Video on Concussions & ImPACT Test

This is a feature story by ESPN Outside the Lines on the epidemic of concussions in teenage sports and the result of untreated concussions

In 2008, 5 high school football players died during games or practices from getting a concussion on top of a concussion – a condition know as Second Impact Syndrome. A recent study by nationwide children’s hospital in Ohio that found an alarming 41 percent of high school athletes with concussion returned to play too soon. And while football has by far the highest rate of concussions compared to any other sport: hockey, wrestling gymnastics, lacrosse, volleyball, cheerleading, basketball, baseball, softball and soccer all have their fair share. Concussions happen when the brain is shaken inside the skull. And even though they’re common in sports many coaches and trainers still don’t know how to manage them. That’s partially because there is no one-size-fits-all guideline for what to do when a player gets one. Some athletes will heal in a couple days and some in a couple months. Researchers are just beginning to unlock the reasons why.

Watch it here

Video about Concussions in Sports

http://www.youtube.com/watch?v=-4nrxgsRa1o&NR=1

The growing number of concussions in sports has many coaches, trainers and parents thinking twice before risking a second hit for an athlete who may have had his bell rung. In this Children’s Channel video podcast, Joseph Congeni, MD, director of the sports medicine center at Akron Children’s Hospital, discusses the signs and symptoms of a concussion, as well as the latest guidelines for a safe return to the field.

Watch it here

Video – A Novel Approach to Concussion Treatment

Here’s the video

“If [certain things hold true]…We have found everyone gets better, in terms of their physiology…”

Specialized exercise regimen relieves post-concussion symptoms

This just in from the University of Buffalo:

UB researchers are the first to show that a controlled individualized exercise training program can bring athletes and others suffering with post-concussion syndrome (PCS) back to the playing field or to their daily activities.

In a paper published in the January issue of the Clinical Journal of Sport Medicine, the researchers report that a program of progressive exercise developed individually for each participant and performed at levels just below the onset of symptoms is safe and can relieve nearly all PCS symptoms.

Read more…

Concussion information

Here’s some concussion info:

Concussion Overview

The term concussion describes an injury to the brain resulting from an impact to the head. By definition, a concussion is not a life-threatening injury, but it can cause both short-term and long-term problems. A concussion results from a closed-head type of injury and does not include injuries in which there is bleeding under the skull or into the brain. Another type of brain injury must be present if bleeding is visible on a CT scan (CAT scan) of the brain.

  • A mild concussion may involve no loss of consciousness (feeling “dazed”) or a very brief loss of consciousness (being “knocked out”).
  • A severe concussion may involve prolonged loss of consciousness with a delayed return to normal.

Concussion Causes

A concussion can be caused by any significant blunt force trauma to the head such as a fall, a car accident, or being struck on the head with an object.

Concussion Symptoms

  • Loss of consciousness after any trauma to the head
  • Confusion
  • Headache
  • Nausea or vomiting
  • Blurred vision
  • Loss of short-term memory (you may not remember the actual injury and the events some time before or after the impact)
  • Perseverating (repeating the same thing over and over, despite being told the answer each time, for example, “Was I in an accident?”)

When to Seek Medical Care

Call the doctor about any of the following situations. The doctor will recommend home care, set up an appointment to see the patient, or send the patient to a hospital’s emergency department.

Go to an emergency department by ambulance in the following situations. For people with less severe injuries not requiring ambulance transport, a car may be taken to the hospital.

  • Severe head trauma, i.e., a fall from more than the height of the person or a hard fall onto a hard surface or object with resulting bleeding or laceration.
  • Any child that loses consciousness as the result of a head injury.
  • Prolonged loss of consciousness (longer than two minutes)
  • Any delayed loss of consciousness (for example, the injured person is knocked out only momentarily, then is awake and talking, then loses consciousness again)
  • Vomiting more than once
  • Confusion that does not go away quickly
  • Extreme drowsiness, weakness, or inability to walk
  • Severe headache
  • Loss of memory of the event (amnesia)
  • Perseverating (saying the same thing over and over)
  • Someone who takes warfarin (Coumadin) for a medical problem suffers and suffers a significant blow to the head.
  • If the person fails to regain consciousness after two minutes, or the injury is very severe even if two minutes have not passed, DO NOT move the person. Prevent movement of the neck, which may cause spinal injuries. If the person needs to vomit, carefully roll the person onto his or her side without turning the head. Call 911 immediately for help.

If you are unsure of the severity of the injury, take the person to the emergency department immediately.

Should an injured person be allowed to fall asleep? Many mistakenly believe it is important to keep people, especially children, awake after they have been struck on the head. Children are often more emotionally upset than they are physically injured after a minor fall. They will cry and appear distressed, but as the parent rushes them to the hospital, children may begin to calm down. Because they have expended a lot of physical and emotional energy crying, they will often want to fall asleep.

  • You do not need to keep the child awake. In many cases it may be helpful to the emergency doctor to be able to awaken the child who is now more calm and rested and will behave normally. This gives the doctor a better assessment of the severity of the head injury.
  • If, however, a child who was initially normal after a head injury cannot be awakened, or is extremely difficult to awaken, then the child may have a more serious head injury and should be evaluated by a doctor.

Read more…

The warrior’s walk

Over the past year or so, I have been giving a lot of thought to head injury survival through the ages. Getting hit on the head, knocked out, attacked, and generally brain-damaged is about as regular a part of the course of human history as, say, losing your teeth or having a part of your body chopped off.

Think about it — dental care as we know it today is a relatively recent development. Used to be, a blacksmith was the one with the tools to pull a tooth — or you did it yourself with a heavy object slammed against a bad molar, or a string (tied around the offending tooth) and a slammed door. And it’s easy to forget in this convenient age, that once upon a time, people used actual tools to get their work done — lots of them sharp — and lived under conditions that were harsh and unyielding. Chopping off part of a finger — or a whole finger, for that matter — losing part of your foot to frostbite, and/or having a piece of your ear bitten off in a bar fight, happened with a lot more frequency than we 21st century folks recall.

Think about it — once upon a time, wars weren’t fought in faraway lands by trained, dedicated armies that only wanted to vanquish each other. Time was, raiders and looters and rapists and pillagers roamed the seas and the countryside, doing as they pleased to whomever was there. What’s more, in the middle ages, just about the only way am ambitious young man who wasn’t the firstborn in his family could get ahead (other than by taking up a trade or currying favor with some overlord) was to sign on as a mercenary with a local feudal lord and maraud his way to fame and fortune.

In our cozy, warm homes, with only the television and the internet to connect us with a reality outside our own, it’s easy to forget just how rough life has usually been on the human race. And it’s easy to forget that traumatic brain injury is not something that is unique to football players, boxers, and survivors of car accidents and falls. We look at statistics about brain injury — how many of them come from sports and falls and accidents and assaults — and we shake our heads, wondering what we can do to make the world safer — both before and after the accidents.

But think about it for a moment… how safe can we reasonably expect life to be? Granted, nobody wants to have their brain rearranged by unexpected trauma. Nobody actively seeks out a cognitive-behavioral condition that can be not only disturbing but downright disabling. Nobody plans to be at a perpetual disadvantage in life. But it happens.

And it’s been happening for a long time.

So, what do we do?

Certainly, we can try to prevent as many head injuries as possible, with helmets and education and training and good sense. But there’s just no way to live your life freely, if you’re on constant alert about what might happen, and what that might mean for your long-term prospects.

As an old, old relative of mine says, “Life is dangerous!” To try to limit the dangers, also means trying to limit the full range of human experience. To live fully, you need — on some level, anyway — to accept the possibility of harm, damage, danger, injury. To live fully, you need to walk — head up, shoulders back — into the face of some pretty scary stuff, and be prepared to deal with the consequences.

To live fully, to walk fully upright in the world, you have to be a warrior.

maori warrior

Maori Warrior

You have to be ready, willing, and able to look the world in the eye with a resolve that says, “I will not bend before you, I will not break beneath you, I will not yield the ground I have won. I will not falter and I will not fail, until I have reached my final destination.  The only way I am going to fall short is if I fall permanently, period.”

To do this, to think this, to live this as a recovering survivor of brain injury (or many other kinds of injuries, including PTSD), you must be a warrior.

Now, I’m not saying everyone should pick up a sword or a spear or a gun and march out into life swinging and shooting. I’m not saying that you have to be on the defensive or the offensive at all times. Far from it. According to dictionary.com, a warrior is someone who is

1. a person engaged or experienced in war(fare)

2. a person who shows or has shown great vigor, courage, or aggressiveness

Vigor, courage, aggressiveness… yes. Those are key. And they are also predicated upon the experience of war.

To be a warrior, you have to realize and accept that you are engaged in war. Not only war in the classical sense, but:

War 4. active hostility or contention; conflict; contest

For those who struggle daily with TBI (or PTSD) in a world that doesn’t give a damn about our struggles, this is not a huge cognitive stretch. We are constantly faced with active hostility or contention, conflict, and contests — whether those come from within, or without. In my case, I would have to say the source is frequently more internal than it is external, but that doesn’t make it any less challenging. If anything, it makes it moreso.

Sometimes walking through the world without acting out, without attacking, without leaping in to “defend” yourself from a mis-judged situation takes more warriorship, than striking out. Being able to stand your ground… to hold your fire… to be fully present in a moment which threatens you on every level, without flinching or fleeing… that takes true strength, courage, and vigor. And mastering the self, learning to calm and/or disregard the constant chatter that goes on in our rewired brains… well, that takes a good deal of aggressiveness.

Not against the rest of the world (tho’ sometimes that’s required), but against the inner impulses which impel us to flinch and flee and fly off the handle. It takes monumental skill to stand when you want to bolt. It takes determination to listen, when you’re just dying to shout. And it takes all you can give, to walk, when everything in you is telling you to run.

Now, don’t get me wrong.  I’m not recommending that everyone just be 100% okay with the after effects of traumatic brain injury or other tragic traumas. I’m not saying we need to just sit back and take all the crap the world has to throw at us. Far from it. What I’m saying is that we as recovering survivors need to develop the inner resources to be our own people, to stand our own ground, hold true to our values, and not be diverted by externals when they keep us from our ultimate goals.

We need to be warriors in the truest sense. To walk our own paths, wherever they may lead us. To know ourselves for what we truly are, not what the rest of the world says we are. To do what must be done to protect ourselves and our lives and all we hold dear. And whatever route we take, it must be our own, and we must be loyal to the True inner voice that compels us, while learning to discern and dismiss the internal chatter and endless distractions which strive to pull us off our path.

Only we can achieve that. But when we do, we know it is our own. We have earned it, we have won it, we have paid dearly for it. And nothing and no one can take that from us.

March on.

Triage on the battlefield of life

From Wikipedia:

Triage (pronounced /ˈtriɑʒ/) is a process of prioritizing patients based on the severity of their condition. This rations patient treatment efficiently when resources are insufficient for all to be treated immediately. The term comes from the French verb trier, meaning to separate, sort, sift or select.[1] There are two types of triage: simple and advanced.[2] The outcome may result in determining the order and priority of emergency treatment, the order and priority of emergency transport, or the transport destination for the patient, based upon the special needs of the patient or the balancing of patient distribution in a mass-casualty setting.

Some days, it seems like everyone is dying. Lying wounded on the battlefield of life and gasping for breath.

Along come the doctors to decide — who lives, who dies. Who gets to wait and see.

They sift through the sheer volume of us… separating, sorting, selecting who will receive a portion of their insufficient resources.

What is our order?

What is our priority of emergency treatment?

How and when and to where shall we be transported?

Where are we going, anyway?

Truly, it seems as though all of this country is in a mass-casualty setting.

Triage continues.

Anger, anger, and more anger

temper strikeOne of the things that can make TBI particularly difficult, in the ensuing weeks, months, even years, is anger issues. Rage issues. Flying off the handle and attacking others for no good reason that they can see.

There are a lot of reasons this happens. Some of them are:

  • Fatigue – your system is compromised by too little sleep and/or too much activity (with me, the two go hand-in-hand), and you don’t have the energy/wherewithall to stop yourself from going off
  • Fear – there’s nothing like a sharp spike of adrenaline, combined with anxiety and fear to set you off. Fear has a way of clouding your judgment, so you not only under-think situations (from fatigue) but you also overreact to the circumstances (which may or may not be true).
  • Frustration – when you’re trying to get something done/said/understood, and it’s just not happening, no matter how hard you try, patience wears thin — especially with yourself. My frustration tends to be directed inwards, though it also gets directed outwards. But the inward-turning kind is actually a lot worse for me. It makes me mean and aggressive. The worse I feel about myself, the angrier I get with life in general, and the more I tend to blow up.

It certainly doesn’t help that my brain gets into an uproar and starts getting into a biochemical soup drama, so that even if I wanted to think straight, I can’t.  The constant restlessness of my brain, coupled with the toll that agitation and fatigue take, can combine for a pretty potent mix of explosives.

So, what can I do about it?

  • At a very minimum, be aware that I’m angry. It often feels like something completely different — it feels like I’m just revved, and I don’t recognize the emotional piece of it. It may sound simple, but realizing that I am actually angry is a big challenge for me.
  • Realize that my anger does not necessarily make sense to others. What I’m thinking and feeling may be entirely unique to me.
  • Realize that my brain may be sending me wrong signals, and the surge of emotion that’s coming up may be simply a biochemical response by a physical system that is WAY overloaded and highly sensitive.
  • Remember that the long-term effects of a blow-up are probably not worth the satisfaction I get from venting. No matter how justified I feel about my anger, it can do much more harm than good. I have to think about whether I want to spend the next days/weeks/months patching up the damage I do to myself and my relationships with others, thanks to uncontrolled anger.
  • Keep myself in check. No matter how justified I feel, the more revved I get, the more I need to step away. I need to do whatever I can to remove myself from that situation, before it escalates and turns really nasty.

It’s not a perfect process, but it’s something. It’s an ongoing thing, and I’m far from perfect. But ultimately, life has a way of teaching me the lessons I need to learn, so if I just keep at it, eventually I do make some progress.

Ouch

I have not been sleeping nearly enough. Now my clothes hurt me. My skin is very sensitive and it feels like  it’s being raked by a wire brush, when my clothes brush against my skin.

Complain, complain, complain. I’m wearing myself out with the complaining.

Work is going pretty well, and when I keep track of what I’m supposed to be doing, I am keeping up with the best of ‘em. At least, I believe I am ;)

I’ve noticed an interesting phenomenon with how I fill in the gaps of my comprehension. Where I am missing details, like what someone’s reaction to me is, I tend to think the worst. They’re angry with me. I’ve messed up. They’re quiet because I’ve offended them and they are thinking about what to say back to me.

But it’s not always true. It rarely is, in fact.

I think this comes from a lot of past experiences of troubling interactions with people. When I was a kid, I seemed to get a lot of stuff wrong, and people used to get so mad at me. Of course, it always puzzled me. I never thought I was wrong when it was happening, but over the years, I gradually came to realize that I messed up a lot more than I thought I did.

In a way, it was kind of good that I was as clueless as I was. But in retrospect, I cringe.

Well, I can’t do much more cringing tonight. I’m dog-tired from dealing with my car conking out – battery died when I was at my neuropsych. And then having to call AAA (and renew my lapsed membership online before I called them) and figure out how to pay for the battery… Ugh. I can do without another day like this.

Oh well… I can’t worry about it. In another six months, I won’t even remember this, probably. I’ll have moved on.

My clothes hurt me, so I’m going to cut myself a break and take it easy tonight. I’ve earned it.