My Life in Brain Injuries

Carol called my office in the spring of 2007. She had come across one of our brochures for Back in Balance, our program to provide free neurofeedback to returning veterans and had read how we address brain injuries through neurofeedback. She asked me in a halting voice, her speech a bit slurred, “If it works for veterans, will it work for normal people?”

For all our differences in experiences, veterans’ brains are the same as civilians’ brains.

I often do an extensive interview over the phone to ascertain whether someone is likely to benefit from the PsyPhy program. Frequently people will go into detail regarding their problems. Carol certainly had plenty to relate.  She had frequent severe migraines, fibromyalgia and poor sleep, but the thing that seemed to bother her most was what she referred to as her “mental degeneration” in general and her loss of sense of humor in particular. She reported that she had alienated most friends by asking, “Was that supposed to be funny?” sincerely wondering whether the person was joking or serious. To have a discerning appreciation of the subtleties of humor, one must have a fully functioning frontal lobe.

In Carol’s most recent accident, her frontal lobe had been badly injured when a workman remodeling her home, not knowing Carol was at his side, turned abruptly, clocked her over her left eye with a solid core door and knocked her unconscious. Since that injury she had lost her job as a registered nurse, as well as her home, support group and ability to think clearly.

 When Carol arrived for her first appointment, she appeared much older than her sixty years. She was physically unstable, hunched over a cane she used to steady herself. Even with the cane, Carol needed to use her other hand to touch the wall beside her for guidance. Narrow spaces, such as the hallway, made her dizzy. In addition, she had to intently focus on whatever she was doing. For example, she had to stare at her hand while she was holding something because if she became distracted, she would drop whatever it was – tea, soup, or money. If she closed her eyes while standing, she would lose her balance and fall over.

The remodeling incident, which occurred in 2006, came just a year after another head injury. Early in 2005 Carol slipped off an icy curb and fell backwards, hitting the back of her head on the curb and losing consciousness. It took her months to feel normal again.

To have two head injuries within such a short period made her recovery from the second blow even more difficult. After the injury in 2006, Carol became prone to infections and spent much of her time in bed, rising only to go to the bathroom or to eat. Carol could no longer work as a registered nurse but had the training and insight to see her situation as a dreadful slippery slope to degeneration and total incompetency. The stark reality of her situation hit her when her primary care provider, an MD, had started her on Aricept, the prescription drug most often used to slow the progression of Alzheimer’s, and had recommended Carol “make arrangements” for long term care.

During our first visit with a new client, we take an extensive personal history and review any recent lab work available from other practitioners. In Carol’s case, we learned that a test showed she was sensitive to both gluten and casein. When we pointed this out to her, Carol dismissed the findings, insisting she had tried removing both casein and gluten from her diet, but it had made no difference. This proved to be an extreme case of wishful thinking.      

Gluten is a protein found in many grains such as wheat, rye and barley while casein is a protein found in most milk products. When a person’s body can not break down proteins, the immune system recognizes them as foreign substances. This leads to inflammation which, over time, harms tissue, including irritating the cortex of the brain. 

There is compelling evidence that TBIs can change genetic expression and the genes that create the enzymes to digest specific proteins may turn off after an injury. This explains why people who never had a problem with casein, gluten, or some other food before become intolerant after a head injury.

The body’s antibody response is what is reflected in the lab test for food sensitivity so it is hard to imagine that it would not make a difference to eliminate the proteins from the diet. When there is a positive lab test and people tell me there was no change after removing casein and/or gluten, I assume they have either not totally eliminated the proteins or did not do so for a long enough period. 

Gluten and casein are the building blocks of the standard American diet. They are everywhere, especially in what many people consider “comfort foods” so it is understandable that one of the most difficult things to do is completely avoid them. Unfortunately, something that is toxic to the body is also damaging the brain.  

Prior to her injury in 2006, Carol had been a very hardy person. She had been what she described as a tomboy as a child and had excelled in sports. (Unfortunately, her physical activity had led to several minor head injuries throughout her life.) Based on our intake, we started challenging Carol’s brain using the Low Energy Neurofeedback System (LENS).

A brain shares some similarities with an electrical generator that can run at several different frequencies or speeds at the same time. Each frequency has a set of jobs. For example, slow speeds are great for sleeping and faster speeds are required for mental challenges. The speed that is dominant at any one moment will help determine how easily a task may be accomplished. Injured brains can become “stuck” – unable to shift gears easily, making accomplishing the tasks of a normal day very difficult. Some people with brain injuries cannot sleep at all while others can’t seem to wake up. Some may have no issue with sleep but find processing information, emotions and/or sensations almost impossible. Each injured brain is different.

The dominant or peak frequency of the brain at any one site can shift continuously or it can be stubbornly consistent. The rationale for the LENS is to provide the brain with information about how it is operating and to invite it to change. It does this by introducing the offset. Leads are attached by conductive paste to one or two of twenty-one sites on the scalp. The EEG reads the frequencies at each site, and the signal is timed to “dance” with the dominant frequency, at a speed slightly different or “offset” from what the brain is generating. This gentle wafting at a distance from the dominant signal is designed to let the nerves and vasculature of the brain know there are options. The brain then reorganizes itself to support better self-regulation and greater efficiency. 

The brain is a pattern seeking device, constantly scanning the environment for the familiar and the peculiar – a survival tool that is common to all mammalian brains. By staying a set distance away from the dominant frequency, the offset is giving the brain information about its own behavior without running the risk of the brain repeating itself to the point of seizure.

After one week, Carol returned. She reported being very tired immediately following our session, but then she noticed improvements in her sleep, balance and mood that had lasted for five days.

After three sessions, her balance had significantly improved, and she had only two headaches that were much less severe than what she had become accustomed to.

 At her fifth session, she reported less body pain and an improved sense of wellbeing. She stopped taking her sleep medications and was feeling stronger and had more stamina. She said she still had the occasional headache, but they were less frequent and less severe.

Because of Carol’s commitment to her health care and her frequent visits to other practitioners, we were hesitant to offer therapies other than the neurofeedback, but we eventually learned that we offered tools that were unlike what the other practitioners used.

The Photonic Stimulator (PS) – a form of infrared light – was particularly calming for Carol. As an aside, she mentioned that she was bothered by a bone spur in her foot. We tried using the PS over the sore area on her foot and she reported the swelling and pain were greatly reduced within two days. The side benefit was improved balance and desire to get out and walk.

We also introduced Carol to the Resperate™, a biofeedback tool to help optimize the potentially soothing effects of breathing. Breathing has a profound effect on mood and perception of pain. In fact, learning to use the proper muscles for breathing has been shown to lower or eliminate the need for pain medication.

Although the skull appears to be a unit, it is made up of several intricately interlaced bones. Because of the nature of the blows Carol received to her head, we believed her cranial bones had probably become misaligned. We decided a Bilateral Nasal Specific would be indicated, a procedure that mobilizes the multiple miniscule joints between the bones of face and sphenoid.

In addition to all the therapies available in the office, we gave Carol homework. We had two major goals: To aid her proprioception (balance, coordination as well as an awareness of where she is in space) and to bolster her short-term memory. Research shows these goals can be attained through coordinated physical activity. We asked Carol to play catch, paddle ball, Twister™; dance whenever possible and toss bean bags at targets. We also asked her to do crossword puzzles since they are great for activating several pathways in the brain.

It was a great day when Carol came in, holding a cup of tea. With a broad smile on her face, she walked toward me heel, toe, heel, toe; backed up, still heel, toe, heel; spun around said, “Ta Da!” and didn’t spill her tea.

But her gains were met by a series of setbacks. After our initial progress, Carol had an increase in head pain and her sleep was disrupted. This was followed by improvement. Then there was blurry vision and increased fatigue, but that too was followed by improvement. Clearly, something was interfering with our therapies. The only time I have witnessed my clients experience such setbacks is when there has been an impediment to cure, but what was Carol’s impediment?

NEXT TIME: Helping Carol’s neurofeedback hold – addressing the impediments to cure.