Category Archives: KO Project Round Table Members

Finding Some Relief

By Madeline Uretsky

It seems as though every summer for the last 5.5+ years I’ve tried some new treatment, plan, regimen, or whatever you want to call it. Some things have worked, and others have not. I’ve tried everything: natural and unnatural, medical and alternative, traditional and obscure. Except for one procedure that many people in the concussion community have tried. And it worked.

I discovered this procedure after reading posts on concussion/TBI Facebook groups, and talking with some friends who have tried it. For some, it works and changes their lives. For others, it does not, and it’s just another failed treatment. I was hesitant to try it for several reasons; I was nervous about the side effects and recovery time, medically intervening this many years later, and of course, fearing the needles.

With mixed reviews, and reassurance that it would not cause any adverse effects, I was optimistic and excited that it may work for me. I have an incredible trust in my neurosurgeon who has been my guide over the last 5.5+ years, so on June 12th, 2017, I underwent a bilateral greater occipital nerve block.

In simple terms, I had a few needles stuck in the back of my head while I was lying down on an operating room table. I was given Valium beforehand, and the procedure itself took no more than fifteen minutes. I was injected with steroids to help reduce the swelling of the tissue around the inflamed nerves in the back of my head that are partially responsible for my daily headaches.

I did not notice relief right away. I was so exhausted, and so out of it after the procedure that I couldn’t tell what was going on. The back of my head was numb from the anesthetic that I was given, so I had to wait for it to wear off before noticing a difference in pain.

Furthermore, a few days later, I had one of the worst days of pain in years. I was extremely dizzy, nauseous, light sensitive, weak, having alternating hot flashes and chills, and elevated head pain. But the next day, and every day since, my head has been better than ever. My constant daily headaches aren’t completely gone, but they are definitely less painful, and less frequent.

Particularly, in two situations:

  1. Hunger
    • My constant headache and head pressure becomes much worse when I’m hungry.

Since this procedure, my head hurts noticeably less when I become hungry.

  1. Changes in weather
    • When the barometric pressure drops, my constant headache and head pressure becomes much worse.
    • Rain, snow, sun, or more than twenty-degree temperature change in a day causes my symptoms to increase.

Lately, it’s just been the sun, even after several days of rain.

I went for a follow up two weeks later, and my doctor explained how the effects may last anywhere from three to six months, but may last forever. He said that once people break their pain cycle, that sometimes, the pain goes away completely. I’m optimistic, but realistic. My head pain is down a whole point on the checklist/scale, but it’s not at a zero.

He palpated the back of my head on and around the injection sites, and I felt nothing. No pain at all. I was in complete disbelief, but relief. I’ve only known pain for the last 5.5+ years, and now I’m back to some sense of normalcy. Being one of his longest-running patients, my doctor was ecstatic to see me feeling better. I follow up again in six months, and I’m hopeful that this could be the solution. I am so thankful that I tried this procedure, and I am looking forward to seeing how long the effects will last.

For More Information:

  1. Johns Hopkins Medicine

http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/nervous_system_disorders/therapeutic_pain_blocks_134,129/

  1. Ohio Health

http://www.medcentral.org/Main/OccipitalNerveBlock.aspx

 

nerveblock2

A Letter to Myself, Two Years Ago

{Editor’s note: Alicia Jensen is a freshman at Towson University. She was diagnosed with post-concussion syndrome her sophomore year of high school. After writing this, she read it and sat on it. She realized that it reminded her of Luka Carfagna’s wonderful piece. I told Alicia to hand it over and that it was important to publish it anyway. –Jay}

By Alicia Jensen

aj

Alicia, second from right 

Dear Alicia,

You’re in pain. I can feel it now, and I know exactly where you are: Probably laying in bed, in the dark, alone, praying and wishing for the pain of PCS to go away. You had a tough day at school today, huh? head on the desk, waiting for the bell to ring just so that you can go to another one for 52 minutes. I wish I could tell you that tomorrow will be easier and that you’ll be in less pain, but I can’t. Continue reading

A Concussion Photo Essay: This Is My Story

By Jay Fraga

Once, there was a little boy. The boy loved to ride motorcycles with his Father. The boy was transfixed with speed and g-forces and devices with two wheels.

collage1

The boy dreamed of two-wheeled heroes; of men with nicknames like, “Hurricane”. Continue reading

The 504 Plan: School Accommodations and Protections for Your Concussed Student Athlete

By Alicia Jensen

After student athletes suffer a concussion, the first thing that pops into their heads is, “When can I play again?” What many might not realize at first is that the effects of concussions are way more than just physical in nature. Concussions mentally and cognitively impair that athlete either along with the physical symptoms or even after they have been cleared to go back on the field.

Many student athletes like me who are diagnosed with Post-Concussion Syndrome may notice some cognitive symptoms as they return back to school. Symptoms such as memory loss, confusion, a short attention span, and the terrible list goes on and on. Continue reading

Press Release: 2008 US Olympic Bronze Medalist and Three Time World Champion BMX Racer Donny “dR” Robinson Joins The Knockout Project’s Board of Directors

FOR IMMEDIATE RELEASE:

2008 US OLYMPIC BRONZE MEDALIST AND THREE TIME WORLD CHAMPION BMX RACER DONNY “dR” ROBINSON JOINS THE KNOCKOUT PROJECT’S BOARD OF DIRECTORS.

Belchertown, Massachusetts – January 17, 2013- The concussion education initiative, “The Knockout Project”, announced today the appointment of Donny Robinson to its board, the “KO Roundtable”.

Robinson, the 2008 Beijing Olympic Bronze Medalist in BMX Racing, brings valuable experience, knowledge, and reflection to the table in terms of concussive history. Robinson has suffered over twenty concussions in his two decades worth of racing. Recently, Donny has been speaking out to racers and parents about a subject that he never really thought twice about; while trying to convey the serious nature of identifying concussions, sitting out until healed, and seeking a doctor’s advice before returning to action. Continue reading

Fixing Concussions with Band-Aid’s: How Effective is the NFL’s Defenseless Receiver Rule?

saum1

By Kevin Saum

Improving health and safety in football became a passion of mine after I suffered from second impact syndrome while playing in a high school football game and fell victim to the culture of toughness that exists in all sports. Despite the fact that football nearly took my life, to this day I still love the game and I do not regret one play from my 10 years of participation. Many of my fondest memories are from playing high school football and I credit the game and my coaches for making me the man I am today. Because of the intense passion I have for football, I become infuriated when I see professional players undermining the NFL’s attempts to make the game safer by taking cheap shots on defenseless receivers. Continue reading

A Wife Opens Up About Living With Someone With Post-Concussion Syndrome

{ Editor’s note: My finger lingered for a while before hitting the “post” button on this piece. It did so, because it’s painful. It was written by my Wife, who I love very much. The physical pain of this fight is equally rivaled by the knowledge that your family is hurting along with you, and that you’re responsible for putting yourself and them in this position. It’s not easy to come to terms with that. But, if we’re truly going to be educational about the aftermath of concussion and ignoring your injuries, then this has to be spoken about. – Jay }

image

By Jessica

I can’t focus today. I have to grade eight more papers and a week’s worth of discussion posts. Yet, here I sit staring at my macbook hoping that it will just magically happen. I’m sitting in my favorite coffee and tea café listening to the chatter of others and the espresso machine. It’s relaxing. I don’t have to worry about anything (other than the fact I’m not getting any work done).

Every day, I wake up with a knot in my shoulders. I’m stressed out before I even leave my bed. I bring a lot of the stress on. I try to do too much. I try to make others happy while often giving up my own simple pleasures (I really want a f’n latte right now but I’m sipping black tea with no sugar). Continue reading

Jay Writes: Dear Diary.

Dear Diary:

My life feels like a race. But, it doesn’t feel like the kind of race that I’m used to being in.

Everything about it seems heightened, urgent, and rushed. I’m in a race to regain the old me. I’m in a race to spend as much time with my family as I possibly can. I’m in a race to educate others about concussions, so that they don’t have to experience what so many of us have experienced as a result.

I’m haunted by the prospect that while intense physical therapy seems to be bringing my visual and vestibular symptoms to a livable (not normal; just, livable) state, that there is still something happening inside my head that is degenerative in nature. I’m a prisoner to my own thoughts, and they are constant. I have always been very analytical in nature and highly sensitive to noticing nuances; differences in every aspect of my experience, whether in terms of subtle sounds that my car was making, a change in weather, or the shift in a person’s body language. That feature has always been my internal alarm mechanism, and it has never done me wrong when it came to illuminating issues. But now, I find that I use it to discern changes in my cognition, and to take notes of it. I can’t help but to itemize those things and extend them out to their logical conclusion in a mental equation.

Our intellect is our lowest common denominator. It’s all that we have. The prospect of it slowly going away is frightening. Each instance of cognitive fog: forgetting words, not knowing why you’re in a certain place, seeing friends in public and not recognizing their face until just after it’s clear to them that something is amiss is terrifying. Seeing the look on my Wife’s face when she sees me struggling to remember something that I wanted to tell her is crushing. And, I think that it all adds up to something. Or, at least, that’s my gut instinct.

For a person whose gut has always served them well, this is a scary road to walk on.

Fall sports are just starting up again. Already, my inbox is on fire from people who’ve just been diagnosed with a concussion or the parents of kids with one. And, as a result, I guess that I have gotten what I’ve asked for: an opportunity to warn others about the pitfalls of not taking concussion seriously as well as not understanding how to deal with the aftermath. Understanding those things while I was racking up concussions could have made an incredible difference for me and I can’t even to begin to tell you about what the regret of putting yourself and your family in a situation like this is like. If you are reading this, I am dedicated, however, to you never finding out what it’s like.

I don’t know where this goes. But, I hope people will listen.

Jay
The Knockout Project

Jay Fraga Interview With Mike Carruth of BMX News

logo

On Tuesday, July 23, Mike Carruth of BMX News spoke with Jay Fraga about concussions in sports and why Jay started The Knockout Project. You can download or stream the interview here:

http://www.blogtalkradio.com/bmxnews/2013/07/24/bmx-news-announcers-tower-live–july-23-2013-1

What’s A Life Worth To You? The Absolute Importance Of Athletic Trainers In High School Sports

{Editor’s Note: I can think of no one better to speak to the need and value of Athletic Trainers in high school sports than someone whose life was literally saved on the playing field by an AT. Kevin Saum can claim that honor. Kevin is a Knockout Project Round Table member and his bio is available on this page .- Jay}

By Kevin Saum

saummudMore than 50% of high school students in the United States do not have the luxury of having an athletic trainer on the sidelines of their games and practices.  Yet athletic trainers are standard in collegiate and professional sports.  This reality is highly questionable considering that the underdeveloped, youth brain is at the greatest risk of injury.  In addition, studies have shown that young athletes take longer to heal from brain injuries, compared to the brains of more physically mature athletes. Why is it that school districts and policy makers are willing to implement safety changes AFTER a fatal, or near death incident occurs?  I often wonder what would have happened to me if Miss Barba were not on the sideline the night I was injured.  I venture to guess that you would not be reading this blog post.

After reading The Concussion Blog’s March 4th post, which recognized March as National Athletic Trainers month and encouraged readers to give a shout out to their favorite athletic trainers, one AT immediately came to mind.  Despite my lack of punctuality, I would like to recognize an Athletic Trainer at a high school, “set in the valley” in Chester, New Jersey.  Suzanne Barba, “Miss Barba” to all the students, is West Morris Central’s Athletic Trainer of thirty years, and not only mends bumps and bruises, but also touches the lives of every athlete she tapes, rehabs and teaches. Suzanne is also responsible for saving my life in a high school football game on October 5, 2007.  I do not remember very much from this night, but it is a night that undoubtedly changed my life forever.

As an athlete, one place you never want to be is in the athletic training room.  Being in this room either means you are out of the game, multiple games, the season, and possibly forever.  Just ask Alex Smith of the San Francisco 49ers, what happens when you go into this room.  Players would rather risk their long-term health and careers to stay out of this room, and look  where that got Robert Griffin III. I was a senior captain and a product of playing in a sports culture, which frequently glorified playing through injuries.   I naturally felt obligated to play injured in what was our team’s last chance to make a run for the playoffs.  In week two of the season, I sustained a separated shoulder, and Miss Barba tended to this injury for the few weeks leading up to my last game.  In the meantime, I strained the rotator cuff in the opposite shoulder, which instinctively left my head as the only blocking/tackling tool to use.  Naturally, like any competitor, I refused to let these ailments keep me off of the field.  However, after playing with these injuries and leading every hit I made with my head, I sustained a concussion. It should be noted that I was never officially diagnosed with a concussion, because I did not inform anyone about the excruciating headaches I was experiencing.  I never told a doctor, my parents, my coaches and certainly not Miss Barba.  She would never have let me play if she knew about my headache.

As I have alluded to previously on this blog, I unsuccessfully attempted to suppress the pain with four Advil and ran out under the glow of the Friday night lights for what turned out to be the very last time.  Just before halftime in this game I received a significant blow to the head, which left me unable to feel my legs.  With my history of chronic leg cramps in hot-weather games, everyone assumed it was just another cramp, as my teammates helped me to the sideline.  Because of Miss Barba’s experience as an EMT and Paramedic, she knew my condition was something much worse than leg cramps.  Upon recognizing my right-sided gaze, a common sign of a subdural hematoma (brain bleed), Miss Barba called for Advanced Life Support, and luckily a helicopter was in the area, on its way back from another call.  The doctor on the sideline was initially surprised by this request, until moments later, when I began to seize.  Miss Barba’s role did not stop at calling for appropriate medical attention.  She was also the one assisting my breathing with a bag valve mask when I went into respiratory failure, because of the brain swelling that ensued from second impact syndrome. The breathing assistance prevented brain damage and ultimately saved my life.

At that time, In 2007, Miss Barba was only a part-time athletic trainer because she was also responsible for teaching health classes during the day.  Due to a lack of time and resources, this work schedule prevented her from implementing baseline concussion testing and working with athletes to rehab their injuries.  Fortunately, in the year following my injury, Miss Barba was made our high school’s full-time athletic trainer.  Now, thanks to Miss Barba’s exceptional work and overwhelming support from parents, our school has a very thorough graduated return to play (RTP) protocol for its athletes.  This RTP process includes input from the strength and conditioning coach, to aid in implementing the graded physical activity protocol. Athletic trainers and strength coaches spend a lot of time with athletes, both during the season and in the offseason.  During this time they get to know the athletes personalities and ability levels.  They can identify when athletes are not acting like themselves, similar to how parents can, but in an athletic environment.   ATs specialize in diagnosing and treating injuries, while strength coaches have a great understanding of each individual athletes physical capabilities.  This collaboration between AT and Strength Coach, during the evaluation of an athlete’s RTP, allows for an appropriately stringent evaluation. The intricacies of Miss Barba’s RTP procedure meet, and I feel exceed, the standards set in place by the AmericanAcademy of neurology.  As a result, Suzanne believes that athletes feel safer and more confident returning to their sports, after passing this test.

On average, 12 football players die every year due to heart conditions, brain injuries and heat-related causes. Most of these deaths could be prevented with an AT overseeing athletic operations.  Athletic Trainers carry AEDs on the sidelines and could save the life of an athlete who has a heart condition.  Without ATs, concussions cannot be adequately managed due to conflicts of interest that exist in sport. Although athletic trainers have limited control in preventing brain injuries, other than educating athletes, nearly all brain injury related deaths could be avoided if concussions are managed properly.  On hot summer days, AT’s monitor the heat index and have the authority to cancel practice if conditions are too dangerous.  In addition, ATs ensure athletes are properly hydrated, which also prevents heat-related deaths.

Recently, the AmericanAcademy of Neurology published their updated return to play guidelines for concussions.  Most notably, they make the following recommendations:

  • The use of baseline testing.
  • Immediately removing a player from play when a concussion is suspected.
  • Individuals supervising the athletes should prohibit an athlete with concussion from returning to play until a Licensed Health Care Provider (LHCP) has judged that the concussion has been resolved.
  • Licensed Health Care Providers should develop individualized graded plans for return to physical and cognitive activity.

These recommendations are based on research and when implemented, they undoubtedly will make sports safer to play.  However, without the presence of an athletic trainer, their feasibility and intended efficiency are significantly hindered.  Not all parents can afford to take their children to LHCPs.  Who will recognize and remove an athlete from play when a potential concussion occurs?  The coaches? Who are trying to win a game and have a million other things and kids to worry about?  Wouldn’t that be a conflict of interest?  Where is the accountability in returning an athlete to play without an AT? Are coaches now going to be responsible for recording injuries and validating their athlete’s medical notes?  Are physicians going to be responsible for administering graded physical activity tests, with no prior knowledge of the individual’s abilities? All of these questions are answered when Athletic Trainers are looking after players.

Clearly, every athletic program would choose to have an Athletic Trainer if they were not faced by budget constraints.  I owe my life to an Athletic Trainer, which is why I am very passionate about the issue.  Considering all the statistics in regards to the dangers on the sports fields and the obvious safety and life saving benefits an athletic trainer brings, I ask the school districts, policy makers and parents, how much is a life worth to you?

Alex Smith Link:

http://bleacherreport.com/articles/1426269-alex-smiths-benching-could-set-nfl-concussion-safety-back-for-decades?utm_term=NFL+Football&utm_content=NFL&utm_source=twitterfeed&utm_medium=twitter

RG III Link:

http://www.nbcwashington.com/news/sports/Shanahan-Wanted-to-Believe-RGIII-Could-Play-Injured-185822561.html

AmericanAcademy of Neurology Guidelines:

http://neurology.org/content/early/2013/03/15/WNL.0b013e31828d57dd.full.pdf+html

Twelve football players die every year:

http://vitals.nbcnews.com/_news/2013/04/05/17621060-12-school-football-players-die-each-year-study-finds?lite

 

barba1

 Suzanne Barba takes care of Michael Burton, who currently plays fullback at Rutgers University

 barba2

I think she did a good job. Ed Mulholland/US Presswire Photo