brain trauma

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‘Only A Game’ Questions NFL Medical Advisor On Football Safety

(Kevin Domingue/Flickr Creative Commons)

(Kevin Domingue/Flickr Creative Commons)

I’ve said it before and I’ll say it again: A child of mine will play tackle football over my dead body. A young brain is too precious a thing to risk. And though the data are not all in, we know plenty about the potential brain damage of repeated head hits, including recent findings that linked youth football to cognitive impairment. Oh, and let’s not forget the 2013 study that found that a single season of contact-sports head blows could affect learning and memory.

So I was surprised to learn from an excellent commentary this morning by WBUR’s Bill Littlefield of Only a Game fame that a prominent Boston medical leader was touting football’s safety. From the Boston Globe here:

Dr. Elizabeth G. Nabel, the president of Brigham and Women’s Hospital and the National Football League’s new adviser, said Tuesday that football is safer than it has ever been, but she called on the NFL to commit more money to medical research and better educate the public about sports injuries.

Nabel, 63, in her first public comments as the NFL’s chief health and medical adviser, said that if her children were still young, she would allow them to play football. She noted that her son, now 29, played football in the eighth grade.

“I think football is getting safer all the time,” Nabel told reporters at the NFL’s offices in New York.

Really, Dr. Nabel? You’ll understand if I want to seek a second opinion — maybe from a former NFL player who can’t remember his own kids’ names.

Bill Littlefield’s commentary — As Concussion Crisis Mounts, NFL Turns To … Cardiology Specialist? — points out that Dr. Nabel’s impressive CV does not seem to include any expertise in brain trauma. He writes:

Experience as a hospital administrator would not seem to be the key qualification for a person charged with advising the heads of an industry where the most significant problem is a 30 percent rate of brain damage among the workforce.

He concludes: Continue reading

Is There A Lesson About Treadmills In Sandberg Spouse Death? Yes: Keep Exercising

(MilitaryHealth/Flickr)

(MilitaryHealth/Flickr)

In this 2013 file photo, Sheryl Sandberg, COO of Facebook, and her husband David Goldberg, CEO of SurveyMonkey, walk to a conference in Sun Valley, Idaho. (Rick Bowmer/AP)

In this 2013 file photo, Sheryl Sandberg, COO of Facebook, and her husband David Goldberg, CEO of SurveyMonkey, walk to a conference in Sun Valley, Idaho. (Rick Bowmer/AP)

The subject line of an email I got last night didn’t mince words: “Exercise can kill you.”

Not exactly the conclusion I’d draw from the tragic death of Sheryl Sandberg’s husband, Dave Goldberg, who is reported to have died of head trauma and blood loss after falling off a treadmill while on vacation in Mexico.

Not surprisingly, the flukish, apparently accidental death of a high-profile spouse led to predictable follow-up stories on the dangers of exercising on treadmills.

From Quartz, under the headline, “After Dave Goldberg’s tragic death, it’s worth a reminder: Treadmills are dangerous:”

Treadmills are notorious for causing accidents—occasionally fatal ones. The machines’ powerful motors and fast-moving belts can punish any momentary loss of balance with bruises, sprains, broken bones, friction burns, or worse. Distractions like watching TV or reading while running increase the likelihood of an injury.

The Washington Post reports on the “risks of treadmills in the era of smart phones:”

But his freakish accident actually isn’t that rare. Every year, tens of thousands of Americans are injured on treadmills. Thousands are taken to the emergency room. A handful die.

Data suggests that the problem is getting worse. As high-tech, high-powered treadmills proliferate, so, too, do the digital distractions that make the machines even more dangerous…

“Almost 460,000 people were sent to the hospital in 2012 for injuries related to exercise equipment,” according to USA Today. “The vast majority—nearly 428,000 were treated and released for their injuries—but about 32,000 were hospitalized or were dead on arrival.”

Treadmills account for the majority of such exercise equipment injuries, Graves told The Washington Post in a phone interview. In a study of 1,782 injury reports from 2007-2011, she found that “treadmill machines comprise 66% of injuries, but constitute approximately only 1/4 the market share of such equipment.

But wait, a reality check, please. Stuff happens. Unpredictable, tragic, life-altering stuff. And we, the survivors, need to keep steady and continue to care for ourselves and for those we love. And that includes exercise.

I asked Dr. Eddie Phillips, director of the Institute of Lifestyle Medicine and an assistant professor of Physical Medicine and Rehabilitation at Harvard Medical School, for his take, and he offered this perspective:

Despite the tragic and paradoxical death of a high profile individual exercising on a treadmill to improve his health we must not lose site of the overwhelming evidence of the benefits of increased physical activity for everyone. Treadmill accidents are rare compared to the pandemic of preventable disease and death from physical inactivity in the majority of the population. Avoiding exercise and remaining sedentary ensures universal increased risks of diseases like diabetes and heart disease as well as premature death and increased health care costs. Continue reading

Parent Dilemma: When A Kid’s Concussion Lingers On

When Eli Davis was 15, his ski popped off in the middle of a steep, bumpy slope and he went suddenly airborne, then landed hard, the back of his head slamming down against unyielding ice. That was his first concussion.

A few months later, at soccer camp, he was defending the goal when a breakaway player took a shot from just five feet away and it rocketed right into his face. He finished the game, but he remembers thinking, “Oh…That was not a normal hit.” Another concussion, a worse one.

So far, so familiar. Efforts to expand awareness about the risks of concussion have exploded in the last few years, changing youth sports that had long been more cavalier about hits to the head. Coaches and parents take courses on identifying and treating concussion. Most know to err on the side of caution with head injuries — “When in doubt, sit ’em out” — and watch for the telltale symptoms that may follow, from dizziness to headache to brain fog.

What fewer know, however, is that while most concussions clear within several days or weeks, a small minority of cases last much longer — like Eli’s.

“He looked at the two of us and said, ‘I don’t care about soccer. I care about the rest of my life.'”

– Al Davis, about his son, Eli

For months after the soccer injury, he suffered a mild headache that would not subside; grogginess and fatigue; sensitivity to light and noise; an inability to think hard that made learning impossible. He found himself stuck on the couch at home, feeling ever more “cabin sick,” when he wanted desperately to be back at school and on the soccer field.

“You can only watch so many seasons of ‘Lost,’ ” he says.

Dr. Neal McGrath, a neuropsychologist and nationally known expert on concussion, estimates very roughly that perhaps 10 to 15 percent of kids with concussions have “longer, tougher recoveries,” often when they’ve accumulated too many concussions, or their injuries have come too close together. That probably amounts to thousands of American children living through prolonged concussion recoveries each year, he says.

Now, Eli’s parents, Robin Friedman and Al Davis of Brookline, Massachusetts, are creating an online venue where those kids and their families can connect, learn from each other and from authorities like Dr. McGrath, and gain support for the long haul they may face.

Professional Web and video content creators who specialize in patient education sites, Friedman and Davis are in the midst of shooting videos like the one above and the others in this post for a site they’ll call Connect2Concussion. They’re trying to fill a void they found as parents groping their own way through post-concussion recovery and all the dilemmas it entails.

Though Eli is thriving now as a sophomore at the University of Massachusetts, his parents still vividly remember how frightening and confusing his condition was in high school. They were worried at first by each day of school Eli had to miss, Friedman says, then scared by how long his symptoms lasted.

“We just didn’t get it,” she says. “With a broken bone or a sprain, you can take an X-ray and you can see it’s healed, and then you know what to do,” she says. “With concussion, they just send you home. It could really be two days or it could be two years, and everything in between, because every child is different, every injury is different and every recovery is different.”

“It gets crazy,” Davis adds, “because every day that goes by, it’s like sand going through an hourglass. You have no idea. You don’t know if he’s going to be OK on Friday, next Monday or two months from now. And what we’ve learned subsequently is that two months from now is actually a reality for people. A year from now is a reality for people. Or it could be three days and everything is good to go.”

Continue reading