I am new and have questions about my own diagnosis and prognosis.

In a car accident on 10/8/14; don't specifically recall impact but given mechanics of it likely hit left side of head on window. Went to ER later complaining of neck pain, arm weakness, and massive headache. Did Cspine CT scan but no concussion protocol.

I do not recall much of next few weeks. Wife says I became withdrawn, apathetic, but turn angry if she tried to draw me out. Complained of headaches 3-4 nights/week. Became overwhelmed w stress, fatigue, and paranoia about losing job. I also would be confused by simple questions at times.

I went to psychologist about 3 weeks after MVA for 1st time ever. My mother was diagnosed with terminal cancer in June (4 mos pre-MVA) w 12-18 mos to live. I knew there was a problem and thought that was it.

Then about 3 weeks ago I felt the "fogginess" begin to clear up only to realize I can't remember much of the past couple months. And I now see my trouble focusing and understanding difficult concepts. I lose words, simple words... Like "car" or "sign" or "curb." Anxiety, stress, and depression are still challenges.

I told my psychologist about this and he started asking more about the accident and finally began putting all my symptoms together and diagnosed PCS.

I see a neurologist on 1/14/15. I saw my PCP last week who did an exam and noted definite short and long term memory problems and "cognitive deficits." I get a brain MRI on 12/30. Meanwhile, spine dr found problems at C5-6 from MVA and I'm doing PT.

So here are my questions if you can help:

1. The Psych keeps warning me this could still be something other than PCS and than scares me even more because atleast now my wife and I had a name for it. And the stuff we had read said you fully recover in 3-12 months. So how consistent or inconsistent is my experience with those with PCS on here?

2. Again, we read recovery in 3-12 months. I am a young lawyer, practicing about 8 years now, and I just started a new job with a firm I love doing work I really love in March. But it looks like the reality from your experiences is not as tidy as that 3-12 month package, is that true????? Should I stop thinking this is only temporary and start preparing for the long haul?

Thank you in advance for your help and answers... (And please don't crucify me because I'm a lawyer!!!)

Lawyer1732,

Welcome to NeuroTalk.

You know why they bury lawyers 10 feet down don't you ? Because, down deep, they are good people.

We'll try to overlook your occupation. LOL

What you are experiencing is common to concussions. The "recovery in 3-12 months" is a wide generality. There really is no way to prognose a recovery timeline.

Your psychological issues are all common to PCS. I don't know what the psych could be referring to when he suggests something else. The stress of your mother's health is mild compared to the stress of living with a struggling mind.

A NeuroPsychological Assessment might be worthwhile. Are there any concussion clinics where you live ? A PCP or neuro are usually not the best at concussions.

What kind of treatments have you had so far ? Meds ?
How are you sleeping ?
Is you current job stressful ?

Please feel free to tell us anything and everything. We have heard it all.

My best to you.

Lawyer,

Seems pretty consistent with my experience.

I found this site while looking for answers to anxiety/panic and that seems to be part of the routine for some of us.

I can be pretty foggy but I am finally experiencing some periods of my old self now.

Try not to worry about the time period, it is very counterproductive. My experience is you can't make this happen, you heal when you are ready...I am now seeing some improvement but it is very common to be followed by a day of needing to lay around.

Sorry I can't write more but I am a bit on the tired side right now.

Bud

Welcome Lawyer1732.

Hi there

Sorry for your struggles. PCS is scary and no 2 healings are just the same. But you can still brain rest which will maximize your recovery.

If you have to work, then that will make brain rest harder, but not impossible. Really work to reduce stress every way you can.

A good resouce you can even get from your public library is the book BrainLashed by Gail Denton.

Check out the vitamin stickie. These extra vitamins are not a cure all, but it si something you can do in order to help yourself and help your brain deal with stress.

Hang in there.

Poetrymom

My psychologist has recommended the neuropsych evaluation so I definitely intend to obtain it.

I honestly thought I was going through some kind of early mourning related to my mother or just going crazy. I guess I can remember thinking my emotions seemed a bit extreme and I needed to hide them. I don't think I was even telling the psychologist everything.

The scariest/saddest part was when my Psychologist asked me to ask my wife for her observations and I started finding out about stuff I had no idea had been going on and for how long. Just stuff like the being a completely emotionless or if I showed any emotion it was just getting angry to the point of throwing things or hitting things over small issues.

I do have this one almost kind of like distant memory of coldly telling my wife that I had supported her emotionally for 10 years and now I was too tired and it was just her turn to support me for awhile while she cried and I was emotionless.

My medications are phentermine, mobic, and Topamax (50mg 1xday). The Psychologist is referring to the Topamax prescribed for weight loss may be another reason for all this. But my symptoms started 3-4 weeks before I was started on Topamax. And the fogginess has cleared up though I continue on it.

I just read an NIH study (that took my ALL day to process!!) that looked at other studies re the cognitive effects of Topamax and they all show problems at doses at least twice mine. And to get my same problems, it's like 6 to 12 times my dosage!

I also read that there is evidence Topamax may help repair damage after a TBI. Could be I just lucked out by getting on the Topamax and it helped my headaches and all w/out anyone realizing it.

I looked into it Bc I thought I might stop taking it. But I just don't see how these symptoms of fogginess, apathy, mood swings, confusion, anxiety, and memory problems, etc, could be caused by a medicine I didn't even start taking until AFTER the symptoms started.

In any case, I worry that they will waste my time with looking for the "easy fixes" that are wrong-- like blaming Topamax even though logically the timing makes no sense. And then I fall more behind ...

But I have already found some help here. The thread on things you wish you'd known early on was helpful re controlling noise. Just to see, I went to Best Buy and tried on the Bose noise canceling headphones. WOW!

I did not even know I was feeling anxious and tense until I tried the headphones' NC feature. But this anxiety melted away! I had already picked out a nice $50 pair of over-the-ear headphones that muffled sound. It was worth the money to go with the Bose noise canceling for that feeling.

I was able to go grocery shopping with my family again without freaking out... And wearing my jersey people just assumed I was listening to the football game!

Then my PT mentioned avoiding too much stimulation, so instead of listening to my Christian pop playlist I found a "classical relaxation" playlist. And there is DEFINITELY a difference in the impact softly playing instrumental classical has on my mind and mood over music with words.

So I found this site and originally posted I think on Saturday. Since then just taking time to rest and using the headphones and cutting back to background "elevator music" has seemed to improve my ability to engage with other people, to be social, and has made my mind feel clearer--

...though admittedly it probably took me ALOT longer than it would have before to get through that NIH paper I mentioned above...

Let me ask another question, if I could--

Is this a common experience as well? And if so, does the effect last at all? I have noticed an increase in stress seems to slow my thinking but can the rest and avoiding noise/overstimulation over time win the battle...I mean-- Is this how you make gains even though there are setbacks?

I am a litigation attorney, a high stress job. I have just been thinking will all this that I feel I've gained over the past few days be lost come next Monday when I return to work?

The brain needs rest to even start to heal. Stress and over-stimulation are counter to this needed rest. Rest between periods of high stress or over-stimulation is not effective. It is important to moderate stress to avoid the peaks. The peaks are most likely to delay recovery.

You said, "I also read that there is evidence Topamax may help repair damage after a TBI." Where did you read this ? If it is true, it should be headlines.

Phentermine is the weight loss drug. It is a psychostimulant. Stimulants are not advisable for recovery. It could be causing problems.

Topamax is an anticonvulsive often prescribed for migraines.

In my experience, Christian pop music is too stimulating. I can not listen to it. I can listen to instrumental music with more 'impact.' I can also listen to quality vocals with quality instrumental accompaniment. I also struggle with music where the vocals are buried in the music so you have to strain to follow the lyrics. The brain wants to understand the vocals. If it can't, it overloads trying.

I have mostly recovered from a nasty bout of PCS that started over 3.5 years ago. Life is now humming along (in fact it is better than before my injury), but getting to this point was by no means easy.

Here are the things that I believe helped me the most:

Rest
Time
Keeping stress low (as best possible)
Good nutrition w/ varied diet including sufficient protein
High-quality fish oil supplement, vitamin D3, good-quality multivitamin
Being disciplined about limiting cognitive and physical activity (not overdoing it) and shutting it down and resting when necessary
Very gradually increasing activity (as slow as necessary - over months/years if necessary)
Support from loved ones who get it (these may be few in number)
Learning relaxation techniques (might be a slow walk in natural/quiet surroundings, a breathing/relaxation tape, classical music, hot bath, etc.)
Understanding that recovery can take a long time
Perhaps most important: no further head impacts! Daily reminders/mental cues can help with this
Apart from learning from others' experiences, don't compare yourself with them - each head injury is different
Acceptance that you've had a serious, life-changing injury

For most people, it does get better, but recovery can take quite a while. Be good to yourself. Recovery is a marathon, not a sprint - it's a cliche, but one that is profoundly true.

My best to you (as Mark likes to say).

Mark,

Here is a quote from the Natl Inst of Health paper that discusses the various studies on Topamax. You can see why it took me all day to get through it all... And it appears as if there hasn't been enough research w one study showing negative results:

"This evidence that administration of TPM [Topamax] confers protection against neuronal damage and cell death following cerebral injury may have implications for learning and memory following cerebral injury. This has been shown in rat models of cerebral injury, induced through hypoxia, induced seizure, middle cerebral artery lesion (to induce ischemia), and TBI. ...

"The studies used rat models to investigate the effect of TPM administration on learning and memory following cerebral injury. Hoover and colleagues found that while there was a beneficial effect on preservation of motor function, learning performance was impaired in brain-injured rats administered TPM 1 month post-injury [Hoover et al. 2004]. Other studies found that rats given TPM had preservation of some cognitive abilities following brain injury compared with brain-injured rats not administered TPM. Amelioration of deficits in learning and memory however, were inconsistent between doses and tests used for assessment making generalization difficult."

Thanks, greenfrog! I live and die by the hourly bill and have typically worked 55-70 hour week in addition to whatever other community service I try to get in.

What you said about supportive family... I have an awesome wife who has already said if need be she is willing to "downsize" and "simplify" our life... I am thinking the first step is to get the Neuro's recommendation and the eval and then see what I can do about adjusting my work.

Speaking of community service, I had also read that PCS tends to cause one to become self-absorbed and to focus on helping others instead. I noticed you and Mark spend a lot of time commenting and helping other here...

Do you find any relief/recovery in anything like that--does that help, to refocus your attention to other people?