Latest / Broken Brains with Bruce Parkman / Dr. Marissa McCarthy, Board Certified Brain Injury Specialist

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Dr. Marissa McCarthy, Board Certified Brain Injury Specialist · Broken Brains with Bruce Parkman

• 0:12
  Speaker 1: If you belong to a church that utilizes ayahuasca as a loophole.
• 0:16
  Speaker 1: So there's a church in Orlando that has affiliation with this veteran owned group and they do vet-only retreats.
• 0:22
  Speaker 1: And I sat in a room of 12 men and women that have all seen combat, that have been through just some of the most troubling experiences with drugs, suicidality, family, child abuse themselves when they were kids and man.
• 0:40
  Speaker 1: We sat next to each other and retched and vomited and crapped our pants and cried and moaned.
• 0:46
  Speaker 1: For a weekend, three treatments.
• 0:48
  Speaker 1: I didn't know this.
• 0:50
  Speaker 1: It was like the ranger school of ayahuasca On Sunday.
• 0:54
  Speaker 1: We're standing up there like, are you guys ready to start?
• 0:56
  Speaker 1: We're like no, we don't want no more.
• 0:59
  Speaker 1: And we went right back at it man and the things you have to address and the progress you make.
• 1:07
  Speaker 1: I watched 12 men and women become better people.
• 1:11
  Speaker 2: Wow, so is there a counselor there as well.
• 1:15
  Speaker 1: Well, no, they are.
• 1:16
  Speaker 1: They have people that don't drink.
• 1:19
  Speaker 1: They don't drink the stuff around you and they watch.
• 1:22
  Speaker 2: Okay.
• 1:23
  Speaker 1: But there's no's.
• 1:24
  Speaker 1: Uh, there's an emt on site um, and you're very, very well screened, like you know, if you yeah but uh, yeah, it was, uh, it was a trip more ways you have to be off all uh medication for two weeks, correct?
• 1:40
  Speaker 1: yeah, and no alcohol.
• 1:42
  Speaker 1: I didn't know this till three days before.
• 1:44
  Speaker 1: No, no sex.
• 1:44
  Speaker 1: I'm like what my wife's like say that again.
• 1:47
  Speaker 1: I'm like I'm sorry, honey, I'm just kind of following the doctor's orders.
• 1:51
  Speaker 1: I had no idea.
• 1:52
  Speaker 1: And then once we got in there, they explained that they really don't know.
• 1:58
  Speaker 1: It's like sex do have something to do with how you interact.
• 2:05
  Speaker 1: I didn't care.
• 2:06
  Speaker 1: But no alcohol, no caffeine.
• 2:08
  Speaker 1: Anybody that's on SSRIs has to get completely off them you know.
• 2:13
  Speaker 1: So these men and women went through all that just to get they like.
• 2:17
  Speaker 1: For some of them, it was their last chance to try something that would help them be better.
• 2:23
  Speaker 2: And maybe they don't need to go back on it after that.
• 2:26
  Speaker 1: And that's what I'm wanting to see.
• 2:27
  Speaker 1: So we have we'll talk about this too is we've got permission from the FDVA now, general Hammer.
• 2:36
  Speaker 2: Oh good, you connected.
• 2:37
  Speaker 1: Yeah, we were in his office with Mike Hartsell from the Avalon.
• 2:40
  Speaker 2: Yeah, oh yeah, I know him very well.
• 2:42
  Speaker 1: Yeah, so we got he got me in there and we've got permission now that they will support legislation for a trial project.
• 2:49
  Speaker 1: We pay for alternative treatments for vets because all of these are out of pocket.
• 2:54
  Speaker 1: You know you go to Mexico, you're out five 6,000 bucks.
• 2:57
  Speaker 1: Oh, I'm sure, and they're paying for this and then Ibogaine, so I've done ayahuasca.
• 3:01
  Speaker 1: I'm going to do a psilocybin treatment with Dr Palanco next, next month, but that's a lot of money.
• 3:06
  Speaker 1: For one day I had like five thousand dollars.
• 3:08
  Speaker 1: I'm paying for it.
• 3:09
  Speaker 1: It's part of my research and I'm trying to.
• 3:11
  Speaker 2: You're your own guinea pig, right what's that?
• 3:15
  Speaker 1: you're again, I walk the walk as a leader, you know I mean that's it.
• 3:19
  Speaker 1: If you're gonna go to combat, I'm gonna be in front of you or right there with you.
• 3:22
  Speaker 1: You know, that's awesome and so I'm just trying it out, but I'm going back bringing my wife, you know, but, man, you lay it out there, so you know it's good but uh okay all right.
• 3:32
  Speaker 1: Well, it's great to see you and so all right so you want to start this from the top, denny?
• 3:36
  Speaker 1: is that what we're looking for, or is that?
• 3:38
  Speaker 1: Hey, denny.
• 3:40
  Speaker 1: Oh, okay, do you want me to start the intro again?
• 3:45
  Speaker 1: All right?
• 3:50
  Speaker 1: Hello folks, welcome to our next episode of the Broken Brains Podcast.
• 3:57
  Speaker 1: I'm your host, bruce Parkman.
• 3:59
  Speaker 1: Let's try that again.
• 4:00
  Speaker 1: Hello folks, welcome to the second episode of the Broken Brains Podcast.
• 4:05
  Speaker 1: I'm your host, bruce Parkman.
• 4:06
  Speaker 1: This is brought.
• 4:07
  Speaker 1: Second episode of the Broken Brains Podcast.
• 4:09
  Speaker 1: I'm your host, bruce Parkman.
• 4:11
  Speaker 1: This is brought to you by the Mack Parkman Foundation, our host and sponsor, and we really appreciate you listening to this broadcast starting to get a lot of attention out there as we're addressing very, very critical issues that are not talked about a lot, that are affecting literally millions and millions of Americans.
• 4:24
  Speaker 1: Today, our guest is Dr Marissa McCarthy.
• 4:27
  Speaker 1: I met Dr McCarthy late last year through a good friend of ours, brant McCarthy no relationship, of course, mccartney, I think, is the way it was and we started talking about her expertise in the areas of concussion.
• 4:43
  Speaker 1: And Dr McCarthy is a board board certified specialist in physical medicine and rehabilitation and she has a subspecialty board certification in brain injury medicine, which makes her highly relevant to this topic today.
• 4:53
  Speaker 1: And as we talk you'll see why and the work she's done, particularly with veterans.
• 4:58
  Speaker 1: She's currently the program director for the University of South Florida Physical Medicine and Rehabilitation Resilient Training Program and holds an academic appointment in the University of South Florida as the Department of Neurology Associate Professor.
• 5:09
  Speaker 1: And she's been around the space for quite a while.
• 5:13
  Speaker 1: She doesn't look her age, she's out there right now.
• 5:15
  Speaker 1: She's earned her doctorate at the University of Miami Miller School of Medicine, completed her internship at the Internal Medicine at New York Medical College and residency training in physical medicine and rehabilitation at Baylor College of Medicine in Houston, texas, which happens to be my nephew Baylor's favorite college and he's trying to get there here as he graduates here pretty soon.
• 5:35
  Speaker 1: And she's received acupuncture training at the Helms Medical Center and is a certified battlefield acupuncture instructor and I think you do work at the polytrauma clinic.
• 5:46
  Speaker 1: I think is with Dr Miller here at the VA Pines Hospital.
• 5:50
  Speaker 2: So I work at James A Haley in Tampa.
• 5:53
  Speaker 1: Okay, All right, Great.
• 5:54
  Speaker 1: Well, we're so happy to have you on board here and obviously you've been around the brain space for quite a while.
• 6:00
  Speaker 1: So how did you get into the brain space?
• 6:02
  Speaker 1: What made you focus from you know obviously becoming you know into being in the medical field, to starting to focus on brain, and particularly brain trauma?
• 6:12
  Speaker 2: So I would say, during my residency training when I was in Houston, you get exposed to everything from spinal cord injury, traumatic brain injury, stroke, amputation, any type of catastrophic injury.
• 6:22
  Speaker 2: Those are the patient populations that we would serve as physical medicine and rehab providers, and during my training I actually really fell in love with the brain itself as an organ.
• 6:35
  Speaker 2: I think we know very little about what the brain has the capability of doing probably like 10% through neuroscience and research and there's just so much more.
• 6:47
  Speaker 2: The brain is responsible for everything and anything that we do.
• 6:51
  Speaker 2: It controls our entire body.
• 6:54
  Speaker 2: So for me it was just it was more of a how do we learn more about this?
• 7:01
  Speaker 2: How can we tap into this?
• 7:02
  Speaker 2: How can we also heal the brain when there is a trauma?
• 7:06
  Speaker 2: So I think I've always kind of focused my energy and my drive in medicine more towards the unknown versus what we do know, and that's pretty much why I chose to work in the brain space.
• 7:20
  Speaker 2: And then, as most of us know exactly where we were on 9-11, I remember being in medical school in our.
• 7:30
  Speaker 2: It was kind of like an area where you could get your mail and take a break and you know, and I you know, as, as I saw what was happening, my grandmother literally lived five blocks from the Twin Towers, so all I remember, and that back then we didn't have cell phones and the ability to contact.
• 7:50
  Speaker 2: She's also older, you know, and here I am thinking, oh my, I mean, I mean, it is right there.
• 7:55
  Speaker 2: I remember my grandfather taking me there as a kid, you know, all the time.
• 7:59
  Speaker 2: So I'm trying to get in touch with her and you know we can't get hold of her for a long period of time.
• 8:11
  Speaker 2: Same thing my cousin worked in the trade towers and she was coming in from Hoboken.
• 8:13
  Speaker 2: So everybody has a story around.
• 8:14
  Speaker 2: You know where they were when it happened and how it changed the trajectory of their lives, right?
• 8:19
  Speaker 2: So for me, I think, at that point in time I knew, you know, that I wasn't necessarily in the military service, but I decided at that point in time that my service would be to take care of the active duty and veterans, you know, for the rest of their lives.
• 8:36
  Speaker 2: So that's what really put me in that space.
• 8:39
  Speaker 1: I mean you talk about not having cell phones.
• 8:41
  Speaker 1: I remember when 9-11 happened I had buddies that were working at Pentagon and they had no communications and they're like, but their computers worked.
• 8:49
  Speaker 1: They're like Pac-Man what's going on?
• 8:51
  Speaker 1: And I'm watching TV going and I'm like dude, another plane just hit another tower.
• 8:55
  Speaker 1: And I'm like, because they had nothing and they were in the.
• 8:57
  Speaker 1: Of course, the Pentagon was locked down and the plane came no-transcript.
• 9:18
  Speaker 2: So you know, as I completed medical school and then I went to residency in Houston, we had a very large VA in Houston.
• 9:26
  Speaker 2: But having grown up in Tampa, I knew at that point in time that I wanted to go back to Florida, just because, I mean, obviously I did my medical school training in Miami.
• 9:36
  Speaker 2: My, my parents lived in Tampa and a friend of mine said to me oh, did you see there's an advertisement at you know, james, a Haley VA, they're looking for a TBI doctor.
• 9:47
  Speaker 2: And I was like, really, and you know, he sent it to me.
• 9:50
  Speaker 2: I, um, I came to interview and it, you know, you know that feeling when you, when you meet someone and you're like it's like family.
• 9:59
  Speaker 2: Well, I got that feeling at the interview and it was, I mean, the rest is history.
• 10:07
  Speaker 2: So I've been there for 16 years and I was hired pretty much during the height of the war, when a lot of catastrophic injuries were happening, even beyond, like subconcussive exposures.
• 10:22
  Speaker 2: I was hired in 2008.
• 10:26
  Speaker 2: We saw a lot of trauma that I know that you're familiar with.
• 10:31
  Speaker 2: But on the road to recovery, end everything that happens in theater, the stabilization, and then going to Germany, and then going to Walter, walter Reed, and then coming to one of the five polytrauma centers we're getting them now where the families are actually meeting them for the first time when everything's happened.
• 10:50
  Speaker 2: So a lot of times families will stay at Fisher House and then they'll come in through MacDill, at least for the Tampa location, and then get transported to our facility.
• 11:00
  Speaker 2: So I was taking care of them.
• 11:02
  Speaker 2: You know, at the very first moment when the family is finally able to reconnect and and truth be told, it's called poly trauma but we often called it poly drama affiliation with the individual show up so all sorts of things can happen.
• 11:28
  Speaker 2: You know when there's a traumatic event in someone's life.
• 11:33
  Speaker 2: But it was a really great opportunity, not only as a fresh physician but, you know, from a humanistic standpoint.
• 11:39
  Speaker 2: You know learning to deal with major, with major trauma and then also, um, kind of the social aspects of things and health and healing and social reintegration.
• 11:50
  Speaker 2: So we see them from.
• 11:51
  Speaker 2: You know, the time they're severely injured to.
• 11:54
  Speaker 2: You know, hopefully getting them home, um, as independent as possible.
• 11:59
  Speaker 1: You must've seen some really amazing, I mean with all the tragedy, of course you know, and the trauma and the drama that's going on.
• 12:08
  Speaker 1: Do you have a particular story of a veteran that you saw that you know maybe people had given up on that?
• 12:15
  Speaker 1: You know, this guy's or girl is just not going to make it, or any, you know, overcame some adversity.
• 12:23
  Speaker 2: I mean it might've been we have several and I would say that's what kind of keeps you know physicians going.
• 12:30
  Speaker 2: It's, it's the ones that you don't expect you know to do well, to, to progress and go home.
• 12:36
  Speaker 2: Yeah, I mean, you know severe helicopter crash, brain injury, amputation, you know burn injury, like you name it.
• 12:45
  Speaker 2: They have it all and now they're, you know, living with a wife and children, perhaps wheelchair bound, but you know, able to function independently, and a lot of them end up moving to the area so that they can do their follow-up care here.
• 12:59
  Speaker 2: So what's really nice is that we continue to see them throughout their lives and the really wonderful thing about our specialty is that we are your doctor for life.
• 13:10
  Speaker 2: It's not like you're here, you leave and we never see you again.
• 13:15
  Speaker 2: So I think that's something a lot of people don't know about physical medicine and rehab.
• 13:19
  Speaker 2: We were kind of like a very small specialty, you know, in the realm of medicine and our specialty was actually born out of World War II.
• 13:32
  Speaker 2: So they didn't realize that there was a need for physicians during World War II when people were coming back with amputations or let's even say PTSD because at the time they didn't even call it that and what would happen is.
• 13:51
  Speaker 2: They would come through, and a lot of times there were nuns or nurses that would rehab soldiers when they were coming back from war.
• 14:03
  Speaker 2: And so in the 1940s, that's when our specialty was born.
• 14:07
  Speaker 2: So learning you know what a physician could do in that space is really how our specialty came to be.
• 14:17
  Speaker 2: I think it was in Warm Springs, georgia.
• 14:20
  Speaker 1: That's hugely interesting Now.
• 14:22
  Speaker 1: I mean, I mean because it makes sense, but I, you know, I I would say too that you know, during World War II and Korea and even Vietnam, I think we did a much better job of taking care of the veterans, because the injuries that we had were mostly physical from a year-long tour.
• 14:42
  Speaker 1: In your opinion, we've had 20 years of war and these veterans go, and then they go again, and then they go again, and they go again.
• 14:52
  Speaker 1: How have you seen the evolution of veteran care, particularly with the brain, since you've been at the trauma clinic?
• 15:02
  Speaker 1: Because what are your thoughts on that?
• 15:04
  Speaker 1: From just the repetitive, not just the stress too, but last exposure.
• 15:10
  Speaker 2: I would say, you know, traumatic brain injury is the signature injury of the war on terror for sure, and it's invisible.
• 15:18
  Speaker 2: You're right, you know there are people that have incurred multiple traumatic brain injuries, mild traumatic brain injury, concussion, however you want to call it, it's all synonymous.
• 15:29
  Speaker 2: There was a blow to the brain somehow, some way, physiologically, there was a disruption.
• 15:34
  Speaker 2: You may not see it on an image, you may not, you know, see it.
• 15:39
  Speaker 2: You know in front of you, like like radiographically.
• 15:43
  Speaker 2: But all you have to do is take a history.
• 15:45
  Speaker 2: If anybody tells you if they tripped and fell and they felt a little dazed and confused, they had a concussion, okay, it doesn't even have to be, you know, a combat experience, it doesn't even have to be a training evolution.
• 16:00
  Speaker 2: It could be something as simple as a slip and fall.
• 16:04
  Speaker 2: It doesn't matter how you get your brain injuries, it's the fact that you have them.
• 16:09
  Speaker 2: And then what happens over time?
• 16:11
  Speaker 2: And you're right, with multiple deployments, with multiple exposures to blasts, with very little downtime and also very little medical care, and it comes from both sides.
• 16:23
  Speaker 2: You know, a lot of times we call them warriors.
• 16:26
  Speaker 2: They don't want to tell anybody what happened because they don't want to be put in a position where they're not able to be in the fight.
• 16:34
  Speaker 2: So they downplay their symptoms so they can continue on in their mission.
• 16:38
  Speaker 2: It's not until we get them as they're ready to transition or to retire, you know, especially when I see them in clinic, I'm like, okay, how many jumps, how many?
• 16:49
  Speaker 2: Oh, I can't even count.
• 16:52
  Speaker 2: Thousands, thousands.
• 16:54
  Speaker 1: Thousands.
• 16:55
  Speaker 2: Really Okay.
• 16:56
  Speaker 2: Well, let me tell you something when your body hits the ground, no matter how like good your knees are, I guarantee you there's a reverberation in your brain, guarantee you.
• 17:05
  Speaker 2: Okay, you know.
• 17:08
  Speaker 2: And how many falls were hard.
• 17:11
  Speaker 1: Yeah.
• 17:13
  Speaker 2: So there's so many ways to incur brain trauma that you know, a lot of times you don't even think about, you know, even artillery rounds, even with ear protection, Okay, and it's, you know, it's not just the brain that bears the brunt of it.
• 17:30
  Speaker 2: You can have barotrauma in your chest, you can have it in your stomach, you know, you can have it in your musculoskeletal system and there's different order effects depending on the type of injuries that that you have, you know, from small pipe bombs to very large blasts.
• 17:45
  Speaker 2: So, um, you know, obviously we promote uh safety, but despite the safety equipment and the protective gear, it can still happen.
• 17:57
  Speaker 1: You bring up a couple of really um, you bring up a couple of really really good, you know points.
• 18:04
  Speaker 1: I mean, I remember you know I've got about 175 parachute jumps and just the opening shock when that parachute goes and you're, and you're, you got this five pound metal thing on your head and your head's going down or it's coming up Exactly.
• 18:20
  Speaker 1: And and then, of course, none of my jumps.
• 18:22
  Speaker 1: They were all night jumps.
• 18:23
  Speaker 1: I had my eyes closed and you hit.
• 18:27
  Speaker 1: I mean that's just one thing.
• 18:29
  Speaker 1: And then the whole piece about artillery tankers and explosive ordnance personnel who we know are suicide rates out there.
• 18:37
  Speaker 1: I mean you're on the cutting edge.
• 18:40
  Speaker 2: I'm going to move my dogs, don't worry about it.
• 18:44
  Speaker 1: That's why we got Danny to produce and edit all this stuff Open the door.
• 18:49
  Speaker 2: I just know them.
• 18:50
  Speaker 2: They're going to jump and bark.
• 18:51
  Speaker 2: Okay, we're good.
• 18:52
  Speaker 1: No, no.
• 18:53
  Speaker 1: But you know we've had, you know the focus on.
• 18:57
  Speaker 1: You know, early on in the war it on in the war it's like we see in sports right, cte concussions, yeah, and the war it's been tbi, tbi and more tbi.
• 19:06
  Speaker 1: And you know, like you talk about the slip and fall, how many parachute jumps, but you can't quantify those subconcussive effects in combat because you never know.
• 19:15
  Speaker 1: You know you can't count how many grenade blasts.
• 19:17
  Speaker 1: Or you know how many times you fired a you know 50 caliber round and that's a high caliber round with high PSI, when that thing, when I think that goes out.
• 19:28
  Speaker 1: You know I am under the impression that most of the medical community to include a lot of the VA that are not in the like my clinic here in Bradenton Florida are just not aware of the impacts that this has on the brain.
• 19:45
  Speaker 1: So let's start with the first question is you know, after suffering all this trauma, what are the symptoms?
• 19:52
  Speaker 1: You know when somebody says, well, you know, I had like 100 parachute jumps, I mean you can quantify those kind of TBIs.
• 19:59
  Speaker 1: But when you dig deeper into their background as a tanker and artillery, you know what are you looking, what are you seeing in these veterans when they come to you.
• 20:10
  Speaker 1: You know what kind of disorders are you are, you are you seeing?
• 20:11
  Speaker 2: So?
• 20:12
  Speaker 2: And I would go even further back, because a lot of the people that that I work with that joined the military also had maybe a traumatic childhood, maybe they played a lot of sports.
• 20:22
  Speaker 2: I'm laughing, maybe they also had a lot of other concussions before they were 18.
• 20:28
  Speaker 2: So we're looking at an injured brain before we join and an injured brain after, up until retirement.
• 20:37
  Speaker 2: Most common thing I hear about is headaches number one, number one symptom.
• 20:42
  Speaker 2: Number two would number one symptom, um.
• 20:43
  Speaker 2: Number two would be, uh, memory issues.
• 20:45
  Speaker 2: Um, you know, I just can't remember where I put my keys or I can't find the remote, or you know, I know I had this conversation but I really don't remember it.
• 20:54
  Speaker 2: Um.
• 20:55
  Speaker 2: And then I would say number four is mood.
• 20:59
  Speaker 2: Uh, mood swings, highs and lows, you know anger, you know just kind of the inability to self-regulate feelings, and then I mean there's a whole host.
• 21:14
  Speaker 2: But I usually tell people, like at the time of a concussion, you can have those symptoms as well.
• 21:20
  Speaker 2: You can have physical, where your vision's blurry, you got a headache, you know, you just feel off.
• 21:25
  Speaker 2: You can have cognitive, where you're not able to remember things, and you can have emotional, where you're kind of like crying and you don't really know why, and that can all happen, you know, at the time of the event.
• 21:37
  Speaker 2: But then you know Fast forward 5, 10, 15, 20 years later when you're having trouble sleeping, when you're having daily headaches.
• 21:47
  Speaker 2: When you're starting to feel the pains, you know, and it's not pains of aging, most likely there's injury there.
• 21:53
  Speaker 2: Again, you know, from hundreds or thousands of jumps, I guarantee you, every joint in your body hurts and that starts to take a toll then on you mentally, Like what is happening to me.
• 22:05
  Speaker 2: So a lot of depression, a lot of anxiety, um, and then even other mental health, um, organically will, um kind of show its head, whether it's, you know, bipolar disorder, schizophrenia, schizoaffective, major depressive disorder, a lot of those we often see, or they, they get diagnosed, you know, certainly later than you know they probably should have been.
• 22:33
  Speaker 1: I'm sorry, go ahead.
• 22:34
  Speaker 1: No, you keep going.
• 22:35
  Speaker 1: This is amazing.
• 22:36
  Speaker 2: No, I just, I just think that you know, over, over time, you know your brain and your body can only take so much and everyone has a breaking point and it isn't until what we were talking about earlier you allow yourself to become vulnerable, to express what's actually going on inside, to share the symptoms that you're having.
• 22:58
  Speaker 2: That it then gives, you know, the provider the opportunity to ask the questions you know that need to be asked and for the individual to provide the answers that are needed.
• 23:13
  Speaker 2: You know, to kind of tailor the care to properly treat the issues that are happening.
• 23:15
  Speaker 2: You know I always tell people like if I had a magic wand and I could take away every head trauma you've had, I would do it.
• 23:23
  Speaker 2: Or if there was a pill or if there was some, you know, treatment like, at this point in time, all we have is the ability to treat symptoms right.
• 23:31
  Speaker 2: We don't have anything that can take away what happened.
• 23:35
  Speaker 2: All we can do is try and work with what we have.
• 23:38
  Speaker 2: And you know I truly believe.
• 23:39
  Speaker 2: You know I'm a little bit more holistic than you know, most medical doctors.
• 23:44
  Speaker 2: You know I do believe that living a healthy lifestyle, getting adequate sleep, exercising, getting out in the sun, eating a low inflammatory diet.
• 23:54
  Speaker 2: Like the longevity medicine side of me really believes that that can help deal with any type of abnormal protein deposition in the brain and not necessarily reverse things but prevent them from getting worse.
• 24:10
  Speaker 2: Because that's all we have.
• 24:12
  Speaker 2: That's all we have right now.
• 24:15
  Speaker 1: No, and I think you said something that I really think everybody should understand is that I mean, we're seeing, you know, severe psychological disorders in men and women that have never seen combat, just from training so hard and um, you know that.
• 24:32
  Speaker 1: That is, you know, something that you know.
• 24:34
  Speaker 1: I know that as a, you know, I was a Vietnam era kind of guy, right I in 1980, we didn't have no budget, we basically had sticks, we didn't have all these grenades and flashbangs.
• 24:44
  Speaker 1: And then, you know, towards the end of my career, when I was, you know, running CQB close quarter combat drills, we were lining up on the door, like you know the charges right there and we had tons of you know, then we had, you know, reagan was getting things moving, we had all kinds of everything we wanted.
• 25:00
  Speaker 1: Now we train.
• 25:01
  Speaker 1: It's like like like it's war every day.
• 25:06
  Speaker 1: I mean like I got a stepson 82nd.
• 25:07
  Speaker 1: I talked to my buddies back and you know, spec ops, some of the uh special units, man and they're, they're training like it's going to war.
• 25:13
  Speaker 1: And I think that, as you know, I mean we gotta have, we have to be smarter about not only training.
• 25:19
  Speaker 1: But then to your point here is, how do we make the community smarter about these issues, Because when they do emerge, you know, like my mental health breakdown was at 59, right Years later, after all my rugby and things, whatever you know, we got to catch this early right.
• 25:37
  Speaker 1: How do we disseminate this knowledge from you know remarkable doctors like yourself out into the community of care, so that people are looking for this and, more importantly, soldiers are educated on this?
• 25:50
  Speaker 1: So when they say, you know, hey, I'm getting, I'm starting to get real irritable, or I'm, you know, I'm flipping my switch, or I got, I'm going to jail, I got in trouble, I got in a bar fight.
• 26:01
  Speaker 1: You know how do we?
• 26:08
  Speaker 1: You?
• 26:09
  Speaker 2: know, how do we, how do we get this out there?
• 26:09
  Speaker 2: How do we educate?
• 26:10
  Speaker 2: What are your thoughts?
• 26:10
  Speaker 2: Well, I kind of think what we spoke a little bit about earlier definitely legislatively providing education.
• 26:15
  Speaker 2: I think it starts earlier.
• 26:17
  Speaker 2: I do teach-ins at my kids' school, even for the little ones, to learn about brain injury or what it's like when mom or dad comes back from war or deployment or something like that, because the youth is the future and if they can understand it, then they can take it forward.
• 26:36
  Speaker 2: I think in schools and hospital systems there are education opportunities all the time.
• 26:42
  Speaker 2: It's just who taps into him and who has the time for it, truth be told.
• 26:46
  Speaker 2: But I also think that top down as well as bottom up is the only way to really make an impact.
• 26:55
  Speaker 2: Again, kind of what we talked about before making sure that people know that it's okay to say, when they've been injured, you know, not being fearful that they're going to let's just take the law enforcement community that they're going to be stuck at a desk and taken out of their patrol car Cause a lot of people don't want that.
• 27:13
  Speaker 2: So it's it's definitely a stigma issue too.
• 27:17
  Speaker 2: So, administratively, I think you know commanding officers and you know, people at the top need to make it a safe space, and then the individual who gets injured needs to feel safe to talk about it.
• 27:31
  Speaker 2: That's just within.
• 27:32
  Speaker 2: Now let's talk about community or society in general.
• 27:35
  Speaker 2: That's a whole other education opportunity.
• 27:40
  Speaker 2: I do believe starting in schools is a great uh place, because that's where all the learners are now, whether you start at the elementary level or you go so far as university.
• 27:51
  Speaker 2: Um, I think that that's a really great way to get the message out.
• 27:54
  Speaker 2: In addition to, I mean, social media, um, you know, public service announcements those kind of, I think are are also ways in which you can educate the public.
• 28:06
  Speaker 2: Now that, all being said, 20 million veterans in America, only 5 million use the VA system of healthcare.
• 28:13
  Speaker 2: So we've got 15 million who aren't using it.
• 28:15
  Speaker 2: Okay, and of those 5 million, I think about like 20% actually like, utilize it to the utmost degree.
• 28:23
  Speaker 2: So now you've got 15 million Americans not getting care through the VA and they're seeing civilian doctors who don't know, like you to your point.
• 28:31
  Speaker 2: So it's also making sure that we get our veterans and our active duty enrolled in in the VA system of care, where you do have more providers that are more educated, you know in the intricacies of injuries related to combat and training and you know military life, as opposed to civilian doctors who don't know the first thing about it.
• 28:57
  Speaker 1: That's a good point.
• 28:58
  Speaker 1: I mean, I think that, on the subject of, you know, repeated blast exposure, rbe, I think more education needs to get out there because we're still seeing gaps with the therapist community that's referred to from the VA, you know, and then the doctor population itself.
• 29:15
  Speaker 1: That just needs more education on, look, this is a from a causality perspective.
• 29:21
  Speaker 1: Now, you mentioned a little bit earlier about, you know, we can make things better, but we can't, you know, heal your brain.
• 29:28
  Speaker 1: Yet there is all kinds of alternative approaches that are that are not FDA funded, they're considered experimental, but we have thousands of benefits.
• 29:39
  Speaker 1: You can talk about all the psychedelics.
• 29:41
  Speaker 1: You can talk about supplementation diet, and then all these technologies, hbod and transcranial magnetic stimulation, photobiomodulation, all these other ways, and some of them are, you know, there's some evidence that there is some neural regrowth, there's some neuroplasticity recovery, there's that they're helping, at least from a physiological perspective, uh, maybe helping the brain compensate for some of the damage a hundred percent although that's out there I, I I've always felt any alternative treatment modality as long as it can't hurt you.
• 30:17
  Speaker 2: Why wouldn't you try it?
• 30:18
  Speaker 2: Okay?
• 30:20
  Speaker 2: Um, you know I I'm not a fan of places that claim to have a cure and want to charge you $10,000 a day, you know, and then you leave with, you know, half a million dollar debt.
• 30:31
  Speaker 2: But I do believe I mean hyperbaric has huge promise.
• 30:36
  Speaker 2: For sure, you know, we've seen a lot of people not only get better but feel better, and I think part of it is feeling better.
• 30:46
  Speaker 2: When they feel like they're getting better, they are better.
• 30:48
  Speaker 2: And neuroplasticity and neurogenesis happens till you're 90 years old, so you do have the ability to create new neural pathways, to grow new nerve and brain cells.
• 30:59
  Speaker 2: Now, what's going to prevent that from happening?
• 31:01
  Speaker 2: Kind of goes back to what I said.
• 31:02
  Speaker 2: If you're smoking and drinking all the time, if you're not eating right and you're not exercising and you're sleeping when they tell me they sleep two hours a night, to me that's a nap yeah, okay, that is not going to help you.
• 31:17
  Speaker 1: Yeah.
• 31:18
  Speaker 2: Not going to help you.
• 31:19
  Speaker 2: So you know my promotion seven to nine hours.
• 31:22
  Speaker 2: American Academy of Sleep Medicine.
• 31:24
  Speaker 2: I'm a nine hour person.
• 31:25
  Speaker 2: I am, I have to have nine hours.
• 31:27
  Speaker 2: We're children right, they all do I sleep.
• 31:33
  Speaker 1: train them from six months old, they all sleep, oh yeah.
• 31:38
  Speaker 2: Very important.
• 31:38
  Speaker 2: I mean sleep.
• 31:40
  Speaker 2: To me, Sleep is the Holy Grail.
• 31:43
  Speaker 1: Wow.
• 31:44
  Speaker 2: I really believe it because you spend, technically, you spend one third of your life sleeping and sleep is actually like your brain's not at rest.
• 31:56
  Speaker 2: It's actually doing all kinds of things.
• 31:57
  Speaker 2: It's regulating your hormones testosterone, insulin your immune system function.
• 32:01
  Speaker 2: In your brain you have something called the glymphatic system, which is like your lymphatic system, but immune system function.
• 32:04
  Speaker 2: In your brain.
• 32:04
  Speaker 2: You have something called the glymphatic system, which is like your lymphatic system, but for the brain, and that is actually almost like a vacuum and that helps get rid of the cells in your brain that are not functioning properly, and that only happens through sleep.
• 32:18
  Speaker 2: Okay, so sleep is restorative.
• 32:19
  Speaker 2: Sleep is very restorative, specifically stage four.
• 32:24
  Speaker 2: So a lot of um, a lot of the people that come through our program, we either put a whoop or an aura on them to see are you actually hitting stage four sleep?
• 32:33
  Speaker 2: Now, those are wearables, you know, and they have their own um pluses and minuses, but you know, at least to get a general idea, are you even hitting stage four sleep?
• 32:42
  Speaker 2: Are you hitting that deep sleep where you have that recovery and repair happening, to know whether or not that is a situation?
• 32:48
  Speaker 2: And then there are certain.
• 32:49
  Speaker 2: I use supplements.
• 32:50
  Speaker 2: I don't use prescription medication, but I will use simple supplements like magnesium to get someone sleeping again, to help them manage their headaches, to help with muscle recovery, and you know, I mean it's a.
• 33:03
  Speaker 2: It's a simple um supplement that has no harm um and it can really really enhance your sleep quality and by enhancing your sleep quality it allows you to recover.
• 33:14
  Speaker 2: And I'll tell you most, most military guys and girls don't sleep no, um, it's uh, they, they don't, they, they don't sleep.
• 33:24
  Speaker 1: And girls don't sleep.
• 33:25
  Speaker 1: No, they don't, they don't sleep and they don't even try to sleep and I think that's normal.
• 33:29
  Speaker 1: I mean, they've gone through 21 years in the military and you know I can literally remember drinking all night and going right to PT and running five miles.
• 33:40
  Speaker 1: You can do anything when you're in your 20s, right?
• 33:42
  Speaker 1: I mean, you know it's just crazy.
• 33:45
  Speaker 1: Unfortunately, it becomes a lifestyle and that's.
• 33:48
  Speaker 1: I think that's where I mean you're talking a lot of.
• 33:50
  Speaker 1: You know.
• 33:51
  Speaker 1: You're talking about a lot of things that you know soldiers just got to get used to being vulnerable, exposing themselves, talking about when we have a problem.
• 33:59
  Speaker 1: And we now understand that.
• 34:02
  Speaker 1: And I think that you know I just went on a retreat ayahuasca retreat veterans this weekend and there is such a significant distrust of the VA and I try to tell them like, look, the VA is trying to do the best they can, but we need to help them do more.
• 34:18
  Speaker 1: And I do think we do need a little bit more innovation, maybe through legislation, to fund some alternative treatments.
• 34:25
  Speaker 1: But it sounds like you'd be all about it.
• 34:27
  Speaker 1: I mean, if nothing?
• 34:28
  Speaker 1: Number one, the drugs that are given to you if you're mentally ill do nothing to help at all.
• 34:34
  Speaker 1: They just zombify you, they mask you, and that's what everybody I'm talking to is afraid of.
• 34:41
  Speaker 1: When I had my issues, they put me on some to is afraid.
• 34:46
  Speaker 1: When I had my issues, they put me on some, you know, just some mild ones, some Bupressorol, something like that, and I hated it.
• 34:49
  Speaker 1: I took it once and I'm like I have to figure this out and I think to your point.
• 34:54
  Speaker 1: Soldiers love a mission and if they're, you know, if they're not, if they're mentally ill, they're scared because they don't want to be mentally ill and they don't know what caused it.
• 35:02
  Speaker 1: But if there is an organic issue behind it, a biological issue, such as a damaged brain, now they have a mission, but they need access to the treatments that can help them.
• 35:11
  Speaker 1: So it sounds like you know you'd be all about them, at least you know, with vetted caregivers trying some of these other non-pharmaceutical modalities in conjunction maybe with some therapy and stuff like that Definitely.
• 35:28
  Speaker 2: And one thing I'll say about the VA you've been to one VA, you've been to one VA.
• 35:32
  Speaker 2: They're all different.
• 35:34
  Speaker 1: Yeah, no, I think you're right, and I think some of the problems that we're seeing that I think can be addressed through the understanding and scaling of this is that you go to the polytrauma clinic, which is amazing, right, you get three weeks, but you're from Alabama, right, you come here, you get this amazing level of care and you leave, and then you go home and you can't follow up.
• 35:57
  Speaker 1: You can't.
• 35:58
  Speaker 1: So we have to get this like throughout the system, and I think the the understanding of RHI is, is, is, is going to be huge.
• 36:09
  Speaker 1: And you got to get that out there.
• 36:11
  Speaker 1: So, as we close out, what are your thoughts on?
• 36:15
  Speaker 1: Like you know, we're here to talk about the brain, broken brains.
• 36:19
  Speaker 1: Obviously you deal with soldiers.
• 36:22
  Speaker 1: Do you have any recommendations to those that are out there that are listening right now?
• 36:26
  Speaker 1: They could be struggling, they could know somebody.
• 36:29
  Speaker 1: I mean, once you hear about this issue of repeated blast exposure, repeated head impacts on contact sports, I've had so many people tell me you can't unsee this.
• 36:37
  Speaker 1: You see this everywhere.
• 36:39
  Speaker 1: I talked to a friend this morning a judge, uh.
• 36:41
  Speaker 1: One of her friends just did a study that 98% of people in custody incarceration had some TBI in their life.
• 36:50
  Speaker 1: Oh, I would agree, we have 1 million veterans that are incarcerated right now.
• 36:55
  Speaker 1: How many of them are incarcerated because of a service-related disability?
• 37:00
  Speaker 1: Now, we can't stop childhood trauma, and guess what?
• 37:03
  Speaker 1: People that are traumatized in childhood sometimes make the best soldiers.
• 37:06
  Speaker 1: I mean, I'm sorry, and if we scream for that, we're going to be really impacting our fight of war.
• 37:11
  Speaker 1: Right, it's like, oh, you can't come back, you had a messed up childhood, right, but you know.
• 37:15
  Speaker 1: So you know.
• 37:16
  Speaker 1: How do we?
• 37:17
  Speaker 1: Just some last thoughts on how do we educate, how do we inform?
• 37:21
  Speaker 1: Not just the caregivers, the VA and our amazing clinics that are out there, but what about our soldiers and their families?
• 37:27
  Speaker 1: Because sometimes it's the wife that's got them by the ear, dragging them in and saying I listen, you need to listen.
• 37:32
  Speaker 1: That's happened to me so many times.
• 37:33
  Speaker 1: What are your thoughts, melissa?
• 37:36
  Speaker 2: So I think coupling mental health with traumatic brain injury from a, I think it'll start out kind of at a state level, um, to get the proper funding and focus and education, um, you know not, and I think I think you gotta go bigger.
• 37:54
  Speaker 2: You gotta go bigger than just, you know, the veteran population, um, you know, couple it with athletes, couple it with law enforcement and kind of get that momentum going so that you know we can create a healthier and happier and more well-adjusted society.
• 38:13
  Speaker 2: You know, to these again, invisible injuries, you know somebody loses an arm or a leg.
• 38:18
  Speaker 2: You see it, somebody has repetitive head injury.
• 38:21
  Speaker 2: You don't see it, you don't see it until they finally get, you know, the help that they need or find the provider that they need.
• 38:30
  Speaker 2: Here in Tampa, you know we have the USF concussion clinic, which is where we see all walks.
• 38:36
  Speaker 2: I see veterans there that are not willing to go to the VA.
• 38:39
  Speaker 2: I see young athletes from ages 12 and up.
• 38:45
  Speaker 2: I see former professional athletes with evidence of CTE as young as their 20s and 30s.
• 38:52
  Speaker 2: I see people that were in car accidents, people that are victims of domestic violence, childhood trauma.
• 39:00
  Speaker 2: Nobody is immune to traumatic brain injury, nobody.
• 39:07
  Speaker 2: So I think you know, kind of having the right people in your court, whether it's the right legislators and and it's both sides there's no political divide here.
• 39:21
  Speaker 2: So so getting everybody on the same page to help with overall brain health.
• 39:29
  Speaker 2: Like I said, the brain is the most important organ in the body.
• 39:32
  Speaker 2: It controls everything.
• 39:33
  Speaker 2: Why wouldn't there be more of a push to make sure that we all have the best functioning brains possible?
• 39:43
  Speaker 2: You know, you know for our nation.
• 39:47
  Speaker 1: We don't focus on how vulnerable the brain is.
• 39:49
  Speaker 1: We don't even understand we as a society, we just think the brain is you know, you can beat it like a muscle.
• 39:54
  Speaker 1: We think the brain's a muscle.
• 39:55
  Speaker 1: We do not understand the complexity and just you know this the magnificence of this organ that you know that God created, we have in our head that does, it determines everything that we have.
• 40:09
  Speaker 1: And and I know that today we kind of focused on veterans I'd love to have you come back on the show and talk about sports, athletes and children, because that's the other.
• 40:17
  Speaker 1: That's the other side of our, that's the other side of our mission here at the Mack Parkman Foundation.
• 40:20
  Speaker 1: That's the other side of our mission here at the Mack Parkman Foundation.
• 40:23
  Speaker 1: But you know, like you know, like you just mentioned, ma'am, you know we've got a lot more we can do for our veterans and not that we haven't been trying.
• 40:33
  Speaker 1: I think now that we understand, after 20 years of war, not just the impacts of that TBI, that IED, but these lifestyles and now tying the mental illness to that which is not really happening yet, but it's coming, it's coming, opening up alternative therapies and educating.
• 40:48
  Speaker 1: I looked at these kids this weekend and I know that World War II, vietnam, you did one year, which still was tough.
• 40:56
  Speaker 1: It was hard.
• 40:56
  Speaker 1: You take two months to get back home.
• 40:58
  Speaker 1: These kids are leaving combat and being with their families within 24, 48 hours.
• 41:03
  Speaker 1: I mean they're bringing all that trauma.
• 41:07
  Speaker 2: Oh yeah.
• 41:07
  Speaker 1: And I watched these boys and girls and their kids.
• 41:10
  Speaker 1: Man, they're in their thirties on the old man struggling so hard.
• 41:13
  Speaker 1: We have never, ever done what we've done to this generation of soldiers with these multiple deployments and we have.
• 41:20
  Speaker 1: We have a huge check to write.
• 41:22
  Speaker 1: These kids we, we owe them.
• 41:24
  Speaker 1: I mean, they did not do anything wrong.
• 41:26
  Speaker 1: Their only crime was they joined the military to serve their country.
• 41:29
  Speaker 1: Or they were there at 9-11 and said, man, I'm going to go whoop some ass.
• 41:34
  Speaker 1: And they did, and they're hurting.
• 41:36
  Speaker 1: They're hurting and for some reason, the traditional levels of care, which is pharmaceuticals and therapy, are not doing anything for them and we need folks like you that understand the correlation between their injury in the brain and their mental illness, to put that together with other treatment programs to get that help.
• 41:56
  Speaker 1: Dr McCarthy, I cannot thank you enough for coming on.
• 42:00
  Speaker 1: It's been so exciting, great to see you again.
• 42:03
  Speaker 1: I look forward to it, and we do need to talk about that study.
• 42:06
  Speaker 1: I want to run with your concussion clinic and get that moving, very, very interested in that.
• 42:11
  Speaker 1: But thank you for bringing your expertise and your passion to our show and we look forward to having you on another edition of Broken Brains.
• 42:21
  Speaker 2: Love to be there.
• 42:22
  Speaker 1: Thank you All, right, thank you All right, thank you, thank you.