Repeated Concussions, PTSD, etc
 

Hello,

I am very new to this website and wanted to introduce myself and my story, followed by some questions that might deepen the understanding of my own condition.

On September 17th 2022, I sustained the initial concussion through falling and knocking my head on the ground. I only had headaches and vertigo. After about 6 months, or around the end of February, I started to come up from the symptoms but, unfortunately, received another concussion February 28th. This occurred because I had to slam on the breaks going 40mph, as someone walked out onto the road. Having almost healed again come July, my friend slammed on the breaks August 4th, giving me my third concussion.
At this point, I quit my second job and withdrew from the next semester of college before it started. I packed up most of my stuff and moved in with my father since, regretfully, my mother/her family refused to believe that there was something wrong with me. They saw it as anxiety.
I was doing well up until October 5th, where I accidentally knocked the top of my head on the bottom of a metal laundry door. By this point, I have developed headaches, vertigo, brain fog, ocular pain, neck stiffness, sharp pains in neck, numbness on the left side of the face, feeling a little disconnected on the left side of my body, feeling like I cannot breathe (I think because of the tension in head/neck), and very minimal weakness. Light and sound disturbs me, but only very slightly.
After the third concussion, I got an MRI. After the fourth, I was only able to get a CT and CT scan with contrast.

I have a few questions for you lovely people.
The first is how do you all manage PTSD? I was only mildly scared of cars during most of these events, but after the fourth incident, I feel that I am having a much harder time managing. I am scared of most everything, including doors, hills, stepping down too hard, stairs, walls, the shower, the backs of chairs, laying my head down on pillows, and even moving too suddenly. I am having daily occurrences where something will set off one of these panic attacks. This morning, I turned my head very abruptly because a bee flew into my face, and I have been panicking since. What is the likelihood of a new injury from that? They tell you to be weary of sudden movements/jerking/jolts!
The second (or I guess third?) is what are some things that I can do to help improve my situation? Throughout this experience, I have honestly changed a good portion of my life for the better. I am sleeping every night (I was an insomniac before this), watching what I eat/inflammatory foods, and walking daily. I am hoping to get a stationary bike for Christmas, which will surely improve my ability to exercise without these anxiety-related upsets. If anyone has any more suggestions, everything helps.
Lastly, if anyone could share some interesting information about concussions with me, that would make me feel better, also. I’ve learned a lot from my situation and what other people have gone through, but furthering my knowledge about neurology has, in some ways, made me see a brighter side of what is happening with me. It is lovely still being able to learn despite this!
Feel free to also drop some encouraging words/stories.

Last bit of important information:
I saw a neurologist after the second and third incident. I asked for a referral for a concussion clinic after the third instance, but for some reason, he would not sign off on it. I am going to see a new PCP at the end of this month in the hopes that I can get started with a clinic. I am thinking about dropping the neurologist, since it has become clear that many neuros do not have training with concussions, and he has been minimally helpful. I am also wondering if the clinic is worth it. I know many people have reported little success with them, as the best way to heal is with time.

Best of luck and thank you all for reading!

Oh, and if I may add -
If anyone has any caffeine, concussion-friendly recommendations on a substitute for coffee… please send them my way! Love the drink and how it tastes, hate how it can hurt your brain.
Thank you.

Welcome powerblackwolf :Tip-Hat: Someone will be along. You don't have bleeding on the brain do you?

Hello Kitt,

Thank you for your kind reply!
I am assuming not, as the CT scan came back without any complications. Unless there is something that has been missed… but even still, I imagine my pain and difficulties would be much worse, should I have a brain bleed.

You might consider whiplash.
the slamming brakes effect and even falling and hitting your head the first time.

Explore the useful sticky above the main section and read other threads here, many similar injuries and concerns
Did your head hit something during the brake slamming?

Jomar,

I am certain that, at least for the first injury, what I received was a concussion. I landed right on my forehead full-impact, without anything stopping me beforehand. I felt a wave sort of pass over my brain, so I have few doubts that the collision with the floor did not give me some sort of head-related injury.

Do you need to whip your head back and forth to receive whiplash?

How might whiplash differ from a concussion?

I understand that the symptoms of concussions and whiplash injuries are similar. How could one tell the difference, especially since I only really began feeling pain in my neck after the fourth instance?

Smacking your head hard nto anything usually affect the neck somehow, by whiplash or hyperextension/strain. Possibly misalignment of c 1 c2 .
Upcspine.com has info on that.
Up C Spine

Jomar,

After the first instance, all I had was headaches and vertigo. These aches were focused on the front, and front/top of my head. The headaches were constant, and would become a lot more severe when I used my brain. Writing, reading, math, etc. became excruciatingly painful, which is why I believe a concussion was sustained during the first issue. Plus, the headache symptom nearly went away after six months, and there was a gradual return to being able to do things as before, until the second instance described above. After slamming on the breaks, all of these issues returned.
I know very little about whiplash, which is why I wonder if that can cause mental complications such as described. Specifically, ones that worsen with academics/etc. Immediately after the second instance, it was excruciating to try and use my brain again. It felt like a new injury. Perhaps I am suffering from both PCS and Whiplash?

Thank you!

powerblackwolf,

Wow, what a story.

Where did you get your ideas about what a concussion is?

You have a lot of false information. There is a garbage pile of bad concussion information online, especially on Reddit and FB.

As Jomar said, you have likely suffered whiplash. The first event with the floor was likely more than whiplash but it appears you have resolved most of that.

Some details about concussions. It takes 60 Gs or even 80 to 90 Gs of acceleration/deceleration to cause a concussion.

It only takes 4 to 5 Gs in acceleration/deceleration to cause a whiplash event. Concussion and whiplash have symptoms that greatly overlap. Whiplash strains the neck, especially the upper neck and can cause inflammation similar to a concussion.

Braking hard in a car can only develop 1 to 1.5 Gs maximum. That braking action cannot cause any higher G forces unless the car or occupants hit a fixed object. The physics don't lie. The very best tires can only cause 1.5 Gs of deceleration.

To add to the braking event, people who struggle with anxiety usually have a very sensitive startle response. That startle can cause more symptoms than the whiplash or concussion.

Your attempts with an anti-inflammatory diet is very good but do it completely with no cheats, for 2 to 4 weeks minimum.

Rather than seeking medical attention, I suggest you seek help with PTSD and anxiety. Your posts reveal a serious struggle with anxiety.

Concussion fact: 80% of people who experience prolonged concussion struggles, beyond a few weeks, have a chronic struggle with anxiety or anxiety and depression.

Over the years on this forum, many have had similar experiences that continued until they sought help for and improved their anxiety issues. Some needed anti-anxiety meds, usually an SSRI or SNRI for 6 months as their anxious mind learned to settle down and not react to severely. Benzodiazepines, (Xanax, Ativan, Valium, Klonopin) are often prescribed for anxiety but they are not recommended when healing from a neurological trauma or stress. They sedate thought but do not help the patient reorient thoughts.

Most concussion clinics do not treat non-sports related concussions. Their protocols are focused on return to play and sometimes, return to study.

While you are out of school, you should find activities or jobs to keep your mind focused on productive tasks.

You might get some help from a practitioner who follows the Complete Concussion Management protocol. The author/developer of CCM, Dr Cameron Marshall, DC has a lot of good ideas but he is Return to Play oriented due to his training at Univ of Buffalo with sports teams. His protocol is rarely covered by insurance.

Mark In Idaho,

Ah, thank you very much for your kind and informative reply. That is very good news to hear. I suppose my misinformation about concussions came partially from what I was experiencing - when each of these instances caused a sudden return of symptoms - and from doctors.

After reading and considering what Jomar has said, I realized that I am likely suffering from whiplash, and possibly something else neck-related. I have already began an effort to treat this, starting with daily icing and improving my sleeping posture. If you have any tips on sleeping well, please let me know!
I have removed pillows from my bed and am resting only on an inch of blanket, but am still waking up very sore. I know it may take some time, but would I benefit more from getting rid of the blanket completely, and laying flat on the mattress? I will also have to try to figure out how to help my GERD, as that has become a bigger struggle since learning to lay flat.

As for the anti-inflammatory diet, do you have any food recommendations or guides that might help me better choose what to eat? I have put in a good effort, but I am finding that I am just cycling through eggs, chicken, dark chocolate, berries (raspberries and blueberries), tuna, and green beans over and over again. If these are most of my options, I’ll roll with it! But, it would be nice to find some alternatives.

You are very correct about the anxiety. I have struggled with anxiety, depression, insomnia, OCD, and ADHD my whole life. I am also a survivor of neglect and sexual abuse, so I am guessing there is some level of PTSD thrown into this whole mix. As I look through the threads that other people have posted, I am learning about how these issues not only make it much harder to recover, but that I am not alone.

My neurologist recommended amitriptyline hydrochloride. What are your thoughts on this? I have been scared to take it as I have a little history wrongfully using medicine, and I was worried about how it might affect my injured brain.
I have always been a little stubborn about using medicine and wanting to find a way to resolve anxious tendencies through other methods. I’ve been trying to expose myself to the things that were previously triggering me - walking down the stairs, hugging others, and even just being outside. I put my hood up for the first time in a while yesterday, and walked in the rain while letting the water hit my head. It was great!

Instead of a concussion clinic, do you think I would benefit more from a PT? I know that they sometimes work with whiplash patients. If I need to get a diagnosis first to see if there are any other problems with my neck, such as a misalignment, what kind of doctor might you suggest? I know nothing about the spine.

For activities, I suppose most anything is alright so long as they do not put me at risk for another injury or severely aggravates symptoms. Are there any guides for noticing what aggravates symptoms? I feel like it should be obvious to me, but I am finding that it hardly ever is. I just notice that there may be triggers, as when I lay down at night, I realize that my head hurts quite a lot more than in the morning. My favorite thing is writing, so perhaps I should try that again.

My final questions to you:

I have heard that whiplash can cause concussions. Would the same force be required in that instance, or no? What would an example of that happening look like? I ask because if I know that if I educate myself on that, I can calm down more about all of these jerks/bumps/etc that are not concussions!

I have also heard that after the initial concussion, we are more susceptible to a second injury, and with less force. Would it become less than 60Gs, or does it the necessary impact force remain within the 60G-120G area?

Finally, what is an example of hitting your head on something that could cause a concussion? When I whacked my head on the metal door, I began developing some more issues with keeping track of what people are saying, and certain levels of what I believe to be derealization. Perhaps these cognitive issues stem from the neck injury, though, or even the chronic stress caused by my situation.

I apologize for how many questions I have, but as you said, there is so much misinformation out there! The only way to improve is to be truly informed, and I see all of what I am going through as a learning experience. Thank you very greatly for your time.

"I have heard that whiplash can cause concussions."

You heard wrong. Whiplash and concussions are entirely different. Some people talk about cervical concussion and use the great overlap in symptoms to try to validate the idea. Whiplash can cause inflammation in the neck that can change blood flow to the brain that can cause neurological symptoms....

Amitriptyline has a good track recover at low doses before bed. It can help with headaches and insomnia.

If you are cautious about meds, you could try some over the counter supplements. I like a supplement I get on Amazon by Deal Supplement called 5-HTP. It is a combination of 5-HTP, L-Theanine, GABA, and L-Tryptophan in a single capsule. You could try taking one capsule a day for a week or two then add a second if you are starting to see improvement. Only Deal Supplement makes it in this combination. It is a good price compared to taking the individual components. I stopped taking a powerful high dose SSRI after 12 years and replaced it with this combination. I don't live with anxiety but my mind is very easily over-stimulated.

Also, get on a good vitamin supplement regimen. The sticky at the top regarding vitamins has my regimen that a doctor prescribed for me 40 years ago. It made a big difference. I've been riding in this rodeo since 1965 with 4 major new injuries along the way.

Regarding sleep. When I was suffering bad whiplash, I got my best sleep in a recliner chair. I used a loose pillow bunched up around the sides of my head so my head did not roll to the side. My whiplash was so bad that poor sleeping posture would cause inflammation that would disrupt my breathing. I had serious Central Sleep Apnea that made everything worse. I also fell asleep watching music videos and later a few selected CDs. Quality music and voices allow my brain to zone out. Dianna Krall's The Look of Love light jazz was amazing. Her voice would calm my mind and I would fall into a deep sleep.

A recliner would also help your GERD.

Gentle PT could be useful. Most PTs push for improving Range of Motion. That should not be a goal for a few months. Gentle cervical traction and vertebra mobilization can help. C-1 to Occiput (base of the skull) is often unstable and needs disciplined care. Imagine your fall. Your head was stopped by the floor but your neck wanted to keep moving toward the floor. This causes C-1 to slip out of place from where it belongs. C-1 to occiput is not a deeply faceted joint so it does not self-recenter like most other vertebra do.

Try a recliner if you can. They can often be found for free on CraigsList or FB marketplace in good condition.

Mark In Idaho,

Thank you again for another very thoughtful reply. It is reassuring to know that my brain has not suffered to the extent that I previously thought.

I will consider the different options that you have provided me with in order to treat my anxiety. The vitamin supplement is interesting, as I had not before considered taking something like that in place of medication, though a part of me still leans towards trying the antidepressant. Have there been other threads or resources, either on here or elsewhere, that speak more on amitriptyline treating concussions? I know that either way it will be difficult to determine what works best without trying them, but I’ve been worried about adverse affects like strokes/seizures. It helps to see how other people may have found benefit with the same medication.

I have gotten some access to a recliner. I hope to try to sleep in it tonight/etc and see if there is any noticeable difference.

I see my new doctor in two days and will bring up the PT to them, so that they can give me a referral. I am lucky to live in an area where there are several physical therapy institutes nearby, so it should not be too difficult to find a PT who knows something about rehabilitation for the neck. Many of these physical therapy places also have programs for concussions. Do you think trying one might be worth it, possibly for the vertigo? Or, do you think it is not worth the effort and I should only seek out the neck stuff?

Are there any guides for anti-inflammatory foods?

Lastly, what are the headaches that PCS patients typically have called? The sharp/burning pain kind, and the inflating/deflating type of headaches?

It has been nice reading through the comments on this forum and knowing that what I am experiencing is normal. Over the last few days, I’ve been feeling even more dissociated, dizzy, and physically numb. Before, this would have caused me to freak out - but seeing that people say there are many setbacks and strange episodes that come with “the PCS rollercoaster” is very reassuring. Thank you for sharing your knowledge with me. It has been so nice to learn more!

Amitriptyline does not treat concussions. No medication does. Low dose amitriptyline before bed helps with headaches and sometimes insomnia.

When one is dealing with concussion symptoms, you treat the symptoms, not the diagnosis.

Every concussion is different so comparing is almost worthless.

There are plenty of online resources for anti0inflammatory diets. Knowing what foods to avoid is a start.

Check out Complete Concussion Management on YouTube. Dr Cameron has lots of good videos about diet and neck care.

Mark In Idaho,

Understood. I have started the anti-inflammatory diet and will continue to do so. I will also check out Dr. Cameron and his videos. And, of course, get the referral soon.

Thank you again for the information and setting me on the right path. It is incredibly appreciated.