PCS and returning to work
Hi every one. I am a 32 year old home health physical therapist, meaning that I go to houses or facilities. In January, while driving between patients, I was at a dead stop and rear ended by someone doing 40mph. Initially, at the hospital, I was only diagnosed with whiplash. 2 days later I went to see the workers comp doctor and was diagnosed with a concussion bc of my symptoms. I was sent to a ortho to rule out any neck problems and I was sent to a neurologist to manage my PCS symptoms.
I was pulled out of work the day of my accident. My PCS symptoms were horrible (HA, trouble speaking, poor memory, unable to control emotions, etc) and have gradually lessened over time. Now I still suffer from headaches, almost daily, and they range from 3-8/10. The neurologist is referring me to a psychiatric hospital for an evaluation to determine if I am ready to go back to work.
Here is my concern/where I need advice. On workers comp, I am making 1/3 of what I was when I was working.....it's a HUGE difference! I was set to close on a house and the lender backed out when they ran my status and saw that I was currently off work. I really really really want to get back to work, start making money again an buy my house. I love my parents and all, but I'm ready. But if I go back to work, I'm back to work. I know that legally I can go back out if needed, but in reality it doesn't work that way. If I start taking on patients, they're mine. So that means that I also can't call in sick 3-4 days if my head is killing me bc my patients would not be seen.
Does anyone have any advice? Or tell me what you would do in my situation? Or any input on the symptoms getting better? My doc said 6 months but it's been just about 5 and I don't forsee them magically disappearing anytime soon.

I know how financially it is to be without work and that you want that house, but my advice is not to go to work until you are ready. A lot of people have gone back prematurely, not able to cope or do a poor job because of the symptoms and then loose their jobs.

The issue is that if you are not really ready, you will be plague with pcs symptoms for a lot longer as you can not get the rest etc. that you need.

Respect your bodies timelines for healing. I know this is easier said than done. I too am anxious to get back to life.

Good luck, I hope things go well.

Ask yourself this question. Do I want to buy a house feeling this way for who knows how long. Or do I want to wait and determine what issues I suffer from and what I can do about it. The desire to just get back to normal can be overwhelming but it is not in your best health interest. I am sorry you are going thru this. You are not alone and are among people who understand.

NikkiG PT,

What are you doing to help with healing ?

Your doctor's 6 month prognosis tells me he does not have a good understanding of concussions. What have you been doing to deal with the whiplash ? You head aches may be as whiplash related as concussion related.

Did the other driver have liability insurance ? Sounds like you need a good concussion attorney to stand up for you.

What state do you live in ? Other than a state of pain ?

LOl Mark. Thanks, I needed a smile today.
To help with healing: The doctor put me on Gabapentin. I also take about 10 Norco 10's a day and 3-4 Somas. I am a single mom to a 2 year old so the only time I get to rest is once a day during his 2 hour nap. I do try and do Yoga a few times a week, that seems to help and I get a massage every 3 weeks. Because it is through workers comp, I'm kind of at their mercy. I am going for a psychiatric consultation (7 hours) at a psych hospital in Long Beach, CA (close to where I live). AND on mhy first visit with the neurologist he told me that any symptoms after 6 months usually is "in the head". At the time, I thought nothing of it. But now as I get closer to that 6 month mark it makes me question my sanity.
The pain from my whiplash lasted about 1 week. I went to PT for about 2 weeks. And then the ortho doctor cleared me so, in the eyes of my workers comp insurance, means that it is resolved.
The other driver has good insurance, thank goodness. I do have a great attorney. But the problem is that I am getting my treatment through workers comp. My attorney has opened a case with her insurance but theres not too much that can be done until I go back to work....or at least that's what I have been told.
I am slowly getting more depressed. It's difficult to be the only person there for your child, and not be able to be there for him. Especially at such a young age. It breaks my heart when he tells me, "mommy be nice" because I have to ask him not to play so loudly or that I can't play with him. So I guess I just feel like I need to get a more normal life back for him.
Thank you all for your opinions/words of wisdom.

When I was about three months into pcs I read a good case study about a woman who didn't get enough help after her injury. And then for the next five years she just kept on trying to push through and her pile of life problems just got larger and larger until she finally went back and got some help.

I decide I didn't want to be that person. Get the rest and the treatment that you need NOW.

Su Seb

Nikki,

You need to read the information at www.tbilaw.com and www.subtlebraininjury.com Attorney Gordon Johnson has some great advice about diagnostic tests done by the insurance companies/WC company.

I would stay away from the psychiatric hospital.

Maybe a NeuroPsych Assessment by a good NP. But, In CA, the IME NeuroPsychs tend to rely on income from the WC companies so they tend to support the WC companies.

It sounds like your whiplash is far from healed. Just because there are no imageable injuries and you have range of motion does not mean the injury is healed. Head aches from upper neck injuries are very common. Upper neck injuries are very difficult to diagnose and treat except by taking the patient's word that they are in pain. There is rarely a specific injury, more a cluster of symptoms.

My wife just asked what I am doing. I told her about your situation with your 2 year old. She suggested you ask WC to cover 4 hours a day of RESPITE child care so you can focus on healing. You need a break from your duties at home. Was you 2yo in day care when you were working ?

You are doing great if you can get your 2yo to nap for 2 hours a day. My grand will usually only power nap for 30 minutes, and she is only 9 months old.

With all the meds you are on, good understanding of your injury is difficult. You said the whiplash pain is gone. Why then are you taking Soma and Norco ?

What does the doctor think the gabapentin will resolve ?

You case is very confusing to me. Maybe doctors are trying to medicate you to pass time until your case becomes weak and easier to settle. It is not uncommon for WC to set up this "medicate her until she goes away.' protocol. Not in a conspiratorial way but because Industrial medicine is usually based on those medical professionals who graduated at the bottom of their class and could not find better paying specialties. They are good at cuts and broken bones but lousy at the more complex injuries like whiplash and mild head injuries.

Have you been icing your head and upper neck ?

Did you hurt your shoulders ? Often the whiplash causes the shoulders to be jerked, especially if you have a strong grip on the steering wheel. This can result in upper back pain and spasms.

Are you taking precautions about your sleeping and resting posture ? This is important.

My best to you.