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Behind Sidney Crosby's Comeback

posted by SK Brain Injury    |   November 4, 2011 10:42

 

Ted Carrick is listening to Sidney Crosby’s heart. The NHL superstar is strapped into a computerized rotating chair that has just spun him like a merry-go-round.

It is, as Carrick likes to tell people who visit his lab at Life University near Atlanta, one of only three “whole-body gyroscopes” in the world, and it’s integral to his work as the founding father of “chiropractic neurology.” He uses it to stimulate certain injured and diseased brains.

Crosby, who plays for the Pittsburgh Penguins and has been famously sidelined with a concussion since January, is Carrick’s newest patient, and this day in August is the first time they’ve met. Carrick leans in close, his balding, tanned head looming inches from Crosby’s face, and rests the stethoscope on his chest. “Let’s make sure you’re not dead.”

Carrick then signals to restart the gyroscope—with one difference. This time Crosby will be turned upside-down while he is also spun around. He hasn’t experienced this dual action yet. The door clangs shut. Above it, a stack of red, yellow and green lights shines while 10 high-pitched beeps signal the gyroscope is about to start. Ding! Ding! Ding! Ding! Ding! Ding! Ding! Ding! Ding! Ding!

A low hum floods the room as the gyroscope begins its 20-second “montage” of rotations. With each flip, Crosby grips the black handles flanking his thighs, his face reddens and his jaw clenches. Before long, the gyroscope, called GyroStim, winds down. “Perfect,” Carrick concludes.
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Since January, when the hockey world was dealt a blow unlike any other it had ever experienced, fans have made Google searches of “Crosby” and “concussion” move in tandem as they try to make sense of what has happened to their favourite player. The best player since Wayne Gretzky was suddenly knocked out of the game indefinitely because of an invisible injury: no blood on the ice, no cracks on any X-rays and no way to know how bad was the damage done.

Scientists, doctors and equipment makers have used Crosby as a talking point to raise awareness and as a case study in the complexity of concussion. The NHL is embroiled in a polarizing debate over fighting in hockey—how to keep it in, but make it safe? And nervous hockey parents everywhere are reconsidering whether their children should keep playing. How Crosby recovers will help them decide.

Maclean’s obtained exclusive access to the lab where Crosby saw Carrick, and learned about his unique methods of treating brain injuries. While the details of Crosby’s personal health data remain private, over the course of two days, the magazine was granted access to a range of information about the treatments used on patients, including him. During that time in late September and early October, anastonishing assortment of patients came through the clinic. A wealthy businessman and his son. A prominent NFL player. An aging biology teacher who’d had a stroke. A boy with brain damage sustained after a van ran him over. A middle-aged physician who’d lost his ability to talk or walk after a tick bite. In every case, Carrick ran through a version of the same evaluation, exercises and equipment he used on Crosby. “We saw something like nine MDs, neurologists, cardiologists,” says one patient’s relative. “I’ve seen nothing that compares to this.”

The wait list to see Carrick can be as long as three years, though in some cases, such as with Crosby, patients can be expedited. By the time they met in Georgia, the reality of what Crosby could lose if he didn’t get better soon was abundantly and uncomfortably clear: his career, his endorsements, the adoration of an entire nation.

However strange that first day of treatment in the gyroscope was for Crosby, it proved encouraging enough that he continued seeingCarrick for the whole next week. They’d meet as early as seven in the morning, and they’d go as late as six at night, says Carrick, running through a circuit of high-tech equipment and low-tech exercises in the lab and at the local hockey rink. By the time Crosby travelled back to Pittsburgh, Carrick says, “he was better than, you know, super-normal.” The Penguins’ medical team, who have been overseeing Crosby’s recovery, also saw an improvement: they ran computerized tests called IMPACT to compare his current neurocognitive abilities with what they were before the concussion. The results: not quite “super-normal,” but “the best we’ve seen” since Crosby got hurt, as MichaelCollins, a neuropsychologist who has been treating him for months said at the Sept. 7 press conference to update Crosby’s health.

“Carrick had a very prominent role in Sidney’s current recovery status,” Brisson, Crosby’s agent, told Maclean’s. “He progressed extremely well under Carrick.” Just 10 days after the press conference, Crosby joined his teammates on the ice for the first day of training camp. Three-and-a-half weeks after that, Crosby was cleared for contact—the final step before returning to play. Now, after nearly a year of nagging symptoms that have included fogginess, light-headedness and nausea so paralyzing Crosby couldn’t drive or watch TV, and after a slew of setbacks each time he pushed too hard while exercising or skating, the greatest hockey player of this generation is verging on a comeback—perhaps because of a relatively unknown therapy he received at a relatively unknown university from a relatively unknown man who isn’t even a medical doctor.

Come what may, Carrick has set out to do what no amount of time or rest or other expert has managed to accomplish so far: rebuild Sid’s brain.

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The Truth Behind Brain Injury

posted by SK Brain Injury    |   November 2, 2011 09:55

Brain injuries happen for many reason and affect everyone who has suffered one in different ways.

For Golden residents Garrett Appleton and Jennifer Maddock, injuries to their brains came at different points in their lives and have led to different challenges.

Appleton  is now a 23-year-old who works at Sobeys. When he was only four months old a type of bacterial meningitis changed what the idea of normal would be.

“When I grew up I felt (the way I was) was normal. What ‘normal people’ say is supposed to be normal, is not what normal is to me,” Appleton said.

One of the biggest issues for Appleton growing up was suffering very serious seizures.

“The difference for me was dropping down and having a seizure. That is the big difference. I do not have many seizures but when I do they are big,” Appleton said.

Maddock suffered her injury in a different way. She worked  at CIBC and is now on disability due to the effects of the meningitis which doctors have told her was a one in a million chance of contracting.

“To look at me I look fine. I look normal, but it is not the outside that is the problem. It is my brain which is different now,” Maddock said.

She developed a viral meningitis which caused encephalitis. This in turn caused her to have seizures. She explained that she has had some problems with her memory and that explaining things to people can cause her issues.

They both deal with questions in their everyday life because people do not completely understand the severity of the injury. The fact their injuries are hidden in their brains and they function fairly well in society causes some confusion for people who think they look fine on the outside.

“We are normal people but my brain does not work like it used to,” Maddock said.

Both Maddock and Appleton are members of the East Kootenay Brain Injury Association.

“For me it has been a place to go to help me. There are people out there in similar situations. They have been awesome in helping me with things such as paper work and things I would normally be able to do on my own. It frustrates me that I can’t anymore, but they help me deal with that. It is nice to know you have that support in your community and there are people who can share their situations,” Maddock said.

The East Kootenay Brain Injury Association is working hard to increase community education and awareness of Acquired Brain Injury(ABI). Throughout the year at various venues:  schools, service clubs, faith organizations, trade fairs, community organizations, public meetings, they speak and have displays.  They have been working with different groups in the region to provide programs that are effective in educating and making people aware of ABI.

The group promotes the use of helmets in sports all year long, not just summer.  Whether it be on a bicycle or a snow sport, the helmet is effective in the prevention of brain injury.

On the group’s website it states “It is important to recognize that brain injury also occurs through non-traumatic causes such as:  stroke, anoxia, substance abuse and heart attacks.  The effects are equally devastating for the individual and families.  If  you  have acquired a brain injury from a sporting activity, fall or any other cause,  know there is help and you do not have to do this alone.”

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Former Soccer Player, Taylor Twellman Retires due to Concussions

posted by SK Brain Injury    |   November 1, 2011 11:43

Taylor Twellman spoke at a conference focusing on brain trauma and concussions on Oct. 28. The former New England Revolution forward retired from MLS in 2010 because of concussions. At the conference, Twellman pointed out that education about this injury was still lacking and needed to improve. Although he left the impression that the Revolution ignored his problem, he explained this further on his official Twitter account.

Soccer
morguefile/karpati

Concussion Problems

Taylor Twellman suffered from multiple concussions during his MLS career. At the press conference for his retirement in 2010, he stated, "I hate the fact that my career has ended on a brain injury." However, he added that he viewed this as an opportunity to educate others about concussions and raise awareness.

Twellman's retirement has not stopped his complete participation in the sport. He is involved with a player program with youth camps, prep camps and recruiting programs. He has also created THINK TAYLOR to help athletes with brain injuries.

Response on Twitter

Twellman's comments at the Oct. 28 conference have drawn a strong response. He has been accused by fans of blaming the New England Revolution for ignoring his injury. Taylor Twellman has responded on his official Twitter account by stating that the team did not ignore his concussion. He also pointed out, "I am not in the business of finger pointing and never will be regarding my #concussion." He emphasized that the point of the Oct. 28 conference was education, and this was his only goal.

Concussions in the MLS

Players continue to struggle with concussions in the MLS. Jimmy Conrad was forced to retire from Chivas USA in 2011 because of a concussion. The Sounders FC goalie Terry Boss was put on the injury list as "disabled" in Oct. 2011 because of a large number of concussions. Chicago Fire captain Logan Pause suffered from a concussion in June 2011 and missed several games. Former Chicago Fire forward Calen Carr suffered from concussions for a long period of time with the team.

I think education about brain injuries is a necessity for both athletes and trainers. Unfortunately, symptoms are sometimes ignored, and athletes continue competing with the injuries. Taylor Twellman has decided to be an advocate for MLS players who suffer from brain trauma.

 

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Sleep Disorders in Veterans with Head Trauma and PTSD

posted by SK Brain Injury    |   October 31, 2011 09:51

New research shows high rates of sleep disorders among veterans of America's wars in Iraq and Afghanistan who have post-traumatic stress disorder (PTSD) or head injuries.

 

The study conducted at Walter Reed Army Medical Center in Washington, DC, found that among some 300 soldiers with PTSD, head injuries or both, more than half had sleep apnea -- a serious interruption of breathing during sleep -- and nearly half had insomnia.

"Sleep complaints were universal," wrote Dr. Jacob Collen and his colleagues in their research summary. Collen's team presented their findings this week at the annual meeting of the American College of Chest Physicians in Honolulu.

The researchers studied 135 soldiers with PTSD, 116 with traumatic brain injury and 66 with both conditions.

Sleep testing performed on most of the patients found obstructive sleep apnea in 56 percent of them and insomnia in 49 percent.

More than two-thirds (71 percent) of the soldiers had restless nights of fragmented sleep. Nearly nine in ten (87 percent) were "hypersomniacs," sleepy during waking hours, Collen said.

"We found that sleep disorders appear to break down by presence or absence of injury and by the type of injury," he noted.

In soldiers with traumatic brain injury, he said, "blast injuries appeared to be associated with insomnia and anxiety," and blunt head trauma was more closely linked to sleep apnea.

Among the traumatic brain injury victims, 63 percent with blast injuries had insomnia, compared to 40 percent of those with blunt trauma. But only 26 percent of those with blast injuries had sleep apnea, compared to 54 percent of those with blunt trauma.

Overall, sleep apnea was significantly more common (78 percent) in patients without traumatic brain injuries, the researchers found.

And in the PTSD patients, sleep apnea was more common in those who hadn't suffered any physical injuries. Among the soldiers with PTSD and sleep apnea, only about a third had battle injuries (37 percent), whereas more than two-thirds of veterans with PTSD but without sleep apnea had been injured in battle (71 percent).

The PTSD data "raise the question of whether having undiagnosed obstructive sleep apnea before you deploy could act as a risk factor for developing PTSD," Collen said. "We don't have data to support that, it was just an interesting question."

Dr. Brian Carlin, a pulmonologist and sleep medicine specialist at Allegheny General Hospital in Pittsburgh, who was not involved in the study, called the rates of sleep problems among the soldiers "inordinately high."

Insomnia among head-injury victims was not a surprise, Carlin said, but sleep apnea is. "Almost half of the soldiers who had blunt trauma had sleep apnea. In a presumably healthy and relatively fit population (similar to the soldiers), the rate of sleep apnea is probably four percent to five percent," Carlin said.

"You just wonder now what is the relationship between trauma to the head and sleep disorders."

Collen told Reuters Health that military and civilian doctors treating recent veterans should keep an eye out for sleep disorders, which can have long-term consequences to health.

"These are durable diseases. Untreated sleep apnea, untreated PTSD -- the (effects) of those go on for some time," Collen said. "So... it's important for non-military physicians who really aren't as familiar with this to pursue a comprehensive sleep evaluation."

 

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Study: Concussion more Common than we Think

posted by SK Brain Injury    |   October 28, 2011 14:16

CBC's The National did an in-depth analysis of the occurrence of concussion as the Silent Epidemic. Please see full story here.

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Brainstreams.ca October Newsletter

posted by SK Brain Injury    |   October 26, 2011 10:41

We would like to link you Brainstreams.ca newest newsletter. You can find it here.

Brainstreams.ca is an online education and social networking site for the brain injury community in B.C. and beyond - a project of the Pacific Coast Brain Injury Conference Society - supported through the BC Neurotrauma Fund via Rick Hansen Foundation.

 

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Brain Lab - CBC's The National

posted by SK Brain Injury    |   October 26, 2011 10:26

The National onf CBC has a segment called Brain Lab. One episode focused on Hits and Head Injuries. We would love you to take a look at it.

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Non-Pharmacological Treatment for Brain Injury

posted by SK Brain Injury    |   October 25, 2011 16:28

With a growing number of cases of traumatic brain injury among a host of other disorders such as neuropathic pain and cervical headaches, Integrative Medicine has found the only non pharmacological cure in the form of Scenar therapy.

In referring to the promise that the cure holds for troops coming back home from Iraq, Dr. Ron Stram says, “The good news is that Troops are coming home and Scenar Therapy can help. But are we ready to care for the growing number of those troops diagnosed with mild Traumatic Brain Injury (TBI)? More than ever, soldiers are facing TBI diagnosis and its associated disability of post traumatic stress disorder (PTSD). Our soldiers need alternate approaches for treatment to reduce dependency on opiods and their adverse side effects – and to allow optimal opportunity for reintegration into society.”

But what is Scenar? It’s a hand-held and portable device that sends a small current across one’s skin in order to measure the resistance that the skin has to the current that has been passed. As the intensity and frequency of the current is changed, this prevents nerves from getting accustomed to only one level of stimulation, and is effective from a therapeutic point-of-view.

With the success of this type of therapy and since patients responded positively to this kind of treatment when offered frequently, patients were also given training sessions on home self-treatment so that they could use these devices at home.

Scenar therapy is easy to learn for self-treatment, especially if it’s for focused areas of pain, and according to Dr. Ron Stram, takes only an half an hour session to educate the patient, making it a better choice of therapy as opposed to using opiods.

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Young Athletes at a Heightened Risk of Brain Injury

posted by SK Brain Injury    |   October 25, 2011 16:23

The number of traumatic brain injuries (TBIs) among young athletes has increased 60% over the last 10 years, federal health regulators warn.   

The U.S. Centers for Disease Control and Prevention (CDC) released a report earlier this month, indicating that youths 19 and under face increasing risk of TBIs with increased severity and prolonged recovery when compared to adults. The CDC estimates that minors account for 65% of all sports-related emergency department visits due to concussions and other TBIs.

In 2001, 153,375 young athletes were admitted to emergency rooms across the country for concussions and other sports-related head injuries. But by 2009, that number had climbed to 248,418, according to data from the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP). Fatal head injuries were not included in the report. Overall, about 298 youths per 100,000 suffered a head injury in 2009, up from 190 per 100,000 in 2001.

Bicycling and playground activities were the most common cause of TBIs. Other sports which were associated with a large portion of youth TBIs included football, basketball and soccer. Males ages 10 to 19 had the highest rate of injuries.

The CDC recommended that increasing awareness of TBI risks from sports and recreation, as well as employing proper techniques, protective equipment and quickly responding to injuries could reduce the number of TBIs among children as well as their severity and long-term health effects.

Traumatic brain injuries are one of the leading causes of death and permanent disability world wide, with 1.4 to 1.7 million people suffering a the head injuries each year. Such brain damage often result in a victim requiring extensive medical treatment and permanent around-the-clock care. Why the number of injuries has increased among minors was not known.

Athletes are not the only people with a high risk of TBIs.  Motorcycle and automobile accidents account for about 20% of all traumatic brain injuries.

 

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Former NHL Player and Neurosugeon Talk About Concussion

posted by SK Brain Injury    |   October 21, 2011 16:12

Head injuries in sports need to stop.

That was something Charles Tator, a leading expert on concussions, and former NHL tough guy George Laraque could both agree on.

The two were at the John George Althouse Auditorium, on Western Road, speaking about the dangers of head injuries during Thursday’s (Oct. 20) conference Violence in Sports: Promotion in the Media.

Tator, a Toronto-based neurosurgeon, opened the discussion by giving people the realities of concussions.

“What treatment do we have for concussions?” Tator asked the audience. “We have no treatment for concussions, zero. We have no pill, we have no medication, we have no remedy and we have no exercise.”

Prevention, Tator added, is the only cure for concussions.

Sports cause 10 to 15 per cent of all brain and spinal injuries in Canada.

“The trauma does not have to be to the head,” Tator said. “If the blow is to the body for example and the head has a whiplash type effect, that could jiggle the brain sufficiently to cause a concussion.”

The easiest way, he said, a sport like hockey can bring down the number of concussions is by changing equipment like large solid elbow pads.

Laraque wore those bulky elbow gaurds in a lot of games during his 13-year career playing professional hockey. In over 130 fights while in the NHL, Laraque wasn’t wearing his gloves a lot of the time.

Laraque, now the Deputy Leader of the Green Party, said fighting wasn’t the issue when it comes to concussions in hockey.

“The real problem is the hits to the head,” he said. “When you fight on the ice you’re on skates and when you’re on skates you’re out of balance. So when you hit somebody in a fight, it’s not as big of a blow as you would think. When you skate 40 km/h and then you hit somebody with a flying elbow, this often causes concussions.”

In all of Laraque’s fights he didn’t receive a single serious head injury. He also doesn’t remember a single boo from the crowd after any of his fights.

He said he never worried about getting hurt while fighting and was always more concerned with the anxiety leading up to a fight.

“The fact that you’re fighting in front of an audience with a lot of people watching you and if you lose too many fights in a row, you can actually lose your job,” Laraque said. “You can be at home eating a happy dinner with your family and then you’re just thinking about the next fight you’re going to have and you can’t focus.”

Ron Wicks, another speaker at the conference, echoed Laraque’s cries for getting rid of hits from behind.

Wicks, a retired NHL referee of 26-years, started officiating before goalie masks became popular.

He had one simple rule to give to hockey players and referee’s to help bring down the number concussions in the sport- play smarter and get control of the game.

“Players need to respect each other more,” he said. “The whole integrity of the game hockey is in the referee’s hands.”

The University of Western (UWO) auditorium was filled with about 400 people, among them 250 delegates from the Thames Valley School Board (TVDSB).

“(Hockey players) are entertaining us,” said Peter Jaffe, a professor at UWO and TVDSB trustee. “But they’re also high school students, they’re also my students, they’re teenagers risking their lives in various ways looking for success.”

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