Archive for the ‘Traumatic Brain Injury’ Category

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The Many Faces of Traumatic Brain Injury (TBI)

Friday, November 21st, 2014

Traumatic Brain Injury (TBI) carries a huge complexity of factors, each of which complicates the healing process.  There is of course the impact, the moment of trauma, causing significant damage to the brain and oftentimes other body structures.  This is the primary concern as the patient is rushed to the emergency room for life-saving procedures.  For everyone involved in a tragedy of this sort, it soon becomes apparent that TBI generates aftershocks that extend way beyond the central nervous system of the individual involved; the aftershocks go on for years to come.

As a naturopathic physician and acupuncturist, I have treated patients with TBI in a primary care setting.  As a student I wrote my thesis on the naturopathic treatment of TBI.  I thought I understood the complexities of this condition.  In fact, I was preparing the outline of a book highlighting my understanding of TBI and the treatment of chronic syndromes that continue for years following injury.  A year ago, however, I was exposed to an entirely new understanding of TBI when one of my patients hit a tree at a projected speed of 120 mph.  She was a passenger in a car and received the full brunt of the impact.  What I would learn is that the impact extended much further, as family and friends, healthcare providers, and many others gathered to support each other and the patient in the healing process.

People mobilized from around the country and gathered in the waiting room of the ICU.  Two could visit at a time, and the rest patiently awaited and prayed for good news.   It was there, in the waiting room, that I saw many angles of the experience transpire.  My first day I met the driver of the car, and the remorse was evident in the downward gaze and the pale expression of worry.  Soon I would meet the driver’s family, the patient’s family, and the school friends, all of whom supported each other and maintained hope for the best possible outcome.

An undeniable presence in a trauma of this magnitude is the attorneys, the media, the insurance companies, the doctors and nurses, the priests, and the bankers; all present on the scene to “help” navigate these treacherous waters.  Some provide support while others make the challenge much more difficult.   Mixing all these ingredients together with the volatility of emotions of sheer joy and utter sadness and grief, the experience mirrors that of a human pressure cooker.

There were many details to organize, like who was taking care of the dogs at home while the family lived in the hospital?  How often would one leave the hospital to shower? There was the horrendous hospital cafeteria food that all were subject to, and the sleep deprivation from consecutive nights in upright chairs.  At one point, a family member awoke with a homeless man sleeping next to her.  Emotions were on overload, as people blindly traversed each moment awaiting updates from medical staff.  Shock and tragedy have a way of catapulting you into the present moment, where nothing else matters.  There’s no more room in the inn.  All emotional sensors are activated.  There were already family rifts present from a previous divorce and a history of abuse with a family member.  Now all were in one room together, forced to get along because this moment was not about them.  Past and future seemed far away.

The media was sneaking into the ICU to get interviews with the family.  Lawyers for the insurance companies were calling to deny charges.  Soon the banks would start sending liens on the family’s home.

I will not get into the details of this experience for the sake of protecting patient confidentiality.  I bring this story to light only as an example of the complexity of TBI.  This story repeats itself over and over again, every time someone experiences a severe head trauma.  The CDC reports that each year, an estimated 1.7 million people sustain a TBI.  Of these, 1.3 million report to the ER.  275,000 will require hospitalization, and 52,000 will die.

The experience of TBI extends way beyond the patient.  As a clinician I focus on helping patients navigate trauma and heal the nervous system.  This involves nutrients, herbs, nutrition, acupuncture, and the movement arts.  Complete healing must also include the families and friends involved, as they too are attempting to release the memory of trauma and accept the ongoing challenge of supporting a loved one dealing with the chronic effects of post-TBI syndrome.  Healing this requires a community.

Written by Andy Swanson, ND, LAc practicing at Nature Cures Clinic in Portland, OR

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What Happens After the Coma?

Tuesday, November 11th, 2014

Many people who have acquired a brain injury tell a similar story.  They gradually awaken from a coma.  They have to relearn aspects of life that were once simple tasks, like balance, walking, speaking, socializing, and tempering emotions.  Weeks pass, exhausted from math and reading classes, speech and physical therapy.  The process challenges the very deepest aspects of the individual, often instigating feelings of frustration, hopelessness, and depression.  After a period of rehab, they leave the hospital with limited options with regard to therapy, relationships, housing, financing and work.

Local support groups are often great resources to steer people towards the help they need.  The Brain Injury Association of Oregon (www.biaoregon.org) offers an excellent resource guide to help those with TBI navigate the assistance available.  Communities are coming together to enhance this network for those recovering from TBI.  Many people in the TBI community, however, are unaware of the options offered by complementary providers such as naturopathic doctors, acupuncturists, yoga therapists and nutritionists.  I’d like to share a brief overview of some of the treatments we provide at Nature Cures Clinic that may be of help in the recovery from TBI.

At Nature Cures Clinic we offer individualized health care focused on addressing not just symptoms, but also the underlying causes of imbalance.  For example, I treated a patient for a year and a half for Hashimoto’s Thyroiditis that started following brain injury.  The treatment plan focused on balancing the thyroid while simultaneously providing the central nervous system with the building blocks for healing.  A generalized TBI treatment would have missed the thyroid imbalance.  Even if it is clear that the majority of symptoms are related to TBI, it is absolutely necessary to consider other systems of the body that may be operating below optimal function.  At Nature Cures Clinic, we treat each person according to the needs of their body.  This is determined by a complete physical exam, a detailed history of illness, and any labs and imaging necessary to accurately assess ongoing internal imbalances.

A brief summary below introduces you to the three modules of the TBI program at Nature Cures Clinic.  There may be concepts here that you are unfamiliar with.  In the coming weeks, I will provide more information on how we use these therapies in the treatment of TBI.

IV Nutritional Therapy offers a unique way to offer the body nutrients to heal following injury.  We have a standard multivitamin formulation we use for many health conditions.  These nutrients help enhance mood, energy, and immune function.  Other formulations specifically target the brain, and these I find particularly useful to accelerate healing post-TBI.  These include nutrients such as alpha lipoic acid and glutathione.  I will discuss this further in future posts.

Nutrition matters.  What you eat directly impacts how you feel and how well your body heals following injury.  Even though food is a very sensitive area for many people and dietary changes are challenging, it can be the pivotal change that decides whether or not the nervous system heals.  I will discuss this further in future posts.

Chinese Medicine provides a fresh approach to working with many symptoms of TBI such as chronic pain, muscle spasms, forgetfulness, and mood disorders.  Through the lens of Chinese Medicine we often encounter underlying imbalances in the body that may have been overlooked by modern medicine.  Addressing these underlying imbalances removes potential obstacles to healing, and thus can speed up the recovery from TBI.  At Nature Cures Clinic, we incorporate three aspects of Chinese Medicine as part of the TBI program: Acupuncture, Herbal Medicine, and Qi Gong.  I will discuss each of these further in future posts.

The three modules above, IV Nutritional Therapy, Nutrition, and Chinese Medicine offer a thorough complementary approach to the treatment of traumatic brain injury.  The program is not intended to replace the current model of care, but rather to augment a medical model that falls short in providing options for continued outpatient care for post TBI syndrome.  It is my belief that the brain can always do better, regardless of how much time has passed since injury.  Please feel free to give us a call with any questions you have regarding supporting your ongoing healthcare.

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Building a Supportive Network for Those with Post-Traumatic Brain Injury (TBI)

Thursday, December 6th, 2012

Often I see patients suffering from post-concussive and post-TBI syndromes that have been told by their physicians that there’s nothing more they can do.  One or two years have passed, and their chronic condition is just something they should accept and learn to live with.

I’m offering a different message.  CONTINUE FOCUSSING ON THE HEALING!!  There are many ways to support your nervous system and improve brain function.  Some of my best results have come with patients that are two plus years post-injury.

The brain is constantly reorganizing and regenerating the terrain.  Think of a map where city lines are defined by activity, business, and the amount of people moving into the area.  If a city like Portland, Oregon is desirable, people move there and the city grows.  As a result it takes up more space on the map.  The brain works in a similar way.  What you focus on, your daily activities and repetitive movements and thoughts, all define your brain map.  If you are focussing on specific exercises that generate more balance, more cross-hemispheric integration, the brain will respond by appropriating more space for these functions.  As a result these skills improve.

There are other factors affecting this growth process.  Just like a growing city, the brain must have the building blocks necessary to create the infrastructure for growth.  That is why you must include NUTRITION as part of a brain-restorative program.  The combination of FOCUS and ATTENTION together with the right balance of NUTRIENTS results in the restoration of FUNCTION.

If you are not seeing restoration of function, then continue looking for guidance in your rehabilitation process.

Here at Nature Cures Clinic, in downtown Portland, we have an extensive Brain Recovery Program involving many modules of care, including nutrition, acupuncture, IV nutrient support and Qi Gong.  I’m seeing excellent results with patients immediately after injury as well as with chronic recalcitrant cases of post TBI and post concussive syndrome.  Acupuncture provides relief for pain, muscle spasticity, mood disorders, and insomnia.  Qi Gong offers movement exercises to generate better balance and cross-hemispheric integration.  IV nutrition allows us to bring therapeutic doses of antioxidants and metabolic support directly to the brain to assure it has the building blocks for growth and healing of neurons.

My hope is that more people with traumatic brain injury (TBI) know about these options for recovery.

I’m currently building a network of practitioners in the Portland area dedicated to generating more awareness of rehabilitation options for patients with TBI.   Practitioners, please contact me to discuss a cross-referral network in the greater Portland area.

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