Pausing on the trail to take in the view
Reflecting on how far I've come with as little equivocation as possible
Taking a moment to look back at the valley
As we approach the longest night of the year, I’d like to take a moment to reflect on everything I’ve written about here on Brainwave this year, as well as provide an update on what my own experience has been with some of the more cutting edge treatments.
On the About page for this newsletter, I talked about my motivations for creating it, and my history of concussions. As I mentioned there, my most significant trauma occurred in 2008.
Back then, concussions were only beginning to be taken seriously. As I would later learn, this reappraisal of their significance was largely due to the volume of veterans returning from Iraq and Afghanistan with post-concussion syndrome.
The current clinical guidelines for treating concussion grew out of that time period, from the lessons learned by physical therapists and other medical professionals, many of them in the military. Historical note: As it turns out, the field of physical therapy was first developed a century earlier to help treat veterans returning from World War I.
It can take a decade or more before new medical information, protocols, and treatments become standard practice for the average patient. The reason for this lag time? Many older doctors don’t know about the latest treatments or even the current framework for treatment. This is one of the many reasons that any given person who suffers a concussion or head trauma may receive totally inadequate care that needlessly perpetuates their suffering. That was what happened to me in the aftermath of my injury in 2008.
The opportunity of 2020 and 2021
In October of 2020, I took a fairly good blow to the head when I was kayaking. I wasn’t knocked unconscious, but I knew that didn’t mean it wasn’t a concussion.
I knew a lot had changed since 2008. I certainly knew a lot more. I wanted to re-approach the whole process, to use this event as an opportunity to heal more deeply and comprehensively than I ever had before.
Since then, the new treatment options I’ve tried (many of which didn’t exist in 2008 or were unknown to me) include transcranial magnetic stimulation, neurofeedback training, syntonic light therapy, specific supplement regimens, the Wim Hof Method, heart rate variability training, dry needling, and Vielight laser therapy, along with vision therapy, physical therapy, and vestibular therapy.
I’ve already written about all of these, usually from a fairly neutral standpoint, with a good dose of equivocation about the results you may or may not expect.
I’d like to take a moment now to give you an update on my personal experience with as little equivocation as possible.
My personal experience with some of the latest treatments
Transcranial magnetic stimulation. I’ve used the NeoRhythm every day since I got it. I use the Improve Sleep mode before bed every night. It helps me fall deeply asleep fairly quickly. Along with making behavioral changes to better align myself with the circadian rhythm, the NeoRythhm has improved the overall quality of my sleep and helped me stop using melatonin. Occasionally, I will use the Deep Meditation mode after dinner. I no longer use it for up-regulating the brain around the 40Hz level because the Vielight is currently serving that function. See below.
Neurofeedback training. While I definitely felt some initial benefits with this, I soon began to feel like it was something I should return to after making more fundamental changes, so I am currently on pause with this. I have the Muse device, as well as the Mendi device. When I do return to it, I will likely start with the Mendi. I might also try the Muse with their dedicated meditation app (rather than the Myndlift app, which I was disappointed in overall, mainly because the game design seemed crude and uninspiring).
Syntonic light therapy. Every day for 8 months, I put on different pairs of colored glasses (prescribed to me by my ophthalmologist) and spent 20 minutes sitting in natural light, typically outside. The result? Measurable improvements to my binocular vision (which can only help with balance) and other vision improvements. While the overall improvements to sensory processing and integration are harder to measure, they also feel improved. For anyone who has vision issues, vestibular issues, VOR (vestibular ocular reflex) issues, or sensory overload issues, I would definitely recommend trying this. My attitude about it was, hey, worst case scenario, I sit out in the sun for 20 minutes a day. I was fortunate enough to begin doing this in the spring, so that the treatment timeline overlapped with the best weather.
Specific supplement regimens. While I’ve taken different supplements over the years, I really zeroed in on the ones that would support my brain health, with a great deal of influence from the Huberman Lab podcast (the host, Andrew Huberman, is a neuroscientist). I’m still following the regimen I outlined in this post. I take nearly all of my supplements before 10 AM, when the body does best with protein synthesis, as most of the supplements I take are amino acids. The combination of magnesium bisglycinate and L-theanine an hour before bed helps with sleep.
Wim Hof Method. I’ve now been doing the Wim Hof Method every morning for over a year (with a small handful of missed days). Currently, in the darker days of the year, my morning routine involves doing rounds of WHM breathing whilst wearing my new Luminette glasses to set my circadian rhythm. Then I take a cold shower with Tito Puente, whose music makes a cold shower feel like a joyful and welcome respite from the tropical heat. While I know there are cardiovascular and hormonal benefits from the cold shower, I welcome the shower as an opportunity to train the mind to deal with external stressors, and I have found myself better able to deal with external stressors in my daily life. I did the Power of The Mind training in the app, which revealed some additional nuances to the method. And while I do the basic breathing every day, I occasionally rely on the Mood Regulation breathing as well.
Heart rate variability training. This is something I often do at night while watching an episode of TV. My HRV numbers have improved. I noticed that if I do it for 24 minutes, I start to feel the effect around the 10-minute mark and then it really kicks in around the 20-minute mark and those last 4 or 5 minutes are a bit of an altered state, in a good way. I am familiar with what the science says about the health benefits of improving your HRV. So this is something I’ll likely continue to do because it’s relatively easy to enfold into the day. If I were in the immediate aftermath of concussion (days later, still climbing out of the symptoms), I would rely on the morning reading to see where I was on the spectrum of sympathetic and parasympathetic activation, to make sure I was activating the parasympathetic and staying in balance.
Dry needling. This was surprisingly effective and it could be pivotal for anyone with neck issues or whiplash (which is common with head injuries). I’ve always found acupuncture to be shockingly effective, especially for muscular skeletal issues, but dry needling is on another level. I realize some people won’t respond to it as readily, but it really worked for me. I lucked out and found a good practitioner, and I would advise you to find a skilled practitioner before trying this, because you don’t want just anyone sticking needles into your body, especially your neck. This treatment really improved my neck muscle tone and function. Your neck is an essential and often overlooked component of both your balance and vision system (and the root cause of cervicogenic dizziness). I’ve now had 7 treatments and I plan on getting this treatment on a regular basis for maintenance. I did these treatments in tandem with physical therapy for my neck with a big emphasis on manual joint manipulations and exercises aimed at improving range of motion.
Vielight laser therapy. I’m about 6 weeks into using this device daily for 20 minutes, typically while doing something else linked to the default mode network, such as HRV breathing. According to Vielight, I should see incremental improvements over a 6 month period. I already feel like it’s helping, although it’s hard to say exactly how or how much. Sometimes I take the supplement Alpha GPC about 15 minutes before the session. In general, I do a session about 30 to 60 minutes after taking my morning supplements. Sometimes I do it after walking for 30 minutes. It feels promising and I look forward to reporting back later.
Vision therapy, physical therapy, and vestibular therapy. In my case, I’ve needed a fair amount of VOR (vestibular ocular reflex) therapy. This involves tracking objects through space while simultaneously moving your body (your head, neck, and whole body) through space in different ways. Even though these protocols are fairly well establish, as with anything, there’s great variation from one practitioner to the next. For example, one PT had me doing VOR exercises once per day for months. The next PT I saw told me that VOR exercises really don’t work unless you do them 4 or 5 times a day. She likened it to training the limb of a tree to grow in a certain direction by applying continuous force rather than occasional force. So now I’m beginning a whole new set of exercises with this framework in mind.
Since I’ve done so many different things in parallel, it can be hard to attribute results to any one thing. However, I think I have a fairly good sense of the ways that each treatment helped me or didn’t, and I’ve tried to outline that here.
Overall, in the past year I’ve made obvious gains in the areas of mental endurance, vision acuity and endurance, sensory integration, emotional regulation, responses to stress, sleep quality, and neck mobility, among other things.
As always, I hope this information has been helpful to you and your loved ones.
Brainwave is an informational resource for people whose symptoms haven’t resolved after a concussion or mTBI. I endeavor to present this information in a clear and concise way, spelling out what’s backed by science and what remains unknown. Nothing here is meant as a substitute for professional medical advice, diagnosis, or treatment. I am not a physician or a healthcare practitioner of any kind; I’ve simply had a lot of sports-related concussions and had to learn this stuff the hard way. If you found this information helpful or know someone who might benefit from it, please share and subscribe to Brainwave.