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Traumatic Brain Injury and Post Concussion Syndrome For traumatic brain injury (TBI) and post concussion syndrome (PCS).

Why did it take so long for my symptoms to show up?

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Unread 02-08-2012, 01:07 AM   #1
SpaceCadet
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Default Why did it take so long for my symptoms to show up?

It took 3 months for my symptoms to show up....THREE FREAKIN' MONTHS!!!

Here's a picture of me (and my fiance at the time) having a BLAST on the strip here in Las Vegas. This is was a little under a month after the assault. It was our anniversary....and I was FINE!! I think my symptoms there were extremely mild. Hardly noticeable...They were obviously tolerable enough to walk the strip, play the slot machines, walk through numerous casinos...for HOURS!!! WHY!?

http://i1114.photobucket.com/albums/.../meandtara.jpg

Why the h*** am I worse now than I was then? End of July through August were great...I was doing lots of fun things and living a normal life...I'm a freakin' hermit now...which I really don't mind, but I can't even watch TV man...so being a hermit isn't fun anymore. If I could watch TV and play video games I'd make an awesome hermit.

Could it be the alcohol I drank when I thought that I was better?

Just wondering...No doctor has been able to answer that question.

I've read somewhere, on here I think, that it takes awhile for the damaged brain cells to die off...is that true?
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What happened: I was randomly assaulted from behind in June of 2011. I was knocked unconscious for an unknown amount of time (less than 30 minutes) and have no memory of the event. CT scan showed contusion and hematoma of the left frontal lobe. I spent 3 days in the hospital. Diagnosed with Post-Concussion Syndrome in September 2011. Currently have Medicaid and SSI.

Current symptoms: Brain fog, anxiety, panic attacks, memory issues, confusion, problems with spontaneity, sensitive to loud noises, trouble thinking, problems with producing speech, spacing out, word finding difficulties, tinnitus in both ears, random tingling in different parts of my head and many other things that I can't explain. I'm very easily overloaded which makes it nearly impossible to watch TV or use the computer.

Slowly but surely regaining my life back.
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Unread 02-08-2012, 02:14 AM   #2
nightnurse30
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Nick....I did the same thing. 3 weeks after my accident i thought i was better and went back to work in the ICU. 12 hour overnight shift. I thought once my bruises were gone, i would be fine. a week later it was determined i was not well enough to work....but i had my 30th birthday party planned in Vegas and i had friends flying in so i was gonna go no matter what. This was only 4 weeks after my accident.

Was I in pain? Absolutely. Was i on a lot of pain medicine to make it through the weekend? Definetly. Was this a smart thing to do? Completely stupid of me. Do i think it made me worse off? I have no idea! I could show you pictures of me as well....and i think i looked like i was having fun in most of my pictures in Vegas. But we all look ok on the outside....thats our biggest problem. Its the inside of our brain that is struggling. I was definetly the first one to say i need to leave every night, i didnt drink alcohol the way i was planning on....had only a few drinks a night. I couldnt tolerate the lights or music of house rooms, i would get dizzy and spacey and need to go outside or to a different area where lights were low and no strobe lights.

Even last summer when i was only a few months into my PCS, i was still trying to be normal and do things i used to....like watch sporting events at a bar, go out and have drinks with friends, go out to eat. All of it brought on the Brain Fog that you write about. My poor friends saw me literally get slow and stupid and not able to speak for a long period. I would just say, "um, um, um, um, um." when they asked what was wrong....and this was after not answering them the first 10 or so times.

I also went to Disneyland with a 2 year old last September....the other stimulation capital of the world. Who knows if doing these things led to a longer recovery time, but if i knew then, what i know now....i probably would have canceled both trips and rested cognitively and physically.

I went back to working the overnight shift 3 months after my accident and lasted for 2 months before i literally could not get out of bed anymore, the fatigue and exhaustion and headaches were so debilitating. I then became a hermit and finally accepted and acknowledged that i truly need to rest! Since i have been resting and staying home and taking very good care of my body, i finally feel better. I am slowly beginning to work again for the past month and taking it easy on my days off, and my symptoms are staying away.

Have you tried reading? Ive been using this time that i have been at home to read a lot of books on spirituality, healing, books on brain injuries, nursing, etc. Ways to make me a better person because of all of this. I believe that the brain injury happened to me for a reason....to open up my awareness and my mind to subjects i wouldnt have considered before. Im trying to use this time the best i can. If it doesnt bother you to read, maybe you can try reading a book on a subject that interests you. Learn a new hobby or interest through reading. Maybe start a thread asking others what books helped them during their recovery?
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Suffered a TBI with PCS on April 25th 2011 from multiple blows to the head from falling, unconscious for 12 hours with no memory of event. Hit the back of my head, and above right eye. MRI and CT negative. Symptoms included constant headaches (migraine, pressure, tension, icepicks), dizziness, tinnitus, visual changes, photophobia, fatigue, "spacing out", word finding difficulties, depression, and emotional lability.
Began Healing in November 2011 after starting acupuncture and Healing Touch (a nurturing energy therapy that promotes relaxation and pain relief). I went back to work in February 2012. Ive been symptom free since July 2012. Very happy, positive, energetic and working out every day, doing yoga, and living a normal life again!
I also began taking Healing Touch classes in November 2011 and completed 5 Levels of Healing Touch Certificate Program that included a 1 year mentorship to become a Healing Touch International Practitioner in June 2013. I am so pleased to offer this wonderful healing therapy to my patients, friends, and clients.
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Unread 02-08-2012, 03:07 AM   #3
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I just read where diffuse axonal injury is largely a matter of secondary biochemical cascades, and not directly a matter of the axonal shearing from the primary injury. This would account for the delayed onset you both experienced (and probably me, but I can't remember that far back).

It is this cascading that causes the actual death of the neuron, and so you heard correctly about it taking a while for the cell to die.

Perhaps Mark in Idaho can jump in and fill in some details.
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Passenger in auto wreck, mTBI:
  • CHRONIC FATIGUE SYNDROME
  • MYALGIA (generalized muscle pain)
  • MIGRAINE HEADACHES
  • INSOMNIA
  • ANGER & SELF-CONTROL (going "Frontal")
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Unread 02-08-2012, 05:13 AM   #4
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Nice pic, what's all this complaining about, you look fine

"Excitotoxic injury cascades, active cell death pathways (apoptosis) and disruption of cellular energy regeneration" are, according to my massive book, all things which can occur "from minutes to weeks" following a TBI. They are obviously very complicated, but generally involve chemicals from the dead brain cells going into live cells and 'exciting' them to the extent that they too die, leading to a gradual cascade of cell death over time.

For me it took a week for my symptoms to fully kick in. I agree three months seems a bit of a long time, but since we've learned that alcohol can have a massive effect, it seems to me a pretty good guess that the drink got involved in this process and made its effects longer and worse.
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mTBI March 2011, spent around a year recovering.

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Unread 02-08-2012, 05:41 AM   #5
Mark in Idaho
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I read long ago about this slow die off. Part of it was attributed to the chemical cascade but the main cause was described as a cellular suicide message sent out. The idea is that the damaged cells, after trying to go on functioning, give off toxins. These toxins trigger a release of tRNA. This is a message Transmitting form of RNA. This tRNA tells the damaged cells to die and this message continues until it find strong healthy cells. This process can take weeks to months.

The failure to rest likely overtaxes the brain so these toxins build up causing a critical mass of cell weakening or death causing this cascade to accelerate.

I have not read about 3 month delays in symptoms but a 6 week to 2 month delay is not uncommon. This tends to support the doctors who have released patients from care for their other injuries just as their concussion symptoms are starting up.

It also messes up Work Comp claims since the delay makes the insurance company try to disregard the concussion symptoms as unrelated to the original injury.

One renowned concussion researcher has specifically suggested noting all head impacts in the medical record whether any concussion symptoms are present at the time of examination. There is an ICD-9 and ICD-10 code 850.9 that specifically notes a head impact with probability of concussion. Noting this head impact is beneficial so that symptoms that show up later can be better understood.

Here are the Concussion ICD-9 codes.

Concussion 850- >
ICD-9-CM 850 is a non-specific medical code.2012 ICD-9-CM Diagnosis Code 850
Concussion
A violent jar or shock, or the condition which results from such an injury.

ICD-9-CM 850.0 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.0 convert 850.0 to ICD-10
Concussion with no loss of consciousness

ICD-9-CM 850.1 is a non-specific medical code.2012 ICD-9-CM Diagnosis Code 850.1
Concussion with brief loss of consciousness

ICD-9-CM 850.11 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.11 convert 850.11 to ICD-10
Concussion, with loss of consciousness of 30 minutes or less

ICD-9-CM 850.12 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.12 convert 850.12 to ICD-10
Concussion, with loss of consciousness from 31 to 59 minutes

ICD-9-CM 850.2 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.2 convert 850.2 to ICD-10
Concussion with moderate loss of consciousness

ICD-9-CM 850.3 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.3 convert 850.3 to ICD-10
Concussion with prolonged loss of consciousness and return to pre-existing conscious level

ICD-9-CM 850.4 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.4 convert 850.4 to ICD-10
Concussion with prolonged loss of consciousness, without return to pre-existing conscious level

ICD-9-CM 850.5 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.5 convert 850.5 to ICD-10
Concussion with loss of consciousness of unspecified duration

ICD-9-CM 850.9 is a specific medical code.2012 ICD-9-CM Diagnosis Code 850.9 convert 850.9 to ICD-10
Concussion, unspecified
A violent jar or shock, or the condition which results from such an injury.
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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 100 mgs of 5-HTP AM, 500 mgs of L-Tryptophan at noon.

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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