WHY CAN’T I GET BETTER? Chronic Illness, Post-COVID, and More: **NEUROLOGICAL INJURY

Welcome to Medicine Health with Dr. Paul, and we're in our Why Can't I Get Better series, and we're talking about all kinds of different reasons why we, you know, whether we're chronically ill or we have a subacute illness or something lingering and we just can't quite get better back to ourselves, or maybe we have a long-term chronic illness, we can't get there. This particular segment, I want to talk about neurological injury, and while this has always been been part and parcel of chronic illness, neurological inflammation and injury. The world of COVID and post-COVID has really brought this out into the public, out to light, so to speak. And so what we want to think about is— and a good analogy for this is the other segment that we did about your mitochondria and them not working as well in a chronic illness, et cetera. When we think about this, your brain not only has a lot of mitochondria, but the dynamics are very similar. There are things that occur when you have an inciting event or events that lead you to chronic illness, and, and you could even be so long chronically ill you don't remember what happened, but there's usually inciting events that collude together to become problematic. And they will start to then create changes in the normal physiologic manner in which you operate. And so one of the things that happens, and this is really— there's a lot of research around this with respect to COVID, but it goes on in most other, you know, subacute and chronic illnesses, and that is the changes in the chemistry, the cytokines and the other chemicals that our immune system uses to talk to our system. And many of them are pro-inflammatory. Some are anti-inflammatory, some are pro-inflammatory. And so the problem with that is that a lot of times, because that is sort of a silent injury, like you don't realize that's going on when you have the initial infection or even a trauma or something, It is happening. You don't see it, and often you don't notice the problems it creates until later. Now, when we're acutely ill, let's say you have influenza or pneumonia, uh, or you have some other, you know, problem like COVID, or, or maybe you've just been in an accident or had surgery. We all know it's normal during those times for us not to feel very well. Our energy will be low. We may have brain fog. Our system might be running slowly. We might sleep a lot more. But a lot of times we think, well, that's kind of normal because that's just part of the healing process. And that's true. So what's going on there is that as a way to protect your body and help you rest enough to recover and all of that, your body or system, whether the trigger is infectious or toxic or traumatic or whatever the trigger is, your system will release these immune chemicals. And then those will go to your whole body. But a lot of them are very brain-specific. And they'll go in there as a way to try and slow your brain function down, slow your motor output and other stuff so that you can rest more and recover. The problem is, is that most of those chemicals that your immune system is using for all of this discussion in your body are pro-inflammatory. And so, as is evidenced in things like acute and chronic COVID problems, the infection may not be doing anything anymore, but the inflammatory aspect may be giving you neurological problems. You have chronic headaches. You could have loss of taste or smell. You could— have fuzzy vision. You have all sorts of other things. Now, with any of these things, if they're going on long-term, you do need to see your healthcare provider to make sure there's not some other bad reason for them going on. But they're very common in the post-infectious patient. So what happens then is you get this, this rush of inflammatory chemistry, and then there's some anti-inflammatory chemistry, but It can have some bystander problems where the inflammation will lead to the supportive membranes that keep your brain chemistry kind of nice and tidy, as tidy as it can be. Those supportive membranes can become inflamed as well. Then they become leaky, and then they're not balanced very well. They don't work very well. goes on. And like I say, that could be chronic fatigue, it could be sleep disturbances, it could be anxiety or depression, it could be any number of neurological, neuro-emotional sort of things. Also, as I said, pain syndromes like headaches or central pain where your whole body just doesn't feel well, sometimes hormonal feedback problems, etc. Just many, many things that can be triggered through this inflammation. And so then when you develop this inflammation in your brain, it leads to physical problems downstream somewhere. And what I would always tell students is wherever the problem is in your brain will show up in your body with whatever that part of your brain is in charge of or responsible for. So if you have a problem in the motor function area, you're going to have a physical motor movement issue. If you have a problem in the sensory apparatus, you might have a change in or a loss of a sense. So this is like with post-COVID, with loss of smell or taste or things of that nature. But it can also be things like numbness and tingling and other unusual symptoms that go on. If it's more of a global area or more of one of the master control areas that gets kind of inflamed, you can, like I say, have centrally mediated either hypersomnia where you're sleeping a lot or insomnia where you're not sleeping much or at all. Or like we said, anxiety, depression, et cetera, et cetera. Or even a centralized pain syndrome where your body just hurts or you just don't feel well. And it's coming not really from your body, but from your brain's processing of what your body is doing. Now, when it comes to the world of what do we do about this, because this— none of this sounds very good. Like, nothing we've talked about in the Why Can't I Get Better series sounds like any, you know, positive or any fun at all. And it's really not. The first thing with neurological inflammation and injury is realizing that it's pretty much, you know, most of the people who have a chronic ongoing illness will have some or a large degree of this. That's a big deal. The next thing to keep in mind is that it's getting a little easier to test for this, but it's still pretty hard to test for it. And so a lot of the determination that you're having these sort of problems is going to be more of a clinical determination by a healthcare provider who works with chronically ill patients, works with people with complex problems. As I said, there are some tests that are getting better at identifying these things, and that's great. But if you've had, you know, whether you remember what the inciting event was or not, you've had a big enough problem where now you're chronically ill, there is a component that is neurological inflammation that you have going on. So the first thing really is recognizing it. We're really good in the brain at finding things like strokes and tumors and abnormal anatomy and other things like that that go on. And, uh, and we can look at some inflammatory signs, etc., when it comes to the, the imaging and things. But with these sort of microscopic problems, we really don't see those things very well. They don't come up. So you might even have gone to a specialist and they've They saw a neurologist and they said, well, you know, neurologically your body is intact. Yes, you may have some sensory damage or something we can pick up on the exam, but your images of your brain look totally normal. And that's good. You don't want your brain to not look normal, but you need to remember that a normal-looking brain on a scan doesn't tell you a whole lot or anything really about the cellular activity that's going on in most cases. So things to do would be, number one, you want to get screened by either your primary care or they might refer you to a neurologist or a specialist just to make sure that you didn't have something, you know, that's organic in nature that went wrong. So there's not an anatomical problem or a vascular problem or, you know, a mini stroke or any clotting that shouldn't be there or, you know, tumors, etc., etc. So that's why they're looking for those things. And really, if you have chronic, you know, neurological symptoms, you really do need to get screened for those things because you don't want to be going treating it as sort of this nebulous chronic illness and then turns out you have some other problem. The next thing though is after you rule in or rule out that it's, you know, a different problem, Then you want to think about, well, what would help with my brain and my inflammatory system working? And so there's a number of things. And again, I'm just going to say what we do with patients a lot of times, and it's very clinically determined. So none of this is medical advice. Again, don't take medical advice from people on the radio or TV or podcasts. That's not real smart. You want to use the information to round out your information, talk to your healthcare providers or find healthcare providers who work with chronic illness and talk to them about it. But things that we have done and seen to be helpful, one is something I bring up with a lot of these areas, and that's hyperbaric oxygen therapy. It's used a lot for brain injuries and other neurological problems, and the mechanisms by which it works are numerous and complex, etc. But that is a possibility, and a lot of times, especially early done in a case, it's really useful to add hyperbaric oxygen therapy in. Now, not everyone can do that. Not everyone has it available, but I like to talk about it and say it. The next thing is the things that I mentioned in the mitochondrial section are actually very good for your brain as well. And so those are things like coenzyme Q10, alpha-lipoic acid, basic vitamins and minerals for repair, amino acids that you should be getting from protein you're eating, but sometimes we give those separately. Then there's a lot of plants that are very good for helping the brain inflammation. There's an Ayurvedic herb called Boswellia from the Boswellia serrata plant, and boswellic acid is in Boswellia, very helpful for brain inflammation. Curcumin, one we hear about a lot. Then there's other fats that can be helpful for some people, like omega-3 fats or phospholipids, et cetera. And all of those are things that really you should work with somebody on. There's an over-the-counter supplement that we use with most of our neurological cases. And like I said, it's not a prescription. It's over-the-counter. Again, run it by your healthcare provider if you want to use it. But it's called Cover-3. And it's all in one little gel packet that you take, usually 1 or 2 packets a day for a little bit, and then taper that off or taper it down. We'll put a link in for that. I don't have any connection to any of these things I'm talking about financially. I'm just sharing what we do with people. But they're all worth looking into. And the next thing is, if you're working with a healthcare provider who doesn't do chronic or long-term illness, sometimes just like if you had a heart problem, you get a cardiologist, you might want to work and find a specialist who works with chronic illness, chronic problems. We'll put some links in the show notes to those types of providers as well. And I think that that will be useful. You can look at them and, you know, take a look. Obviously, those are not— I'm not recommending anyone in particular, but they're links to organizations that work with chronic illness. So that's usually a good place to look for providers. But we're running out of time for this particular segment, so we're going to need to wrap this up. Please keep in mind we're on all the pod burners, CTR Radio, Live and in in their podcasts, and then we're also over on YouTube at DRA Online. We need subscribers in all of them, so please like, share, subscribe, do the notifications. It really helps the community to grow, and we're going to keep doing these patient education oriented videos and audios for you guys. But right now, we're going to cut off and move on to our next segment. So I will.