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


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Old 05-20-2014, 05:57 PM #1
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Default Trying to Determine Best Course of Action for Whiplash/PCS 9 Months...

I know I'm preaching to the quire here, but getting desperate for a solution to my life limiting condition. I was involved in a motorcycle accident May/13 and then a subsequent fall in my home Aug/13. Unconscious on both occasions and PCS/whiplash symptoms since the second impact.

As of now, I have moderate tinnitus and the main symptom preventing me from living a normal life/working in any capacity is some pretty nasty dizziness. Whenever I enter an area with artificial lighting, such as malls, restaurants I go through a period of feeling completely spaced out followed by pretty bad dizziness. It's not a spinning sensation, but a feeling of near fainting and difficulty focusing on things. This happens every time I enter an area with ambient noise (chatter, etc) and will sometimes subside in about 30 minutes, other times not at all. I then have almost an out of body experience, as I feel so spaced out. It's almost as if I'm not even physically present at times.

As of current I have been going to physio to deal with some serious whiplash and has helped quite a bit, but more temporary results. The neck starts to seize up again after a week or no physio, which is also when my dizziness symptoms seem to be at their worst.

I will be receiving neck trigger point injections in about a week. They apparently inject a freezing agent, similar to that of dental clinics and then use needling techniques to release tension in the neck. They mentioned that they have had good results with some patients, however my only concern is it also being a temporary fix.

Anyway, without dragging this on too long, my purpose is to see if anyone has had any success with managing/reducing symptoms with medication or exercises. I really need to get moving on with my life again. I have been sitting at home for 9 months now with these brutal symptoms and although have been very patient and along the mindset of my body just needing time to recover, starting to get pretty scared that I'll never return to normal. I have been prescribed Betahistine, however upon reading reviews, skeptical it will help, as I've tested negative for BPPV 3 times and told that I don't have meniers disease.
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Old 05-20-2014, 08:55 PM #2
Mark in Idaho Mark in Idaho is offline
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random,

Do you take any steps to reduce these stimulations ?

I need to wear sunglasses and a hat to reduce the effect of lights. I also always have ear plugs ready to use. Malls and restaurants are always risky for me.

You may need to learn these trigger minimizing techniques so you can do some normal things. There is no real treatment for PCS. It just takes time for the brain and sensory systems to heal.

Until your neck heals, it may continue to make your PCS symptoms worse. Are you being disciplined with neck posture, especially when resting or sleeping ? It is very important to not aggravate a neck injury so it can heal. It has taken me years for my neck to heal. It has required discipline sleep posture. For me, this was extremely important because my neck injury was causing central sleep apnea. I would just stop breathing if I slept with my neck in a bad position. Now, after years of discipline, my neck is more tolerant of bad positions.

To sum it up, I think you need to accept your current condition as the way things are for the near term. Learn to minimize your exposure to triggers. Learn work-arounds so you can do the things you want to do. Social events may be possible just shorter or with a safety escape plan.

Many of us have learned to live with PCS rather than fight against it. It is possible.

My best to you.
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Old 05-26-2014, 12:12 PM #3
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Originally Posted by Mark in Idaho View Post
random,

Do you take any steps to reduce these stimulations ?

I need to wear sunglasses and a hat to reduce the effect of lights. I also always have ear plugs ready to use. Malls and restaurants are always risky for me.

You may need to learn these trigger minimizing techniques so you can do some normal things. There is no real treatment for PCS. It just takes time for the brain and sensory systems to heal.

Until your neck heals, it may continue to make your PCS symptoms worse. Are you being disciplined with neck posture, especially when resting or sleeping ? It is very important to not aggravate a neck injury so it can heal. It has taken me years for my neck to heal. It has required discipline sleep posture. For me, this was extremely important because my neck injury was causing central sleep apnea. I would just stop breathing if I slept with my neck in a bad position. Now, after years of discipline, my neck is more tolerant of bad positions.

To sum it up, I think you need to accept your current condition as the way things are for the near term. Learn to minimize your exposure to triggers. Learn work-arounds so you can do the things you want to do. Social events may be possible just shorter or with a safety escape plan.

Many of us have learned to live with PCS rather than fight against it. It is possible.

My best to you.

Hi Mark. I do avoid all stimulation if I'm having a bad day. That said, I have seen concussion specialists that recommend I lightly trigger the symptoms to allow my body to be aware that an issue is still there. I somewhat believe it, as when I subject myself to lighting, etc my symptoms usually subside within 30 minutes to a bearable point.

My update on Betahistine. I tried the drug for the first time last week and although was skeptical it would help in any capacity based on user reviews I've read, it helps me noticeably. It's not a cure all, but I have been taking a very light dose to trial (half a 16mg tab when symptoms arise). It helps quite a bit with the dizziness and I also notice that it brings some mental clarity, likely due to increased blood flow to the inner ear/head area. Don't know what to say, it has allowed me to reduce symptoms, but not eliminate. Knowing that I have found something to take off the edge during an episode is comforting.

I am now thinking of trying Zofran for nausea. I have been using Gravol natural source with Ginger for nausea and does help quite a bit.

I know that I will likely be dealing with symptoms for some time, however not going to sit back and be miserable. I'm a fighter and know that I can better myself with research, trying new things and listening to what my body is telling me. I am at current attempting to get outdoors daily, complete a couple of tasks, whether they be miniscule or not, it's something to feel a sense of productivity during this hard time.
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Old 05-26-2014, 03:31 PM #4
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I bet the day after subjecting yourself to lighting and other stimulations, you have a bad day. Often, we can get our brain to meet the task at hand but the fatigue manifests at a later time, usually the next day or that evening.

I disagree with the challenge your brain protocol. Minimal levels of stimulation are good but pushing is counter-productive in my opinion and the opinion of many experts.

You want to find the correct kind and level of stimulation to keep the brain engaged but not over-taxed.

My best to you.
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Old 05-26-2014, 04:26 PM #5
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Originally Posted by Mark in Idaho View Post
I bet the day after subjecting yourself to lighting and other stimulations, you have a bad day. Often, we can get our brain to meet the task at hand but the fatigue manifests at a later time, usually the next day or that evening.

I disagree with the challenge your brain protocol. Minimal levels of stimulation are good but pushing is counter-productive in my opinion and the opinion of many experts.

You want to find the correct kind and level of stimulation to keep the brain engaged but not over-taxed.

My best to you.
Right on, Mark. People who push us to do things, aren't around to see the fallout.
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Old 05-26-2014, 04:33 PM #6
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Originally Posted by Mark in Idaho View Post
I bet the day after subjecting yourself to lighting and other stimulations, you have a bad day. Often, we can get our brain to meet the task at hand but the fatigue manifests at a later time, usually the next day or that evening.

I disagree with the challenge your brain protocol. Minimal levels of stimulation are good but pushing is counter-productive in my opinion and the opinion of many experts.

You want to find the correct kind and level of stimulation to keep the brain engaged but not over-taxed.

My best to you.
Totally agree in that it's not about overdoing it, but stimulating lightly. If I do too much, I absolutely feel it for 1-2 days afterwards. My doc also seems to believe that coffee does PCS patients well, due to increased mental focus and also the research around brain protective properties. He certainly doesn't recommend drinking a pot of coffee every day, but condones one cup per day.

Should mention that my new doc is the head doc for our cities NHL team and well known in the sports/concussion community. I always take what docs say with a grain of salt and listen to my body, but some of what he has to say makes sense to me.

At this stage I'm just wondering if I'll ever return to a somewhat normal life. Neck trigger point injections start tomorrow for my whiplash. I will post results.
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Old 05-26-2014, 04:38 PM #7
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Interesting... my neuro says that I am ok at 1-8 oz cup of coffee...

What are the trigger point injections?
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The Start: MVA, t-boned, on 1-12-14 (my sons 5th birthday) and did not think anything of it.. my back hurt on site but everything else seemed ok. Lost about 10-12 hours from about 3 hours after the accident to the next day...Experienced terrible brain fog for over a month, plus intense headaches, nausea, dizziness, cognitive difficulties, disorientation, no short term memory, depression and just an overall hangover feeling daily.

Current Situation: I'm about 7 months in and my local neurologist has waived her white flag and therefore I am headed to Dallas to be seen (I have family there). The headaches are still daily. I have nausea, dizziness as well.

Drugs I have been on- Vicodin (off), Naproxen (off), proanolol (off), topamax (off), cataflam (off), Midrin (off), Flexeril (off) and now Namenda XR (off), Nortrptylin (off), Verapamil (off)

Therapy- Osteopath, Vestibular and balance therapy, fuzion/soft tissue massage, acupuncture

Drs- ER (no help), GP, Chiropractor, Neurologist and Osteopath
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Old 05-26-2014, 05:01 PM #8
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Interesting... my neuro says that I am ok at 1-8 oz cup of coffee...

What are the trigger point injections?
I have pretty severe whiplash from a motorcycle accident (came down on my head/neck in excess of 80 km/h).

As my neck isn't resolving, my doc has ordered therapy in which a freezing agent is injected in to what the believe to be areas of triggering symptoms.

Will post results.
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Old 06-24-2014, 08:31 AM #9
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I have pretty severe whiplash from a motorcycle accident (came down on my head/neck in excess of 80 km/h).

As my neck isn't resolving, my doc has ordered therapy in which a freezing agent is injected in to what the believe to be areas of triggering symptoms.

Will post results.
Wanted to post an update. I have been taking Betahistine (SERC) when the dizziness gets bad and has been working quite effectively. That in conjunction with IMT (Intramuscular Therapy - trigger point injections) has helped immensely. My neck is about 60% better and dizziness is less of an issue. I am now able to go to the grocery store, malls, etc. I do still have symptoms come on, but about 20% of what they were previously and I haven't had to take a nausea/anti vertigo med in over 3 weeks now. I went to Walmart last night, which is a big accomplishment for me, as Walmaert would always make me sick...I was walking around, shopping and honestly hardly even noticed any symptoms for the first time in a year! Considering symptoms were still moderate to severe 3-4 weeks ago, I'd say that this therapy has really helped me. I had previously been doing physio 2 times per week for 9 months, with little result. My neck would always seize up again a day later and symptoms of dizziness/nausea would come on strong. From what I've researched I knew that getting the neck under control could only help the post concussion dizziness that I've had for almost a year now.

I'd encourage anyone with concussion + moderate to severe whiplash to consider IMT. There's a clinic in my city that does this technique, however don't see as much online regarding it. They inject what's similar to a dental freezing agent (lidocaine) deep in to my muscle tissue, at points that they define as triggers. This immediately released tense muscles at about 10 trigger points in my neck. The doc says like night and day when examining my muscle stiffness afterwards. As soon as they inject, my muscles completely relax. This allows my body a more long term solution of muscle relaxation and time for more oxygen to be delivered to the muscle tissue for healing. It hurts at first, but has helped big time with stiffness, soreness and the rest of the whiplash symptoms that I've had since Aug/13.

Now all that I need is more time for my brain to heal more. I know that I'm not out of the woods, but this therapy really has helped me out of the several treatments/therapies/tests I've done over the last year. PCS symptoms have been reduced in half (if not more). I would be interested to see if the treatment could help someone else as much as it has me.
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Old 06-24-2014, 09:33 AM #10
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I wonder if it would have the same effect as botox...
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The Start: MVA, t-boned, on 1-12-14 (my sons 5th birthday) and did not think anything of it.. my back hurt on site but everything else seemed ok. Lost about 10-12 hours from about 3 hours after the accident to the next day...Experienced terrible brain fog for over a month, plus intense headaches, nausea, dizziness, cognitive difficulties, disorientation, no short term memory, depression and just an overall hangover feeling daily.

Current Situation: I'm about 7 months in and my local neurologist has waived her white flag and therefore I am headed to Dallas to be seen (I have family there). The headaches are still daily. I have nausea, dizziness as well.

Drugs I have been on- Vicodin (off), Naproxen (off), proanolol (off), topamax (off), cataflam (off), Midrin (off), Flexeril (off) and now Namenda XR (off), Nortrptylin (off), Verapamil (off)

Therapy- Osteopath, Vestibular and balance therapy, fuzion/soft tissue massage, acupuncture

Drs- ER (no help), GP, Chiropractor, Neurologist and Osteopath
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