My Dr. Mom credentials fall shy of diffential diagnosis so I defer to you, fellow mamapedia experts! I do have calls into the pediatrician and physchiatrist as well but would welcome your opinions.
So...14-year-old son sustained a concussion around 11/19 of last year. He was seen by his pediatrician and the school's athletic trainer and ordered onto physical and cognitive rest until his symptoms cleared. After 3 weeks, on 12/7, he was headache-free and eased back into hockey and full academics following a stepped return to play plan.
On 12/10, he started taking Concerta for ADHD, 18 mg. In early January, he increased to 36. At some point during this time, he started complaining of headaches again and was worried that it was post-concussion syndrome. Three weeks ago he consulted with the athletic trainer at school. His IMPACT (cognitive testing) was fine but he recommended stopping hockey to see if the headaches would stop. After about 2.5 weeks, he stopped getting headaches and was headache free for a few days as of this morning. The plan was to ease back into physical activity over school vacation (next week) and return to hockey if all is well.
What he failed to mention to me until yesterday is that he hasn’t taken his ADHD meds at all for about a week because he kept forgetting. Today he took 36 mgs and now has a headache. Seems pretty likely to me that the headaches after the initial concussion period were related to the medication and not the concussion.
Because he never got a doctor’s note ordering him to not play for his club team, he technically doesn’t need a note to return to play and is eligible to play this weekend. If he wakes up headache-free tomorrow I’m considering letting him play in a game tomorrow, or at least skate warm ups and sit on the bench (during concussion recovery players don’t go to the games because watching the activity can strain the brain).
WWYD if you were me? I would think that if the headaches were concussion-related it wouldn’t have taken 2.5 weeks to feel better on a second round of rest. It was only after he stopped taking the meds that he felt better and only on the medication that his head hurt. Seems a shame to have him continue to sit out of a sport that he loves due to a medication side effect. Thoughts?
Normally I am the last person to go to a doctor's but a head injury is not something to play with. I think you need to consult a sports medicine doctor. I would be getting a second round of x-rays and an MRI done to make sure there is no damage.
A serious head injury can cause personality changes, a lifetime of headaches, vision problems ect.
If he were my son I would have him sit out until he has another round of tests.
He was not see by a sports/ concussion specialist?
His recovery plan needs to be consistent across both the school and club teams. You can mention the medication to the club coach, but if he is not cleared for the school team, he should NOT play for the club team. My vote would be to not play.
My son had a football related concussion on 9/4/12 and was cleared for sports end of Oct. 2012. He had 3 IMPACT tests before the concussion specialists would clear him for full activity.
I take concerta 54 mg extended release and if I run out and go a few days without. I get a headache starting back up. same as my DD does as well on Focalin xr. Have him set a reminder on his cell phone or I pod touch to take meds. Although I would double check like you are with the doctor because of concussion. Best of luck,
L.
You've got 2 issues which have not been resolved fully: a head injury, and a possible reaction to medication. There is great attention being paid to head injuries, which have been swept under the rug in high school, college and professional sports. He was told by his pediatrician and the school trainer to refrain from sports, but somehow this didn't get carried over to club sports? Something fell into the cracks here.
There's also a huge problem with kids with ADD/ADHD forgetting to take their meds. Goes with the territory. He's also a typical teen in that he doesn't always tell you what's going on, and it's hard to supervise a kid of that age when they want to be independent and you still want to be the parent on top of them all the time.
I don't think you have enough answers. You can get some additional medical work if you want (for both the injury and the medication), or you can do something more natural to help his focus. My son had a significant head injury in high school (loss of consciousness too) and I also work heavily in nutrition to help with focus in kids and adults. There's SO much that's been done that is safe and not a lot of hype or dangerous self-medicating. So I've gone both routes and I think there's a balance that can be achieved.
