DavidK,

Welcome to NeuroTalk.

I'm not surprised you got relief from the neck therapy. But, I doubt he fixed. He just improved it for the short term. Neck injuries take months to stabilize.

At the present, I think your fatigue problems are due to poor sleep. If you look at your time line, you have had a lot of poor sleep as you fatigue has gotten worse. Learning how to sleep without stressing or reinjurying your neck will be good. Neck exercises should be limited to gentle strengthening with limited range of motion for a few weeks. Anti-inflammatory meds (ibuprofen) and icing can help.

Your response to the Nortriptyline is common. It and its predecessor, amitritpyline have been successfully prescribed in low doses for insomnia and headaches from PCS.

The most important factor for you to understand at this point is quite simple. Just because you are having a good day or couple of days does not mean you can increase your activity and work load. You need weeks of those good days to improve. Lasting improvement comes when your symptoms are low.

It will be helpful to learn the early signs of impending overload. Things like struggling to focus to read, rereading a line of text, and may other minor struggles are indicators of a need to slow down and even take a break. Using ear plugs or headphones can help in noisy areas.

Feel free to tell us about any specific situations where you might be over-stimulated or pushing the limits.

My best to you.