August 21, 2024 • 42 mins
What if the secrets to preventing long-term brain injuries in professional bull riders could fit into a single podcast episode? Join us on this episode of Beyond the Rodeo as we welcome Dr. Anthony Alessi, a revered neurologist and WSF provider, who opens up about his fascinating journey into the rugged world of caring for professional bull riders and shares critical insights on evolving concussion protocols in Western sports. Learn about the transformative impact of baseline testing and the tireless efforts to ensure athletes' safety through stringent concussion management.
In our conversation, Dr. Alessi sheds light on the often-overlooked condition of traumatic encephalopathy syndrome (TES) in athletes. As he explains the symptoms and treatments of TES, Dr. Alessi explains how tailored medical plans can elevate an athlete's performance and overall well-being. This episode strikes a compassionate tone as we discuss comprehensive medical evaluations, which include state-of-the-art brain imaging and neuropsychometric testing, and how these assessments pave the way for effective solutions to issues such as migraines and attention problems.
Brain health isn't just about recovery; it's about maintenance. From the critical role of proper diet, regular exercise, and sufficient sleep to the dire consequences of alcohol and smoking, Dr. Alessi walks us through practical strategies to sustain brain health. We also touch on the benefits of helmet use, the importance of aerobic exercise, and how athlete-to-athlete sharing fosters a supportive community. Tune in to learn more about the holistic and dedicated approach that is changing the landscape of athlete care in Western sports.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Aubrey O'Quin (00:12):
You're listening to Beyond the Rodeo,
brought to you by Western Sports Foundation,
the podcast that will explore the ups and
downs of rodeo life and reveal ways to help
the sport of rodeo reach new heights.
I'm your host, Aubrey O'Quinn.
Let's get to the show.
(00:40):
Hi everyone, Thank you for joining us today
on Beyond the Rodeo.
I am your host, Aubrey O'Quinn, and I am
joined by my dear friend and amazing doctor,
Dr Anthony Alessi.
Thank you for joining us today.
Dr. Anthony Alessi (00:54):
Great to be here, Aubrey, as always.
Aubrey O'Quin (00:55):
Well, today I wanted to just spend a little
bit of time.
First, just tell us about you and what you
do and how long you've been doing what
you're doing, and then we can jump into a
little bit of what you do with Western
Sports Foundation.
Dr. Anthony Alessi (01:09):
Oh great.
So I'm a neurologist, I'm a medical doctor
specializing in diseases of the brain and
peripheral nervous system, that's, the
brain spinal cord and the peripheral nerves
that go to the arms and legs, and in my
specialty, back in 1995, I started doing
(01:32):
work with athletes.
Particularly about that time is when I
started working with the New York Yankees
and concussion was just becoming an issue
back then and we were just starting to hear
about it.
Shortly after that I started working with
combat sports athletes.
So these are athletes who do MMA boxing,
(01:56):
because we had several casinos near us here
in Connecticut.
So I started working with these
self-employed athletes who are out there
boxing and with that my practice gradually
evolved to doing a lot of different sports.
About 17 years ago I started working with
(02:16):
Dr Tandy Freeman and Rich Blinn, who were
working with PBR back then and they were
coming to the Mohegan Sun Casino and we
developed a friendship and a relationship
professionally where I would start seeing
some of their athletes who had brain injury
or any other neurologic injury.
(02:37):
So it's been an interesting evolution with
me and Western sports, especially someone
who's born and raised in New York knowing
very little about Western sports, over the
years I've come to not only appreciate it,
but truly enjoy the athletes I get to work
with in Western sports.
Aubrey O'Quin (02:59):
I always enjoy listening to all of the
different facets of athletics that you're
involved in and who you've gotten to work
with, and so tell us, I guess, a little bit
about what you've been able to do with Dr
Tandy and Rich and how you know I know over
the years they've kind of put together this
(03:19):
concussion protocol and all of that.
So how did that kind of come about and did
you help them in kind of putting that whole
process together?
Dr. Anthony Alessi (03:28):
Yeah.
So putting that all together was a
collaboration, you know, among us really,
when we realized something had to be done I
mean, the number one injury in professional
bull riding is concussion and so it was a
big issue.
But you know we have to turn back.
The was a big issue, but you know we have
(03:49):
to turn back the page a little bit.
You know, when I was in medical school in
the late 70s and early 80s, when I was in a
residency in neurology at the University of
Michigan, we never heard the word
concussion.
I don't think I heard the word concussion
more than five times because it's such a
vague term, it doesn't really define
anything.
So it's really over the last 30 years that
(04:09):
this term has become part of the
conversation, where now you can't turn on a
show or watch an event without the word
concussion and protocol coming up.
So when we look at concussion, by
definition it's a syndrome, it's a group of
symptoms that come on after a biomechanical
(04:30):
force is applied to the brain.
So a blow to the head and you get a
transient group of symptoms.
So that means not everybody who hits their
head has a concussion.
But yet in professional bull riding we were
seeing the same symptoms that fit
concussion, but not necessarily by getting
(04:51):
a direct blow to the head.
It was more this indirect movement back and
forth on the bull, and we were seeing that
more and more.
So we had to have some criteria to tell us
when somebody shouldn't get on.
And that's how this developed.
Was you know, how do we know when somebody
(05:11):
shouldn't be getting back on?
And that's when the whole re-screening.
So the best way to do that is to have some
baseline of all of your riders, and that's
when we put together originally Cognigram
and using the balance board and things such
as that.
So we had a group of baseline tests that we
(05:32):
could compare the athlete to after they got
injured, and that made a huge difference
and it's carried through today and we've
gone through several iterations.
Every year it gets better and better and it
makes the sport safer and safer for
athletes.
Now we only do that for professional bull
(05:54):
riding and we're only doing it on the
highest level of tour.
Aubrey O'Quin (06:00):
So we're starting to get it down to
velocity in some of the lower tours, which
is our next big challenge rodeo athletes is
(06:27):
the same sort of um, like increase in
concussion with, like bareback and saddle
bronc riders, just cause they have that
same sort of um, you know, back and forth
movement while they're on the bucking horse,
I mean concussions fairly uh, common with
those athletes as well.
Have you seen?
Dr. Anthony Alessi (06:40):
Well, it is uh, you know, know it's common
in all Western sports, but there are
different circumstances, different
mechanisms of injury.
And it's interesting when you say, are we
seeing it more?
I don't think we're seeing it.
I think we're recognizing it more.
I think it's always been there.
(07:01):
It's just that you just got back on and
what we found is that getting back on, even
if you're hurt, shortened the career, and I
think we're finding that in all of Western
sports.
So are we seeing it in bareback?
Yes, we're seeing it in rope words.
I mean, there's so many incidents where you
(07:25):
know their head is hitting a rail.
Any number of events can happen whenever
humans and animals are interacting at high
speed.
You're going to have something go wrong.
(07:49):
Something go wrong.
So you know, the question becomes now
Western sports athletes are finally being
treated as athletes.
Let me explain.
I guess I was surprised that they weren't
necessarily treated as athletes like
baseball players, football players, in
terms of training, diet, mental approaches
to your sport, all the things that increase
(08:12):
your longevity in the sport.
And finally, some of the younger athletes
are figuring it out.
They're figuring it out that they're a
business and the longer they can stay in
business, the better off they're going to
be, the more money they're going to earn,
the more secure they're going to be and the
safer they're going to be.
So they're starting to realize that there's
(08:36):
a lot more to this than just getting on a
bullet, hanging on for eight seconds, and
with that, brain health has become a big
issue and a big plus for them, thanks to
Western Sports, really, and the Western
Sports Foundation and working with
physicians and athletic trainers who
(08:56):
understand the nervous system and how it
works and how you can get it healthy.
Aubrey O'Quin (09:02):
You know, we, you, you mentioned a little
bit about, um, concussions and symptoms and,
uh, you know.
So what, what are some of those symptoms
that are either defined that you have had a
concussion or just you know what are, what
makes it a concussion and just what makes
it where you're maybe showing some symptoms
of it, but you don't necessarily have a
concussion Cause.
(09:23):
I mean, I've, I know, I have, and I'm sure
you have too, had conversations with a lot
of Western sports athletes that are like,
oh, I've had 50 concussions in my career.
Um, you know so is that a?
Nor is that a normal number, is that kind
of an exaggerated number and it's probably
more realistic of five concussions, but
they maybe had some of those symptoms.
Dr. Anthony Alessi (09:49):
Yeah, I'm glad you brought that up.
So when we look for a concussion, we're
looking for some basic signs, the initial
signs being that vacant stare, being
somewhat disoriented, not knowing where
they are, having an initial headache,
nausea, vomiting, dizziness, inability to
keep their balance.
So when we're looking at a rider who's down,
we're looking.
(10:09):
Is it taking them longer to get up?
Do they need more help getting up?
Are they dazed when they get up?
Are they looking around, not knowing?
We know they're very dependent on the
bullfighter, but are they more dependent
than other times?
So we're looking for the initial signs of
(10:30):
concussion to really direct us and let us
know how severe the injury is.
And don't forget, concussion is really the
most mild on this spectrum of brain injury,
right the most severe being a bleed into
the brain, and we've seen plenty of those
and that becomes a neurologic emergency.
(10:52):
Now, when it comes to bull riders counting
their concussion, they don't count a
concussion until they've lost consciousness.
So they come to me with these concussions
and you know one in particular said, you
know he had nine concussions in two years
with loss of consciousness.
That's an unbelievable number.
(11:13):
But then he started showing me video after
video after video on his phone and it was
pretty impressive from that standpoint.
So there are these signs of concussion,
among them loss of consciousness or
alteration of consciousness.
So those are the things we look for in the
initial sign.
The symptoms are the more long-lasting
(11:35):
signs, the headaches we can't get better,
the difficulty thinking and processing
information.
Alterations in their sleep pattern
processing information, alterations in
their sleep pattern, diet, things that have
really changed in their day-to-day function.
That also point to the idea of concussion.
Aubrey O'Quin (11:54):
Well, and those are always good symptoms
too for spouses or parents or whatever
their support system is, to kind of look
for as well and recognize, because I'd
imagine sometimes either the athlete
doesn't want to necessarily admit that
they're having some of those symptoms and
or maybe doesn't realize it.
So those are always good things for, I
think, the, the families to look out for.
(12:16):
And so I want to next kind of ask you a
little bit about you know CTE, I think you
know that's kind of been the topic of
conversation over the last you know,
several years occasionally, and you know I
think that we've we've had some athletes
that I don't want to say self-diagnose, but
(12:37):
there's a lot of that self-diagnosing of,
hey, I have CTE or whatever else.
So can you explain a little bit about what
is CTE?
How are you know, how are we actually able
to diagnose that?
And then you know when, when does it become
something that they do need to be reaching
out to Western Sports Foundation so we can
get them to see you, and what does that
(12:58):
kind of that process kind of look like?
Dr. Anthony Alessi (13:00):
So CTE is a diagnosis made after you die.
That's the only way to make the diagnosis
is if you're dead.
You take your brain, cut it up, look at it
with certain stains and they come up with
this diagnosis.
So the idea that we know who has CTE ahead
of time, while they're alive, is a mistake.
(13:24):
The term we prefer is traumatic
encephalopathy syndrome.
Again, syndrome are a group of symptoms.
So what we're looking for are symptoms that
have been developed as a result of
repeatedly hitting your head or repeated
head injuries, and those are the things
where we can intervene.
(13:47):
So many people think well, I have CTE, so
my future is out of front of me, I'm not
going to be able to recognize my family,
I'm going to try and commit suicide.
That's not what we're about.
The idea is to look at something and decide
how we're going to treat those symptoms, no
matter what they are.
(14:09):
So symptoms as a result of repeatedly
hitting your head are things we can address.
Whether they be headaches, whether they be
behavioral issues, your inability to
remember things.
We have medication that could help those
individual things.
(14:29):
I think the best example are probably the
early writers you sent over here to the
University of Connecticut and both of those
original writers who were sent by Western
Sports had the idea that, well, I'm going
to see a neurologist.
He's going to tell me I've got to shut it
down, my career is over.
(14:50):
And it was quite the opposite, in the sense
that one of them had migraine headaches,
had nothing, nothing to do with getting hit
in the head.
He had had them his whole life, essentially,
but he resigned himself to the fact that it
was from getting hit in the head.
So he treated his migraine headaches and he
didn't get headaches anymore.
(15:11):
The other one was having some behavioral
issues and they were the result of having
an attention deficit disorder.
He had this his whole life.
He was always the student in the back of
the room who couldn't keep up, so he always
had a learning disability.
He treated the learning disability.
Both of those riders rose to being in the
(15:33):
top 10 in the world.
Disability.
Both of those riders rose to being in the
top 10 in the world.
So suddenly, our program of going from
identifying people with brain injury, who
should never ride again, to one of brain
health and finding a way to improve your
performance.
So and that's where we need to be is
looking at how do we help riders and other
(15:56):
athletes improve their performance, no
matter what their disability or what their
problem is.
How do we approach this?
And I think we've had really good success
if you talk to the riders who have been
through the program to have been through
the program?
Aubrey O'Quin (16:15):
No, absolutely.
And I think that you hit the nail on the
head when I think a lot of them are fearful
of going and meeting with you and seeing
you because they're fearful that you're
going to say, hey, you shouldn't ever ride
again.
And so often I think a lot of times those
athletes, after they've seen you, walk away
with that sense of relief of I'm not going
crazy or I'm not, you know, I'm not losing
(16:36):
it, I just it's.
It's X, Y, Z, and you know Dr Alessi has
helped me with that.
So, talking about sending an athlete to go
and see you, can you walk us through kind
of what does that look like?
What are they doing when they go and see
you?
What's that kind of process over those two
to three days when we send an athlete to
Connecticut to visit with you and Dr Peck?
Dr. Anthony Alessi (16:57):
So originally they come in and before they
come they fill out a questionnaire so we
get an idea of why they're coming, what the
issues are that we're going to need to
address.
When they arrive, they see me typically
first to do a neurologic evaluation and
kind of map out the next couple of days.
(17:19):
We do advanced imaging of the brain, not
the typical MRI.
We're looking to go back and see what
damage may have been done as a result of
previous injuries, and we've been really
good at that.
It's something.
We have neuroradiologists who excel in this.
(17:41):
So we look at images of the brain.
They have what we call neuropsychometric
testing.
This is very advanced kind of IQ testing,
but let us know where the athlete's
cognitive abilities are, and this is where
things come out like a learning disability,
(18:02):
where a depression diagnosis may come out,
anxiety may come out or just the damage
from repeated head trauma in being able to
perform executive function, and we could
see it very early on when we're looking at
it that way.
So it's something that we could still do
(18:23):
something about.
We also have them evaluated by a physical
therapist.
Many of them who come to us have dizziness,
difficulty with balance.
They're noticing their performance off.
So we have a physical therapist meet with
them and look at what they're doing as part
of their workouts, what things they might
be able to incorporate to help them improve,
(18:48):
and then at the end they meet with me again.
So we go over all of the information except
for the neuropsychometric testing.
The neuropsychometric testing takes about
three weeks to score and really work with.
So about three weeks after the visit we'll
then reconvene by telephone or by video
(19:09):
with the rider and or his or her family and
go over everything from the
neuropsychometric perspective.
We'll review the imaging again and we'll
have a discussion about the future and what
needs to be done.
Aubrey O'Quin (19:26):
Well, and I think that a lot of the
feedback that I've ever received from the
athletes is just how athletes is, just how
how approachable and personable you and
your team are, and that you know when, when
you're going over all of this with them,
you're explaining it to them in a way that
they can understand.
(19:46):
I think you know so often with anything
within the medical field, it's above the
normal.
You know understanding of people and then,
especially when you get into talking about
the brain and you know everything along
those lines, I think you and your team have
done a really good job at explaining it in
a way that anybody can understand it and
also, I think, kind of taking that fear out
(20:08):
of it.
I mean, I know, anytime I've had any type
of medical things, like you go in and
whether you hear good or bad news, the
first thing that you hear you know either.
Whatever that news is, that's all you hear,
and then you don't hear anything after that,
and so I think you got you do a really good
job at hey, your brain is okay, but these
are some of the things that we need to do
to make sure that it remains to stay that
(20:29):
way.
So you know, I think the athletes have all
really one built that trust in you but also
just feel really safe and you know, just
feel secure in what it is that you're
telling them and having the knowledge to
kind of continue to move forward in
whatever their career may look like.
Dr. Anthony Alessi (20:48):
Well, thank you.
I think the staff that I work with
understand that these are professional
athletes who are coming a long distance for
an evaluation.
So when you're seeing a patient who is what
we term a destination patient, you know the
system has to move in the level of
efficiency.
With athletes you don't have like, okay,
(21:09):
come back in two months for your MRI or
whatever, we have to come up and we have to
come up with an answer.
And you know we do that with all the
athletes we see here, no matter what their
sport is.
So we have an appreciation for that.
I, like you, know when I find them the most
(21:30):
rewarding is when I'm back out on tour at
the events and I get to follow up with
people, with the athlete, to see how
they're doing.
Often they'll come over to me and say, doc,
I started doing this, this.
You know what?
Do you think this has gotten better?
Whatever that's really the payback for me
(21:52):
is getting to see them in their environment
and being part of that.
Aubrey O'Quin (21:56):
Yeah, and I think too, you know.
So some of the follow up sometimes, you
know, like you mentioned, they're coming to
see you in Connecticut, so it's not just a
hey.
I saw Dr Alessi and Dr Peck and you know
they told me everything is good and it's
kind of like a move on if there is that
follow up care that's needed to be done.
Good, and it's kind of like a move on if
there is that follow-up care that's needed
to be done.
Um, you know, I know that we've all worked
(22:17):
really closely with ann hayes and in
helping to find folks that are near where
the athletes are living for whatever some
of that follow-up is.
But I know you also are really good at
staying in touch with some of the athletes
that need that longer term sort of check-in
and care, um on things.
But what are some of the situations where
we may be calling in Ann to kind of assist
(22:40):
in what you've done?
And you know what does that kind of look
like?
Dr. Anthony Alessi (22:44):
So the situations where we meet Ann are
situations where we think that the deficits
we're seeing are the result of a mental
health disorder that has either developed
or something that we're born with by
inherited, that has become exacerbated by
(23:07):
the anxiety of having to compete and lead
by kind of a crazy schedule having to
compete and lead by kind of a crazy
schedule.
The other one is when the deficits we're
finding are related to either alcohol or
drug dependency that has developed over
(23:32):
time, and that's when we get Ann involved
in terms of getting to someone, to the
appropriate personnel to guide us through a
rehabilitation process or to get them to an
inpatient setting where we can better
analyze and treat what they're going
through, so we can get them back on tour.
And again, that's not just Western sports
(23:55):
athletes, that's everybody you know.
Ann and I work a lot in baseball and that's
where we first met, and so we're doing the
same thing for Western sports athletes as
we do for the New York Yankees or any other
large organization, and I think that's been
the biggest thing that Western sports has
brought to the sport, to Western sports.
(24:19):
You know we talk a lot about bull riding,
but certainly I've had great experiences
with all Western sports.
I was a speaker at the PRCA meeting at the
national finals several years ago.
It was just a great experience overall.
Aubrey O'Quin (24:36):
What are some of the things that athletes
can do to and I guess, maintain brain
health or help brain health?
I mean is you know, obviously hydration and
stuff like that, but what are some of those
things that you would recommend that you
know?
One maybe they avoid prior to competing or
(24:58):
prior after competing, but also what are
some of those things that they can do on a
daily basis that's going to help keep their
brain health?
Dr. Anthony Alessi (25:07):
It's not rocket science, aubrey, it's diet
and exercise.
Diet, exercise and sleep are the best
things you can do.
When we look at diet, you don't need a lot
of supplements, you don't need a lot of
hocus pocus.
You got to stop drinking, you got to stop
(25:28):
smoking, you got to cut back and chew.
Those things are not helping you, they're
not helping your brain.
In terms of sleep, getting adequate amounts
of sleep easier said than done, right,
because these are cowboys, when they're not
riding, they're ranching.
So they've got to really adjust their hours
(25:51):
the best they can.
You know, the human body loves I love to
say homeostasis.
The human body wants to do the same thing
every day at the same time, wants you to
wake up the same time, go to sleep the same
time, wants you to eat three meals a day at
the same time Not possible.
Not possible in life and certainly not
possible in sport.
(26:12):
So what you have to do is get as close to
that as you can, and you have to be in a
good place to do that.
So those are the things that keep your
brain healthy.
Another thing is don't hit your head a lot.
I mean, it's pretty obvious.
If you wear a helmet, it's going to help
(26:35):
save your life in many cases in
professional bull riding, because a lot of
people get stepped on and that's going to
hurt.
So with that, you know, the use of helmets
is finally increasing, I think, now that
it's become mandatory, and the younger
riders who have been brought up with it, I
(26:57):
think that that's been a great addition to
what we do.
Aubrey O'Quin (27:02):
So I think those are the things that are
key overall so a lot of our athletes, um,
are the road warriors, right, they're
driving from one rodeo to the next, a lot
of times in the middle of the night, um,
which is going to mess with their sleep
habits.
(27:22):
Is there something that, from a from a
professional standpoint, that you could
recommend, that is, you know, going to help
them perform as best as they possibly can,
but things to try and avoid when they're
making those long drives?
(27:45):
Or is there anything that they can do to
kind of combat the fatigue that comes with
that and hopefully not pumping themselves
full of energy drinks and caffeine to try
and make it through?
Dr. Anthony Alessi (27:51):
It's a loaded question in the sense that
you know it's an impossible situation,
right, because you have to do that to earn
a living.
The question becomes when you can sleep,
get the appropriate amount of sleep.
Energy drinks Okay, Aren't going to help.
(28:15):
It's not going to help and it's going to
throw things off as much as it can.
Now, I understand you don't want to stay
awake while you're driving and things such
as that.
But when you get to the hotel right, maybe
it's time not to go out with the other
folks and shut it down a little bit early.
So you've got to use some common sense.
There are certain things you have to do,
(28:35):
certain things you don't really have to do,
and it's that time that you really need to
get some rest.
So it's a judgment call.
Medications to help sleep you know a lot of
people use melatonin.
They find it to be helpful to get them to
sleep.
Most people don't take melatonin the right
(28:57):
way.
They think that you take it right before
you go to sleep, and that's a mistake,
because it takes two, three, four hours to
take effect.
So if you're going to bed at 11 o'clock,
you should be taking it around 7 o'clock
when you're having dinner.
What happens is they take it at 11 o'clock
right before they go to sleep and they
(29:18):
can't fall asleep until like 2 am and then
they can't get up in the morning.
Aubrey O'Quin (29:25):
But if you could do it without, doing that
everybody has a different way in what helps
them get to sleep, but I think that you
have to look at that as best you can and
you know I want to and I know it's a touchy
subject, but you know alcohol and the brain
(29:46):
and you know competing and and all of that
and and you know what does actually alcohol
do to the brain.
And if it's, either you know prior to
getting on and then you get a concussion
while you're competing, or if you're
drinking after you've had a concussion, how
does alcohol affect or, you know,
(30:08):
exaggerate, whatever type of injury you
just occurred to your brain, whatever, type
of injury you just occurred to your brain.
Dr. Anthony Alessi (30:16):
The data has come out and it's been pretty
definitive that there's no advantage
neurologically to drinking any level of
alcohol Zero, zero, not a beer, not wine,
not a margarita Not going to help the brain.
And in fact we've found that it's
detrimental in the long run when you look
(30:39):
at it.
And I'm not talking about getting drunk,
I'm just talking about any alcoholic.
You know, for years we heard, well, you
should have a glass of red wine.
And it does this.
That the other thing All been debunked.
So the more you can stay away from alcohol,
the better off you're going to be, the
(30:59):
better off your brain is going to be.
Why is that?
It's directly toxic to the brain.
It just is of no help to the brain.
So from that standpoint, you know and it's
easier said than done drinking is no help.
(31:20):
And the question is what's more important
going out drinking or lasting longer on
tour at the highest level?
You know you've got to make those
sacrifices, those changes in your lifestyle
and as you approach them.
So and I've heard all the excuses the only
way I can relax this that but, the bottom
(31:41):
line is that it's going to shorten your
career in anything you do.
Aubrey O'Quin (31:47):
Well, and I think it's.
You know we, we talk about it a lot with
you know the at our wellness clinics that
you've gone and spoken at, and even just in
casual conversations with the athletes.
But you know treating your brain the same
way you would any other muscle in your body,
um and or a bone.
So if you do get a concussion, you know if
(32:08):
somebody's recommending you stay out a week
or two weeks or however long that is.
Or you know if you are training those
muscles in your body to do the same thing
for your brain and to you know, give, allow
yourself one the longest career you could
possibly have, but also just from a
standpoint of overall health for the rest
(32:28):
of your life.
You know your brain controls everything in
your body.
So really treating that as a as, as as just
as important as any other thing in your
body is your brain.
So listening when people are telling you to
take that time and allow yourself to heal.
Dr. Anthony Alessi (32:42):
Well, the other factor here is exercise,
something we haven't talked about and you
know, regular aerobic exercise is
absolutely key, something we don't think
about a lot in Western sports, and you have
really brought that out at the clinics,
right, when they're meeting with Doug and
(33:03):
the other folks.
The point is, you know, to start doing
things like wingsprings, aerobic exercise
of any type is key.
Even right after a concussion, you need to
start walking.
Light exercise is crucial to the brain
healing itself.
(33:25):
It's the way our bodies were made.
Again, it's key.
Aubrey O'Quin (33:30):
Is there a common question that you get
asked by Western sports athletes that we
didn't cover today, or that I didn't ask
you today that you think might be helpful
to share?
Dr. Anthony Alessi (33:55):
thing I hear about are headaches, whether
they be related to riding or traveling and
things such as that.
So I think headaches are a big issue and
how to approach those.
There are often good medications to look at
from that standpoint.
So I think that's one of the big questions
that people ask me about all the time, so I
can't think of any one.
(34:17):
There's been so many issues that have come
up over the years that I think are key.
I think that one of the ones is always at
your seminars, right?
We always hear about does marijuana help?
(34:39):
We've heard that several times and it
doesn't the use of helmets.
I've heard every excuse why not to use a
helmet, but there's one key thing in favor
of using a helmet It'll probably save your
life at some point.
So it's interesting.
What I find so helpful at the seminars,
when we're together, are other athletes
(35:01):
helping other athletes, other riders
sharing their experiences that help other
riders, and I find that to be the most
helpful thing, rather than people just
listening to me.
If you can hear from another rider who has
gone through the same thing, I think that's
(35:22):
made a big point.
Aubrey O'Quin (35:24):
Well, it's always nice because I think in
those settings at the clinics is, you
always are going to have a few athletes
that are comfortable asking the questions
and talking, and then you're going to have
most of the athletes that just kind of want
to sit back and soak it all in.
So it's always nice to have those athletes,
those ask those questions and and you know
I think it it allows for other people to
(35:46):
kind of start thinking in that way of oh
gosh, I didn't even think of that, or I'm
glad he asked because I didn't want to ask
that question.
So those are always.
It's always good to have that.
And the one thing I do want to add to all
of this for anybody that is listening, is
that anytime somebody does go and see you
or has a conversation with you whether it's
going to Connecticut or just a one-off it's
(36:08):
always confidential.
So the only part that Western Sports
Foundation kind of has in that process is
obviously the application process.
So it's going to our website filling out an
application.
I then share the questionnaire that you and
Dr Peck have put together with them and
send that back over to you.
But from that time on, whatever their
(36:30):
results end up being or anything like that.
That is between you and that athlete.
You know we obviously help cover the
expense and the cost of getting them to see
you and whatever those expenses are after
they've seen you.
But the actual diagnosis and whatever
conversation you have with them is
confidential and that's between you and
that athlete slash patient.
(36:51):
So you know that's always an important
thing that you know we try, I think, to
tell the athletes is one.
It doesn't come back to us but it doesn't
go back to any governing body.
It doesn't go back to the PRCA or the PBR
or you know any, any of those.
It is knowledge and information for the
athlete to make an educated decision on
(37:12):
whatever it is that they choose to do based
off the information that you give them.
Dr. Anthony Alessi (37:17):
Absolutely.
The only exception to that is when it's a
mandated exam.
There have been a few instances where PBR
has mandated the exam and not permitted a
rider to get on unless they were seen, and
in those cases I have to report the
findings to PBR because they're paying for
(37:37):
that evaluation.
You know, one of the things I guess that's
been most rewarding I talked about catching
up with riders on tour is that, you know, I
feel like I've become their personal
neurologist, I mean, and in a good way.
So when other family members become ill, if
they have a neurologic problem, it's great
(37:58):
to hear from them because I know that they
trust me, they trust my opinion, so-and-so.
You know my so-and-so's in the hospital, my
kid's in the hospital, they want to call a
neurologist.
I don't understand what they're saying.
I'm just so happy to have that conversation
with them.
Aubrey O'Quin (38:16):
I can personally say how appreciative I've
just been of any time there's, you know,
from a rash on my kid to you know, a big
life experience of calling and being like
Dr Lester.
I'm really sorry to bother you but you know,
(38:37):
so I do.
I think that you know you obviously are one
of the best neurologists, I would say, in
the United States, but you know just to to
have you as a, as a friend and somebody
that we can reach out to and trust and know
that you're going to.
You know, shoot a straight and and tell us
what's going on.
You know you are, you're changing people's
lives in so many, so many more ways than
just from a neurological standpoint.
And I think every single athlete that has
(38:59):
seen you or will see you, they all say the
same thing about you and I think that any
one of them, would you know, can definitely
say that you are helping them long-term
with their careers, but I think also just
even giving them that peace to know, hey,
you're not going crazy, it's helping their
marriages, it's helping them be better
parents, it's just helping them be better
humans.
(39:19):
So you know, I am eternally grateful from a
personal perspective to call you a friend
and to have you, but also just to have you
as a part of, you know, western Sports
Foundation and you've been, you know, one
of the providers that we've had since the
very beginning and to have you kind of be
along for that evolution.
It's been great to have you as a part of
the team and we're just blessed to have you
(39:40):
here and to have your expertise and
everything that you bring to the table and
to the program.
Dr. Anthony Alessi (39:46):
Well, thank you.
I think it's become a big part of my career
and I certainly enjoy it.
Aubrey O'Quin (39:52):
Well, it's exciting.
So is there anything else before we wrap up
today that you want to share, or any bit of
advice or anything like that that you'd
have for any athletes or family that are
listening to our podcast?
Dr. Anthony Alessi (40:07):
No, I just.
I want people to understand that the brain
is a very resilient organ.
The brain will heal itself if you give it a
chance.
And I think that's the key message is
knowing when and how to give the brain a
chance to heal itself after an injury, and
it doesn't necessarily mean it's the end of
(40:29):
the career.
Aubrey O'Quin (40:30):
I think that's great advice and for anybody
that you know would like to you know some
more information or you know is maybe
concerned, please go to our website, wsforg,
and you can go to Athlete Services, mental
Wellness and you can read a little bit more
about the neurological services.
But there's also an application there that
you can fill out if you, you know, would
(40:52):
like to kind of see if you are a candidate
to go and work with Dr Alessi and maybe
what we'll do is open it up to to kind of
take some questions on if there's something
that you would like to for us to ask.
Ask Dr Alessi and maybe have him back on
the podcast here in a month or two and we
can ask him those questions and get some of
those answers for you guys.
(41:12):
So thank you again for joining us.
As always, it's always a pleasure to talk
with you and hear about the brain.
I'm always fascinated and I know we have a
lot of people that are excited to listen to
this because I think that you are such a
wealth of information, but you just deliver
it in a way that people can understand it
and digest it and walk away feeling
knowledgeable about the brain and empowered
(41:33):
about their own brain my pleasure.
Well, thank you for joining us on Beyond
the Rodeo and we'll catch you at the next
episode.
(41:56):
Thanks for listening to Beyond the rodeo.
To learn even more about western sports
foundation and how we're helping western
sports reach new heights, head to
westernsportsfoundationorg.
We'll catch you back here for the next
episode.
Thank you.
You're listening to Beyond the Rodeo,
brought to you by Western Sports Foundation,
the podcast that will explore the ups and
downs of rodeo life and reveal ways to help
the sport of rodeo reach new heights.
I'm your host, Aubrey O'Quinn.
Let's get to the show.
(00:40):
Hi everyone, Thank you for joining us today
on Beyond the Rodeo.
I am your host, Aubrey O'Quinn, and I am
joined by my dear friend and amazing doctor,
Dr Anthony Alessi.
Thank you for joining us today.
Dr. Anthony Alessi (00:54):
Great to be here, Aubrey, as always.
Aubrey O'Quin (00:55):
Well, today I wanted to just spend a little
bit of time.
First, just tell us about you and what you
do and how long you've been doing what
you're doing, and then we can jump into a
little bit of what you do with Western
Sports Foundation.
Dr. Anthony Alessi (01:09):
Oh great.
So I'm a neurologist, I'm a medical doctor
specializing in diseases of the brain and
peripheral nervous system, that's, the
brain spinal cord and the peripheral nerves
that go to the arms and legs, and in my
specialty, back in 1995, I started doing
(01:32):
work with athletes.
Particularly about that time is when I
started working with the New York Yankees
and concussion was just becoming an issue
back then and we were just starting to hear
about it.
Shortly after that I started working with
combat sports athletes.
So these are athletes who do MMA boxing,
(01:56):
because we had several casinos near us here
in Connecticut.
So I started working with these
self-employed athletes who are out there
boxing and with that my practice gradually
evolved to doing a lot of different sports.
About 17 years ago I started working with
(02:16):
Dr Tandy Freeman and Rich Blinn, who were
working with PBR back then and they were
coming to the Mohegan Sun Casino and we
developed a friendship and a relationship
professionally where I would start seeing
some of their athletes who had brain injury
or any other neurologic injury.
(02:37):
So it's been an interesting evolution with
me and Western sports, especially someone
who's born and raised in New York knowing
very little about Western sports, over the
years I've come to not only appreciate it,
but truly enjoy the athletes I get to work
with in Western sports.
Aubrey O'Quin (02:59):
I always enjoy listening to all of the
different facets of athletics that you're
involved in and who you've gotten to work
with, and so tell us, I guess, a little bit
about what you've been able to do with Dr
Tandy and Rich and how you know I know over
the years they've kind of put together this
(03:19):
concussion protocol and all of that.
So how did that kind of come about and did
you help them in kind of putting that whole
process together?
Dr. Anthony Alessi (03:28):
Yeah.
So putting that all together was a
collaboration, you know, among us really,
when we realized something had to be done I
mean, the number one injury in professional
bull riding is concussion and so it was a
big issue.
But you know we have to turn back.
The was a big issue, but you know we have
(03:49):
to turn back the page a little bit.
You know, when I was in medical school in
the late 70s and early 80s, when I was in a
residency in neurology at the University of
Michigan, we never heard the word
concussion.
I don't think I heard the word concussion
more than five times because it's such a
vague term, it doesn't really define
anything.
So it's really over the last 30 years that
(04:09):
this term has become part of the
conversation, where now you can't turn on a
show or watch an event without the word
concussion and protocol coming up.
So when we look at concussion, by
definition it's a syndrome, it's a group of
symptoms that come on after a biomechanical
(04:30):
force is applied to the brain.
So a blow to the head and you get a
transient group of symptoms.
So that means not everybody who hits their
head has a concussion.
But yet in professional bull riding we were
seeing the same symptoms that fit
concussion, but not necessarily by getting
(04:51):
a direct blow to the head.
It was more this indirect movement back and
forth on the bull, and we were seeing that
more and more.
So we had to have some criteria to tell us
when somebody shouldn't get on.
And that's how this developed.
Was you know, how do we know when somebody
(05:11):
shouldn't be getting back on?
And that's when the whole re-screening.
So the best way to do that is to have some
baseline of all of your riders, and that's
when we put together originally Cognigram
and using the balance board and things such
as that.
So we had a group of baseline tests that we
(05:32):
could compare the athlete to after they got
injured, and that made a huge difference
and it's carried through today and we've
gone through several iterations.
Every year it gets better and better and it
makes the sport safer and safer for
athletes.
Now we only do that for professional bull
(05:54):
riding and we're only doing it on the
highest level of tour.
Aubrey O'Quin (06:00):
So we're starting to get it down to
velocity in some of the lower tours, which
is our next big challenge rodeo athletes is
(06:27):
the same sort of um, like increase in
concussion with, like bareback and saddle
bronc riders, just cause they have that
same sort of um, you know, back and forth
movement while they're on the bucking horse,
I mean concussions fairly uh, common with
those athletes as well.
Have you seen?
Dr. Anthony Alessi (06:40):
Well, it is uh, you know, know it's common
in all Western sports, but there are
different circumstances, different
mechanisms of injury.
And it's interesting when you say, are we
seeing it more?
I don't think we're seeing it.
I think we're recognizing it more.
I think it's always been there.
(07:01):
It's just that you just got back on and
what we found is that getting back on, even
if you're hurt, shortened the career, and I
think we're finding that in all of Western
sports.
So are we seeing it in bareback?
Yes, we're seeing it in rope words.
I mean, there's so many incidents where you
(07:25):
know their head is hitting a rail.
Any number of events can happen whenever
humans and animals are interacting at high
speed.
You're going to have something go wrong.
(07:49):
Something go wrong.
So you know, the question becomes now
Western sports athletes are finally being
treated as athletes.
Let me explain.
I guess I was surprised that they weren't
necessarily treated as athletes like
baseball players, football players, in
terms of training, diet, mental approaches
to your sport, all the things that increase
(08:12):
your longevity in the sport.
And finally, some of the younger athletes
are figuring it out.
They're figuring it out that they're a
business and the longer they can stay in
business, the better off they're going to
be, the more money they're going to earn,
the more secure they're going to be and the
safer they're going to be.
So they're starting to realize that there's
(08:36):
a lot more to this than just getting on a
bullet, hanging on for eight seconds, and
with that, brain health has become a big
issue and a big plus for them, thanks to
Western Sports, really, and the Western
Sports Foundation and working with
physicians and athletic trainers who
(08:56):
understand the nervous system and how it
works and how you can get it healthy.
Aubrey O'Quin (09:02):
You know, we, you, you mentioned a little
bit about, um, concussions and symptoms and,
uh, you know.
So what, what are some of those symptoms
that are either defined that you have had a
concussion or just you know what are, what
makes it a concussion and just what makes
it where you're maybe showing some symptoms
of it, but you don't necessarily have a
concussion Cause.
(09:23):
I mean, I've, I know, I have, and I'm sure
you have too, had conversations with a lot
of Western sports athletes that are like,
oh, I've had 50 concussions in my career.
Um, you know so is that a?
Nor is that a normal number, is that kind
of an exaggerated number and it's probably
more realistic of five concussions, but
they maybe had some of those symptoms.
Dr. Anthony Alessi (09:49):
Yeah, I'm glad you brought that up.
So when we look for a concussion, we're
looking for some basic signs, the initial
signs being that vacant stare, being
somewhat disoriented, not knowing where
they are, having an initial headache,
nausea, vomiting, dizziness, inability to
keep their balance.
So when we're looking at a rider who's down,
we're looking.
(10:09):
Is it taking them longer to get up?
Do they need more help getting up?
Are they dazed when they get up?
Are they looking around, not knowing?
We know they're very dependent on the
bullfighter, but are they more dependent
than other times?
So we're looking for the initial signs of
(10:30):
concussion to really direct us and let us
know how severe the injury is.
And don't forget, concussion is really the
most mild on this spectrum of brain injury,
right the most severe being a bleed into
the brain, and we've seen plenty of those
and that becomes a neurologic emergency.
(10:52):
Now, when it comes to bull riders counting
their concussion, they don't count a
concussion until they've lost consciousness.
So they come to me with these concussions
and you know one in particular said, you
know he had nine concussions in two years
with loss of consciousness.
That's an unbelievable number.
(11:13):
But then he started showing me video after
video after video on his phone and it was
pretty impressive from that standpoint.
So there are these signs of concussion,
among them loss of consciousness or
alteration of consciousness.
So those are the things we look for in the
initial sign.
The symptoms are the more long-lasting
(11:35):
signs, the headaches we can't get better,
the difficulty thinking and processing
information.
Alterations in their sleep pattern
processing information, alterations in
their sleep pattern, diet, things that have
really changed in their day-to-day function.
That also point to the idea of concussion.
Aubrey O'Quin (11:54):
Well, and those are always good symptoms
too for spouses or parents or whatever
their support system is, to kind of look
for as well and recognize, because I'd
imagine sometimes either the athlete
doesn't want to necessarily admit that
they're having some of those symptoms and
or maybe doesn't realize it.
So those are always good things for, I
think, the, the families to look out for.
(12:16):
And so I want to next kind of ask you a
little bit about you know CTE, I think you
know that's kind of been the topic of
conversation over the last you know,
several years occasionally, and you know I
think that we've we've had some athletes
that I don't want to say self-diagnose, but
(12:37):
there's a lot of that self-diagnosing of,
hey, I have CTE or whatever else.
So can you explain a little bit about what
is CTE?
How are you know, how are we actually able
to diagnose that?
And then you know when, when does it become
something that they do need to be reaching
out to Western Sports Foundation so we can
get them to see you, and what does that
(12:58):
kind of that process kind of look like?
Dr. Anthony Alessi (13:00):
So CTE is a diagnosis made after you die.
That's the only way to make the diagnosis
is if you're dead.
You take your brain, cut it up, look at it
with certain stains and they come up with
this diagnosis.
So the idea that we know who has CTE ahead
of time, while they're alive, is a mistake.
(13:24):
The term we prefer is traumatic
encephalopathy syndrome.
Again, syndrome are a group of symptoms.
So what we're looking for are symptoms that
have been developed as a result of
repeatedly hitting your head or repeated
head injuries, and those are the things
where we can intervene.
(13:47):
So many people think well, I have CTE, so
my future is out of front of me, I'm not
going to be able to recognize my family,
I'm going to try and commit suicide.
That's not what we're about.
The idea is to look at something and decide
how we're going to treat those symptoms, no
matter what they are.
(14:09):
So symptoms as a result of repeatedly
hitting your head are things we can address.
Whether they be headaches, whether they be
behavioral issues, your inability to
remember things.
We have medication that could help those
individual things.
(14:29):
I think the best example are probably the
early writers you sent over here to the
University of Connecticut and both of those
original writers who were sent by Western
Sports had the idea that, well, I'm going
to see a neurologist.
He's going to tell me I've got to shut it
down, my career is over.
(14:50):
And it was quite the opposite, in the sense
that one of them had migraine headaches,
had nothing, nothing to do with getting hit
in the head.
He had had them his whole life, essentially,
but he resigned himself to the fact that it
was from getting hit in the head.
So he treated his migraine headaches and he
didn't get headaches anymore.
(15:11):
The other one was having some behavioral
issues and they were the result of having
an attention deficit disorder.
He had this his whole life.
He was always the student in the back of
the room who couldn't keep up, so he always
had a learning disability.
He treated the learning disability.
Both of those riders rose to being in the
(15:33):
top 10 in the world.
Disability.
Both of those riders rose to being in the
top 10 in the world.
So suddenly, our program of going from
identifying people with brain injury, who
should never ride again, to one of brain
health and finding a way to improve your
performance.
So and that's where we need to be is
looking at how do we help riders and other
(15:56):
athletes improve their performance, no
matter what their disability or what their
problem is.
How do we approach this?
And I think we've had really good success
if you talk to the riders who have been
through the program to have been through
the program?
Aubrey O'Quin (16:15):
No, absolutely.
And I think that you hit the nail on the
head when I think a lot of them are fearful
of going and meeting with you and seeing
you because they're fearful that you're
going to say, hey, you shouldn't ever ride
again.
And so often I think a lot of times those
athletes, after they've seen you, walk away
with that sense of relief of I'm not going
crazy or I'm not, you know, I'm not losing
(16:36):
it, I just it's.
It's X, Y, Z, and you know Dr Alessi has
helped me with that.
So, talking about sending an athlete to go
and see you, can you walk us through kind
of what does that look like?
What are they doing when they go and see
you?
What's that kind of process over those two
to three days when we send an athlete to
Connecticut to visit with you and Dr Peck?
Dr. Anthony Alessi (16:57):
So originally they come in and before they
come they fill out a questionnaire so we
get an idea of why they're coming, what the
issues are that we're going to need to
address.
When they arrive, they see me typically
first to do a neurologic evaluation and
kind of map out the next couple of days.
(17:19):
We do advanced imaging of the brain, not
the typical MRI.
We're looking to go back and see what
damage may have been done as a result of
previous injuries, and we've been really
good at that.
It's something.
We have neuroradiologists who excel in this.
(17:41):
So we look at images of the brain.
They have what we call neuropsychometric
testing.
This is very advanced kind of IQ testing,
but let us know where the athlete's
cognitive abilities are, and this is where
things come out like a learning disability,
(18:02):
where a depression diagnosis may come out,
anxiety may come out or just the damage
from repeated head trauma in being able to
perform executive function, and we could
see it very early on when we're looking at
it that way.
So it's something that we could still do
(18:23):
something about.
We also have them evaluated by a physical
therapist.
Many of them who come to us have dizziness,
difficulty with balance.
They're noticing their performance off.
So we have a physical therapist meet with
them and look at what they're doing as part
of their workouts, what things they might
be able to incorporate to help them improve,
(18:48):
and then at the end they meet with me again.
So we go over all of the information except
for the neuropsychometric testing.
The neuropsychometric testing takes about
three weeks to score and really work with.
So about three weeks after the visit we'll
then reconvene by telephone or by video
(19:09):
with the rider and or his or her family and
go over everything from the
neuropsychometric perspective.
We'll review the imaging again and we'll
have a discussion about the future and what
needs to be done.
Aubrey O'Quin (19:26):
Well, and I think that a lot of the
feedback that I've ever received from the
athletes is just how athletes is, just how
how approachable and personable you and
your team are, and that you know when, when
you're going over all of this with them,
you're explaining it to them in a way that
they can understand.
(19:46):
I think you know so often with anything
within the medical field, it's above the
normal.
You know understanding of people and then,
especially when you get into talking about
the brain and you know everything along
those lines, I think you and your team have
done a really good job at explaining it in
a way that anybody can understand it and
also, I think, kind of taking that fear out
(20:08):
of it.
I mean, I know, anytime I've had any type
of medical things, like you go in and
whether you hear good or bad news, the
first thing that you hear you know either.
Whatever that news is, that's all you hear,
and then you don't hear anything after that,
and so I think you got you do a really good
job at hey, your brain is okay, but these
are some of the things that we need to do
to make sure that it remains to stay that
(20:29):
way.
So you know, I think the athletes have all
really one built that trust in you but also
just feel really safe and you know, just
feel secure in what it is that you're
telling them and having the knowledge to
kind of continue to move forward in
whatever their career may look like.
Dr. Anthony Alessi (20:48):
Well, thank you.
I think the staff that I work with
understand that these are professional
athletes who are coming a long distance for
an evaluation.
So when you're seeing a patient who is what
we term a destination patient, you know the
system has to move in the level of
efficiency.
With athletes you don't have like, okay,
(21:09):
come back in two months for your MRI or
whatever, we have to come up and we have to
come up with an answer.
And you know we do that with all the
athletes we see here, no matter what their
sport is.
So we have an appreciation for that.
I, like you, know when I find them the most
(21:30):
rewarding is when I'm back out on tour at
the events and I get to follow up with
people, with the athlete, to see how
they're doing.
Often they'll come over to me and say, doc,
I started doing this, this.
You know what?
Do you think this has gotten better?
Whatever that's really the payback for me
(21:52):
is getting to see them in their environment
and being part of that.
Aubrey O'Quin (21:56):
Yeah, and I think too, you know.
So some of the follow up sometimes, you
know, like you mentioned, they're coming to
see you in Connecticut, so it's not just a
hey.
I saw Dr Alessi and Dr Peck and you know
they told me everything is good and it's
kind of like a move on if there is that
follow up care that's needed to be done.
Good, and it's kind of like a move on if
there is that follow-up care that's needed
to be done.
Um, you know, I know that we've all worked
(22:17):
really closely with ann hayes and in
helping to find folks that are near where
the athletes are living for whatever some
of that follow-up is.
But I know you also are really good at
staying in touch with some of the athletes
that need that longer term sort of check-in
and care, um on things.
But what are some of the situations where
we may be calling in Ann to kind of assist
(22:40):
in what you've done?
And you know what does that kind of look
like?
Dr. Anthony Alessi (22:44):
So the situations where we meet Ann are
situations where we think that the deficits
we're seeing are the result of a mental
health disorder that has either developed
or something that we're born with by
inherited, that has become exacerbated by
(23:07):
the anxiety of having to compete and lead
by kind of a crazy schedule having to
compete and lead by kind of a crazy
schedule.
The other one is when the deficits we're
finding are related to either alcohol or
drug dependency that has developed over
(23:32):
time, and that's when we get Ann involved
in terms of getting to someone, to the
appropriate personnel to guide us through a
rehabilitation process or to get them to an
inpatient setting where we can better
analyze and treat what they're going
through, so we can get them back on tour.
And again, that's not just Western sports
(23:55):
athletes, that's everybody you know.
Ann and I work a lot in baseball and that's
where we first met, and so we're doing the
same thing for Western sports athletes as
we do for the New York Yankees or any other
large organization, and I think that's been
the biggest thing that Western sports has
brought to the sport, to Western sports.
(24:19):
You know we talk a lot about bull riding,
but certainly I've had great experiences
with all Western sports.
I was a speaker at the PRCA meeting at the
national finals several years ago.
It was just a great experience overall.
Aubrey O'Quin (24:36):
What are some of the things that athletes
can do to and I guess, maintain brain
health or help brain health?
I mean is you know, obviously hydration and
stuff like that, but what are some of those
things that you would recommend that you
know?
One maybe they avoid prior to competing or
(24:58):
prior after competing, but also what are
some of those things that they can do on a
daily basis that's going to help keep their
brain health?
Dr. Anthony Alessi (25:07):
It's not rocket science, aubrey, it's diet
and exercise.
Diet, exercise and sleep are the best
things you can do.
When we look at diet, you don't need a lot
of supplements, you don't need a lot of
hocus pocus.
You got to stop drinking, you got to stop
(25:28):
smoking, you got to cut back and chew.
Those things are not helping you, they're
not helping your brain.
In terms of sleep, getting adequate amounts
of sleep easier said than done, right,
because these are cowboys, when they're not
riding, they're ranching.
So they've got to really adjust their hours
(25:51):
the best they can.
You know, the human body loves I love to
say homeostasis.
The human body wants to do the same thing
every day at the same time, wants you to
wake up the same time, go to sleep the same
time, wants you to eat three meals a day at
the same time Not possible.
Not possible in life and certainly not
possible in sport.
(26:12):
So what you have to do is get as close to
that as you can, and you have to be in a
good place to do that.
So those are the things that keep your
brain healthy.
Another thing is don't hit your head a lot.
I mean, it's pretty obvious.
If you wear a helmet, it's going to help
(26:35):
save your life in many cases in
professional bull riding, because a lot of
people get stepped on and that's going to
hurt.
So with that, you know, the use of helmets
is finally increasing, I think, now that
it's become mandatory, and the younger
riders who have been brought up with it, I
(26:57):
think that that's been a great addition to
what we do.
Aubrey O'Quin (27:02):
So I think those are the things that are
key overall so a lot of our athletes, um,
are the road warriors, right, they're
driving from one rodeo to the next, a lot
of times in the middle of the night, um,
which is going to mess with their sleep
habits.
(27:22):
Is there something that, from a from a
professional standpoint, that you could
recommend, that is, you know, going to help
them perform as best as they possibly can,
but things to try and avoid when they're
making those long drives?
(27:45):
Or is there anything that they can do to
kind of combat the fatigue that comes with
that and hopefully not pumping themselves
full of energy drinks and caffeine to try
and make it through?
Dr. Anthony Alessi (27:51):
It's a loaded question in the sense that
you know it's an impossible situation,
right, because you have to do that to earn
a living.
The question becomes when you can sleep,
get the appropriate amount of sleep.
Energy drinks Okay, Aren't going to help.
(28:15):
It's not going to help and it's going to
throw things off as much as it can.
Now, I understand you don't want to stay
awake while you're driving and things such
as that.
But when you get to the hotel right, maybe
it's time not to go out with the other
folks and shut it down a little bit early.
So you've got to use some common sense.
There are certain things you have to do,
(28:35):
certain things you don't really have to do,
and it's that time that you really need to
get some rest.
So it's a judgment call.
Medications to help sleep you know a lot of
people use melatonin.
They find it to be helpful to get them to
sleep.
Most people don't take melatonin the right
(28:57):
way.
They think that you take it right before
you go to sleep, and that's a mistake,
because it takes two, three, four hours to
take effect.
So if you're going to bed at 11 o'clock,
you should be taking it around 7 o'clock
when you're having dinner.
What happens is they take it at 11 o'clock
right before they go to sleep and they
(29:18):
can't fall asleep until like 2 am and then
they can't get up in the morning.
Aubrey O'Quin (29:25):
But if you could do it without, doing that
everybody has a different way in what helps
them get to sleep, but I think that you
have to look at that as best you can and
you know I want to and I know it's a touchy
subject, but you know alcohol and the brain
(29:46):
and you know competing and and all of that
and and you know what does actually alcohol
do to the brain.
And if it's, either you know prior to
getting on and then you get a concussion
while you're competing, or if you're
drinking after you've had a concussion, how
does alcohol affect or, you know,
(30:08):
exaggerate, whatever type of injury you
just occurred to your brain, whatever, type
of injury you just occurred to your brain.
Dr. Anthony Alessi (30:16):
The data has come out and it's been pretty
definitive that there's no advantage
neurologically to drinking any level of
alcohol Zero, zero, not a beer, not wine,
not a margarita Not going to help the brain.
And in fact we've found that it's
detrimental in the long run when you look
(30:39):
at it.
And I'm not talking about getting drunk,
I'm just talking about any alcoholic.
You know, for years we heard, well, you
should have a glass of red wine.
And it does this.
That the other thing All been debunked.
So the more you can stay away from alcohol,
the better off you're going to be, the
(30:59):
better off your brain is going to be.
Why is that?
It's directly toxic to the brain.
It just is of no help to the brain.
So from that standpoint, you know and it's
easier said than done drinking is no help.
(31:20):
And the question is what's more important
going out drinking or lasting longer on
tour at the highest level?
You know you've got to make those
sacrifices, those changes in your lifestyle
and as you approach them.
So and I've heard all the excuses the only
way I can relax this that but, the bottom
(31:41):
line is that it's going to shorten your
career in anything you do.
Aubrey O'Quin (31:47):
Well, and I think it's.
You know we, we talk about it a lot with
you know the at our wellness clinics that
you've gone and spoken at, and even just in
casual conversations with the athletes.
But you know treating your brain the same
way you would any other muscle in your body,
um and or a bone.
So if you do get a concussion, you know if
(32:08):
somebody's recommending you stay out a week
or two weeks or however long that is.
Or you know if you are training those
muscles in your body to do the same thing
for your brain and to you know, give, allow
yourself one the longest career you could
possibly have, but also just from a
standpoint of overall health for the rest
(32:28):
of your life.
You know your brain controls everything in
your body.
So really treating that as a as, as as just
as important as any other thing in your
body is your brain.
So listening when people are telling you to
take that time and allow yourself to heal.
Dr. Anthony Alessi (32:42):
Well, the other factor here is exercise,
something we haven't talked about and you
know, regular aerobic exercise is
absolutely key, something we don't think
about a lot in Western sports, and you have
really brought that out at the clinics,
right, when they're meeting with Doug and
(33:03):
the other folks.
The point is, you know, to start doing
things like wingsprings, aerobic exercise
of any type is key.
Even right after a concussion, you need to
start walking.
Light exercise is crucial to the brain
healing itself.
(33:25):
It's the way our bodies were made.
Again, it's key.
Aubrey O'Quin (33:30):
Is there a common question that you get
asked by Western sports athletes that we
didn't cover today, or that I didn't ask
you today that you think might be helpful
to share?
Dr. Anthony Alessi (33:55):
thing I hear about are headaches, whether
they be related to riding or traveling and
things such as that.
So I think headaches are a big issue and
how to approach those.
There are often good medications to look at
from that standpoint.
So I think that's one of the big questions
that people ask me about all the time, so I
can't think of any one.
(34:17):
There's been so many issues that have come
up over the years that I think are key.
I think that one of the ones is always at
your seminars, right?
We always hear about does marijuana help?
(34:39):
We've heard that several times and it
doesn't the use of helmets.
I've heard every excuse why not to use a
helmet, but there's one key thing in favor
of using a helmet It'll probably save your
life at some point.
So it's interesting.
What I find so helpful at the seminars,
when we're together, are other athletes
(35:01):
helping other athletes, other riders
sharing their experiences that help other
riders, and I find that to be the most
helpful thing, rather than people just
listening to me.
If you can hear from another rider who has
gone through the same thing, I think that's
(35:22):
made a big point.
Aubrey O'Quin (35:24):
Well, it's always nice because I think in
those settings at the clinics is, you
always are going to have a few athletes
that are comfortable asking the questions
and talking, and then you're going to have
most of the athletes that just kind of want
to sit back and soak it all in.
So it's always nice to have those athletes,
those ask those questions and and you know
I think it it allows for other people to
(35:46):
kind of start thinking in that way of oh
gosh, I didn't even think of that, or I'm
glad he asked because I didn't want to ask
that question.
So those are always.
It's always good to have that.
And the one thing I do want to add to all
of this for anybody that is listening, is
that anytime somebody does go and see you
or has a conversation with you whether it's
going to Connecticut or just a one-off it's
(36:08):
always confidential.
So the only part that Western Sports
Foundation kind of has in that process is
obviously the application process.
So it's going to our website filling out an
application.
I then share the questionnaire that you and
Dr Peck have put together with them and
send that back over to you.
But from that time on, whatever their
(36:30):
results end up being or anything like that.
That is between you and that athlete.
You know we obviously help cover the
expense and the cost of getting them to see
you and whatever those expenses are after
they've seen you.
But the actual diagnosis and whatever
conversation you have with them is
confidential and that's between you and
that athlete slash patient.
(36:51):
So you know that's always an important
thing that you know we try, I think, to
tell the athletes is one.
It doesn't come back to us but it doesn't
go back to any governing body.
It doesn't go back to the PRCA or the PBR
or you know any, any of those.
It is knowledge and information for the
athlete to make an educated decision on
(37:12):
whatever it is that they choose to do based
off the information that you give them.
Dr. Anthony Alessi (37:17):
Absolutely.
The only exception to that is when it's a
mandated exam.
There have been a few instances where PBR
has mandated the exam and not permitted a
rider to get on unless they were seen, and
in those cases I have to report the
findings to PBR because they're paying for
(37:37):
that evaluation.
You know, one of the things I guess that's
been most rewarding I talked about catching
up with riders on tour is that, you know, I
feel like I've become their personal
neurologist, I mean, and in a good way.
So when other family members become ill, if
they have a neurologic problem, it's great
(37:58):
to hear from them because I know that they
trust me, they trust my opinion, so-and-so.
You know my so-and-so's in the hospital, my
kid's in the hospital, they want to call a
neurologist.
I don't understand what they're saying.
I'm just so happy to have that conversation
with them.
Aubrey O'Quin (38:16):
I can personally say how appreciative I've
just been of any time there's, you know,
from a rash on my kid to you know, a big
life experience of calling and being like
Dr Lester.
I'm really sorry to bother you but you know,
(38:37):
so I do.
I think that you know you obviously are one
of the best neurologists, I would say, in
the United States, but you know just to to
have you as a, as a friend and somebody
that we can reach out to and trust and know
that you're going to.
You know, shoot a straight and and tell us
what's going on.
You know you are, you're changing people's
lives in so many, so many more ways than
just from a neurological standpoint.
And I think every single athlete that has
(38:59):
seen you or will see you, they all say the
same thing about you and I think that any
one of them, would you know, can definitely
say that you are helping them long-term
with their careers, but I think also just
even giving them that peace to know, hey,
you're not going crazy, it's helping their
marriages, it's helping them be better
parents, it's just helping them be better
humans.
(39:19):
So you know, I am eternally grateful from a
personal perspective to call you a friend
and to have you, but also just to have you
as a part of, you know, western Sports
Foundation and you've been, you know, one
of the providers that we've had since the
very beginning and to have you kind of be
along for that evolution.
It's been great to have you as a part of
the team and we're just blessed to have you
(39:40):
here and to have your expertise and
everything that you bring to the table and
to the program.
Dr. Anthony Alessi (39:46):
Well, thank you.
I think it's become a big part of my career
and I certainly enjoy it.
Aubrey O'Quin (39:52):
Well, it's exciting.
So is there anything else before we wrap up
today that you want to share, or any bit of
advice or anything like that that you'd
have for any athletes or family that are
listening to our podcast?
Dr. Anthony Alessi (40:07):
No, I just.
I want people to understand that the brain
is a very resilient organ.
The brain will heal itself if you give it a
chance.
And I think that's the key message is
knowing when and how to give the brain a
chance to heal itself after an injury, and
it doesn't necessarily mean it's the end of
(40:29):
the career.
Aubrey O'Quin (40:30):
I think that's great advice and for anybody
that you know would like to you know some
more information or you know is maybe
concerned, please go to our website, wsforg,
and you can go to Athlete Services, mental
Wellness and you can read a little bit more
about the neurological services.
But there's also an application there that
you can fill out if you, you know, would
(40:52):
like to kind of see if you are a candidate
to go and work with Dr Alessi and maybe
what we'll do is open it up to to kind of
take some questions on if there's something
that you would like to for us to ask.
Ask Dr Alessi and maybe have him back on
the podcast here in a month or two and we
can ask him those questions and get some of
those answers for you guys.
(41:12):
So thank you again for joining us.
As always, it's always a pleasure to talk
with you and hear about the brain.
I'm always fascinated and I know we have a
lot of people that are excited to listen to
this because I think that you are such a
wealth of information, but you just deliver
it in a way that people can understand it
and digest it and walk away feeling
knowledgeable about the brain and empowered
(41:33):
about their own brain my pleasure.
Well, thank you for joining us on Beyond
the Rodeo and we'll catch you at the next
episode.
(41:56):
Thanks for listening to Beyond the rodeo.
To learn even more about western sports
foundation and how we're helping western
sports reach new heights, head to
westernsportsfoundationorg.
We'll catch you back here for the next
episode.
Thank you.
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