank your body
• Sara’s instagram is a great source of workout inspiration
• Surprising lessons post brain injury
• Embarrassment about the injury
• What you eat really affects your brain (refer to episode 18 “Find your Triggers, Stop your Suffering” with Chelsie Moore)
• Journaling and meditation impact your brain and make a huge difference
• What you put in is what you get out
• There isn’t a lot of instant gratification in recovery. It takes a lot of time, patience, work, and building habits before you feel the effects
• “I need to do more to be more productive and to be better”--flip it to “what can I add into my day to feel joy and feel better today” (refer to episode 21: Facing Fatigue with Jenn Freeburn)
• We don’t need to go, go, go to be productive--rest is productive.  You are giving your brain what you need by resting.  (39:15)
• Not being able to go back to normal life and having to accept a new way
• People in the right places at the right time during your accident--divine intervention?
• “Nothing is wrong with you.  You aren’t flawed, there is nothing to be embarrassed about. This is something that has happened. It is up to you to decide if this is something you want to use to propel yourself in life or if you want to be a victim of your brain injury.   Who you surround yourself with is really impactful, what support system and friends you have.  At the end how are you going to use your injury for good? (45:25-46:16)
• Be patient and reach out for help.  Got to therapy.  Anyone listening should go, everyone needs it even if you don’t have an injury
• There is life after injury.  Injury is not a bad thing, you can still live your best life
• You are not broken, you are you.  There doesn’t need to be a measurement between pre and post injury you
• Don’t sweat the small stuff  If it isn’t going to matter in 5 years, don’t spend more than 5 minutes being upset by it.  Brain injury puts into perspective how quickly life can disappear.  
• Would you give someone else a hard time about the thing you are giving yourself a hard time about? If not, let it go.  Be your own friend.  What you say to yourself matters.  Our thoughts are so powerful.  Your body is listening to what you’re thinking i.e. gut issues. Anxiety and negativity manifest in so many different ways in our bodies

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C’mon, y’all know you’ve done some strange and laughable things while being brain injured. Maybe it was funny at the time, maybe it's taken years to laugh, or maybe you still can’t. Finding the humor in all the heart-(ahem, brain)-ache makes those hard days just a little easier. After Mimi Hayes suffered a brain hemorrhage from a ruptured cavernous malformation, she did just that. Taking her experiences on the road, she has made a career as a comedian. Nothing makes her feel better than having people laugh with her.  Join us for some chuckles today with Mimi Hayes, making brain hemorrhages look cool since 1992! 

In this episode:

• Mimi’s Survivor Story: brain hemorrhage due to a ruptured cavernous angioma in the cerebellum
• Symptoms of fatigue, loss of balance, didn’t know where she was in space, visual disturbances, migraines, couldn’t move head or eyes without vomiting 
• Symptoms mistakenly categorized as psychological!!!
• Took a couple weeks to get an MRI--Mama Bear to the rescue!
• The bleed happened at a stressful time in Mimi’s life.  She thinks the added stress contributed to bursting her previously benign cavernous angioma (a clump of vessels that never unfurled correctly at birth) 
• Initial treatment was at home: watch, wait, and hope for reabsorption. Mimi started losing physical function, coordination, double vision and vision loss, loss of taste, weight loss.  With the increase in symptoms, her neurosurgeon reassessed and now Mimi needed brain surgery
• Recovery from brain surgery: 
• Post-anesthesia hilarity: Sit Down Helen! 
• ICU
• Rehab Hospital: coming to grips with changed abilities.  Aggressive therapy soon after surgery led to quick physical results.  If you didn’t get this it doesn’t mean it’s too late!
• Outpatient therapy
• Back to work in 5 months with accommodations and self regulation
• Recovery is nuanced.  Everybody’s recovery timeline is different.  The intensity of your injury doesn’t mean a certain timeline, i.e. “mild” injury doesn’t mean quick recovery and visa versa
• After about two years of teaching post injury, Mimi started some new creative pursuits: book writing and comedy.  
• Humor in tragedy, the importance of finding laughs through hard times
• Finding new purpose after brain injury
• Teaching after brain injury no longer felt like her purpose.  She opened herself up to new possibilities.  She hit the eject button and moved to NYC.
• Be open to new possibilities
• Jump into the void
• Book deal: I’ll be OK, It’s Just a Hole in my Head by Mimi Hayes
• Brain Injury circuit: TV spots, comedy gigs with sets on brain injury, Brain Injury Association presentations
• Step into yourself after injury: you have a new perspective, changed spirituality, changes in life.  Get into those changes. It's a great time to reinvent yourself (48:12)
• Being an advocate in the brain injury community helps you care that much more about doing the work, It becomes bigger than you.  You are helping others.  
• Being a part of the brain injury community throughout the years: A support for you and others!
• Brain injury is always going to be a part of your story
• Owning your story and deficits showcases what is possible after brain injury
• How can you reframe your deficits as a special super power?? Own it! (52:41)
• Everyone is trying to make their way and be happy and confident
• Take that step and figure it out as you go.  You don’t have to be perfect; there’s never a perfect time.  Take the plunge if you feel a pull.
• Some of us are ready to share and others are not at that point.  Be patient with yourself and reach out to the community if you are ready.
• Some may not be aware the community exists and when they do find it they may not know how to interact with it
• Figure out what platform works for you and be patient.  
• There’s a full array of types of people, people in different stages, people with different abilities and many groups for them all.  Find what works for you 
• Is breaking into comedy really like the show Crashing?
• Yes!
• The Fringe festival in Scotland: working the hustle
• Not everyone gets it but they don't need to.  You do you.  Do what feels good! For Mimi, people laughing at her makes her feel better than anything else 
• Give yourself grace, this is not an easy place to be in life.  It’s hard stuff that we’re doing.  

Links to resources mentioned

• I'll be Ok, It’s Just a Hole in My Head by Mimi Hayes: 
• Audiobook (using this link gives us a small kickback to pay those podcast bills, thanks for your support!)
• Paperback (this one does too)
• For an autographed copy, connect with and message Mimi on Facebook or Instagram
• Find Mimi at: 
• http://mimihayes.com/ 
• Mimi and the Brain podcast
• Instagram: @Mimihayesbrain
• Facebook: @mimihayesbrain
• Clubhouse: Mimi Hayes

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 If you dug this episode head on over to Apple Podcasts and kindly leave us a rating, a review and subscribe!

Ways to subscribe to the Making Headway Podcast:

• Click here to subscribe via Apple Podcasts
• Click here to subscribe via Spotify
• Click here to subscribe via RSS
• You can also subscribe via Stitcher

Visit the Making Headway Podcast website to learn more about Eryn and Mariah and our journey to podcasting.

Follow us on Instagram, Twitter, or Facebook.

As an Amazon Associate, Making Headway may earn from qualifying purchases via links provided.

Surprise! Our brains control our bodies! While it’s common knowledge that our brains control thoughts, movements, and perception; did you ever think about it controlling your hormones? Hormonal imbalance may sound abstract but could be behind many persistent and chronic brain injury symptoms. Fatigue, brain fog, mood changes, not feeling like yourself, menstrual irregularities, changes in libido, and weight gain, among many others could be signs of hormone imbalance related to your brain injury.  While hormone dysfunction may not be your answer; if it is, it is easily treatable and totally worth getting checked. Gain awareness and knowledge from our talk today with Dr. Tamara Wexler neuroendocrinologist.  

Topics covered:

• Neuroendocrinology
• A specific set of hormones overseen by parts in your brain
• Includes: thyroid hormones, sex hormones (testosterone, estrogen, prolacin), growth hormones, and stress hormones
• Systems in the brain involved are the pituitary gland and hypothalamus--they affect end organs like the adrenal glands, ovaries, testes, the liver, and the thyroid
• The end organ glands are in a feedback loop with the brain
• The hormones carry the messages between the brain and the end organs
• Awareness of hormone insufficiency post brain injury
• There is under awareness of hormonal issues in brain injury
• It is under diagnosed and under treated
• You need testing to determine if there is pituitary deficiency.  You can replace the deficient hormone and remove the symptoms associated with its insufficiency
• Pituitary insufficiency is most researched in post concussion/TBI.  There is some information about acquired brain injuries and hormonal deficiencies but the literature isn’t as broad
• Common symptoms associated with hormonal insufficiency are vague and non-specific.  Not all of these symptoms are caused by hormonal changes but without looking you do not know if they are.  There is a higher rate of pituitary insufficiency after injury but it doesn’t mean every symptom is due to it.  Treatment may not lead to a complete return to pre-injury self. 
• Fatigue
• Mental fog
• Not feeling like yourself
• Changed menses and fertility
• weight changes
• exercise intolerance
• Body composition changes
• Slowed thinking
• Poor tolerance of things you used to be able to handle
• Mood changes
• School performance
• Behavior
• Growth 
• If you don’t look for insufficiency, you can’t tell if it exists
• How do you test?
• Menstrual irregularities, absence of menses, or changes in libido that persist more than 3 months after a concussion can reflect a brain related hormonal change (pituitary damage)
• If you are having regular periods without being on oral contraceptives you don’t need to be tested
• Estradiol and FSH: if ovary insufficiency or menopause are causing the symptoms, the estrogen will be low and FSH will be high.  The pituitary sends FSH to signal the ovaries. FSH is high if the ovaries are the problem
•  If the pituitary gland/brain is the problem the FSH will be normal or low.  It is trying to mount a response but it can’t
• You have to look at multiple hormones as they rely on each other to understand the cause of the problem (brain vs end organ)
• Thyroid testing: TSH and Free T4 need to be measured together after brain injury to determine if there is a brain or organ problem
• Testosterone deficiency in men post brain injury: needs two morning blood tests timed appropriately to catch insufficiencies
• Hormone testing is done by a blood test timed appropriately with your cycles.  If you are looking to see if something is low you need to test it when you expect it to be high. 
• Provocative testing is when you stimulate your body to mount a hormonal response and then test it
• There are 4 systems monitored by the pituitary gland: stress hormone system, thyroid hormone system, sex hormone system, and the growth hormone system 
• There is a domino effect if any one of the systems monitored by the pituitary is affected
• Thyroid hormone system. Symptoms indicating imbalances:
• Metabolism
• Mood 
• Thinking
• Temperature sensation
• Poorer school performance
• Behavior 
• Growth
• Menstrual changes
• Weight gain
• Sluggish
• Skin and hair changes
• All of these changes can also come from something else
• Thyroid insufficiency because of pituitary damage is less common after brain injury than problems in the other systems 
• Sex hormone system (refer to the above notes for menstrual and reproductive irregularities) 
• Symptoms from testosterone insufficiency:
• Changes to libido
• Erectile dysfunction
• Decrease in frequency of spontaneous erections
• Changes in bone strength
• Changes in muscle strength
• Changes in red blood cells
• In one study, researchers looked at people with brain injury and sexual side effects, irregular periods in women and sexual changes in men.  There were higher rates of hypogonadism (decreased estrogen and testosterone due to the pituitary) but also higher rates of other pituitary issues.  The symptoms may not be as specific to just one system as we thought. 
• Stress Hormone System
• Cortisol supports our body and its blood pressure during times of stress.  
• Need to look for adrenal insufficiency acutely after injury (ACTH and cortisol system)--if you miss this issue it can be fatal.  It is easily replaced  
• Among pituitary deficiencies, the most common are sex hormone or growth hormone defficiency 
• They all have to be tested because they have to be replaced in a specific order
• First replace any stress hormone issues with cortisol, then replace thyroid, then sex hormone, then growth hormones.  You can’t diagnose growth hormone insufficiencies without first treating sex hormone issues
• Growth hormone system
• It affects linear growth: in kids look for changes in growth patterns (a drop or change from their norm)
• Symptoms of insufficiency:
• Cognitive and mood effects
• Cognitive slowing
• Brain fog
• Bone strength, more fragile bones
• Body composition: harder time gaining muscle and will see more fat around the middle
• Exercise intolerance and low energy
• Fatigue
• Cardiovascular health: too much hormone is bad and too little is bad
• Blood glucose effects
• When do you know when to screen for pituitary damage post brain injury?
• If the symptoms are persistent and consistent beyond three months to a degree that is disturbing you, get hormonal screening
• Symptoms can show up later (3, 6, 12 months and beyond) after TBI
• You can’t tell if it is a pituitary problem without looking. 
• If symptoms are getting worse or new symptoms are showing up over time, it is worth getting rechecked
• Finding help with hormones
• Bring up with your provider that you have heard that there are increased rates of pituitary insufficiency after brain injury and ask how you can get that checked out
• Some providers that may be able to help: a provider that knows you well (your PCP or NP), rehabilitation medicine physician or physiatrists, neurologists, neuroendocrinologists
• Not brushing off symptoms
• It is worth raising your questions even if you are unsure if it is related
• Your “usual” may be ramped up. You may be in ‘fight or flight.’ It could be hormonal but it may not.  It is always worth looking
• It is worth going down different avenues until you find the reason for your symptom.  Even if hormones isn’t the answer it is worth looking at and checking off the list
• Acute hormone deficiencies do not predict later problems. There is a much higher rate of acute issues at time of injury. This doesn’t correlate with having or not having long-term issues.

Links to any resources mentioned:

• https://neuroendocrineassociates.com/ 

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 If you dug this episode head on over to Apple Podcasts and kindly leave us a rating, a review and subscribe!

Ways to subscribe to the Making Headway Podcast:

• Click here to subscribe via Apple Podcasts
• Click here to subscribe via Spotify
• Click here to subscribe via RSS
• You can also subscribe via Stitcher

Visit the Making Headway Podcast website to learn more about Eryn and Mariah and our journey to podcasting.

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Domestic abuse and brain injury. Don’t let this scare you off. It is a conversation we all need to take part in. 75% of domestic abuse survivors suffer TBI as a result and you know we can’t leave friends in the community hanging! Today we join How to Love a Battered Woman’s Nia Renee to discuss domestic abuse and brain injury. Strikingly, overcoming both require similar skills of resilience, perseverance, strength, and o-so-much inner work. You won’t want to miss out on this insightful conversation.  There’s a tremendous amount of wisdom shared for all those going through either or both experiences. And if you aren’t in either situation, it is still a crucial listen to gain understanding and insight. You never know when you might need to be an ally!      

Covered in this episode:

• CTE is a result of repetitive brain trauma commonly recognized as a disease affecting professional football players.  Victims of domestic abuse are probably even more affected due to repeated knocks on the head at home but it is not publicized like it is for professional athletes
• Women are more susceptible to TBI due to the structure of our necks
• 75% of domestic abuse survivors have a TBI
• Nia is a survivor of 20+ years of domestic abuse
• She has a brain condition called Chiari Malformation that was sped up due to the abuse
• Therapy is an ongoing process throughout the rest of your life (5:45).  It’s not a one and done fix 
• Chiari Malformation
• Happens when the brain is herniating into the spinal canal because the brain is too big for the skull
• 185 (ish) symptoms associated with this disease
• Nia started experiencing symptoms her sophomore year of college
• While experiencing symptoms of the brain injury she was also being hit in the head which likely exacerbated her condition
• There is a lot of stigma around this disease in the neurologic world.  Some neurologists believe that Chiari is an incidental finding that doesn’t cause symptoms
• It took Nia advocating for herself and finding the right fit with a neurosurgeon to get treatment and surgery. Shout out to Dr. Holly Gilmer, M.D.!
• Nia talks about recovery from surgery and trying to get to know her chronic illness self  
• A metaphor for living with chronic illness: A handful of spoons: every activity in your day requires you to give away a spoon. Eventually you have no spoons left to give away.  This represents the energy each activity in life takes when you have a chronic illness and brain injury.  You have to be deliberate on what you give your spoons to
• Surgery is not a cure; it just gives you a more livable life
• The surgery can make some people worse.  The experience and decision to have surgery is highly individualized 
• Ehlers-Danlos Syndrome (EDS): a connective tissue disorder that is commonly associated with Chiari. 
• Allow yourself to evolve and let go of the preinjury self.  You are who you are now.  
• Brain injury can cause an identity crisis
• Life lessons from surviving domestic abuse and living with a chronic brain condition
• Nia’s only 27! She has wisdom beyond her years.
• Remaining resilient
• Resiliency as a child consisted of doing something creative to express herself and help her bounce back, especially writing.  It was later on that she realized she doesn’t need to be quiet about what was happening to her. 
• Speak out! “I got to a point where I realized I don’t have to be quiet about any of these things.  Why do I have to? If it makes you uncomfortable that is not my concern, business or problem” (19:30)
• “If hearing about domestic violence experiences makes you uncomfortable, question why, look inside yourself.  Does it make you uncomfortable because you are a part of the problem?  Is it because it touches on something that you haven’t had a chance to work on yet? Are you realizing that you are not alone?”  
• Being vocal and talking about it has been her number one strategy to get through all her struggles
• Dealing with talking about uncomfortable topics has to be addressed to progress
• Why aren’t we talking about domestic violence and abuse more?
• The world isn’t ready for the fallout of high profile abusers
• Victim shaming--victims are scared because they hear “why didn’t you leave,” why did you stay,” “why did you let someone do that to you.”  There’s a lack of understanding and so much stigma.  We have to talk about it to know what to do when confronted with abuse
• It makes people uncomfortable to hear hard things but we have to do it! 
• Speaking out takes you out of the dark and connects you with others
• HowToLoveABatteredWoman on Instagram
• You hear what you want to hear and cancel out what you don’t.  In our internet world, you opt in to what you want to hear and block what you don’t
• There’s a difference between cancelling someone and holding someone accountable.  
• Cancelling is called for in people who have been given the opportunity to change after being called out on bad behavior but choose not to change. 
• “If the behavioral patterns are the same and you continue to do the same things then, yes you deserve to be cancelled...You can only give a certain amount of chances to somebody because eventually it is just who they are.” (26:40)
• You can’t change someone else
• I'm in therapy because you chose not to
• We can only control ourselves
• Not talking about abuses and issues in life applies to national conversations all the way down to the personal level.  The less you talk about things the more chronic an issue it becomes.  “If you keep sweeping stuff under the rug iIt piles up and builds under the surface until one day when it all comes out” (30:45)
• Grappling with abuse and advice to those who are dealing with it
• You are not making it up.  Narcissists are master manipulators and will make you think that it is your fault, not really happening, and not really abuse.  
• You are not weak minded.  You are stuck in a situation because it may be what you are used to, many grow up in it and see abusive behaviors as the norm.
• One day you realize it is not normal 
• It’s not your fault
• You’ll feel lonely and stuck and like you don’t have anyone or that anyone will believe you.  You feel stuck--but you don’t have to be.  
• It is tough to get out.  The abuser will have many behaviors that pull you back--they stalk, threaten to kill you and your family.  You end up having to create a whole new identity to be able to get away.  It is hard and takes a really long time!
• The narcissists make abuse feel like the safety zone because they try to make leaving harder than staying.    
• You can only get out when you are ready. It takes a long time to get out!
• You are not crazy! You are stronger than you think you are, you are not weak minded.  It takes a lot of strength to get out! 
• There can be a beautiful life after abuse; if you are willing to do the inner work to figure out why you keep attracting abusive men and women.  
• Therapy is Nia’s life saving space.  She had to get to the root of why these people keep finding her and why she was attracted to them. 
• The work is not easy and can make you question yourself and why you are doing it. It is painful, hard, isolating, and lonely.  
• “If you are willing to do the work…(and the work is not easy it is hard and isolating. You question yourself as to why you are doing it.) Once you get through it and realize that you can set boundaries and that you can pick and choose what is in your life whether they are family or not and that you can choose what you have around you [it’s all worth it]” (35:34)
•  Mental health journey through brain injury and abuse
• Requires self advocacy
• It’s not in your head
• You have to know yourself and what is not ok
• So many people want to be heard but are fearful of what others might think.  It takes time to be brave and speak out.
• Negative comments to what you are saying is not a reflection of you--it's them! 
• Their negative comment is their opinion
• If you lose family or friends after speaking out it hurts, but it is you taking the power back.  You get to steer your life again.  You are in control.  You don’t have to depend on anyone.
• Family is important but not worth it if they destroy you.  
• It’s ok to not be ok.  It's ok to say that and be honest with how you are doing.  
• Be real
• You have the choice for how you want to rebuild your brain and life.  But it is HARD! You may have the view of the happy ending you want but it is a hard and painful road to get there.  Anything that is worth getting to is bumpy and challenging.  It’s not fun work but it is worth it.  
• The destination is the journey.  There is no ending point at which all is ok forever and always.  It will always take work. 
• How to Love a Battered Woman (website; blogs)
• A place to let others know they are not alone
• A community for those with invisible illnesses and suffering chronic illness
• A community for those suffering abuse
• Gives a voice to those going through abuse--it's what she would have wanted to hear as a child going through abuse 
• When you are ready you can do it. You can get out when you are ready!
• “It's a process. To everyone dealing with this and feeling like they are not doing enough, or feel like they aren’t being heard enough, or that they are scared; it's ok to feel what you feel.  As long as at some point you have a plan to work on it and to get through it.”  
• The reality is nobody heals from trauma without feelings.    

To connect with Nia:

• Instagram: HowToLoveABatteredWoman 
• Website: How to Love a Battered Woman

National Domestic Violence Hotline 1-800-799-SAFE (7233)

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What is one symptom all brain injury survivors have in common? No, the answer we’re looking for is not our overwhelming awesomeness--although that’s also true! It’s FATIGUE.  There are several different types of fatigue and many ways to manage it.  Join Jenn Freeburn, MS, CCC-SLP as she schools us on the hows and whys of cognitive fatigue.  She’ll help us strategize our way through the fog, no loud fog horn necessary.  

Covered in this episode: 

• Types of fatigue
• Physical fatigue- the body being tired and needing rest
• Psychological fatigue- lack of motivation, trouble starting anything
• Cognitive fatigue (mental fatigue)- brain fog, not being able to attend or focus
• Theories for brain fatigue
• The brain is trying to heal and has less energy for other things.  Tasks feel more taxing
• The brain is less efficient after injury possibly due to:
•  the healing process or 
• additional attentional resources are being put towards other aspects of life and those resources drain energy leading to fatigue
• After a brain injury, the brain is more sensitive to things in life that cause tiredness.  You used to be able to push through and now your brain can’t
• Your brain is healing! And that can make you feel tired
• Managing fatigue: it's not just about today; there is a cumulative effect.  If you drain your daily “battery” and dip into your reserve battery, it will take more than a good night’s sleep to recover from the cognitive fatigue.  When you are running low, you have to be gentle with yourself and not schedule a lot when you are drained
• Examples of cognitive demands:
• Sensory heavy environments: crowds, bright lights, stores, noisy, socializing
• Prolonged attentional tasks: reading especially nonfiction, anything that requires a lot of processing, taking in a lot of information.  Tasks where you need to focus in and wouldn’t do with someone watching TV in the background. 
• Mixing physical, cognitive, and psychological demands
• Laundry: has lots of steps mixing physical movement with cognitive aspects
• Times when your attention is pulled multiple directions: example parties and conversations
• Multi-step processes:
• Cooking: lots of steps and movement
• What’s one to do?
• Understand yourself
• What triggers fatigue for you? 
• Plan your day around those: 
• know what is going to cause fatigue and be nice to yourself after so you can rest 
• Do the hardest tasks during the time of day you are feeling your best
• Don’t schedule hard/high stakes things during your times of higher fatigue
• Structure your day around your fatigue patterns with breaks interspersed throughout the day
• What does fatigue look like for you? 
• Brain fog
• Not being able to pay attention
• Irritability, everything is annoying or frustrating.  
• Self judgment i.e. negative self talk
• Making errors
• Emotionality
• Try not to ignore your triggers
• What are your early indicators that fatigue is setting in? It’s important to understand these so you can slow down and not hit the wall
• Check in with yourself to see where you are rather than pushing through
• Fighting to complete tasks isn’t beneficial for your brain
• How do I figure out my patterns?
• Keep a simple journal/log of what you do throughout the day and when
• Rate how fatiguing each thing was on a scale of 1-5
• Look for patterns
• Build your day around your patterns
• Increase routine
• Especially important when you are recovering at home and don’t have much of a schedule or structure to the day
• Establish some regularity, especially around sleep
• What is restful?
• What restores you? I.e. what recharges the battery; how can we make deposits to our energy bank? (rather than constantly drawing from it)
• Breaks are something that provides cognitive rest and is pleasurable
• What actually restores your energy? Mindless scrolling is not cognitively restful
• Identify what gives you back mental energy
• Physical movement or “active rest” is activity for your body and rest for your brain
• stretching, taking a walk, going outside, 
• Activities with low cognitive engagement are most restorative--something gentle you can follow along with (not an intensive class with lots of directions)
• “Rather than focusing on the negative, ‘what am I doing that is exhausting me? I’m clearly doing too much every day’.  Try to focus on how you can do more of these things that give you something back. This is a nice way to flip the script and offer yourself gentleness.  This puts the focus on adding something relaxing and pleasurable rather than taking away something that feels productive” (32:40)
• Need to set good expectations.  Don’t set the bar too high.  Need to have a gradual return to activity.  You don’t go out and run a marathon without training first
• When setting expectations, find someone to talk to that understands brain injury
• Other examples of restful activities:
• Music
• Art
• Meditation
• Restful activities are highly individualized.  What gives back to you and makes you feel good?
• Be on the lookout for patterns
• Boom or bust: going too far into the overdoing it camp which will lead to needing a lot of rest to restore
• Would I benefit more from just taking a break?
• Find balance
• Is there a way to schedule your day so that you aren’t hitting the wall but having a reasonable amount of fatigue that you can recover from?
• Building a strong brain. Brain health activities:
• Sleep
• Healthy eating: know what works for your body.  A colorful plate. Less sugar.  Moderation. 
• Staying hydrated
• Is this more than brain fog: 
• depression (not wanting to do anything)
• vitamin deficiencies, low B12
• There may be other reasons beyond cognitive fatigue that are causing your symptoms. Talk to your healthcare provider
• What are you asking your brain to do? 
• You may need to say no to things
• It’s not that you can’t do something.  But it is for how long and at what cost.
• You might have to reprioritize to be able to do what is important
• Your self-expectations may need to change.  Would you have the same expectations of a friend with a brain injury as you would on yourself?
• Recovery requires you to take care of yourself and prioritize yourself at the top
• If you are struggling with extended fatigue after your injury, bring it up with your neurologist, speech therapist, mental health professional, occupational therapist
• Find a knowledgeable thought partner to use as an outlet to discuss your fatigue with, to build strategies with, and to have accountability
• You are not alone
• Fatigue is very common
• You are not weak or doing something wrong if you are feeling fatigued.  It might mean you need to shift how you are doing things--you don’t need to do it alone; there’s lots of help out there
• How to find help:
• Brain Injury Association in your state
• Ask your medical team
• Be your own self-advocate
• Use hospital connections or academic medical institutions

Questions for Jenn:

• Shoot us an email at [email protected]
• DM us on Instagram or Facebook.
• Find your local Brain Injury Association at: https://www.biausa.org/ 

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Faces of TBI, Huffington Post, Brain Health Magazine, author of multiple books, brain behind the scene of many advocacy events...what do all these things have in common, Amy Zellmer!  Amy used her experience as a concussion survivor to build community, share resources, and advocate for policy to benefit brain injury survivors across the country. If you’ve wondered how you can get more involved, listen here to get some ideas of where to go!   

Topics covered:

• Amy’s Injury: a fall on the ice that led to concussion
• Helpful treatments: chiropractor, yoga, functional neurology
• Vision issues: nystagmus, trouble focusing 
• Amy feels neurologists tend to focus more on managing long term neurologic diseases rather than brain injury
• Amy’s injury taught her that there are resources available but they were hard to find.  This spurred her on to advocacy and education with a focus on making resources more readily available to all. 
• Medical advances and technology had the unintended consequences of pulling medical doctors from the bedside doing thorough physical exams to an over reliance on imaging
• “You know your body best, don't ever let a doctor, friend or loved one tell you that that is not possible or can’t happen” (19:30)
• Amy’s Journey to Brain Injury Leader
• Her goal has been to build community, share resources, and advocate.  Every 9 seconds someone in the US has a brain injury and they don’t know what to do or where to go.
• First Huffington Post article
• Facebook group: Amy’s TBI Tribe
• Author: Life with a Traumatic Brain Injury: Finding the Road Back to Normal by Amy Zellmer, a compilation of her articles early on; helps with understanding what it is like to have a brain injury and validates experience
• Second book came after she started getting better: Embracing the Journey: Moving Forward After Brain Injury by Amy Zellmer
• Podcast: Faces of TBI: features survivor and caregiver stories,
• Brain Injury Awareness Day in Washington D.C.
• Minnesota Brain Injury Alliance
• Advice to others who want to help with advocacy and policy
• Don’t recreate the wheel
• Connect with your local brain injury alliance or brain injury association
• Reach out to Brain Injury Association of America
• Know your own limitations and where you are in your recovery
• Take baby steps.  Maybe the first thing you do is write down your story and share it;  be a guest on a podcast.  You don’t have to do everything to have a ripple effect.   
• Be mindful of your energy reserves
• Be ok with your limitations.  Learn how to understand your energy and how much you have to give so you don’t crash
• Continue to be mindful
• You are a part of the brain injury community no matter where you are on the road of recovery
• Poor experiences with brain injury resources may cause you to try to start from scratch.  Don’t recreate the wheel, join it and make it better.  MAny state alliances and associations only have 1 or 2 employees--have grace and understanding. 
• Advocacy work takes a lot of energy and you have to be ready to take it on
• Don’t compare your recovery to somebody else’s
• Imposter Syndrome: just because you are in a better place than someone else doesn’t mean you don’t have a voice or that your injury isn’t “worthy” of speaking out about.  Join the community, you may be the voice and have the ability that someone else needs but doesn’t have
• March 16th, 2021: Join the free event “Not Invisible” a Virtual Brain Injury Awareness Day
• March 22nd, 2021: launch of season 2 of Concussion Discussions video series, free event to help you find your way through the murky waters of recovery

Links to any resources mentioned:

• Amy’s Huffington Post articles
• Life with a Traumatic Brain Injury: Finding the Road Back to Normal by Amy Zellmer
• Embracing the Journey: Moving Forward After Brain Injury by Amy Zellmer
• Minnesota Brain Injury Alliance
• Brain Injury Association of America

Connect with Amy:

• Instagram and Facebook: @Amyzellmer 
• Faces of TBI page on Facebook
• Faces of TBI Podcast
• Amy’s TBI Tribe

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Every once in a while, we like to give y’all an update on how we are doing and what we are learning from hosting the Making Headway Podcast (MHP).  Listen today as we get real on everything from our mission, to our reflections on hosting, and all the positive takeaways we’ve learned along the way.    

Topics covered today:

• Making Headway Podcast Mission:
• To share brain injury related information from multiple viewpoints without judgement
• We want to make as many resources as possible available to survivors  so you know what your options are and can choose a recovery path that makes the most sense for you.
• To advocate for the brain injury community
• Make our voices heard
• To promote the open sharing of recovery journeys in the hope that it lends support to other survivors 
• Every story comes with an epic tale.  Sharing stories is a source of inspiration and hope to keep moving forward.
• Reflections from doing the podcast
• Protecting ourselves from re-traumatization and getting stuck in our past selves
• The fine dance between telling your story, self awareness, recognizing your needs, and moving forward
• There’s no simple fix for brain injury recovery.  You have to make the decision and put in the work to move forward. 
• Effects on parenting. Increased concussion awareness
• Brain injury baggage- finding the positive.  
• Staying in the moment and stopping comparisons. I just am me! “You get what you get and don’t get upset.” (17:40)
• Just be where you are.  The pre-injury self is not the gold standard. 
• Books
• Where is the Mango Princess?  by Cathy Crimmins
• Has been a really helpful book in moving forward about a person with brain injury and his caretaker
• This is Your Brain on Food by Uma Naidoo, MD
• Positive things we’ve learned
• Eating well
• 4 colors on the plate.  Frozen veggies really make this easy
• Stir fries are easy ways to add more veggies
• Bowl full of blueberries always available to snack on
• You can add a lot of veggies into chili and soups
• The Defined Dish by Alex Snodgrass, converts recipes to Whole 30, clean and healthy eating
• Embracing where I’m at.  Doing something positive just for me everyday.
• Love Your Brain Yoga
• Yoga nidra
• Meditation apps: Calm, Insight Timer, Headspace
• Getting back into exercise.  Working out now is more about what feels good rather than having lofty goals.  Working out without body shame and self-judgement. Inconsistency is ok.  
• Caution keeps you safe.  Fear keeps you from doing things.  
• You can’t “fix” it all at once.  Your reliance on the team and not trying to be everything. Recognizing your strengths and weaknesses; when to delegate and when to hang on.
• Stay in the moment.  Be real with who you are and let people know your strengths and weaknesses are.
• People pleasing: have had to stop filling the needs of others without ever filling yourself up
• Making boundaries is like putting your airplane oxygen mask on first.  You can’t help someone else if you haven’t saved yourself
• Allowing relationships to evolve, especially in families. 
• I don’t need someone else telling me that what I am doing is ok.  I need to be ok with what I am doing. 
• Enjoy the journey!  
• Support us:
• Leave us a review on Apple Podcasts
• Follow us on Instagram or Facebook: @makingheadwaypodcast
• Follow us on Twitter: @makingheadwaypo 
• Use the links in our show notes if you’d like to buy products mentioned
• Donate, 10% of proceeds go to a brain injury group of our choice
• Share our podcast with a friend 

Links to any resources mentioned

• Where is the Mango Princess?  by Cathy Crimmins
• This is Your Brain on Food by Uma Naidoo, MD
• The Defined Dish by Alex Snodgrass
• Love Your Brain Yoga
• Meditation apps: Calm, Insight Timer, Headspace

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• Click here to subscribe via Apple Podcasts
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• Click here to subscribe via RSS
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Looking to learn more about how your diet can influence your brain injury recovery? Post-concussion and all other brain injury survivors, go no further!  This episode has it all!!  Chelsie Moore functional medicine nutritionist, action sport aficionado, and all-around super-smart, bad-ass teaches us about all things brain and gut.  We dive deep on neuroinflammation, the brain-gut connection, and hormonal imbalances along with what YOU can do to take control and get better.  Grab your pencil and take notes; you’re going to feel inspired to take action after hearing this!

Topics covered in this episode:

• Functional Medicine
• Getting down to the root cause of what is going on with your health
• Differs from Western medicine as it looks to treat what causes the problem instead of just treating the symptoms of the problem
• Practitioners in functional medicine spend a lot more time with their clients to uncover root causes and provide individualized care
• Chelsie’s Story--Motocross rider with multiple concussions
• She lost 5 years of her 20s because she didn’t have the right help that she needed.  As bad as it was, it led her to turn it on its head and became a functional medicine nutritionist to be able to help others heal their brains
• Suicide prevention 
• Untreated brain injuries can lead to chronic inflammation causing mental health struggles which include suicidal thoughts
• People may feel embarrassed to seek help if they’re having depression, anxiety, or suicidal thoughts.  There can be a stigma in the action sports community to not seek help and suffer alone
• Don’t be ashamed to ask for help: https://suicidepreventionlifeline.org/ 
• Neuroinflammation
• There is a lot we can do for neuroinflammation
• Brain injuries cause a breach to the blood brain barrier which allows toxins into the brain.  That creates a cascade of reactions that cause inflammation (inflammation is an immune response)
• Anti-inflammatory diet
• Clean diet
• The first most basic thing to do is to do lower inflammation in the brain is to eliminate gluten, dairy (casein), and sugar
• gluten and casein fuel trigger an autoimmune reaction called molecular mimicry that fuels the vicious cycle of neuroinflammation 
• What has gluten in it? 
• Learn how to read your food labels.  Most food labels have to say if it has wheat (gluten) in it
• Wheat, barley, soy sauce, some condiments
• Anything that is “enriched”, “self risen” 
• Graham or durum flour, food starch
• Emulsifiers
• Most of the fake meats have gluten
• Hydrolyzed vegetable protein
• Malt
• Cammett
• Rye
• Oats, unless certified gluten free
• Stabilizers
• Thickeners
• Wheat starch, wheat bran, wheat germ, semolina
• What has dairy in it?
• Milk
• Whey
• Casein
• Anything lacto-based (although some lactobacillus is dairy free)
• Brown sugar and caramel
• Binding agents
• More chronic severe symptoms may need more dietary controls than the above
• Autoimmune paleo diet: Fruits, vegetables ,grass fed meats, wild caught fish
• Ketogenic diet: has the most research around it for neuroinflammation.  Can be hard to maintain
• How you exercise affects inflammation. Subthreshold high-intensity interval training protocols are best
• It’s better to do something rather than nothing.  It is ok if you can’t fully overhaul your diet overnight.  Take it in small bits. Chelsie focuses on easing people in by assessing where they are at and making small changes over a period of time.
• Maybe it is starting with just cutting sugar or gluten and then see how you feel
• When you actually feel a difference you will be more inspired to make more changes. That is when you can introduce other changes
• Get through two weeks of cutting sugar.  You do detox and don’t feel well at first; but it gets better!!
• EAT REAL FOOD, stop eating processed food
• Is there ever a place for moderation (aka cheat days)? 
• Stay strict for a certain period of time when you are in the thick of post concussion symptoms
• After you get through 3-6 months of being very strict with your diet, you may be “cheat” in moderation.  More importantly, remember there are many substitutions that fill your craving and stay within your diet
• Grain free pasta: Cappello’s 
• Desserts that are very anti-inflammatory: Keto Cups 
• Dark Chocolate sweetened with coconut sugar: Hu
• Pizza: Capello’s
• Coconut mozzarella: Miyoko’s
• Thrive Market has all these foods!! Delivers these foods directly to you.
• Brain-gut connection
• Your brain controls digestion through your vagus nerve.  With a brain injury, the vagus nerve slows down so your gut isn’t working optimally.  The slow down allows for leaky gut syndrome and bad bacteria to colonize. 
• If there is gut inflammation in the gut, it triggers and exacerbates brain inflammation
• A healthy gut relies on real food (nothing processed) and organic foods with as little chemicals as possible
• Microbiome- assess this with a stool sample.  The sample tells what is wrong and then you make adjustments 
• Have to look at digestion--is there enough stomach acid? Is the pancreas working correctly? 
• You can exercise your vagus nerve through: lowering your stress levels, gargling water (60 seconds three times a day), singing really loudly, activating your gag reflex, tiger yawns (sticking your tongue out and yawning), stick your tongue out, tilt your head back, close your lips around your tongue and swallow
• Do all this everyday for at least a month
• Stimulates digestion to work more efficiently
• Many mood dis-regulatory aspects of brain injuries (brain fog, cognitive sharpness, fatigue, headaches, anxiety, depression) are triggered by diet.  Need to keep the toxins down and the gut healthy.  Gut inflammation can trigger a lot of the brain injury symptoms by itself.  
• We live in environments plagued with chemicals.  Our bodies have trouble keeping up.  This stems chronic diseases as our bodies are worn out trying to handle the daily toxins. 
• It’s as simple as eating whole, organic foods!
• Hormones and brain injuries
• When our hormones are in balance our brain works at it’s best and our energy levels and moods are at their best
• With concussions and brain injuries the pituitary gland is susceptible to damage.  It’s in a vulnerable area and is fragile tissue.  This gland controls our hormone secretions in our bodies and when it is injured we see hormone deficiencies all over the place
• About 25% of people with brain injuries have a hypo-functioning pituitary gland after injury.  It’s not common for practitioners to look at hormone function post injury so hormonal imbalances are often missed
• Hormonal imbalances are linked to common brain injury symptoms
• Low testosterone: anger, fatigue, depression, memory issues, troubles focusing.  Address with replacement, ginseng, high-intensity interval training, low carb diet
• Low pregnenolone: anxiety and social anxiety
• Low progesterone: Progesterone is a potent anti-inflammatory and neuroprotective hormone.  When it is low you have anxiety, insomnia, irregular menses, bone loss. Address with bioidentical hormone replacement, Vitex, diet controls
• Adrenal hormones: cortisol is high with stress and brain injuries which leads to adrenal exhaustion.  Looks like blood sugar dysregulation, being lightheaded with standing, and burnout.  Address with exercise, stress management, mindfulness, naps, meditation, ashwagandha, phosphatidylserine 
• Dutch Complete: test to diagnose hormone dysregulation.  Looks at hormones over the course of a period of time (whereas a blood test is only a snapshot of your hormones at the time the blood is drawn)
• Need to work with a qualified provider to take a stepwise, smart approach to make a treatment plan
• How to learn more: https://www.mooreintegrativehealth.com/ 
• “Concussion Comeback” program: Self-paced, 12 week virtual concussion recovery program.  The program includes video modules, monthly Zoom conference calls to answer questions and individualize care; and a support group.
• Goes over the 5 most beneficial treatment areas and gives action steps.  Each module has 10-15 minute videos that teach all the main categories. Neuroinflammation: digestive function, food intolerances, triggers, neuroinflammation protocol supplements to bring down inflammation
• Neuroinflammation
• Mastering Diet
• Toxin Levels
• Hormones
• Lifestyle: exercise, cognitive exercises, stress management
• Concussion Kits
• Concussion First Aid: what you need in your pocket for acute stage brain damage prevention (take immediately after impact)
• Concussion Recovery Kit: for first month after concussion
• Comprehensive Recovery Kit: for longer term post-concussion symptoms
• Free 3 day meal plan on website
• Save-a-Brain helps connect brain injured people to the right treatment 
• Concussion Recovery Cookbook--stay tuned to the website, coming soon!
• Work with Chelsie Moore--she is not limited to one state or country and can work with you individually 

Links to any resources mentioned:

• Suicide Prevention: We’ve been there and we care about you, please get help! Suicide Prevention Hotline: 1-800-273-TALK (8255)
• Grain-free pasta and pizza crust: Cappello’s 
• Desserts that are anti-inflammatory: Keto Cups 
• Dark Chocolate sweetened with coconut sugar: Hu
• Coconut mozzarella: Miyoko’s
• Thrive Market
• Concussion Comeback Program
• Concussion Kits
• Save-a-Brain 
• Sessions with Chelsie Moore: https://www.mooreintegrativehealth.com/ 
• Instagram: @mooreintegrative

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Ways to subscribe to the Making Headway Podcast:

• Click here to subscribe via Apple Podcasts
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• Click here to subscribe via RSS
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Visit the Making Headway Podcast website to learn more about Eryn and Mariah and our journey to podcasting.

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As an Amazon Associate, Making Headway may earn from qualifying purchases via links provided.

Mariah and Eryn were interviewed for episode 72 of the Concussion Talk podcast. If you like what you hear, check them out on a podcast platform near you- they have tons of great interviews and resources for brain injury and concussion survivors!