So a bit over two years ago, I was hit from behind in a car accident. I thought I was fine, if maybe a bit giddy at being alive, and went to work, only getting checked out by my family gp and chiro.

Fast forward to the following week, and I woke up to severe disorientation, dizziness, nausea, and what felt like fluid trickling from my ear, and difficulty staying awake for more than an hour, among other things. I was fortunate, and they got me into an outpatient concussion clinic in a city nearby, and I went for pt, occupational, and speech therapy for about 3 months. They sent me off with assurances that I would be totally better in 3-6 months.

At about 9 months, I checked back in with them. I was still having trouble with "overdoing" it, especially at work. They sent me to the psych portion of their unit for counseling on anxiety, and how to handle it when people ask for things I can't give at that moment.

At the two year mark, I could finally say I had days where I felt almost normal. It was still a battle of up and down days, and I had a stretch of about a month where I felt like I could actually function fairly well if I watched my energy levels.

And then. Then I really overdid it, and it was as if someone had knocked me back to the 6 month recovery point. What had been a daily issue of having to watch my energy level, avoid lots of noise, and tinnitus flared back up, plus the fogginess, major irritation, and sitting at my desk praying nobody would ask me a question, because I couldn't parse what they were talking about. My concussion headaches have returned, and I'm still trying to get back to that having a good day feeling after 4 months.

So, I returned to the neurologist to try to figure out what was happening. He did a lot of "follow my finger" movements, checked my reflexes, had me walk forward and backward, and then declared there was nothing wrong with me that a neurologist could help me with. He left me with a "get more exercise, and see someone who specializes in anxiety".

Ok, so rationally I get it...he felt like I was wasting his time, and that this is anxiety driven. All I can say is that I am seriously not anxious at all, until after I feel the dreaded decline in cognition set in for several weeks. The neurologist said once you improve, you don't get worse again. I'm still chewing on this a bit, since that has been my experience since day 1, on a smaller scale...try to pile on too much social, noise, or cognitive, and be prepared to be useless in all capacities for several days.

Sorry to ramble, but I've got to admit I'm frustrated. I know I am bad at explaining what's going on with me, and feel like I missed an opportunity to have someone take another serious look at whether or not there was anything that got overlooked the first time around. I mentioned my issues with neck pain go hand in hand with the fogginess, and he said there was no relationship between neck pain and concussion.

So my questions for the community is if anyone else knows what I'm talking about? Or do I take the neurologist at his word, and pursue a psych eval and a gym membership?

Hello Karenthek: Welcome to neuroTalk! I can't really comment knowledgeably with regard to your concerns. However there are a lot of very knowledgeable members here on NT. I trust you will find the time you spend here to be of benefit. While you're here be sure & check out the stickies here at the top of the TBI forum & use the Advanced Search function to find previously posted threads related to your concerns:

https://www.neurotalk.org/search.php

My best wishes to you...

K the K,

I don't find you out of line from my experience, nor does your docs comments surprise.

I think every doc who works with concussed patients should be required to have pcs so they will stop telling us we are nuts, they can't relate at all.

I find ups and downs quite common and I have no real good explanation for an onset of a down period. Oct and Nov of 2016 I thought all was behind me and out of nowhere Dec and Jan felt like I was starting all over again with recovery after 2.75 years.

The good news is the downs aren't as deep,as long or as frequent now.

Hang in there, you are not nuts and you will see improvement.

Bud

Karen,

Welcome to NeuroTalk. Sorry to hear you are struggling. Your experience is not uncommon for people with PCS. Many ride the PCS roller coaster, often for years.

Unfortunately, your neuro is no better or worse than most neuros. He is not informed of how concussions and neck injuries are related. Up to 80% or more of concussions include a neck injury component.

If your neck is symptomatic/painful, what have you done to resolve that?

Neck injuries can cause inflammation that disrupts blood flow to the brain. They can disrupt proper sleep and breathing. A single day of overdoing it can start a progression that messes with sleep and everything just gets worse.

Hopefully, we can help you sort through this relapse. And yes, People with PCS do relapse. It can take time to learn the early signs of a relapse so we can make changes to limit the intensity of the relapse. We should be able to help you learn these issues.

My best to you.

Well, at this point my family physician has prescribed me antidepressants in response to what the neurologist said. Needless to say, I am extremely hesitant to take them, simply from the standpoint that I don't want anything else messing with my cognition! It's also a little frustrating to try to explain that you are a generally optimistic person, until going into the second week of feeling like you overdid it, and can't think straight.

Thanks for the reassurances that this is still normal. I'm with you that people have to experience it to know what it's all about, but I wouldn't wish it on anyone. In fact, I wish I didn't have anyone on this board who knew what it's like to ask!

As far as what I'm doing for my neck pain - I do the daily neck stretches from the physical therapist. I go to a yoga class weekly, and do extra stretching at home as needed. I have chiro adjustments monthly, together with a deep tissue massage that focuses on that area. I use a tens unit in between, which seems to give me some relief from the pain, and lessens the amount of tension that resides from under my shoulder blade to the back of my head. Advil is my occasional friend, but I try to limit this as it's hard on digestion and organs.

That's about all I seem to be able to do on my own to manage the neck pain. I think out of all of it the massage helps the most, but my insurance doesn't cover it, or I'd go more often. Typically after I get back to my car, my right ear (the affected side) is popping and loses the "plugged" feeling.

Since there was never any imaging done following my accident, I wonder sometimes if it would be worthwhile to have my chiro run a set on my neck, although he's experienced enough he generally is able to feel what is going on.

Is your chiro doing the Twist the head and pop the neck, adjustment ? This can be too aggressive for many. Even range of motion exercises can be a strain.

I was a mess from T-4 up. Chiro helped some but PT who uses myofacial release did the most for me. The muscles that were spasming in my upper back and neck needed to be calmed down. My chiro diagnosed TOS (Thoracic Outlet Syndrome) and sent me looking for a PT who knew how to treat TOS.

There is an X-ray set than can help. Some of us have cervical or false ribs at the bottom cervical vertebra. They can cause inflammation and spasming and TOS. I have them. Targeting them changed my life. I also did a lot of icing to reduce the inflammation. I took anti-inflammatory meds daily (enteric aspirin works great)

The most important thing was changing my sleep posture. When I sleep with good head and neck posture, I sleep better and wake refreshed. It takes months of good sleep posture for the ligaments to stabilize the vertebra. In the beginning, I spent many nights sleeping in a recliner. An adjustable bed that helps one sleep straight on their back can do the same.

My wife noticed that when I fell asleep in my recliner, my breathing improved and the expression on my face was peaceful. When I was in bed, I would have odd breathing and maybe a grimace on my face. She could tell how my day was going to be by observing my breathing and facial expression.

I finally learned how to sleep in bed in a good posture.

Hope you can find the solution to your neck.

My best to you.

Yes, my chiro uses the twist neck adjustment on me. He discontinued it for about a year after my initial TBI, and I haven't noticed anything getting worse immediately following adjustments. Usually my head feels slightly better after, but I've also been pairing it with a deep tissue massage for the past 6 months. That combination has done wonders for mental clarity, other than this recent crash and burn.

Yes, I still have the daily clumsiness, forgetfulness, and sometimes brain fog. I struggle with fatigue, and often joke that I'm living the life of an 86 year-old, because I got tired out from "Going to the Wal-Mart", and sometimes go to bed by 8 pm. The tinnitus I was told will likely never go away, and I still get the very rare vertigo, but most of the time I feel almost normal.

I will discuss options for P.T. with my doctor, and see if the chiro wants to run a cervical set. Thanks again for the advice and encouragement!

So, at my visit to the chiro yesterday, we discussed running a cervical set of x-rays. Interestingly enough, he did do some after my accident...I just don't remember having them done. At all. Not really surprising as I went to see him the day of the accident, after I got out of work.

He's going to run another set for comparison, but we decided to wait for the next time my roller coaster goes down, so that if anything is going on with vertebrae, we don't miss it because they aren't in a position that causes issues. Not sure if that even makes sense, but this is my somewhat flawed logic.

TBD, I guess. In the meantime, I'm trying to strike a better balance with social events, and give myself a bit more recovery time in between. And yes, get more exercise. Even if the neuro frustrated me, the reminder to get more walking in won't hurt me or my dog.