Hello, lurker for long time, registered, and thought to add to the threads and give my history.


I have history of multiple injuries since childhood:

-flew into 2x8 headfirst running, cracked open scalp 5 inch cut, and crazy / woozy for hours at age 7

-softball to left face at age nine – wacky dizzy for hours, funny kid syndrome per doc back then

- racing bike and hit parked car, flew over handlebars and hit telephone pole head first, smashed face at age 12 – dizzy, and quiet for days

- fell off dirt cliff 15 feet as teen, rolled down hill, gravel, and came away dizzy and not self for hours – running around with friends, they didn't find me for hours they said

- 1965, went thru windshield, but not all the way, and whipped back into broken front seat, in T-bone accident (we T-boned a truck in an austin-healy, Iwas passenger, not seat belted, since they had none in 1965) – I was out of car first, wobbled to other vehicle that had flipped, and supposedly asked why they were speeding, then don't remember much until the hospital, and months of treatments in followup with outpatient docs for dizziness and memory gaps

- military from 1967 – 1971, the usual exposures to gunplay and explosions fairly nearby in Vietnam as a Corpsman, maybe one concussive blast injury, being thrown about 20 yards over a rice paddy, no real damage recalled

- Martial Arts competition injuries in the 70's and early 80's; and working my way through college as Bouncer in various 'country' bar's in late 70's (friendly talking did not always work).

- 1976 – backseat passenger , Blaser tried to mate with the Jeep I was in, on icey hill, and left me with bruised impression on left face of the spare tire and a subluxed c5/6, no serious neuro deficits still, however everyone tries to blame current issues on pre-existing problems of that issue (since it has left the most visible changes on CT, MRI, and x-ray)

- 1998 – rear ended on off ramp of expressway, by Jeep at deceleration speed from 60 to 45, neck pains and no LOC, just neck pains

- 1999 – rear ended at 40mph, someone on cellphone, neck pain no LOC. (Gads, writing it all out, makes me wonder how I got by – knowing what I know – which I will get to).

Current Problem: 6/2010, Concussion, PCS, Loss of self, Loss of Love of My Career Choice, Irritability, Rage (sporadic, situational), Fussy, Fuzzy me, Not on same page with myself, Can't stay on one subject long times, bright lights irritate, Recurring acute headaches (requiring daily and repeated acute use medication which impedes my abilities to maintain a regular work schedule), Insomnia, drowsy and not restful napping.

My background: I am a Physician Assistant, 45 years in the Profession, working Primary Care , Trauma, and Ortho/Neurotrauma. I have always prided myself in not being locked into the Allopathic world and being open to the Holistic world as well for care of the patients I was charged to care for. My patients and my superivising physicians trusted and looked to me for overall care and gatekeeping to balance out the picture of their management of their care management issues.

Since the issues, all that has gone downhill, even though I managed with medication and FMLA, and working closer with my physicians supervision / input, due to the last injury.

My injury (My latest Neurologist says its my "icing on my cake" - not funny): I was working in the Operating Room, setting up for surgery, we had the patient prepared, and intubated and turned prone for surgery on the Operating table when it stopped working; I got under the table to manipulate the wiring connections to reconnect them to have them again work, and when they did, the team proceeded to move it and arrange it to position, I came out from under and stood. On standing, I came up under the wrought-iron arm of the Anesthesia machine's monitor and sandwiched my head (top, left, just behind the ear area) - with enough force to move the 400 lb machine up and to the side - and slammed back down to my knees, leaning on the patient table for stability....sometime after that, while still down, the Neurosurgeon slapped me on the shoulder and said “Now, there is a concussion.”....I got passed the initial dizziness and wooziness, and loss of focus feeling, and finished my part of the surgery; eventually went to employee health to report the injury, maybe the next day – I can't recall – and the nurse noted a large bruise and an abrasion at the site of the injury.

Over time, for the next few months I self cared for occasional headaches and took personal time for headaches that were 'too much', and eventually got written up for missed time; at which time, I went to my family doc, who signed off on FMLA for the headaches to protect my job; and through out the next months I finally had to see a Neurologist for them and proceeded down the work compensation trail for the FMLA, concussion, headaches and other sequelae noted. Eventually, now, I have been dismissed from work, due to “excessive absenteeism” due to having missed the deadline for the third FMLA filing. I have been out of work since end of April 2012; and the picture is still not improving. I should mention that over a period from 3/2011 thru 3/2011 I was on Amitriptylline from 25 mg twice daily to 200 mg twice daily without real improvement long-term; and it was changed to Topamax 25 mg in April 2012 (new Neurologist – old one retired) and being advanced now to 100 mg. twice daily over the past 3 weeks, and waiting the outcome for the next week to see if improvements. Am on Vitamins and minerals, and other noted supplements on Marks threads, and not extreme dosing in mega-ranges.

The work comp thing is in the hands of the attorneys; I am exploring the termination of employment due to the employer waiting til the very end to explore accomodations with my known troubles to dismiss me instead of arranging for other vocational opportunities; I read many of these threads, and will respond on my clear days if/when I can focus enough to do so; and I want to tell you all that you have a good person here with Mark's very reliable tips, information and offered advice; as well as this board's many informed experienced folks who have gone through much to get where they have enough recovery to offer their input.

Now, I have the beginnings of a throbbing of the headaches, getting fogged, and will take a pill and rest....take care folks, good to finally be clear enough to finish this and meet you.

Concussion,

I know the meaning of 'icing on the cake' personally. My neuro did not use than term. He just said I used up any recovery reserve my brain had. I was 46 years old.

You sound like you are 63 or so. It is a tough time to have a head injury. You have done very well with your career considering your concussion history prior to med school.

Is your primary struggle just intense head aches? Is that what the amitriptyline and Topamax were prescribed for?

It sounds like you would benefit from some intense diagnostics of your neck. Head aches often result from spasms that radiate from the neck. Do you have tender spots behind either ear just above the C-1 to cranium condyle? Have you done any icing of your neck?

Has anybody ever tried to observe you sleeping to see how your breathing is? The trouble sleeping and difficulty getting rest from sleep can be tied to poor oxygenation from poor breathing. There are pulse-ox monitors that can be used at home to track O2 levels. It might be worth a try.

My heart goes out to you as you fight with WC. I was completely denied any benefits .

Regarding your career, Is there a neuro you can work for as an outside consultant to high school athletic departments? Does your state have a brain injury trust fund that may have funds to pay for an experienced professional to help serve the brain injured community? If you can have more control over your time and efforts, you may be able to get back working at some level. Just an idea to think about.

My best to you.

64 now, almost 62 at time of injury.

Career is essentially over, no one will hire someone my age, with dependency on medication for headaches which are chronic, quality of 3-5/10, with sporadic acuity to 10+/10; and no guarantee availability of scheduled work .

No State funded groups like that around this area, 2 universities with training programs for Med Schools that have their Professorial staffings tenured only. And 4 Physician Assistant Schools with their Professorial staffings tenured only.

I am in talks with the PA Schools for possible talks within the programs.

My insomnia is without Oxygen deficits, no Oximetry deficits, no Sleep Apnea. From my Primary Care days, I have quite a few office supplies, kept up to date maintenanced (I worked in the Boondocks, and had some overnight guests at times in the clinic), and they Oximetry has kept well in the 90's thru the night.

The Amitriptylline and, now, Topamax were/are for the Chronic headaches; as the Amitriptylline dosing maxed out, the headaches continued to crescendo especially to the newness at that occipital point of the posterior cranio/nuchal area on the left side, presenting with occipital neuritis symptoms - at which time the diagnosis of Occipital Neuralgia was made by the swelling at that point and the spread of the neuropathic tingling tenderness. They have offered possible injections, but the Topamax has so far quelled the sensations to minimal. The MRI did show Left C2/3 facet Arthopathy, which is something never before reported on previous MRI's from my history.

I use Ice massage regularly on my neck and left neck/occiput when the area has large tender swelling.

As noted, I do not have symptoms of any C5/6 problems from the history and changes noted from the past subluxation, but they like to lock in on it.

I'm essentially in Limbo. I know it. I just woke up from a 6 hour off and on day of napping since I wrote my other post, and here I am. Going off again to try and read a bit.

See you all later. Letting the lawyers dotheir thing, and doing my thing of trying to read what/ when I can, and being with family otherwise.