University of Buffalo Concussion Clinic
 

Hey all-

Thought I would start a new thread because I was unsure of where to post about my visit to the clinic yesterday. I had a great visit yesterday, and it felt so good to be examined by people who actually know what they are talking about!

First of all, since I am 7 hours from Buffalo, Dr. Leddy said that we could correspond via email once I had my initial consultation, and would not need to return to the clinic. The doctor consultation is covered by insurance, but the exercise session is $250.

The physical therapist there administered the exercise. They hooked me up to a heart rate monitor and one of those sleeves that takes your blood pressure. We did the test on a treadmill and they started me off walking at 3.6, with each minute increasing the incline until we got to 15. Each minute they would also ask me to choose a number that matched the way I was feeling physically (not symptoms, but how hard it was/how tired I was). The goal was to reach a maximum heart rate with out exacerbating my symptoms. Based off of that maximum heart rate Dr. Leddy sends you home with the order to exercise 15-20 minutes at 80% of that maximum heart rate obtained in the test, but to stop if you have any increase of symptoms whatsoever.

During the test the PT was also talking about how many of the times someone who sustains a concussion usually develops neck problems, which will prolong concussion symptoms considerably if not dealt with properly. Both Dr. Leddy and the PT believe that most of my problems are not so much brain anymore, but neck.

Anyways, hope this is helpful to anyone whose interested in making an appointment.

Erica

I am glad that you had a good appointment. It is very refreshing to talk to people that know what they are talking about. Thanks for passing along the information you received.

The comments regarding neck make sense - especially if you talk to a NUCCA doctor. Their philosophy revolves around the head and neck needing to be in property alignment. If you are out of "balance" an array of problems can result.

Good luck with your exercise regiment.

[QUOTE=nancys;654448]

The comments regarding neck make sense - especially if you talk to a NUCCA doctor. Their philosophy revolves around the head and neck needing to be in property alignment. If you are out of "balance" an array of problems can result.

QUOTE]

What exactly do you mean by a NUCCA doctor?

NUCCA - National Upper Cervical Chiropractic Association

They are chiropractors that just do upper cervical stuff. My daughter has been going to one for 3.5 weeks and I think it's making a difference. Her headaches have decreased and seems to have more energy. She's also been able to handle more exercise on a regular basis and also increase the duration/intensity. The last time she attempted to exercise aerobically about 5-6 weeks ago, the next day she had a major return of symptoms. This time, she's been ok. I honestly don't know if it's the chiropractor or time that has made the difference - but I'll take it either way.

I have also started working with my daughter's nucca chiropractor. I've been seeing a regular chiropractor for a couple of years. I've noticed a big difference in just a couple of adjustments.

If you go to the organizations website is: http://www.nucca.org/, you can search for providers in your area and get more information.

Thanks for this report Erica. How has your therapy been progressing? I am considering visiting the clinic, but still undecided on whether it's right for me.

questions about visit
 

Hi Erica,

I'm new to the site and curious about your visit, as I have read all of their studies and thought about going there. I was injured being thrown on the ground a few times in karate over two years ago. I still cannot exercise, or for that matter vaccum quickly, without getting symptoms. If you don't mind I'm very curious about your visit:

1. How do you know when to stop exercising if you don't know exactly at what point you'll become symtomatic? How did they determine when you should stop exactly?

2. Why do they think there might be a neck issue?

3. What did they determine was your max heart rate? I have been able to ride my exercise bike for 20 min if I keep my heart rate at 105 or less, which is pretty low.

I would love to hear how you are progressing!!

Anastasia

Anastasia,

The neck issue is a simple answer. Since most concussions are the primary concern, the neck issues are overlooked. But, the head is critically supported by the neck so any trauma to the head will include some level of trauma to the neck. Since the neck issues are not easily treated by medical doctors, they do not check the neck unless there is a significant complaint.

A common problem with concussion is concussion whiplash or a similar injury. The head aches can be from the concussion or from the neck injury that can result in neck muscle spasms up into the head. There are neck muscles that attach to the skull behind the ears. When these spams, they often manifest as a headache. They can also cause a true head ache due to the effect they have on a myriad of systems related to the head (circulation, muscles, and sleep, etc).

If your exercise bike works at 105 BPM, you will likely get good results. Bike exercise causes much more blood flow that other exercises because the legs act like an addition blood pump. It takes serious oxygen debt to get pulse rates up high on a bike. Such an effort may be too much for your brain. Besides, you do not want oxygen debt when exercising for your brain's sake.

Have you taken your blood pressure while doing or right after your 20 minute session? It will help you understand what strains you are putting on your brain.

Mark,

Thank you very much for your response. I use a heart monitor while I'm on the bike, because if I go over 105 bpm my symptoms recur- dizziness, elevated heart rate at night, fatigue, headaches, saddness and moodiness, nausea. It has taken me 2 years for these symptoms to go away at rest. Now my goal is to be able to vacuum or go for a walk or anything really without triggering the whole mess.

I'm on hold right now because I missed a step when coming down off a step stool about 2 weeks ago. I feel sick to my stomach reading and writing this now, as the thud of just hitting the floor harder that normal with my foot has brought everything back. But I will wait a few weeks till it passes and try again. I'm hoping that a graduated increase in bp over a long period of time will help my brain relearn how to adapt to changes in blood pressure.

Because apparently it doesn't know what to do with those changes now. It just shuts me down. Thank you again

My injury on Jan 16th, 2001 was a missed step like yours. I was carrying a garbage bag held in front of me. I walked down a sidewalk and off a curb. I thought it was a ramp but it was an 8 inch curb. I landed with my left knee locked and back arched. I jarred from my left pelvis to my head. I am still suffering from the symptoms from that event.

An Upper Cervical Chiro found that my left Atlas/occipital condyle joint is still out of place. I started treatment until my insurance company refused to pay.

So, I know how much damage a missed step can do.

My best to you.