[MHBird]

I hope I'm doing this right...I'm brand new here, but this seems to be a really great forum! Sooo I guess I'll just jump right in...

My first diagnosed concussion was in August 2010 after a collision with another girl in a high school field hockey game. No LOC, but a whole lot of other symptoms (mainly severe headaches, confusion, light sensitivity, lack of balance, etc.) that kept me off the field for 8 weeks. I returned to playing as soon as I passed the ImPACT test at my school despite not being completely recovered--many symptoms persisted but I kept quiet, etc. etc. (I know, I know...seriously regretting that now). I did not get the recovery I needed and was not given any accommodations at school for those 8 weeks.

Fast forward to today (March 2012) and I'm still having severe headaches on an almost daily basis (despite 200mg of topamax taken daily), have severe light sensitivity and insomnia, and believe that I might have depression (though that could be unrelated to PCS--family history, many 'things' going on, etc.). The most troubling issue is the headaches, though the insomnia and light sensitivity only fuel the flame. The depression is basically a reactant and a product in this equation, as I think it tends to be. Any cognitive issues I have are contributed to my headaches-- I had pretty severe impairment after the initial injury, but now any impairment seems to be directly related to how much pain I'm in (these are my observations, only...my actual cognition hasn't been tested since my last ImPACT test in 2010). Basically, I have some really bad days at school sometimes, but my grades are still quite good.

I have seen two neurologists for the treatment of my headaches/migraines/whatever they're calling them on any given day, and one has taken to saying I have PCS. Because he's saying this and field hockey preseason is sneaking up, I'm realizing I probably have a decision to make-- is it time to give it up? Obviously this concussion really messed with my brain if I'm still suffering from symptoms 18+ months later. And also, I'm pretty sure it's not my first concussion-- I rode horses for 7 years and have had at least three falls that have either knocked me out or left me dazed. Those were never diagnosed as anything, but looking back it worries me. I did play a full season last year despite these symptoms, but that was prior to being diagnosed with PCS (I went a year without seeking treatment for my headaches, which was what brought on the diagnosis). I'm afraid this only made things worse.

Neither of my doctors nor my school's athletic trainer has explicitly told me it's time to give it up, but I haven't explicitly asked (and none of them have openly communicated with each other as of yet). I have an appointment with the PCS-diagnoser this coming week, and I'm thinking about broaching the subject. Part of me--the rational part-- wants him to tell me he thinks it's time I sit the bench so I don't have to decide for myself. The other part of me doesn't want to miss out on my senior year, the chance to feel what it's like to be recruited, the chance to enjoy being at the top of the pack, etc.. I know that part is probably not being very logical, but it's so hard...I'm quite the worrier, so maybe I'm just over thinking things? Maybe one more year won't be too bad? As you can probably tell, I'm very conflicted for this issue...a lot is relying on it (at least a lot to a sixteen year old). I'm going to bring it up with him no matter what, but in the meantime: does anyone have any experience with retiring from sports because of PCS as a teenager? Or just in general? Or any advice on how I can tell if it's time for me to give it up? I know there's no 'magic number' of concussions that indicate when you should stop, but if that's the case, how is one supposed to know?

Thanks in advance!

-Max

[Jomar]

Just from reading around the forum and my own very minor concussion many many years ago....horse fall also... I would give it up and not risk more problems and possible lifelong issues.

At some point later on you can re-evaluate, or find another sport or activity that is just as fulilling for you.

[Mark in Idaho]

Max,

Welcome to Neurotalk. Sorry to hear of your struggles. They sound par for the course.

First bit of advice. Disregard the ImPACT test. It has absolutely no value as predictor of your ability to tolerate another impact.

I suggest you sit down and write a list of every time you have had any impact or serious jarring to your head. Only a very small percentage of concussions are ever 'diagnosed concussions.' Most concussions are just shaken off and forgotten.

Any Loss of Consciousness (LOC) is a concussion. Any ding that makes you feel strange or have a head ache, even if not until a day later, is a concussion. Any bump that leaves a metallic or bloody taste in your mouth is a concussion.

Then there is the cumulative effect of subconcussive impacts. The inadvertent body jolts (checks) that shake the head are subconcussive impacts.

There are lots of people here with good ability to help. If you could tell us about your symptoms without complicating them with an attempt to explain/diagnose them, we should be able to help you. Many of us need a simpler explanation as the concussed brain does not process complex sentences/ideas well.

It sounds like you are at least open to the risk of your future. A year/season of fun is not worth the risk of a lifetime. Once the brain has reached it critical mass of impacts and sub-concussive impacts to cause prolonged symptoms, the risk of future impacts get multiplied.

You should be focusing on getting symptoms free and staying that way.

And yes, I had to retire from sports during my sophomore year. I took up distance running/cross-country during the spring of my junior year and did quite well without making my PCS symptoms worse. But, no more contact or risk of contact sports.

As a field sport athlete, you should have some basic conditioning for distance running. Running without jarring your head or causing head aches will be your challenge. You can try running with foam ear plugs in to hear the impact of your foot plant. Finding the right shoes and foot plant and gait to minimize the head jarring will go a long way toward being able to continue in competition.

A sport that is wide open for girls is rowing/crew. An ergo/rowing machine is low impact and fabulous for body conditioning. There are computerized recording machines that show your conditioning that allow you to compete for crew scholarships without ever being in a shell/boat. It is a great team sport with a chance to compete in gorgeous water settings.

So, tell us about your individual symptoms and hopefully we c an help you understand how to deal with them. There is no quick cure or single treatment that resolves them all. PCS is just a slow healing process that requires discipline.

My best to you.

[MHBird]

Thank you so much for such a detailed response, Mark--I think you're understanding exactly where I'm coming from, which isn't that common in relation to PCS it seems.

You're totally right about running being jarring--more times than not it leaves me in a state of disorientation. I had just never thought about the shock going all the way to my head! It really does make a lot of sense.

Crew is definitely an option. My school has a really strong program, and a lot of my friends are actually on the team. I had been considering it as an alternative even before you mentioned it, but now it's making the switch from hockey even more logical.

Anyway, onto those symptoms...

List of persisting symptoms:

• sensitivty to light
• insomnia
• chronic headaches/migraines (currently taking topamax w/ no significant relief)
• depressive feelings

List of the less bothersome, though still worrisome symptoms:

• dizziness when rising too quickly
• tinnitus, comes and goes
• disorientation/feeling like I'm in a dream when overstimulated

Those are the ones I can think of. I tried to keep it as simple as possible, but I can add details as needed!

[Mark in Idaho]

If you are not getting relief from the Topamax, ask your doctor about amitriptyline. It is helpful at small doses (10 mgs to start) and it also can help with the insomnia and depression.

Many of us use sunglasses to help with the light sensitivity, even indoors. Some light is more of a problem.

The dizziness upon rising is probably your brain's slow response to the change in blood flow.

Don't get worried about them. It is counter to recovery.

Try to get used to and learn to ignore the tinnitus. There is not much you can do for tinnitus.

The disorientation from over-stimulation is best resolved by learning to reduce stimulation. Over-stimulation and the resulting anxiety and confusion is probably the most common and disabling PCS symptom. You are fortunate that it is not on the top of your list.

Good for you about crew. If you develop good skills and endurance, you should have good scholarship prospects.

[MHBird]

Amitryptiline was actually the first medication I was prescribed and it had no effect on my headaches while it actually increased my depression. I guess that is somewhat common amongst children and young adults unfortunately.

Thank you so much for all of your suggestions and help!

[Hybernating]

Max...

I am a female athlete...or should I say I use to be an athlete. I feel at work, hit my head and am going on 18 months with PC. It's not a matter of wanting to still play...I just CAN"T!! I will not EVER take the chance of putting myself in a position they may jeapordize my healing, if that is even possible. Learning to give up sports and being an athlete, is the hardest thing I am learning to do. If I were you I wouldn't risk it.

Originally Posted by MHBird

I hope I'm doing this right...I'm brand new here, but this seems to be a really great forum! Sooo I guess I'll just jump right in...

My first diagnosed concussion was in August 2010 after a collision with another girl in a high school field hockey game. No LOC, but a whole lot of other symptoms (mainly severe headaches, confusion, light sensitivity, lack of balance, etc.) that kept me off the field for 8 weeks. I returned to playing as soon as I passed the ImPACT test at my school despite not being completely recovered--many symptoms persisted but I kept quiet, etc. etc. (I know, I know...seriously regretting that now). I did not get the recovery I needed and was not given any accommodations at school for those 8 weeks.

Fast forward to today (March 2012) and I'm still having severe headaches on an almost daily basis (despite 200mg of topamax taken daily), have severe light sensitivity and insomnia, and believe that I might have depression (though that could be unrelated to PCS--family history, many 'things' going on, etc.). The most troubling issue is the headaches, though the insomnia and light sensitivity only fuel the flame. The depression is basically a reactant and a product in this equation, as I think it tends to be. Any cognitive issues I have are contributed to my headaches-- I had pretty severe impairment after the initial injury, but now any impairment seems to be directly related to how much pain I'm in (these are my observations, only...my actual cognition hasn't been tested since my last ImPACT test in 2010). Basically, I have some really bad days at school sometimes, but my grades are still quite good.

I have seen two neurologists for the treatment of my headaches/migraines/whatever they're calling them on any given day, and one has taken to saying I have PCS. Because he's saying this and field hockey preseason is sneaking up, I'm realizing I probably have a decision to make-- is it time to give it up? Obviously this concussion really messed with my brain if I'm still suffering from symptoms 18+ months later. And also, I'm pretty sure it's not my first concussion-- I rode horses for 7 years and have had at least three falls that have either knocked me out or left me dazed. Those were never diagnosed as anything, but looking back it worries me. I did play a full season last year despite these symptoms, but that was prior to being diagnosed with PCS (I went a year without seeking treatment for my headaches, which was what brought on the diagnosis). I'm afraid this only made things worse.

Neither of my doctors nor my school's athletic trainer has explicitly told me it's time to give it up, but I haven't explicitly asked (and none of them have openly communicated with each other as of yet). I have an appointment with the PCS-diagnoser this coming week, and I'm thinking about broaching the subject. Part of me--the rational part-- wants him to tell me he thinks it's time I sit the bench so I don't have to decide for myself. The other part of me doesn't want to miss out on my senior year, the chance to feel what it's like to be recruited, the chance to enjoy being at the top of the pack, etc.. I know that part is probably not being very logical, but it's so hard...I'm quite the worrier, so maybe I'm just over thinking things? Maybe one more year won't be too bad? As you can probably tell, I'm very conflicted for this issue...a lot is relying on it (at least a lot to a sixteen year old). I'm going to bring it up with him no matter what, but in the meantime: does anyone have any experience with retiring from sports because of PCS as a teenager? Or just in general? Or any advice on how I can tell if it's time for me to give it up? I know there's no 'magic number' of concussions that indicate when you should stop, but if that's the case, how is one supposed to know?

Thanks in advance!

-Max

[LisaGH]

Some great suggestions here on sports in which to get involved eventually--distance running and rowing would be fantastic for you!

Don't rush the healing process. As others have said, it's just not worth it. You don't fully know what the long term repercussions of this will be on your health yet. And isn't it better to err on the side of caution? It's your head :-)

I'm a female athlete too (sustained a concussion in a rugby match 5 weeks ago) and it's been extremely tough not being active. Every time I try to run, my concussions symptoms return. One thing that's helped me is getting involved in coaching. That way I can still stay close to sports and be a part of my team.

Perhaps while you heal you can explore taking on some other roles within your hockey team or other sports teams. It may help to keep you fulfilled.

Good luck with your recovery and hang in there.

[Jomar]

There are also other fitness activities - like yoga, many styles of bodywork, weights and some of those could work into a career field if you wanted to.

[Klaus]

If you look for them you will most likely have no trouble at all finding a neurologist or other expert who will tell you that once you have recovered from a concussion you are completely healed and have no more risk of further injury than anyone else. Many of them seem to have this opinion.

However such 'experts' are wrong and are ignoring all the evidence for increased susceptibility following concussion, even after a 'full recovery'. I loved my sport, particularly soccer, but I will never play a contact sport again, my injured brain is just too precious. So is yours.

I think it was put best by Australian Footballer Scott Stevens, a professional sportsman who had been at the top of his game in Australia's biggest sport:-

Scans failed to reveal a specific problem with Stevens, leaving Crows medicos puzzled by what they termed post-concussion syndrome.

Stevens told his teammates of his decision to immediately retire on Tuesday morning.

"Concussion is a brain injury, something to be taken very seriously, and it affects your whole quality of life and has ramifications beyond football," Stevens said in a statement.

"To play again, I would have to regain health and fitness and then be prepared that if I suffered another concussion the recovery time would be as long or longer.

"This is something I don't want to go through again."

Read more: http://www.theage.com.au/afl/afl-new...#ixzz1qv304m6w

I reckon if he can bear to give up his sport and his living and find safer things to do then so can we. Good luck!