Brain Injury Awareness Month is Winding Down

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Brain Injury Awareness Month is drawing to a close. I hope that you have taken the time to look at a few websites, read a journal article or attend a talk or two to learn more about concussions and mild traumatic brain injuries. The Brain Injury Association of Maryland’s conference last week was a tremendous success. Attendees told me about some exceptional presentations: Brianna Scurry’s personal story of recovery, Dr. Jeff Barth’s research data on concussion as people age, HeadFirst’s own Dr. Robert Graw’s presentation on a community-based concussion clinic and Dr. Kevin Crutchfield’s talk on cervical injuries.

Sadly, we are reminded all too often that brain injuries can affect anyone, at any time, even those close to home. Close to us here in Maryland are two midshipman from the U.S. Naval Academy who have been affected. Please keep in your thoughts and prayers MIDN William McKamey, a Naval Academy football player suffered a neurological event while at practice three days ago and succumbed to his injuries at University of Maryland R. Adams Cowley Shock Trauma Center in Baltimore on Tuesday, March 25th. Also please keep in your thoughts MIDN Hans Loewen, who sustained a severe brain injury while skateboarding and is being treated at the same medical center. We pray for the McKamey and Loewen families, the Naval Academy football coaches and team, and their Naval Academy Family.

Brain_Injury_Awareness_Month

Don’t Give Up! You Will Recover After a Concussion

by Sherray Holland, PA-C
HeadFirst Concussion Care Provider

Editor’s Note: Following is a first-hand account from HeadFirst Concussion Care Provider Sherray Holland, PA-C (pictured below), about her own experience with brain trauma while engaged in the most routine of activities — grocery shopping.

Sherray_HollandI want to start off and say that this is a subject near and dear to my heart. I have worked with concussion patients since 2008. According to the Centers for Disease Control and Prevention (CDC), at least 1.7 million people in the United States sustain a concussion each year and seek help, but we believe this number is actually doubled because so many people still do not get checked out.

When I was younger (I am in my mid 30s now!), I was told to “shake it off” and keep playing or not go to sleep after hitting my head. Sound familiar?! So much has changed since those days as more education and research has been done about concussion. However, I think we still have that mentality when it comes to ourselves and we end up trying to push hard through the pain.

Now, I would like to share my story. A few years ago, I was texting and walking into a store in a shopping center. As I stepped onto the curb, my shoe got stuck and I tripped!  I could not gain control (picture my arms flailing and trying to stand). Then I suddenly realize I was going to fall…and hard. I kept thinking, “This is going to hurt.”  My next memory was lying face up with a few people looking down at me in panic. I remember being upset because an older man said “Boy that was a bad fall, are you okay?” Embarrassed, I thanked everyone, dusted myself off, grabbed my boot (which came off) and took my purse. My head hurt but I went in anyway to get a few items. I figured “Hey, I work with brain injuries so I will check myself out later.”

You can imagine my annoyance when I was stopped by a security officer. He said, “Ma’am, are you ok?” Frustrated, I said, “Why is everyone so concerned, I just fell!” The next few words have always stuck in my head. He replied, “You may want to get checked out, I can call for help. You have been wandering the store for two hours.” I rolled my eyes but I caught a glimpse of myself in a mirror. I was in shock! I was bleeding down my head, onto my face. I saw cuts and bruising to my forehead and left cheek. My knee was bleeding through my jeans. I was a mess! I ran out of the store, leaving my empty cart.

I went home and cleaned myself up. I figured since I was a medical professional, I could treat myself. I knew I needed to rest. I took medication for my headache. I took the next couple days off and slept. I returned to work full-time and cared for my infant son as usual.

Easy peasy, right? Wrong! I struggled tremendously, especially with my memory. I could not remember anything:  What a patient asked me two minutes ago; what my supervisor just told me to do; what I read in a chart or typed on the computer, not to mention at home with my son and family. I had headaches from trying to think too hard. I was so tired all the time. I was emotional and frustrated because I could not do it all anymore!

Finally, I gave in. I confided to my supervisor and doctor because I wasn’t getting better. They echoed what I already knew:  RELAX. REST. WRITE THINGS DOWN, etc. Once I cut back my hours, gradually went back to work and did not stress about things at work or my life I immediately saw improvements. It took me longer because I did not want to slow down but I am fully recovered.

Here is the bottom line: If you have been seen and told you have a concussion, please do the brain rest and gradually go back to the activities, whether it is work, school or sports or all of the above. Trust me, I’ve been there.  I wanted to go back to my regular activities immediately but it simply is not the way to go. You will NOT be giving yourself a fair shot if your brain does not have the time to heal completely.

Think of your brain like a sprained ankle for a second. You would not want to hurry and start walking on it right away. I think we forget how important it is because we cannot see the brain injury. Recovery time can vary and depends on other things such as your past medical history, symptoms, etc. But the sooner you seek help and follow the guidance of your provider, the sooner you will improve!

Know the signs and symptoms of concussion. If you or someone you know has had a head injury and is not getting better, please contact HeadFirst Concussion Care at 855-SIT IT OUT (748-4868) to speak with someone and/or set up an appointment for an evaluation. Visit myHeadFirst.com for more information on concussion.

Thank you for allowing me to share my story, and I would love to hear yours.

The AB and ZZZZZs of Sleep for Athletes: Get Your Rest Before Taking Your Baseline Test!

by Sherray Holland, PA-C
HeadFirst Concussion Care Provider

It is recommended to get a good night’s sleep on a regular basis, but how much is considered a “good” amount? How long do you sleep?  I am mainly asking high school and college athletes here. And I know sometimes it is easier said than done when you factor in homework, sports, other extracurricular activities….maybe even a job!

Picture this: You are eager to start your season.  Then your coach or athletic trainer tells you to take a baseline test. You may have heard about it from other students or not at all. Most schools and many organizations, including HeadFirst Concussion Care, are using the ImPACT® baseline test to measure the way an athlete’s brain functions, including cognitive thinking, memory and reaction time. The computerized test takes about 25 minutes to complete (as cited in Lovell, 2010) and is intended to give your coach, trainer, and provider a baseline measure of your normal brain function. In the unfortunate event of a concussion, you will take the ImPACT test over time (usually every office visit) to help your healthcare provider, coach, athletic trainer, and teachers make proper decisions for school and returning to play as you recover.

Getty Images

Getty Images

Okay, back to the subject at hand. Now it is the night before the baseline test. How long should you sleep? A recent study published in the American Journal of Sports Medicine reported that athletes who slept fewer than seven hours before the baseline performed worse on three of four ImPACT scores and reported more symptoms related to their brain injury (as cited in McClure, et al., 2014).

Here’s the bottom line: it is important to get enough sleep on a regular basis, aiming for more than seven hours. If you do not get enough sleep before your ImPACT test, it may not represent your academic ability at its best, especially if you have to go through the entire day and take it after school. Many times in the HeadFirst clinic, I have seen the results of a patient’s test after a suspected concussion better than his or her baseline!  Remember, this is a serious matter so make sure to put your best effort forward. I hope you found this helpful and would like to hear your thoughts.

Tips for Getting a Good Night’s Sleep

Having trouble falling or staying asleep? Here are some helpful advice for healthy sleep habits:

  • Keep a regular bedtime routine every night
  • Do not exercise or eat a heavy meal three hours prior to going to bed
  • Do not drink or eat foods with caffeine three hours prior to going to bed
  • Avoid naps. If you are tired and must take a nap, make sure it is a short nap and not close to your bedtime.
  • Rest and unwind before heading to bed. Avoid stimulating television shows or video games.
  • Make sure your room is quiet, comfortable, and without bright lights.
  • If you do not go to sleep after 30 minutes,  try reading , listening to music, or other quiet activities to encourage relaxation.

Ms. Holland typically works at HeadFirst Waugh Chapel clinic. She received her Bachelor of Science in Physician Assistant Studies/Certificate in Primary Care at Howard University. Ms. Holland is a Board-certified Physician Assistant and is a member of the American Academy of Physician Assistants and an American Academy of Physician Assistants Veteran’s Caucus Member.