SUMMARY KEYWORDS

Concussion recovery, neuroendocrine changes, thyroid function, adrenal function, blood sugar control, neurocognitive testing, pituitary levels, hypothalamus, brain function, hormone panel, autonomic dysregulation, dysautonomia, brain health assessment, cognitive tests, executive functioning.

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Dr. Ayla Wolf  00:00

This is part two of my important conversation with Dr Tatiana Habinova, where we discuss neuroendocrine changes that can happen after a concussion that has an impact on thyroid and adrenal function, as well as blood sugar control. We also discuss the importance of more consistent neurocognitive testing and screening for monitoring brain function. I hope you enjoy this conversation. Please subscribe to our show so you don't miss an episode, and as always, you can email us questions at lifeafterimpact@gmail.com or send us a text by clicking on the Text us link in the show notes.

 

Welcome to Life after impact, the concussion recovery Podcast. I'm Dr Ayla Wolf, and I will be hosting today's episode where we help you navigate the often confusing, frustrating and overwhelming journey of concussion and brain injury recovery. This podcast is your go to resource for actionable information, whether you're dealing with a recent concussion, struggling with post concussion syndrome or just feeling stuck in your healing process. In each episode, we dive deep into the symptoms, testing, treatments and neurological insights that can help you move forward with clarity and confidence. We bring you leading experts in the world of brain health, functional neurology and rehabilitation to share their wisdom and strategies. So if you're feeling lost, hopeless or like no one understands what you're going through, know that you are not alone. This podcast can be your guide and partner in recovery, helping you build a better life after impact. I have certainly had patients that have after a concussion, they've actually developed thyroid conditions. I've actually seen people go hypothyroid, and I've seen people go hyperthyroid. And so why don't you talk a little bit about this research that was published in 2023 where they were looking at pituitary levels, and obviously the pituitary then talks to the thyroid, the ovaries, the adrenals. So maybe get a little bit into some of this newer research that is looking at these types of changes.

 

Dr. Tatiana Habanova  02:07

Yes, absolutely. So really, it's just a trickle down downstream aspect, you know, it's really almost a secondary hypothyroidism as opposed to a primary condition around the thyroid. So I know sometimes language and words that we use to explain things in the medical world can be slightly confusing, so we really have to tease that out. So it's probably not a direct issue at the thyroid, although we obviously want to make sure there's no growth or problems. You know, maybe there's an autoimmune condition at the thyroid that could certainly happen. So we got to be careful, but it's usually a downstream effect coming from the pituitary. Now we can't really address the hypothalamus per se, so we can assess from the pituitary level, and then, of course, downstream from that. So definitely, you know, current research is indicating that. And this is the interesting thing. I thought was nice to see it. They now say doesn't matter the level of injury, like they used to believe, a more severe injury would lead to more severe hypothyroidism, low or hypopituitary is in low pituitary function, which would then lead to low thyroid function, which would lead to low adrenal function, right? So it's just a downstream effect. Now actually means it's just showing that it could. Doesn't matter the degree of injury, even mild TBI, which are concussions, can even cause those issues.

 

So definitely seeing what they recommend is to have a let me take a step back. Some recommend doing an assessment at the acute phase, okay, when you first have the concussion, go ahead and just do the hormone panel at that moment and document what's going on. Others are like, give it a few weeks, maybe even six weeks, let kind of everything, let the dust settle, so to speak, and then take the assessment at that point and see sort of, how has the system kind of rallied back and then from that point, if there's issues, consider moving forward, you know, in care, treatment and continuation of assessing long term in that management, right? So there's a couple of ways to go about that, but definitely, you know, seeing changes, those neuroendocrine changes, which, of course, for the thyroid, is so important for brain function.

 

So not only is a person maybe dealing with the concussive symptoms, whatever that profile might look like, now there's an added layer that kind of comes back and nips them, you know, in the bud, like a kind of around two where, you know, maybe it's just now new symptoms are showing up, or symptoms are getting more manifested, you know, at a greater degree, and the the approach they were doing to manage them isn't working anymore, right? So, like with headaches, for example, you spoke about earlier, maybe they were managing them a certain way, and that worked until the shoe dropped, because that neuroendocrine. Change. You know, was affected. It took several weeks to months to do what it's going to do, and it didn't rally back. So throughout that time, maybe there weren't those thyroid symptoms just yet, but now there are, you know, because it's dropped so much. And here, two, three months, six months later, Wolf a new, you know, a new manifestation is occurring, or, uh, you know, the treatment is not working anymore. That's, again, when I talk about that stagnation, we need to go back and evaluate if we haven't initially.

 

Dr. Ayla Wolf  05:31

And I think there's a really important piece here too. It would be great if we could all just get a baseline hormone test, you know, just to know where things are at. But I think a big piece here is that when you have a brain injury, as people's brain heals, then also, if there's a pituitary dysfunction or imbalance, then that is all as the brain heals, that can also heal. And so it might be a case too, where if somebody does get put on a thyroid medication, we maybe shouldn't wait a year to recheck it, right? Maybe we shouldn't even wait six months to check it, because as the brain heals, they might not need the same dose. And so I think that that's also important too, is that in the context of a brain injury, if somebody is taking medications to manage a thyroid disorder, that might need to actually be like retested every three months instead of every six months or every year.

 

Dr. Tatiana Habanova  06:22

Absolutely, that's exactly the take home point. And you're right again, that thyroid medication may be a needed ingredient to help also the brain heal, right in addition to other things that's going on for the brain to heal, and maybe the brain needed that little bit of thyroid hormone in the brain to be able to do that right, and then it heals up, and now maybe we need to titrate that down, or slowly take it away and not become dependent on it. And I think currently in the field of medicine, you know, thyroid is not looked at that way. It's sort of looked at, oh, you go hypo, and then you most likely need meds your whole life. And then maybe they're just going to slightly tweak the levels, because, you know, maybe someone's feeling a racing heart or right, so they're going to start to maybe kind of play with the dose, but they never take you off of it, right, or look to maybe wean out completely and again. Maybe that is needed. Maybe it's not, but I agree with you. I agree of that the idea of providing it, if necessary, and then seeing how the brain develops right and heals.

 

Dr. Ayla Wolf  07:31

and I think you just mentioned a beating heart, which made me want to point out the fact too, that we in functional neurology, we spend so much time assessing for autonomic dysregulation. And so it is really important to also see this overlap between thyroid disorders and a lot of the symptoms kind of overlap with a dysautonomia type presentation, too. And so it just like makes, like you said, it's just the ability to understand the Functional Medicine and the Functional Neurology at the same time is so huge, exactly

 

Dr. Tatiana Habanova  08:03

That makes me think of a case I had about four years ago with a patient who had a history of concussion and previous and was on thyroid medication for a very long time, maybe 30 plus years, and constantly spoke about a racing heart, like she used to call it, like horses are pounding in my chest, like when horses running here their hooves, you know, they come at beating. And so she was going to her, you know, Doctor constantly about the thyroid, and they didn't want to change levels, because they have the highest you can be. And then take her too low, and then she would have some thyroid crashes. Because, again, there's some dependency a little bit on the meds too, because the system isn't, kind of working on its own. It's working on the environment it's provided with, right? So, so again, that could be a challenging river to navigate, to some degree as well, and but just never could get it right. And always felt it was the thyroid and had brain fog and all this. And, you know, evaluated her and she had dysautonomia, and so treated the dysautonomia and the racing heart went away and was able to lower her thyroid meds to some degree. She still did require some but not to the degree that she was no more racing hearts and the energy levels brain fog, a lot of things help. But again, you know, was dysautonomia? Was it over medication? A thyroid, you know, it's, it's really takes, I think, a practitioner who can peel back multiple layers and look at the person from different perspectives.

 

Dr. Ayla Wolf  09:35

Yeah, yeah. I had a patient that was in a lot of pain after her concussion, she also had a an injury to her neck, and so being on a lot of pain can cause your blood pressure to rise. And so she was placed on a blood pressure medication at some point. And I, you know, I think what happened was, you know, maybe the pain levels came down, but she was still on the blood pressure medication. And so a lot of the autonomic nervous system, like the dysautonomia piece, wasn't getting better because she had this medication artificially decreasing her blood pressure. And it was like, once she went off of that, because she was able to track the blood pressure, say to her doctor, hey, this is consistently low. Like, I don't think I need to be on this medication. And so they said, Yep, you're right. I'm looking at the data here. Let's take you off of it, and then all of a sudden the dysautonomia improved. And instead of plateauing, it's like, all of a sudden, it's like, her progress just shot way up. And so it just really highlights that importance of like in the case of concussion recovery, we've got to be paying attention to all the data, you know, the hormones, the blood pressure, the autonomics, if we've got any medications that are controlling any piece of this, as things improve, or if people plateau, we gotta step back and say, okay, is all of this stuff still needed at the moment, right?

 

Dr. Tatiana Habanova  10:55

And I think you hit upon some two really important pieces, is allowing patients to take on more responsibility of tracking symptoms, right? So like tracking the blood pressure regularly or whatever the case is, and keeping a little journal or log like really normalizing that, really allowing patients to just take that time to do that and recognize how key that is, that data is so important, right? So that data collection and then working corporately with their primary care physician and being able to say, okay, you know, let's work on this where the medication is needed for a time being, but as the system heals, let's work on normalizing and maybe getting off of it if needed or whatnot, right? So that collaborative piece amongst professionals and really, to serve the patient at the highest level,

 

Dr. Ayla Wolf  11:44

yeah, yeah, it takes a lot of, you know, awareness of all the moving parts.

 

Dr. Tatiana Habanova  11:52

it does.

 

Dr. Ayla Wolf  11:55

And then when you are seeing these hormonal imbalances and things showing up on labs you know that are clueing you into, say, a pituitary imbalance having downstream consequences. Do you want to talk a little bit about your approach to working with those patients? Sure.

 

Dr. Tatiana Habanova  12:11

So you know, kind of after initial kind of meeting, and a lot of times, I am in favor of getting some lab tests on the front end. Sometimes patients will already have some recent blood work that they've done. So I always ask them to send that to me if it's within three months. Can utilize that data? I find a lot of times they're not very complete, or a lot of bits are missing, you know. So we'll have to just go out and get a little bit more testing if we need to fill in a few gaps. But really, then, you know, upon doing a comprehensive neurological evaluation, I take about three hours to do that comprehensive assessment. So again, information gathering, data gathering, and being able to look at what are the primary areas that are needed depending, again, on symptomology and what they're presenting with, right? So then I'd like to prioritize for patients, sort of, how can we best achieve, you know, their goals, right? Usually, most people want to get out of pain. They want to function better than one that brain fog, you know, they want to feel dizzy, headaches, like, whatever those things are. You know, we'll start to identify their goals, and then I'll lay out trajectories or paths and be okay. This is the goal you want to achieve. This is what I feel we need to do to achieve that. And then I'll really ask them, what do they want to take on? What makes what gravitates to them the most, what matters to them the most, and what are they willing to take on? Because I think what's also important before I start working with anyone and really getting, you know, involved in their pair, because I want them to be aware of the things that they're going to have with hurdles are going to have to cross, and to also start preparing for some of that. So not all of a sudden, oh, okay, here we are. And now you need this. And they're like, oh, you know, because many times when you have brain fog, you're not firing off all pistons. It takes a lot of energy just to do something simple, right? The resources are limited. You're probably not sleeping very well, right? So there's a little bit of that going on, symptoms, pain, all of that can just add to the burden, right? So I want to try to make it as simple as possible for patients to be able to feel they can be empowered, to feel like they're in control, that I'm guiding them so that they feel confident in the path that they're taking, but they feel comfortable they're taking on, and the most important part is creating that compassion and safety, right? So that's really kind of how I begin leading those cases. They can take a long time, in the sense that it could be a six month to a year process together. We're not just gonna solve some things immediately. Some things may happen quickly, which is great, and some things can take a little longer. So you know, what are things we're going to do to manage some of the symptoms in the meantime, what are going to be things that we're going to heal and improve, and what does that take? So I think it's really important to have an honest conversation about that so people can make a decision. Position that makes sense for them, and the willingness to take that journey on and to do that together. So I'm not sure if I answered the question where you were leading it. But

 

Dr. Ayla Wolf  15:10

well, I mean, you, you, you bring up that important concept of expectations. And I think that when you do all that work on the front end, and you spend the three hours, you know, assessing somebody and looking at all the data, and then maybe collecting more data a lot of times, what happens is that, because you spent all that time in the front end, you can very quickly get to here's what what is wrong, here's what the problem is. But then the patient says, Oh, well, they were so quick to figure out what's wrong. So that must mean that they are going to be really quick to fix it too. And like you said, sometimes it takes a while, and so managing those expectations is huge.

 

Dr. Tatiana Habanova  15:48

Yes, and even on my end, because just if I can wave that magic wand and make it all go away like this, I would be waving it all, yeah. So I tell them I can only work as fast, you know, and guide you and support you and coach you and address these things as I have to respect your body and your body's healing time. I can't push you more than or push your body and brain more than it's capable of, and that's a really important piece, because if we over fatigue, you know, we end up crashing the system. And now we're kind of, you know, putting ourselves behind the eight ball, right? That doesn't make sense. So again, managing those expectations and guiding them even in their life, because people tend to take on more than you know, and sometimes can set back their healing a little bit too. So yeah, really supporting him in that. But definitely, if I seeing some issues, you know, on the thyroid side, because I don't prescribe medications. You know, that is something where I'll refer them to their primary or another physician. If that support is needed many times, we'll also work on supplementations and other things to kind of support the the need for the body to work better, just support cellular function. So, you know, with the endocrine system, particularly, you know, looking at endocrine burdens, right? So what are things that are affecting the hormonal system from working as well, and I'm talking about now receptor sites. So are we dealing with toxicities and things of where we could do some liver support and maybe, you know, clear out some things, some toxins and burdens that will allow your hormonal system to actually function better, right? So it's almost like I say you have a knapsack with a bunch of rocks in it, or boulders, and you're trying to run up a hill. That's really darn hard. But why don't we take that knapsack off? Boy, you can sprint up. No problemo, right? So let's deal and look at sometimes, instead of always working from a mindset of, let's just improve, improve, improve, improve, why don't we stop and take a look and go behind our shoulder and look, what are some of the burdens that are occurring to the system? What's going on dietarily, are the things that we may be consuming, you know, that have pesticides in them, or we're exposed to environmental toxins, you know, maybe we should do a panel and see if there is mold or, you know, various infections or other things that are maybe burdening and pulling the system down. So I think that's an important thing as well. Instead of saying, oh, let's just always try to create performance for these hormones.

 

So again, another mindset of consideration their history will dictate some of this. Of course, right? Women that are in their perimenopausal and menopausal, we now need to be thinking a little bit on hormones and what's going on there. So definitely I start to see changes in progesterone as women are in their perimenopausal phases, whereas progesterone is starting to decrease, so that is going to not be as much of a neuroprotective effect and create a little bit of a heightened anxiety around things as well. So in terms of managing patients that might have these neuroendocrine changes, perhaps due to a concussion, perhaps just neuroendocrine changes that are happening in life to also support them, from that perspective as well. So the literature doesn't speak per se, to any of the sex hormone changes. There's really talking more about that Pituitary and the thyroid and the adrenal the cortical, they do do also now mention growth hormone and insulin growth factor starting to be influenced, so that is going to now link back up to sugar handling. Okay, so that's important from an energetics perspective. So energy metabolism, so how else do I manage neuroendocrine changes? Is I look at bioenergetics. I know you've talked a lot on your podcast about red light therapy. I also like to do a lot of PEMF pulse electromagnetic stimulation as well. So other ways to provide. Energy to the system, supplementation, herbs, there's a variety of things, lifestyle changes to support those processes, too.

 

So I think we've got to look at it from a practitioner's perspective, a few different angles, and for patients to realize, oh, there's a lot of choices and options that I can maybe explore when I'm trying to stabilize a system or improve upon a system. What are some rocks that I haven't Unturned turned over yet to explore again, those neuro endocrine disruptors, right? There are several that we are know, in the food and just, you know, chemicals and water and things like that. Should I get a, you know, water purifier? Should I just, you know, shop slightly differently, eat slightly differently. That goes a long way. That really goes a long way. And then, you know, looking at some energetics as well. So I kind of, again, looking at the case really guides me. But these are all the things that I have at my disposal that I'm kind of considering as I kind of have this imaginary white board in front of me as I, you know, have all the dots for the patient and, you know, all that information I'm kind of holding in my mind, yeah? These are the things that I'm thinking about as well. You know, there's nothing really we can do for the pituitary specifically, we can only do like the downstream, yeah, yeah. And then stress, right? So cortisol, the other component we haven't discussed, if you want to approach that or not, but looking at cortisol, elevation of cortisol, and dysregulation of the circadian rhythm and just stress overall, right, and the influence that has on neuroendocrine effects, yeah,

 

Dr. Ayla Wolf  21:37

When you do the Dutch test, are you typically ordering the one that includes the cortisol awakening response, to look at that cortisol activity first thing in the morning within that first hour,

 

Dr. Tatiana Habanova  21:48

I do absolutely. And there's always disruptions, you know, in that circadian rhythm. And then also I look at the drop that occurs around the lunchtime hour, because that is when the adrenals need to kick in to provide the cortisol for as the circadian rhythm will naturally decline. That's a natural circadian rhythm. It should drop and then kind of level out around 5pm right? So it should start to rise in the morning. We do want cortisol first in the morning. That is a very good thing that creates an awakening response. So, you know, sometimes people are alarmed that their cortisol is so high in the morning, it's like, well, relatively, right? So, but then I look at the peak and then look at that drop, and generally, that's where people have an afternoon lull, right? Sometimes it could be kind of eating food. Maybe they have some, you know, glucose intolerance. So they're eating lunch, and then they get sleepy, tired, drowsy, 15 to 30 minutes after a meal. Well, you know, that's a glucose metabolism issue, right? But assuming it's not that they just kind of feel like drop in energy, and then they kind of get better later in the day, those adrenals are not kicking in and supporting the chain the dropping of the cortisol and the adrenals are supposed to, you know, bring it in and to kind of level you out slowly, right, not a crash. So there is herbs that can be used to support that process, to help kind of bring you down more comfortably. And I find that very, very effective for people to manage their energy so they don't crash. They could be productive all day. Keep going. You know, we know movement, brain function, thinking, body movement, so important for brain health and brain healing, absolutely and managing and supporting those effects.

 

Dr. Ayla Wolf  23:36

Well you have shared a wealth of information. Do you want to talk a little bit... You said you're on a mission to provide annual brain health assessments to everybody. So tell me a little bit about what that looks like. So I think that this is something that I would love to see. This happen if we were in charge of healthcare, right? This is what we would implement.

 

Dr. Tatiana Habanova  23:59

I think on some level, there might be bigger powers in motion. There's some amazing women already on, I think, moving this torch forward as well. So I'm happy to be one of those voices to continue to create that movement. And not just particularly for women, but definitely for everyone in terms of, you know, we go to the eye doctor once a year. We go to the dentist maybe once or twice a year. We get an A yearly physical. These are normal, you know, little moments of assessments that we do in our health, right? It's just norm. It is what we do. But we don't do that for our brain. And why not? We're living longer. You know, we want, uh, longevity health, you know, especially if we've had a history of concussion or any brain injury. You know, I think it becomes a more of a due diligence that you take it upon yourself to say, hey, if your practitioner is not recommending this, which most of them aren't, at this moment, but trust me, time. Come, they will be and this will be a norm. You know how that looks like? I'm trying to develop a model right now of what should be included, because, as you know, we could do so many elements to neurological assessments, and we don't want it to be taxing and and too comprehensive in the sense where it takes so many hours, and it's difficult to implement into a practice, and for people to come in, maybe get it in a one hour visit, right? So keep it doable, to keep it the right information and things like that. So I'm trying to create a model and a standard or or beginnings of something that we can do, but the idea of that yearly is so critical, because it's going to pick up on anything that maybe you need to work on that you don't realize, right? It's just sort of like you get you a dental and you realize, oh, you have a little cavity. Well, you better deal with it. You better do something. You're not gonna just let it go. You're gonna treat it right. Or your eye eye prescription maybe needs to change slightly, right? So you go ahead and, you know, change your prescription, get new contacts or glasses. It's just what happens. So why not here, and why not move forward in life with the best brain that you possibly can have? Right? Because should something happen like a concussion or some brain injury, you know, going into the concussion is so important that you go, you never want to have a concussion? I don't want for anybody. But should that happen? You want to go into it with the best brain possible, and the only way you can do that is you keep tabs on if you don't measure it, you don't know what's going on.

 

So I think that idea of just doing that yearly, and then checking again the next year, and everything's the same, awesome. You know, if things have altered a little bit, let's fix that. And again, it's always better. It'll only be a quick little fix, and won't it be major right? Now, if there's something that we need to work on, let's work on it. Let's get that sorted out, and then you're good again. Let's move forward, right? So, so that's kind of the mission there, and just that, the stigma around the cognitive aspects of it, most people are pretty comfortable having their vestibular system evaluated, or the cervical, the neck and various things. But sometimes it comes to the cognitive people. People don't sometimes really want to take those cognitive tests because they don't want to know, because, I think they're afraid that maybe the test is going to show that they have some, you know, a cognitive decline, and we they feel at this moment, still in society there, yeah, there's people who doing amazing work of altering that stigma and helping people realize that even with mild cognitive impairment, there's things that we can do to turn That boat around and improve brain health. You know, having an evaluation that shows that there's some mild cognitive impairment is not a death sentence or a sentence to ulcer is Homer. You know, there isn't that, but we don't want you know, if we leave it unattended, maybe it might lead to that. So why? Why be risky like that, why not take care of it? I personally would rather learn about something sooner than later. So there's still a few things kind of help people in terms of navigating that and learning and education. And you do just such an amazing job on your podcast sharing this information, helping listeners, you know, really get to the truth behind things. And so, you know, I just support you 1000 different ways in the work that you do in the world and in your clinic and personally with patients so but, yeah, the yearly brain health assessment, I think, is something that should be normalized. I'd love to see more practitioners do it. I think they're not sure just how to not how people know what tests to do, just how well the structure. So I'm working on a doable model that people can just cookie cutter, tweak it to, obviously your patient appropriately, but something easy to implement. And there you go. There's the blueprint, you know, go, have at it, and let's get this going.

 

Dr. Ayla Wolf  28:59

And like you said, I think a lot of people are, they're okay being assessed, other things being assessed. But as soon as you say, Let's assess your brain, it's almost like people have reminiscence of, like, high school math test, right? They're all of a sudden having like, test anxiety, or they, you know, they are reminiscent of this whole grading system in school, and it's like, oh, you're gonna make me do a test. And so I think that the that's a little bit like you said, of a hesitancy, where people are like, my I'm fine. I don't want you to look at my brain. I don't want to be tested, you know. And it's, it's like, we're not in we're not testing your intelligence. We're just assessing different cognitive functions. It's not an intelligence test,

 

Dr. Tatiana Habanova  29:36

exactly, and that's a key point there. And also, I find, like, some people, like, honestly, don't want to know they're in denial. So there's that. But also what I find is, if there are cognitive changes, right, mild cognitive changes, so it's not like, drastic right, down somebody's after a concussion, you can have significant cognitive changes like this, right? And it is clear, I that. Is a little bit my experience. I think maybe your experience has some degree as well, right? But the mild cognitive changes people start to shrink their world so they can operate in a way that that they can tolerate to their brain function so they don't realize that their world is shrinking to some degree. So they can keep managing within that well, because we all want to do well. We want to feel well and good and successful, right? It's very important so, so, but they don't realize they're shrinking their world. And then when you expose them to some standardized cognitive tests, and again, not to make them feel bad, but just to say, hey, here's a benchmark of of, really the level you should be functioning at, right? And that's where we want to get you to, and we can make that happen, right, if possible, right? So again, don't make proposition. But again, let's say, realistically, I think that really helps. Sometimes people realize like, oh, wow, because they feel I'm fine. I can drive I can go to work, I can do this and this and this, my life's okay. I don't need that, right? And it's like, Well, okay, let's just kind of measure you to some standards. You know, is your world shrinking or not? Because the smaller it gets, the smaller it gets, the smaller it gets, the less of an existence we have. And there's so much to enjoy in this world, and we don't want to limit our potential, our abilities and our experiences. So I find also, that has been the case for many people too, where they're thankful afterwards and they're like, Wow, I had no idea that that that was happening, because I felt, you know, you put them in a new environment, you put them a little bit outside their world, and now, can you navigate things if you're not in the familiarity of your own little space?

 

Dr. Ayla Wolf  31:47

Yeah, right. And the other thing that I see is that when people have had a concussion, if their executive functioning is affected to some degree, part of executive functioning is internal self monitoring and self awareness, and so some people are not able to have that self awareness of when they're making mistakes, and so they might actually not even understand the degree to which the concussion has been affecting them cognitively, until somebody comes in and says, let's just look at these functions. Let's assess them, and then maybe shine a light on where you're struggling. Absolutely,

 

Dr. Tatiana Habanova  32:22

I think that's a good a good point, and that many times that's what I do. I just shine a light on people as well. They may not want to pursue this or that. If something showed up, sometimes they do, sometimes they don't. They said, hey, at least we have data. And this was a case, actually, with a patient of mine four years ago. We did a little mini evaluation. She's an equestrian athlete, and, you know, left for season, so they go up north and then back. So, you know, working together. And this, this season, actually, just a few months ago, I was like, You know what? We haven't, you know, done assessment for a while. Why don't we just run that real quick, right? I mean, we didn't do anything about it before, but we gathered some data, which is, why not just take a few minutes? Let's just run a few tests, right? Well, she was significantly worse at this current moment four years ago, and that opens her eyes of just like, Oh, wow. And I was like, we have a concussion in these last four years now, of course, she had a little history prior to that, but, you know, she felt she was functioning fine. You know, it happens. Life happens it you know. But she's like, Oh yeah, I did fill up a horse in September.

 

Dr. Ayla Wolf  33:29

Oh, wow.

 

Dr. Tatiana Habanova  33:30

I didn't really think that that affected me in any way. And here we are in February, March. I believe it was when we did it. So again, many months after that incident, you know, she got right back on the horse, and she felt a little off for a couple days, but, you know, whatever, and carried on, you know, and so, wow, now that we did our comparison, she's like she was a, thank God, we did that four years. I really don't want to do it, but I did it because you wanted me to.

 

Dr. Ayla Wolf  33:56

I did it to make you happy, but now I'm glad I did!

 

Dr. Tatiana Habanova  34:01

Bless her, but I'm good, grateful that we just did that. You know now we did some neuro rehab and cleaned that all up. And two months later, now she's left her season again, and she's doing a whole lot better

 

Dr. Ayla Wolf  34:14

Amazing, what a great example.

 

Dr. Tatiana Habanova  34:16

exactly. So even if you think it doesn't really matter, I think this is why it should just be a part of it annual. You don't think there's a problem, but hey, let's just take a look. Let's document it. Let's just keep some tabs. Same with the hormonal changes. You know, women should definitely be managing and tracking their menstrual phases, even postmenopausal or perimenopausals and things like that, or any type that someone has a concussion, I think they should just get a little notebook out, you know, and start writing down and tracking some of those symptoms as well, so that a physician can maybe then look at it and piece it together. Yeah,

 

Dr. Ayla Wolf  34:52

Well, you have shared such a wealth of information that I think a lot of people are going to be it's gonna be eye opening and fascinating for a lot of. People to be able to listen to this. So thank you so much for coming on the show. Why don't you tell us where people can find you

 

Dr. Tatiana Habanova  35:07

Absolutely you can just reach out to Palm Beach brain center. I'm actually not heavily on social media, as I once was in the past, trying to do a little bit of detoxing in terms of mental health and well being. So you can just go to the website, Palm Beach braincenter.com, or, you know the phone number and email is there, you could always reach out that way if you have any questions.

 

Dr. Ayla Wolf  35:31

Wonderful, amazing. Thank you so much Dr Tatiana.

 

Dr. Tatiana Habanova  35:36

Thank you so much for having me on your podcast and to share this time with your listeners. I'm really appreciative and grateful for our time together. Thank you.

 

Dr. Ayla Wolf  35:48

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