On this Friday evening, in Rosny-Sous-Bois, Bruderick Nsiete’s osteopathy practice is almost empty. In a small consultation room, located at the back of the cabinet, Bruderick Nsiete performs a somewhat special session with Catherine, one of his patients. Drawing exercises and cryotherapy are on the program.
Catherine suffers from chronic traumatic encephalopathy (CTE). This progressive neurodegenerative disease, caused by repeated concussions, leads to brain dysfunction. Often complex to determine during examinations, it is manifested by heterogeneous, irregular symptoms with no apparent link. Listed are headaches, fatigue, insomnia, disturbances in concentration, memory, balance, and behavior, depression, nausea, inability to read, write or calculating, irritability, or even schizophrenia, bipolarity, and dependence.
From then on, the evil almost systematically sows trouble among doctors. “This disease is poorly understood and therefore comes very late in the development of the diagnosis”, highlighted François Lhuissier, President of the French Society of Exercise and Sports Medicine.
“The hardest thing is not knowing what you have and what people don’t understand. My wife thought it was psychological. She wanted me to go to a nursing home “, says Mark. At 54, this teacher suffered two concussions twenty years apart. Like Catherine, he is followed by Bruderick Nsiete.
Physiologically, what is happening? During a shock to the head, the brain will hit the cranial box, thus causing a hematoma to appear, which is not always visible on imaging, synonymous with cell damage. “Each hemisphere of the brain is in charge of one or more functions of the body. When a hemisphere is affected, it will alter the neurons more or less permanently, depending on the violence of the impact and the frequency of the blows. apoptosis, programmed cell death”, explains Bruderick Nsiete.
Thus, an individual who receives one or more blows to the frontal hemisphere may then show difficulties in managing his emotions and have behavioral problems. However, a concussion does not necessarily translate into immediate clinical problems. It can be reabsorbed without apparent sequelae, but the patient will remain weakened for life, underlines the osteopath. The next shock(s), in a more or less long time, will mark the official entry into the disease.
If many athletes are victims of concussions, and therefore of ETC for some, most of the patients followed by Bruderick Nsiete are not top athletes. Four times a week, after his day of consultation, the osteopath takes care of them in his office, on a voluntary basis.
If the disease is recognized, the High Authority for Health has issued no recommendations concerning ETC. Besides, “no treatment protocol has been established”, supports François Lhuissier. Bruderick Nsiete therefore wanted to make up for this lack. When he was still a student, twelve years ago, he was confronted with the pathology, without being able to solve it. It was not until 2017 that he found the missing piece of the puzzle, by studying the case of Lucas, son of his midwife colleague, Séverine Morin. The boy, who played ice hockey for several years, suffered several concussions. He suffers from multiple symptoms.
“By observing it on a daily basis and seeing the failure of different other protocols, I was able to make a connection with the cases I had had in the past.”
Bruderick Nsiete, osteopathat franceinfo: sport
The protocol is based on three elements: cryotherapy and rest to relieve pain; oxygen therapy to halt neuron death; rehabilitation for long-term healing. “Since the beginning of the protocol, I have followed around twenty patients”, emphasizes Bruderick Nsiete, who says he adapts his sessions according to the history and the ailments of each one.
The protocol was validated by Jean Chazal, neurosurgeon in Clermont-Ferrand, one of the first to have warned of the danger of violent shocks in sport and author of the book This rugby that kills (ed. Solar). “There is no cure for concussion. Bruderick Nsiete alleviates and treats the symptoms. He puts his patients in good conditions of physical and intellectual rest, which allows the plasticity of the brain to compensate for the microlesions that have appeared “, supports this specialist.
At the end of the drawing exercise, Catherine settles into a red armchair in the consultation room. Only a night light illuminates the room, because a stronger light would be unbearable to him. Her head propped on the corner of the armchair, her eyes closed, she isolates herself in order to get away from the noise. A 56-year-old executive assistant, her life changed on October 9, 2020. While she was at her son’s house, she suffered a vagal illness, causing him to lose consciousness. In her fall, Catherine suffered a concussion. “I had two broken cervicals. I risked paralysis. So I had surgery”says Catherine.
Yet the intervention did not solve the heart of the problem. His state of health deteriorated. “I started having mood swings, dizziness, nausea, constant fatigue. I had a feeling of drunkenness, and then, for a year without a break, I had headaches I couldn’t stand anything anymore, neither the noise, nor the light, nor even the human presence”, she testifies in a low voice.
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First, misunderstanding prevailed. “I used to go to work, I was full of life and dynamic, and I could follow conversations in the noise”, remembers the former marathon runner. She has suffered other head injuries in the past, which remained clinically unaffected until her recent fall. Left to her own devices, Catherine made appointments with neurologists and psychologists. They then diagnosed a psychological disorder.
“For them, I was in depression, so they gave me antidepressants, and we didn’t look for more than that. But I’m not depressed.”
Catherine, suffering from ETCat franceinfo: sport
In April 2021, she heard about the firm of Bruderick Nsiete, and began to follow his protocol. He was the first to diagnose her with ETC. With three sessions per week, Catherine works on her concentration and the precision of her gestures through drawing and treats her pain with cryotherapy. These headaches quickly diminished, although even today she points out “no longer having a social life”. “Before, I didn’t believe what was happening to me. Like my family, I thought I was going crazy. I always say my outer shell is intact, but inside it’s another person. My life has been turned upside down.”
Catherine always ends her session with cryotherapy. Below the swimming pool, with walls covered with small blue and gold tiles, Bruderick Nsiete has transformed two showers into cabins. A large white plastic armchair is placed under the pommel. Catherine sits there and turns on the shower. The osteopath stands next to her, a jet of water in hand, and adjusts the intensity.
Next to the showers, there is a wind tunnel which allows the environment to be warmed up. “It’s an alternating cryotherapy, between hot and cold. The hot [de la soufflerie et de la douche] allows to maintain the intensity of the session compared to the repetition of cold bursts [par le jet] on a session”, details Bruderick Nsiete.
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After a few seconds, Catherine gives him the green light. The osteopath complies: he directs and moves the jet of cold water over his patient’s entire body. Catherine remains silent, but her features are drawn as the exercise requires resistance. His breathing is getting harder and harder. After several repetitions, Bruderick Nsiete ends by emptying a bottle of ice water on his head, protected by a towel.
The method is artisanal, the patients questioned affirm it : the protocol works. Generally, the first results are visible after three months according to the osteopath. “Today, my headaches are much less, and the mood swings are less. I’m still sensitive to light and sound, but now I know myself, and I know what to do to to prevent ailments or to relieve myself”, confirms Marina Olarte, former judokate of the France team, who followed the protocol intensively for four months, before reducing the frequencies.
Like her, several patients confide in repeating cryotherapy sessions at home to relieve certain crises. According to the osteopath, his mission also consists of educating patients to prevent or relieve their symptoms. “ETC is constantly evolving, but we can limit the outbreaks”says Bruderick Nsiete.
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At the end of her session, Catherine wraps herself in a towel, sits on the edge of the swimming pool, closes her eyes, plugs her ears and freezes. As always, the session cost her, but she knows that the benefits will follow. It is almost 10 p.m. in the Rosny-sous-Bois medical office when Bruderick Nsiete is arrested by another of his patients, Ellea, a 17-year-old high school student. “This week, I managed to read 100 pages, as before”, slips the teenager to her osteopath. The latter was the victim of several falls from horseback, the last of which, which occurred at the age of 14, started it all. “It’s very good, you have to continue reading”, encourages him Bruderick Nsiete.
The osteopath now wants to go further: “The protocol is in place, it must now be applied on a large scale. This is why, I wish, with Séverine Morin, to bring out of the ground a specialized center with real means.”
It would include specific facilities, such as hyperbaric chambers, noiseless and lightless rest rooms, rooms for oxygen therapy, others for cognitive and neurosensory rehabilitation, water basins of different temperatures, cabins cryotherapy… This center would also aim to enable ETC patients to step out of the shadows a little more and be better supported in their daily lives.