Pushing myself to work Full time
 

Today its almost 4 months from my head injury, my major issues are headaches, fatigue, dizziness and some memory issues. I am fatigued and dizzi even after 45 mins of normal activity (getting ready for office, cooking, shopping)

Thanks to my husband, I am getting all possible help at home so that I can continue my new job which I like, part time (4 hrs/day). As a Sr. Software Engineer I have to work on computers, keep developing new products and learning new technologies.

My neurologist at Kaiser is not willing to extend my part time work request and wants me to start full time. She mentioned that nothing much can be done for my issues as they do not understand PCS much. My symptoms got worse when ever I tried pushing my self more than I can do.

Any suggestion on how to deal with this situation? How can I reduce my dizziness and fatigue, is there any treatment I can ask my neuro for?

What I have tried till now: Vitamin ragim, yoga, vivactil/protriptyline for headaches, speech therapy for memory issues.

Any help, suggestion is appreciated,
Thanks and Regards,
Pinka
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My story if you are interested:

I had general anesthesia for my 3 wisdom teeth extraction. After taking rest for 5-6 hours, I did kitchen chores for 15-20 mins. I felt dizzy and fell head first on tile floor on one side from the stool. I was unconscious for 3-4 minutes and did not feel the cuts which I got from the broke bowl which was in my hand. We rushed to the emergency as those cuts were too big to be taken care at home. I had one of the worst headaches in my life even though I was on strong painkillers for my teeth extraction.

I contacted my dentist for headaches and week ness who mentioned this might be because of head injury. Got normal CT and MRI result and was diagnosed by Post Concussion Syndrome.

Today its almost 4 months from my injury, my major issues are headaches, fatigue, dizziness and some memory issues. I am fatigued and dizzi even after 45 mins of normal physical activity (getting ready for office, cooking, shopping)

I never thought that such a small head injury can lead to long lasting issues, I got very good job offer, joined it after two months of head injury, taking 2-3 weeks of intermittent time off and reduced work from my previous job. Initial two week of my new full time job were very bad so reduces it to 4 hours/day with help at home.

I am desperate to come back to my normal state and would like to take care of my 3 year old son and husband, instead of them taking care of me.

pinka,

Welcome to NeuroTalk. Sorry to hear of your struggles.

The only suggestion I have is for you to learn to pace the intensity of your activities. Doing things a bit slower and with less intensity can be a big help. Using notes on paper rather than trying to remember and juggles information in your head will help.

How is your sleep ? Failure to get good restful sleep can cause a serious delay in recovery. Ask your husband what he sees when he sees you sleeping ? Are you calm and breathing smoothly ?

You may benefit from a hormone analysis. Esthers Doll has lots of information about hormonal imbalances.

My best to you.

Hello,

Welcome and sorry to hear about your head injury.

As always, Mark has wonderful advice :)

I have to write everything down and sleep is SO important, my concussion was over a year ago and I have learned the hard way rest is important, just pace yourself and don't do too much.

Stress and trying to do too much make me feel so much worse.

Look after yourself!

Thank you Mark and Sitke for your quick reply.

I asked my Neuro for the hormone tests but she denied saying that hormones imbalance is not related to PCS,its not routine to check it and it would not be of any help. I can not do the test with out referral.

Even before injury I had trouble sleeping, I do not generally get good restful sleep. Any suggestions for good night sleep?

Last week I was feeling little better so I worked more than usual and did jogging for 10 mins or so. Since then I am experiencing more dizziness and fatigue :( PCS is really a life changer.

The first step toward good sleep is to make sure you are breathing well while sleeping. Sleep apnea will prevent good sleep. Maybe your husband can tell you what he observes when he is awake and you are asleep. If you are tired during the day, this is a sign of poor sleep.

I have a strict sleep hygiene I use to sleep well. I only wear cotton pajamas. They give me a consistent soft feel against my skin. I also have a pillow top mattress with a pillow top mattress pad so I feel cozy. I do not lay in bed if I am tossing and turning. I will get up and watch some TV until I start to doze off then I get back in bed. My goal is to be able to fall asleep within a few minutes of getting in bed. You will need to experiment to find what's best for you to feel comfortable in bed.

Your neuro is uninformed about hormones and PCS. Here is a link to the thread where EsthersDoll discusses hormones. http://neurotalk.psychcentral.com/thread202646-2.html

Hope this helps. Kaiser can be frustrating.

My best to you.

Before my concussion I was a runner/hiker/climber... I remember one day thinking I felt a bit better and went for a run, not long, like you, around 10 minutes, oh boy I paid for it for days after!

When I could I just started walking, only short distances at first as it made my head hurt but it got better.

This is so deceiving, we feel a bit better and try to do a lot more but it backfires. I had to take it so slow but then didn't get that crushing fatigue etc.

I didn't sleep well for years and then after the concussion it became worse, would wake up every hour or so.

I take magnesium in the evening, sometimes an epsom salts bath and also read in bed, it relaxes me.

Of course a comfy bed, pillow, sheets etc helps. I know if I'm on the computer before bed it's harder to sleep so I try to have quietness.

Also, sounds funny but in the evening I hardly have any lights on in the house, my husband calls me an owl! Light hurts my eyes though.

I have some of those flameless candles, just love them, they relax me just by looking at them!

Don't do too much, we think we can but then feel worse afterwards, take it easy! take good care of yourself! hugs...

I am so glad that we have this forum, good to know that there are people who understand what I am going through. Thanks a Ton!

I will try these suggestions for better sleep.

I had neuro appointment yesterday, I will be going for physical therapy from next week.

I red that chiro neuro can help, but they are not covered under insurance, general Chiropractor are covered. Does Chiro Neuro makes real difference? Should I try general Chiro instead?

Have a great week end!
Pinka

Chiro Neuro has helped a few but it only helps with some. It can be very expensive since insurance usually only covers spinal manipulations, not the diagnostics and other work done by a Chiro neuro.

A general chiro may help if you can get some VERY gentle upper neck treatments. The 'twist the head and pop the neck" adjustment is often too aggressive and can sometimes make matters worse. A gentle neck massage with some gentle traction and manipulation with icing after may help with head aches. Good neck posture is important. It takes months for a strained upper neck to heal with disciplined good posture, especially during rest and sleep.

Pinka, what type of physical therapy will they do for you? I had an appointment for physical therapy in my schedule, but I cancelled it because movement just makes things worse for me.

I will know more about the physical therapy on my first appointment next week. I will update you later.

I've been working with a Neuro PT specialist since January (I got hurt in June 2013, worked with an ortho PT who suspected I had a concussion and worked to have me transferred to the Neuro specialist at a related facility, which took a few months).

Our first session was an evaluation, followed by some very easy-looking movements that were incredibly, frustratingly difficult and symptom-provoking. I started out doing "head turns" where I focused on a dot on the wall and tried to turn my head back and forth at a certain cadence. The first time, I went out to my car afterwards and slept for 30 minutes before I felt well enough to drive back to my office. My PT also does some gentle work on my neck to help deal with the whiplash issues. We've done a lot of drills to re-educate my eyes and brain, and I'm finally seeing some results.

For the physical exertion, we figured out at what heart rate I became symptomatic (increase in headache, dizziness, and/or nausea), and I start out keeping my heart rate no higher than 70% of that number. For a long time, all I could do was walk, and if there was the slightest hill, I'd have to rest along the way to bring my HR back down. I started this with my ortho PT before I was transferred to the Neuro PT, and in 7+ months, I've been able to increase my effort very slowly (started at 90 beats/minute, just got the ok to go to 130, where I can finally work up a sweat and feel as if I'm working out - yay!!) I'm a triathlete (was a triathlete? Still not ready to give up but we'll see) and used to working through discomfort, but my mantra has been "You can't work your way out of a head injury."

@Jeo,
I went for first physical therapy yesterday. It was very light physical exam of neck, stability, back, nothing aggressive.
Therapist thinks that I have tightness in my neck so It might be related to whiplash. I can see some light of hope. I was wondering if there are any other diagnostic measures for neck injury out there. I will contact my neuro about the same.

for the sake of you and your health going forward:

RUN AS FAST AS YOU CAN AWAY FROM KAISER...

i speak from experience...

when they could not deal with my brain injury, they cancelled my insurance...they were wrong on just about everything while they treated me.

they are ignorant, arrogant, highly paid health care buffons.

i now use another plan and have had all the care i ask for...

Kaiser is a joke for PCS and any brain injury, they simply lack the capacity to care...you are a number, not a person.

Run. Far. Away.

brainstemmed,

I bet you developed a 'thick file.' This is when the patient's file is thick with records of many visits. This often is the start of being labeled somatoform, the kiss of death for getting good health care. I was a Kaiser member for decades and developed a thick file. Many doctors used it against me. A few looked deeper and took an interest in my health.

Once they reach a point where there is nothing they can do to treat your condition, the walls go up. If the patient does not follow through with recommended treatments or asks for treatments that they do not offer, such as chiro, etc. the walls start to go up.

Add to this the fact that there are very few effective treatments for mTBI and even non-Kaiser health plans tend to fall short. As a vertically integrated health plan, Kaiser just magnifies these issues. Add to this the uniqueness of your injury and you have found the perfect storm.

agreed...100%!!!

I am already stuck in this mess, can not do any thing till next year :(.
I have to make it work as my employer will give up on me if I dont see any improvements with in couple of weeks. My only hope now is physical therapy and chiro. Hope for the best.

Here is a helpful guide to TBI for employers that I provided to my boss when I returned to work: http://www.mayo.edu/pmts/mc1200-mc1299/mc1298.pdf

Thank you very much, this link is very helpful.

My doctor basically ignored me last visit and said I should try to push myself to be ready to resume work in 1 month. I am getting better, but she wouldn't know for not listening to my symptoms.

So mad. I got a second opinion and that doctor had no idea what the "push yourself" was supposed to help with. No idea how to proceed now.

so... if you can find a good doctor who will listen to you and think about your problems, cherish him or her :)