Hi there,

I've been checking in with these forums for ages and thought I'd make a post myself. I'm a 26yo male.

I was knocked out briefly (few seconds) playing Australian Rules Football. I jumped up to mark a ball, and as I came down a knee caught the right side of my head, and I was knocked out when the back of my head made contact with the ground. My head bounced when I hit the ground in a whiplash kind of way.

I haven't been well ever since. My major symptom is brain fog. I feel this persistent fog that never alleviates. It's hard to separate the fog from fatigue, but I'm always tired, and I tire quickly from activities. I also get nauseous, have difficulties concentrating and remembering, and get headaches and migraines (though these are manageable compared to the fog).

Prior to the accident I was studying a law degree and was very active. I also worked part time. All these endeavours have come to a grinding halt.

My GP and Neurologist have trialled many medications with me. From the studies I've read, and my own experience, I don't believe that these are beneficial for PCS. I've tried a number of anti-depressants and beta-blockers but I haven't found anything helpful. For the last two weeks I have been taking sleeping pills to better regulate my sleep but this is not a long-term thing.

My current treatment regime is as follows:

Following the Buffalo Concussion Treadmill Test Protocol. This is 6 days/week of sub threshold intensity cardio with regular reviews. I think this is the most promising of all my treatment avenues. I have had a high resting HR since hitting my head, which greatly increases with exercise. I've been following this protocol for the past month and I'm finding improvements to my HR.

Prism glasses and vision therapy. I have had poor eye coordination since the accident as well as a peripheral vision loss in the left eye. I was prescribed training prism glasses to help with reading 3 months ago. With the glasses I have been able to do some reading which I wasn't before. At my review, wearing the glasses had lead to a noticeable improvement in eye coordination/tracking. I will begin Vision Therapy next week.

Neck physiotherapy. I think a portion of my fogginess comes from the damage the whiplash motion caused to my neck. I've read a number of studies that indicate that a neck injury alone can lead to PCS, i.e. the same collection of symptoms. The physiotherapy has been helpful but I now need to work on strengthening the neck muscles for sustainable posture improvements.

Cognitive behavioural therapy. I had never spoken to a psychologist before this accident. I have a number of high standards which I set myself, that have become unobtainable with the concussion. This naturally brings my mood down so I'm trying to have a more healthy relationship with the standards to better cope with PCS.

Occupational therapy - which has mainly been around planning my weeks.

So it's a fairly comprehensive treatment plan that I'm going through. I see these areas as very important for my recovery.

My guiding principal at the moment is around de-conditioning. Over the last year I have had days/weeks of rest believing that this was the best thing for my concussion. As a result I think being de-conditioned from life is my number 1 encumbrance. As I'm not used to driving, socialising, working, studying, etc jolts of such activities make me very tired. I try and reintroduce these things where I can but this is a difficult task to balance, and I constantly hit set-backs where I've tried to do too much.

For all of the above though, I'm just as symptomatic as I've ever been.

I'd appreciate any feedback/suggestions on my approach. There seems to be a wealth of knowledge in these forums.

I have seen a number of suggestion in the forum which I have never seen in a study or heard from any of my specialists.

One is coffee consumption - I drink 3-4 cups/day. I trialled dropping this to 2 and
maybe noticed slight improvement but haven't managed to maintain it.

I have a low carb diet - I haven't found a link between this diet and PCS.

Vitamin regime. This seems to be very important within the forum. The lists of things a lot of members are taking is very overwhelming to me. I don't like the idea of is taking a long list of vitamins, finding an improvement, and then feeling as though I need to take 10 supplements forever, when maybe there was a specific one that helped. I'd really appreciate a methodology for introducing some key vitamins in a scientific way, where the outcome can be monitored.

Screen time. My number one biggest hobby is TV/Movies. I watch SO many. I have cut this back because I physically can't watch as much as what I once did. Early on I cut all screen time but didn't really notice a benefit. But still, the combination of TV/Movies/iPhone/iPad/Computer usage would be very significant every day. I see this area as a conditioning one. If there's a TV show I know and I watch an episode at home I will be fine. But one time I went to the movies and watched Mad Max and was sick all week. One task I'm conditioned too the other I'm not.

Masturbating/porn. This is embarrassing to ask but there are many posts on here regarding it. Is it genuinely detrimental to recovery? If so, what is a realistic approach to take.

Thanks for reading. I'd appreciate any tips/suggestions.

Also I'm a bit nervous about having my medical information so available. Is there anyway to hide my post from search engines etc?

As long as you don't post identifying information or details you should be fine..
But the forum is public and visible to search engines.

lbpc,

Welcome to NeuroTalk. As long as you use an anonymous screen name, your medical information should be OK. Just don't use the same screen name in other online forums and such where it can be tied to your real name.

It is unfortunate you feel so averse to the vitamin regimen. It is not a drug regimen. Most are things that are in a good diet but may be hard to get in adequate amounts. One does not need 10 vitamins/supplements to see improvements. There are some basics, B-12, a B-50 Complex, D-3, and fish oil are a good start.

Think of the regimen as a form of nutritional exercise conditioning. We exercise because we don't usually have enough physical activity in our daily life. The vitamin regimen is because we do not have adequate nutrition in our diets.

The injured brain has physiological struggles that increase the need for these supplements. A common brain injury due to concussion is Diffuse Axonal Injury. The basic regimen helps the brain rebuild the myelin sheath that insulates the axons so they work properly.

Getting sleep without sleep meds is important. Sleep meds can disrupt the sleep stages. A Magnesium supplement can help in place of drugs. Proper sleep stages are very important. The Slow wave sleep stage is when the brain flushes toxins. REM stage is when the brain consolidates memories.

Caffeine can make sleep a struggle so coffee after 12 noon should be avoided. Caffeine is an exicto-toxin. It causes toxic stress on brain cells.

Sleep, especially proper sleep with proper breathing is key to combating brain fog. Upper neck injuries can cause inflammation at the brain stem that can disrupt blood flow and proper breathing function, especially during sleep.

I found the most important part of neck healing is good posture during sleep and resting.

Regarding deconditioning. It can be helpful to engage in short periods of the avoided activity then remove yourself from the stimulus. These short challenges can slowly be increased in time. Understanding what part of each activity cause stress can be helpful. Sounds, light, voices, etc are common triggers of fatigue.

My best to you.

(Reposted with product names instead of links)

Hi Mark, thank you so much for you comprehensive response.

I have become a little averse to the vitamin regimen as I'm not an expert, and haven't had great success with it to date.

One specialist recommended I take Vitamin D and a Fish Oil. Specifically these two:

Caruso's Natural Health Ultra Max Vitamin D3 1,000IU

BioCeuticals UltraClean EPA/DHA Plus

I took these for months and didn't notice a symptom change.

I was then recommended a nighttime magnesium:

BioCeuticals Ultra Muscleze Night

I think over an extended period the magnesium might have been helpful. However, it gave me incredibly vivid dream/nightmares, which I found outweighed the benefit.

I switched to this magnesium because I could take it in the day but the taste was horrendous:

BioCeuticals Ultra Muscleze Energy


My neurologist recommended 400mg Vitamin B2. I was taking this but there was a dosage issue as this is only 100mg:

Nature's Own Vitamin B2 100mg

I was then recommended curcumin, brahmi and ginkgo biloba as found in these:

Blackmores Brain Active

Nature's Own Focus & Perform

All of these showed no improvements but I didn't take it in a controlled way - (i.e. I had so many other variables changing at the same time).

Finally, I was recommended this B complex (I have it but haven't taken it yet):

BioCeuticals Mega B Q10

The only other thing I have done is research the magnesium and was thinking of changing to one of these three:

Nature's Own Magnesium Chelate 500mg

Doctor's Best Magnesium Chelated

Neutralife Magnesium Chelate

Sorry for so many links but I didn't know how else to get you the information.

Right now, from a medication stand point, I'm almost down to nothing so it would be a good time to introduce a vitamin regimen.

Your recommendation is to start with B-12, B-50 Complex, D-3, Fish Oil, and Magnesium. I can order from the iherb.com if that is familiar to you, alternatively I can get any of the products in the links (so if that vitamin D or fish oil, etc is suitable I can easily get that). Could you give me any recommendations on exactly what to take now, in what dosage, and how you would recommend monitoring the vitamins and assessing the benefit?

Part of a vitamin/supplement plan is to assess your diet.
Mainly weed out any junk foods & drinks, excess sugar/treats/desserts..

It sounds like your specialist is selling you expensive supplements. You don't need such expensive supplements. BioCeuticals are outrageously expensive.

1000 mcgs of methylcobalamin B-12
1000 mgs or more of D-3
a single B-50 Complex
a magnesium or calcium-mag combo. Not mag oxide. Mag citrate is fine.
any fish oil with decent EPA/DHA

Adding the common anti-oxidants will help (C and E). Oxidative stress is rough on a struggling brain. 1000 mgs of C twice a day is good. Some take twice that. 400 iu of E.

No need for fancy or expensive brands.

It is far more important to get started and stay consistent that hesitate while looking for the best (if there is even such a thing). The issue is more about avoid the junk than finding the best researched and likely overly hyped.

I wonder why your specialist omitted a good B-12 dose ? Maybe he is more focused on selling his products than getting you what you need. The things you took were limited in value without a B-12 and B-50 Complex foundation.

Why do you buy a supplement but delay taking it ?

Watching porn will exacerbate your symptoms. It is best not to masturbate at all but at the very least cut back and don't fantasize. Check out these guidelines:

Rebooting Basics: Start Here | Your Brain On Porn
Tools For Change: Recovery from Porn Addiction | Your Brain On Porn

Really interesting reading Drew - I never new any of that. I've cut P and will reduce M. Was pretty shocking to see brain fog as a symptom associated with it, as it is my worst symptom.

Mark thank you so much for all the advice.

I try and do a controlled test wherever possible. I had a fairly drastic medication change when I purchased one lot of supplements and decided to delay taking them otherwise it would be hard to judge what is helping/hindering.

I made a big list of your recommendations, and my specialists' recommendations. I found somebody I could go and discuss this with locally and purchased some vitamins - unfortunately their supplements were a little expensive, but now I have a better understanding, I will just order online.

This is my regime, for reference I have an at home treadmill, and I normally wake up and do my 20 minutes of subthreshold cardio. After the exercise (fasted) I take:

2 x Magnesium chelate 500mg
1 x Activated Sublingual B12 1000mcg

With Breakfast I take:
1 x Vitamin D3 1000IU
1 x Vitamin E 500IU
2 x Vitamin C 500mg
1 x triple strength omega 3 (EPA 540mg, DHA 360mg, Omega-3 triglycerides 900mg)

With Dinner
2 x Vitamin C 500mg
1 x triple strength omega 3 (EPA 540mg, DHA 360mg, Omega-3 triglycerides 900mg)

I could not find a B-50 Complex anywhere locally. I purchased Nature's Way B-50 complex online so I hope that's okay. When it arrives I will probably add it to the morning fasted regime.

Am I on the right track or any glaring issues? I'm particularly confused with the timing of when to take them during the day and whether it should be with food.

Thanks again for the excellent advice.

Your regimen looks good. The changes will be long term and hard to track. Think of weeks before you may say, " Ah ha, I have not noticed xyz symptom in a few weeks."

Getting good sleep is important. It is when your brain heals.