How to Keep Working Safely with a Concussion - Symptoms, Accommodations, Risks

Understanding Concussions and Their Effects

A concussion is a traumatic brain injury caused by a blow or jolt to the head that disrupts normal brain function. The effects of a concussion can vary from person to person but common symptoms include headache, confusion, memory loss, dizziness, nausea, and sensitivity to light or noise.

When you suffer a concussion, the impact causes your brain to bounce around or twist inside your skull. This process injures brain cells and creates chemical changes in your brain. The damage is usually temporary but can result in symptoms that may last from a few days to a few months or occasionally longer.

Common Effects of a Concussion

Some of the most common effects of a concussion include:

• Headache
• Confusion, feeling dazed or disoriented
• Memory loss (amnesia) surrounding the injury
• Nausea or vomiting
• Balance problems or dizziness
• Sensitivity to light or noise
• Ringing in the ears
• Fatigue or drowsiness
• Blurry or double vision
• Sluggishness, haziness or grogginess
• Concentration or memory problems
• Irritability or emotional changes
• Sleep disturbances

These symptoms may appear immediately after the injury or develop over the next few days or weeks. In most cases, concussion symptoms go away within 7-10 days but some can linger for months.

Post-Concussion Syndrome

In about 10-15% of concussions, symptoms can continue for weeks or months after the initial injury. This long-lasting concussion condition is known as post-concussion syndrome (PCS).

Post-concussion syndrome symptoms can include headache, dizziness, fatigue, irritability, anxiety, insomnia, loss of concentration and memory, and noise and light sensitivity. These persistent concussion effects can interfere with a person's ability to return to normal daily activities and work.

Doctors don't know exactly why some people develop post-concussion syndrome after a head injury while others recover more quickly. Factors like previous concussions, age, and genetics may play a role.

Second Impact Syndrome

Second impact syndrome is a rare but life-threatening condition that can result from a second concussion before recovery from an initial concussion. The second injury causes the brain to swell rapidly and catastrophically, leading to severe disability or death in about 50% of cases.

To avoid second impact syndrome, it is crucial to avoid any further head impacts or activities that could cause another concussion until symptoms from the initial concussion have completely cleared.

Can You Work with a Concussion?

Working while you have a concussion requires careful consideration of your symptoms and job duties.

Consider Your Concussion Symptoms

In the early days after a concussion, most people will need to take a few days off work to rest and recover. The CDC recommends waiting until you are completely symptom-free for 24 hours before returning to any activities, including work.

Once you start to feel better, whether you can return to work depends on the types of concussion symptoms you're experiencing:

• Cognitive difficulties: Problems like headache, confusion, memory loss, and trouble concentrating may make work very difficult. Jobs requiring a lot of focus, memory, learning, or decision-making may need to wait.
• Fatigue: Excess fatigue and drowsiness after a concussion can also hamper your ability to get through a workday. Make sure you're well-rested before going back.
• Sensory sensitivities: If you havesensitivity to light or noise, you may need to avoid very bright or loud workplaces in your recovery.

As a rule of thumb, you should wait to return to work until you can get through your usual daily activities without a significant increase in symptoms.

Consider Your Job Duties

In addition to your symptoms, you also need to consider what type of work you do when deciding if you can return after a concussion.

Jobs that may be high risk to return to soon after a concussion include:

• Operating heavy machinery
• Professional driving
• Construction work
• Electrical work
• Working with dangerous chemicals
• Climbing ladders or heights

In these types of jobs, a concussion could impair your coordination, reaction time, or balance and put you or others in danger. It's best to avoid these duties until fully recovered.

Jobs that involve high cognitive function like computer work, accounting, management, or detail-oriented tasks may also be difficult if you are experiencing memory, concentration, or headaches issues.

Less hazardous desk jobs or light duties are lower risk options if your symptoms are mild and allow for a gradual return to work.

Talk to Your Doctor

To decide if you should return to work after a concussion, it's important to discuss your specific symptoms and job duties with your doctor.

Be honest about any issues you are still experiencing so they can advise if work activities might aggravate your symptoms or put you at increased risk.

Your doctor can write a medical clearance for returning to work or recommend waiting longer before going back if they feel you are not ready yet.

Tips for Working with a Concussion

If your concussion symptoms are relatively mild and your job is low risk, you may be able to return to work with some adjustments and precautions.

Here are some tips for safely working while recovering from a concussion:

• Talk to your manager about concussion accommodations like a reduced schedule, more breaks, or temporary change in duties.
• Avoid tasks requiring heavy focus or concentration when symptoms are worse.
• Wear sunglasses or reduce screen brightness if bothered by light sensitivity.
• Take frequent breaks in a quiet area if bothered by noise.
• Stay well hydrated and get adequate rest between shifts.
• Avoid overly stressful situations that can exacerbate symptoms.
• Consider carpooling or taking transit if driving long distances.
• Use a planner, notes, and reminders if struggling with memory issues.
• Check in regularly with your doctor and take more time off if symptoms worsen.

Communicating openly with your manager and co-workers can help avoid over-exerting yourself too soon. Most employers want to help support your gradual return to full duties.

Accommodations for Working with Post-Concussion Syndrome

If you develop prolonged post-concussion syndrome, you may need extended work accommodations for the headaches, dizziness, fatigue, and cognitive difficulties these long-term symptoms can cause.

Some potential accommodations for working with post-concussion syndrome include:

• A reduced work schedule temporarily (e.g. part-time hours).
• Allowing flexible arrival and departure times.
• Allowing periodic breaks to rest in a quiet room.
• Modifying tasks to avoid safety hazards.
• Providing a computer screen filter or sunglasses for light sensitivity.
• Allowing telecommuting from home to avoid noise and stimulation.
• Granting extended time off for medical appointments.
• Adjusting performance targets until symptoms improve.

Being patient and scaling back duties is key to managing persistent concussion effects at work. A neuropsychological assessment can also help identify cognitive impairments that require accommodation.

Maintaining open communication with your employer and doctor is important so they understand your ongoing limitations and progress.

When to Stop Working After a Concussion

Although many people recover fully within weeks, you should stop working immediately and seek emergency care if you experience:

• Worsening headache, nausea, or dizziness
• Confusion, strange behavior, or difficulty waking
• Seizures
• Loss of consciousness
• Vomiting more than twice
• Increasing agitation or restlessness
• Slurred speech or weakness in arms/legs
• Blood or fluid leaking from nose/ears

These can indicate a more serious brain injury requiring immediate medical treatment. It's also vital to stop any activity and see a doctor if you hit your head again before fully recovering.

Long-lasting or severe post-concussion symptoms that interfere with work may also be a sign to go back on leave while you continue to heal.

Supporting Co-Workers with Concussions

As a manager or co-worker, you can provide important support if someone returns to work while recovering from a concussion.

• Check in regularly and offer help with tasks if they seem overwhelmed or fatigued.
• Remind them to take breaks if concentrating for long periods.
• Turn down phones and reduce noise if they are light/sound sensitive.
• Save a quiet room or area for them to use when needed.
• Ask how you can assist with any cognitive difficulties.
• Avoid rushing them and allow extra time for tasks.
• Reassure them it's okay to take time off if symptoms worsen.

With patience and support from co-workers, many people recovering from concussions can successfully return to work while continuing to heal.

In Summary

Working with a concussion requires carefully weighing factors like your symptoms, job duties, and medical advice before returning. While moderate concussion symptoms can often be managed with accommodations, take more time off immediately if you experience any warning signs of complications.

Staying in contact with your healthcare provider and being honest about your limitations will allow you both to determine if and when it's appropriate to return to work while recovering from a concussion.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.