concussions

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greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

"CTE took your mind but I still have your heart…"

Post by greybeard58 » Mon Feb 24, 2020 2:41 pm

"CTE took your mind but I still have your heart…"

Zac –

You told me you’d never leave me. But you did. I know you were just looking for peace. Yet sometimes I’m so sick with grief and sadness that I’m mad. I am mad that you’re not here. I am mad that I’m alone. I am mad at every person, moment and unknown that contributed to you developing that horrifying disease that ultimately took you from me and from the world.

The hardest part about losing you is trying to move forward in life, peacefully and happily when I still feel so broken inside.

I loved you so much that it’s impossible to describe. It was overwhelming. It started when we became really good friends in high school. I used to ditch fourth period just to go hang with you. It was my senior year, after you graduated, that we became more than just friends. Even when we were miles apart we spoke with such depth every night and our connection grew with each passing word. Our relationship wasn’t traditional and at times we kicked ourselves for it. But, as we always said, our story and our love was perfectly imperfect.

You were my safe space and my home. Affectionately, you called me by middle name, Winslow. You believed in me so ferociously.

You once wrote to me, “Just know someday you will always have my vote for you to become president. Please go out and change the world. I love you more than words can explain.”

That unwavering confidence in me scares me. What if I don’t achieve all you believed I would? What if I do something disappointing? What if I can’t carry on your legacy the way your legacy deserves to be carried?

You were my confidant and to this day you still hold secrets no one else knows. You made me feel strong and loved. I truly lost a part of myself when you left.

The night you died is still so fresh in mind. On December 19, 2015 I received a text from you at 12:24 am.

It read, “Thank you for everything. You have helped me through so much and never ever blame yourself for anything. I love you and will always be over your shoulder to look after you no matter what. Always keep having fun. Always remember me. Always keep striving for greatness, or should I say, first female president. Keep fighting for what you believe for. I love you, Winslow.”

My heart dropped into my stomach. I knew what was about to happen but I didn’t want to believe it. Shortly after, you shot yourself in the heart, not only to end your own suffering but also to help prevent others from suffering, too. You were only 24 years old.

Almost everywhere I go and everything I do there’s a reminder of you. Of us. Discovering new music on Spotify, ridiculous dance moves at the bars and watching a movie I’ve seen a hundred times all take me back to you and me.

I am angry at the disease in general. It began to develop likely long before I even met you. You started football in third grade. You loved football. You weren’t as big as the others but you were incredibly more powerful in your punch because you used your head. You weren’t afraid to do that.

One story I remember is you had this drill at practice and you went up against our very large friend, D. You definitely knocked him down and he was twice your size. You were determined and unafraid to go head-to-head with anyone on the field.

But as much as you loved football, you also felt betrayed by it. Because the disease torturing you stemmed from all the concussions you accumulated playing throughout your childhood and through high school.

There were so many late nights where you kept trying to articulate your pain and I kept trying to tell you to hold on. We used our connection and love for music to get you through the particularly rough nights.

You struggled to explain your disease. You had headaches and memory loss, among so many other symptoms.

I remember you told me, “I just don’t feel right, I don’t feel normal.”

You didn’t feel like you had control over your mind.

You went to different doctors, who gave you conflicting answers. One said it could be Bipolar Disorder. Another said you would end up homeless or in a mental institution. There were so many different answers, but no answers at the same time. So, you did your own research and accurately self-diagnosed yourself with Chronic Traumatic Encephalopathy, also known as CTE, a disease that results in changes in the brain in response to repeated hits to the head. Once you realized you had CTE you knew there was no cure and no way to even confirm your diagnosis until after you passed away. Nothing could be done and you knew your symptoms were not going to improve.

Before you died you wrote journals, documenting your disease. You also left behind a note, asking that your brain is donated to science to help researchers learn more about CTE. You did all this so you could lessen someone else’s struggle. And by the way, the researchers who examined your brain did confirm you had CTE.
I know you wanted me and your family to also help spread your message. You wanted us to tell your story and to warn and help athletes. I am proud to share with you that we started a foundation in your honor. It’s called CTE Hope. Our goals are to educate people about CTE and concussions, find ways to prevent CTE, and create better return-to-play protocol.

Now I am sure you want an update on my life, too. It’s been incredibly hard to navigate life without you. One minute I was embarking on a new chapter with you by my side, and the next I had the wind permanently knocked out of me. I became a three-legged table unable to keep steady. But I’ve had to learn. I’ve had to learn to be a three-legged table, if for no other reason than that’s what you wanted. I did it for me, but also for you because you couldn’t for yourself.

Do you remember that you specifically told me I would make it through law school and I couldn’t use you as an excuse not to graduate? Well, Zac, I not only graduated, but I also excelled in law school just as you expected. I won a national award, in part, because of the work you inspired. I interned for the U.S. Attorney’s Office. I got hired by a great law firm. I moved to New York City, something we always planned to do together. I survived (and passed) the bar exam. I traveled the world. But as great as all those things have been, nothing, I mean nothing has been easy. I always feel a slight sting of sadness because you’re not here to experience these moments with me.

You did tell me to move on and find someone great to spend my life with. Now, when I first read those words, I was annoyed and defiant – how could I ever find someone else? Well, a little more than two years after you passed I did find someone. He is a great person, who supports me and loves me and approaches my past and grief with such grace. I often wonder, did you send me this wonderful human? Do you approve? Do you even want me to ask that?

I still live in this constant state of guilt. I truly love my boyfriend. But I miss you every second of every day. How do I live with that? How do I reconcile these two extremely powerful emotions? It’s tough to grapple with the hard fact that you had to die for me to find him.

Even though I am living my life as you advised and honoring your life as you requested, there are so many questions I still have unanswered. And some days I’d rather crawl back in bed, shut my eyes, and remember what it was like to just lay on your chest and feel your steady breath under me. I’ll forever have a piece missing, a piece only you hold. I’ll never stop loving you, or missing you, or wishing you were here. But I have come to realize, no matter how broken I feel or how much I miss you, I owe it to both of us to live my life for myself.

I have to show the same strength you did and live the life we both deserve. I have to accept this forever new normal and let myself be happy, let myself move forward and free myself of the guilt. I have to be the best possible version of myself. Because by doing so, I honor you, I honor your legacy, and I honor the love we shared.

Zac, I would’ve done anything to heal you. Instead I am now doing what I can to keep your memory alive, while also trying to pursue my own joy in life. However I still can’t do that without you. I know you found your peace but as I move forward in life, I keep you close because it is still you that helps me find mine.

I’ll love you until the end.

Winslow


About the author:
Alison Epperson is a laywer in New York City. In 2018 she graduated from Case Western University School of Law Magna Cum Laude. She was also named National Law Student of the Year by the National Jurist. She is a co-founder of CTE Hope.

Alison Epperson writes an open later to her late boyfriend
Read more: https://theunsealed.com/cte-took-your-m ... our-heart/

CTE took your mind but I still have your heart…
Watch the video at https://www.youtube.com/watch?v=X70t8_w ... e=emb_logo

CTE Hope
https://ctehope.com

greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

‘You only have one brain’

Post by greybeard58 » Wed Feb 26, 2020 11:23 am

‘You only have one brain’

‘You only have one brain’: With Ryan McDonagh returning, ex-NHLers describe unknowns of concussion recovery
https://theathletic.com/1539554/2020/01 ... -recovery/

greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

"out with a concussion a majority of last year"

Post by greybeard58 » Thu Feb 27, 2020 6:58 pm

"out with a concussion a majority of last year"

Aria Van De Hei is a senior on the Bay Area Ice Bears girls’ hockey team, which is comprised of players from 11 area schools.

The team went through a stretch last season where it didn’t win in seven games. How does the team stay together during losing streaks?

"I was out with a concussion a majority of last year. We had good vibes in the locker room and made sure we worked as a team to get back to our winning ways."

Aria Van De Hei - West De Pere hockey, golf
Read more: https://gopresstimes.com/2020/01/15/nic ... ckey-golf/

greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

"It’s an invisible injury that nobody can see.”

Post by greybeard58 » Tue Mar 03, 2020 10:19 pm

"It’s an invisible injury that nobody can see.”

Fiona Tomas has been shortlisted for the Sports New Story of the Year Award for her investigation into female concussion.
https://www.societyofeditors.org/soe_ne ... -for-2019/


Nicola White winced as the needle pierced her forehead. The doctor calmly sunk another into her scalp. One by one, 31 injections of Botox penetrated areas around her head, temples and the back of her neck. It is another medicine to add to the long list of drugs, therapies and holistic treatments the British hockey Olympian has tried in an attempt to banish the migraines and daily headaches that stubbornly persist, 20 months after she sustained a concussion. The procedure is designed to calm nerves and sensory pathways around White’s brain. It cannot, however, erase the date permanently seared in her mind: Monday, March 12, 2018.
It was the day White’s life changed forever, when a player’s shoulder spontaneously rammed into her right temple during a Commonwealth Games warm-up match. Excruciating pain ravaged her jaw, she lost vision – but not consciousness – and felt dazed and confused. Astonishingly, she returned to the pitch and finished the remaining quarter of the game. Within a week, her health spiralled and in the months that followed, her flat morphed into a prison cell. “I went from being an Olympic champion to a bedridden nobody,” White says.

“I could barely lift my head off the pillow. My head was pounding, the room was spinning, I felt like I couldn’t communicate with my mum. I had a constant noise in my ears and in my head – like the old-school computer dial-up system – or when you come back from a night out. I felt really unwell and really frightened. I was like, ‘If I go to sleep, will I wake up?’ ”

Two months after the injury, White could not walk in a straight line, even to her local corner shop. She struggled with processing lists and the headaches and migraines became a daily nightmare. She was later told she was suffering from post-concussion vestibular migraines. What relief the diagnosis did provide was quickly abated by the harrowing reality that there is no quick cure, although there is a 75 per cent chance the Botox will be successful.

White’s prolonged recovery offers an insight into the chilling concussion epidemic gripping women’s sport. Last December, footballer Natasha Prior was forced to retire from playing for Canberra United in Australia’s W-League after suffering her fifth concussion at just 21. That same month, US Olympic track cyclist Kelly Catlin was concussed in a crash. In March, she took her own life, aged 23. Her family, who have donated her brain to research, spoke of her depression, among other behavioural changes, in the months before her death.

Concussion accounted for 19 per cent of all injuries during the 2017-18 Tyrrells Premier 15s season. The figure could be higher, as only six out of 10 clubs submitted data to the Rugby Football Union’s injury surveillance report.

Studies focusing on female collegiate athletes in the US have shown that women are more prone to concussion than men in comparable sports. Weakened neck musculature among females is commonly attributed, but one neurologist has delved even deeper to suggest why females have higher symptom severity and longer post-concussive recoveries.

“In concussion the head is struck, which causes rotational acceleration of the brain,” says Dr Douglas H Smith, vice-chairman of neurosurgery at the University of Pennsylvania. “What it means is that your brain is moving at a very fast rate and kind of deforms inside the skull.

“In concussion, we see damage to the axons, which are nerve cells in the brain and 100th the size of a human hair. Their tiny and fragile structure renders them particularly vulnerable to become damaged with the forces of concussion. Your brain can literally break with concussion, but down to the nanoscale. Given the same type of head impact, male axons are more likely to be on the side of recovery, where more female axons will be on the side of degeneration and dysfunction.”

Although a cranial osteopath helped White to understand the trauma from her concussion – likening her brain to an indented ping-pong ball – she slumped into a six-month depression. “You know in Alice in Wonderland when she goes down the rabbit hole? I was thrown into a dark, warped world where all your senses are just confused and not really aligned with reality,” she says. “When you take sunlight and time away, you’re sleeping 15 hours a day. I didn’t want to be awake because I was in so much pain. You just lose all perception of what’s real. When you do open the curtains, I didn’t know if it was bright or dark, and if I stepped outside, I didn’t know if that pavement was high or low, or if it was loud or quiet.”

In her desperation, she reached out to former England rugby player Kat Merchant, who was forced to retire at 28 after experiencing 11 reported concussions in 14 seasons. Merchant, who puts her career longevity down to the isolated nature of being a winger, is confident the number could be higher. When she was concussed playing for Saracens in 2013, she demonstrated the fencing response, an unnatural extension of the forearms which are flexed in the air when a person is knocked unconscious.

“All I remember was running up to hit the girl and her hip bone hit my temple,” recalls Merchant. “I was knocked out in the air – the photographer caught the moment – you can see I’ve slumped and my eyes were gone. I was convulsing and choking on my gum shield and couldn’t breathe. One of my team-mates thought I was dead.”

Merchant’s recovery became more challenging with every passing concussion. Bright lights were off limits, she felt nauseous walking up stairs, she called people the wrong name. A year out from the 2014 World Cup, the pressure to return to the pitch was unbearable. “I’d almost be crying at the thought of making an omelette,” she says. “I just couldn’t do it. I couldn’t process it. I had to do things one by one and not be distracted. My mood changed, I got aggressive, I got snappy, my personality changed as well. I could see it happening but I couldn’t do anything about it.”

The disparity between White’s 18-month lay-off from a single blow to the head and Merchant’s repeated comebacks after a dozen suggest the need for more gender-driven research among post-concussed female athletes.

“We really should be thinking about treating concussion and higher levels of traumatic brain injury according to the person’s sex,” Smith argues. “We have to consider that there’s not one type of concussion, and we can’t assume under the umbrella of concussion that men and women are going to be the same.”

A study published in the Journal of Neurotrauma in July last year – believed to be the first of its kind to examine sex differences in the length of recovery among concussed US collegiate athletes – found that female athletes on oral hormonal contraception reported lower symptom severity from concussion than females not on contraception. The decline in female reproductive hormone levels caused by oral contraception was thought to provide a protective layer following concussive injuries. Other research in July this year published in Frontiers in Neurology identified a nine-day window in the late luteal phase of a woman’s menstrual cycle – from ovulation until the first few days of menstruation – where a woman was more vulnerable to concussion.

“People are starting to ask the question as to whether contraception influences post-concussion recovery rates, or if women are more susceptible to concussion at various points in the menstrual cycle,” says Dr Steve Broglio, professor of neurology at the University of Michigan.

White was not taking oral contraception at the time of her concussion and cannot remember if she was on her period, but her migraines and headaches are more pronounced during the first few days of menstruation. Merchant, too, has no recollection of menstruating during any of her reported concussions. She took doctors’ advice and retired after recovering in time to play in the World Cup. “One of them said, ‘We don’t know what the next knock will do to you’, ” she says.

White has hopes of returning to hockey, but is equally determined to better the understanding around concussion and flag potential mental health issues which can surface in the aftermath. “Nobody would know I’m ill,” she says. “They’d probably think, ‘She looks fine, she could go out and do 10 cartwheels. I probably could, but I’d be feeling ill afterwards. It’s an invisible injury that nobody can see.”

Case study: Cycling

Two-time Olympic pursuit champion Elinor Barker believes awareness around concussion is growing in the peloton six months after British Cycling implemented a new Mental Health Strategy to support the well being of its riders.

Barker said her recovery was “much quicker than expected” after sustaining a concussion at the RideLondon Classique women’s race in August. The 25-year-old rode a static bike for 15 minutes on the first day of her concussion protocol a week after the crash, having had surgery for a broken collarbone that she suffered in the incident.

“Concussion is taken a lot more seriously now than when I first started cycling,” Barker told Telegraph Sport. “There’s posters everywhere in the velodrome, it’s all in the changing rooms, it’s drilled into us now. Whereas I don’t think it’s been really been taken seriously in the past.”

Concussion remains a hot topic in cycling after two-time US Olympic track champion Kelly Catlin took her own life in March this year, just three months after being concussed in a crash last December. Her family has dedicated her brain to research in the hope of finding answers as to whether behavioural changes in the aftermath of the incident may have contributed to her death.

Barker, who did not lose consciousness at the time of her concussion, added: “British Cycling have a return protocol and they were really strict with it. I think you need someone else to be strict with it because it’s always hard to make that decision yourself. I’m quite grateful for that even though it was very frustrating.”

British Cycling’s Mental Health Strategy was implemented in May by Dr Nigel Jones, who joined the body two and a half years in the wake of the Cycling Independent Review which found British Cycling had created a “culture of fear” in its relentless pursuit of medals.

“Traditionally concussion was managed by the idea you had to rest for seven days, or 14 days, or 21 days. But they were just arbitrary numbers plucked out of the air,” said Dr Jones. "In the same way you wouldn’t say that every ankle injury would definitely be better within 14 days, for example, you would go through various stages of rehabilitation and tick all of those off before you progress to the next one. That’s what we are now doing with concussion management.”

Concussion in Women
Read more: https://www.telegraph.co.uk/womens-spor ... ortswomen/

Two sidebar articles

Why Female Brains Are More Prone To Damage By Concussion
• Concussion causes damage to the axons, which are nerve cells in the brain. Their tiny and fragile structure renders them particularly vulnerable to become damaged during a head impact.
• Male axons are quite a bit larger in diameter and have a more complex structure than female axons, which are much finer and prone to breakage of microtubules – tiny train tracks which run longitudinally inside each axon and are stabilised by a protein called TAU.
• Under rapid stretching conditions that occur in concussion, microtubules slide past each other. TAU proteins cannot unfurl fast enough to keep up, causing the microtubules to rupture. This damage to the axon’s train tracks derails transported protein cargoes, which pile up and form swellings along the axon, leading to degeneration and death of some axons.
• In addition, an influx of sodium and calcium ions disrupt electrical signalling inside the brain.
• Given the same type of head impact, female axons have much more microtubule breakage and a greater influx of ions than male axons. The pathological soup this creates pushes female axons towards degeneration and dysfunction, rather than recovery.
Dr Doug Smith, vice-chairman of neurosurgery University of Pennsylvania

The Debilitating Effects Of Concussion | 10 Sportswomen Who Have Suffered
Kat Merchant, England rugby player
Suffered 11 concussions in 14 seasons. Was offered a professional contract in 2014 after winning World Cup but retired aged 28 on doctors advice.

Nicola White, England hockey player
Concussed in Team GB’s last Commonwealth warm-up game in 2018. Since diagnosed with post-concussion syndrome and has been out of action for 20 months.

Kelly Catlin, former America cyclist
Suffered concussion last December in cycling accident, two months later she killed herself in her apartment at Stanford University. Her family believe behavioural changes sent her life into tragic tailspin.

Eugenie Bouchard, Canadian tennis player
Slipped on wet locker room floor at 2015 US Open which forced her to miss rest of season. Ranking has plummeted to world No 220 since.

Natasha Prior, former Australian footballer
Suffered fifth concussion in six years after an elbow to the head during a match last December. Retired at 21. “I didn’t really want to have dementia at the age of 30. It’s been a hard journey.”

Casey Dellacqua, former Australian tennis player
In desperation to retrieve a ball at China Open in 2015, she tumbled and hit head on hard court. She was sidelined for nine months and then later hastened decision to retire. “I just felt like I was never the same.”

Briana Scurry, former American footballer
Retired in 2010 after career-ending brain injury sustained playing football. The 1999 World Cup winner endured health difficulties and had occipital nerve release surgery in 2013.

Doris Schweizer, Swiss cyclist
Crashed into wall at 2015 Giro Rosa and four years on still has extreme headaches, vertigo or difficulty concentrating. “I would have preferred that I had broken 100 bones,” she said.

Shona McCallin, England hockey player
Clattered in head by opponent during England match earlier last February, Rio Olympics gold medal winning was sidelined for 10 months. “Planning and trying to live a normal life was impossible.”

Ashley Wagner, former American figure skater
Three-time US champion suffered several concussions and believes incidents affected her cognitive abilities. Said she lived in “silent terror” after injuries.

greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

CDC Reports Suicide is Top Cause of Death Tied to Traumatic Brain Injury

Post by greybeard58 » Thu Mar 12, 2020 11:00 am

CDC Reports Suicide is Top Cause of Death Tied to Traumatic Brain Injury

In a new report issued by the Centers for Disease Control and Prevention (CDC), the CDC reported that suicide is the top cause of deaths tied to traumatic brain injury. The CDC reported there were 61,000 traumatic brain injury linked deaths in 2017 and that nearly half of these deaths were caused by suicide.

CDC Reports Suicide is Top Cause of Death Tied to Traumatic Brain Injury
Read more: https://www.natlawreview.com/article/cd ... ain-injury

Death Rates Due to Suicide and Homicide Among Persons Aged 10-24: United States, 2000-2017
Read the study at: https://www.researchgate.net/publicatio ... _2000-2017

greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

Children consider suicide more than their caregivers think

Post by greybeard58 » Mon Mar 16, 2020 8:33 am

Children consider suicide more than their caregivers think

Children consider suicide more than their caregivers think
About 8 in every 100 kids who are 9 or 10 years old think about suicide or act on those ideas, a new study of nearly 8,000 children across the U.S. concludes. Their caregivers were aware of fewer suicidal thoughts, plans, or attempts — 107 attempts reported by kids versus 39 by adults — raising alarm that such distress might be overlooked. Suicide is the second-leading cause of death in children 10 to 14 years old, and over the last 10 years, emergency visits and hospital stays for children who thought about or tried to die by suicide have doubled. The strongest risk factors are kids' psychological problems and family conflict. Also a risk: more screen time.

Risk and protective factors for childhood suicidality: a US population-based study
Read the study at: https://www.thelancet.com/journals/lanp ... 3/fulltext

greybeard58
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Joined: Sat Aug 21, 2004 11:40 pm

Memory and Brain Lab looking at impacts of concussion on college-age students

Post by greybeard58 » Thu Mar 19, 2020 12:46 pm

Memory and Brain Lab looking at impacts of concussion on college-age students

"Despite the fact that the undergraduates average more than four years since their concussion, they do not perform as well as their peers who have never had a concussion.”

It may come as a surprise that the Centers for Disease Control (CDC) estimates there are more than three million concussions each year in the United States alone. Concussion, or mild traumatic brain injury (mTBI), is commonly caused by accidents, falls, car crashes, and other traumas. It refers to a hit to the head that causes the brain to bounce back and forth within the skull. At the neural level the jolt causes the neurons to stretch, with some of them stretching to the point of breaking.

Diagnosis of concussion is through clinical interaction, as there is no reliable lab test or accurate imaging protocol that can detect concussion. Loss-of-consciousness is not required for a concussion diagnosis, although it does often occur. The physical symptoms associated with concussion include headache, sleep disruption, brain fog, attention and memory difficulties, and greater emotionality. After a few days of rest, symptoms tend to subside and people are expected to slowly return to normal activities. The expectation is that within a few months all symptoms and cognitive effects will return to normal. However, new findings suggest that maybe recovery does not mean pre-injury ability.

Recent research in my Memory and Brain Lab has asked whether there may be lasting consequences of concussion. My research team, with work lead by graduate student Hector Arciniega, and long-term undergraduate research assistant Alexandrea Kilgore-Gomez, is asking this question because many of our students report having experienced head injury from skiing, horseback riding, bike accidents, and life in general.

Over the last few years we have tested more than 225 undergraduates with a history of concussion over their lifetime. Students come to the lab and complete computer tasks asking them to remember a few items for a brief amount of time. For example, participants might see one to three colored squares briefly flashed. Then, after a brief delay they would be asked to report whether one test square changed its hue or not.

Despite the fact that the undergraduates average more than four years since their concussion, they do not perform as well as their peers who have never had a concussion. We see general performance impairments in the concussion group when we test them on many kinds of visual working memory and visual attention tasks.

It is troubling to see that performance deficits emerge when participants are asked to hold onto three things for only .5 seconds. This pattern of impairment so long after concussion is particularly troubling for undergraduates because working memory is needed for problem solving, manipulating information, and even reading. All of these tasks may make being an undergraduate even harder for these students.

This semester, undergraduate students Joseph Castellanos and Olivia Hall are beginning research to determine whether students with a history of concussion are more likely to change majors or classes, or whether they need to study more, or in more quiet areas. We suspect lasting effects might be even worse in the general population.

Our current work is understanding the neural changes associated with behavior differences. Our long-term goal is to develop interventions that improve performance in students with a history of concussion. This work is supported in part by generous funding from the Tahoe Institute for Rural Health Research.

Prevention of head injury is important. Please remember to always wear your helmet while skiing and biking, to childproof your home effectively, and to place reflective tape on stairs to avoid falls in older adults’ homes.

Memory and Brain Lab looking at impacts of concussion on college-age students
Read more: https://www.unr.edu/nevada-today/blogs/ ... jury-month

greybeard58
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Help is here

Post by greybeard58 » Thu Mar 26, 2020 1:09 pm

Help is here

These are trying times for all, but the effects can be especially straining for those experiencing lingering concussion symptoms.

Managing Post-Concussion Syndrome in a Time of Coronavirus

In an unfamiliar new era of social distancing, those who are experiencing lingering symptoms from a concussion may feel these changes to daily life even more than most. Perhaps you're unsure whether you'll be able to access the medical services in your community as you normally would for your treatment. Perhaps the social distancing protocols are making an already isolating recovery feel even more isolating. Perhaps you’re feeling heightened anxiety.

Join Concussion Legacy Foundation co-founders Chris Nowinski, PhD and Dr. Robert Cantu, psychologist Dr. Shannon Albarelli, and PCS survivors James Schorn and Gracie Hussey to learn what you need to know about managing Post-Concussion Syndrome in a time of Coronavirus.

Mar 27, 2020 04:00 PM in Eastern Time (US and Canada)

Register at: https://zoom.us/webinar/register/WN_ExB ... qAvsFsDgnw

greybeard58
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"The U.S. needs a nationwide registry for traumatic brain injury registry"

Post by greybeard58 » Mon Mar 30, 2020 8:26 pm

"The U.S. needs a nationwide registry for traumatic brain injury registry"

The congressional Brain Injury Task Force, co-chaired by Reps. Bill Pascrell Jr. (D-N.J.) and Don Bacon (R-Neb.), spoke to hundreds of people gathered at the Rayburn House Office Building last week. The crowd included brain injury survivors, caregivers, advocates, policymakers, and various divisions of the health care industry to discuss a growing public health crisis.

One area of focus was the development of a national traumatic brain injury registry, a vital step for getting a handle on how best to manage this difficult-to-treat condition.

Traumatic brain injury (TBI) is usually caused by a blow or jolt to the head that disrupts the brain’s normal function. It can be mild and temporary or severe and life-altering. Individuals who sustain a TBI often suffer from a cascade of health conditions, including problems with movement and sensation, anxiety and depression, epilepsy, sleep deprivation, personality changes, alcohol or opioid abuse, and memory loss.

Members of the military, athletes, children, and the elderly are especially prone to TBI. More than 100 U.S. soldiers suffered brain trauma after Iran’s missile strike on Al Asad Air Base in western Iraq. And it disproportionately affects vulnerable populations, leading to sociologically damaging results at an increased and alarming rate: 53% of homeless individuals, more than 65% of prisoners, and up to 75% of women experiencing domestic violence.

Traumatic brain injury places a massive personal and economic burden on the United States and other countries, with an estimated $80 billion in lifetime costs in the U.S. alone. Since 2006, the number of TBI-related emergency department visits, hospitalizations, and deaths has increased by 53% to nearly 3 million, of which more than 837,000 were among children. And just last week the Centers for Disease Control and Prevention reported that since 2008, the number of TBI-related deaths from falls increased 17%, mainly in the elderly.

I’ve been working in neuroscience research for more than 20 years and am appalled at how this devastating condition is often overlooked and poorly resourced.

The need for a nationwide traumatic brain injury registry
To better address this public health issue, the Department of Health and Human Services must create a national TBI registry. That would help improve research and treatment in many ways.

Management guidelines for TBI haven’t been updated since 2008, and current treatments do little to help those living with its long-lasting effects.

A rudimentary tracking system exists, but it is decentralized and relies on states and regions to construct their own registries. That makes it difficult to get comprehensive data on TBI.

A centralized, nationwide TBI registry would collect and collate data on thousands of TBI patients — and ideally all of them. It would include how they were injured, how they were treated, the outcomes of this treatment, and the long-term effects of both the injury and the treatment.

This kind of data could galvanize the development of updated clinical treatment guidelines, standardize care across the country, and drive clinical trials that lead to breakthroughs and innovation. It would also give individuals living with traumatic brain injuries and their families better information for navigating the disjointed health care system for TBI care and support.

I am heartened that there is support in Congress for such a registry. During the Brain Injury Task Force hearing in Congress, which was sponsored by the Brain Injury Association of America, Pascrell said that Congress is “working to develop a national TBI registry so brain injury survivors and loved ones can access adequate care and provide proper protocols.”

It is imperative that this registry be accessible from 360 degrees of care: clinical researchers, physician specialists, patients and patient advocacy groups, the Departments of Defense and Veteran Affairs, and other stakeholders.

The ultimate goal of this registry would be to find a cure for traumatic brain injury, something my company, SanBio, has been working to do using an experimental stem cell therapy that aims to treat paralysis, uncontrolled movements, and other motor deficits that often accompany TBI.

A centralized national TBI registry would provide a resource to accelerate knowledge sharing across organizations and state borders, which is essential for easing the effects of traumatic brain injury.

To overcome the devastating effects of this trauma, we need to make resources and research accessible at a national level. The millions of Americans who sustain TBIs each year — including those serving in the military and some of the most vulnerable members of society — depend on us to do so.

Keita Mori is the president and co-CEO of SanBio, a regenerative medicine company headquartered in Tokyo and Mountain View, Calif.

The U.S. needs a nationwide registry for traumatic brain injury registry
Read more: https://www.statnews.com/2020/03/11/us- ... in-injury/

greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

"Dr. Tator's own research shows people who've had multiple concussions are more impulsive."

Post by greybeard58 » Sat Apr 04, 2020 8:39 am

"Dr. Tator's own research shows people who've had multiple concussions are more impulsive."

A leading concussion expert says suicide attempts are much more common among people suffering from concussions than many realize, but are preventable if patients get the proper care.

"This issue of suicide is always looming," said Dr. Charles Tator, director of the Canadian Concussion Centre at Toronto Western Hospital. "We're always worried about it because we do know that some people do commit suicide after suffering from this."

The family of Taylor Pryor, 21, who died by suicide last October — a year after suffering a concussion during a soccer game — is calling on the province to provide better care for those suffering from mental health issues.

Pryor's family says her demeanour drastically changed after the concussion. She went from being a motivated university student to suddenly exhibiting severe post-concussion syndromes like anger, lethargy and sensitivity to light.

Pryor attempted suicide at least 22 times before her death.

"We should be more active in our management of concussion and this terrible episode is a reminder of what we need to do," said Dr. Tator.

Suicide related to impulsivity, says researcher

There are about 80 different symptoms of post-concussion syndrome, said Dr. Tator, including headaches, dizziness, memory problems, anxiety, depression and post-traumatic stress disorder.

When it comes to suicide, Dr. Tator's own research shows people who've had multiple concussions are more impulsive.

"The usual breaks that someone has that says, 'No, don't commit suicide' aren't there. So when the impulse arises … they can't resist the impulse. So that sort of makes it doubly sad."

According to one 2016 study published in the Canadian Medical Association Journal, "adults with a diagnosis of concussion had an increased long-term risk of suicide."

The 20-year study looked at more than 235,000 patients who had suffered a concussion on either weekends or weekdays — 667 of those patients died by suicide. The study notes those who suffered concussions on weekdays were three times more likely to die by suicide than the general population.

The authors write that care providers need to pay more attention to the long-term care of concussion patients "because deaths from suicide can be prevented."

Concussion care 'a team sport'

For Dr. Tator, that means creating a multidisciplinary support team for each person experiencing long-term concussion symptoms.

Changes in personality — like the ones Pryor's family saw in her — are very common, Dr. Tator said.

"Symptoms of that type can occur after a concussion, especially if their symptoms aren't being taken seriously let's say by practitioners or even family members. They can become even worse," he said.

Dr. Tator said long-term care includes counselling, antidepressants, cognitive behavior therapy, handling sleep disorders and sleep deprivation. For that to happen, he said you need a support team, not just one doctor.

"Concussion is in itself a team sport. It's not just the [medical doctor], but it's the social worker. It's the occupational therapists, the physiotherapist," said. Dr. Tator. "It can't be the [medical doctor] alone. By its very nature, it needs to be multidisciplinary."

Pryor's family said she saw at least 13 psychiatrists and five other medical doctors in less than a year.

A month before she died, a community support plan was drawn up, saying Pryor should be brought to Victoria General Hospital urgent care during a crisis. Pryor was four days away from entering dialectical behavioural therapy at the Selkirk Mental Health Centre when she died.

Her family said there was no mention of any multidisciplinary support.

"Everyone refused to acknowledge the concussion," Taylor's father Doug said. "We kept asking for a neuro-psych consult, and we just kept getting stonewalled again and again."

Family support is key, says advocate

A big part of helping someone with post-concussion syndrome is showing support, according to the Manitoba Brain Injury Association (MBIA). Their support groups help partners and spouses show support for someone going through behavioural and personality changes after injuries — including concussions.

"It relates to the frustration of being in pain," said Yinka Abiola, who helps advocate for people with brain injuries.

"They can get aggressive about anything, or knowing you can't even remember what happened for a long time...that can lead to depression, because you're not the same person you were before the concussion."

Abiola said it's not easy for people with brain injuries to navigate Manitoba's healthcare and work compensation systems — it's what she spends most of her time doing at work. Her best advice is to be relentless or seek out help from an advocate.

"What I've learned with the MBIA is that whenever an organization with a name advocates for someone, then they tend to take it seriously," she said. "But if it's an individual, they don't take it seriously."

Post-concussion treatment, suicide prevention 'a team sport,' says lead researcher
Suicide attempts common in post-concussion patients, says Dr. Charles Tator of the Canadian Concussion Centre
Read more: https://www.cbc.ca/news/canada/manitoba ... -1.5491646

greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

"And the sad part is, Taylor is not the only one. There will be more Taylors"

Post by greybeard58 » Fri Apr 10, 2020 3:27 pm

"And the sad part is, Taylor is not the only one. There will be more Taylors"

It was on a clear and warm autumn day in 2018 that Taylor Pryor's life began a spiral toward a tragic end.

She collided mid-air with a fellow soccer player — both jumping for the ball — during a game with the women's soccer team at the Canadian Mennonite University in Winnipeg.

Taylor didn't lose consciousness, but she sustained a concussion. Soon, everyday tasks became a struggle.

"We knew things weren't right. She wasn't the Taylor we knew," said her mother, Darseen.

"She was there, but she wasn't there. She had a vacant look on her face."

Severe concussion symptoms — anger, sensitivity to light and lack of concentration — soon began to surface, her family said.

About four months later — in February of 2019 — she made her first suicide attempt.

In the months that followed, Taylor saw at least 13 psychiatrists and five other medical doctors. Often she waited hours to be seen — in one instance it took 70 hours as she was bounced between three different facilities until she was finally admitted. She attempted suicide at least 22 times.

On Oct. 17, 2019 she was discharged — against her wishes — from Victoria Hospital. She went missing and two days later, searchers found her body in a treed area a short walk from the hospital.

The 21-year-old was mere days away from being admitted to a long-term program.

"I am still having a hard time believing this happened," said Darseen. "I am in disbelief that it did and how she was treated. I was just appalled."

She and Taylor's father, Doug Pryor, say there was no co-ordination or continuity of care, medical staff at times contradicted each other, and a community support plan put in place the last month Taylor was alive wasn't followed.

The family said they decided to come forward with their painful story in hopes of preventing others from falling through the cracks in the medical system like Taylor did.

"I have frustration and anger to how Taylor was treated. It just breaks your heart. She wasn't treated as a person. She was treated as an illness," said Doug.

"We need accountability for what went on," said Darseen, and "some answers as to why this happened."

Happier days

Taylor's family, including her two sisters, describe her as a fun-loving ball of energy who was enthusiastic about life and people. Those close to her say she was a "mover and shaker," someone destined to make a difference.

One video in particular captures what family and friends say was the essence of Taylor — a woman of deep faith on fire to change the world.

Filmed while she was doing missionary work in Guatemala in 2017 through the Canadian Mennonite University's Outtatown program, it shows Taylor inviting people to worship as she testifies to her faith.

Taylor was taking courses in international development in 2018, with a dream of improving the lives of people and children who were poor and outcast.

But that drive, and her outgoing personality, changed after her concussion.

"We started to see things like anger really come out of her. Her personality changed and so did her language. This was not our daughter," said Doug. "She wouldn't hurt a fly."

Taylor also experienced lethargy, double vision and was having difficulty hearing.

A doctor from Sport Manitoba advised Taylor to stay out of classes for three weeks, and to stop playing sports, driving and using computers.

But she continued to have trouble sleeping and was plagued by headaches. Her life unravelled as she found she couldn't keep up with her studies.

Repeated admissions

In February 2019, Taylor was rushed to Grace Hospital by ambulance from her university residence after a suicide attempt.

After a 17-hour wait, she was transferred and admitted to the psychiatric ward at St. Boniface Hospital.

It was her first admission for an attempted suicide.

She spent two weeks on the ward, before being released and going back to university.

The family decided it would be best for one of them to relocate from Portage la Prairie, Man., to live with Taylor in Winnipeg, to make sure she was safe. Darseen rented an apartment and moved in with Taylor. They got her a dog.

But weeks later, Taylor was forced to drop out of university because she could no longer function or keep up.

Over the next six months, she would be admitted another 13 times at three different hospitals: Victoria, Health Sciences Centre and St. Boniface. Darseen says there were multiple instances when Taylor was restrained, sedated or isolated because she was showing aggressive behaviour.

"She would get violent but it was only in retaliation of what they would do to her — wrestle her and hold her to give her a shot," said Doug. "The first thing you would do is defend yourself."

There were also six visits to the Crisis Response Centre, a 24-hour facility for those in mental health crisis.

During it all, at least 13 psychiatrists and five other medical doctors were involved in her care, her family says. And in many instances, she waited hours to be seen, likely because Taylor wasn't classified as a medical emergency, like someone having a heart attack might be, the family says.

In one instance, she had a 70-hour wait between three different care facilities before being admitted into care.

Those long waits caused Taylor's agitation to escalate, Darseen says.

Waiting in noisy, chaotic ERs was "pretty brutal," she said — and staff seemed solely focused on settling Taylor down and sending her home.

"But that didn't work for Taylor. There were many times they would release her and within 24 hours she would be back in the hospital or attempt suicide, or I would call 911."

In one incident,Taylor's sister saved her during a suicide attempt after she left from St. Boniface ER.

In another instance in August of 2019, a passerby found Taylor lying in the middle of the road on William Street after she was discharged from the Crisis Response Centre. Police picked her up and took her to the Health Sciences Centre ER.

No plan

Such transitions between units, facilities and from facility to home can be quite risky, said Laurie Thompson, executive director of the Manitoba Institute for Patient Safety.

"Those are points in care we really need to pay attention to in terms of supporting that family and that patient, so they are safe," she said.

Continuity of care is "absolutely critical" to patient safety, said Thompson. Not only does it build confidence between patients and their families with the health care team, it can ensure patients get treated faster and better because medical teams aren't repeating treatments that didn't work. It can also save lives.

"People fall through the cracks. And that appears to be what happened in this situation," she said.

"We didn't even see continuity in the same hospital," said Doug. "On one admission she would have a doctor who would have her meds up here. And she would come in a week later and be admitted again, and the doctor would say no, that it needs to be this … and then a different doctor would change it again."

While Doug and Darseen say there were several well-intentioned nurses and doctors in the system who were genuinely committed to helping Taylor, there was one psychiatrist in particular who they believed actually caused more harm than good.

They say the psychiatrist told them in the presence of a hospital employee that Taylor "needed a place to deregulate, and that place would be jail."

"I was dumbfounded," said Darseen, who herself has worked for almost 30 years as a nurse in health care, including in emergency departments. "I honestly had no words for what I was hearing."

That psychiatrist also suggested Taylor may have borderline personality disorder, but there was no consensus. Other psychiatrists were convinced she was severely depressed and anxious.

More than once the family said they were told by health-care professionals that Taylor was responsible for her own safety.

"You have a person who has received a head injury and they aren't thinking correctly. How can they keep themselves safe?" said Doug.

"That's why she was in the hospital. She didn't trust herself. She needed protection from herself, and they didn't protect her."

Thompson agrees.

"What we say is everybody is responsible for patient safety. It is not solely up to the patient, in my view. It's a partnership, a team."

The constant stress of not knowing whether Taylor was safe, and where she was, "was just devastating for us," said Darseen.

She and Doug also grew frustrated with the unwillingness of some health-care professionals to share information about Taylor.

"Some were really good, and some [were] just, like, 'We can't do that. We can't give you that information because she is 21. I will have to ask her.'"

They had meetings with members of her medical team at hospitals to discuss her care, and say they felt alienated at times.

"We almost felt like the enemy in some cases," said Doug. "We wanted to help but we didn't feel always invited into that circle to be part of her care."

Last discharge

Taylor's family says the fragmented care sent a devastating message to her. The more people she saw, and the more often she had to tell her story, the worse she got.

She was hanging onto the hope that she might get admitted to the Selkirk Mental Health Centre for dialectical behavioural therapy — a type of psychotherapy aimed at helping patients regulate emotions and deal with harmful behaviours.

Though the family was warned about long waits for the program, Liberal MLA Jon Gerrard helped them get an earlier admission — reducing a six-month wait to two.

Meanwhile, a community support plan was finally drawn up in September of 2019. Victoria General Hospital urgent care was designated as the place Taylor would be taken in crisis, and she was assigned a psychiatrist and nurse therapist there.

Her parents say they were relieved there was finally a plan in writing — but it wasn't followed.

"When we would call paramedics, they would tell us that [Victoria Hospital] was not in their region. 'We have to take her to the Grace,'" said Doug.

On Oct. 16, 2019, Taylor was taken to Victoria hospital for the last time. It was almost a year after her concussion. She was seen by psychiatry and kept overnight.

Later on the 17th she was discharged — even though her family said Taylor did not want to leave. She was four days away from being admitted to the Selkirk treatment centre.

A social worker stated that Taylor was 21 years old and was free to go without her mother, Darseen says. Taylor walked out and scaled a fence on Pembina Highway, between Markham Road and Thatcher Drive.

Her mother tried to follow in her car, but lost sight of Taylor when she went into a wooded area at the University of Manitoba.

It was the last time she saw her daughter alive.

Over the next two days, police — along with members of the community, the Pryors' church and the university — scoured the area for Taylor.

"It was a parent's worst nightmare," said Doug. "To lose your daughter and not know if you are going to find her or not — to find her alive or not."

Her body was found by one of the searchers.

The Pryor family believes Taylor would be alive today if she had been kept at Victoria Hospital for the four days before she was set to be admitted to the Selkirk treatment centre.

"She wanted to live. She wanted to go to Selkirk," said Darseen, but her daughter "was at the end of her own self.

"There are many times we would hear her cry out, 'I can't do this anymore. I can't do this anymore.'"

Who is responsible?

The Pryor family blames an underfunded health-care system that they say is profoundly broken, with departments and wards operating in silos.

"And the sad part is, Taylor is not the only one. There will be more Taylors," said Doug.

There have been similar cases in the past, too.

As they were trying to get help for Taylor, the Pryors connected with the Bricker family, whose son Reid died by suicide in October 2015, shortly after being released from the hospital he went to for help. It was the third time in 10 days Bricker had been discharged from a Winnipeg hospital following suicide attempts.

In a written statement sent to CBC, the Winnipeg Regional Health Authority says its quality improvement and patient safety program is currently conducting a comprehensive review of Taylor's case.

"All aspects of Ms. Pryor's care are included in the review process," the health authority said. "Ms. Pryor's death is a tragic and devastating loss and our sympathies continue to be with her family and friends."

But Doug and Darseen think Taylor's death should be investigated as a critical incident.

Under Manitoba legislation, a critical incident is when a patient dies or is seriously harmed by an unintended issue related to their care in hospital — such as mistaken medication dosages or breakdowns in communication resulting in serious harm.

Doug and Darseen met with the patient relations officer at Victoria Hospital. They obtained medical records from them, as well as St. Boniface and the Grace. They are still waiting on documentation from HSC and the Crisis Response Centre.

They have also met with the head of patient safety and quality improvement with the WRHA and plan to meet with an independent psychiatrist who can help them understand what happened in Taylor's last couple of days, and other incidents leading up to it.

The family also sent a written request to the Office of the Chief Medical Examiner, asking for an inquest into systemic issues — such as why patients with a history of suicide attempts are stabilized and released with no where safe to go, why effective treatment approaches aren't available in a timely manner — all in hopes of preventing a similar death in the future.

In December, Manitoba Health Minister Cameron Friesen reached out to the Pryor family, saying he wanted to hear about what changes they recommended. They met with him in January.

While their faith in the health-care system has been shattered, they have a new glimmer of hope that the system will be changed -- and that Taylor's life-long mission of making a difference will be realized.

"We believe Taylor is going to continue to change this world. That is what she wanted. That's who she was," said Doug.

"She was a world-changer. And even though she isn't here with us right now, she will continue to change this world so others won't have to suffer the way she did."

Broken, fragmented health-care system failed daughter who died by suicide, family of Taylor Pryor says
21-year-old, who died last year, was repeatedly admitted to, discharged from hospital after suicide attempts
Read more: https://www.cbc.ca/news/canada/manitoba ... -1.5473904

greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

suicide hot lines

Post by greybeard58 » Fri Apr 10, 2020 10:36 pm

do to the stressful situation caused by the virus if you need help here are some numbers
Minnesota Suicide Hotlines
APPLE VALLEY

Crisis Line

Dakota County Crisis Response

24 hours / 7 days

(952) 891-7171
(952) 891-7202 TDD

BRAINERD

Serving Aitkin, Cass, Crow Wing,
Morrison, Todd, & Wadena Counties


Crisis Line & Referral Service
24 hours / 7 days

(218) 828-4357 (HELP)
1-800-462-5525

DULUTH

Arrowhead Region - Northeast

24-Hour Crisis Line

Miller-Dwan Medical Center

24 hours / 7 days

(218) 723-0099
1-800-720-3334

GRAND RAPIDS

Serving Aitkin, Cass, Clearwater, Beltrami,
Itasca, Koochiching, & Lake of the Woods Counties

Emergency Mental Health Line

First Call For Help - Itasca County

24 hours / 7 days

Itasca County
(218) 326-8565
1-800-442-8565
(218) 326-4634 TTY

Outside Itasca County
1-800-543-7709

LUVERNE

Serving Cottonwood, Nobles,
Pipestone, & Rock Counties

24-Hour Crisis Hotline

Southwestern Mental Health Center

24 hours / 7 days

1-800-642-1525
1-800-642-1525 TDD
(507) 372-7671 TDD

MANKATO

Suicide Prevention Hotline

Immanuel St. Joseph's

Mayo Health System

24 hours / 7 days

Toll-Free Statewide

1-800-865-0606

MARSHALL

Serving Southwest Minnesota: Lincoln, Lyon,
Murray, Redwood, & Yellow Medicine Counties

24-Hour Crisis Lines

Western Mental Health Center

24 hours / 7 days

(507) 532-3236
1-800-658-2429

MINNEAPOLIS

Crisis Intervention Center

Hennepin County Medical Center

24 hours / 7 days

Suicide Hotline
(612) 873-2222

Crisis Referral Line
(612) 873-3161

MINNEAPOLIS / ST. PAUL

For Twin Cities Metro Area for Residents Only

24-hour Crisis Counseling

Crisis Connection

24 hours / 7 days

(612) 379-6363
(612) 379-6377 TDD

MINNEAPOLIS

Suicide Crisis Hotline

Love Lines Crisis Center

24 hours / 7 days
(612) 379-1199

OWATONNA

Serving Steele & Waseca Counties
Contact Helpline

Crisis Intervention - Suicide Hotline

24 hours / 7 days

(507) 451-9100

OWATONNA

Serving Dodge, Steele & Waseca Counties

CONTACT

Crisis / Listening Hotline

24 hours / 7 days

(507) 451-9100
1-866-451-9191

PIPESTONE

Serving Residents of Cottonwood,
Noble, Pipestone, & Rock Counties

24-Hour Crisis Hotline

Southwestern Mental Health Center
24 hours / 7 days

1-800-642-1525

ST. PAUL

Crisis Services

Ramsey County

Adult Mental Health Services

24 hours / 7 days
(651) 266-7900

Crisis Program

Regions Hospital Emergency Center

24 hours / 7 days

(651) 254-1000
(651) 254-3285 TDD

WACONIA

Serving Residents of Carver or Scott Counties

Crisis Intervention

County Mental Health Crisis Program

24 hours / 7 days
(952) 442-7601

WASHINGTON COUNTY

Washington County Crisis Line

24 hours / 7 days

(651) 777-4455
(612) 379-6377 TDD

WILLMAR

Serving West Central Minnesota: Chippewa, Kandiyohi,
Lac qui Parle, Meeker, Renville, & Swift Counties

24-Hour Crisis Line

Woodland Center

24 hours / 7 days
1-800-992-1716

WINONA

Serving Fillmore, Houston, & Winona Counties

Suicide Crisis Line

First Call For Help

24 hours / 7 days

(507) 454-2528

Toll Free Minnesota, Iowa, Wisconsin

1-800-362-8255
1-800-362-8255 TTY

WORTHINGTON

Serving Residents of Cottonwood,
Noble, Pipestone, & Rock Counties

24-Hour Crisis Hotline

Southwestern Mental Health Center

24 hours / 7 days

1-800-642-1525
1-800-642-1525 TDD

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greybeard58
Posts: 2086
Joined: Sat Aug 21, 2004 11:40 pm

"These players are easily forgotten. It's out of sight, out of mind."

Post by greybeard58 » Tue Apr 14, 2020 2:19 pm

"These players are easily forgotten. It's out of sight, out of mind."

In undertaking an academic study of depression in minor-league professional hockey players, Peter Aston was an obvious fit on the team of researchers. Not only does Aston hold a doctorate in clinical psychology from California's Stanford University. He's a former pro player himself, a graduate of North York's youth hockey arenas and Peterborough Petes player who was once on the same Oshawa Generals power play as Maple Leafs captain John Tavares and was a sixth-round draft pick of the NHL's Florida Panthers.

And Aston, too, has suffered from bouts of depression, beginning shortly after his first season as a pro in the American Hockey League.

So the study's key finding — that retired minor leaguers self-reported levels of moderate to severe depression at twice the rate of active minor leaguers, and significantly higher than the general population of the United States — wasn't necessarily a surprise to him. The study, published in the "Canadian Journal of Behavioural Science, " is the largest yet to investigate the mental health of minor-league hockey players in North America, including as it did participation from 234 retired players and 175 active ones. Having lived their existence recently — his last game as a member of the East Coast Hockey League's Utah Grizzlies came about a decade ago — Aston knows their plight intimately.

"It's part of the reason why I wanted to do this research, because I felt like this was a struggling population, " Aston said. "When I was playing, I felt like there were a lot of under-the-surface issues that players were faced with, and that weren't being addressed.”

What did throw Aston for a loop, mind you, was the response from his fellow minor-league alumni when he put out a call for volunteers to discuss their mental health struggles with a newspaper reporter. Aston said he reached out to about a half-dozen retired players who participated in the study to gauge interest in publicly discussing their experiences. He was met mostly with silence.

"I was surprised. I was hesitant to reach out to too many people too quickly because I thought the response would be pretty overwhelming, that people would want to speak about their experiences, " Aston said.

This is the Bell Let's Talk era, after all. Talking about one's mental health challenges is supposed to feel something like talking about one's recent run-in with the flu: It's a sickness, not a weakness; a chemical imbalance, not a character flaw. The stigma, we tell each other, ought to have completely disappeared by now. Except, in some minds, it clearly hasn't.

"I don't want to diminish the stigma anyone faces in our society, but it might be particularly strong for an athlete, " Aston said. "And maybe even more particularly so for hockey players."

Such is the reality of a player raised in a tough-it-out, keep-it-in culture that rewards those who soldier on without complaint.

"I think when it comes to talking about depression, athletes may have a particularly tough time with it, just because of the conditioning you go through in sports, " Aston said.


Which is not to diminish the significance of the athletes who participated in the study, which was funded in part by the Professional Hockey Players' Association (the minor-league players' union) with an eye toward improving programs designed to help ex-pros make the transition to meaningful existences beyond the rink.

While plenty of attention has been focused on the mental health of NHL players — and while progressive teams such as the Maple Leafs have made player well-being a priority — the minor leagues don't often provide comparable resources. While the very best NHL players get retirement tours, and even run-of-the-mill ones leave the game with lucrative financial rewards, a typical minor-leaguer retirement can arrive abruptly and without much in the way of fanfare or support. Players on the game's fringes are often pushed into the real world with little warning and less preparation.

"These players are easily forgotten. It's out of sight, out of mind. You just pack your bag and go home, and that's it, " said Aston, 34. "These people are Canadian heroes, but they didn't make it to the pinnacle of the sport."

While the study doesn't claim to explain why the retired minor leaguers in the survey self-report depression at such a high rate — and to be clear, two thirds of retired players in the sample did not report significant depressive symptoms — it does provide potential clues. One of the findings is that retired players see themselves as having lower social support than active players. Social support, psychologists say, is important in protecting individuals from depression.

Aston said one of the questions on the survey asked respondents to identify the hardest part of retiring from hockey.

"A lot of the responses were about feeling isolated, going through an identity crisis, not really knowing what to do next in their life, " Aston said. "And also feeling unprepared in some ways, not having the requisite skills to enter the workforce."

While depression has been linked to repetitive head trauma — an occupational hazard for players who spend their lives playing a collision sport — Aston said he wanted his study to focus on potential causes beyond brain injuries.

"Concussions are something that's not necessarily easy to change about the game, although it's great that changes have happened to increase player safety, " Aston said. "But the goal of this research is to find other important factors that might be related to how players might be doing in their retirement years."

Larry Landon, the former Maple Leaf who's now executive director of the Professional Hockey Players' Association, said in an interview this week that he's of the belief there's a support system in place for players suffering from the effects of concussions.

"We hold the players' hands as they go through that, " Landon said.

But as for navigating the shock to the system that can come with the realities of a post-hockey existence, Landon said his organization is always looking for ways to improve its career-enhancement program, which attempts to smooth players' landings into second careers.

"We're trying to prepare the players to be ready for the next phase in their life while they're still players — before they drop off the earth, " Landon said. "While you have exposure, while you have a brand, let's help you move on and get ready for it."

Still, when you're dealing with young men in a world geared toward instant gratification, it's not always easy to convince players to plan ahead. And even for those who do, there are bound to be down moments.

Maybe that's only natural. A life in sport can be all-consuming, after all. Exiting sport, no matter one's level of foresight, leaves a void that's difficult to fill.

"The other part of it is that you cannot recreate the intensity of the feelings that you get through sport, " said Victor Oreskovich, 33, a retired former second-round pick of the Colorado Avalanche who played 67 NHL games, most recently in 2011.

Oreskovich, who grew up in Whitby and now works on Bay Street, was the only participant in the study contacted by Aston who consented to speak publicly about its findings. That Oreskovich and Aston were once teammates with the Rochester Americans speaks to a mutual trust. The wild swings of Rostropovich's career arc — which included a two-year absence from the sport after he "stopped enjoying" hockey in his early 20s, not to mention a trip to the Stanley Cup final as a member of the Vancouver Canucks after he returned — speaks to the challenge of maintaining the proverbial even keel.

"The ups and the downs — I mean, to score a goal, whether you're in the NHL or the AHL, it feels incredible. To lay a big hit, it feels incredible. And it's very, very difficult to recreate that in real life, " Oreskovich said. "The reality is, you'll never hear that stadium again, people cheering, feeling that level of admiration. Real life is kind of mundane at times, and as an athlete you're not really exposed to much of that feeling. And once you are, it's easy to feel very underwhelmed."

It's also easy enough to keep those feelings to oneself, for better or worse. As much as the public conversation around mental health encourages open dialogue, Aston said pro athletes aren't always given the same message. Thinking back to his struggle with depression in the off-season of 2008, Aston said he received conflicting advice from people he trusted.

Aston's agent suggested he tell the Florida Panthers about his struggle, perhaps with the hope that his transparency might buy him organizational mercy in forthcoming evaluations of his on-ice regression. His psychologist, meanwhile, suggested he keep quiet about his internal struggles around his employer, and chalk up his poorer-than-expected performance to a concussion — not exactly a lie since Aston had been previously diagnosed with more than one.

The psychologist's rationale, Aston said, was that given his status as a borderline player who was easily replaceable, it wouldn't be wise to give a team a reason to move on.

"It's easy to side with the agent who's saying, 'Be open about this, ' but I completely understand the psychologist's perspective. I think he also had my best interests in mind, " Aston said.

It's a complex issue, to be sure. Which is why Aston's research with the PHPA is ongoing, which is why he's also urging minor-league organizations to consider depression screening for active players — to catch the signs of trouble before, as Landon puts is, too many minor leaguers drop off the earth. Convincing those players to be completely honest could be another challenge altogether.

"I think (taboos around mental health) still exist to a great degree. Working as a clinical psychologist, it's remarkable how many people you meet with have waited so long to finally reach out for help, and the biggest barrier is stigma, " Aston said. "A lot of players, my sense is they want to speak out, but there's also a real fear of the consequences. So it's one of these things where you want to respect people's wishes, but also honour the part of them that probably does want to speak out, but there's just this fear involved. And that fear is appropriate in some ways."

Many minor leaguers suffer mental health issues silently
Even in the Let’s Talk era, players feel excessive pressure to hide battles with depression
Read more: https://www.thepeterboroughexaminer.com ... -silently/

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Q&A on Concussions & Post-concussion Syndrome on Thursday at 3 pm CT

Post by greybeard58 » Tue Apr 14, 2020 3:05 pm

Q&A on Concussions & Post-concussion Syndrome on Thursday at 3 pm CT

20 Questions on Concussion with Dr. Robert Cantu

Join us for a Q&A on concussions and Post-Concussion Syndrome with Concussion Legacy Foundation co-founder and medical director Dr. Robert Cantu!

Have questions you'd like answered? Email them to us at info@concussionfoundation.org.

Apr 16, 2020 04:00 PM in Eastern Time (US and Canada)

Register at: https://zoom.us/webinar/register/801586 ... WosO6ybdpg

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Less Than Half of Patients Recover Within 2 Weeks of Injury After a Sports-Related Mild Traumatic Brain Injury

Post by greybeard58 » Sat Apr 18, 2020 8:29 pm

Less Than Half of Patients Recover Within 2 Weeks of Injury After a Sports-Related Mild Traumatic Brain Injury

CONCLUSIONS

Recovery from a SR-mTBI is slower than previous international consensus statements have indicated. Less than half of all participants in this study recovered within 2 weeks after injury, and it is only at 28 days after injury do recovery rates match those quoted in these statements. This is irrespective of age with adults, adolescents, and children showing similar recovery rates within 2 weeks, by 4 weeks, and by 8 weeks after injury with best practice clinical care delivered across all age groups. Delay to presentation leads to delay in recovery with the message of early access to care needing to be mandated within individual sports.


Less Than Half of Patients Recover Within 2 Weeks of Injury After a Sports-Related Mild Traumatic Brain Injury: A 2-Year Prospective Study
Read the study at: https://journals.lww.com/cjsportsmed/Fu ... eks.2.aspx

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Webinar Today at 2:30

Post by greybeard58 » Tue Apr 21, 2020 12:57 pm

Webinar Today at 2:30

Supporting Caregivers for Suspected CTE

With most of the United States under stay-at-home orders due to the Coronavirus, the role of caregivers who are living with a loved one suffering from suspected Chronic Traumatic Encephalopathy (CTE) has never been more important. If possible symptoms of CTE were already having an effect on family life, those difficulties may be magnified with everyone under one roof at all times.

Join the Concussion Legacy Foundation (CLF) for a conversation hosted by CEO Chris Nowinski, Ph.D. about strategies and support systems for suspected Chronic Traumatic Encephalopathy (CTE) caregivers. Hear insights from Dr. Robert Stern, Director of Clinical Research at the Boston University CTE Center, on caring for your loved one during the pandemic. Plus, we’ll welcome caregivers Kim Adamle, whose husband Mike Adamle is suffering from probable CTE; Liz Nicholson Sullivan, whose husband Gerry is suffering from probable CTE; and Dr. Shannon Albarelli, whose husband Mike passed away in 2018 and was diagnosed with CTE.

At the end of the webinar, Dr. Albarelli will lead a special meditation session to help viewers cope with any stress and anxiety they are feeling.

Apr 21, 2020 03:30 PM in Eastern Time (US and Canada)

https://zoom.us/webinar/register/791586 ... pEuIbHg6VQ

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Posts: 2086
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Katie Rerko: Get Your Head In The Game

Post by greybeard58 » Thu Apr 23, 2020 6:54 pm

Katie Rerko: Get Your Head In The Game


When she isn’t protecting the net from blistering slapshots, Katie Rerko protects her peers by educating them on an injury that has damaged careers and lives outside of the rink.

Rerko, a sophomore goalie for the Pitt women’s club ice hockey team, volunteers with the Washington, D.C.-based nonprofit organization Student Athletes for Educational Opportunities. SAFEO aims to “address the educational, career, health and athletic needs faced by low income, at-risk inner city student athletes.”

Within the organization, Rerko, a psychology major, specializes in raising awareness about the immediate and long-term effects of concussions as well as promoting measures to decrease the risk of concussions anytime someone steps onto the playing surface.

“I talk about my experience with my concussions to try to raise awareness because there’s not as much awareness for concussions as there should be,” Rerko said. “Especially with ice hockey being a pretty contact-heavy sport, it’s important that people are aware of concussion symptoms.”

Rerko received her first concussion in the seventh grade while playing ice hockey. Since then, she’s had one more documented concussion, during her first season of high school. She emphasizes the word “documented,” as she suspects having suffered others that weren’t officially diagnosed.

Sports have always played a major role in Rerko’s life, so much so that it’s easier to ask what sports she hasn’t played rather than what she has. She’s swam, played field hockey, softball, lacrosse and soccer. It wasn’t until the fourth grade, when her family moved to Urbana, Maryland, that she found her true love — ice hockey.

“I had a few neighbors that played ice hockey [in the fourth grade],” Rerko said. “They played roller hockey outside a lot, and I got into it by playing with them a lot. My brother played with them a lot too, so my brother and I got into hockey around the same time.”

Rerko soon wanted to play the sport at an organized level, but there remained one problem — she didn't live in an area known for hockey whatsoever. Because of this, girls’ hockey leagues did not exist anywhere near her. So she competed in boys’ leagues.

For the next four or five years, Rerko played in several boys’ hockey leagues. On the rare occasion that she did find a girls’ league, she had to drive as far as two hours away to reach practice. Although she played against a few other female players in boys’ leagues, none of them played her position. As the starting goalie for her high school team her first year, many of her opponents underestimated her abilities in net.

“Especially from where I was from, there wasn’t really a developed girls’ hockey league,” Rerko said. “Being able to compete with guys in a male-dominated sport I think definitely threw people off.”

In the eighth grade, coach J. Laffeyette Carter approached a local rink Rerko played at, informing her team of his new organization, SAFEO. From there, Rerko contacted Carter to convey her interest. A couple weeks later, Rerko and some of her teammates met with Carter again to learn about concussions. Later that day, they appeared in a TV interview at the outdoor ice rink in Bethesda, Maryland, to promote the organization and encourage safe practice.

Because of her involvement in SAFEO, Rerko realized she needed to make changes as an athlete to better protect her brain. One of the immediate realizations she made involved her own safety, playing among athletes much larger than her.

“I used to play hockey with boys, and I’m obviously not very big,” Rerko said. “I played against boys that played Junior A and Junior B hockey. Playing with them probably wasn’t the smartest decision, because just anatomy. They’re bigger and stronger and I’m 5’2”, weigh 110 pounds. There was just a lot of danger.”

Rerko’s mother insisted that she stick to playing solely against other girls. In addition, Rerko made sure to purchase the safest goalie equipment, as a quality helmet can make a huge difference on the impact of a collision. She’s also had to change the way she plays.

“For players, [they can focus on] keeping your head up,” Rerko said. “If there’s a shot that I know is coming towards my head, I’ll duck. It’s not worth saving it at this point. Just making sure you’re aware of your surroundings.”

As she got more serious about the sport, Rerko started to participate in girls’ showcases for college recruitment. While at a showcase in Massachusetts, a coach for a Boston prep school offered her a spot on their roster, where she played her junior year, taking online classes in the process.

“This all happened at the end of the summer, so I had basically two weeks to pick up and move to Massachuesetts,” Rerko said. “It was very sporadic, but I think it was worth it. I had a lot of fun doing it.”

As Rerko decided on a college to attend, she knew the school must have a club hockey program for her to further her playing career. That’s when she reached out to Jim Napoli, the head coach of the women’s club hockey team at Pitt, where she had already been offered admission.

After meeting Napoli and learning about the program when touring Pitt’s campus, she realized she wanted to spend the next four years in Oakland.

As a first-year goaltender, Rerko was thrust into the starting role almost immediately when the team’s veteran starting goalie experienced medical issues. In her first year, Rerko started every game in net.

“It’s a little remarkable to me, to have to step in right away and play every game,” Napoli said. “And she did a fine job. She works really hard.”

Rerko’s teammates immediately took to her. Sophomore forward Cierra Lutz noted that her confidence in net allows their defense to push forward on offense, knowing they can trust her to protect the net in transition. Also, her skills make the whole team better when the players practice against one another.

Heading into her second season in goal, Rerko looked to develop her leadership abilities on and off of the ice.

“Being a goalie, a lot of people look to you for support no matter how the game’s going,” Rerko said. “We’ve had lots of issues this season of people playing positions that they’re not used to, so that made us have a pretty rough season. I just try to stay as positive as I can, even though things didn’t really go the way we wanted to this season.”

Rerko praised Napoli and the rest of Pitt’s coaching staff for caring about their players’ safety.

“Our coaches are very understanding when people are injured or when they have some type of head injury,” Rerko said. “If they need to miss practice [because of their injuries], then they by all means can miss practice without being punished.”

Napoli attributes resources like the UPMC concussion center, a special division of the UPMC Sports Performance Center located on Pittsburgh’s Southside, as a huge help in making the sport as safe as possible.

“Fortunately, being at the University of Pittsburgh, you’ve got the UPMC concussion center at your fingertips, so you can get the world’s best care,” Napoli said. “[The players] are here to get an education and be successful students number one, and we certainly don’t want something that happens as a result of playing the game to impact that more than it has to.”

Although her school semesters are now filled with classes, practice and homework in Oakland, Rerko has stayed active in SAFEO during the summer. She visits youth hockey teams to talk about her own experiences with concussions and how to recognize symptoms of the injury. This summer, they plan on hosting a hockey camp for kids that will enhance concussion awareness while developing their skills on the ice.

Despite over four years passing since her concussion in the ninth grade, Rerko believes that the injury still impacts her day-to-day life.

“It’s hard sometimes to do school work because I don’t have the same attention span that I used to,” Rerko said. “It’s made me question if I continue to play hockey over the next two years, is it really worth it? I could get hurt again, and it’s my brain. That's kind of more important than playing two more years of hockey.”

Lutz shares Rerko’s concerns about severe brain injuries in the sport. A history of concussions have compounded previous neurological issues of her own, causing seizure-like episodes and frequent nausea. These issues have even caused her to retake classes, as a concussion left her unable to leave her bed her first year of college. She appreciates Rerko’s commitment to the topic.

“Katie is very humble about her devotion to concussion prevention and awareness,” Lutz said, “but it’s a great cause to champion and we’re all very proud of her. It’s been an important part of her life for a long time.”

When she’s done with her undergraduate degree, Rerko wants to continue her education at occupational therapy school. Although she’s gained plenty of experience working with children, she also sees herself practicing on the other end of the age spectrum.

“I worked with elderly patients in the hospital over the summer and I really liked that, so I probably want to work in a nursing home,” Rerko said with a laugh. “So, I guess either elderly people or kids.”

Rerko, a longtime Pittsburgh Penguins fan, has tried to model her game in many ways after her favorite player, former Penguins goalie Marc-Andre Fleury. Like Fleury, whose 180-pound frame makes him somewhat undersized in today’s NHL, she must utilize her athleticism and flexibility in net.

What stands out most to her, though, is Fleury’s ability to lead on and off the ice. She aims to employ Fleury’s work ethic in all aspects of her work.

“Not only is he a fantastic goaltender, but he’s a positive person and you can see that his team really likes him,” Rerko said. “If your teammates like you, it makes it a lot easier to have a better season.”

Katie Rerko: Get Your Head In The Game
Read more: https://pittnews.com/article/157349/sil ... -the-game/

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How Concussion Legislation is Failing Young Athletes

Post by greybeard58 » Tue Apr 28, 2020 3:21 pm

How Concussion Legislation is Failing Young Athletes

For many Americans, the reality of the danger caused by concussions in football began with the PBS Frontline documentary "League of Denial," or the book by Mark Fainaru-Wada and Steve Fainaru that inspired it. Perhaps it was the movie "Concussion" starring Will Smith, or the death of former NFL star Junior Seau.

There is evidence that Seau, who died by suicide, and other professional football players who took their own lives or otherwise died prematurely exhibited signs of Chronic Traumatic Encephalopathy (CTE), allegedly caused by the effects of multiple concussions or even repeated sub-concussive blows to the head. Though Seau's fate is horrible, the danger of head injuries suffered by youth and high school football players is far more pronounced.

There are approximately 2,000 professional football players currently. Comparing that number to the almost 3.5 million who play football as youths and 1 million playing in high school, the amount of potential concussions rises exponentially, as do the dangers to young brains. Though no professional player has died in the immediate aftermath of a concussion, the National Center for Catastrophic Sports Injury Research found that head and other injuries sustained at lower levels of football competition can indeed prove fatal. From 2007 to 2017, 55 players died participating in high school football. At least seven players died last year alone.

The dangers associated with concussions caused state legislatures across the country to enact statutes to protect youth and high school athletes. Unfortunately, flaws in such legislation often lead to confusion — and actually provide immunity to the very individuals who are charged with protecting young athletes from harm.

Concussions in high school sport
In September 2019, Roane County (W.V.) High School football player Alex Miller collapsed on the sideline during the first half of a game and died soon after being rushed to a nearby hospital. The cause of his death has not been released. On the same weekend, Peter Webb, a player at Southwest Covenant in Oklahoma City, tackled the opposing quarterback, fell to the ground and hit his head. He never got up, and died of the traumatic injury to his 16-year-old brain.

Although deaths on the football field remain rare, the incidence of concussions suffered at these lower levels of sport participation continues to increase.

According to the most recent National High School Sports-Related Injury Surveillance Study, in 2018-2019, 26.8 percent of the injuries recorded in high school sports were to the head and face. These injuries were the most-common diagnosis in competition, and second-highest in practice. In fact, concussions continue to be the most common injury diagnosis in football, and perhaps surprisingly in boys' and girls' soccer, wrestling, softball, cheerleading, field hockey, boys' ice hockey, and boys' and girls' lacrosse.

Concussion legislation
The legislative focus on concussions in high school football began in 2006, with Tahoma (Wash.) High School football player Zach Lystedt. A multisport athlete, Lystedt sustained a concussion and was then allowed to return to the game, where he suffered a second head impact. As he left the game, he complained that his head hurt, fell to the ground and suffered multiple seizures.

Lystedt was on life support for the following seven days and has been dealing with the aftereffects of his brain injury ever since. He and his family pushed for Washington to pass legislation to develop guidelines to protect athletes suffering from concussions in sports [Rev. Code Wash. § 28A.600.190, 2020].

By 2015, every state had proposed similar legislation. These statutes focus on mandatory education so that those involved — from coaches to athletic trainers — can detect the symptoms of a concussion and remove an athlete from play. They also mandate some form of medical clearance before an athlete can return to play.

Such requirements are mirrored in state high school athletic association regulations that mandate all prospective student-athletes receive concussion education before they can participate. For example, the Wisconsin Interscholastic Athletic Association's "When in Doubt Sit Them Out" program (www.wiaawi.org/Health/Concussions) includes resources regarding symptoms, as well as best practices for all of those involved in high school sports.

This focus on education and training should provide injured players and their families with some assurance that a coach will know the signs of a concussion, pull their child from the field, and only allow them to return after receiving proper medical clearance. Whether these measures have been put into proper practice is open to debate.

Return-to-play decision-makers
Zach Lystedt returned to play after receiving his first concussion, and was then more susceptible to the second impact, which led to serious harm. Most statutes now mandate that players cannot return to play after a concussion until they have been cleared by a properly trained healthcare provider. However, these laws are not consistent as to who can provide this clearance.

For example, the Wisconsin law requires that such a provider have some experience in evaluating concussions [Wis. Stat. Ann. § 118.293(1)(am)], while the Illinois statute says merely that "licensed healthcare professionals" who make the return-to-play decision must follow "established medical protocols" — nowhere requiring the professional to have training specific to treating concussions [105 ILCS 5/22-80(g), 2020].

This inconsistency is mirrored in the medical community, where different professionals — from athletic trainers to sports medicine providers to neurologists — have their own return-to-play standards.

Many state high school athletic associations follow the international Consensus Statement on Concussion in Sport. This statement has changed every several years — from the third in 2008 to the fourth in 2012 and now the fifth in 2017. The WIAA includes all three different statements on its concussion website.

State associations are met with a challenge when training their coaches, as they might be teaching a standard that may change or may not meet actual accepted medical standards. In addition, the healthcare provider tasked with the return-to-play decision may follow one of many different standards in making these decisions.

Even in Wisconsin, where a provider must have concussion training, it is difficult to determine what that training should be. Each state holds these healthcare professionals as the gatekeepers to return to play. Without a consistent medical standard informing their decisions, how can parents trust that their children will not be returned to play too soon?

Duty of care and immunity
Immunity provided in the statutes themselves may cause additional confusion. The initial Washington statute immunized volunteer healthcare providers from liability for the care that they provided [Wash. Rev. Code § 28A.600.190(5)]. More than half of the concussion statutes extend this immunity further to virtually anyone involved. For example, Wisconsin's statute provides that "[t]his section does not create any liability for, or a cause of action against, any person" [Wis. Stat. Ann. § 118.293(6)].

This leaves injured athletes and their families with little recourse. Even if educational and return-to-play standards laid out in the statute are not followed by the coach or medical provider, the statute immunizes these individuals from potential liability for their negligent conduct. When faced with no other form of recovery, injured athletes may go to court claiming that their coach or medical provider should be responsible for not meeting the standard laid out in the statute.

Courts drop the ball
Surprisingly, there have been only 12 cases involving these statutes in eight states, and most cases merely refer to the statute in some small way. Courts rarely make decisions allowing an athlete any form of recovery for their harm.

For example, a 2015 Iowa court denied an athlete's attempt to assert a claim against his school district for failing to remove him from play, finding that the Iowa statute did not "explicitly provide a cause of action" [K.R.S. v. Bedford Comm. Sch. Dist., 109 F.Supp.3d 1060, 1081 (S.D. Iowa 2015)]. A Pennsylvania court similarly dismissed a claim against a coach even though the injured student alleged that the coach did not follow the procedures within the Pennsylvania statute [M.U. v. Downingtown High Sch. East, 103 F.Supp.3d 612, 631 (E.D. Penn. 2015)].

The only court to offer some hope to an injured athlete was in Washington, the state with the first concussion statute. Noting that the statute does not include any "mechanism... to enforce the requirements intended to address the risks of youth athlete concussions," the Washington Supreme Court recognized the legislature's concern with youth athlete concussions and found it "logical to infer that the legislature intended that there be some sort of enforcement mechanism" [Swank v. Valley Christian Sch., 398 P.3d 1108, 1117 (Wash. 2017)].

No other state court has followed this example. In the latest case involving a similar Massachusetts statute, the court dismissed the claim even though the school district did not implement and adhere to proper concussion protocols pursuant to the state statute [Lincoln Sudbury Regional High Sch. Dist. v. W., 2018 WL 563147, *18 (D. Mass. 2018)].

Statutory scheme with no teeth
Approximately 300,000 high school athletes suffer sports-related traumatic brain injuries each year, often as the result of a concussion. The harm that a concussion can cause in young athletes can be severe, and in the worst cases, lead to death. Although states tout the laws they have passed, these laws do more to protect those who do not follow them than the injured individuals themselves. Courts have done little more in the way of protection, rarely allowing an injured athlete to even bring a claim when a coach does not live up to the mandate in state law.

Several concussion laws have been amended in recent years, but none of these amendments have extended liability to those responsible for protecting young athletes. Until the statutory scheme includes some enforcement mechanism, injured athletes will have to rely on their coaches and medical providers to be properly educated and trained. When they are not, injured athletes will be left with no way to recover for their harm.

How Concussion Legislation is Failing Young Athletes
Read more: https://www.athleticbusiness.com/athlet ... letes.html

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Helping concussion patients in crisis: Webinar Thursday May 7 at 3 pm

Post by greybeard58 » Tue May 05, 2020 11:42 am

Helping concussion patients in crisis: Webinar Thursday May 7 at 3 pm

Helping Concussion and Suspected CTE Patients in Crisis

The Concussion Legacy Foundation is supporting the mental health of those struggling with the effects of brain injury, through the COVID-19 pandemic and beyond.

Public health pandemics such as COVID-19 can cause emotional distress and anxiety. Feeling anxious, confused, frustrated or hopeless is common during a time of such uncertainty and isolation. For those who are already struggling with the effects of brain trauma, those feelings may be heightened and emotional crisis more likely. There is support available to help you prepare for, and get through, these crisis situations.

Join host CLF CEO Chris Nowinski, Ph.D., and mental health experts Dr. David Reiss, a psychiatrist for over 30 years who treats suspected CTE patients, and Dr. Ciara Dockery, Director of the NFL Life Line, for a webinar on helping concussion or suspected CTE patients through a crisis.

Warning: topics discussed during the webinar will be sensitive and potentially triggering to some.

May 7, 2020 04:00 PM in Eastern Time (US and Canada)

Register at https://us02web.zoom.us/webinar/registe ... mSdyLQ5Ueg

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Why incoming NCAA athletes say they hid concussion symptoms

Post by greybeard58 » Mon May 11, 2020 8:15 pm

Why incoming NCAA athletes say they hid concussion symptoms

New study in the Clinical Journal of Sport Medicine reports most-common answers from 156 incoming NCAA athletes about why they hid concussion symptoms:
*81% don't want to appear weak
*76% afraid to lose spot on team
*64% afraid coaches will be mad.

"Greater concussion knowledge did not reduce the number of reasons that participants viewed as drivers for concussion nondisclosure. In other words, participants understood why athletes choose to hide symptoms even when they also understood the symptoms, risks, sequelae, and consequences of concussion (and potential harm of nondisclosure). Situational contexts and important stakeholder attitudes also appeared to importantly influence symptom disclosure decisions. A multifaceted approach that goes beyond current educational strategies to addresses situational, social, and athletic pressures may be needed to initiate a widespread cultural shift away from concussion nondisclosure."

Concussion Symptom Underreporting Among Incoming National Collegiate Athletic Association Division I College Athletes
Read more at: https://journals.lww.com/cjsportsmed/Ab ... ing.2.aspx

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BU CTE study named one of Top 10 discoveries of the year n neurodegeneration

Post by greybeard58 » Fri May 15, 2020 2:51 pm

BU CTE study named one of Top 10 discoveries of the year n neurodegeneration


While the fact that repetitive mild traumatic brain injury leads to devastating long-term sequelae in professional boxers has been recognized for close to a century without controversy, chronic traumatic encephalopathy (CTE) only recently began to achieve substantial scientific scrutiny and public interest when it was identified in American football players. While there is strong evidence that repetitive head injuries are causal for CTE, skeptics remain. Among the criticisms is that while clinicopathological studies are powerful, they are association analyses that ostensibly cannot prove a causal relation-ship on their own. This is not the whole story. In 1965, Sir Austin Bradford Hill, an English statistician, proposed nine criteria that, when met, provide epidemiologic evidence of causality. In terms of CTE, eight of these criteria had been met, including strength (effect size), reproducibility, specificity, temporality, plausibility, co-herence, experimentation and analogy. The missing criterion, until now, was evidence of a biological gradient: the presence of a dose-response relationship showing that increased exposure leads to a greater incidence/magnitude of the effect.

In a report published online in November 2019 in the Annals of Neurology, researchers led by Drs. Jesse Mez and Ann C. McKee (Boston University) measured exposure to contact sports in the largest autopsy series of American football players ever assembled and calculated CTE risk. They found that the odds of CTE doubled with every 2.6 years of American football played (Mez et al., 2020). This paper firmly establishes that there is a dose-response relationship between exposure to American football and CTE, which the strongest indicator of causality obtainable. This study also provides hard data for athletes and families trying to determine how much exposure might be considered safe.

Chronic Traumatic Encephalopathy And American Football: A Dose-response Relationship
Read about the top 10 discoveries at: https://www.uni-muenster.de/Ejournals/i ... /2634/2620

Complete paper demonstrating CTE odds increase by 30% per year of American football, providing evidence of a dose-response relationship and meeting the final Bradford Hill criteria for proving causation
Duration Of American Football Play And Chronic Traumatic Encephalopathy
Read more: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6973077/

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CLF Helpline Concussion Legacy Foundation

Post by greybeard58 » Tue May 19, 2020 4:29 pm

CLF Helpline

If you are fighting long-term concussion symptoms and would like help in the form of referrals, education, or just someone to talk to, reach out to the CLF HelpLine here: https://concussionfoundation.org/helpline

SUBMIT A REQUEST TO THE CLF HELPLINE
At the Concussion Legacy Foundation, our mission is to support athletes, Veterans, and all affected by concussion and Chronic Traumatic Encephalopathy (CTE); achieve smarter sports and safer athletes through education and innovation; and to end CTE through prevention and research.

We support patients and families through the CLF HelpLine, which provides personalized help to those struggling with the outcomes of brain injury. If you or a loved one are seeking guidance on how to choose the right doctor, struggling with lingering concussion symptoms, or have any other specific questions, we want to hear from you. Submit your request below and a dedicated member of the Concussion Legacy Foundation team will be happy to assist you.

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greybeard58
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"couldn’t remember what day it was, couldn’t walk in a straight line and couldn’t handle lights or reading"

Post by greybeard58 » Tue May 26, 2020 10:07 pm

"couldn’t remember what day it was, couldn’t walk in a straight line and couldn’t handle lights or reading"

Spurred by a state legislator’s demands, the Minnesota State High School League is exploring revisions of two contentious league bylaws that help determine student-athlete eligibility.

Sen. Julie Rosen, R-Vernon Center, got involved after a daughter of a family she knew ran afoul of two bylaws unintentionally and faced a premature end to her high school activities. While the student-athlete, Ceci Driano, ultimately won both appeals, her family and Rosen were incensed by what they contend is an arduous process and league members’ guilty-until-proven-innocent tone.

In a meeting last fall with MSHSL Executive Director Erich Martens and league board President Bonnie Spohn Schmaltz, Rosen said she “made it very clear to them that I expected changes. And if changes don’t come, then we will be pulling this whole issue in front of the Legislature. And that it’s not going to be pretty. Because every single legislator probably has some constituent, some example of this in their district, and they would love the opportunity to talk about it.”

At Rosen’s insistence, sweeping changes to the entire eligibility process are being discussed. The key point, she believes, is drafting bylaw language that presumes “the eligibility rules are to be liberally construed so as to make students eligible.”

That phrase comes from a Jan. 10 memo sent by Martens to Rosen. At issue are Bylaw 110, which allows students eligibility for 12 consecutive semesters beginning with their first entrance into seventh grade, and Bylaw 111, which deals with eligibility stemming from transfer and residence matters. Bylaw 111 aims to police student movement between schools for athletic transfers. Student-athletes lose a year of eligibility if they transfer schools without a change of residence.

A league task force to review the transfer bylaw was approved in February at the league’s board of directors meeting. Discussion of Bylaw 110 is ongoing.

Martens wrote in an e-mail that “it is very difficult when students are deemed ineligible,” adding, “Expedient reviews of eligibility situations will continue to be a focus to provide families and, most importantly, students with timely decisions based on their situations.”

Rosen’s involvement is the latest public outcry regarding concerns with the league’s processes for determining eligibility. More families such as the Drianos, whether or not they won their cases, still are fighting to ensure a less frustrating experience for future families.

Steve and Kim Sommer started a “Fix Bylaw 110” Twitter account after their son, James, was embroiled in an appeal process. He was granted eligibility and became the leading scorer for the Cristo Rey Jesuit basketball team this season.

The family of football standout Craig McDonald went public with its case against Bylaw 110. McDonald, who repeated the eighth grade when he enrolled at Minnehaha Academy to mature academically and socially, was forced to sit out his senior season at SMB, a three-school co-op that includes Minnehaha Academy.

“All these eligibility rules need a child-first mentality,” said Steve Sommer, whose son repeated the seventh grade for medical reasons. “Right now, it’s the opposite. It’s ‘how can we punish a segment of kids?’ ”

All three cases came in the wake of a 2017 report by the Minnesota Office of the Legislative Auditor that found the process for handling student transfers was plagued with “deficiencies’’ and needed action by lawmakers to provide more transparency. A follow-up report released less than a year later showed progress, but recommended discretionary legislative review of complaints regarding league eligibility bylaws, rules and procedures.

‘Talking in circles’

Nancy and Dominick Driano waded into league bylaw policies when their daughter’s brain injury resulted in a need to repeat her junior year.

Ceci Driano sustained a severe concussion on the soccer field a few days before her freshman season at Visitation, a private school in Mendota Heights. An exemplary student, Driano couldn’t remember what day it was, couldn’t walk in a straight line and couldn’t handle lights or reading. She attended only two full days of school her freshman year.

By her junior year in 2017, Driano regained her status as a full-time student and decided to try tennis as a fall sports alternative to soccer. Then another medical setback occurred when she collapsed at school on Halloween. Months of testing revealed that she needed neurosurgery to address underlying medical conditions aggravated by her concussion.

She missed a great deal of time at school and withdrew from Visitation because she needed a fresh start. She transferred to Mounds Park Academy, a private school in Maplewood located about 16 miles away, for the 2018-19 school year and repeated her junior year.

Because her family did not change its residence, Driano was automatically ruled ineligible for tennis, track and field and speech based on Bylaw 111. She appealed but was denied by the league. She pressed and was granted a hearing before the league’s eligibility committee, which approved her case without explanation.

“But by the time I was granted eligibility, I had about two tennis tournaments left,” Driano said.

Frustration peaked about a year later as Driano faced a second eligibility denial. This time it was because she repeated a grade and used up the 12 consecutive semesters provided in Bylaw 110.

The family wrote a lengthy letter to explain the complicated time line. The league didn’t budge. So the Drianos hired an attorney. The family appealed the ruling in person with the same information it presented in the letter.

“I was talking in circles because I didn’t know why I was denied the first time,” Driano said. “I didn’t know how else to prove that neurosurgery was not within my control.”

The league granted Driano eligibility for her senior year. But the process soured the family. So Nancy Driano reached out to Rosen, who had known the Drianos from when the family lived in Fairmont, part of Rosen’s district.

“It’s not right to keep kids out of activities,” Nancy Driano said. “I’m not sure what they’re protecting against.”

Ceci said jokingly, “The girl who taught herself tennis is a threat.”

Dominick Driano found no humor in the situation.

“I told them at one of the meetings that ‘I have a sense that you don’t take these things seriously until you’re threatened with a potential lawsuit,’ ” he said. “It’s not right. You can’t treat people this way. Who knows if they are going to change? They’ve been fighting people like us forever. Somebody’s got to do something.”

Options for change

Rosen had three meetings with league leadership last fall, characterizing them as initially contentious before becoming collaborative.

“They were really hurting people, whether the right leadership knew it or not,” Rosen said. “It took them a while, but they did come around.”

Martens, in his memo to Rosen, outlined several possible initiatives to refine the eligibility process by focusing on the experience of students and parents.

Ideas include expanding responsibilities for eligibility among other league staff members, providing training to activity directors and principals to effectively assist parents in eligibility cases, and creating a student advisory committee. Action could come as soon as June  1, when the league’s board of directors meets.

“Execution is nine-tenths of this whole thing,” Rosen said. “I will be watching this. If they pull this off and get this adjusted, this is a big deal. I’m banking on them being able to pull this off.”

Minnesota high school athlete eligibility rules get fresh scrutiny
Read more: https://www.startribune.com/minnesota-h ... 570753382/

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