Hi everyone, this seems like a wonderful community. Like so many say I wish none of us needed to be here but it is a godsend when you find yourself needing the help and understanding that only those who have lived it can provide. My 13 y/o daughter is now going through a second PCS and I am so worried for her. I just keep feeling like I'm going to wake up and find this isn't really happening. It is surreal. She suffered PCS three years ago after an accident in a gymnastics class that involved falling onto her head from a handstand position (no mat) and then going onto a trampoline. It took her two months to recover and we were told by the neurologist we should consider ourselves very lucky. At that time we knew she had had two prior concussions and I will always wonder about more. We certainly recognized she would forever be at much greater risk for concussion/greater injury from head trauma. Fast forward three years, during which time there were no recurring symptoms of PCS (though I know now there were subtle things occurring). Two weeks ago she ran a 10k and three days later full blown PCS. I was numb for awhile but the hugeness of this is settling upon me more and more along with a lot of guilt. I'm terrified about her full-recovery and the level of fragility/susceptibility to concussion that she may have.

pretdou,

Welcome to NeuroTalk. Sorry to hear your daughter is struggling.

There is no reason for you to feel guilty about her current struggles. There is no way you could have known she would react this way.

At 2 weeks, she is very early in her recovery. She should focus on being well hydrated and be sure to have good nutrition. At her age, her hormones could be adding to her symptoms. Not much you can do about that.

What symptoms are the most trouble?

Does he have any stiffness in her neck, especially her upper neck? I would not be surprised if she caused upper neck inflammation from the pounding for 10 k. Icing her upper neck is worth a try. A zip lock bag with 3 parts water and 1 part rubbing alcohol will freeze to a moldable ice pack. 15 minutes on and 30 off as often as possible may show some improvement.

Let us know how we can help with other symptoms.

My best to you.

Thanks Mark. Yes her neck is sore and I will definitely try icing it. She has all the symptoms of concussion: emotional lability (she does recognize this), slowed processing, brain fog effecting overall mental acuity, blurry vision that comes and goes, constant headache all over that is raised by any activity, can't fall asleep/not having restful sleep, feels loopy at times, light/sound sensitivity--all of which are aggravated by pretty much anything (bathing, being in car, small trips to the store let alone socializing). We hope to get in to see a Dr. in town who works with a lot of PCS sooner rather than later. Our GP sent a rererral so that her knows she has had multiple concussions/ and now PCS again. The inabililty to fall asleep is really, really tough and I don't think her sleep is very restful. She is out of school and all activities and I am now greatly reducing screen time--no gaming for sure. I read to her at night to help with the horrible restlessness and yesterday we started playing cards/monopoly.

I do feel guilty. But finding my way with that is my job and it will come I know. I think that the information that is here about the possible issues with hard vibration is incredibly valuable and I'm not sure you will find it elsewhere.

The upper neck inflammation can cause a reduction in blood flow and muscle spasms, etc. The jarring from so many foot plants can also be very traumatic.

It would surprise me if she does not get relief from the icing. Taking an anti-inflammatory med like aspirin or ibuprofen can help, too. She could alternate the two meds to reduce the strain they can cause on a body when used long term.

Her previous concussion from a vertical impact to her head and neck leads me to believe she may have a chronic upper neck injury that needs to be considered.

I suffered a vertical impact 12 years ago that has never completely healed. I am very sensitive to car rides down a rough road.

If she needs to ride in the car, have her lean forward with her shoulders forward if there are any rough road areas. This creates more vertical shock capability in the upper spine. If her shoulders are against the back of the seat, she will feel every bump right into her head.

When she gets seen by the doctor, you might ask for a full hormone panel, thyroid and sex hormones can get messed up. A blood test for B-12, folate, magnesium, calcium and some others can be helpful. If she is not getting enough B-12 and folic acid, she can take supplements to get them up. Her B-12 should be about 1000 pcgms/mL and folate should be above 20.

If her hormones are way off, she could use a bio-identical hormone therapy to get back in balance. A good referral source is https://www.womensinternational.com/..._referral.html

Some have found progesterone therapy to be helpful. It is a neuro-protective hormone. Progesterone is being studied for brain injury therapy.

So, Mom, relax and just help her without feeling like you have to solve her problems. She does not need stress or to see you under stress.

If she struggles to get her body and mind to relax, you can ask the doctor about a prescription for gabapentin. It is an anti-epileptic that helps the brain settle down. I need it to sleep. Without it, my body is tense and my mind goes too fast. I take it an hour before going to bed.

Hope she feels better.

My best to you.

Mark, thank you for your reply. I have read it several times and greatly appreciate your thoughtful suggestions. I will definitely be pursuing the blood work to measure B levels, as well as a hormone work up--although in all likelihood I will have to find private doctors and pay for it out of pocket. I'm in agreement about the likelihood of a neck injury and have gotten some medical input on that. I think I'm going to need to approach someone about a low dose of Elavil as she is having such difficulties falling asleep (mercifully she is mostly staying asleep once she gets there). Thank you for all that you do here as moderator, your depth of knowledge really helps to make this fourm outstanding (and some wonderful contributors as well). Coming here to read has been very, very helpful. I do have some new questions but will probably start a thread.

pretdou,

Actually, I am not a moderator. Just a very busy poster who sometimes get a bit overbearing. I have lots of free time to watch NT.

If she is not having head aches, maybe she will do well with gabapentin to help her sleep. It will be much easier on her than a tricyclic antidepressant.

I take it to help my mind relax. It does not sedate me. It just lets me relax if I want to.

Has she tried icing her upper neck?

Regarding the hormone analysis, the lab fees can be close to $400 for the complete work-up. Having a health insurance plan can help reduce the fees even if it does not cover them. The lab will usually only charge the contract rate for the health insurance plan you have. Blue Cross/Blue Shield usually get a hefty discount. Most other major insurance companies usually do to. You apply for coverage, the lab bills at the contracted discount rate, the insurance company declines to pay, then you pay out of pocket at the discount rate.

We've been down this road when my wife had a very high deductible. Paying out of our poor house pockets was worth it for the benefit.

My best to you.

Mark, keep it up you are helping lots of people

I live in Canada (I moved from the US thirteen years ago and I'm now a citiczen, BTW we lived in ID for awhile ). The medical system here is a very mixed bag from what I have experienced. I hadn't realized the hormone work up would be that expensive, but I should certainly know better by now (we have paid for many, many services both educational and medical out of pocket--some of if has been very, very worth it). OK I will need to see if I can't push someone to look at her hormones. Interestingly she is 13.5 years old and has yet to start her menses. I don't believe I see signs of thyroid issues thankfully.

Yes, I'm now icing her neck. It is tender when trigger points are pressed. I do believe there are on-going issues there. Thanks for your input about sleep medication ideas. I've been leery to do anything, as hard as it is to see her like this. I believe she is now far more sensitive to medications because of these concussions. She had an emergency surgery last year and responded poorly to some of the medications (an anti-nausea and an antifungal-antibiotic/very, very loopy/angry) and I believe the hx of concussions plays a role. So I'm not keen to put any prescription medications into her system. She is still having problems falling asleep but she doesn't become as restless and agitated now. She is also staying asleep/waking less. She presents pretty well but when you scratch the surface it's clear she is pretty symptomatic (slowed processing, memory issues, emotionally liable, can't take going out but for short periods and then everything is much, much worse, the list goes on). One of the things we do battle with is that the doctors have a very hard time appreciating all that she is experiencing--obviously a common issue.

Thanks again Mark, I will be following up on your suggestions.