Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).


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Old 08-31-2017, 05:53 PM #1
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Default Fractured Skull, TBI and now PCS

Hi all,

Unfortunately, I have to register to be on this forum since my fiancee had a TBI. The incident occurred on the last day of May 2017. We kept following up with the doctor that was assigned to her at the ER ever since. My fiancee is clearly showing signs of PCS and the doctor's assistant mentioned it MULTIPLE times. They had been nice, but since her WC attorney called them regarding the degree of disability (which they never answered) they seem to be dismissing everything we say. Our most recent visit was 2 days ago and the assistant still said all those lingering symptoms are due to PCS.
When asking her to write a doctor's note for work she just said daily headaches. I told her to revise it to PCS since I want to make it clear to my fiancee's supervisor/HR, but she just brushed me off and won't change it.

They are referring us to go to a neurologist because they said they can't do anything anymore. WTF? It's been 3 months and if they knew from the start they can't treat her, why not refer us to a neurologist from the getgo?

Is this normal?
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Old 08-31-2017, 06:52 PM #2
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TBIpain,

Welcome to NeuroTalk.

What you are experiencing is quite common with WC cases. The WC protocols usually try to limit access to specialists. A generic neurologist may not be much help. You would be wise to look for a concussion clinic that takes WC cases. A Physiatrist (Physical Medicine and Rehab) may also be worthwhile. They are often more experienced with TBI's.

WC TBI/PCS cases are challenge due to the subjective nature of the complaints.

Unfortunately, most WC attorneys are lacking in full understanding of TBI issues. Check out Brain Injuries Help: Crashing of the Mind After Traumatic Brain Injury and Subtle Brain Injury Permanency from Concussion for a better understanding to help understand if the attorney is giving her all the representation she deserves and needs.

It is very difficult to get a percent disability rating with TBI/PCS. It is usually an all or nothing situation with a gradual return to work once cleared to make the try.

Depending on the state, she should qualify to change doctors to a doctor of her choosing. Call the local neuro rehab hospitals to find a Physiatrist and maybe a neuro or neuropsychologist. Concussion clinics may help but most are sports injury focused and shy away from WC cases.

Please feel free to ask us anything and tell us anything about her condition. Every question is worth asking.

My best to you.
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Old 09-01-2017, 08:11 AM #3
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Thanks for the warm welcome, Mark.

I'm in NYC. Is bone healing usually 12 weeks? I mean these past few days, she's been in a lot of pain.

Is the pain part of the healing process?

Also, the neurosurgeon said she has whiplash because of the fall. Her neck has been stiff and in pain since her injury. She uses a heat pad and I massage her, but it is only temporary relief.

We have a WC attorney right now, but we are worried that the doctor just might dismiss everything and says she okay to be back to work when she is clearly not. Can a neurologist say otherwise?

Thank you.
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Old 09-01-2017, 01:39 PM #4
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Icing should be better for her neck inflammation. Check the Vitamins sticky at the top for a recipe for making crushable/moldable ice packs at home. 15 minutes on, 30 off, then 15 on and repeat.

The skull should heal in 12 weeks but the damage to the skin layers can take much longer and leave her sensitive to contact. The injury to the brain can take much longer to heal. The healed fractured skull has little to do with her ability to work or her recovery.

Headaches from a head injury can last much longer that fractures. I have suffered for up to 6 to 9 months of recurring headaches after 2 different head impacts.

The neck is often a cause or contributor to headaches. Finding a specialist in whiplash and upper neck injuries is helpful. A Physiatrist, PT or upper cervical chiro or even an osteopath may be worthwhile. Remember, everybody has different skill levels regardless of their credentials. Most in the PCS community understand the need to find the doctor or other specialist who truly 'gets it.'

Her posture during rest and sleep is important to her neck. She needs to maintain good straight head and neck posture, 27/7. The ligaments in the upper neck take a long time to heal. Some gentle traction and light head rocking can help the upper cervical spine settle. A good PT can do this.

A neuro is not usually qualified to say whether she should return to work in this situation. The neuro will do a basic neuro exam and say she is fine. A Physiatrist will usually look at the bigger picture. If she is having any memory, cognitive or mental focus issues, a neuro psychologist is helpful.

As I said, a neuro rehab hospital or clinic is a good start. Weill Cornell and NYU Langone both look worthwhile.

I hope your attorney is one of the TBI specialists. NYC has some good ones.
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Old 09-06-2017, 12:16 PM #5
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Thanks Mark.

I am so confused as why the doctor that we've been following up with refuse to give a degree of disability when she is clearly 100% disabled for the first 3 months. The attorney's office is trying to get them to cooperate.
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Old 09-06-2017, 04:01 PM #6
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Some doctors do not like to give any disability ratings because that draws them into a legal mess. Nobody pays them to respond to attorneys' questions.

As I said, a Physiatrist would be worthwhile.

When a person is fully ambulatory and their only disabilities are neurological but do not affect motor functions, the level of disability is entirely subjective until they have a Neuro Psychological Assessment.

Her attorney should be pursuing this better. He does not sound very knowledgeable in the long term issues from brain injuries.

Did you read up on the two links I posted ? You need to be educated about how the legal system handles TBIs.
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