Thank you for all of your insight and suggestions. No, as yet he has not been to a specialist. We have though come to the conclusion that we need to take that as our next step. I am taking alot of your suggestions to heart and praying over the right course of action. Thank you for your thoughts and prayers.

My research says that he should not be mixing the amitriptyline and codeine. The Tylenol 3's should be stopped 4 hours before his amitriptyline dose is taken and not taken again until 8 to 12 hours after the last amitriptyline dose.

If his doctor has OK'ed him to take aspirin, he can take a maximum dose of aspirin and Tylenol together. They are about as good at pain relief as the Tylenol 3's. I was taught this trick by my doctor. I use it for my worst head aches.

He needs to take a break from the Tylenol from time to time, at least 12 hours or more. Tylenol is rough on the liver.

I'm someone that has been struggling on and off with PCS issues for almost 28 years now. As for the number of concussions I have had it is in the double digits (mostly all sports related). I am almost 36 yrs old and was told by my neuro doc that I must avoid any bump to the head even as something like bumping it a shelf. I don't even have to hit my head anymore. Any sudden motion or the snap of the neck could have the same impact. Simple tap in a vehicle accident would kill me. There is so much more information out there now versus years past. This will help so many young people now.

As for the mood changes that are occurring with your son, they may not be all in the physical sense. The emotional effect that he may be going through might include the whole sense of not feeling like himself. The inability to express that he knows he is not like himself but not understanding why. It is am extreme sense of helplessness as like a dementia patient.
There had been moments I struggled with frustrations of memory loss and delayed thinking processes and not understanding why I was feeling the way that I was. If you consider someone that all of sudden ends up in a wheel chair the emotional roller coaster that they go through coping with the change or limitation of the moment. When it concerns your brain you can't think straight and you don't understand and even if someone explains it to you there is great difficulty in retaining the information.
Along with the emotional side effects your son could be going through hormonal or sleep deprivation issues. Only in the last 2 years have I learned that my fatigue that I struggled with for years was actually damage in the area of my brain that controls sleep and wakefulness. I was sleeping 18 hours a day and struggling to function. Even though I slept that many hours in my condition my brain would registered that I had only slept 2 hours so over time my organs were shutting down. Proper REM cycles are important to the overall health of being able to heal oneself. Even though your son maybe physically sleeping it may not be the proper sleep cycles that he requires. Sleep deprivation can create tons of issues. He may benefit from a sleep test to see if there are any abnormalities. Sleep issues like insomnia is a very common issue for PCS. Sleep/hormones can increase headache problems too.
As for hormonal changes it may be wise to see an endocrinologist for any options of hormonal imbalance. Thyroid problems can occur with head injuries too.
There are so many areas of the body that it can effect beyond the brain. Like just this week I learned that my constant muscle tension is a lasting effect from my head injuries. Who knew that my lack of REM cycles that my body can't repair itself normally.
So make sure you notice even the smallest of changes because it could help him in the long run. I had issues for a long time that I didn't understand and didn't realize they were symptoms.

mickeymouse,

Welcome to NeuroTalk. Sounds like you have been living with PCS since you were 8 years old. We probably have a lot in common. I was first concussed at 10 years old in 1965. Had 14 concussions since than. I can concuss my brain shaking my head "No." Ten of those 14 concussions would not be considered concussions by a doctor. But, those of us with sensitive brains know better.

Yes, the sleep issues can be a contributing factor. The neurons can only heal during REM sleep.

FrustratedMomma, As MM said, watch his sleep. If he does not maintain normal breathing, this can easily be a big factor in his volatility and fatigue. My breathing problems are due to poor neck position. My wife can predict the kind of day I will have by seeing how I am breathing at night.

It is just one factor but a big factor that can be corrected.

FrustratedMomma, take him out of school, and make the school system live up to their obligation to educate him anyway by providing a home tutor. He is not capable of going to school for medical reasons, they HAVE to supply what he needs. At this point, it would only be for an hour or so a day anyway, to help him with what he needs, and he could work on the rest in little slots throughout the day. It can only help to take him out of the horribly overstimulating school environment.

I was 47 when I was in an auto-accident. I had a great career, wonderful and active life and had it together mentally and emotionally. Felt like I was on top of my game and on top of the world.

I'm 50 now. I can't even begin to imagine having to deal with a TBI as a young person, particularly a teen.

The stress, depression, anger and frustration is so difficult to deal with rationally as a mature adult. To live with it as a young person has to feel so much more magnified.

Outside support/counseling could be of benefit...But your support for your child is one of the best things for them, even if unspoken by them, you're their safe haven.

Hoping the best for all moms and dads caring for a child with this type of injury...Treading where angels fear to go. Best to all.

Input needed please....! I requested a referral from the Dr he has been seeing to a neuropsychiatrist. When I got on the phone with the referred Dr.'s office, I found out the Dr. is actually a sport and performance neuropsychologist. After many questions to the front desk, the gal connected me with the Dr himself. I spent 15 min on the phone with him. I told him that I thought my son actually needed a neuropsychiatrist, as his injury/recovery is not sports related, and many medical issues seem to be involved. I said that I really didn't want to waste our or his time by starting with him if he was just going to need to refer us elsewhere. He told me that there really is no such thing as a neuropsychiatrist (??!!). He said that the neuropsychologists, like himself, would do a very time-consuming, detailed assessment, which is what is needed to find out where his issues are exactly. He said there really isn't a 'one-stop' fit. If an EEG and/or meds are needed, he would refer to a neurologist. If behavioral management needed, he would refer to a psychiatrist. Is this right?? My gut tells me that this Dr. is not the solution for him.

Frustrated Mamma-

Not knowing anything about the dr or his credentials/methods, I can tell you what my experience has been.

I was referred to a neurologist two weeks in by my primary care. 3 months later, I wasn't any better, and kept being told go home and rest (which is VERY important, don't get me wrong). However I continued to be plagued by dizziness, nasuea, migraines, neck pain, extreme fatigue, emotional outburst, memory issues, etc. When I started having trouble regulating body temperature, the neurologist said, it was all in my head and that my symptoms were no longer neurological. Really? all of the above symptoms are "just in my head"??? I immediately decided I did not want him continuing my care.

A few acquaitances with children who play sports suggested a local concussion clinic for sports medicine. I too said, it's not a sports related injury. However, I soon found out that the treat many people who have concussion, who are not related to sports at all. For me, it has been a great fit. He did the neuropsych evaluation and a physical exam. From the results he referred me to: Vestibular therapy (for balance); physical therapy for my neck; vision therapy, (I was unable to get my eyes to focus on anything closer than 2 feet from my face.). He also referred me to a phsyical medicine and rehab dr who put me on meds for sleep and the headaches. I also see a psychiatrist for the emotional rollercoaster.

So as this person told you, that is what my Dr. did. He has been great, and given me hope. I am now actively engaged in all the various therapies and am making progress. So for me, choosing the sports medicine doctor was a life changer.

However, as a mother if he gave you the vibe that he wasn't going to be a good fit for your child, then by all means follow your gut! If you have any questions about my experience, let me know. Hope this helps!

Frustrated,

Google neuropsychiatrist. You will find lots of information about this subspecialty that will sound like what your son needs.

A neuro-psychologist may be able to help but they are not medical doctors with the deeper understanding of the physiology of the brain and how nervous system injuries and dysfunctions can effect the rest of the body.

As smilin said, some do a good job of referring. Others try to keep the patient in their own practice. A good Neuro-Psychological Assessment (NPA)would be worthwhile for the issues it can identify and address. They can become very expensive. Check with your insurance if costs are a factor.

Also, the specialist (physiatrist) usually listed as a Physical Medicine and Rehabilitation doctor can be helpful. It might be the specialty to use as the center point of the rest of your son's care.

Your insurance company may have a medical advice/help line that can direct you to finding the best doctor to coordinate referrals and treatment. Your son needs a team of specialists to work together.