E5. Concussion Part 1

What's a concussion, really, and do you really have to sit in a dark room without your cell phone? How many are too many? How long should it really take to recover? 

We offer plain talk and practical information to help listeners understand what exactly a concussion is (and isn't!), what kinds of things matter during recovery, and more. We talk about progress vs. perfection and separate fact vs. fiction on a subject that is near and dear to all of us as sports neuropsychologists and parents of athletes.  You might even learn a little Yiddush too.

Follow us on Instagram @DrMomCast and send us your questions and any topics about which you'd like to learn more.

Chapters

• 2:38 How we explain concussions to teens and why it matters - eggs, energy crises, and more!
• 8:45 Give them back their phones & progress vs. perfection
• 12:08 Get out of the dark room too
• 14:50 Who should be on your concussion management team...and who shouldn't
• 20:53 What's doing nothing going to get you... & whare are risk factors for longer recovery?
• 26:09 Athletic trainers, education, and injury prevention
• 28:32 Unplugging your computer vs. hammering the hard drive

Transcript

0:04

Welcome to Dr. Mom Cast. On today's episode, we talk about a topic that is near and dear to our hearts. Concussion. Concussion is what brings us together as women in sports neuropsychology. and we talk about how this injury affects youth athletes in particular. Our discussions lead us to debunking many of the myths related to concussion, and we find that we have so much to say. We'll break it into several episodes. Today we will tackle myths such as you must hit your head to sustain a concussion, The myth that you must rest in a dark room to recover and the misinformation that all concussion treatments and recovery timelines are alike. Instead, we will talk about what happens in your brain when we have a concussion. Provide facts to debunk these myths and give you the most recent and up-to-date Information on treatment and management. Marla continues to expand our Yiddish vocabulary, and I learned that perhaps all these years I may have been wound too tight.

Marla: 1:01

the wound two titers, you don't know that that diagnostic entity

Alissa: 1:05

Is it hyphenated

Sonia: 1:06

The fact that you're asking that means you are one.

1:10

We are Dr. Mom cast real moms talking about real science and real life.

Marla: 1:16

Hi everybody, I'm Marla Shapiro. Welcome to Dr. Mom Cast. I'm here with some of my favorite sports neuropsych colleagues to talk about kids health, sports safety, and anything else that comes up tonight.

Alissa: 1:26

I'm Dr. Alyssa Wicklund.

Lisa: 1:28

I'm Dr. Lisa Alba.

Summer: 1:30

Dr. Summer.

Sonia: 1:31

Dr. Sonya Mosh.

Marla: 1:32

So I needed to talk to you guys this week. It's that time of year sports are ramping back up and my concussion client volume is increasing. I would love to talk about how y'all manage kids in concussions. One of my personal frustrations when kids have seen all these specialists for so many months and they're still wondering why they're symptomatic, I start by asking, well, tell me what you think a concussion is. And I'm rather gobsmacked at how few kids know how to answer that. I underscore how important it is because if you don't know what it is, how do you know how to manage it So I'm wondering how talk about that with your teens in and Lisa, you're another peds person.

Lisa: 2:12

Yeah, I think that's a good point Marla. The reason I think that this happens is because a lot of times the first point of contact for kids who are injured is the emergency room or urgent care clinic. And so it's just kind of this in and out. And so the clinicians to no fault of them, they're busy people, they don't specialize in this, but they don't take the time to actually sit and explain what a concussion is, what the trajectory is going to look like. And we know this is essential because research tells us that the most effective treatment for concussions is psychoeducation. That's not educating psychos, it's education about what is going to be happening in their brain and psychologically as their path to healing continues. Ideally we would be, or somebody would be getting in there right out the gate and telling people what's going on in their brain, and what that's going to look like as they get on their path to recovery. So back to your question about how I explained this to teenagers. I like to use the egg example and I throw it against the wall and I say, this is your brain on concussions. Any questions? not, not literally, but I do talk about an egg because that is a good metaphor for our brain. We have this pretty hearty shell our skull, and then inside of our skull is our brain around that brain. It's this fluid that keeps it nice and cushioned. When our head gets slammed around or vibrated or twisted or turned or whipped, basically our brain shuffles around inside of our head and it gets stunned in a way. It's not anything that we can see on imaging in, in most cases. Chemicals that make our brain fire and work. It takes them a minute or a day or a week or sometimes a couple months for that process to sort of settle itself down and figure itself out. Then we talk about the pattern of what that might feel like while your brain is doing its job healing and what needs to happen to make sure that we allow it to heal itself. I'll give more and less detail and depending on the kid too, you know, some kids are super into it, some kids are like, just get me outta here lady.

Marla: 4:19

What do the rest of y'all say? Unless you all talk about eggs, I talk about jello, but.

Summer: 4:24

I just say the brain's in an energy crisis and that resetting period is likely different for everyone. Early on in the first couple of days we're trying to do things that don't jost us too much. I like the way that Lisa described it the egg yolk example because that's something that people can wrap their head around, no pun intended, At our institution we do brain night for kids. We have these fun helmets. And so we have kids come to this we say, Hey, do you wear a helmet? Surprisingly, maybe not surprisingly, a lot of kids don't wear their helmets. And so everyone's looking around. Parents are cowering hiding their faces. We say, okay, well if you have a helmet, we put the egg in the helmet and then we, throw it down in this pan and there's no crack. Hopefully it works out the demonstration, then we say, look, there's no problems with this egg now. And then we let them do it. We say, what if you don't wear your helmet And we let them drop the egg. And of course it breaks. We talk about how, that could be good blood hemorrhaging you could have a skull fracture. It's a really nice way for them to get that visual.

Marla: 5:24

That's cool,

Sonia: 5:25

I don't explain it to kids cause my practice is adults, but I explain it in terms of GForce when I see pro athletes, like hockey players in particular, they understand how much GForce was coming at your head when you were checked and you went down and you hit your head, it's gotta be pretty strong force to actually affect that brain tissue. Then I talk about the metabolic crisis that summer referred to The chemicals that are firing are sort of off, and it takes a while for those to recalibrate. I usually say right away in that spiel, the modal recovery for an adult is seven to 10 days, sometimes 14, and kids are longer like a month. So I say words like modal and GForce.

Lisa: 6:11

There's a G-Force movie about Guinea pigs.

Summer: 6:13

You work with military service members too, so that's a different type of, you

Sonia: 6:17

They understand that terminology to like blast injuries and they wanna talk about, I was concussed when an I e D went off and what exactly happened? Cuz I don't think it hit me in the head. So then we have to talk about the mechanics of that. The force of the, debris and the wind velocity and how that affected the impact that was coming towards your brain. An object in motion stays in motion, and if your brain is moving forward, like marching through the battlefield or skating on the ice and then something boom, hits against it, then there's a force directed back at that brain tissue.

Alissa: 6:54

Sonia that speaks to one of the common myths that a concussion occurs only when you hit your head. But in fact, a concussion can be caused by a blow to the head, the face, the neck, or elsewhere on the body, or even a force as long as the force of the impact is transmitted to the head and the brain, and you give that example with military service members who may have sustained a concussion when an I E D went off in their general vicinity.

Marla: 7:19

I love that you used the words energy crisis. so if you've got a brain that's fuel starved and you keep doing stuff, are you gonna feel better, worse, or same? Worse, and that to me is the ODA of concussion. Lisa, how do you translate that for the tweens?

Lisa: 7:34

Their brain is going to tell them what their body is able to do over the next several days or weeks. For the first two to three days, and this is for any kid, and this is what our most up-to-date concussion guidelines tell us, you get to sleep and rest and skip school and do all of the things. But after that we need to be taking a rehabilitative approach. You're gonna feel yucky. Your brain is confused, the chemicals are very confused. They're working very hard to write themselves and. If you push it too hard, your brain is going to shut down and tell you to stop. When I say it's gonna tell you to stop, it's going to make your symptoms worse. You're gonna get worse headaches, you're gonna feel foggy, fatigued and tired. I think more importantly than telling and talking to the kids about this, it's where when kids go back to school, if they have a broken leg, everybody can see it. We know what to do about it. Teaching the parents what it feels like, and even though it might look normal, they might be miserable We take this tough love approach of get back in the saddle, get back to school, get back to life after three days, but it's slowly and with accommodations in place, and very gradually so that you're not pushing yourself to the point of being absolutely miserable.

Alissa: 8:44

I also like to be the hero of the day. Well, your lucky day with mom and dad's permission, Take your phone back. There's no. Evidence that your head will explode from looking at your phone. the research really suggests that too much is not good, if it's bothering you or giving you symptoms, stop doing it. We're trying to listen to our body and to our symptoms.

Marla: 9:07

Or say, how long can you snap until your head hurts? Well stop before it happens,? Set a timer, take a break, ask yourself if you're better, worse, or same. And if you're better, same, then get right back to it. To their bodies because, you know, they hear so often. Suck it up, push through it, push through So do y'all talk about that explicitly with athletes?

Alissa: 9:25

I think there's a reasonable approach to that. You have to push it to see where you're at. We all have to do that regardless of injury. If, you had these surgery one day, you have to get up and walk on your leg and see how it feels. And there are gonna be days where you do too much and also life happens, and there are going to be things that maybe you have to just get done. You're aiming for moderation. You're aiming for what's the term?

Sonia: 9:51

Progress, not perfection.

Alissa: 9:53

progress, not perfection. I found another T-shirt idea that that probably somebody else's trademarked. But I think that is such an important point. Progress not perfection. Some days you're gonna overdo it. Some days you probably could have done a little bit more, but you didn't. It's finding that balance, and I think people are often surprised oh, this is a more reasonable approach. It's not all or none. And also, especially with really little ones you can't slow them down, they are going to overdo it. And I think just giving parents the knowledge to say they are gonna overdo it and they're not gonna suffer brain damage because of it.

Lisa: 10:32

that's just said, don't panic when they all of a sudden power down and take a four hour nap at two o'clock in the afternoon. And back to what you were saying, Alyssa, I think to elaborate it, which is really important, is we're not talking about going back to sports like Marla, you said, do we talk about pushing through it? We're not talking about okay, I'm gonna helmet up and get back out on the field and not tell anybody and just fight through this. No we strongly advocate and explain that we do not do that. We're talking more about, getting out of bed, going for walks and doing sports specific exercises that do not involve any contact, Stretching, yoga Even some practices, depending on what you're doing, if you're a dancer or a gymnast doing the moves off to the side. But again, stopping when your body tells you to stop Back in the day with concussion, the dark ages, the eighties, we. Would tell people Well, and honestly, frankly, the, the 2010s, we would tell people to lay in a dark room until their symptoms went away and then come out of that room. Well, they were worse than the day they became concussed. We're gonna let you cry in your weedies and, and relax and do nothing for a day or two. But then we start to push by, okay, we're rehabbing, we're walking, we're going to school, we're using our brain, but we're not gonna throw a bib on the person coming outta knee surgery and send him out to the marathon passing by the hospital. Same thing with kids. We're gonna, we're gonna take it.

Alissa: 11:59

When a kid has been shut down for a while, I always say the 1980s called him once it's concussion information back,

Lisa: 12:06

Yes.

Sonia: 12:06

my God, for sure.

Alissa: 12:07

But that is in fact one of the myths, and I think one of the more common ones, that when you have a concussion, you need to be shut down, in a dark room and not exposed to stimulation. But in fact, the science tells us that a gradual increase in activity, is going to be the best treatment. So spending time laying low or sleeping the first 24, 48 hours. And then gradually getting back to life. Being shut down completely can actually have the opposite effect where individuals who are shut down actually take longer to recover than those that gradually increase activity.

Marla: 12:44

How many times do you hear about kids that are told no homework, no tests. And for some kids, the one thing guaranteed to jack their anxieties, tell them no tests, no homework. wouldn't you agree it's important to give them control? These are teenagers. They want control and they need to know what's important to them. Also to be motivated to do it.

Summer: 13:02

But as we're like putting them back to those things, it's like Alyssa said, I'm their hero for the day. Returning'em back to phones. That is kind of a fun aspect. They look at you very fearful, or at least my patients have, and I've always been like, wow, they really have Googled right. And they've read, they should do nothing but shut down and be in their dark room. And when you're saying this, they're questioning like, really? that's different from anything we ever have read. And I have to have the conversation. I'm sure you'll all do too as well about. you reading is not gonna cause permanent damage. You trying to take a walk, you trying to exercise on the stationary bike is not gonna cause permanent damage cuz they are so anxious and they are so worried that anything that they do is gonna set them back and compromise their recovery. That's like a first visit conversation. Right. And if that conversation exists, then they're much more reassured.

Alissa: 13:53

We probably should mention the things that could cause setbacks, though, to your point, summer. I think more often than not in our offices, we see people that we need to push. A little bit to get them to not be so fearful. But the other side of that is there are certain things like going back to a contact sport or riding your bike without a helmet or any opportunity to hit your head again could very well cause a setback. And that is something that people should be cautious of.

Lisa: 14:19

Mm-hmm.

Marla: 14:21

the thing that I see a lot is people tend to think it's all or nothing. I mean, I used to say it's shades of gray, but that connotes a whole nother thing we just don't wanna bring up in front of kids and parents anymore. Don't you do guys do prom concussion appointments, like how to go to prom and not create major setbacks. I mean,

Alissa: 14:37

Oh.

Marla: 14:38

there's..Yeah. There's so many in betweens and I don't think people realize that. This kind of comes to mind some red flags people can look for to see if their concussion provider knows what they're doing. Who should be on their team? Of course, we think we're wonderful, but when do y'all think, kids of any age or teens should see sports neuropsych? Lisa? What recommendations would you.

Lisa: 14:59

Yeah, it's tricky because we are few and far between. There just aren't enough of us to be the first point of contact and there's other people out there who are competent and qualified to do so. Once you've been diagnosed with a concussion, ideally seven days to two weeks, that kids should be feeling better or at least making forward progress, meaning that their symptoms are lessening, they're able to do more and more, and as long as everything is moving in the right direction. That's okay if things are plateauing or going backward or getting worse, that is when you want to start to involve a team, and that's when more intensive intervention might be necessary. Everything we've talked about are things that you can do at home, go for walks, watch your phone, call your friends, hang out with your friends. That's all therapeutic in its own right but if that is not working or if the symptoms are not getting better, there are a ton of services. Most communities have concussion clinics and thankfully the one very few good things that Covid brought us is access to telehealth, where if you don't have a concussion clinic in your community, you can usually get in touch with one through telehealth and then you can meet with a sports neuropsychologist who can give you the education if you weren't provided that at the initial. Outset of the injury these kids are like snowflakes. every single one of them is markedly different. And so the treatment plan is going to be just that.

Alissa: 16:25

And with that, Lisa, you just hit on another one of our myths, which is that all concussions are alike. And in fact, we know that no two concussions are alike. there may be common features within concussions, such as constellation of symptoms, headache, mood changes. Cognitive problems, dizziness and vestibular issues. For example, how they present after each injury can be very different, even within the same person. The same person can experience different symptoms from two different concussions. So it's important to have that individualized treatment and the type of provider you need to treat those particular symptoms for that particular injury.

Summer: 17:07

I would say that there's no one specialty. Let's list some of them. Neuropsychology, neurology, physical medicine, rehabilitation, primary care, sports medicine neurosurgeons. I think part of your care and your treatment is dictated by what you have around you. Resources, right? So in rural Texas, where we don't have all those specialists, you're gonna go to your pediatrician and then you're gonna probably get a referral to Houston or somewhere where you have more specialty care. That initial contact, I think varies based on some of those factors. From like, where's the referral? Is it from the ER or the athletic trainer? So there's no consistency is my point about the initial person. But what I will say is paramount is the interdisciplinary team. So for our program, I work closely with a primary care sports medicine physician. We manage them con jointly. We both have our expertise and contributions in that way. And then if we need something further, we will go on down to our list of other specialists. I think as a mom, I would use my pediatrician cuz many of us have that comfort as a parent, right? But we also recognize, if I were to go see my pediatrician, I thought my kid had a heart problem. My pediatrician's not gonna treat the heart problem. They're gonna be referred. So it'd be, yeah, it'd be the same kind of thing.

Lisa: 18:21

the first week or two, you're still in the normal path of recovery. You're more in the rehab stage. You're rehabbing it. You do your exercises, you do your at home things, and then when it starts to stall out or if it's not getting better as expected, fine, we can start to look at these other interventions

Marla: 18:36

What about recommendations? We've all talked about some of the, All the treatments dujour, what are red flags? If you hear this or this is recommended,

Lisa: 18:46

yeah In terms of red flags, Marla, I would run from any program, doctor, anything who ordered eight weeks of therapy, eight weeks of treatment, the day that you're diagnosed with a concussion because they're basically telling you, you are going to feel bad for eight weeks or however long. If you're not feeling like the person is listening to you and your symptoms, that's when I would go get a second opinion someplace else. And watch out for cost. You should not go broke treating an injury that in theory, will treat itself or will run its course. As we know, it will heal up quicker if we get some of these therapies in place. But if you go to a doctor and they're telling you that it's going to cost$20,000 out of pocket, or, if they're signing you up for weeks or months, long treatment plans run. What happens if somebody does say this is gonna cost 20 grand you feel between a rock and a hard place that you want your kid to get better? an insurance company will only cover certain services. And they will not pay for an intervention unless it's been researched fairly rigorously. And that's not to say that they cover every single service because they definitely don't. you're not gonna have to go broke to make this better.

Alissa: 19:59

I think the individualized piece of it is so important because, with athletes for example, we'll often have a physical therapist do a treadmill test within the first week you can do a certain test of endurance or exercise tolerance on a treadmill or bike within that first week to see how an individual responds in terms of concussion symptoms.

Lisa: 20:21

and that's great. And here's my thing though, Alyssa with that is they should not be ordering an eight week treatment plan and saying, come back and see me every single week for the next eight weeks. That, to me, is where it becomes problematic.

Alissa: 20:33

And maybe we should explain why a lengthy treatment plan is maybe not necessary.

Lisa: 20:39

Yeah, I think I said it earlier that you're basically telling somebody who has an injury that should last three days to three weeks, that their symptoms are gonna go on for eight weeks. Like the day that they're injured, you're telling them

Sonia: 20:52

Lisa said, psychoeducation not educating psychos which I love that. I'm gonna use that. But one of the psychoeducation pieces I say right out of the gate is if you did nothing at all rehab treatment wise, your brain naturally heals.

Summer: 21:08

Yes.

Sonia: 21:09

Your brain is already healing. Frame it in terms of what we know about, the neuroscience of the the metabolic recovery We know that there are natural recovery processes that are happening irrespective of anything you're doing. You don't need to prescribe a week treatment on day two because your brain has already started the process of healing. If you're still feeling yucky at six weeks, let's talk. And maybe we treat those symptoms with something specific. I like to emphasize that there's a natural course of recovery that happens in everyone's brain

Marla: 21:45

you mentioned that it can take teenagers longer to recover and I wonder, is it cause their brains take longer? Or is it because our kids go, go, push,, push, don't modulate as well And does that contribute to why it can take them? The flip side is we don't want people to wait eight weeks, go, God, I still feel like crap. And then seek help.

Summer: 22:04

And we should also point out that there are evidence. Factors that That prolong recovery and that's been demonstrated and re researched multiple times. Risk factors for delayed recovery include. Female sex. Repetitive concussions, poor management from previous concussions. Learning disabilities, A D H D, and then psychiatric issues and migraines. Those are a whole list

Alissa: 22:27

ooh, you just debunked Another myth summer that everyone recovers from concussion at the same rate. But in fact, there are a lot of pre-injury factors like the ones you just mentioned, that can affect how long it takes to recover. So people become fearful when they know someone who recovered from a concussion in 14 days, and they may be on day 19. In fact, this is very normal and everybody's recovery path may be different.

Marla: 22:53

You know, I tell people it's like you're putting kerosene on a smoldering fire at anything that was there before the concussion will invariably be worsened by the concussion. I think one of the groups at most at risk of that are the wound two titers. You know, the people that don't have those,

Alissa: 23:07

A who?

Marla: 23:08

the wound two titers, you don't know that that diagnostic entity

Alissa: 23:12

No, but I'm pretty sure I am one. Explain more.

Marla: 23:15

wound too.

Sonia: 23:16

You definitely are Dr. Wick.

Alissa: 23:19

I've been called a lot of things. I've never been called a too tighter, but I'm, people have clearly missed their opportunity.

Lisa: 23:25

A panty panties. And a buncher.

Marla: 23:27

The folks that aren't anxious but they're hanging on by a fingernail or everything's just right so that when there's any blip, you know, the kids that are taking 17 AP classes, but they're just fine. So that when there is a disruption, it can launch full-blown anxiety or freak out because they don't have room for those unexpected bumps. In terms, yeah. Wound too titers. It's a thing, man.

Lisa: 23:50

Yeah.

Alissa: 23:51

whatever I said earlier was gonna be on a t-shirt. That's a much better slogan for a t-shirt. The way too titers.

Lisa: 23:58

Are you gonna declare your cellphone though? Just like a wound Too tighter.

Alissa: 24:00

Yeah, I have no problem calling myself out and being authentic. Is it hyphenated

Sonia: 24:06

The fact that you're asking that means you are one. Phonetically. Grammatically? What is the swelling? Are we hyphenating or is that a slash

Alissa: 24:17

Yeah.

Marla: 24:18

That is hilarious.

Alissa: 24:20

So, back to how it relates to concussion. I'm sorry, that's a total tangent

Marla: 24:24

It's like threshold. Kind of this bar or how close to that bar do we start already? Who's most at risk for developing anxiety after a concussion? The wound two titers. The folks that are just prone to that rigidity, not that diagnosed anxiety necessarily, but the worry. It's one set of metabolic things on top of another set of metabolic things where the hole becomes greater than the sum of the parts.

Alissa: 24:46

hmm.

Marla: 24:47

kerosene kerosene on the smoldering fire, whatever you wanna call it. And that's, but that's also an explanation that resonates really well with kids. they get the metabolic thing of the concussion and I'll say, and your sleep, it was kind of foco. That's the technical Yiddish term. And fair to say that sleep has probably got some biochemical component. Yeah. Okay. And you weren't exactly anxious, but you were wound a little tight. Fair to see people take meds for anxiety. Fair to say. That's metabolic. So I add up these little metabolic piles and say, so what do you think happens when you put all this stuff together, you know, to help to explain That

Alissa: 25:19

you're forked or whatever.

Marla: 25:22

would be the word of

Lisa: 25:23

Yep.

Sonia: 25:24

Can that again, Marla? Cause to me it sounded like focaccia bread. I'm trying. Low carb right now, and that's all I'm can think about is did she just say Paca bread? That sounds so good

Lisa: 25:35

buck. No. Spell it.

Marla: 25:39

Okay, I'm gonna Google the joys of Yiddish but maybe it's a word my mother always made up. Messed up. It's, but it's like fur.

Lisa: 25:45

Okay. We might need to record the explanation. I love it.

Sonia: 25:49

Not delicious Italian bread that is best served warm with

Lisa: 25:54

Little tomatoes baked

Alissa: 25:56

that is off limits for Sonya right now.

Lisa: 25:58

Yeah.

Sonia: 25:58

is like completely taboo for me. Okay, got

Marla: 26:02

For Clet, you know, for Clet.

Lisa: 26:04

Oh, for sure. Mike Myers on SNL taught us

Sonia: 26:07

Yeah.

Lisa: 26:07

Okay.

Marla: 26:08

So one of the things I wanna circle back is you very briefly mentioned athletic trainer earlier summer, and I wanna say it again what a critically important role they play in athlete safety and all levels. And it also speaks to injury prevention.

Summer: 26:22

Where we kind of fail with concussions is educating patients, young kiddos, athletes, before it ever happens. We work with teams, we work with schools, and all of the efforts Eden legislation is aimed at the coach has to be trained. The athletic trainer, the physician, the parent has to watch a video, but almost always, if you look, the kid themselves has been left out of that process. So another thing to hit home here is that we have great educational things to offer our patients, but we fail at that early stage. And so even The athletic trainer talking about some of this stuff early on, should they have a concussion, they're already somewhat prepared for how that process may.

Marla: 27:04

And I love some of the stuff that athletic trainer they can do within their wheelhouse that helps with preventative risk injury. Like do screening for balance screen for ocular motor functioning, look at strength and conditioning, ask about sleep. All these things that are preventative from an injury risk management perspective that allows them to get to know athletes but also do some risk mitigation.

Summer: 27:27

Well, the education part facilitates healing, so it's very important that you are educated about it, so you can understand about what to do and not to do. If no one talks to you about that, then you're gonna hold all these misconceptions and probably do all the wrong.

Marla: 27:43

And so it, it sounds like my, my gosh, we're just getting started. We haven't even talked about return to learn That could be a whole episode, but I think that's so important. How do we get people back on the classroom, the workplace, the playing field, do it quickly, do it safely. Clearly there's more that we want to talk about. Let's come back next episode and revisit this. What are the takeaways from tonight? The key points are an energy crisis, for sure. That rest does not mean sit in a dark room in the fetal position. It means, you aim for not too much, not too little, just right. You're gonna hurt a little bit, but not too much. Let your brain and how it feels dictate how you live your day. Yes.

Lisa: 28:23

Yes. Yeah. And you will get better. that's, I think the big takeaway from this, Karen Postal, this a neuropsychologist who metaphor of a concussion versus a traumatic brain injury where a concussion is like unplugging a computer, it quits working, it powers down. It's not doing its thing. But as soon as you plug it back in, it might take a little bit to reboot. It's gonna take some time, but it's gonna work like normal traumatic brain injury is like taking a sledgehammer to a disc drive like it's done. you could maybe rebuild it, but it's never going to function the same way again. And we are talking about the unplugged laptop here, like this is not a sledgehammered computer. And so I think just the take home that you will get better and that alone should be medicine to know that your kid will recover from this. If you have a concussion, you will recover from this. And we'll talk more about prolonged recovery and what can cause that and how to, how to fix it

Alissa: 29:23

Wound too tight can cause it

Marla: 29:26

Keep going round too tight

Alissa: 29:27

wound too tight. Can cause you to recover slower. I learned that tonight.

Marla: 29:33

you've learned that, but Lisa, I couldn't think of a more fitting end

29:37

join us again for part two of our discussion about concussion. We will continue to debunk the myths and misinformation, and talk about topics such as returning to school, sport, and life. This is Dr. Mom Cast Real moms talking about real science and real life.