Nutritional Approach to Combating COVID-19

At the moment it is fairly difficult to think about anything other than COVID-19, and I don’t know about you, but despite my best efforts, it is taking a toll on my own anxiety and stress systems.

There are so many factors to consider – our own health, the health of our loved ones, our ability to be strong when it counts… and then the nutritional and psychological implications of a 30 day isolation period. Every single factor which places stress on our nervous system has the potential to decrease how robust our immune system is, which merely adds to the stress and worry. How do we escape?

After thinking about this for some time, I have come to the conclusion that we can’t. We simply have to accept it, accept what is happening in the world and around us, make peace with it, and look at all the positives it is going to bring, because, once you start thinking about it, there are many of these.

So we can’t escape and we can’t change what is happening.

But we CAN change and affect many things around us and those are the things that we need to focus on. With this post and those that follow, we are going to start looking at what we can do, to turn this around, and take some form of control back.

First of all, something we have a whole lot of control over is what we eat – our nutrition. Even if we are stressed and anxious we can eat in a way that nourishes our immune system, which will help to alleviate some of the anxiety around our health. Almost more importantly however, we can eat in a way that helps our nervous system to cope as the events unfold, and as the nervous system and immune system are intimately linked, this way, we are killing two birds with one stone. Interestingly, and to drive this point home, many of the nutrients are the same. So yay! Easy peasy. Let’s get started.

In this first post, we will address nutrition for the immune system and in Part 2, nutrition for anxiety, stress management and resilience.

PS In no way does this stand in the place of medical advice, and if you develop COVID-19 symptoms (runny nose, cough, sore throat, fever and shortness of breath) ensure you get medical advice and/or attention ASAP.

Nutrition for Optimal Immune Health & Defense.

First, a very quick, short and sweet overview. I categorise nutrients into three major fields:

Macronutrients (protein, carbs, fat, fibre)

Micronutrients (vitamins and minerals, such as zinc)

Phytonutrients (the amazing array of bioactive compounds we get from plants eg anthocyanins, from berries, are a potent antioxidant)

We will consider each one.

  •   Macronutrients

For overall health, every single macronutrient is important, which means that, for immune health, eating a well-balanced diet is your absolute first go-to. However, protein needs to be a major point of focus during this time, as not only does it contain the building blocks for important immune molecules (such as glutathione), but in addition, when we are sick, the breakdown of our muscle proteins is increased to help us both fight disease and recover. The major way to cover both immune demands and this increased loss is by eating high-quality dietary protein. That means your animal proteins, such as eggs, meat, fish, dairy if you can tolerate it, and whey protein powder if you happen to be a smoothie fan. If you don’t eat animal protein, soy is your highest quality plant-based protein. The recommended optimal intake for protein is at least 1.2 g per kg of body weight per day, although, for highly-active individuals and the elderly, this can increase to around 1.6 g per kg of body weight per day. The best way to ensure you are achieving this is to consume high-quality protein at every meal.

Alongside protein, fibre is essential for maintaining the health of your gut bacteria, which form an intimate alliance with your immune system, and if the immune system in the gut is compromised, so is that of the entire body. However, also super important to consider is that the gut bacteria ferment the fibre to produce short-chain of fatty acids, which appear to play key roles in immune cell recruitment and function, alongside many other important functions in the body. Fibre is also delivered in combination with a bunch of phytonutrients that add to the strength of the immune system (which we will cover in a bit). The absolute best sources of fibre are your fruits and vegetables, as well as nuts, beans, legumes and whole-grains. Some people find it hard to tolerate large amounts of nuts, beans, legumes and whole-grains, and if this is you, eating fresh produce is your best bet for optimal immune health. However, keep in mind that fibre can be overdone! Too much fibre can reduce the absorption of other key nutrients…so there is no need to go overboard, just be sure to include some form of fibre with every meal.

  •   Micronutrients

One of my favourite gurus in the micronutrient health world is Chris Masterjohn (CMJ). In a recent document, he outlined the most effective micronutrients specific to combating SARS-viruses such as COVID-19. In particular, these are zinc and copper.

Zinc has been shown to directly inhibit at least three mechanisms associated with the original SARS coronavirus, indicating that it is likely to be a key micronutrient here as well. In general, zinc interferes with the ability of the virus to replicate and function inside a cell. CMJ pairs zinc with elderberry extract (which we will talk about under phytonutrients), which may be able to prevent the virus actually entering a cell in the first place, so is the first line of defence.

All forms of zinc supplementation are useful, including sprays, lozenges and tablets, and the recommended dose to fight the virus is 10-15 mg 4 times per day, spaced well apart. These can be taken with food, or on an empty stomach, but if taken with food, it is recommended to avoid nuts, beans, grains and legumes, as these may interfere with full absorption of zinc.

Of course, zinc is potentially best obtained from food, primarily from oysters. However, since oysters are not common fare for the majority of people, supplementation is your best bet.

When you purchase a supplement, check that it is not in the zinc picolinate or zinc oxide forms, as these are not well absorbed, and once the threat of the virus has diminished, keep taking around 10 to 15 mg per day, as this is one mighty nutrient for overall health.

Copper is toxic to viruses, including coronaviruses, which is why copper surfaces are effective for hygiene maintenance. Copper works synergistically with zinc, and we should aim to get around 1 mg of copper for every 10 to 15 mg of zinc. This means that if you are taking 15 mg of zinc four times per day, you will need at least 4 mg of copper per day. Many supplements provide zinc and copper together, although copper from foods is superior to copper from pills. The best food sources to provide 2 mg copper are 2 oysters, 25 g spirulina, 40 g shiitake mushrooms, 50 g sesame seeds, 50 g cocoa powder, 56 g of 90% dark chocolate and 70 g of 70% dark chocolate. I know which one my go-to is going to be! However, since you would need 2 or 3 times the amount in each of these servings, supplementation is going to be necessary with a high zinc intake.

My personal approach moving forward is going to be 15 mg zinc 4 times per day, with 4 mg of copper from a supplement, and as much dark chocolate as I want. Why wouldn’t I?

Phytonutrients

Ah, nature, in all her glorious wisdom, who provided us with more healing compounds than you can poke a stick at right there in our garden. Or the fresh produce aisle of your local supermarket. For overall health, every single herb, vegetable and fruit is beneficial, when consumed in moderation. However, different phytonutrients work in different ways and some are more (and less) beneficial for a respiratory virus like COVID-19.

Elderberry. As I mentioned above, CMJ also states that elderberry has been shown to prevent the ability of the SARS coronavirus to enter cells, and so for this reason, it is an effective supplement to add to your virus prevention list. If you already have the virus, it is unlikely to reverse its effects, so zinc and copper are your best bets for this, although taking elderberry will definitely not hurt!

The recommended dose for elderberry extract is 700-1000 mg per day. After extensive searching, and finding that many elderberry supplements are sold out, I came across this Product: which would require 4-5 servings per day to provide the recommended elderberry dose. However, it also contains Vitamin C, for which the research is equivocal – while some studies show it is highly beneficial for respiratory infections, others show it may increase the inflammatory response. Personally, I am going to buy this supplement and take it, as a preventative measure, since it is all I can find! However, if I were to contract the virus, I would likely stop and focus on zinc and copper.

Allicin. In addition to elderberry, allicin, the key bioactive ingredient in garlic, has been shown to play a significant role in fighting a viral infection. Keep in mind that you have to eat garlic raw in order to gain the maximal benefits of allicin, which may not go down too well unless you are in self-isolation, in which case go nuts! However, allicin supplements are easy to come by, and I am going to add these to my regime. While CMJ recommends 180 mcg stabilised allicin per day, the supplements I have been able to find easily are 3000 to 4000 mcg per day, so I am just going to take these as is and hope for the best.

Oils of oregano, tea-tree and eucalyptus. We can also look at some essential oil powerhouses for fighting viruses. Oil of oregano is a traditional remedy for respiratory viral infections, as well as gastrointestinal viruses and inflammatory conditions, and research in animals is supporting this traditional use. While pure oregano oil can be taken internally, it must be totally pure for consumption, so a good alternative is to put a couple of drops on the soles of the feet. Oregano can be combined with tea tree oil and eucalyptus, also shown in research studies to possess potent antiviral activity. Both tea-tree and eucalyptus can be toxic when taken internally, so topical application, or aroma diffusion, is recommended.

Is there anything I should avoid?

Yes. Most definitely. As always, limit inflammatory foods such as refined sugar, refined vegetable oils and processed meats. In addition, CMJ recommends avoiding supplementation with high levels of Vitamin A and Vitamin D, as these can increase the production of molecules in the body that may benefit viruses like coronavirus.

Wrapping up….

This is by no means an extensive list! Every single macro, micro and phytonutrient has a role to play in our overall health and therefore, our immune health, when consumed in a balanced way. However, the nutrients that have been mentioned and described here were selected as those most beneficial for immune health, in the specific context of the SARS family of coronaviruses.

At the very least, if they assist in reducing some of the anxiety that you might feel at this time, that will be a huge benefit in and of itself. Share this list with friends and family, and possibly assist older family members in obtaining some of these supplements. Everything we can do to enhance our immune health, and the health of those we care about at this time is on the table.

Keep well! And stay tuned for Part 2….

 

-Carlene Starck

COVID-19: Everything thing you need to know

Now deemed a Global Pandemic we are learning more day by day about COVID-19. With all the hysteria across the media, it has become difficult to determine what is hype and what is true. From people panic shopping and fighting over toilet paper, the world is going a little bit crazy.

In this post, we will aim to provide you with an overview of accurate up to date information. Following this post, we will discuss strategies on how to combat this issue.

Hysteria:

First of all, I need to address the panic, we all need to calm down……… There is no need to prepare for the end of the world and stock up on supplies like toilet paper and food. Well not in New Zealand at least as we produce all essential supplies (food, toilet paper etc) in New Zealand, we are not reliant on global markets. Even the supermarkets are requesting for everyone to calm down and to shop as normal, there is plenty to go around. 

From a hysteria standpoint, the timing couldn’t be worse for NZ/ southern hemisphere with the changing of seasons and drop in temperature and as we head into flu season. As a result of lack of education and understanding of COVID-19, people that are suffering from common flu are unnecessarily concerned for the worst and stressing our health system which is going to need every spare bed atm. What is the difference between common flu and COVID-19? Stay tuned as we will highlight this below so you can stay informed and rest easy.

Important: COVID-19 is treatable.

 

Stop stressing! 

Don’t forget stress is one of the leading causes of disease (something I have written extensively around) so you are not doing yourself any favours worrying about things you cannot control. Our hope in this article is by sharing the facts we can help in easing any anxiety or stress you may have. Our next post will begin to address what you can do to mitigate this and the anxiety around it.

What is it COVID-19?

Similar to SARS, research points out that the virus also originates from bats. COVID-19 causes respiratory and intestinal infections in animals and humans. 

What happens in the respiratory system and immune system in response to the virus?

  1. Your body will produce mucus in an attempt to contain or trap the virus. 
  2. The infection involves overstimulation of the body’s defences against viral infections. Cytokines, proteins secreted by certain immune cells, signal for more immune cells to enter the picture and try to engulf the virus, resulting in cell death and increased inflammation.
  3. Due to the high replication rate of the coronavirus, it often overwhelms the immune responses leading to local tissue destruction and depletion of infection-fighting cells. Cytokines also can travel via the circulatory system to other organs such as the kidneys, liver, and small intestine. Dramatic increases in cytokines are referred to as a cytokine storm and this appears to be a distinguishing feature of severe respiratory viruses vs lesser viruses like the common cold.

Not all people with the virus will experience all three stages and also in some cases, you may be a carrier of a virus but have no symptoms (meaning you can unsuspectingly pass it on).

How COVID-19  spreads

As a new disease, we are still learning how it spreads but below as of 19th of March the CDC believe these are major methods: 

 

  • Human interaction

 

    • Between people who are in close contact with one another (within about 6 feet).
    • Passed through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

 

  • Can someone spread the virus without being sick?

 

    • People are thought to be most contagious when they are most symptomatic (have symptoms)
    • Potentially it is possible before people show symptoms. However, it is not thought to be the main method in which the virus spreads.

 

  • Contaminated surfaces or objects

 

The virus could potentially spread through cross-contamination of surfaces or objects that have the virus on it and a person touching it and then touching the mouth, nose or possibly eyes. However, this is not thought to be the main method for the virus spreading.

 

What happens if you feel sick?

Remember that symptoms of the common cold or seasonal flu can be similar to symptoms of coronavirus, which can make it difficult to determine what might be going on. Especially with New Zealand heading towards flu season. Here is a great chart to review symptoms and determine next steps.

Determine what you are dealing with

We encourage anyone with signs of a respiratory infection or COVID-19 (fever, dry cough, and shortness of breath) to contact their primary care physician for guidance. Ideally where possible connect with your doctor online or by phone to reduce the risk of transmission. 

If you develop severe symptoms or are in the high-risk groups outlined below and develop shortness of breath, call 111 or go to the nearest emergency room after calling ahead for safe arrival instructions. 0800 358 5453

 COVID-19 risk factors:

If you are high- or medium-risk and fall within any of these risk factors below, it is recommended that you self-isolate and practice social distancing for a minimum of 14 days, even if you have no symptoms. 

 

  • Age: 

 

While the overall global mortality rate of COVID-19 is currently estimated to be around 3.4% by the WHO (as of March 3), early reports out of China and a similar pattern identified in Italy (the highest number of coronavirus deaths outside of China) show that the mortality rate increases with age. The mortality rate is highest (14.8%) for those over the age of 80. This most likely due to older individuals often suffer from at least one chronic health condition that stresses their immune system, increasing their risk. 

Children are rarely affected by the disease. 

 

  • Pre-existing conditions

Adults with preexisting conditions like heart disease and diabetes or chronic lung conditions such as asthma, emphysema, COPD have a greater risk of being affected by any virus, including COVID-19 because of decreased ability to fight off infections due to a less robust immune response. In China, coronavirus patients with heart disease had a 10 per cent mortality rate, while those with diabetes had around a 7 per cent mortality rate, far greater than the global average — which WHO estimated at 3.4% on March 3rd.

 

  • Immunocompromised adults 

Immunocompromised means the inability to normally respond to environmental exposures including viruses or bacteria due to a weakened immune system. People who are immunocompromised include those with diabetes, heart disease, hepatitis B, chronic kidney disease, autoimmune conditions, malnutrition, and cancer because those conditions do lessen one’s ability to mount an adequate immune response. 

 

  • Smoking

 

Adults who smoke on a regular basis (cigarettes, cigars, marijuana) are at an increased risk for more severe upper respiratory infections overall. Some Experts believe that this is one of the reasons that men in China died more often than women from coronavirus was because of their smoking habits. 

Social distancing: bell curve

Why should we consider social distancing? 

This is a manageable/treatable disease but if we don’t control the spread we will surpass the health systems capacity and will result in a higher mortality rate as health professionals won’t be able to keep up with demand. The primary goal is to slow the spread of disease, a concept which is being referred to as  “flattening the curve” which you will see depicted down below. Essentially it will provide us the time to manage the disease but more importantly and often forgotten it will also allow the health system the capacity to deal with other business as usual cases eg. trauma, surgeries, chronic diseases etc. If capacity is maxed out COVID-19 patients won’t be the only ones who will suffer the consequences! 

The new research also showed that 97.5% of people who are infected develop symptoms within 11.5 days. About 1% of patients, however, show symptoms after 14 days – outside the window of the CDC’s quarantine guidelines.

Cure

Once again no need to fear. The University of Queensland Centre for Clinical Research director Professor David Paterson told news.com.au they have seen two drugs used to treat other conditions (Malaria and HIV) wipe out the virus in test tubes.

Prof Paterson said the medications given to some of the first positive cases of COVID-19 in Australia, had already resulted in “disappearance of the virus” and complete recovery from the infection. 

Another reason for us to flatten the curve and provide scientists like Prof Paterson the time they need to design a cure which could be distributed worldwide.

Keeping safe in the meantime

It is simple, practice good hygiene and social distancing where possible. 

  • Most importantly due to the nature of how it spreads through bodily fluid, if coughing or sneezing do so into your left elbow as many people are now greeting using right elbow touch instead of a handshake (weird I know, but best to be safe than sorry).
  • Wash hands frequently (at minimum 20 sec, see image below) and carry a hand-sanitiser with you and use frequently (if you can find one…).
  •  
  • If you use tissues, do not reuse them, throw out after use.
  • Avoid highly populated areas, where possible.
  • Aim to keep a 1.5m distance between other individuals to prevent spread.
  • Clean and disinfect everything after use.
  • Avoid travel were possible. 

Sick or medium-high risk

  • Self-isolate a minimum of 14days.
  • Wear a mask around other people. You do not need to wear a facemask unless you are caring for someone who is sick (and they are not able to wear a facemask). 

Future

The news is not all bad. I am one to always look on the bright side and there are plenty of learnings to take away from this outbreak. For example, it will greatly impact our lives in so many ways, some of which we probably haven’t thought about yet. I will touch on some of these in future posts, I will discuss things like the future of the workplace etc.

Next post

Stay tuned for our next post where we will discuss the science and nutrition around prevention and management of COVID-19.

Post Concussion Syndrome Support Document: An Alternative Perspective to Tradition Treatment

“No head injury is too trivial to ignore” -Hippocrates 4th century BC

No doubt you or someone close to you has experienced a Traumatic Brain Injury (TBI).  In New Zealand, 36,000 people suffer TBIs each year. After suffering a serious knock to the head you quickly realise they are nothing like a physical injury. Whether you lose consciousness or not, symptoms can remain from days, weeks, months to even years, this is known as post-concussion syndrome (PCS) when the symptoms last beyond 10 days. Symptoms can include; headaches, dizziness, fatigue, irritability, anxiety, insomnia, loss of concentration and memory, nausea, ringing in the ears. All of which can be extremely debilitating. I have suffered many knocks to head from my years of rugby and extreme sports and thankfully concussions with minimal symptoms but after my most recent crash, I now have a new appreciation for the true impact of TBI’s.

It has truly blown me away from the number of people silently suffering with TBI. So many people have come out of the woodworks with unbelievable stories either referring to their own experience or one of their loved ones. Sadly so many people that I know yet I had no idea they were suffering or had suffered. It is truly the silent killer being so debilitating yet nobody sees or understands the true extent of the implications. We all present similar stories, told that there is not much you can do you just need to give it time. I don’t believe this is the case! Following this eye-opening experience into this dark world with little answers it has really driven me to help those in need and offer support as best I can.

Purpose of this Article

With the prevalence of TBI, sadly there is still very little in regards to assessment and treatment protocols. My goal with this article is to provide a resource for those also struggling, I want to keep this as simple and actionable as possible distilling the protocols and strategies I have applied. 

When suffering the last thing you want to be doing is reading literature or doing any kind of thinking at all so I hope this can help in guiding suffers towards finding the right tools and treatments for them. Again with the target of keeping things simple, I have linked in the exact products I have used. The great thing about many of the strategies used they will not only benefit TBI suffers but anyone looking to enhance your brains potential. 

My Goal:

Screw back to baseline, this incident is going to become my launching pad to optimal brain health and performance, surpassing pre-injury status.

Shotgun Approach:

In true scientific fashion, you should really stick to one treatment and track progress before adding another to see it’s effectiveness but at the end of the day who really cares as long as things are improving and moving the dial in the right direction. Plus as an A-Type personality, I don’t want to sit around and wait too long. As I write this I am over 3 months post-TBI and haven’t been able to train since and as an Ironman athlete who trains a couple of times a day this has been extremely tough. Along with this, I have had to pull the pin on my final two peak races for the year Ironman Malaysia & Taupo 70.3 which have now both been and gone. 

Sadly with a head injury, there is no telling how long recovery will take (weeks, months, years or ever…) but I am doing everything I can to create the optimal environment so that my brain can heal and repair itself. It may not be in time to race this season and I will face that as it comes but in the meantime I am going to give my brain/ body every opportunity to bounce back in time. Although, I am hitting this from all angles taking an intensive approach this doesn’t mean I am overdoing it. My key focus is still rest and recovery, keeping my overachieving mindset in check so the majority of strategies are around attaining deeper states of rest and recovery.

Tools & Strategies: Where to start

In my last post, I shared my incident and my initial treatment while still overseas with limited resources, I discussed what is vital in the initial stages post-TBI so if you haven’t read this I highly recommend checking this out. 

In this post, I want to shed light on what I have been implementing since returning to NZ. I will introduce a wide range of tools and strategies, many of which are alternative treatments that are not often suggested or provided to TBI suffers. My hope is that this highlights there is a lot more you can do than the common recommendation of waiting for it out feeling helpless. 

Reframe

With something as debilitating as a TBI it is easy to play the victim card but in doing so you are only crippling your recovery. Your recovery starts here! Shift your perspective from tragedy to opportunity, we are a makeup of how we perceive the world. There is no such thing as a positive or a negative situation, that can only be created from our own personal perception of a given situation. 

For example, it would be easy for me to take the crash negatively as I dedicated so much time, money and effort towards this one race, plus the aftermath to follow of still 3 months no training and missing my A race Ironman Malaysia and a few other smaller races. However, instead, I flipped it as a big believer that everything happens for a reason, this is where I realised first of all this was to teach me to slow down (Previously: Running Taylored Health & Performance, 3x Startup businesses, Studying Masters and Full-time Ironman training) and that I had the perfect foundation with academic background and now a TBI suffer to first help myself but in doing so learn what works and then use my story to help other people suffering from this silent killer.

Attaining this mindset is easier said than done and like any skill takes time to cultivate but is quite possibly the most important skill in the recovery of any injury! I am thankful to have a life coach as a mum so this was ingrained into me early on so lucky this is a great skill of mine. If this is a new skill it will take the time you want to ensure you have a support team to remind and keep you honest in cultivating this mindset. But if done right, I see time and time again in my practice those who frame things in a positive light always bounce back substantially quicker.

Floatation Therapy

I have been asked many times what is the one treatment that I believe is having the most impact. I have found that nothing comes close to floatation therapy especially initially but also ongoing as it puts you into a state of sensory deprivation which provides the perfect environment for your brain to rest and recover due to removal of stimuli (sound, feel, sight). Plus with the high concentration of magnesium in the water (something I discussed in my previous post around initial TBI Treatment) magnesium is not only important for inflammation but will also help you with sleep which is often a struggle with TBI suffers. If you would like to learn more around Floatation Therapy I wrote a dedicated post, please 

Application:

Palming/ Mindfulness

For those that can’t access or afford regular floats, don’t worry you can do your best to replicate at home with a blacked-out room and placing your palms over your eyes, this will remove all eye stimulation and provide them a chance to rest. 

Coupling this with some mindful meditation (discussed in the previous post) will enhance the benefits as you will also impact your parasympathetic nervous system (downregulation system) which will calm your system down and as a result aid in reducing inflammation and heart rate which can be the trigger to worsening symptoms.

Breathwork

Another practice I have been really doubling down on recently is my breathwork practice. I have been doing breathwork for a while now but again with the extra time and the healing power of our breath I put a greater focus on this. 

Lung injury often occurs shortly after brain damage, therefore, anything that helps in regaining or enhancing lung function will be beneficial. Besides this though breathwork is powerful in its ability to tap into the autonomic nervous system (responsible for the control of the bodily functions not consciously directed). The breath is the only autonomic nervous system function under your control. It allows you to either stimulate (Sympathetic nervous system) or down-regulate (Parasympathetic Nervous System). Obviously in the case of recovery and trying to regain control of an overstimulated system we are after the latter. 

Application:

  • A regular morning and evening practice and I also utilised it whenever overstimulated most the time alongside mediation

Sleep

Although floating has been most effective nothing is more important than sleep when it comes to brain recovery. It doesn’t matter what else you are doing if you are not getting the good quality sleep you are crippling your recovery. This is a bit of a double-edged sword as TBI often impacts the ability to sleep especially achieve Rapid Eye Movement (REM) sleep which is a critical restorative stage of sleep vital to promote recovery. With any injury, sleep should become primary focus but this is even more important for any brain injury because it was recently discovered that as we sleep our brain has a clearing and repairing system (Glymphatic System). Following a TBI your brain will see an influx in beta-amyloid and tau protein these are what will cause the long term impact if not removed because these two are also the key mechanism associated with Alzheimer’s and Dementia. This is why following a TBI your chance of also suffering Alzheimer’s and Dementia skyrockets. This is one reason why TBI recovery is so vital. Therefore, the number one goal in TBI rehab should be to allow the body to do what it does best and flush out these via the glymphatic system while sleeping because if not sleeping the system is unable to work at the same capacity

A recent study shows that deep non-REM sleep, is where both the brain and cardiopulmonary activity slow down, is the perfect sleep stage for the glymphatic system to function properly.  This may be the reason why REM is often harder to achieve post-TBI as you body is naturally requesting more deep sleep to clear and repair the brain, this is just my insertion this is a very new area of science that will need to be validated. 

Application:

Now that I have presented the argument around why sleep is important post-TBI, how do you take charge of your sleep?

  • Prioritise: Nothing is more important
  • Sleep Consistency: Lock in a consistent time aim for a minimum of 8hrs (your brain needs more sleep than normal to repair itself)
  • Prime your sleep: Morning and Evening Routine that primes your circadian rhythm
  • Sleep Sanctuary: Develop a relaxing sleep environment
  • Track: I use: Oura Ring
  • Remove Stimulants:
    • Technology: No 1hr before bed and limit as much as possible elsewhere
    • Bluelight: After Sunset
    • Caffeine & Alcohol: Limit as much as possible, especially close to bedtime

Highly recommend a previous post of mine to explore further:

“The most Restorative Sleep you will ever have”

Cold Immersion

Ice bath at a breath workshop

This is another novel method of treatment although still in the early days of research most of which use a brain cooling device to impact deeper parts of the brain. However, I see it as low hanging fruit in my eyes that can not hurt and is something I have personally found extremely helpful. I have found cold exposure both the whole body and especially directly onto the injury site extremely beneficial. 

Coldwater immersion is nothing new to me I start each day with a cold shower or cold dip due to its physiological effects: 

  • Increase in Mitochondria health (Free energy ;))
  • Increase in weight loss/ management 
  • Reduction in inflammation
  • Improved lymphatic system
  • Improved immune system
  • Improved circulation
  • Mental toughness
  • Temperature regulation

Daily cold plunge while over in the mount

With this knowledge and experience around the impact of cold water immersion, I naturally started playing around with it as it has been pivotal in speeding up previous injuries. Anything that helps with the increase in circulation, decreases in inflammation and promotes mitochondria biogenesis (creation of mitochondria= more energy!) is going to be beneficial to an injury. Since then I have looked further into the research as mentioned early days with TBI specific treatments. However, there seems to be a clear correlation between brain temperature and recovery. Especially in the initial stages which I obviously didn’t address and most likely exacerbated my TBI with completing the remainder of my Half Ironman in hot humid 38degree conditions following my bike crash. In the research they are using specific brain cooling devices that a NASA spacesuit spinoff head-neck cooling technology is engineered to optimize conductive heat exchange with the brain, thereby reducing the physical temperature. Obviously I have not had access to anything like this but everyone has access to cold water so why not try cold water you won’t just be charged with more energy but you may find it helps your overall symptoms.

Application:

  • Daily cold showers: Full body and especially injury site and Ice Baths or winter lake and ocean swims (where possible)

    Work Retreat in Queenstown taking others through the process

Screen Time

Initially and throughout recovery, one of the worst things you can do is stare at a screen which is challenging in this day and age because when you not doing anything that is the first thing you do is pick up a screen and watch something or aimlessly scroll through social media. This was particularly hard for me while still overseas as I was travelling by myself I had to use screens to get around not to mention the unneeded stress of getting around. Regardless, early on you want to provide your brain with the best opportunity to rest so you want to stay clear from screens a much as possible. However, like anything sometimes you can’t avoid them if this is the case the next section is for you.

Application:

  • Avoid as much as possible. Turn down brightness and put on night mode or install a blue-blocking app to reduce stimulation (F.Lux or Iris)

Glasses

Rocking my blue blockers in my Qantas business class PJ’s on my home from Singapore

One of the most simple yet effective things I have implemented has been the application of glasses whether they be sunglass or blue-blocking glasses. I have found them both effective in allowing my eyes to rest. First of all, make sure you have some great polarized sunglasses, cheap glasses will actually make things worse! Take the celebrity look for a spin and wear them inside and outside as it will aid in reducing stimulation to the eyes and as a result your brain. 

As you progress or not keen on looking like a celebrity any more blue-blocking glasses are great for the times you can’t avoid screens or just need to reduce stimulation. You can now get these in clear lenses so you don’t have to stick with the horrific orange lenses anymore but worth getting a pair for when you are at home and things are bad because in my experience the clear lenses are great but the orange are definitely more effective. Added bonus put your blue-blocking glasses on at sunset to aid with you winding down for sleep, Learn more about this hack here

Application:

Get yourself some good quality polarized sunglasses and blue-blocking glasses. When it comes to sunglasses you have endless options but with blue blockers, there is a lot of cheap rip-offs on the market but I can recommend Ra Optics or Felix Gray

Near-infrared light

Although some light is damaging others are healing! I also stopped into Recharge Cryo for clinical-grade light therapy or photobiomodulation therapy (PBM). this is a passive non-invasive treatment which lasts approximately 15min where you lie under a lamp which emits deep penetrating and soothing light which is targeted deep into the skin cells to help heighten their internal functions, increase blood flow and help induce faster healing through the stimulation of ATP (the energy to your cells),

Application: 

  • 15min sessions more always better, I have struggled to find the time to get across town but would like to do 2x/week

Nutrition

Once home, I remained on a similar protocol to while I was in Singapore but now home I could access everything I needed to enhance the recovery. Lucky I had the majority of everything I was after already waiting in my cupboard back at home. 

Initially, I tried to remain as ketogenic as possible with my diet due to the positive impact of being in ketosis as it is the ideal environment for brain repair and performance (same reason I was taking keytone supplements). Although normally easy for me to do, this time it wasn’t! I found my brain was craving carbohydrates and calories and those that follow me know I am all about listening to the body. Instead of stressing my system and restricting carbohydrate I instead did my best to achieve ketosis through diet and time-restricted eating (14-18hrs) without stressing the system any more but when body was craving calories and/ or carbs I would give it what it was asking for. The last thing you want to do when recovering is to starve yourself and be in a calorie deficit as your body won’t be able to recover optimally. However, it is a fine line between boredom eating and actually cravings which has definitely been a struggle for me as I never had so much spare time….

Keytone Supplements:

Once home, I consulted a friend who is an expert in this space Cliff Harvey and he suggested to keep beta-hydroxybutyrate levels (keytones) high throughout the day to provide the required fuel to the brain. But instead of eating keto he suggested taking supplements to upregulate and aid my damaged brain.

Application:

Once home as per cliff suggestion for the initial 3 weeks:

  • MCT oil 3xday (breakfast, lunch, dinner) to aid with slow production of keytones 
  • 1-2x Exogenous keytone supplement (Pruvit) broken out across the day, to achieve deeper states of ketosis to prolong impact. 

I continued this for 5weeks and thanks to Ryan Stag another TBI suffer found Melrose MCT oil combined with DHA (Fish oil) which as mentioned in the previous post is extremely powerful in brain rehab so I began using this as my go-to MCT for this period.

Lions Mane (Mushroom):

You may not have heard about this one but it is something I have a deep knowledge of as I am currently doing my Masters around this amazing mushroom! Due to the high concentration of the Beta-Glucans in this fungus Lion’s mane is known for its neuroprotective and growth potential while reducing reactive oxygen species (ROS) and bringing down the inflammation. Naturally the best thing for me right now! Also another recommendation from Cliff 

Application:

Coenzyme Q10

A naturally occurring antioxidant in the human body and if you recall I discussed the power of antioxidants in my last post. Following TBI Coenzyme Q10 has presented a positive effect on animals and their brian recovery, as it reduces neurodegeneration

(the death of brain cells) and increasing blood supply to the brain. Another supplement that won’t cause any more harm and with potential benefit I absolutely think it is worth taking

Application:

  • 2x BePure10 twice/ day (Morning and afternoon)

I choose to take a reasonable high but if not viable something is always better than nothing!

Exercise:

Throughout this process, I continued to keep active as best I could, which was very light probably better described as a movement not exercise. Lots of walking and stationary bike, however, focusing on staying symptom-free. The rule of thumb post-concussion syndrome rehab is to work at 80% of symptom threshold. This is best achieved by working out with a heart rate strap and working out until you reach symptoms. Once achieved symptoms calculate 80% of heart rate and aim to keep future workouts under this threshold eg. symptoms spike at Heart Rate of 100 beats/min, 80 beats/min is your new threshold. However, this can be challenging and requires regular testing as you recover because the goalposts will keep moving.

I have also used this as an opportunity to focus on areas that often get neglected and focused on more restorative movement practices such as Yin Yoga, and imbalance correction work. Too often when in the mix of intense training it can be hard to find the time and initially I had nothing but time…. However, due to the mental fatigue, I can’t say it always happened but did my best. I have also been putting a greater focus on getting out into nature for my movement due to the therapeutic standpoint as nature promotes so many positive health benefits. 

Application:

  • Don’t exceed 80% HR of symptom threshold. Use additional time to focus on the restorative types of training we often neglect eg imbalance correction and yoga etc 

Professional help

I know all advice up until now is a result of being frustrated by the current limitations of the system but by no means have I gone this alone. Regardless I highly recommend everyone wraps themselves around with practitioners to aid you on your journey. Also, in no way is this an attack on practitioners knowledge or services many of them were amazing! However, the practitioners are fighting an uphill battle especially in concussion treatment as it is a quickly growing body of research (American football is the key driver behind this) and due to the system they work within it often takes time to filter through to practice as it needs to be accepted as the scientific consensus prior to them being able to utilise as a practitioner, this sadly takes time. If they suggest something away from the consensus it is their head on the chopping board so it is in their best interest to stick to the tried and true. I believe it is the model not the practitioner’s fault, they have the patients best interests in heart, just fighting a limited model.

Below I have outlined the reasons behind each practitioner I saw to help guide my recovery:

  • Doctors: 

Saw both initially at the race venue, then at the hospital, to get properly checked out before flying home (ensure no brain bleed as it could be fatal if I flew home.) and GP once home as ACC requested it, too be honest I am not sure why. The doctor had minimal knowledge of concussions and I had just been and seen the sports doctor who specialises in cases like this.

 

  • Osteopath: 

This was extremely important early on in assisting with whiplash, physical injuries plus some osteos can perform cranial work which is minimal movements which is great in aid with releasing tension and taking the pressure off my head. However, Osteopaths can not diagnose post-concussion syndrome so if you think this is the case, you want your practitioner to refer you to someone like a sports doctor.

 

  • Chiropractor:

I also saw a Chiropractor to get some additional support. Personally I never really go to a Chiropractor so this was interesting I found myself and awesome practitioner who approached it from a variety of angles which I believe would be extremely helpful but sadly due to time constraints haven’t made it back yet but will be short to explore this further.

 

  • Sports Doctor 

This is where I obtained my official diagnosis of post-concussion syndrome and actually highlighted the extent of my situation with testing also providing baseline data to see how I my recovery tracks. For anyone suffering I would highly recommend getting here as early as possible, I personally didn’t get there until 1.5months post-crash. Early is important as they can create a claim with ACC and help guide you towards services that will help such as a concussion clinic.

 

  • Occupational Therapist (Concussion Clinic):

The sports doctor sent me to a concussion clinic to wrap some support around my recovery. The first session was with the OT who explored the impact of my injury and help design a plan accordingly. She referred me to the neuro/vestibular physio and neurologist for further testing and treatment and been there to aid me with any questions.

 

  • Physiotherapist (Concussion Clinic): 

Specifically, neuro/vestibular physio who specialises in cases like mine. This involved a lot of additional specific testing such as visual, balance, autonomic nervous system (treadmill test). Through this testing, we identified I had ‘Benign Paroxysmal Positional Vertigo’ (BPPV) 

  • Benign – it is not life-threatening
  • Paroxysmal – it comes in sudden, brief spells
  • Positional – it gets triggered by certain head positions or movements
  • Vertigo – a false sense of rotational movement

BPPV is a mechanical problem in the inner ear that prompts vertigo as your brain is getting sent confusing messages from the inner ear which is often associated with head injuries. The identification of this was a pivotal moment for me as it is a quick treatment of head movements known as the ‘Epley Maneuver’ which corrects this problem. I instantly noticed an improvement in my eye-tracking. Previously my left eye had severe nystagmus “An involuntary eye movement which may cause the eye to rapidly move from side to side, up and down or in a circle, and may slightly blur vision.”- Mayo Clinic. This was cleared immediately after the manoeuvre, taking a lot of stress off my system. Quick note; I have now had the Epley Maneuver twice as when I came back the symptoms had returned. Keep in mind it may take more than one Epley Maneuver.

 

  • Neurologist (Concussion Clinic):

To ensure everything was on track and nothing was being missed I also had a meeting with Neurologist to discuss everything. This involved some further testing and was great from a peace of mind standpoint. I personally enjoyed this session as they have deep mechanistically understanding of what is going on so I could talk at a deeper level to get his perspectives on my recovery strategies etc. Plus I could discuss recovery timelines which were longer than I would have liked.

Thinking outside the box:

 

The next few are not a classical treatment but again I am interested in hitting it from all angles. 

  • Clinical Pharmacist & Mineral Therapist: 

This was fascinating as she discovered I had a potassium deficiency which is common post head injury due to biochemical response. She put me on a specific supplement to aid with this which I believe has been beneficial.

 

  • Auditory/ Visual Therapy: 

As someone who also has dyslexia, this was something I was already looking into and following the crash, it was clearly the right time to explore this. I have only done the testing so far but WOW! It provides powerful data to work with which really highlight my current deficiencies. The only difficulty is with no pre-crash baselines we have to try and determine between what is my dyslexia or a result on my brain injury. A chicken or egg problem but at the end of the day it doesn’t really matter what caused me to read at a grade 3 age etc (scary right!) I now know the mechanism I now need to train.

What are the specialist telling me now? 

(100+ days post-crash) 

Although I am not back to where I would like to be, the rate of my recovery is continually surprising the specialists. As I write this I saw the neurologist earlier this week and he was impressed about where I am but reminded me I still have a long way to go and said it will be at least another 3months until I am able to race again…. That was a tough pill to swallow! As this means I am only halfway… I will keep this in the back of my mind, however bringing back to my first tip it is all about perspective so I now see this 3-month window as a challenge. What does this mean for me? Keeping myself in check and gradually building over time because anytime I overdo this will just set me back and I don’t have the time for any setbacks. If i don’t beat the 3 months that is fine I will accept that when it comes but in the meantime I keeping things positive. 

Summary

This is only a snapshot of something I have been doing in all honesty but without getting too long in the tooth I wanted to provide what I have so far found the most impactful in my recovery. I hope that in this article you find something that can either help yourself or a loved one. Please if struggle feel free to get in contact as I understand the pain and I am here to help!

THE GAME CHANGERS FILM REVIEW

Game changers is all the hype at the moment, every day I get asked my opinion on my thoughts around the documentary so I thought best to outline my thoughts with a blog post, to provide a resource for all the confusion that is being produced.

Firstly, I am a big proponent of plant-based nutrition and I believe it should be the foundation of our diet. In the film, they presented a wide argument for why this is the case. Debunking many social beliefs around plant-based diet and performance. 

I truly believe if done right, this could have been a really good documentary. However, this film can not be referred to as a documentary. A documentary presents a balanced argument which this was not! I found it extremely dogmatic and reductive, twisting science to tell a story, that plant-based is the only way to eat….

An important caveat before getting into it, I found it interesting how they used the term plant-based which I believe is just in an effort to rebrand the dogma around veganism. I can’t blame them because it has taken a bad wrap but maybe that is for a reason….  In this article, you will see I have used both variations synonymously.

Balanced Argument?

As for a balanced argument, the first thing we must do is look at the funding and the expert’s background. Firstly it was funded by the founders of ‘Verdiant Foods’, an organic pea protein company. Who obviously benefit from people going vegan. What about the experts? All plant-based themselves which alone creates a basis

Some examples:

  • Dr. Dean Ornish: Author of several books including, “Undo It!” Which is a guide to reverse chronic disease with a plant-based diet. In addition, he hosts retreats and offers online programs for plant-based lifestyle approaches. 
  • Dr. Aaron Spitz: Author of “The Penis Book,” which highlights the importance of a plant-based diet for optimal penile function. 
  • Dr. Robert Vogel: A cardiologist and author of “The Pritikin Edge,” which focuses heavily on plant-based eating.
  • Dr. Caldwell Esselstyn: Sells books DVDs, ad programs for reversing heart disease through a plant-based diet.                               (Maeve Hanan (2019), An Evidence-based Review of ‘The Game Changers’)

Naturally, these “experts” are all for veganism which is not necessarily a bad thing. However, I would have loved to have seen both sides of the argument to create a balanced discussion vs the pushing the vegan agenda. Great news Chris Kresser M.S., L.Ac the Co-director of the California Center for Functional Medicine, founder of Kresser Institute will be on Joe Rogan Podcast to debunk this film on the 19th of November. He will no doubt discuss many of the points I am touching on here but will also have the platform to go a lot deeper so I highly recommend tuning into the podcast if you are interested.

Telling a Story through Science

Twisting science to tell a story is nothing new with so much potential financial gain to be had. It was poor science which led us into the obesity epidemic we now face. Ancel Keys an American physiologist in 1950s dubbed obesity on fat in particularly saturated fat. He did this through his famous 7 countries study that became the basis from the food pyramid and way of eating for 55yrs …. (we are still battling this today…) When it was really a 22 countries study (see image below) which he cherry-picked two markers and removed countries that didn’t fit his linear correlation…. I have written a blog around this if you want to learn more. Sadly game-changers took a leaf out of this book and created stories firstly they referenced Ancel Keys poor research, demonising saturated fat which as mentioned has been highly scrutinised on top of this they compared the average western (processed food, hamburgers etc) against a plant-based diet. Sorry but any diet is better than the standard western diet! I wouldn’t be surprised if we saw the same effect going full carnivore (meat only) for the same period of time to these studies (Not saying this is a good thing either, just making a point). The negative impact of the standard western diet has been well documented and evidence is clear all you need to do is look at the obesity epidemic, obviously, nutrition is not the only factor but definitely one of the leading contributors.

Vitamin C

Another unbelievable moment for me was when a scientist states that plants are higher in Vitamin C and since our bodies can’t make Vitamin C we should only eat plants. I am not arguing that vitamin C comes from plants and I don’t think any other dietary approach would either (besides maybe carnivore…). But why is it we have to function in extreme measures of all or nothing (Plant vs. Meat)? Why can we not eat a balanced diet of plants and meat, we are omnivores after all…

One Diet Fits All

They state in the film that the plant-based diet is the one diet for everything …Sadly, there is no such thing as a one diet fits all we each possess so much diversity that what works for one person will not work for the next. Nutrition like most things needs to be individualised. There are some guiding principles that will apply to the majority but there are always exceptions to the rule and to ignore this is just foolish. 

Anecdotal Evidence

The film does a great job at highlighting a handful of vegan athletes. Their anecdotal stories are fascinating but again like mentioned earlier there are always outliers… I am not saying that these athletes are but with very little to work off besides anecdotal evidence, it is difficult to determine.  We must always approach anecdotal evidence with a grain of salt before we take it as the gospel. For example, when someone goes through a dietary change it often acts as what we call a keystone habit which promotes cascading of other positive habits to follow such as mindset shift, lifestyle changes (Prioritise sleep, implement stress management strategies etc), a greater focus on training and integration of new training methods etc. Besides the habit change and controllable factors are they genetic outliers? Plus just because they are seeing performance gains short term what is it doing to their overall life and healthspan? Once again I am not saying that plant-based couldn’t have achieved these results but a pinch of scepticism is always good when digesting anecdotal evidence, it is important to look at all the evidence such as what the science tells us. Let’s touch on a bit more science then 😉

Amino Acids: Meat Vs Plants

I would be remiss if I did discuss the amino acids argument. Firstly, as defined by the FDA, a complete protein contains all of the essential amino acids in adequate amounts. Incomplete proteins do not have sufficient amounts of one or more of the essential amino acids[*]. Or, they’re missing amino acids altogether.

Animal protein sources consist of all the essential amino acids and quantities our body requires. Whereas plant proteins do not contain some essential amino acids with the exception of soy. Plants are especially low in the essential amino acid leucine compared to animal-based proteins. Leucine is well known for being a trigger for muscle protein synthesis (eg. muscle growth). To attain adequate protein then you’ll have to combine plants to get a complete protein. This is fine in theory however how much beans and rice do you need to eat to make the amount of complete protein that is present in a piece of chicken? A great example of this in the film was when they stated a peanut butter sandwich has the equivalent protein as 3oz beef or three egg. I love my nut butters as much as the next person, probably more but to achieve the same protein level you would need 5 tablespoons of peanut butter, for a total of 500 calories! (Not including the bread). Regardless, of the massive calorie intake of ¼ cup of Peanut Butter, it is a bit overkill for one sandwich.

Just like everything, it is not just about quantity but quality, this is no difference for protein. Quality of amino acid is characterized by the composition and digestibility. On average, animal-based protein is digested at a 90% or higher rate, while plant protein ranges anywhere from 55% to 80%.

Why? Plant proteins less digestible because of the “anti-nutritional” factors (trypsin inhibitors, hemagglutinins, phytates, etc). The good news for vegans is that cooking techniques like soaking, boiling, steaming, and fermentation have been shown to reduce the content of these anti-nutrients. It doesn’t solve the problem but does help with protein uptake. Another great option especially if an athlete as you need more protein, you should also consider plant-based protein powders (Hemp & Pea) as these are stripped of the anti-nutrients and allow for the uptake of the protein. 

Summary; With Plant proteins offering less digestibility vegans will often have to consume more calories to attain the same quantity of protein, like the peanut butter sandwich mentioned above.

Blood Testing 

The blood tests following meal really spiked my interest so naturally, I looked into what it all meant, was the “cloudy serum” a bad thing?

The cloudy effect seen in the blood is called postprandial lipemia. It is physiologically normal to see a rise in triglyceride-rich lipoproteins in the blood post-consumption of dietary fat and if a concern which it shouldn’t be for most, it is simply mitigated by movement and fasted windows. If we tested all these athletes fasted, their serum would all look identical. 

So really just a quick and easy way to fear-monger and scare you to confine to their story.

 

Cholesterol, Blood Pressure, BMI

How about the firefighters who lowered their cholesterol, blood pressure, BMI, etc from going vegan. Do you truly believe they had to go full plant-based, for these effects? No, because at the end of the day you will be healthier with a well-balanced diet with some meat consumption as long as it of high-quality source and not processed.

Vegan Paradigm

This is not related to the movie as such but I think an important consideration to include because no doubt some people will try the plant-based diet. In fact, many I know have already begun as a result. 

When on a new diet especially a restricting diet you will often see profound benefits early on, it is what I like to call the vegan paradigm. You change your diet and full of motivation you kick all the ‘bad foods’ and receive a massive influx of new nutrients which your body thanks you for as it is not used to getting them so you feel amazing as a result. Plus due to the limited nature of the diet, you naturally stay clear of all the junk food you used to eat so, of course, you see great results. This is the foundation of most diets but especially important for the vegan diet because if not a well thought out and structured, you will begin to lose key micronutrients B12, Omega 3, Iron etc that just can’t be attained in adequate quantities through the vegan diet. Yup, I said it, to do a vegan diet successfully you most likely need to supplement to get adequate nutrients that can’t be attained through you diet which to me begs the question, is this the way we are designed to eat? However, back to vegan paradigm, early on in the diet our bodies are great and compensating for this but over time this takes its toll and roughly 1-3yrs down the track of being vegan they begin to see a significant decline in their health and because they felt so great early on they don’t correlate it with the vegan diet, it must be something else? So often get more strict on the diet and really begin to spiral down.

Game Changers Take Home Message

Finally, thankfully they took a step back with their take-home message which was not to go full vegan but aim to reduce meat intake which I can absolutely get behind. Not that meat is bad but if you have a few meat-free meals of meat-free day (meat-free Mondays is a common approach) you will be forced into increasing the diversity of your diet which is a great thing for attaining more nutrients in your diet and improving your overall health.

My Summary of the Film

Although extremely dogmatic and reductive, it championed vegetables which is not a bad thing! We should all eat more vegetables and great diversity of vegetables. What really frustrated me is the way they approach it, saying it is the only way to eat and then backing their story with poor science and anecdotal evidence, not a balanced argument at all. One thing that really infuriates me around films like this, is they push the extremist narrative we must be all or nothing (Meat vs Vegetables) when instead we should eat both we are omnivores after all. I am all about championing the vegetables a reducing overall meat intake but there is no need to be so extreme. There are exceptions to this of course as discussed but let’s bring some common sense back into the nutrition game!

When Everything Changes in Seconds: Traumatic Brain Injury (TBI) + Initial Recovery

One decision, one slip in judgment and everything can change in seconds….

I want to use this post to discuss my accident along with the initial protocol I implemented as a result. My goal is to show those that have suffered you are not alone and for those who may suffer in the future hopefully offer some hope and guidance that there is a lot you can do to help. However, it is important to not get caught up stressing around doing everything but to do what you can because at the end of the day the most important thing is to be stress-free and rest and remember we are all different

Why Bintan 70.3 Ironman?

At the beginning of this year, I set two pretty ambitious goals, targeting World Championship qualification in both Half and full distance Ironman, something I previously never perceived as possible.

In my pursuit to attain an early qualification for 2020 Taupo 70.3 World Championships, I flew over to Bintan, Indonesia to race a Half Ironman. Everything was going perfectly to plan with a solid swim and on target for an awesome bike on a very challenging technical & hilly course, I was racing my perfect race, feeling great with everything going to plan, in fact, if I kept tracking as I was I would have won my Age Group (I needed a podium to guarantee my qualification spot) and also came in the top 5 overall. However, this was not meant to be as at the 75km mark of the bike everything went blank….

I couldn’t tell you what happened first hand because I have no recollection but from what I was told, I came flying around the corner towards two speed bumps, the first I bunny hopped and then hit the second of the two with my front wheel off-centre (according to my Garmin Computer at 42kms) sending me flying over my handlebars headfirst into a curb, with my right side taking most the impact/ road rash but I must have rolled as well because I was cut up on my left as well. I am not sure how long I was out for but I don’t recall anything from my time at the crash site but apparently, I was repeatedly asking the same questions over and over “what happened??” “Is my bike ok??” Once told I would ask the same question straight away again. Not surprisingly the volunteer that was helping me knew I was not in a good place so he called in the doctor to assess me, you would think at this point my race was over but the doctor said if I want to keep going I can and those who know me I am extremely stubborn and a sucker for a challenge so there was no choice in my head (not that it was working anyway) I assume, this is when I jumped straight back on my bike and went on autopilot. This is the part that really scares me because I still have no memory of any of this, I am not sure why the doctor let me go, maybe it was because I was being difficult wanting to jump back on my bike and not listening (I wouldn’t be surprised, I put a lot into the prep of this race) but he should have never given me the option in the state I was in, he should have pulled me from the race. The volunteer that helped me at the time of the accident found me after the race and filled me on all of this he couldn’t believe the doctor let me back on the bike, he also could believe I had finished the whole race.

With no one stopping me there was no way I wasn’t getting back on my bike. Dazed and confused it wasn’t until after the race I looked back to my Garmin Computer for answers and they truly shocked me! Turns out I spent 17mins at the crash site…… No clue how much of that I was unconscious or what was going on and then back onto the bike on autopilot with 15kms left of the 90km bike course. Still with no memory of this, I wonder what was going through my mind because this was quite possibly the stupidest thing I could have ever done, not just because I was back on the bike but the speeds I was going with an extremely beaten up mind, body and bike (Bike had $3700 worth of damage….). My Garmin once again highlighted my stupidity although overall last 15km was slower than it would have been it showed multiple times where I exceeded 60km/hr and if you know anything about concussions the absolute worst thing you can do is have another in close concession… Even within up to 3 weeks. Thankfully I survived this very silly decision.

In to transition and onto the 21km run, this is where I somewhat came to. Dazed and confused and with no memory of losing 17min at the crash site or my slow last 15km, I did my best to keep my mind on what I came here for a podium finish to qualify. Again not a smart move in hot humid 35-38 degree conditions and with a whole host of injuries and road rash that I never took the time to assess my situation. It didn’t take long until I turned my Garmin off the speed setting because I wasn’t even close to my target pace and I just focused on getting to finish as fast as possible. This was not easy as I had also pulled my right calf in the crash so I felt each and every step.

Long story short, I got through the hottest run of my life (thank god for all the sponges) and pretty much collapsed across the line and mumbled the words “medical, I need medical” I was in an absolute state, I could no longer stand and had to be helped and lost all control of my body (even my bladder….) even sitting wasn’t possible. I spent the next 3-4hrs or so getting checked and monitored in the medical tent trying to figure out the extent of everything.

Everything seemed to come somewhat better and was I able to hold a conversation but it wasn’t until I got back to my accommodation (maybe due to all the movement?) things really hit me and went downhill. Travelling alone this can be scary but thankfully I was surrounded by a really nice Italian man, who had also raced and some really helpful resort staff. Although none of their English was great I managed to get my message across (google translate was our best friend). I got them to monitor me every couple of hours and then made the decision if I was not better by 9 pm I would go to the hospital. Reluctant as being on isolated island I can’t imagine they had assessment tools like MRI that I would need to assess a brain bleed etc. Thankfully by 9 pm I felt slightly better and decided to stay and rest.

I used my high pain threshold to my advantage and endured the pain and passed on any medication offered (I got some pretty confused/weird looks saying no). Why would I refuse? TBI on their own result in extreme gut damage so I didn’t want to cause further damage by adding them to the mix. Plus I would rather be conscious/mindful of the pain to ensure I can truly assess my symptoms and ensure I am not doing anything to aggravate them.  I am not saying you have to say no to drugs if needed, this is just my personal choice as I like to be in tune with what my system is telling me not masking it. If you do choose to take drugs you do need to be careful especially if there is any chance of a brain bleed as non-steroidal anti-inflammatory drugs (NSAIDs) will increase the bleeding so try your best to stay clear and stick to traditional painkillers eg paracetamol.

I was lucky I didn’t have to leave until the day after the race and my Italian friend broke down and packed my bike for me because there is no way I could even fathom doing that. I spent the rest of my time taking things very slowly which wasn’t too hard as I couldn’t walk after pulling my calf and running a half marathon on it, you could say it was not too happy so walking was very slow with a massive limp. The upside I was thankful to be in paradise, so just chilled and got straight onto my rehabilitation.

Initial treatment

This is the part where I want to share what I did initially to support my TBI and hopefully can help as a resource for others struggling or know someone struggling.

Obviously, on an Island, I had very limited access to support or interventions but luckily I always travel with supplements for optimal health and performance which in this case I was lucky as some of them are also the first line of call for brain health and repair.

Below is a list of the things I implement with dosages and why they were applied, to provide you with a greater understanding. You may note some of these are a little higher than recommended doses so please check with medical professional first. Obviously I had to work with what I had in an isolated location, in the future I will endeavour to provide a detailed protocol of what I would do in an ideal world but for now, here is what I implemented:

Sleep/ Rest:

Why: When it comes to TBI nothing comes close to rest so that became my primary focus. I have an Oura Ring which is one of the leading personal sleep trackers so this was great for me to monitor and assess my sleep. Although sleep is the best thing for a TBI, poor sleep is also often associated in particular REM sleep can be affected. I designed my day around maximise my sleep. Priming the circadian rhythm with early morning

Dose: I aimed for more sleep than normal targeting 9-10hrs. However, I did not always get that

Daily Routines:
Morning:

  • Meditate: to relax the mind
  • Sun Exposure (no sunglasses with as much skin as exposed as possible)
  • Grounding (bare feet),
  • Movement (or should I say limping…)

Day:

  • Napping: As required but no later than 3 pm as I didn’t want to impact my sleep during the night

Evening: Focused on winding down early

  • Early Dinner
  • Blue-blocking Glasses (which were also godsent when over stimulated throughout the day)
  • Meditate: to relax the mind

Meditation:

As mentioned above

Why: Not only is mediation powerful for cultivating a positive perspective but it is great for unloading the exhausted mind. I ensured I had a solid foundation of daily meditation (morning and night) and whenever I overloaded the system and felt symptoms worsening I would take a step back and meditate and straight away fell a release in the pressure within my head.

Dose: 10-20min Morning and night and when needed throughout the day

Exogenous Keytone Salts
Brand: Pruvit

Why: Quite possibly the most important thing I could take early on. Keytones are known to be the most efficient clean fuel for the brain and they can provide up to 70% of the brains energy. Even more importantly a TBI resembles Alzheimer’s disease (AD) as they both present with a reduced ability to utilise glucose for energy. With the reduced capacity to utilise glucose (carbohydrate) for energy, ketones are even more vital in supplying the brain fuel.

Dose: 1 Max Packet per day (half in the morning and the other half in the afternoon)
To increase ketones in the body across the day

DHA (Docosahexaenoic Acid)
Brand: BePure Three

A high strength DHA/EPA Omega 3 Fish oil with Vitamin D and natural vitamins A and E.
Why: DHA is recognized as an essential nutrient for the proper development and function of the brain. In a number of TBI animal trials have shown an improvement in cognitive function, reduction in nerve swelling, stabilisation of cellular energy production and increase nerve repair with the supplementation of DHA & Omega3.

Dose: 2 capsules Morning and Evening

Probiotic
Brand: BePure

Why: Probiotics offer a health benefit to brain function and promote the diversity of gut microbiota.
TBI has shown to greatly impact the gut-brain axis. The communication pathway that has lead to the gut being known as the second brain. TBI results in increased colon permeability, leaving individuals 12 times more likely to die from blood poisoning which is often caused by bacteria, and 2.5 times more likely to die of a digestive system problem, compared with those without such injury. However, a good probiotic can mitigate these effects and help in assisting the healing of the gut.

Dose: 2 capsules Morning and Evening

Antioxidant:
Brand: Viberi Powder

Why: Following a TBI there is a significant increase in reactive oxygen species (ROS). It is the ROS which causes the cascading of events and the primary stress to the brain following a TBI. Antioxidants are important early on as they can fight the increase ROS, reducing the load on the brain allowing it to heal.

Dose: 1 sachet/day (However sadly ran out over there so split them over a few days)

Magnesium
Brand: Bepure

Why: Depletion of magnesium is observed in the animal brain and in human blood after TBI. Magnesium is critical in restoring brain plasticity and for improving cognitive function. Researchers showed that with magnesium supplementation they could reverse brain ageing by as much as nine to 14 years. Anything that helps the health of the brain long term can be assumed is helping in the short term acute situation like a TBI. Not only this but magnesium is great in regulating inflammation along with assisting in sleep which can be challenging when suffering from a TBI

Dose: 2 capsules Morning and Evening

Diet: Fasting + Whole Food Antioxidant-Rich Diet

Why: Fasting: Purpose of fasting is to naturally increase levels of ketones in the body, reduce inflammation and along with providing the gut a period to heal and repair following the onslaught of racing and the TBI. However, important to note I was not strict, I did not want to place any unneeded additional stress on my system so when hungry I would eat.

Outside of the fasting, I tried to limit carbohydrates as much as possible and a trend towards a more keto approach. Although this turned out to be challenging to do due to limited food choices over in Asia. Interestingly, I did find myself craving carbohydrates more, I am not sure if this was due to having more than normal or if my body was requiring them so I would listen to the body and not restrict when craving carbohydrates.

Aside from the fasting and minimising carbohydrate where possible I aimed to eat a diverse wholefood rich diet. With a special focus on getting in vibrant colourful foods as vibrant colours are closely associated with nutrients and antioxidant properties. Also in a new country presented a great opportunity to try new foods and develop a bit more of a diverse microbiome.

Does: Length of Fasting is dependant on your ability and adaptation to do so. The key thing to keep in mind is you need to listen to the body. I can happily do 16-18hrs but this is never a target! I just listen to what the body was telling me and adjust accordingly.

Activity:

Walking: Broken and chronically exhausted I couldn’t do much but walk/limp so I took it easy and stayed well within my limits and walked as much as possible and gradually increase easy day.

Why: Movement is phenomenal for recovery as long as you stay within limits as it increases blood flow, Neurotransmitters, (the chemicals in your brain that transmit messages between neurons) and activates neuroplasticity (the brain’s ability to rewire and repair itself after brain injury)

Dose: Every morning and as much as my mind/body would allow throughout the without aggravating symptoms. Gradually increasing each day as my body/mind allowed. For me mornings where best by the afternoon-evening I was exhausted and just rested

Two days post Crash: Bintan to Singapore

 

Then Tuesday rolled around and it was time to leave and catch the ferry back to Singapore and straight to the airport to fly home. Still waiting to hear back from my travel insurance I slowly and painfully got myself to the airport. While waiting to check-in, they finally got back to me and told me to get straight in a taxi to the hospital to be cleared before catching my flight home. At the time, however, this just seemed like too much! I just wanted to get home even as much as I was dreading the flight. However, after talking to my mum, as I was in no state to make a decision she made me realise they were right, you only get one brain and I have worked hard on mine so just not worth the risk. I thought I would only have to stay one night but the insurance company still wouldn’t let me fly so I ended up staying for another 4days in Singapore going back and forth from the hospital for assessments, scans and then for my road rash which became infected. In this time I persisted with my protocol as listed above the best I could.

When it comes to assessment for concussion there is not much they can do in the way of identifying the extent of damage, all an MRI can do is look for a brain bleed which would be a worst-case scenario. Thankfully I was cleared to fly home which by this time I had exhausted my supply of supplements so I was keen to get home to get back on to them to regenerate my brain.

Home:

Finally back home with access to all the resources I need and touched base with a couple of friends of mine a special mention to Cliff Harvey who was really helpful to bounce some ideas and get his thoughts and advice. Especially with a foggy mind, this was extremely helpful as reading literature wasn’t really possible at this time. I then distilled what I knew and what Cliff and others had suggested into a protocol. In my next post, I will discuss what I have implemented in the month or so since coming home.