In the Vail Valley, concussions are both commonplace and dangerous

Editor’s note: This story first appeared in Vail Health magazine. Look for it on newsstands everywhere.

“Raise your hand if you have had a concussion.”

Kim Greene, the injury prevention specialist for Vail Valley Medical Center’s Trauma Services, frequently asks this question in local classrooms. Five years ago, she was met with blank stares and silence. But today, on average, five students will tentatively lift their hands. Have concussions increased that much?

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“Yes,” Greene said, “and so has awareness.”

Sobering stats

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Centers for Disease Control and Prevention data show the amount of reported concussions has doubled in the past 10 years. The American Academy of Pediatrics has reported that emergency room visits for concussions in kids ages 8 to 13 has doubled, and concussions have risen 200 percent among teens ages 14 to 19 in the past decade.

Traumatic brain injuries, more commonly referred to as concussions, are getting a lot of attention lately. When left undetected, concussions can result in long-term brain damage and may even prove fatal.

The data is sobering — cumulative sports concussions are shown to increase the likelihood of catastrophic head injury leading to permanent neurologic disability by 39 percent. Additionally, according to Head Case, an organization to help protect young athletes from the risks of undetected cumulative concussions:

• 1 in 5 high school athletes will sustain a sports concussion during the season.

• 33 percent of high school athletes who have a sports concussion report two or more in the same year.

• 4 million to 5 million concussions occur annually, with rising numbers among middle-school athletes.

• 90 percent of most diagnosed concussions do not involve a loss of consciousness.

An estimated 5.3 million Americans live with a traumatic brain injury-related disability, according to the CDC. Because of heightened awareness and, more importantly, a desire to educate students, local parents, coaches and medical professionals are teaming up to get the word out on the prevention, recognition and treatment of concussions.

“When I ask students who’ve had concussions to share their experience with their classmates, the students will listen to that. It is the most effective part of what we do (in regards to education),” said Greene, the chapter director of ThinkFirst, an international nonprofit organization that promotes education and resources.

Educating students

Through Vail Valley Medical Center, which operates the ThinkFirst chapter, Greene visits Eagle County schools and distributes free bike helmets, provides education regarding concussions and helps administer ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), baseline testing through a computerized neurocognitive assessment.

While passionate about spreading the word on traumatic brain injury prevention and safety, this is not the profession that Greene would have originally chosen. Her journey began when her then-16-year-old son, Jeremy, was driving his car without a seatbelt; his vehicle spun out of control and crashed into a tree.

“It was a game of wait-and-see every day,” she said. “His brain was sloshing around in his skull.”

Derived from Latin, the word concussion means to “shake violently,” which was exactly what happened to Jeremy’s brain. For 3 1/2 months, he was in a coma and nonresponsive.

“When someone is in a coma, you can’t say that in two months something in particular is going to happen. It is day to day,” she said.

Now 32 — 15 years later — Jeremy still takes things one day at a time. Although he did graduate from college, he is, as Greene said, “definitely disabled.” He can no longer drive and has balance and vision problems. He is currently living at home, as he needs the extra support.

As an example, Greene said her son needs to be supervised when doing anything that involves multiple steps, such as cooking. He struggles with executive functions such as putting his day in order: what day is it, what does he need to do, where does he need to be?

Compounded injuries

Nineteen-year-old Clare Baker, a Vail Mountain School alumna, can relate. She is a self-described sticky-note junkie and is always writing lists.

Baker suffered her first of eight to 10 concussions when she was in second grade and fell 30 feet from a tree. A gymnast, her first instinct was to put her arm out to protect her head. While that broke her arm, Baker believes had she not done that, she would be paralyzed, as she hit the ground with such high velocity.

When she arrived at the hospital, she was functioning normally and answering questions. However, she has no recollection of the first few hours of what happened after she hit the ground.

“I was not unconscious, but my mind was essentially black,” she said. “I don’t remember a thing, and that is really scary. In my mind, I was dead for those few hours.”

Baker’s mother initially chalked up her nausea to the pain medications she was given, but her maternal instincts took over, and after more tests, Baker was diagnosed with a concussion.

“I’ve learned that after your first concussion, it is easier to get a second and then a third and so on,” Baker said.

From second to seventh grade, she suffered four more concussions, some more severe than others, but each collectively contributing to the problems she experiences today. Prior to the start of 11th grade, Baker suffered a particularly disturbing concussion when she fell at the top of the wake while wakeboarding.

“I caught an edge and hit the water, which was like glass,” she said. “I got up and was walking and talking normally, my dad said. But I was in the shower a few hours later and the hot water ‘brought me back to life.’ I couldn’t remember how I got in the shower.”

“When I was in second grade, I wasn’t old enough to realize what it was like not to remember what had happened, but this time I was 16 and to not remember was terrifying,” she said, pausing while choosing her words.

Determined to start her junior year at VMS the following day, Baker was tired and the lights bothered her. Additionally, her athletic director would not let her train with the lacrosse team until she received proper clearance.

“That’s what sparked my interest in concussions, going through the whole protocol of returning to my sport. It’s one thing to sit in a dark room over the course of the summer until you feel better, but it is another when you need to be cleared. I am glad the trainers made me go through this because they cared about my well-being,” Baker said.

Now a sophomore at the University of Colorado Boulder, Baker is studying integrative physiology and hopes to become a physical therapist or physician’s assistant and help student-athletes return to their sports after a brain injury.

Injury prevention

Howard Heads Sports Medicine physical therapist Brittney Huntimer, who specializes in concussion and return-to-sport treatment and management, is as much an advocate of organized sports as she is of injury education and prevention.

“There are great things involved with organized sports. We just want the kids to be safe,” she said.

Huntimer noted that it can be confusing for parents who aren’t aware of the new concussion guidelines; she wants parents to be a part of the process and see the neurocognitive test results.

“We are working with medical professionals, coaches, athletic directors and others within the school system to see that parents and kids are getting the same information,” she said.

“It doesn’t have to be a huge hit to the head to be a concussion. If you have a hit to the head and you have symptoms, you have a concussion,” she said, adding that there are doctors, therapists and athletic trainers on site at many sporting events.

Prior to participating in sports, all Eagle County high school athletes must be cleared by a physician. Each spring, Vail Valley Medical Center and The Steadman Clinic’s physicians, physical therapists and athletic trainers volunteer their time to provide free pre-participation physicals to ensure every student-athlete is healthy to compete.

The students are screened for vision, blood pressure and general, heart and orthopedic health. Baseline neurocognitive tests are also administered, and student-athletes and their parents are offered educational materials and the opportunity to speak with health-care professionals who specialize in injury prevention, when to return to sport after injury and physical rehabilitation.

“In the 12 years I’ve done pre-participation physicals, I’ve met an increasing number of athletes and parents who want to learn more about concussions,” said Brandie Martin, a certified athletic trainer at The Steadman Clinic and director of the athletic training program for Eagle County Schools. “I have also seen an increase in the number of reported concussions, which may mean that our initiatives to educate athletes about the danger of concussions is being heard.”

“It’s important for kids to know the signs, as well,” Greene said. “If two friends are skiing and one of them gets hurt, his buddy can know what signs to look for. It’s one of the things we teach.”

In 2015, Greene and her team of volunteers educated more than 12,000 people about brain and spinal cord injuries and donated 1,142 bike and ski helmets to children and adults in the community through VVMC’s ThinkFirst program. She has also formed a pledge, which she asks children and parents to sign — a formal promise to think first, wear a helmet, fasten your seatbelt and protect your brain.

For more information about ThinkFirst, visit http://www.vvmc.com/thinkfirst or call 970-477-5166.