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Now displaying: Page 1
Nov 9, 2021

In this episode, Founder of the Concussion Corner Academy®, Jessica Schwartz, talks about the nature of concussion treatment.

Today, Jessica talks about her concussion experience and how it has shaped her work leading up to the Concussion Corner Academy®, the reality of long-term concussion symptoms, and some of the top concussion myths. Is it ever too late to have your concussion symptoms treated?

Hear about treatment barriers, some of the surprising statistics in concussion and TBI research, and the importance of education, all on today’s episode of The Healthy, Wealthy & Smart Podcast.

 

Key Takeaways

  • “When you’re young, make sure you have extended disability on yourself.”
  • “There’s no evidence-based, agreed upon international definition of concussion or traumatic brain injury.”
  • “There’s been zero phase 3 trials on TBI and concussion in over 30 years.”
  • “Up to 30% of folks now have persistent symptoms of concussion.”
  • “If we can teach one, we can serve many.”
  • “2012 was the first year the International Consensus Statement discussed the cervical spine in terms of examination treatment.”

“2015 was the first academic year in which there was a formal training for both TBI and concussion if you were a neurology resident.”

“2017 was the first year on the International Consensus Statement that we identified concussion as a rehabilitative injury.”

  • “The injury of concussion is an injury of loss. It’s a loss of your ‘I am.’”
  • “Join Twitter.”

 

More about Jessica Schwartz

Jessica Schwartz PT, DPT, CSCS is an award-winning Physical Therapist, a national spokeswoman for the American Physical Therapy Association, host of the Concussion Corner Podcast, founder of the Concussion Corner Academy®, and a post-concussion syndrome survivor, advocate, and concussion educator.

After spending a full year in rehabilitation, experiencing the profound dichotomy of being both doctor and patient, Dr. Schwartz identified the gaps in concussion treatment and management in the global healthcare community. Her role has been to identify the cognitive blind spots and facilitate collective competence for healthcare providers, physicians to athletic trainers, focusing on comprehensive targeted physical examinations, rehabilitative teams, and concussion care management.

 

Suggested Keywords

Healthy, Wealthy, Smart, Concussion, Research, Statistics, Physiotherapy, Neurology, Concussion Corner, Myths, Healthcare, Rehabilitation, Injury, Loss,

 

To learn more, follow Jessica at:

Website to Join the Program:          The Concussion Corner Academy®

Facebook:       Concussion Corner

Twitter:            @ConcussionCornr

Instagram:       @ConcussionCorner

LinkedIn:         Jessica Schwartz

YouTube:        Concussion Corner

LinkTree:         https://linktr.ee/ConcussionCorner

 

Subscribe to Healthy, Wealthy & Smart:

Website:                      https://podcast.healthywealthysmart.com

Apple Podcasts:          https://podcasts.apple.com/us/podcast/healthy-wealthy-smart/id532717264

Spotify:                        https://open.spotify.com/show/6ELmKwE4mSZXBB8TiQvp73

SoundCloud:               https://soundcloud.com/healthywealthysmart

Stitcher:                       https://www.stitcher.com/show/healthy-wealthy-smart

iHeart Radio:               https://www.iheart.com/podcast/263-healthy-wealthy-smart-27628927

 

Read the full transcript here: 

00:02

Hey Jess, welcome to the podcast. Finally, I'm so excited to have you on.

 

00:07

Thank you so much for having me. I can't believe we haven't done this yet.

 

00:10

I know it's like absolutely insane. And just so people know Jessica and I both live in New York City, and we actually see each other quite a bit. And this is the first time I've had you on the podcast. But I'm really excited to have you on today because we're going to be talking about concussion, persistent post concussion symptoms, and you'll talk a little bit more about that name changed in the bulk of the interview. But before we get into some common myths around concussions, I would love for you to let the listeners know a little bit more about why you decided to really specialize in this niche within medicine and rehabilitation.

 

00:52

Awesome. Well, I thank you for the softball pitch care know. For those that don't know, Karen used to play softball on Central Park quite a bit. But yeah, no, I mean, I thank you so much for having me on. First. I've been listening to healthy, wealthy smart forever. So just thank you again. And yeah, I mean, gosh, I think back to I was a we were one of the first six residents actually, we were the first six residents in orthopedics at NYU in 2010. When I finished up grad school and all that jazz, and we I had it, I got the dream job, right, got the dream job. I had to leave New York City for it, which sounds crazy. But I think a lot of folks can connect to that, you know, working in, you know, the old adage, Jay, we used to call mills and things like that are seeing three or four patients plus per hour. And I was like, this isn't why I went into physical therapy. This is not why I wanted to do this. And I found this great clinic out in New Jersey during residency and we saw one to two patients per hour. And we had a support staff and they were emotionally intelligent. They were physical therapy owned, and they let us grow. And keep that like use of excitement, right? I don't know about you. But I'm hopped up on caffeine and too little sleep as we launched a new business this week. But it was great. And it really it fed my soul. It was wonderful colleagues and we ended up I ended up starting kind of in the opposite end of things, a civilian prosthetics program. So I was, you know, volunteering and showing up at the Manhattan VA, which has a wonderful prosthetics program. And then we also launched a breast cancer program and be launched a concussion program. So that was kind of like my first entree into concussion about 1011 years ago. And we were the only really only office in New Jersey with that type of rehabilitative practice at approaching concussion. And so very Dunning Kruger ask, it was like, you know, you don't know what you don't know until you kind of are made self aware of it. I got hit by a car. So I was hit by a car in October 3 of 2013. And right before then, oh, actually, it wasn't even right before then care. I'm sorry about that. But it was two years before it was our last day of residency. We saw that there was a conference at NYU at the hospital. And it was on concussion and it was NY us first concussion conference. Now this was 2011. So my best friend from Italy Beatrice, you know, hi, BIA. She's in Lucca. She's a great physio, if you're out in Italy listening in. And we were like, What do you want to go and it was our first weekend off for residency. I mean, we were exhausted, excited. And we're like, let's do it. So we went to this conference, I fell in love with it. And so we were at least aware of what this program was at NYU. Fast forward two years from there. And I was actually hit by a car here in Manhattan. So that's really where it's my life's work and passion is to become because I actually live with persistent symptoms. So and went through quite a recovery. So that's kind of how it all kind of came together and coalesced.

 

03:49

And when you suffered a concussion, and this was in 2013 It did you did you have kind of the self awareness at that time to think, well, you know, I've been learning a lot about concussions, I think I can I can kind of help myself here and did that then really propel you to learn more and to dive in even more.

 

04:19

So when I was hit, I was hit by an unlicensed driver from behind and my airbags did not go off. I was in my Toyota Prius you may have even been in that car at some point. And I didn't think anything of it but I knew I when I said the story is I I got out of the car. I want to get out of the car. I got hit so hard. I was stoplight at a red light wasn't looking behind me because we were stopped. And it was the traditional traffic right care like we're just inching forward. And I was probably on that block of 12 Street between Fifth and Sixth Avenue for about two or three light cycles because of traffic. So I just got Walt from behind and so the New Yorker in May right so born and raised New Yorker You know, unbuckle the seatbelt and get out of the car to give this guy the business. And I was just so dizzy care. And I held onto the top of the hood of my roof of the car and I was like, I gotta sit down. Fast forward. I thought this was quote unquote, just going to be a concussion. And at that time, we really thought concussions were pretty much resolved spontaneously within seven to 10 days based off of the literature from 2002. From Brolio and McCrea at all from the NCAA study. But we don't have that's false. And we have so much updated information we can chat about if you'd like. So I thought it was just going to be seven to 10 days. I went back to work for for a week, I thought, you know, I would just be sore, kind of like a whiplash or like a Dom's. And now, I just kept D compensating and then from there went from 10 to 14 hours of rehab a week for 14 months.

 

05:53

And how did you continue to work and continue to function during all this time?

 

05:58

I did not. So I went off of I went out of work, mind you, I was just promoted to junior partner the week I got hit. So I remember I was like directing a prosthetics program, we had all these other programs, I just became junior partner, which would have been a profit share with a company and I loved my job, I would still send people back to that clinic, those four clinics in New Jersey in northern New Jersey. So essentially what happened was, it was a conversation that went on for months. So I was on short term disability for six months. And I say this to all physical therapists, physicians, OTs, PTs, whoever's listening to this, when you're young, make sure you have extended disability on yourself, because our bodies are so fragile at the end of the day. And again, I was an athlete, I was a cyclist I was training for, for a century bike ride and life changes in the blink of an eye. And I was underinsured with a $50,000 policy policies for car insurance to go up to 300,000 to 3 million for certain policies. And it would have been an extra $12 a month. But again, you're a new grad, you're just out of residency, just out of DPT school and you know, you're thinking about student loans and just being out of school. And so you don't really plan that far. So that's a whole other conversation we can have on another podcast. So I was on short term disability and we all know the legality of and we all have our own cognitive biases about this, right? So when people are involved in litigation, we know that their care tends to go a little bit longer. So I just I knew that. And I didn't want to, I almost didn't want to set myself up for failure, right? I just wanted to be a good soldier, show up for therapies, neuro psychology, vision therapy, talk therapy, vestibular therapy, regular musculoskeletal for the whiplash therapy, and just be a good soldier and show up as a good patient, just thinking that I would get better and slightly different than a musculoskeletal injury. The difference is with with brain injury is that there are cognitive and behavioral impairments that differentiate those from brain injury from musculoskeletal injury and rehab. On top of that, add the environmental aspect, and that's a whole other aspect of the injury. So there's no finite, you know, six to eight weeks of tissue healing or things like that, when it comes to brain brain injury, that it's a very gray area. So I was on disability for six months. And then that ended and that was petrifying. So two weeks before disability ended. I wanted to burn it down. That's when I got angry. And I think that's when I really went through that whole grief cycle, because I just kept showing up to therapy thinking I was going to get better, and then I did not. So went back after 14 months, I had the no fault car insurance, which helped pay some bills back home with mom at the time. And that was it. So after that, when I went back to work, I actually realized I had a vision handicap with overhead LED lights. So I still live with persistent symptoms, I still live with neuro fatigue, I still have an ocular motor disorder. But we learn how to manage and cope and I have wonderful support systems and definitely a grit that a lot of people don't have as well, I think I'm missing a chromosome there somewhere.

 

09:03

And you know, and this was eight years ago. So I think it's important for the people listening to understand that, you know, when one is diagnosed with a concussion, it's not just like you said over and seven to 10 days or maybe a week or a month or even a year, and that there are symptoms that can persist. And I think that's a great segue into what are some common myths around concussions. So I asked Jessica give me like maybe your top three common myths that surround concussion and and post concussion. So Jessica, I'll throw it over to you. So what would be Myth number one that is circulating out in whether it be layman's world or even the medical world? Well,

 

09:53

um, I was actually I'm going to give you something that we didn't speak about. I'll kind of combine one of them with three but One of them, actually two that we didn't speak, I'll surprise you as well. But there's actually no evidence based definition agreed upon international definition of concussion or traumatic brain injury. And that kind of will segue a little bit into two is that there's actually been zero phase three clinical trials on TBI concussion in over 30 years. So, when we're talking about research, I mean, talk about ground floor ground level, I mean, we were in the basement 10 years ago, just not having any idea what we were looking at. So I even I try to tell people like when we're talking about this, and looking at the literature, the medical legal literature got ahold of this injury 50 plus years ago, and it's been in the trapped with closed head injury and medical legal literature, but really not until 22,004. And on how we've been talking about this as a rehabilitative injury, and things like that. So, you know, historically, when we don't know what to do with someone in medicine, we tend to send them down to trajectories, we send them, we allude that they're milling, lingering, or looking for a secondary gain, or we tell them that's all in their head, and it can't be real, right. So that's what's kind of happening with these patients that we know up to 30% of folks now have persistent symptoms of concussion, they don't just spontaneously. You know, in even two weeks, we even actually, because we didn't really know what we're looking for right care. So we didn't have an agreed upon definition. So how can you know what you're looking at unless you know where you're looking for. So that's so very important to connect to is that a lot of the mismanagement of concussion was so much more prevalent in a well cared for patient.

 

11:38

That's wild. And so before 2004, basically, if you had persistent persistent symptoms after a concussion, it was like, good luck.

 

11:50

Yeah, you were allude that you're faking it. You were looking at this, that it was a psychological injury. Yeah. You know, and

 

11:57

that, that in and of itself is crazy making?

 

12:00

Yes, well, that's the whole thing and the chicken or the egg, right. And you can't deny psychological conversations when it comes to the brains like Hello. However, you know, it's really the chicken or the egg, you have these somatic things that we have the ability today in 2021, in a well versed clinician to validate the patient's symptom profile by doing targeted, comprehensive physical examinations as it pertains to concussion. So we actually the best thing that we can do for a patient like this, and I'm sure you've had all the chronic pain people on your podcast and things like that is validate their symptom profile. Listen, you're not crazy for seeing words coming up off the page. No, you didn't drop some LSD or an illegal drug. You have an ocelot Xia? You know, but the difference between the moderate and severe TBI is is that these folks have the self awareness to know that something's not right. But they do not have this objective language to express the what or how they feel with brain injury. So what do we do all day care? And how are you feeling? What's your pain level? What's your number? How are you feeling? But brain injury folks do not have the subjective language to express that so when they go to the mall and our fear avoidant of that, or they go to the supermarket, and they are don't like to be in a complex visual sensory environment, because the colors may blur, and things like that, that is then looked at as a fear avoidant behavior. And that's been sent to psychological counseling for decades. So how can we as physios how do we get these guys first and gals? So not to Detroit too much to keep you on track. But those are two. The first two is that there have been there are over 43 working definitions of concussion. One of them is evidence based. And to that there are zero phase three clinical trials in over 30 years for TBI concussion.

 

13:42

Wow. Wow. Wow, those are two biggies. Two big myth.

 

13:46

I would think so then I'll combine the last three because there are points. So the third one is, you know, I really, I'm really into education care. And I really believe that if we can teach one we can serve many, okay. And that's just what I've been privy to. And this implicit trust in the last, like eight to 10 years with this injury, that I've been invited to all different conferences for emergency physician athletic training, PT, you name it, because we all need to be on the same page here. So folks really need to I always say that we need to have a really humble approach when we come here because and I say this with kindness and I but I say this very firmly, is that with concussion, we have infinite ports of access to entry to care. Okay, you can go to the urgent care the emergency department, you could even be at your OB GYN appointment and you might have had this fall and a ski injury over the weekend and in your annual or biannual you know OBGYN appointment if you're a woman. And you know, you could have had you could have pre presented with signs and symptoms of concussion and not be aware of it. So I see that because there's infinite ports of entry on like cancer or unlike cardiology, you have a heart attack, where do you go care and you go to the emergency room, right? And then you see the cardiologist just right or you get diagnosed with cancer or your PCP or you start losing weight, you have some red flag showing up. Where do you go? Yeah, young colleges right to the oncologist, right. So that's a, that's a defined pathway. With concussion, we don't have a defined pathway. And that's not necessarily a bad thing. However, it's where a lot of this mismanagement has come up over the last few years and decades, and that's where patients start to suffer. And that's where it healthcare, we've actually imparted something that's called AI atherogenic suffering, which is where actually the health care system where your doctor is actually part of a way of suffering on a patient. So I bring that to our attention with these three quick facts. I'll say them quickly, and then we can chat about them. Go for one 2012. That's the number you got to know. 2012 was the first year the international consensus statement discuss the cervical spine in terms of examination treatment, that whole stick that connects the central nervous system to the peripheral nervous system and runs the autonomics up and down, right 2012. We just started talking about the cervical spine internationally. 2015 was the first academic year in which there was a formal training for both TBI and concussion, if you are a neurology resident. So if you were a brain physician in 2015, that was their first formal didactic year, they had training in concussion and brain injury. So just let that settle in there for a second because that's, that's just wow. Again, this is a place to build up, not tear down, but that was taking place within the behavioral neurology section of the American Academy of Neurology. And the third one was that 2017 was the first year on the international consensus statement that we actually identified the concussion as a rehabilitative injury. 2017. So, like, what? So if you think about it, as physical therapists, congratulations, happy 100 years care. We just had our centennial, right. So we were rehabilitation aids, literally in the trenches 100 years ago, like now, and we were treating what we were treating brain injury, what are we doing in the ICUs for treating brain injury? We're getting them up, we're getting them moving. But what do we prescribe when we don't know what to do with someone and healthcare rest? So we now know that that's not the ideal thing to do beyond the first 72 hours, but yeah, 2012, cervical spine 2015, brain physician started learning how concussion and 2017 was we call the rehabilitative so that's my third.

 

17:29

Wow, that's, it just seems like that cannot be possible.

 

17:33

Yeah. And, and it seems like that and because we know better, right? But imagine then being, you know, having deficits and having trouble thinking and processing, and what's our most valuable resource attention, but then you can't process. So it's, it's so horrible when you're a patient, and you have to negotiate the system, if you go through a no fault, or you go through a worker's comp, and there's all these other aspects, you know, of that of, of the injury. So I always say, sorry, I always say is that concussion as an injury of loss of it, I am, so you have to really pay attention to where your patients are in space and time when you when you meet them.

 

18:10

And it all seems to me like just not having a clear pathway. To me sounds like barriers to treatment, and barriers to to improvement. And then my question, I just one quick question. It. If you if the patient doesn't quite know who to go to, they don't know that they're they they have a concussion? Because some people like oh, you know, he got his bell rang, or whatever. And they don't even go to see a doctor, but they're having some symptoms, but they're not quite sure who to go to? Is it that the longer your symptoms go on, the less likely you are to recover?

 

18:50

So there's a yes or no answer to that. I don't want to say it depends. But the good news is, is that we have folks five and 10 years out who may have not sought treatment, like the patient you just alluded to, or sought treatment, then kind of plateaued, the brain wasn't ready yet. And that's totally fine. And we've got to tell patients that No, hey, maybe we need to take three to six months and just kind of let this settle. Let's reset, regroup, and then let's come back. Because the brain just may not be ready. You cannot force this. This is not about grit and resilience, in terms of being sore and pushing through. You've got to listen to the brain and I talked about it with like the knee effusion principle. You know, we have residency in orthopedic so I talk ortho all the time, although I love the neuro, neuro world these days as well. But you know, it's like the knee effusion principle, right? You do too much the knee fuses, we want to give it if it doesn't come down in two days, we did too much. Let's cut in half, right. So it's the same thing with concussion except the difference that is super frustrating to both patients and clinicians that aren't in the know is that you can have delayed symptom onset. So you can do something within the therapy office or they can do something like for example, have a vestibular migraine, where they feel good while they're walking outside and they feel okay walking But as soon as they stop their body like isn't really caught up to them yet. And then they get this distributor migraine within 20 to 60 minutes, and then they feel like garbage. But then they don't know what even to associate with. And that right there, Karen will make you feel crazy. So so it's very important to have somebody in the know, but you said something right before that question about barriers? And you're absolutely right, there are barriers, but I'll do you one better is that we're not only have barriers to accessing quality care for concussion, we also have i atherogenic, suffering, where they come and I, as a provider may not know enough about concussion to look at this from 360. So we have providers that don't know, they may be maybe in 2021, we'll be able to pull up the international consensus statement. But that's only for sport, and it's very limited. So it doesn't go through the nuance of the suffering and the delayed symptom onset and things like that. It's very white paper esque, right? So we actually then cause harm by quote unquote, just treating the neck, not looking at the vestibular system, not looking at sleep, not looking at the ocular motor system, not looking at is the the migrant or aspect of it, not, you know, all these other things and aspects that make concussion concussion. So from a symptom profile standpoint, so if you feel typically I should say,

 

21:15

yeah, and, and, you know, like you said earlier, you're all about education, and getting people to therapists, and whether you're a physical therapist, occupational therapist, you've been a personal trainer, physician, really understanding the ins and outs of concussion. And so I'm going to, I'm going to plug your educational entity that is that is launching, and it's concussion, corner Academy. And so now, I really like that you're coming at this from the patient and the provider standpoint. So talk a little bit more about concussion, quarter Academy, and what separates it from other educational programs. Because, you know, as you know, there's a lot out there in the world, right? So how, what, what is it about this that makes it different, and that you're really proud of as you should be?

 

22:08

Oh, I appreciate that care. And, golly, I mean, talk about like, your life's work, right? And I really, I just get goosebumps thinking about this. And I'm like, wow, this is this is really just a dream. And I'll be very honest with you, this is a we're in a pandemic, still, some people may not want to admit that. But we're, we're still in a pandemic. And we all kind of went through something, right, especially in New York City, we really went through it initially in the acute phase of this pandemic. And I did, I lost a good chunk of my practice, and I had to really sit with myself and I said, Gosh, just what do you want to keep doing? You know, what do you want to do with your life, I had patients no less than four years, some 11 years as patients. And I was like, I'm not doing this again, I just don't have the energy. And that was from just a like a, like, almost like a burnout aspect. I just couldn't imagine re building up my my practice again, I have no problem seeing patients, if they call me but I have no desire to market. Now. I was like, Well, my ideal life based off of my symptoms and persistent symptoms. You know, I really work every other day. So yeah, I can push through every five days and do a regular work week if needed, but I don't feel well. And then I'm not pleasant. And it's just, you know, I just know my limits. So with the neuro fatigue and the stuff that I live with, I said, Well, what's, uh, what's, what's something I can do? Well, if I could work remotely, that was kind of it. And I said, How can I help the concussion community? So we decided, and my partner is a graphic designer and in to animation and editing and all of this stuff. We said, how can we make this beautiful, and deliver it? Because the user experience was so important to us? And then how can we deliver it internationally to where it's accessible? So we're, we formed the academy, and essentially, the goal has always been to promote healing, decrease suffering, increase support, and deliver it with kindness to this mismanage patient population, but we need to have access. So I have a tremendous faculty. We're launching we are we have a nonprofit partnership. We have the faculty are actually the people on the international consensus statement. They're the people treating the the boots on the ground, their clinician scientists, and they get it, they get concussions, and they're vested in concussion. So it's going to be a 12 week online course for our first cohort. It's fixed. It's from January 16 to April 10. It's going to be two hours per week one posted for you and one live on Sunday mornings at 10am. Eastern which will allow for our European friends and our California friends as well on the West Coast. And it's going to be 24 hours of CEU activity for for for physical therapists and athletic trainers. As long as we have 10, ot speech pathologists, neuropsychologist, psychologists, social workers, we can see you them as well, but it's the first round so it's kind of a lot of investment here. So I'm just going with PT and 80 to start unless we have 10 of the others. And we're going to have a nonprofit partnership, but the the beauty of it all is already I'm actually going to have, we're going to be doing research on our students. So we're actually going to be looking to change outcomes based off of evidence based practice and education. So we're going to be able to study our students, and then link up with our nonprofits as well to support them because it's really an underfunded sector of research where cancer gets billions and trillions and and TBI and concussion tend to get hundreds of millions. So we're really going to try and support the folks you know, who are boots on the ground.

 

25:29

I love it. It sounds so great. Where can people find more information about it?

 

25:34

Sure. It's going to be it? Well, it's already at it's at concussion corner.org.org. If you follow the podcast, we tried to give things away just like you do with healthy, wealthy smart. So we've had the concussion corner podcast is 2018. I hosted the Super Bowl concussion are moderated, I should say, the Super Bowl concussion conference in Minneapolis and we launched it then it's been around in over 50 countries, it's been so well received, we have a lovely community. So we're going into education, and how can we have a supportive community with open office hours and open office hours and things like that, that will what will provide our students with, with eventually a rehabilitation video database, where that's going to be searchable for folks as well. So they can search, you know, cervical spine examination intervention, what's the referral process look like. So it'll be a robust program, but we're going to be beta in January with I just want to point out, we're going to have a referral program. And, again, I'm a person and have one right, so we're not going to have an early bird special, like we're used to at conferences. But the whole thing is to spread this word of mouth. So instead of taking $100 off, we're going to give a $75 referral. If you have seven to eight people that you refer your whole tuition is paid for Plus, you get your 24 hours of CEU. So we want to really just want this to be word of mouth, from from like grassroots, let's build it by conversation and internal marketing and get people in who are invested in wanting to learn about this injury.

 

27:02

Awesome, awesome. And of course, we'll have a link to it in the show notes here at podcast at healthy, wealthy, smart calm for anyone who wants to learn more about the program and about the modules and how it's set up. Or you want to just get some more information. Or if you're ready, you heard this and you're like, I see people with concussion all the time. I'm not 100% comfortable, I need to learn more, or this is something I want to learn more about, I think now you have the perfect opportunity to learn. So we'll have a link there in the podcast notes for anyone who is ready to pull the trigger and join Jessica in January. So now just is there anything that you really want the listeners to take away from this conversation around concussion and rehab of concussion?

 

27:58

Yeah, so I'm sure there's, there's so many things off the top of my head, really connecting to that concussion is a rehabilitative injury. And if we can connect to that the injury of concussion is an injury of loss. It's a loss of your I Am your I am funny, I am husband, I am wife, I am Doctor, I am surgeon, you're I am. So if we are sensitive to that and connect to that concussion is an event, it's not an event there, it has to be a mechanism of injury, don't get me wrong, but it's not an event, it's an actual process. And we have this neuro metabolic cascade. And then we tend to have this loss of function in our in our environment. So that is really what I want folks to connect to. Because we have to make sure we're meeting our patients where they are and their moments of recovery. So that's really the big thing to connect to is that folks tend to really connect to the event of the concussion, you know, the post traumatic amnesia, the domestic event, the loss of consciousness, and less than 10% of those folks, but they're not connecting to where those folks are in their trajectory. And how many folks have they seen before you on average, people see six to 10 providers before they walk into my door. Okay, connect to that. Do they trust healthcare providers before they've talked to you? Did they have physical therapy in a hospital gym that wasn't really, neurologically sensitive to their needs, their smell, their sound, their lights, things like that. So connect to your patients in a different way. I can guarantee you if you're a new grad, this is going to this is going to get you excited. And if you're a little more seasoned, like Karen and myself and you're feeling a little burnt out, this is a great way to look at your patients 360 We're looking at autonomics we're looking at neurology, vestibular ocular motor. The physiological aspect of its sleep, nutrition, neuro endocrine, let's talk about sexual dysfunction and concussion. That's a whole other podcast. But it really is something that you can hear my passion about, or these patients are being mismanaged much more probably than they're being well cared for. And we can change that and there's no reason that we can't change that for next day. Not Knowledge Translation in the clinic, so I challenge your listeners to that care.

 

30:03

Amazing, amazing. And now I have one more question to ask. And it's one that I asked everyone. And that's knowing where you are now, in your life and in your career, what advice would you give to your younger self, let's say, you know, straight out of straight out of Ithaca physical therapy school.

 

30:21

Um, let's see here, straight. So I've honestly joined Twitter, I have had so many, I've had so many positive experiences, the 99 that I've had positive and the one negative, you know, and you really have to conduct yourself in a certain way, of course, but I joined Twitter, I've had so many amazing opportunities. I was invited to the Super Bowl, I was asked to be one of our spokeswoman like you for American Physical Therapy Association, I've been invited to speak at conferences and, and just network with people who I would never have access or touch points to. And I really think it was the most powerful thing I've done for my education, besides, you know, maybe a residency postdoc, really. So I really do and we wouldn't have met the same way either. So I think it's been great.

 

31:05

All right. Well, that I think that might be the first time I've gotten that. What advice would you give to your younger self is to join, join Twitter and join social media. So thank you for that. And like you said, you have to make it your own, and you have to approach it, approach it in the right way. So I think that's great advice. And now, again, people can go to concussion corner.org. To find out more. And of course, like I said, we'll have all the links at podcast at healthy, wealthy, smart, calm. So a big thank you, Jessica, for coming on the program busting some concussion myths. So thank you so much.

 

31:42

Oh, thank you so much for having me and to all your listeners. Thanks so much for your time and attention. I really appreciate it.

 

31:47

Of course and everyone thanks so much for listening, have a great couple of days and stay healthy, wealthy and smart

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