WEBVTT
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Okay.
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Right.
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So the vagus nerve is a cranial nerve, cranial nerve 10.
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So that starts all the way up and when it's in there, it's kind of everywhere.
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Right.
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Okay.
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So when those, those chemicals that we were talking about get rereleased up into the brain.
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They don't just go to one little area, they kind of go everywhere up in the brain, which is why it's so effective because it kind of starts remapping the brain where that injury site was meaning like where the area in your brain that the stroke occurred.
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Mm-hmm.
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Uh, kind of remapping all of those connections to go around that area.
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Right.
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And then we start kind of.
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Developing those pathways and getting them nice and strong with the therapy that's paired with the stimulation.
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Opinions shared by the guests of the show are their own and do not necessarily represent the views of the hosts bindwaves Or the Brain injury network.
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This podcast is for informational purposes only, and it's not a substitute for professional medical advice, the diagnosis or treatment.
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Always seek the advice of a healthcare provider with any questions you may have regarding a medical condition.
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Thank you.
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Hi, I'm Carrie, a stroke survivor and a member of BIND.
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And I'm Brittany.
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I'm a brain injury survivor and member of BIND Today we're excited to welcome Colin Cooper, um, doctor of Occupational Therapy at Pam Health and Allen specializing in stroke and brain injury rehab.
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But over 10 years experience.
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He also is certified in Parkinson's care and currently pursuing a fellowship in hand therapy.
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Colin, thank you so much for joining us.
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Thank you for having me.
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I'm excited to be here.
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Oh, cool.
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We're excited too.
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Opinions shared by the guests of the show are their own and do not necessarily represent the views of the hosts Bind-Waves or the Brain injury network.
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This podcast is for informational purposes only, and it's not a substitute for professional medical advice, the diagnosis or treatment.
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Always seek the advice of a healthcare provider with any questions you may have regarding a medical condition.
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Thank you.
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So, first question, what got you interested in the brain injury community and occupational therapy?
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Um, well.
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In school, neuroscience is a big part of our education, and that's kind of where my brain injury interest began.
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Uh, it was one of my favorite classes, neuroscience Neuroanatomy.
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Um, just learning about how complex and how unknown the brain is and, and how injuries related to the brain can impact, uh, people in so many different ways.
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Uh, it was just very, very fascinating.
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Hmm,
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that's, I know a lot of people kinda hear that way about the brain.
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I mean, we learn so much now.
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It's more than we should know as a brain injury survivor.
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But so where, what got you decided in the occupational therapy route?
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Sure.
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Well, I actually had an injury, um, it's about nine years ago now, where I dislocated my left elbow and broke the bones in my arm and totally lost function.
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Um, so basically I spent a year relearning how to use my arm at hand, and that was with an occupational therapist.
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Mm-hmm.
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And it changed my life, changed my outlook on life.
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And so as soon as I was cleared medically to go back to normal living.
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I applied to OT school and got in, and here we are.
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Oh, that's very cool.
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Okay, so I'm gonna go off script like I told you I would.
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Sure.
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So what is specific?
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Like you're doing a fellowship for hand therapy?
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Mm-hmm.
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What I mean, I'm interested because.
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Yeah,
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my hand doesn't work.
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Right.
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So, um, so there is a specialty certification within occupational therapy.
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Physical therapists can also obtain that certification, and it's essentially certified hand therapist.
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So what a certified hand therapist is, is a specialist from the shoulder down to the fingers.
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Okay.
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And they basically specialize in every.
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Almost every condition, um, known, whether that's a fracture or a neurological condition, um, muscle weakness, that sort of thing.
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Post-surgical, basically anything and everything related to the arm and hand.
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It's just a specialty where you can design splints or, um, do specialty wound care, you know, stitches, stuff like that after surgery.
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And so for me.
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Uh, that's kind of what actually got me into being an ot.
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'cause I was with a hand therapist relearning how to use my arm.
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So I feel like it's just kind of my natural progression.
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Okay.
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Um, to continue, um, pursuing that.
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But I love what I do at Pam, uh, working with our neurological stroke brain injury population.
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So my kind of idea is to bridge the gap between the two.
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Mm-hmm.
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Um, because oftentimes, you know.
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When you're going through therapy after those sort of things, there isn't a whole kind of holistic approach to the recovery, right?
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They kind of just focus on one thing, right?
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Mm-hmm.
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So by having this extra knowledge related to the function of the arm and hand, I'm hoping I can kind of bridge that gap between our neuro and stroke population and with the information that I have, or education for the hand, how I can make things a lot better for my patients.
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That's, that's pretty cool.
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I like it.
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All right.
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So, um, I know when you work with it, it comes up as you work with the vagus nerve, so there's vagus nerve stimulation and vivi stem.
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Mm-hmm.
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So how does that work?
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Sure.
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Um, so Vivas stem is, uh.
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Therapy supplement, if you will, part of a company called Micro Transponder, actually got their start here in Dallas and it's basically designed to put a little, um, generator in the, the left chest, right under the clavicle or the collarbone.
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And there is a lead that attaches to the vagus nerve up in the neck.
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And so what the patient does then is.
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Uh, do some therapy with me after that process has been started and we stimulate the vagus nerve to help regain function in the arm, in the hand after a stroke.
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Okay, so, and I kind of have, we did have, I think her name was Julie.
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Julie from Viva Stemm on a couple of episodes back.
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Um, so we learned a little bit about Viva Stem and I think that's how we got you.
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Yeah.
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So we're excited to have someone that actually works with the patients doing it.
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Mm-hmm.
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I mean, not that we didn't like Julie, don't say don't get it wrong.
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Um, but something that came up like we ask our other members for, to help us come up with questions that I don't think we ask this of Julie is, so when you have.
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A stroke or whatever, traumatic brain injury is the va, is the vagus nerve actually damaged or that's just, it just actually helps all those other little things in your Correct.
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Correct.
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For your fine motor function skills.
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But it's not actually that, that is damaged.
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No.
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Um, I mean obviously there's always the, a possibility that it could be, that it could be impacted in some way, but.
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For the most part, it is not involved with, uh, with a stroke.
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Um, so you basically have two parts, right?
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So you have one that goes down, the one that goes down on that right side of the body basically helps with everything.
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That your body does kind of automatically, right?
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So your digestion, your heart rate, your breathing, all of that.
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So we stay away from that one.
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'cause we don't want to interrupt any of that stuff.
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Right?
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Right.
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Yeah.
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But the one on the left side actually is the one that goes from down the lower part of your body all the way back up into the brain.
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So that's one of the main reasons why they target the left vagus nerve is because that is where those neurotransmitters or neuromodulators that I'm sure Julie had talked about, uh, um, that that's where those are going back up into the, into the brain and getting released.
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And that's where some of that, that new learning, um, the, all of the, uh, neuromodulators, like the serotonin, acetylcholine, dopamine, all of that is getting released, but it's going up that left side.
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So that's why we're targeting the left and not the right'cause we don't want to disrupt any of the other stuff.
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Right.
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Yeah.
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That, that's not Okay.
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So now that, that brings me to another question.
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Like I told you, I get sidetracked.
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Not sidetracked, but you know.
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Sure.
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So you're targeting the left, left side of vagus nerve.
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Mm-hmm.
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That controls both sides, the right and the left side because like I know my stroke was on the left, my stroke was on the right side, so my left side is affected.
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I still always wanna say that wrong.
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Yeah.
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But.
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So that left side vagus nerve controls both sides.
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Mm-hmm.
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Okay.
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Right.
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So the vagus nerve is a cranial nerve, cranial nerve 10.
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So that starts all the way up and when it's in there, it's kind of everywhere.
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Right.
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Okay.
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So when those, those chemicals that we were talking about get rereleased up into the brain.
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They don't just go to one little area, they kind of go everywhere up in the brain, which is why it's so effective because it kind of starts remapping the brain where that injury site was meaning like where the area in your brain that the stroke occurred.
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Mm-hmm.
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Uh, kind of remapping all of those connections to go around that area.
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Right.
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And then we start kind of.
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Developing those pathways and getting them nice and strong with the therapy that's paired with the stimulation.
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Yeah.
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Yeah.
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So like speaking of pathways and the vagus nerves.
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So I had drop foot or a foot drop.
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Mm-hmm.
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And so basically where my foot and my brain were not connecting and not communicating.
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And so after my accident, so I was in a car wreck where someone.
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Slammed into me and like I went like going to the left.
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So, okay.
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I obviously hit that, but it's like my brain started remapping itself and rewiring, so like didn't finish those connections, so, right.
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Yeah.
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Yeah.
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So very, very similar.
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Yeah.
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Mm-hmm.
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Yeah.
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Mm-hmm.
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So, um.
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When should someone consider vagus nerve simulation slash recovery?
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Okay.
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Uh, well, it is for patients that have had, uh, an ischemic stroke.
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So with the FDA process, with this, um, technology you have to follow or, or you have to fall under, you know, there are guidelines in that criteria.
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So you have to be an ischemic stroke survivor and you have to be six months.
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Post stroke, right?
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So we can't do anything for trying to get you or the patient, uh, qualified for the, the surgical piece until it's been at least six months.
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Because the big piece is you gotta be considered chronic, right?
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So beyond six months, 10 years, 20 years, it can really be anything as long as you meet all of the little checkbox criteria that are, that are required.
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So it's
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definitely not acute.
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It's not
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acute.
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More
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outpatient and error.
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It could, what you're saying is.
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So like I'm, I mean, one, I don't qualify'cause I had a hemorrhagic stroke, so.
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Sure.
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Well, well you don't qualify right now.
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Yeah, I know.
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We talked about that.
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Yeah.
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So in general, for, you know.
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Sake of the podcast.
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Let's say I had an ischemic stroke.
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I am 16 years post-stroke.
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I've just learned about this.
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Mm-hmm.
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I can come in, I guess you're, I'm gonna come to you and I'm like, I wanna try this.
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We're gonna go, we need doctor referral and then start that process, or whatever it may be.
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Exactly right.
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So you would go to your neurologist most of the time, um, and you would come in for, uh, an occupational therapy evaluation with say somebody like myself.
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And I do a special test, it's called a ugal.
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My assessment, basically looking at the motor function of your arm, um, you know how well you can move it.
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What you can do with your wrist.
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Can you grab a ball, pick up a pen, you know, all of that kind of stuff, right?
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That's all part of the test.
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And I score all of that and then it kicks out that final score.
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And the hope is that you are around like 20, outta 66, give or take a couple.
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Um, and then we get that secondary process started, which would be then I send all of your paperwork to Viti.
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That gets you set up with a, uh, surgical consultation with one of the surgeons.
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And they make sure you're safe to actually have the surgery.
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And then it goes to insurance.
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And then that process can take a couple weeks to a couple months.
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And then the hope is that it goes through and then you come back and see me and we do the, the protocol, which is six weeks, three times a week, 90 minute sessions each.
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Okay.
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So it's very intense, but a lot of fun.
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Right?
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Sure.
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There would be a lot of fun.
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I make it fun.
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I know, I'm just kidding.
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Um, so.
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Kinda not related to Vivas stem, but still vagus nerve.
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Are there everyone's, you know, making the supplements these days?
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Yeah.
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Are there supplements that you could take specifically if you don't qualify yet for this simulation that would be beneficial to take or.
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Um, well, there's always going to be some vitamins and supplements that are gonna help the body.
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Um, but in the grand scheme of things, the, the improvements that I think you're kind of looking for aren't gonna be that great.
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Okay.
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But it's definitely gonna help with just overall health and function.
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Right.
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Okay.
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But isn't specifically targeting that?
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No.
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So like magnesium, vitamin B, like B12, B complex, um, zinc, those sorts of.
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F minerals, vitamins, supplements are really good for the neuromodulator function, for your just general nerve health.
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Um, but it's not gonna help improve overall function.
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Okay.
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If that's what you're looking for.
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Yeah.
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But all of those things that I mentioned, you just obviously want to make sure you clear it with your, your doctor just to be on the safe side.
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Right.
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I
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think that question may have come more when people were thinking that the vagus nerve is what actually gets damaged.
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Mm-hmm.
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Yeah.
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Okay.
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Mm-hmm.
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Okay.
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Um, so what setting the, is the vagus nerve stimulator used in and how does it work?
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Sure.
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Uh, primarily we use, uh, the viti vagus nerve simulation in outpatient.
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Mm-hmm.
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There have been a few cases where it's done inpatient, right.
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So maybe a patient had, uh, a stroke a couple years ago and they got the nerve.
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Um, the nerve stimulator put in and then something else happened and then they got put back into the hospital kind of thing.
00:14:24.192 --> 00:14:31.481
So then as long as that therapist at that facility has been trained on how to use it, it can definitely be used in an inpatient kind of setting.
00:14:31.871 --> 00:14:33.131
Um, but the most.
00:14:33.897 --> 00:14:43.017
I would say most of the time it's gonna be in an outpatient kind of situation where patients are coming in, do a few, the few days a week, and then back to wherever they're living.
00:14:43.346 --> 00:14:43.586
Yeah.
00:14:44.006 --> 00:14:47.636
But then, but they also, it works at home for themselves.
00:14:47.636 --> 00:14:47.647
Correct.
00:14:47.647 --> 00:14:48.542
Is it's not just
00:14:49.076 --> 00:14:49.466
Correct.
00:14:49.527 --> 00:14:51.027
And for the outpatient therapy.
00:14:51.057 --> 00:14:51.506
Correct.
00:14:51.567 --> 00:14:58.017
So the main, the main, um, deliverance of stimulation is gonna be in.
00:14:58.346 --> 00:15:07.076
The therapy setting because myself or another therapist that is using this technology has the ability to deliver a stimulus every few seconds.
00:15:07.736 --> 00:15:10.496
We also train the patients to be able to do this at home.
00:15:10.496 --> 00:15:16.197
They get a little device, it's a little magnet that they can swipe over the left chest and turn it on and it can run.
00:15:16.616 --> 00:15:16.947
Um.
00:15:17.861 --> 00:15:20.081
Uh, for 30 minutes.
00:15:20.142 --> 00:15:22.211
And so you can turn it on about eight times a day.
00:15:22.211 --> 00:15:22.241
Okay.
00:15:22.241 --> 00:15:23.711
So a total of four hours.
00:15:23.922 --> 00:15:32.081
So that way when you're doing stuff at a house or if they're in here, like at the clubhouse, they can turn it on and do things around here or at the house, whatever it might be.
00:15:32.081 --> 00:15:35.711
Getting dressed, laundry, brushing their teeth, that sort of thing.
00:15:35.711 --> 00:15:37.572
So the therapy doesn't just happen in.
00:15:38.052 --> 00:15:41.201
The session, I can just give more during that time.
00:15:41.201 --> 00:15:41.471
Right.
00:15:41.682 --> 00:15:42.461
You can bypass
00:15:42.461 --> 00:15:43.511
the resting period.
00:15:43.511 --> 00:15:44.081
Exactly.
00:15:44.081 --> 00:15:44.652
Exactly.
00:15:45.432 --> 00:15:45.822
Okay,
00:15:45.912 --> 00:15:48.942
so again, um, you have to be six months post,
00:15:48.971 --> 00:15:49.361
correct.
00:15:49.366 --> 00:15:49.397
Screw.
00:15:50.022 --> 00:15:50.412
Yes.
00:15:50.501 --> 00:15:51.611
Have to be six months.
00:15:51.912 --> 00:15:53.381
At least that's what it is right now.
00:15:53.381 --> 00:16:02.172
There's a ton of research going on with them to look at how it affects people with, um, you know, like walking leg function.
00:16:02.442 --> 00:16:05.981
And then they're also exploring other versions of strokes, like a hemorrhagic stroke.
00:16:06.011 --> 00:16:06.101
Right.
00:16:06.162 --> 00:16:06.312
Yeah.
00:16:06.642 --> 00:16:08.292
So that's a good, that's what I was saying that too.
00:16:08.297 --> 00:16:12.341
So right now it strictly focuses on the arm and the hand.
00:16:12.341 --> 00:16:12.432
Mm-hmm.
00:16:12.761 --> 00:16:16.572
So it's not, not yet ready to help with foot dropper.
00:16:16.841 --> 00:16:17.861
'cause like, I'm like Brittany.
00:16:18.971 --> 00:16:21.491
I kinda have foot job, but more of my foot rolls.
00:16:21.491 --> 00:16:21.881
Rolls.
00:16:22.001 --> 00:16:22.062
Yeah.
00:16:22.062 --> 00:16:24.552
So I can't put it down flat without the A FO, so, right.
00:16:25.062 --> 00:16:25.241
Yeah.
00:16:25.241 --> 00:16:29.772
All of that research is kinda under, under wraps, I guess.
00:16:29.802 --> 00:16:30.042
Right.
00:16:30.042 --> 00:16:32.831
But that vagus nerve still affects all those things.
00:16:32.831 --> 00:16:33.221
Everything.
00:16:33.251 --> 00:16:35.052
Right, because the brain controls everything.
00:16:35.201 --> 00:16:35.322
Right?
00:16:35.322 --> 00:16:39.101
So even though weed focus mostly on the arm.
00:16:39.807 --> 00:16:50.307
That's, because that's what, um, the, the labeling for, for the FDA approved protocol is for That doesn't mean that the rest of the body is not getting affected.
00:16:50.667 --> 00:16:50.876
Right.
00:16:50.876 --> 00:16:50.966
Right.
00:16:50.971 --> 00:16:51.062
Just,
00:16:51.062 --> 00:16:52.422
we're just not focusing on that yet.
00:16:52.451 --> 00:16:52.741
It's
00:16:52.741 --> 00:16:53.456
not, yeah, exactly.
00:16:53.456 --> 00:16:59.037
And that research hasn't been published yet, so we don't have that support to say Yes, it can sure.
00:16:59.067 --> 00:17:00.177
Affect the, the like.
00:17:00.267 --> 00:17:00.476
Right.
00:17:00.657 --> 00:17:00.807
Yeah.
00:17:00.897 --> 00:17:01.167
Okay.
00:17:01.167 --> 00:17:08.817
I'm gonna take a quick little break and just remind our listeners while you're listening to go ahead and click that like button, that follow button, that subscribe button.
00:17:09.656 --> 00:17:13.136
Whatever button you see that has a thumbs up, go ahead and click that button.
00:17:13.467 --> 00:17:29.402
And then so, um, do you know like kinda where they are in the research process of when they might be able to branch out to other be, you know, hemorrhagic stroke or even are they looking at, I guess just not even stroke?
00:17:29.576 --> 00:17:32.547
'cause it sounds like right now it's strictly ischemic stroke.
00:17:32.547 --> 00:17:36.987
So is the goal not just maybe hemorrhagic stroke, but also.
00:17:37.376 --> 00:17:40.557
Traumatic brain injury, brain tumor, brain cancer, I mean, right.
00:17:40.886 --> 00:17:44.217
Is the goal to hit all those areas or Right.
00:17:44.217 --> 00:17:45.356
I can't say for sure.
00:17:45.656 --> 00:17:45.686
Okay.
00:17:45.747 --> 00:17:47.126
Um, just because I
00:17:47.126 --> 00:17:48.086
You're on the therapy side.
00:17:48.116 --> 00:17:48.537
Yes.
00:17:48.596 --> 00:17:48.896
Right.
00:17:48.957 --> 00:17:58.826
Um, but I'm gonna go with Yes, because just working closely with this company and the people that work there, their main objective is to help as many people as they can.
00:17:59.366 --> 00:18:00.057
So.
00:18:00.717 --> 00:18:01.136
Yes.
00:18:01.136 --> 00:18:04.826
Right now it's geared just towards ischemic stroke survivors, right?
00:18:04.832 --> 00:18:04.882
Mm-hmm.
00:18:04.967 --> 00:18:06.957
And the arm function and the hand function.
00:18:06.957 --> 00:18:09.926
But they are trying to branch it out, right?
00:18:09.926 --> 00:18:09.957
Okay.
00:18:09.957 --> 00:18:11.636
And trying to get it so that.
00:18:12.372 --> 00:18:17.412
Other patients can, can take advantage of this, this technology as much as possible.
00:18:17.592 --> 00:18:17.741
Yeah.
00:18:18.372 --> 00:18:18.701
Okay.
00:18:18.701 --> 00:18:24.517
And one other thing I was just thinking about too for,'cause we do have some therapists that listen, you know, that mm-hmm.
00:18:24.642 --> 00:18:25.751
Know us so they listen.
00:18:25.751 --> 00:18:34.481
Um, what, as a therapist, if you're in the day neuro program somewhere, or you're an outpatient program somewhere, what do you as a therapist.
00:18:34.872 --> 00:18:38.741
Need to do to become Vivas STEM certified therapist?
00:18:38.771 --> 00:18:39.041
Sure.
00:18:39.041 --> 00:18:43.481
There's a little, uh, training program that Viti will put you through.
00:18:43.662 --> 00:18:55.271
Um, if your clinic or hospital system, wherever you're working, wants to get involved with this, um, Julie, uh, would be a great person to get in touch with.
00:18:55.271 --> 00:18:55.902
Julie Graham.
00:18:56.201 --> 00:19:04.301
She is their, um, therapy development specialist, and so she would be the one to get that new therapist onboarded to get trained.
00:19:04.856 --> 00:19:08.487
Teach them how to use all of the software and the technology and all that good stuff.
00:19:08.547 --> 00:19:08.727
Yeah.
00:19:09.507 --> 00:19:09.777
Okay.
00:19:09.781 --> 00:19:09.981
Mm-hmm.
00:19:10.061 --> 00:19:10.182
Cool.
00:19:10.182 --> 00:19:10.192
Mm-hmm.
00:19:12.057 --> 00:19:19.076
Um, so what are some smaller steps to gain momentum to reach larger goals, whether you use Viva stem or not.
00:19:19.346 --> 00:19:19.616
Sure.
00:19:20.186 --> 00:19:29.426
I think the, the biggest thing that I have learned working with patients going through, whether it's a stroke recovery or a brain injury recovery, is to keep.
00:19:29.832 --> 00:19:30.311
Fighting.
00:19:30.551 --> 00:19:30.821
Right.
00:19:30.821 --> 00:19:32.021
And to keep working hard.
00:19:32.531 --> 00:19:40.422
I think that sometimes during recovery it is, um, very difficult, sometimes dark, right?
00:19:40.426 --> 00:19:40.686
Mm-hmm.
00:19:40.771 --> 00:19:47.622
And it's, it's tough to see the light at the end of the tunnel when you're in that, and you feel like you're alone in that sort of thing.
00:19:48.011 --> 00:19:57.432
And so, my biggest piece of advice, you know, small steps, all of that good stuff would be to continue to work as hard as possible, whether that's with family, friends, therapists.
00:19:57.821 --> 00:20:10.332
A place like this, you keep continuing to work hard because I feel like a, a big common misconception is you only have a certain amount of time to get better, which in my experience is not true.
00:20:10.451 --> 00:20:10.721
Right.
00:20:10.721 --> 00:20:11.807
In our state, we definitely
00:20:11.807 --> 00:20:11.926
not.
00:20:12.426 --> 00:20:19.422
So the biggest thing is you just take it day by day and you keep trying and you don't give up because you got a life to live.
00:20:19.811 --> 00:20:20.082
Right.
00:20:20.321 --> 00:20:21.612
It's just a different life now.
00:20:21.701 --> 00:20:23.592
But you still got lots to live for.
00:20:23.846 --> 00:20:24.086
Absolutely.
00:20:24.086 --> 00:20:24.247
Yeah.
00:20:24.866 --> 00:20:25.541
So, okay.
00:20:25.541 --> 00:20:27.102
We've talked a lot about Viva and Sure.
00:20:27.432 --> 00:20:30.791
We really haven't talked much about your organization, Pam.
00:20:30.791 --> 00:20:32.951
So tell us a little bit about Pam.
00:20:32.951 --> 00:20:35.741
You said it's, I don't remember what it stands for now.
00:20:35.741 --> 00:20:38.142
So medical I know is the last word I think.
00:20:38.142 --> 00:20:38.172
Uh,
00:20:38.442 --> 00:20:39.521
post-acute medical.
00:20:39.521 --> 00:20:39.761
Okay.
00:20:39.761 --> 00:20:43.092
We were rebranded to Pam Health a few years ago, so basically.
00:20:43.737 --> 00:20:48.926
Um, there are, I want to say 70 to 80 hospitals around the country.
00:20:49.257 --> 00:20:49.406
Mm-hmm.
00:20:49.407 --> 00:20:50.457
Started out on the East coast.
00:20:50.906 --> 00:20:56.217
Um, there are lots in Texas and we've kind of branched all the way out west to around Las Vegas.
00:20:56.666 --> 00:21:05.396
And the main deal is, like I said earlier, was the stroke, traumatic brain injury, and neurological, uh, rehabilitation.
00:21:05.787 --> 00:21:12.926
Um, here in Allen where I work, we have a 40 bed inpatient hospital, and then I'm in the outpatient department, so.
00:21:14.231 --> 00:21:20.652
We try to do as much as we can for our patients, which is why we also have the outpatient department.
00:21:20.652 --> 00:21:20.711
Okay.
00:21:20.711 --> 00:21:28.571
So they do their time inpatient, then they come and hang out with me for however long we need to get them back on their feet and moving and groove in the way that they need to.
00:21:28.576 --> 00:21:28.737
Yeah.
00:21:28.926 --> 00:21:29.217
Okay.
00:21:29.217 --> 00:21:32.922
And so that, that I, I think I've heard of Pam, but not very much.
00:21:32.922 --> 00:21:38.321
Like we know a lot about paint and CNS, I mean, but so y'all are similar to that?
00:21:38.622 --> 00:21:39.251
Very similar.
00:21:39.402 --> 00:21:39.612
So
00:21:39.612 --> 00:21:42.497
like someone goes to whatever hospital they go to and it.
00:21:43.451 --> 00:21:45.882
They've done their, maybe they're not done with inpatient.
00:21:45.882 --> 00:21:48.281
They need more and they're wanting somewhere to go.
00:21:48.342 --> 00:21:48.612
Yes.
00:21:49.061 --> 00:21:51.372
They're, you're just another option for, um,
00:21:51.432 --> 00:21:51.642
right.
00:21:51.882 --> 00:21:51.912
Okay.
00:21:52.271 --> 00:21:52.511
Right.
00:21:53.451 --> 00:21:56.007
Trying to wonder why we don't hear more about you guys.
00:21:56.096 --> 00:21:56.517
Yeah.
00:21:56.606 --> 00:21:59.126
Um, the outpatient department is kind of new.
00:21:59.247 --> 00:22:05.336
Um, we're trying to get that word out a little bit more because we're basically known for the inpatient side.
00:22:05.336 --> 00:22:05.426
Mm-hmm.
00:22:05.666 --> 00:22:10.047
'cause we also have a smaller facility in Richardson that does inpatient as well.
00:22:10.287 --> 00:22:15.446
Um, but the outpatient department has been there for, I don't know, seven years.
00:22:15.567 --> 00:22:15.596
Okay.
00:22:15.686 --> 00:22:16.227
Probably.
00:22:16.616 --> 00:22:18.297
Um, it's just.
00:22:18.852 --> 00:22:25.182
One of those where most of the time patients come for inpatient, but the outpatient we are are thriving.
00:22:25.182 --> 00:22:33.672
And like I said, we are stroke, uh, neurological and traumatic brain injury certified for all of our programming there.
00:22:33.882 --> 00:22:34.152
That's great.
00:22:34.152 --> 00:22:37.481
And like I said, we, we deliver everything we can do.
00:22:37.481 --> 00:22:40.961
Orthopedic conditions, hip replacements, knee replacements, all that stuff too.
00:22:41.442 --> 00:22:43.241
Um, kind of a one stop shop.
00:22:43.241 --> 00:22:46.751
Everything under the sun is basically what we can do at Pam.
00:22:46.842 --> 00:22:47.112
Yeah.
00:22:47.112 --> 00:22:47.682
Up in Allen.
00:22:47.711 --> 00:22:48.102
It's great.
00:22:48.626 --> 00:22:49.287
That's awesome.
00:22:49.676 --> 00:22:51.326
We'll need to come visit y'all.
00:22:51.866 --> 00:22:52.646
Learn more about you.
00:22:52.646 --> 00:22:53.457
Yeah, come on in.
00:22:54.567 --> 00:22:58.346
So, um, do you have any success stories you could share with us?
00:22:58.352 --> 00:22:58.942
Like for someone that's.
00:22:59.622 --> 00:23:00.821
You used Vivas, dim that.
00:23:00.942 --> 00:23:01.301
Sure.
00:23:01.451 --> 00:23:02.082
Um,
00:23:02.172 --> 00:23:04.866
and we can change all the names to protect those and I'm just Right.
00:23:04.872 --> 00:23:05.112
Right.
00:23:05.261 --> 00:23:11.711
Um, so for, for us at Pam and Alan, we've only had one patient so far, go through that whole program.
00:23:12.132 --> 00:23:16.961
Um, I have I think six patients in the process right now.
00:23:16.991 --> 00:23:17.021
Okay.
00:23:17.471 --> 00:23:18.672
So, um.
00:23:18.757 --> 00:23:24.457
Whether that's going through surgical consultation, insurance approval, appeals, all of that kind of stuff.
00:23:24.517 --> 00:23:31.926
So I don't have a ton of success stories for this right now just because it is really new for our facility.
00:23:32.047 --> 00:23:33.936
We've only been doing it for about a year.
00:23:33.936 --> 00:23:33.967
Okay.
00:23:34.386 --> 00:23:42.156
Um, that patient that, uh, I was referring to, she was about 11 years post-stroke and she actually was able to get that arm back up on a shopping cart.
00:23:42.442 --> 00:23:42.501
Wow.
00:23:42.892 --> 00:23:48.561
Still have a long way to go for her, but that shoulder motion started to improve with our time together.
00:23:48.561 --> 00:24:00.832
So she was able to lift it up high enough to get it on a shopping cart and be able to kind of push that shopping cart around, which was a big deal for her, you know, during her recovery, especially being so far out from having the stroke.
00:24:00.951 --> 00:24:01.672
Yeah, that's awesome.
00:24:01.676 --> 00:24:04.461
And that's, I like to hear those stories where it's that far post.
00:24:04.461 --> 00:24:06.711
'cause like I said, I'm 16 post and yeah,
00:24:07.192 --> 00:24:09.711
Viti has some really cool success stories.
00:24:10.001 --> 00:24:19.451
I, um, I could be misspeaking, but I believe there was an individual that was 20 plus years, I think outta Chicago that has made some really, really good gains.
00:24:19.451 --> 00:24:21.461
That's really, really cool to, to check out.
00:24:21.461 --> 00:24:21.701
Yeah.
00:24:22.211 --> 00:24:22.511
Awesome.
00:24:22.902 --> 00:24:23.051
Yeah.
00:24:23.112 --> 00:24:25.541
Well, is there any last little piece of advice?
00:24:25.541 --> 00:24:29.531
I know you kinda said it already, but, um, that you'd like to share with our listeners?
00:24:29.531 --> 00:24:30.821
We know, don't give up.
00:24:31.152 --> 00:24:31.332
Yeah.
00:24:31.332 --> 00:24:32.297
You can always get better.
00:24:32.297 --> 00:24:32.576
Yeah.
00:24:32.582 --> 00:24:33.761
There's not a limitation.
00:24:34.781 --> 00:24:36.896
Um, I would just say that, you know.
00:24:38.936 --> 00:24:39.086
Just
00:24:39.446 --> 00:24:39.656
ignore him.
00:24:39.747 --> 00:24:45.207
How, how, uh, life presents you with those challenges.
00:24:45.207 --> 00:24:46.856
You just, you just keep going.
00:24:47.576 --> 00:24:47.817
Right.
00:24:47.817 --> 00:24:52.317
It could be a little rocky and a little bit bumpy, but at the end of the day, you're still here.
00:24:52.467 --> 00:24:52.886
Right?
00:24:52.886 --> 00:24:52.896
Right.
00:24:53.067 --> 00:25:06.116
And so not to give up and, um, not to toot our horn over at Pam, but, but we love everybody and anybody, so any listener out there that thinks that they need a little bit of therapy or needs a little push, come and see me.
00:25:06.596 --> 00:25:07.856
Our doors are always open.
00:25:07.856 --> 00:25:15.176
We're willing to take anyone and everyone because our main objective over there is to get people back on their feet and living in life.
00:25:15.567 --> 00:25:16.047
That's awesome.
00:25:16.047 --> 00:25:16.646
I love to hear that.
00:25:16.646 --> 00:25:20.277
And so thank you so much, Colin, for coming in and sharing your experience with us.
00:25:20.277 --> 00:25:23.037
Just your experience and then also your experience with the booth stem.
00:25:23.037 --> 00:25:27.001
And like I said, we'll have to get the Clubhouse more involved with Pam so we can come out.
00:25:27.001 --> 00:25:27.281
That'd be great.
00:25:27.281 --> 00:25:28.287
And talk to your survivors.
00:25:28.797 --> 00:25:28.977
Awesome.
00:25:29.307 --> 00:25:32.247
Do more of that and thank you to our listeners for listening.
00:25:32.307 --> 00:25:32.757
Thank you guys.
00:25:32.997 --> 00:25:37.196
And remember, you can find all our new episodes on all your favorite platforms.
00:25:37.287 --> 00:25:38.186
Until next time.
00:25:38.457 --> 00:25:39.326
Until next time.
00:25:42.619 --> 00:25:53.354
Continue to support Brain Injury Network in our nonprofit mission, we support brain injury survivors as they reconnect into life, the community, and the workplace.
00:25:54.104 --> 00:25:57.673
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00:25:58.483 --> 00:26:00.884
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00:26:01.544 --> 00:26:07.153
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00:26:07.739 --> 00:26:13.288
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00:26:30.568 --> 00:26:31.888
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00:26:33.808 --> 00:26:34.888
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00:00:00.165 --> 00:00:00.405
Okay.
00:00:00.405 --> 00:00:00.414
Right.
00:00:00.854 --> 00:00:03.825
So the vagus nerve is a cranial nerve, cranial nerve 10.
00:00:03.825 --> 00:00:07.544
So that starts all the way up and when it's in there, it's kind of everywhere.
00:00:07.605 --> 00:00:07.964
Right.
00:00:07.964 --> 00:00:07.974
Okay.
00:00:08.234 --> 00:00:12.345
So when those, those chemicals that we were talking about get rereleased up into the brain.
00:00:12.605 --> 00:00:26.254
They don't just go to one little area, they kind of go everywhere up in the brain, which is why it's so effective because it kind of starts remapping the brain where that injury site was meaning like where the area in your brain that the stroke occurred.
00:00:26.285 --> 00:00:26.375
Mm-hmm.
00:00:26.795 --> 00:00:31.355
Uh, kind of remapping all of those connections to go around that area.
00:00:31.445 --> 00:00:31.774
Right.
00:00:31.804 --> 00:00:33.094
And then we start kind of.
00:00:33.414 --> 00:00:38.604
Developing those pathways and getting them nice and strong with the therapy that's paired with the stimulation.
00:00:47.203 --> 00:00:55.332
Opinions shared by the guests of the show are their own and do not necessarily represent the views of the hosts bindwaves Or the Brain injury network.
00:00:55.843 --> 00:01:04.212
This podcast is for informational purposes only, and it's not a substitute for professional medical advice, the diagnosis or treatment.
00:01:04.602 --> 00:01:11.112
Always seek the advice of a healthcare provider with any questions you may have regarding a medical condition.
00:01:11.472 --> 00:01:11.923
Thank you.
00:01:14.007 --> 00:01:16.766
Hi, I'm Carrie, a stroke survivor and a member of BIND.
00:01:17.126 --> 00:01:17.787
And I'm Brittany.
00:01:17.787 --> 00:01:31.557
I'm a brain injury survivor and member of BIND Today we're excited to welcome Colin Cooper, um, doctor of Occupational Therapy at Pam Health and Allen specializing in stroke and brain injury rehab.
00:01:32.126 --> 00:01:34.016
But over 10 years experience.
00:01:34.016 --> 00:01:40.406
He also is certified in Parkinson's care and currently pursuing a fellowship in hand therapy.
00:01:40.617 --> 00:01:43.076
Colin, thank you so much for joining us.
00:01:43.736 --> 00:01:44.637
Thank you for having me.
00:01:44.697 --> 00:01:45.537
I'm excited to be here.
00:01:45.927 --> 00:01:46.106
Oh, cool.
00:01:46.346 --> 00:01:47.096
We're excited too.
00:01:47.677 --> 00:01:55.807
Opinions shared by the guests of the show are their own and do not necessarily represent the views of the hosts Bind-Waves or the Brain injury network.
00:01:56.316 --> 00:02:04.686
This podcast is for informational purposes only, and it's not a substitute for professional medical advice, the diagnosis or treatment.
00:02:05.076 --> 00:02:11.586
Always seek the advice of a healthcare provider with any questions you may have regarding a medical condition.
00:02:11.947 --> 00:02:12.396
Thank you.
00:02:14.426 --> 00:02:20.127
So, first question, what got you interested in the brain injury community and occupational therapy?
00:02:20.727 --> 00:02:21.896
Um, well.
00:02:22.947 --> 00:02:31.287
In school, neuroscience is a big part of our education, and that's kind of where my brain injury interest began.
00:02:31.407 --> 00:02:35.037
Uh, it was one of my favorite classes, neuroscience Neuroanatomy.
00:02:35.637 --> 00:02:47.606
Um, just learning about how complex and how unknown the brain is and, and how injuries related to the brain can impact, uh, people in so many different ways.
00:02:47.697 --> 00:02:49.526
Uh, it was just very, very fascinating.
00:02:49.586 --> 00:02:49.646
Hmm,
00:02:50.877 --> 00:02:53.217
that's, I know a lot of people kinda hear that way about the brain.
00:02:53.217 --> 00:02:54.806
I mean, we learn so much now.
00:02:54.806 --> 00:02:58.137
It's more than we should know as a brain injury survivor.
00:02:58.137 --> 00:03:02.637
But so where, what got you decided in the occupational therapy route?
00:03:02.967 --> 00:03:03.296
Sure.
00:03:03.747 --> 00:03:17.366
Well, I actually had an injury, um, it's about nine years ago now, where I dislocated my left elbow and broke the bones in my arm and totally lost function.
00:03:17.681 --> 00:03:24.401
Um, so basically I spent a year relearning how to use my arm at hand, and that was with an occupational therapist.
00:03:25.062 --> 00:03:25.241
Mm-hmm.
00:03:25.481 --> 00:03:28.391
And it changed my life, changed my outlook on life.
00:03:28.481 --> 00:03:32.951
And so as soon as I was cleared medically to go back to normal living.
00:03:33.641 --> 00:03:35.891
I applied to OT school and got in, and here we are.
00:03:36.132 --> 00:03:36.942
Oh, that's very cool.
00:03:37.032 --> 00:03:39.521
Okay, so I'm gonna go off script like I told you I would.
00:03:39.521 --> 00:03:39.611
Sure.
00:03:39.641 --> 00:03:42.312
So what is specific?
00:03:42.312 --> 00:03:45.882
Like you're doing a fellowship for hand therapy?
00:03:45.972 --> 00:03:46.062
Mm-hmm.
00:03:46.301 --> 00:03:47.592
What I mean, I'm interested because.
00:03:48.866 --> 00:03:49.076
Yeah,
00:03:49.526 --> 00:03:50.157
my hand doesn't work.
00:03:50.247 --> 00:03:50.546
Right.
00:03:50.546 --> 00:03:55.616
So, um, so there is a specialty certification within occupational therapy.
00:03:55.646 --> 00:04:01.076
Physical therapists can also obtain that certification, and it's essentially certified hand therapist.
00:04:01.076 --> 00:04:07.051
So what a certified hand therapist is, is a specialist from the shoulder down to the fingers.
00:04:07.122 --> 00:04:07.412
Okay.
00:04:07.412 --> 00:04:09.747
And they basically specialize in every.
00:04:11.681 --> 00:04:22.841
Almost every condition, um, known, whether that's a fracture or a neurological condition, um, muscle weakness, that sort of thing.
00:04:23.531 --> 00:04:28.271
Post-surgical, basically anything and everything related to the arm and hand.
00:04:28.331 --> 00:04:38.531
It's just a specialty where you can design splints or, um, do specialty wound care, you know, stitches, stuff like that after surgery.
00:04:39.432 --> 00:04:41.232
And so for me.
00:04:41.802 --> 00:04:45.041
Uh, that's kind of what actually got me into being an ot.
00:04:45.072 --> 00:04:47.831
'cause I was with a hand therapist relearning how to use my arm.
00:04:48.161 --> 00:04:52.512
So I feel like it's just kind of my natural progression.
00:04:52.512 --> 00:04:52.541
Okay.
00:04:53.021 --> 00:04:56.201
Um, to continue, um, pursuing that.
00:04:56.591 --> 00:05:03.521
But I love what I do at Pam, uh, working with our neurological stroke brain injury population.
00:05:03.521 --> 00:05:07.362
So my kind of idea is to bridge the gap between the two.
00:05:07.752 --> 00:05:07.841
Mm-hmm.
00:05:08.081 --> 00:05:09.911
Um, because oftentimes, you know.
00:05:10.887 --> 00:05:20.757
When you're going through therapy after those sort of things, there isn't a whole kind of holistic approach to the recovery, right?
00:05:20.997 --> 00:05:23.096
They kind of just focus on one thing, right?
00:05:23.127 --> 00:05:23.216
Mm-hmm.
00:05:23.456 --> 00:05:37.377
So by having this extra knowledge related to the function of the arm and hand, I'm hoping I can kind of bridge that gap between our neuro and stroke population and with the information that I have, or education for the hand, how I can make things a lot better for my patients.
00:05:37.677 --> 00:05:38.752
That's, that's pretty cool.
00:05:39.151 --> 00:05:39.432
I like it.
00:05:39.776 --> 00:05:39.927
All right.
00:05:40.797 --> 00:05:50.367
So, um, I know when you work with it, it comes up as you work with the vagus nerve, so there's vagus nerve stimulation and vivi stem.
00:05:50.372 --> 00:05:50.622
Mm-hmm.
00:05:50.706 --> 00:05:51.956
So how does that work?
00:05:52.107 --> 00:05:52.406
Sure.
00:05:52.797 --> 00:05:55.076
Um, so Vivas stem is, uh.
00:05:57.701 --> 00:06:13.211
Therapy supplement, if you will, part of a company called Micro Transponder, actually got their start here in Dallas and it's basically designed to put a little, um, generator in the, the left chest, right under the clavicle or the collarbone.
00:06:13.632 --> 00:06:17.112
And there is a lead that attaches to the vagus nerve up in the neck.
00:06:17.442 --> 00:06:20.021
And so what the patient does then is.
00:06:21.026 --> 00:06:29.757
Uh, do some therapy with me after that process has been started and we stimulate the vagus nerve to help regain function in the arm, in the hand after a stroke.
00:06:30.612 --> 00:06:33.612
Okay, so, and I kind of have, we did have, I think her name was Julie.
00:06:33.617 --> 00:06:36.641
Julie from Viva Stemm on a couple of episodes back.
00:06:36.672 --> 00:06:40.002
Um, so we learned a little bit about Viva Stem and I think that's how we got you.
00:06:40.151 --> 00:06:40.271
Yeah.
00:06:40.302 --> 00:06:43.482
So we're excited to have someone that actually works with the patients doing it.
00:06:43.482 --> 00:06:43.572
Mm-hmm.
00:06:43.812 --> 00:06:46.211
I mean, not that we didn't like Julie, don't say don't get it wrong.
00:06:46.661 --> 00:06:56.016
Um, but something that came up like we ask our other members for, to help us come up with questions that I don't think we ask this of Julie is, so when you have.
00:06:57.716 --> 00:07:09.312
A stroke or whatever, traumatic brain injury is the va, is the vagus nerve actually damaged or that's just, it just actually helps all those other little things in your Correct.
00:07:09.416 --> 00:07:09.747
Correct.
00:07:09.807 --> 00:07:11.307
For your fine motor function skills.
00:07:11.427 --> 00:07:13.406
But it's not actually that, that is damaged.
00:07:13.406 --> 00:07:13.677
No.
00:07:14.007 --> 00:07:20.697
Um, I mean obviously there's always the, a possibility that it could be, that it could be impacted in some way, but.
00:07:21.041 --> 00:07:24.791
For the most part, it is not involved with, uh, with a stroke.
00:07:25.242 --> 00:07:28.541
Um, so you basically have two parts, right?
00:07:28.541 --> 00:07:34.601
So you have one that goes down, the one that goes down on that right side of the body basically helps with everything.
00:07:34.947 --> 00:07:37.466
That your body does kind of automatically, right?
00:07:37.466 --> 00:07:41.216
So your digestion, your heart rate, your breathing, all of that.
00:07:41.216 --> 00:07:42.326
So we stay away from that one.
00:07:42.326 --> 00:07:43.857
'cause we don't want to interrupt any of that stuff.
00:07:43.862 --> 00:07:44.002
Right?
00:07:44.007 --> 00:07:44.187
Right.
00:07:44.187 --> 00:07:44.247
Yeah.
00:07:44.607 --> 00:07:51.266
But the one on the left side actually is the one that goes from down the lower part of your body all the way back up into the brain.
00:07:52.302 --> 00:08:07.541
So that's one of the main reasons why they target the left vagus nerve is because that is where those neurotransmitters or neuromodulators that I'm sure Julie had talked about, uh, um, that that's where those are going back up into the, into the brain and getting released.
00:08:07.692 --> 00:08:21.161
And that's where some of that, that new learning, um, the, all of the, uh, neuromodulators, like the serotonin, acetylcholine, dopamine, all of that is getting released, but it's going up that left side.
00:08:21.432 --> 00:08:25.721
So that's why we're targeting the left and not the right'cause we don't want to disrupt any of the other stuff.
00:08:25.726 --> 00:08:25.807
Right.
00:08:25.807 --> 00:08:25.927
Yeah.
00:08:25.927 --> 00:08:27.072
That, that's not Okay.
00:08:27.401 --> 00:08:29.742
So now that, that brings me to another question.
00:08:29.742 --> 00:08:31.812
Like I told you, I get sidetracked.
00:08:31.992 --> 00:08:33.006
Not sidetracked, but you know.
00:08:33.037 --> 00:08:33.326
Sure.
00:08:33.402 --> 00:08:37.211
So you're targeting the left, left side of vagus nerve.
00:08:37.241 --> 00:08:37.331
Mm-hmm.
00:08:37.721 --> 00:08:46.631
That controls both sides, the right and the left side because like I know my stroke was on the left, my stroke was on the right side, so my left side is affected.
00:08:46.631 --> 00:08:47.951
I still always wanna say that wrong.
00:08:47.981 --> 00:08:48.042
Yeah.
00:08:48.067 --> 00:08:48.287
But.
00:08:49.106 --> 00:08:52.826
So that left side vagus nerve controls both sides.
00:08:52.976 --> 00:08:53.277
Mm-hmm.
00:08:53.606 --> 00:08:53.846
Okay.
00:08:53.846 --> 00:08:53.856
Right.
00:08:54.297 --> 00:08:57.267
So the vagus nerve is a cranial nerve, cranial nerve 10.
00:08:57.267 --> 00:09:00.986
So that starts all the way up and when it's in there, it's kind of everywhere.
00:09:01.047 --> 00:09:01.407
Right.
00:09:01.407 --> 00:09:01.417
Okay.
00:09:01.677 --> 00:09:05.787
So when those, those chemicals that we were talking about get rereleased up into the brain.
00:09:06.047 --> 00:09:19.697
They don't just go to one little area, they kind of go everywhere up in the brain, which is why it's so effective because it kind of starts remapping the brain where that injury site was meaning like where the area in your brain that the stroke occurred.
00:09:19.726 --> 00:09:19.817
Mm-hmm.
00:09:20.236 --> 00:09:24.797
Uh, kind of remapping all of those connections to go around that area.
00:09:24.886 --> 00:09:25.216
Right.
00:09:25.246 --> 00:09:26.537
And then we start kind of.
00:09:26.856 --> 00:09:32.047
Developing those pathways and getting them nice and strong with the therapy that's paired with the stimulation.
00:09:32.131 --> 00:09:32.422
Yeah.
00:09:32.706 --> 00:09:33.006
Yeah.
00:09:33.277 --> 00:09:35.947
So like speaking of pathways and the vagus nerves.
00:09:35.947 --> 00:09:38.677
So I had drop foot or a foot drop.
00:09:38.682 --> 00:09:38.902
Mm-hmm.
00:09:38.986 --> 00:09:43.897
And so basically where my foot and my brain were not connecting and not communicating.
00:09:44.047 --> 00:09:46.657
And so after my accident, so I was in a car wreck where someone.
00:09:47.172 --> 00:09:50.591
Slammed into me and like I went like going to the left.
00:09:50.591 --> 00:09:51.101
So, okay.
00:09:51.251 --> 00:09:59.922
I obviously hit that, but it's like my brain started remapping itself and rewiring, so like didn't finish those connections, so, right.
00:10:00.101 --> 00:10:00.251
Yeah.
00:10:00.341 --> 00:10:00.672
Yeah.
00:10:01.032 --> 00:10:01.991
So very, very similar.
00:10:02.111 --> 00:10:02.261
Yeah.
00:10:02.261 --> 00:10:02.381
Mm-hmm.
00:10:03.312 --> 00:10:03.522
Yeah.
00:10:05.292 --> 00:10:05.892
Mm-hmm.
00:10:05.951 --> 00:10:06.581
So, um.
00:10:08.261 --> 00:10:12.596
When should someone consider vagus nerve simulation slash recovery?
00:10:12.881 --> 00:10:13.121
Okay.
00:10:13.631 --> 00:10:18.402
Uh, well, it is for patients that have had, uh, an ischemic stroke.
00:10:18.402 --> 00:10:28.302
So with the FDA process, with this, um, technology you have to follow or, or you have to fall under, you know, there are guidelines in that criteria.
00:10:29.351 --> 00:10:33.581
So you have to be an ischemic stroke survivor and you have to be six months.
00:10:34.091 --> 00:10:35.471
Post stroke, right?
00:10:35.741 --> 00:10:46.272
So we can't do anything for trying to get you or the patient, uh, qualified for the, the surgical piece until it's been at least six months.
00:10:46.272 --> 00:10:48.942
Because the big piece is you gotta be considered chronic, right?
00:10:48.971 --> 00:10:57.221
So beyond six months, 10 years, 20 years, it can really be anything as long as you meet all of the little checkbox criteria that are, that are required.
00:10:57.221 --> 00:10:57.461
So it's
00:10:57.461 --> 00:10:58.751
definitely not acute.
00:10:58.812 --> 00:10:59.381
It's not
00:10:59.381 --> 00:10:59.682
acute.
00:10:59.682 --> 00:10:59.922
More
00:10:59.922 --> 00:11:01.241
outpatient and error.
00:11:01.331 --> 00:11:02.456
It could, what you're saying is.
00:11:03.596 --> 00:11:06.927
So like I'm, I mean, one, I don't qualify'cause I had a hemorrhagic stroke, so.
00:11:06.927 --> 00:11:07.017
Sure.
00:11:07.022 --> 00:11:08.246
Well, well you don't qualify right now.
00:11:08.277 --> 00:11:08.876
Yeah, I know.
00:11:08.876 --> 00:11:09.476
We talked about that.
00:11:09.476 --> 00:11:09.596
Yeah.
00:11:10.437 --> 00:11:12.836
So in general, for, you know.
00:11:13.736 --> 00:11:14.576
Sake of the podcast.
00:11:14.576 --> 00:11:16.226
Let's say I had an ischemic stroke.
00:11:16.287 --> 00:11:18.447
I am 16 years post-stroke.
00:11:18.476 --> 00:11:19.797
I've just learned about this.
00:11:19.802 --> 00:11:19.881
Mm-hmm.
00:11:19.961 --> 00:11:24.206
I can come in, I guess you're, I'm gonna come to you and I'm like, I wanna try this.
00:11:24.386 --> 00:11:28.706
We're gonna go, we need doctor referral and then start that process, or whatever it may be.
00:11:28.736 --> 00:11:29.456
Exactly right.
00:11:29.456 --> 00:11:38.667
So you would go to your neurologist most of the time, um, and you would come in for, uh, an occupational therapy evaluation with say somebody like myself.
00:11:39.611 --> 00:11:41.621
And I do a special test, it's called a ugal.
00:11:41.621 --> 00:11:49.182
My assessment, basically looking at the motor function of your arm, um, you know how well you can move it.
00:11:49.782 --> 00:11:51.011
What you can do with your wrist.
00:11:51.011 --> 00:11:54.581
Can you grab a ball, pick up a pen, you know, all of that kind of stuff, right?
00:11:54.611 --> 00:11:55.692
That's all part of the test.
00:11:56.022 --> 00:11:59.322
And I score all of that and then it kicks out that final score.
00:11:59.591 --> 00:12:05.322
And the hope is that you are around like 20, outta 66, give or take a couple.
00:12:05.711 --> 00:12:11.741
Um, and then we get that secondary process started, which would be then I send all of your paperwork to Viti.
00:12:12.581 --> 00:12:16.006
That gets you set up with a, uh, surgical consultation with one of the surgeons.
00:12:16.767 --> 00:12:19.317
And they make sure you're safe to actually have the surgery.
00:12:19.797 --> 00:12:21.326
And then it goes to insurance.
00:12:21.657 --> 00:12:25.407
And then that process can take a couple weeks to a couple months.
00:12:25.797 --> 00:12:34.527
And then the hope is that it goes through and then you come back and see me and we do the, the protocol, which is six weeks, three times a week, 90 minute sessions each.
00:12:34.527 --> 00:12:34.557
Okay.
00:12:35.307 --> 00:12:37.856
So it's very intense, but a lot of fun.
00:12:38.517 --> 00:12:38.876
Right?
00:12:39.057 --> 00:12:39.356
Sure.
00:12:39.567 --> 00:12:40.466
There would be a lot of fun.
00:12:41.216 --> 00:12:41.817
I make it fun.
00:12:41.817 --> 00:12:42.897
I know, I'm just kidding.
00:12:43.616 --> 00:12:44.606
Um, so.
00:12:45.011 --> 00:12:48.461
Kinda not related to Vivas stem, but still vagus nerve.
00:12:48.522 --> 00:12:51.491
Are there everyone's, you know, making the supplements these days?
00:12:51.491 --> 00:12:51.552
Yeah.
00:12:51.581 --> 00:13:00.312
Are there supplements that you could take specifically if you don't qualify yet for this simulation that would be beneficial to take or.
00:13:01.317 --> 00:13:06.386
Um, well, there's always going to be some vitamins and supplements that are gonna help the body.
00:13:06.476 --> 00:13:14.876
Um, but in the grand scheme of things, the, the improvements that I think you're kind of looking for aren't gonna be that great.
00:13:14.966 --> 00:13:14.996
Okay.
00:13:14.996 --> 00:13:17.907
But it's definitely gonna help with just overall health and function.
00:13:17.907 --> 00:13:18.236
Right.
00:13:18.297 --> 00:13:18.386
Okay.
00:13:18.386 --> 00:13:19.947
But isn't specifically targeting that?
00:13:19.947 --> 00:13:20.336
No.
00:13:20.336 --> 00:13:27.032
So like magnesium, vitamin B, like B12, B complex, um, zinc, those sorts of.
00:13:27.397 --> 00:13:35.706
F minerals, vitamins, supplements are really good for the neuromodulator function, for your just general nerve health.
00:13:36.157 --> 00:13:39.636
Um, but it's not gonna help improve overall function.
00:13:39.756 --> 00:13:39.907
Okay.
00:13:39.966 --> 00:13:41.106
If that's what you're looking for.
00:13:41.136 --> 00:13:41.197
Yeah.
00:13:41.197 --> 00:13:47.736
But all of those things that I mentioned, you just obviously want to make sure you clear it with your, your doctor just to be on the safe side.
00:13:47.736 --> 00:13:47.917
Right.
00:13:47.947 --> 00:13:47.976
I
00:13:47.976 --> 00:13:53.496
think that question may have come more when people were thinking that the vagus nerve is what actually gets damaged.
00:13:53.542 --> 00:13:53.961
Mm-hmm.
00:13:54.072 --> 00:13:54.361
Yeah.
00:13:54.552 --> 00:13:54.841
Okay.
00:13:55.177 --> 00:13:55.626
Mm-hmm.
00:13:55.677 --> 00:13:55.706
Okay.
00:13:56.216 --> 00:14:01.736
Um, so what setting the, is the vagus nerve stimulator used in and how does it work?
00:14:01.856 --> 00:14:02.216
Sure.
00:14:02.606 --> 00:14:08.517
Uh, primarily we use, uh, the viti vagus nerve simulation in outpatient.
00:14:08.547 --> 00:14:08.636
Mm-hmm.
00:14:08.937 --> 00:14:12.866
There have been a few cases where it's done inpatient, right.
00:14:12.866 --> 00:14:17.996
So maybe a patient had, uh, a stroke a couple years ago and they got the nerve.
00:14:18.371 --> 00:14:24.192
Um, the nerve stimulator put in and then something else happened and then they got put back into the hospital kind of thing.
00:14:24.192 --> 00:14:31.481
So then as long as that therapist at that facility has been trained on how to use it, it can definitely be used in an inpatient kind of setting.
00:14:31.871 --> 00:14:33.131
Um, but the most.
00:14:33.897 --> 00:14:43.017
I would say most of the time it's gonna be in an outpatient kind of situation where patients are coming in, do a few, the few days a week, and then back to wherever they're living.
00:14:43.346 --> 00:14:43.586
Yeah.
00:14:44.006 --> 00:14:47.636
But then, but they also, it works at home for themselves.
00:14:47.636 --> 00:14:47.647
Correct.
00:14:47.647 --> 00:14:48.542
Is it's not just
00:14:49.076 --> 00:14:49.466
Correct.
00:14:49.527 --> 00:14:51.027
And for the outpatient therapy.
00:14:51.057 --> 00:14:51.506
Correct.
00:14:51.567 --> 00:14:58.017
So the main, the main, um, deliverance of stimulation is gonna be in.
00:14:58.346 --> 00:15:07.076
The therapy setting because myself or another therapist that is using this technology has the ability to deliver a stimulus every few seconds.
00:15:07.736 --> 00:15:10.496
We also train the patients to be able to do this at home.
00:15:10.496 --> 00:15:16.197
They get a little device, it's a little magnet that they can swipe over the left chest and turn it on and it can run.
00:15:16.616 --> 00:15:16.947
Um.
00:15:17.861 --> 00:15:20.081
Uh, for 30 minutes.
00:15:20.142 --> 00:15:22.211
And so you can turn it on about eight times a day.
00:15:22.211 --> 00:15:22.241
Okay.
00:15:22.241 --> 00:15:23.711
So a total of four hours.
00:15:23.922 --> 00:15:32.081
So that way when you're doing stuff at a house or if they're in here, like at the clubhouse, they can turn it on and do things around here or at the house, whatever it might be.
00:15:32.081 --> 00:15:35.711
Getting dressed, laundry, brushing their teeth, that sort of thing.
00:15:35.711 --> 00:15:37.572
So the therapy doesn't just happen in.
00:15:38.052 --> 00:15:41.201
The session, I can just give more during that time.
00:15:41.201 --> 00:15:41.471
Right.
00:15:41.682 --> 00:15:42.461
You can bypass
00:15:42.461 --> 00:15:43.511
the resting period.
00:15:43.511 --> 00:15:44.081
Exactly.
00:15:44.081 --> 00:15:44.652
Exactly.
00:15:45.432 --> 00:15:45.822
Okay,
00:15:45.912 --> 00:15:48.942
so again, um, you have to be six months post,
00:15:48.971 --> 00:15:49.361
correct.
00:15:49.366 --> 00:15:49.397
Screw.
00:15:50.022 --> 00:15:50.412
Yes.
00:15:50.501 --> 00:15:51.611
Have to be six months.
00:15:51.912 --> 00:15:53.381
At least that's what it is right now.
00:15:53.381 --> 00:16:02.172
There's a ton of research going on with them to look at how it affects people with, um, you know, like walking leg function.
00:16:02.442 --> 00:16:05.981
And then they're also exploring other versions of strokes, like a hemorrhagic stroke.
00:16:06.011 --> 00:16:06.101
Right.
00:16:06.162 --> 00:16:06.312
Yeah.
00:16:06.642 --> 00:16:08.292
So that's a good, that's what I was saying that too.
00:16:08.297 --> 00:16:12.341
So right now it strictly focuses on the arm and the hand.
00:16:12.341 --> 00:16:12.432
Mm-hmm.
00:16:12.761 --> 00:16:16.572
So it's not, not yet ready to help with foot dropper.
00:16:16.841 --> 00:16:17.861
'cause like, I'm like Brittany.
00:16:18.971 --> 00:16:21.491
I kinda have foot job, but more of my foot rolls.
00:16:21.491 --> 00:16:21.881
Rolls.
00:16:22.001 --> 00:16:22.062
Yeah.
00:16:22.062 --> 00:16:24.552
So I can't put it down flat without the A FO, so, right.
00:16:25.062 --> 00:16:25.241
Yeah.
00:16:25.241 --> 00:16:29.772
All of that research is kinda under, under wraps, I guess.
00:16:29.802 --> 00:16:30.042
Right.
00:16:30.042 --> 00:16:32.831
But that vagus nerve still affects all those things.
00:16:32.831 --> 00:16:33.221
Everything.
00:16:33.251 --> 00:16:35.052
Right, because the brain controls everything.
00:16:35.201 --> 00:16:35.322
Right?
00:16:35.322 --> 00:16:39.101
So even though weed focus mostly on the arm.
00:16:39.807 --> 00:16:50.307
That's, because that's what, um, the, the labeling for, for the FDA approved protocol is for That doesn't mean that the rest of the body is not getting affected.
00:16:50.667 --> 00:16:50.876
Right.
00:16:50.876 --> 00:16:50.966
Right.
00:16:50.971 --> 00:16:51.062
Just,
00:16:51.062 --> 00:16:52.422
we're just not focusing on that yet.
00:16:52.451 --> 00:16:52.741
It's
00:16:52.741 --> 00:16:53.456
not, yeah, exactly.
00:16:53.456 --> 00:16:59.037
And that research hasn't been published yet, so we don't have that support to say Yes, it can sure.
00:16:59.067 --> 00:17:00.177
Affect the, the like.
00:17:00.267 --> 00:17:00.476
Right.
00:17:00.657 --> 00:17:00.807
Yeah.
00:17:00.897 --> 00:17:01.167
Okay.
00:17:01.167 --> 00:17:08.817
I'm gonna take a quick little break and just remind our listeners while you're listening to go ahead and click that like button, that follow button, that subscribe button.
00:17:09.656 --> 00:17:13.136
Whatever button you see that has a thumbs up, go ahead and click that button.
00:17:13.467 --> 00:17:29.402
And then so, um, do you know like kinda where they are in the research process of when they might be able to branch out to other be, you know, hemorrhagic stroke or even are they looking at, I guess just not even stroke?
00:17:29.576 --> 00:17:32.547
'cause it sounds like right now it's strictly ischemic stroke.
00:17:32.547 --> 00:17:36.987
So is the goal not just maybe hemorrhagic stroke, but also.
00:17:37.376 --> 00:17:40.557
Traumatic brain injury, brain tumor, brain cancer, I mean, right.
00:17:40.886 --> 00:17:44.217
Is the goal to hit all those areas or Right.
00:17:44.217 --> 00:17:45.356
I can't say for sure.
00:17:45.656 --> 00:17:45.686
Okay.
00:17:45.747 --> 00:17:47.126
Um, just because I
00:17:47.126 --> 00:17:48.086
You're on the therapy side.
00:17:48.116 --> 00:17:48.537
Yes.
00:17:48.596 --> 00:17:48.896
Right.
00:17:48.957 --> 00:17:58.826
Um, but I'm gonna go with Yes, because just working closely with this company and the people that work there, their main objective is to help as many people as they can.
00:17:59.366 --> 00:18:00.057
So.
00:18:00.717 --> 00:18:01.136
Yes.
00:18:01.136 --> 00:18:04.826
Right now it's geared just towards ischemic stroke survivors, right?
00:18:04.832 --> 00:18:04.882
Mm-hmm.
00:18:04.967 --> 00:18:06.957
And the arm function and the hand function.
00:18:06.957 --> 00:18:09.926
But they are trying to branch it out, right?
00:18:09.926 --> 00:18:09.957
Okay.
00:18:09.957 --> 00:18:11.636
And trying to get it so that.
00:18:12.372 --> 00:18:17.412
Other patients can, can take advantage of this, this technology as much as possible.
00:18:17.592 --> 00:18:17.741
Yeah.
00:18:18.372 --> 00:18:18.701
Okay.
00:18:18.701 --> 00:18:24.517
And one other thing I was just thinking about too for,'cause we do have some therapists that listen, you know, that mm-hmm.
00:18:24.642 --> 00:18:25.751
Know us so they listen.
00:18:25.751 --> 00:18:34.481
Um, what, as a therapist, if you're in the day neuro program somewhere, or you're an outpatient program somewhere, what do you as a therapist.
00:18:34.872 --> 00:18:38.741
Need to do to become Vivas STEM certified therapist?
00:18:38.771 --> 00:18:39.041
Sure.
00:18:39.041 --> 00:18:43.481
There's a little, uh, training program that Viti will put you through.
00:18:43.662 --> 00:18:55.271
Um, if your clinic or hospital system, wherever you're working, wants to get involved with this, um, Julie, uh, would be a great person to get in touch with.
00:18:55.271 --> 00:18:55.902
Julie Graham.
00:18:56.201 --> 00:19:04.301
She is their, um, therapy development specialist, and so she would be the one to get that new therapist onboarded to get trained.
00:19:04.856 --> 00:19:08.487
Teach them how to use all of the software and the technology and all that good stuff.
00:19:08.547 --> 00:19:08.727
Yeah.
00:19:09.507 --> 00:19:09.777
Okay.
00:19:09.781 --> 00:19:09.981
Mm-hmm.
00:19:10.061 --> 00:19:10.182
Cool.
00:19:10.182 --> 00:19:10.192
Mm-hmm.
00:19:12.057 --> 00:19:19.076
Um, so what are some smaller steps to gain momentum to reach larger goals, whether you use Viva stem or not.
00:19:19.346 --> 00:19:19.616
Sure.
00:19:20.186 --> 00:19:29.426
I think the, the biggest thing that I have learned working with patients going through, whether it's a stroke recovery or a brain injury recovery, is to keep.
00:19:29.832 --> 00:19:30.311
Fighting.
00:19:30.551 --> 00:19:30.821
Right.
00:19:30.821 --> 00:19:32.021
And to keep working hard.
00:19:32.531 --> 00:19:40.422
I think that sometimes during recovery it is, um, very difficult, sometimes dark, right?
00:19:40.426 --> 00:19:40.686
Mm-hmm.
00:19:40.771 --> 00:19:47.622
And it's, it's tough to see the light at the end of the tunnel when you're in that, and you feel like you're alone in that sort of thing.
00:19:48.011 --> 00:19:57.432
And so, my biggest piece of advice, you know, small steps, all of that good stuff would be to continue to work as hard as possible, whether that's with family, friends, therapists.
00:19:57.821 --> 00:20:10.332
A place like this, you keep continuing to work hard because I feel like a, a big common misconception is you only have a certain amount of time to get better, which in my experience is not true.
00:20:10.451 --> 00:20:10.721
Right.
00:20:10.721 --> 00:20:11.807
In our state, we definitely
00:20:11.807 --> 00:20:11.926
not.
00:20:12.426 --> 00:20:19.422
So the biggest thing is you just take it day by day and you keep trying and you don't give up because you got a life to live.
00:20:19.811 --> 00:20:20.082
Right.
00:20:20.321 --> 00:20:21.612
It's just a different life now.
00:20:21.701 --> 00:20:23.592
But you still got lots to live for.
00:20:23.846 --> 00:20:24.086
Absolutely.
00:20:24.086 --> 00:20:24.247
Yeah.
00:20:24.866 --> 00:20:25.541
So, okay.
00:20:25.541 --> 00:20:27.102
We've talked a lot about Viva and Sure.
00:20:27.432 --> 00:20:30.791
We really haven't talked much about your organization, Pam.
00:20:30.791 --> 00:20:32.951
So tell us a little bit about Pam.
00:20:32.951 --> 00:20:35.741
You said it's, I don't remember what it stands for now.
00:20:35.741 --> 00:20:38.142
So medical I know is the last word I think.
00:20:38.142 --> 00:20:38.172
Uh,
00:20:38.442 --> 00:20:39.521
post-acute medical.
00:20:39.521 --> 00:20:39.761
Okay.
00:20:39.761 --> 00:20:43.092
We were rebranded to Pam Health a few years ago, so basically.
00:20:43.737 --> 00:20:48.926
Um, there are, I want to say 70 to 80 hospitals around the country.
00:20:49.257 --> 00:20:49.406
Mm-hmm.
00:20:49.407 --> 00:20:50.457
Started out on the East coast.
00:20:50.906 --> 00:20:56.217
Um, there are lots in Texas and we've kind of branched all the way out west to around Las Vegas.
00:20:56.666 --> 00:21:05.396
And the main deal is, like I said earlier, was the stroke, traumatic brain injury, and neurological, uh, rehabilitation.
00:21:05.787 --> 00:21:12.926
Um, here in Allen where I work, we have a 40 bed inpatient hospital, and then I'm in the outpatient department, so.
00:21:14.231 --> 00:21:20.652
We try to do as much as we can for our patients, which is why we also have the outpatient department.
00:21:20.652 --> 00:21:20.711
Okay.
00:21:20.711 --> 00:21:28.571
So they do their time inpatient, then they come and hang out with me for however long we need to get them back on their feet and moving and groove in the way that they need to.
00:21:28.576 --> 00:21:28.737
Yeah.
00:21:28.926 --> 00:21:29.217
Okay.
00:21:29.217 --> 00:21:32.922
And so that, that I, I think I've heard of Pam, but not very much.
00:21:32.922 --> 00:21:38.321
Like we know a lot about paint and CNS, I mean, but so y'all are similar to that?
00:21:38.622 --> 00:21:39.251
Very similar.
00:21:39.402 --> 00:21:39.612
So
00:21:39.612 --> 00:21:42.497
like someone goes to whatever hospital they go to and it.
00:21:43.451 --> 00:21:45.882
They've done their, maybe they're not done with inpatient.
00:21:45.882 --> 00:21:48.281
They need more and they're wanting somewhere to go.
00:21:48.342 --> 00:21:48.612
Yes.
00:21:49.061 --> 00:21:51.372
They're, you're just another option for, um,
00:21:51.432 --> 00:21:51.642
right.
00:21:51.882 --> 00:21:51.912
Okay.
00:21:52.271 --> 00:21:52.511
Right.
00:21:53.451 --> 00:21:56.007
Trying to wonder why we don't hear more about you guys.
00:21:56.096 --> 00:21:56.517
Yeah.
00:21:56.606 --> 00:21:59.126
Um, the outpatient department is kind of new.
00:21:59.247 --> 00:22:05.336
Um, we're trying to get that word out a little bit more because we're basically known for the inpatient side.
00:22:05.336 --> 00:22:05.426
Mm-hmm.
00:22:05.666 --> 00:22:10.047
'cause we also have a smaller facility in Richardson that does inpatient as well.
00:22:10.287 --> 00:22:15.446
Um, but the outpatient department has been there for, I don't know, seven years.
00:22:15.567 --> 00:22:15.596
Okay.
00:22:15.686 --> 00:22:16.227
Probably.
00:22:16.616 --> 00:22:18.297
Um, it's just.
00:22:18.852 --> 00:22:25.182
One of those where most of the time patients come for inpatient, but the outpatient we are are thriving.
00:22:25.182 --> 00:22:33.672
And like I said, we are stroke, uh, neurological and traumatic brain injury certified for all of our programming there.
00:22:33.882 --> 00:22:34.152
That's great.
00:22:34.152 --> 00:22:37.481
And like I said, we, we deliver everything we can do.
00:22:37.481 --> 00:22:40.961
Orthopedic conditions, hip replacements, knee replacements, all that stuff too.
00:22:41.442 --> 00:22:43.241
Um, kind of a one stop shop.
00:22:43.241 --> 00:22:46.751
Everything under the sun is basically what we can do at Pam.
00:22:46.842 --> 00:22:47.112
Yeah.
00:22:47.112 --> 00:22:47.682
Up in Allen.
00:22:47.711 --> 00:22:48.102
It's great.
00:22:48.626 --> 00:22:49.287
That's awesome.
00:22:49.676 --> 00:22:51.326
We'll need to come visit y'all.
00:22:51.866 --> 00:22:52.646
Learn more about you.
00:22:52.646 --> 00:22:53.457
Yeah, come on in.
00:22:54.567 --> 00:22:58.346
So, um, do you have any success stories you could share with us?
00:22:58.352 --> 00:22:58.942
Like for someone that's.
00:22:59.622 --> 00:23:00.821
You used Vivas, dim that.
00:23:00.942 --> 00:23:01.301
Sure.
00:23:01.451 --> 00:23:02.082
Um,
00:23:02.172 --> 00:23:04.866
and we can change all the names to protect those and I'm just Right.
00:23:04.872 --> 00:23:05.112
Right.
00:23:05.261 --> 00:23:11.711
Um, so for, for us at Pam and Alan, we've only had one patient so far, go through that whole program.
00:23:12.132 --> 00:23:16.961
Um, I have I think six patients in the process right now.
00:23:16.991 --> 00:23:17.021
Okay.
00:23:17.471 --> 00:23:18.672
So, um.
00:23:18.757 --> 00:23:24.457
Whether that's going through surgical consultation, insurance approval, appeals, all of that kind of stuff.
00:23:24.517 --> 00:23:31.926
So I don't have a ton of success stories for this right now just because it is really new for our facility.
00:23:32.047 --> 00:23:33.936
We've only been doing it for about a year.
00:23:33.936 --> 00:23:33.967
Okay.
00:23:34.386 --> 00:23:42.156
Um, that patient that, uh, I was referring to, she was about 11 years post-stroke and she actually was able to get that arm back up on a shopping cart.
00:23:42.442 --> 00:23:42.501
Wow.
00:23:42.892 --> 00:23:48.561
Still have a long way to go for her, but that shoulder motion started to improve with our time together.
00:23:48.561 --> 00:24:00.832
So she was able to lift it up high enough to get it on a shopping cart and be able to kind of push that shopping cart around, which was a big deal for her, you know, during her recovery, especially being so far out from having the stroke.
00:24:00.951 --> 00:24:01.672
Yeah, that's awesome.
00:24:01.676 --> 00:24:04.461
And that's, I like to hear those stories where it's that far post.
00:24:04.461 --> 00:24:06.711
'cause like I said, I'm 16 post and yeah,
00:24:07.192 --> 00:24:09.711
Viti has some really cool success stories.
00:24:10.001 --> 00:24:19.451
I, um, I could be misspeaking, but I believe there was an individual that was 20 plus years, I think outta Chicago that has made some really, really good gains.
00:24:19.451 --> 00:24:21.461
That's really, really cool to, to check out.
00:24:21.461 --> 00:24:21.701
Yeah.
00:24:22.211 --> 00:24:22.511
Awesome.
00:24:22.902 --> 00:24:23.051
Yeah.
00:24:23.112 --> 00:24:25.541
Well, is there any last little piece of advice?
00:24:25.541 --> 00:24:29.531
I know you kinda said it already, but, um, that you'd like to share with our listeners?
00:24:29.531 --> 00:24:30.821
We know, don't give up.
00:24:31.152 --> 00:24:31.332
Yeah.
00:24:31.332 --> 00:24:32.297
You can always get better.
00:24:32.297 --> 00:24:32.576
Yeah.
00:24:32.582 --> 00:24:33.761
There's not a limitation.
00:24:34.781 --> 00:24:36.896
Um, I would just say that, you know.
00:24:38.936 --> 00:24:39.086
Just
00:24:39.446 --> 00:24:39.656
ignore him.
00:24:39.747 --> 00:24:45.207
How, how, uh, life presents you with those challenges.
00:24:45.207 --> 00:24:46.856
You just, you just keep going.
00:24:47.576 --> 00:24:47.817
Right.
00:24:47.817 --> 00:24:52.317
It could be a little rocky and a little bit bumpy, but at the end of the day, you're still here.
00:24:52.467 --> 00:24:52.886
Right?
00:24:52.886 --> 00:24:52.896
Right.
00:24:53.067 --> 00:25:06.116
And so not to give up and, um, not to toot our horn over at Pam, but, but we love everybody and anybody, so any listener out there that thinks that they need a little bit of therapy or needs a little push, come and see me.
00:25:06.596 --> 00:25:07.856
Our doors are always open.
00:25:07.856 --> 00:25:15.176
We're willing to take anyone and everyone because our main objective over there is to get people back on their feet and living in life.
00:25:15.567 --> 00:25:16.047
That's awesome.
00:25:16.047 --> 00:25:16.646
I love to hear that.
00:25:16.646 --> 00:25:20.277
And so thank you so much, Colin, for coming in and sharing your experience with us.
00:25:20.277 --> 00:25:23.037
Just your experience and then also your experience with the booth stem.
00:25:23.037 --> 00:25:27.001
And like I said, we'll have to get the Clubhouse more involved with Pam so we can come out.
00:25:27.001 --> 00:25:27.281
That'd be great.
00:25:27.281 --> 00:25:28.287
And talk to your survivors.
00:25:28.797 --> 00:25:28.977
Awesome.
00:25:29.307 --> 00:25:32.247
Do more of that and thank you to our listeners for listening.
00:25:32.307 --> 00:25:32.757
Thank you guys.
00:25:32.997 --> 00:25:37.196
And remember, you can find all our new episodes on all your favorite platforms.
00:25:37.287 --> 00:25:38.186
Until next time.
00:25:38.457 --> 00:25:39.326
Until next time.
00:25:42.619 --> 00:25:53.354
Continue to support Brain Injury Network in our nonprofit mission, we support brain injury survivors as they reconnect into life, the community, and the workplace.
00:25:54.104 --> 00:25:57.673
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00:25:58.483 --> 00:26:00.884
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00:26:01.544 --> 00:26:07.153
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00:26:07.739 --> 00:26:13.288
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00:26:14.159 --> 00:26:28.858
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00:26:30.568 --> 00:26:31.888
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00:26:33.808 --> 00:26:34.888
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