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<p>True</p>
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<p>However there is a progression to returning to physial activity that is recommended … it is not a simple wait and then start up again … another piece of info a lot of family doctors do not seem to know here.</p>
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<p>This is ABSOLUTELY the case. And it’s also why I do not accept a note from a family physician and release an athlete to play right away.</p>
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<p>Yes, he did… that one time. And as I said, it was about four blocks from our house and at the time, he had not had any of these dizzy spells. I’ve sort of concluded that it’s difficult to determine the severity of the concussion (I didn’t even know they could be rated) based on pain level since he’s taking ibuprofen for the ribs. If he stopped taking the ibuprofen, he might then notice he has headaches. But who’s going to tell a guy with six badly broken ribs, who’s recovering from clavicle surgery, not to take his ibuprofen? So in light of not having any headaches, we did not take the concussion as seriously as perhaps we should have, which is why H has probably tried to resume activities too quickly. Man, this whole concussion thing is really, really tricky. The night of the accident, H was brought home by a good samaritan who found him. Had I had any idea that he had a concussion, I would have asked this guy more questions, like where he was found, when, etc. But I assumed H would be able to fill me in on the details after the guy left. </p>
<p>We’ve been with our PCP for almost 20 years, and I have complete confidence in him to refer out when he feels something is over his head. In fact, I think he refers out too easily sometimes, based on what I hear other people have to go through to get referrals to specialists. And, I gave our PCP an earful when I saw him a couple of weeks ago, when retelling the story of how badly the immediate care center screwed up the night of the accident. He knows we are very sensitive to things being overlooked or neglected since H’s accident and the night (or 35 minutes from entering and exiting to be correct) at the immediate care center.</p>
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<p>I’m sure that falling over dizzy got his attention. I would be surprised, after that, if he’s not cooperative with a plan to take it easy and make sure this thing clears up.</p>
<p>Maybe I missed it earlier in the thread, but this is how concussions are graded: </p>
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<p>My daughter has had two grade III concussions. Her neurologist recommended she quit soccer entirely. The compromise my daughter has made is that she no longer heads the ball. She no longer plays competitive soccer, but I still hold my breath watching her play soccer in school.</p>
<p>nrdsb4 - the problem is, because there were no witnesses, we don’t know if he lost consciousness! The doctor kind of assumed he did. He has no memory of the event, not even where along the bike path he was when it happened. He just knows where he was at his last stop (where he met some friends), and then remembers laying on the ground and someone coming to help him up (the good samaritan). He doesn’t know how they knew where to bring him… did he tell them and give them directions to our house, or did they look at his ID in his wallet?</p>
<p>Such scary stuff!</p>
<p>^^^^That really is scary. I think with absolutely NO recall of the event, it’s probably safe to assume he lost consciousness.</p>
<p>I don’t know if he lost consciousness, but if he didn’t remember the event, he definitely had a concussion. Losing memory of the event can be a result of concussion: your brain chemistry goes wacko after an injury, and temporarily stops being able to turn short term memory into long term memory.</p>
<p>^^^^Basically I was just saying that personally I’d err on the side of caution, assume he lost consciousness, and act accordingly.</p>
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<p><----- This guy. Ibuprofen should not be given to an individual suspected of having suffered a head injury.</p>
<p>Nrdsb4 and everybody else: Disregard EVERYTHING that Nrdsb4 quoted. It’s old and has been shown to be inaccurate. That grading scale was introduced by a neurologist Dr. Cantu. Dr. Cantu has since come out and said to completely disregard that grading scale. Concussions are no longer graded. You either have a concussion or you don’t.</p>
<p>I hope your husband is doing better. And has been agreeable to staying off his bike. Everyone has given you some great advice.
A few things to remember:
- A concussion IS a brain injury. End of discussion. Do not treat with a doctor that tells you otherwise.
- It is not unusual for someone with a brain injury to have a “normal” CT scan immediately after injury. Actually, you can always have a “normal” CT scan and have a brain injury. You can also have a normal CT scan right after injury, and an abnormal one 24-48 hours later.
- Loss of consciousness or traumatic amnesia is a pretty good indicator that there was a significant impact on the brain, regardless of the CT findings.
- Older brains take longer to heal than younger ones. The body will heal first. Lots has been written about HS and pro sports concussions over the past few years, and ongoing research is being done. When you read anything about sports concussions, remember the type of athlete that is being discussed is a little different that you and I in age and level of fittness.
- Post-concussion syndrome is real, and needs to be treated. Simple info can be found on Mayo Clinic’s website (if this link does not remain or will not work)
[post-concussion</a> syndrome - Bing Health](<a href=“http://www.bing.com/health/article/mayo-126692/Postconcussion-syndrome?q=post-concussion+syndrome]post-concussion”>http://www.bing.com/health/article/mayo-126692/Postconcussion-syndrome?q=post-concussion+syndrome) - Your husband has multi-trauma, and his body and brain are trying to heal. That is hard work for the body- it needs the time, rest, nutrition to do it.
- Symptoms can get worse, instead of better.<br>
- Symptoms need to be managed by a doctor that believes in and knows how to treat post-concussive syndrome.
- Multiple concussions, no matter how mild, or how far apart, have cumulative effects. Pretty good article in Men’s health on that. [This</a> is Your Brain on Multiple Concussions | Men’s Health](<a href=“http://www.menshealth.com/fitness/your-brain-multiple-concussions]This”>This Is Your Brain on Multiple Concussions)
- You are right to be concerned, you are right to encourage your husband to seek medical help/ advice/ direction, and you are right to go to the appointment and speak with the MD about his symptoms. Often with brain injury our loved ones cannot see all of the symptoms they are having, or cannot describe the symptoms wel to the physician. (oh- wait, that is my husband all of the time!! LOL).
- All of the symptoms he is having may go away on their own in the next week or so. They could be related to the fact that he has multiple injuries, has spent a significant time in bed, and he is taking narcotics. The real effects of the concussion may not be apparent until he is off the narcotics, and on a more normal daily routine.
- If you do look up info on the web (or take advice from someone posting medical advice on CC like me), please use reputable sites for info. and use as a very basic reference only. People all react differently to injury and treatment, and nothing on the internet can take the place of a doc standing right in front of you that knows what he is doing!! </p>
<p>I hope that this helps, and I do hope your husband recovers quickly!</p>
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<p>I’m not sure I agree with this comment. Youth athletes are under a much greater risk of 2nd Impact Syndrome than an adult…</p>
<p>hops- agreed about second impact. But older brains definately take longer to heal. And getting back on bike when dizzy and taking narcotics puts someone at a higher risk too. Good news is that more and more is being done to try to prevent athletic concussion. YEAH!</p>
<p>Teriwitt- I hope you can find a chance to go buy him a new helmet, and get rid of the old one so he is not tempted to use it again. I am sure you know it is less than worthless right now. It just gives the impression of being protection for the head.</p>
<p>I hope he feels better soon, and can quickly resume what he loves doing. I also hope he listens to you again, and will seek further medical advice to make sure this is all a part of normal healing.</p>
<p>vlines has given you some great advise. (I’m an EMT, so I have modest medical training). Has your husband gone back for a follow up specifically for the head injury? If not, he really needs to. 2-3 weeks is about the earliest doctors want to see concussion patients for followup.</p>
<p>Regarding the helmet, the protocol is anytime a helmet is in a crash, it should be replaced. If you have a high-end one, some manufacturers actually provide free replacements. </p>
<p>It is also correct he should be taking Tylenol, not Ibuprofen or aspirin for pain due to the bleeding issues associated with the latter. Have him bring this up with his doctor.</p>
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<p>Thank you. When was this scale discontinued? My daughter’s last concussion was in Feb. 2 years ago and was graded a III as she was unconscious for several scary minutes. Her neurologist put this in her notes. Should we get a new one?</p>
<p>Not totally serious. We’re not seeing her at present and hope to not need to.</p>
<p>Oh-so either you have one or you don’t-how do you know you’ve had one?</p>
<p>Nrdsb4, it sounds like your neurologist was using out-dated materials then. The Consensus State on Concussion in Sport: The Third International Conference on Concussion in Sport Held in Zurich, November 2008. If you google that, you can actually read the Consensus Statement that is now the gold standard for concussion management. I believe this information was formally released in the summer of 2009.</p>
<p>I’m not saying you need to replace your neurologist; that’s at your discretion. </p>
<p>LoC has no bearing on the severity of a concussion. That said, if I have an athlete who suffers a head injury on the field and is unconscious when I get out there, he/she is getting spineboarded and taken to the hospital.</p>
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<p>Recognition of the signs and symptoms of a concussion.</p>
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<p>Most of my athletes are minors. My instructions are that they can take Tylenol only if their parents ask. I suggest they take nothing. If it is an emergency (like a kid I spineboarded a year ago) I give no medications at all. I leave that up to the doctor.</p>
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<p>You would be appalled, completely appalled at how my daughter’s concussion was handled. Reading the above, I shake with anger at the memory of how it was handled, the potential consequences of same, and get a cold sweat knowing how lucky we are that she is now okay.</p>
<p>What a valuable discussion. Concussion care has come a long ways since I was hit by a car 15 years ago, returning home after walking my kids to school. I have vague memories of the scene, and the ambulance ride, and know I was talking. But returned to ‘myself’ going into the CT scanner at the hospital where I work, and had to be told the story. I have no memory after dropping the kids off at school. No ID on me, luckily a neighbor recognized my body in the street, and got me to the right hospital. CT was ok, no skull fracture, though I had massive oozing hematoma. So they sent me home (alone) with some ice, and that was the end of the matter. A friend called in the morning to make sure I’d woken up. </p>
<p>But I felt out of it during the following week, and went to Immediate Care, where the PA (my primary at that point was an OB/Gyn) told me to not do anything to increase my intercranial pressure for the next few weeks while things healed. No aerobic exercise. That concept, of not increasing intercranial pressure, I think is an important one for recovery from head trauma. A gentle walk, ok. Heavy lifting, bounding up the stairs, off limits. No valsalva. </p>
<p>I work in a hospital, but neurology is not my area of expertise. I’ve always wondered if Battle’s sign-bruising in the area of the temples was an indication of perhaps having had a skull fracture after all.</p>
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<p>No, because as far as I know, no one told him that he needed to follow up with anyone. He did schedule a PT appt. today for next Wednesday, but did not call our PCP. Says he hasn’t had a dizzy spell since Tuesday night. I’m really starting to think someone dropped the ball on referring him for follow-up (whose job would that have been?). It will be three weeks since the accident tomorrow and the only follow ups he’s had are with the orthopedist.</p>