I originally wrote this in the General area but now see there's a better place for me to write!

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Hello all!

I'm PCS Mikey from Arizona and I'm a Husband/Daddy/runner/triathlete.

Last May I suffered a post-marathon syncope where the result ended up with obtaining a concussion.

My initial symptom a couple of weeks post syncope was fatigue, then it went to intense cognitive impairment, memory problems, and dizziness. After thorough testing, I was cleared by my cardiologist being zero risk for having a cardiovascular problem. The first neurologist said it was post concussion symptoms and my brain simply needed some time to reboot/rewire. I was greatly relieved after several months, that the symptoms cleared up 100%.

Unfortunately I had to have surgery for an unrelated issue (diverticulitis) in December of 2009 and in February, the crazy symptoms came back with intense headaches, more cognitive impairment, memory problems, dizziness, and lots of neck pain, with greater intensity and symptoms than the initial ones last summer.

The second neurologist did more tests (sleep deprived EEG, MRA, carotid u/s) to reassure me, and yes, thankfully, there isn't anything wrong structurally with the brain. But, like many others I'm reading, I CAN tell there's something not right up there! It's been three months since the return of the symptoms and some issues have lessened but as long as I don't exert myself with a heartrate elevated activity, I seem to be fine. If I try to swim, bike or run, I'll get a screaming headache which will last for a couple of days, with mental fog rollin' in, plus some dizziness.

Currently on 30mg of Nortriptyline at nighttime plus phosphorus from the naturopathic Doc. The phosphorus is, by explanation of the ND, supposed to speed up the healing process so my recovery time would be less than compared to not taking it.

And so my journey continues! Happy to be alive, mentally aware enough to write this, fully aware it would have been worse, and patiently healing in order to run again.

Mikey

Wow, your symptoms are likely chemo brain, similar to PCS as the anesthesia poisoned your brain. A PCS patient can be very susceptible to anesthesia. You likely had isoflurane administered. It can be brutal.

I have lost a little bit of cognitive skills each time I have been under for ortho surgery. It was rough on my father when he had a prostatectomy.

The surgeons like to use it because it causes the abdominal muscles to relax.

I have never heard of phosphorus being used to speed up healing from a concussion or such.

I would definitely get into a mega nutrition supplementation for the near future and possibly longer. B-6, B-12, folic acid, Omega 3's. Do a search of these posts for nutrition. We have discussed it at length. A blood test for B-12 and folate levels will tell if you are deficient. You want to be at the high end of the normal range.

Amitriptyline is considered a better choice for sleep issues. Nortriptyline does not have the same level of sedating effects.
BTW, Both are tri-cyclic antidepressants. Amitriptyline is commonly used for PCS and usually at small doses such as 10 mgs.

Hi Mark,

Thanks for your insight and recommendations, I do appreciate it.

I've read the posts here and appreciate the comments from experience you have. Sounds like you've had enough with concussions. I don't know if the headaches and such will go away with me but certainly the current meds are keeping my mind calm and emotions from going into overdrive. I've already 'mourned' the fact that I may never run again in the way I used to so I'm now finding new outlets.

One question: I've read thru some of the posts here that some folks experience the increase in PCS when exercising or exertion. What's your thought on that?

Thanks for the welcome, positive mojo to you!

Mike

You will likely do best if you find the exercise level that causes a return of symptoms and limit your exertion to just below that level. The Buffalo protocol does this limiting from a pulse rate perspective. If you have the resources to purchase an exercise pulse rate monitor, you can likely find your pulse rate limit.

For me, exercise does not cause a return of symptoms of headaches. My head aches just come and go as they please.

There is a great benefit to learning to limit the triggers that cause emotional overload. One can also develop a thought process that allows one to accept the reality of a world with ample emotional triggers that do not need to be resp0onded to. Very few of those emotional triggers will respond to a reaction. So, if you can't do anything about them, why fret about them?

Whether you develop you own philosophical perspective or hold to a religious perspective as I do, either way, the calm is worth the effort.

My best to you.

[QUOTE=Mark in Idaho;657006]You will likely do best if you find the exercise level that causes a return of symptoms and limit your exertion to just below that level. The Buffalo protocol does this limiting from a pulse rate perspective. If you have the resources to purchase an exercise pulse rate monitor, you can likely find your pulse rate limit.
QUOTE]


Mark,

Thanks for the information on the heart rate monitor. I've used one for many years when training for triathlon, so it does make sense. I kinda knew there was a threshold there mainly from my use of RPE (rate of perceived exertion). When I was in PT the therapist had me using something as simple as an arm cycle and I noticed the increase in symptoms.

I noticed that LOTS of new stimuli gives me an increase in some symptoms too. I call that crossing my ambient processing threshold, for a lack of articulating it better! This is probably what you are referring to when mentioning emotional overload. Yeah, I got a little cranky and had to simply let the brain rest a couple of times this weekend.


Mikey

~May you have easy days ahead.~

The medical/psychological term for this excess of stimulus is 'over-attending.' Your brain get overwhelmed trying to attend to too much at the same time.

You threshold will vary from day to day, depending on things like sleep deprivation, physical effort, sensory stimuli, pro or con nutrition, etc. It is very worthwhile to use simple empirical science to observe the many factors that precede an over-attending episode. You will likely find the overlaps form event to event and learn to moderate these factors.

I like you term 'ambient processing threshold.' I know that if I am in a setting with multiple people talking, eventually, I will walk away from the group to a quieter area. I do not even need to be paying attention to the voices. My brain will hit its threshold either way.

People, even professionals, fail to understand how we can become overwhelmed by the ambient noise in a room. Maybe we need to try to ask them how they feel when they are at the theater and someone behind them is talking on and on. Eventually, even the most patient person will become unable to follow the dialogue on the stage or screen. We live with this 24/7.