13 year old with pcs
 

My daughter 13 years had her 4 th concussion 8 weeks ago. She is staying home and resting she had been seen by her pediatrician, physicist and neurologist specializing in concussion, she also had MRI ( negative)
Her symptoms; constant 24/7 low grade headache which is worsen if physically or mentally active or if expose to noise or light. She has great long and short term memory and no balance or dizziness issue (was tested ), her neck is fine
We tried anti migraine abortive medication and amandatine with no success and discontinue and she is on low dose of beta blocker for about 4 weeks now
She is resting and home and attempts to go to school resulted set backs it is too noisy for her. She can not go to church for longer then 20 minutes - singing in high pitch increase her headache, flipping light switch when it is dark increase her headache loud conversation at the dinner table increase her headache ( we have 4 years old who speaks loud) walking longer then 10 minutes increase her headache. She lays down in dark room her headache goes down to low grade where she can function as described below .


She is at home listening to audiobooks (she knows and red before several times), just resting laying down in dark room, play with our dog, and walks a little outside. She sleeps well 12 hours a night and has regular sleeping schedule, she was reading a lot at the beginning of her recovery and we made her stop as we heard that reading is not good for her, although it did not seem to increase her low grade headache

We decided we just let her rest not pushing her to do anything.
She takes b50, b12 1000mg fish oil 2000mg magnesium 400 mg cucurmine and q10
We decided to continue with this strategy until she gets better.

We don't want to start antidepressants for headache she is vey sensitive and all meds she tried so far make her vey sleepy and absent also we worry about withdraw effect later and side effects which maybe worst than her current headache. She also wants to wait it out and dose not want to try more headaches meds. Her last app with neurologist was 4 weeks ago. I don't see the point of taking her back unless her condition will get worse or we wanted to try some more medications.

Can she read or if so for how long ? Can she watch Tv?

She is in good spirit and not anxious or depressed , just understand she needs time to heal.

I am very worry since I don't see improvement, but don't show it to her. Thinking about hbot and acupuncture , but worry that that may increase her headache and I don't have solution for it.
Do we have right strategy ?
Form what I read on this forum and on line rest and low stress is the best strategy and only thing which truly will help her recovery. Masking symptoms, which are not terrible May lead her doing more things and pay the price of set back.
Do I miss something important.
Thanks
Anna

It sounds like you are taking all the right steps. i would say if tv doesn't cause her to be symptomatic then its fine. With my son, the tv seemed to not bother him, but the comp did. We had to ease him back into things. It is so good that she is not dealing with depression, my son is, he is 5 months out, headaches almost gone completely. (Yay!) They say it just takes time to heal. He is back at school full time too. Every brain injury is different, for me, that was so hard to "get", but there is no box that all tbi's will fit into, so she really has to listen to her body and what is ok, and what is not. Best of Luck, It's a rough journey, but it sounds like she's making great progress. :)

Anna,

Welcome to NeuroTalk. Your daughter is still early in her recovery. With time, her head aches will likely improve. Does she have any tenderness at the bony parts behind her ears ?

I think she should be allowed to read for short periods. Try 10 minutes. If her head aches do not increase, she can try 20 minutes. Same goes for TV, except only quiet shows. No TV with fast action and loud audio.

Tr to stop worrying. She likely senses this and it increases her stress and anxiety levels. She needs time to heal. You are taking good care of her, so relax and let time help her heal.

My best to you both.

Thank you both very much
I is good to know that you think we are making right choices for her
I was awake a lot thinking about giving or not giving her antidepressant for headache it is good to have some conformation there
What is your opinion about accupuncture ?
Also 10 or 20 minutes tv and books is for a day or she can do it again after 1 hr or so break ?
I have to set up limits myself if she enjoy something she will not stop untill she has rather bad headache
Thanks again
Anna

For my son that was a good approach, read a bit take a break, and if you have to start off only at 10, that is fine. She just really needs to listen to her brain and take it easy, not to do too much, and for everyone that "too much" varies. My son can read for longer periods of time now, at first that was a challenge as well, it was hard for him being an avid reader, but let her know that it's just going to take time, little by little. Rests in between are very important. Like I said, for some reason the tv never bothered my son, but the comp was another issue. We eased him back into everything that made him symptomatic. There was even a time he couldn't stand in the halls during passing time, so what we did at school while easing him back was to have him leave his class 10 min early, go to the nurses office and go to his next class 10 min later, which was hard for him, because at that point he was still symptomatic and forgetful as well. Slow and steady, she will know when she needs to back off, and hopefully she will listen to her symptoms and allow herself to be guided by what she can do and not push it. My son would say he could almost feel his symptoms coming on/getting worse, it is good to back off when this happens. It is a very very very slow process. I know people who have cleared at 3 mo, 6 mo, 12mo and 2 yrs. (My son still isn't fully healed and we are at the 5 mo mark--but he is able to read, use comp, study for tests, write reports and is functioning fully in school-- he stays away from heavy lifting though, he tried and it made him very dizzy, so luckily he made the decision to not try that again at this point). We have tried several different things, acupuncture, chiropractic neurology, pt, hearing and balance, massage, speech therapy, and as we go through this the more that I learn is that it seems to boil down to time and letting the brain heal and do it's thing on it's own... slowly but surely my sons brain has been healing itself little by little, and i see it. He is doing some pt, the rotation on his neck is still not full and his posture is off (he played football) i just got him back into it last week, his neck is tight and he carries himself incorrectly (i believe its from the football blows) So we are straightening him out there. I am just happy that he is out of the constant headache state so his brain can rest a bit. Hold on to the small things, they are really huge in reality.

Hi Anna,
My daughter has had great results, meaning that her headaches/head pressure almost instantly went away for a few days with acupuncture. We live in CA and the Integrative Clinic up at Stanford started us on acupuncture.

Best to you and your daughter,

Anna,

Your daughter needs to pay attention to how she is processing her environment, TV and reading. If she has to strain to focus, she has overdone it. Needing to reread a line of text is the same. She may not need to rest when she has hit her limit reading. She may just need to change to an activity that uses a different part of the brain.

The important thing is for her to learn how to recognize her limits. When she can do that and is willing to take charge of her recovery, you can let her set her own limits. If she is a disciplined person, letting her set these limits will be good for her confidence.

I used to spend a while on the computer. Notice a need to reread a line and go to the TV room and watch a documentary show or something light. Or spend time with my dogs. It was as if I was ADD. I just switched activities through out the day.

When she reads, it may help if she uses a blank sheet of paper to hide the text below the line she is reading. Reducing the visual clutter may enable her to better focus on the text.

It may also help if she has access to head phones when she watches TV. Getting a more direct TV audio that is not contrasted with ambient sounds can make TV watching much easier.

Thanks a lot !
One thing is a little confusing to me
I am not sure she should start school work or trying to go back to school or
just take it as easy as possible at home untill she is headache free
She has low grrade headache since her injury for 8 weeks 24/7 resting in dark room or not. About the same pain level no improvement

After geometry class she tried went up 2-3 grades, but went down after 2-3 hrs ( that was 4 weeks ago) watching tv or walking 1 to 1,5 grade up being at school last week for a picture day for 30 minutes during recess went up 2 grades and stayed one grade over her average for about 3 days
Her friends are just too noisy for her no stress no learnig just noise made her suffer 3 days
She has noise canceling headphones but is hard to were them at school
I bought her ear plugs but they don't make any difference what are good plugs to try?
Outside of noise sensitivity issue I don't know if learning is good for her at the moment. Geometry is out if the question but even easier subjects ?
I also don't want her to be paranoiac about her headache and I am not sure what she can tolerate with no harm to her recovery or what she can not
Thanks
Anna

If she has all of these sensitivities that cause an increase in head ache, she should avoid them. It may help if she can find some manual activities to do. Playing solitaire with real cards, knitting or crocheting, and any activity that requires her to use her hands (not video games) will give her brain some gentle stimulation at a slow pace. This will hopefully gently increase the blood flow through her brain.

I use the yellow foam cylinder ear plugs. I twist them tight then insert them. They block the background sounds quite well.

I would add to avoid shows that display 'emotional' situations, no matter how light and harmless they may appear.

I remember my mom not feeling well while watching a Disney film, at some point when a little girl receives a visit by her cat, who was allegedly dead, or something like that. My mom have had a concussion some weeks before that.

In my opinion, if the math does not make her symptomatic I would let her try, even if she can do 5 min and that's it, then that's a start. with this situation, you will get two pieces of advice on opposite ends of the spectrum, some will say, no, do not attempt it, others will say if you don't use it you will lose it. I have both views told to me from people in the medical field. I am glad we started my son back with math. He took his time, at first it is difficult, but then all of a sudden, things started falling back in place. The stress of him getting behind and not being at school was not good for his brain as well. recovery is aimed so much toward each individual and what makes them symptomatic, what they can/can't do. Without trying you won't know what they can/can't do. It's such a hard process, I wanted a set of rules, but there are none in recovery. She just really needs to listen to her brain and what it can or can't do. Let's say reading doesn't bother her, I would say go for it, until she feels worsening symptoms starting to come on. Then switch to something else as Mark stated. I was told for my son to attempt puzzles, such as suduko etc (as long as it doesn't make him symptomatic) that every time info runs down a nerve path, the brain will recognize that that portion is not processing correctly and send a message to the other portion of the brain that that area needs help, and start the regeneration process. If that portion has experienced neuronal atrophy, then other portions of the brain will begin to make up for that portion that isn't working properly.----- but then I have also been told to rest that it is like a bruise that needs to heal, all by medical professionals that supposedly specialize in this. SO FRUSTRATING. but, I would say just really pay attention to what makes that headache go from a 1 to a 5 and let her learn to recognize the onset of that and learn how to back off. (I hope I am making sense) Mark has a fountain of info and has done a lot of research as well, he is a good go to and is on often on here. Slow and steady is probably my best advice. It is a slow, straining hard process, but the brain is amazing, it does heal itself, little by little, she will get better. My son was so much worse 4 moths ago, he is not fully healed, but has made great progress. Slow, but progress. He is driving, going to school, maintaining a 4.0 (he has honors and advanced classes) i didn't know what was going to happen four months ago. Now we are moreso dealing with mood, and depression-- which didn't seem to start hitting him until the 2 to 3 month mark. I just have to remind myself that his brain is healing, and this probably won't be a fast fix either. Church still sets my son off (he just is very tired towards the end of sundays, and will sometimes get a headache), I think it's the lights, all the people, the singing---it's a lot for the brain. i would say let her take Sacrament and then maybe excuse herself into the foyer and let her read if that isn't causing her symptoms. This experience is no fun at all, and I know how you are hurting for her, but I know things will get better. It's just slow :(

I don't believe the "Use it or lose it" claim of many. The brain does not lose information or skills except in severe situations. They just become dormant. They can be relearned much easier because the information is still there. The pathways to that information just needs to be reawakened. I had to retrain my mind with math skills many times. It was never like I needed to relearn. I just needed to refresh the skill.

I had a NeuroPsych Assessment last month. My skills are no different than in previous NPA's. My memory is still horrible but my prompted memory is much better. Prompted mean that with just a little clue or reminder, the memory becomes available. This is what I experienced with academics. Just a bit of a reminder and the pathways to the memories were reawakened. Then, this information can be stared in new memory location that is more accessible. It takes a bit more work the second time but it is not like learning from scratch.

A problem I have is trying to process a long multi-step formula. I need to break it down into many simpler steps. I believe my problem is a reduced digit span that limits my ability to hold multiple items in memory at the same time. I have the same problem trying to comprehend complex and overly descriptive sentences. I get a sense of being lost trying to juggle too many concepts.

These problems gave me a new empathy for people with learning and comprehending difficulties.

headache 24/7 3 monts aftre concussion
 

Helo, my daughter has 24/7 headache 3 monts after concussion with light and noise sensitivity. Our neuroligist recomends antidepressants, but I ma very worry about withdraw affect of them Elavil for example seems very scary reading the posts and the symptomps of withdraw are much worst for some people then orininally treated. I ma not sure if we should just continue to wait it out. Any comments are welcome, my daughter is 14 yeras old.

Elavil (amitriptyline, a tricyclic antidepressant) is usually prescribed at a very low dose, 10 mgs or so. It is usually well tolerated. I have not heard of people having serious withdrawal problems with this low dose. An SSRI would be more problematic. You can often get good information about a drug from your pharmacist.

Has she had any treatment for her upper neck ? This is often a cause of head aches. It may help to ice her upper neck. A day of on and off icing would be worth a try. It is reduces her head aches, it points to neck inflammation. If she has any tenderness at the bony part behind her ears, this is indicative of an upper neck injury. They can be very subtle and still cause head aches. These head aches are sometimes responsive to Botox injections.