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-   -   Advice please (https://www.neurotalk.org/traumatic-brain-injury-and-post-concussion-syndrome/106046-advice-please.html)

Mark in Idaho 10-26-2009 12:15 AM

JT,
**

You do not want to get in the way of your doctors.

The Hyberbaric Oxygen Therapy can be a double edged sword. It can either help or it can cause problems.
Oxiracetam and Cerebrolysin are controversial substances to use.
Neurotherapy should be prescribed by a physician and should follow other diagnostic tests such as a neuro-psych assessment.

Your best bet is contacting the Brain Injury Association for your state. The local chapter may have some recommendations for doctors with a better understanding of concussion. Some states have a TBI agency too.

Either way, it sounds like you need to find a doctor who has a better understanding of concussion. What kinds of tests have they done?

Stay away from stimulants such as caffeine and 'energy' drinks.

I would ask more about the balance issue. The medication may just hide a symptom that points to a more serious issue.

Soccer14,

Good to hear you got some things going at school. Take it slow and work at your pace, not the tutors.

If you find that you are exhausted after a tutoring session, it means you need to slow down. It is better for you to heal as much as you can that to try to keep up with the school calendar. Excessive mental fatigue can slow your recovery.

mhr4 10-26-2009 12:55 PM

Mark,

How is Hyperbaric oxygen therapy a double edges sword? Can you please clarify why you think it can either help or cause problems?

Why do you consider oxiracetam and cerebrolysin controversial? Do you have evidence to support this?

Why are you stating that neurotherpay should be prescribed by a physician only and should only follow a neuro psych evaluation?

Thanks.

Quote:

Originally Posted by Mark in Idaho (Post 582564)
JT,
**

You do not want to get in the way of your doctors.

The Hyberbaric Oxygen Therapy can be a double edged sword. It can either help or it can cause problems.
Oxiracetam and Cerebrolysin are controversial substances to use.
Neurotherapy should be prescribed by a physician and should follow other diagnostic tests such as a neuro-psych assessment.

Your best bet is contacting the Brain Injury Association for your state. The local chapter may have some recommendations for doctors with a better understanding of concussion. Some states have a TBI agency too.

Either way, it sounds like you need to find a doctor who has a better understanding of concussion. What kinds of tests have they done?

Stay away from stimulants such as caffeine and 'energy' drinks.

I would ask more about the balance issue. The medication may just hide a symptom that points to a more serious issue.

Soccer14,

Good to hear you got some things going at school. Take it slow and work at your pace, not the tutors.

If you find that you are exhausted after a tutoring session, it means you need to slow down. It is better for you to heal as much as you can that to try to keep up with the school calendar. Excessive mental fatigue can slow your recovery.


JT5493 10-28-2009 01:12 PM

Everyone. Can someone please direct me to something that can solve my problem bcuz i am having a hard time here. I just want my life back, but the pain is unbearable, and it seems like its never gonna go away. I am so depressed that i just feel so down in the dumps which just adds on top of the pcs.

soccer14 10-28-2009 02:46 PM

Quote:

Originally Posted by JT5493 (Post 583557)
Everyone. Can someone please direct me to something that can solve my problem bcuz i am having a hard time here. I just want my life back, but the pain is unbearable, and it seems like its never gonna go away. I am so depressed that i just feel so down in the dumps which just adds on top of the pcs.

are you on any medication right now?:(

Mark in Idaho 10-28-2009 05:56 PM

For the PCS head ache, low dose amytryptiline is commonly used with success. I get relief with Tylenol. Tylenol can be combined with aspirin at max dose for an effect like codeine without the risk of codeine. Ibuprophen can be counter-indicated if your are on an SSRI med.

Regarding hyper-baric oxygen therapy (HBOT), One of the studies is posted here:
http://www.ahrq.gov/clinic/epcsums/hypoxsum.htm

This concern has also been mentioned at our local rehab hospital that has an active Hyper-Baric Oxygen Therapy department. They use it more for wound care than brain injuries due to its questionable value in TBI.

Regarding oxiracetam, it has some benefits but it also has some serious downsides. It is very bad for someone with an increased risk for Alzheimer's Disease. Since mTBI/PCS results in a drastic increase in AD risk, I would avoid it.

The various 'racetams' are used in the weight lifting/body building community and by athletes and others who want to maximize performance. Even there, is has downsides.

Cerebrolysin is the love child of Dr Wise Young. Very few others promote it yet. It is still being studied in clinical trials. Just because someone can buy it does not make it safe and effective.

I would wait for the clinical trials to show its value and safety.
btw, It is still in clinical trials all over the world.


Yes, I would integrate any neuro-feedback or other neuro-therapy with the Primary treating physician and sound pre and post diagnostics. To do otherwise will be counter-productive.

If an M.D. learns that you are self treating or seeking separate treatment outside of medical consent, you run the risk of being labeled "somatoform."

Any good rehab facility has all of the disciplines available to consult.

My local rehab facility bases treatment on the consensus of a Rehab/Neurologist M.D., a Nuero-psych Ph.D., OT, PT, ST, and Recreational therapist, a nutritionist, and a social worker.

The OT recommends neuro-therapy if appropriate. They have HBOT on site too.

soccer14 10-29-2009 11:53 AM

[QUOTE=Mark in Idaho;583676]For the PCS head ache, low dose amytryptiline is commonly used with success.

right now im on amitriptyline and have been on it for about a month. It has definitely helped. Before taking it nothing else had helped and i had had constant headaches for 10 months. anywhere from the dull ache to the unbearbale migraines. since i have been on it though the headaches are virtually gone and if i do have one its very mild and doesnt usually last long. It also helps with depression and irritability. try asking you doctor about it maybe its worth a shot.

mhr4 10-29-2009 03:55 PM

Mark,

Do you have any evidence that Oxiracetam is harmful for Alzheimers patients? My understanding is that it has been used in studies to treat Alzheimers. This article substantiates this: http://content.karger.com/ProdukteDB...asp?Doi=118805 And the 'racetams' actually have been found to have little to no side effects at all in multiple studies.

HBOT is probably the most contraversial of all of the alternative therapies. I have read about it not working at all to saving someone's life after a major car accident.

Cerebrolysin is certainly not the love child of Dr. Wise Young seeing that he only discovered it a couple of years ago. It has been around since the 1970's in Europe and Asia. It has been demonstrated in studies to be beneficial in the acute (less than 2 years) phase of brain injuries. Here is a link demonstrating this: http://www.springerlink.com/content/j28hlwg135835041/ and this one also: http://journals.lww.com/intclinpsych...ysin_on.3.aspx

You don't need a medical doctor's approval to begin neurofeedback, as you implied. There are plenty of well qualified phd's and such that can diagnose conditions and administer the neurofeedback better than most MD's can. Besides, 99% of MD's either haven't heard of neurofeedback or don't believe in it. So, usually talking with one about it is pointless.



Quote:

Originally Posted by Mark in Idaho (Post 583676)
For the PCS head ache, low dose amytryptiline is commonly used with success. I get relief with Tylenol. Tylenol can be combined with aspirin at max dose for an effect like codeine without the risk of codeine. Ibuprophen can be counter-indicated if your are on an SSRI med.

Regarding hyper-baric oxygen therapy (HBOT), One of the studies is posted here:
http://www.ahrq.gov/clinic/epcsums/hypoxsum.htm

This concern has also been mentioned at our local rehab hospital that has an active Hyper-Baric Oxygen Therapy department. They use it more for wound care than brain injuries due to its questionable value in TBI.

Regarding oxiracetam, it has some benefits but it also has some serious downsides. It is very bad for someone with an increased risk for Alzheimer's Disease. Since mTBI/PCS results in a drastic increase in AD risk, I would avoid it.

The various 'racetams' are used in the weight lifting/body building community and by athletes and others who want to maximize performance. Even there, is has downsides.

Cerebrolysin is the love child of Dr Wise Young. Very few others promote it yet. It is still being studied in clinical trials. Just because someone can buy it does not make it safe and effective.

I would wait for the clinical trials to show its value and safety.
btw, It is still in clinical trials all over the world.


Yes, I would integrate any neuro-feedback or other neuro-therapy with the Primary treating physician and sound pre and post diagnostics. To do otherwise will be counter-productive.

If an M.D. learns that you are self treating or seeking separate treatment outside of medical consent, you run the risk of being labeled "somatoform."

Any good rehab facility has all of the disciplines available to consult.

My local rehab facility bases treatment on the consensus of a Rehab/Neurologist M.D., a Nuero-psych Ph.D., OT, PT, ST, and Recreational therapist, a nutritionist, and a social worker.

The OT recommends neuro-therapy if appropriate. They have HBOT on site too.


mhr4 10-29-2009 03:59 PM

Please read prior posts regarding therapies. Also, Dr. Diane Stoler might be a good resource for you. She is unique in that she has suffered two major head injuries and has successfully rehabilitated herself after both of them. So, she understands what we go through because she has been there.

Quote:

Originally Posted by JT5493 (Post 583557)
Everyone. Can someone please direct me to something that can solve my problem bcuz i am having a hard time here. I just want my life back, but the pain is unbearable, and it seems like its never gonna go away. I am so depressed that i just feel so down in the dumps which just adds on top of the pcs.


JT5493 11-03-2009 03:22 PM

hello today i went to go see a hypnotist since i have not been getting better. I feel more relaxed but pain is still constant. Tomorrow i go to neurofeedback, and i was just wondering what they do and how they do it? I just cant ffind any websites thhat explain it well to me.

Mark in Idaho 11-04-2009 03:18 AM

Unfortunately, there are many different modes of neurofeedback used today. The therapist/practitioner you are seeing should be able to explain the system he/she uses.

Please let us know how it goes and what system is used.


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