reurn of PCS symptoms in an adolescent
 

I posted last spring when I realized my daughter was in fact experiencing PCS for the second time, following a 10k run. She is fourteen.

She had been pretty much symptom free for three years prior and we had been mindful of the fact she is much more vulnerable to concussion due to her history.

After three months she was doing much, much better and we continued to take it easy over the summer.

Five days ago she came home with a splitting headache (8 out of 10) and although it is at about a 4 now, it remains. I believe she needs to stay home from school until it is gone. As hard as that is I am really, really concerned about what might happen if she returns to school prior to the headache resolving.

The headache came on while doing computer coding and timed typing tests. I will seek significant accomodation with the teacher as I believe this is not a safe situation for her. She did have one or two headaches that lasted the night prior to this, and they came on in this class.

We are doing lots with supplements and are going to try a type of biofeed back called Brainstate some have benefitted from. We will also take her for NUCCA chiropractic as I think her neck remains injured from gymnastics accident.

If anyone has further thoughts or suggestions please post. I really want to avoid migraine medications. I am going back through the posts again as I have learned so, so much from the site.

Wishing all of us well.

pretdou,

Welcome back. I am sorry to hear of your daughter's I think she needs to be head ache free before returning to school. To make a more important point, she needs to NOT do timed tests until she has SLOWLY rebuilt her tolerance for such intense cognitive and motor control work. This rebuilding should be spread over the next 6 to 12 months. She should seek care for her neck.

I would advice against the BrainState conditioning. There is only anecdotal evidence that it works. It has downsides. Input brain therapies can cause seizures. I suggest being extremely cautious about any non-volitional neuro-therapies for a brain as young as hers. Her brain is already under stress as she goes through the many maturing processes at her age.

You need to help her slow down. It is obvious she has a sensitivity to pushing either cognitive or motor or both brain functions. Keep in mind that some of her symptoms may not show up until the next day. Cognitive effort usually has a lag before some of the symptoms return.

If she needs to build keyboard speed, she should be doing it naturally rather than under pressure. Unfortunately, teachers like to measure achievement. She is not ready to be put under such pressures. The most common learning environment accommodation Post Concussion students need is a slower pace, more time for tests, and a quieter study and testing environment. It sounds like she needs the same.

I hope the NUCCA chiro can help her. Sometimes, neck injuries can lead to head aches.

The keyboarding may have been only the straw that broke the camels back with your daughter. She may have other cognitive loads that need to be moderated. I hope you can help her in these areas.

My best to you and your daughter.

For example, I had a very busy day online Tuesday. I was typing all day. Yesterday I crashed like I hit a concrete wall .

Good points
 

Mark,

You make some good points. I am in complete agreement that things will have to be slowed down at school.

Yes, it seems that she is vulnerable to relapse if she pushes too hard with cognitive or motor functions. The pushing in this regard was the final straw after running a 10k last spring.

I agree that this had likely been building this time too--she was doing the typing and coding the week beforehand. We felt that she had a great schedule this year, with very low stress:( I think this class is just too much.

I will also contact another provider of biofeedback who is well recomended, that does the volitional type of biofeedback. Are there other concerns with the BrainState input type of biofeedback? I'm concerned, I feel her brain is in a really vulnerable state so I will be looking into this. Thanks for letting me know about this information.

I am not a proponent of any of the non-volitional neuro-therapies. They do not publish their research and they tend to over represent their value. These therapies are only approved for assistance with relaxation. Any promotion for medical conditions is against the law. Any comments about FDA approval are misrepresentations.

The FDA application process only accepts them as 'exempt' from FDA regulations. This exemption means they have presented claims that the process does not have any negative risks. Unfortunately, there is no mandated reporting of negative side-effects or adverse reactions for exempt medical devices.

Before you try a biofeedback therapy, if you post some basics, I can give you as much information as I can find. There are certain buzz words used that I understand.

What symptoms are you hoping to treat with neuro-therapy?

There are no quick fixes, especially at her age.

Have you had any blood work done? B-12, folate, D3, calcium, magnesium, DHEA, Thyroid, and the female hormones can all be tested.

Also, her brain may be more sensitive to stress at the end of her cycle when her progesterone is at its lowest.

If she has a history of being a high achiever, she needs to learn to take a slower approach. The academic pressures put on young women today is ridiculous. Just because they can be pushed to high achievement does not mean it is proper.

In my day, we just had honors courses. Now, there are AP courses starting in 9th grade. The competition to graduate with a 4.3 GPA is unreal. In the long run, it does not make a difference.

When does her school administer the PSAT? Academically, she should be focusing on learning new test taking skills so she can do best on the PSAT. Good grades with a great PSAT will benefit her better that a poor PSAT and great grades, IMO. I was very cognitively challenged for my PSAT and missed an opportunity for a great score.

If she can learn how to study in a low stress way, she will do great. No cramming for exams. The concussed brain needs to plan way ahead of any testing. This way, the information is well remembered in long term memory. I did not learn this need until I was too far beyond the academic benefit.

Sorry about the fire hose of information. I am passionate about this because I struggled so much at her age because nobody told me what was happening in my brain.

My best to you both.

The informaion is great
 

Hi Mark,

I hear your passion and appreciate it. There is nothing like lived experience to add to knowlege.

My daughter is just entering grade 9.

She was planning to go to a very "achievement" oriented high school but while out of school for all of the spring last year decided to attend our neighborhood high school. It has been fantastic. It is not a high pressure enviornment in anyway and we are thrilled.

It turns out that none of her current teachers believe in homework so she has not been needing to study at night.

Sadly we learned about too much stress the hard way last year and we were really feeling good that her schedule was quite manageable this semester.

Obviously we are really concerned as what is happening opens up a lot of questions about whether she will remain symptom free.

I know her computer teacher will be very good about working with us.

My daughter does have dyslexia and this likely complicates things in terms of getting taxed cognitively. She is bright and loves to do well and is prone to over doing and yes she has to work harder to begin with:(

I think you are absolutely correct about the need to develop good methods and strategies for studying to prevent cramming.

We are hoping to help with stress and headache through the biofeedback. There is someone here who is well recommended who does the Qeeg neurofeedack.

Unfortunately I have been unable to get our doctor to test vitamin levels for anything. I am paying out of pocket to have it done.

I am going to take her to someone who specializes in bioidentical hormones as I've read about progesterone and I think we need to try and get that on board. Interestingly she was at the end of her cycle and this was only her second cycle ever so it has me wanting to get this all checked out.

We are aware that life in the more mellow lane will really benefit her. I personally hope she will start at a community college and go from there. We certainly wish she didn't have all this on her plate. She is a really wonderful person and is remarkably unself pitying:)

Thanks again for all the good information.

I think you are making some good decisions. Something I have learned is that my need to slow down has put me in a unique position. Most high achievers do not spend much time with those who struggle to achieve. Since I have come to understand my struggles, I have been able to recognize and understand the struggles in others. It has provided a completely new understanding of how much of the world has to struggle to get the job done.

Have you been given access to the educational help for her dyslexia? My nephew was not diagnosed until 9th grade. He finally go approved for the help he needed a year or more later. He and his folks were furious when they realized how successful the educational help was. He missed out on most of his education. He was finally approved for help at Lindamood-Bell. They have centers all over the US.

There is enough tendency for PCS based dyslexia without the struggle of a pre-existing dyslexia. Has she ever suffered a concussion previously, maybe an undiagnosed head impact from gymnastics?

Do you have a hormone specialist lined up? Here is a referral system. https://www.womensinternational.com/..._referral.html
They also have the best price on the compounded creams.

My best to you both.

Mark it sounds like your experiences have made you a far more compassionate person. I really, really admire your views about your injuries and resulting issues. Reading your posts has helped me to move away from "futurizing" any number of times. *Sigh*, that work is ongoing.

Unfortunately my daughter has had at least three concussions, the third was terrible. And given what she went through after the 10k last spring, I do believe that was yet another concussion for her brain and not a good one.

Her dyslexia predates all the concussions. We ultimately did something called Arrowsmith and it was incredibly helpful. Due to cost and very, very limited availability this amazing program is able to help only a few. They have a website if you are interested.

Good news for your nephew with the Lindamood-Bell program:) I've heard good things about it. I hope the doors to his strengths and talents will be opening wide.

My daughter does have an IEP and we are very pleased with how that is being handled this year in her grade nine. The resource teacher is excellent.

Thanks for the encouragement. I too have to remember to slow down, this is a marathon not a sprint, eh?

There is a doctor who specializes in bio-identical hormones and I can just call for an appointment. Her website looks good. I do feel that given the timing of all this it should be checked out.

I'm going to run my big worry by you. Last spring the PCS started with about a week or so of headache and then went into every concussion symptom in the book. I believe that was the lag time between the run and the full symptoms, with the stress at school being the final straw (again timed testing).

Do you think, based on your experiences and research etc. that this could play out like that as well, with mental stress as the trigger? So far she's holding, but we are not to 7 to 10 day point.

The run could very well have been the trigger. The 10k also caused quite a chemical trauma to her with the way if breaks down muscle tissue. The delay of a week is not uncommon. When the brain cells are injured, they try to go on in an attempt to heal. After a while of this effort, the surrounding cells can notice this poor cellular function and send out a signal (tRNA, transmitting RNA) telling the damaged cells to shut down, die and be absorbed. This can be delayed by up to 6 weeks.

Another issue to consider it the impacting from the run. If you put foam ear plugs in your ears and take a run, you can hear the impact of each foot plant. It can be rather intense.

The hormone doctor may have some good direction for her. The timing of her entry into womanhood and her symptoms are likely more than a coincidence. Hopefully, this doctor also understand the ortho-molecular needs of the brain.

My best,

That is reassuring. It's what I think too (without as much technical understanding):)

I actually read a post on here by someone who developed PCS after running a marathon severely dehydrated. The things no one knows:(

I have set the course for now. I 've contacted the bio-identical hormone doctor and we will go for an assessment with a developmental optometrist (full doctor), who can provide Vision Therapy through his clinic.

My husband and I joke that we will be in the "Freedom 85" group of retirees.

We had an assessment done by this doctor, long ago, and it was absolutely excellent. She needed Vision Therapy then, and it was obvious to us, but we couldn't get the treatment where we live.

The four concussions since her first assessment will not have helped things and the clinic does work specifically with brain trauma and LD both of which are at play.

Thanks for the support Mark! I will post as things unfold.

Best to you.

My good doctor (been through a few) talked about it like a graph with the line going up and down (that being symptoms) and that there is a line that we must try to go under at all times in order to heal. The more often you keep it on or under the line, the line will rise up. Doing timed tests is definately NOT the good thing to do.

As for her headaches, I'm 17 so I totally get the resistance to medications (tried that approach, only a quick fix). I've cut all sucralose, aspartame, stuff like that out of my diet, it helped a bit. I find even cane sugar (health food department) for my bad pop craving every once in a while, doesn't affect my head as much. Check out a nutrition feed on this website to see some of the stuff she should cut out of her diet. For excruciating pain, I have had a small glass of coca-cola, caffeine helps my headache, although others may argue and I've been told you should try to avoid caffeine. If she's home, try a cold compress or ice pack and have her rest in the dark with it on, I found it helped a bit. :)

I think a chiropractor is a great idea. Even if she does not have neck pain, I'd go. I had mad headaches every day (6 or 7/10 at least) and bad neck pain as well as cognitive stuff. I was fortunate to find a doc who does acupuncture, chiropractic, physiotherapy and cognitive therapy. Not only has he fixed my neck pain, but headaches lessened (less tight muscles in the neck and less stress from pain) but I can think clearer. Definately look into that. You can also try massage therapy if she does have tight neck muscles. A good doc will recommend you try a couple things in conjunction, as they work much better together.

Is she sleeping? If not, an herbalistic approach would be to take Melatonin. You can buy it anywhere in a drug store. Non- drowsy in the morning and it would help me fall asleep. MORE SLEEP EQUALS LESS HEADACHES :)


Hope some of that helps, and let your daughter know, she's not the only teen dealing with tough symptoms !