Dr. Adam Harcourt Explains Why Migraine Treatments Fail After Head Injury | E41 - Life After Impact: The Concussion Recovery Podcast

Episode Transcript
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Dr. Adam Harcourt (00:00):
The decrease in caffeine from, let's say, 10
to 1, or 2 to 1, or 5 to 1, or 5to 2, any decrease whatsoever
doesn't make a difference.
Doesn't really make adifference at all.
But when you start looking atthe change from having any
amount of caffeine to zero, thechange is huge.

Dr. Ayla Wolf (00:18):
Welcome to Life After Impact, the Concussion
Recovery Podcast.
I'm Dr.
Ayla Wolf, and I will behosting today's episode where we
help you navigate the oftenconfusing, frustrating, and
overwhelming journey ofconcussion and brain injury
recovery.
This podcast is your go-toresource for actionable
information, whether you'redealing with a recent

(00:39):
concussion, struggling withpost-concussion syndrome, or
just feeling stuck in yourhealing process.
In each episode, we dive deepinto the symptoms, testing,
treatments, and neurologicalinsights that can help you move
forward with clarity andconfidence.
We bring you leading experts inthe world of brain health,
functional neurology, andrehabilitation to share their

(01:01):
wisdom and strategies.
So if you're feeling lost,hopeless, or like no one
understands what you're goingthrough, know that you are not
alone.
This podcast can be your guideand partner in recovery, helping
you build a better life afterimpact.
Dr.
Adam Harcourt, welcome to LifeAfter Impact.

(01:23):
How are you?
I'm great.
Thanks for having me.
Yeah, so you are a fourthgeneration chiropractor, a
board-certified functionalneurologist, and you have a
clinic in Pennsylvania calledthe Harcourt Brain Center.
Is that correct?
Yep, that's right.
Awesome.
Well, I've had the honor oftaking courses with you on
migraines.
You teach a 150-hour coursecalled Mastering Migraine, which

(01:46):
was life-changing for me and mypractice and my patients.
And I know you have people thatfly from all over the world to
see you to work.
And so you're you're an expertin treating these very
complicated headache patterns.
And so I wanted to talk to youtoday about the, you know, kind
of the patient that I see often,which is somebody who walks
into my clinic, they've had aconcussion or maybe multiple

(02:08):
concussions, they're sufferingfrom all different types of
headaches and head pain.
They've maybe tried a lot ofdifferent medications.
I assume these are the patientsthat walk into your clinic as
well.

Yeah, absolutely.

Yeah.
So talk us through your kind ofclinical process, your thought
process, and working with thesepeople.

Yeah, and uh, and I actually have a great
example as of last week, justkind of randomly.
Um, but we see these all thetime, and and this is why I'm
I'm so passionate about um kindof the teaching and and whatnot
is I feel like when I firststarted getting into this, my
education and understanding ofthese conditions was wildly off
of what is actually happening.
And it's also makes it reallydifficult to treat people,

(02:47):
right?
If you don't know what headachethey're having, how are you
supposed to treat them properly?
And so um typically when peopleare coming in with
post-concussion or what theythink is migraine or whatever,
there is a lot of overlap, whichmakes it challenging and
there's not an objectivecriteria for either one.
That's my big problem.
Um, and so the most commonthing you probably see as well
is people come in and they've,you know, had head trauma or

(03:09):
whatever, and they say, Well,you know, I've been diagnosed
with migraine.
They say, and you go throughthe list.
Well, I've tried Topamax, I'vetried risotript, insumatript,
and immatrex, relpax, ubrelvi,amivig, jovi.
And and I they list this wholelist of things.
And I go, Well, have any ofthem helped you?
They go, No, not really.
And and you're still tryingthese medications, like just for
migraine.
That's what they're for.
And I say, Well, they said itwas post-traumatic headache, but

(03:32):
then when I had it for a longtime, they said it was migraine.
And I go, it just like hurts mysoul because I'll see these
people sometimes that have beenin this situation for 10 years
or 20 years or 30 years.
And the changes you can make ina couple weeks, right, is
life-changing.
And it goes, well, what if wedid this 30 years ago?

(03:52):
Right.
And so um, when I'm looking atwhat is going on with this
patient, my first question isalways history, right?
Because if you're 40 years oldand you've never had a migraine
in your entire life, and you getin a car accident, now you have
headaches, and they you getdiagnosed with migraine, I can
almost guarantee you it is notmigraine, okay?
Migraine is genetic, worksdifferently than other

(04:13):
headaches.
Post-traumatic headache is notthat, okay?
The problem is it presents verysimilar, right?
So if you have a subjectivediagnosis and you have
subjective symptoms that looksimilar to migraine, I mean,
technically, the medical doctor,neurologist, whoever diagnoses
you isn't wrong, right?
They're using the gold standardcriteria.
But when it comes to actualtreatment, then you don't get

(04:34):
good results.
And it's frustrating foreverybody.
And so what I found is we startwith things that we can
objectify, right?
We look at things like bloodpressure differences side to
side.
We look at oxygen levels sideto side, we look at um things
like palatal parasites and justways that we can look at the
system and say, hey, does thislook like it is migraine or does
this look like concussion?
And I'll have a good examplefor you in just a second.

Okay.
And so what you're describingwith these exams is actually
looking at a difference in, say,the sympathetic output or
parasympathetic output from thebrainstem, and is it different
from the left side versus theright side?
And that kind of gets into thisidea of imbalances within the
brain have these kind of bothmotor and autonomic output

(05:18):
consequences that can actuallybe objectively measured.

Yeah.
And it's really excitingbecause we're we're getting
better at measuring thesethings.
So for a perfect example iswith post-concussion syndrome.
You know, when when I was evenstarting school, the prevailing
thought process was that onlyabout 15% of people that get a
concussion have long-termeffects.
And the reality was we justdidn't know how to measure it,
right?
So that that was the bestnumber we had.

(05:41):
Now you look at research thatcomes out and we're going, oh
crap, it's like 70, 80% ofpeople that get concussion that
end up having long-termconsequences because we can see
it.
And I don't know about you, butthis is a weird thing that I've
seen commonly is people willget knocks to the head, whether
it's car accidents, falls,things where, you know, again,
20, 30 years ago, you thought ifyou got a knock to the head and

(06:03):
you didn't pass out, then itwasn't a concussion, right?
So they think nothing of it.
I recovered, I'm fine.
But what happens is they got aconcussion, there was damage to
the brainstem or some area thatis common with concussion.
The brain was able to deal withthe symptoms to where you felt
like you were okay.
And then in this like 15 to 17year window, they start getting
strange symptoms.
And they'll they'll come andsay, Yeah, I'm dizzy or I get

(06:24):
lightheaded when I stand up ormy headaches are coming out of
nowhere, my neck's been reallytight, or whatever.
And you do an exam and you seeall the same signs you see after
concussion.
You go, wait a minute, did youlike, did you get in a car
accident?
No, no, not last couple ofyears.
You go, what about like 15, 16years ago?
They'll go, oh yeah, you know,I was got hit, I got, you know,
rear-ended sitting at astoplight.
It was fine, right?
You go, maybe, like you didn'tdie, right?

(06:47):
That's good.
But there was trauma there.
And because we didn't reallypay attention to it, we didn't
know how to measure it, peopleforever have just been told that
they're okay.
And, you know, again, yes, inthe emergency, not going to die
since that is true, but therewas an injury.
And so um, it's one of thosethings that we're seeing more
commonly.
And so I always recommend, youknow, if you get any knock to

(07:08):
the head, get an evaluationbecause if it's fine, it's fine.
I've done that with many, manypatients where I say, Oh, you're
fine, go home, rest, you'regood.
But a good number of them, youdo an exam, you go, oh my gosh,
if you live with this for thenext 10, 15 years, you're gonna
be miserable and you won't knowwhy.
And so I always encouragepeople to just get checked out
because we have betterdiagnostics these days than we
ever have.
And you're able to kind of nipthis in the bud before it

(07:30):
becomes a long-term problem.

Yeah, absolutely.
Uh, yeah, I I can't rememberwhen I was probably in my 30s
when I had kind of my firstx-ray of my neck, and they were
like, Well, you have no cervicalcurvature anymore.
And they're like, It's probablybecause of all your
concussions.
And so I think people don'trecognize that even if they get
a concussion and like you said,all their symptoms go away,
there can still be thesepatterns in how your brain

(07:53):
functions that then downstreamcauses a loss of extensor tone
or a loss of certain firing downpathways that are meant to
promote the proper tone andposture to maintain a cervical
curvature and to do all thesethings that are kind of uh
unconscious that we don't haveto actively think about, but
they can change over time whenyou hit your head.

Absolutely.
Yep.

So uh you mentioned you have kind of a
good case that just came inrecently.

Yeah, so this kind of highlights what I talk
about is we I had a case, younggirl, and uh, you know, about 10
years old, and she came inbecause another patient had come
in for migraine and uh waslike, well, you know, go see
them.
And the reason they came in wasbecause unfortunately, out of
nowhere, she started havingthese intractable, miserable
headaches, and she was in thehospital for two weeks, which I

(08:40):
have a nine and a half year old,so I'm thinking, oh my
goodness, this is I I can'timagine.
And so they dealt anothercouple weeks with these
headaches, and they said, Well,um, you have these migraines,
and and I didn't find this outtill later, but turns out they
had three independentneurologists all diagnosed her
with chronic contractablemigraine.
And so they said, Okay, well,here's all the medications we're
gonna start.
They could not break theheadache um until they gave her

(09:03):
a massive cocktail in thehospital intravenously, and that
brought it down a little bit,and then it came right back.
And so she's, I mean, she can'tgo to school.
It's it's awful.
So, luckily, this is why I sayluckily, I end up seeing her
about six weeks after thishappens.
And so she comes in for theexam, the mom's there, and real
sweet little girl.
And we're doing the exam.

(09:23):
And and they said, Yeah, it'sfor migraine.
And during the exam, I'm theseeye movements are just rough.
Now, in migraine, we're we seeaberrancies commonly with things
like convergence or I'm orpursuits and whatnot, but
they're they're minor, right?
They're they're not horrendous.
This was to the point where Imean, she couldn't even follow a
target if I was, I'm like, lookat this thumb, please look at

(09:43):
this thing, and could not do it.
And, you know, her eyes, if youbring them in like that, they
start going like this likecrazy.
I go, what the heck is goingon?
And so I just kind of mentionedto our mom, I go, you know
what, this this doesn't reallylook like migraine.
It looks like she had aconcussion.
And the mom kind of looks at mesideways and is like, okay.
And uh we keep doing the examand what we're finishing up, I
go, yeah, this looks likeconcussion.

(10:04):
I said, well, you know, it'spossible it's migraine.
She's young, you know, we'llsee.
But I said, and I justoff-handed, I go, you know
what's interesting is I found anumber of patients where I tell
them I think they have aconcussion and they swear up and
down they didn't have it.
And then later on we found outthey did.
It's not because they werehiding it from me, it's because
they got hit so stinking hard,they forgot that it happened.
And I'm telling this to themom, and the little girl looks

(10:26):
up and she goes, Oh, she's like,Mom, I got hit really hard in
the face with a basketball.
And the mom looks down, shegoes, What?
And she goes, Well, when didthis happen?
You never told us this.
She goes, Um, the day before Istarted having headaches.
And and the mom's like, What?
And so I start going through itand I say, Well, you know,
she's probably gonna havetrouble in the car.
She might have trouble in likegrocery stores or crowds.

(10:47):
Mom's like, oh my gosh, that'sexactly what's been going on.
And she goes, This makes somuch more sense because they
tried tryptins and other things,none of it was touching it.
I go, well, tryptins arespecific for migraine, they
don't work with post-traumatic.
And they go, Oh my gosh.
And so we got her in, we wetreated her when within like two
days uh of treatment, noheadache.
And I just saw her yesterday.
Um, she's been fine ever since,back in dance class and school,

(11:09):
and um, she's great, she'sfine.
And the reason I was so excitedabout that case is I typically
see that little girl 20 years inthe future, right?
Didn't go to college, havingtrouble at work, on 15 different
medications, no idea what'sgoing on.
And we end up doing the sametype of thing for that person
when they're 30.

(11:29):
And it's great because we helpthem out, but that was 20 years
that they didn't know what todo.
And so that was a uh for me, itwas a really exciting case,
just because it kind of putsinto perspective all the things
that we keep trying to teach,like, hey guys, if you're not
getting this success, if ifpeople keep telling you, hey,
it's migraine, but everymigraine medication doesn't even
touch it, you gotta look forsomething else.

(11:52):
Okay.
And um, so this is this is onewhere, you know, the mommy would
say, she's like, well, what theheck's going on?
You know, these neurologists,they they all said it was
migraine.
I go, technically, they're allright, right?
Because by the diagnosticcriteria, she had the intensity,
she had the light sensitivityand sound sensitivity, she had
the things that meet the goldstandard diagnostic criteria.
They're not wrong, right?

(12:13):
The way we diagnose it, they'renot wrong.
But again, this is why Iemphasize in in teaching and
everything how we have to lookat migraine completely
differently than than it'scurrently looked at, because
it's wrong.
It's just not, it's not a goodway to diagnose these
conditions.
And if you can differentiatebetween the two, now these
people get better wildlyquicker.

And can you talk a little bit?
I know that you use a lot ofdifferent therapies.
You practice functionalneurology, and so you're
creating individualizedtreatment programs for everybody
that comes in.
Uh, in this individual case,were there certain things that
you felt really made thedifference for her within just
those two days where she hadthis really quick recovery?

Yeah, um, so there's a few things.
The one big one, and this isactually, well, you're one of
the first ones to hear aboutthis, is we're in the process of
doing a new research paperlooking into certain eye
movements and the correlationwith migraine, because I see it
so commonly.
And so there's certainmovements that if I see that
they're off, I'm like, oh mygoodness, that's that's probably
a bad migraine.
And sure enough, they're theones that have 20 or 30.

(13:14):
So we're gonna actually lookinto this a little bit more
closely so we can, because a lotof what we do, there's evidence
in the literature that thiskind of thing could be helpful
for migraine, but there's noindication why or when or how
you do the therapy or what thebackground is.
So we're kind of gonna startfrom the ground up and say,
okay, here's the problem we'reseeing.
And then once we see thatproblem, we can quantify it.

(13:36):
Now we're gonna do therapy forit, the way you and I do, and
then show the outcomes and showthat this gets better.
And it helps bring it back tothe fact that this is not a
blood constriction problem ordilation problem.
It's not, you know, anythingelse that we used to think.
It's a hyperexcitabilityproblem in the brain, and we can
make that more stable throughtreatments.
And so um, in her case uhspecifically, we saw big issues

(13:59):
with um what are known as uh sogaze stabilization, so big gaze
stabilization problems.
She could not keep her eyes ona target to save her life.
Um so we had to do really wehad to modify those a few times
where she couldn't look at atarget because she would keep
looking away from it.
She couldn't keep her eyes on.
So we had to modify that.
Um and then we also foundreally interestingly, I thought
it was more the eyes that werethe problem.

(14:20):
But then when we startedlooking at neck proprioceptive
activity and had her moving backand forth, we found that that
was really challenging andstarted to flare up quite a bit.
And so I think what happened iswhen she got hit, she got
extension of some of these neckmuscles.
And that proprioceptive changemade a big difference in the way
the eyes were moving.
So we did a combination ofbasically having her look at a

(14:42):
target with, you know, a headlaser so she's focused on a
target, and then we would rotateher.
And what was really interestingis when she went one direction,
she did really good.
And then when she went theother direction, the head kind
of goes with it and it can'tstay still.
You go, what the heck is goingon?
And what what's interesting isyou think about that stuff, you
know, as a patient or somebodythat's not familiar with this,
you go, who cares, right?
That what's the big deal?

(15:04):
But then you think about it,wait, the way our muscles are
controlled, the way our eyes arecontrolled, are all unconscious
and they're just supposed towork.
Now imagine if you're turningto look at your computer or
you're driving or you're seeingall this stuff and you're
constantly processing thisinformation, but you're not
doing it properly.
That is exhausting when you doit throughout the day.
And it gets to the point wherethe brain just goes, I can't do

(15:25):
this anymore, and it shuts down,right?
It locks the neck muscles, itmakes you headache, dizzy, and
it basically gives you symptomsto say, hey, quit moving around.
We don't know what's going onright now.
And so when you fix these verysimple, basic things, which are
not simple and basic to fix, butsimple, basic ideas, and they
get better.
Now you've laid the foundationfor the rest of the nervous

(15:46):
system to function properly.
And so that's how I kind oflook at my treatment approach is
if there's very basic stuffthat's not working, I could care
less about everything else.
I hammer that until it'sbetter, right?
I just I want the basics to begood.
Once they're better, then wecan do more interesting stuff.
I had her up dancing by Fridayand she's doing all these
different movements, and youknow, I have her doing D2, which

(16:06):
is like that lightboardexercise, and she's having a
good time.
But if you start there becausethat's the end goal, but you
don't fix the foundation, thesethese people go through, I may
just had one that went throughrehab for three years with zero
change whatsoever, becauseagain, they're working on things
that the foundation can'thandle.
So I think that's a reallyimportant point.

It is.
The uh the the kind of order ofoperations of how to kind of
rebuild a nervous system is iskey.
And uh I see that all the timetoo, that people um are maybe
doing great therapies, but theywere just the wrong therapy at
the wrong time.

Exactly.
I I always liken it to like,you know, if you had a twisted
ankle and the goal was to run 10miles, so your first therapy
was to run 10 miles, thatankle's probably not getting
better, right?
It's not a bad therapy, it'snot quite there yet, you know?
And uh it's also like if youget the ankle to where you can
put some weight on it and youcan take two or three steps,
it's like that's great, we'remaking progress.

(17:01):
But if you go out and run twomiles, it's probably gonna hurt,
right?
And so that's another toughthing with recovering from this,
is you can't see the area inthe brain or brainstem that's
damaged, so it doesn't feel likean ankle or a broken bone.
But it's the same problem.
And so a lot of times you'llget people that have concussion
that let's say they have reallybad headaches or really bad
dizziness, and you get themsomewhat stable to where they're

(17:22):
not having that all the time.
That's great.
But the first time they dosomething that overstimulates
the system, they have them comeback, they go, Oh, I thought I
was better and now I'm not.
It's like, no, you're you'rejust taking five or six steps
right now.
You're you're not to the threemiles yet.
And that's okay.
Um, and everybody does it.
It's not unusual, it's a verycommon thing.
Um, it's just it's really toughfor us to process because once

(17:44):
you feel better, you kind offeel like you've you're always
gonna feel better.
Um, and that's just kind of nothow recovery works.

Right.
We want it to be very linearand upwards, but 100%.
It's not that way.

We do too.
I I want the same thing.
It's just unfortunately not howit works.

Yeah, yeah.
Now, there was something thatuh you had taught in the courses
that that I took from you, andit was a little kind of like
sensory trick to help abort amigraine, which is where you
take an insulation bulb and youjust do a puff of air into the
ear like once every threeseconds for 90 seconds.
I have used that with likeabsolute great phenomenal

(18:21):
success in my practice.

Oh, isn't it?
Yeah.

Yeah.
So can you talk about that?
Because most of my patients arelike, what are you about to do
and why is this working?
And then I do it, and thenwithin 10 minutes, they're like,
oh my gosh, my migraine's gone.

It's the craziest thing.
And I'll give credit to anotherneurodoc that actually
published the first paper onthis, Dr.
Dave Sullivan.
Um, he's the one that kind ofdiscovered this, if you will.
And he published a simplepaper.
He said, you know what?
We take this insufflator bulb,um, we pump it into the ear, and
we see migraines go down.
I go, that's interesting.
And so I started using it and Ifound a couple, a couple

(18:54):
nuances to it.
And one is um you can't justpuff air into the ear, it has to
actually deflect the tympanicmembrane.
I don't find that it works verywell if you don't do that.
Um, the other thing is with thestimulation, the reason it
works, we think, again, this issomewhat experimental, is
there's about three differentcranial nerves that are all
innervated into that tympanicmembrane, and they relate to

(19:17):
migraine, right?
Trigeminal being one of them,vagal being another.
And so what we think happens isit's a neuromodulatory effect,
just like peripheral nervestimulation, just like laser,
just like anything else.
And what they they found is ifyou do the insufflation, and you
can do it differently.
So a lot of times I'll start atmaybe 30 seconds, do like two
hertz, right?
Pump it once or twice a second,and then I'll go longer,

(19:40):
shorter, depending on how theyrespond.
But what he showed in his paperis if you do about five rounds
of that and they don't reallyget much better, they're
probably not going to getbetter, right?
But if they're improving afterfive, they can keep improving up
to about eight or nine roundsof that, you know, 30, 40
seconds.
The other thing that I foundpersonally is that if they've
already taken like a tryptin,like a rescue med, doesn't tend

(20:01):
to work as well.
It can.
I've had one or two where theyget responses, but usually if
they say, Yeah, I got amigraine, I took my Imatrex, and
then I came in, that's fine.
It's just probably not gonnawork as well.
So um, I use this as kind ofpart of my armamentarium to
knock out a migraine, but it'sone of the first things that we
start with because it'snon-invasive.
It usually doesn't botherpeople.
Some people have an issue withit, but most people feel okay.

(20:24):
Um and it's like, well, theworst case scenario is it
doesn't help, right?
But best case scenario is youtake your eight or nine out of
ten migraine down to like athree.
You don't have to take mes, norebound effects.
It's a pretty, pretty cool andinteresting uh modality.
And um I again, I I don't knowthe specifics, but I believe

(20:44):
there's some people in our groupthat are working on more of an
automated version of it whereyou could just put it in the
ears, set it to whatever youwant, and then it could either
be an at-home unit or one youcan use in your office.
Um, so there's some cool stuffcoming down that'll make this a
little bit more uh kind ofaccessible and tangible for
people.

Yeah, I really like it because usually I can
knock that headache, like yousaid, down uh from an eight out
of 10.
Then all of a sudden you said,like you said, it's oh, you
know, like they're like insteadof this throbbing pain, maybe I
now just feel like a little bitof a dull pressure.
And so then obviously, onceyou've knocked their pain down a
few notches, then it's easierfor them to do the other
therapies afterwards uh to help,like you said, help stabilize a

(22:34):
hyper excitable brain,essentially.

Yep.
Yeah, and that's that that thathyper excitable, that's the
cool part about what we do isthe the only way to fix this is
either through fixing the genes,which we don't know how to do,
or creating protein, becauseprotein's negative.
And that's the cool thing aboutthese therapies is it might be
good for them, but if you do toomuch, they get migraines.
Okay.
And if you do less, then itdoesn't, it's not enough to make

(22:58):
a change.
And so, like you said, part ofour part of the difficulty in
the early stages is finding thatsweet spot where you're pushing
it enough to make that proteinproduction, but not too much to
push them over the edge.
So I always have thatconversation with people because
um, you know, very a lot ofthem have, you know, got
adjusted and then they get amigraine.
They go, oh, chiropractic'sterrible for my migraine.
I go, that's great.
They go, what?
I said, no, no, no, not becauseyou get a migraine.

(23:20):
I said, that means that pathwayis directly involved in your
migraine.
There's just too muchstimulation, right?
And so we have protocols to fixthat.
So it's an exciting thingbecause there's no one perfect
way to fix this stuff.
And each person with a migrainehas different areas that are
involved.
So you might benefit more fromacupuncture for patient one, but
then from massage from patienttwo.
And so that's what's exciting,I think, about the model is it

(23:42):
doesn't say here is thetreatment.
If that doesn't work, goodluck.
It says, well, we have a goodidea of what we're gonna treat
with you, but that's gonnachange based on how you respond,
and we can adjust from there.
So I think I think it's just anexciting way to go about these
cases.

Yeah, absolutely.
And I have some people that canhandle acupuncture very well.
I have other people that uhthey'll come in and they'll say,
you know, anytime I getacupuncture anywhere on my head,
it triggers a migraine.
And I'm like, okay, cool toknow.
We're not gonna do that.

Exactly.
Well, and that's the thing, isit that's what I love, is it's
not because you know, in thecourses, we we have
chiropractors, acupuncturists,PTs, massage therapists, uh,
DOs, MDs, like everybody hasdifferent backgrounds.
And so the point isn't you haveto do this one thing.
The point is let's zoom out andunderstand migraine.
And from there, if you have allthe modalities to address it,
hallelujah.

(24:31):
But if not, you take care ofwhat you can take care of and
then send them to somebody elsethat um takes care of something
else that you know that theyneed.
And it just, it's my bigproblem with um kind of primary
care for migraine is is nobodytreats it like that.
Everybody treats it for whatthey do and not for what
migraine is, and that's whypeople tend to bounce around so
much.
And it's just it's a reallyfrustrating cycle.

Yeah.
And then you're uh you'reinvolved with a company called
Biogenic Nutrition, and theymake a very interesting product,
which is a ginger migraineabortive product.
And I love that as an optionfor people because a lot of my
patients, they are really tryingto limit the amount of, say,
sumatryptin or those tryptinabortives that they have.
And so to give people an optionthat's more natural, if it

(25:15):
works for them, awesome.
So, are how often are you usingthat ginger in your practice?

Yeah, so we use it for every migraine
patient.
Um, not because it works forevery patient, but because if it
doesn't, no problem, right?
It's not like you're given abunch of meds.
But if it does, what we find isthen they can kind of come off
of their tryptins and you have alot less rebound headaches and
hangover headaches.
And that was interestingbecause I helped formulate that
as well as MQ7.
And the reason was the program,the migraine program.

(25:43):
When I was going through this,I we had our you know, three
days where we just talk aboutnutrition and hormones.
And I'm going through all thesesupplements.
I go, oh my goodness.
I looked them up, and to haveall of those on a monthly basis
was like over 200 and some bucksa month.
I go, this is ridiculous.
So I didn't know these guys.
I called them up and said, heyguys, I'm doing this program.
I they had some other productsI liked.
I said, is there any way youcould just make something that

(26:06):
has all this stuff in it?
Would that be okay?
And they were like, yeah,nobody's ever asked us that
before, but sure.
And so it took them like a yearand they they were able to put
together the MQ7, whichessentially has all of the
vitamins, minerals, nutrients,you know, anything that's been
shown in literature to help withmigraine in the right dosages
and right combinations.
So we started using that backwhen the program started, and

(26:29):
it's been fantastic forprevention.
Again, not because it preventsall migraine, but if supplements
are gonna help, that's gonna doit.
It's wildly more affordablethan if you were to get all the
stuff individually.
And so I have people start withthat because if that helps out,
then we don't need to takeother supplements, right?
We're done.
And if it doesn't, well, wedon't keep trying a million

(26:49):
different things because sure,there is a possibility that
other stuff could help withindividual patients.
But at that point, you know,you have a million different,
you know, options.
And so then there was a studyback in 2013 where they were
giving people uh ginger capsulesand it was helping with
migraine.
And the cool thing was it wasequivalent to sumatryptin as far
as what patients felt like theythey got benefit from.

(27:12):
And so I started doing that,and I liked it because we would
give them ginger capsules and itwould help.
But because it had to gothrough the GI tract, it took
like two, three hours to work.
So I asked the guys at Biogenicagain, hey, could you make this
sublingual?
And they go, sure.
And so it's literally just MCToil and high dose ginger.
That's that's what it is.
But because it's sublingual, itgets into the system within 15,

(27:33):
20 minutes.
And what I found personally isif you've responded well to
tryptins in the past, you'llprobably do well with the MGR.
The other important point is alot of people confuse their
different headaches formigraine.
So they might get servagogenicwhere it hurts back here 10 days
a month, and then two days amonth it goes into the eye.
Well, what they're telling youis they have 10 servagogenic

(27:54):
headaches and two migraines.
And so what I tell them is Isay, hey, these headaches back
here, MGR is not gonna help.
But if it's up here, there's agood chance that uh it's gonna
work for you.
And so, you know, fulldisclosure, I had nothing to do
with the company up untilrecently.
And so they actually asked meto come on to help create
content and um talk more aboutmigraines.
So I am working with them now,but I've been using it for six

(28:16):
years.
And it's just such an easy,simple thing to add into their
care instead of trying to, youknow, take 50 different things a
day.
Um, so it's been it's been areally neat thing.
And I think looking at theliterature, there's some new
stuff coming out.
And as new things come out, Iwant to actually incorporate
that into the product.
And that's kind of the goallong term is to keep up with the
literature.

Awesome.
And I find too that a lot ofpeople are out there searching
for answers on the internet bythemselves, and then they they
hear, oh, well, this supplementis supposed to help, and that
supplement is supposed to help,and then they start ordering
things off Amazon and you don'tknow what the quality is, and
then all of a sudden you got acupboard full of 20 bottles and
you forget kind of why you'retaking what.
And so the fact that the MQ7takes all of the kind of

(29:02):
evidence-based uh vitamins,minerals, herbs, and puts it all
together in one bottle is likevery nice for people.

It's so simple.
I I know.
I I actually got kind ofoverwhelmed when I was teaching
the program.
I'm like, how are people gonnatake all this stuff every day?
And um, it just makes itsimple.
And now that that's also whatuh it's also kind of the basis
of what I do for hormonetreatment, which we probably
won't get into that too much.
But um, the only time that I'llreally give other stuff then is
if we do actual testing and wefind out, yeah, actually we need

(29:30):
to, you know, add this or addthat for you personally, but we
don't know that till testing.
And so I feel like that's thebest way to do it is here's the
blanket.
This helps kind of a bunch ofpeople no matter what.
And then for you personally,let's do some individualized
testing.
And if you need other, youknow, vitamin supplements,
hormones, whatever, then we canaddress that like for each
individual person.

Yeah, yeah.
Well, and I find too thatsometimes when you've got
somebody with really severemigraines that are having
migraines like 20 days out of amonth, a lot of times for women,
as they get better and as theirbrain stabilizes, then all of a
sudden it becomes much moreobvious that the migraines are
now coming on hormonally duringthe cycle.

Yeah.

It's like, okay, now let's dive into those
hormones and figure out thatpiece.

Yeah.
And I always tell people if ifsomebody comes to me and they're
having 30 a month and I getthem down to two, I can
guarantee those two are going tobe right before their cycle
starts, every time.
And so what I've what I used todo was run the hormone test
right away.
But then I was finding a lot ofthat was inflammatory, and the
diet was taking care of itanyway.
So what we do is we do dietarystuff first for like a month or

(30:32):
so.
And then if they're, you know,getting better and they still
have those hormone issues, thenwe do the hormone test because
at that point they've been onthe diet, they're
anti-inflammatory, all that.
And if they still haveabnormalities in in the the uh
hormones, we know that that's aproblem we have to address.
And that's where, you know,every month we see it get a
little bit better, a little bitbetter.
And that that's a goal of care.
I don't expect it to go awaylike that.

(30:53):
It's not how it works.
But as long as we see adecrease in frequency,
intensity, or duration month tomonth, we know we're doing doing
the right thing.

Yeah, yeah, absolutely.
And in terms of the diet, sinceyou brought that up, uh, are
there are there certain likethings that you feel like are
the biggest?
offenders that you absolutelysay to people, like, let's cut
this out.
Our favorite beverage.

I I'm offending right now.
Well, and it's the worst theworst thing is like, um, because
I I don't get migraine, but Ilove coffee.
And you know, it's somethingthat I I have all of my migraine
patients off of.
And so if I make the bigmistake of having coffee out in
the thing, I I get heck from allof my patients.
What are you doing to me?
You got me off of it.
Come on.
So real quick about caffeineand because there's a bunch of

(31:38):
arguments.
And what irritates me aboutliterature actually is if you
look at each individual paper,there's one that says no, it
doesn't make a difference.
And then oh it makes a hugedifference and no it doesn't
actually make a difference.
But if you just look at all ofthe literature in an aggregate
and what their conclusions are,what they actually find, not
just what they think they found,what you notice is that the

(31:58):
decrease in caffeine from let'ssay 10 to 1 or 2 to 1 or 5 to 1
or 5 to 2, any decreasewhatsoever doesn't make a
difference.
Doesn't really make adifference at all.
But when you start looking atthe change from having any
amount of caffeine to zero, thechange is huge.
Right?
And what they found is thatcaffeine itself does a couple

(32:21):
different things.
You know, it is a drug so itchanges your brain conformation
specifically it changes like CSFproduction and things like
that.
But more importantly related tomigraine there's studies that
directly say caffeine directlyincreases neuronal
hyperecitability.
What are we trying to do withmigraine?
Decreased focal excitedhyperexcitability, right?
So it just makes sense acrossthe board that it's likely to

(32:43):
contribute.
And so my spiel is always thesame with every patient because
I've done this with thousands atthis point.
And I say look we're going toget off this caffeine for a few
weeks okay if you havewithdrawal it's all the same.
It's a bell curve, right?
And so what happens is day one,you're kind of tired but you're
okay.
Days two and three, if you'regoing to have withdrawal, that's
usually when you have fatigue,headaches, all the miserable

(33:04):
stuff where most people arelike, this is worse than being
on caffeine like I'm just I'mgoing back on, right?
But if you can get over thathump, then everything levels out
and you get better.
So let's say we're doing ourtreatments, you're off caffeine,
you're doing good stuff, andyou get to a point where you're
like, man, I'm I'm doing a lotbetter.
I was having 20, I'm down toone a month, the MGR takes care
of it.
This is great.
If you then try the caffeineagain and you start getting

(33:27):
migraines, I don't have to tellyou to stop, right?
You know what's going on there.
But conversely, I do have asmall number of patients, I'd
say 10 to 15%, that go back oncaffeine, they're feeling great
and they have no problems.
Well I don't care.
Like I'm not anti-caffeineright it's not like I just don't
like it.
It's just I don't want it tocause your migraines.
And so if you go back on andit's fine, well, hallelujah good

(33:48):
for you.
That's that's fantastic.
But that's why we only have theconversation one time.
And after that it's like eitheryou know it's not good for you
and you just stay away or itdoesn't bother you and you're
fine.
Right?
We just want to make sure wecover our bases because when it
comes to migraine there's somany little things that can
create a problem.
I just want to make sure thatwe're we're being comprehensive
because I I've had cases whereyou know everything should be

(34:10):
good and it turns out pineapplewas the thing that was driving
their migraines.
You're like who would haveguessed sinking pineapple and so
we have all these things thatsound kind of silly but it's
because I've had one or two orthree cases where they just did
not go the way I expected andI'm so confused and it ends up
being something silly like that.
So I always tell people I'mvery mean for the first couple
weeks and then I get a lot niceras you feel yep got it.

And I guess that brings up the the histamine
conversation too like somepeople are very sensitive to
histamine production certainfoods that are higher in
histamine so how um how muchattention are you placing on
that?

A lot.
Yeah I actually it's funny Ihad a patient yesterday where I
was going through this stuff andthey're like that's we're
really weird because like everyfood I would point out in the
histamine they go wait I have anallergy to that I'm sensitive
to that I'm I have an issuethere.
And it was literally everyhistamine food I said well I I
think we know what what theproblem is there.
But most people don't have thatreaction because the big
problem with migraine diet ismost people are looking for what

(35:09):
what you would considertriggers right so I took gluten
out it didn't really help myheadaches.
I took dairy out didn't help myheadaches.
Well I found in my experiencealmost zero people have triggers
right not zero it's like threepercent maybe almost everybody
though has sensitivities meaningthat if you are sensitive let's
say to gluten and dairy andtomatoes and pineapples right

(35:32):
well none of them are driving orcausing migraines as soon as
you take them but what they dois they are inflammatory to you.
So if you take out gluten forexample but you're still eating
dairy and tomatoes and whatnot,you're still getting the
inflammation so you don't noticea change so you go oh it wasn't
gluten.
Then you go off with dairyright same experience.
So what I found is if we getoff all the things that can
cause a problem includinghistamine so that includes you

(35:53):
know things like your nuts, youreggs, pineapples, papayas,
tomatoes, those types of thingswhen you get off of everything,
see how you're feeling when youadd them back in what typically
happens is I didn't get amigraine but you know what I got
really congested or I gotreally tired or my stomach felt
weird or something that justsays this isn't inflammatory
food.

(36:13):
And then you end up findingabout three or four of these,
you go, holy cow, I eat thesethings every day.
And so once you know what theyare, it doesn't mean you can't
have them again.
It just means okay I'm notgonna have a pineapple pizza
every day, right?
Because for me all those foodsare a problem.
So if you're gonna eat them,you know, do it every once in a
while try not to eat themtogether.
But also I just find thecontrol of knowing that is so

(36:36):
just relaxing to migrainepatients.
So then if they do go have apineapple pizza and they have
three glasses of red wine andthey wake up the next day with a
migraine, they're like, yeah,it sucks, but I I know why that
happened and it's not asstressful.
And I I found that that controlis is really really important
for long-term compliance becausenobody wants to be on a super
strict diet their whole life.

(36:56):
But if we can say well I wenton this diet now I know there's
a couple things that kind offlare me up now then now it's
your decision, right?
Just like if I want to go outand have five beers tonight, you
know, might be my decision,might have fun, but I'm probably
not going to feel greattomorrow, right?
That's that's okay.

Yeah.
And then I find too like peopledo when people are experiencing
true migraines, they do usuallycome in and they'll tell me
these are the certain foods Ineed to avoid.
Whereas when I have people withpost-traumatic headaches or
they're not coming in saying ohwhen I eat this food I get a
headache.
They're you know and so I thinkthose little clues just in

(37:33):
people's in you know intake toocan kind of guide you and to be
like, okay, you know, does thislook more like a real migraine
or are we dealing more with apost-traumatic headache?

For sure.
Yeah and I have a couple basicquestions I always ask I always
say where exactly is theheadache located?
Okay, that's my my number one.
Then I always just ask theirhistory of medication use,
right?
What helped them, what didn'tbecause can you have migraine
and try to work for you?
Sure.
But normally the reason thatthat happens is each tryptin
works on different serotoninreceptors.

(38:03):
And so if they've tried threeor four and none of them have
worked, now it's less likely tobe migraine.
Still not impossible.
But if they say well none ofthe tryptins have worked when I
say migraine it's top of theforehead or it's back of the
neck or it's on the sides wellthose two things combined right
there tell me that's probablynot migraine, right?
And then if they say well I gotit and it started right after a
head injury and I never had ahistory before probably not

(38:25):
migraine right um and thenthey'll say well I, you know, I
actually can't be migrainebecause I don't get any of those
auras, the visual stuff.
Well only about 33% of peoplewith migraine have aura right so
most people don't uh so there'sjust there's all these little
clues that I kind of walkthrough and then when I'm doing
the exam, for example the thedifferences in blood pressure
and all that, they're usuallypretty subtle with migraine

(38:47):
where they can be a lot moreaccentuated with post-traumatic
headache.
And just as you talked aboutthe importance of like diet
nutrition and hormones huge inmigraine not as not I don't want
to say not important.
It's just not as many peoplehave that as a big problem.
So like 98% of my migrainepatients there's a hormone
nutrition component.

(39:08):
I'd say like 40 or 50% ofpost-traumatic headache that
actually ends up playing a part.
So it it that's a case by casebasis um which is why I don't I
don't kind of emphasize it asmuch.
I typically go right in for theneurotreatment on those cases,
get them treated right away andthen if they need more we do
diet and hormones.
Whereas if you have migraineI'm making you do the diet and

(39:30):
hormone testing all that beforeI even see you if you're coming
from out of town.
So that way we know all of thatis dialed in.
So when I see you for the theneurological treatment we know
that any changes are due to thecare and not from withdrawal
from caffeine or blood sugarissues or those types of things.

Yeah.
And how often are you seeingpeople who you think are
actually suffering frommedication overuse headaches?

Yeah so this is this is interesting is they
used to put migraine kind of waydown there in the disability
you know kind of scale and itwasn't until a few years ago
where they go, wait a minute, inthe medication overuse category
like 99% of those are frompeople that have migraine.
And so once they combine thosetwo, they found wow, migraine is
the second leading cause ofdisability worldwide period.

(40:12):
And in people under 50 it's theleading cause which is just
wild.
And so the reason that if youtake tryptins they say no more
than about nine or 10 a month isbecause once you get past that
your brain gets used to thatkind of you know flood of
serotonin receptors being beingactivated or it um or the
agonist to them and they getused to it.
And so now it's really reallyhard to not have a headache

(40:35):
because you're basically havingwithdrawal from the medications
which increases your stresslevels which increases your
probability of migraine so youtake another medication and it's
just like this snowball effect.
It's awful.
So that's why the first thing Ido is get them on MQ7 and MGR
because even if I can take themfrom 15 or 20 tryptins a month,
which again they're not supposedto do, but people got to get
through if I can get them downto taking like five a month,

(40:58):
that already starts to reversethis process right away.
And so that we we try to doeverything we can to kind of
lessen the load and that helpsthem get off the medication
overuse headache because thatthat it's like a drug withdraw.
It is a drug withdrawal it'slike a caffeine withdrawal it's
just it's really really roughbut if you can get them over
that hump they do wildly better.

Yeah and I find too like some people will take
their tryptins uh as prescribedmeaning they might only take
them nine or 10 days out of themonth but then they're taking
ibuprofen or you know Advilevery other day of the month and
it's like okay well that's alsoa problem too.

Yeah doing what you got to do.
And that's why I tell people isthat well you know I tried
Botox but I didn't want to Idon't I'm on this medication.
It's like well if you didn'thave any other options I mean
what do you do?
You got to get through liferight and so when we talk about
what what to take when you havea migraine I never say there's a
good or bad thing to take Ijust say look there there's kind
of a hierarchy of stress levelsor what we call allostatic load
to the system.

(41:53):
So if we can just lay down,take some MGR and put some ice
on the front of your neck andyou feel better, hallelujah,
right?
That's great.
But if that doesn't work andyou end up having to take a
tryptin and that gets rid of it,well that's what they're for
right so you just want to usethese things as needed.
When you haven't been given anyother options and this is
basically all that you have todo, well then that's all you

(42:13):
have to do.
And so that's how people tendto get in this medication
overuse kind of spiral.
And that's why again I I'm likewe try to get out and talk to
as many people as we can.
I just did a grand rounds downat uh Johns Hopkins and we we
had a great conversation withthe doctors there because
they're in this same kind ofboat.
They're like look we go by theobjective diagnostic criteria

(42:36):
that's given to us and based onthat then we follow the
protocols that are laid out forthese conditions.
And in that scenario a lot ofpeople fall into migraine and
then the sequence is you knowyou take the topamax or you take
the you know risotriptins oryou take the uh whatever it is,
the the Mgalides, Jovies.
And that's kind of the model.

(42:58):
And they're doing the best theycan but you also have to
realize with medical neurologythey're also dealing with
life-threatening conditions,genetic disorders, rare
conditions, things that justtake a wild amount of time to
keep people from dying from likethat's that's really what
they're doing.
So when you end up withmigraine, it's like yeah it's
miserable but you're gonna beokay meaning this person's not

(43:20):
going to die.
My other one over here might soI'm gonna put all my effort
into keeping that person fromdying.
And so our my I feel like ourresponsibility is to say, okay,
that that's great.
We need to start putting out alot more literature and
education to say thank you forruling out the tumors and
strokes and all the stuff thatcould be causing terrible
things.
Now our expertise is makingsure that this this functional

(43:41):
debilitating condition can becleared up and get like a nice
kind of continuation of careinto what do you do once you
rule out the scary stuff.
And that's what doesn't existright now.
So that that's kind of my nextgoal is is to open that line of
communication and make it a lotmore simple for your general
practitioner neurologist to saygreat everything's ruled out

(44:02):
that's fantastic you're gonnasay see Dr.
Wolf and she's gonna take careof the migraines.

That's where we want to get to yeah and then
talk to me about vestibularmigraines and I'm also curious
if you've had uh if you've foundthat the MQ7 helps in those
cases too or if you're uhapproaching them completely
different.

Yeah and and I'll lump that in with
hemiplegic migraine as wellbecause I what what's
interesting about all thesedifferent variations is they get
treated as different disorders.
They're they're all migraineright they're all migraine and
so when we talk about you knowthe bucket theory and this
hyperexcitability and all thisstuff it's the exact same thing
but instead of being in the areathat inhibits head and face

(44:40):
pain it's in the area thatcontrols balance or controls
facial movements or whatever.
I just I I had a hemiplegiccase come in two days ago and it
was post-surgical.
They they had a history ofmigraine they had a history of a
little bit of facial droopingbut now after surgery they came
out full facial drooping theyhave full tingling and numbness
and at first they go you'rehaving a bunch of TIAs and then
they're like but we're notseeing them on imaging so we're

(45:03):
not sure what's going on whichis common hemiplegic migraine is
not not super common.
And so with vestibular migraineor hemiplegic I still do the
MQ7 and the MGR.
Now for me with hemiplegicmigraine I had no reason
whatsoever to think that MGRwould be helpful with the
hemiplegic symptoms.
And so I never recommended it.
And I had a few cases wherethey had both hemiplegic

(45:26):
migraine and classic migraineand I had about three about
three patients in a row all sayyou know what was weird?
I had the headache I also hadthe hemiplegia come on I took
the MGR and my hemiplegicsymptoms went away.
I don't know why.
I'm just being honest I have noidea why that happened.
But it has helped so I go allright well it's better than
whatever else you were takingand so we still start with the

(45:48):
the diet the hormones like I hada hemiplegic case that um had
been couch bound basically forseven months they couldn't move
and we just started remotelybecause they were in in uh
central they were in the themiddle of the country and they
just did the nutrition andhormones and got like 78% better
just from that.
And they're like but it wasstroke why are they getting

(46:09):
better?
It's like no it was migraine.
And so if it's vestibularmigraine I still start with the
base of the nutrition andhormones but the therapy as
opposed to being straight youknow trigeminal or going after
that that kind of uppermid-brain stem, we do a lot more
that affects the lowerbrainstem, right?
The vestibular system andthings like that.
So the neurological rehab mightbe a little bit different, but
the approach is still exactlythe same and same thing with

(46:31):
hemiplegic migraine.

Yeah so as kind of a take home for our listeners
there's this concept thatwhether you're having a migraine
manifesting as head pain or avestibular migraine manifesting
as extreme vertigo ordisequilibrium or a hemiplegic
migraine which is manifesting asparalysis, temporary paralysis
of the face or an abdominalmigraine where you're having

(46:54):
nausea it's that this is thehyperecitability in the brain
and based on where thehyperecitability is, it's
affecting different systems andthen people are having these
different symptoms as a result.

Exactly yep that's exactly right and
interestingly about abdominalmigraine you you might see
something different than I havebut um I I have yet to see a
case that was actually abdominalmigraine everyone that I've had
ended up coming back tofiguring out oh no they actually
had a really bad concussionthat brought on all these
symptoms.
I'm not saying it doesn'texist.

(47:28):
I'm just saying every case I'veever seen initially they would
say yeah it's migraine it cameout of nowhere but upon like I
had I had one kid he came inlike yeah it's they say it's
abdominal migraine abdominalmigraines it's miserable and
they came in and it turns out hegoes oh yeah all this started
after I was sailing and the boomcame around and hit me and
knocked me off the boat.

(47:48):
I go and you didn't ever haveany symptoms before that they go
no I go maybe that was it.
Maybe that had something to dowith and so I mean again they
because these are there's not anobjective way to say which is
which my guess is there arepeople that have these abdominal
migraines that are really lowerbrain stem and that's where
that's coming from but the vastmajority I feel like are

(48:10):
diagnosed as abdominal migrainebecause of the nausea and the
different symptoms that aren'tas classic I guess with with
post-traumatic um headaches orpost-traumatic um concussion
syndrome and when in realitythey're just a knock to the head
right and so that's just aninteresting observation I've had
uh over the years is I justhaven't seen one yet.

(48:33):
It's just very interesting.
Yeah yeah interesting and thenlet's talk about barometric
pressure because a lot of peoplethat suffer from migraines uh
become their own weathermen in asense that as soon as the
barometric pressure changes theythey get a migraine yep yeah
yeah the way I describe that isis when we talk about the bucket
theory which we didn't talkabout here but I'm sure you've
talked about it is if youimagine that part of the brain

(48:55):
that's hypereccitable forwhatever type of migraine you
have, you imagine it as a bucketbecause as stressors, right,
hormonal stress, musculoskeletalstress, nutritional stress,
whatever it is, fills up thatbucket and the bucket overflows,
that's when you get migraine.
Now you we technically we talkabout it this hyper excitable
state and all that, but thebucket makes sense.
And what's interesting is overtime the bucket can either get

(49:18):
bigger or smaller.
So if you have two migraines ayear, right, you have a big old
bucket it takes a lot of stressfor you to end up having that
migraine.
But now it starts being everymonth, every two weeks every
week every other day andeventually you get to the point
where the bucket is so smallthat even if you go in, let's
say you get acupuncture and it'swonderful for you, there's too

(49:38):
many other things filling up thebucket so it looks like oh that
didn't work I'm going on thenext thing.
And you try chiropractic andit's great for you, but the
bucket's so small so it lookslike it didn't help.
And you move on to the nextthing.
And this keeps happening overand over.
That's why with chronicmigraine we approach it in this
comprehensive manner where welook at all the different things
and we try to remove thingsfrom the bucket but stimulate
the area that is involved in themigraine so that it creates

(50:00):
more proteins, makes it lesshyperexcitable and makes the
bucket bigger the way thisrelates to barometric pressure
is believe it or not, I haven'tfigured out how to control the
weather can't do that yet.
So I can't empty the bucket.
But what I can do is I can makethe bucket bigger okay and so
what we find is as people getbetter and they get more stable,
they'll get to a point wherethey'll feel the bare they'll
still feel the barometricpressure they'll feel everything

(50:23):
that usually leads up to thatmigraine and then it just
doesn't it doesn't come on rightand what that tells me is the
bucket's gotten big enough whereit was filling up, right?
It was getting close to beinghyper excitable and it didn't
quite make it over the edge.
Okay, we've got it big enough.
Hallelujah we know we're ingreat shape then and that's
that's kind of how you treatexogenous stressors that you
have no control over whatsoever.

(50:44):
You're not gonna get rid ofthat stressor just like I had
one one time where um she wasdoing really well and then she
started spiking up headaches.
I go, what the heck happened?
She's like my mother-in-lawmoved in with us I go oh I can't
can't take that stressor awaysorry let's keep working on the
things to make that bucketbigger and that's what we did.
So there's always things youcan't control.
That's why I'm a very very kindof staunch advocate of

(51:09):
continuing with exercises untilyou feel really stable not
because you're gonna get amigraine if you stop doing them,
but because we want to makethat bucket as big as we can.
So when inevitably those bigstressors come along, it's not
taking you out for for weeks ormonths.

Yeah yeah that makes sense so it's uh when
people tell you that it's reallyjust an indication of kind of
where they're at in terms of howfull is their bucket or how big
or small is their bucket.
And your approach is stilltechnically the same.
Let's try to decrease thehyperexcitability in the brain
let's try to stabilize the brainthrough active neural rehab
create those proteins thatcreate the the proper voltage of

(51:46):
the cell membrane so that it'snot so hyperexcitable.

That's exactly right.
Yep.

Awesome well why don't you give us uh some
information on where people canfind you uh where your clinic is
and then some of these otherthings you have going on I know
you also wrote a book that isprobably chock full of helpful
information for people.

Yeah yeah so um we're at Hardcourt Brain
Center right it's the easiestthing is just look on uh Google
you can find us pretty easilywe're in York Pennsylvania uh
we're also on on Instagram it'sat mygrain doctors so we've been
on there for quite a while alot of content there um anything
I I think I have part of myspeech from Hopkins we were on
uh when we was with Dr.
Drew doing his podcast that'son there so lots of cool stuff

(52:25):
uh to look up a lot of helpfulhints you know we do things for
the holidays things like that soit's a great resource um for us
um I did write the book it'snot not available very easily
right now but that hopefullywill change soon so uh it used
to be on Amazon it'll probablybe available on a different
website um we are yeah we areworking with biogenic nutrition
so there's some really excitingthings that will be coming out

(52:45):
in the next couple months umthrough them so some at-home
things that you can do um onyour own and then as as we kind
of alluded to um we're alsolooking at a couple different
research papers one actuallywith laser therapy because
there's there's not a lot outthere about it but so there's
some really cool things thatwe've been doing.
So that's one study that'sgoing to be coming out.
And then there's another onewe're gonna start looking at

(53:06):
with with eye movements, beingable to track those and then
kind of quantify that.
So again that's that's allcoming down the pipeline.
But um easiest way is just lookus up online or go to Migraine
doctors at uh at Instagram.

Excellent well I'll post all that in the show
notes and then once your book isavailable uh I can also put
that on my Instagram and and getthat out to people too.

Perfect that sounds great.

Yeah well thank you so much for sharing all your
wisdom your experience and uhit's been a great conversation.

Yeah thanks so much for having me.

Absolutely medical disclaimer this video or
podcast is for generalinformational purposes only and
does not constitute the practiceof medicine or other
professional healthcare servicesincluding the giving of medical
advice.
No doctor-patient relationshipis formed the use of this

(53:57):
information and materialsincluded is at the user's own
risk.
The content of this video orpodcast is not intended to be a
substitute for medical advice,diagnosis or treatment and
consumers of this informationshould seek the advice of a
medical professional for any andall health related issues.
A link to our full medicaldisclaimer is available in the

(54:19):
notes

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Dr. Adam Harcourt Explains Why Migraine Treatments Fail After Head Injury | E41

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Dr. Adam Harcourt Explains Why Migraine Treatments Fail After Head Injury | E41