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Ds12 has a concussion - help!


texasmama
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He was playing basketball at the gym this afternoon and hit heads hard with another boy.  He did not lose consciousness.  He was a bit loopy and threw up several times.  We took him to the ER for evaluation.  CT scan was normal.  Neurological exam was normal.  He has a large bump on the right side of his head, on his temple.  He was given Zofran but continues to throw up.

 

The question I have is what now?  The doctor said that he should avoid basketball or other sports for three weeks but gave no other guidelines.  I asked about brain rest, and he did not think this was necessary.  The doctor did not even call it a concussion, though I asked directly.  He called it a "closed head injury", but this seems to be the same thing.  None of us has ever had a concussion. 

 

I don't feel that we got the best advice at the ER, though we did rule out brain bleeds, skull fractures and such.  Googling is not all that helpful.  Can some folks with experience please help me figure out what to do with my son?

 

I sprained my ankle while walking the dog this morning so we are a big mess around here.

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I'm sure others will chime in with more detailed information, but I'd start by putting him in a quiet room with nothing audio or visual for a while. Not sure how long. I think there was a recent post on concussions, you might do a search. 

 

 

((hugs)) Head injuries are scary, I'm glad his cat scan was normal. 

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Thank you for the hugs. 

 

I did a search for concussions and read through some threads but didn't really get specifics on what to do.  Google isn't all that helpful, either.  I am surprised since this seems to be a very common injury.

 

Between throwing up, he is sleeping in his bed, poor guy.

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I have too many experiences with concussions.   No TV/screen time is a MUST.  Also, he should listen to his body.  Let him sleep when he's sleepy.  They no longer recommend keeping someone up... they want the brain to rest.

 

Also, if he is on any stimulants (ADHD meds) then he should refrain from taking them for several days to a week.  This really threw my dd off when at college she got a concussion and couldn't take her meds for about 2 weeks.

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Thank you for that advice.  He is sleeping now, and I will let him sleep as much as he wants.  He is not on any stimulants. 

 

How long should he avoid screens?  This is the question I cannot seem to find definite information on.  We are off of school for another week.  If he is normal by the time we start back up, should he start school with the rest of us?  At what point can he read?  He is a big reader.  Would audio books be okay? 

 

I am so lost here.

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When my husband started back he went slowly.  So, yes, probably after a good week of rest he may be ready to go at his own pace.  My dh found that if he pushed himself, he would be unusally tired and his stomach would hurt.  He went 1/2 days for at least 1-2weeks after his accident.  Even over a year later, I find that if he is overly tired he gets angry much more quickly (short fused).  Your son is young, so hopefully he will not have any long-term issues.   The main thing is that the more his pushes himself, the longer his recovery will be.    Encourage your son to listen to his body.

 

I'm sorry this happened.  Perhaps calling your regular doctor in the morning and discussing it with the nurse would be helpful.  Your doctor may have much more helpful advice.

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I'm so sorry to hear about your son!!! :(

 

I would definitely contact a specialist tomorrow morning, just to be safe, and I know you will keep a close eye on your son all night long so I'm sure no one needs to suggest that to you. Keep a close watch for any concussion symptoms and if anything seems wrong during the night, don't hesitate to call 911 just to be safe.

 

I hope he makes a quick recovery. At his age, it's so hard to stay still and quiet! :grouphug:

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I am so sorry!:grouphug:

 

DS20 did not vomit yet had a grade II concussion. Three years later, he still sees a neurologist twice a year for headaches and post-concussive syndrome, so I tend to be extra conservative about brain rest.

 

Was your son seen by a neurologist, or a general ED physician?

 

I hope he feels better very soon! :grouphug:

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Have you seen the AAP guidelines http://pediatrics.aappublications.org/content/126/3/597.full

 

Notmsure if they'll answer all your q's but it's a start. I think the cognitive rest guidelines are 7-10 days...

This link is actually very helpful - thank you!

 

And I will follow up with his regular doc for evaluation, for sure.

 

He is sleeping still.

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I am so sorry! :grouphug:

 

DS20 did not vomit yet had a grade II concussion. Three years later, he still sees a neurologist twice a year for headaches and post-concussive syndrome, so I tend to be extra conservative about brain rest.

 

Was your son seen by a neurologist, or a general ED physician?

 

I hope he feels better very soon! :grouphug:

He was seen by a general ED physician.  Did your ds lose consciousness?

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When my youngest received a concussion several months ago, we were given strict guidelines, dark room, no electronics, no ear buds or headphones, no thinking, no reading, very light (no violent or scary ) TV, nada. It was a tough week.  I printed out some basic preschool level coloring pages and would let her color one, then rest for an hour or two. I let her listen to a few audio books - again simple stories that she had heard many times (Beatrix Potter in fact!). But I would only let her listen to one, then rest, and then she could do something else from the approved list. When we watched a TV show - again it was simple, no excitement - original Blues Clues level. 

 

After a week of darkened rooms and very little activity, we slowly resumed our regular activities. If she did school for very long or was outside for over an hour, she would get a headache, and we would take a break for the rest of the day. 

 

It was about 3-4 weeks before she was able to handle our regular routine of classes & activities.

 

In another concussion post, I listed the instructions we were given from the ER. I'd link it but the search feature isn't working for me right now.

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Another thing I remembered, no ibuprofen or aspirin. If he need pain relievers you can use Tylenol.  http://www.mckinley.illinois.edu/handouts/head_injury/head_injury.html

Thank you for this.  I wondered about it.

 

I have been on the phone with my dad, texting concerned friends and family and trying to piece this all together so things are still falling into place as far as needed information for recovery.

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Thank you for this. I wondered about it.

 

I have been on the phone with my dad, texting concerned friends and family and trying to piece this all together so things are still falling into place as far as needed information for recovery.

When it comes to a head injury, I am all in favor of erring on the side of being overly-cautious. Better to let him be bored to tears for a while now because of all the brain rest, instead of maybe ending up with long-term problems if he tries to get back to normal too quickly.

 

I'm hoping this will turn out to be very minor, but I tend toward being paranoid about this stuff, so I would treat it as something major just to be on the safe side. Concussions really scare me.

 

How is the other boy? Is he OK?

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My daughter had two concussions. Both times she needed brain rest especially the first few days. This means no TV, no reading or schoolwork or even loud music. She was supposed to lay in a dark quiet room as much as possible. She also has headaches with both so that helped to guide when she was ready for more.

 

For her first one I took her to the ER. She didn't black out but was acting really out of it. They said she had a minor concussion but gave no guidelines past the first day or two. We went to her regular doctor and he advised us better. Even though the first one was very mild she had trouble learning and retaining information for over a month. It may take awhile to be back to normal for school.

 

She had her 2nd concussion last year in hockey. We actually thought she just hurt her neck since she wasn't really acting like she had a concussion. She ironically had been seeing a physical therapist for neck problems when this happened and he recommended that she got checked for a concussion. We saw her primary care doctor who referred her to a sports medicine doctor since she felt dd had a concussion. DD was 19 and we both really didn't think she had one. We went to the sports medicine doctor who gave her a computerized concussion test. It tested things like memory, reaction time etc. Dd is in college and was getting straight A's so we were shocked when she failed the test miserably.

 

The doctor started with brain rest (no school,computer, reading etc) and had her retake the test in a week. Luckily she was on spring break. The next time she did a bit better so he allowed her to read or go on the computer for 20 min at a time and had her follow up again. After each improvement he allowed her to do more but it was 2 or 3 months before she was allowed to play hockey again.

 

I dont mean to scare you or make it into a big deal but concussions are usually taken more seriously now. Some ER doctors don't seem to emphasize this enough. Even though both of my daughter's concussions were considered mild and she never lost consciousness the doctors still were quite serious about taking time to let her heal. Prayers for your son's quick recovery!

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I did the best I could to have complete brain rest, which is what they advised for us. That meant laying in a dark, quiet room! It was hard/nearly impossible after that first day. But I kept low lights, light coloring, soft music, etc. as much as he would tolerate. We didn't start back up with anything that required cognitive effort until he was having no symptoms. The last thing to go was recurring headaches and some speech articulation changes. It took a really long time, but my son did lose consciousness/had a severe concussion symptom wise.

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When it comes to a head injury, I am all in favor of erring on the side of being overly-cautious. Better to let him be bored to tears for a while now because of all the brain rest, instead of maybe ending up with long-term problems if he tries to get back to normal too quickly.

 

I'm hoping this will turn out to be very minor, but I tend toward being paranoid about this stuff, so I would treat it as something major just to be on the safe side. Concussions really scare me.

 

How is the other boy? Is he OK?

I will be approaching this very conservatively, for sure.  If he needs several weeks off - well, that is the beauty of homeschooling.  This is the ds who was inpatient two months ago with a migraine that persisted for nine days.  He has had a bad run of it!

 

The other boy seems to be fine.  My ds took the brunt of it.  I talked to another mom who saw the incident, and she described it to me as they were both going for the ball on the floor, and my ds hit the other boy coming from above him.

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My daughter had two concussions. Both times she needed brain rest especially the first few days. This means no TV, no reading or schoolwork or even loud music. She was supposed to lay in a dark quiet room as much as possible. She also has headaches with both so that helped to guide when she was ready for more.

 

For her first one I took her to the ER. She didn't black out but was acting really out of it. They said she had a minor concussion but gave no guidelines past the first day or two. We went to her regular doctor and he advised us better. Even though the first one was very mild she had trouble learning and retaining information for over a month. It may take awhile to be back to normal for school.

 

She had her 2nd concussion last year in hockey. We actually thought she just hurt her neck since she wasn't really acting like she had a concussion. She ironically had been seeing a physical therapist for neck problems when this happened and he recommended that she got checked for a concussion. We saw her primary care doctor who referred her to a sports medicine doctor since she felt dd had a concussion. DD was 19 and we both really didn't think she had one. We went to the sports medicine doctor who gave her a computerized concussion test. It tested things like memory, reaction time etc. Dd is in college and was getting straight A's so we were shocked when she failed the test miserably.

 

The doctor started with brain rest (no school,computer, reading etc) and had her retake the test in a week. Luckily she was on spring break. The next time she did a bit better so he allowed her to read or go on the computer for 20 min at a time and had her follow up again. After each improvement he allowed her to do more but it was 2 or 3 months before she was allowed to play hockey again.

 

I dont mean to scare you or make it into a big deal but concussions are usually taken more seriously now. Some ER doctors don't seem to emphasize this enough. Even though both of my daughter's concussions were considered mild and she never lost consciousness the doctors still were quite serious about taking time to let her heal. Prayers for your son's quick recovery!

Thank you, and I appreciate hearing your dd's story.  I knew at the time that the ER doc was not giving it the importance it should have.  He was very clear about not doing sports for three weeks, but that was the only recommendation.  I have told ds that he will be doing pretty much nothing, and I will plan to have him evaluated by his regular doctor on Friday for further advice.  He is a cooperative little guy and twelve years old (versus a younger kid) so that does help.

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This is a good reference site too:

http://www.cattonline.com/

Oh cool!  I will look at this tomorrow.  Seems very helpful.  Headed to bed now after our eventful day...

 

Ds got up for a bit, ate a little, drank some water, slept with his head on my lap on the couch and just got up and went to his bed.  I think he is done throwing up (fingers crossed).

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So sorry to hear this about your son!

 

I had a concussion from a martial arts accident in Nov of last year, and we didn't receive much help as far as recovery from the ER either.  My primary care doctor was a wealth of information.  Most of this I think PP have covered.

 

Brain rest is a MUST.  It made me crazy, but no reading, no electronics (video games which require lots of eye movement and have bright lights are awful), no audio, no TV.  Pretty much I was told if it has a screen or makes a sound, avoid for at least two weeks.  Dark room and quiet.  I ended up wearing one of my husband's giant hoodies for almost three weeks because the hood came down over my eyes and helped with light, which was very painful for me.  I was obviously not allowed to drive for awhile - your son may find that riding in a car is difficult initially as well.  

 

I would definitely follow up tomorrow with your family physician.  I had to go in once a week for two weeks, then I got to skip a week, but at my next check in I was still having trouble, so back to brain rest and once a week check ins.  I think it would really be helpful to have a doctor follow your son like that as well - at least for your peace of mind and to make sure he is progressing and not doing too much too fast.  I ended up being diagnosed with post concussive syndrome. I wished I had taken things slower (and it felt like overkill at the time).

 

I was on prescriptions for pain and zofran for the nausea, and I took it as soon as I could on schedule for the first three or four days.  Did they give your son something for pain/nausea?  It helped tremendously for that first little bit.  

 

I was told lots of fluids also.  And when my homeopathic doctor found out, he recommended hyperbaric oxygen if it happened again, as it really speeds up the brains ability to heal.  (I told him I'd rather just not get another one.)  Lots of sleep.  If he gets bored, bribe him to take a nap.  I was told the more I could sleep, the better for my brain.  I had heard you wake people up periodically, but I guess that is old thinking now.  The more sleep, the better.

 

I found that even a month or two out from my accident, I still struggled with things like remembering where I parked my car (more than usual), finding the right words, recalling something that happened just prior to the incident, explaining things clearly.  I carried post it notes around to help for months.  It was scary.  You don't realize just how much work your brain really does...until it needs a break from doing it!

 

Praying your son has a restful night!  (And you also!)

 

ETA:  I also did not lose consciousness and could remember exactly what had happened to cause the injury.  I thought that meant it wasn't so bad, and that is partly why I rushed to get back to my regular activities.  Just because a person stays conscious, doesn't mean that there isn't a significant injury.

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So sorry to hear this about your son!

 

I had a concussion from a martial arts accident in Nov of last year, and we didn't receive much help as far as recovery from the ER either.  My primary care doctor was a wealth of information.  Most of this I think PP have covered.

 

Brain rest is a MUST.  It made me crazy, but no reading, no electronics (video games which require lots of eye movement and have bright lights are awful), no audio, no TV.  Pretty much I was told if it has a screen or makes a sound, avoid for at least two weeks.  Dark room and quiet.  I ended up wearing one of my husband's giant hoodies for almost three weeks because the hood came down over my eyes and helped with light, which was very painful for me.  I was obviously not allowed to drive for awhile - your son may find that riding in a car is difficult initially as well.  

 

I would definitely follow up tomorrow with your family physician.  I had to go in once a week for two weeks, then I got to skip a week, but at my next check in I was still having trouble, so back to brain rest and once a week check ins.  I think it would really be helpful to have a doctor follow your son like that as well - at least for your peace of mind and to make sure he is progressing and not doing too much too fast.  I ended up being diagnosed with post concussive syndrome. I wished I had taken things slower (and it felt like overkill at the time).

 

I was on prescriptions for pain and zofran for the nausea, and I took it as soon as I could on schedule for the first three or four days.  Did they give your son something for pain/nausea?  It helped tremendously for that first little bit.  

 

I was told lots of fluids also.  And when my homeopathic doctor found out, he recommended hyperbaric oxygen if it happened again, as it really speeds up the brains ability to heal.  (I told him I'd rather just not get another one.)  Lots of sleep.  If he gets bored, bribe him to take a nap.  I was told the more I could sleep, the better for my brain.  I had heard you wake people up periodically, but I guess that is old thinking now.  The more sleep, the better.

 

I found that even a month or two out from my accident, I still struggled with things like remembering where I parked my car (more than usual), finding the right words, recalling something that happened just prior to the incident, explaining things clearly.  I carried post it notes around to help for months.  It was scary.  You don't realize just how much work your brain really does...until it needs a break from doing it!

 

Praying your son has a restful night!  (And you also!)

 

ETA:  I also did not lose consciousness and could remember exactly what had happened to cause the injury.  I thought that meant it wasn't so bad, and that is partly why I rushed to get back to my regular activities.  Just because a person stays conscious, doesn't mean that there isn't a significant injury.

Thank you for sharing your experience and the caution about LOC not equating to less severe injury.  The more I read and hear, the more it seems that concussion injury and recovery are very individualized and difficult to quantify as a general rule.  I made an appointment for ds with his regular doc for next Monday, and I will continue to have him evaluated by this doc until he is considered recovered and released. 

 

Ds did not throw up any more, and I am pushing fluids and feeding him nutritious foods.

 

He did ask if I could read aloud to him, and I don't know the answer to this.  I will research it (and am open to feedback if someone has advice based on experience) and would start with a simple, light book.  We have Cheaper by the Dozen going right now.  I think he is just bored.

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This is a good reference site too:

http://www.cattonline.com/

Coming back to say that this is a very helpful site with video learning modules going step by step through the process of assessing and recovery from a concussion.  It has materials to print, as well. 

 

My ds14 was kind of poo-pooing my conservative approach, and I had him watch some of the modules with me so he would understand the seriousness of the injury and the importance of the recovery.  The entire family needs to be on board to help ds12.

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Coming back to say that this is a very helpful site with video learning modules going step by step through the process of assessing and recovery from a concussion.  It has materials to print, as well. 

 

My ds14 was kind of poo-pooing my conservative approach, and I had him watch some of the modules with me so he would understand the seriousness of the injury and the importance of the recovery.  The entire family needs to be on board to help ds12.

 

In my experience, 14yo boys are masters at the art of poo-pooing their mothers!!!   :glare:

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My dd had a mild concussion last fall. From a suggestion here, I took her to a sports medicine doctor. I wasn't happy with the exam in ER and felt it wasn't thorough enough. Also dd is in college, so we needed a doctor's note to get her homework/projects/etc. deadlines relaxed. I was happy with the care (we went three times) and since dd recovered, she didn't need further care. While she was recovering, it was impossible for me to get her to do nothing. I mean impossible. I did teach her to recognize signs she over did brain activity (it was a "fuzziness in the head") so when it happened, she stopped doing whatever she was doing. Reading was one of the latest things she could do without getting a headache, also it was difficult to process the reading material right after the concussion. She watched tv, but only low key things, or things she had already seen. And she jokingly said that she only had one tab open on her computer, rather than twenty... So my vote is whatever it takes to keep your child calm and resting (not mad at you or restless).

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When my DS had a concussion, the ER gave us papers from childrens hospital of Philadelphia called "return to learn" and "return to play." You can google that. It had pretty specific instructions. Hope he feels better soon.

For those who may search for this topic after we are recovered, the cattonline site has very specific criteria for return to learn and return to play, likely the same instructions which were given in the ER.  It also has a printable evaluation form for use after a head injury/hit.

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My dd had a mild concussion last fall. From a suggestion here, I took her to a sports medicine doctor. I wasn't happy with the exam in ER and felt it wasn't thorough enough. Also dd is in college, so we needed a doctor's note to get her homework/projects/etc. deadlines relaxed. I was happy with the care (we went three times) and since dd recovered, she didn't need further care. While she was recovering, it was impossible for me to get her to do nothing. I mean impossible. I did teach her to recognize signs she over did brain activity (it was a "fuzziness in the head") so when it happened, she stopped doing whatever she was doing. Reading was one of the latest things she could do without getting a headache, also it was difficult to process the reading material right after the concussion. She watched tv, but only low key things, or things she had already seen. And she jokingly said that she only had one tab open on her computer, rather than twenty... So my vote is whatever it takes to keep your child calm and resting (not mad at you or restless).

Thank you for this.

 

Ds is currently somewhat resistant to total rest, so I am doing education about the whys.  :)

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