On the Road to Recovery – What it’s Like to Have a Concussion
By: Jill Cates
Concussion, which originates from the Latin word concutere “to shake violently”, is the most common type of traumatic brain injury. In the US, concussions result in 1.365 million visits to the emergency room and 275,000 hospitalizations each year 1. A large portion of these concussions are sports-related, but other causes include car and bike accidents, work-related injuries, falls and bar fights.
Earlier this month, I got a concussion from a bike accident. It happened on a Monday night while I was biking home, without a helmet, in the pitch dark and pouring rain. On my way home, my tires lost traction and I swerved. I blacked out. Sprawled out in the middle of the street. Drenched from lying on wet pavement. What could have been seconds or minutes (still unclear), I slowly regained my consciousness. The rest of the night is a blur.
The next morning, I felt extremely dizzy, disoriented, and drowsy. What felt like a sledge hammer slamming the back of my head, was just a small bump on my head. I thought I could continue my day if I just took Tylenol and drank water. But I ended up visiting the emergency room at Mount Sinai Hospital to make sure that my symptoms weren’t anything serious. Upon admittance, I explained to the doctor what had happened, did several neurological reflex tests, and got a CT scan. The diagnosis? A “nasty” concussion. Treatment? Bed rest in darkness and Tylenol for the pain. I was told that it might take several weeks to completely recover.
A concussion extends beyond temporary headaches and dizzy spells. It’s a traumatic brain injury – a debilitating condition that should be taken seriously. In simplest terms, a concussion occurs when your brain smashes against the inside of your skull. In rare cases, this can cause laceration of a blood vessel, which can result in a bleed, and possibly death if not treated. While most people recover from their first concussion with no long-term effects, there is risk for permanent brain damage if subsequent concussions occur.
Several weeks later, I still rely on Tylenol to cope with headaches. I still get dizzy spells, and it’s hard to concentrate at work. Another challenge that I did not expect to have with a concussion is emotional changes. Irritability, nervousness, random emotional outbursts – these are all common symptoms of a concussion that are well-documented but often overlooked. Most of the time, I am normal. But sometimes, I feel like an emotional train wreck. Unexplained bursts of anger, uncontrollable crying, feelings of impending doom. It’s hard to understand how a head injury can affect our thoughts and feelings – things that we think we have complete control over. Despite research efforts, the pathophysiological mechanisms that underlie these emotional changes are not yet understood.
Recovery from a concussion is frustrating because there isn’t much you can do except rest – both physically and mentally. Restricting the brain from cognitive strain, known as “brain rest”, has been shown to speed up the recovery process. In fact, it has been shown that those who engage in strenuous mental activities take an additional 50-80 days longer to recover from symptoms of concussion as compared to those who practice proper “brain rest” 2. Rest is also important in the prevention of second-impact syndrome, which involves a second blow to the head before symptoms of the first one have cleared. Though rare, second-impact syndrome results in rapid swelling of the brain and has a high morbidity and mortality rate, with most patients suffering either permanent brain damage or death 3. The severity of this syndrome highlights the importance of rest and full recovery from a concussion. That being said, “resting” is much easier said than done. Lounging in a dark room is not as enjoyable as it sounds. I miss my everyday activities, like going to work, playing tennis, attending spin class, and reading books. Drinking alcohol is strongly discouraged and going to parties is out of the question (I went to a party two weeks after my concussion and regret it terribly). These restrictions on my life have made me feel isolated and disabled, but it has also helped me realize how fortunate I have been to be a healthy human being.
1. Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006. US Department of Health and Human Services;2010.
2. Brown NJ, Mannix RC, O’Brien MJ, Gostine D, Collins MW, Meehan WP, 3rd. Effect of cognitive activity level on duration of post-concussion symptoms. Pediatrics. Feb 2014;133(2):e299-304.
3. Cantu RC. Second-impact syndrome. Clinics in sports medicine. Jan 1998;17(1):37-44.