Posted: August 1, 2017

Disclaimer: I am not a medical professional. The advice that I’m giving is based on my personal experience and treatments that have worked for me. Please consult with your doctor before beginning any of the treatments.

Thank you to everyone who submitted questions on Post-Concussion Syndrome (PCS) for this #AskEsther mailbag! If you need a reminder of who I am, you’ll find that here. I hope to have more content soon, so if you have questions on PCS for a teenager who has been through it, don’t stop sending them to [email protected]. Now… on to the mailbag!

From Jenn

Hi Esther — my 13 yr old daughter had a severe concussion during a soccer game over 2 years ago. She has since struggled with migraines, neck pain, her grades have suffered, and she has not been the same socially. She went through extensive physical therapy for about a year following the concussion to help her back and neck. Is there anything we can do to help her with these other things that might be associated with her concussion?

Thanks for your help!

Jenn,

I’m so sorry to hear about your daughter, and I can relate to what she’s going through. Physical therapy significantly helped me with my symptoms. The aspect of PT that was most helpful for me was vestibular therapy, which not all PT includes. Vestibular therapy can help with neck pain and headaches. In addition, my physical therapist gave me exercises for my eyes; I had a severe convergence insufficiency, which meant that I was seeing double much too far away which made reading and schoolwork difficult. I had no idea that I had this convergence issue so I’d suggest asking about it even if your daughter doesn’t have any eye symptoms. Improving this helped my headaches and made schoolwork easier.

I would also recommend Cognitive Behavioral Therapy (CBT), which is basically memory and executive functioning retraining; doing CBT made me feel confident about going back to school after concussions, and I really credit it with my success in school. Finding a CBT specialist may not be easy: make sure that he or she combines memory retraining with helpful daily skills.

In terms of school and grades, help your daughter find good advocates at school (a school nurse, teacher, adviser) since she may need accommodations such as extra time or reduced coursework. Her school may ask for neuropsychological testing in order to grant accommodations.

Other treatments that I tried were acupuncture, chiropractic therapy, massage, and migraine medications; I would suggest talking with your doctor about any of those. The Concussion Legacy Foundation has some great content on PCS treatments here.

As I understand it, and I’m not a doctor, headaches with PCS can be migrainous, and they can also be tension headaches as a result of having to try harder to stay focused.  Ask your daughter’s doctor to help her distinguish which she might be having.

You also mentioned that your daughter has not been the same socially. I have found the social piece one of the hardest things during my concussion journey. I think it is extremely important to stay social, but oftentimes social engagements seem like a burden. I’m in high school, and I’ve found that I just can’t go to parties because of the noise, stimulation, and lights, but I’ve found alternative ways to still see friends. I’d recommend finding quiet restaurants to go to dinner with friends or having friends over to watch a movie rather than going to the cinema, which can be a lot of stimulation. And please tell her not to be afraid to tell her friends why she can’t participate in certain things. I have found that while some friends cannot understand or even remotely empathize with invisible symptoms, good friends are more than happy to accommodate you.

Hope this helps, and I wish all the best to you and your daughter!
Esther

From Jennifer

In September, it will be two years since I was run over by my horse. I don’t remember any of it, and I was in the hospital for 3 days and 2 nights, I didn’t break anything, it was for the concussion, and I couldn’t remember what someone said to me the moment before for about 20 hours afterwards apparently. It was a rough go for several months afterwards, I’m doing much better now, however I still get light headed every time my head bends down low, will this go away at some point or can I expect to deal with that indefinitely?

Jennifer,

I’m glad that you are feeling better now, but that sounds like such an awful experience! The lightheadedness is hard—I’ve experienced it as well. One thing that may help is vestibular therapy, which helps dizziness, lightheadedness, and balance.  You might also ask a trained physical therapist or specialized eye doctor to check you for any vision problems, such as convergence insufficiency. These therapies helped to decrease my dizziness and lightheadedness.

Generally, when you’ve suffered with symptoms for a while you can think that this will be a problem forever, but I urge you to be hopeful since you certainly have been recovering since this injury!

All the best,
Esther

From Marrianne

Hi Esther, 

I’ve never had a concussion before until I had a really bad fall on May 10th, 2017.  It was more like a “flying face plant” to the floor, rushing through the airport full speed, and tripped over a table and went flying and landed on my face/head. Paramedics checked me out, but I didn’t want to go right to the hospital because I hadn’t seen my son in 2 years. However, the next morning the pain was twice as bad all over, & in my head and my right eye was swollen shut. My husband took me to the ER and they did a CT scan, lots of x-rays, etc. I was bruised from head to toe, but only broken nose and lots of swelling above my right eye. Really big bump on the forehead above right eye. I’ve also had my eyes checked w/ an ophthalmologist because my right eye vision is just a little off, not terribly blurry, but a little around the periphery. He didn’t find anything wrong, and said something like if there’s swelling inside pressing on my optic nerve there’s nothing he can do about that anyway. I’m hoping that the swelling will continue to go down and it will get better. I use ice packs on my head, warm wraps on my very painful neck, etc.

Previous to all this I had chronic migraines which doesn’t help matters, but my question is that as the weeks have gone on I was still having daily headaches and nausea every day which has been super bad some days. No actual vomiting, just nausea. I have read a lot since the accident about concussions and realize how important rest is, and I’ve tried in the last couple days to rest more (actually feel like I’ve done nothing, other than washing dishes and a little laundry; which is hard for me- I normally work from home, and do lots of computer work, I know the screen time has to be limited).  The last two days have been a little bit better, no nausea.

Would you still advise seeing a neurologist at this point or not?  I’m frustrated because I don’t know how much rest is rest. And I don’t know how long this is supposed to take to recover. 

If you can give any advice I will really appreciate it! 

Thank you!

Marrianne,

I’m so sorry to hear that you experienced this! I would definitely suggest seeing a neurologist since you are still experiencing symptoms.

As for rest, this was a hard thing for me to gage as well; if you are used doing a lot and always being busy it can be very hard to take time off, but it’s very important to do so, especially if you have felt better the last two days whilst resting—seems like your brain needs this. I think taking frequent breaks from tasks and especially from screen time can be very helpful. I would also recommend a yellow filter for your screen when you have to use a screen (you can use a clear plastic folder from Staples). Anything you can do to reduce stimulation to light, noise, elevated heart rate, and cognitive work would help now in my experience. Wear sunglasses when outside, when indoors face away from sunlit windows, try to avoid stimulating environments (sometimes a mall or loud restaurant can feel very overwhelming).

Some people with Post-Concussion Syndrome experience migraine-like headaches, so your history of migraines confuses things, and your vision issue may be contributing.  A good neurologist may be helpful.

Posted: February 7, 2017

I wake up most days with a headache. Sometimes a cup of tea does it, but other times I need two Motrin and twenty minutes more sleep.  Sometimes I need two hours and miss classes. At school, I put a strong face on. I smile, I engage in class, I work hard, and I get good grades. However, sitting in class I often find the board blurring in front of me and I have to work so hard to keep all of the writing as just one of itself. The teacher’s voice often goes in and out as I struggle to focus with a splitting headache.

During free periods, I spend all of my time doing homework because it just takes me longer to do everything.  I have to carefully plan how I study. Prior to the injury, I had an excellent memory which was advantageous for school. After, I struggled with my memory and other symptoms. I could no longer just quickly review work the night before, so I began to have to plan more before any assessment, carefully making study guides, and using mnemonic devices to master vocabulary. I could no longer sit for four hours straight and complete all of my assignments. I had to set a timer for thirty minutes, get up, stretch, do some jumping jacks, drink water, and then return back to work. I still quickly understand material, and my performance and output are as strong as they were pre-concussion – I just have to work differently. Initially it was frustrating to have to drastically alter the way that I studied, but I have made it work.

I had to totally change the way that I exercise as well.  Rather than playing team sports, running, and doing workouts specific to my sports, I found myself having to work out just to work out.  No longer able to run, I had to switch to Pilates, yoga, and light weights, always careful not to hurt my neck or back more.

It is hard to have to change so many routine things that you never imagined would have to change. Once a stress reliever and something I enjoyed, running even for just a few minutes leaves me extremely dizzy and nauseated with a blood-pounding headache.

When I’ve thrown up at school because of a headache, I had to just continue my day because I hate complaining and I didn’t want to miss school.

With a bad headache I often become very sensitive to smell. I feel bad when I turn down a meal that is usually one of my favorites and have to go to a dark room instead of eating with my family.

I sometimes get really irritable. I was a very calm and ‘go with the flow’ person, and now, sometimes the littlest things just really annoy me.

My confidence has taken a toll. When you no longer feel like yourself and struggle to remember things, you don’t feel very confident about schoolwork. I was always a strong student and now I tentatively submit my answers to online quizzes. Though I still receive good grades, they come with more work and stress.

I used to have 20/10 vision in both eyes and my eye doctor told me that I should be an aviator with such crisp vision. Now, I squint to read and my vision blurs or doubles – I don’t think I’ll be piloting any time soon.

I used to put my hair in a ponytail almost every day. Now, ponytails worsen my headache so even when working out, I have to leave my hair down or in a braid.

I sometimes wear sunglasses inside my house while doing work since sunlight and glare make me headachy. I wear sunglasses almost all of the time when I’m outside.

I randomly lose my balance and get dizzy. I guess I’m glad that I can make people laugh as I topple over or near-miss a wall, but it is disconcerting to walk around when everything is blurry or have a conversation when the person is blurry and double.

I always considered myself a quick wit, and now I laugh with a considerable delay or think of a great addition to a conversation that happened five minutes ago.

All of these things show how pervasive Post-Concussion Syndrome (PCS) is. It’s not just your sport or just your academics. It’s your whole life and each little loss and change adds up.