Hello all. I was wondering if anyone has experienced something similar to this. I had a mild concussion from falling back and hitting my head on concrete about 5 months ago. I had no bleeding or broken skull, but had all the normal symptoms of PCS. Mostly headaches, constant brain fog, vision issues, trouble concentrating, etc.

Now I was doing much better and was almost back to normal after a month or so when I decided to help a friend build a fence at his house last weekend. This involved using an auger to dig holes and many other work tools. Although I did not hit my head or anything I am experiencing almost week 1 PCS in the following days. Like all my symptoms are back!!

Has anyone experienced anything like this? I dont drink(after the concussion), dont smoke, eat healthy, and get decent exercise. And thought I was back to normal. But now Im having to take off work for an injury months ago!

Thanks in advace

bumponthenoggin,

Welcome to NeuroTalk.

What you experienced is quite common. When you hit your head, you likely suffered a subtle upper neck injury. This contributed to you concussion symptoms. The weekend project likely aggravated this almost healed neck injury causing a return of symptoms.

All you can do is take it easy like you did before. You may benefit from icing the back of your neck. Read the Vitamins sticky at the top. There is a link at the bottom of the first post with a link to post #101 with the latest information. It has a recipe for making soft ice packs and lots of other good information.

Feel free to tell us more about your struggles.

My best to you.

I had a similar thing happen. Got a concussion in July, made continual good progress (some setbacks but usually explainable), and then had terrible PCS symptoms beginning in October due to a cold.

It was the impetus for me to seek actual treatment. I'd only been seen in the ER/Urgent Care facilities during the initial few weeks, never by a specialist. Going to specialists has resulted in treatment for some eye issues and initially some neck issues that may not have resolved on their own. If you have access to a specialist (sports medicine/neurologist, generally), then this might be a good thing to check out to make sure there aren't lingering problems/address any problems that they do find. You would likely need a referral from your primary care doctor/an ER. I hadn't reached normal again, so you likely don't have as many complications and may not have any at all, but it may be worth getting checked out, especially if this second round takes awhile to recover from or it happens again.

Thank you for both of your responses.

I did go see a neurologist about a week after the concussion and was told that all my symptoms were normal and to just give it time. What I am afraid of is that the doctor will just blow it off as normal again. My insurance is terrible and has a high deductible. I think I spent $700 just to see a specialist last time.

Icing the neck is great idea as i have noticed some stiffness. However my main problem even when I was getting better was the headaches from work on a computer/TV screen. After too much, I would have a lingering numb headache for the entirety of the next day. Which would go away depending on how much sleep I would get. This numbness would also cause me to be extra aware of my speech as It felt as if I needed extra effort to speak correctly without a slur. But this was the first time the physical exercise caused a set back. So now i'm worried to do anything outside. Run, yard work, etc.

What can a doctor do really? And is it worth doing a follow-up? Thank you all for your responses.

As you can see in my signature I had the same experience of symptoms coming back, and then some without hitting my head. Two years later I still haven't recovered.
Take it easy is the only advice I can give you.

Only a few doctors that I've seen so far have helped me somewhat, even then they just tell me to wait it out when their treatments don't have the desired effect.
In the last 2 years I probably spent close to $40K on doctors/imaging/studies, etc.

I saw a sports medicine/concussion specialist who sent me to physical therapy for a slight neck injury. She did a stress test to see how I responded to exercise, as exercise (within reason) can help with recovery from a concussion due to blood flow regulation in the brain. PT would also address balance issues which are common. My neck got better but I still have headaches so the specialist sent me to an ocular/occupational therapist and a neurologist. The ocular therapy uncovered some eye problems, namely convergence, so I'm working on fixing those. This therapist sent me to a neuro-ophthalmogist who prescribed prisms for my glasses to reduce the strain on my eyes since they're not aligning right (fourth nerve palsy). I get those tomorrow so don't know how well they'll work yet. She's also mentioned a eye muscle specialist if the prisms don't work. The neurologist told me to take specific vitamins and I will be getting an MRI next month to make sure nothing super crazy is going on. I've also been seeing a counselor as the concussion/situations caused by the concussion caused anxiety and flashbacks. I've been steadily (albeit slowly) improving since October, although some of that is due to time and me learning my limits. So basically...there's a crazy ton of specialists out there, the doctors can look at a lot, they can fix some stuff, and other stuff ends up with me crossing my fingers and a pretty long haul.

I see an average of 2 doctors/week, although counseling is one of the more frequent (~1x every other week) and that's free because I'm a student. I'm also covered under worker's comp so almost everything is paid for. You could probably choose to go to PT/occupational therapy less frequently if you were referred there, and that's the bulk of the appointments.

I'm also lucky to be in a city where there are this many specialists (and they take concussions seriously) so I can access treatment without having to travel. I've been told that some of these problems don't resolve on their own in everyone, but you likely still have time to see if your current problems respond well to rest. Light sensitivity is the only problem I've been told of a time frame on, and it's a year.

For me, heat works better than ice/cold for the headaches, so that's something to consider if you haven't tried it yet!

Bump,

My injury was 4/12/14. Sometime in July I went outside and commenced hitting on some metal fence posts with a sledge hammer to see if I could jar them loose to remove them, they were in concrete.

I felt my head do something and I was not good for a good while after that, I further suspect that is possibly the reason I am having problems still.

Be patient and test the waters easy on more vigorous activities is my advice.

Bud

That's interesting that you were told that.

nema, can you describe what kind of care you have received more specifically? i think i have a lot of the same symptoms as you and am curious to see if i'm doing all i can.

in particular: what kind of deficits did you experience in your eyes? what kinds of specialists did you see and what tests did they perform?

what was done for your neck and by who?

Light sensitivity has been a big problem for me. I wore sunglasses initially and then for most of October-January, when I started seeing an ocular therapist. She shined a light in my eyes and could tell that my pupils didn't stabilize quickly afterwards and weren't necessarily the same size. This is a reflex so can't be addressed with exercises. She told me not to wear sunglasses constantly/to wear light sunglasses so that my eyes would have to work and either my eyes or brain will figure out how to deal with light again. I have improved and can tolerate indoor lighting most of the time but not sunlight without sunglasses.

I had trouble going between the board and my notes in school, as it would give me a headache and feel uncomfortable. Not dizzy but wrong. The physical therapist was able to address this problem back in Nov/Dec by having me do exercises where I would look at an object and move my head or look between two objects, which is how she discovered this problem. My neck/ability to know where my head is in space was also involved, which she tested using a headband with a laser and a target on the wall.

The rest of my eye problems are more discreet and I am not usually consciously aware of the specific problems. My eyes do often feel tired at the end of the day and I sometimes get 'headaches' behind my face which is due to the eye muscles behind my face hurting from over-exertion.

The ocular therapist found that I have difficulty sustaining convergence. Basically, if I look at a pen that is 4-5 inches from my face, I don't see double but my headache significantly increases within seconds. Also, if my eyes are really tired, I do see double at that distance. She also gave me a string with beads on it, where the goal is to look at each bead for 10 seconds and move to the next. My eyes have a hard time finding the next bead and I initially see double before the images converge. Sometimes the image wavers between single and double. This exercise also increases my headache. My left eye particularly tends to 'turn out' and look more to the left when tired so my eyes aren't looking at the same thing.

The ocular therapist sent me to the neuro-ophthalmologist to look at these symptoms more. She did a crazy number of tests (the appt was 2-2.5 hours, not including waits). She diagnosed me with fourth nerve palsy (nerve going from brain to an eye muscle, muscle doesn't work well now). She did so by having me but a red lens over my right eye and look at a light she held straight on and with my head tilted to the left and right. I saw two lights instead of one. Another symptom of fourth nerve palsy was my tendency to subconsciously tilt or turn my head instead of looking straight on to relieve some of the strain. Fourth nerve palsy causes vertical double vision, which in my case is pretty subtle but straining on my eyes and likely contributing to headaches because my eyes have to work harder. She prescribed prisms for my glasses to make my eyes work together better, so hopefully that works (Hopefully getting them next week). If they don't work, then I will likely end up going to an eye muscle specialist. The fourth nerve palsy is causing/contributing to the convergence problems as well. The ocular therapist told me that this is not a particularly common problem in her patients, and she sees a lot of people with concussions, just to give some context.

The neuro-ophthalmologist looked closely at my eyes using a dye and found that they had some dry patches so I now put artificial tears in at night.

She ran a bunch of other tests that didn't turn up anything. Those that I remember are: visual field test, eye dilation/retinal scan, depth perception check, a prism test to see when things got blurry/double, color vision test, a check to see if bifocals would help, and other stuff that I don't remember/don't know what it did. Likewise the ocular therapist ran tests on my visual response time using a board with lights that I pressed when they lit up, my ability to switch from something near to something far (I need to work on this though), ability to follow lines on a page with my eyes, and several other things that I can't remember.

For my neck, I saw a physical therapist who specializes in treating concussions. She assessed my neck by feeling around and seeing what spots were tender and regularly massaged them (not a comfortable type of massage!). I also didn't have good posture so she gave me exercises to strengthen those muscles as that could be contributing to my symptoms even though it hadn't been a problem before. She also told me to play with a laser pointer and follow it with my eyes to get better with saccadic motions were difficult. I got better with all of these exercises pretty steadily.

It's been a lot, so hopefully you don't need this much!