kelly,

I am confused as to why your neuro would be against the graduated exercise. The whole concept is to avoid triggering symptoms. Anything you can do to increase blood flow without increasing/triggering symptoms sounds good just on basic physiological logic. Many doctors will commonly allow any activity that does not cause pain (our body's first line of communication) or other symptoms.

all,

I am also confused by the reference of a concussion specialist. In all my years of PCS and PCS research, I have never found a Concussion Specialist on the treatment side. Dr Dorothy Gronwall and her colleagues in New Zealand are probable the best but Dr Gronwall has passed away and her colleagues are retired.

There are only concussion believers and concussion deniers. Even the concussion believers are not specialists. The Buffalo people are not concussion treatment specialists. They are "return to play after concussion" specialists.

Most cognitive rehabilitation specialists are focused on much more severe symptoms that those of PCS. Their targets for success are often about level that PCS subjects are when requesting help/therapy. In other words, my current level of symptoms, memory deficits, cognitive deficits, slowed processing speed, behavioral struggles, are considered to be the end goals for most TBI patients.

I just got home from my local brain injury support group. I am the highest functioning in the entire group despite my many difficulties. Hopefully, someday, health care providers will discover ways to help PCS subjects with our struggles. At present, we do not meet the 'severity of symptoms' minimum for serious consideration.

Dr. Julian Bailes, chairman of neurosurgery at the West Virginia University Hospitals is more expert than most, especially since he understands the long term problems. There is also a researcher in Boston who understand concussion from a post mortem diagnostic perspective.

Both are still hoping to discover treatment modalities that offer consistent results that insurance companies will fund. Treatment for long term symptoms is still a mixed bag.

One expert recently stated that the first priority is to stop denying care to PCS subjects. He stated that this requires that medical records properly list concussion as an early diagnosis (ICD-9 diagnostic code 854.0 ). This way, when symptoms become evident at a later date, they can be considered as possibly caused by the previous concussion. Otherwise, later care is refused and the symptoms are labeled somatoform, psychological, or malingering.

Good luck as you push your health care providers to acknowledge your PCS condition.