SD Voyager Interview

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functional neurology

We are honored to have been interviewed for SD Voyager. Below is a transcript of the interview. Enjoy!

Today we’d like to introduce you to Stephanie Barbakoff and Benjamin Terrano.

Stephanie and Benjamin, can you briefly walk us through your story – how you started and how you got to where you are today.
My partner Ben Terrano and I, the owners and clinicians at Oculus Brain Centers, met during our doctorate program. One day during a short break between classes, Ben told me he was going to “Func Neuro Club”. To which I replied, “func what?”. I thought it was a new genre of music. In reality, the Functional Neurology club was a group of soon to be Chiropractors studying the functions of different areas of the brain. They were applying extremely complex material to their understanding of the body in order to make their Chiropractic treatments more precise and effective. I was so intrigued by the depth of the information and I realized that in order to master the nervous system, I would have to confront my, then, primitive understanding of the brain’s role in health and healing.

Ben had worked in a Functional Neurology office previously so he knew this was what his career in health care was going to look like. But for me, I was floating downriver just waiting for the next twist or turn, submitting to wherever the current took me.

The chain reaction started in 2012 when I totaled my car and my whole life changed.

I sustained injuries to my neck and head that required me to seek medical help. I was a relatively healthy individual growing up and rarely had to go to the doctor. So when my parents and friends told me to go see a neurologist, orthopedist, or an osteopath for my injuries, I wasn’t thrilled about the idea.

My instincts told me to go see a chiropractor. At the time, the extent of my understanding of the profession was that it may help with my neck pain and I wouldn’t be pressured to take medications or have surgery. So when I had my first visit and immediately felt like my old self again, I was completely intrigued by this new side of healthcare I’d never been exposed to before. A side where people looking to stay healthy were given tools to do so. Preventative medicine- what a concept! From here, I decided to pursue a doctorate in Chiropractic and that was easily the best decision I’ve made in my life.

I’m so grateful for my training at Life Chiropractic College West. It offered me a foundation of knowledge and hands-on training that I continue to build on every single day. My doctorate and specialized training in clinical neuroscience through the Carrick Institute have enabled me to focus my efforts on helping people with complex neurological conditions and brain injuries. Moreover, it allows me the avenue and opportunity to serve people who are out of options and out of hope. This has become my life’s work.

In order to be eligible to become a diplomate in Functional Neurology, you must attend at least 300 hours of clinical neuroscience courses through an accredited institution. On top of those 300 hours, you must pour over dense neuroscience textbooks and research in order to prepare yourself for a two-day board examination. This examination tests both your clinical skills and competence by requiring the applicant to complete a full neurological examination with history on a patient, provide a clinical opinion with treatment strategies, as well as answer several hundred multiple-choice questions over the course of the weekend. Earning our diplomate status was one of the most cherished accomplishments of our lives so far. It brought our journey full circle. We started our doctorate program together, studied together, earned our Chiropractic Doctorate and became licensed together, and finally earned diplomate status together. There was only one box left on the list to check off: opening a clinic together.

After practicing together for several years in Central California, we decided it was time to move down to our favorite city in the state: San Diego. There are so many brilliant clinicians and healthcare facilities here, we knew it was the right place for us. With Ben’s love of homebrewing and my love of tacos, there really isn’t another city that even comes close! We made the move down this spring and opened our doors in August. The overwhelming love and support from our colleagues and the community have been staggering. We specialize in patients suffering from chronic pain, post-concussion symptoms, migraine headaches, and other complex neurological disorders and there are way more of them than there are of us. We definitely have our work cut out for us and we are grateful to have such a wonderful community to serve.

Dedicating ourselves to helping people feel and function better has far-reaching effects we will never be able to quantify. When people don’t have pain, they have the chance to be their best selves. When they don’t have neurological dysfunction, they can hold jobs and support their families. What a gift to be able to give to patients! This is why our days are filled with learning, training, and researching, so we can sleep well knowing we are offering the most effective solutions available.

We’re always bombarded by how great it is to pursue your passion, etc – but we’ve spoken with enough people to know that it’s not always easy. Overall, would you say things have been easy for you?
The big picture: sure, it’s been a pretty smooth road.

The small picture, the nitty-gritty: there were absolutely struggles along the way.

Getting to the point where we could open our own practice and see it thrive took a LONG time. It’s a painstaking process. First, you have to pay a quarter of a million dollars EACH for your education, add ten grand if you want to be a neurology diplomate, add a few more thousand for all of the extra seminars and training to be the best of the best and maintain certifications- it adds up. Taking on the financial burden of becoming a doctor is a big struggle. You hope that all of your hard work will pay off in the end and that your outstanding customer service and dedication to helping your patients will neutralize your debt so you can continue to help more patients who walk through your door.

Then you have to convince yourself you’re not an impostor. Lots of people struggle with this concept but more so women; that they’re good enough, that they have what it takes, or that they’re ready to climb the huge mountain that’s in front of them. Even with over 20 years of education and healthcare specific training between us, initially, we didn’t know if we were ready for the challenge. We took a job offer as associates in another practice. In the end, we learned we already had it- the training, empathy, and passion to open our own practice. The few years we spent working in another clinic allowed us to see how far we had already come, how capable we were, and how it was time to move forward on our own. But it was a great experience overall- getting the opportunity to serve patients and build strong connections as you help people heal is something that we will always be grateful for. However, having to dig up the roots that you grow in a place and leave patients behind is one of the hardest things we’ve ever done. Each of those people has left an everlasting impression in our hearts.

Since we’ve gotten to San Diego, our biggest struggle was getting into our office. A major struggle with being trained as doctors, you are not trained to be business owners. Navigating the legal world, the corporate property management world, and insurance world, was brand new to us. Luckily, I have a background in running my family’s corporations back in New York and I have had to wear my business-owner’s-hat more than my clinical-hat these days.

Like I said, big picture, it’s been smooth sailing. Our job is pretty black and white. We only concern ourselves with two things: figuring out what’s going on and finding a way to get the patient better. Patients and other doctors appreciate our honesty and transparency in addition to our refined clinical approach. Now we need to continue to get our name out there so people can find us better!

We’d love to hear more about your practice.
In short, we identify the root cause of a patient’s symptoms and offer drug-free solutions to correct neurological dysfunction, rather than medicating.

Many patients ask us the difference between medical neurology and functional neurology. Traditional medical neurology looks at the “black and white” of neurological disease; Do you have a tumor? Are you having a stroke? Call a medical neurologist. Functional Neurology explores the gray side of neurological problems, with a focus on conditions relating to diminished function such as migraine headaches, post-concussion syndrome, dizziness, post-stroke rehabilitation, and many others.

Functional Neurologists are trained to detect subtle changes in the nervous system, oftentimes detecting conditions early, before they become pathological. A functional approach means our doctors are focused on optimizing neurological integrity. They continue to study the most current research in order to gain a diverse array of therapeutic tools to create meaningful changes in the brain.

Dysfunction of neurological systems can occur at a level that may not be detected through advanced imaging techniques, as there may be no pathological origin of the dysfunction. Many of our patients end up in our office with normal brain scans wondering why they are still having symptoms. This is often because many higher imaging techniques are not sensitive enough to detect the subtle changes in the brain found in people with the conditions I’ve listed above.

Why we’re different: Our patients come to us after seeing dozens of doctors, most of the time even specialists, with normal brain MRI’s and CT scans. They need someone to look at things in a different way. If they have neck pain due to chronically tight muscles, we don’t always blame the muscle- we ask WHY is the muscle tight in the first place? Is it an issue with the muscles or joints? Or is there an issue with the brain’s control of those structures? Does the patient have an altered perception of where their head is in space? And therefore the brain can’t figure out which muscles should be relaxed and which should be contracted? We apply this type of reasoning to other presentations as well: the patient has poor balance and increased fall risk. Do we tailor treatment towards the feet and ankles? Is the vestibular system in the inner ear involved? is there an ocular issue that requires moving the eyes in a certain direction? How do we combine treatment strategies to make care the most effective?

We can differentiate one cause from another. Then, once the clinical clues are all collected and using the latest research to guide us, we put the pieces all together into a customized treatment plan for the patient. THIS is why we’re different. Some therapies we utilize in the practice are identical to what other practitioners are doing. Some are wildly different from what other practitioners are doing. We just combine these therapies in such a way that helps to create neuroplasticity, a re-enforced, long-lasting neurological change in the system. It requires an individualized approach.

Two migraine patients with the same exact presentation may require completely different treatment strategies. Same thing goes for post-concussion patients. No two brains have the same composition or response to treatment so we don’t have cookie-cutter care plans. When function is restored to that person’s specific brain areas which need it and systems that have been “off-line” come back “on-line”, symptoms often diminish. We see this in our practice time and time again! We don’t treat conditions, we help people function better.

Stephanie, what were you like growing up?
I was an active, sporty and athletic kid. School came naturally to me so I had the luxury of participating in after-school sports such as softball, lacrosse, volleyball, soccer, and many forms of dance. I was always an extremely social kid. Tons of friends, center of attention, lots of energy. I was always told I was “bossy”. It grinds my gears that little girls are discouraged for this attribute but little boys are rewarded. Beyonce once said “I ain’t bossy, I’m the boss!” and let’s be honest, Beyonce is right about that! I’ve always wanted to be self-sufficient and be my own boss. I would come up with business schemes constantly: My friends and I would run lemonade stands, sell their siblings’ toys, etc.

Reflecting on this question, these are still my main attributes I carry with me today. I have lots of friends already here in San Diego and my job allows me to be social, network, and build connections in my community. I run my own business and although I try not to be bossy, I’m definitely the boss. I’m still very athletic and not only do I lead a healthy life, but teach and encourage others to do the same.

Picture of Dr. Stephanie Barbakoff DC, DACNB

Dr. Stephanie Barbakoff DC, DACNB

Originally from New York, specializes in women’s health as it relates to post-concussion syndrome, hormones, fatigue, dizziness, and chronic migraines.

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