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Whiplash injury frustration!!! What to ask???
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Whiplash injury frustration!!! What to ask???

Hallo,
I am a 41 old man in good health (eating right, not overweight, not smoking, exercising regulary).
I sustained a concussion and a whiplash injury a month ago in a bike-cycle accident (had to brake very suddenly as a car drove out in front of me - put both feet on the ground to brake - fell on my back and hurt my back and the back of my head on the asphalt - was wearing a helmet, but it cracked - oh, and the driver drove off without stopping).
I spent a week in hospital for observation and had several scans (including an MRI scan), which really didn't show anything (good news I believe).
However, since the accident, I have suffered from strong headaches (take max dose of paracetamol/codein every day), I wake every night and need to take headache pills (before I slept like a baby - taking sleeping medication but it does not really work - I still wake up), I have pain in my neck and shoulders (have started physiotherapy and taking muscle relaxation medication), feeling dizzy all the time (like I am on a boat / being seasick), have a slight constant ringing in my left ear, have lost some of my periphial vision on the left side, have constant pins and needles in my left hand and sometimes feel shooting pain in my arms (mostly on the left side), get very quickly tired (max 15-20 mins in front of a computer or reading a book) and I have become more depressed (before the accident I took 20 mg of citalopram per day and was fine, but now I am at 40 mg per day and is considering with my doctor if I need to go to 60 mg per day).
I have been off work for the last month and been at home. Have had time to spend more time with my 1-year baby (trying to see the positive), but I am very frustrated that no-one can tell me how long this will take. I am afraid of losing my job and see a general negative spiral to my health and possible my marriage (my wife is understanding but I can see that I am not easy to live with in my current situation).

Q: WHAT CAN I DO? Or what can I ask my doctor? How long should these symptoms go on for? Is there any surgery or alternative solutions that anyone can suggest and I can look in to them?

ANY HELP AND ADVISE HIGHLY APPRECIATED

Thx,
Ken
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Avatar_m_tn
I had a similar injury and hit the back of my back on May 2009 and I can totally relate what you are going through.  Yes and still suffering with quite few issues.  Doesn't mean you have to suffer that long bcuz each head injury is unique.  Collectively they call it as Post Concussion Syndrome which means there is no single pill or therapy which can cure.  It is a poorly understood by many doctors and you need to find a specialist who knows about this.  Still no one can tell how long and you may be ok in few months.

Neurologists can help with medications but medications only help so much.  In the beginning the only advice is to rest and anti-depressants.  But if you didn't see any progress then there are plenty of therapies you can try and of course no guarantee and insurance doesn't cover.

My main symptoms which are disabling is dizziness, heavy feeling in head and fatigue.  I have tried lot of meds/therapies and lately I am doing PT for neck and it helps only that day and next day I am back to hell.

Therapies you can try are so many : Acupuncture, Trigger Point therapy, Vestibular therapy, HBOT, Chriopractor, Cranio sacral therapy etc., and some even tried Stem Cell Therapy (not available in U.S)

There are surgeries too for dizziness etc., but most of them exploratory meaning it won't show in any tests but only a trial. I recommend to stay away from any surgergy unless you can find a doctor who is an expert (Neuro-Otologists, Neurolgists etc.,)

Since you a bike you can try controlled exercise suggested by University of Buffalo concussion clinic and I have been trying few months and I see some benefit.

Good luck.


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Avatar_m_tn
I had a similar injury and hit the back of my back on May 2009 and I can totally relate what you are going through.  Yes and still suffering with quite few issues.  Doesn't mean you have to suffer that long bcuz each head injury is unique.  Collectively they call it as Post Concussion Syndrome which means there is no single pill or therapy which can cure.  It is a poorly understood by many doctors and you need to find a specialist who knows about this.  Still no one can tell how long and you may be ok in few months.

Neurologists can help with medications but medications only help so much.  In the beginning the only advice is to rest and anti-depressants.  But if you didn't see any progress then there are plenty of therapies you can try and of course no guarantee and insurance doesn't cover.

My main symptoms which are disabling is dizziness, heavy feeling in head and fatigue.  I have tried lot of meds/therapies and lately I am doing PT for neck and it helps only that day and next day I am back to hell.

Therapies you can try are so many : Acupuncture, Trigger Point therapy, Vestibular therapy, HBOT, Chriopractor, Cranio sacral therapy etc., and some even tried Stem Cell Therapy (not available in U.S)

There are surgeries too for dizziness etc., but most of them exploratory meaning it won't show in any tests but only a trial. I recommend to stay away from any surgergy unless you can find a doctor who is an expert (Neuro-Otologists, Neurolgists etc.,)

Since you a bike you can try controlled exercise suggested by University of Buffalo concussion clinic and I have been trying few months and I see some benefit.

Good luck.


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Avatar_m_tn
Hi Sam,

Thanks for your reply. It is nice to know that I am not alone (although I do not wish it upon anyone to feel how I feel).

You seem to have been through the mill, so to speak, and seem to have done a lot of research as well. I would love to learn more about your experience and what you have done - I feel I am all alone here. I do not know anyone who have had a head / neck injury before and I find the medical advise I get very limited (my GP and a physiotherapist). The internet seem to be my best ally for information at the moment.

Have you done a journal here on MedHelp or are there any good online resources you can recommend? WebMD, MayoClinic etc all have a description of whiplash etc, but it does not really go very deep - and it is the details, the action steps etc that I am really looking for now.

Will research the options you have listed.

Thanks again, Kenneth
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Hi Ken.

How much has your doctor explained about whiplash? To put it very simply, whiplash occurs when the muscles in the neck are "whipped" in one direction then another, causing them to tear, and spasm to protect themselves. Ironically, the spasms can actually cause more problems which I suspect is what's happening in your case.

It sounds like you had a fairly nasty accident, and I would not expect you to recover within a month; for a moderate-to-severe muscle tear it can take two weeks just for the inflammation to stop . You should have been given anti-inflammatories and told to ice it for at least the first few days - if that didn't happen, it will have contributed to the severity of your symptoms now.

All the problems you describe are along nerve routes leaving the spinal cord at your neck. It may be that your neck muscles have spasmed and tightened in response to the injury, causing pressure to the nerves where they leave your cervical spine.

If this is the case, you will need fairly aggressive physiotherapy - I know you're already seeing a physio, but there are many poor physios out there. As a guide, if their treatment is not causing considerable pain and even bruising, it's unlikely to be effective - I wish you lived in the UK, as I'd know exactly who to recommend to you for this problem. Your physio should be working HARD into the muscles of your neck, partly to improve the quality of the scar tissue that will be forming where you tore them and partly to relieve the spasms that are causing your problems. You may also find that acupuncture in the muscles of your neck might help, as it has been shown to break muscle contractures if the practitioner knows what they're doing ... and has the added benefit of being nowhere near as painful as someone sticking their elbows into your sore muscles.

It sounds like you've had a lot of tests and scans already, and I can certainly understand your concern especially in the light of your vision and hearing problems. Do mention this to your physio or your doctor though, and as long as they're confident that you have no underlying damage to your spine or brain you should be able to have more aggressive treatment. I'd advise that you ask your physio to check the arterial blood-flow through your neck prior to treatment just to be extra safe, but that should be SOP for a good physio when treating a neck problem anyway and only takes a few painless moments.

Best of luck, I hope you start to feel better soon!
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Avatar_m_tn
Ken,
I didn't have any medical journal and good point you mentioned.  I will work on that and if it helps one person I will be glad.  You are not alone in the virtual world and yes, in the real world I am all alone like you.  I met few people who had Head Injury who completely recovered.  I even know few relatives had severe to mild Head injury and all of them recovered.  So they compare which I found is illogical.  But it is not possible even for me not to compare.

As SoggyMoggy first consult a Neurologist and Neuro-Otologist to get all the scans done.  MRI/MRA of brain (with and with out contrast), look at the internal cartoid arteries, vertebral arteries, cervical spine MRI, MRI of auditory canals if you have not already.  This is just to rule out anything obvious and if some issues they found then it can be relatively easy to address them.  Also check ALL your hormones (blood test) thyroid, B12 etc.,   I even did Lumbar Puncture and a tough one and unless you need it don't do it.  Again this is just to rule out anything.

Be careful with medications they prescribe.  It is important to find a doctor who listens to your symptoms rather throw medications at you.  Medicines treat only the symptoms and sure can help but you don't want to get addicted.  

I lately realizing doctors completely ignored my whiplash  even though I mentioned few times.  If it is a muscular issue no test will show it.  Diagnosis is based only on symptoms.



You can find some information:
www.tbiguide.com

I heard the book is a good one to read:
Brainlash: Maximize Your Recovery from Mild Brain Injury [Paperback]
Ph.D. Gail L. Denton (Author)

Latest updates on TBI:
http://www.seriousinjurylaw.co.uk/news/Brain-Injury-News.php

One player's recovery:
http://sports.yahoo.com/mlb/news?slug=ge-koskie022409

Ok.  I guess these will keep you busy.  Since you are only 1 month away there is a great chance you will be normal in 6 months so for now you can try to relax.  Regardless it is better to be pro-active which I didn't do in the beginning and followed doctor's by taking all the medicines they throwing at me without listening to my symptoms.  It is a scary world for us sufferers and watch your step.

My recommendation is to get  a Neurologist, Neuro-Otologist and Endocrinologist  to get all the tests done to rule out anything and address the whiplash symptoms first.  You send an email too if you want any more information.  I sure gone through the mill.

Good luck.
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Avatar_m_tn
Hi SamPCS,

My accident now happened 3 months ago, and most of the "whiplash" symptoms have now gone or have been drastically reduced.

However, the PCS symptoms are still here, strong as ever. I am now seeing a neurologist that specializes in concussions early next week, and would love your input as to what I might expect, or could ask.

I am still suffering from strong headaches, dizziness/problems with my balance, feeling tired most of the time, problems sleeping, problems with my concentration and memory (short term), feeling very emotional and still depressed, constant slight ringing in the left ear, problems with my vision in the upper left corner (of both eyes), can't stand noise (previously it did not bother me), have lost about 10 lbs, and had a seizure a couple of weeks ago, where I fainted for a few minutes.

I have recently had an MRI scan, as well as EKG and EEG scans (heart and brain), but all came up empty (which I guess is good news). The neurologist believe it might be micro lessions in the brain that the MRI does not pick up!?!

Besides being patient and still taking pain killers, muscle relaxations and anti depressants, what can I do???

I am starting to get very nervous and stressed about my condition as well as keeping hold of my job, which I still have not returned to.

Any advice highly appreciated. Thank you in advance,

Ken
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144586_tn?1284669764
Generally muscle relaxants are contraindicated.

The reason is that the muscles that keep the cervical segments segregated will atrophy after a period of using muscle relaxants. They will lose muscle tone and the discs will be subject to crushing and the nerves will be compressed. For the same reason a cervical collar is not a very good idea.

You have more than one problem. The first is the post-concussion syndrome and the second is the whiplash injury. Concusions cause swelling and there is a window of opportunity to stop this swelling, and if lost, you can end up with long-term problems.

The whiplash injuries are generally treated, after a period of healing, with intermitant gentle axial cervical traction, range of motion exercises through the limits of pain, and anti-inflammatories.

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Avatar_m_tn
All the medications may treat the symptoms but if possible with the help of PT/ a "Knowledgeable Doctor" who knows about PCS (which are rare) identify the root cause.  Since you mentioned your Neurologist specialized in Concussions which is a definitely a plus.

As caregiver22 pointed out muscle relaxers may not be a good idea.  I was on Xanax for a while which helped with my dizziness but now I quit.  Still not sure where the perpetual dizziness/headaches/fatigue/nausea etc., is coming from.

For sure you must ask about seizure which means something is not right and there are many different types and EEG may not pick up.  Few things you can ask about is neck related issues which itself can cause many symptoms, for sure about your vision issues and any neuro-optometrists available.  Hormone panel analysis since hormones may go out of whack after head injury.

I have an appointment with a Physical Medicine and Rehab director week to see if I can get some shots in my neck or head for my headache/dizziness.  That is a question you can ask her too.

Next month I will be completing 2 years and I was told to rest and keep taking medicines which I did for 1 year.  Didn't see much improvement.  But your case can be very different, so for the first 6 months that is what they advice.  I wanted to say you can try some gentle exercise (start with 2 minutes and increase) but now you mentioned seizure I wouldn't advice that.  If you can try some massage therapies (trigger point, myofascial pain release, cranio sacral etc.,) which may give temporary relief.

Keep me posted what your neurologist says and just curious about Neurologist recommendation.
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Avatar_m_tn
Thx for the comments. Really appreciate it. Will post an update after visit next week.
Ken :-)
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Avatar_m_tn
Hi SamPCS,
I finally saw a doctor yesterday that was able to give me some more concrete answers. It was a neurologist that specializes in concussions and post concussion issues. He confirmed that I was still suffering from the concussion and that I need "brain training".
After the initial training sessions he should then be able to give me some more concrete answers, which I very much look forward to. It is very frustrating not to know when you will get better.
Hopefully on a lighter and brighter path now...
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Avatar_m_tn
Hi Ken,
Great you found a good Neurologist which is key thing to help you in this frustrating process and consider yourself lucky in that regards.

Keep us posted if anything works for your symptoms.

Good luck.
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