Recovery Overview
Hypoxic TBI · PFC Rehab
🧠
Priority #1. Hypoxic brain injury preferentially damages the PFC — the exact circuitry for habit formation, impulse control, working memory, and follow-through. The failure to stick to things is neurological, not a character flaw. This protocol targets structural repair and functional restoration across every available lever.
Active Peptides
10
compounds in stack
Daily Steps
6
morning protocol
Training Days
6/wk
PPL split
Neurofeedback
⏳
pending qEEG
Rehab Duration
4 yrs
since injury
FIRE Target
Age 45
13 years out
Core Repair Targets
- 1 PFC gray matter density — structural repair
- 2 Dopaminergic signaling — motivation & reward circuitry
- 3 Default Mode Network regulation — focused attention
- 4 Synaptic plasticity — new habit loop formation
- 5 Autonomic regulation — HRV, stress response, sleep
CNS Vital Signs Results
Baseline
| Domain | Score |
|---|---|
| Verbal Memory | Low Average |
| Visual Memory | Very Low |
| Reasoning | Very Poor |
| Simple Attention | Very Low |
Clinical Team
| Provider | Role | Contact | Status |
|---|---|---|---|
| Dr. Richard McAlister | qEEG · Integrative Neurotherapy LLC, East Brunswick NJ | 732-307-7229 | ⏳ Pending qEEG |
| Spravato Provider | Esketamine (Spravato) sessions | — | ✓ Active |
Pharmacy & Insurance IDs
| Item | Number |
|---|---|
| Pharmacy Member ID | 51207792511 |
| RxGrp | 99994002 |
| RxBIN | 610020 |
| Medical Member ID | 100174E33 |
| Medical GRP | 00003636 |
| Medical Payer ID | 56155 |
Daily Brain Rehab Protocol
Morning · Every Day
⚡
Execute this protocol before work, every day. Sequence matters — OM meditation primes alpha state for neurofeedback, which primes PFC activation for cognitive training.
Morning Sequence
01
OM Meditation
Silence, early morning. Primes alpha brain state before neurofeedback.
20+ min
02
Box Breathing
4s inhale · 4s hold · 4s exhale · 4s hold. Activates PFC via vagal tone before cognitive work.
5 min
03
Myndlift — Alpha Uptraining
Post-qEEG targeted electrode placement. Theta inhibition · Alpha reward · SMR reward · High-beta inhibition.
Per session
04
Dual N-Back Training
Start at N=1. Do NOT rush progression. Most validated PFC-targeting cognitive intervention available.
15–20 min
05
Cold Exposure
NE spike → dopaminergic upregulation → PFC activation. Peak effect during afterdrop/rewarming phase.
2–4 min
06
Single-Leg Balance Drills
Cerebellum-PFC coordination pathways. Proprioception rehabilitation.
5–10 min
Weekly Pennebaker Writing
Mon – Thu
Expressive writing 4× per week. Processes emotional load that would otherwise consume PFC bandwidth. Write continuously for 20 minutes about whatever is on your mind — thoughts, feelings, experiences. No editing. No rereading during the session.
Mon
Tue
Wed
Thu
Fri off
Sat off
Sun off
Breathwork Stack
| Protocol | Pattern | When | Effect |
|---|---|---|---|
| Box Breathing | 4–4–4–4 | Before cognitive tasks / neurofeedback | PFC activation via vagal tone · ↑ HRV |
| 4-7-8 Breathing | 4–7–8 | Before sleep | HRV improvement · deep sleep priming · GH optimization |
| Cyclic Sighing | 2× inhale · long exhale | Real-time stress | Fastest physiological stress reduction · <5 min effect |
Peptide & Neuroprotective Stack
Injections · Intranasal
⚠️
Cerebrolysin cycle: 20 days ON / 10 days OFF. Log your cycle start date. On off-weeks all other protocols continue as normal. EVER Neuro Pharma 20mL ampoules only — pharmaceutical grade, IM only, not subQ.
Full Peptide Stack
| Compound | Route | Dose | Frequency | Cycle | Notes |
|---|---|---|---|---|---|
| Cerebrolysin | IM | 5mL→10mL | Daily Mon–Fri | 20 on / 10 off | EVER Neuro Pharma only |
| Semax | Intranasal | 250–500mcg | 2×/day | 10 on / 5 off | AM dose · cognitive drive |
| Selank | Intranasal | 250–500mcg | 2×/day | 10 on / 5 off | PM dose · calm + anxiety |
| BPC-157 | subQ | 250–500mcg | Daily | 4–8 wk on / 2–4 wk off | Neuroprotection + systemic healing |
| GHK-Cu | subQ | 1–3mg | Daily | Same as BPC-157 | Rotate injection sites |
| TB-500 | subQ | 2.5mg | T/Th loading → 1×/wk | 4–8 week cycle | Systemic healing + neuroprotection |
| MOTS-c | subQ | 5mg | Every 5 days | Max 3 cycles/yr (20d each) | Inject at night · 2hrs post-meal |
| Retatrutide | subQ | Mid-titration | Every 5 days | TRIUMPH Phase 3 | Switched from tirzepatide |
| NAD+ | subQ | 100mg | M / W / F | No strict cycle | AM only · avoid evening |
| Glutathione | subQ | 200–400mg | M / W / F | No strict cycle | Can stack same day as NAD+ |
| Adderall XR | Oral | Current dose | Daily · before 1pm | — | No dosing after 1pm |
| Spravato | Intranasal | Prescribed | Per protocol | — | ↑ BDNF · synaptogenesis · heavy lifting |
Research Compounds — To Evaluate
| Compound | Suggested Dose | Mechanism | Source | Priority |
|---|---|---|---|---|
| NSI-189 Phosphate | 40mg/day AM | Hippocampal neurogenesis · 20–30% volume increase · procognitive | SwissChems $39.99/60 caps · PureRawz | 🟡 Medium |
| Dihexa | Research only | More potent BDNF mimetic than cerebrolysin per some researchers | Harder to source | 🔴 Future |
PFC-Specific Supplement Stack
Oral · Daily
💡
Immediate adds: Mag L-Threonate + CDP-Choline + Creatine + Lion's Mane. All available on Amazon, low cost, low risk, high evidence. Add these this week.
Core Supplement Stack
| Supplement | Dose | Timing | Mechanism | Status |
|---|---|---|---|---|
| Magnesium L-Threonate | 2,000mg | Before bed | Crosses BBB · ↑ synaptic density in PFC specifically · ↓ cortisol · improves N3 sleep depth | ⬜ Add |
| CDP-Choline (Citicoline) | 250–500mg | AM with food | Phospholipid membrane integrity · dopamine receptor upregulation · PFC energy substrate | ⬜ Add |
| Creatine Monohydrate | 5g/day | Any time · consistent | ↑ Cerebral phosphocreatine · directly improves PFC energy availability · underused in TBI recovery | ⬜ Add |
| Lion's Mane Extract | 1,000–2,000mg | AM | NGF upregulation · remyelination support · low cost, low risk, strong evidence | ⬜ Add |
| Phosphatidylserine | 300mg | AM with food | PFC membrane repair · cortisol regulation · synaptic signaling | ⬜ Add |
| Omega-3 (DHA-dominant) | 2,000–3,000mg DHA | With largest meal | Structural component of PFC neuronal membranes · ↓ neuroinflammation | ⬜ Add |
| B-Complex | Full spectrum | AM with food | Myelin repair · methylation support · homocysteine regulation | ⬜ Add |
| Zinc + Copper | 15–30mg Zn / 1–2mg Cu | PM away from iron | NMDA receptor function · hypoxic injury disrupts Zn/Cu ratio | ⬜ Add |
Nutrition Targets (PFC Repair)
| Target | Amount | Why |
|---|---|---|
| Protein | 180–200g/day | Neurotransmitter synthesis · muscle preservation |
| Calories (training days) | 2,200–2,400 kcal | Energy availability for brain repair + training |
| DHA (Omega-3) | 2–3g DHA/day | Structural component of PFC membranes |
| Creatine | 5g/day | Cerebral energy · direct PFC function improvement |
| Polyphenols | Daily | Blueberries, dark chocolate, green tea · cross BBB · ↓ neuroinflammation |
| Fermented foods | Daily | Kefir, sauerkraut, kimchi · gut-brain axis → PFC function |
| Prebiotic fiber | 25–35g/day | Microbiome diversity → downstream PFC signaling |
| Zinc:Copper ratio | ~15:1 | NMDA receptor function · hypoxic injury disrupts this |
Cognitive Training Protocol
PFC Activation · Daily
Training Modalities
| Protocol | Duration | Frequency | What It Trains | Notes |
|---|---|---|---|---|
| Dual N-Back | 15–20 min | Daily | Working memory · PFC activation · fluid intelligence | Start N=1 · do NOT rush progression |
| Task-Switching Drills | 10–15 min | 3–4×/wk | Cognitive flexibility · PFC executive control | Alternate 2 distinct tasks on timer (e.g. math → reading → math) |
| Working Memory Journal | 5–10 min | Daily PM | Hippocampal-PFC encoding | Recall your entire day in order from memory, without notes |
| Timed Reading + Recall | 20+5 min | 3–4×/wk | Sustained attention · encoding · PFC endurance | Read 20 min → close book → write everything recalled |
| Delayed Gratification Practice | Ongoing | Daily | PFC inhibitory circuits · impulse control | Wait 10–15 min before acting on any impulse (food, phone, etc.) |
Habit Engineering Principles
Implementation Intentions
Write every habit as: "When X happens, I will do Y". This bypasses the PFC initiation bottleneck and routes through habit circuitry directly. Your injured PFC doesn't need to decide — the trigger decides for it.
Environment Engineering
Remove the decision point entirely. Gear out the night before. Schedule locked. Triggers automatic. PFC is depleted by decisions — the fewer required, the higher the execution rate.
Self-Compassion Is Mechanistic, Not Soft
Shame activates the amygdala and suppresses PFC activity. Every time you beat yourself up for failing a habit, you make the next attempt neurologically harder. Reframe failure as data, not character evidence.
Physical Protocol
6 Days/Week · PPL Split
Training Overview
| Variable | Target | Notes |
|---|---|---|
| Training Split | PPL — Push / Pull / Legs | 6 days/week |
| Body Goal | Recomposition · ~210 lbs | — |
| Cardio A | 12/3/30 | 12% incline · 3.0 mph · 30 min |
| Cardio B | Stairmaster Level 6 | 30 min |
| Zone 2 Target | 150–180 min/week | Conversational pace · HR ~120–140 · #1 BDNF producer |
| Heavy Compounds | 2 sessions/week min | Squat · deadlift · press → IGF-1 + BDNF cascade |
Cold Exposure
Target: 2–4 minutes · Daily
NE spike → dopaminergic upregulation → PFC activation. Peak catecholamine effect occurs during the afterdrop and rewarming — not during cold exposure itself. Don't cut short.
Balance & Mobility
· Single-leg balance drills — daily · 5–10 min
· 90/90 hip stretches
· Couch stretch (hip flexors)
· Copenhagen adductor work
· Dead bugs + glute bridges
· Single-leg RDLs
Additional Daily Movement
| Activity | Duration | Notes |
|---|---|---|
| Qi Gong | Daily · 10 min min | Even 10 minutes counts |
| Breathwork (morning) | 5 min | 4s inhale / 6–8s exhale on wake |
| Jump Rope | Per session | Coordination + cardio |
Sleep Architecture Optimization
The Multiplier
🚨
Sleep is the multiplier on every other intervention. Fragmented or shallow sleep cuts the efficacy of cerebrolysin, neurofeedback, peptides, and cognitive training by ~50%. Brain consolidates plasticity changes during N3 and REM. If sleep is broken, the protocol is running at half power.
Sleep Optimization Targets
| Variable | Target | Why It Matters |
|---|---|---|
| Wake Time | Consistent · 7 days/week | Single highest-leverage sleep intervention. Anchors circadian rhythm. |
| Room Temperature | 65–68°F | Core temperature drop is required for N3 (deep sleep) entry. |
| Blue/Bright Light | None after 9pm | Delays melatonin onset by 90+ minutes. |
| Adderall XR Cutoff | No dosing after 1pm | Half-life fragments sleep architecture if dosed late. |
| Mag L-Threonate | 2,000mg before bed | ↓ Cortisol · improves N3 depth · synaptic density. |
| 4-7-8 Breathing | Before sleep | HRV improvement · growth hormone optimization overnight. |
| Sleep Tracking | Oura Ring or Whoop | Need objective N3 + REM % data. Subjective feeling is insufficient. |
Target Sleep Architecture
N3 Deep
20%+ target
REM
25%+ target
Total Sleep
7.5–9 hrs
Track with Oura Ring or Whoop for objective data. Log N3 + REM % weekly.
Neurofeedback Protocol
mPFC Rehab · qEEG-Guided
⏳
Pending qEEG results from Dr. McAlister. Everything below gets more precise once the qEEG maps exact dysregulation patterns at specific electrode sites.
Hardware
| Headset | OpenBCI Cyton + Ultracortex Mark IV |
| Source | eBay · ~$595 |
| Channels | 8 channels · full 10-20 system |
| App | Myndlift (alpha uptraining) |
| Target Sites | Fp1, Fp2, Fz, F3, F4 (mPFC) |
| Ruled Out | Emotiv EPOC X — lacks Fz/Cz coverage |
Training Protocols
| Alpha Uptraining | 8–12 Hz · Fz/Cz · restores calm focused attention · reduces hypervigilance |
| SMR Training | 12–15 Hz · C3/C4 · impulse control · motor regulation |
| Theta Suppression | 4–8 Hz · Fp1/Fp2 · directly targets PFC underactivation in hypoxic TBI |
| High-Beta Inhibition | >25 Hz · reduces anxiety/rumination loops |
Clinical Provider
| Provider | Dr. Richard McAlister |
| Practice | Integrative Neurotherapy LLC |
| Location | East Brunswick, NJ |
| Phone | 732-307-7229 |
| Credential | qEEG Diplomate certified |
Action Items
- Receive qEEG results from Dr. McAlister
- Configure Myndlift targeting based on qEEG results
- Update Python neurofeedback app post-qEEG
- Add Supabase integration to recovery dashboard
- ✓Select hardware — OpenBCI Cyton + Ultracortex Mark IV
- ✓Rule out Emotiv EPOC X (insufficient electrode coverage)
- ✓Take CNS Vital Signs baseline test
- ✓Send MRI to Hackensack.nj@myneurva.com
Weekly Injection Schedule
All Routes · All Compounds
⚠️
Cerebrolysin is 20 days ON / 10 days OFF. Log your cycle start date. On off-weeks all other protocols continue as normal.
Daily Schedule
Monday
Cerebrolysin 5–10mL IMBPC-157 250–500mcgGHK-Cu 1–3mgNAD+ 100mgGlutathione 200–400mgSemax 250–500mcgSelank 250–500mcg
Tuesday
Cerebrolysin 5–10mL IMBPC-157 250–500mcgGHK-Cu 1–3mgTB-500 2.5mgSemax 250–500mcgSelank 250–500mcg
Wednesday
Cerebrolysin 5–10mL IMBPC-157 250–500mcgGHK-Cu 1–3mgNAD+ 100mgGlutathione 200–400mgSemax 250–500mcgSelank 250–500mcg
Thursday
Cerebrolysin 5–10mL IMBPC-157 250–500mcgGHK-Cu 1–3mgTB-500 2.5mgSemax 250–500mcgSelank 250–500mcg
Friday
Cerebrolysin 5–10mL IMBPC-157 250–500mcgGHK-Cu 1–3mgNAD+ 100mgGlutathione 200–400mgSemax 250–500mcgSelank 250–500mcg
Saturday
BPC-157 250–500mcgGHK-Cu 1–3mgSemax 250–500mcgSelank 250–500mcg
Sunday
BPC-157 250–500mcgGHK-Cu 1–3mgSemax 250–500mcgSelank 250–500mcg
Every 5 days
Retatrutide (TRIUMPH Phase 3)MOTS-c 5mg — inject at night
Priority Order of Operations
What to do first
Ranked Action List
01
Complete qEEG with Dr. McAlister
Everything downstream gets more precise. This is the master unlock.
02
Protect sleep architecture
Consistent wake time · Adderall cutoff at 1pm · Mag L-Threonate before bed · 65–68°F room
03
Continue cerebrolysin cycles + Spravato
Structural work in progress. Don't interrupt cycles.
04
Dual N-Back daily
Even 15 minutes minimum. Start at N=1. Do not rush progression.
05
Zone 2 cardio + cold exposure
150–180 min/week Zone 2 · 2–4 min cold daily. BDNF production engines.
06
Add Mag L-Threonate + CDP-Choline + Creatine + Lion's Mane
All available on Amazon. Low cost, low risk, high evidence. Order this week.
07
Write implementation intentions for all habits
"When X happens, I will do Y" format for every protocol step. Do this week.
08
Evaluate NSI-189 Phosphate
40mg/day AM · SwissChems $39.99/60 caps · loop in provider first
09
Consider EMDR if injury period carries unprocessed trauma
Chronic threat state from unresolved trauma is a direct headwind on PFC function.
10
Add Omega-3 DHA, B-Complex, Phosphatidylserine, Zinc/Copper
Complete the oral supplement stack for full membrane repair support.