Looking for advice
 

I am a mother to a 14 yr old boy who suffered a concussion in September 2012. It happened at school during football film review. The situation that happened was strange in itself and I'm still not 100% positive if what I understand is the truth.

Apparently what happened was the players were released from film review in the schools library and as he and 2 of his friends were walking down the hallway playing around "shadow boxing" his leaned into a punch or something was hit in his cheekbone/temple area pretty hard. He stumbled a little and his friends asked if he ok and he said yes then his eyes rolled in the back of his head and he fell face first into the cement floor. When he hit the floor he was already unconscious. He remained unconscious for over a minute they believe. His friends while he was unconscious started to shake him and trying to pick him up off the floor. They dragged him into the bathroom where he regained consciousness but mentally wasn't with it. At that time his coaches came in the bathroom and took him to the head coaches office where the paramedic that is an asst coach evaluated him and determined he had a concussion and they called me to take him to the ER.

While at the ER he would repeat the same 10 questions for about 6 hours. He was very emotional about people knowing he was ok and complained of a headache but just kept asking the same 10 questions. Over and Over and having no knowledge that he had asked them previously. They reluctantly performed a CT scan and XRay which both came back good and eventually sent him home. We monitored him for the evening and the next day. He continued to have issues so Monday we followed up with the pediatrician and she referred him to a sports medicine doctor.

They removed him from football, obviously, and also school for 2 weeks. Once he regained who he was he was instantly a different person. He moodier, agitated quickly, really rude when he was responding and couldn't concentrate. We continued to see the sports medicine doctor who allowed him to go back to school however he couldn't use his phone, play video games, play sports, no test taking, no homework, no computers and no reading. Bascially as the Dr. said he was there to socialize and still be apart of his original group but do nothing that would tax his brain. We also went to see the neurologist and when we did they make him take a bunch of test to see where he was at. He did well on all the test and we were told by the neurologist to monitor him. The sports med Dr slowly brought him back into school and eventually in the end of October he ok'd him to return to playing football.

I have always believed that my son was dishonest because his passion to play was more persistent than his concern for his future. He had problems when he returned to football because of the sounds and lights at the stadium. He was a more aggressive player than he was before the accident. And where I had never heard his name announced for a big play I heard it often now. He almost had no fear. I came to find out he would try to fight everyone who he got ruffled at. Which is not how he was before. He got a knee injury the championship game which he continued to play through until the next day we got it looked at and he was to start PT.

In our town when middle school football ends you get to start wrestling for the high school immediately. So it was now time for wrestling which he had done a year previously. We as a family decided it was best he wait out this season because of his concussion and knee injury and he could start condition for football in January.

All the while since his concussion my son is just a different person. He is moodier, more smart alec, back talks more, seems a little distant, can't remember to tie his shoes most of the time, gets agitated quickly, still believes he could win a fight, and goes from zero to ****** with a quickness. Now to top it all off he is failing school. We grounded him over grades (he previously is a procrastinator but never been to the point of failing). And we have taken away everything that requires electricity for the most part but it always lingers in the back of my head that it could be an issue with his concussion. In our most recent convo with him he admitted the downtime between football and condition (about 2 months) he was really depressed. And even thought about what it would be like if he wasn't around anymore. This came as a total shock to me! Now he is back into conditioning and happier but I just don't know what to do.

Can someone please let me know if all this seems like a normal 14 yr old boy or if I should be concerned. I don't want to be that parent that says I wish I would have seen the warning signs and they were right here all along. Sorry about the length and thanks for reading.

Hi,

Sadly, your son sounds like he's trapped in the midline of a few situations:

- an adherent practitioner of IMPACT guidelines (not useful in most situations of this nature per NIH)

- and some form of possible mTBI type injury we are seeing in boxer injured - since his injury was in fact a supposed boxing injury, and not a football injury by all reports;

He was reportedly - fooling around, shadow boxing with friends when one connected, and he , soon after went unconscious and hit the floor --- then was 'dragged to bathroom by friends and coaches? and taken to other coaches (an EMT - who should have known not to move an unconscious patient).......so many wrongs here.

Then the ER didn't keep a bewildered youth for overnight observation? after an unconscious period from an obvious head injury? with repeat studies ?

What were those 10 questions he kept asking, may I ask?

All his behaviors sound as if he has had some very severe lingering residual effects from his injury that have not been evaluated, and very much should be.

He should be evaluated in depth by a NeuroPsychiatrist/NeuroPsychologist, if he has not already had one evaluate him.

Recommendations should be that he stop contact sports until all evaluations are completed, and a new 'game' plan is reached, prior to a scheduled resumption of sports activities; as well as those limitations listed in the stickies above.

Others will also present their input Im sure.

Best wishes.

Sorry, just reread your post and mine, and wished to add to this some about the mechanism of injuries -

- a punch = a head snapping, thus a whiplashing type injury, with or without some injury to inside the brain in a contra-coup ; he, after went unconscious, and hit the floor; again hitting his head - definitely causing a contra-coup injury to his brain.

- dragging by friends and coaches - was his head supported? thus preventing other possible neck injuries?; when he regained consciousness, he should have already had the EMT notified and all coaches should know not to move unconscious or recent unconscious persons, and those with neck injuries without neck support to alleviate possible future injuries; the EMT should have gone to patient, not other way around.

- it has always been a practice that persons who suffered unconsciousness for certain periods of time should be given overnight observation and possible further testing for changes prior to discharge home ; was a reason given why that was not done?

dcjmonhollon,

Welcome to NeuroTalk. Sorry to hear of your son's injury.

I wont try to rehash the mechanism of your son's injury or his treatment since other than one. He should have never been released for Return To Play. The standards for return to play are a complete recovery of all symptoms. He is still sensitive to lights and sound. He has a serious change in personality. He should have not been returned to school so soon. I seriously doubt the skills and judgements of the sports medicine doctor regarding concussions.

I think he needs some serious evaluation by somebody who really understands concussions in a pediatric patient. He may need to be put on an anti-seizure type of medicine to help him settle down. His personality changes put him at risk for another concussion, especially in a fight.

He may benefit from an fMRI, functional MRI. A good specialist should be able to find out what is going on. A diffusion tensor imaging MRI may be able to find an injury.

Sports should be off the table until his personality and academic changes are resolved. Even then, no contact/collision sports should be allowed. I can understand his comments of 'not wanting to go on.' I had similar struggles as a youth. The frustration of PCS as a youth and the injury itself can lead to serious depression. Antidepressants can be very dangerous for people his age so other ways to treat him need to be found. As I said, maybe an anti-seizure med. I was put on phenobarbital and responded well.

His brain is at a very busy maturing stage. This needs to be the primary focus. He needs to be convinced that he needs to be making choices that will be good for his future. This will require lots of help from you and a professional who understands.

If you will post your location, we can try to find referrals to professionals for you to consult.

I can understand your concern. My mother went through the same when I was injured at 10 then again at 15. My wife has watched my personality changes over 30+ years as I have suffered subsequent concussions. btw, I have tried to avoid concussion risks since I was 14 and told to end all contact sports. I had a roller coaster ride of academic struggles that ultimately changed my college direction. There was very little understanding of PCS back then.

With help, you should be able to find much better help for him.

Let us know how we can help.

My best to you.

Mark is dead on and speaks with both personal experience and a sound knowledge of good return to play protocols. At 5 months your son is a prime candidate of post concussion syndrome. I would seek out a physiatrist experienced with mTBI injuries. A neuropsch assessment may be in order. Post concussion syndrome effects can be very frustrating to experience. Short term memory issues are common, rapid mood swings, anger issues, headaches, vision and hearing issues are not uncommon. All this maybe very scary but there is good evidence that his youth is on his side. It sounds like you need GOOD medical advice. Be cautious with regard to concussion clinics some are little more than a economic medical model for profit. You might try to google your state BIA and see if there are any Drs close to you.

The advice given by previous posters is sound advice. I don't have anything to add except that as a mama, my heart breaks for you and your son. I think that PCS being so widely misunderstood and so hard to live with, is very sad for a child to have to deal with.

My son (only 9) recently got a concussion playing hockey. I'm a PCS sufferer so I've been very cautious with his return to school and he is still not cleared to play hockey. The thought of further damage to his developing brain makes my heart hammer in my chest...

I feel for you. You've come to the right place for answers and guidance. :hug:

Thank you!
 

Thank you so much for the time you took to respond. I apologize for the delay in my response but I was having trouble getting back to this board.

In response to your questions. When they were playing the hallway (walking to the locker room) there were no coaches present. They were dismissed from film review and the players started to walk out in small groups and this is when this happened. Another kid came around the corner and saw him passed out and his friends shaking him. He went to notify the coaches and they in turn rushed to my son who was already in the bathroom. So the coaches (had they been present) knew he shouldn't have been moved. And they never contacted the EMTs. I was called and asked where I was located and that I needed to hurry to the school because he needed to go to the ER. I arrived about 15-20 minutes later and he was sitting in a chair by the coaches office and was shaking his head (like he was having foggy thoughts) and kept repeating the same questions.

1. What day is it?
2. Did we have film review?
3. Are these my clothes?
4. What happened?
5. Do I have a girlfriend?
6. Have we played football? (And he was 4 scrimmages and 2 actual games into their season and watching the film review of the game the previous night).
7. Do I have a concussion?

Our experience at the University of Kentucky ER was less than desirable. First we got there and he was still asking those same questions. And they did take him right in and put us in a room. A "student" doctor came in and looked into his eyes and pushed on his neck and said he didn't believe that they needed to do x-rays or CT scan because if he was injured he would know it. Then the senior doctor came in about 2 hours later and overruled him. She said to put him in a neck brace immediately and to order the CT Scan and X-Rays. She also said that she would be back every 30 minutes and he needed to remember these 4 words (Obama, Horse, Shoe, Turkey). Well an hour later he still hadn't been taken down for x-rays or CT and no one came in to check on us in the room but my husband and I continued to answer all 7 questions he asked each time and in return would ask him what were the 4 words he was suppose to remember. He answered "no excuses just win" which is the team motto. But never remembered the words. At this point he was almost asleep in the room and complaining of his head hurting and the lights bothering him. The nurse said she would bring Tylenol (which never happened) and turned the lights off. He was an emotional roller coaster. He and his girlfriend had broken up on Monday and it was Friday. So I would tell him that he didn't have a girlfriend and he would start to cry and then laugh and say I don't know why I'm crying. Then start the questions again. He did complain of neck pain which they said was normal.

As far as why they didn't keep him there was no reason given. I didn't know this wasn't suppose to happen or I would have made a stink about it. I was nervous because I thought you aren't suppose to let someone who had a head injury go to sleep and they said it was ok to let him sleep and no need to wake him just let him sleep.

I am truly grateful for your information and appreciate any additional information you have.

Thank you so much Mark. I am located in Lexington, Ky and would appreciate any information you have.

The sports medicine doctor he saw was supposedly the best in the state. We did a follow up appointment with him this morning and I wasn't impressed. I explained everything I said in this forum and he response was well his test scores from the neurology testing were really good. He scored average on everything but 2 items (1 was exceptional and 1 was below average). So he said as far as the depression you need to go to his pediatrician so they can refer you to someone for him to talk to. And I will go ahead and request for this same testing to be redone but he did so well last time that I don't see how this is going to do anything. I really started to believe I am crazy. But like I said I just want someone to say this is a typical 14 yr old boy or it isn't.

Thank you again.

Thank you for the information and I will definitely follow up.

Thank you and good luck to you and your son.

What kind of neurological testing did they do at the sport medicine doctors' clinic ?

Was it called ImPACT or HeadMinder or CNS VitalSigns or SCAT II ?

Or was it just a balance, reflex, and simple memory test ?

Very few sport medicine doctors have any more than a weekend conference of concussion training, often related to the testing system they use. They are usually more orthopedic oriented.

Please be very careful about any meds for depression. He is too young for most unless he is under the care of an expert pediatric psychiatrist. My neuro put me on anti-seizure meds at a similar age. They settled my brain down.

Please tell me again what his biggest struggles are. I try to scroll back but my brain damaged memory leaves me confused.

btw, If you use the Post Reply button at the bottom left, it will not quote the previous post. It makes it easier to scroll through comments.

My best to you.

His sports medicine doctor didn't believe in the results of the ImPACT testing however we did have those. My son also participated in a case study for UK regarding concussions.

His sports medicine doctor also tested his balance and reflexes each week.

His symptoms are ... all the while since his concussion my son is just a different person. He is moodier, more smart alec, back talks more, seems a little distant, can't remember to tie his shoes most of the time, gets agitated quickly, still believes he could win a fight, and goes from zero to ****** with a quickness. Now to top it all off he is failing school. We grounded him over grades (he previously is a procrastinator but never been to the point of failing). And we have taken away everything that requires electricity for the most part but it always lingers in the back of my head that it could be an issue with his concussion. In our most recent conversation with him he admitted the downtime between football and condition (about 2 months) he was really depressed. And even thought about what it would be like if he wasn't around anymore. This came as a total shock to me! Now he is back into conditioning and happier but I just don't know what to do.

Thank you so much Mark I greatly appreciate your insight.

atlas vertebrae adjustment
 

Hi there, I just wanted to let you know about something that has been a major game changer for me. Your son sounds like he has the same residual problems that I have had for the past two years after slipping on ice and hitting my head. I have been suffering for two years and have been researching day and night to find a cure for my condition. Doctor's couldn't help me.. just gave me anti depressants and more pain killers.... but a piece of my personality was still missing. I recently found a specialist who adjusted my Atlas vertebrae. It's a very specific adjustment that regular chiropractors don't do. It's the vertebrae at the very top of your spine. It is only about 1.5 oz and supports your brain and skull. I had an mri which regular docs said was fine but when the specialist looked at it she realized that that vertebrae was off to one side which meant that my cerebellum (rear brain section) was falling below my skull and being pulled into my spinal cavity. After the adjustment I have no stabbing brain pain, my balance is better, I don't stutter, and my memory seems to have improved....along with several other symptoms. The doctor that I see is in Vancouver BC. Her name is Dr. Sabrina Chen-see. You can look her up on the net and see what I'm talking about. I hope this helps your son. Hugs

Has anyone looked at his Atlas vertebrae? It was a miracle for me and I just wanted to share that as an option.
Sue