Blake Stillings, Lucas Walker, Cody Miner and Alyssa Dunbar have more in common than most 16-year-old Grade 11 students. All four have had their academic, athletic, personal and physical lives devastated by post-concussion syndrome.
For most adults, concussions can be very traumatic. But for teenagers, because their brains are still developing, the level of trauma can be much more complex and severe.
“The adolescent brain is much more susceptible than the adult brain,” said Red Deer College psychology instructor and concussion researcher Dr. Elena Antoniadis at a recent Red Deer College workshop on concussions. “Sometimes you may have a swelling or contusion of the brain tissue, and sometimes just the mere acceleration is sufficient enough to damage or compromise the connections between the brain cells. This is especially vulnerable in youth where the axon has myelin that protects the axon and that is still developing.”
Axons are the communication centre for neurons, and when blows to the head damage the axons and the myelin sheath that protects them, this and brain contusions can lead to a large array of symptoms. These post-concussion symptoms can include headaches, migraines, pressure in the head, nausea, balance problems, dizziness, fatigue, insomnia, hypersomnia, blurry or double vision, sensitivity to light and noise, numbness or tingling, difficulty thinking and concentrating, brain fog, anger, depression, irritability, panic attacks and anxiety.
The medical community no longer refers to these impacts as concussions, preferring to call them mild traumatic brain injuries or MTBI. Each MTBI is unique, and even though there are some commonalities, there are just as many differences in each case.
Dunbar received her concussion as result of a car accident. She and her mother and brother were eastbound on Hwy 42 in late October when a truck pulling a trailer ran a stop sign and collided with their vehicle. Along with the MTBI, Dunbar suffered a lacerated liver, internal bruising and nerve damage to her foot. One of the passengers in the truck died from the collision.
Post-concussion symptoms do not always manifest immediately, and can show up days, weeks or months after the accident. Dunbar did not notice any symptoms until after she left the hospital.
“When I was in the hospital for five days/ I didn’t notice any symptoms. But when I went home and rested for two weeks, the headaches came on … whenever, I would put my head down to lay down, I would get instant headaches. If I moved it the wrong way, it would shoot pain up my neck and into my head.”
Miner was playing hockey in the fall of 2013,when he was on the receiving end of an awkward hit.
“I chipped the puck into the corner and the puck kind of got stuck behind me. I was reaching back and I got hit,” said the Lindsay Thurber Comprehensive High School student. “My head hit with so much force that my head bounced up right into the kid who hit me as he was falling, which squished me back down into the ice and then slid my head into the boards.”
Miner, got up and skated back to the bench, then collapsed unconscious.
The symptoms started immediately.
“Right off the start, even when I got out of the hospital, I felt different. A lot of my simple motor skills like walking in a straight line were gone. I was really unco-ordinated and unbalanced. First couple of weeks I would go to grab the pencil off of my desk and completely miss it.”
After taking three months off, Miner returned to sports. That was when he had his second MTBI.
“I had made the Grade 9 basketball team at Thurber. We thought I was OK to play basketball and in my first shift I took an elbow to the head as I was going to rebound the ball. I felt fine after it and the next game my coach put me out there and I went out of it again and kind of went unconscious like I did with the first concussion.”
After that, the symptoms escalated.
“I had worse headaches than I did in my first (concussion). I felt more light-headed, I felt dizzy. There was pressure in my head that felt like there was a balloon in my head that was expanding. Your entire body feels different. Your head may be what was getting hit, but sometimes my legs would just go numb for no reason. I couldn’t really comprehend why this was happening to me.”
Lucas Walker’s first concussion came as result of lineman drill while playing for the LTCHS Grade 9 football team in September 2012. There was head-to-head contact with another teammate, but he only experienced symptoms for two days after that.
His second concussion came as a result of a practical joke, but the repercussions were significantly more severe.
Walker was at hockey practice waiting to take shots at the goalie when one of his teammates skated by and swooped his feet out, causing Walker to fall straight backwards, whiplashing his head off of the ice.
The young forward blacked out. He came to with ringing in his ears and his teammates gathered around him. He sat out for 10 minutes and then returned for the last 30 minutes of practice and that was when he sensed that something was not right.
“I had a slight headache and I really wasn’t myself, missing shots, it just wasn’t me,” explained Walker. “I finished the practice grabbed my bag and hopped in my mom’s truck, and it just hit me, I felt I was going to get nauseous and opened up the window. I didn’t really feel good at all. My head was pounding and hurting.”
Walker went to the hospital the next day. After a cursory evaluation, he was told that he might have a concussion, received two handouts on concussions and was told he could go home.
Things went from bad to worse.
“I went home and slept for the next three days and barely woke up. Every time I woke up, I felt nauseous; balance, speech wasn’t right. I just wanted to lay in a dark room. It was severe in the first two weeks and I just didn’t know what was going on.”
The Grade 9 student ended up losing the rest of his school year and was only able to return to school the next fall.
He received doctor’s clearance to return to hockey and that was when he received his third MTBI in a little over a year.
“I was playing hockey again and I was breaking out of the zone when I kind of got a suicide pass. It bounced off my skates, so I looked down to grab it with my stick, when out of nowhere from behind the d-man, came another player. It caught me off guard and he hit me on top of my head. I felt kind of a crunch in my back and then fell straight backwards on my right side. On the way down, I hit my head and my shoulder. I was out for 15 to 20 seconds … I wasn’t really functioning. My eyes were closed and it was just all black. I was yelling. I don’t remember what I was yelling.”
The hit fractured four vertebrae in Walker’s back. He couldn’t feel anything in his hands and his feet. He left the ice strapped to a spinal board and was transported to Red Deer Regional Hospital Centre, where he was evaluated and then sent to Calgary Foothills Hospital Spinal Unit.
Walker spent two weeks in the Foothills Hospital. When he went home, he was unable to move for a month and was in a back brace for eight weeks.
Then he began to experience a full onslaught of post-concussion symptoms and lost his entire Grade 10 school year.
Stillings, like Walker, had three concussions in a relatively short period.
His first was in the fall of 2011 playing bantam football. He remembers getting hit and he just played through it.
It wasn’t until two days later that he started to notice symptoms and was diagnosed with a mild concussion. The doctor told him to stay out of football for a week or two but the symptoms continued. His parents withdrew him from all sports.
The next fall, he returned to football and in October 2012 he experienced his second MTBI.
“I remember it vividly,” explained Stillings. “It was total head-to-head contact. I tackled him and it wasn’t until I got up that I felt weird. I was totally off balance, I was woozy and I took a knee.”
Again, a doctor said 14 days. But the symptoms did not go away and his parents again pulled him from all athletic activities.
By January, Stillings was feeling better and his family decided to go on a family ski day. Snowboarding, he fell once and got a little shook up. Then he hit a jump and fell. He did not hit his head again but experienced whiplash on both falls.
On the ride home, he knew something was wrong. From there, the intensity of his post-concussion symptoms went to another level.
“I couldn’t handle light, I couldn’t handle any noise I was so anxious, ridiculous anxiety. The pain from everything, light, it was overwhelming. There was too much going on … I’m like, oh my gosh I can’t take it. It was like the whole world came crashing down, it was like all of my five senses were wrecked.”
He began to have trouble walking. Every step he took hurt his feet and jarred his brain. His balance was completely off. He had to walk with a cane, wear dark sunglasses and earplugs in order to survive.
Like Walker he lost his entire Grade 9 year.
Once you have one concussion it becomes significantly easier to experience a second or even a third MTBI. The second blow to the head, which can occur immediately after the first concussion or weeks or even months after can cause much greater trauma and symptoms than a stand-alone concussion.
“In youth sports, returning a player to the game too early puts them at higher risk for sustaining a second concussion,” explained Antoniadis. “Second impact syndrome, is when there is an initial blow to the head or post-concussion injury and the symptoms (from the previous head injury) have not yet resolved, and the child receives a second blow to the head.”
Miner had three impacts on his initial hit, and then another concussive event three months later.
Walker, had an initial concussion, three months later a second MTBI, and then a year later had a third concussion as a result of a hit to the head and his head subsequently hitting the ice.
Stillings had three MTBIs in a 15-month span.
All four students, now in Grade 11, had their lives turned upside down by concussions, and experienced personality and emotional symptoms. Their athletic lives came to a grinding halt.
Dunbar was a multi-sport athlete — downhill skiing, basketball, volleyball, badminton, track and field, rugby, handball and shooting.
She has returned to shooting but has found her slow recovery hard to deal with. Before the accident, here shooting scores were 369 out of 400. Since her accident, she has slowly regained her shooting abilities, but her competitive score at the Canada Winter Games Trial was 342, and she was eliminated from the Alberta Team by one point.
As she regains her health, she hopes to slowly reintegrate her other athletic endeavours.
Miner has returned to sports, having played volleyball at Lindsay Thurber. He is not sure if he will return to basketball this year but knows that hockey is no longer an option.
Walker and Stillings will most likely never return to contact sports.
All four have found the healing process for a concussion runs contrary to any other injury they have experienced.
“I’ve dislocated two ribs, broken both my wrists, broke two toes, I have partly torn my ACL in my right knee. I have dislocated my knee cap in my left knee, I have partially torn my achilles tendon on my right ankle,” said Miner. “My concussions would definitely be the worst injuries I have had in my life.”
“It is a lot worse,” said Walker. “Other injuries you can kind of heal it and go to school still. You can kind of work past it and it heals quicker. With concussions, it doesn’t really go away soon at all, it kind of lingers. With the brain, it doesn’t think right and your personality changes a bit.”
All four have similar advice for any young athlete who has suffers a MTBI.
“Don’t rush back to something that could damage or cause more injury to your concussion,” said Walker. “I tried to go back and it really didn’t work. They should have time to just to heal.”
“Do not push your injury too far,” agreed Dunbar. “Because if you do, you pay for it the next day or even a week. You feel fine doing it but you are not 100 per cent back to normal so you will pay for it afterwards.”
Stillings feels that he was not honest with himself or his parents.
“You have to remember that the only way I knew how to burn off feeling antsy or unhealthy was to go exercise, walk around or do push-ups, which I did. The worst person for me was myself. I was trying to push through it. I was trying to pretend I was normal even though deep down inside I knew something wasn’t right. You need to acknowledge the injury. Eventually I couldn’t even get out of bed.”
All four students have had tremendous help along the way.
Research has also found that Sertraline, a drug normally used for depression or anxiety, can help alleviate some post-concussion symptoms.
All four have taken a positive approach to their recovery.
“It was a long journey,” explained Miner. “I feel like I am stronger for it. It was definitely not worthwhile that it happened, but it kind of showed me that I am a lot stronger than I thought.”
“It sounds crazy but I have changed as a person,” elaborated Stillings. “I am honestly kind of grateful for it. You realize what is important and what life is about.”
Doug Rowe is a local freelance writer and teacher who is recovering from his own concussive incidents.