Discussion: Concussion in the Medical Community and Society

[Lemon_Pie]

This is a topic I have been wanting to write about since I suffered from a mild concussion in June of this year. I believe that medical and societal views towards concussion need to change in order for patients to receive higher quality medical treatment from GPs and nurses.

In popular culture, when a cartoon character falls or bumps his head, he may see some stars for a few seconds but then quietly and astutely he snaps out of it and returns to normal. This largely demonstrates societies attitudes towards concussions; that they are minor injuries that do not cause much harm to the person afflicted; that such injuries are quick to resolve and heal. For some lucky people with head injuries, symptoms do not last long and there is a return to pre-injury status within about a week or two. For some, the injuries do not clear so quickly and some long term cognitive effects still persist months or even years later.

I would even argue that the term "concussion" actually takes most of the seriousness away from the injury; if "mild traumatic brain injury" was used instead, both society and the medical community would take such injuries more seriously.

There is too much vagueness with regards to a patient's prognosis after a head injury. People sent to hospital with suspected concussion should not be discharged until after a time period of 24 hours, because many symptoms of concussions or more serious brain injuries can take several hours to become evident. Sending a patient home five hours after injury and telling them to "come back if they do not improve" is in itself a flawed approach to treatment because a concussed person may not have the ability to judge exactly how they are feeling. Another reason why it is flawed is because most people do not go back to hospital after being discharged; they wrongly believe they would be wasting the doctor/nurse's time by going back with worsening symptoms.

Most medical websites will tell you that a "full recovery" is possible, and that there is a "return to pre-injury status," after 3 months or so. The problem there is that it creates a misleading expectation for recovery; if your emotional and cognitive symptoms are not improving as quickly as to be completely resolved within 3 months, you start to feel as though there is something wrong and that you won't ever get better. This in turn leads to depression and a worsening of symptoms, which can hamper recovery.

Another thing is that having a concussion distorts your perception of perception itself, which is a very traumatic and terrifying experience. There needs to be more done to help people deal with the temporary/ long term consequences of concussions, by letting them know about the expectations of recovery early on in the recovery process.

I wasn't allowed time off college despite being concussed, and this lead to a worsening of my symptoms and a delayed recovery. If my lecturers had understood the seriousness of my injury and allowed me time off to test, I would have improved more significantly in both the short term and in the long term. More needs to be done to educate the public about how serious concussions/ head injuries can be, and how to treat them.

Thoughts?

[StrawberryCream]

Silmilarly for Brain injury as it is equally misunderstood and the follow up care and support a post code lottery and often non existent!!

[NightBird]

I absolutely agree, and I believe "brain injury" should be the standard term. I'm sceptical of MTBI. "Mild" is classified by blunt-instrument tests that don't find all the symptoms, so your injury can be officially "mild" and still debilitating. The "traumatic" part is tricky because people tend to associate that with psychological stuff. We're already overdiagnosed with psych problems, so that's not a helpful association.

Losing "traumatic" is also good for people who injured their brains through infection, vaccination and suchlike rather than accidents. We're an ignored minority within an already-sidelined population.

I am seriously considering getting an advocacy project together. But I need to be recovered - or almost so - if I am to handle it.

Lia

[asbas]

Absolutely. What I found interesting was doctors and OTs were all telling me that they could not predict what happened after a head injury yet they were telling me I should be fine after 6 months and that beyond that it was all in my head. Meaning I was either imagining it or causing it because I was anxious about it. That, in my state of concussion made no sense to me. What I think is that GPs who have a special interest in head injuries should be out there so that people can go to them. Sometimes it takes up to 3 years for the body to bounce back - in that time it feels like you are just struggling. I do think that forcing your brain to start working on cognitive stuff before it has healed enough is detrimental and takes more time to recover. You should have been allowed to stay away from studies and recover and systems (Health/work/insurance/education) need to know this