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Protecting Our Brains: TBIs, Concussions, and Everyday Healing

With Dr. Jeremy Schmoe

Season 11, Episode 11  | November 10, 2020

Traumatic brain injuries (TBIs) are most often connected to sports-related trauma, yet nearly half occur in everyday life from incidents such as slips, falls, and even infections. They can affect many integral aspects of our lives, including cognition, focus, vision, balance, and function. The good news: There’s hope for healing. Jeremy Schmoe, DC, joins us to talk about how to identify abnormalities and the ways we can better support our brains.

Headshot Of Dr. Jeremy Schmoe.

Jeremy Schmoe, DC, is the founder and director of the Functional Neurology Center and co-developer of the Brain Health Online Summit. He works with patients with complex neurological dysfunction, as well as ones with head injuries, vertigo, dizziness, movement disorders, neuro-degeneration, and developmental disorders.

There are some quick and easy self-assessments you can do to test your brain function and learn if you could potentially use some support. Dr. Schmoe suggests paying attention to the following:

Assess your balance.

  • Stand with your eyes open, then closed. Does your balance change?
  • Move your head left, right, back, and forward while standing. Do you feel dizzy or does your body sway?

Test your skills.

  • Tap your pointer fingers and thumbs together repeatedly. Is one hand slower than the other?
  • Wiggle both your hands while saying every other letter of the alphabet. Is it hard to do both at the same time?

Notice your heart rate.

  • Is your resting heart rate abnormal for your age?
  • Does your heart rate shoot up when you go from sitting to standing?

If you answered “yes” to any of these questions, consider trying the exercises featured in the “The Neurobic Workout” listed under “Mentioned Resources” or consulting with your healthcare provider.

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Transcript: Protecting Our Brains: TBIs, Concussions, and Everyday Healing

Season 11, Episode 11  | November 10, 2020

Jamie Martin 
Welcome to Life Time Talks, the healthy-living podcast that’s aimed at helping you achieve your health, fitness, and life goals. I’m Jamie Martin, editor in chief of Experience Life, Life Time’s whole-life health and fitness magazine.

David Freeman 
And I’m David Freeman, the national program leader for Life Time’s Alpha program. We’re all in different places along our health and fitness journey, but no matter what we’re working toward, there are some essential things we can do to keep moving forward in the direction of a healthy, purpose-driven life.

Jamie Martin 
In each episode of this season, we’ll break down various elements of healthy living, including fitness and nutrition, mindset and community, and health issues. We’ll also share real, inspiring stories of transformation.

David Freeman
And we’ll be talking to experts from Life Time and beyond who’ll share their insights and knowledge, so you’ll have the tools and information you need to take charge of your next steps. Here we go.

[Music]

Jamie Martin
Hey, everyone. I’m Jamie Martin.

David Freeman
And I’m David Freeman.

Jamie Martin
And welcome back to this episode of Life Time Talks. In this episode, we’re talking about concussions and traumatic brain injuries. This trauma is most often connected with sports-related injuries, yet nearly half of these injuries are not the result of sports or activity, but actually our everyday lives, including things like falls and whiplash. What’s more, they can affect so many aspects of our lives including cognition, focus, vision, proprioception and balance, and autonomic function. The good news, however, is that there is hope for recovery and healing.

David Freeman
Yes. And to talk with us about them and what we can do we’re joined with Dr. Jeremy Schmoe. He is the founder and director of the Functional Neurology Center in Minnetonka, Minnesota. He’s also the co-developer of the Brain Health Online Summit, and over the past 10 years, Dr. Schmoe has worked with so many patients with complex neurological dysfunction and has treated thousands of patients with head injuries, vertigo, dizziness, movement disorders and developmental disorders.

I actually had the opportunity to meet up with Dr. Schmoe myself in person and let me just go ahead and tell you, there’s a play on words here, I’m mind blown. He showed me so much within an hour timeframe of working with him with my focus, with my eyes, my gait, and just remembering certain things that he was saying at the beginning and at the end of our session. I tell you right now, the way I came in versus the way I left out, I noticed a significant change, and I’m looking forward to continuing to work with him in the future.

Jamie Martin
That’s so great, David. And I haven’t personally worked with Dr. Schmoe but we have featured him as an expert in many articles in Experience Life over the last few years. I think one of the things that I love about his approach is how it really is an individualized patient-center focus that he has. The exercises and practices he shares are things like, yes, we can do with a healthcare provider and they can give them to us, but there are also some things at least we can do at home to begin to improve our brain function in those different pieces. But he also takes a lifestyle approach and that’s something that we talk about so much on here on the podcast and also in the magazine.

It’s not just one thing or another. It’s a bunch of interconnected dots. Our health is our brain function and that’s supported by our nutrition, exercise, sleep, stress management, and all of those things. So, I think he brings the functional approach to our brain health, but that really contributes to our quality of life as a whole.

David Freeman
Yeah. Another key point that was taken from our conversation is he was able to humanize males. We’re so in this stigma as far as when we ask for help it’s a sign of weakness or things of that nature. So many different individuals, me, myself, that I’ve had concussions and we kind of hide that because we the of it as a weakness. But when you’re going to get help that’s where your strength really is because you’re asking for help. So that’s one thing I encourage males, females as well. When you need help, get it.

Jamie Martin
Well, there are a lot of different facets to our conversation, so anything else you want to add, David, before we get into this with Dr. Schmoe?

David Freeman
You guys always hear me say it. Mind right, body right, so let’s get after it.

Jamie Martin
Hey, everyone. Thanks for joining us for another episode of Life Time Talks. We’re excited to have Dr. Jeremy Schmoe of the Functional Neurology Center here in Minnesota joining us today to talk about the health of our brains and the effects of traumatic brain injuries and concussions, as well as ways that we can truly find healing and begin to recover. Dr. Schmoe, thanks for joining us.

Jeremy Schmoe
Yeah. Thanks for having me. Really excited to be here.

David Freeman
We’re excited to have you here. Let’s dive right in. Dr. Schmoe, when we think of a few different terms, usually it comes to different people in different ways, so I’m going to rapid fire you right now. In just a sentence or two, I want you to give us your definition of the following terms. Brain health.

Jeremy Schmoe
Yeah. So brain health is so many different aspects. Obviously, you think about your body and your body health. Obviously, your body affects your brain health. So say if you have changes in your gut and you have inflammation and you have all this peripheral inflammation in your body, that can affect your brain. How you think, your cognitive outlook on things, your outlook on life, being positive versus being negative, that can affect your brain health. Overall how your brain is doing just from a chemical standpoint, all your neurotransmitters and all the things that you guys love to talk about at Life Time, very, very important. Functional medicine aspects, that’s important for your brain health, but a lot of people don’t really think about what’s going on with their balance, how quick their eyes move, their reaction times, how their vestibular system works. That’s important for your brain health.

So I always tell people, we look at things neurologically, structural, and metabolic and those can all affect your overall brain health.

David Freeman
Awesome. I love that answer. So I want to throw two more at you and sometimes people might get these two confused or they might be very similar. So I want to know TBI, alright, I’m going to let you say what that acronym is and concussion. Those are my next two I’m going to throw at you.

Jeremy Schmoe
Yeah. So I mean a concussion is a traumatic brain injury. You hear so many times people are like you just had a concussion, you just had a concussion, but that means that you injured your brain. Obviously, there is different categories and there’s different variations and there’s a whole spectrum of mild, moderate to severe. But really a concussion is a traumatic brain injury. Really, with concussion you can have all sorts of different systems affected with concussion. So no two concussions are the same. You could have a concussion that affects more of, say, your cervical spine and so you might have some dizziness or some imbalance or nausea.

Another person, their cervical spine could totally be fine but then they have issues, say, with their eye tracking and then they have all sorts of visual-based symptoms. Some patients don’t have visual symptoms. They just feel dizzy and they might feel like they’re spinning. So depending on how you injure your brain and what areas of the brain are actually affected, that’s how you get your different symptoms. So with concussion you could have, like I said, you could have cognitive, vestibular symptoms, more balance-based symptoms, more visual symptoms and sometimes people just have anxiety and depression. So they’ll have more limbic or emotional-based symptoms.

So really, a concussion is totally different for each individual person. No two concussions are the same, which is very important because you have to address people differently. So say if you had one person that had more of a neck issue, you’re going to address that differently compared to somebody who had more of, say, an issue with their emotional regulation.

Jamie Martin
So we’re going to keep diving into this, but I want to talk a little bit about your background, Dr. Schmoe. How did you get interested, one, in brain health and then how did you get into this field of functional neurology because I think that’s a unique take on neurology in the traditional sense.

Jeremy Schmoe
Yeah. So it’s interesting. I actually injured my shoulder in high school, and I had a couple of shoulder surgeries. There was this guy, his name is Dennis Thompson, and you might have heard of him before but he basically was the CEO for a company called ARPwave, which is a type of electrical modulation device.

So he lived down the street from my grandma and grandpa. So basically, they were neighbors, so I got introduced to him and he was working with a chiropractor who was doing functional neurology, mostly working with athletes. So when I first got introduced to this, I saw different types of performance things that you could do with athletes to improve their function by doing different eye exercises and balance stuff and adjusting them and doing these different types of workouts. So that’s initially what first got me interested and then I ended up going to chiropractic school. So I went to chiropractic school and then I studied under a guy named Dr. Ted Carrick. So he’s kind of the founding father of functional neurology.

So I started doing all the neurology courses and then when I got out of school that’s when I started and I opened up my own practice. It just so happened that I had about three skiing concussions in the middle of school and then one right when I graduated. That happened out in Portland, and I developed vestibular symptoms. So I had this kind of weird rafty, floaty, dizzy type sensation and trouble driving. That kind of persisted and kept going on. I would get adjusted and I would change my diet and do these gut repair protocols but I actually turned out doing some very specific types of flips and rotations actually with that Gyrostim chair that’s right behind me was the thing that helped get me better.

So just very specific vestibular rehab. That helped me improve. So then I started my practice and then over the last 10 years I’ve helped thousands of people from all over the Midwest, all over Minnesota. I work with very severe cases to just your typical everyday weekend warrior that might have had five concussions over their career and they’re still struggling with symptoms.

They might not be debilitated now but they still have issues that are occurring that need to be addressed. That’s why I was excited about the neurobic’s article because those are simple things that people can just do to basically test themselves. So if you have trouble doing those figure eights and walking and moving your head or doing some of those balance things there could be some issues wrong with you that might need to be addressed.

Jamie Martin
Absolutely. And that workout you’re talking about is in the October 2020 issue of Experience Life. I think it’s four or five moves, and I personally have been doing them regularly as part of my warmup. I don’t have any known concussions that I know about. I’m kind of risk averse when it comes to a lot of things, so I don’t risk hitting my head too often, but they have been really helpful just from a warmup perspective, and I think, finding focus. We’ll make sure to link to that.

Jeremy Schmoe
Those are activating your brain, they’re getting your frontal lobe working better. When you do those complex movements, your cerebellum really, really likes that motion. So anything that’s uniplanar, it’s kind of easy for the brain. When you start moving in different complex patterns the cerebellum, that area in the back of the brain that’s very important for balance and also cognition and energy levels and knowing where your body is in space. All those exercises activate that area of the brain and then that helps you know where your body is in space so then you have a good, solid foundation to move and absorb force better and not get injured.

David Freeman
Well, let me share my personal experience with concussions. I played football from the years of me being eight years old all the way to 22. So from little league through high school, collegiate, and a little bit pro overseas, and I remember easily five concussions that I’ve had during that span of playing football. Two of them really stand out to me. So I’m going to share those experiences.

Jeremy Schmoe
That sounds great.

David Freeman
So the two that I remember, one was in high school. I mean football is a contact sport, right, and running over individuals — I played running back so running over the linebackers, running over the safety is almost like a badge of honor. We didn’t avoid contact, we went towards contact. I remember I ran straight at the safety and both our heads hit and it as a loud hit. I remember getting up and I was kind of like whoa, what just happened. I remember a loud ringing sound, a very loud ringing sound and everybody sounded muffled, so it was like [muffled noise], everybody sounded muffled, and then sound came back after a while.

Then we got into the huddle and the said a play with numbers and stuff, and I had no clue what the heck they were talking about. At some point, obviously I needed to go to the sideline, and I started just saying certain things that I remember. I wanted to remember my birthday. I wanted to remember my address. I was purposely trying to be like did I just lose my memory. It was a very weird feeling. So that was my first experience.

Jeremy Schmoe
OK.

David Freeman
So I want to pause there real quick and what’s your assessment from just hearing me kind of explain that to you?

Jeremy Schmoe
I mean those are the types of things that people, you know, right when you have a concussion those are the symptoms that you get. What’s happening, there’s a whole bunch of stuff that’s actually happening at the cellular level of the brain. So in the brain you can think about it like you have these networks and they all communicate with each other but you also can just think of the cells in your brain. They have different organelles in there. There’s all these different ratios. There’s all this chemical soup that’s involved.

When you get those hits there’s changes that are going on at the cellular level of the brain and you can get changes in the way that these neurons communicate with each other. So say you had more auditory symptoms. We could go the cells in your brain, say for example, in your temporal lobe are very, very unstable right now. So neurons get unstable when they get injured and then they fire spontaneously. Those are the kind of things that you see with recent concussions.

So you have neurons in the brain and then the neurons are also supplied by something called glial cells. So you have what are called microglia. They’re kind of like the scavengers. Say if you had that concussion, literally within the first few days the brain is trying to repair itself. So there’s all this chemical stuff that’s going on and then the networks start to go from being firing very high to firing more stable and then you’ll start to see your symptoms decrease as those neurons become steadier.

David Freeman
So then moving on to the second concussion. Usually, they say if you have one you’re more susceptible to having another I’m assuming, especially playing in that contact sport where you could possibly make contact and get into your head. So the second one came my junior year, sorry my senior year of college. Once again, running down the sideline, last minute, cut into a safety and this time it came from the side. I remember watching the film. It literally looks as if my body just goes limp and I fell down to the ground. I do not remember a lot from that one. I just remember waking up in the locker room. So this was like I got knocked out.

Jeremy Schmoe
Yeah, you got knocked out. If you got knocked out, I would say that there was probably more areas in the brain that were involved with these different networks that fire up to activate your brain. A lot of this comes from the brainstem. So no matter where you get hit, just due to the biomechanics of your brain and your neck, there’s almost a moment of basically torsion. What happens is midline areas in the brain get affected. So to me, it sounds like some areas potentially in the brainstem that fire up into the brain could have been affected on that second one.

I mean obviously there is changes that were occurring in the brain. What we do that’s cool is we’ll actually assess those different neuronal networks by looking at eye movement. So eye movements, balance, gait, reaction times. It’s really hard to 100 percent know what’s going on at the cellular level of the brain with current technology right now but we can use different biomarkers to watch you move and how your eyes track and how your balance is even now after however many years it has been to see if there’s any changes in how your neurocircuits are firing.

So your neurological circuits potentially could still be off now even though those happened years ago. So like I said, there’s the neurological circuitry aspect but then there’s also this kind of neuroinflammatory chemical soup aspect of what’s going on in the brain. So the brain has neurons and they also have glial cells and these glial cells want to go on and they want to scavenge around in the brain and take care of debris and get rid of dead and dying neurons and keep the good ones. That’s what helps repair your brain.

I don’t know if you guys know this, but everybody loses neurons every single day. I mean I think they’re saying between 10,000 to 50,000 per day, so it’s normal to lose neurons, but your brain does a really good job of doing all this scavenger stuff. As you have more concussions, what happens are those glial cells in the brain can start to fight back against you a little bit and start going and they can go attack or basically get rid of healthy neurons as well. So you don’t want to get rid of too many healthy neurons, which could overall affect your cognition, your emotions, how you walk, how you talk, how you move. And those are the things that we assess from a neuro exam stand point that are important to be checked out.

Jamie Martin
I don’t want to go down too far of a rabbit hole here but I think this goes back to some of the research that’s being done on former pro football players, correct? I don’t know, Dr. Schmoe, if you can speak to some of that in terms of the post-humous research that’s being done on those brains and what it looks like in the gray matter.

Jeremy Schmoe
Yeah. I mean there’s changed in tau protein. So there’s accumulation of tau protein in various regions of the brain. Usually, it starts more focal and this is neurodegenerative disease or CTE, chronic traumatic encephalopathy. Things will start focal and as you start to degenerate then basically it will expand and go to other areas of the brain. So it could have started, say, in your left frontal lobe but now things move into, say, the temporal lobe and then you start getting different symptoms and things can go down into the brainstem and even into the spinal cord and affect how you move and how you breathe and things like that as well.

That has a pattern of what are called tau proteins. There’s all these different proteins and neurons and things like that, but there’s accumulation of that specific protein that is shown postmortem.

Jamie Martin
Right, exactly. We have another article at Experience Life that we can link to that has some more details about that as well. I want to keep us moving. What David, his experiences that he shared were really tied to those sports and recreation-related concussions or traumatic brain injuries, which according to the CDC there’s up to almost four million of those a year but there’s a really wide range of how many that happens. But then there’s this whole other category of every day injuries that happen. Another CDC stat is up to 47 percent of all TBIs are not actually connected to sports or activity. So let’s talk about that. When are these other brain injuries happening?

Jeremy Schmoe
Yeah. I mean domestic abuse is huge. So trauma, domestic abuse, but just slips and falls as well. I’ll give you an example. I had a father who got hit in his head by his daughter with a pillow and that led to lingering post-concussion symptoms. I’ve seen a whole bunch of things. I’ve seen people stand up and get hit in the head with ceiling fans, slips and falls on the ice are huge in Minnesota, car accidents are huge. Most people only think about the structural aspects to it but what’s actually occurring in the brain can also be affected as well.

I’ve seen people develop post-concussion symptoms after basically just having infections and issues with their gut. So not even hitting their head. So there’s this whole idea of chemically induced, post-concussion-like symptoms. So people can have inflammation and infections and get brain-based inflammatory response and develop almost PCS-like symptoms. That happened with a kid that I saw probably eight years ago. He just had a minor car accident, a fender-bender going two miles per hour and that kicked him into post-concussion symptoms for two years.

So there’s a whole host of things that obviously can affect the brain, alright. When you injure your brain you can develop changes in the gut. You can develop changes hormonally. You can develop changes with your pituitary adrenal access. So there’s a whole host of whole-body issues that can develop after TBI. So we’ll see people that will have an injury five years ago, say, from a car accident and then it’s five years later and now they have a whole host of metabolic and inflammatory issues that have developed. So it gets to be pretty complex, and there’s all these different variables that go into it. Your preexisting status before you hit your head is very important.

So say if you had a bunch of inflammation, you had diabetes, your diet is very poor, your fatty acid levels are very poor, that might make you more susceptible to having potentially symptoms that keep going in one individual versus another. What I’ve seen clinically, I don’t know if all the research is there for that, but I think things can get pretty complex pretty fast once you start getting into all of the different variables that could affect people’s brains. Then people just get concussions on top of concussions.

So it’ll be I had this happen and then maybe that affected your balance or your idea of where you are in space and then you had another car accident and then you had another one. So we see a lot of injuries on top of injuries as well.

Jamie Martin
So you start seeing that cumulative effect. That just makes me wonder, if so many of these things are happening in everyday life, how many people are actually getting diagnosed with TBIs versus just going about their daily life and just not feeling great or just thinking this is just my baseline, this is how I feel.

Jeremy Schmoe
Yeah. I had a lady this week that I worked with. She came to see me from the East Coast. She had a horseback riding accident 20 years ago where she fell off a horse, she hit her head, they did some imaging, they found some subtle changes in her cerebellum, and then she just kind of went on with her life. Then 20 years later, she got an inner ear infection. So she developed vertigo and her brain would not calibrate because her cerebellum was actually still off. So we examined her and her whole left side was very uncoordinated and her finger to nose was off and she was going over to the left with her balance.

We actually did quite a few of those exercises that we show in that article and that helped activate her cerebellum and we were able to go in there and do some very specific head and eye movements. We got her dizziness to basically calm down in two days. So I think things just kind of accumulate on top of each other. So people have injuries, then more injuries, and then you throw in other factors. That’s just an example.

Another girl that I saw this week, she was 10. She was just playing in her front yard two years ago and she’s got a baseball bat and she swung it around and she actually hit herself in the back of the head and knocked herself out. So it’s just random things that happen with people. It was two years later and she has dizziness, she has headaches, she complains about her screen time that her eyes aren’t tracking right and it’s been two years. She got referred to me by her MD pediatrician and we were able to make changes with her in two weeks basically of doing these different exercises.

So that’s 20 years later, that’s two years later. The brain is pretty plastic. If you do the right things you can make improvements and if you also run labs on people and look at those underlying issues and address those as well, I think that’s kind of the mixture that helps get people better. Specific rehab, healing the gut, nutrition, and then getting people back into exercising. That’s the combination that’s going to get people with persistent symptoms to get in the right direction.

David Freeman
Alright. So Dr. Schmoe, let me ask you this because we kind of know a lot of the obvious ones. We kind of threw some of them out there like the headaches, the hearing loss, or the ringing sound. So we talked about some of those. But what are some at-home self-assessments that somebody that’s listening right now that they can do?

Jeremy Schmoe
Just simple, simple stuff. So like I said, with concussions it can affect midline areas of the brain and in those area’s midline those are the areas that control your eye movements, your balance and actually just the way that you breathe. So I always tell people, see if there’s any changes in your breathing patterns. Have you developed changes in like sleep apnea? What’s your resting heart rate? Say if your resting heart rate is at 80 that might be too high for your age. What’s your heart rate doing when you go from seated up to standing? Say if I’m at 60 here and I stand up and my heart rate goes up to 120, that’s totally abnormal.

So you can get these autonomic changes with concussions. So looking at some of those autonomic things are very, very important and looking at your balance is very important. So standing up, eyes open, eyes closed, what’s the difference between eyes opened and eyes closed. Move your head left, right, back, forward. See if you have increased sway or if you feel dizzy. That’s very important to know how you balance is doing.

Some other simple tests are just some cerebellar tests. So look at what your finger to nose looks like. So if you’re going here and if we come in and you’re totally missing your nose or if it looks really jerky coming in on one side compared to the other that could be a problem with your cerebellum on that side.

Another test that you can do is just do finger tapping. If you’re really, really slow on one side and you have hesitations, that could potentially mean you have an issue with your brain over on the other side. So looking at those things are important. I always have people, I tell them I just want you to bring up your thumb and look at your thumb and ask them, can you actually just keep your eyes steady on your thumb, or do you feel dizzy with that? How do you feel when you look over to the left, the right, up and down? Does that make you feel dizzy or lightheaded? How do you feel when there’s stuff in the background? So say if you had your thumb up and then say the TV was going on in the background and you feel super nauseous and dizzy from that, that could be a problem with your brain’s ability to kind of gate some of those visual reflexes.

Those are really easy things that people can do at home, and then also, what do you feel like when you walk? So when you walk are you going over to one side? Are you going to the left, are you going to the right? Look at your husband or your wife walk, is she not swinging one of her arms on one side? That could be indicative of some changes in the brain on the other side. How easy is it for them to walk and turn? Can you make a quick turn or do you make a slow turn? So by looking at just those simple things, that can give us an idea of what areas of the brain might be dysfunctional. Some common areas are like the cerebellum, the vestibular system, the brainstem, and take it to the bank with concussion, it always seems to affect the frontal lobe, so your planning and your cognition.

So here’s a fun one, people can try this. Try just going like this and then say every other letter of the alphabet.

Jamie Martin
I want to make sure people know what you’re doing. You’re wiggling your hands back and forth, almost like jazz hands, but not quite.

Jeremy Schmoe
Like jazz hands. Do it if it feels coordinated and then go A, C, E, and see if that becomes uncoordinated. If that becomes uncoordinated you might have issues with dual tasking, which involves the frontal lobe. We like to have people dual task with walking and see if they get worse. That might mean that they have some issues with their cognitive planning in their frontal lobe. So that’s what we’re trying to figure out is what areas neurologically are off. Then we design exercises to activate those areas of the brain to get them to function better. That’s what those exercises do from the article. So even those basic exercises, if you do those, if you have a problem doing those, you could have had an issue with, say, your cerebellum or your head/eye tracking or your vestibular system, which needs to be addressed. What happens when you address those things? People feel more balanced, cognitively they feel quicker, your autonomics become steadier. What are autonomics? Basic human functions like digestion, heart rate, respiration, things like that.

Jamie Martin
Are those similar assessments that you look for when someone comes into your clinic or are you looking at other things? I know I had a team member, for instance, that worked with you and he talked about some eye tracking work that you would do. So are there specific things that you do in your clinic as an initial assessment to gauge whether that might be a brain injury issue?

Jeremy Schmoe
Yeah. So all those things that I just said, that’s my bedside examination. But then we have other technologies that we use to actually video record and graph your eye movements out. So we use what’s called BNG where we can actually blow your eyes up on a flat screen TV and watch every single movement. So we look at do your eyes drift around in the dark? That lady that I was talking about that had the horse injury and then the inner ear infection, she had seen seven different people but she still wasn’t getting better. We put her in the dark and her eyes were subtly just going like this over to left. By the end of the week, we basically made that flat line disappear and what turned out was her walking looked better, her dizziness was less, and she actually had less anxiety, which was really, really cool.

So I always tell people when your brain doesn’t know here your body is in space that can be anxiety provoking. So I’ll see patients that will have done CBT or EMDR or other psychological-based techniques but there could be physiological things that are affecting the brain that if you get those taken care of all of those other therapies will work better. So we look at the eyes. We have technologies where we actually graph your balance out. Eyes open, eyes closed, flat, foam, head in different positions. We have some other technology. It’s called The Right Eye where it graphs your eyes out and gives you what’s called a brain EQ score. So it looks at your pursuits, your saccades, and then gives you normative data and how you are compared to age-matched scores.

Some other things that just literally graph out your quick eye movements and can literally let us know are you stopping short, are you going too far, and it’s all these little subtleties that I think make all the changes with getting people better. So we try and objectify it and get data and then do rehab and then actually go back and recheck that data and see if we objectively made your eyes track better or your balance look better. Did we make these tests look better? Hopefully, what that does is translate over to a change in your every day life. When you leave the office does it make something like driving easier? Do you feel less anxious? Do you have less brain fog? I mean that’s the whole goal is to get transfer over into real life.

One of the things that we’ve been doing is doing virtual reality training. So we have this virtual reality goggle device. We’ll put people in a situation where they have crowds moving past them. we’ll put them in a car and have them move, we’ll move you up and down on an elevator or escalator, and it’s really cool to see what kind of things actually trigger people. Then we basically help them work through that and get those things better. So our goal is to not just make you better in here, but to make you better at whatever it is that you want to do.

We work with people that are your everyday person that had an injury, but we also work with athletes and things, too. So I work with some professional hockey players that have come in, big name guys, local guys from Minnesota that they don’t know if they’ve had something happen, but we find these little subtle things and we make improvements and then they’re like I can totally skate better and rotate over to the left easier or something like that.

David Freeman
What about also I started getting a lot of motion-type sickness as far as getting on some kiddy rides when we went to the fair. I used to always be able to get on rides with no issues, but now it could be simply going up and down slow, and all of a sudden I feel very sick, I start sweating, so I didn’t know if that was also a symptom of concussions.

Jeremy Schmoe
100 percent. I mean a majority of the people that I see have changes in their vestibular system. So your vestibular system is a system that connects from your inner ear into your brainstem and then it goes up to your brain to let you know how you’re moving your head. So whether you’re moving your head left or right, or forward, backwards, or tilting or shifting or even bobbing up and down. There are sensors in your inner ear that detect those different motions and all of that information goes into the brainstem, right in that area that can get concussed, that can get injured when you get that acceleration or you get that torsion that happens.

On one of those injuries that you had that could have affected some of the neurons, some of the different networks in your vestibular system that affect how your brain perceives basically moving up and down. They’re called the otolith organs. So there could be some sort of issue with that in your brain and how your brain takes that information in. Those pathways are really, really connected to your autonomic. So people can get nauseous and feel dizzy and lightheaded and just feel gross, alright.

So those pathways are very, very important to assess, and we can do that by looking at different combinations of head and eye movements and then graphing all your eye movements out, and doing some different assessment. I can pretty much guarantee you that there’s something going on with you if you have that occurring with going on with those kiddie rides. We just have to find what it is and then we need to development a very specific rehab protocols to activate those areas of the brain to get them to integrate better.

So basically, it’s ears, brainstem. In the brainstem you’ve got these things called vestibular nuclei. Think about what a cirque de soleil person can do. Think about all of those different motions. That’s just insane. The brain has the capability to do that stuff. There’s all of this complex circuitry in the brainstem that if it just gets a little bit off you get symptoms like what you just explained.

Jamie Martin
I just have to say, David is a super high-performance person already, so I can’t imagine if you get that figured out, David, all these things, what your performance will be like.

David Freeman
I believe in the work because I’ve already heard some great things about you. So let’s get to the lab question. You kind of said what they could do for a self-assessment. What should they be asking their family doctors to test for?

Jeremy Schmoe
Just like basic stuff is very important like are you anemic, what are your iron levels, what are your ferritin levels, what’s your vitamin D status. Obviously, your immune system is very, very important for brain function. Say if your vitamin D is really low and you’re anemic, you need to get those things taken care of. It’s important to know how are you with your thyroid. Thyroid is very important for brain function. Say if you checked TSH, TPO, thyroglobulin antibodies to see if you had any thyroid autoimmunity. There’s all these connections between the brain and the gut and the development of autoimmunity after TBIs. So those things are very important and just looking at are you inflamed, so C-reactive protein, homocysteine, those markers are very, very important. Basically running CBC, white blood cells, red blood cells to see if there’s any underlying infection that might be going on. So those are some of the basic things that everybody should know and especially with everything going on right now you should know what your vitamin D levels are. You don’t want to see them at 10. You don’t want to see your ferratin at two.

I always tell people you need good metabolic stability for your neurons to function for you to be able to build plasticity. So if you’re anemic, it’s really hard to improve brain function because people might feel a little bit better and then they just get wiped and then they get fatigued, and that’s neuronal fatigue. There’s something called neuron theory, how these neurons need oxygen, they need glucose, the need activation, they can’t be inflamed. So there’s this whole life around these cells and then all of these cells just think about these cells and what they need, the needs of that neuron and then take them and put them into those other areas of the brain.

So say if that was in your cerebellum, your cerebellum’s probably going to fatigue out with doing different types of movement. So overall cellular health in everything that you guys talk about in your magazine is very, very important for brain function, alright. So we’re setting that foundation from that functional medicine standpoint and then we’re adding the whole rehab aspect on it with functional neurology. Some of the patients that we see that come in have already had every lab test in the book. Everything’s normal, their diet is perfect, their labs are perfect, but they still feel off. There’s usually that circuitry issue that we have to try and figure out what it is and that’s where you need neurorehabilitation.

Jamie Martin
So you’re talking about the baseline things that we can do. So what other things can we do? Obviously, you’re getting support, you want to go and ask for help in certain situations, but if you know you’ve had a concussion in the past or you know you’ve been diagnosed with this, what are some things that somebody could do at home to start to make a difference or to maybe start seeing some improvement if they don’t have access to somebody like you who has this experience?

Jeremy Schmoe
What I would do, honestly, I would start doing those exercises from that article. It’s that easy. Then get your magnesium levels appropriate because we know that neurons basically are stabilized by magnesium on that outer membrane to allow your neurons to not fire spontaneously. Get your vitamin D levels up. Get appropriate fatty acids, you know that your neurons need fatty acid support to be able to function appropriate. So just those basic exercises and doing some metabolic things are very, very important. Then obviously knowing if you’re off with those areas of the brain.

So those are just some very basic things. It’s hard because every individual person has individual findings and you need to be very specific with what you do because, surprisingly, if you do the wrong things you can make some people worse if their issues are more complex. But those exercises that we put in there, those are pretty basic things that if you feel worse from doing those there’s something that’s wrong that needs to be assessed.

Jamie Martin
Right, right. Just as an example I’m going to talk through the one that I do literally every morning. It almost looks like a Frankenstein kick where you put your right hand out and you kind of kick your left foot up to kick your hand. You do that for I think 15 to 20 reps then you repeat it on the other side. You mentioned you can make it more challenging by not putting your foot down when you go back or you could say the alphabet backwards or those kind of things, which is interesting. So that’s one example.

Jeremy Schmoe
Adding in that dual tasking like saying every other month, every other letter of the alphabet, every type of food you can think of, every state that you can think of. That’s going to get some of these higher cortical areas working and then as you do this that’s going to work the cerebellum, some of these different networks in the brainstem. So it’s very, very simple. If you can work on just your gait, the way that you walk and then the way that you breathe. So work on breathing exercises, your gait exercises, and then some of those figure eights. That’s a pretty good foundation for getting you started with this and then add in some of those simple metabolic things as well.

Jamie Martin
Alright, David, I think it’s time.

David Freeman
Yeah. I was about to say I think it’s time. The power minute. This is what we always do at the end of our episode. So we always want to leave our listeners with a golden nugget. So with that being said, if there’s one key takeaway that you want to leave our listeners with, what would that be?

Jeremy Schmoe
There is hope. I mean it’s written all over my door. If you come into my office it says it all over the place. I’ve seen so many issues that people have had that are just lingering that 10 years ago, five years ago, 20 years ago and people don’t think that they can get fixed. They think they’re broken. If you get very specific and you look at these things you can, for the most part, make changes and make improvements still, alright. A lot of times, what I see are people have done all the right stuff — it might not be in the right order. This stuff’s kind of like baking a cake. You need to be very, very specific for things to be perfect. Some people need that very specific rehab to help get them better.

We’ve done our program with thousands of people. We’ve made changes in a lot of people’s lives. I see miracles in our office happen every day. It’s just kind of the way things are when you apply this method clinically of assessing people. So there’s definitely hope. It’s worth continuing to keep trying and don’t give up.

Jamie Martin
Before we sign off, where can people learn more about your work?

Jeremy Schmoe
So they can visit our website it’s thefnc.com and you’ll be able to go on there. We have our clinic video. We also have a YouTube channel, which has just a lot of the different technologies and things that we do. We just did a mini summit called Technologies and TBI where we had videos on there of me talking about visual vertigo and some of my other doctors talking about all the different technologies, where you can learn about it. But we have so much educational information on our website. Tons of things about nutrition and brain health, all the things about the different circuitry in brain health. So if you just start going through there, you’re going to get some really amazing information.

Jamie Martin
Thank you so much for joining us. This has been really eye opening and informative. Thank you.

Jeremy Schmoe
Thank you.

[Music]

David Freeman 
Thanks for joining us for this episode. As always, we’d love to hear your thoughts on our conversation today and how you approach this aspect of healthy living in your own life. What works for you? Where do you run into challenges? Where do you need help?

Jamie Martin 
And if you have topics for future episodes, you can share those with us, too. Email us at lttalks@lt.life, or reach out to us on Instagram at @lifetime.life@jamiemartinel, or @freezy30 and use the hashtag #LifeTimeTalks. You can also learn more about the podcast at thesource.lifetime.life/podcasts.

David Freeman 
And if you’re enjoying Life Time Talks, please subscribe on Apple Podcasts or wherever you get your podcasts. Feel free to write a review and also let others know about it, too. Take a screenshot of the episode and share it on social, share it with your friends, family, work buddies, life coach. You get the gist.

Jamie Martin 
Thanks for listening. We’ll talk to you next time on Life Time Talks.

[Music]

Jamie Martin
Life Time Talks is a production of Life Time — Healthy Way of Life. It is produced by Molly Schelper, with audio engineering by Peter Perkins and sound consulting by Coy Larson. A big thank you to the team who pulls each episode together and everyone who provided feedback.

We’d Love to Hear From You

Have thoughts you’d like to share or topic ideas for future episodes? Email us at lttalks@lt.life.

The information in this podcast is intended to provide broad understanding and knowledge of healthcare topics. This information is for educational purposes only and should not be considered complete and should not be used in place of advice from your physician or healthcare provider. We recommend you consult your physician or healthcare professional before beginning or altering your personal exercise, diet or supplementation program.

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