Nervous about my Concussion

rmschaver · 07-18-2012, 01:04 PM

Quote:

Originally Posted by Mark in Idaho

rmschaver,

Do you have any links to Hovda's work. I can find lots of articles and videos or him talking about research and the needs for more research but nothing that addresses a protocol for recovery.

btw, Syndrome is used to describe a condition that is observed repeatedly. Disorder is used to describe a condition that has been scientifically established with a fixed set of diagnostic criteria. The Veterans' Admin and NIH has awarded a contract to the NeuroTrauma Foundation to establish diagnostic criteria for Post Concussion Syndrome / Disorder. The current standards are too subjective.

Hovda's work may include concussion but is primarily focused on sTBI/TBI, not mTBI. This is common in the brain injury community. He appears to still be struggling to establish a criteria for 'return to play' or 'return to action' after concussion. This is no better than the common problem most clinicians deal with.

There are other doctors who have a greater understanding of concussion. I have watched some of their lectures presented at the Howard Hughes Medical Institute.

The NIH and CDC are years behind the best concussion technology due to their need of a consensus before drafting a document. At least Hovda recognized this serious lack of consensus.

Even Mayo Clinic and Cleveland Clinic are behind the times. The Ontario NeuroTrauma Foundation is a bit ahead of the US organizations but still fighting an uphill battle with the consensus issue and the efforts of health and liability insurance companies fighting against a common diagnosis and treatment plan.

The combined knowledge on NT is much more up to date than any individual source elsewhere.

Even the multidisciplinary concussion clinics tend to have weak links in their programs/protocols. Most concussion clinics are oriented toward fee generating rather than effective treatment. Just about any group of doctors and therapists can hang out a 'Concussion Clinic' shingle. There is no standard of care or board certification for concussion specialists.

I will look for links but as I am new member won't be able to post hyperlink. You are correct about Hovda but without his work the military and profesional sports refused to consider cuncussion as anything more than a temporary condition. Dr Hovdas work and basis is relevant as he found the smoking gun to ongoing pathologies but that is a discussion for a different forum.

The CDC and NIH are behind the times but even they acknowledge cuncussion and MTBI are interchangeable terms. Both organizations are large and large wheels turn slow and large goverment wheels are even slower.

It is an unfortunate truth but I feel we are at the seminal moment when the medical industry realizes that cuncussion or whatever you call it can be a diabling injury. Cuncussion as an injury is not well understood as anyone PCS/D can attest. The medical industry also includes insurance companies. These same companies will not acknowledge treatments that are not well established.

It is my opinion, that with so many differing organic systems in and supporting the head/brain, to assume a one treatment fits all will not work. But rather a tailored individaul treatment for the individaul would be best. The medical science portion of the industry proceeds on a scientific basis model. Analyze, hypothesize, test and then validate.

Hate to say it but I think were in the analyze/hypothize stage.

Hope we all feel better.

Mark in Idaho · 07-18-2012, 01:48 PM

Actually, Hovda had little to do with the NFL finally recognizing concussion as an issue. The alarm was sounded first by Robert Cantu, M.D. in Boston and Julian Bailes, M.D. in W Virginia. The Sport Legacy Institute was founded on the basis of the combined input of Cantu and a pathologist in Boston who first observed CTE, Chronic Traumatic Encephalopathy.

Dr Cantu was trying to sound the alarm well over 20 years ago. It has been an uphill battle for 20 years with team doctors straddling the fence between the team owners and the players.

The research into soccer related concussion issues goes back to the 70's.

It was not until some big lawsuits that the tide started to change. That combined with the publicizing of some suicides of players brought the issue to the public.

It is sad and maybe criminal to see the way CDC, NIH, NFL, NHL, NCAA, and others have tried to deny the long term risks of concussion.

The best research was done in the 70's by Dorothy Gronwall, et. al. but was ignored even when she repeated it and republished her findings in the 1990's.

We still have a long way to go. The players are stronger and faster and the hits are harder. Even air bags are not preventing concussions like needed.

But, the momentum is starting to build. We just need to keep it going by promoting the good concussion doctors and refuting the concussion quacks.

MaryinIA · 08-14-2012, 12:00 AM

Well, my focusing is getting better, but then I got a virus that caused coughing fits. It didn't help my head at all. Stalled the slow progress I was making. Still can't multitask, which really is odd for me, but at least I can focus almost consistently on one thing for the most part. I am still very sensitive to medium to high light contrasts and too much activity around me. In the last few weeks I have had two major adrenaline rushes. One happened when someone got in my face and started arguing with me and the other one a week later was for no reason whatsoever. The fight or flight instinct kicked in and was leaning towards fight, which is not me at all unless I am really mad, but I have never been in a fist fight. They last about 2-3 hours and result in a hangover type headache. Other times I am ambivalent to the point of not even caring what test results are.
The waves of pain have stopped, but the point of impact throbs when I get stressed and or tired. A sort of clinching headache follows. Still have "the bees" most of the time.
Thanks for listening and not thinking I am crazy. It's hard for some people to understand.

Mark in Idaho · 08-14-2012, 04:25 AM

MaryinIA,

You should not be trying to multi-task. It is too stressful on the brain. Research shows that multi-tasking is not healthy for an uninjured brain. It causes strain and stresses that fatigue the brain and can lead to depression or other mental strains.

I have never regained my ability to multi-task.

Good to hear you have been able to avoid getting into trouble when people get in your face. A simple solution is to turn and walk away. It will help you avoid the relapse of symptoms from the outbursts.

Tell us more about your struggles. We are here to help.

My best to you.

stormcloudfire · 08-14-2012, 07:38 PM

Mary
The humming in your head is Perhaps Af rom of tinnitus caused by the Impact.your
The OFF nature behavior can be controlled its your Job to do that Somewhat purposefully.
Concussions are additive I would talk to your Doctor and perhaps Go to that Clinic! This is not a TIME LIMIT Controlled problem you respond to it now not when its too late.
Brain centered Pain is not treatable with ANalgesics Morphine and lesser drugs will simply drug you and not the pain. You need a Gabba-blocker medication such as Gabbapentin and that family of drugs . as this is now one of many injuries you may be onmedicatgion for life . Tinnitus of very severe levels can ve calmed by Gabapentin . So far its the only drug I know that can keep me out of the psych Ward .

PEter

Quote:

Originally Posted by MaryinIA

I suffered a concussion two weeks ago. I went down a water slide and hit my head on the concrete bottom of the pool when I exited the slide. I had a concussion or two as a kid, but I don't remember them.
My case is no where near as severe as others on this board, but I am just nervous about recovery. I can function, but my husband has noticed (and so have I) that I have had slight personality changes along with the lack of concentration abilities, vision focusing slowness, "humming" in my head, which I call "the bees", and fatigue. I am a lot more blunt and have less tolerance and the "filter" that usually stops people from saying what they really think isn't quite there. When I get stressed or sometimes just because, the point of impact on the back of head (outside isn't sore) seems to constrict and is painful. The pain wraps around my head sort of in waves.
I had an MRI and it fine.
If there is not improvement or things get worse I will be going to a concussion clinic in the next few weeks.
I guess just talking about it will help me not feel so crazy. Anyway, thanks for listening.

MaryinIA · 08-14-2012, 11:43 PM

It's more of a conscious effort not to get into the mud-slinging match, which in itself is tiring. I just work with some very inconsiderate people that were hard to deal with before my concussion. I have a good situation in that I have no issues going for a walk to regroup. I have a few trusted friends at work that understand. Just talking to them helps me regroup. At home my husband has been marvelous, even though he has had the same virus/cough. Even my 7 year old is great. He knows that I will still play with him, but I just get tired faster (and won't do anything that might risk a bonk on the head). Again, it's just very, very tiring and a life lesson in the making.

I know that I am lucky that things aren't worse and for that I am thankful, but it's still difficult to deal with, so thanks for being here and understanding.

MaryinIA · 08-20-2012, 11:18 PM

I ended up in the ER last weekend because I was extremely lethargic for 24+ hours and my cough would not let go. Hubby thought it was low blood oxygen, but that was fine. I think it was just exhaustion. To get the coughing to stop, I am taking prednisone, which in itself is enough to drive me over the edge. Just starting to taper off, so I can maybe get back to healing.
Hubby is thinking I may have also damaged the occipital nerve, which is not allowing my head to relax like it needs to and then the PCS is bothering the nerve, round and round.
Extremely frustrated, but hanging in there.

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