inflammation
 

Can anyone explain to me how inflammation is related to the big picture of PCS? The neurologist put me on prednizone and while taking it I'm about 90%symptom free. It's like a window into being normal again. When off it, I'm a complete wreck.

Is inflammation causing all of these PCS issues? I thought it was something more sinister like axon tearing.

Isn't inflammation supposed to be the body's natural way of healing? Is it right to take that away or will I stall healing to keep fighting it?

I thought taking inflammation away would stall healing, but then why do I feel so well when it's gone?

HOpe these are not dumb questions. I need to understand the logic of what I'm doing and the loops aren't connecting. Thanks.

The prednisone may be acting on inflammation or it may be just replacing some corticosteroids that are being under produced by the adrenal cortex.

<Corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. Corticosteroids are involved in a wide range of physiologic systems such as stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior.

* Glucocorticoids such as cortisol control carbohydrate, fat and protein metabolism and are anti-inflammatory by preventing phospholipid release, decreasing eosinophil action and a number of other mechanisms.
* Mineralocorticoids such as aldosterone control electrolyte and water levels, mainly by promoting sodium retention in the kidney.>

I would consider the prednisone to be symptom reducer but not necessarily a supporter or promoter of any healing mechanism. Hormone imbalances are common with PCS.

Be careful that you don't mistake 'feeling better' with recovery. When you can feel better without the prednisone, then you are recovering.

Inflammation occurs in the brain all the time.

The inflammation from a trauma would involve the nerve damage itself.

This is done by inflammatory cytokines of the Cox-2 series being released in response to the trauma trigger.

Here is a link a poster on PN found that shows diagrams and pictures of nerve damage. If focuses on peripheral nerves, because that is where most of the research is, but it diagrams how the injuries can involve inflammation.
http://www.georgiapainphysicians.com...od2_slides.htm

Under the subheadings of inflammatory response and peripheral sensitization, these chemical cytokines are listed there.

There are drugs in the pipeline called ampykines, which block glutamate release in certain central brain disorders, and these may prove useful for brain injured patients as well. I believe they are not yet available for general use yet.

Because glutamate is inferred to be the largest problem released by damaged neurons, it would be prudent to avoid all MSG in your diet and food choices. MSG is very hard on the nervous system.

Thank you. That helps to broaden my understanding. I'll look at the link today about nerve damage - only have about an hour in me today and have to focus on work. From a quick scan of your comments though I can see once again as it keeps presenting itself that rest/sleep is really the only current cure - and of course a huge component even if future drugs can assist.

A few of my clients are medical researchers and they have specifically worked on neuro regeneration. They seem think they are quite a few years away from helping us out.

thanks again.

So I wrote a lengthy reply and then just deleted because I rambled. I guess even with the extra info, I'm not sure if I should be taking the prednisone. I don't want to just mask issues. I want to heal.

BTW, about glutemate. MSG is some nasty stuff and I don't touch it. I wish everyone knew about it. It gave me stroke-like migraines in my 20s and 30s. I haven't had it in over a year and have been completely headache free. Until now with the concussion of course...

One thing to remember about Prednisone. Many doctors use a system of every other day in an attempt to get the body to sense the absence and try to make the corticosteroids it needs. Long term use can cause some psychological problems.

If you have to pay full price for it, ask if you can get it from a vet supply. It is much cheaper and exactly the same. My beagle was on it for 14 years. I tried getting it at Walgreens when I ran out and it cost 3 times as much in human use packaging.

is MSG in soy sauce??.

Read the label. Different companies have different recipes. If it is Kikkoman soy sauce, it does not have MSG per say. It is made with a fermentation process to get the flavor. The online sources suggest that the fermentation process produces “processed free glutamic acid (MSG)”

Be careful, MSG can be hidden under natural flavor, hydrolized protein contains processed free glutamic acid (MSG) Here is a web page that may help: http://www.truthinlabeling.org/MSG.Aliases.Exposed.htm

I have been sensitive to MSG for a long time.

Axonal/neuron-injury leads to mass release of neurotransmitters and cellular content. The cellular content stimulates inflammation to "clean" up the lost cells. Some neurotransmitters (like glutamate) when extracellular and Ca2+ ions (when intracellular) case damage on its own if in to great concentrations.

These are toxic and cause some "unneccesary" damage.

The inflammation itself cause damage to healty neurons but is not at all as destructive as it can be in a bacterial infection (bacterial meningitis etc).

Either way.... I think theory behind the idea of treating a concussion/mtbi/tbi with immunodepressants/anti-inflammatory meds are valid.

You should listen to your doctor and report your progress to him.

The concern you have about the debri not being cleaned up properly in your brain and that would cause prolems are unlikely. The cleanup-process will continue later (even after youre off the antiinflam meds) and scartissue instead of dead neurons arent doing to much of a different for your functioning.

If you feel anxious, you should have your doctor explain better.

Emil (med. student)

Thank you. That's more along the lines of what I was thinking and hoping. Thus, taking away the inflammation can work but it's complicated for sure. We will see. I'm a few days into the prednisone and all is great - hopefully will be better after too. thanks.

freezer,

Keep in mind that most medications that act on the brain cells have limited know mechanisms of action. That is why so many doctors use a "try this and report back to me" system of treatment. The hypothetical reasons are just that. As the saying goes. "Your mileage may vary."

Research suggests that there is a component of brain injury that is due to a suicide mission message being sent out. The damaged cells trigger this message in tRNA (transmitting RNA) to create a clean margin of healthy cells by destroying questionable cells. This is a difficult process with diffuse axonal injury as is the most common injury from concussion.

There is no such thing as neuronal or axonal scar tissue. The damaged tissue breaks down and is absorbed. Blood flow will determine how well the damaged tissue remnants will be removed. Also, proper chemical balance is needed to gather all of the waste products of this cellular deterioration. Thus the need for healthy nutrition.

With the significant increase in how i'm feeling, my guess is, either i'm termporarily not producing the right hormones in my own brain and the prednisone is supplying them, or i simply needed to get rid of the inflammation to feel better. What that does to the toxins in my brain - I don't know. They will go away eventaully.

My diet is nearly perfect and pact full of antioxidants, protein, and omegas.

I will wait it out and see how it plays out. Right now I feel like I could go for a run. Don't worry - I won't. : )

I'd really like to know why some people get PCS and others don't. Maybe we should all take inventory on what we have in common.

The myriad of factors that lead to PCS is beyond research. There is often a complete absence of information about prior concussions, sub-concussions, toxic exposures to the brain, other brain stressors, etc. Ability to process B-12 and other B vitamins can be a factor. Fatty acid levels also is an issue. Low fat diets can leave the brain susceptible to injury. Add to these issues the unknown impact of processed foods and additives and the matrix of complications is huge.

A concussion during a bout with depression will manifest different than a concussion absent any depression. Different hormone levels/balances also impact the damage left by a concussion especially in women. Blood glucose levels at time of concussion may also effect the symptom levels.

The research is all over the map.

Trying to compare notes is a futile effort. It only causes anxiety. Understanding the brain's intolerance to impact trauma is still grossly ignored. Maybe when a celebrity with the right connections suffers from PCS, there will be a openness to the issues. Gary Busy is ridiculed for his behavior when in reality, he has done extremely well despite his brain injury. Nobody cares to understand the underlying reason for some of his behaviors. Meatloaf gets applauded for his brain damaged antics that result from his drug abuse. Go figure.......

Please share your diet?
 

Freezer,

Could you share your diet with us?

Thanks.

I'm not sure how to share my diet. I eat so many foods and i"ve never been on a "diet". I'm a vegetarian and eat a lot of whole grains, soy, egg, beans, and dairy proteins - occasional fish but that's the only meat I eat. I eat a lot of fruits. For a typical lunch I'll have a bean or cheese or tofu protein food with a salad that is like a spinach salad, boiled egg, carrots, etc.

I am a chocoholic. probably my main inflammitory vice.

what in particular are you asking?

With this prednisone I'm reaching feeling about 90% myself today. Even if it's short lived, it's the best.

mark - I have to say after experiencing this, I have a new appreciation for those who suffer a brain injury. It's really hard to comprehend the nature of it if you have not been affected. It should be so obvious that damaging the organ that governs higher thinking would cause all sorts of irrational changes but it's hard to really get it to sink in unless you've walked a mile. Hopefully medical research will change all of that soon in that there will be better therapeutic devices/drugs and then who cares what people think, science will force it.

Soy proteins and their derivatives contain processed free glutamic acid. Soy should be avoided due to this problem.

Even though your diet looks good, the available B vitamins is likely lacking. In my experience, I need 10 times to 50 times the RDA of B's. This is hard to get from normal foods. Supplements are needed. A whole egg or two on a regular basis can help with these brain needs. The yolk has important nutrition in it. Also good for cholesterol.

Hey,

I just wanted to know what you considered a "perfect diet" for your PCS. It sounds similar to mine though I am not a vegetarian. Thanks.

I think a PCS nutrition thread would be very useful for many members. For a lot of people nutrition isn't as easy as it sounds.

sorry - i guess i spoke too loosely. I wasn't thinking if I said it was perfect for PCS. I just think that i eat very well. I try to get a mix of everything and have never had health issues to date.

FreezerDoor, time to get a new neurologist. Corticosteroids don't cross the blood brain barrier so they won't help at all. The anti-inflammatory benefits from these corticosteroids are to inhibit the release of arachidonic acid from the cell membrane. Arachidonic acid is the building block of inflammatory hormones, prostaglandins and leukotrienes. This is fine but they also inhibit the release of the omega 3 EPA which is anti-inflammatory. All is pointless because the brain can't use utilize the benefit. This is why you can't use them long term in any circumstance because by inhibiting the release of fatty acids from the cell membrane, essentially you are cutting off your innate immune system all together. The only thing that has shown significant benefit is HIGH doses of omega 3's, primarily EPA, because it will reduce the effects of arachidonic acid and reduce neuro-inflammation. You do need DHA as well! Arachidonic acid is an omega 6 fatty acid you can only obtain in the diet and therefore, get them out of your diet. Vegetable oils, egg yolks, meat are all sources of omega 6's. Insulin helps to convert the omega 6, linoleic acid to arachidonic acid so try to cut back on high glycemic carbs. Here is a study that explains!

Paul

Since my fall 16 weeks ago, I've had 2 - 6 day courses of prednisone for an all over itchy rash (that I've had for 10 weeks now!) and during those 2 courses I felt better. My headaches seemed not quite as severe and I had way more energy and I felt a little more "with it".

I honestly wish I could stay on it for longer periods of time, it was... nice :) But I understand why that's not possible.

Now if I could just get rid of this rash, that would be a huge relief!
Starr

Natural anti-inflammatories include vegan diet, omega-3s, flaxseed, algal DHA & EPA. I experienced significant improvement in both my PCS symptoms and my piriformis syndrome after starting these therapies. My blood tests did show elevated inflammation at the outset; I'm curious to see my results after a few months.

I must say this has been a very interesting post. Thank you freezerdoor. This is a new idea in "last resort" folder. I file away some last resort ideas for when I've had enough. I'm at 10 months. I'm giving myself at least a year before I start trying some meds although I seriously hope to avoid them at all cost.
Freezerdoor along with your headaches have you had a lot of dizziness?