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Nick Mercer: Bubble Times – Is it going to pop?

21 Feb

Continuing with my analogy from my last post, “Brain injuries and pro contact sports: Bubble times” , in which I compared the concussion issue in pro sports with the financial crisis, I thought I’d try to complete the comparison without, hopefully, forecasting the end of contact sports, notably the NFL and football in general.

In my previous post I said that fans, teams, and leagues play the same role in the concussion issue as the banks/financial institutions did in the recent financial crisis; interested only in their short-term benefit, making them unintentionally complicit in the looming collapse. Players are like the borrowers; they want to play the sport they love and make lots of money doing it. Consequences be damned. Just like people wanted to buy houses and a bunch of other stuff, not thinking, wishing away the potentially negative long-term consequences. It’s about the looming collapse that I will write.

Since my last post, I have listened to Malcolm Gladwell talk about the undesirable, yet inevitable decline of football. Then I read an article on the Oxford University Press blog Why football cannot last’ discussing Chronic Traumatic Encephalopathy (CTE) – a neurological disorder resulting from repetitive blows to the head. It got me thinking about the optimism shown at the end of my last post – had I not considered the situation fully? Was it simply wishful thinking?

Gladwell makes a convincing case Continue reading 

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Call it what you want, just don’t panic

25 Oct

Confidence, arrogance, or indifference. It doesn’t matter which term you use, as long as you understand what it means to show any  of those characteristics. The popular conception is that confidence encapsulates valuing yourself, being proud of what you’ve accomplished and ‘standing up for yourself’. The unfortunate circumstance is that the word ‘confidence’ (as used in the phrase, ‘Have confidence in yourself’) appears to have been corrupted and used to connote an arrogant, narcissistic attitude. People who have been affected by brain injury, or any other health condition that has had detrimental effects on self esteem, are encouraged to  show confidence, with the hope that they will feel good about themselves when they go out into society. This is well-meaning, but perhaps, not the best way to go about instilling true confidence.

Confidence is defined by the Oxford Dictionary as: the feeling or belief that one can have faith in or rely on someone or something; the state of feeling certain about the truth of something; a feeling of self-assurance arising from an appreciation of one’s own abilities or qualities.

That is what confidence means. What’s often impressed on people – recovering from brain injury or not – is that Continue reading 

Why do I write?

17 Oct

Nick Mercers provides some insight into why he chooses to write for us and his blog.

Because, as much as it lets others ask questions, it encourages me to ask questions of myself.

Granted, I have always questioned myself, I’m hyper-self-critical. In general, it’s not necessarily a good thing. I hesitate or stop completely. I waste opportunities. I’ll pass up a good chance (with a woman, for a job,…) for a safer, if not longer, chance. However, in writing, my exhaustive self-analysis, is probably beneficial. It means I take longer to write, because I’m always correcting what I wrote and how I wrote it. There aren’t many sentences in this post that haven’t been ‘renovated’ in some way. That’s not to say there aren’t mistakes, or that I catch-all of those errors on the first, second, or even third read. I’m cognizant, but maybe not enough, of the propensity of my self-criticism to take the emotive punch out of what I write. So I try to guard against that. I try to be open, and I hope that shows through, but since this personality trait has been with me my whole life, it’s not completely natural for me to silence it. It is at constant odds with the my ‘newly’ acquired (9 years ago) impulsive nature.

My impulsive side has not completely balanced out my patient and measured side (or vice versa), but it has made some headway. That said, I’m certainly calmer and less anxious than I was before my brain injury, which could have more to do with the severity of my brain injury than with the injury itself, however I don’t know, I’m just speculating, and I don’t have any medical information to back up such a claim. See that? That was Continue reading 

In Her Own Words: Rachel Abrams

9 Oct

To anyone else September 22 is any other day, for me it is forever etched in my mind; I call it the devil’s day. Many people are slowly beginning to understand concussions, I want to make sure that the world knows how serious they are, how simple it is to get one and what you can go through if you get one. I will do this by explaining my story.

I was a rough tough athletic kid in high school; who had a few injuries during that time, fractured my back twice, tore my quad and fractured my orbital bone. Nothing kept me out for that long; I did rehabilitation, rested for a short time and did physical therapy. I never thought anything of concussions, I was uneducated of this injury. I was one of those kids that thought, “Oh it’s just a bump on the head, I’ll be fine.” I graduated high school and went to a community college upstate, I was going to play soccer and softball there. I was one of the goalkeeper’s on the women’s soccer team and was having the time of my life. What is better for a kid whose life was sports, I loved every part of it, that was what I was known for and who I was. Then came September 22, 2010, when my life changed.

It was during one of our games, I was in goal and my team was up by a few goals if I remember correctly. Sometimes it is hard to keep complete focus when you do not get much action in goal. It was a corner kick from the opposing team, it came into my area and I went out to catch it in the air. It was not a very hard kick, I misjudged it a bit and caught it against the side of my face and then brought it into my hands. It hurt a little bit but I was fine and kept playing, finishing out the rest of the game. Then came the headaches, I didn’t think anything of it because I thought, “oh that barely hit me and hardly hurt, it’s just a little knock to the head.” I practiced the next day and the next 3 days after the hit, the headaches were getting worse. A friend suggested that I go see the athletic trainer and that I may have a concussion. I refused to go see him, I believed that I just had some small headaches and he would take me out when I didn’t need to be sat out. I was forced to go see him and got checked out, I was taken out, just as a precautionary. Then it got worse, my symptoms got worse, now experiencing nausea and increased headaches. I went to the emergency room at a local hospital where they did either a MRI or CAT scan, I don’t remember exactly. Everything came out fine, the hospital gave me medication for my headaches and nausea and I went back to my dorm. This was on Friday September 24, 2010; my mom came up to see my game that Saturday September 25, 2010, when I told her that I was not playing because of a suspected concussion. I ended up having to go home that Monday Continue reading 

Still Relating

9 Oct

A few weeks ago I wrote a post entitled Relating. It was about the new (past 9 years, since my brain injury) difficulty I had relating to others. I discuss how it’s tough to convey the experience and how great the help from my friends and family was. Recently, I read an article, entitled Voyages in Concussion Land: the homeless, Sidney Crosby and me by Tabatha Southey in The Globe and Mail on Friday, Oct 5, 2012. In it, Tabatha wonders about, “the dissociation many concussion sufferers experience”.

Immediately I thought ‘Dissociation! That’s the word! Perfect.’ However, being my critical, nit-picking-self, I soon found reasons why ‘dissociation’ wasn’t, in fact, ‘perfect’ to describe me. This bit of criticism was made much easier by my recent trip to Toronto and London, Ontario to see my best friends from university. We had a great time! Not only that, I got to see their children (except one). Dissociated could in no way describe how I felt at any time that weekend. Even though all the guys are married and almost all have children, it was such an easy, if not natural, situation that it was as though we still all lived in the same house (Granted, their actual houses now are much, much, cleaner – I can’t emphasize that enough).

Then I came home and this past weekend had a much different, yet also easy/natural time at a friend’s party. So, I’ve started thinking  Continue reading 

Limiting Head Trauma is Logical

31 May

The research is starting to come in; the problem is that results and conclusions bring more questions that should be answered.  Naturally some will look at early evidence and make a 180 degree change on their attitudes about certain things.  We are talking about concussions and the research associated with it.  Unfortunately there is plenty of anecdotal and observational cases that sear into our memory, this perhaps shape our thought process.  Along with that there is gathering evidence that supports some sort of process change in how we handle this particular injury.

The need to make change is upon us, that cannot be debated; what can be debated is how or what the changes should be.  I recently read an article where Micky Collins of UPMC said something to the effect of current concussion concern is like a pendulum that has swung all the way to the other side.  Although the changes in sports and activities has certainly not taken that full swing the other way, the pendulum is on the way.  His feelings, like mine is that there is no evidence to suggest that a full swing to the other side is warranted, rather there needs to be competent and complete understanding of what we are facing.  Rather than making full sweeping changes that would be akin to digging up your backyard to rid your self of a mole; when placing traps and poisons and maybe only having to dig up a small section would fix the problem.

There are definitely things we can do as parents, players, coaches, researchers, doctors and concerned people in general to make a dent in the issue.  If we find that the changes are not working then taking another aggressive step may be necessary.  I guess the reason for the above rant is to reinforce the need for changes, but the right changes.  (As I wrote the last sentence I realized how do we know if the changes are the “right” ones; I guess we don’t but certainly what is happening now needs attention).

One of the small changes that can be made is very obvious to me; Continue reading 

Open Letter and Proposals to IHSA about Concussions

15 May

I have been working on this letter for a little while but was really spurred to action by the parent in Maryland, Tom Hearn who discussed his concerns with the local school board.  I have tried and tried to use the “chain-of-command” with these thoughts and ideas, however at every step I got the feeling I would have to go alone on this, so I have.  This letter may or may not reflect the opinions of my employer, high school, athletic training sanctioning bodies, or others I am involved with.  This letter is from a concerned individual who feels I can spread the message effectively by these means.  I have emailed the letter, proposals and the Sports Legacy Institute Hit Count White Paper to all Executive Directors and Board of Directors of the Illinois High School Association.

OPEN LETTER

May 15, 2012

Illinois High School Association
c/o: Marty Hickman, Executive Director
2175 McGraw Drive
Bloomington, IL 61704-6011
(309) 663-7479 – fax

Dear IHSA – Executive Directors, Board of Directors and Sports Med Advisory Board:

I am writing this letter to address the growing concern of concussions in sports, mainly in football.  It should be noted that football is not the only sport with a concussion issue; however this sport combines the highest participation, highest risk, and highest visibility.  This letter should not be construed as an attack on the sport of football, but rather a way to keep the sport continuing to grow.

As a licensed and practicing Athletic Trainer, researcher, commenter, father, and survivor of too many concussions, I feel that in order to keep the sports we love, proactive steps must be taken.  Often being proactive is a painful process and easily dismissed because of the trouble it will cause.  I urge all involved to think about what the future of all sports will be if nothing is done.

The Illinois State Legislature with the IHSA took the initiative by creating a mechanism of concussion education and awareness in response to the mounting scientific evidence of potential long-term impairments resulting from mishandling of this injury.  However, this only represents a first step in the process; passing out a flyer or having parents and athletes initial that they have read the information is one small element of the issue.  Another crucial element of the issue is coaching. We must ensure that those we entrust with the care and leadership of our children understand Continue reading 

Former Players Reaction to Seau

3 May

With all the illogical conclusions that are happening in the press there are some small positives already.  The biggest of which, less than 24 hours after the untimely death of a great individual is the former players speaking out about depression and post-career condition.  No longer has it become taboo to talk of depression.

Now players need to take stock of their physical and mental health, some players are such as Emmitt Smith;

“Depression & suicide are serious matters and we as current and former NFL players should demand better treatment. Lack of info … no more!!!,” former Dallas Cowboys Hall of Fame running back Emmitt Smith said on his Twitter account.

“And for you current players who think this issue doesn’t effect u. Get your head out of your but. Where u r 2day was his (Seau’s) yesterday.”

In the same article James Johnston Jr., had this comment on former NFL’ers; Continue reading 

RIP #55… Everyone Hold your Horses #C4CT

2 May

With the tragic news of the death, at his own hands, of Junior Seau along with the peculiarly similar initial circumstances of Dave Duerson everyone needs to step back.  Yes, the very first thought that crossed my mind was Dave Duerson upon hearing the reports, mainly by Twitter.  However, what we must collectively do now is allow the process to unfold.

Not unlike sustaining a concussion the news is just the beginning.  When someone sustains a concussion often there are instant leaps to conclusions about time missed, long-term effects, and safety.  With a concussion it is a process, after time is allowed to properly asses the situation, create a plan and implement it there is nothing more to note other than it is a concussion.

And just like concussions people act in different ways, there is no rhyme or reason for many of these tragic situations, often it is because one has not had the proper education and levity of the situation.

I would just like to caution EVERYONE, let the process begin without jumping to conclusions.  In due time we will find out all the necessary information.  I for one hope against all hope that this has nothing to do with his brain health.

Thank You. #C4CT

Another Lawsuit

20 Jan

I received this press release from the law firm representing the newest of the former NFL players filing suit for damages for long-term problems associated with concussions (commentary follows);

Locks Law Firm Files Class Action Suit Against NFL Regarding Head Injuries

and Concussions on behalf of Former Players

Includes Three Former Philadelphia Eagles: Ron Solt, Joe Panos and Rich Miano

Philadelphia – Jan. 19, 2012 – Locks Law Firm attorneys Gene Locks, Michael  Leh, and David  Langfitt filed a class action lawsuit yesterday in Philadelphia against the NFL on behalf of all former NFL players, including seven named  players and four spouses, all of whom are the class representatives. The named players include former Philadelphia Eagles Ron Solt, Joe Panos, and Rich Miano. The suit charges that the NFL and other defendants intentionally and fraudulently misrepresented and/or concealed medical evidence about the short- and long-term risks regarding repetitive traumatic brain injury and concussions and failed to warn players that they risked permanent brain damage if they returned to play too soon after sustaining a concussion.

Ron Solt, age 50, Continue reading 

Recent Trend

4 Jan

The real job of this author not only includes being an athletic trainer for a local high school, but also doing rehabilitation on the entire spectrum of the population.  However, from time-to-time I am called upon to be a physician extender in a sports medicine doctors office.  The past few weeks I have been doing that more frequently and have noticed a very surprising trend.

Granted there is no “scientific evidence” of this trend, rather just my observation and upon asking questions to the doctor and the rest of the regular staff, they too have noticed relatively the same thing.

As we have progressed in the concussion era the doctor that we work for has been near the front on the concussion issue.  To his credit he used all the resources in the program to develop this progressive attitude and has taken all of his information along with others and developed a comprehensive concussion program.  When he started many, including some athletic trainers in the sports med program were in disagreement with the longevity and “conservative” nature of the treatment/management.  That quickly subsided with much of the evidence we have seen in the recent year, but it never really translated to acceptance among local coaches, school administrations, and players/parents.

All of the original skepticism about concussion care has slowly been washed away and this doctor has been accepted as one of the “go-to” guys in the area for this injury.  This is not the trend I speak of, although it is very nice to see; all the hard work of the athletic trainers has begun to sink in.

Rather the trend I am beginning to see is something mirrored in the national/international press Continue reading 

NHL Concussion Thoughts

29 Dec

Recently there has been a spike in awareness and number of concussions in the National Hockey League.  Last year we began compiling the injuries in our database to see where the sport stands (we also do NFL, NCAA football, and Aussie Rules Football).  When Sidney Crosby sustained his initial concussion in the Winter Classic last year it seemed that NHL has begun to take notice.

It was refreshing to see The Star of the NHL deal with the brain injury with some transparency, although he endured some criticism what Crosby did was set into motion the awareness of concussions.  Last season prior to the new year it was very difficult to find actual listed concussions; they were veiled in “upper body” or “undisclosed” listings.  In some cases the injury was improperly reported as a neck or shoulder injury; a sign that the concussion was either a) not understood (unlikely) or b) needed to be hidden.

Before you read on it is important to understand the position of the blog and this author about concussions.

Concussions, brain injuries, are an inherent part of collision sports.  There is very little in the way of equipment that can prevent concussions, the only way to impact a positive change (see decrease) is to address the culture and mechanics of sports.  This does not mean that professional sports should be outlawed, rather subtly changed to protect those that play, not only for the immediate time, but for the long-term health of the athletes.  With this; Continue reading 

Who signed up for this?

3 Dec

The widespread understanding of the concussion injury can be defined as scattered, for many may adhere to the simplest definitions of the neurological phenomenon while others may delve more thoroughly into all that the event entails.  There are those who would rather set aside definition and reject any potential complications as something that may interfere with their daily objectives, and there are those who care to recognize the injury as a neurometabolic cascade of chemical imbalance—an attempt by the brain to self-repair after the moment of cell damage in order to restore a more stable sense of homeostasis.  I’m not sure how we can exactly describe the state of the sports environment as it relates to the understanding or attempt to understand the concussion injury, but I do believe that there is a message that needs to be sent and it needs to be sent loud and clear.  Yes, there are questions to be raised regarding the specificity and legitimacy of claims being placed upon terms such as post-concussion syndrome, second-impact syndrome, and chronic traumatic encephalopathy, but that does not mean there is an absence of truth in these trauma-related conditions.  Many of us can understand athletes’ points of view regarding this matter, for you can’t go out on the field and perform with fear haunting your thoughts and be quite as effective, but we all need to be better educated on what a concussion really is.  By this, I am not talking about a neuroscientific breakdown of the processes that develop during the brain’s recovery.  I am talking about listening to the people who have felt the debilitating and, often times, life-altering effects of the concussion injury.  I am talking about allowing those who have been impaired or have had even the slightest of alterations in cognitive ability to have a platform on which they can project their voices—their stories.

Efforts toward a more agreed upon and stable set of terms regarding concussion management protocol are by no means an attempt to overanalyze the injury itself.  These efforts are not, in my opinion, indicative of overanalyzed nature because the risks are essentially laid out for us in the examples of real people struggling with real lives who have been in the shoes of the athletes who are complaining about what’s going on in professional, collegiate, and high school and youth sports.  I cannot find any reason to reject such protocol because of the reality of the injury—meaning its capacity to act as a temporarily parasitic collection of damaged cells, where all it would take is one hit to end one’s season, one’s career, or one’s life.  Even with that in mind, there is enough accessible information out there that can interest us in understanding the cumulative effects of the concussion injury, where the compilation of multiple traumatic events could come to haunt one’s life beyond the game in which they play.  Everyone is entitled to an opinion, and in fact, I have many of my own that aren’t necessarily considered as approving of certain decisions made regarding this subject, but it is hard to sound reasonable in any manner when one is openly criticizing the concussion injury as an insignificant event that athletes might as well have ‘signed up for anyway.’ Continue reading 

A Concussion Survivor

16 Nov

Drew is the son of Tracey Mayer – one of our Parent Advocates – and like John Gonoude a person that has overcome the stigma of concussion.  Not only is it a real brain injury, not treating it correctly can have life long effects for more people than we care to admit.  As Drew finds time he will send us updates, we hope this avenue will help him as well.

When my mom asked me to write for the blog, I knew instantly that I was interested but the first few times I sat down to write about it, things became tougher for me than I had thought.  Although I have had so much support and worked on moving forward from my freshman incident, this whole situation continues to be a sensitive topic for me to talk about.

As my senior year progresses, everything has been moving more smoothly than ever.  Starting off the year I still continued to set my standards high; to keep improving in my classes.  Just in case I needed a little GPA boost, I had taken a couple AP classes for the first time in my 4 years of high school – unlike many of my friends who decided to have a blow off schedule.  This was more of something that would just Continue reading 

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