Still PCS? Chicken and egg and frustration
 

Saw my PCP today. She signed off on my last month of short-term disability with the diagnosis of Post-Concussion Syndrome.

She said that she feels the headaches, depression, and physical/mental reactions I have to stress now are NOT related to my concussion last January.

I did have mild depression before the concussion. Is this now causing all my symptoms that I have been thinking were PCS?

I am very very frustrated. For months she has been doing nothing as far as treatment but just telling me, it doesn't seem like you're back to normal yet. But now all of a sudden it's not PCS any more?

I scheduled an appointment with a physiatrist (I had to call a bunch of different places and the scheduling office at one of the offices I was referred to as HAVING physiatrists did not even know what they were or that doctors with specialty in physical medicine and rehabilitation existed :eek:). I also have an appointment with a psychiatrist later this week.

Basically, today has been a nightmare. I want to crawl under the sheets and not come out for several months. Depression? Or PCS?

That does seem pretty frustrating. I can't tell you whether it is or isn't PCS, but honestly it very well could be. I hope these appointments you have scheduled help you come up with some answers.

I think you stated it correctly.

You said <For months she has been doing nothing as far as treatment but just telling me, it doesn't seem like you're back to normal yet. But now all of a sudden it's not PCS any more?>

I don't think she ever knew what you were experiencing and why. She probably thinks that since it has been almost a year with little improvement, it may have never been PCS or such. Not an uncommon attitude from a generic doctor. Or, maybe your insurance company has asked her why she continues to send them a bill if there is no treatment going on. insurance companies often grill the doctor for their disability diagnosis.

I hope she listed "concussion/mTBI" in your medical record.

2011 ICD-9-CM diagnosis code 850.9 Concussion, unspecified
or
2011 ICD-9-CM diagnosis code 850.0 Concussion with no loss of consciousness
followed by
2011 ICD-9-CM diagnosis code 310.2 Post Concussion Syndrome

A failure to list this in your medical record can make you sound like a hypochondriac at a later date.

Often, doctors do not want to get to involved in drawn out disability issues because they can become unpaid witnesses if litigation is pursued.

Hope you get better help from the next doctor.

btw, Unless you were diagnosed by a doctor as having Mild Depression, you did not have Mild Depression. Be careful about any volunteering of a self-diagnosis. It can hamper your rights in the future.

My best to you.

Mild depressive like feeling are common in the daily roller coaster of life. Until you have a prolonged continuous period of diagnosed depression symptoms, it is likely just the ups and downs of life and hormone fluctuations.

Wow that is awful. I dont know how your MD can say this. Is this person really qualified to take on neurological problems. Seeing the new MD's should help you.

I often wonder (Im in the healthcare field) why some doctors become doctors. For some it's all about the money and not the patient. I hope you change MDs and find someone who is willing to listen and help you.

I'm sorry you're having such a hard time.

My thoughts are with you...

This whole experience has been a real eye-opener for me with regard to doctors. I can find more up to date, good quality evidence regarding head injuries and PCS with a few minutes search of google scholar than seems to be known by most of the doctors I have seen, or heard about on this forum.

What on earth were they doing during their extensive training? Bunch of charlatans.

Hope things go ok with you, I don't understand how the US system for all this works but I really hope things turn out ok :hug:

I believe it is now well-established that PCS can cause depression. In other words, depression is a common *symptom* of PCS, not a substitute diagnosis. I also think there is a complex interplay between depression and PCS, so that it would be very difficult (if not impossible) to say, "while I conclude that you have recovered from your PCS, you are now experiencing symptoms from depression - a different medical condition."

Klaus, I totally agree with you. I have learned way more about my condition and treatment options from this board than any doctor seems to know. I have initiated every single action that has led to actual treatment and improvement in my condition, up to and including identifying med possibilities and dosages for my prescriptions. The only two things my doctor has initiated were "rest" (but did not explain the concept of brain rest) and prescriptions for opioid painkillers.

Mark, I do have a 2008 diagnosis of either mild or moderate depression in my medical records (I think mild but maybe not). I had been taking 20 mg of Prozac since that time. I think my depression screening tests that are on record at the doctor's office will show that it has worsened substantially since the concussion, though.

Fortunately, I do also have 12 months of short-term disability paperwork with the diagnostic codes for concussion and PCS on them and her signature.