Hi,
I had a severe whiplash the day after my cervical fusion (June 2011), while still in the hospital. Long story short, the nurse tech didn't bring the head of my bed upright when I was getting into bed and I didn't know this (was concentrating on holding my IV pole, etc.), and my skull flew back all the way and smashed into my upper back, so in addition to the neck trauma, I had a concussion from my brain smacking around in my skull. I had trouble reading and speaking--I would read a page and my eyes didn't stay focused on one sentence--they would jump to another sentence on the page. When I spoke, I felt I was grasping for words. I wasn't ultra-tired, but I just felt like my body wouldn't MOVE, as if my muscles were gone. I have some comments/suggestions which may or may not apply to your son.

Afterwards, I too hated standing up--I felt weak and woozy when I did. I looked on the internet, and I found out about POTS (postural orthostatic tachycardia syndrome):

"Postural orthostatic tachycardia syndrome is defined by excessive heart rate increments upon upright posture. A person with POTS will experience heart rates that increase 30 beats or more per minute upon standing and/or increase to 120 beats or more per minute upon standing (Grubb, 2000). These exaggerated heart rate increases usually occur within 10 minutes of rising". I'm thinking the doctor may already suspect POTS if he's pushing liquids and salt--that is a primary treatment for it. If you'd like more info., one site that is really good is:

http://www.dinet.org/pots_an_overview.htm

I went to my cardiologist and had a tilt-table test. It was negative, so I didn't have POTS. I noticed that I had weird tingling/numbness, etc. in one arm, and after many months (seeing multiple vascular surgeons and neurologists), I found out I have vascular and neurogenic thoracic outlet syndrome--TOS (often caused by head and neck trauma); you may want to Google TOS for more info. This was verified by an ultrasound, a chest CT, an arteriogram and venogram, and nerve tests (nerve conduction and electromyography). My arm visibly twitches all the time.

I had extreme migraines and nausea for months, all day, every day. In particular, I had a lot of pain in my ear and/or jaw--I wasn't sure which. Have you been to a dentist to check for TMJ? That is often caused by head/neck injuries, which can cause stress on the jaws and terrible pain. Finally my neurologist put me on Topamax (an anti-seizure med that's also used for headaches) and Cambia (a new migraine medication). The Topamax takes a few weeks to take effect, but after taking it for a while, I'm headache free.

People in the forum may jump on me for this, but this is my opinion: a chiropractor doing adjustments on the neck (or anywhere else) is very dangerous, so I would strongly advise against doing that, but again, my personal opinion. That kind of manipulation of the neck is not good for the discs, at all. You may want to seek out a pain management physician--mine is fantastic. I trust only him and my orthopedic surgeon with my neck and back.

If the amitriptyline doesn't agree with him, there are other antidepressants which have fewer side effects. I take Ambien (a sleeping pill) so I can get a restful night of sleep, and I wake up refreshed, not at all groggy.

One thing my pain management doctor mentioned, that you may want to look into, is trigeminal neuralgia, which can be caused by this trauma.

As for caffeine, it can actually help with some types of headaches, although I don't know if it's acceptable for young people (I'm 47). Some migraine/headache meds do contain caffeine.

Did he ever have a brain and neck MRI? CT scans are not great at showing soft tissue damage or brain bleeds/strokes. Also some of his symptoms could be explained by herniated/bulging discs in his neck, and X-rays are useless for showing those. An MRI is the gold standard for disc problems; trust me--I've been through lower back and neck disc injuries for years.

Mark in Idaho is totally correct--dehydration is simple to detect by looking at the urine, and also by having the doctor do a simple urinalysis (dipping a cheap strip in the urine). Also, you can buy urinalysis strips yourself (I got mine on Amazon) for him to test his urine. Make sure you get the ones that test "specific gravity" which is the concentration of the urine.

I'm so sorry if I've panicked you with all this info.--I just learned it all the hard way. You may want to search on the internet for some of the things I mentioned above. Knowledge is power, and it's essential to do research so that you can ask these doctors probing questions, because sadly, some of them don't know about some of these more obscure conditions. Again, I apologize for rambling and maybe boring you, but if I can help you save time, it may be worth it.