Concussion Recovery Tips From a TBI Nurse Practitioner Who Has Been There Herself

What happens when a healthcare provider who has spent more than two decades working in neurology suddenly becomes the patient? For Mandi Swanson, NP, a motor vehicle accident in 2023 led to a traumatic brain injury and a recovery that took nearly two years.

She went from running half-marathons and caring for neurological patients to dealing with severe headaches, balance and vision problems, brain fog, memory loss, anxiety, PTSD, and an inability to read more than a few sentences at a time. Today, she is back in practice caring for people with concussion, traumatic brain injury, and persistent post-concussion symptoms. In our conversation, she shared the lessons that changed how she approaches recovery—for herself and for her patients.

1. A Recovery Plateau Does Not Necessarily Mean You Are Done Recovering

Mandi's recovery did not happen in a straight line. Physical therapy, occupational therapy, neuro-optometry, red-light therapy, PEMF, and neurofeedback each moved something forward. Then she would plateau.

Instead of assuming she had reached the limit of recovery, she kept asking: What have we not addressed yet? Sometimes that meant a different therapy. Other times it meant revisiting something at a different point in recovery, with a different dosage, provider, or sequence. Addressing autonomic dysfunction became another important turning point; within about a month, she progressed from reading a couple of sentences to reading pages and then entire chapters.

2. There Is No One-Size-Fits-All Concussion Treatment

No two concussion patients are exactly alike. One person may have significant vestibular dysfunction; another may have visual problems, autonomic dysregulation, sleep disruption, cervical injury, cognitive changes, or post-traumatic headaches. Many people have more than one system involved.

That is why simply following a generic concussion protocol may not be enough. Meaningful rehabilitation starts with identifying which systems are struggling in that particular person and deciding what needs attention first.

3. More Rehabilitation Is Not Always Better

Mandi describes herself as the model rehabilitation patient. If she was given exercises, she did them—regardless of how she felt. She was determined to work hard enough to get her old brain back.

Eventually, an occupational therapist gave her an unexpected message: she might be working too hard. Concussion rehabilitation requires challenge, but the brain also needs enough opportunity to recover from that challenge. Sometimes the answer to a plateau is not more; it may be adjusting intensity, allowing more recovery time, or addressing another system first.

4. Do Not Assume Every Post-Concussion Headache Is a Migraine

Mandi had migraines before her injury and post-traumatic headaches afterward. They were not the same. Yet persistent headaches after concussion are often placed into the broad category of migraine without enough curiosity about the pattern and contributing factors.

Better questions include where the head hurts, what the pain feels like, when it occurs, what makes it better or worse, whether it is constant or episodic, and whether visual symptoms or other systems are contributing. If a migraine-directed approach is not helping, it may be time to reconsider the headache phenotype rather than assume the headache is simply treatment-resistant.

5. Pay Attention to How Often You Use Pain Medication

Daily headaches can make over-the-counter pain medication feel like a routine part of getting through the day. But frequent use of acute headache medicines can contribute to medication-overuse headache, sometimes called rebound headache, and may perpetuate the cycle.

Do not stop a prescribed medication on your own. Instead, tell the clinician managing your headaches exactly what you are taking and how often. That detail can materially change the clinical conversation.

6. Do Not Overlook the Basics

For all the sophisticated rehabilitation Mandi experienced, she returns again and again to fundamental needs: hydration, regular meals, nutrition, electrolytes, magnesium, and vitamin D when appropriate for the individual.

These basics are not replacements for appropriate medical care or rehabilitation. They are reminders that recovery is metabolically demanding, and a healing brain should not be consistently under-fueled just because more advanced interventions are also part of the plan.

7. Find Someone Who Can Be the Quarterback of Your Care

Concussion recovery can become fragmented quickly. You may have a neurologist, physical therapist, neuro-optometrist, occupational therapist, psychologist, chiropractor, acupuncturist, and vestibular therapist. But who is looking at the whole picture?

Mandi believes a medical provider who follows recovery over time can be especially valuable. That person can coordinate referrals, review objective findings, document progress, and help determine what may need to happen next—particularly when an accident or workplace injury makes insurance authorization part of the recovery journey.

8. Acceptance Is Not the Same as Giving Up

During recovery, Mandi wanted to become the person she had been before the accident. Through therapy for PTSD, she began to distinguish acceptance from surrender. Acceptance did not mean deciding, “This is as good as I will ever get.” It meant acknowledging, “This is where I am right now.”

That distinction allowed her to stop measuring each day against who she had been before the injury and begin working with the brain and body she had in that moment. Right now, as she puts it, does not necessarily mean forever.

Perhaps the Most Important Tip: Keep Asking Questions

Mandi's recovery was not the result of discovering one miraculous treatment. Different interventions moved the needle at different times, and sometimes progress came from recognizing that the current approach had taken her as far as it could. A plateau may not be the end of recovery; it may simply mean it is time to ask a different question: What might we still be missing?

This article is educational and is not a substitute for individualized medical advice. If you experience new, persistent, worsening, or safety-affecting symptoms after a head injury, seek evaluation from an appropriately qualified healthcare professional.