For those who haven't read my other posts on this, my recovery is complicated by two prior concussions in January 2009 and June 2010; and my age, now 48. While the symptoms of my first concussion (a fall on a boat ramp to the back of my head where I briefly lost consciousness) faded to almost nothing after a year, they were "revived" when I had another concussion six months later.
- Migraines/Headache/Neck Pain
- Noise/Light Sensitivity
- Mental Fatigue
- Lack of Concentration/Distractible/Scattered/Foggy
- Problem-Solving/Generating New Solutions
They were worse when I was tired, and I was more sensitive to stress (would lose appetite, get more socially withdrawn) than I had been before, when I had a damned robust imperviousness to stress that allowed me to survive and thrive working psychiatric inpatient units for fifteen years. I was quieter, but since few people minded :) it was mostly me who noticed these problems.
This was a hard hit for me. For someone whose pride and self-image comes from not only being intelligent but being a hard worker, in the hard field of child protective services and mental health treatment, taking on more, toughing out pain and loving every challenge thrown my way, to have my integrity questioned was kind of brutal. Though nothing was "conclusive" and there were interesting patterns in the test data that could have been explained by the concussion and the cognitive symptoms I was having, the results were reinforced by the statements of my treating neurologist, both before and after the testing, that I "shouldn't" be having nearly the level of problems that I do.
Adolescent Concussion types. There is also a link on the Beth Israel site that explains the cognitive, somatic, and emotional (3 types) of post-concussive symptoms. It's true. I have both and that's unusual, and unusual is suspicious.
He then explains to the doctor that there's some battle of wills going on but what he's worried about, what he sees, is that I made a lot of mistakes and bad decisions and couldn't we possibly try some medication before we send me back into a work setting to make them there too? This seems to sway the guy's thinking and he hands over an Adderall script and says call him in two weeks and tell him if it helps, if not we'll try Paxil.
Now if you're a doctor maybe you know that sometimes after wrangling with a patient for a while sometimes you just give in and give them a script if they want one. And maybe that's what happened. But the end result was that I started Adderall XR (10 mg) on Saturday and it was fascinating.
Exactly three hours after I took the Adderall I looked up and saw that I had within the past hour sorted all the pictures, taken small piles and made 4 pages in a flash. The chatter from my next-seat mate was muted, like I had cotton in my ears, and my irritation with all those other distractions gone because I no longer noticed them. My daughters were across from me and I attended to them but otherwise I was in "the zone."
So, I looked up using Adderall for PPCS and it sounds like it typically does a pretty good job, though it's unclear why. It makes depression better (though anxiety worse) and the cognitive symptoms of PPCS much better. The article I link to above says Vyvanse does an even better job. People who take it say 20mg is a typical long-term dose, but that it becomes less effective over time (you build tolerance to the amphetamine) and you'll want more to get this same effect. Also, the side effects (insomnia, loss of appetite) are already problems for me, and while they haven't been worse yet, they might get there.
Sigh. The neurologist has already said not to get used to it because he won't prescribe it to me for years, it's just a short-term experiment. There's no evidence that you can get ADHD from concussions, nor that long-term ADHD medication is indicated. And yet...that's sure how it feels.