swim4life,

Welcome to NeuroTalk. Sorry to hear about your son's fall. My first concussion that I remember was falling down wood stairs in 1963. I did not get knocked out. That happened a year later in a serious bike accident. I was 10 years old.

My suggestion is you get him to a concussion specialist. His primary car doc sounds like a "I took an online concussion CME course." I get annoyed at any set time lines. With his LOC and amount of time getting his wits back, I think he needs to be assessed and followed by a specialist. If you have a neuro rehab hospital, they may have a more experienced doctor. A physiatrist can often be worthwhile (Physical Medicine and Rehabilitation doctor). If you have a children hospital, they would likely have a concussion specialist.

At 10 days post injury, he should be up and about enough to cause good blood flow to his brain. Rest is only advise for the first 2 days. He should not be sleeping all day especially if his sleep is sporadic and with poor head and neck posture. Walks, even some non-stress swimming if he tolerates it without increasing his headaches. Like a warm down swim. I swim 45 minutes of head up breast stroke.

Freestyle with the head turning might not be good until his neck is stable and his headaches are gone.

He may and likely did suffer a subtle neck injury. They can be the cause of headaches. If he is sore to the touch behind his ears at the bony part, that is a good sign of muscles spasms radiating from his upper neck. Neck injuries are part of 80% of concussions.

A gentle physical therapist can do some gentle traction and mobilization. No range of motion until his headaches are gone. A gentle chiropractor may be able to help but finding a gentle chiro is a challenge. No twist the head and pop the neck chiro adjustments. They are too aggressive. An upper cervical chiro may be helpful. Read the Vitamins sticky for information about upper cervical chiros.

btw, If someone in your charge suffers a LOC concussion with the other symptoms, be safe and call an ambulance, especially for this son. If your insurance does not provide good ambulance coverage, in many areas you can insure the whole family for ambulance for a reasonable fee.

It is far safer for him to be observed in an ER for 8 hours that at home.

Did he just have an X-Ray or was it a CT Scan ? Did they do a full neuro work-up ? Most concussion bleeds do not show up for 48 to 72 hours. Only a CT Scan will show them.

He should be taking the ibuprofen 3 times a day to keep the anti-inflammatory effect working. If he needs more pain relief, ask his doctor if there is any reason he cannot take Tylenol/acetaminophen and aspirin at max dose instead. The combined effect will be much better than ibuprofen. My doctor told me to combine them. btw, This is what is in Excedrin but Excedrin adds caffeine. He should not have any caffeine so Excedrin should not be taken.

Acetaminophen is fine as long as he does not take it continuously for more than a few weeks without his doctor's approval. Aspirin can be taken in the enteric form so it is easier on the stomach. Not buffered, enteric.

When I have strong head aches, that is what I take. Better than acetaminophen and codeine and no drowsy feeling.

Find somethings for him to do with his hands that do not strain him. No video games. Solitaire with real cards. Puzzles. Anything where the main focus is around using his hands. Coloring, drawing, painting. The hands cannot do anything faster than a concussed brain can tolerate as long as it is not video games. Even learning to knit or crochet. Many athletes knit and crochet to focus away from competitive stress. The mild mental stimulation are good and can get his mind off his headaches and other frustrations.

Try to keep the house sounds to a minimum. Sound can be a stressor.

I'm interested to hear what the school concussion protocol is.

My best to you both.