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Cracking concussions: Iowa hospitals, clinics, other groups team up to clear up confusion

Community meetings set Friday, Saturday in Cedar Rapids, Iowa City

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With concussions in the spotlight lately — particularly related to the National Football League (NFL), who recently announced the Play Smart Play Safe initiative to prevent, diagnose and treat head injuries — area doctors are hoping to clear any confusion.

“The more knowledge around, the better,” said Dr. Devin Smith, a physiatrist at St. Luke’s Hospital Physical Medicine and Rehabilitation Center.

“Brain injuries have always been around — there’s a correlation between getting bonked on the noggin and cognitive issues,” he said.

But “now there is a new spotlight on this, with the issues on the NFL level,” like chronic traumatic encephalopathy (CTE) — a progressive degenerative disease of the brain found in people who have had a severe blow or repeated blows to the head — and concussions, he continued.

And with all the attention in the media, “people are becoming very alarmed and concerned about their student athletes,” said Jill Miller, a nurse practitioner in PCI’s neurology department.

“There is a hesitancy with athletes to self-identify” head traumas, Smith said. But when in doubt, research shows it’s best to sit it out.

In fact, according to new research from the University of Pittsburgh Medical Center’s Concussion Clinic published in the journal Pediatrics, playing through the pain of a concussion not only doubles your recovery time, it could also lead to more severe symptoms.

The study reported approximately 1.6 to 3.8 million sport-related concussions occur each year in the United States, but an estimated 50 to 70 percent go unreported or undetected due to many factors, including “play through the pain” culture in sports as well as athletes, coaches and parents not fully understanding or acknowledging the condition.

“Student athletes are more prone to suffer greater injury,” Smith said. And a second impact — even a mild one or “collisions that seem inconsequential from the stands” — can cause permanent disability or even death.

“You definitely don’t want to go back into the game unless you are completely normal,” Miller said. “Going back in increases the risk of second impact syndrome and if you haven’t cleared from your first injury, you could end up with brain swelling.”

According to the Centers for Disease Control and Prevention, signs of a concussion might include:

l Difficulty thinking clearly, concentrating or remembering new information

l Feeling “slowed down” or tired

l Headache, dizziness and/or sensitivity to noise or light

l Nausea or vomiting

l Balance problems

l Feeling more emotional, irritable, sad, nervous or anxious

l Change in sleep patterns including more or less sleep than usual or trouble falling asleep

Symptoms may appear right away or take days or even months to appear after the injury, so sometimes people don’t recognize or understand their symptoms right away. If symptoms appear to get worse or if weakness, numbness, decreased coordination or slurred speech occur, seek immediate medical attention. If the person cannot be awakened, loses consciousness, cannot recognize people or places, has other unusual behavior, convulsions or one of their pupils is larger than the other, go to the emergency room.

Unlike adults, who can typically recover from a concussion in 10 to 14 days, Miller said, “It tends to take kids longer to recover — sometimes two to three weeks to completely heal.”

It’s important for kids to get rest and avoid activities that could result in another bump or blow to the head or body. Waking a child with a concussion every hour to “constantly check if they know who they are” is a myth, Miller said. So when they are tired, let them sleep. Once headaches and dizziness subside — usually after 24 to 48 hours — allow the child to return to school and “try to keep things as normal as possible,” she suggested. “Too much seclusion can lead to depression and anxiety.”

When Miller was completing her doctorate, she studied concussions and the “lack that we have here in Cedar Rapids and surrounding areas for concussion management and care,” she said. “There were no resources for athletic trainers and therapists if kids were still having symptoms.”

Last year, though, Brain Injury Alliance Iowa organized the Iowa Concussion Consortium — a collaboration of Iowa hospitals, clinics and other organizations — is bringing concussions to the forefront through the REAP project.

REAP, which stands for reduce, educate, accommodate and pace, is a community-based model for concussion management that was originally developed in Colorado’s Rocky Mountain Hospital. The project aims to bring together families, schools and medical professionals to help adults and student athletes better understand concussion recovery to prevent further injury and properly heal.

On Saturday, Miller and Smith will host a free community discussion where they’ll address concussion symptoms, when to seek medical attention, signs that recovery might not be going normally, long-term effects of brain injuries and the facts and myths surrounding the condition.

Student athletes, parents, coaches or anyone interested in learning more are invited to the event starting at 2 p.m. in the third floor community room in the PCI building in Cedar Rapids.

Gazette reporter Chelsea Keenan contributed to this story.

IF YOU GO

Concussion Management town hall meeting

When: 6 p.m. today Sept. 23

Where: Iowa City Public Library

Details: Dr. Karen McAvoy, author of REAP, will host a town-hall meeting at the Iowa City Public Library to discuss community-based concussion management. Register online at www.biaia.org/ICC

Concussion 101 — Student Athletes

When: 2 p.m. Saturday

Where: Physicians’ Clinic of Iowa building — third floor community room — 202 10th Street SE, Cedar Rapids

Cost: Free

Details: Student athletes, parents, grandparents, coaches, school staff, area league coordinators and anyone else interested in learning about concussions are invited to attend a free community discussion about concussions, hosted by UnityPoint Health St. Lukes Hospital Physical Medicine and Rehabilitation Center. Please register by calling (319) 369-8877 or online at www.unitypoint.org

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