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


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Old 07-23-2013, 06:08 PM #1
deniseg deniseg is offline
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Default concussion issues at high altitude?

Next month I am leaving to climb Mt Kilimanjaro. I was rear-ended in June, resulting in a concussion and post-concussion syndrome. I'm still getting migraines, nausea, am hyper-sensitive to sound and light, and definitely am not back to my pre-accident activity level (where I was training for the climb). I'm not running. Walking is fine, but I tire easily.

Also in preparation for my climb, I have raised over $10,000 for colon cancer research and screening awareness in honour of my dad, who died last summer just six weeks after being diagnosed with colon cancer. Clearly, this climb is very important to me, personally. It's more than a climb. It's for my dad. Not going is not an option, but I'm aware that I may not summit. (Probably won't summit?) I've been reading a few wilderness and adventure doctor blogs/sites, which indicate I'm not at greater risk for HACE. Does anyone have any experience with concussion symptoms at altitude?

I'm not looking for a miracle, but some hope would be nice.
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Old 07-23-2013, 06:52 PM #2
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you're really going to have to take it day by day. don't do it if you don't feel good enough. trust me, you don't want this thing hanging around longer than necessary or getting worse. you have a whole lifetime once you are all better. just see hoe you feel and be careful if yhou do it.
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Old 07-23-2013, 09:40 PM #3
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You don't post where you are so:

At what altitude do you currently live?

At what altitude do you currently train?

Go train at 1 altitude differential above your normal for a few days and see how you are affected? :

I.E. If you are currently at/near sea level living/training, then go at/near 6800 ft. above sea level, and train awhile.... as that can be an altitude that altitude illnesses can be felt, and some altitude illnesses can appear within immediate time relations up to 72 hours of exposure to that altitude, so you could note any ill effects.

And many areas at that altitude are still near areas with access for immediate care, and highway access to leave when not feeling up to further exposure.
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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 07-24-2013, 12:29 AM #4
Mokey Mokey is offline
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Great project. Good for you for perservering.

I live more or less at sea level, and flew to Alberquerque and then drove up to Santa Fe @ 7000 feet. My three days there were pretty tough....and I think a lot of how I was feelong was due to the altitude. I felt worse than usual, and very lethargic. I finally realizd I needed to go very slow and keep hydrated. During the night I easily drank five glasses of water or more.

Hope that helps a bit. Good luck. It will be a challenge. Sorry about your dad.
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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 07-24-2013, 07:50 AM #5
deniseg deniseg is offline
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Thank you for replying.

I live in Nova Scotia, at sea level. We are surrounded by water! Although it's a great idea, I have no opportunities for practising at any kind of altitude, unfortunately. All I can really do is hill repeats on a >1000 ft trail, which helps to mimic the physical exertion.
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Old 07-24-2013, 01:41 PM #6
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Quote:
Originally Posted by deniseg View Post
Does anyone have any experience with concussion symptoms at altitude?
Best thing is as mentioned, take it easy, very easy and if you start experiencing issues, then best to return to a lower elevation.

Couple of years ago my family drove to Tucson and up Mount Lemmon. We took the Sky Ride up to the top of the mountain, and after about 20 minutes, my brain was not feeling normal (this was 2 years post concussion). I immediately got back to the parking lot which was lower elevation.

I can tolerate higher elevations much better now - hiking around Humprey's Peak near Flagstaff is no problem.

Good luck and very sorry about your families loss.

Mike
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May 31, 2009: Concussion from syncope due to low blood volume resulting from severe dehydration. Occurred after finishing my 9th marathon. 100% of symptoms cleared by August 2009.

December 15, 2009: Major surgery due to diverticulitis. 6 weeks after surgery, dizziness, fog, cognitive difficulty, anxiety, some panic, lots of headache. These symptoms largely gone, but still cannot exercise above a very low threshold otherwise resulting in severe headache and cognitive fog. Same for overwhelming odors.

Meds: Nortriptyline and Naratriptan as needed to rid severe headaches (exertional migraines).
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Old 07-24-2013, 01:57 PM #7
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Wish I was going to climb Kilimanjaro, I'm a climber myself

Are you an experienced climber?

I live at just under 9000 ft out West so can't really say if the altitude makes my concussion feel worse as I'm used to it.

You live at sea level so the altitude might be a problem especially as you're not being able to practice climbing to see how you feel.

A lot of visitors here experience issues. I'm not climbing right now or even walking up hill because of all the issues I'm having.

Have you spoken to a Dr?
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Old 07-24-2013, 04:29 PM #8
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I was driven up Mt Teide on Tenerife with lingering PCS symptoms (at 3,718 metre/12,198 ft, it's much smaller than Kilimanjaro). The last bit was by cable car. Did you ever blow up too many balloons at a kids' party and feel really weird and have to sit down? That was how I felt as soon as I got up there.

It wasn't actually that unpleasant as long as I didn't panic, stopped hyperventilating and had a good long sit down about every 10 steps or so. Any actual serious climbing would have been totally impossible.

See also this:-

Quote:
Ten university students who had recovered from minor head injury between one and three years previously were given vigilance and memory tests at a simulated altitude of 3,800 metres. Their performance was significantly below that of a matched group of students who had never had a head injury. The finding supports the proposition that even minor head injury has persisting effects, though they may be subtle and only emerge under the effects of stress.
http://www.tandfonline.com/doi/abs/1...9#.UfA_lClwb4g

If you're asking me, considering climbing up Mt Kilamanjaro at the stage of PCS that you describe sounds like a really, really bad idea - and a very dangerous one at that. You can't even run and you want to climb the highest mountain in Africa?

I generally don't like telling people that they can't do things, and I know you came on here looking for hope - but for the first few months after my concussion I had unrealistic expectations as well, and I know from experience how the brain can make up for a lack of insight with overconfidence. I took risks at work that could have turned out really badly, and I needed someone to tell me 'look, you're not up to this right now'. So I'm not trying to come across as all high and mighty or anything, I've been there too.

If not doing the climb is not an option (and I can see it's very important to you, understandably so) then I would postpone it, go another time perhaps with different people when your brain has healed a lot more. The symptoms you describe are your brain's way of telling you it needs rest. Your sponsors should understand if you explain it to them - and so would your dad.

You've had a brain injury (yes, a concussion is a brain injury) and that is not something to be taken lightly. If you had broken your leg, you would not be on here saying "pulling out is not an option" and asking if anyone had any experience of climbing huge mountains on crutches with a leg in plaster - you and the organisers would think it was perfectly acceptable to wait until your leg had healed before undertaking such an extreme physical challenge. An injured brain is worthy of just as much protection as a broken leg - more so, I would argue. Colon cancer research will still need funds a year or two from now.

Apologies again for putting a downer on things But I'm really worried for your safety & recovery from PCS.
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Old 07-24-2013, 04:49 PM #9
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I think it will be likely you will struggle to go past 12,000 feet or maybe 14,000 feet. As Klaus noted, the research has show the brain struggling at only 8000 feet (2700 meters)

Taking time to acclimate to the altitude will only help with red blood cells. It will not help your brain absorb oxygen.

Good luck and be careful. Be sure to have a solid plan about who is making judgement decisions. The altitude deficits most prominently were regarding judgement.

My best to you.
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Old 07-25-2013, 01:53 PM #10
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Best of luck with this. It will be a massive achievement for you, take you time and get regular breaks.

What your doing is truely inspiring, I am further on than yourself in my PCS, but reading what you are doing made me go on the crosstrainer for 45 minutes last night in the gym.

Thankfully no ill effects today after months of trying to get going again in the gym, previously had fatigue, headaches etc when trying before but not this time.
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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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