Headaches ... "They come out of nowhere"

One of the most prominent symptoms of concussion is headache. After a concussive injury headaches are often the main symptom that impacts one’s daily functioning. One moment you might be effectively managing your pain and then the next thing you know you have a significant headache that causes you to stop what you are doing. Patients often remark, “It just came out of nowhere!” . Usually, however, there is some kind of trigger that you are unaware of, causing the significant increase in head pain. 

While some triggers are more obvious, such as working for hours, others are less so.  Some triggers can be as simple as looking at a screen for too long, stepping outside without sunglasses, having the TV on in the background, overdoing it with physical exercise, etc.. The best way to understand your personal headache triggers is to monitor your symptoms, record your daily activities and any increase in symptoms you notice. Everyone is different, some symptoms may increase immediately at the onset or just after a trigger, but some symptoms may increase hours/days later. Keep an Activity & Symptom Log. 

For Example: 

• Gardening outside from 1:00 pm - 4:00 pm 

… difficulty sleeping and a massive headache the next morning 

• Went to the Costo 

… significant increase in headache beginning while at the store and continuing to increase on the way home

Once you have a log of your activities and symptoms, you can begin to find the patterns and identify your personal triggers. 

In the gardening example, the triggers may be sunlight, heat, and/or physical activity (e.g., bending down and standing up). Next time you garden, plan ahead and try to mitigate these triggers by wearing sunglasses and/or a hat, taking frequent breaks inside, and bringing a chair to sit down in instead of standing or kneeling. 

In the Costo example, the triggers may be background noise (e.g., people talking or music playing), fluorescent lighting, or trying to remember a long grocery list in your head. Next time you take a trip to Costo, plan ahead and try to mitigate these triggers by wearing a hat to shield your eyes from the fluorescent lights, wearing earplugs, and writing everything down in a grocery list organized by section in the store. 

The ultimate goal early in concussion recovery is to reduce significant symptoms such as headaches. When one is in a state of high pain and intense headache they are unable to complete daily activities (understandably so!). This is disruptive to one's life, and is also counterproductive to recovery. Once you understand your triggers, you will be able to hopefully reduce the frequency and intensity of your headaches, allowing the brain more time to heal your concussive injury.

Hannah Beach MS CCC-SLP

Helping Family Members with Concussion

When someone has a broken leg, it’s pretty obvious how we can be helpful.  We can drive them places, open doors for them, carry their groceries, etc.  Concussion is a different kind of injury.  It is known as “the invisible injury” because it is not externally obvious to others.  There’s no cast, no crutches, and it doesn’t even show up on a CT scan. The individual often struggles with thinking, overstimulation, and fatigue, among other things.  Sometimes people aren’t sure what they can do to help. The answers may vary, depending on the individual, but here are some general tips for how to help someone you know who has had a concussion.  

1. Ask if they would like you to go with them to an appointment. Sometimes people become very overwhelmed by the large amount of information they are presented with, and having another set of eyes and ears may be helpful.

2. Gain their attention and make sure they are looking at you before you speak to them. If possible, let them finish what they were doing.  Dividing their attention between two things will likely be unsuccessful.  Also understand that it may take the person a minute to switch gears from what they were doing before.

3. Text them instructions or important information so that they can process it when they are able to focus, rather than telling them in passing or when they cannot write it down.

4. Provide assistance, but try not to take all responsibility away from the person.  For instance, it is okay to remind the person of their appointments, but if they are able to schedule them and check their calendar, this is something they should continue to do. It will be good for their brain to have to pay attention to such things.

5. Try not to take it personally if they are wanting more alone time or need a break from a conversation. This is very common, as people with concussions often become quickly overloaded and symptomatic. After a while it may be difficult for them to process what you are saying.

6. Offer to bring them a meal or something else that might make their life a little easier.  Many people with concussions are very busy with medical appointments when they aren’t working, which can make it difficult to find the time to cook.

At the Colorado Concussion Clinic, we understand that mild traumatic brain injuries impact not only those who are injured, but those with whom they are closest.  There can be frustration on both sides, even if there is a lot of love.  You may feel just as overwhelmed as your partner if all of a sudden you are working full time and taking on a majority of the household responsibilities.  It can be helpful to see a therapist to address any feelings you may be having and learn effective coping and communication strategies.  If your loved one who is injured is open to it, it may also be helpful for you to ask their providers questions about their symptoms or treatment plan.  Having a deeper understanding of the injury may help you help not only your loved one, but you as well.

- Ramya Shyam, MS CCC-SLP