Exhausted,

Dmom was one letter short in her recommendation. Your daughter should be able to apply for SSDI, Social Security Disability Income. This will come with MediCare health care. Since she is over 17, keeping her in a health care plan can become problematic.

I am interested in the WAIS scores. If she is highly intelligent, then her scores in WAIS would show it. But, her processing speed might be markedly less. If she is just at or slightly above 50% in memory and such but higher in IQ's, this shows a residual neurological/cognitive deficit.

High intelligence with even average cognitive functions can be very difficult, especially for the immature person.

You said <She had a full neuropsych eval and all processing, memory, executive functioning, language, etc came back average to above average. What did show as a problem was social problems, anxiety, and somatic issues. When she leaves school she tells me she doesn't know what is wrong and describes it as a fight or flight feeling. I know she has self esteem issues and worries about what classmates think. She also runs if she gets even the slightest bit frustrated. She doesn't do well being told what to do by anyone but me>

Did she get MMPI-II test scores? If so, which scales were elevated? Misinterpreting her MMPI-II can cause a serious misdiagnosis.

The anxiety sounds classic PCS. I need a strong SSRI anti-anxiety med to function well. The somatic sounds classic NeuroPsych misinterpretation.

Does the report show her validity/malingering scores? It may have not been in the report but kept in her NP record. NP's often leave out validity scores if they conflict with the diagnosis, especially for someone with a high intelligence. Ask for the full set of scores if they did not include them in the report. It is her right to have them.

I would encourage a full hormone panel by a hormone specialist, not a generic endocrinologist or gyn. You can find some good referrals at https://www.womensinternational.com/..._referral.html

PCS can really mess up the hormone and neurotransmitter systems. Together, they cause the perfect store of imbalances.

Have you done any nutrition therapy? Do a search on this forum for nutrition or vitamin and you will find quite a few posts. Her brain is likely still dealing with a flood of toxins from her injury. Without a serious brain nutrition regimen, the brain gets stuck playing catch-up but never quite gets ahead enough to continue healing. The classic nutritional needs are B-6, B-12, Omega 3's, folic acid, all of the anti-oxidants, and others my broken mind cannot remember.

Nutrition therapy is a long slow process but well worth it. Keep her away from caffeine and alcohol except for a single serving max of caffeine per day. Her anxiety is made worse with caffeine.

If you haven't already, download, print out, and read the TBI Survival Guide by Dr Glen Johnson at www.tbiguide.com

I know you are exhausted but it will help many of us if you will put a double paragraph space every 5 or 6 lines. Some of us struggle to follow from the end of one line to the start of the next. These same struggles may be effecting your daughter. The PCS subject often is too close to the symptoms to understand the causes. Visual and auditory processing are common struggles.

Guardianship or at the least a Power of Attorney with specifics for her health care will be advantageous. HIPPA can get in the way unless you have these in place. It will also be helpful if you printed out a small note for her wallet that can be presented to police or other officials that can explain her struggles with anxiety and such. If she were ever to have an outburst episode and be confronted be someone who is unfamiliar with her condition, it can save her from lots of heart ache.

I carry one that says: "Please be patient with me. I suffer from a brain injury that causes me to over-react when confronted with shouting or someone barking orders. I respond by getting loud. Any assistance to help limit excessive auditory stimulation is helpful. "

It has been very helpful.

If she will not participate in a brain injury support group, you should go anyway. You will find good support from the others who have to care for similar loved ones. My wife will not miss them but I am the injured party.

If she can start to understand her dysfunctions, she can possibly reduce some of her lack of confidence issues. Understanding and accepting the limitations frees the person to work with work-arounds and accommodations. I believe it is helpful to discuss those limitations and struggles with friends and family. When friends and family understand, they usually become very supportive.

Think of it as if she were wheel chair bound. Her friends would quickly understand her need for help with curbs or reaching a high shelf in the library. If they understand her neurological struggles, they can be just as helpful/accommodating. The more she can discuss these issues 'matter of factly," the less her friends will struggle to help her while not putting her in a place of pity.

I very succinctly tell people that I have almost no visual immediate or short term memory. I might even turn away and describe the very little that I can remember or envision about them. They will often say, Wow, accept my condition and go on without expecting me to rely on visual memory functions. Most people are very understanding, ONCE they understand.

A common dysfunction that may be a part of your daughter's struggle is an inability to recognize facial expressions and social cues. Once she understands this and explains it to family and friends, they will likely give her more acceptance and tolerance. It is no different than being color blind. She is just "facial expression" blind.

I hope you are starting to recognize and understand some of her NP report from my explanations. It can be a life changing event when you start understanding these issues.

My best to you.