Tackling concussion

CMH helps student-athletes play it safe

By Felicia Struve, Marketing & Communications Coordinator

The headache was instant and so severe that it brought tears to his eyes. 

Kellan Patterson, a junior at Astoria High School, had just experienced his second concussion in less than two weeks. It would take him six more weeks to return to school full-time and for the headaches to subside. 

Chad Rankin, Kellan Patterson, and Howard RubEach year, CMH Athletic Trainer Chad Rankin gives varsity athletes at Astoria, Warrenton, Seaside and Knappa high schools the computer-based ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) exam, which measures brain function through reaction times, memory and awareness. Since 2012, Rankin has conducted more than 3,600 baseline tests.

When a student-athlete, like Kellan, has a suspected concussion, Rankin retests them. Comparing the baseline test with the second test allows a doctor to determine if and how badly the athlete has been injured. 

This quantitative measure of brain function makes concussion management less subjective and helps doctors determine when an athlete is ready to go back to practice and competition – preventing further or lasting brain injury. 

On brain rest

Kellan was one of 134 student-athletes from area schools who showed signs of a concussion during the first six months of the 2018-19 school year. He’d received the first concussion while playing football when he collided head-to-head with another player. 

A concussion happens when the brain gets rattled or shaken inside the skull from a fall, a blow or some other jarring event. The brain responds by releasing its neurotransmitters, or chemical messengers, all at once. This chemical flare-up causes physical, cognitive, behavioral and emotional problems.

The most dangerous concussions may be the ones that get missed. When that first concussion is missed, the person is at risk of having a second and more severe concussion within the first year. 

“A common myth is that someone needs to lose consciousness to sustain a concussion, which is certainly not true, as more than 80% of all concussions do not involve a loss of consciousness,” Rankin says. 

Kellan didn’t pass out, and his initial symptoms were mild, with a headache and some disorientation. Howard Rub, Astoria High School Head Football Coach and Athletic Director, was the first to notice something was off. 

Kellan was put on “brain rest” by his doctor, Allison Martin, MD. Brain rest means avoiding anything that is stimulating to the brain intellectually or emotionally, including doing school work, playing sports, watching TV or listening to music, talking with friends and driving.

“It got really boring,” Kellan says.

Out for a season

Just when he was feeling better and getting back to school and on the sidelines at football practice, Kellan had a car accident. Fortunately, it was a minor accident, but it still set his recovery back by months. 

“The second concussion or the third concussion is more severe, and the recovery is longer,” says Dr. Martin. “Even though most kids feel better within about two weeks, your brain is not back to normal for about a year.”

It’s also more vulnerable to reinjury during that time, “which is why it’s so important to protect your head,” she says. 

After the second concussion, Kellan had migraine-type headaches, with light and sound sensitivity. He had trouble sleeping and struggled to stay awake. He also had trouble concentrating and was grumpy.

With extended brain rest, accomodations at school and sitting our for the rest of the football season, Kellan’s ImPACT test scores began to slowly improve. 

Dr. Martin says she tells kids, “if you don’t rest, you’re never going to get better – it’s just like a broken arm. But your brain is more important!”

Now, months later, Kellan remembers most how boring it was to be cut off from his regular activities for weeks and how difficult it was to catch up in school. “It was a lot of falling behind and then a lot of catching up,” he says. 

He’s looking forward to his senior year and playing football in the fall. His mother, Melissa Patterson, says she worries that Kellan could be reinjured. “You wonder if high school football is worth it,” she says. “You just don’t want them to ever get another one.”

However, she says, “He loves the game. He loves the team.”

Taking precautions

While football tends to draw a lot of attention, other sports also cause high numbers of concussions. Rankin says behind football, girls’ soccer is the second-most concussed sport, followed by girls’ basketball. 

The risk for Kellan and others like him is post-concussive syndrome, in which concussion symptoms stick around for months and even years. Dr. Martin says people with post-concussive syndrome often experience persistent headaches, poor performance at school or work, difficulty concentrating and depression. Rankin works closely with injured athletes across the country.

“Athletes often don’t want to let their team down, let their coach or their parents down, as the team is the most important thing to them – especially if they’re having a good season,” he says. 

“Furthermore, many don’t know or believe that a concussion is a serious issue and believe they can simply play through it because they’re ‘tough.’ It can be a silent injury. No one can see the headache someone else is experiencing or realize they’re having issues until grades start to slide.”

He tells his players, “You can be a tough guy all you want with your arms and legs, but when it comes to your head, we have to know.”

Since Rankin began administering the ImPACT test in schools seven years ago, the number of student-athletes he’s followed through concussion treatment has risen. He attributes this to more kids turning out for sports and better awareness in youth sports of the risk that repeated concussions post to our children’s well-being.

“As a parent, we can’t put them in a bubble,” Rub says. “We try to help them do what they love to do – and be as safe as possible while doing it.”