Fatigue After Brain Injury: BrainLine Talks With Dr. Nathan Zasler

Hi all... wow TBI fatigue is such an unknown. I feel compelled to share a brief of my story as reading others post has helped me feel not so alone. I am 16 months post TBI due to debulking of a cerebellar astrocytoma (brain tumor). 31 years of age. Pre TBI held a high level finance job. So I was lucky, Doc said low-grade, good position for removal (even though the tumor was on my brain stem!) short recovery period. At 16 months, I now know that there will be nothing short about my recovery. While the major difficulties are behind me (i.e. normal motor movements, speech, vision), although the period of normalcy is short lived each day - 4/5 hours of good function in the morning, hour nap, 2/3 hours of okay function in the afternoon. I am able to workout for an hour at a time, I have regained some athleticism. Currently I am trying to push it, build up physical endurance. I maintain an elevated heart rate for 1/2 hour involving movements that challenge my vestibular system (squat movements, box jumps, kettle bell swings) and it just wrecks me for the whole day... even post nap I do not recover. I'm in bed before 9pm and sleep 9/10 hours at night, but wake up multiple times ruminating. My hope is that by pushing my capacity of physical endurance the threshold will expand. I have been on this schedule for about 6 weeks now, exhausted all the time, but hopeful I will see good results. It is too early to tell. My experience with a similar approach helped my cognitive endurance. For one month I endured intense cognitive training, while I noticed diminishing returns during the month, after a few weeks off I noticed a boost in cognition.

My wisdom at 16 months post TBI is that doesn't get any easier, it just sucks less.

I want to mention something else that is helping me and hope for feedback from others. When I am in the second half of my day (during the period of okay function), cannabis helps tremendously with motivation and PTSD. I live in Colorado (cannabis is legal) and use a medicinal strain that is low in THC (cannabinoid that gives high feeling) and high in CBD (cannabinoid that is associated with pain relief). I hate feeling like a stoner, but it helps better than any of the pharmacological stuff! Most of the time I'm not smoking it. I ingest it J Does anyone else find this helps with motivation issues caused by TBI? 

Clean, organic food lifestyle and yoga help tremendously too

Be well. j

I am a vet post tbi 15 yrs ago. I am still having cognitive issues as well as chronic fatigue . Hearing loss/ tinnitus.

This is helpful. I conked my head six weeks ago and am keen to resume exercise but walks wipe me out. I really can't figure out if I should rest up or resume regular light training. Sounds like resting too much can cause fatigue which is what I hoped but maybe I'm reading this as I want to. My doctor is ok with gentle exercise.

I suffered a TBI in early 2013 and also developed post-traumatic epilepsy. I also am terribly fatigued and wonder if anyone else with a seizure disorder has tried any of the stimulants mentioned in this article? I'm not sure if it is an option in my situation. I will discuss with my MD but am curious about anyone else's experience.

My TBI was in 1997 and I still to this very moment fight fatigue. I am on Social Security disability. There are two drugs I have taken (as needed) for energy if I have a day with alot going on and need "help" staying awake and focused. I was told that these drugs were originally for people with narcolepsy. They are called Provigil and Nuvigil ... they are pretty much the same.  They really do help but sometimes I'll take one and STILL get extremely tired and CANNOT sleep but most of the time they help alot. I do not take them daily because I do not want to become dependent on them. Good luck and hope this helps!

My 'injury' was the surgery performed to remove a glioblastoma. Lucky as hell and in generally very good condition, including virtually no loss in cognition, or so it seems most of the time. Depending on how well I've been feeling, I can push my brain 4,5, 6 hours or a little more before I'm outta gas and sleep is going to happen. I'd better at least sit down. Golf is a bit of mental exercise, but the physical side of that is enough to keep me awake. I can take up to three naps a day, but am usually awake, up and going between 5 and 7 every morning. My ability to sleep at night is interrupted by an aging male's prostate, too, eliminating my chances at a good night's sleep. More of my great luck is an ability to turn the euphoria enjoyed through the use of cannabis into an energy that motivates activity. It's why I walk 5-8 miles a day, depending on how well I hit the ball, 4-5 days a week. Fatigue is unbeatable, but we can still lead active and reasonably normal lives.

Anna here, I get 2-3 hours of sporadic sleep a night.  Was told I have Chronic Fatigue Syndrome.  I cannot takes meds because of my TBI, we've tried.  I'm so tired of being tired.  My TBI came about from an auto accident in 1993, so, for almost 20years I have been exhausted.  Sad because my son was 8months old and I couldn't do much with him that little boys are supposed to do.  I constantly worry about TBI's and Alzheimers.

Quite interesting, thanks for sharing. A large, and oft overlooked contributing factor to neurofatigue is diet. I sustained a TBI 10+ years ago and found that fatty, carbohydrate saturated foods dramatically increased the mid-day "brain drain" that so many survivors report. I found that modifying my diet and including regular cardio exercise into my daily routine drastically improved my fatigue.

I'd be interested to see what research exists on exercise and also nutrition on fatigue after a brain injury.

i have lost my smell sensation to some extent, i in 90% cases dont feel smell what others can,but while and after exercising , smell sensation works well but for 30 minutes after exercise.

i had forgotten to mention-  the real cause for my fatigue is constipation , i dont pass stool for 3-4 weeks or more if i dont exercise and if i exercise , i pass stoll but in a very less quantity, after passing stool , fatigue goes off.

my previous comment-

When did the symptoms of post-TBI fatigue start?before weight loss

Did the onset of fatigue symptoms correlate with any other event such as starting a new medicine or getting depressed?depression after accident

What helps make the fatigue go away, or decrease? exercise in the morning and evening and fitnessblender metabolism 5 minute exercise every 2 hours , speak a lot the whole day and keep thinking and repeating things in brain

What aggravates it?no exercise, little or excessive food, walking fast for around 10 minutes and not for an hour to get enough exercise(i lost wt by walkingfrom 7pm to 2 am in the 3rd month of wt loss)

What triggers it? lack of exercise, depression, negative thoughts, inability to focus,

In what ways are you fatigued physically, and when? afternoon or after heavy exercise for 10 minutes.After 9.30pm and 12.00pm , sleep is must and my body automatically sleeps and i cant think at all and i must sleep.TO work at night, i must take a nap at 9.30 pm for 30 minutes

In what ways are you fatigued mentally, and when?morning

one day no exercise, its all over

How is your sleep? 6-7 hours

How is your mood?depends

Do you suffer from significant chronic pain?back injury , otherwise, i do feel left front brain and sometimes right front brain paining a bit and at the rear of the left brain.Apart from this, i sometimes feel something wrong with my right side of the heart, some sort of choking.and sometimes, this heart pain becomes severe and i can feel the vein of that right part of the heart tapping some 4-5 times very heavily.

Apart from this, on monday i have signs of panic anxiety, as doctor says.Chest becomes real hot, brain stops working and pains a bit and i become nervous.

All my heart and brain reports are normal.ECG report was abnormal but doctor said its a machine error, there are p waves in the report which the machine isnt able to recognise and hence is generating wrong report

and  comment of the 52 kg loss

this is how i damaged my brain-

1. I gained too much fat (130kgs) that i needed to sleep after every meal and after that meal i again felt hungry.I had no exercise for 9 or more years before i lost weight.

then one day i decided to loose weight and then in 3 months i lost 52 kgs ,the last month without having food.(ketones found in blood)

Even after weight loss, the sleep issue didnt got resolved and i had one more issue ,i couldnt focus at all while sitting.

So i need to stand and speak aloud to read something and i gained too much interest in reading that i never took a single second pause and keep on reading.Then i took a pause.This is when i felt something isnt good.I am losing listening power, bvefore weight loss i used to write at the speed at which someone speaks but now i cant

another issue that i am facing after weight loss is in the morning.BEfore wt loss, i could wake up any time in the night or anytime i want and i never lack energy but now i just have hardly any energy to think.I need to do exercise to start my day.

It is a feeling like you brain is in quicksand.