[missmarch1978]

Hello, new here. Long story long, I fell down a flight of ceramic stairs about 3.5 weeks ago, I don't remember if I knocked myself out, but I also don't remember getting up from the fall and putting myself to bed. I just know nothing has been good since. I fell on a Thursday (late night) but didn't go to my doc until the next Monday (just before Christmas). Was told by him that it was probably a concussion and to just rest. Suffered through the next two weeks (holidays) and finally went back to my docs this past Wednesday. Had a CT scan done this past Friday. Not sure what to expect as far as results and future treatment. Or if there is any future treatment.

List of symptoms:
My scalp is still fairly bruised on my left side, behind my ear, even after 3.5 weeks.
Headaches.
Dizzy.
Exhausted.
Hearing is jumbled (this is what is hardest for me to explain. No one is understanding what I am trying to tell them and I am frustrated. I can hear out of both ears, but they aren't syncing. A bubble type sound. I can't always figure out which direction the sound is coming from. Certain noises are excrutiating, voices, dishes, road noise, bass, loud bangs, which isn't good because I am a fairly accomplished percussionist, or I was....., this hearing thing leaves me exhausted, I haven't practiced my instrument since the fall).
My eyes hurt and get worse as the day goes on.
Depressed.
HIGH anxiety/panic attacks.
Insomnia. (Doc gave me lorazepam for this and panic attacks)
Nausea.
Mood swings. (I threw an absolute fit in my diveway this morning for zero reason and then cried all the way to work because I didn't know why I was mad).

I feel like everyone thinks I am over reacting or over embellishing my physical pain and symptoms. "Yup! You bumped yer head, Silly!". (That feels so condescending). I don't feel like my doc is taking this very seriously, either.

Any suggestions on how I am supposed to deal with starting this healing? Where to reach out to for serious help? I feel like I am going crazy and I want support, but I also just kinda want everyone to leave me the hell alone at the same time. If another person asks me if I am feeling better yet, I feel like I will snap on them. "NO! I DO NOT FEEL BETTER YET! I DON'T EVEN KNOW WHAT'S WRONG YET!" Is
what I think in my head, "Not yet! *smile*" is what I say to them. And then I find somewhere to cry.

Any positive feedback on my rant would be appreciated.

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[Mark in Idaho]

missmarch1978,

Welcome to NeuroTalk. Sorry to hear you are struggling so.

What you are going through is very common. You just have a more intense set of symptoms. 85% will recover spontaneously within the first 6 weeks. The remaining 15% take a wide range of time to recover.

[My scalp is still fairly bruised on my left side, behind my ear, even after 3.5 weeks.]
The skin over the skull has 7 layers with lots of nerve fiber throughout. These nerve fiber have been damaged, Unfortunately, for some it takes months for this pain and sensitivity to heal. The myelin sheath that covers the nerve fibers heals very slowly.

[Headaches.] These can be from the impact, from excessive blood pressure within your head, or from a subtle neck injury causing muscle spasms radiating from your neck or any combination of the three. All are normal and take time to resolve. A neck injury may be treatable. Upper cervical chiro, gentle traction and mobilization by a PT, osteopathic manipulation can help but good sleeping posture is also necessary as the ligaments strengthen and stabilize. Ibuprofen or aspirin can help. Acetaminophen can also help but is not an anti-inflammatory and has some negative chemistry effects.

[Dizzy.] This can be due to some vestibular challenges. Or, moving too fast for blood pressure to keep up. At 3.5 weeks, it's not always worth getting an assessment yet unless it is serious.

[Exhausted.]
Your brain is injured and working overtime just to keep up.
It is overwhelmed with audio, visual and other stimulation. You also are probably not getting good restorative sleep. The holidays are a miserable time to struggle with PCS because there is so much stimulation and activity.
You should be focusing on getting quiet rest. That means low stress activity with minimal sensory stimulation. Many wear ear plugs to reduce auditory stimulation. The foam Mack's brand are good.

[Hearing is jumbled (this is what is hardest for me to explain. No one is understanding what I am trying to tell them and I am frustrated. I can hear out of both ears, but they aren't syncing. A bubble type sound. I can't always figure out which direction the sound is coming from. Certain noises are excrutiating, voices, dishes, road noise, bass, loud bangs, which isn't good because I am a fairly accomplished percussionist, or I was....., this hearing thing leaves me exhausted, I haven't practiced my instrument since the fall).]
The jumbling and lack of syncing needs to be checked by an ENT or audiologist. It is not uncommon for eyes to not sync properly after a concussion. Never heard of it with hearing. But, it is called auditory neuropathy.

[My eyes hurt and get worse as the day goes on.]
Your eyes may be struggling to work together. This can cause fatigue and soreness. Computer screens can make this worse. It would help to take breaks with your eyes closed at least 5 minutes very 2 hours.

[Depressed.]
Your brain is struggling to process everything. This can lead to depression. Many doctor will prescribe low dose amitriptyline or nortriptyline to help with this and the anxiety.

[HIGH anxiety/panic attacks.] The concussed brain is easily over-stimulated into fight or flight syndrome and every variety of anxiety. If you have spikes in blood pressure with these, you could ask for a beta blocker like propranolol or atenolol. Reducing your exposure to over-stimulation can make a big difference for many.

[Insomnia] The above low dose meds can help with the insomnia, headaches and

[(Doc gave me lorazepam for this and panic attacks)] A benzo like lorazepam should be taken at minum dose and only when needed. Maintenance use of benzos can be a problem.

[Nausea.] Ginger can help some. Nausea can be made worse by anxiety.

[Mood swings. (I threw an absolute fit in my diveway this morning for zero reason and then cried all the way to work because I didn't know why I was mad).] This is not uncommon. Outburst can be a struggle. The injured brain has little tolerance for stress. The crying is part of this symptom.

[I feel like everyone thinks I am over reacting or over embellishing my physical pain and symptoms. "Yup! You bumped yer head, Silly!". (That feels so condescending). I don't feel like my doc is taking this very seriously, either.] Do you have a concussion clinic in your area ? Most schools have them available for athletes in football, soccer, LaCrosse, and other contact sports. Not all concussion clinics are tops in their skills, though. Worth a try anyway.

If you can tolerate it, watch the You Tube video series 'You Look Great' about concussion problems when everybody thinks 'you look great.'
https://www.youtube.com/watch?v=x9Xso4qGdlI

And, read the sticky at the top about Vitamins. The injured brain needs extra nutrition to rebuilt the nerve fiber coverings, help tolerate stress and a number of other needs.

In your condition, many would be working a part day only. At the least, take quiet breaks during the day.

And, feel free to tell us any of your struggles. We have heard them all and are here to help.

My best to you.

[missmarch1978]

Thank you for replying so quickly, Mark! All of this information has given me a lot of comfort. Knowing is half the battle, right? And I think a majority of my stress was coming from the non answers I've been given and dismissive attitudes.

I've obviously heard of "concussions" and believe I one other time suffered a mild one after falling on the lake during ice fishing as a teenager, but I don't remember the symptoms being as severe as they are now. And usually, when I hear of people having them, they usually seem to bounce back far quicker than I seem to be doing with this one. I guess all that had me overly concerned as well.

I was only able to listen to the first video right now, as it is time to go to work and my eyesears/brain already hurt, but I plan on watching/listening to the rest over the next few days.

(One interesting connection I had to the video, that isn't related to TBI, is I had mentioned being a somewhat accomplished percussionist in my original post. The percussion I play is snare drum, and I am a lead tip in a competitive pipe band in Ontario.) It was such coincidence that the son in this video was a bagpiper and they were on their way home from "band practice". It makes me feel a little more connected to the man telling his story. Like, he and his son would definitely get my frustrations about not being able to practice our instruments daily, if at all, and the stress that comes from letting my corps/band down in my absence.

So thank you for picking that specific series for me to watch.

I will return to the group with any updates and to read further responses from you and others.

Thank you again. I feel a bit more confident now, while starting my day, and it assures me that all my bedrest up to now is necessary, not just laziness.

Best wishes!
K.

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[SMSotr]

Mark-- Thank you for sharing the info on the video. I just watched it and sent it to family members in the hopes that they get a better understanding of living with PCS.


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[missmarch1978]

A quick follow up to my original post. (I'm not technically supposed to be online right now because of docs orders, but I thought I'd give an update, and then I am off again for my "neuro shut down" per docs orders, WEEK 2) I have reached out to a chiropractor specializing in sports concussions, an audiologist for my hearing issues, and forced my gp doctor to book (begrudgingly) an appointment with an ENT specialist. (He was ****** off at me for reachng out to others for help and informed me that they, in fact, "aren't real doctors".) I have been taken off work by the chiropractor who confirmed through multiple tests and frequent reassessmens, that I have sustained a rather severe concussion, my ct scan came back positive, so no major damage to my skull, I am doing daily eye exercises, have been told to avoid ear plugs and busy environments. Progess so far includes; less headaches, less insomnia, less anxiety (I stopped taking the lorazepam because I hate how it feels and I don't like medications that can become a dependence), less eye strain (other than when I am doing my eye exercises, they are headache inducing, frustrating, stomach turning, and I hate them, in general) My biggest problems right now/still are; exhaustion, slow reactions to visual and auditory stimulation, focusing my brain on targets, moodiness/shortness in conversations, confusion, forgetting my thoughts spontaneously midsentance, an absolute hatred for any environment that involves more than one noise at a time or specific noises, like road noise, fireplace fan, florescent lights, bells, squeaky doors, hand driers, dishes, some peoples voices, my own voice, etc.. I've read a bit about hyperacusis and I think, besides the almost certain perforated ear drum acknowledged by the audiologist and chiropractor, (but NOT by my GP), I am also dealing with that.
Thank you for the guidence and support. It helped motivate me to reach out to other forms of help than I originally would have. I better stop and get back to the nothingness of "no computers, no phone, no reading, low voices, no busy environments, etc. Basically, hermitting in my basement.
K.

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[Mark in Idaho]

missmarch,

I hope you check this before too much time goes by.

[A quick follow up to my original post. (I'm not technically supposed to be online right now because of docs orders, but I thought I'd give an update, and then I am off again for my "neuro shut down" per docs orders,]

You sound like you have been given 'old school' advise. The recent best research shows that gentle stimulation is best. You are long past the 'neuro shut down' time. You should be working with gentle stimulation. The injured brain needs good blood flow for best recovery. Mild activity that does not cause an increase in symptoms is best. If you do something that makes you feel fatigued and like you could take a short nap, take a short nap.

Besides not providing the brain with good blood flow, the isolation can contribute to depression and anxiety.

[(WEEK 2) I have reached out to a chiropractor specializing in sports concussions, an audiologist for my hearing issues, and forced my gp doctor to book (begrudgingly) an appointment with an ENT specialist. (He was ****** off at me for reaching out to others for help and informed me that they, in fact, "aren't real doctors".) ]

Your GP does not sound like he is 'real experienced' in concussions. Is this the doc who prescribe lorazepam ? A common 'rookie' treatment to get the patient to settle down.

[I have been taken off work by the chiropractor who confirmed through multiple tests and frequent reassessments, that I have sustained a rather severe concussion, my ct scan came back positive, so no major damage to my skull, I am doing daily eye exercises, have been told to avoid ear plugs and busy environments. ]

Frequent assessments can be problematic and cause needless over-stimulation to the brain and injury to the wallet. Once a month should be adequate. Is he a chiro-neuro (Carrick trained) ?

A good CT Scan result is a negative result, negative finding of injury. Positive would mean a positive finding of injury.

[Progress so far includes; less headaches, less insomnia, less anxiety (I stopped taking the lorazepam because I hate how it feels and I don't like medications that can become a dependence), less eye strain (other than when I am doing my eye exercises, they are headache inducing, frustrating, stomach turning, and I hate them, in general)]

Are you being treated by a behavior optometrist ? You just mentioned that your eyes get tired and hurt but nothing about any diagnostics.

[My biggest problems right now/still are; exhaustion, slow reactions to visual and auditory stimulation, focusing my brain on targets, moodiness/shortness in conversations, confusion, forgetting my thoughts spontaneously mid-sentence, an absolute hatred for any environment that involves more than one noise at a time or specific noises, like road noise, fireplace fan, florescent lights, bells, squeaky doors, hand driers, dishes, some peoples voices, my own voice, etc.. ]

Please give yourself time to heal. The single sound problem may be the last to improve. It is often related to a slow to heal injury such as a diffuse axonal injury. Axons heal slowly and need good nutrition (B-12 and folic acid). It takes a lot of brain processing power to filter out background sounds. Your brain is already using all the power it has to process your vision and hearing.

I often tell people that many of us can either process the words or the sentences but struggle to process both if the person is speaking with a strong accent. It is a processing capacity struggle.

The forgetting thoughts mid-sentence is likely due to distractions. Your thoughts get interrupted by a visual or audio distraction. I find closing my eyes can help me stay with my thought.

[I've read a bit about hyperacusis and I think, besides the almost certain perforated ear drum acknowledged by the audiologist and chiropractor, (but NOT by my GP), I am also dealing with that.]

Did the ENT check you for a perforated ear drum ? Your lack of sync between right and left can be due to inflammation of the auditory nerve fibers or stress/damage to the myelin sheath surrounding the auditory nerve. Damage can influence the speed that the nerves function. An Auditory Evoked Potential test would likely identify a difference in nerve conduction speed. Neuros can order them. ENTs and audiologists can, too.

[I better stop and get back to the nothingness of "no computers, no phone, no reading, low voices, no busy environments, etc. Basically, hermitting in my basement.]

Your eyes will likely do better with a full size computer screen rather than the small fast scrolling screen of a smart phone. fLUX can reduce brightness/glare and such from a computer screen. https://justgetflux.com/

I hope you can find some low stress activities to encourage good brain blood flow.

Just know that no matter how tough this is, things will get better.

My best to you.

[newbie787]

missmarch1978, Mark has already given you the important information, but I just thought I'd say that over time the symptoms do ease. I'm about 10 weeks out from a fairly similar hit to you, and had a lot of your symptoms to begin with, especially the nausea, headaches, dizziness etc. Over time they just get less and less. Early on I was getting major panic attacks at everything, talking to people, being in any environment bam panic attack. Now they've drastically reduced, as has the headaches, nausea.

They can still come back though, if I push too hard at work, too long infront of a screen I still get symptoms, but instead of lasting for a week they typically clear up with a good nights rest.

You won't find you wake up one day and feel a lot better, you'll likely find that when you look back to weeks or months prior your symptoms have drastically reduced, especially if you write them down and check that list after a month.

[missmarch1978]

Thanks for the feedback! I should have stated that the ct scan came back as negative, you're right. I just meant it made me feel positive. It was nice to get some good news for a change. The results were mumbled off to me, but the gist was no cranial damage and no damage to my sinus cavity.

My chiropractor is doing weekly assessments right now, but they are getting more and more spaced out each time I go. He knows I am nervous about missing so much time from work and that I need to keep on top of reporting back to my employer about progression/no prgression.

I've been going out in short stints, for lunch, or just the local shopping store, but I find most restaurants too loud and busy at dinner times and the stores too visually irritating at any time. (Yesterday, I discovered that hand driers in Tim Hortons coffee shops were made by the devil. True story!) I feel like a grouch. I just keep wincing and grumbling about every noise made. And then I am exhausted when I get home. So I only attempt one thing each day and in short stints. I'm not a very good dinner date or shopping buddy lately, so I tend to go alone. I can't handle conversations in that chaos and I end up being snappy or ignoring my companions. That's not fair to my friends and family. I spend time with friends at home. It's easier to converse when I can control the environment around me. But that is only occasionally.

My gp definitely seems to feel that this is no big deal and that I should just be back to work and over it. Because I can successfuly stand still with my eyes closed without falling over, I must be okay. He has insisted over the past three visits that there is ABSOLUTELY NO PERFORATION, because he can't see it. He just keeps putting me on antibiotics, saying it is swimmers ear.. And yes, he is who put me on lorazepam to calm me down. But like I said, I have stopped them now. I just take a tylenol ultra when the headaches come around and I have started some breathing/meditation methods to calm me in the evenings. So far, that has really helped me with sleeping. I also find listening to books on tape at low volume help me drift off. I've also invested in a cheap eye cover thing (like the fancy ladies in the movies, lol) I like it, because it lets me sleep in later in the day. I sometimes don't fall asleep until well after midnight and any sort or light or movement has me up at dawn, regardless of how tired I am. It also helps me nap, as, for the same reasons above, I'm not a very good napper. Never have been. Doesn't matter how tired I am.

It was actually my mother who set me up with the chiropractor, who then, suggested I go see an audiologist. The audiologist did a specific ear pressure test and confirmed that my left ear drum is not responding to any stimulus at all. Both the audiologist and the chiropractor are sure that they can see a small perforation on the scar seam on my ear drum (from the tubes I had as a child). My gp assured me "there is no test for ear drums. Audiolosts aren't real doctors. There is no perforation. Here are more antibiotics". I had to insist that he refer me to an ENT before I left the office. I heard him tell the office assistant to make the referral and she said to expect a call for a date and time. That was 5 days ago and I haven't received a confirmed appointment date yet. I know offices are busy but I'm calling the specialist myself this afternoon to see if a referral was actually made. I'm starting to feel skeptical.

I usually don't speak so negatively of my gp. I've had him my entire life (he delivered me) and he's always seemed so supportive an knowledgeable. But this issue is really causing us to have conflict.

My friend, who's husband suffered a major tbi a few years ago, after being hit by a drunk driver, recommended I contact a local physiotherapist who does specific therapies for tbi, so I will also be reaching to him soon to see if he can help me in any way, as well.

I will definitely look into the vitamins. I already take standard vitamins, but I will look into the b12 and folic acid.

I do see improvements. And you're right, they are very gradual. It's frustrating, but also promising. I have to keep reminding myself of that when I get down in the dumps. It's easy to just curl up in a ball and shut everything out, but I know I have to get up and find something to do. I also have to accept that it's a process, no quick fix. (Although I'd really like to know if there is a quicker fix for my eardrum.)

I currently don't own a computer or laptop, so my tablet will have to do. I agree though, the scrolling is a bit jarring for my eyes. Also, I should apologize for all of the spelling errors. I think the autocorrect on this thing is a worse speller than I am!

I'll post another update in a week or so if I have found anymore progress.
Thanks again, for all the feedback. I really do appreciate it.
K.

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[MVTBI]

Keep everyone updated, and good luck

I just got to say you found the right place to come for all those issues, there is some unbelievable people on here, every time I come on here I am taken back by the knowledge and the willingness to help, it has made a huge impact on my ongoing recover.

Sorry to Hijack your post but I feel like all those people deserved to be thanked!

so, THANK YOU GUYS

[Mark in Idaho]

missmarch,

I don't understand why you were told to not use ear plugs, especially when out in noisy environments. Foam ear plugs or professional musicians ear plugs can do wonders. By reducing the backgrounds sounds, voices etc., the brain is able to better process the remaining sounds and not react to an over-stimulation.

They cannot cause damage to the eardrum if inserted gently. The eardrum is too far in for physical contact. The only risk is pushing them in forcefully and causing a moment of pressure against the ear drum. Pushing ear wax deeper into the canal can happen is some cases.

The concept of subjecting your ears and brain to the sounds as a step toward healing is controversial. Not many agree with that concept. Most suggest gently reintroducing loud sounds after the brain has had time to improve.

Please keep in mind that there are two hearing issues. Some react to the volume or intensity of sound or fast changes in sound volume no matter what that sound may be, a loud motorcycle, loud hand drier (Lowes has them, too) etc.

Others react to the sounds with a variety of different sounds, especially multiple voices or loud restaurant kitchen, loud dining room, background music, and voice. Echos can be a problem. I can hear echos that few others can hear. The healthy brain can filter out or reduce the volume of the sounds that are not part of your immediate environment so you can process and understand them.

Some tricks. If there are going to be multiple voices and sounds, try to stay at the perimeter of the room, near a wall or such. Corners of a room can be good. This reduces the variety of directions the sounds can come from.

When you are trying to think, reducing the variety of sounds can help. I used to be able to drive my truck, listen to the radio, have the air conditioning blasting and read a map at the same time. Now, if I want to read a map, I need to turn off the radio and air conditioning and sometimes pull to the side of the road and stop. With those noises reduced, my brain can finally focus to read a map. (Yeah, I'm old school. I like to understand the bigger picture rather than turn by turn from a GPS).

The explanation for this is we need to "Stop to think." Stop all the distractions so the brain can focus to think. If the brain is struggling with distracting noise, there is no way to over-ride this other than to reduce the distracting noise. Once the brain has had time to heal, these distractions can be slowly reintroduced. The reintroduction of sounds process may take 12 months.

I know this issue very well. My neuro did an Auditory Evoked Potential test and told me, without knowing my struggles with sounds, "You hear everything. How do you handle that ?" The VEP showed that my brain was letting every sound get past the sensory filtering process to the conscious mind and overwhelming it. He had never seen a patient with such sensitivity to sounds.

For me and many, this is the toughest part of recovery. Give it time and use the ear plugs so you can still try to be in noisier environments.

My best to you.