Post-Concussion Syndrome

Does anybody here have experience with post concussion syndrome? Would love to hear about your experience with it, road to recovery, and how you manage it with climbing objectives as well as day to day living. Thanks!!

I experienced PCS for about 2 years after slamming my head on the pavement. I really can’t sugar coat it, it was the worst period of my life. Everyone’s experience will be different, but for me it was a 24/7 headache in a specific part of my head, nearly constant brain fog, and the manifestation of severe anxiety.

As far as my climbing during that period, I found myself sticking to less committing objectives. This was in large part due to the anxiety, I didn’t feel safe being in remote and exposed environments. I had experienced some severe panic attacks, and the thought of one occurring 10 pitches off the deck in the backcountry prevented me from going for it. It was also difficult not to hyper focus on the constant pain in my head in those situations. I would convince myself I was on the cusp of a brain aneurysm, which would make the anxiety/panic spiral.

I shifted to climbing objectives that felt “safer”. At the time I was living in an area with more sport climbing, so I did that. I also spent a lot more time in the gym. In terms of physical fitness, I was pushing the hardest grades I had ever climbed. Unfortunately, PCS sucked so much of my joy out of climbing. Climbing could distract from the pain in the moment, but it always came rushing back once I was on the ground.

I do think staying active contributed to my eventual recovery. I didn’t wake up feeling better one day. It was gradual. I did find myself drinking quite a lot during that period, in part to cope and mask the pain. If I could do-over, I would try to be sober and limit the time spent in front of a screen.

I was hit by a truck whilst on a bike ride in my 30's, came to with a shattered helmet on the ride to the hospital. A month of severe headaches, and then I had multiple small TIA's followed by a big one. My language centers and hippocampus got dinged pretty good. 

The big trick for me seems to be monitoring "resources". Good rest, hydration, meds, and diet are not optional. When those resources get low, that's when symptoms increase. After 25 years, the symptoms are much more manageable. It's probably person-by-person, but you may need to come to terms with being a different "you". So really take care of yourself, and give climbing partners the beta on how your injury manifests.

Ditto the piece about anxiety. When the thing that does the perceiving is faulty, it's hard to perceive whether or not the thing that does the perceiving is faulty. Kinda scary.

Oh and if you're in Eldo and say "hi" to the trail guy, I know who you are, but the pathway from faces to names is like sending morse code over barbed wire fence. Don't take it personally.

Right, so I had two concussions within a two-week period, first was an explosion and second was being evacuated from a vehicle at about 30 miles an hour (because of an explosion). This was around 2005/2006 and still have some residual effects. Primary presentation in the immediate was memory loss, and frontal lobe damage. We joke about some people not having a filter between their brain and their mouth but its a real pain in the ass in real life. I would literally say anything I was thinking, would walk off from people mid-conversation the moment I lost interest, my friends had to start intervening on my behalf to protect me from interacting with the wrong people (high level bosses, etc.). Anyway, that lasted about a month. Secondary was from about a month to a year: trouble sleeping, diet control, trouble committing things to memory. Sleep was either too much or not enough, diet was same way. Sometimes I'd stay up for close to 36 hours then crash (like nearly impossible to wake) for 14-18 hours, food was the same where I wouldn't eat for days then eat non stop. Would introduce myself to a new person for days in a row before I started remembering them. Frequency of these events decreased over time and eventually stopped. Third stage is what I'm in now and appears to be pretty much permanent, minor and infrequent issues with memory, sleep, focus, irritability. The major ping is getting stuck on a word and then completely losing my train of thought. This one is a weekly if not more often event. I don't really have much recollection of my childhood particularly or a lot of things before the accidents. Still surprised to learn things about my past self (its kind of fun in a weird way, like I've lived two different lives).

Anyway, can't speak to climbing during the initial and secondary stage because I wasn't climbing then. I was doing some sports and my work at the time required a lot of focus and physical labor. Its pretty easy to get knocked out again in the first year. Pretty much anytime I even dinged my head I got dizzy and my vision narrowed. Endurance exercise really seemed to help with irritability and sleep, like if I laid off the exercise there was an immediate change. I started doing daily coordination and balance exercises that, while frustrating in the beginning, really seemed to help with recovery. Don't know what kind of trauma is associated with your situation, but talk to someone you trust even if you feel like you don't need it. It helps the process immensely. I feel like at the permanent stage, climbing is great for helping me keep my balance and focus sharp. 

I had a TBI (traumatic brain injury) in 2011.  I would be dead had I not been wearing a motorcycle helmet.  What helped the most was hyperbaric chamber therapy.  This gets more oxygen to the brain for healing.  I had 40 hours of this.  Hyperbaric chambers are most known for people who get the “bends” from surfacing too quickly while diving.  The place I had it done is in Boulder, CO but there are other places in the country.  I was shown videos of soldiers with brain injuries from Iraq and Afghanistan who were vegetables before they had the therapy but seemed to be normal after.  Unfortunately it is not FDA approved so regular physicians won’t prescribe it and it may cost you a lot.

See a doctor who specializes in post concussive treatment.  They are out there especially in metro areas.   Normally post concussive symptoms should resolve or greatly improve within one to four weeks after the initial event. Not sure what your timeframe is regarding symptoms, You should avoid doing any activities initially that provoke symptoms.

Bolting Karen wrote:

Right, so I had two concussions within a two-week period, first was an explosion and second was being evacuated from a vehicle at about 30 miles an hour (because of an explosion). This was around 2005/2006 and still have some residual effects. Primary presentation in the immediate was memory loss, and frontal lobe damage. We joke about some people not having a filter between their brain and their mouth but its a real pain in the ass in real life. I would literally say anything I was thinking, would walk off from people mid-conversation the moment I lost interest, my friends had to start intervening on my behalf to protect me from interacting with the wrong people (high level bosses, etc.). Anyway, that lasted about a month. Secondary was from about a month to a year: trouble sleeping, diet control, trouble committing things to memory. Sleep was either too much or not enough, diet was same way. Sometimes I'd stay up for close to 36 hours then crash (like nearly impossible to wake) for 14-18 hours, food was the same where I wouldn't eat for days then eat non stop. Would introduce myself to a new person for days in a row before I started remembering them. Frequency of these events decreased over time and eventually stopped. Third stage is what I'm in now and appears to be pretty much permanent, minor and infrequent issues with memory, sleep, focus, irritability. The major ping is getting stuck on a word and then completely losing my train of thought. This one is a weekly if not more often event. I don't really have much recollection of my childhood particularly or a lot of things before the accidents. Still surprised to learn things about my past self (its kind of fun in a weird way, like I've lived two different lives).

Anyway, can't speak to climbing during the initial and secondary stage because I wasn't climbing then. I was doing some sports and my work at the time required a lot of focus and physical labor. Its pretty easy to get knocked out again in the first year. Pretty much anytime I even dinged my head I got dizzy and my vision narrowed. Endurance exercise really seemed to help with irritability and sleep, like if I laid off the exercise there was an immediate change. I started doing daily coordination and balance exercises that, while frustrating in the beginning, really seemed to help with recovery. Don't know what kind of trauma is associated with your situation, but talk to someone you trust even if you feel like you don't need it. It helps the process immensely. I feel like at the permanent stage, climbing is great for helping me keep my balance and focus sharp. 

That was an incredible read... heavy stuff...

Explosions!?

Hi Luke!

I'm so sorry to hear that you're experiencing post-concussion syndrome. I'm a physical therapist so I see this condition often and have also experienced it myself. The symptoms and timeline are different for every single person, they can even vary within the same person if they experience it more than once. Something that I wish I had known when I had these symptoms, and have taken it upon myself to learn now as a physical therapist, is that there are a lot of conservative treatment options to help with your specific symptoms so you don't have to deal with them for years and years. If you haven't seen a physical therapist who specializes in vestibular or concussion rehab (oftentimes, these specialties go hand-in-hand) I would highly recommend seeking one out, it can be life-changing. For the short term, I will include an article from The Climbing Doctor blog about climbing after concussions for you to look through and try out some of the recommended strategies. This blog is overseen by Dr. Jared Vagy, a physical therapist who specializes in the treatment and research of rehab for climbers. 

Climb On After a Concussion - Article

If you have any questions or need help finding a PT who can help don't hesitate to ask. 

Took a 70 footer onto a ice slab major TBI to front cortex. It's my 2nd TBI other was a work accident. It's a year and few months I still have my moments. My therapist has helped a ton, cold turkey on the meds. 

Everything the others have said is very good information, feel free to reach out. The hardest part of both is now I realized I have had extreme personality changes twice in my adult life. It's hard for us and can be very very hard on the people who love us. I wish my 3 pre teens didn't have to go through it. Unfortunately it was hard enough my wife starts crying when we talk about it. I don't remember my behavior during the initial 8 months. It's a long road don't try and do it on your own.

As someone who also has had and is currently dealing with post concussion syndrome or now coined persistent concussion symptoms it is a tough road. My accident happened when I spotting someone and they took a weird unlucky fall and happened to land on my head first. But it’s been about 4ish months and I am just starting to see the light with symptom reduction and return to real life and climbing. My main recommendations are finding a specialized doctor who can kind of monitor you along the way to recovery (I am located in LA and see the ucla concussion clinic) these kinds of people see this stuff a lot and know how to try and get you better. Although all cases are different something else that I recently started and is helping a lot is vestibular therapy/physical therapy for issues with my neck that came along with the concussion as these can also lead to headaches and other pcs symptoms. Feel free to reach out I’ve found it’s always nice to talk to someone who understands what it’s like to go through something like this and it’s a little more common than you would think. But the main thing is believing it will get better you’re not stuck with these symptoms for good 

Anyone familiar with a concussion specialist they would recommend in front range CO? Thanks

Did anybody get prescribed Gabapentin? Any info on it's results short or long term for tbi?

 I took a small amount (for 10 days?) after a bike crash, where I was unconscious for 2 days in the hospital. Luckily my brain confusion subsided within a month or so, and have had no lasting symptoms going on 4 years now.

Evan Gerry wrote:

Anyone familiar with a concussion specialist they would recommend in front range CO? Thanks

Responded in the migraine thread - but highly recommend Jaimy Wahab. She’s amazing and also does telehealth. I’ve had 7 concussions, with #6 being a more serious TBI that took a couple years to recover to ‘new normal’. Worked with Jaimy after #7 (16 year gap between 6 and 7) and she definitely helped me recover more quickly. Happy to talk off line.

http://www.balanceandneurologic.com/contact.html

Good recommendations on seeing PTs and Doctors who specialize in concussion therapy. I also suggest looking into Occupational Therapists who specialize in concussion therapy. I’ve had two serious concussions, the first many years ago when concussion therapy was not really known (to me at least). My second concussion was more recent and I was referred by my primary doctor to a place that did both Occupational and Physical Therapy (as I had other injuries as well). It was a great experience and something I looked forward to going to. It seems like a lot of the OT work was to stress the brain  just enough to bring on the symptoms, and then back off and let the brain recover. Like slowly reintroducing exposure to screen time, interesting reaction time type games using a touch screen, eye exercises to stress your vision a little bit before tapering it back. Memory exercises. I definitely recommend reaching out to an OT, and I think insurance should likely cover it (they did in my experience in the US)