smutsik,

From what I have read about DTI is it just shows an increase in fluid flow compared to the normal. The science has not yet defined why that increased flow exists other than to observe that is coincides with an injury and/or anxiety/depression. Whether it is axon related, myelin related, inflammation, edema, or ischemia, nobody appear to know yet. Damaged myelin is as problematic as damaged axons. Axons have greater healing potential than myelin. Folic acid, B-12 and such help with myelin healing. The other issues disrupt normal function.

If you want to fry your brain trying to understand DTI, here is a good article.
Diffusion Tensor Imaging of the Brain

Increased fluid flow in the area where it looks like there is a lesion? I seem to have my facts backwards, this sounds really interesting.

Axons having greater healing potential than myelin? Cool, I'd love to read more about this. Is it covered in the article you linked? I haven't read much about continual myelinization at all (at least regarding the concept as a part of rehabilitation), just some vague points about what kind of fats are beneficial for the process in general. Are myelin sheaths thought to be damaged in traumatic brain injury?

Thanks for the article, I'll look into it tomorrow.

The myelin sheath heals/grows very slowly. It does not close open gaps well. Nerve fibers will grow/heal looking to reconnect with the other side of a break.

Multiple Sclerosis is mainly a auto-immune disease of the myelin. That is why it is so deadly. Remove the insulation and the nerve signals short out.

When nerve reconnect surgery is done, they just have to connect the sheath. The nerve fiber will grow along the sheath.

Vitamin therapy is helpful with the myelin. Omega 3 fatty acids are for the nerve fibers.

Mark,

I appreciate the reply. I really liked the knee scope analogy.

I don't think I really ever gave myself much of a break. I've been so concerned about getting back to what I was, that I continue to be active and expose myself to a lot of stimulation.

There is certainly something to be said for relaxing, taking a step back and not being so focused on the problem. I appreciate your insight.

Over the 9 years I have been on NT, I have witnessed dozens who spent a year or more pushing through their symptoms with a drive to get on with their lives. When they finally decide to slow down and give their brain a chance to heal, recovery starts. I've seen people waste 18 months of misery then slow down and recovery remarkably in 6 months or so.

I cannot thank everyone enough for all the thoughtful and helpful replies. Thank you so much! I have printed them off and spent time off and on reading them and re-reading them.

Ben- Thank you so much for your insight...this is so hard for me to think about relaxing and just letting the brain heal, as I've never relaxed my entire life- It's just not something we did or do....it's a complete lifestyle change, but I am going to work on learning how to relax.

Jo-Mar- Thank you for your insight. My cognitive therapist said for me to stop when I notice symptoms....I've just started doing that, but it's so hard as my personality is to push through. Thanks for the CSF leak link- I will check that out!

Mark- Thank you so much for taking the time to give me such a comprehensive reply!! I see why you are so highly respected and valued on this board. It sounds like our histories have a lot in common. I will look into the methylcobalamin B-12 and try to get some ordered. I forgot to mention I also take Magnesium Citrate before bed ...it's called "Calm". The Curcumin is by Bio Schwartz, it has 1350 mg of Tumeric (Curcumma Longa root), 150 mg of Tumeric Extract (95% standardized curcuminoids) and 10 mg Black Pepper fruit extract (bioperine). Is that a good one or is there a better one I could order?

I will look into some anti-inflammatory diets. The hardest part about Keto for me is the fruit, as I've always been a big variety of fruit eater. I only eat Meat, fruits, and vegetables.

For my neck, I don't know what posture discipline is. I know my neck feels best when it's positioned straight forward. I lay down a lot to alleviate symptoms, but any way that I lay hurts my neck more. I have a soft, flat, down, feather pillow and the best way I've found is to "mold" the feathers to stabilize my neck. I have to do this whether I am on my back or my side. I have never been a back sleeper before, but my neck feels best when I"m on my back. My chiropractor is very gentle .....more like an osteopath and just barely pushes. The physical therapist, however, got a little aggressive one day a couple weeks ago and the neck pain was unbearable for 4 days. Once I told him about it, he said he wouldn't manually stretch it sideways and up like that any more. When he stretches it straight I'm okay and then a gentle massage I'm okay. I have to wear sunglasses and ear plugs in their office- I have to go to a quiet dark room when I get there and my therapy takes place in the quiet dark room. Even that, overstimulates me.

I have never heard of presbyopia, so I looked it up....I have never had vision problems and have never warn glasses. All vision tests have been 20/20 my whole life until now.

I have never heard of a behavioral optometrist. I will see if my PCP will refer me to one.

As for sleep- I've been an excellent sleeper my whole life....and despite our active lifestyle I've always gotten 8-9 hours of solid sleep and have always had vivid dreams that I remember every single detail when I wake up. After this head impact, my sleeping would be- sleep 4 hours wake up 2 hours sleep 2 hours...then I went to being able to sleep one additional hour....then I went to 5 hours without waking...now I'm up to the 7 hours without waking most nights. Some nights I still wake up at 2am and am awake for an hour or so. For the first month and a half, I had no dreams...or at least didn't remember them- which was the first time in my life to experience that (I can still recall many childhood dreams even). When I finally started dreaming, it was only about going back to work...I'd sneak into the office so no one would see me, I'd crawl, I'd get there in the middle of the night, I'd walk to the office, ride bikes, steal vehicles to get there. Now- I have a few more mellow dreams- nothing stressful at all, but I still dream about going back to work at least once a night (one dream I even drilled a hole in the side of the office and stole my co-workers).

I will look into the 5-HTP, it sounds worth trying and might even settle me a bit.

Part of the problem is that I live in a tiny, tiny town in the middle of no-where....closest neurologist is a 4 hour drive, closest neuro-opthamologist and neuropsychologist is an 8 hour drive. I'm sure the behavioral optometrist is 4-8 hours away as well. These drives have about killed me. I don't drive, but just being a passenger has been overly demanding on my senses. Your reply to Tom on multi-tasking and constant overstimulation is my former life in a nutshell. Won awards at work for my multitasking ability...literately an activity every night and weekend beyond work. Never thought about how it was actually affecting me. On belief I personally have is that God has a plan for me...maybe his plan is to slow my butt down a bit! Mindfulness and Meditation are both things my cognitive therapist is teaching me about and having me practice daily. A whole new experience. One thing I forgot to mention and am not sure if it matters, is I have an auto-immune disease Hashimotos that has caused Hypothyroidism for which I take Compounded Thyroid medication daily. Again- thank you so much for your insightful and comprehensive reply Mark!

Tom- Thank you for your reply. Yes- it's like my brain just can't process everything, goes on overload, and shuts down. I have several lesions on my left side and one larger one on my right side. The doctors have told me it's nothing to worry about, so I don't.

Smutsik- Thank you for your reply. It's SO GREAT to hear that your symptoms rarely bother you 11 months out and that you have been able to resume your life! I can't wait for that day!! You are right about holding myself to perfection and being so overly-active and demanding of myself....that is...was...so me! Maybe it's good that I'm learning a new way...learning to chill out.

You are all so helpful! Thank you!

Mark,
I forgot to mention-the neck exercises I’m supposed to do everyday are mild but cause more neck pain and vertigo. I push through thinking that’s it’s the only way to heal my neck. I’ve learned to do them less strenuously, and that does help. And PT said I’m presenting with typical whiplash....

LMLS,

First, your supplements. The Turmeric is very low dose. The turmeric has only 4 or 5% curcumin so you are only getting 200 mgs total of curcumin. Twice that 3 times a day should be a starting level. I use the VitaCost house brand. It is all curcumin extract https://www.vitacost.com/vitacost-ro...ng-60-capsules Sign up for the VitaCost email ads and they will tell you when they have it on sale. Buy one, get one for 50% is quite common. Start an order in the online cart, leave it uncompleted and they will email you a 10% discount to finalize your order. I like the NOW B-12 1000 mcgs lozenges. Vitacost also has a good 5-HTP. I start my day with 1000 mcgs of B-12, 100 mgs of 5-HTP and 200 mgs of L-Theanine. My osteopath thinks this is a good morning start.

Posture discipline is limiting the odd and stretched neck positions, especially when sleeping or napping. A position where you head is looking straight forward is best. I am not a believer in range of motion exercises until the neck is stable. C-0 to C-2 do not self align like the lower vertebra do. No facets to slide back into alignment.

The whiplash of your fall likely strained and stretched the ligaments that hold C-1 in alignment with C-0 (occiput/skull base). C-1 to C-2 also. Any strain to these joints can cause inflammation that can interrupt blood flow to the brain and brain stem, reduce nerve function, and reduce the autonomic nervous systems proper function.

My off hand opinion is most of your problem comes from this area and the blood flow problems it can cause.

Learning to sleep on your back will be good. My best nights, I fall asleep on my back and wake up in the same position. This takes effort to find the right combination of factors that allow you to sleep like that. You should not be going to bed until you are ready to fall asleep within a few minutes. This way, you can fall asleep in a good posture. I did a lot of sleeping in a recliner when I was still learning how to sleep on my back. I could sleep 2 hours in my recliner and get more benefit than an all night effort in bed.

All my PT did was gentle traction with some light mobilization and manipulation. Rocking my head gently and manipulating the cervical vertebra. She would massage and use trigger point/myofacial release to relax the neck muscles first. No painful joint movements. Some chiros are trained in Active Release Therapy or Specific Release Therapy. It sounds similar to what my PT does.

You have more than typical whiplash. The skull stopped moving at the floor while the cervical vertebra continued to try to move toward the floor. This causes C-1 to try to slip to the back of the skull. Typical whiplash is mostly just a hyper-extension of the joints.

I would call your dreams bizarre and stressful. The need to get into the office is your mind under stress. Likely a result of poor blood flow or poor oxygenation or both.

Blood sugar issues can impact sleep. Many of us have to feed our brains to get a continuous night of sleep. If you are waking up 5 to 7 hours after your last meal, you brain could be hungry/lacking glucose. Eating a complex carb or fat and protein or other slow to digest snack before bed may help. 200 calories usually is all I need. Cheese and crackers, peanut butter and crackers, a piece of sliced turkey with cheese, and such help me sleep longer.

My injury caused me to slow down and also to be more aware of others who I previously discounted as lazy or lacking direction. Understanding mental processing struggles from the inside has given me a better perspective on how others function. I am now somewhat intolerant of impatient and overly driven people. Slow down, get and life and enjoy it. I know God has allowed me to impact a few lives because of my struggles. My signature "Be still...." refers to Stop striving and listen to/for God.

What big nowhere do you live in the middle of? If you have to drive so far, maybe I can help you find better help in one of those distant cities.

The Hashimoto's could cause some metabolic challenges as your metabolism may cycle through the day as your synthetic thyroid meds rise and fall. I'm just wondering....

Please consider the 5-HTP. It is fast acting if your brain is serotonin and melatonin deficient. No side effects unless you take a large dose for an extended period. I can explain those later if needed.

My best to you.

Mark- thank you so much for sharing that link and the cost saving details! I will order the supplements today, including the 5HTP. I will work on being more aware of my posture. The blood flow thing makes a lot of sense....especially because when the PT does his mild straight stretch and massage- it's so weird, but I swear I feel more blood flow going into my brain....so, you know when you push down on the vein in your wrist and then your hand starts to feel funny from lack of blood flow? Then you let go! That Let Go feeling is how my head feels for a good couple hours after the PT is finished with my neck!

I can't sleep in a recliner at all- as it's not flat enough to alleviate my symptoms, but I am going to work on trying to sleep on my back. I found if I wrap my feather pillow around my ears and then under my neck and kind of "mold it" my neck feels best. I will try some protein before going to bed each night- thank you for that suggestion. It didn't help last night, but I woke up in pain...not from just waking up.

I forgot to mention the xray of my neck showed degenerative disc disease in my neck and lower back. Doc said not to worry about that as most people have it too and don't know it and that it doesn't matter. My lower back has been killing me off and on these past couple weeks and I think it's from all the laying down. I've always been able to walk a lot and do exercises to keep my tummy muscles strong. I had a slipped disk and scoliosis as a child, had to be in a back brace for a couple years, but since then have maintained tummy muscles until now. I can still lay flat and push my tummy muscles to the floor to help, but I can't do any crunches or situps like I used to due to my neck. UGH!!

This here that you said is terrific. "My injury caused me to slow down and also to be more aware of others who I previously discounted as lazy or lacking direction. Understanding mental processing struggles from the inside has given me a better perspective on how others function. I am now somewhat intolerant of impatient and overly driven people. Slow down, get and life and enjoy it. I know God has allowed me to impact a few lives because of my struggles. My signature "Be still...." refers to Stop striving and listen to/for God."

I too have SO MUCH more awareness and empathy for people that I used to write off as "lazy" or "just not trying hard enough". I now know what it feels like to struggle cognitively....never knew that feeling in my life. Every time since this has happened that I pray- I get the STRONGEST feeling of a voice "This is my plan for you- trust me...you'll see".....only thing that has kept me from going crazy.

LMLS,

I had an accident involving my head 4 years ago.

PCS changed my whole world big time, it's a long story.

Be patient with your recovery, PCS has its own timeline and progress can be difficult to assess, it's not like a broken bone or a cut. I think with all certainty I can say I'm better off in many ways today than prior to my accident, character, determination and patience are necessary and achievable.

Bud