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Archive for the ‘Falls’ Category

There has been much attention given recently to the potentially serious injury to the brain from suffering a concussion.

For professional athletes, such as football players, the recovery goal has been to return to the game as soon as they are physically able.

But for schoolchildren — who are at significant risk of learning disabilities, emotional or behavioral changes and memory problems — the focus of recovery should be mental as well as physical rest.

From babies to high school students, children with concussions make nearly 144,000 visits to emergency rooms each year. A significant number of injuries also go unrecognized and are not reported. I personally see a number of concussion injuries in my practice each year.

Younger athletes may be at a greater risk of damage from a concussion, because their brains are not fully developed. When athletes take a hit to the head in football, are slammed by an elbow in soccer or fall from a bike or skateboard, the brain gets banged against the inner walls of their skulls, thus causing the injury commonly referred to as a concussion.

Common symptoms of a concussion are:

– Loss of consciousness, no matter how brief

– Headache

– Vomiting

– Memory loss or behavioral changes, especially confusion or feeling “foggy”

Children with the above symptoms, or any other symptoms that worry parents or adult guardians after a head injury, should prompt an immediate medical evaluation at a facility best suited for this, such as an urgent-care clinic or a hospital emergency room. The evaluating physician may order a CAT scan of the head, depending on how serious the signs and symptoms are.

It can no longer be acceptable for a head-injured athlete, young or old, to “shake it off” and get back into the game. Our young athletes must be instructed to immediately report any head injury.

Coaches and trainers have become more aware of the potential dangers, both short and long term, of traumatic brain injuries and are having the injured players seek immediate medical evaluation.

Especially dangerous is the “second-impact syndrome” when a player receives a second significant head injury within a short time after the first injury. This can lead to even more serious health consequences.

Those of us in the medical profession who deal with head injuries are using protocols to help return the young athlete to their routine activities. The focus of recovery is rest, both physical and mental. The injured athlete needs to be eased back into all routine activities, and a medical reevaluation should be performed before allowing a return to contact sports.

The bottom line is that head injuries in athletes need to be taken seriously because of both immediate and potential long-term consequences. Mental rest after the injury is just as important as physical rest.

Although this column focuses on sports-related head injuries, the principles I have discussed pertain to anyone with a head injury, no matter the age of the individual or the cause of the injury.

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Careful on That Ladder

It finally caught up with me. After 40-plus years of climbing ladders (mostly to get onto my roof), I recently fell off of one and injured myself.

On Dec. 13, in the middle of a relaxing afternoon, I decided to climb my extension ladder and get up on my roof to reposition a plastic tarp. Now, you must understand that in the past 37 years, I have treated hundreds of patients (mostly men) for injuries from falling off a ladder. Therefore, I have always promoted ladder safety, and I thought I had been very cautious when getting up and down on a ladder.

On this particular occasion, I climbed the ladder on my back deck to my one-story flat roof. I did what I set out to accomplish and then started back down the ladder.

I ever-so-cautiously placed my first foot on the top rung of the ladder. I started to put my other foot on the rung and, suddenly, I knew something bad was about to happen — I was going down.

In a split-second, with absolutely no chance of saving myself, I fell.

The ladder base had slipped away from the house, and I fell straight backward, landing 10 feet below, flat on my back, on top of the ladder.

I felt as if I had broken my back, it hurt so much. I lay there on top of my ladder for a few minutes — no one else was at home (another critical mistake). I realized I could move my legs and arms, so at least I knew I wasn’t paralyzed.

After a while, I managed to get up and hobble into the house. I felt like passing out from the pain and shock to my body.

My injuries turned out to include a broken right ankle, a cracked rib below my shoulder blade and a severely bruised and swollen lower back. The next day, I ended up with a cast on my leg, with instructions to not place any weight on that leg for four to five weeks. So I’m now hobbling around on crutches — not a pleasant experience — dealing with a pretty painful back. But I am slowly improving.

More than 2 million people suffered ladder injuries from 1990 to 2005. That equals about 135,000 injuries a year, and I’m sure there are many more that are not reported. The majority of ladder injuries happen at home, and mostly to men older than 40.

Injuries include but are not limited to:

• Death

• Permanent disability, from paralysis, pain or head, neck or back injuries

• Temporary disability, usually from a broken arm or a leg

• Painful arthritis in later years as a result of those injuries

• Loss of income

• Loss of recreational activities

• Loss of intimacy

My ladder safety recommendations:

• When you think about climbing a ladder, consider whether doing so is worth the risk of possible serious injury or disability.

• Never climb a ladder when no one else is at home.

• Always have another responsible person to work with you, to secure the base of the ladder and to be your conscience when you try to do something stupid (come on — we all do it) while up on the ladder.

• Check out ladder safety Web sites for information on proper ladder placement and safety.

To you ladder climbers out there, please read and think long and hard about what I have written. Women, show this article to your men. If it can happen to me, it can happen to anyone. Don’t kid yourself.

I thank God I’m alive after my accident. I see how easily, in a split second, I could have died or become permanently disabled. That just wouldn’t have been fair to my wife, my children or anyone who cares about me.

Ladders are not casual tools. They are as dangerous as a loaded gun — respect them accordingly.

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