Hello everyone. I am going through PCS from what I think is a second concussion and I am looking for any help or thoughts on the issue. Here is my story.

5 years back I fell off of a bunkbed and slammed my head onto a concrete floor, didn't lose concusiouness (dazed for a bit) but threw up shortly after. The next day I had sensitivity to light fatigue foggy etc. but that cleared the day after that for about a month. A month later this foggy confused disoriented feeling instantly came over me. I was having these vision problems, very hard to explain, not dizzy or headache problems but like everything moves in slow motion. I also developed a stutter during this time. CT and MRI ok. Me and my doctors assumed PCS. The past few years I think I have been getting a little better and I grew content with how I was feeling. I was able to workout and exercise, and I felt good afterward.

A few weeks ago I was punced in the nose, and a waterfall of blood drained out of my nose for about 2 minutes. I didn't loose concusness or throw up, I felt like I usually do with the exception of a swollen and bruised nose. A few days after that my fog that I constantly experience got much worse. I now have horrible fatigue, alot of anxietly and irritability but no light sensitivity or piercing headaches. I cannot work out or exert myself because I get so confused and foggy that I get extrmely disoriented. The main issue here is the weird slow moving vision issues I am having.

Can getting hit in the nose give a concussion? My head was knocked back but is there enough force to slam the brain against the skull? Would it be wise to get another CT or MRI just to see if there is any bleeding of the brain even though I didn't throw up or get knocked out?

I would really appreciate any advice or thoughts on this. I have been dealing with this PCS for many years and it would be nice to hear from people who have experienced this or that have some information they can share.

Sorry to hear about your ordeal.

It seems that you may experiences a setback with PCS due to the punch.
A MRI will do no good with head injuries of this nature, a QEED will be more informative. For a Qeed i would wait out for another 6 weeks to see if the symptoms are still pronounced... ( you probably will be fine)

Try to relax, if not own your own , than through medication. Anxiety can mimic PCS symptoms, especially fatigue. I once thought to have received another concussion, instantly anxiety kicked in, after a couple of days on Xanax I bounced back. I think most of my symptoms where related to anxiety at that time.

You may also consider controlled exercise, in where you work out only to a point in where the symptoms are not increased.( try to keep your heartbeat below a 130 for the first week and than increase by 5 for each additional week. 15 minutes the first week and 30 minutes thereafter)
there is a study with some evidence be able to bring athletics back on track with exercise.

Keep us informed on your progress.

Welcome to NT

It's never good to have a second injury on a head injury. PCS patients are fragile.

I hope you find some answers and some peace.

take care and keep us posted...

Thank you for the advice. These past few weeks I have been reall set back in my life. I used to wake up early go to the gym 5 times a week before and after work, now I can only barley make it to work on time. I tried to work out this week and I got so fogged up and confused I almost forgot where I was. This seems different than what most people with PCS experience. I read all about painful headaches and dizzy spells, which I do not have.

Also, I read about Rhodiola Rosea on this forum. Has anyone tried it? Any luck?

i do get dizzy spells, but headaches are not an issue for me, i am 'a'typical.
pcs wears lots of faces.

you will get better...

One topic I did not see talked about much on this forum is the effect of caffiene (especially) coffee on PCS. I had a coffee the other day at work because I am used to having 2-3 a day, I noticed my fog and confusion sky rocketed afterward. I know coffee can increase stress levels, but when I drank it I was quite relaxed. Does caffiene have any negative impact on the healing? Coffee in general is considered very good for you.

Also, does anyone suffer from the inability to "feel" time? 10 seconds ago feels the same as 10 days ago to me. This combined with my slow vision is the majority of the fog I experience, it is absolutlely horrible.

I'm sorry for your injuries; we all know what you're going through.

To answer your first question, a punch in the nose has more than enough force to cause a concussion. This is especially true in a brain that has suffered a previous injury. As you are exhibiting symptoms, it's a safe bet you've got another concussion.

I know it's frustrating, but traditional CAT scans and MRIs can't image the millions of tiny axons that get damaged and/or torn during a Traumatic Brain Injury (which is what a concussion is - and should be called). As a consequence, even people with profound cognitive deficits often have "clean" MRIs. There are more sophisticated scans that might image your injury, but they are very expensive. Besides, they can't really tell you how your damge is playing out in your daily functioning. For that, you're better off having a neuro-psychological exam.

As you've already discovered, your TBI doesn't like caffine. You need to avoid it and all alcohol and eat a healthy diet. It is also paramount that you rest. Exerting yourself mentally or physically at work, the gym or anywhere else will only make your recovery slower and less complete.

In your case, you need to be super careful because this is a second impact. Multiple impacts and cumulative injuries are serious. You are exhibiting symptoms that might indicate injury to several lobes (for example, behavior=frontal lobe, vision= occipital, etc...). When an injury extends to all area of the brain, it's termed diffuse.

Like you, my TBI causes me to suffer depression, anxiety, panic attacks, etc... Worst of all are the outbursts of temper. These are all signs of damage to your frontal lobe. I would advice you to find a psychologist experienced with brain injury patients to help with the depression, anger management techniques and general coping skills that might reduce your frustration level.

One of the best things you can do is educate yourself about your injury. Some excellent sources for further reading include: the Brain Injury Association of America (BIAA)www.biausa.org; www.tbiguide.com and our own TBI forum here on NT http://neurotalk.psychcentral.com/forum92.html If that's too much reading, there are a number of excellent Traumatic Brain Injury (TBI) videos on You Tube. (Who knew it wasn’t just idiots surfing on cars?)

Good Luck with your recovery.

Thanks for the info and insight Hockey. I am seeing a doctor on Monday so I will update on how that goes. I agree that MRIs CT scans (and cocky overpaid neurologists) are useless, as they did not show anything from my first injury even though I suffered PCS. Reading a recent post on this forum, just made me realize that my symptoms were triggered after a recent flight. Prior to the flight I felt completely ok. After the flight my PCS kicked in, even worse than my original injury. I am confident that this flight is the cause of my recent suffering. Does this mean I just need to "re-oxgenize" my brain? I also lost alot of blood out of my nose when I got hit. I think this means that the initial blow might not have cause as much harm as I thought, however the altitude and lack of oxygen I experienced really did the damage. Any thoughts on this situation?????

baseball,

Yes, a punch in the nose can be enough to cause a concussion. Your brain is much weaker now. Very minor impacts can have a devastating effect. There is no imaging that will help at this late date.

I learned recently that a CT or MRI taken at three days post injury is most likely to show any damage that exists. The Doctor/med school lecturer at Howard Hughes Medical Institute said that any damage will be evident by the third day but will be absorbed within a short period of time thereafter.

The damaged cells take a few days to die. It is only when they are dead that they will show up on an image. Within a few more days, the body will have absorbed the damaged tissue and neighboring healthy tissue will move in to fill the space. Once this happens, the image will be normal.

A qEEG could give some indication but it will depend on the interpretation. Probably not worth the money at this time.

Caffeine is definitely counter-indicated ( a no-no). Basically, caffeine messes with your adrenal system. It will speed up the timing of brain cell processing and this will cause the brain cells to overload and malfunction. It will delay healing.

I tried using caffeine to help me with sleepiness. When I told my doctor, he read me the riot act.

So, rest, stay away from people throwing punches and stay away from alcohol. Also, no caffeine, no aspartame (Equal artificial sweetener), no MSG. They all mess up an injured brain the same way. They overstimulate weak cells to the point that the weak cells can die.

Get some decent nutrition. B vitamins, B-2, B-6, B-12 and folic acid, niacin, thiamine, and Omega 3 oils with DHA and EPA are a good start. The brain needs them to function properly. A damaged brain needs them to heal.