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

Reply
 
Thread Tools Display Modes
Old 04-12-2013, 12:44 AM #1
MsRriO's Avatar
MsRriO MsRriO is offline
Member
 
Join Date: Dec 2012
Location: Saskatchewan
Posts: 237
10 yr Member
MsRriO MsRriO is offline
Member
MsRriO's Avatar
 
Join Date: Dec 2012
Location: Saskatchewan
Posts: 237
10 yr Member
Default My confusing Return to Work plan

Saw my MD today who was supposed to have the report from the last assessment I had done by the WCB hired guns team.

(Remember that? The thread is called Functional Assessment Evaluation, if you want to read the back story)

Ok so, he didn't have it. Instead we discussed my progress. At five months PCS I am improving but still have a ways to go. (See signature lines for details)

Anyway later, after I left, he apparently reached WCB who faxed him the report. It states that I'm to attend daily vestibular therapy for six weeks, then return to work on a graduated basis as such:

2hours/5 days a week on week 1
4hours/5 days a week on week 2
6hours/5 days a week on week 3
8hours/5 days a week on week 4 (full time)

However when I was in his office he stated he did not think I was ready for an aggressive return to work plan.

My confusion is this: isn't the plan I just described pretty darn aggressive or is that just a standard workers comp RTW plan?

I'm trying to stay in the moment here and just focus on the fact that I have six weeks yet to heal. Positive mentality. But. I think the RTW plan stinks. And I'm confused as to what the heck my doc is thinking by agreeing to it?
__________________
About it: October 26, 2012 I fell backward on an icy parking lot at work. I was on Workers Comp for 9 months. My PCS : everyday headaches became once in a while headaches, and neck pain became manageable. Still have occasional mild dizziness, sometimes fullness in the ears, convergence insufficiency, sequencing struggles, short term memory struggles, verbal processing delays. CT neg, MRI neg. Therapies: prism glasses, acupuncture, icing neck, resting, supplementing, Elavil 20mg at bedtime.

NEW: Completed 12 weeks of physical therapy and returned to work full time.

About me: I'm a marketing manager, a mom with a blended family and wife to a heart attack survivor. I believe my brain injury taught me more than it cost me. I'm grateful to still be me!
MsRriO is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
Brain patch (04-12-2013)
Old 04-12-2013, 01:11 AM #2
Mark in Idaho Mark in Idaho is offline
Legendary
 
Join Date: Feb 2009
Location: Somewhere near here
Posts: 11,427
15 yr Member
Mark in Idaho Mark in Idaho is offline
Legendary
 
Join Date: Feb 2009
Location: Somewhere near here
Posts: 11,427
15 yr Member
Default

I doubt this is carved in stone. When there is an absence of better ideas, it is not uncommon for a plan to be made out of pure conjecture. The vestibular therapy is conjecture too.

Try to relax and go with it documenting in your journal along the way. If you struggle the first week of work, you can ask to extend the 2 hours per day.

Try to relax. You don't have any better ideas than they have. You just have anxiety. Go with the flow for 6 weeks and see where you are then.

My best to you.
__________________
Mark in Idaho

"Be still and know that I am God" Psalm 46:10
Mark in Idaho is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
Brain patch (04-12-2013), MsRriO (04-12-2013)
Old 04-12-2013, 01:18 AM #3
MsRriO's Avatar
MsRriO MsRriO is offline
Member
 
Join Date: Dec 2012
Location: Saskatchewan
Posts: 237
10 yr Member
MsRriO MsRriO is offline
Member
MsRriO's Avatar
 
Join Date: Dec 2012
Location: Saskatchewan
Posts: 237
10 yr Member
Default

Nailed it Mark, I am freeeeeaking out. Anxiety high, pain high, (not sure which caused which today, chicken/egg) ears full, and still able to laugh at myself a little.

Time to attempt sleep. Tomorrow is a new day!
__________________
About it: October 26, 2012 I fell backward on an icy parking lot at work. I was on Workers Comp for 9 months. My PCS : everyday headaches became once in a while headaches, and neck pain became manageable. Still have occasional mild dizziness, sometimes fullness in the ears, convergence insufficiency, sequencing struggles, short term memory struggles, verbal processing delays. CT neg, MRI neg. Therapies: prism glasses, acupuncture, icing neck, resting, supplementing, Elavil 20mg at bedtime.

NEW: Completed 12 weeks of physical therapy and returned to work full time.

About me: I'm a marketing manager, a mom with a blended family and wife to a heart attack survivor. I believe my brain injury taught me more than it cost me. I'm grateful to still be me!
MsRriO is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
Brain patch (04-12-2013)
Old 04-12-2013, 01:42 AM #4
cyclecrash's Avatar
cyclecrash cyclecrash is offline
Member
 
Join Date: Nov 2012
Location: Ontario, Canada
Posts: 267
10 yr Member
cyclecrash cyclecrash is offline
Member
cyclecrash's Avatar
 
Join Date: Nov 2012
Location: Ontario, Canada
Posts: 267
10 yr Member
Default

I knew you had your doctors appt and was hoping you'd update us! Mark is spot on with this, your anxiety about the return is going to be your toughest fight here! It's understandable to be worried.

At any stage of this it can be changed if your doctor feels it's necessary or if your therapist doesn't feel you're ready. A good therapist will be golden because they will spend much more time with you and do tests etc that they can use in reports to WCB.

I find it a little odd that your vestibular therapy is daily. I see my therapist weekly or every two weeks and in between I do the exercises myself. I wonder what they're going to do with you every day. Is it just vestibular therapy or is it physical or occupational also? When does that start? Please share what they're having you do as I'm still having dizziness as one of my biggest issues.

I hope you are able to find a way to remain calm and take this all one day only at a time. I was not succeeding in that and have found low dose medication helpful. it might be an option for you if needed in the future.

Good luck to you! You've come a long way!

CC
__________________
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!
cyclecrash is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
Brain patch (04-12-2013), MsRriO (04-12-2013)
Old 04-12-2013, 07:16 AM #5
poetrymom's Avatar
poetrymom poetrymom is offline
Member
 
Join Date: Mar 2013
Location: Minnesota
Posts: 398
10 yr Member
poetrymom poetrymom is offline
Member
poetrymom's Avatar
 
Join Date: Mar 2013
Location: Minnesota
Posts: 398
10 yr Member
Default Returning to work

I was supposed to go back to work next week to ease back in per doctors plan. I was to work Tues and Thurs to have a day off in the middle and weekends to recover. My HR won't allow it. They want me back all or nothing and I think the doctor is right -- to ease back in. (I am better, but also wonder about a relapse) I have my union looking into this and need to work on my rights too -- but going back to work does make me nervous a bit because I did that once and it didn't go so well.

It seems to me that no one, no doctor, not you, certainly not the Human Resources dept, really know **for sure** how to ease back to work, or there are guidelines, but you have to listen to yourself, watch what happens to avoid a relapse.

Keep us posted about returning to work. It is on my mind too as I prepare yet another week of lessons for school.

Take care,

poetry mom aka JJ
__________________
[SIZE="1"]What happened. I was in a car accident 2-23-2013, and got a mild concussion from it. I had some time off for brain rest, got somewhat better, but slipped into PCS in March 2013.

Symptoms I had: dizziness, light and sound sensitivity, fatigue, tinitis, occasional headaches and migraines,

Symptoms as of 5--2013: poor sleep, tinitis, some confusion /short term memory blanks, balance. The other symptoms are mostly gone, but flare up if I OVERdo something.

Therapy I had: vestibular

3 months in: I could drive more and for longer distances. I felt like a younger, happier version of myself and I feel so blessed to have this feeling.

9 months in and I am working full time. I do get tired, and some sound and light sensitivity from time to time, but mostly I am over most of my symptoms.
I pray every day and I m praying for your recovery.

Over a year in: I can multi task (limited) and have humor in my life. But when I am tired, I am very tired.
poetrymom is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
MsRriO (04-12-2013)
Old 04-12-2013, 09:07 AM #6
mouse1's Avatar
mouse1 mouse1 is offline
Member
 
Join Date: Feb 2013
Posts: 448
10 yr Member
mouse1 mouse1 is offline
Member
mouse1's Avatar
 
Join Date: Feb 2013
Posts: 448
10 yr Member
Default

Your plan looks reasonable to me, but you should be allowed to cut back if its too much, you don't want to relapse, and surely neither does your employer want you to. I agreed the following because it takes 45 mins drive to work and 45 back to home:

5hr day In the first week.
2 x 5hrs 2nd week.
2 x 5hrs and 1 x 8hr 3rd week - just done this.
3 x 8hrs 4th week.

I will then agree another part time 4 week plan, possibly moving upto full time during this.

I think what works depends on the individual, I hope it works for you. Expect to be tired, but you will gain confidence and strength the more you do. Good luck with your return!

Poetrymom - you have to do this gradually, all or nothing is very unreasonable of HR, and to ask this is very unrealistic.
__________________
PCS following head injury November 2012. Experienced dizzyness, light and noise sensitivity, hypercusis, fatigue, insomnia, migraines, facial pain, problems concentrating, irritability, sensory overload, exercise intolerance.

Symptoms mostly resolved, working full time and I am now mostly better. I wake 6am daily since my injury. Was experiencing daily Neuralgia which was controlled with Cymbalta 30mg, Lyrica 200mg daily. Now only on 30mg Cymbalta.
mouse1 is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
Brain patch (04-12-2013), MsRriO (04-12-2013), poetrymom (04-12-2013)
Old 04-12-2013, 09:24 AM #7
Concussion Concussion is offline
Member
 
Join Date: Aug 2012
Location: East Coast
Posts: 259
10 yr Member
Concussion Concussion is offline
Member
 
Join Date: Aug 2012
Location: East Coast
Posts: 259
10 yr Member
Default

I would agree that your anxiety is bothering your perception over the planning.

I would also recommend that you demand your PCP only agree to this with his/hers and the Vestibular Therapists ability to recommendations to extend the weekly plans as they see the needs during your evaluations since you will be visiting the therapist regularly...and that therapist should be having regular contact with your PCP .

Hang in there.

Best Wishes.........
__________________

.
Current: Changes of more insomnia, new reviews with findings of more Depression, tremors, vertigo, tinnitus, loss of focus, fatigue; SSDI - accepted on Depression, Cognitive Deficits; Seizures ruled out, mTBI changes including cognitive slowing/lapses.
Medication update: Topamax 200mg twice daily it seems to minimize daily headaches to a 1-2/10 quality(I still know they are there); and acute headaches erupt without warnings.
Concussion is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
mouse1 (04-12-2013), MsRriO (04-12-2013)
Old 04-12-2013, 10:10 AM #8
Brain patch's Avatar
Brain patch Brain patch is offline
Member
 
Join Date: Feb 2013
Location: Salt Lake City, Utah
Posts: 520
10 yr Member
Brain patch Brain patch is offline
Member
Brain patch's Avatar
 
Join Date: Feb 2013
Location: Salt Lake City, Utah
Posts: 520
10 yr Member
Heart

Stay in the moment Ms. Rrio. It sounds to me like your doctor was not agreeing to that plan. I also think that is an aggressive return to work plan. You said your doctor wants you to ease back in slowly. I am not sure he is agreeing with their plan. I think this plan can be changed as needed. I don't think it is written in stone. This is the plan they would like to have you accomplish but if you need to take it slower, I think they will be accommodating to you. You seem an important employee for your employer and I am sure they want you back but want you back ok and working good. Not pushing you too hard and causing more problems or loosing you.
You also still have the six weeks to go. That is almost two months. You reported in your signature that your speech (stuttering) is improving quite a bit and the prism glasses were helpful. This is progress. You still have the six weeks. Go through that first and then see how you feel. If you are not up to work by the end of the six weeks then you and your doctor and employer can come up with a kinder, gentler plan. Lets wait and see how your doing after those six weeks of therapy before you worry so much about returning to work. What's the worst that can happen? You won't be ready and will have to take more time or you might have to quit or get fired. No big deal. You are a smart lady. Things will work out. Don't let the anxiety over what has not happened yet and may never happen bother you now. Take it one day at a time.
Best of luck to you. I am pulling for you! This is going to work out ok!
Love,
Brain
__________________
Brain patch.
.


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.)
Brain patch is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
mouse1 (04-12-2013), MsRriO (04-12-2013)
Old 04-12-2013, 11:55 AM #9
berkeleybrain berkeleybrain is offline
Member
 
Join Date: Dec 2012
Posts: 205
10 yr Member
berkeleybrain berkeleybrain is offline
Member
 
Join Date: Dec 2012
Posts: 205
10 yr Member
Default

Just as every brain injury is different, I think each return to work plan should also be unique.

Within a gradual return to work (each week you should monitor symptoms, if they worsen return to previous week), I found in this forum the following return to work accommodation "guidelines" for brain injury:

http://askjan.org/media/brai.htm

Again, this is in the U.S. and for the ADA (Americans with Disabilities Act), but it provides some information.

The anxiety must be overwhelming--sending you lots of light!
__________________
The event: Rear ended on freeway with son when I was at a stop in stop and go traffic July 2012. Lost consciousness.

Post-event: Diagnosed with post-concussion syndrome, ptsd, whiplash, peripheral and central vestibular dysfunction and convergence insufficiency. MRI/CT scans fine.

Symptoms: daily headaches, dizziness/vertigo, nausea, cognitive fog, light/noise sensitivities, anxiety/irritability, fatigued, convergence insufficiency, tinnitus and numbness in arms/legs.

Therapies: Now topamax 50mg daily; Propanolol and Tramadol when migraine. Off nortryptiline and trazodone. Accupuncture. Vitamin regime. Prism glasses/vision therapy. Vestibular therapy 3month. Gluten free diet. Dairy free diet. On sick leave from teaching until Sept. 2014.
berkeleybrain is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
Brain patch (04-12-2013), MsRriO (04-12-2013), poetrymom (04-18-2013)
Old 04-12-2013, 01:31 PM #10
Mokey Mokey is offline
Member
 
Join Date: Oct 2012
Location: canada
Posts: 553
10 yr Member
Mokey Mokey is offline
Member
 
Join Date: Oct 2012
Location: canada
Posts: 553
10 yr Member
Default

This is not something that can be predicted. Ii have been trying to work for over a year....some weeks I can do more and some less. The past two weeks have been zero. Too much pain and brain being fried, etc. have not been able to sustain a full day yet, and have not been able to do the teaching part of my job

I want so badly to go back to work fulltime. But wanting it doesn't make it happen!
Go slow and take it day by day. A plan is only a plan.
__________________


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.

Last edited by Mokey; 04-12-2013 at 02:06 PM. Reason: Tons of ipad typos!!!
Mokey is offline   Reply With QuoteReply With Quote
"Thanks for this!" says:
Brain patch (04-12-2013), MiaVita2012 (04-14-2013), MsRriO (04-12-2013), poetrymom (04-18-2013)
Reply


Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Return to work, return to pain rmschaver Traumatic Brain Injury and Post Concussion Syndrome 6 10-06-2012 03:51 PM
Return to work strategy greenfrog Traumatic Brain Injury and Post Concussion Syndrome 3 10-07-2011 04:48 PM
Return To Work hairdresser Thoracic Outlet Syndrome 11 11-19-2007 11:34 PM
return to work? RSI sufferer Social Security Disability 1 11-20-2006 12:47 AM


All times are GMT -5. The time now is 03:17 PM.


Powered by vBulletin • Copyright ©2000 - 2025, Jelsoft Enterprises Ltd.

vBulletin Optimisation provided by vB Optimise (Lite) - vBulletin Mods & Addons Copyright © 2025 DragonByte Technologies Ltd.
 

NeuroTalk Forums

Helping support those with neurological and related conditions.

 

The material on this site is for informational purposes only,
and is not a substitute for medical advice, diagnosis or treatment
provided by a qualified health care provider.


Always consult your doctor before trying anything you read here.