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Day 2/3 concussion thread:
Day two and another bunch of things I have learned. I felt great yesterday. Good enough to tweet at least. Today, well, not so much.
I went for a walk Saturday and I only got a very mild headache when I had to walk up a steep Hill which settled when the ground evened out. in retrospect this should have been a warning sign if indeed the significant concussion wasn’t in the first place. 2/?
Additionally, overnight I had a strange experience when up to the loo. Walking down the hallway it felt like my spinal cord was “hanging” from my brain. Weird, eh. With each step I would get a jarring tingling sensation through my whole body. This hasn’t recurred. 3/?
Today (yesterday)I went in to work. I had blocked out several rest breaks through the morning (making my morning about 80% capacity) and my colleagues were aware of the situation, should they need to step in. 4/?
I managed the workload fine... at the time. In fact I felt like I was performing at >100% for the morning despite a few “tricky” cases. Only clue that session that something was up was a couple of times during one of my “patters” I lost my train of thought for a few seconds. 5/?
(The “three reasons that PSA screening for prostate cancer does not reduce all-cause mortality” for example - I got stuck for a few seconds after reason number 1 - like a kind of “thought blocking”). 6/?
After doing my 80% session and I was writing up my notes, what suddenly hit me was I felt like I had worked a full day at 100%. And that was when a few things started to change. I felt a rising panic realising that I had not only the whole day ahead of me but a whole week. 7/?
The more I thought about it, the more impotent I felt, to the point that I was on the verge of tears. It felt like it came out of nowhere, like when you’re watching an ad on TV that brings you to tears unexpectedly. 8/?
I went and talked to my HR partner and our practice manager and everyone was in consensus - off home to bed. Unfortunately I still had that problem thumb to attend to so popped into the Urgent Doctors. Turned out it was broken (remember, concussion is a distracting injury). 9/?
I got home and did have a low grade headache by the end of the day. But had a sleep then a meal then off to bed for an early night. 10/?
Day 3 has been yet worse. Woke with a low grade headache for the first time (1/10) but had something that I HAD to attend to at work. Don’t @ me. For the patient involved it was potentially life and death and only required short involvement from me. Then back home and to bed.11/?
Now feeling much better after a 3-hour afternoon sleep. The best I have felt since waking on the morning of day 2 perhaps.

I think the key thing I have learned in the last 48 hrs is that things CAN get worse before they get better. 12/?
Also, reinforcing what I already know, recurrence of post-concussive symptoms is proportional to exertion: physical, mental AND emotional. 13/?
No more work for now, seeing my GP tomorrow and I’ll probably request a concussion clinic referral (despite it being earlier than I would usually recommend to my own patients - I just feel a bit ominous about where this is headed). 14/?
And to all of you who have been @ing me to get off my screen, to reassure you, my screen time is way down. I’m dictating these threads when I can and then transferring them to twitter. I consider this journaling/therapy and it seems it has been helpful for other people too. 15/?
Now off screens for the night and off to bed. I will refrain from checking in for as long as possible. I will miss you my pocket friends but we will meet again soon. /fin
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