Returning PCS?
 

Hey everyone, I've posted here a few times before so I'll give you a quick rundown of my PCS history.

I'm 19. I hit the back of my in December '10 on a faucet while showering. Wasn't that hard of an impact, but I suffered mild PCS for about 7 months. December '10 to late August '11.

My symptoms were mainly feeling very cloudy and off most of the time, slight anxiety every once in awhile, problems sleeping very occasionally, and feeling uncomfortable and restless every so often. Nothing too serious, but still enough to bother me every day.

Well that being said, in August I returned to college for my second year and my symptoms disappeared. I felt completely normal again! It was great. The only times I would feel my old symptoms a little bit was whenever I was a bit under the weather.

This past Sunday I accidentally bumped the side of my head on a cabinet, but not nearly hard enough to do any damage. I was a bit anxious due to my past injury and had a bit of a rough time sleeping, but my girlfriend helped to calm me down and get a good night's sleep.

But for the past week or so, I've been feeling like I did with my mild PCS. Very out of it, a bit anxious, very tired out. This is a bit startling to me since I haven't felt this way since the summer. Is this a common occurrence? I'm not sure why my symptoms would return after a 3 month absence.

I am a very healthy 19 year old, I go to the gym 4 times a week, eat fairly well, and I'm a very positive person. Please give me some advice!

This is totally second-hand, but I do know that Justin Morneau (who plays for the Minnesota Twins) got a concussion last season, was out for seven months, and then returned to play.

He later experienced a mild relapse of symptoms after diving to catch a ball in the outfield, even though he didn't hit his head directly on anything. I think they reported that he had brain fog and possibly a headache after that. He sat out a couple more games.

So, apparently, yes, you can experience renewed symptoms after minor events.

Really? Do you know if they went away quicker or were they back for awhile? I mean, I really don't want to go through this again for 7 months.

yeah...i get major headaches after just going shopping and enjoying myself -- but that isn't another concussion...but sometimes I feel like it is!!

Teams don't always provide a lot of information about player injuries - I'm not sure anyone outside the organization knows the timetable for Morneau's return (who knows - he might already feel back to normal). His return of symptoms came towards the end of the 2011 baseball season, and the Twins were out of contention by that point, so he simply went on the disabled list for the remainder of the season. He has the next few months to rest up and gradually get in shape for next spring, assuming he decides to keep playing.

According to wikipedia, the hockey player Patrice Bergeron had a serious concussion in 2008-09 (out for about a year) and has since had a productive career, despite having had a couple of more concussions that caused him to be out for much shorter periods.

I think the bottom line is that you can't predict these things, and everyone is different. I would think it would be important to take good care of yourself and "do all the do's" required to support your recovery the second time around (which includes being patient). Hopefully it won't take as long this time - best of luck.

Okay, thanks a bunch man! I really appreciate it.

Alexnew,

What you experienced was a sub-concussive impact. Your brain has been sensitized to even minor impacts so it is likely to happen again.

I have to be very careful about any risk of a sub-concussive impact. I suffered one about two months ago and am just now getting back to normal. I got hit in the forehead by a piece of metal that dropped while I was under my truck repairing the transmission. It dinged my skin, left a small bump and made me a space cadet for the next 6 weeks or so.

I bet that if you did some serious recollecting, you will discover that this was not your first head ding. You have probably had many sub-concussive impacts in your 19 years. You may have even suffered a full concussion but since it was your first and you are young, you did not have serious prolonged symptoms.

If this is the case, you will need to work at becoming diligent with your body movements in risky situations. I realize that a shower and cabinet are not risky but there will be other activities that are risky, such as snow boarding, roller blading, contact sports, even just a ride down a rough road in a car.

This sensitivity will not go away. But, you can easily reduce your risks.

My best to you.

How did you manage to hit the faucet hard enough to cause concussion? Did you fall?

Thanks a lot for the advice, Mark! But does this mean this will happen for every little bump on my head? Will it get worse?

Nope, no fall was involved. I think what happened was not a factor of hitting the faucet hard enough, it was a case of hitting my head in the right (or I should say wrong) place. Last year I lived in a dorm where the shower knob was about sternum height. I was taking a shower and accidentally dropped the shampoo bottle, so I bent down to pick it up. As I was standing back up, though, I hit the direct back of my head on the knob pretty hard. I did not pass out, but I definitely saw stars. That's what did me in.

AlexNew,

As I said, if your brain is now or is becoming very sensitive to sub-concussive impacts you will need to learn to be careful.

I know that I can not do certain activities because of the head jarring involved. With some activities, I just need to take some precautions. An important precaution is sitting while on a bumpy ride. This can be a shaky roller coaster or riding in the car on a bumpy road. I know to lean forward in my seat so my back can absorb the jarring. If I sit back against the seat back, the jarring is transmitted to my head more directly. A curved back has plenty of energy absorbing capability. I also need to snow ski with my shoulders forward to better absorb the terrain.

There are enough situations that you can not control so you need to reduce the risk in those situations that you can control.

Sub-concussive impacts are well understood by a limited few researchers. Most doctors are clueless about them.

A sub-concussive impact is any head impact. It does not need to manifest any symptoms. That is why it is called sub-concussive. If it caused immediate symptoms, it would be a concussive impact.

Your impact with the faucet handle was a concussion since you had immediate symptoms. The delay of prolonged symptoms is due to the physiology of how the brain handles a minor injury. Many minor concussions will clear up immediately but then manifest symptoms 2 to 6 weeks later. Even later than that if there is a stressful event, such as getting drunk or high or any other stress to the brain.

Getting dinged by the cabinet so soon after your symptoms cleared just means that the obvious symptoms cleared. All concussions cause lifelong damage. It just does not show up until another stress to the brain.

As a returning college student, you need to make a serious effort to avoid any chemicals that effect the brain. The very occasional single beer may be OK but if you get hung over from just one beer, it is your brain telling you no alcohol. My brain is very sensitive to just one beer. Avoid caffeine of more than a single serving per day. No late nights cramming and staying up with caffeine/NoDoze. Besides, research shows that cramming does not help with long term retention and only marginally with short term retention.

If you are interested, I can post some memory tricks, especially for a PCS brain.

I have been asked similar questions about the event leading to my concussion. I hit my head at work on a piece of equipment that was hidden behind a curtain. I had dropped some paperwork and had been sitting up on a high chair. I slid down off the chair and bent down to pick up the paper all in one swift motion. I smashed my forehead into a metal bar, not realizing it was there and was stunned for a few minutes. I had a huge bump and bruise on my head for a week. My symptoms of PCS started about 7 days after the event. Initially, I had the misfortune of seeing a doctor who insisted that I did not have PCS, and that there is NO WAY I could have struck my head hard enough to experience a concussion. I then saw a neurologist who confirmed that it was, in fact, PCS and that she sees many people for PCS who have had 'minor' head trauma. It is now three months later and I am still experiencing many symptoms. I think often of that first doctor, who misdiagnosed me, and caused me much anxiety of wondering 'what is going on with my brain?' At least now I know the reason for my symptoms and am trying to stay positive while I heal.