Concussions and head trauma: symptoms, treatment, and recovery | Micky Collins, Ph.D.

**Peter Attia** (0:11)
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Now, without further delay, here's today's episode.
My guest this week is Dr. Michael Collins, an internationally renowned expert in sports-related concussions. Mickey, as he goes by, is the Clinical and Executive Director of the University of Pittsburgh Medical Center Sports Medicine Concussion Program, the largest research and clinical program focused on the assessment, treatment, rehabilitation, research, and education of sports-related mild traumatic brain injuries in athletes of all levels. Mickey has published more than 150 peer-reviewed research articles and was also the co-lead author of the CDC's Concussion Toolkit for Physicians, an education standard for concussion management.
He is also co-founder of IMPACT, the Immediate Post-Concussion Assessment and Cognitive Testing, the most widely used computerized sports concussion evaluation system that has become the standard of care in organized sports. He has been instrumental in the development of numerous concussion management programs for youth, collegiate, and professional sports leagues and teams. Mickey is currently a consultant for several athletic organizations, including the Pittsburgh Steelers and the Pittsburgh Penguins. I won't hold either of those against him. In this episode, we focus the entire conversation around head trauma and concussions. This includes the definition and diagnosis of a concussion, the signs and symptoms of concussion, and the various types of concussions.
We speak about the risk factors that can cause someone to be more susceptible to concussions or can cause more severe concussions in certain individuals. We speak about the importance of quick treatment and recovery from concussions and what to do as part of that recovery, whether the concussion is in a child or an adult, including in the elderly population. Lastly, we speak about what we know and don't know about hyperbaric oxygen specifically and synthetic ketones as treatments for concussion.
Overall, this was a really interesting episode to me. A lot of times I come into podcasts already having a pretty good handle of the subject matter, but that was not the case here, and I knew that, and that's part of why I was so excited to do this. I came away from this far more optimistic and upbeat about the prognosis for people with concussions. And in the short time since we recorded this episode, I've already sent several people to Mickey who have been suffering, I now believe, needlessly for so long post-concussive. So without further delay, please enjoy my conversation with Dr. Mickey Collins.
Well, Mickey, thanks so much for making time to sit down. I know you're particularly busy today, so I really appreciate it. This is a conversation I've wanted to have for quite a while. It's a topic that comes up over and over again in my life personally and even professionally, whether it be patients or children of patients, things like that. And that's basically that of head trauma. And particularly, you know, what happens when someone has a concussion? What are their options? I think before we get to that, I'd kind of like to give folks a bit of a sense of your background. How did you come to do this?

**Michael Collins** (3:44)
It's a really interesting question, and it's kind of a long-winded response, but I went to college and didn't really know what I wanted to do in life. I had a bunch of family members that were physicians and in the medical field.
I also went to college to play baseball as much as I did to be a student.
And I was playing baseball my junior year, and my coach came up to me and said, Mickey, if you don't declare a major today, you're gonna be ineligible. So I was like, okay. And I was taking a neuroscience course at that time, like a biopsychology course, and it kind of hit my buttons when they needed to be hit. And I was very intrigued by it. So I just kind of dove in and studying biology and psychology and really the neurosciences, and graduated college, went to graduate school, and knew I wanted to do brain behavior studies. And I got involved in a program at Michigan State University. I got my PhD from there and studied in clinical psychology with an emphasis in clinical neuropsychology, which is a study of brain behavior, and took some of the medical classes there through Michigan State, but also did psychology, clinical psych, and neuroscience courses and combine that into my PhD. And maybe two or three years into studying that at Michigan State, I said to myself, I really miss sports. And I wanted somehow, wanted to combine traumatic brain injury and sports into something. And no one had really done that before, really. I mean, there wasn't, there was no concussion specialty when I went to school, period.