Thanks again for the replies. Part of my frustration (and everyone else's I'm sure) is that I'm 3.5 months in and just don't know the best course of action to get better. Immediately after my fall I rested well, doing nothing for 5 days and feeling better and better each day.

Then I ever so slightly nudged my head against a car visor (I really just kind of pushed my head into it trying to change my car registration because I was feeling good) and that caused pain (that I still feel sometimes), and a downward spiral of anxiety, depression and insomnia.

For the next week I probably wasn't resting that well because I was so anxious, but I still wasn't really doing anything. I then went home to MN for 2 weeks (I'm a grad student in Ithaca, NY) and rested well there, saw a concussion specialist at a sports medicine clinic who advised to start easing back into activity, and that's what I did, pretty slowly.

For the next month I gradually upped my activity, starting to do some mindless labwork, attending some talks. My headaches weren't getting worse, but they weren't getting better either, and I still felt dulled and down a lot.

I went back to MN for a wedding, and was lucky enough to get in to see the specialist again, where I saw a neuropsychologist, and did the exercise exertion test. The results of the neuropsych test were such that they didn't really worry the doc, and I passed the exertion test, running to exhaustion without making the headaches worse (I had a minor headache starting and throughout though).

I was cleared for starting to exercise more in the form of stationary biking (which made me really excited as I normally run 70 miles a week), and I continued to do more and more (although still nowhere near my normal schedule of work).

A month after this I was doing more, but the headaches were still mostly the same and I still felt dulled and "off" and depressed some of the time, I decided to go on a short backpacking trip with some friends, which the doctor cleared me for.

The 5 day trip itself went well, I had fun and tried new things (drank more coffee, had a little alcohol). When I got back I thought if I can do that without getting worse, I'm bound to get better soon, and I figured this was all just a bad dream that I was soon to wake from.

Then a few days after I got back I started feeling worse, getting a new kind of rubber band sensation on both sides of my head which I hadn't gotten before, and I had greater difficulty concentrating on doing work like writing and reading. This caused a further downward spiral of feeling depressed about not being myself.

The doctor in MN thinks this relapse of sorts isn't related to the concussion, but to tension headaches that might be due to carrying a pack around, and that I shouldn't back off on what I'm doing. I'm frustrated because a theme I see on this site is that backing off and resting is the most important thing, while my doctor is saying the opposite. It's also hard because I feel like he can't fully grasp the situation over the phone.

It's also difficult to pinpoint triggers, as sometimes I'll be fine working on the computer or reading/writing, or watching TV, while other times I'll get worsening headaches doing those things. Similarly since getting back from this trip sometimes it feels that with exercise the headaches get slightly worse, which is confusing given I passed the exertion test earlier.

Basically, I just don't know what to do. I've been eating exceedingly healthy, started on parts of the vitamin regimen, been seeing a counselor, massage therapist, physical therapist, and now a NUCCA chiro. I've considered trying accupuncture, neurofeedback (the active kind), craniosacral therapy.

I just don't know if I should back off and rest for a while (a scary thought as doing things keeps my mind occupied and off feeling depressed), or keep doing what I'm doing and hope the headaches go away and I feel sharper as time goes on.

Sorry for the long post, I hope I broke it up OK for people with tracking issues, and that I don't come off sounding whiny given my comparatively minor symptoms.

Also, and sorry for the barrage of questions above, how important is the NUCCA rule to never sleep on your stomach? I've slept better the past couple nights, but still not as well as when I sleep on my stomach.

If it is that important, any tips for making the switch? Thanks.

Laupala,

It sounds like you may be struggling with anxiety. Your attention to detail suggest you are overly concerned with the little details. Recovery is a marathon, not a series of sprints. Just because you passed the exertion test does not mean that exertion never causes head aches. PCS is problematic in that day to day symptoms often do not follow an understandable pattern.

When you become symptomatic, rather than getting anxious and depressed, try to find a diversion activity to use to rest and be a distraction from your symptoms. Learning to relax when symptomatic is an important skill. Often times, I can relax a head ache away. Accept the fact that symptoms will come and go. It is just how PCS heals. It does not mean a whole lot except that you are still needing to continue the healing process.

So, try to relax and take is slow when symptoms arise.

My best to you.

Thanks for the response. I'm a scientist, so paying attention to details to understand a situation is who I am, which makes this all the more difficult. I'm not having anxiety like I was early on with panic attacks and such, but I guess a lot of my thoughts are essentially worrying about my current state and whether what I'm doing is making things worse, but I'm not getting the sort of visceral reaction from it that I was early on.

Also, there really aren't many, if any, moments where I feel like I'm asymptomatic. Sometimes the headaches get worse, but there's almost always some kind of baseline headache, and I pretty much haven't felt like my normal self in 3.5 months.

Any suggestions on good diversion activities? Most of what I normally rely on (running, reading, watching TV) seem to sometimes exacerbate symptoms. Meditation has been a big help to me, but it'd be nice to find others. Would rewinding and committing to a week or two of near total rest be beneficial at this point?

The over-stimulation anxiety of PCS is understood. Being focused on symptoms can be self-defeating. Gently moving forward through your current symptoms by learning relaxation and other stress reducing skills will be helpful.

Except for rare traumatic situations, you can only make symptoms worse. You can not make the injury worse. Only you can track your triggers that make symptoms worse.

Rather than worry about your current state, try to accept it as a normal part of the healing process. Be patient with this process. Try to minimize triggers. Take care of your neck with icing and good posture, especially when resting or sleeping.

Have you been able to reduce your head aches by relaxing and resting ?

For me, resting means eyes closed. This reduces the visual processing load.

Thanks for saying that I can't make the actual injury worse, that reassures me. Doctors have said the same thing too, I'm not sure why I have in my head that if I push too hard I'll make things worse.

Sometimes meditating can reduce my headaches, but other times they remain throughout. Even when I'm feeling my best I can usually feel some kind of sensation when meditating or relaxing.

About sleeping posture, I asked this above, but it's understandable if it got lost in my long post! Is the NUCCA rule about never sleeping on your stomach very important? I often sleep on my stomach and the past few nights after my first adjustment haven't been high quality sleep because of this I think (although each night has gotten better). If it is that important, any tips on how to make the transition?

Again, thanks for taking the time and energy to respond.

Sleeping on your stomach means your neck is twisted to an extreme. That is likely not a good idea. I sleep with my head straight. I try to avoid sleeping with my head turned. That is the important issue.