Any Doctors or Nurses... please read

[SlateCoaster]

I fell as I was walking down some stairs last Monday (just over a week ago now). I'd had four gin and tonics. I was carrying a holdall full of clothes. It all happened very quickly. I didn't let go of the bag to use my arms to break my fall, I held on it it.

I came crashing down, hitting the back (lower part) of my head on a step. I also hit my back on a step. I heard a "crack". It was incredibly painful. I put my hand to the back of my head, fully expecting to find blood. I was surprised I hadn't cracked my head open.

I felt dazed and in a lot of pain. I should probably have gone to hospital, but didn't. Two days later and I still felt dizzy/nauseous and drowsy. I took myself to an urgent care centre and was triaged by an Advanced Nurse Practitioner. She had me do various things, such as pushing away her hands, pulling them towards me, follow the movement of her finger with my eyes.

She said she doesn't think there's anything seriously wrong, she thinks I dodged a bullet and that because I have had a "knock to the head" I am entitled to feel groggy for a few days. She sent me on my way without seeing anyone else. No scans were done.

It's now been a week and my head still doesn't feel right. I am still just as dizzy/nauseous with on-off headaches. I've been taking paracetamol and trying to rest as much as possible.

Should I go back to hospital? Or is this normal following a very hard "knock to the head" ?

Thanks in advance.

I’m no expert, but I’ve just had a look on the NHS website and it says headaches/dizziness can last up to two weeks with concussion. I’ll link below.

Could you call your GP and talk it over with them?

www.nhs.uk/conditions/head-injury-and-concussion/

Are you on any blood thinning medication, OP?

No. I don't take any medication.
I'd had four gin and tonics that evening (typical, it was the first time I'd had an alcoholic drink in 2023!) and I've learnt since the accident that alcohol can thin your blood.

Thanks @Pinkplasticbathcup

This is why I haven't been back to hospital. I don't want to waste the NHS' time. But just a bit concerned because.. well, it's my head! I thought maybe the hospital would have done a scan, but perhaps my estimation stems from watching too many hospital based TV dramas.

Just go back. You're not wasting their time

I don’t think you’re wasting anyone’s time at all. You don’t feel well and something big happened that’s given you legitimate cause for concern. But I’d try to go via GP first (I know that’s a lot easier said than done these days) and they can chat to you over the phone and either reassure you or get you in to see them or send you to A&E.

The criteria for head scans is actually quite high. You have to lose consciousness for more than a few seconds or have a seizure, or concerning neurological symptoms which it doesn’t really sound like you have. But I really would get some advice so you are reassured.

You have probably got concussion.
But deffo get checked out again to rule anything else out

I’d fight to be seen again. Took one of mine to A&E last week, fobbed off. Fobbed off by GP too. Ended up with an ambulance being called and a hospital admission. Pretty serious condition that wasn’t picked up/was misdiagnosed. The NHS is in a dire state.

Having a CT scan does expose you to radiation, so they should only be done when absolutely necessary, for example if you are on blood thinners and have a head injury (obviously not the only reason, but a very frequent occurrence in A&E. Frequent fallers on blood thinning meds will apparently have an increased risk of cataracts due to repeated exposure to radiation via CT scans, I can't remember the exact figure, but risk increased by a significant percentage 😬)

If you are worried though, you should seek further medical advice. Don't worry about wasting anyone's time 🙂

I had a minor head injury a few years ago, like you I didn't meet the criteria to have it scanned. I went to the GP a couple of weeks later as I was still feeling dizzy. He explained that this isn't particularly unusual with a concussion and sometimes it can take a while to recover.
It was about 3 weeks before I felt well enough to drive and something like 3 months before I was able to do any exercise other than walking. The doctor did say that because I hadn't rested properly immediately after the injury (2 kids and husband working away, I didn't have much choice!) then that can have an impact on how long it takes to recover.

If you had sustained a serious head injury (i.e. causing haemorrhagic bleeding) one week ago, you'd be either seriously unwell or dead by now.

If an ANP hasn't referred you onto A&E for a CT scan then your symptoms/the history of the event mean one isn't warranted under criteria. Unless you go on to develop red flag symptoms, I can almost guarantee that going to A&E a week after the event isn't going to result in further investigation in the realms of a scan; it'll be a repeat neurological exam and advice to see your GP.

That's not to say you don't feel pretty crap after it still, but your GP is definitely the most appropriate route. If they want to refer you for a scan out of concern then that's entirely different, but I'd suggest if the sole outcome of a theoretical A&E visit is seeking a scan, you'd be wasting your time.