Diving head first into the concussion debate

If we can protect our own children, why can't we protect professional athletes?

RED DEER, Alta. April 10, 2016/Troy Media/ – I took two hard knocks to the head in the space of two weeks playing rugby when I was 16.

After the second one, I was seeing double, had an overwhelming headache that made me nauseous and had serious balance issues.

The doctor diagnosed a concussion, prescribed a few days of bed rest (and no more rugby that spring), and sent me for tests that determined I had also damaged muscles that controlled my left eye. The eye issue was resolved with time and therapy, although it still aches when I become overtired. The headaches persisted for weeks, but eventually diminished. The doctor also forbade me from playing football that fall.

Over the next few years, I would lead with my head too many more times. Two particular incidents resulted in trips to the hospital for multiple stitches. In all, my head has been stitched at least four times because of some sort of violent collision (excluding the rugby injuries). The external damage is usually obvious. The internal? Time, concussion research now suggests, will tell.

While the possibility of concussions was mentioned by medical personnel in each case, no detailed tests were done. Certainly no baseline protocol existed to establish damage or even potential damage.

The medical community has come a long way since then. Too bad the professional sporting world seems intent on following only by modest degrees, and usually kicking and screaming. How else do you explain the persistence of fighting in hockey, and the National Hockey League’s resolute refusal to admit the depth of its concussion problem?

For every minor sports organization that establishes stringent best practices – a high school football program in Red Deer, for example, is replacing all of its helmets with the latest technology, at the cost of tens of thousands of dollars – there are the laggards in professional sports who can’t bring themselves to be the trendsetters they should be.

Their lack of common-sense is staggering: use of the best helmets, in professional football and hockey, is not mandated, nor is the use of specific facemasks in football or visors in hockey. The NHL also does not demand the use of mouthguards, although they are proven to diminish the impact of head trauma, nor does it insist that helmets are even tightly fastened. And, of course, fighting remains a staple of the NHL (hockey thrives right up to the junior level without fighting, so why it belongs in the junior and pro ranks is an acute frustration).

The NHL repeatedly treats issues of workplace safety inconsistently and even cavalierly. Look no further than the stream of emails from the league released recently as part of the concussion-related class-action lawsuit former players have brought against the NHL. No other major industry could so blatantly violate common law and good sense.

Concussions (or mild traumatic brain injury) heal with tremendous uncertainty, if they heal at all. Medical science is getting closer to understanding how concussions damage the brain, but still does not know how to repair damage some concussion sufferers face long-term.

A concussion appears to involve a change in chemical function that alters how the brain works. Symptoms include: dizziness; difficulty concentrating, solving problems and making decisions; headaches and blurry vision; a lack of energy and motivation; being tired and irritable; sensitivity to light and sound; and nausea.

Those who suffer multiple head injuries often have a disease known to cause cognitive decline, behavioural abnormalities and ultimately dementia. Premature death has also been found in this group, by as much as 20 years (the rash of suicides by former pro athletes who suffered head trauma should be included in these numbers).

Such head injury can preclude a productive, normal life – let alone playing a sport.

A recent study by Toronto’s York University and the Institute for Clinical Evaluative Sciences found that the number of young people treated for concussions is on the rise. The Ontario study showed that concussion treatment rose to 754 from 466 per 100,000 boys and to 440 from 208 per 100,000 girls from 2003 to 2011. In all, almost 89,000 pediatric concussions were treated.

That snapshot is chilling, but it should also be heartening. It means that more parents and minor sports officials recognize the dangers of head injury and are reacting appropriately.

Awareness is a huge thing in concussion treatment. The more that young people are protected from repeated head trauma, the less impactful concussions will be.

Now if we can just get professional sports organizations to understand what savvy parents have always known.

Troy Media columnist John Stewart is a born and bred Albertan who doesn’t drill for oil, ranch or drive a pickup truck – although all of those things have played a role in his past. John is also included in Troy Media’s Unlimited Access subscription plan.

The views, opinions and positions expressed by all Troy Media columnists and contributors are the author’s alone. They do not inherently or expressly reflect the views, opinions and/or positions of Troy Media.

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2 Responses to "Diving head first into the concussion debate"

  1. Avatar
    Carolyn Johnson   April 10, 2016 at 2:46 pm

    I want to thank John Stewart for helping to educate the public about head injuries. The attitude thatyou just got your bell rung, you’ll be fine, get back in there, is almost criminal in my opinion. The competitive nature of many coaches and parents is putting the future of their children at risk. I believe those in professional sports have a moral duty to set a good example by following the guidelines set forth by the most up-to-date medical research.

    I’ve had a few concussions myself and according to the most recent research, being female makes it even more difficult to recover. There are still doctors who believe you should just wait and see if you get better on your own, wasting valuable time when you should be getting treatment and nutrients that heal the brain.

    Thanks to people like Dr. Sanjay Gupta of CNN and Dr. Michael Lewis of Brain Health Education, the importance of omega 3’s and other nutrients to stop inflammation as soon as possible is critical as inflammation can continue to damage the brain for months after an injury.

    When I asked the ER doctor about this he told me he knew nothing about that and I should be fine in a week or two. It’s now 3 years later and I’ve lost almost everything. It’s a very slow, frustrating process to educate not only the professional athletes, but the medical community which, for the most part, still wants to treat TBI the way they were taught in med school 20-30 years ago. Too many doctors aren’t even aware of the latest diagnostic tools including Diffuse Tensor Imaging, blood tests to detect TAU proteins and harmless nutrients that in many cases can be used to heal the brain instead of medications that have intolerable side effects that many times include suicide, seizures, internal bleeds, etc.

    It’s a slow process to change attitudes toward head injuries as there is so much that’s new, but every little bit helps! I just wanted to thank you for helping with this article.

  2. Avatar
    Dr. Rob Beckman   April 11, 2016 at 9:31 am

    Effective, Immediate Treatment for Head Injury is Readily Available with Current Medical and Therapeutic Intervention

    The TreatNow Coalition is focused on the use of hyperbaric oxygen therapy (HBOT) to treat traumatic brain injury/concussion. We have spent the last eight years building coalitions of civilian physicians and clinics to provide safe and effective care to more than 1,400 veterans, active duty service members, professional athletes and civilians who have suffered head injuries. Nearly all have experienced significant, often life-altering, improvements in brain function. In more than 20 cases, we have helped heal special operations warriors who were at risk for medical discharges due to head injury. Published clinical trials led the Israeli Defense Forces to make HBOT the standard of care for TBI. Research published in January in the journal Neurological Sciences concludes: “Compelling evidence suggests the advantage of HBOT in traumatic brain injury…suggesting its utility as a standard intensive care regimen in traumatic brain injury.”

    “Watchful Waiting” and repeated cognitive tests are wholly unacceptable standards of medical care for concussion or any head injury given that effective, brain-healing therapies are readily available. Regardless of the type of head injury, research has shown that underlying neurological and vascular brain damage can lead to long-term, even fatal, conditions that do not heal themselves. Meanwhile, evidence-based clinical success with head injury treatment protocols worldwide continues to accumulate. Tragic stories of ball players suffering long-term debilitating consequences of brain injury have focused media and public attention on the role of head injury in sports, especially in young people. The head injury epidemic in sports and the recognition of traumatic brain injury (TBI) as the “signature wound” of the wars in Afghanistan and Iraq, have been extensively documented for more than a decade. Yet treatment has been available for more than 30 years.

    It is known that a single blow to the head, multiple impacts or a blast wave, whether from sports, car wrecks or combat, can lead to cognitive impairment, degenerative brain damage, depression, dementia, thoughts of suicide, PTSD, post-concussion syndrome (PCS), and chronic traumatic encephalopathy (CTE), and myriad other complex diagnoses. According to the Centers for Disease Control, there are nearly 2.5 million emergency room visits for traumatic brain injury (TBI) each year in the US. The Rand Corporation puts the numbers of veterans living with brain injury at more than 420,000, with some estimates nearing 800,000. The consensus in civilian and military medicine is that any protocol to heal the brain must include multiple, integrated therapies including medical intervention to reduce the effects of brain swelling and inflammation, nutritional support, physical therapy, psychological/behavioral and cognitive therapy; other alternative therapies such as meditation, yoga, and acupuncture can be considered.

    Dr. Joseph Maroon, a noted neurosurgeon and medical advisor to professional football, has written that, “Substantial animal and human research now suggests that…natural dietary supplements, vitamins and minerals, and the use of hyperbaric oxygen may be a better first-line choice for the treatment of [concussion] which has generally been underreported by both athletes and the military.” Unfortunately, military medicine and the Veterans Administration rely heavily on the use of combinations of unproven and potentially suicidal psychoactive and other drugs.

    According to Dr. George Mychaskiw II, former editor-in-chief of The Journal of Hyperbaric Medicine, “Hyperbaric oxygen is a safe, easily used treatment that, in many cases, has resulted in a dramatic improvement in the symptoms of patients with [TBI/Concussion]. Every day we are…gathering more data validating its efficacy…I feel, as do many of my colleagues, that there is sufficient clinical and research evidence to justify the use of [HBOT] as a standard-of-care treatment for [TBI]…” The medical establishment has been slow to adopt proven alternative therapies to treat injured brains. Conventional passive and palliative care approaches costing billions, including drugs and unproven, often negative interventions, aim to treat symptoms, not underlying physiological and neurological damage. Sadly, while they wait, they and their families suffer, and underlying damage goes untreated.

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