Too many concussions...yikes

I wrote this same topic back in April, but now it is real real. Saw a neurologist earlier this week. She specializes in concussions. Started me on Lyrica to try to reduce the frequency of migraines and is referring me to a Sports Concussion Clinic for further evaluation and support. Unfortunately it is a very specialized program and so has a very long wait (a year or so) for those of us no playing national level sports.

Has anyone done any sort of brain rebuilding therapy beyond the typical “how to cope therapy”?

Although the most recent fall where I broke my pelvis didn’t involve a direct head injury, it was enough to affect my short term memory and possibly my emotions (could also be the shock of how many life changes I am facing though) but I really have to work the “count to three before responding” coping mechanism. It has also returned the CSF leak that had seemingly healed.

She also feels the symptoms that were formerly attributed to an auto-immune disease (because I had a positive ANA test almost a decade ago), are probably concussion related - it fits better with how things have progressed (or not progressed).

I know we didn’t know then what we know now about concussions, but I am frustrated looking back, at how often I sustained concussions as a kid (and it took a random breeder/trainer to step in and get me off the horse that was the cause of most of them). Being unwealthy led to an unhealthy feeling that I needed to sacrifice myself to ride the tougher horses for riding opportunities…which led to the same feeling as an adult/trainer/coach. Fixing spoiled or previously broken horses. Fixing problems created by people who just wouldn’t listen.

I dislike the memes of how tough horses create tough riders, or how “real” riders’ power through falls etc. Tough horses also create brain damaged kids and adults. Horses don’t need to be tough/dangerous.

Helmets are helpful, and I always wore one, but they DO NOT prevent concussions. Please, please take care of yourselves. Please, please watch out for others, in particular youth on unsuitable horses. I am forever grateful for that one adult for stepping in and getting me on a much safer horse as a kid for no personal gain.

For now she recommended upping my protein intake, ensure I drink lots, avoiding typically migraine triggers, and exercise my brain as I am able (I do Duolingo - language learning is good for the brain). Obviously no riding - nothing to risk a knock or jolt to the brain. This is one thing I don’t know how or when to talk to clients about. Brain damage terrifies me. The last two falls didn’t have big head impacts, but both had big impacts on my brain.

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Some things we know about concussions.

They are made worse if you don’t rest adequately after and continue to jiggle your brain.

One concussion symptom can be changes in executive function and disinhibition
that can lead to increased risk taking and future concussions making it much worse.

Cognitive issues can be very subtle yet still impact quality of life and decision making. Early concussion can lead a child to poor success in school or to understand thenselves as unfocused or lazy.

And most horse pros have had multiple concussions starting at a young age, which might explain persistent issues with poor time management skills or business and financial management. And at the worst end, anger issues.

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I suffered a concussion and brain bleed 2 years ago. It was my second, with the first one occurring in 1992 from coming off a horse.

My helmet, which was a basic Tipperary Sportage, was cracked through in 3 different places. While the helmet did not prevent the concussion or brain bleed, it did save my life. I am currently riding in a UVEX Exxential II MIPS, with the hopes of providing a little extra protection.

Since my injury, I have been participating in a study at Vanderbilt University in brain trauma. While I don’t necessarily see the results of the experiments participate in (I can if I ask), just participating makes me think about what I can do to improve my memory and cognitive function. I also hope my participation helps the next brain injury victim.

Someone here also suggested reading Dale Earnhardt Jr.’s book “Racing To The Finish”, as he talks about his multiple concussions and treatment in Pittsburgh.

I experienced migraines after the fall fairly frequently, but I have had them for the last 40 years. They were more frequent than they had been, and have now gone back to a regular amount for me, about once every 3-4 months. At the time of the fall, the migraines were different than ones I had experienced previously. Almost like a slow motion migraine, if that makes any sense.

I had dizzy spells, even as far as 6 months out, when I looked up. If one of my horses raised their head while I was grooming would be an example of when the dizzy spell would occur. They were sometimes bad enough that I had to sit down. They eventually went away on their own.

I didn’t ride for about 6 months after my wreck. I got on my most trusted, retired at the time, horse and rode him 4-5 times before getting on my younger horses.

I didn’t drive for about 6-8 weeks, and found when I started back it exhausted me rapidly. That did get better with time though.

I still have a difficult time finding words at times, and get flustered when in large groups and conversing, but I blame part of that to COVID times and not being exposed to groups for a long period of time. I have always been a “word” person, a big reader and writer. I have been playing an online version of Scrabble, which seems to make a difference plus I no longer have to beg my husband to play with me!

I had two concerns about the brain trauma that sound kinda strange, but here they are.

I have always had an uncanny sense of direction. I can go somewhere once and always find my way back, so much so that I am the designated map holder/ navigator with my trail riding buddies. But I was so scared for awhile, I actually marked the trails in the 20 acres of woods that lie within my own farm. My husband and friends laughed but I know why I needed to do it, and at that point it was about my own level of comfort.

I was also worried about pulling and backing a trailer, which I can usually do in my sleep. I am not great at using mirrors when backing, as I usually get out, visually assess where I want to put the trailer, then put it where I want it to go by turning myself around in the driver’s seat and minimally using the mirrors. Came to find out mirroring can be difficult after a brain injury, so now I do it my way and take my time doing it.

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I relate on many levels. I was the only one in my family interested in horses. I initially learned the hard way and started out as a child at a barn with really poor philosophies. Struck the lottery and shortly found the best horse woman I’ve ever met who taught me horsemanship and dressage soon after. She was a godsend. Unfortunately, my parents divorced and the parent who had the money refused to pay for my horse. Quite cruel but unfortunately not the cruelest thing to happen in a family of DV. I took the opportunities I could as a young teen and to my 20s when I started riding with professionals and GP riders. Often those opportunities were NOT the best, but I would have rather stopped breathing than have stopped riding. I rode a lot of rank and ill trained horses. Many concussions and falls. Even when working with GP riders, I had some nasty accidents. It wasn’t until my late 20s and 30s that I was financially stable enough to really ride the horses I wanted and to remove myself from the bad situations. Rode some really tough horses when riding for a living or riding just to afford the sport. I learned priceless lessons and skills but definitely at the sake of my brain. It wasn’t until I was 34 (last November) when I was actually diagnosed with TBI. I had been misdiagnosed until then. My temporal lobe was affected resulting in issues with my memory. Considering how devastating TBIs can be, I feel very lucky with the limited damage that I have. It has certainly altered my path in life and changed certain career paths and aspirations. Accompanied with the TBI was frequent adrenal overload which was mistaken for an anxiety disorder. I also have CPTSD from my childhood and I think symptoms intertwine with TBI symptoms. I finally got on the right medications and with the neuropsychiatrist who initially tested me for TBI, was referred to cognitive behavioral therapy. There are therapies that retrain the brain and have proven successful for TBI patients. I started cognitive behavioral therapy but admittedly had to postpone some of the specialized brain related therapy with the neuropsychiatrist but plan to pursue them. The new medications I’ve taken have helped immensely. It’s been life changing. For those who may be suffering from TBI or concussions, please don’t give up on treatment options if you are not happy with where you are with your injuries. If you don’t feel you are progressing, find a psychiatrist that specializes in neurological injuries and keep pursuing your treatment until you do find something and someone that helps. Don’t give up hope.

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I have a pet theory that the trait of “crazy horse person” is really the result of repeated concussions.

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Yup! It’s hard! Drink lots of water, sleep when you need it, and don’t push therapy too hard too fast. If it makes you sick, you did too much. Feel free to pm me to chat. I’ve done a ton of therapy.

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I agree with @Texarkana . I , too, wonder about some of the big name pros who grow bad reputations and those who are in trouble with SS. How much disinhibition and poor choice is due to chronic head injury

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A melatonin supplement might be worth trying and probably isn’t going to hurt. There are some studies out there that show it can help. This is a snippet from the conclusions in this paper:

Taken together, the evidence suggests that MEL is a safe and low-toxic drug with neuroprotective properties after TBI

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The neurologist did ask if I had tried melatonin for sleep issues - I had, but it didn’t seem to help, - sleep therapy did help, and although I can fall asleep quickly, I don’t stay asleep long enough and my sleep patterns are messed up - I should try the melatonin again, but will wait until I am settled into the new medication for Migraines (lyrica) as it takes a while to get on to the full dose.

@Warmblood1 currently trying to deal with an adrenal overload now! If my pelvis wasn’t busted I would go for a snow shoe walk as walking with the cats is my normal coping mechanism.

@AnnaKarena92 Thank you. I won’t be getting brain therapy any time soon unfortunately, but start therapy for my pelvis and DVT next week (hopefully, our city has been hit hard with a few viruses so they cancelled once already).

What may frustrate me the most is not really knowing what I am capable of. Now I can’t ride, I was hoping to get another part time job in early 2023, but I don’t even know what I can do. Right now my time is occupied trying to sort out what to do with my horses, but then what? I know I really hate how stupid I am now, and I don’t want to do anything to risk any more brain cells. For some reason talking about brain damage honestly (with friends/clients) is harder than talking about other injuries.

A few days ago client whose horse bucked me off was freaking out because her horse’s liquid supplement was more empty than it should have been. Asked me why. I honestly have no idea. In part it turns out I was giving too much (I gave what the bottle said, not what we had been giving pre injury. I honestly forgot. I had to restrain myself when she asked “do you have written instructions to give him 50 ml?” but that still doesn’t explain the fact the bottle is lower than it should be. In all honesty I probably spilled some, and then forgot I had 10 seconds later. But I don’t feel I can tell her that. I don’t want my brain issues “public”. I see her for the first time today since the supplement math incident. She is moving her horse, but no idea when. I hope sooner rather than later. It is really hard for me to not deal with her fair question/complaint without feeling a bit of anger. Which isn’t fair really to either of us. Must count 1-2-3 then respond.

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One thing I do is ask “will this matter in a week? in a month? in a year? in five years?” and try to adjust my response accordingly. In this case: Yes she has a legitimate gripe if her horse did not receive the correct supplement as instructed. This mistake has probably cost her some extra money. But also: meh, she’s already leaving, and there isn’t anything you can do to fix or un-do it.

I would apologize and then make sure to write the instructions on the bottle itself so there’s less chance of a mistake during her remaining time at your barn. She’s probably also dealing with some conflicted feelings if her horse was the cause of your injury, and that may come out in ways that aren’t totally rational.

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I use melatonin. I also use a mixed product that has Melatonin in it. It’s called Shut Eye. I then take an additional 5mg of melatonin for a total of 10mg. It’s the only thing that lets me sleep.

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Do you know which brand? Shut eye comes up with a few results. Are there other active ingredients? I saw one with Camomile. Some of my sleep issues are pain related, but I would like to fix my sleep patterns.

Nuvana is the brand. It has chamomile, valerian, and some other herbs in it along with 5mg melatonin. It doesn’t leave me groggy or give me weird dreams, which is nice. It does help with overcoming pain related sleep disturbances. If I’m in pain, I take 4 advil along with it and sleep fine until morning. That worked even immediately after my accident when I was in pretty intense amounts of pain (enough to leave me sobbing hysterically before they upgraded me to 3200 mg of advil daily) since I can’t do narcotic pain relief.
Once the pain started decreasing, I was left with the sleep issues from the neurological problems. I still have to sleep with the AC on high even when it’s negative temps outside and lotion on my feet (yes, it’s weird) to sleep properly…but the melatonin and shut eye have taken it from barely sleeping to sleeping well enough to feel rested in the morning, which is huge.

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You may want to play around with your Melatonin dosage, people can have wildly different reactions to it. I take anywhere from 5-20 mg nightly (and have taken more when needed) and that’s what works for me. My doctors are fine with that amount and I’ve never had any of the side effects people report. I’ve also had friends who’ve taken 1mg and acted like they were tripping on acid, so YMMV. If you didn’t get much response from the intro dose you may just need more. I honestly don’t think the 1-3 mg tablets would even register in my system.

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I wanted to share this link - the research scientists at this company are pretty amazing and the work they’ve done has helped a lot of people with TBI. Maybe it would be worth looking into for you?

https://www.brainhq.com/blog/category/traumatic-brain-injury/

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Give yourself some grace. You deserve it. Neurodiversity is what makes the world brilliant, fascinating and beautiful. You aren’t stupid, you just think differently now. I completely understand the frustration and having to feel it all out. I understand the hit to your confidence. You will make mistakes because you are human, try to forgive yourself for that and not immediately assume you wouldn’t have made the same mistake prior to your injury. That’s a tough way to live. Everyone needs coping skills, if you get stuck, research some online. I think we get stuck in our patterned thinking and sometimes the simplest solutions don’t come to us. There are a lot of websites devoted to different types of coping skills because of it. I think you will have to create new routines in your life and new ways of thinking, living and coping but that too can open new horizons and actually be a good thing.

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I’d add in a bioactive b12 supplement. It should work with the melatonin and enhance nerve repair.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491933/

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If you do try the melatonin, monitor yourself as it can make depression symptoms worse.

I think I will try it, but only until I have been on Lyrica’s full dose for a bit. Lyrica can take a few weeks to get up to full dose (I was on it before - didn’t tolerate it well). I didn’t know about depression risks - that is good to know.

Same here. My doctor said that up to 50 mg is fine. I can usually do well at about 10 to 20, but have used much more when sleep has eluded me (including waking up at 2 am, taking another 20 mg and sliding back to sleep).

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