Celebrating World Brain Day with Brain Health Tips and Listener Questions

Episode Transcript

Dr. Correa:
From the American Academy of Neurology, I'm Dr. Daniel Correa.

Dr. Peters:
And I am Dr. Katy Peters, and this is the Brain & Life Podcast.

Dr. Correa:
Welcome back to the Brain & Life Podcast. Katy, how are you doing?

Dr. Peters:
I'm doing great. It's just it's so hot, and I know it's been so hot in NYC. Did you get to go to the wedding? That's what I want to know.

Dr. Correa:
I was not invited to the wedding. I also thankfully was not affected by Taylor Swift's and Travis Kelce's complete and total disruption of traffic throughout New York City, which a lot of people were not too happy about. I do know some people from nonprofits around the city that received ridiculously large donations-

Dr. Peters:
Oh, wow.

Dr. Correa:
... I guess to acknowledge the amount of disruption they were bringing to the city. So that was a big positive-

Dr. Peters:
That is a positive.

Dr. Correa:
... to hear. Yeah, yeah. That weekend, I stayed home and relaxed, got into the park, and that was very hot. But then thankfully, we were followed by a nice little reprieve. Some rain came in and several cool days. So I mean, the mid-east and Mid-Atlantic and around the Northeast area does have a very temperamental fluctuation in the summer. We keep going back and forth from hot and oppressive and then randomly beautiful 70s days with just a light breeze. I don't know. Yeah.

Dr. Peters:
I haven't seen the 70s. It's just been hot, hot. We've been in the really 100, and now, definitely the humidity has descended on us, but I try to get out every morning and do something before it gets to be unbearable.

Dr. Correa:
Yeah. It's just at some point, that getting out in the morning before starts moving earlier and earlier, but hey-

Dr. Peters:
Yes, it does.

Dr. Correa:
... we got to balance it out and figure it out. So one of the other things is, Katy, for World Brain Day, how do you celebrate your brain's amazing functions and things we talk about that we're all nerdy about or just your overall brain health?

Dr. Peters:
Well, so Happy World Brain Day to you, Daniel. Of course, I love brain games. Wordle, chess, puzzles, oh my, I love to play a good game. And I even got into making a crossword puzzle. You can actually get these apps and make a crossword puzzle, and it was just so much fun to make a puzzle. I'm doing it for an upcoming AN event that I'm hosting for our neuro-oncology section. So maybe someone's listening, and now, I've just let the surprise out of the bag, but hey, it's going to be a fun puzzle time. And I'm in full-swing AM swimming, so I have good concerted effort to get up early. One day, I even got up at 5:55 and got up bright and early, got in the pool. It's my exercise and zen time. How about you? What are you doing to celebrate your brain?

Dr. Correa:
I mean, I was thinking of the puzzles and making your own crossword puzzle. I've seen people do them for lectures and other fun things. I've never actually really even thought about doing it myself. Although we did interview and talk with Will Short and learn some about that, but-

Dr. Peters:
Enigmatology.

Dr. Correa:
Yes, that's right. But I didn't even realize there are now apps to create your own. That's a fun, free thing for someone potentially to play with, or maybe even there's websites where you can do it for free. And then you mentioned puzzles. I was thinking of Shawn Letford and how I like jigsaw puzzles, but I don't always do them at home. I tend to do them on vacation or when I'm visiting family and just get a group together and play around with the puzzle.
But lately, I do a morning workout, and that varies. Some days, it's actually I think more the thing I would verify in my head as, oh, the workout, whether it's exercising, running, going to the gym, picking up and putting things down, et cetera. And then some days, I'm not there for that, and just the workout might just be lying down on my floor with a cup of coffee and doing some stretches and eventually doing something that looks like a few random yoga movements until my body warms up and then maybe just do some pushups, but a little bit something each day.
But for World Brain Day, I like to come back to that pillar and the idea of community. It gives me a reminder to reach out to my father, mother, friends and family, really share some of the things I'm enjoying that week and that day, what I'm looking forward to that week and maybe hopefully hear some great stories from my friends and family all over the country and world. It just helps me be in a different place than the standard, just work or the other activities of the day. And recently, I asked my niece. I liked the idea. I was like, I wonder what she would do, to draw either a brain or something related to the brain or even just a picture of us playing together and doing something healthy. And so of course, out of that came out her drawing me picking her up and lifting her up and partnering her for a ballet that she made up in her living room.

Dr. Peters:
Did she make you dance, too?

Dr. Correa:
Oh, yeah, no. I was-

Dr. Peters:
Oh, you were the partner.

Dr. Correa:
Oh, yeah. So she put on a full-on and have everybody sit there and put on a full-on her own version of The Nutcracker ballet and had us play songs from The Nutcracker ballet. But my wife who grew up dancing Nutcracker, her knowledge of any specific what you were supposed to do was not required at all. No, no. Maya knew and told us all the right steps and where people needed to be, and I, of course, was the one lifting her and carrying her around.

Dr. Peters:
Well, I'm sure I can't wait to catch that. I'm sure it'll make its way to Broadway.

Dr. Correa:
And for our listeners who didn't catch it, globally, every July 22nd, we celebrate and observe World Brain Day since it was established by the World Federation of Neurology. This is a worldwide organization that the American Academy of Neurology is part of. And it's to raise awareness about brain health and different neurologic disorders. And so today, we're going to take one of our episodes of taking a break from other interviews and talk together and share with you about some of the recent articles out from Brain & Life and also share and discuss some recent listener and reader questions.

Dr. Peters:
So we have our first question, Daniel. Do you want to start with that?

Dr. Correa:
Yeah. So we heard from Emma in Pennsylvania. Glad I actually remember the initials for Pennsylvania there. And she said, "I have MS and would love to join a support group, but there's literally nothing near me. I live in the middle of nowhere. I know there are online things available, but what can I do actually to make connections? This is so frustrating and disheartening."

Dr. Peters:
Well, Emma, thank you so much for your question. This is a soft spot for me, because I'm from a very rural community in Tennessee. And so for our patients in those rural communities, getting access to specialized neurologic care is often challenging. And personally, I've been part of the ASCO Rural Task Force for patients with cancer, including brain cancer, and we sought to find creative ways to make things more accessible to patients really from more of a provider-patient perspective. And much of this comes from patients interfacing with providers via telehealth modalities. Daniel, you as an epilepsy doctor, what do you think about this article that has been published on the Brain & Life website? It's entitled, "People with Epilepsy in Rural Areas Face Greater Health Risks, Studies Find."

Dr. Correa:
Yeah. I promise and I'll tell my colleagues that I didn't set you up for that article. You put it into our notes and asked me about it. But the study that's featured in that article was actually written by colleagues in our epilepsy neurosurgery and neurology group. It's very interestingly, they took a look at a broad set of data of people living in more rural areas or based off of the rural category of access, and they found that the people living with epilepsy in the most rural US counties had nearly twice the odds of dying during a hospital stay compared with those people living in the most urban counties. That makes us wonder, is it something about the resources and/or the support of those living with epilepsy in those areas to have good control of their medical conditions?
And as we might imagine, their insurance status also appeared to matter in these outcomes. So among those who had private insurance, it didn't actually end up mattering very clearly in this data, whether they were rural or urban patients, and they had similar hospital outcomes, but those who didn't have a private insurance or were uninsured were really the ones with the greater risk. So really suggesting they may not be getting the care that they need outside the hospital, might be leading towards poor outcomes or more frequent seizures. And then once they're in hospitals, maybe they don't get to have all the different services or be connected even after that hospital stay in the ideal way that we would like.
But I also think that this kind of study, we focus and look within an area where we have data, the outcomes of people in the hospital with epilepsy. But I think it's also pointing to areas and problems that there are across the healthcare system and healthcare access, not just epilepsy, and there can be lots of things that are major contributors to these differences. And these line up with what we see and what we hear from people living with neurologic disorders across many different communities. They thought and I think, we think that a lot of these factors that might affect their outcomes are probably associated to more things beyond the epilepsy, but fewer specialists, in this case, epilepsy, in some rural communities, a longer distance to travel to see their neurologist or to get to the specialized hospital that have the extra resources in epilepsy that might be longer monitoring of their EEG or the electrical activity of the brain to know whether or not they're having a seizure, maybe ICUs with more specialized support. But it can be a little bit different in some of the different areas of neurology.
And then the delays of seeing those specialized doctors who have the additional and extra training, especially when someone isn't well-controlled. If someone's well-controlled on one or two medications and they like their neurologist, whether or not they're an epilepsy specialist, it's very possible they're getting what they need, but the people who are continuing to have seizures or their condition, if it's another neurologic disorder, is not well-controlled or they're having a lot of limiting side effects really should continue progressing and consider a referral or a second opinion with another specialist in that area.
And for epilepsy, there are comprehensive epilepsy centers and really limiting and having challenging ways of getting access to those centers really could be a major factor that impacts a person's outcomes and especially something to the point where we think about their outcomes like death in a hospital stay or after a hospital stay.
So Emma, we really feel and understand the challenge that you're feeling and getting the support in community. One thing I would say is maybe going to and following up with the doctors that you're seeing. Is there maybe a support community that they would suggest? Is there a chapter for one of the MS foundations? I know maybe not in your immediate area, but just speaking with them, they may be able to actually put you in contact with people who are closer to you and/or online groups. I think that's the way to start making the connection - to reach out to one of the MS societies or foundations and just call one of their helplines. A lot of them will have help and social support lines that will connect you with a nurse or a social worker that works with that organization and can help you find the chapter and the representatives in your area to help you connect with other people in your community or an online community that can really speak to your own experience.

Dr. Peters:
And thank you, Daniel, for going over that article. I think it's really important in the epilepsy space. And when I was on that task force, one of the big concerns frequently for our brain tumor patients that also may have an epilepsy diagnosis, too, because of their tumor, just driving alone in a lot of these rural places that don't have access to public transportation. So when I was researching your question, Emma, as it pertains to MS, I came across a neat website. It's called ruralhealth.us, and there's a nonprofit organization called National Rural Health Association. And they are really coming to the problem about access to medical care in rural settings by trying to change public policy, but they do have a lot of resources also about support groups, and they did have specifically an article that just pertained to multiple sclerosis. So I'd really encourage you to check out their website.
In particular to your question, I think it's about support groups and building a community. As Dr. Correa mentioned, making those online connections, I think, is a nice way to start. Another way that some of my patients have made interesting relationships and connections is just even in their waiting room. So if you're seeing a specialty person, sometimes, there's somebody that's in the waiting room that, if you're in an MS clinic, may be having a similar experience as you that may be closer to you. So sometimes, it's also just starting a very polite conversation with someone next to you without being too prying about why they're there. But I've had some patients that have made some really great connections and have learned a lot from each other just for waiting in the waiting room. So you never know who you're going to meet.
So we have the next question. This was sent in by Mark from Nevada. It reads, "I take care of my elderly aunt with dementia. I try to get her to engage with support groups and do things like fun activities with other seniors, but she's just too feeble to really get anything out of it sometimes. Is it worth it for me to keep trying to make that work? What else should I try?" And that's Mark from Nevada.

Dr. Correa:
I mean, above all things, Mark, you're doing a super job being there, being a caregiver and supporter for your aunt, and taking some time to celebrate in that time and space you have to share together. I think that is a key point. And as much as often you might be trying to work to solve a problem or solve the idea of her connecting more, don't let go of the fact that you guys are connecting also together. But I do agree there's value to finding what way connecting with community makes sense for her. And so I don't want you to not continue to try, but also acknowledge the ways that she feels like she's not getting something out of some of the activities, or the effort of getting to some programs or activities might be overall too taxing. So I think that would be something to consider, just keep that conversation moving forward and look for ways and activities that she might enjoy engaging.
And one of them makes me think of a while back, we did an episode interviewing the disability access program at Lincoln Center, and that team talked about that their center in many places do online activities for community members who aren't able necessarily to go there to see the arts, to listen to music. And sometimes, even though we might not see that as the same way as connecting with community, still being in that space and being able to share in those, and sometimes, those communities or activities will have some discussion time and connection, so that might be a low-level place that you can try and see if you find things and activities that are also in online communities that your aunt would enjoy. What do you think, Katy?

Dr. Peters:
Again, big kudos to Mark for helping out his aunt. And I think it's so important those connections that you have with her. I'd say tap into finding out what your aunt's interests are. The local senior center in many towns or cities can have many different activities. I'm going to invoke my mother-in-law. She is always doing events at the senior center. She attends lectures in person, but also online. And what I think is really neat about what she does and what their senior center does is that the seniors themselves run some of the sessions. So they actually lead and even come up with the ideas about the sessions. So my mother-in-law is a big opera fan, and so she's done lectures on opera and done some listening sessions for her senior group. And so I don't see her slowing down at all. And I hope that for you, Mark, that you can tap into your aunt's interest and maybe find something similar.

Dr. Correa:
Yeah. If she's at a stage where she's not sure what she wants or what she gets out of those things, you can also just have her join you along in something that you're interested in or even if something you're attending online to be there in the space and have conversation with her or to share what you felt and how you enjoyed the activity might itself be a way for her to explore these kinds of events and activities.
So we had another question come in from Sam. She's in New Jersey. She shared, and thank you, Sam, in her own words, "Hi, I love the podcast. Can you guys share anything else free for me to listen to or do online to help my brain health? I love Wordle and listening to stories like the ones you share. I'm trying to keep my mind sharp."
Sam, thank you so much. We really enjoy that you are joining us here as a listener, and I'm glad you're looking for more activities. I'd say one thing I've been enjoying recently is a lot of the free meditations and guided mindfulness audio and even video sessions that are available on an iPhone app called Insight. There's a few different meditation apps out there. I find more and more of them are moving to almost only subscription or paid-for content. Insight is a nice one. It has just a timer if you want to just use it for your own free meditation, but also has lots of free sessions for meditations, mindfulness, guided walking and different ideas. And so that is something you can look at. It has paid options, too, but you can access and see lots of different free things there also.
And I know Katy before mentioned Wordle and other games. I've been trying out and playing some of the other games on the New York Times Games app, always just like exploring, beyond Wordle, some of the other things that they have there. So I think those is another place you can look at some free activities. Some of those, again, you can subscribe for, but there are also the free e-games that are available through there. Katy, what have you been playing and enjoying?

Dr. Peters:
Well, I'll tell you, I just downloaded the Insight Timer meditation because that sounded really good. It looks like it even got an award for being a highly coded app. And so it looks pretty cool, so thanks for the tip.
So yeah, I'm really good with any kind of game. It doesn't necessarily need to be online. There's even some things that you can do just really simply at home. I'm a big fan of having a pack of cards around. You never know when you can play a card game. And it seems that it can go across generations, just like when Mark is talking about his aunt before. So I was even playing a card game with one of my friend's teenager, and he taught me the game. And one of the games that he does is he changes the rules every time. So you have to be really quick. I think he changes it for his benefit. But again, I think we can engage with things that particularly for moments that need to be free that we aren't paying money for.
Also, from our recent podcast with the Letfords, I'm now a big fan of dragonfly time and going outside and getting absorbed in nature. And I now have a bunch of flowers blooming, and I've been enjoying all of the pollinators and looking at all the butterflies, including some dragonflies, and a wonderful crop of hummingbirds, which are now in town.

Dr. Correa:
Yeah, that's funny. It reminds me one of my just favorite games or conversational things when my wife and I will go on a walk or just go sit in the park is just the stories, and to sit on a park bench, watch people and animals, and you catch on someone who catches your attention. And at some point then, I just turn to my wife and I start narrating whatever story I think they're doing, my thought about that person and something. You just start to make up a little narrative and story for that person, and I think that is a fun thing, just a version of people watching, but also tapping into some creativity.
And I think I like your idea of the other free games that aren't necessarily technical, and it reminds me of a lot of times, I check in those little free libraries that are around the neighborhoods and stuff like that. And sometimes, you don't just find books in there. Several times, I've found a jigsaw puzzle or another set of games, and I'll pick it up, try and play with a bit and then go donate it or take it back to another free library. So I think those are places also, Sam, you can look for some other free activities, maybe even meet someone there at the free library, little cubby that's there.
And I did think of another app maybe for you to try, if you haven't already. Most of the public libraries have an application where you can access the public library materials, books and audio online for free with your library card. And so I've been using and I use the Libby App, but I think there are a few that you can log in your library card and then you can check things in and out that way. So if you're not already using that, that's a great place to get some free content.
Now, we had a few articles. Now, just before, we were talking and Katy pointed out the article on Brain & Life on people with epilepsy in rural areas. So we'll have that also available in the show notes. And another article I was going to bring and ask you about, Katy, we're both maybe at stages where our bodies and brains are adapting to changes, maybe it's metabolism or other changes throughout our body. Did you see the recent article titled, "Study Suggests Certain Hormone Therapies May Support Memory After Menopause?"

Dr. Peters:
Absolutely. And I read that article. It's called experiential for me right now to say the least. In this article, I think it's really important. It broke down how the study found an association between certain estradiol-based hormone therapies and better performance on some memory tests, but it does not mean that hormone therapy should be prescribed solely to improve your memory. I mean, I think that to be on menopausal hormone therapy really needs to be individualized. You need to discuss it with your doctor. You need to discuss what the symptoms you're having, whether it's hot flashes or fatigue or other postmenopausal or menopausal or perimenopausal symptoms. Some of that also includes some what we call brain fog that can happen to women that are essentially undergoing this change in their life that you're essentially now having fluctuations in your hormones. But that needs to be a very individualized decisions made with your medical provider.
You need to think about age, timing, your medical history, whether you have a family history also of certain types of cancers, particularly uterine cancer, ovarian cancer or breast cancer, also, risk of also neurologic diseases and family history, and then also the benefits. There's been some misinformation on hormonal replacement therapy. There's been some updates on how we best understand it. I'm not an OB-GYN. I'm not an endocrinologist. I always found that endocrinology is the hardest part of medicine. But menopause is a real thing, and it can really affect a lot of women and cause these transient changes in your memory and in your cognition. So I think it's really important to at least get the information and that's what this article does. So definitely, I would say everybody should check it out.

Dr. Correa:
Yeah, absolutely. And at the same time, also, if you're having and experiencing some challenges or changes in your memory or thought process, but are around perimenopause, menopause or so on, don't just alone ascribe it to that situation and change and transition that you're in. Make sure that you're already seeing or you follow up and see your primary care doctor or your other doctors that you're following with and discuss it, because there's lots of things that could be affecting or changing memory and we want to make sure we're not missing something else.

Dr. Peters:
Absolutely.

Dr. Correa:
But once you've had those other tests and you know you're not having something else that's concerning and/or if there is a reason already to take a look at other menopausal symptoms, I think that's where you can continue that discussion. And I'm so glad that Brain & Life has covered this, and I find this article helps really drive home this point that menopause is a brain transition also. It's not just a reproductive transition. And I think so many people just categorize it and don't think of all the other symptoms. Many women can notice symptoms that are not just changes in memory or attention, but also throughout their body. And so science is increasingly recognizing and along with some and hopefully more and more doctors that these symptoms have a clear biological basis. And so make sure you discuss them with the doctors that you seek support. And if you feel like your doctor isn't understanding your symptoms, then that's always an opportunity to get a second opinion or to see another doctor within a specialty areas that that works. And I'm glad this study adds to the growing evidence that estrogen may play different roles in different types of memory and our cognition. So we hope more research will help us know the best ways to support women in their transition or in the brain's transition throughout life.

Dr. Peters:
Yeah. And first of all, we appreciate all of our partners that support us that goes for us women that are going through menopause, and it is all about support and having a community. And one of our favorite parts of the Brain & Life articles is always pictures of you. Don't you love those articles-

Dr. Correa:
I do.

Dr. Peters:
... Daniel?

Dr. Correa:
Yeah. Yes.

Dr. Peters:
Yeah. I think they're really good because they really focus in on patients, maybe the loved ones of patients. And we had one with a teen whose father has Parkinson's disease and she created a community for herself and others as a child or really a teenager with a dad with Parkinson's. And her name is Alex Sunshine, which, first of all, is a great name.

Dr. Correa:
Absolutely.

Dr. Peters:
And she started a teen-to-teen support group called The Circle of Helping Hands, and it's a safe, understanding, supportive space for teens who have a parent living with Parkinson's disease. And I know several of you did check out our podcast with our other child that was all about supporting their parent with Parkinson's disease, and that was Ryan Reynolds. We recently had a conversation with him and really talked about his experience. And so it's great to see so many different people in so many different ways helping their parents and helping others through advocacy.

Dr. Correa:
Absolutely. And it's unfortunate that sometimes when people talk about Parkinson's disease, they may focus on the person living with the diagnosis and sometimes even only just the movement. But every neurologic condition ripples throughout entire families and that this story really reminds us that the children and teenagers are living the experience, too. It's great to see Alex and others also building community within that space. And so I think I want to cheer on Alex and encourage others to help and continue to build community in the spaces and groups that you need support.
Now, I just wanted to thank you, Katy. I hope you stay cool for the rest of the summer. I think today, we're going to take our breaks. You're probably going to the pool. I don't have one that close to me.

Dr. Peters:
Yeah, I'm going to jump right in. Yeah. Yeah. Yeah. I think we may be getting a little rain, so I may hold off. But yeah, you'll have to come down from NYC. Check out North Carolina.

Dr. Correa:
Well, thank you to all our listeners for joining us today. Check out these articles in the show notes. There are many more articles on the Brain & Life website. And we're hoping to look forward to you joining us this next week for our next interview with a guest and a whole nother topic.
Thank you again for joining us today on the Brain & Life Podcast. Follow and subscribe to this podcast so you don't miss our weekly episodes. You can also sign up to receive the Brain & Life Magazine for free at brainandlife.org.

Dr. Peters:
Also, for each episode, you can find out how to connect with our team and our guests along with great resources in our show notes. We love it when we hear your ideas or questions. You can send these in an email to blpodcast@brainandlife.org and leave us a message at 612-928-6206.

Dr. Correa:
You can also find that information in our show notes, and you can follow Katy and me and the Brain & Life Magazine on any of your preferred social media channels. We're your hosts, Dr. Daniel Correa, connecting with you from New York City and online, @NeuroDrCorrea.

Dr. Peters:
And Dr. Katy Peters joining you from Durham, North Carolina and online, @KatyPetersMDPhD.

Dr. Correa:
Most importantly, thank you and all of our community members that trust us with their health and everyone living with neurologic conditions.

Dr. Peters:
We hope together, we can take steps to better brain health and each thrive with our own abilities every day.

Dr. Correa:
Before you start the next episode, we would appreciate if you could give us five stars and leave a review. This helps others find the Brain & Life Podcast. See you next week.

Celebrating World Brain Day with Brain Health Tips and Listener Questions

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