going for neuroendocrine testing/pcs
 

Hi all, I'm 14 weeks post concussion, dx with post traumatic vision syndrome at week 6. I had some improvement at 1st with my prism glasses, but now I have an increase in symptoms.

I asked for a neuro-pysch eval and Neuroendocrine testing.

Any thoughts on above testing?

Symptoms: sleep issues(vivid dreams) headache, brain fatigue, light and noise sensitivity, decreased endurance over the past month, balance issues, nausea. Mood swings! I leave out small words when reading and writing. memory issues.

A Neuro Psych Assessment can be worthwhile, especially if you can find a Neuro Psych who has good experience with concussions and MTBI. Some NeuroPsychs have a bias against concussion causing dysfunctions. My NeuroPsych said my vast dysfunction was caused by depression even though I had no indication of depression on the MMPI. He claimed I faked the test even though I scored 49 out of 50 on the malingering scale. One needs to score below 37 to be considered malingering.

So, research to find a good NeuroPsych. Those who work with a NeuroRehab hospital or clinic are usually good.

The neuroendocrine testing can be good if you have a doctor who understands the results and knows what to do about them.

I would wonder if you are getting good sleep. When I have vivid dreams, it usually means I am not breathing correctly during sleep. Maybe a sleep lab test would be worthwhile. Or, an at home recording pulse-ox system for sleep.

I hope your doctor is open to the assessments you ask for.

Thanks Mark. Sleep has been new issue over the last month and I did talk with my doc. He wanted to try a benzo, but we decided to give melatonin a try first. He warned me that it might make my dreaming worse. Last night was the 1st half decent sleep I've had and I didn't remember the dream last night. T;)oday so far is one of the better days in a long time.

My doc is referring me to a specialist of for neuroendocrine testing, he said it was outside of his realm. My ST therapist suggested a neuropsychiatrist for me to see.

I put most of my faith in my Neuro optometrist and ST,OT and Vestibular therapist!

Magnesium citrate may help with sleep, too. You could also try 50 mgs of 5-HTP or 100 mgs of L-Tryptophan. Your system needs to convert the L-Tryp to 5-HTP to serotonin and melatonin. 5-HTP bypasses the need to convert the L-Tryp. 5-HTP is also easier to find in stores. You can increase to 100 mgs or even 200 mgs if you don't notice a sweating side-effect.

Some find a complex carb or protein snack (150 to 200 calories) before bed helps with sleep. I have a slice of cheese and 4 crackers and 20 minutes later, I'm out.

Thanks Mark. Last night the dreams returned and I'm in a fog this morning. Do you have any experience with SSRI that you'd be willing to share?

I have a good friend who is a psychiatrist and she suggested taking 50 mg of Trazodone to sleep. She told me that is a small dose and at that level it should help with sleep and would have a small anti-depressive and anti-anxiety effect. I found that 50 mg made me feel really groggy in the morning, but using a pill cutter to to take 25 mg was very helpful.

I had been taking Ibuprofen for headaches every day for more that three months and think that's not good and so, at the recommendation of my friend, asked my doc to let me try Fioricet - a combo drug that has acetaminophen ann caffeine along with a barbiturate.

I had been taking a very small amount (2.5 to 5 mg) of diazepam to since about a month before my dad died in January. Before the car accident it alone made the difference between sleeping and not sleeping. After the car accident it didn't seem to do it.

Adding the Fioricet to the Tradodone and diazepam seemed like a lot of drugs - especially for someone who normally sleeps really well with no drugs. My doc, the pharmacist, and my friend the psychiatrist said there is not a problem with all three together, although my friend told me several times to not try stopping the diazepam abruptly, but to taper it down no matter what else I was doing.

I asked the pharmacist what to do about the three meds and she told me I should try different things and see what worked. I asked my friend and she said, "Experiment." I discovered that the Trazodone really helps me sleep. It's hard to tell how much the Fioricet is helping with the headaches. I may be too skittish about it to take enough. I'll have to investigate that. And maybe experiment with timing and dosage.

I think the bottom line about psych meds is that some amount of experimentation is necessary for almost everyone. If you take a drug and the first dosage of that drug works, you are amazingly lucky because most people have to to a fair amount of trial and error. I have worked as a counselor for 20 years and have heard a lot of stories about people getting frustrated with the trial and error, and concluding that their Dr. doesn't know what s/he is doing and is experimenting on them. I am not qualified to advise anyone about medications, but I have tried to reassure clients of all ages and the parents of the young ones, by commenting that the trial and error seems to be more true of psych meds than other kinds of drugs. I have no idea why that is true, but it is.

I think you have to give your Dr a lot of feedback about how you seem to be responding to the the drugs and not wait too long in between, so you can give them data for their trial and error for you. Of course, the other problem is that you may find something that is perfect, only to find that after some time it stops working and you are back to the trial and error. Another thing to try is checking with your blood relatives to see if they ever took similar meds and what worked. There does seem to be some correlation in families as to how things work.

Good luck! I hope you find something that works for you

SSRI's don't help with sleep in my experience. I've used Paxil for 14 years and Celexa for 6 months. I now use 5-HTP and L-Theanine in place of the SSRI's.

If you are having serious anxiety issues, an SSRI may useful. But, it is not simple decision. There are side-effects and most have additional symptoms when they stop the SSRI. I don't believe in SSRI's being prescribed by anybody but a psychiatrist or other doctor with extensive understanding of SSRI's. Family docs, most neuros, and PCP's should not be prescribing them, in my view.