The Buffalo Protocol says to reduce aerobic exercise to a heart rate that does not cause headaches. Then, after 2 weeks, try increasing the heart rate by 5 to 10 bpm. If this rate can be sustained without headaches for 2 weeks, another increase can be tried. Some need to spend more than 2 weeks at the safe heart rate before increasing heart rate. The vascular structure in the brain needs to regain control over blood flow/shunting that is lost during the injury. For some, this can take quite some time.

The current goal is retraining the brain, not maintaining or improving cardio ability. That can be restored in due time. Pushing heart rate into symptom levels can have a negative impact on recovery.

Thank you, Mark. I'll let my daughter know.

Mark, my daughter wants to know the following: She gets a migraine from talking or listening to language, so does she need to work up to that also? Is it damaging her brain that she talks to me every couple of days even though it give her a migraine? She's been trying to push through it, but she wants to know if she is hurting herself by doing that.

Thank you.

Has she tracked her blood pressure to see if elevated blood pressure contributed to head aches ?

Is it any kind of talking ? Her talking or her listening ?

I don't think migraines are damaging but they may delay healing.

What is her struggle with computer screens ? Can she use them if the screen brightness is turned down ?

My daughter said:

"My blood pressure has historically been very low, and it is low every time I check it at the doctor's office, but I do not track it on a regular basis."

"My migraines are triggered by me talking, or me listening to anyone talk. Sometimes even if I am practicing a conversation in my head, if I get really into it, that can trigger a migraine too."

"I cannot look at computer screens even with the brightness turned down. They greatly bother me."

"My big problems at the moment is that nearly everything seems to trigger a migraine, including just getting out of bed to go to the bathroom, or to microwave food, and showering as well is very difficult (which I think is due to the sound of the running water)."

"Most days I lie in bed all day with my eyes closed and earplugs in, only getting up to use the bathroom or to eat. Every couple of days I do talk to my mother on the phone just to get news of the world. If I didn't have these phone breaks, I think it would be very difficult for me to keep from going crazy from the complete lack of outside stimulation. I think it is good for my psychological health to be able to talk periodically, and I just hope that it is not bad for my brain, but I really don't know. It is hard for me to strategize about how to go forward as it has been almost 1/2 a year since my last concussion and my symptoms just seem to be worsening."

"Thank you as always for your advice and input. I will try using the buffalo protocol if I can find the level of exercise that does not trigger a migraine. I would appreciate any additional advice; I am not exactly sure how to go forward right now."

Pushing through the pain will make your symptoms worse. Are you living with anyone who can care for you? Can your mom come stay with you?

Little bit of a headache is ok as long as you give yourself time to recover.

Do you see any improvement after the migraine cycles end? Say talking for 5 minutes gives you a headache, then you rest a few days. Then can you talk for 6 minutes before getting another migraine?

Improvements may seem miniscule but as long as you keep making tiny gains you will get better.

Salt and electrolytes will help your blood pressure. I drank a cup of Pedialyte every morning and that helped lessen my dizziness.

I can relate to everything you're saying- the sensitivity to talking, listening, evening thinking. So this edvice comes from my own experience:

1. Hire a caregiver. The amount of care you need may be more than one family member can handle.
2. Get a hospital style bed so you can sit up at meal times. Have the caregiver serve you meals in bed.
3. If going to the bathroom aggravates your head, then use a bed pan.
4. Get sponge baths instead of a shower. You can use a waterless body wash. To wash your private areas, place an absorbant pad under you, wash with regular soap, then pour warm water to rinse. The pad will absorb quite a bit of water. Your hair can be washed in the same manner.
5. Get a wireless doorbell to use as a call bell.
6. If taking fish oil, then monitor your blood pressure because fish oil lowers bp which can cause other symptoms.
7. Ear plugs can cause earwax impactions. See my ealier post.

Your brain will heal if you give it a chance to heal. Eliminating trips to the bathroom and the kitchen will give your brain a better chance.

For an explanation on why you should adopt this approach, see my posts at the end of this thread:
Any theory, explanation or treatment for dizziness/vertigo/nausea?

These are quite extreme.
These may have helped you but for many, they just increase stress levels, such as the stress of fighting with a bed pan. The bed ridden concept creates more risks such as DVT's. If someone is bed ridden, they need to be medicated to prevent DVT's. A simple solution is 325 mgs of aspirin, enteric is OK, twice a day. Fish oil also thins the blood so it can help with DVT's.

Ear plugs rarely cause ear wax impaction. There are simple ways to resolve or prevent this.

JudyAnn's daughter needs to find a way to get gentle brain stimulation to encourage good blood flow. She also needs to have normal sleep patterns to get all of the sleep stages. lt does not sound like she struggles to walk to the bathroom. Some sense of normalcy is good. Most important, she needs to find someone who can understand her symptoms and give her some help to move forward. Third person advice is very problematic because we cannot get the full picture. .

Being in bed all day with PCS is a tough situation. But you have to slowly start moving around and some medicines may help. At least for me it worked since I was in that situation where every movement made my condition worse.

I even feel that way severely at times but it passes. I still have symptoms at some level everyday.

One thing helps me during initial stages a lot is Xanax. I don't advice on Benzos but it can help your brain to stay calm and you can start moving around and before you get used you can quit and take only on a needed basis.

Just a thought.

My daughter wanted me to post the following:

"Thank you everyone for all of your advice. It is hard to know exactly where to start, but I am just going to try to rest as long as possible and my psychiatrist is putting me on Depakote, so we will see if that helps with the migraines. If that doesn't work, she is going to try me on Zyprexa next time we meet.

Thanks again, I'll let you know how it goes."