PCS/mTBI? Two years out
 

I'm posting for my husband. He suffered a concussion two years ago from walking into a pole at work. He had to take three weeks off work and has had periodic flare ups for the past two years. He's been on anti-nausea medicine for a year, but it's not working at all in this flare up. Also, the doctor just seems to be treating the symptoms, not the root cause, which is the brain injury. We need to find an expert who can help. His main symptoms are nausea, dizziness, vertigo, sensitivity to light and sound, and balance issues. He is having the worst flare up he's had in two years this week--all triggered by tossing the ball with our dog in the backyard--he was turning quickly to watch her run with the ball. Anyway, he was off work all week and began to feel better, went back to work for four days, and now is having trouble walking because of the vertigo/nausea. We live in Ohio and I have no idea how to begin finding him the specialist or care he needs. Any help would be most appreciated. I'm swinging between panic and demoralization. What are the best medical journals for concussions? How can I tell if a concussion clinic is reputable? Who are the leading doctors and clinics and treatment centers in the midwest? Or in the US as a whole?

CincyPaul,

Welcome to NeuroTalk.

Your husband's flare up from turning quickly may indicate he has an upper neck injury that has never been addressed. 80% of concussions include an upper neck injury.

Gentle physical therapy, gentle chiropractic, and discipline with his posture when he sleeps.

He could also have an inner ear issue. The Epley Maneuver may help. Most PTs and vestibular Therapists can help with that. YouTube explains what the Epley Maneuver is. Crystals can become dislodged in the ear and cause sensations that overwhelm the brain and vestibular system.

Other than finding a subtle neck injury or vestibular disorder, treating the symptoms is the standard. There is no standard treatment for brain injury or concussion. You treat the symptoms.

Vision issues can also cause nausea as the eyes are a big part of balance. A behavioral optometrist can often help. There is a clinic in Chicago that is the best in the country.
The Mind-Eye Institute : Neuro-Optometric Rehabilitation

Hope this helps.

Sorry to hear of your husbands problems. I have experienced similar symptoms (triggered by sudden movements), and I wasn't getting answers from the clinic I was seeing. I didnt know why the symptoms kept coming back from minor things so long after the initial injury. I did a bit of a nationwide search to find good doctors and get opinions on my case. The consensus was that I have vestibular migraine. I blew this off at first because I thought, "I don't get headaches," but you don't have to get headaches to get migraine (its really a much broader disorder than most people realize), and your husbands symptoms seem to fit vestibular migraine perfectly. Just something to consider. I'd Google it and see if the symptoms match. Any sensory overload can trigger migraine pathology (quick movements counts as that). I think migraine is one of the most common PCS complications, and taking migraine preventative meds can really help.

A good place to start in terms of clinic searches (in my experience) is to see who treats your local NFL/NHL teams and try to get in there. Also, see which clinics are nationally ranked in neurology (Cleveland Clinic maybe?)

Best of luck!

PS--Even if nothing suggested on this site is helphul, don't give up hope--keep at it until you find good help. Vestibular (balance/vertigo/dizziness) problems are often difficult to find good treatment for. Doctors are humans who are just trying to collect a paycheck, and because dizziness is somewhat difficult to measure, they rely on patient descriptions of symptoms. If a patient describes a symptom the doctor isn't familiar with, it's easy for them to either pass it off as anxiety or tell the patient, "No, you must be experiencing X, not Y." If a doctor doesn't understand your symptoms, they will not be able to treat you properly. If a doctor isn't listening to your husband, find a new one. The world is big, and there is truly a large amount of medical knowledge out there, if you can find your way to it.

Second opinion services can be helpful. Sometimes an employer will offer one as a benefit. Both Cleveland Clinic and Johns Hopkins offer an online second opinion service, though I think those each cost around $500.

A Carrick trained Functional Chiropractor or Functional Neurologist 'may' help. They usually include a lot of movement testing in the diagnosis battery.

BW, I see your screen name and my brain keeps reading it as Burrito Warmer. LOL

The search function will bring up lots of discussion on vestibular issues and various treatments.

Rarely has JohnsHopkins or Cleveland Clinic been noted as a good source of care. They both have layers to get through to find the right help in many cases.