Hello,

I was involved in a bicycle accident around 3.5 months ago. I was diagnosed with PCS. At first my symptoms were clouded thinking, difficulty concentrating, constant headache, nausea, fatigue, etc.

After about a month or two, I came mostly out of the fog. I mostly stopped needing to sleep for several hours during the day. There are still days where I'm still foggy--but it's not nearly as bad. But I still have a headache every day basically all day. I'm also mostly nauseous and tired all day long. I sleep for about 10 hours per night and have difficulty falling asleep (but not staying asleep). I cannot do any physical activity without feeling worse. Every time my heart rate goes up, my symptoms get worse, even if for a short period.

I don't feel like I'm improving--some days I feel miserable and other days slightly better. I have not felt "normal" once during this period. I am getting pretty worried that things won't change. I don't know what to do.

wakey,

Welcome to NeuroTalk. Sorry to hear of your struggles. Been there, done that back in 1965.

You sound like you definitely have PCS.

You have provided very little information so I am asking all of these questions.

What is your prior history of concussions?

Do you play any contact sports where you may have been dinged but not remember the head ding?

Has your doctor recommended anything besides rest to help you recover?

Have you had any diagnostics done to check out your neck? Many PCS symptoms are related to unresolved neck injuries.

What is your diet like? Do you consume caffeine, alcohol, foods with MSG, or any other chemicals/drugs that may alter brain chemistry?

Do you take any nutritional supplements?

What do you do to fill your day?
Work?
Study?
Play video games?
Listen to music, what kind?
Watch TV, what kind?
Computer/online?

PCS can be a slow drawn out recovery. Stress is the worst thing to have while recovering.

Check out and download the TBI Survival Guide at www.tbiguide.com

You may want to watch John Byle's YouTube series called "You Look Great" : Inside a TBI. There are 6 episodes to watch. It takes about an hour in total.

We're here for you. You have found a place where everybody understands your struggles.

My best to you.

Hi Mark,

See below

We seem to have a commonality. I too was in a bicycle accident. I got hit by a car on a training ride. How about yourself?

The first month or two, I did nothing - literally. I'm back at work staring at the computer screen after a lot of painful adjustments my brain had to make. There was one week where I nearly quit my job because of the headaches, interaction with people and irritability. That's subsided somewhat but I still catch myself having to cope with when the emotions come about. Hard to do when your mind is cloudy.

Working in front of the computer, I suggest taking periodically longer rests like 15 to 30 minutes or longer, especially if you have headaches.

Have you been out on the bike yet? If you're an avid cyclist like myself, it might be a good idea to test yourself as a gauge to your progress. As for exertion, I've just kept the effort steady and incrementally increase it.

wakey,

You redefined my question. <Do you play any contact sports where you may have been dinged but not remember the head ding?
I've been dinged--I played contact sports--but nothing like this.>
What contact sports did you play?
What positions did you play?
How often were you in any type of head or helmet contact situations or even head jostling situations? Heading the ball in soccer? LaCrosse?

Concussion can be progressive. Small dings can accumulate so a point where a simple concussion can do big damage. Your 'ding' history is important. Even your history where you were at risk to get dinged is important. The best concussion doctors complain about the lack of collecting this kind of history.

I felt like crap at 3.5 months and now at 8 months am definitely on the way to recovery. It never feels like you're improving, but think back a month or two ago and you will likely notice a difference. Gradually it becomes more bearable, don't lose hope.

Stress is a killer, all my periods of improvement came when I managed to remain calm, all my plateaus and downhill times when I let the stress get on top of me. So make a plan (nutrition, rest etc) then tell yourself you're doing everything you can so there's no point worrying about it.

To start thinking it will never get better and catastrophising is hard to resist, but that way lies madness as well as lots of stress hormones which are bad for the brain. Try to chill out and if you can't feel happy, try to go 'flat' (ie not feel much at all). I found that it's safer.

Thanks to all of you. The support is very helpful.

I am not an *avid* cyclist, but I enjoy it. I have not yet been back on a bike.

My ding-history is basically irrelevant. I didn't play football or lacrosse for significant periods of time, nor did I incur significant dings during that period. In any case, my aim is recovery.

Re: recovery. This is very difficult to deal with--for the reason you say: it doesn't seem like things are improving. I see some improvement from day 1, but not as much from month 1. Until I feel markedly better, it will be difficult to know how much improvement I've made. You are right to remain calm; but then again it is very difficult to not do anything. I'd kill for the chance to go for a run, or even a 2-hour walk--or simply feel well for one day...

Your suggestions are much appreciated. If you have more, please let me know.

So sorry you are joining us!

I was in a car accident 10 months ago and I'm still working to rehab my brain. I was working full time & going to grad school in the evenings. I spent the first 3 months doing absolutely nothing, laying in bed or the couch and watching tv or doing some very light reading.

My neurologist didn't really get PCS and I wasn't getting any better. Someone suggested our university's medical center that has a concussion clinic. Here are my suggestions:

1) I agree 100% with Mark, thinking about even "minor dings" is important when it comes to your current condition. I have had 3 concussions in the past 3 years. (2 work related, 1 in the accident). Each time the PCS was worse/longer lasting. I'm sure there are other times I've taken a hit to the head and didn't feel anything. But all those little ones add up, as I've learned after the past 10 months.

2) Have you considered taking a leave from your schooling? School is very stressful and it adds a TON of added stimulation & stress. (Stress is the WORST thing for your recovering brain!) I have been on leave for my Master's program since the accident and am hoping to start up again this summer, as I'm still not ready to start this spring. I couldn't have made the progress I have, without completely stopping school and work.

3) Sounds like you really struggle with the computer. How's your vision? I was referred for a developmental eye evaluation in which I learned that I had lost some of my vision in my left eye and my eyes were struggling to work together, making my brain work really hard to try to "see" reality. He referred me to vision therapy and I now have glasses that help make reading and computer stuff easier because they have an anti glare function, as well as magnification.

4) Does your nausea get worse when you move your head around, or your body is moving or in the car? If so, you may have some things off with your vestibular (balance) system. I have been doing rehab for this as well. It has really made my life much more bearable by taking away some of the dizziness and most of the nausea. It really has improved my level of functioning.

5) I also second Mark that you should have your neck evaluated. I have been doing PT for this as well. This has also helped my PCS symptoms.

Hoping you can find some relief soon! We're here for you! The rest of the world doesn't "get it", but you won't find anyone here who won't understand your struggles.

Thanks for your post.

"1) I agree 100% with Mark, thinking about even "minor dings" is important when it comes to your current condition. I have had 3 concussions in the past 3 years. (2 work related, 1 in the accident). Each time the PCS was worse/longer lasting. I'm sure there are other times I've taken a hit to the head and didn't feel anything. But all those little ones add up, as I've learned after the past 10 months.

I agree completely, but I'm looking prospectively.

2) Have you considered taking a leave from your schooling? School is very stressful and it adds a TON of added stimulation & stress. (Stress is the WORST thing for your recovering brain!) I have been on leave for my Master's program since the accident and am hoping to start up again this summer, as I'm still not ready to start this spring. I couldn't have made the progress I have, without completely stopping school and work.

If I took a leave from school, what would I do with myself all day? I can't imagine a life of sitting around waiting to feel better. That seems worse than my current situation.

3) Sounds like you really struggle with the computer. How's your vision? I was referred for a developmental eye evaluation in which I learned that I had lost some of my vision in my left eye and my eyes were struggling to work together, making my brain work really hard to try to "see" reality. He referred me to vision therapy and I now have glasses that help make reading and computer stuff easier because they have an anti glare function, as well as magnification.

My vision is more-or-less OK.

4) Does your nausea get worse when you move your head around, or your body is moving or in the car? If so, you may have some things off with your vestibular (balance) system. I have been doing rehab for this as well. It has really made my life much more bearable by taking away some of the dizziness and most of the nausea. It really has improved my level of functioning.

Yes. I have noticed this. I will take your advice.

5) I also second Mark that you should have your neck evaluated. I have been doing PT for this as well. This has also helped my PCS symptoms. "

Thank you. I will check this out.

As a true type A, overachiever, tons of stuff going on all the time person, I completely understand your fear in taking a break from school.

However, if you continue to have the added stresses and stimulation that school brings, you may be prolonging your recovery, because your brain can't heal in the state you are in right now.

Complete physical and mental rest, (especially mental... the least amount of stress as possible) are what you brain needs to be able to begin healing so you can feel better.

You seem pretty certain you want to continue with school, but speaking from experience if you are able to take a break from school, consider doing so. You will heal faster and feel better sooner. If not, you are going to continue to be stuck in the awful place you are right now.

Hope you find some relief soon