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More than meets the eye
“You really have no idea what it’s like to have a concussion until you have had one,” says Amanda Jones who preferred not to use her real name because of current legal proceedings.
Being in the health-care profession, Jones had studied about concussions and knew the medical side of things, but it wasn’t until she was in a car accident last year and suffered one of her own that she realized it wasn’t “just a concussion.”
A concussion is a mild traumatic brain injury, says Ann Greener, a physiotherapist with the Julie Skaling Clinic in Wollfville, N.S. who works with many concussion patients. It can be a result of a blow to the head or a whiplash-type injury and causes a shearing injury to the nerve in the brain and does not allow the brain to produce enough energy to function normally.
“Even simple tasks become more difficult because there is simply not enough energy produced by the brain to meet the demands,” explains Greener.
Jones can attest. After her concussion, she couldn’t safely drive and wasn’t able to do things like exercise or grocery shop without becoming extremely dizzy and sometimes nauseous.
Julie MacDonald, of Port Williams, N.S. agrees. Six years ago, the car in which she was a passenger hydroplaned on the highway, landed in the median and flipped five times, resulting in the roof caving in and impacting her head with each flip.
For about 18 months after the accident, she still felt the impact.
“I had severe adversity to light and noise, was unable to work, spent a lot of time in the dark and at home, had severe vestibular dizziness, mental fogginess and lack of memory skills, headaches, migraines and severe insomnia,” says MacDonald.
Greener confirms with a concussion you can expect headaches, fatigue, nausea, difficulty with light, sound, loss of focus and concentration, memory and emotional problems, and sleep disturbances. People often can’t read as they can't remember what they read and are unable to focus, she adds.
Cognitive strain can aggravate all symptoms and exacerbate the fatigue, explains Greener.
Concussions also bring emotional problems, like having difficulty being in crowds and social situations, explains Greener. People with concussions can become isolated as they can't tolerate noise or light.
“Our society thrives on fast, bright and loud,” says MacDonald.
Anxiety and depression can be significantly aggravated with a concussion as often the anxiety is made worse when people are not able to work and have the extra worries or financial and family issues, says Greener.
Concussions are a very common injury. An estimated 2,700 new brain injuries happen every year in Nova Scotia, says Leona Burkey, executive director Brain Injury NS. These numbers, however, are based on emergency room stats and admissions, reflecting more severe brain injuries and do not accurately capture people who suffer concussion and don't go to the ER, she adds.
It might seem the number of concussions is increasing, however, Greener says we have just become better at recognizing the signs and symptoms and starting treatment early. Over the last several years, she says, there has been a lot more research done on concussions and much more education is available. Trainers and coaches are now made aware of what to look for on the field and know to not ignore the symptoms.
An important thing to be aware of, says Burkey, is Second Impact Syndrome, especially for athletes. If someone has a concussion and gets a second hit to the head it can be devastating.
In most cases 80 to 90 per cent of concussion symptoms will resolve in the first couple of weeks, says Greener. About 10 per cent, however, will go on to develop post-concussion syndrome in which the symptoms can last for years.
And the trouble is, it’s a hidden condition.
“Some days I wish I had a bandage on my head, since although I appear normal, inside my brain is anything but, and no one can see that anything is wrong,” says MacDonald.
Jones has advice for others who have had a concussion.
Don’t rush the healing process: Jones says she tried to do too much too soon after her accident and ended up getting really sick again as a result. Not only did all her symptoms return, but they intensified.
Try to look for the silver linings: We only get one life and bad things happen, says Jones. But don’t give up hope and try to stay focused on good things that have come because of your change in circumstances.
“I’ve slowed down and now spend time doing things I enjoy doing that I never had time for before, and am around with my family more, and have made new friends along this journey,” says Jones.
Accept and come to terms with the new normal, adds MacDonald. Remember, it is going to take a lot of time and you will learn you have more patience than you ever thought possible. With that, there will be a lot of tears and frustration and you will grieve for what you've lost.
Burkey says another important thing is to make sure people with concussions find good information. She recommends Parachute (parachutecanada.org) and the Ontario Neurotrauma Foundation’s website as they are national leaders in evidence-based information and guidelines in the area of mild TBI/Concussion (braininjuryguidelines.org).
And, don’t be afraid to reach out for help, adds Burkey. BIANS offers a very popular monthly program called "Concussion Cafe", a peer-led gathering that provides a safe space for people living with the after-effects of concussion. Right now, the meetings are in Halifax, with plans to expand through the local chapters in the province.