Hi Ben, I am sorry to hear how you are feeling this week. My symptoms are quite similar to yours (headaches, brain fog, fatigue, some memory impairment and concentration difficulties).

I am sorry but I am unable to give an educated answer to your question, as Mark will surely do. Have you thought about giving yourself some quiet rest to see if that helps? I would certainly not quit all activities for an extended period of time, but a few days of rest to go through the relapse would perhaps be useful. I sometimes do it (for 24-48 hours) when my symptoms are too strong.

Have you invested in good shoes? I personally find hiking shoes to be the best, but there are also some comfortable sneakers or running shoes, as I already told you. Walking shouldn't be a problem with these.

To reduce the inflammation, have you started an anti-inflammatory diet? I think I mentioned that to you already. Many people on these boards have had good results with it, in particular for the sensitivity that many suffer from. It takes some discipline and patience, but it is probably worth trying. You can see these threads for instance:
Update on diet and PCS
An unusual head injury

There are many people on these boards who recovered well even after a prolonged period of post-concussion syndrome; perhaps you could try thinking more about these cases than about the nightmare scenarios that seem to obsess you?

Thanks for the response, yes I've dug out some old basketball shoes and will try and wear those for a change since the have more cushion than skateboard shoes or boots. I've also bought some insoles but I don't find them to provide much relief. I went out last night and had to do a lot of walking and it was hell.

Ive been eating as healthy as I can but it's almost impossible for me to never eat any 'inflammatory' foods.

Your right, the thought that I'm causing myself constant damage with every step or bump in the road/train does consume me at times but if only I could get that idea out of my head it would be much better.

My mom had an interesting idea, she said that perhaps the walking sensitivity and sensations in my head started out mild but now that i look for it and focus on it whenever I'm walking and I essentially move around on eggshells with my whole back tense and now that has made it much worse. Not because of physiological reasons but because I've built up so much in my head.

She said maybe if I could convince myself that there was no way waking could actually harm my brain, I would not think about it and it would go away.

I'm not sure I agree but it's plausible, regardless I just want to be able to walk comfortably again, without thinking about it and without it causing me problems, it is truly all I care about and it not being able to do so makes my day to day life a living hell.

I'm also considering moving in with my grandma who lives much closer to my school than I do. This would diminish the travel I would have to do and would reduce the time I have to spend on the awful metro every day.

Ive been taking it easy, as much as I could this week but I still had to leave the house to go to appointments and a few events. I had a bad setback on the metro earlier this week also.

Why can't you eat an anti-inflammatory diet? I agree that it requires some organization, but given the potential benefits don't you think you could try to stick to it religiously for a few months?

Try different types of shoes. I was bothered by some running shoes (the ones with air, especially when walking on very hard surfaces) but not by others. I finally found a great relief with good hiking shoes. Not overthinking it will definitely help, but you also want to put yourself in the best possible conditions to minimize symptoms.

Your right I'll do my best to stick to the diet. Sometimes though it's hard since I'm a broke college student so I kinda tend to eat what's given to me but you make a good point.

Also though I'm very skinny so I fear I will lose too much weight on it

Why do I have to minimize symptoms, is this because it will make my recovery faster?

Perhaps, but primarily because minimizing symptoms is an objective per se. Isn't it what we are all trying to do?

Also, one tip for the subway. I have a bumpy bus ride everyday to go to work. It used to set me back frequently but now that I stand on my tiptoes (instead of sitting) it is much less of a problem. Of course you have to hold yourself to something to avoid falling.

Ben, I hope that is OK for me to offer you some CBT.

You wrote "continued brain deterioration". and "I feel severely brain damaged"

You also wrote "I was evaluated by a top neurologist who said I had no noticeable deficits. A few days ago I spoke with a top psychiatrist who said I sounded very intelligent and articulate and should consider becoming a psychologist for my career. My parents and gf say they have not noticed any drop off in my intellect and my friends have not mentioned anything about me acting differently besides that I am now more quiet."

In CBT jargon the first quotes are forms of a Negative Automatic Thought (NAT) called Catastrophising.

The key to CBT is to challenge a NAT, asking if there is any evidence for it.

The second quote shows that there is not a scrap of evidence that your NAT has any basis in reality.

Thanks, that is something I've seen in cbt. I actually have a whole form on that exact concept. I really wish I could just stop thinking about all this though and I guess I was just worried since the neuro appointment was about 5 months ago and I know that alot can happen in 5 months.

Thanks for reminding me my training though, it helps

Ben, We all agree that inflammation is a big contributor to concussion symptoms. It is not the only cause. The web article you pointed to just says that but does not offer treatment suggestions.

As you said, you spend a lot of time focused on your concussion symptoms and concussion issues like worry about a passionate kiss or hug or bumps on the metro. If the bumpy part of the metro is only 90 seconds, stand up with your knees flexed and let your body absorb those bumps.

I don't think you should be doing weight training. It may seem safe but it causes neck muscle tension that can be a problem.

An issue you have failed to understand is quite simple. Your recovery is not based on the amount of time you spend resting. It is more impacted by the most stressful things you do. Just as you say that only 90 seconds of the metro ride are a problem, spending a small part of your day wrapped up in anxiety will prevent the rest from having any value. It is like you keep picking a scab off just as a wound starts to heal.

You have not developed brain damage since the neuro appointment 5 months ago. Also, top neuro or top psychiatrist is completely meaningless unless they have expertise with your condition (most top neuros don't) or you are willing to believe them.

Alright, i appreciate it Mark. So you believe that my routine is safe and worth contiunuing as is so long as i make certain adjustments such as reducing weight training and making serious efforts to reduce stress at all costs?

Im assuming you believe my great fears and concerns over harm of small things such as the transportation dilemma, walking, others, is unjustified?

Yah i agree with you about the doctors, i was only stating it for me to properly answer your question in an objective manner.

Also, small i thought i would mention this small anecdote: a couple months ago, while on the previously mentioned family trip to Boston, i had an interesting experience. I had been taking a mild dosage (5mg) of the ssrri lexapro over the last 4 days. On the 4th day of taking it i had a 3-4 hour period during which i felt much better. Its as if some of the fog was lifting and i was beginning to feel like myself again. The difference was definitely noticeable and what surprised me was that is came following the period of last few days which were FILLED with some extremely bumpy and long car and plain rides. I was certain i had just ruined myself but then out of nowhere that experience happened.

It was short lived, i soon went back to normal and the next day i got cold feet and discontinued the medication but that 4 hour window gave me a glimmer of hope. Now i know it doesnt mean much but its meaningful to me since its the onlyntime over the past several months were ive kinda felt like my old self.

Also do you think all the very bumpy driving/travel around boston/plane ride could have been potentially harmful?