Concussions

Concussions: How Much Do Teachers and Staff Know? Apparently, Not Enough!

Written on August 20, 2013 at 11:04 am , by

The start of the school year is just around the corner. My 16-year-old, Luke, is an athlete who suffered two concussions playing football last year, and I’m nervous—not about him doing sports, but over the lack of knowledge about traumatic brain injuries among the administration, teachers and school staff.

Coaches, trainers and parents of athletes know the signs and symptoms. When Luke returned to practice after the first concussion, it was his coach who suspected—correctly—that he had suffered a second one. Luke had to pass physical and cognitive tests before even being allowed to begin the return-to-play protocol, a series of guidelines for players to ease back into the game and make sure the brain has healed.

But this same level of care was not given to Luke in the classroom. I spent countless hours on the phone, sent emails, demanded and attended meetings with everyone and anyone who had anything to do with his school day. I was constantly amazed at the complete ignorance of the needs of post-concussive students not only from teachers and administrators, but nurses and even the school psychiatrist.

I understand that when a student is taking a rigorous schedule of AP and honors classes teachers expect a high level of learning skills and self-discipline. Luke did not lose these abilities; he just needed certain accommodations. I was finally able to get these under Section 504 of the Rehabilitation Act, which provides them for students with permanent or temporary physical or mental impairments. However, many of his teachers felt the accommodations allowed under 504 were optional. As one administrator said to me, “When I talk to him, he seems fine.” When a teacher called to say she was concerned Luke was not going to make the due date for a research paper, I asked if she was talking about the class due date or Luke’s due date. (One of his accommodations is extended time.) She said he had plenty of time and did not need the extra time on this assignment. I reminded her that the law said he did.

As fall comes back around I am prepared for all the media stories about the role coaches, trainers and parents play in preventing and treating concussion. I applaud those efforts. But I think it is time to educate the administrators and teachers about the long-term effects of concussions and how they impact a student’s ability to learn. Even after I explained my son’s condition to everyone involved in his education they still pushed him to try harder, when trying harder was making his condition worse.

We have a return-to-play protocol to get kids back on the field. Now we need a classroom protocol. I asked a concussion specialist at Children’s Hospital about this. He said there are too many people and too much politics to come to an agreement. That makes me sad. I thank God every day that I had the luxury and the ability to devote the entire last year to getting Luke healthy. I pray for the kids whose parents don’t.

 

Becky Patton Logan, author of The Retired Housewives’ Guides, is a mom of two in Olney, Maryland.

Concussions: Education Is Key for Diagnosis and Treatment

Written on August 13, 2013 at 2:00 pm , by

As a pediatric nurse practitioner in the Brain Injury Center at Boston Children’s Hospital, I work daily with patients and families dealing with concussion. This is an invisible injury that can’t be seen on a CAT scan or MRI. and often goes unnoticed. Kids may not know they have a concussion but do know they “don’t feel right.” Education is key for diagnosis and treatment, and the informative article “What’s Your Concussion IQ?” covers all of the questions I discuss with children and their families. Sometimes just by explaining what the injury is helps eliminate fear of the unknown.

But in my clinical experience one of the most difficult things to manage is school. Kids go five days a week, seven hours a day. And that doesn’t include the time to complete homework. Children often struggle with school requirements while recovering from concussion. It can be stressful and can increase feelings of anxiety/worry for patients and parents.

It is essential that everyone, including school personnel, understand that although the child may look well, he or she may not feel well. During recovery, kids should be given extra time to complete assignments as well as a decrease in overall academic responsibilities. If they are able, they should return to school after a few days of rest to avoid feelings of isolation and a disrupted sleep pattern. Parents and administrators should also consider a modified school schedule during recovery, so it’s key that there’s good communication between both sides.

 

Michelle Parker, RN, MS, PNP, Program Manager, Brain Injury Center, Neurosurgery, Boston Children’s Hospital 

My Son, His Concussion, and a Friend’s Smart Advice

Written on August 6, 2013 at 11:32 am , by

 

When the phone rang with my son’s school’s caller ID, I never expected it would be the secretary, telling me my 13-year-old had gotten seriously injured. “Mrs. Owenby, Chandler hit his head on the gym floor playing basketball,” she said, assuring me he was alert and responsive, and then handing him the phone. “Mom, I’m okay, but my head hurts,” Chandler said. I grabbed my keys and headed out the door, thinking about all those stories of kids with brain bleeds—and praying all the while.

When I arrived at school, Chandler was sitting in the office with an ice pack on the back of his head. He’d been given some Advil and was resting. Since it was lunch period, I took him to get a smoothie. While we were in the car, Chandler told me he had fallen backwards and hit the back of his head; then a teammate fell on top of him and hit his forehead. At the smoothie place, the sound of the blenders made his headache worse—a symptom of concussion, though I didn’t know that. He went back to school since he didn’t want to miss his last period, science, but after that he still had a headache. I called our doctor, who told me to watch for sleepiness, vomiting or confusion. Chandler slept well that night, but when he woke up his head still hurt, and despite more Advil, nothing had changed by the end of the day.

So I took him to the doctor. He performed a basic neurological exam, asking Chandler to balance on one leg, touch his nose, make a fist; he also did a  vision tracking test. The diagnosis: a mild concussion. The advice: rest for the weekend. After we left, a friend called and suggested we see a sports medicine concussion specialist. At our Monday appointment, Chandler failed two specific neurological tests—putting his hand on his thigh and flipping it over and back quickly, and doing jumping jacks. “What’s a jumping jack?” he said when asked to do one. I looked at the doctor in shock.
He explained that a concussion is like someone swinging a baseball bat and into a telephone. Some of the plugs will pop out and it takes time for the brain to put everything back in place. He was put on full cognitive rest—no TV, iPhone, video games, excessive schoolwork or athletic training—for seven days. With weekly follow-up visits, Chandler improved, and was gradually allowed to resume normal activities.

He’s fully recovered, with no after effects. My advice to moms out there: It takes a specialist to recognize the symptoms of concussion, and without an accurate diagnosis your child is at risk for additional injuries or lifelong complications. I’m thankful Chandler’s injury was not worse, and that I had a smart friend who told me the right thing to do.

Christy Owenby  is a mom of three in Covington, Louisiana, and a smarter, wiser concussion survivor.

(She’s pictured above with her boys, Chandler is on the left.)

 

 

My Son Has a Concussion…Could it Be All in His Head?

Written on July 30, 2013 at 3:57 pm , by

My concussion IQ tests off the charts. I’m not a neurologist, coach, trainer or health teacher. I’m  just mom who learned way more about concussions than I ever wanted to.

My son picked up a ball before he could crawl, and has continued to toss one around virtually every day since. Given the number of hours he’s spent in a gym or on a field, it’s probably statistically pretty good that he didn’t get his first concussion until freshman year in high school, back in March 2012. He was out of school for two weeks, and sports for eight.  The injury was bad, but the recovery process was worse. The doctor’s instructions were clear—no activity, reading, bright lights, loud noise or looking at screens (TV, computer, phone) until all symptoms cleared. It took several days for my son to power down and be okay sitting quietly, just thinking or resting.  It was isolating.  It was boring. And what I didn’t realize at the time is that it was also pretty scary.

At first he acted like a typical invincible teenager. He was fine and a little TV, he reasoned, won’t matter. But as days passed, he didn’t feel better. He realized that if he did too much (or anything at all) too soon he could permanently damage his brain. He became more willing to chill out. I told him that it was his head, and only he could know if he was healing. Problem was, just as there are no visible signs of a concussion, there are no concrete markers for recovery. Everyone, including him, wondered if he was sure that he did or didn’t feel better yet. But he eventually did bounce back, and when he decided to quit rugby and football and just play basketball, I rejoiced.

When he got a second concussion exactly one year later, the fear was exponentially bigger. Concussions are bad. Two concussions could mean more damage, a longer recovery and, worse of all, the end of competitive sports. This time, my son was a model patient. He iced his head, rested, avoided screens, didn’t even dribble the ball.

After three weeks, he was feeling 100% and back to school and sports.  While doing homework a few days later, he dropped his pencil and as he bent to retrieve it, banged his head on the table.  He panicked. He had a headache, nausea, was sensitive to sound and light. The doctor said he had re-concussed.  A week later, he bumped into a door and freaked out again. He was so fearful that if a butterfly had landed on his head, he’d have sworn he was re-concussed yet again. Or so it seemed.

Eventually my pediatrician stepped in and suggested my son talk to a therapist.  When I shared the doctor’s thoughts with my son, I could see him turn over the idea in his mind. “Hmm, you mean I could be fine but not know it,” he said.  “Well, then I feel better.” Within one day he was fully recovered.  He never saw the shrink. The mere suggestion that it was all in his head was enough to cure him.

These days he’s careful but still plays aggressively, which he has to—the team motto is “Play Hard or Go Home” (why we push kids to train at profession levels is a topic for another post). When a basketball lands on his head he wonders if he’s concussed, but then realizes probably not, and keeps going.

Concussions: How Much Do You Know to Protect Your Teen?