[MsRriO]

January 18th my 9 y/o son got hit in hockey (by accident, two players collided) and suffered a concussion.

That is five and a half weeks ago.

He has been steadily improving and we did everything we could to assist in his healing by providing a calm, quiet, no video games, no strenuous activity environment. I already live that way. He eventually had gradual return to school, even more gradual return to outdoor recesses and gym.

He had not been cleared by his doctor to play hockey until three days ago. He played three games this weekend, short shifts, no incidents. No recurring pain. Overall he did excellently and I was full of hope!

But today he called me from school, crying. Says his head is hurting so bad. The noise was so bad in the background I had to wonder what kind of zoo he was in!

I have a tough decision there with my sensitive child, whether to rescue him immediately (they are clever at this age especially when Mom is soft) or talk him into trying Tylenol and ear plugs for an hour then call again if no relief. I chose the latter because he has an after school cooking club that he loves and if he makes it through, he'll be happier for it.

If I don't hear from him in another 15 minutes I will call there to check on him and get husband to pick him up if need be.

Here's my dilemma though.

I think at this stage we're in PCS territory and that scares me to no end. If he is getting headaches due to noise and activity (he had gym class this morning) and he is approaching the six week mark.... That's PCS, from what I've read.

Tomorrow afternoon we are going for a preliminary vision check for him (he gets dizzy when tracking objects and reading, or flashing lights) and I hope they can help us. (Thanks to Mokey for the info about vision therapy!!)

Caring for his concussion, I had hope (and anxiety that I try to hide) for his recovery. Caring for a child with PCS is so scary because to me, it's like a concussion on steroids, it never seems to get better. I never see a story of true recovery. I see stories of work arounds and modified expectations. I don't want him to end up with this fate. I'd add on 100 years of misery to my life to spare him of this. But I have to wonder...

Is there a genetic component to prolonged suffering with brain injuries?

I find myself struggling with guilt. And anger at whatever is making my family suffer so much, with husbands heart attack and two mTBI's in 10 months. It's hard to remember the "it could be worse" mantra today.

Any advice? Thoughts?

[cyclecrash]

Oh no! I was upset as soon as I read your title. I'm sorry to hear that he's having problems again

There's so much of this that I don't understand though... why was he given the ok to return to play if he's still having eye issues with dizziness? This seems to be a symptom still and I thought they had to wait until all symptoms were gone? I know my eye problems are still one of my biggest symptoms and movement, walking, etc, makes the dizziness worse but also the head fog and pain.

I also don't get why he played three games over one weekend? I thought return to play was try something one day (one game), rest a day and see if any symptoms flair up then if not go ahead and play again. I would definitely think 3 games and then phys-ed and noisy, active school all in a row would be way too much stimulation with no weekend resting even from the stress of the week he just had.

I'm exhausted just thinking about it. Another thing with me is that quite often I don't see my symptoms increase until 2 days after a stressful event or increase in activity. I've been trying to increase my light recumbent bike riding but find that 2 days later I'm suffering for it. I see my neurologist/sports concussion specialist tomorrow and will be asking her more about symptoms increasing after exercise so maybe I'll have more info for you then.

I'm sure some of the others with more experience on return to play will have comments. Maybe if you just think of it though from how YOU are feeling and would YOU be able to handle all of this and apply that to your son. Because you're going through it too you have a great understanding of what he's going through. Kids under 10 are supposed to be extra cautious about return to play so maybe take that route. One season off wouldn't hurt would it? Just to be on the safe side?

I hope he's feeling a lot better and happier after his cooking club! Perhaps if the school could let him lie down somewhere for 20 minutes or something he could get some relief but then I guess school is almost over so not much point in that.

I can understand why you're afraid. I would be too! The long term consequences are just too severe. He'll be fine though just give him time to rest and heal!

Take care,
CC

[MsRriO]

Originally Posted by cyclecrash

... why was he given the ok to return to play if he's still having eye issues with dizziness?

Because he didn't report the dizziness, which is mostly with reading not movement, at the doctors. Dad is also his hockey coach. There's a bias to return him to play and he showed immense physical progress. They are all doing what they think is best and I'm just the worried mom with PCS bias. So my testimony is dismissed anyway.

My son will say he's fine until I press him for more information. He will also play up symptoms for me at times, and play down symptoms for Dad. Really hard to tell the truth with a child!

I also don't get why he played three games over one weekend?

It was a tournament. He played 2 games Friday and 1 on Saturday. Again he was short shifted for all of these and spent some time just benched to prevent him burning out.

Prior to this he was cleared to practise which he did on several occasions so we knew and he knew his limits. That's the best we could do. I didn't want him to play at all but I also get accused of pushing my anxiety onto his life. Tough call.

I hope he's feeling a lot better and happier after his cooking club! Perhaps if the school could let him lie down somewhere for 20 minutes or something he could get some relief but then I guess school is almost over so not much point in that.

That's a great idea though. Thanks for that. I will mention that in email to the teacher. I don't even know if they have a sick room/place for him to rest. I guess it's time to have a meeting with the school but where and how do I find the health to do that... Right now I'm relying on emailing the teachers because I'm maxed out with my own pain. Argh.

Plus no one trusts what I say. They think I'm just a worried mom and I have no support for my "medical" opinions. Without a doctors note saying he needs this or that accommodation, schools are the same as workplaces... They just don't believe and they don't bend rules. Especially for boys, IMO, we still live in the dark ages where a boy is not "allowed" to be anything but strong.

In other news he called back and his headache is reduced to half, it was 8/10 and now is 4/10. So he's coping and sounded happier.... He is staying at school and cooking club.

Hope he will be ok. I just don't even know sometimes what is the right answer. Parenthood with impaired thinking is brutal.

[MiaVita2012]

Sorry to hear of the problems.I am having issues over here with my love and it is eating me up literally! Because of all my health problems I cannot think straight and I go manic when I have no control and my love does not understand this horrible syndrome.My love and I are suffering together..... in different way's and I feel hopeless....I hope and pray things get better for you and your family

[Mokey]

As my daughter heads out to her playoff game....yikes! I am really sorry your son is still suffering. To be blunt about my opinion....he should not play again for the rest of the season and should also skip soccer or baseball or whatever sport like that he does in summer. If the concussion didn't just last a few days, it means he had some more profound issues....not that they can't clear in in the very short term, but I would say he needs rest and no more injuries or potential injuries. too risky.
I can't imagine your stress and anxiety...and trying to deal with the school, etc. Must be awful! That is the big anxiety I am dealing with on a daily basis....'what if my daughter gets a concussion playing hockey'? Tring to find a balance....and figure out the right thing to do. Very difficult!
Hope he feels better tonight. And hope the coach (dad) can understand that doing the wrong thing at this stage can affect your son's career choices, university studies, future sports, etc. He needs to heal 100%. Good luck with all that! Hang in there. He will get better quickly with lots of rest and a mum like you.

[Mark in Idaho]

MsRriO,

I completely agree with CC's first two paragraphs. If the doctor who released him to play did not ask him directly and check him for balance, he should not have returned him to play. He should have been challenged with a full neuro status check.

There are two goals in return to play decisions. First, does he have any residual symptoms, especially symptoms that put him at risk of putting himself in danger; lack of balance; lack of cognitive function causing poor decision making; memory struggles, especially visual memory that can cause a disorientation to persons and surrounding (spacial awareness).

The second goal is to try to determine if there is risk of further injury. This is a very difficult issue. The best indicators are things like, how does the player respond to stimulation and activity. For your son, this would have including asking how he is responding to a full active day at school. Return to play is not suggested at all until the player has returned to full participation at school, including reading skills, tolerance of noise and confusion, etc.

You would do well to get Dr Cantu's book, Concussion and Our Kids. Your son will be at greater risk of long term consequences until he is 14 years old. This is due to nerve and myelin development. Then his risk will slowly decrease to match the risk of an adult when he is 20 to 25 years old.

I would not doubt his struggles at school. In my opinion, they are to be expected. He had a busy weekend. Relapse to post concussion symptoms usually has a delay of a day or so.

Slowly return him to school, with ear plugs and other coping mechanisms. A too much recovery time at home is better than too little. You need to be Mama Bear and be strong. He is too young to try to heal under stress or activity.

I know this is an emotional strain on you. Better to be safe than sorry. I don't know about genetic sensitivities for concussions but it is know that each consecutive concussion usually cause more injury from the same or less impact force.

Give him a hug and say, let's stay home for a while so you can get strong.

My best to you.

[Consider]

I'm truly sorry to hear about your little one. It breaks my heart to hear a child has to go through this. What's even worse, is that your child is playing the strong card, I did this too until I was at the hospital and it was almost too late. I felt like I had to be strong for my family, to pick up the groceries, to do the housework, to act a bit "normal" and act like nothing is wrong. I would cover it up even though 5 hours later I was completely nauseous, and even after that I would hide my suffering in silence. I will admit, this isn't easy. I still wonder where I will be in 1 month, 3 months, 5 months, and sometimes maybe a year. What I am noticing is that I am improving throughout the weeks and months. When a month goes by, a symptom decreases and slowly is gone.

Here's the good news: He WILL recover.

Bad news: He needs to stop playing and take off the "I'm strong" mask. I had to do it, and it's hard. Cognitive rest, healthy diet and a strong support system is what he needs right now. He needs Mom and Dad.

Other bad news: Dizziness is a symptom I had for a very long time. A very long time, mostly would occur in the mornings for me, it was so bad I would get sick. If he has dizziness, he needs to stop and limit his activities.

I wish you and him all the best. No child should ever suffer through this.

[MOMMYMBD]

MsRrio-

I play softball regularly and with all I deal with every day it is always such a relief to get back out on the field and feel "normal" for a minute. My father coached me as well and I used to play numerous games with injuries because of that push plus my own intention of not missing the sport my life revolved around. Though hocky is much more of a worrisome sport due to the contact, I know his feeling of need for returning ASAP due to all he's been through for this. Quite honestly though, the bright white and constant movements would wear him out visually, and since he'll be straining so much to keep his focus during the game the Monday after will always be hard on him. You responded to my post saying exactly that, I played a softball tournament Saturday and because of the visual strain I was in for a rough Monday indeed.

That all being said, I am a mom as well and would sit him down and ask what his feelings are about playing. If he feels he has to then it's take to talk to coach Dad. If he feels he is ok to play, and you believe that is true, you may give him sunglasses for after the games to allow his eyes to rest fully, blueblocker types help me the most, and just make sure he gets extra sleep the night before and after. If he's not having symptoms during the games then I would bet money on it being from the mental fatigue from his eyes. You may see if he can spend a class period or even lunch in a room without flourescent lights, or a homeroom period laying down on days like today. Put in a game plan for days after games with the school. He may be able to lay in the athletic trainer's office and feel less obvious than in the nurse's office.

If he's not feeling better today however than he needs to get back into the doctor in my opinion. Schools are very loud and bright places and will make it hard for him to focus if he's feeling as such. There are homebound programs if it is necessary, in most states I know of, that will take care of him for a while so he can recover in a calm and better lit environment.

[Mark in Idaho]

He is only 10 and likely wants to please his dad and team mates. His judgement will not be mature. You need to help him and your husband make the right decision. Continued mental strain will leave him even more confused about his own welfare.

Has his personality changed ? Is he more impulsive and argumentative ? Harder to get him to finish a project ? These are signs of his brain struggling to function. It was a miserable existence for me at that age.

My best to you both as you struggle with this decision.

[MsRriO]

Thanks everyone. Much to consider.

My gut says everything you are all saying to me. I guess I just needed affirmation that my gut isn't just anxiety talking.

He is far too much a people pleaser to be objective or even truthful sometimes, so I know I'll have to take control here.

I agree that he should not have been cleared to play but the doctor we have is only slightly better than the ones I had before and that means only slightly more educated about concussion... Unfortunately not educated well.

Also like I said, son hides symptoms until I fish them out of him by watching him struggle so, he was two weeks pain free when we had the doctor appointment and didn't mention the dizziness. I'm but one voice in a room with 3 males who know it all better than the anxious mom ever could...

His personality isn't noticeably altered although I would say he's slightly more sensitive and prone to crying than before. I attribute that to mental fatigue.

It's hard to balance the need for him to be active for his health, the need for him to be an optimistic boy and not risk-averse (mental health) and the need to protect his future health!

It's playoff season and then hockey is over. I'll do my best to bench that boy! As for summer, it's usually soccer which he also loves but we'll cross that bridge later.

Oh the battle I will get from husband, teachers, principal who is a total jerk (side story).... This is going to require me to be strong and articulate. I am unfortunately prone to weeping and a very pronounced stutter so people think I'm a head case. Yikes....

I am Mama Bear, hear me roar! ;-)