Toto's Take: Going to a functional neurologist and suggested exercises for healing
What I learned after 8 sessions at the functional neurologist's office
Dear Companions,
One of the inquiries in the Healingvrse that has attracted interest is the exercises I have learned for calming the autonomic system from a functional neurologist. While there may be products that can assist, such as GammaCore and Truvaga, I'm happy to know that I can target autonomic rewiring using just my mouth and body alone.
Below, I will provide some background on my experience of visiting the functional neurologist, along with explanations for certain exercises and their impact on the brain which were given for my condition. After that, I will present a three-week program with a list of exercises, accompanied by a couple of (subpar) videos demonstrating them.
(As a side note, I'm currently reading Shalamov, a major Russian writer on the Gulag experience. I can't help but wonder if someone like him would write a post like this, if he had gone through my experience, and had access to social media. I will return to this to this odd contemplation in the coming weeks, but for now please check out the below for this week’s endeavors!)
Basics
When I entered the functional neurologists office in order to further treatment on my post covid chronic headaches and migraines, I had no idea what to expect. Because I had not done any research prior to my appointment, I spent the first 15 minutes discussing medications. I realized, hours later, it was the wrong place for that discussion.
Unlike traditional neurologists who focus on diagnosing and treating neurological diseases and disorders, functional neurologists take a holistic approach to brain health, emphasizing the connections between the nervous system, the body, and the environment.
In my case, the doctor was a Chiropractic Neurologist—a chiropractor with brain training—who specializes in the diagnosis and treatment of neurological disorders by evaluating the function of the nervous system, specifically the brain and spinal cord.
Functional doctors are applicable to a wide range of issues:
Headaches and migraines (me)
Vertigo and balance problems
Movement disorders, such as Parkinson's disease and dystonia
Chronic pain conditions, such as fibromyalgia and neuropathies (me?)
Neurodegenerative disorders, such as Alzheimer's disease and multiple sclerosis
Autism spectrum disorders and other developmental delays
Attention deficit hyperactivity disorder (ADHD)
Cognitive impairment and memory loss
Post-concussion syndrome and traumatic brain injury (me?)
Sleep disorders, such as insomnia and sleep apnea
For Long Covid, there are many theories about the causes of the hundreds of symptoms people experience, including the post-viral headaches, which exhibit symptoms similar to traumatic brain injuries. However, almost everyone agrees that autonomic dysfunction plays a role to some extent. Visiting a functional neurologist can assist in addressing this issue and expedite the healing process. Since the exercises I'm sharing could benefit a wide range of individuals, please be kind enough to share them.
Initial assessment
The functional doctor I was referred to was the amiable Dr Kaplan, founder of Kaplan Brain and Body, a full service chiropractic neurology and wellness center located in in New York City. Dr Kaplan diagnosed me immediately as being in a protracted state of fight or flight. He said there were several things that he noted within 2-3 minutes of talking to me:
My Pupillary Hippus (PH) in my eyes were contracting and dilating as though I were afraid of him through the duration of our first meeting
The carotid vein in my throat was bulging, meaning poor blood flow
Also interesting to note, after a series of exercises which I performed with both my left and right hands and feet, Dr Kaplan noted a weakness on my left side, a very small one—less than 1 point, on a scale of one to ten—and that is exactly the same result that I got when visiting the traditional neurologists office where I was hooked up to a special machine. When my migraines are right-side focused, Dr Kaplan suggested that it is because my right side is compensating for my left side, and this is the crossed representation theory, which means:
One theory is that weakness on one side of the body can be a sign of dysfunction in the opposite hemisphere of the brain, which may be more susceptible to cortical spreading depression and the resulting migraine symptoms on the opposite side of the head. This is known as the "crossed representation" theory, which suggests that the left side of the brain controls the right side of the body, and vice versa.
What we need to do
Those of in sustained fight or flight need to activate the parasympathetic nervous system. According to Dr Kaplan, the main problem with taking medicine to achieve that end is that it tends to achieve one purpose at all times, like calming us down at all times. This may be a good for a time, but, ideally, even if we do take medication, we learn how to achieve a balance with an activated sympathetic and parasympathetic systems working together.
In simpler terms, there are appropriate times to be alert and times to rest. The issue lies in the fact that the sympathetic system is often required to be active much more frequently in modern life demands. Chronically ill or stressed individuals may find themselves in a sympathetic state for several hours each day. However, in reality, a healthy person might only need about 60 minutes of sympathetic activation throughout the day.
Another silent yet associated benefit of engaging in this work, especially when I was in the state I found myself in a couple of months ago, was that it instilled a proactive mindset regarding my healing process. It provided me with the strength to pursue other avenues of healing, (think getting a Therasage for detoxification, despite being heat intolerant, which I will delve into in a future discussion).
Parts of the brain we are working on
The exercise that I learned tackled four parts of the brain: the cerebellum (in charge of balance), the frontal lobe (in charge of memory and cognition), the parietal lobe (visual and spacial awareness) and the brain stem, which consists of pons and the medulla oblongata, (in charge of the autonomic system). As all of these parts of the brain are connected—the regions simply demarcated like lines on a map—activating one, can activate others and help to balance the autonomic system.
For example, exercises that involve sorting through a challenge with eyes closed are proprioceptive and activate the parietal lobe, which is responsible for spatial awareness. The infinity symbol exercises, which I will explain below, focus on balance and activate the cerebellum. Exercises that require focusing on spelling the months of the year while performing another exercise or increasing difficulty by listing the months backwards address cognition and activate the frontal lobe. That is why it is always great to increase complexities of exercises once your mind gets adjusted to them.
Four main nerve branches
Those of us in a sustained fight or flight need to figure out how to re-activate the parasympathetic nervous system which is in charge of rest and digestion. The medulla oblongata activates the parasympathetic system through the release of neurotransmitters, such as acetylcholine, which binds to receptors on target organs and initiates parasympathetic responses. The parasympathetic fibers arising from the medulla oblongata travel through the vagus nerve and other cranial nerves to reach various organs, including the heart, lungs, gastrointestinal tract, and urinary bladder.
The exercises I was given therefore focus on 4 main nerve branches (below) which hook up to the pons and stimulate the vagus nerve.
Oculomotor nerve: This nerve originates in the midbrain and innervates the muscles that control pupil constriction and lens accommodation in the eye.
Facial nerve (CN VII): This nerve originates in the pons and innervates the salivary glands, lacrimal gland, and nasal mucosa, as well as the muscles of facial expression. Breathing exercises while stroking your face would activate this nerve.
Glossopharyngeal nerve (CN IX): This nerve originates in the medulla oblongata and innervates the parotid gland, as well as the posterior one-third of the tongue and the pharynx. Several tongue exercises here.
Vagus nerve: The one we seem to be most popularly acquainted with, this nerve is the longest of the cranial nerves and has multiple branches that originate in the medulla oblongata and innervate the heart, lungs, liver, pancreas, stomach, small intestine, and colon. The vagus nerve also plays a role in regulating heart rate, blood pressure, and digestion.
In-office visit
There are certain exercises that can be done both in the office and at home. During office visits, the staff used a laser for inflammation, usually applied to my neck. Dr. Kaplan also utilized a special zapping device that stimulated the tongue (specifically the glossopharyngeal nerve). However, tongue-centric exercises can also achieve similar results at home. Needless to say, chiropractic adjustments or massages required Dr. Kaplan's special touch.
Of course, a doctor is also able to assess progress. For instance, around 5-6 sessions in, Dr. Kaplan noted that my previously weaker left side was catching up with my right side. However, many of us seeking to simply feel better can gauge if the exercises are working by experiencing a reduction in symptoms. These days, I have certain exercises that I rely on in stressful situations to immediately induce a state of relaxation.
Duration and best results
Generally, my appointments were intended to last 1 hour, about 20 minutes spent with the doctor and 20 minutes with staff on exercises. Often, there was a lot more downtime in the office due to other patients.
Dr Kaplan said best results could be achieved by doing 8 sessions in-office per week for 3 weeks, or 24 sessions in total for three weeks, and in combination with at home exercises starting at 15 minutes per day 3x per day.
Exercises
Most of us will simply be doing the at home exercises. My homework started with 6 exercises to be done for 15 minutes per day 3x per day for Week 1. In Week 2, you can layer on another set of 6 exercises, building up the length of time you do them. In Week 3, you are doing all 12 exercises 3x per day.
Do whatever you can, and feel free to increase the challenge level at your own pace, so by week 2 or 3 you may have your own ideas for song you want to hum and combinations of things you are doing.
First week assignment
Gargle for 30 seconds
Hum for 30 seconds
Draw the infinity sign in the oppose direction with your opposite arm and leg (eventually you can add on complexity like listing the months backward while doing this, or listing anything in an office that starts with the letter “S”). Start with 15-30 seconds and do each side.
Splash cold water on the face for 30 seconds (and ultimately tack on a couple minutes to the end of every shower)
Rub ear for 30 seconds
Blow air between your checks
See video:
Try these in week two…
Gag reflex 1x per day (should be a strong gag but not to vomit!)
Tongue exercises (example: infinity symbol, spell your name, numbers, shapes, etc., with your tongue, switch it up!) for 30 seconds
Golf Ball Swallow for 30 seconds
Breath work inhale, hold, and exhale for 4/7/8 second respectively and use your fingers to brush your forehead, across your checks and alongside your jawline in an upward motion with each inhale, hold, and exhale
Blow air between your cheeks and sing a tune (example: happy birthday, or Miley Cyrus’s wrecking ball) for 30 seconds
Make animal sounds (example: pig sounds, frog, any animal, really get in there and use your vocal chords!) for 30 seconds
See video:
Combine all 12 exercises in Week 3, 3x per day!
Bonus: Intensives (2x per week) TBD
In a future post, I will add a few bonus exercises, which may require another persons help, and which you can add twice a week, as though you are going to the office and working with one of the nurses staff.
I hope this is useful and helps you get started doing these in conjunction with your healing routine.
As always, much love from the Healingvrse,
Rebecca
Super interesting. Can’t wait to hear how this goes for you!