PCS getting worse
 

Hi everyone

Long time reader, first time poster. 4 months ago in August I received a concussion, my 3rd since April this year and have been experiencing post concussion symptoms since. All 3 concussions happened playing rugby.
My symptoms have mostly been dizziness and lightheadedness (not vertigo) and headaches. There was some cognitive impairment but that passed within the first few weeks. Some light and noise sensitivity but not major. The worst thing was the dizziness. I thought I was gradually improving but since about 3 weeks ago I have been getting progressively worse and feel as if I am back where I started.
Does anyone have any idea what could have triggered this regression? I dont think I have been overdoing it as I have been very careful to stop and rest every time I felt the headache get worse. The only thing I can think of is I bumped my head around the time things started getting worse. I was bending over to clean under a bench and hit my head on the edge as I was standing up. It hurt, but definitely not bad enough to be another concussion. Since then my neck has been very stiff and sore and I think that could be triggering some of my symptoms. The headache has worsened. I have been doing eye exercises daily and have noticed my tolerance for them has been getting worse also.
I am seeing a vestibular physiotherapist and osteopath. I am currently on a very low dose of zoloft as I couldn't tolerate any higher and dont think it is doing anything for me. My doctor wants me to go off the zoloft and on amitriptyline instead. But I see that dizziness is a side effect and worried about my dizziness getting even worse.

Any thoughts or recommendations?

Thanks a lot.

dizzyozzie,

Welcome to NeuroTalk.

It sounds like you are on the right track with the vestibular therapist and neck. The question is. What is being done to help your neck heal properly? Are you doing range of motion exercises to maximize range of motion or a more gentle therapy to help your neck get stable? Gentle is usually better. How do you take care of your neck when you sleep?

What is the symptom the doctor is targeting with the Zoloft? It is not usually used for PCS unless one is struggling with anxiety or depression.

Amitriptyline is commonly prescribed in low doses for insomnia and headaches.

Have you tried anti-inflammatory pain relievers for your headaches? Ibuprofen or aspirin (enteric coated) can be worthwhile. Tylenol/acetaminophen can help with pain, especially when combined with aspirin but Tylenol alone does not provide much anti-inflammatory effect. Have you done any icing of your upper neck?

Hi Mark

Thanks for the reply.

The zoloft was prescribed for depression. I have been seeing a neuropsychologist as well which has been helpful. She said that depression is often associated with PCS and seems to think I may have been depressed prior to the last concussion which could have contributed somewhat to my ongoing symptoms. The zoloft is too low a dose to be helpful as I couldnt tolerate higher. But I am concerned about going on another drug especially one with dizziness as a side effect. Has anyone experienced dizziness on amitriptyline? Perhaps I should ask for a different med?

The osteopath is using gentle manipulations mostly focusing on myofascial release as most of the pain is due to excessive tension which he thinks is compressing some nerves. I have a herniated disc in my neck C5/C6 from my 2nd concussion so avoiding any more aggressive treatment.
For sleeping I have switched to a firmer pillow and sleep on my side. It seems to help as I dont wake up with any pain or stiffness and sleep well. In fact I feel best in the morning and seem to deteriorate during the day the longer I hold my head up. I have tried painkillers but my doctor told me to go off them as she is concerned about rebound headaches. I've mostly been using a heat pack and gentle stretching.

My vestibular system has definitely gotten worse over the past few weeks. Most of my eye issues is due to convergence insufficiency and my convergence distance has worsened. Do you think that could be due to the bump on the head?

Thanks for the help. This forum is definitely helpful as it's very hard to find people that understand what we are going through. When I tell people I can't go out because of a headache their response is always an incredulous "still??"

Ozzie,

I went on a down hill slide around 6 months post accident, seen others here who have experienced the same thing.

It caught me totally off guard and wasn't ready for the next 2 years...not saying that will be your case or time frame.

I also had convergence problems, 9 months of therapy. The therapy hasn't necessarily cured everything but when my eyes are tired or stressed I now recognize what is going on and how to reel it back in, I'll settle for that.