27 Ways To Recover From Traumatic Brain Injuries

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Summary
  • How to determine if you’ve had a concussion
  • Long-term health effects of post-concussion syndrome
  • Things to do, take, and avoid if you get a head injury
Transcript
Jason Prall

I’m your host, Jason Prall. And with me now is Dr. Dan Engle. He’s a psychiatrist with a clinical practice that combines the aspects of regenerative medicine, psychedelic research, integrated spirituality and peak performance. Dr. Engle is an international consultant to several global healing centers, facilitating the use of longstanding indigenous plant medicines for healing and awakening. He is the founder of full spectrum Medicine, a psychedelic integration and educational platform. And thank you life nonprofit funding stream supporting access to psychedelic therapies. Dr. Engle’s medical degree is from the University of Texas in san Antonio. His psychiatry residency degree is from the University of Colorado in Denver and his child and adolescent psychiatry fellowship degree is from the Oregon Health and Science University. He is the author of the concussion repair manual, a practical guide to recovering from traumatic brain injuries as well as his new book, a dose of hope, a story of M. D. M. A. Assisted psychotherapy. Welcome Dr. Engle.

 

Dan Engle, MD

Jason. Good to be with you again.

 

Jason Prall

Well I’ve chatted with you before about plant medicines, M. D. M. A. Assisted psychotherapy and all things sort of shamanism as well as I know you have a deep background experiential wisdom with that side of the healing world and although I’m so tempted to continue to talk more about that because I love that world and I’m so fascinated. I really wanted to bring you on to talk about concussions because I think this is a fascinating area of of neuroscience and and health that that many of us may not realize that that we’re touching and I think we have this idea of concussions as something that, you know, a football player, hockey player, a boxer might get. But us regular folk don’t really have any relationship with concussions. And so, I think there’s a little bit of something here for all of us. And I just want to start off by asking kind of how you got into this sort of concussion world. How did that sort of pique your interest?

 

Dan Engle, MD

Yeah, it’s a great question. You know, when I hear you read my bio, there’s a bunch of things I could put in there and the bio is kind of a little bit more heavy on the plant medicine side. But truth be known what got me into integrated medicine and eventually plant medicine in the first place was a series of head injuries at about six really good strong severe concussions. The 5th 1 was two weeks before medical school jumped off a pier, hit a sandbar, broke my neck, ended up starting medical school in a halo. One of those things where you haven’t screwed into your school, had that on for three months finally slowed me down. And it was what got me out of surgical care and emergency care, which is the direction I was going into the new trajectory of psychiatry neurology because I wanted to understand more about hedonic injury. 

 

And then I also just been fascinated about the brain and the mind and that kind of interface. So it was very much an experiential process. And it’s also the direction of mind body medicine, particularly as it relates to what I would call hardware and software technologies. We might even think of like plant medicine work or psychedelic work being on the software side of things, neurology and neuro generation and healing from concussions and brain injuries. Being on the hardware side of things. We’re actually gonna be closing the were already closing the gap. The gap needs to be closed even further between neurology and psychiatry to bring those two fields even closer together when you study either you get boarded in both. 

So I’m actually boarded in psychiatry neurology. So I kind of geek out on both sides of the equation. But for me, when I had my last concussion, which was actually the worst one that turned upside down on a snowboard park, put an eight inch crack in the back of my helmet, started having a really bad post concussive syndrome And I couldn’t shake it. I was able to shake off the residue from most of the others, but that one really crossed the line, so to speak. And I had neurologic colleagues in the space, I studied it. I was pretty sure I had posted syndrome, nobody had really good therapeutics. This was about 20 years ago. So I put almost a half a million dollars of my own money into neurologic research to try and fix my brain, so to speak. And that’s essentially what became the majority of the therapeutics that I put in the concussion repair manual. 

 

Jason Prall

Maybe help us define concussion, right. I mean, I think, I think a lot of us may know what it is sort of just in, in sort of layman’s terms and we understand it on some level, but, but from a medical perspective, what’s actually happening in the case of a concussion, how do we sort of define that? On a sort of physical level?

 

Dan Engle, MD

Yeah, it’s, I find for me it’s helpful to understand where we’ve come from in the previous diagnosis and kind of like the orientation. We used to think about it and what we know about it now, 

 

Jason Prall

Because most of us are probably hanging out in that sort of former definition.

 

Dan Engle, MD

100%. I don’t know if you even saw like, I don’t follow a whole lot of sports, but I do follow head of neck injury in sports and the Miami dolphins, quarterback, tua tavola, I think I said his name wrong. But he just had a really bad, very public repeat head injury over less than a week period. And the defense on the coach’s side was that he cleared all the protocols. So it wasn’t a head injury. Well that’s like saying, you know, my, my engine light is going off in my car and I take it to the mechanic and he looks at everything and he says there’s nothing wrong because I checked it out. Well the engine lights on right there, I can see it and there’s a mismatch between like what’s clearly evidential because the light wouldn’t be going on anyway and he clears it from his perspective, but there’s something else or some of the glitch in the system. So we have not yet, everybody’s brains unique. 

Everybody’s injury is unique and everybody’s healing is gonna be unique. So it’s really hard to have a one size fits all model NFL all the combat sports have gotten a lot better in the last decade With assessment of concussion off the field and returned to play requirements were a lot better than we have been. We still have a long way to go. So when I studied neurology, like started studying neurology in med school 30 years ago the definition at that time was that a concussion equal and loss of consciousness. And a lot of physicians even E. R. Physicians in many. ER because I talked to clients all the time and they said I fell, bonked my head was dizzy, vomiting. Couldn’t, you know, find out where I was very clear concussion went to the. ER but I didn’t lose consciousness, went to the ER told the doctor what happened, he said, well you didn’t lose consciousness so it wasn’t a concussion that’s absolutely wrong, we don’t need a loss of consciousness to have a concussion and most people to your point before, most people have concussions, aren’t playing combat sports. There’s like your average, you know, soccer mom getting in a fender bender and, you know, having a frontal head contusion with the steering wheel or a neighbor walking down the street, slipping on ice and hitting the back of their head skiing,

 

Jason Prall

Right? I mean, there’s so many activities that we might do and we hit our head and there’s no, there’s no obvious signs, right? Vision is not blurry necessarily. Might be a little woozy or something, but maybe not even then. And I guess what I’m, what I’m curious about is you kind of further explain this. It seems to me logically that there might be some spectrum where there’s not this like, definite line where it’s like, okay, now you have a concussion and you know, on this side of whatever equation or diagnosis or symptomology, you didn’t get a concussion, everything’s fine, The brain’s cool, Like no issues whatsoever. So in other words, everything’s cool. And then all of a sudden everything’s not right. Like it doesn’t seem to be much, 

 

Dan Engle, MD

It’s not a clear delineation. I can’t, I can’t take a blood test and say, oh yeah, you test so many degrees positive in the concussion arena. It’s the evidential symptoms are both subjective and objective. So the subjective symptoms would be, cognitive impairment. So if I can tell my attention focused concentration ability to focus on one thing and then shift sets to another short term memory, going into long term memory, my ability to track multiple things simultaneously. If I have the subjective experience of that, that’s the first marker. Now I can test that objectively with executive function tests. You know, there are a lot of either even more available at home tests to do that. Like cns vital signs is one company that does that. It’s an online testing system. But if you don’t have a baseline to compare it to, it’s hard to be able to say like, oh this is how well you refund before and then you had your hit and now here is where you’re at. 

 

Jason Prall

And theoretically does that give us an location or part of the brain that we can tell is affected?

 

Dan Engle, MD

It could if you put it in the context of the other objective findings. So this is where the neurologic test comes in. You were speaking about a functional neurologist You know, right before we got on the show part of who’s like, you know, building this kind of platform that. Now this discussion that we’re having in my experience, the functional neurologist, chiropractic trained have some of the best diagnostics to be able to tell the location and therefore functionality. But a particular area of the brain that’s been injured. And so when I first started going through my rehabilitation and found my first mentor was a chiropractor. He wasn’t a functional neurologist, more of applied kinesiology. more like structural integration therapist, Amazing practitioners. And there’s a lot of different schools of chiropractic medicine. Just there’s a lot of different schools of medicine in general. But in regards to functional neurology, excellent objective neurologic clinical findings and therefore being able to identify the area of the brain that’s injured and therefore the rehabilitative practices to engage. So you’ve got the subjective sign cognitive functions, just one. Also like sociability. Like for me when I had post because of syndrome, everything was so I was hypersensitive because there was so much neurologic inflammation. I didn’t want to be around a whole lot of external stimuli. It was like way too overloading for my system. So externally that would look like social isolation, but mostly it was just like trying to get the inflammatory response because my nervous system was too keyed up. Other symptoms, might look like increased sensitivity. Light sensitivity, noise sensitivity, kind of like that environmental sensitivity, could include headache, immediate post concussion, could include nausea, vomiting, disorientation, not having recall for the hit or the event that just happened. 

So some of what I’m talking about is both in the like post acute early concussion symptoms and then you get into what’s called post concussive syndrome. I was using that term before, that’s when you have symptoms of the concussion. Usually it’s increased sensitivity and deficits in cognitive function. May also look like depression, insomnia and those are symptoms that last for four weeks or more after the the hit of insults, so to speak. The worst thing you can do is stack concussions on top of each other. And that’s what happened in the Miami dolphins game that I was just referring to a few weeks ago was super obvious. He got hit, was kind of dazed after the game said it was a back injury four days later, gets hit again and now is clearly in this like reactive neurologic concussed state where you can see the tour to call us in that the hands going into this really like extended, overreacted neurologic position. So that’s one clear example of where the system failed Again. The systems, the systems are getting better first and foremost. And this is what a lot of the NFL players were talking about after the game is they have to hold each other accountable. Because if you’re in that situation and your athlete, you know that if you’re in the middle of the game and I’ve had the same experience, if I get hit, my competitive drive is just like, I’m gonna wrap that thing tighter so that I can keep playing well. And this is,

 

Jason Prall

Yeah, sorry, this is what I find to me because I know it very well. In fact, I remember in maybe sixth grade when I was just starting, you know, tackle football and I remember, I remember getting hit and blacking out. Well I don’t remember blacking out, remember the hit. And then I remember waking up and I couldn’t tell, you know, at that point I didn’t know it was I out for half a second was out for four seconds. There was no concept of time except for I woke up at that point, I actually felt fine once I came to, but it was a very jarring experience for me at that age. And then of course, I remember many others that would, you know, would get hit and they would be coming off. And so woozy. And of course you ask them their name or, you know, the date or what city they’re in and they have no concept for any of that stuff, right? And what’s wild about that and, and this is sort of the competitive driver, the athlete or, you know, to be honest, just the average person that might be against snowboarding or skiing. 

That takes a gnarly fall. There’s this period of just letting things play out, right? And sure enough on the football field, I’ve seen many guys in that state that, and this is, you know, at this 0.20 years ago. So back then we didn’t have as much sensitivity around this stuff to actually say, hey, when you need to be held out for a bit, it was more like hey you be held out for a bit and tell you you seem normal again, right? And that’s what happened, right? So eventually that person that didn’t know what his name was and what city he was in and didn’t know, couldn’t follow the finger, couldn’t add or subtract or anything like that. all of a sudden would come to and they were normal again, it’s like okay, go in. Right. And so this is what I think you can find again, even when you’re snowboarding, right, is that you sit there and you kind of just wait for things to come back to reality and then you’re off again. And this is where you’re saying that we have a really precarious situation at our hands, that why is that why is it so precarious in that state?

 

Dan Engle, MD

Because stacking an additional injury on top of a previous injury has exponential worse effects because you start to increase exponentially this inflammatory load, the reactive oxygen, oxygen species. The meninges start to tear and fray even further. The lymphatic system. So the body has a lymphatic system, the brain has a glimpse Matic system. So it’s essentially the system that washes out that inflammatory load when you cross the threshold and this internal systems aren’t able to take care of that inflammatory load. Then you start building up this reactive oxidative stress. So that’s kind of like what happens on more of the like cellular level. Then you get more of the an atomic level. We start talking about stress to the injuries. We start talking about these areas of the brain that get bruised. 

And when you look at the long term effects of these stacked injuries it looks like evidentially and pathologically like advanced Alzheimer’s disease. So now we have a term for that called chronic traumatic encephalopathy or CTE and it’s this progressive accelerated neurodegenerative condition because you’ve been stacking so much of this inflammatory load over time with both cellular and atomic negative impacts. So ideally in that and that pause before returning to play or returning to this daily usual activities, you’ve got enough of the opportunity for the neurological system to take care of itself and start healing. The human operating system is a self organizing healing system. But when we cross the threshold of its ability to take care of the acute injury then we have to have a time out just like if you break an arm it’s best to not use that arm while it’s healing and everybody’s injury is different. Everybody’s brain is different and everybody’s healing is different. So that’s going to look a little bit different for everybody and there are things that you can do to stack the cards in your favor both therapeutically. Like what can you do after you get hit but also what can you do to prevent the degree of potential impact that has a negative effect. So we can kind of talk about both those, but I also want to just highlight what you’re talking about, which is in each of those experiences that person may not have lost consciousness. You did momentarily. I have at times in the past, but even when that person doesn’t have the full loss of consciousness, but that they don’t know who they are, where they are, if they’re sensory if they’re kind of like state of orientation is off, that’s an altered state of consciousness. 

So you don’t know have to have the loss of consciousness if there’s any altered state of consciousness, that’s a hallmark indication of a concussion, even if it’s brief. So we have now kind of like this picture of what’s happening symptomatically what’s happening clinically and what’s happening at a cellular level. And once we start educating people on the importance of paying attention to that and the downstream effects of if they’re not paying attention to and they get hit again, what are the long term impacts of that? And we’re able to see that more evidentially. So it’s so much of around about it now is around education, education players, education coaches and educational layperson because like how many people are skiing and snowboarding and having just random falls, how many people are hiking? Like, you know, I live in Sedona now there’s always people mountain biking and you know, super manning over the handlebars.

 

Jason Prall

Yeah, that’s one of the worst. I have some friends that do that and they’re always injured.

 

Dan Engle, MD

Yeah because you’re like stuck in your pedals and you can’t get out or a variety of other things. So how many times the average person hitting their head having an altered state? A little dizziness? Maybe they just shook it off and it didn’t seem like it was that important. But at that point it’s not like okay stop start the ticker and at least for the next couple of weeks be really kind to yourself to your energetic input to how you’re treating your nervous system. Pay attention to your sleep immediately post injury. People oftentimes will sleep 10 12 14 hours maybe several hours more than they’re used to. And actually that’s adaptive and therapeutic. Some people might call me and say you know for the last three weeks I’ve been sleeping like 12 hours a day and usually I sleep like seven or eight. And I’m kind of worried like well that’s actually supportive because when you have deep sleep is when your nervous system is repairing if that goes on longer than 4 to 6 weeks now we need to talk but allow yourself to have that just down time so your nervous system can repair. That’s just building in the ability for the system to kind of take care of itself.

 

Jason Prall

So I want to center most of the rest of the conversation around sort of the chronic aspects to the things you’re talking about. The C. T. E. S. The concussions and the repetitive brain injuries. But for a moment I’d like to stay on this sort of acute topic. So if somebody were to sort of go through a concussion experience or or or traumatic brain injury of any kind what are some of the things beyond just kind of rest and sort of turning things down? Is there anything else we can do any therapeutic? Well we’ve got a lot of technology these days, there’s a lot of cool things in the sort of neurology world. Are there any tools that we can use to help recovery in that sort of immediate window after an injury occurs.

 

Dan Engle, MD

Yeah. Yeah absolutely. I think of it in three Arenas I think of things to do. Things to take and things to avoid things to do. Get rest things to take targeted supplements and some therapeutics particularly in the tech side if it’s available things to avoid another head injury, alcohol, sugar, anything inflammatory to the system, a lot of environmental kind of overload a lot of screen time really. Everything we’re wanting to do is just calm the nervous system down. So things to let’s kind of unpack it from there. Let’s start on the thing because these are more like active things to do and take. No tropics and you’re kind of like your neuro reparative agents. easy things to get over the counter. CBD. Number one very good as a neuro anti inflammatory agents. Also good on the neuro protecting side CB fish oil. Also incredible anti-inflammatory agents systemically. 

 

Jason Prall

But really good quality. Right?

 

Dan Engle, MD

Absolutely 100%. you know I’m not pushing any products here but Nordic naturals bigger isn’t always better. So usually the bigger companies kind of have tend towards a lesser quality. But Nordic naturals is one of those exceptions are absolutely the largest purveyor and distributor official but they have a pretty good product, usual therapeutic dose. I won’t get into doses because that’s a little bit more detail but you can use a hefty dose and in an acute particularly ICU setting some people benefit up to 12 to 16 g official day and only for that acute phase where you’re just needed to put out the neurological fire, so to speak.

 

Jason Prall

I’ve noticed this with CBD as well and of course I think what I’ve also noticed with CBD as some people are very sensitive to it. In other words it actually affects them in a fairly like they can almost be like they’re they’re they’re on a journey with it like it’s a plant medicine and other people tolerate it very well regardless of that. My point is that I often find that people that aren’t familiar with taking CBD you know I think it is always good to start slow and see, see your tolerance, but I think people stop too early with CBD, in other words, I’ve seen really really profound benefits with just what what seemed to be massive doses of CBD. But that’s where it seems like that the benefits lies in the upper end when it comes to those neurological conditions.

 

Dan Engle, MD

Yeah. Yeah, CBD is really interesting one because to your point you can it has such a wide dose range and it’s extremely safe. You take too much, you get tired and then that’s usually beneficial, especially if you know now that’s your like nighttime dose and then you would usually peel it back to half or maybe a third of that for your daytime dose. There’s different CBD. A full spectrum, you have isolates and there’s such a wide variety of efficacy. So it’s kind of like, okay, try and find a good clean product and take it to the point that you know, as a benefit. And then again if you overshoot the mark, then take that at night and then peel it back during the day. 

We’ve used 1000 to 2000 mg a day in the neurologic rehabilitation clinic because it’s such a good anti-inflammatory agent and we would often times work with veterans who had a combination of PTSD, which is the psychological downstream effect of trauma plus A T. B. I. Or post because of syndrome, which is the neurologic downstream effects of trauma. So when you have both of those like the mind and the brain are both in these hyper reactive state CBT is really good for both of those. So those are two magnesium is really good for settling the system because really calming as a kind of a nerve ein single mineral agent. and then we can get into more kind of like those would be the big three kind of over the counter very low side effect profile, extraordinarily safe. And then you get more of the targeted supplements so that would be like alpha GPC phosphor, Syrian phosphor alkaline. some of the peptides some of the more like specific anti-inflammatory agents like glutathione.

 

Jason Prall

Yeah this is beneficial in this regard to, right? 

 

Dan Engle, MD

Melatonin is great, particularly person has insomnia, it’s great anti-inflammatory agent. Most people take too much of that and you know you took too much if you get a little kind of groggy or hungover the next day. These are just kind of like examples of a few different things in that acute window that are really good. One thing that is very effective in the long term post concussive syndrome kind of arena is in a. D. Yeah, be right because of syndrome just feels like the system’s on overload. It’s either really kind of tax and fatigued or it’s still super inflamed and kind of like hyper reactive but N. A. D. Is one of those things that brings cellular energy into the engine so to speak and really churns out mitochondria 80 80 P. Production. Now you have better energy output. It’s not very comfortable it’s a somewhat uncomfortable experience. And some people like oh yeah I tried N. A. D. In this like oral pill form but I’m talking about ivy and a d usually a pretty therapeutic dose and then we get into more of even kind of like the next stage ivy therapeutics which could be for many people to be ketamine therapy is Amazing because it’s so good at supporting that lymphatic system kind of cleaning of the neurological like that inflammatory residue.

 

Jason Prall

And for people who aren’t familiar with ketamine just give us a quick primer on what that is. 

 

Dan Engle, MD

Yeah. It’s been clinically used over the last 40 years as a surgical anesthetic and then off label use for the last 35 years and treatment resistant depression. It is scheduled three people do need to have a diagnosis in order to receive it from a licensed provider. And I tend to work with clients who have pretty severe pcs post concussive syndrome and a variety of different psychological issues as well like PTSD addiction depression, anxiety O. C. D. Etcetera. That they oftentimes didn’t have before or weren’t near as bad until their injury. So again now you’ve got like the neurologic kind of presentation of the psychological presentation, ketamine can be really good for both but you do need prescription. 

 

Jason Prall

And it’s and it’s a psychoactive substance, a synthetic psychoactive substance that would we could loosely call the plant medicine so to speak. and often generates visions or understandings and also physical responses in the body in the neurology. Right? There’s some really, again, I’m always tempted to go down that rabbit hole with you and get into the fun stuff, right? But there’s some really interesting things experientially when you start to work with some of these type of medicines, right? Especially in a clinical setting, there’s a lot of therapeutic value that can happen both in the mental emotional space as well as in the neurology, in the biology, right? Like that’s I think it is under appreciated with the ayahuasca psilocybin. You know, and the things like the kedah means and M. D. M. A. But there’s an actual physical aspect to this stuff that’s undergoing. 

 

Dan Engle, MD

And to your point ketamine is legal, right? So it’s an entry point into self discovery and self examination because it does engender this altered state of consciousness. We oftentimes in the kind of like the psychedelic renaissance, we oftentimes kind of focus on that software side of things but ketamine is a very good neurologic healing agent to and not many people are using it particularly for long term head injury residue. So then that kind of opens up the rest of like the tech side and the interventional therapeutic side. If we keep going down like we talked about over the counter supplements, we just started talking about targeted supplements and we got into an A. D. And I mean if we keep kind of going down that road you eventually get to stem cells excess. Which our next generation ivy therapeutics excess. You can think of like signal messengers. Stem cells are kind of like seeds of potentiality to stimulate new growth. We’ve seen exceedingly good benefits in both of those arenas. Stem cells unfortunately can’t use the most effective just because of legalities. And therefore not everything is equal. So again kind of due diligence but that field is significantly accelerating.

 

Jason Prall

Yeah it’s happening outside the U. S. Right Like all around the world there’s some really exciting thing. Things happening with stem cells and really profound benefits being realized in a wide range of chronic ailments right? Even things like A. D. D. And autism and cancers in the Autumn Unity. And you know the worst of the worst. We’re seeing things progress in a beautiful way. So and I think because the brain is so metabolically active and there’s so much going on there. I’m very excited that once we get approval to use and I think stem cells the most beneficial stem cells are we are able to use them for certain cancers. I believe that the FDA has cleared them. But for the most part we have to use our own stem cells, right? Really? What we want is the youthful stem cells that come from umbilical cord tissues and these type of things from safe births and all that where nobody’s harmed. And like that’s the really, really vital stem cells. Right? And there’s I’m just super excited to get to that point because they’re showing so much prominence I think with neurological issues, brain issues, we’re going to see tremendous, tremendous benefits.

 

Dan Engle, MD

Absolutely. and this is part of the excitement. I think it was this past decade of the 2010 was the decade of the brain. You know, we’re just finding more and more of these available therapeutics and ideally making them more and more widely available to the masses because not everybody’s gonna be able to access or afford themselves in exorcisms. But if I don’t put it in the equation that I’m leaving out one of the biggest therapeutic agents. So just shy of that, we also could think about peptides. a new novel agent that’s exceedingly helpful in neurologic repair. They’re not as scheduled. They’re regulated as stem cells. They are much less expensive and they’re easy to get there’s a variety of different peptides on the market. I won’t go into that list because that’s a whole deep rabbit hole, but something else to investigate. And then we and then we have, so that’s more of like the interventional therapeutics. And then you get into practitioners, we mentioned functional neurology. Somebody who has an experience of Chinese medicine and acupuncture, who know how to use actual acupuncture, acupressure and needles to really calm the nervous system can be super helpful. and then we peel it back to like things that people can do at home and things that they get things that they can access on their own. 

Like flotation therapy is extraordinarily good for helping a person calm their nervous system if they’re in a reactive kind of overprotected neurologic state, which is good. Like if I’m, if I’m healing from an injury, I actually don’t want a lot of input because my brain’s already got so much happening internally. Anything that usually would be okay might feel now assaulting. So if somebody presents with that’s like, okay, go into the tank, get on some CBD, maybe some fish oil and just turn the volume down on everything. So flotation is very good. A lot of people now are starting to own or rent hyperbaric oxygen tanks and chambers at home for use more and more widely available are like 30 day trials for people to use at home. So now you have water float tanks, you have oxygen in the hyperbaric arena, pulsed electro Magnetics and those frequency devices neurofeedback, the ability to retrain overactive brain states cognitive rehabilitation which is both at home and also practitioner driven. So now you’ve got like the tech side of things that people can do at home and then I get into like the nature side of things that people can do.

 

Jason Prall

How about E. M. D. R. Is that something that is gonna provide?

 

Dan Engle, MD

EMDR? Amazing. Right? Typically more on the psychological side as we talk about like the downstream effect of trauma. I don’t even know if there’s a lot of research for MDR as it relates to T. B. I. And pushing syndrome. When I say T. B. I, traumatic brain injury. But anybody that has any, if you have a significant T. B. I. You’re gonna have some degree of psychological adjustment to that, right? E. M. D. R. Is very good because it has these cross lateral stimulation patterns that rewire the brain to a more rested state. So no downside. Only an upside and very applicable to use, especially if anybody has experience with MDR before a head injury with benefit. Like great, let’s use that again because it was good for you before. It’s only going to be supportive now.

 

Jason Prall

I’ve only heard of it is beneficial on the software side, I’ve seen tremendous things.

 

Dan Engle, MD

Tremendous especially with the MDR practitioner who knows it really well. Yeah. And then we get into the nature side of things. Sun vitamin D Sound and really therapeutic Like treatment and healing oriented. Sound therapies, vibrational devices, even using your own sound therapy or even your own intern sound therapy. So humming and something called memory meditation when you actually like close your ears, you can also close your eyes. That’s kind of like the old school looks a little funny. But if I’m ever because I’m I track my neurologic state all the time because I’ve had so many injuries in the past and I know what it feels like to really be on. And if I you know if I’m traveling a lot and maybe my nervous system is a little keyed up, people don’t know have any idea what I’m doing if I’m just holding my ears closed and I’m humming at the same time, right? Because that stimulates the vagal nerve, any humming or vocalization will do that and when you do that for long periods of time now you’re resting the primary nerve center between the gut and the brain that dictates what’s called parasympathetic tone. 

So after injury usually were in Paris were in sympathetic overdrive because now we need to be in a protected state. We don’t want another injury so you can start to deregulate towards parasympathetic tone by doing a lot of different things including that humming kind of practice. Let’s see we talked about sound sex. So sex is therapeutic for sure, particularly getting a person back into their body and their hormones kind of re regulated but too much sex or particularly in ejaculation and like giving too much energy out can be a downstream effect. So if I’m talking to a lot of athletes who have a big sex drive and maybe particularly as men in a performance oriented culture, we tend to have a lot of identity around our sex and our sexual performance. 

It’s actually rehabilitated to be able to hold a person’s energetic experience and work on the energy body by doing some of the like ejaculate Torrey with holding techniques. and writing the wave of that experience without losing any of the energy on the other side. So there’s just different ways to kind of like uplevel our experience of being able to hold our own energy. We might call that qigong, taichi, yin yoga, things that the increased energy in the in the the energetic system, so to speak, Chinese medicine might call that like the meridian chains vedic might might call that like the noughties, we don’t really have a sense in al empathic Western medicine of what the energy body even is. But anything that’s going to bring energy into the system and kind of generate more and more and have it be held in a place towards dictating repair. Yeah, that’s regardless of it’s just a head injury or anything else, but particularly neurologically with a head injury.

 

Jason Prall

Yeah, this is what you’re naming here is a sort of unique concept that I think in the west we again we don’t have a lot of understanding around how to work with it. But it’s this idea of cultivating energy right? And holding it like to be able to cultivate it without losing it is a concept. Again, this is a lot of practices in the east and all over the world use these types of techniques to cultivate energy. But again for us it’s like the only place we get energy is from food or maybe the sun and we don’t really think about energy any more than that. And it’s and it’s wild because we don’t fully recognize, I think most of us even myself who understands the concept don’t fully recognize our power to cultivate energy on that level. Again this is probably the primary practice that is sort of dedicated to this cultivation of energy itself, right? And cheap. Really? 

 

Dan Engle, MD

Yeah. Yeah. Your energy force. you’re kind of like energetic imprint and how much energy you have available on your own right? Because weird primates natural, you know natural products of the living ecosystem, we can access energy from the sun from food from water but also from our own internal practices so that we don’t have to reach for caffeine, we don’t have to reach for the young based adaptive genes that are gonna bring exogenous energy and how do we cultivate it internally all these practices are around and if we start now we’re talking about like we’re starting to get into prevention. So one of the prevention strategies for post because of syndrome is simply meditation because it increases levels of self awareness. That’s what meditation is for. As well as when you would do it more actively. 

We can actually start to have more agency and resource in self regulation. Right Right so that means being able to will regulate our nervous system. We can track it become aware that now we’re in a sympathetic tone or fight or flight tone or just too stressed or maybe it’s just like you know becoming normalized to a stressful environment, how do we become more aware of that? And how do we start to re regulate our internal state meditation? Really good because it generates that level of self awareness. And if I know what my previous normal healthy baseline is after a hit I can tell how far I’ve come and now I’ve got more insight into really being able to knuckle down on a Pcs or brain recovery protocol. Physical resilience, interestingly enough the more strength and tone a person has in their neck, the less likelihood of a concussion and especially post concussive syndrome because you have more stability. So if you get hit, if I have more internal integrity here then and less laxity then it’s less likely my head’s gonna do one of those like it’s called the coup counter coup or like a hit and rebound kind of like bouncing effect, so to speak, in the brain, it’s not quite like that, but we can just use that as an analogy. So like you know some of the fighters are used to now using this thing called the iron neck which is this device builds that like internal integrity. So that’s like one example of like physical resilience, cognitive resilience. We can build into the we’re talking about mental resilience with meditation, physical resilience with something like strength training and cognitive resilience by actually having different aspects of climbing, different learning styles having more internal mental and neurological flexibility. So brain training exercises just by themselves can also be protective against long term effects of post concussive syndrome as well as long term effects of nerve degeneration in general like dementia etcetera.

 

Jason Prall

Yeah so talk to me about sort of the longer term aspects of concussions, head injuries, T. B. I. S. Of all kinds because again if it’s if we refer back to something that and I find this actually sometimes in my practice when I’m working with people that people may have had a head injury that they totally forgot about. That that was 10 years ago or whatever and and I find that it’s probably still affecting them today you know and when it comes to chronic health conditions. You know one of the things that I like to teach is that they really all come down to core wounds and these can be core emotional wounds, right? Core core wounds, in these sort of, again, mental emotional aspects of things, traumas and that kind of thing. They can be heavy metals, right? Somehow building up a chronic heavy metal issue or or it could be infection right of mold. These tend to if, if affecting the system long enough or in a more in a cute way can have long term effects, but they all go back to a core wound or many court wounds. 

And one of the things that I find is again, not really looked at when it comes to chronic ailments that aren’t head related, so to speak, that obviously head related again might be a gut issue, right? It might be infections, might be migrating motor complex motility issues. SIBO right, a classic example of something that people can continue to look for in the gut, but these things can be tied to the brain, right? And and and a traumatic brain injury of some kind that was two years ago and not fully addressed is now having downstream effects throughout the body. And so I think we don’t often look to head injuries enough and for that matter of physical ailments, physical injuries, they may be affecting structural postures and soft tissues and throughout the body that again, have downstream effects that are complex, no question. But the source of the injury of the wound has not been acknowledged, let alone address. So, maybe talk to me about some of that because again, I’m painting a picture that could be kind of hard to unwind for both the practitioner and somebody that’s dealing with chronic ailments. But nevertheless, I want to bring awareness to it because at least if we, if we have a little awareness, we can investigate that side of the equation.

 

Dan Engle, MD

Yeah, 100%. Okay, I’m just doing a time check. So, I want to see how much time we have to get deep into these waters because you’re bringing up something fascinating then in my experience, any significant wounding? If we look at it on the software side of things or on the hardware side of things, software side of things, those woundings might be like rejection, abandonment, betrayal, injustice, you know, humiliation. So, like you can think of it like government talks about in regards to addiction, it’s not so much the trauma, It’s our response to the trauma. Right, so, we have these core wounds that can happen. Our response to the adaptive aspect. Right? So on the software side, how are those traumatic events getting encoded into a person’s psyche? And on the physical side, how are those traumatic events getting encoded into the physical substrate, the structure itself. If we look at it just on the neural. 

I mean, that’s a deep rabbit hole and it’s also if we look at the long term effects when the person has education and support, then usually those those insults, those injuries, those traumas are actually used as fertilizer, per growth, adaptation, personal development, personal mastery, but we need both education and support. So if a person is suffering in isolation and they don’t know why you get 10 years down the road from a really bad head injury, but there’s no appreciation for the severity of what happened. But now that person doesn’t think it’s clearly their memory is a little off, maybe they’re a little bit more irritable. I know when I had posted cause the syndrome, I was highly irritable and I would swing already have a lot of fire. So I would really swing pretty precariously from one side of the equation to the other. 

It was disruptive from my life as well as the others around me. And it was only when I really started to dedicate myself to the repetitive process and I could slowly see benefits. That was the first thing that I noticed as I was less reactive, it’s like, okay, now I’m on the right track, but if we don’t have that education and the support, then we’re kind of like suffering in isolation and how do you, like, how do you, like, point back to the original event. That’s where it’s really important to work with an intuitive practitioner or a guide of some sort ideal. You know, medicine is as much of an art as it is a science and we have handicapped The majority of our medical practitioners, especially Alpa’s especially Western medicine docs because the average time that the doc spends with their clients is 11 minutes. It’s really hard to be intuitive in 11 minutes.

 

Jason Prall

When you say intuitive, by the way, I just want to maybe put a different word to it for those who kind of have, it’s a hard time with sort of psychic intuition that that’s sort of the equation but it’s a feeling, right? So you know, so much of our Western culture with medicine and with a lot of things is head based, its thinking right? And there’s a lot of cognition and there’s a lot of reasoning that comes from that and it’s beautiful and you make a lot of headway part in the pun. But when I hear intuitive what I what I’m hearing is feeling. There’s like a feel playing the piano, there’s a feel that you’re playing. Yes, you know where the keys are, Yes, you understand, you know the notes and the chords and how it all works together, but it’s it’s the field, right? And there’s this different aspect to whether it’s the game of basketball playing the piano, doing medicine or any other sort of artistic endeavor. It’s the intuition I feel. Is this feeling that you have in the moment, as you’re listening with your body with your entire system, right? And that’s it. So I just wanna kinda bring it out of the sort of the wu intuitive, you know, psychic lady type of thing because I know you and that’s really what you’re talking about, right? Is this like feeling through what’s really happening with this person? 

 

Dan Engle, MD

Yeah. Yeah. It’s like seeing what’s not necessarily obvious. Yeah. We’re having a kind of a gut feeling to your point, a gut feeling of what might be the underlying primary factor. And so the reason I bring it up is because the majority of people are not going to see functional neurologists, they’re gonna see their primary care providers or they’re going to go to the ER where they’re going to see a nurse practitioner or a variety of other people. Right? So I’m actually speaking of those people on the clinical side as well as the person on the consumer, the person going through the process themselves. It’s really important for us to develop our feeling tone and in this culture we’re so bombarded with so much really fast information. It requires a lot of methodology, slowing down being a little bit more kind of like spacious to allow the gut feeling to present itself. Otherwise we’re gonna override it. 

And we’re just gonna be like these practitioners that just trying to make widgets following standard of care protocols without understanding client’s experience and what without understanding the subtle aspects that could be a head injury years ago, if somebody is presenting with chronic headaches and that is a slow build up of a neuro inflammatory process because maybe their gut is off, maybe their diet is off, maybe they’re in a stressful living situation, but the insulting event was a head injury many years ago and their neurologic system now has been kind of like tweaked from its ideal expression. It’s like if you tune your radio dial to an ideal neurologic optimization point and then you get injured, it gets knocked off of that optimal kind of frequency setting and just a little bit can have a long term downstream effect. It’s like sailing a boat. You know, if I’m wanting to go here and I gradually start going here by the time I get further down the road may be way off track. So that’s where it really, it it’s a, it’s an, it’s a requirement if we’re going to reclaim excellence in the medical arena predominantly in the primary care sector, that we slow everything down and we start to get back to more of like an intuitive gut feeling aspects where we can actually give more space to the practitioners so that the client can actually tell the full story and then they can have a dialogue and then they can both kind of come to a more intuitive center, a felt sense of where the original insult is and then Now be able to educate the person on the things to do to repair. 

And maybe a secondary specialist to be able to confirm that or evaluated further. Like a functional neurologist who’s able to now do a full neurologic exam that has more subtleties than general practitioner is going to know how to do and be able to say like, oh yeah, look at how your eyes are tracking or look at the fact that now your cognitive measures have dropped by 30% over five years. Maybe it’s neurological, early cognitive impairment. But if the original event is a brain injury which downstream can look like Alzheimer’s disease, you treat it differently than if it’s an Alzheimer’s disease picture because of heavy metals.

 

Jason Prall

Exactly, that’s the key, right? Like that is so important what you said there. And again, it’s one of those pieces that I find is missed in so many clinical pictures. Again, what no matter what chronic issue it is. We’re starting especially Integrative functional medicine space, we’re looking for metals. We’re looking for parasites were looking for these things now more and that’s fantastic. You know, we’re doing a lot more detox and cleansing of the system and and again, I think because so many aren’t trained in sort of functional neurology, we just blank out on the fact that there’s a there’s a possibility that there was some traumatic brain injuries in the past that could have set the stage and so we need to attack this thing in a different way and you know, again, that’s why I’m so excited for clinics like yours and the work that you do mind body medicine, which hopefully we eventually just call medicine. Because how could we ever set the two. 

But we’re coming back to this reality that we can play the software and hardware game together and really develop a full clinical picture with some really cool stuff. Right? I mean, again, the ketamine and the C. B. D. S and and the functional neurology tools that we have, the technology that’s coming and of course all the things that we have at our disposal like nature exercise of course, adjusting diet, sleep, loved ones, right? Hanging out in a setting where you’re, you’re feeling loved and accepted. Again, float tanks, right? Like I think you’re playing at a very, very beautiful picture here of all the tools we have at our disposal. And to me this is where we’re going when it comes to these traumatic brain injuries, concussions. I mean, you see this in the NFL you see this with, with those groups and organizations that have a lot of money and resource to be able to dedicate. That’s where they’re turning, they’re turning toward these type of things, right? Because that’s what’s having the biggest impact. And so again Dr. Engle, I appreciate you coming on and sharing your wisdom with us. Please tell us more where they can, where people can find your book and more of what you do. 

 

Dan Engle, MD

Mhm. Yeah, thanks for asking. Jason. Always a pleasure to be with you. Thanks for having me on. Yeah, I always enjoy our conversations and I know we could go deep in the paint for hours and a variety that, 

 

Jason Prall

I want to be mindful of time here. I really could keep going.

 

Dan Engle, MD

So the easiest place to find me directly is drdanengle.com. I work you know, on that software side of things. Full spectrum medicine is our psychedelic integration program on the hardware side of things that’s a concussion repair manual and our concussion repair program. And then kind of like spanning the gap between both of those as this whole growing field of what I would call transformational medicine. M. D. M. A. With some of the neurologic tools like E. M. D. R. Even for instance, like a trauma recovery therapeutic like M. D. M. A. With a trauma therapy practitioner who can train somebody like E. M. D. R. And now you’ve got a better exponential benefit So the book, a dose of hope is about that kind of M. D. M. A supportive psychotherapy aspect. And we just launched a nonprofit called Thank You Life, which is a funding stream to support people to access ketamine suicide and an M. D. M. A. When they become legal and people that wouldn’t be able to afford it on their own. So it’s, it’s the first thing you literally focus on Psychedelic Therapy Fund. And I think there’s probably half a dozen other other projects or so, but those are kind of like the big ones for now.

 

Jason Prall

Well again, thank you so much for coming on. I’ve got a two year old pulling on my arm here now. That means it’s time to go. But it’s great to see you again and again. Thanks so much for everything you do.

 

Dan Engle, MD

Yeah. Likewise, Jason Take care man.

 

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