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Got much worse, very quickly, should I take time off?

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Unread 11-20-2012, 11:37 AM   #1
sigoria
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Default Got much worse, very quickly, should I take time off?

Hi, everyone! I'm fairly new here, I have been lurking for a while trying to find some answers on what I can do and what I should expect, but never previously felt the need to ask anything. I have, however found some great advice, and also some great comfort from reading in this forum, and I thank you for that! Please excuse my bad english, it's not my first language, but I hope you can get through my post/question anyway.

I got my concussion on november 30th last year, after fainting in class and hitting my head on a radiator. I was on full sickleave for about 6 months, since I was in too much pain and had too much cognitive difficulties to keep studying, but after that I've been trying to get back to my studies. I've still been in pain, I've had to stay home from school at least 2 days/week, and I've been constantly exhausted, but I've managed.

The last three weeks, however, have been a nightmare. I'm worse than I can remember EVER being, pain to the point of crying from simple things like socializing with my family for an evening or taking the subway to the doctor. I've had no energy at all, it's taken several hours to even get out bed in the morning, or to do menial things like cooking or washing the dishes. During this time I haven't been able to get myself to school at all.

I saw my doctor yesterday, hoping that he would put me on sickleave again, but he simply gave me a stronger painkiller. This new pill takes the pain away completely (though also making me so high I cannot be trusted to do anything outside the house), but I worry that I might make things even worse if I go back to the pace I had before the relapse. My doctor isn't a specialist (and he's previously refused to refer me to a specialist since "they wouldn't take me in anyway, since my injury is so minor"), so I trust your word more than his in this instance. Is it ok for me to just take painkillers and try to power through with my studies? I feel like I'm breaking down, but I can't afford to take time off if it's not absolutely necessary. Could I make things even worse if I just keep going? Or should I just push myself to go back to school even though it feels impossible?

I'm also unsure about this new drug. It's active substance is tramadol, and I feel like it's really risky to take this addictive drug several times a day, every day, especially if I can avoid it (dealing with the pain isn't half as bad when I'm at home - as long as I can keep relatively isolated it doesn't escalate as much). At the same time, it's absolute bliss actually getting rid of the pain instead of having to deal with it 24/7. But then again, I actually get high on it, nausea, dizzyness, giddyness and fascination over the world all included, and I can't really say how much I would learn in class if I've taken the drug. Do any of you have any experience with taking tramadol or other opiates? Is it worth it?

I'm thankful for any advice you can give me!

I'm 23 years old and female, if that makes a difference.

Best wishes
/Sigoria
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Unread 11-20-2012, 03:30 PM   #2
rmschaver
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Sigoria,
I have taken tramadol and had many the same effects. Mark in Idaho uses a combination of aspirin and tylenol for headaches. What is the nature of your pain? Are you suffering from any other symptoms? What did the doctor originally diagnose your injury as?
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Unread 11-20-2012, 03:49 PM   #3
sigoria
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Quote:
Originally Posted by rmschaver View Post
Sigoria,
I have taken tramadol and had many the same effects. Mark in Idaho uses a combination of aspirin and tylenol for headaches. What is the nature of your pain? Are you suffering from any other symptoms? What did the doctor originally diagnose your injury as?
I got into the emergency room almost as soon as the accident happened. I was unconcious for a couple of minutes, and I was spasming (I usually do when I faint, so nothing unusual there), so my teachers called for an ambulance. I had total lack of short term memory for about 4 hours, I didn't remember anything for a couple of weeks back and didn't form any new memories during that time. So they were pretty sure that it was a concussion, but they said I didn't have any indications of whiplash. They took a CT scan in the emergency room, which didn't show any sign of damage or bleeding, and so they said it was a minor concussion and that I'd be better in 2 weeks time. I got diagnosed with PCS about 2 months in, never had any other diagnosis.

I have lack of concentration, dizziness, general fatigue and I'm really sensitive to sound, light and other sensory impressions. I have about a hundred different kinds of pains in my head, no pain at all in other parts of the body. The most common pains are sharp pains (in my temples, between the eyes and in the back of my head (where I hit it)), a pressuring pain that feels like I've got a two sizes too small helmet on, a dull pain on the top of my head and another dull pain right behind my forehead. All of them are managable if I can avoid a lot of sensory impressions but get out of hand in about 5 mins if I'm in a place with a lot of people, or otherwise very loud and/or bright.
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Unread 11-21-2012, 07:46 PM   #4
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I wouldn't go full tilt on the painkillers. They are just masking the symptoms. You are liable to have "rebound" pain when you come off them. I don't think you r doctor is competent based on this medication choice. It shows he is choosing not to treat the cause of your problem, just the symptoms. And it sounds like he is doing it in an irresponsible way. Your fatigue is your brain/body telling you to slow down. I experience it daily.

As for your headaches, have you tried any injections? Other therapies besides medication? You need to have your neck and evaluated to see if there is soft tissue damage. Many here will tell you that your best bet is rest. That is largely true. Rest and try to build up to certain tolerances for activity. I am young like you and it is incredibly difficult to do this every day. But the alternative will make you worse.
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Unread 11-22-2012, 02:18 AM   #5
Mark in Idaho
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sigoria,

The first question should be: What have you been doing to help with recovery?

What was your pace before the relapse?

Those who do best learn by looking back to the activities and stressors before a relapse. Some keep a journal. Riding a train/subway can easily be too much stimulation. Same for spending time socializing where there are too many voices.

Getting a diagnosis of any neck injuries is also very important. Sometimes, the neck diagnosis is done in reverse. If icing or gentle head and neck traction causes an improvement, then continue that until the symptoms resolve. If the area behind your ears is tender, it is evidence of an upper neck injury. Ice can make a big difference.

My best to you.
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59 years old, retired due to disability, married 34 years, father of three, grandfather of four, Suffered a serious concussion at 10 years old (1965) stopped most driving after concussion at 46 years old (2001), Post Concussion Syndrome/Multiple Concussion/Impact Syndrome with PTSD, immediate/short term visual and auditory memory problems, slowed processing speed, visual/auditory processing difficulties, insomnia, absence seizures, OCD, 14 concussions since first concussion at 8 years old, Taking paroxetine for 14 years and gabapentin for 12 years. Added L-Tryptophan and stopped paroxetine after 3 months of tapering. I currently take 500 mgs of L-Tryptophan AM, 500 mgs noon, and 500 mgs PM.


As of Nov 15th, Due to high stress issues resulting in PTSD, docs put me on 3 meds. Clonazepam but only for 30 days ) .125 mgs twice daily (Doc presc. .25 mgs 2x daily but half a tablet is good) , citalopram (Celexa), an SSRI , and olanzapine (Zyprexa), an atypical anti-psychotic that usually causes weight gain before bed. I lost over 30 pounds since mid July. It just stopped the weight loss. Took me off the gabapentin. I am feeling better than I have in years.

This great feeling only lasted a month. Back to the same old PCS doldrums.

May 2014, I am off the olanzapine due to a 6 fold price increase. Back on 600 mgs of gabapentin before bed.

I am also taking L-Theanine to help with GABA regulation


"Be Still and Know That I am God" Psalm 46:10
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Unread 11-22-2012, 09:27 AM   #6
sigoria
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wakey: I got a TENS-machine from my physiotherapist that I've been using, and that helps to reduce the pain, though not nearly enough to get me back to school. I haven't tried any medication except for over-the-counter paracetamol and ibuprofen, usually taking full dosage of both at the same time to even get out of bed. I'm also enrolled in a rehabilitation program with a specialized team focused on dealing with long term pain. But that isn't at all about lessening the pain, it's just about learning to live and function even though you're in pain. I tried rest, as I said I was on full sick-leave the first 6 months, and that did work, but my doctor has kept telling me that too much rest can be just as bad as too little, and so I've tried to push myself to do as much as possible to keep this from happening. Have you heard anything about too much rest being bad for pcs?

Mark: I was on full sickleave until june 1st, after that I have tried to keep my food- and sleep-patterns as stable and healthy as possible, but it's been hard since all my energy has gone to trying to stay in school. Instead I've tried to pull back on my spare-time activities, and I haven't really been out to see friends, or even visiting my family, almost at all.
I've got some different ways of dealing with the pain, as mentioned above to wakey. But I can't say that I've been that focused on recovery, since my doctor basically have told me, time and time again, that any physical damage is already healed and that too much rest would be counterproductive. I guess I have been telling myself that it's "all in my head" and that I should just push through. I'm starting to realize that this might not be the best strategy if I ever want to be able to go back to my "normal" self again, and so I come here asking for advice.

My pace before the relapse was high, I've been trying to study full time, but as I mentioned in my first post that hasn't really worked. So I've constantly been stressed about falling behind and losing my student-loans, and at the same time I've been forced to move so there's been that stress as well. The relapse came as soon as I started to relax a bit - we had a week-long autumn break about 2,5 weeks ago, and after that I just haven't been able to get up and going again. But I had been deteriorating ever since I started working/studying again after my sickleave, so it was really just a matter of time anyway.

I'm not tender at all in the area around my neck, or behind my ears, but I'll make sure to get a referral to get that checked out anyway. Thank you!
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Unread 11-24-2012, 08:32 AM   #7
rmschaver
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In my opinion you should seriously consider a new Dr. if it is possible. I would look for one that will really listen and work with you to address the often many symptoms a PCS suffer can feel. Some of what you are feeling can very well be a result of vestibular injury.

If your Dr is only willing to prescribe pain meds and rest then that forces you into being the managing role for your injury. I know from experience that this is a near impossible role for a lay person to do. I only started making real headway when I got my GP involved to coax the neurologist to give me the referrals that would address my health issues.

Mark in Idaho is dead on with the icing. I have used narcotics from the onset put ice has been more effective in dealing with neck and back pains. When those are addressed my headaches are lessened. It can not be stressed enough to get the proper rest in your recovery.

Too much stimulation has been the downfall way more posts than is healthy. Quiet rest is best, very low physical, mental, visual and auditory stimulation. Yes this means you may have to adjust your goals and timelines. But ask yourself how long do you want your recovery to last. Would it be so bad if things got put on hold for a short time.

Trying to do too much with PCS is akin to running a marathon on a broken leg.
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49, Male Married, PCS since June 2012, headaches, Back pain, neck pain, attention deficit, concentration deficit, processing speed deficit, verbal memory deficit, PTSD, fatigue, tinutitus, tremors.

To see the divine in the moment.
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Unread 11-26-2012, 08:26 AM   #8
sigoria
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I will try to change doctors, I've been having doubts about him for a while and now that I know that it's not just me I'll get to that as soon as possible.

Since I don't have any pain at all in other parts of my body, I wouldn't know where to start with the icing, and putting it directly on the parts of my head that ache seems like a bad idea since cold usually makes the pain worse. But if I would get any back/neck pains, I'll remember that advice. Thank you!

The reason why I've been so active is, like I said, that my doctor keep telling me that being to inactive might well make things even worse than beeing too active would. Is this not true?

And don't worry - I've long since given up on any timelines. It's hard to put things on hold completely, since I wouldn't have any income if I did (and I don't think becoming homeless and starving would improve my situation much). But I don't have any problems with letting my recovery take the time it needs, as long as I know I'm on the right track.
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Unread 11-27-2012, 12:27 AM   #9
Mark in Idaho
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signoria,

"since my doctor basically have told me, time and time again, that any physical damage is already healed and that too much rest would be counterproductive."

This is not true at all. This doctor does not know what he is talking about. The brain only heals during low stress times. It needs good REM sleep, too. The skull may have any fractures already healed but the brain tissue needs rest to heal.

What did you do while on sick leave?

Ice the back of your head, high on your neck when you have a head ache. I bet it makes a difference. Put a towel over the ice pack so the cold is not extreme.

Try paracetamol and aspirin (salicylic acid) combined and see if it helps your head ache.

What is your physiotherapist doing for you? Where/how do you use the TENS machine?

btw, Where are you? Somewhere in Europe I guess but???

My best to you.
__________________
Mark in Idaho
.


59 years old, retired due to disability, married 34 years, father of three, grandfather of four, Suffered a serious concussion at 10 years old (1965) stopped most driving after concussion at 46 years old (2001), Post Concussion Syndrome/Multiple Concussion/Impact Syndrome with PTSD, immediate/short term visual and auditory memory problems, slowed processing speed, visual/auditory processing difficulties, insomnia, absence seizures, OCD, 14 concussions since first concussion at 8 years old, Taking paroxetine for 14 years and gabapentin for 12 years. Added L-Tryptophan and stopped paroxetine after 3 months of tapering. I currently take 500 mgs of L-Tryptophan AM, 500 mgs noon, and 500 mgs PM.


As of Nov 15th, Due to high stress issues resulting in PTSD, docs put me on 3 meds. Clonazepam but only for 30 days ) .125 mgs twice daily (Doc presc. .25 mgs 2x daily but half a tablet is good) , citalopram (Celexa), an SSRI , and olanzapine (Zyprexa), an atypical anti-psychotic that usually causes weight gain before bed. I lost over 30 pounds since mid July. It just stopped the weight loss. Took me off the gabapentin. I am feeling better than I have in years.

This great feeling only lasted a month. Back to the same old PCS doldrums.

May 2014, I am off the olanzapine due to a 6 fold price increase. Back on 600 mgs of gabapentin before bed.

I am also taking L-Theanine to help with GABA regulation


"Be Still and Know That I am God" Psalm 46:10
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Unread 11-27-2012, 09:43 AM   #10
sigoria
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Quote:
Originally Posted by Mark in Idaho View Post
signoria,

"since my doctor basically have told me, time and time again, that any physical damage is already healed and that too much rest would be counterproductive."

This is not true at all. This doctor does not know what he is talking about. The brain only heals during low stress times. It needs good REM sleep, too. The skull may have any fractures already healed but the brain tissue needs rest to heal.

What did you do while on sick leave?

Ice the back of your head, high on your neck when you have a head ache. I bet it makes a difference. Put a towel over the ice pack so the cold is not extreme.

Try paracetamol and aspirin (salicylic acid) combined and see if it helps your head ache.

What is your physiotherapist doing for you? Where/how do you use the TENS machine?

btw, Where are you? Somewhere in Europe I guess but???

My best to you.
Ok, then I know it wasn't a bad move forcing him to put me on sick leave again, though only for three weeks this time. Thank you!

On sick leave I tried to rest as much as possible, I stayed home a lot, took some longer walks when the weather allowed it and tried to stay away from screens (tv, computer and such) as much as possible. I also had some appointments with the doctor I've been telling you about, a pysiotherapist and a therapist, but none of these had any tips at all of what I could do to recover, other than rest.

Ok, I'll try the icing. Thank you!

I tried that when I was on sick leave, and I thought that it didn't work as well as paracetamol and ibuprofen combined. And that doesn't work as well as the kodein + paracetamol pills I've got now. But maybe I'll give it a second try, it isn't like I'm actually pain-free on anything, except the tramadol-pills I had when I wrote the OP, and those made me far too high to be helpful.

I saw a psysiotherapist this spring who didn't do anything except give me, and teach me how to use, the TENS. I use the TENS on my neck/shoulders when I'm in stressful situations and get headaches from tensing up, and it helps for that. It doesn't help at all for the original headaches though. Right now I'm starting to see another physiotherapist, but she doesn't seem to have any ideas for helping me with my head, so we'll probably focus mainly on other things.

Yes, I'm in Europe. I'm actually in Sweden. Why?

Best wishes!
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