Hello,
I originally posted this in another board but thought a new thread would make more sense:
I am newly diagnosed with Post-Concussive Syndrome stemming from a MVA on 9/27/11. For a couple of months it seemed my main symptom was having an extremely hard time getting out of bed at my usual time in the morning. As time went one, I had infrequent (since 9/27 about once every 2-3 weeks lasting 15-30 minutes) periods of impaired conscious or a brief loss of consciousness. It never affected my work performance except during those 15-30 minutes once or twice a month. I was put on forced medical leave my my employer where I gathered all necessary documentation regarding my diagnosis and the symptoms surrounding it and what to expect. Before and after receiving doctor documentation, they have regarded my brief losses of consciousness as a "Behavioral Workplace Issue" citing I was "sleeping at my desk." This last episode on 12/14/2011 I was terminated for "lack of alertness" during work hours. They would not allow me to make a rebuttal on my memos or "write-ups" nor did they change their tune after getting multiple doctors sending in documentation citing specific diagnosis' and what my employer could expect from these syndromes. It almost seems equivalent of firing a patient with documented epilepsy who has a seizure at work and was unable to fulfill their job requirements during the periods of the seizures, which was the only time I was unable to fulfill my job requirements. The rest of the time, I was an overachieving employee going over ever goal they set for me and receiving a specific certification that same day I was terminated which I studied for while on forced medical leave and under extreme stress due to them having me run around town getting multiple doctor's documentations because each one I got wasn't good enough even though it was exactly what they asked for. Is this legal? It doesn't seen like it would be.

GRTRT719,

Welcome to NeuroTalk. Sorry to hear of you struggles at work.

It does not sound as if you were treated properly.

My first suggestion is to file for unemployment. The Unemployment office will look into whether you were fired for cause (bad work behavior) or whether this was a medical issue that caused the firing.

You also may need to talk to an Employee's Rights attorney. If your condition is considered a disability, your firing was against the law.

Michigan is an "At Will" employment state meaning they can let you go without cause. Only discrimination guidelines protect workers in Michigan.

Do you have litigation going regarding the MVA? If you were not at fault, you should seek a good attorney. Check out http://tbilaw.com/choiceoflawyer.php

Finally, I am concerned about your condition. If these are seizures, you should not be driving, AT ALL. If they are confusion due to mental overloading, then you need to determine what is triggering the overload. I had serious problems with 'spacing out' after my injury in 1965. My teacher thought it was day dreaming. Now, I have a better understanding. I think the space out periods were petit mal (absence) seizures.

The length of these periods makes them sound severe. 15 to 30 minutes of loss of awareness is a long time. You may be having sleep deprivation mini-naps. I have these from time to time.

I have fallen asleep sitting here at my computer. It starts with me staring at the screen. This may go on for a few minutes. Then, my eyes get heavy. As my head starts to nod off, I usually wake up. These periods can last from 5 to 10 minutes. When I notice this, I need to go take a nap. It usually means I did not sleep well. My sleeping well depends on whether I am breathing properly when i sleep.

You should get checked for sleep disturbances. They may be causing your problems.

So, you need to determine whether this is a disability protected by Michigan law. And, you need to find out if you are having a seizure or just falling into a dozing kind of sleep due to sleep deprivation.

Lastly, it will help in your future posts if you will add some paragraph spacings. Many of us struggle to follow from the end of a line to the start of the next line if the paragraph is longer and 5 or 6 lines.

So, I hope I have not overloaded you. I tend to do that.

My best to you.

I did have a heat CT and an EEG which showed no abnormalities. So as far as they know they don't believe it is seizures.
I understand the at-will employment which I think would be fine, if they had not started this whole medical/doctor documentation thing, which I believe would be the line that crosses the at will into a discrimination suit.
I am meeting with a lawyer next week to exactly understand the legalities considering the situation.
I am def not sleep deprived. I actually sleep really well. From what I have been told by several doctors is that it is a symptom of a cerebral concussion/PCS/tMBI and no doctor no even the neurologist could guarantee that it when they would stop/how long they would continue. My work wanted an exact answer on if they would ever happen again which several doctors told them they could not do.
My work asked the following to my doctors.
1. What is the exact diagnosis and the chances of these continuing
2. Am I at a safety risk to myself or others
3. Can I perform my job duties
4. Does my medication have any effect over these instances?\

Three doctors including a neurologist answered these for them stating while over time, they should lessen and eventually cease but cannot give an exact date, I am not a safety risk and I can and was exceeding my job requirements except during the times of the "space-outs" and no my medication was not causing them.
After these letters, this is when they continued to pursue this as a behavioral issue and told me I was expected to remain alert while during work hours. I was confused and directed them back to the doctor documentation they wanted that relayed that was an impossibility to guarantee them that. About a week and a half after coming back to work I had another episode. Terminated.
To me, and especially my doctors, feel that it was a disability discrimination and is no longer at will due to all the documentation they made me gather and so on. One of my doctors is actually the person who set me up with my lawyer whom I am meeting with. The really ironic things is I worked in medical billing office which included over 100 doctors. Any one of them could have been consulted to the nature of my condition by the HR director and my boss.
Those two just took it upon themselves to decide my future state with the company. I think if none of the medical documentation etc would have taken place, at will employment would have happened and then I would have needed to move on. To me this just seems like its more than that.

What have people said you look like during these episodes?

What do you feel like just before and just after these episodes?

What are you doing just before these episodes?

I ask these questions so that maybe we can understand what is happening. I have dealt with these kinds of issues on and off since 1965. Just because the EEG was normal does not mean these were not a seizure like event.

I had normal or inconclusive EEGs but continued to have these kinds of events just much shorter duration. I had one the day after the inconclusive EEG.

My question about sleep can be better understood as, Are there mornings when you wake up not feeling refreshed? Sleep disturbances can be hap hazard, only happening at infrequent intervals.

You said <For a couple of months it seemed my main symptom was having an extremely hard time getting out of bed at my usual time in the morning.> This is a common symptom of sleep disturbances. The cause of these problems may have resolved to be only an occasional problem. This could easily be the reason for your spaced out or dozing off periods.

Do you drink coffee/ Do you ever feel like you really need it to function?

btw, What meds have the doctors put you on? If this is your only symptom, I am confused at to why you are on any meds.

Are you experiencing any other symptoms?

With a good understanding of your symptoms, you will be better equipped to handle your job discrimination issues. ADA (Americans with Disabilities Act) says the employer must provide 'reasonable accommodations.' If you can offer some reasonable accommodations, they have not grounds to stand on.

My best to you.

It sounds like you got all the required documention that your employer wanted you to get. They still terminated you. I would do as the other post suggested for WC. I would also start the process for SSD. You have a documented medical condition and I don't think they treated your fairly eithor. I am so sorry this happened to you. If this forces you out of the work force I should would get some help and file for disability. I am sorry they did not count all the good work you did over and above what was required. To make an allowance for your medical condition would have been the more humane way to deal with a person. I don't know where the compassion in our society has gone to. I wish you all the best, and I hope you are able to get some help. ginnie

FYI,

Applying for SSD (Social Security Disability Income) can not happen until the applicant is almost 12 months after the injury.

Yes, some employers and HR departments suck rotten eggs.

What have people said you look like during these episodes?
**An impaired conscious state or a brief loss of consciousness (If I am talking with someone during the episode I can have a conversation, I just have no recollection of it. If I am at my computer by myself, its more like "falling asleep at my desk or spaced-out), Mild confusion, glazed over eyes, slow to answer or answers make no sense. If sitting, when I stand up, poor coordination until I can get my bearings, slightly slurred speech and my writing style changes.

What do you feel like just before and just after these episodes?
**I feel 100% completely fine before and after the episodes, its like they never happened what so ever.

What are you doing just before these episodes?
**Every episode (or more what I was doing at the time directly preceding it) has been completely different to the fact that I haven't been able to link any one thing to every episode.

My question about sleep can be better understood as, Are there mornings when you wake up not feeling refreshed? Sleep disturbances can be hap hazard, only happening at infrequent intervals.

You said <For a couple of months it seemed my main symptom was having an extremely hard time getting out of bed at my usual time in the morning.> This is a common symptom of sleep disturbances. The cause of these problems may have resolved to be only an occasional problem. This could easily be the reason for your spaced out or dozing off periods.

**I have had bouts before my MVA of insomnia to the point where I could literally stay up all night and go to work the next add and be completely functional and up to par work wise. The sleep issue never effected me until the MVA and then I had no problem with getting to sleep.

Do you drink coffee/ Do you ever feel like you really need it to function?
**I do drink coffee/Monster/Java Monster. I don't necessarily feel I need it to function, but I think more its been a huge staple of my work day since my teens, its just a normal thing to grab in the morning.

btw, What meds have the doctors put you on? If this is your only symptom, I am confused at to why you are on any meds.
**I am an Ultra-Rapid Metabolizer (This has also been documented-its where the enzymes in your liver that metabolize medications multiply and I have too many than "normal" making most medications useless) I also have a chronic lower back pain which existed well before my MVA. I had a leg fracture that was set incorrectly therefore throwing my whole weight distribution and alignment out of what. All the following medications I was taking well over a year before the MVA and each has been monitored since to see if due to metabolic changes b/c of the MVA anyone of them could be the issue. My doctors found this not to be the case with any of the medications. p.s. I am 5'2" and weigh about 115 lbs
1. 20/80 Hydrocodone/APAP custom compound (2 every six hours)
2. Soma 350mg (1 every 4-6 hours)
3. Adderall 30MG XR (Twice Daily)
4. Xanax 1mg (as needed)
None really worked very well before the MVA and that hasn't changed since the MVA

Are you experiencing any other symptoms?
**No other symptoms

With a good understanding of your symptoms, you will be better equipped to handle your job discrimination issues. ADA (Americans with Disabilities Act) says the employer must provide 'reasonable accommodations.' If you can offer some reasonable accommodations, they have not grounds to stand on.

My doctor said that I required no modifications to my work station, however, periodic breaks for 10-15 minutes 3 times a day would help reduce fatigue in my muscles and alleviate anxiety. They also documented that there is no way to guarantee to them 100% that these would never happen again, however those are the only times I am unable to perform my job functions. I am not "falling asleep" at my desk as they continued to document but according to the physical signs of a cerebral concussion out of the Psychiatric Manifestations of Neurologic Disease, Impaired conscious state or a brief loss of consciousness is the #1 sign.
Since the periods (4 times in 2 1/2 months) was so infrequent per the doctors, FMLA should not be an option as my brain needs to get used to being back on a normal schedule, as I could go on FMLA for 12 weeks, be completely fine and when I come back to work, have one the first day I'm back.
My doctor said and I quote "Your head went through a windshield, and besides these infrequent space-outs you're completely fine. In my book, that's miraculous. You will get better, your brain just needs time to heal and during that healing, these brief losses of consciousness may occur. Eventually they will stop but no doctor will be able to tell your work when or guarantee them that they will never happen again. These are not behavioral issues but a direct result of the accident and should be treated as such. You cannot control them, so how can they be documented as a behavioral issue?

Your first two definitions are complex partial seizures.

Or could be, sorry for being so direct. My son has these and they
are exactly what you describe. He can carry a complete conversation,
but not know what we descussed later. Or he can walk and walk and
talk to us. But not have a clue later. He walks like he knows where he
is. But has no clue how he got there.

Now he has the slurred speech, and the falling asleep, and then
just waking back up say 15 to 30 minutes later. Too.

That can be either a simple if there is nothing else, but if there is
more, then its a complex too.

Donna

Thanks Donna, I will check into that. I did have an EEG, but as far as I know it didn't show any signs of seizures. Do they sometimes not show?

Seizures that are infrequent will not necessarily show up on an EEG. Some people end up wearing a 24 hour plus EEG recording system to try to catch the infrequent seizure activity.

Your caffeine intake is possibly a problem. Research suggests only a single serving per day of caffeine. It is an excito-toxin, meaning it excites the brain cells to the point of failure or fatigue. Add to this caffeine the Adderall and you have quite a mix.

The you add the Soma and hydrocodone and you are a walking pharmacy lab.

If these meds to not do much, would it be a problem to taper off them altogether and try to find out what your drug free state is like?

You could then try to get your brain detoxified and provide some supplemental nutrition to help it heal. There are plenty of post about the nutritional and supplement regimens used by many of us. We can repost if you need.

Are your various doctors in communication with each other? Have you ever had a pharmacist take the time to do a thorough assessment of your meds cocktail?

The doctor that thinks your brain can heal while on such a load of caffeine and your meds is lacking in his knowledge of mTBI.

This complex sentence has me completely baffled. <I am not "falling asleep" at my desk as they continued to document but according to the physical signs of a cerebral concussion out of the Psychiatric Manifestations of Neurologic Disease, Impaired conscious state or a brief loss of consciousness is the #1 sign.>

Keep in mind that many of us are struggling with prolonged or even permanent PCS and the convoluted sentence structures are difficult to process. Same goes for the long paragraphs without a blank line spacing. My eyes get completely lost. I know that PCS can cause some of the convoluted sentence structures so please do not be offended by my comments.

btw, Are you a male or female? This can make a difference as hormonal fluctuations can be extreme with PCS.

Hope we can help you.

My best to you.