So I went to upmc concussion clinic and met with Micky Collins.
I went through all the testing and basically we decided that I need to get really busy, and to follow a vestibular and exertional exercise program. He said that after three months my brain is not so much damaged as it is sensitive at this point. He suggested I push myself physically and socially each day until my symptoms get to a 5/10 and then recover and repeat all day. This is the first time I've been told to not rest very much. in fact, he told me to do all the things everyone else has said not to do.

That being said, he mentioned I would feel like crap for awhile from all the stimulation, and he so far he wasn't lying.

He was very confident, and told me I will absolutely recover from this.

So for anyone who is not getting better with rest and hiding from stinulation, maybe consider this approach.

Some of us including I have mentioned the need for stimulation for good brain blood flow. Learning to recognize the early signs so you can be active without triggering a hard crash is important.

Finding that 5/10 place will be a challenge. You want to be able to recover within a short period. If it takes too long to recover, the next time, you want to reduce the intensity level.

For me, I would flit between activities. If I was at a social activity, I'd step way from over-stimulating conversations for a break.

As Micky Collins said, over time, things will get better.

What do you guys mean by a "5/10"? Is it where your symptoms are bad but no so bad you can handle them? For me, my symptoms get worse more suddenly and quickly so it's hard to know when stop. I could be fine one moment the next I could feel like my symtomps are sky rocketing.

Sam

Sam,

I can relate to that. I can feel pretty good for 5 mins, and then have intense symptoms the next 5. Drives me nuts..

Sam I agree. It's super hard to tell when it's a '5/10' especially with a symptom as vague as 'foggyness'

Basically the way I've been treating it is I go out and do things, go have one drink and watch a few innings of baseball at a bar, go to a restaurant, go to church, etc and then I go relax and get back to my baseline.

Basically they were less concerned with the actually severity of the symptom and more concerned with building a cycle of repeated exposure and rest.

miller,

If you can tolerate all that activity and drinking alcohol included, you are doing well.

When I mentioned learning how to recognize hitting your limit, in my experience, there are a variety of signs. A change in sound sensitivity. A feeling like you need to shake the cobwebs out. A need to look a little harder. A change in emotional senses.

So, slow down and pay attention to the various senses. When you sense a change, maybe you have hit your limit.

For others who do not sense these changes, you have to use your experiences and memory. If doing 30 minutes of an activity takes a long recovery, try 15 minutes and so how strong your symptoms are.

I spent years just knowing I had limits and expecting to need time to recover if I pushed those limits. I did not get angry or stressed when I went past my limits. I expected that I was at risk of pushing past my limit.

So, give yourselves room to overdo it and need time to recover. Do it over and over and slowly, over weeks or months, things will get better.

That's interesting advice, and good to hear. This post is actually quite timely as I've been feeling very demoralised lately about my activity levels.

This past Saturday, I was feeling "ok" in the AM and thought it might be a good day to hit the treadmill. Over the past year I've tried it off and on with all negative results. For this session, I walked 3 min at a slow pace and 2 min (total 5 min) at a normal gait. Within the first 30 sec my headaches increased; by 3 min I felt different, and by 5 min I knew I had done way too much.

From this relatively benign activity, I have been recovering for the past 3 days in which I've had progressively worse symptoms, including intense headaches, frustration/anger, rumination, and the need for isolation. Based on my experience, my symptoms will platueau for a day or two and then taper off over the following 3-4 days. This recovery from a 5 min walk seems ridiculously disproportionate to the activity level, but it's what I experience regardless of activity/stimulation.

I like what Mark says about learning to recognise your queues, but for me the index between ok and over-stimulated is insanely narrow.

In the end, I am so utterly frustrated and demoralised with my intolerance to activity. Miller, if you can post your progress through this I would greatly appreciate it. I recently said to my wife that if I knew it would make me better I'd get back to running again, issues be damned.

So, I love this approach already and it seems to fit my situation, as I've been trying to be a counselor at camp all week.


My only concern is, when you repetivley over do it day by day isint going to actually set back recovery?

Normally when I over do it a good nights sleep fixes it. Recently, that has not been cutting it.

Can anyone answer my question above?

Sam

MicroMan,

Be patient and keep probing. I walked 1.5 mi per day back in February and March and had to quit. Could no longer take the nose dives that happened within a half
Hour of being done. I started swimming in June and have increased it to 25 minutes now and can walk 2 mi in 100 degrees and swim for 10 after the walk, I walk every third day and swim the others.My injury site can get sore some days but I can live with it.

Frustratingly so I can't run yet....grrrr, but I am not a couch potato any longer.

It took a good bit of time for me to probe around and find out if symptoms were actual or anxiety induced. Once I came to the conclusion it was a great deal of anxiety involved I had to start believing I would be ok and keep it under check.

Never had to do this before. Life was pretty easy.

Bud