Hi, new here, first post. My son (big 22 yr old guy) fell Saturday night (it's now Wednesday night), and hit the back of his head. Mild to moderate TBI, as per his symptoms. Ct scan showed skull fracture with bleeding. He did not lose consciousness, but was dazed, and threw up a lot. Discharged from hospital yesterday.

My question is - what can we do about the very severe pain he is in? Prescribed Fioricet, and oxycodone. Nothing helps. He hasn't eaten or slept since the accident pretty much. The pain is all over his head, throbbing with his heartbeat. dr's aren't much help, and he would prefer to stay put of the hospital with all the noise, lights, smells, etc. The pain is not getting better, it's an 8 on a scale 1 - 10. and he's a tough guy.

Any suggestions?

If it was me I'd pack him up and head to the ER.

i agree with light rail. I mad a very minor tbi, certianly no bleeding or fractjre and im still payting for it with pain 7 months later! go to th er or atleast a hospital to get some advice on the next steps, good luck!

Long shot, but try treating for migraine. Although his symptoms aren't classic migraine (all over vs. on one side), it may still be serotonin related and maybe a triptan would help. Good luck.

Prior to discharge was a new CT done to verify the bleeding was stopped?

However, I agree , he needs to return to hospital for followup for increasing symptoms, and new imaging for possible rebleed since a possible change of pain "all over his head" are occurring.

New symptoms > new tests........always the expectations ...demand them.
If he doesn't want to go to ER, have your PCP order them, but get them done. And wait for what they call a Wet-read - so the radiologist can call the PCP for a preliminary reading and if something is found, your doc can arrange for a Direct Admission to the Hospital. And that way they can give you an immediate copy of the films to carry with you.

You already know there is boney problems (the original CT showed that with the skull fracture) , so also ask for an MRI, it can help find finer problems.

What else can you tell us?

Big guy or not, TBI's knock down anyone, ask any pro-sports player.


Best wishes.

Lightrail and Concussion have it right in my opinion. Pack him up and get him back to the hospital. They can at least control his pain this way. It is important to have the pain controlled as it can turn in to chronic pain. They can also reassess and see what is happening. If he is wanting to be at the hospital because of pain, noise etc. that is a big clue. He needs to be there. I hope you get him back to the hospital. Good luck. I hope he gets feeling better soon.
Brain

I think the ER is a good idea too but I also wanted to suggest he wear really good sunglasses and earplugs or noise cancelling headphones if you have them. I can understand the pain of the noise and the lights (and the horrible effects from driving in the car) but hopefully he can feel better once they get him some meds that work.

Good luck and I hope he finds relief soon. As a mother I know that must be tough on you too so big hug for support.

CC

thanks all! Yup he's back in the hospital. IV Dilaudid helps with the pain, but I hope he gets som sleep. He's in a special Neuro unit which is quiet, dark, and seems to provide excellent care. Turns out his TBI is actually minor - 15 on GCS - except for that pesky fracture and sub arachnoid bleeding. But a second ct showed that that is resolving. So we are on the right track. I hope it all heals completely, and we can avoid PCS. Is there anything we can do to avoid it? Or does that just happen to a lucky group of folks?

PCS is just something that happens, after a TBI/concussion. A lot of things can impact recovery, including flu viruses and whatnot. It's important to keep a good vitamin regimen. Refer to Mark in Idaho's post about Vitamin Supplements. Also, make sure B-12 levels are adequate as the injured brain seems to use more of these. Rest is key for recovery. Stop cognitive activities such as television, texting and video games, then when there are no symptoms, gradually introduce these activities. The same for exercise, gradually introduce physical activity when no symptoms show. Remember, take it slow and easy. Happy healing!

Glad he is getting the care he needs. I know the GCS is the most common "measure" of TBI severity, but with a skull fracture and subarachnoid hemmorahage I think it prudent to monitor him in hospital for a bit.

FWIW my GCS was 11, and I have no symptoms normally associated with PCS.