Parent Advocate, Tracey Mayer will be offering up her writings to The Concussion Blog as a resource to the readers, especially the parents out there. As time allows she will be submitting posts for you to read. I truly hope that everyone gets a chance to read about concussions from yet another perspective. Thank you Tracey!
Although Drew knows the university setting is challenging, I think he sees it as a fresh start. Now that he is 18, he will have to advocate for himself even more, so it is very important that he fully understands his disability and what his needs will be. The strategies that have worked for him in high school may or may not work in college.
As I mentioned in a previous post, Drew’s original plan of study at ISU was the College of Business. Post-concussion, he can no longer handle the calculations and problem solving of high levels of math and science so he is looking at different career paths. He may also consider taking a reduced load of courses his first year to help with the transition.
His neurologist is preparing a letter for the Disabilities office, which outlines his medical disability of migraines, the cause of it, the impact on cognitive ability, limitations and recommendations for Drew. I sent her nurse a detailed letter to use as a guide, as we generally have to spell out exactly how the letters from the doctor should be written. Then we wait until the Disabilities office at ISU makes a decision about accommodations for Drew.
It is difficult to have the doctor’s letter focus only on Drew’s condition of migraines and not also address his cognitive issues, but we believe that he has a stronger case with this approach. If he is refused, he will have to approach it from a psych-educational viewpoint, which will require additional cognitive evaluations.
I will keep you posted on his progress…
Coming tomorrow will be the introduction of Drew Fernandez, Tracey’s son, as he writes for the first time.
The Concussion Blog 
Ms. Mayer,
Best wishes to Drew and family.
Your post concussion statement resufaces an important issue re concussions. That is…
Is the term post- concussion an accurate term or are the symptoms merely the ongoing effects of the initial concussion injury?
Below is an excerpt of my 2004 dissertation re NFL PLayers’ knowledge of concussions which discusses this issue and related concerns.
TBI and Postconcussion: Many Years of Controversy
Approximately 50% of persons who sustained a TBI experienced postconcussion syndrome (PCS), which manifested itself in various symptoms that were not present in the person prior to sustaining the concussion (Bazarian & Atabaki, 2001). Although controversy exists pertaining to the existence of PCS as a direct outcome of sustaining a minor TBI, more sensitive brain-imaging techniques such as SPECT, PET, and functional MRI have documented an organic basis for the symptoms (Bazarian & Atabaki, 2001).
The term postconcussion evolved from early conceptions of a concussion as an entirely reversible syndrome without detectable neural pathology. As such, the prefix post literally meant after [the event] (Gasquoine, 1997). Agreement does not exist on how to conceptualize the concept of post concussion syndrome or even if the syndrome exists. According to Evans (1987), symptoms attributed to the effects of a concussion may also be called postconcussion syndrome. Rutherford (1989) advocated for the dropping of the prefix post, and thus called the collection of presenting symptoms the concussion syndrome. The author also argued and pointed out that since fractured ribs-related pain is not labeled “post rib fracture” pain, concussion-related symptoms should not be perceived as postconcussion symptoms. Furthermore, since some symptoms of a concussion and post concussion are similar, it is not easy to recognize when a concussion ends and the postconcussion syndrome begins (Wills & Leathem, 2001).
Strauss and Savitsky (1934) are credited with coining the phrase postconcussion syndrome (Evans, 1994), and they posited that not only may a concussion occur without a loss of consciousness, but that it has an organic basis. In their extensive 63-page review of the topic, they emphasized the importance of documenting clinical observations and of not quickly attributing vague or unusual findings to functional/psychological origins. The value of the clinical judgment was also highlighted in the following statement: “Results of tests and exact quotients cannot take the place of the opinion of an experienced clinician” (p. 912).
The authors also reported that some physicians, who had personally experienced concussions themselves, changed their beliefs regarding the origin of postconcussion syndrome from a psychological basis to a physiological basis. Discussions among various physicians also gave credence to the existence of PCS: They reported similar clinical features and symptoms in their patients who neither conversed with other patients nor lived near each other.
Very good point- as always, thank you.