Am I doing myself further damage? Or prolonging recovery?
 

I am back in college for the first time since December 2010. Although I am only taking 12 hours, every day is a struggle. Last week in my physics lab, my head felt the worst it has ever felt. I felt unbelievably nauseous and kept going to the bathroom because I thought I was going to throw up. Each passing minute I was trying not to pass out. Inevitably, I had one of the worst panic attacks I've ever had. My teacher had to call the EMT people. It was awful.

I am on 100 mg of Zoloft for the post-concussive anxiety/panic attacks I get when I overexert my brain, but no amount of medicine would've stopped that panic attack.

On my worst days, I also feel extremely disoriented. It's like I'm not even in my body. I can't explain it. I almost feel like if I was any more disoriented, I wouldn't even know where I was.

Basically, I'm getting worse.. than I've ever been. Is this dangerous? I feel like I'm going to keep pushing through this until I completely break and something bad happens.

I played collegiate soccer and have, without a doubt, sustained a good number of concussions in the 15 years that I played. The thing that got me was playing on my symptoms for a week last October 2010. I have had two major relapses, one in January 2011 after being released to run and one in June 2011 after the UB return to exercise program.

One way to look at it is: my brain has, and will always have, limitations. In other words, this is permanent, and I should treat it as an "illness" so to speak and make accommodations.

Another way to look at it is: I will one day be somewhat fully recovered (maybe even able to consistently exercise or run!) and I am only prolonging my recovery by being in school right now and overexerting my brain.

I'm seeing a neurologist here asap, I just don't know what to do..? :confused:

My first thought.. Make sure your neurologist is one that has had a great deal of experience with PCS and TBI! I didn't do that in the beginning and ended up wasting a great deal of time. Now that I have one who works with these types of injuries daily, he has been able to do a lot to improve how I'm feeling.

Second, I have realized and have been told by doctors that anything that brings on an onslaught of symptoms such as what you experienced in physics lab, means you are taxing your systems too much. From what I've been told, but it just my drs opinions is that this prolongs the recovery process. I don't know that it necessarily does damage? But it makes your recovery take longer.

Best to you- I've been on medical leave from grad school since March 2011. Hoping to attempt a return in January, but I worry that I will experience what you are.

I don't know anything about all this but if you feel you are getting worse, i would take it easier... you only get one brain...

Kelly,

12 units may be a light load for a normal full time student but it is likely too much for your concussed brain. Have you done any serious though about your triggers. The physics lab probably had lots of sounds to over-stimulate.

Try wearing ear plugs during class. It may help.

Your soccer history was likely full of sub-concussive impacts leavening your brain in a very sensitive state. Add some tears to the damage and you end up with a brain that will struggle to recover from a concussion.

I would not put too many expectations on the visit with the neuro except to rule out other issues.

I doubt you will break anything. But, you can continue to exacerbate your symptoms such that you end up on a long roller coaster ride.

I understand you struggles same difficulties in college except I did not have the panic attacks.

btw, Have you tried propanolol to lower your blood pressure when you suffer a panic attack. I keep some in the cabinet to help me recover from those extreme panic attacks even though I am on a maximum dose medication.

My best to you.

For what it's worth, I just met with a second concussion specialist in my city. Like the first specialist, he predicted a full recovery (but recommended avoiding any further head impacts). He was happy to hear that I'd taken the full four months since my injury off - he thought that this may have helped with the progress I've made thus far. We're tentatively looking at a back-to-work plan that would have me starting back in a month or so. Under this stepwise plan, it would take me a further eight weeks to get back to full-time status.

Dissociation has many causations, but Zoloft has been known to cause dissociative symptoms in some people. For me, I have dissociation a lot from anxiety/possibly organic issues with my brain. But I would do some research on side effects of Zoloft.

Any concussion specialist who predicts a full recovery and also has timelines for such a prediction is not a true concussion specialist. He just reads publications that are either too old or are published by groups that have a bias against the reality of long term symptoms. Many neuro-psychs hold these biased errant opinions.

Return of full or mostly full function is not a full recovery. Many of these specialists think their patients have recovered fully because the patient has stopped asking for help.

When they stop saying over 90% recover fully, we may start to see some better concussion prevention. Side curtain airbags in cars are designed as concussion prevention devices. We need the same level of prevention effort in sports.

I consider it an oxymoronic statement to predict a full recovery but recommend avoiding further head impacts. This shows that he knows there is a weakened brain after even a full recovery from the concussion. How can this be a full recovery?

Treat the symptoms that can be treated. Get proper rest and nutrition while avoiding further brain stresses from environments (noise and visual), trauma, emotions (anxiety etc), chemicals (MSG, alcohol, caffeine etc ). Learn work-arounds to improve functions, and slowly return to a life that includes many of the functions of the pre-concussion life. Live with hope for the best but be prepared for the worst.

If the specialist is not including these recommendations in his/her treatment plan, they are not true concussion specialists.

i am actually having the same problem as you right now. im only doing 6 hours of college though and its killing me.

i get a massive headache everytime i have to read and its a ton of reading. im thinking about just dropping the classes and taking the next few months off.

what do yall think is best for me? is getting a headache from reading everyday prolonging my recovery?

Mark, based on my experience with PCS thus far, I agree with your prescription for healing/recovery. That is the path I've been attempting to follow (although at times I tend to overdo the visual/mental stimulation through reading, TV and internet...my Achilles heel).

I should have been a bit more specific. The first specialist I saw (who is quite renowned in Canada) predicted a "full recovery." However, he observed that after each concussion, subsequent concussions tend to be more severe and/or longer-lasting. Therefore, he was not predicting full recovery in the sense that the brain is as good as it was pre-concussion. He seemed to be saying that my symptoms would ultimately recede and I would be fully functional again. But he would not predict how long this would take (sensibly, in my view). He was also very clear that subsequent concussions could present additional and possibly greater risks, even many years later. He noted that the research in this area is still evolving.

The second specialist predicted that eventually, I would no longer suffer from concussion symptoms (first and foremost, headache and tinnitus). He did not use the words, "full recovery" (although I did, in my question to him). Again, he seemed to be suggesting something more like, "fully functional with no remaining symptoms." Hence the caution about avoiding future head impacts. As for a timeline, he was not saying that I would be fully functional or recovered in 1-3 months; rather, he was saying that based on my progress to date, it should be "safe" for me to start a graduated return to work plan in approximately a month. The plan would be to proceed cautiously and incrementally over the course of two months, so that three months from now (assuming that this goes acceptably well), I would be back to working full-time.

These prognoses were based on my health history, physical exams (including several balance and memory tests), a head MRI, ImPACT test results, and my reporting of symptoms during appointments spaced out over the course of four months.

However well I "recover", I know that I will forever be at risk of further damage from another concussion (or subconcussive impact), but I am encouraged by my gradual progress and by the opinions of these docs, if only because they both seemed sensible, informed and experienced in dealing with concussions.