[justaguy394]

In March of 2002 I got a concussion while playing indoor soccer, from hitting my head on the astroturf. I had about 20-30 minutes where I couldn't recall anything to do with numbers: didn't know any phone numbers or addresses or the current day/week/month/year etc. But I felt pretty normal by the next day.

Fast forward five months when I went on a scuba trip to Florida. I was a new diver and had done some short, shallow training dives at home in the springtime. But these were my first real dives; deeper and longer (40-50 feet, 45 minutes). First dive was fine, but when I surfaced from the second, something happened to me. Literally as I took the regulator out of my mouth upon surfacing, I felt like I got hit by a ton of bricks: I felt out-of-it, dizzy (like I was drunk), and had a senation of pressure on the top of my head (like someone was pressing on it). I haven't been the same since. I have chronic pain (more like an intense soreness) in all my muscles from the shoulders up (face, neck, scalp etc). I still feel out-of-it or foggy-headed, difficulty concentrating, and cannot feel positive emotions (depression). I just feel crummy all the time. It's like this 24/7, it never gets better or changes and it's been 8.5 years. I've tried almost every treatment you can imagine to no avail, but it's hard when no one can give me a good diagnosis. Some say I have TMJ, TOS, atypical neuralgia, etc. but the treatments usually do nothing.

A TMJ-type issue makes the most sense (because symptoms started at the instant when I removed the pressure on my jaw from clenching on the regulator), but treatments for this have been mostly ineffective. I have seen numerous TMJ specialists and had many special appliances made. Most of these did nothing. But one got rid of my constant headaches. And another one would sometimes (though not always) give me a 20% improvement in facial tension/soreness and mood for about 10 minutes the morning after each weekly appliance adjustment. But it never lasts and eventually the dentists give up.

So my current doc wants to go after the concussion side of this, thinking that the dive's pressure somehow brought out symptoms from the concussion. It sounds somewhat-plausible... though why would it happen just as I took the regulator out of my mouth? I had varied my depth several times during that dive (all within dive tables), and I had spent a long time at very shallow depths (not as much pressure) prior to surfacing. That part doesn't add up. But some of my symptoms do sound a little like PCS. I have had neuropsych testing done twice and they thought I looked very normal, but I don't feel normal. I feel I can focus for short periods of time to take their tests, but not for my day-to-day life.

Anyone think PCS is a factor here? My doc is having me go for HBOT next week. I think it's worth a shot, but it's also very expensive. Any input? I'm just so tired of feeling this way...

[Mark in Idaho]

HBOT at the late time in your progression is odd. The PCS could be a real diagnosis. I would suggest getting check out for neck injuries of any kind. The removal of your face mask at about the same time as removing your regulator could have aggravated a cervical injury from the concussion.

How is your sleeping? Do you feel like you are getting enough rest? Do you feel sleepy during the day? Do you have any weird or stressful dreams?

Flat emotions are not necessarily depression. It is not uncommon with PCS.

Are you on any meds?

I have benefited greatly from myofacial release Physical Therapy. My PT can get the muscles from the shoulder up to stop spasming. A combination of chiropractic with kinesiology and massage also has helped. My shoulder to neck area has been chronic since 2001 when I was injured with a whiplash like injury.

It often requires the patient to become the diagnostician by learning how to describe the symptoms. Vague symptoms lead to vague treatment and shots in the dark by doctors. Download, print out and read the TBI Survival Guide found at www.tbiguide.com It can help you better understand your symptoms.

Neuropsych assessments are not always interpreted correctly when concussion is a possible cause o0f minor deviations from the normal scales. The irregularity of the scales can point toward problems even when the scales are within the normal range. If one scale is in the high end of normal and the other is at the low end of normal, it can possibly indicate concussion. The Trail Making test is a common test with these differentials between the A and B times. The WAIS-II and WMS also can show this discrepancy.

To make matters worse, some neuro-psychs have a bias against organic causes of minor deviations in scores.

More specific information about your symptoms and NP Assessment results could help to offer possibilities.

We are here to help. Let us know what we can do to help.

My best to you.

[justaguy394]

Mark, thanks for your input. To answer your questions:

Most of the dozens of doctors I've seen dismissed the concussion, they all focused on the dive. I don't think any of them, other than my current one, tried to do anything about the concussion. So that is why we are trying HBOT at such a late date... no one had suggested it before. I'm not sure how to get checked out for neck injuries... I've seen neurologists, physical therapists, physiatrists... none has shown concern for my neck after examination.

My sleep has been difficult since the dive. For several days after the dive, I was sleeping 12 hours a night and still waking up feeling terrible. Then over the next few weeks I started waking up early, 5 or 6am, and being wide awake despite being tired and having gotten little sleep. Then I started having trouble both falling and staying asleep, but I've been on lots of medications to help with this over the years. Currently I'm taking L-tryptophan, which was working for many months, but never seems to give me refreshing sleep. I don't think I've felt "rested" in the morning since the scuba dive. I don't really feel sleepy during the day, just tired and worn out, but I generally am unable to fall asleep if I try to nap. I don't usually have weird or stressful dreams.

I'm not currently on any prescription meds, though I've tried tons over the years: neurontin, numerous anti-depressants and benzos, muscle relaxers, etc. Most just made me feel worse. Amitriptiline at low doses (10-20mg) helped me sleep for years, but I felt it was affecting me in other ways and eventually got off it. Currently I take some supplements to help me sleep (L-trptophan). I actually had some small benefits from other amino acids (tyrosine) that intermittently helped my mood a little, but the results never stayed, and my stomach always felt irriated by these pills.

I've tried tons of chiros, massage etc. though I'm not sure I did myofacial release. Is that the one that is really light? Where they just barely pull on the muscle? That sounds familiar and I tried it for a while without any results... though I do remember my ears popping nicely during on session, but nothing else.

I am looking at the tbiguide, thanks for the link.

I'll have to dig up my neuropych results to provide more info on them.

Off to my first HBOT...