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My Concussion Story…

Concussions are serious. This I know from personal experience. My concussions changed my view of life. Thumps on the head are like that.

My first concussion happened in a cyclocross race. The track had 2 grassy mounds, both about 3-feet high and in close succession. You approached them at speed. Physics dictate that going over mounds on a bike pushes your body forward. (Think front wheelie.) I had done them numerous times in practice. I thought to myself, John, you had better keep your weight back going over these things during the race.

The thing about thinking during a bike race is that it is not so easy. So I forgot about keeping my weight back—or at least that is what I was told by my wife Staci, who was watching as I flew through the air and landed on my head at her feet.

I say it that way because I cannot recall anything about that race—not the start, not the accident and not how I asked the same stupid questions over and over. My first memory of that day was being in the ambulance. I remember thinking…why am I in an ambulance? Time was gone.

The CT scan was negative. I was discharged from the ER. I felt fine the next day. I was told to rest. I rode my bike the next day. I went to work the next day. I did not have headaches, balance problems or any slowing of thinking. I was also told that second concussions were worse.

Concussions were not so bad, I thought. I used to be really foolish.

My second concussion happened about a year later. It was a Tuesday night practice race. I had good legs. (In retrospect, I think having good legs is an independent risk factor for bike wrecks.)

It was time. The group had just reformed after a furious chase. I was in the drops. Coiled. Ready to go. A gap opened.

(What follows is second hand—because I cannot remember!) Just one of the 53 teeth in my front chain ring was bent in. When I stood to sprint, the chain jumped on the bent tooth. I flew over the bars and landed on my head.

What I remember next is looking up from the pavement at Staci. Uh oh, I thought, we were at least a twenty-minute car ride from our house. That meant I was gone for twenty minutes. Lost time again. My friends told me I was asking the stupid questions again, over and over.

They were right about second concussions.

This one was worse. My head hurt. I had nausea. The headaches lasted for weeks. I could think and I could work. But I could not easily lay flat or move my head through space. When I got up from a chair, bent over, or turned my head to look one way, the world spun. It was as if the world was still moving when I was still. I got used to getting up from bed slowly and putting two hands on the bed before I stood.

I had never had vertigo before. Vertigo stinks. The weird part was that I could ride. I was like the Parkinson’s guy who could not walk but could ride. Sit-ups or push-ups were utterly impossible.

One day you are riding off the front of the group at 600 watts, alive and youthful. The next day you are elderly, holding the bed with two hands while sitting.

It took a year before the dizziness stopped. A year.

The thing I most remember now about concussions is the notion of lost time. It makes you think about being dead. As in, if you die from a sudden event, like landing on your head, you don’t even know you are gone, or ever were. That is weird.

Some experts might cause such thoughts existential. I don’t know about that. Mainly it makes you think about not hitting your head again.

It also makes you think about all those young kids banging heads with each other on the football field while we watch in glee.

Parallax is when one the same image looks differently depending on the position of the lens.

My lens is that I don’t like seeing humans hitting their heads.

JMM

P.S. I am fine now.

6 replies on “My Concussion Story…”

I’d worry about the long term impact (no pun intended) on your brain as you age. Is there research about this? PS I keep watching for your thoughts on A/V noda ablation + pacemaker.

I’m sorry to hear you’ve twice suffered from brain injury and am so glad you recovered.

As a rehab doc, I view head trauma and sports through a similar lens. Can’t stand football and ice hockey for this reason. I grudgingly watch UFC MMA fights with my husband to be social, but I am fundamentally opposed to any sport in which the participants are likely to sustain head or other physical injury. I’m not sure why this view is so controversial, but I can only imagine it’s seen as a buzz kill for what most folks view as fun.

My husband, also a physician and former martial arts instructor, appreciates the technical aspects of the fight and thinks the fighters are sufficiently informed of the risks and sequelae of potential injuries. I think these are young guys who don’t fully appreciate the impact injuries will likely have upon their lives down the road.

More broadly, I suspect our celebration of top athletes injuring each other bodes poorly for our compassionate treatment of each other.

As bad as the effects of your second concussion were,they could have been much, much worse. The second hit or second impact syndrome is rare but can be fatal.Its pathophysiology is still unclear but the increased intracranial pressure ( possibly due to a loss of cerebral blood flow autoregulation) that occurs sometimes with a second concussion within a short period of time can be fatal.The dramatic nature of that event in a high school football player in Texas led to legislation mandating training about head injury and rules about return to play post concussion.Reading about and blogging a bit about concussion in high school and college kids has completely changed the way I watch a football game.Now I look for the head impacts and wince a lot.

John,

Thanks for your writing, I learn a lot.

Did you make a decision to modify your lifestyle following the second head injury?

g

Gordo, Yes. I did. My wife can attest that I am a painfully slow learner. I cannot stop riding a bike. Life is too short for that. But I have made a conscious decision to master the obvious, and to make decisions that lower my risk of hitting my head that hard a third time.

So glad you felt up to writing about concussive impacts Dr. J. They are critically important..and strangely neglected part of patient care plans. The incessant perseveration “what is a hematoma again?”, the chronic nausea, food looking like plastic toys for 2 years, certain line patterns on tv and clothing sending my brain into an optical paroxyzm of searing pain and weeping eyes that lasted for hours. I’ve become really concerned that heart patients are still not checked for concussions as so many of us just drop where we are with no time for defensive postures. I found myself crumpled against a plaster wall at the bottom of a long staircase, then on my bathroom tile floor after discharge from lengthy ICU stay. 3 impacts in 15 days. Blank stares from all doctors at my descriptions of symptoms. What I learned: the brain is highly resistant to anything but REST…and it is on its own healing timeline. We aren’t allowed in. 20 years later the gag reflex remains present.

Nor are ER heart attack patients who have blacked out scanned for fractures. I find this astonishing.

GLad you have managed. Few of us have the luxury of lenghty downtimes real concussive healing demands.

Jaynie

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