Hi everyone,

What a great support forum. A little depressing, but of course the people with the quickest recoveries aren't here.

I had two concussions in close proximity in 2012 that occurred unfortunately at the same time that I also had a stomach virus and was developing POTS caused by small fiber neuropathy probably resulting from an auto-immune reaction to the virus. I was initially diagnosed with PCS, but the POTS was later discovered and confirmed by nerve biopsy.

Good news: I 95% recovered over the next couple of years although it was hell for the first year. I did a lot of exercise during that time.

Come to 2015. Life is pretty much back to normal. I had a couple concussions in close proximity again (probably not as severe quite as 2012) 4 weeks ago and then 2 weeks ago.

This time there's no other condition complicating things - it's very clear my current symptoms (headache that gets worse with activity/throughout the day and bit of off balance feeling) are a result of the concussion and started the next day. It also focuses for me that some of my symptoms 2.5 years ago were indeed PCS on top of the POTS.

Anyway, so here are my questions:
- I've seen the Buffalo Protocol and read all of the papers. There's some misinformation in these forums (Mark, I love your posts - they're generally very informative - but it's only in the original that they excluded people < 6 weeks, a later study was with < 3 weeks exclusion and also it's not only measuring athletes ability to return to sports). I tried stationary biking (my old exercise of choice) two days ago and was able to do 8.2 miles in 35 minutes (well below my old usual a month ago, but I was purposely going slowly). It did hurt directly on the top of my head where I hit it. Does this mean it's too soon? I'll probably try going even more slowly today.
- What do y'all think about getting Omega-3s through eating sardines/mackerrel/salmon every day instead of taking the pills. I've been on the pills since the accident but I feel for some reason like I feel worse after taking them each day a couple hours later - maybe it's impurities... I also have been eating these fish most days so I feel like that's covering my omega-3s?
- Since symptoms are not as severe as in 2012, I have better support (nutritional, emotional, etc), and I'm a couple weeks out from the second hit, I'm hopeful that this will not be as long a recovery (also not clear what symptoms were caused by POTS and what by PCS). Do people ever see worsening symptoms after a couple weeks out? Is that normal - because if this is the baseline, I can live with that and it would put me at ease quite a bit.

I haven't looked into the Buffalo Protocol in about 2 years. Sports based protocols tend to be limited in scope. They also rarely address the risks of future injuries to long term prognosis.

The Buffalo Protocol uses heart rate as a standard rather than miles ridden. Maybe you should track your pulse and set your pace at a pulse that does not cause this pain.

It is common to see a worsening of symptoms as far as 6 weeks after the injury.

There are fish oil capsules that concentrate the EPA and DHA so you don't need to take as much. Maybe that would be worth while. Fish has a broad base of fish oil without the concentration of EPA/DHA.