weight range of concussions making her perfect for the show well now you know her credit credentials let's begin so it's sort of what the basics what is a concussion well concussion is basically direct or a non functions of the brain so you have this massive rush of potassium that goes out of the cells you have this talks that calcium that actually rushes back into the cells and it really disrupts the brain function so when you have that impact and that can be either direct like if somebody gets hit in the head or another example is whiplash so somebody gets hit in their head forces front worded backwards and the brain actually shakes inside the skull that can cause a concussion too so what you have is this energy wave that kind of goes through the brain and it disrupts it and it can be very detrimental and you can have a concussion that kind of last just for a few minutes one that can last a day weeks months and even years so when you have that shift that's what's causing all the concussion symptoms that go on so it doesn't would you say it doesn't have to be an impact with the so you think i could get hit with the chest with something and if my neck moves exactly right so a good way to think about that is in a car accident if somebody rear end you and you don't actually hit your head which have that whiplash motion of a forward and backward so it's an acceleration and deceleration of the brain and that can cause a concussion as well same thing of somebody would fall backwards and on their backside and again you have that forceful movement of the head the brain actually sits inside the skull it's not attached to anything so it can actually bump up against the skull bone and that can cause bruising and damage and then that shift of the physiological functions i had mentioned previously so once i get the concussion a student gets a concussion what do you look for to make sure they actually do have a concussion so there are definitely signs usually students just have a general feeling that they don't feel well headaches are probably the most common something that you have a concussion which can have a whole range so it actually affects your cognition so thinking you might feel very foggy not be able to concentrate again i said the headaches are definitely a cause you can also have sensitivity like to light and sound you can be nauseous you can vomit you can have almost like migraine type symptoms with a concussion you know do a number of concussions and that are yes so what the found out through the research is that concussions can kind of and i still play sports i saw interactive with that whole scene what would you recommend what sport well i did you do a little bit of research in that to find out what sports kind of have the most concussions and  you know football is probably one of the biggest you know the line men are the ones that you know they are showing that have the highest rate of concussions but if you're looking for a sport to do that you know  lower number you know you would be looking for things that don't have impacts so things like maybe track and field swimming but you know any time that you have any type of an accident and that's you know what can happen during sports is you can actually you know sustain a concussion anytime it doesn't just have to be and in a sport related activity you can fall off your bed and hit your head and still receive a concussion so i think the most important part that i want to say about that is it's not necessarily the sport there are some sports the higher incidence of concussion football being one of them but it's just to use the safety practices and protocols that are out there to protect interesting so what type of ways as an athlete could i prevent getting concussion so you definitely should follow all the rules of the game so you know in sports where you do have that impact you should be using the proper procedures and protocols not taking are not giving a dirty hit you know not trying to hit somebody in the head using the safety equipment that's  what is their role in making sure students know how to do like certain tackles correctly well they're heard you know there has been a push i believe it was in probably two thousand and nine that they have the youth and safety sport act that came out where they actually you know had rules pennsylvania developed rules that schools have to have trained people on staff so that's where like our athletic trainers come in and here peters we do have athletic trainers a great department that you know is on the sidelines storing events for students so if a student has an injury and they are being evaluated they're going to be evaluated by somebody who is trained in concussions and then can treat and follow up with it so i think that you know there has been more rules that go along with that i don't think we're exactly where we need to be i think there's going to be a general push in the future as we get more information and more research on the brain and what these concussions are doing long term that you will see push for less contact that you may but whenever somebody gets a concussion what can they do to optimize their ability to come back to functioning normally as a human being so to speed up the recovery process you definitely  need to be evaluated and to be truthful sometimes that we find you know students that are in competitive sports they don't always want to be honest about their symptoms so if you receive a hit and you believe that there might be something wrong you need to tell someone that's the first step and i've even had students come to me and say you know i was playing in a game of sports and this happened to me but i thought i was ok however three days later i have a headache so i just don't feel right so again that would be you know one of the first steps so what you should do then is to be evaluated students either go to their primary care physicians we are very fortunate here in peter's township many of our doctors now are concussion trained already we have many concussion specialists we have you p m c which we're very fortunate to have that they are one of the four runners of concussion research allegheny health network have concussion specialists are one of our school doctors actually is a concussion specialist so we're very fortunate to have this services and they should follow what the doctor saying so typically when you're first diagnosed there is a definite rest period they usually say about seventy two hours and then the other part of it is actually just trying to go through a normal schedule making sure your sleep schedules are normal make sure you're staying hydrated eating well and then using and we give a student what's called initial academic accommodations to kind of help them until the time that they get to see their physician which could be maybe a week after they actually had the injury so we go ahead and send an email it to the teachers to let them know that the student was concussed when they receive the concussion and then they'll get some accommodations to help them in their classes so there they won't receive any testing until we get accommodations from their doctor they will be allowed to come to the nurse's office for breaks as they need we never want to student to kind of push through really bad sometimes the theory is that you do your normal schedule and activities until you develop symptoms that are at a high level and usually when a student comes in i'll ask them to grade their symptoms on a scale of zero to ten so if you have like a headache of a four or five that's fine you can move on you know go through your schedule they get up to that six seven or greater range definitely come in and take a break we allow students to leave their classes a couple minutes early like two minutes early so that they avoid that hallway traffic think about it here at the school you know we have four minutes to change classes is really very busy and that kind of takes that edge off all that commotion all that movement we actually pare down assignments and make up work for the student till we get further accommodations from their doctor and then if they have a physics class we actually pull them out of it until we get some more recommendations from a physician because we would never want a student that's already concussed to have a potential second concussion that can be very dangerous now with say somebody who doesn't report your symptoms they correctly and they have very bad symptoms in actuality what happens if they still have like all this influx of voids and action and still very  kind of continue to do some physical activity maybe on the side that maybe nobody knows about they're just really doing their themselves a disservice it's going to take their brain longer to heal if you remember i have said that with a concussion there's an energy crisis of the brain so if you don't allow your brain to heal and to have those chemicals get back where they need to be you're just going to prolong your cover your process so in the long run you're just doing yourself a disservice because you can't get back to normal life interesting this is a very in depth video hopefully you can provide some insight with a movie concussion recently came out maybe a year ago a lot is come out about what do you what's your knowledge of c to you well definitely not an expert in c t e but i certainly have been trying to follow you know where that's leading and i think that that research and that information is what's going to drive concussion protocols and how we how we treat the brain in the future so c t e the very serious and as we hear about more you know of course our athletes are always the one that you know sparks everybody's attention when we hear the stories of you know what happens to these athletes lives after they're out of the spotlight it's very serious it's  e symptoms and issues so it's not even that you have a concussion you may have been had direct or indirect slow to your head and not know that you have a concussion and those they're finding out stack upon each other and then you have this reaction to the brain or these proteins develop you don't even know it's occurring and then over time you know they're definitely  causing the brain to not function properly so you have a lot of symptoms a lot of the concussion symptoms that i had mentioned you will have but then it will start to turn into memory issues personality changes  depression anxiety and of course is you know heard as well that you know players can get so bad that they commit suicide to somebody does obtain few to you is it kind of basically game over  there any way to reverse the effects of the war at this point you know c t e isn't really even diagnosed until until the person is deceased and i did just read a very interesting article that one of the athletes had had they are deceased at this point in time but they were looking back on some skin hands of that athlete and they found changes in those scans that is pointing to c t e so i think that that is hugely remarkable and i'm sure that we're going to be looking further in the research for that but at this point in time as far as i am aware that there there is nothing to stop that c t e because we don't know about it until it's too fascinating now if you think this whole information and influx of information about fiji do you think that it would change the way parents like what kids do certain sports like football compared to what's aggressive sports like silver truck i do i mean i do think as we get more you know get more information and the research is you know definitive in what brain injuries do for the long term that we're all going to be looking at sports differently i believe that we maybe will have it's like i think i mentioned before a change in the age of certain sports because they are finding that you know children who have concussions they do not have the protective mechanisms that an older person has that's why there are certain roles know hockey is a good example where you don't get into actually checking or hitting until certain age that's because they're your brain when your child is not developed you don't have the protective there's a thing called a mile and sheath that protects your neurons that just aren't developed in children yet your neck muscles your shoulder muscles that hold your your neck in your head aren't as developed so you're more prone to concussions so to answer your question i do believe that parents are going to be looking at sports differently i know when i talk to parents already if their child has had several concussions some will just remove them from the sport altogether that isn't right now why dilly recommended even by concussion doctors at this point in time but i do think we'll see changes the research you brought up an interesting thing about effects younger people to order people but how does age affect the recovery part process from say a twelve year old to somebody in their mid seventy's that's a good question and you  they in anything any any health issue they just will require cover quicker than an order person so you know concussions they the typical concussion will be resolved in usually three to four weeks  and i would say one thing that probably not known is that concussions are very individualistic just like any other health condition one person might do very well and respond to treatment and recover quickly and another may not even though they've had the same treatment it's the same in concussion but overall you know children will recover quicker than probably and older adults so the order you are  there are there are some what they call multipliers factors that if you have as an individual will usually not always make your recovery possibly a little longer delayed so i actually have a form in the packet that i give to students and to families that are concussed i think and mention we have a concussion protocol here at the high school so there's a lot of information that parents get when they're first diagnosed and in that information there is you know multiple things in there but the questions that ask do you have a history of migraine headaches do you have any mental health disorders depression or anxiety do you have a history of a d h d those things they have found through the research that people may have a little bit of prolonged recovery time when they are can cost you obviously do a lot with can cost students but what do you mostly do with can go students what is your action somebody comes in you know there can go but and they also do and it's a mutual understanding what for you so if a student comes in and say that they had practice last night soccer you know football whatever sport that it might be and they're like you know hey mrs hey i got a head and i you know didn't think much of it but i'm not feeling well and i have a headache you know i feel fog i can cause some trades i would then be the first point of contact to the parent so i'll call the parent say hey your child has told me that this occurred on sure if you're aware at this point in time you know i believe that you should consult their physician and then i'll walk them through kind of that basic part of the concussion protocol to let them know if your student is concussed your child is concussed you know please let us know that we do have a you know an action plan in place so for a student to you know does know that there could cast on that kind of first point of contact a lot of times to call the parent and give them information if a student is knows that there can cost again on that first point of contact all the paperwork it to me lucky me but then i send out that information to the teachers we do use a concussion management team process here so it's not just myself there's a team of us and it includes  teachers and includes the grade level principal the guidance counselor and actually the guidance secretary a lot of people who you know make up the team to make sure that the student is being followed and that you know we basically follow from the time that they're diagnosed with a concussion all the way until they're cleared fastenings so the group just only focus is on once you know the time where does it go and multiple it is a good question that we have typically about seventy concussions high school a year and that's going down we used to have over one hundred and so through the years it's gotten less and less i think as  you know the information has come out concussions are diagnosed and treated in a better way we have lots of caregivers in the community all the way you know from  pediatricians to concussions specialists to chiropractors to some alternative treatments that i believe that you know that has helped students be diagnosed earlier treated earlier and then cleared earlier you also brought up another thing i found interesting is how was concussion like protocol changed from ten years ago to now and do you think that has resulted in a decrease in concussions the high school least yes i do think because of all the things that i had just mentioned that we do have better treatment so students realize that if i do follow the doctor's orders if i do rest that my recovery is going to be quicker like i said you know a concussion a normal typical concussion student should be cleared in probably max three weeks and that's if they follow all the protocols they do it you know what they're told to do and everything in their brain is healing and jiving well three weeks so i think students will see now that they you know aren't necessarily you know thrown off of a competitive team that you know they can get back into their sport they can go on you know with their studies and their outside school activities you know without having a hindrance to their life so i think that yes that has changed the protocols arses of has developed in evolved through the years the past ten years we do work with brain steps  there are a group that we developed actually our concussion protocol through and they are a group through the pennsylvania department of education that was set up just to help students reintegrate back into school after being diagnosed with a concussion so there is this whole support network that's out there i've seen concussions range from very simple you know cleared within i've even seen you know a concussion cleared within a week's time if a student is doing really well and i've seen students actually have you know that that truth traumatic brain injury and have to develop some other skills in their life we've had students that have had  get service agreements p s in order to help them with the deficits that they may that might be a little long lasting or long term in their life memory actually so again back to the concussions are very individualistic it's very true you can have what you know one student you know pretty much the same hit however you know one student's recovery is and they they just continue to have symptoms and don't recover as well so again i it just goes back to every student being very individualistic and you know what one student might need in some assistance school and other you know might be able to have just me sending an email to the teachers another student you know may not do as well and need additional support and need the long term and that's why we would go and develop a five or four or p for that students right off the bat so the the child has even been to the doctor yet they get all those ones that i had mentioned about leaving class two minutes early having modify and assignments being able to come to the nurse's office  rast all of those are just a given for any student that we might we do that to protect the students so if you know we send those out and you come back to me and say i went to my doctor and i'm not concussed great you know we just we did something to help you in that process when when the student does go to their doctor we most doctors will complete what's called a recommendation sheet or accommodations for school that go through you know testing homework classwork just you know those those accommodations are typically like extra time you know basically for testing extra time to turn in work  they might have testing that tries to maybe not repeat things so like if you have math you you know do ten problems instead of twenty so those are the probably the most common ones i see well it seems like our time is over thank you first of all for coming here thank you i didn't unfortunate get there all the questions i was hoping for nonetheless i wish on this show to be both educational and helpful for