An Integrative Medicine discussion featuring experts in diagnosing and treating Traumatic Brain Injury. The Brain Injury Summit is held June 1, 2019 in Scottsdale Arizona at Holistic Urgent Care. Our goal is to share the latest updates in diagnostic testing for traumatic brain injury and effective management of TBI patients to maximize healing and restore function. visit www.holisticurgentcare.com to learn more. Or follow us on Facebook or Instagram!

1. Brain Injury Summit
Saturday June 1st 2019
www.holisticurgentcare.com
Dr. Rebecca R. Miller - Holistic Urgent Care + Primary Care
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2. Today’s Agenda
• Clinical Assessment and Diagnosis of
Concussion/TBI
• Dr. Rebecca Miller – Naturopathic Physician and
founder of Holistic Urgent Care
• Dr. Gary Rosas – E.R. Physician
• Dr. Raul Galvez – Pediatric Radiology
• John Leonard – former NCAA quarterback, BrainScope
Market Development Manager
• TBI Recovery – Therapeutic Modalities and
Lifestyle Medicine to promote healing from TBI
• Dr. Rebecca Miller
• Dr. Simon Billingham – Functional Neurology and
Electrons Plus Guided PEMF
• Dr. Diana Mladenoff – Chiropractor, Neurofeedback
Expert, and Concussion Clinic Medical Director
• Joanne Phillips M.S. R.D. – Empowered through TBI,
Nutrition Expert and TBI Survivor
• Marian Mitchell – Integrative Medicine Health Coach
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3. Learning Objectives
• Clinical Assessment and Accurate
Diagnosis of TBI/Concussion
• Identify Common Signs and Symptoms
• SCAT 5 Diagnostic Tool; ACE Form
• Criteria for CT Scan and/or ER Visit
• Applications for BrainScope
• Second Impact Syndrome/Return to Play
• Effective Treatments for TBI Recovery
• Nutrition Strategies for Brain Health
• Vitamins and Supplements that benefit
TBI Patients
• OTC and RX Pharmaceuticals for TBI
• Hormone Therapy in TBI Patients
• Clinical Modalities for Rehab of TBI
• PEMF, Neurofeedback, HBOT
• IV Therapy – Ozone, HDIVC, NAD
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WTF is a Holistic Urgent Care?
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What is Naturopathic Medicine? AKA - are you a “real” doctor? 5

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7. The Pickle Pledge
I will turn every complaint into a constructive suggestion
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9. I hit my head –
now what?
Clinical Assessment and Diagnosis
of mTBI/Concussion
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#metoo
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11. Dr. Gary Rosas M.D. MBA
www.thebalancedlifemd.com
Emergency Room Physician
Human Potential Coach
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Before we get going, let’s introduce some key terminology
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Its all about C.Y.A. No one gets sued for doing “too much”
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14% of ER Visits for Head Injury.
70% of CT Scans run in the ER were of the Head.
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26. Dr. Raul Galvez-Trevino M.D.
Pediatric Radiology
Considerations for Neuroimaging of TBI
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So what’s the big deal about CT Scans anyways?
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Medical Imaging and Cancer Risk
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Diagnosis in Babies/Toddlers is especially difficult.
Radiation Exposure at this age is especially dangerous.
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Head Trauma CT Scan Criteria Ages 2-13
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Intracranial Hematoma or Hemorrhage
A.K.A. “Brain Bleed”
Often Asymptomatic at first
Without prompt diagnosis & treatment, Often fatal
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What happens in Vegas….. …was brought to AZ! 🌵
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40. Second
Impact
Syndrome
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How can we prevent
Second Impact Syndrome?
When is it appropriate to return to play?
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45. Healing from a
Traumatic Brain Injury
Lifestyle Medicine
Therapeutic Modalities
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49. Therapeutic Tools for Healing TBI’s
• Interventional Therapies
• Dr. Diana Mladenoff
• Concussion/TBI Expert
• Neurofeedback
• Dr. Simon Billingham
• Functional Neurology Expert
• Founder Electrons Plus PEMF
• Dr. Rebecca Miller
• RX and OTC Therapies for TBI
• Procedures, Infusions, and Holistic Treatments for TBI
• Individual Practices/Lifestyle Medicine
• Joanne Phillips
• TBI Survivor, founder “Empowered Through TBI”
• Masters in Nutrition Science; Designs for Health
• Dr. Rebecca Miller
• The 3 Non-Negotiables
• Environmental Exposures and Clinical Variables to
consider with TBI patients
• Marian Mitchell
• Integrative Medicine Coach
• How to feed a Brain
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51. TBI’s Cause Oxidative Stress
Making you MORE SENSITIVE to other stressors!
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54. The Three
Non-negotiables
1.Clean Air
2.Clean Water
3.Clean Food
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Clean Air?
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CLEAN AIR
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Clean Air?
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HBOT – Hyperbaric Oxygen Therapy
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HBOT – Hyperbaric Oxygen Therapy 62

63. Clean
Water
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66. CLEAN
FOOD
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Effects of ALCOHOL
Intake on the Body
Bad Idea for TBI Patients!
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The Gut-Brain Axis
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85. Avoid Pesticide Residue
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90. What a Healthy
Diet Looks Like
for TBI Recovery
Marian Mitchell
Integrative Health Coach
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93. Environmental
Exposures and TBI
These every day threats become MAGNIFIED when your
Brain is Injured.
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An injured brain loses it’s ability to regulate – easily overstimulated and emotionally labile

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104. Vitamins and Minerals
Nutritional Supplements to consider
for TBI Recovery
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105. Test.
Don’t Guess.
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111. Nutrient
Density in
Food
Why would I need to take
vitamins?
How could I be so deficient?
But I eat so “HEALTHY”!
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114. Joanne Phillips, MS, RD
Nutrition Expert and TBI Survivor
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115. Joanne Phillips M.S. R.D.
• TBI Survivor
• Expert in TBI Recovery
• Brain Injury Nutrients/Supplements
• Cranial Osteopathy
• PRP and Stem Cells
• HBOT
• Empowered Through TBI – est. 2019
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The Day EVERYTHING Changed – April 15, 2007

120. Nutrients for
the Brain
• DHA (Omega 3’s)
• Phosphatidylserine (PS)
• Aceytl-L-Carnitine
• Glycerophosphocholoine
• Ginko Biloba
• Vinpocetine
• Magnesium Threonate
• CoQ10/PQQ
• Exogenous Ketones
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121. DHA
• Fish oils
• Helps release neurotransmitters more efficiently and effectively across
the synapse resulting in better communication
• Increases BDNFs (Brain Derived Neurotropic Factors)
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123. Phosphatidylserine
(PS)
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Phospholipid
component of brain
cell membranes
Need to maintain
cell membrane
fluidity along with
FA (DHA)
Plays a vital role in
cell to cell signaling
in the brain
Helps in memory (working and long term),
logic, concentration, recall, clarity of thought,
initiative, attention span

124. Glycerophosphocholine (Alpha-GPC)
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NATURAL COMPOUND FOUND
IN OUR CELLS
HELPS IN THE SYNTHESIS OF
PHOSPHOLIPIDS
BOOSTS ACETYLCHOLINE LEVELS
WHICH HELP WITH MEMORY, MENTAL
FOCUS AND REACTION TIME

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126. Acetyl-L-
Carnitine
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Naturally found in the brain, CNS, spinal cord, motor
nerves and skeletal muscle
Form of L-Carnitine that helps energize the brain
Plays an important role in the transfer and utilization
of long chain fatty acids to produce energy
Helps support acetylcholine production which
needed for memory, focus and learning
Antioxidant

127. Ginko Biloba
• Promotes good blood circulation in the brain
• Protects the brain from neuronal damage
• Antioxidant
• Helps with cognitive function
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128. Vinpocetine
• Vasodilator
• Relaxes the vascular smooth muscle
• Enhances cerebral blood flow
• Protects neurons
• Improves memory, focus and learning
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Exogenous Ketones and TBI

134. Brain Derived
Neurotropic
Factors
(BDNFs)
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Miracle grow for the brain
Stimulates the growth of new neurons:
neurogenesis
Higher BDNFs make the brain more resistant to
decline
Increases the size of the hippocampus
Enhances long term memory
Lower BDNFs have been associate with
depression and dementia

135. Proven to Increase BDNF
• Exercise
• Sunlight
• Sleep
• Socializing
• Fasting/Caloric Restriction
• Meditation
• Yoga
• Coffee Fruit Extract
• Curcumin
• Omega 3’s
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136. Treatments
that helped me
HEAL my TBI
• Craniosacral Osteopathy
• Intranasal Stem Cells
• PRP
• HBOT
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137. Craniosacral Osteopathy
• Cranial osteopathy (also called cranial therapy or craniosacral therapy)
is one variety of osteopathic manipulative therapies.
• It stimulates healing by using gentle hand pressure to manipulate the
skeleton and connective tissues, especially the skull and sacrum
• Frees up restrictions in the movement of cranial bones and associated
soft tissues and to stimulate the flow of the cerebrospinal fluid, which
bathes all the surfaces of the brain and the spinal cord
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138. Intranasal Stem Cells
• Pluripotent stem cells from the blood
• These are uncommitted cells that can generate into neural cells
• Goal of stem cell treatment is to replace damaged cells and to promote
the growth of new blood vessels and tissues to help the target organ
function at a greater capacity.
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139. PRP (Platelet Rich Plasma)
• 300 different growth factors
• These can help rebuild collagen in the brain
• Pluripotent cells work in combination with PRP to help the stem cells
migrate to the damaged tissue
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140. HBOT – Hyperbaric Oxygen Therapy
• Hyperbaric oxygen therapy (HBOT) is a medical treatment which
enhances the body's natural healing process by inhalation of 100%
oxygen in a total body chamber
• The HBOT was used post stem cell treatments as it upregulates stem cell
activity by 400-500%.
• The use of HBOT increases oxidation, increases blood flow, increases
angiogenesis and increases collagen production.
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142. Dedicated to
empowering the
survivors of Traumatic
Brain Injury and their
caregivers with
cutting-edge
information and
resources
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143. Everyone
deserves an
chance to have
a SuperBrain
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144. Tools for TBI RECOVERY in
offered in our Practice
•Nutritional Supplements
•IV Therapy
•Glutathione
•NAD Therapy
•Ozone Therapy
•Infrared Sauna
•Acupuncture & Cupping
•PEMF – Electrons Plus Guided PEMF
•Neurofeedback
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155. IV Therapy
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156. Ozone
Therapy
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Ozone Therapy
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166. Dr. Simon Billingham
• Chiropractor
• Functional Neurology
• Founder of Electrons Plus Guided PEMF
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169. Comprehensive Chiropractic
Care for Concussion Recovery
Dr. Diana Mladenoff
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170. Neurofeedback and TBI
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171. Acupuncture and TBI
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172. RX and OTC Meds and TBI Patients
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174. Inpatient
Neuropharmacology
for TBI
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Current Recommendations for
Outpatient Drug Treatment of
Post Concussive Symptoms
• Antiemetics
• OTC Analgesics
• Acetaminophen most commonly
recommended
• Amantadine (potentiates
dopamine)
• SSRI’s (anti-depressants)
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181. SMART DRUGS
Neuropharmacology of enhancing Memory and Cognitive
Function
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190. Hormone Therapy and TBI Recovery
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NED = Neuroendocrine Disorder

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Sufficient Thyroid Hormone is
Necessary for Brain Injury Healing.
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Testosterone and TBI

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TBI Shrinks the size of your “Bucket”

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205. v
• Minimum 150 Minutes per week
of Moderate Exercise
• Or 75min/wk Vigorous Exercise
• Strength Train 2X per week
• At least 20min per day gentle
activity for TBI recovery
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