News

Taking a Hit

Written by Laura Bell this article was first published in VVMC's Vail Health Magazine spring 2016 edition. Free copies are available at newsstands throughout Eagle County.

"Raise your hand if you have had a concussion.”

Kim Greene the injury prevention specialist for VVMC's Trauma Services frequently asks this question in local classrooms. Five years ago she was met with blank stares and silence. But today on average five students will tentatively lift their hands. Have concussions increased that much?

“Yes” says Greene “and so has awareness.” Centers for Disease Control (CDC) reports show the amount of reported concussions has doubled in the last 10 years. The American Academy of Pediatrics has reported that emergency room visits for concussions in kids ages 8 to 13 years old has doubled and concussions have risen 200 percent among teens ages 14 to 19 in the last decade.

Traumatic brain injuries (TBI) more commonly referred to as concussions are getting a lot of attention lately. When left undetected concussions can result in long-term brain damage and may even prove fatal.

The data is sobering — cumulative sports concussions are shown to increase the likelihood of catastrophic head injury leading to permanent neurologic disability by 39 percent. Additionally according to Head Case an organization to help protect young athletes from the risks of undetected
cumulative concussions:

• 1 in 5 high school athletes will sustain a sports concussion during the season.
• 33 percent of high school athletes who have a sports concussion report two or more in the same year.
• 4 to 5 million concussions occur annually with rising numbers among middle school athletes.
• 90 percent of most diagno sed concussions do not involve a loss of consciousness.
• An estimated 5.3 million Americans live with a traumatic brain injury-related disability (CDC).

Because of heightened awareness and more importantly a desire to educate students local parents coaches and medical professionals are teaming up to get the word out on the prevention recognition and treatment of concussions.

“When I ask students who've had concussions to share their experience with their classmates the students will listen to that. It is the most effective part of what we do (in regards to education)” says Greene the chapter director of inkFirst an international non-profit organization that promotes education and resources.

Through Vail Valley Medical Center which operates the ThinkFirst chapter Greene visits Eagle County schools and distributes free bike helmets provides education regarding concussions and helps administer ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) baseline testing through a computerized neurocognitive assessment. She also does car seat inspections throughout the county giving hands-on demonstrations on how to install them properly and safely secure a child.

While passionate about spreading the word on TBI prevention and safety this is not the profession that Greene would have originally chosen. Her journey began when her then-16-year-old son Jeremy was driving his car without a seatbelt his vehicle spun out of control and crashed into a tree. “It was a game of wait-and-see every day” she says. “His brain was sloshing around in his skull.”

Derived from Latin the word concussion means to “shake violently” which was exactly what happened to Jeremy's brain. For three-and-one-half months he was in a coma and non-responsive.

“When someone is in a coma you can't say that in two months something in particular is going to happen. It is day to day” she says.

Now 32 — 15 years later — Jeremy still takes things one day at a time. Although he did graduate from college he is as Greene says “definitely disabled.” He can no longer drive and has balance and vision problems. He is currently living at home as he needs the extra support.

As an example Greene says that her son needs to be supervised when doing anything that involves multiple steps such as cooking. He struggles with executive functions such as putting his day in order: what day is it what does he need to do where does he need to be?

Nineteen-year-old Clare Baker a Vail Mountain School (VMS) alumna can relate. She is a selfdescribed sticky-note junkie and is always writing lists.

Baker suffered her first of eight to 10 concussions when she was in second grade and fell 30 feet from a tree. A gymnast her first instinct was to put her arm out to protect her head. While that broke her arm Baker believes had she not done that she would be paralyzed as she hit the ground with such high velocity.

When she arrived at the hospitalshe was functioning normally and answering questions. However she has no recollection of the first few hours of what happened after she “hit the ground.” “I was not unconscious but my mind was essentially black” she says. “I don't remember a thing and that is really scary. In my mind I was dead for those few hours.” 

Baker's mother initially chalked up her nausea to the pain medications she was given but her maternal instincts took over and after more tests Clare was diagnosed with a concussion.

“I've learned that after your first concussion it is easier to get a second and then a third and so on” Baker says.

From second to seventh grade she suffered four more concussions some more severe than others but each collectively contributing to the problems she experiences today. Prior to the start of eleventh grade Baker suffered a particularly disturbing concussion when she fell at the top of the wake while wakeboarding.

“I caught an edge and hit the water which was like glass” she says. “I got up and was walking and talking normally my dad said. But I was in the shower a few hours later and the hot water 'brought me back to life.' I couldn't remember how I got in the shower.”

“When I was in second grade I wasn't old enough to realize what it was like not to remember what had happened but this time I was 16 and to not remember was terrifying” she says pausing while choosing her words.

Determined to start her junior year at VMS the following day Baker was tired and the lights bothered her. Additionally her athletic director would not let her train with the lacrosse team until she received proper clearance.

“That's what sparked my interest in concussions going through the whole protocol of returning to my sport. It's one thing to sit in a dark room over the course of the summer until you feel better but it is another when you need to be cleared. I am glad the trainers made me go through this because they cared about my well-being” Baker says. 

Now a sophomore at the University of Colorado in Boulder Baker is studying integrative physiology and hopes to become a physical therapist or physician's assistant and help student athletes return to their sport after a brain injury.

Howard Heads Sports Medicine physical therapist Brittney Huntimer who specializes in concussion and return-to-sport treatment and management is as much an advocate of organized sports as she is of injury education and prevention. “There are great things involved with organized sports. We just want the kids to be safe” she says.

Huntimer notes that it can be confusing for parents who aren't aware of the new concussion guidelines she wants parents to be a part of the process and see the neurocognitive test results.

“We are working with medical professionals coaches athletic directors and others within the school system to see that parents and kids are getting the same information” she says.

“It doesn't have to be a huge hit to the head to be a concussion. If you have a hit to the head and you have symptoms you have a concussion” she says adding that there are doctors therapists and athletic trainers on site at many sporting events.

Prior to participating in sports all Eagle County high school athletes must be cleared by a physician. Each spring Vail Valley Medical Center and The Steadman Clinic's physicians physical therapists and athletic trainers volunteer their time to provide free preparticipation physicals to ensure every student-athlete is healthy to compete. e students are screened for vision blood pressure and general heart and orthopaedic health. Baseline neurocognitive tests are also administered and student-athletes and their parents are offered educational materials and the opportunity to speak with healthcare professionals who specialize in injury prevention when to return to sport after injury and physical rehabilitation.

“In the 12 years I've done pre-participation physicals I've met an increasing number of athletes and parents who want to learn more about concussions" says Brandie Martin a certified athletic trainer at The Steadman Clinic and director of the athletic training program for Eagle County School District. "I have also seen an increase in the number of reported concussions which may mean that our initiatives to educate athletes about the danger of concussions is being heard."

“It's important for kids to know the signs as well” says Greene. “If two friends are skiing and one of them gets hurt his buddy can know what signs to look for. It's one of the things we teach.”

In 2015 Greene and her team of volunteers educated over 12000 people about brain and spinal cord injuries and donated 1142 bike and ski helmets to children and adults in the community through VVMC's ThinkFirst program. She has also formed a pledge which she asks children and parents to sign—a formal promise to think first wear a helmet fasten your seatbelt and protect your brain.

VVMC ThinkFirst | vvmc.com/thinkfirst | (970) 477-5166

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High School Pre-Participation Physicals
Saturday May 14 2016
Eagle Valley High School Gypsum

8:00 AM - 9:00 AM Incoming Freshman Girls
9:00 AM - 10:00 AM Incoming Freshman Boys
10:00 AM - 12:30 AM Incoming 10th 11th 12th Girls
1:00 PM - 3:30 PM Incoming 10th 11th 12th Boys

- Physical exams provided by the doctors and staff at The Steadman Clinic and the Vail Valley Medical Center.
- Freshman Impact baseline testing for concussions.
- Referrals for athletes with health concerns.
- Education regarding concussions injury prevention return to sport after injury and physical rehabilitation.

*Incoming Freshman - physicals can take up to 2 hours
*Please wear shorts a t-shirt (sports bra) and bring current insurance information
*Athletes under age 18 must be accompanied by a guardian physical forms must be signed and filled out by a guardian.