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The big one
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  1. Melissa Romano
  1. Private, Indiana, Indianapolis, USA
  1. Correspondence to Melissa Romano; mo1511{at}aol.com

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I have had concussions before, but this was different. In 2012, I was playing first base in a recreational softball league. A throw came to me for a double play, but I did not get my glove up, it tipped off my glove and hit me between the eyes. I did not lose consciousness, but was feeling out of it and foggy immediately. I played the rest of the inning despite my symptoms. I did not go to the hospital that night. The next morning, I drove into work (I am not sure how I drove in that day) flooded with symptoms: headache, dizziness, fogginess, to name a few. A coworker talked to me and it felt like she was screaming in my ear. I did not realise sensitivity to sound was a symptom of concussion. My bosses sent me home; I stopped at the pharmacy on the way. When I mentioned my symptoms, the pharmacist said, ‘Go to the ER right now’. So, 12 hours after being hit, I finally went to the Emergency Room (ER), got a CT and MRI, and was told I had a concussion. I was prescribed pain medication, and told to go home, rest and follow-up with my primary care physician (PCP). My recovery took 6 years.

Experience matters

The common thread of the team I eventually worked with was whether the professionals had experience in concussion, and if I made progress with them. I knew I could heal, and I was not going to stop until I found the right people to make it happen. I saw two neurologists, two speech therapists, one occupational therapist (OT) and five physical therapists (PT), including one vestibular therapist. My PCP referred me to a neurologist, who was not very well versed in traumatic brain injuries, so I found another one, even though I kept the first for paperwork continuity. I was in a programme that had a speech therapist, a PT, an OT and a neuropsychologist. After I was discharged at 3 months, I needed to find a new speech therapist. I saw a neuro-ophthalmologist, because I had a lot of eye issues we were trying to figure out. My biggest problem with my PTs was that, even though I had a 7 or 8/10 headache for a year and a half, it felt like they were just treating my neck issues. I was not going to stay with someone if it felt like they were treating the symptoms, instead of the root cause. The therapist I had the most success with (a PT who did cranial sacral therapy) was a referral from another female who got hit in the head playing softball. She had a positive impact on my headaches in the first session, and I was like, ‘Oh you’re not going anywhere’. She recognised I suffered from whiplash from my hit in the head, where the other therapists did not notice and/or treat it.

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On my own

Before my injury, I was always on the go—playing sports, working everyday. After my concussion, I was sensitive to any stimulation, had headaches and fatigue so bad that I slept all day. It went from 100 to zero, and I had no idea how to adjust to it. I felt silly because I could not go anywhere without sunglasses and ear plugs. I felt stupid because I had trouble speaking, then self-conscious because I thought other people could notice me messing up…I ended turning into a hermit. I lost many friends, because I could not go out and do things. My job (as an accountant) was very detail-oriented and computer-heavy, but I had trouble with maths, focusing and using on any electronics. After 2 months, I had to go on medical disability from work. My family lives out of state, so they were hearing what I would tell them, but they thought it was like they heard on the news, where the symptoms just last for a short time but, then it gets better. It was very isolating. It affects everything: your mood, who you are as a person. When your recovery is so long, it rewires the way your brain functions. People do not really think about the little things you lose, and that can be hard on your psyche.

A new perspective

I needed something to look forward to, and since my symptoms prevented me from going back to my previous work, I pursued a new passion. I started training to get certified as a life coach a year after my injury, and was certified in 2014. I was still experiencing debilitating symptoms, but I made some adaptations, and by taking advantage of the programme’s flexibility to complete the training. I survived a weekend of classes with sunglasses, earplugs and classmates who helped me take notes. The practical component was telephone-based, and I scheduled less people in a day so I could rest in between sessions. I now work with people who have concussions/brain injuries. Currently, while there are more protocols for when someone gets injured and to get back on the field, I have noticed that community doctors’ and medical professionals’ knowledge about concussions has not changed much. Most of my clients do not live in big cities, so they see PCPs, and maybe one neurologist. They either hear from the medical professional that ‘You’re not going to heal or get better and you’re just stuck like this for the rest of your life’, or ‘Oh, you should be better in a few weeks’. People have questions about how long they’ll have symptoms, or are their symptoms normal, or which professional should they see if they have these symptoms—things they should ask their doctor. But they ask me or others that have gone through the same thing for the answers, because that is who they feel they can most rely on.

Take home messages

  • Talk to people who have suffered from concussions, and learn from their experiences to get a better understanding. I was the typical athlete, stubborn, wanting to get back to exercising. My first physical therapist automatically put me on the treadmill to try and build me back up with running because that was my goal. She did what I wanted, not what was best for my recovery. That hindered my healing because in being focused on what I wanted, she was not focused on what I needed to heal using her professional knowledge.

  • Know and understand all the symptoms of concussion, so you can help educate your athletes about how to manage them more completely.

  • Use that knowledge and your clinical expertise to help them set boundaries that help their recovery and reduce setbacks.

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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