Trying to narrow things down

[Halfnelson]

Hi all,

I'm just attempting to narrow down the possible causes behind my symptoms as well as factors that aggravate these following a concussion 12+ months ago.

Symptoms; brain fog, tingling/fuzziness on left side of head (especially upon physical or mental exertion), mixing up words, word finding difficulties, stuttered/slurred speech, blurred vision in left eye and difficulty hearing in left ear.

Factors that aggravate symptoms; any form of mental or physical exertion, even a bowel movement..

After 24-48 hours of no mental and physical exertion my symptoms decrease and I am back to 95% normal.

Symptoms immediately return upon mental or physical exertion.

Quick recovery to 95% may indicate that my condition is non-permanent and does not involve severe 'damage' to brain structures - maybe something is just being obstructed/blocked in the 24-48 hours following mental/physical exertion?

For anyone with experience in this area, are there any structures of the brain or nervous system that could be affected following mental/physical exertion and simply be causing my symptoms? E.g. brain nerves being obstructed by blood vessels, lack of blood flow, inflammation etc.

MRI of brain and neck are fine.

Many thanks!

[Mark in Idaho]

All of the symptoms you have sound like Post Concussion Syndrome. Your recovery after quiet rest is also a PCS sign. You will be more likely to have longer lasting recovery from weeks of quiet rest. Each time you relapse, it breaks the chain of quiet rest and you lose the value of the recovery.

It takes weeks of sustained quiet rest and a slow return to activity to get recovery to last. It also helps to understand all of your triggers so you can moderate them. Consuming more fiber will help the bowel movements to be less stressful.

You may have damaged the blood vessels to that portion of your brain. Until they heal, any change in blood pressure (stress) can cause symptoms. The myriad of causes that can be effecting your are vast. Only you can narrow down these causes.

My best to you.

[Halfnelson]

Originally Posted by Mark in Idaho

All of the symptoms you have sound like Post Concussion Syndrome. Your recovery after quiet rest is also a PCS sign. You will be more likely to have longer lasting recovery from weeks of quiet rest. Each time you relapse, it breaks the chain of quiet rest and you lose the value of the recovery.

It takes weeks of sustained quiet rest and a slow return to activity to get recovery to last. It also helps to understand all of your triggers so you can moderate them. Consuming more fiber will help the bowel movements to be less stressful.

You may have damaged the blood vessels to that portion of your brain. Until they heal, any change in blood pressure (stress) can cause symptoms. The myriad of causes that can be effecting your are vast. Only you can narrow down these causes.

My best to you.

Thanks Mark.

It makes sense that I damaged blood vessels to some portion of the brain. Slight bleeding, inflammation, or both upon exertion. The damage is probably extremely small as nothing appears on MRI with contrast.

However, as hard as I try, it is realistically impossible to make it a few days without some form of relapse caused by physical/mental exertion. Perhaps over time the symptoms will be less easily aggravated but unfortunately this has not occurred yet. Every relapse takes me back to 'square one'.

Although it is probably impossible, I wonder if I could arrange for a doctor to put me into a coma for a few weeks?! If anything was to solve the problem that would be it! I'd pay almost anything for the opportunity.

How anyone considered this?

[Mark in Idaho]

Drug induced comas are quite common for severe brain injuries. They use them to slow the brain until vessels heal and the brain is better able to control fluid pressures. The problem with comas is it causes the brain to forget the map to nerve pathways. This is why many comatose patients need extensive rehabilitation to slowly wake up these nerve pathways. Not a good solution for a mTBI.

Quiet rest is the recommendation. A few weeks off work in a disciplined low stress environment can make a big difference. It takes discipline to not over-exert while resting quietly. I suggest something like fresh water fishing. Sitting watching a red and white bobber for hours is good quiet rest. Or cast and retrieve a lure or fly fishing. They all have a slow pace.

There are other quiet rest activities. Quiet rest is the only worthwhile treatment.

My best to you.

[Halfnelson]

Originally Posted by Mark in Idaho

Drug induced comas are quite common for severe brain injuries. They use them to slow the brain until vessels heal and the brain is better able to control fluid pressures. The problem with comas is it causes the brain to forget the map to nerve pathways. This is why many comatose patients need extensive rehabilitation to slowly wake up these nerve pathways. Not a good solution for a mTBI.

Quiet rest is the recommendation. A few weeks off work in a disciplined low stress environment can make a big difference. It takes discipline to not over-exert while resting quietly. I suggest something like fresh water fishing. Sitting watching a red and white bobber for hours is good quiet rest. Or cast and retrieve a lure or fly fishing. They all have a slow pace.

There are other quiet rest activities. Quiet rest is the only worthwhile treatment.

My best to you.

I will have to wait until I can get a few weeks off work but that will not be until May 2013.

The 'pace' of activity is not the only thing that aggravates my symptoms. They are so easily offset that simply pulling a fishing rod to reel in a fish may worsen symptoms.

The only way to recover appears to be absolute bed rest. I would also hope that, over time, going to the bathroom would not aggravate things as it currently does.

If anyone else has advice that would be appreciated!

Thanks

[Mark in Idaho]

Bed rest is more than you need. You brain needs quiet rest with simple stimulation so your brain gets good blood flow.

What kind of work do you do? Is there any way to scale back your efforts for a few months? It will help you return to a full work load sooner.

[Halfnelson]

Originally Posted by Mark in Idaho

Bed rest is more than you need. You brain needs quiet rest with simple stimulation so your brain gets good blood flow.

What kind of work do you do? Is there any way to scale back your efforts for a few months? It will help you return to a full work load sooner.

I'm an Industrial/Organisational Psychologist and work for a private company. The work is difficult and the workload very demanding. Given that I do not have a replacement and we have clients to look after, scaling back the work is not possible and I can only take the leave I am allowed (i.e. 4 weeks per year). So I will have to wait until early next year before this can be considered.

Having a great day today though - back to 95%.

Hopefully I wake up tomorrow feeling the same.

[rmschaver]

I have two narcotics prescribed to me that can make a bowel movement much harder. Oxycodone and tramadol. I drink lots of water, walk and try to keep my fiber intake high. Lots of raw veggies and fruit.