Friday, November 11, 2022

MedPreneur Spotlight: MEET JANUARY HOWARD!

IPHA NEWS is proud to kick off our spring 2022 feature spotlight series on female role models in our community.  Welcome January Howard, owner of MedSpa 101.  Her business is coaching medical professionals who are new to aesthetics- looking for financial freedom.  January found her passion with coaching professionals find their next interest in the world of aesthetics.  She is among a set of remarkable women chosen as part of the EMPOWERMENT SERIES by our panel of public advocates for their leadership in their respective careers or fields of study, while others have been chosen for social or technical achievements that can inspire us all.   

A VENTURE IN PERSONAL ENHANCEMENT
An interview with January Howard (by Josh Schueller, PT  / Edited by: Lennard Gettz)

If process of elimination is a direction finder, I learned at a very early age where I didn't belong.  I started out with a degree in exercise science and went the gym route as a personal trainer.  The hours were exhausting, the pay was defeating and it didn't lend itself to a truly fulfilling existence.  I hate to admit that my mother may have been correct about choosing the wrong degree, but lets face it, many of us never end up in the first field we start out.

We are at a great age when we can access inspirations to explore and evolve in a better direction. You can learn just about anything on YouTube.  Nowadays, you can become an expert at just about anything. Finding those kinds of resources and just being inspired to question life and find better ways in life-- and when you surround yourself with innovators, you too can take note and chose to look for the positive.  And by doing so I did just that I became an expert in the medical aesthetic field!  A mentor of mine taught me that 'you don't sell your product, you sell the solution... your product solves". So it's whether it's pain, whether it's anti-aging, whether it's just straight vanity and/or it's the newer cooler best thing.  I enjoy being healthy and happy, so I choose to inspire others to find their own healthier, happier ways as well by teaching medical professionals how to implement medical aesthetics in their current practices.  Aesthetics clients are typically healthier, happier, and cash paying clients, which elevates the mood of the entire practice!  


My career has been quite the roller coaster of evolution, I've always loved helping people, I had a successful marketing and events company for a while where I brought anywhere from 40 to 400 ladies to my clients special events unfortunately it crashed when the economy crashed.  I then became an event planner for a booming network marketing company where we launched a game-changing 90 Day Fitness Challenge and set a world record for the largest simultaneous flash dance to date!  The rock star life was awesome because when the economy was down, we were growing but I totally burned out on that and went back into aesthetics and evolved into the person I am now. My evolution in aesthetics started when I began selling a micro-needling device. Micro-needling found it’s self on the FDA's radar, a competing pen got the FDA clearance first and I temporarily got swept into a nasty battle with a less than ethical local rep.  In reflecting, I simply decided to become better.  My team gave our all, offering better trainings, better support, and simply put more fun!  


On the Aesthetics Business

I formed a new business model focused on edutainment as we call it, thorough yet entertaining skill and marketing training.  Most clinical trainings, are mundane and boring, educational, but far from inspiring.  Simply put my courses are more fun, more condensed and just better all around.  This program was more focused around the client and their growth- and took off beautifully. My retention rate is literally at 99.5%. After a while, we created an elevated culture where our students left fulfilled and ready to not only preform a skill but to thrive. 
 I won't take all the credit for a successful business. There's Tony Robbins, which was my catalyst, and then there is Jeff Henderson, which is a direct mentor of mine. He was actually the CMO of Chick-fil-A. He teaches very similarly to likes of  John C. Maxwell and Napoleon Hill, A major lesson I learned from Jeff is that "you must become a raving fan of your clients, in order for then to become a raving fan of you... and that's the goal is our clients be our raving fans!". I choose to surround myself with like-minded, grounded individuals who strive to evolve into the best versions of themselves!  When I am not teaching Drs aesthetics over the weekend.  I serve at my non-denominational church by teaching 4 year olds in Sunday School, I get by giving and am grateful for the teachings and support I get for free every Sunday I attend.  


I love what we do. Even though our line of work can be the more on the vane side, we do help people look and feel better about them selves. We help people with scars, hyperpigmentation and hair loss, we help soften fine line and wrinkles, which improves overall texture. This truly helps people build their self-esteem. It's not just for the socialites that want to look amazing-- aesthetics is also for someone scarred from a fall, or that's had a bad bicycle accident and her lip has been scarred and we help bring their face a back to symmetry.  And for that child that was acne ridden or a beautiful woman that's full of acne scars - we can smooth her face out. I did it. We worked on an accountant that works with us and we had done six treatments--  acne takes a while (some take several couple years). I had not physically seen a difference and I asked her thoughts, after a while, she tears up and she said, "oh my God, I can smile without it hurting... I can move my face now, like a normal person.".  We literally worked on her to address a major piece of scar tissue. So this part of her face used to hurt when she smiled.  Stories like this make it a beautiful space to work in.  Also, there's a lot in PRP for wound care including diabetics, treatments that actually save limbs, and restore burns to the natural color and texture!  Not to mention scar revision for the many women who have decided to explant do to Breast Implant Illness as well as Cancer related surgeries.  

We provide accredited classes and that's my specialty. This can be ongoing and speaking of evolution, I've had to evolve again because of COVID. My primary focus is working with clients who are medical providers who are new to aesthetics.  I help everyone from ophthalmologists, orthopedic surgeons, nurse practitioners, physician's assistants- anyone that that hunger and wants to grow into aesthetics because we're the fun part! And I use the word 'FUN' a lot but I truly believe that once you get into aesthetics, you don't really want to go back.  In addition to FUN, aesthetics is a cash based business which is an immediate return on investment for the practice!

WHAT IS MICRONEEDLING?
So in very layman terms, micro-needling Is the exact same thing as aerating the lawn or the golf course. So aerating for some ladies that don't know, you put little pivots into the grass and it makes the grass come back thicker and greener. In creating perfect micro injuries to the skin in which the skin comes back firmer, tighter, more polished, more radiant. It works on skin, scars and hair. It's just a moderately aggressive treatment. It is literally is like a tattoo needle with 12 to 16 needles in the little cartridge and you use a topical numbing cream then you put the little holes in the skin. The best treatment I believe is with PRP -that's called the vampire facial coined trademarked by Dr. Charles Runels.  For best results a series of 4 sessions spaced 4 weeks apart is needed.  

MEDSPA 101
I'm great at branding everyone else but a little slow to brand myself.  It's been up and running but formally launching the website was a little challenging. This is how you can open a med spa with as little as $5,000, as much as $200,000. And I can teach you to easily make a hundred thousand dollars in a year with that. So it's very simple. I am focusing on the beginning stages of med spas. That's where I would rather work and building a library of resources for my clients and those clients mainly general practitioners that want to just start offering Neurotoxins,  Fillers,  micro-needling and PRP.


To me, microneedling and PRP should be your first investment in launching aesthetics in both new and or existing practices!  Simply because with those two, you train and immediately start earning income.  Botox takes time and practice. You need to practice on your friends a lot before you really start charging for it. With PRP, if someone's a confidant injector, they can immediately start making money.  PRP is actually platelet rich plasma. You would take a vial (or six). Some, some treatments require around 60 Ml's of blood (it's not even equivalent to a cup of coffee) and it's way less than you give if you donate blood.   The provider will spin the blood in a medical grade centrifuge. In which the machine separates the red blood cells from the white blood cells.  Red blood cells have absolutely no value. And then you will extract the platelet rich. So typically if you did that 60 ML draw, you would typically have anywhere from five to 10 Ml's of platelet, rich plasma, after you can dilute it depending on the procedures that you're doing.  PRP for are the platelet rich plasma facials, which we call the vampire facial. 

The VAMPIRE FACELIFT, which would be injecting the PRP with a synthetic filler can be used for joints, The O-SHOT and P-SHOT for sexual function, (and yes they really work) for hair loss and just about anything.  It's great for acne. PRP just brings the body back to a state of homeostasis- correcting, scars, softening the skin, thickening hair.  However if a man's been bald for 10 years, his hair is not going to come back.  If someone is thinning we can thicken the hair up, wake it up quicken up the hair cycle.   Hair loss has been on the rise due to elevated stress levels, a rise in hormone, issues, as well as a lingering side affect of the Covid virus.  We now have white papers proving PRP restores hair lost due to Covid!  Women with these root causes have great results with PRP therapies!  In addition BioFiller requests are on the rise this is where the provider uses heated plasma mixed with PRP instead of synthetic filler.  This is perfect for those more on the  homeopathic side, as well as those looking for a softer more natural look.  

ON PARTNERSHIPS
I've been very lucky. I think maintaining my ethical values and my core beliefs throughout running a business has really paid off. I remember working with a med spa and Dr. Reynolds came to town and we hired him to speak at our event. I loved what he was doing. I love the Cellular Medical Association teaches medical professionals, life changing therapies that also create financial freedom for the provider at the same time!  I joined his affiliate system and working with him motivates me because I'm continuing to learn about the benefits.  For example, in a weekly training, there was a situation about people getting synthetic filler in their temple and a provider injected PRP to reverse necrosis. The patient could have been scarred for life yet PRP to fixed that!  I am also a product of the product!  I micro-needle myself every 4 to 6 weeks, have thickened my own hair, and navigated a gnarly injury to my face without scaring; do to my access to PRP and micro-needling!  In addition to working with Dr Runels I also have the privilege of working with Dr Arun Garg, one of the original inventors of the very first centrifuge!   It’s truly a privilege to work with these innovators, and living legends!  

EPILOGUE
There is truly a plug and playbook to aesthetics, and or I/ she call it a spa in a box!  Navigating aesthetics is a fun and fruitful journey when you partner with the right team!   You simply have to push play to begin!  I changed my stars and would love to show you how you too can evolve your business and personal happiness to a level you never imagined possible!  





Tuesday, October 25, 2022

BRAIN INJURY ESSENTIALS: NERVE CHECK-UP

By: Dr. Jerry Dreessen

In a common case like a patient surviving a car accident, one of my first targets is to evaluate what's happened to the inside of their head. There's a difference between the effects of a slight rear end-- Was it a high or low speed impact? Was it a T-bone? Did they experience two car accident?  Any kind of quick stop is going to cause everything to slide forward in the head and then come back-- what we call as "coup contrecoup". And it can disrupt the brain and may cause a mild hemorrhage. It can cause a little bit of bruising. Some people talk about feeling a little foggy after an accident- similar to walking into an attic with dust flying all around. That's what can happen to your brain when it starts to slap around inside the skull, just even from a mild car accident. 

There are concussion protocols that we perform in the clinic. To process this type of patient starts with a questionnaire about:

* Cognitive abilities: What are the things that they can or can't do? 

* Do they have a headache? 

* Are they having a hard time focusing? 

We also get into studying their emotional state as far as any feelings of SADNESS. Some people may have immediate reactions and seek help right away, while others come in for a consult weeks later. 


THE 12 POINT CRANIAL NERVE CHECK

A standard exam is studying a CRANIAL NERVE CHECK. Not only do you have the brain sitting in the skull with a brain stem, which can be greatly affected with a whiplash scenario, but in the floor of the skull, there's 12 sets of nerves that come out and they perform different functions. This is often overlooked.  There are many cases that do not show apparent concussion symptoms, but if they have one of the cranial nerves that doesn't work properly, this is a sure giveaway. 

We can start by helping that nerve system heal either through nutrition or through cognitive exercises but also eliminating the inflammation. Reading an MRI can be a challenge when looking for any mild type of inflammation in the brain- but with the proper diagnosis, we can reduce not only the concussion, but the possible post traumatic stress disorder and, and personality changes that can go along with it. 

This standard process of reading the performance of the cranial nerve means studying 12 different nerves. This test helps determine if there's any kind of cranial nerve loss due to a car accident or sports injuries. 




The first is the OLFACTORY nerve; this conveys the sense of smell. Some people can come in, barring the challenges of Covid symptoms and may already have loss of smell.  Otherwise, if the accident may have affected their ability to smell, that's one signal that the olfactory nerve isn't functioning properly. (2) The next nerve that we check is the OPTIC nerve and that is what transmits information including blurry vision vs. the ability to focus on an object. Retinal reaction to light gets us the pupillary response.



The Double Impact of Post Concussion Disorder By: Ray Ciancaglini 


The first concussion was mild and it was a little bit of a headache and some fatigue. I got stunned but never been knocked out or knocked down, so that kind of fooled me here. Um, and then one week later in Syracuse, I got my bell rung again for the second time in one week.  Only this time, it was a little bit more serious. And from being a well behaved high honor student, things changed. After that night, I started failing on all my courses, started sleeping excessively, and then I developed an attitude especially toward authority figures, and couldn't explain why. And, uh, this just lasted with me till I retired from boxing in 1974. From here, it got progressively worse.

TESTING THE MEDS: 
After enough medical evaluations and care, everything was going well until one day, I wanted to adjust being under these meds. I felt I can do it now, so I did a dangerous thing which is to stave off the medicine without telling anybody. Luckily, my wife picked it up right away. She said, "--you're a different person... I could tell right away from your eyes, what she called SHARK EYES!  You have this glare like you're in a pre fight weigh in, like you're staring the opponent down. Everyone was afraid of this and so was I. I could hurt somebody out of impulse and I never would want to do that."  I was easily angered, unreasonable, stubborn and defiant. Nobody could tell me what to do.  I was short tempered and irritable such that one day, I walked to the next room and a door swung back and hit me on the wrist-- and by some heated impluse, I punched a hole right through it!  Needless to say, I got back on the medication after those outbursts. If punching a hole through a door meant a lack of self control, this was enough to point out that there's definitely something wrong with me.  



THE 12 POINT CRANIAL NERVE CHECK (Continued)

And then we have the cranial nerves three, four, and six, which are the OCULOMOTOR, TROCHLEAR and ABDUCENS (see chart). This is  where the patient simply follows our finger with their eyes and we observe their field of gaze to find out if they're tracking properly. Depending on how the eyes perform during this test, we can determine which of those three cranial nerves and functioning properly.  Next is the fifth cranial nerve called the TRIGEMINAL- that's the skin of the face. And as far as chewing (mastications). Oftentimes it's subjective information to ask if they have challenges chewing their food.  Cranial nerve seven is the FACIAL nerve as far as what's involved in TASTE. Then, Cranial nerve eight is the VESTIBULAR COCHLEAR nerve- involving the hearing and balance. For this, we conduct the Trendelenburg test, where they stand on one foot and we just push them a little bit and see if they're able to balance.  

Then we employ the use of a tuning fork close to the ear and also touch the bone on the back of the head to see whether they can hear all of that. Any loss of hearing is indicative of an injured nerve. Cranial nerve #9 is checked by asking the patient if food tastes the same, or if it has changed in anyway, and if they have a developed a dry mouth. Cranial nerve #10 involves swallowing and also breathing. This is a significantly major nerve out of the whole system.  We check the ability to swallow by by manually pressing the hand over the patient's throat and ask them to swallow. 

The ACCESSORY NERVE is #11 - where we instruct the patient to shrug their shoulders. We check for weakness or asymmetry.  As the cranial nerve is split down the center, if the patient can only function on one side or another, this may indicate nerve paralysis, damage to the cranial nerve or the damage to the muscles of the neck. 

The final (#12) cranial nerve is the HYPOGLOSSAL- tongue movement. By monitoring the patient's ability to push their tongue against their cheek.








CONCUSSION EXAMS (Part 2)- THE BENEFITS OF IMAGING: Concussion literature notes that in a Funduscopic exam, the retinal arterial-venous width will show as ASYMMETRIC (indicative of possible trauma). This is a potential response of the autonomic nervous system.   Microcirculatory hemodynamics that are optically visible are useful in validating the treatment progress. (see complete review)Now that radiologists are using Doppler blood flow to examine eye disease, including systemic diseases (including Diabetes, Brain tumors, heart disease, sickle cell disease etc.) that affect the eye, we are hopeful that the ophthalmologic and neurological communities will start using this noninvasive technology as well to improve noninvasive and more rapid treatment of potential eye disorders, such as cancers of the eye, diabetes and glaucoma.  Another future use will be to correlate the effect of decreased vascular pulsation in the production of cerebrospinal fluid that is removed by the cleansing glymphatic system is postulated as a contributing factor in degenerative neuromuscular disease.    






DR. JERRY DREESSEN is a chiropractor dedicated to the specialized work in Spinal Biomechanical Engineering Analytics and Case Management.  He holds specialized credentials as a Trauma Team, Hospital care and Primary Spine Care in Mountlake Terrace, WA. He is the clinical director of an independent pain management practice called BACK TO ACTION CHIROPRACTIC the Executive Director for the Association of PEMF Professionals, a national organization for all PEMF users, and is a best selling author on Amazon with his book about Pain Management. 






Ringside Review: Why the Boxing Commissioner Called to "STOP THE FIGHT" ? The photo was a stunning one-in-a-million shot of a moment in time (as captured by the sports photographer, Stephanie Trapp).  Standing at the right place and at the right time, her lens managed to freeze multiple streams of explosive action that comprised Deontay Wilder completely obliterating Stiverne.  The empty, worn out 'rag-doll' form of Stiverne's flacid body laid melted and dangling senselessly from the bottom rope. Center frame was the referee (Arthur Mercante Jr.) airborne on top of the highly charged and powerful Wilder, desperately grappling on the aggressive champ with his own unremarkable body. "Mercante responded vigorously to my raising the hand in the air at ringside-- that's the signal to 'STOP THE FIGHT!'... any more than this would be unconscionable". (See complete OP-ED feature)


2022 TRENDING INTEREST IN BRAIN HEALTH July 19, 2022- IPHA NEWS conducted a private interview with the co-developers of NEUROVINE - a portable headband using EEG (electroencephalogram) technology to measure brain waves.  Meet CEO Ashleigh Kennedy, Ph.D., and CMO Matthew Kennedy, MD, MSc (co-founders of Neurovine) from Ottawa, Ontario, CA. who shares their objectives in support of concussion monitoring by measuring brain health as part of optimizing their recovery process. Neurovine offers this portable interactive monitoring program for athletes, students, professionals and anyone undergoing mentally strenuous work by “alerting them to take brain breaks before an activity becomes too strenuous”.


2022 STUDY OF INTRACRANIAL IMPACT DISORDERS - Concussions are viewed as a mild form of traumatic brain injuries and most frequently occur following an event that involves an acceleration–deceleration mechanism without actual injury to the head, such as whiplash, or the head striking an object. As we study these, researchers and clinicians are learning that these are fairly common, but often underdiagnosed.  While the vast majority of people with concussions recover without obvious disability, people can end up with long-term cognitive, emotional and functional issues affecting quality of life – including memory issues and Alzheimer’s disease. Efforts to better predict outcome from head injuries by focusing on the age, sex, type of injury and acute assessments have led to some improvement, but still fail to predict or explain the variation in healing and outcomes. Studies in professional athletes have shown that about 80–90% are sufficiently recovered to return to playing within 7–10 days. But that means that 10-20% are not, and their recovery can take up to 3 times longer. Even taking into account variations in initial injury, this variation is difficult to explain or predict.  (see complete feature by Dr. Roberta Kline)


CONCUSSION ON THE FIELD..."Miami, We Have a Problem!" OP-ED by: Dr. Michael Gruttadauria |  9/25/2022 - The Miami Dolphins prized quarterback Tua Tagovailoa sustained what was clearly a concussion.  He was dazed and in trying to walk off the field, staggered and nearly collapsed.  He was helped off the field and taken into the injury evaluation tent.  You didn’t need to be a neurologist to see that he was shaken from hitting his head on the ground.  Incredibly, the QB cleared the NFL Concussion Protocol and to everyone’s surprise, was allowed to play in the second half of the game.  Many questions were raised about the injury following the game and everyone from the Dolphins coach, to their staff to Tua himself seemed to blame the entire incident on a back injury he said he sustained earlier in the game. (see complete issue)


ON POST-CONCUSSION SYMPTOMS By: Dr. Robert L. Bard | The underreported cases of bowel permeability to toxins in concussion is likewise mostly anecdotal. The possibility of scanning the gut for increased blood flow following brain trauma may be easily performed as followed as a guideline for evaluation of concussion chronicity. As the bowel activity is regulated by the autonomic nervous system we may apply the same diagnostic endpoints as other physiologic norms.  The response of the microvasculature in the retina provides a functional guideline as to the progression of brain trauma and concussion as measured by blood flow. The application of optical devices and sensors for physical (temperature, respiration, heart rate, blood pressure) chemical (pH, pO2, glucose, lipids, oximetry) and biological (antigens, antibodies, electrolytes, enzymes, inhibitors, metabolites, proteins)  data with imaging (endoscopy, optical tomography, confocal microscopy) adds new classifications of metabolism in the altered state. 

A PARTNERSHIP WITH SPORTS MOMS  Another key launch pad to this research program is his alliance with MOMS OF ATHLETES, co-architected by Dr. Roberta Kline (Women's Diagnostic Network) and Dr. Donna Febres.  This educational advocacy group supports clinical care and preventive science to college level athletes.  This unique alliance of professionals and moms are dedicated to finding the safest options in injury and pain care - with an emphasis on new solutions for concussion research and prevention.  This includes the modern non-invasive (non-surgical) alternatives where possible.  NCMOA also teams up with the professional pain and medical associations to collaborate on latest protocols and information on ground-breaking neurostimulation, electromagnetic, holistic/full-body solutions and wearable therapeutics plus the latest in non-radiation clinical imaging validation. (see complete details)




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Wednesday, October 5, 2022

OP-ED/ Photo Review: Why the Boxing Commissioner Called to "STOP THE FIGHT" ?


"BLAST FROM THE PAST":
In a recent interview with former boxing commissioner John Signorile, we covered much ground about preserving lessons learned from the "age-old sport of kings".  

Throughout his stream of historical sports highlights, we landed on the topic of CONCUSSION, where the commissioner was inspired by many references.  Signorile stepped back and peeled a dusty framed photo of a first round knockout round between Wilder vs. Stiverne where this prized memorabilia would travel us closer to this historical heavyweight title event.

The photo was a stunning one-in-a-million shot from Nov. 2017 - from a moment in time (as captured by the sports photographer, Stephanie Trapp).  Standing at the right place and at the right time, her lens managed to freeze multiple streams of explosive action that comprised Deontay Wilder completely obliterating Bermane Stiverne.  The empty, worn out 'rag-doll' form of Stiverne's flacid body laid melted and dangling senselessly from the bottom rope. Center frame was the referee (Arthur Mercante Jr.) airborne on top of the highly charged and powerful Wilder, desperately grappling on the aggressive champ with his own unremarkable body. "Mercante responded vigorously to my raising the hand in the air at ringside-- that's the signal to 'STOP THE FIGHT!'... any more than this would be unconscionable".  

Signorile held the sole discretion of ending the bout prematurely, and enacting this was no easy decision.  The obviously gross mismatch between the animalistic laser-speed punches by Wilder and the three knockdowns (at the first round) of the un-responsive, out of shape Stiverne  "called for real intervention in the worst way!"  

See Video of the ONE-Round Fight: https://www.youtube.com/watch?v=mS4i7a-L-9M

2) https://www.ringtv.com/521691-deontay-wilder-destroys-bermane-stiverne-round-1-heavyweight-title-rematch/




ATHLETES JOINING THE FIGHT FOR FUNCTIONAL WELLNESS (Pt 1) 9/2/2022‐ In the spirit of a joint partnership for improved public wellness, a unique and special advocacy team was formed in Montreal, Canada between three unlikely yet profound champions in their own respective arenas. This trio is comprised of a functional clinician (Prof. Joseph Toy), an imaging specialist from NYC (Dr. Robert Bard) and a world class boxing champ (WBC Bridgerweight Oscar Rivas). Their immediate synergy inspired a collective message for what will soon be part of the next episode of MEDICAL VISIONARIES, a wellness news series produced by IPHA (Integrative Pain Healers Alliance) and the AngioFoundation (501c3). This issue offers informative concepts about the growing trend in non-invasive alternatives including regenerative medicine in the athletic community. (See Press Release)



SAFETY & HEAD INJURY AT THE RING
John Signorile was an amateur boxer for 20 years (1981 to 1995) with an extensive career in local, national and in world boxing tournaments. With a record of 41 wins over 11 losses, Signorile trained with a wide range of fighters on the amateur and professional scale.   By 1995, he retired his gloves and entered the professional ranks as a judge, referee and cornerman- and then evolved on the official arena as the New York State Boxing Commissioner from 2013 to 2018. 

TRANSCRIPT: INTERVIEW WITH NYS FORMER BOXING COMMISSIONER (Part 1)
As an amateur I sparred with the pros to get experience, which may not have been the best idea in hindsight. Long term effects of that may haunt you because professionals could hit very hard- much harder than an amateurs. 

I was never knocked out- only stopped once, which is a good thing (laughs).  In most boxers cases, when they get a traumatic punch to the head, you have concussions that can occur. I recall one incident when I was training with a gentleman for a fight-- a firefighter, actually. We were training for the Police/Fire show at Madison Square Garden. The guy gets hit on the chin and they called the stop because he said "the back of my head is BURNING" - and we didn't know why. I watched him continue and then I left the gym. I heard 10 minutes later he came out of the ring and he was nauseous and he started to throw up. Our coach had a lot of experience (with this type of issue) so he rushed the fighter to the hospital. They concluded a concussion... and poor Frankie fell on the floor at the hospital and was out cold. 

SAFETY AND PREVENTION
When training, amateurs or pros must train with a headgear and box with headgear during tournaments. This is very regulated and there's a penalty of a 30-180 day suspension for not wearing headgear if you are caught training and getting injured without it.  You won't be able to train or enter fights at all. You may even get your license suspended for (I think) 180 days.  The commissioners do not regulate the gyms-- you need to send boxing inspectors who can go to each gym and make sure they have the safety equipment (like electro defibrillators) and have CPR trained and certified individuals.

ON CONCUSSION
Over a prolonged period of time they've shown studies that a boxer may get jabbed at the top or front of the skull during a fight an average of (say maybe) 70 to 150 times easily. The same goes for training. Every time you're getting tapped in the front of your skull, your brain is hitting the back of your skull. So trauma is slowly developing. It's like tapping an egg lightly many times. Eventually that egg's going crack if you keep tapping on it.  Reports show boxers have more of the traumatic brain injuries than the mixed martial artist. If you look at MMA fighters,  they're not too pretty with their noses smashed... their cauliflower ears etc.  But prolonged period of getting "tap, tap, tapped" is worse than that one elbow to the top of your skull. 

During my tenure as (Boxing) Commissioner, I witnessed many cases involving suspension for things like testing positive for steroids.  They need to undergo neurological testing to be released (to compete again).  I think you need CT-scan and neurological testing when you're getting your license and you need one for every fight. I find regulations and testing like this are crucial for the health of all fighters and to keep the sport clean for everyone.



SPECIAL ANNOUNCEMENT:
Each season, the INTEGRATIVE PAIN HEALERS ALLIANCE nominates inspirational speakers, educators or advocates whose commitment to supporting public health and safety awareness is noticed by a wide spectrum of audiences.  We are proud to announce our latest ROLE MODEL, Mr. Ray Ciancaglini of Geneva New York for his tireless crusade in reaching our youth and sharing his wisdom and experiences about sports related brain injury.



In an exclusive interview with Ray, he shared his launch as an up-and-coming boxing champ, his plight with CONCUSSION and his life-saving educational crusade to his road to advocacy.

"...when you're tough and you think you're tough- that's a boxer's heart that keeps you going. I dealt with the punishment that I was receiving (on and off the ring)- I had no idea that concussion was cumulative." 

I started out getting involved in some local amateur fights- and then by the age of 16, I pretty much had everything going for me. I'd vibe for two golden glove titles and seemed to be on my way. As an amateur, I think I ended up 31 or 33 and nine with four draws. Then I ran into some trouble and I failed an EEG test by the New York State Boxing Commission. They didn't want to give me a boxing license in NYS till I passed that test and went before another hearing, which was a one year suspension along with it. I took the advice of some old-timers who told me to go down south where they didn't have some boxing commissions or these rules and regulations.  They suggested to change my name and then when I came back to retake the test, I'll be sharp as ever- and be on top of my game. But that didn't happen because I carried a lot of symptoms with me. 

The first concussion was mild and it was a little bit of a headache and some fatigue. I got stunned but never been knocked out or knocked down, so that kind of fooled me here. Um, and then one week later in Syracuse, I got my bell rung again for the second time in one week.  Only this time, it was a little bit more serious. And from being a well behaved high honor student, things changed. After that night, I started failing on all my courses, started sleeping excessively, and then I developed an attitude especially toward authority figures, and couldn't explain why. And, uh, this just lasted with me till I retired from boxing in 1974. From here, it got progressively worse. 

"Many athletes do not understand or take seriously the possible repercussions of hiding or playing though a concussion. They sometimes feel that they are invincible or that they are tough enough to gut it out. I was once one of those athletes. For many years, I have been battling Dementia Pugilistica and Parkinson's Syndrome. These progressive disorders are the direct result of my not addressing concussions properly as a young boxer.  Athletes need to be honest about any concussion symptoms with their coaching staff and Athletic Trainer and not attempt to hide a concussion. Through my talks, student athletes will understand the importance of addressing a concussion promptly and properly. I strongly recommend that they follow their school concussion program and their doctor's instructions to ensure a safe return to play. Education is the key."   See: www.thesecondimpact.com.

*Interviewer: Josh Schueller, PT (editorial team @ HealthTechReporter.com)



CONCUSSION ON THE FIELD..."Miami, We Have a Problem!"
OP-ED by: Dr. Michael Gruttadauria
9/25/2022 - The Miami Dolphins prized quarterback Tua Tagovailoa sustained what was clearly a concussion.  He was dazed and in trying to walk off the field, staggered and nearly collapsed.  He was helped off the field and taken into the injury evaluation tent.  You didn’t need to be a neurologist to see that he was shaken from hitting his head on the ground.  Incredibly, the QB cleared the NFL Concussion Protocol and to everyone’s surprise, was allowed to play in the second half of the game.  Many questions were raised about the injury following the game and everyone from the Dolphins coach, to their staff to Tua himself seemed to blame the entire incident on a back injury he said he sustained earlier in the game. (see complete issue)


ON POST-CONCUSSION SYMPTOMS
The underreported cases of bowel permeability to toxins in concussion is likewise mostly anecdotal. The possibility of scanning the gut for increased blood flow following brain trauma may be easily performed as followed as a guideline for evaluation of concussion chronicity. As the bowel activity is regulated by the autonomic nervous system we may apply the same diagnostic endpoints as other physiologic norms.  The response of the microvasculature in the retina provides a functional guideline as to the progression of brain trauma and concussion as measured by blood flow. The application of optical devices and sensors for physical (temperature, respiration, heart rate, blood pressure) chemical (pH, pO2, glucose, lipids, oximetry) and biological (antigens, antibodies, electrolytes, enzymes, inhibitors, metabolites, proteins)  data with imaging (endoscopy, optical tomography, confocal microscopy) adds new classifications of metabolism in the altered state. 




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Op-Ed: Concussion in Sports


"Miami, We Have a Problem!" By: DR. MICHAEL GRUTTADAURIA

9/25/2022 - The Miami Dolphins prized quarterback Tua Tagovailoa sustained what was clearly a concussion.  He was dazed and in trying to walk off the field, staggered and nearly collapsed.  He was helped off the field and taken into the injury evaluation tent.  You didn’t need to be a neurologist to see that he was shaken from hitting his head on the ground.  


Incredibly, the QB cleared the NFL Concussion Protocol and to everyone’s surprise, was allowed to play in the second half of the game.  Many questions were raised about the injury following the game and everyone from the Dolphins coach, to their staff to Tua himself seemed to blame the entire incident on a back injury he said he sustained earlier in the game.


The NFL Player’s Association publicly announced that they were investigating the Dolphins/NFL handling of the entire incident.   https://sports.yahoo.com/nflpa-initiates-concussion-investigation-after-wobbly-tua-tagovailoa-continued-playing-vs-bills-235433110.html


Then, the unthinkable happened.  The Dolphins were scheduled to play again just four days later and they announced that Tua would be the starter.  He came out Thursday night looking great until a play where he was thrown to the ground again.  His head bounced off the ground and he immediately went into what appeared to be a decorticate posture.  His body flexed as he appeared to lose consciousness and his arms, hands and fingers became stiff and distorted - indicating a severe trauma to the brain.


He was immediately stabilized and taken off the field on a stretcher to be evaluated at a local hospital.  Accusations have been flying and denial is the word of the day.  What is clear is that we must do better.  


With the knowledge that concussions are linked to chronic neuroinflammatory changes and more recently to neurodegenerative disease, we must do better.  Tua is a professional athlete in arguably the most violent sport there is.  He is tough... a modern day warrior.  He is also a very young man competing on the biggest stage in the world with fame and fortune on the line.  He must be protected, even if that means from himself.  


Watch the progression of the injuries here:

https://www.youtube.com/watch?v=EPbg_KIyUko


Personally, I have a difficult relationship with football.  I am a big fan of the sport as I played it from when I was 9 until I was 18 years old and loved every minute of it.  I sustained countless blows to the head and who knows how many concussions, but that was a different time.  We were always told to shake it off and be tough.  I also love watching the games on TV and follow along in my Fantasy League.  However, as a clinician, I have seen countless athletes from high school, college and professional sports suffer head injuries that altered the course of their lives to varying degrees.  Understanding the neurology and biochemistry of head trauma makes me worry for the players and their futures.  I struggle with this dichotomy.

AFTERTHOUGHT:

The NFL generates close to $20 billion annually.  They have the resources to facilitate change, but there appears to be conflicts of interest.  Who made the final call to allow Tua to play after the first injury?  Can a doctor who is employed or contracted by the NFL be truly impartial? Are they personally liable for their decision to let him play and if not, maybe they should be…we need some adults in the room.


DR. MICHAEL GRUTTADAURIA is a Board Certified Chiropractic Neurologist and Professional Biohacker. He manages a private practice in Huntington, NY, treating people with chronic health conditions from early Alzheimer's Disease, IBS, neck/back pain, anxiety/depression, dizziness, vertigo, migraines and concussion/PCS. "Dr. Mike" uses functional neurological examination and advanced testing to evaluate the body, brain and brainstem to develop strategies to rehabilitate most chronic neurological conditions. He applies interventions including functional neuro rehab, balance training, eye movement rehabilitation, chiropractic adjustments and functional nutrition.  
www.TheOptimumU.com. Additionally, He is the founder of the SameHere Global Functional Doctors Alliance on Mental health.  
https://samehereglobal.org/docs-alliance-directory/




Concussions are viewed as a mild form of traumatic brain injuries and most frequently occur following an event that involves an acceleration–deceleration mechanism without actual injury to the head, such as whiplash, or the head striking an object. As we study these, researchers and clinicians are learning that these are fairly common, but often underdiagnosed.  While the vast majority of people with concussions recover without obvious disability, people can end up with long-term cognitive, emotional and functional issues affecting quality of life – including memory issues and Alzheimer’s disease. Efforts to better predict outcome from head injuries by focusing on the age, sex, type of injury and acute assessments have led to some improvement, but still fail to predict or explain the variation in healing and outcomes. Studies in professional athletes have shown that about 80–90% are sufficiently recovered to return to playing within 7–10 days. But that means that 10-20% are not, and their recovery can take up to 3 times longer. Even taking into account variations in initial injury, this variation is difficult to explain or predict.  (see complete feature by Dr. Roberta Kline)




What happened to Miami Quarter back Tua Tagovailoa is likely Second Impact Syndrome,  where an athlete receives a second concussion before a previous concussion has totally healed, carrying  with it a high risk of permanent brain damage and in exceptional cases can be fatal among adolescents as their brains are not fully myelinated like an adult brain. Tua’s head slammed on the playing surface, he got up, wobbled and appeared disoriented. The Dolphins claimed it was a back injury.  This happens under the guise of a minor back or a neck injury to circumvent the NFL concussion protocol.  When concussed, playing at full potential both physically and mentally is compromised.  Winning obviously meant more to the Dolphins than Tua’s future quality of life as he returned to play already being concussed. 

When Tua played the second game, I wasn’t surprised.  I expected it.  The Dolphins rolled the dice where the wager far exceeded the prize.  I have battled Parkinson’s Syndrome and 2nd stage Dementia Pugilistica since I was 41.  I’m now 72.  I’ve had 58 years to ponder what went wrong. In all probability, I wouldn’t be writing this article if I had addressed my first concussion promptly and properly.  

Ray Ciancaglini, The Second Impact





Copyright Notice: The materials provided on this website/web-based article are copyrighted and the intellectual property of the publishers/producers (The NY Cancer Resource Alliance/IntermediaWorx inc. and The AngioFoundation). It is provided publicly strictly for informational purposes within non-commercial use and not for purposes of resale, distribution, public display or performance. Unless otherwise indicated on this web based page, sharing, re-posting, re-publishing of this work is strictly prohibited without due permission from the publishers.  Also, certain content may be licensed from third-parties. The licenses for some of this Content may contain additional terms. When such Content licenses contain additional terms, we will make these terms available to you on those pages (which his incorporated herein by reference).The publishers/producers of this site and its contents such as videos, graphics, text, and other materials published are not intended to be a substitute for professional medical advice, diagnosis, or treatment. For any questions you may have regarding a medical condition, please always seek the advice of your physician or a qualified health provider. Do not postpone or disregard any professional medical advice over something you may have seen or read on this website. If you think you may have a medical emergency, call your doctor or 9-1-1 immediately.  This website does not support, endorse or recommend any specific products, tests, physicians, procedures, treatment opinions or other information that may be mentioned on this site. Referencing any content or information seen or published in this website or shared by other visitors of this website is solely at your own risk. The publishers/producers of this Internet web site reserves the right, at its sole discretion, to modify, disable access to, or discontinue, temporarily or permanently, all or any part of this Internet web site or any information contained thereon without liability or notice to you.

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