The dosages of a multi are usually very low. Very few of the vitamins have any over dosage problems. There used to be a concern for B-12 overdoses but that is not a concern any more. If you look at the minimum dosage sizes you can buy each vitamin or supplement in, you will see that the manufacturers are within the dosage ranges I have mentioned.

Magnesium needs to be combined with calcium. Some calcium comes with magnesium already combined. I don't know if the lip cracking is related. Never heard of that before.

Have her eyes settled down? Nystagmus is a symptoms that is common to PCS.

Have you or she tracked her symptoms with her cycle? The ups and downs of hormones may be related. I've been reading about progesterone. Its neuro-protective value is interesting. It surges the two weeks before a woman's period. The other two weeks could be more symptomatic. Just another thing to consider.

From what I see on this forum, it appears that teenage girls have more PCS struggles. Could their body's changes be part of the difference? Worth considering.

My best to you and her.

Nancy we have hijacked your thread. Something tells me you won't mind as many of these issues are pertinent to your girl as well.

The nystagmus has settled down for the most part. She had a recurrence for about a week when she went from 30 to 20 mg. of Elavil and now again when she went from 20 to 10. It usually only happens now when she has been reading for awhile, especially if she is reading for homework rather than pleasure, and if she is tired. Her neuro opthamologist was a total jerk ("it's all in her head") even though she did have some atrophy on optic nerves and slowed response on the evoked potential test. He didn't see any need for therapy. The neuro continues to ask about it at appointments but doesn't believe there is any need for therapy at this point. I don't know if it would be worth a 250 trek to another neuro opthamologist?

Teenage girls do seem to have a lot of problems with PCS! My daughter has the worst symptoms during the week prior to her period. It's more complicated in her case, however, as until now she is the only female on her dad's side of the family (3 generations) without menstrual migraines. Her neuro thinks the concussion "reminded" her brain that it is supposed to hurt. Outside of the typical concussion headaches she had one migraine and it fit the description of menstrual migraine. She may get migraines monthly, maybe never again, maybe occassionally. We just have to wait to see.

I'm struck by how the high-achievers seem to be so severely affected by it. I do not for one second believe it is purely psychological, but I do wonder if the profound sense of loss exacerbates the symptoms. The young ladies on this forum are facing identity-changing circumstances at a time in life when your outward identity is everything. If you define yourself as a female athlete with strong academics, it's tough to lose it all in one instant. They go from the top dogs at school to complete question marks. Where do they fit in? Who are their friends? What do they DO? She has had teachers and other students make HORRIBLE comments to her ("are you going to die or something?" "do I need to talk slow to you now" "why are you making this up, nobody has a concussion for this long"). People seem to enjoy letting her know just how far down she's fallen in the pecking order. It's not all bad, though. She is learning early who her real friends are and, as we've discussed before, she's learning a lot about compassion. She'll be stronger for it.

Psychologists will diagnose many PCS subjects as schizoid (loners, lacking social connections). I have always thought the schizoid is a follow on symptoms rather than a primary symptom. We tend to remove ourselves from social settings due to the negative reactions of others. We would prefer to be engaged socially but the frustration prevents it.

The high achievers are also the most difficult to get a sound diagnosis of PCS. The professionals see the high functions as 24/7. They do not accept that the high functioning is not the normal or that it is necessary to put extraordinary effort to achieve the high function that was very easy pre PCS.

My biggest struggle was learning to study. I hardly had to crack a book pre PCS. My memory skills were outstanding. Some casual review and I was ready for finals. I challenged freshman algebra the second week of class and got an 85% on the final. Took sophomore geometry instaed. Had straight A's (93% GPA).

Concussion first quarter of sophomore year. Grades fell apart. Freshman year I had been given the nickname 'brain'. Sophomore year, classmates were complaining that they could not cheat off me because I was struggling to take tests.

Even when I studied harder, I struggled with tests. The stress of the testing environment froze my brain. I would have blank stares at the questions.

It is unfortunate that schools teach to the test in a way that makes it difficult for the brain injured to compete. I am sure she still exhibits her intelligence, just in a different way. Not the 'one size fits all' way of classroom schooling.

Remind her that there are two kinds of high achievers, those who can get good grades (good at memorizing facts) and those who are truly intelligent and understand the subject matter. The 'good at memorizing facts' students tended to be more snobbish. They were achievement oriented just for achievement's sake. The truly intelligent achieved good grades just because they could. The latter still understand the information but struggle to regurgitate it on cue.

The intelligent guys tended to be cut-ups or nerds. I never did figure out the intelligent girls. Most of the high achieving girls I knew were of the snob variety, except my girlfriend. At a 20th reunion, those snobs were still snobs. There were popular with classmates snobs and popular with teachers snobs.

High school can be such a challenge. The 'on cue' issue also effect the social settings. Friends will want an instant response.Maybe once she has sort out or made sense of the conversation, she will be able to respond. People tend to think this slowed reaction is being dumb. In reality, it is just a slower, more diligent effort at understanding the issues.

before my recent injury, I would be the first to respond or even break into a conversation that was going too slow. I had "important information to tell." Now, as I have had to slow down with my responses, I don't talk over people as much or just plain talk too much.

Even with my weakness at recognizing social cues (PCS), I still behave better in social setting due to my need to have patience to listen and understand others.

Her social circles will evaporate the summer after high school graduation. Help her make it through those years and she will be fine. Help her focus on character development rather than social connections. Here in Idaho, the Dairy Association gives out an award for overall achievement that is based on character values. Volunteerism is a big part of their criteria. The Distinguished Student Award recipients often work with younger or disadvantage students or people groups, mentoring, etc.

Finding these opportunities for her will fill her needs to have social connections, except her social connections will have strong benefits for all concerned. Working with adults will give her a better chance of not being ridiculed. Peers can be so petty.

I watched my daughter who had some learning difficulties flourish outside a school environment. The girls at school could be wicked. The constant grade competition is inappropriate.

Mark - I totally agree! I think that is why the concussion clinic dismissed my daughters PCS as psychological/behavioral issues. They looked at the scores from the brief cognitive screening the neuropsychologist did and said she was fine. They told me they had kids functioning in school with lower scores than hers and she should just go to school. They failed to look at her as individual and understand that for HER, the decrease is scores was has having huge impact. I still don't understand why they thought she was "cognitively fine" when she couldn't remember things from day to day. Maybe there definition of cognition is different than mine.

PCSLearner - From what I have read, adolescent girls take the longest to recover from PCS. If you are a high achiever - PCS symptoms are worse. I also agree with you on their lose of identity. That is exactly what my daughter experienced.

I think being a high achiever with PCS is like having a high powered sports car that has tires with slow leaks. You can keep filling up the tires and drive a bit but you never get the full performance.

I can imagine the identity issue. My withdrawals have been in steps. If my life was built around friends, I can see how miserable it would be.

If it is true that high achievers and girls seem to be particularly affected by PCS, this is interesting. (If anyone has any data on that, please pass it on.)

I think that the first scientific explanation to consider would naturally be that those groups are somehow more affected by the condition. By this I do not mean that they just make more of a fuss over it. I actually think that they could be worse off.

The high achiever might have the sort of mind that is particularly vulnerable to trauma. For instance, neurological pathways involving the neurotransmitter glutamate, which is involved in memory, might be more active in high achievers. That would mean that there is overall a greater concentration of glutamate in their brains. When a trauma occurs, glutamate is released and, being toxic, might cause at least part of the physiological damage of PCS. That would be more in people with greater amounts of it, ie high achievers. This would mean that being a high achiever might mean a greater amount of damage in the brain when it is traumatized.

In a similar way, girls might be more susceptible than boys to brain trauma. Their heads on average weigh less than those of boys. So, for a given impact, girls heads would be accelerated more causing greater damage.

These reasons might not be the whole explanation but I think that they are more plausible than having to say that differences in recovery rates are due to psychological differences.

If anyone has any hard data on such differences in recovery rates, please pass it on. Thanks.

CS

I do not think the head size has anything to do with the girls with PCS issue. I think it has more to do with fluctuating hormones. The balance between progesterone, estrogen, testosterone, etc changes throughout the month for women. These same hormones effect how the brain functions. If the balance get too far out, symptoms would be greater.

As far as the high achiever with PCS issue goes, my neurologist said that my brain is very high powered frontally. My concussions have left it underpowered in the rear/occipital lobes. This leaves a serious timing differential between the two lobes that disrupts the proper functions. I also have a damaged 'gating' system that blocks or allows information to flow to the frontal lobe.

The occipital lobes can easily get overwhelmed with information. This prevents any of the information from being processed, sort of like a bottle neck.

The high achiever also has habits of depending on the high function levels. If these expectations are maintained, the errors are blatant. If the high achiever is able to lower their expectations a bit and moderate the environment, some of the frustration can be reduced.

Sounds exactly like the conversation I had with my daughter last night! I keep trying to tell her that her grades don't matter this year. Her college adviser will write her a letter of recommendation and explain the circumstances of her freshman year. The colleges won't care.