“You can’t put a cast on a concussion. That’s what I tell my friends when they ask about what it’s been like to get over a concussion. They’re invisible. When you have one, you look like you’re fine. But you’re not. I’m Remy, and I’m 14 years old.” A couple of years ago, my hockey team went to Holland Bloorview Kids Rehabilitation Hospital so we could all have a baseline concussion test. That’s a series of tests that gives you a picture of your brain and your body. It was my mom’s idea. She was the team manager. Everyone on the team got tested. We played computer games to test our memories and did different tests to measure our fitness, agility, and balance. We also had to wear a heart-rate monitor for a day. It was fun but I never dreamed I would actually get a concussion. A few months later, I was playing soccer and I got hit really hard in the head with the ball. Hurting, stressed and scared My ears started ringing and I felt dizzy. I sat on the bench for a short time but I didn’t think I had a concussion, so I went back into the game. I think I made it a lot worse, so I went to my doctor. I had really bad headaches and felt tired all the time. And when I looked at a bright light my head would start to hurt. I was scared. And I was getting stressed because my teachers were still expecting me to hand in my homework. I was having trouble thinking and concentrating. But then we remembered my baseline testing, so we went back and I did all the tests again and they proved that I had a concussion. It’s OK to say “no” I started going to Holland Bloorview for treatment. At first I was really nervous. But as soon as I arrived, everyone made me feel a lot better. Everyone was so happy and I felt really welcomed. Every time I went back and did the tests again, I was getting closer and closer to my healthy score. It was such a relief to see that I was improving. My team in the Concussion Centre told me that while I was recovering it was OK to say no to things like school and sports. I took some time off school. I slowed down. Sometimes I would just come downstairs in sunglasses and eat dinner and that’s it. Other times I would listen to music quietly. It took me one month before I got better and went back to school. I would go for half-days and then full-days when I felt ready. Excited about my future I’m in grade 9 now and I feel a lot better, but now I’m a lot more cautious. When I play soccer, I am always aware of where the ball is. I’m also back on my school’s track and field team. My advice to other kids is to get a baseline test done. If you wonder if you’ve had a concussion, go and get checked by your doctor. If you keep playing sports you might make it worse. Take your recovery seriously and slowly, and you can get back to doing the things you love, just like I did. Reprinted with permission from Holland Bloorview Kids Rehabilitation Hospital. Concussion Guidelines for Parents & Caregivers What is a concussion? A concussion is a brain injury that cannot be seen on routine x-rays, CT scans, or MRIs. It affects the way a child may think and remember things, and can cause a variety of symptoms. What are the symptoms and signs of concussion? A child does not need to be knocked out (lose consciousness) to have had a concussion. THINKING PROBLEMS • Does not know time, date, place, period of game, opposing team, score of game • General confusion • Cannot remember things that happened before and after the injury • Knocked out CHILD’S COMPLAINTS • Headache • Dizziness • Feels dazed • Feels “dinged” or stunned; “having my bell rung” • Sees stars, flashing lights • Ringing in the ears • Sleepiness • Loss of vision • Sees double or blurry • Stomachache, stomach pain, nausea OTHER PROBLEMS • Poor coordination or balance • Blank stare/glassy eyed • Vomiting • Slurred speech • Slow to answer questions or follow directions • Easily distracted • Poor concentration • Strange or inappropriate emotions (i.e. laughing, crying, getting mad easily) • Not playing as well What causes a concussion? Any blow to the head, face or neck, or a blow to the body which causes a sudden jarring of the head may cause a concussion (i.e. a ball to the head, being checked into the boards in hockey). What should you do if your child gets a concussion? Your child should stop playing the sport right away. They should not be left alone and should be seen by a doctor as soon as possible that day. If your child is knocked out, call an ambulance to take him/her to the hospital immediately. Do not move your child or remove any equipment such as helmet, in case of a cervical spine injury. Wait for paramedics to arrive. To learn more visit: www.parachutecanada.org/concussion horizon.parachutecanada.org/en/collection/parent-resources-for-concussion/ How long will it take for my child to get better? For most people, the signs and symptoms of a concussion will be gone within the first 10-14 days. In children, symptoms can last up to 4 weeks. In some cases, it may take many weeks or months to heal, but most people will show clear signs of getting better in the first weeks following the injury. How is a concussion treated? The most important treatment for a concussion is rest and gradual return to activity. Even though it is very hard for an active child to rest, this is an important first step immediately after the injury. After 24-48 hours of rest following the concussion, your child can start to gradually return to daily mental and physical activities. The child should not exercise, go to school or do any activities that make their symptoms worse. If your child goes back too soon to activities that increase symptoms, they may get worse and have symptoms longer. It is important that your child is seen by a medical doctor before beginning the steps to return to sport and recreational activities. If possible, your child should be seen by a doctor with experience in treating concussions. When can my child return to school? Sometimes children who have a concussion may find it hard to concentrate in school and may get a worse headache or feel sick to their stomach if they are in school. Children should stay home from school if their symptoms get worse while they are in class. Once they feel better, they can try going back to school part time to start (e.g. for half days initially) and if they are okay with that, then they can go back full time. When can my child return to sport? No child with a suspected concussion should return to sport the same day. After your child completes the initial 24-48 hours of rest, they can begin the gradual return to mental and physical activity. It is very important that your child not go back to sport if they have any symptoms or signs of a possible concussion. When should I take my child to the doctor? Every child who gets a head injury should be seen by a doctor as soon as possible. Your child should go back to the doctor IMMEDIATELY if, after being told he/she has a concussion, he/she has worsening of symptoms such as: 1.being more confused 2.headache that is getting worse 3.Vomiting more than twice 4.strange behaviour 5.not waking up 6.having any trouble walking 7.having a seizure Problems caused by a head injury can get worse later that day or night. The child should not be left alone and should be checked throughout the night. If you have any concerns about the child’s breathing or how they are sleeping, wake them up. Otherwise, let them sleep. If they seem to be getting worse, you should see your doctor immediately. No child should go back to sport until they have been cleared to do so by a doctor. Return to sport must happen in a step-by-step approach: STEP 1) Daily activities that do not make symptoms worse. Once concussion symptoms are gone, and as long as your doctor says it’s OK to do so, move to step 2. STEP 2) Light exercise such as walking or stationary cycling, for 10-15 minutes. As long as these activities don’t make symptoms worse, move on to step 3. STEP 3) Individual sport-specific exercise with NO CONTACT (i.e., skating in hockey, running in soccer), for 20- 30 minutes. When your child has no more symptoms and is back to full-time school activities, move on to step 4. STEP 4) “On field” practice with NO CONTACT (i.e., ball drills, shooting drills. No checking, no heading the ball, etc.). STEP 5) “On field” practice with body contact, once cleared by a doctor. STEP 6) Normal game play. Note: Each step must take a minimum of one day. If your child has any symptoms of a concussion (e.g. headache, feeling sick to his/her stomach) that come back at any step, STOP activity, wait 24-48 hours, and resume activity at previous step.
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