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    Concussion Questions & Answers

    Gina Niemeier, PA-C PA-C, of the Deaconess Concussion Clinic ​ 06/20/2014

    The Deaconess Concussion Clinic specializes in the assessment and treatment of concussions.  Through this blog post, I’ll explain what a concussion is, how to tell if you or someone you love has one, what should be done if you have a concussion and some prevention tips.
    What is a Concussion?
    A concussion is a brain injury caused by a bump or blow to the head. Even what seems to be a mild bump or blow to the head can be serious.
    In the Deaconess Concussion Clinic, we see patients who have had concussions caused by a variety of different events. Some of the most common causes are:

    • Sports related, particularly football, basketball, soccer, cheerleading, and hockey.
    • Motor vehicle accidents
    • Work-related injuries, such as falls
    • Other falls, such as from a ladder, on icy sidewalks, etc.

    What are the Signs and Symptoms of concussions?
    There are two kinds of symptoms - those reported by the patient (the person who has the concussion) and those symptoms reported by others (such as family, friends, coaches, etc.).
    Symptoms reported by patient:

    • Headache or "pressure" in head
    • Nausea or vomiting
    • Balance problems or dizziness
    • Double or blurry vision
    • Sensitivity to light or noise
    • Feels sluggish, hazy, foggy or groggy
    • Concentration or memory problems
    • Confusion
    • Doesn't "feel right"

    Signs observed by others:

    • Is confused or appears dazed or stunned
    • Forgets an instruction
    • Is unsure of game, score or opponent
    • Moves clumsily
    • Answers questions slowly
    • Loses consciousness (even briefly)
    • Shows behavior or personality changes
    • Can't recall events before or after injury

    Signs and symptoms may show up right after the injury, or they may not be noticed until days or weeks later.

    If you realize that someone is exhibiting signs of concussion, what should you do?
    If the person has had a significant loss of consciousness or has an altered mental status (highly confused, aggressive, behavior way outside of the norm), they should be seen urgently in the emergency department. For patients who have the symptoms listed earlier in the discussion, they need rest – both physical and cognitive. With a concussion, your brain is injured and needs time to heal. By decreasing all kinds of activities and mental stimulation, that rest can take place.

    What does that rest look like?
    Here’s a typical example.  Say a 16-year-old gets a moderate concussion on the football field. He needs to do several things:

    • School may need to be missed for a few days up to a couple of weeks.
    • Screen time (TV, computer, tablets, phones, etc.) and reading should be highly minimized, if not completely eliminated for that time.
    • Rest.  Repeat.  Repeat.
    • Healthful, balanced eating to give the brain the fuel it needs to repair itself.  On any day, the brain is responsible for about 20% of our total energy expenditure.  When the brain is trying to repair and heal, even more high quality energy needs to be available.  Lots of water for hydration is also important.
    • Limit naps, so that the sleep/wake cycle isn’t significantly altered.

    What can you do if you have a concussion?
    Low-key activities can be done to help in the healing process while preventing boredom!

    • Low-key card games or board games
    • Painting, drawing or other art  (free-thinking things—no high-concentration/structure activity)
    • 20-30 minute slow walks
    • Low-key family involvement, such as family dinner, walking the dog, sitting on the patio, etc.
    • Can listen to music, as long as it’s low volume and not overly stimulating.
    • Audio books are OK, and listening to TV is OK too.

    Can concussions be prevented?
    Not entirely, because accidents happen.  That’s why they’re called accidents. (And there is no way to prevent the movement of your brain inside your skull, which is how a concussion happens!)
    However, if you have a child involved in sports, there are some guidelines to reduce their risk of serious concussion effects.

    • Ensure they follow the coach's rules for safety and the rules of the sport.
    • Encourage them to practice good sportsmanship at all times.
    • Make sure they wear the right protective equipment and that it fits properly, is well maintained and is worn consistently and correctly.
    • Learn the sign and symptoms of a concussion so it can be identified and addressed early.

    What does the Deaconess Concussion Clinic (DCC) do for patients?
    After a concussion, the DCC assesses your cognitive function and develops a treatment plan to maximize recovery, including a schedule for returning to school, physical activity, sports or your job.

    My job is to guide people through the recovery process of what feels like an “invisible injury.” No one can “see” a concussion, yet it’s there, and the patient isn’t themselves. Yes, they might be talking, walking, joking, thinking, etc.  but they’re not themselves. To quote Dr. Dhingra, a physiatrist at HealthSouth Deaconess, he says, “Your brain is who you are, how you act, and how you think.”  When your brain is injured, you’re altered.  So help people get through the healing process and get back to being themselves.

    At times, it takes coordination with physical medicine, optometry, and in some cases, medications.  Most of all, time is the key factor in concussion recovery.

    I understand what someone is going through when they have a concussion, as I have had a pretty serious concussion in the past.  So I’m able to apply that personal experience to my job here at the Deaconess Concussion Clinic.
    Click to learn more about the Deaconess Concussion Clinic.

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