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
✓
qEEG received 6/22
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
Pre-Injury Cognitive Baseline (CBS, June 25 2021)
Healthy Brain
⚠️
Taken June 25, 2021 at Hanley Center — after first overdose but before the 2022 hypoxic brain injury. This is what your brain looked like when it was intact. These are the targets, not just the baseline.
| Domain | Score | Percentile | Range |
|---|---|---|---|
| Spatial Planning | 126 | 96th | Above Average |
| Grammatical Reasoning (Verbal) | 117 | 87th | Above Average |
| Feature Match (Attention) | 105 | 62nd | Average |
| Monkey Ladder (Visuospatial WM) | 103 | 58th | Average |
| Odd One Out (Deductive Reasoning) | 103 | 58th | Average |
| Token Search (Working Memory) | 102 | 55th | Average |
| Digit Span (Verbal STM) | 95 | 38th | Average |
| Spatial Span (Spatial STM) | 92 | 29th | Average |
Post-Injury CNS Vital Signs (2026)
Current State
| Domain | Score | Percentile | Range |
|---|---|---|---|
| Neurocognition Index (NCI) | 81 | 10th | Low Average |
| Composite Memory | 69 | 2nd | Very Low |
| Verbal Memory | 80 | 9th | Low Average |
| Visual Memory | 69 | 2nd | Very Low |
| Reaction Time | 62 | 1st | Very Low |
| Complex Attention | 87 | 19th | Low Average |
| Cognitive Flexibility | 87 | 19th | Low Average |
| Processing Speed | 113 | 81st | Above Average |
| Executive Function | 85 | 16th | Low Average |
| Reasoning | 65 | 1st | Very Low |
| Simple Attention | 76 | 5th | Low |
| Executive Function Brain Age | 41 | — | 9yr gap (chronological: 32) |
Before / After — The Impact of the Injury
📌
CBS (2021) vs CNS Vital Signs (2026) use different instruments so scores aren't directly comparable — but the domains overlap enough to see the trajectory clearly. Pre-injury: all scores average or above. Post-injury: most domains in the bottom 2–20th percentile.
| Domain | Pre-Injury (2021) | Post-Injury (2026) | Direction |
|---|---|---|---|
| Planning / Executive | 126 — 96th %ile | 85 — 16th %ile | ⬇ Severe drop |
| Reasoning (Verbal / Deductive) | 117 / 103 | 65 — 1st %ile | ⬇ Severe drop |
| Working Memory | 102–103 — avg | 69–87 — 2nd–19th %ile | ⬇ Significant drop |
| Attention | 105 — 62nd %ile | 76–87 — 5th–19th %ile | ⬇ Significant drop |
| Processing Speed | not tested (CBS) | 113 — 81st %ile | ✓ Preserved |
Clinical Team
| Provider | Role | Contact | Status |
|---|---|---|---|
| Dr. Frederick Starr | qEEG · Integrative Neurotherapy LLC, East Brunswick NJ | 732-307-7229 | ✓ qEEG Complete (6/22) |
| 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 |
Habit Tracker
Today
💾
Backed by Cloudflare KV — persists across devices. No login/auth on this yet, same limitation as the PIN gate elsewhere on this dashboard. Low-sensitivity data (checkbox completion only).
Today's Checklist
0/7
Last 14 Days
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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
Dual N-Back
2-back
How it works:
Each round, a letter is spoken and one square lights up.
Your job: did the letter match what you heard N rounds ago? Did the position match where it lit up N rounds ago?
Press A for audio (letter) match · L for location (position) match.
You have 3 seconds to respond before the next trial begins automatically.
First 2 trials are warm-up — just watch, no response needed yet.
N-Back History
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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
✓
qEEG received 2026-06-22 (MYNEURVA BEAM). Protocol thresholds set v1.0 2026-07-07: SMR reward at Fz/F3 (z=0.0), Theta inhibit at Fz (z=1.5), High-Beta inhibit at F3 (z=1.0), Beta+High-Beta inhibit at F4/C4 (z=1.0/0.7), Alpha reward at P3/P4 (z=−0.5). All Z-score based — auto-scales to your per-session baseline. Progression schedule embedded in config.
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. Frederick Starr |
| Practice | Integrative Neurotherapy LLC |
| Location | East Brunswick, NJ |
| Phone | 732-307-7229 |
| Credential | qEEG Diplomate certified |
Action Items
- ✓Receive qEEG results from Dr. Starr (2026-06-22, MYNEURVA BEAM)
- Configure Myndlift targeting based on qEEG results
- ✓Calibrate protocol_config.json from qEEG findings (numeric thresholds pending Dr. Starr's review)
- 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. Starr
Received 2026-06-22 (MYNEURVA BEAM). protocol_config.json calibrated — numeric thresholds now pending Dr. Starr's clinical review.
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.