sudden recurrence, due to flying?
 

Just like many of you, I cannot believe I am still here. My original concussion was minor (minor dizziness no headaches, was able to work,...).

The first recurrence happened after sprinting (a month post concussion) the day after a flight from Europe. That was almost exactly a year ago. I spent the whole year recovering from PCT and I only had a solid recovery few months ago.

Now I am back from another trip to Europe that went well (got minor dizziness while swimming) and somehow 2 days after a small gym session (which I have been doing regularly) made me extremely dizzy. I have been VERY dizzy over the last 5 days, I had to take time off work.

Thinking about it, the only times I had such a bad recurrence was these two times which happened right after a flight back from Europe... So is that a no no for PCT?

I am quite desperate now. A year in I feel I have not healed. How much more will it take, I wish someone can tell me...

Do you mean PCS, Post Concussion Syndrome ? I don't know what PCT is. Or is the PCT reference just a brain fart common to PCS ?

I would connect your symptoms to your physical activity more than to the airline flight. The altitude (8000 feet) issue would resolve within a hour or two. Fatigue from travel can last a bit longer.

PCS is a strange animal. There is often now way to connect symptoms to a cause, especially later in recovery. That later roller coaster ride can be frustrating. Try to not let it get you anxious or frustrated. That only makes it worse.

My best to you.

Thanks Mark, I meant post concussion syndrome.

I am now regretting not having taken a full day off or two the day after my flight.

The bigger question is however when how can I help the healing as best as possible? Grateful for your thoughts on this. This is what I am doing:


- Physical therapy by concussion specialists (they work on my neck and jaw muscles once a week). I am going to see another clinic and go more often.

- Went to an optometrist that specializes in vision therapy. He recommended lowering the strength of my prescription reading glasses, I did that. He doubts it is due to my vision but vision therapy is plan B to him if PT fails.

- doing neck and back stretching. Sometimes I go to chiropractor when back pain is bad.

- supplements: magnesium, fish oil, B complex

- sports: swimming free style (i get out of the water every 10 mins or so to check whether I am dizzy), gym (light work out, I avoid all vibrating machines, avoiding treadmills and stationary bikes,..), I avoid running completely as this was a major trigger.

- I am almost completely avoiding alcohol, in the last year I perhaps had 5 drinks. Somehow beer is much worse than wine (??).

- meditation and reduction in stress. scaled back my work ambitions.

- emotional stress: quite a bit, still dealing with breakup and the stress from living quite a lonely life.

Any ideas? MANY THANKS

"swimming free style (i get out of the water every 10 mins or so to check whether I am dizzy)" Why do you stop to check for symptoms ?

If you regularly check for symptoms, I guaranty that you will notice them. I have miserable tinnitus, Have for almost 15 years. If I stop to check, the tinnitus seems to ring louder. If I just go on with life ignoring the tinnitus, it fades into the background.

Instead, learn behaviors that allow you to move forward. If dizziness is an issue, learn to move with more purpose rather than impulse.

What are you doing to help your neck and jaw improve ? Doctors, chiros and PT do not cause healing. They just make it so that healing can happen. If you use bifocal reading glasses or glasses that require you tip your head back to use the reading lens, that may be rough on your neck. It was a struggle for me. I had to lower my computer monitor to the lowest possible level so I could look down at it. ??

mag, fish oil and b complex is barely a start. Some B complexes are better than others but even the best are usually low in B-12 and often have the wrong B-12. I'm a believer in the whole regimen. I just took a handful a few minutes ago.

"He doubts it is due to my vision but vision therapy is plan B to him if PT fails." What are you expecting the PT to resolve ? What are you expecting the vision therapy to resolve ?

Thanks again for the answers.

The neurologist I saw that specializes in concussion told me that the standard protocol right now for people whose concussion symptoms do not resolve on their own is PT and vision therapy.

According to him the concussion could have affected my vision, the way my eyes coordinate together (and there was a slight evidence for this). The PT is because of muscle related issues after injury.

I really do not know whether this is standard or recommended but if any of these are contributing to my dizziness I wanted to help resolve them.

Any thoughts to the contrary? I am not clear what you think about this protocol.

I used to take high doses last year of a liquid b12, forgot the source but will look it up.


regarding checking for symptoms, my concussion got worse the day when I did not care about an incipient dizziness while running. Before that I was doing just fine. I do not always feel dizzy, even when I stop and check.

So, is he hoping the PT will help with your dizziness ?

And, it not, then the vision therapy may help the dizziness ?

btw, I have had poor convergence for decades. It is noticed every time I need to get checked for new glasses. The only effect it has is to reduce my depth perception accuracy.

I wonder how he sees a connection between either and your dizziness.

"regarding checking for symptoms, my concussion got worse the day when I did not care about an incipient dizziness while running."
What do you mean by your concussion got worse ?
Could it be that your dizziness was from the pound with each stride rather than the exercise ? I suggest that it was.

Regarding B-12, you don't need a high dose. But something more than is common in a B complex is usually helpful. Methyl is better than the cyano version that is in most B complexes. Plus, the D-3, calcium, anti-oxidants and such are all helpful.

Please keep in mind that many concussion specialists are just sport medicine doctors, usually orthopedists, who have taken a weekend seminar about concussions given by one of the computerized neuro-cognitive test (CNCT) companies like ImPACT. Their focus is return to play and signing off athletes so they can return to play. Because schools require such sign offs, they develop multi-discipline clinics and are able to collect fees before they sign off on these athletes.

While waiting for the athlete to pass the ImPACT or other CNCT, they are able to bill for lots of care. I'm not sold that most athletes need most of the treatments. There is a saying, give a man a hammer, everything looks like a nail. Give a doctor responsibility to sign off and every athlete/patient becomes an income source.

Yes, there are neck injuries with concussions. Studies say as high as 80%. But, they are more likely to cause headaches and the roller coaster of other symptoms. Chronic dizziness may be not related to the neck injury.

Dizziness is a key symptom that prevents a return to play sign-off. So, he keeps trying to treat.

But, as I said, what are you doing to help your neck and jaw heal ? Jaw problems can be due to jaw clenching or grinding, often during sleep. Do you wake up with a sore jaw ? Jaw clenching can be cause by a concussion and some meds.

If flying (or any other change in pressure) seems to bring on the symptoms, check into the possibility of a "Perilymph Fistula". Basically a leak in one (or both) of your inner ears. It is very controversial and some doctors don't believe in it.
Surgery to fix it helps some people and doesn't help others. I had surgery for it almost a year ago and it didn't help, so hard to tell if I had it and the surgery didn't take or I didn't have it in the first place.

thanks to both.

Russianrulez: i will look into this. I had a complete ear testing and they did not find anything. Not sure if they checked for this, does not sound they did. Actually interestingly after 2-3 months of my concussion I had two episodes of ear and jaw pain together with symptoms of flu. My ear doctor told me I might have that common jaw issue called TJ something, really can't google now... But these symptoms went away.

I have been using ear plugs in the last two days, and i feel they help a great deal. If I go for a walk I feel I am less dizzy. I would say slight improvement. I am also wearing an orange tainted sunglasses and that seems to help. I am trying to minimize stimulus to my brain, hoping to heal fast.

Mark: I am not sure if I understand but you sound skeptic about all therapies. Basically I went to a neurologist who works on concussion and he is at a rehabilitation clinic (so I don t think associated with any team although perhaps influenced by the college trend of sending people back to sports to quickly). My understanding is that this is a ghost (PCS that is) that no one understands well. So basically they want me to do everything and give every therapy a chance...
What do you think of Russian's story about Perilymph Fistula?

Have you seen people recover fully after a year? I need some hope, all of us do. I think it is hard for many of us accepting that one tiny accident is going to change the course of our life (mine is already .

I heard some people were able to go back 100% after a year or so. right?

bachissimo,

I am not against any therapy. You presented the concept as it there is a standard protocol for trying various therapies. I think therapies need to be diagnostics based. Plus, there are many physical issues that may exist but not have any bearing on PCS symptoms.

My point was that just because you have mild convergence insufficiency, it does not mean that is causing your dizziness or other symptoms.

Just as Perilymph fistula necessarily being a cause. There are some very specialized tests, some using specialized microscopic techniques, to diagnose inner ear issues.

Many people have not seen much recovery during the first year then they find a treatment or maybe a change in lifestyle or activities that allows recover to continue. Others find that after making some reductions in life expectations and building a life with those reduced expectations, they are able to move forward toward a full life.

Try to keep in mind that you may experience coincidental symptoms and issues. Just because you have jaw pain does not mean it is connected to dizziness.

Other than the ear plugs and tinted glasses, what are you trying to do to help your neck and back ? What about learning to move with more purpose ?

I have been going to chiro and therapy, got a new pillow, I am stretching, working while standing. Frankly these could be coincidental findings, even the therapists admitted that my jaw is not that tight anymore and my neck has also been getting better after my regular stretching at home.

But please this is not the first time you mention it and I forgot to ask: what do you mean by "moving with purpose"? Not sure if it is my language barrier.