21 Aug 2014
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Concussion: One Football Player's Story

Doctors treat the injury in different ways, but in this case it was 'total cognitive rest.'

Concussion: One Football Player's Story

Author's note: I am not a medical professional. Not all doctors treat concussed patients the same way. The information below is not intended as a guide to treating concussions. If presented with similar symptoms, seek the advice of your own doctor.

Dee didn’t see the last play of her middle son’s first football game of the season. She was working in the concession stand. Cam was on the opposite side of the field. He was on defense and running behind the play. He never hit the ground so not even his coaches knew he was injured.

It was a helmet-to-helmet hit to the side of his head. As he began to fall, another player actually hit him back into a standing position. He stumbled the few short yards to the bench and sat down. He remembers feeling crappy and dizzy — like he wanted to throw up and pass out.

The EMT covering the game was already at his side. Dee hurried across the field and began answering the EMT's questions. An ambulance was called. Cam was helped down to the ground and immobilized, and the EMT held his head and checked his vitals until the rescue team arrived. Dee figures it wasn’t more than five minutes before they began strapping him to a board for the ride to the hospital. Dee rode with Cam.

On most autumn weekends, emergency rooms at children’s hospitals are full of kids with football-related injuries. Cam spent the next four hours immobilized. He needed a CAT scan. Was there a brain bleed or fractures to his neck or spine? He tested negative for all of them, was released and told to follow up with his pediatrician.

Dee knew he had the classic symptoms of a concussion — confusion, blurred vision, headache, nausea, tiredness, and light sensitivity. Was it only a year ago when Cam’s older brother, Chris, had hit the ground hard during a high school game triggering a concussion without even hitting his head? When speaking with Dee about concussions you immediately realize that she’s extremely knowledgeable about every aspect of the injury. She’s quick to point out that an ill-fitting chin or mouth guard can contribute to a concussion as easily as a poorly fitted helmet. And as was the case with Chris, the head may not even be impacted.

The next day Cam’s doctor performed various neurological tests on him and confirmed that he did have a concussion. Her recommendation for concussion treatment was total cognitive rest. If you are new to all of this it translates to not using your brain. As Cam explained to me, he was not allowed to watch TV, text, use the computer, play video games, listen to music, or go to school until he was totally free of symptoms for a minimum of 24 hours.  

Cam needed sleep — lots of it. While awake he had to lie around and do nothing. He slept sixteen hours a day. That’s quite different from what many of us practiced in years past. I remember being told to make sure my child was kept awake after a head injury and to wake them up throughout the night. The focus now is letting the brain heal by allowing the person to sleep.

Cam had headaches for the first seven days of his injury and was on total cognitive rest for eight days. He was taking two showers a day to occupy time. He’d “cheat” by watching the guys cut down trees outside his window. When asked to do something, he’d reply that he couldn’t think and wasn’t supposed to use his mind. Dee tells me about the day Chris “threw Cam under the bus.” Chris received a text from a sick friend asking if he was also home sick. Chris answered back that he was in school. The friend then replied that he saw someone was online using his XBox. It was Cam. The next day Dee took all the remotes, game controllers, laptops, and cell phones to work with her.

On the tenth day Cam was able to go to school for three hours but could not take tests, do homework, or participate in any physical activities. On the 15th day, he came home from school with a headache.  He was still very fatigued and a little light sensitive.

The Boy and I had pedaled to the library in the next town to meet with Dee and Cam. I needed to feel some of what I was going to be writing about. And I wanted The Boy to see and hear how a peer was dealing with the constraints dictated by such a devastating injury.

Dee put on her “Dr. Mom” face as she pondered a huge decision that needed to be made regarding Cam’s return to sports. She pointed out that “concussions are injuries to the brain and nothing to fool around with. If a person were to suffer a blow to the head before their brain has fully healed, they are at risk for Second Impact Syndrome, which almost always causes permanent brain injury. It can also cause death within minutes as the brain can swell at an enormous speed. This is the reason for the long recovery time after symptoms disappear.” She pointed to NHL superstar Sydney Crosby and his recent problems with concussions as documented in a recent edition of Sports Illustrated.

Part of Cam's post-concussion treatment involves a computer-generated cognitive assessment that tests memory and reaction time using design and word sequences. The software is trademarked under various names. At the high school level the test is administered prior to the start of all sports as a baseline. If a student suffers a head injury during their sport, a post-concussion test is given and the results are compared to the baseline, signifying to the trainer or physician whether or not the student has indeed suffered a concussion and/or healed from one. Some medical facilities will run tests to establish baselines on pre-high school athletes as well.

Little by little Cam’s life is beginning to feel as it did before his concussion. After playing two years of football without winning a single game, his team is entering the weekend undefeated and the favorite to win the championship. His hope is that he can dress and take the field for just one play in the last game of the season. He’s frustrated that he’s finally on a winning team but unable to contribute.

He had to drop some school classes and rearrange others so that he can meet with those teachers and make up the work. He’ll be caught up by semester’s end.

Dee wonders if he should forego the last game of the season and start the basketball season rested and healthy. It only takes one play to ruin another whole season or perhaps a high school career. Besides, basketball is really his game.

When our meeting ended, I hugged both Dee and Cam while The Boy and Cam gave each other a 13-year-old-boy nod that meant something more than, “See ya.” And if I had to guess, I’d say it was more like The Boy acknowledging, “Dude — that’s crazy. I’m not sure I could have done what you did.” It’s amazing how the injured human brain can still talk you into protecting it.

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