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


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Old 11-09-2017, 11:56 PM #1
cmer cmer is offline
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Default Mild head impacts while recovering from PCS

I’m new to posting in this forum btw, but not new to reading it. Thanks to whomever created it. It has been very helpful. I’m posting because no one (that I can find) has talked about the importance of avoiding additional impacts to the head. So this post is perhaps part anxiety, part science - when your brain is in a weakened state, what sorts of impacts can really cause additional damage? What can’t? What warrants the stress you’re feeling and what doesn’t?

I’ve been recovering from a concussion (that I experienced while playing two-hand-touch football) and a mild second impact (while surfing 2 weeks later - very lucky it wasn’t worse, but also had very poor advice from my doctor aka no advice to avoid activity) for 7 months now. It’s been a rough recovery. Ups and downs, but I’ve had some good support along the way which has been very helpful. I have seen multiple neurologists to talk over my symptoms, have received tons of recommendations including some contradicting ones, and have had an MRI and a CT scan which came up clear. I am now exercising more again, and doing physical therapy and cranio sacral therapy which seems to be helping the most.

I’ve bonked my head a few times during this recovery - I just can’t seem to be able to avoid it - the best I can do to be aware of my head just doesn't seem to be good enough. One while swimming (I swam into a wall while doing the backstroke), and one while looking at a book in the library while not paying attention while leaning forward where I hit my forehead on the shelf. Both of those brought increased symptoms, but this time feels quite different. This time I was feeling almost symptom free for 2-3 weeks beforehand. This time I was installing a propane tank after cleaning our grill, messing with the propane valve while kneeling, when I stood up quickly and bonked the top of my head on a piece of metal on the bottom of an outdoor hot water heater box (which when I touched it just a few minutes ago it does not give). I was feeling light headed the night that it happened but I was also pretty hungry. A day and a half later i was on a walk, and I started feeling symptoms I haven’t felt for 2-3 months. I was feeling moments of dizziness again/vertigo, and general dizziness by the end of the walk. Today, a day later, I am feeling more brain-moving sensations and throbbing (some of the many symptoms I’ve felt over the past few months), and a massive headache that I’ve had for the past day in a half (but luckily just went away this morning). I’ve had no return of feeling confused, dazed or any other form of mental incapacity that I can recognize though.

My question is - can something like this, this far into recovery, actually cause a mild concussion where it prolongs my recovery or makes it worse, doing more damage? Or is it simply a manifestation of symptoms again - maybe something similar to PTSD or something from the original event that is causing me to be so afraid of hitting my head again? Granted I just bonked my head much harder than I did swimming and I do have a return of symptoms, but I’m also anxious and stressed about it. Looking at it logically, I do feel like the G-forces to my head a few days ago could not have been even in the mild concussive range and there’s no way I could have actually done any real damage that warrants a return of symptoms, but it doesn't change the fact that I am feeling symptoms again. So is it really possible that I did even more damage like I am imagining or is this just part of the ups and downs of recovery?
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Old 11-10-2017, 01:28 AM #2
Mark in Idaho Mark in Idaho is offline
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Mark in Idaho Mark in Idaho is offline
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cmer,

Welcome to NeuroTalk.

Your experience is quite common. People with PCS tend to become overly sensitive to the times that their head make contact with an object. Very few of these bumps are of even a sub-concussive intensity. The symptoms are PTSD like memorized/flashback symptoms.

There are two parts at play. One, people tend to forget the 'bonks' prior to suffering a lasting concussion. When they bonk their head, they may have noticed the bump but quickly discounted it as just an annoyance. Two, When someone with PCS is also struggling with anxiety, they tend to be a bit more clumsy because they are putting their attention in too many diverse areas. Sometimes, it is because they struggle to ignore other stimuli that previously they could easily avoid.

BUT, the frequency of minor bumps may increase but the intensity of those bumps usually does not. As one NT participant notes. He had to learn to put bumps into perspective. If he would not have paid attention to that type of bump prior to his concussion, there is not need to pay attention to it now.

What specific therapies are you receiving from your PT and cranial-sacral therapist? Is the CST with an osteopath?

If you have been reading for a while, most would have noticed that neuros are rarely much help with concussions.

From what you say about seeing multiple neuros and getting an MRI and CT Scan, and the idea that they gave you bad advice by not telling you to avoid activity suggests that you have become overly focused on every detail and needing to understand them all. This is common, especially for people who have a history of anxiety or sometimes a high drive in life. Both serve to make PCS worse.

You have not said what symptoms you are experiencing. Can you tell us about the your up and down symptoms?

Regarding your question about whether these minor bumps are causing damage. Nobody knows. They do know that some people are more sensitive to these bumps but they also see a correlation with this sensitivity and anxiety or other psychological characteristics.

If you are self-checking for symptoms, you will be more prone to notice symptoms. It can be a bad habit. The power of suggestion can be strong.

Have you been treated for any neck issues? Aggravating a subtle neck injury can manifest as a return of concussion symptoms.

Have you ever checked your blood pressure when you have a headache or other return of symptoms?
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Old 11-10-2017, 03:58 PM #3
cmer cmer is offline
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Quote:
Originally Posted by Mark in Idaho View Post
cmer,

Welcome to NeuroTalk.

Your experience is quite common. People with PCS tend to become overly sensitive to the times that their head make contact with an object. Very few of these bumps are of even a sub-concussive intensity. The symptoms are PTSD like memorized/flashback symptoms.

There are two parts at play. One, people tend to forget the 'bonks' prior to suffering a lasting concussion. When they bonk their head, they may have noticed the bump but quickly discounted it as just an annoyance. Two, When someone with PCS is also struggling with anxiety, they tend to be a bit more clumsy because they are putting their attention in too many diverse areas. Sometimes, it is because they struggle to ignore other stimuli that previously they could easily avoid.

BUT, the frequency of minor bumps may increase but the intensity of those bumps usually does not. As one NT participant notes. He had to learn to put bumps into perspective. If he would not have paid attention to that type of bump prior to his concussion, there is not need to pay attention to it now.

What specific therapies are you receiving from your PT and cranial-sacral therapist? Is the CST with an osteopath?

If you have been reading for a while, most would have noticed that neuros are rarely much help with concussions.

From what you say about seeing multiple neuros and getting an MRI and CT Scan, and the idea that they gave you bad advice by not telling you to avoid activity suggests that you have become overly focused on every detail and needing to understand them all. This is common, especially for people who have a history of anxiety or sometimes a high drive in life. Both serve to make PCS worse.

You have not said what symptoms you are experiencing. Can you tell us about the your up and down symptoms?

Regarding your question about whether these minor bumps are causing damage. Nobody knows. They do know that some people are more sensitive to these bumps but they also see a correlation with this sensitivity and anxiety or other psychological characteristics.

If you are self-checking for symptoms, you will be more prone to notice symptoms. It can be a bad habit. The power of suggestion can be strong.

Have you been treated for any neck issues? Aggravating a subtle neck injury can manifest as a return of concussion symptoms.

Have you ever checked your blood pressure when you have a headache or other return of symptoms?
Hi Mark,

Thank you for the reply. To be more specific, the lack of advice to avoid activity that could put me at risk of hitting my head again came from my PCP, not the neurologists. The one thing that all the neurologists have said in common is that it's of paramount importance to avoid another concussion in the first 3 weeks after the initial impact, preferably a full month. This is due to the brain being in a very vulnerable state after a concussion where it is very easily susceptible to another (It was even described to be by one neuro that don't feel bad that you sustained your 2nd impact from something so miniscule - to explain here my 2nd impact was sustained from literally just a high speed face plant while surfing. My head did not come in contact with anything but the water - 2nd impacts can come from things like slamming on the breaks while driving. Just your body moving forward and coming to a stop with the seat belt can be enough to cause your brain to come in contact with your skull again when your brain is in a weakened state (not to mention the likelihood of your head coming back in contact with your headrest). In any case, that's usually only possible in the first two weeks after an injury is what I was told. The month is to be on the safe side.

Regarding symptoms, I sustained the first concussion while sprinting down the field while playing pick up football where I jumped up for the ball and got hit at my feet. In the air, I flipped around, and then hit the ground on my head and shoulders (no helmet). I feel lucky that this happened on one of the newer turf fields where there are little rubber pellets between the surface and what is probably most likely concrete below (as I believe the rubber pellets helped absorb some of the impact). If it had been a dry grass field or an older turf field, I think the injury would have been much worse.

That night I had a tiny bit of nausea, but the feeling sick to my stomach feeling only lasted for about 45 minutes, so I was convinced it was just a minor case of food poisoning. The next morning I was told I looked "dazed" during the meetings, and my eyes were "wide open" whatever that meant. I also was feeling moments of dizziness while walking, especially if making sudden turns to the right or left. So I checked in with my primary care doctor. This doctor made me feel nothing but stressed out. Besides for what I mentioned above, she also told me that because I didn't go to the ER and get a CT scan I messed up and there was nothing I could do about it now. I actually felt like it wouldn't be the worst thing if I were to just hit my head again and then go to the ER and get a CT scan. Boy was that a mistake, and boy did I receive terrible advice.

A couple of weeks later, the dizzy for a moment symptoms seemed to be going away, so due to the poor judgement I was subject to as mentioned above, and the fact that I almost felt like it wouldn't be a bad thing if I just knew that there was something wrong, I went surfing. The morning after the surfing accident, I became very confused in a meeting and couldn't remember what we we're talking about, and what people were saying. I also started feeling dizzy while looking at a computer screen, and noticed I was dizzy when I got up from my desk. I was also having some ringing in the ears, but not too bad. I called my girlfriend. We went to the ER.

For the next month or so I was dizzy every time I moved my head. I literally couldn't have conversations with people. Just moving my head to indicate a yes or no gesture - things we all do without thinking about on a regular basis - made me dizzy.

There are some concussion guidelines out there that say to start going for walks and getting outside after 48hrs. I couldn't have walked in even close to this amount of time because I was feeling dizzy any time I moved. But when the dizziness started to improve, I started walking slowly around the block while steadily increasing my speed and going for longer and longer walks.

When the general dizziness improved, I was feeling the dizzy for a moment feelings again quite frequently (I was told this is considered vertigo or at least a type of vertigo?), and then a new symptom started that I have been calling brain-moving sensations. Not sure how else to describe it, but it would feel like the back of my brain would move in it's socket, and then suddenly stop - kind of like a knocking. Maybe this is sort of what intense throbbing feels like Idk. Throughout this time, I've getting headaches, not really that frequently, but when I do they just won't go away, and will last for 2-3 days despite taking acetaminophen, laying down in the dark with a wet, cold cloth on my forehead, etc. I had some constant aching in the back of my head, and tingling for some time though. I have also had some major issues with stress, and my ability to handle the stress was zilch. I also had some physical pain that was induced by the stress - chest pain even though I'm an otherwise healthy 28 yr. old male. I've had lots of memory issues, been very spacey in conversations, consistently was finding myself confused and lost (like why am I in the kitchen right now?). There were many times where I felt like I wasn't going to get better, and where I would never be able to do the things I'm passionate about again (like surfing, skiing and other outdoor activities).

The first down came after the first up, at about the 5 month mark. I was swimming again, and had been swimming everyday for the past 3-4 weeks. My symptoms were decreasing, literally was going most of the day without feeling much. But then I swam into a wall. Not metaphorically, but literally. Head straight into the concrete wall. All my symptoms returned except the constant dizziness. Ended up taking another week off from work. The symptoms started didn't start going down again for about 3 weeks.

I then started seeing a PT to work on my shoulder (which is from another injury, but the muscles between your neck and shoulders are all related). Around the same time I encountered a place in Canada online called Myoworx, for concussion recovery. I emailed them and my PT to see if I could do any form of treatment for my concussion. That's when they suggested CST, and my PT happens to be trained it in, so he is the one administering the CST. I have noticed most of my improvement to be located in the last month in a half or so - when I've been doing CST and exercising more (including some running on the treadmill and beach, but am still not supposed to run on pavement yet). This improvement also coincides with the fact that I am 6/7 months into my recovery. So perhaps the improvement is just subject to time like all the doctors - for the most part - say (which is difficult when you're trying to be proactive about recovery like any other sports injury).

What you said about self checking symptoms, I haven't heard before. That is something that resonates with me though. I will do my best to avoid doing this. I have not been treated for any neck issues except a related back/neck spasm also by my PT. Also very interesting. Furthermore, I have never checked my blood pressure while having a headache. Why do you suggest that? Thank you.

I also want to respond to some of the neurologist information on this site, and some of the other treatments I have tried, but I have to go - will write again tonight.

Thanks,
Cole
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