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


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Old 10-28-2018, 12:51 PM #1
MrT-Man MrT-Man is offline
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Originally Posted by jakedavid View Post
How much damage did I likely do to myself by having alcohol in my system when I hurt myself and then continuing to drink for the next 2 days after the accident?

The following week on two occasions I had a 3rd of a panadeine forte tablet for my whiplash, again how much damage did I likely do there?
The brain is poorly understood, and no one can know the answer to that. But those are irrelevant questions to ask. You can't stress about what you should or shouldn't have done. That's in the past, and you can't do anything about it. All you should do is focus on your recovery.

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5 weeks after the initial injury I bumped the top of my head while under a cupboard. My head probably moved about 5-10 cms up before hitting the base of the cupboard. I felt bad for the next few days. Would that incident likely have been another concussion or more likely just exaggerating present issues?
See above. Although having an incident like that at 5 weeks is probably a lot better than at 2-3 weeks...

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Do people usually recover from PCS?
Some do, and some don't. There's a study on the topic, if you google a paper written by Carmen Hiploylee, "Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers". (I'd post a link, but it won't let me do that).

On the one hand, it's a little depressing, because it shows that a lot of people don't recover. But it also shows that three months is still very early in the recovery process, so you shouldn't let yourself get too stressed at this stage. You're also probably considerably younger than the average age of the study, so your odds are probably somewhat better.

Also, being "not recovered" doesn't necessarily mean your life is over. I think the flaw with a study like that is, what's the definition of recovery? Let's say you were super messed up for the first few weeks, and then a year later, you're mostly fine, except that your balance is still a bit off, you have some ongoing neck pain, and your a little bit more forgetful than you used to be. But you can do your job, and/or succeed at school. Does that fall into the bucket of recovered, or not recovered?

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Does anyone else have cognitive issues with PCS?
Thank you.
I think that's extremely common, especially in the first few weeks. I had some issues in the first 3-6 months, and now at 9.5 months, I think my cognitive issues are 90%+ resolved (though it's admittedly hard to say for sure, since I wasn't formally tested before and after) and my co-workers tell me that I seem fine in that regard. (I do have other issues, like fatigue, eye/neck pain, and still not being able to drive -- at least not on a highway).

I know a guy who could barely read/comprehend his emails in the first few weeks, and after a year or two, he said his cognitive ability returned to normal.

So don't let yourself get too stressed at this stage. You're a step ahead of most, by doing all the things you're doing. And again, your age should play to your advantage.
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Old 10-29-2018, 03:57 PM #2
jakedavid jakedavid is offline
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Thanks for the response MrT-Man.

I shall try not to stress too much about things that I did poorly in the beginning of my injury. Would you have any recommendations for things I could try to do to help with my recovery? I’m starting to consider going for a neuropsychological assessment as my cognitive and memory issues cause me the greatest concern and it would hopefully provide my a baseline to continue improving upon in the following months.

Would you mind telling me what your job is? Working in IT no longer seems like a likely outcome for me due to both it’s intensive cognitive and stress elements. Fortunately, I could change majors next year and still be able to graduate in 2 years.

Many thanks,

Jake
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Old 10-29-2018, 09:47 PM #3
MrT-Man MrT-Man is offline
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Originally Posted by jakedavid View Post
Thanks for the response MrT-Man.

I shall try not to stress too much about things that I did poorly in the beginning of my injury. Would you have any recommendations for things I could try to do to help with my recovery? I’m starting to consider going for a neuropsychological assessment as my cognitive and memory issues cause me the greatest concern and it would hopefully provide my a baseline to continue improving upon in the following months.

Would you mind telling me what your job is? Working in IT no longer seems like a likely outcome for me due to both it’s intensive cognitive and stress elements. Fortunately, I could change majors next year and still be able to graduate in 2 years.

Many thanks,

Jake

Personally, I don't know if it would be a great idea to go for a neuropsychological assessment just yet, because I think they're generally expensive, and because you're still so early in your recovery that you're extremely likely to have ongoing improvement from here. I mean... unless you think you have more serious issues, beyond short-term memory and brain fog...

One thing I did was sign up for Brain HQ, which has a bunch of cognitive training exercises, and (while I don't know how scientific it is), I scored high percentiles on a bunch of the exercises, so that gave me some assurance that my cognitive ability isn't too messed up. I'm thinking of doing a full assessment at some point, to determine if there are any residual issues that I need to focus on.

I think it's *far* too early for you to make conclusions about what career you may, or may not, be able to do in the future. I can't promise you'll ever make a full recovery, but I can almost guarantee you'll show some significant improvement over the next few weeks/months.

In terms of my injury,

- the first three months were pure hell (extreme fatigue, dizziness, fog, convergence issues). There were many days that I had to spend just cocooned at home, and many times where walking down the street seemed challenging;

- the next three months were more tolerable -- I couldn't function all that well at work (I was doing maybe 20% of my job), but I could cope with most day-to-day errands (so long as I paced myself), other than driving;

- At 9.5 months, I'm just starting to try to get back to normal at my job. In the past two weeks, I've been maybe 75% effective at work... I'm hoping it lasts, and that I continue improving from here.

I'm in my 40s, so I think your recovery should be better than mine.

I don't want to get too specific about what I do, for the sake of anonymity, but it's very intellectual demanding. I'm an expert in my field, and work very long hours speaking to clients and writing on my areas of expertise. At this point I don't feel that my cognitive abilities are holding me back. Maybe I lost 5% of my IQ, maybe I didn't, I don't know -- but whatever IQ I have left seems to be sufficient to make my employer and my clients happy. Fatigue/mental stamina is pretty much the only thing that's still affecting my work.

So again, don't let yourself get too stressed at this point.

In terms of other things you can try -- given that you're having dizziness, a vestibular specialist should evaluate you. It might be stemming from your convergence insufficiency, but there could be other factors also at play (e.g. particles in your inner ear, which can be fixed with the Epley maneuver, cervicogenic dizziness that can be caused by your neck) -- and if that's the case, you might need to be doing other types of physio to help rectify that.

You should be taking more supplements. See the sticky on this board. I take 300mg of Magnesium Citrate, a B-complex, B-12, a multivitamin, fish oil, vitamin C and D, Curcumin and creatine.

You want to get a blood test to evaluate all your hormone levels (TSH, IGF, testoserone, prolactin.. basically a full endocrine panel) because it can often be the case that a brain injury can cause your hormones to be out of whack. There's a thing called empty sella syndrome, for example, which is when the cerebral fluid causes the pituitary gland to get squished, affecting its function.

And finally, I found zoloft to be super helpful. I was reluctant to take it because I didn't think I was depressed, per se. I mean, I was somewhat sad and a bit anxious about my condition, but far from despondent about it. Though I tried it anyway, starting a couple of months ago, and it's been great. I get less stressed about my remaining symptoms, I have quite a bit more energy than I used to, and I feel like my cognitive performance has actually improved. A caveat here is that I don't know whether there are special considerations to be taken into account with respect to someone your age taking zoloft.

I'll mention that I also did 30 sessions of HBOT therapy (90 mins apiece), though HBOT can be expensive and the science is inconclusive on whether or not it works. All I can say is that I unquestionably felt better on the days I did HBOT than on the days that I didn't. I also had some permanent improvement after the session when compared to before the sessions. But I can't say for sure that it actually helped my recovery, because I don't have another version of me who didn't do the sessions to compare to, as a control. I'd recommended if the time/money are manageable for you, but I wouldn't tell you to spend your education funds on it given the uncertain science...

Hope this helps. And at this risk of repeating myself, it's still early days for you, you're going to improve from here, and you really shouldn't let yourself get stressed at this point.
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Old 10-29-2018, 10:07 PM #4
MrT-Man MrT-Man is offline
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...and by the way, the fact that you can do high-intensity cardio is a good sign. I could barely do 100 bpm in the first month post injury, and it took maybe three months to work my way up to 120 bpm. (I can now exercise for a half hour at 145 bpm, though I feel it somewhat the next day).

But do make sure that cardio isn't aggravating your symptoms. I believe the rule is that you've hit your threshold heart rate if your symptoms increase by 3 points on a 10-point scale. And once you've found what this is, you should be exercising at 80% of that.

If exercising isn't really aggravating your symptoms, I would even crank it up and do more than 20 mins per day.
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Old 11-22-2018, 11:07 AM #5
SuperElectric SuperElectric is offline
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Quote:
Originally Posted by MrT-Man View Post
Some do, and some don't. There's a study on the topic, if you google a paper written by Carmen Hiploylee, "Longitudinal Study of Postconcussion Syndrome: Not Everyone Recovers". (I'd post a link, but it won't let me do that).
Basically she found that if you don't recover within three years then you are unlikely to. However, I think there are always exceptions to the rule and not everyone finds the right treatment that suits their symptoms. I continue to make progress beyond the three years she cites and I'm sure others do too.
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Concussion 28-02-2014 head butted a door edge.
.

Symptoms overcome: Nausea, head pressure, debilitating fatigue, jelly legs, raised pulse rate, night sweats, restlessness, depersonalisation, anxiety, neck ache, depression.
Symptoms left: Disturbed sleep, some residual tinnitus.
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