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Concussion and Fractured Skull ***Update in post #37****


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My rising 9th grader was in a longboarding accident.  He did have on a helmet.  He has a really bad concussion and a fractured skull (no swelling in the brain, or bleeding at this point).  The fracture is on the small side, and is not jagged, or pushing on his brain.  We are supposed to wait and see.  He has an appointment with a neurosurgeon in four weeks.  He's extremely light and sound sensitive right now, and spends all his time in his room, in the dark, alone.  I worry about him, I'm afraid he's going to become depressed.  There was a point where he had no headache yesterday, so he tried to read, this was a huge mistake, it caused a horrible headache.  When he is able to read, he can't remember anything, and has to read it over and over again.

 

Obviously, his health is number one.  And, we've got a long road ahead.  But, how do I know when he's ready for some school work?  I'm not going to push him to start at any point, and I'm imagining that he's got AT LEAST a month of laying around left.  But, how do you know?  He could seem back to normal, so start some school work, and have it all come raging back.  And, I've read that there is a certain point where if you don't start giving the brain some sort of exercise, it could prolong everything as well.  Our Pediatrician isn't giving us many answers.  I guess I'll ask the Neuro when we see him/her.  But, in the meantime, my mind is racing.  How do I know? 

 

The Doctor said that as far as head injuries go, a small fracture is really less scary than swelling or bleeding.  and I agree, but it's still pretty darn scary to me. 

 

We were getting so excited for his 9th grade year. He was helping me plan the year, and was looking forward to it.  Now I think I need to pare everything back a bit.  And, he's upset, because he was due to take his first CLEP test (US Govt) in a few weeks, of course that's not going to happen.  He's a highly motivated academic minded kid, this is all very hard for him.  Chances are, he'll decide to try too early.

 

Also, a reminder, he was wearing a helmet.  I can't imagine how much worse it could have been.  Make sure your teens wear their helmets!!!!

 

 

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:grouphug:  from here too.  What does he read or look at for pleasure?  I'd keep those things around and let him try them out once in a while.  As he feels better, you'll know and can add more stuff.

 

The one thing I'd really concentrate on would be depression setting in (as you mentioned), esp if he was an active youngster.  At his age, I think I'd have a flat out discussion with him (not a lecture, a discussion).  Something like, "So... here's where we're at (in as little or much depth as you need - little is probably better)... what do you think we should do now?  I don't want to see you slipping into depression or anything else bad as you recover, so I'd love if we could come up with plans.  Obviously, they might have to change as you see/feel what's going on, but let's work together through this, ok?  Any ideas to try?  What would you like us to start with (entertainment, time fillers, companionship, sleep, favorite foods, etc)?"  If he knows he has a team on his side and he's in control, I think he's likely to do better.

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My understanding is that a simple concussion should feel better (as in able to do simple things) after a week.  Is there an animal in your house that might appreciate some simple cuddle time?  You might try a very light audio book first before having him try to read.  But watch out - any thing that causes him to have to concentrate at first is not good.  

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It's been almost two weeks now Which is why the doctor ordered the CT scan that found the fracture. I wonder if the headaches are from the fracture then? I'll have to ask the doctor.

 

I'm going. To the library today to get some light hearted audio books. He slept for the first week, and has started to really wake up the last few days. He asked for Stephen King books.... Um no! I don't think nightmare inducing is the way to go.

 

Thank you to the person who said to ask him to help with his plan, I don't know why I didn't think of that.

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He might do better with large print books (but not yet)

 

I wouldn't do audio books til he was no longer light and sound sensitive.

 

A more serious concussion, or a repeat (even if he didn't realize he had one the first time), will take longer to heal.

 

The concussion test at the local school (ie. computer IQ games) triggered a relapse in one of our swimmers, a few weeks after she had been cleared for sports.

 

ETA.  From what I've been told, he's supposed to be bored.  If he's not bored, his brain is doing something and it's supposed to be resting.

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What kills me right now is that he stares longingly at his longboard, and says he can't wait to get on it again. I'm inclined to throw the thing away and move on with our lives. My husband says it's a good thing that he wants to get back on it, that we can't let fear rule our lives. I understand that, but darn it, I'm a mom, and I worry.

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ds10 had a concussion with no fracture (they suspected one but it was clear) 2 weeks ago after a fall from his bike with no helmet.  So lesser injury than your ds is dealing with.  He still gets a headache and really tired if he tries to read more than a page or 2, can only handle about 20 minutes of screen time at a time without it being too much to handle etc. I started him on summer break already.  He has been listening to audio books, making crafts out of duct tape, made gak the other day while I was at work, building his fort etc.  He naps or rests part way through the day as needed.  I have been following his lead but cautioning him to remember to stop when it gets too hard so as not to over tax himself.  If your son is motivated you could do the same thing.  allow him to start up with school etc but don't expect anything out of him and remind him to take breaks as soon as it starts being difficult.  For ds10 he starts having issues with blurriness/words jumping...basically the issues he had with his eyes and worked so hard to overcome show up when he is pushing too hard right now.  If he tries to keep going the headache starts.  So he stops as soon as the words start moving around and does something that uses a different part of the brain (like playing with the gak instead of reading).  Later when he feels rested he tries again, either reading or screen time etc.

Now if your ds is the type to try and push past those warning signs his body is giving him I would not go along with it because you don't want him to prolong healing.  But if you think he can monitor himself and not over do it then let him take the lead on it and let him do school when he can, even if 1 lesson is broken up into 4-5 sessions over the day.

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What kills me right now is that he stares longingly at his longboard, and says he can't wait to get on it again. I'm inclined to throw the thing away and move on with our lives. My husband says it's a good thing that he wants to get back on it, that we can't let fear rule our lives. I understand that, but darn it, I'm a mom, and I worry.

 

ds10 was furious that he could not be back on his bike the day after his concussion.  He wants to do what he likes and hated the limitations put on him.  Your dh is right, but man it is hard as a mom to not want to prevent them from getting hurt again.

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Swellmomma,  HUGS!!!!  Seems like they had their accidents around the same time.  It's hard to go through, seeing your child like this.  Mine isn't to the point where he's trying to do things, more just wishing he could.  We have a friend whose daughter was going in the hospital for heart surgery.  The kids all made cards for her.  He tried, and he just couldn't think his way through it.  Finally, he just slammed everything down, and said "Mom, you can do it for me".  He's usually my creative child.  So, he hasn't tried anything like that again.

 

The doctor gave him permission to do light reading...  Not the neurologist, just the pediatrician.  It's becoming obvious that he can't read yet.

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The doctor gave him permission to do light reading...  Not the neurologist, just the pediatrician.  It's becoming obvious that he can't read yet.

 

I would definitely double check with the neurologist. My ex had a mild concussion in 2009 and it took a few weeks of getting to the point of doing anything. He's ADD, so it was hard to simply be still. 

 

 

:grouphug: I'm glad he had on his helmet. 

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I suffered some significant brain damage from seizures a couple years ago. The seizures are much fewer now, so any new damage will be more minor, but...I have never fully recovered and probably never will.

It is so weird what I can and cannot do. I start to do things, and it's like running full steam down a hallway and suddenly there is no more hallway, and coming to just air, like in a cartoon. I feel like I'm pumping my feet in the air, and look down and see I'm going to fall, and fall a long way. What was there is just gone, or there is a break between bits of brain.

Doctors and occupational therapists know so little. I gave up on them. And because I have PTSD, the medical brain people didn't want to treat me and just threw me back to the psych people and told me it didn't matter what was brain damage and what was PTSD. That I was costing too much money to treat and that the tax payers couldn't afford to rehabilitate someone with so little chance of moving beyond the effects of the PTSD.

I've studied a lot about what Waldorf and CM say about brain development and healing. Walking helps! I guess any activity that is rhythm of both sides of the body works. Knitting is good too.

:grouphug:

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I suffered some significant brain damage from seizures a couple years ago. The seizures are much fewer now, so any new damage will be more minor, but...I have never fully recovered and probably never will.

 

It is so weird what I can and cannot do. I start to do things, and it's like running full steam down a hallway and suddenly there is no more hallway, and coming to just air, like in a cartoon. I feel like I'm pumping my feet in the air, and look down and see I'm going to fall, and fall a long way. What was there is just gone, or there is a break between bits of brain.

 

Doctors and therapists know so little. I gave up on them. And because I have PTSD, the medical brain people didn't want to treat me and just threw me back to the psych people and told me it didn't matter what was brain damage and what was PTSD. That I was costing too much money to treat and that the tax payers couldn't afford to rehabilitate someone with so little chance of moving beyond the effects of the PTSD.

 

I've studied a lot about what Waldorf and CM say about brain development and healing. Walking helps! I guess any activity that is rhythm of both sides of the body works. Knitting is good too.

 

Yuck!  And  :grouphug: .  That sure can't be easy to deal with...

 

Good point about the fact that he's supposed to be bored. 

 

Boredom would completely kill me after a couple of days - if it took that long.  Mindless entertainment could be better.  Does he have something furry and cuddly?  Can he still sleep a bit?  Is there something he can do on autopilot that takes up time and is enjoyable?  Did you get to ask him if he has suggestions?

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abdesigns, is your son being seen by a neurologist who is a head trauma/concussion specialist? If he's not being followed by a head trauma specialist, I would get him into a clinic that has one and follow their recommendations. Rest- including mental rest is absolutely essential to recovery. Also, if you get into a clinic, you'll be able to have a team approach to care, which typically includes care for emotional adjustment during recovery.

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He hasn't seen a neurologist yet, the appt is for four weeks from now.  Since there was no swelling or bleeding, and the small'ish fracture, they wanted to wait to see how the fracture healed.    Should I call and raise hell to get him in there quicker.  We see the pediatrician on thursday, or friday, I can't remember right now.  It's scary, his best friend had a concussion in November, and is still dealing with the headache. 

 

He is saying that his headache is exactly the same, but he's out of his room a lot more, and is a lot more talkative this evening than in the past.  I'd like to believe that means it's getting better, or maybe he's just getting used to it.

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When my son had a (pretty severe, but no fracture) concussion, we were told to try to enforce as much brain rest (sleep, lowest activity possible for him, no lights) as long as it took for every last symptom to go away. He wasn't great about the still part after a few days, but I tried, because reading made me believe the doctor was correct. Headaches and some speech issues were the last things to entirely resolve. That headache would return with anything for a really long time. It scared me.

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Hunter, wow, I'm sorry that you are going through all that, and are having a hard time finding help.  Is there a large research hospital in your area.  Just reading your post, I feel very very frustrated for you.

 

I'm in a major city. It doesn't help. There is a real stigma against mental illness and a big push to reduce the cost of maintaining the mentally ill. And as mentioned, one of the results of brain damage is speech issues. I just cannot pull myself out of the cracks in the system, especially without proper speech.

 

Eastern medicine can be weird about the mind body connection, but Western medicine has done worse by refusing to deal with it at all. I have brain damage and I have a diagnoses of mental illness that is classified as "severely disabled" and "not expected to recover", and although I can write, my speech is impaired. Having a mental illness decreases life expectancy by 25 years, and I believe a huge part of that is reduced access to basic medical care.

 

But even your son isn't getting the best care. He has a brain injury and isn't going to be seen my a neurologist for another month? Individuals in the medical field are overworked and underpaid and they are my heroes. But the SYSTEM leaves them untrained, misinformed, and with their hands tied behind their backs; too often the care they deliver is unacceptably negligent. I'm not blaming the individuals, just the system.

 

I've had to totally reevaluate the rest of my life. I have to be realistic, and also keep an open mind that I really cannot predict how much healing and further damage will take place. It can be hard to be redirected to another path; very very very hard. Survival depends on adaption though, so I try to just adapt.

 

Sometimes the subtle little results of the damage are so critical to who was once a globally gifted person. It's like unplugging a huge machine. It doesn't matter all that is there of the machine. Without the current being able to flow properly, the machine can't function properly. Giant gears cannot turn, for lack of an invisible current.

 

Two years ago I couldn't do long division. Even though I restudied long division, there was something deeper wrong. Something that healed on it's own and fixed itself without explicit remediation, but it took time, and waiting was the only solution. Two years later, I skipped right ahead to reworking my way through Saxon Algebra 1 and am doing well with it, and think I can cognitively hit at least algebra 2 if I work slowly and quietly.

 

I cannot be rushed. I absolutely cannot be rushed now. My brain malfunctions terribly under pressure. Yes, some of that is the PTSD, but, it's more than that.

 

It's almost like my brain got cut up in pieces and thrown hodge-podge back in my skull. It's mostly all there, but fragmented. If I'm calm and have time, I can jump from piece to piece and retrieve the information, but I cannot multitask and cannot see the end of a long list. I cannot give directions to lost people. I get lost in the historic parts of the city that are not on a grid, if I don't have a map.

 

Reading aloud can be tricky; it requires some sort of multitasking. Writing while thinking can be tricky, compared to copying or taking dictation. I have to read slower now. I love the Kindle immersion reading; it helps; I think mostly because it forces me to slow down. Immersion reading is NOT a computer generated voice. Google it if you don't know what it is.

 

I really hope you son makes a quick and full recovery, but if he notices some quirky stuff, that he cannot identify and articulate, he's probably going to feel a lot of frustration. And depending on how those around him react, a lot of fear and shame.

 

One trick, I have learned, when my brain is being rushed, is to run to the bathroom, CALM down, think SLOWLY, and then go back and deal with the situation I couldn't respond to properly. Yes, there are people that think I'm weird, rude, and have a weak bladder, but it's a good DEFAULT plan for a person with brain damage who finds himself temporarily overwhelmed. It might be a tool your son will need to resort to.

 

Time to heal and time to think are critical. Life has to SLOOOOOW down, even though our culture has no tolerance or room for that.

 

:grouphug: to your family. If you have the ability to do so, I'd so everything I could to get him to a well trained neurologist. It probably won't make a difference in anything, butĂ¢â‚¬Â¦maybe he can at least give you more information, and reassure you.

 

But no matter what experts tell you, trust your gut and trust your son, over the professionals. They only know as much as their training.

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When my son had a (pretty severe, but no fracture) concussion, we were told to try to enforce as much brain rest (sleep, lowest activity possible for him, no lights) as long as it took for every last symptom to go away. He wasn't great about the still part after a few days, but I tried, because reading made me believe the doctor was correct. Headaches and some speech issues were the last things to entirely resolve. That headache would return with anything for a really long time. It scared me.

 

Yes, ideally you do total brain rest until symptoms resolve.  Then you can advance slowly but back off if symptoms recur. 

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He hasn't seen a neurologist yet, the appt is for four weeks from now.  Since there was no swelling or bleeding, and the small'ish fracture, they wanted to wait to see how the fracture healed.    Should I call and raise hell to get him in there quicker.  We see the pediatrician on thursday, or friday, I can't remember right now.  It's scary, his best friend had a concussion in November, and is still dealing with the headache. 

 

He is saying that his headache is exactly the same, but he's out of his room a lot more, and is a lot more talkative this evening than in the past.  I'd like to believe that means it's getting better, or maybe he's just getting used to it.

 

Ack, it seems like I cannot add a hyperlink to a webpage w/o losing my entire post. I'll just be brief this time.

 

If my son were exhibiting your son's symptoms coming up on 2 weeks post injury, I would be calling a concussion clinic ASAP to ask about their guidelines for referral to their clinic and what is considered best practice for activity during the recovery period. Such clinics are most typically found in university or other major medical centers. It sounds like you have a referral to a general neurosurgeon, maybe regarding the fracture, rather than a concussion specialist? If that's the case, it might not be what you need now for getting good guidelines for recovery.

 

Here is a link to an info sheet which suggests a concussion clinic consult when symptoms last longer than 5-7 days post injury: http://www.childrensnational.org/files/PDF/DepartmentsandPrograms/Neuroscience/Neuropsychology/SCORE/Instructions_for_Families_after_a_Concussion.pdf

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Ack, it seems like I cannot add a hyperlink to a webpage w/o losing my entire post. I'll just be brief this time.

 

If my son were exhibiting your son's symptoms coming up on 2 weeks post injury, I would be calling a concussion clinic ASAP to ask about their guidelines for referral to their clinic and what is considered best practice for activity during the recovery period. Such clinics are most typically found in university or other major medical centers. It sounds like you have a referral to a general neurosurgeon, maybe regarding the fracture, rather than a concussion specialist? If that's the case, it might not be what you need now for getting good guidelines for recovery.

 

Here is a link to an info sheet which suggests a concussion clinic consult when symptoms last longer than 5-7 days post injury: http://www.childrensnational.org/files/PDF/DepartmentsandPrograms/Neuroscience/Neuropsychology/SCORE/Instructions_for_Families_after_a_Concussion.pdf

 

:iagree:

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Boredom would completely kill me after a couple of days - if it took that long.  Mindless entertainment could be better.  Does he have something furry and cuddly?  Can he still sleep a bit?  Is there something he can do on autopilot that takes up time and is enjoyable?  Did you get to ask him if he has suggestions?

 

I had a ruptured apendix at that age that went 2 full days before surgery (oops), and was within hours of dying.  The one thing I remember most when I was the sickest was being bored!  I could not even open my eyes.  It was awful just laying there.  If it is going to take weeks to heal, I would consider very seriously how boredom can lead to depression.

 

Give him something mindless to do:

Coloring books?

Doodling or Zentangle?

Kitting? (If he already knows how)

 

Even something like sorting beads or shells or legos if you are desperate. Anything is better than just waiting and worrying and having nothing at all you are allowed to do.  So BTDT!

 

Ruth in NZ

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Okay here is a serious question about rest/boredom with head injury.  I get that the best thing to do is rest and maintain low activity etc but how do you enforce that in an active adhd boy child?  That's why I opted to just follow ds10s lead, he does what he does and stops when it fatigues him, or causes headache. But there is no real stopping him from being active.  Heck even when he was healing from his broken leg and in a cast up to his thigh and mostly using a wheelchair to get around he figured out quickly how to scoot around dragging that broken leg to be active, he was riding his bike with cast on when he was bumped down to an air cast 8 weeks post accident despite the leg still being broken.  Even with the chronic pain he suffers he just keeps motoring, the kid never stops.  So how do you get them to just rest and relax and allow themselves to be bored without making it be a punishment to you both because ultimately it would come down to a battle of wills which doesn't help the healing process either.

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That's a very good question.  I have no idea.  Mine seems a lot more laid back than yours, very calm kid, and I JUST caught him texting with a friend.  At the very least he could  video text or something.  He misses his friends, I totally get that.  Invite them over!  I don't know what the answer is.   I read one article that says to do absolutely nothing, and another article says that doing a little bit of something is okay.  There's a lot of conflicting information out there.

 

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Okay here is a serious question about rest/boredom with head injury.  I get that the best thing to do is rest and maintain low activity etc but how do you enforce that in an active adhd boy child?  That's why I opted to just follow ds10s lead, he does what he does and stops when it fatigues him, or causes headache. But there is no real stopping him from being active.  Heck even when he was healing from his broken leg and in a cast up to his thigh and mostly using a wheelchair to get around he figured out quickly how to scoot around dragging that broken leg to be active, he was riding his bike with cast on when he was bumped down to an air cast 8 weeks post accident despite the leg still being broken.  Even with the chronic pain he suffers he just keeps motoring, the kid never stops.  So how do you get them to just rest and relax and allow themselves to be bored without making it be a punishment to you both because ultimately it would come down to a battle of wills which doesn't help the healing process either.

 

Mine wasn't my ADHD kid, but he also isn't a still one. I just did the best I could with him, and tried to think of sort of mindless stuff to keep him busy.

 

I wanted to encourage you, though, that I really think the cognitive/thinking rest is more important than the physical.

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Okay here is a serious question about rest/boredom with head injury.  I get that the best thing to do is rest and maintain low activity etc but how do you enforce that in an active adhd boy child?  That's why I opted to just follow ds10s lead, he does what he does and stops when it fatigues him, or causes headache. But there is no real stopping him from being active.  Heck even when he was healing from his broken leg and in a cast up to his thigh and mostly using a wheelchair to get around he figured out quickly how to scoot around dragging that broken leg to be active, he was riding his bike with cast on when he was bumped down to an air cast 8 weeks post accident despite the leg still being broken.  Even with the chronic pain he suffers he just keeps motoring, the kid never stops.  So how do you get them to just rest and relax and allow themselves to be bored without making it be a punishment to you both because ultimately it would come down to a battle of wills which doesn't help the healing process either.

 

I wouldn't know how to enforce that with ME for more than a day or two, much less an active youngster of mine...

 

Best wishes to anyone having to deal with something like this.

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Okay here is a serious question about rest/boredom with head injury.  I get that the best thing to do is rest and maintain low activity etc but how do you enforce that in an active adhd boy child?  That's why I opted to just follow ds10s lead, he does what he does and stops when it fatigues him, or causes headache. But there is no real stopping him from being active.  Heck even when he was healing from his broken leg and in a cast up to his thigh and mostly using a wheelchair to get around he figured out quickly how to scoot around dragging that broken leg to be active, he was riding his bike with cast on when he was bumped down to an air cast 8 weeks post accident despite the leg still being broken.  Even with the chronic pain he suffers he just keeps motoring, the kid never stops.  So how do you get them to just rest and relax and allow themselves to be bored without making it be a punishment to you both because ultimately it would come down to a battle of wills which doesn't help the healing process either.

 

 

 

It would be really hard.  The pet-cuddling idea up-thread is probably the best plan I've heard.

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We have very non-cuddly ferrets... who if held too long, will bite. 

 

I know that typing is out, but, do you guys think facetime and video texing with friends is okay?

 

I found a concussion specialist in my area, they even have a balance specialist.  I'm going to set something up with them.

 

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I know that typing is out, but, do you guys think facetime and video texing with friends is okay?

 

Sorry, but no.  Firstly, because the eyes will focus on the screen (not resting), and secondly, because whenever I have the slightest tendency toward headache or nausea, looking at any screen (phone, ipad, computer or TV)  always makes it much worse.

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  • 3 weeks later...

*****UPDATE***** 

 

Thank you all for your kind words, and information.  Because of you guys, we found a concussion center to treat him!  Thank you!.  I had no idea where to go with this.

 

His brain has no swelling, bruising, or bleeding at this time. So that's good.  But, he's still having double peripheral vision, and will sometimes have tunnel vision.  He is unbalanced on his right side, and still has a really bad headache.  But, I feel like there is progress, or he's just getting used to it, I'm not sure which.  He isn't as confused as he was, so that's good.  His short term memory is getting better, but still has some problems.

 

The Neurologist with the concussion center said "no" to camp, so he's really sad that his friends are there, and he is here.  His Godbrother has Post Concussion Syndrome, so he comes to the house, and they sit and do simple things together, quietly, and that has lifted his spirits.

 

He'll start balance training and eye movement therapy after his skull fracture is healed, but we aren't there yet.

 

I was wondering if maybe something like Tai Chi would also help his balance? 

 

We were planning to start school on Aug 18th, but I'm starting to think that's not going to happen, or maybe it will happen with just videos.  I  know it's more than a month away, but his progress is so slow.    I'm trying not to freak out about everything, and trying to stay calm.  But, I hate that he's missing his entire summer.

 

Thank you all, from the bottom of my heart!!!!!!

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We are going to start little art projects here and there.  He doesn't like audio books, but I did try.  He just wasn't into it.  He's taking photography this year, and we are friends with the teacher, so she is going to start sending little projects for him to do, here and there.  Nothing major, just something to make him feel like he can do something.   I'm just afraid to do too much, because he always pays for it the next day. 

 

I've asked friends to send him funny cards, so he's been getting a lot of those, and that's lifted his spirits A LOT.  Never underestimate the power of a simple card, this is the lesson I've learned from this.  From now on, I'm going to make sure to send people cards, and lots of them.

 

 

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I'm just afraid to do too much, because he always pays for it the next day.

You are so wise to be cautious here. Please give him as much time as he needs to heal. School can wait. It's truly better to fall behind school work than to hamper his recovery.

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