PCS-month 6 specialist visit-very confused
 

I just returned from a very confusing visit with a neurologist at one of the country's best hospitals in Boston who specializes in PCS. The PCS symptoms in their 6th month, are a result of my 5th sports related concussion. The symptoms are slowly improving although I still have all of the almost constant classic symptoms to some degree.

the doctor surprised me by saying that I shouldn't have any long term effects and can slowly ease back into playing hockey (no contact league). I truly miss hockey and surfing and all of the other activities that i loved so much, but returning to play? His words were music to my ears but it goes against my best judgement. He also says that all of the latest concussion treatment and prevention efforts are "basically BS". This doctor seems to be very old-school. Any thoughts on this advice?

I also learned that PCS is due to hypersensitivity and is linked to a history of migraines in my family members. Without saying it, the doctor was almost insinuating that the symptoms were from a state of mind and because of nervousness of the symptoms occurring , they actually occur?

I have already had two prior setbacks with recovery due to jarring my head from what would seem to be otherwise harmless activities.

Wow.
 

Um, that's a load of crap IMO. Get a second opinion. Returning to play when you are still symptomatic is insane to me!

Hi Noland
 

I agree with the other post. Don't go back to play until you know you are OK again. You know your body better than anyone else. All I have heard on this site about PCS is to take it easy in the recovery. Another knock to your noggin wouldn't be a good thing. Maybe seek another opinion or neurologist. ginnie:hug:

Yes, trust your instinct. You can ask to see another doctor within the hospital. Find a doctor specifically who has had experience with mtbi / PCS.

My neuro-ophthalmologist was very emphatic when she was diagnosing me that many doctors still try to dismiss PCS/mtbi as "negligible" psychological symptoms.

While anxiety/ptsd, etc do occur, PCS/mtbi also have other causes to its many symptoms. Just because you have a predisposition to migraines does not rule out other factors that are contributing to lingering PCS/mtbi.

My neurologist, while open and flexible to mtbi, dismissed my months of vertigo, nausea and dizziness saying they would resolve on their own.

My vision therapy wasn't progressing after 4 months so I trusted my instinct and others on this forum who said to go to an ENT.

I pursued getting an appointment with an ENT who did VNG testing to identify that I do have central and peripheral vestibular dysfunction. I have another brainstem/ cerebellum MRI scheduled Friday.

So, when in doubt trust your instincts and advocate for yourself!

Noland,

That doctor sounds far out of touch about concussions. Just because a hospital has some good doctors does not mean they all are good. His comments do have some truth to them. There is a lot of over-treatment of concussions as concussion clinics pursue profits.

What doctor did you see ?

What symptoms are you still struggling with ?

The Neurology Dept Chief, Dr. Walshe at Brigham and Womens. He seemed to make a lot of sense and explained things well, except for the fact that he said that i can ease back into playing hockey and can surf. I feel like the slightest contact will revert me back to the more severe symptoms that I suffered in December and January. My wife and I couldnt believe that he was encouraging me to "ease" back in to play.

Dr Walshe aslo said that I shouldnt have any long term effects and that the MTBIs and PCS that I am dealing with really have no connection to future Alzheimers.

Symptoms that I am still dealing with:

I am in a "fog". I am still very sensitive to light and noise, constant but usually very mild headache which worsen with physical activity and noise and light exposure. slight blurred vision in left eye and some memory issues. I am also dealing with some anxiety.

All of the symptoms are mild enough where I can still function (although noticeable by colleagues) at work and seem to be improving a bit. This was the case in early March when I suffered a set back by shaking my head, which brought me back to the severity of the original PCS that started in early December from the hockey hit.

He wants to start me on Desipramine. Through a different doctor, I tried Nortriptaline back in February and had some nasty side effects so I had to stop taking it.

Dr Walshe has nothing in the concussion research records. His ideas are very old school. As a department head, he may be difficult to teach new information.

His idea that you are clear to return to risky activities is completely without foundation. His claim that you will have no long term effects is also without foundation.

Many doctors prescribe low dose amitriptyline (10 to 20 mgs) for sleep and head ache issues. It is similar to nortriptyline and Desipramine. Either should be used in a low dose.

Watch the YouTube series "You Look Great" at http://www.youtube.com/watch?v=x9Xso...ature=youtu.be
It takes about an hour to watch all 6 segments. John Blyer is a Bostonian.

As for returning to play, the risks are real. The cognitive problems that manifest in mid life can be life changing. The concussions you know about are just the tip of the ice berg. You also have had a vast number of subconcussive impacts from hard checks and falls. Subconcussive impacts are often more damaging that full concussions. They do not cause the player to take a break and rest the traumatized brain like a concussion.

You and your wife are right to be concerned. There are lots of opportunities to live a full life without putting your brain at risk.

Read my comments to Yankees Fan. She is in a similar situation.

My best to you.

I wouldn't put too much faith in what some doctors have to say. They do not seem to be aware of the long-term effects concussions can cause. I was told that I would be better in a couple of weeks. Several years later, I am still struggling with some symptoms. Your brain is much more important than hockey. Researchers have studied the brains of athletes who have sustained multiple concussions. Some of these athletes developed severe mental health issues and eventually committed suicide. The researchers found a build up of the protein tau in certain parts of their brain. This causes a progressive neurodegenerative disease similar to some demetias, which Dr. Omalu has named Chronic Traumatic Encephalopathy, or CTE. He found that even minor subconcussive injuries can contribute to this. If you want to have a good quality of life in the future, stay away from the hockey. Do whatever you can to preserve and heal your injured brain.

You can watch Dr. Omalu's lecture about CTE on YouTube:

http://www.youtube.com/watch?v=pOKvhcBelwQ