Josh | Maryville, Illinois

Josh | Maryville, Illinois

With the temperature edging toward 100 degrees, Josh spent July 13, 2015 on a motorbike running errands in northern Thailand. He and his family were living in Southeast Asia as part of their work with the Global Hope Network International (GHNI), a Swiss-based humanitarian organization.

He arrived home tired and dehydrated, but Josh couldn’t resist when his children begged him to join them on their trampoline. “I never fell or hit my head, but when my feet landed on one jump, it didn’t feel right. I literally felt my brain hit the front of my skull,” he recalls.

It triggered an odyssey of problems that Josh and his wife, Lisa, feared would be permanent.

Concussion Symptoms

“The next day I worked from home in a brain fog,” says Josh, then 32 years old. “And I cancelled dinner with friends. I was nauseated.”

His family doctor in Thailand told him dehydration could shrink the brain, but a CT scan showed no damage. “She advised me to take it easy and drink lots of water,” says Josh. “But I knew something more was wrong.”

Josh initially saw some improvement. But two minor bumps to the head — one as a passenger on a bumpy ride and the other helping his son get out of his car seat  — worsened his symptoms, which included:

  • Difficulty balancing and judging distances
  • Becoming easily tired
  • Painful headaches
  • Sensitivity to light and noise
  • Uncharacteristic mood swings

Then one night, Josh couldn’t even remember how to tell a taxi driver to drive him home.

Concussion Diagnosis

Josh went on to see several neurologists, each confirming that he had a concussion and advising him to rest  — but his symptoms only continued.

Unable to work, Josh and his family returned home to Maryville, Illinois, in January 2016. “We tried to get an appointment with a neuropsychologist in nearby St. Louis, but couldn’t get one for 10 months,” he says.

Josh’s wife had heard about the UPMC Sports Medicine Concussion Program through an online concussion support group and called. Three weeks later, she had Josh meet with its clinical and executive director, Michael “Micky” Collins, PhD.

“At that point, I was getting ready to file for permanent disability,” says Josh. “I thought, what do I have to lose? If I don’t get better, I’ll know I was seen by one of the top concussion doctors in the field.”

Concussion Recovery

Josh scored in just the 50th percentile on ImPACT® (Immediate Post-concussion Assessment and Cognitive Testing) during his initial appointment with Dr. Collins, who told him that rest was the exact opposite of what he needed.

“He said that if I followed his directions, I could expect to regain a normal life,” says Josh. “Dr. Collins took time to explain the science behind his approach. He’s done extensive research. I trusted his history and depth of knowledge.”

In addition to exertion therapy to strengthen his vestibular system, Josh underwent behavioral therapy to confront situations he was avoiding due to fears they could trigger concussion symptoms. Vestibular issues are linked to the emotional center of the brain and can create higher levels of anxiety.

Josh remembers Dr. Collins telling him that he couldn’t hide from his symptoms: he needed to attack them. “Those words freed me to tackle my fears. The therapy wasn’t easy, but it produced results.”

Three weeks later, when Josh returned for his second appointment with Dr. Collins, he showed impressive test gains, reaching the 76th percentile in cognitive performance. On his third visit six weeks later, his scores exceeded the 90th percentile.

The Outcome

Josh describes his work with GHNI, which serves people on the fringes of society worldwide through knowledge transfer and community development, as “more of a calling than a job.”

“The thought of not being able to continue that work was daunting,” he says. “But thanks to the UPMC Sports Medicine Concussion Program, I was able to resume work with limited hours in November 2016.”

Dr. Collins’ final assignment was for Josh to take an overseas trip as part of his recovery. “That was major, because sleep hygiene is a huge part of my recovery and travelling abroad really wreaks havoc on sleep,” says Josh.

In March 2017, Josh and his wife successfully traveled back to Southeast Asia. It marked the first of subsequent trips for GHNI to Myanmar, Kenya, and Hawaii — and an upcoming return assignment in Thailand.

Running was also part of Josh’s concussion rehabilitation. Although he doesn’t consider himself a true runner, Josh ran a 5K race and placed third in his age group.

His final meeting with Dr. Collins was in April 2017. “He said my tests were normal and my results phenomenal,” says Josh. “I no longer live my life with restrictions, but I know when I push myself too far.  While everyone’s concussion is different, if you’ve been seeking help without results, I’d recommend UPMC’s concussion program without hesitation.”