Questions about concussions

DrDoc

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Back in 1971 I had just bought my first VW Beetle, a used one from a friend. I had to work early the next day and it was very foggy. I drove down the 2 lane road rather slowly because I knew there was a 4-way intersection with a blinking yellow light (meant stop, look, then go if clear). What I did not know was that the storm of the previous night had broken a branch of a large oak tree and that branch was now preventing me from seeing the blinking yellow light. I just kept creeping along and the next thing I saw was the word Mushroom on the side of a tractor trailer (I was in mushroom growing country in SE pennsylvania), then everything went dark. I was thrown out the window of my new used VW Beetle and slammed into a telephone pole. The ambulance came and I woke up in the ambulance. As a former medic in Nam I started giving the EMT instructions on what to do. I am uncertain how long I was out, but it was long enough to call an ambulance and come get me in a rural part of Pennsylvania. I felt cold on waking up, but was not really aware of much until after I was seen by the physician. I had no observable physical injuries, not even a bruise. They observed me for a few hours and then I was released and I went off to work with my parents driving me. My new used Beetle was crushed by the rear wheels of the trailer and totaled, and I haven't owned a Beetle since. My whole life I have wanted a Beetle.
 
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Evelyn_Alexie

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Yikes! I'm glad that story had a happy ending. (Well, sorta happy. It is too bad about the Beetle.)
So maybe my scenario isn't too implausible.
 

MDSchafer

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- What's the story with keeping people awake with concussions? I know they used to tell you not to let the person sleep, but isn't that just so as to watch for symptoms a serious brain injury? My male protag knows he's not in a position to do anything for her if she does have a serious problem, and I'm thinking of his logic being that if she was going to die from say a brain bleed or something that he'd rather it happen in her sleep.

You don't need to keep people awake with a concussion so long when they are awake they are able to hold a conversation, don't have dilated pupils, have good balance and haven't vomited recently. Sleep is good for a concussion. That said, if it were my family member or close friend I would make sure they didn't drive and I'd wake them up every two hours and have them tell me their name, date of birth and location, cause I'm a just paranoid enough to be a good nurse.

As far as developing a brain bleed several hours after a concussion? It's rare, but it happens.

Your male protag could just use google, and see there's no problem with sleeping after a concussion.

One of my favorite M.A.S.H episodes deals with this where Hawkeye has a concussion, is trapped with some Korean villagers and he says he knows that you can go to sleep with with a concussions, but is afraid that he can't trust that information because he has a concussion, and so he keeps talking in an effort to keep himself awake. It's a brilliant piece of television.
 

MDSchafer

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I've got a female protag whom I need to be knocked out or at least completely dazed and only semi-conscious for about an hour or two.

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Tornadoboy

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Again thanks for the help everybody! It's all been VERY useful!

I'm thinking at this point to not have her really knocked out at all, just very dazed. She also went through an emotional hell right before (and I mean REALLY bad, reliving something truly horrible) and was in the midst of a semi-meltdown at the time of the crash, so between that and the accident itself I think it's plausible she's simply overwhelmed by everything, that would render her kind of a complete wreck for a little while even if she wasn't neurologically unconscious. I kind of like the idea of the male protag sort of entering new territory with his understanding of her as a person and her vulnerabilities, this is not something he would have expected from her at all, but it's completely believable when he knows the whole story later.
 

blacbird

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Having experienced a couple of concussions, and having read a lot about sports injuries of this sort, I can provide some perhaps useful details.

Detail No. 1 is that every "concussion" is an individual event. The symptoms and consequences of each one are not entirely predictable, or even diagnosable at the time of injury. Many of the consequences don't manifest themselves until much later.

My most recent incident of this sort happened several years ago. I slipped on black ice in the parking lot of my local grocery store, at night, while carrying two large bags of goods in my hands. Direclty backward, no chance of catching myself, landed on my shoulders and the back of my head. I never lost consciousness, but I literally could not move for maybe half a minute. A bystander saw this happen and rushed over to help me, and asked me questions, and I could not respond. It was, I suspect, much like a lot of boxer's knockouts. The ref could have counted to fifty or more, and I would have heard every number.

After about half a minute I managed to struggle to a sitting position and was able to respond verbally. He helped me to my feet, and I leaned against my car for a minute or so, while he collected the goods that had been scattered across the parking lot in the fall. I think he was about ready to go get medical help when I convinced him that I was okay, thanked him profusely, and could drive home, which wasn't very far away. In retrospect, that was probably a bad idea; I should have had somebody look me over. I did get home, but had a significant bleeding cut and swelling on the back of my head, which alarmed my wife considerably. I went directly to bed, and was both dizzy and slightly nauseous (although I didn't vomit).

For the next three or four days I was unusually sleepy and lacking in energy. Stairs were a bit of a challenge, especially going down. Eventually it cleared up, and I never did see any medical people about this incident, but I doubt I would have passed an NFL concussion protocol, unless I played for the Seattle Seahawks.

A pro sports incident that has always kind of haunted me happened in Major League Baseball five or six years ago. A really fine player named Justin Morneau, who had won a Most Valuable Player award a couple of years earlier while playing for the Minnesota Twins, was struck in the head by a defensive player's knee while attempting a slide into second base, on a routine infield grounder play. I've seen the replay of that incident numerous times. It didn't look like much, and certainly wasn't intentional. But Morneau missed more than a year of playing time, in the central portion of what should have been his most productive years, because of concussion symptoms. You don't want to stand at the plate and face 98-mile-an-hour fastballs if you can't focus your eyes and feel like you're about to fall down. Morneau never recovered his all-star abilities.

And, of course, we now know the effects of multiple concussions are cumulative. Stories of punch-drunk boxers who can't enunciate clearly are legendary. Medical evidence of severe brain deterioration in NFL and HHL players is well-documented. Some of these players have, tragically, known about this. The great NFL linebacker Junior Seau, who had a really good gig announcing and starring in feature shows after his playing career ended, shot himself in the heart, so he dould donate his brain to the medical people for study of the syndrome.

Concussions are serious injuries, and every one is its own thing. So, for your writing purposes, you have leeway to make your concussion have whatever effects you need. But they are significant injuries, in any event.

caw