Post-Concussion Syndrome: A Neurology Provider’s 2-Year Road Back

Why do some concussion symptoms last for months—or even years—and what can you do when your recovery seems to plateau? In this episode of Life After Impact, I sit down with neurology nurse practitioner and traumatic brain injury specialist Mandi Swanson, who spent nearly two years recovering from her own TBI after a motor vehicle accident.

Mandi went from running half-marathons and practicing neurology to struggling with severe post-traumatic headaches, brain fog, memory loss, balance problems, vision dysfunction, anxiety, PTSD, and an inability to read more than a few sentences at a time. Her CT showed no brain bleed, yet her concussion ultimately changed nearly every aspect of her life.

Now back in clinical practice treating patients with concussion and persistent post-concussion symptoms, Mandi brings a rare perspective: she understands concussion recovery from both sides of the exam room. 

Mandi shares what happened when traditional rehabilitation helped—but only to a point—and why hitting a plateau didn't necessarily mean a therapy had failed. Throughout her recovery, physical therapy, occupational therapy, neuro-optometry, speech therapy, red-light therapy, PEMF, neurofeedback, and eventually work targeting autonomic function each played different roles at different stages.

One of the most important lessons she learned was that concussion recovery isn't one-size-fits-all—and sometimes the right therapy delivered at the wrong time may not produce the same results as it does later in recovery.

We also dig into post-traumatic headaches, including why persistent headaches after concussion shouldn't automatically be treated as migraines. Mandi explains why understanding the location, quality, timing, and triggers of a headache matters, and we discuss medication-overuse or “rebound” headaches that can develop when medications such as ibuprofen or acetaminophen are used too frequently. 

Mandi also shares practical lessons she now brings into her own concussion clinic, including the importance of hydration, nutrition, magnesium and vitamin D assessment, vision evaluation, appropriate exercise, sleep, stress management, and looking beyond symptoms to identify the systems that may still be struggling.

But some of the most powerful parts of this conversation aren't about treatment at all.

Mandi describes losing access to medical knowledge she had accumulated over decades, wondering whether she would ever practice medicine again, and realizing how deeply her identity was tied to being a nurse practitioner. She talks candidly about anxiety, depression, financial stress, PTSD after her car accident, and eventually learning that accepting where she was in that moment did not mean giving up on getting better.

We also discuss something that doesn't get nearly enough attention in concussion care: the importance of having a healthcare “quarterback.” Mandi explains why coordinated medical care, thorough documentation, and advocacy can become especially important for people navigating workers' compensation or auto insurance while simultaneously trying to recover from a brain injury. 

In this episode, we discuss:

•  Why some concussion recoveries take much longer than expected 
•  Brain fog, memory loss, cognitive fatigue, and difficulty reading 
•  Post-traumatic headache versus migraine 
•  Medication-overuse and rebound headaches 
•  Vision problems and neuro-optometry after concussion 
•  Autonomic dysfunction and dysautonomia 
•  Why concussion rehabilitation can plateau 
•  Why a treatment that didn't help before may be worth revisiting 
•  PTSD and emotional recovery after a traumatic accident 
•  Returning to work after a prolonged brain injury 
•  Navigating workers' compensation and auto insurance 
•  The importance of coordinated concussion care 
•  Emerging concussion diagnostics and treatments 
•  Why recovery may require multiple therapies at different stages 

Perhaps the most important message from Mandi's story is that a plateau does not necessarily mean you've reached the end of your recovery.

Sometimes it means it's time to ask a different question, investigate another system, change the timing or combination of therapies, or find a provider who approaches the problem differently.

Mandi cannot promise her patients exactly how quickly—or how completely—they will recover. But her experience as both a patient and clinician has given her something equally important to offer:

A long recovery is still a recovery.

And nearly two years after wondering whether she would ever be able to practice neurology again, Mandi returned to medicine with an entirely new mission: helping other people find their way through the complicated journey she once had to navigate herself. 

Mandi Swanson LinkedIn

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