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How fast the brain recover itself at sleep? What can be done to accelerate this process?

How fast the brain recover itself at sleep? What can be done to accelerate this process?


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In Computer Science we have "Big O Notation" to describe how efficient is an algorithm at processing some task. Those can be linear, time constant, exponential among others.

Using that analogy, How much time the brain needs at sleep to recover itself from an intensive day at work/over stimulation/training/learning/etc?

After it reach it's "specific time", I know that we dream, and that can take very few minutes. Last night I've dreamt of hardest college exams, even done my last one in 2011. So, dreaming time is a period where the brain clean itself from toxins? I've waked up early, so I should have "dreamed a litle bit more" to recover, or the dream it's just the output imaging of the brain recovery process?

What can I do to recover faster? Things like dimmer and silent ambient help better than the total time slept? How they affect and interrelate? If you can provide technical and scientific papers, it will help a lot!

Thanks a lot for your time and patience!

Edit: "Typed Bio O instead of Big O".


You should see some talks from TED about deep sleep.

One researcher summarized that adults generally need 8 hours every night to be at optimum strength. What is most important though is the Delta-wave sleep that occurs during very deep sleep. To accelerate the process: It's pretty fringe research, what he said is early days… Alledgedly, playing a certain kind of noise triggered near the delta wave phase promotes Delta wave activity in the brain as measured with electrodes. it's essentially slow delta-synchronised seashore kinds of of grey noise played in sleep at the right moment. He said they were working on a device for it.

here's the talk. https://www.ted.com/talks/dan_gartenberg_the_brain_benefits_of_deep_sleep_and_how_to_get_more_of_it

My own method to have amazing sleep is lots of nights at my girlfriends and to change mattress every few days mat my house, because my unconscious breathing is forced to exercise different muscles of the chest based on whether I am on a swimming pool matress, a futon, a cozy matress, covers similar to sleeping on a lawn. Physiology and muscles benefit from varied exercise, including the 8 hours of chest muscles during sleep. another matress for example I feel all the breathing in the lower belly. I just got out a pool matress for the last 2 nights on boards and rugs, and I dreamed that I was flying around the mountains and cities for about 3 hours and that other people were flying too, which is always nice. I swear I was sleeping a bit rough 3 days earlier on a normal mattres. other factor for me optimum warmth and lots of water for me:) i'm weird though because I had liver damage from a pesticide and following doctor care when I was 18 and I need drink more and sleep hot in order to sleep well.


What Happens in Your Body and Brain While You Sleep

You might think of sleep as the negative time in your day when nothing on your to-do list gets done. Your brain and several other systems in your body see it quite differently.

“Your brain is actually very active during sleep doing important things — it’s not just resting,” says Carl W. Bazil, MD, PhD, the Caitlin Tynan Doyle Profesor of Neurology at Columbia University Medical Center. “And if you don’t get sleep you don’t function on a number of levels the way you should.”

(Everything from learning to your mood to your risk of getting sick and becoming obese can get thrown off kilter.)

Related

Sleep Rx A Guide to BETTER Sleep

Physiologically sleep is defined as a state our bodies enter into during which brain wave activity changes and our nervous system is less reactive to external stimuli (i.e. we temporarily leave consciousness). But our sleep is not constant throughout the night. We actually cycle through four distinct sleep phases multiple times (five if you count “awake” as one stage), Bazil, who is also Director of the Division of Epilespy and Sleep at Columbia University College of Physicians and Surgeons, tells NBC News BETTER.

There are two stages of light sleep. The lightest is the stage of sleep you’re likely in if you nod off during a lecture when consciousness is decreased, but the brain is still processing some information around you (sometimes hearing your name or another stimulus will jolt you awake). Intermediate light sleep is slightly deeper, which is harder to awaken from, Bazil explains.

Your brain is actually very active during sleep doing important things — it’s not just resting.

Deep slow-wave sleep is the next stage of sleep. This is the deepest, most restful, and most restorative stage of sleep, when it’s hardest to awaken. If you do get woken up during this stage of sleep you’re likely to feel groggy. And finally, there’s REM sleep (short for “rapid eye movement sleep”), which is when we dream. Our bodies tend to spend more time in restful slow wave sleep earlier in the night when our bodies and minds are most tired. Later in the night we tend to spend more time in REM sleep.


How to Boost Brain Cell Regeneration

Your brain can make thousands of new neurons every day and maintains this ability well into old age. (2)

By the time you turn 50, you will have replaced all the original neurons in your hippocampus, your brain’s “memory center,” with new neurons! (3)

Initially, adult neurogenesis was found to occur in only two regions of the brain: the hippocampus and the striatum. (4, 5, 6)

But now there’s evidence that new brain cells can also grow in the amygdala, the hypothalamus, the olfactory bulb, and possibly the cerebral cortex. (7, 8)

It seems likely that neurogenesis will be found in other areas of the brain as research continues.

A number of major neurotransmitters are involved in adult neurogenesis, including serotonin, dopamine, GABA, and glutamate. (9)

But the two most important brain chemicals for promoting the formation of new brain cells are brain-derived neurotrophic factor and nerve growth factor (NGF).

Brain-derived neurotrophic factor (BDNF) is one of the most active substances involved in neurogenesis.

It has been called “Miracle-Gro” for the brain because it helps your brain grow and flourish.

It encourages the growth of new brain cells and helps to keep existing brain cells healthy via a variety of mechanisms. (10, 11)

BDNF increases brain plasticity, suppresses damaging brain inflammation, offsets the negative effects of stress on the brain, and protects the brain against degenerative diseases. (12, 13, 14, 15)

Nerve growth factor (NGF) was the first growth factor to be discovered. (16)

NGF heals and protects your nerve cells, and stimulates the growth of new ones in both the brain and the nervous system.

A quality brain supplement can make a big difference.

Dr. Pat | Be Brain Fit


What Causes Encephalopathy?

Encephalopathy is a term that means brain disease, damage, or malfunction. Encephalopathy can present a very broad spectrum of symptoms that range from mild, such as some memory loss or subtle personality changes, to severe, such as dementia, seizures, coma, or death. In general, encephalopathy is manifested by an altered mental state that is sometimes accompanied by physical manifestations (for example, poor coordination of limb movements).

The term encephalopathy, in most cases, is preceded by various terms that describe the reason, cause, or special conditions of the patient that leads to brain malfunction. For example, anoxic encephalopathy means brain damage due to lack of oxygen, and hepatic encephalopathy means brain malfunction due to liver disease. Additionally, some other terms either describe body conditions or syndromes that lead to a specific set of brain malfunctions. Examples of these are metabolic encephalopathy and Wernicke's encephalopathy (Wernicke's syndrome). There are over 150 different terms that modify or precede "encephalopathy" in the medical literature the purpose of this article is to introduce the reader to the main categories of conditions that fall under the broad term of encephalopathy.

What Is Hepatic Encephalopathy?

Symptoms of early-stage HE can be hard to spot but may include:

  • Small changes in personality
  • The trouble with multi-step thinking
  • Slightly shorter attention span
  • Delayed reaction time
  • Sleeping a lot or trouble sleeping
  • Depression
  • Irritability

What causes encephalopathy?

The causes of encephalopathy are both numerous and varied.

Some examples of causes of encephalopathy include:

  1. infectious (bacteria, viruses, parasites, or prions),
  2. anoxic (lack of oxygen to the brain, including traumatic causes),
  3. alcoholic (alcohol toxicity),
  4. hepatic (for example, liver failure or liver cancer),
  5. uremic (renal or kidney failure),
  6. metabolic diseases (hyper- or hypocalcemia, hypo- or hypernatremia, or hypo- or hyperglycemic), ,
  7. many types of toxic chemicals (mercury, lead, or ammonia),
  8. alterations in pressure within the brain (often from bleeding, tumors, or abscesses), and
  9. poor nutrition (inadequate vitamin B1 intake or alcohol withdrawal).

These examples do not cover all of the potential causes of encephalopathy but are listed to demonstrate the wide range of causes.

Although numerous causes of encephalopathy are known, the majority of cases arise from several major categories (some examples in parentheses):

  1. infection (HIV, Neisseria meningitides, herpes, and hepatitis B and hepatitis C),
  2. liver damage (alcohol and toxins),
  3. brain anoxia or brain cell destruction (including trauma), and
  4. kidney failure (uremic).

Some drugs may cause encephalopathy for example, posterior reversible encephalopathy syndrome (PRES) may occur due to the use of drugs like tacrolimus and cyclosporine. This syndrome manifests with symptoms of headache, confusion, and seizures.

QUESTION

What are the symptoms of encephalopathy?

Despite the numerous and varied causes of encephalopathy, at least one symptom present in all cases is an altered mental state. The altered mental state may be subtle and develop slowly over years (for example, in hepatitis the decreased ability to draw simple designs, termed apraxia) or be profoundly obvious and develop rapidly (for example, brain anoxia leading to coma or death in a few minutes). Often, symptoms of altered mental status can present as inattentiveness, poor judgment, or poor coordination of movements.

Other serious symptoms that may occur include:

  • lethargy, ,
  • seizures, ,
  • muscle twitching and myalgia,
  • Cheyne-Stokes respiration (an altered breathing pattern seen with brain damage and coma), and
  • coma.

Often the severity and type of symptoms are related to the severity and cause of the brain disease or damage. For example, alcohol-induced liver damage (alcoholic cirrhosis) can result in involuntary hand tremors (asterixis), while severe anoxia (lack of oxygen) may result in a coma with no movement. Other symptoms may not be as severe and maybe more localized such as cranial nerve palsies (damage to one of the 12 cranial nerves that exit the brain). Some symptoms may be very subtle and result from repeated injury to the brain tissue. For example, chronic traumatic encephalopathy (CTE), due to injuries like concussions repeatedly sustained by football players and others who play contact sports, may cause slow changes over time that are not easily diagnosed. Such injury may lead to chronic depression or other personality changes that can result in life-changing consequences.

Even infants and children can suffer encephalopathy. Similar symptoms can occur in the perinatal period if the neonate had any compromise to brain blood flow during its development. Rasmussen's encephalitis is a rare disease that is seen in children that progresses to intractable seizures if untreated. It may be due to autoantibody development. Another rare form of encephalopathy that usually develops in younger people (about ages 4 to 20 years) is the MELAS syndrome ("Mitochondrial Encephalopathy, Lactic Acidosis, Stroke-like episodes") due to faulty DNA in the patient's mitochondria (a tiny part within the cell that is responsible for energy conversion).


Are We “Brain Washed” during Sleep?

New research from Boston University suggests that tonight while you sleep, something amazing will happen within your brain. Your neurons will go quiet. A few seconds later, blood will flow out of your head. Then, a watery liquid called cerebrospinal fluid (CSF) will flow in, washing through your brain in rhythmic, pulsing waves.

The study, published on October 31 in Science, is the first to illustrate that the brain’s CSF pulses during sleep, and that these motions are closely tied with brain wave activity and blood flow.

“We’ve known for a while that there are these electrical waves of activity in the neurons,” says study coauthor Laura Lewis, a BU College of Engineering assistant professor of biomedical engineering and a Center for Systems Neuroscience faculty member. “But before now, we didn’t realize that there are actually waves in the CSF, too.”

This research may also be the first-ever study to take images of CSF during sleep. And Lewis hopes that it will one day lead to insights about a variety of neurological and psychological disorders that are frequently associated with disrupted sleep patterns, including autism and Alzheimer’s disease.

The coupling of brain waves with the flow of blood and CSF could provide insights about normal age-related impairments as well. Earlier studies have suggested that CSF flow and slow wave activity both help flush toxic, memory-impairing proteins from the brain. As people age, their brains often generate fewer slow waves. In turn, this could affect the blood flow in the brain and reduce the pulsing of CSF during sleep, leading to a buildup of toxic proteins and a decline in memory abilities. Although researchers have tended to evaluate these processes separately, it now appears that they are very closely linked.

To further explore how aging might affect sleep’s flow of blood and CSF in the brain, Lewis and her team plan to recruit older adults for their next study, as the 13 subjects in the current study were all between the ages of 23 and 33. Lewis says they also hope to come up with a more sleep-conducive method of imaging CSF. Wearing EEG caps to measure their brain waves, these initial 13 subjects were tasked with dozing off inside an extremely noisy MRI machine, which, as anyone who has had an MRI can imagine, is no easy feat.

“We have so many people who are really excited to participate because they want to get paid to sleep,” Lewis says with a laugh. “But it turns out that their job is actually—secretly—almost the hardest part of our study. We have all this fancy equipment and complicated technologies, and often a big problem is that people can’t fall asleep because they’re in a really loud metal tube, and it’s just a weird environment.”

But for now, she is glad to have the opportunity to take images of CSF at all. One of the most fascinating yields of this research, she says, is that they can tell if a person is sleeping simply by examining a little bit of CSF on a brain scan.

“It’s such a dramatic effect,” she says. CSF pulsing during sleep “was something we didn’t know happened at all, and now we can just glance at one brain region and immediately have a readout of the brain state someone’s in.”

As their research continues to move forward, Lewis’ team has another puzzle they want to solve: how exactly are our brain waves, blood flow, and CSF coordinating so perfectly with one another? “We do see that the neural change always seems to happen first, and then it’s followed by a flow of blood out of the head, and then a wave of CSF into the head,” Lewis says.

One explanation may be that when the neurons shut off, they don’t require as much oxygen, so blood leaves the area. As the blood leaves, pressure in the brain drops, and CSF quickly flows in to maintain pressure at a safe level.

“But that’s just one possibility,” says Lewis. “What are the causal links? Is one of these processes causing the others? Or is there some hidden force that is driving all of them?”

This work was funded by the National Institutes of Health and the Martinos Center for Biomedical Imaging.


Super Healing

by Julie K. Silver, M.D., November & December 2008 | Comments: 0

In the fall of 2006, Arlene and David Rubin were flying home to Boston after a vacation in northern California wine country. But somewhere over the Midwest, Arlene looked up from her magazine and got the shock of her life. Her 80-year-old husband’s eyes were rolling around in his head, his skin was purple, and his tongue was blue.

“I’ve never seen anyone that color before. It was very scary,” Arlene recalls. “I yelled, ‘David, David, David!’ but he didn’t answer. Then I yelled, ‘Help!’ and the flight attendant told me, ‘Get out of the way!’”

David’s heart had stopped completely. But three strangers were determined to save his life. A doctor and a nurse who were passengers worked side by side with a flight attendant trained to use an automated external defibrillator. The pilot made an emergency landing in Milwaukee, where David underwent open-heart surgery.

Today David has returned to his work as a highly successful Boston real-estate developer. Remarkably, he was able not only to survive that life-threatening episode but, just as important, to heal from it and regain his strength.

How did he do it? His body’s natural healing processes did most of the work. Each of us possesses a surprising capacity to bounce back from illness and injury, under the right conditions. But David also took specific steps to help the process along. These steps—suggested by scientific research—can help anyone weakened by trauma or disease to find the strength to heal.

Healing is my specialty. I’m a physiatrist, a doctor in the field of physical medicine and rehabilitation. The first physiatrists helped injured World War II soldiers. Modern-day physiatrists treat people with a variety of serious illnesses and injuries, including strokes, spinal cord injuries, and lower-back problems. Two words summarize what we do: we help people to “physically recover.” (The American Academy of Physical Medicine and Rehabilitation makes it easy for people to find physiatrists by providing a map on its website, www.aapmr.org. When you click on your state, you will see a list of doctors to choose from.)

Your body will work hard on its own to help you recover—even if you do little to help the process along. Thousands of chemical and biological reactions occur throughout the day and night to help you to heal. When you’re injured, white blood cells called neutrophils rush to the site, to ward off infection. Other blood cells called monocytes transform themselves into scavengers (macrophages), to engulf and devour dead tissue and help to control inflammation. If you break a bone, bone cells called osteoblasts kick into action to knit the rough edges back together. And cell damage caused by illness—or by harsh therapies, in the case of cancer, hepatitis, and other diseases—gets mended by the same hordes of microscopic miracle workers. There are so many cells assisting us in healing that we could never count them all.

But even though these processes are involuntary and automatic, there are things smart patients can do to speed and strengthen their recovery. The best healing occurs when you are able to optimize your immune system to avoid infections encourage the healing of skin, bones, muscles, nerves, and tendons and build strength and endurance.

In my practice, I have developed an eight-part strategy to put patients on the path to optimal healing. And at the heart of this strategy are three fundamentals: how you eat, how you sleep, and how you move.

We physiatrists have a saying: “Good health is a temporary condition.” So I fully expected to face serious illness myself at some point. But that didn’t make things much easier when, at age 38, my time came. I vividly recall the day the surgeon came into the exam room with tears in her eyes. I wanted her to say what other doctors had told me in the past: “Go home you’re fine.” Instead, she softly said, “You have breast cancer.”

I can still feel the overwhelming sadness and pure heartache of that day. Every time I looked at my children, I wondered how many weeks, months, or years I’d be able to see their faces.

The surgery and chemotherapy were grueling, as I knew they would be. I also knew that the end of treatment would be only the beginning of getting well. I had helped many people with all kinds of illnesses heal now I needed to help myself.

Like most people struggling with serious illness, I lost my appetite, slept fitfully, and became less physically active. From a human standpoint, this was perfectly understandable. But from the standpoint of a body trying to heal, it was a disaster.

Skipping meals saves time in the short run. But in the long run, it can delay healing and hinder your return to health.

I call inadequate nutrition, lousy sleep patterns, and physical deconditioning the Triple Threat to optimal healing. These three factors affect almost everyone who has had a serious injury or illness—including chronic-pain conditions such as arthritis or fibromyalgia—and they work synergistically to interfere with your body’s natural healing processes, creating an environment for mediocre healing at best and unnecessary disability at worst.

I knew the Triple Threat was keeping me from healing optimally, and I needed a plan to combat it. The answer seemed simple: eat better, sleep better, and exercise. But these goals don’t seem so simple when you’re weakened, depressed, and isolated by the million worries on your mind. For me, the trick came from having learned not only what to do but why and how it all works to accelerate healing in the body. When I acted on this knowledge, I got results, and I know you can, too.

STEP ONE: DON'T NEGLECT NUTRITION

We often read about how to eat to avoid disease. But once you get sick, there are also foods that will help you get better. For example, skin and bones need vitamin A to repair themselves. Vitamin C is crucial to the formation of collagen, the main protein of our connective tissue. Bromelain, a mixture of enzymes found in fresh pineapple, reduces swelling, bruising, and pain, and it improves healing time following trauma or surgery. And adequate protein is absolutely essential for optimal healing.

When people are healthy, they often get away with bad dietary habits. Skipping breakfast and using coffee as a pick-me-up might have worked fine for you in the past. But if you are ill or injured, these timesavers will actually cost you time, because your recovery won’t go as quickly as it might otherwise.

I tell my patients to eat five times a day: three small- to medium-size meals and two nutritious snacks. This helps prevent severe drops in blood sugar levels that can leave you fatigued. A registered dietitian can be helpful for patients who need to gain or lose weight, or who have other specific needs.

So what are the best eating habits for optimal healing? Some will sound familiar, while others may surprise you.

Carbohydrates These compounds provide ready energy, and they are crucial to a healing diet. All carbohydrates are broken down into sugar when digested, but complex carbohydrates such as nuts, seeds, legumes, and whole grains break down more slowly than simple carbohydrates such as sugar and white bread. The slower a carb breaks down, the less likely it is to cause a blood sugar spike. Since these spikes can spark inflammation and lead to damage on a cellular level, you should avoid them always, but especially when you’re healing. A measure called the glycemic index indicates how fast the body converts a food into sugar. As much as possible, stick with complex carbohydrates and other foods that have a relatively low glycemic index (below 55). One reliable source of this information is www.glycemicindex.com.

Protein The building block of cell repair, protein gives you energy, as well. Generally, it’s a good idea to get about 15 to 20 percent of your calories from protein, though some conditions, such as burn recovery, may require more. If your body has undergone extensive cellular injury, talk to your doctor about what your protein needs are. Plant-based proteins such as beans and nuts have some advantages over animal proteins, especially if you don’t have much of an appetite. In addition to having cell-repairing properties, plant-based proteins provide phytochemicals (which can help with healing) and fiber.

Fruits and Vegetables Eating at least five servings each day of fruits and vegetables is one of the best things you can do for your body. A colorful array of fruits and vegetables provides a remarkable assortment of healing nutrients, including high amounts of vitamins and minerals that can promote physical recovery. Vitamin C, for instance, helps heal wounds, strengthen blood vessels, and ward off infection. Lycopenes—particularly powerful antioxidants that can boost immune function—are plentiful in tomatoes, apricots, guavas, watermelon, papayas, and pink grapefruit. As a general rule, dark-colored fruits and vegetables are richer than light-colored ones when it comes to phytochemicals and antioxidants.

Supplements While your doctor can best advise you on which supplements you may need, food is usually the best source for healing nutrients. We know that fruits and vegetables are extremely important in helping to prevent particular kinds of cancer, but we aren’t certain which ingredients are the most important. In addition, there is some evidence to suggest that taking too many antioxidant supplements (such as vitamins C and E) might actually depress rather than enhance your immune system. And while zinc, among other minerals, is critical to wound healing, taking too much of it can inhibit recovery and even lead to a copper deficiency. Foods such as beef, peanuts, and lentils are rich in zinc, and they’re the best way to get it.

The one supplement I routinely recommend is a multivitamin. This is a good idea even for healthy people, since it’s nearly impossible to eat a perfectly balanced diet every day. Consider taking a multivitamin that provides 100 percent of the Recommended Dietary Allowances (RDA) for essential nutrients established by the U.S. Food and Nutrition Board of the National Academies/Institute of Medicine, and ask your doctor whether you need calcium and vitamin D supplements, too.

STEP TWO: MAKE SLEEP A PRIORITY

If you’re like most people, you need seven to eight hours of sleep each night. During an illness you may need more rest than that, because some of your body’s healing processes require sleep to work. For example, the hormone melatonin is produced during sleep. This hormone is believed to boost your immune system and to help repair corrupted DNA. It may even play a role in preventing some forms of cancer. But if you’re tossing and turning at night, your melatonin levels can be diminished.

After David Rubin’s heart stopped on the airplane and he underwent surgery, he spent many weeks trying to get his sleep back to normal. In fact, up to seven out of every ten people who undergo heart surgery sleep poorly during the recovery period. This problem is of special concern because it can lead to rises in heart rate and blood pressure, both of which can cause unnecessary strain on the heart and put it at risk for further injury.

But if you’re ill and missing sleep because of discomfort, worry, or medications, the last thing you need is the added worry that sleeplessness is harming your recovery. That’s why it’s important to tackle the causes of your sleeplessness calmly and systematically. I have my patients write down how much sleep they are getting each night and what is interfering with it. Some causes might be pain, anxiety, hot flashes, or waking to use the bathroom. Then, one by one, we tackle these problems.

For example, Karen Horowitz, 55, a planned-giving officer with the American Cancer Society, couldn’t sleep during her breast cancer treatment for two reasons: shoulder pain due to complications from her mastectomy, and hot flashes. She was constantly tired and frustrated. It took only a few weeks of physical therapy for her shoulder, and a prescription medication for her hot flashes, to get Karen sleeping through the night. In David’s case, cutting back on coffee and alcohol—which can interfere with restful sleep—made a big difference. If you decide to take an over-the-counter sleep aid, be sure to tell your doctor, because these interact with many prescription drugs.

STEP THREE: GET YOURSELF MOVING

It may seem inconsistent to say that people who desperately need rest also desperately need to move their bodies around, but it’s the truth. If the benefits of exercise could be packaged as a pill, it would be the most popular prescription drug available.

Physical activity has a positive effect on what is called hemostasis: how the chemicals in the blood interrelate and work together. Exercise also improves the healing of muscles, bones, tendons, and ligaments. For example, it spurs the formation of collagen, helping injured tissues heal properly. In addition, it appears to decrease the formation of excessive scar tissue, called fibrosis. Exercise helps us heal better.

Exercise also helps us to heal faster. A 2005 study at Ohio State University in Columbus followed a group of people 55 and older for three months. Each was given a small wound—the kind you’d get from having a mole removed. Then half of the participants were put into an aerobic-exercise program. The results were significant. The average number of days it took the exercisers’ wounds to heal was 29. Among nonexercisers, the average was 39 days.

A soldier I know named Charley, who asked that his last name be withheld, knows just how important exercise is in healing. In May 2007 he went for his annual physical. As a very fit 50-year-old, he was expecting a clean bill of health. Instead, he was diagnosed with prostate cancer. Following multiple surgeries, Charley was having difficulty controlling his bladder and was physically quite weak. He began to get stronger first by walking and then by light jogging. “The first time I ran up the mountain that I lived on, I could only run a block,” he recalls. He would run as far as he could, then walk until he caught his breath. “After about four attempts in the following week or so, I was able to return to my three-mile route,” he says. “It wasn’t good form, but I did it—and recovered in the shower.” Within six months he was back to his usual regimen of running, sit-ups, and pull-ups, and strong enough to accept a one-year assignment to Afghanistan.

There are many ways to begin exercising after an illness or an injury, and it is always a good idea to check with your physician about this. But most people can do what Charley did and begin with walking. A fun and helpful strategy is to buy a pedometer (you can get one for less than ten dollars) and, for one week, tally the number of steps you take each day. The goal for active, healthy adults is 10,000 steps per day. My goal for my patients is simply to increase their level of activity gradually. Keep a log, and each week try to increase the number of steps you take by 500 per day (with your doctor’s permission).

If you have a medical condition such as arthritis, you can still exercise without hurting yourself. For instance, nonweight-bearing cardiovascular exercises such as swimming help to avoid stress on the joints.
You can strengthen the muscles around painful joints with isometric exercises that involve tightening and releasing muscles. Or you can try exercises such as leg lifts, which don’t stress the joints. If you aren’t sure how to start exercising, ask your doctor about seeing a physical therapist. Most health insurance plans will cover physical therapy that focuses on helping people recover.

You can strengthen the muscles around painful joints with isometric exercises that involve tightening and releasing muscles. Or you can try exercises such as leg lifts, which don’t stress the joints. If you aren’t sure how to start exercising, ask your doctor about seeing a physical therapist. Most health insurance plans will cover physical therapy that focuses on helping people recover.

Illness is an unavoidable part of life, but your body wants to heal. And you can help it do that, despite the obstacles. I learned a lot about what it takes to heal from my own recovery journey. I learned to be patient. I learned to measure progress in weeks or months rather than days. And most of all, I learned to have faith in my body’s ability to recover.

I also witnessed this quality in my patient Liz Frem. Having suffered a devastating stroke at 57, Liz came to see me for a consultation. She didn’t believe what her doctors seemed to believe: that her weakness, balance problems, and headaches were with her for good. Though it had been more than a year since her stroke—usually considered the time limit for neurologic recovery—Liz was determined to get her life back. And that she has. With a program that includes an exercise routine involving weightlifting, golf, and Wii Fit games, Liz has improved every year. She’s now a vibrant 61 and volunteers as a golf referee.

Serious illness and injury can force people to accept a “new normal.” But many people experience more pain, fatigue, and disability than they have to. In short, they accept a “new normal” too soon. If you’ve been ill or injured or you are living with a chronic medical condition, aim for maximum healing—and don’t stop until you achieve it.

Julie K. Silver, M.D., assistant professor at Harvard Medical School, has written several books on health. This essay is adapted from Super Healing (Rodale, 2007).

Putting Your Mind to It

Mental strategies that can boost your potential to heal

The body’s healing process isn’t entirely physical. Along with eating right, sleeping well, and exercising, the five mental and emotional tactics below comprise an eight-point plan for maximizing your powers of recuperation.

Reduce Your Pain Though pain may be a normal part of many conditions, it can interfere with healing by interfering with sleep or causing needless, recovery-delaying stress. If you are in pain, don’t be a hero: talk to your doctor and get some relief.

Consider Mind-Body Therapies Meditation, guided imagery, and progressive muscle relaxation are all risk-free treatments that can reduce stress hormones and strengthen the immune system.

Monitor Your Mood It’s impossible to be in a good mood every day, even when you’re well. But how you feel emotionally will have an effect on how you physically heal, so it’s important not to give depression or anxiety the upper hand. In one 1998 study of dental students at Ohio State University in Columbus, small wounds that researchers created before a big exam took 40 percent longer to heal than identical wounds created during summer vacation. Each day plan activities that make you feel good, such as calling a cherished friend or drawing a bubble bath. If you find that you are down in the dumps or anxious day after day, seek professional help.

Surround Yourself with Love When you’re ill, it’s easy to withdraw. But people who care about you can help your physical healing with their support. In a study published in 2005 in the Archives of General Psychiatry, researchers found that when wounds of the same shape, size, and depth were experimentally induced in couples, healing was much faster if the couples were loving toward each other rather than hostile. So, if you are ill or injured, embrace those who reach out to you. And if you find yourself alone, seek out shoulders to lean on, whether of friends, relatives, colleagues, or a formal support group.


Mental Illness in the Population 2

Many people feel that mental illness is rare, something that only happens to people with life situations very different from their own, and that it will never affect them. Studies of the epidemiology of mental illness indicate that this belief is far from accurate. In fact, the surgeon general reports that mental illnesses are so common that few U.S. families are untouched by them. 44

Few U.S. families are untouched by mental illness.

Mental Illness in Adults

Figure 1

Scientists estimate that one of every four people is affected by mental illness either directly or indirectly.

Even if you or a family member has not experienced mental illness directly, it is very likely that you have known someone who has. Estimates are that at least one in four people is affected by mental illness either directly or indirectly. Consider the following statistics to get an idea of just how widespread the effects of mental illness are in society: 4, 25, 44

Mental Illness in Children and Adolescents

Mental illness is not uncommon among children and adolescents. Approximately 12 million children under the age of 18 have mental disorders. 4 The National Mental Health Association 33 has compiled some statistics about mental illness in children and adolescents:


Introduction

The recovery of neurocognitive function after brain network perturbations such as sleep, general anesthesia, or disorders of consciousness is of both scientific and clinical importance. Scientifically, characterizing recovery processes after such perturbations might provide insight into the more general mechanisms by which consciousness and cognition are reconstituted after major network disruptions. The ability to recover cognitive function quickly after sleep, for example, likely confers a natural selection advantage. Moreover, understanding which brain functions are most resilient to perturbation could inform evolutionary neurobiology (Mashour and Alkire, 2013 Kelz and Mashour, 2019). Clinically, understanding the specific recovery patterns after pathologic states of unconsciousness could inform prognosis or therapeutic strategies. However, it is challenging to characterize differential cognitive recovery after sleep because of the rapidity of the process, whereas it can be impossible in pathologic states because of the unpredictable recovery. General anesthesia, by contrast, represents a controlled and reproducible method by which to perturb consciousness and cognition that is also amenable to systematic observations of the recovery process. Studying recovery of cognition after general anesthesia in humans is also of particular importance because animal studies suggest that general anesthetics have the potential to immediately and persistently impair cognition in the post-anesthetic period (Culley et al., 2004 Valentim et al., 2008 Carr et al., 2011 Callaway et al., 2012 Zurek et al., 2012 Jevtovic-Todorovic et al., 2013 Zurek et al., 2014 Avidan and Evers, 2016 Jiang et al., 2017), creating a potential public health concern for the hundreds of millions of surgical patients undergoing general anesthesia each year (Weiser et al., 2015).

To improve scientific understanding of recovery of consciousness and cognition after anesthetic-induced unconsciousness, we studied 30 healthy volunteers at three centers who were administered deep general anesthesia using isoflurane for 3 hr, with cognitive testing conducted at pre-anesthetic baseline as well as every 30 min for 3 hr after return of consciousness (Figure 1). We hypothesized that post-anesthetic recovery would be an extended process rather than a single point, commencing with return of responsiveness and concluding with return of executive function. We hypothesized that executive function would be the last to recover because there is evidence that neurologic recovery from general anesthesia occurs in a caudal-to-rostral direction (Långsjö et al., 2012 Reshef et al., 2019), suggesting that anterior structures mediating higher cognition would have the most prolonged recovery. To assess differential return of cognitive functions after the major perturbation of deep anesthesia, we assessed a neurocognitive battery of tests (including the Psychomotor Vigilance Test (PVT), Motor Praxis (MP), Digit Symbol Substitution Test (DSST), fractal 2-Back (NBCK), Visual Object Learning Test (VOLT), and Abstract Matching (AM) Table 1) at baseline and at multiple time points after the 3-hr period of anesthetic exposure. Isoflurane anesthesia was chosen because of its heterogeneous molecular targets, which affect multiple neural systems, and because its slower offset compared to other anesthetics would allow us to observe differential recovery of function (Hemmings et al., 2019). A halogenated ether was chosen instead of propofol because of the greater diversity of molecular targets, which would be predicted to have a more profound effect on neural dynamics through multiple neurotransmitter receptor and channel systems. Clinical observations as well as clinical research comparing recovery from isoflurane vs. propofol support this interpretation (Pollard et al., 1994 Geng et al., 2017). The 3-hr duration of anesthesia was chosen based on clinical data related to recovery of surgical patients, the pharmacokinetics of isoflurane, and practical considerations for volunteers participating in day-long experiments.

Neurocognitive battery, associated cognitive domains, and neuroanatomy.
TestCognitive domains assessedBrain regions primarily recruited
Motor PraxisSensorimotor speedSensorimotor cortex
Visual Object LearningSpatial learning and memoryMedial temporal cortex, hippocampus
Fractal 2-BackWorking memoryDorsolateral prefrontal cortex, cingulate, hippocampus
Abstract MatchingAbstraction, concept formationPrefrontal cortex
Digit Symbol SubstitutionComplex scanning and visual tracking, working memoryTemporal cortex, prefrontal cortex, motor cortex
Psychomotor VigilanceVigilant attentionPrefrontal cortex, motor cortex, inferior parietal and some visual cortex

Experimental design.

Participants were randomized to one of two groups for investigating recovery of consciousness and cognition after general anesthesia. Sleep-wake actigraphy data were acquired in the week leading up to the day of the experiment, which started with baseline cognitive testing followed by either a period of general anesthesia (1.3 age-adjusted minimum alveolar concentration of isoflurane) or wakefulness. Upon recovery of consciousness (or similar time point for controls), recurrent cognitive testing was performed for 3 hr. Actigraphy resumed for 3 days after the experiment.

To control for the learning effects of repeated cognitive testing (Basner et al., 2018), we also recruited 30 healthy volunteers who, instead of receiving anesthesia, were engaged in wakeful behavior for 3 hr and then underwent equivalent cognitive testing at time points corresponding to the cohort that underwent general anesthesia (Figure 1). All participants received actigraphy watches to monitor sleep-wake activity before and after anesthesia or the control condition, and all participants had electroencephalographic recording throughout the experiment to assess cortical dynamics of relevance to consciousness and cognition, with techniques that have been used to assess information processing in specific brain regions (permutation entropy) as well as more complex spatiotemporal patterns across the cortex (Lempel-Ziv complexity). With the control group serving as a reference, the aims of the study were: (1) to determine whether emergence and cognitive recovery occurred at a point or, as we hypothesized, through a process (2) assess the sequence of cognitive recovery following emergence from a prolonged state of unconsciousness with serial neurobehavioral assessments to test the hypothesis that higher executive functions reconstitute only after more primary functions and (3) to measure correlated changes in cortical dynamics that might account for the hypothesized differential recovery of cognitive function.


Stuck in Negative Thinking? It Could Be Your Brain

When we feel depressed, we are more likely to get stuck in cycles of repetitive ruminative thoughts that have a negative emotional tone. We may regret the past, judge ourselves as unworthy or unlovable, blame others for our problems, or anticipate a bleak future. These ruminative cycles exacerbate feelings of sadness, shame or anger, and interfere with motivation to try to move on or actively solve problems. Depressive thought cycles like these seem to be entrenched, and are very difficult to break, even when we try to use logic to refute the negative thinking. Ruminative thinking makes depression worse and is even a predictor of subsequent depression in non-depressed people and of relapse in previously depressed people.

What Brain Processes Underly Depressive Rumination?

Recently, scientists at Stanford University have begun to uncover what might be going on in our brains during depressive rumination. A July 2015 study, “Depressive Rumination, the Default-Mode Network, and the Dark Matter of Clinical Neuroscience,” authored by J. Paul Hamilton and colleagues was published in the journal Biological Psychiatry. This study statistically combined several previous research studies using meta-analytic tools and came to the conclusion that depressed people had increased functional brain connections between two different brain areas:

The DMN is a part of the brain that is active when we self-reflect, worry, daydream, or reminisce. It has been described as facilitating a wakeful state of rest in which the mind naturally wanders. The DMN refers to a network of interacting brain regions including the posterior cingulate cortex (PCC), anterior cingulate cortex (ACC), and ventral prefrontal cortex (PFC).

The subgenual PFC helps to direct the DMN towards reflecting on and trying to solve the problems which the brain considers most pressing or important for survival. This process can be functional if such reflection actually leads to finding new answers or taking effective action.

In depression, the subgenual PFC seems to go haywire, hijacking normal self-reflection into a state of mind that is negative, self-focused, and withdrawn. In this state of mind, we continually reflect on our problems in a repetitive, negatively-toned way, but are de-motivated to actually engage with the world so as to solve those problems. Depressed people tend to go on and on talking about themselves and their problems, yet seem mentally stuck and unable to move forward. The fact that they can’t just “snap out of it” is consistent with the idea that a dysfunctional brain network may be involved in depressive thinking.

What You Can Do to Combat Depressive, Ruminative Thinking

Try Transcranial Magnetic Imagining

Some preliminary research shows that this intervention may change abnormal functional connectivity within the DMN.

Deliberately Focus on a Task

It doesn’t matter whether it’s tidying your closets, doing the laundry, or doing a crossword puzzle, getting an “on-task” focus can de-activate the DMN and instead activate the “on-task” areas of the brain.

Take a Walk in Nature

A 2015 study by Bratman and colleagues from Stanford University, published in the journal Proceedings of the National Academy of Science found that for healthy participants, a 90-minute walk in a natural setting, decreased both ruminative thinking and neural activity in the subgenual prefrontal cortex whereas a 90-minute walk in an urban setting had no such effects on either rumination or neural activity. In other words, walking in a natural environment seems to open up your thinking in a way that lessens the grip of the faulty brain network.

Focus on Your Senses

Deliberately focusing your attention on what you are seeing, hearing, feeling, sensing, or smelling right now, can help your brain get out of an automatic mind-wandering state and de-activate the DMN. Instead, you focus mindfully on your direct experience in the present moment, which activates the “on-task” network.

THE BASICS

Practice Meditation

Mindfulness meditation is a practice that can teach you to gain control of the focus of your attention—to be more aware of what you are thinking about and able to redirect your focus. In one small study (Brewer et al.) that scanned the brains of novice and experienced meditators, the experienced meditators showed less DMN activation and reported less mind-wandering during three different meditative activities (like watching the breath or doing a compassion meditation).

Gregory N. Bratman et al. Nature experience reduces rumination and subgenual prefrontal cortex activation PNAS 2015 112 (28) 8567-8572 (doi:10.1073/pnas.1510459112)

Brewer et al. Meditation experience is associated with differences in default mode network activity and connectivity (PNAS article off web: www.pnas.org/cgi/doi/10.1073/pnas.1112029108)

Hamilton, J. Paul et al. Depressive Rumination, the Default-Mode Network, and the Dark Matter of Clinical Neuroscience. Biological Psychiatry , Volume 78 , Issue 4 , 224 - 230


What Are the Types of Brain Damage and How Severe Are They?

All traumatic brain injuries are head injuries. But head injury is not necessarily brain injury. There are two types of brain injury: traumatic brain injury and acquired brain injury. Both disrupt the brain’s normal functioning.

  • Traumatic Brain Injury(TBI) is caused by an external force -- such as a blow to the head -- that causes the brain to move inside the skull or damages the skull. This in turn damages the brain.
  • Acquired Brain Injury (ABI) occurs at the cellular level. It is most often associated with pressure on the brain. This could come from a tumor. Or it could result from neurological illness, as in the case of a stroke.

Both traumatic brain injury and acquired brain injury occur after birth. And neither is degenerative. Sometimes, the two terms are used interchangeably.

There is a kind of brain damage that results from genetics or birth trauma. It's called congenital brain damage. It is not included, though, within the standard definition of brain damage or traumatic brain injury.

Some brain injuries cause focal -- or localized -- brain damage, such as the damage caused when a bullet enters the brain. In other words, the damage is confined to a small area. Closed head injuries frequently cause diffuse brain damage, which means damage to several areas of the brain. For example, both sides of the brain are damaged and the nerves are stretched throughout the brain. This is called diffuse axonal injury or DAI.

The severity of brain damage can vary with the type of brain injury. A mild brain injury may be temporary. It causes headaches, confusion, memory problems, and nausea. In a moderate brain injury, symptoms can last longer and be more pronounced. In both cases, most patients make a good recovery, although even in mild brain injury 15% of people will have persistent problems after one year.

With a severe brain injury, the person may suffer life-changing and debilitating problems. They will have cognitive, behavioral, and physical disabilities. People who are in a coma or a minimally responsive state may remain dependent on the care of others for the rest of their lives. .


Frequently asked questions

When will the stitches (sutures) or clips be taken out?

Usually stitches or clubs will be removed seven to ten days after surgery. The ward staff will tell you the date your stitches or clips are due to be removed and who will be performing this.

Usually, this will usually be done by district nurses who visit you at your home. Or you can go to your local treatment centre, depending on the services available in your area.

If you’ve had previous surgery or radiotherapy, the stitches may be left in a little longer. This will be discussed with you before you go home.

If you have dissolvable stitches, these are usually inserted inside the scalp, so you’re unlikely to be aware of them. Occasionally they will be inserted into the scalp. They usually dissolve after 2-3 weeks. Try to avoid touching the suture line (line of stitches).

Do I need to keep taking my anti-seizure medication after my operation?

Yes – this is very important. Anti-seizure medication should only be stopped on the advice of your medical team.

Even if you haven’t had any further seizures.

Some patients need long-term, anti-seizure medication others for just a few months following surgery.

Do I need to keep taking my steroids after I go home?

Yes. Don't stop taking steroids suddenly.

It’s important that you keep taking your prescribed dose of steroids (usually dexamethasone) when you leave hospital, as well as continuing to take stomach-protecting tablets.

You’ll be given specific instructions to either:

  • reduce the dose over a set time until you’re no longer taking any steroids, or
  • reduce to a specified dose of dexamethasone tablets until your clinic appointment.

The discharge team will explain all your medications, i.e. when, how often and how long to take them for. If you have any trouble taking them or experience severe side-effects, contact your healthcare team for advice.

While in hospital my blood sugar levels were checked every day. Will this continue?

Blood sugar levels don’t necessarily have to be checked every day. But, if you’re still taking dexamethasone at home, the ward staff will arrange for your local district nurses or practice nurse to monitor your blood sugars at home

How often they’re checked will depend on what your blood sugar levels were during your hospital stay.

When can I wash my hair after surgery?

You need to wait at least 48 hours, but 72 hours is better.

If there’s been any leakage from the wound, or you’ve had previous surgery, you may be advised to wait a little longer before washing your hair.

Use a gentle shampoo, such as baby shampoo, or the hair wash provided to you before coming into hospital. And be careful not to rub around the wound area.

It’s not a problem if some water runs onto the wound - you can gently pat the area dry with a clean towel.

If you have dissolvable stitches in your scalp (rather than inside your scalp), you can wash your hair as above, but don’t put shampoo over the suture line (line of stiches).

When can I dye my hair again?

You need to wait at least 6 weeks. This is to make sure your wound is fully healed.

However, if you’re going to be starting chemotherapy or radiotherapy, you’ll need to discuss this with your oncologist.

How long before I can fly?

It is strongly advised that you seek your doctor’s advice on whether they believe that you’re fit to fly, before booking any travel arrangements. You should also speak to your airline.

There are no specific guidelines regarding the minimum time before you can fly.

However, the Civil Aviation Authority (CAA), which is responsible for air travel safety, advise that you should avoid air travel for approximately seven to ten days following brain surgery.

The general advice from the NHS is to wait until around 6 weeks from your operation and you’ve made a full recovery from your treatment before flying.

You can find more information on our travelling abroad page.

This depends on a range of factors including:

  • the type of tumour you have/had
  • the type of operation you had
  • the symptoms you've been experiencing.

This can be very difficult to adjust to, but it’s very important that you don’t drive until your healthcare team decides you are fit to drive and the DVLA return your licence.

You can find more detailed information on our driving and brain tumours page.

When will I be able to return to work?

Like most aspects of recovery, this will be different for everyone depending on their diagnosis, how their heath is following surgery and what their job is.

Most people need at least six to twelve weeks off work. However, this may be longer if you're having further treatment or if your job involves certain risks - for example, if you drive, work at heights or use heavy machinery.

You’ll be able to discuss this with your doctors and CNS to make plans that best suit your personal circumstances.

It may be useful to discuss returning to work with your employer before your surgery. We have a range of resources available to help you have that conversation.

If you're worried about returning to work because of financial issues it may help you to look at our financial support page.

Will I need to have further scans after my surgery?

Yes. Your healthcare team will let you know about any scans you need to have.

Initially, scans may be done more frequently, but over time the interval between scans may become longer. This will depend on the type of brain tumour you’ve been diagnosed with.

You can find more information on our diagnostic scans page.

Alternative approaches to helping recovery

People often ask about alternative treatments to help in their recovery.

We understand that you may want to look at these options, but it’s important to keep in mind that they’re not fully supported by medical evidence and they may interfere with your standard treatment.

You should always speak to your healthcare team before pursuing alternative treatments.

Ketogenic diet

A ketogenic diet is one that encourages eating very low amounts of carbohydrates and increased amounts of fats. Although there is currently no scientific evidence to show that a ketogenic diet is effective in treating brain tumours, it is being trialed by some specialist centres.

Cannabis oil

The use of cannabis oil is highly publicised and there is some evidence that it can help treat some side-effects caused by brain tumours - for example, pain and chemotherapy-induced nausea and vomiting,

However, there’s no supporting evidence for the treatment of the tumour itself. It’s important to remember that cannabis-based products have not been licensed for people with brain tumours.


Watch the video: Πώς να κοιμάσαι για να καθαρίζει ο εγκέφαλος σου (November 2022).