Among the health care denizens of the deep known to frequent this board, I am probably the most prone to "surgically create new orfices without the aid of anaesthesia" when I read how one of our Scubaboard docs is issuing dictums and time-frames for diving with a disability, in that many of said dictums are just parrot-like repetitions of folk lore and old-wives tales. Having started with this auspiciously inflamatory opening, I would serious caution you against letting someone dive two-weeks post concussion. You have not provided much detail so I can hardly say this is based on any informed assessment of your son's risks, but rather based on the imprecision in diagnosis of brain injuries and the fact that "mild head injuries" tend to creep up on a person following an allegedly "mild concussion." In this situation, the symptoms of a mild brain injury can be very subtle and only really noticeable over time, when the contrast becomes more evident, but the symptoms can be clinically significant and, relative to the cognitive clarity needed for diving, quite relevant to the issue of diving.
I'm sure the ER docs told you that "he be doing fine, just keep an eye on him for a day or two." This well-intentioned, but nonetheless irresponsible blather demonstrates a lack of understanding of mild brain injuries.
Considerations may include the nature and location of the trauma, along with the functions controlled by that area of the brain. In addition, consideration needs to be given to the possibility of continuing, but more subtle effects from the trauma. Some of our patients who have had a mild brain injury will seem to be doing okay, but over time, the patient, his/her family, co-workers, or friends will notice that some functional areas "seem a little bit off." In these cases, a neuropsychological evaluation (i.e., aimed at neuro issues impacting functioning, rather than psychiatric symptoms) may identify things that other methods have not.
Assuming that everything is going great, who should you work with re evaluating the risks associated with a return to diving given your medical history and your current condition (notice the words - not "is it okay to dive?" Rather "what are the specific risk issues that your particular constellation of history and current functioning represent?"). In my opinion, this gets a little bit more complicated than some might suggest (and you are saying to yourself, "you mean it wasn't complicated before??!?") A neurologist or a physiatrist (not a psychiatrist, a physiatrist - a doctor specializing in physical medicine and rehabilitation) with no expertise in diving medicine will be (WARNING: another inexcusably cheap aquatic reference is about to happen) like "a fish out of water" trying to consider what diving-related issues will be critical for you. Anything less is an open invitation for the repetition of folk lore and irrational blather.
On the other hand, many diving docs are more focused on pulmonary medicine and, knowledgeable as they may indeed be, won't have sufficient expertise to speak to the neurological nuances that may be important. (At this point, you may be hoping to find a one-armed physician who therefore cannot say "on the other hand" - sorry, I like bad jokes, what can I say?) If it is at all possible, you may need to bring together experts from the two disciplines. And please don't assume that an MRI or an EEG is going to give a definitive answer. These tools can only help guide the assessment process and the ensuing discussion.
I'm sure your son will be bummed out, but this is one of those times when you have to be the adult in the parent-child relationship.
Questions - PM me or respond through this thread.
Good luck,
Allen G.
(and now the usual disclaimers - none of the above is intended to serve as medical consultation or in place of your seeking medical consultation or treatment. Only a physician who has personally evaluated or treated you can provide you with the guidance that you need. The information provided above merely documents issues associated with the treatment of certain medical conditions, in the hope that you will be able to more effectively participate in your own treatment and consultation with such physician)
