Watch the full interview below or listen to the full episode on your iPhone HERE.
Stu: This week, I’m excited to welcome Kelly Tuttle to the podcast. Kelly is a brain-loving neurology nurse practitioner and a traumatic brain injury survivor. She strives to share her coping strategies and tools, and helps other TBI patients continue to work and study while they heal. In this episode, we discuss the most common symptoms of a TBI, strategies we can use for healing, and explore nutrition, exercise, and sleep as recovery tools. Over to Kelly…
Audio Version
Some questions asked during this episode:
- What is the definition of a traumatic brain injury?
- What are the most common symptoms of a head injury?
- What strategies could we utilise for healing a TBI?
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The views expressed on this podcast are the personal views of the host and guest speakers and not the views of Bega Cheese Limited or 180 Nutrition Pty Ltd. In addition, the views expressed should not be taken or relied upon as medical advice. Listeners should speak to their doctor to obtain medical advice.
Disclaimer: The transcript below has not been proofread and some words may be mis-transcribed.
Full Transcript
Stu
(00:03)
Hey, this is Stu from 180 Nutrition, and welcome to another episode of The Health Sessions. It’s here that we connect with the world’s best experts in health, wellness, and human performance in an attempt to cut through the confusion around what it actually takes to achieve a long-lasting health. Now, I’m sure that’s something that we all strive to have. I certainly do.
(00:23)
Before we get into the show today, you might not know that we make products too. That’s right. We’re into whole food nutrition, and have a range of super foods and natural supplements to help support your day. If you are curious, want to find out more, just jump over to our website that is 180nutrition.com.au, and take a look. Okay. Back to the show.
(00:44)
This week, I’m excited to welcome Kelly Tuttle to the podcast. Kelly is a brain-loving neurology nurse practitioner and a traumatic brain injury survivor. She strives to share her coping strategies and tools, and helps other TBI patients continue to work and study while they heal. In this episode, we discuss the most common symptoms of a TBI, strategies we can use for healing, and explore nutrition, exercise, and sleep as recovery tools. Over to Kelly.
(01:15)
Hey, guys. This is Stu from 180 Nutrition. I am delighted to welcome Kelly Tuttle to the podcast. Kelly, good morning. How are you?
Kelly
(01:22)
Good morning. I am doing good, and I’m happy to be here with you, Stuart.
Stu
(01:26)
Oh, I really appreciate it. I think I said good morning for me, but it’s probably not for you, is it? Because you’re on the other side of the globe, and it’s probably the afternoon or late afternoon. Thank you so much for sharing some of your time.
(01:39)
You’ve got an incredible story, and I’d love for you to share your story with our audience today. First up, for all of our listeners that may not be familiar with you or your work, I’d love it if you could just tell us a little bit about yourself, please.
Kelly
(01:52)
Sure, definitely. Well, I’m a nurse practitioner, and I have specialized in neurology. I did that after surviving a traumatic brain injury. Since my car accident, I have loved helping people with brain injuries to continue to work, study, and live life to their fullest.
Stu
(02:21)
Wow. Yeah, fantastic. It’s interesting as well that traumatic brain injury, I’ve heard different descriptions and definitions of that. Everything from a concussion, to perhaps playing soccer or football, all the way through to much worse, I think, when you mentioned that you had a car accident, and that may take it to the next level. I’m keen to hear your definition then as a specialist in the area of traumatic brain injury. What would be the clinical, or at least your definition of that?
Kelly
(02:57)
Well, you just said it. There really isn’t a single quite quick to the point definition because there are various ways that you can sustain a brain injury, so I’ll just go through some of the bigger chunks of them. Usually, a traumatic brain injury is either from an external force or it can be from an internal force.
(03:25)
Most people are common with the external force that causes brain cell damage, such as a blunt force to the head, or which can cause either a closed head injury or an open head injury. Closed head injury is where the skull’s left intact. Open is where the skull’s been either fractured or breached, such as with a bullet to the head wound.
Stu
(04:01)
Wow.
Kelly
(04:01)
Then there’s a brain injury from sudden acceleration to deceleration, where there may or may not have been a strike to the head, but because of the forces … The brain is a soft organ that kind of sits in the skull, gets forced and slammed back and forth with the skull, so then you can have multiple areas of injury. The skull, with that also in mind, there can be a rotation with that acceleration or deceleration, and that’s when you have the tearing and stretching of the cells in the brain, causing injury.
(04:47)
The other, some people may know about is an explosive, being exposed to an explosive, a blast where that concussive wave goes through the body and the head, and causes cellular damage that way. Then with what they used to call an acquired or internal force type brain injury, that happens with strokes where you have either a clot forming and blood not getting to cells down the line, and dying due to lack of oxygen.
(05:34)
You have where someone will have a cardiac arrest or a near a drowning and their brain won’t get enough oxygen, and then you have cellular death. You have infection, like meningitis, and you can have an exposure to neurotoxins, such as lead or carbon monoxide. The question is, is what type of brain injury? The definition, it can vary drastically.
Stu
(06:06)
Yeah, absolutely. I remember, you mentioned the explosives as well. I read a piece in National Geographic about soldiers and how they were affected, or how their brain was affected during explosives, and it was really quite profound. I never even thought about that. Obviously, as you just mentioned, it comes in all ways, and shapes, and forms as well. Tell us a little bit about your traumatic brain injury, or TBI is the abbreviation for that, isn’t it?
Kelly
(06:40)
Yes. You can have also mild traumatic brain injury, or moderate, or severe. Mine was mostly mild to moderate, and it was as a result of a car crash. I was driving home from work and a teenager pulled out in front of me on a rural road at the last minute. I T-boned her, and my car bounced, hit, and it bounced and twisted, so I got that accelerated, decelerated effect, and then that rotational turn with the car accident. Yeah, and I thought I would get up and walk away from the car accident.
(07:26)
I had no time to rest. I wanted to shake it off. I was getting ready to test for my third degree black belt, had actually been heading to class to train. It took me a while to figure out what was going on, actually, about three months, that I had sustained a significant injury and was not getting better on my own.
Stu
(07:50)
Oh boy. Then not instantly recognizable, I guess, like a laceration or something along those lines. You walked away and thought, “Okay. Well, I can deal with this.” What were the symptoms then that you were experiencing, or perhaps some of the most common symptoms when people suffer a head injury?
Kelly
(08:14)
I do cover those in my book. Some of the common symptoms are behavioral changes, so irritability, mood swing. I definitely had that. Vision changes, which could be loss of vision or light sensitivity.
Stu
(08:39)
Okay.
Kelly
(08:40)
Hearing changes, which could be you could be sensitive to normal sounds. Or loss of hearing, tinnitus, or vertigo because the head injury has affected the vestibular, which is the organ in your ear that tells you where your head is in the world. There’s dizziness, headaches, and then there’s an unbelievable difficulty to describe fatigue, which is also a common symptom that people don’t realize that can be quite persistent in some people.
Stu
(09:16)
Okay. How is it diagnosed? Did you go in there and have the screening and brain scans, et cetera? Or was it just something that was diagnosed through the symptoms that you were expressing at the time?
Kelly
(09:30)
Well, for me, it was pretty obvious that I had a concussion, but it wasn’t from a head CT or an MRI. My head CT came back normal. Most of the time, for my patients, they have normal head CTs and MRIs because the current ones that we use every day in practice, they are good at screening for bleeding, for like I said, a skull fracture, a penetrating injury. Think of large, gross injuries.
(10:13)
With a mild traumatic brain injury, some of the symptoms that people suffer or struggle with happens actually at the cellular level, and these tests don’t see that well. Like I said, you could still have a concussion or a mild traumatic brain injury and have a normal head CT or brain MRI, unless you’re lucky and you get a functional MRI, which isn’t used in everyday clinical practice, but in research. The functional MRI is more sensitive and sometimes can show what we call diffuse axon dysfunction or shearing, and that’s when the cells of the brain have been pulled apart.
Stu
(11:06)
Yeah, right. That is absolutely fascinating. Given the fact that you suffered a traumatic brain injury from a car accident, and we’ve spoken a little bit about other forms, soldiers and perhaps even into the sports as well. What are your thoughts on, perhaps, children and sports at the moment? It just popped into my head because I know that youngsters are playing football, and rugby, and soccer, and all of these different forms nowadays.
(11:38)
Typically, we think, “Oh, they’re youngsters. Their bones fix, and they’ll bounce back.” Should we be paying any particular attention, perhaps, to that area in terms of head protection for youngsters? Because I know that perhaps, obviously, they’re not as resilient as we would make them out to be. Given everything that you’ve spoken to about the fragility of the brain, perhaps there needs to be further thought around that area.
Kelly
(12:13)
Yes. Well, first of all, children, their brains are still developing until they get into their early 20s. The concern is, with head injuries, whether they happen in childhood or as an adult, they’re cumulative. What that means is that if you have a repeat head injury, it could take you longer to recover or even possibly, on occasion, that disability may become permanent, so it is key in protecting the brain.
(12:59)
Then as you get older, especially here in the U.S., people develop chronic illnesses such as diabetes, high blood pressure, that sort of thing. Then say you have a little bike injury when you’re 13, and then as a young adult, you have a snowboarding accident where you hit your head. Then maybe as an older adult, you were in a car accident, and then you get into your 60s, and you could have a stroke because of chronic illnesses.
(13:37)
What I call like to call this is an accumulation of brain baggage. The more brain baggage you have, or head injuries, or concussions, or effects on the brain, the more your disability is going to be later on as an adult. Instead of enjoying a long, active retirement, you end up with issues such as dementia.
Stu
(14:00)
Yeah, right. Fascinating stuff. I’m keen to understand then … We’re going to get into your book a little bit later on. At this point in the conversation, I’m keen to understand some of the strategies then that you called upon as part of your healing and recovery protocol to address your specific TBI.
Kelly
(14:25)
Well, it took me a really long time to put my bag of tools and tricks together. That’s one of the reasons why I wrote the book is because I didn’t want other people to struggle to find ways to support their brain’s healing. The key foundations are sleep, quality sleep, and then exercise, and quality nutrition, mindfulness. I do recommend mindfulness, and then protecting your livelihood, your finances as you’re recovering.
(15:07)
Then another process that I do talk about in my book is letting go, so if you do find yourself … A majority of people recover just fine from a concussion, but there is a percentage of people who do not. I’m one of those people, and I’ve also seen, by taking care of patients who have permanent disabilities. What I see, one of the key components of healing is also being able to let go of your old self and embrace your new limitations, and your new brain, and getting to know your new self. Because what I found after my head injury is it felt like, to me, that the person I was actually died that day in that car accident.
(16:04)
Over time, I began to get to know the new me. At first, it’s hard doing that. You feel alone. You feel alone in your head, but if you’re able to get outside your head through things like exercise and mindful thinking, and accept what has changed and move on, then you’re doing to do so much better in your recovery than someone who just stays back in the past.
Stu
(16:36)
Yeah, yeah. You touched on exercise as well. Given some of the symptoms that you outlined previously in terms of dizziness, nausea, light sensitivity, general lethargy, what types of exercise do you think might be beneficial? Where should we start? Because let’s just say that I’ve come off the football field and I have been concussed, I might not feel like getting back on the football field, so should I start somewhere different, perhaps with, I don’t know, walking as a starting point for exercise?
Kelly
(17:17)
Definitely. I recommend, early into recovery, walking or yoga. If you do suffer from dizziness, if you want to walk, I do recommend walking outside because getting outside in nature has also been shown to be beneficial for the brain. I usually tell my patients to get those walking sticks, where they have them in both hands, and to use that to feel more stable while they’re walking. Then with yoga, there’s always chair yoga, or just holding onto something solid while you’re trying to do the poses.
Stu
(18:00)
Yeah, okay. I guess, the exercise feeds into the sleep as well, because the more we exercise, the better quality of sleep we have. Do you have any tips, tricks, or techniques for sleep that you’ve found particularly beneficial for your recovery?
Kelly
(18:15)
Yes. That is the thing with the brain too, is if you do have a disruption with the brain, whether it’s a head injury, Parkinson’s disease, multiple sclerosis, epilepsy, it can affect the circadian rhythm in the brain, which is the part of the brain that tells us when to be awake and when to be asleep.
(18:38)
Sleeping is actually a learned behavior, and so the best way to get the high quality of sleep is to establish a sleep routine or sleep hygiene. That means making sure you have a routine every night before you go to sleep. It usually starts two hours before you want to go to sleep, so that would be like dimming the lights, turning off all your media devices and TVs because they emanate blue light, which has been shown to diminish melatonin levels in the brain.
(19:15)
Melatonin levels increase as it’s time for your brain to start kick-starting that sleep cycle, so the last thing you want to do is to lower that back down right before you sleep. Sleeping in a cool room. Taking a shower, if you can, before going to sleep. Reading from a book, not from a Kindle or an iPad. Those type of things. Relaxing music, candles. Whatever it takes, but doing that same routine so that your brain knows that when you start doing these steps, this is when it’s to kick in that circadian rhythm, that sleep cycle for you.
Stu
(19:57)
Yeah, no, it’s a good idea. Good sleep takes work. I know oftentimes-
Kelly
(20:03)
It does.
Stu
(20:03)
… people don’t think that. I’ve been obsessed with sleep for years because we had twin girls and that was just a huge disruption, as you can imagine. I work very, very hard on my sleep because I’m getting older and I understand the value of quality sleep. Nobody wants to walk around feeling jet lagged on top of a traumatic brain injury as well. I can only imagine that would be quite awful, so yes- [inaudible 00:20:33]
Kelly
(20:34)
Yeah, and sleep is going to be your foundation for your recovery from your brain injury. There’s also research finding that people who get six hours or less of sleep had an increased risk of developing dementia, and cancer, and strokes, and heart attacks, so it’s not something to pooh-pooh at. It’s very-
Stu
(21:00)
That’s right.
Kelly
(21:00)
… very important.
Stu
(21:03)
That’s exactly what we do when we’re young. We stay out till all hours, and we burn the candle at both ends, and just think, “Ah, look, I’ll sleep when I’m dead,” I think, and that’s the-
Kelly
(21:12)
Yes, yes. Yeah, and that thought, we have that here in the U.S., “Work, work, work, work, be efficient. Get as much done in as little as possible.” I speak to people and I go, “Oh, so how do you sleep?” They say, “Oh, I sleep great.” I’m like, “Oh, good. How many hours do you sleep?” “Oh, five.”
Stu
(21:33)
Wow, yeah.
Kelly
(21:34)
I’m like, “Oh my god. How do you function?” You get used to that, that functionally sleep-deprived, and that’s why people think, “Well, that’s what I’ve always done,” and I say, “Well, just because you’ve done it doesn’t mean it’s a good thing.”
Stu
(21:51)
Exactly. When you have had a truly fantastic game-changing sleep, that’s it. It’s next level. You realize what you’ve been missing. I feel shell-shocked if I don’t get eight hours a night.
Kelly
(22:06)
Yeah, yeah.
Stu
(22:08)
I track my sleep. I’m like a data nerd that has, what’s the REM, and the deep, and awake time? All that kind of stuff, but it’s just what I need to do to feel the best version, I guess, of myself. Because I spent a few years when the twins were growing up in that kind of six-hour zone, and it wasn’t pretty. I just couldn’t function properly.
Kelly
(22:31)
No, yeah, and I also use a Fitbit to track my sleep. I do recommend that for my patients because if you do have a bad night of sleep and you can look at those readings, you could see, you could know, “Well, you know what? Today may not be a good brain day, and so maybe I just need to do the minimum, not push myself, conserve my brain energy.”
(23:00)
When you do get a good night’s sleep, then you’re like, “Okay. This is good. I’ve got a good foundation of sleep last night, or last couple of nights. Now I’m going to push myself. Maybe I’m going to exercise a little bit longer. Maybe I’m going to learn something new. Maybe try to see if I can read a little bit longer.” That kind of thing, so it’s a really good indicator on how well your brain’s going to function the next day.
Stu
(23:24)
That’s right, that’s right. You mentioned that it might not be a good brain day. I’ve heard you refer to the phrase brain breaks in your book as well. I’d love for you just to expand on that a little bit, and just tell us exactly what that means and why it’s so important.
Kelly
(23:44)
Well, brain breaks are essential for even people with healthy brains, but they’re even more paramount for someone who has a brain injury or brain issues. One of the breaks is a mini-brain break where you, every 20 minutes or 10 to 15 minutes, you just look away from your computer. You’re looking out a window, or you’re looking 20 feet away. Optometrists recommend that for resting the eyes. That’s one break.
(24:28)
The other is just getting up and getting a glass of water every hour or so, 30 minutes to an hour, using the restroom, just stretching at your desk. That kind of thing. Then there’s an exercise break where you’re going to do … That should be done every one to two hours, where you’re actually going to do maybe some yoga stretches, maybe go for a short walk outside. Just get that blood flowing back to the brain and rejuvenating it before you come back to your task.
(25:07)
Then there’s also mental health days. We all need mental health days. That is a brain break. That’s giving your brain a break, whether it’s to help treat your anxiety, or your depression, or it’s because you’ve had a traumatic brain injury and your cognitive fatigue is getting too much to work through. You’re starting to have headaches again, dizziness. You’ve having difficulty speaking and your memory’s getting glitchy. That kind of thing. You’re needing more sleep, or you’ve had a really bad migraine headache.
(25:42)
A mental health day is when you take the day off from school or work and you actually catch up on your sleep. You hydrate, you eat really, really healthy, and you do things that are good for your brain like either it’s the yoga, the walking. Maybe doing some adult coloring, getting into that mindful thinking mindset intermittently through the day. Just being gentle and kind to yourself.
Stu
(26:10)
What are your thoughts on mobile phones and social media, and the like? Because just listening to how you outlined the importance of brain breaks just made me think that oftentimes, when we do have downtime, we reach for our mobile phone, and we get caught in this endless spiral of interaction and stimulation. Perhaps that isn’t the best thing at all for our brain if we wanted to, like you said, just give it … Relax, and be present and in the moment, which could never be further from the truth when we’ve got the mobiles in our hands.
Kelly
(26:46)
Oh, yeah, yeah. Are you familiar with Mel Robbins?
Stu
(26:51)
Yes.
Kelly
(26:52)
Okay. I read one of her books, and she shared an interesting thought. A lot of times, people will grab their social media … iPhone and start scrolling through social media when they’re starting to get anxious, stressed, and overwhelmed. Grabbing your iPhone and taking that break is not a bad thing. It’s actually a signal from your brain that you do need a break, that something’s going on.
(27:28)
Your brain is telling you, “I need something.” That could be it needs you to get up and move around. You’re getting dehydrated. You haven’t drank enough fluids. Maybe it’s been a while since you ate. Maybe the task you’re working on is overwhelming you and it needs to be broken down into small steps, so procrastination is not a bad thing.
(27:53)
Grabbing that iPhone and scrolling through your social accounts is not a bad thing. It’s a signal. It’s your brain telling you, “Hey, you need a break,” so don’t beat yourself up over it. It’s only human nature, but try not to do it often. When you’re doing it, you find yourself grabbing that phone, ask yourself why first. If you can, ask yourself, “Why am I leaving my work task, this email I’m writing to my boss, and wanting to grab this phone?” and delve into that a little deeper. Of course, you should also reward yourself for when you’re working hard, and take a brain break.
Stu
(28:36)
I think there’s going to be a lot of people now asking themselves, “Why have I got my mobile phone in my hand?” Because it’s just become so ingrained, I think, behavior in our cultures across the globe that oftentimes, you can’t imagine your life without it, which is kind of crazy given the fact that I remember when they didn’t exist and it was quite a different time.
Kelly
(29:03)
Yeah, yeah. Yeah, so sometimes, I’ll have people who struggle with concentration and focus because they do tend to grab the iPhone. Then they end up procrastinating too much, and then the consequence is not getting the work done or studying for that exam, right?
Stu
(29:23)
Yeah.
Kelly
(29:23)
What I often tell people is to turn off all your notifications on your phone. You know how they pop up? To go in your settings and turn off all those notifications. Put the phone down, but set the alarm for an amount of time that you’re able to concentrate, whether that’s 10 minutes, up to 20 minutes.
Stu
(29:43)
Yes.
Kelly
(29:43)
When the alarm goes off, then you can reward yourself with five or 10 minutes of social media, and that helps people cope a little bit, get their motivation going on their projects, and help them with their time management.
Stu
(30:01)
I love the strategy, but I’m thinking that five minutes of social media might very easily slip into 50 minutes of social media because you get caught in that time suck, where you realize-
Kelly
(30:13)
You do. You do.
Stu
(30:16)
… “Where have I been? Where have I been for that last hour?”
Kelly
(30:16)
That’s why you have to reset the alarm for the five to 10 minutes. Otherwise, oh, yeah, you’ll be going down that rabbit hole.
Stu
(30:28)
Yeah, it’s true. Wanted to duck into nutrition. You mentioned that it’s obviously very important to get good quality nutrition to support the body and the brain, of course. Did you use any specific foods, or food types, or supplements to support your recovery? Because, I guess, if we went into the High Street, typically, people might say to you, “Well, let’s eat a Mediterranean diet.” Lots of oily fish, good for the brain. Then maybe you’d want some omega-3 fatty acids because they’re good for the brain as well. Possibly throw in a few eggs because that’s got choline, and choline’s healthy for the brain.
(31:06)
What’s your take on that given the fact that you would have really dug down on the data and gone for what you believe to be the very best in terms of what we should be eating and supplementing for brain health?
Kelly
(31:23)
Well, I think, fortunately for myself, prior to my car accident, I had discovered the plant-based diet. I feel like because of the plant-based diet and my athletic shape at the time, that I recovered a lot better. I feel like that car accident, man, when I look back, it was nasty. Broken glass everywhere, air bags exploded. My car was totaled, and so fortunately, I started off with my brain injury with a good foundation of a plant-based diet and habit.
(32:03)
Then while I was recovering, I read Dr. Neal Barnard’s book, Power Foods for the Brain. You mentioned supplements. Well, if you follow a plant-based diet or vegan diet, it’s important to supplement your nutrition with a B12 vitamin, and to have your general practitioner check it every year to make sure it doesn’t dip too low. Then the other thing I added was a vegan omega-3 and DHA supplement. The omega-3 vegan gets its omega-3 from algae instead of fish.
Stu
(32:48)
Okay.
Kelly
(32:50)
I tell my patients that I don’t recommend fish oil because fish oil is an oil, and oils have been shown to increase your risk of vasculature occlusions such as heart attacks and strokes. If you’re dealing with a brain that is healing, the last thing you want to do is to add oil into your diet, or at least limit it and keep it to a minimum so that you’re not increasing your risk of developing a stroke later on in life.
Stu
(33:31)
Got it, got it. Okay, fantastic. Let’s talk about the book then because I’m guessing that a lot of these principles are going to be outlined. The book’s called After the Crash. What could our readers expect if they grabbed a copy and they really wanted to knuckle down on this because they’d suffered something similar to yourself?
Kelly
(33:52)
I wrote the book because after my car accident it was, all I wanted to do was get back to my martial arts training, and back to work, and being the person I had been prior to the car accident. I ended up finding out that the information about traumatic brain injury and recovery is so widespread. When I researched, I found information that was supportive for military personnel, for young kids, like you said, and for people who had moderate to severe traumatic brain injuries.
(34:31)
Well, I was just a regular Joe Blow who was in a car accident. I wasn’t significant disabled, but I did have cognitive disabilities, mild cognitive disabilities. Like I said, I really just wanted to get back to work and exercise.
(34:50)
When I wrote my book, my book really focuses on using strategies and techniques that I learned to help support my ability to go back to work and to study. It talks about strategies and tools to deal with the symptoms of concussion, such as light sensitivity, wearing dark glasses. Sound sensitivity, wearing noise-canceling headphones while at work to help with the ear focus and concentration.
(35:18)
I talk about various symptoms that people have and the specialist to see, because that’s also very difficult to navigate, for patients to know who specifically to see for a certain symptom. I also talk about those pillars to recovery, sleep, nutrition, exercise, mindful thinking. I talk about, what we have here in the United States is Federal Medical Leave Act, and that is time that you can take off from work to heal from your brain injury, and not be retaliated against or risk losing your job.
(36:03)
Then I talk about job and school accommodations. We have a Disability Act here in the United States that people should become familiar with and know how to ask for accommodations from their school or from their employer.
Stu
(36:27)
Excellent, excellent. Something that we haven’t touched on, it’s kind of a … You’re probably not going to be able to answer this. It’s open-ended, but recovery time. It’ll change from person to person, but if I was concussed from a game of soccer then perhaps, what would you recommend that my recovery time perhaps be before I get back on and do some sort of athletic pursuit?
Kelly
(36:57)
Well, you’re asking two questions. Let’s go with the recovery time, generalized recovery time. That is a really good question, Stuart, because a lot of my patients want to know, “When am I going to get better?”
Stu
(37:07)
Yeah.
Kelly
(37:11)
Some people get better within two to three weeks. Some people get better within three to four months. I tell my patients … It really, the other component … Sorry. Tangents. The other component is also how your brain reacts to the injury. Someone could have a really severe brain injury and be in the ICU, the intensive care unit, and walk away with no residual effects. Or someone could simply just have been in a fall, and it can profoundly affect their ability to work, so there’s that component.
(37:51)
Every person, every brain reacts differently to the injury, whether it’s a severe injury or a light injury. Being in an accident or a fall’s not a light injury, but comparatively. You can’t know how someone’s going to recover based on the injury, how severe the injury is, but in general, I like to tell my patients, “Hey, you will see the most improvement and the biggest leaps in your improvement within two years.”
Stu
(38:24)
Right.
Kelly
(38:26)
After two years, there’s still growth and improvement in the individual, but it’s more subtle and incremental. It’s more farther apart. What I recommend for my patients who are having persistent symptoms going into that second month is to start journaling their symptoms.
Stu
(38:45)
Got it, got it.
Kelly
(38:47)
Because while you recover, you’re going to notice some symptoms. Then while they heal and go away, another symptom might replace it because it’s been uncovered. You didn’t notice it because the other symptom, such as dizziness, was your worst symptom. Then you’re feeling better, and then you realize, “You know what? My memory’s not so good.” That kind of thing.
(39:13)
I always recommend people to journal their symptoms, look back on their symptoms every three to six months to see if anything has changed, gone away, or shown up, and always keep that, I call it a recovery journal. Because if you end up being that individual who takes years to recover, there are going to be times where you’re depressed, and bummed out, and feel like everyone is going on with their life and you’re not.
(39:41)
That’s when you can grab that journal, look back and see how far you have come. Because the last thing you want if you’re suffering or recovering from a head injury is to focus on what you can’t do today and worry about what the future’s going to be. The best thing to do is to look back and see how far you have come.
Stu
(40:03)
That’s right. Oftentimes, similarly, even with something like weight loss, you can get really dejected because you think, “I’m just not doing anything.” Then when you realize that, “Hold on. I’ve lost a pound a day for the last three or four months,” well that all equals … That’s significant. It’s a big number, and that’s quite an achievement, so small steps, I think.
Kelly
(40:26)
It’s a step in the right direction.
Stu
(40:28)
Yes, it is. Absolutely, yeah, which is so important. Absolutely. We’re starting to come up on time, but I’m keen to hear … I’ve got a question here which outlines, essentially, if you could give three top tips or strategies, or tools, techniques that you think could make the biggest impact on our brain health, and irrespective of whether we have suffered a TBI or we just want to support healthy cognition and healthy brain function, what might you think those would be given your findings?
Kelly
(41:08)
That is a really hard one. I’ll give, my top three is definitely the sleep. That is key. If you’re not sleeping, you can’t do anything else. Exercise. Get that blood circulation to your brain, lower your risk of a stroke or dementia. I strongly support the plant-based nutrition for my patients.
(41:36)
The other two I would throw in there that’s really important for maintaining your cognitive health is always to be learning something. Learning can be simply trying a new recipe, eating at a different restaurant, or as drastic as traveling to another country and learning a different language. Then last is to be social. Being social can be as simple as texting a friend, writing a letter to a family member, or as big as volunteering at your local community animal shelter.
Stu
(42:16)
Yeah, that’s a-
Kelly
(42:16)
Those are the five things-
Stu
(42:16)
No, that’s great.
Kelly
(42:17)
… that I would recommend.
Stu
(42:17)
Your number four as well, you spoke about learn new things. I heard a quote and I can’t remember who or where the quote came from. I’m probably going to mess it up, but essentially, it said, “Routine is amazing for the body, but disastrous for the mind.” I think that just touches on what you said in terms of, just learn new stuff. Because I do believe that we can form new brain cells and connective tissues in the brain. I think they call it neurogenesis, and things like that.
Kelly
(42:52)
Neuroplasticity.
Stu
(42:53)
Neuroplasticity. Exactly right.
Kelly
(42:54)
Oh my gosh. That’s huge. That is a huge subject.
Stu
(42:57)
Yeah.
Kelly
(42:57)
Yeah. It’s very fascinating.
Stu
(43:00)
Oftentimes, when we’re just following the same course day in, day out and sometimes, just autopilot, we don’t even realize how we got here.
Kelly
(43:10)
Yeah.
Stu
(43:11)
I really don’t think that that’s the best for a growing, thriving brain.
Kelly
(43:18)
Right. Then there’s also discussion of cognitive reserve, which is the more you learn, the more brain cells you develop, the larger you have in your bank for brain cells, and so if something does happen like a stroke or an injury, you have these extra, residual brain cells to tap into. Whereas, if you don’t have those and you stay in a rut, you don’t learn, you’re watching TV, not exercising, then the impact of a stroke or dementia is going to be more significant.
Stu
(43:51)
Yeah, yeah. Completely agree. Wonderful advice. What’s next for Kelly Tuttle? What have you got in the pipeline? Are you crushing your martial art goals?
Kelly
(44:04)
No, not yet, not yet. I’m just trying to keep my feet wet with the martial arts. Yeah, my cognitive fatigue is a little bit too significant at this point. It’s gotten better, but I’m not back to where it was.
(44:20)
I’m going to continue practicing, taking care of my patients. I work 40-plus hours a week doing that, but I want to start creating content about brain injuries, and just talking a lot about what you said. Just quick, to the point information that somebody who doesn’t have a lot of cognitive energy can absorb. I’m going to look at beefing up my social media accounts. I’m trying to put together a YouTube account.
Stu
(44:56)
Oh, right. Yeah.
Kelly
(44:57)
You can find me … Let’s see here. The best place to find me for more of that information is kellytuttle.org, O-R-G. That’s the best place to reach out to me, but you can also find me on Instagram @brain-np. I’m also on Facebook and LinkedIn under Kelly Tuttle.
Stu
(45:24)
Wonderful.
Kelly
(45:24)
That’s T-U-T-T-L-E.
Stu
(45:27)
That’s fantastic. We’ll put all of those links in the show notes today. Everybody that wants to find out more about you, yourself, order a copy of the book, that’s where we go. That’s where we go.
Kelly
(45:38)
Exactly. My book will be available on Amazon and shortly, I just finished recording it for Audible too, for those who have difficult with reading,
Stu
(45:47)
Fantastic. That is absolutely amazing. Kelly, it’s been a joy to converse with you today. I always like the fact that we can fast-track to the juicy bits for anybody that’s just landed themselves in a position where they’ve had a traumatic brain injury and think, “I just don’t know where to start,” and then here you go. You’ve done all the hard work for them.
(46:08)
This is just a great resource to be able jump in and execute immediately, which is fantastic, so much appreciated. Really, really had a great time in this conversation and look forward to sharing this information with our listeners.
Kelly
(46:21)
Thank you, Stuart. I had fun too. Thanks.
Stu
(46:23)
Thank you. You take-
