My Journey with Concussion

Walked headfirst right into a glass door.

Lost a month of shofar practice.  And possibly may have lost more than that.

I’ve developed a great deal of sympathy for those who have also suffered brain injuries.  I had many of the symptoms.  My head hurt, like a fist was grinding and turning inside my head, pushing outward on various parts of my skull over the course of the day.  My eyes wouldn’t focus.  Walking a straight line was beyond my ability.  Time was compressing and expanding, such that I couldn’t tell whether five minutes had passed or five hours.  My son was shocked that I couldn’t recall whether his fiancé and I had spoken or texted, though I remembered clearly the information she’d conveyed.  For the first two weeks I couldn’t focus on anything for longer than a few minutes, much less do my usual multi-tasking.  My short-term memory was horrible; I relied on typing tasks into my phone calendar to remind me what to do.  Sometimes I couldn’t stay awake, sometimes I couldn’t sleep.  I rattled around the house, keeping the lights low, watching old 1970s tv shows.

I couldn’t take walks because walking shook my brain, so I taught myself to slow-glide-walk.  I asked my sons whether they thought I should try out as a runway model, now that I knew how to stride smoothly, knees first.  Apparently neither son thought much of that idea.

Constrained as to which doctors I could see because this was a workplace incident, my appreciation for the medical profession did not increase.  With deference and exception to fellow Times blogger and friend Dr. Jonathan Weinkle, whom I didn’t consult in this case but whom I respect greatly, I came out with mixed feelings about some other doctors.

The first mandated doctor, at an urgent care facility, drew me a picture of a brain inside a skull and told me I had a concussion.  He ordered me to stop work immediately, not to go back for two weeks, and to stay home.  I was not to drive my son to the airport, not to go anywhere.  I could take acetaminophen only for pain, nothing else. He didn’t really tell me anything to do to treat the injury, but plenty of what not to do. And he sent his recommendation to the insurance company.

Next, the insurance company had me see a neurologist. His staff had me complete twelve pages of medical information upon arrival even though they had computer access to my health records. The nurse spoke with me at length. Having this shot at a neurologist, I confided that I was concerned that I treat this appropriately as I’d read that brain injuries can trigger many negative conditions including dementia. I was worried about my vision, too, and wanted it back. They later had me draw marks on an outline of a body showing the seven points where I had pain so they would know where to aim the MRI.

And then I met the doctor.  If I weren’t so fond of Groucho Marx and so subsequently disenchanted with this fellow, I’d say he reminded me of Dr. Hackenbush.

The doctor came in immediately after yelling at his laughing staff to lower their voices. His introduction was to tell me that he’d been in practice for 45 years, and that I should remove my COVID mask because he couldn’t hear (though I’d not yet spoken). He declared that since I had not lost consciousness and had not been carted away by an ambulance, I did not have a concussion. It was just, he declared, as if I’d hit my head on a piece of cotton. Everything I’d expressed to the nurse was nothing to worry about, and pending his doing an MRI I should plan to go back to work the following day.

I called him on this. I reported that not long ago I’d read in Scientific American about brain injuries being just as severe and serious when consciousness was not lost. The National Institutes of Health website reported that all brain injuries are serious and to be treated with care. The Cleveland Clinic’s website advised that as well. He alone felt that there was nothing wrong with me based on not having been knocked out.

He dismissed this, making it clear that he felt I shouldn’t read. I might have pointed out that it would be difficult to read going forward if my eyesight didn’t improve.

As for my vision, he said I should see an ophthalmologist. I said the eye doctor would send me away to heal my brain first. He said, “So don’t tell him about it.”

He wrote in his official report that I had a little headache probably due to stress about causing dementia, and nothing further was wrong with me.

Now, as if this were not enough insult added to injury, a few other things were simultaneously transpiring. I’d asked my primary care doctor about whether I should postpone a pending test which would require anesthesia, as some friends who are nurses had said it isn’t a good idea to undergo such a process until my brain would be healed. Unfortunately, my PCP believed what the neurologist had opined, and told me that maybe my symptoms were being caused by something else. This started an avalanche of disbelieving physicians who had access to my health information, as my PCP had insisted that the neurologist enter a summary into my record.

The other, more major and positive thing going on was my visit to the Simkovich Concussion Institute to be treated by my old friend Dr. Charlie Simkovich, who runs it. (I use his name and practice name with his permission.) I’d refused to leave myself entirely in the hands of mandated insurance doctors and had made the appointment with Dr. Charlie (as my kids have called him) even before filing for worker’s comp.

Dr. Charlie examined me, and said, “Your vision is blurry, isn’t it?” He could tell that my sphenoid bone had been dislodged and was leaning on my optic nerves. His premise is that all the bones in the head should be able to move freely, to keep the cerebrospinal fluid and blood flowing, clearing away damaged tissue, bringing in nutrients, and allowing nerves to function. They shouldn’t get jammed into bad positions. He told me that plaques can form from all those systems backing up, and that is what we try to avoid. He has informed me how things function and don’t function at length. As I understand it, he is working with the NHL, and has worked with football players as well, as well as with other physicians.

I’m certain that I don’t know enough to fully explain what he does.  But by looking at the signs in his office I know that in most brain injuries the patient did not lose consciousness.  One sign says that “the brain will continue to deteriorate after head trauma unless normal cranial bone movement is restored.”  It goes on to say that “Cranial Movement Therapy is the only known solution to accomplish restoration.”

I do know that it’s been three months and I’m doing much better than friends and colleagues had done with concussions at this point, or even six months in.  Some have been sent for physical therapy to ameliorate symptoms, but as Dr. Charlie quoted someone he has worked with, that would be like sending someone with a broken leg for physical therapy without setting the bone first.  I can’t imagine how anyone with a head injury of any sort could decide to go anywhere else for treatment.  Folks take their children, and the kids are back in classes within days rather than enduring months of suffering.

Do I sound like an advertisement?  Forgive me.  Charlie is a friend of many decades standing, but what I’m advocating is that folks get treated for their head problems!  Family and friends I’ve known with dementia might just possibly have avoided it had they sought this treatment early enough.

Dr. Simkovich treats ADHD as well; I’ve known folks to take their children to him rather than using pharmaceuticals, and adults to seek help as well.  He also treats colic – I took my own son to him decades ago, thus avoiding the endless vacuuming and car rides that we had gone through with the prior son.  Certainly anyone with a head injury should visit him for an examination.  At the very least, one shouldn’t do “nothing.”

My concussion – if in fact I have to own it as “mine” – has been a difficult journey.  It has been frightening, it has been a scary glimpse of dementia, a cacophony of unpredictable symptoms, a trail of frustration.  It has been a mandate to slow down.  And it has been an education of sorts, though everyone’s experiences are different.

My healing continues.  After the first dark week and a half, I worked only half days, and then would go home wasted, spending all my mental capital on my employer.  It’s incredibly difficult to turn off one’s brain and rest it.  I found that even scintillating conversation, usually a greatly curative respite, is exhausting with a brain injury.  In fact, reading, learning, working, and even playing can be tough on a healing brain.  I had to wait until nearly a month later than prior years before beginning shofar practice (usually in Av), but by Elul at least I could blow at morning services.  I got my lip back by practicing at low volume, for long enough times.  (Our cat was fascinated by the tunes I’d play rather than scaring him out of his wits as usual.)  And I did make it to proficiency by Rosh Hashanah.

For all those who denied anything was wrong with me because they couldn’t see it, or because some other doctor said so, I feel a need to educate.  No one should suffer if there is a possible alternative.  And no one should judge another’s suffering as non-existent.

I understand that the worker’s comp doctor may have greater incentive to get me back to work.  Yet under the treatment I chose for myself, and with thanks to our excellent doctor Charlie who actually examined me and can treat the problem, I am more capable of working than I would have been had I done nothing.  I offer that bit of education for all of us.