I hadn't bought a heart rate monitor when I posted this thread, but I suppose the anxiety could have elevated it to pretty high when walking. I think it's mostly the fear of doing something that will set me back that triggers the anxiety.

I'll do the Buffalo protocol test tonight, and if all goes well I should have a sturdy indicator of what my body can actually handle (unless the anxiety caps my performance and introduces symptoms earlier, of course). Then I should be able to feel more comfortable in exercising below the threshold I come up with.

Did you do the Buffalo protocol thing?

I don't think one can self-administer a Buffalo Protocol test accurately, especially if one is experiencing problems with anxiety. The usual threshold for exertion is based on headaches and dizziness, not a sense of fatigue.

I think everybody should have a home blood pressure system, either wrist or upper arm style. They are only $30 to $40 US. A PulseOx finger tip monitor can also be useful to check just pulse, without BP. Learning to relax to lower pulse and BP is an important skill, especially with PCS and anxiety.

I never did look into or read about the Buffalo Protocal.

I sort of felt my way through the whole recovery, and did a lot of praying looking for guidance.

I know I will never really understand what and why things happened the way they did, it took the better part of two full years before I could return to any consistent exercise without debilitating symptoms, I'm just glad it's over for the most part.

Bud

You'd be right in the accurately-part, but I achieved something that at least resembled the Buffalo Protocol test the other day. I actually found that I could raise my heart rate higher than I'd thought possible, without symptoms returning. After getting up to about 172 (without concious experience of significant symptom increase, the Buffalo Protocol sets the bar at an increase of 3 points of symptoms on a scale of 1-10), I stopped the test and sat down to cool off. The rest of the evening I felt some symptoms returning in a way that felt very real but that could of course have been the anxiety. Anyway, I've used a cross trainer to get my pulse up to 80% of 172, and I use that value as a point at which symptoms returned. Then I've stayed around that heart rate for 6-7 minutes. No symptoms returning, and I feel like such an increase in heart rate could be beneficial for my excretion of BDNF and thus synaptogenesis and therefore restructuring of my brain.

(I got the idea from this study, and even though it's only a preliminary one it provides some guidelines to how one can approach cardio exercise with PCS. I've also read a bunch about white matter density improvements from cardio which should be relevant for us, but BDNF is the main thing I'm after. A preliminary study of subsymptom threshold exercise training for refractory post-concussion syndrome. - PubMed - NCBI)

I'm glad to hear that. Finding a beam of support to lean on mentally seems to be key for recovery and though I'm not religious I'm trying my best with rigorous meditation practice. I've never seen myself as an anxious person but I'm realizing that I've been carrying a lot more anxiety than I thought I did, and now I don't have the resources to ignore it in the same way I used to.

I used to do a lot of weightlifting before I hit my head but I remember reading something Mark said about heavy lifting secreting chemicals in the brain that impairs our recovery. I feel like it will take some time before I can lift again but I'll ever so slowly try to ramp up the cardio to my best ability to get myself the best conditions for recovery.

Took me 2.5 years before I could start lifting at the levels I did prior to my accident.

I did a lot of light and less reps for close to a year before I was up and running again. I still pay for some lifts but i accept the trade as worth it, sort of like a sore muscle.

Don't be in a hurry, pay attention to your body, don't be afraid to take a break from activity or certain activities and don't quit, you will find your way back.

Bud

Walking has helped me a lot, it promotes blood circulation and is good for anxiety. It can be hard to judge how much to do, you have to feel your way a little. I would say an hour is good going, instead of increasing the time you could start to increase the pace for a portion of the walk. If you get any symptoms you can take a day off.