[roralea]

Hi all. It has been 6 months since my concussion and my PCS symptoms have not improved much since a few weeks after the injury. Since the accident happened at work, I have been seeing a workers comp doctor. She seemed to be supportive until today's visit, when she announced that she thinks anxiety is causing my symptoms. I'm not sure if there is some sort of 6 month mark for insurance purposes, but it was a dramatic change. She said there is no medical explanation for the fact that my symptoms haven't improved, and that the CT scan showed nothing.

My symptoms consist of nausea, headaches, sound sensitivity, imbalance, discomfort when I bend over, look up, or keep my head in one position for too long, fatigue, memory problems, difficulty driving, going to stores, etc.

My husband and I spent quite a while trying to assure her that my symptoms were real, but she was argumentative and full of speculation. She did not cut me off from WC but it seems she is headed in that direction. I find it demeaning and exhausting to go see her every couple of weeks and try to "prove" myself. I am not even able to drive to my job right now, so I can't think about going back any time soon. My whole life has changed and that is about all that I can deal with right now. Thankfully we will be ok for a while if she cuts me off, although I am considering quitting just to not have to see her or deal with this any longer.

I wonder if anyone has any advice about finding a doctor who may be more supportive, so that I can seek treatment on my own. What sort of specialist should I look for? I am in the Kaiser Permanente network in Northern California, so I don't have a lot of choice about who I see. Thanks!

[PamelaJune]

Originally Posted by roralea

Hi all. It has been 6 months since my concussion and my PCS symptoms have not improved much since a few weeks after the injury. Since the accident happened at work, I have been seeing a workers comp doctor. She seemed to be supportive until today's visit, when she announced that she thinks anxiety is causing my symptoms. I'm not sure if there is some sort of 6 month mark for insurance purposes, but it was a dramatic change. She said there is no medical explanation for the fact that my symptoms haven't improved, and that the CT scan showed nothing.

My symptoms consist of nausea, headaches, sound sensitivity, imbalance, discomfort when I bend over, look up, or keep my head in one position for too long, fatigue, memory problems, difficulty driving, going to stores, etc.

My husband and I spent quite a while trying to assure her that my symptoms were real, but she was argumentative and full of speculation. She did not cut me off from WC but it seems she is headed in that direction. I find it demeaning and exhausting to go see her every couple of weeks and try to "prove" myself. I am not even able to drive to my job right now, so I can't think about going back any time soon. My whole life has changed and that is about all that I can deal with right now. Thankfully we will be ok for a while if she cuts me off, although I am considering quitting just to not have to see her or deal with this any longer.

I wonder if anyone has any advice about finding a doctor who may be more supportive, so that I can seek treatment on my own. What sort of specialist should I look for? I am in the Kaiser Permanente network in Northern California, so I don't have a lot of choice about who I see. Thanks!

Not sure how it works in the US but in AUS we have the w/comp dr who is all about supporting the company, not you. You should have your own GP that you have seen prior too the incident who I hope who can document the changes in you since the incident. These are worthwhile to help you down the track when you try to recoup loss of income, pain and suffering once they put you off w/comp. Depression and anxiety are all normal outcomes from long term w/comp issues and they gruel of monthly trying to prove yourself to these heartless souls is a constant grind downwards. It's a common tactic to put pressure on you to resign so they can wipe their hands free of you. If you are going to consider resigning, get yourself an injury lawyer who should be able to give you advice. If you do resign you may be able to go down the route of constructive dismissal, ie they have made it untenable for you to continue on in employment. Thoughts and hugs to you

[Concussion]

roralea,

I am sorry you are in that situation.

1.) The Wk. Comp. carrier is obligated to help you find a care giver for you - not just a work comp doc to oversee your care for them. That is to say, an independent doctor to care for your needs, separate from their Wk. Comp. doctor - demand it. That doctor is your doctor, not theirs, he will care for you, and gatekeep what is occurring with your care, independent of their direction - making decisions with you, to recommend your needs; then get approvals to have those needs met.

If they do not wish to assist you in that matter, then you are free to obtain your own Neurologist, submit his name for approval of coverage for care to the Insurer, and he will direct your care.

These are the practical paths to use; without lawyers involved; or you can get lawyers involved and it should then transpire that way. You should always have an independent Physician (Neurologist or Physiatrist) acting on your behalf in all care-giving for your problem, acting as the gatekeeper for your issues.

2.) No Wk. Comp. doctor will ever agree that the injury at work caused your problems........ period...... they are on the Insurer's payroll.... they are paid to get you back to work; and not find anything, or find the least problem associated with the work injury as a cause of your problems.

You can try to use a Neurologist or Physiatrist within Kaiser, or talk to the Wk. Comp. Insurer (through your company's employee health department/ HR dept. - if they have one dealing with this to arrange them helping you find an independent Physician for your care, not their Wk. Comp. 'doc' ) - it is your privilege - call the Work Comp. Commission to verify such.

History will support it - you will eventually need to process complete Work Comp. Claims and ride out the entire process to receive quite a bit of support.

Your symptoms, complaints noted are all related to Concussive injuries and PCS - that Wk. Comp. 'doc' is wrong - and most likely not well informed regarding mTBI (concussion) and PCS. As well as their statement of 'anxiety' - well thats possibly present too, since its also possible in the post-concussive stages of mTBI, but she missed the mark why.

Please read the link on Supplements by MarkofIdaho, begin refreshing your system; REST as much as possible still; try to get more outside Medical support of an appropriate nature.

Don't be afraid to look into Legal help.

Best Wishes..............

[Mark in Idaho]

Read up on California Work Comp law. You have the right to be seen by your own doctor at WC expense. You may benefit from being assessed by a Physiatrist (Physical Medicine and Rehabilitation) Kaiser has such a department. A specialist in NeuroRehab will be worthwhile.

Also, read www.tbilaw.com and www.subtlebraininjury.com.

Calif WC law makes it difficult for concussion injuries to be properly treated. You need to do the work yourself until you find an advocate in your corner.

My best to you.

[roralea]

Thank you all so much for the advice and support, it is really appreciated.

[berkeleybrain]

I did not go the worker's comp route as my injury occurred on vacation, but you should work the system at WC to use specialists to help your healing.

I know if seems silly, but 6 months can still be early in the process of the brain healing and building up its threshold to increased stimulation. You have to pace yourself and work just to threshold so you don't trigger migraines or fatigue. But a neurologist should be working with you with either medicines to help with sleep/insomnia, migraines/headaches and yes, even anxiety.

Although anxiety is often present (I had intense panic attacks and propanolol worked very well for me), it is not the key symptom that drives pcs.

At minimum, see a neurologist to help with the pcs and brain fog/ fatigue/ dizziness issue. Have you been prescribed any meds? I know amitryptiline and noritryptiline are popular to help the brain stabilize and build up thresholds.

An Ear Nose and Throat doctor may be able to help if you have inner ear, tinnititus, vestibular or balance issues. There are some very specific tests they do to measure any dysfunction.

An neuro-opthalmologist (not just ophthalmologist but one who is trained to look at issues of binocular vision, convergence insufficiency, etc.) The UC Berkeley Binocular Clinic is a first rate teaching program that I have been pursuing vision therapy.

Also, a neuro-psychiatrist can give you a battery of tests to see how you are processing information and assess where you are in terms of comprehension and analytic capabilities. As a college professor, although I am rather high functioning, the neuro-psych I saw could tell that even though my test results were comparable to the average 75% in test scores, I was still functioning way below my average. I am still on sick leave to resolve my issues with reading/comprehension.

I am also in the East Bay and I know there are good Kaiser doctors available. (I have Blue Shield). The hard thing is that you or your husband are going to have to advocate for you-you will need to learn enough to push for adequate healthcare and specialists. But it's hard when all your brain wants to do is rest.

Be good to yourself-