Concusssion? Always Get it Checked!

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He sits birth upright in bed and says stop don't cut my car hearts and he woke up and was fine

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And we were like trying to wake him up the whole time and he was just totally unconscious playing possum

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Apparently he had a family member. They were in some dispute over some inheritance and

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He thought the only thing he could think of and there was a rifle pointed right at him

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And he said the only thing he could think of was to fake his death and grab his chest and collapse at the ground and pretend like he had a hard massive heart attack

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And then we I guess the relative that was pointing the gun felt guilty and he dropped the gun

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picked him up and I brought him to the hospital

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Some of you's just trying to scare him and he wasn't really gonna shoot him

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And I said oh my god, he got to be kidding and the guy was fine

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And I said, why did you why did you think of this because I don't know I saw them TV once

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And it seemed like a good thing to do and it got him out of a jam

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And he was a goodie man. He cut his Carhartts. I guess they're pretty expensive overalls

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But that was only years ago, but I just remember like it was just the craziest thing

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And now the podcast we're together we discuss proactive aging on your terms

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Connecting to the professional advice of our special guests while creating better days throughout the aging process

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Now here's your host Mark Turnbull

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Hello everyone and welcome back to another lively discussion on aging today

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We are the podcast where together we explore the many options to aging on your terms

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You can find aging today and our past eight years of programming on our website

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All you got to do is go to agingtoday.us

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And I want to thank all of you for tuning in today for another live-dead discussion

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And we're gonna be talking about concussions

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We're gonna be talking about over the five million people that go to the ER every year

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to report some kind of a concussion and

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Here to lead us in this discussion is our expert for today his name is Dr. Chris de Vlantis

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And he is the senior medical director at Abbott and also the board certified emergency

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Medicine physician so Dr. de Vlantis welcome to aging today

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Thanks for having me Mark

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Yeah, I'm very excited to have this conversation because it is a really important conversation that we should be having

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And not just for the population in general, but in particular for our senior population

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I'm I may

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In-home care agency owner we have over 60 caregivers that are in various homes throughout the Portland area

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And oftentimes our seniors

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Take a tumble even with the care of our caregivers and when that happens

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Some interesting things can happen if we don't pay attention

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But before we get into our topic of the day, I'm very curious about your

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Your story and what led you to become a doctor and then as a as an emergency

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Medicine physician I got to ask your top two favorite stories in the ER

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That's great

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So let's start with how you got how you got to be a doctor with where you as a child where you always interested in

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Medicine I was I was that nerdy kid in biology that like to dissect the worm in the frog and I was just fascinated by anatomy and

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physiology and how

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Living creatures work and I always really love that and I volunteered at an early age

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I think I was in seventh grade because nobody in my family was in medicine my dad was a Greek immigrant worked in a factory welding army tanks together

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And I was the only one that pursued medicine and I volunteered in an emergency room

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In the hospital where I was born in Northwest Indiana and just to see and get exposed to it because back then

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We didn't have George Clooney and emergency and all these like graze anatomy shows. We had mash

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And we had there was a show called emergency back there

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Johnny with Johnny Gage and Roy DeSoto

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So it actually was one of my early I remember that one

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I remember that squad 51 and Dr. Becker with the sideburns. Yep. I do

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I wanted to be a firefighter paramedic just like Johnny Gage and Roy DeSoto

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So I said that's what I want to do and then maybe I can be an ER doctor too

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So I think it started a young age even back I can think seventh grade is probably the earliest I can think

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And then I worked my way through medical school by driving an ambulance

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I became an EMT in college and then I've always kind of forged this path toward emergency medicine

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Which always excited me because you get for the reason you mentioned there's always crazy stories

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I can think you know I've been doing this 28 years

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I can tell you a lot of stories some of them probably not rated PG

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You know things that you know for bodies where they don't belong and things like that but but the

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The craziest story I think was right out of residency

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I remember working we had a hospital that was in a rural setting in Kansas

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And I also worked in the in the city hospital as well

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And I was working there one night and some guy comes carrying in this guy in his 40s

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And he was limp and he came in saying help me help me my my my nephews or my my my uncle's dead

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And he came so he threw him on the stretcher. We started to cut off his clothes

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and

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We're doing all the things we do when we think we have a cardiac arrest and there's all this excitement

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And we're in this little rural hospital. We have eight beds

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You know we don't see that kind of stuff that often

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And he sits birth upright in bed and says stop don't cut my car hearts

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And he woke up and it was fine

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And we were like trying to wake him up the whole time and he was just totally unconscious

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Playing possum apparently

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He had a family member. They were in some dispute over some inheritance and

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He thought the only thing he could think of and there was a rifle pointed right at him

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And he said the only thing he could think of was to fake his death and grab his chest and collapse at the ground and pretend like he had a hard massive heart attack

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And then we

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I guess the relative that was pointing the gun felt guilty and he dropped the gun picked him up and I brought him the hospital

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Some of you's just trying to scare him and he wasn't really gonna shoot him and I said oh my god

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He got to be kidding and the guy was fine and

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I said why did you why did you think of this because I don't know I saw them TV once and it seemed like a good thing to do and it got him out of a jam

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And he was a goodie man. He cut his car hearts. I guess they're pretty expensive overalls

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But that was only years ago, but I just remember like it was just the craziest thing

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But yeah, it's been it's it they're all that's a great that's a great commercial

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Yeah, that's a great commercial for car heart. Yeah, it would be they should take they should pick that one up and make a commercial out of that

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Yeah, and then so red to clear out the waiting room because we didn't know if the guy was still loaded or armed with you know

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I got loaded gun so we had to call the sheriff out there and evacuate the waiting room. It was a big it was a big mess

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So so a lot of stories like that. I'd sort of love about it. The you know the variety you never know what to expect and it is stressful

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Probably got most of my gray hair, but I do enjoy I still practice every other weekend

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Even though I work full-time as a medical director at Abbott when I care diagnostics

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I do like to take part in patient care. I don't want to give that up and I still enjoy being able to help people in their time of need

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You know, it's not fun to be in the ER and we'll maybe touch on some of that you know waiting times are long and it's a stressful part of the day and

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Nobody really wants to be there, but if you can help people in their time of need it's it's a good feeling. Yeah, I will bless to be able to do that. Yeah

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Well, it's it's nice to know that there's talent that as you're waiting to get into the ER and whatever

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You know amality that you have

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You know as you're waiting it's good to know that there's competent people like yourself that are waiting for me to take care of me

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That's all I care about

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We're practicing medicine and we're gonna keep practicing till we get it right. That's the

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Adagia head. Yeah

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Yeah, I'm curious about titles. So there you have this title board certified

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Emergency medicine physician

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What what does that mean a board certified?

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So when you finish medical school you have to go through different residency programs depending on your specialties

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So to become board certified by the American board of emergency medicine

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You have to go through a three or four year training program after medical school to learn to be a physician in that field

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So if you're a pediatrician you go for three years if you are a surgeon

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You typically go five years card of thoracic surgeons go seven years or more plastic surgeons

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So so board certified

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Emergency medicine means I was trained to handle all life threatening emergencies and what from delivering babies to traumas to strokes hard attacks and

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And so forth

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So you have to be a kind of a jack of all trades

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We rotate through all the different departments of the hospital so that you can be a

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skilled at being able to do anything you need to do at that time now back in the days in the 70s

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Before emergency medicine became a specialty anybody could be a family practice physician or an internist and they can move light in the ER

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So it wasn't always a specialty so there was not always a residency program to go to to become board certified

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It got recognized in the late 70s as a specialty of itself just like internal medicine, pediatrics and

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Androchronology and so forth. So that's what that means is is you have to pass a board exam and it's a pretty stringent process

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And then to keep up the license you have to go through continuing medical education and so forth

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Yeah, yeah, and then you've also in your past and I

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I'm assuming presently are you teaching in a university?

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I was and I enjoy that too

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So it's another way of giving back and you know when you've been doing as long as I have

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It's actually great and very fulfilling to be able to teach skills and teach

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Emergency medicine to young docs that are right out of medical school that wanted going to emergency medicine as a specialty

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So I did that at University of Kansas Medical Center for almost 10 years as a part-time faculty there

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Before moving to New York City during the pandemic, which seemed like a good idea at the time

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Yeah, yeah, and then you've and then you were also

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A contributor or you wrote a textbook is that correct on the psychology of aging?

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I didn't write a textbook, but I'll take credit for that

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But uh, okay

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That was another guest I have published some articles

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pertaining to my specialty and and some of the other things I've done in my career

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But but not not the textbook article that wasn't me

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Yeah, all right, so so

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And I made this statement that there's over five million

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Concussions reported in the ER room

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That's that's a lot

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What's going on there? It is and actually we see and that's half of what we what we know is happening

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so most people hit their head

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And don't even go to the hospital so we know it's under reported and under recognized

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For one, but we do get at least five million visits to the emergency room for a head injury

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Not all head injuries result in concussions

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That's important to remember and some head injuries can be more serious and involve other complications

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Not just a concussion, but structural injury to the brain bleeding in the brain bruising of the brain and skull fractures and other things

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So that it's a kind of a

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Continuum so there's mild head injuries moderate and severe so it depends on the mechanism of injury

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But concussions overall are under reported and there's a lot of misconceptions among the public about what a concussion is because everyone thinks

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It's just athletes that suffer concussions and in fact probably 95% of the ones we see are are not an athlete

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So they're the you know regular people tripping on the rug in the living room or losing their balance on the sidewalk

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Or tripping on the sidewalk and hitting their head is not necessarily athletes

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It's actually a smaller percentage of what we see in the emergency room that are attributed to sports

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Yeah, yeah, so so let's start with what is a concussion

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What's what's the the definition for whether it's in the medical side or on the street side, you know, for just people in general

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What what is a concussion the simplest explanation or definition would be a blow to the head that causes

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Disruption of the brain's ability to function properly so that blow could be in the way of

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Acceleration and deceleration like when you're in a car accident and you stop abruptly the brain can kind of move in forward and back

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Within the skull itself

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It could be a blast injury as you see in the military or it can be a direct blow to the head and you can also get penetrating

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Injuries to the brain, but that's less common when we're talking about concussions. We're usually talking about blunt trauma

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But that impact can cause stretching and tearing of some of the fibers and axons and all the things that make the the brain function

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All the neurotransmitters and chemicals that make our brain work the way it does for our memory and our behavior and our motions

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Those things don't work properly when those those structural injuries to the brain occur and sometimes those symptoms can be very vague and

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And delayed and may not always be evident on imaging when we see people in the hospital

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So so describe what's

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Underneath our our skin in in the brain, you know to to us, you know because as I understand it

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There's a fluid that encircles the brain to keep sit kind of floating and

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Protected from from blows and traumas like you were just describing

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Yeah, there is your brain is basically floating in cerebral spinal fluid

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Which also goes all the way around your spinal cord and into your back

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But more importantly, there's a lining around the brain called the meninges

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And so when you have a blow to the head you can get sometimes shearing of blood vessels that can cause bleeding

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So you get bleeding around the brain you can get bleeding underneath that membrane

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You can get bleeding within the brain itself

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But these blows can cause injuries structural injuries to the brain itself

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um

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and uh

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That that can be sometimes very serious or life-threatening now in most cases when we're talking about concussions

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um, you do have some ability to absorb that blow and some people do fine and don't have any any symptoms or any complications

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But there are a lot of people that can have

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ongoing problems from that blow to the head and depending on what part of the brain is affected because different parts of the brain

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Control different things the the symptoms you have will vary based on what part of your head was impacted

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So that that fluid is really important to protecting the brain if if that's true

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Then how does aging affect so in other words when i'm young maybe in my 20s or 30s is there a certain amount of

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Bounces of this fluid that are floating around you know to protect the brain and then as we age does

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Does that fluid diminish over time or if i had a concussion is it like popping a hole like in a balloon and then i've got leakage and then i lose some of that fluid

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How does all that work i'm curious about that

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That's a great question um, i haven't had that many people asking you that it's not so much the fluid that changes

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It's actually the brain density itself so you can imagine your skull is fixed right once you your adult and your your

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Growth plates of fuse your skull's not going to grow any bigger as you get older as an adult but the brain will shrink

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So as we get older there's invariably some degree of atrophy that will occur especially in really older patients that are

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Above the age of 75 when the brain will shrink a little bit you have a little more space

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It's not quite as tight so you have a 20 year old brain or a 10 year old brain

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It's pretty tight so if there's any bleeding in the brain it can be quite serious because it doesn't tolerate that extra pressure

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But when you have somebody with atrophy of the brain and elderly people for instance they can have a fall

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And not only can they have a concussion which is important for us to discuss today but

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They can also have bleeding around the brain or blood clot. We call it a subdural hematoma

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Where it can happen underneath that lining that we talked about earlier

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And that blood clot may go unnoticed they may not have symptoms because they can tolerate

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You know a couple tablespoons of blood and not have a headache and not have symptoms because of that atrophy that occurs

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There's a little bit more space in there for it to tolerate that blood

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And they sometimes people come to the ER a month later and they'll say you know

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Gramma Mary is not acting right it's a little confused not quite as sharp

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And you do a cat scan you find they've got a blood clot around the brain

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So that's what happens as you get older is the ability to pick these things up and have symptoms

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Is lessened and so sometimes it can be very vague symptoms can be very mild people present in a delayed fashion

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And more importantly as we get older the the aging population are more commonly on blood thinners

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00:17:20,080 --> 00:17:27,200
So that's you know going to make things even worse because the risk of bleeding around the brain or within the brain is going to be even higher

209
00:17:27,200 --> 00:17:30,880
As we age and especially if you're on these blood thinners

210
00:17:30,880 --> 00:17:36,480
Mm-hmm. Well, let's talk a little bit about the signs and symptoms

211
00:17:36,480 --> 00:17:44,620
So let's say I'm walking in the house and I trip on the carpet or I slip on the floor with my socks

212
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And I take a thud

213
00:17:47,420 --> 00:17:53,580
Okay, so how serious then and this is really common with seniors especially

214
00:17:53,580 --> 00:17:58,300
So how serious do I take that fall and then as I'm

215
00:17:58,300 --> 00:18:07,020
Observing what's going on? What are some of the signs and symptoms that I should be looking for to know whether I should take mom

216
00:18:07,020 --> 00:18:08,860
Dad myself to the ER

217
00:18:09,820 --> 00:18:15,900
Well, there's signs or symptoms that are more serious that require urgent evaluation for sure

218
00:18:15,900 --> 00:18:19,580
And that's the things I alluded to with bleeding around the brain and so forth

219
00:18:19,580 --> 00:18:25,180
So the things we look for in the emergency room are some red flags which prompt us to do a cat skin

220
00:18:25,180 --> 00:18:27,260
So it's loss of consciousness

221
00:18:27,260 --> 00:18:29,100
Altered mental status

222
00:18:29,100 --> 00:18:31,420
Seasures persistent vomiting

223
00:18:31,420 --> 00:18:34,620
And those kinds of things usually have some amnesia

224
00:18:34,620 --> 00:18:38,220
But someone's not acting right immediately after head injury

225
00:18:38,460 --> 00:18:42,060
You have to assume there's some major injury there or until proven otherwise now

226
00:18:42,060 --> 00:18:46,860
Most concussions I would say 90% of them don't have those structural problems

227
00:18:46,860 --> 00:18:49,180
you can hit your head and

228
00:18:49,180 --> 00:18:51,260
Not have those signs and symptoms

229
00:18:51,260 --> 00:18:54,460
And it doesn't mean there's no brain injury that doesn't mean there's no concussion

230
00:18:54,460 --> 00:18:56,300
It just may not be something

231
00:18:56,300 --> 00:19:02,940
Serious like I would describe with the bleeding around the brain and so concussion symptoms are a little bit more subtle

232
00:19:02,940 --> 00:19:04,220
It can be headache

233
00:19:04,220 --> 00:19:07,020
It can be trouble with balance, dizziness, nausea

234
00:19:07,740 --> 00:19:10,780
A little bit of confusion some people will have some amnesia

235
00:19:10,780 --> 00:19:12,860
Some people will have a brief loss of consciousness

236
00:19:12,860 --> 00:19:18,460
But the majority of people with a mild brain injury or concussion will not have a loss of consciousness

237
00:19:18,460 --> 00:19:20,460
So they'll usually stay awake

238
00:19:20,460 --> 00:19:22,140
And

239
00:19:22,140 --> 00:19:24,540
Sometimes people have trouble remembering details

240
00:19:24,540 --> 00:19:26,540
They'll have some retrograde amnesia

241
00:19:26,540 --> 00:19:28,620
If you're having trouble concentrating

242
00:19:28,620 --> 00:19:32,140
And these things can happen within hours or can happen within days or weeks

243
00:19:32,140 --> 00:19:33,500
So it varies

244
00:19:33,500 --> 00:19:36,220
And that's why it's important if you don't feel right

245
00:19:36,220 --> 00:19:40,140
Something's not right and you probably should go to the hospital and get checked out

246
00:19:40,140 --> 00:19:43,980
Now we won't always do a cat scan on every single person that comes into the ER

247
00:19:43,980 --> 00:19:48,220
And that's the common misconception because the people that come in think

248
00:19:48,220 --> 00:19:49,820
Well, I must add a concussion

249
00:19:49,820 --> 00:19:52,460
I want a cat scan to tell me whether I had a confession or not

250
00:19:52,460 --> 00:19:53,660
And that's not how it works

251
00:19:53,660 --> 00:19:58,460
The cat scans we do aren't there to diagnose a concussion

252
00:19:58,460 --> 00:20:03,020
We do a cat scan to detect those things I describe which are more life-threatening

253
00:20:03,020 --> 00:20:05,340
Which happens less than 10% of the time

254
00:20:05,340 --> 00:20:09,020
It's bleeding around the brain, bruising of the brain, skull fractures

255
00:20:09,020 --> 00:20:11,660
That's what the cat scan can pick up, pick up

256
00:20:11,660 --> 00:20:15,900
90% of people that actually have a concussion will have a normal cat scan

257
00:20:15,900 --> 00:20:18,380
So we do over-utilize cat scans sometimes

258
00:20:18,380 --> 00:20:22,460
And the people think, "Well, my cat scan's okay, that means I'm fine, right? I didn't have a concussion

259
00:20:22,460 --> 00:20:24,140
That's far from the truth

260
00:20:24,140 --> 00:20:27,100
This head injury may lead to chronic symptoms

261
00:20:27,100 --> 00:20:29,980
And those symptoms of dysonis headache, insomnia

262
00:20:29,980 --> 00:20:31,980
Those can linger for months or years

263
00:20:31,980 --> 00:20:38,540
Sometimes, so it's important to get help, be evaluated, let the doctor decide whether you need imaging or not

264
00:20:38,540 --> 00:20:41,900
And then try to make sure you get the referral to a specialist

265
00:20:41,900 --> 00:20:44,780
They have neurologist and concussion specialists

266
00:20:44,780 --> 00:20:49,100
And in some places that can are skilled at dealing with this

267
00:20:49,100 --> 00:20:52,380
And detecting whether you've had a concussion or not

268
00:20:52,380 --> 00:20:55,180
And detecting how severe it is so they can help you

269
00:20:55,180 --> 00:20:58,140
Determine how to go back to your normal routine

270
00:20:58,140 --> 00:21:03,820
So the principal, no blood, no foul doesn't apply in this case with concussions

271
00:21:03,820 --> 00:21:07,420
In other words, I used to say naively

272
00:21:07,420 --> 00:21:14,140
I used to say, "Well, if there wasn't any blood when mom, dad, fell, then they're gonna be okay

273
00:21:14,140 --> 00:21:17,340
And yet, that's not always true

274
00:21:17,340 --> 00:21:23,580
You know, because blood usually comes from abrasion from the skin

275
00:21:23,580 --> 00:21:28,780
But that doesn't have any indicator towards what's going on inside the brain

276
00:21:28,780 --> 00:21:29,980
That's absolutely right

277
00:21:29,980 --> 00:21:32,380
When you twist your ankle, it swallows up right away

278
00:21:32,380 --> 00:21:33,820
You can see it right in front of you

279
00:21:33,820 --> 00:21:37,580
That you have a full and ankle, something that right either sprained it or I might have broken it

280
00:21:37,580 --> 00:21:40,380
But with your brain, you don't know what's going on underneath the skull

281
00:21:40,380 --> 00:21:42,140
You don't have to have a big goose egg

282
00:21:42,140 --> 00:21:43,580
You don't have to have an abrasion

283
00:21:43,580 --> 00:21:47,580
And you certainly shouldn't have any fluid leaking out of your nose or out of your ear

284
00:21:47,580 --> 00:21:49,660
If you do have that, that's pretty serious

285
00:21:49,660 --> 00:21:51,820
And you might have a basilar skull fracture

286
00:21:51,820 --> 00:21:59,180
But we typically don't see any outward signs of head injury with most mild concussions that we see

287
00:21:59,180 --> 00:22:03,580
Now, if there's a big goose egg, I'm gonna be more concerned and I might do a cat scan

288
00:22:03,580 --> 00:22:03,980
Yeah

289
00:22:03,980 --> 00:22:09,100
Depending on the mechanism, if they lost consciousness and have those other signs and symptoms I talked about

290
00:22:09,100 --> 00:22:13,180
But the problem is, why it's difficult to diagnose the brain

291
00:22:13,180 --> 00:22:16,060
And that's why it's really exciting with some of the technology

292
00:22:16,060 --> 00:22:17,740
Which maybe we can touch on

293
00:22:17,740 --> 00:22:20,300
That's come out now that wasn't around 25 years ago

294
00:22:20,300 --> 00:22:21,900
And it wasn't training

295
00:22:21,900 --> 00:22:24,860
We're able to see what's going on with the brain with blood tests now

296
00:22:24,860 --> 00:22:26,620
Which before we didn't have that

297
00:22:26,620 --> 00:22:28,140
We just did our exam

298
00:22:28,140 --> 00:22:30,140
And we

299
00:22:30,140 --> 00:22:33,260
You know, kind of made a judgment call whether we needed to do imaging

300
00:22:33,260 --> 00:22:35,820
And it was really hard to know what's going on under the brain

301
00:22:35,820 --> 00:22:37,260
Like when you have a chest pain

302
00:22:37,260 --> 00:22:39,020
We can draw blood tests and measure

303
00:22:39,020 --> 00:22:41,340
Approaching in the bloodstream, called trapponin

304
00:22:41,340 --> 00:22:44,300
That's elevated, tells us whether it was damaged to the heart

305
00:22:44,300 --> 00:22:46,860
And when we have liver injury or kidney injury

306
00:22:46,860 --> 00:22:52,460
Almost all the organs in the body have some blood tests that we can use to diagnose and assess

307
00:22:52,460 --> 00:22:56,940
But we didn't up until now have anything like that to assess the brain

308
00:22:56,940 --> 00:23:00,380
In combination with cat scans and a good neurologic exam

309
00:23:00,380 --> 00:23:09,900
Yeah, so if a senior falls on the floor and you attend to them right away

310
00:23:09,900 --> 00:23:12,300
And you start observing what's going on

311
00:23:12,300 --> 00:23:15,340
And you're going, "Oh, everything seems to be fine"

312
00:23:16,540 --> 00:23:18,700
But that's not necessarily true

313
00:23:18,700 --> 00:23:23,180
And so there could be some delayed symptoms as what you're saying

314
00:23:23,180 --> 00:23:31,740
How often should I as the adult child in the situation that came and checked on mom

315
00:23:31,740 --> 00:23:34,460
And she says, "Oh, I fell earlier today"

316
00:23:34,460 --> 00:23:39,740
I think it's important to check back if you're an adult child

317
00:23:39,740 --> 00:23:41,900
Even though you're not living with mom

318
00:23:41,900 --> 00:23:46,220
How often should we check back to say, "Hey, you okay?"

319
00:23:46,220 --> 00:23:48,620
Or, "Should I do it over the phone?"

320
00:23:48,620 --> 00:23:51,020
"Should I come over and make some observation?"

321
00:23:51,020 --> 00:23:56,540
I mean, these are really practical things that I think we should be paying attention to

322
00:23:56,540 --> 00:24:00,060
Yeah, and that's tough, you know, it depends on how bad the injury is

323
00:24:00,060 --> 00:24:05,180
Of course, you know, in the hospital we're always doing neurology checks on patients every couple of hours

324
00:24:05,180 --> 00:24:07,900
Right, because things can change over time

325
00:24:07,900 --> 00:24:13,180
That's not practical if you're not living in the same household or in the same city for that matter

326
00:24:13,180 --> 00:24:15,900
That's why I think it's important to try to get somebody there

327
00:24:16,380 --> 00:24:20,140
That's the most important advice I can give is if there's been a head injury

328
00:24:20,140 --> 00:24:22,300
They should be observed kind of continuously

329
00:24:22,300 --> 00:24:26,140
Somebody should be there with them and not be a lot let them be alone

330
00:24:26,140 --> 00:24:28,140
Because they could start getting worse

331
00:24:28,140 --> 00:24:32,540
And you really won't know and it's hard to say, you know, every couple hours, every four hours

332
00:24:32,540 --> 00:24:36,300
That's why it's important to err on the side of caution

333
00:24:36,300 --> 00:24:39,180
And seek, you know, evaluation when you're not really sure

334
00:24:39,180 --> 00:24:40,860
Especially if it's an unwitnessed fall

335
00:24:40,860 --> 00:24:43,900
A lot of elderly will fall and it wasn't really witnessed

336
00:24:43,900 --> 00:24:47,980
And you ask them if they were knocked out or not, they can't tell you because they won't remember

337
00:24:47,980 --> 00:24:49,980
If they were knocked out or not

338
00:24:49,980 --> 00:24:56,380
And so that's where it gets a little riskier as nobody was really there to see the fall

339
00:24:56,380 --> 00:24:59,180
But that happened with my father who recently passed away

340
00:24:59,180 --> 00:25:02,380
At the right young age of 100 years and one month

341
00:25:02,380 --> 00:25:06,940
He had an unwitnessed fall and my mom didn't think anything of it

342
00:25:06,940 --> 00:25:10,940
He seemed to be acting okay and he came to the hospital later for other reasons

343
00:25:10,940 --> 00:25:15,660
And then when they scanned his head, was there doing their thorough work up, they found a blood clotter on his brain

344
00:25:15,660 --> 00:25:19,420
From a fall that happened presumably a week or two earlier

345
00:25:19,420 --> 00:25:22,540
And he just never sought medical attention because I'm fine

346
00:25:22,540 --> 00:25:24,220
I've got a little headache and I'm okay

347
00:25:24,220 --> 00:25:27,260
So a lot of people minimize it

348
00:25:27,260 --> 00:25:30,700
But it's important to have family members or friends

349
00:25:30,700 --> 00:25:36,060
You know, be there to observe the person if there's been a head injury especially within the first 24 hours

350
00:25:37,500 --> 00:25:43,180
Yeah, I think the key word that you said was he thought he had a little headache

351
00:25:43,180 --> 00:25:46,220
If you have any headache at all after a fall

352
00:25:46,220 --> 00:25:51,020
How serious should I take this and getting myself down to the ER

353
00:25:51,020 --> 00:25:58,380
You should take it very seriously and that's where it gets, you know, the water gets muddy a little bit when they show up in the emergency room

354
00:25:58,380 --> 00:26:02,380
And they have a histocronic migraines or maybe they were drinking the night before

355
00:26:02,380 --> 00:26:05,820
And the next morning they think their headache is due to a hangover

356
00:26:05,820 --> 00:26:08,620
Oh, I just drank some cheap wine, I'll be fine

357
00:26:08,620 --> 00:26:11,340
I'm just a little nauseated and I've got a headache from that

358
00:26:11,340 --> 00:26:13,180
And then you don't really know

359
00:26:13,180 --> 00:26:16,460
So I think but any headache is cause for concern

360
00:26:16,460 --> 00:26:21,020
And those headaches can be persistent for some people that have concussions

361
00:26:21,020 --> 00:26:23,900
Some people get better on their own

362
00:26:23,900 --> 00:26:27,180
But it's important to get advice and seek medical attention

363
00:26:27,180 --> 00:26:29,500
Because it could be a sign of something more serious

364
00:26:29,500 --> 00:26:32,300
Especially again, the aging population on blood thinners

365
00:26:32,300 --> 00:26:36,380
That's a big red flag, headache, fall, head injury

366
00:26:36,380 --> 00:26:39,420
You know, that's a bleed until proven otherwise

367
00:26:39,420 --> 00:26:41,020
Now we're always concerned about concussion

368
00:26:41,020 --> 00:26:44,380
But we're more concerned about missing that serious complication

369
00:26:44,380 --> 00:26:50,460
Did you know that 5 million Americans go to the ER for concussion every year

370
00:26:50,460 --> 00:26:54,700
But more than half of the people who suspect they have a concussion

371
00:26:54,700 --> 00:26:55,740
Never get it checked

372
00:26:55,740 --> 00:26:58,140
This is a serious problem

373
00:26:58,140 --> 00:27:00,300
As concussions can lead to memory problems

374
00:27:00,780 --> 00:27:04,460
Headaches, depression and more if left untreated

375
00:27:04,460 --> 00:27:07,900
For your best shot at a full recovery

376
00:27:07,900 --> 00:27:10,380
Get professional medical help immediately

377
00:27:10,380 --> 00:27:14,380
This did you know moment was provided by today's guest

378
00:27:14,380 --> 00:27:18,540
And is brought to you by Royal Hospice of Oregon

379
00:27:18,540 --> 00:27:25,100
Yeah and concussions, anyway, I think this is pretty obvious

380
00:27:25,100 --> 00:27:27,820
But concussions really are not age related

381
00:27:27,820 --> 00:27:30,380
So I'm going to tell a share of story with you

382
00:27:30,380 --> 00:27:37,260
To prove that point and I'm sure that many out there have had similar stories

383
00:27:37,260 --> 00:27:40,460
And that is my son who is a long-border

384
00:27:40,460 --> 00:27:42,380
Escape-border

385
00:27:42,380 --> 00:27:47,020
And they were really, it was really common to long-border to classes

386
00:27:47,020 --> 00:27:49,020
Going to the university

387
00:27:49,020 --> 00:27:54,300
His brother-in-law was long-bording, fell off his long-border

388
00:27:55,420 --> 00:27:58,140
Went home and went to sleep

389
00:27:58,140 --> 00:28:02,140
And nobody knew where he was

390
00:28:02,140 --> 00:28:04,220
He'd just walked into his apartment

391
00:28:04,220 --> 00:28:08,860
And the next morning they found him, you know, delirious

392
00:28:08,860 --> 00:28:11,340
And you know, half conscious

393
00:28:11,340 --> 00:28:12,780
And so they took him to E.E.R.

394
00:28:12,780 --> 00:28:19,020
And found that he'd literally had a, I don't know if it was a concussion

395
00:28:19,020 --> 00:28:20,940
But there was bleeding around

396
00:28:20,940 --> 00:28:22,780
I don't know if that's part of some of the

397
00:28:22,780 --> 00:28:25,980
What's going on with a concussion is bleeding around the brain

398
00:28:25,980 --> 00:28:30,780
And he ended up losing his life over it at the age of 2022

399
00:28:30,780 --> 00:28:32,460
And that's just too young

400
00:28:32,460 --> 00:28:36,140
So, falls you've got to take serious, doesn't matter your age

401
00:28:36,140 --> 00:28:39,580
That's exactly right and I'm so sorry for that

402
00:28:39,580 --> 00:28:41,260
That's horrible

403
00:28:41,260 --> 00:28:42,780
And it can happen at any age

404
00:28:42,780 --> 00:28:44,300
It can happen to a young brain

405
00:28:44,300 --> 00:28:45,900
It can happen to an older brain

406
00:28:45,900 --> 00:28:48,060
We have to protect our brain, we only have one

407
00:28:48,060 --> 00:28:50,300
And so you never want to take a chance

408
00:28:50,300 --> 00:28:51,500
You know, you just never know

409
00:28:51,500 --> 00:28:52,780
It could be something mild

410
00:28:52,780 --> 00:28:54,620
And I wouldn't say concussions are mild

411
00:28:54,620 --> 00:28:56,460
You know, when we get the bleeding around the brain

412
00:28:56,460 --> 00:28:58,940
We talk that we call that medically a moderate

413
00:28:58,940 --> 00:29:01,580
To severe traumatic brain injury or TBI

414
00:29:01,580 --> 00:29:04,220
The concussions are by definition the mild ones

415
00:29:04,220 --> 00:29:08,300
So they're typically awake, alert, oriented

416
00:29:08,300 --> 00:29:11,660
You know, no major concerning symptoms

417
00:29:11,660 --> 00:29:13,020
But I wouldn't say it's mild

418
00:29:13,020 --> 00:29:16,220
Because when they've done some studies on patients and follow up

419
00:29:16,220 --> 00:29:20,540
They found 17% of patients with mild concussions

420
00:29:20,540 --> 00:29:23,420
Were unemployed a year after their head injury

421
00:29:23,420 --> 00:29:25,900
Well, if you lose your job because you can't sleep

422
00:29:25,900 --> 00:29:28,220
And you have persistent headaches and depression

423
00:29:28,220 --> 00:29:31,820
And insomnia and difficulty concentrating

424
00:29:31,820 --> 00:29:35,020
I would say that that's probably not mild at all

425
00:29:35,020 --> 00:29:37,980
So the nomenclature is actually changing in the near future

426
00:29:37,980 --> 00:29:39,900
The medical community is getting together

427
00:29:39,900 --> 00:29:44,220
All these experts in neurology and psychology are gathering

428
00:29:44,220 --> 00:29:47,740
To change the redefinition of head injury

429
00:29:47,740 --> 00:29:49,820
So it's no longer mild moderate severe

430
00:29:49,820 --> 00:29:53,900
We're going to be using a different framework to classify these head injuries

431
00:29:53,900 --> 00:29:59,260
That's why it does need to be something that people are cognizant of

432
00:29:59,260 --> 00:30:02,060
And that they get followed for so they can get help

433
00:30:02,060 --> 00:30:05,260
And again, rule out that really bad bleed

434
00:30:05,260 --> 00:30:08,780
That might take the life of someone if it goes unnoticed

435
00:30:08,780 --> 00:30:11,660
But more importantly, if you don't have the bleed, which as I mentioned

436
00:30:11,660 --> 00:30:13,900
90% of the people we see in the ER

437
00:30:13,900 --> 00:30:16,780
If we did a CAT scan on them, the CAT scan is going to be normal

438
00:30:16,780 --> 00:30:22,300
Now they may have still a lot of concussion, we have to do MRI scans and other neurocognitive testing

439
00:30:22,300 --> 00:30:24,620
And those things again need to be taken seriously

440
00:30:24,620 --> 00:30:26,220
Because there are things we can do

441
00:30:26,220 --> 00:30:29,740
Now there are therapies that may help them get over their symptoms

442
00:30:29,740 --> 00:30:33,500
And minimize the risk of persistent post-concussion symptoms

443
00:30:33,500 --> 00:30:38,380
Yeah, yeah, I think the moral of the story is

444
00:30:38,380 --> 00:30:41,260
If you do fall, it doesn't matter what age you are

445
00:30:41,260 --> 00:30:44,940
Whether you're 22 or 122

446
00:30:44,940 --> 00:30:47,180
Tell somebody that you've fallen

447
00:30:47,180 --> 00:30:50,540
And because you just don't know

448
00:30:50,540 --> 00:30:54,380
And if you don't share that story with somebody else

449
00:30:54,380 --> 00:30:56,620
That can help observe and watch you

450
00:30:56,620 --> 00:31:01,340
But there's something interesting about the psychology of us as human beings is

451
00:31:01,340 --> 00:31:02,860
It was nothing

452
00:31:02,860 --> 00:31:04,940
You know, I've fallen all my life

453
00:31:04,940 --> 00:31:08,700
And but yet I think as a senior, especially

454
00:31:08,700 --> 00:31:13,580
Make sure that you share that information

455
00:31:13,580 --> 00:31:17,820
With somebody so that there can be somebody to look after you

456
00:31:17,820 --> 00:31:19,420
In case something does happen

457
00:31:19,420 --> 00:31:23,180
That's absolutely right

458
00:31:23,180 --> 00:31:24,940
And now we have a lot

459
00:31:24,940 --> 00:31:26,620
We have a lot more we can do

460
00:31:26,620 --> 00:31:30,940
We've learned a lot over the last few decades about concussions and about assessing people

461
00:31:30,940 --> 00:31:34,460
I think a lot of people as we talked about before

462
00:31:34,460 --> 00:31:36,300
Half the people won't even show up

463
00:31:36,300 --> 00:31:38,460
So half the people don't even get assess

464
00:31:38,460 --> 00:31:41,340
So we may find there are more and more concussions out there

465
00:31:41,340 --> 00:31:44,540
That we never see in the emergency room or never get diagnosed

466
00:31:44,540 --> 00:31:46,700
I know it happens a lot with athletes because they

467
00:31:46,700 --> 00:31:50,940
They minimize their symptoms and they don't want to get pulled out of the game and be sideline

468
00:31:50,940 --> 00:31:54,460
But even again in the aging population

469
00:31:54,460 --> 00:31:55,740
They just want to minimize things

470
00:31:55,740 --> 00:31:58,140
Oh, be fine, I've got a headache, I'm tired

471
00:31:58,140 --> 00:31:59,820
I'm dizzy, I'm just getting old

472
00:31:59,820 --> 00:32:01,020
You know, that's how my dad was

473
00:32:01,020 --> 00:32:04,380
He just kind of brushed it off and didn't think anything of it

474
00:32:04,380 --> 00:32:06,220
Didn't associate the two together

475
00:32:06,220 --> 00:32:10,060
So but we again, we have more technology now

476
00:32:10,060 --> 00:32:14,620
We have a blood test that you know Abbott has this iStat TBI cartridge

477
00:32:14,620 --> 00:32:18,380
We can actually detect with two drops of blood

478
00:32:18,380 --> 00:32:23,020
When people come in we can determine whether or not they had an injury

479
00:32:23,020 --> 00:32:26,300
Severe enough to cause bleeding or require a cat scan

480
00:32:26,300 --> 00:32:29,020
Because part of the reason I think people don't want to go to the hospital

481
00:32:29,020 --> 00:32:31,660
They don't want to wait, they don't want to be in the waiting room

482
00:32:31,660 --> 00:32:35,020
And some people are worried about the cost

483
00:32:35,020 --> 00:32:38,860
They don't have health insurance and they're worried about the radiation of the cat scan

484
00:32:38,860 --> 00:32:43,100
So what's nice now is that we have a way that we can quickly assess people

485
00:32:43,100 --> 00:32:48,380
More objectively with this blood test that measures these two brain-specific biomarkers

486
00:32:48,380 --> 00:32:51,900
And in the absence of elevation of either of those biomarkers

487
00:32:51,900 --> 00:32:55,420
Now, eyes of physician can tell this person reassure them

488
00:32:55,420 --> 00:32:58,460
You're fine, you had a head injury, it's mild

489
00:32:58,460 --> 00:33:04,300
You don't need a cat scan, the likelihood of you having a significant concussion is pretty minimal

490
00:33:04,300 --> 00:33:07,420
And you can go to sleep and not worry about not waking up in the morning

491
00:33:07,900 --> 00:33:13,660
And that's what people worry about, they come in and say, "Well, do I need to wake the person up every two hours?"

492
00:33:13,660 --> 00:33:14,860
"Do I need to stay with them?"

493
00:33:14,860 --> 00:33:21,260
Well, having this blood test now will allow us to be able to objectively tell people

494
00:33:21,260 --> 00:33:25,420
How much at risk they are and send them home quickly, which is really exciting

495
00:33:25,420 --> 00:33:28,700
I find that fascinating, how?

496
00:33:28,700 --> 00:33:32,060
How from two drops of blood you said

497
00:33:32,060 --> 00:33:36,140
Can you learn something that there's some kind of trauma?

498
00:33:36,860 --> 00:33:39,980
What are their little cells in there that are saying, "Help me, help me?"

499
00:33:39,980 --> 00:33:48,300
What do you see through the microscope that says, "Hey, there's been a trauma here in a blood sample?"

500
00:33:48,300 --> 00:33:50,220
I just find that fascinating

501
00:33:50,220 --> 00:33:54,060
It is pretty fascinating and scientists have been working on this for a couple of decades

502
00:33:54,060 --> 00:33:59,340
Through work with the DOD Abbott helped to get this to market

503
00:33:59,340 --> 00:34:03,180
And actually, it's FDA-approved test, it's available now

504
00:34:03,180 --> 00:34:06,220
Not everybody in the hospital has it because it is so new

505
00:34:06,220 --> 00:34:10,140
But there are brain-specific proteins that are released into the bloodstream

506
00:34:10,140 --> 00:34:14,780
So those proteins should not be in the bloodstream when there's a brain injury

507
00:34:14,780 --> 00:34:15,740
Just like with the heart

508
00:34:15,740 --> 00:34:21,180
When you have a triponin in the blood, that measurement means it was damaged with the heart muscle

509
00:34:21,180 --> 00:34:23,180
It shouldn't be there, it's pretty specific

510
00:34:23,180 --> 00:34:25,420
So these markers are specific to the brain

511
00:34:25,420 --> 00:34:29,740
So when there's an injury, as I mentioned before, you get stretching and tearing

512
00:34:29,740 --> 00:34:33,580
Structural injury that causes this to leak into the bloodstream

513
00:34:33,580 --> 00:34:37,420
And if we can detect it with just a couple drops of blood, which is pretty fascinating

514
00:34:37,420 --> 00:34:42,540
They can measure the quantitative level that those markers are

515
00:34:42,540 --> 00:34:44,780
Because what research is now starting to show

516
00:34:44,780 --> 00:34:47,500
And where I think the future is promising is

517
00:34:47,500 --> 00:34:51,980
Based on how high those markers are, we might be able to do some risk stratification

518
00:34:51,980 --> 00:34:55,260
And prognostication to determine how bad their concussion is

519
00:34:55,260 --> 00:34:56,860
And they're likely to have recovery

520
00:34:56,860 --> 00:35:01,340
But what it's cleared for now by the FDA is kind of a rule out test

521
00:35:01,340 --> 00:35:05,900
So if neither of these markers are above the established cutoff

522
00:35:05,900 --> 00:35:08,940
Then we can pretty much rule out the need for a cat scan

523
00:35:08,940 --> 00:35:13,500
So that helps us as physicians to assess people quickly and objectively

524
00:35:13,500 --> 00:35:16,300
And not immediately send them down the hall to get a cat scan

525
00:35:16,300 --> 00:35:19,500
Which may take three or four hours to get the results from

526
00:35:19,500 --> 00:35:21,500
And which they may not have needed

527
00:35:21,500 --> 00:35:24,300
Because 90% of the time it's going to be normal anyway

528
00:35:24,300 --> 00:35:27,900
So it really is changing how we assess people

529
00:35:27,900 --> 00:35:33,180
And we're hoping in the future this may be available now with a whole blood test

530
00:35:33,180 --> 00:35:37,340
A couple drops of blood in certain urgent cares and ambulances

531
00:35:37,340 --> 00:35:39,340
Maybe someday even in the playing field

532
00:35:39,340 --> 00:35:42,620
To be able to assess people right there at the point of injury

533
00:35:42,620 --> 00:35:45,980
Rather than having to transport them by ambulance to the hospital

534
00:35:45,980 --> 00:35:51,980
Well, what are the barriers from keeping that out of all the hospitals

535
00:35:51,980 --> 00:35:53,900
And all throughout the medical system

536
00:35:53,900 --> 00:35:55,900
I mean, that seems like a no-brainer

537
00:35:55,900 --> 00:35:57,900
No pun intended

538
00:35:57,900 --> 00:36:03,580
It is relatively new so there are societies now that have started to adopt

539
00:36:03,580 --> 00:36:05,820
Biomarkers as part of the assessment

540
00:36:05,820 --> 00:36:09,740
The American College of Surgeons establishes brain injury guidelines

541
00:36:09,740 --> 00:36:12,860
And that just last month actually they publish their guidelines

542
00:36:12,860 --> 00:36:16,860
So as these societies and as these guidelines start to mention this

543
00:36:16,860 --> 00:36:18,940
More and more clinicians will become aware of it

544
00:36:18,940 --> 00:36:23,020
And hospitals will put these devices in their in practice

545
00:36:23,820 --> 00:36:27,820
So the other barrier from like outpatient settings is regulatory bodies

546
00:36:27,820 --> 00:36:30,700
So there are certain types of complexity to testing

547
00:36:30,700 --> 00:36:32,700
So when you do diagnostic testing

548
00:36:32,700 --> 00:36:35,900
There's moderate complexity testing and high complexity testing

549
00:36:35,900 --> 00:36:39,740
So some sites have to have a license or registration

550
00:36:39,740 --> 00:36:42,460
By the lab regulatory bodies

551
00:36:42,460 --> 00:36:43,660
To be able to do that testing

552
00:36:43,660 --> 00:36:47,340
It's not like going to the drug store and getting your bi-next now test

553
00:36:47,340 --> 00:36:49,340
And doing your own self-colded test

554
00:36:49,340 --> 00:36:51,420
That's a different level of complexity

555
00:36:51,420 --> 00:36:56,460
So these tests can only be used in places that have that moderate complexity ability

556
00:36:56,460 --> 00:37:00,460
And many urgent cares do or places that have a stat lab

557
00:37:00,460 --> 00:37:02,460
You can't just put it up everywhere

558
00:37:02,460 --> 00:37:04,460
But that's where we hope the future will be

559
00:37:04,460 --> 00:37:07,820
I think that's where we'll start seeing this more in remote areas

560
00:37:07,820 --> 00:37:10,460
Where they don't always have a CAT scan available

561
00:37:10,460 --> 00:37:12,460
Urgent cares, walking clinics

562
00:37:12,460 --> 00:37:16,620
Again, ambulances to make decisions in the field

563
00:37:16,620 --> 00:37:19,180
Whether somebody really needs to go to the hospital or not

564
00:37:19,180 --> 00:37:23,180
But that's the only thing that's keeping it as it's how new it is

565
00:37:23,180 --> 00:37:26,860
And the lack of awareness by many physicians about these biomarkers

566
00:37:26,860 --> 00:37:30,220
And about the Abbott I-STAT TBI test that's available

567
00:37:30,220 --> 00:37:34,940
Is it a, so you get this little couple of samples of blood

568
00:37:34,940 --> 00:37:42,220
Is it a machine then that separates and analyzes the, is it an expensive process to get

569
00:37:42,220 --> 00:37:46,220
And how big is this machine? Is it a desktop?

570
00:37:46,220 --> 00:37:48,060
Is it a, Philip a room?

571
00:37:48,780 --> 00:37:52,940
Describe what that is and then I'm excited about

572
00:37:52,940 --> 00:37:55,420
You know, the same thing that you know, we did with COVID

573
00:37:55,420 --> 00:37:58,620
Where you swab the mouth or the nasal passage

574
00:37:58,620 --> 00:38:01,180
You know, to be able to take that blood test

575
00:38:01,180 --> 00:38:02,860
And boom, you can tell right there

576
00:38:02,860 --> 00:38:06,220
And how close are they to that level of technology?

577
00:38:06,220 --> 00:38:09,260
So that's a, I'll answer the first part

578
00:38:09,260 --> 00:38:11,340
So the machine varies

579
00:38:11,340 --> 00:38:14,860
So Abbott has these two biomarkers cleared

580
00:38:14,860 --> 00:38:17,820
On their big huge lab machines in the core lab

581
00:38:17,820 --> 00:38:20,220
So when you go to the hospital and you get blood drawn

582
00:38:20,220 --> 00:38:23,420
And we send it to the lab to do chemistries and other types of tests

583
00:38:23,420 --> 00:38:27,420
It's on their big machine, it's called a Linitii or architect

584
00:38:27,420 --> 00:38:31,020
That's the big lab machine that you'll see that does a lot of blood, you know, blood counts

585
00:38:31,020 --> 00:38:33,180
And chemistries and electrolytes and so forth

586
00:38:33,180 --> 00:38:35,660
So it's able to be done on that machine

587
00:38:35,660 --> 00:38:39,260
But it's also available on what's called, I referred to it earlier, it's called I-STAT

588
00:38:39,260 --> 00:38:43,260
And I practiced in Kansas City at hospital where we use this a lot

589
00:38:43,260 --> 00:38:46,460
It's a handheld analyzer that has cartridges

590
00:38:46,460 --> 00:38:48,380
Where you put a couple of drops of blood

591
00:38:48,380 --> 00:38:51,340
And it gives you results anywhere from two to 15 minutes

592
00:38:51,340 --> 00:38:54,060
So for blood gases and other types of tests

593
00:38:54,060 --> 00:38:55,500
It could take a couple of minutes

594
00:38:55,500 --> 00:38:58,380
For this brain injury test, it takes 15 minutes

595
00:38:58,380 --> 00:39:00,380
But you put the drops of blood in the cartridge

596
00:39:00,380 --> 00:39:03,100
You insert the cartridge in this handheld analyzer

597
00:39:03,100 --> 00:39:06,300
It's probably, I don't know how to compare it

598
00:39:06,300 --> 00:39:09,100
It's not that big, it's bigger than a TV remote

599
00:39:09,100 --> 00:39:11,260
But you can hold it with one hand

600
00:39:11,260 --> 00:39:13,740
Has a touchscreen, a color screen

601
00:39:13,740 --> 00:39:18,220
And the machine actually has micro-fluidics that occur

602
00:39:18,220 --> 00:39:19,900
It's pretty fascinating the technology

603
00:39:19,900 --> 00:39:26,140
But the cartridge has a way that the blood will actually go back and forth across sensors

604
00:39:26,140 --> 00:39:31,580
And so it's all, it's really a fancy technology called a lysos

605
00:39:31,580 --> 00:39:36,220
And the amino-asse, I won't get into the details of it on this call

606
00:39:36,220 --> 00:39:42,860
But it's a way of looking for these things with these sensors

607
00:39:42,860 --> 00:39:46,540
And just from those two drops of blood, the cartridges can do that

608
00:39:46,540 --> 00:39:50,380
The, the micro-fluidics that the analyzer is capable of

609
00:39:50,380 --> 00:39:53,980
To get it to pass that sample to pass back and forth across the sensors

610
00:39:53,980 --> 00:39:56,060
So I can't share the details of the secrets

611
00:39:56,060 --> 00:40:00,700
But it's not magic, it's definitely technology that's pretty amazing

612
00:40:00,700 --> 00:40:03,100
And the engineers are pretty phenomenal

613
00:40:03,100 --> 00:40:04,060
That have come across this

614
00:40:04,060 --> 00:40:05,740
Not only to be able to do a big machine

615
00:40:05,740 --> 00:40:07,500
We also do a handheld machine

616
00:40:07,500 --> 00:40:10,620
But we use that same, similar handheld machine

617
00:40:10,620 --> 00:40:15,180
Called iStat for other tests, as I mentioned, love emergency rooms across the country already

618
00:40:15,180 --> 00:40:18,860
Using that for things where they want the answer within a few minutes

619
00:40:18,860 --> 00:40:22,060
And the patients really critically ill and that we can't wait

620
00:40:22,060 --> 00:40:27,420
For the lab to send us the results which may take 30 to 60 minutes sometimes

621
00:40:27,420 --> 00:40:32,940
What's the accuracy rate of it? I mean, if you, I mean, if it is there any

622
00:40:32,940 --> 00:40:40,140
Anything that would cause, you know, a false positive or a false, you know, negative or

623
00:40:40,140 --> 00:40:41,500
You know, with the blood

624
00:40:41,500 --> 00:40:42,140
That's a great question

625
00:40:42,140 --> 00:40:44,540
I don't even know if that's the right, but it is a great question

626
00:40:44,540 --> 00:40:45,340
That's exactly right

627
00:40:45,340 --> 00:40:47,900
Yeah, and the reason why I bring that

628
00:40:47,900 --> 00:40:50,220
The reason why I bring that up is because

629
00:40:50,220 --> 00:40:52,620
I mean, that was the big thing with COVID, right?

630
00:40:52,620 --> 00:40:56,780
I mean, false positives and negatives and that was like, oh my goodness

631
00:40:56,780 --> 00:41:01,500
They don't know for sure how accurate is this machine in knowing for sure

632
00:41:01,500 --> 00:41:05,020
Is it a done deal or is there some variables

633
00:41:05,020 --> 00:41:06,540
Yeah, for most, that's a great question

634
00:41:06,540 --> 00:41:12,540
For most diagnostic tests we do in medicine we want a high degree of sensitivity

635
00:41:12,540 --> 00:41:14,620
As well as a high degree of negative predictive value

636
00:41:14,620 --> 00:41:17,660
So you don't want any false positives if you can avoid it

637
00:41:17,660 --> 00:41:19,500
But more importantly, you don't want false negatives

638
00:41:19,500 --> 00:41:20,780
You don't want to miss something

639
00:41:20,780 --> 00:41:26,460
So this test has upwards of 96.5% sensitivity

640
00:41:26,460 --> 00:41:30,540
Maybe even higher according to some studies of places that have been using it

641
00:41:30,540 --> 00:41:32,700
And the negative predictive value is quite high as well

642
00:41:32,700 --> 00:41:37,420
Offers of 99% depending on the prevalence of head injury

643
00:41:37,420 --> 00:41:42,380
But 96.5% is the number that was quoted in one of the big pivotal studies

644
00:41:42,380 --> 00:41:44,540
It did that led to the FDA clearance

645
00:41:44,540 --> 00:41:46,940
Which means yes, it's not 100%

646
00:41:46,940 --> 00:41:49,260
There will be false negatives from time to time

647
00:41:49,260 --> 00:41:54,060
But none of those require any neurosurgical intervention

648
00:41:54,060 --> 00:41:57,260
So the ones in the big studies that were done

649
00:41:57,260 --> 00:42:01,260
Of what we used the blood tested determined we didn't need a CAT scan

650
00:42:01,260 --> 00:42:03,820
Of the ones that were missed and was a very small handful

651
00:42:03,820 --> 00:42:06,060
Compared to the thousands of patients studied

652
00:42:06,060 --> 00:42:09,500
None of those people had bleeding in the brain that was serious

653
00:42:09,500 --> 00:42:11,900
Nothing that required neurosurgeon intervention

654
00:42:11,900 --> 00:42:13,260
So they had good outcomes

655
00:42:13,260 --> 00:42:15,660
There is really hardly any test we use

656
00:42:15,660 --> 00:42:19,660
Any emergency medicine especially that's 100% accurate

657
00:42:19,660 --> 00:42:22,300
So it's quite sensitive

658
00:42:22,300 --> 00:42:24,300
Addiquate compared to what we're doing now

659
00:42:24,300 --> 00:42:28,060
Which is really subjective and this is more objective

660
00:42:28,060 --> 00:42:29,100
But that's a great question

661
00:42:29,100 --> 00:42:33,340
And it had the sensitivity, specificity, and negative predictive value

662
00:42:33,340 --> 00:42:37,420
That was sufficient for the FDA to clear this for use in hospitals

663
00:42:37,420 --> 00:42:41,260
In the US and the United Kingdom, Hong Kong, New Zealand, other parts of the world

664
00:42:41,260 --> 00:42:45,340
So slowly this technology will start to get registered and available

665
00:42:45,340 --> 00:42:48,700
All over the world, not just in our country

666
00:42:48,700 --> 00:42:52,380
Yeah, so does this have a name this particular

667
00:42:52,380 --> 00:42:55,100
So if I'm going to the hospital, I have a concussion

668
00:42:55,100 --> 00:42:56,300
I can ask the hospital

669
00:42:56,300 --> 00:43:03,020
Hey, do you have the, you know, the Abbott blood test machine

670
00:43:03,020 --> 00:43:07,020
Or how would I, you know, bring awareness to that

671
00:43:07,020 --> 00:43:09,420
That's a great question

672
00:43:09,420 --> 00:43:12,460
Again, not every hospital has Abbott in the Core Lab

673
00:43:12,460 --> 00:43:14,460
But you can ask for the TBI test

674
00:43:14,460 --> 00:43:16,860
So if they have a TBI machine

675
00:43:16,860 --> 00:43:18,860
TBI stands for traumatic brain injury

676
00:43:18,860 --> 00:43:22,460
So if they happen to have an Abbott machine in the Core Lab

677
00:43:22,460 --> 00:43:24,540
And they're using that technology there

678
00:43:24,540 --> 00:43:27,180
They can do the test in the Core Lab

679
00:43:27,180 --> 00:43:29,340
If they're using the handheld analyzer

680
00:43:29,340 --> 00:43:32,860
It's called the Abbott iStat TBI cartridge

681
00:43:32,860 --> 00:43:35,980
Which is used on the Abbott iStat analyzer

682
00:43:35,980 --> 00:43:37,500
Or iStat system

683
00:43:37,500 --> 00:43:38,700
That's the handheld system

684
00:43:38,700 --> 00:43:42,380
Which I mentioned earlier can take iStat

685
00:43:42,380 --> 00:43:45,900
Take several cartridges for different various blood tests that we do

686
00:43:45,900 --> 00:43:47,900
In emergent settings

687
00:43:47,900 --> 00:43:48,940
So you can ask for that

688
00:43:48,940 --> 00:43:50,140
Do you have iStat here?

689
00:43:50,140 --> 00:43:51,340
Do you have the TBI test?

690
00:43:51,340 --> 00:43:53,020
Is the simplest way

691
00:43:53,020 --> 00:43:54,300
But again, it's new

692
00:43:54,300 --> 00:43:56,780
And not every hospital that is using iStat

693
00:43:56,780 --> 00:43:59,740
Has the next generation iStat analyzer yet

694
00:43:59,740 --> 00:44:01,340
That can do this TBI test

695
00:44:01,340 --> 00:44:03,980
So it's so new that I think you're gonna

696
00:44:03,980 --> 00:44:06,220
It's not rampant yet

697
00:44:06,220 --> 00:44:10,540
But I think it will get adopted very quickly over the next 12 months or so

698
00:44:10,540 --> 00:44:11,660
As more and more research

699
00:44:11,660 --> 00:44:14,860
Are there certain parts of the country

700
00:44:14,860 --> 00:44:16,380
Where hospitals do have them

701
00:44:16,380 --> 00:44:17,980
Like the Are we talking midwest

702
00:44:17,980 --> 00:44:18,940
Northeast

703
00:44:18,940 --> 00:44:19,820
East Coast

704
00:44:19,820 --> 00:44:20,460
West Coast

705
00:44:20,460 --> 00:44:21,340
I mean

706
00:44:21,340 --> 00:44:22,300
Where is it

707
00:44:23,020 --> 00:44:25,340
Predominantly being used

708
00:44:25,340 --> 00:44:28,060
There's at least 30 hospitals that I'm aware of right now

709
00:44:28,060 --> 00:44:29,740
That are using the iStat analyzer

710
00:44:29,740 --> 00:44:30,940
The handheld test

711
00:44:30,940 --> 00:44:32,060
Florida's where it started

712
00:44:32,060 --> 00:44:34,780
So the first place to use the plasma test

713
00:44:34,780 --> 00:44:36,940
Was in Tampa

714
00:44:36,940 --> 00:44:37,900
The whole blood test

715
00:44:37,900 --> 00:44:39,660
Which is where you actually draw the blood from the vein

716
00:44:39,660 --> 00:44:41,900
And put the drop directly into the cartridge

717
00:44:41,900 --> 00:44:43,820
You don't have to centrifuge the sample

718
00:44:43,820 --> 00:44:44,780
Like before

719
00:44:44,780 --> 00:44:48,460
That whole blood test was cleared in April of this year

720
00:44:48,460 --> 00:44:50,220
It was made commercial available in July

721
00:44:50,220 --> 00:44:51,900
And Orlando Health

722
00:44:52,540 --> 00:44:54,620
Dr. Linda Papa is a researcher

723
00:44:54,620 --> 00:44:57,020
Who's been researching these biomarkers for years

724
00:44:57,020 --> 00:44:58,620
They were the first hospital in the world

725
00:44:58,620 --> 00:44:59,980
To actually start using this

726
00:44:59,980 --> 00:45:01,660
And there are many other hospitals in Florida

727
00:45:01,660 --> 00:45:02,700
Following suit

728
00:45:02,700 --> 00:45:03,820
And which is actually great

729
00:45:03,820 --> 00:45:05,980
Because a lot of our aging population

730
00:45:05,980 --> 00:45:07,260
Tends to retire in Florida

731
00:45:07,260 --> 00:45:09,260
So you have skilled nursing facilities

732
00:45:09,260 --> 00:45:11,420
And assisted living

733
00:45:11,420 --> 00:45:13,900
And a lot of retirees that tend to trip and fall

734
00:45:13,900 --> 00:45:14,700
Lose their balance

735
00:45:14,700 --> 00:45:15,420
They have weakness

736
00:45:15,420 --> 00:45:16,700
They bounce issues

737
00:45:16,700 --> 00:45:18,140
So it actually is quite fitting

738
00:45:18,140 --> 00:45:19,740
That they are the first part of the country

739
00:45:19,740 --> 00:45:20,860
To start using it

740
00:45:20,860 --> 00:45:23,580
But there are other states that are following suit as well

741
00:45:23,580 --> 00:45:25,900
I know the hospital in Colorado is using it

742
00:45:25,900 --> 00:45:28,940
I have to mention UCSF and San Francisco

743
00:45:28,940 --> 00:45:30,540
Dr. Jeff Manley

744
00:45:30,540 --> 00:45:32,220
And many of the researchers

745
00:45:32,220 --> 00:45:33,980
With what's called TrackTBI

746
00:45:33,980 --> 00:45:35,740
There are a network of researchers

747
00:45:35,740 --> 00:45:37,420
That have been researching these biomarkers

748
00:45:37,420 --> 00:45:39,740
For over 10 years

749
00:45:39,740 --> 00:45:42,780
Jeff Manley is leading the way at UCSF

750
00:45:42,780 --> 00:45:44,300
And they're using the test

751
00:45:44,300 --> 00:45:46,220
There I believe in the near future

752
00:45:46,220 --> 00:45:48,860
Well, they've already been using in research settings

753
00:45:48,860 --> 00:45:49,740
Michigan is another one

754
00:45:49,740 --> 00:45:50,940
University of Michigan

755
00:45:50,940 --> 00:45:52,620
And Dr. Fred Corley

756
00:45:52,620 --> 00:45:53,820
And their institution

757
00:45:53,820 --> 00:45:55,180
They've been using these

758
00:45:55,180 --> 00:45:55,980
This test as well

759
00:45:55,980 --> 00:45:56,780
So it's

760
00:45:56,780 --> 00:45:58,380
It's really on the cusp of something

761
00:45:58,380 --> 00:45:59,260
That's going to change

762
00:45:59,260 --> 00:46:00,140
Stand of care

763
00:46:00,140 --> 00:46:01,660
It's not standard of care yet

764
00:46:01,660 --> 00:46:03,260
Because it is so novel

765
00:46:03,260 --> 00:46:05,100
But with more education and awareness

766
00:46:05,100 --> 00:46:06,380
And more of the guidelines

767
00:46:06,380 --> 00:46:07,580
Adopting this

768
00:46:07,580 --> 00:46:10,380
Encouraging physicians to use this objective test

769
00:46:10,380 --> 00:46:12,380
I think we're going to see it more and more often

770
00:46:12,380 --> 00:46:15,980
So if I've been diagnosed with a concussion

771
00:46:15,980 --> 00:46:17,980
What's my treatment?

772
00:46:17,980 --> 00:46:18,620
I mean

773
00:46:18,620 --> 00:46:19,660
Are you going to send me

774
00:46:19,660 --> 00:46:20,860
Home with where I

775
00:46:20,860 --> 00:46:22,860
Like you know with a neck brace

776
00:46:22,860 --> 00:46:24,060
So I can't move my head

777
00:46:24,060 --> 00:46:25,820
And you know I mean

778
00:46:25,820 --> 00:46:28,300
What what what transpires after that

779
00:46:28,300 --> 00:46:29,500
After the diagnosis

780
00:46:29,500 --> 00:46:31,820
That's a great question

781
00:46:31,820 --> 00:46:36,380
Basically the overall theme is just to take it slow

782
00:46:36,380 --> 00:46:39,420
So when people go home after a mild concussion

783
00:46:39,420 --> 00:46:41,420
We tell them to just

784
00:46:41,420 --> 00:46:45,020
Have their recovery be paced based on their symptoms

785
00:46:45,020 --> 00:46:46,860
So it depends on

786
00:46:46,860 --> 00:46:48,380
What their symptoms are

787
00:46:48,380 --> 00:46:50,300
But you want to never go back

788
00:46:50,300 --> 00:46:53,500
Right to work and go right back to your normal routine

789
00:46:53,500 --> 00:46:54,780
Back in the old days

790
00:46:54,780 --> 00:46:56,780
We used to tell people go sleep in a dark room

791
00:46:56,780 --> 00:46:57,740
And don't watch tv

792
00:46:57,740 --> 00:46:58,780
Don't get on the computer

793
00:46:58,780 --> 00:47:00,540
Don't read a book to stay in bed

794
00:47:00,540 --> 00:47:03,740
And they actually found that it made people worse

795
00:47:03,740 --> 00:47:05,340
Their recovery was more prolonged

796
00:47:05,340 --> 00:47:07,580
So they they promote an active

797
00:47:07,580 --> 00:47:10,220
Gentle slow recovery

798
00:47:10,220 --> 00:47:12,060
So we want people to stay active

799
00:47:12,060 --> 00:47:13,340
You need to exercise

800
00:47:13,340 --> 00:47:14,460
Gentle walking

801
00:47:14,460 --> 00:47:16,460
You get on the treadmill if you'd like

802
00:47:16,460 --> 00:47:20,140
I wouldn't be doing any major hit classes at the gym

803
00:47:20,140 --> 00:47:22,380
Or or Taekwondo or anything crazy

804
00:47:22,380 --> 00:47:23,260
No boxing

805
00:47:23,260 --> 00:47:24,060
You know boxing

806
00:47:24,060 --> 00:47:26,220
We're going to get a repeated blow to the head

807
00:47:26,220 --> 00:47:27,180
And obviously

808
00:47:27,180 --> 00:47:28,380
Whatever you're doing

809
00:47:28,380 --> 00:47:30,060
If it's making your symptoms worse

810
00:47:30,060 --> 00:47:31,260
Let's say you're at the computer

811
00:47:31,260 --> 00:47:33,820
And you have a headache that's starting to get worse again

812
00:47:33,820 --> 00:47:35,340
Then stop take a break

813
00:47:35,340 --> 00:47:36,940
You know take frequent breaks

814
00:47:36,940 --> 00:47:40,140
And limit how much time you're on the computer

815
00:47:40,140 --> 00:47:41,180
On the tv

816
00:47:41,180 --> 00:47:42,220
With the younger people

817
00:47:42,220 --> 00:47:43,180
We tell them watch there

818
00:47:43,180 --> 00:47:45,020
You know how much time they're spending on the video games

819
00:47:45,020 --> 00:47:47,260
On their phone on social media

820
00:47:47,260 --> 00:47:49,820
Any of that overstimulation of the brain

821
00:47:49,820 --> 00:47:52,060
Will cause these symptoms to come out

822
00:47:52,060 --> 00:47:55,260
So it's basically take it slow

823
00:47:55,260 --> 00:47:58,860
Reintroduce your normal activity in a graduated fashion

824
00:47:58,860 --> 00:48:01,820
But your healthcare provider can help guide you

825
00:48:01,820 --> 00:48:02,940
How quick that can be

826
00:48:02,940 --> 00:48:05,260
For some people they're back to work in a week

827
00:48:05,260 --> 00:48:07,820
And some people it takes four to six weeks

828
00:48:07,820 --> 00:48:09,580
To get back to being 100%

829
00:48:09,580 --> 00:48:12,620
I had a concussion myself about six months ago

830
00:48:12,620 --> 00:48:17,180
It took me about six to eight weeks to be where I could feel like I was back to normal again

831
00:48:17,180 --> 00:48:18,860
I had trouble concentrating

832
00:48:18,860 --> 00:48:21,260
I had headaches and trouble sleeping

833
00:48:21,260 --> 00:48:23,100
Just wasn't feeling right

834
00:48:23,100 --> 00:48:24,300
And so it just takes time

835
00:48:24,300 --> 00:48:26,060
Everybody is different

836
00:48:26,060 --> 00:48:29,420
We find actually females are more prone to concussions

837
00:48:29,420 --> 00:48:32,300
More than males because of structurally

838
00:48:32,300 --> 00:48:35,500
And hormonally there's something with the brain that's a little bit different

839
00:48:35,500 --> 00:48:37,260
So we're finding more and more with research

840
00:48:37,260 --> 00:48:39,580
That females are more vulnerable to concussions

841
00:48:39,580 --> 00:48:40,860
We're finding this true to be in the

842
00:48:40,860 --> 00:48:42,860
True in the athletes as well

843
00:48:42,860 --> 00:48:45,660
But everybody is different

844
00:48:45,660 --> 00:48:49,500
Not everybody will recover as quickly as the next person

845
00:48:49,500 --> 00:48:51,100
But it's important that it's take it slow

846
00:48:51,100 --> 00:48:53,660
And there are therapies

847
00:48:53,660 --> 00:48:55,660
So depending on the symptoms

848
00:48:55,660 --> 00:48:57,340
If you have depression

849
00:48:57,340 --> 00:48:59,260
They might send you to a neuropsychiatrist

850
00:48:59,260 --> 00:49:00,940
They might put your nantidepresent

851
00:49:00,940 --> 00:49:02,300
If you have trouble sleeping

852
00:49:02,300 --> 00:49:04,380
There are supplements that may help with that

853
00:49:04,380 --> 00:49:06,780
If you have trouble with dizziness and balance

854
00:49:06,780 --> 00:49:09,180
They might send you to ear, nose and throat

855
00:49:09,180 --> 00:49:11,420
Or to vestibular therapy

856
00:49:11,420 --> 00:49:13,260
So you might be able to go to physical therapy

857
00:49:13,260 --> 00:49:16,620
And work on strength and balance exercises

858
00:49:16,620 --> 00:49:18,940
So there's different ways to treating the symptoms

859
00:49:18,940 --> 00:49:21,020
Based on what the symptoms are

860
00:49:21,020 --> 00:49:23,020
So there's not really a magic pill

861
00:49:23,020 --> 00:49:26,700
It depends on what symptomatology you're having

862
00:49:26,700 --> 00:49:30,220
And that will dictate what your therapy or treatment will be

863
00:49:30,220 --> 00:49:34,060
Yeah, so a concussion will gradually get better

864
00:49:34,060 --> 00:49:38,060
Is there any scarring that happens where

865
00:49:38,060 --> 00:49:41,660
After you feel better and the symptoms are all gone

866
00:49:41,660 --> 00:49:43,820
You don't have headaches anymore and blah blah blah

867
00:49:43,820 --> 00:49:45,420
All the things that go along there

868
00:49:45,420 --> 00:49:47,180
Is there scarring?

869
00:49:47,180 --> 00:49:50,620
And then is that if there is scarring in the brain

870
00:49:50,620 --> 00:49:54,460
Is it are you more susceptible to getting a concussion

871
00:49:54,460 --> 00:49:57,340
repeated concussions over and over again?

872
00:49:57,340 --> 00:49:59,740
You are and if it's a mild head injury

873
00:49:59,740 --> 00:50:03,980
And a concussion without any structural abnormality on CT or MRI

874
00:50:03,980 --> 00:50:05,900
There's not really any scarring per se

875
00:50:05,900 --> 00:50:08,460
Like when you scrape your arm or you cut yourself

876
00:50:08,460 --> 00:50:11,180
You'll see a scar there, a visible scar

877
00:50:11,180 --> 00:50:15,260
Theoretically you won't have that type of scarring per se

878
00:50:15,260 --> 00:50:17,500
But you are at risk for repetitive concussions

879
00:50:17,500 --> 00:50:18,780
And it's cumulative

880
00:50:18,780 --> 00:50:21,340
So these proteins that are released in the bloodstream

881
00:50:21,340 --> 00:50:22,700
There are some biomarkers

882
00:50:22,700 --> 00:50:25,420
Not the two that are in this Abbott test

883
00:50:25,420 --> 00:50:27,420
G-FAP and UCHL-1

884
00:50:27,420 --> 00:50:31,180
But there are other biomarkers that actually remain quite elevated

885
00:50:31,180 --> 00:50:33,100
Chronically and that's what they're tracking

886
00:50:33,100 --> 00:50:35,660
For people that have chronic traumatic encephalopathy

887
00:50:35,660 --> 00:50:37,260
Because there is a cumulative effect

888
00:50:37,260 --> 00:50:40,540
And your risk of further concussion is heightened

889
00:50:40,540 --> 00:50:43,660
When you've had a concussion because you might have trouble with dizziness

890
00:50:43,660 --> 00:50:46,940
And balance and concentration and coordination

891
00:50:46,940 --> 00:50:48,620
And that can lead to another head injury

892
00:50:48,620 --> 00:50:52,140
So when you have these blows that can definitely prolong

893
00:50:52,140 --> 00:50:54,460
For long your symptoms and it can be permanent

894
00:50:54,460 --> 00:50:57,260
So people that we're seeing this with athletes

895
00:50:57,260 --> 00:51:00,380
This thing called CTE which is very controversial

896
00:51:00,380 --> 00:51:02,380
But it's a really a thing

897
00:51:02,380 --> 00:51:06,700
Chronic traumatic encephalopathy is where the brain over repetitive blows

898
00:51:06,700 --> 00:51:09,660
Over time and we do see this mostly in athletes

899
00:51:09,660 --> 00:51:11,660
Can cause permanent injury

900
00:51:11,660 --> 00:51:14,940
And neurodegenerative changes that can mimic Parkinson's

901
00:51:14,940 --> 00:51:18,380
And Alzheimer's and other types of neurodegenerative disorders

902
00:51:18,380 --> 00:51:21,420
That's where I was going to go with this is

903
00:51:21,420 --> 00:51:23,900
You know what are what are some of the long-term effects

904
00:51:23,900 --> 00:51:26,940
And is there any correlation between

905
00:51:26,940 --> 00:51:30,140
Concussions and dimensions of various kinds

906
00:51:30,140 --> 00:51:33,740
There is and again it's quantity and severity

907
00:51:33,740 --> 00:51:34,780
And it's cumulative

908
00:51:34,780 --> 00:51:38,700
So one fall and one blow and one mild concussion

909
00:51:38,700 --> 00:51:41,900
Assuming you follow the right recommendations for recovery

910
00:51:41,900 --> 00:51:43,740
Shouldn't lead to chronic problems

911
00:51:43,740 --> 00:51:45,580
Majority people will get better on their own

912
00:51:45,580 --> 00:51:48,380
And have no sequelae in long-term sequelae

913
00:51:48,380 --> 00:51:50,460
But the people that have repetitive injuries

914
00:51:50,460 --> 00:51:53,820
Can be at risk for chronic neuro-logic problems

915
00:51:53,820 --> 00:51:59,580
Yeah and then it does it take on a whole another level of

916
00:52:00,140 --> 00:52:04,540
You know therapies to recover from

917
00:52:04,540 --> 00:52:09,500
You know from a concussion that translates or

918
00:52:09,500 --> 00:52:13,020
You know goes into a dementia of some kind

919
00:52:13,020 --> 00:52:16,780
Then then there's a whole another level of treatment

920
00:52:16,780 --> 00:52:18,620
Yeah and they're studying that now

921
00:52:18,620 --> 00:52:21,500
They're studying different pharmacologic agents

922
00:52:21,500 --> 00:52:23,740
To treat those types of injuries

923
00:52:23,740 --> 00:52:24,940
As well as preventative

924
00:52:24,940 --> 00:52:26,780
So there are things that they're studying now

925
00:52:27,500 --> 00:52:30,220
And they're using some of these brain biomarkers early on

926
00:52:30,220 --> 00:52:34,300
To help select the people that can benefit from these therapies

927
00:52:34,300 --> 00:52:35,820
But more preventative medicines

928
00:52:35,820 --> 00:52:37,580
So when there's been a concussion

929
00:52:37,580 --> 00:52:39,580
There are drugs on the horizon

930
00:52:39,580 --> 00:52:42,540
That might minimize your risk of a concussion

931
00:52:42,540 --> 00:52:46,300
Or complication for a concussion or chronic sequelae

932
00:52:46,300 --> 00:52:49,660
So those are not you know quite ready for prime time yet

933
00:52:49,660 --> 00:52:51,820
There's a lot of research still underway

934
00:52:51,820 --> 00:52:53,580
And for some of those to get to market

935
00:52:53,580 --> 00:52:55,420
And to be used in the mainstream

936
00:52:55,420 --> 00:52:57,900
I think is going to be another couple of years or so

937
00:52:57,900 --> 00:53:00,460
But there are therapies there

938
00:53:00,460 --> 00:53:06,060
Yeah and Dr. DeVlentes we're up against the end of our show here today

939
00:53:06,060 --> 00:53:10,140
And I just want to say thank you for being on aging today

940
00:53:10,140 --> 00:53:14,060
But if someone wants to get in touch with you

941
00:53:14,060 --> 00:53:17,260
And they want to learn more about concussions

942
00:53:17,260 --> 00:53:21,980
You know what's the best way to get in touch with you

943
00:53:21,980 --> 00:53:27,020
And then secondly if somebody that is interested in learning more about

944
00:53:27,020 --> 00:53:28,540
The Abbott blood test

945
00:53:28,540 --> 00:53:32,380
How would they get in touch with you or somebody at Abbott

946
00:53:32,380 --> 00:53:35,260
Couple different things you can go to Abbott's website

947
00:53:35,260 --> 00:53:40,940
And it's Abbott.com/braindashhealth

948
00:53:40,940 --> 00:53:43,740
So Abbott.com/braindashhealth

949
00:53:43,740 --> 00:53:45,900
And you can also go for symptoms

950
00:53:45,900 --> 00:53:49,340
Some information about symptoms of concussion and other information

951
00:53:49,340 --> 00:53:53,180
We have an alliance or partnership with concussion awareness now

952
00:53:53,180 --> 00:53:56,060
So you can go to concussionawarenessnow.org

953
00:53:56,060 --> 00:54:00,060
That's all one word concussionawarenessnow.org is another website

954
00:54:00,060 --> 00:54:04,380
That's very useful that talks about symptoms of concussion and what to watch for

955
00:54:04,380 --> 00:54:08,060
Yeah that would be very helpful

956
00:54:08,060 --> 00:54:10,940
And great information to have at your fingertips

957
00:54:10,940 --> 00:54:13,180
So anything else that you want to

958
00:54:13,180 --> 00:54:16,780
You know, impart on to our listening audience

959
00:54:16,780 --> 00:54:20,300
About concussions that we haven't talked about

960
00:54:20,300 --> 00:54:23,820
I think we covered it all. I really appreciate the time. I think the best advice is

961
00:54:23,820 --> 00:54:30,620
You know don't delay a lot of people minimize this entity and when there's frequent falls

962
00:54:30,620 --> 00:54:32,780
Like we see especially in the winter months

963
00:54:32,780 --> 00:54:36,540
Now we're going to have a lot of slippery pavements and people outshuffling the snow

964
00:54:36,540 --> 00:54:40,300
And slipping and hitting their head don't delay

965
00:54:40,300 --> 00:54:43,740
If you're not sure like you said it could be a loved one. It could be an older relative

966
00:54:44,460 --> 00:54:47,180
When in doubt send them out is my adage

967
00:54:47,180 --> 00:54:53,260
If you're not sure just go to the hospital and let us evaluate your your love one or yourself

968
00:54:53,260 --> 00:54:56,060
To make sure that you don't have anything more serious going on

969
00:54:56,060 --> 00:54:59,900
That's the best advice I can give you if you're not sure what to do

970
00:54:59,900 --> 00:55:05,820
All right, Dr. Chris de Vlantis. Thank you so much for being on aging today

971
00:55:05,820 --> 00:55:12,300
We really appreciate your time your expertise and the wisdom that you brought to our conversation about concussions

972
00:55:12,700 --> 00:55:16,460
Thank you for having me and I hope I don't don't have to see you at work one day

973
00:55:16,460 --> 00:55:19,340
At least not in my other job of the year

974
00:55:19,340 --> 00:55:24,860
And and now I'll have two options. You'll either ask for a CAT scan or a TBI

975
00:55:24,860 --> 00:55:27,100
That's right or that I get that down

976
00:55:27,100 --> 00:55:30,700
Yeah, yeah the blood test. Yeah, okay. All right. Sounds good

977
00:55:30,700 --> 00:55:36,140
All right, this is Mark Turnbull your host and I want to thank all of you for tuning into aging today

978
00:55:36,140 --> 00:55:42,060
We are the podcast where together works blurring the many options to aging on your terms

979
00:55:42,700 --> 00:55:49,980
And then join us every Monday when we release a new conversation on aging day to your favorite podcast channel

980
00:55:49,980 --> 00:55:54,620
And remember this we're all in the process of aging and as we age

981
00:55:54,620 --> 00:55:58,940
We really are better together. So stay young at heart

982
00:55:58,940 --> 00:56:01,740
You make me feel so young

983
00:56:01,740 --> 00:56:05,100
You make me feel like spring is from

984
00:56:05,100 --> 00:56:08,460
And every time I see your face

985
00:56:08,460 --> 00:56:10,700
I'm such a happy

986
00:56:10,700 --> 00:56:12,220
individual

987
00:56:12,220 --> 00:56:14,220
The moment that she's been

988
00:56:14,220 --> 00:56:17,660
I want to go play hide and see

989
00:56:17,660 --> 00:56:21,260
I want to go and bounce the moon

990
00:56:21,260 --> 00:56:23,260
Just like a toy balloon

991
00:56:23,260 --> 00:56:25,660
Well you

992
00:56:25,660 --> 00:56:27,180
And I

993
00:56:27,180 --> 00:56:29,260
I'll just like a bullet

994
00:56:29,260 --> 00:56:30,780
Tots

995
00:56:30,780 --> 00:56:32,780
Running across the metal

996
00:56:32,780 --> 00:56:38,780
Big enough lots of forget me not so you made me feel so young

997
00:56:40,380 --> 00:56:43,100
You made me feel there are songs to be sung

998
00:56:43,100 --> 00:56:46,860
There will still be wrong and wonderful thing to be fun

999
00:56:46,860 --> 00:56:50,300
And when I'm old and grey

1000
00:56:50,300 --> 00:56:56,620
You've been listening to aging today where together we explore the options to aging on your terms

1001
00:56:56,620 --> 00:57:03,580
Join Mark and his guest next week for another lively discussion on proactively aging on your terms

1002
00:57:03,580 --> 00:57:09,580
Connecting you to the professional advice of his special guests with the goal of creating better days

1003
00:57:09,580 --> 00:57:11,580
Throughout the aging process

1004
00:57:11,580 --> 00:57:13,900
Your host has been Mark Turnbull

1005
00:57:13,900 --> 00:57:16,940
Join Mark and his guest every week on aging today

1006
00:57:16,940 --> 00:57:21,420
Your podcast to exploring your options for aging on your terms

1007
00:57:21,420 --> 00:57:23,420
And you went all grey

1008
00:57:23,420 --> 00:57:28,220
You make me feel the way I feel today

1009
00:57:28,220 --> 00:57:31,420
Cause you make me feel so

1010
00:57:31,420 --> 00:57:34,700
You make me feel so

1011
00:57:34,700 --> 00:57:38,700
You make me feel so young

1012
00:57:38,940 --> 00:57:41,420
So young

1013
00:57:41,420 --> 00:57:45,180
You make me feel so young

1014
00:57:45,180 --> 00:57:48,300
You make me feel so young

1015
00:57:48,300 --> 00:57:50,880
(guitar music)

1016
00:57:50,880 --> 00:57:51,940
(Music)