Introduction
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Hello everyone. I've been lurking on this website for the last couple weeks and recently felt I should share my story.

Who am I?
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18 year old male, 5 foot 11 inches, good physical and mental health, no history of alcohol or drug use, never played contact sport, currently studying Information technology. No previous medically diagnosed concussions but have likely had 3 throughout my life, 2 of them minor and one resulting in slight amnesia after the event (occurred 8 years ago).

What happened?
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Friday, 10/8/18 (79 days ago)

I was visiting and staying the night in an old house my parents had recently bought to retire too. Before the accident, I had driven for 4 hours (to get to the house) and had 2 alcoholic drinks and dinner with my parents.

After dinner i went to make the bed i’d be sleeping in. I was tucking in the corner of my sheet under the mattress (in a bent over position). After doing so (in a lapse of consciousness) I shot myself up quickly before smacking the back right of my head into the corner of the wooden shelf behind me.

It felt as if I’d had a massive bell go off next to me. I had ringing in my ears, was dazed and shook up, but after about 20 seconds i managed to get myself to my bed so I could lie down. After hurting myself my memory is a bit foggy but I remember reading a little before calling my girlfriend and going to bed.


Saturday, 11/8/18
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I woke up in the morning with a headache, but presumed it was because of the drinks from the previous night. I helped paint all day before having dinner and another 2 drinks.

Sunday, 12/8/18
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I felt like something was off but decided to do the 4 hour drive home, before having another drink at home.

Monday, 13/8/18
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This was the day when it finally clicked in my head. I had 8 hours of uni classes planned for the day but by lunch i knew i wasn't well. I had a headache, dizziness, difficulty concentrating at the screen in front if me and I was quite anxious. That night I went to my GP who told me I had a concussion and that I should take the next 2 days off from Uni before returning.

Unfortunately for the rest of the week I pushed myself to attend family gatherings on classes on Wednesday before finally confining myself to the darkness of my bedroom for the next 3 weeks.

Initial Issues
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-Vertigo
-Tinnitus
-Sensitivity to bright light
-Sensitivity to loud sounds
-Headache (above right eye and impact site)
-brain fog or feeling dazed
-Neck and shoulder pain
-Dizziness
-Unable to look at screens
-Unable to look tolerate fast moving objects (trains etc)
-Difficulty concentrating
-Short term Memory issues
-Convergence Insufficiency


Current Issues
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-Slight headache above right eye and impact site (severity changes day by day)
-brain fog or feeling dazed
-Immediate memory issues (regularly forgetting where I put stuff)
-slight anxiety and depression
-cognitive issues
-trying to find items in supermarkets can be overwhelming
-troubleshooting computer issues can be overwhelming
-trying to deal with multiple strains of information can make me shut down mentally
-occasional comprehension issues.

Current Recovery strategies
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-Ketogenic diet high in good fats and protein
-having a tablespoon of Brain Octaine MCT oil every morning
-therapy for convergence insufficiency
-physio for neck and back
-20 mins of high intensity cardio 6 times a week


Questions?
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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?

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?

Do people usually recover from PCS?

Does anyone else have cognitive issues with PCS?


I know this post is very long, but again I feel I need to share my issues in the hope that someone may be able to provide some answers or at least thoughts on my current situation.

Thank you.

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.

See above. Although having an incident like that at 5 weeks is probably a lot better than at 2-3 weeks...

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?

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.

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.

...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.

I am 23 months post injury. I had a fall down 20 cement steps and had a grade 3 concussion with loss of consciousness for 20 min. I go to p/t for shoulder,neck,back . I go to vestibular therapy weekly, and also go to cognitive therapy weekly. Still suffering from pcs, headache, blurred vision , tinnitus , cog issues memory loss,etc. I have seen improvements in my vestibular issues but not much improvement in my cog issues. I’m starting to feel that in my case these issues will be permanent. Prior to my injury I was a supervising pharmacist with 20 workers under my supervision. I also trained and taught future pharmacy interns from 3 pharmacy schools. I worked at a busy fast paced chain that filled over 4500 rx’s per week. I have come to the conclusion that I will never be able to do that again do to my disability’s. But I never give up and continue with all my therapy’s and go to all my md’s every 6 weeks that’s a Orthopaedic, neurologist, internist,hand specialist ortho, and a chiropractor 3/week. This is going on 2 years!!!


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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.