Mandi D. Transcript

My name is Mandi Dickey. I am a nurse practitioner, actually. So I started out in healthcare back in 1999 and have always been working in neurosciences to some extent. Started as a nurse practitioner back in 2012.

Again, neurosciences, neurology, all the way. I am a brain nerd, a hundred percent, and so my story is a little bit unique in that I had that background before 2023 happened. So I’ve worked in the hospital, I’ve worked in clinics, and thought I did a really great job doing what I was taught in medical, in my medical training, to take care of the concussion patients, give them identification or information for when they were discharged and went home.

And I think I did a pretty good job from what I was taught. But in 2023, in April of 2023, I was in a car accident, and I had just actually switched about a month prior to that to neurosurgery, and my goal had always been to see brain surgery. So I got to see a brain surgery on this particular day in April 2023, and just hours later, I was in a car accident and then in an ambulance on the way to the emergency room with a collar on my neck and all the things. I don’t remember much from then on.

For quite some time, I thought it was just going to be a weekend experience. I’d had several head injuries as a kid playing sports, riding horses, car accidents growing up when I was learning to drive, and all of those experiences, my symptoms never lasted more than a day, maybe two days, I think in my last previous concussion, and nothing was ever significant.

Nothing ever lasted. I went back to my normal activities. So this time I thought it was going to be the same thing. They checked me out in the ER for orthopedic injuries. My shoulder and my knee were both sore, so they did a bunch of imaging, and not once in that emergency room visit did they ever say anything about concussion.

They looked for my orthopedic injuries and sent me home and said follow up with my primary. Having the neurology background that I did, when I developed a significant headache that weekend, I reached out to one of my former colleagues and said, hey, do you have time to check me out this week? I was in a car accident and I have a really bad headache. Can you just check and see if I got a concussion? And the headache was the only thing that I was aware of at that timeframe.

When I went in to see him, I had issues with my vision. My eyes weren’t tracking together, and when I closed my eyes, I couldn’t stand up straight. And his first question to me was, did you know these things were there? And I said no. I had no idea my own symptoms.

And we focused on the headache for months, because that was the big significant thing. We thought a lot of my other problems were related to my headache. I had some speech issues. We didn’t really, again, think anything of it. We thought it was just my headache, and once the headache went away, everything else would go away.

And days turned into weeks, turned into months, and we were treating this headache for many months, not really making any headway. I was having side effects to any medication that they put me on. Six months into it, he finally said, you know, we’ve tried everything inside the box. We need to now look outside the box.

I had done PT, I had done OT. He didn’t think that I was in need of speech therapy at that point because, again, we thought everything was related to my headache. So I had an opportunity to try red light therapy, and the clinic I went to, we did red light therapy in the form of a bed, in the form of a laser wand over my skull, and then PEMF and exercise with oxygen therapy.

So a little bit of everything. I got to try all of these things. We tried a couple things at a time because if I added too many things, it was too much and my brain did not like those things. But from there on out, I proceeded to see improvements.

So we continued working with therapies, and we added speech therapy because my headache was getting better, but my cognition was not. So then we added speech therapy, and I tried all of those things, and I was getting better to some degree, but still not where I needed to be.

As again, I had been a nurse practitioner for 12 years up to this point, and I could hear a medical term, I knew I should know it, but I couldn’t access it. The bridges were all broken in my brain. I could not access anything related to medicine. So there was no going back to work at that point.

So financial issues were significant. Mental health started to plummet because I was the breadwinner of my family, and now I could no longer perform. I could not provide for my family, and that was really, really tough. And I didn’t realize how much I identified with my title of nurse practitioner until I couldn’t do it.

So we went through all of these things, and then we added neurofeedback to try to do some electrical correction of my brain and worked with a peripheral nerve stimulator to try to again correct the nervous system because I started having significant symptoms of autonomic nervous system dysfunction.

But we didn’t really know that that was what it was at the time. I now know, looking back, I can identify all of these things that were happening to me, but it took almost two years to get function back to where I could go back to work as a nurse practitioner part-time. It was not full-time.

And prior to my accident, I had a full-time job, I had a part-time job, I host a podcast, I have three teenagers in the house plus an adult child. Our family was busy, and I couldn’t do any of those things. My multitasking ability went by the wayside because I couldn’t even task half the time.

So trying to get through day-to-day activities was a challenge. I couldn’t provide for my family financially. I couldn’t provide doing housework, which I figured if I’m going to be home, I should at least do those things, but I couldn’t. I was training for a marathon when the accident happened, and then I couldn’t walk around the block.

All of these things just compounded, and literally it took almost two years before I got any kind of semblance of myself back. Once I did, it’s still been a struggle. I’ve been at my job now for a year and I’m still not up to full time, but every time I add something new, it’s exciting, but it takes a little bit of time to recover from it again, and it’s just been one learning thing after another.

So what happened when I got back to work? To back up for just a little bit, about a year and a half after the accident, I tried going back to my old job just to see what it was going to be like, shadow, just a four-hour shadowing thing. I thought it was to see how close am I to returning, and it was really to see, can I return?

And as I like to say now, I tell people it kind of tongue in cheek a little bit, I failed it craptastically because it was too loud, too stimulating, too many people talking, too bright. I could not tolerate the hospital environment anymore, and my job was terminated.

And that hit me hard again because I thought, well, darn, other words for darn, but I didn’t know what I was going to do at that point and talked with my provider, who again now was somebody who was a friend and a colleague prior to my accident, but now he was my provider, and he said, you know, we need a concussion provider.

So when you get ready for it, if you want to come back as that, that works. So over the next several months, as I started thinking about returning back to work, we met a couple times and kind of talked about what that would look like, what could a job look like, and how can we build this concussion program to be really the best thing that we could possibly offer.

And it’s nothing like anybody else offers in the Twin Cities area because I have that lived experience. And so I’m kind of bridging our traditional medical world with the outside, non-traditional treatments that have always been considered, or not really considered, considered non-traditional but not really thought about, because a lot of providers don’t even know that they exist.

I didn’t know that they existed until I had the opportunity to try them, and if it wouldn’t have been for the open-minded providers that I had, I don’t know that I would have had that opportunity. So I realized I was very privileged in that I had some great providers who did think outside the box and wanted me to try things that I hadn’t tried before.

Because if I hadn’t tried those things, I don’t know that I would have gotten to the point I am now, timeline-wise. I’ve seen many other patients who look very much like I did initially, and they didn’t get all of these opportunities, and their recovery is much slower. I’m very grateful that I had all of that.

And yeah, it’s still a work in progress. I’m still not back to a hundred percent, but I really, really love what I do now, helping other people go through what I did but giving them the options of other things that they can do.

Matt: If you had one piece of advice that you wish you would have known during your recovery or wish somebody would have told you, or what you’ve learned along the way that you could give off, what would that be?

You know, one thing that I tell my patients all the time is that we now know better than we used to, and there’s a lot of things that we can do. It is no longer a wait-and-see type of thing. Time is not your friend when it comes to recovering from a concussion.

Will some people get better immediately? Sure, absolutely, and I’m super jealous when I do, but for the grand majority of people, we now know research from 2021 on has identified 30 to 50% of people continue to have symptoms well beyond a year.

I think if people know that going into it and know that there are options, there’s some things I want people to know, but I think that the fact that it’s okay if they’re not getting better right away, it doesn’t mean there’s not anything wrong with them.

But keep asking, keep looking for options, because somebody out there has the options for you, even if it’s not the person that you’re talking to at the moment.