Hi there!! I’m new here (23 year old female, very active) and have a question Sorry for the long post!

Background:
Oct 1: Hit in head by 30 pound longboard while in a surf comp in 8ft waves - delayed symptoms (36hr) Nausea, headache, confusion, light and noise sensitivity, temperature regulation, screen intolerance, tinnitus, unequal pupils, exhaustion. Was only ever diagnosed via symptoms over the phone with my physician.

Most symptoms entirely gone by Oct 20 but some PTSD-like symptoms remained

Nov 9: (maybe another concussive event?) Fell on ice while hiking landed on bum quite hard but did not hit my head - Relapse in more severe headaches for a few days and unequal pupil size

Since this second incident I have had symptoms on and off for the last 6 weeks. Mainly headache (back of head, temples, jaw), nausea, vision issues and a weird sensation behind my eyes. No cognitive issues. Symptoms have improved to a degree. I was able to complete my semester, get back to normal activity level (working out 90 minutes daily) and fly to Hawaii with my family even surfed again a few days ago. I was back to living a fairly normal life with only a few lingering symptoms.


Health History:
I have been seeing a vision therapist as of Nov 10 my vision was fairly off. As of Dec 15 my vision metrics were back at normal/baseline.

I did however also injure my neck quite badly in the Oct. surfing accident. I sustained pretty severe whiplash and a bulging disc in my c4-5. I also already have stage 2 degenerative issues in my neck from 12 years as a national level swimmer. All confirmed by MRI after accident.

I have sustained several small bumps (hitting head on cabinet that sort of thing) since the initial incident, and while they do tend to make me anxious I am usually able to talk myself out of rumination within a few minutes. I was on SSRIS prior to the accident for anxiety and had OCD as a young teenager. These conditions have been well managed for years and don’t seem to have much impact on my daily life, but I realize that the concussion could cause an increase in severity of anxiety.

I have Celiac disease which can make it confusing to determine wether nausea is coming from a gluten exposure or PCS.

Finally, I have had migraines with aura since I was 10. There is a huge history of migraines in my family. Some times I end up with an actual headache (blinding pain on one side) and others I will just get a visual aura (blind spots, lines ect.) nausea and a really out of it feeling for a few hours to days.

Question:
This week I was on vacation with my family and was sitting on my partner’s shoulders in the ocean. I asked him to put me down and he lightly pushed me backwards off of him into the water. I realize that the force of falling maybe 2.5 feet into water should not be enough force for a new concussion. (?) However, after the incident I had immediate nausea and have had an on and off pressure type headache, nausea, neck pain and a foggy feeling.

My question is essentially, are these type of symptom flare ups likely caused by aggravated cervical spine issues, anxiety/PTSD, migraine, some combo, or are they a new concussive incident.

I am just trying to figure out which area (CBT, physio, cervical chiro) to funnel resources to and whether I need to shut down (no screens stop activity) after each of these incidents or just accept they are not inherently dangerous and move forward without letting them control my life.

My gut feeling is some mix of ptsd and neck issues. The reaction I have to hitting my head even lightly is very similar to a flashback with instant fear. I had a similar reaction my first time out in the waves again, but have continued exposing myself to this environment to the point that I was calm enough to be able to surf again in waist high waves the other day. Unfortunately I’m not sure if there is a way to safely expose myself to getting hit in the head (although maybe there is?)

Anyways, my apologies for the long post, I am hoping someone who has been in this situation may have some advice to help me move forward!

Thank you for your help!

Kiwis099,

Welcome to NeuroTalk.

My first comment is simple. You are looking for symptoms. That is problematic.

Nobody can self-diagnose unequal pupils. They are not a normal symptom of a concussion. They indicate a much more severe closed head injury that would usually require hospitalization.

No, the fall into water was not a concussion or even a sub-concussive impact.

You sound like you fall into the category of Long history of depression, anxiety, and OCD (an anxiety disorder) with PTSD as a later add-on. Multiple research shows that such a history causes the brain to be easily triggered into an inflammatory response. This can cause all of the concussion symptoms you mention.

My recommendation is to start with your OCD and anxiety. Seek help to find natural ways of resolving those issues. CBT could be part of that.

Supplements can be helpful. After 14 years on a strong SSRI, I quit and replaced it with 5-HTP and L-Theanine with a doctor encouraging me and following my progress. I've added GABA recently. I use the brand of 5-HTP with L-Theanine and GABA that is sold on Amazon.

An anti-inflammatory diet is helpful. Low sugar is important.

Stop tracking symptoms or looking/checking for symptoms. That makes them worse.

Accept that you have an injured body, especially your neck. If you choose to participate in risk activities, that is your choice. That choice can impact your future life. Many of us have chosen to moderate our risks.

With your neck, you should consider ways to improve sleeping posture. Poor sleeping posture can make your symptoms worse. How did swimming impact your neck?

You sound like you live an intense/high stress life, maybe even using that intensity to 'self-medicate' your emotion issues. Many do. You should consider how to moderate that intensity so you can hope to remain active for decades to come.

Thank you for the quick response! I really appreciate all of the input, makes sense!

Thanks again.

The flare-ups you experience are probably an inflammatory response. Inflammation is what causes the symptoms. After multiple head bumps, the brain tends to overreact and pump out too much inflammation.

Seek treatment for your neck injury, because that can contribute to concussion symptoms and inflammation.

Don't push through the pain. Rest to allow the inflammation to subside, then gradually increase your activity level. Do just enough activity to cause mild discomfort, but not so much to cause a setback. The do a little more activity each week.

What kind of foods do you eat? A lot of the foods we eat cause inflammation, which will contribute to the symptoms and inhibit the healing process. Inflammation also contributes to anxiety and migraines. So stop eating processed foods, sugary drinks, fried foods, fast food, wheat, and industrial seed oils. Eat lots of healthy saturated fats, vegetables, dark leafy greens, fruits, legumes, seeds, protein, and fish for the omega-3.

Hi everyone, first time poster here...

Kiwis099 - very sorry to hear about your struggles. The unexplained flare-ups sound very similar to what I am currently going through, so I thought I'd share my experience.

For context, I suffered a couple of head injuries in March 2019 and February 2021.

I had my first flare-up in June 2021, around 3 months after I thought the symptoms had gone. I was out walking with friends when I suddenly started to feel odd. It was like a pressure inside my head, a fuzziness all over and mild disorientation. It ended up lasting about 2 weeks then vanished. Not entirely sure what brought it on but it was a very hot day and I was possibly a bit dehydrated.

Then in November 2021, I woke up one morning with the exact same symptoms, although quite mild. No obvious cause for why it came back, That ended up lasting about a week before disappearing as quickly as it came.

Then on 25th August 2022, around 9 months after my last flare-up, I was on a see-saw (that's a teeter-totter in the USA!) with a friend's 3-year old daughter. We were going up and down for about 30 seconds. I stood up and my head was going crazy again. The symptoms came flooding back out of nowhere - pressure around my head, mild dizziness, feeling slightly disorientated, some brain-fog.

You mention falling backwards off your partner's shoulders. It seems similar to my flare-up, like the brain doesn't like the unusual, uncontrolled movement. In your case it was falling backwards, in my case it was going up-and-down quite quickly. I'd be interested to know if there's any rationale behind that and whether sudden movement can trigger the brain's response mechanism.

Unfortunately for me it's been four months of struggles. There have been ups-and-downs (like a see-saw ironically ). After six weeks I had improved a lot, but then suffered another small flare-up and things deteriorated. Then I seemed to be getting better again, but I got a nasty sickness bug at the start of December and went back square one again.

One thing I find helps is exercise. You mentioned your an active person. I enjoy running and find when I do that my symptoms improve. I wouldn't necessarily notice an improvement immediately, and I might even feel worse for a bit, but I can generally see improvements week-on-week.

I'm trying Omega-3 suppliments. Hard to judge whether they're having any effect.

I'm also really trying not to get stressed or overwork myself. I think that helps with not making the symptoms worse... I'm not entirely sure it makes them better.

So I certainly feel your frustration. Great to hear the advice from Drew and Mark, which ties in to what I was thinking already - inflammation is likely to be the root cause. I am definitely a stickler for "looking for symtoms" and over-thinking it too!

I suppose ultimately I'd like to know why these flare-ups are happening in the first place so I know how best to avoid them. It doesn't feel like going on a see-saw or falling 2.5 feet into water should cause this level of suffering!

Best of luck on your recovery though Kiwis099!