I grew up around sports, so people I knew would get concussions. My brother bumped his head a couple times, once on the basketball court. This was the 80s, the “throw some dirt on it” era. I was also a cheerleader for the high school football team, so we’d hear about boys on the football team getting knocked silly. One of the cheerleaders on our team fell off the top of the pyramid onto the gym floor and had to go to the hospital.

Dr. Sherrie All Promotes Power of Neuroplasticity and Personal Choice

NEURO-ENTHUSIAST BEGINNINGS
I am originally from Wisconsin, but I have not been there since 1994. The military and different employment opportunities brought me to and from Arizona several times. Nowadays, the Windy City of Chicago is where I call home.

Professionally, my first exposure to brain injury was when I worked in an assisted living home in Colorado. One of my favorite people was a man who’d had a series of strokes. He was quite a bit older, had left-side neglect, was legally blind, and hard of hearing. Around that time, I’d also started reading a lot of Oliver Sacks (famed British neurologist who died in 2015); his books were about odd neurological case studies— one of his most famous books, Awakenings, was even turned into a film. I fell in love with the realm of how the brain works, especially what makes things go wrong. I got to meet Oliver during my first year of grad school, which was so exciting! That led to me seeking training to be a neuropsychologist.

Clinically, I saw a few people with brain injuries in my training years, but when I first went into private practice, one of our first patients, who is actually someone I’m still in contact with, survived a really severe TBI and made an amazing recovery. His injury caused him to be in a month-long coma, but he was really lucky and ended up earning two master’s degrees and going back to work full-time, although he struggled with the social and emotional components of recovery.

The practice I built is about trying to help people [like this gentleman] get to a better self and maximize their functioning and adjust emotionally to all the post-injury changes. I really worked to insert myself into the field of neuroscience; I was trying to be disruptive by spreading the good news of neuroplasticity and challenge the myth of the “one year mark” as the timeframe for best outcomes post-ABI, which was an idea a lot of people in my field still subscribed to. My practice is like a post, post, POST-acute acute rehab for once [survivors] have exhausted all the other treatment options, so we can provide ongoing support to help people get the most out of life.

A “neuro translation” niche

Part of the draw of what I do is the field is always evolving. I always had a raw interest in brain-behavior relationships. There were some mental health issues in my family, which made me wonder what happens in the brain that causes people to act in a particular way. I realized there are so many levels of detail, and I felt I needed to know it all— I didn’t want to leave grad school with the brain still being a mystery.

I think what keeps me engaged is that I get to be a translator. Lots of people who work in the neurosciences struggle to talk to lay people. When I speak with colleagues, we’re speaking in “neuropsych” and they admit they have trouble communicating their point in simpler terms. I have a knack for coming up with helpful analogies and making it comprehensible. I’ve been told the book I wrote reads like a conversation, which I love, because I wanted it to be like “A Girlfriend’s Guide to the Brain.” The whole point is to make neuroscience comprehensible to someone I might start talking to in the street.

Neuroplasticity in a nutshell

It is this bucket term we are all using to describe a new way of thinking about the brain. We used to think it was hardwired and fixed, and we now know it’s more changing and malleable. If you break it down into the two words, “neuro” refers to brain and brain cells, and “plasticity” means moldable, plastic, changeable. Now we know the brain is changing all the time, affected by how we live our lives, what we’re doing, how we do it, even by what we’re not doing.

Cognitive wellness is a broader term, and encompasses neuroplasticity (the mechanics), but cognitive wellness is how lifestyle affects brain aging, risk for dementia, and sources of cognitive decline. It’s essentially taking wellness and applying it to your brain and thinking skills. What we’ve come to appreciate over the years is that how we live our lives ultimately affects our brains.

The Neuroscience of Memory

I’ve been working on this book in some form for nearly a decade. It was inspired when I was doing my post-doctoral fellowship when I was doing these tasks that really propelled me into my professional mission of popularizing the new understanding of the brain (plasticity). One task involved working in memory disorders clinics to give neuro assessments where I would see people week after week who would say they didn’t understand why they had memory problems, since it wasn’t something that ran in their family. Looking at their health history, we’d see they’d have high blood pressure, a history of smoking, or diabetes. This was very telling that the public has little understanding of the connection between short-term choices and long-term health outcomes.

Another task was a cognitive rehab course I’d written for people with severe mental illness and part of it was teaching people how to care for their brains holistically. When I finished my post-doc, I realized everyone needed to know this information. So that’s when I decided I was really going to focus my profession on helping bridge that gap of expanding the public’s understanding of how lifestyle affects our brains. An early version of the book was me writing a brain health class for an Institute on Aging in Chicago in 2012, and it has taken all the years since then to get the rest of the book together and published.

Walking the talk

When it comes to incorporating the seven skills in my own life, I’ll be the first to admit I do so modestly. We’re all doing the best we can. A lot of people think of brain health as stimulation. When I first got into the field, people were focused on brain fitness. I was an outlier because I realized there were other factors that also mattered. For me, as a busy mom and academic, I had TONS of brain stimulation, so that was not an area for me that needed focus; where I needed to take a step back and make sure I tend to myself is in sleep, nutrition, physical activity, and relaxation. I’ll be honest, those are areas where I struggle. When you encounter a global pandemic, with four kids doing at-home learning while trying to run a business, while not being able to see friends or have that social interaction… some of those skills fall by the wayside.

Brain fitness is like other types of fitness—it’s usually about re-commitment—falling away, then recommitting again and finding the little things you can do. I’m trying to focus on nutrition and doing physical fitness like yoga. Once those became more naturally integrated, I can focus on doing more cardio. It’s about always moving, always evolving, never static. I’m super good about talking myself out of doing a thing; I talk myself into it (exercise in the book) by drilling down the “no big deal” step. If my intention is to go for a brisk walk, I try not to think about how many miles I’ll log, how long I’ll be out, or how fast I’ll go. I rewind it to the one thing I have to do to find success. For me, it’s putting on sneakers, and stepping outside. Once I’m out, I’m fine, because I’ll get going, and it usually leads to the endpoint I wanted.

The important thing is we try to develop a kind voice to ourselves and remember we can’t focus on everything all at once. It’s possible to make sweeping changes in areas of wellness all at once, but one way to be kind to ourselves is remembering we have limited capacity in our attention. If you put a lot of focus in revamping how you eat, that takes up a lot of bandwidth that may not then be available for other things. We can get in trouble when we take on too much then can’t balance all those things, which can lead to lack of follow through when we put too much wellness on our plate.

The power of choice

I want people to know they have a lot of power to transform their brains by the choices they make day in and day out. We’re not just a victim to our genetics, so our choices do make a big difference; whether you go for the walk, eat the apple, or talk to that sleep care doctor. Just because you’ve made certain choices in the past doesn’t mean you can’t make new choices now.

Collaborating with the Brain Injury Alliance

I spoke at the Brain Injury Alliance’s virtual Rays of Hope Conference and also presented my book at their virtual Coffee with the Author event. I initially got connected with them through Joyce Marter, who also had her book featured on Coffee with the Author. The brain injury part of the Alliance appealed to me; the Brain Injury Alliance of Arizona is a model for Brain Injury Alliances. Plus, there’s also so much synergy between our groups. There are far fewer organizations in general that specialize in brain injury, so I was excited to speak with the Brain Injury Alliance’s groups and be connected in that way. When things start to settle down with the pandemic a bit more, I can’t wait to get out to Arizona and be with all of you in person!

Off the clock

I am a mother of four, so that eats up a lot of time and focus. I love karaoke (my go to song is embarrassing, but I love “Killing Me Softly,” the Fugi’s version). I do yoga. I also love being still and laying on the beach and walking by the lake.

ABOUT BRAIN INJURY ALLIANCE OF ARIZONA

The Brain Injury Alliance of Arizona (BIAAZ) is the only statewide nonprofit organization dedicated to improving the lives of adults and children with all types of brain injuries through prevention, advocacy, awareness and education. BIAAZ also houses the Arizona Brain Health Resource Center, a collection of educational information and neuro-specific resources for brain injury survivors, caregivers, family members and professionals.

What began in 1983 as a grassroots effort has grown into a strong statewide presence, providing valuable life-long resources and community support for individuals with all types of brain trauma at no charge.

The Brain Injury Alliance of Arizona:

• Works with Congressional Brain Injury Task Force
• Houses Arizona Brain Health Resource Center
• Hosts Statewide Opioid Use Disorder & Cognitive Impairment Workgroup
• Has Statewide Opioid Use Disorder & Cognitive Impairment Response team with peer support, training, and family wraparound services
• Facilitates Brain Health Advisory Council
• Manages statewide Neuro Info-Line: 888-500-9165