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


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Old 03-21-2013, 02:36 PM #1
"Starr" "Starr" is offline
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Default NPA Next Week

Just found out my neuropsych assessment is booked for next week. I wasn't going to have it done as I wasn't going to pay out of pocket for it. Apparently exceptions can be made for it to be covered under OHIP in some cases, even when they tell you it can't and mine will be covered.

Since mine isn't being paid for by workers comp or anything, it should be a fair assessment (i hope) of what's really going on, no one is paying to have a particular result in their favour.

I'm not looking forward to 5 hours of testing though. Not sure I'm looking forward to getting the results either, though I suppose its better to know than not know. And maybe good to know what strengths are intact still, as well.

Just feeling a bit caught off guard since I'd decided not to have it, then suddenly they booked it. Wasn't expecting that.

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Old 03-21-2013, 02:44 PM #2
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I'm hoping you get some good information from your test that you can use to improve your work or life going forward! 5 hours is brutal but I've heard some of them are longer. Plan to do nothing the rest of the day and next.

I would love to have my testing paid for. Can you tell me who ordered it (family doc, psycologist, psyciatrist, neurologist)? And where are you having it done (hospital, private practice, clinic)?

Let us know how it goes and good luck!

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 03-21-2013, 03:59 PM #3
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It was ordered by my physiatrist (doc of physical medicine and rehab) that I see at the brain injury rehab clinic at the Ottawa Hospital. It'll be done at the Ottawa Hospital at the psych dept... normally, they only do inpatient NPA's, they only very occasionally make exceptions for outpatients, apparently its part of new cost saving restructuring blah blah blah.

If you have any extended health care benefits, they won't accept you. While I do have benefits, I've used all my coverage for the year already, which is how I qualify at all.

I did the intake interview on the phone today, which took about an hour and cuts down on the overall testing time. It also gives them more flexible scheduling, they just slot you in between their inpatient appointments. So when I arrive next week, we just start right away with the testing, no interview to start. She said it also helps by not tiring people out just from the interview before testing even starts.

I didn't expect to have this done at all, never mind so soon, so I'm still feeling a bit off balance about it all.
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Old 03-22-2013, 07:11 AM #4
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I had min done on Wednesday this week Starr... It was pretty long, about 4.5 hours. I don't have any psych problems though (mood or depression issues) so it was shorter since they didn't have to do those tests.

I was ridiculously tired afterwards... I slept the entire way home (1.5 hour drive), and was thankful for the transportation provided by my insurance.

There were parts of the test I did just fine on. Mainly reading words, remembering names, following directions (for the most part). There were other tests I didn't do as well at. Adding numbers while crossing off all the A's in the line (killed me because I used to be top of my class in engineering calculus). Image remembrance (test one was horrible, test two marginally better). And the abstract shape remembrance test was the absolute worst. Maybe because it was last and I was exhausted. I don't know....

I was told that there are treatments that haven't been given, for headaches, for concentration... I am praying I finally get the treatment I need... and you too Starr! I was wondering how you were doing, and praying that you wree a lot better, and sad to hear you are not....
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Feb 24, 2012 - Slipped on a large puddle of ice at work, hitting the back of my head. No loss of consciousness, so I assumed I'd be back at work within a few days. I was wrong.

When resting, symptoms are low. With exertion, I still suffer from fatigue, migraines, vision problems, problems thinking or reading, troubles sleeping, issues finding or getting words to my mouth when the headaches are bad, tinnitus, and thyroid issues which I think are due to the concussion. Seen one specialist, and now a few others through insurance review of my case. Hoping for further treatment.
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Old 03-22-2013, 09:39 AM #5
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Yes, I believe the point of the NPA in my case is to open up opportunities for referrals to speech therapists etc... just to figure out what comes next. Find out what cognitive deficits exist and who to see about them.

Luckily its just information based and not for workers comp or for an insurance company or anything like that where someone is paying for a biased opinion. Any referrals will require private payment, through extended health benefits or out of pocket, so the testing and results should be ok, I think?

I don't know if they are testing for mood disorders or not, our intake interview didn't really get into that.

I will be driving myself to and from the test, but if I'm exhausted after, I'll just plan to hang out in the truck and have a short nap in the parking lot before I leave. I don't have any real options as I'm the only driver in the house and since we live rurally, taxis aren't really an option. (minimum $150 one way and you have to beg them to come pick you up and even then sometimes when they say they will come, they just don't show up.)

The tests scare me... they sound hard. But then again, writing a cheque, a task that used to take like 2 mins, now takes me at least 30 mins and may or may not be correct at the end... I can't pay cash reliably and be sure I give and get correct change, filling out questionnaires confuse me, etc etc... so these will definitely be a challenge.

Heck, the one hour intake phone interview yesterday pretty much wiped me out and that was just basic information about my injury and symptoms. By the end of the conversation, she wanted to give me her phone number in case I needed to contact her before next week and it took me 5 tries before I had it written down correctly and could repeat it back to her, reading it off the paper I had written it on. I imagine her job must be frustrating at times.

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Old 03-22-2013, 11:12 AM #6
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Originally Posted by "Starr" View Post
I don't know if they are testing for mood disorders or not, our intake interview didn't really get into that.

The tests scare me... they sound hard. But then again, writing a cheque, a task that used to take like 2 mins, now takes me at least 30 mins and may or may not be correct at the end... I can't pay cash reliably and be sure I give and get correct change, filling out questionnaires confuse me, etc etc... so these will definitely be a challenge.

Starr
Hi Starr. Try not to stress over it. In mine, they started with easy questions (5+3= ? ) and worked up to harder ones until I "failed" at answering the question, the point being seeing where your ability to process the various test question ends, and if that place is within a normal range.

Regarding the mood disorders, on mine they did a Beck Anxiety and Depression inventory which is self reported.

Consider that it's a diagnostic tool, the outcome to of which is to evaluate where you are, with a goal of identifying next steps in your recovery.
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What Happened: On November 29, 2010, I was walking across the street and was hit by a light rail commuter train. Result was a severe traumatic brain injury and multiple fractures (skull, pelvis, ribs). Total hospital stay was two months, one in ICU followed by an additional month in neuro-rehab. Upon hospital discharge, neurological testing revealed deficits in short term memory, executive functioning, and spatial recognition.

Today: Neuropsychological examination five months post-accident indicated a return to normal cognitive functioning, and I returned to work approximately 6 months after the accident. I am grateful to be alive and am looking forward to enjoying the rest of my life.
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Old 03-22-2013, 04:15 PM #7
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Good luck Starr. I am still having my evaluation. I have gone twice now for 5 hours each time. I am supposed to have my last session at the end of the month and then I will get their report. I, like you am hoping they can direct me as to what treatments could be helpful. It is very tiring. I think that is why they have split up my appointments so much is so I can recover before going through another round. They know exactly the kinds of things we have trouble with and aggravate our brains. Wish you had more people around you to help you with chores and driving etc. I wish you the best and am in support of you.
Let me know what they say.
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Had MVA in 2006 resulting in post concussive syndrome manifested by cognitive impairment, chronic pain/ fatigue. Chronic pain of head, neck, back, left leg.
Other problems include REM sleep behavior disorder, nocturnal frontal lobe epilepsy, chronic migraines associated with nausea/vertigo, episodes of passing out, hypoglycemia, liver dysfunction (had accidental overdose of acetaminophen in 2009) had liver and kidney failure, hernia, degenerative disc disease with compression of nerve root, PTSD, and other problems associated with functioning problems from traumatic brain injury (light, sound sensitive, easily overloaded, easily distracted, cannot focus, anxiety problems etc.)
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Old 04-04-2013, 09:10 PM #8
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My NPA was delayed a week and was today. Whew that was brutal. 5 full hours.

By the end, I was having a lot of trouble answering the general knowledge questions, like "tell me who martin luther king jr is" and "who is ghandi" and stuff that I would normally know and be able to explain, I just couldn't find words to describe things anymore.

It was like my brain just gave up and left the building. I barely remember leaving, I just remember saying to the woman doing the testing, "I'm all done and can go?" and her saying "yes".

I walked out to my truck, locked the doors and passed out for about 45 minutes. Then I felt awake enough to drive the 40 minutes home and walk upstairs and just laid in the dark for 3 hours and napped on and off, too over stimulated to really sleep, but not able to really do anything either. My head was and still is brutally sore.

Some of the tests were not too bad, but some were obviously quite difficult... the ones where you look at a picture and then remember who is in the picture, where they were located and what they were doing, I failed miserably at. All the tests that involved remembering numbers, I know I did poorly at.

The results should be ready in about 2 weeks, so we'll see what they come up with... see if the official results match what I had noticed or if there are any surprises.

I'm feeling pretty hyper emotional tonight... the sort of night where anything/anyone can bring me to tears... you know you overdid it when...!!

Starr
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Old 04-04-2013, 10:42 PM #9
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My NPA was delayed a week and was today. Whew that was brutal. 5 full hours.

By the end, I was having a lot of trouble answering the general knowledge questions, like "tell me who martin luther king jr is" and "who is ghandi" and stuff that I would normally know and be able to explain, I just couldn't find words to describe things anymore.

It was like my brain just gave up and left the building. I barely remember leaving, I just remember saying to the woman doing the testing, "I'm all done and can go?" and her saying "yes".

I walked out to my truck, locked the doors and passed out for about 45 minutes. Then I felt awake enough to drive the 40 minutes home and walk upstairs and just laid in the dark for 3 hours and napped on and off, too over stimulated to really sleep, but not able to really do anything either. My head was and still is brutally sore.

Some of the tests were not too bad, but some were obviously quite difficult... the ones where you look at a picture and then remember who is in the picture, where they were located and what they were doing, I failed miserably at. All the tests that involved remembering numbers, I know I did poorly at.

The results should be ready in about 2 weeks, so we'll see what they come up with... see if the official results match what I had noticed or if there are any surprises.

I'm feeling pretty hyper emotional tonight... the sort of night where anything/anyone can bring me to tears... you know you overdid it when...!!

Starr
Let us know how it goes! We got it covered from a referreal from my husband's neurologist. We have and HMO so I was surprised, but I think having a TBI diagnosis helped get it covered. We just pay a co pay. Not sure if it's for all the testing or for each visit. We are waiting for an opening, but the person we are getting in with is supposed to be the best out here, so I am hopeful. I had no idea how intricate the testing was! So after the testing it's like 'normal' psychology therapy right?
Best of luck...be sure to get lots of rest!
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Old 04-04-2013, 11:38 PM #10
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It sounds like mine, which my LTD paid for after a long while. I did it in one hour chunks. Hope you can rest after that grueling day!
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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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