Tag Archives: Traumatic brain injury

Straight, No Chaser: Traumatic Brain Injuries (Concussion), Part II

Neurology, Trauma, , , , , , , , , ,

concussionboxing_facial__4_

Your son is a star in Friday Night Lights (actually football, not the TV show) and has been concussed.  Amazingly, the most common question I get asked is not “Will he be ok?”, but “When will he be able to get back on the field?” My answer, coming out the ER, is never going to be less than two weeks, and I won’t be the one who provides medical clearance.  It’ll either be your family doctor or preferably, a neurologist.  Don’t just take my word for it.  Consider the following Quick Tips from the Center for Disease Control and Preventions.
CDC’s Discharge Instructions

  • You may experience a range of symptoms over the next few days, such as difficulty concentrating, dizziness or trouble falling asleep.  These symptoms can be part of the normal healing process, and most go away over time without any treatment.
  • Return immediately to the ED if you have worsening or severe headache, lose consciousness, increased vomiting, increasing confusion, seizures, numbness or any symptom that concerns you, your family, or friends.
  • Tell a family member or friend about your head injury and ask them to help monitor you for more serious symptoms.  Get plenty of rest and sleep, and return gradually and slowly to your usually routines.  Don’t drink alcohol.  Avoid activities that are physically demanding or require a lot of concentration.
  • If you don’t feel better after a week, see a doctor who has experience treating brain injuries.
  • Don’t return to sports before talking to your doctor.  A repeat blow to your head-before your brain has time to heal-can be very dangerous and may slow recovery or increase the chance for long-term problems.

Finally, there are two particularly impactful consequences about which you should be aware.

Impact-Syndrome616x314new

  • The ‘second impact syndrome’ is irreversible brain injury triggered by a fairly routine second head impact after a prior concussion.  You must take the time off needed for the brain to heal.  I care more about your child’s mental future than the upcoming playoff game.
  • The ‘post-concussive syndrome’ represents long-term neurologic and psychologic consequences of the head injury.  It includes such symptoms as inability to sleep, irritability, inability to concentrate, headache, dizziness and anxiety.

Post Concussion Syndrome 3D cube Word Cloud Concept with great terms such as brain, injury, trauma and more.
There are no definitive treatments for concussions other than prevention of an additional injury, and that fact should be chilling to you.  Be mindful of the risks involved in choosing to engage in activities putting the brain at risk.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Traumatic Brain Injuries (Concussions), Part I

Neurology, Trauma, , , , , , ,

tbi basics

It’s probably not a coincidence that National Traumatic Brain Injury Awareness Month occurs at the same time as the onset of the NFL season in the U.S. However, it’s also important to appreciate that traumatic brain injuries (TBIs) don’t only occur in the setting of professional sports. Regarding sports, the really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing, or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame, and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.

concussion

A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes, ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia. (It’s important to note that not all blows to the head result in a TBI.) For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contribute to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.

tbi traumatic-brain-injury-chart

Healthcare professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

tbi brain-injury-awareness

Red Flags
Here’s what you need to know today. Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty waking
  • Any loss of consciousness, confusion, or significant agitation
  • One pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to identify people, places, the date, or self
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

We’ll continue the conversation about concussions in the next Straight, No Chaser.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress
 

Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

General Health and Wellness, Mental Health, Neurology, Health Prevention, , , , , , , ,

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
http://www.aarp.org/health/brain-health/
www.luminosity.com
Whatever you choose to do, do something!
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!
Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

General Health and Wellness, Mental Health, Neurology, Health Prevention, , , , , , ,

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
www.brain.aarp.org
www.luminosity.com
Whatever you choose to do, do something!
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Traumatic Brain Injuries (Concussion), Part II

Neurology, Trauma, , , , , , , , ,

concussionboxing_facial__4_

Your son is a star in Friday Night Lights (actually football, not the TV show) and has been concussed.  Amazingly, the most common question I get asked is not “Will he be ok?”, but “When will he be able to get back on the field?” My answer, coming out the ER, is never going to be less than two weeks, and I won’t be the one who provides medical clearance.  It’ll either be your family doctor or preferably, a neurologist.  Don’t just take my word for it.  Consider the following Quick Tips from the Center for Disease Control and Preventions.
CDC’s Discharge Instructions

  • You may experience a range of symptoms over the next few days, such as difficulty concentrating, dizziness or trouble falling asleep.  These symptoms can be part of the normal healing process, and most go away over time without any treatment.
  • Return immediately to the ED if you have worsening or severe headache, lose consciousness, increased vomiting, increasing confusion, seizures, numbness or any symptom that concerns you, your family, or friends.
  • Tell a family member or friend about your head injury and ask them to help monitor you for more serious symptoms.  Get plenty of rest and sleep, and return gradually and slowly to your usually routines.  Don’t drink alcohol.  Avoid activities that are physically demanding or require a lot of concentration.
  • If you don’t feel better after a week, see a doctor who has experience treating brain injuries.
  • Don’t return to sports before talking to your doctor.  A repeat blow to your head-before your brain has time to heal-can be very dangerous and may slow recovery or increase the chance for long-term problems.

Finally, there are two particularly impactful consequences about which you should be aware.

Impact-Syndrome616x314new

  • The ‘second impact syndrome’ is irreversible brain injury triggered by a fairly routine second head impact after a prior concussion.  You must take the time off needed for the brain to heal.  I care more about your child’s mental future than the upcoming playoff game.
  • The ‘post-concussive syndrome’ represents long-term neurologic and psychologic consequences of the head injury.  It includes such symptoms as inability to sleep, irritability, inability to concentrate, headache, dizziness and anxiety.

Post Concussion Syndrome 3D cube Word Cloud Concept with great terms such as brain, injury, trauma and more.
There are no definitive treatments for concussions other than prevention of an additional injury, and that fact should be chilling to you.  Be mindful of the risks involved in choosing to engage in activities putting the brain at risk.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Concussions – Traumatic Brain Injuries, Part I

Neurology, Trauma, , , , , ,


tbi basics

It’s probably not a coincidence that National Traumatic Brain Injury Awareness Month occurs at the same time as the onset of the NFL season in the U.S. However, it’s also important to appreciate that traumatic brain injuries (TBIs) don’t only occur in the setting of professional sports. Regarding sports, the really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing, or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame, and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.

concussion

A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes, ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia. (It’s important to note that not all blows to the head result in a TBI.) For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contribute to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.

tbi traumatic-brain-injury-chart

Healthcare professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

tbi brain-injury-awareness

Red Flags
Here’s what you need to know today. Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty waking
  • Any loss of consciousness, confusion, or significant agitation
  • One pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to identify people, places, the date, or self
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

We’ll continue the conversation about concussions in the next Straight, No Chaser.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Brain Health – Mental Gymnastics to Keep You Vibrant

General Health and Wellness, Neurology, Health Prevention, , , , , , ,

brain-exercise function

I always found it odd that we assume our brain will simply perform in every way we need it to once developed. It seems reasonable to me that if we choose to diet and exercise in an effort to maintain and build every other part of the body, we should be doing the same for our brains. Previous Straight, No Chaser posts have reviewed how the brain works and have addressed the basics of exercising and eating to best support your brain. We have also discussed sleep, which is another essential component of brain health.
This post will discuss activities for you to perform that will actively engage and grow your brain power. We will review several types of activities that work well to keep your brain working well.

brainbike

To start with, ask yourself to actually consider what you want to accomplish with your brain. Are you still in building mode, where you’re willing to continue to learn and grow, or are you fighting to maintain what you have (e.g. stem the tide of memory loss)? The difference in your answer may suggest the need to engage in more vs. less global brain development activities.
Consider certain passive and active activities that exercise your brain and functionally make you a lifelong student. Pick up a new hobby. Take a class. Build things.
Want another approach? Develop a part of your brain that you may not be using as much. Practice writing with your other hand. Learn to play an instrument.

brain exercise CrosswordPuzzles

Do you like games? Certain games hit the sweet spot of brain development. These include daily crosswords, puzzles, Rubik’s cubes and video games. However the best of all is chess. Playing chess stimulates many different areas of the brain; it’s worthwhile learning or continuing to play for brain health.
Are you more verbally inclined? Read, read, read (we recommend Behind the Curtain; we’ve heard it’s quite stimulating). Join a book club or chat room, and discuss what you’ve read. Increase your vocabulary by learning a new word a day. Learn a new language. Learn to write (don’t forget to proofread!).

brain exercise training

Learn to be an active user of your brain. Start by reducing or eliminating the most passive of your activities, such as watching TV; it’s mostly receptive and not very good for exercising your brain, unless you’re interacting with the program in some way. Plan your activities, and envision various scenarios. Break the monotony in your activities; instead of a routine, force yourself to choose differing options in your activities.
If you are interested in an organized approach to brain exercise, here are two sites that I’d highly recommend.
www.brain.aarp.org
www.luminosity.com
Whatever you choose to do, do something!
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: In the News – NFL Star Retires Over Concussion Concerns

Neurology, Trauma, , , , , , , , , ,

chris-borland-wisconsin-fumbles

Chris Borland, a 24 year old linebacker with the San Francisco 49ers, has made the decision to retire from the National Football League because of fears of concussions and the consequences playing football could have on the rest of his life. He made this decision prior to the onset of any chronic symptoms and after presuming that he may have suffered from a concussion at some point in the past (when attempting to make the team).
Straight, No Chaser has discussed concussions in previous posts, including the following (click the links to review):

In this space we talk a lot about health as currency and how our choices spend that currency. It wouldn’t be very Straight, No Chaser not to call this what it is: a very smart decision, which Mr. Borland is very fortunate to be able to make. His background and personal circumstances allow him to place a different value judgment on the risk/benefit ratio that playing professional football offers. To some degree many of us place ourselves in dangerous work environments: healthcare workers are exposed to diseases, police officers and firemen are exposed to danger, construction workers face multiple occupational hazards and on and on.

 cte-symptoms

It becomes an additional concern when health risks are minimized or denied. It has only been in the last few years that the extent of the dangers of pro football have been analyzed, ranging from concussions to chronic traumatic encephalopathy (CTE), a condition that results from multiple head injuries and can include multiple neurologic symptoms including memory loss, confusion, aggression, depression and suicide. Several notable former NFL players have committed suicide and on autopsy were found to be suffering from CTE.

 chris borman

It’s not that playing football will cause these conditions; it’s that it clearly increases the risks. We are past the point of pretending it’s a debate. Folks, head trauma causes brain injury, and repeated head injuries are incredibly likely to cause chronic brain injury and damage. This is especially true in children who are physically abused in ways that affect the still-developing brain, and it is especially true is sports that cause violent, repeated trauma to the head.
Yes, it’s somewhat tragic that those of a certain social standing disproportionately feel like they have to make the choice to risk their health to pursue certain careers. However, there does come a time when as long as these choices are educated, informed choices, you have to accept that whether we’re discussing smoking, drinking, working in a hospital, boxing or playing professional football, in the U.S., freedom of choice doesn’t equate to absence of risk. When it comes to those whose careers are spent in harm’s way, we hope accurate information, advice and education continue to be offered instead of opinions, obstruction and half-truths.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Heads Up! Concussions – Traumatic Brain Injuries, Part I

Neurology, Trauma, , , , , , ,

concussion-football

The really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing, or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame, and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.
A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes, ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia. (It’s important to note that not all blows to the head result in a TBI.) For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contribute to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.
Healthcare professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

Red Flags
Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty waking
  • Any loss of consciousness, confusion, or significant agitation
  • One pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to identify people, places, the date, or self
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

Click here for Part II, in which we discuss complications and treatment options.
Click here for Part III, in which a neurologist adds his thoughts.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Heads Up! Traumatic Brain Injuries (Concussions), Part I

Neurology, Trauma, Health Prevention, , , , , , , ,

concussion-football
Human Shark Week continues with a discussion about concussions.  The really interesting thing about concussions these days is many individuals seem to have convinced themselves that the risk of a concussion or even continuing in football, wrestling, boxing or MMA type activities after having had concussions won’t deter them from pursuing the glory, fame and fortune to be obtained in putting themselves at risk. That’s a fascinating but very flawed concept, as evidenced by the increasing suicide rate among concussed former athletes.
A traumatic brain injury (TBI) is caused by a blunt or penetrating head blow that disrupts some aspect of normal brain function. TBIs may produce changes ranging from brief alterations in mental status or consciousness to an extended period of unconsciousness or amnesia (It’s important to note that not all blows to the head result in a TBI.). For the purposes of this discussion, the majority of TBIs that occur each year are concussions. In terms of societal impact, TBIs contributes to a remarkable number of deaths and permanent disability. Every year, at least 1.7 million TBIs occur in the US.
Health care professionals may describe a concussion as a “mild” brain injury because concussions are usually not life threatening. Even so, their effects can be serious. Concussive symptoms usually fall in one of four categories:

  • Thinking/remembering
  • Physical
  • Emotional/mood
  • Sleep

Red Flags:
Get to the ER right away if you have any of the following danger signs after any type of head injury, no matter how minor it may seem:

  • Any difficulty being awakened
  • Any loss of consciousness, confusion or significant agitation
  • Have one pupil (the black part in the middle of the eye) larger than the other
  • Loss of ability to recognize people, places or inability to identify the date or themselves
  • Loss of motion or sensation, weakness, numbness or loss of coordination
  • Persistent, worsening headache
  • Repeated vomiting.
  • Slurred speech or difficulty with expression
  • Seizures
  • Kids will not stop crying and cannot be consoled
  • Kids will not nurse or eat

This afternoon, in Part II, we will discuss complications and treatment options.

Straight, No Chaser: Heads Up! Traumatic Brain Injuries (Concussion), Part II

Medical Treatment, Neurology, Health Prevention, , , , , ,

concussionboxing_facial__4_

Your son is a star in Friday Night Lights (actually football, not the TV show) and has been concussed.  Amazingly, the most common question I get asked is not “Will he be ok?”, but “When will he be able to get back on the field?”.   My answer, coming out the ER, is never going to be less than two weeks, and I won’t be the one who provides medical clearance.  It’ll either be your family doctor or preferably, a neurologist.  Don’t just take my word for it.  Consider the following Quick Tips from the Center for Disease Control and Preventions.
CDC’s Discharge Instructions

  • You may experience a range of symptoms over the next few days, such as difficulty concentrating, dizziness or trouble falling asleep.  These symptoms can be part of the normal healing process, and most go away over time without any treatment.
  • Return immediately to the ED if you have worsening or severe headache, lose consciousness, increased vomiting, increasing confusion, seizures, numbness or any symptom that concerns you, your family, or friends.
  • Tell a family member or friend about your head injury and ask them to help monitor you for more serious symptoms.  Get plenty of rest and sleep, and return gradually and slowly to your usually routines.  Don’t drink alcohol.  Avoid activities that are physically demanding or require a lot of concentration.
  • If you don’t feel better after a week, see a doctor who has experience treating brain injuries.
  • Don’t return to sports before talking to your doctor.  A repeat blow to your head-before your brain has time to heal-can be very dangerous and may slow recovery or increase the chance for long-term problems.

Finally, there are two particularly impactful consequences about which you should be aware.

  • The ‘second impact syndrome’ is irreversible brain injury triggered by a fairly routine second head impact after a prior concussion.  You must take the time off needed for the brain to heal.  I care more about your child’s mental future than the upcoming playoff game.
  • The ‘post-concussive syndrome’ represents long-term neurologic and psychologic consequences of the head injury.  It includes such symptoms as inability to sleep, irritability, inability to concentrate, headache, dizziness and anxiety.

There are no treatments for concussions other than prevention of an additional injury, and that fact should be chilling to you.  Be mindful of the risks involved in choosing to engage in activities putting the brain at risk.

Straight, No Chaser: The Drama of Motor Vehicle Trauma

Trauma, Health Prevention, , , , , , ,

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‘Tis not my task to preach but to inform.   Maybe you think you’ve heard it all before, but let me lay it all out for you so you can truly be an informed consumer.  Forewarned is forearmed.  There’s a reason you hear so much about drinking or texting and driving, wearing seat belts/helmets and speeding.  We have to kick off Human Shark Week with the biggest and baddest predator in the Trauma World: motor vehicle crashes.
Motor vehicle collisons are the single leading cause of death among those between ages 5-34 in the US.  More than 2.3 million adult drivers and passengers were treated in ERs as the result of being injured in motor vehicle crashes in 2009.   Let’s lay this out simply and review the risks, the consequences and preventative efforts you should be taking.
Risky Behavior: Danger is enhanced by various distractions and inadequate protection.  The mistake people make is not understanding that much of the danger is outside of your control – other drivers.  If you’re impaired or distracted, you can’t respond effectively.  I’ve seen it all.

  1. Drinking while driving – Stop it with the “I can handle my liquor” nonsense.  Someone dies every hour from drinking while driving.  It’s not just drunk driving, it’s impaired driving.  Your senses are altered and ability to respond diminished at any level of alcohol consumption and is incrementally more so with more consumption.
  2. Texting while driving
  3. Eating while driving
  4. Reading while driving
  5. Doing your hair/shaving/makeup while driving
  6. Kissing and other sexual activities while driving
  7. Motorcycle driving/riding without a helmet
  8. Letting your children drive without a license and/or formal training: it’s all too true.  Teens are most at risk for accidents and being impaired/distracted/drunk while driving.
  9. Letting your children ride in the front of the car
  10. Not wearing seat belts (the biggest mistake of them all)

Injuries:
I’ve seen nearly every conceivable injury from motor vehicle collisions.  It doesn’t take as much effort as you’d think to have a very bad life after a crash.  Consider the following possible going head to toe (and yes, the list is abbreviated)…

  • Traumatic Brain Injury, including intracranial bleeds, strokes, seizures, concussions, herniation and death…
  • Neck Injury, including fractures, strains, pinched nerves, temporary and permanent loss of motion/sensation in your extremities…
  • Chest wall bruising, heart and lung bruising, collapsed lungs, stab wounds to the heart and lungs, ruptured heart vessels…
  • Abdominal injuries, including contusions to and rupture of the liver, spleen, pancreas, diaphragm and intestines…
  • Genital, urinary and pelvic injuries, including the kidneys and multiple fractures…
  • Nervous, psychologic and musculoskeletal system injuries, including contusions, life-threatening fractures and dislocations, paralysis, facial disfigurement and other scarring, post-traumatic stress syndrome and long term pain syndromes.

Prevention:

  1. Seat belt use reduces serious injuries and deaths in crashes by 50%.  Air bags provide added protection but are not a substitute for seat belts in a crash.
  2. Wear a seat belt every time, every trip.
  3. Seat all kids under 12 in the back seat.
  4. Seat backseat passengers in the middle (it’s the safest spot in the car)
  5. Regarding any function on a smartphone, if you can’t be hands free, it can wait.  If you must use your hands, pull over.
  6. Remember designated drivers?  Yes, that’s still a thing.
  7. If you’re on a motorcycle, wear a helmet, every time, every trip.
  8. Protect your teen.  No license, no vehicle.  Consider driving school.

Impaired and distracted driving will cause you harm; it’s not an ‘if it’ll happen’ situation, it’s ‘when it happens’. Please consider the points I’ve mentioned and the lives of passengers/other drivers when deciding how you handle your vehicle.  Good luck.