[concussionfromski]

Hello all,
I am in a fourth month of post concussion. After reading many threads in this forum I found my case is rather different than others. I was knocked out after a failed ski jump without helmet. No need to say how horrible the first few weeks is. I thought I was doing quite well after 2 months, the remaining symptoms were mediate depression and insomnia no problem with balance, or cognitive. I was eager to play sport again. So after 2 months I play soccer and have a slight collision with a player. That alarmed me and I stop playing immediately even though I have no headache or anything. It seemed that my sleep get worse since then. I am not sure if it is just psychological effect or real second impact. All symptoms slowly came back with my insomnia I now have vertigo, memory problem, nausea, migraine. I could not run or swim as I could 2 months after the injury.
I am trying to find a good doctor or a concussion specialist but could not find any reliable source. I went to a neurologist but she seems does not understand my problem. I also searched this website but have not found a list of good doctors. If you have good experience with concussion specialists, neurologists, or happen to know a good source that I can find good doctors please let me know. I live in Tricities of Washington state. Thank you.

[Mark in Idaho]

Welcome to NeuroTalk. Sorry to hear of your struggles.

First, You are not suffering from Second Impact Syndrome. You would have had disabling head aches and be in the hospital fighting for your life.

What you have is Multiple Impact Syndrome. Your second concussion has magnified symptoms because of the accumulation of injuries.

SIS is when the brain loses its ability to control blood and cerebral spinal fluid pressure and swells to the point of brain death.

MIS is like getting a second sunburn on top of a sunburn that has not healed yet. The cell damage is worse but not fatal. It just takes longer to get the maximum level of healing.

MIS also creates a much greater risk if long term or even permanent symptoms, such as PCS.

When you collided playing soccer, did you collide heads? Did you head the ball during your play? Did you play to a point of body or muscle fatigue?

These all can cause a return of concussion symptoms. The first two can cause a concussion like cluster of symptoms even if you did not sense an immediate concussed sensation.

It will help to understand a bit more about you? Gender, age, lifestyle choices etc. Your skiing injury leads me to think you are male and like to push the limits.

For the short term, you should stop all caffeine, alcohol, and any chemicals that may influence your brain. You need quiet rest. You should minimize physical exertion to no more than a brisk walk and even less if you feel any symptoms after a brisk walk.

If you play soccer frequently, you likely have suffered previous concussions that did not cause symptoms beyond a momentary bit of confusion. You surely have experience many sub-concussive impacts from heading the ball. The combined history has left you much more susceptible to any head impacts.

Regarding finding a doctor, it will not likely be much help. There is little a doctor can do, even a concussion specialist.

If you have head aches, Tylenol is a good start. It you need more relief, combine Tylenol and aspirin. If you struggle with head aches and insomnia, a doctor may prescribe a low does of Elavil (amitriptyline, an antidepressant).

Many of us use nutritional supplements to help our brain detoxify and heal. Start with B-12 (500 to 1000 mcgs daily), a B-50 complex, D3, Omega's, calcium, magnesium, and good protein for the essential amino acids ( pork is the best source of Broken Chain Amino Acids.

If you have any severe head aches or loss of balance or motor function, get to an ER immediately.

Otherwise, let us know how you are doing. There are plenty of great people here with lots of experience with PCS.

My best to you.

[pretdou]

It seems that one of the biggest problems is that the advice we recieve from medical professionals is not nearly conservative enough. Reading through this forum has helped me to learn so much about how to care for/protect a concussed brain. Although my daugther has now had four concussions and is currently having sx of PCS (having already had PCS three years ago), brought on by doing a 10k run one month ago, I just had a doctor say that if her current sx were from the run we would need to look at having her wear a helmet for sports like Lacrosse I hope you will find a great doctor but educating yourself is really critical as it's very possible to be underadvised by doctors.

[concussionfromski]

Thank you all for responses.
Mark in Idaho, you are knowledgeable about concussion. Your information is helpful. I collided with soccer player at body part and I have a the ball tap to my head. Before the game that I have collision, I played a game that made me tired. I am a 32 year old man.
I worried about my insomnia, sometime I could not even sleep all night. Is there any natural product that ease sleep? I don't want to use a chemical pill.
I am going to have a sleep test but I am not sure if it is help.

Originally Posted by Mark in Idaho

Welcome to NeuroTalk. Sorry to hear of your struggles.

First, You are not suffering from Second Impact Syndrome. You would have had disabling head aches and be in the hospital fighting for your life.

What you have is Multiple Impact Syndrome. Your second concussion has magnified symptoms because of the accumulation of injuries.

SIS is when the brain loses its ability to control blood and cerebral spinal fluid pressure and swells to the point of brain death.

MIS is like getting a second sunburn on top of a sunburn that has not healed yet. The cell damage is worse but not fatal. It just takes longer to get the maximum level of healing.

MIS also creates a much greater risk if long term or even permanent symptoms, such as PCS.

When you collided playing soccer, did you collide heads? Did you head the ball during your play? Did you play to a point of body or muscle fatigue?

These all can cause a return of concussion symptoms. The first two can cause a concussion like cluster of symptoms even if you did not sense an immediate concussed sensation.

It will help to understand a bit more about you? Gender, age, lifestyle choices etc. Your skiing injury leads me to think you are male and like to push the limits.

For the short term, you should stop all caffeine, alcohol, and any chemicals that may influence your brain. You need quiet rest. You should minimize physical exertion to no more than a brisk walk and even less if you feel any symptoms after a brisk walk.

If you play soccer frequently, you likely have suffered previous concussions that did not cause symptoms beyond a momentary bit of confusion. You surely have experience many sub-concussive impacts from heading the ball. The combined history has left you much more susceptible to any head impacts.

Regarding finding a doctor, it will not likely be much help. There is little a doctor can do, even a concussion specialist.

If you have head aches, Tylenol is a good start. It you need more relief, combine Tylenol and aspirin. If you struggle with head aches and insomnia, a doctor may prescribe a low does of Elavil (amitriptyline, an antidepressant).

Many of us use nutritional supplements to help our brain detoxify and heal. Start with B-12 (500 to 1000 mcgs daily), a B-50 complex, D3, Omega's, calcium, magnesium, and good protein for the essential amino acids ( pork is the best source of Broken Chain Amino Acids.

If you have any severe head aches or loss of balance or motor function, get to an ER immediately.

Otherwise, let us know how you are doing. There are plenty of great people here with lots of experience with PCS.

My best to you.

[Eowyn]

There is a sleep thread here with lots of info and suggestions:

http://neurotalk.psychcentral.com/sh...d.php?t=169324

Are you having trouble falling asleep, or staying asleep, or both?

For trouble falling asleep, some natural things to try are melatonin or Hyland's Calms homeopathic tablets.

If you have trouble staying asleep, you might need to work more on resetting your circadian rhythm.

There is also a good thread on nutrition here: http://neurotalk.psychcentral.com/sh...d.php?t=165807

Have you considered seeing a physiatrist (one who specializes in Physical Medicine and Rehabilitation)? Many of us have found this type of doctor more helpful than neurologists, etc.

Welcome and good luck!

[concussionfromski]

I forgot to ask do your depression get better with Nedley? Is It worth to try? How much do they charge for 10 days?

[concussionfromski]

Hi Eowyn,
Thanks for the tips. I have trouble with both falling asleep and stay asleep. I would be happy if I could sleep for 5h per day. I will try melatonin Hyland's Calms homeopathic tablets.
I have not try a physiatrist, not sure what they do.If you know someone good please suggest me.

[Mark in Idaho]

I have to resolve two things to get to sleep at night.

Earlier in the day, I can easily fall asleep at the computer or TV. By late evening, I need to have some food in me to help my blood sugar get to a good level for sleep. I also take gabapentin to help my mind settle down. I will watch soothing music videos or non-stimulating movies or TV shows to occupy my mind.

Natural substances like melatonin and L-tryptophan help with sleep.

[concussionfromski]

Mark in Idaho,
Thanks for your sleep tips. Have you ever try ambient for sleep? Doctor prescribed ambient for me but I have not try it yet. I used some sleep aid but normally medicine effect just get weaker the next day. Does gabapentin work all the time for you?

Regarding your first reply. I am very worried about my future. With my insomnia the syndrome seems to get worse. Though I don't want to believe what you said it might be true. Have you experiencing this situation yourself or know a real case like mine. Thanks.

Originally Posted by Mark in Idaho

I have to resolve two things to get to sleep at night.

Earlier in the day, I can easily fall asleep at the computer or TV. By late evening, I need to have some food in me to help my blood sugar get to a good level for sleep. I also take gabapentin to help my mind settle down. I will watch soothing music videos or non-stimulating movies or TV shows to occupy my mind.

Natural substances like melatonin and L-tryptophan help with sleep.

[Eowyn]

Originally Posted by concussionfromski

I forgot to ask do your depression get better with Nedley? Is It worth to try? How much do they charge for 10 days?

Both my depression and my post-concussive symptoms improved DRAMATICALLY after the ten-day residential program. They only run it a few times a year, so it can be hard to get into it. The basic cost when I did it was around $5000, but it may have changed since then so be sure to call and ask about current pricing.

Dr. Nedley also has a lot of self-study materials available on his website. There is a book Depression: The Way Out and also a DVD series that contain most of the material covered in the ten-day program. Of course, you will miss out on the "boot camp" effect that you get from being there but it can at least help you get started with a lot of the natural principles at home.

Originally Posted by concussionfromski

Hi Eowyn,
Thanks for the tips. I have trouble with both falling asleep and stay asleep. I would be happy if I could sleep for 5h per day. I will try melatonin Hyland's Calms homeopathic tablets.
I have not try a physiatrist, not sure what they do.If you know someone good please suggest me.

If you are having trouble staying asleep, you could try some light therapy to reset your circadian rhythm. Go outside into daylight for at least 20 minutes between 5-7 AM and again between 2-4 PM every day. That should help you feel sleepy around 9 PM and can help prevent early waking (it won't help if you have sleep apnea or something else waking you up, though).

Also, you might have your blood levels of vitamin D and calcium checked. The brain needs both of those present in order to produce melatonin throughout the night to keep you asleep. If you are deficient in either, it can impact your sleep.

A physiatrist is a specialist in Physical Medicine and Rehabilitation. You can find one in your area here: http://www.aapmr.org/patients/findph...s/default.aspx

This listing doesn't seem to be exhaustive, though; my doctor isn't listed there. So there might be others near you. You could also ask your primary doctor for a referral.

Hope this helps! Good luck.