Paul B,

Welcome to NeuroTalk. It sounds like you have some good life experiences to talk about, not that a head injury is good but you are making good use of your experiences.

Please feel free to introduce yourself. There are lots of good people here.

My worst injury was in 1965 and my life changing very minor injury was in 2001 with a myriad of injuries between even though I did not participate in risky activities. Sounds like we have a lot in common.

My best to you.

Thanks for your welcome, Mark.
I feel I almost know you, for my part, because of the frequency of your excellent postings, which are a mainstay of this web-board, as regular readers (and occasional visitors, like me) will know well.

In self-intro, I've mentioned already my original TBI, from a horse onto farmyard concrete in 1991. I had most of a week's coma (and a large subdural haematoma, but was not operated-on). I'm living in Ireland now -- I sometimes liked to say that my blood is Irish, my voice is English and my brain is from an interplanetary visitor. I'm not fixed in Ireland and feel it's likely I will move again soon.

After my TBI, I had zero access to any rehab (in England at that time) and, without any self-awareness, I tried to go back to work immediately, which was a successful small business. My colleagues had difficulties with me, although I would still believe that their real and imagined difficulties were partly from their own lives, not only mine (but that is not at all to say all was well in my mind).

From that time I wandered. I lived in the US for a while, in CA. I had money, from which I was parted by my own folly sometimes, and by other people's outright deceptions at other times. I then wandered up to Canada and lived in Vancouver for some more years. At that time, Vancouver was terrific -- so beautiful and friendly too. I was in a fairly poorly state, I'd say, altho well enough disguised. In Vancouver I took part in a very good and (for me) re-constructive brain injury support group, and more time passed, with a large amount of stop-go-fail-restart fairly haphazard self-rehab.

After ten years I went back to England in a better state (altho dirt-poor, of course). I went to England because I thought I would seek out some qualification (in the country where I'd had my previous schooling) to do more and be more organised about helping other people with brain injury, who were stuck (being without effective rehab). I had spent some time in Vancouver progressed to where I found I could be helpfully effective in some people's diverse situations (varying widely, from being paralysed, mute and ignored, to being "invisibly" disabled people with constant day-to-day problems but not publicly known as TBI-ers).

So, back in England, I found it VERY straining at the start, (a very different densely populated environment from even big-city Vancouver), but I found I could get on academically, although I truly still cannot really understand how. Boastful-sounding, I managed to do two Masters and then a rehab PhD in London. Strangely, each component task was the immediate hillock just in front. I still alternate between absurd courage-bluster and being overwhelmed by really tiny non-challenges. Getting those degrees should give me confidence, but I know for certain, hour-by-hour, that there's less than a wafer between seeming success and complete nothingness.

However, both much more importantly and much more interestingly, it's a lasting puzzle to find how one can slot in somewhere to produce enough benefit for people (and families) who've had brain injuries. You yourself do very well, I believe, as a main NeuroTalker here. For the last few years I've volunteered in the Irish brain injury association, but I sorrowfully find it ineffectual, or "under-effectual" at least.

It's valuable to have the insider acumen for living as best we can with brain injuries, I hope and believe (and have found too, to sound more positive), because medical and therapeutic outsiders have poor insights still, unfortunately, scandalously and wastefully.

Thank you for what you do, for me and for many others here. It's a pleasure to read you -- and a large benefit too.
Be best.
Paul

Hi there,

I've been away from the forum for awhile but came back and read your story; and I must say I feel like I can really relate. I was a varsity hockey player and have been out with my 1st concussion for over 1.5 yrs now. My only symptoms are headaches and fatigue; and some days it just seems surreal to me that one single concussion can do so much damage. I absolutely loved hockey and working out. It's been driving me crazy that I can't do either. Walking is the best I've got.

Earlier you were struggling with the idea of having to make the call to avoid contact sports. I can tell you my approach. For the longest time my mindset was "I'm not going to call it quits after only 1 concussion; 2 then I will consider hanging up the skates, but not only 1". But then the 1 year mark rolled around, with headaches still every day, and I started having doubts. I have still left it that I will not make the decision until the decision needs to be made (ie I am 100% symptom free and cleared for activity), at this point I realize playing competitively as an elite athlete again is out of the cards; right now I just haven't completely ruled out playing pick-up hockey for fun somewhere down the road.

I'm still "part of" the varsity team- will go and watch practices/games and offer my support. It's tough; but I after much thought I've decided the benefits of being part of the team and the game I love slightly outweigh the pain caused from being on the sidelines and missing out on what I love to do.

comeback,

You need to remember that this was only your first 'diagnosed' concussion. If you have played hockey long and hard enough to make it to an elite level, your brain has taken quite a beating. The many body checks and dings have accumulated to quite a mass of sub-concussive impacts. There are some athletes who have had to stop playing but have never had a diagnosed concussion.

I bet you were into serious body checking before your reached 14. The brain is much more sensitive to impact at the younger ages because the myelin sheath is not fully developed to protect the axons and dendrites.

I spent a year on the sidelines as the soccer team manager keeping the stats. I switched to track and had two fabulous seasons. I was headed for my senior season with expectations to be the likely state champion in the 2 mile run. Then, I tore my medial meniscus during the first track meet. I held a stop watch as I watch the league championship. The lead runner was half a lap from the finish when my coach lean over and said, "Mark, you would have been finished by now." The next week, I watched the state champion finish 20 seconds slower than my best time from the preseason.

Yes, it is painful watching from the sidelines. I still have useful knees because I did not run on an injured knee. The doctor wanted to remove the meniscus so I could recover sooner. That was 1973. I took the conservative approach and rested the knee for the rest of the season. I finally needed that same meniscus trimmed in 2004.

Being able to live for another day or a lifetime is well worth the pain one experiences early on. It may take a decade to fully realize that but you have made a great start.

My best to you.

Hi Mark,

I was wondering if you could explain a little more about "sub-concussive impacts"?? I am not familiar with that; is it a cumulative effect that never completely heals? Is there a way this has been measured at all or is it just a theory?? Thanks!

Sub-concussive impacts (SCI's) have been studied extensively. There are athletes who have never suffered a concussion who have played sports where sub-concussive impacts are common who have developed severe symptoms of PSC, some in their early 20's.

A sub-concussive impact is any impact to the head that does not result in an immediate or even delayed feeling of being concussed.

Football linemen and hockey players are the usual sufferers of sub-concussive impacts. The average football player who plays positions where SCI are common receive between 800 and 1000 per season. They are cumulative.

The article I posted shows what can happen from SCI's

It is often the most damaging head injury because there is not time taken off from play to recover. I can tell you more but the simple truth is any hit to the head cause a risk of damage.

Sorry, if I'm missing it, but where is the SCI article you posted?

Thanks