Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 02-22-2013, 06:52 AM #1
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Default Returning to work following PCS?

Should you be symptom free before returning to work?

I am greatly improved but still experienced the following symptoms this week:
Fatigue
Lightheadedness
Problems concentrating
Tinitus
Head Pressure
Insomnia
Sinus Pain
Neck Pain
Numbness in head
Milder noise and light sensitivity

What do people think, I want to get back part time, but have only started to get better this week after an injury in early November?
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Old 02-22-2013, 09:26 AM #2
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Great question! I have all of the same as you right now...but no sinus, and i have visual problems (just thought...could your sinus be similar to the eye strain I get from vision problems?)....

I work at home at my own pace...but have not started the teaching part of my job. I have been advised to possibly start that in September, but only pgasing in slowly...a few hours a week.
I guess it all depends on how you feel and what your job is like. I think we should be more or less symptom free before taking it on full time full speed.
Not easy!
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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Old 02-22-2013, 10:37 AM #3
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I wouldn't say you need to be symptom free, but any return to work should definitely be graded with reduced duties and hours. How reduced these need to be, or indeed whether or not you are well enough to be at work at all obviously depends on your individual circumstances. It sounds to me like if you've only just started to improve, perhaps you are not ready yet? But I don't know what your symptoms etc are.

I found occupational health very helpful in returning to work. Not only did they come up with a useful plan regarding the hours and duties I should be attempting (initially four hours per day of non-urgent desk work), the fact that they were the ones making this recommendation rather than me gave it more weight in the eyes of my managers etc.

So if you think you could do some reduced duties work then I would recommend getting yourself referred to and assessed by any occupational health department your employer may have. Once they realise that you genuinely want to work they will often be much more accommodating in terms of reduced workload than you might expect them to be. I'd repeat though that if you are not ready for it, I would not go down this road yet.

Good luck!
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Old 02-22-2013, 11:43 AM #4
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I am working with a neuro psychologist and she has said that I do not need to be 100% symptom free to return and that that would be unrealistic as some of the "symptoms" cognitive issues etc may never go away. She believes that a VERY gradual return to work is the best way to slowly retrain and challenge the brain to continue to heal.

By gradual she is talking about 2 hours a couple days a week to start. I am nowhere near ready to start this process yet however. You have to think, can you get up at a certain time, get ready for work, drive to work, do a couple hours of work, drive home from work and still feel well enough and recover quickly enough to do it all over again the next day? Your recovery time from doing these things is a big factor.

Good luck with the decision and don't rush it.

CC
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I'm a 39 year old, female, accountant. On July 2, 2012 I crashed my bike at the end of a 65KM road ride. I was fine that day but woke up the next morning to my current world.

Ongoing symptoms include: dizziness, blurred vision, light and noise sensitivities, cognitive problems, uncontrollable emotions/depression/anxiety, headaches (but they're getting better), mental and physical fatigue, difficulty communicating and sleep disturbances.

Currently seeing a fabulous Neuro Psychologist and vestibular physiotherapist and hoping to soon see a neuro ophthalmologist. I am currently doing 20 minute stationary bike rides daily, 20 minutes of meditating, 15 minutes of Lumosity and lots of resting. I have not been able to work or drive since the accident.

The things that have helped me the most since the accident are vestibular therapy, gel eye drops (for blurred vision, sensitivity and dryness), amitriptyline (10mg), and meditating. I am finally starting to see some slight improvements and am hopeful!

My brain WANTS to heal itself... I just have to let it and stop trying to get better!
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Old 02-22-2013, 01:24 PM #5
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Just met my neuropsychologist, she has told me to get another month off work as I am only starting to get better. Need to be 95% better before returning to work, and I am way off that! Also it will be done through occupational health, as this is the most sensible approach in order to prevent relapse and to create a condusive work environment.
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Old 02-22-2013, 07:35 PM #6
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Good for you Mouse. Listen to your doctors and make the best decision for you. I struggle with my return to work but I did not get much of a choice. Neurologists told me go back to work or go on unemployment. It would have meant losing my home. If you can afford it go back slowly at your pace. I love my work but am unable to safely perform as I did before.
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Old 03-22-2013, 12:39 PM #7
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I am now just down to mild headaches, tinnitus, ear ache, mild noise/light sensitivity and I think I am pretty much exercise intolerant. Been cleared for work, so starting back on a phased basis, one day first week, two days second week etc. Really glad about this after all I have been through, I just hope I can cope with what is a very stressful job!
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Old 03-22-2013, 12:43 PM #8
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Good luck! Take it slow.
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What happened: Legs pulled forward by a parent's hockey stick while resting at the side of the rink at a family skate....sent me straight back. I hit the back of my head (with helmet) on the ice, bounced a few times, unconscious for a few minutes. September 11, 2011. Off work since then…I work part-time at home when I can. It has been hell but slowly feeling better (when I am alone☺).

Current symptoms: Vision problems (but 20/20 in each eye alone!) – convergence insufficiency – horizontal and vertical (heterophoria), problems with tracking and saccades, peripheral vision problems, eyes see different colour tints; tinnitus 24/7 both ears; hyperacusis (noise filter gone!), labyrinthian (inner ear) concussion, vestibular dysfunction (dizzy, bedspins, need to look down when walking); partial loss of sense of smell; electric shocks through head when doing too much; headaches; emotional lability; memory blanks; difficulty concentrating. I still can’t go into busy, noisy places. Fatigue. Executive functioning was affected – multi-tasking, planning, motivation. Slight aphasia. Shooting pain up neck and limited mobility at neck. Otherwise lucky!

Current treatments: Vestibular therapy, Vision therapy, amantadine (100 mg a day), acupuncture and physiotherapy for neck, slow return to exercise, magnesium, resveratrol, omega 3 fish oils, vitamins D, B and multi. Optimism and perserverance.
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