Hi Guys,

I've been "lurking" for about 4 months now, but now I'm in a bad situation and need help. I trust the expertise of the people here more than any doctor I've been to. I live in WA state, which imo, has the worst medical system of anywhere in the country. To give a few examples, I've been told to my face by a neurology specialist (harborview) that xanax "has no side effects" and no withdrawl effects(!). I filed a complaint against him and the staff told me that no one reads the complaints. When I went to (highline) for my first concussion after I was involved in an accident, I was told by the ER doctor that I wasn't actually injured, that I was just a drug addict (I absolutely am not) because I was extremely pale and shaking. They discharged me with no paperwork and my husband found me face down in the parking lot an hour later. I am not even kidding, and I have dozens of similar stories.

Since my first accident I've had 3 more concussions over the last 5 months, ranging from things like hitting my head (pretty hard) on a desk when I was picking something up, another time on a door, and once when the shocks went out in the car for half an hour (it was extremely bumping/jolting in a 1.5 ton truck). I have pretty bad PCS and I can throw up if I move my head a little too fast. I have a lot of the same problems that mark in idaho has actually, that's what started me reading this forum. The main symptoms I have are cognitive problems, I still can't work, my memory is totally shot, and a lot of dizziness and nausea. After my second concussion I became highly intolerant to medications. I was taking meclizine for a while, but now taking it makes me really sick.

So last month I took a trip to AZ to visit my family. The day I got here, that's the day I got my fourth concussion. That night I was almost nonverbal. I was muttering jibberish for hours and throwing up. I don't have a lot of memory of that night really. It took me 2 days before I could get out of bed and be on my feet again. My mom drove me to a hotel and I've been stuck there almost 3 weeks now, mostly relying on people to bring me food. My husband came and stayed with me for a while and bought groceries. When I'm in a car for even a few minutes I'll start getting dizzy and nauseous so I haven't been able to travel. I've been so scared of getting a fifth concussion that I haven't left the room.

I was planning on flying back to seattle this saturday, thinking I should be recovered enough by then, but just yesterday around noon, I twisted my head a little too fast, a few times actually. Ever since then all my symptoms have come back with a vengence, the dizziness, the nausea. I only actually threw up once though. Even writing this post is making me physically sick, but I have to get help somehow. But now I'm running out of money and I'm running out of my medications. I only have enough of my medication to last me until maybe tuesday if I hold out.

I'm scared to death, but I don't know what to do. Should I take the risk and fly (about 3 1/2 hours)? I'm scared about the turbulence, landing, and takeoff most of all. If I get another concussion mid flight, with no way to control or stop the aircraft shaking, I don't even know what I'm going to do. Does anyone have any advice? A lot of the people here have been dealing with similar things to me and I trust your guys input more than anyone. Thanks in advance, sorry for the long post and all that. Should I take the risk and fly? Will it give me another concussion? Is there anything I can do?

The one thing that I can think of that could help would be high dose fish oil. Specifically Dr. Lewis' protocol.

BHERI | The Omega-3 Protocol for Brain Health

Personally, I saw results right away. I also have this head sensitivity to movements. It does get better with time, but concussions need to be avoided.

Small movements and most bumps to the head are not concussions, BUT they can cause similar symptoms than a concussion from a chemical cascade.

Hope this is helpful!

-Jake

foxyproxy,

You will not get a concussion from turbulence flying in a plane unless you were flung out of your seat into a hard object. The G forces to cause a concussion would tear the wings off the plane. But, if turbulence causes anxiety, your symptoms may come charging back.

So, a xanax before the flight may be worthwhile. An occasional xanax is not addictive. High dose xanax for a continuous period can be. There are other anti-anxiety meds you can try. But, it you need a maintenance med for anxiety, an SSRI or SNRI or such may be better.

If there is a late night flight or early morning flight, they are much less prone to turbulence. Try to fly during the dark.

I'm concerned that you may have trained your brain to react to any bump like it is a concussion. If you have an inner ear disorder, the head turning can cause symptoms that trigger your anxiety and and trigger your memorized concussion-like symptoms.

A neuro-rehab specialist I know says this memorized symptom phenomenon can be very convincing.

I can easily fly, even in turbulence. My problem flying is visual claustrophobia. I need a bulkhead seat so I do not have a seat back 8 inches from my face. My problem is basically a visual over-stimulation issue. I only have a problem with prolonged vibration and jerking, more that a minute or two of continuous serious vibration and jerking. So, I stay off shaky wooden roller coasters and avoid long drives on potholed roads. If I tilt my shoulders forward, I can increase my tolerance by reducing the movement to my head.

You would be shocked to hear how often I bump my head. I smacked my forehead and face into a solid tree branch on Tuesday. Ouch. Bruised my eye brow and smashed my glasses. But, I just go on. I don't worry about the outcome. If I get a metallic taste in my mouth or a moment of dazed feeling or vision disturbance, I will take it easy for a while. If I do not have any of those symptoms, I just go on.

But, I think you need to get home. Isolation is not good. I think a late night flight would be fine but, you can take Amtrak from Flagstaff to Seattle. The Coast Starlight is supposed to be a nice train ride. The rails are smooth so no clackety clack to worry about. There are buses to Flagstaff.

Guys, thank you so much for the quick responses!

JBuck - I have been taking fish oil the past few months, but not in that high dose. I'll try to take a few tonight, and take a higher dose tomorrow and the next few days. I'll take anything at this point to help. Thanks for the link!

Mark - After reading a lot of posts, I too thought that maybe the problem was a PTSD/anxiety neurological response to that kind of stimuli, but I've kind of ruled it out. I have actually done some research on neuroplasticity and I've learned a bit about how certain receptors, through continued use, can hijack other parts of your brain to perpetuate similar problems (like pain, dizziness, or whatever) so that it feels like it's a similar situation even during normal functions, or during a trigger. So I understand what you're saying. The last time a few weeks back when I got my fourth concussion, I was slurring words, my pupils were dilated, I was throwing up, I was really messed up for at least 2 solid weeks...typically not just anxiety stuff lol Even today I've been basically bedridden, typing this response message is the first time I've gotten up since I wrote that last post.

I don't normally take benzos or anything like that, but I do have a few klonopin and I experimented the past few days to see that if I was sedated whether some of my symptoms would go away. Unfortunately none of them have...although, I guess I was relaxed to feel "better" about it. I had to take a phone call an hour ago, after 5 minutes of the call, I was dizzy, my head was pounding, nausea, blurred vision...do you think these could be part of a "memorized symptom phenomena"?

I had an MRI done last month (of course they found nothing), but the girl at the concussion rehab center thinks that my brain is extremely sensitive to stimuli of any kind. Even a tiny sip of caffeine has the impact to me of someone drinking a pot of coffee. I can't even take an SSRI since it will immediately give me serotonin toxicity syndrome (I was in ICU because of that once). I joke that I should be in a medical textbook...and then I have a good cry.

I trust your judgement about these kinds of things, if you think it's safe. I have no problems dealing with headaches, pain, nausea, or whatever. My only concern is "will this cause me another concussion". Temporary setbacks I can deal with, it's more brain damage that I'm scared about. I know for sure I have whiplash as well, so I'm thinking about getting a neck brace to be safe.

As an aside, I saw this today, maybe it's been shared on this forum before ** without the spaces. They're developing a collar that supposedly will increase the blood in your brain, to give your brain slightly more cushion from rocking around as much I wish this was something I could hurry up and buy already

Foxy,

I'm an airplane guy.

You won't get a concussion from flight. There is one thing you can do to help insure that, keep your seatbelt on with the exception of the restroom.

As Mark correctly says from his piloting experience night time is typically much calmer air.

Planes are designed to be structurally safe and perfectly at home in turbulent environments.

I have taken some pretty good knocks to the head since my accident and am no worse for the wear. Learning to deal with the resultant anxiety from a normal life hit to the head is a chore but must be done so you can carry on.

You can do this, can your husband or mom ride with you on the flight?

Sincerely,

Bud

When I read the totality of your posts, it appears you are very focused on even minor issues.

All of your symptoms can be caused by anxiety. You sound detail oriented in a way that is common to intelligent people. The combination of focus on details and intelligence makes even very minor PCS symptoms much worse. As that brain tries to make sense and struggles to do so, anxiety levels increase. They may not manifest as common anxiety but rather a sort of obsession of thoughts about 'what is going on.' This can be exhausting and the stress can cause increased symptoms levels.

I used to have thought overload, not about trying to understand my symptoms, but rather, my mind would get stuck and overwhelmed in repetitive mundane thoughts. It would take me a few days to recover.

You could do some assessment on your own with a home blood pressure kit. If your symptoms parallel an increase in blood pressure, that could be a indicator of anxiety. I have Klonopin and propranolol (beta blocker) for such events, depending on the trigger. I prefer the propranolol as it does not make me drowsy.

Your caffeine sensitivity suggests possible anxiety since caffeine increases anxiety.

Have you ever had any hormone or neurotransmitter testing done ? Adrenaline, cortisol, the sex hormones, thyroid, GABA, etc. You could have an overactive response in those areas. I struggle with adrenal cortical hyperfunction.

Are you taking any supplements ?

What do you do to moderate over-stimulation ?

btw, I can be overstimulated by phone calls, especially if it is an animated conversation. I also know what serotonin syndrome is because I lived with a mild case for 14 years from max dose SSRI's.

Time to take my gabapentin so my system will settle down so I can get to sleep in a couple hours from now.

My best to you.

Bud - I can't fly with anyone unfortunately, they're both out of town now, but the anxiety alone isn't really a big deal for me, even though I guess it seems like it. I'm hearing from a few people now that I probably wont get another concussion, this is reassuring and I do appreciate you guys taking the time to help me.

Mark - I have tried gabapentin and propranolol in the past. I have fairly low blood pressure so propranolol makes me feint and I had to stop taking it. When I saw my last concussion/pcs specialist (who is also pretty useless), she ordered a series of tests, so I did a thyroid and hormone test, both came back normal. I haven't tried a GABA test, I actually didn't know that was a thing, although if I had to guess it would be *very* low. Same with cortisol, I assume that would be pretty high. Maybe I can check those out.

I used to have a pretty bad panic disorder, I've been able to beat a lot of it over the years, through a LOT of work. It's still wrecked my brain, even if the symptoms have diminished. They say that people with underlying neurological conditions are much more likely to develop PCS than "normal" people. I think that's why I'm now 5 months with little relief. The only medication I'm taking right now is lamictal, which helps a little, and it's pretty safe.

One thing that stuck with me that an old psychiatrist told me years ago was that with anxiety disorders people's brains will change to focus on things like laser beams. It's not to say that symptoms are just "all in your head", but rather your brain will amplify symptoms 10x or sometimes 100x the typical effect. So you DO experience things in a way that's heightened significantly. It's possible that this is what's been happening to me.

Let me ask one final question that would really help me out in a lot of situations. If I do something like move my head too fast or over exert myself, and I'm suddenly feeling exhausted, dizzy, throwing up, confused (sometimes I forget where I am), or any of these other symptoms.

My biggest fear is not that these incidents happen, but that the effects will last for days, sometimes weeks (like in this case). When they last this long, it feels like I've really done serious damage, as everything I read suggests that I should not be experiencing these symptoms for more than an afternoon, or a day at worst. Is this a sign of further brain damage? How should I be thinking about these kinds of episodes? Is this just in my head or do I inadvertently cause real damage?

Thanks you guys, this means so much to me.

I don't think your events, even when prolonged, likely cause physiological damage. But, they do establish neural habits. You sound like you can get that laser focus on your symptoms with little provocation. Have you tried CBT (Cognitive Behavior Therapy) ?

Lamictal acts by enhancing GABA.

In my view, propranolol should not be taken as a maintenance drug unless you constantly have high BP which you don't. But, it is can be very effective as a rescue drug to settle things down. That is why having a BP home kit is important.

Regarding CBT, It could also be combined with some facts. Nausea and some of your other worst symptoms can be caused by anxiety and/or a concussion. But, if your nausea was caused by a concussion, it would be a sign that your brain had suffered a serious trauma and the other symptoms would make it so you would not be able to put such organized thoughts together as you have.

Concussion nausea would be combined with mental confusion and a reduced ability to focus cognitively.

Anxiety nausea would be combined with heightened focus on symptoms and a strong desire to understand them and an ability to communicate about those symptoms.

Word finding and similar struggles can be anxiety and even depression so they do not necessarily point to brain injury.

How much time do you spend each day online or with a smart phone ?

What can you do to be active in ways that distract your mind ?

Mark - you're right in that I'm not having the same kind of cognitive problems right now that I used to. After my first few concussions, when I was in the ER, I couldn't read. Words on a page wouldn't make sense and it was really...frustrating to say the least. Like I knew what a word was, but when I read a sentence I wouldn't understand what the sentence was trying to say. The day or so after my first concussion when I was in an accident, I tried to email my boss. I knew that I wanted to tell him that I was in an accident, but the email didn't make any sense. Even now sometimes I mix up words when I'm speaking out loud, but it's less frequent. Now it usually only happens if I'm totally mentally exhausted. I can tell when that happens, I'll have to stop whatever I'm doing and lay down with my eyes closed for an hour or so, even if it's mid conversation.

After my injury 3 weeks ago, I couldn't make verbal sentences either, I was just muttering nonsense. In my head I wasn't sure what I was trying to say, but memory of that day is spotty at best. Even still, it wasn't as bad as my first two concussions.

It's still a little easier for me to write things than speak them, since I can re-read a few times through what I'm trying to communicate and make sure it comes across right. But yes, right now I'm not having serious cognitive problems, the past 3 days or so it's been mostly dizziness, nausea, and pretty bad fatigue. Typing things like this or looking at a screen or watching a movie makes my head hurt so I can't do it for very long.

I used to work as a programmer, so I guess I used to spend a lot of time online lol After my first few concussions, I would look at code that I had written in the past and it wouldn't make sense to me. Like I might be able to understand bits and pieces, but the big picture of what I was trying to do wouldn't make sense and I would get frustrated. Right now I can do some things, it's gotten a little better as the months have gone on, but I can't focus on a project for more than an hour or so before I have to lay down for a while, usually for several hours. Sometimes I can get up and do another hour of work before it relapses.

The past two days I've been mostly laying in a dark room listening to an audiobook and occasionally checking and replying to emails (and this forum). I have done CBTI courses in the past, but I don't think the girl running the program knew what she was doing. I would be interested in trying that again.

I think that my brain (or people maybe in my situation) does exacerbate symptoms. So maybe it's a little of both, while I'm still dealing with PCS and the fact that my brain is so sensitive that my brain is amplifying the effects that I get when triggered, even only slightly. I think I'm going to try to fly out tomorrow, I'm going to take a klonopin on the uber over to try to dull those neurons. If I get to the airport and have a total collapse then I'll have to get back to the hotel and try again in a week or two, but I think it's worth the shot.

BTW: The book I've been listening to is called "The brain's way of healing", it's on neuroplasticity, some of you out there might be familiar with it. I think it's pretty good so far. It's given me some hope that maybe I can eventually re-wire my brain to recover from this, or at least reduce a lot of the symptoms...which in the end, is what really matters.

Personally, I would not be reading or listening to neuro books. You need to find a distraction. Norman Doidge takes the extreme cases with miraculous results and tries to make them sound normal. He sells books but he also causes a lot of anxiety as people struggle to get the same results.

The brain heals best when it is stress free. That means no anxiety or angst or pushing to a setback. If you do projects but collapse at a hour or so, you need to learn to recognize the early signs of fatigue and stop at those first signs. You should not be pushing into fatigue. That will keep you on the roller coaster. I had 3 or 4 tasks i could switch between as I sensed fatigue coming on. Each used a different combination of senses and processing.

A short break between these tasks switches can do wonders. I used to build computers from scratch and had no problem keeping track of the many different settings and connections. But, I now have serious struggles with process thinking and memory. If I were to try to do the same tasks, I would need to use a totally different mental process. No relying on memory or expecting quick understanding. That was the old me but not the new me. I need to make notes and follow visual instructions.

In high school, I was a math wiz until a concussion in 10th grade. I could still do the math but it took hard work. I regained some ability but if I tried to push, I would crash hard. I struggled miserably with E&M Physics because it requires process thinking. But, I was an honor student... Why was I struggling so ? If I knew then what I know now, I would have approached these tasks differently and done much better.

Despite what Norman Doidge says, the injured brain cannot push through. The success stories he mentions took months of slow patient moderated effort.

Plus, he never really addresses the chemistry and such that can be disrupted and need assistance. Neuro-fibrillary tangles appear to have a genetic weakness in some.

Various members of NT were told by their doctors to stop reading about brains and just go slower. Most finally started doing much better. Their struggles were similar to yours.

Find something to do with your hands that does not require serious thought. Give your brain a rest while still stimulating good brain blood flow. Crafts can help. Playing solitaire with real cards. The hands cannot move any faster than an injured brain can follow. But, moving hands will keep the brain occupied.

Have a good flight. Take hearing protections and know you can close your eyes to limit stimulation.

My best to you.