[redwing88]

I was rear ended in March of 2010 and got a concussion. I was diagnosed with a concussion and was told it might be a few days before I felt better. Throughout the first week I lost the ability to speak coherently. I could not construct a sentence properly and obscure and irrelevent phrases would be scattered throughout my speech. I could not find words, would substitute wrong words, and then get angry when someone couldn't understand me. My balance was affected and I started walking with on hand out to the side to keep my balance. I had the typical headaches, earpain, and intolerence of noise and stimilation and busyness.

I worked very hard and had a lot of support in the first 6 months or so. After 10 months I was able to return to work part time in a limited capacity. I'm a police officer in a tough city. My family and coworkers were amazed at my recovery and some told me that they never thought I'd be able to live independently again much less return to work.

I have now been working full time on my own for 7 months, and without any restrictions for the past 4 months.

All of that means that I have recovered greatly but I still struggle so much. Most noticable to others are my change in personality, ability to handle stress, and how quick I am to anger and mood changes.

Most noticable to me is my inability to find ideas or memories especially placing those in context. I get "lost" when I try to find a memory or read a book. Thinking is so much more difficult. I used to be able to read a James Patterson type book in a few hours with complete comprehension and recall. Now I struggle to read one over several weeks and usually have to reread parts of it and look back over it to remember what happens.

Whenever I'm overly tired my symptoms get worse. When I'm really stressed, tired, or sick I have so many symptoms that I can't function.

My doctor calls this a depleted cognitive reserve and says that I need to rebuild my "brain buffer."

Has anyone else heard of this? Does anyone have any suggestions on anything I can try to keep improving my functioning?

Thanks for letting me share. Due to the nature of my job, its not like I can share with anyone that I still struggle so much.

[AllAmericanAmy]

Some of the anger issues, etc can be helped by medication such as Zoloft. My husband (TBI in Jan 2011) has anxiety issues since the TBI. Unreasonable anxiety. He is now taking 75 mg Zoloft and it helps a lot. Please consider talking to your doctor about it. The Zoloft also helps control some of his other issues, including bring a little more clarity to his thinking.

I know. You don't WANT to take a pill. Neither did he. He is a former drug addict (30 years ago), but wants NOTHING to do with any kind of medicine that messes with his brain. After waiting months and months, he finally agreed to try it and readily admits it is a HUGE help to him in overcoming some of the problems (including brain fog).

As far as concrete things to do to help improve your cognitive thinking skills, I highly recommend the website LUMOSITY. Once you join (it is about $75 for a year but there are always discount codes on the internet) you can take their tests that target various cognitive skills. They measure where you are and then direct you to the games on their website that will help you strengthen the areas you are weak. The "games" are timed and "rated" with the scores retained and you can see one week or one month later where you were and how you have improved. Search this site for more ideas - folks on here are GREAT with GREAT ideas.

Cognitive thinking therapy is also covered under a FEW (very few) insurance policies. Hubby's rehab doctor has kinda snuck him into "speech" therapy (more readily covered by insurance) where they do about 3 minutes of speech for his "slurring" of words occasional and "stumbling" to find the right word. I think the dr. said on the prescription it was to help improve his speech and communication to help reintegrate into the workforce and daily life. Majority of the time is spent doing cognitive skill work - very similar to Lumosity, according to my husband.

So, may I say I am very, very concerned about your working while feeling the symptoms you described? My heart hurts for you, and I know some of the struggles you are going thru with all of this, but I'd encourage you to consider going back out on Family Medical Leave act or whatever you need to do because your LIFE may be at risk since your thoughts are not CLEAR. Additionally, your fellow officers lives depend on your clarity of thought and good judgment capabilities, as well as the general public. Sorry, but I felt it needed said.

Blessings to you...
Amy (daughter of a retired police officer)

[Mark in Idaho]

RedWing88,

Welcome to NeuroTalk. I fully understand what you are going through and sympathize with you.

AAAmy makes some good points but is commenting as an observer.

Regarding cognitive thinking skills,,, Lumosity may help but you need to be cautious. It also can easily deplete your "cognitive reserve" as your doctor calls it.

My first recommendation is for you to have a full battery NeuroPsychological Assessment. Was your accident while on the job? If so, it means you are likely limited to Work Comp benefits unless your state allows you to file a claim against the other driver even when you are injured while on the job.

Your proper diagnosis should have been concussion with whiplash. This can greatly complicate the simple concussion injury.

Your situation sounds similar to John Byler's as he recounts in "You Look Great" as his YouTube video series describes. Check You Tube for "You Look Great." It is 6 videos that take about an hour total. Your family and friends should view it too.

I have heard of "reserve" but not "brain buffer. "

Your brain may have used up its reserve. This reserve is the brains ability to utilize under-utilized areas to make up for losses. Think of it as a 8 lane highway. During commute hour, all 8 lanes are busy. During normal times, the traffic could easily flow smoothly on 4 lanes. At midnight, it could work on just 1 or 2 lanes.

Your 8 lane brain has been reduced to 4 lanes during normal times and only 1 or 2 lanes when you are under stress. This causes the traffic jam of thoughts. The question is whether you can restore it to 8 lane function. This depends on the level of injury. There are very limited ways of determining if your brain can rebuild the damaged 4 lanes.

To add to you situation, I would assume that you have experienced a fair number of sub-concussive impacts during your life, both in sports and during POST training and retraining. Add the constant repetition of minor blast concussions from maintaining firearm proficiency and your brain has likely seen a considerable amount of sub-concussive impacts. Add to that any prior concussions and your cumulative injury can become quite a problem.

All this to say that further recovery will likely be a combination of two modes. Cognitive training may be of help but needs to be carefully done so as to not overload your brain. The more important task will be learning some work-arounds and other accommodations and coping skills.

Minimizing stress should be your first objective. As a cop, that will be a tough one. The common stress reliever of a beer or such will be counterproductive as it causes chemical stress on the brain. A single serving may be tolerated but not much more. Caffeine is also a brain stressor. Again, a single serving per day, early in your day is recommended.

There are many work-arounds and accommodations to help with specific struggles. Word finding, memory recall, contextualizing memories, etc, are all common PCS symptoms. Your description of your own struggles sounds like you have stolen my brain. Been there, doing that.

The reading issue sounds familiar too. To show you how work-arounds can help, I'll explain a reading work around.

Take a piece of paper and cut a wide slit in it so you can see a few lines of print in your book. Holding this over the pages, slide it down the page as you read. This will allow your eyes to see the lines you are reading and about to read. The reduced visual image may help you read the book.

Reading fiction may continue to be a struggle, even with this work-around. I can not read fiction anymore. My brain can not keep all of the details in memory. I also struggle with overly descriptive sentences. Too many issues variable to try to combine into one image. This is a result of losing 'digit span' capabilities.

A mature] adult] mind] should] be able] to process] and hold] for combined processing] as many] as 8 items] (digits)] without difficulty]. Many] can do] many more]. The first sentence has 12 digits. The second sentence has 3 or 4. I used the ] bracket to show each digit in the first sentence.

If James Patterson uses too many complex and overly descriptive sentences, I can understand your struggle. You likely have to read the text three or four times to follow the story.

When you are reading, if you can read without having to reread a sentence, continue reading. once you start to reread sentences, your brain has reached cognitive fatigue and you should stop. You may be able to relax, close your eyes for a few minutes and resume reading. The key point is to avoid the fatigue. The medical term for this is 'over-attending.' Your brain is trying to attend to more than it has the ability to process at that moment.

There is lots more I can tell you. I've been living with this condition for almost 12 years. But, I have probably overloaded you already.

Print out this post so you can read it again later. Highlight the things that are making sense. Write down some questions for a later post.

And lastly, try to realize that you are running a marathon, not a sprint. You can and will need to learn many new skills to regain the rest of your life.

My best to you.

[redwing88]

thanks for the thoughts. I used Luminosity during my initial rehab but not since returning to work since I do lots of varied thinking on the job.

I have managed to be successful at work for the past 8 months, 6 months with no mandated restrictions. If I feel foggy, disoriented, or overwhelmed I go out of service and take a break, strecthing, walking, meditating, etc. If I cannot return to clear thinking within a reasonable time I either become the "gopher" doing the more mundane tasks such as property checks or parking tickets or just do desk work in the office. If I'm having a really hard time I just leave work as sick. I haven't had to leave work early for this since August.

Obviously when I have relapses I call in sick for a few days until I'm doing better.

I think part of the reason I can be successful at work is that I work so hard to protect myself and my energy levels while at home on my work days. I spend my days before going to work doing the things that help protect my thinking and energy level and never schedule activities or difficult chores for those days.

I wanted to say those things so those of you scared about me working can be assured that I am aware of the importance of being at my best at work. I went through four months of every type of testing required by my department before they felt I could return to work. Then I had another 3 months of riding with a training officer both to relearn what I had lost and also so the training officer could do daily evaluations of me. Lastly my LT is very supportive and allows me to pace myself while not letting me limit myself unnecessarily.

My doctor told me that he doesn't believe that any cops have been able to return to work after a pcs with this severity. Does anyone know of any?

With all that being said, I am still very concerned about the continuing problems and am very open to any and all suggestions for how to continue to recover.

I don't drink at all and my doctor told me that mtbi can cause people to not be able to handle alcohol. I do drink a lot of caffeine, more so in the past several months which might account for some of the problems returning. Is there any suggestions about nicotine?

This was my 8th documented concussion. My first one was when I was 14 and I had partial amnesia for about 8 hours (I knew who I was and where I was but I didn't know who anyone else was.) My one prior to this last one was about 4 years ago and I had such bad headaches and dizziness I didn't work for 3 weeks. I know there have been other blows to the head from fights and falls that I never went to the doctor for because they didn't seem like they were bad enough. I'm praying for safety at work and take extra care to protect my head now. (as in no more rollarblading with the kids, and extra backup if I think a fight might break out.)

Also, today was my most successful day socially at work since I returned. I took four more calls than I usually can handle well and was more interactive with the guys than I have been since the injury.

thanks again, I wish I had found this website earlier

[xxxxcrystalxxxx]

Redwing,

I can relate to what you are saying..I too take FOREVER to read a book. Preaccident I could read a book in hours... It's frustrating I know. I know when I'm stressed or tired my symptoms come back ten fold. I think it's our bodies way of saying...whooah buddy...slow down.

Do you have any vacation time? Maybe a week off will help you. Perhaps it would give your tired brain some relief.

Sorry I dont have any more suggestions but I wanted to let you know people are thinking about you.

As for the nicotene...I'm sure it's not helping. I quit smoking a couple of months before my accident. How I'm able to continue that I have no clue....You know how it goes... The cigarette is who I turned to for over twenty years when things went bad. It's hard but I know financially and physically it wouldn't be good for me... even though the thought of buying a pack and lighting up sounds wonderful...lol.... Good luck my friend...

[redwing88]

Thanks Crystal.

I have actually had a great work week. The last three days have all been great days in every way. I was more successful at work, socially, and did not experience any symptoms at all any day. I have the next two days off and am not going to push myself.

I had pneumonia and I think I have finally kicked the last of it. Maybe I'm finally getting some traction now that I'm not sick. I have had foster kids living with me and in October they left to go to an adoptive home. Then I was sick.

Maybe now that I can focus more on taking care of me and I'm feeling healthy, I will be able to maintain my recovery. My mom has me documenting my good/ok/bad days. Three great days in a row is a huge victory.

I cut out my caffeine except for one when I wake up and I restarted my lumosity courses.

[Mark in Idaho]

redwing88,

Glad to hear you have had some good days.

Your concussion history sounds on par with mine. My neurologist told me after reviewing some diagnostic tests, that he believed my current condition may be permanent due to the severity of my prolonged and continuing symptoms. His position was that due to my concussion history, I had exhausted my brain's ability to recover. This is what is sometimes called Multiple Impact Syndrome. The accumulation of injury from multiple impacts has caused damage beyond the brain's ability to tolerate.

This may be your situation. If it is, your best approach now is to learn the various work-arounds and such to do your job. Beware that you may be one slug to the head away from permanent disability.

When you are at the range, pay close attention to how you feel during your session and the day after. If you sense any return of symptoms, you may want to find a full face shield helmet to wear during shooting practice. The blow back blast forces from a 40 or 45 caliber can be more powerful that one would expect.

On a different note, you have an excellent opportunity to explain the cognitive issues of a concussion victim to your department. Being able to recognize the deer in the head lights look of a person struggling with PCS can prevent some escalations in the field. The police normal of using power of voice to maintain control of a subject is counter to a person suffering from PCS. The strong voice can cause the sensory overload resulting in strange behaviors and even violence as the subject tries to protect themselves from the sensory overload.

With the number of Iraq War vets getting in trouble due to their PTSD and PCS, having an inside view of PCS will be a great skill.

My best to you.

btw, Three good days does not a recovery make. Be glad for them but don't take those good days for granted. It is great to have someone who can help you log your good and bad days.

[redwing88]

Thanks Mark.

I was very grateful for the three good days in a row. I was preparing for a harder day after the second great day. Thank God it waited for a day off. I didn't have any cognitive challenges or symptoms of any kind today, except for the ringing in my ears. But I was extremely tired. I took care of myself today and have no hard plans for tomorrow.

I had not thought about the shooting being a problem, except that I don't like the noise so much anymore. I have worn double hearing protection at the range for several years and maybe that helps.

I didn't think about using my experience to educate other officers. I've tended not to talk about it with them. I have quickly recognized concussions in car accident victims before any other officer a few times. I'll give some thought to how to help others to recognize symptoms and responses without damaging their perception of me.

Do you know if anyone else's doctors have recommended supplements for pcs? My doctor started me on B12, fish oil, melatonin, and magnesium. I notice a big difference when I stop taking the melatonin and magnesium. I can't tell the difference with the B12 and fish oil, though.

[Mark in Idaho]

The B12 and fish oil are a good start. Folate and B6 is also worth adding. It takes months for vitamin and mineral supplementation to show a difference. The biggest difference will be strengthening your tolerance of stress and moderating your mood,personality.

You can get you B12 and folate tested with a blood test. You want to be near 1000 pg/mL of B12. (picograms per milliliter)

I have been on a supplement regimen since a doctor started me on it in 1982. My wife can tell when I have skipped a few days by changes in my personality and mood.

A B100 complex each day plus 100 mgs of B12 and 100 mgs of B6 is about my level of B's. The compromised brain needs B's.

The melatonin is not a help to many. The magnesium should be part of a full spectrum of minerals.

Think of supplement nutrition like going to the range. If you miss a few times at the range, you don't notice. If you miss a few months at the range, the difference become obvious.

Supplements need to first help the brain detoxify from the byproducts of the trauma. Then, they can start to help you brain strengthen and rebuild.

The range issue is one of cumulative very minor impacts. Subconcussive impacts are the biggest problem for those of us with Multiple Impact Syndrome. Our brains are so much more sensitive to any jarring of the brain. The ear plugs and head phones is a good idea. I do the same when I go shooting.

Before you talk about your PCS, it will be good for you to gain some strong background understanding of concussion. The TBI Survival Guide is a good start. Download it at www.tbiguide.com

The YouTube video series by John Byler at http://www.youtube.com/watch?v=x9Xso4qGdlI would be a good start for your fellow officers.

Your department should make it a part of recurrent training. This past week's episode of Harry's Law also did a good job of explaining mTBI and concussion.

Next time you are at the range, put your hand against the divider separating shooters. Unless it is a brick or concrete wall, you can feel the impact of the shots fired on the other side. This impact is hitting your brain. This is similar to the blast concussions suffered by soldiers in Iraq except much less intense.

You sound like you have some better than normal doctors helping you. You are fortunate.

My best to you.

[Hybernating]

Personally...I don't see how you function at all at work. I worked in recreation and made it working for 8 months, then I just couldn't do it any longer. Took FMLA and was fired. Wow.... and a cop on the road dealing with post concussive disorder. God help us..I'm just kidding, I just don't know how you van handle the stress? Perhaps your on the lucky end of healing from your injury. Let's hope huh...

Originally Posted by redwing88

I was rear ended in March of 2010 and got a concussion. I was diagnosed with a concussion and was told it might be a few days before I felt better. Throughout the first week I lost the ability to speak coherently. I could not construct a sentence properly and obscure and irrelevent phrases would be scattered throughout my speech. I could not find words, would substitute wrong words, and then get angry when someone couldn't understand me. My balance was affected and I started walking with on hand out to the side to keep my balance. I had the typical headaches, earpain, and intolerence of noise and stimilation and busyness.

I worked very hard and had a lot of support in the first 6 months or so. After 10 months I was able to return to work part time in a limited capacity. I'm a police officer in a tough city. My family and coworkers were amazed at my recovery and some told me that they never thought I'd be able to live independently again much less return to work.

I have now been working full time on my own for 7 months, and without any restrictions for the past 4 months.

All of that means that I have recovered greatly but I still struggle so much. Most noticable to others are my change in personality, ability to handle stress, and how quick I am to anger and mood changes.

Most noticable to me is my inability to find ideas or memories especially placing those in context. I get "lost" when I try to find a memory or read a book. Thinking is so much more difficult. I used to be able to read a James Patterson type book in a few hours with complete comprehension and recall. Now I struggle to read one over several weeks and usually have to reread parts of it and look back over it to remember what happens.

Whenever I'm overly tired my symptoms get worse. When I'm really stressed, tired, or sick I have so many symptoms that I can't function.

My doctor calls this a depleted cognitive reserve and says that I need to rebuild my "brain buffer."

Has anyone else heard of this? Does anyone have any suggestions on anything I can try to keep improving my functioning?

Thanks for letting me share. Due to the nature of my job, its not like I can share with anyone that I still struggle so much.