HEALTH AND WELLNESS
What Doctors Don’t Tell You About Concussions
What I learned the hard way and what you can do to heal
Two years ago, I suffered not one, not two, but three concussions. That’s right, three back-to-back concussions.
Now before you start wondering how I could be so unlucky (I’ve asked myself that many times) — you should know that the likelihood of getting a second concussion once you have had the first one is extremely high.
In fact, the British Journal of Sports Medicine recently studied this in children and found concussed children are four times more likely to sustain a second concussion. And the odds of getting a third or a fourth are higher still.
I was fortunate because despite taking some pretty bad knocks to the head, none of these concussions caused any bleeding or swelling. My doctors assured me that my CT-Scans were completely normal. And while my MRI showed some impact, the doctors seemed to believe that my brain was largely okay.
Only I wasn’t okay. I felt nowhere near okay.
I spent days with severe headaches, dizziness, blurred vision, light sensitivity, and an unrelenting ringing in my ears (tinnitus). The doctors instructed me to rest — so I dimmed the lights, crawled under the covers, and stayed there.
The Case for Rest — At Least Initially
Now resting, drinking plenty of fluids, and staying away from screens/music/bright lights are critical during the first two weeks following a concussion. It takes this long for your brain to heal. And according to most medical findings, 80% of people suffering from concussions recover after resting for a period of 10–14 days.
Why does it take this much time?
Well, when you hit your head hard enough, you end up triggering inflammation in your brain near the site of the injury. This inflammation can cause a breakdown in and around your brain cells (neurons, glial cells, blood vessel cells, and cells responsible for controlling your cerebral spinal fluid) — making them misfire.
This is why you can end up with headaches, brain fog, vision, and balance-related issues. The cells, which are damaged don’t have enough oxygen and can’t perform their usual regular tasks correctly. So other neural pathways try to take over.
Only they often can’t do the job quite as well.
Not surprisingly, the more you hit your head — the more inflammation your brain must deal with. And the more time it can take for things to get things back to normal. During this period, you have to rely more on other neural pathways — and this has the effect of making your brain really tired.
Post-Concussion Syndrome-the Great Unknown
In my case, two weeks passed, and my symptoms were no better.
But then weeks gradually turned into months, and still, I found no reprieve. The neurologists I saw told me that I had post-concussion syndrome. Google it. But don’t expect to find much useful info on this. I know. I tried. Apparently, it is quite common, though with anywhere from 5%-30% of people suffering from this affliction.
The doctors asked me to be patient. But for how long? That was what I always wanted to know. It’s, of course, an answer that no one can give you.
Months later, I finally decided if I would get better, that I needed to take matters into my own hands. If resting wasn’t helping, then I would find a new course of action. And so, this is exactly what I did.
I am not a doctor or a medical practitioner. This experience is solely my own. But I have lived this. I am still living this. And I wanted to share the learnings that I came across the hard way. But let’s start with one simple thing that every person out there should know. It is perhaps the most important piece of advice to keep in mind if you ever find yourself knocked down and concussed.
The Key to Rehabilitation
If you are going to be successful at rehabilitating your brain, you will have to understand and treat the part of your brain that has been affected.
Sounds straightforward, right?
Unfortunately, it’s not.
Doctors rarely talk about the various types of concussions that are out there. Concussions tend to get lumped into one big bucket. In fact, most doctors (mine included)) use CT-Scans which do a miserable job of identifying anything beyond massive trauma to the head. These scans don’t really tell you much about how the brain functions or what part of your brain is not working. They merely look at how the brain looks.
To get a feel for what is happening in your brain-you will want to get an fMRI or a Brain SPECT. Both help doctors analyze what is happening in your brain by looking at changes in blood flow when you perform routine tasks.
The downside of these scans?
They are incredibly expensive and typically not covered by insurance. But identifying which part of your brain is affected is key. Think of it this way: if you are a runner and have pain in your leg, you need to isolate where this pain is coming from. Treating the wrong part of your leg won’t really help you out.
The same goes for your brain.
Understanding what type of a concussion you have will go a long way in helping you understand what exercises you need to do to help that part of your brain recover. Your brain is like any other muscle, after all. And if you rest it for too long, it doesn’t repair itself. It merely gets weak.
So, whatever you do, if there is only one thing you take away-make sure it is this. Know what type of concussion you have, and make sure you treat it accordingly.
5 Types of Concussions
According to a recent paper published in March 2020 by Stanford researchers, there are 5 types of concussions. It may be that you suffer from more than one. I, unfortunately, hit the jackpot and suffered from all five. But identifying what type of concussion you are afflicted with is key to properly rehabilitating the most important organ in your nervous system.
#1. Cognitive concussion
What is this?
This is where your hippocampus or prefrontal cortex is typically affected. Cognitive concussions usually mean that you have difficulty concentrating or with short or long-term memory.
What can you do to treat it?
Playing games like go fish, stop and go, chess, the missing item game, or concentration can all help rehab your brain when you have this type of injury. I practice these daily. I also found some great free memory games on Alexa, including Song Quiz (one of my favorites), the number memory game, and Jeopardy!
#2. Ocular-motor based concussion
What is this?
Typically, when you have an ocular-motor-related concussion, you will experience double vision, blurred vision, sensitivity to light, and you will likely have a hard time moving your eyes quickly between points.
Reading will be challenging, and you may even feel dizzy and tired using your eyes. I had all these symptoms in spades.
Ocular-motor-related concussions come about if your thalamus, your occipital lobe at the back of your head, your cerebellum (which controls your motor skills), or various parts of your cortex are affected when you are hit.
Interestingly, vision is processed in several different areas of the brain. But not to worry, because treating ocular-motor-related concussions is fairly straightforward.
What can you do to treat it?
First and foremost, try to find yourself a good functional neurologist and an optometrist. You’ll want to get your eyes checked to make sure your ocular nerves have not been affected. And if you wear glasses as I do, you may need to alter your prescription. My eyesight changed pretty dramatically. Getting tinted glasses also provides your eyes with a bit of a break as white light is the hardest for the eye to process.
Good optometrists can usually test you to find out which color tinting is the most relaxing for your eyes. I love mine even though I now look like Elton John.
Doing repetitive eye exercises to strengthen your neural pathways will also help. One great app online that does a range of eye and memory exercises is called EQ Brain Performance. I use this daily. It is fun and uses gamification to get your brain back on track.
Working on your cerebellum using simple exercises like bouncing and catching a tennis ball in one hand or closing your eyes and balancing on one foot and then the other are all great ways to get this part of your brain in shape.
And if you are curious which side of your cerebellum needs more work-the left or the right side, here is a great simple video that will help you figure it out.
It’s important to note that the left cerebrum is linked to the right side of your brain, and the right cerebrum is linked to the opposite side. Both may be affected, but it is more likely that one side has been impacted more severely. Doing a quick test to understand which side needs work will help you target your exercises and maximize your impact.
#3. Headache and migraine concussion
What is it?
Have you ever suffered from a migraine? Well, imagine feeling this way daily. Throw in some nausea and fatigue, and you have the makings of a migraine-based concussion. People with these concussions also tend to have sensitivities to smell, light, and sound.
It’s hard to pinpoint exactly where this type of concussion comes from-as many parts of your brain are impacted when it comes to sight, sound, and smell, including your occipital lobe, your parietal lobe, and your temporal lobe.
What can you do to treat it?
Oftentimes these symptoms result from misfiring in your brain and a lack of oxygen to your vital tissues. In this instance, using hyperbaric oxygen to pump more oxygen than normal into your brain can help with healing.
Getting your body moving with regular exercise is also a great way to get more oxygen pumping through your brain. But be sure to build up slowly.
Myofascial release and craniosacral therapy also help to relax your nervous system and realign and rebalance your muscles. Both techniques can be incredibly helpful in relieving head pain and dural tension on the cranial bones.
#4. Vestibular concussion
What is it?
If you feel dizzy or nauseous every time you roll over in bed or get up quickly, you can be pretty sure you have a vestibular concussion.
Most people who suffer from vestibular concussions also have brain fog and light-headedness. If I was to describe what it feels like, imagine your brain losing track of where your head is, and you’ll have a pretty good sense of what I am talking about.
We get these feelings because there is a disconnect between our vestibular system (your ears) and our cerebellum. When your vestibular system is working properly, it sends information about the position of your head to your cerebellum, which controls your movement. When this breaks down, you tend to feel like the whole world is spinning around you.
What can you do to treat it?
Sometimes we feel this way because we have vertigo, and a quick trip to an ENT specialist will do the trick.
You can also try to do the Epley maneuver at home to alleviate these symptoms, but I wouldn’t recommend it. It’s oftentimes difficult to know which side is affected, and doing this on your own can hurt your neck if you are not careful.
I love self-help but, I think leaving this one to the specialists is best.
Oftentimes, we also need to augment this with the cerebellum and balancing exercises. Do a quick search on YouTube for cerebellum exercises, and you will see a whole slew pop up. Be sure to do these every day.
#5. Anxiety and mood-related concussion
What is it?
If you get hit, this can affect you physically and mentally. This is perhaps one of the most under-diagnosed types of concussions out there. But the symptoms are real and painful. In my case, what started as an inability to look at bright lights turned into an overwhelming fear.
My anxiety shot through the roof. I was terrified of getting injured again and found it difficult to do the things I loved. Some might liken this to post-traumatic stress disorder.
Often, your fight or flight response is so heightened post-concussion that your body starts to produce cortisol on a near-constant basis. That is until it can’t anymore, and you find yourself so run down and exhausted you can barely get out of bed.
Here your hypothalamus (which helps regulate your pituitary glands) is affected as well as your amygdala. The amygdala is what drives your body’s fear and stress responses in the brain. It also plays a pivotal role in memory. For example, say a big dog bites you. The next time you see a big dog, your amygdala will remember that dogs are dangerous and trigger a response in your body telling you to run away.
This is all well and good if the amygdala is functioning properly. But oftentimes, when we have brain injuries, the amygdala starts to misfire. When this happens, it triggers a fear response to things that are not dangerous and can lead to a never-ending battle with anxiety and stress.
What can you do to treat it?
First and foremost, get your blood checked (by a GP or naturopath) to determine if your adrenals need some help. They likely will. You may also find you need more vitamin B, magnesium, and fish oil — all of which are critical to healthy muscle and brain function.
If your amygdala is acting up, you can also use various tools, including meditation, cognitive behavioral therapy, neurofeedback, visualization, or biofeedback. Visualization is a personal favorite of mine, and I have seen great results from using this daily.
It would be best if you also got your amygdala in check, and the one surefire way to do this is to face your fears head-on. It took me a long time to realize that I needed to face my fears around light. One year ago, I could only look at light for 2 minutes. I lived in the dark. Today my world is filled with light again. Facing my fears repeatedly and being okay with the resulting discomfort (which lessens in time) has made all the difference.
In the End
Concussions can turn your life upside down. And not in a good way. Fortunately, most people bounce back with a little rest. But if two weeks pass, and you are not better, then be sure to give your brain the help it needs. I don’t care what the doctors tell you — after two weeks — rest is not best. Understand what kind of concussion you have and make sure you treat it accordingly. Your brain will thank you.
© Courtney Burry 2021, All Rights Reserved
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