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Follow-up treatment scarce for those with concussions

Toronto Star by Sarah Neville 23 August 2014

Sidney Crosby brought attention to concussions but it’s time to ensure that emerging knowledge and follow-up treatment is accessible to everyone.

I thought of Sid the Kid when I first woke up in St. Michael’s Hospital, unable to sit up without vomiting. After his infamous blows to the head on the ice, I wondered, did he experience extreme vertigo and fatigue, memory loss and mood swings? Did he worry not only that his career was over, but that he might be physically dependent on others for the rest of his life?

Maybe as a professional hockey player Sidney Crosby was better educated about the dangers of concussion than I was. But riding my bike along Queen St. in early May on the way to a meeting about my relatively risk-free communications seminars, it never occurred to me that I would end up sharing a diagnosis with the NHL’s most valuable player.

My concussion education began in early May when my bicycle tire suddenly became firmly jammed in a Queen West streetcar track. Bike halted, I was pitched headfirst into the cement. Yes, I wore a helmet, but was still knocked out for several minutes and remember nothing of the following few hours.

Stars like Crosby have helped shine a light on the implications of concussions for athletes. The result: growing awareness among parents and coaches, new protocols in sports, and growing support in sports medicine. For a kid in hockey, it’s a welcome start. But if you’re an adult, or your concussion wasn’t delivered by a puck or a ball, you’ll likely be fending for yourself.

I required a five-day hospital stay for the room to stop spinning every time I turned my head. Medical staff stitched me up, ruled out spinal damage and released me, once I could shuffle down the hall with the aid of a walker. But no follow-up plan was offered by either St. Mike’s or my GP, who removed the stitches a week later.

For youth who’ve sustained head trauma through sports, there are new resources.Hockey Canada has a concussion awareness website and an app for parents, coaches and kids to teach young players how to prevent them. Protocols exist for “return to play,” and many sports medicine clinics are rebranding themselves as specialists in concussion treatment.

This is good news: kids playing contact sports have a decidedly high risk of head injury and repeated blows can cause irrevocable damage to young brains. But continued public education, prevention and follow-up care protocols that are broadly and rigorously followed are critically important.

Moreover, sports injuries aren’t the primary cause of concussion — in any age group. Statistics Canada data shows that 77 per cent of head injuries sustained between 2009-2010 was among working age adults or seniors. Parachute Canada — the leading resource on preventable injury — reports that 81 per cent of concussions requiring hospitalization result from either falls or transport injuries like mine: motor vehicle collisions, cycling and pedestrian injuries.

For me, the lack of readily available support meant a murky and stressful recovery. In addition to the symptoms described above, I felt extraordinarily weak, perpetually dizzy and extremely sensitive to noise. I had loving care from family and friends, but no idea how or where to access follow-up treatment. This was made even tougher by headaches that prevented me from reading or looking at screens for more than a few minutes. As a small-business owner, a “return to play” plan would have been handy. I had no idea when I’d be able to resume working and the fickleness of my brain terrified me.

My consulting work includes diversity training that enables people to transcend cultural, gender and generational differences in workplace communication. Effective communication means getting inside someone else’s world view; now I had to actually live it. An extrovert whose normal approach to life is activity-based and outcome-focused, I was now forced to introversion, dependent on family and community, and re-evaluating my worth as someone who could no longer do, but had to simply be. Not feeling like myself was a lesson in understanding others.

I was lucky to find a sports medicine clinic and empathetic chiropractor, trained and knowledgeable in concussions. He turned my experience around with a full assessment, clear treatment plan and monitored outcomes, providing immeasurable comfort and relief.

Sidney Crosby’s knocks on the head drew much-needed attention to concussions, and organizations like the Ontario Neurotrauma Foundation and Parachute Canada offer valuable resources for health providers and families. Now it’s time to ensure that emerging knowledge and follow-up treatment is accessible to everyone.

Sarah Neville is principal of Open Line Communications in Toronto and a board member of Media Action.