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I got a concussion in December 2018. It took me 15 months to recover, and the symptoms still come up to this day when I’m stressed, flying, or in a hot tub. I knew nothing about concussions, and certainly didn’t expect depression, panic attacks, skittering vision, or debilitating exhaustion. By the time I was finally diagnosed, I was terrified, confused, and felt very alone. Some of my earliest reassurance was @mollyparkerpt’s Instagram page.

It was a treasure trove of concussion information, and immediately made me realize this was serious, but it was also treatable. Today, Dr. Molly Parker is here to share her expertise on concussions—the symptoms you might expect (and those you might not), finding the practitioner that’s right for you, working your treatment plan and evaluating success, and what to do if you find, like me, that your symptoms aren’t resolving in a few weeks, as they usually do.

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Molly Parker

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Website: concussioncompass.com

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Show Notes

The Work of Byron Katie (the podcast about my personal concussion journey)

#melissaurbanreads (and watches)

Racing to the Finish, Dale Earnhardt Jr. (autobiography, largely around his concussion journey)

Head Games: The Global Concussion Crisis (movie)

Melissa Urban:
Hi, my name is Melissa Urban and you’re listening to Do The Thing, a podcast where we explore what’s been missing every time you’ve tried to make a change and make it stick.

Melissa Urban:
Today’s episode is a little different. It is a deeply personal journey through a really difficult season in my life and my guest is someone who made a real difference during those dark days.

Melissa Urban:
In December, 2018, I had an accident while I was playing with my son and I was hit in the head pretty hard. I saw stars. I fell to the ground. I was dazed for a few minutes, but I shook it off and went right back to playing. I had no idea that that would be the start of a concussion journey that would take me the better part of 15 months to resolve, with symptoms that still show up to this day.

Melissa Urban:
I’d never been hit in the head. I wasn’t a race car driver or a football player. What I didn’t know about concussions would fill volumes and I’m guessing if you’ve never suffered one yourself, or you don’t know someone who has, you probably don’t know that much about concussions either.

Melissa Urban:
There were three people, all physical therapists who played pivotal roles in my healing. The first was my physical therapist friend Anne, who lives on the East coast. After spending a few weeks in complete denial that I did in fact have a concussion and trying to power my way through it and getting sicker and sicker every day, she finally got me on the phone and told me to get my butt to a physical therapist, stat.

Melissa Urban:
Then I found my team of physical therapists at Park City Hospital. They tag teamed my vision and vestibular therapy treatment plan that ultimately allowed me to work, hike, exercise and socialize after months of incapacity.

Melissa Urban:
Finally, I was introduced to Doctor Molly Parker and her Instagram account by a good Samaritan in the DMs who heard me mention, I had a concussion and said, “Do you follow her? You probably should.”

Melissa Urban:
Molly is a physical therapist, concussion educator, and the co-founder of Concussion Compass. In 2011, she was hit by a cab as a pedestrian. After years of frustration, struggling to find help, the gaps in concussion treatment were clear. She decided to step up and create for others, the resources and support she never had.

Melissa Urban:
Molly’s Instagram page was a treasure trove of concussion information and immediately made me realize that what I had was serious but it was also treatable and above all I wasn’t alone. She was a constant source of inspiration and reassurance during some really difficult days.

Melissa Urban:
It took me over a year before I was ready to talk about my concussion on any of my platforms. I did a podcast about it almost exactly a year after my accident. But since I first mentioned I had a concussion, so many people have messaged me asking, “I think I got a concussion. How do I know? Where do I start? What should I do? Where should I go?”

Melissa Urban:
Today, Doctor Molly Parker is here to share her expertise on concussions, the symptoms you might expect and those you might not, finding the practitioner that’s right for you, working your treatment plan and evaluating success and what to do if you find, like me, that your symptoms aren’t resolving in a few weeks, as they usually do.

Melissa Urban:
This podcast is about making change stick and ultimately empowering you to achieve health on your own terms. My concussion made me wonder if I’d ever be the same again and I don’t want anyone else to have to worry like I did or feel alone like I did.

Melissa Urban:
This episode and Molly’s Concussion Compass Program will help you move through this difficult season, feeling guided and supported every step of the way, while reminding you that you are far more powerful than you are giving yourself credit for.

Melissa Urban:
I have to just note the irony in that in recording this intro, I had to stop and re-record probably 10 times because I’ve had an incredibly heavy day of calls and Zoom calls, and that tends to aggravate my concussion symptoms. The irony is not lost on me. All right. Now onto the episode.

Melissa Urban:
Please welcome To Do The Thing, Molly Parker, doctor of physical therapy. Molly, thank you for joining us today.

Dr. Molly Parker:
Thank you for having me.

Melissa Urban:
I’m excited to talk to you. The first question I ask all of my guests is what’s your thing?

Dr. Molly Parker:
So my thing is I help people recover optimally after they’ve had a concussion.

Melissa Urban:
I love that. Okay. So here is everything I knew about my concussion before I sustained one. I knew that it happened to race car drivers and football players and maybe if you’ve gotten a really bad car accident. I knew that if you didn’t go to sleep for that first night, as long as you just rested a couple of days, you would be okay. I now understand that my own understanding of concussions was so severely lacking.

Melissa Urban:
Do you find people in general don’t understand concussions well?

Dr. Molly Parker:
All the time. I think it shifted quite a bit in the last three or four years, but there is still so much misinformation about concussion in general, that we’re just continuing to learn more and more and even when I had my own, I was in the boat you were, even though I was a fairly new, recent graduate out of PT school, we didn’t cover concussions. We covered severe TBI and that was it. So it’s been a learning curve.

Melissa Urban:
So when you were first a physical therapist, you were working for a neurological research facility?

Dr. Molly Parker:
No. I was actually an orthopedic physical therapist. So we did the typical neck, back, shoulder, that sort of thing. But we also became known as the clinic in town that saw a little of the more out of the box cases and the ones that people just couldn’t quite figure out.

Dr. Molly Parker:
So it would end up being people with sensitive nervous systems and chronic pain and autoimmune and things like that. So I kind of learned right out of school, this almost ortho neuro blend that lends itself actually very well to concussion but isn’t something that was readily taught. So, that was just dumb luck.

Melissa Urban:
That must’ve been what I was reading in your bio then, that neuro ortho blend.

Melissa Urban:
Tell me about your concussion experience. It happened in 2011, so that’s been nine years now. What happened?

Dr. Molly Parker:
So I was actually out celebrating, dinner and dancing night with girlfriends, and we were leaving a nightclub and a cab driver fell asleep at the wheel and he hit myself and many other people. I knew initially I had a big bump on my head. I had some memory loss, but I remember, it was like you. I remember thinking I was fine and I felt so fortunate that I just had a concussion and I really had no idea what they could turn into.

Dr. Molly Parker:
I was cleared in the emergency room and I missed I think a day of work, went back and was just really often, very much felt like I got hit by a car, but on top of that, it was just, I was cognitively not quite there and very quickly I started falling into these worsening symptoms where I developed really severe headaches and then kind of this dizziness and then this feeling where I felt like I was going to faint and I was out of my body. Started to develop a lot of working memory stuff and it just didn’t go away.

Dr. Molly Parker:
So I would go from healthcare provider to provider saying, this is what’s going on and like you said, people just had no inkling that concussion symptoms could really last longer than about a couple of weeks.

Dr. Molly Parker:
So once I passed that point, I continued to get significantly worse, struggling to find help and it took me probably two years to get diagnosed with post concussion syndrome, which we’re now kind of shifting to prolonged concussion symptoms and another year on top of that to find a healthcare provider who knew what they were doing.

Dr. Molly Parker:
By that time I ended up fairly severely debilitated. I’d had personality changes. I ended up with a movement disorder. Everything that could’ve gone wrong did and there was just no help. There was no resources and they told me, this is it. This is going to be the rest of your life. You’re debilitated and I remember thinking, “I hear you, but that just can’t be the case. These are functional injuries.”

Dr. Molly Parker:
So I spent probably the last five years doing extensive rehab and just kind of clawing myself out of a pile of symptoms that really shouldn’t have developed, had I known what I know now. It was just a bear.

Melissa Urban:
My concussion was December, 2018. So it’s been over a year. I’ve been over the most of my symptoms, but I do have, I guess I call them relapses when I get sick or when I get stressed. They come back with a vengeance. I am so lucky and fortunate that I found good help here in Park City but the first physical… The first two doctors I went to had no idea what to do with me. They both recognized that I had a concussion but my primary care physician was completely out of his element and the first physical therapist I saw was like, “Well, try to do some exercise and if you don’t feel good, you should rest.” I mean, there was no specific advice.

Melissa Urban:
Do you find that even physical therapists, unless they’re particularly trained in TBIs and concussion therapy, just don’t understand the condition or know how to treat them?

Dr. Molly Parker:
It’s across the board really, through the healthcare system, where you find, just like you said, you have this accident and people say, “Oh, go rest in a dark room.” Or, “There’s nothing you can come do.” Or, “Come back in six weeks,” which is all at one time, what we thought was the best course of treatment but what we know now is outdated and that kind of managing the concussion that way can actually be detrimental.

Dr. Molly Parker:
So we’ve seen a shift, we seen a big surge in the research, which is amazing and then we’ve seen a shift in healthcare providers starting to become a little more aware that maybe there’s more to these than we thought.

Dr. Molly Parker:
They’re also doing better at getting trained but we still have a pretty big gap and a long way to go and right now it’s just a little bit of luck of the draw. Do you wind up with someone who knows their stuff? Or do you wind up with someone who just hasn’t been aware yet that these things aren’t what they seem. So, yeah.

Melissa Urban:
Yeah. You know, I think the thing that was the hardest for me was that there are some concussion symptoms that I recognized as concussion symptoms like headaches and then there were up ton of them that I had no idea could be related to my concussion; depression, anxiety bordering on, I had a few panic attacks in the early days of my concussion. Exercised induced symptoms, blurry vision, trouble focusing. I felt like my eyes weren’t working well together. Dizziness, personality changes. I would be really irritable one moment and then I would be so sad. The next, exhaustion. I think there’s just…

PART 1 OF 4 ENDS [00:11:04]

Melissa Urban:
so much to what can happen in a concussion, and people’s symptoms can look so different. I felt a little bit like I was crazy, like there was something seriously wrong with me and I didn’t know what, and I had a hard time even explaining to people how I felt.

Dr. Molly Parker:
Hugely relatable, not only in my own journey, but I hear that from people all the time. And it’s one of those things where we’re having people who… Concussions are a brain injury, and that affects really everything you do and everything you are and how you relate to the world, and it’s so hard to apply language to some of these symptoms when you’re in this mess of a state. I think that’s only added to the mismatch between what people are experiencing and then what they’re able to translate to the people who could help, like their doctors or their family and, yeah, but hugely relatable.

Melissa Urban:
It’s funny, at this point in my journey, I can now tell the difference between, “Oh, I’m exhausted, it’s been a long day,” and, “My concussion is acting up and I need to get off the phone.” I call it concussion brain now, like, “Oh my, I have concussion brain,” versus just what you would normally feel from day to day fatigue. It feels different now, but I could not identify that for a very long time.

Dr. Molly Parker:
Yeah. I could tell, like there was a time everything was so messy, I couldn’t tell what was coming from where. The fatigue is just the worst.

Melissa Urban:
It is. And life doesn’t stop. So I had my son that I was taking care of, and a job, and household responsibilities, and driving and all of that stuff, and so I felt really helpless, I felt really alone, I was terrified. I was terrified that this was now my new normal. I remember saying to Brandon, “What if I never get better?” And it didn’t occur to me in the beginning that that was a possibility, but as the symptoms went on for months and months, I started to get really scared.

Dr. Molly Parker:
Yeah. I can definitely relate to that.

Melissa Urban:
In one of your last Instagram posts, you talked about there being three, like a Venn diagram with three different drivers of concussion symptoms, cervicogenic, vestibular-ocular and physiological, I’ve heard concussion symptoms described in a few different categorical ways, but can you talk about these three symptoms and how they might appear in different ways based on your injury?

Dr. Molly Parker:
Yeah. So what we know now is, just like there’s not one type of knee injury, one type of back injury, there’s not one type of concussion. And so once we have folks that are maybe about 10 to 14 days out, and they’re still experiencing symptoms, we start to treat them proactively as if they were to develop prolonged symptoms. And so that comes into play where we identify what particular types of concussion they’re dealing with on their own.

Dr. Molly Parker:
So we have what’s called phenotypes, where there’s six or seven different types of concussion, and then we match that with the corresponding healthcare provider. So we’re really, the key is matching exactly what’s going on with that person. It’s like you said, people experienced different symptoms, so matching someone that had vision symptoms with a vision therapist and so on and so forth, and the paradigm that you just mentioned is from a study that’s really simplified down to the three core groups in concussions.

Dr. Molly Parker:
So there’s cervicogenic, which is basically meaning it’s coming from your neck. Given the mechanism of injury and the concussion, the concussion occurs when you have that acceleration and deceleration force of the brain within the skull. And anytime you have that, your neck is going to be involved. So the symptoms of whiplash and the symptoms of cervicogenic involvement can very much mimic concussion symptoms.

Dr. Molly Parker:
So it can be things like headache and dizziness or feeling like you don’t know where you are in space, and you can even have that with lack of neck pain at all. So if you’re in that category, we’re looking at mostly a physical therapist chiropractic type route, and I always tell people, “You’re looking for someone with specific training in concussions.” It’s not enough just to be a general practitioner, you really want someone who focuses their practice there and has taken advanced training.

Dr. Molly Parker:
And then you have vestibular-ocular, and so that’s going to be your eyes and your inner ear basically. So your inner ear tells you where your head is in space, tells you where you’re moving, and then vision, I think, is something that I know I didn’t fully appreciate, and I think a lot of people don’t, is that your vision is more than 20/20, it’s more than, can you see? It’s, can your eyes work together? Can they track objects? Can your brain process what’s coming in through your visual system. These are all things that are hugely important, and that visual input actually goes for about 80% of your brain.

Dr. Molly Parker:
So when that’s not working, things don’t feel good. So if you’re in that vestibular-ocular category, we have a neuro optometrist, which is a particular type of optometrist for concussion. For the vestibular piece, it’s typically physical therapists who are trained in particular vestibular therapy, but also in concussion. And you’ll often find that when you’re in that category, that you might have more than one health care provider working together to put together the best team for you.

Dr. Molly Parker:
And then the last one is that physiologic. So this could be, like you mentioned, you would get symptoms when you would exercise. And I know, I’ve been watching you in your gym exercise during everything. But that’s for someone, they might be exercising and they get more symptomatic with an increase in blood flow. It’s called exercise intolerance and we can treat that. Someone else in that category, it might be more like metabolic things, maybe hormones or something like that, but those are your three main hubs based off how you’re feeling, is based on what treatment we put you in so that people can get back to life.

Melissa Urban:
Yeah. So my symptoms are mainly vestibular vision, and vision is like the biggest one. I still get very… My vision system gets very stressed, especially when things are really closed up. This morning, my son wanted me to look at something, and he held it up so close to my face, and I panicked a little bit. I still get really stressed. And then the physiological too is something that I was not aware of nor expecting.

Melissa Urban:
I read a statistic, I don’t know how accurate it is, that about one in three concussion sufferers will be faced with some sort of HPA axis dysregulation, either pituitary, adrenals, sex hormones, and I certainly found that to be the case. I’ve been doing a lot of testing with my functional medicine doctor, but for the first time in my life, my thyroid hormones have been off, and I’ve been getting my period every two weeks since my concussion basically, with very little break in between. And my cycle used to be incredibly normal. Are those also lingering effects of post-concussion or prolonged concussion symptoms?

Dr. Molly Parker:
Yeah. So hormones can be affected in concussion recovery. The most common we see is pituitary type issues because of pituitary gland, it’s in a vulnerable position, if you were to ever Google a picture of where it is. So we do see people that have hormone issues fairly frequently, the statistics range heavily from the research I’ve read. But not only can you have them early on, you can actually develop them a little bit later. So three months, six months, 12 months down the line, and people will start having thyroid issues and pituitary issues. I’ve gone through the gauntlet myself, I see a naturopathic doctor who’s fantastic, but yeah, you go through it too.

Dr. Molly Parker:
It’s a lot of stuff that you are having to do and take and get back online, and the amount that that affects, not only personality changes and being irritable and things like that, but it can also affect your fatigue levels and your sleep, and it’s one of those things that usually when we have someone who’s really struggling with sleep and fatigue and they just can’t get back, we’ve done everything under the sun and we just can’t figure out why, oftentimes we look at hormones and there it is.

Melissa Urban:
Yeah. We’ve decided not to do any specific treatment for it. I feel like my body has been under so much stress and inflammation since the accident, and I was really healthy to begin with, so we’ve taken the approach that if we just rest and continue with self-care practices and physical therapy, that that stuff will come back online, and it is getting better, but that was another…

Melissa Urban:
It was something else that just knocked me out of the blue, like, “Okay, now I’m dealing with this as well.” I want to ask, how many people suffer concussions recover relatively quickly versus those like you and I that end up with symptoms months or even years down the line. And is there any rhyme or reason or predictor to why someone might suffer from prolonged concussion symptoms?

Dr. Molly Parker:
So it’s estimated that about 70 to 80% of folks who have a concussion will recover back to their baseline within about one to four weeks, and we most commonly see that within about the first two weeks, children tend to take just a little bit longer. So yeah, that’s about the timeline, but then we’ll see this group of about 20, in my mind is closer to 30, it’s that 20 to 30%, but I really do think there’s a lot of cases that we just don’t pick up on, that will develop prolonged symptoms.

Dr. Molly Parker:
Now, with that said, we’re learning that if we get people in right away, so if they’ve had a concussion or they suspect they’ve had a concussion and we get them into proper care and we get them in with someone who really knows their stuff and can, we have what we call a guided gradual return to work school, life, whatever it may be, and if they’re guided through that process, they tend to have a much better chance of not developing prolonged symptoms.

Dr. Molly Parker:
So I suspect that we’ll see the group like you and I, who developed prolonged symptoms, will lessen when we get better overall care. With that said, we don’t really know why some people develop it and some people don’t. There’s, there’s predictive factors and risk factors that might be time into proper care, there’s some that say, “Well, if you’ve had a concussion before, and if you’ve had any those preexisting things,” but we really don’t have any hard and fast this-is-a-why.”

Dr. Molly Parker:
I think the biggest predictor we have right now is dizziness immediately after concussion. So if you’re someone who has a concussion, your first immediate symptom is dizziness, you’re more likely than with other symptoms to be someone who might fall into that prolonged category.

PART 2 OF 4 ENDS [00:22:04]

Dr. Molly Parker:

Melissa Urban:
That’s really interesting. I’ve also read that women tend to be harder hit in terms of concussion symptoms, whether it’s because of our delicate hormonal balance or I’ve read also maybe it’s that our necks are generally weaker and don’t sustain the force of trauma as effectively. Have you found that as well, that women tend to suffer more?

Dr. Molly Parker:
Yeah. So the statistics are that women tend to suffer more and then the question is, well, why? And I don’t think we really have enough research. The kind of underlying big problem is that most of the research done in concussion and brain injury in general is done on men. So we don’t have many studies that are really looking at differences between men and women or not many studies that are really looking at differences between the type of concussion you sustained. For example, if you were in car accident versus if you had a blast injury, those might be a little bit different. So there are groups working for female brain injury to try to figure out what kind of differences we need to make. And the running theories are hormones or females tend to have longer necks and if they have longer necks, it’s kind of a longer lever arm for when you sustain an injury.

Dr. Molly Parker:
There’s also that women tend to report symptoms and be more honest about them than maybe men do. But then I recently saw a study in the last year and it was small, but when they began to control for all those things, they found that if both, and this was in adolescents. So if it was both boys and girls got into treatment at the same time, then all those other factors went away and they recovered equally. So we don’t know if it’s some of these factors that just affect women, or if it’s that maybe women aren’t getting in and getting the proper care as well as some of the men and boys are. So we really don’t know.

Melissa Urban:
Here’s what I was thinking about. I’m very lucky in that I work for myself. I could take time off from work whenever I wanted to. I have a great co-parent who would take extra time with my son. I bet that there are a lot of women who both run a household and manage the kids and work full time. And if you need to take time out of your day or out of your life to focus on your recovery and you’re responsible for all of those areas, I can imagine that you would see a much slower progression in your recovery.

Dr. Molly Parker:
Yeah. Yeah. It’s hard when you have a lot of things on the plate and particularly when you look so normal, it’s hard for people to understand. And it’s hard for people to know. If you have a woman in that position for your people around you to know when and how to step in just isn’t as immediately obvious as with other exercise or as other injuries. So big time.

Melissa Urban:
Having my concussion gave me so much more empathy towards those who suffer from these silent conditions, chronic pain, chronic fatigue. I looked totally normal. I could still go to the gym. My workouts were modulated. I could still drive a car. You couldn’t see what was wrong with me and it was really hard. For a long time, I struggled with imposter syndrome, almost feeling like I was a faker, like people were going to accuse me of faking because I looked fine and I felt so sick. And I think it really held my progress back because I was unwilling to ask for help, to talk about how bad I felt. I was like, people don’t want to hear me over and over and over again, say how dizzy I am, how tired I am, how much it hurts. And I think that really held me back. I struggled with that emotionally and mentally.

Dr. Molly Parker:
Same. Hugely, hugely. So can relate to that. Same. Had I asked for help and really articulated it sooner I wonder if it would have been a little bit different.

Melissa Urban:
But it was also hard for me to even know that I needed help. It took Brendan two days to convince me I had a concussion because I was only hit in the side of the head. I was playing with my son. I didn’t have a violent car accident or a fall. I never lost consciousness. I had no experience with this and it was very hard for me to even accept that, that little accident, playing with my kid, led to a concussion. There are so many different ways, I think, that it can happen and unless you’re a race car driver or a boxer, I think people discount the hits they take on their head as being serious.

Dr. Molly Parker:
I think they did too. And it’s really easy to put it off or put it on the back burner or to not really be cognitively aware enough to get yourself help, but to not necessarily understand that you’re not aware. So I’ll talk to people who it took them a while to get in to see someone because they it’s not that they didn’t know something was wrong, it was just that they couldn’t wrap their head around it or know what to do or know where to go or who to ask or what to say. I hear that a lot.

Melissa Urban:
Well, before we go there, because I definitely want to talk to you about, what if you do have a concussion, what are your first steps. But what are some of the signs to look for if you do take a bump to the head or get hit in the head or have an accident that would clue you in. You already mentioned dizziness, but what are some other signs that people should be on the lookout for?

Dr. Molly Parker:
I mean, so a concussion, the first thing that’s important understand is it can occur directly or indirectly as a bump or blow to the head, but you could also get one if you were to, say, slip on ice and fall really hard on your tailbone. Anything that causes enough acceleration or de-acceleration. So they say a concussion is… all you need is the mechanism of injury. So you don’t even need to be this massive accident. It can be these smaller things that you discount. And the interesting thing is there actually isn’t any correlation between the severity of the hit and if you’re going to develop prolonged symptoms. So you can have what you perceive as something really and minor and still develop symptoms whereas somebody who had this massive thing might recover symptom-wise in two weeks, brain recovers in about three to six and be on their way.

Dr. Molly Parker:
So really what you’re looking for is any sort of mechanism of injury and one immediate symptom. And that could be something like headaches is very common, dizziness. It could be emotional like irritability or crying. It might be nausea. It might be seeing stars or blurring vision. Anything that’s kind of out of the norm that can’t be explained any other way, it could be considered a possible concussion. And so whether you’re unsure or know for sure that that likely was the case, either way, we recommend you getting into see someone as soon as possible. And we find if people get in within about 24 to 48 hours, that is the best likelihood of having a positive outcome and a smooth recovery.

Melissa Urban:
It’s funny that you said seeing stars. I could never really understand that impression until I was hit in the head and I literally saw stars. I was never unconscious, but I was dazed and confused for a solid 30 seconds and that probably should have been my first clue. So when I recognized that I had something wrong, I just went to my urgent care clinic and I saw the first doctor who was available. And he said, “You might have a concussion. You should go home and rest.” What are people supposed to do? How do you know who to go see in a way that’s going to be effective for you?

Dr. Molly Parker:
So you’re really looking for someone… there’s going to be multiple access points into the health care system. So it might be your primary doctor or your neurologist or an urgent care type situation, or going into a PT clinic. You’re really looking for someone and you might not be all there so you can have someone with you. Give them a call and ask, do you treat concussions? Do you have experience with these types of things? And you’re looking for someone who has kind of that current and advanced training and what it should sound like when you get there is they should be doing an evaluation. Particularly early on they’re ruling out any other more serious injuries. So they’re going to rule out if you have a brain bleed or a skull fracture, they’re looking for any of those red flags and then they should be properly educating you.

Dr. Molly Parker:
And that education should sound like, you can do 24 to about 72 hours of rest. If you need to take the day off work, take the day off school, that’s fine. But then what we switched to in recent years is what we consider an active recovery. So any of that go home and rest and don’t do anything, go lay in a dark room, you don’t have symptoms, it’s fine. Go back. None of that stuff is current anymore. So what we see now is we want to get people doing what they’re able as quickly as they can. So that is going to look a little bit different for everyone, which is why we have a healthcare provider guide you through it. But that’s looking and adding in more physical and cognitive activity each day, as long as your symptoms aren’t increasing.

Dr. Molly Parker:
And if you start to get any increase in symptoms, you go back a little bit, spend some time there and then increase it back up. So that’s what that really should look like. And you should see kind of that progression through symptoms. Your symptoms should be going away around that 10 to 14 day mark. If they’re not, we’re going to proactively start treating as if you are going to have prolonged symptoms. And that means we’re going to go back to those three things and figure out what exact symptoms you are and match them with the corresponding healthcare provider. But that’s what we should see the continuum look like. It shouldn’t be just rest. It shouldn’t be just medication. It should not be rest in a dark room. It shouldn’t be restrict yourself from anything and every thing. It is really letting the brain do what it’s able step-by-step so that you can slowly work yourself back into life.
Melissa Urban:
So before I sought the treatment of a physical therapist who specialized in concussion, I kind of treated my concussion like it was a cold where if you have a cold, once you get past the worst of it, you can kind of just muscle your way through it. And I really tried, after resting for a few days, to muscle my way through it. I went back to the gym. I tried to ignore my symptoms. I tried to go back to work and I blew up. I ended up crying in the middle of the gym, having a panic attack. I had to take several days off of being a functional human being.

Melissa Urban:
And it wasn’t until my physical therapist started treatment and initiated this green light, yellow light, red light system exactly as you’ve just talked about. So I could go to the gym and workout. When I noticed my symptoms starting to come on, that was yellow light and I had to pause. And if I continued to accelerate or it didn’t go back to green, my workout was done. But if I could get myself back to green, then I could continue. Is that the kind of tolerance testing you’re talking about?

Dr. Molly Parker:
Yeah. So that’s a good way to do it. And that’s a little going to be more useful for people with prolonged symptoms. And we’re talking, could be applied to people in acute recovery as well, where you’re just looking to keep the kind of two no-nos in the

PART 3 OF 4 ENDS [00:33:04]

Dr. Molly Parker:
early on stages are don’t do anything where you’re going to get a second concussion, and trying to stay below that symptom threshold. So when you notice them coming on, like you said, backing off and going from there.

Melissa Urban:
So you have a program now called Concussion Compass.

Dr. Molly Parker:
Yes.

Melissa Urban:
And I’ve been doing some digging into it. Boy, do I wish this was around a year and a half ago,.

Dr. Molly Parker:
Right.

Melissa Urban:
And I bet you wish it was for you as well.

Dr. Molly Parker:
Exactly.

Melissa Urban:
That’s probably why you created it. Tell me about Concussion Compass.

Dr. Molly Parker:
Well, I created it because it was what I wish I would have had.

Melissa Urban:
Yeah.

Dr. Molly Parker:
So it’s just these resources weren’t available, and it really bothered me that people might not have the education that they need so they can get back to where they want to go. So it’s really the ultimate resource for people four weeks out or more in concussion recovery. So it’s, if you have, “Gosh, I wonder who treats my headaches.” We have that in there. It’s, “Oh, I’m going to fly. I wonder if that’s okay.” If there’s tips, it’s in there. So we really have kind of the research done for you and done all the hard work and pulled it all together and put it in one spot, so that you can just pull in and grab what you need when you’re ready. And then we surround you the entire time by people who are going through it too through our community, and myself and my partner Natasha Welch who’s this phenomenal physical therapist. She and I mentor you through it so that you always have guidance when you’re going through this process. And hopefully we can get people, back to where they need to go quicker.

Dr. Molly Parker:
And yeah, it’s, it’s been a lot of fun. We just launched and we’ve got a great group and yeah, we’re loving it.

Melissa Urban:
That sounds so wonderful. There were so many things I had to figure out on my own, like travel. I was not prepared for how much travel, just the act of traveling, nevermind when I got to my destination, fired up my symptoms. The airport is so loud and it is so busy and it’s visually stimulating and you have no control over the environment. And then altitude, I didn’t realize altitude would affect my symptoms, and it does. So there are so many little things that I wish I could have had a heads up on that you are now providing people through your program.

Dr. Molly Parker:
Yeah. Yeah, I remember when you came back from travel, just like, “What the heck?” And how would you know if you didn’t have anyone to guide you through it?

Melissa Urban:
Yeah. I also have this really weird thing. Actually, I was going to ask you about this. I’m just going to ask you now.

Dr. Molly Parker:
Okay.

Melissa Urban:
I noticed that hot tubs exacerbate my symptoms. I can no longer spend time in a hot tub because every time I do, it’s probably within 24 hours, my vision symptoms come back. I’ve never heard of that before.

Dr. Molly Parker:
Yeah. Some people have difficulties in higher temperatures. Concussions just in general can affect your autonomic nervous system, which regulates our heat. So some people might have a harder time with heat. We’ll also hear people having a hard time like in hot showers, particularly if they have something called dysautonomia. So yeah, all those little, it’s all those little things that you don’t think about. A
Melissa Urban:
And this is where I would be in your program talking to all of the other people saying-

Dr. Molly Parker:
Exactly.
Melissa Urban:
“Hey, does anyone have this, because?”

Dr. Molly Parker:
Exactly. Exactly.

Melissa Urban:
I love that. And then do you also help people either find the right practitioner in their area or coordinate with their practitioner? If you’ve had symptoms for more than four weeks at this point, there’s a chance that you’re not working with the right provider. Is that something that you assist with?

Dr. Molly Parker:
Oh yeah. So we have our first big, what we call research, done for you. And it’s where you save the time scrolling and on the internet and we do all the legwork for you and tell you exactly what you need to know in a way you can digest. It’s called Concussion 101. And we quite literally take people from here’s a concussion. Here’s what prolonged symptoms are. And then we match, we have them match their individual concussion profile. We match their proper symptoms to their healthcare provider. If they have multiple things, which most people do, we help them understand exactly where to start and why. And then we link you up with the proper health care team. So we give you exactly what to look for. We have resources in there that give, directories for people that may be in your area. You can poll us, you can poll the community. So it’s really been helping people put things together.

Dr. Molly Parker:
And then we also have mentorships. So just this Monday we had office hours and someone was saying, “I have these multiple providers and none of them talk. And I just feel like I’m doing this a la carte and nothing’s matching and I’m so frustrated.” And so we talk about how to remedy those kinds of things. And that is extremely, extremely common, especially when you get these cases where people have multiple things, which most do, and you really have to start to coordinate that care.

Melissa Urban:
I remember the irony of thinking to myself, “I have so much research to do to try to find the right practitioner and get the job done. And if I spend one more moment looking at my screen, I’m going to cry because it hurts so much.”

Dr. Molly Parker:
Yes. Yeah.

Melissa Urban:
That’s the frustration.

Dr. Molly Parker:
Yeah. I don’t think people appreciate, unless, and I don’t know that I could have, unless you’ve gone through it, how hard screens are, and how hard scrolling is and how hard reading is.

Melissa Urban:
Yeah.

Dr. Molly Parker:
And so, yeah, we put it in video format and then we made these nice little handouts. We even made the font big. We kind of went through.

Melissa Urban:
You’re so good.

Dr. Molly Parker:
And said everything of what would people struggle with and trying to remedy it.

Melissa Urban:
Yeah. You know, I really think that unless you’ve been through it yourself, it’s going to be very hard to pour so much passion and energy and support into a program like that. But because you’ve been through it for such a long time, it will be so impactful for people to have not only your professional support and advice in the program, but from your personal experience too, what would I have wanted to feel supported during this really stressful time?

Dr. Molly Parker:
Yeah. Yeah, definitely.

Melissa Urban:
All right. The last question I ask all of my guests, if you are a listener and you had suffered a concussion, or knew someone who suffered a concussion, and you were really ready to take the next steps, what’s one piece of advice you would give them?

Dr. Molly Parker:
I would tell people first, concussions are treatable, so to seek out proper care in your area. And if you’re struggling to know where that is, you can contact me through Instagram, @MollyParkerPT, or if you’re just ready for like that ultimate toolbox, like we’ve been talking about, Concussion Compass is also a wonderful resource for you. I guess that’s not really one thing is it?

Melissa Urban:
Yeah. Most people answer with like two or three things, so you were pretty succinct.

Dr. Molly Parker:
All right.

Melissa Urban:
Where can people find more about Concussion compass?

Dr. Molly Parker:
It is at www.concussioncompass.com. And then myself and my partner are both on Instagram. I am @MollyParkerPT and she is @Natasha.Welch. And if you’re needing advice or someone to listen or want to know what’s the fit for you, we’re definitely available and there to support you through your journey.

Melissa Urban:
I found you pretty early on in my concussion. Someone sent me your page and said, you, “This woman has a lot of fantastic resources.” It was such a source, your Instagram page was such a source of support for me.

Dr. Molly Parker:
Good.

Melissa Urban:
And education and information. And every time I messaged you, you always messaged me back.

Dr. Molly Parker:
Of course.

Melissa Urban:
So I just want to say thank you so much for helping me during that really difficult time.

Dr. Molly Parker:
Oh, absolutely. Yeah. And thank you so much for bringing more attention to it now. I know it’s such a hard journey and it’s appreciated.

Melissa Urban:
I think it’s going to be so important. I’ve heard from so many people who are suffering and they feel lost and they feel alone. And I think being able to offer them your advice and resources is going to be just so helpful and impactful. So thank you so, so much. Molly Parker, physical therapist, doctor of physical therapy. Thank you so much for joining me today.

Dr. Molly Parker:
Thank you.
Melissa Urban:
Thanks for joining me today on Do The Thing. You can continue the conversation with me @MelissaU on Instagram. If you have a question for Dear Melissa or a topic idea for the show, leave me a voicemail at 321-209-1480. Do The Thing is part of The Onward Project, a family of podcasts brought together by Gretchen Rubin all about how to make your life better. Check out the other Onward Project podcasts, Happier with Gretchen Rubin, Side hustle School, Happier in Hollywood and Everything Happens. If you liked this episode, please subscribe, leave a five star review, and tell your friends to Do The Thing. See you next week.
Speaker 1:
From The Onward Project.

PART 4 OF 4 ENDS [00:41:59]


Thanks for listening!

Continue the conversation with me @melissau on Instagram. If you have a question for Dear Melissa or a topic idea for the show, leave me a voicemail at (321) 209-1480.

Do the Thing is part of The Onward Project, a family of podcasts brought together by Gretchen Rubin—all about how to make your life better. Check out the other Onward Project podcasts– Happier with Gretchen RubinSide Hustle SchoolHappier in Hollywood, and Everything Happens.

If you liked this episode, please subscribe, leave a 5-star review, and tell your friends to Do the Thing.