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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18452
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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A year ago my boyfriend caught his head on a sharp edge as

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A year ago my boyfriend caught his head on a sharp edge as he was walking under an arch. It was very painful and he got a tiny bump but there were no sign of anything else being wrong.
the night before he had suddenly decided to travel from London to Manchester to attend the Iain Brady tribunal as part of his research and had been at work all day. He stayed at a hostel where he had to share a room with two strangers and only got at the most three hours sleep before he was up at 3am to get a taxi and wait outside the tribunal until it opened, not knowing that he’d definitely get in.
He bumped his head on his way out of the hostel to book a taxi. He got the taxi and phoned me about three hours later. He was able to describe everything that happened in detail and sounded very alert and aware. He then sat outside the building where the tribunal was to take place for at least three or four hours reading a Norman Mailer book for some of that time.
When he got inside he was speaking to one of the other people attending the tribunal and the man asked ‘What time did you get here this morning?’. My boyfriend answered ’No, I got here this evening.’ He said he knew that didn’t sound right and after a moment corrected himself saying that he got here the night before. He is convinced that this is evidence of a concussion. It only happened once and has never happened again since. He was very worried about what people would think of him attending the tribunal and after so little sleep I am convinced this was just a run-of-the-mill momentary mistake. He was able to focus for the next seven or eight hours on the tribunal and when he left traveled back to London by train and told me in detail about the tribunal.
He then got up the next day and went to work. He didn’t have any headaches or any problems. However he was convinced he’d suffered a concussion. For the last year he has been convinced. He says writing his book is too painful but he is too depressed to move on. He went to A&E, his local GP, a neurologist at UCLH and has written to various concussion experts on line. He’s even had an MRI scan. All have said that he has no symptoms at all and the neurologist did various test and concluded that he was suffering from anxiety. He’s always had an issue about concussions and has gone through periods like this before (of maybe a week at most), but never this long.
The neurologist sent him to a cognitive therapist. Unfortunately the woman who took the sessions has been very irresponsible and after only four session (with a four week break after three of those sessions) has told my boyfriend that he has completed the therapy and is ’sorted’. My theory is that she is still on probation and doesn’t know how to deal with his case and rather than say this to her superiors she tells my boyfriend that he ‘doesn’t have to come back any more’ because she thinks it will jeopardise her career. This has made things even worse.
I am so desperate I don’t know who to turn to. There have been no changes to his personality and any other so called ‘symptons’ (e.g he’s had occasional days where he’s described finding noisy environments even more noisy than usual and three weeks after it happened there was a short period when he was getting headaches in the evenings after work) I think are clearly due to stress and anxiety. He’s incredibly talented writer and it is so awful to see him so sad all the time.
If he could sit down and talk to a concussion specialist face to face who could just tell him that there is no way he could get a concussion from the way he caught his head at walking speed then he could move on and hopefully try and tackle his anxiety problem. But until then we are stuck in a viscous cycle. I don’t know what to do so any advice would be really appreciated.
Thank you for your time
All the best
Ella
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
Hello from JustAnswer.
It will help if you could provide some further information.
It certainly sounds like he has had the appropriate evaluation.
Have you expressed to his GP about referral to a concussion specialist?
Has he been tried on any medicines for anxiety or depression?
Customer: replied 3 years ago.

Hi,

Thanks for getting back so quickly. His GP is aware he was referred but, not about his bad experience. He is going to try and report it.

He hasn't tried any medication and wants to try and avoid that if possible. For him it is the idea that if he's damaged his brain at all then he can't go on. Until he is convinced that he hasn't damaged his brain then I feel like even medication won't resolve this issue, if that makes sense?

Thanks again

Ella

Expert:  Dr. D. Love replied 3 years ago.
Thank you for the additional information.

There are several issues to consider in this situation.

If he thinks that it would be helpful to see a concussion specialist, that would be a reasonable step, but it will need to be for a slightly different assessment. The specialist will not be able to say that any particular head trauma would never cause a concussion. It can be said that it would be extremely unlikely that he suffered a concussion from this situation, as a concussion typically requires much greater force than occurs from walking into a wall or other surface. However, the specialist will be able to perform an assessment and say whether there is any evidence of a concussion, and he may accept that assessment from a concussion specialist more than he has accepted a similar determination from A&E, his GP, and the UCLH Neurologist. His GP would be the proper route to seek referral to a concussion specialist.

I realize that he does not wish to take any medicines, but the other intervention that would be appropriate in this situation would be to take a medicine for the anxiety and depression, and the most common medicines used for this are the SSRI antidepressants. These medicines have been shown to help with anxiety as well as depression, and would be appropriate for his situation. If he cannot be seen by a concussion specialist in a reasonable time frame, it would be better if you can try to convince him to try such treatment.

If I can provide any further information, please let me know.







Customer: replied 3 years ago.

Thank you so much for your reply. I will try and persuade him to go back to the GP, but it's hard as he feels so ashamed of himself.

This might seem like a silly question but is it possible to go on the SSRI antidepressants for a little while and then be able to stop taking them or do people tend to become reliant on them?

Are there any concussion experts that you would recommend that I might be able to contact online?

I think if he understood more about the forces often involved in concussions compared to just glancing the top of your forehead as well as the physics in terms of the movement of the head then that might help as well. it didn't even stop him in his tracks, it just clipped the top of his scalp and was very painful. Do you know of any books, websites or articles that might explain these things?

Expert:  Dr. D. Love replied 3 years ago.
Many people are able to take the SSRIs for a limited period of time and then stop the drug. There are also some people with chronic symptoms that require long-term treatment with the SSRIs, but this is because of the persistence of the symptoms, not because of reliance on the medicines.

I am not aware of a concussion specialist online, but even if I knew of one, it would still be necessary to be seen by the specialist, as no specialist would be able to give a definitive statement without performing a proper assessment.

You can read this article at http://www.medscape.com/viewarticle/735057_1 which tries to identify an injury threshold for concussion.



Customer: replied 3 years ago.

Thank you for all your help. I will try and persuade him to take your advice. Also thank you for the article.

All the best

Ella

Expert:  Dr. D. Love replied 3 years ago.
You're welcome. I hope that things get better soon.
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