concussions

Discussion of Minnesota Girls High School Hockey

Moderators: Mitch Hawker, east hockey, karl(east)

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

BAC Hockey

Post by greybeard58 » Sun Mar 10, 2019 8:34 pm

A Junior Career in the Dark
First, I would like to thank BAC Hockey for the opportunity to tell my story. My name is Ryely McKinstry, I am 20 years old and I am a retired hockey player due to concussions. Other than my family, this is the first time I have really opened up and talked about my story publicly. I want to make it clear that I am not a writer, but this is my honest story. The purpose of my story is to help others who have or are currently going through concussion problems, and hopefully giving them the perspective from someone who has been through it.

I grew up in Calgary playing in the Buffaloes organization. I played two years for Blair with the Bantam AAA Bison’s, where I ended up getting 2 minor concussions in my two years. In the summer after Bantam, I was invited to try out for Team Alberta at the top 80 camp. At this camp I was hit from behind and suffered my first more than minor concussion. After my Bantam years, I played one year of Midget, where I managed to stay concussion free, before moving on to play for the Vancouver Giants of the Western Hockey League. My rookie season as a 16 year old was a struggle. I got a concussion and a back injury around Christmas time so I went home to recover and returned two and a half weeks later.

After the season ended, I was invited to try out for U18 Team Canada. I didn’t make the team but I felt like I was playing good hockey and carried that into the next season. Under a new coach, I had a fresh start, and was excited. I played 6 games before getting hit and suffering another concussion. This one kept me out for about 3 weeks and off the ice for a month. My symptoms were pretty much just a bad headache, like the others, but I also felt very foggy and dizzy. After the three weeks however, all my symptoms seemed to subside. I went back to practicing and working out full-time, played 5 more games and got hit again and had another one. This one put me out for a month and the team decided to send me home for the rest of the year to rest up and get myself back to 100%. This was a tough time for me. All I wanted to do was play hockey. I would watch all the boys’ games on the internet, just wanting to be back in Vancouver.

Another thing I struggled with was school. I came back to high school in Calgary. Coming back to Calgary was a tough time. My brother, cousins and most of my buddies moved away to play hockey, so I didn’t have much to do. I didn’t have hockey, I didn’t have friends to hang out with and I didn’t really care about my school marks because I knew I wasn’t going to graduate that year. I had missed close to two months of school in Vancouver due to my head, and I was informed I wouldn’t be able to graduate on time with all my friends. Luckily enough for me, the principal allowed me to walk the stage with my buddies.

I finished off my school year and went back to Vancouver for my 18-year-old season. I can’t even call it a “season”. I got concussed in my second preseason game. This was the worst one. I couldn’t watch TV, I could barely look at my phone. I couldn’t read books, the only thing I could do was stay in my room and sleep. I had to wear sunglasses inside because the light bothered my eyes and my head so much. For 2 months all I did was sleep. I would try to go for a walk with my mom, but I would make it to the end of the block and would have to turn around because it was just too much. The headache was awful, the dizziness was so unbearable I couldn’t walk without feeling like I had to throw up, and the fogginess made me feel like I just wasn’t myself. I’ve been asked by a few people what a bad concussion feels like and the only way I can really describe it is think of your worst hangover but it lasting for 2 months. I couldn’t do any physical activity, and pair that with eating like PLEASE BAN ME, I got fat. I was clearly unhappy because of my hockey situation and now I was becoming unhealthy, so I really wasn’t in a great place mentally or physically. So sleeping all day and getting fat was all I did until I started feeling a little better and was able to go see a doctor. You can probably assume how the appointment went. After 7 concussions, the doctor with reason told me retirement should be my only option. Obviously this was heart breaking to hear as an athlete. You spend so much of your time trying to build your dream and you sacrifice so much for it just to have it shattered in a couple of words. The doctor’s appointment was the first time I realized that one day I won’t be a hockey player anymore and that day was coming up quick. I had to make a choice. Either I quit hockey or I put my health on the line and give it one more go. People probably think I made the wrong choice. Hell, my parents probably thought I made the wrong choice, but they supported me all the way and I decided to give it one more shot and lay it all on the line.

I had to wear sunglasses inside because the light bothered my eyes and my head so much
I started to get back into shape, back in the gym and back on the ice. Unless you’ve done it before, people don’t realize how much work it is to get back into WHL playing shape. I hadn’t played a regular season game in over two years. I hadn’t played a semi-competitive game since the preseason game. I was 20 pounds heavier than my playing weight. I had to lose weight, get stronger and get faster. I also had to start from scratch on the ice. When you’ve been stuck in a bed for two months and haven’t been able to work out for three, you are pretty much an out of shape, 19 year old, bantam player, trying to get back to playing in one of the best junior hockey leagues. The physical stuff I could handle. I enjoyed grinding it out and getting back into shape both on and off the ice, but it was the mental side of things that I struggled with. I heard a lot of things like “once you get one concussion, it’s easier and easier to get another”. Well PLEASE BAN ME, I’m almost 19 years old and I’ve had seven. The thought of me being stuck in a bed for months again absolutely terrified me. Plus, there’s all the stuff about the brain disease, CTE, which is very common in people who have suffered concussions. This is still one of my biggest fears to this day. I think the fear of lying in bed was the factor that pushed me so hard physically. I felt like if I was stronger, I could take the hits better, if I was faster, I wouldn’t be in positions to get hit or I could move out of the way, and if I was just overall better, it would help my injury management. I want to be very clear here though, I have never been scared to get hurt in hockey. Once I got on the ice, the fear was gone. Hockey was my release from anything and everything. I kept thinking if hockey was worth putting my health on the line, but I just couldn’t hang the skates up yet. I loved the game. So, I got into the best shape so far in my life, and I felt like my game was WHL ready.


I think the fear of lying in bed was the factor that pushed me so hard physically

Just when I started feeling like I was ready to make a comeback, everything was put on hold. Vancouver’s staff wouldn’t let me play for them. I was a 19 year old kid who just wanted to play hockey. The organization had told me over and over again that the next time I play hockey, I would be in a Giants’ jersey. However, that seemed to change while I was kept in the dark. Less than a week before I was supposed to head back to Vancouver, I received a call from them saying they won’t let me play. I hadn’t played a game since September, and now it is mid-August and they are just telling me now. They had almost a year to make a decision. Don’t get me wrong, I appreciate everything the Giants did for me, but I felt like this situation could have been handled a lot better. Now, I don’t have a team to play for, so I stayed at home and kept trying to stay in shape. I was lucky enough to be able to practice and eventually play a game with the Okotoks Oilers while a trade was put in place. I want to thank the Okotoks coaches, staff and players for letting me be a part of their team for a short while. They really didn’t have to do that, but they are truly a top notch and professional organization so a big thanks to them. While I was with Okotoks, I was traded to the Calgary Hitmen. I wasn’t with them that long, but I practiced with them for about a week and a half and right before I was about to get back in the lineup for a game at home against Everett. I got hit in practice and was concussed again. So, a couple weeks after the hit, I get called in to their office and they tell me I can’t play anymore. I want to make this clear that this was not my decision. People always say to me “oh that must have been such a hard decision”. I didn’t choose to retire, but just like that, hockey was taken away from me. No matter how hard it was to hear, I do not blame them for making this decision. If I were in their shoes, I probably would have made the same call for a player. In saying this, I would also like to thank the Hitmen for taking a chance on me and giving me another shot at my dream. Very classy and professional organization.

My recovery this time was a lot different. I was introduced to a doctor in Burnaby, and his treatment was life changing for me. So much of the time I worried that I was never going to feel normal again, but after Dr. Sigalet’s treatment, I finally felt like myself again and got back to feeling 100%. I could never repay him for all that he has done for me. People who struggle from concussion problems realize how big of a deal just feeling normal is, and I was lucky enough to get back to that feeling. I am currently going to University and am an assistant coach for the Midget AAA Calgary Northstars. A day doesn’t go by where I don’t wish I was playing again, but I have come to terms with it and started a new chapter of my life, with new goals and aspirations and I am excited to see my concussion free future.

So much of the time I worried that I was never going to feel normal again

In closing, for anybody who has or currently is struggling with concussion problems, feel free to reach out to me and I will try and help in any way I can. The only advice I could really give is that if you are struggling and seeing a “specialist” and things aren’t working out, don’t be afraid to change it up. For me, the traditional doctor treatment didn’t work, so I kind of said screw it, I can’t get much worse so let’s try something different, and it ended up changing my life. However, if the traditional doctors are working for you, than stick with that. Everybody is different so everybody needs different treatments.

I just wanted to take this time to thank my family for all the time and money they spent to support my dream. Not many people would do the things you guys did for me and I can never thank you guys enough. Also, I would like to thank Blair Courchene for everything he has done for me. I have learned so much from him as a player, a person and a coach. Truly one of the best hockey minds and more importantly, one of the best people I’ve met in my life. Thank you for bringing me on to your coaching staff and letting me be a part of the game I love, and also thank you for letting me share my story.


Thanks for your time

Ryely McKinstry

https://bachockey.ca/2019/03/05/a-junio ... -the-dark/

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Bodychecked head-first into the boards

Post by greybeard58 » Mon Mar 11, 2019 5:34 am

Bodychecked head-first into the boards

Kristen Siermachesky wishes she was on the other side of the glass. As Syracuse makes a playoff push, the sophomore has been sidelined for the past seven games due to a Penn State player’s body check that sent her head-first into the boards.

Siermachesky (head and shoulder) has joined a long list of Syracuse players — Dakota Derrer (lower body), Savannah Rennie (concussion), Lindsay Eastwood (illness) and Mary Corby (upper body) — who have been ruled out for stretches this season. Many of the injuries, like Siermachesky’s, have come along the boards — the most dangerous part of a hockey rink, SU head coach Paul Flanagan said.

“It’s the scariest thing in our sport,” Flanagan said about a rink’s boards. “Every other sport, you can run out of bounds.”

In women’s ice hockey, players are prohibited from body checking, according to NCAA rules. But collisions are inevitable. The illegality of hitting presents challenges for preventing injuries, Mercyhurst assistant coach Kelley Steadman said. There’s no way to completely eliminate game injuries, but players and coaches often stress teaching young players more efficient habits to prevent dangerous hits.

Women’s ice hockey has the third-highest injury rate out of any women sport — behind soccer and gymnastics — according to an American College of Sports Medicine study. That study also found that incidental or intentional contact accounts for 40 to 58 percent of injuries, most commonly concussions, which members of SU are prone to on the boards.

In search of a possible solution, some have advocated for a “Look-Up Line” — a 40-inch wide painted orange strip along the circumference of the rink to remind players to skate with their heads up. SU players like Jessica DiGirolamo would favor a warning track, but no one has approached the College Hockey America’s office about it, Robert M. DeGregorio Jr, the league commissioner, said. The Look-Up Line Safety Program could not be reached for comment.

Flanagan puts the responsibility on coaches to teach young skaters awareness. Avoiding vulnerable positions can help reduce the impact of a hit, and avoid an injury entirely. Also, skating with bent knees and a balanced core helps brace for impact.

“I think as hockey players, part of your growth and development is knowing where you are on the ice,” Steadman said. “Making sure you’re not putting yourself in a situation where you can either injure somebody or be injured yourself.”

Racing for pucks along the boards is among the most dangerous situations in the sport, DiGirolamo said. While fighting for position, players can lose their footing two to three feet away from the glass, which RIT head coach Chad Davis calls the “danger zone.” Last weekend, a Lindenwood forward held DiGirolamo from behind in pursuit of a loose puck, which led to a skirmish.

DeGregorio Jr. said the league sends out points of emphasis to coaches before every season. This year, his and the league’s emphasis were on hits to the head and from behind.

“(It’s) trying to get the players to understand nobody wants a concussion,” DeGregorio Jr. said. “So you’ve got to stop delivering concussions.”

But even with the extra precaution of a warning track, SU captain Brooke Avery said the “Look-Up Line” might not work because once skaters see it, “it’s too late.” Meanwhile, Davis and DiGirolamo still favor the reformed rink, even though it may be an adjustment for players.

“Even if it could help eliminate one serious situation,” Davis said. “It would be worth it.”

Possibility of ‘Look-Up Line’ could help prevent injuries in ice hockey
Read more: http://w.dailyorange.com/2019/02/possib ... ce-hockey/

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

U.S. Olympic cycling medalist Kelly Catlin concussion

Post by greybeard58 » Mon Mar 11, 2019 12:02 pm

National Suicide Prevention hotline 24 hours
1-800-273-8255


U.S. Olympic cycling medalist Kelly Catlin dies at 23

Olympian Kelly Catlin, who helped the U.S. win the women's pursuit team silver medal at the 2016 Rio Games, died at the age of 23, USA Cycling said March 10. (Reuters)

By Cindy Boren March 11 at 8:59 AM

Kelly Catlin, a member of the U.S. women’s pursuit team that won a silver medal during the 2016 Olympic Games, died Thursday night, ending her focused, driven life at the age of 23. Her death left her father describing “unbelievable” pain and her sister saying, “I want the world to know there was a human being underneath that hard shell."

Catlin died in her on-campus residence at Stanford University; her family members confirmed that she died by suicide, her second attempt since January. Her father, Mark, called her a “warrior princess” in a phone interview with The Washington Post, saying that “part of her undoing was her personal code. She gave 110 percent to whatever she was doing.”

Catlin was one of a set of triplets; her sister, Christine, wrote in an email that Kelly Catlin was “a really special person — kind, funny, empathetic, and talented at literally everything she did. She just felt like she couldn’t say no to everything that was asked of her and this was her only escape.”

A graduate student at Stanford, Catlin was pursuing a degree in computational and mathematical engineering while training in track cycling as a member of the national team and racing as a professional road cyclist. She also excelled at the violin and as an artist. “Everything she did, she was the best at when we were little kids,” Christine Catlin said in a telephone interview Sunday night. “Sports, violin and she casually picked up cycling. We were the Catlins, so we were this force.”

Colin Catlin, the third triplet, said he helped push his sister into cycling, and that “she didn’t really want to, but she started winning things and she likes winning things.” He also helped spur her interest in data science, he said.

“I always saw myself as the planner and she was the doer,” he said in a telephone interview. “I could always see the three of us taking over the world. We were a massive ball of energy and we supported each other in everything.”

Two crashes, one in which she broke her arm in October and another in which she sustained a concussion in December, seemed to take away the control, the multitasking, that Catlin had always prized. In January, she attempted suicide for the first time and was clearly a different person to her family. “She was not the Kelly that we knew,” her father said. “She spoke like a robot. We could get her to talk, but we wondered, ‘what has happened to our Kelly?’

" . . . Everything was open to her, but somehow her thinking was changed and she couldn’t see beyond, I guess, her depression. After her concussion, she started embracing nihilism. Life was meaningless. There was no purpose. This was a person with depression. For her, she could no longer concentrate on her studies or train as hard. She couldn’t fulfill what she felt were her obligations to herself, she couldn’t live up to her own standards. She couldn’t realize that what she needed to do was get away and rest, heal. We were all searching for the magic words, that life was worth living.”

She also suffered from headaches and light sensitivity. “She had written this lengthy email [to her family in January] and said her thoughts were racing all the time,” Christine Catlin said. “She was suicidal, her thinking was really dark, and she had taken to nihilism. We called police the moment we got the email and they got there in time to save her that time [from suicide].”

Although she was in treatment, she convinced her family that she was thinking of the future, even amid her struggles. “It was my impression that she was of two minds about the whole thing,” Colin Catlin said of her suicide. “What killed her was her own stubborn determination. She had to win at everything. She got this idea [about suicide], which may have been related to her concussion. Just a week or two ago, we were making plans and I was optimistic about her future. She did have plans for the future, it turned out. Her plans.”

“The thing that haunts me is that she called me about a week and a half before [she died] and we talked for like 2½ hours and she opened up to me about her whole life,” Christine Catlin said.

Her father described what happened to his daughter as “a perfect storm” of depression, concussion symptoms, overtraining, “not being able to say no” and a rapid heart rate that kept her from being able to train, which he called “the final straw.”

It was all too much and in a recent VeloNews blog post on how she managed three intense pursuits, Kelly Catlin had written that she sometimes felt as if she needed “to time-travel to get everything done. And things still slip through the cracks.

“This is probably the point when you’ll expect me to say something cliche like, ‘Time management is everything.’ Or perhaps you’re expecting a nice, encouraging slogan like, ‘Being a student only makes me a better athlete!’ After all, I somehow make everything work, right? Sure. Yeah, that’s somewhat accurate. But the truth is that most of the time, I don’t make everything work. It’s like juggling with knives, but I really am dropping a lot of them. It’s just that most of them hit the floor and not me.”


Catlin, an Arden Hills, Minn., native who had earned an undergraduate degree in biomedical engineering and Chinese from the University of Minnesota, helped the U.S. team win three consecutive world titles in pursuit between 2016 and 2018. She won bronze in the individual pursuit at the track cycling world championships in 2017 and 2018. She withdrew from the cycling world championships last month in Poland despite being on USA Cycling’s initial roster. She attended the Rally Cycling road team’s January training camp in Oxnard, California but this season she had not competed with the team she first joined in 2017.

Kathryn Bertine
@KathrynBertine
The sisterhood of pro cycling is absolutely devastated to hear the news of @kelly_catlin’s death. Suicide claimed this amazing woman, Olympic silver medalist, world champ, Stanford grad student. We’ll never know the weight she carried, but we will carry her in our hearts forever.

477
12:00 PM - Mar 10, 2019
132 people are talking about this

“We are deeply saddened by Kelly’s passing,” Rob DeMartini, the president and chief executive of USA Cycling, said in a statement. “We will all miss her dearly. Kelly was more than an athlete to us and she will always be part of the USA Cycling family."

Her sister described her feelings as “mostly numb” because “it feels like we went through the grieving process the first time she did this. It feels so unreal, but I’m glad that after her first attempt we had the chance to be there and let her know how much we cared.”

Kelly Catlin ended her VeloNews journal by echoing her father, who had told her she needed to rest — even if that meant quitting cycling or leaving school for a while and taking time off. “Ask for a rest day,” she wrote, “or, if you’re fortunate to be your own taskmaster (er, coach), give yourself a rest day.”

https://www.washingtonpost.com/sports/2 ... tlin-dies/

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Family Say Concussion Months Before Suicide Changed Her

Post by greybeard58 » Thu Mar 14, 2019 6:13 pm

Family Say Concussion Months Before Suicide Changed Her: She Felt ‘Trapped’

Olympic cyclist Kelly Catlin died by suicide Friday, months after suffering a concussion during a race.

The family of Olympic cyclist Kelly Catlin say a devastating concussion several months ago may have sparked the symptoms that eventually lead to her apparent suicide.

Catlin, who helped the U.S. women’s pursuit team win the silver medal at the 2016 Rio de Janeiro Games, died Friday after she was found in her Stanford University dorm room in California. She was 23.

The athlete’s father Mark Catlin told PEOPLE that Kelly’s attitude and behavior took a drastic turn in December, when she suffered a concussion during a cycling race.

Following the injury, Kelly was plagued by various symptoms, including vision problems, severe headaches, and an inability to complete workouts with her team.

“My wife and I talked to her weekly on the phone and she started to express apathy about cycling, which she’d never done before,” Mark said. “She had a lack of enthusiasm for the Olympic team, for training, for everything in life. We were concerned. She ran herself down. The concussion had a profound impact on her. She had these mental issues and she started to feel trapped.”

Her sister Christine, meanwhile, said Kelly attempted to die by suicide in January. She survived, and underwent physical and mental health treatment for about two weeks before returning to school, where she was pursuing a graduate degree in computational mathematics.

Christine told PEOPLE that when she heard from Kelly in an email, her sister wrote that she was having “racing thoughts” and that “her mind wasn’t working the way it used to,” which she thought was Kelly describing her concussion symptoms.

“She described being tortured mentally by not being able to do what she used to do,” said Christine, who was Kelly’s triplet, along with brother Colin.

A concussion is a common word used to describe a mild form of a traumatic brain injury (TBI), according to the Centers for Disease Control this link opens in a new tab.

The injury is common among children age 19 or younger, and between 2001 to 2012, the rate among kids diagnosed with a concussion or TBI from a sports or recreation-related injury more than doubled, according to the CDC.

Typical symptoms match those Kelly described to her family, like difficulty thinking clearly and concentrating, sensitivity to noise or light, dizziness, headaches, blurry vision and changes in sleep patterns.

A Danish study published in August found that people with traumatic brain injuries may be nearly twice as likely to die by suicide than those without a history of TBI, according to Reuters this link opens in a new tab.

The study also reportedly found that the risk of suicide was highest within the first six months after initial treatment for a brain injury.

“[Kelly] had such a bright future. She was so multi-talented,” Mark told PEOPLE. “There was so much about life that she enjoyed and this was such a temporary setback that she couldn’t see through. It’s such a loss to the world and a loss to her that she’s gonna miss so many good things. She had so much to look forward to. Now it’s not gonna happen.”

Kelly’s family has opted to donate her brain to Veterans Affairs-Boston University-Concussion Legacy Foundation Brain Bank in order to see if her death was in any way connected to her concussion.

“Our family decided to have a neuropathologic examination performed on Kelly’s brain to investigate any possible damage caused by her recent head injury and seek explanations for recent neurologic symptoms,” Mark said, according to the Washington Post this link opens in a new tab.

The Bank confirmed the donation to PEOPLE, noting that it received the brain on Tuesday.

If you or someone you know is considering suicide, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), text “home” to the Crisis Text Line at 741-741 or go to suicidepreventionlifeline.org.

Kelly Catlin’s Family Say Concussion Months Before Suicide Changed Her: She Felt ‘Trapped’
Read more: https://people.com/sports/kelly-catlin- ... hanged-her

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Kelly Catlin's Father Shares

Post by greybeard58 » Fri Mar 15, 2019 9:13 am

Kelly Catlin's Father Shares What He Believes Could Have Saved His Daughter
MARK CATLIN, M.D., ANALYZES THE FACTORS LEADING TO THE OLYMPIC CYCLIST’S SUICIDE, IN HOPES OF PREVENTING FUTURE TRAGEDIES.

BY GLORIA LIU
Mar 14, 2019

Father of Olympic cyclist Kelly Catlin, who died by suicide last week, shares a memo with an analysis of what he believes could have saved his daughter.
Kelly's death, her dad says, was caused by a number of factors, including depression caused by concussion, overtraining, stress, and personality.
He recommends prevention tactics including assigning primary care physicians to Olympic athletes, and access to individualized mental health care.
Last Friday, Olympic track cyclist Kelly Catlin (center, in the photo above) died by suicide at the age of 23. Catlin was a silver medalist at the 2016 Rio Olympics, a three-time world champion in the team pursuit, and a graduate student at Stanford University studying computational and mathematical engineering.

Her father, Mark Catlin, M.D., has released a document detailing a timeline of events leading to his daughter’s death, along with an analysis of factors that he believes may have contributed to it—in hopes that lessons can be learned to prevent future tragedies.

By all accounts, Kelly Catlin displayed a nearly unmatched drive for excellence in all that she did—which also included playing classical violin, and fluency in Chinese. Catlin was beloved among the cycling community for being what her Olympic team coach Andy Sparks describes as “the exemplar of a team rider” who “always put others first.”

Catlin’s family believes that her depression was largely precipitated by an initially undiagnosed concussion, which may have occurred during a January 2019 training ride crash at a camp for her pro team, Rally UHC Cycling. (According to Velonews, the team said that Kelly was assessed immediately after this crash and there was no indication of serious injury.) After the crash, she began complaining of severe headaches, nausea, and sensitivity to light. Signs of depression soon followed.

Mark Catlin, who is a pathologist—a doctor who studies the causes and effects of diseases—near Minneapolis, tells BICYCLING that his daughter had never displayed any indication of depression or anxiety prior to this. He told the Washington Post, “She was not the Kelly that we knew...She spoke like a robot. We could get her to talk, but we wondered, ‘What has happened to our Kelly?’” She also described having racing, repetitive thoughts, and the sense that life was meaningless. In January, Kelly Catlin attempted suicide for the first time.

A Tribute to Kelly Catlin From Teammate Kirsti Lay
In his memo, Mark Catlin describes the cause of his daughter’s death as a combination of depression caused by the concussion, overtraining, stress from trying to juggle schoolwork with cycling, frustration from being unable to train like she wanted to because of her injuries, and—despite a personality that could also be funny, animated, and kind—an all-or-nothing approach to life that could not accept failure or letting others down. He also includes recommendations to the US Olympic program that he believes could help to prevent other athletes from slipping through the cracks.

“You kind of go through this ‘if only’ this, ‘if only’ that,” Mark Catlin says, describing a desire to “analyze” what happened. “I think part of the grieving process for me is trying to understand really what took place and how this came about because it really did come as a shock to us... And I guess that memo almost grew out of that process, but it was also a desire to maybe make some changes. There are a couple things about concussion testing and cautionary things about how important it is to have a baseline [test result], and if you have a head injury, to get checked out if you have any kind of symptoms.” Kelly, he says, was able to memorize passages and essentially outsmart reading tests that were administered to assess her potential head injury. The Catlin family has donated Kelly’s brain for concussion research.

Mark Catlin also stressed the importance of watching for signs of overtraining. “It can have severe mental issues, with depression, anxiety, sleep disorders, all kinds of stuff,” he says.

His memo is not intended to assign blame or imply wrongdoing. “In my grief, I do get upset thinking it shouldn’t have happened, but I have no intention of letting it go beyond a passing feeling,” he says. “She isn’t coming back.” Mark Catlin simply hopes that, as a result of Kelly’s passing, some “institutional” changes can be made to prevent this from happening again.

Below is his original memo, with minor edits for clarity. Though he is a medical professional, BICYCLING notes that the following should not be considered a medical review. It is written from the perspective of a father, based on his observations of his daughter.—Ed.

Analysis of Kelly’s death with recommendations.

Based on recently discovered notes from weekly (and later daily) phone conversations with Kelly.

Basic timeline and sequence of events:

September: Normal, enthusiastic, looking forward to next year’s World Cup, enthusiastic about team and future (can be seen in home videos).

October: Training accident in LA causes broken arm [Ed. Note: This occurred during a national-team camp that ran from October 11-22.]

October-January: Reports to me that she is training harder than ever, muscles stronger than ever.

November: World Cup event. Reports (to father) increased difficulties training, some apathy, trouble focusing. We thought these may have been symptoms of overtraining.

Early January: Initially unrecognized concussion from training ride accident. Reports to training camp and experiences severe headaches with first several hard training efforts. Stops participation and returns to Olympic Training Center (OTC) for evaluation. [Ed. Note: “Training ride accident” refers to the January 5 training ride crash. According to VeloNews: “The following day, she left Rally’s camp and traveled to Colorado Springs to attend a training camp with the U.S. national team. Mark Catlin says Kelly reached out to the family during the camp and complained of dizziness, nausea, and sensitivity to light.”]

January: Reports increasing apathy regarding Rally, National team, Olympics, and life. First time I hear about her embracing nihilism. Out of body sensations. Headaches with training and sometimes when just walking.

End of January: Suicide attempt [by asphyxiation]. Admitted to psych lockup. Has evidence of hypoxic damage with elevated cardiac enzymes (not followed up by hospital, as far as we know). We (parents) fly to Stanford to be with her.

February: During hospital stay gets extremely distressed by confinement, lack of sleep (roommate is hearing voices and talking to unknown entities), constant monitoring, exposure to some very disturbed individuals, and frustration with what she felt was an inability of staff to understand her issues as an elite athlete. Only help comes from a sports psychiatrist who will not be available to see her on outpatient basis until May. Released from hospital after promising not to commit suicide again as well as to begin group therapy sessions.

February-March: Returns to Stanford with reduced class load and resumes training enthusiastically, with thoughts of going to Poland for World Championships and racing individual pursuit. Feels really good after week of forced rest in hospital. Does as many as three high-intensity workouts a day to get prepared. Goes 11 days without a rest day. Attends outpatient group therapy sessions—pronounces them worthless. MRI shows indeterminate white lesions in gray matter. Had TBI (traumatic brain injury) testing that she passed perfectly except for some mild abnormalities. Cleared to go to Worlds. Steve McGregor [Kelly’s personal coach] finds world-class sports psychologist at Stanford, but tells me the University will not allow her to see Kelly because she is not a varsity athlete. Begins experiencing increasing difficulties training—concussion symptoms return (has to close her eyes because of headaches during Uber car ride), heart racing with only moderate efforts, rest does not seem to improve. Training essentially stops because of heart issues. Poland is ruled out. Rally wants her to race with them in March and April. No one tells Rally of the seriousness of her troubles. Contemplates end of racing career because of training issues.

March, about a week before her death: Has long discussion with sister. States that if she is not better after month she will kill herself. This is reported to her parents. We didn’t act because of her promise, what we thought was her reduced academic stress (she was on a leave of absence) and training stress, and daily phone conversations that suggested she was fine.

First week in March: No response to phone calls and text messages. March 8 kills herself.

Analysis:

Kelly’s death was a combination of:

1) Kelly’s personality

2) Overtraining + additional stresses

3) Concussion

4) Additional hypoxic brain and cardiac damage from first suicide attempt.

In more detail:

1) Kelly was incredibly intelligent, determined, focused, hardworking, stoical to a fault, unable to say no, in denial of personal feelings and emotions, a limited ability to express emotions, and a certain inflexibility and inability to change. Her pride, self-worth, and identity were tied up in her success, her ability to endure incredible pain and stoical affect. She lived by Yoda’s motto of, “There is no try, only do.” Although all these traits led to her tremendous success it is also readily apparent how, when she got in trouble they led to her death. As she struggled with the effects of overtraining, stress, and the concussion, she was unwilling to admit she was in trouble and seek or even accept help.

2) Overtraining + other stresses. In October, and increasingly in November and December, Kelly reported apathy and inability to concentrate during training and study. She was training harder than ever and still doing complex mathematics and computer programming. Add the stresses of travel, training camps, and a bone fracture. Her muscles may have gotten days off—her brain never did, and intense training is very mentally fatiguing. After forced rest from failed suicide attempt, she immediately launched into a training routine that would reactivate her symptoms.

3) Concussion. This compounded and accelerated her mental deterioration from overtraining and resulted in despair. This was initially unsuspected but after experiencing severe headaches her mother suggested she closely inspect her helmet. She [Kelly] found cracks in the front and back. In addition to increasing apathy she was having spinning thoughts and severe headaches with walking. I believe these symptoms led to her first suicide attempt.

4) Compounding injuries of first suicide attempt. The resulting hypoxia exacerbated her training symptoms and caused an additional complication—heart problems. She still reported headaches with exertion but now she found her heart would race even with light to moderate exertion. Her mother and I suggested she take time off completely, even quit school, Rally, and the national team. We suggested she come home or go to the OTC to live and be evaluated. She wouldn't accept this advice. Steve reduced her training to "coffee ride" level but she was still struggling. I don't think anyone notified Rally of her struggles (certainly not her).

Could someone have successfully intervened and saved Kelly? No one knows. This was a determined girl who reacted to the result of her first suicide attempt with anger, saying, “I don’t fail at anything.”

I think there were three possibilities to save her: 1) Prolonged, forced, and enforced rest—she clearly improved after the forced rest of her hospital stay. 2) Intense individual therapy with a sports psychologist who understood her and to whom she would relate. 3) Taking off some of the pressure to train by ruling out participation in Poland and racing for Rally.

Recommendations:

1) Olympic Committee work to guarantee all college and university Olympians be granted varsity status, regardless of their sport. This would allow better access to training facilities, recovery facilities, trainers, and medical care. It would also allow greater flexibility in academic planning. In this case Kelly would have had access to a sports psychologist that might have saved her life.

2) Have Olympians with medical issues assigned to a primary care physician to coordinate their care. For residents at the OTC this should be a permanent, in-house primary care specialist. In Kelly's case there was no one to follow up on her abnormal cardiac enzymes, to make sure she was getting the individual therapy she needed, and who could coordinate all the specialists she was seeing. She needed an advocate and someone who could interpret and follow up her results. At the OTC this is very difficult because there is no permanent medical staff—just rotating volunteers from various specialties.

I hope the Olympic Committee will follow up on these recommendations. Instituting these changes will help prevent future medical issues and help many of us feel that Kelly's death has contributed to some positive changes.

—Mark Catlin, M.D.

The National Suicide Prevention Lifeline is 1-800-273-8255.

The Catlin family and USA Cycling have set up a memorial fund in Kelly Catlin’s name. To donate, visit usacycling.org/foundation/kelly-catlin-fund.

GLORIA LIU Contributing Writer, Bicycling & Runner’s World
Gloria Liu is a writer-at-large, and formerly the features and gear editor at Bicycling.

https://www.bicycling.com/news/a2682377 ... -daughter/

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

"If our data tells us one thing

Post by greybeard58 » Fri Mar 15, 2019 6:46 pm

"If our data tells us one thing – it's that female athletes are not willing to report their own injuries"

Mark Herceg, PhD, a leading concussion expert, researcher and neuropsychologist at Northwell Health's Phelps Hospital, presented today at the 13th World Congress on Brain Injury in Toronto results of a study on elite female youth ice hockey players and their knowledge about concussions, including how their behavior is influenced by their awareness.

Few studies have examined the knowledge about concussion in female athletes, which is an important factor in concussion care, according to Dr. Herceg, a member of The Feinstein Institute for Medical Research. A vast majority of research to date primarily focused on men's sports. Dr. Herceg argues that female athletes have a higher prevalence of concussion and recover from injury slower as compared to male athletes.

The main focus of Dr. Herceg's study examined how the knowledge girls have about concussion interacts with their self-reported behaviors and included questions asking participants about their behavior in order to assess how much their awareness is connected and applied to their behavior.

"It's troubling that the vast majority of studies on reporting behavior are not comprehensive because they either do not include women or do not probe players' knowledge about concussion," Dr. Herceg said. "There needs to be a greater effort to get female athletes to take ownership when they are hurt and for professionals and the general public to address the female athlete in the same fashion."

More than 400 out of 535 female players, or 75 percent of the participants, completed the 33-item survey, which was issued to 47 youth ice hockey programs across New Jersey, New York, Connecticut and New Hampshire, of which 20 confirmed participation. The form included questions on severity of injury, whether they ever had a concussion they did not report, and what they think constitutes a concussion. Dr. Herceg's results indicate that although girls tend to demonstrate good overall knowledge of concussion, this notion does not necessarily impact their behavior or alter how they report their own head injuries.

"If our data tells us one thing – it's that female athletes are not willing to report their own injuries, which can have lasting consequences," Dr. Herceg added. "Female participation in ice hockey across the country is growing, so it will become ever more critical not only to address the risk factors but to improve education and awareness so that proper diagnoses can be made and appropriate treatment recommended."

Ultimately, the research aims to characterize the relationship between knowledge and action and the extent of knowledge generally and seeks to encourage girls to consistently report their injuries.

"The seriousness of sports-related concussions elevate the importance of Dr. Herceg's findings that athletes sometimes fail to report their injury which leads to misdiagnosis and absence of therapy," said Kevin J. Tracey, MD, president and CEO of the Feinstein Institute.

In February, a group of more than 60 leading international neuroscientists – including Dr. Herceg – published a correspondence in The Lancet Neurology, asking for balance when reporting on sports-related injury chronic traumatic encephalopathy, a type of dementia associated with exposure to repeated concussions that has been linked with a variety of contact sports such as boxing, football, American football and rugby.

Concussion expert explores
Read more: https://www.benzinga.com/pressreleases/ ... avior-foll

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Retiring from hockey at age 20 due to concussion issues

Post by greybeard58 » Wed Mar 20, 2019 12:11 pm

Retiring from hockey at age 20 due to concussion issues

After sitting out the season, HV71 defender Selma Aho retires from hockey at age 20 due to concussion issues. Her announcement on Instagram:

"It's 15 months since my last concussion - it has been a long roller coaster since the first day. Last fall and winter have been characterized by various medical visits, sick leave, rehabilitation clinic, anxiety and disappointments. A heavy decision has emerged throughout this time, which has really been addressed to me, this is the absolute last thing I want but I have no choice, my hockey is over. Life goes ahead.

I want to thank all the fantastic teammates and all the fantastic guys I played / trained with over the years that always seen me as one of them and made me feel welcome, thank you!
Thanks to all the trainers, materials, associations and, above all, thank you to my family who have been there and supported me through all the years.

Having been assigned to teams that become like your second family is the finest I know.
Hockey has been my first and greatest love in life and I will forever miss a big piece of my heart."

Reply to the instagram, Sofia Stellansdotter says this about her concussions: Hi first of all, I just want to regret that this has happened to you! I also want to tell you about a treatment that helped me to get completely healthy from PTS. I got a concussion before the summer and 4th in a short time at the beginning of last year so in six months so I got 5 and was really bad, I absolutely managed not by working and i had difficulty coping with my everyday life and it was talk that i might possibly get sickness compensation because i was so poor and the forecast did not look good at all ... At the beginning of summer last year i went to a very good craniosacral therapist and she felt that it was not as it would at my one temple and when she was on and treated so i felt how it started clearing her head and it started to feel more normal again and afterwards it continued to feel better and better and all the symptoms were gone the next day! The only thing I have a little problem with now is that my near memory has been much better and that I feel a little confused at times.

https://www.instagram.com/p/BuwQAF4A0ZL

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

"tough transition" to move on from hockey

Post by greybeard58 » Thu Mar 21, 2019 8:39 pm

:: "tough transition" to move on from hockey

After months of darkness, Josephine Pucci was finally beginning to recover from what she had thought would be a career-ending concussion.

An elbow to the head during a USA hockey game against Canada had put the Olympic hopeful in bed for weeks, lying in a dark room as she recovered. She tried to get up to go to class, but the sunglasses didn't stop the throbbing headaches or the dizziness. It was difficult to read or concentrate. She decided to withdraw from Harvard University for at least a semester.

Finally, a friend recommended a new type of treatment: chiropractic neurology. Instead of bedrest, it involved intense exercises for the eyes, head and musculoskeletal system to restore balance.

At a clinic in Atlanta, Pucci delved into the exercises with a passion. That's where she saw the light.

The epiphany came when she met a woman who hadn't walked in years. During therapy, with others cheering her on, the woman stood up and took her first steps in a decade.

"That was really powerful," Pucci said. "Everyone in the room came to tears."

At that moment, Pucci was inspired with a new goal in life: to help others as she was being helped.

It motivated her to take pre-med classes and eventually join the Army, where now as a second lieutenant she attends the Uniformed Services University of the Health Sciences.

"I just want to be the best doctor I can be," she said, "so that I can one day have that positive impact that my doctor had on me and I saw him have on others."

LONG ROAD BACK

The injury Pucci suffered in Calgary, Canada, in 2012 wasn't like any other she had experienced playing hockey. This time, the problems persisted for months.

"I felt like I was losing hope that I was going to be able to fully recover," Pucci said.

When a fellow hockey player told her about the neurology institute in Atlanta run by Dr. Frederick "Ted" Carrick, she was at first a bit skeptical, but decided to give it a try. After all, it was the same clinic that Pittsburgh Penguin hockey star Sidney Crosby had recently used for his recovery after a concussion.

"He was able to give me that hope back," she said about Carrick as he helped her make progress with his diagnosis and treatment plan.

He prescribed a series of saccades exercises for eye tracking, along with routines for gait and stability. He also put her on a gyrostim, a two-axis rotational chair that flips around to help restore balance.

"She followed my direction for her treatment with a passion," Carrick said, adding at the same time, she encouraged other patients not to give up.

After just two days, Pucci was able to take off her dark sunglasses and even get out on the ice to slowly skate in a circle.

"As soon as she started to improve her function," Carrick said, "she was a natural support system for other patients. She counseled them, worked with them, and served as a role model."

ROAD TO SOCHI

Over the next few months, Pucci went back and forth from Boston to the clinic in Atlanta.

"I was so invested in my recovery," she said, explaining she was determined to try out for the 2014 Olympics.

She began training again for hockey at a sports center in Bedford, Massachusetts. After months of practice, she went back to Lake Placid, New York, and impressed the national team coaches. She made the cut for the Olympic team headed to Sochi, Russia.

In Team USA's first game against Finland, Pucci played defense like she did at Harvard, and USA won 3-1. In the second game against Switzerland, she was credited with an assist -- a goal that helped USA beat the Swiss, 9-0.

The USA women lost to Canada, 2-3, but went on to beat Sweden 6-1 in the semifinals. That set up a gold-medal match between USA and Canada again and in overtime, Canada ended up prevailing 3-2.

After coming home from Sochi with silver, Pucci had been all fired up to go back and avenge the loss.

"The competitor in me wanted to get back to training and redeem how things ended up," she said. But other goals interceded. A month later, she called the USA Hockey coach.

CHANGING DIRECTION

It was one of the most difficult phone calls she ever made, Pucci said.

"I wanted to pursue a career in medicine and didn't want hockey or anything else to get in the way," she said. "I didn't want to have another brain injury that might affect me worse than that one."

She went back to Harvard full-time to finish her undergraduate degree, taking as many pre-med courses as she could. She even told Coach Katey Stone that she wouldn't play hockey her final year at Harvard.

It was a "tough transition" to move on from hockey, Pucci said. She finally relented and agreed to play hockey her senior year at Harvard. Her focus, however, was on pre-med studies as she finished courses for her major in social and cognitive neuroscience.

Between classes, she worked part-time in a traumatic brain injury research laboratory at Massachusetts General Hospital for Children. Dr. Michael Whalen was her supervisor there when not teaching as an associate professor at Harvard Medical School.

Pucci said she learned a lot working in the lab and Whalen motivated her. "I felt like he had confidence in me before I had confidence in myself," she said.

She was introduced to western blotting, counting cells and behavioral studies with mice. She worked full-time at the lab during semester breaks and the summer.

"You have to be fully dedicated," she said, in order to pursue a career in medicine, and Whalen convinced her she could do it.

After she graduated Harvard, Pucci began working in a neurology lab at Columbia Presbyterian Hospital in New York City while taking more pre-med classes in the evenings.

GIVING BACK

During this time, she also worked to expand a nonprofit organization she had established to help those suffering from concussions. She wanted to spread the word about alternatives for recovery.

Pucci first had the idea for a nonprofit shortly after she recovered from her concussion. She connected with a couple of hockey players at Yale University who had experienced concussions. They began researching how to establish a nonprofit.

"Our mission is really to promote a safer sports culture," she said. "That means encouraging athletes to not just fight through a concussion and play through it, but handle the concussion properly."

Another goal of the organization is to "provide a community" for those who suffer from concussions so that they can network and share resources.

"We call it a concussion circle," she said. "A lot of the work I was doing with the nonprofit, or just projects to volunteer and give back, it is fulfilling and it's exciting."

When she was looking into medical schools, she came across the Uniformed Services University of the Health Sciences. "I had never heard of it before," she said. "It caught my eye right away."

She was encouraged, however, to apply to multiple schools; so she did. She was on a waitlist for Stanford School of Medicine when she heard from USU.

The idea of pursuing a medical degree while serving her country was appealing, she said, adding it was exciting to think about "serving those who serve." So the decision was an easy one.

HITTING THE ICE AGAIN

During her second semester at the Uniformed Services University in Bethesda, she was contacted about playing a pick-up hockey game for the Army against Navy. The game was scheduled for Feb. 7, immediately following a Washington Capitals game.

It was just her fourth time wearing hockey equipment since college, Pucci said, "but it was fun to get out there; it was fun to meet some people on the team."

Army Chief of Staff Gen. Mark A. Milley coached the team, while Vice Chief of Staff Gen. James C. McConville played defense alongside Pucci.

"She took great care of me playing left defense," McConville said about his young teammate.

The two of them had an opportunity to talk during practice sessions prior to the game with Navy.

"What impressed me the most is really the way she faced adversity and overcame it," the general said. "We're looking for resilience in men and women of character and she fits the mold perfectly."

Hockey and the Army share a lot of similarities, he noted.

"They're both contact sports," he said. "You get knocked down and sometimes you need to get [back] up."

He also met Pucci's father at the hockey game. "You could see where she got her character," McConville said, explaining her dad spent over 25 years as a police officer in New York City.

Passion will make 2nd Lt. Pucci a great doctor, McConville said, adding "she's going to help a lot of people in the future."

Now in the Army, she said she's on the "best team in the world" and feels that her experience recovering from a traumatic brain injury gives her "perspective" that may help her as a doctor.

"I feel like, unfortunately, a lot of service members suffer with that injury," she said.

TBI treatment is changing in the military, she said. Soldiers no longer are told to just stay in a dark room and rest, but she added there's still a ways to go to advance treatment.

"Hopefully I'll be able to take what I've learned … and give them a little more answers," she said.

Giving back: Olympian aims to help Soldiers with concussions
Read more: https://www.army.mil/article/218734/giv ... oncussions

After months of darkness, Josephine Pucci was finally beginning to recover from what she had thought would be a career-ending concussion.

An elbow to the head during a USA hockey game against Canada had put the Olympic hopeful in bed for weeks, lying in a dark room as she recovered. She tried to get up to go to class, but the sunglasses didn't stop the throbbing headaches or the dizziness. It was difficult to read or concentrate. She decided to withdraw from Harvard University for at least a semester.

Finally, a friend recommended a new type of treatment: chiropractic neurology. Instead of bed rest, it involved intense exercises for the eyes, head and musculoskeletal system to restore balance.

At a clinic in Atlanta, Pucci delved into the exercises with a passion. That's where she saw the light.

The epiphany came when she met a woman who hadn't walked in years. During therapy, with others cheering her on, the woman stood up and took her first steps in a decade.

"That was really powerful," Pucci said. "Everyone in the room came to tears."

At that moment, Pucci was inspired with a new goal in life: to help others as she was being helped.

It motivated her to take pre-med classes and eventually join the Army, where now as a second lieutenant she attends the Uniformed Services University of the Health Sciences.

"I just want to be the best doctor I can be," she said, "so that I can one day have that positive impact that my doctor had on me and I saw him have on others."

LONG ROAD BACK

The injury Pucci suffered in Calgary, Canada, in 2012 wasn't like any other she had experienced playing hockey. This time, the problems persisted for months.

"I felt like I was losing hope that I was going to be able to fully recover," Pucci said.

When a fellow hockey player told her about the neurology institute in Atlanta run by Dr. Frederick "Ted" Carrick, she was at first a bit skeptical, but decided to give it a try. After all, it was the same clinic that Pittsburgh Penguin hockey star Sidney Crosby had recently used for his recovery after a concussion.

"He was able to give me that hope back," she said about Carrick as he helped her make progress with his diagnosis and treatment plan.

He prescribed a series of saccades exercises for eye tracking, along with routines for gait and stability. He also put her on a gyrostim, a two-axis rotational chair that flips around to help restore balance.

"She followed my direction for her treatment with a passion," Carrick said, adding at the same time, she encouraged other patients not to give up.

After just two days, Pucci was able to take off her dark sunglasses and even get out on the ice to slowly skate in a circle.

"As soon as she started to improve her function," Carrick said, "she was a natural support system for other patients. She counseled them, worked with them, and served as a role model."

ROAD TO SOCHI

Over the next few months, Pucci went back and forth from Boston to the clinic in Atlanta.

"I was so invested in my recovery," she said, explaining she was determined to try out for the 2014 Olympics.

She began training again for hockey at a sports center in Bedford, Massachusetts. After months of practice, she went back to Lake Placid, New York, and impressed the national team coaches. She made the cut for the Olympic team headed to Sochi, Russia.

In Team USA's first game against Finland, Pucci played defense like she did at Harvard, and USA won 3-1. In the second game against Switzerland, she was credited with an assist -- a goal that helped USA beat the Swiss, 9-0.

The USA women lost to Canada, 2-3, but went on to beat Sweden 6-1 in the semifinals. That set up a gold-medal match between USA and Canada again and in overtime, Canada ended up prevailing 3-2.

After coming home from Sochi with silver, Pucci had been all fired up to go back and avenge the loss.

"The competitor in me wanted to get back to training and redeem how things ended up," she said. But other goals interceded. A month later, she called the USA Hockey coach.

CHANGING DIRECTION

It was one of the most difficult phone calls she ever made, Pucci said.

"I wanted to pursue a career in medicine and didn't want hockey or anything else to get in the way," she said. "I didn't want to have another brain injury that might affect me worse than that one."

She went back to Harvard full-time to finish her undergraduate degree, taking as many pre-med courses as she could. She even told Coach Katey Stone that she wouldn't play hockey her final year at Harvard.

It was a "tough transition" to move on from hockey, Pucci said. She finally relented and agreed to play hockey her senior year at Harvard. Her focus, however, was on pre-med studies as she finished courses for her major in social and cognitive neuroscience.

Between classes, she worked part-time in a traumatic brain injury research laboratory at Massachusetts General Hospital for Children. Dr. Michael Whalen was her supervisor there when not teaching as an associate professor at Harvard Medical School.

Pucci said she learned a lot working in the lab and Whalen motivated her. "I felt like he had confidence in me before I had confidence in myself," she said.

She was introduced to western blotting, counting cells and behavioral studies with mice. She worked full-time at the lab during semester breaks and the summer.

"You have to be fully dedicated," she said, in order to pursue a career in medicine, and Whalen convinced her she could do it.

After she graduated Harvard, Pucci began working in a neurology lab at Columbia Presbyterian Hospital in New York City while taking more pre-med classes in the evenings.

GIVING BACK

During this time, she also worked to expand a nonprofit organization she had established to help those suffering from concussions. She wanted to spread the word about alternatives for recovery.

Pucci first had the idea for a nonprofit shortly after she recovered from her concussion. She connected with a couple of hockey players at Yale University who had experienced concussions. They began researching how to establish a nonprofit.

"Our mission is really to promote a safer sports culture," she said. "That means encouraging athletes to not just fight through a concussion and play through it, but handle the concussion properly."

Another goal of the organization is to "provide a community" for those who suffer from concussions so that they can network and share resources.

"We call it a concussion circle," she said. "A lot of the work I was doing with the nonprofit, or just projects to volunteer and give back, it is fulfilling and it's exciting."

When she was looking into medical schools, she came across the Uniformed Services University of the Health Sciences. "I had never heard of it before," she said. "It caught my eye right away."

She was encouraged, however, to apply to multiple schools; so she did. She was on a wait list for Stanford School of Medicine when she heard from USU.

The idea of pursuing a medical degree while serving her country was appealing, she said, adding it was exciting to think about "serving those who serve." So the decision was an easy one.

HITTING THE ICE AGAIN

During her second semester at the Uniformed Services University in Bethesda, she was contacted about playing a pick-up hockey game for the Army against Navy. The game was scheduled for Feb. 7, immediately following a Washington Capitals game.

It was just her fourth time wearing hockey equipment since college, Pucci said, "but it was fun to get out there; it was fun to meet some people on the team."

Army Chief of Staff Gen. Mark A. Milley coached the team, while Vice Chief of Staff Gen. James C. McConville played defense alongside Pucci.

"She took great care of me playing left defense," McConville said about his young teammate.

The two of them had an opportunity to talk during practice sessions prior to the game with Navy.

"What impressed me the most is really the way she faced adversity and overcame it," the general said. "We're looking for resilience in men and women of character and she fits the mold perfectly."

Hockey and the Army share a lot of similarities, he noted.

"They're both contact sports," he said. "You get knocked down and sometimes you need to get [back] up."

He also met Pucci's father at the hockey game. "You could see where she got her character," McConville said, explaining her dad spent over 25 years as a police officer in New York City.

Passion will make 2nd Lt. Pucci a great doctor, McConville said, adding "she's going to help a lot of people in the future."

Now in the Army, she said she's on the "best team in the world" and feels that her experience recovering from a traumatic brain injury gives her "perspective" that may help her as a doctor.

"I feel like, unfortunately, a lot of service members suffer with that injury," she said.

TBI treatment is changing in the military, she said. Soldiers no longer are told to just stay in a dark room and rest, but she added there's still a ways to go to advance treatment.

"Hopefully I'll be able to take what I've learned … and give them a little more answers," she said.

Giving back: Olympian aims to help Soldiers with concussions
Read more: https://www.army.mil/article/218734/giv ... oncussions

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Head Injuries in Hockey

Post by greybeard58 » Thu Mar 28, 2019 5:12 pm

Head Injuries in Hockey
By Ansie Sago - March 27, 2019


National concern about concussions in sports have risen. While fear of
concussions has resulted in the cancellation of football programs, that has not been the
case with ice hockey. Division One Men’s hockey is the most popular sport at Clarkson
with up to 4,100 fans at the home games. While the games are exciting, falling on the
ice, ramming up against the boards, and colliding with other players puts the players
at risk for injury including brain injury, or concussion as it is now called. The NCAA
(National Collegiate Athletic Association) found that Division I men's had the highest
rate where 8% of these exposures result in a concussion.
Clarkson trainers take concussions seriously; following the Headway protocols,
checking players and keeping them off the ice until they are able to make a full recovery. The Headway movement aims to educate athletes, coaches, and trainers about
the risks associated with head injuries. To combat concussions in hockey, the Headway
Foundation created the New Tough Pact which was signed by 4,000 athletes. When
they sign the New Tough Pact, players agree to report symptoms of concussion, be patient
with the recovery process, and agree to play within the rules. Through the New Tough Pact,
players agree to play within the rules; however, that may be difficult to enforce
because no matter what, according to assistant captain Devin Brosseau, “There
will be dirty plays”. Nowadays, referees have the ability to playback any penalties to
limit hits to the head and other dangerous plays. Though the Headway movement has
increased concussion contact awareness, that
might not be enough.
Even without ‘dirty plays’ and the introduction of state-of-the art helmets,
concussions can still occur. There is still much not understood about safety and “there
are times when equipment is not going to do anything.” In some cases, concussions are
not the result of a direct impact to the head, but occur as a result of a blow to the body or
even a sudden motion of the head which causes the brain to move within the skull.
The movement of the brain in the skull disrupts the way that the nerves and cells
and chemicals in the brain function. This leads to communication problems between
the brain and the body. While no sport is risk free, the question is whether the risks are acceptable. Dr. Stephen Casper, a Clarkson expert on
concussions notes that the consequences of repeated head injuries will follow players
throughout their entire lives. Both active and retired players experience reduced cognitive
functioning, CTE, dementia, suicidal thoughts and opiate addictions. Clarkson trainers make sure to inform the players about the risks, requiring them to sign a form stating that they understand that playing hockey could result in “permanent brain damage, and even death”. However, Dr. Caper believes that that is ineffectual because players are “trained into disbelieving a problem”, believing that “it won’t happen to me”. When interviewed, players like Tyko Karjalainen disagreed stating that, “I have accepted it [the risk] in order to do
something I love”. As a result, Dr. Casper believes that the only solution to ending head injuries in hockey is to change the sport completely. However, simply changing the rules will not result in a end to head injuries in hockey. Clarkson trainer Alana Alpert believes that there is always a risk involved in all sports, “if you want to get rid of concussions you
have to get rid of the the game”. However, Alpert believes that as of right now, the Headway movement is the most effective method of protecting players from serious
and lingering head injuries. Dr. Casper believes that the first step in reducing head injuries is to educate fans. Dr. Casper hopes that because, “players are selling something players want to buy”, if fans were more educated about the risks of the game, they might encourage a less violent game. However, Dr. Casper is not very optimistic about the potential use of education as a solution because “fans of sports [are] determined to never let their sports change”. This statement was corroborated by hockey fan, Marcy Wilcox who said, “It’s a good game and I’d hate to see it change”. As a result, the future of hockey
remains to be seen.

https://cuintegrator.org/2019/03/head-i ... in-hockey/

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

New CDC report looks at which sports

Post by greybeard58 » Mon Apr 01, 2019 12:49 pm

New CDC report looks at which sports are most likely to send your kid to the ER

Contact sports such as football, soccer, basketball, lacrosse, ice hockey and wrestling resulted in twice as many emergency visits for TBIs as did non-contact sports and four times as many as recreational activities such as playing on a playground.

These sports are most likely to send kids to ER with brain injuries
Read more: https://www.cnn.com/2019/03/14/health/t ... index.html

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Anger Following Brain Injury

Post by greybeard58 » Mon Apr 01, 2019 5:35 pm

Anger Following Brain Injury

Kinds of Anger after Brain Injury
Anger is a very common problem after brain injuries. When someone with a brain injury has a problem with anger, there are usually several causes acting in combination. Some people are angry about the injury or problems that may have come with it, such as disabilities and loss of job, friends, money and control over one’s life. Some people were angry people before their injuries and still have that problem. People who have always been angry may need psychotherapy to help them learn to cope, and in some cases medication is required. (In our experience, people unfamiliar with the person or with brain injury are often too quick to assume that personality alone is to blame.) But many people also develop impulsive anger as a direct effect of the damage to the brain. In other words, the parts of the brain that normally inhibit angry feelings and behavior have been damaged and do not do their jobs as well. This means that the person’s anger threshold is lowered so that he or she becomes angry more easily and more intensely. We can tell that this impulsive anger is directly due to the brain injury when:

- The anger begins with the brain injury or is made much worse by it
- Angry feelings come and go relatively suddenly
- Anger episodes may be in response to minor events
- The person having the angry episodes is surprised and embarrassed or distressed by them
- The anger is made worse by physiological stress such as fatigue, pain or low blood sugar

This was the problem Joe had. Joe was a quiet man, an accountant; active in his church and an assistant little league coach. He never drank or used street drugs; he was healthy; and he had never been in a fight or in trouble with the law. He was well liked in the community. His wife said that he rarely got angry, and when he did he usually sulked. When his car was hit by a drunk driver and Joe hit his head on the window, all that changed. He had been knocked out for five minutes but after he was checked out at the Emergency Room they sent him home. He went back to work a week later but had trouble concentrating and remembering. Worse, he started yelling at his wife and children, often for little things like laughing loudly at the TV. One day at work, he broke a computer keyboard by hitting it with a stapler; and he sometimes tore up papers he was working on. After each of these episodes, he would be very embarrassed and apologetic. He came for help after loudly cursing at his daughter because she was playing with her program at a Wednesday evening church service.

With Joe, it was clear that he was having impulsive anger resulting from his head injury. When other more familiar causes of anger are also present, such as difficult personality, alcohol abuse, or anger at the injury itself, the impulsive anger resulting directly from the brain injury can get overlooked. It is important to try to identify and treat that part of the anger too.

Dealing with Impulsive Anger Resulting from Brain Injury
When a person with a brain injury first wakes up from a coma, they are usually disoriented and confused and often they are agitated. They do not understand what is going on around them, and they are not truly responsible for their own actions. It is up to the people taking care of then to keep them safe, even if this means restraining them or using medications when absolutely necessary. As they recover, they gradually come to be able to control their actions. Their staff and families can then gradually teach them about the best ways to manage their angry feelings. Because a person with a brain injury's “anger thresholds” or “flashpoints” have been lowered, they need to relearn how to manage the changed reactions. They need emotional rehabilitation in addition to physical and cognitive rehabilitation.

Understanding the Anger
The brain injury survivor is, in some ways, a different person. What makes him or her angry may be different. We need to learn what those things are. Here are some common factors that contribute to anger after brain injury.

Anger Factors

Stimulation factors:
- High noise or activity level
- Unexpected events
- Lack of structure

Personal factors:
- Frustration
- Fear or anxiety
- Embarrassment, shame or guilt
- Discovery or confrontation of problems
- Cognitive impairments – especially memory deficits and confabulation (remembering things that did not happen)
- Communication impairments
- Rigid thinking

Medical factors:
- Pain
- Fatigue
- Hypoglycemia (low blood sugar)
- Medications (levels low or high?)
- Alcohol or drugs

Anger Warning Signs

Speech signs:
- Loud high voice
- Cursing
- Name calling
- Threats

Behavioral signs:
- Making fists
- Increased movement and fidgeting
- Angry face
- Moving towards the object of anger
- Breaking things
- Throwing things
- Threatening people
- Searching for or picking up weapons
- Hitting, kicking and other forms of violence

Physiological signs:
- Fast breathing
- Fast heart
- Sweating
- Over-aroused
- Tense muscles
- Flushed face
- Bulging eyes

Mental signs:
- Fantasies of doing any of the speech or behavioral signs
- Negative thoughts about others
- Confusion
- Feelings of frustration
- Feelings of fear or anxiety
- Feelings of embarrassment, shame or guilt
- Feelings of hurt

Early Strategies
These strategies are for staff and families to use when the person with brain injury is too confused to be responsible for his or her actions. It is important for staff and families to remember during this time that the anger is due to the injury, and they should not take it personally.

Prevention

Make the environment safe
- Remove potential weapons
- Keep alcohol and drugs inaccessible
- Keep vehicles and dangerous tools inaccessible

Regulate Level of Stimulation
- Some need to avoid over stimulation
- Some need to be kept busy and distracted

Provide Appropriate Level of Supervision
- Provide the least restrictive environment possible

Provide Reorientation as Needed
- Much of the anger in an agitated confused and disoriented person can come from misperceiving and misunderstanding the situation
- Staff and families should frequently remind the person of where they are, what is happening and why

Management

Withdraw
- Leave the person alone for a short period of time if this can be done safely. As you leave, tell them briefly what you are doing and why. “You are beginning to get upset. We are going to leave you alone for a few minutes so you can calm down.”

Distract
- Change the subject, the focus of activity or the location
- Use a concrete object as a focus when possible

Reorient and Reassure
- Remind the person of where they are, what is going on and why
- Try to clear up misunderstandings when this can be done without renewing argument
- Direct the person in activities that may reduce agitation, such as guided relaxation

Self-Control Strategies
These strategies are to be phased in when the brain injury survivor has recovered enough learning abilities and awareness to begin to cooperate in learning to control anger.

“Back Off, Calm Down, Try Again”

Because the impulsive anger resulting from brain injury often comes and goes suddenly, an effective way to deal with it is for the angry person to back off, calm down and try again. This strategy can be phrased in the individual’s own words or whatever expression is comfortable such as “retreat, relax, return” or “take a break” or “time out”.

Back Off

When warning signs appear, the person should leave the situation and go to a safe place. Others will have to cue him or her to leave. If the person will not leave, the other people present should leave instead, if possible. Practicing backing off when not angry (like a fire drill) will help this go more smoothly when it is really needed.

Calm Down

When the person has backed off to a safe place, he or she should work on claming down. Many techniques can be used to calm down including:
- deep breathing
- soft music
- meditation
- prayer
- closed eyes
- physical exercise

Preparing to Return

Once calm, the person may need to rethink the situation and prepare to return.

Reviewing a list of questions is a possible preparation;
- Do I need to apologize?
- Do I need to explain why I left?
- Do I need to tell anyone my feelings?
- What can I do to avoid this next time?

Here are some statements to encourage rethinking the situation;
- “I don’t hate my mother; I’m just angry with her”
- “Maybe she had a point I should listen to”
- “He’s not wrong, we just disagree”

Try Again

When the person returns from backing off and calming down he or she may need to
- apologize,
- talk through the issue,
- explain the backing off and feelings
- resume what he or she was doing.

Once a person has learned to back off, calm down and try again successfully, he or she can work on calming down in the situation without leaving.

Anger Cue Cards
Anger cue cards can be used to remind the brain injury survivor of their warning signs such as Loud Voice, Tense Muscles, Confusion, or Thoughts of Hitting. These cards should be carried by the person with a brain injury and optional copies can be placed where anger incidents often happen or where backing off takes place.

A Back Off card might say:
- “I’m feeling angry, I need to back off”
- Leave the room
- Breathe deeply
- Relax muscles.

Angry Reactions to Brain Injury
Anger at the cause of injury: The victim of an injury may be angry at the cause of the injury such as a drunk driver, an assailant, a corporation or a government. Such people often need help finding effective and satisfying channels for their anger. Often, they can talk this out with a trusted friend or family member.

Grief Reaction

It is part of human nature to grieve when we lose something, not just when someone dies, but also when we suffer an injury or illness. We try to find reasons for our losses. One part of a grief reaction is anger at what we think caused it. This anger can also get displaced onto any handy target. People can work through these reactions by talking out their feelings. This is such a human experience that it usually does not require a psychologist, just a trusted and understanding person. However, poor memory or judgment or emotional or personality problems can complicate grief reactions and psychotherapy may be needed.

Frustration

When frustration contributes to angry reactions, the person needs to be trying easier things. Specific preparation can also be given before difficult tasks. For example, “Now it’s time to go shopping. I know this is sometimes frustrating for you. How will you know if you are starting to get frustrated, and what will you do about it?”

Normal, Legitimate Anger

People with brain injury still have legitimate reasons to get angry. If their legitimate anger is discounted, ignored or “treated”, they may get angrier. If they have expressed their anger inappropriately, their angry actions should be dealt with separately from their legitimate complaint. They should not get their way just because they made a fuss, but the complaint should not be ignored.

Brain injury survivors often have impaired judgment which can contribute to anger problems. Cognitive rehabilitation for judgment can help. People with these difficulties need to check their judgments with caregivers or people they trust. Alcohol and drugs can contribute to anger problems. The clearest solution is abstinence but abuse programs or counseling may be needed. Not taking prescribed medications can also contribute to anger problems. The doctor should be told if the medications have not been taken as directed and if there have been any problems.

Conclusion
Anger is a common problem following brain injury. It has many causes, and there are many solutions to be tried. The rehabilitation team, the family and friends and the brain injury survivor can all work together to understand and manage the problem to help the person with brain injury to work towards recovering self control.

Anger Following Brain Injury
Tedd Judd, Ph.D., Hispanic Neuropsychological Society
Read more: https://www.brainline.org/article/anger ... ain-injury

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Minnesota-Duluth hockey star suffered from CTE

Post by greybeard58 » Mon Apr 01, 2019 8:47 pm

Tests show former Minnesota-Duluth hockey star suffered from CTE | KSTP.com


https://kstp.com/news/andrew-carroll-ct ... y/5300332/

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Rising star's hockey career ends

Post by greybeard58 » Tue Apr 02, 2019 1:56 pm

Rising star's hockey career ends with two serious concussions


19-year old Sarah Renberg was on track to play major college hockey.

She went from being a potential D-1 recruit to barley being able to get out of bed.

Two serious concussions ended the Churchill high school grad's playing career.

As ABC7 sports reporter Scott Abraham shows us, driven by her personal experience with concussions, Sarah helped start the Headway Foundation.

Rising Star: Sarah Renberg
For the complete story watch the video at: https://wjla.com/sports/rising-stars/ri ... ah-renberg

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Mild? Not so much

Post by greybeard58 » Sat Apr 06, 2019 1:30 pm

Mild? Not so much

Amy Stuart
In February 2017 I was diagnosed with a “mild” concussion after a fall at a hockey practice I was running (helmet on). It was months before I was functional again, and recovery required permanent - and ultimately positive - changes to my lifestyle. Mild? Not so much.
https://twitter.com/AmyfStuart/status/1 ... 5329948679

Kathryn Blaze Baum
"At one point, I never thought I’d write again. I’m out the other side and never better, but so many are still suffering — going it mostly alone, and mostly in the dark. Brainstorm: How my ‘mild concussion’ became a dizzying, year-long ordeal." (Subscribers only)
Brainstorm: How my ‘mild concussion’ became a dizzying, year-long ordeal
https://www.theglobeandmail.com/opinion ... year-long/

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Hotline

Post by greybeard58 » Tue Apr 09, 2019 5:34 am

Suicide.org is a 501c3 NON-PROFIT Organization and Website

If any numbers need correcting please contact me via pm and I will edit


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 Free Suicide.org Newsletter!
Enter Your Email:




Suicidal?
Need Help Now?
Call 911
or
1-800-SUICIDE
(1-800-784-2433)
or
1-800-273-TALK
(1-800-273-8255)
or
Text Telephone:
1-800-799-4TTY
(1-800-799-4889)

Military Veterans
Suicide Hotline:
1-800-273-TALK
(Press 1)

Suicide Hotline
in Spanish:
1-800-273-TALK
(Press 2)
LGBT Youth
Suicide Hotline:
1-866-4-U-TREVOR














Suicide.org
Suicide.org is a 501c3 NON-PROFIT Organization and Website

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Strib article Kelly Catlin

Post by greybeard58 » Tue Apr 09, 2019 5:42 am

Olympic cyclist Kelly Catlin of Minnesota seemed destined for glory. Why did she die by suicide?

WABASHA, Minn. - In the weeks before Olympic cyclist Kelly Catlin killed herself, she felt her mind slipping.
She could not focus on her schoolwork at Stanford, where she was a first-year graduate student in computational mathematics. In an email she sent to her family, a coach and a friend in January, she said her thoughts were "never-ending spinning, spinning, spinning" as if they were "never at rest, never at peace.”

She wrote that she cried about it, and that made her feel even worse. For years, Catlin, 23, was someone who took pride in holding back tears.

Catlin told her sister, Christine, that seeking therapy meant she was weak and that she would rather suffer. She told her brother, Colin, that she thought she was going insane and she worried that she was a danger to others because she was filled with rage.

She wrote that she was scared of dying.

"What is it like to no longer have a mind?" she wrote in January, just days before a first suicide attempt. She answered the question.

"It is unimaginable," she wrote. "Terrifying.”

Catlin was poised for stardom at the 2020 Olympics in Tokyo, where she had a reasonable shot for Olympic gold that eluded her in 2016. With the advanced degree from Stanford she was working toward, she could have her pick of jobs in computers.

How, those who knew her are asking now, could she find no purpose to keep living? How could she be so unknown to the people closest to her?

Kelly Catlin had sought to explain herself and her distress, both over the phone and in notes before she was found dead in her Stanford apartment on March 8. In one note she wrote in January, she even asked, "What do you wish to know?" leaving a trail of cryptic answers.

"You think you know your children," her mother, Carolyn Emory, said, "but there was so much about Kelly, especially this secret personal code she lived by, that was startling to me in the end. She was very private.”

On Friday, a month after she killed herself, a white van showed up at her parents' farmhouse to drop off her things.

Three bikes. Nearly a dozen boxes of clothes, books and cycling gear. Her carbon-fiber violin. Duffel bags stuffed with cycling gear and U.S. Olympic team uniforms from the 2016 Rio Games, where she won a silver medal.

Her mother and her brother, Colin Catlin, sifted through the belongings, retrieved from her apartment.

Every item provoked a memory, none a clue.

Colin Catlin had hoped to find telling information on her phone, but instead he found the wallpaper she selected for it haunting: an album cover featuring a body with daggers in its back. The album title was "Try to Die."

He broke into tears.

It was hard to absorb that just months before in November, on the podium at a World Cup track cycling race, where Catlin's squad finished second in the team pursuit, she soaked in the moment: flags waving, fans cheering, adrenaline pumping. A three-time world champion, Catlin considered the victory a prelude to finally winning an Olympic gold medal.

Off the track, she was fulfilling a lifelong obsession with numbers and order through her academics and planning for a career in Silicon Valley.

This solid trajectory she appeared to be on had made her mental downward spiral and death all the more mystifying to teammates, friends and family members.

Catlin's father, Dr. Mark Catlin, a pathologist, blames her suicide on a combination of factors, including her success-at-all-costs personality, overtraining, stress, and physical injuries from a January suicide attempt about a month before she was found dead in her dorm. On both occasions, she inhaled noxious gas.

But the breaking point, he and other family members believe, was a concussion she sustained during a training ride on Jan. 5. They have donated her brain to researchers to find out if the head injury contributed to her behavior changes.

Regardless of the results, nothing can give the family a definitive answer. Suicide is much more complicated than lab results can reveal and multiple factors, like destabilizing life events, brain chemistry and persistent mental struggles, almost always come into play.

"I wake up every two to three hours at night to go through all of these permutations on what could have saved her," her father said. "I can't help but wonder what she would've done with her life.”

Kelly's mother answered, weeping, "Something great.”

'Never Love’

Catlin and her triplet siblings, Christine and Colin, grew up in Arden Hills, Minnesota, a suburb of Minneapolis. Her parents — her mother is a former Alzheimer's researcher — met in a lab dissecting brains.

The Catlins lived in a large house with an indoor gymnasium. They took European vacations and roasted s'mores in the backyard. They were a family of introverts who enjoyed staying at home for tea parties. For Kelly, Christine and Colin, school and sports were equally important. They excelled at both.

"You never once had to tell them to do their homework," their mother said. "They pushed each other.”

Kelly was the super-focused athlete, a first-chair violinist who studied nonstop. Christine was the creative writer and runner who played three instruments. Colin was the math whiz who played guitar and rode bikes competitively. In middle school, the siblings tied for Most Likely to Succeed.

"Our parents always told us that we could be great at anything we wanted to, if we worked hard enough," Christine said. "Looking back, maybe we kind of twisted that into thinking we weren't worth anything if we weren't the best. I think Kelly believed that.”

Kelly's parents said she was an intense child who grew socially awkward with age. In elementary school, when she could not figure out addition or subtraction, she would scream for hours in frustration, they said, and refused to take a break.

For years in her youth, she was obsessed with horses. She studied the 512-page book "The Ultimate Book of the Horse and Rider" so much that she had to tape the binding because the book was so worn. She maintained a collection of dozens of model horses that she did not allow anyone to touch because they were arranged in a certain order.

Christine Catlin described her sister as a once outgoing, friendly girl who began closing herself off in middle school because she was "so obsessed with success.”

Kelly Catlin also began to limit her social interactions to "robotic social motions," as Catlin herself put it in the January note to family and friends. Around third grade, Catlin established her lifelong code to live by and included some of it in the note, which was shared with the New York Times:

Fear not physical discomfort. Never love. Never engage in a relationship that could be defined as having a significant other. (In my case, a so-called "boyfriend.") Never allow yourself to become close enough to another that their actions or inactions might cause you (any amount of) distress or pain. If kindness and gentleness are at all an option, they are the only option.

"We all knew that she didn't like to express her emotions," Christine Catlin said. "She never really told anyone how she ever felt, until the very end, that is.”

Cycling calls

Colin and Christine Catlin were cycling for a local development team, NorthStar, when Kelly quit high school soccer and joined them, at Colin's prodding. She loved long training rides and used cycling as a way to practice memorization, another passion.

She would remember dozens of license plates of cars passing her and would recite the number pi to hundreds of decimals, Colin Catlin said. She mapped out training routes in her head.

"She liked that cycling kept her mind focused, but I think she liked it most when she started winning everything," said Colin, a data scientist.

"Her mentality was, if you wanted to be an Olympian, all you had to do was train hard.”

And Kelly did make it seem easy. Within two years of starting to race, she was invited to the U.S. Olympic Training Center in Colorado, where coaches put cyclists through testing to see if they are national team material. Kelly was that, and more.

Her power output on the stationary bike was higher than every other recruit and higher than several athletes on the national track cycling team, said Neal Henderson, one of the coaches then.

Track cyclists compete on a banked oval, called a velodrome, and Catlin seemed suited for it because it required both power and precision.
Kelly Catlin was drawn to the science of cycling. She wasn't comfortable with the social aspect of it. In the notes she wrote in her final weeks, she acknowledged not having many friends.

"It's not that she didn't want friends," her brother said. "It was just a matter of priorities. And her priority was to be successful and respected.”

Like her siblings, she could not stand to be hugged, family members said. She would rather bury herself in a book than chat with peers. She had a playful sense of humor — often dark humor — within her family circle, but rarely showed it to outsiders.

Although she exuded confidence, she described in a note having a "phenomenally powerful fear of social embarrassment," and also long worried that she would not be able to keep up with other cyclists, said Charlie and Sherry Townsend, co-founders of her development team. It was a classic impostor syndrome, they said.

"But she changed because of cycling, she really did," said Sherry Townsend, a psychologist, adding that Catlin's self-esteem rose after she competed in the Olympics. "She was slowly learning how to be better engaged with people, slowly learning how to share her thoughts with others. But it was still hard to really know her. I personally felt really close to her, and communicated with her a lot, but still felt that I never knew her all that well.”

Catlin's nickname at the Olympic Training Center, where she lived before the 2016 Olympics, was Roy Orbison, because she always wore dark glasses. She wore her hair short because it was practical for the sport, so short that she was sometimes mistaken for a young man.

Chloé Dygert, an Olympic teammate, said she was thrilled when Catlin started to open up, even occasionally agreeing to a quick hug. Dygert and a teammate once convinced her to play the violin for them.

"It was, like, whoa, so good that it was jaw-dropping," Dygert said. "Kelly was just amazing. She read a book every day, even while brushing her teeth, and it was hard to keep up. She was a lovely girl on the inside.”

A concussion, then changes

The concussion that her family said changed everything happened Jan. 5 when she crashed while riding with her professional road cycling team, Rally UHC Cycling. A team spokesman said there was "no indication that she hit her head or had a serious injury" when it evaluated her.

But at a national team training camp two days later, Catlin felt dizzy and could not continue working out. She told the team about her crash.

Medical personnel at the Olympic Training Center placed her on concussion protocol and suggested rest, said Guillermo Rojas, a spokesman for USA Cycling.

Yet Catlin continued to complain to her parents of headaches, sensitivity to light and trouble sleeping. And this was coming months after a fall in October that left her with a broken arm and weakened interest in the national team.

"There was this profound apathy," her father said. "She didn't care about winning medals anymore.”

Life at Stanford was much different from she was used to. She moved into a dorm there after living with her brother at the University of Minnesota while finishing her undergraduate degree. Colin had cooked her meals and often had to trick her into taking breaks from studying and training, playing episodes of the television show "Stargate" because she could not resist science fiction.

At Stanford, she often spent time alone because her roommate, a law student, was often not there.

After the concussion, she simply could not focus anymore on school or cycling — or anything. In late January, she wrote that she had started planning her suicide before her crash and concussion. But her family thinks that was not true.

"For the first time in her life, Miss Stoical couldn't force herself to go on," Mark Catlin said. "This is when she began planning her suicide."

After her first suicide attempt, she spent about a week in a hospital psychiatric ward. When she left that treatment, she began attending group therapy sessions, which she deemed useless, her parents said, and she said she could not find an available psychiatrist who met her needs.

When Catlin moved back into her on-campus apartment, her parents flew back to Minnesota to give her space, telling her "we love you, we want you alive," Mark Catlin said. They banked on her assurances that she wouldn't try to kill herself again. She had given her word, a part of her personal code they knew.

"She fooled us all," her mother said.

The suicide attempt and concussion had damaged her brain and heart, her family said, so competing at the world championships on Feb. 27 was not possible. She wrote a blog posted the day the championships began in which she described managing her cycling career with her graduate studies as "juggling with knives" and said, "I really am dropping a lot of them." In a note she wrote in March, she said, "If I am not an athlete, I am nothing.”

Looking back, her father said it was clear she needed time for her brain to heal, but it appeared nobody could impress that on her.

He said Kelly's lifelong resolve to succeed in everything played a big factor in trying to kill herself again.

"She was furious that she survived her first suicide attempt," her father said.

A last call

Christine Catlin's phone rang in late February, and it was Kelly. They had not spoken at length in years because they were busy with their own lives after high school, but now Kelly wanted to talk. Christine found it strange. It was nothing Kelly would have done before her concussion.

Kelly said she worried that the physical effects of her concussion or her first suicide attempt — or both — were affecting her judgment.

She asked: What could Christine see her doing in the future?

The sister answered: You could do public speaking about suicide awareness and help people. Or you could do remote computer programming so you don't have to be around people. You could own a farm and be around horses all day.

"You could bike, if you want to," Christine said. "Or not.”

Kelly seemed to feel better after the 2 1/2-hour call.

Still, she said, "If things don't change in a month, I'm probably going to kill myself.”

Christine begged her not to do it.

"OK," Kelly said, with a tone Christine now realizes was less than convincing.

The call was over. The two texted a few times afterward, and Christine regrets not reaching out more. But two weeks after that conversation, Kelly Catlin's life was over.

At a memorial service in Minneapolis on March 23, she was dressed in the uniform the U.S. team wore for the Rio Games opening ceremony, and the majority of her pallbearers were her cycling teammates. She was buried at the foot of a 50-foot oak tree at Lakewood Cemetery, where the sound of robins and woodpeckers break the silence. It's near one of her favorite bike paths.

Before the coffin was closed, her sister, Christine, slipped in a handwritten note that included these words: Kelly, if I could trade my life for yours, I would. I love you without all your accomplishments.

Olympic cyclist Kelly Catlin of Minnesota seemed destined for glory. Why did she die by suicide?
http://www.startribune.com/olympic-cycl ... 508290342/

http://strib.mn/2U7OMd3

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Audrey Warner's hockey career cut short by concussion

Post by greybeard58 » Fri Apr 12, 2019 7:44 pm

Audrey Warner's hockey career cut short by concussion

Running the Boston Marathon is no easy task, but for one young woman it's a chance to pay forward the help she received after a traumatic brain injury.

Audrey Warner started playing hockey at just three years old and continued to play up until just two years ago when the Harvard University senior took a crushing hit.

"I was in the middle of a game and took an open ice hit from behind. I fell back and hit my head on the ice and kind of knew right away," Warner said.

She recognized the symptoms she was experiencing as another concussion, and she knew her hockey career was over.

"In life you can't always choose the cards you're dealt. Sometimes you come across a joker and you get up and you keep moving," Warner said.

That movement came in the form of running, an activity she'd always enjoyed. A friend had run the Boston Marathon last year to support The Stepping Strong Center for Trauma Innovation at Brigham and Women's Hospital.

It opened in 2017 with funds raised by the Reny family. In 2013, they were at the Marathon finish line when the bombs went off. Their daughter, Gillian, was critically injured and rushed to Brigham and Women's where doctors saved her life and her legs.

A year later, the Gillian Reny Stepping Strong Foundation launched to support the hospital's work in trauma research and recovery.

"We just wanted to do something to express our gratitude," said Gillian's mother, Audrey Epstein Reny.

Reny can't quite believe how far the foundation has come in the last five years. It has raised and awarded more than $3,000,000 to researchers and innovators.

"It's really become much bigger than our family. It's really changing lives and touching other people in a meaningful way and that's just so incredibly humbling to us," Epstein Reny said.

This year, Audrey Warner will join more than 140 other runners in supporting that work. She'll be running with her sister on race day and has already raised $11,000.

"I realized while I could never pay back all that the doctors had done for me, if I could pay back even a fraction of it I could probably help a lot of people or their lives tremendously," Warner said.

College hockey player sidelined by concussion to run Boston Marathon
See video and read more at: https://www.wcvb.com/article/college-ho ... n/27090005

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

Emma Watson

Post by greybeard58 » Mon Apr 15, 2019 11:13 pm

Emma Watson couldn't play anymore because of concussions

Atom Girls C Assistant Coach Emma Watson
"Pretty proud of this girl. When she couldn’t play anymore because of concussions, she could have quit hockey but she started coaching and look at her now!!!"
https://mobile.twitter.com/Watsden/stat ... 5031513089

greybeard58
Posts: 1914
Joined: Sat Aug 21, 2004 11:40 pm

To drive or not to drive?

Post by greybeard58 » Sat Apr 20, 2019 7:46 am

To drive or not to drive? Something to consider after a concussion
GORD HOLDER, POSTMEDIA Updated: April 7, 2019

SHARE
ADJUST
COMMENT
PRINT
Even casual fans have heard or read references to players being in “concussion protocol” for one sports league or another.

That usually means the athlete is sidelined for a week or more while progressing through mandatory stages of recovery such as a rest period, cognitive tests, increasing levels of physical activity and contact and medical or training staff clearance before returning to competition.

“Return to work” and “return to classroom” protocols exist, too, but what about the act of getting to the arena, gym, office or school?

There’s not much more than common sense involved with “return to driving,” so this represents an opportune time to reference a University of Georgia finding of a negative impact on driving-simulator performances even 48 hours after concussed individuals no longer experience symptoms and medical professionals deem them clinically recovered.

These “drivers” are less able to centre virtual vehicles in the lane and allowed the vehicles to hit road shoulders more frequently, especially when negotiating curves, the 2017 study found.

A followup study of student-athletes with reported concussions says most of them will not stop driving at any point, even though they believe it’s unsafe to drive immediately following a concussion. More than one in three say driving restrictions will “definitely” or “probably” influence decisions to report brain injuries to health-care providers.


Dr. Julianne Schmidt is an assistant professor in the Department of Kinesiology at the University of Georgia in Athens, Ga. She is a researcher focusing on concussions and the impacts they can have on an individual’s ability to drive a motor vehicle. UNIVERSITY OF GEORGIA

“It would be really easy to say, ‘That’s simple. Let’s just say anybody with a concussion cannot drive until their symptoms go away,’” says Julianne Schmidt, lead author for both studies and an assistant professor in the university’s kinesiology department.

“But we have to think about the negative consequences that could actually deter people from seeking care to begin with, which is already a surmountable problem that we face in sports medicine. Just to get them to come in the door at all is a challenge, so we have to think about the negative consequences of what extensive driving restrictions mean.”

Ontario Ministry of Transportation provisions revised in 2018 require physicians, nurse practitioners and optometrists to report “certain high-risk medical conditions, functional impairments and visual conditions,” including cognitive impairment, sudden incapacitation, motor or sensory impairment, visual impairment, substance-use disorders and psychiatric illness.


Dr. Julianne Schmidt stands as graduate student Michelle Weber demonstrates use of a driving simulator as part of a study led by Dr. Schmidt into the effects of concussions on an individual’s ability to drive a motor vehicle. Dr. Schmidt is an assistant professor in the Department of Kinesiology at the University of Georgia in Athens, Ga. CASSIE WRIGHT / UNIVERSITY OF GEORGIA

In assessing fitness to drive, a spokesman adds, the ministry relies on those regulations and on Canadian Council of Motor Transport Administrators national standards that list concussion as a “transient” or temporary impairment with no likelihood of recurring episodic or ongoing persistent impairment.

“Depending on the severity of the concussion, however, some practitioners may choose to report the condition if they are of the opinion that the person poses a risk while driving,” the ministry’s statement adds. “Where significant cognitive or motor/sensory impairment is noted, a licence suspension may be issued.”

Dr. Jamie Dow of the Société de l’assurance automobile du Québec says someone who has a concussion should probably not drive for at least another day or two, when they no longer have headaches and normal neck movement returns, but the provincial auto insurance agency isn’t concerned about a temporary condition that should resolve itself in 48-72 hours.


Dr. Jamie Dow. PROVIDED / POSTMEDIA

However, Quebec’s highway code also requires all drivers to demonstrate that, despite any incapacity, they can still drive correctly.

“The problem for many people is nothing important happens when they’re driving, so they’re on autopilot or they’re thinking about 101 other things, whatever it is. They’re listening to the radio, singing along …,” says Dow, SAAQ’s medical spokesman.

“But, when you are not ill or you don’t have a problem, if something happens, you can stop whatever you’re doing and you have the reserves to be able to cope with any emergency, we hope.” However, distracted driving is still a major cause of accidents or crashes.

“But I think it’s common sense that, if you’re not feeling well, then you’re probably better off not driving, just in case something happens that you have to respond to rapidly. After a concussion, you’re not thinking normally. You’re slower, mainly, and, when you’re on the road, you don’t have more time to handle an emergency because you’re not feeling well.”


Dr. Shawn Marshall of The Ottawa Hospital often works with patients who need treatment for concussions. DAVID KAWAI / POSTMEDIA

Multi-tasking at 100 km/h

Dr. Shawn Marshall says patients frequently ask him if they can drive after a concussion or other more serious brain injury.

The answer is usually “yes,” says Marshall, the division head for physical medicine and rehabilitation at the Ottawa Hospital, but he adds that he reminds every driver they’re responsible for being fit for driving.

Marshall, who has research affiliations with University of Ottawa Brain and Mind Research Institute, Ottawa Hospital and Bruyère Research Institute, compares concussion impairments to those for alcohol or marijuana: Having a drink or smoking a joint is legal, but an individual is temporarily impaired from driving because they’ve decided to do that.

Immediately after an acute concussion, an individual is not fit to drive, Marshall says, and anyone with a concussion is cognitively affected in three areas, which are all relevant to driving:

• Information-processing speed, or how quickly they take in information and use it;

• Dividing their attention between tasks like checking the speedometer, then looking down the road and refocusing on the rear-view mirror;

• Ability to focus.

“Guess what’s really important for driving?” Marshall says. “Well, the ability to multi-task and the ability to take in information quickly. You’re moving at 100 km/h. Our bodies weren’t made to move at 100 km/h. Information is coming to you, your focal point is changing at 100 km/h. We fully don’t understand how much brain power it’s using.”


This is a screen shot from the simulator used in a study about concussions and the impact they can have on an individual’s ability to drive a motor vehicle in a study led by Dr. Julianne Schmidt, an assistant professor in the Department of Kinesiology at the University of Georgia in Athens, Ga. PROVIDED / UNIVERSITY OF GEORGIA

Many possible signs

Dr. Charles Tator, director of the Canadian Concussion Centre in Toronto, told a hearing of the House of Commons Subcommittee on Sports-Related Concussions in February that Canadians reported 200,000 concussions annually.

And most people with concussions don’t show up at physician’s offices or emergency rooms, says Blaine Hoshizaki, director of the University of Ottawa’s Neurotrauma Impact Science Lab. Even if they know they’ve taken hits to the head and experience headaches or confusion, they often don’t link those factors.


Blaine Hoshizaki is director of the University of Ottawa’s Neurotrauma Impact Science Lab. COLIN ROWE PHOTOGRAPHY / UNIVERSITY OF OTTAWA

“Because the signs or symptoms are so inconsistent, if they got hit in the head, they have to be aware of all the signs, any sorts of inconsistency with vision, balance,” Hoshizaki says. “I think there’s probably close to 60 symptoms, so, if you hit your head and you recognize any of these, then you should be concerned because the problem we have is that driving is a pretty complex thing that we kind of learn to do almost automatically.

“So, how that influences awareness alone, knowing that there’s a person in your blind spot, that’s a pretty subtle sort of cognitive responsibility, that you’re driving along and you’ve seen a guy and you know he’s driven up into your blind spot. If you’re cognitively compromised, that little thing might miss …

“There are so many elements to how your brain functions that it’s almost automatic, that you won’t necessarily pick up when you’re missing it.”


Individual differences

Schmidt says other conditions such as severe traumatic brain injury (TBI), stroke or Parkinson’s disease aren’t as transient as concussion, which means they won’t go away and are easier to identify, which in turn eases the process of getting an individual into disability services.

Concussions typically require 10- to 14-day restrictions, Schmidt adds, but the unknown is exactly how long concussion-related impairment lasts beyond symptoms, and what about potential differences based on age, gender or other demographic factors?

“We used college-age athletes and non-athletes — mostly non-athletes — but what does this look like in your 16-year-old adolescent driver? What does this look like in your 50-year-old driver,” Schmidt says. “Concussion recoveries can differ quite a bit in those groups, as well.

“So, I don’t have an answer for you, but I’m curious about the same thing.”

Significant in daily life

Dow says medical personnel examining a patient with a possible concussion or head injury often start out by asking that individual if they can move their fingers or hands or having them count backwards, but they don’t think to tell that person to avoid driving for a few days.

Medical personnel “tend to forget” that driving is an everyday activity, particularly for Canadians who don’t live in major city centres, he adds.

To counter that situation, SAAQ has a workshop for physicians and other health personnel to underline the importance of driving and how it should be considered when they’re talking about the impact of whatever has happened on a patient’s life.

To be fair, Hoshizaki says, evaluating incapacity after a concussion is difficult even for specialists, so imagine the dilemma of a layperson trying to figure out if he or she is ready to return behind the wheel.

Physicians can provide guidance, Hoshizaki adds, but there’s no real way of telling people they can’t drive.

“When we talk about guidelines to return to play or (other) guidelines, they’re guidelines,” he says. “They’re not rules.”

Dow says the process of removing a driver’s licence takes about six weeks, so, effectively, SAAQ tells Quebec physicians to report conditions only if the consequence of previous injury or disease — formally called “sequelae” — last six months or more. As one example, he refers to a former municipal transit driver who, following a severe concussion, functioned at the cognitive level of an eight-year-old.

“Temporary” conditions such as concussions do not have to be reported to provincial authorities unless they affect driving and a patient says he’ll drive anyway.

“The point is, if you were advised by your physician not to drive and you do drive and you kill somebody, you can be liable for accidental homicide, which is something you have to bear in mind,” Dow says. “You’re also going to have that on your conscience for the rest of your life.”

Looking for biomarkers

It would be easier to advise someone not to return behind the wheel after a concussion based on specific medical indicators or “biomarkers,” but nobody has figured that out, despite what Hoshizaki describes as “a fair bit of money” invested in research in Canada.

There are known biomarkers for brain injury, Marshall adds, but, because brain injury is a spectrum, even those biomarkers are not useful enough in diagnosing concussion.

Similarly, magnetic resonance imaging (MRI) or diffusion tensor imaging (DTI) scans can reveal signs of concussion, but Marshall says that again they are neither sensitive nor specific enough to be gold-standard tests for diagnosing concussions. In other words, they could miss diagnosing concussions at the individual level, which is a clinical diagnosis anyway.

The ideal, Schmidt says, would be to use current clinical tools to predict or find patient patterns differentiating between someone who shouldn’t drive and someone who could.

“Even though they both have a concussion, maybe you’re having issues with reaction time, and we know that is a better predictor, better indicator of your driving safety,” she says. “However, you’re having more issues with your memory, which might not be as related to your safety in driving. It might hurt your ability to navigate in driving, but you’re OK, your safety on the road is fine …

“My second preference, then, if that’s not possible because it’s possible that the clinical tools we use now don’t predict those things very well or are not sensitive enough to those things that they wouldn’t work in that way, would be then to introduce a new tool or assessment battery that was short and succinct, but got at someone’s readiness to return to driving so that, clinically, we could return them to driving as soon, as quickly, but as safely as possible.”


Dr. Shawn Marshall. PROVIDED / OTTAWA HOSPITAL RESEARCH INSTITUTE

Out of the dark

Guidelines to concussion management have changed, with “return to activity as tolerated” as a general counsel.

Marshall says “return to sport,” is easy since concussed athletes simply must go through established protocols and show themselves to be symptom-free because they’re otherwise at increased risk of injury.

“Return to school” is hard, he says, because it’s a distracting environment requiring cognitive and social energy, so a concussed student might have to start off by avoiding gym or taking only one class.

For driving, perhaps a 10-minute commute would be OK, but not a long vacation trip, says Marshall, who likens it to recovery from a sprained ankle: If you can walk without pain, proceed, but, if walking causes pain, back off temporarily before trying again.

“Obviously, if the person is acutely confused and doesn’t know the date or doesn’t know where they are, they shouldn’t be driving. Most of us would say that,” he says.

“We used to say, ‘Go into a dark room and wait for your symptoms to get better.’ They tell them not to do that now. Now they say, ‘After the first 24 to 48 hours, return to activity as tolerated.’ And, if you return to activity as tolerated, that would mean you get to make decisions on what you can handle and can’t handle.”

gholder@postmedia.com

Twitter.com/HolderGord

https://ottawacitizen.com/news/local-ne ... concussion

Post Reply