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chitowndizzy · 06-02-2011, 04:27 PM

I'm back from Buffalo. Here is the short version: I'm no longer suffering from PCS. My symptoms are mostly caused by an upper cervical neck injury. Dr. Leddy is a really nice guy and a fellow cyclist to boot! He also said that 90% of the people he tests have problems due to neck injuries, not PCS.

The appointment consists of a meeting with Dr. Leddy, the "treadmill" test, then a follow up to get an exercise plan.

The first meeting with Dr. Leddy is just to get your history, background and to do those "touch your nose, follow my eyes" tests I'm sure you've all done a hundred times.

Then they take you into the next room where a physical therapist tests your balance and physical exertion. I had an additional test which I"ll explain later.

The balance test was fairly standard. Stand with your feet together, hands on hips and close your eyes. Stand on one foot, hands on hips, eyes closed. Stand with one foot in front of the other, hands on hips and eyes closed. Now repeat all three but while standing on a wobbly piece of foam. I had success with only the feet together test, otherwise I had trouble with the rest.

The treadmill test is simple. You walk, every few minutes they increase the incline, you stop when you are maxed out or your symptoms stop you. I was hooked up to an EKG, blood pressure and heart rate monitor and I also would rate my perceived exertion every time the incline was increased. They also tracked how straight I walked using pressure sensors in the treadmill.

I would imagine if any of these measurements changed in a strange way they would pull the plug. For me this didn't happen -- I hit a new max heart rate of 210 (always thought it was 205) and a 19/20 on the perceived exertion scale and then we stopped.

After this they took me to a wall with a target on it. They took a laser pen and attached it to the side of my head with a bandage like the borg, (star trek joke). I had to point the laser at the center of the target using my head. Then with my eyes closed move my head all the way to the left and then back to the center of the target. We also went up, down and to the right. I missed far to the left every single time.

Then the therapist took me to a room and poked and prodded parts of my neck and asked if it hurt, (yes). Then he checked for mobility. Then he told me he thinks my issue is an upper cervical neck injury.

I followed up with Dr. Leddy who then cleared me to exercise as much as I wanted and to start physical therapy for my neck. If I had PCS still, the workout plan is pretty simple. They have you exercise at 80% of the heart rate that exacerbated your symptoms. I don't know how often or how long -- sorry, I should have asked!

I'm still getting migraines weekly and I am easily overwhelmed in noisy places. Both are getting better with time, but I don't really see how those could be related to a neck injury. Dr. Leddy seemed to think they might.

Could you duplicate this test on your own? Probably. Would it be better to have it done by someone that has seen 100's of people take the test? Certainly. For example, I tried exercise on my bike on the trainer only two weeks ago and stopped after feeling dizzy and light headed. Now I can't figure out if it was concussion symptoms or I just aggravated my neck by getting back on the bike.

Is it worth flying to buffalo? For me it was. I still feel a little crappy, but now I know I can go back to work and normal life without fear of hurting my brain even further. Rest alone is simply not going to help me fix my neck.

I think if you are past the 2-3 week point it might be worth jumping on a treadmill and seeing how you do. You could at the very least measure perceived exertion, heart rate and blood pressure with a friend helping. Or just go by how you feel. I suspect if you have problems still it will be pretty obvious.

Worth noting: the test itself cost $250 and is not covered by insurance.

06-02-2011, 04:27 PM	#12
chitowndizzy Junior Member Join Date: May 2011 Posts: 23	I'm back from Buffalo. Here is the short version: I'm no longer suffering from PCS. My symptoms are mostly caused by an upper cervical neck injury. Dr. Leddy is a really nice guy and a fellow cyclist to boot! He also said that 90% of the people he tests have problems due to neck injuries, not PCS. The appointment consists of a meeting with Dr. Leddy, the "treadmill" test, then a follow up to get an exercise plan. The first meeting with Dr. Leddy is just to get your history, background and to do those "touch your nose, follow my eyes" tests I'm sure you've all done a hundred times. Then they take you into the next room where a physical therapist tests your balance and physical exertion. I had an additional test which I"ll explain later. The balance test was fairly standard. Stand with your feet together, hands on hips and close your eyes. Stand on one foot, hands on hips, eyes closed. Stand with one foot in front of the other, hands on hips and eyes closed. Now repeat all three but while standing on a wobbly piece of foam. I had success with only the feet together test, otherwise I had trouble with the rest. The treadmill test is simple. You walk, every few minutes they increase the incline, you stop when you are maxed out or your symptoms stop you. I was hooked up to an EKG, blood pressure and heart rate monitor and I also would rate my perceived exertion every time the incline was increased. They also tracked how straight I walked using pressure sensors in the treadmill. I would imagine if any of these measurements changed in a strange way they would pull the plug. For me this didn't happen -- I hit a new max heart rate of 210 (always thought it was 205) and a 19/20 on the perceived exertion scale and then we stopped. After this they took me to a wall with a target on it. They took a laser pen and attached it to the side of my head with a bandage like the borg, (star trek joke). I had to point the laser at the center of the target using my head. Then with my eyes closed move my head all the way to the left and then back to the center of the target. We also went up, down and to the right. I missed far to the left every single time. Then the therapist took me to a room and poked and prodded parts of my neck and asked if it hurt, (yes). Then he checked for mobility. Then he told me he thinks my issue is an upper cervical neck injury. I followed up with Dr. Leddy who then cleared me to exercise as much as I wanted and to start physical therapy for my neck. If I had PCS still, the workout plan is pretty simple. They have you exercise at 80% of the heart rate that exacerbated your symptoms. I don't know how often or how long -- sorry, I should have asked! I'm still getting migraines weekly and I am easily overwhelmed in noisy places. Both are getting better with time, but I don't really see how those could be related to a neck injury. Dr. Leddy seemed to think they might. Could you duplicate this test on your own? Probably. Would it be better to have it done by someone that has seen 100's of people take the test? Certainly. For example, I tried exercise on my bike on the trainer only two weeks ago and stopped after feeling dizzy and light headed. Now I can't figure out if it was concussion symptoms or I just aggravated my neck by getting back on the bike. Is it worth flying to buffalo? For me it was. I still feel a little crappy, but now I know I can go back to work and normal life without fear of hurting my brain even further. Rest alone is simply not going to help me fix my neck. I think if you are past the 2-3 week point it might be worth jumping on a treadmill and seeing how you do. You could at the very least measure perceived exertion, heart rate and blood pressure with a friend helping. Or just go by how you feel. I suspect if you have problems still it will be pretty obvious. Worth noting: the test itself cost $250 and is not covered by insurance.