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


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Old 09-18-2014, 07:56 AM #1
ChristineA ChristineA is offline
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Default Return to Work

Hi everyone,

I am new here. I'll ask my question first then give some info about my situation so you don't have to wade through a bunch of text to find the question. Screens and reading are very difficult for me so I'll need to be brief. Plus, did a quick search as I'm sure this has been asked and answered but my brain has its limits!

What type of work do/did you do? How long until you returned to work? How was that decision made? I have a PhD and recently moved from a faculty to administrative role. Concussion #3 on July 17, 2014. Usual litany of symptoms. Not able to work. Had MRI....no bleeds. Referred to UPMC concussion center. Since appt there, doing visual, vestibular, and physical therapy. ImPact scores were scary to me but I don't know what they typically are for others. My percentiles were: verbal memory 44 th ; visual memory 13th; processing speed 33rd, and reaction time 4th. Need to ask when I return next week what the reference group is!

Ok...nausea setting in. Bye tour now.
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Old 09-18-2014, 08:20 AM #2
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Welcome!

I had what I thought was my first concussion (more than likely not, played soccer through HS, college and after along with multiple car accidents) back in Jan. I have not been back to work yet... Each and every doctors appointment I hope that they tell me this is the one where they will release me to go back...

I still have daily headaches, dizziness and some nausea.
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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 09-18-2014, 09:17 AM #3
GingerandBella GingerandBella is offline
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[QUOTE=ChristineA;1097378]Hi everyone,

Hi ChristineA,

I too had an administrative job. Have been out of work for almost 2 years. I believe that if I had a different type of job I probably could try to go back. Right now I just know that I cannot do my job. Too many demands and decision making - just can't handle that right now.

Hoping desperately to return to my job - miss it and all the people.

Hope you have better luck.

GB
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Old 09-18-2014, 09:20 AM #4
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Welcome ChristineA.
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Old 09-18-2014, 09:52 AM #5
Mark in Idaho Mark in Idaho is offline
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The reference group is usually the general population in your age group, sometimes normalized for educational background. Your scores sound like mine except mine were even lower. I can understand why you are struggling.

It is very difficult to compare injuries. As the saying goes, If you've seen one head injury, you've seen ONE head injury. There may be some similarities in symptoms but there is a wide range of recovery times.

It sounds like UPMC is on top of the issues.

My best to you.
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Old 09-18-2014, 11:02 AM #6
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Quote:
Originally Posted by ChristineA View Post
What type of work do/did you do? How long until you returned to work? How was that decision made?
Hi Christine and welcome to NT.

Regarding your RTW questions, I work in an administrative staff position at a private law school, as the project/process manager. This work includes strategic planning, goal setting, and data analysis among other duties.

My injury wasn't a concussion, it was a closed head TBI rated moderate to severe, that included a skull fracture. I had an epidural hematoma and subarachnoid hemorrhage that required emergency craniotomy surgery.

I returned to work part time from home about three months after my accident, and full time back in the office six months after the accident.

I gamed the system a little, my part time return release was from my PCP, who I convinced I could work PT (which was true in retrospect).

Regarding Full time return to work, this release was from my neuro-rehabilitation MD after my neuropsychological assessment. I don't have the exact percentiles in the report, but my functioning was summarized as:
Working memory - superior
Digit span - average
Arithmetic - superior
Processing speed - average
Symbol search - average
Coding - high average
Executive (trail marking B) - average

Your percentiles are probably based on tests from a similar demographic group, but that is a very good question to ask.

Your concussion was relatively recent as TBIs go. Your therapies sound appropriate to your symptoms, and your percentiles actually look pretty good for this juncture of your recovery. I'd expect continued progress.

Very best to you as you recover.

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What Happened: On November 29, 2010, I was walking across the street and was hit by a light rail commuter train. Result was a severe traumatic brain injury and multiple fractures (skull, pelvis, ribs). Total hospital stay was two months, one in ICU followed by an additional month in neuro-rehab. Upon hospital discharge, neurological testing revealed deficits in short term memory, executive functioning, and spatial recognition.

Today: Neuropsychological examination five months post-accident indicated a return to normal cognitive functioning, and I returned to work approximately 6 months after the accident. I am grateful to be alive and am looking forward to enjoying the rest of my life.

Last edited by Lightrail11; 09-18-2014 at 11:20 AM.
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Old 09-21-2014, 01:24 PM #7
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Hi!

I've been on leave from work for 2 years and am thinking about returning to modified work in January. I teach college so will teach one course.

I, too, have a PhD, so our scores will be a bit "higher" in the neuropsych evals, if only because we've had more years of education.

I couldn't return to work earlier because of binocular vision issues and vertigo migraines. Both have been addressed through vision therapy and medication-not resolved but are manageable now. I also feel that if I don't return to work, albeit somewhat minimum work levels, I am about to be fired! So I will try.

It's really isolating to be with mtbi and recovering from pcs. I did do volunteer work at 1.5 years. This seem to help with the social aspects of work, and the administrative processing. The risk was very low. I got to work through a lot of my own fears about being ready or not through volunteering and that helped!

Your neuropsych can also help with a return to work plan as well!

Best of luck!
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The event: Rear ended on freeway with son when I was at a stop in stop and go traffic July 2012. Lost consciousness.

Post-event: Diagnosed with post-concussion syndrome, ptsd, whiplash, peripheral and central vestibular dysfunction and convergence insufficiency. MRI/CT scans fine.

Symptoms: daily headaches, dizziness/vertigo, nausea, cognitive fog, light/noise sensitivities, anxiety/irritability, fatigued, convergence insufficiency, tinnitus and numbness in arms/legs.

Therapies: Now topamax 50mg daily; Propanolol and Tramadol when migraine. Off nortryptiline and trazodone. Accupuncture. Vitamin regime. Prism glasses/vision therapy. Vestibular therapy 3month. Gluten free diet. Dairy free diet. On sick leave from teaching until Sept. 2014.
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Old 09-21-2014, 08:33 PM #8
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For me, the issues have been mostly one of endurance. Even when i was in really bad shape, but still attempting to work 5hrs a week or so, my colleagues said, "you're still super sharp." but those calls/work would utterly wipe me out.

My endurance is a bit better now so after really taking about two months off (ok, i worked about 10hrs in 2 months) i'm starting back 5-8 hrs a week next week. My boss has been great and is going to start me on just focusing on two projects rather than taking back over management of my team. They got jerked around a lot when i kept trying to return to work then had to quit again (like 6 times), so she's being cautious about my return, which works in my favor. I'll do 5-8hrs/wk as long as i need to until i feel i can handle more without impacting my rate of recovery.

Good luck. I guess my advice is to start back as gradually as possible. Biting off more than you can chew is bad for everyone, especially you.
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April 11, 2014 Flipped in class 2 white water while kayaking, hit my forehead (was wearing a helmet). Lots of symptoms to begin with. Those remaining are fatigue, brain freezes/overstimulation, headaches, sensitivity to light and sound. Insomnia is getting better but still an issue, and appetite is ba-ack! Depression and anxiety are largely under control thanks to Lexapro, exercise, and a very distant light at the end of the tunnel.

Drugs: Lexapro, occasional 2-5mgs ambien. Off amatryptaline. Taking about 453 supplements.

Just started vision therapy, waiting on some blue-tinted prism glasses.

"You will encounter many defeats, but you must not be defeated. In fact, it may be necessary to encounter the defeats, so you can know who you are, what you can rise from, how you can still come out of it." Maya Angelou
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Old 09-21-2014, 08:42 PM #9
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for me, it's the chronic pain and tension in back of head and neck. also the pulsatile tinnitus. actually, tinnitus is the number one claim for disability among veterans of the two wars. I found that shocking
Lucky to have girlfriend who makes a good salary but my pride takes a hit every time she leaves for work and I'm on the couch.
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Old 09-23-2014, 09:41 AM #10
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Thanks for all your responses. I had a 3 week follow-up with "my team" at UPMC yesterday. Everything is progressing in the right direction. If things continue to improve at my next follow- up, we will begin a back to work plan. Their philosophy is that returning to work is part of the rehab process so it will be done gradually and thoughtfully. My biggest fear is having cognitive impairments that I am not currently aware since I haven't been using my brain in a manner similar to the work situation.

Thanks again!
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