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


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Old 05-20-2013, 01:05 PM #1
Stewardess Stewardess is offline
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Default PCS Treatment. Seroquel?

I got my injury on 5/5/13, so just a few weeks ago, when I decided to try to skateboard. Ive had major headaches, vomiting, mood swings with unreasonable crying, and simply cant sleep. I will be in a conversation with someone then feel as if the volume and speed of everything around me went several notches up. I've been on Narco for headache, Soma for head tension and Phenergan for nausea/vomiting. My dr just prescribed Seroquel for sleep. Has anyone tried these meds? I took the Narco, Soma and Phenergan for a couple weeks but stopped because of how druggy I felt and tried Advil only which only tore my IBS stomach up even more. I wanted to see what symptoms were from the injury and what were caused by the meds. What treatments have been successful for y'all? What recommendations do yall have? Seroquel is most commonly used to treat schizophrenia and bipolar disorder, its very strong medicine and that makes me very nervous. I've read that psycho-meds are sometimes prescribed to treat PCS. Any tips or advice are welcomed.
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Old 05-20-2013, 01:21 PM #2
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Please forgive me, I just joined today. I also forgot to mention I have a contusion on the brain and am a Flight Attendant so that makes working near impossible right now
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Old 05-20-2013, 02:10 PM #3
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Could you help us out a bit?

Your injury was early May. Did you also have any neck injury? Did you receive care in the E.R., or just at your Family care setting? Have you seen a Neurologist, or Physiatrist? Have you had any testing - CT, MRI, etc?

Is the Narco, actually Norco ?

Soma is a muscle relaxant - was that prescribed for neck injury? - that does make many folks "woozy", and some prescribers hesitate to use it due to patient reliance on it long term.

Many physicians do use Phenergan for Nausea / Emesis; however it is best used for that in the suppository form; it is available in tablet form - best for other needs; and liquid - in cough formulae, or used in a plain liquid form for help with abdomenal cramping or varied anxiety levels in some. The link will give you much information on why many docs do or don't use Phenergan.

Ice packs to the neck are useful for any neck complaints - very in depth evaluations of your neck are important, falling from Skateboards can involve neck injuries even if you struck your head and only experience head complaints........please assure your neck was thoroughly evaluated.

Check the Stickied threads up top, for the Vitamins supplements which are helpful for brain injuries recovery.

Headaches are common complaints from head injuries, short and long-term - assure you are under Neurologist or Physiatrist care for follow-up and whatever term care necessary for continual recovery, or therapeutic follow-up needed - generally, primary care physicians just are not up to par for the most part to care for all the needs of the Head injured.

You do not need a Narcotic for these headaches - you need something for coverage of a Post-Traumatic/Post-Concussion Migrainous Headache problem.

Regarding Seroquel - my research has found that some PTSD has had some hopeful reduction of symptomatology, per NIH papers, for veterans, not so much just using it for sleep, but for PTSD, psychosis, etc.

Seroquel is an Antipsychotic medication. And has been used by many docs as a Sleeping med.

I forgot my one source for drugs I like to add for folks - Seroquel from Crazymeds site - he offers interesting information , IMO.

Hoping to hear more from you.

Hope some of this is helpful.

Best wishes............... I'm sure others will jump in and offer more.

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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.
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Old 05-20-2013, 02:51 PM #4
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Thank you so much....

Im sorry, I do mean Norco. The Soma was prescribed for "posterior head pain". I have both oral and phenergan suppositories. Good to know the suppository is better.

I went to the ER the following day after vomiting several times and having nose bleeds. I did not have much of a headache at this time. After doing a simple exam they discharged me with a simple concussion diagnosis. Well, I am a Flight Attendant and went back to work a few days later. It wasnt until an hour or so into flying that these other symptoms started - confusion, nausea, headache. I hadnt even really had a headache until this point. I called the ER and they told me I wasnt supposed to fly that soon - well, that would have been nice to know before now - and to come back in. Well, their CT machine was broke. SO I left there and went and got a CT that was ordered by my PCP (internal medicine). She has been treating me since. She is confident that everything I am experiencing is normal and what Im feeling aligns with what Ive read online so I didnt feel the urgency to get a neuro consult. I guess I felt like people get concussions all the time and thought I would be overreacting, little did I know. She suggests that if I can restore my sleep it will allow the brain a better chance to heal. I also still have and have had a low grade temp - she said that is normal as well.

Both the ER and she said I would feel this way for a lil while, so I assumed this is just how it is. I had read that psychotic meds are sometimes used to treat PCS but this makes me a little bit uneasy.

Where is the link for supplements? I dont know what stickied threads means....


My mother strongly suggests a Neurologist but I havent gone to one since everything Im dealing with is apparently "normal".

As far as I know I do not have a neck injury, I did have a trickling feeling down the back of my head and neck. I felt as if water was trickling down the base of my head and neck. She assured me that it was normal. I did have a small contusion and this it was "near my ocular and nerves around my ear and that was a just those nerves recovering". She also said it was on the "nausea center of the brain and that is was causing the nausea"

Thank you for your help. I really appreciate it. I feel for anyone having dealt with this long term. I know I am already sick of it, I cant imagine this going on for months or years.
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Old 05-20-2013, 03:23 PM #5
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I agree with Concussion. Avoid the Seroquel. I was offered that years ago and looked into it. It is a scary strong drug for use in extreme situations. It sounds like your doctor likes to use his prescription pad to treat patients. You need to find a doctor who has better skills with concussion and whiplash.

Icing your head and neck frequently should be beneficial. Some light head traction and head/neck mobilization should be helpful. Finding a physical therapist who can help with this is important. A physiatrist (Physical Medicine and Rehabilitation ) may be able to direct you.

Ginger is a good anti-nausea agent. You can get it in many forms from cookies, soda, in root form for juicing or grating into food, or in capsule and tablets.

Low dose amitriptyline (10 to 25 mgs) at night is a standard med to help with sleep and head aches. It does not help everyone but is a safe med to try.

Stay in touch as you struggle through these symptoms.

My best to you.
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Old 05-20-2013, 03:48 PM #6
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The better part of the suppository is that you don't lose the medication if emesis occurs before its all absorbed from the upper G.I. tract... especially if you took a pill.

Being a Flight Attendent will make some of your recovery tricky - all the bumpy take-offs and landings, the altitude changes, the alterations on your brain, aggrevations on you vasculature.

Even with pressurized cabins you are not receiving appropriate pressures for normal brains let alone injured brains for 2 hr flights or longer, so it will present with constant aggrevations to you.......if at all possible you are faced with some added needs for some type of rest that we, other brain injured are not - rest from those altitude aggrevations.

You might explore with your employee health folks if any accommodations in scheduling might be possible for a while, while you get a handle on the headaches - I know its a hardship, I don't know how your job is arranged with Health Benefits etc. but might be worth exploring....in this early stage.

A very good source for information on Brain injury is Brainline.org , if you wish to wish to garner information.

Mark offers good information about Ginger, a good natural way to approach stomach issues.

A Stickie is a thread that is always 'stuck' >posted at the top of the forum, ready for access with information.
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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.
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Old 05-20-2013, 03:49 PM #7
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Default Thank you...

Always helpful to talk to people who have been in your shoes. Most people around me keep asking me "whats wrong" because I act differently or am not chipper.... I want to say "well, Ive had a bad headache for weeks, you are talking too much, and Im tired... thats whats wrong with me". Perhaps they are like me in thinking "concussions are normal, no biggie" well this has rocked my world. I feel different, I feel sad, I feel uncomfortable, I feel TIRED and CRANKY, I feel like Im in the twilight zone".

Im going to skip the Seroquel. I just dont have peace about taking it. Perhaps if I am not improving this week, I will consult a Neuro maybe even sooner.

Quote:
Originally Posted by Mark in Idaho View Post
I agree with Concussion. Avoid the Seroquel. I was offered that years ago and looked into it. It is a scary strong drug for use in extreme situations. It sounds like your doctor likes to use his prescription pad to treat patients. You need to find a doctor who has better skills with concussion and whiplash.

Icing your head and neck frequently should be beneficial. Some light head traction and head/neck mobilization should be helpful. Finding a physical therapist who can help with this is important. A physiatrist (Physical Medicine and Rehabilitation ) may be able to direct you.

Ginger is a good anti-nausea agent. You can get it in many forms from cookies, soda, in root form for juicing or grating into food, or in capsule and tablets.

Low dose amitriptyline (10 to 25 mgs) at night is a standard med to help with sleep and head aches. It does not help everyone but is a safe med to try.

Stay in touch as you struggle through these symptoms.

My best to you.
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Old 05-20-2013, 04:01 PM #8
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I am not sure what to advise, I know about concussions, but a contusion is a brain injury. Contusions to the brain may affect the functioning of the brain depending which area is affected.Is it a frontal lobe contusion? You are right to stay well away from work.
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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.
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Old 05-20-2013, 05:35 PM #9
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You are correct.

Quote:
I want to say "well, Ive had a bad headache for weeks, you are talking too much, and Im tired... thats whats wrong with me". Perhaps they are like me in thinking "concussions are normal, no biggie" well this has rocked my world. I feel different, I feel sad, I feel uncomfortable, I feel TIRED and CRANKY, I feel like Im in the twilight zone".
.. is just what you should say.........let them know just what you are going through.

Sadly, they will not grasp it at all. They are well meaning, from their standpoint, which is only natural..its what is bred into our public persona - when people generally say "Hi, how are you?", they do not expect a real answer. Its just a "correct " thing to say. - While I was still working and trying to cope, I got to the point with all my co-workers, the surgeons I worked with , etc. and told them, " I am alive" . And left it at that. Because that was at least the truth.

I am presuming that the contusion was on the inside of your skull on the brain from your description, was there any noted bleed or blood collection? - please have them give you a referral to a Neuro-Otologist and/or Neuro-Opthalmologist ( a few Neuro-Sensory Centers are in Austin, and Baylor, as well as Scott & White and UT), in case you continue residual effects with the issues from the contusion to region. I proffer this due to the fact that Brain contusions are worse effects on the brain than concussions, and possibilities to expect are not predictable, just as those from concussions.

And we here, can tell you much about what we found unexpected from our concussion injuries; which you are also having from your "crankiness " and other feelings. (which, by the way we have all been there too)

Best Wishes,
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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.
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Old 05-20-2013, 06:26 PM #10
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As far as I know there was not any noted bleeding, no fracture and no remarkable swelling of the brain. I couldn't scientifically prove it but in the air, I had so much pressure I felt it in my eyes - I think I had to have had some swelling. By the time my BF got to the airport I was sobbing, shaking, vomiting and totally freaked out. By the time I got the CT hours later, everything was normal except for the small contusion. I was lead to believe they are just a normal part of a concussion. My BF hit his head at work last week and went to ER. Nothing showed up but he kept telling me how bad he was hurting and how he was sinning etc. In a way, although it may sound horrible, he had a brief experience into what I've been feeling and that helped. He just thought I was being moody. I'm going to call my Dr and ask about the amitriptyline and something like Elivil in the morning. I hate taking narcotics. I would not be a good drug dealer at all.


Quote:
Originally Posted by Concussion View Post
You are correct.

.. is just what you should say.........let them know just what you are going through.

Sadly, they will not grasp it at all. They are well meaning, from their standpoint, which is only natural..its what is bred into our public persona - when people generally say "Hi, how are you?", they do not expect a real answer. Its just a "correct " thing to say. - While I was still working and trying to cope, I got to the point with all my co-workers, the surgeons I worked with , etc. and told them, " I am alive" . And left it at that. Because that was at least the truth.

I am presuming that the contusion was on the inside of your skull on the brain from your description, was there any noted bleed or blood collection? - please have them give you a referral to a Neuro-Otologist and/or Neuro-Opthalmologist ( a few Neuro-Sensory Centers are in Austin, and Baylor, as well as Scott & White and UT), in case you continue residual effects with the issues from the contusion to region. I proffer this due to the fact that Brain contusions are worse effects on the brain than concussions, and possibilities to expect are not predictable, just as those from concussions.

And we here, can tell you much about what we found unexpected from our concussion injuries; which you are also having from your "crankiness " and other feelings. (which, by the way we have all been there too)

Best Wishes,
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