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Concussion: Post-Crash Recovery Phase 6, Indeterminate Recovery

Last updated 2018-06-12 - Send Feedback
Related: health

Legal disclaimer: Since we are not doctors, never follow anything based on health-related topics on this or related sites without first consulting with your doctor or other trusted health professional. OTOH, the study of brain injuries is at best in its infancy, like studying outer space with primitive telescopes.

Lloyd’s view from the personal experience of having healed himself is that possibly excepting a few groundbreaking clinics, sadly most doctors (including neurologists) have little insight into the best way to recover from a mild traumatic brain injury. Not only that, there is a large professional reservoir of false cognitive commitments about brain function, the best example being the recently proven fact that neuroplasticity does not cease after childhood, and indeed endures into old age. Search the web—the medical literature is a vast uncharted desert as of 2018, even for the acute phase. The field is only now getting the attention it deserves. See two recommended books which have solid suggestions.

Every concussion is *personal* and there is no timeline or one-size-fits-all approach. There is/was no expert concussion specialist in his densely populated urban area that Lloyd could turn to—none. Indeed the ER physicians were totally clueless about what to do after leaving the ER giving not just bad, but extremely risky advice (“OK to do go back to work, to ride a bike right away”)—worse than anything else they could have said. Just stating “we are totally ignorant about how to recover” would have been much better, and at least honest. I am adamant on this point, based on my own recovery trajectory.

About this page

This page begins with the first day on which full normalcy was perceived, including mental and physical alertness all day without a need for a nap or early bedtime. That perception was found to be false both physically and emotionally, but most of the time things seem back to normal.

Thank you to supportive readers, and especially my loyal subscribers. The latter are critically important to me as I recover, and I am grateful to them. I also want to thank OWC / MacSales.com and B&H Photo for their ongoing support as I work through this.

Continued from Concussion Recovery Phase 5.

Up to 1527MB/s sustained performance

June 12, 84 days after crash

Sleep: 58°F @ 6060'. Too little sleep past several nights. MRHR=42-44 steady.

About 5 days ago, I had what I’ll just call an “emotional event” that lasted all day even while I retained the ability to do other things. The event was provoked by a powerful negative stimulus I won’t go into here. Clearly the brain has varying degrees of recovery in different areas of the brain. It leaves me wondering whether some areas don’t fully recover—seems likely.

June 11, 83 days after crash: fixing the physical damage from the cash

Sleep: 48°F @ 6950'. MRHR=NA. To bed at 02:30, woke at 7:30, so sleep deprived... then drove 10 hours an 500 miles.

Yesterday I finished up 4 days of intensive medical massage (16 hours over 4 days) with Dee Sickles MMT, LMT in Flagstaff, AZ*. I drove all the way there because of her exceptional skill, which likely has few peers.

Two issues had been lingering from the crash, leaving my back and rib cage squashed on the right side, resulting in a twist that a picture shows clearly with the following issues:

  • Lower left back pain from a weakened muscle complex (quadri-something juncture). This caused me 100 miles of pain and loss of power for the 2018 Eastern Sierra Double.
  • A “squashed” right rib cage (the crash put most of the impact energy into my right shoulder and rib cage), leaving that side of the rib cage unable to expand normally while breathing in, an asymmetric difference obvious in pictures: rounded-out with a deep breath on the left side (non crash side) and no rounding (flat-looking) and little expansion on the right side (crash side).
  • Overall, my torso was still twisted and “locked down” in areas, with lingering muscle trauma from the impact.

With Dee’s deft hands, the twist in my back was removed and my right chest is now expanding (mostly) normally again. The only “problem” is that with the twist gone, I am now sitting symmetrically on my bike saddle, which changes the fit requirements slightly—I’ll have to revisit that with Kevin at 3DBikeFit.com.Also, there almost certainly will be some muscle memory of the trauma that will linger and be provoked over the course of the upcoming Terrible Two Double Century.

She also freed-up my forearms and hands, plus quadriceps and related tendons, neck, feet/ankles, too.

If you have a seemingly intractable physical issue, I highly recommend Dee Sickles. She can fix things that many doctors will call 'impossible', themselves having no real idea how to fix anything (see my notes at the top of this page, I speak from numerous experiences over the years). Visit Dee and see for yourself.

* That many hours that intensively not recommended for most people; Dee states that few people can handle more than 1.5 hours in a single day, let alone as much as 6 hours in a day (2 X 3 hours), as with me. I’m told I’m as unusual as they come for about 12 hours in her experience. Maybe because I’m a double cnetury rider—dunno.

Asymmetric lung expansion 13 weeks after bike crash (before being addressed)

June 5, 77 days after crash

Sleep: 61°F @ 6000'. Good sleep past several nights. MRHR=55 after June 2 Eastern Sierra double century (good), lower today but did not measure.

Hooray! Energy and strength are back starting on June 1 in spite of intensive demands. 24 hours after winning the double, only slight muscle soreness and I felt great all day the next day and the next and today.

Remarkable and unprecedented: near complete recovery in 48 hours (after a very hard double), complete recovery in 72 hours with a hard ride today proving that—this fast a recovery is unprecedented in 7 years of doing doubles. One reason I think is the PEMF vascular therapy and the other reason the protein source I am now using for recovery: Primal Feast hydrolized beef protein powder.

Below, from today’s ride, my Team OWC (MacSales.com) sponsorship bike and wheels, which still needs OWC decals.

At the top of Mosquito Flat (Rock Creek)
f1.8 @ 1/125 sec, ISO 20; 2018-06-06 00:48:40
iPhone 7 Plus + iPhone 7 Plus 4.0 mm f/1.8

[low-res image for bot]
At the top of Mosquito Flat (Rock Creek)
f1.8 @ 1/125 sec, ISO 20; 2018-06-06 00:50:24 [selfie]
iPhone 7 Plus + iPhone 7 Plus 4.0 mm f/1.8

[low-res image for bot]

May 26, 67 days after crash

Sleep: 56°F @ 500'. Better sleep than past week or so. MRHR=NA.

After 10 days of not feeling right, I finally had a strong ride yesterday evening, riding at high power levels with no brain fade. My legs had nearly recovered from Davis Double in only 44 hours (unprecedented in 36 double centuries!), but in retrospect it is now clear that post-concussion my brain requires at least a week to recover. Hence Davis Double only one week after Central Coast Double never allowed for brain recovery. Or at least that is now my working theory. Yesterday’s ride was only about 85 minutes. Perhaps if I had tried 3 hours I would have encountered brain fade and maybe more than a week is required.

I don’t yet have the answer, but I have the Eastern Sierra Double coming up on June 2. Unfortunately, several factors predispose me to a poor performance: attend a graduation June 1, then drive 7+ hours, sleep at best 5 hours, wake at 4:30 AM, and with no time to acclimate yet with climbing to 8000 feet elevation. And still—stuff happens—I could have a bang-out day. Should be interesting, or a sufferfest!

MacPerformanceGuide.com

May 23, 67 days after crash

Sleep: 57°F @ 500'. have not ridden for two days. Restless sleep for a week now. MRHR=NA.

Today I rode my standard 90 minute ride, after not riding for 2 days (highly unusual). My legs were rested and could put out power easily enough, but after an hour I felt like I had 2-3 weeks ago: legs feeling fine, but mental focus gone and in general a system feeling of wanting to close my eyes and sleep. Sure feels like a regression, now about 10 days going. Oh well, maybe this will takes months or a year, and maybe not—who knows. I would like to just go travel for 2 weeks and recover and rest, but the ice is now very thin financially, so there is just no choice but to plod along and hope for better days.

May 22, 66 days after crash

Sleep: 57°F @ 500'. 2 hour nap in evening after ride, then 23:30 to 6:30. MRHR=46.

Morning resting heart rate (MRHR) at 46 suggests full recovery from the May 19 Davis Double, 3 days ago, which is remarkable; see my speculation in that blog post. A short ride yesterday and legs had zero soreness and felt nearly recover—44 hours after finishing. And yet, today was a very poor day: I had an unexplained headache all morning and felt light-headed all day, getting little work done, though ultimately forcing myself to one ~2 hour task.

How does one discern whether recovery is complete and it’s just a crummy day for no apparent reason, or whether it is a symptom/regression from a concussion? That’s a question I have no good answer to. It feels like a little bit of both, but I don’t know.

In a few days I will have some fast-grown lumps scanned by ultrasound (8mm sphere in groin morphing into an odd-shaped 40mm X 10mm X 5mm thick mass, plus 3 lumps in my neck, plus another spherical lump appearing yesterday in my groin) . They are surely lymphatic, being in key areas of the lymphatic system, and are not showing any sign of fading. Probably just a side effect of double century riding, though I’ve never had that before. The local in-network facility doesn’t respond to it as anything important, telling me to come in 3 weeks for their earliest appointment— if benign no big deal, but if not it’s a bad plan—not that I really think it’s cancer; it’s almost certainly some lymphatic system blockage. Maybe that’s why I feel crappy. Anyway, the 3-week thing is what my unsubsidized $34K/year ($44K last year but I had to downgrade) premiums for family of five pays for. Fortunately I found another place also in network that can see me two days from now on May 24. I am hoping they don’t want to surgically remove the thing in the groin since it would mean the end of the cycling season (can’t ride 200 miles on a suture), but I am also hoping it goes away.

ANYWAY, regular issues morph into that “is it the concussion thing” and become hard to distinguish.

Up to 1527MB/s sustained performance

May 18, 60 days after crash

Sleep: 46°F @ 500'. 2 hour nap in evening after ride, then 21:30 to 8:30, solid sleep. MRHR=na. This has been a two day regression with no apparent cause.

Davis Double tomorrow (I hope I can handle it, I will rest most of today), along with a win at Central Coast Double last Saturday.

I have generally felt good but one deficit that remains is focus and drive as to work—it takes effort. I think these are subtle lingering effects that will resolve, and summer is coming which I also think will help. Another lingering effect is the feeling of being emotionally more fragile, a symptom I’ve read can happen to some. I will overcome that I am certain but maybe it will take longer.

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