[NormaW]

There is a new Guidelines for Concussions/Mild Traumatic Brain Injury & Persistent Symptoms. Google "Concussions Ontario" and it will lead you to the Guidelines.

It is a huge document but it is broken into sections. I have read the one on fatigue which gives helpful hints on how to deal with it.

The document is a guide for doctors to treat Concussions/Mild Traumatic Brain Injury.

There is a lot of information in this document and it is current. Worth looking at.

[Concussion]

Thank you for this, it looks well put together.

Best Wishes,...............

["Starr"]

http://onf.org/documents/guidelines-...second-edition
Starr

[Mark in Idaho]

I have high regard for the Ontario Neurotrauma Foundation..... But

I suggest that most people suffering from PCS NOT try to read this new set of guidelines.

First, it is too complex for most to understand
.
Second, it will likely lead to inappropriate self-diagnosis that can damage or interrupt any attempt to establish a relationship with a doctor who may be offended or turned off by self-diagnosis and such suggestions.

It is designed for medical professionals and tends to be written from a statistical perspective. Statistical (providing all of the statistically significant findings) based medical care tends to be very confusing and sometimes misdirected medical care. For example, over 85% of concussions resolve spontaneously. This statistic causes many doctors to discount the persistent symptoms of their patients.

Instead, for those in Canada, ask if the doctor who is treating you or you have been referred to is aware of and follows the ONF guidelines.

[Concussion]

I have to agree with Mark.

That being said........... I am a Medical Professional (albeit now retired), and have no plans to overstep my bounds with my physicians, other than explain that I have read the New guidelines from Ontario, and wonder if they have and what their feelings are about them.... as I work with my physician to understand my problems.

It does help to know how current they are keeping themselves, and bringing up the new information may stimulate them to update themselves. But definitely do not self-diagnose from that information.

[NormaW]

I agee it does not replace a medical professional but it does give you an idea of other test that may have been missed and you can request.

I know my doctor is very receptive to any ideas I have found on this forum or elsewhere.

[sospan]

My main issue with this sort of document is the first part of this snippet where they assume the "ideal" world exists

"A patient experiencing reduced cognitive functioning in the first few days following injury, with education and support, should be expected, in the majority of cases, to have these symptoms resolve and pre-injury cognitive functioning return within days or up to three months."

For the majority of us whom have a mTBI you receive the "You have bumped your head, take this leaflet, pain killers, time off work and you will be fine" next patient please! approach. The leaflets even in this guide don't really paint the picture of what you need to do. I haven't heard of anyone in the UK getting any education or support certainly in the short term.

Only this week my NeuroPsych said I could do with some community rehab, however, there are none that you could go to. A really helpful comment

[Concussion]

Sadly Sospan,

That is common place everywhere.

All these Specialists are stuck in their training world, what they got out of their training days is all they got / learned / stuck in their minds.

And demanding that they update their training isn't part of the Specialty Boards, in any particular arenas, other than general CME and few Boards even require retesting with actual tests.

So, they read journals, go to symposiums, get credits and maybe publish an article here and there, and get recertified in their specialty.

Don't know about the UK, but in the USA, Family Practitioners, Internists, and Physician Assistants have to re-test on varied year schedules; some others may have to, but I haven't kept up enough to be aware. I am not aware that any sub-specialists have testing or anything other than certification symposiums or training fellowships such as specialties in PCS/mTBI training/care , etc.