Traumatic Brain Injuries (TBI) in Children: How to Prevent, How to Treat
When you need to learn about a hot topic in medicine, you consult an expert. That’s what I did. After researching “who’s who” in TBIs, I found Dr. Michael Lewis, the military’s leading researcher in TBIs and author of a new book, When Brains Collide, and founder of the nonprofit: Brain Health Education and Research Center.
On a beautiful summer day in 2015 I invited Dr. Michael and his family to our home for the day. He loved teaching me about TBIs, and I loved learning about an increasing medical problem, especially in teen athletes. I also enjoyed dancing with his teen daughter during our meeting. When he asked, “What’s for dinner?” I quipped, “The best brain food” as Martha and I prepared our traditional salmon-at-sunset meal.
Much of this article is what Dr. Michael Lewis taught me and I gleaned from his insightful must-read book, When Brains Collide.
Scary Statistics About Brain Injuries
- Over two million children a year suffer concussions or TBIs.
- Many TBIs go unnoticed and untreated.
- The CBC reports that in 2010 2.5 million ER visits were associated with TBIs.
- The most common cause of youth concussions is boy’s high school football.
- The second most common cause of youth concussions is girl’s high school soccer.
- Because the female brain is more vulnerable to TBIs (why is being studied), contact sports (hockey, lacrosse, and soccer) warrant increased attention in girls.
- The July 2017 issue of JAMA (The Journal of the American Medical Association) reported a study of 200 former football players who had died. Their families asked experts to examine the brains of these players. Shockingly, the autopsies revealed that 87% of them showed evidence of brain damage called chronic traumatic encephalopathy (CTE).
The Double-Whammy Causing TBIs
Two factors of modern living, and eating, have set-up the brain for injury: sports are getting rougher and the SAD (standard American diet) is getting dumber. One of those “dumb” dietary changes is the “oiling of the American diet.”
We are “Fatheads”
Around 60 percent of brain tissue is fat and around half of that fat is a “smart fat” called omega 3s, which are aptly called “the building blocks of the brain.” Sadly, the SAD diet is woefully low in the smart omega-3 fats.
The brain grows – and heals – by engaging the right balance of omega-3 fats and omega-6 fats in approximately a 1:2 ratio. The grain-feeding of animals and humans, plus the increased consumption of vegetable oils (soy, corn, and cottonseed), has lessened the natural healing power of brain tissue, leaving the brain more vulnerable to the effects of a concussion. In a nutshell, brains are getting hit harder and are getting insufficient healing nutrients. (Link to Omega Balance on our website).
My Lessons from Little League
One of my greatest teen memories was being captain of my high school football team. And, after coaching Little League sports for thirty-five years, I still preach: sports is one of the best tools for success in life. It teaches teamwork, leadership, compassion, resilience, and the total-body and brain benefits of movement. These facts of sport life makes it challenging for me to give a “yes” or “no” answer to a frequent question I am asked: “Should my child play contact sports, such as football, hockey, or soccer?” Okay, soccer isn’t supposed to be a “contact sport,” but heads collide with heads and with hard soccer balls.
Best TBI-Preventive Medicine
If TBI is caused by “contact sports,” just lessen the “contact.” That was simple! Wisely, in the last five years, Pop Warner Football has alerted coaches to limit head-to-body contact during practices; severely punish “head-butting” or “targeting” with being ejected from the game; ban “heading” in youth soccer; and “preload” your child’s brain with plenty of omega 3s as you will learn about later.
An Ounce of Prevention
Dr. Michael Lewis and other experts in TBI-prevention recommend feeding a sports-bound child with high doses of omega 3s, both by eating more omega-3-rich seafood and by eating omega-3 supplements. This is a nutritional perk I call “preloading the brain.” So, if a potential TBI occurs, the brain already has a store of repair nutrients to start immediately. Just think, if damage to a structure occurs and you already have a supply of repair materials on hand, less damage would occur than if you had to wait days or weeks for delivery of the repair materials. That makes sense!
Toss the Tilapia
As I advise in our book, The Omega-3 Effect, and a fact now confirmed by medical experts, tilapia ranks near the top of the list of unhealthy seafood. Why? Feed farm-raised fish food they are not meant to eat (corn and soy, which are extremely high in omega 6s and low in omega 3 fats) and the meat of the fish becomes high in omega 6s and low in omega 3s – just the opposite nutrition you want from seafood. Tilapia is the darling of restaurants because it’s cheap to farm and cheap to buy. Don’t do tilapia!
You may worry when you read, “Can high doses of omega 3s cause bleeding?” No! This mythical worry has been dispelled. The military and universities who have studied this concern conclude that even though one of the reasons omega-3s help lessen the risk of heart attacks and stroke is by decreasing platelet stickiness, you would need to consume in excess of 30 grams a day (30-60 capsules) to have a blood-clotting concern.
Suppose you want to heal, or help your child heal, from a broken brain or TBI. It helps to think of the healing brain like a garden, the greatest garden ever grown. What do you need to grow a healthy garden, or to repair a withering or injured garden? You increase the irrigation, or water, to it, feed and fertilize it, and keep out the pests. That was easy!
Regarding the brain, first increase blood flow to the tissues in need of nourishment. The EPA component of omega-3 fats is credited with relaxing blood vessels or making blood flow less sticky. More blood flow equals more brain-healing fertilizer. That was simple!
Healing 101: injured tissue heals when the healing nutrients in the blood flow is increased.
Healing 202: Tissue-healing begins with the rebuilding of damaged cells. DHA (the buddy fat to EPA in omega 3s) is known as the membrane molecule, providing the structural components of the cell membrane. A medical truism is every tissue in the body is only as healthy as each cell in it. Healthy brain cells grow into healthy brain tissues.
Finally, you want your immune system to quickly rush healing biochemicals to the site of the injury, but you don’t want them to “overheal” or “get inflamed” with scar tissue. Omega 3s send the biochemical text message to the immune system: “Heal it, but then cool it.” Simply stated, a concussion is a brain bruise. When hit or shaken the brain strikes the inside of the hard skull and gets bruised, sort of like striking your knee against a wall.
My Personal Concussion Story
(Excerpt from When Brains Collide)
“In November of 2014, while on a medical mission trip to a third world country, Dr. Sears suffered a blow to the head and a pretty significant concussion. Even in the following months after the initial injury he found himself still suffering with symptoms of a concussion, a result of secondary trauma and the effects of biochemical cascades.
I met up with Dr. Sears for lunch at his house the following February, nearly four months after his initial injury. Though mostly recovered, he was still suffering from some headaches and brain fog. His concussion was not severe, but he couldn’t shake the symptoms. We were colleagues and friends. I knew he was incredibly health-conscious, and even though he was already taking omega-3s I convinced him to take more. The amount of omega 3s he was taking wasn’t enough and he needed to up his dosage. I recommended “the omega-3 protocol” (TOP) for him. Dr. Sears agreed and started that afternoon. Within a week, all symptoms resolved. His headaches vanished, and his brain fog lifted.
What was happening, of course, was that the biochemical cascades were being doused with omega 3s, prompting the inflammation to dial down. The fuel feeding those proinflammatory biochemical cascades, omega 6s, were now in balance with the resolving power of the omega 3s, immediately resulting in dialing down of his inflammation. Once that reduction took place, Dr. Sears’ symptoms resolved. With nutritional support, his brain healed itself.”
In my talks on TBIs, I summarize brain-healing nutrition with what Dr. Mom always advised, “Eat more fruits and vegetables and seafood.” Again, a high plant-based diet (ten fistfuls of fruits and vegetables daily) and wild salmon (at least three fistfuls a week), is the brain-health diet made simple.
Besides eating more fruits, vegetables and seafood, Dr. Mom also advised, “Go outside and play!” Here’s why my favorite “brain specialist” was right. While it’s common to recommend that a person with a TBI “just rest and take it easy for a week or two until you feel better…” when you are feeling better this advice needs to be altered. Sitting too much decreases blood flow to the brain; moving more increases blood flow to the area of the brain that was shaken up. Again, remember to heal a withering garden you need to increase the irrigation. More blood flow and more delivery of nutrients equals more healing. Since the bruised brain needs more blood flow to deliver more nourishment to heal, it doesn’t make sense to sit too much.
Also, telling an active person to “sit quietly and rest” or “do nothing” for two weeks is likely to increase stress hormones to the brain. Stress hormones, if too high for too long, can actually hinder healing by a scary process dubbed glucocorticoid neurotoxicity. One of my favorite movements during the healing of my own TBI was flotation therapy.
Swimming is a magnificent movement for your mind. It can be more calming than walking, because you can relax your whole body. You can even take a moment to close your eyes and just enjoy the feeling of floating. There’s even a name for this: floatation therapy. I do not only prayer walks, but prayer swims. While doing the breast stroke, I look at the blue water under the green trees and the blue sky and pray, “Praise God” during one stroke, and “I’m happy” during the next. The rhythm of the body and mind moving and praying together is very calming.
Walk in Water
In a peaceful pool, immerse yourself shoulder high and enjoy the floaty feelings of a slow, rhythmic walk. Time the touch of each step with a calming word, “Thank (step) God (step) I’m (step) Healthy (step).” Or, try: “Walk (step) in (step) wa (step) ter (step).” Synchronizing your mantra with your natural stepping rhythm calms your mind. Focus on giving thanks for what you have: eyes that see, lungs that breathe, and so on.
Make your own mantra. Here’s my attitude-of-gratitude mantra during flotation therapy, one word with each breaststroke:
Thank you, God, for my life! (Cancer survivor.)
Thank you, God, for my wife! (Of fifty-one years.)
Thank you, God, for my health! (At age , everything works and nothing hurts.)
Thank you, God, for my wealth! (Eight kids.)
Thank you, God, for my MD! (Fifty-one years.)
Please make T5 my ministry.
One day during my flotation therapy session, two friends, one a neurologist and the other a psychotherapist, walked by the pool and saw me “vegging” while floating. I looked up and said, “I’m in therapy.” They got the message.
Recommended Omega-3 Dosage for TBIs
Remember, each person with a TBI needs personalized treatment. Always consult your healthcare provider before beginning what Dr. Lewis calls “the omega protocol.” For a step-by-step list of nutrients, especially omega 3, dosages needed to heal a TBI, consult the following resources:
- Michael D. Lewis, M.D., When Brains Collide: What Every Athlete and Parent Should Know About the Prevention and Treatment of Concussions and Head Injuries, 2016, Lion Crest Publishing, available on Amazon.
- Google “Brain Health Education and Research Institute, Dr. Michael Lewis”
- BrainHealthEducation.org offers a wealth of information about TBIs
- Measuring your omega blood levels: https://www.vitalchoice.com/product/the-vital-omega-3-6-hufa-test-trade
- The Omega-3 Effect, by William Sears, M.D. and James Sears, M.D., 2012, Little, Brown and Company.
- The Dr. Sears T5 Wellness Plan, by William Sears, M.D. and Eris Sears Basile, 2017, BenBella.