Monthly Archives: April 2013

Reality of Post Concussion Syndrome Driven Home By Web Search Statistics

By Jay Fraga

As the founder of this site, I take a keen interest in trying to figure out how people are getting here. Many arrive at The Knockout Project because of an article or post that has been shared via social media. Some people get here by accident; many after their own accident while they search for answers in an attempt to get some relief.  As someone who still suffers from some rather lousy post concussion symptoms daily, I can’t help but to read our site’s internal statistics and envision the suffering on the other end when a person types a phrase or question into a search engine that ultimately leads them here.

I’d like to share with you some of the searches that have led people to our site within the last four months. Some of the search queries offer poignant insight into the suffering that can exist post-concussion. For me, these queries are often hard to read. I’ve felt many of these symptoms and know how bad they can be physically and mentally. In that particular light, they’re not just search queries: they’re my life. They’re the lives of other athletes that I know. And now they are an unfortunate part of someone else’s life; someone seeing our site for the first time via a search engine query.

  • the knockout project
  • post concussion syndrome
  • the knockout project concussion
  • knockout project
  • theknockoutproject.org
  • raising a child with post concussion syndrome
  • can post concussion syndrome last forever?
  • post concussion college teen
  • post concussion light sensitivity and computer screens
  • how to explain my post concussion syndrome
  • nobody understands my concussion
  • how do i explain post concussion syndrome to people
  • looking backward when you have a concussion
  • post concussion syndrome changed my life
  • post concussion syndrome even years later some people can’t focus
  • why do we forget what happens concussion
  • my boyfriend has post concussion syndrome
  • my post concussion story
  • why are memories forgotten during concussion
  • multiple concussions data tables
  • concussion can’t bend head down
  • stories about second impact syndrome
  • how to get my taste back after concussion
  • sara birkholz
  • theknockoutproject.com
  • concussion project
  • kevin saum
  • www.knockoutproject.org
  • concussions april 2013
  • ride at disney world feels like concussion
  • theknockout.org concussion
  • junior seau eye of a champion #45
  • a soccer player
  • kevin saum project
  • concussion project.org
  • www.theknockoutproject.org
  • the knockout project new jersey jensen concussion soccer
  • http://theknockoutproject.org/
  • concussed me
  • knockout project wordpress
  • concussion emergency they gave me an iv
  • concussion mission statements
  • kevin saum concussion article rutgers
  • knockout project blog
  • post-concussion syndrome soccer
  • sara birkholz rochester mn images
  • cuncussion from bouncing on mountain bike
  • amateurism perpetuates
  • vivid dreams after concussion
  • post concussive syndrome in adolescents
  • kevin saum football injury
  • kevin saum the knockout project
  • the knockout project-21st century
  • duluth mn neurologists who specialize in concussions
  • racing drivers head whipped forward after crash pain shooting up head
  • can someone help me write an impact statement after a car accident that cause whiplash
  • post concussion doctors in mineapolis
  • second impact syndrome survior
  • bmx biking project
  • jay fraga bmx
  • 12 yr old with multiple concussions
  • concussion helps me hang on some people claim
  • i crashed on my mountain bike and i got unconcious what possible the cause
  • jay fraga bmx racer
  • multiple concussion syndrome
  • knockout jay fraga
  • bradley multiple concussion
  • concussions in sports paraphrases
  • athlete and concussions story
  • football post concussions
  • multiple soccer concussion stories
  • theknockoutproject
  • concussion awareness programs rochester
  • second impact syndrome
  • need more toughtness to ride my bike
  • knockoutproject.org
  • relapse of concussions symptoms
  • i didn’t have a headache until the day after i hit my head, could i have a concussion
  • century projects april 2013
  • post concussion syndrome for time on act
  • words of wisdom for people with concussions
  • sara birkholz 
  • sara birkholz 
  • i have a concussion now what? 
  • can a concussion cause you to see upside down
  • post concussion syndrome athletes stories
  • post concussion dizziness when bending down
  • most common freak accidents
  • mental toughness in education project
  • knockout i don’t remember
  • no screen time for post concussion
  • teen who misses freshman year in h.s. because of concussion
  • post concussion syndrome in football
  • i need help with my post concussion symptoms
  • i ‘ m fine coach put me back in the game
  • can a concussion change your belief
  • bmx massachusetts
  • seeing my daughter lying on a backboard in the er
  • kimberly mcnicholl ny high school east
  • is a knockout a concussion
  • nausea when reading post concussion
  • most interesting bmx speech
  • vivid dreams concussion
  • had a concussion can’t look at screen
  • can i play soccer if i have post concussion syndrome
  • why is whiplash a major part of concussions
  • concussions mission statement
  • alicia jentzen
  • alicia jensen
  • senior project concussions
  • life course for someone with cte concussions
  • do concussions force bad throws
  • multiple concussions
  • i got my fourth concussion
  • when did society become aware of football concussions
  • projects on concussions
  • music to go along with a concussion project
  • no.14,mcnichols
  • are amusement rides dangerous for those with a recent concussion
  • second-impact syndrome story
  • why is using a cell phone post concussion
  • amantadine concussion
  • trends of how more teens are going to get tested for concussions
  • reboundibility in mental toughness
  • nauseous after second impact
  • nausea from flourescent lights post concussion
  • kevin saum nj

Concussions are no joke. They entail much more than just an abstract sounding word. This list only scratches the surface of that reality.

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

 

 

 

 

 

The Fog

By Jay Fraga

oldschool

Jay, 1982

The fog rolls in without notice. Some days, you wake up and it is there. On others, you are lulled into a false sense of security; you forget that it lurks, waiting to cover you in its confusion, emptiness, and uncertainty.

Yesterday was good. Today, I woke up and the fog was there. Simple tasks became monumental ones. Normal thought process became labored. This weekend, I called my wife on her cell phone when I heard her car start up in the driveway and start to pull out. I was upset and asked her why she didn’t say goodbye to any of us. She said, “Jay, I just gave you a kiss a minute and a half ago and said, “See you later”.” Hearing that and not being able to remember even a sliver of the experience sucked every ounce of air out of the room.

You try to take experiences like that and shove them far away someplace. You try to marginalize them and tell yourself that they don’t matter; that they’ll pass. But, they are scary. They make you wonder. Where you once felt strong and unbeatable, those experiences make you feel weak. I will turn 41 in three months and I’m not quite sure what is happening to me.

Ray Bradbury, “The Foghorn”:

“One day many years ago a man walked along and stood in the sound of the ocean on a cold sunless shore and said, “We need a voice to call across the water, to warn ships; I’ll make one. I’ll make a voice like all of time and all of the fog that ever was; I’ll make a voice that is like an empty bed beside you all night long, and like an empty house when you open the door, and like trees in autumn with no leaves. A sound like the birds flying south, crying, and a sound like November wind and the sea on the hard, cold shore. I’ll make a sound that’s so alone that no one can miss it, that whoever hears it will weep in their souls, and hearths will seem warmer, and being inside will seem better to all who hear it in the distant towns. I’ll make me a sound and an apparatus and they’ll call it a Fog Horn and whoever hears it will know the sadness of eternity and the briefness of life.”


16 Year Old NY HS Junior Has Her World Turned Upside Down By Concussion

By Kimberly McNicholl

kimberlymcI had everything going for me. I had my own tutoring business, I was extracting DNA at a lab for a college university, and taking Physics and Chemistry courses in school. I was enrolled in drivers ed and practicing driving. I was a group leader in my school’s Robotics team and had straight “A’s”. My schedule was always packed. I loved it that way. Never would anyone imagine that a small bump on the head would cause me to lose all of this.

Everybody bumps heads once in awhile. It’s so common that you forget it happened because it’s such a minuscule part of your life. Your head may hurt for a little bit, but a week later you would forget it even happened. That’s why when I got my concussion, no one thought anything of it. The night of the concussion was the most painful night of my life. I spent the entire night in tears not being able to sleep because of the throbbing pains. The next morning, I was diagnosed with a “significant concussion” and was advised to take the rest of the week off and return to school on Monday. As the week went by, the headaches did not subside in the slightest bit. I was living on pain pills and even the tiniest noise or light could induce tears from the excruciating pain.

Trying to go back to school that Monday after seeing a Concussion Specialist was absolutely impossible. I ended up leaving early and seeing a different doctor. I was told by her that my health was more important than my education, and that I would not be able to go back to school until I was somewhat recovered. Not only that, but I was no longer able to look at any screens, or listen to any loud music. That meant no cell phone, no computer, no iPod and no way to contact my friends other than the house phone. I had to give up my whole life to go into complete isolation for a month.

During this isolation, most of my time was spent in a dark room listening to audiobooks and doing anything to ease the constant headaches. As time went by, most of my friends started to forget about me. I was out of sight and out of mind to them. Only a few close friends would call and visit me. The isolation was depressing. I would be lying if I said I stayed strong during this time period. I cried often and felt extremely lonely. I had many emotional breakdowns and anxiety attacks which made the headaches worse. I missed my life and my friends who had forgotten about me. I tried a couple of times to leave my house, but car rides as well as fluorescent lights made me sick. Even seeing too many colors in one place would make my head spin. 

Also during this time, the school district attempted to start me on home schooling. While I could usually handle seven hours worth of school without a break, I couldn’t handle twenty minutes of tutoring without completely breaking down. I was forced to drop one of my science courses because of my lack of lab hours. The labs would have been basically impossible for me to make up. Because I was not attending school, Smithtown’s policy stated I would be unable to attend all the clubs I was in. I was forced to miss the entire build season in Robotics. My entire life was falling apart and there was nothing anyone could do to help me. The depression got so bad where I was advised to start seeing my old social worker again. Although it helped a little, it is basically impossible to keep your head up when you lose your entire life and all you get in return is non-stop pain. 

Although the pain was the worst symptom, there were plenty more accompanying it and making my life miserable.I was constantly dizzy to the point where sometimes I couldn’t walk across the room without falling. I was also having memory problems and my vision was very blurred. Occasionally I would start to see stars and I always felt like I was in a fog. I didn’t feel like myself and didn’t remember what I was like pre-concussion. During this entire time I was not myself, and I hated the person who I had become. I felt lazy and disgusting from laying in bed for weeks. I hated myself for not being strong through this. I didn’t believe that I would ever get better. After six weeks of these symptoms, the Doctor decided that I would need medication to give me the push I needed to get better. I was put on Amantadine, which is also used for Parkinson’s and Alzheimer’s patients. This was a miracle drug, it minimized most of the symptoms just enough so that I could start being a human being again. 

After ten weeks of isolation, I was finally cleared to go back to school for four periods a day. On top of that, I would be doing home tutoring after school to try to catch up on all the work I missed. After several fights with the school, I finally got all the tutors I needed for my five core classes. Although I was back in school, the amount of limitations I had were insane. No gym, a zero percent exertion rate, no homework, no tests or quizes, and no independent reading were just some of the requests on the several doctors notes the school received. As much as I wanted to go back to school, it was torture. My head was constantly still hurting. The doctor tried helping the constant headaches by increasing the Amantadine. Unfortunately, this did not help at all and I experienced extreme shortness of breath. I couldn’t even walk up a flight of stairs without feeling as though I just ran a mile. 

As of now I am in five periods of school a day. I still have tutors after school and I am just starting to get my life back, although I don’t think it will ever go back to the way it was at the beginning of this year. I still am not allowed to do any physical activity and I have to restrict my mental activity. I have a list of accommodations regarding school work. The school is currently in the process of completing the 504 paperwork, so the teachers are forced to listen to these limits, which has been a problem for the last two months.

Every two weeks I go back to the doctor who is tracking my progress and we are always trying new things to try to push start recovery. Recently my body became immune to the Amantadine and my doctor advised me to stop taking it and try acupuncture. The week I got off the Amantadine was a very hard week to get through. I’m not sure if we were wrong and the pill was actually helping, if it was withdrawal symptoms or if it was just because of the relapse I had the week before. Regardless, it caused a decent amount of pain. In the past month I have relapsed twice. Once from doing too much homework and another time from lawn work. Although I recover from the relapses, it sets me back a couple of weeks and scares me. I’m always terrified that I will have to go back into isolation if I over work myself. 

Especially in the eleventh grade, the pressure to get all your work done on time is immense. Colleges look at this year more than any other year, and that causes extreme amounts of stress to every kid going through it. As of now, I still can not read without getting massive headaches. This makes me unable to sit through four hour reading comprehension tests like the SATs and ACTs. After working a whole lifetime to try to get into college, the fact that I may only get one shot on these standardized tests is frustrating to deal with. I also know that if I don’t recover over the summer, these scores will be a lot lower and not be an accurate representation of all the hard work I put into educating myself. The college board is very stingy when it comes to giving extra time on their tests. Because the impact test I took in November and in February tested for mostly cognitive and memory symptoms, which I didn’t have as much of, my scores did not represent how bad my pain was. The only way the college board will even consider giving me extra time on the standardized tests is if I take a neuropsychological test. I will most likely be taking this over the summer considering it is seven hours of intense testing that can very easily cause concussion patients to relapse. Even now, taking tests causes me a lot of anxiety. Although I learn the material and understand it, It takes me a little longer than most and I forget it very easily. Also forty minutes of pure concentration and writing is enough to induce headaches. Thankfully, most of my teachers are working with me and making learning this years curriculum a little easier. 

When going through freak accidents like this, the most important thing is support from friends and family. Without this support, it is absolutely impossible to recover. During this time you need your friends and family to step up and help you in whatever ways possible. Even if its just believing you when you say your head hurts or you can’t do something. It sometimes gets to the point where if enough people tell me that I am “milking it” or “overreacting” to get out of work, I start to believe it myself. I start pushing myself harder to show them that I am truly trying my best and I end up relapsing by the end of the week or sooner.

Because of lack of support and ignorant comments from most of my extended family, I know how important it is to educate people on Post-Concussion Syndrome, which is why I am writing this paper. People think since you look fine on the outside, that you are fine, which is not the case. Because concussions are “invisible injuries” that you can’t even see on a MRI or CAT scan, people have a hard time believing that it could be as painful and hard to get through as it is. I have met other people with concussions, some even worse than mine, who also agree that support is so important during this recovery period. Unfortunately, some people think they know everything about concussions and won’t take the time to research them, you don’t always get the support you need. A person with a cast on their leg would never be expected to run a mile, so why are concussion patients expected to do all the mental work of a “normal person”?

I know I would not have been able to survive this injury without the amazing support of my mom, my boyfriend, and specifically two of my close friends. These close friends would call often and sit with me for hours, even though I wasn’t able to do much. One of my close friends would occasionally sit with me and read me things off of our favorite websites since he knew I couldn’t go on the computer. My other friend would call me several times a week and make time every week to visit me and sit with me. He would also attempt to help me with physics and drivers ed homework, even though I later ended up dropping both. I can not thank these two people enough, they are truly my best friends and they proved it during this time. My boyfriend was over any time he had the chance to be and is always the first one to offer if I need help with anything. He is always keeping a close eye out for me and making sure I won’t do anything that will hurt me in the long run. Whenever I have headaches, he makes me rest, he literally deserves an award for dealing with my stubbornness.

My mom was the biggest help, and still is. She is constantly fighting with the school to get me everything I need to succeed. She is on basically every concussion website known to man talking to other concussion patients and looking up remedies and medications that could help shorten the recovery process. She was there for me for every emotional breakdown and for every tear I shed. She took off of work to be with me and took me to every doctor’s appointment, while also making sure I was only seeing the best doctors. She put everything into making my isolation easier on me. 

The reason I’m posting this is because people with Post Concussion Syndrome need to know they are not alone and that they are going to get better. There is a reason we got hurt and we are all going to somehow make it into a positive experience. As soon as I started talking to people off of these websites, I started to feel a lot better. There is a whole community of amazing people from all over willing to help you and talk to you because they went through exactly what you’re going through. I want to be there for someone like all these people have been there for me.