Symptoms return after healing
 

HI, new to the forum.

Last August, I crashed my drag racing car. 170 mph. I had all the required safety equipment. My left thumb was cut off and replanted that night. And I also received a concussion. I was wearing a HANS device which I believe helped, since I received no neck and spinal injuries. My head/helmet bounced in the padded roll cage, side to side.

When I was brought to the hospital by ambulance, they did a scan and there was no bleeding in the brain. Every blood vessel in my eyes popped. They were completely blood shot for about 10 days. The doctors in the hospital were more concerned about my thumb than the concussion.

When I got home, I saw my PCP and explained my symptoms. He said you have to give it 3 months. I did and the symptoms went away. I couldn't believe it. I asked if I should see a neurologist and he said it wasn't necessary.

My symptoms were getting dizzy when I got up from a sitting/laying position. If I looked up, I would get dizzy. After a car ride, when I would go to get out, I would have to adjust. At first, the sun would bother me, but that went away fast. Lastly, when I would lay my head down to sleep, ear on pillow, the room would spin for about 5 seconds.

But like I said after 3 months, all symptoms were gone. I felt great. Honestly, I was more concerned with the concussion than the replant of the thumb.

2 weeks ago, I went to the dentist to have a cavity filled on one of my front, upper teeth. The dentist give me a local and it numbed my gums, nose and side of my face. He drilled away and filled it. After that, I started to get symptoms again. Not as bad as the first time, but noticeable.

I had a second hand surgery a week ago and was knocked out with anesthesia. I went back today to remove stitches. I asked my hand doctor and she thought it might have been due to the drilling and not the local. I have yet to see my PCP yet.

Any ideas, opinions?

Thanks
Tom

Tom,

Welcome to NeuroTalk. Glad to hear you survived your crash with only minor issues. Hope your hand surgeon is one of the good ones. I have not been so lucky with hand surgeons.

I think you should consider a few things. A dentist chair is rough on the neck. Lots of tensing of neck muscles and such. The HANS system helped but did not prevent all cervical trauma. C-1 to occiput and C-1 to C-2 can be very sensitive to inflammation. This can make symptoms come roaring back due to poor cerebral blood flow and such.

Did the dentist give you any nitrous oxide to help you relax ?

I suggest you avoid sleeping with your head turned. If you sleep on your side, be sure your pillow supports your head so your neck is straight.

You may benefit from an assessment and maybe an Epley maneuver by a good vestibular or physical therapist. The crystal material in your ear may need to be re-positioned. It is a simple assessment and simple treatment.

My best to you.

Thanks Mark.

No NOS at the dentist. I am usually relaxed, my dentist is very good, for me.

Who should I go see first? Neurologist (MRI)? Vestibular person??

Thanks

A Neuro will not help much. An MRI will not likely show anything. There is a moving x-ray that can detect loose ligaments at C-1 to occiput, the area the HANS is designed to protect. But, the HANS is not perfect. Your head and neck still get jerked around.

A Physical Therapist with good vestibular skills will be good and likely easier to get in with than a vestibular specialist. Not all PTs are equally skilled. Same goes for chiros. Some can help with subtle neck injuries. others make things worse.

Just extending your head/neck can be part of the issue. Icing your neck can help. Read the vitamins sticky at the top. It has a recipe for a crushable ice packs.

Hey Mark what kind of doctor would be the best to seek for the Epley maneuver?

A physical therapist or vestibular therapist or ENT all should know the Epley. But, if you pass the diagnostic test, the Epley is not going to help.

A Carrick chiro should have tested you to see if the Epley will help.

I agree and think Mark's advice will benefit you. Keep in mind that the Epley Maneuvre can irritate a sensitive neck.

The symptoms from neck damage and a vestibular lesion can be similar.

I had a physio who over-did the Epley maneuvre with other vestibular treatments because I would report post-treatment symptoms... my physio was desperate for success and I couldn't think clearly. Eventually, more complex testing revealed that my vestibular crystals had been put back in place properly and that my symptoms were now sourced from my neck.

Your recovery will be quicker if you can avoid this mistake by not confusing the source of your symptoms during pre- and post-treatment testing.

Good Luck

Hains

Just an update

Just came from the ENT. He feels it is small crystals in the inner ear that may have become dislodged.

He did some exercises with me (turn head, lay back, sit up, turn head, etc) to see if they would dislodge themselves and go somewhere else.

He told me to wait 3 days. If it doesn't help, he would send me to a physical therapist who would do similar exercises, but more aggressively.

We'll see.