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

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Old 06-12-2013, 11:34 PM #1
anon22217
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Default my neuroopthamologist appt

Okay,,went to see Dr. Joyce Liao at Stanford today who is apparently a very famous detail oriented neuroopthamologist. She was three hours late for my appointment Anyway, the experience wasnt' so great as she was very rushed. Looked at my visual field test results which were excellent...looked at my eyes for about 5 minutes. Then said my eyes are completely fine and the photophobia and trouble focusing is a symptom of migraines/headaches. Then rushed me out of the office.

So I guess i'm happy I dont have any vision issues. But i'm just curious about other peoples experiences wiht their neuroophtamologist and how they were diagnosed just because her exam was so quick! I guess I do trust her. But I think I will seek a second opinion.

Sigh realized it's so hard to find good doctors of PCS.
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Old 06-13-2013, 03:45 AM #2
Mark in Idaho Mark in Idaho is offline
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It is not uncommon for highly skilled and sought after doctors to give their patients such a short visit. They often get deluged with patients looking for miracle solutions to tedious problems. They may also be focused on finding that next patient that has a problem that is worthy of publication in a national or worldwide journal.

Good to hear she did not find any problems.

I like to compare fast doctors this way.

If you have a loved one who is going into surgery, it is common to ask how long the surgery will take. If the surgeon says, 3 to 5 hours, you sure hope he walks out of the surgery at 3 hours to tell you everything went fine. If you have not heard anything at the 5 hour mark, you start to get worried. Then, if the slightest complications come up, you wonder if it took so long because the problem was more than the surgeon could handle.

I'll take the faster doctor.
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Old 06-13-2013, 04:27 AM #3
berkeleybrain berkeleybrain is offline
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Hmm, it doesn't sound like she did any tests for accommodation or convergence (ie tracking in motion, looking at a pen while they move it close, far, left to right, etc.).

If you continue to have vision issues, I would make an appointment with Dr. Pia Hoenig at UCB Binocular Vision Clinic (510-642-2020). They have patients who fly in from out of state.

I'm so sorry you were rushed--very disappointing!

Best of luck-I hope you feel better!
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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.
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Old 06-13-2013, 09:09 AM #4
Mokey Mokey is offline
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I second BerkeleyBrain. Doesn't sound like they did any real testing. It should have taken much longer. You should go to someone else.
Not all neuro-opthamologists specialise in brain trauma.
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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 06-13-2013, 02:52 PM #5
DFayesMom DFayesMom is offline
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Default That doesn't sound right to me

My neuro op appointment took at least two hours. I don't think a visual field test would supply the kind of information she would need to properly diagnose you. I would definitely seek a second opinion. How frustrating for you!
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I have recovered my cognitive function, and I've overcome severe vertigo through sensory integration therapy. Wellbutrin has helped me escape depression. I have recently had a few stress-related migraines, as well as headaches stemming from eye strain. I'm also dealing with tinnitus, lack of stamina, extreme light sensitivity, and eye pain. Diagnosed with 9 different vision issues: convergence insufficiency, pursuit eye movement deficit, egocentric visual midline shift, photophobia, visual information processing delays, accommodative insufficiency, saccadic eye movement deficit, lack of coordination, and central peripheral visual integration deficit.

*First concussion: October 2010. I was pregnant and got rear ended. I associated my mild PCS symptoms with baby brain and blamed my light sensitivity on allergies and dry eyes.
*Second concussion: December 2011. I hit my head on a wooden beam, saw stars but did not lose consciousness, and I had very disturbing PCS symptoms but didn't go to the doctor.
*Third concussion: August 2012. I caused a car accident as a result of PCS symptoms. Thankfully no one was injured but me. My husband confronted me, and I finally sought help and took medical leave from work. My symptoms worsened, and I developed severe vertigo.
*Fourth concussion: November 2012. I was riding in a car with a friend and we were hit head on by a driver who lost control of her car. I didn't have a big increase in PCS symptoms.
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Old 06-13-2013, 03:29 PM #6
NormaW NormaW is offline
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Default Doesn't sound right

My appointment was 2 hours. I did the visual field test at the regular eye doctor, I do not believe I did it at the neuro opthamologist.

I did a series of test with the vision therapist (visual memory, etc.) and then I went in to the see the doctor. She had the pen in front of my face and asked when it lined up to my nose. I apparently has all of the classic symptoms of post traumatic vision syndrome.

My symptoms were dizzy, not feeling right when I walked (which later turn out to be the vision mid line shift syndrome), headache with reading, watching t.v., pain in my eyes, sore burning eyes.

It was really nice to have someone say they new exactly what I was experiencing.

Maybe there was nothing in your symptoms that rang a bell for him....
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Old 06-16-2013, 08:15 PM #7
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My dream is to create a pcs center. We all run around to so many docs who sometimes treat four symptoms in isolation wouldn't it be lovely to have a pcs center in the woods with no fluorescent lights and with doctors and therapists of all stripes including "alternative" therapists. There would be a meditation center and a nutritionist and .passage and acupunture. I can just see it. Anyway, I digress. I wonder if you would have amore thorough exam if you went to a neuro optometrist. Someone who is on NNORA. We all need to learn to trust our gut when it comes to medical care and seems like your gut is saying second opinion
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