Concussions and Cognitive Limitations: A Bit Too Close to Home

My son recently suffered a concussion at wrestling practice.  He never wrestled before, however, he is in great shape as he just finished his first season on the JV water polo team, swims competitively in the summer, and has earned his 2nd degree black belt in martial arts.  At the same time, he has not fully grown and is much lighter than most on the wrestling team.  In person to person collisions, the laws of physics can benefit those with greater mass, and my son lost out on that front with a rapidly rotating elbow of a larger wrestler making contact with my son’s face.  Other than a bloody nose, and a wounded pride, there were no other noticeable results from the mishap, at least, that was what we thought then.

Over the course of the next few days, my son’s behavior seemed erratic, and atypical.  Woefully, I wrote much of it off to adolescent angst combined with a lack of sleep, and etcetera.  In hindsight, everything stands out clearly as warning signs.  Yet, at the time, nothing seemed linked; I may have commented on some behaviors with my son, or wife, but I did not associate them with a head injury.  So, my son continued to attend wrestling practice, running miles, lifting weights, and wrestling.  He also attended PE and academic classes, during which his performance and behavior started to falter.  He commented that he thought people were starting to talk about his behavior.  He was in a dazed state, uncertain how to respond, which left him feeling more anxious; a negative spiral began which in some ways thankfully served to alert his wrestling teammates a few days later.  Nearly a week after his injury, more experienced wrestlers informed the coach that something was amiss.  The coach dispatched my son to the athletic trainer who believed he was suffering from a concussion.  Later that evening, I admitted my son to an ER.

After hours of waiting, questions, examinations, and talks with the ER doctor, and nurses, they decided to discharge my son for home care, where we were to: 1) follow-up with his pediatrician for a more detailed physical exam, 2) see a pediatric neurologist, and 3) get an MRI, all per the ER doc’s orders.  I left the ER thankful that there was a course of action to follow.

As both my wife and I teach, she took the next day off to take my son to his pediatrician and get the MRI.  I took off the next day meeting with the pediatric neurologist, who showed me the MRI scans, which were all clear, thankfully.  Upon further questioning, and examination, the neurologist diagnosed my son with post-concussive disorder with a need for further medical tests such as an EEG; although he ruled out physical injury, there are neurologic, ionic, metabolic, and other aspects to investigate – our brain is an awesome organ!   The doctor also wrote a letter for my son’s school stating that he requires a modified education plan.  As a teacher, I had not heard of that particular accommodation, however the doctor assured me that the school would know.  He explained that my son needs to determine whether he can tolerate being in a classroom, due to his sensitivity to light and noise, or even is capable of finishing a timed assignment if his head starts to hurt as is common with the syndrome, all of which were to make sure he did not exacerbate his symptoms.  I left understanding the gist of the doctor’s orders.

Unfortunately, when I spoke with the school, the administrator stated he did not know what comprised a modified education plan and zeroed in on one word, modified, from the doctor’s order.  He explained that ed code only spoke to 1) individualized education plans, known as IEPs, which are modifications for those identified in need of special education, or 2) 504 plans, which are special accommodations for students, which are not temporary in nature, or for transient issues.  While I understood, at a certain level, the points made by the administrator, I sensed a potential roadblock starting to arise for my son.  My immediate reaction, as a parent, was to dial the doctor’s office to ask the doctor if he could explain his order to the administrator.  I did not want a possible play on words to interfere with my son obtaining the protection he required to recover from his injury, while minimally impacting his academics.  The conversation between the doctor and administrator did not fare that well, as I could clearly hear the doctor admonishing the administrator for what I perceived as a case of semantics.  The call ended brusquely.  Fortunately, the meeting ended on a high note as the administrator offered up an independent study (“IS”) plan, which sounded exactly like what he doctor intended.  Another administrator agreed, so I left the office relieved, and with a plan of action.

When I returned home, I emailed all my son’s teachers explaining I would help them in any way as I understood the challenge creating a last-minute IS plan.  Afterwards, I researched post-concussion syndrome and realized my son exhibited each symptom listed at the Mayo Clinic site, and most of those listed in a pamphlet for physicians created by the U.S. Department of Health and Human Services, Centers for Disease Control.

I decided to write this post to help spread the word about post-concussion syndrome (“PCS”), which is also known as mild traumatic brain injury (“MTBI”), or just “concussion.”  Whatever we call it, the symptoms are frightening to witness in a loved one, whether it be a child, spouse, relative, or someone else in our care such as a student.  I know I will consider the behavior of my students carefully going forward, especially for those I know play contact sports.

Key excerpts from the CDC pamphlet follow.  I shared these with my sons teachers, as well as the entire booklet.  I hope it helps other students who suffer similar symptoms receive rapid treatment, as necessary.

I hope these did not overwhelm my son’s teachers.  I did not send them as listed above, but separated into buckets, with the most pressing 2-3 integrated into my email text, and the others appended at the end with a header noting them as more information.  If I were the teacher of a student diagnosed with this condition, I would appreciate the education.

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About Dave aka Mr. Math Teacher

Secondary math teacher teaching math intervention, algebra 1, honors precalculus, and AP Calculus AB. I spent 25 years in high tech in engineering, marketing, sales and business development roles in the satellite communications, GPS, semiconductor, and wireless industries. I am awed by the potential in our nation's youth and I hope to instill in them the passion to improve our world at local, state, national, and global levels.
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12 Responses to Concussions and Cognitive Limitations: A Bit Too Close to Home

  1. Math Mom says:

    Wishing your son a speedy recovery! I would also hope that any time a student athlete suffers a blow to the head they are checked out more formally to prevent this type of situation happening.

    Like

    • Thank you. My wife and I were a bit surprised at how long it took before the coach noticed. However, it was “just” a bloody nose from what we could tell, and likely him, too. My main surprise was how the AP reacted initially…but glad he eventually saw the bigger picture…

      On Sun, Nov 18, 2012 at 10:09 PM, Reflections of a Second-career Math

      Like

  2. xiousgeonz says:

    How terrifying!!
    Heads are fragile things…
    From my sped background, admins can be sensitive to the “accommodation or modification ” language (504s generally involve accommodations — giving access to the “regular” curriculum that the student’s individual situation merits. This would be things like a wheelchair ramp… or a quiet place or extra time. “Modification” woudl be changing the assignments (making them shorter and/or simpler). Of course, confounding this is any individualization/differentiation that happens anyway without the whole sped thing.
    Hoping fervently that the whole situation resolves itself with speedy recovery.

    Like

  3. stick with it, you are doing the right thing…I had a concussion Dec 2011, still experiencing some issues, as an adult I did not have an advocate the way your son does…it’s been very difficult especially on the work front, you “appear” fine to others but really your mind feeling like it’s been put through a blender

    Like

  4. AnneMarie Esswein BSN END says:

    Thank you for your post. Having suffered TBI and being a school nurse, I know how hard it is to meet the academic needs to stay on track in class while meeting the rest the brain needs to recover. The more rest and decreased stress the patient has on the brain, the faster the recovery

    Like

  5. My wife suffered a disabling concussion 5 1/2 years ago slipping on a book laid on the stairs at our home. Unfortunately, she was sent back to work the next day, working in a job that was very stressful, high use of computers and analysis, and remote conference calls. She never got the brain rest she needed and her symptoms just got much worse, until finally 3 years later she began having seizures, at which point they finally put her out on disability. Unfortunately for her, it was too late. 2 1/2 years later, she is still having seizures and has been unable to return to work. My son 9 year old son plays hockey and recently got his first concussion at a practice. You can read our story at http://wyattsshotongoal.com/2012/09/26/concussions-no-fun/ and http://wyattsshotongoal.com/2012/10/01/wyatt-burt-8-cleared-to-play/. By the way, his favorite subject is math….and he has always excelled in that subject, unfortunately, he doesn’t always do it the way it is taught, he kind of has his own way. I’m interested in reading more of your blog.

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  6. Pingback: Concussions, Gaming, and Mathematics | Reflections of a Second-career Math Teacher

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